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1.
Article in Chinese | WPRIM | ID: wpr-920824

ABSTRACT

@#Objective    To evaluate the diagnostic value of various severity assessment scoring systems for sepsis after cardiac surgery and the predictive value for long-term prognosis. Methods    The clinical data of patients who underwent cardiac sugeries including coronary artery bypass grafting (CABG) and (or) valve reconstruction/valve replacement were extracted from Medical Information Mark for Intensive Care-Ⅲ (MIMIC-Ⅲ). A total of 6 638 patients were enrolled in this study, including 4 558 males and 2 080 females, with an average age of 67.0±12.2 years. Discriminatory power was determined by comparing the area under the receiver operating characteristic (ROC) curve (AUC) for each scoring system individually using the method of DeLong. An X-tile analysis was used to determine the optimal cut-off point for each scoring system, and the patients were grouped by the cut-off point, and Kaplan-Meier curves and log-rank test were applied to analyze their long-term survival. Results    Compared with the sequential organ failure assessment (SOFA) score, acute physiology score-Ⅲ (APS-Ⅲ, P<0.001), the simplified acute physiology score-Ⅱ (SAPS-Ⅱ, P<0.001) and logistic organ dysfunction score (LODS, P<0.001) were more accurate in distinguishing sepsis. Compared with the non-septic group, the 10-year overall survival rate of the septic group was lower (P<0.001). Except for the systemic inflammation response score (SIRS) system, the 10-year overall survival rates of patients in the high risk layers of SOFA (HR=2.50, 95%CI 2.23-2.80, P<0.001), SAPS (HR=2.93, 95%CI 2.64-3.26, P<0.001), SAPS-Ⅱ (HR=2.77, 95%CI 2.51-3.04, P<0.001), APS-Ⅲ (HR=2.90, 95%CI 2.63-3.20, P<0.001), LODS (HR=2.17, 95%CI 1.97-2.38, P<0.001), modified logistic organ dysfunction score (MLODS, HR=2.04, 95%CI 1.86-2.25, P<0.001) and the Oxford acute severity of illness score (OASIS, HR=2.37, 95%CI 2.16-2.60, P<0.001) systems were lower than those in the low risk layers. Conclusion    Compared with SOFA score, APS-Ⅲ score may have higher value in the diagnosis of sepsis in patients who undergo isolated CABG, a valve procedure or a combination of both. Except for SIRS scoring system, SOFA, APS-Ⅲ, SAPS, SAPS-Ⅱ, LODS, MLODS and OASIS scoring systems can be applied to predict the long-term outcome of patients after cardiac surgery.

2.
Acta Physiologica Sinica ; (6): 208-216, 2021.
Article in Chinese | WPRIM | ID: wpr-878249

ABSTRACT

The transcription factor X-box binding protein-1 (XBP1) plays a key role in unfolded protein reaction. This study was aimed to investigate the expression pattern and regulation of XBP1 in the mouse uterus during early pregnancy. The methods of immunohistochemistry (IHC) and real time quantitative RT-PCR were used to test XBP1 expression in early pregnancy, artificial decidualization, oestrous cycle and hormone-regulated mouse models. The results showed that XBP1 was spatiotemporally expressed in mouse uterus during early pregnancy. The XBP1 protein was mainly detected in the luminal and glandular epithelia on days 1-4 of pregnancy, and was strongly detected in the decidual area on days 5-8 of pregnancy. Similarly, XBP1 expression was also mainly expressed in decidual cells following artificial decidualization. During the oestrous cycle, Xbp1, Xbp1u, and Xbp1s mRNA was predominantly present in proestrus. In the ovariectomized uterus, the expression of XBP1 in luminal and glandular epithelia was up-regulated after estrogen treatment. These results suggest that XBP1 is associated with embryo implantation and decidualization during early pregnancy in mice, and the expression of XBP1 in luminal and glandular epithelia may be regulated by estrogen.


Subject(s)
Animals , Decidua , Embryo Implantation , Estrogens , Female , Mice , Pregnancy , RNA, Messenger/genetics , Uterus
3.
Chinese Journal of Neurology ; (12): 696-699, 2021.
Article in Chinese | WPRIM | ID: wpr-911779

ABSTRACT

Spinocerebellar ataxias (SCAs), formerly known as autosomal dominant cerebellar ataxia, are a group of hereditary heterogeneous neurodegenerative disease that contains many subtypes. Spinocerebellar ataxia type 23 (SCA23), one type of SCAs, is caused by mutant prodynorphin (PDYN) gene. A 22-year-old patient was diagnosed with sporadic SCA23 due to gene detection, with a novel identified mutation, PDYN c.647C>T (p.P216L). Located in the dynorphin A-coding-region of PDYN gene, the pathogenic mechanism of the mutation may be relevant to the pathological changes caused by the variant including neurological dysfunction and death of cells. Mild improvement with the patient has been witnessed after active balance and speaking exercise.

