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Objective:To monitor intra-fractional set-up errors in tumor radiotherapy using a real-time intelligent capture system for precision displacement.Methods:A simulated radiotherapy environment was created in both the laboratory and the treatment room. A three-axis ( xyz) displacement platform (LD60-LM) and dial gauges were used as displacement measurement tools. Moreover, a real-time intelligent capture system for precision displacement was developed for displacement monitoring. With 23 patients treated with radiotherapy enrolled in this study, the above system was employed to monitor their intra-fractional set-up errors in fractionated radiotherapy. Descriptive analyses were conducted on the deviations between the data captured by cameras and the actual displacement, obtaining the mean values and standard deviation. Results:The monitoring calibration data from the laboratory revealed displacement differences of ≤ 0.5 mm within 20 mm and a maximum displacement difference of 1.47 mm for 50 mm. In contrast, the calibration result from the treatment room exhibited deviations of ± 0.2 mm on the y- z axes, as displayed by both the left and right cameras, and ± 0.31 mm on the x- z axes, as displayed by the middle camera. During 37 radiotherapy sessions in 23 patients, the monitoring result from the middle camera revealed five deviations exceeding the threshold of 5 mm, with the maximum deviation duration and displacement of 57.2 s and 9.24 mm, respectively. Conclusions:The real-time intelligent capture system for precision displacement based on machine vision can achieve real-time monitoring of set-up errors during tumor radiotherapy. Nevertheless, further improvements and service testing are necessary for this system.
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BACKGROUND@#Knee osteoarthritis (KOA) is a prevalent chronic joint disease caused by various factors. Mesenchymal stem cells (MSCs) therapy is an increasingly promising therapeutic option for osteoarthritis. However, the chronic inflammation of knee joint can severely impede the therapeutic effects of transplanted cells. Gelatin microspheres (GMs) are degradable biomaterial that have various porosities for cell adhesion and cell–cell interaction. Excellent elasticity and deformability of GMs make it an excellent injectable vehicle for cell delivery. @*METHODS@#We created Wharton’s jelly derived mesenchymal stem cells (WJMSCs)-GMs complexes and assessed the effects of GMs on cell activity, proliferation and chondrogenesis. Then, WJMSCs loaded in GMs were transplanted in the joint of osteoarthritis mice. After four weeks, joint tissue was collected for histological analysis. Overexpressing-luciferase WJMSCs were performed to explore cell retention in mice. @*RESULTS@#In vitro experiments demonstrated that WJMSCs loaded with GMs maintained cell viability and proliferative potential. Moreover, GMs enhanced the chondrogenesis differentiation of WJMSCs while alleviated cell hypertrophy. In KOA mice model, transplantation of WJMSCs-GMs complexes promoted cartilage regeneration and cartilage matrix formation, contributing to the treatment of KOA. Compared with other groups, in WJMSCs+GMs group, there were fewer cartilage defects and with a more integrated tibia structure. Tracking results of stable-overexpressing luciferase WJMSCs demonstrated that GMs significantly extended the retention time of WJMSCs in knee joint cavity. @*CONCLUSION@#Our results indicated that GMs facilitate WJMSCs mediated knee osteoarthritis healing in mice by promoting cartilage regeneration and prolonging cell retention. It might potentially provide an optimal strategy for the biomaterial-stem cell based therapy for knee osteoarthritis.
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Objective To explore the effects of Jinghou Zengzhi Granules(JHZZG),on ovarian GDF9 secretion and granulosa cells(GCs)apoptosis in controlled ovarian hyperstimulation(COH)rats through p38MAPK/CK2/IκBα/NF-κB pathway.Methods A model of COH rats was prepared and 18 rats were randomly divided into 3 groups,including natural ovulation group(NO group),COH group,and COH+JHZZG group.The expression of p38MAPK,CK2,IκBα,NF-κB,GDF9 mRNA and protein were detected by qRT-PCR and Western blot,and the apoptosis rate of ovarian GCs by TUNEL.Results Compared with the NO group,the expression of p38MAPK and NF-κB in the ovarian tissue of rats in the COH group increased,while the expression of CK2,IκBα and GDF9 decreased,and the apoptosis rate of ovarian GCs increased(all P<0.01).Compared with the COH group,the expression of p38MAPK and NF-κB in the ovarian tissue of rats in the COH+JHZZG group decreased,while the expression of CK2,IκBα and GDF9 increased(all P<0.01),and the apoptosis rate of ovarian GCs decreased(P<0.05).Conclusion Jinghou Zengzhi Granules could promote the secretion of ovarian GDF9 and inhibit the apoptosis of ovarian GCs of COH rats through p38MAPK/CK2/IκBα/NF-κB signaling pathway,which thereby improve the quality of COH oocytes.
