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1.
Acta cir. bras ; 36(1): e360107, 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1152691

ABSTRACT

ABSTRACT Purpose The present study explored the potential therapeutic role of oleuropein in sepsis-induced heart injury along with the role of GSK-3β/NF-kB signaling pathway. Methods Sepsis-induced myocardial injury was induced by cecal ligation and puncture (CLP) in rats. The cardiac injury was assessed by measuring the levels of cTnI and creatine kinase-MB (CK-MB). Sepsis-induced inflammation was assessed by measuring interleukin-6 (IL-6), IL-10 and HMGB1 levels. The different doses of oleuropein (5, 10, and 20 mg/kg) were given prior to CLP. Oleuropein (20 mg/kg) was administered after 6 hof CLP. The expressions of GSK-3β, p-GSK-3β (Ser9) and nuclear factor-κB (NF-κB) were measured in heart homogenates. Results Cecal ligation and puncture was associated with myocardial injury, an increase in IL-6, a decrease in IL-10 and an increase in HMGB1. Moreover, it decreased the ratio of p-GSK-3β/GSK-3β and increased the expression of p-NF-kB. Pretreatment with oleuropein attenuated CLP-induced myocardial injury and systemic inflammation in a dose-dependent manner. Administration of oleuropein after the onset of CLP also attenuated cardiac injury and inflammation. It also restored CLP-induced changes in the HMGB1 levels, the ratio of p-GSK-3β/GSK-3β and expression of p- NF-kB. Conclusions Oleuropein attenuates sepsis-induced systemic inflammation and myocardial injury by inhibiting NF-kB and GSK-3β signaling.

2.
Article in Chinese | WPRIM | ID: wpr-880834

ABSTRACT

OBJECTIVE@#To explore the mechanism by which ginsenoside 20(S)-Rg3 upregulates the expression of tumor suppressor von Hippel-Lindau (VHL) gene in ovarian cancer cells.@*METHODS@#Ovarian cancer cell line SKOV3 treated with 20(S)-Rg3 were examined for mRNA and protein levels of VHL, DNMT1, DNMT3A and DNMT3B by real-time PCR and Western blotting, respectively. The changes in VHL mRNA expression in SKOV3 cells in response to treatment with 5-Aza-CdR, a DNA methyltransferase inhibitor, were detected using real-time PCR. VHL gene promoter methylation was examined with methylation-specific PCR and VHL expression levels were determined with real-time PCR and Western blotting in non-treated or 20(S)-Rg3-treated SKOV3 cells and in 20(S)-Rg3-treated DNMT3A-overexpressing SKOV3 cells. VHL and DNMT3A protein levels were detected by immunohistochemistry in subcutaneous SKOV3 cell xenografts in nude mice.@*RESULTS@#Treatment of SKOV3 cells with 20(S)-Rg3 significantly upregulated VHL and downregulated DNMT3A expressions at both the mRNA and protein levels (@*CONCLUSIONS@#Ginsenoside 20(S)-Rg3 upregulates VHL expression in ovarian cancer cells by suppressing DNMT3A-mediated DNA methylation.


Subject(s)
Animals , Cell Line, Tumor , DNA Methylation , Female , Gene Expression , Ginsenosides/pharmacology , Humans , Mice , Mice, Nude , Ovarian Neoplasms/genetics , Promoter Regions, Genetic , Von Hippel-Lindau Tumor Suppressor Protein/genetics
3.
Article in English | WPRIM | ID: wpr-880623

ABSTRACT

OBJECTIVES@#To compare the short-, mid-, and long-term outcomes in patients with esophageal cancer between minimally invasive esophagectomy via Sweet approach in combination with cervical mediastinoscopy (MIE-SM) and minimally invasive esophagectomy via McKeown approach (MIE-MC), and to evaluate the value of MIE-SM in the surgical treatment of esophageal cancer.@*METHODS@#A prospective, nonrandomized study was adopted. A total of 65 esophageal cancer patients after MIE-SM and MIE-MC from June 2014 to May 2016 were included. Among them, 33 patients underwent MIE-SM and 32 patients underwent MIE-MC. Short-term outcomes (including the duration of surgery, intraoperative blood loss volume, ICU stay time, postoperative complications, postoperative hospital stay, reoperation, open surgery, number of dissected lymph nodes, and 30-day mortality), mid-term outcomes, [including Quality of Life Core Questionnaire (QLQ-C30) and the esophageal site-specific module (QLQ-OES18)], long-term outcomes [including overall survival and disease-free survival] were compared between the 2 groups.@*RESULTS@#Radical resection (R0) were achieved in all patients. There were no significant differences in the duration of surgery, intraoperative blood loss volume, ICU stay time, postoperative complications, and postoperative hospital stay between the 2 groups (all @*CONCLUSIONS@#MIE-SM appears to be a safe surgical approach, which may get better quality of life, suffer less pain, and can achieve the same therapeutic effect as MIE-MC. Therefore, MIE-SM should be considered as a valuable approach for the treatment of middle and lower esophageal cancer.


