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Objective:To explore the changes and influencing factors of psychological distress in patients with primary acute myocardial infarction (AMI) in different periods, and to provide reference for the management of psychological distress in patients with primary AMI.Methods:This was a longitudinal, prospective, observational study. From June 2021 to September 2022, 118 patients with primary AMI in Peking Union Medical College Hospital and Peking University First Hospital were selected as the research objects. The psychological distress level of patients was investigated on the points of 24 hours after illness (T 1), before discharge (T 2), 1 month after discharge (T 3), 3 months after discharge (T 4), 6 months after discharge (T 5) and 12 months after discharge (T 6), and the influencing factors were analyzed. Results:The detection rate of psychological distress in 6 follow-up survey nodes was 66.95% (79/118), 48.31% (57/118), 29.66% (35/118), 24.58% (29/118), 19.49% (23/118) and 15.25% (18/118) respectively. Education level, family per capita income and disease awareness had significant effects on the psychological distress of patients with primary AMI at the time points from T 1 to T 6 ( β values were - 1.262 to - 0.212, all P<0.05). Conclusions:The level of psychological distress in primary AMI patients decreased with time. Nursing staff should pay attention to the trajectory and influencing factors of psychological pain, and formulate targeted intervention measures to reduce the level of psychological pain and promote the comprehensive rehabilitation of patients.
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Background: Pembrolizumab is a guideline-recommended, both first- and second-line treatment option for microsatellite-instability-high (MSI-H)/mismatch repair-deficient (dMMR)advanced colorectal cancer patients. The aim of the present study is to investigates the health and economic outcomes of three treatment strategies with or without pembrolizumab in MSI-H/dMMR advanced colorectal cancer to define the best treatment strategy from the perspective of the US payer. Methods: A microsimulation model was developed to estimate the cost and effectiveness of three treatment strategies: 1) pembrolizumab used as first-line, 2) pembrolizumab used as second-line and, 3) chemotherapy. Life years (LYs), quality-adjusted LYs (QALYs) and lifetime costs were estimated. Results: The model projected that patients receiving pembrolizumab in the first-line setting gained 5.579 QALYs; this value was 1.501 and 3.941 QALYs more than that for patients receiving pembrolizumab in the second-line setting and chemotherapy, respectively. First-line pembrolizumab strategy dominated second-line pembrolizumab strategy. Compared with chemotherapy, first-line pembrolizumab strategy yielded an incremental cost of $50613.7, which resulted in an ICER of $13441 per QALY. Conclusion: For patients with MSI-H/dMMR advanced colorectal cancer, reserving pembrolizumab for second-line line use is dominated by its first-line use, and first-line use of pembrolizumab is cost-effective compared with chemotherapy.
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Objective:To promote the application of the best evidence in the prevention of venous thrombosis in patients with lung cancer in thoracic surgery, so as to improve the nursing management, elevate the nursing quality and reduce the incidence of venous thrombosis.Methods:High quality literature guidelines related to perioperative venous thromboembolism prevention of lung cancer were searched and screened, and the evidence was extracted. Combined with clinical background, nursing strategies were generated through expert demonstration meetings and used as clinical review indicators. On the basis of evidence-based i-PARIHS as the theoretical framework, through the establishment of core groups, removal of existing obstacles, education and training and quality control, the evidence was applied to the clinical practice effectively, and the data were collected by means of on-the-spot observation and consulting cases, and the effect of evidence application was evaluated from the three aspects including system, nurses and patients.Results:Systemically speaking, in the process of evidence application, the department established the standards and procedures for perioperative venous thromboembolism prevention of lung cancer patients, improved thrombus risk assessment tools, made educational materials, brought thrombus prevention into the scope of quality control, and optimized the organizational environment with full consideration of manpower and materials. For nurses, after the application of evidence, the scores of nurses' knowledge, attitude and practice of venous thromboembolism prevention were (17.6 ± 1.8), (17.4 ± 1.8), (18.8 ± 1.2), (53.8 ± 2.9) respectively, which were higher than those before the application of evidence (12.0 ± 2.9), (14.5 ± 2.8), (11.6 ± 2.7), (38.3 ± 5.1), the differences were significant ( t values were -11.40 - -3.90, all P<0.05). For patients, the incidence of venous thromboembolism before the application of evidence was 4.7% (19/403), and venous thromboembolism after the application of evidence was 0 (0/118), and the difference was statistically significant ( χ2 value was 5.774, P<0.05). Conclusions:The best evidence of perioperative venous thromboembolism of lung cancer on the basis of evidence-based is of great scientificity. Its application on clinical practice could effectively optimize the systematic organizational environment, standardize nursing behavior, improve nursing quality, and reduce the occurrence of venous thromboembolism in patients with lung cancer surgical procedures.
