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Objective To summarize the experience and practical value of living donor kidney harvesting in Bama miniature pigs with six gene modified. Methods The left kidney of Bama miniature pigs with six gene modified was obtained by living donor kidney harvesting technique. First, the ureter was occluded, and then the inferior vena cava and abdominal aorta were freed. During the harvesting process, the ureter, renal vein and renal artery were exposed and freed in sequence. The vascular forceps were used at the abdominal aorta and inferior vena cava, and the renal artery and vein were immediately perfused with 4℃ renal preservation solution, and stored in ice normal saline for subsequent transplantation. Simultaneously, the donor abdominal aorta and inferior vena cava gap were sutured. The operation time, blood loss, warm and cold ischemia time, postoperative complications and the survival of donors and recipients were recorded. Results The left kidney of the genetically modified pig was successfully harvested. Intraoperative bleeding was 5 mL, warm ischemia time was 45 s, and cold ischemia time was 2.5 h. Neither donor nor recipient pig received blood transfusion, and urinary function of the kidney transplanted into the recipient was recovered. The donor survived for more than 8 months after the left kidney was resected. Conclusions Living donor kidney harvesting is safe and reliable in genetically modified pigs. Branch blood vessels could be processed during kidney harvesting, which shortens the process of kidney repair and the time of cold ischemia. Living donor kidney harvesting contributes to subsequent survival of donors and other scientific researches.
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【Objective】 To explore the relationship between the storage time of leukodepleted red blood cells and transfusion adverse reactions by analyzing the occurrence of transfusion adverse reactions of patients after leukodepleted red blood cells transfusion from four hospitals. 【Methods】 By using the electronic medical record management system, the collection and transfusion dates of leukodepleted red blood cells from four hospitals in Enshi Prefecture from 2018 to 2022, as well as the information on transfusion adverse reactions, were retrieved. 【Results】 From 2018 to 2022, a total of 697 61 bags of leukodepleted red blood cells were transfused in four hospitals, resulting in 166 cases of transfusion adverse reactions, among which 93 were allergic reactions, 63 were non hemolytic febrile reactions, and 10 were others, with a total incidence rate of transfusion adverse reactions at 0.24%. The average storage time of leukodepleted red blood cells with and without transfusion adverse reactions was (20.25±6.31) and (19.88±5.50) days, respectively. With a storage time of 7 days as the threshold, the incidence of transfusion adverse reactions was the lowest for a storage time of 15~21 days. The incidence of transfusion adverse reactions of leukodepleted red blood cells in two groups (with storage days ≤21 days and >21 days) was not statistically significant(P>0.05). 【Conclusion】 Allergic reactions were the main type of transfusion adverse reaction caused by leukodepleted red blood cells, and the incidence of transfusion adverse reactions decreased and then increased with the prolongation of the storage time of leukodepleted red blood cells. There was no significant difference in the incidence of transfusion adverse reactions with leukodepleted red blood cells stored for ≤ 21 days and >21 days.
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Objective To investigate the establishment of a six-gene-edited pig-to-non-human primate kidney xenotransplantation model. Methods The kidney of humanized genetically-edited pig (GTKO/β4GalNT2KO/CMAHKO/hCD55/hCD46/hTBM) was transplanted into a cynomolgus monkey. The survival of the recipient and kidney condition after blood perfusion were observed. The parenchymal echo, blood flow changes, and size of the kidney were monitored on a regular basis. Routine blood test, kidney function test and electrolyte assessment were carried out. Dynamic changes of urine, feces and body mass were monitored. At the end of life, the transplant kidney, heart, liver, spleen, lung, and cecum were collected for pathological examination. Results The recipient died at postoperative 7 d. After blood flow was restored, the kidney was properly perfused, the organ was soft and the color was normal. At the end of the recipient's life, a slight amount of purulent secretion was attached to the ventral side of the kidney, with evident congestion and swelling, showing the appearance of "red kidney". Postoperatively, the echo of renal parenchyma was increased, blood flow was decreased, the cortex was gradually thickened, and a slight amount of effusion surrounded the kidney and abdominal cavity over time. In the recipient, the amount of peripheral red blood cells, hemoglobin, albumin, and platelets was progressively decreased, and serum creatinine level was increased to 308 μmol/L at postoperative 7 d, whereas the K+ concentration did not significantly change. Light yellow urine was discharged immediately after surgery, diet and drinking water were resumed within postoperative 3 h, and light yellow and normal-shape stool was discharged. The reddish urine was gradually restored to normal color within postoperative 1 d, which were consistent with the results of the routine urine test. A large amount of brown bloody stool was discharged twice in the morning of 2 d after surgery. Omeprazole was given for acid suppression, and the stool returned to normal at postoperative 4 d. The β2-microglobulin level was increased to 0.75 mg/L at postoperative 7 d. The body mass was increased by 1.7 kg. Autopsy pathological examination showed interstitial edema and bleeding of the transplant kidney, a large amount of infiltration of lymphocytes and macrophages, infiltration of lymphocytes in the arteriole wall and arterial cavity, accompanied by arteritis changes, lymphocyte infiltration in the cecal stroma and congestion in the spleen tissues. No significant abnormal changes were observed in other organs. Conclusions The humanized genetically-edited pig-to-non-human primate kidney xenotransplantation model is successfully established, and postoperative survival of the recipient is 1 week.
