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Objective:To construct a narrative nursing intervention program for patients with advanced lung cancer undergoing chemotherapy based on the meaning in life theory, so as to alleviate the negative psychology of patients and improve the meaning in life of patients.Methods:Using a mixed research design, based on the literature study and qualitative interview, the first draft of narrative nursing intervention program for patients with advanced lung cancer undergoing chemotherapy was constructed based on the theory of meaning in life. From June to September 2021, the Delphi method was used to conduct 2 rounds experts consultations among 15 experts from 8 hospitals, and the items were revised according to the expert′s advice.Results:The experts positive coefficients of the 2 rounds consultations were 83.33% and 100.00%, the expert authority coefficient was 0.88, and the Kendall coefficients of importance were 0.183 and 0.215, and the operational Kendall coefficients were 0.234 and 0.363. Finally, a narrative nursing intervention program for lung cancer patients based on the theory of meaning in life was formed. It included four modules: narrative theme, narrative content, narrative interview outline and homework assignment/auxiliary measures. It was performed 7 times in each chemotherapy cycle.Conclusions:The construction process of narrative nursing intervention program for patients with advanced lung cancer undergoing chemotherapy based on the theory of meaning in life is rigorous, scientific and practical and can be used to guide clinical psychological nursing intervention for patients with advanced diseases and enrich the way to seek the meaning in life of patients
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Objective:To explore the meaning of life in patients with advanced lung cancer.Methods:A total of 21 patients with advanced lung cancer who were hospitalized in the Pulmonary Hospital Affiliated to Shanghai Tongji University from April 2018 to July 2018 were selected for in-depth interviews using qualitative research method, and the collected data were analyzed with the Colaizzi 7-step Colaizzi method.Results:Three dimensions, seven themes were extracted. The core of the meaning of life was "self-iteration", which included the two themes of self-recognition and cherishing life; the existence form of the meaning of life was "you-wei", which included the two themes of self-reliance and altruismin; the meaning of life was embodied in three levels: life -reviewing, including gratitude, stigma and avoidance; cherishing the present, including using the support system, active response, independence and integrity; confronting the future, including accompanying relatives, preparing for death, living with high quality of life.Conclusions:Medical care providers and family members can provide targeted professional guidance and psychological support according to the characteristics of patients to help them discover the meaning of life, thereby enhancing their sense of meaning of life, improving the quality of life, and achieving a good end.
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Pediatric acute liver failure(PALF)is a rare and life-threatening clinical syndrome caused by multiple etiologies with high mortality, rapid progress and bad prognosis.It′s crucial that how to identify liver failure early and evaluate the operation opportunity of liver transplantation accurately.Traditional serum biomarkers can be used to diagnose and evaluate the conditions of PALF, and they can also provide suggestions for treatment.In recent years, some new biomarkers of PALF have been emerged.This review summarized the traditional biomarkers and new biomarkers according to liver′s biological functions, aiming to improve the ability of clinicians to diagnose and treat PALF.
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Objective:To explore the impact of narrative nursing on the meaning and quality of life in chemotherapy patients with advanced lung cancer.Methods:A total of 86 chemotherapy patients with advanced lung cancer hospitalized in the Oncology Department of Shanghai Pulmonary Hospital Affiliated to Tongji University from October 2020 to November 2021 were selected and divided into control group with 42 cases and narrative group with 44 cases by random number table method. The control group was treated with routine nursing of patients with tumor chemotherapy while the narrative group was implemented on narrative nursing intervention as well as routine nursing. A total of 12 to 14 times, each chemotherapy period was 7 times. The effect of the intervention was assessed by Meaning in Life Scale for Advanced Cancer Patients (MiLS)、Chinese Version of the Functional Assessment of Cancer Therapy-Lung(FACT-L 4.0) and Distress Thermometer (DT) before intervention, 1 week, 3 weeks and 2 months after intervention.Results:Forty cases in the control group and 42 cases in the narrative group were involved in the statistical analysis. Two months after intervention, the total score of MiLS, the score of the will to search for meaning, the meaning of life and satisfaction,existential frustration, life control, suffering tolerance and death acceptance in the control group were (98.60 ± 9.17), (14.90 ± 1.91), (13.38 ±2.62), (16.40 ± 2.73), (26.48 ± 3.19), (14.30 ± 1.68), (13.15 ± 3.07) points, which were significantly lower than those in the narrative group (112.02 ± 9.73), (16.45 ± 2.24), (16.31 ± 1.96), (19.40 ± 2.42), (28.76 ±3.48), (16.14 ± 1.82), (14.95 ± 2.39) points, and the difference were statistically significant ( t value were -6.42 --2.98, all P<0.01), and the main effect between groups and time were statistically significant ( F values were 2.76-24.47, all P<0.05). Two months after intervention, the total score of FACT-L, social/family status, emotional status, functional status and lung cancer specific module in control group were (90.75 ± 11.65), (18.58 ± 3.75), (15.65 ± 3.85), (13.48 ± 3.34), (22.00 ± 4.93) points, which were lower than those in the narrative group (102.12 ± 9.32), (20.36 ± 4.29), (18.10 ± 3.25), (16.74 ± 4.05), (24.80 ±3.83) points, the differences were statistically significant ( t values were-4.89--1.99, all P<0.05), and there was intergroup effect ( F values were 5.14-24.47, all P<0.05). Three weeks and 2 months after intervention, the psychological distress score of control group were (3.88 ± 2.73), (3.60 ± 2.19) points, which were significantly higher than the narrative group (2.52 ± 2.18), (1.90 ± 1.78) points, and the differences were statistically significant ( t=2.50, 3.85, both P<0.05), with a time, groups, interaction effect ( F=15.29, 15.86, 2.80, all P<0.05). Conclusions:Narrative nursing can effectively improve the meaning and quality of life and relieve psychological distress in chemotherapy patients with advanced lung cancer. It is worthy of clinical promotion.
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Objective:To examine the relationship between meaning in life (MIF) and social support in Chinese hospitalized patients with advanced lung cancer (ALC).Methods:Totally, 231 ALC patients from Shanghai Pulmonary Hospital Affiliated to Tongji University were recruited to complete the Meaning in life Questionnaire (MIFQ) and Social Support Rating Scale (SSRS) from December 2018 to December 2019.Results:The total score of MIFQ in ALC patients was (97.81 ± 15.74), and the total score of SSRS was (27.47 ± 6.37), with the former and its each dimension positively correlated to the latter ( r = 0.275-0.417, P<0.01), genders (female), marital status (married), ocupational status and total score of social support were the important factors of the life meaning ( F = 9.82, P<0.001), which accounted for 23.6% of the changes of life meaning. Conclusion:ALC patients sensed the middle level of social support and MIF. Patients who were females, married, the higher the degree of social support, tended to have higher level of MIF. Medical workers need to value the social support system of ALC patients, in an effort to improve MIF of patients.
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Objective:To investigate the level of trimethylamine N-oxide (TMAO), one of gut metabolites, in patients undergoing maintenance hemodialysis (MHD) accompanied by congestive heart failure (HF) and its influencing factors.Methods:Those patients of 18-75 years old who received three or more times of hemodialysis sessions per week for three months or longer during Nov 2018 and Mar 2019 were enrolled. Those attended health checkup at the same time without obvious kidney abnormality served as non-kidney disease controls. Serum TMAO concentrations were measured using high-performance liquid chromatography electrospray ionization-tandem mass spectrometry (HPLC-ESI-MS/MS). The levels of TMAO were compared between patients on hemodialysis and controls, between those with heart failure and without heart failure using logrithmically transformed TMAO (lnTMAO). Linear regression analysis was performed to investigate factors influencing TMAO levels.Results:A total of 195 patients undergoing MHD and 40 controls were enrolled. Among them, 30 hemodialysis cases (15.4%) manifested as heart failure symptoms and/or left ventricular ejection fraction less than 50%. Males accounted for 67.2% in patients on hemodialysis and 37.5% in controls ( χ2=12.426, P<0.001) respectively, while the median ages in both groups were 62.0(48.0, 71.0), 45.0(33.3, 55.0) years old respectively ( Z=5.685, P<0.001). TMAO concentrations were significantly higher in patients on hemodialysis than controls [5.54(3.84, 8.91) mg/L vs 0.17(0.11, 0.30) mg/L, after log transformed, t=21.687, P<0.001]. However, there was no statistically significant difference between those with heat failure and those without in male [63.3% vs 67.9%, χ2=0.238, P=0.626], age [64.5(56.8, 71.0) years old vs 61.0(47.0, 72.0) years old, Z=0.894, P=0.372] and TMAO [5.17(3.30, 9.46) mg/L vs 5.57(3.87, 8.95) mg/L, after log transformed, t=-1.537, P=0.135]. Multivariate linear regression analysis demonstrated that in all the participants, serum urea was the main risk factor for TMAO [standardized coefficient ( SB)=0.483]. lnTMAO=0.078×[serum urea(mmol/L)]+0.001×[serum creatinine (μmol/L)]-0.002×[serum uric acid (μmol/L)]-0.003×[platelet (×10 9/L)]+0.014×[age (years old)]+0.344 (if diabetic)-1.266. While in those undergoing MHD, ultrafiltration volume had the most significant effect on TMAO levels ( SB=0.279). lnTMAO=0.249×[ultrafiltration volume(L)]+0.059×[serum albumin (g/L)]+0.008×[age (years old)-0.526 (if heart failure existed)-1.865. Conclusions:MHD patients have gut dysbiosis, while those hemodialysis patients accompanied by heart failure may have peculiar gut microbiota which induces lower serum TMAO levels than those without heart failure after adjusting for multiple related factors. Serum TMAO levels may be associated with ultrafiltration volume and nutrition status etc.
