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Objective:To analyze the evolution of China′s national-level healthcare sector regulatory policies between 2003 and 2021, and explore the characteristics and patterns of the use of policy instruments at different stages, for references in policy optimization.Methods:The policy documents related to the regulation of the healthcare sector released by the central government were searched from 2003 to 2021 from the policy document database of the State Council using the keywords " medical" " regulation" and " health" " regulation". Based on the analysis framework of " formulation subject-implementation subject-policy tools", such methods as content analysis, social network analysis, and policy tool analysis were used to analyze policy documents and conduct descriptive analysis of data.Results:A total of 236 policies were included in the study.From 2003 to 2008, according to the time progression, a total of 27 documents were issued, with the State Council as the main formulation subject (77.78%, 21/27), and the government as the main implementation subject (100.00%, 27/27). 191 policy tools were used, and the composition ratios of supply-based, demand-based, and environment-based policy instruments were 21.46% (41/191), 30.37% (58/191), and 48.17% (92/191). From 2009 to 2017, a total of 48 policies were issued, the formulation subject was mostly the State Council (93.75%, 45/48), and the implementation subject was still mostly the government (100.00%, 48/48), but the proportion of institutions (25.00%, 12/48), industry organizations (43.75%, 21/48) and the society (37.50%, 18/48) has increased. 500 policy tools were used, and the composition ratios of supply-based, demand-based, and environment-based policy instruments were 17.40% (87/500), 32.00% (160/500), and 50.60% (253/500), respectively.From 2018 to 2021, a total of 161 documents were issued, with the formulation subjects featuring multiple subjects (38.51%, 62/161), with a decrease in the percentage of the State Council′s issuance (22.36%, 36/161), and 157 (97.52%) policies were implemented by the government. 1 140 policy tools were used, and the composition ratios of supply-based, demand-based, and environment-based policy instruments being 18.42% (210/1 140), 34.74% (396/1 140), and 46.84% (534/1 140), respectively.Conclusions:From 2003 to 2021, there was an upward trend in the number of policies issued in the field of healthcare sector regulation in China, and the subjects of formulation and implementation were diversified. But the use of different types of policy instruments was uneven.
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Objective:To explore the link between the differentially expressed long non-coding RNAs (lncRNAs) and the number of regulatory T cells (Tregs) by detecting the lncRNAs expression profiles in patients with systemic lupus erythematosus (SLE), then analyze the correlation between Tregs and lncRNAs and the clinical features of SLE patients. We also predict the mechanism by which lncRNAs regulate the differentiation and development of Tregs, and provid new approach for the treatment of SLE.Methods:Peripheral blood of 9 active SLE patients was collected and mononuclear cells (PBMCs) were extracted. The lncRNAs expression profiles of PBMCs was analyzed by whole transcriptome sequencing. Nine healthy people served as controls to screen the differentially expressed lncRNAs, and to analyze the correlation between lncRNAs and Tregs number. Pearson test was used to analyze the correlation between lncRNA and the number of Tregs, and the correlation between Treg-associated lncRNAs and systemic lupus erythematosus disease activity index(SLEDAI) score, erythrocyte sedimentation rate (ESR), C3, C4 in SLE patients. The targeted genes of Treg asso-ciated lncRNAs were predicted with miRcode and Targetscan databases and co-expression network.Results:There were 240 differentially expressed lncRNAs in SLE patients compared with healthy controls, including 134 highly expressed lncRNAs ( P<0.05) and 106 low expressed lncRNAs ( P<0.05). The expression of ANKRD44-AS1 ( r=0.74, P=0.022), LINC00200 ( r=0.70, P=0.037), AP001363.2 ( r=0.78, P=0.014) and LINC02824 (r=0.79, P=0.011) were positively correlated with the number of Tregs, and the expression of AP000640.1 ( r=-0.72, P=0.028), AC124248.1 ( r=-0.77, P=0.016), LINC00482 ( r=-0.83, P=0.005) and MIR503HG ( r=-0.96, P<0.001) were negatively correlated with the number of Tregs. Among these eight Tregs associated lncRNAs, the expression of LINC00482 ( r=-0.73, P<0.001) and MIR503HG ( r=-0.76, P<0.001) were negatively correlated with C3. LINC00200, ANKRD44-AS1 and AP000640.1 related to Tregs regulated the expression of STAT5, PLD1, HOPX and RUNX3 through competitively binding of miRNA or transregulatory mechanism, thereby regulating the differentiation and development of Tregs. Conclusion:The lncRNAs expression profiles are changed in SLE patients, the differentially expressed lncRNAs are associated with abnormal number and function of Tregs in SLE patients, and Treg associated lncRNAs are associated with SLE disease activity, which may affect the expression of STAT5, PLD1, HOPX, RUNX3 and regulate Tregs function and participate in the pathogenesis and progression of SLE by competitively binding to miRNAs or trans-regulatory mechanism.
