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Objective:To analyze the Risk factors for rapid progression of inpatients with anti-melanoma differentiation associated gene5 (MDA5) antibody-positive dermamyositis (DM) complicated with interstitial lung disease (ILD), and construct a clinical predictive model.Methods:A total of 63 hospitalized patients with anti MDA5 positive DM combined with ILD (MDA5+ DM-ILD) from January 1, 2016 to May 30, 2022 at the Second Affiliated Hospital of the Air Force Military Medical University were included in the study. They were divided into a control group (DM-ILD) and an observation group (DM-RPPILD) based on whether they had rapidly progressing interstitial lung disease (RPILD). Retrospective collection and organization of clinical case data from patients were conducted, and binary logistic regression was used to summarize the risk factors of DM-RPILD. R software was used to construct a clinical prediction model for RPILD occurrence using training set data, and validation set data was used to verify the predictive ability of the model.Results:The proportion of patients with SpO 2<90% at the initial diagnosis of ILD, the titers of anti MDA5 antibodies, immunoglobulin M (IgM), serum ferritin (FER) levels, and positive rates of anti Ro52 antibodies in the observation group were higher than those in the control group, the lymphocyte (LYM) count level was lower than that of the control group (all P<0.05). Binary logistic regression analysis showed SpO 2<90% at the initial diagnosis of ILD, FER level, LYM count, and anti Ro52 antibody were the influencing factors for the occurrence of RPILD (all P<0.05). The area under the curve (AUC) of the training set prediction model for predicting resistance to MDA5+ DM-RPILD was 0.922(95% CI: 0.887-0.957), with a sensitivity of 95.7% and a specificity of 72.5%; In the validation set, the prediction model predicted an AUC of 0.939(95% CI: 0.904-0.974) for resistance to MDA5+ DM-RPILD, with a sensitivity of 90.0% and a specificity of 88.9%; The calibration curves of the training and validation sets indicated that the predictive model had good calibration ability. Conclusions:SpO 2<90% at the initial diagnosis of ILD, FER levels increase, LYM count levels decrease, and anti Ro52 antibody positivity are risk factors for RPILD. The constructed clinical model has good predictive ability and has certain guiding significance for clinical work.
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ObjectiveTo determine whether HBV DNA polymerase is associated with T-cell failure and thus mediates the immune escape of HBV-related hepatocellular carcinoma （HCC） tumor cells， and to investigate the specific molecular mechanisms. MethodsLiver cancer cell lines Huh7 and HepG2 stably transfected with HBV DNA polymerase expression plasmid with Flag （Flag-HBV-P） and intercellular adhesion molecule-1 （ICAM1） were co-cultured with Jurkat cells， and MTT assay， qRT-PCR， and ELISA were used to measure Jurkat cell proliferation， activation （CD69 expression）， and secretion of the cytokine IFN-γ. RNA-seq was used to screen for differentially expressed immune-associated molecules between stably transfected cell lines and control cells， and mRNA half-life and protein half-life assays were used to determine the specific levels of the immune-associated molecules that were affected by HBV DNA polymerase. Related websites were used to predict the transcription factors that may bind to the promoter region of this immune-associated molecule， Western blot was used to verify the effect of transcription factors on the immune-associated molecule， and rescue experiment was used to determine whether HBV DNA polymerase affects the expression level of the immune-associated molecule through this transcription factor. The independent-samples t test was used for comparison between two groups. ResultsThe experimental group had significant reductions in Jurkat cell proliferation， activation， and cytokine secretion compared with the control group （all P<0.01）. Compared with the control group， the experimental group （Huh7 and HepG2 cell lines） had significant reductions in the mRNA and protein expression levels of ICAM1 （all P<0.01）. Website prediction identified the ICAM1 promoter and preliminarily highlighted NFKB1， RELA， and STAT3. Compared with the control group， the experimental group （Huh7 and HepG2 cell lines） had a significant reduction in the protein expression level of p65 （all P<0.01）. After p65 overexpression， there was a significant increase in the protein expression level of ICAM1， and after the expression of p65 was reduced， there was a significant reduction in the protein expression level of ICAM1 （all P<0.01）. In the rescue experiment， there was no significant difference in the protein expression level of ICAM1 between the control group and the experimental group after p65 overexpression （all P>0.05）. After the overexpression of ICAM1， there were no significant differences in the proliferation， activation， and cytokine secretion of Jurkat cells between the control group and the experimental group （Huh7 and HepG2 cell lines） （all P>0.05）. ConclusionHBV DNA polymerase downregulates the level of ICAM1 to mediate HCC immune escape by inhibiting the expression of p65 in NF-κB.