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OBJECTIVE It's known that post-retrieval extinction but not extinction alone could erase fear memory.However,whether the coding pattern of original fear engrams is remod-eled or inhibited remains largely unclear.Here we try to investigate whether the coding pattern of memory engrams is altered during post-retrieval extinction induced memory updating.METHODS To answer the question,by using activity-depen-dent neuronal-tagging technology,neuronal trac-ing technique combined with optogenetic manipu-lation and in vivo calcium imaging,we identified the fear and extinction cells in PrL and BLA and investigated the dynamic encoding of memory engram ensembles in the PrL and BLA during CS versus US initiated memory updating.RESULTS We found increased reactivation of engram cells in the prelimbic cortex and basolat-eral amygdala during memory updating.More-over,conditioned stimulus and unconditioned stimulu sinitiated memory updating depend on the engram cells reactivation in the prelimbic cor-tex or basolateral amygdala respectively.Finally,we found memory updating causes increased overlapping between fear and extinction cells and the original fear engrams encoding was altered during memory updating.CONCLUSION Our data provide the first evidence to show the overlapping ensembles between fear and extinc-tion cells and functional reorganization of original engrams underlying conditioned stimulus and unconditioned stimulus initiated memory updating.
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Trace amines(TAs)are metabolically related to catecholamine and associated with cancer and neuro-logical disorders.Comprehensive measurement of TAs is essential for understanding pathological pro-cesses and providing proper drug intervention.However,the trace amounts and chemical instability of TAs challenge quantification.Here,diisopropyl phosphite coupled with chip two-dimensional(2D)liquid chromatography tandem triple-quadrupole mass spectrometry(LC-QQQ/MS)was developed to simul-taneously determine TAs and associated metabolites.The results showed that the sensitivities of TAs increased up to 5520 times compared with those using nonderivatized LC-QQQ/MS.This sensitive method was utilized to investigate their alterations in hepatoma cells after treatment with sorafenib.The significantly altered TAs and associated metabolites suggested that phenylalanine and tyrosine metabolic pathways were related to sorafenib treatment in Hep3B cells.This sensitive method has great potential to elucidate the mechanism and diagnose diseases considering that an increasing number of physiological functions of TAs have been discovered in recent decades.
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Objective:To investigate the correlation between systemic inflammatory response index (SIRI) and the outcomes at 90 d after intravenous thrombolysis in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke received intravenous thrombolysis in Nanjing Drum Tower Hospital from January 2016 to December 2019 were retrospectively enrolled. SIRI was calculated according to neutrophil count, lymphocyte count, and monocyte count at admission. The modified Rankin Scale score was used to evaluate the outcomes at 90 d after onset. 0-2 was defined as good outcome, and 3-6 were defined as poor outcome. Multivariate logistic regression analysis was used to evaluate the independent correlation between SIRI and poor outcomes. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SIRI for poor outcomes. Results:A total of 303 patients with acute ischemic stroke receiving intravenous thrombolysis were enrolled in the study, including 178 (58.7%) males. Their median age was 69 years (interquartile range 60-78 years), and 69 patients (22.8%) had poor outcomes. SIRI in the poor outcome group was significantly higher than that in the good outcome group (1.53±2.45 vs. 3.51±4.73; P<0.05). Multivariate logistic regression analysis showed that the National Institutes of Health Stroke Scale (NIHSS) score at admission (odds ratio [ OR] 1.230, 95% confidence interval [ CI] 1.151-1.315; P<0.001) and SIRI ( OR 1.240, 95% CI 1.074-1.432; P=0.003) were significantly associated with the poor outcomes at 90 d. ROC curve analysis showed that the areas under the curve for SIRI and NIHSS scores alone and in combination to predict poor outcomes were 0.721 (95% CI 0.650-0.792; P<0.001), 0.824 (95% CI 0.771-0.878; P<0.001) and 0.853 (95% CI 0.804-0.902; P<0.001), respectively. The best cut-off values were 1.59, 8.00, and 0.23, respectively, and the sensitivity and specificity were 60.9% and 73.9%, 76.8% and 75.6%, 75.4% and 82.5%, respectively. Conclusions:High SIRI at admission is independently associated with 90-day poor outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis. SIRI may be used as an outcome predictor in patients undergoing intravenous thrombolysis.
