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Objective:To analyze the effects of different plasma B-type natriuretic peptide (BNP) changes on worsening renal function (WRF) on 1-year all-cause mortality in patients with acute heart failure (AHF).Methods:The clinical data of 399 patients with AHF admitted to our hospital from January 2015 to December 2019 were retrospectively analyzed. According to the severity of WRF, the patients were divided into non-severe worsening renal function (nsWRF) group, severe worsening renal function (sWRF) group and non-WRF group. Plasma BNP decrease was defined as a reduction of B-type natriuretic peptide (BNP) at the time of discharge by ≥30% compared with the time of admission.Demographic characteristics and medical history, clinical data at admission, during hospitalization and at discharge, and survival status 1 year after discharge were collected. The measurement data presented in the form of normal distribution are as follows: single factor analysis of variance is used for comparison between groups, and LSD- t test is used for comparison between pairs; The Kruskal Wallis rank sum test was used for the multi group comparison of non normal distribution measurement data, and Wilcoxon rank sum test was used for the pairwise comparison. The comparison of counting data between groups was conducted using χ 2 test. Survival analysis was conducted using the Kaplan Meier method and Log rank test, and the Cox proportional risk regression model was used to analyze the influencing factors of 1-year all-cause mortality in patients. Results:399 cases of AHF were divided into nsWRF group with 68 cases, sWRF group with 82 cases, and nWRF group with 249 cases. 86 cases (21.5%) died within 1 year after discharge. The one-year mortality rate of the sWRF group was higher than that of the nWRF group and nsWRF group [42.7% (35/82) vs 16.1% (40/249), 16.2% (11/68)], and the differences were statistically significant (The χ 2 values were 24.94 and 12.28 respectively, both P<0.001), while there was no statistically significant difference between the nWRF group and the nsWRF group (χ 2=0.00、 P=0.982). The 1-year mortality rate of the nWRF group and sWRF group with decreased BNP during hospitalization was lower than that of the non decreased BNP group [29.1% (6/55) vs 70.4% (19/27), 10.5% (17/162) vs 26.4% (23/87), The χ 2 values are 12.61 and 10.67 respectively, and the P values are <0.001 and 0.001, respectively. The occurrence of nsWRF during hospitalization did not increase the one-year all-cause mortality risk of AHF patients ( P=0.754), but the occurrence of sWRF increased the all-cause mortality risk of AHF patients (odds ratio=2.33, 95% confidence interval: 1.31-4.13, P=0.004). The decrease in BNP during hospitalization reduced the one-year all-cause mortality risk of AHF patients (odds ratio=0.36, 95% confidence interval: 0.23-0.55, P<0.001). Conclusions:NsWRF does not increase the one-year all-cause mortality risk of AHF patients, while sWRF increases the one-year all-cause mortality risk, and a decrease in BNP during hospitalization reduces the one-year all-cause mortality risk.
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Objective: To investigate the effect of accuracy of phase 3 Oxford prosthesis positioning on short-term effectiveness of unicompartmental knee arthroplasty (UKA). Methods: The clinical data of 26 patients (26 knees) who were treated with UKA between September 2015 and November 2015 was retrospectively analyzed. The single-peg Oxford prosthesis was implanted in 15 patients (single-peg group), and twin-peg Oxford prosthesis was implanted in 11 patients (twin-peg group). There was no significant difference in gender, age, body mass index, Kellgren-Lawrence grading, and preoperative Hospital for Special Surgery (HSS) scores between 2 groups ( P>0.05). HSS, knee society score (KSS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Oxford knee score (OKS) were used to evaluate the knee function. Radiographic criteria for Oxford UKA was used to evaluate the prosthesis position. The reason and treatment of bearing dislocations were recorded. Results: All patients were followed up with mean follow-up time of 26.2 months in single-peg group (range, 24-27 months) and 25.2 months in twin-peg group (range, 24-26 months). The bearing dislocation occurred in 2 cases of twin-peg group during follow-up. At last follow-up, there was no significant difference in HSS, WOMAC, OKS, and KSS scores between 2 groups ( P>0.05). There was no significant difference in radiographic scores of femoral component, tibial component, and overall components between 2 groups ( P>0.05). No significant correlation was found between radiographic scores and postoperative functional outcome in 2 groups ( P>0.05). Conclusion: Within a safe range, the accuracy of phase 3 Oxford prosthesis positioning has limited influence on the short-term functional outcome.