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Two new sucrose cinnamates(1 and 2) along with nine known compounds(3-11) were isolated from ethanol extract of Polygonum lapathifolium var. salicifolium by silica gel column chromatography, ODS column chromatography and semi-preparative HPLC. Their structures were elucidated by extensive spectroscopic methods including 1 D-and 2 D-NMR experiments, as well as HR-ESI-MS analysis. Eleven compounds(7 sucrose cinnamates, 3 phenylpropanoids and 1 lactone) were obtained and their structures were identified as(1,3-O-di-p-coumaroyl)-β-D-fructofuranosyl-(2→1)-α-D-glucopyranoside(1),(1,3-O-di-p-coumaroyl)-β-D-fructofuranosyl-(2→1)-(6-O-acetyl)-α-D-glucopyranoside(2),(3-O-feruloyl)-β-D-fructofuranosyl-(2→1)-(6-O-p-coumaroyl)-α-D-glucopyranoside(3), hydropiperoside(4), vanicoside C(5),(1,3-O-di-p-coumaroyl)-β-D-fructofuranosyl-(2→1)-(6-O-feruloyl)-α-D-glucopyranoside(6), vanicoside B(7),trans-p-hydroxycinnamic acid methyl ester(8), trans-p-hydroxycinnamic acid ethyl ester(9), methyl ferulate(10) and dimethoxydimethylphthalide(11), respectively. Compounds 1 and 2 were two new sucrose cinnamates, and compounds 1-11 were isolated from this plant for the first time. The antioxidant activities of the isolated compounds 1-9 were investigated by an oxygen radical absorbance capacity(ORAC) assay, and all nine compounds were found to show strong antioxidant activities. Among them, compound 6(10 μmol·L~(-1)) was the supreme one in antioxidant activities, with its ORAC value equivalent to(1.60±0.05) times of 50 μmol·L~(-1) Trolox.
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Antioxidantes , Cinamatos , Ésteres , Estructura Molecular , Polygonum , SacarosaRESUMEN
Aim To study the combination of lysinespecifc demethylase 1 (lysine-specifc demethylase 1, LSD1) inhibitor pargyline and the chemotherapy drug doxorubicin on the proliferation, migration and invasion of murine triple negative breast cancer 4T-1 cells. Methods In vitro, the effect on the proliferation, invasion and migration of 4T-1 cells of the combination of these two drugs were detected with CCK-8 method, lactate dehydrogenase release test, Chou-Talay method, Scratch test, Transwell assay, Western blot and etc. Tumor-bearing mice were used to investigate the combined effect of these two drugs on the proliferation of 4T-1 cells in vivo. Results The combination of pargyline and doxorubicin effectively inhibited the proliferation, migration and invasion of 4T-1 cells. Compared with single drug group, the combination of these two drugs could significantly inhibit the proliferation of breast cancer and prolong the survival time of mice with triple negative breast cancer. Conclusions The combined application of pargyline and doxorubicin has a synergistic inhibitory effect on the proliferation, migration and invasion of mouse breast cancer 4T-1 cells, and has potential value for clinical treatment on triplenegative breast cancer.
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Objective To investigate whether the low-frequency pulsed electromagnetic fields (LF-PEMFs) can enhance the osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs) induced by bone morphogenetic protein 9 (BMP9). Methods We isolated CD146＋/STRO-1＋ cells (namely PDLSC) from periodontal ligament cells of healthy human premolars, transfected the PDLSC with BMP9-overexpressing recombinant adenoviruses (Ad-GFP-BMP9), exposed the cells to the different intensities of PEMF stimulation (15 Hz, 0.6，1.2，1.8，2.4，3.0 mT, 1 h/12 h), and then detected the expression of runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP), osteopontin (OPN) and osteocalcin (OCN) by qRT-PCR and Western blotting. Results Overexpression of BMP9 significantly promoted the expression of osteogenic markers (Runx2, ALP, OCN and OPN) in PDLSC (P0.05). After the intervention with 1.2, 1.8, 2.4 and 3.0 mT PEMF, the expression levels of osteogenic markers in PDLSC were significantly higher than those exposed to BMP9 alone (P0.05), and reached the peak at 2.4 mT (P0.05), indicating that LF-PEMFs enhanced BMP9-induced osteogenic differentiation of PDLSC, and there was a “window effect”. Conclusion LF-PEMFs stimulation (15 Hz, 1.8 to 3.0 mT) can enhance BMP9-induced osteogenesis of hPDLSCs in vitro.
