Correlation between uterine incisional hematoma following cesarean section and scar diverticulum / 中华围产医学杂志

Objective:To investigate the correlation between the uterine incisional hematoma following cesarean section and scar diverticulum.Methods:This is a retrospective study involving 1 939 women who underwent cesarean section for the first time at the People's Hospital of Longhua Shenzhen from January 2020 to December 2021. Women with uterine incisional hematoma were selected as the hematoma group ( n=149) and were further divided into the dehiscence group, including patients with uterine incisional dehiscence caused by hematoma, and non-dehiscence group, including those without uterine incisional dehiscence. The patients without uterine incisional hematoma during the same period were selected as the control group ( n=110). The incidence of scar diverticulum after uterine incision healing and the long-term outcomes in the two groups were compared. Statistical analysis was performed using a t-test or Chi-square test. Results:(1) The incidence of uterine incisional hematoma was 7.7% (149/1 939). In the 149 cases with uterine incisional hematoma detected by postoperative ultrasonography, 74 were in the dehiscence group and 75 in the non-dehiscence group. (2) The number of women developing cesarean section scar diverticulum was 41, with an incidence of 2.1% (41/1 939), and all of them were in the hematoma group, accounting for 27.5% (41/149). The proportion of women who developed scar diverticulum in the dehiscence group was higher than that of the non-dehiscence group [52.7% (39/74) vs. 2.7% (2/75), χ2=35.96, P<0.001]. (3) The incidence of scar diverticulum in patients with uterine incisional dehiscence caused by intra-incision hematoma, intra- and posterior incision hematoma, as well as a combination of intra-, anterior, and posterior incision hematoma were 10/18, 55.1% (27/49), and 2/2, respectively. None of the five patients with uterine scar diverticulum were caused by anterior incision hematoma plus partial intra-incision hematoma. The incidence of scar diverticulum was 2.7% (2/75) in the non-dehiscence group. (4) Among the 41 cases with scar diverticulum, ultrasound re-examination by postpartum 6-24 months found that the results of 40 (97.6%) cases were consistent with the last ultrasound findings. A small "v"-shaped scar diverticulum was observed in another patient by ultrasound 42 d after delivery, which disappeared in a re-examination 13 months after surgery. Conclusions:Uterine incisional hematoma is associated with scar diverticulum following cesarean section. Uterine incisional dehiscence due to hematoma may be an influencing factor for diverticulum formation.

Role of Intestinal Flora Metabolites in Colitis-associated Colorectal Cancer / 胃肠病学

Patients with inflammatory bowel disease (IBD) are at a significantly increased risk of colitis-associated colorectal cancer (CAC). The relationship between intestinal flora metabolites and CAC has attracted much attention. Regulating intestinal flora metabolism or increasing beneficial metabolites may play an important role in preventing CAC. This article reviewed the role of intestinal flora metabolites in CAC.

Application of wound dressing training based on Thorndike's learning theory in clinical nursing education / 中华医学教育探索杂志

Objective:To explore the effect of applying the wound dressing training based on Thorndike's learning theory (WCTT) in clinical nursing education.Methods:The study conducted controlled trial among nursing interns selected from Thyroid Surgery Department of West China Hospital of Sichuan University, and the nursing students were divided into the experimental group ( n=51) and the control group ( n=49). Nursing students in the experimental group were trained with WCTT, while the control group adopted the traditional teaching. Two groups were investigated by the ability of wound dressing questionnaire and were examined on the practical wound dressing operation to evaluate the teaching effect. SPSS 20.0 was used for statistical analysis. Results:Nursing students in the experimental group showed a higher self-evaluation on such aspects as understanding, interests, theoretical mastery, evaluation of wounds, practical skills, independence, fulfillment and model assessment. Meanwhile, the experimental group had a higher score of practical wound dressing operation than the control group [(93.25±2.11) points vs. (90.06±2.43) points] ( P<0.05). Conclusion:In clinical nursing teaching, WCTT could improve the wound dressing ability, independence and enthusiasm of nursing students, and this training mode had a positive effect on the clinical nursing teaching efficiency, which is worth further promotion.

