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Malaria remains a major global public health concern, and nearly half of the global populations are still at risk of malaria infection. However, continuous emergence and spread of drug-resistant malaria parasite strains lead to ineffectiveness of conventional antimalarials. Therefore, development of novel antimalarial agents is of urgent need for malaria elimination. As an important component of the host natural immune defense system, antibacterial peptides provide the first line of defense against pathogenic invasion, and the mechanism of preferentially attacking the cell membrane makes them difficult to develop drug resistance. Antimicrobial peptides are therefore considered as a promising candidate for novel antimalarial agents. This review summarizes the advances in researches on antimicrobial peptides with antimalarial actions and discusses the potential of antimalarial peptides as novel antimalarials.
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Objective:To identify the risk factors for decrease in regional cerebral oxygen saturation (rScO 2) during one-lung ventilation (OLV) in the patients undergoing thoracic surgery. Methods:A total of 175 patients of both sexes, aged ≥55 yr, with expected operation time≥2 h, scheduled for elective thoracic surgery with OLV, were selected in the Fourth Hospital of Hebei Medical University from August 2017 to September 2018.The rScO 2 was continuously monitored from the beginning of anesthesia induction until removal of tracheal intubation.General anesthesia, general anesthesia combined with epidural block or general anesthesia combined with local nerve block were used.The baseline characteristics, previous medical history and history of anesthesia surgery, type of surgery, method of anesthesia, duration of anesthesia, duration of OLV, duration of surgery, and intraoperative adverse events (hypoxemia, hypotension, bradycardia, etc.) were recorded.According to whether a decrease in rScO 2 occurred during OLV (absolute value of rScO 2 was less than 65% or a decrease of more than 20% of the baseline value), the patients were divided into 2 groups: low rScO 2 group and normal rScO 2 group.Multivariate logistic regression analysis was used to identify the risk factors for decrease in rScO 2 during OLV. Results:One hundred and seven patients developed decrease in rScO 2 during OLV, with an incidence of 61.1%.The results of logistic regression analysis showed that hypoxemia was an independent risk factor for decrease in rScO 2, and general anesthesia combined with epidural block was a protective factor for decrease in rScO 2 during OLV. Conclusion:Hypoxemia is an independent risk factor for decrease in rScO 2 during OLV, while general anesthesia combined with epidural block is a protective factor for decrease in rScO 2 in the patients undergoing thoracic surgery.
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Objective To establish an "integrated management system" for pelvic floor dysfunction and explore its effects on clinical practice. Methods A pelvic floor nursing team was set up to connect the outpatient management system, the ward perioperative management system and the home follow-up management nursing system, and to build an integrated management system for pelvic floor dysfunction diseases. ResuLts After five years of practice, the qualified rate of residual urine in pelvic floor dysfunction patients increased from 58.2% (191/330) to 93.6% (309/328), the difference was statistically significant( χ2=113.008, P<0.01). The compliance of pelvic floor muscle exercise at home increased from 63.6%(210/330) to 83.8%(275/328). The difference was statistically significant( χ2=36.654, P<0.01). ConcLusions The three level prevention of pelvic floor dysfunction disease has been formed through "the integrated management system", which can play a significant role in the development of disease management and specialized nursing.
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Objective@#To establish an "integrated management system" for pelvic floor dysfunction and explore its effects on clinical practice.@*Methods@#A pelvic floor nursing team was set up to connect the outpatient management system, the ward perioperative management system and the home follow-up management nursing system, and to build an integrated management system for pelvic floor dysfunction diseases.@*Results@#After five years of practice, the qualified rate of residual urine in pelvic floor dysfunction patients increased from 58.2%(191/330) to 93.6%(309/328), the difference was statistically significant(χ2=113.008, P<0.01). The compliance of pelvic floor muscle exercise at home increased from 63.6%(210/330) to 83.8%(275/328). The difference was statistically significant(χ2=36.654, P<0.01).@*Conclusions@#The three level prevention of pelvic floor dysfunction disease has been formed through "the integrated management system", which can play a significant role in the development of disease management and specialized nursing.