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Objective@#To observe how glutamine affect the skeletal muscle membrane repair in severely burned mice through promoting the mitsugumin 53 (MG53) dimerization in skeletal muscle and to explore its functional mechanism.@*Methods@#(1) Animal experiments. A total of 179 BALB/c male mice aged 6 to 8 weeks were divided into sham injury group (n=43), burn group (n=73) and burn+ glutamine group (n=63) according to the random number table (the same grouping method below). Mice in sham injury group were sham injured on the back, and mice in burn group and burn+ glutamine group were inflicted with 30% total body surface area full-thickness scald (hereinafter referred to as burn) on the back. Mice in burn+ glutamine group were intragastrically administered with glutamine (1 mg/kg), and the other two groups were given the same amount of amino acid solution once per day for 14 days. On post burn hour 12, 10 mice from burn group were taken for preparation of burn serum, which is used in the following cell experiments. Blood samples were collected from the hearts to prepare serum from 10 mice in sham injury group immediately after burn and from 10 mice in burn group and burn+ glutamine group on post burn day (PBD) 5, 10, and 14, respectively. And then the whole gastrocnemius muscle was harvested after the mice were sacrificed. On PBD 10, the whole flexor brevis digitorum was harvested from 6 mice in the 3 groups respectively after the mice were sacrificed. On PBD 5, 10, and 14, the whole gastrocnemius muscle tissue was harvested from another 9 mice in the 3 groups respectively after the mice were sacrificed. The mass of the whole gastrocnemius muscle of mice was weighed. The total protein content of gastrocnemius muscle of mice was detected by coomassie brilliant blue method. The repair function of myolemma of flexor brevis digitorum of mice was detected by two-photon laser fiber membrane perforating. The serum content of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) of mice was determined with radioimmunoassay. The expressions of MG53 dimer and monomer in gastrocnemius of mice were determined with non-reductive electrophoresis-Western blotting. The protein expressions of endoplasmic reticulum stress sign proteins CCAAT/enhancer binding protein homologous protein (CHOP) and glucose-regulated protein 78 (GRP78) in gastrocnemius of mice were determined with Western blotting. (2) Cell experiments. Mice skeletal muscle precursor cells C2C12 were cultured in vitro, and cells of the second passage were selected for the experiments. The cells were divided into normal control group, burn serum group, and burn serum+ glutamine group, with 3 dishes in each group and 1×103 cells in each dish. Cells in normal control group were cultured with 1 mL Dulbecco′s modified Eagle medium (DMEM) with fetal bovine serum of volume fraction 10%, cells in burn serum group were cultured with 1 mL DMEM with burn serum of volume fraction 10%, and cells in burn serum+ glutamine group were cultured with 1 mL DMEM with burn serum of volume fraction 10% and 4 μL glutamine with a final molar concentration of 8 mmol/L. After 24 hours of culturing, the repair function of myocyte membrane after differentiation of skeletal muscle precursor cells in mice was detected with the same method before. Another cells were grouped and cultured as before, with 3 wells in each group and 1×105 cells in each well. After 24 hours of culturing, the expressions of MG53 dimer and monomer and endoplasmic reticulum stress marker proteins in the cells were detected as before. Data were processed with analysis of variance of factorial design, one-way analysis of variance, least significant difference t test, and Student Newman Keuls test.@*Results@#Animal experiments. (1) Compared with those in sham injury group, the mass and total protein content of gastrocnemius muscle of mice in burn group were significantly decreased on PBD 5, 10, and 14 (P<0.05). Compared with those in burn group, the mass and total protein content of gastrocnemius muscle of mice in burn+ glutamine group were significantly increased on PBD 5, 10, and 14 (P<0.05). (2) Compared with that in sham injury group (0.9±0.4), the fluorescence intensity of FM1-43 in myofiber of mice in burn group (7.8±0.4) was significantly increased on PBD 10 (t=7.75, P<0.05). Compared with that in burn group, the fluorescence intensity of FM1-43 in myofiber of mice in burn+ glutamine group (4.0±0.4) was significantly decreased on PBD 10 (t=-4.31, P<0.05). (3) Compared with that in sham injury group, the serum content of TNF-α and IL-6 of mice in burn group was significantly increased on PBD 5, 10, and 14 (P<0.05). Compared with that in burn group, the serum content of TNF-α and IL-6 of mice in burn+ glutamine group was significantly decreased on PBD 5, 10, and 14 (P<0.05). (4) Compared with 56.97±2.82, 44.89±4.72, 42.46±1.06, 14.26±0.99, 62.36±2.74, and 29.45±0.84 in sham injury group, the expressions of MG53 dimer and monomer in gastrocnemius of mice were significantly decreased in burn group on PBD 5, 10, and 14 (6.16±0.25, 