Factors Associated with Behaviors Toward End-of-life Care Among Chinese Oncology Nurses: A Cross-Sectional Study

Purpose@#The goal of this study was to describe the current status of oncology nurses' behaviors toward end of life (EOL) care in China and to explore the factors associated with oncology nurses’ behaviors toward EOL care. @*Methods@#A cross-sectional design was applied and a convenience sample of 1038 oncology nurses from 22 grade A hospitals were recruited into this study. A general social demographic data questionnaire was administered, and the Chinese version of Nurses’ Behaviors of Caring for Dying Patients Scale was used to assess nurse behavior toward EOL care. The total score ranges from 40 to 200 points. Data were analyzed with SPSS 26.0 software. @*Results@#Chinese oncology nurses' average score of holistic EOL care behaviors was 2.97 ± 0.59. Oncology nurses provide physical care most (3.81 ± 0.76), followed by family care (3.02 ± 0.86), and spiritual care (2.37 ± 0.67). Multiple regression analysis showed that a higher frequency of sharing EOL care experience with colleagues, in-service palliative care education, higher level of head nurse support for EOL patient care, more cases of EOL care, higher working position, and nurse's perceived high level of support were positively associated with behavior toward EOL care. These six factors explained 16.2% of the total variance. @*Conclusions@#The results may help provide a basis for converting behavior for EOL care among oncology nurses and design interventions to better improve quality of life for EOL patients with cancer in China.

Correlation between peritoneal thickness and baseline peritoneal solute transport function / 中华肾脏病杂志

Objective:To investigate the relationship between peritoneal thickness and baseline solute transport function in peritoneal dialysis (PD) patients, and analyze the factors affecting the function of peritoneal transport.Methods:Non-diabetic end-stage renal disease (ESRD) patients admitted to the Second Hospital of Longyan City from January 2017 to June 2019 were enrolled in this study. The thickness of the peritoneal membrane was measured by color ultrasound instrument before the peritoneal catheterization. Standard peritoneal equilibration test (PET) was performed after one month of peritoneal dialysis. The ratio of corrected creatine in 4 h dialysate to 2 h serum creatine (D/Pcr) was used as a solute baseline transport index, and according to the D/Pcr evaluation results, the patients were divided into high/high average transfer (H) group (D/Pcr≥0.65) and low/low average transfer (L) group (D/Pcr<0.65). The clinical data, peritoneal thickness and peritoneal dialysis related indicators between the two groups of patients were compared. Binary logistic regression was used to analyze the factors affecting the function of peritoneal transport.Results:The amount of peritoneal ultrafiltration in H group was significantly lower than that in L group, intraperitoneal creatinine clearance (Ccr) and peritoneal thickness were significantly higher than those in L group (both P<0.05). Pearson and Spearman correlation results showed that the thickness of peritoneal membrane positively correlated with D/Pcr ( r=0.673, P<0.05), peritoneal Ccr ( r=0.261, P<0.05), and negatively correlated with ultrafiltration of peritoneal dialysis ( r=-0.365, P<0.05). Partial correlation analysis showed that the peritoneal thickness was positively correlated with the solute transport index D/Pcr ( r=0.539, P<0.05) and the peritoneal Ccr ( r=0.338, P<0.05). Binary logistic regression results showed that peritoneal thickening was a risk factor affecting peritoneal transport function ( OR=1.175, 95% CI 1.009-1.369, P<0.05). Conclusions:There is a positive correlation between the peritoneal membrane thickness and the baseline solute transport index in patients with non-diabetic peritoneal dialysis. Peritoneal thickening is a risk factor affecting peritoneal transport function.

