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Diabetes mellitus （DM） is a metabolic disease mainly characterized by chronic hyperglycemia and has multiple etiologies. The complications of DM， such as coronary atherosclerosis， nephropathy， foot disease and cardiac dysfunction， have high morbidity， disability rate and mortality. DM and its complications have a long course of disease and are easy to relapse， which are difficult to be cured， seriously affecting people's life and health. NOD-like receptor pyrin domain-containing 3 （NLRP3） inflammasome is an important component of inflammatory response and innate immune system. The inflammatory cascade induced by NLRP3 activation is involved in the occurrence and development of DM as well as its complications by releasing inflammatory factors， damaging endothelial cells and affecting metabolic stress. Therefore， as the core of the inflammatory response， NLRP3 may provide a new target for the treatment of DM and its complications. Traditional Chinese medicine plays a key role in the treatment of DM and its complications， and has a regulatory effect on NLRP3. Thus it has become a novel research strategy to prevent and treat DM and its complications via modulating NLRP3. However， at present， there are relatively scattered reports and a lack of systematic review on the role of traditional Chinese medicine in the treatment of DM and its complications from the perspective of NLRP3. As a result， this paper reviewed domestic and foreign literature in recent years and conducted the discussion from two aspects： the influence of NLRP3 on the occurrence and development of DM and its complications， and the progress of traditional Chinese medicine in intervening in DM and its complications through NLRP3. This paper provided reference for the research on the regulation of NLRP3 and a new direction for the treatment of DM and its complications.
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Objective:To investigate the molecular mechanism of VRC01 resistance in HIV-1 subtype B′ strains isolated from a patient (DRVI01) with broadly neutralizing antibody (bNAb).Methods:Sequences of the HIV-1 subtype B′ strains isolated from patient DRVI01 were compared with those of HIV-1 subtype B′ strains that were isolated at the same time but sensitive to VRC01 antibody. Key amino acids that might affect the neutralization of VRC01 were selected according to literature reports. Effects of the selected amino acids on VRC01 neutralization were verified by site-directed mutation and sequence exchange of membrane proteins from different patients.Results:Single-point mutations of E279D and R282K in LoopD region and N460A and N463Q in V5 region reversed the viral sensitivity to VRC01 neutralization. Combined mutations in two or three above-mentioned sites significantly increased the viral sensitivity to VRC01 antibody compared with single-point mutations. Contrary to literature reports, the glycosylation site mutation of N276 had no influence on the viral sensitivity to VRC01.Conclusions:HIV-1 subtype B′ strains isolated from patient DRV01 with bNAb carried the mutations of D279 and K282 in LoopD region and N460 and N463 in V5 region, resulting in resistance to VRC01 antibody.
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Objective:To analyze the potential specificity of broad neutralizing antibodies (bNAbs) in one patient (DRVI01) with chronic HIV-1 infection.Methods:Sequences of the envelope glycoprotein (Env) obtained from DRVI01 at different time points were analyzed by comparing with the key amino acids of reported HIV-1 bNAbs in HIV Database. After reverse mutation of key amino acids that had frequently mutated to wild type, the neutralizing sensitivity of autologous plasma against wild-type and mutated Env-pesudoviruses was compared and the potential bNAbs in DRVI01 were speculated.Results:Reported key amino acids of 10 bNAbs classes were detected in 155 Env sequences derived from DRVI01. Frequent mutations were found in key amino acids of two bNAbs classes of gp41 fusion domain and gp120/gp41 interface. Neutralizing sensitivity of the contemporaneous autologous plasma and the plasma collected at the next time point against the mutated pesudoviruses was significantly increased as compared with wild-type pesudoviruses.Conclusions:Potential NAbs with similar key amino acids to those of gp41 fusion domain and gp120/gp41 interface might present in the HIV-1 infected patient with broad neutralizing antibodies.
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Objective To explore the effects of family empowerment program on comprehensive care ability and care preparedness for main caregivers of patients with initial stroke.Methods A total of 64 main caregivers of patients with initial stroke were enrolled from a tertiary hospital in Hangzhou from January 2017 to July 2017,and assigned into the intervention group and the control group according to different wards,with 33 cases in the intervention group and 31 cases in the control group.Both groups received routine care,and the intervention group also received family empowerment program.The stroke caregivers' comprehensive care ability questionnaire and the Caregiver Preparedness Scale were used to evaluate the effects of the intervention.Results Before the intervention,there were no statistically significant differences in disease-related knowledge,daily and disease-related care skills,self-stress and health management,coping strategies,and total scores of comprehensive care ability,and caregiver preparedness scores between two groups(P＞0.05).After the intervention,the total scores and each dimension score of comprehensive care ability,and caregiver preparedness scores of two groups were significantly higher than those before the intervention,and the differences were statistically significant(P＜0.05).Conclusion Family empowerment program can effectively improve comprehensive care ability and care preparedness of main caregivers of patients with initial stroke,making the caregiver playing a positive role in the rehabilitation of stroke patients.
