Experimental study on the correlation between microcirculation and contrast-enhanced ultrasonography after crush injury of limbs / 中华超声影像学杂志

Objective:To explore the microcirculation formation mechanism of contrast-enhanced ultrasonography imaging performance in rabbits with limb muscle crush injury.Methods:Seventy-two New Zealand white rabbits were randomly divided into two groups. A limb muscle crush injury model was created by airing a balloon cuff device with a force of 40 kPa. Contrast-enhanced ultrasonography parameters were detected in the first group.In vivo microcirculation parameters were detected in the second group. Fine blood vessel diameter and blood flow velocity were calculated before extrusion and 0.5 h, 2 h, 6 h, 24 h, and 3 days after decompression.Results:Totally six animals died before the end of the experiment (3 rabbits in ultrasonic imaging and microcirculation detection groups, respectively). Compared with the uninjured muscle, the reperfusion of the injured muscle showed early and high enhancement in contrast-enhanced ultrasonography images. The peak intensity and area under the curve were significantly higher than those of the control subgroup at each time point after decompression(all P<0.05), and reached the peak at 24 h after decompression. The time-intensity curve showed a trend of rapid elevation and gradual drop. In the microcirculation group, compared with the control group, fine artery and vein diameters in the experimental group were wider and the blood flow velocity was slower, especially in the fine veins(all P<0.05). At each time point after decompression, there was a statistical difference between the control subgroup and the control subgroup, and the change reached the peak at 24 h after decompression. The blood flow state showed that the arterioles were dominated by linear flow and linear grain flow at each time point after decompression, and linear grain flow, grain flow and grain pendulum flow were observed in the fine veins. Blood flow stagnation and adhesion of white blood cells and white microthrombus were also observed in the fine veins. Correlation analysis showed that the peak intensity and area under the curve were positively correlated with the inner diameter of arterioles and veins( r=0.84, 0.94; r=0.85, 0.94; all P<0.05), and negatively correlated with the flow velocity of arterioles and veins( r=-0.94, -0.96; r=-0.93, -0.96; all P<0.05). Conclusions:In vivo microcirculation detection can reflect changes in muscle microvascular diameter and blood flow velocity, which have a correlation with quantitative ultrasound imaging parameters.

Spontaneous remission of follicular bronchiolitis with nonspecific interstitial pneumonia: A case report and literature review / 北京大学学报(医学版)

A 41-year-old female patient was admitted in Department of Respiratory and Critical Care Medicine, Peking University Third Hospital because of having cough for a year. Multiple subpleural ground grass and solid nodules could be seen on her CT scan. Four months before admission, she began to experience dry mouth and eyes, blurred vision, finger joints pain, muscle pain and weakness in both lower limbs and weight loss. At the time of admission, the patient's vital signs were normal, no skin rash was seen, breath sounds in both lungs were clear, no rales or wheeze, no deformities in her hands, no redness, swelling, or tenderness in the joints. There was no edema in both lower limbs. Some lab examinations were performed. Tumor markers including squamous cell carcinoma (SCC) antigen, neuron-specific enolase (NSE), carcinoembryonic antigen (CEA), Cyfra21-1, pro-gastrin-releasing peptide (proGRP), carbohydrate antigen 125 (CA125) and carbohydrate antigen 199 (CA199) were all normal. The antinuclear antibody, rheumatoid factor, antineutrophil cytoplasmic antibody, anti-dsDNA antibody, anti-Sm antibody, anti-SSA/SSB antibody, anti-ribonucleoprotein (RNP) antibody, anti-Jo-1 antibody, anti-SCL-70 antibody and anti-ribosomal antibody were all negative. The blood IgG level was normal. The blood fungal β-1.3-D glucose, aspergillus galactomannan antigen, sputum bacterial and fungal culture, and sputum smear test for acid-fast staining were all negative. Lung function was normal. Bronchoscopy showed the airways and mucosa were normal. To clarify the diagnosis, she underwent thoracoscopic lung biopsy, the histopathology revealed follicular bronchiolitis (FB) with nonspecific interstitial pneumonia (NSIP). She did not receive any treatment and after 7 months, the lung opacities were spontaneously resolved. After 7 years of follow-up, the opacities in her lung did not relapse. To improve the understanding of FB, a literature research was performed with "follicular bronchiolitis" as the key word in Wanfang, PubMed and Ovid Database. The time interval was from January 2000 to December 2018. Relative articles were retrieved and clinical treatments and prognosis of FB were analyzed. Eighteen articles concerning FB with complete records were included in the literature review. A total of 51 adult patients with FB were reported, including 18 primary FB and 33 secondary FB, and autoimmune disease was the most common underlying cause. Forty-one (80.4%) patients were prescribed with corticosteroids and/or immunosuppressive agents, 6 (11.8%) patients were treated with anti-infective, 5 (9.8%) patients did not receive any treatment. The longest follow-up period was 107 months. Among the 5 patients without any treatment, 1 patients died of metastatic melanoma, the lung opacities were unchanged in 1 patient and getting severe in 3 patients. In conclusion, FB is a rare disease, the treatment and prognosis are controversial. Corticosteroid and immunosuppressive agents could be effective. This case report suggests the possibility of spontaneous remission of FB.