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Heat stress refers to a series of stress reactions such as heat balance disturbance and physiological dysfunction when the body is exposed to the thermal environment for a long time. Studies have found that heat stress can damage intestinal morphology, such as length of intestinal villi, number of goblet cells, and depth of the crypt, affecting the digestion and absorption functions. It also can increase the permeability of the intestinal barrier by damaging the tight junction of the intestinal epithelium, which in turn allows endotoxin and bacteria to enter the blood circulation from the intestinal cavity to cause a systemic inflammatory response. At the same time, heat stress can disrupt the homeostasis of intestinal microbiota, increase pathogenic bacteria, and change downstream metabolites such as short-chain fatty acids. In addition, heat stress can inhibit the occurrence of hippocampal neurons and reduce the number of neurons; decrease the density of synapses; damage important organelles of neurons; induce inflammation of the central nervous system, and then lead to cognitive dysfunction. The brain-gut axis is a two-way signal axis between the intestine and the brain. Intestinal microorganisms and the intestinal barrier can participate in central nervous system regulation, and the brain can change the intestinal homeostatic function and affect the quality of the intestinal barrier through the hypothalamic-pituitary-adrenal axis (HPA axis). The interaction plays an essential role in the body's homeostasis. Therefore, this article reviewed current understandings on the impacts of heat stress on the gut and cognitive function, aiming to provide a reference for subsequent research.
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The review summarizes the risk factors, diagnostic criteria and perioperative control strategies of acute kidney injury in pediatric liver transplantation, aiming to provide rationales for proper managements.
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Cardiovascular diseases (CVDs) and metabolic disorders are major components of noncommunicable diseases, causing an enormous health and economic burden worldwide. There are common risk factors and developmental mechanisms among them, indicating the far-reaching significance in exploring the corresponding therapeutic targets. MST1/2 kinases are well-established proapoptotic effectors that also bidirectionally regulate autophagic activity. Recent studies have demonstrated that MST1/2 influence the outcome of cardiovascular and metabolic diseases by regulating immune inflammation. In addition, drug development against them is in full swing. In this review, we mainly describe the roles and mechanisms of MST1/2 in apoptosis and autophagy in cardiovascular and metabolic events as well as emphasis on the existing evidence for their involvement in immune inflammation. Moreover, we summarize the latest progress of pharmacotherapy targeting MST1/2 and propose a new mode of drug combination therapy, which may be beneficial to seek more effective strategies to prevent and treat CVDs and metabolic disorders.
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The outpatient and emergency electronic medical record system is an important part of the hospital information system. By analyzing the current outpatient and emergency electronic medical record system in hospitals in China, this paper rounded up weaknesses in the development of the outpatient and emergency electronic medical record system in terms of management standards, support, technology bottleneck, data sharing and security. On such basis, the authors suggested to improve the policy standards, clarify the construction objectives, increase the support, optimize the system functions and strengthen the security management, which aimed at promoting the high-quality development of the construction of outpatient and emergency electronic medical record system in China′s hospitals.
