Factors influencing the extubation of patients in a vegetative state after tracheotomy / 中华物理医学与康复杂志

Objective:To explore the factors influencing the extubation time of patients in a persistent vegetative state (PVS) after tracheotomy so as to provide a theoretical basis for early extubation for such patients.Methods:Clinical data were collected on PVS patients after a tracheotomy. The cases were divided into an extubation group and a difficult extubation group according to whether the extubation was successful or not. Version 22.0 of the SPSS software was used to evaluate univariate and multivariate logistic regressions analyzing the factors influencing the success of extubation.Results:The single-factor analysis revealed significant differences between the groups in terms of average age, nursing level, nutrition, swallowing function, hypoalbuminemia and incubation time. Gender, brain injury, stroke, ischemic anoxic encephalopathy and lung infection were not, however, significant predictors. The multivariate logistic regression analysis highlighted nutritional mode, swallowing function, intubation time, pulmonary infection, full-time care and age as independent predictors of extubation success.Conclusions:Intermittent oral to esophageal tube feeding and full-time care are protective factors for extubation of patients in a PVS after a tracheotomy. Swallowing disorders, intubation for more than 30 days, pulmonary infection and greater age are risk factors for unsuccessful extubation. Nutritional support, swallowing function training and intensive nursing can effectively improve the success rate of extubation.

Observation on the composition and distribution of human papillomavirus infection and its aging changes in female genital tract of Zhuang and Han nationality in Guangxi / 中华老年医学杂志

Objective:To study the composition and distribution of human papillomavirus(HPV)in female genital tract of Zhuang and Han nationality in Guangxi.Methods:The composition and distribution of cervical human papillomavirus(HPV)infection in Han and Zhuang women visiting Department of Gynecology and Obstetrics of the First Affiliated Hospital of Guangxi Medical University from August 2012 to October 2020 were retrospectively analyzed to provide the basic data for prevention and treatment of HPV infection.A total of 20 736 cases were divided into Han nationality group(n=16 390 cases)and Zhuang nationality group(n=4 346 cases). Polymerase chain reaction(PCR)was used to detect HPV type 21 and analyze the epidemiological characteristics of cervical HPV in women of different ethnic groups in this area.Results:In the 20, 736 cases, the proportion of positive HPV was 27.0%(5 591/20, 736). Among them, positive HPV accounted for 27.7%(4 536)in the Han group, and 24.3%(1 055)in Zhuang group, which were statistically significant( χ2=20.17, P<0.01). Peak age of infection in Zhuang women was more than 65 years.The most common HPV genotypes in both ethnics groups in Guangxi were HPV 16, 52, 58, 18, and 53.In women with positive HPV, the constituent ratio of HPV16 and HPV 52 rose with age ageing, while constituent ratio of HPV 6 and 11 presented the opposite trend. Conclusions:The HPV and HR(high-risk)-HPV positive composition ratio is lower in Zhuang women than in Han women in Guangxi.Among Han and Zhuang females, HPV 16, 52, 58, 18 and 53 have the highest positive composition ratio.HPV genotyping shows an age-increasing change.

The etiological characteristics of premature ovarian insufficiency: Latest research progress / 中华老年医学杂志

At present, the etiology and pathogenesis of Premature ovarian insufficiency have not been fully elucidated, and no effective medical treatment options are found.This article reviews the research progress of the etiology of POI, in order to provide theoretical basis for clinical identification of high-risk groups and early prevention and treatment.

Research progress on the role of the Wnt signaling pathway in the development of intrauterine adhesions and its significance in treatment / 中华老年医学杂志

The Wnt signaling pathway also plays a role in fibrotic diseases of various tissues and organs, such as pulmonary fibrosis, liver fibrosis, renal fibrosis and skin fibrosis.Activation of the Wnt signaling pathway is related to the fibrosis of the endometrium and ectopic endometrial tissue, and it is a key component of the potential mechanisms for the development intrauterine adhesions.It could also be a target for treatment via promoting endometrial proliferation and angiogenesis and enhancing colony formation and self-renewal ability of endometrial stem cells.Wnt signaling pathways may regulate the complicated cross-talking networks and balance the dynamic processes of fibrogenesis and repair in intrauterine adhesions, thus potentially providing a new route for studying the pathological mechanisms of intrauterine adhesions and finding therapeutic targets.