Study on fingerprint and content determination of Zilian oil / 国际中医中药杂志

Objective:To establish HPLC fingerprint and content determination methods of Zilian oil, which will provide the scientific basis for the quality control and evaluation of Zilian oil. Methods:TLC was used for the qualitative identification of Arnebiae radix, Coptidis rhizoma and Borneolum syntheticum in oil. HPLC was adopted for to determine the fingerprints of different batches, and the content determination of β,β'-Dimethylacrylalkannin of Zilian oil was determined. Results:TLC showed that Arnebiae radix, Coptidis rhizoma and Borneolum syntheticum had clear spots and good specificity. A total of 13 common peaks of Zilian oil were identified by HPLC fingerprint analysis, and 2 characteristic peaks (Berberine hydrochloride and β,β'-Dimethylacrylalkannin) were identified, and the similarity of fingerprints between batches was ≥ 0.981. The linear range of β,β'-Dimethylacrylalkannin was 40.48-202.40 μg. Conclusions:The methods of TLC identification, fingerprint and content determination are simple, reliable and stable, which can be used for the quality control of Zilian oil.

Expressions of plasma D-dimer, von Willebrand factor antigen and blood coagulation factor Ⅶ in lymphoma and their clinical significances / 白血病·淋巴瘤

Objective@#To investigate the clinical value of blood coagulation and fibrinolysis index detection in lymphoma patients.@*Methods@#A total of 115 lymphoma patients hospitalized at Zhongshan Hospital of Xiamen University from January 2013 to September 2017 were retrospectively analyzed. According to the diagnostic and therapeutic criteria of lymphoma from World Health Organization (2008), these patients were divided into chemotherapy remission group (76 cases) and chemotherapy non-remission group (39 cases). A total of 138 healthy examination subjects at the same period were selected as the control group. Coagulation factor Ⅶ (FⅦ), D-dimer (D-D), von Willebrand factor antigen (vWF: Ag) and serum lactate dehydrogenase (LDH) levels were measured in all subjects. Kruskal-Wallis test was used to compare the differences of blood coagulation and fibrinolysis indicators in patients with different lymphoma staging and stratified treatment outcomes. Correlation test of D-D and LDH and disease staging was performed by using Spearman correlation analysis. The receiver operating characteristics (ROC) curve was used to analyze the efficacy of D-D in the assisted diagnosis of lymphoma with thrombosis.@*Results@#The plasma D-D, vWF: Ag levels and FⅦ activity [the median (interquartile range)] in lymphoma patients were higher than those in healthy controls [1 240 ng/ml (1 610 ng/ml) vs. 250 ng/ml (43 ng/ml), Z = -10.728, P < 0.01; 170 ng/ml (113 ng/ml) vs. 105 ng/ml (28 ng/ml), Z = -6.425, P < 0.01; 120% (26%) vs. 96% (26%), Z = -4.602, P < 0.01]. With the increase of Ann Arbor stage, plasma D-D, vWF: Ag levels and FⅦ activity were also increased gradually (all P < 0.05); plasma D-D, vWF: Ag levels and FⅦ activity in lymphoma with thrombosis group were higher than those in the group without thrombosis (all P < 0.01), D-D and vWF: Ag levels in the chemotherapy remission group were lower than those in the chemotherapy non-remission group (all P < 0.01). Plasma D-D levels were positively correlated with LDH level and Ann Arbor stage (r values were 0.414 and 0.530, respectively, all P < 0.01). When the plasma D-D level was 1 735 ng/ml, the sensitivity of diagnosis of thrombosis in patients with lymphoma was 81.8%, the specificity was 85.7%, the area under the ROC curve was 0.894, and the Youden index was the highest (0.675).@*Conclusions@#Clinically, blood coagulation and fibrinolysis in patients with lymphoma can be evaluated by detecting blood coagulation and fibrinolysis indexes such as plasma D-D. Real-time monitoring of plasma D-D level can determine the thrombosis trend of lymphoma patients, and it may play an important role in evaluating the efficacy and prognosis.