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Objective:To investigate the body composition and sarcopenia in patients with stable chronic obstructive pulmonary disease (COPD) and to analyze the influencing factors.Methods:A total of 220 patients with stable COPD were enrolled in the study from China-Japan Friendship Hospital during July 2018 to December 2019; 220 age and sex-matched healthy subjects (control group 1) and 220 healthy young adults aged 20-40 years (control group 2) were enrolled from the community. The body composition was measured by bioelectrical impedance method. The demographic characteristics, disease conditions, living background and other related factors were collected by questionnaire. T test or one-way ANOVA were used for comparison between groups, and non parametric test was used for non normal distribution data.Results:Compared with the control group 1 and control group 2, the body fat rate ( Z=-10.037, t=-8.411), the fat free mass index ( Z=-8.165, t=-7.856), and appendicular skeletal muscle index (ASMI) ( t=-7.158, t=-11.989) were significantly lower in stable COPD patients ( P<0.05). Among 220 patients with stable COPD, 51 (23.2%) were diagnosed as sarcopenia; the prevalence of sarcopenia was 18.3% (24/131) in men and 30.3% (27/89) in women (χ2=4.297, P=0.038). The decreased ASMI and grip strength in COPD patients with sarcopenia were significantly associated with age≥75 (χ2= 15.746, F= 14.048), female sex ( Z=5.805, t=2.672), low income ( Z=-4.291, t=-4.789), Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade Ⅳ (χ2=22.644, F=3.905), Modified British Medical Research Council (mMRC) Dyspnea Scale grade 4 (χ2=12.475, F=4.369), not receiving systematic health education ( Z=-4.239, Z=-2.474), no exercise (χ2=14.786, F=3.402), insufficient nutrition intake (χ2=40.531, F=10.529). The range of 6-min walking distance was (110-268) m, that was even shorter for patients with mMRC dyspnea scale grade 4 ( F=3.468, P<0.05). Conclusion:The impairment of body composition is common in COPD patients, which will further affect the body function. It is suggested that the routine evaluation of COPD should include the measurement of body composition.
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Detection of mycoplasma pneumoniae infections is essential to diagnosis and initiate appropriate antibiotic therapy.Laboratory detection of mycoplasma pneumoniae includes culture, nonamplified antigen detection, molecular-based methods(detection of DNA and RNA), serology and other new diagnostic methods.These relative methods, advantages, limitations and clinical utility are summarized in this review.
