Case Report: Small Bowel Obstruction Owing to Self-Anchoring Barbed Suture Device After TAPP Repair.

Groin hernioplasty is the most performed intervention in the adults worldwide, the minimally invasive inguinal hernia repair techniques widely used by surgeons today are transabdominal preperitoneal patch plasty (TAPP) and total extraperitoneal patch plasty (TEP). We report a 62-year-old man with bowel obstruction caused by the use of self-anchoring barbed suture to close the peritoneum 3 days after TAPP. Surgeons using the barbed suture should be alert to this possibility when encountering this complication of intestinal obstruction, so as to avoid more serious consequences.

The pattern of hospital-community-home (HCH) nursing in tracheostomy patients with severe traumatic brain injury: Is it feasible?

BACKGROUND: Tracheostomy is very common in patients with severe traumatic brain injury (TBI), long-term nursing care are needed for those patients. We aimed to evaluate the effects of hospital-community-home (HCH) nursing in those patients. METHODS: This study was a before-after study design. Patients were divided into control groups (traditional nursing care) and HCH group(HCH nursing care). Tracheostomy patients with severe TBI needing long-term care were included. All patients underwent a two-month long follow-up. Glasgow coma score (GCS), Karnofsky, Self-Anxiety Scale (SAS) from caregiver and Barthel assessment at the discharge and two months after discharge were evaluated. The tracheostomy-related complications were recorded and compared. RESULTS: A total of 60 patients were included. There were no significant differences between the two groups in the GCS, Karnofsky, SAS from caregiver and Barthel index at discharge((all P > .05); the GCS, Karnofsky and Barthel index were all significantly increased after two-month follow-up for the two groups (all P < .05), and the GCS, Karnofsky and Barthel index at two-month follow-up in HCH group were significantly higher than that of the control group(all P < .05), but the SAS from caregiver at two-month follow-up in HCH group was significantly less than that of the control group(P = .009). The incidence of block of artificial tracheal cannula and readmission in HCH group were significant less than that of control group (all P < .05). CONCLUSION: HCH nursing care is feasible in tracheostomy patients with severe TBI, future studies are needed to further evaluate the role of HCH nursing care.

Effect of lentivirus-mediated CFTR overexpression on oxidative stress injury and inflammatory response in the lung tissue of COPD mouse model.

We aimed to investigate the regulatory mechanism of lentivirus-mediated overexpression of cystic fibrosis transmembrane conductance regulator (CFTR) in oxidative stress injury and inflammatory response in the lung tissue of mouse model of chronic obstructive pulmonary disease (COPD). COPD mouse model induced by cigarette smoke was established and normal mice were used as control. The mice were assigned into a normal group (control), a model group (untreated), an oe-CFTR group (injection of lentivirus overexpressing CFTR), and an oe-NC group (negative control, injection of lentivirus expressing irrelevant sequences). Compared with the oe-NC group, the oe-CFTR group had higher CFTR expression and a better recovery of pulmonary function. CFTR overexpression could inhibit the pulmonary endothelial cell apoptosis, reduce the levels of glutathione (GSH), reactive oxygen species (ROS), and malondialdehyde (MDA) and increase the values of superoxide dismutase (SOD), GSH peroxidase (GSH-Px), and total antioxidant capacity (T-AOC). The overexpression also led to reductions in the white blood cell (WBC) count in alveolus pulmonis, the concentrations of C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor-α, and the protein expressions of NF-κB p65, ERK, JNK, p-EPK, and p-JNK related to MAPK/NF-κB p65 signaling pathway. In conclusion, CFTR overexpression can protect lung tissues from injuries caused by oxidative stress and inflammatory response in COPD mouse model. The mechanism behind this may be related to the suppression of MAPK/NF-κB p65 signaling pathway.

Noninvasive ventilation for acute lung injury a meta-analysis of randomized controlled trials.

PURPOSE: To compare the effect of noninvasive ventilation (NIV) and standard oxygen therapy on treating acute lung injury (ALI). METHODS: A search on PubMed, Embase, Springer, Cochrane Central Register of Controlled Trials and Clinical Trials was carried out up to Nov 2015 for randomized controlled trials (RCTs) with NIV as cases and standard oxygen therapy as controls. Risk ratios and weight mean difference were used for estimation. RESULTS: This meta-analysis included seventeen RCTs. Results showed NIV significantly reduced the intubation rate, length of ICU stay and hospital mortality. The length of hospital stay and ICU mortality were not different. High heterogeneity was found across the studies of intubation rate. The types of acute respiratory failure might be a source of heterogeneity. CONCLUSION: Our results suggest that NIV is effective for ALI in reducing the intubation rate, hospital mortality and length of ICU stay than the standard oxygen therapy.