Performance and comparison of assessment models to predict 30-day mortality in patients with hospital-acquired pneumonia / 中华医学杂志(英文版)

BACKGROUND@#Hospital-acquired pneumonia (HAP) is the most common hospital-acquired infection in China with substantial morbidity and mortality. But no specific risk assessment model has been well validated in patients with HAP. The aim of this study was to investigate the published risk assessment models that could potentially be used to predict 30-day mortality in HAP patients in non-surgical departments.@*METHODS@#This study was a single-center, retrospective study. In total, 223 patients diagnosed with HAP from 2012 to 2017 were included in this study. Clinical and laboratory data during the initial 24 hours after HAP diagnosis were collected to calculate the pneumonia severity index (PSI); consciousness, urea nitrogen, respiratory rate, blood pressure, and age ≥65 years (CURB-65); Acute Physiology and Chronic Health Evaluation II (APACHE II); Sequential Organ Failure Assessment (SOFA); and Quick Sequential Organ Failure Assessment (qSOFA) scores. The discriminatory power was tested by constructing receiver operating characteristic (ROC) curves, and the areas under the curve (AUCs) were calculated.@*RESULTS@#The all-cause 30-day mortality rate was 18.4% (41/223). The PSI, CURB-65, SOFA, APACHE II, and qSOFA scores were significantly higher in non-survivors than in survivors (all P < 0.001). The discriminatory abilities of the APACHE II and SOFA scores were better than those of the CURB-65 and qSOFA scores (ROC AUC: APACHE II vs. CURB-65, 0.863 vs. 0.744, Z = 3.055, P = 0.002; APACHE II vs. qSOFA, 0.863 vs. 0.767, Z = 3.017, P = 0.003; SOFA vs. CURB-65, 0.856 vs. 0.744, Z = 2.589, P = 0.010; SOFA vs. qSOFA, 0.856 vs. 0.767, Z = 2.170, P = 0.030). The cut-off values we defined for the SOFA, APACHE II, and qSOFA scores were 4, 14, and 1.@*CONCLUSIONS@#These results suggest that the APACHE II and SOFA scores determined during the initial 24 h after HAP diagnosis may be useful for the prediction of 30-day mortality in HAP patients in non-surgical departments. The qSOFA score may be a simple tool that can be used to quickly identify severe infections.

Prognostic value of primary tumor surgery in seminoma patients with distant metastasis at diagnosis: a population-based study / 亚洲男科学杂志(英文版)

The aims of this study were to determine the prognostic value of primary tumor surgery and identify optimal candidates for such surgery among patients with seminoma and distant metastasis at diagnosis. We identified 521 patients with seminoma and distant metastasis at diagnosis between 2004 and 2014 from the Surveillance, Epidemiology, and End Results database. Among these patients, 434 had undergone surgery, whereas 87 had not. The prognostic value of primary tumor surgery was assessed by Kaplan-Meier methods, log-rank analyses, and multivariate Cox's proportional hazards model. Survival curves and forest plots were also plotted. Survival analysis indicated that patients who underwent surgery had a better 5-year overall survival and cancer-specific survival than those who did not. Multivariate analyses demonstrated that primary tumor surgery is an independent prognostic factor for overall survival and cancer-specific survival, along with age at diagnosis, M stage, and marital status. In addition, primary tumor surgery still had considerable prognostic value in the subgroup of patients with lymph node metastasis. Further, forest plots demonstrated that patients with M1a stage, N1 or N2-3 stage, and a younger age at diagnosis (<60 years) may benefit from primary tumor surgery. In conclusion, our findings indicate that primary tumor surgery is correlated with improved survival in patients with seminoma and distant metastasis. Furthermore, primary tumor surgery is an independent prognostic indicator for patients with seminoma and distant metastasis.