Subject(s)
Esophageal Neoplasms/surgery , Esophagectomy , Humans , Laparoscopy , Mediastinoscopy , Minimally Invasive Surgical Procedures , Postoperative Complications/epidemiology , Prospective Studies , Quality of Life , Retrospective Studies , Treatment Outcome
4.
Article in Chinese | WPRIM | ID: wpr-879398

ABSTRACT

OBJECTIVE@#To evaluate clinical effect of unilateral approach and bilateral decompression via large channel endoscopic system for the treatment of lumbar spinal stenosis.@*METHODS@#The clinical data of 32 patients with lumbar spinal tenosis treated by unilateral approach and bilateral decompression via large channel endoscopy from February 2018 to February 2019 were retrospectively analyzed. There were 18 males and 14 females, aged 65 to 84 years old with an average of (70.6± 8.4) years. The course of disease was from 1 to 12 years. All 32 cases were accompanied by numbness or pain in the lower limbs, of which 28 cases were accompanied by intermittent claudication. Narrow segments were L@*RESULTS@#All the patients were followed up for 12-24 (17.68±2.43) months and all operations were successfully completed with the operation time of 70-160(85.64±11.94) min. Spinal dural tear occurred in 1 case during the operation, and sensory disturbance in the other side of lower limb in a short period of time occurred in 2 cases, all improved after corresponding treatment. Postoperative imaging showed that the spinal canal was significantly enlarged and the nerve root was fully released. Before operation and 3 days, 3 months, 1 year after operation, VAS scores of low back pain were 4.62 ±1.41, 2.73 ±1.35, 1.21 ±1.17, 1.11 ±0.34, respectively;VAS scores of leg pain were 6.83 ± 1.71, 3.10±1.50, 1.08±0.19, 0.89±0.24, respectively. VAS scores of low back pain and leg pain each time point after operation were obvious improved (@*CONCLUSION@#It is a safe and effective way to treat lumbar spinal stenosis with unilateral approach and bilateral decompression via large channel endoscopic system. It has the advantages of sufficient decompression, less trauma, fast recovery, high safety and low incidence of postoperative complications. It can minimize the damage to the stable structure of the lumbar spine and is an ideal minimally invasive operation for the treatment of lumbar spinal stenosis.


Subject(s)
Aged , Aged, 80 and over , Decompression, Surgical , Endoscopy , Female , Humans , Lumbar Vertebrae/surgery , Male , Retrospective Studies , Spinal Stenosis/surgery , Treatment Outcome
5.
Article in Chinese | WPRIM | ID: wpr-905262

ABSTRACT

Objective:To analyze the contractile properties of the lumbar erector spinae in patients with chronic nonspecific low back pain (CNLBP), and to explore their correlation with pain and dysfunction. Methods:From January to June, 2020, 24 patients with CNLBP in the outpatient and the ward of geriatric rehabilitation medicine department and 26 asymptomatic volunteers were included. Their contractile properties of the lumbar erector spinae were measured with tensiomyography, including maximum radial muscle displacement (Dm), contraction time (Tc), delay time (Td), sustain time (Ts), half-time relaxation (Tr) and lateral symmetry (LS). The contraction velocity (VC) was calculated. Potential associations of tensiomyography parameters to Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were assessed using correlation analysis. Results:No significant differences were found in Td, Ts, Tc, Tr and LS between two groups (P > 0.05). Dm and Vc were significantly lower in both sides of CNLBP group than in the control group (t > 2.058, P < 0.01). Dm or Vc were not correlated with VAS and ODI (P > 0.05). Conclusion:Erector spinae are stiff and fatiguable in patients with CNLBP, however, they are not associated with pain and dysfunction. Tensiomyography could be used for accurate diagnosis and treatment of CNLBP.

6.
Article in Chinese | WPRIM | ID: wpr-881215

ABSTRACT

@#Objective    To compare the effect on postoperative immune function between da Vinci robot-assisted thoracoscopic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) , and to provide clinical support for more effective surgical procedures. Methods    A total of 90 patients undergoing radical resection of pulmonary carcinoma in our hospital from June to November 2019 were included. There were 49 males and 41 females with an average age of 62.67 (37-84) years. Among them, 50 patients underwent da Vinci robot-assisted thoracoscopic surgery (a RATS group) and 40 patients underwent video-assisted thoracoscopic surgery (a VATS group). The perioperative indexes as well as postoperative inflammatory factors and immune level effects between the two groups were compared. Results    Compared with the VATS, RATS could significantly shorten the operation time and decrease intraoperative blood loss (P<0.05). RATS also effectively reduced the increase of postoperative inflammatory factor level (P<0.05). But there was no significant difference in postoperative immune function between the RATS group and the VATS group (P>0.05). Conclusion    RATS is superior to VATS in the treatment of non-small cell lung cancer in perioperative indicators and inflammatory factors.