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Objective:To explore the effect of Z type lateral decubitus position in patients with stroke-related pneumonia.Methods:Totally 52 patients with stroke-related pneumonia admitted to the neurology care unit in Qilu Hospital of Shandong University (Qingdao) were randomly divided into the control group and the observation group with 26 cases in each group from February to December 2021.The control group adopted routine position management, and the observation group adopted the Z type lateral decubitus position to observe. The differences in sputum volume, clinical pulmonary infection score (CPIS), blood oxygen saturation change, and hospital stay between the two groups were compared.Results:The SpO 2 was 0.966 ± 0.210 in the observation group and 0.948 ± 0.223 in the control group on the 7th day after the implementation of the measures. There was a significant difference between the two groups ( t=3.07, P<0.01). The sputum aspiration volume of the observation group was (30.65 ± 10.01), (39.27 ± 11.30), (36.92 ± 12.94) ml on the 1st, 3rd, 7th day after the implementation of the measures, which were significantly higher than those of the control group (24.81 ± 9.55), (28.92 ± 9.40), (27.65 ± 7.85) ml. The differences were statistically significant ( t=2.16, 3.59, 3.12, P<0.05). On the 7th day after implementation, the CPIS score of the observation group was 4.54 ± 1.63, which was better than that of the control group 5.46±1.61 ( t=-2.06, P<0.05). The average length of stay in the observation group was (13.35 ± 2.74) d, which was significantly shorter than (15.46 ± 4.42) d in the control group ( t=-2.07, P<0.05). Conclusions:The use of Z type lateral decubitus position has a positive significance for the rehabilitation and recovery of patients with stroke-related pneumonia. This position can promote sputum drainage and improve patients pulmonary function, accelerate the dissipation of patient inflammation, and reduce the length of hospital stay.
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Thyroid cancer is one of the most common malignant tumors. After standardized surgery, selective
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Objective:To compare the clinical efficacy of transperitoneal robot assisted laparoscopic radical prostatectomy (RARP) versus extraperitoneal single port RARP.Methods:A retrospective analysis was perfoumed on 142 cases of RARP from July 2019 to June 2020 in Robotic Minimally Invasive Center of Sichuan Provincial People's Hospital, including 82 cases(Group A) , aged 70.0(65.6-78.0), undergoing transperitoneal RARP and 60 cases(Group B), aged 68.2 years old(60.1-79.2), undergoing extraperitoneal single port RARP. For group A, PSA was 12.9(5.6-64.0) ng/ml, with 26 cases of less than 10 ng/ml(31.7%), 40 cases of 10-20 ng/ml(48.8%), and 16 cases of more than 20 ng/ml(19.5%), the Gleason score was 7.2(6.0-10.0), with 14 cases(17.1%) of ≤6, 56 cases(68.3%) of 7, and 12 cases(14.6%) of ≥8, and the prostate volume was 61.3(29.0-112.0) ml. There were 49 cases with BMI≤25 kg/m 2, accounting for 59.8%, and 33 cases with BMI>25 kg/m 2, accounting for 40.2%. There were 17 cases(20.7%) of T 1, 44 cases(53.7%) of T 2 and 21 cases(25.6%) of T 3. The proportion of lymph node dissection was 17.1%, and 4 cases(4.9%)had a history of operation. For group B, the PSA was 12.2(1.0-42.6)ng/ml, with 20 cases (33.3%) of <10 ng/ml, 31 cases(51.7%)of 10-20 ng/ml, and 9 cases (15%) of >20 ng/ml. Gleason score was 7.1(6.0-9.0), with 12 cases (20.0%) of ≤6, 42 cases (70.0%) of 7, and 6 cases (10.0%)of ≥8. Prostate volume was 42.4(31.2-72.8)ml on average. There were 37 cases (61.7%) with BMI≤25 kg/m 2, and 23 cases (38.3%)with BMI >25 kg/m 2 . There were 17 cases(28.3%)of T 1, 32 cases(53.3%)of T 2 and 11 cases(18.3%)of T 3.The proportion of lymph node dissection was 11.7% and 4 cases (6.7%) had a history of operation.There was no statistically significant difference in term of age, PSA level, Gleason score, BMI, clinical stage, proportion of lymph node dissection or history of operation between the two groups( P>0.05), but there was statistically significant difference for prostate volume( P<0.05). All operations were performed by the same operator. Four different ways of bladder neck and urethral dissociation was selected according to the intraoperative conditions in Group A, include VIP style, T-shape incision style, VIP plus T-shape incision style or the style along the lateral side of the bladder neck. Small and single anterograde incision stripping of bladder neck was