4.
Article in Chinese | WPRIM | ID: wpr-911226

ABSTRACT

Objective:To evaluate the effect of sevoflurane-dexmedetomidine combined anesthesia on inflammatory responses in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).Methods:A total of 96 American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 45-60 yr, weighing 60-75 kg, with New York Heart Association Ⅱ or Ⅲ, scheduled for elective CABG with CPB, were divided into 4 groups ( n=24 each) using a random number table method: routine general anesthesia (group C), sevoflurane-based general anesthesia group (group S), dexmedetomidine-based general anesthesia group (group D) and sevoflurane combined with dexmedetomidine-based general anesthesia group (group SD). In D and SD groups, dexmedetomidine was intravenously infused in a loading dose of 1μg/kg over 10 min at the beginning of induction anesthesia, followed by an infusion at 0.4 μg·kg -1·h -1 until the end of the surgery.After tracheal intubation, 1%-2% sevofluran was inhaled in S and SD group.Before anesthesia induction, before the CPB, immediately at the end of CPB, at 6 h after the end of CPB and 24 h after surgery, central venous blood samples were collected for determination of plasma interleukin-6 (IL-6), IL-10 and tumor necrosis factor-alpha (TNF-α) concentrations by enzyme linked immunosorbent assay.The restoration of spontaneous heart beat, the occurrence of serious adverse events during surgery and within 24 h after surgery, the retention time of intubation and duration of intensive care unit (ICU) stay after surgery were recorded. Results:Compared with group C, the plasma concentrations of IL-6, IL-10 and TNF-α were significantly decreased in the other 3 groups, and the postoperative retention time of tracheal intubation was shortened in group SD ( P<0.05). Compared with group S or group D, the plasma concentrations of IL-6, IL-10 and TNF-α were significantly decreased ( P<0.05), and no significant change was found in the postoperative retention time of tracheal intubation in group SD ( P>0.05). There was no significant difference in the duration of ICU and restoration of spontaneous heart beat ( P>0.05), and no serious adverse events occurred during surgery and within 24 h after surgery among the groups. Conclusion:Sevoflurane combined with dexmedetomidine anesthesia is helpful in reducing the inflammatory responses in patients undergoing CABG with CPB, but provides no value in clinical outcomes.

5.
Chinese Journal of Urology ; (12): 925-931, 2021.
Article in Chinese | WPRIM | ID: wpr-911151

ABSTRACT

Objective:To comprehensively analyze the expression profile of circular RNA (circRNA) and construct competing endogenous RNA (ceRNA) regulatory networks in tuberous sclerosis complex related renal angiomyolipoma (TSC-RAML).Methods:According to the diagnostic criteria of TSC determined by the international consensus group on tuberous sclerosis in 2012, tumor tissues and paired normal renal tissues of 3 patients with TSC-RAML who were diagnosed in our hospital from January 2017 to January 2019 were collected. The circRNA, miRNA and mRNA of 3 paired samples were detected by circRNA, miRNA chip technology and next generation sequencing respectively, and the differential molecules were determined. Gene Ontology(GO) functional enrichment analysis and Kyoto Encyclopedia of genes and genomes(KEGG) pathway enrichment analysis were performed based on differential mRNA molecules and host genes of circRNA. Based on differential circRNA, miRNA and mRNA, up-regulated and down-regulated ceRNA regulatory networks were established.Results:A total of 330 up-regulated and 336 down-regulated differential circRNA, 8 up-regulated and 7 down-regulated miRNA, 800 up-regulated and 1130 down-regulated mRNA were screened. Through GO and KEGG enrichment analysis, many pathways including lipid metabolism, focal adhesion and mineral absorption were abnormally altered. Finally, the up-regualted ceRNA network led by hsa_circ_0092022, hsa_circ_0076859 and hsa_circ_0033388 and down-regulated network led by hsa_circ_0000374, hsa_circ_0000141, hsa_circ_0072665, hsa_circ_0009503 and hsa_circ_0000009 were constructed.Conclusions:There were many differentially expressed circRNA between TSC-RAML and paired normal renal tissues. ceRNA regulatory networks may be involved in the occurrence and development of TSC-RAML.

