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OBJECTIVE: To explore the treatment of malignant arrhythmia induced by acute poisoning. METHODS: To analyze the treatment of 11 cases of malignant arrhythmia caused by acute poisoning. The therapeutic effect of malignant arrhythmia treated by drug, electrical cardioversion and detoxification was observed. RESULTS: The arrhythmias in the patients included premature ventricular beats, ventricular tachycardia, ventricular fibrillation, sinus tachycardia, sinus bradycardia, atrial premature beats, and ST-T changes. After treatment with cardioerter drug such as amiodarone, lidocaine, esmolol and other drugs, electric defibrillation, removeing poisons with hemoperfusion and specific antidotes, and multiple organ protection symptomatic treatment, 10 cases were successfully rescued and 1 case died. CONCLUSION: Malignant arrhythmias caused by acute poisoning could be given combined treatment with anti-arrhythmias and relief of etiology.
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Objective To observe whether ketamine improves the symptoms of post-traumatic stress disorder (PTSD).Methods Sixty male SD rats were randomized into four groups:groups CN,CK,PN and PK,15 in each.PTSD animal model was established by inescapable foot shock (IFS) procedure.In groups PK and CK,rats were treated with ketamine 2.5 mg/kg by intraperitoneal injection beginning at 30 min after the IFS procedure once a day for 14 days.Twelve rats were used for be havioral tests,and the others were sacrificed to collect hippocampus tissues for Western blot in each group 14 d after IFS procedure,respectively.The expression of neuroligin (NLGN)-1 was detected by Western blot.Results In the fear conditioning test,compared with group CN,the percent age of freezing time in total time in group PN was significantly increased (P＜0.01).Compared with group PN,the percent age of freezing time in PK group was significantly decreased (P＜0.01).In the water maze test,compared with group CN,the escape latency of group PN was significantly increased on day 2,3,4,5 of training period (P＜0.05).Compared with group PN,the escape latency of group PK was significantly decreased on day 2,4,5 of training period (P＜0.05).There was no significant difference in the time spent in the target quadrant.The expression of NLGN-1 in the hippocampus was significantly increased in PN group compared with group CN (P＜0.05);compared with group PN,the expression of NLGN-1 in the hippocampus was significantly decreased in PK group (P＜0.05).Conclusion The study suggest that the fear memory is significantly,increased and the hippo campus-dependent spatial learning capacity is impaired in the PTSD model rats.And the increased ex pression of hippocampal NLGN-1 may be involved in the development of PTSD.Ketamine mediated down regulation of NLGN-1 in the hippocampus might contribute to attenuating the fear memory and improving the hippocampus dependent spatial learning in the PTSD model rats.
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Objective To investigate the effect of penehychdine hydrochloride (PHCD)on acute lung injury induced by acute severe acute pancreatitis and the expression of hypoxia inducible factor-1α(HIF-1α)in rats.Methods Forty healthy adult male SD rats were used and randomly divided into 3 groups, group S of sham operation,group ALI of pancreatitis-associated acute lung injury (PALI)and group P of PALI with PHCD.Rats of group ALI and group P were the model established of acute lung injury associated with SAP by retrograde injection of 4% sodium taurocholate into biliopancreatic duct.Rats of group P of acute lung injury with SAP were immediately given PHCD after SAP.Rats of group S and group ALI were injected the same amount of 0.9% sodium chloride solution.After modeling,the rats were sacri-ficed at 12 h.The wet/dry weight ratio (W/D)of lung tissue was calculated.Pathological changes of pan-creatic and lung tissues were scored.HIF-1α,IL-1β,IL-6 of lung tissues and serum amylase were detected by ELISA.The expression of TLR4,NF-κB p65 in lung tissue was detected by Western blot.Results Ex-tensive infiltration of neutrophils,alveolar hemorrhage and necrosis and fat necrosis with pancreatic tissue were observed in group PALI and group P.Pancreatic tissue injury score was significantly higher than that of group S (P <0.01).However,there was no statistically significant difference between the level of serum amylase in group P and group ALI.The W/D ratio of lung tissue in rats of group ALI and group P was sig-nificantly higher than those in group S (P <0.05).Compared with those of group ALI,the lung tissue pathological changes of group P were significantly improved,and the lung W/D value was significantly lower than that of group ALI (P <0.05).Compared with group S,the expression of TLR4,NF-κB p65,HIF-1αin lung tissue of group ALI and group P was significantly higher (P <0.01),and the expression of TLR4, NF-κB p65,HIF-1α,IL-1βand IL-6 in group P was significantly lower than that in group ALI (P <0.05).Conclusion PHCD could not alleviate the damage of pancreatic tissue of SAP.It suppressed the expression of HIF-1α,IL-1βand IL-6 and reduced the acute lung injury induced by SAP in rats,which might be depen-ded on suppressing the expression of inflammatory factors,such as HIF-1α.