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Objective:To investigate the effect of a single-trial transcranial direct current stimulation(tDCS) of the dorsolateral prefrontal cortex (DLPFC) on fairness-related decision-making behavior.Methods:From September 2018 to February 2019, a total of 60 healthy participants between the ages of 18 and 45 were enrolled.Then, the participants were randomly divided into 3 groups with 20 in each group to receive left anode stimulation/right cathode stimulation (left anode /right cathode group), left cathode/right anode stimulation (left cathode /right anode group) or bilateral control electrodes (sham stimulation group) on the bilateral dorsolateral prefrontal cortices (DLPFC), respectively.After tDCS, the participants immediately completed the ultimatum game (UG) task as responders and a fairness questionnaire in turn.SPSS 22.0 statistical software was used to analyze the data with repeated measurement ANOVA and nonparametric test.Results:In the UG task, there was no significant difference in the acceptance rate among the three groups of participants as responders (all P>0.05). When analyzing the acceptance rate facing different proposers (" computer" and " human" ) under different fairness levels in the three stimulus types through the paired samples Wilcoxon test, it was found that the acceptance rate of the sham stimulation group to the extremely unfair proposals proposed by the human opponent was lower than that proposed by the computer(0.28 (0, 0.67), 0.44 (0.33, 0.89), Z=-2.14, P=0.032), while there was no difference in acceptance rates (both P>0.05) in the face of fair or unfair proposals proposed by computer and human opponents.The acceptance rate of the left cathode /right anode group to the unfair(0.90 (0.50, 1.00), 1.00 (0.70, 1.00), Z=-1.90, P=0.046)or extremely unfair(0.44 (0, 1.00), 0.89 (0.50, 1.00), Z=-2.73, P=0.006) proposals proposed by human opponents was significantly lower than the proposals proposed by computer opponent, and there was no differences in acceptance rate when facing fair proposals proposed by computer and human opponents ( P> 0.05). There were no significant differences in acceptance rates in the left anode /right cathode group when faced with fair, unfair, and extremely unfair schemes proposed by computer and human opponents (all P>0.05). For fairness questionnaire scores, a repeated measurements ANOVA showed that the interaction effect between group and proposer types was not significant ( F(2, 54)=2.037, P=0.140), and the group main effect was not significant ( F(1, 54)=0.165, P=0.848), but the proposer type main effect was significant ( F(1, 54)=6.363, P=0.015), indicating that the fairness questionnaire score in the face of the human opponents was lower than when facing the computer opponents( P<0.05). Conclusion:Although a single-trial tDCS on bilateral DLPFC has no significant effect on the overall acceptance rate of fairness-related decision-making, it affects the decision-making of unfair distribution scheme proposed by human or computer.
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Objective:To provide reference for the sustainable development of county medical communities through analyzing key issues in the construction of such communities in China.Methods:Such Database websites as CNKI, Wanfang Data and VIP Information were selected to retrieve journal papers and dissertations with the keywords of " county medical community" " county medical alliance" " county medical and health community" and " medical alliance" . The time period ranged from the establishment of the database to December 2021. Content analysis and social network analysis were used to classify and sort key issues of county medical community construction in the included literature, and the descriptive analysis was used for all the data.Results:274 literatures were obtained in this study, 82 high-frequency issues were extracted for the construction process of county medical communities. It was divided into 3 dimensions of service system, operation mechanism and fund guarantee, including 14 items of integration of resources, integrated management, resource intensification, information construction, medical services, medical quality, family doctors, public health, management system, personnel system, salary system, supervision mechanism, medical insurance fund and financial input. The results of social network analysis showed that the top three high-frequency issues of point centrality and intermediary centrality were lack of highly unified information exchange platform (107.00, 514.48), insufficient service capacity of primary medical institutions (61.00, 238.48) and lack of sustainable benefit distribution mechanism (45.00, 192.38).Conclusions:The construction of county medical community covered three aspects: medical service system, operation mechanism and fund guarantee.The shortage of primary medical service capacity, the lack of coordination of an information platform, the general shortage of essential drugs, the imperfect internal assessment and incentive system, the imperfect supervision system and the imperfect medical insurance supporting policy becomed the main roadblocks in building county medical communities in China. In order to promote the sustainable development of county medical community, the authors recommend to further upgrade the county integrated medical service system, perfect the operation mechanism, and strengthen the input into county health care.