Genomics study of human lung epithelial cells against new coronavirus SARS-CoV-2 infection / 西安交通大学学报(医学版)

【Objective】 Based on the high-throughput sequencing data of the whole genome， genomics and bioinformatics analyses were made to analyze the gene expression changes in the epithelial cells of the lung tissue from patients with coronavirus disease 2019 （COVID-19）， and explore the effects of the new coronavirus SARS-CoV-2 on human lungs. This study can provide a theoretical basis for the exploration of SARS-CoV-2 on the pathogenesis of lung tissue. 【Methods】 The public data set GSE160435 was retrieved. The data were analyzed by Network analyst， Cytoscape 3.7.2， String 11.0， and other software. The differentially expressed genes were screened， gene function （Gene Ontology， GO） and signal pathway KEGG （Kyoto Encyclopedia of Genes and Genomes） enrichment analysis were carried out. We established the Protein-protein Interactions Network （PPI）， PPI of lung tissue-specific DEGs， DEG microRNA regulatory network， Transcription Factor （TF）-DEG regulatory network， and environmental chemicals DEGs regulatory network. 【Results】 We found 324 DEGs in the lung epithelial cells of patients with COVID-19， of which 112 （34.57%） were upregulated and 212 （65.43%） were downregulated. Enrichment analysis showed that DEGs were mainly involved in biological processes such as virus-related defense response， mainly involved in protein digestion and absorption， anti-human papillomavirus infection and other signaling pathways. Specific PPI network closely related to DEGs and lung tissue showed that PDGFRB and KIT were core proteins； hsa-mir-340 had targeted interaction with DEGs. It indicated that HOXB4， ISG15 and other related genes were regulated by transcription factors； DEGs interacted with environmental chemicals such as nickel and estradiol. 【Conclusion】 The gene expression pattern of lung epithelial cells in lung tissue of COVID-19 patients has changed significantly. Proteins or genes such as PDGFRB， MMP9 and KIT may play a vital role in the defense immunity of lung tissue. Micro-RNA， TF， signaling pathway molecules， environmental chemicals， and lung tissue-specific genes also play a role in the above-mentioned process. This study provides new ideas for exploring the pathogenic mechanism of SARS-CoV-2 on lung tissue and formulating clinical prevention， diagnosis and treatment measures.

Change of gene expression profiles in human cardiomyocytes and macrophages infected with SARS / 中南大学学报(医学版)

OBJECTIVES@#Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 can damage the myocardium directly, or activate the immune system, trigger a cytokine storm, and cause inflammatory cells to infiltrate the myocardial tissue and damage the myocardium. This study is based on the sequencing data to analyze the changes in gene expression of cardiomyocytes and macrophages after SARS-CoV-2 infection, and explore the potential effects of SARS-CoV-2 on the heart and immune system.@*METHODS@#The public data set GSE151879 was retrieved. The online software Network Analyst was used to preprocess the data, and the differentially expressed genes (DEGs) [log@*RESULTS@#After data standardization, the data quality was excellent and it can ensure reliable results. Myocardial cell infection with SARS-CoV-2 and gene expression spectrum were changed significantly, including a total of 484 DEGs in adult cardiomyoblasts, a total of 667 DEGs in macrophages, and a total of 1 483 DEGs in human embryo source of cardiomyopathy. The Stum, mechanosensory transduction mediator homolog (STUM), dehydrogenase/reductase 9 (DHRS9), calcium/calmodulin dependent protein kinase II beta (CAMK2B), claudin 1(CLDN1), C-C motif chemokine ligand 2 (CCL2), TNFAIP3 interacting protein 3 (TNIP3), G protein-coupled receptor 84 (GPR84), and C-X-C motif chemokine ligand 1 (CXCL1) were identical in expression patterns in 3 types of cells. The protein-protein interaction suggested that CAMK2B proteins may play a key role in the antiviral process in 3 types of cells; and silicon dioxide (SiO@*CONCLUSIONS@#CAMK2B, CLDN1, CCL2, and DHRS9 genes play important roles in the immune response of cardiomyocytes against SARS-CoV-2. SiO