Efficacy evaluation of biofeedback combined with swallowing function training at different times on dysphagia after stroke / 中国现代医生

Objective To evaluate the efficacy of biofeedback combined with swallowing function training at different times on post-stroke dysphagia. Methods 124 patients with post-stroke dysphagia were randomly divided into observation group and control group. The observation group was given biofeedback combined with swallowing function training for 2 weeks and 4 weeks of treatment. The control group was given routine swallowing function training for 2 weeks and 4 weeks of treatment. Kubota drinking water test was used to evaluate the swallowing function before treatment, 2 weeks and 4 weeks after treatment in both groups. Results There was no statistically significant difference in the scores of swallowing function between the two groups before treatment (P=0. 401). After 2 weeks of treatment, there was also no statistically significant difference in the evaluation of swallowing function between the observation group and the control group (P=0. 138). After 4 weeks of treatment, the evaluation of swallowing function in the observation group was significantly better than that in the control group(P=0. 003). Conclusion Biofeedback combined with swallowing function training is better than the routine swallowing function training. After 4 weeks of treatment, the efficacy of biofeedback combined with swallowing function training is better than the biofeedback combined with swallowing function training after 2 weeks, indicating that there is a correlation between the treatment effect and the length of treatment time.

Comparative hearing outcomes of tympanostomy tubes and combined with adenoidectomy for pediatric otitis media effusion treatment:a Meta-analysis / 实用医学杂志

Objective To investigate the hearing outcome efficiency of tympanostomy tubes and when combined with adenoidectomy for otitis media with effusion treatment. Methods A systematic literature review of tympanostomy tubes and tympanostomy tubes combined with adenoidectomy were performed using PubMed, EMBASE,the Cochrane Library,MEDLINE,all of the included studies were randomized controlled trial. The quality of included studies was evaluated according to the Risk of Bias Table of the Cochrane Handbook. Data were analyzed with Review Manager 5.02 software. Heterogeneity was examined,and forest plot was drawn. Results All of the included 4 studies were randomized controlled trials. At 6 month follow-up patients,the tym-panostomy tubes and tympanostomy tubes combined with adenoidectomy had no difference in hearing improvement (WMD = 1.06,95%CI-0.18 ~ 2.29,P = 0.09). At 12 month follow-up patients,the tympanostomy tubes com-bined with adenoidectomy were better than tympanostomy tubes alone(WMD = 3.03,95%CI 0.91 ~ 5.14,P =0.005). Conclusions The meta analysis result reveals that tympanostomy tubes combined with adenoidectomy have an advantage in long term follow up time for hearing improvement in children's otitis media with effusion treatment.

Research progress of esophageal collision tumor / 国际肿瘤学杂志

Esophageal collision tumor is an extremely rare tumor which defined as the concrescence of two distinct primary neoplasms.The pathobiological mechanism of collision tumors is yet to be understood.Clinical symptoms,endoscopic examination and imaging are all lack of specificity.Diagnosing a collision tumor prior to surgery is difficult.Careful pathological examination is crucial for accurately diagnosing the neoplasms in a collision tumor and ensuring appropriate management and a favorable prognosis.Esophageal collision tumors have been increasingly reported in recent years.With the aim of improving the knowledge level of esophageal collision tumor,the clinical and pathological features of this tumor is needed to be summarized.

Risk factors analysis for postoperative cognitive dysfunction and nursing intervention in patients undergoing laparoscopic radical hysterectomy / 中国实用护理杂志