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Objective@#To investigate the prevalence of anxiety and depression among inpatients with AIDS and its influencing factors, so as to provide the evidence for improving the psychological health among inpatients with AIDS.@*Methods@#The inpatients with AIDS that were hospitalized in an infectious disease hospital in Chengdu City were recruited using the convenient sampling method. The demographic features, depression and anxiety were collected using a self-designed questionnaire, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale ( SDS ), respectively, and factors affecting the development of depression and anxiety were identified using a multivariable linear regression model among inpatients with AIDS.@*Results@#The 228 AIDS inpatients included 186 men (81.58%) and 42 women ( 18.42% ), and had a mean age of ( 48.04±16.03 ) years. There were 113 inpatients ( 49.56% ) with a CD4+T cell count of ≤200 cells/μL, and the mean SAS and SDS standardized scores were 35.87±8.01 and 42.07±11.08 among AIDS inpatients, which were both significantly greater than in normal populations ( P<0.05 ). The prevalence rates of anxiety, depression, and comorbid anxiety and depression were 5.26%, 16.23% and 4.82% among the participants, respectively. Multivariable linear regression analysis identified unemployment as a risk factor of anxiety ( β'=0.168, P<0.05 ), and CD4+T cell count as a risk factor of anxiety ( β'=-0.151, P<0.05 ) and depression ( β'=-0.238, P<0.05 ) among inpatients with AIDS.@*Conclusions@#Anxiety and depression are prevalent among inpatients with AIDS. Unemployment and a low CD4+T cell count may cause a rise in the risk of developing anxiety and depression among inpatients with AIDS.
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Objective:To revise the Chinese version of Caregiver Task Inventory (CTI-C) and to evaluate its reliability and validity in family members of mental disorder patients.Methods:Chinese version of Caregiver Task Inventory was revised and adjusted and a survey in a convenience sample of 175 family members of mental disorder patients treated in Jining Psychiatric Hospital was conducted with revised Chinese version of Caregiver Task Inventory (CTI-RC). Two weeks later, another survey 30 of the 175 participants with the CTI-RC were carried out for retesting. After that, item analysis, content validity analysis, exploratory factor analysis, reliability analysis and confirmatory factor analysis for the CTI-RC were implemented.Results:The CTI-RC included five common factors: learning to cope with new role, providing care according to care-receiver′s needs, managing own emotional needs, appraising supportive resources, balancing caregiving needs and own needs, covering 25 items. The reliability analysis showed that Cronbach α of the CTI-RC and its 5 factors of learning to cope with new role, providing care according to care-receiver′s needs, managing own emotional needs, appraising supportive resources, balancing caregiving needs and own needs was 0.850, 0.871, 0.887, 0.817, 0.851, 0.841, respectively. The test-retest reliability of the CTI-RC was 0.878.Conclusions:The revised Chinese version of Caregiver Task Inventory has good reliability and validity, and thus, appear to assess valid dimensions of caring ability in family member of individuals with mental disorders.
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Patient diagnosis and treatment data are scattered in various clinical systems related to electronic medical records(EMR). The data can be better applied to the emergency prevention and control, medical research and government supervision only through unified integration. The authors analyzed the construction level of the EMR system in medical institutions, and sorted out the problems faced by directly extracting the diagnosis and treatment data of patients through the EMR system, including the lack of patient-centered integration of data, insufficient application depth of the EMR system, insufficient data standardization, lack of data and so on. Public health emergencies posed a severe challenge to the extraction of EMR data.For medical institutions with different information construction levels, the authors gave a feasibility analysis of data extraction by classification and time period, and suggested that medical institutions should fundamentally strengthen the understanding of information, establish data standard system and realize data integration and unified management.
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Objective:To analyze the application status and problems of clinical decision support system(CDSS) in medical institutions in China, and put forward corresponding suggestions.Methods:From April to May in 2020, a questionnaire survey was conducted in 1 013 medical institutions in 31 provinces of China. The contents of the questionnaire included the current situation of CDSS installation and deployment, the purpose of establishment, the source of knowledge base, the content to be optimized and the factors hindering the use.Results:199(19.64%) medical institutions had CDSS, among which 123 were used in the whole hospital and 76 in some departments; 426 medical institutions did not use CDSS, but had plans to use it. It was found that the current CDSS system had setbacks, such as big cognitive difference, lack of authority in knowledge, high difficulty in data governance, lack of industry standards and so on.Conclusions:In the future, the standardized use of CDSS in medical institutions could be promoted from the aspects of raising awareness, establishing knowledge authority and establishing standards.