26.09±1.22, 28.86±1.53, 5.63±0.25, 26.74±0.79, 4.41±0.52, P<0.05). Compared with those in burn group, the expression of MG53 dimer of gastrocnemius of mice in burn+ glutamine group was significantly increased on PBD 10 and 14 (36.79±1.44, 43.96±1.62), and the expression of MG53 monomer of gastrocnemius muscle of mice in burn+ glutamine group was significantly increased on PBD 14 (13.16±2.17, P<0.05). Compared with those in sham injury group, the protein expressions of CHOP and GRP78 in gastrocnemius muscle of mice in burn group were significantly elevated on PBD 5, 10, and 14 (P<0.05). Compared with those in burn group, the protein expressions of CHOP and GRP78 in gastrocnemius of mice in burn+ glutamine group were significantly reduced on PBD 5, 10 (P<0.05). Cell experiments. (1) Compared with that in normal control group (1.76±0.25), the fluorescence intensity of FM1-43 in cells in burn serum group (9.46±1.22) was significantly increased after 24 hours of culturing (t=12.28, P<0.05). Compared with that in burn serum group, the fluorescence intensity of FM1-43 in cells in burn serum+ glutamine group (4.71±0.45) was significantly decreased after 24 hours of culturing (t=-7.59, P<0.05). (2) The expressions of MG53 monomer of cells were similar in normal control group, burn serum group, and burn+ glutamine group after 24 hours of culturing (P>0.05). Compared with 58.5±1.8 in normal control group, the expression of MG53 dimer of cells in burn serum group was significantly decreased after 24 hours of culturing (14.1±1.4, P<0.05). Compared with that in burn serum group, the expression of MG53 dimer of cells in burn serum+ glutamine group was significantly increased after 24 hours of culturing (30.9±0.6, P<0.05). Compared with those in normal control group, the protein expressions of CHOP and GRP78 of cells were significantly elevated in burn serum group after 24 hours of culturing (P<0.05). Compared with those in burn serum group, the protein expressions of CHOP and GRP78 of cells were significantly reduced in burn serum+ glutamine group after 24 hours of culturing (P<0.05).@*Conclusions@#Glutamine can promote MG53 dimerization by alleviating endoplasmic reticulum stress in severely burned mice. Thus it can accelerate skeletal muscle membrane repair, reduce the local inflammatory reaction of skeletal muscle and consumption of skeletal muscle.
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Objective@#To explore the effects of different doses of dopamine on organ function of rats at early stage of severe scald.@*Methods@#Thirty-two male Wistar rats aged 8 to 12 weeks were divided into sham injury (SI) group, simple resuscitation (SR) group, small dose (SD) group, and moderate dose (MD) group according to the random number table, with 8 rats in each group. After rats in the 4 groups were performed cardiac catheterization, rats in group SI were sham injured on the back by immersing in 37 ℃ warm water for 18 s, and rats in the other 3 groups were inflicted with 30% total body surface area (TBSA) full-thickness scald on the back by immersing in 97 ℃ hot water for 18 s. Rats in group SI were not treated after the injury, while rats in the other 3 groups were performed fluid resuscitation for 24 h through jugular vein catheter with micro syringe pump according to the Parkland formula. They were given 4.0 mL·kg-1·% TBSA-1 normal saline during the first 24 h, of which they were given half of the total amount for the first 8 h, and they were given half of the total amount for the second and third 8 h. Rats in group SR were infused normal saline only, while rats in group SD and group MD were infused normal saline+ 1.25 μg·kg-1·min-1dopamine and normal saline+ 6.00 μg·kg-1·min-1 dopamine respectively. Volume of 0.5 mL venous blood of all rats were taken through the cardiac catheter with serum separated at post injury hour (PIH) 1, 3, 6, 12, and 24. Serum content of cardiac troponin I (cTnI) was determined by enzyme-linked immunosorbent assay; serum content of diamine oxidase (DAO) was detected by ultraviolet spectrophotometer; serum content of β2-microglobulin (β2-MG) was determined by latex-enhanced immunoturbidimetric assay; serum content of total bile acid (TBA) was determined by enzyme colorimetry; serum content of lactic acid, malondialdehyde, and myeloperoxidase (MPO) was determined by ultraviolet spectrophotometer. Data were processed with analysis of variance for repeated measurement, one-way analysis of variance, least significant difference test, and Bonferroni correction.