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High-grade gliomas (HGG) are a group of malignant tumours with high recurrence rate, rapid progression, poor prognosis and short median survival. Patients suffer with severe symptoms after operation, which seriously affect the quality of life of patients. Palliative care is an important nursing measure to improve the quality of life of patients with malignant tumors. This paper reviews the current situation and research progress of palliative care in patients with advanced glioma at home and abroad, and provides the evidence and guidance for medical staff to carry out palliative care of patients with high grade glioma.
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Objective To explore the expression of Bcl-6 mRNA in the Tfh cells of HIV/AIDS patients and the relationship between Bcl-6 mRNA and the progression of HIV/AIDS.Methods This experiment chose 60 patients who were confirmed by HIV antibody test positive,during May 2014 to November from AIDS Research Institute in the First Affiliated Hospi-tal,Henan College of Traditional Chinese Medicine.According to the amount of CD4+T cells,the patients with HIV/AIDS were divided into A(CD4500 cells/μl)three groups.The Tfh cells expressed CD4+ CXCR5 + ICOS+ and lymphocyte subpopulation including T,B and NK cells were detected by flow cytometry (FCM).The expression of Bcl-6 mRNA levels were detected by reverse transcription-polymerase chain reaction (RT-PCR).The association between Tfh cells and Bcl-6 mRNA,B cells were analyzed.Results The expression of Bcl-6 mRNA from patients of A,B and C three groups was increased than in healthy individuals (2.94±0.91,2.27±0.62,2.15± 0.351,P <0.05).The percent of Tfh cells from group A patients was higher than group C patients (5.88±3.01 vs 1.26± 0.87,P =0.032)and also the healthy control group (5.88±3.01 vs 0.78±0.42,P =0.004).The percentage of NK cells and B cells in HIV/AIDS patients was no statistically significant.Correlation analysis showed that there was positive corre-lation between the proportion of Tfh cells and Bcl-6 mRNA (r=0.799,P =0.000).And Tfh cells were observed no relation-ship with B cells (r=-0.083,P =0.657).Conclusion The changes of Bcl-6 mRNA and Tfh cells may be related to the progression of HIV/AIDS.
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Objective To explore the method of increasing the mastering rate of health knowledge of patients and effective rate of health education by nurses on the premise of shortened average length of hos-pital stay.Methods 316 patients were divided into group i (96 cases),group ii (117 cases) and group iii (103 cases).Patients in group i had no pre hospital education.Patients in group ii accepted quasicollective education on hospitalization notices.Patients in group iii accepted quasi-collective education on hospitalization notices and some general peri-operative knowledge.The mastering rate of knowledge and time cost for health education were compared between three groups.Results Compared to group i,group ii and group iii got higher mastering rate in 8 items of hospitalization notices.No difference was seen in acknowledge of general peri-operative knowledge.The education of hospitalization notices and total time was shortened.The difference between group ii and group iii was not positive.Conclusions Taking quasi-collective education on hospitalization notices improves patients' mastering level of hospitalization notices and nurses' education efficiency.
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Objective To assess the clinical value of pentraxin-3 (PTX-3) in diagnosis and survey of therapeutic effect for lung cancer.Methods The serum level of PTX-3,carcinoembryonic antigen (CEA),cytokeratin 19 fragment (CYFRA 21-1) were measured in 802 patients with lung cancer,462 with benign lung diseases and 522 healthy controls from multiple research centers,using ELISA and electrochemiluminescent assays.The clinical value of PTX-3 was assessed by comparing the area under receiver characteristic curves (AUC) with CEA and CYFRA21-1.The optimum cutoff value for diagnosis of lung cancer was investigated by maximizing the sum of sensitivity and specificity.By following-up,the serum level of PTX-3 was measured at 3 day,7 day,and 14 day in 61 lung cancer patients after surgical resection of lung cancer.Results In test group and validation,the serum levels of PTX-3 (g/L) are significantly higher in lung cancer group [9.21 (6.13-12.80),10.4(5.54-13.11)] than in benign lung diseases [5.28 (3.42-8.53),6.52 (3.84-7.89)] and in healthy controls [2.18 (0.54-5.44),2.44 (0.67-5.87)],[Z =8.161,14.118,(test group,all P ＜ 0.05) ;Z =9.832,17.595 (validation group,all P ＜0.05)].ROC curve showed the optimal cut-off values for PTX-3 was 8.03 g/L [AUC of 0.831,with a sensitivity of 76.1％ and specificity of 75.2％ in the test cohort; 0.828,71.3％,89.2％ in the validation cohort].Similar results were noted for early-stage lung cancer [0.764,79.1％,and 62.2％ in the test cohort; 0.744,71.3％,and 69.6％ in the validation].In the diagnosis of early-stage lung,the AUC and sensitivity and specificity of PTX-3 were 79.1％,0.764,71.3％ (test group),and 75.2％,89.2％,0.824 (validation group) significantly higher in these patients than CEA and CYFRA21-1.In small cell lung cancer,PTX-3 and NSE shared similar AUC differentiating LC from benign lung diseases and health controls.In following-up 61 lung cancer patients,PTX-3 levels before surgical resection of tumours [11.12(9.12-12.59)] was significant high than following 3 day after surgery(Z =4.32,P ＜0.01),and 14 day (5.12 ±2.54) vs.7 day (7.13 ±3.42) (t =2.143,P =0.023).The correlation between PTX-3 and CRP in LC,benign lung diseases,health control was 0.364,0.592,0.512 (all P ＜ 0.05).Conclusion Serum PTX-3 is a valuable biomarker of lung cancer and early-stage lung cancer with high sensitivity and specificity and improved identification of patients with lung cancer from those with non-malignant chronic lung diseases.