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Objective:To analyze the immune response in mice after immunization with vaccine of rAd5F35-SIVenvT in combination with rMVA-SIVenvT to evaluate the efficacy of different immunization strategies.Methods:Two recombinant viruses were identified in vitro by PCR and Western blot. The BALB/c mice were immunized with homologous and heterologous immune strategies. The numbers of splenic lymphocytes secreting IFN-γ were measured by ELISPOT assay, meanwhile SIV gp120 antibody titer were measured by ELISA assay. Results:SIVenvT protein was expressed effectively by rAd5F35-SIVenvT and rMVA-SIVenvT in HEK293 cells. The specific immune response reached its peak at 4-week post first immunization, then decreased. SIV Env specific cellular immune response and SIV gp120 specific antibody could be detected at 4-16 weeks post first immunization. The specific cellular response was significant stronger in heterologous immunization group than homologous group at 4 week and 16 week. Furthermore, heterologous immunization induced significant higher titer of SIV gp120 antibody at 4 week than homologous group.Conclusions:Specific immune response induced by rAd5F35-SIVenvT in combination with rMVA-SIVenvT was stronger than homologous vector immunization. The results provided references for further study in nonhuman primates.
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OBJECTIVE@#To study the genetic variants of a child with Autism Spectrum Disorder (ASD) combined with epilepsy, and explore its possible pathogenic mechanism.@*METHODS@#Clinical data of the child were collected and evaluated, whole-exome sequencing (WES) technology was used to explore the genetic variants sites of the child and his parents and candidate genes were filtered out. Sanger sequencing were performed to verify the variants identified by WES and PolyPhen2 was utilized to predict the function of these variants. qPCR was carry out to determine the expression of the variant gene.@*RESULTS@#The proband carried a compound heterozygous mutation in the SIK3 gene (Chr11 q23.3, NM_025164.6), which contains a missense mutation c.1295A>G (p.N432S) inherited from the father and a deletion [c.2389_2391del(p.797del)] inherited from the mother. Both mutation sites are highly conservative, and PolyPhen2 predicted (c.1295A>G [p.N432S]) to be harmful. Compared to the mother, expression of SIK3in mRNA level in the peripheral blood of the proband and his father were both significantly decreased; compared to normal child, SIK3 expression in the peripheral blood of the proband and two other children with ASD were all decreased significantly too. In addition, studies on mice found that Sik3 gene has a marked higher level of expression in the brain.@*CONCLUSION@#The SIK3 gene variants may probably be associated with ASD. The detailed mechanism needs to be studied further, which may involve lipid metabolism dysfunction in the brain.
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Animais , Masculino , Camundongos , Transtorno do Espectro Autista/genética , Epilepsia/genética , Mutação , Mutação de Sentido Incorreto , Proteínas Quinases , Proteínas Serina-Treonina Quinases/genética , Sequenciamento do ExomaRESUMO
OBJECTIVES@#To establish an electrophysiological model of alcoholic cardiomyopathy by inducing pluripotent stem cells (iPSCs) to differentiate into cardiomyocytes (iPSC-CM) in vitro.@*METHODS@#The human iPSC were expanded in vitro and differentiated into iPSC-CM. The iPSC-CM were divided into a blank control group, an alcoholic experiment group (according to the concentration of alcoholic, the alcoholic experiment was also divided into many subgroups), and a KN93 treatment group. Then the efficiency of iPSC differentiated to iPSC-CM was detected by immunofluorescence, the function of iPSC-CM was detected by cell counting kit-8 (CCK8) assay and lactate dehydrogenase (LDH) activity assay kit. The electrophysiological activity of iPSC-CM was monitored by real time cellular analysis (RTCA), the injury of iPSC-CM caused by alcohol was further verified by the mitochondrial membrane potential fluorescence probe JC-1 staining combined with RTCA analysis.@*RESULTS@#Compared with the blank control group, the different doses (25, 50, 100, 150, 200, 250, 300 mmol/L) of alcohol could significantly inhibit the proliferation of iPSC-CM in a dose-dependent manner (all <0.05). Compared with the blank control group, the activity of iPSC-CM was significantly reduced by 100 mmol/L alcohol, resulting in the increase of LDH release, the decrease of mitochondrial membrane potential, the amplitude and beating rate (all <0.05). Compared with the 100 mg/mL alcoholic experiment group, the KN93 treatment group significantly alleviated the damage of alcohol to iPSC-CM by blocking the necrotic apoptotic pathway, resulting in the decrease of LDH release, the increase of mitochondrial membrane potential, the amplitude and beating rate (all <0.05).@*CONCLUSIONS@#The electrophysiological model of alcoholic cardiomyopathy based on the differentiation of cardiomyocytes are successfully established, which can be used to study the electrophysiological activity and the molecular mechanism for relevant diseases, and it may provide a more reasonable and effective research tool for drug screening and clinical study.