Correlation between cervical elastography parameters and time of the first stage of labor in late pregnancy by transvaginal ultrasound / 中华超声影像学杂志

Objective:To investigate the correlations between the labor process and the elastography parameters, and to explore the correlations among the elastography parameters.Methods:A total of 48 pregnant women in the late periods of pregnancy in Beijing Hospital from November 10, 2018 to January 30, 2019 were recruited prospectively. Elastography was performed to measure several elastographic parameters including the cervical length (CL), elasticity contrast index (ECI), hardness ratio (HR), internal orifice uterus(IOS) and external orifice uterus(EOS). They were followed up to delivery, and were divided into normal group and prolonged group according to the time duration of the first stage of labor. The correlation between the parameters and the time duration of the first stage of labor, as well as the relationships among the parameters were evaluated.Results:Among the 48 pregnant women, 35 cases were delivered by the vagina, 13 by cesarean section, 4 of whom were due to the prolongation of the first stage of labor and the other 9 cases for other reasons. The values of the CL and HR in normal group were significantly lower than that in prolonged group ( P=0.004, 0.02). The ECI in the normal group was significantly higher than that in the prolonged group ( P=0.046). Both the IOS and EOS in the normal group were higher than those in prolonged group without no significant difference( P>0.05). For the 35 women who underwent cervical elasticity assessment before labor and finally delivered vaginally, the duration of the first stage of labor was negatively correlated with cervical ECI ( r=-0.415, P<0.05). The ECI were negatively correlated with CL and HR ( r=-0.528, -0.374; P<0.05), and HR were negatively correlated with IOS and EOS ( r=-0.669, -0.558; P<0.01), whereas HR had no significant correlation with CL( P>0.05). Conclusions:The ECI of cervical tissue measured by cervical elastography can be used to semi-quantitatively evaluate the maturity of the cervix, it has potential value in predicting the labor duration and guiding clinical decision-making.

Advances in the Influence of EGFR Mutation on the PD-L1 Expression in Non-small Cell Lung Cancer / 中国肺癌杂志

Researches on the inhibitors of programmed death-1 (PD-1) and programmed death-1 ligand (PD-L1) enjoy considerable breakthroughs in recent years, which has brought relative changes in the therapeutic model of non-small cell lung cancer (NSCLC) at an unexpected speed. However, it seems that PD-1/PD-L1 inhibitors are less effective in patients with epidermal growth factor receptor (EGFR) mutation than those without. Previous studies have shown that the expression rate of PD-L1 on tumor cells is correlated with the therapeutic effect of PD-1/PD-L1 inhibitors. Yet, there is no complete agreement on the effect of EGFR mutation on PD-L1 expression. In this review, relevant studies will be summarized with an expectation of making some contributions to basic researches and to the clinical treatment.

Molecular genetic study of a family affected with punctate palmoplantar keratoderma / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics and causative mutation in an ethnic Han Chinese family affected with punctate palmoplantar keratoderma (PPPK).</p><p><b>METHODS</b>Clinical characteristics and inheritance pattern of the family were analyzed. Two seriously affected individuals from the family were investigated by whole exome sequencing. Three healthy individuals from the family and 120 non-PPPK individuals were evaluated to validate the result.</p><p><b>RESULTS</b>The family was characterized by keratotic papules on the palms and soles, which gradually increased in size and number with age and coalesced with each other, particularly over the pressure part of the palms and soles. The family has featured autosomal dominant inheritance. A heterozygous frameshift variant c.419delC in exons of the CELA1 gene was identified in all affected individuals but not among non-affected members.</p><p><b>CONCLUSION</b>A heterozygous frameshift variant c.419delC in CELA1 gene probably underlies the disease in the family affected with PPPK.</p>

Relationship between the thyroid autoimmunity and the risk of preterm birth in pregnant women:a meta-analysis / 中华妇产科杂志

