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Objective:To investigate the association between the initial red cell distribution width (RDW) and all-cause mortality in patients with cardiac arrest (CA) in intensive care unit (ICU).Methods:We conducted a retrospective cohort study and extracted the related clinical data in ICU among adult CA patients (age ≥18 years), using the Multiparameter Intelligent Monitoring Intensive Care III (MIMIC-Ⅲ, v1.4) database from 2001 to 2012. Based on whether they survived or not on 90 days, the patients were divided into the survival group and death group, and the clinical data of the two groups were compared. Meanwhile, the RDW values were divided into four parts according to quartile. The cumulative survival rate of 28-day and 90-day were estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox proportional hazard models were also used to reveal the association between RDW and all-cause mortality.Results:Based on the inclusion and exclusion criteria, 853 adult CA patients were finally enrolled. The mean age was (67.26±15.84) years, and 534 (62.60%) patients were male. And the mean SOFA score was (6.13±3.70). Compared with the survival group ( n=410), the patients in the death group ( n=443) were older and had a higher SOFA score, RDW, anion gap, creatinine and blood phosphorus. Moreover, the proportion of chronic obstructive pulmonary disease, acute kidney injury and sepsis in the death group were higher than those in the survival group, and the length of stay in ICU in the death group was longer than that in the survival group (all P<0.05). However, the indicators of arterial blood oxygen partial pressure, hemoglobin and total blood calcium, as well as the proportion of coronary heart disease and acute myocardial infarction were lower than those in the survival group, and a shorter duration of hospitalization in the death group was noted (all P<0.05). Kaplan-Meier survival curves demonstrated that there was a significant difference in the cumulative survival rate of 28-day and 90-day (all P<0.001). In the multivariate Cox proportional hazard models, a higher RDW at ICU admission was an independent risk factor for 28-day ( HR=1.399, 95% CI: 1.014-1.930, P=0.041) and 90-day ( HR=1.433, 95% CI: 1.064-1.929, P=0.018) all-cause mortality among CA patients. Conclusions:An elevated RDW is an independent predictor for 28-day and 90-day all-cause mortality of CA patients. As a clinical indicators, it indicates a poor prognosis for adult CA patients.
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Objective To investigate the status quo of drinking water toxicology indicators in poor rural areas of Handan, Hebei, and analyze its influencing factors. To provide suggestions and opinions for water quality monitoring and water quality treatment in this area, and to provide new ideas for further promoting the construction of new rural areas in impoverished areas. Methods From 2017 to 2020, 6860 drinking water samples were collected from impoverished rural areas in Handan, Hebei. According to the “Sanitary Standards for Drinking Water” (GB 5749-2006), the toxicological indicators were evaluated. And the logistic regression model was used to analyze the influencing factors of drinking water toxicological indicators in the poor rural areas of Handan, Hebei. Results From 2017 to 2020, the difference in the qualified rate of drinking water toxicological indicators in the poor rural areas of Handan was statistically significant (P＜0.05). And with the increase in years, the pass rate of drinking water toxicology indicators showed an upward trend. Among them, the pass rate was the lowest in 2017, with a pass rate of 87.51%, and the highest in 2020, with a pass rate of 96.81%. From 2017 to 2020, except for carbon tetrachloride, selenium, and cyanide, other toxicological indicators all exceeded the standard to varying degrees. According to the degree of exceeding standard, the top four were fluoride, nitrate nitrogen, hexavalent chromium and lead. Logistic regression model analysis showed that untreated water, not using disinfection equipment as required, non-disinfection, pollution sources, and small-scale water supply were the risk factors for unqualified toxicological indicators (P＜0.05). Conclusion The quality of drinking water in poor rural areas in Handan, Hebei has been greatly improved, and the qualified rate of toxicological indicators has been increasing year by year, and the national policy support has provided an important guarantee for it; however, some toxicological indicators still exceed the standards due to various factors. It is necessary for relevant departments to do a good job in rural water supply projects, strengthen the operation and management of poor rural drinking water safety projects in Handan City, do a good job in rural water source protection, strengthen water plant management, and continuously explore rural drinking water treatment techniques to promote rural water supply development and improve rural drinking water quality.