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The ongoing COVID-19 epidemic worldwide necessitates the development of novel effective agents against SARS-CoV-2. ACE2 is the main receptor of SARS-CoV-2 S1 protein and mediates viral entry into host cells. Herein, the membrane nanoparticles prepared from ACE2-rich cells are discovered with potent capacity to block SARS-CoV-2 infection. The membrane of human embryonic kidney-239T cell highly expressing ACE2 is screened to prepare nanoparticles. The nanomaterial termed HEK-293T-hACE2 NPs contains 265.1 ng mg-1 of ACE2 on the surface and acts as a bait to trap SARS-CoV-2 S1 in a dose-dependent manner, resulting in reduced recruitment of the viral ligand to host cells. Interestingly, SARS-CoV-2 S1 can translocate to the cytoplasm and affect the cell metabolism, which is also inhibited by HEK-293T-hACE2 NPs. Further studies reveal that HEK-293T-hACE2 NPs can efficiently suppress SARS-CoV-2 S pseudovirions entry into human proximal tubular cells and block viral infection with a low half maximal inhibitory concentration. Additionally, this biocompatible membrane nanomaterial is sufficient to block the adherence of SARS-CoV-2 D614G-S1 mutant to sensitive cells. Our study demonstrates a easy-to-acheive memrbane nano-antagonist for curbing SARS-CoV-2, which enriches the existing antiviral arsenal and provides new possibilities to treat COVID-19. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=182 SRC="FIGDIR/small/247338v1_ufig1.gif" ALT="Figure 1"> View larger version (81K): org.highwire.dtl.DTLVardef@4086baorg.highwire.dtl.DTLVardef@4d239eorg.highwire.dtl.DTLVardef@5d8b76org.highwire.dtl.DTLVardef@16f2581_HPS_FORMAT_FIGEXP M_FIG Graphical Table of Contents C_FIG
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The burgeoning epidemic caused by novel coronavirus 2019 (2019-nCoV) is currently a global concern. Angiotensin-converting enzyme-2 (ACE2) is a receptor of 2019-nCoV spike 1 protein (S1) and mediates viral entry into host cells. Despite the abundance of ACE2 in small intestine, few digestive symptoms are observed in patients infected by 2019-nCoV. Herein, we investigated the interactions between ACE2 and human defensins (HDs) specifically secreted by intestinal Paneth cells. The lectin-like HD5, rather than HD6, bound ACE2 with a high affinity of 39.3 nM and weakened the subsequent recruitment of 2019-nCoV S1. The cloak of HD5 on the ligand-binding domain of ACE2 was confirmed by molecular dynamic simulation. A remarkable dose-dependent preventive effect of HD5 on 2019-nCoV S1 binding to intestinal epithelial cells was further evidenced by in vitro experiments. Our findings unmasked the innate defense function of lectin-like intestinal defensin against 2019-nCoV, which may provide new insights into the prevention and treatment of 2019-nCoV infection.
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PURPOSE: The significance of neuroendocrine differentiation (NED) in gastric carcinoma (GC) is controversial, leading to ambiguous concepts in traditional classifications. This study aimed to determine the prognostic threshold of meaningful NED in GC and clarify its unclear features in existing classifications. MATERIALS AND METHODS: Immunohistochemical staining for synaptophysin, chromogranin A, and neural cell adhesion molecule was performed for 945 GC specimens. Survival analysis was performed using the log-rank test and univariate/multivariate models with percentages of NED (PNED) and demographic and clinicopathological parameters. RESULTS: In total, 275 (29.1%) cases were immunoreactive to at least 1 neuroendocrine (NE) marker. GC-NED was more common in the upper third of the stomach. PNED, and Borrmann's classification and tumor, lymph node, metastasis stages were independent prognostic factors. The cutoff PNED was 10%, beyond which patients had significantly worse outcomes, although the risk did not increase with higher PNED. Tumors with ≥10% NED tended to manifest as Borrmann type III lesion with mixed/diffuse morphology and poorer histological differentiation; the NE components in this population mainly grew in insulae/nests, which differed from the predominant growth pattern (glandular/acinar) in GC with <10% NED. CONCLUSIONS: GC with ≥10% NED should be classified as a distinct subtype because of its worse prognosis, and more attention should be paid to the necessity of additional therapeutics for NE components.
