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Objective:By analyzing the cost change trend,internal structure change and main influencing factors of diabetes inpatients'hospitalization expenses,it provides empirical basis for promoting the reform of medical service prices,optimizing the internal structure of hospitalization expenses,effectively controlling hospitalization expenses,and reducing the economic burden of diabetes inpatients.Methods:Using the first page data of medical records of 13 426 diabetes inpatients in the target hospital from 2017 to 2021,it analyzes the structural change of diabetes inpatients'hospitalization expenses by using structural change degree and grey correlation degree methods,and analyzes the influencing factors of hospitalization expenses by using linear regression and BP neural network model.Results:Drug expenses and medical technology expenses are the top two in the proportion of total hospitalization expenses of discharged patients with diabetes,and they account for a large proportion in the total hospitalization expenses.The results of structural change and grey correlation show that drug expenses and medical technology expenses are these two factors that cause changes in the total hospitalization cost structure and have a high correlation with the total hospitalization cost,with a cumulative contribution rate of 90.50%.According to the results of linear regression and neural network model,the length of stay is the most important factor affecting the total cost of hospitalization of diabetes patients,followed by the number of operations/procedures and diagnoses.Conclusion:The internal composition of hospitalization expenses for diabetes patients is unreasonable.The proportion of drug expenses and medical technology expenses is too high.The proportion of medical and nursing expenses reflecting the technical labor value of medical personnel is relatively low.The structure of medical income needs to be further optimized.The length of stay is the most critical factor affecting the hospitalization expenses of diabetes patients.Reasonable control of the length of stay can effectively control the unreasonable growth of medical expenses and reduce the economic burden of diabetes patients.
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Acute respiratory distress syndrome (ARDS) is a clinical syndrome defined by acute onset of hypoxemia and bilateral pulmonary opacities not fully explained by cardiac failure or volume overload. At present, there is no specific drug treatment for ARDS, and the mortality rate is high. The reason may be that ARDS has rapid onset, rapid progression, complex etiology, and great heterogeneity of clinical manifestations and treatment. Compared with traditional data analysis, machine learning algorithms can automatically analyze and obtain rules from complex data and interpret them to assist clinical decision making. This review aims to provide a brief overview of the machine learning progression in ARDS clinical phenotype, onset prediction, prognosis stratification, and interpretable machine learning in recent years, in order to provide reference for clinical.
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Humanos , Hipoxia/complicaciones , Síndrome de Dificultad Respiratoria del Recién Nacido/etiología , Pronóstico , Aprendizaje AutomáticoRESUMEN
The ongoing SARS-CoV-2 pandemic represents a brutal reminder of the continual threat of mucosal infectious diseases. Mucosal immunity may provide robust protection at the predominant sites of SARS-CoV-2 infection. However, it remains unclear whether respiratory mucosal administration of DNA vaccines could confer protective immune responses against SARS-CoV-2 challenge due to the insurmountable barriers posed by the airway. Here, we applied self-assembled peptide-poloxamine nanoparticles with mucus-penetrating properties for pulmonary inoculation of a COVID-19 DNA vaccine (pSpike/PP-sNp). Not only displays the pSpike/PP-sNp superior gene-transfection and favorable biocompatibility in the mouse airway, but pSpike/PP-sNp promotes a tripartite immunity consisting of systemic, cellular and mucosal immune responses that are characterized by mucosal IgA secretion, high levels of neutralizing antibodies, and resident memory phenotype T-cell responses in the lungs of mice. Most importantly, pSpike/PP-sNp completely eliminates SARS-CoV-2 infection in both upper and lower respiratory tracts and enables 100% survival rate of mice following lethal SARS-CoV-2 challenge. Our findings indicate PP-sNp might be a promising platform in mediating DNA vaccines to elicit all-around mucosal immunity against SARS-CoV-2.