Objective To evaluate the relationship between thyroid autoimmunity and the risk of preterm birth. Methods Literature search was done among PubMed, Embase, Wanfang Medical Database, China Academic Journal Network Publishing Database and China Biology Medicine disc from Jan. 1st 1980 to July 31st, 2015. (1) Literature were extracted according to inclusion and exclusion standards, and the quality of the extracted literature were evaluated by Newcastle-Ottawa Scale (NOS). (2) Meta-analysis was performed by RevMan 5 software formulated by using the Cochrane library databases. Various heterogeneity of the research was inspected firstly. According to the results of the inspection a certain effect model was selected (including fixed effects model, the random effects model) to be utilized in merger analysis. In this study pregnant women with both thyroid peroxidase antibodies (TPO-Ab) and thyroglobulin (TG-Ab) positive were defined as thyroid antibody positive pregnant women. Pregnant women with only TPO-Ab positive were defined as TPO-Ab positive pregnant women. Then the relationship of antibody positive and the risk of a pre-term birth was analyzed respectively. Results (1) Ten cohort studies were enrolled, of which NOS scale score were 7 or higher. All the studies are of medium quality and above. A total of 1 322 cases of preterm birth occurred among 19 910 pregnant women. (2) Positive thyroid autoantibodies did not increase the risk of preterm birth in euthyroid pregnant women (OR=1.41, 95%CI:0.83-2.40, P=0.200) or in pregnant women with hypothyroidism (OR=0.68, 95%CI: 0.32-1.44, P=0.310). Positive TPO-Ab in euthyroid pregnant women increase the risk of preterm birth significantly (OR=2.08, 95%CI:1.09-3.97, P=0.030), but positive TPO-Ab in pregnant women with hypothyroidism did not increase the risk of preterm birth significantly (OR=1.21, 95%CI:0.65-2.24, P=0.550). Conclusion Positive TPO-Ab is an independent risk factor of preterm birth in euthyroid pregnant women.

Obstetrical complications of thyroid peroxidase antibody positive during pregnancy and effects of intervention:a meta-analysis / 中华妇产科杂志

Objective To explore the correlation between thyroid peroxidase antibody (TPOAb) and outcomes during pregnancy and the effects of treatment on outcomes. Methods PubMed, Cochrane Library, Science Direct, Embase, Chinese Biomedicine, and Wanfangdata had been searched. Case-control and cohort studies about TPOAb and pregnancy outcomes were searched according to the inclusion and exclusion criteria. Fifty studies were finally recruited (all of cohort-studies, 10 for English and 5 for Chinese). Review Manager 5.3 were used to test the heterogeneity of the results among the different studies and amalgamate the effect size using fixed or random effect models. Results Meta-analysis showed TPOAb (+)with normal thyroid function increase the risks of miscarriage,and premature delivery, OR calculated were 2.02(95%CI:1.13-3.62, P=0.001)and 1.39(95%CI:1.11-1.76, P=0.005), while showed no relative risk to hypertensive disease,placental abruption in pregnancy and fetal growth restriction, OR calculated were 1.29(95%CI:1.00-1.67, P=0.080),0.42(95%CI:0.12-1.43, P=0.210)and 1.61(95%CI:0.23-11.12, P=0.100). TPOAb(+)with normal thyroid function increase miscarriage in in vitro fertilization and embryo transfer (IVF-ET), OR calculated were 2.14(95%CI:1.43-3.21, P=0.000). Levothyroxine (LT4) for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes, OR calculated were 0.43(95%CI:0.22-0.85, P=0.020). Conclusions TPOAb(+)with normal thyroid function increase the risks of miscarriage,and premature delivery. TPOAb(+) with normal thyroid function increase miscarriage in IVF-ET. LT4 for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes.