routinely performed in the Group B. Postoperative follow-up was performed to compare the operation time, intraoperative blood loss, bladder neck and urethral anastomosis time, postoperative hospital stay, postoperative exhaust time, postoperative complications, positive rate of surgical margin, indwelling time of urinary catheter, urinary continence satisfaction rate of immediately after operation, 3 months and 6 months after operation, wound healing and aesthetics. Results:All of the operations were successfully completed under robot-assisted laparoscopy, and there was no conversion to open surgery. The operation time was 56.0(45.0-112.0) min in the Group A and 65.4(55.5-96.8) min in the Group B, and there was no statistically significant difference( P>0.05). The intraoperative blood loss was 76.2(30.0-120.5) ml and 55.6(45.5-114.6) ml, respectively, and the difference was not statistically significant( P>0.05). The time of bladder neck urethral anastomosis was 18.9(12.6-25.6) min and 16.2(10.7-19.3) min, respectively, and the difference was not statistically significant( P>0.05). The postoperative hospital stay days were 9.3(8.0-16.0) d and 8.4(7.0-13.0) d, respectively, and the difference was not statistically significant( P>0.05). The postoperative exhaust time was 1.3(0.7-3.0) d and 3.4(2.0-7.0) d, respectively, and the difference was statistically significant( P<0.05). There was 1 case of anastomotic fistula with ureteral injury in Group A, and no serious complication in Group B, and the difference was not statistically significant( P>0.05). The number of positive surgical margin in the two groups was 13(15.9%)and 9(15.0%)respectively, and the difference was not statistically significant( P>0.05). The indwelling time of urinary catheter after operation was 9(7-21) d and 6(4-8) d, respectively, and the difference was statistically significant( P<0.05). The number of patients with satisfactory urinary continence immediately after surgery, 3 months and 6 months after surgery in the two groups were 8(9.8%), 51(62.2%), 62(75.6%) and 17(28.3%), 43(71.7%) and 54(90.0%), respectively. The differences were statistically significant( P<0.05). The total incision lengths in the two groups were 12.1(10.4-13.4) cm and 5.6(5.0-6.0) cm, respectively, and the difference was statistically significant( P<0.05). Conclusions:The extraperitoneal single port RARP is safe and feasible, and the postoperative effect is similar to that of transperitoneal RARP. It has the advantages of shorter recovery time, higher urinary continence satisfaction rate, neater and more beautiful incision. The long-term therapeutic effect needs further confirming by prospective study.
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OBJECTIVE@#To investigate the relationship between sleep quality and bone mineral density (BMD) in urban residents.@*METHODS@#Data of 28 756 Han adults (14 355 males and 14 401 females), who completed both Pittsburgh sleep quality index (PSQI) assessment and radial BMD tests by dual energy X-ray absorptiometry in the Health Management Center of Southwest China University from June 2012 to June 2019 were retrospectively analyzed. The degree of sleep disorder was determined based on PSQI scores, while osteopenia and osteoporosis was diagnosed according to BMD T-value. The test and multiple regression model were used to investigate the relationship between sleep quality and BMD.@*RESULTS@#The numbers of normal BMD, osteoponia and osteoporosis were 17 039 (59.3%), 7916(27.5%) and 3801(13.2%), respectively. The mean PSQI score was 5.6±1.4 points. According to PSQI scores, there were 15 936 subjects without sleep disorder (55.4%), 5965 with mild (20.7%), 4897 with moderate (17.0%) and 1958 with severe sleep disorder (6.8%), respectively. There was no significant difference in osteoponia/osteoporosis rate between subjects with mild sleep disorder and normal ones (=0.948, >0.05), while the rate of osteoporosis in moderate sleep disorder group was higher than that in mild group (=525.583, <0.01), and the rate of osteoponia/osteoporosis in severe sleep disorder group was much higher than that in moderate group (=1124.877, <0.01). Multiple regression results showed that female, elders, mental labor, smoking and higher PSQI scores were independently associated with lower T-value (all <0.05), while moderate to intense daily physical activity was associated with higher T-value (<0.05).@*CONCLUSIONS@#Sleep disturbances may be a major risk factor for BMD loss in urban residents, indicating that it would be a potential target of osteoporosis prevention.
