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This paper collected the case and interview data in the hospice wards of X Community Health Service Center in Harbin with the method of participant observation and in-depth interview.It sorted and analyzed the disease narrative,psychological experience and social-cultural significance of terminal stage patients.Through describing three field cases,this paper analyzed the depressed-helpless and request-desire pain experience in terminal stage patients.It emphasized the cultural narrative research in this special group,terminal stage patients,and further to provide realistic basis for the improvement of hospice care in China.
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Objective@#To investigate the expressions of Fra-1 and HMGA1 in laryngeal squamous cell carcinoma and their correlation.@*Methods@#Immunohistochemistry and reverse transcription-polymer chain reaction (RT-PCR) were used to detect the expressions of HMGA1 and Fra-1 in laryngeal squamous carcinoma tissues in 47 cases and para-carcinoma tissues in 21 cases(the First Hospital of Shijiazhuang). The relationship between the gene expressions in carcinoma tissues and clinopathological parameters such as pathological grade, clinical stage, lymph metastasis, age and anatomic site and the relevance of the two gene expressions were analyzed. SPSS 13.0 software was used to analyze the data.@*Results@#The positive expression rates of Fra-1 and HMGA1 proteins in laryngeal squamous cancer tissue were 48.9% and 53.2%, which were respectively higher than the rates of 19.0% for Fra-1 (χ2=5.416, P<0.05) and of 23.8% for HMGA1 (χ2=5.083, P<0.05) in adjacent tissues. The expression of Fra-1 gene was correlation with pathological grade, clinical stage and lymph metastasis (t values were -1.079, -1.066 and -1.067, all P<0.05), but not with age and anatomic site (t values were -1.068 and -1.054, both P>0.05). The expression of HMGA1 gene was correlation with pathological grade, clinical stage, lymph metastasis and age (t values were -1.112, -1.065, -1.009 and -1.066, all P<0.05), but not with anatomic site (t=-1.036, P>0.05). The expressions of Fra-1 and HMGA1 gene were positively correlation (r=0.672, P<0.05).@*Conclusions@#In laryngeal squamous cancer, Fra-1 and HMGA1 are excessive expression, with a positive correlation between the expressions of both genes.
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Objective To evaluate the effect of curcumin pretreatment on c-Jun N-terminal kinase (JNK) signaling pathway during one-lung ventilation (OLV)-induced acute lung injury in mice.Methods Ninety SPF male C57BL/6J mice,aged 6-9 weeks,weighing 18-24 g,were randomly divided into 6 groups (n=15 each) using a random number table:two-lung ventilation (TLV) group;OLV group;curcumin 100,150,200 and 250 mg/kg groups (C100,C150,C200 and C250 groups).The corresponding doses of curcumin were administered intraperitoneally at 2 h before one-lung ventilation in C100,C150,C200 and C250 groups.The animals were tracheally intubated and mechanically ventilated in volume-controlled mode.The ventilator settings were adjusted to maintain the end-tidal pressure of carbon dioxide at 35-45 mmHg.In OLV,C100,C150,C200 and C250 groups,unilateral lung was ventilated for 1.5 h followed by 0.5 h of TLV.Bilateral lungs were ventilated for 2.0 h in group TLV.Peak airway pressure and airway pressure were recorded at 1.5 h of OLV and 0.5 h of TLV.At the end of mechanical ventilation,left lungs were removed for microscopic examination of the pathologic changes,and the index of quantitative assessment for alveolar damage (IQA) was recorded.Wet/dry lung weight ratio (W/D ratio) was determined,and the cell apoptosis in lung tissues was detected using TUNEL.The apoptosis index (AI) was calculated.The expression of JNK mRNA was determined using real-time polymerase chain reaction.The expression of JNK and phosphorylated JNK was determined by Western blot.The phosphorylation of JNK was calculated.Results Compared with group TLV,the IQA,W/D ratio,AI,expression of JNK mRNA and phosphorylation of JNK were significantly increased in group OLV (P＜0.05).Compared with group OLV,the IQA,W/D ratio,AI,expression ofJNK mRNA and phosphorylation of JNK were significantly decreased in C150,C200 and C250 groups,the parameters mentioned above were significantly decreased in sequence in C100,C150,C200 and C250 groups (P＜0.05),and no significant change was found in the parameters mentioned above in group C100 (P＞ 0.05).Compared with group OLV,the pathological changes were significantly attenuated in sequence in C150,C200 and C250 groups.Conclusion The mechanism by which curcumin pretreatment reduces cell apoptosis during OLV-induced acute lung injury is related to inhibition of JNK signaling pathway activation in mice.