6.
Chinese Journal of Orthopaedics ; (12): 1163-1170, 2021.
Article in Chinese | WPRIM | ID: wpr-910703

ABSTRACT

Objective:To measure and compare the geometric rotation axis of the talocrucial joint at different poses during the normal gait.Methods:The kinematic data of 15 healthy volunteers, 8 females, 7 males; age, 26.2±5.4 y (range 19-39 y); height, 170.4±6.9 cm (range 160-183 cm); mass, 65.6±14.0 kg (range 52-100 kg). They were collected using the dual-fluoroscopy technique, and the spatial position of the tibia and talus was determined using the 3D-2D registration method. The medial and lateral side of the trochlear of each talus was fitted by two spheres and the geometric rotation axis of the tibiotalar joint was defined as the line connecting the origins of two spheres. Compared the position and orientation of the axis for different poses during the gait and also compared the difference of the radius of the medial and lateral spheres fitting the trochlear of each talus.Results:The radii of the medial spheres fitting the trochlear of each talus 19.52±1.47 mm,were significantly less than that of the lateral spheres 20.62±1.49 ( t=7.081, P<0.05). The averaged anterior-posterior distance between the geometric rotation point of the tibiotalar joint were 1.54±1.84, 1.71±1.69, 1.70±1.57, 1.72±1.62, 1.80±1.75, 1.96±1.86 mm, respectively, while the averaged medial-lateral distance were 0.06±1.84, -0.03±1.83, 0.08±1.83, 0.10±1.73, 0.10±1.47, 0.09±1.46 mm, respectively, and the averaged superior-inferiordistance were -21.92±1.46, -22.10±1.32, -22.10±1.50, -22.06±1.64, -21.93±1.62, -21.98±1.50 mm, respectively. The averaged angle between the geometric rotation axis of the tibiotalar joint and coronal plane were 3.31°±2.48°, 3.10°±2.67°, 3.64°±2.71°, 3.96°±3.19°, 4.28°±2.82°, 4.16°±3.11°, respectively, while the averaged angle between that and sagittal plane were 84.11°± 2.42°, 83.77°±3.19°, 83.77°±3.45°, 83.81°±3.69°, 83.99°±2.97°, 84.23°±3.01°, respectively, and the averaged angle between that and transverse plane were 4.40°±2.93°, 4.54°±3.74°, 3.97°±3.34°, 3.73°±2.49°, 3.78°±2.76°, 4.48°±2.49°, respectively. The position and orientation of the geometrical rotation axis of the tibiotalar joint at different poses during the gait showed no significant difference ( P>0.05). The rotation axis orientated from laterally and inferiorly to medially and superiorly with an averaged inclination angle from the horizontal plane of 3.74° and an averaged deviation angle from the coronal plane of 4.15°. Conclusion:The geometric rotation axis of the tibiotalar joint was fixed during the gait, therefore fitting the talar trochlea with the two-sphere model with a small radius of the medial sphere and a large radius of the lateral sphere may better mimic the kinematics of tibiotalar joint.

7.
Chinese Journal of Orthopaedics ; (12): 1040-1045, 2021.
Article in Chinese | WPRIM | ID: wpr-910688

ABSTRACT

Objective:To compare the operative treatment and non-operative treatment of the re-ruptured Achilles tendon with rupture end distance within 1 cm.Methods:We retrospectively analyzed 14 cases with Achilles tendon postoperative re-rupture in our hospital from May 2012 to March 2019. All 14 cases showed distance of rupture end less than 1cm during imaging in a passive plantarflexion position. Among the 14 cases with re-rupture, 8 were in the operative treatment group (7 males and 1 female, mean age 36.3±6.4 years, duration from initial rupture to re-rupture 3 to 213 weeks, height 174.9±8.7 cm, weight 75.5±13.9 kg, body mass index 24.5±2.7 kg/m 2, distance of re-ruptured ends 4.9±2.5 mm) and 6 were in the non-operative treatment group (5 males and 1 female, mean age 40.0±9.0 years, duration from initial rupture to re-rupture 4 to 60 weeks, height 173.8±3.5 cm, weight 77.5±7.4 kg, body mass index 25.7±2.5 kg/m 2, distance of re-ruptured ends 5.7±2.1 mm). The Achilles tendon rupture score (ATRS), visual analogue scale (VAS), and foot and ankle ability measure (FAAM) were used to evaluate the result at the patients' last follow-up. Results:All the 14 cases were followed for 8.7 to 92.2 months, with mean follow-up of 39.6 months. Ultrasound or MRI was performed at 6 months postoperatively or at last follow-up to ensure the Achilles tendons' healing. The average ATRS score, VAS score, FAAM-ADL score, and FAAM-Sports score of the operative treatment group were 85.4±13.5, 0 (0, 1.0) , 86.9±8.3, and 76.3±15.4, respectively. While those of the non-operative treatment group were 82.8±5.7, 0.5 (0, 1.3) , 88.1±8.3, and 77.2±15.0, respectively. The average VAS score, FAAM-ADL score, and FAAM-Sports score of the operative treatment group and those of the non-operative treatment group was not significantly different. The ATRS scores of 7 patients of the operative treatment group were between 81 and 96. The satisfaction rate of operative treatment group was 87.5% (7/8). The ATRS scores of 5 patients of the non-operative treatment group were between 81 and 91. The satisfactory rate of non-operative treatment group was 83.3% (5/6). All Achilles tendon re-rupture cases had no complications such as a third time Achilles tendon rupture or wound infection after treatment.Conclusion:For the re-ruptured Achilles tendon with rupture end distance within 1 cm, non-operative treatment achieved similar curative effect compared to operative treatment through extended duration of immobilization and non-weightbearing.