Composite prevention strategy for shoulder dystocia: meta-analysis / 中华妇产科杂志

Objective To investigate the composite prevention strategy for shoulder dystocia.Methods The published articles of randomized controlled trial (RCT)of comparison about the prevention of shoulder dystocia were searched in PubMed,EMBASE,EBSCO databases and Cochrane Library,and these studies were screened under inclusion and exclusion criteria.The quality of included studies were evaluated.And the Meta-analysis using statistic software RevMan 5.1 was completed.Results Totally 16 articles,all English published with no one Chinese article being searched out,were included in this analysis,published from 1993 to 2009.(1)To the gestational diabetes mellitus (GDM)patients,reviewed from 2 articles,it was found that the incidence of shoulder dystocia was reduced significantly by prenatal intervention versus usual care (OR=0.40,95％ CI:0.21-0.75,P=0.004).(2)To the GDM patients with intensive prenatal intervention,reviewed form 5 articles,it was found that the incidence of shoulder dystocia was reduced significantly by intensive intervention (diet control combined with insulin if necessary)versus less intensive intervention (only diet control),OR=0.29 (95 ％ CI:0.11-0.73,P=0.009).(3) To the non-GDM patients with suspected macrosomia,reviewed from 4 articles,it was found that the incidence of shoulder dystocia was not reduced by early artificial induction of parturition (OR=0.85,95 ％ CI:0.41-1.75,P=0.660).(4)To the GDM patients,reviewed form 2 articles,it was found that the incidence of shoulder dystocia was reduced marginal significantly by artificial induction of parturition in 38-39 gestational weeks compared with all spontaneous parturition patients (OR=0.18,95 ％ CI:0.03-0.97,P=0.050) and significantly reduced when compared with those spontaneous parturition patients after 40 gestational weeks (OR=0.13,95 ％ CI:0.02-0.75,P=0.020).(5)To the GDM patients with suspected macrosomia,reviewed from only one article,it was found that the incidence of shoulder dystoeia was reduced marginal significantly by early artificial induction of parturition (OR=0.34,95 ％ CI:0.12-0.99,P=0.050).(6)Reviewed from 2 articles,it was found that the incidence of shoulder dystocia was not significantly reduced by the intrapartum prophylactic maneuvers (OR=0.44,95％ CI:0.16-1.18,P=0.100).Conclusion Some varieties of intervention for the high risk patients could reduced the occurrence of shoulder dystocia.

Clinical or subclinical hypothyroidism and thyroid autoantibody before 20 weeks pregnancy and risk of preterm birth: a systematic review / 中华妇产科杂志

Objective To evaluate the relationship between clinical or subclinical hypothyroidism and positive thyroid autoantibody before 20 weeks pregnancy and risk of preterm birth.Methods Literature search was done in PubMed,EMBASE,Wanfang Medical Database,China Academic Journal Network Publishing Database and China Biology Medicine disc databases from January 1st,1980 to December 31th,2013.The following search terms were used:hypothyroidism,subclinical hypothyroidism,hypothyroxinnism,thyroid antibody,preterm labor,preterm birth,etc.(1) Criteria for inclusion:cohort studies and clinical studies were included; only articles that described at least l0 patients were eligible;the exposure was clinical or subclinical hypothyroidism and positive thyroid autoantihody,and outcome was preterm birth.(2) The excluded subjects were articles that described less than 10 patients; controls were pregnant women without eurothyrodisim.Meta-analysis was performed by RevMan 5.The relationship between clinical or subclinical hypothyroidism and positive thyroid autoantibody and risk of preterm birth was evaluated by OR or RR.Results (1) Twenty cohort studies were enrolled.A total of 39 596 cases of preterm birth occurred among 498 418 pregnant women.The controls in these studies were pregnant women with eurothyrodisim.(2) Clinical hypothyroidism in pregnancy:eight studies were included,reported data on 478 418 pregnant women (5 473 women with clinical hypothyroidism and 472 945 euthyroid pregnant women).The risk of preterm birth in pregnant women with clinical hypothyroidism was higher than those eurothyroid pregnant women in control group (OR=1.25,95％ CI:1.15-1.36,P＜0.01).(3) Subclinical hypothyroidism in pregnancy:ten studies were included,reported data on 277 531 pregnant women (5 257 women with subclinical hypothyroidism and 272 274 euthyroid pregnant women).The risk of preterm birth in pregnant women with subclinical hypothyroidism was higher than those in control group by random effects analysis (OR=1.25,95％ CI:1.14-1.36,P＜0.01).(4) Thyroid autoantibodys positive in pregnancy:eleven studies were included,reported data on 28 781 pregnant women (3 036 women with thyroid autoanti body positive and 25 745 euthyroid pregnant women).The risk of preterm birth in pregnant women with positive thyroid autoantibody was higher than those negative thyroid autoantibody in control group (OR=1.47,95％ CI:1.27-1.70,P＜0.01).The funnel plots presented symmetrical graphics,indicating that there was no publication bias.Conclusion Clinical or subclinical hypothyroidism and positive thyroid autoantibody in pregnant women is risk factors of preterm birth.

