Flavonoid compounds improve hippocampal neuro-genesis and cognitive dysfunction in mice / 中国药理学与毒理学杂志

OBJECTIVE To investigate the improve-ment functions of flavonoid compounds on temozolomide(TMZ)-,aging-or AD model-induced dysregulation of hip-pocampal NSC lineage progression,retardancy of den-dritic spine maturation in new-born neurons,as well as impairment of hippocampal-related learning and memory.METHODS We applied 30-week-old neural stem cell(NSC)specific promoter Nestin-GFP and NestinCreERT2:Rosa26-LSL-tdTomato transgenic mice and 16-week-old AD model 5XFAD transgenic mice,together with hippo-campal microinjection(ih),endogenous fluorescence trac-ing and immunofluorescent staining.RESULTS Both fla-vonoid compound A and its functional derivative flavo-noid compound B dose-dependently improved TMZ-,aging-or AD-induced defects of hippocampal NSC lin-eage progression and the maturation of dendritic spines of newborn neurons,thereby improving hippocampus related learning and memory.CONCLUSION This paper provides a new idea and treatment strategy for the devel-opment of new flavonoids that can promote neurogene-sis for neurodegenerative diseases and aging.

Mechanism of Buyang Huanwutang in Regulating Macrophage Cell Polarization Based on TLR4/NF-κB/NLRP3 Pathway / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of Buyang Huanwutang in regulating macrophage polarization based on the Toll-like receptor 4 （TLR4） / nuclear factor-κB （NF-κB） / nucleotide-binding oligomerization domain-like receptor 3 （NLRP3） pathway. MethodRAW264.7 macrophages were intervened with lipopolysaccharide （LPS） of different concentrations （0， 1.25， 2.5， 5， 10， 20， 40， and 80 mg·L-1） for 24 hours. Cell Counting Kit-8 （CCK-8） assay was used to determine the cell viability of RAW264.7 macrophages. The optimal concentration was chosen to establish an in vitro inflammation model induced by LPS. Cells were divided into a blank group （20% blank serum）， a model group （20% blank serum + 10 mg·L-1 LPS）， a model control group （20% FBS + 10 mg·L-1 LPS）， low-， medium-， and high-dose （5%， 10%， and 20%） Buyang Huanwutang-containing serum groups， a high-dose （20%） Buyang Huanwutang combined with NLRP3 inhibitor MCC950 （50 μmol·L-1） group， a high-dose （20%） Buyang Huanwutang combined with reactive oxygen species （ROS） inhibitor NAC （10 μmol·L-1） group， and a high-dose （20%） Buyang Huanwutang combined with NF-κB inhibitor PDTC （10 μmol·L-1） group. Enzyme-linked immunosorbent assay （ELISA） was used to detect the expression of interleukin-1β （IL-1β）， interleukin-18 （IL-18）， and tumor necrosis factor-α （TNF-α） in RAW264.7 macrophages. Flow cytometry was employed to measure ROS levels in macrophages. Western blot was used to determine the protein expression of M1-type macrophage-related factors inducible nitric oxide synthase （iNOS） and TNF-α， M2-type macrophage-related factors arginase-1 （Arg-1） and interleukin-10 （IL-10）， as well as the proteins in the TLR4/NF-κB/NLRP3 pathway. ResultCCK-8 results indicated that under 10 mg·L-1 LPS stimulation， RAW264.7 macrophages exhibited the highest cell viability （P<0.01）. Compared with the blank group， the model group showed significantly increased levels of IL-1β， IL-18， and TNF-α （P<0.05，P<0.01）， increased ROS expression （P<0.05，P<0.01）， increased protein expression of M1-type macrophage factors iNOS and TNF-α （P<0.01）， decreased protein expression of M2-type macrophage factors Arg-1 and IL-10 （P<0.05，P<0.01）， and upregulated expression levels of TLR4， myeloid differentiation factor 88 （MyD88）， phosphorylated inhibitor of NF-κB （p-IκB）/NF-κB inhibitor （IκB）， phosphorylated NF-κB （p-NF-κB） p65/NF-κB p65， NLRP3， apoptosis-associated speck-like protein containing a CARD （ASC）， and pro-Caspase-1 （P<0.05， P<0.01）. Compared with the model group， all Buyang Huanwutang-treated groups and inhibitor groups significantly reduced levels of IL-1β， IL-18， and TNF-α （P<0.01）， suppressed the expression of inflammatory factors in RAW264.7 macrophages， decreased cellular ROS expression levels （P<0.01）， downregulated M1-type macrophages iNOS and TNF-α protein expression （P<0.01）， upregulated M2-type macrophages Arg-1 and IL-10 protein expression （P<0.01）， and lowered protein expression levels of TLR4， MyD88， p-IκB/IκB， p-NF-κB p65/NF-κB p65， NLRP3， ASC， and pro-Caspase-1 （P<0.05， P<0.01）. ConclusionBuyang Huanwutang can improve macrophage inflammation， potentially by reducing macrophage ROS levels， inhibiting RAW264.7 macrophage polarization， and downregulating the protein expression levels of the TLR4/NF-κB/NLRP3 pathway.