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Background China is facing enormous challenges of occupational disease prevention and control and high incidences of occupational diseases. Occupational disease diagnosis is an important part of occupational disease prevention and control. However, the current situation of occupational disease diagnosis service system in China is not optimistic. Relevant national laws, regulations, policies, and plans require to improve the current technical support system of occupational disease diagnosis and treatment, and to establish a sound occupational disease diagnosis, treatment, and rehabilitation network on the foundation of existing medical and health institutions. Objective To analyze the development status and existing problems of occupational disease diagnosis institutions in China, and propose countermeasures and suggestions. Methods All occupational disease diagnosis institutions in China were surveyed by questionnaire using comprehensive census. The Occupational Health Center of the National Health Commission organized the preparation of the questionnaire and the participation of all relevant institutions in the survey. All data collected in the survey were for the year 2020 and available as of December 31, 2020. The questionnaire covered the overall situation, service provided, staffing of certified physicians for providing occupational disease diagnosis, and instruments in selected categories of occupational disease diagnosis institutions. Results As of December 2020, there were 587 occupational disease diagnosis institutions in China; the highest average number of enterprises served by an occupational disease diagnosis institution was 39000, and that of employees served by an occupational disease diagnosis institution was 2.15 million in Chongqing. There were a total of 5809 physicians certified to diagnose occupational diseases in China, with 20.4 doctors per specified occupational disease prevention and treatment hospital, 9.5 doctors per general hospital, and 8.3 doctors per disease control and prevention center. Only 87.7% of the institutions were equipped with digital radiography (DR), 58.1% with computed tomography (CT), and 96.4% with pulmonary function meters; the equipment rate of computed radiography (CR) was only 6.5%, and that of CT was only 14.6% in all-level disease control and prevention centers; 45 disease control and prevention centers were not equipped with any common x-ray machine, CR, DR, or CT. Conclusion In the face of the still serious situation of prevention and treatment of occupational diseases, the overall distribution of institutions is uneven around China, the number of institutions in some regions is relatively insufficient, and the comprehensive capacity of centers for disease control and prevention at all levels needs to be improved. Strengthening comprehensive capacity building of occupational disease diagnosis institutions and training of relevant physicians would be helpful to ensure the accuracy and scientificity of diagnosis. At the national level, further increasing policy guidance and financial input would help occupational disease diagnosis institutions upgrade their techniques and service capacity, and protect workers' occupational health rights.
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Objective To explore and analyze the effect of test paper method and microscopic examination in urine test. Methods A total of 198 patients with urinalysis in our hospital from February 2016 to January 2018 were selected as the study subjects and were randomly divided into the control group and the observation group by drawing lots. The number of patients in each group was 99. The control group was tested by urine test, the observation group was tested by microscopic examination. The results of two test methods were observed and recorded, and comparative analysis. Results The contents of erythrocytes and leucocytes were detected by both methods. There was no significant difference between the two methods in the positive rate, negative rate, false positive rate and false negative rate(P>0. 05). Conclusion The traditional single test of test paper method and microscopic examination can both ensure the basic correctness of the test results in urine test, and there is no significant difference in monitoring results.
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Objective To study the occurrence of acute gastrointestinal injury under different critical status in Pediatric Intensive Care Unit,and to assess the connection between citrulline and acute gastrointestinal injury.To ana-lyze the correlation among serum citrulline and C-reaction protein(CRP),procalcitonin(PCT),creatinine,urea nitro-gen,bilirubin,lactate,albumin.To study the role of citrulline in evaluating the children condition,prognosis and changes in critically ill children.Methods Ninety-six pediatric patients who were critically ill at the Pediatric Intensive Care Unit of the Second Hospital of Lanzhou University were selected,excluding those with primary gastrointestinal diseases and chronic kidney disease.Clinical features were recorded and CRP,PCT,creatinine,urea nitrogen,bilirubin,lactate, and albumin were measured.Serum citrulline concentrations were measured by high performance liquid chromatography in 65 patients with gastrointestinal injury,and sensitivity,specificity and area under the receiver operating characteristic (ROC)curve were calculated.Results The incidence of acute gastrointestinal injuries in non-critical group,critical group,reorganization critical group were 47.06%(16/34 cases),75.00%(36/48 cases),92.86%(13/14 cases) (χ2=11.848,P=0.003).The serum citrulline concentrations of gastrointestinal injury group and non- gastrointesti-nal injury group were(14.655 ± 8.231)μmol/L,(23.522 ± 11.079)μmol/L(t=4.398,P<0.05).The area under ROC of citrulline was 0.079 8.Serum citrulline concentrations increased significantly in infants with very severe gastro-intestinal injury after 3 days of treatment compared with admission[(26. 40 ± 16. 10)μmol/L vs.(14. 40 ± 6.82)μmol/L,t=5.524,P=0.029].The lower serum citrulline levels the children had,the higher mortality was. There were negative correlations among serum citrullin and CRP,PCT and length of hospital stay(r = -0. 319,-0.299,-0.364,P=0.003,0.006,0.001).There were no correlations among serum citrullin and blood urea nitro-gen,lactic acid,albumin,and bilirubin levels.Conclusion The more critically ill children have a higher incidence of acute gastrointestinal injury and the worse the prognosis.Serum citrulline levels may well reflect the extent of acute gas-trointestinal injury and the outcome.Perhaps it can be one of the reliable markers to evaluate the function of gastrointes-tinal and participate in assessing critical condition and prognosis in critical ill children ness.