A multicenter research on validation and improvement of the intelligent verification criteria for routine urinalysis / 中华检验医学杂志

Objective:A multi-center and large sample volume study was conducted on the verification and improvement of the early established criteria for intelligent routine urinalysis validation (including the microscopic review rules and manual validation rules, referred to as intelligent criteria for short), in order to improve the clinical application of this intelligent criteria.Methods:A total of 31 456 urine specimens were collected from the inpatients and outpatients in six hospitals in China, from March to September 2019. Firstly, 3105 specimens were analyzed for preliminary verification and improvement of the intelligent criteria based on the results of the microscopic examination and manual validation. Secondly, 28 351 specimens were used to verify the clinical application of the improved intelligent criteria. All samples were manually validated as reference.Results:The approval inconsistency rate of the manual validation rules in the original intelligent criteria was 8.59% (202/2 352), and the interception inconsistency rate was 8.84% (208/2 352). The false negative rate and the microscopic review rate of the microscopic review rules were similar to the previous results. Based on an in-depth analysis of big data and the discussions by senior technicians from eight hospitals, one microscopic review rules and four manual validation rules were added, meanwhile two manual validation rule was deleted. The manual validation standards were unified. Finally, the intelligent criteria was improved. Based on the improved intelligent criteria, for microscopic review rules, the false positive rate, false negative rate (misdiagnosis rate), and microscopic review rate did not change significantly, which were 14.72% (457/3 105), 4.06% (126/3 105), and 24.73% (768/3 105), respectively. The approval inconsistency rate and the interception inconsistency rate of manual validation rules were both reduced to 0; the total manual validation rate of the intelligent criteria was 50.89% (1 580/3 105), and the auto-validation rate was 49.11% (1 525/3 105). The large sample volume verification results were consistent with the preliminary verification results of the improved intelligent criteria.Conclusion:This multi-center and large sample volume study had shown that the improved intelligent criteria had better clinical performance.

Contribution of NOD2 signal pathway to Chlamydia pneumonia Cpn0423-induced inflammatory response / 中华微生物学和免疫学杂志

Objective:To understand and determine the biological properties of Chlamydia pneumonia (Cpn) hypothetical protein Cpn0423 and the mechanisms of which involved in Cpn0423-induced inflammatory response. Methods:The biological properties of Cpn0423 gene were analyzed using bioinformatic software. The subcellular localization of nucleotide-binding oligomerization domain-like receptor 2 (NOD2) in bone marrow-derived macrophages (BMDMs) was detected by confocal microscope. NOD2-siRNA was used to inhibit the expression of NOD2 at mRNA level. Cpn0423-induced macrophage inflammatory protein 2 (MIP-2) and IL-6 production in BMDMs were detected by ELISA. PCR was performed to detect Cpn0423 DNA in bronchoalveolar lavage fluid (BALF) of Cpn-positive patients.Results:The homology between Cpn0423 and other type Ⅲ secretion system effector proteins of Chlamydia ranged from 85% to 93%. NOD2-siRNA could effectively inhibit the expression of NOD2 at mRNA level in BMDMs ( P<0.001). Moreover, Cpn0423-induced production of MIP-2 [(920.5±99.1) pg/ml vs (130.1±11.5) pg/ml, P<0.001] and IL-6 [(266.2±58.4) pg/ml vs (165.7±21.5) pg/ml, P<0.001] in BMDMs were decreased following NOD2-siRNA pre-treatment. Cpn0423 DNA was detected in the BAlF of 83.3% (10/12) of Cpn-positive cases, but not in Cpn-negative cases. Conclusions:Cpn0423 induced inflammatory response in host cells through NOD2 pathway, which was closely related to the chronic inflammatory injury caused by Cpn.

Mechanism underlying the anti-apoptotic activity of pORF5 plasmid protein in Chlamydia trachomatis via high-mobility group box 1 protein: a preliminary study / 中华皮肤科杂志