Clinical observation of electroacupuncture combined with Qingyi Xianxiong Decoction in the treatment of acute respiratory distress syndrome due to severe acute pancreatitis / 中华危重病急救医学

Objective:To observe the clinical effect of electroacupuncture combined with Qingyi Xianxiong Decoction on the treatment of acute respiratory distress syndrome (ARDS) caused by severe acute pancreatitis (SAP).Methods:From February 2021 to April 2022, 120 patients with ARDS caused by SAP who were admitted to the department of critical care medicine of Tianjin Nankai Hospital and whose syndrome differentiation belonged to the syndrome of knot chest were selected. They were randomly divided into pure traditional Chinese medicine group and acupuncture medicine group, with 60 cases in each group. The pure traditional Chinese medicine group was received Qingyi Xianxiong Decoction on the basis of conventional western medicine treatment, and the acupuncture medicine group was received electric acupuncture treatment on the basis of the pure traditional Chinese medicine group. The two groups continued to be treated for 7 days. The primary outcome was the ventilator-free days within 28 days after admission to the intensive care unit (ICU), and the secondary outcome measures were mechanical ventilation time, the length of ICU stay, total lenth of hospital stay, time of intra-abdominal pressure recovery, scores of organ function, oxygenation index (PaO 2/FiO 2), serum inflammatory factors, blood amylase, urine amylase, etc. Results:Compared with the pure traditional Chinese medicine group, the ventilator-free days in the acupuncture medicine group within 28 days after admission to the ICU were significantly longer [day: 22.10±2.29 vs. 20.97±2.31, P < 0.05, odds ratio ( OR) = 1.24, 95% confidence interval (95% CI) was 1.053-1.460, P < 0.05]. The time of mechanical ventilation, the length of ICU stay, total length of hospital stay, and recovery time of intra-abdominal pressure were significantly shortened [mechanical ventilation time (days): 5.90±2.29 vs. 7.03±2.31, the length of ICU stay (days): 8.07±1.89 vs. 12.08±2.23, total length of hospital stay (days): 19.55±6.82 vs. 22.28±5.19, recovery time of intra-abdominal pressure (days): 6.05±1.81 vs. 8.45±1.76, all P < 0.05]. The Murray score and bedside index for severity in acute pancreatitis (BISAP) score of the two groups after 7 days of treatment were significantly lower than those before treatment, while PaO 2/FiO 2 was significantly higher than those before treatment, and the Murray score of the acupuncture medicine group after 7 days of treatment was significantly lower than that of the pure traditional Chinese medicine group [score: 0.50 (0.33, 0.75) vs. 1.00 (1.00, 1.33), P < 0.05], PaO 2/FiO 2 was significantly higher than that in the pure traditional Chinese medicine group [mmHg (1 mmHg ≈ 0.133 kPa): 390.75±27.73 vs. 330.02±42.34, P < 0.05]. With the prolongation of treatment time, the levels of inflammatory factors such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), serum amylase and urine amylase in both groups after treatment continued to decrease, and the levels of the inflammatory factors in the acupuncture medicine group after 7 days of treatment were significantly lower than those in the pure traditional Chinese medicine group [TNF-α (ng/L): 38.20±10.00 vs. 45.35±5.09, IL-6 (ng/L): 0.95±0.44 vs. 7.42±1.39, CRP (mg/L): 8.55±2.79 vs. 36.20±13.97, all P < 0.05]. Subgroup analysis showed that biliary system disease was a risk factor for the duration of mechanical ventilation ≥ 7 days in the treatment of ARDS with acupuncture and medicine ( OR = 2.728, 95% CI was 1.293-5.754). Conclusion:Compared with the pure traditional Chinese medicine, acupuncture combined can better reduce the clinical symptoms of patients with ARDS caused by SAP, promote the recovery of patients, and reduce systemic inflammatory reaction, which is worthy of clinical promotion.

Relationship between SIRT3 and mitochondrial function in mice with endotoxin-induced lung injury / 中华麻醉学杂志