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Objective:To evaluate the feasibility, safety and efficacy of single-stage percutaneous nephrolithotomy (PCNL) combined with flexible ureteroscopy (FURS) for the management of staghorn calculi with pyonephrosis.Methods:A total of 13 patients of staghorn renal calculi with pyonephrosis, which was diagnosed by intraoperative pelvic urine bacteria culture, were treated by PCNL combined with FURS from May 2017 to December 2019. Of all the 13 patients, 7 were males and 6 were females, with mean age of 52.5 years, ranged from 33 years to 68 years. The mean stone burden was (1 070.9±397.0) mm 2, ranged from 507.4 mm 2 to 1 809.5 mm 2. Bacteria culture and microbial sensitivity test was performed for all the patients. Four patients with fever on admission accepted ureteral stenting at least a week before the surgeries. All the patients received preoperative antibiotic therapies for at least a week, and the infective symptoms and inflammatory indexes was normal before the surgeries. Under general anesthesia, the procedures were performed in a modified supine Valdivia position. After the transurethral FURS was performed, the standard percutaneous track was placed at the subcostal point between mid-axillary line and scapular line under the FURS and ultrasounic guide. The purulence and the stones were shattered and removed by PCNL with negative pressure system, and FURS helped to shatter and move out the stones beyond the PCNL reach through the same tract. A double-J tubes and a nephrostomy tube was routinely indwelled postoperatively. A radiological imaging was performed within three days after the operation to evaluate the stone free rate. The residual stone was defined as the stone larger than 4 mm. Results:All the procedures were successful. The one-stage stone free rate was 76.9% (10/13). The mean operation time was (94.2±21.8) min, ranged from 65 to 135 min. Six patients suffered postoperative systemic inflammatory response syndrome, and no patient occurred sepsis or complications of Clavien-Dindo classification Ⅲ or above. They were followed up for 3-24 months with median of 12 months.Four cases with recurrence of ipsilateral stones, two cases with ipsilateral mild renal atrophy, no recurrent ipsilateral upper uninary infection were found in the followup.Conclusions:Single-stage PCNL combined with flexible ureteroscopy could be feasible for the management of staghorn calculi with pyonephrosis with safety and efficacy.
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Objective@#To evaluate the effect of massage combined with external application of Xiaoji powder on Shenque point in treating children’s functional constipation (FC) of gastrointestinal heat accumulation syndrome.@*Methods@#A total of 88 FC children who met the inclusion criteria were randomly divided into two groups, 44 in each group. The control group was treated with viablebifidobacterium tetrad tablets orally, while the treatment group was treated with massage combined with external application of Xiaoji powder on Shenque point. Both groups were treated for 18 days. Before and after treatment, TCM syndromes were scored from the main symptoms and secondary symptoms to evaluate the clinical efficacy.@*Results@#The effective rate was 93.2% (41/44) in the treatment group and 65.9% (29/44) in the control group. There were significant differences between the two groups (χ2=9.058, P=0.004). After treatment, the scores of main symptoms (3.8 ± 0.6) and minor symptoms (1.7 ± 0.4) in the treatment group were significantly lower than those in the control group (6.8 ± 1.3) and (3.1 ± 0.4) (t=13.899, 16.417, respectively, P<0.05).@*Conclusions@#Massage combined with external application of Xiaoji powder on Shenque point can improve the constipation symptoms and clinical efficacy of children suffering from FC of gastrointestinal heat accumulation syndrome.
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Objective@#To investigate application value of "point-line-surface-volume" four dimensional holmium laser enucleation of prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH).@*Methods@#From December 2016 to November 2017, the clinical data of 60 cases of BPH with the treatment of "Point-line-surface-volume" four dimensional HoLEP at Department of Urology, Peking University Third Hospital were analyzed retrospectively. The age was (73.8±8.0) years (range: 60 to 96 years), body mass index was (23.2±3.6) kg/m2 (range: 14.9 to 31.1 kg/m2), volume of prostate was (64.5±36.9) ml (range: 15.5 to 197.9 ml). All the cases were operated by the same chief surgeon expert in endoscopic surgery. First of all, taking verumontanum as the anchor point, crossing point between the outer 45° line of verumontanum and middle line of the lateral lobe and verumontanum was made as the breakthrough point. The "blasting and paddling" method was used to find prostatic surgery capsule, and the two sides of the capsule plane were connected in front of the verumontanum. Secondly, the plane was maintained by the "fan tunnel" method, and the middle lobe and the lateral lobes were divided at the 5 o′clock and 7 o′clock positions. The glands of the middle lobe were first removed and pushed into the bladder. Then, on the anteroinferior inclined coronal plane through 12 o′clock point right above of verumontanum, the urethral mucosa was cut apart in a semi-curved shape in advance. Bilateral semi-curved incision confluenced above the verumontanum, and extend to the bladder neck to form an inverted Y-shaped groove which completely divided the bilateral lobes. Finally, the bilateral lobes were enucleated respectively, and glands in the bladder were removed by tissue morcellator. Clinical data included operative time, hemoglobin decrease, catheterization duration, postoperative hospital stay, preoperative and postoperative international prostate symptom score and quality of life (QOL) score. The efficiency of enucleation was calculated as prostatic volume divided by enucleation time (not including morcellation time). The efficiency of morcellation was calculated as prostatic volume divided by morcellation time. Paired t-test was used to compare the indexes before and after surgery.@*Results@#All the operations of 60 cases were sumlessful, one of which prostate tissue was removed by conversion to transurethral resection prostate due to malfunction of tissue morcellator. The operative time was (115.2±52.9) minutes (range: 25 to 276 minutes). The enucleation efficiency was (0.81±0.35) ml/minutes (range: 0.17 to 1.58 ml/minutes). The morcellation efficiency was (6.60±4.28) ml/minutes (range: 0.89 to 17.42 ml/minutes). The hemoglobin was decreased by (15.9±12.3) g/L (range:-10 to 57 g/L). Meanwhile, catheterization duration was (5.2±2.9) days (range: 0.8 to 19.8 days), and postoperative hospital stays were (5.0±1.5) days (range: 1.9 to 11.9 days). Preoperative and postoperative IPSS scores (10.92±6.98 vs. 23.37±7.49, t=10.357, P=0.000) and QOL scores (1.75±1.62 vs. 4.53±1.47, t=9.373, P=0.000) were significantly different. Postoperative complications included: 4 cases of fever (greater than 38.5 ℃), 1 case of acute epididymitis, 1 case of bladder mucosal injury, and 1 case of active bleeding need blood transfusion therapy.@*Conclusion@#"Point-line-surface-volume" four dimensional HoLEP is an effective and safe minimally invasive method in the treatment of BPH.