Objective To investigate the risk factors for postoperative cognitive dysfunction (POCD) and nursing intervention in patients undergoing laparoscopic radical hysterectomy. Methods One hundred patients undergoing laparoscopic radical hysterectomy were included, surgical history, general anesthetics way, education, family factors(alone), body mass index, age, duration of anesthesia, dose of sufentanyl, hematocrit, the time for regaining orientation, dysphoria, postoperative pain degree were recorded. The occurrence of POCD was observed at 7 days (early period) and 3 months (later period) after surgery. Logistic regression analysis was used to examine the risk factors for POCD at early period and later period. Results The incidence of POCD at early period was 29.0%(29/100). Logistic regression analysis of surgical history, general anesthetics way, body mass index, age, hematocrit, the time for regaining orientation, postoperative pain degree in patients, general anesthetics way (OR=2.821, 95%CI 1.099-7.240) and postoperative pain degree(OR=2.292, 95%CI 1.129-4.654) were the significant risk factors for POCD at early period. The incidence of POCD at later period was 7.0%(7/100). Logistic regression analysis of education and family factors(alone) in patients, family factors(alone) was the significant risk factor for POCD at later period (OR=5.517, 95%CI 1.010-30.126). Conclusions General anesthetics way and postoperative pain degree are the significant predictors for POCD in patients undergoing laparoscopic radical hysterectomy during hospitalization, and family factors(alone) is the risk factor for POCD at 3 months after surgery, and active nursing intervention could reduce the occurrence of POCD.

Regulation Effect of Berberine on the Inhibition of Hexokinase Ⅱ in Breast Cancer Cells Glycolysis / 中国药师

Objective:To investigate the effects of berberine on glycolysis in breast cancer cells and its effect on hexokinase Ⅱ. Methods:The inhibitory effects of berberine on the proliferation of breast cancer cells were studied by MTT with human breast cancer cell line MDA-MB-231 and MCF-7. The glucose consumption and lactic acid in breast cancer cells were detected to evaluate the effect of berberine on glycolysis in breast cancer cells. The energy supply situation of breast cancer cells was evaluated after the detection of ATP and NAD+/NADH. Finally,the hexokinase Ⅱ activity and protein content were also detected in breast cancer cells.Results:The experimental results showed that berberine had an obvious inhibitory effect on the proliferation of human breast cancer cell line MDA-MB-231 and MCF-7 cell in a concentration-dependent manner. While reducing the cell ATP content and increasing NAD+/NADH con-tent(P<0.05),berberine could clearly reduce the consumption of glucose and lactic acid content in the different breast cancer cell lines. In addition,berberine could inhibit the activity and protein content of hexokinase Ⅱ in breast cancer cells.Conclusion:Berber-ine can significantly inhibit the proliferation and the glycolysis of breast cancer cells,reduce the energy supply and obviously inhibit the expression of hexokinase Ⅱ in breast cancer cells as well.

Progress of pediatric pain management and sedation in the emergency department / 中国小儿急救医学

Children usually come to emergency department accompanied with painful conditions and injuries.During the emergence care,additional painful,distressing or unpleasant diagnostic and therapeutic procedures may be required.Emergency doctors are anticipated to provide safe and effective analgesia and se-dation for children.This review summarized recent studies on the following aspects:make sure that children do not experience lengthened or additional pain when coming to emergency medical care;at triage use a com-posite pain assessment tool to assess;aim to provide effective analgesia at the first attempt-use the appropriate drug,dose,and route;choose painless modes of delivery(nasal route,flavoured syrups) if possible;reassess frequently pain scores to make sure that analgesia is effective and allow adequate time for it to work;use non-pharmacological and pharmacological modalities to manage pain;avoid the"routine"use of unnecessary painful invasive procedures;use topical,local and regional anaesthesia together with proper safe procedural se-dation to avoid further pain.

Value of evaluating left ventricle regional wall motion abnormality by two-dimensional echocardiography in non-ST-elevation myocardial infarction / 中国介入影像与治疗学