Objective To explore the molecular mechanism underlying the anti-apoptotic activity of pORF5 plasmid protein of Chlamydia trachomatis,so as to provide an experimental basis for further clarifying the pathogenesis of Chlamydia trachomatis.Methods HeLa cells were divided into two groups:carbonyl cyanide m-chlorophenyl hydrazone (CCCP,an apoptosis inducer) group was stimulated by CCCP for 30 minutes,and pORF5 + CCCP group was pretreated with pORF5 plasmid protein for 18 hours followed by CCCP for 30 minutes.Then,Western blot analysis was performed to determine the expression of apoptosisrelated proteins Bcl-2,Bax and caspase-3,JC-1 fluorescent probe was used to detect changes in the mitochondrial membrane potential in HeLa cells,and cytochrome c release from mitochondria was analyzed by indirect immunofluorescence assay.To analyze whether high-mobility group box 1 (HMGB1) protein participated in the anti-apoptotic role of pORF5 plasmid protein,HMGB 1 shRNA and control RNA were separately transfected into the HeLa cells,which were then stimulated by pORF5 plasmid protein and CCCP.Then,the protein expression of Bcl-2,Bax,activated caspase-3 was determined,and cytochrome c release was analyzed.Data were compared between two groups by using paired t test.Results pORF5 plasmid protein could antagonize the CCCP-induced decrease of mitochondrial membrane potential,and the red/green fluorescence intensity ratio was significantly lower in the CCCP group (0.4 ± 0.1) than in the pORF5 + CCCP group (1.7 ± 0.3;t =6.95,P ＜ 0.01).The protein expression of Bcl-2 in the HeLa cells in the pORF5 + CCCP group was 5.3 ± 0.6 times more than that in the CCCP group (t =8.62,P ＜ 0.01),while the protein expression of Bax and activated caspase-3 in the pORF5 + CCCP group significantly decreased by 79％ ± 10％ (t =9.23,P ＜ 0.01) and 75％ ± 8％ (t =4.26,P ＜ 0.05) respectively compared with the CCCP group.Compared with the control RNA transfection group,the HMGB1 shRNA transfection group showed significantly decreased mitochondrial membrane potential in the HeLa cells (t =11.23,P ＜ 0.01),increased cytochrome c release,decreased Bcl-2 expresson (t =7.19,P ＜ 0.05) and increased Bax expression (t =13.06,P ＜ 0.01) after stimulation with pORF5 and CCCP.Conclusion Chlamydia trachomatis plasmid protein pORF5 plays an anti-apoptosis role by blocking the mitochondrial apoptotic pathway through HMGB1 protein.

Clinical analysis of candidemia in immunocompetent patients / 北京大学学报(医学版)

OBJECTIVE@#To investigate the etiological and clinical characteristics of immunocompetent patients with candidemia.@*METHODS@#The clinical and microbiological data of patients diagnosed as candidemia admitted in Peking University Third Hospital from January 2010 to June 2016 were retrospectively analyzed. Underlying diseases, Candida spp. colonization, clinical manifestations, microbiological data, treatment and the outcome were compared between the HIV-negative immunocompromised (IC) and nonimmunocompromised (NIC) patients.@*RESULTS@#A total of 62 cases diagnosed as candidemia were analyzed including 36 men and 26 women, with 16 to 100 years of age [(66.02±17.65) years]. There were 30 NIC and 32 HIV-negative IC patients respectively. In the NIC patients, there were 19 cases (19/30, 63.33%) with admission in intensive care unit (ICU), 21 (21/30, 70.00%) associated diabetes mellitus or uncontrolled hyperglycemia and 22 (22/30,73.33%) receiving invasive mechanical ventilation, while in the HIV-negative IC patients, there were 8 (8/32, 25.00%), 13 (13/32, 40.63%) and 7 (7/32, 21.88%) respectively (P<0.05). The NIC patients had higher acute physiology and chronic health evaluation (APACHE II) scores and sequential organ failure assessment (SOFA) scores both at admission (19.98±5.81, 6.04±6.14) and candidemia onset (25.61±6.52, 12.75±8.42) than the HIV-negative IC patients (APACHEII 15.09±5.82, 22.15±5.98) and SOFA 2.87±2.73, 7.66±5.64 respectively (P<0.05). In the NIC patients, twenty-one cases (21/30, 70.00%) died in hospital, while 14 cases (14/32, 43.75%) in HIV-negative IC. The crude mortality was significantly different between the two groups (P<0.05). By blood culture, Canidia albicans remained the the most prevalent isolates in all the patients. Clinical manifestation, Candida spp. colonization, etiology and drug susceptibility were also similar between NIC and HIV-negative IC patients (P>0.05).@*CONCLUSION@#Candidemia in NIC patients tends to occur in those who are much more critically ill, more often admitted in ICU, and more frequently have diabetes mellitus or uncontrolled hyperglycemia and receive invasive mechanical ventilation than HIV-negative IC patients. NIC patients also have poorer prognosis than HIV-negative IC patients. Clinical manifestations, and microbiological characteristics are similar between HIV-negative IC and NIC patients.

Airway inflammation and small airway wall remodeling in neutrophilic asthma / 北京大学学报(医学版)