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OBJECTIVE： To investigate the potential effective components and mechanism of Achyranthes bidentata in the treatment of osteoporosis （OP）. METHODS： The effective components of A. bidentata were retrieved from the TCMSP database， and corresponding targets of them were collected. The targets related to OP were retrieved from DisGeNET database. TBtools 1.0 mapping software was used to draw the Wayne diagram， and screen the intersecting targets of effective components of A. bidentata and disease OP. Cytoscape 3.6.1 software and STRING database were used to construct and analyze the “drug-component- disease-target” network and protein-protein interaction （PPI） network； KEGG pathway enrichment analysis was conducted by using DAVID bioinformatics resource database. RESULTS： A total of 19 effective components were screened from A. bidentata， and there were 32 intersecting targets between effective components and disease OP. In “drug-component-disease-target” network， there were 45 nodes [1 for A. bidentata， 1 for OP， 11 for effective components （8 of the 19 effective components had no corresponding OP target）， 32 for intersecting targets] and 119 edges between nodes； quercetin， kaempferol， wogonin， baicalein and palmatine were important effective components. In PPI network， there were 31 nodes （1 of 32 intersecting targets was not associated with other proteins） and 212 edges， among which IL6， ESR1， MAPK1， IL8 and MAPK14 were the core targets of the network. There were 67 KEGG enrichment pathways， including rheumatoid arthritis， hepatitis B， Toll-like receptor signaling pathway， PI3K/Akt signaling pathway， JAK/STAT signaling pathway， NF-κB signaling pathway and so on. CONCLUSIONS： The main potential effective components of A. bidentata in the treatment of OP are quercetin， kaempferol， wogonin， baicalein and palmatine， the mechanism of which may be associated with cell differentiation and apoptosis， metabolism， inflammation reaction， etc. It has multi-component， multi-target and multi-system chara- cteristics.
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This study explores the application of three-dimensional(3D) printing technology combined with PACS in the standardized training of residents in urology.For the residents who received phase Ⅱ standardized training,they were guided to observe and analyze CT images,3D CT reconstruction data,and 3D printing entity during teaching;with reference to the cases of kidney tumors,the 3D printing entity model was explained to help the trainees learn the characteristics of the disease and formulate the operation plan of partial nephrectomy;an explanation of the actual surgical procedure gave them a deeper understanding of the anatomical characteristics and treatment regimens of the disease.The preliminary results of practice show that the application of 3D printing technology combined with PACS can enable residents to grasp the anatomical characteristics of renal tumors within a short time and deepen their understanding of surgical procedures and techniques.This teaching method holds promise for application in clinical specialties.
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Objective To evaluate the relationship between hypophosphatemia and prognosis in critically ill patients. Methods Some hypophosphatemia-associated prospective or retrospective clinical cohort studies were searched through CNKI, Wanfang Data, PubMed, Embase, Cochrane library, and Google Scholar English database respectively, with the guidance of these key words such as hypophosphatemia, intensive care, prognosis and fatality rate. The articles were concerned about the correlation between hypophosphatemia and the prognosis of patients in intensive care unit (ICU). The literatures collected were restricted from the creation of data base to April 2017. The mean value of < 0.8 mmol/L in serum phosphorus concentrations of the patients within the first 2 days of ICU admission would be treated as the diagnostic criteria of hypophosphatemia. Literature qualities were assessed by Newcastle-Ottawa scale (NOS). Meta-analysis was carried out by RevMan 5.3, and the sensitivity analysis was performed to test the stability of the meta-analysis. The existence of bias was analyzed by using the funnel graph analysis. Results Ten articles were ultimately included in the analysis, including 9 in Chinese and 1 in English, all of which were high qualities. 1 555 patients were involved in these clinical studies, of whom 606 patients had hypophosphatemia and other 949 were normal phosphatemia. Meta analysis results showed that patients with hypophosphatemia had higher acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score as compared with that of normal phosphatemia group [standardized mean difference (SMD) = 0.64, 95% confidence interval (95%CI) = 0.24-1.04, P = 0.002]. Subgroup analysis showed that APACHE Ⅱ score increased in mild, moderate and severe hyperphosphatemia subgroups, and there were significant differences between any two subgroups (all P < 0.01). Longer duration of mechanical ventilation (SMD = 0.50, 95%CI =0.23-0.78, P = 0.000 3) and the length of ICU stay (SMD = 0.36, 95%CI = 0.06-0.67, P = 0.02), and even higher ICU mortality [odds ratio (OR) = 2.99, 95%CI = 2.09-4.27, P < 0.000 01] were seen in patients with hypophosphatemia as compared with normal phosphatemia patients. However, serum creatinine (SCr) levels (SMD = -0.19, 95%CI =-2.76-2.39, P = 0.89) and serum albumin (Alb) level (SMD = -0.63, 95%CI = -1.54-0.27, P = 0.17) were all similar between hypophosphatemic group and normal phosphatemia group. Sensitivity analysis excluded the effect of heterogeneity on statistical results. The funnel graphics were basically symmetrical, which indicated that the included literatures were distributed well, and the publication bias was small. Conclusions Occurrence of hypophosphatemia in ICU patients is associated with severity of illness, prolonged duration of MV and length of ICU stay, and higher mortalities. Levels of serum phosphorus may have certain clinical values for assessing prognosis of ICU patients.