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Humanos , Cardiomiopatia Alcoólica , Diferenciação Celular , Fenômenos Eletrofisiológicos , Células-Tronco Pluripotentes Induzidas , Miócitos CardíacosRESUMO
Coronavirus disease 2019 (COVID-19) can cause great damage to the elderly patients and lead to high mortality. The clinical presentations and auxiliary examinations of the elderly patients with COVID-19 are atypical, due to the physiological ageing deterioration and basal pathological state. The treatment strategy for the elderly patients has its own characteristics and treatment protocol should be considered accordingly. To improve the diagnosis, treatment, and prevention of COVID-19 in the elderly, the Expert Committee of Geriatric Respiratory and Critical Care Medicine, China Society of Geriatrics established the "Expert consensus for the diagnosis, treatment, and prevention of coronavirus disease 2019 in the elderly" . We focused on the clinical characteristics and key points for better treatment and prevention of COVID-19 in the elderly. (1) For diagnosis, atypical clinical presentation of COVID-19 in the elderly should be emphasized, which may be complicated by underlying disease. (2) For treatment, strategy of multiple disciplinary team (mainly the respiratory and critical care medicine) should be adopted and multiple systemic functions should be considered. (3) For prevention, health care model about integrated management of acute and chronic diseases, in and out of hospital should be applied.
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Objective:To study whether aspirin has inhibitory effect on microglia activation induced by Poly-IC and its mechanism.Methods:Microglia cell line BV2 were cultured in vitro to establish a Poly-IC stimulation-induced microglia cell immune activation model. The experiment groups were divided into control group (no treatment), model group (Poly-IC 10 μg/ml), high dose aspirin group (1 mmol/L aspirin), low dose aspirin group (0.1 mmol/L aspirin), high dose aspirin pretreatment group (Poly-IC 10 μg/ml + 1 mmol/L aspirin) and low dose aspirin pretreatment group (Poly-IC 10 μg/ml + 0.1 mmol/L aspirin). The phagocytosis ability of microglia cells, reactive oxygen species (ROS) and Iba1 protein expression were detected by using immunofluorescence method. The expression of the inflammatory cytokines Il-1β, Il-6, Il-10, TNF-α and cox-2 mRNA in microglia cells were detected by real-time quantitative PCR (RT-qPCR).Results:Compared with the control group, the morphology of microglia cells in model group changed significantly, and the phagocytosis ability and production of reactive oxygen species (ROS) increased. At the meantime, the expression of Iba1 protein was strongly decreased. In the model group, The mRNA expressions of IL-1β(20.55±1.92), IL-6 (63.98±7.83), TNF-α (16.84±3.19), COX-2 (6.78±0.42) were higher than IL-1β(1.01±0.14), IL-6 (0.95±0.17), TNF-α (1.22±0.38), COX-2 (0.87±0.11) in the control group. (Il-1β ( t=26.14), Il-6 ( t=10.22), TNF-α ( t=17.06) and COX-2 ( t=37.07), all P<0.01). In the aspirin pretreatment group, the phagocytic ability of microglia cells was inhibited compared with the model group, and the production of reactive oxygen species (ROS) reduced. The expression of Iba1 protein was also partly recovered. Meanwhile, the effect of the high aspirin dose pretreatment group on pro-inflammatory factors IL-1β(9.95±0.52), IL-6 (39.64±6.89), TNF-α(1.57±0.42), COX-2 (2.47±0.14)were lower than those in the model group significantly.(IL-1β: t=14.18, IL-6: t=3.69, TNF-α: t=16.68, COX-2: t=27.03, all P<0.01). Conclusion:Aspirin has an inhibitory effect on microglial activation induced by Poly-IC, which may be related with inhibiting the expression of inflammatory factors.