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Objective To establish a biotin-streptavidin ELISA method to measure CTGF,and evaluate the clinical value of CTGF for the diagnosis of liver fibrosis in chronic hepatitis B (CHB) patients.Methods Biotinylated anti-CTGF polyclonal antibody and monoclonal antibodies were prepared for the establishment of this biotin-streptavidin ELISA method.Two hundreds and sixty-four CHB patients were subjected into non-or mild liver fibrosis group (S0-S1,108 cases) and severe liver fibrosis group (S2-S4,156 cases),according to the liver biopsy pathological diagnosis.The CTGF assay's diagnostic capacity for CHB was assessed by comparing the area under ROC (AUC) with that of a panel of hepatic fibrosis markers ( HA,PC Ⅲ,C Ⅳ,LN and APRI).Analysis of variance and rank sum test were performed to carry out comparisons between multiple groups.Student's t-test and Mann-Whitney U test were performed for the pairwise comparison between multiple samples.Spearman rank correlation test was performed to analyze the correlation between different hepatic fibrosis stages.Results The minimum detectable dose and detection rang of the ELISA was 0.2 μg/L and 0-64 μg/L respectively.The intra-assay and inter-assay CV at high and low level were 4.5％,9.8％ and 10.1％,12.8％ respectively.Serum CTGF concentrations in S0-S1 group and S2-S4 group were 6.7(3.1 - 10.1 ) μg/L and 16.1 ( 11.8 -27.2) μg/L,with a statistically significant difference (U =1 217,P ＜0.001 ).There was a significant correlation between the levels of serum CTGF and fibrosis stages ( r =0.689,P ＜ 0.001 ),AUC of CTGF was 0.841 (95％ CI:0.762 - 0.920) in distinguishing mild fibrosis from significant fibrosis.When the cut-off value of CTGF was 10.3 μg/L,the sensitivity and specification was 70.5％ and 82.4％ respectively.The sensitivity of parallel combination test of CTGF and APRI was 96.1％,which was higher than that of HA (75.6％),PC Ⅲ (70.5％ ),C Ⅳ(63.6％),LN(79.5％ ),APRI(86.3％ ).The specificity of the combination test was 65.5％,which was lower than of above liver fibrosis markers [HA ( 72.5％ ),PC Ⅲ ( 76.5％ ),C Ⅳ ( 78.4％ )].The specificity of serial combination test of CTGF and PC Ⅲ was 95.9％,which was higher than that of HA,PC Ⅲ,CⅣ,LN(64.7％ ),APRI(66.1％ ),however,the sensitivity of the combination test was 67.7％,which was lower than that of above HA,PC Ⅲ,and APRI.Conclusions The biotin-streptavidin ELISA method measuring serum CTGF has a high minimu detectable dose sensitivity,and specificity.Serum CTGF level is significantly correlated with fibrosis stage,and CTGF maybe a valuable marker for liver fibrosis assessment.The paralledl combination of CTGF and APRI could be used as screening for significant liver fibrosis markers.The serial combination of CTGF and PC Ⅲ may be considered as a confirmatory diagnostic marker for liver fibrosis.