7.
Article in Chinese | WPRIM | ID: wpr-911445

ABSTRACT

To evaluate the efficacy and safety of left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) over 75 years. A total of 82 patients with AF who underwent LAAO successfully in Beijing Anzhen Hospital from March 2014 to March 2019 were divided into two groups according to age: the elderly group (aged>75 years) and the young group (aged ≤75 years). Risk of perioperative complications and incidence of ischemic stroke and major bleeding during follow-up were retrospectively analyzed. The results showed that there were no significant differences in procedure-related ischemic stroke(0 vs.1.6%, P=0.768) and major bleeding (0 vs.1.6%, P=0.768) during perioperative period between the two groups. No complications as death or pericardial tamponade occurred in the two group. During a (25.9±15.9) months period of followed up, ischemic stroke event rate was 3.6/100 person-years in the elderly group and 4.9/100 person-years in the young group, respectively. Major bleeding event rate was 2.5/100 person-years in the elderly group and 0/100 person-years in the young group, respectively. Compared with the expected ones, the relative risk reduction (RRR) of stroke in the elderly group was more profound than that in the young group (32.0% vs. 25.0%), while the risk of major bleeding in the young group was significantly lower than that in the elderly group (RRR 100% vs. 56.9%). Therefore, LAAO might be suitable for stroke prevention in the elderly AF patients.

8.
Article in Chinese | WPRIM | ID: wpr-911428

ABSTRACT

Objective:To explore the difference of coagulation function and its correlation with prognosis in patients with acute respiratory distress syndrome (ARDS) caused by extrapulmonary sepsis and pulmonary infection.Methods:ARDS patients caused by extrapulmonary sepsis and pulmonary infection admitted to the ICU were retrospectively analyzed at the First Affiliated Hospital of China Medical University from July 2017 to June 2019. The clinical characteristics were collected including sequential organ failure assessment (SOFA), coagulation parameters [prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (Fib), D-Dimer (D-D), fibrinogen degradation product (FDP), antithrombin Ⅲ(AT-Ⅲ), platelet (PLT)], duration of mechanical ventilation, length of stay (LOS) in ICU and 28-day mortality. According to the risk factors, the patients were divided into extrapulmonary sepsis group and pulmonary infection group. The correlation analysis between coagulation parameters and the prognosis of ARDS patients were analyzed by multivariate logistic regression analysis.Results:A total of 268 ARDS patients were screened and 28 cases were excluded. Finally, 240 ARDS patients were enrolled, including 145 caused by extrapulmonary sepsis and 95 by pulmonary infection. PT, INR and APTT in the extrapulmonary sepsis group were significantly higher than those in pulmonary infection group ( P<0.05). AT-Ⅲ level was lower than that in pulmonary infection group ( P<0.05). Ninty-three patients survived at 28 days in the non-pulmonary sepsis group, the mortality rate was 35.9% (52/145). PT, INR, APTT in patients who died at 28 days were significantly higher than those of the patients who survived ( P<0.05), while AT-Ⅲ level was lower than those of the patients who survived ( P<0.05). 49 patients survived at 28 days in the pulmonary infection group, the mortality rate was 48.4% (46/95). There was no significant difference in the coagulation parameters between two groups. Multivariate logistic regression analysis showed that SOFA score without PLT( OR=1.210,95% CI 1.067-1.372, P=0.003) and INR ( OR=2.408,95% CI 1.007-5.760, P=0.048) were independent risk factors for 28-day mortality in extrapulmonary sepsis group. Coagulation parameters are not independent risk factors for 28-day mortality in ARDS patients related to pulmonary infection. Conclusion:There are significant differences in coagulation function between ARDS patients caused by extrapulmonary sepsis or pulmonary infection. INR is an independent risk factor for 28-day mortality in extrapulmonary sepsis group.