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Objective To explore the feasibility and repeatability of deltoid muscle volume measurement using MR volume of interest method, and discuss the clinical significance. Methods Seventy-eight subjects'' MR images were retrospectively reviewed including 33 normal shoulders, 22 rotator cuff tear (7 male, 15 female), 12 cases with labrum lesions (11 male, 1 female), and 2 long head of biceps tendon lesions. Routine axial 2D MR images of deltoid muscle were transported into post-processing work station, the matrix of all images were higher than 275 × 336, and the imaging field included the upper and lower margin of the deltoid muscle, and the three dimension shape of muscle was reconstructed by software based on MR volume of interest, then the muscle volume was calculated automatically. This process was independently performed by 2 operators, and operator 1 repeated this process 1 week later. Intra-class correlation coefficient and 95%confidence interval were used to analyze the reliability and repeatability of the measurement. Deltoid muscle volumes of different ages and different pathological processes were compared using stratified sampling method, one-way analysis of variance (ANOVA), least significant difference (LSD) multiple comparison method, and independent-samples t test. Results Three-dimensional shape of deltoid muscle were well demonstrated and corresponded well to the known anatomy. The measurement showed very good inter-and intra-observer consistency (ICC: 0.983 and 0.995, respectively). There were statistical differences in deltoid muscle volume between group A and C [volume:(382.39 ± 38.87) cm3 and (279.15 ± 63.65) cm3;P=0.000], group B and C [volume:(358.49 ± 44.50) cm3 and (279.15 ± 63.65) cm3; P=0.000]. The normal participants were divided by gender into normal group 1 (9 males and 15 females) and normal group 2 (13 males and 1 female) using stratified random sampling method. The deltoid muscle volume of patients with rotator cuff tear was lower than the normal group 1 [volume:(313.21±63.48) cm3 versus (359.08±57.98) cm3;t=-2.562, P<0.05], and there was no statistical difference in deltoid muscle volume between labrum-ligament complex lesions patients and the normal group 2 [volume: (394.28 ± 33.67) cm3 versus (389.30 ± 22.14) cm3; t=0.385, P=0.704]. Conclusions Volume of interest measurement based on routine MR images could evaluate the deltoid muscle volume conveniently and directly, and which could be used as a preferred choice for muscle volume evaluation.
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Based on the holism,the medical and health care model of the Integrated Traditional Chinese Medicine & Western Medicine is referred that the practitioners who work with the TCM & Western medicine,apply the methods combined westem medicine with TCM to treat patients and health educationfrom the "person-centric" holism.Professor Ka-Kit Hui,who is the founder of the East and West Medical Center (CEWM) belonged to the University of California,Los Angeles vigorously advocate,and always adhere to the education and clinical.In this paper,we briefly introduced this model.Taking clinical case discussion of CEWM as an example,we focused on and summarized how the team of CEWM applied this model to train the clinical practitioners who would like to work in the Integrated Traditional Chinese Medicine & Western Medicine.Through this paper,we hope we could get some useful references for the education of Chinese integrated traditional Chinese medicine & westem medicine practitioners.