Objective:To evaluate the relationship between silent information regulator 2 homologue 3 (SIRT3) and mitochondrial function in mice with endotoxin-induced lung injury.Methods:Twenty clean-grade healthy adult male wild C57BL/6 (SIRT3 + /+ ) mice, 20 SIRT3 knockout (SIRT3 -/-) mice, weighing 20-25 g, aged 6-8 weeks, were studied.SIRT3 + /+ mice and SIRT3 -/- mice were divided into 4 groups ( n=5 each) according to the random number table method: blank control group (group C, group SIRT3 -/-C), endotoxin-induced lung injury group (group L, group SIRT3 -/-L), endotoxin-induced lung injury plus resveratrol group (group L+ R, group SIRT3 -/-L+ R), and resveratrol group (group R, group SIRT3 -/-R). Resveratrol 15 mg/kg was intraperitoneally injected once a day for 7 consecutive days in L+ R, R, SIRT3 -/-L+ R and SIRT3 -/-R groups, while the equal volume of normal saline was injected in the rest groups.Lipopolysaccharid 15 mg/kg was injected via the tail vein to develop a mouse model of endotoxin-induced lung injury at 30 min after resveratrol injection on 7th day, in L+ R and SIRT3 -/-L+ R groups and at the corresponding time points in L and SIRT3 -/-L groups, while the equal volume of normal saline was injected in the other groups.Blood samples were collected from the orbital venous plexus at 12 h after injection of normal saline or lipopolysaccharid for determination of serum total oxidation state (TOS) and total antioxidant state (TAS) levels by the xylenol orange method and ABTS colorimetric method, and the oxidative stress index (OSI) was calculated.After the mice were sacrificed, the lung tissues were taken for microscopic examination of the pathological changes which were scored and for determination of the mitochondrial membrane potential (MMP) (by JC-1 method), cellular oxygen consumption rate (OCR) (by the specific fluorescent probe method), and expression of SIRT3 (by Western blot). Results:Compared with group C or group SIRT3 -/-C, the lung injury score, serum TOS concentration and OSI were significantly increased, TAS concentration, MMP and OCR were decreased, and SIRT3 expression was down-regulated in L, L+ R, SIRT3 -/-L and SIRT3 -/-L+ R groups ( P<0.05). Compared with group L, the lung injury score, serum TOS concentration and OSI were significantly decreased, TAS concentration, MMP and OCR were increased, and SIRT3 expression was up-regulated in group L+ R, and lung injury score, serum TOS concentration and OSI were significantly increased, TAS concentration, MMP and OCR were decreased, and SIRT3 expression was down-regulated in group SIRT3 -/-L ( P<0.05). Compared with group L+ R, the lung injury score, serum TOS concentration and OSI were significantly increased, the TAS concentration, MMP and OCR were decreased, and the expression of SIRT3 was down-regulated in group SIRT3 -/- L+ R ( P<0.05). There was no significant difference in the indicators mentioned above between group SIRT3 -/-L+ R and group SIRT3 -/-L ( P>0.05). Conclusions:Down-regulation of SIRT3 expression can lead to impaired mitochondrial function, which is involved in the pathophysiological mechanism of endotoxin-induced lung injury.

Analysis of the status quo of early postoperative pain belief in patients with mixed hemorrhoids and its influencing factors / 中国实用护理杂志

Objective:To investigate the current situation of early postoperative pain beliefs in patients with mixed hemorrhoids and its influencing factors, and to provide a basis for formulating targeted intervention measures.Methods:Totally 242 postoperative patients with mixed hemorrhoids who were treated in Guilin Integrated Traditional Chinese and Western Medicine were selected by convenience sampling method from January 2020 to January 2021 as the research object. The general information questionnaire, Pain Belief and Perception Scale, Visual Analogue Scale, Positive and Negative Emotion Scale were used to investigate. Multiple linear regression was used to analyze the factors influencing of early postoperative pain beliefs in patients with mixed hemorrhoids.Results:The total score of early postoperative pain belief in patients with mixed hemorrhoids was -21-30 (5.32 ± 2.57) points; the results of multiple linear regression analysis showed that age, education level, anal visual analogue score, and negative emotion scores were main factors affecting their pain beliefs ( r=0.736, P<0.05). Conclusions:Patients with mixed hemorrhoids have negative pain beliefs in the early postoperative period. Patients with advanced age, primary/junior high school, high anal pain intensity, and high negative emotion scores are more likely to have negative pain beliefs. Nursing staff should promptly formulate targeted intervention measures according to the main influencing factors in order to reduce the occurrence of negative beliefs about pain.

Qualitative study of pain catastrophic experience of patients after mixed hemorrhoid surgery / 中国实用护理杂志

Objective:To deeply understand the pain perception and experience of patients after mixed hemorrhoid surgery, so as to provide reference for taking targeted intervention measures to relieve pain symptoms.Methods:Purpose sampling method was used to conduct semi-structured in-depth interviews with 9 patients with postoperative pain of mixed hemorrhoids admitted to Guilin Hospital of Integrated Traditional Chinese and Western Medicine from February to March 2021, and Colaizzi phenomenological analysis method was used to analyze data and refine themes.Results:The pain perception and experience of patients after mixed hemorrhoid surgery can be summarized into 5 themes: fear of pain, persistent negative thinking about pain, perception of inability to cope with pain, emotional expectation, and expectation of Traditional Chinese Medicine nursing techniques.Conclusions:Patients after mixed hemorrhoid surgery have many burdens and needs in terms of pain experience. Medical staff must establish a complete pain management system for patients after mixed hemorrhoid surgery, aiming at the catastrophic pain experience of patients, correcting their cognitive level of pain management, and satisfying patients Alleviate the need for pain, establish an effective emotional and family support system, improve its pain self-management ability, and promote postoperative recovery.

Research Progress of Immunoscore in Prediction of Tumor Prognosis and Efficacy to Treatment / 肿瘤防治研究

The occurrence and development of the tumor are closely associated with the tumor microenvironment (TME) and host immune status. Traditional TNM staging has gradually been insufficient in the assessment of patients' outcomes, as the TNM system solely evaluated tumor cell characteristics and failed to predict clinical outcomes based on immune factors. Therefore, immunoscore (IS), derived from the concept of immune contexture, was proposed to establish a more comprehensive and accurate TNM-I staging above the TNM staging. Recently, increasing studies have shown that IS can predict the survival outcome and treatment efficacy more accurately than TNM staging. Moreover, IS possess characteristics such as feasibility, convenience, robustness and reproducibility, which make it possible for IS to be used as a biomarker for clinical application, to classify patients better and contribute to developing individualized treatment strategies, ultimately, to improve the overall survival of patients with cancer. This article reviews of the progress of immunoscore in predicting patients' prognosis and response to therapy among different tumors.