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Objective:To investigate the level and changing trend of microparticles (MPs) in super-elderly infected patients, and explore its early warning effect on infection.Methods:The infected patients ≥ 85 years old admitted to the Second Medical Center of Chinese PLA General Hospital from December 2018 to March 2019 were selected as the observation group, and the healthy volunteers ≥ 85 years old in the same period were selected as the control group. Venous blood samples were collected at the 2nd hour, the 2nd day and the 7th day after fever, and the inflammatory markers such as white blood cell count (WBC), neutrophil percentage (NEUT), C-reactive protein (CRP) and procalcitonin (PCT) were measured. The levels of MPs were determined by flow cytometry. AnnexinⅤlabeled CD11b positive MPs (AnnexinⅤ +/CD11b + MPs) represented leukocyte microparticles (LMPs), and AnnexinⅤlabeled CD66b positive MPs (AnnexinⅤ +/CD66b + MPs) represented neutrophil microparticle (NMPs). The differences of each index at different time points between the two groups were compared, and the predictive value of each index to the infection of elderly patients was analyzed by receiver operating characteristic (ROC) curve. Results:A total of 38 subjects were enrolled, including 28 cases in the observation group and 10 cases in the control group. The levels of LMPs and NMPs in the observation group increased to the peak at the 2nd hour after fever, and were significantly higher than those in the control group [LMPs (cells/μL): 55.0 (28.8, 197.2) vs. 19.0 (13.5, 28.3), NMPs (cells/μL): 226.5 (123.3, 516.5) vs. 26.5 (22.0, 48.8), both P < 0.01]. With the control of the disease, LMPs and NMPs decreased gradually. The NMPs on the 2nd day was significantly lower than that at the 2nd hour of fever [cells/μL: 106.0 (40.0, 309.0) vs. 226.5 (123.3, 516.5), P < 0.05], and the LMPs and NMPs on the 7th day were significantly lower than those on the 2nd day [LMPs (cells/μL): 17.0 (12.5, 43.8) vs. 42.0 (13.0, 117.0), NMPs (cells/μL): 30.0 (15.8, 62.0) vs. 106.0 (40.0, 309.0), both P < 0.05]. There was no significant difference in the levels of LMPs and NMPs between the two groups on the 7th day. Among the inflammatory markers, the NEUT in the observation group was significantly higher than that in the control group at the 2nd hour of fever (0.70±0.09 vs. 0.59±0.04, P < 0.01), but there was no significant difference in WBC, CRP and PCT between the two groups. On the 2nd day, the inflammatory markers in the observation group reached the peak and were significantly higher than those in the control group [WBC (×10 9/L): 9.33±2.44 vs. 6.37±1.28, NEUT: 0.78±0.08 vs. 0.57±0.04, CRP (mg/L): 5.67±2.99 vs. 0.33±0.18, PCT (μg/L): 0.80±0.67 vs. 0.07±0.03, all P < 0.01]. On the 7th day, the inflammatory markers in the observation group decreased significantly, and there was no significant difference between the observation group and the control group. ROC curve analysis showed that the area under ROC curve (AUC) and 95% confidence interval (95% CI) of LMPs and NMPs on the day of fever were higher than those of WBC, NEUT, CRP and PCT [0.888 (0.763-1.000), 0.973 (0.931-1.000) vs. 0.679 (0.346-0.811), 0.829 (0.700-0.958), 0.607 (0.404-0.811), 0.554 (0.358-0.749)]. Conclusion:LMPs and NMPs are significantly increased in the early stage of fever, which can predict the incidence of infection in the super-elderly patients.