Objective To investigate the value of two-dimensional echocardiography (2DE) in detecting left ventricular regional wall motion abnormality (RWMA) in non-ST-elevation myocardial infarction (NSTEMI) by contrast with coronary angiography (CAG).Methods Totally 68 cases of NSTEMI patients (NSTEMI group)and 50 cases of normal peoples (normal group)were collected.2DE dynamic image and CAG results were comparatively analyzed in two groups.Left ventricular RWMA of all patients were observed through multi-section dynamic images by 2 experienced echocardiographic physicians.Left ventricular wall motion abnormalities were determined according to the 16 segment method of the American Society of echocardiography (ASE).2DE-RWMA was positive if there were one or more segments of motion abnormalities.All NSTEMI patients underwent CAG 2 days after 2DE examination,CAG was positive if the degree of coronary artery stenosis was more than 50％.Results In 68 NSTEMI patients,66 cases were CAG positive and 2 cases were negative,35 cases were 2DE-RWMA positive and 33 cases were negative.Taking CAG as a gold standard,the sensitivity,specificity and accuracy,positive predictive value and negative predictive values of 2DE-RWMA in diagnosis of NSTEMI were 51.52％ (34/66),50.00 ％ (1/2),51.47％ (35/68),97.14％ (34/35),3.03 ％ (1/33).Compared with the 2DE-RWMA negative patients,the rate of three branches of coronary artery stenosis in 2DE-RWMA positive patients was higher (62.85％ vs 39.39％,P＜0.05),the degree of coronary artery stenosis that reached 90％-99％ was higher (68.57％ vs 48.48％,P＜0.05).Conclusion The sensitivity of 2DE is low of NSTEMI in detecting the left ventricle RWMA.The degree of coronary artery stenosis is probably serious if 2DE-RWMA is positive,which is helpful for preliminary clinical judgment.

Study on the Separation of Ketoprofen Enantiomer by Pre-column Derivation RP-HPLC / 中国药师

Objective:To establish a method for the separation and determination of ketoprofen enantiomer .Methods:A pre-col-umn derivation RP-HPLC method was used with L-alanine-β-naphthylamine ( L-Ala-β-NA) as the derivation reagent .The RP-HPLC conditions were as follows: a Hypersil ODS-2 column (250 mm ×4.6 mm,5 μm) was applied, the mobile phase was acetonitrile-0.025 mol· L-1 phosphate buffer solution (40∶60, v/v) and the flow rate was 1.0 ml· min-1 , the detection wavelength was set at 245 nm and the column temperature was 25℃.The injection volume was 10μl.Results:Base line separation was achieved for the sep-aration of enantiomer from ketoprofen , and the retention time for S-(+) -ketoprofen and the R-(-) -ketoprofen was 24.2 min and 26.0 min, respectively.Dexketoprofen within the range of 0.025-0.125 mg had a good linear relationship (r=0.998 1) and the aver-age recovery was 90.93%(RSD =4.10%, n=9 ).Conclusion:The method is simple, accurate and reliable, which can be applied in the separation and determination of ketoprofen .

Clinical Efficacy of Inhaled Nitric Oxide in the Treatment of Persistent Pulmonary Hypertension of the Newborn and Nursing / 沈阳医学院学报

Objective:To analysis clinical efficacy of inhaled nitric oxide in the treatment of persistent pulmonary hypertension of the newborn and nursing. Methods: A total of 84 cases of persistent pulmonary hypertension of the newborn received high-frequency oscillation mode of mechanical ventilation at higher ventilation parameters,and inhaled nitric oxide therapy. Before inhalation of nitric oxide and 30 min, 24 h after inhalation of nitric oxide, transcutaneous oxygen saturation (SpO2), blood gas analysis,blood pressure,heart rate,mean arterial blood pressure and oxygenation index (OI) were recorded. Results:There was significant difference in SpO2,PaO2,PaCO2,FiO2,OI at 30 min and 24 h after inhalation of nitric oxide (P<0.05) . There was no significant difference in HR,SPAP,SBP,MAP,pH (P>0.05) .Conclusion:Inhaled nitric oxide combined with a high-frequency oscillation mode of mechanical ventilation in newborns with persistent pulmonary hypertension significantly improve OI,blood gas analysis,oxygen saturation and other indicators,and effective interventions can avoid nitric oxide-related adverse reactions.