OBJECTIVE@#To investigate the distribution of airway inflammation phenotype in patients with bronchial asthma (asthma), and to analyze clinical characteristics, inflammatory cytokines, pulmonary small vessels remodeling and small airway wall remodeling in patients with neutrophilic asthma.@*METHODS@#Sixty-three patients with asthma were enrolled from January 2015 to December 2015 in Peking University Third Hospital. Clinical data including gender, age, body mass index (BMI), pulmonary function tests (PFTs), asthma control test (ACT) were recorded. All the patients underwent sputum induction. The cellular composition of the sputum was evaluatedand the concentration of active MMP-9 in the sputum tested. Blood routine tests were done and the concentration of IgE, periostin, and TGF-beta1 levels were measured in serum by enzyme-linked immunosorbent assay (ELISA). Small airway wall remodeling was measured in computed tomography (CT) scans, as the luminal diameter, luminal area, wall thickness and wall area % adjusted by body surface area (BSA) at the end of the 6th generation airway, in which the inner diameter was less than 2 mm. Small vascular alterations were measured by cross-sectional area (CSA), and the total vessel CSA < 5 mm2 was calculated using imaging software.@*RESULTS@#The distributions of airway inflammatory phenotypes of the asthmatic patients were as follows: neutrophilic asthma (34.9%, 22/63), eosinophilic asthma (34.9%, 22/63), mixed granulocytic asthma (23.8%, 15/63), and paucigranulocytic asthma (6.3%, 4/63). The neutrophilic subtype patients had a significantly higher active MMP-9 level in sputum compared with the eosinophilic phenotypepatuents, as 179.1 (74.3, 395.5) vs. 50.5 (9.7, 225.8), P<0.05. Sputum neutrophil count was negatively correlated with FEV1%pred (r=-0.304,P<0.05), and positively correlated with active MMP-9 level in sputum (r=-0.304, P<0.05), and positive correlation trend with airway wall thickness (r=0.533, P=0.06). There was a significantly negative correlation of active MMP-9 level in sputum with FEV1%pred (r=-0.281, P<0.05), in positive correlation with small airway wall area (%)(r=0.612, P<0.05), and inpositive correlation trend with airway wall thickness (r=0.612, P=0.06). Neutrophils count in peripheral blood was positively correlated with neutrophil counts in sputum.@*CONCLUSION@#Neutrophil count in airway is related to lung function in asthmatic patients. Neutrophils may accelerate small airway wall remodeling through the release of active MMP-9. Neutrophil count in peripheral blood is related to neutrophils count in sputum, which may be used as a substitute for evaluating inflammatory phenotype.

Effect of Shenqi Fuzheng injection on invasion of MHCC97L cells based on RNA interference technology / 中国现代普通外科进展

Objective:To investigate the inhibitory effect of Shenqi Fuzheng injection on the expression of VEGF gene in human hepatocellular carcinoma cell line MHCC97L,and to elucidate the effect of Shenqi Fuzheng injection on tumor invasiveness,and to validate it through siRNA technology.Methods:After 24 hours of addition of Shenqi Fuzheng Injection (MHC) in the culture system of MHCC97L,Real-time PCR and Western-blot were used to detect the expression of MMP-9 and MMP-9 in the control group (Shenqi Fuzheng),negative control group (NaCI) And the expression of VEGF and RNA in the blank control group,and to determine the effect of Shenqi Fuzheng injection on the expression of VEGF and RNA.The effect of Shenqi Fuzheng Injection on the invasiveness of MHCC97L cells was detected by Transwell assay.The lentiviral vectors of MHCC97L cells were transfected into 293T cells and transfected into MHCC97L cells.The transfected cells were transfected into 293T cells by Lipofectamine 2000,and transfected into MHCC97L cells.The Effect of Shenqi Fuzheng Injection on the Invasion of VEGFi Tumor by Transwell.Results:Shenqi Fuzheng injection could significantly decrease the expression of VEGF mRNA and protein in normal MHCC97L cells (P＜0.05),and decrease the invasiveness of tumor cells (P＜0.05).VEGF RNA interference was successful.After intervention,Shenqi Fuzheng injection could not decrease the invasiveness of MHCC97L tumor (P＞0.05).Conclusion:Shenqi Fuzheng injection can reduce the invasion of MHCC97L cells by inhibiting the expression of VEGF gene.

Prevention of postpartum hemorrhage and diverticulum in scarred uterus with oxytocin and hemabate / 中国生化药物杂志

Objective To investigate the efficacy of oxytocin combined with hemabate in the prevention of postpartum hemorrhage and diverticulum in scarred uterus. Methods 88 patients with scar uterus, postpartum hemorrhage and diverticulum in Chang'an Hospital from May 2016 to May 2017 were divided into two groups by maternal numbering and randomization, with 44 patients in each group. The control group was treated with oxytocin, and the observation group was treated with oxytocin combined with hemabate. It must compare the amount of bleeding, the amount of 2 h bleeding, the amount of postpartum 24 h bleeding and the incidence of adverse reactions in the two groups after the treatment. Results Compared with the control group, the amount of bleeding, the amount of two hours' bleeding and the amount of postpartum 24 hours' bleeding in the observation group were significantly lower than that in the control group(P<0.05). The postpartum hemorrhage volume of the observation group was 6.81%, which was lower than that of the control group, and the rate of postpartum hemorrhage was 27.27% (P<0.05). The incidence of adverse reactions such as nausea, vomiting, heart rate and blood pressure in the observation group was significantly lower than that in the control group (4.54% vs. 18.18%), the difference was statistically significant(P<0.05). Conclusion In the scar uterus, postpartum hemorrhage and diverticulum, the use of oxytocin combined with hemabate treatment has obvious curative effect. It is an important measure to reduce the amount of bleeding and ensure safety.