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Objective:To investigate the diagnostic value of renal injury molecule-1 (KIM-1) and β2-microglobulin (β2-MG) concentration in hypertensive disorder of pregnancy (HDP) complicated with early renal injury.Methods:From July 2017 to October 2018, the clinical data of 56 pregnant women with HDP complicated with renal injury and 56 normal pregnant women in the same period in Xi′an Central Hospital were analyzed retrospectively.The pregnant women with HDP complicated with renal injury were the observation group and the 56 normal pregnant women were the control group.The difference of serum creatine (SCr), KIM-1, β2-MG concentration between the two groups at 30, 32, 34 and 36 weeks of gestation was compared, and the value of KIM-1, β2-MG combined diagnosis of early renal injury in HDP was analyzed.Results:At 30, 32, 34 and 36 weeks of gestation, Kim-1, β2-MG and SCr in the observation group increased significantly (Kim-1: Fintra-group=11.234, β2-MG: Fintra-group=12.852, SCr: Fintra-group=8.308; all P<0.001). In the observation group, SCr(30 weeks, 32 weeks, 34 weeks, 36 weeks: (75.35±10.32), (75.41±10.35), (77.02±10.50), (87.78±10.64) μmol/L), Kim-1 (30 weeks, 32 weeks, 34 weeks, 36 weeks: (5.68±1.50), (7.56±1.52), (8.25±1.62), (9.65±1.76) ng/L), β2-MG (30 weeks, 32 weeks, 34 weeks, 36 weeks: (0.26±0.07), (0.29±0.08), (0.75±0.29), (1.02±0.38) ng/L) were all higher than those of control group SCr(30 weeks, 32 weeks, 34 weeks, 36 weeks: (74.37±10.34), (74.43±10.40), (75.10±12.52), (76.80±11.66) μmol/L), Kim-1 (30 weeksL, 32 weeks, 34 weeks, 36 weeks: (5.31±1.75), (5.36±1.77), (5.39±1.60), (5.41±1.70) ng/L), β2-MG (30 weeks, 32 weeks, 34 weeks, 36 weeks: (0.25±0.07), (0.26±0.09), (0.28±0.08), (0.27±0.08) mg/L), the difference was statistically significant (SCr: Fintergroup=10.254, Kim-1: Fintergroup=16.352, β2-MG: Fintergroup=18.221; all P<0.001). There were interaction between the two groups at different time(SCr: Finteraction=15.632, Kim-1: Finteraction=25.645, β2-MG: Finteraction=34.251; all P<0.001). The sensitivity, specificity and accuracy of Kim-1 combined with β2-MG were 96.43% (54/56), 94.64% (53/56) and 95.54% (107/112), respectively.It was significantly better than Kim-1 alone (88.24% (45/51), 92.86% (52/56), 86.61% (97/112)), β2-MG alone (81.13% (43/53), 78.57% (44/56), 77.68% (87/112)), the difference was statistically significant (all P<0.05). Conclusion:The serum levels of KIM-1 and β2-MG in pregnant women with early renal injury of HDP are significantly increased, which can be used as a reliable indicator for prenatal monitoring and screening of early renal injury, and the combined detection can improve the accuracy of diagnosis.
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Objective:To evaluate the effectiveness of anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft.Methods:A retrospective analysis was made of the clinical data of 12 patients who had undergone anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft between December 2016 and January 2018. They were 8 males and 4 females, aged from 18 to 38 years (mean, 21.8 years). According to the AO/OTA classification, 5 cases were defined as type 12-A1.2, 2 as type 12-A1.3, 2 as type 12-B1.2, 2 as type 12-B1.3 and one as type 12-C1.1. The operation time, intraoperative blood loss, early postoperative complications and union time were recorded; the functional recovery of the elbow joint was evaluated by the Mayo elbow performance score (MEPS) and that of the shoulder by the University of California at Los Angeles (UCLA) shoulder rating scale at the final follow-up.Results:The mean operation time was 63 minutes (range, from 43 to 130 minutes), and the mean intraoperative blood loss 139 mL (range, from 60 to 280 mL). All incisions healed by the first intention without any neurologic complications or wound infection. All the 12 patients were followed up for 10 to 21 months (mean, 13.7 months). Bony union was obtained in all cases after 11 to 20 weeks (mean, 15.8 weeks). No loosening or breakage of internal fixation occurred. At the final follow-up, the MEPS ranged from 90 to 100 (mean, 99) and the UCLA shoulder scores from 31 to 35 (mean, 34.5).Conclusion:Anterior minimally invasive osteosynthesis using a locking compression plate is safe and feasible for spiral fractures of the mid-distal humeral shaft, leading to minimal invasion, a low risk for iatrogenic nerve injury and satisfactory effectiveness.