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Objective:To explore the effect of dialysis pipeline nursing group mode combined with predictive nursing measures on hemodialysis efficacy of diabetic nephropathy patients with maintenance hemodialysis (MHD).Methods:A total of 96 patients with MHD of diabetic nephropathy admitted to No. 904 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from January 2015 to December 2019 were selected as the research objects and divided into control group and observation group, 48 cases in each group. Patients in the control group were treated with routine dialysis pipeline and other hemodialysis nursing interventions, while patients in the observation group were treated with predictive nursing measures on this basis. The biochemical indexes, psychological state, compliance, incidence of nosocomial infection and complications and nursing satisfaction of the two groups before and after intervention were compared.Results:After the nursing intervention, the blood urea nitrogen (BUN), creatinine (Cr), and β2 microglobulin (β2-MG) of the two groups of patients were lower than those before the intervention, and the BUN of the observation group after the intervention, Cr and β2-MG were (12.04±1.98) mmol/L, (451.62±82.49) μmol/L, (13.53±2.31) mg/L, respectively, which were lower than those of the control group (15.82±2.31) mmol/L, (591.35±99.21) μmol/L, (18.83±2.92) mg/L, the difference was statistically significant ( t value was 8.608, 7.503, 9.862, P<0.05). After the intervention, the scores of the treatment compliance subscales of the observation group were 29.06±3.58, 23.42±2.99, 20.11±3.01, 14.76±2.94, which were higher than those of the control group (31.91±3.97, 21.53±3.21, 17.03±2.74, 12.36±3.04), the difference was statistically significant ( t value was 2.985-3.932, P<0.05). After the intervention, the SAS and SDS scores of the two groups were lower than those before the intervention, and the SAS and SDS scores of the observation group after intervention were 39.12±4.82 and 36.43±6.03, which were lower than those of the control group 48.25±5.14, 46.75±5.36, the difference was statistically significant ( t value was 8.997, 8.862, P<0.05). The incidence of nosocomial infections and complications in the observation group were 2.08% (1/48) and 4.17% (2/48), which were significantly lower than those in the control group, 14.58% (7/48) and 18.75% (9/48), The difference was statistically significant ( χ2 value was 4.91, 5.26, P<0.05). The nursing satisfaction degree of the observation group was 95.83% (46/48), which was higher than 72.92% (35/48) of the control group, and the difference was statistically significant ( χ2 value was 9.56, P<0.05). Conclusions:The dialysis pipeline combined with predictive nursing can improve the psychological state of patients, reduce the incidence of hospital infection and complications, prolong the service life of vascular access, improve the quality of life of hemodialysis patients, improve the relationship between nurses and patients, and create a harmonious atmosphere, which is worthy of clinical promotion and application.
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Objective:To explore the feasibility in evaluating segmental extracellular volume (ECV) using dual-layer spectral detector CT in patients with heart failure with various percentages of delayed hyper-enhanced volume, using MRI as a reference.Methods:Twenty-seven patients with heart failure in Peking Union Medical College Hospital were prospectively enrolled in this study from July 2019 to January 2021. All the patients underwent both CT late iodine enhancement and MR late gadolinium enhancement imaging within a week. According to percentages of hyper-enhanced volume on cardiac MR image, myocardial segments were classified into 3 groups: 0-4% (group A), 5%-49% (group B) and 50%-100% (group C). ECV images were independently observed by 2 experienced radiologists. The correlation and agreement between CT-ECV and MRI-ECV for the whole myocardial assessment and for the segmental assessment were evaluated using Spearman correlation and Bland-Altman analysis. Inter-observer agreement was assessed using the ICC.Results:Of the 27 patients, 432 segments were analyzed, with 199 segments in group A, 151 segments in group B and 82 segments in group C. In the whole myocardial analysis, the CT-ECV and MRI-ECV were 32.25% (28.04%, 34.28%) and 32.27% (28.35%, 34.77%), respectively. A good correlation was found between CT-ECV and MRI-ECV ( r=0.969, P<0.001). Bland-Altman analysis between CT-ECV and MRI-ECV showed a small bias (0.4%), with 95% limits of agreement of -6.9% to 7.8%. as for the segmental myocardial assessment, the CT-ECV was 28.23% (26.18%, 29.92%) for group A, 33.29% (30.16%, 35.96%) for group B and 40.22% (34.06%, 46.70%) for group C. There was statistically significant difference in ECV among three groups (all P<0.001). Good correlations between CT-ECV and MRI-ECV were found in group A ( r=0.614, P<0.001), group B ( r=0.852, P<0.001) and group C ( r=0.953, P<0.001). Bland-Altman analysis between CT-ECV and MRI-ECV showed a small bias 2.0% (95% limits of agreement:-17.6%-21.6%) in group A, a small bias -0.4% (95% limits of agreement: -13.8%-12.9%) in group B and a small bias -1.8% (95% limits of agreement: -17.4%-13.9%) in group C. The ICC values between 2 observers were 0.877 and 0.945 on CT-ECV and MRI-ECV, respectively. Conclusions:The larger percentage of hyper-enhanced volume on cardiac MR image, the stronger correlation are between the CT-ECV and MRI-ECV. CT-ECV may be taken as an alternative tool for quantitative evaluation of myocardial tissue in patients with heart failure.