8.
Article in Chinese | WPRIM | ID: wpr-907767

ABSTRACT

Objective:To explore the new generation of intelligent ICU Unit based on 5G and artificial intelligence technology.Methods:This study was conducted at the Second Affiliated Hospital, Zhejiang University School of Medicine from May 2019 to August 2020. Based on a multidisciplinary team including medical, nursing, hospital management, clinical medical engineering, 5G technology, information technology, artificial intelligence technology, logistics service, etc, was assembled to intelligently design and reconstruct an intelligent ICU Unit of Emergency ICU.Results:Based on 5G technology, a new intelligent ICU unit environment was constructed to realize remote and high-speed interaction of multi-dimensional information in ICU, including intelligent assistance of remote monitoring, remote ward rounds, remote consultation and family visits. An intelligent hospital infection prevention and control system was established including automatic identification and alarm of hand hygiene and personal protection.Conclusions:The new generation of intelligent ICU unit combined with 5G and artificial intelligence technology has changed the mode of medical service for critically ill patients and improved the service level, which is worthy of further exploration and application.

9.
Article in Chinese | WPRIM | ID: wpr-907746

ABSTRACT

Objective:To explore the feasibility and effectiveness of the construction of urban unmanned aerial vehicle (UAV) blood distribution system, and to provide a novel way for the distribution of emergency blood.Methods:The study was completed in Hangzhou from April 2019 to January 2021, and the main participants were from the Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province Blood Center and Hangzhou Fast Ant Network Technology Co., Ltd. Firstly, an unmanned aircraft delivery system was built for urban emergency blood and a special blood storage box for drones were developed. The drone was used to deliver blood products from Zhejiang Province Blood Center to Binjiang Campus, the Second Affiliated Hospital of Zhejiang University School of Medicine, and the following indicators were obtained: (1) flight time of the drone blood delivery; (2) real-time temperature of blood products during transportation; (3) Baidu map software was used to measure the blood delivery time of road traffic, which was compared with the flight time of the drone.Results:The urban drone blood delivery system consists of intelligent logistics drones, cryogenic blood storage tanks, unmanned logistics hub stations, and cloud-based operation control platforms. The drone route distance from Zhejiang Provincial Blood Center to Binjiang Campus, the Second Affiliated Hospital of Zhejiang University School of Medicine was 2.36±0.06 km, and the ground distance was 5.8 km, with 27 flights from April 12, 2019 to January 29, 2021, and the drone flight time was, shorter than the road travel time for a round trip [(6.37±0.35) min vs. (17.00±1.94) min]. At different time points of the day, UAV blood delivery could save 15.98-4.28 min, with an average saving of 10.62±1.87 min. Conclusions:Urban UAV blood delivery systems have the advantages of being fast, unaffected by ground traffic conditions, and can ensure the safety of blood products during transportation, and are worthy of further exploration.