9.
Article in Chinese | WPRIM | ID: wpr-910031

ABSTRACT

Objective:To explore the correlations of α-melanocyte stimulating hormone ( α-MSH) levels in serum and synovial fluid with progression of primary knee osteoarthritis (KOA). Methods:A retrospective analysis was conducted of the 96 patients who had been diagnosed as primary KOA at Department of Orthopedics, The First Hospital of Huizhou from October 2018 to October 2019. Radiographic severity of KOA was determined by Kellgren-Lawrence (K-L) grades; α-MSH levels were measured by enzyme-linked immunosorbent assay (ELISA). Levels of pro-inflammatory cytokine interleukin-1 β (IL-1 β) and matrix metalloproteinase-3 (MMP-3) were also detected. Another 64 patients with patellar dislocation, matched in age and gender, were enrolled as controls. The Numeric Pain Scale (NPS) and revised Oxford Knee Score (OKS) were employed to evaluate their symptomatic severity. Receiver operating characteristics (ROC) curve was used to compare α-MSH, IL-1 β and MMP-3 with regard to their diagnostic values in the K-L grading. Results:There were no statistically significant difference in age, gender and body mass index between the 2 groups, showing they were comparable ( P> 0.05). The α-MSH levels in synovial fluid were significantly lower in the KOA patients than in the controls [(16.9±3.8) pg/mL versus (18.8±2.7) pg/mL] ( P<0.001); there were no significant differences between the KOA patients and the controls in the serum α-MSH levels [(24.9±1.8) pg/mL versus (24.8±1.7) pg/mL] ( P>0.05). The α-MSH levels in synovial fluid were negatively correlated with K-L grades ( r=-0.382, P<0.001) and negatively correlated with NPS ( r=-0.382, P<0.001) but positively correlated with OKS ( r=0.339, P<0.001). Moreover, the α-MSH levels in synovial fluid were negatively correlated with the IL-1 β levels in synovial fluid ( r=-0.483, P<0.001) and with the MMP-3 levels in synovial fluid ( r=-0.336, P< 0.001). Conclusions:The level of serum α-MSH may not be correlated with the progression of KOA but the synovial fluid α-MSH is negatively correlated with the progression of KOA. Therefore, the expression level of α-MSH in joint synovial fluid can be used as a potential biomarker for assessment of severity of knee osteoarthritis.

10.
Article in English | WPRIM | ID: wpr-888244

ABSTRACT

Objectives To validate the reliability of the Chinese version of the Consultation and Relational Empathy (CARE) in physician-standardized patient (SP) encounter. We also tried to examine the agreement between video-based ratings and in-room ratings, as well as the agreement between the faculty ratings and SP ratings. Methods The CARE was translated into Chinese. Forty-eight anesthesia residents were recruited to make preoperative interview in SP-counter. Performance of each resident was graded by in-room raters, video raters and SP raters. Consistency between different raters was examined. Results The Chinese-CARE measure demonstrated high scale reliability with a Cronbach's alpha value of 0.95 and high consistency in the in-room ratings in intraclass correlation (coefficient=0.888,

11.
China Pharmacy ; (12): 2347-2353, 2021.
Article in Chinese | WPRIM | ID: wpr-886915

ABSTRACT

OBJECTIVE:To study the effects of Cu rcumin solid lipid n anoparticels (Cur-SLN) on cardiac ,renal and pulmonary functions ,the expression of autophagy related factors in cardiorenal syndrome model rats. METHODS :The rats were divided into sham operation group ,model group ,rapamycin group (positive control ,2 mg/kg),Cur-SLN low-dose and high-dose groups(5,10 mg/kg),except for 13 rats in the model group (3 of which are used to judge whether modeling is successful ),10 rats in the other groups. Except for sham operation group ,cardiorenal syndrome of other groups were induced by abdominal aortic coarctation combined with acute renal ischemia-reperfusion injury. After successful modeling ,rats in each administration group were injected with corresponding drugs through caudal vein ,and rats in sham operation group and model group were injected with equal volume normal saline ,once a day for 4 weeks. Twenty-four hours after the last administration ,the contents of angiotensin converting enzyme (ACE),free triiodothyronine (FT3) and arginine vasopressin (AVP) in rat serum were detected. The pathological morphology of rat heart ,kidney and lung were observed. The distribution and expression of LC 3 and Beclin- 1 protein in rat heart ,kidney and lung were detected. RESULTS :Compared with sham operation group ,the contents of ACE and FT 3 in serum,the indexes of heart and kidney ,the expression of LC 3(except in renal tissue )and Beclin- 1 protein in heart ,kidney and lung were significantly increased (P<0.01),and the contents of AVP and lung index were decreased significantly (P<0.01); myocardial cells in the non-infarcted area of the heart were obviously hypertrophic ,the arrangement of myocardial fibers was disordered ; the structure of renal tubules in the non-infarcted area of the kidney was disordered ;and there was cystic expansion and obvious inflammatory cell infiltration llittls- in the alveoli ;positive expression of LC 3 and Beclin- 1 protein nows@126.com in heart ,kidney and lung increased ,mainly distributed in the cytoplasm of cardiomyocytes ,distal renal tubular epithelial cells ,alveolar macrophages and epithelial cells. Compared with model group,the above indexes of rats in each dose group of Cur-SLN were mostly significantly reversed ;the pathological changes of heart,kidney and lung tissues were reduced ,the infiltration of inflammatory cells was reduced ;and the positive expression of LC 3 and Beclin- 1 protein were reduced ,which were mainly distributed in the cytoplasm of cardiomyocytes and proximal renal tubular epithelial cells ,and a few in distal renal tubular epithelial cells ,alveolar macrophages and epithelial cells. CONCLUSIONS : Cur-SLN can improve the heart ,kidney and lung functions of rats with cardiorenal syndrome ,and its mechanism may be related to regulating the distribution or expression of LC 3 and Beclin- 1 protein in heart ,kidney and lung.