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Objective: To observe the effects of Naomaitong, a compound traditional Chinese herbal medicine, combined with mobilization of bone marrow mesenchymal stem cells (BMSCs) on neuron apoptosis in rats with cerebral ischemia, and to explore the possible mechanism by detecting the expressions of Fas, FasL and caspase-3 proteins. Methods: Two hundred and two SD rats were divided into sham-operated group, untreated group, recombinant granulocyte colony-stimulating factor (rG-CSF) group, Naomaitong group and Naomaitong plus rG-CSF group (combination group). Focal cerebral ischemia was induced by intraluminal middle cerebral artery occlusion using a nylon thread with some modification. Rats in the rG-CSF group and the untreated group were administered with rG-CSF 10 mug/(kg.d) by subcutaneous injection 3 d before and 2 d after the operation respectively, once a day, and rats in the Naomaitong group and the combination group were intragastrically administered Naomaitong before and after the operation until sacrificed. Two, three, seven and fourteen days after operation, count of CD34-positive cells in peripheral blood and CD34 expression in brain tissue were determined. General neural function score (GNFS) was evaluated. Neuron apoptosis, expressions of Fas, FasL and caspase-3 in rat's brain were all measured. Results: Count of CD34-positive cells in peripheral blood and CD34 expression in brain tissue were high in the untreated group, and reached the peak at 3 d and 7 d respectively. CD34 expression in brain tissue was increased in each treated group, especially in the combination group. GNFS was increased at 3 d and 7 d in the untreated group, 7 d and 14 d in the rG-CSF group and the combination group. Expressions of Fas, FasL and caspase-3 were increased 2, 3 and 7 d after operation, while expression of FasL at 2 d in the rG-CSF group, expressions of Fas, FasL and caspase-3 in the combination group were decreased. Expressions of Fas, FasL and caspase-3 at 7 d and 14 d in the combination group were lower than those in the rG-CSF group. Meanwhile, expressions of Fas, FasL and caspase-3 were decreased in each group at 14 d as compared with those at 3 d. Conclusion: There exists interaction between Naomaitong and BMSC mobilization in the effect of improving nerve function and inhibiting neuron apoptosis in rats after cerebral ischemia. It is implied that Naomaitong combined with BMSC mobilization down-regulates the expressions of Fas and FasL in early phase and then inhibits the apoptosis cascade reaction caused by caspase-3, which causes further inhibition of Fas and FasL expression after cerebral ischemia.
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Objective To discuss the effect of targeted information support on the sense of uncertainty and anxiety among patients treated with percutaneous coronary intervention and its instructive significance to nursing work.Methods We randomized 118 patients treated with percutaneous coronary intervention whose sense of uncertainty and anxiety were relative intensive into the test group and the control group with 59 cases in each group.We gave routine health instructions to the control group while targeted information support besides routine health instructions to the test group.We investigated the patients in two groups by Chinese version of uncertainty scale and State Anxiety Inventory at 4 time points,that is ,the first day in hospital,night before the operation,24 hours after the operation and 1 day before leaving hospital.Results The anxiety level and sense of uncertainty about illness decreased at the night before operation,24 hours after operation and 1 day after operation compared with the control group.The sense of uncertainty and anxiety level has statistical difference between whatever two adjacent time points except for anxiety level between the time points between the first day in hospital and before operation.Drop of sense of uncertainty at 24 hours after operation was significantly different between the two groups(P<0.01).Conclusion Supplying targeted information support could decrease the sense of uncertainty and anxiety among patients treated with percutaneous coronary intervention.
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0.05 ;Ti milled/VITA vs Ni Cr/VITA P
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0.05),while there was significant difference among other groups(P
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Objective:To investigate the effects of oxidation of titanium on bonding strength of titanium and porcelain. Methods: 24 specimens with a size of 28 mm ?3 mm?0.5 mm were cast from pure titanium and divided into 4 groups, 6 specimens each group. Group 2, 3 and 4 were degassed at 750, 800 and 900 ℃ respectively, group 1 not degassed as negative control, then a uniform thickness of 1mm of Noritake super porcelain Ti-22 was veneered on 8 mm?3 mm in the central portion of each specimen. The specimens were subjected to a three-point bending test on a load-test machine with a span of 20 mm, and the failure loads were recorded and analyzed statistically. The opposite side of specimens of each group were observed by thin-film X-ray diffraction. Results: The failure loads (N) of group 1, 2, 3 and 4 were 10.33, 9.98, 5.53, 3.37. The oxide of group 1 was Ti6O only, the oxide of the gropu 2, 3, and 4 were Ti6O and TiO2 and the amount of TiO2 increased significantly as the temperature iss increasing. Conclusion: The oxide adherence strength value for pure titanium decreased while the oxide temperature is increasing. The higher of the degassed temperature of the specimens, the more TiO2 can be found in the oxide film and the smaller the failure load is, which indicats that oxidation of titanium has a negative effect on the bonding strength of porcelain and titanium.