Relationship between changes in Golgi apparatus morphological structure and endotoxin-induced acute lung injury in mice / 中华麻醉学杂志

Objective:To evaluate the relationship between changes in Golgi apparatus morphological structure and endotoxin-induced acute lung injury (ALI) in mice.Methods:Twenty healthy male C57BL/6J mice, weighing 18-20 g, aged 6-8 weeks, were divided into 2 groups ( n=10 each) using a random number table method: sham operation group (group Sham) and endotoxin-induced ALI group (group ALI). Lipopolysaccharide (LPS) 10 mg/kg was injected intravenously in group ALI, while the equal volume of normal saline 0.5 ml was given instead in group Sham.The animals were sacrificed at 12 h after LPS injection and the lung tissues were taken for detection of the content of reactive oxygen species (ROS) and wet to dry weight ratio (W/D ratio), for observation of the pathological changes (using HE staining) and Golgi apparatus morphological structure (with a transmission electron microscope) and for determination of expression of Golgi matrix protein 130 (GM130), Golgin97 and mannosidase alpha class II member 1 (MAN2A1) and its mRNA (by Western blot and quantitative polymerase chain reaction). Results:Compared with group Sham, ROS content and the W/D ratio in lung tissues were significantly increased, GM130, MAN2A1, Golgin97 protein and its mRNA expression were down-regulate ( P<0.01), the pathological changes of lung tissues were accentuated, the Golgi cisternae was swollen, and Golgi fragments were dispersed in the cytoplasm in group ALI. Conclusion:The mechanism of endotoxin-induced ALI may be related to the changes in Golgi apparatus morphological structure.

Television Viewing Time and the Risk of Colorectal Cancer Mortality among Japanese Population: The JACC Study / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Sedentary behavior attributes to the increased risk of some cancers and all-cause mortality. The evidence is limited for the association between television (TV) viewing time, a major sedentary behavior, and risk of colorectal cancer death. We aimed to examine this association in Japanese population. @*Materials and Methods@#A prospective cohort study encompassed of 90,834 men and women aged 40-79 years with no prior history of colorectal cancer who completed a self-administered food frequency questionnaire, and provided their TV viewing information. The participants were followed-up from 1988-1990 to the end of 2009. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by the Cox proportional hazard regression for risk of colorectal cancer mortality according to TV viewing time. @*Results@#During the median 19.1-year follow-up period, we documented 749 (385 men and 364 women) colorectal cancer deaths. The multivariable-adjusted HRs for mortality from colorectal cancer were 1.11 (0.88-1.41) for 1.5 to < 3 hr/day, 1.14 (0.91-1.42) for 3 to < 4.5 hr/day and 1.33 (1.02-1.73) for ≥ 4.5 hr/day in comparison to < 1.5 hr/day TV watching; p-trend=0.038, and that for 1-hour increment in TV viewing time was 1.06 (1.01-1.11). Moreover, the multivariable-adjusted HR (95%CI) of colon cancer for 1-hour increment in TV viewing time was 1.07 (1.02-1.13). Age, body mass index, and level of leisure-physical activity did not show significant effect modifications on the observed associations. @*Conclusion@#TV viewing time is associated with the increased risk of colorectal cancer mortality among Japanese population, more specifically colon rather than rectal cancer.

Television Viewing Time and the Risk of Colorectal Cancer Mortality among Japanese Population: The JACC Study / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Sedentary behavior attributes to the increased risk of some cancers and all-cause mortality. The evidence is limited for the association between television (TV) viewing time, a major sedentary behavior, and risk of colorectal cancer death. We aimed to examine this association in Japanese population. @*Materials and Methods@#A prospective cohort study encompassed of 90,834 men and women aged 40-79 years with no prior history of colorectal cancer who completed a self-administered food frequency questionnaire, and provided their TV viewing information. The participants were followed-up from 1988-1990 to the end of 2009. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by the Cox proportional hazard regression for risk of colorectal cancer mortality according to TV viewing time. @*Results@#During the median 19.1-year follow-up period, we documented 749 (385 men and 364 women) colorectal cancer deaths. The multivariable-adjusted HRs for mortality from colorectal cancer were 1.11 (0.88-1.41) for 1.5 to < 3 hr/day, 1.14 (0.91-1.42) for 3 to < 4.5 hr/day and 1.33 (1.02-1.73) for ≥ 4.5 hr/day in comparison to < 1.5 hr/day TV watching; p-trend=0.038, and that for 1-hour increment in TV viewing time was 1.06 (1.01-1.11). Moreover, the multivariable-adjusted HR (95%CI) of colon cancer for 1-hour increment in TV viewing time was 1.07 (1.02-1.13). Age, body mass index, and level of leisure-physical activity did not show significant effect modifications on the observed associations. @*Conclusion@#TV viewing time is associated with the increased risk of colorectal cancer mortality among Japanese population, more specifically colon rather than rectal cancer.

