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Objective:To compare the hemostatic effects and patient comfort of different compression methods for hemostasis after transradial coronary intervention.Methods:A total of 160 patients who received transradial coronary intervention in The Affiliated Hospital of Hangzhou Normal University from October 2018 to February 2020 were included in this study. In group A ( n = 80), patients underwent spiral compression at the puncture point (release for 1 turn at 2 hours after surgery, rotation for 1 circle after 1 hour, and full decompression). In group B ( n = 80), patients underwent spiral compression at the puncture point (release for 1 turn at 2 hours after surgery, rotation for 1 circle after 2 hours, and full decompression). Percutaneous arterial oxygen saturation value in the affected limb, heart rate, and Visual Analog Scale score at different times after surgery, pain and comfort score at 2 and 12 hours post-surgery were compared between the two groups. Results:Percutaneous arterial oxygen saturation value at 4 and 12 hours post-surgery in group A was (96.6 ± 0.7)% and (97.8 ± 0.5)%, respectively, which was significantly higher than that in group B [(96.2 ± 0.6)%, (97.6 ± 0.7)%, t = 3.88, 2.08, both P < 0.05]. There were no significant differences in total score and subscale score of the General Comfort Questionnaire at 2 hours post-surgery between groups A and B (both P < 0.05). At 12 hours post-surgery, scores of psychological and physical subscales and total score of the General Comfort Questionnaire in group A were (23.64 ± 3.02) points, (12.64 ± 2.05) points, (68.25 ± 6.04) points, which were significantly higher than those in group B [(22.20 ± 2.96) points, (11.38 ± 2.47) points, (64.42 ± 6.71) points, t = 3.05, 3.51, 3.79, all P < 0.05]. At 2 hours post-surgery, there was no significant difference in Numerical Rating Scale score between groups A and B ( P > 0.05). At 4 and 12 hours post-surgery, Numerical Rating Scale score in group A was (2.51 ± 0.58) points and (1.75 ± 0.76) points, respectively, which was significantly lower than that in group B [(2.95 ± 0.63) points, (2.31 ± 0.71) points, t = -4.59, -4.82, both P < 0.05). The incidence of complications was significantly lower in group A than in group B (8.75% vs. 20.00%, χ2 = 4.11, P < 0.05). Conclusion:Compression for hemostasis is highly effective by releasing for 1 turn at 2 hours after transradial coronary intervention, rotating for 1 circle after 1 hour, and full compression because it can greatly mitigate pain, ensure the oxygen supply to the affected limbs, and improve patient comfort.
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Objective:To explore the impact of mentors' behaviors on the professional identity of medical students during the internship.Methods:Based on the data of the China Medical Students Survey in 2020, a research was conducted on 25 557 medical graduates from 104 universities in China. The Wilcoxon rank-sum test and multiple linear regression were used to analyze the impact of mentors' behaviors on the professional identity of medical students during the internship.Results:More than 70% of medical students believed that the clinical mentors they met during their internship had positive medical and teaching behaviors. If students believed that clinical mentors were enthusiastic, responsible for their work, highlighted role modeling and paid attention to their behaviors in teaching, the scores of professional identity would be 3.027, 0.445, 0.840 and 1.234 points greater than if they did not respectively (all P<0.001). Conclusion:The students have generally good evaluation on mentors' behavior during the internship. The positive medical and teaching behaviors of mentors have a positive impact on the professional identity of medical students and the impact of enthusiasm is the greatest. Medical institutions should provide complete institutional support and standardize the behavior of clinical teachers in order to enhance the professional identity of medical students.
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Objective To explore the inhibitory effect of captopril on acute radiation-induced lung injury in rats and the possible mechanism. Methods Sixty-four female Wistar rats were randomly divided into control group, irradiation group, irradiation+low-dose captopril group, and irradiation+high-dose captopril group. A single dose of 20 Gy was given to the right lung of all rats except those in the control group to establish a rat model of acute radiation-induced lung injury. These rats were sacrificed at 1, 2, 4, and 8 weeks. HE staining was used to observe the pathological changes in lung tissue;RT-PCR and Western blot were used to measure the mRNA and protein expression of CCL-2 in lung tissue;immunohistochemical assay was used to determine the number of monocytes ( CD68 ) in lung tissue. A one-way analysis of variance was performed. Results Captopril significantly reduced lung inflammation in rats with acute radiation-induced lung injury (P<005), inhibited the accumulation of monocytes (CD68) in lung tissue (P<005), and decreased the content of CCL-2 in lung tissue ( P<005 ) . Conclusions For rats with acute radiation-induced lung injury, captopril can reduce the expression of CCL-2 to inhibit the accumulation of monocytes in lung tissue and thus attenuate lung inflammation.