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Objective To investigate the Rv2346c gene function through constructing Rv2346c gene knockout strains of Mycobacterium tuberculosis (M . tuberculosis) mediated by bacteriophage and observing its virulence after infecting mice lung tissue in vivo .Methods The affinal exchange sites (AES) of the target gene was built ,and then integrated into the phage genomes of M .tuberculosis for harvesting the phagemids .The phagemids was imparted into Mycobacterium smegmatis to get recombinant phages with the same AES .A high titer of the recombinant phages was harvested through amplification in vitro . The M .tuberculosis was transfected and coated on solid medium with hygromycin resistance and cultured for 4 weeks at 37℃ .Single clone was picked out and gene knock-out was confirmed by PCR . Then C57BL/6J mice were infected with either wild type strain (WT ) or knockout strain (KO ) of M . tuberculosis .Mice mortality ,lung tissue inflammation and colony-forming units (CFU ) counts in vitro were observed 6 to 8weeks post infection with different strains . Paired-samples t test was used for comparison between groups ,chi-square test was used for comparison of rates .Results The products of PCR and inserted fragment sizes were consisted with the expectation and confirmed to be the target gene . The target fragment of Rv2346c was removed successfully and the mice were infected for 6-8 weeks .Themice infected with Rv2346c KO strain had reduced mortality (53％ vs 20％ ,χ2 =6 .1112 ,P<0 .05) ,lung tissue inflammation (1040 ± 89 vs 1960 ± 56 ,t=7 .1016 ,P<0 .05) and CFU count in vitro (15 .0 ± 0 .8 vs 90 .0 ± 1 .5 ,t=23 .0361 , P<0 .05) compared with WT strain 6-8 weeks post infection .Conclusion Rv2346c gene knockout strains of M . tuberculosis mediated by bacteriophageis are successfully constructed ,which establishes the foundation for the future gene function study of Rv2346c .
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Objective To investigate the association between silent intralesional micro-hemorrhage (SIM) and symptomatic intracranial hemorrhage (ICH) of brain arteriovenous malformations (bAVMs) by using evidence of old hemorrhage (EOOH) and hemosiderin dyeing results.Methods Sixty-three patients with bAVMs,admitted to our hospital firom September 2014 to September 2016,were chosen in our study;their clinical and pathological data were retrospectively analyzed.Logistic regression analysis was performed to assess the correlations of ICH of bAVMs with EOOH and Prussian blue staining results after adjusting the factors as gender,age,lesion size,location,single or multiple supplying arteries and deep venous drainage.Results Gender,age,lesion size were not associated with ICH of bAVMs,while single or multiple supplying arteries,deep venous drainage and SIM were significantly associated with ICH ofbAVMs.EOOH and Prussian blue staining results were the independent predictors of ICH ofbAVMs (OR=5.507,95％CI:1.208-25.111,P=0.028;OR=6.055,95％ CI:1.479-24.793,P=0.012).Conclusion ICH of bAVMs could be proved by EOOH and hemosiderin,and EOOH could serve as a potential predictor ofICH ofbAVMs.
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Objective To investigate the effectiveness of follow-up learning of difficult cases triage in outpatient triage training. Methods From June 2016 to September,on-duty nurses were required to register the difficult cases who needed to follow up. The case study plan was implemented.The consistency between difficult cases triage and the follow-up results and the rate of complaints from triage were compared between pre-and post-implementation of triage training. Results The rate of consistency between the difficult cases triage and the follow-up results after the implementation was significantly higher than that before the implementation(P<0.05).The rate of complaints from triage was significantly lower than that before the implementation(P<0.05). Conclusion The model of difficult cases follow-up learning is effective in improving the triage accuracy in outpatient departments and bettering the patients'experience.