10.
Article in Chinese | WPRIM | ID: wpr-907141

ABSTRACT

ObjectiveThe clinical research team is the key to improving clinical research ability. The purpose of this study is to identify the main problems with the development of clinical research teams in specialized hospitals, and to explore countermeasures. MethodsOn the basis of literature review and consultation with experts, a self-made questionnaire was distributed online to survey 300 relevant staff engaged in clinical research in 10 tertiary specialized hospitals in Shanghai. The severity of existing problems was analyzed from four aspects: clinical research personnel planning, recruitment and allocation; training and development; evaluation and performance management; career management. Then in-depth personal interviews were conducted with the main heads of clinical research departments in some hospitals. ResultsFour problems have relatively high severity scores, with 3.65±1.0, 3.43±1.0, 3.53±1.0, and 3.44±1.0 points, respectively. They are: “The development of the clinical research team is incomplete, and there is a lack of stable multidisciplinary and multi-level talent teams”, “A systematic and continuous clinical research training system has not been established”, “An objective and fair evaluation index system has not yet been established”, and “There are obstacles in the career development and promotion path of clinical research professionals”. ConclusionTo further enhance the clinical research capabilities of hospitals, we urgently need to establish multidisciplinary and multi-level clinical research teams, strengthen the training of clinical researchers on their clinical research capabilities, establish a scientific evaluation index system and incentive methods, and explore career development that meets the characteristics of clinical researchers.

11.
Article in Chinese | WPRIM | ID: wpr-907118

ABSTRACT

ObjectiveThe clinical research team is the key to improving clinical research ability. The purpose of this study is to identify the main problems with the development of clinical research teams in specialized hospitals, and to explore countermeasures. MethodsOn the basis of literature review and consultation with experts, a self-made questionnaire was distributed online to survey 300 relevant staff engaged in clinical research in 10 tertiary specialized hospitals in Shanghai. The severity of existing problems was analyzed from four aspects: clinical research personnel planning, recruitment and allocation; training and development; evaluation and performance management; career management. Then in-depth personal interviews were conducted with the main heads of clinical research departments in some hospitals. ResultsFour problems have relatively high severity scores, with 3.65±1.0, 3.43±1.0, 3.53±1.0, and 3.44±1.0 points, respectively. They are: “The development of the clinical research team is incomplete, and there is a lack of stable multidisciplinary and multi-level talent teams”, “A systematic and continuous clinical research training system has not been established”, “An objective and fair evaluation index system has not yet been established”, and “There are obstacles in the career development and promotion path of clinical research professionals”. ConclusionTo further enhance the clinical research capabilities of hospitals, we urgently need to establish multidisciplinary and multi-level clinical research teams, strengthen the training of clinical researchers on their clinical research capabilities, establish a scientific evaluation index system and incentive methods, and explore career development that meets the characteristics of clinical researchers.

12.
Article in Chinese | WPRIM | ID: wpr-906596

ABSTRACT

@#Objective    To explore the hemodynamic effects of inhaled nitric oxide (iNO) on postoperative hemodynamic in patients with cyanotic congenital heart disease (CHD) combined with decreased pulmonary blood flow. Methods    From 2014 to 2018, there were 1 764 patients who received corrective repair of cyanotic CHD with decreased pulmonary blood flow in the Department of Pediatric Cardiac Surgery of Fuwai Hospital. We included 61 patients with the ratio of right ventricular systolic pressure to systolic blood pressure (SBP) ≥75% after weaning from cardiopulmonary bypass. There were 41 males and 20 females, with the age of 20.5 (9.0, 39.0) months and weight of 12.5±7.8 kg. The patients were divided into two groups: a conventional group (33 patients, conventional therapy only) and a combined therapy group (28 patients, iNO combined with conventional therapy). The hemodynamics during the first 24 hours after iNO therapy and the in-hospital outcomes of the two groups were investigated and compared. Results    There was no statistical difference between the two groups in demographic characteristics and surgical parameters (P>0.05). The hemodynamic effects of iNO within 24 hours included the decrease in the vasoactive inotropic score (VIS, 21.6±6.6 vs. 17.3±7.2, P=0.020) along with the increase in blood pressure (SBP: 73.7±9.7 mm Hg vs. 90.8±9.1 mm Hg, P<0.001) , the decrease in central venous pressure (10.0±3.1 mm Hg vs. 7.9±2.1 mm Hg, P=0.020), the decrease in lactate (2.2±1.7 mmol/L vs. 1.2± 0.5 mmol/L, P<0.001) and increase in urine output [2.8±1.7 mL/(kg·h) vs. 4.9±2.2 mL/(kg·h), P<0.001]. The decrease of VIS at 24 h after the surgery in the conventional therapy group was not statistically significant (22.1±7.9 vs. 20.0±8.5, P=0.232). Besides, we discovered that the need for renal replacement therapy (RRT) was less in the combined therapy group than that in the conventional therapy group, especially in the moderate complicated surgery [risk adjustment in congenital heart surgery (RACHS-1) ≤3] subgroup (9.5% vs. 40.7%, P=0.016). Conclusion    In pediatric patients after corrective repair of cyanotic and pulmonary blood follow decreased CHD with increased pulmonary vascular resistance, iNO combined with conventional therapy can improve the hemodynamics effectively. Compared with the conventional therapy, the combined therapy with iNO can decrease the VIS and the need for RRT, which is beneficial to the postoperative recovery of patients.