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There are some problems in clinical teaching of cardiovascular medicine, such as insuf-ficient attention to the "three bases" skills, not teaching trainees in accordance with their aptitude ade-quately, monotonous instructional mode, and assessment becoming a mere formality. Aiming at these prob-lems, we have explored the training methods of medical talents adapted to the modern medical model, and improved the clinical basic skills and thinking of the students and the quality of teaching through such measures as paying close attention to basic skills training, standardizing ward rounds, paying attention to teaching students in accordance with their aptitude, and reforming teaching methods and assessment modes.
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Objective To investigate the protective effect of curcumin on apoptosis of human umbilical vein endothelial cells (HUVECs) induced by oxidized low density lipoprotein (ox-LDL) and its possible mechanism.Methods Cultivated HUVECs were divided into six groups: control group, ox-LDL group, ox-LDL plus endoplasmic reticulum stress(ERS) inhibitor PBA group,curcumin group, ox-LDL plus curcumin group,ox-LDL plus curcumin plus PI3K inhibitor LY294002 group.Cell viabilities were evaluated by CCK-8 assays.The proportions of apoptotic cells were assessed by flow cytometry.The translocation of activating transcription factor 6 (ATF6) observed by laser confocal microscopy.Western blot was used to determine the expression of the ERS associated proteins:glucose-regulated protein 78(GRP78), protein kinase-like ER kinase(PERK), inositol-requiring kinase1(IRE-1) and the related pathways protein: LOX-1, AKT and phophorylated AKT.Results Compared with control group,increasedthe proportions of apoptotic cells(P<0.01),enhanced the expressions of ERS related proteins(P<0.01),promoted the transfer of ATF6 into the nucleus,as well as increased the expression of LOX-1(P<0.01)and decreased the expression of p-AKT(P<0.01) in the ox-LDL group;Compared with ox-LDL group,PBA inhibited ox-LDL-induced HUVECs apoptosis(P<0.01),curcumin inhibited ox-LDL-induced the expression of ERS associated protein and LOX-1(P<0.01), the nuclear translocation of ATF6, the apoptosis of HUVECs (P<0.01), and it also increased ox-LDL-induced down-regulation of p-AKT expression (P<0.01);LY294002 partially attenuated the inhibitory effect of curcumin on ERstress-related protein expression induced by ox-LDL(P<0.05).ConclusionsCurcumin can reduce ox-LDL induced apoptosis of HUVECs, its mechanism may be through the inhibition of LOX-1 expression and activation of AKT pathway to reduce ERS in cell.
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Objective To analyze the influence of age on the diagnosis of acute heart failure (AHF) with amino terminal brain natriuretic peptide (NT‐proBNP) ,and to explore the best cut‐off value of NT‐proBNP in the diagnosis of AHF .Methods Totally 457 inpatients suspected with AHF obtained a blood NT‐proBNP measurement within 24 hours when in charged ,including 194 patients with AHF .Patients were divided into three groups according to their age :≤50 years ,>50-70 years and >70 years . The relationship between NT‐proBNPand AHF was analyzed .The diagnostic value of NT‐proBNP was evaluated for AHF in differ‐ent age groups .Results The median NT‐proBNP levels of AHF in all age groups were significantly higher than those without (P50-70 years and >70 years groups were 0 .95 ,0 .91 ,0 .88 ,the best diagnos‐tic cut‐off points were 1 100 ,1 800 ,3 000 pg/mL ,respectively .The diagnostic specificity was 88% ,76% and 73% ,respectively .O‐verall ,the specificity of NT‐proBNP cut‐off values for age group was higher than non‐age groups .Conclusion NT‐proBNP has a good value in the diagnosis of AHF in patients with different ages .According to the age group ,the different NT‐proBNP cut‐off values can be used to improve the specificity of diagnosis .
