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OBJECTIVE@#To analyze the clinical characteristics of patients with emergency in-hospital cardiac arrest (IHCA) in Kashgar, Xinjiang Uygur Autonomous Region and the factors affecting the success rate of cardiopulmonary resuscitation.@*METHODS@#Retrospectively selected patients who had cardiac arrest and cardiopulmonary resuscitation in the emergency department of the People's Hospital of 6 counties and cities in Kashgar area from January 2019 to January 2022. The clinical data of all patients were collected, including gender, age, major underlying diseases, the beginning and duration of resuscitation, the number of electric defibrillation acute physiology and chronic health evaluation II (APACHE II). According to whether the resuscitation was successful, all patients were divided into successful resuscitation group and failed resuscitation group. The clinical characteristics of the two groups were compared. Then, the influencing factors of the success rate of cardiopulmonary resuscitation in IHCA patients were analyzed by binary Logistic regression.@*RESULTS@#A total of 1 376 patients were enrolled, including 1 117 cases of failed resuscitation and 259 cases of successful resuscitation. The success rate of resuscitation was 18.82%. Compared with the resuscitation failure group, the patients in the successful resuscitation group were younger (age: 49.10±20.99 vs. 58.44±18.32), the resuscitation start time was earlier [resuscitation start time ≤ 5 minutes: 76.45% (198/259) vs. 66.61% (744/1 117)], the proportion of cardiovascular and cerebrovascular diseases was lower [cardiovascular disease: 49.42% (128/259) vs. 58.19% (650/1 117), cerebrovascular disease: 17.37% (45/259) vs. 21.58% (241/1 117)], the number of electric defibrillation was lower [times: 0 (0, 2) vs. 1 (0, 1)], the proportion of endotracheal intubation was more [80.31% (208/259) vs. 55.60% (621/1 117)], APACHE II score was lower (13.75±8.03 vs. 17.90±4.63), and the difference was statistically significant (all P < 0.01). Binary Logistic regression analysis showed that age, start time of resuscitation, ventilation mode and APACHE II score were protective factors affecting the success rate of cardiopulmonary resuscitation in patients with emergency IHCA [age: odds ratio (OR) = 0.982, 95% confidence interval (95%CI) was 0.973-0.991, P < 0.001; resuscitation start time ≤ 5 minutes: OR = 0.629, 95%CI was 0.409-0.966, P = 0.034; tracheal intubation assisted ventilation: OR = 0.243, 95%CI was 0.149-0.397, P < 0.001; low APACHE II score: OR = 0.871, 95%CI was 0.836-0.907, P < 0.001], while underlying diseases (cardiovascular diseases) are a risk factor affecting the success rate of cardiopulmonary resuscitation (OR = 1.190, 95%CI was 1.015-1.395, P = 0.036).@*CONCLUSIONS@#Age, resuscitation start time, ventilation mode, APACHE II score and major underlying diseases (cardiovascular diseases) have a greater impact on the success rate of resuscitation in IHCA patients. The above factors are conducive to improving or formulating more effective rescue strategies for IHCA patients, so as to achieve the purpose of improving the success rate of clinical treatment.
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Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Estudos Retrospectivos , Reanimação Cardiopulmonar , Parada Cardíaca/terapia , Cardioversão Elétrica , HospitaisRESUMO
Objective:To prepare bone marrow mesenchymal stem cells (BMSCs) transfected with therapeutic gene early growth reactive protein 1 (Egr1)-sodium/iodine symporter (NIS) and carrying gold nanoparticles (AuNPs), and to investigate the feasibility of Egr1 in promoting NIS expression and the radiasensitization effect of AuNPs.Methods:BMSCs transfected with lentivirus(Lv)-Egr1-NIS-cytomegalovirus(CMV)-green fluorescent protein (GFP) in the experimental group and Lv-Egr1-GFP in the control group were prepared and the expression of NIS induced by radioiodine was verified by iodine uptake determination. The optimal incubation time and concentration of AuNPs were observed with laser confocal microscopy. The cytotoxicity of AuNPs suspension liquid was investigated using cytotoxicity test. Iodine uptake assay was performed to investigate NIS gene expression of BMSCs-Egr1-NIS incubated with AuNPs. In vitro chemotaxis of BMSCs-Egr1-NIS incubated with/without AuNPs to breast cancer cells were verified by cell migration experiment. The radiosensitization effect of AuNPs for 131I on killing breast cancer cells MDA-MB-231 were explored. The one-way analysis of variance and Dunnett t test were used for data analysis. Results:BMSCs-Egr1-NIS (unstable transformation) was successfully prepared. Egr1 could promote NIS expression with the induction of radioiodine. The iodine uptake capacity in BMSCs-Egr1-NIS increased by 2.5-5 times or even higher compared with BMSCs-Egr1-GFP. The better incubation conditions of AuNPs for BMSCs phagocytosis were 0.20 g/L(24 h) or 0.10 g/L(48 h). The cytotoxicity of AuNPs was low in appropriate incubation time and concentration, and there was no effect on iodine uptake and chemotaxis. The chemotaxis to MDA-MB-231 of BMSCs-Egr1-NIS was identified. AuNPs radiasensitization assay showed that absorbance ( A) 570 nm of MDA-MB-231 cells were significantly deferent in 131I killing groups and blank control group without 131I ( F=60.670, P<0.01), and the cytotoxicity of 131I to MDA-MB-231 cells in the 131I killing groups with 0.20 g/L AuNPs and 0.40 g/L AuNPs ( A570 nm values: 0.87±0.05, 0.41±0.07) was significantly higher than that in the group with 0 g/L AuNPs ( A570 nm=1.39±0.11; both P<0.01). Conclusions:BMSCs, transfected with therapeutic gene Egr1-NIS and incubated with AuNPs, can be used as a carrier to target breast cancer. NIS gene expression of BMSCs-Egr1-NIS was highly promoted in the presence of radioiodine. At the same time, AuNPs can be used as a radiation sensitizer for 131I treatment.
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Gold nanoparticles ( AuNPs) have been widely used in biomedicine due to their unique physical and chemical properties as well as good biocompatibility. Current research in this field has been focused on AuNP radiosensitization in radiotherapy for cancer. Extensive studies in vivo and in vitro have showed the radiosensitization effect of AuNPs. However, the mechanism of radiosensitization by AuNPs still requires further studies. Right now, the radiation?insensitive phase ( G0+G1 phase) to radiation?sensitive phase ( G2+M phase ) transition of tumor cells by AuNPs is widely considered as the main cause of radiosensitization. There are many influencing factors for AuNP radiosensitization such as particle size, surface modification, microscopic distribution, radiation energy, radiation dose, and type of tumor cells. Moreover, safety should also be taken into account in AuNP radiosensitization. Clinical trials of AuNPs have been carried out right now. More studies on AuNP radiosensitization are needed to achieve real clinical transformation.
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Objective To explore the relationship of bone marrow micrometastases(BMM) with nm23 expression of breast cancer(BC) in patients with stage Ⅰ BC. Methods BMM and nm23 expression of carcinoma tissue in 52 cases of stage Ⅰ BC were examined by immunohistochemical technique with monoclonal anti epithelial membrane antigen(anti EMA) and nm23 H1. Results BMM was observed in 10 of 52 patients(19.2%). In the group of poor differentiated cancer, the positive rate of BMM was significantly higher than that in well differentiated cancer(P