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Objective@#To investigate application value of narrow-band imaging (NBI) flexible ureteroscopy in the diagnosis, treatment and follow-up of upper urinary tract transitional carcinomas (UTUC).@*Methods@#From June 2015 to June 2017, 16 patients of UTUC were treated by flexible ureteroscopy with white light (WLI) and NBI at Department of Urology, Peking University Third Hospital , including 10 females and 6 males. The age of patients ranged from 43 to 84 years (average 68.9 years). There were 54 cases, including 16 cases with first-suspicion of cancer, and 38 cases with known of UTUC as follow-up. Full renal collecting system examination was performed first under WLI and then under NBI by a single urologist, using the URF-V digital flexible ureteroscope. Then number of tumors visualized by WLI and NBI flexible ureteroscopy were imaged, recorded, and then biopsied or subsequently treated by holmium laser resection with pathological examination. The diagnosis results of NBI flexible ureteroscopy were compared with WLI flexible ureteroscopy results. All the patients underwent 2nd-look ureteroscopy after 4 to 6 weeks since the first ureteroscopy, and after that follow-up flexible ureteroscopy was every 6 months.@*Results@#All the operations of 54 cases were successful. One case was treated with flexible ureteroscopy and percutaneous nephroscopy to treat the renal pelvis tumors, duo to the multiple and much larger tumors. Subjectively, NBI significantly provided a much clearer view of the tumors, especially their limits and vascular architecture. Objectively, 4 additional tumors (11.5%), as well the extended limits of 3 tumors (8.5%) were detected by NBI when findings by WLI were considered normal. The rate of diagnosis of tumors raised 20.0%.@*Conclusions@#Compared with WLI, NBI flexible ureteroscopy provided even more image of UTUC especially their border between tumor tissue and normal tissue. NBI improved the detection of UTUC over standard WLI with higher rate of diagnosis or lower rate of missed diagnosis.
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Objective To compare the lung protection roles of intraperitoneal pre-injection with penehyclidine for two kinds of rat models with pulmonary and extrapulmonary acute respiratory distress syndrome (ARDSp and ARDSexp). Methods Forty healthy adult Sprague-Dawley (SD) rats were randomly divided into five groups (each n = 8): the rats in sham group received only tracheotomy; the ARDS rat models were reproduced by intratracheal inhalation of 0.1 mol/L hydrochloric acid (HCl) 2 mL/kg to simulate ARDSexp (HCl group) and 0.15 mL/kg oleic acid (OA) intravenous injection to simulate ARDSp (OA group) after tracheotomy; and the rats in two intervention groups were intraperitoneal injected with penehyclidine 0.5 mg/kg. All rats were received mechanical ventilation immediately after model reproduction. Carotid arterial blood was collected 4 hours after model reproduction for determining the arterial partial pressure of oxygen (PaO2), and oxygenation index (PaO2/FiO2) was calculated. Carotid venous blood and lung tissues were harvested, and the levels of myeloperoxidase (MPO), interleukin-8 (IL-8) and nuclear factor-κB (NF-κB) in serum and lung tissue were determined by enzyme linked immunosorbent assay (ELISA). Pulmonary pathology was observed under optical microscope, and pathological score of Smith was calculated. Results Under optical microscope, a large number of inflammatory cells infiltration in lung tissue, obvious alveolar collapse, fibrous exudation in alveolar and alveolar hyaline were found in HCl group. In OA group, however, microvascular congestion and interstitial pulmonary edema were the main pathological changes, with alveolar structure being kept relatively intact. Compared with sham group, pathological score of Smith in HCl and OA groups were increased, oxygenation was lowered, and inflammatory factors levels in serum and lung tissue were increased with levels in lung tissue being higher than those in serum, without significant difference between the two models. When pretreated with penehyclidine, however, pathological injury induced by HCl or OA was alleviated, and pathological score of Smith was also decreased as compared with that of corresponding model groups (5.48±1.76 vs. 9.69±2.02, 3.97±2.14 vs. 8.71±2.18, both P < 0.05), PaO2/FiO2was raised significantly [mmHg (1 mmHg = 0.133 kPa): 323±55 vs. 211±27, 307±56 vs. 207±31, both P < 0.05], the inflammatory factors levels in serum and lung tissue were obviously decreased [MPO (μg/L): 11.91±1.55 vs. 14.82±1.25, 12.75±1.16 vs. 16.97±2.06 in serum, 25.80±3.36 vs. 35.18±4.01, 24.23±1.24 vs. 33.94±1.43 in lung tissue; IL-8 (ng/L): 358±30 vs. 459±25, 377±38 vs. 427±34 in serum, 736±53 vs. 866±51, 701±53 vs. 809±39 in lung tissue; NF-κB (ng/L):483±68 vs. 632±73, 514±83 vs. 685±78 in serum, 984±75 vs. 1 217±123, 944±90 vs. 1 163±105 in lung tissue;all P < 0.05]. But all parameters above were similar between the two pretreatment groups (all P > 0.05). Conclusions Inflammatory cell infiltration and alveolar collapse mainly happened in HCl induced ARDSp, while pulmonary interstitial edema and hemorrhage was mostly seen in ARDSexp rats induced by OA intravenous injection. There was no significant difference in oxygenation and inflammatory response between the two models of rats. Pre-intraperitoneal injection of penehyclidine equally improved oxygenation state, inhibited lung inflammation response, and reduced lung injury in the two kinds of ARDS, but there was no difference in protective role between two models pretreated with penehyclidine.