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OBJECTIVE:To study the mechanism of improvement effects of exenatide on mitochondrial function of H9c2 cells under hypoxia/reoxygenation (H/R) condition. METHODS:H9c2 cells were cultured in vitro and were divided into blank control group,drug control group(exenatide 200 nmol/L),model group(H/R),pretreatment group(exenatide 200 nmol/L+H/R),gluca-gon-like peptide-1 receptor (GLP-1R) inhibitor [Exendin-(9-39) 100 nmol/L+exenatide 200 nmol/L+H/R], cAMP inhibitor (Rp-cAMPS 1 μmol/L+exenatide 200 nmol/L+H/R)group and PKA inhibitor(H-895 μmol/L+exenatide 200 nmol/L+H/R)group. Except for first 2 groups,H/R model was established in other groups,and they were given exenatide 30 min before modeling and relevant inhibitor 10 min before giving exenatide. Morphology of mitochondria was observed by TEM,and mitochondrial calcium (Ca2+m)and the mitochondrial membrane potential(ΔΨm)were determined by flow cytometry. Cellular ATP content was measured by microplate reader. RESULTS:Compared with blank control group, mitochondrial cristae swelling was enhanced in model group,while density decreased,showing vacuolization;Ca2+m level increased while ΔΨm and ATP decreased (P<0.05). Com-pared with model group,mitochondrial cristae swelling relieved in pretreatment group,while density increased,showing vacuoliza-tion relieved;Ca2+m level decreased,while ΔΨm and ATP increased(P<0.05). Compared with pretreatment group,the levels of Ca2+m increased in 3 kinds of inhibitors group,while ΔΨm and ATP decreased(P<0.05). CONCLUSIONS:Exenatide attenuates H9c2 cell mitochondria Ca2+m accumulation,increases ΔΨm and ATP production. Which indicate its mechanism may be associated with activating GLP-1R/cAMP/PKA pathway.
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Objective To analyze the influence of atrial fibrillation(AF) on N‐terminal pro‐brain natriuretic peptide(NT‐proB‐NP) for the assist diagnosis of acute heart failure(AHF) .Methods Totally 457 inpatients with suspected AHF due to acute dysp‐nea and conducting blood NT‐proBNP detection and electrocardiogram(ECG) within 24 h of admission were collected and devided into groups according to whether AHF was diagnosed and complicated with AF identified by ECG on admission ,that was AHF +AF group ,AHF + non AF group ,non AHF + AF group ,non AHF + non AF group .The receiver operating characteristic (ROC) curve was adopted to evaluate the value of NT‐proBNP for diagnosing AHF .Results Among 457 cases ,194 cases (42 .5% ) were diagnosed as AHF and 140 cases (42 .5% ) as AF .The NT‐proBNP level in the AF group was significantly higher than that in the non AF group (4 482 .0 pg/mL vs .1 302 .0 pg/mL ,P 0 .05) .The NT‐proBNP level in the non AHF + AF group was significantly increased compared with the non AHF + non AF group (403 .3 pg/mL vs .2 892 .0 pg/mL ,P< 0 .01) .The area under the curve(AUC) of NT‐proBNP for diagnosing AHF in the AF group and the non AF group was 0 .759(95% CI :0 .677 - 0 .841 ,P < 0 .01) and 0 .931(95% CI :0 .903 - 0 .985 ,P < 0 .01) .Conclusion The NT‐proBNP level in AF patients without AHF is significantly increased ,which might affect the value of NT‐proBNP in the diagnosis of AHF .In the clinical applica‐tion ,whether the patient has AF cardiac rhythm should be paid attention to for better interpretating the detection result of NT‐proBNP .
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ObjectiveTo investigate the nursing key points to 8 end-stage ovarian cancer patients with totally implantable venous access ports.Method The totally implantable venous access ports were used in the 8 patients and nursing was carried out to them.Result There were no occurrences of infection,leakage,seepage,pipe obstruction and the needlepoint shift.Conclusions The ovarian cancer patients in the end-stage had very low resistance and high risk of infection.Individualized nursing care to them may ensure the use of the ports in a safe way.