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Objective:To synthesize autoinducer-2 by the clone and prokaryotic expression of Streptococcus mutans(S.mutans)UAl59 luxS gene and to observe the influence factors.Methods:The expression vector pET21 a(+)-luxS of S.mutans UAl59 was transformed into Escheriehia coli BL2l(DE3).The S-ribosylhomocysteinase(Luxs)expression was induced by IPTG.The His tag fusion protein was isolated by Ni-chelating column and identified by Western blotting.Finally the protein was renatured by dialysis method.S-ribosylhomo-cysteine (SAH)was catalyzed by s-adenosylhomocysteine nucleosidas (Pfs)and LuxS,and then AI-2 was syntheszed.The AI-2 activi-ty was examined by luminescence of Vibrio harveyi BB1 70 when the concentration of LuxS protein or pH(4 -1 2)or the concentration of sodium fluoride was changed in reaction mixes of AI-2 synthesis.Results:Compared with the control group,with the increase of LuxS protein concentration,the relative activity of in vitro synthesized AI-2 increased gradually(P <0.001 ).When pH was between 6 -1 0, the relative activity of AI-2 were the highest,beyond the range of pH,the relative activity of AI-2 decreased(P <0.001 ).When a final concentration of sodium fluoride was more than 0.3%,the luminescence values decreased(P <0.05).Conclusion:LuxS fusion protein can promote the production of AI-2.Optimum pH for AI-2 biosynthesis in vitro must be between 6-1 0.Biosynthesis of AI-2 is inhibited by sodium fluoride with final concentration of more than 0.3%.
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Objective To investigate the effects of mannan-binding lectin(MBL) on TNF-α production induced by peptidoglycan (PGN) and its mechanism in human THP-1/CD14 monocytes.Methods The THP-1/CD14 cells were stimulated for 24 h with PGN at the indicated ratios after pretreated with human natural MBL at concentrations ranging from 1 to 20 mg/L for 2 h.The content of TNF-α and IL-6 in culture supernatants were detected by ELISA,and the levels of TNF-α and IL-6 mRNA expressions in these cells were determined by RT-PCR.FACS was used to investigate the interaction of MBL with THP-1/CD14 cells and the impact of MBL on PGN binding to THP-1/CD14 cells.Western blot was used to detect PGN-induced NF-κB translocation in THP-1/CD14 cells.Results ELISA showed that secretion of TNF-α and IL-6 from THP-1/CD14 cells could be induced by PGN ;The productions of TNF-α and IL-6 by THP-1/CD14 cells induced with PGN were profoundly inhibited by MBL at higher concentrations (10-20 mg/L) but not MBL at lower concentrations (1 mg/L).RT-PCR analysis also indicated that the mRNA expressions of TNF-α and IL-6 in THP-1/CD14 cells were decreased by MBL at higher concentration,compared to the corresponding THP-1/CD14 cells stimulated with PGN only.FACS showed that the binding of MBL to THP-1/CD14 cells was evident in a Ca2+-dependent manner.PGN could competitively inhibit the binding of MBL to THP-1/CD14 cells.MBL could competitively inhibit the binding of PGN to THP-1/CD14 cells by binding to THP-1/CD14 cells directly.Similarly,MBL at higher concentration (20 mg/L) decreased the NF-κB translocation in THP-1/CD14 cells.Conclusion MBL may inhibit TNF-α and IL-6 production induced by PGN in THP-1/CD14 cells through NF-κB signaling pathways,suggesting that MBL can play some roles in the regulation of PGN-induced inflammatory response.