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Humanos , Adenocarcinoma , Cromogranina A , Clasificación , Inmunohistoquímica , Ganglios Linfáticos , Metástasis de la Neoplasia , Moléculas de Adhesión de Célula Nerviosa , Pronóstico , Estómago , Neoplasias Gástricas , SinaptofisinaRESUMEN
Cardiovascular disease is one of the main causes for women death .However ,cognition of CVD risk is rel‐atively low in women .After treatment ,patients with acute coronary syndrome (ACS) still possess risk of heart fail‐ure and death .As a secondary prevention program ,cardiac rehabilitation (CR ) helps to reduce ACS risk .Though CR participation possesses significant benefits ,utilization rate of CR remains low in ACS female patients .The pres‐ent article mainly described therapeutic current condition of ACS female patients and known benefits of CR for women ,and explore CR utilization rate in female patients and methods to improve utilization rate .
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A lot of evidence have proved that low level of cardiopulmonary fitness (i.e.functional capacity ) is related to high risk of cardiovascular diseases (CVD) ,high all‐cause mortality and high mortality of cancer .Cardiopulmonary fitness low level combined traditional risk factors can improve risk prediction for CVD .The present article aimed at reviewing cur‐rent knowledge about correlation among CVD ,other diseases and cardiopulmonary fitness ,improving people's consciousness for impact of cardiopulmonary fitness on risk prediction in order to optimize prevention and treatment of diseases .
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Objective To investigate whether elevated parathyroid hormone (PTH) levels could induce endothelial - to - mesenchymal transition (EndMT) and adipocyte transition in endothelial cells (ECs), and to determine the possible underlying mechanism. Methods (1) A rat model of secondary hyperparathyroidism and chronic kidney disease (CKD) was established. The adiposity in bone marrow was detected by oil red O staining. Immunofluorescence staining was performed to detect the expression and localization of cluster of differentiation 31 (CD31) and fibroblast-specific protein 1 (FSP1). (2) The human umbilical vein ECs were cultured in vitro. Western blotting was performed to detect protein expressions of EndMT-related markers CD31, FSP1 and α-smooth muscle actin (α-SMA) in interference groups with different PTH concentrations (0, 10-11, 10-9, 10-7 mol/L PTH for 48 h) and times (0, 12, 24, 48 h, 10-7 mol/L PTH), as well as the expression of β-catenin in interference groups with different PTH concentrations. The localizations of CD31, FSP1 and β - catenin were observed by cell immunofluorescence. Protein expressions of adipocytes markers peroxisome proliferator - activated receptor-γ (PPAR-γ) and CCAAT/enhancer binding protein-α (C/EBP-α) by Western blotting and the degree of adipogenesis by oil red O staining were detected after transformed ECs were cultured in adipogenic culture medium for one week. Small interfering RNA (siRNA) was performed to silenceβ - catenin expression. ECs were divided into control siRNA group, β - catenin siRNA group, PTH +control siRNA group and PTH+β-catenin siRNA group. Protein expressions of CD31, FSP1 and PPAR-γby Western blotting and the degree of adipogenesis by oil red O staining were determined. Results (1) In vivo, compared with the control, CKD rats had increased adipocytes in bone marrow (P<0.05), and the co-expression of CD31 and FSP1 in bone marrow ECs. (2) In vitro, PTH significantly inhibited the expression of endothelial marker CD31 and increased the expressions of mesenchymal markers FSP1 and α-SMA in concentration-and time-dependent manners. These indexes in 10-7 mol/L PTH group and 0 mol/L PTH group, in 48 h group and 0 h group showed statistical differences (all P<0.05). In PTH group ECs with 10-7 mol/L PTH for 48 h showed FSP1 accumulation in the cytoplasm and reduced expressions of CD31, and ECs had higher expressions of PPAR-γ and C/EBP-α as well as the degree of adipogenesis than those in control group (all P<0.05). Furthermore, PTH enhanced the nuclearβ-catenin protein levels in ECs in concentration-dependent. The expressions of β-catenin in 10-7 mol/L PTH group and 0 mol/L PTH group showed statistical differences (P<0.05). β - catenin expressed in the cytoplasm in control group, while it enter into the nucleus in PTH group. Compared with those in PTH+control siRNA group, the expressions of CD31 and PPAR-γ as well as the degree of adipogenesis decreased in PTH+β-catenin siRNA group (all P<0.05), while the expression of FSP1 increased (P<0.05). Conclusions PTH induces ECs - to - adipocytes transition by the canonical Wnt/β - catenin signaling pathway, which might account for bone loss in CKD. Silenced β - catenin expression can inhibit PTH-induced EndMT and adipogenesis.