Effect of Shenqi Fuzheng injection on invasion of MHCC97L cells based on RNA interference technology / 中国现代普通外科进展

Objective:To investigate the inhibitory effect of Shenqi Fuzheng injection on the expression of VEGF gene in human hepatocellular carcinoma cell line MHCC97L,and to elucidate the effect of Shenqi Fuzheng injection on tumor invasiveness,and to validate it through siRNA technology.Methods:After 24 hours of addition of Shenqi Fuzheng Injection (MHC) in the culture system of MHCC97L,Real-time PCR and Western-blot were used to detect the expression of MMP-9 and MMP-9 in the control group (Shenqi Fuzheng),negative control group (NaCI) And the expression of VEGF and RNA in the blank control group,and to determine the effect of Shenqi Fuzheng injection on the expression of VEGF and RNA.The effect of Shenqi Fuzheng Injection on the invasiveness of MHCC97L cells was detected by Transwell assay.The lentiviral vectors of MHCC97L cells were transfected into 293T cells and transfected into MHCC97L cells.The transfected cells were transfected into 293T cells by Lipofectamine 2000,and transfected into MHCC97L cells.The Effect of Shenqi Fuzheng Injection on the Invasion of VEGFi Tumor by Transwell.Results:Shenqi Fuzheng injection could significantly decrease the expression of VEGF mRNA and protein in normal MHCC97L cells (P＜0.05),and decrease the invasiveness of tumor cells (P＜0.05).VEGF RNA interference was successful.After intervention,Shenqi Fuzheng injection could not decrease the invasiveness of MHCC97L tumor (P＞0.05).Conclusion:Shenqi Fuzheng injection can reduce the invasion of MHCC97L cells by inhibiting the expression of VEGF gene.

Prevention of postpartum hemorrhage and diverticulum in scarred uterus with oxytocin and hemabate / 中国生化药物杂志

Objective To investigate the efficacy of oxytocin combined with hemabate in the prevention of postpartum hemorrhage and diverticulum in scarred uterus. Methods 88 patients with scar uterus, postpartum hemorrhage and diverticulum in Chang'an Hospital from May 2016 to May 2017 were divided into two groups by maternal numbering and randomization, with 44 patients in each group. The control group was treated with oxytocin, and the observation group was treated with oxytocin combined with hemabate. It must compare the amount of bleeding, the amount of 2 h bleeding, the amount of postpartum 24 h bleeding and the incidence of adverse reactions in the two groups after the treatment. Results Compared with the control group, the amount of bleeding, the amount of two hours' bleeding and the amount of postpartum 24 hours' bleeding in the observation group were significantly lower than that in the control group(P<0.05). The postpartum hemorrhage volume of the observation group was 6.81%, which was lower than that of the control group, and the rate of postpartum hemorrhage was 27.27% (P<0.05). The incidence of adverse reactions such as nausea, vomiting, heart rate and blood pressure in the observation group was significantly lower than that in the control group (4.54% vs. 18.18%), the difference was statistically significant(P<0.05). Conclusion In the scar uterus, postpartum hemorrhage and diverticulum, the use of oxytocin combined with hemabate treatment has obvious curative effect. It is an important measure to reduce the amount of bleeding and ensure safety.

Effect of Shenqi Fuzheng injection combined with IFN-α on the expression of STAT1 gene in hepatocellular carcinoma cells / 中国现代普通外科进展

Objective:To study the effect of Shenqi Fuzheng injection combined with interferon-α (IFN-α) on the expression of STAT1 gene in hepatocellular carcinoma cells,and to elucidate its mechanism of IFN-α synergistic effect.Methords:The effect of IFN-α injection alone or combined with Shenqi Fuzheng injection on the proliferation of MHCC97-L cells was detected by MTT assay.IFN-α was detected by Real-time PCR and Western-blot respectively.The expression of STAT1 mRNA and protein in the experimental group,the negative control group (NaCl) and the blank control group were determined,and the effect of Shenqi Fuzheng injection on the transcription and expression of STAT1 was determined.The expression of STAT1 in lentiviral vector MTT assay was used to detect the effect of IFN-α alone or in combination with Shenqi Fuzheng injection on the STAT1 gene silencing cells.The expression of STAT1 was detected by RT-PCR and Western-Blot in MHCC97L cells.Strain,on cell proliferation.Results:Compared with IFN-α alone,Shenqi Fuzheng injection combined with IFN-α enhanced the inhibitory effect of IFN-α on MHCC97-L (P＜0.01) and up-regulated the expression of STAT1mRNA and protein (P＜0.05).Successfully constructed the STAT1 gene silent in the MHCC97-L cell line.There was no significant difference in the inhibition rate of MHCC97-L between Shenqi Fuzheng injection and IFN-α (P＞0.05).Conclusion Shenqi Fuzheng Injection can up-regulate the expression of STAT1 in human hepatocellular carcinoma cell line MHCC97-L,so as to increase the effect of IFN-α.