Prevalence and risk factors of human papilloma virus among women attending cervical cancer screening in Nanning city / 重庆医学

Objective This study evaluates the prevalence and factors related to high-risk human papilloma virus (HR-HPV) infection in Nanning adult women.Methods A total of 431 women who presented cervical cancer screening in (gynecological clinic, maternal and child health hospital of the Guangxi Zhuang Autonomous)were selected as subjects,from January to June,2014.A standardize questionnaire regarding demographic characteristics and possible risk factors of cervical cancer was filled by each partici-pant.Routine gynecological examination,microbial detection of reproductive tract,cervical cell HC2 test,cervical cytological and HPV DNA testing were applied to all participantes.Individuals who were suspicious for cervical intraepithelial neoplasia or cervical cancer received colposcopy biopsy and histopathological diagnosis.The date were analyzed in SPSS 1 9.0.Results Out of the total number of 431 samples.54 (12.53%)subjects were positive for HR-HPV.Among women with cervical abnormalities,82.50%had HR-HPV infection compared to 9.64% of those women with healthy cervix (P <0.01.Analysis for risk factors of HPV infec-tion showed that extramarital sexnal behaviors and maltiple sexual partners would increase the risk of HPV positivity.For vaginal micro ecological environment of multi-factor analysis showed that pathogen infection and bacterial vaginal disease are risk factors of HPV infection.Conclusion Among women with cervical abnormalities,HR-HPV positivity was significantly higher than that a-mong women with normal cervix.extramarital sexnal behaviors,multiple parity,pathogen infection and bacterial vaginal disease in-crease the risk of HPV infection.

Survey of the influencing factors of learning adaptability in nursing student of the emergency department / 现代临床护理

Objective To investigate the influencing factors of learning adaptability of nursing student in the emergency department and come up with relevant countermeasures. Methods Two hundred nursing student in the emergency department participated in the survey. A self-designed questionnaire on their learning adaptability and the results were analyzed. Result The job category, work environment, disease of the patients, internship time, teaching method and the professional identification were the top six factors influencing their learning adaptability situation. Conclusion Such measures as strengthening the orientation of student nurses, cultivating their observation ability and communication skills, enhancing the consciousness about law, increasing practice time appropriately, improving teaching methods and ability, and strengthening sense of identity can guarantee effective internship and adaptability of the nursing student in emergency department.

Overexpression of glucosylceramide synthase and its significance in the clinical outcome of non-small cell lung cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Glucosylceramide synthase (GCS), an enzyme responsible for ceramide glycosylation, plays an important role in multidrug resistance (MDR) in some tumors in vitro; however, its expression and clinicopathological significance in non-small cell lung cancer (NSCLC) remains unclear.</p><p><b>METHODS</b>We evaluated GCS expression in 116 paired tumor and adjacent non-cancerous tissues and 50 frozen tissues from patients with NSCLC using immunohistochemistry and western blotting, and explored the correlation between GCS and NSCLC clinicopathological characteristics and prognosis. We observed the association between GCS and the MDR proteins P-glycoprotein (P-gp) and lung resistance-related protein (LRP) to determine the link between GCS and MDR at the histological level.</p><p><b>RESULTS</b>GCS expression was significantly upregulated in NSCLC tumors compared with non-cancerous tissue. There was high GCS expression in 75/116 tumor specimens (64.7%) and 16/116 non-cancerous specimens (13.8%). High GCS expression was significantly associated with poor differentiation (P = 0.01), lymph node metastasis (P = 0.004), recurrence/distant metastasis (P = 0.006), and chemotherapy resistance (P = 0.025). Multivariate analysis demonstrated that GCS immunopositivity was an independent risk factor for survival (P = 0.018). P-gp was expressed in 80/116 tumors (69.0%) and in 12/116 non-cancerous tissue specimens (10.3%; P = 0.001); LRP was expressed in 85/116 tumors (73.3%) and 19/116 non-cancerous tissue specimens (16.4%; P = 0.001). Importantly, the results demonstrated that increased GCS expression in NSCLC cancer specimens correlated with increased expression of P-gp and LRP, molecules known to stimulate cancer cell MDR (r = 0.612 and 0.503, P = 0.01 and 0.035, respectively).</p><p><b>CONCLUSION</b>GCS upregulation might contribute to the development of NSCLC and could be a useful prognostic indicator and chemoresistance predictor for NSCLC patients.</p>