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Objective To investigate the effect of Anerdian type III solution on the treatment of acute gouty monoarthritis. Methods Total 108 cases of acute gouty monoarthritis were divided into two groups according to the method of random number table, including 56 cases in the Anerdian group and 53 cases in the Votalin group, respectively. The Anerdian group was applied Anerdian type III solution to compress the swelling joint wet for 30 minutes, while the Votalin group was given Votalin Emulgel for external application in the swollen joint. Then the scores of pain and redness were calculated, and the effects of local treatment were compared directly before and after the treatment, and these variables were also compared after 7 days. Results 24 hours and 72 hours after the treatment, the pain score in the Anerdian group was 3.44 ± 0.89 and 2.43 ± 0.73 (t=2.375, 3.393, P<0.01), while the pain score in the Votalin group was 3.85 ± 0.74 and 3.14 ± 0.68 (t=2.208, 3.120, P<0.01), respectively, which referred to improvement in both groups.And the score of redness in the Anerdian group was 1.57 ± 0.70 and 1.13 ± 0.35 (t=0.589, 0.964, P<0.01), while the score of redness in the Votalin group was 1.95 ± 0.73 and 1.61 ± 0.49 (t=0.151, 0.623, P=0.091, P<0.01) respectively. 24 hours and 72 hours after the treatment, the score of redness in the Anerdian group was smaller than that in the Votalin Group (t=3.379, 4.290, P<0.01). In Anerdian group, local treatment showed fully cured in 28 cases, marked effective in 15 cases, effective in 11 cases, not effective in 2 case, and total effective rate was 96.4% (54/56) after 7 days′treatment, while in Votalin group, local treatment revealed fully cured in 24 cases, marked effective in 11 cases, effective in 8 cases, not effective in 9 case, and total effective rate was 83.0% (44/53). There was statistically significant difference between the two groups in local treatment ( χ2=4.019, P<0.05). Conclusion Anerdian type III solution can alleviate the symptoms of acute gouty unilateral arthritis quickly. It hasbetter curative effect on local treatment of acute gouty monoarthritis than Votalin.
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Objective To explore the value of two dimentional colour Doppler flow image (2D-CDFI) combined with three-dimensional color power angiography (3D-CPA) in diagnosis of placenta accreta.Methods A total of 43 pregnant women at risk of placenta accreta selected from September 2010 to August 2015 were enrolled,and underwent 2D-CDFI and 3D-CPA to scan entire placenta.Taking the results of clinical outcome and delivery pathology of the placenta as standard,the ultrasound characteristics of 2D-CDFI and 3D-CPA were analyzed.Results Taking the results of clinical outcome and delivery pathology of the placenta as standard,24 were proved with placenta increta,3 patients with adherent placenta,2 patients with placenta percreta,14 patients with no placenta implantation.Out of 43 cases,29 cases displayed the placental thickening and rich blood vessels in placenta,and at interface of placenta and bladder wall in 2D-CDFI.For 2D-CDFI,19 cases were correctly diagnosed with placenta accrete,while 6 cases were mis-diagnosed and 4 cases missed diagnosed,the diagnosis coincidence rate by 2D-CDFI was 65.5％ (19/29).The ultrasound characteristics displayed irregular arranged myometrial arcuate artery,rich blood vessels at interface of placenta and bladder wall in 3D-CPA.For 3D-CPA,23 cases were correctly diagnosed with placenta accrete,3 cases were misdiagnosed,the diagnosis coincidence rate by 3D-CPA was 79.3％ (23/29).For 3D-CPA combined 2D-CDFI,1 case missed diagnosed,the diagnosis coincidence rate by combination 2D-CDFI with 3D-CPA was 96.6％ (28/29).Conclusions Placenta accrete can all be prenatally diagnosed by characteristic ultrasonic features of 2D-CDFI and 3D-CPA.But 3D-CPA can clearly display the range of placenta accrete lesions and the depth of the blood vessels diffused,has more advantage than two-gray scale ultrasound and 2D-CDFI and has broad application in clinic.