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Heart rate variability (HRV) is an important point to judge a person's state in modern medicine. This paper is aimed to research a person's fatigue level connected with vagal nerve based on the HRV using the improved Welch method. The process of this method is that it firstly uses a time window function on the signal to be processed, then sets the length of time according to the requirement, and finally makes frequency domain analysis. Compared with classical periodogram method, the variance and consistency of the present method have been improved. We can set time span freely using this method (at present, the time of international standard to measure HRV is 5 minutes). This paper analyses the HRV's characteristics of fatigue crowd based on the database provided by Physio-Net. We therefore draw the conclusion that the accuracy of Welch analyzing HRV combining with appropriate window function has been improved enormously, and when the person changes to fatigue, the vagal activity is diminished and sympathetic activity is raised.
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Humanos , Fatiga , Diagnóstico , Frecuencia Cardíaca , Análisis de RegresiónRESUMEN
Objective To investigate the expressions of Nanog and Oct4 (stem cell transcription factors) in endometriosis and adenomyosis, and to explore their potential functions in the development of endometriosis and adenomyosis. Methods The expressions of Nanog and Oct4 in the ectopic and eutopic endometrium of 50 patients with endometriosis and/or adenomyosis (ectopic endometrium group and eutopic endometrium group), and 21 patients free from endometriosis and adenomyosis (control group) were detected by immunohistochemical SABC methods. Statistical analysis was conducted for the correlation between the expressions of Nanog and Oct4 based on patients′ clinical pathological parameters. Results Nanog and Oct4 protein expressions in ectopic endometrium group were higher than that in control group (P 0.05); there was positive correlation between the expressions of Nanog and Oct4 in ectopic endometrium group (r = 0.590, P < 0.01). Conclusion Nanog and Oct4 present high expression in eutopic and ectopic endometrium , which may play a important role in the development of endometriosis and adenomyosis.
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Objective:To detect changes in mitochondrial membrane potential after sperm mother cell damage induced by bisphenol A by laser scanning confocal microscopy(LSCM) and underline its potential action mechanism.Methods: The cultured spermatogenic cells were divided into 3 groups, respectively. Then 0, 10μmol/L, 100μmol/L of Bisphenol A(BPA) were added into the culture, after 3 hours culture, fluorescence probe JC-1 was used to lable the three groups. The fluorescence intensity of JC-1 in mitochondrial was then detected by LSCM. LSCM software was used to analyze the fluorescence intensity. Change of the mitochondrial membrane potential was represented by the change of fluorescence colors (relative proportion of red and green fluorescence is commonly used to measure mitochondrial depolarization ratio). Results:The ratio between the red and green fluorescence in the control group, low dose group and high dose group had significant difference. Intracellular mitochondrial membrane potential of Bisphenol A treatment group was lower than that of the control group, while mitochondrial membrane potential of high dose group was lower than that of the low dose group. Conclusion: Bisphenol A could damage spermatocytes, and as the dose increased, the more serious the injury. The method could real-time monitor with high sensitivity the change of intracellular mitochondrial membrane potential.
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A new method was developed for the determination of 11 fat_soluble vitamins ( A, D, E and K) and its derivatives in vitamin tablets by ultra performance convergence chromatography ( UPC2 ) . The mobile phase was the mixture of supercritical CO2 and acetonitrile at a flow rate of 1 mL/min. The separation was carried out on the Waters Acquity UPC2 HSS C18 SB 100 mm × 3. 0 mm i. d. , 1. 8 μm column. The UV detector was set at a wavelength of 284 nm. The limits of detection ( LOD) were 1. 5-2. 0 mg/L, and the calibration linear for VK1 , VK2 , VK3 and VB3 was 3-300 mg/L, linear for VA, VA palmitate, VA formic acid, VE, VE acetate, VD2 and VD3 was 5-300 mg/L, respectively. Its spiked recoveries were 97. 31%-98. 76%, and the relative standard deviations ( RSDs) were 0. 41%-0. 96%. The method is applicable for the determination of fat_soluble vitamins ( A, D, E and K) and Their derivatives in vitamin tablets.