Preliminary study on expression and significance of plasminogen activator inhibitor-1 in endometrial carcinoma / 中华老年医学杂志

Objective To research the relationship between the expression of PAI-1 and the clinical characteristics of the endometrial carcinoma.Methods We detected the level of the serum PAI-1 by ELISA in the patients with endometrial carcinoma,the patients with endometrial hyperplasia and the patients with normal endometrium.The expression of PAI-1 in endometrial carcinoma and normal endometrial tissues was observed by immunohistochemistry.Results The concentration of serum PAI-1 in patients with endometrial carcinoma was 18.64 ± 6.22 μtg/L,significantly higher than those of patients with endometrial hyperplasia (6.94 ± 2.87) μg/L and patients with normal endometrium (6.68 ± 2.13)μg/L (P=0.00).The expression rate of PAI-1 was 68.2％ (15/22) in endometrial carcinoma tissue,and 8.3％ (2/24) in normal endometrial tissue (P=0.00).Compared with the early endometrial carcinoma,the expression rate of PAI-1 in the advanced endometrial carcinoma was significantly higher (6/6 w 9/16,P=0.03).Conclusions The expression level of PAI-1 may be related to the stage of the endometrial carcinoma.

The Relative Bioavailability of Diclofenac Sodium Eye-ointment in Rabbit Eye / 中国药房

OBJECTIVE:To determine the retative bioavailability of Diclofenac sodium eye-ointment in rabbit eyes and to evaluate its pharmacokinetics following topical application METHODS:48 rabbits were divided into two groups 0 1% Diclofenac sodium eye-ointment and Diclofenac sodium eyedrops were applied topically to rabbit eyes and aqueous humor and iridic tissue were collected at given times The concentration of Diclofenac sodium in tissue were measured by HPLC RESULTS:Diclofenac sodium eye-ointment group had higher concentration and longer half-time than Diclofenac sodium eyedrops group,however,the peak time were the same in two groups The relative bioavailabilities of Diclofenac sodium ointment in aqueous humor and iridic tissue were 183 33% and 205 68% respectively,compared with those of Diclofenac sodium eyedrops CONCLUSION:Diclofenac sodium eye-ointment can be absorbed well and released slowly,which can reduce the frequency of application of drug It is especially suitable for operation patient or application at night

Effects of neural retina on development of the structure of outer blood-retinal barrier in embryogenesis / 中华眼底病杂志

Objective To investigate effects of neural retina on development of the structure of outer blood retinal barrier in embryogenesis. Methods The retinal neural epithelium (RNE) and pigment epithelium (RPE) layers of 150, 120 and 90 embryonic chicken eyes incubated for 7, 10, and 14 days were peeled off. RNE was used to prepare the culture medium with different conditions (7drcSF3, 10drcSF3, 14drcSF3). RPE cells of 7- and 14-incubated chicken embryos were cultured on laminin-coated transwell filter. The SF3, 7drcSF3, 10drcSF3, 14drcSF3 medium were used respectively in the apical chamber and SF2 was used in basolateral chamber. After the formation of monolayer, the transepithelial electrical resistance of the RPE was detected. After the fixation of RPE cells, the condition of the tight junction among the cells was observed by immunohistochemistry and transmission electron microscopy. Results For the RPE cells of 7- and 14-day incubated embryonic eyes, the difference of TER in various medium of SF3/SF2, 7drcSF3/SF2, 10drcSF3/SF2, 14drcSF3/SF2 was statistically significant (P