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BACKGROUND: Recurrent aphthous stomatitis (RAS) is one of the most common chronic oral diseases with morbidity ranging from 5% to 20%. The pathogenesis is still not fully understood though immune dysregulation and local trauma have been implicated and the curative effect that can be achieved through current therapy is mainly to alleviate the pain. So, the understanding of its molecular mechanisms can allow the prevention and treatment of RAS at the molecular level. METHODS: 14 normal tissues and 14 ulcerated tissues were subjected to Affymetrix Human Genome U133 Plus 2.0 Array transcriptome analysis. Then, Gene Set Expression Analysis and Gene Pattern tools were carried out to determine the gene expression differences between normal and ulcerated tissues. qRT-PCR was used to validate the expression level of identified genes in 10 normal and 10 ulcerated tissues. RESULTS: We obtained a total of 1379 DEGs with adjPval < 0.05 and |logFC| > 1 including 1052 up-regulated genes and 327 down-regulated genes. 4 GO terms and 4 KEGG pathways were screened out by comparing the genomewide gene set expression patterns of normal and ulcerated tissues. 7 genes involved in RAS were identified from the VEGF signaling pathway. CONCLUSIONS: Present findings demonstrated that several immune processes have a deep impact on RAS and a number of genes involved in the VEGF signaling pathway may be critical mediators or participators in the pathogenesis of RAS.
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Perfilación de la Expresión Génica/métodos , Análisis de Secuencia por Matrices de Oligonucleótidos , Estomatitis Aftosa/genética , Transcriptoma , Adulto , Estudios de Casos y Controles , Bases de Datos Genéticas , Femenino , Redes Reguladoras de Genes , Estudios de Asociación Genética , Marcadores Genéticos , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Reacción en Cadena en Tiempo Real de la Polimerasa , Recurrencia , Reproducibilidad de los Resultados , Transducción de Señal/genética , Estomatitis Aftosa/diagnóstico , Adulto JovenRESUMEN
Objective To evaluate the safety and efficiency of robot assisted surgery guided by damage control orthopaedics(DCO) in polytraumatised patients with pelvic ring injuries.Methods A retrospective review of the pelvic fracture database was performed.Twenty-six patients who had sustained a pelvic fracture from September 2012 to December 2015 were suitable for robot-assisted minimally invasive internal fixation.They were 17 men and 9 women,aged from 23 to 58 years (average,42.6 years).Their Injury Severity Score(ISS) ranged from 20 to 31 points (average,21.3 years).According to Tile classification,6 cases were type B2,3 type B3,9 type C2 and 8 type C3.Guided by DCO,the vital signs were stabilized by all means and the fractures treated by simple and temporary external fixation before the pelvic and other fractures were managed by the robot-assisted minimally invasive internal fixation.Demographics,times to operating room (TOR),time from acute stabilization to late definitive internal fixation (TAL),time for bone union,type of robot-assisted surgery for major fractures,length of stay (LOS),postoperative complications and mortality were recorded.The outcomes of the pelvis were evaluated at the final follow-up according to the Matta criteria.Results Of the 26 patients,robot-navigated percutaneous screwing was conducted with 23 sacroiliac screws in 19,with 9 ramus pubicus screws in 9,with 6 supraacetabular screws in 4,and with 4 both-column screws in 2 cases.TOR averaged 2.7 times,TAL 5.9 days,LOS at ICU 2.1 days,ICU admission rate 46.2% (12 of 26),hospital LOS 7.3 days,and time for pelvic bone union 79.0 days.None patients had postoperative complications related to the pelvic fracture and no one died.According to the Matta criteria at the final follow-ups,8 cases were excellent,11 good,5 fair and 2 poor,yielding an excellent and good rate of 73.1%.Conclusion Robot-navigated minimally invasive surgery plus DCO is effective,time saving and safe treatment for polytraumatised patients with pelvic ring injuries.
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Objective To investigate the regularity and predictors of weight loss during concurrent chemo-radiotherapy for nasopharyngeal carcinoma patients. Methods A retrospective study was carried out on 82 patients with nasopharyngeal carcinoma ,with average age of 45 years ,who received concurrent chemoradiotherapy at the Affiliated Cancer Hospital of Guangzhou Medical University. Paired t-test was used to analyze the weight loss pattern during chemoradiotherapy. The Spearman′s rank correlation analysis was used to investigate the correlation between high weight loss(HWL)and the clinical factors. Results The paired t-test showed that the weight of the patients decreased continuously every week during chemoradiotherapy(P 10%). Spearman′s rank correlation analysis showed that HWL was associated with older age,female,higher T and TNM stage,3D-CRT technology,the higher dose of radiotherapy in nasopharynx and in neck lymph node,and decreases of leukopenia and hemoglobin over degree Ⅱ(P<0.05). Conlousions Weight may decrease continuously every week during chemoradiotherapy for nasopharyngeal carcinoma patients. Age,gender,T stage,TNM stage,radio-therapy dose,and leukopenia and hemoglobin decreases may be predictors for weight loss degree during concurrent chemoradiotherapy for nasopharyngeal carcinoma patients.