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Objective:To explore the effect of International Classification of Functioning, Disability and Health, Children and Youth Version (ICF-CY) framed oral motor therapy combined with acupoint massage intervention on children with cerebral palsy swallowing disorder.Methods:From September 2018 to September 2019, 80 children with cerebral palsy accompanied by dysphagia who were diagnosed and treated in the Department of Neurological Rehabilitation of our hospital were selected as the study subjects, and were divided into the experimental group (40 cases) and the control group (40 cases) by random number table method. A total of 76 patients completed the study. On the basis of routine swallowing training and oral movement intervention, the experimental group was comprehensively evaluated from the aspects of body function and structure, activity and participation, and environmental factors with ICF-CY theory as the framework, and was given oral and facial acupoint massage for 12 weeks. The control group was given conventional swallowing training and oral exercise intervention for 12 weeks. The modified water swallow test was used to evaluate the effect of improving swallowing disorder in two groups of children after 12 weeks of intervention. The improvement of oral motor function in two groups of children after 4 and 12 weeks of intervention was evaluated by using the Grading Criteria for Evaluation of Oral Motor Function.Results:After 12 weeks of intervention, the total effective rate of swallowing disorder improvement in the experimental group and the control group were 89.47% (34/38) and 63.16% (24/38), respectively, and the difference between the two groups was statistically significant ( χ2 value was 7.28, P<0.05). After 4 and 12 weeks of intervention, the functional scores of oral motors in the experimental group were (67.13±2.35) and (82.08±2.33) points, respectively, which were higher than those of the control group at the same time (56.16±2.57) and (65.63±2.54) points, and the differences were statistically significant ( t values were -3.320, -4.433 P<0.05). After 4 and 12 weeks of intervention, the children's functional scores of oral motors in each group were higher than those in each group before intervention. Compared with the group before intervention, t values of the experimental group were -5.377 and -5.376; t values of the control group were -10.715 and -17.486; compared to the group with 4-week intervention, t value of the experimental group was -12.732; t value of the control group was -13.281, all the differences were statistically significant (P<0.05). The results of repeated measures analysis of variance showed that the time effect, grouping effect, and the interaction between time effect and grouping effect of functional scores of oral motors were statistically significant ( F values were 426.780, 9.084, 26.538, P < 0.05). Conclusions:Oral motor therapy combined with acupoint massage based on ICF-CY framework can effectively promotes the recovery and reconstruction of mouth perception and motor function in children with cerebral palsy, significantly improves the children's dysphagia and their ability to actively participate in feeding.
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Objective To investigate the effect of dexmedetomidine pretreatment on Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway during myocardial injury induced by liver ischemia-reperfusion (I/R) in rats.Methods Twenty-four healthy adult male SpragueDawley rats,aged 8-10 weeks,weighing 220-250 g,were divided into 3 groups (n=8 each) using a random number table method:sham operation group (group S),liver I/R group (group I/R),and dexmedetomidine pretreatment group (group D).The portal vein,superior and inferior vena cava,subhepatic inferior vena cava and hepatic artery were clamped,and the liver was perfused with 4 ℃ lactated Ringer's solution for 60 min through the portal vein to establish the model of liver cold I/R in anesthetized rats.Dexmedetomidine 100 μg/kg was intraperitoneally injected at 30 min before ischemia in group D.Blood samples were collected at 8 h of reperfusion from the inferior vena cava for determination of serum cardiac troponin Ⅰ (cTnⅠ) and heart-type fatty acid binding protein (H-FABP) concentrations (using the automatic biochemistry analyzer),tumor necrosis factor-alpha (TNF-α) and high-mobility group box 1 protein (HMGB1) concentrations (by enzyme-linked immunosorbent assay).The rats were then sacrificed,andhearts were harvested for examination of histopathological changes (with a light microscope) and for determination of the malondialdehyde (MDA) content (using thiobarbituric acid method) and superoxide dismutase (SOD) activity (by xanthine oxidase method),and expression of phosphorylated STAT1 and STAT3 (p-STAT1,p-STAT3) and phosphorylated JAK2 (p-JAK2) in myocardial tissues (by Western blot).Results Compared with group S,the serum concentrations of cTnI,H-FABP,TNF-α and HMGB1 were significantly increased,the MDA content was increased,the SOD activity was decreased,and the expression of p-JAK2,p-STAT1 and p-STAT3 was up-regulated in I/R and D groups (P＜0.05).Compared with group I/R,the serum concentrations of cTnI,H-FABP,TNF-α and HMGB1 were significantly decreased,the MDA content was decreased,the SOD activity was increased,the expression of pJAK2,p-STAT1 and p-STAT3 was down-regulated (P＜0.05),and pathological changes of myocardium were significantly attenuated in group D.Conclusion The mechanism by which dexmedetomidine pretreatment mitigates myocardial injury induced by liver cold I/R may be related to inhibiting activation of JAK/STAT signaling pathway in rats.