13.
Chinese Journal of School Health ; (12): 1527-1529, 2021.
Article in Chinese | WPRIM | ID: wpr-904599

ABSTRACT

Objective@#To analyze the prevalence of poor vision and eyeglass prescription, refractive examination among primary school students of grade 4-6 in Henan, so as to provide scientific basis for precise interventions for student vision health.@*Methods@#A stratified cluster random sampling method was used to investigate a total of 29 187 students of grade 4-6 from 17 cities in Henan Province. Distant vision examination and questionnaire survey were conducted.@*Results@#The overall prevalence of poor vision for grade 4-6 students in Henan was 63.6%, with girls (69.0%) higher than boys (59.0%),urban students (65.3%) higher than suburban students (62.5%)( χ 2=312.6, 23.6, P <0.01). The prevalence of severe poor vision was 28.5%.With the increase of grade, the detection rate of poor vision and severe poor vision increased( χ 2 trend =278.7, 775.4, P <0.01). Totally 13.2% of pupil did not have a visual examination in the past year. The rate of wearing glasses was 27.0% for students with poor eyesight and 3.2% for students with poor monocular eyesight. Totally 46.8% of the students wearing glasses received mydriatic optometry before wearing glasses.@*Conclusion@#The problem of poor vision among students of grade 4-6 in Henan is prominent, so it is necessary to strengthen eyesight monitoring and eye health education.

14.
Acta Pharmaceutica Sinica ; (12): 799-807, 2021.
Article in Chinese | WPRIM | ID: wpr-876521

ABSTRACT

Autophagy, an evolutionarily conserved process by which components of the cell are degraded in lysosomes, may facilitate survival of cancer cells under stress conditions. 8-Azaguanine (8-AG), an inhibitor of purine nucleotide biosynthesis, shows antineoplastic activity in multiple tumor cells. However, chemoresistance has restricted its development as an anticancer agent, and the mechanism of 8-AG resistance is not fully understood. We report here that 8-AG induces a protective autophagy to eliminate its cytotoxicity, and inhibition of autophagy increases cellular sensitivity of cancer cells to 8-AG treatment. Using HepG2 or SMMC-7721 hepatic cancer cell lines, we found that 8-AG inhibited cell viability and induced intrinsic apoptosis, accompanied by the up-regulation of the pro-apoptotic protein BimS, one of Bim (also known as BCL-2-like protein 11, BCL2L11) isoforms. Furthermore, 8-AG treatment enhanced the autophagy flux by promoting the dephosphorylation and activation of Unc-51-like autophagy activating kinase 1 (ULK1) via Akt/mTORC1 (mammalian target of rapamycin complex 1) signaling inhibition. Depletion of autophagy-related gene 7 (ATG7) markedly enhanced the level of BimS, and promoted cell death in response to 8-AG. 8-AG in combination with autophagy inhibitor chloroquine (CQ) or bafilomycin A1 (Baf A1) promoted the 8-AG-induced apoptosis in hepatic cancer cells. Altogether, these findings suggest that autophagy promotes chemoresistance of cancer cells for 8-AG, and blocking autophagy increases cellular sensitivity of cancer cells to 8-AG treatment.