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In recent years, more and more reports have been reported on the treatment of refractory primary membranous nephropathy with rituximab in bed, and its effect has been confirmed.A case of refractory primary membranous nephropathy was treated in the Department of Nephrology, Peking university Third Hospital.After the treatment of hormone combined with cyclophosphamide, cyclosporine and tacrolimus was ineffective, the patients were treated with low-dose rituximab for 2 years according to their condition, and the condition of the patients was finally relieved.
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Objective:To explore the effect of mind map on health education of children with asthma and their parents.Methods:Ninety children with asthma admitted for the first time were divided into observation group (45 cases) and control group (45 cases) by random digits table method. The control group used the traditional health education method, and the observation group used the mind map pattern health education method. The drug compliance of the two groups was evaluated before discharge and at the 1st, 2nd,3rd month after discharge, and the satisfaction of the children and parents and therapeutic effect of the two groups were compared at the time of discharge.Results:There was no significant difference in treatment adherence between the two groups before discharge ( P > 0.05). The treatment adherence at the 1st, 2nd,3rd month after discharge was (7.22±1.31), (7.58±1.55), (7.78±2.11) points in the observation group, and (6.98±2.01), (7.01±1.58), (7.11±2.48) points in the control group, there were significant differences between the two groups ( t values were 4.426, 3.884, 5.233, all P < 0.05). The satisfaction of the children and parents was (96.01±3.45) points in the observation group,and (78.13±2.39) points in the control group, there was significant difference between the two groups ( t value was 38.223, P < 0.01). The total effective rate was 77.8%(35/45) in the observation group,and 64.4%(29/45) in the control group, there was significant difference between the two groups ( χ2 value was 4.013, P < 0.05). Conclusions:Health education integrated with mind map can effectively improve the satisfaction of children and their parents, and improve the drug adherence and therapeutic effect of children.
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Objective:To explore the effect of specialized games combined with bi-cardiac nursing on postoperative complications and caregivers′ emotions in children with hypospadias.Methods:A total of 100 children with hypospadias treated in our hospital from January 2018 to December 2018 were randomly divided into control group and experimental group, 50 cases in each group. The control group was given routine treatment and nursing. The experimental group was given specialized games combined with bi-cardiac nursing intervention. The incidence of complications after operation was compared between the two groups. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to test the main caregivers of the two groups before and after the intervention for 3 months respectively. At the same time, their satisfaction was compared after the intervention.Results:The incidence of complications was 10.00% (5/50) in the study group and 28.00% (14/50) in the control group, the difference between the two groups was statistically significant ( χ2 value was 5.263, P=0.022); after intervention, the scores of SAS and SDS of the caregivers in the study group were 23.35 ± 7.33, 37.06 ± 8.22 respectively, and those in the control group were 32.22 ± 6.70, 40.94 ± 8.95, the difference between the two groups was statistically significant ( t values were 6.316, 2.258, all P<0.05); after the intervention, the satisfaction of the study group was 96.00%(48/50), and that of the control group was 84.00%(42/50). The difference between the two groups was statistically significant ( χ2 value was 4.000, P=0.046). Conclusions:Specialized games combined with bi-centric nursing can reduce the incidence of complications after urethroplasty in children with hypospadias, alleviate the bad mood of the main caregivers and improve nursing satisfaction.