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BACKGROUND: The peripheral blood stem cell is a multi-differentiation precursor cell, and it can differentiate into osteoblasts. Tissue engineered bone, which is regarded as a vector of cell transplantation, has good compatibility with receptor tissue and seed cells. Transforming growth factor-β (TGF-β) is an important regulatory factor for repairing bone injury. Additionally, TGF-β can induce peripheral blood stem cells to differentiate and proliferate into osteoblasts.OBJECTIVE: To study TGF-β expression in repairing alveolar bone during synergetic transplantation of peripheral blood stem cells and tissue engineered bone. DESIGN: Observational study.SETTING: Stomatology Hospital of Xi'an Jiaotong University.MATERIALS: This study was performed at the Stomatology Hospital of Xi'an Jiaotong University from 2003 to 2006. Experimental animals were provided by the Animal Experimental Center, Medical College of Xi'an Jiaotong University (original Xi'an Medical University). All animals were intramuscularly induced with ketamine, intramuscularly anesthetized with sumianxin, and then sacrificed for surgery. The experiment was approved by the local ethics committee.METHODS: Peripheral blood stem cells were extracted from dog and prepared as a cell suspension. Iliac bone was obtained from healthy pig to prepare decalcifying-deproteinic tissue engineered bone. The tissue engineered bone was then dipped into peripheral blood stem cell suspension. Ten healthy hybrid dogs were randomly divided into an experimental group and a control group, with 5 dogs in each group. An incision was made from left to right along the canine teeth of the lower mandible, along the lip, lateral to the gingival sulcus, to the alveolar crest, and then along the bilateral vestibular groove to form a trapezoid segment. Subsequently, the segment was turned downward to expose the bone lamella lateral to the lip. In addition, a bone defect region of 2 cm × 2 cm × 1 cm was drilled between the lateral incisor of lower mandible using a turbine drill. Peripheral blood stem cell-tissue engineered bone was implanted in the experimental group but tissue engineered bone only was implanted in the control group. At 2, 3, 4, 8 and 12 weeks after surgery, during the differentiation and proliferation of peripheral blood stem cell into osteoblasts, TGF-β expression was measured using immunohistochemistry.MAIN OUTCOME MEASURES: ① Morphological changes of peripheral blood stem cells differentiating into osteoblasts and structural function of organoid were observed under optical microscopy and by transmission electron microscopy. ② TGF-β expression was measured using immunohistochemistry during the differentiation and proliferation of peripheral blood stem cells into osteoblasts.RESULTS: Two weeks after peripheral blood stem cell-tissue engineered bone transplantation in the experimental group, TGF-β expression was mildly positive at the fringe of the bone defect. Four to eight weeks after the transplantation, high numbers of osteoblasts, fibroblasts and collagenous fibers were found at the center of the bone defect region, and TGF-β expression was strongly positive. The bone defect was completely repaired after 12 weeks. In the control group, 8-12 weeks after tissue engineered bone transplantation, TGF-β expression was mildly positive only at the fringe of the bone defect. CONCLUSION: During dog alveolar bone defect repair, TGF-β can induce peripheral blood stem cells, in combination with tissue engineered bone, to differentiate and to proliferate into osteoblasts.
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OBJECTIVE To investigate the pathogenic change and bacterial antibiotic resistance in lower respiratory tract infection in inpatients of chronic pulmonary heavt disease(CPHD) for recently 3 years and to provide reference for clinical treatment.METHODS Retrospective analysis was conducted on sputum cultivation from CPHD patients who were hospitalized from Jan 2004 to Dec 2006.RESULTS A total of 772 pathogenic strains were isolated,60.1 % of which were Gram-negative bacilli.Pseudomonas aeruginosa,Klebsiella Pneumoniae,Escherichia coli and Acinetobacter baumannii were the main Gram-negative pathogens.Gram-positive bacilli accounted for 13.7%,most of which were Streptococcus pneumoniae,Staphylococcus aureus and so on.Fungi accounted for 26.2%.Imipenem/cilastatin sodium was the most sensitive drug for P.aeruginosa,Acinebacter and Enterobacteriaceae.And vancomycin hydrochloride was the most for S.aureus.Their multiple drug-resistance to anti-microbial agents was serious.CONCLUSIONS Gram-negative bacteria are the majority of the pathogens from CPHD of lower respiratory tract infection in hospital.The pathogens show multiple drug-resistance in drug sensitive test.It is suggested that there be urgent need for surveillance of bacterial resistance and rational use of anti-microbial agents during the clinical therapy.