12.
Article in Chinese | WPRIM | ID: wpr-885289

ABSTRACT

Objective:To evaluatte the high risk factors of stent occlusion in patients with acute iliofemoral vein thrombosis and Cockett syndrome.Methods:The clinical data of 178 patients of Cockett syndrome and acute lower extremity deep vein thrombosis from Jan 2014 to Dec 2016 was analyzed retrospectively. All patients underwent catheter directed thrombolysis or percutaneous mechanical thrombectomy combined with stent placement. The patency rate of stent was followed up by color Doppler ultrasound. Patients were divided into study group (stent occlusion) and control group (stent patency).Results:The stent patency rate at 6 months was 83.7%, body mass index ( OR=1.245, 95% CI: 1.097-1.413), time of thrombosis more than 2 weeks ( OR=3.899, 95% CI: 1.147-13.257), low thrombus clearance ( OR=0.238, 95% CI: 0.117-0.486) was the high risk factor of short-term stent occlusion. Stent patency rate at 3 years was 75.3%, body mass index( OR=1.225, 95% CI: 1.076-1.394), thrombosis history more than 2 weeks( OR=11.777, 95% CI: 2.576-53.832), malignant tumor( OR=4.444, 95% CI: 1.153-17.127) , compression therapy( OR=0.332, 95% CI: 0.113-0.977), low thrombus clearance( OR=0.184, 95% CI: 0.089-0.381), long stents( OR=8.427, 95% CI: 2.329-30.488) was the high risk factor for mid-term stent occlusion. Conclusions:Obesity, the duration of thrombus longer than 2 weeks and low thrombus clearance are the high risk factors of early stent occlusion, while malignant tumor, irregular compression therapy and long stents may lead to lower medium and long term patency rate of the stent.

13.
Chinese Journal of Dermatology ; (12): 335-341, 2021.
Article in Chinese | WPRIM | ID: wpr-885221

ABSTRACT

Objective:To explore the role of group 2 innate lymphoid cells (ILC2) in atopic dermatitis (AD) .Methods:C57BL/6J and Rag1 -/- mice served as research objects. The C57BL/6J mice were divided into 2 groups: model group topically treated with calcipotriol (MC903) on both ears every day for 14 consecutive days, control group topically treated with anhydrous ethanol alone at the same time. On day 15, peripheral blood samples were collected from the mice. After the sacrifice, the ear skin tissues were obtained for histopathological examination, and the spleens were resected. Real-time fluorescence-based quantitative PCR was performed to determine the expression of inflammatory factors in the skin and spleen tissues, and flow cytometry to determine the proportion of ILC2 in the skin tissues. The Rag1 -/- mice were divided into model group, control group and experimental group: the Rag1 -/- mice in the model group and control group received the same treatment and evaluation as the C57BL/6J mice; two days before the topical treatment with MC903, the Rag1 -/- mice in the experimental group started to be intraperitoneally injected with the monoclonal antibody CD90.2 at a dose of 300 μg/150 μl once every other 2 days for 7 sessions, with the purpose of antagonizing the function of ILC2, and other treatments were the same as those in the model group. Skin manifestations were observed, and histopathological features were evaluated. Two-independent-sample t test was used for comparisons between 2 groups, and one-way analysis of variance for comparisons among multiple groups. Results:In the model group, the ear skin of the C57BL/6J mice was apparently red, swollen and dry with crusts, and hematoxylin and eosin (HE) staining showed increased thickness of the epidermis and dermal infiltration of eosinophils; the serum level of IgE (6 751.016 ± 282.324 μg/L) was significantly higher in the model group than in the control group (6 387.038 ± 267.853 μg/L, P= 0.007) , so were the expression of interleukin (IL) -4, IL-13 and interferon (IFN) -γ in the skin tissues ( P= 0.005, 0.012, < 0.001, respectively) , but there was no significant difference in IL-5 expression ( P= 0.190) ; the expression of IL-4, IL-13 and IFN-γ in the spleen was significantly higher in the model group than in the control group (all P < 0.001) , but there was no significant difference in IFN-γ expression ( P= 0.278) ; moreover, the model group showed significantly increased proportion of ILC2 (5.604% ± 2.105%) compared with the control group (1.750% ± 1.104%, P= 0.003) . In the Rag1 -/- mice, the ear skin was obviously red, swelling and dry with crusts in the model group, and HE staining showed increased epidermal thickness and eosinophil infiltration in the dermis; the model group showed significantly increased expression of IL-4, IL-5, thymic stromal lymphopoietin (TSLP) and IL-33 in skin tissues ( P= 0.010, 0.043, 0.034, 0.007, respectively) , but no significant difference in the expression of IL-13 or IFN-γ ( P= 0.274, 0.697, respectively) compared with the control group; the proportion of ILC2 was significantly higher in the model group (5.165% ± 2.436%) than in the control group (0.835% ± 0.578%, P= 0.014) ; the experimental group showed markedly attenuated skin lesions, reduced epidermal thickness and number of eosinophils infiltrating in the dermis, but no significant difference in the expression of IL-4, IL-5, IL-13, TSLP or IL-33 compared with the model group (all P > 0.05) . Conclusion:ILC2 play a role in the mice with AD-like inflammatory response induced by MC903, which dose not depend on adaptive immunity.