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OBJECTIVE： To systematically evaluate therapeutic efficacy of Zinc preparation for radiation-induced oral mucositis （ROM） in head and neck cancers， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed， Medline， Embase， the Cochrane library， CJFD，VIP and Wanfang database， RCTs about additional use of Zinc preparation （trial group） in adjunctive treatment of ROM in head and neck cancers base on routine treatment or blank control （control group） were collected during database establishment to Dec. 2018. After data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was carried out for the incidence of ROM within 2 weeks after medication， total incidence of ROM and the incidence of serve ROM by using Rev Man 5.3 statistical software. RESULTS： A total of 8 RCTs were included， involving 550 patients. Results of Meta-analysis showed that there was no statistical significance in the incidence of ROM within 2 weeks [OR＝0.55， 95％CI（0.26，1.17）， P＝0.12]， total incidence of ROM [OR＝0.59， 95％CI（0.08，4.39）， P＝0.60] or the incidence of serve ROM [OR＝0.58， 95％CI（0.23，1.47）， P＝0.25] between 2 group. CONCLUSIONS： Based on routine therapy or blank control， additional use of Zinc preparation can not reduce the incidence and control the development of ROM in head and neck cancers.
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Objective@#To explore the correlation between serum 25-hydroxyvitamin D3 (25[OH]D3) levels and esophageal variceal bleeding (EVB) in cirrhotic patients.@*Methods@#Eighty-three cases with liver cirrhosis hospitalized from November 2016 to January 2017 were collected. The patients were divided into bleeding group (51 cases) and non-bleeding group (32 cases) depending on the presence or absence of bleeding under gastroscopy. Serological tests were performed on both groups, including hemoglobin (Hb), albumin (ALB), alkaline phosphatase (ALP),γ-glutamyltransferase (GGT), interleukin-6 (IL-6), and 25-hydroxyvitamin D3 (25[OH]D3). Both groups were analyzed by univariate analysis. The differences between both groups were compared by t-test, after normality test. The other variables were compared by Mann-Whitney U test. The correlation between the relevant variables and EVB were analyzed by Spearman's rank correlation and a multivariate analysis. Cases with primary biliary cirrhosis were relatively low in number (four cases in bleeding group, accounting for 8%, 10 cases in non-bleeding group, accounting for 31%). The effects of ALP and GGT on serum 25(OH)D3 level were analyzed by stratified analysis. Moreover, ALP and GGT levels were divided into two and three groups: < 140 U/L and >140 U/L and < 30 U/L, > 30 U/L, and ~≤60 U/L.@*Results@#Bleeding group had low levels of hemoglobin (t= -2.827,P= 0.005), alkaline phosphatase (t= -3.097,P= 0.002), gamma-glutamyltransferase (t= -2.292,P= 0.022), and 25(OH)D3 (t= -3.134,P= 0.002) than non-bleeding group. Both groups (P> 0.05) had similar levels of albumin, interleukin-6, AAR, and FIB-4. Logistic regression analysis showed that 25(OH)D3, alkaline phosphatase and hemoglobin were independent risk factors for EVB. Spearman’s correlation coefficient analysis showed that 25(OH)D3was significantly positively and negatively correlated with interleukin-6 (r= 0.306,P= 0.005) and albumin (r= -0.327,P= 0.003). Stratified analysis showed that serum 25(OH)D3 level was lower in ALP≤140U/L group and the bleeding group, and the difference was statistically significant than non-bleeding group (P= 0.007), while the serum level of 25(OH)D3was decreased in both groups for alkaline phosphatase > 140 U/L group, and the difference was not statistically significant (P= 0.051). Furthermore, in the GGT > 60 U/L group, the serum level of 25(OH)D3was significantly lower in the bleeding group, and the difference was statistically significant in non-bleeding group (P= 0.003), while the difference between the two groups was not statistically significant (P> 0.05) in GGT≤30 U/ L, > 30 U/L, and ~≤60 U/L group.@*Conclusion@#Serum 25(OH)D3level was significantly lower in EVB cirrhotic patients, and it was an independent risk factor for EVB. Serum 25(OH)D3 low levels was more apparent with ALP normalization or GGT level > 60 U/L.