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Objective To study the value of echocardiogram in preoperative examination for the diagnosis of silent myocardial is-chemia in patients before surgery .Methods 172 patients with surgical preoperative suspected diagnosis of coronary heart disease , were divided into heart valve surgery group (72 cases) and non heart valve surgery group (100 cases) .All of the patients had echo-cardiography and coronary angiography before 2 weeks of operation .We drew a series of analysis to assess the sensitivity、specialty and accuracy of diagnosis of silent myocardial ischemia with regional wall motion abnormality (RWMA) and wall motion score in-dex (WMSI) .Results Coronary angiography as the gold standard of coronary heart disease diagnosis .The sensitivity of RWMA for the diagnosis of silent myocardial ischemia in patients undergoing heart valve surgery group and non heart valve surgery group was 85 .7% and 100 .0% ,while the specificity of RWMA was 100 .0% and 80 .0% ,respectively ,the differences between the two groups had no statistical significance (P>0 .05) .We also drew the ROC curve of WMSI for the diagnosis of silent myocardial ische-mia ,maximum area under the ROC curve of WMSI were 2 .20 and 2 .05 .In patients undergoing cardiac surgery and non-cardiac sur-gery ,the curves indicated that the sensitivity were 79 .7% and 75 .9% ,the specificity were 83 .0% and 67 .7% ,respectively .Area under the ROC curve was 0 .832 and 0 .702 ,but the difference was not statistically significant (P>0 .05) .Conclusion Using RW-MA and WMSI as reference indicators ,surgical preoperative echocardiography in the diagnosis of patients with silent myocardial is-chemia has good sensitivity ,specific ,and accurate ,there is no statistically significant difference between heart valve surgery and non heart valve surgery .
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Objective To analyze the usual death causes of cardiovascular disease and the differences in gender and age .Methods By adopting the retrospective study method ,the clinical data of death cases in cardiovascular disease were collected and analyze on the situation suffering from cardiovascular disease ,direct death causes ,gender and age difference .Results (1) among 181 cases of cardiovascular disease death ,coronary heart disease(115/181 ,64% ) and hypertension(96/181 ,53% ) were the most common dis-ease ,lung infection(104/181 ,57% ) was the most common complication ;(2)There was no significant difference in the situation suf-fering from basic diseases between male and female(P>0 .05);(3)The basic diseases in cardiovascular death cases aged over 60 years old were dominated by coronary heart disease and hypertension ;the proportion of complicating pulmonary infection was grad-ually increased with age increase ;(4) in the direct death causes ,the top 3 places were sudden cardiac death (44/181 ,24 .3% ) ,multi-ple organ dysfunction syndrome(24/181 ,13 .3% ) and cardiogenic shock(24/181 ,13 .3% ) .Conclusion Strengthening the manage-ment of diagnosis and treatment on elderly patients with coronary heart disease ,hypertension ,especially those complicating diabe-tes ,strengthening the treatment intervention of lung infection in cardiovascular disease population and conducting the emphasis pro-tection on the target organ function may reduce the mortality of cardiovascular inpatients .
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Objective To find out the living condition of the elderly adults and their needs for community bealthcare services so as to provide evidence-based guidance for our govemment. Methods A total of 925 participants aged ＞ 60 years were personally interviewed for questionnaire and ADL scale evaluation. Chi-square test and Kmskal-Wallis H test were used for data analysis. Results The subjects showed relatively lower education level and the illiteracy rate was high. Their marriage was stable and a decreased divorce rate was found. The economic situation was satisfactory. Their life satisfaction was farbeyond the health satisfaction. Most of the elderly did not live with their offspring,although 21.8% could not take care of themselves. The prevalence rate of chronic diseases was 81.5% ,which resulted in more demands for social activities, health consultation, rehabilitation nursing, and home healtheare services in the community. Conclusion They need to pay more attention to physical and mental health of the elderly. A community healthcare system that could provide services in an-all-round way,including medical care, should be established and improved.