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Objective To assess the influence of miRNA (miR)-124 ,miR-26A and miR-126 single nucleotide polymorphism (SNPs) on the prognosis in patients with colorectal cancer (CRC) .Methods A total of 724 cases of patients with CRC treated in this hospital from July 2011 to December 2013 served as the research subjects .The peripheral blood samples were collected ,and genotype analysis of miR-124 rs531564 ,miR-26A rs7372209 and miR-126 rs4636297 SNPs locus were performed by using the PCR-LDR .The patient′s overall survival (OS) and progression-free survival (PFS) were calculated by using Kaplan-Meier method ,and the univariate log-rank method was used to analyse the influence of different genotypes and haplotypes of SNPs on OS and PFS .Re-sults The OS after operation in CRC patient′s carrying miR-124 rs531564 CG genotype was decreased compared with that in pa-tients carrying CC genotype ,and the patient′s death risk was increased[HR2 =1 .450 ,95% CI(1 .043-2 .017) ,P=0 .026];the pa-tient′s death risk in patients carrying GG genotype was also increased compared with that in patients carrying CC genotype [HR2 =2 .339 ,95% CI(1 .171-4 .674)];in the dominant gene model ,the OS in patients carrying CG +GG genotype was significantly de-creased compared with patients carrying CC genotype [HR2 = 1 .532 ,95% CI(1 .119 -2 .096) ,P= 0 .008];in the recessive gene model ,no statistically significant difference was found in OS between patients carrying GG genotype and those carrying CC + CG genotype[HR2 =1 .975 ,95% CI(1 .000-3 .900) ,P=0 .0052];in the co-dominant model ,compared with patients carrying CC+CG genotype ,the OS in patients carrying CG genotype was decreased and their death risk was increased [HR2 =1 .395 ,95% CI(1 .007-1 .931)] .There was no correlation of miR-26A rs7372209 locus and miR-126 rs4636297 locus gene SNPS to OS and PFS in CRC patients (P>0 .05) .Conclusion miR-124 rs531564 gene polymorphism might be an independent influence factor of the prognosis in CRC patients .
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Objective According to the assessment results of Norton Scale at admission, to evaluate the prognostic of Norton Scale on postoperative complications after total hip arthroplasty (THA) in elderly patients, and to guide clinical practice. Methods A prospective study was conducted. Selected the quasi for THA in elderly patients as the research object. The patients were divided into low Norton group(total scale score≤14 points, 28 cases) and high Norton (total scale score≥15 points, 125 cases) according to the Norton Score. Postoperative complications after THA between the two groups were compared. Results The postoperative complications of wound infection, urinary tract infection, urinary retention, bedsore and deep vein thrombosis after THA was 32.1％(9/28), 17.9％(5/28), 10.7％(3/28), 10.7％(3/28), 14.3％(4/28) in low Norton group and 2.4％(3/125), 1.6％(2/125), 1.6％(2/125), 0.8％(1/125), 1.6％(2/125) in high Norton group, and there was significant difference (P<0.05). Logistic regression analysis showed that low Norton were independently associated with postoperative complications (P<0.05), the probability model of judgment after total hip replacement surgery complications accuracy was 86.9％, sensitivity was 96.5％, specificity was 60.0％. Conclusions In addition to predicting pressure ulcer risk, the Norton Scale may be used to predict the incidence of postoperative complications in elderly patients with THA.
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AIM: To investigate the protective effect of microRNA-218 (miR-218) silencing on kidney tissue of streptozotocin (STZ)-induced diabetic nephropathy rats and the potential mechanism.METHODS: The diabetic rat model was established by a single intraperitoneal injection of STZ (50 mg/kg).Meanwhile, the miR-218 short hairpin RNA (shRNA) lentiviral vector was constructed.The Sprague-Dawley rats were randomly divided into 4 groups: healthy control group, diabetes group, empty vector group and miR-218-shRNA group.The blood glucose, 24 h urinary protein, serum creatinine (SCr) and blood urea nitrogen (BUN) in the rats at different time points (4, 8 and 12 weeks) were measured by an automated analyzer.The expression of miR-218 was detected by RT-qPCR, while the expression of heme oxygenase-1 (HO-1), nephrin and p38 mitogen-activated protein kinase (p38 MAPK) at mRNA and protein levels in the kidney tissues was determined by RT-qPCR and Western blot.The caspase-3 activity was detected by caspase-3 activity assay kit, and the cell apoptosis of the kidney tissues was analyzed by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL).RESULTS: Compared with healthy control group, the expression of miR-218 was significantly increased in STZ-treated rats.Meanwhile, the concentrations of blood glucose, 24 h urinary protein, SCr and BUN were significantly increased in STZ-treated rats (P<0.05).The mRNA and protein expression of HO-1 and nephrin was significantly decreased, while the level of phosphorylated p38 MAPK was significantly increased in STZ-treated rats.In addition, the activity of caspase-3 was also significantly increased in STZ-treated rats.When the model rats were infected with miR-218-shRNA, the expression of miR-218 was significantly decreased and the above effects were markedly reversed.Furthermore, TUNEL results showed that compared with diabetic group and empty vector group, miR-218 silencing significantly attenuated the cell apoptosis in the kidney tissues in miR-218-shRNA group.CONCLUSION: miR-218 is involved in the kidney injury in diabetic rats, and silencing of miR-218 by lentiviral vector-mediated miR-218-shRNA transfection effectively inhibits kidney cell apoptosis, suggesting that miR-218 is a potential target for the treatment of diabetic nephropathy.