Effect of fluid overload on the prognosis of patients with acute kidney injury receiving continuous renal replacement therapy / 中华急诊医学杂志

Objective To investigate the relationship between fluid overload(FO) and prognosis of critically ill patients with acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT), so as to provide a basis for the reasonable optimization of fluid management and improve the prognosis of critically ill patients with AKI. Methods We enrolled 261 adult AKI patients receiving CRRT who were admitted in ICU Department of the First Hospital of Jinlin University from January 2012 to June 2017. We retrospectively analyzed the clinical data of all enrolled patients and compared the clinical data between the survival group (n=149) and the death group (n=112). We screened and analyzed the risk factors of 30-day mortality after entering ICU of AKI critically ill patients receiving CRRT through multiple Logistic regression analysis. The Kaplan-Meier survival curve was used to compare the difference of 30-day mortality after entering ICU between the subgroups of fluid overload and non-fluid overload patients. Results ① The 30 day mortality was significantly higher in AKI patients receiving CRRT when the following situation existed: ％FO total ≥ 10％(OR=1.30, 95％CI:1.13-2.05, P=0.01), ventilator dependency(OR=1.65, 95％CI:1.01-2.55, P=0.03), oliguria(OR=1.55, 95％CI:1.13-2.15), SOFA ≥ 13(OR=1.15, 95％CI:1.01-1.20, P<0.01), the time from the diagnosis of AKI to the start of CRRT >3 days (OR=1.03, 95％CI:1.01-1.13, P=0.04) and mean arterial pressure<72 mmHg (OR=1.10, 95％CI:1.00-1.30, P=0.04). ② There was significant difference in the 30 day survival rate between the fluid overload group (n=92) and the non-fluid overload group (n=169) (P<0.01). ③ Sub group analysis:group1(n=130): ％FO pre-CRRT <10％ and ％FO total<10％; group 2 (n=39): ％FO pre-CRRT ≥ 10％and ％FO total<10％; group 3 (n=64): ％FO pre CRRT <10％ and ％FO total ≥ 10％; group 4 (n=28):％FO pre-CRRT ≥ 10％ and ％FO total ≥ 10％. There was a significant difference in the survival rate between the four groups, that was group 1 >group 2> group 3> group > 4 (P<0.01). ④ The 30 day survival rate was significantly different between fluid overload patients(n=62) and non-fluid overload patients (n=92) in the septic group (P<0.01), while in the non-septic group the 30-day survival rate had no significant difference between fluid overload patients (n=31) and non-fluid overload patients (n=76) (P=0.291). The 30-day survival rate was significant different between fluid overload patients (n=57) and non-fluid overload patients (n=78) in the SOFA ≥ 13 group (P=0.026), while in the SOFA<13 group the 30-day survival rate had no significant difference between fluid overload patients (n=35) and non-fluid overload patients (n=91) (P=0.074). Conclusions Fluid overload is closely associated with poor prognosis of critical ill patients with AKI. The removal of too much fluid through CRRT appears to reduce the mortality of severe AKI patients. The adverse effect of fluid overload on survival is more evident in AKI patients with sepsis or with more severe illness (SOFA ≥ 13).

Effect of mean arterial pressure on acute kidney injury in patients with septic shock / 中华急诊医学杂志

Objective To study the effect of mean arterial pressure (MAP) level on acute kidney injury (AKI) in patients with septic shock, and to determine the best resuscitation target MAP to prevent the occurrence or progression of sepsis- associated AKI.Methods The study subjects included 168 adult patients with septic shock (age≥65 years) who were admitted to the Department of Intensive Care Unit (ICU) of the First Hospital of Jilin University from January 2016 to January 2019. The clinical data of all enrolled patients were retrospectively analyzed. The baseline data were compared between the AKI group (n=111) and non-AKI group (n=57). Multivariate logistic regression analysis was used to determine the risk factors of AKI in patients with septic shock.Results ① The first, second, third, and forth quartile ofΔMAP (pre-resuscitation MAP minus post-resuscitation MAP) were -24.3-3.9 mmHg, 4.0-12.3 mmHg, 12.4-19.8 mmHg, and 19.9-43.5 mmHg, respectively. The second to fourth quartile interval wasΔMAP≥4 mmHg.② There were no significant differences in age, body mass index, sex, pre-resuscitation MAP, MAP at first hour, SOFA score, positive culture ratio, negative culture ratio, hypertension, peripheral vascular disease, cerebrovascular accident, chronic obstructive pulmonary disease, gastrointestinal ulcer, liver cirrhosis, and tumor between the two groups (P>0.05). There were significant differences in post-resuscitation MAP (P=0.01), APACHEⅡ score (P=0.02), diabetes mellitus (P=0.01), fluid balance (P=0.01), andΔMAP from the second to fourth quartile (P=0.03) between the two groups.③ΔMAP≥4 mmHg (OR=0.26, 95％CI: 0.12-0.57,P=0.01), diabetes (OR=6.03, 95％CI: 1.35-44.16,P=0.04), and high APACHEⅡ score (OR=0.96, 95％CI: 0.84-0.97,P=0.02) were closely related to the increased incidence of AKI in patients with septic shock. Post-resuscitation MAP and fluid balance had no significant effect on the incidence of AKI in patients with septic shock.Conclusions ΔMAP≥4 mmHg, APACHEⅡ score and diabetes were independent risk factors for the incidence of AKI in patients with septic shock. The incidence of AKI in septic shock patients with post-resuscitation MAP 4 mmHg or more lower than pre-resuscitation MAP is significantly increased.