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Objective To evaluate the clinical value of angiographic diagnosis and effectiveness of transcatheter therapy in hemorrhage after cholecystectomy. Methods The site and cause of hemorrhage after cholecystectomy were verified by selective DSA in 5 patients and then followed by treatment with target artery embolization. The cause of hemorrhage after cholecystectomy wasn't verified by selective DSA in 4 patients,surgical resection was then carried out. Results Nine cases had hemorrhage with various degrees after cholecystectomy. 55.56% of them were arterial hemorrhage identified by angiography,including 5 cases treated with target artery embolization effectively without any other important complication. The other cases were cured by abdominal exploring operation totally belonged to venous hemorrhage. Conclusion DSA and interventional therapy are of great value for arterial hemorrhage after cholecystectomy,especially the method of embolization is safe and efficient.(J Intervent Radiol,2007,16: 696-698)
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Aim To study the effect of simvastatin(Sim) on left ventricular remodeling and heart function in rats with myocardial infarction(MI).Methods Myocardial infarction models were successfully induced by ligation of anterior descending coronary artery.24 h later the survivals were randomly divided into 3 groups.① MI group;② 20 mg Sim group(20 mg?kg~(-1)?d~(-1));③ 40 mg Sim group(40 mg?kg~(-1)?d~(-1)).The rats with sham ligation formed sham group.After 8 weeks,hemodynamic parameters,blood serum lipids,the ratio of RV and LV weight to body weight(RVWI,LVWI) were examined.The pathomorphological change and the collagen volume fraction(CVF) were analyzed by PSR dyeing.Results There were no significant differences in values of serum lipids among 4 groups.Compared with sham group,the left ventricular end-diastolic pressure(LVEDP) was increased and left ventricular systolic pressure(LVSP) was depressed significantly in MI group; the RVWI and LVWI and the CVF in border infarcted zone and Ⅰ/Ⅲ ratio were increased in MI group too.Compared with MI group,Sim partially normalized LVSP and LVEDP;abated ventricular weight index;reduced CVF in non-infarction zone in both Sim groups.Conculusion Simvastatin improves LV remodeling and heart function in rats with MI,which is associated with the effect of limiting myocardial hypertrophy and interstitial fibrosis.
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Objective To investigate the beneficial effects of simvastatin on ventricular remodeling in rats after myocardial infarction and the possible mechanisms involved.Methods The myocardial infarction rat model was reproduced.Twenty-four hours after infarction,the survived rats were randomly divided into myocardial infarction group(MI group,n=9),simvastatin 10mg group [10mg/(kg?d),Sim1 group;n=8],simvastatin 20mg group [20mg/(kg?d),Sim2 group;n=10] and simvastatin 40mg group [40mg/(kg?d),Sim4 group;n=9].A sham-operated group(Sham group;n=10) served as control.Four weeks later,the serum lipid level,hemodynamic indexes and left ventricular weight index(LVWI) were measured.The changes in rats' myocardial tissue were observed with HE staining;the cross-sectional area of myocardial cells was calculated.The expressions of transforming growth factor ?1(TGF-?1) and TGF-?-activated kinase 1(TAK1) in non-infarction area were determined by Western blotting and reverse transcription polymerase chain reaction(RT-PCR).Results The hemodynamic indexes,LVWI,cross-sectional area of myocardial cells and the pathological changes were improved,and mRNA and protein expressions of TGF-?1 and TAK1 were down-regulated significantly in the 3 Sim-treated groups compared with that in MI group.The indices mentioned above were significantly different in Sim2 and Sim4 group compared with Sim4 group(P0.05).Conclusion The inhibitory effect of simvastatin on ventricular remodeling after acute myocardial infarction is independent of its lipid-regulating effect,but possibly attributed to its action in inhibiting the TGF-?1/AK1 signal transduction.Within the concentration of 20mg/(kg?d),the therapeutic efficacy of simvastatin may be more obvious with an increase in its dosage.