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Objective:To analyse and discuss the variance and mass spectrometry of proteomics of rats 'lung tissues between groups of normal and simulated cold environments.Methods:A total of 20 SD rats were randomly divided into two groups of normal and simulated cold environments with 10 rats in each group.The temperature of normal environment group was controlled in 21℃ with a fluctuation of 2℃lasting 24 h per day.In contrast, the temperature of simulated cold environment group was controlled in 6℃ with a fluctuation of 2℃lasting 4 h per day while the temperature and humidity for the rest of time were exactly the same as the situation in normal environment group.The preoperative fasting , water-deprivation and weighting were adopted 12 h before anaesthesia to both groups after the continuing 7-day experimentation.Left lung tissues of each rat in both groups were removed by the amount of 10 mg, whereas three random samples from each group were tested by experiments of protein extraction , bidirectional electrophoresis , image analysis and mass spectrometry identification.Results: Given the proteomics analysis of two differential sets , it is indicated that in simulated cold environment group , among nine sorts of protein , four sorts perform rising while five falling compared to that of normal group.Conclusion:There exists a correlation between protein and cold environment based on the results of proteomic analysis .
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Objective:Normal and lung qi deficiency rats of proteomics of lung tissue of rats differentially expressed and mass spectrometry.Methods:A total of 20 SD rats were randomly divided into control group,lung qi deficiency group,with 10 rats in each roup.Lung qi deficiency group model replication using composite method by intratracheal injection of lipopolysaccaride and smoked.All rats in each group before anesthesia 12 hours of fasting,water deprivation,weight after 28 days modeling,Thoracotomy to remove left lung tissue after anesthesia was 10 mg from each rat, 3 rats from each group, using two-dimensional electrophorsis analysis, two-dimensional gel electrophoresis image, peptide mass fingerprinting and electrospray tandem by mass spectrometry to protein identification.Results:2 differntial protin profiles for proteomics analysis,identified 14 protein in rat lung tissue,protein 5 expression, regulation 9 expression.Conclusion:By proteomic analysis,identify the protein have correlation with lung deficiency syndrome.
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Objective To survey aesthetics cognition for smiling beauty in young people smile. Methods Smile model was established. The middle incisor width/length ratio, lateral incisor and middle incisor width ratio, difference of lateral incisor and the middle incisor gingival level, gingiva exposure, buccal corridor width and smile line radian were used as variable values to change respectively. A total of 200 young people were selected to evaluate results. The differences in index of ideal value and acceptable range between different dender groups were calculated. Results The ideal value of middle incisor width/length ratio was 0.75, and acceptable range was 0.65-0.85. The ideal value of lateral incisor and middle incisor width ratio was 0.618, and acceptable range was 0.518-0.718. The ideal value of lateral incisor and the middle incisor gingival level difference was-0.5 mm, and the acceptable range was-1-0 mm. The ideal value of gingiva exposure was 0 mm, and the acceptable range was 0-2 mm. The ideal value of buccal corridor was 0.09, and the acceptable range was 0.05-0.21. Coordinate smile was ideal smile line (value=1), and the acceptable range was 0.5-1. There were no statistically significant differences in smile esthetics of six ideal value indicators and acceptable ranges between different gender groups. Conclusion The ideal values and acceptable ranges of six indexes of quantitative criteria can be used for clinical treatment.