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OBJECTIVE@#To screen new serum metabolic biomarkers for different drug resistance profiles of pulmonary tuberculosis (TB) and explore their mechanisms and functions.@*METHODS@#We collected serum samples from TB patients with drug sensitivity (DS), monoresistance to isoniazid (MR-INH), monoresistance to rifampin (MR-RFP), multidrug resistance (MDR), and polyresistance (PR). The metabolites in the serum samples were extracted by oscillatory and deproteinization for LC-MS/MS analysis, and the results were normalized by Pareto-scaling method and analyzed using Metaboanalyst 4.0 software to identify the differential metabolites. The differential metabolites were characterized by function enrichment and co-expression analysis to explore their function and possible pathological mechanisms.@*RESULTS@#Compared with the DS group, 286 abnormally expressed metabolites were identified in MR-INH group, 362 in MR-RPF group, 277 in MDR group and 1208 in PR group by LC-MS/MS analysis. Acetylagmatine ( < 0.05), aminopentol ( < 0.05), and tetracosanyl oleate ( < 0.05) in MR-INH group; Ala His Pro Thr ( < 0.001) and glycinoprenol-9 ( < 0.05) in MR-RFP group; trimethylamine ( < 0.05), penaresidin A ( < 0.05), and verazine ( < 0.05) in MDR group; and PIP (18:1(11Z)/ 18:3(6Z, 9Z, 12Z)) ( < 0.001), Pro Arg Trp Tyr ( < 0.001), N-methyldioctylamine ( < 0.001), and phytolaccoside E ( < 0.05) in PR group all showed significant differential expressions. Significant differential expressions of phthalic acid mono-2-ethylhexyl ester ( < 0.05) and eicosanoyl-EA ( < 0.05) were found in all the drug resistant groups as compared with DS group.@*CONCLUSIONS@#Acetylagmatine, aminopentol, tetracosanyl oleate, Ala His Pro Thr, glycinoprenol-9, trimethylamine, penaresidin A, verazine, PIP(18:1(11Z)/18:3(6Z, 9Z, 12Z)), Pro Arg Trp Tyr, N-methyldioctylamine, phytolaccoside E, phthalic acid mono-2-ethylhexyl ester, and eicosanoyl-EA are potentially new biomarkers that indicate monoresistance, multi-drug resistance and polyresistance of Mycobacterium tuberculosis. The combined use of these biomarkers potentially allows for assessment of drug resistance in TB and enhances the diagnostic sensitivity and specificity.
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Humans , Biomarkers , Chromatography, Liquid , Tandem Mass Spectrometry , Tuberculosis, Multidrug-Resistant , Tuberculosis, PulmonaryABSTRACT
OBJECTIVE： To screen potential eEF2K inhibitor molecules， and to provide reference for the design and R&D of eEF2K inhibitor. METHODS： The eEF2K crystal structure model was constructed by homology modeling technique. The model was optimized by Loop optimization and molecular dynamics. With the help of SAVES online server， the above models were evaluated from three aspects such as Verify_3D， EERAT and Laplace diagram. Totally 55 eEF2K inhibitor molecules were collected. Hypogen pharmacophore model with activity prediction ability was constructed based on 28 of them （odd number， as training set） by Insight Ⅱ software and validated by other 27 （even number， as test set）. The optimal pharmacophore model was screened by fitting the predicted and experimental values of activity [i.e. negative logarithm of half inhibitory concentration （pIC50）] and using Ligand profiler thermogram. The virtual screening of small molecules of eEF2K inhibitors was carried out by combining the above pharmacophore model， Lipinski’s five rules and molecular docking method. RESULTS & CONCLUSIONS： The overall quality factor score of the crystal structure model of eEF2K protein was 93.697. Among them， 83.33％ of the amino acid Verify_3D score was more than or equal to 0.2， and 1.7％ of the total amino acids were located in the non-permissible region. The amino acid conformation and skeleton structure of the model were reasonable and the reliability of the model was high. Totally 9 Hypogen pharmacophore models （No. 02-10） with active predictive function were constructed， among which No. 03 pharmacophore model included 2 hydrogen bond receptors and 2 conjugated aromatic rings， which could better distinguish active and inactive molecules. The predicted value of pIC50 fitted the experimental value best （the correlation coefficient was 0.665 3）， and it had good predictive ability and high reliability. Finally， 9 potential eEF2K inhibitor molecules were obtained through virtual screening （pIC50 ranged from 1.074 to 1.185， and Dcoking-score of protein-molecule interaction ranged from －9.730 to －7.467）. Pro268， Asp267， Gln171， Phe121 and Glu212 may be the key amino acids for the interaction between eEF2K inhibitors and target proteins， including hydrogen bonds， salt bridges and hydrophobicity. These 9 molecules are expected to be the lead compounds for the development of eEF2K inhibitors.