@*Results@#(1) At PIH 1, 3, 6, 12, and 24, serum content of cTnI of rats in group SR, group SD, and group MD [(2.69±0.19), (3.04±0.19), (4.96±0.25), (6.88±0.28), (4.75±0.31) μg/L, (2.70±0.14), (3.08±0.13), (5.06±0.19), (7.11±0.21), (4.89±0.16) μg/L, (2.18±0.14), (2.54±0.09), (3.97±0.14), (5.46±0.34), (3.32±0.33) μg/L] were higher than that in group SI [(1.70±0.08), (1.70±0.08), (1.69±0.11), (1.69±0.08), (1.70±0.08) μg/L, P<0.05], serum content of cTnI of rats in group SR and group SD was similar (P>0.05), and serum content of cTnI of rats in group MD was lower than that in group SR and group SD (P<0.05). (2) At PIH 1 to 24, serum content of DAO of rats in group SR, group SD, and group MD was higher than that in group SI (P<0.05), serum content of DAO of rats in group SR and group MD was similar (P>0.05), and serum content of DAO of rats in group SD was lower than that in group SR and group MD (P<0.05). (3) At PIH 1 to 24, serum content of β2-MG of rats in group SR, group SD, and group MD was higher than that in group SI (P<0.05), serum content of β2-MG of rats in group SR and group MD was similar (P>0.05), and serum content of β2-MG of rats in group SD was lower than that in group SR and group MD (P<0.05). (4) At PIH 1 to 24, serum content of TBA of rats in group SR, group SD, and group MD was similar (P>0.05) and higher than that in group SI (P<0.05). (5) At PIH 1 to 24, serum content of lactic acid of rats in group SR, group SD, and group MD was higher than that in group SI (P<0.05), serum content of lactic acid of rats in group SR and group MD was similar (P>0.05), and serum content of lactic acid of rats in group SD was lower than that in group SR and group MD (P<0.05). (6) At PIH 1 to 24, serum content of malondialdehyde and MPO of rats in group SR, group SD, and group MD was higher than that in group SI (P<0.05), serum content of malondialdehyde and MPO of rats in group SR and group MD was similar (P>0.05), and serum content of malondialdehyde and MPO of rats in group SD was significantly lower than that in group SR and group MD (P<0.05).@*Conclusions@#With effective liquid recovery, dopamine of MD can improve early cardiac function of rats with severe scald, while dopamine of SD can alleviate tissue ischemia and hypoxia, reduce oxygen free radical damage in internal organs, and improve functions of intestine and kidney.
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Objective@#To examine sleep quality and related factors among middle school students,and to provide a scientific reference for making the relevart interventional measures.@*Methods@#A cross-sectional questionnaire anonymous survey was conducted among 9 560 students randomly selected from Shanxi province using multi-stage stratified cluster sampling. Pittsburgh Sleep Quality Index (PSQI) was used to collect information on sleep quality.@*Results@#Among all the participants, 2 255 (23.6%) middle school students were reported poor sleep quality. The prevalence of poor sleep quality was significantly higher in girls (24.5%) than in boys (22.4%)(χ2=5.93, P<0.05). Significant differences were observed in the prevalence of poor sleep quality between junior middle school (12.9%), senior middle school (36.6%) and vocational school students (24.6%) (χ2=636.07, P<0.01). The global PSQI, sleep duration and sleep disturbance scores were higher in girls than in boys (t=3.76，8.38，3.47，P<0.01). There were significant differences between students with different school stages in global PSQI, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleeping medication, and daytime dysfunction scores (F=727.43,83.69,1 670.07,8.24,26.19,4.20,609.80,P<0.05). Multivariable Logistic regression analysis showed that gender, school stage, academic pressure, parental marital state, relationship with teachers, physical activity, smoking and drinking were associated with poor sleep quality among middle school students in Shanxi.@*Conclusion@#Sleep problems are common among middle school students, and appropriate intervention should be taken to improve sleep quality of students from individual, school-and family level.
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Objective: To evaluate the efficacy of bone marrow mesenchymal stem cells (BMSCs) in the treatment of lower limb ischemic disease using Meta-analysis. Methods The literature of clinical controlled trials concerning BMSCs in treatment of lower limb ischemic disease were retrieved by searching PubMed, EMbase and Cochrane Library databases. Literature screening and data extraction were carried out according to the inclusion and exclusion criteria. Meta-analysis was conducted by using RevMan 5.3 software. The amputation rate, amputation-free survival rate, ankle-brachial index, ulcer healing rate, pain score and pain-free walking distance were compared between BMSCs group and control group. Results A total of 5 articles were included. Meta-analysis showed that ankle-brachial index (mean difference [MD]=0.15, 95%CI [0.12,0.18], P<0.000 01), pain score (MD=-1.38, 95%CI [-1.65, -1.11], P<0.000 01), pain-free walking distance (MD=202.20, 95%CI [154.30, 250.10], P<0.000 01) and ulcer healing rate (relative risk [RR]=1.42, 95%CI [0.82, 2.46], P=0.021) were significantly improved in BMSCs group than those in control group. The amputation rate (RR=0.52, 95%CI [0.24, 1.10], P=0.09), amputation-free survival rate (RR=1.09, 95%CI [0.98, 1.21], P=0.12) demonstrated no significant differences between BMSCs and control group. Conclusion: Meta-analysis shows no advantage of BMSCs therapy on the amputation rate and amputation-free survival rate in patients with lower limb ischemic disease, but BMSCs treatment is more effective in improving clinical symptoms of patients.