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Objective To explore the inhibitory effect of captopril on acute radiation-induced lung injury in rats and the possible mechanism. Methods Sixty-four female Wistar rats were randomly divided into control group, irradiation group, irradiation+low-dose captopril group, and irradiation+high-dose captopril group. A single dose of 20 Gy was given to the right lung of all rats except those in the control group to establish a rat model of acute radiation-induced lung injury. These rats were sacrificed at 1, 2, 4, and 8 weeks. HE staining was used to observe the pathological changes in lung tissue;RT-PCR and Western blot were used to measure the mRNA and protein expression of CCL-2 in lung tissue;immunohistochemical assay was used to determine the number of monocytes ( CD68 ) in lung tissue. A one-way analysis of variance was performed. Results Captopril significantly reduced lung inflammation in rats with acute radiation-induced lung injury (P<005), inhibited the accumulation of monocytes (CD68) in lung tissue (P<005), and decreased the content of CCL-2 in lung tissue ( P<005 ) . Conclusions For rats with acute radiation-induced lung injury, captopril can reduce the expression of CCL-2 to inhibit the accumulation of monocytes in lung tissue and thus attenuate lung inflammation.
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Maxillary first molar with twin-root canal in palatal side is rare. This article described two cases of maxillary first molar with twin-root canal. A properly designed and prepared access of the cavity is helpful for the diagnosis and negotiation of the root canal morphology.
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Humanos , Cavidad Pulpar , Maxilar , Diente Molar , Tratamiento del Conducto RadicularRESUMEN
ObjectiveTo investigate the molecular response of adult and neonate ovine articular cartilage to acute mechanical injury.MethodsAn established in vitro model was used to compare gene expression difference of ovine articular cartilage explants at different developmental stages 24 hours after mechanical injury and the gene expression was compared between these models and that of the uninjured controls by microarray analysis.Total RNA was isolated from the tissue samples,linearly amplified,and applied to a 15 208 Ovine probes cDNA microarray(Agilent).Validation for selected genes(PPARγ,GRO TNC and LDHA) was obtained by real-time polymerase chain reaction.Comparisons between groups were performed by variance analysis.ResultsThere was significant difference in gene expression in adult and neonatal ovine articular cartilage after mechanical injury.Eighty-six genes were significantly manipulated at least 2-fold following mechanical injury for neonate sheep and 83 genes for adult sheep (P<0.05).Conclusion Our findings indicate that mechanical injury to adult and neonatal ovine articular cartilage results in the activation of a series of signaling responses.We could identify four significant genes that are up or downregulated in response to acute mechanical injury.Significant functional clusters including genes associated with wound healing,articular protection,repair integration,and energy metabolism.Of these,PPARG could be specifically identified as novel target molecules and potential chondroprotective agent involved in traumatic cartilage injury and cartilage integrated repair.
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s-thanatin, an analogue of thanatin, was synthesised by substituting the fifteenth amino acid threonine with serine and showed broad antimicrobial activity against Gram-negative and Gram-positive bacteria. To evaluate its antimicrobial activity against a multidrug-resistant (MDR) clinical isolate as well as its anti-endotoxin activity, its lipopolysaccharide (LPS)-binding and -neutralising activity in vitro and its therapeutic efficacy in an experimental model of septic shock caused by a MDR clinical isolate of Escherichia coli were studied. The ability of s-thanatin to bind or neutralise LPS from E. coli O111:B4 was determined using a quantitative assay kit. Male ICR mice were given an intraperitoneal (i.p.) administration of 2x10(10) colony-forming units of E. coli E79466. Following bacterial challenge, all animals were randomised to receive i.p. administration of saline, 40mg/kg ceftazidime (CAZ), or 40mg/kg CAZ+s-thanatin (10, 20 or 40mg/kg). The results showed that s-thanatin not only completely bound to the LPS (median effective concentration of 17.5microg/mL) but also improved the survival and reduced the number of inoculated bacteria in a mouse model of septic shock. s-thanatin may be an attractive candidate to develop as an anti-MDR bacterial agent.