15.
Article in Chinese | WPRIM | ID: wpr-876069

ABSTRACT

@#Objective    To identify the risk factors of postoperative blood loss among pediatric patients following corrective operation of tetralogy of Fallot (TOF) and to develop nomogram predicting the risk of postoperative blood loss. Methods    A retrospective case-control study was conducted in pediatric TOF patients who underwent corrective operation in our hospital from November 2018 to June 2019. And the clinical data from each enrolled patient were gathered and analyzed. Clinically significant postoperative blood loss was defined as drainage volume from chest tube ≥ 16 mL/kg during the first 24 h after surgery, which corresponded to the 75th percentile of the blood loss in our population. The primary outcome was to determine the independent predictors of postoperative blood loss by the least absolute shrinkage and selection operator (LASSO) regression, univariate and multivariate logistic regression analysis. On the basis of the independent predictors of postoperative bleeding, nomogram was developed and its discrimination and calibration were estimated. Results    A total of 105 children were selected (67 males and 38 females aged 3-72 months). The drainage volume from chest tube in the bleeding group was significantly higher than that in the non-bleeding group during the first 24 h (P<0.000 1). Multivariate logistic regression analysis showed that low body weight (OR=0.538, 95%CI 0.369-0.787, P=0.001), high preoperative hemoglobin concentration (OR=1.036, 95%CI 1.008-1.066, P=0.013) and prolonged intraoperative aortic cross clamp time (OR=1.022, 95%CI 1.000-1.044, P=0.048) were independent risk factors for postoperative blood loss. In the internal validation, the model displayed good discrimination with a C-index of 0.835 (95%CI 0.745-0.926) and high quality of calibration plots in nomogram models was noticed. Conclusion    The nomogram demonstrated good discrimination and calibration in estimating the risk of postoperative blood loss among pediatric patients following corrective operation of TOF.

16.
Article in Chinese | WPRIM | ID: wpr-873545

ABSTRACT

@#Objective    To summarize the early clinical features and perioperative management strategies for patients with transposition of the great arteries (TGA) after one-stage arterial switch operation (ASO), and investigate the risk factors for prolonged recovery in ICU, with a focus on the age structure and deformity complexity. Methods    The clinical data of 231 consecutive TGA patients who underwent one-stage ASO were retrospectively analyzed. There were 165 males and 66 females, aged from 3 d to 10 years. The patients were sequenced by the length of ICU stay. The time at the 75th percentile was defined as the critical value for grouping. Patients with an ICU stay time over this point were allocated to a prolonged recovery group (n=54), while the rest were allocated to a normal recovery group (n=177). The perioperative clinical data were compared between the two groups, and the risk factors for prolonged recovery were evaluated. Results    About half (49.6%) of the patients received late operation. The mean ICU stay time was 23.9±15.6 d in the prolonged recovery group, and 4.9±2.3 d in the normal recovery group. Complication of aortic arch lesion, delayed chest closure and postoperative pulmonary infection were independent risk factors for prolonged recovery after ASO in ICU. However, late operation had no significant effect on the overall recovery. Conclusion    With strict surgery indications and excellent postoperative management, most patients can have satisfactory early-stage outcomes, but are confronted with  increased complications, which is associated with prolonged recovery. Complication of aortic arch lesion, delayed chest closure and postoperative pulmonary infection are independent factors for delayed recovery of ASO.

17.
Chinese Journal of School Health ; (12): 1306-1310, 2021.
Article in Chinese | WPRIM | ID: wpr-886897

ABSTRACT

Objective@#To explore the status of PM 2.5 pollution in school classrooms and the student exposure level, and to provide basic data to safeguard the health of students.@*Methods@#This study continuously monitored the PM 2.5 levels of 16 naturally ventilated classrooms in eight primary and secondary schools in Jiamusi for one academic year using an online environmental monitoring instrument. At the same time, outdoor PM 2.5 data was captured for comparative research, and student exposure to PM 2.5 during school hours was evaluated.@*Results@#The average concentration of PM 2.5 in the classroom in the spring and autumn semesters was (26.93±24.7) and (31.85±30.37)μg/m 3, respectively, and the indoor/outdoor ratio ( I/O ) was 0.92 and 0.95, respectively, which indicated a strong correlation between them. The daily average concentration of all classrooms during both semesters was ( 28.93 ±26.85)μg/m 3, which was slightly higher than the average concentration of (27.53±26.53)μg/m 3 during the daytime when students were in school. In addition, the concentration on workdays was higher than that observed on weekends, and this was termed the "weekend effect". The indoor PM 2.5 concentration was lower on higher floors. The comprehensive exposure concentration of students during school was 28.48 μg/m 3 in spring semester and 31.87 μg/m 3 in autumn semester.@*Conclusion@#PM 2.5 levels in the classrooms varied according to time, the horizontal space, and the vertical space, and the level of indoor PM 2.5 pollution largely depended on outdoor pollution sources. Differences in PM 2.5 exposure were observed between.