Atorvastatin inhibits atherogenesis by RXRα-mediated depressing oxida-tive stress in STZ-induced diabetic ApoE-/-mice with fat-rich diet / 中国病理生理杂志

AIM:To explore the effects of atorvastatin (Atorv) on atherosclerosis in streptozotocin (STZ)-in-duced diabetic apolipoprotein E knockout ( ApoE-/-) mice with fat-rich diet and the possible mechanism .METHODS:C57 mice served as control.ApoE-/-mice (n=34) fed with high-fat diet were randomly divided into ApoE-/-group, STZ-ApoE-/-group and STZ-ApoE-/-+Atorv group.Intraperitoneal injection of streptozotocin was performed to create di-abetic animal model .Blood glucose was determined by glucose oxidase method .Blood lipid levels were detected by enzymic method or selective homogeneous method .The plaque area in the thoracic aorta was measured by HE staining .The protein level of nicotinamide-adenine dinucleotide phosphate ( NADPH) oxidase subunit gp91phox in the thoracic aorta was deter-mined by Western blotting .The levels of reactive oxygen species ( ROS) in blood and thoracic aorta homogenates were de-tected by Fenton reaction and Griess reagent .Human umbilical vein endothelial cells ( HUVECs ) were isolated from healthy umbilical cords by collagenase I and cultured .ROS production was detected by flow cytometry .NADPH oxidase ac-tivity was measured using lucigenin assay .Effects of retinoid X receptor α( RXRα) on inhibition of oxidative stress by ator-vastatin were evaluated by RNA interference and plasmid transfection .RESULTS: (1) Compared with C57 group, the plaque areas of the thoracic aorta in ApoE-/-group were increased .No difference of the fasting glucose between the 2 groups was observed.The levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), thoracic aorta gp91phox protein and ROS in blood and thoracic aorta homogenates were higher in ApoE-/-group than those in C57 group.(2) Compared with ApoE-/-group, the plaque areas of the thoracic aorta in STZ-ApoE-/-group were further enlarged [(314.13 ±35.72) μm2 vs (215.88 ±34.19) μm2, P<0.05].The levels of blood glucose, TG, TC and LDL-C, thoracic aorta gp91phox protein and ROS in blood and thoracic aorta homogenates were higher in STZ-ApoE-/-group than those in ApoE-/-group (P<0.05).(3) Compared with STZ-ApoE-/-group, the plaque areas of the thoracic aorta in STZ-ApoE-/-+Atorv group were reduced [(217.47 ±24.56) μm2 vs (314.13 ±35.72) μm2, P<0.05].The levels of blood glucose , LDL-C, TC, HDL-C and TG showed no significant difference between the 2 groups.Thoracic aorta gp91phox protein level and ROS production in blood and thoracic aorta homogenates were lower in STZ -ApoE-/-+Atorv group than those in STZ-ApoE-/-group (P<0.05).(4) High glucose-induced increases in NADPH oxidase activity and gp91phox expression were significantly inhibited by atorvastatin (10-6 mol/L) in HUVECs.The inhibitory effects of atorvasta-tin on high glucose-induced ROS production and NADPH oxidase activation were largely impaired when the cells were trans -fected with RXRαsiRNA.However , the effect of atorvastatin was significantly strengthened when RXRαwas over-expressed in the HUVECs transfected with RXRαplasmid.CONCLUSION: Atorvastatin inhibits atherogenesis by depressing high glucose-induced oxidative stress in diabetic ApoE-/-mice with fat-rich diet.The anti-oxidative stress effect of atorvastatin is mediated by RXRα.