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Purpose To explore the application of vascular echo tracking technology in early stage vascular lesions of type 2 diabetes mellitus combined with proteinuria with normal intima and medial membrane of femoral artery,in order to provide evidence for early clinical intervention and to reduce complications of diabetes patients.Materials and Methods Fifty-two patients with type 2 diabetes mellitus diagnosed in Longgang Central Hospital from March 2015 to July 2016 were selected,20in proteinuria group and 32 in group without proteinuria.30 patients at the same stage with normal physical examination results were selected as control group.Vascular echo-tracking technology was used to check femoral arterial elasticity on both sides of the examinee,including stiffness parameter (β),pressure-strain elasticity modulus (Ep),arterial compliance (AC),augmentation index (AI) and one-point pulse wave velocity (PWVβ).Results ① Ep,β and PWVβ of femoral artery in diabetes patients were higher than those in control group,and AC was lower than that in control group.The differences was of statistical significance (P＜0.05).There was no statistical difference in AI between the two groups (P＞0.05).② Ep,β and PWVβ of femoral artery for patients in proteinuria group were higher than those in group without proteinuria and AC was also lower.The difference was of statistical significance (P＜0.05).There was no statistical difference in AI between the two groups (P＞0.05).③ After judgment and analysis,AC and diastolic blood pressure were of statistical significance for judgment,and sensitivity was 92.3％ and specificity 100.0％ when adopting its function to diagnose diabetes femoral arterial elasticity.Conclusion Vascular echo-tracking technology can accurately assess femoral elasticity for diabetes patients and is of great significance in early preventive treatment of diseases.The appearance ofproteinuria indicates that vascular elasticity function decreases dramatically.
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Objective The study was to investigate the spectrum and incidence of the hot-spot deafness gene mutations from non-syndromic hearing loss(NSHL)in Guizhou province.Methods Genomic DNAs of 356 patients of NSHI in Guizhou were obtained from peripheral blood and a deafness gene test chip was used to screen nine hot spot mutation in the gene GJB2,SLC26A4,GJB3 and mitochondria 12SrRNA.Results Eighty-eight (24.72%)out of 356 patients were found carrying at least one pathogenic gene mutation.Among them,40 patients with the GJB2 mutations were found(11.24%),including 19 cases(5.34%)of homozygous matutions,5 cases(1.40%)of com-pound heterozygous mutations,and 15 cases(4.21%)of single heterozygous mutations.Twenty-nine patients with the SLC26A4 mutations were found (8.15%),including 9 cases(2.53%)of homozygous mutations and 19 cases (5.34%)of single heterozygous mutations.Homogenic mitochondrial 12SrRNA 1555A>G mutations were in 10 patients(2.81%)and 1494C>T mutations in 10 patients (0.56%),and heterogeneous mitochondrial 12SrRNA 1555A>G mutations in 7 patients(1.97%).GJB3 gene c.538C>T heterozygous mutations was found in 1 patients. Conclusion The mutations of GJB2 and SLC26A4 gene are two major pathogenic genes for patients with NSHL in Guizhou province.Our study provides a theoretical basis for the early diagnosis,genetic counseling and treatment of deafness.
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Aim To study the molecular mechanism of Raptor in the migration and invasion of breast cancer cells and provide the clinical theory basis for prevention of breast cancer invasion and metastasis.Methods Western blot was used to detect the expression of Raptor protein in MCF-7 cells and MDA231 cells.The siRNA plasmids were used to transfect MDA231 cells.At the same time,the plasmid pcDNA3.1-Raptor was transfected into MCF-7 breast cancer cells.And Western blot was used to analyze the protein expression level of E-cadherin and Vimentin.Transwell was used to test the ability of invasion.Nucleus mass separation experiment was used to test the expression of Snail.Results The expression of Raptor protein in MDA231 cells was higher than in the MCF-7 cell.When the control group of Scr/MDA231 cells compared with siRaptor/MDA231,Raptor protein expression was decreased obviously after plasmid transfection interference,accompanied by reduction of Vimentin protein expression and increase of E-cadherin protein expression.Compared with MCF-7/Con,Raptor protein expression significantly increased in MCF-7/Raptor,accompanied by increase of Vimentin protein expression and reduction of E-cadherin protein expression.The number of cells through the artificial basilemma Transwell in siRaptor/MDA231 cells was significantly reduced(P<0.05),and the number of cells through the Transwell chambers artificial basilemma was significantly increased in MCF-7/Raptor(P<0.05).Nucleus mass separation experiment results showed that the expression of Snail decreased obviously in the siRaptor/MDA231 than in the Scr/MDA231,however,the expression of Snail was obviously higher in the MCF-7/Raptor.Conclusions Raptor can promote the occurrence of EMT in breast cancer,thus it promotes invasion and metastasis of breast cancer.