Analysis of incidence and risk factors of septic cardiomyopathy / 中华急诊医学杂志

Objective To investigate the incidence and risk factors of septic cardiomyopathy,and to provide evidence for the diagnosis,treatment and prevention of septic cardiomyopathy.Methods Totally 208 patients with septic or septic shock (≥ 18 years old) were admitted to ICU Department of The First Hospital of Jilin University from January 2015 to August 2017.The clinical data of all patients were retrospectively analyzed,and the baseline data and clinical outcomes were compared between the septic cardiomyopathy group (39 cases) and non-septic cardiomyopathy group (169 cases).Multiple Logistic regression analysis was used to analyze the risk factors of septic cardiomyopathy.Results (1) The incidence of septic cardiomyopathy in patients with septic or septic shock was about 18.8％.(2) There was no significant difference in baseline body weight,atrial fibrillation,hypertension,diabetes,malignant tumor,maximum body temperature,blood leukocyte,C-reactive protein(CRP),procalcitonin(PCT),positive blood culture,in-hospital mortality and 30-day mortality between the two groups (all P＞0.05).Age (P=0.01),sex (P=0.02),history of heart failure (P=0.03),history of coronary heart disease (P=0.01),platelet at ICU admission (P=0.01),lactic acid at ICU admission (P=0.02),vasoactive drugs (P=0.03),APACHE Ⅱ score (P=0.03),SOFA score (P=0.01),and ICU length of hospital stay (P=0.03) were significantly different between the two groups.(3) Patients with a history of heart failure (OR=1.55,95％CI:0.73-1.66;P=0.01),a history of coronary heart disease (OR=1.18,95％CI:1.03-1.66;P=0.03),and lactic acid at ICU admission ＞ 4.0 mmol/L (OR=1.10,95％CI:1.00-1.30;P=0.04) were independent risk factors for the incidence of septic cardiomyopathy.Conclusion Septic cardiomyopathy has a relatively high incidence in patients with septic or septic shock.Patients with a history of heart failure,a history of coronary heart disease and lactic acid at ICU admission ＞ 4.0 mmol/L are independent risk factors for the incidence of septic cardiomyopathy.

Effect of mean arterial pressure on acute kidney injury in patients with septic shock / 中华急诊医学杂志

Objective@#To study the effect of mean arterial pressure (MAP) level on acute kidney injury (AKI) in patients with septic shock, and to determine the best resuscitation target MAP to prevent the occurrence or progression of sepsis- associated AKI.@*Methods@#The study subjects included 168 adult patients with septic shock (age≥65 years) who were admitted to the Department of Intensive Care Unit (ICU) of the First Hospital of Jilin University from January 2016 to January 2019. The clinical data of all enrolled patients were retrospectively analyzed. The baseline data were compared between the AKI group (n=111) and non-AKI group (n=57). Multivariate logistic regression analysis was used to determine the risk factors of AKI in patients with septic shock.@*Results@#① The first, second, third, and forth quartile of ΔMAP (pre-resuscitation MAP minus post-resuscitation MAP) were -24.3-3.9 mmHg, 4.0-12.3 mmHg, 12.4-19.8 mmHg, and 19.9-43.5 mmHg, respectively. The second to fourth quartile interval wasΔMAP ≥4 mmHg.② There were no significant differences in age, body mass index, sex, pre-resuscitation MAP, MAP at first hour, SOFA score, positive culture ratio, negative culture ratio, hypertension, peripheral vascular disease, cerebrovascular accident, chronic obstructive pulmonary disease, gastrointestinal ulcer, liver cirrhosis, and tumor between the two groups (P>0.05). There were significant differences in post-resuscitation MAP (P=0.01), APACHEⅡ score (P=0.02), diabetes mellitus (P=0.01), fluid balance (P=0.01), and ΔMAP from the second to fourth quartile (P=0.03) between the two groups.③ ΔMAP ≥4 mmHg (OR=0.26, 95%CI: 0.12-0.57, P=0.01), diabetes (OR=6.03, 95%CI: 1.35-44.16, P=0.04), and high APACHE Ⅱ score (OR=0.96, 95%CI: 0.84-0.97, P=0.02) were closely related to the increased incidence of AKI in patients with septic shock. Post-resuscitation MAP and fluid balance had no significant effect on the incidence of AKI in patients with septic shock.@*Conclusions@#ΔMAP ≥4 mmHg, APACHE Ⅱ score and diabetes were independent risk factors for the incidence of AKI in patients with septic shock. The incidence of AKI in septic shock patients with post-resuscitation MAP 4 mmHg or more lower than pre-resuscitation MAP is significantly increased.