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Péptidos Catiónicos Antimicrobianos/metabolismo , Péptidos Catiónicos Antimicrobianos/uso terapéutico , Infecciones por Escherichia coli/tratamiento farmacológico , Lipopolisacáridos/antagonistas & inhibidores , Péptidos Cíclicos/metabolismo , Péptidos Cíclicos/uso terapéutico , Choque Séptico/tratamiento farmacológico , Sustitución de Aminoácidos/genética , Animales , Líquido Ascítico/microbiología , Sangre/microbiología , Recuento de Colonia Microbiana , Farmacorresistencia Bacteriana Múltiple , Endotoxinas/sangre , Escherichia coli/efectos de los fármacos , Inyecciones Intraperitoneales , Masculino , Ratones , Ratones Endogámicos ICR , Viabilidad Microbiana , Péptidos Cíclicos/administración & dosificación , Péptidos Cíclicos/genética , Unión Proteica , Análisis de SupervivenciaRESUMEN
DNA microarray generally refers to gene chips. Its basic principle is that a large number of oligonucleotide molecules were fixed on the support, and then hybridized with the labeled samples, and then the chip hybridization signal strength was scanned to determine the number of target in the samples. Gene chips can trace the nucleotide sequence in the samples for testing and analyzing. Its characteristics of high-throughput,rapid and parallel acquisition of biological information are better than that of other traditional gene detection technology. It has been widely used in various fields of medical research. This article reviews the application of DNA microarray technology in the study of orthopedics including biological characteristics, formation and development,injury and repair, degeneration and regeneration of articular cartilage.
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Objective To observe the effect of LIGHT on synovial macrophage-osteoclast difier entiation in rheumatoid arthritis.Methods Synovial macrophages were collected from 8 synovial tissues har vested from RA patients by digestion with conagenase.The macrophages from each patient were divided into 5 subgroups:group 1 was co-cultured with Macrophage Colony Stimulating Factor(MCSF).group 2 was co cultured with MCSF and LIGHT.group 3 was co-cultured with MCSF and Receptor activator for Nuclear Fac tor kB ligand(RANKL),group 4 was co-cultured with MCSF and LIGHT and RANKL group 5 was co-cul tared with LIGHT.After two weeks of culture.tartrate resistant acid phosphatase(TRAP)and F-actin staining were used to detect the formation of osteoclast on cover slip(CS).Functional evidence of osteoclasts was as sessed by the formation of resorption pits ou dentine slice(DS).Results TRAP and F-actin were both nega tive in group 1 and group 5 and no pit on dentine slice could be observed.In group 2.there were some small round and ovoid osteoclasts with TRAP(+)and F-actin(+).Pits on DS were small and discrete.In group 3. there were many large irregular osteoclasts with TRAP(++)and F-actin(++).The number and volume of pits were both increased.In group 4.there were even more and larger osteoclasts with TRAP(+++)and F-actin (+++).The pits were even larger and became confluent,ie,pits(++++).Conclusion LIGHT can promote RANKL-mediated osteoclastogenesis in RA synovial macrophages.and it can induce osteoclast formation through a mechanism independent of RANKL.
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[Objective]To explore the effect of external fixator combined with vaccum sealing drainage(VSD) for the treatment of infection after internal fixation in tibial and fibular fracture.[Method]Thirty-six patients with infection after internal fixation in tibial and fibular fracture were treated by external fixator combined with VSD from June 2004 to June 2008.[Result]During the following-up period from 8-30 months in thirty-two patients,the infection in all cases were controlled effectively,no case of recurrence was found in all patients,and satisfactory healing were found in 32 cases.The average time of fracture union were 4.5 months;the removal time of external fixation were 5 months on average.[Conclusion]The combined operative procedure is simple,reliable and less traumatic and allow to early functional exercises.Therefore,it is a satisfactory measure for the infection after internal fixation in tibial and fibular fracture.