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Objective To investigate the safety of trial of labor after cesarean (TOLAC) and clinical factors associated with successful TOLAC and to compare TOLAC with elective repeat caesarean section (ERCS) in terms of obstetric and neonatal outcomes.Methods A prospective cohort study was conducted among gravidas who had a history of lower segment cesarean section and were hospitalized in the Department of Obstetrics and Gynecology,the Affiliated Drum Tower Hospital of Medical School of Nanjing University from January to December 2014.Exclusion criteria included indications for caesarean section (such as placenta previa,placenta accreta,twin pregnancy,breech presentation and severe preeclampsia),serious maternal complications after cesarean section,lower uterine segment thinner than 3 mm and poor healing of uterine incision.Totally,287 gravidas were enrolled.Among them,142 chose TOLAC and the other 145 requested ERCS.Clinical data of those gravidas were collected and statistically analyzed by t-test,Log-rank test,Chi-square or Fisher's exact test.Results (1) The success rate of TOLAC was 90.8％ (129/142).There was no significant difference in maternal age,gestational age,thickness of lower uterine segment,interval between the two deliveries and neonatal birth weight and asphyxia rate between the successful (n=129) and unsuccessful (n=13) groups (all P＞0.05).Although the two groups had no significant difference in postpartum hemorrhage (PPH) rate,the gravidas who failed in TOLAC lost more blood than those who succeeded [425 (195-675) vs 200 (50-1 400) ml,P＜0.05].Moreover,higher amniotic fluid contamination rate was observed in the unsuccessful group [6/13 vs 17.1％ (22/129),P＜0.05].In the TOLAC group,99.3％ (141/142) were under continuous fetal heart rate monitoring.Incomplete uterine rupture occurred in one women without serious maternal or neonatal outcomes.The reasons for 13 failed TOLAC cases were unbearable pain during labor,abnormal labor,fetal distress and threatened rupture of uterus.(2) Compared with the ERCS group,the TOLAC group showed shorter interval from last cesarean section to the indexed delivery[5 (2-18) vs 6 (2-19) years],younger maternal age [(31±4) vs (33 ±4) years old] and less blood loss [200 (50-1 400) vs 300 (100-1 500) ml] (all P＜0.05).Conclusion Our study shows that,those who preferred TOLAC were younger,or had shorter pregnancy interval from last cesarean section.The success rate of TOLAC is high for women undergoing systematic prenatal assessment and close management during labor with less blood loss and non-serious maternal and neonatal complications compared with ERCS.
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Objective To study the clinical features of hand-foot-mouth disease(HFMD) in neonates.Method From April 2015 to May 2016,the clinical manifestations,laboratory examinations,treatments and prognosis of neonates with HFMD in our hospital were retrospectively analyzed.Result A total of 6 cases of neonatal HFMD were included,with 4 males and 2 females.The ages of 2 patients were ≤7 days and the other 4 patients 8 ～ 28 days.5 patients developed this disease during April to July,while the other one in January.2 cases had a definite contract history of HFMD.4 cases presented with fever and rashes in hand and foot,one case with fever,rash and oral ulcer,and one case with rash in hip and oral ulcer without fever.The nucleic acid test of enterovirus were positive in 4 cases.The symptoms of these neonatal HFMD were mild and recovered after symptom-relieving treatment.Conclusion HFMD in neonates with fever and/or rash should be considered during the HFMD epidemic period.