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Objective To evaluate the efficacy and safety of super-selective renal arterial embolization (SRAE) for treatment of huge renal angiomyolipoma (RAML).Methods Data of 16 patients with huge RAML treated with SRAE were retrospectively analyzed.The clinical symptoms,tumor size,serum creatinine and complications were compared before and after SRAE.Results A total of 26 SRAE treatments were performed on 16 patients with huge RAML.The technical success rate of SRAE was 100％ (26/26).Seven cases (7/16,43.75 ％) received one SRAE treatment,whereas 8 (8/16,50.00％) required two SRAE treatments.Only one case (1/16,6.25％) received three SRAE treatments.The mean follow-up period was (16.60± 15.60) months.The maximum diameter of the tumor reduced significantly after SRAE at final follow-up than before embolization ([9.00±2.80]cm vs [12.60±2.40]cm,t=12.41,P＜0.01).The symptoms of flank pain and hematuria gradually relieved after SRAE.And there was no statistical difference of mean serum creatinine before and after SRAE ([76.00±14.90]μmol/L] vs [79.10±12.80]μmol/L,t=0.89,P=0.39).Fourteen cases (14/ 16,87.50％) experienced post-embolization syndrome including varying degrees of fever,local pain or nausea on 1-3 days after embolization.No serious complications occurred.Conclusion SRAE is an effective method for stopping bleeding of ruptured huge RAML,as well as relieving symptoms and reserving nephron.
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<p><b>BACKGROUND</b>Acute abdominal pain is a common symptom of emergency patients. The severity was always evaluated based on physicians' clinical experience. The aim of this study was to establish an early risk stratification method (ERSM) for addressing adults with acute abdominal pain, which would guide physicians to take appropriate and timely measures following the established health-care policies.</p><p><b>METHODS</b>In Cohort 1, the records of 490 patients with acute abdominal pain that developed within the past 72 h were enrolled in this study. Measurement data and numeration data were compared with analysis of variance and Chi-square test, respectively. Multiple regression analysis calculated odd ratio (OR) value. P and OR values showed the impacts of factors. ERSM was established by clinical experts and statistical experts according to Youden index. In Cohort 2, data from 305 patients with acute abdominal pain were enrolled to validate the accuracy of the ERSM. Then, ERSM was prospectively used in clinical practice.</p><p><b>RESULTS</b>The ERSM was established based on the scores of the patient's clinical characteristics: right lower abdominal pain + 3 × diffuse abdominal pain + 3 × cutting abdominal pain + 3 × pain frequency + 3 × pain duration + fever + 2 × vomiting + 5 × stop defecation + 3 × history of abdominal surgery + hypertension history + diabetes history + hyperlipidemia history + pulse + 2 × skin yellowing + 2 × sclera yellowing + 2 × double lung rale + 10 × unconsciousness + 2 × right lower abdominal tenderness + 5 × diffuse abdominal tenderness + 4 × peritoneal irritation + 4 × bowel sounds abnormal + 10 × suspicious diagnosis + white blood cell count + hematocrit + glucose + 2 × blood urea nitrogen + 3 × creatine + 4 × serum albumin + alanine aminotransferase + total bilirubin + 3 × conjugated bilirubin + amylase. When the score was <18, the patient did not need hospitalization. A score of ≥18 and <38 indicated that the patient should be under observation or hospitalized. A score of ≥38 and <50 indicated the need for an emergent operation. A score of ≥50 indicated the need for admission to the Intensive Care Unit. The area under the receiver operating characteristic curve of the ERSM in Cohorts 1 and 2 were 0.979 and 0.988, respectively.</p><p><b>CONCLUSIONS</b>This ERSM was an accurate and reliable method for making an early determination of the severity of acute abdominal pain. There was the strong correlation between scores of ERSM and health-care decision-making.</p>
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Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Dolor Abdominal , Diagnóstico , Distribución de Chi-Cuadrado , Estudios de Cohortes , Unidades de Cuidados Intensivos , Curva ROC , Medición de Riesgo , Métodos , Factores de RiesgoRESUMEN
Objective To evaluate the efficacy and safety of super-selective renal artery embolization in treatment of iatrogenie renal pseudoaneurysm and arteriovenous fistula.Methods Twenty-nine patients with iatrogenic renal pseudoaneurysm and arteriovenous fistula underwent renal angiography after ineffective conservative treatment.After identifying the location and characteristic of lesions by DSA,super-selective renal artery embolization was performed.Symptoms and signs,renal function changes before and after embolization and complications were recorded to evaluate the therapeutic effect.Results The technical success rate of super-selective renal artery embolization was 100％ (29/29),and clinical success rate was 96.55 ％ (28/29).The serum creatinine level before and after embolotherapy was (93.26 ± 28.79) mmol/L and (91.51 ± 27.68) mmol/L respectively,and there were no significant differences (t=1.28,P=0.22).No serious complications such as nephrapostasis or renal failure occurred in the study.Conclusion Super-selective renal artery embolization has technically and clinically high success rate with limited effect on renal function.It is a safe and effective therapy method in patients with iatrogenic renal pseudoaneurysm and arteriovenous fistula.