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OBJECTIVE： To investigate the clinical distribution and drug resistance of pathogenic bacteria of bloodstream infection in Zigong area， and to provide reference for the diagnosis and treatment of bloodstream infection in the region. METHODS： The blood culture positive strains and drug susceptibility results of 3 third-class comprehensive hospital of Zigong district during Jan.-Dec. 2017 were collected. Using Escherichia coli ATCC25922， Staphylococcus aureus ATCC25923， Pseudomonas aeruginosa ATCC27853， Streptococcus pneumoniae ATCC49619 as quality control bacteria， clinical distribution and drug resistance of pathogens of bloodstream infection were analyzed by using WHONET 5.6 and SPSS 19.0 software. RESULTS： A total of 879 strains of bacteria were isolated， including 212 strains of Gram-positive bacteria （24.1％） and 667 strains of Gram-negative bacteria （75.9％）. Top 5 bacteria were E. coli （50.7％）， Klebosiella pneumoniae （10.2％）， Staphylococcus aureus （6.5％）， S. epidermidis （3.2％） and S. pneumoniae （2.6％）， respectively. The age and gender distribution of pathogenic bacteria was 88.5％ in the population over 40 years old， and the scale of male to female was 1.15 ∶ 1. Drug resistance of common Gram-positive bacteria showed that S. aureus， Coagulase negative staphylococcus， Enterococcus faecalis， Enterococcus faecium and S. pneumoniae resistant to vancomycin and linezolid were not isolated； the detection rates of MRSA and MRCN were 15.8％ and 64.2％， respectively. E. faecium was more resistant to common antibiotics than E. faecalis. Drug resistance rate of E. faecalis to penicillin and ampicillin was 0， and penicillin-resistant S. pneumoniae was not detected. The drug resistance of common Gram-negative bacteria showed that E. coli and K. pneumoniae resistant to ertapenem were not isolated. The drug resistance of two bacteria to amikacin， cefotetan， cefepime， piperacillin/tazobactam and imipenem were lower （＜10％）， among which the detection rates of ESBLs-producing stain were 42.2％ and 24.4％； detection rate of ESBLs-producing stain to common antibiotics was higher than that of non-producing ESBLs stain. The resistance of Acinetobacter baumannii was higher than that of P. aeruginosa to common antibiotics， and the resistant rates to imipenem were 68.8％ and 13.6％， respectively. And amikacin-resistant or tobramycin-resistant P. aeruginosa were not isolated. CONCLUSIONS： The bloodstream infection is mainly caused by Enterobacteriaceae in Zigong area， and the drug resistance of A. baumannii is serious. It is necessary to strengthen the hospital infection control and management.
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Induced pluripotent stem cells (iPSCs) are a kind of stem cells induced from somatic cells by reprogramming with some specific pluripotent transcription factors.Compared with traditional stem cells,iPSCs have many advantages,including a wide range of sources,the ability of totipotent differentiation,and less ethical and sourcing issues associated with embryonic stem cells which have been debated for a long time.In dermatology,iPSCs can be used to make regenerative skin,establish models of skin diseases,provide a new platform for studying the pathogenesis of skin diseases,and perform cell treatment or gene modification treatment for specific skin diseases.At present,the application value of iPSCs has been verified among animal models,and clinical trials are also under way.
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Objective To evaluate the effect of latanoprost on cell proliferation of and melanogenesis in human epidermal melanocytes,and to explore its mechanism.Methods Latanoprost was added into the 254 medium to prepare latanoprost solutions at different concentrations of 10-5,10-6 and 10-7 mol/L.In vitro cultured human epidermal melanocytes were divided into 4 groups to be cultured with media containing no latanoprost (control group) or 10-5,10-6 and 10-7 mol/L latanoprost for 48 hours.Cell counting kit-8 (CCK8) assay was performed to evaluate the proliferative activity of melanocytes,dopa oxidation assay to estimate the activity of tyrosinase.Sodium hydroxide (NaOH)-lysis method was used to determine the content of melanin,and Masson-Fontana staining to observe the number and distribution of melanin granules.Westernblot analysis and real-time fluorescence-based quantitative PCR were performed to determine the protein and mRNA expression of melanogenesis-related genes including microphthalmia-associated transcription factor (MITF),tyrosinase (TYR) and tyrosinase-related protein 1 (TYRP1).Comparison among the 4 groups and multiple comparisons were done by using one-way analysis of variance and least significant difference (LSD)-t test.Results Compared with the control group,the 10-6-,10-5-mol/L latanoprost groups showed significantly increased proliferative activity of melanocytes (1.064 ± 0.172 and 1.078 ± 0.080 vs.0.784 ± 0.015;t =3.289,3.454 respectively,both P ＜ 0.05),increased activity of tyrosinase (0.510 ± 0.017 and 0.454 ± 0.009 vs.0.355 ± 0.041;t =6.139,3.939 respectively,P ＜ 0.01 or 0.05),and increased content of melanin (t =7.232,5.967,both P ＜ 0.01).However,there were no significant differences in the proliferative activity of melanocytes,activity of tyrosinase or content of melanin between the 10-7-mol/L latanoprost group and control group (all P ＞ 0.05).Masson-Fontana staining showed more and darker melanin granules on melanocyte dendrites in the 10-5-,10-6-,10-7-mol/L latanoprost groups than in the control group,and the color of melanin granules changed from light brown to black brown along with the increase in the concentration of latanoprost.The mRNA expression of MITF increased along with the increase in the concentration of latanoprost (P ＜ 0.01),and the protein expression of MITF wassignificantly higher in the 10-6,10-5-mol/L latanoprost groups than in the control group and 10-7-mol/L latanoprost group (all P ＜ 0.01).The 10-6-mol/L latanoprost group showed significantly increased mRNA and protein expression of TYR and TYRP1 compared with the control group,10-7-,10-5-mol/L latanoprost groups (all P ＜ 0.01).Conclusion Latanoprost can increase the proliferation of human epidermal melanocytes,and promote tyrosinase activity and melanogenesis likely by enhancing the mRNA and protein expression of MITF,TYR,TYRP1.