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Objective To investigate the effect of cluster nursing in the prevention of aspiration pneumonia in patients with cerebral infarction. Methods A total of 72 patients with acute cerebral infarction from January 2014 to January 2014 were recruited and divided into 2 groups with 36 cases each by random digits table method. The patients in control group were given diet nursing, nursing of sputum ejection, education of disease related knowledge and another routine nursing methods. While cluster nursing such as the application of swallowing function training, feeding management, homemade angle measuring instrument for position management were conducted on the patients in intervention group. The difference of incidence of aspiration pneumonia, improvement of swallowing function, and patient satisfaction between two groups were compared. Results The incidence of aspiration pneumonia was 5.56%(2/36) in intervention group and 25.00%(9/36) in control group, and the difference was statistically significant (χ2=5.258, P=0.022).The swallowing function ratings after treatment in intervention group was also obviously better than that in control group, and the difference was statistically significant (χ2=7.943, P=0.036). The patient satisfaction was 94.44%(34/36) in intervention group and 63.89%(23/36) in control group, and the difference was statistically significant(χ2=17.526,P=0.000). Conclusions Cluster nursing can effectively reduce the risk of aspiration pneumonia in acute cerebral infarction patients, and help to improve the patients' swallowing function and relationship between nurses and patients, has certain clinical application value.
ABSTRACT
Objective To investigate the effect of maternal limb ischemic preconditioning on the expression of caspase-3 in neurons in brain tissues after reoxygenation in the fetal rats with intrauterine distress.Methods Forty Sprague-Dawley rats at 19 days of gestation were randomly divided into 4 groups (n=10 each) using a random number table:sham operation group (group S),limb ischemic preconditioning group (group LIP),fetal rat distress group (group FD),and limb ischemic preconditioning + fetal rat distress group (group LIP+FD).Distress/reoxygenation model was established by clamping the uterine and ovarian arteries and veins with a micro-artery clamp for 15 min followed by removal of the clamp to permit reperfusion.Limb ischemic preconditioning was induced by 3 cycles of occlusion of the lower limb blood flow at the site of the right groin for 5 min with a tourniquet followed by 5 min unclamping.In group LIP+ FD,the uterine and ovarian arteries and veins were clamped,and limb ischemic preconditioning was performed at the same time.Cesarean section was performed on 2 days after the end of treatments in each group,and the fetal rat mortality rate was calculated.The fetal rats alive were sacrificed,and the hippocampi were isolated for determination of neuronal apoptosis (by TUNEL) and expression of caspase-3 protein and mRNA (by Western blot and real-time reverse transcriptase polymerase chain reaction,respectively) in hippocampal CA1 region.Apoptosis index was calculated.Results Compared with group S,the fetal rat mortality rate and apoptosis index were significantly increased,and the expression of caspase-3 protein and mRNA in hippocampal CA1 region was significantly up-regulated in FD and LIP+FD groups (P＜0.05 or 0.0l),and no significant change was found in the parameters mentioned above in group LIP (P＞0.05).Compared with group FD,the fetal rat mortality rate and apoptosis index were significantly decreascd,and the expression of caspase-3 protein and mRNA iu hippocampal CA1 region was significantly down-regulated in group LIP+FD (P＜0.05 or 0.01).Conclusion The mechanism by which maternal limb ischemic preconditioning inhibits apoptosis in neurons after reoxygenation is related to down-regulation of the expression of caspase-3 in the fetal rats with intrauterine distress.