18.
Article in Chinese | WPRIM | ID: wpr-886855

ABSTRACT

@#Objective    To assess outcomes of transcatheter aortic valve replacement (TAVR) for pure native aortic valve regurgitation. Methods    A total of 129 patients underwent transfemoral TAVR in Fuwai Hospital from May 2019 to October 2020 were retrospectively analyzed. There were 83 males and 46 females with an average age of 72.26±8.97 years. The patients were divided into a pure native aortic valve regurgitation group (17 patients) and an aortic valve stenosis group (112 patients). Results    The incidence of valve in valve was higher in the pure native aortic valve regurgitation group (47.0% vs. 16.1%, P<0.01). There was no statistical difference between the two groups in conversion to surgery, intraoperative use of extracorporeal circulation, intraoperative left ventricular rupture, postoperative use of extracorporeal membrane oxygenation (ECMO), peripheral vascular complications, disabled stroke, death, or pacemaker implantation. There was no statistical difference in the diameter of annulus (25.75±2.21 mm vs. 24.70±2.90 mm, P=0.068) or diameter of outflow tract (25.82±3.75 mm vs. 25.37±3.92 mm, P=0.514) between the pure native aortic valve regurgitation group and the aortic valve stenosis group. Conclusion    Transfemoral TAVR is a feasible method for patients with pure native aortic valve regurgitation. The diameter of annulus plane, the diameter of outflow tract and the shape of outflow tract should be evaluated.

19.
Article in Chinese | WPRIM | ID: wpr-886757

ABSTRACT

Objective To investigate the population dynamics and Echinococcus infections in small rodents around human settlement in Yushu City, Qinghai Province. Methods Rodents were captured using the mouse trap method in pastures from Batang Township and Longbao Township of Yushu City, Qinghai Province on May, August and October, 2018. The body weight and snout-vent length of all captured rodents were measured, and the species was identified according to the rodent morphology. Genomic DNA was extracted from rodent liver specimens and lesion specimens, and the mitochondrial cox1 gene of Echinococcus was amplified using PCR assay for identification of parasite species. In addition, the tissue specimens positive for PCR assay were sampled for pathological examinations. The prevalence of Echinococcus infections was estimated in rodents, and a phylogenetic tree was created based on Echinococcus cox1 gene sequences. Results A total of 285 small rodents were captured, including 143 Ochotona curzoniae (50.2%), 141 Lasiopodomys fuscus (49.5%), and 1 Neodon irene (0.3%), and there was a remarkable variation in habitat selection among these three rodent species. The number of L. fuscus correlated positively with vegetation coverage (r = 0.350, P = 0.264), with the greatest number seen in August, and the number of O. curzoniae negatively with vegetation coverage (r = −0.371, P = 0.235), with the highest number seen in August and the lowest number in May. The female/male ratios of O. curzoniae and voles were 1:0.96 and 0.82:1, respectively. The body weight (r = 0.519, P < 0.01) and snout-vent length (r = 0.578, P < 0.01) of O. curzoniae showed a tendency towards a rise with month, while the body weight (r = −0.401, P < 0.01) and snout-vent length (r = −0.570, P < 0.01) of voles presented a tendency towards a reduction with month. No Echinococcus infection was detected in voles, while 2.1% prevalence of E. shiquicus infection was seen in O. curzoniae. Phylogenetic analysis revealed consistent sequences of cox1 gene from E. shiquicus in Yushu City of Qinghai Province and Shiqu County, Ganzi Tibetan Autonomous Prefecture of Sichuan Province. Conclusions The small rodents around the human settlement in Yushu City of Qinghai Province mainly include O. curzoniae and L. fuscus, with the greatest numbers seen in May and August, respectively. Following the concerted efforts for echinococcosis control, the prevalence of Echinococcus infections is low in small rodents around the human settlement in Yushu City; however, there is still a risk of echinococcosis transmission.

20.
Article in Chinese | WPRIM | ID: wpr-886531

ABSTRACT

@#Objective    To compare and analyze the clinical effects of two kinds of frame design valves after transcatheter aortic valve replacement (TAVR). Methods    We retrospectively reviewed 124 patients who underwent TAVR and were followed up for 1 year. There were 71 males and 53 females aged 75.57±6.21 years. These patients were treated with Venus-A or Edwards Sapien aortic valves. The hemodynamics and cardiac function of these two kinds of transcatheter aortic valves (THV) were evaluated by echocardiography. The 30-day mortality and 1-year clinical effect of the patients were calculated. Results    Eight-one patients used Venus-A valve and 43 patients used Edwards Sapien valve. The aortic valve transaortic pressure gradient was reduced and the rate of perivalvular leakage was low (both 2.6%) in both groups, and there was no statistical difference between the two groups. The implantation rate of permanent pacemaker was 17.3% and 11.6%, respectively. The 1-month survival (94.0% and 93.0%) and 1-year survival (94.0% and 91.0%) rates were not statistically different. Conclusion    The two groups of THV with different stent structures have good short-term clinical effect and low implantation rate of permanent pacemaker.

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