Effects of exposure to ambient particulate matter and polycyclic aromatic hydrocarbons on oxidative stress biomarkers in the patients with chronic obstructive pulmonary disease / 北京大学学报(医学版)

Objective:To investigate the effects of exposure to ambient particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs) on systemic oxidative stress biomarkers in chronic obstructive pulmonary disease (COPD) patients.Methods: A panel of forty-five diagnosed and stable COPD patients, whose residences were within 5 kilometers from Peking University Health Science Center (PKUHSC), were recruited and followed up twice between November 2014 and May 2015.The lung function index percentage of forced expiratory volume in 1 second (FEV1) to predicted value (FEV1%pred), was measured to reflect the severity of COPD patients.The systemic oxidative stress biomarkers malondialdehyde (MDA) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) in their urine samples were measured using high performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA), respectively.Concentrations of ambient air pollutants and levels of meteorological factors were measured continuously through the air pollution-monitoring station located in PKUHSC.PM2.5 samples, which were used for measuring the concentrations of PAHs, were collected by PM2.5 high volume air sampler.We constructed linear mixed-effects models, including single-pollutant model, 2-pollutant models and stratification analysis, to estimate the effects of air pollutants on urinary MDA and 8-OHdG after adjusting for confounding factors.Results: In our COPD-patient panel, the associations between ultrafine particles (UFP) and PAHs and urinary MDA were statistically significant at lag2 (P<0.05).For an interquartile range (IQR) increase in UFP and PAHs, respective increases of 28% (95%CI: 4%-57%) and 36% (95%CI: 4%-77%) in urinary MDA were observed, and the effects became stronger after adjusting for the concentration of black carbon (BC).The COPD patients were divided into 2 groups stratified by FEV1%pred.Most air pollutants had stronger effects of systemic oxidative stress in the COPD patients of FEV1%pred≥50%.In this group, we observed that an IQR increase in UFP was associated with a 98% (95%CI: 38%-186%) increase in urinary MDA, and an IQR increase in BC, UFP and PAHs were associated with respective increases of 87% (95%CI: 32%-166%), 69% (95%CI: 24%-130%) and 156% (95%CI: 66%-294%) in urinary 8-OHdG.We didn't find significant associations between fine particulate matter (PM2.5) and urinary oxidative stress biomarkers.Conclusion: Our results suggested that exposure to air pollutants, especially UFP and PAHs, was responsible for exacerbation of systemic oxidative stress in COPD patients.Most air pollutants had stronger effects of systemic oxidative stress in mild to moderate COPD patients.

Prevention of postpartum hemorrhage and diverticulum in scarred uterus with oxytocin and hemabate / 中国生化药物杂志

Objective To investigate the best application time and effect of the prevention and treatment of postpartum hemorrhage caused by uterine atony. Methods A total of 168 women with bleeding tendency were treated in our hospital from October 2014 to October 2016. They were randomly divided into three groups, 56 cases each. Among them, A group was used immediately after delivery, and group B was suffering from uterine atony, which was the use of hemabate, and C group did not use hemabate. The blood loss and the amount of postpartum hemorrhage in the three groups were compared and analyzed. Results Compared with group B and C, the amount of bleeding, the amount of bleeding in the 2 hours postpartum and the amount of 24 hours postpartum hemorrhage in group A were significantly lower than that in group(P<0.05). The 2 hours postpartum bleeding volume and 24 hours postpartum hemorrhage in group B were significantly lower than that in group C(P<0.05). The incidence of postpartum hemorrhage in group A was 3.57％, significantly lower than that in group B, group 14.28％ and group C, 30.36％(P<0.05). The incidence of postpartum hemorrhage in group B was 14.28％, significantly lower than that in group C (30.36％) (P<0.05). Conclusion To prevent and treat uterine atony postpartum hemorrhage, it is effective to prevent and treat postpartum hemorrhage. And the best application for the immediate use of fetal labor, can further reduce the amount of postpartum hemorrhage, to ensure maternal safety.