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BACKGROUND: T?nnis classification is commonly used to quantify the severity of developmental dysplasia of the hip (DDH), which relies on the presence of the epiphyseal ossification centre. Thereafter, a new classification system (IHDI method) has been developed by the International Hip Dysplasia Institute (IHDI). However, the pathologic morphology has not been defined based on the IHDI grade.OBJECTIVE: To analyze the correlation of the pathologic changes of the hip on MRI with IHDI classification.METHODS: Image data of 65 infants (89 hips) with DDH were analyzed retrospectively, with an average age of 20.4 months. The radiographic severity was graded by IHDI system, and the correlation between IHDI classification and pathological changes of the hip was analyzed, by observing the morphology and position of the limbus, and the cartilaginous acetabular index.RESULTS AND CONCLUSION: (1) A positive correlation was detected between severity of the IHDI grades and age at reduction (r=0.456, P < 0.001). (2) Unexpectedly, the cartilaginous femoral epiphysis still remained contacting with the acetabulum in a part of type III DDH. The cartilaginous acetabular index was significantly increased with IHDI grade increasing (P=0.028). (3) The limbus was everted in all of the type I hips; however, inverted or mixed shape accounted about 60% in the type II hips, 86% in the type III, and 97% in the type IV, respectively. (4) These results manifest that the DDH was severer, and the limbus trended to be more inverted with the increasing in IHDI grade. Moreover,understanding the correlation of the pathologic morphology with the IHDI classification is of great significance for planning an appropriate treatment scheme for DDH.
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Based on the stakeholder theory,externalities theory and marginal utility theory,this paper analyzes the behavioral needs of stakeholders in the process of market access of innovative drugs.It also draws out the core of the government and the pharmaceutical enterprises in the policy of access to innovative drug market and supply to the community,the patients,and the medical institutions enter the mechanism of the interaction of the various stakeholders in the innovative drug market for the demand community and construct the above-mentioned stakeholder perspective Innovative Drug Market Access Policy Environment Model.Based on the status quo of China's innovative drug market access,the present study puts forward to encourage innovative drug market access to the interests of the main body,to optimize the existing innovative drug market access policy environment to make reference recommendations.
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Objective To investigate the status of coal-burning-borne fluorosis in Chunmuying Township,Xuanen County,Hubei Province,to provide basis for the prevention of endemic fluorosis and the protection of the health of local population.Methods According to the methods and requirements of Hubei provincial monitoring program,a baseline survey was carried out.Fifteen diseased villages were selected as survey sites to investigate the changes of furnace stove,and to detect 8-12 years old children's dental fluorosis prevalence (Dean method).From 2007 to 2016,50 urine samples of children aged 8 to 12 years of age and 10 samples of dried corn and dried pepper each,were collected each year,and fluorine ion selective electrode method was used to detect fluorine content.Results In 2016,the qualified improved stove coverage rate was 98.84％ (2 733/2 765).The correct utilization rate of the qualified improved stove was 99.56％ (2 721/2 733).Dental fluorosis was 0.84％ (5/596).The correct drying rate of corn and pepper was both 99.10％ (2 740/2 765).The total qualified rate of urinary fluoride in children from 2007 to 2016 was 91.40％ (457/500),the mean value of urinary fluoride concentration was 0.83 mg/L.Fluctuation trend was decreasing year by year.The geometric average of the total fluorine content of dried corn was 3.78 mg/kg,and the range was 0.09-127.10 mg/kg.The geometric average of the total fluoride content of dried chili peppers was 105.26 mg/kg,and the range was 0.13-1 984.90 mg/kg.The content of fluorine in dried corn and dried chili decreased year by year.Conclusion With the deepening of fluoride reduction measures,the fluoride intake of residents has decreased year by year,but the residents are still lived in a high fluoride environment,and the measures of reducing fluoride should be strengthened.
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Objective To analyze the changes of varicella outbreak in Minhang District before and after practicing "the varicella emergency vaccination implementation program (2013-2014 trial version),Shanghai",and to evaluate the effects of live attenuated vaccine against varicella.Methods We used cross-sectional investigation to collect monitoring data of vaticella outbreak recorded in "China Information System for Disease Control and Prevention".The observation periods before and after the implementation of the program were during 2012-01-01 to 2013-06-30 and during 2013-07-01 to 2014-12-31.Results Before the implementation of the program,14 cases of varicella epidemic were reported in Minhang District.All cases were up to the outbreaks in the epidemic,the longest duration was 82 days,the average duration continued was 50.86 days (912/14),the average cumulative generation was 2.42 generations (50.86/21),the total number of people was 159,the total incidence rate was 1.26％ (159/12 625),the class incidence rate was 9.09％ (159/1 750),the average number of people was 11.36 (159/14),the average number of class was 3.21 (45/14).After the implementation of the program,169 cases of the varicella epidemic were reported in Minhang District,only 22 cases rose to the outbreaks in the epidemic,the longest duration was 66 days,the average duration continued was 41.32 days (909/22),the average cumulative generation was 1.97 generations (41.32/21),the total number of people was 200,the total incidence rate was 1.10％ (200/18 200),the class incidence rate was 8.38％ (200/2 387),the average number of people was 9.09 (200/22),the average number of class was 2.50 (55/22);Although the varicella epidemic in the total outbreaks had significantly increased in Minhang District before and after emergency implementation,but the varicella outbreak in the varicella epidemic significantly decreased,the total incidence rate,the class incidence rate,the longest duration,the average duration,the average cumulative generation,the average number of people and the average number of class had decreased in varying degrees.There is statistical difference between the average duration before and after the implementation (x2 =4.06,P＜0.05).Conclusions Emergency vaccination of varicella vaccine in high risk population can effectively control the spread of epidemic situation and reduce the possibility of secondary transmission.