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A method was developed for the determination of bifenthrin in tea by ultra performance convergence chromatography ( UPC2 ) . The samples were extracted with petroleum ether and cleaned up with Waters Sep-Pak:Carbon NH2 , and then detected by UPC2 . The mobile phase was the mixture of supercritical CO2 and acetonitrile at a flow rate of 1. 5 mL/min. The separation was conducted on a column of ACQUITY UPC2 TM BEH (100 mmí3. 0 mm,1. 7 μm). The UV detector was set at a wavelength of 220 nm. The detection limit was 20 μg/L. The linear range of bifenthrin was 0. 32-10. 30 mg/L. The recoveries ranged from 88. 7% to 98. 2%. The relative standard deviations (RSD) were from 1. 4% to 2. 8%. The result showed that the UPC2 was more efficient, rapid and low-cost than GC-MS. The method can meet the testing requirements of bifenthrin in tea. The efficacy of UPC2 on testing the concentration of bifenthrin in tea was compared with GC-MS based on National Proficiency Testing and the results were satisfactory.
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Objective To compare the difference of prospective memory(PM) between schizophrenia patients and normal people,and to analyze the internal component of prospective memory using multinomial processing tree(MPT) model.Methods 17 schizophrenia patients and 17 age-and education-matched control participants completed an event-based PM task which was embedded within an ongoing computer-based color-matching task.Internal component of prospective memory was analyzed using multinomial processing tree(MPT) model.Results The scores of prospective memory performance in schizophrenia patients and normal controls were (21.83± 2.46) % and (38.81±2.26) %, and the difference was statistically significant (t=2.11, P<0.05).The difference of ongoing task between schizophrenia patients ((75.88±0.43) %) and controls ((71.44±0.45) %) was statistically significant (t=2.79, P<0.05).The reaction time of schizophrenia patients was significantly longer than that of normal controls((2.34±1.41) s vs (1.81± 1.19) s, t=11.24, P< 0.05).The MPT model revealed a significant group difference in the prospective component (0.82 vs 0.97, G2(1)=14.17, P< 0.01) and retrospective component (0.54 vs 0.41 ,G2(1) 14.17, P<0.01).Conclusion The prospective component of event-based prospective memory of schizophrenia patients was lower than normal controls,which may result in the impairment of PM performance.
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BACKGROUND:Acute toxicity in vivo experiments in previous studies has been confirmed that the median lethal dose of chitosan microcapsules is higher than 2 000 mg/kg, but the specific pathogenic mechanism is unclear. OBJECTIVE:To explore the influence of nano chitosan on MC3T3-E1 cellgrowth as a bone substitute material, as wel as the physiological function of rats. METHODS:MC3T3-E1 cells were respectively cultured in Dulbecco’s modified Eagle’s medium with different concentrations of chitosan nanoparticles (0, 10 mg/L, 100 mg/L, 1 g/L, 10 g/L). The absorbance values were determined. Changes in MC3T3-E1 cellmorphology were observed by scanning electron microscope after 24 hours culture. 10 g/L nano chitosan suspension was prepared using PBS. Two different doses of nano chitosan suspension (166.67 and 16.67 mg/kg body weight) with PBS were injected intraperitoneal y into Sprague-Dawley rats, three times a week, for 4 weeks. The control group was injected with equal volume of physiologic saline. Serum biochemical markers were detected to analyze the functions of liver and kidney of rats. Moreover, histopathology slices were observed to evaluate the morphological changes of tissue and inflammatory infiltration. RESULTS AND CONCLUSION:10 mg/L, 100 mg/L, 1 g/L, 10 g/L nano chitosan suspensions were found growth inhibition in MC3T3-E1 cells as compared with the control group (P<0.05). The reunion of chitosan was observed in the cytoplasm of MC3T3-E1 cells by transmission electron microscopy. On the cellsurface, pseudopodia formed, wavy undulating membrane, nucleus degeneration, fragmentation and condensation were found. Compared with the control group, blood urea nitrogen, Na+levels were significantly increased in rats injected with nano chitosan suspension at two dosages, but the K+level in the high concentration group was decreased significantly (P<0.05). cellapoptosis was found in the liver and renal tissue in a dose-dependent manner. It suggests that apoptosis may be the possible mechanism of nano chitosan toxicity, and normal physiological function may be impacted over a certain dose.
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Leptin and its functional receptors play a crucial role in hepatic fibrogenesis.However,the precise mechanisms underlying the profibrogenic action of leptin in the liver has not been well elucidated.There are two different mechanisms at present.Immunity system and some cytokines may act on it.The reseach on the mechanism of leptin offer a new way for the clinical treatment of hepatic fibrosis.