14.
Article in Chinese | WPRIM | ID: wpr-885070

ABSTRACT

Objective:To compare the patient-centered doctor-patient communication skills in anesthesiologists with different working experience and genders.Methods:The second and third year residents who had been trained as residents in the Department of Anesthesiology in our hospital from September 2017 and September 2018 and senior physicians who had worked for 10-15 yr in our hospital, were recruited to perform a preoperative interview in a standardized patient counter.Consultation and Relational Empathy (CARE) measure was used to assess the communication skills among senior physicians, residents, and anesthesiologists of different genders.The residents also took the objective structured clinical examination (OSCE) and theory examination.Results:Thirty-six residents and 20 senior physicians were included.There was no significant difference in the CARE measure score between residents and senior physicians and in the total CARE measure score between residents who received doctor-patient communication training at the stage of medical students and those who did not ( P>0.05). Compared with the residents in the second year, the listening ability score and decision-making ability score were significantly decreased ( P<0.05), and no significant change was found in the scores for the other items in the residents in the third year ( P>0.05). Compared with residents, the listening ability scores were significantly increased, and the caring ability scores were decreased ( P<0.05), and no significant change was found in the scores for the other items in senior physicians ( P>0.05). There was no difference in CARE measure scores between the male and female anesthesiologists.The resident′s CARE measure score was positively correlated with the annual OSCE score ( r=0.486, P<0.05), and there was no correlation between the resident′s CARE measure score and annual theoretical examination grade ( r=0.308, P>0.05). Conclusion:Senior anesthesiologists with more clinical experience are not superior to the junior residents in patient-centered communication skills, and the doctor-patient communication skills of residents are not related to their medical theoretical grade.Moreover, there is no significant difference between male and female anesthesiologists in terms of doctor-patient communication skills before surgery.Therefore, training of patient-centered doctor-patient communication skills should be strengthened at all levels of anesthesiologists.

15.
Article in Chinese | WPRIM | ID: wpr-884474

ABSTRACT

Objective:To investigate the accuracy and feasibility of 3D-printing individualized template-guided and CT-guided 192Ir interstitial brachytherapy in the central recurrent gynecologic tumors by comparing pre-plan and intraoperative physical dosimetric parameters. Methods:This study involved 38 patients with central recurrent gynecologic tumors who underwent 3D printing individual template (3D-PIT)-assisted and CT-guided 192Ir interstitial brachytherapy in the Department of Radiation Oncology of the Peking University Third Hospital from Jan 2018 to Dec 2019.The prescription doses for the target tumor areas were 10-36 Gy to be delivered at 5-6 Gy/fraction for 2-6 fractions.The pre-plan and intraoperative dosimetric parameters were compared, including the minimum prescription doses delivered to 90% and 100% of target volume( D90, D100)and the mean percentage of volume receiving 100% of the prescription doses ( V100). Meanwhile, the doses delivered to 2 cm 3 ( D2 cm 3) of organs at risk (bladders, rectums, and colons) were analyzed.The quality parameters of the brachytherapy were studied, including conformity index (CI), homogeneity index (HI), and external index (EI) of the target volume.Perioperative complications were also observed. Results:A total of 194 treatments were included.During the treatment, 5-13 (median 6) needles were inserted, with a prescription dose of 5-6 Gy per fraction.There were no statistical differences between pre-plan and intraoperative D90, D100, V100, CI, HI, and EI as well as the D2 cm 3 of bladders and colons at risk ( P>0.05). In contrast, for the D2 cm 3 of rectums, the intraoperative dose was slightly higher than the pre-plan dose, showing a statistical difference ( t=-0.335, P=0.027). Conclusions:The 3D-PIT-assisted and CT-guided 192Ir interstitial brachytherapy at a high dose rate is accurate and feasible in the treatment of recurrent gynecologic tumors, meeting the pre-plan dose requirement.