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Objective To study the primary volume of bone cement and the method of perfusion and the clinical effect of percutaneous vertebroplasty for bone metastatic tumors. Methods Percutaneous vertebroplasty was performed in 218 vertebral bodies of total 150 patients,including 92 males and 58 females with age of 26-85,averaging 56.8 y. 218 vertebral bodies included 73 dorsal vertebra and 138 lumber vertebra and 7 sacral vertebra. Operations were taken under the DSA monitoring. The approach route was selected according to the morphology of the vertebrae,damage extent and puncture site. Results Operation was successful in all 218 vertebrae of total 150 patients with a ratio of 100%. The primary volume of bone cement needed to fill dorsal vertebra was 2-5 ml,average 3.5 ml; that for lumber vertebra was 3-8 ml,average 5.5 ml; and that for sacral vertebra was 4-7,average 5.5 ml. 134 patients showed total pain relief (89.3%); 15 patients had partial remission (10%) and 1 failure (0.7%). The cement extravasated to intervertebral disk in 12 patients,to scleromeninx capsula externa in 10,to para-vertebra plexus venosus in 3 and to paravertebra soft tissue in 4. The incidence of leakage of bone cement was 13.3%,but no complications occurred during and after the operation. Concolusion Percutaneous vertebroplasty provides obvious pain relief effect for vertebral metastasis,worthy to be recommended widely in clinical application.
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Objective To investigate the efficacy of transcutaneous injection of MIIGX3 artificial bone and methylprednisolone for recurrent bone cysts.Methods From January 2004 to March 2006,a total of 13 children with recurrent bone cysts received transcutaneous injection of methylprednisolone and MIIGX3 in our hospital.X-ray was employed to detect the degradation of MIIGX3 and formation of new bones.Results The operation time ranged from 30 to 95 minutes(mean 42 minutes).The patients were followed up for 1 to 3 years.None of them had recurrence of bone cysts during this period.The artificial bones were completely degraded and replaced by new bones in 1.5 years after the injection.Conclusions Transcutaneous injection of methylprednisolone and MIIGX3 is effective for recurrent bone cysts.Patients have shorter operation time and hospital stay after this treatment because the procedure is microinvasive.
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Objective To evaluate the mid- and long-term results of coronary artery bypass grafting (CABG) in patients with severe left ventricular systolic dysfunction. Methods Between January 1988 and December 2002, 34 cases with left ventricular ejection fraction (LVEF) less than 0.30 underwent CABG. They were aged 41 to 73 years [mean, (58.0?9.4) years], and 30 of them were male. Coronary angiography revealed LVEF was 0.15 to 0.30(mean, 0.27?0.04), and triple-vessel disease in 31 cases, and left main stem disease in 4. Preoperative echocardiographic examinations revealed a mean of left ventricular diastolic dimension (LVDD) (61.5?8.9) mm and LVEF 0.28?0.07. New York Heart Association (NYHA) class was (2.9?0.7). Off-pump CABG was performed in 8 cases. The number of grafts used ranged from 2 to 6 (3.9?0.9). 32 patients (94.1%) were followed up for 3.5 years (with 7.2 years maximum). Results No patients died in hospital. Heart failure as the main postoperative complications were observed in 5 (14.7%) patients. Postoperative echocardiographic examinations revealed a mean LVDD of (55.2?7.1) mm and LVEF of 0.47?0.11. NYHA class was1.9?0.3 postoperatively. In the follow-up period [mean (3.5?1.9) years], 3 patients died. The survival rates were 91.9% at 3 years and 85.7% at 5 years. Functional status improved significant in left ventricular end-diastolic diameter and left ventricular ejection fraction. There was significant improvement in mean NYHA from class 2.9?0.7 to 1.4?0.6 postoperatively. 26 survivors (81.3%) are free of angina. Conclusion Observations suggest that CABG may offer a better quality of life in patients with poor ventricular systolic function in mid- and long-term follow-up. Preoperative management was the key point of the survival advantage.
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0.05).Conclusions After hepatectomy,in rats is associated with an obvious insulin resistance,mainly due to the level of serum insulin was obviously decreased(P