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Objective To determine the expression of nucleobindin 2-encoded satiety and fatinfluencing protein-1 (nesfatin-1) and interleukin (IL)-26 in the serum of patients with vitiligo,and to explore the relationship of nesfatin-1 and IL-26 with anxiety status,disease stage and distribution pattern of vitiligo lesions.Methods From March 2017 to September 2018,123 outpatients with vitiligo,as well as 30 healthy controls (control group),were enrolled from Department of Dermatology,Affiliated Hospital of Jiangsu University.Of these patients,93 rated as anxious (vitiligo with anxiety group),and 30 as nonanxious (vitiligo without anxiety group).Another 30 anxious patients with other autoimmune diseases and background diseases like hypertension and diabetes mellitus but not vitiligo (anxiety group) were enrolled from Zhenjiang Fifth People's Hospital.Enzyme-linked immunosorbent assay (ELISA) was performed to detect levels of nesfatin-1 and IL-26 in the above groups,and state-trait anxiety inventory (STAI) was used to evaluate the anxiety status.According to the vitiligo disease activity (VIDA) score,the vitiligo patients with anxiety were divided into 3 subgroups:stable stage group,active stage group and rapid progressive stage group.According to the distribution pattern of skin lesions,the vitiligo patients with anxiety were divided into 5 subgroups:localized vitiligo group,segmental vitiligo group,generalized vitiligo group,sporadic vitiligo group and acral vitiligo group.The levels of nesfatin-1 and IL-26 were compared among different stage groups and type groups.Statistical analysis was carried out using one-way analysis of variance for comparison among several groups,multi-way analysis of variance and stratification analysis for multifactor data,paired t-test for comparison before and after treatment,and Pearson correlation analysis for analyzing correlations.Results The serum level of nesfatin-1 significantly differed among the vitiligo with anxiety group,vitiligo without anxiety group,anxiety group and control group (F =10.78,P ＜ 0.001),and was significantly higher in the vitiligo with anxiety group than in the other 3 groups (P ＜ 0.001).No significant difference in the serum level of IL-26 was found among the 4 above groups (F =1.34,P =0.26).As pearson correlation analysis showed,the serum level of nesfatin-1 was positively correlated with the STAI score in the 93 vitiligo patients with anxiety (r =0.55,P ＜ 0.001).The serum level of nesfatin-1 was significantly higher in the rapid progressive stage group than in the stable stage group (P ＜ 0.05),while there was no significant difference in the IL-26 level among different stage groups (P ＞ 0.05).The generalized vitiligo patients with anxiety showed significantly increased serum level of nesfatin-1 compared with the localized vitiligo patients with anxiety (P ＜ 0.001).After 3-month treatment,the nesfatin-1 level in the 10 vitiligo patients with anxiety significantly decreased compared with that before the treatment (paired t =4.40,P =0.02),but the STAI score did not change (P ＞ 0.05).Conclusion Nesfatin-1 as an emotioninfluencing factor may participate in the occurrence of vitiligo,especially affect patients with rapid progressive vitiligo or generalized vitiligo,while IL-26 may be irrelevant to vitiligo.
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This study reviewed the definition of resilience, evaluation tools, protective factors and its effect on health outcomes of adult patients with chronic diseases, in order to provide theoretical guidance for the intervention of resilience of adult chronic disease patients.