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Objective:To verify the clinical safety and efficacy of new intelligent ventilation mode adaptive minute ventilation (AMV)+IntelliCycle ventilation in patients with mild-to-moderate acute respiratory distress syndrome (ARDS).Methods:The patients with mild-to-moderate ARDS, admitted to intensive care unit (ICU) of the First Affiliated Hospital of Jinzhou Medical University from February 2018 to February 2019, were enrolled in the study. The patients were divided into synchronous intermittent mandatory ventilation+pressure support ventilation (SIMV+PSV) group and AMV+IntelliCycle group according to the random number table method. All patients were given mechanical ventilation, anti-infection, analgesia and sedation, nutritional support and symptomatic treatment of primary disease after admission. SV800 ventilator was used for mechanical ventilation. In the AMV+IntelliCycle group, after setting the minute ventilation volume (VE), inhaled oxygen concentration (FiO 2) and positive end expiratory pressure (PEEP), the ventilator was turned on the full-automatic mode, and the preset value of VE percentage was 120%. In the SIMV+PSV group, the ventilator parameters were set as follows: the ventilation frequency was 12-20 times/min, the inspiratory expiratory ratio was 1∶1-2, the peak inspiratory pressure (PIP) limit level was 35-45 cmH 2O (1 cmH 2O = 0.098 kPa), and the setting of FiO 2 and PEEP was as the same as that of AMV+IntelliCycle group, the triggering flow was set to 2 L/min. All of the clinical parameters between the two groups were compared. The main outcomes were duration of mechanical ventilation, ventilator alarm times, manual operation times, and the mechanical power; the secondary outcomes were respiratory rate (RR), VE, tidal volume (VT), PIP, mouth occlusion pressure (P0.1), static compliance (Cst), work of breathing (WOB), and time constant at 0, 6, 12, 24, 48, 72, and 120 hours; and the blood gas analysis parameters of patients before and after ventilation were recorded. Results:A total of 92 patients with mild-to-moderate ARDS were admitted during the study period, excluding those who quit the study due to death, abandonment of treatment, accidental extubation of tracheal intubation and so on. Eighty patients were finally enrolled in the analysis, with 40 patients in SIMV+PSV group and AMV+IntelliCycle group respectively. ① Results of main outcomes: compared with the SIMV+PSV mode, AMV+IntelliCycle ventilation mode could shorten the duration of mechanical ventilation (hours: 106.35±55.03 vs. 136.50±73.78), reduce ventilator alarm times (times: 10.35±5.87 vs. 13.93±6.87) and the manual operations times (times: 4.25±2.01 vs. 6.83±3.75), and decrease the mechanical power (J/min: 12.88±4.67 vs. 16.35±5.04, all P < 0.05). But the arterial partial pressure of carbon dioxide (PaCO 2) of AMV+IntelliCycle group was significantly higher than that of SIMV+PSV group [mmHg (1 mmHg = 0.133 kPa): 41.58±6.81 vs. 38.45±5.77, P < 0.05]. ② Results of secondary outcomes: the RR of both groups was improved significantly with the prolongation of ventilation time which showed a time effect ( F = 4.131, P = 0.005). Moreover, compared with SIMV+PSV mode, AMV+IntelliCycle mode could maintain a better level of RR, with intervention effect ( F = 5.008, P = 0.031), but no interaction effect was found ( F = 2.489, P = 0.055). There was no significant difference in VE, PIP, P0.1 or Cst between the two groups, without intervention effect ( F values were 3.343, 2.047, 0.496, 1.456, respectively, all P > 0.05), but they were significantly improved with the prolongation of ventilation time in both groups, with time effect ( F values were 2.923, 12.870, 23.120, 7.851, respectively, all P < 0.05), but no interaction effect was found ( F values were 1.571, 1.291, 0.300, 0.354, respectively, all P > 0.05). The VT, WOB or time constant in both groups showed no significant changes with the prolongation of ventilation time, and no significant difference was found between the two groups, there was neither time effect ( F values were 0.613, 1.049, 2.087, respectively, all P > 0.05) nor intervention effect ( F values were 1.459, 0.514, 0.923, respectively, all P > 0.05). Conclusion:AMV+IntelliCycle ventilation mode can shorten the ventilation time of patients with mild-to-moderate ARDS, reduce mechanical power, and reduce the workload of medical care, but PaCO 2 in the patients with AMV+IntelliCycle mode is higher than that in the patients with SIMV+PSV mode.