Epidemiological and clinical characteristics of imported malaria in Dalian from 2013 to 2018 / 中华地方病学杂志

Objective To understand the epidemiological and clinical characteristics of imported malaria cases admitted in Dalian and provide evidence for clinical diagnosis,treatment and control of the disease.Methods A retrospective analysis method was used to descriptively analyze the epidemiological data of 104 cases of imported malaria from 2013 to 2018 treated in Dalian Sixth People's Hospital.The clinical characteristics of 93 hospitalized patients (13 in the severe group and 80 in the non-severe group) were analyzed by t (t') test or Mann-Whitney U test.Results Among 104 cases of imported malaria,82 cases were falciparum malaria,5 cases were vivax malaria,4 cases were oval malaria,2 cases were quartan malaria,2 cases were mixed infections,and there were 9 cases without classification.The ratio of males to females was 16.33:1.00 (98:6).The age was (42.07 ± 11.07) years.There was no obvious seasonality in the onset time.We found 102 cases were come from Africa,and their main occupations were outbound workers or fishermen.After blood laboratory examination at admission between severe group and non-severe group,the differences of red blood cell (RBC),hematocrit (PCV),hemoglobin (Hb),serum creatinine (SCr),and blood urea nitrogen (BUN)were statistically significantly different (t =6.561,7.140,6.962;Z =-3.469,-3.739,P ＜ 0.05).Conclusions In Dalian the falciparum malaria is the main infectious species in imported malaria cases,and Africa is the main area of infection.Outbound workers should be trained in malaria prevention and treatment in Africa.Early admission indicators (RBC,PCV,Hb,SCr,BUN) help clinicians to diagnosis and treat severe cases early.

PET imaging on neurofunctional changes after optogenetic stimulation in a rat model of panic disorder / 医学前沿

Panic disorder (PD) is an acute paroxysmal anxiety disorder with poorly understood pathophysiology. The dorsal periaqueductal gray (dPAG) is involved in the genesis of PD. However, the downstream neurofunctional changes of the dPAG during panic attacks have yet to be evaluated in vivo. In this study, optogenetic stimulation to the dPAG was performed to induce panic-like behaviors, and in vivo positron emission tomography (PET) imaging with F-flurodeoxyglucose (F-FDG) was conducted to evaluate neurofunctional changes before and after the optogenetic stimulation. Compared with the baseline, post-optogenetic stimulation PET imaging demonstrated that the glucose metabolism significantly increased (P < 0.001) in dPAG, the cuneiform nucleus, the cerebellar lobule, the cingulate cortex, the alveus of the hippocampus, the primary visual cortex, the septohypothalamic nucleus, and the retrosplenial granular cortex but significantly decreased (P < 0.001) in the basal ganglia, the frontal cortex, the forceps minor corpus callosum, the primary somatosensory cortex, the primary motor cortex, the secondary visual cortex, and the dorsal lateral geniculate nucleus. Taken together, these data indicated that in vivo PET imaging can successfully detect downstream neurofunctional changes involved in the panic attacks after optogenetic stimulation to the dPAG.

The risk factors and prognosis of septic shock patients treated with fluid overload / 中华急诊医学杂志

Objective To investigate the risk factors and prognosis of fl uid overload in patients with septic shock in order to provide guidelines for the reasonable optimization of fluid resuscitation to improve the prognosis of patients with septic shock. Methods A total of 203 septic shock patients admitted in ICU of the fi rst Hospital of Jinlin University from July 2013 to December 2016 were enrolled for retrospective study. The clinical data of all patients were collected to analyzed the differences in clinical settings and outcomes between fluid overload group (n=51) and non-fluid overload group (n=152). The risk factors of fluid overload were achieved using multiple logistic regression analysis. Results Compared with non-fl uid overload group, there were statistically higher levels of APACHE II score(27.5± 9.8 vs.22.7± 9.2,P=0.03),rate of congestive heart failure(17.6% vs.9.2%,P=0.02),rate of acute kidney injury(47.1% vs.29.6%, P=0.04), rate of liver cirrhosis(17.6% vs.9.2%,P=0.02), percentage of albumin≤20 g/L(39.2% vs.36.2%,P=0.03),percentage of blood transfusion(43.1% vs.15.1%,P=0.04), percentage of mechanical ventilation employed(64.7% vs.39.5%,P=0.02),volume of fluid infusion in 24 h(8.3 L vs.5.8 L,P=0.01),rate of renal replacement therapy(15.7% vs.7.9%,P=0.02),and mean duration of mechanical ventilation(4.5 d vs.2.6 d,P<0.01)found in fluid overload group.The hospital mortality of fluid overload group was higher than that of non-fluid overload group(45.1% vs.34.9%,P=0.01).The length of ICU stay in fluid overload group was longer than that of non-fluid overload group(6.8 d vs.3.8 d, P=0.02). The ICU re-admission rate within 48 h in fl uid overload group was higher than that in non-fluid overload group(7.8% vs.3.9%,P=0.03).with free fluid infusion without meticulous calculation of fluid volume(OR=2.65,95%CI:1.33-5.28,P=0.01)and serum albumin≤20 g/L(OR=2.35,95%CI:1.24-4.21,P=0.04)were more likely to develop fluid overload. Conclusion Fluid overload in septic shock patents is associated with poor prognosis. Free fl uid infusion without careful calculation of fl uid volume and severe hypo-albuminemia are the independent risk factors of fl uid overload in septic shock patients.