Exploration of microteaching combined with simulated endoscopy in the training quality of bron-choscopy / 中华医学教育探索杂志

Bronchoscopy has been an important tool for clinicians. Based on the traditional training, this research tries to introduce microteaching combined with simulated bronchoscope, strengthens the chest CT reading training, standardizes operation practices, which significantly improve the operation speed, flex-ibility and accuracy, shorten the training cycle of the novices. This medical teaching method are effective to contribute the novices to master the operation skill of bronchoscopy.

Association between Polymorphism of Endothelin Receptor Type A and Delayed Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage / 现代检验医学杂志

Objective To investigate the genetic association between endothelin receptor type A(EDNRA)gene polymor-phism and delayed cerebral vasospasm(DCVS)in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods 133 aSAH patients from January 2015 to January 2017 were recruited to participate in the study.According to whether com-bined with DCVS,they were divided into the DCVS group(78 cases)and the control group(55 cases).Genotype was deter-mined by polymerase chain reaction-restriction fragment length polymorphism combined with DNA direct sequencing tech-nique for the polymorphism of the EDNRA gene.Results Samples of DCVS group and control group both were consistent with Hardy-Weinberg's law of inheritance(χ2=0.295,P=0.863;χ2=0.652,P=0.722).There were significant differ-ences of EDNRA gene rs5335 polymorphism between DCVS group and control group,under allele model(χ2=4.213,P=0.040)and the dominant model(χ2=4.790,P=0.029).However,there was no difference of EDNRA gene polymorphism between DCVS group and control group under recessive model(χ2=1.299,P=0.254).Multivariate Logistic regression a-nalysis showed that allele C was protective factor of DCVS for aSAH patients(OR=0.572,95%CI 0.401~0.872,P=0.021).Conclusion For aSAH patients,EDNRA gene rs5335 polymorphism may closely related to DCVS.

Exploration of Training of Rational Drug Use Knowledge and Skills for Clinical Medical Students in the In-ternship Period / 中国药房

OBJECTIVE:To provide reference for improving the education of rational drug use and skills for clinical medical students in the internship period. METHODS:Teachers in the respiratory department of our hospital took part in training interns and clinical pharmacists took part in teaching rounds to train about medication education and skills,including linking up the theoret-ical knowledge of rational drug use,training of skills about issuing rational prescriptions and judging drug information,guiding to participate in the education of rational use of drugs to patients and evaluating the knowledge and skill of rational drug use. RE-SULTS & CONCLUSIONS:Carrying out rational drug use education in practice will improve the mastery of knowledge of rational drug use,enhance the awareness of rational drug use and the idea,which is helpful for achieving the irrational drug use in clinical practice,and improve the overall quality of medical services. but there still remain some problems to be explored.

Interleukin-32, not reduced by salmeterol/fluticasone propionate in smokers with chronic obstructive pulmonary disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The interleukin (IL)-32/tumor necrosis factor (TNF) a pathway is supposed to play a key role in the amplification of the immune response in chronic obstructive pulmonary disease (COPD) inflammation. Inhaled corticosteroids (ICS) in combination with long-acting β2-agonists (LABA) have shown airway anti-inflammatory effects in recent studies, but the mechanism is still uncertain.</p><p><b>METHODS</b>Patients were treated in a randomized, open-labeled, parallel group clinical trial with either a combination of salmeterol xinafoate/fluticasone propionate (SF; Seretide, GlaxoSmithKline) Diskus (50/500 µg twice daily) or ipratropium bromide/salbutamol (IS; Combivent, Boehringer Ingelheim) MDI (42 µg/240 µg quartic daily) for 12 weeks. At the start and the end of treatment, induced sputum was collected and the concentration of IL-32 and TNF-α, the number of neutrophils and eosinophils were measured.</p><p><b>RESULTS</b>Following 12 weeks of treatment, a statistically significant fall from baseline in the concentration of TNF-α in sputum (P = 0.004) was seen after treatment with SF but not with IS. However, neither treatment had significant effects on the concentration of IL-32 in sputum. There was a decrease from baseline in the number of sputum neutrophils with SF that approached statistical significance (P = 0.028) but not with IS, while the number of sputum eosinophils did not change significantly from baseline in either treatment group. There was a statistically significant decline from baseline in the quality of life as assessed by the St George's respiratory questionnaire in both the SF (P = 0.004) and IS (P = 0.030) treatment groups, but no evidence of improvement in lung function was observed in either group.</p><p><b>CONCLUSION</b>The sputum TNF-α and neutrophils, but not IL-32 and macrophages, could be reduced by ICS/LABA treatment, suggesting that IL-32 could be involved in the corticosteroid resistance of COPD inflammation.</p>