16.
Article in English | WPRIM | ID: wpr-922417

ABSTRACT

OBJECTIVES@#To study the changes in biochemical metabolites in the thalamus and the cerebellum and their association with clinical features in children with autism spectrum disorder (ASD).@*METHODS@#In this prospective study, magnetic resonance spectroscopy (MRS) with point-resolved spatial selection was used to analyze the thalamus and the cerebellum at both sides in 50 children with ASD aged 2-6 years. Creatine (Cr) was as the internal standard to measure the relative values of N-acetylaspartate (NAA)/Cr, choline (Cho)/Cr, myoinositol (MI)/Cr, and glutamine and glutamate complex (Glx)/Cr, and the differences in metabolites and their association with clinical symptoms were compared.@*RESULTS@#In the children with ASD, NAA/Cr in the left thalamus was positively correlated with the scores of hearing-language and hand-eye coordination in the Griffiths Development Scales-Chinese (@*CONCLUSIONS@#There are metabolic disorders in the cerebellum and the thalamus in children with ASD, and there is a correlation between the changes of metabolites in the left cerebellum and the left thalamus. Some metabolic indexes are related to the clinical symptoms of ASD. MRS may reveal the pathological basis of ASD and provide a basis for diagnosis and prognosis assessment of ASD as a noninvasive and quantitative detection method.


Subject(s)
Autism Spectrum Disorder/diagnostic imaging , Cerebellum/diagnostic imaging , Child , Choline , Humans , Magnetic Resonance Spectroscopy , Prospective Studies , Thalamus/diagnostic imaging
17.
Article in Chinese | WPRIM | ID: wpr-921980

ABSTRACT

OBJECTIVE@#To detect variant of TRNT1 gene in a child featuring sideroblastic anemia with B-cell immunodeficiency, periodic fever and developmental delay (SIFD).@*METHODS@#The proband and his parents were analyzed through trio-whole exome sequencing. Sanger sequencing and bioinformatic analysis were carried out to verify the candidate variant sites associated with the clinical phenotype.@*RESULTS@#Genetic testing showed that the proband has carried compound heterozygous variants of the TRNT1 gene, namely c.88A>G(p.Met30Val) and c.363G>T(p.Glu121Asp). Sanger sequencing confirmed that the variants were respectively inherited from his father and mother. The variants were unreported previously. By bioinformatic analysis, both variants were predicted to affect the stability of binding of the TRNT1 protein with tRNA. Based on the American College of Medical Genetics and Genomics standards and guidelines, c.88A>G and c.363G>T variants of TRNT1 gene were predicted to be uncertain significance (PM2+PP3+PP4) and likely pathogenic (PM1+PM2+PP3+PP4), respectively.@*CONCLUSION@#The c.88A>G (p.Met30Val) and c.363G>T(p.Glu121Asp) compound heterozygous variants of the TRNT1 gene probably underlay the disease in this patient. Above finding has enriched the spectrum of TRNT1 gene variants.


Subject(s)
Genetic Testing , Humans , Nucleotidyltransferases
18.
Chinese Medical Journal ; (24): 2175-2185, 2021.
Article in English | WPRIM | ID: wpr-921109

ABSTRACT

BACKGROUND@#Macrophages are involved in the pathogenesis of idiopathic pulmonary fibrosis, partially by activating lung fibroblasts. However, how macrophages communicate with lung fibroblasts is largely unexplored. Exosomes can mediate intercellular communication, whereas its role in lung fibrogenesis is unclear. Here we aim to investigate whether exosomes can mediate the crosstalk between macrophages and lung fibroblasts and subsequently induce fibrosis.@*METHODS@#In vivo, bleomycin (BLM)-induced lung fibrosis model was established and macrophages infiltration was examined. The effects of GW4869, an exosomes inhibitor, on lung fibrosis were assessed. Moreover, macrophage exosomes were injected into mice to observe its pro-fibrotic effects. In vitro, exosomes derived from angiotensin II (Ang II)-stimulated macrophages were collected. Then, lung fibroblasts were treated with the exosomes. Twenty-four hours later, protein levels of α-collagen I, angiotensin II type 1 receptor (AT1R), transforming growth factor-β (TGF-β), and phospho-Smad2/3 (p-Smad2/3) in lung fibroblasts were examined. The Student's t test or analysis of variance were used for statistical analysis.@*RESULTS@#In vivo, BLM-treated mice showed enhanced infiltration of macrophages, increased fibrotic alterations, and higher levels of Ang II and AT1R. GW4869 attenuated BLM-induced pulmonary fibrosis. Mice with exosomes injection showed fibrotic features with higher levels of Ang II and AT1R, which was reversed by irbesartan. In vitro, we found that macrophages secreted a great number of exosomes. The exosomes were taken by fibroblasts and resulted in higher levels of AT1R (0.22 ± 0.02 vs. 0.07 ± 0.02, t = 8.66, P = 0.001), TGF-β (0.54 ± 0.05 vs. 0.09 ± 0.06, t = 10.00, P < 0.001), p-Smad2/3 (0.58 ± 0.06 vs. 0.07 ± 0.03, t = 12.86, P < 0.001) and α-collagen I (0.27 ± 0.02 vs. 0.16 ± 0.01, t = 7.01, P = 0.002), and increased Ang II secretion (62.27 ± 7.32 vs. 9.56 ± 1.68, t = 12.16, P < 0.001). Interestingly, Ang II increased the number of macrophage exosomes, and the protein levels of Alix (1.45 ± 0.15 vs. 1.00 ± 0.10, t = 4.32, P = 0.012), AT1R (4.05 ± 0.64 vs. 1.00 ± 0.09, t = 8.17, P = 0.001), and glyceraldehyde-3-phosphate dehydrogenase (2.13 ± 0.36 vs. 1.00 ± 0.10, t = 5.28, P = 0.006) were increased in exosomes secreted by the same number of macrophages, indicating a positive loop between Ang II and exosomes production.@*CONCLUSIONS@#Exosomes mediate intercellular communication between macrophages and fibroblasts plays an important role in BLM-induced pulmonary fibrosis.