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All information processing and transmission in the brain involves synapses, the synaptic cell adhesion molecules play an important role in the formation, maturation and maintenance of synapses. Neuroligin1 ( NL1) is excitatory postsynaptic trans?membrane cell adhesion molecules. The interaction between NL1 and other molecules, such as Neurexin1 ( NRXN1) , involves in the formation, plasticity and function of synapses. NL1 knockout or overexpression displayed impairment in learning and memory, thus sug?gesting that NL1 participates in the pathophysiology of neuropsychiatric disease with cognitive dysfunction. Therefore, study of NL1 will open up new avenues to understand pathogenesis of cognitive dysfunction, and may provide a novel insight into prevention and treatment of cognitive dysfunction?associated diseases.
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Objective By analyzing the cesarean delivery rate (CDR) and the indications of cesarean section in Jiangsu Province from 2012 to 2014, to find the strategy to reduce CDR.Methods Data of 40 hospitals whose number of delivery was over 2 400 per year from the database of the Quality Control Center of Gynecology and Obstetrics of Jiangsu Province from 2012 to 2014 were selected.The cohort was divided into two groups, one was specialized hospital including 11 maternal and child health hospitals and the other included 29 general hospitals.After analyzing the current status of cesarean section of the whole province, the average CDR and the distribution of the first indications of cesarean section in two groups were compared using Chi-square test.Results The average CDRs at year 2012, 2013 and 2014 were 53.8％(96 347/178 970), 51.8％ (97 509/188 142) and 48.8％(106 323/217 877), which had a trend of decrease (x2=1 026.2, P ＜ 0.01).CDR without medical indications for each year were 15.7％ (28 098/178 970), 15.5％ (29 162/188 142) and 12.8％ (27 888/217 877).The rate had decreased apparently from both 2012 and 2013 to 2014 (x2=217.6, P ＜ 0.01;x2=341.3, P ＜ 0.01).The CDRs of specialized hospitals for year 2012, 2013 and 2014 were 51.2％ (45 496/ 88 916), 50.6％ (45 853/90 607) and 49％ (55 404/113 105), while the CDRs of general hospitals for each year were 56.6％(50 851/90 054), 53.0％(51 656/97 535) and 48.6％(50 919/104 772).Both showed significant decreasing trend (x2=105.8 and 1 215.7, both P ＜ 0.01).The average CDR of general hospitals was obviously higher than that of specialized hospitals in 2012 and 2013 (x2=505.6 and 104.3, both P ＜ 0.01).However, the difference disappeared in 2014 (x2=3.2, P ＞ 0.05).The three main first indications of cesarean section were associated and postoperative pregnancy complications, and no medical indications.Interestingly, from 2012 to 2014, the CDR for scarred uterus in specialized hospitals raised from 5.4％ to 20.3％, and that in general hospitals increased from 6.7％ to 21.6％, which became the first.Conclusions The average CDR in Jiangsu Province tends to decrease each year, so does the CDR without medical indications.The first indication of cesarean section is associated or postoperative pregnancy complications, while scarred uterus becomes the most common in cesarean section.