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Objective To investigate the photoregulation of transient receptor potential ankyrin 1 (TRPA1) in HaCaT cells,and to explore its mechanisms.Methods Cultured HaCaT cells were divided into 225-mJ/cm2 UVA radiation groups and 25-mJ/cm2 UVB radiation groups.HaCaT cells in the UVA radiation groups were further classified into 6 groups:blank control group 1 receiving no treatment,retinal group 1 treated with 12 μmol/L retinal alone,UVA group treated with 225 mJ/cm2 UVA radiation alone,retinal + UVA group (UVA-TRPA1 control group),retinal + UVA + 500 μmol/L cinnamaldehyde group (UVA-TRPA1 agonist group) and retinal + UVA + 1 mmol/L camphor group (UVA-TRPA1 antagonist group).Additionally,HaCaT cells in the UVB radiation groups were also further classified into 6 groups:blank control group 2 receiving no treatment,retinal group 2 treated with 12 μmol/L retinal alone,UVB group treated with 25-mJ/cm2 UVB radiation,retinal + UVB group (UVB-TRPA1 control group),retinal + UVB + 500 μmol/L cinnamaldehyde group (UVB-TRPA1 agonist group) and retinal + UVB + 1 mmol/L camphor group (UVB-TRPA1 antagonist group).Real-time fluorescence-based quantitative PCR (qPCR) and Western blot analysis were performed to determine the mRNA and protein expression of TRPA 1 respectively.Flow cytometry was conducted to investigate changes of calcium influx in HaCaT cells in the above groups.Results qPCR and Western blot analysis showed that TRPA1 mRNA and protein were expressed in HaCaT cells.The fluorescence intensity of calcium influx significantly differed among the blank control group 1,retinal group 1,UVA group and retinal + UVA group (155.06 ± 7.62,148.37 ± 18.77,166.92 ± 3.71 and 331.333 ± 40.563;F =44.509,P ＜ 0.01),as well as among the blank control group 2,retinal group 2,UVB group and retinal + UVB group (150.20 ± 1.73,171.66 ± 56.23,147.56 ± 6.60 and 250.44 ± 9.13;F =85.261,P ＜ 0.01).Additionally,retinal + UVA/UVB groups showed significantly higher fluorescence intensity of calcium influx compared with the blank control groups (q =18.442,6.052,P ＜ 0.01).The TRPA1 agonist cinnamaldehyde and its antagonist camphor could regulate the UVA-and UVB-induced calcium influx (P ＜ 0.001).Compared with the blank control group 1 and 2 respectively,the fluorescence intensity of retinal-dependent calcium influx was significantly higher in the UVA/UVB-TRPA1 agonist group (q =14.934,32.770,P ＜ 0.001),and significantly lower in the UVA/UVB-TRPA1 antagonist group (q =7.986,14.596,P ＜ 0.001).Conclusion TRPA1 is expressed in HaCaT cells,and UVA or UVB can regulate the calcium influx in HaCaT cells by adjusting the activity of TRPA 1.