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Based on the stakeholder theory,externalities theory and marginal utility theory,this paper analyzes the behavioral needs of stakeholders in the process of market access of innovative drugs.It also draws out the core of the government and the pharmaceutical enterprises in the policy of access to innovative drug market and supply to the community,the patients,and the medical institutions enter the mechanism of the interaction of the various stakeholders in the innovative drug market for the demand community and construct the above-mentioned stakeholder perspective Innovative Drug Market Access Policy Environment Model.Based on the status quo of China's innovative drug market access,the present study puts forward to encourage innovative drug market access to the interests of the main body,to optimize the existing innovative drug market access policy environment to make reference recommendations.
RESUMEN
Objective To investigate the status of coal-burning-borne fluorosis in Chunmuying Township,Xuanen County,Hubei Province,to provide basis for the prevention of endemic fluorosis and the protection of the health of local population.Methods According to the methods and requirements of Hubei provincial monitoring program,a baseline survey was carried out.Fifteen diseased villages were selected as survey sites to investigate the changes of furnace stove,and to detect 8-12 years old children's dental fluorosis prevalence (Dean method).From 2007 to 2016,50 urine samples of children aged 8 to 12 years of age and 10 samples of dried corn and dried pepper each,were collected each year,and fluorine ion selective electrode method was used to detect fluorine content.Results In 2016,the qualified improved stove coverage rate was 98.84％ (2 733/2 765).The correct utilization rate of the qualified improved stove was 99.56％ (2 721/2 733).Dental fluorosis was 0.84％ (5/596).The correct drying rate of corn and pepper was both 99.10％ (2 740/2 765).The total qualified rate of urinary fluoride in children from 2007 to 2016 was 91.40％ (457/500),the mean value of urinary fluoride concentration was 0.83 mg/L.Fluctuation trend was decreasing year by year.The geometric average of the total fluorine content of dried corn was 3.78 mg/kg,and the range was 0.09-127.10 mg/kg.The geometric average of the total fluoride content of dried chili peppers was 105.26 mg/kg,and the range was 0.13-1 984.90 mg/kg.The content of fluorine in dried corn and dried chili decreased year by year.Conclusion With the deepening of fluoride reduction measures,the fluoride intake of residents has decreased year by year,but the residents are still lived in a high fluoride environment,and the measures of reducing fluoride should be strengthened.
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Objective To analyze the changes of varicella outbreak in Minhang District before and after practicing "the varicella emergency vaccination implementation program (2013-2014 trial version),Shanghai",and to evaluate the effects of live attenuated vaccine against varicella.Methods We used cross-sectional investigation to collect monitoring data of vaticella outbreak recorded in "China Information System for Disease Control and Prevention".The observation periods before and after the implementation of the program were during 2012-01-01 to 2013-06-30 and during 2013-07-01 to 2014-12-31.Results Before the implementation of the program,14 cases of varicella epidemic were reported in Minhang District.All cases were up to the outbreaks in the epidemic,the longest duration was 82 days,the average duration continued was 50.86 days (912/14),the average cumulative generation was 2.42 generations (50.86/21),the total number of people was 159,the total incidence rate was 1.26％ (159/12 625),the class incidence rate was 9.09％ (159/1 750),the average number of people was 11.36 (159/14),the average number of class was 3.21 (45/14).After the implementation of the program,169 cases of the varicella epidemic were reported in Minhang District,only 22 cases rose to the outbreaks in the epidemic,the longest duration was 66 days,the average duration continued was 41.32 days (909/22),the average cumulative generation was 1.97 generations (41.32/21),the total number of people was 200,the total incidence rate was 1.10％ (200/18 200),the class incidence rate was 8.38％ (200/2 387),the average number of people was 9.09 (200/22),the average number of class was 2.50 (55/22);Although the varicella epidemic in the total outbreaks had significantly increased in Minhang District before and after emergency implementation,but the varicella outbreak in the varicella epidemic significantly decreased,the total incidence rate,the class incidence rate,the longest duration,the average duration,the average cumulative generation,the average number of people and the average number of class had decreased in varying degrees.There is statistical difference between the average duration before and after the implementation (x2 =4.06,P＜0.05).Conclusions Emergency vaccination of varicella vaccine in high risk population can effectively control the spread of epidemic situation and reduce the possibility of secondary transmission.