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Objective Accumulating evidence has demonstrated that the sub-anesthetic dose of ketamine exerts rapid and ro-bust antidepressant-like effects though its action mechanisms are not yet fully understood .The aim of this study was to investigate the role of gamma-aminobutyric acid ( GABA) in the antidepressant effects of ketamine . Methods Thirty-two male Wistar rats were e-qually randomized into four groups: saline, ketamine, GABA, and GABA+ketamine.All the animals were implanted with a guide cannula into the lateral ventricle and on the eighth day after operation subjected to a 15 min forced swimming test (FST) for the estab-lishment of a depression model .At 24 h after modeling , the rats of the saline and ketamine groups were treated intracerebroventricularly with 2μL isotonic saline solution, and those of the GABA and GABA +ketamine groups with 50μg (2μL) GABA, followed by intrap-eritoneal administration of 1 mL saline in the former two groups and 10 mg/kg (1 mL) ketamine in the latter two groups 10 min later.At 30 min after treatment , the open field test ( OFT) was carried out for crossing and rearing scores and a 6-min FST was performed to re-cord the immobility time in the last 5 minutes.The content of GABA in the prefrontal cortex of the rats was measured following behav -ioral tests. Results The immobility time was significantly decreased in the ketamine group ([107.5 ±21.2]sec) as compared with the saline, GABA, and GABA+ketamine groups ([167.2 ±22.1], [159.8 ±17.5], and [143.8 ±22.1]sec) (P0.05).The level of GABA in the prefrontal cortex was remarkably lower in the ketamine group ([12.4 ±3.4]ng/mg prot) than in the saline, GABA, and GABA+ketamine groups ([23.3 ± 6.3], [27.3 ±5.7], and [18.0 ±5.4]ng/mg prot) (P0.05 ). Conclusion The antidepressant effects of ketamine are related to the decreased GABA level in the prefrontal cortex in rats receiving FST .
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The aim of this study was to evaluate the changes in the expression of Bax, Bcl-2 and P53 when HeLa cells were induced by free cytokines or co-immobilized cytokines. The cells were induced for 24 hrs,72 hrs, 120 hrs and 168 hrs. Then, the expression of Bax, Bcl-2 and P53 was observed by immunohistochemistry. The average optic density of reaction products was tested by image analysis. Lastly, data were analyzed statistically. After the HeLa cells were induced for 120 hrs, the average optic denisity of Bcl-2 was much decreased. However, the average optic Bax was much increased. The average optic density of P53 also increased with the increase of time. The results suggest that HeLa apoptosis was induced by tumor necrosis factor-a and interferon -gamma, and the increasing expression of P53 may induce the expression of Bax and prevent the expression of Bcl-2, via the mitochondrial induction of cell apoptosis.
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Humanos , Apoptosis , Células HeLa , Proteínas Inmovilizadas , Farmacología , Interferón gamma , Farmacología , Fotoquímica , Métodos , Proteínas Proto-Oncogénicas c-bcl-2 , Metabolismo , Factor de Necrosis Tumoral alfa , Farmacología , Proteína p53 Supresora de Tumor , Metabolismo , Proteína X Asociada a bcl-2 , Genética , MetabolismoRESUMEN
Objective To discuss the nurses'satisfaction degree with work and its influencing factors and analyze the difference of nurses'satisfaction degree with work with different background.Methods 398 nurses in a certain comprehensive hospital were investigated with Mueller/McCloskey(MMSS)satisfactory inventory. Results The nurses'general satisfaction degree with work was less than middle level with a score of (3.12±0.46).The satisfaction degree was statistically different in different dimensionality and nurses with different background. Conclusion The management department of hospitals should adopt positive measures to improve the nurses'satisfaction degree with work and prompt them to supply more high-quality and effective nursing services.
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IFN-gamma and TNF-alpha were co-coupled to the polystyrene cell culture plate by the photo-immobilization method. To investigate the synergistic effect of IFN-gamma and TNF-alpha on the HeLa cells, HeLa cells were treated with co-coupled cytokine or non-coupled cytokine in a time course in this study. The morphology detection, cell cycle analysis by flow cytometry, phosphatidyl serine analysis and capase-3 activity detection demonstrated that the two kinds of treatments both induce HeLa cells apoptosis. Non-coupled cytokine worked more quickly while co-coupled cytokine kept more permanent effect. The caspase-3 activity assay indicated that the caspase-3 activity of HeLa cells treated with non-coupled cytokine is higher than that of HeLa cells treated with co-coupled cytokine. This may imply that co-coupled cytokine not only induces the caspase-dependent pathway, but also induces the caspase-independent pathway.