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Objective To investigate the present status of early diagnosis and misdiagnosis of nasopharyngeal carcinoma (NPC). Methods A total of 50 patients diagnosed as NPC were recruited at the department of nasopharyngeal carcinoma in our hospital. The time from that patients felt discomfort to be diagnosed of NPC was determined bydifferent symptoms and signs. Furthermore , the status of misdiagnosis were also investigated. The spearmans rank correlation was used to analyze the correlation between the cancer stage and the time of confirmeddiagnosis , and the relationship between the rate of misdiagnosed and the rank of the hospital they visited. The χ2 test was then used to analyze the cancer stage with the time when they were diagnosed. Results Results indicated that the time when patients were diagnosed significantly correlated with pTNM stage (P < 0.05). Patients diagnosed in one month were most at stage Ⅱ, diagnosed in six months were stage III, and diagnosed after twelve months were stage Ⅳ(P < 0.05). Furthermore, we found that the rate of misdiagnosis of NPC was 12%. Moreover,the misdiagnosed rate was associated with the rank of the hospital patients visited. Discussion In conclusion , the present status of the early diagnosis of NPC is not optimistic. Most of the patients with NPC were misdiagnosed in basic medical institutions , especially in town or village health center. Thus, it is important to popularize the health knowledge about the secondary prevention of NPC and train the doctor in basic medical institutions.
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Objective To identify the role of miR-124 in regulating the radiosensitivity and the epithelial-mesenchymal transition (EMT) of nasopharyngeal carcinoma (NPC). Methods Transient transfection of cells with miR-124 mimic or inhibitor was performed and wound-healing assay was used to investigate the role of miR-124 in the EMT of NPC. The apoptosis affected by miR-124 was also measured after irradiation , followed by investigating the cell proliferation by EdU assay. Finally , proteins of Akt and ERK associated with EMT and radiosensitivity, were measured by western blot. Results The migration index from NPC cell line indicated that miR-124 repressed the EMT. The results from caspase-3 activity assay showed that caspase-3 activity after irradiation significantly increased in miR-124 mimic group compared with the control group (P < 0.01). It was also confirmed that irradiation led to a higher percentage of apoptosis in miR-124 group compared with the control group in NPC cells. Cell proliferation after irradiation was significantly decreased in MiR-124 group as compared with control group . MiR-124 inhibited the protein expression of p-Akt . Conclusion MiR-124 may repress the EMT and decrease radio-resistance of NPC via p-Akt signaling pathway , which may provide a new insight into radio-resistance in NPC.
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Objective The radiotherapy resistance is one of important causes for nasopharyngeal carcinoma(NPC) treatment failure.Junctional adhesion molecule A(JAMA)is closely correlated with the tumor poor prognosis.Thus this experiment is to in vestigate the relationship between JAMA expression and the radiosensitivity of NPC.Methods To overexpress or interfere the JAMA expression in CNE2 and HONE1 cell lines.Then different doses of X-ray were adopted to conduct irradiation.The cell clone formation capacity and cellular apoptosis change were detected after 24 h.The role of JAMA in the NPC radiotherapy was understand.The related signal pathway protein in cell lines with different JAMA expression was detected by Western blot.Results The cell lines with low JAMA expression were more sensitive to radiotherapy:After low JAMA expression,the D0 value in the CNE2 cell line was decreased from 3.26 ±0.78 to 1.92 ± 0.23;the Dq value was decreased from 46.51 ± 4.27 to 32.12 ± 3.19.The radio therapy induced apoptosis was significantly increased in the cell lines with low JAMA expression,after low JAMA expressing,thcellular apoptosis was elevated from 6.9 % ± 0.9 % to 13.7 % ± 1.3 %;the HONE1 cellular apoptosis was elevated from 6.5 % + 1.1 % to 12.3 % ± 1.7%;JAMA overexpression cell lines were significantly decreased.The preliminary mechanism research results showed that JAMA played the effect via Akt signal pathway.Conclusion This research results verifiy that JAMA expression level is closely correlated with the radiosensitivity of NPC cell line:JAMA can increase the radiotherapy resistance of NPC cell lines,which provides a new feasible research direction for NPC enhancing radiosensitivity.
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ObjectiveTo compare the values of serum citrulline, intestinal fatty acid binding protein (IFABP) and intes-tinal trefoil factor (ITF) in diagnosis of acute gastrointestinal injury in critically ill children.MethodsA total of 84 critically ill children were enrolled. The serum citrullin, IFABP, and ITF were measured by high performance liquid chromatography and enzyme-linked immunosorbent assay. The testing results and clinical data were analyzed.ResultsCompared with non gastroin-testinal injury group, the serum citrulline level was signiifcantly lower and IFABP and ITF levels were signiifcantly higher in gas-trointestinal injury group (allP<0.05). In critically ill children, the serum citrulline level was negatively correlated with C-reactive protein, procalcitonin and hospitalization time (r=-0.36 to -0.31,P<0.01).ConclusionsThe levels of citrulline, IFABP and ITF have diagnostic values for acute gastrointestinal injury in critically ill children. The level of citrulline may relfect the degree of acute gastrointestinal injury in critically ill children.