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0.05).Compared with those in Sham group,LVWI,the typeⅠCVF,type Ⅲ CVF andⅠ/Ⅲ ratio in NIZ were increased significantly in MI group.Compared with those in MI group,the LVWI,the type ⅠCVF,type Ⅲ CVF andⅠ/Ⅲ ratio in NIZ were decreased significantly in Sim groups(but higher than those in Sham group).Compared with MI groups,left ventricular function in rats treated with simvastatin was also obviously improved.(2) Contrasted to those in MI group,the expressions of TGF-?1 and Smad3 were down-regulated in simvastatin treatment groups(but higher than those in Sham group).Conclusions Sim can ameliorate ventricular remodeling and ventricular function in rats induced by MI,and the mechanisms can be independent of its lipid-lowering and associated with inhibition of TGF-?1/Smad3 signal transduction.
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Aim To investigate the changes of heme oxygenase-1(HO-1) in cardiomyocytes after acute myocardial infarction and the impact of simvastatin on HO-1 expression in rats.Methods Myocardial infarction models were made by anterior descending coronary artery ligation on male SD rats whereas sham group by spurious ligation.Survivals were randomized into myocardial infarction(MI) group,simvastatin(Sim) group and sham group 24 hours after the operation.The Sim group was treated with simvastatin 40 mg?kg-1?d-1 via gavage till sacrifice.MI and sham groups were gavaged with equal volume of 0.9% NaCl at the same time.Rats were sacrificed at time points of 24 hours,7 days and 28 days after the operation,for the detection of HO-1 mRNA by RT-PCR,HO-1 protein level by Western bolt,activity of superoxide dismutase(SOD) and content of malondialdehyde(MDA) by spectrophotometric method in non-infarcted zone.Results Expression of HO-1 mRNA and protein level increased at 24 hours,peaked at 7 days and decreased to basal levels at 28 days.All the indexes at each time point mentioned above were significantly higher in MI group than those in sham group.At the 7th day and 28 th day after the operation,the indexes were higher in Sim group than those in MI group(P
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Aim To assess the effect of HMG-CoA inhibitors simvastatin on collagen remodeling in rats after myocardial infarction. Methods Myocardial infarction models were induced by ligation of anterior descending coronary artery. 24 hours later the survivals were randomly divided into 3 groups: (1) MI group; (2) 20 mg Sim group(20 mg? kg-1? d-1); (3) 40 mg Sim group(40 mg? kg-1? d-1). Rats with sham ligation formed into Sham group. After 8 weeks, the ratios of LV and RV weight to body weight (RVWI, LVWI) were examined and the collagen content was detected. The type Ⅰ and type Ⅲ collagen volume fraction (CVF) and Ⅰ/Ⅲ ratio in infarcted and non-infarcted zones were examined with PSR dyeing; also the mRNA expressions of type Ⅰ and type Ⅲ collagen in non-infarcted zone (NIZ) were detected with RT-PCR.Results Comparing with Sham group,the RVWI and LVWI in MI group increased significantly. The type Ⅰ CVF and type Ⅲ CVF in NIZ and the Ⅰ/Ⅲ ratio were increased in MI group. The mRNA expressions of type Ⅰ and type Ⅲ collagen in NIZ in MI group were higher than those in Sham group. Comparing with MI group, the RVWI and LVWI in both Sim groups were decreased significantly. The type Ⅰ CVF and type Ⅲ CVF in NIZ and the Ⅰ/Ⅲ ratio were depressed in both Sim groups, and the mRNA expressions of collagens were also lower than those in MI group, but higher than those in Sham group. Conculusion Simvastatin could attenuate the development of myocardial interstitial fibrosis in non-infarction zone to improve myocardial interstitial remodeling in rats after MI.
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Objective To study the effect of gallic acid isolated from Pu-erh Tea on the peroxisome proliferators activated receptors function.Method The appropriate concentration of gallic acid added to three cell models was decided to be 50 ?g/ ml,and the activity of gallic acid on peroxime prolipevators activated receptors PPAR?,PPAR?,PPAR? was studied.Results Gallic acid could activate PPAR?,as high as 2.436 fold and the effect corresponded to that of positive drug which value was 2.438.gallic acid had no effect on PPAR? and PPAR?.Conclusion Gallic acid in Pu-erh Tea had good activity on PPAR? and this could offer scientific basis for study of the anti-diabetes and anti-hyperlipidenmia mechanism of Pu-erh Tea.