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Rho/ROCK pathway is a ubiquitous singling pathway in organisms,and is involved in many biological processes. In the brain of Alzheimer′s patients,the activities of Rho and Rho associated coiled coil forming protein kinase(ROCK)are up-regulat?ed,which is accompanied by the elevation of Aβ42 level,and the abnormal change of the morphology and function of neuronal process?es,suggesting that the occurrence and development of Alzheimer′s disease(AD)is associafed with the overexpression and excessive activation of Rho or ROCK. Rho/ROCK2 pathway is considered a target pathway for the prevention and treatment of AD,and Rho or ROCK2 also becomes an important target for AD drug development. Numerous studies have revealed that suppressing the expression or decreasing the activity of Rho or ROCK2 can reduce Aβ42-induced neurotoxicity,protect neurons,and slow down the occurrence and de?velopment of AD. Therefore,specific inhibition of ROCK2 has an important significance for the repair of central nervous system dam?age and the treatment of AD. This article reviews several effects of Rho/ROCK2 pathway on the development of AD.
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Objective To investigate influencing factors of disability after craniocerbral injury caused by road traffic accident.Methods We collected 486 cases with craniocerebral injury caused by traffic accident,and conducted analysis.Factors related to disability were found by univariate analysis,and multivariate logistic regression analysis was conducted to filter the most important factors.Results Degrees of brain injury,drunk driving,age and types of accident were the major influencing factors.Drunk driving and age were positively related with disability grade while the degree of brain injury and type of accident were negatively related.Concuusiorn It is helpful to reduce disability and the burden on society by taking intervening measures on the related factors of disability after brain injury in road traffic accident.
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BACKGROUND:Under co-culture conditions, mesenchymal stem cel s could regulate osteogenic differentiation and osteogenesis of osteoblasts. OBJECTIVE:To observe the osteogenic efficiency of osteoblastic precursor cel s co-cultured with undifferentiated bone marrow-derived mesenchymal stem cel s, umbilical cord-derived mesenchymal stem cel s, or placenta-derived mesenchymal stem cel s in mineralization medium. METHODS:Adipose-derived stem cel s were induced in osteogenic differentiation medium for 7 days before being indirectly co-cultured with undifferentiated mesenchymal stem cel s isolated from different tissues (bone marrow group, umbilical cord group and placenta group) in Transwel plates. Induced adipose-derived stem cel s cultured alone served as control group. At different experimental intervals, quantitative analysis of alkaline phosphatase activity and calcified matrix was preformed to observe the effects of mesenchymal stem cel s from different sources on the osteogenic efficiency of induced adipose-derived stem cel s. RESULTS AND CONCLUSION:Expression of alkaline phosphatase was significantly higher in different experimental groups than the control group (P<0.05), and it was also higher in the bone marrow group than the umbilical cord and placenta groups (P<0.05). Quantitative analysis of calcified matrix revealed that the experimental groups were significantly higher than the control group (P<0.05);and in experimental groups, the umbilical cord group was higher than bone marrow group and placenta group (P<0.05). These findings indicate that the osteogenic efficiency of induced adipose-derived stem cel s is improved dramatical y under co-culture conditions.