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<p><b>OBJECTIVE</b>To investigate the clinical characteristics of pulmonary artery sarcoma (PAS) and to improve doctors' awareness and the early diagnosis of this disease.</p><p><b>METHODS</b>The clinical data of 9 cases confirmed by operation and pathology of PAS from November 2001 to November 2012 in Beijing Anzhen Hospital were reviewed. The clinical characteristics, laboratory tests, imaging manifestation, pathology as well as follow-up were studied. Survival was determined by the Kaplan-Merier method.</p><p><b>RESULTS</b>(1)Main clinical manifestations were chest distress (8/9), palpitation (2/9), syncope (2/9), cough (2/9), weight loss (2/9) and chest pain (1/9). (2)Lactate dehydrogenase (LDH) , high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) were all elevated to different extents, but D-Dimer remained in the normal range. (3) Seven cases received CTPA examination and evidenced filling defect in the main pulmonary artery trunk (6/7), left pulmonary artery (6/7), right pulmonary artery (7/7). 7 cases received TTE examination and showed enlarged right ventricle (6/7) : mean right ventricular end-diastolic diameter was (38.54 ± 16.30) mm; enlarged right atrium (7/7): mean right atrium diameter was (55.11 ± 5.45) mm; and tricuspid insufficiency (7/7) : estimated mean pulmonary artery pressure was (81.14 ± 21.17) mmHg (1 mmHg = 0.133 kPa) , and pulmonary stenosis (5/7) . Four cases received deep venous ultrasound examination and deep venous thrombosis (DVT) was found in 1 patient. Four cases received Ganz catheter examination and the preoperative and postoperative mean pulmonary artery pressure was (52.00 ± 5.23) mmHg and (23.00 ± 5.60) mmHg, respectively. (4) All 9 patients received surgery and intimal sarcoma was diagnosed in all of them. Leiomyosarcoma was diagnosed in 3 cases, leiomyo-angiosarcoma was diagnosed in 1 case, undifferentiated sarcomas was diagnosed in 1 case. (5)The 1-, 3- and 5-month survival was 71.4%, 53.6% and 35.7%, respectively, median survival time was 5 months post surgery.</p><p><b>CONCLUSION</b>PAS is difficult to differentiate with PTE. PAS should be suspected in patient with right atrium, right ventricular enlargement and early appeared right heart failure, and normal D-Dimer level. Outcome for PAS patients is poor despite surgery in this cohort.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios de Seguimiento , Hemangiosarcoma , Diagnóstico , Patología , Arteria Pulmonar , Patología , Estudios RetrospectivosRESUMEN
Objective To compare levels of glycosylated hemoglobin detected by 3 kinds of analytic instruments .Methods 75 samples were measured by D-10 glycosylated hemoglobin automatic analyzer(ionexchange chromatography) ,HA-8160 glycosylated hemoglobin automatic analyzer(affinity chromatography) and 7170A automatic analyzer(immune turbidimetry) .Results were tested by the homogeneity of variance ,the one-way analysis of variance and correlation analysis .Results There was a positive correlation between D-10 glycosylated hemoglobin automatic analyzer and HA-8160 glycosylated hemoglobin automatic analyzer(r2 =0 .996) , the linear equation was Y=0 .953X+0 .519 .There was a positive correlation between D-10 glycosylated hemoglobin automatic ana-lyzer and 7170A automatic analyzer(r2 =0 .996) ,the linear equation was Y=0 .925X+0 .576 .There was a positive correlation be-tween HA-8160 glycosylated hemoglobin automatic analyzer and 7170A automatic analyzer(r2 =0 .998) ,the linear equation was Y=0 .969 X+0 .081 .Conclusion In the premise of quality control in laboratory ,three different instrument can use to detect the level of glycosylated hemoglobin .