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Objective To investigate the photoregulation of transient receptor potential ankyrin 1 (TRPA1) in HaCaT cells,and to explore its mechanisms.Methods Cultured HaCaT cells were divided into 225-mJ/cm2 UVA radiation groups and 25-mJ/cm2 UVB radiation groups.HaCaT cells in the UVA radiation groups were further classified into 6 groups:blank control group 1 receiving no treatment,retinal group 1 treated with 12 μmol/L retinal alone,UVA group treated with 225 mJ/cm2 UVA radiation alone,retinal + UVA group (UVA-TRPA1 control group),retinal + UVA + 500 μmol/L cinnamaldehyde group (UVA-TRPA1 agonist group) and retinal + UVA + 1 mmol/L camphor group (UVA-TRPA1 antagonist group).Additionally,HaCaT cells in the UVB radiation groups were also further classified into 6 groups:blank control group 2 receiving no treatment,retinal group 2 treated with 12 μmol/L retinal alone,UVB group treated with 25-mJ/cm2 UVB radiation,retinal + UVB group (UVB-TRPA1 control group),retinal + UVB + 500 μmol/L cinnamaldehyde group (UVB-TRPA1 agonist group) and retinal + UVB + 1 mmol/L camphor group (UVB-TRPA1 antagonist group).Real-time fluorescence-based quantitative PCR (qPCR) and Western blot analysis were performed to determine the mRNA and protein expression of TRPA 1 respectively.Flow cytometry was conducted to investigate changes of calcium influx in HaCaT cells in the above groups.Results qPCR and Western blot analysis showed that TRPA1 mRNA and protein were expressed in HaCaT cells.The fluorescence intensity of calcium influx significantly differed among the blank control group 1,retinal group 1,UVA group and retinal + UVA group (155.06 ± 7.62,148.37 ± 18.77,166.92 ± 3.71 and 331.333 ± 40.563;F =44.509,P ＜ 0.01),as well as among the blank control group 2,retinal group 2,UVB group and retinal + UVB group (150.20 ± 1.73,171.66 ± 56.23,147.56 ± 6.60 and 250.44 ± 9.13;F =85.261,P ＜ 0.01).Additionally,retinal + UVA/UVB groups showed significantly higher fluorescence intensity of calcium influx compared with the blank control groups (q =18.442,6.052,P ＜ 0.01).The TRPA1 agonist cinnamaldehyde and its antagonist camphor could regulate the UVA-and UVB-induced calcium influx (P ＜ 0.001).Compared with the blank control group 1 and 2 respectively,the fluorescence intensity of retinal-dependent calcium influx was significantly higher in the UVA/UVB-TRPA1 agonist group (q =14.934,32.770,P ＜ 0.001),and significantly lower in the UVA/UVB-TRPA1 antagonist group (q =7.986,14.596,P ＜ 0.001).Conclusion TRPA1 is expressed in HaCaT cells,and UVA or UVB can regulate the calcium influx in HaCaT cells by adjusting the activity of TRPA 1.
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Objective To study the effects of improved Wright-Giemsa staining. Methods 40 semen samples by both traditional and improved Wright-Giemsa staining.The morphological characteristics stained by two methods was ob-served. Results The defective rates of the middle and tail parts of sperm were 7.02%± 2.4%and 11.02%± 2.03%respec-tively in improved staining group;while those were 5.48%±2.8%and 8.05%±2.56%in traditional staining group. There was statistical significance between two staining methods (P < 0.05). There was no significant difference of normal sperm and sperm head between these two staining methods;however, improved staining method showed a much clearer nucleus and ac-rosome staining than that of traditional methods. Improved Wright-Giemsa staining is better for sperm, vaginal discharge and Trichomonas vaginalis. More importantly, axostyle and flagella were clearly stained with the improved method. Conclusion Improved Wright-Giemsa staining is simple and can be used in clinical diagnosis.