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Objective To evaluate the efficacy of I-gel laryngeal mask airway (LMA) for airway management in patients undergoing radical mastectomy.Methods One hundred and twenty ASA Ⅰ or Ⅱ patients (Mallampati Ⅰ or Ⅱ),aged 25-64 yr,weighing 45-90 kg,with body mass index ＜ 30 kg/m2,scheduled for elective radical mastectomy under general anesthesia,were randomized into 2 groups (n=60 each): I-gel LMA group (group Ⅰ) and Classic LMA (group C).Anesthesia was induced with iv midazolam 0.04 mg/kg and vecuronium 0.10 mg/kg.I-gel and classic LMAs were inserted in I and C groups,respectively,after induction of anesthesia.The success rate of LMA placement at first attempt,LMA placement time,airway sealing pressure,peak airway pressure,leaks and hypoxemia,and complications (nauseas and vomiting,bucking,aspiration and blood stain on the LMAs,sore throat and hoarseness within 24 h after surgery) were recorded.Correct position of the LMAs was verified by fiberoptic bronchoscopy.Results The success rate of LMA placement were 100 ％ in both groups.The success rate of LMA placement at first attempt and fiberoptic bronchoscope scores were higher,the LMA placement time was significantly shorter,and the incidence of blood stain on the LMAs and sore throat were significantly lower in group Ⅰ than in group C (P ＜ 0.05).A transient increase in airway pressure and leaks occurred in 5 patients in group C,and the airway pressure returned to normal and no leaks developed after treatment.No transient increase in airway pressure and leaks occurred in group Ⅰ.Hypoxemia was not found in both groups.Conclusion The placement of I-gel LMA is easier than that of Classic LMA and the success rate of placement at first attempt is high,with fewer complications.I-gel LMA can be safely and effectively used for airway management in patients undergoing radical mastectomy.
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Objective To evaluate the efficacy and safety of remifentanil and propefol combined with local anesthesia for cobiation-assisted upper-airway procedure (CAUP). Methods Eighty ASAⅠorⅡpatients aged 25-60 yr body mass index ≤ 35 kg/m2 with sleep apnea hypopnea syndrome scheduled for CAUP were randomly divided into 4 groups (n=20 each): normal saline group (S), propefol group (P), remifentanil group (R) and propoful + remifentanil group (PR). After topical anesthesia with 1% decicaine, the patients in group S, P, R or PR received iv infusion of normal saline 0.15 ml·kg-1·h-1 , propofol 25 μg·kg-1·min-1 , remifentanil 0.05 μg·kg-1·min-1, or propefol + remifentanil at the same rate respectively. Ten minutes later local infiltration anesthesia was performed in operative field with lidocaine containing epinephrine 1:200 000. Ramsay sedation score and verbal rating scale (VRS) were assessed every 5 min. VRS Ⅲwas defined as anesthesia failure in group S. It was also defined as anesthesia failure that Ramsay sedation score > 3 or occurrence of respiratory depression during increment of propofol or remifentanil in patients with VRS Ⅲ in the other 3 groups. BP and HR were recorded before coblation and 5 rain after coblation. Airway obstruction and apnea were also observed. Results Anesthesia achievement ratio was significantly higher in group R and PR (90% and 100% respectively) than in group S and P (40% and 65% respectively) (P<0.05). SP, DP and HR were significantly lower 5 rain after coblation in group R and PR than in group S (P < 0.05). There was no significant difference in incidence of adverse effects between the 4 groups(P>0.05). Conclusion Remifentanil or propofol-remifentanil combined with local anesthesia is safe and effective for CAUP.
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By inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, statins up-regulate the expression and activation of endothelial nitric oxide synthase (eNOS) in brain tissues, increase the levels of serum catalase and plasma nitric oxide, enhance antioxidant capacity, decrease oxygen free radical release, improve immunoreactivities of tight junction (zonula occludens), transmembrane proteins and glial fibrillary acidic protein of astrocyte. Stains may also exert the effects that is completely unrelated with inhibiting HMG-CoA reductase, e.g. binding to leucocyte function-associated antigen-1(LFA-1) L-site, restraining its interactions between LFA-1 and intercellular adhesion molecule-1 (ICAM-1), and playing anti-inflammation and immunoloregulation roles. The above mechanisms contribute to remain the integrity of blood-brain barrier and the activity of astrocyte under the pathological conditions.