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Aim To explore the relationship between IL-8 and ELMO1 in breast carcinoma and the mecha-nisms of IL-8 induced invasion and metastasis. Meth-ods Under the IL-8 stimulation, chemotaxis assay was examined to detect the chemotaxis ability of breast cancer cell line MDA-MB-231 and MCF-7 . ELMO1 protein levels in breast cancer cell lines were detected using Western blot. MDA-MB-231 cells were transfect-ed with small RNA interference plasmids in order to downregulate ELMO1 expression, and overexpression plasmids were used to upregulate the expression of EL-MO1 in MCF-7 cells. Matrigel invasion assay and chemotaxis assay were used to detect the in vitro inva-sion and chemotaxis ability of breast cancer cells with IL-8 stimulation. Results IL-8 induced chemotaxis of the different breast cancer cell lines in a dose-depend-ent manner. After transient transfection, Western blot results showed that ELMO 1 protein levels observably decreased in SiELMO1/MDA-MB-231 cells compared with Scr/MDA-MB-231 cells, while the expression of ELMO1 protein levels significantly increased in MCF-7/ELMO1 cells compared with the MCF-7/Con cells;with IL-8 stimulation, SiELMO1/MDA-MB-231 cells showed significantly decreased chemotaxis ability com-pared with Scr/MDA-MB-231 cells. MCF-7/ELMO1 cells showed significantly increased chemotaxis ability compared with MCF-7/Con cells; the invasion assay showed under the stimulation of IL-8 , and the invasion ability was significantly reduced in SiELMO1/MDA-MB-231 cells compared with Scr/MDA-MB-231 cells ( P<0. 05 ) . The invasion ability was significantly en-hanced in MCF-7/ELMO1 cells compared with MCF-7 cells( P<0. 05 ) . Conclusion IL-8 promotes the in-vasion and migration of breast cancer cells MDA-MB-231 and MCF-7 , and ELMO1 plays an important role in IL-8 induced chemotaxis and invasion.
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AIM: To explore the protein levels of chemokine receptor 7 (CCR7) and vascular endothelial growth factor ( VEGF)-C in breast carcinoma , and to investigate the effects of CCR 7 and VEGF-C on prognosis of breast carcinoma.METHODS:The protein expression levels of CCR 7 and VEGF-C in the breast carcinoma tissues and normal breast tissues were detected by the method of immunohistochemistry .At the same time, the relationship between clinico-pathologic characteristics and the protein expression of CCR 7 and VEGF-C in the breast carcinoma tissues was analyzed . The relationship between the protein expression of CCR 7 and VEGF-C and survival time of the breast cancer patients was estimated by Kaplan-Meier method.RESULTS:The positive expression rates of CCR 7 and VEGF-C in the breast carcino-ma tissues were significantly higher than those in the normal breast tissues (P<0.01).A positive correlation was observed between the protein expression of CCR7 and the protein expression of VEGF-C in the breast carcinoma tissues (r=0.613, P<0.01).The protein expression of CCR7 and VEGF-C was correlated with lymph node metastasis and TNM stage (P<0.05), but both were not related to patients ’ age, primary tumor size, estrogen receptor and progesterone receptor .The survival time of the patients with CCR 7 and VEGF-C positive expression was significantly shorter than that of the patients without the expression (P<0.05).CONCLUSION:The positive expression of CCR7 and VEGF-C proteins is associated with the prognosis of breast cancer , and combined detection of CCR 7 and VEGF-C protein expression levels may be helpful to judge the prognosis of breast cancer .
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Objective To analyze the risk factors that affect severe infection following flexible ureteroscope Holmium laser lithotripsy for upper urinary tract calculus,and to construct the regression model and nomogram for predicting the probability of postoperative SIRS.Methods We retrospectively analyzed the clinical data from 457 cases (male 302 and female 155) of upper urinary calculi treated by flexible ureteroscopy from January 2014 to May 2016,with mean age of 49.9 (ranged 20-76) years.The mean maximum size of stones was (16.5 ± 3.0) mm (ranged 12-22rmm).There were 51 cases (11.2％) with a recent infectious febrile history related to stones.The patients were divided into two groups as patients developing SIRS or not.Univariate and multivariate statistical analyses were performed to determine factors affecting the development of postoperative SIRS,and then a nomogram was built based on regression coefficients.Results The incidence of SIRS after flexible ureteroscopic lithtripsy was 5.9％ (27/457).Multivariable logistic regression analysis identified febrile history related to urinary stones (OR =1.5569,P =0.009),without preoperative placement of ureteral stent (OR =1.4004,P =0.004),small-caliber (F 13-14) ureteral access sheath (OR =1.1120,P =0.016),endoscopic signs of infection (OR =2.0176,P =0.000) and infectious stones (OR =1.0981,P =0.013) as independent risk factors for postoperative SIRS.The concordance index was 0.845 in the nomogram model sample and 0.79 in the validation sample.Conclusions Febrile history related to urinary stones,without preoperative placement of ureteral stent,small-caliber ureteral access sheath,endoscopic signs of infection and infectious stones would be independent risk factors to predict SIRS after flexible ureteroscope holmium laser lithtripsy.A nomogram based on perioperative clinical factors could be used to predict the risk of SIRS.