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Objective To observe the influence of Huiyang Shengji Ointment and its modified formulae on interleukin-1 (IL-1α) and thromboxane B2 (TXB2) in diabetic rats with chronic skin ulcers, and explore the mechanism for promoting the healing of ulcer.Methods Six out of 160 rats were randomly selected as a blank group, without any further processing. The remaining rats were made diabetic model and randomly divided into five groups after 2 weeks:1 d, 3 d, 5 d, 7 d and 14 d groups. Then, these groups were further divided into normal group (Vaseline ointments), model group (Vaseline ointments), Huiyang Shengji Ointment group (whole formula Ointment), Wenyang Yiqi group (Yiqi group, modified Wenyang Yiqi formula ointments) and Huoxue Shengji group (Huoxue group, modified Huoxue Shengji formula ointments). Normal group and model group were given Vaseline ointments;whole formula group, Yiqi group and Huoxue group were given corresponding ointment. Normal group used the method of skin excision, while other groups used STZ injection-hydrocortisone interference-skin excision-foreign body embedded preparation of composite factors for chronic skin ulcer model. After the appropriate treatment period, the rats were executed and tested for the contents of IL-1α and TXB2 in serum by enzyme-linked immunosorbent assay of five time points.Results In treatment 3 d, the contents of IL-1α in Yiqi group were significantly higher than the blank group, model group, whole formula group and Huoxue group (P<0.05). In treatment 5 d, the contents of IL-1α in whole formula group were significantly higher than the blank group and model group (P<0.05). In treatment 7 d, the contents of IL-1α in each treatment group were significantly higher than blank group and model group (P<0.05), and the whole formula group was higher than the Yiqi group and Huoxue group. In treatment 14 d, the contents of IL-1α in model group and Huoxue group were lower than the blank group (P<0.05). In treatment 3 d, the contents of TXB2 in normal group and the whole formula group were higher than the blank group (P<0.05). In treatment 5 d, the contents of TXB2 in whole formula group were higher than the blank group and the normal group (P<0.05). In treatment 7 d, the contents of TXB2 in Yiqi group were higher than the blank, the model, the whole formula and Huoxue groups (P<0.05). In treatment 14 d, the contents of TXB2 in Huoxue group were higher than the blank and model group (P<0.05), and the contents of TXB2 in the blank group and normal group was lower than those treatment groups (P<0.05).Conclusion Huiyang Shengji Ointment and its modified formulae could promote inflammation, stimulate secretion of inflammatory cytokines, while Yiqi Wenyang ointments played a more active role in promoting inflammation of the early phase of wound surface.
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Objective To investigate whether cyclooxygenase-2(COX-2)expression are related to the clinicopathological features,and to microvessel density(MVD).Methods COX-2 expressions were detected in 45colorectal carcinoma samples by immunostaining.MVD was evaluated with the specific antibody CD105.Quantitationof COX-2 mRNA was performed by RT-PCR in 45 specimens of colorectal carcinoma.Results The expressions of COX-2 mRNA and protein were significant variation among lymphatic metastasis,high Dukes stages and grade of differation(P＜0.05);Increased value of MVD were significant variation among lymphatic metastasis,high Dukes stage and depth of tumor invasion(P＜0.05).Both the overexpression of COX-2 protein and mRNA was positively correlated with the value of MVD(P＜0.05).Conclusion COX-2 plays an important role in the development of colorectal carcinoma.COX-2 may up-regulate the value of MVD,which induces angiogenesis and accordingly contributes to metastasis.
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In handling crises in hospitals caused by natural disasters like earthquake, systemati cpractical measures of crisis management are needed, which include: early contact with top managements for support in counter disaster supplies, immediate organization of temporary first aid stations by hospital staff, logistic support by full time personnel to solve problems such as drugs and medical equipments as well as food and drinking water, and psychological consultation to patients and staff members.
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Idopathic pulmonary fibrosis (IPF),with unknown pathogeny,is a interstitial lung disease. The pathological features are diffuse epithelial-cell lesion and excessive extracellular matrix deposition. Many investigators consider alveolar epithelial cells impairment and abnormal activation,fibroblast proliferation and myofibroblast differentiation as causes,resulting in excessive extracellular matrix disorganization of lung. Recently,it is believed that telomeres and telomerases might play a role in regulating the capacity of fibroblast proliferation and aberrant epithelial repair in IPF. The aim of this article is to review the telomeres,telomerases and their relationship with the idopathic pulmonary fibrosis,furthmore,to identify the etiology and pathogenesis of the idopathic pulmonary fibrosis and provide the study measure for establishing an effective treatment.