Subject(s)
Angiotensin II , Animals , Bleomycin/toxicity , Exosomes , Fibroblasts , Lung , Macrophages , Mice , Mice, Inbred C57BL , Pulmonary Fibrosis/chemically induced , Receptor, Angiotensin, Type 1
19.
Article in Chinese | WPRIM | ID: wpr-878990

ABSTRACT

Gastrodiae Rhizoma-Uncariae Ramulus cum Uncis is the most frequently used herbal pair in the treatment of Parkinson's disease(PD). Gastrodin and isorhynchophylline are important components of Gastrodiae Rhizoma-Uncariae Ramulus cum Uncis herb pair with anti-Parkinson mechanism. This study aimed to investigate the effect of gastrodin combined with isorhynchophylline on 1-methyl-4-phenylpyridinium(MPP~+)-induced apoptosis of PC12 cells and their antioxidant mechanism. The leakage of lactate dehydrogenase(LDH) from cells to media was analyzed by spectrophotometry. Apoptotic cells were labeled with Annexin V-fluorescein isothiocyanate(FITC) and propidium iodide(PI) and analyzed by flow cytometry. The cell cycle was analyzed using propidium iodide(PI) staining. Lipid peroxidation(LPO) level was analyzed by spectrophotometry. The mRNA expression of caspase-3 was examined by Real-time RT-PCR. The protein expressions of heme oxygenase 1(HO-1) and NADPH: quinoneoxidore-ductase 1(NQO-1) were determined by Western blot. Gastrodin combined with isorhynchophylline reduced the percentage of Annexin V-positive cells and cell cycle arrest in MPP~+-induced PC12 cells. Gastrodin combined with isorhynchophylline down-regulated the mRNA expression of caspase-3, up-regulated the protein expressions of HO-1 and NQO-1, and reduced LPO content in MPP~+-induced PC12 cells. PD98059, LY294002 or LiCl could partially reverse these changes pretreated with gastrodin combined with isorhynchophylline, suggesting that gastrodin combined with isorhynchophylline inhibited MPP~+-induced apoptosis of PC12 cells and oxidative stress through ERK1/2 and PI3 K/GSK-3β signal pathways. Our experiments showed that gastrodin combined with isorhynchophylline could down-re-gulate the mRNA expression of caspase-3 and up-regulate the protein expressions of HO-1 and NQO-1, so as to reduce oxidative stress and inhibit apoptosis.


Subject(s)
1-Methyl-4-phenylpyridinium/toxicity , Animals , Antioxidants , Apoptosis , Benzyl Alcohols , Cell Survival , Glucosides , Glycogen Synthase Kinase 3 beta , Oxindoles , PC12 Cells , Rats
20.
Chinese Journal of Biotechnology ; (12): 1406-1414, 2021.
Article in Chinese | WPRIM | ID: wpr-878642

ABSTRACT

The toxin-producing bacterium Vibrio cholerae can cause severe diarrhea and has caused seven global pandemics. Traditional viable cell counts and phage plaques are commonly used to evaluate the efficacy of virulent phage clearance of V. cholerae, but these operations are time-consuming and labor-intensive, and difficult to provide real-time changes. It is desirable to develop a simple and real-time method to monitor V. cholerae during phage lysis. In this study, a luminescence-generating plasmid pBBR-pmdh-luxCDABE was transformed into three O1 serogroup drug-resistant strains of V. cholerae. The results showed that the luminescence value as a monitoring index correlates well with the traditional viable cell count method. Monitoring the number of live cells of V. cholerae by measuring the luminescence allowed real-time analysis of the number of bacteria remaining during phage lysis. This method enables repeated, interference-free, continuous multiple-time-point detection of the same sample without the time delay of re-culture or plaque formation, facilitating real-time monitoring and analysis of the interaction between the phage and the host bacteria.


Subject(s)
Bacteriophages/genetics , Luminescence , Plasmids , Vibrio cholerae
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