Effects of Preoperative Application of Tirofiban on Related Indexes of Patients with Acute Myocardial In-farction / 中国药房

OBJECTIVE:To observe the effects of preoperative application of tirofiban on related indexes of patients with acute myocardial infarction. METHODS:In retrospective analysis,128 patients with acute myocardial infarction selected from our hospital during Jan. 2015-Jun. 2016 were divided into observation group (76 cases) and control group (52 cases) according to whether or not the tirofiban was used before PCI. Control group was given Aspirin enteric-coated tablets 300 mg,po+ Clopidogrel sulfate tablets 600 mg,po,before PCI,and given Heparin sodium injection 100 U/kg ,iv,during PCI. Observation group was ad-ditionally given Tirofiban hydrochloride injection 0.2 μg/(kg·min),iv,before PCI,on the basis of control group. ST-segment depres-sion and chest pain remission of 2 groups were observed after PCI. CK-MB level before surgery,CK-MB peak value,the time of CK-MB reaching the peak value,duration after surgery as well as TIMI blood flow grading after surgery were also observed in 2 groups. The levels of von Willebrand factor(vWF),ET-1 and NO were observed before and after surgery;the occurrence of ADR was recorded. RESULTS:After PCI,ST-segment depression rate(89.74%)of observation group was significantly higher than that (67.31%)of control group,the chest pain remission rate(89.47%)was significantly higher than that of control group(75.00%), the patients with TIMI blood flow grading grade 2-3 in observation group was more than control group,with statistical significance (P0.05). After PCI,CK-MB peak value,the time of CK-MB reaching the peak value,duration in observation group were significant-ly lower or shorter than control group;the levels of vWF and ET-1 significantly decreased,while NO levels increased;the improve-ment of vWF,ET-1 and NO in observation group was significantly better than control group,with statistical significance (P0.05). CONCLUSIONS:The application of tirofiban before PCI can relieve clinical symptom,improve cardiac function,protect vascular endothelial and restore coronary artery perfusion. The attention should be paid to the risk of bleeding.

Therapeutic effect of endoscopic retrograde biliary drainage and nasal biliary drainage for hilar cholangiocarcinoma / 中华消化内镜杂志

Objective To evaluate the clinical effect of endoscopic retrograde biliary drainage (ERBD) and endoscopic naso-biliary drainage (ENBD) on hilar cholangiocarcinoma (HACC).Methods The clinical data of 87 patients with HACC,who underwent ERBD and ENBD form January 2010 to January 2016,were retrospectively analyzed.The incidence of postoperative severe cholangitis,biliary obstruction again within 4 weeks,reduction of total bilirubin and survival time were studied.Results There were significant differences between ERBD group and ENBD group on the incidence of severe cholangitis[29.2％ (14/48) VS 10.3％ (4/39),x2 =4.689,P=0.030] and bile duct obstruction in 4 weeks after operation [47.9％ (23/48) VS 23.1％ (9/39),x2=5.710,P =0.017].The total bilirubin within 2 weeks and 4 weeks postoperatively was significantly reduced compared with that before operation (P＜0.05).There was no statistical difference in descend range of total bilirubin between the two groups.There was significant difference between ERBD group and ENBD group in the median survival time [14 weeks (range,0-60 weeks) VS 34 weeks (range,2-96 weeks),x2 =10.101,P=0.010].Conclusion Compared to ERBD,ENBD has certain advantages on palliative care for HACC.

The study of association between PTEN gene polymorphisms and schizophrenia of HAN ethnic with type 2 diabetes mellitus in Shanghai / 中国神经精神疾病杂志

Objective To examine the correlation between the gene of phosphate and tension homology deleted on chromosometen (PTEN gene) polymorphism and schizophrenia (SCZ) associated with the type 2 diabetes mellitus (T2DM ) in Shanghai Han population. Methods The study recruited 591 long-stay schizophrenic inpatients including 304 with and 287 without type 2 diabetes mellitus, 206 patients with the type 2 diabetes mellitus and 205 normal subjects from Shanghai Han population. SNPs of PTEN gene (rs1234225, rs12569998, rs1234223) were genotyped by using Taqman genotyping. The frequency distributions of allele, genotype and haplotype between groups were analyzed. Results There were significant differences in the frequency of rs1234223 genotype (P=0.01) and allele distribution (P=0.02) between the SCZ with type 2 diabetes mellitus group and the SCZ without type 2 diabetes mellitus group. The difference of genotype frequencies remained statistically significant (P=0.03) but the allele distribution was not (P=0.06) after Bonferroni correction. Haplotype analysis showed that TTC haplotype was less common in the SCZ with type 2 diabetes mellitus group than in the SCZ without type 2 diabetes mellitus group (P=0.02). Conclusions PTEN gene may be a susceptibility gene for schizophrenia with type 2 diabetes mellitus in Chinese Han population. The TTC haplotype may be a protective factor for schizophrenia with type 2 diabetes mellitus.