Identification of differentially expressed genes associated with burn sepsis using microarray.

The aim of the present study was to identify the potential target biomarkers associated with burn sepsis using microarray. GSE1781 was downloaded from Gene Expression Omnibus and included a collective of three biological replicates for each of the three conditions: Sham­Sham, Sham­cecal ligation and puncture (CLP) and Burn­CLP. Subsequently, limma was applied to screen the differentially expressed genes (DEGs). Additionally, functional annotations were predicted by pathway enrichment. Furthermore, the transcription factors were screened according to the transcriptional regulation from patterns to profiles database. Furthermore, the interaction associations of the proteins were obtained from the STRING database and the protein­protein interaction (PPI) network was constructed using Cytoscape. Finally, the gene co­expression analysis was conducted using CoExpress. In total, compared with Sham­Sham, a total of 476 DEGs and 682 DEGs were obtained in Sham­CLP and Burn­CLP, respectively. Additionally, 230 DEGs were screened in Burn­CLP compared with Sham­CLP. Acadm, Ehhadh and Angptl4 were significantly enriched in the PPAR signaling pathway. Additionally, Gsta3, Gstm2 and Gstt1 in Burn­CLP were significantly enriched in glutathione metabolism. In the PPI network, the transcription factor Ppargc1a interacted with Angptl4, while Acadm interacted with Ehhadh. The gene co­expression analysis showed that Ehhadh could be co­expressed with Aqp8. In conclusion, Acadm, Ehhadh, Aqp8, Gsta3, Gstm2, Gstt1, Ppargc1a and Angptl4 may be potential target genes for the treatment of burn sepsis.

Gene expression profile analysis of ventilator-associated pneumonia.

Based on the gene expression profile of patients with ventilator-associated pneumonia (VAP) and patients not affected by the disease, the present study aimed to enhance the current understanding of VAP development using bioinformatics methods. The expression profile GSE30385 was downloaded from the Gene Expression Omnibus database. The Linear Models for Microarray Data package in R language was used to screen and identify differentially expressed genes (DEGs), which were grouped as up­ and down­regulated genes. The up­ and downregulated genes were functionally enriched using the Database for Annotation, Visualization and Integrated Discovery system and then annotated according to TRANSFAC, Tumor Suppressor Gene and Tumor Associated Gene databases. Subsequently, the protein­protein interaction (PPI) network was constructed, followed by module analysis using CFinder software. A total of 69 DEGs, including 33 up­ and 36 downregulated genes were screened out in patients with VAP. Upregulated genes were mainly enriched in functions and pathways associated with the immune response (including the genes ELANE and LTF) and the mitogen-activated protein kinase (MAPK) signaling pathway (including MAPK14). The PPI network comprised 64 PPI pairs and 44 nodes. The top two modules were enriched in different pathways, including the MAPK signaling pathway. Genes including ELANE, LTF and MAPK14 may have important roles in the development of VAP via altering the immune response and the MAPK signaling pathway.

Identification of crucial genes in ventilator associated pneumonia through protein-protein interaction network.

PURPOSE: Ventilator-associated pneumonia (VAP) is still an important cause of morbidity and mortality in patients receiving mechanical ventilation. This research aimed to investigate the genes related to VAP and potential diagnosis targets. MATERIALS AND METHODS: Gene expression profiles data of GSE30385 were downloaded from Gene Expression Omnibus, which included 10 samples of patients with VAP and 10 samples of patients without VAP. The differentially expressed genes (DEGs) between two types of patients were identified by limma package and the functions and pathways of DEGs were predicted by Gene Ontology and KEGG pathway enrichment analyses. Next, the protein-protein interaction (PPI) pairs of all genes in the samples were obtained from STRING database. Then we searched genes related to VAP in NCBI, and constructed a PPI network of these genes. Subsequently, the overlapped genes between genes in the PPI network and DEGs were searched, followed by expression patterns analysis. Furthermore, genes in PPI network were subjected to function and pathway enrichment analysis, and transcription factors were screened on the basis of TRANSFAC database. RESULT: A total of 69 DEGs were screened between two types of patient samples, and 7 genes related to VAP were obtained. The overlapped genes (e.g. LTF, MAPK14) were enriched in MAPK cascade and immune system-related processes. In addition, MAPK14 was enriched in MAPK signaling pathway. CONCLUSION: The VAP-related genes (MAPK14 and LTF) might be the crucial genes in the pathogenesis of VAP, and be served as potential diagnostic targets.