RESUMO
Objective To investigate the predictive value of the expression levels of YY1 transcription fac-tor(YY1)and microRNA(miR)-181a-5p in peripheral blood mononuclear cell for adverse pregnancy out-comes in gestational diabetes mellitus(GDM).Methods A total of 200 patients with GDM were enrolled as the GDM group.100 healthy pregnant women who underwent prenatal examinations during the same period were selected as the control group.The expressions levels of YY1 and miR-181a-5p in peripheral blood mono-nuclear cell were detected by fluorescent quantitative PCR.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of YY1 and miR-181a-5p for adverse pregnancy outcomes in GDM pa-tients.Results Compared with the control group,the expression levels of YY1 and miR-181a-5p in peripheral blood mononuclear cell of GDM group were obviously decreased(P<0.05),and the incidence rates of post-partum hemorrhage,macrosomia and neonatal hypoglycemia in GDM group were obviously higher(P<0.05).Multivariate Logistic regression analysis showed that age and poor blood glucose control were inde-pendent risk factors for adverse pregnancy outcomes in GDM patients(P<0.05),and the expression levels of peripheral blood mononuclear cell YY1 and miR-181a-5p were independent protective factors for adverse preg-nancy outcomes in GDM patients(P<0.05).ROC curve results showed that the area under the curve(AUC)of the expression levels of YY1 and miR-181a-5p in peripheral blood alone and in combination in predicting ad-verse pregnancy outcomes in GDM patients was 0.717,0.751 and 0.832,respectively,and the AUC of their combination was obviously higher than that of the two alone(P<0.05).Conclusion The decreased expres-sion levels of YY1 and miR-181a-5p in peripheral blood mononuclear cell of GDM patients could increase the risk of adverse pregnancy outcomes,YY1 and miR-181a-5p are closely related to adverse pregnancy outcomes in GDM patients,and both could be used as predictors of adverse pregnancy outcomes in GDM patients.
RESUMO
ObjectiveTo investigate the changes of endogenous metabolites in serum of ovariectomized rats and the effect of Erxiantang on them based on liquid chromatography-mass spectrometry(LC-MS). MethodTwenty-four healthy female SD rats were randomly divided into sham-operated group, model group and Erxiantang group(7.5 g·kg-1), with 8 rats in each group. Bilateral ovarian tissues were excised in the model and Erxiantang groups, and small pieces of adipose tissues were excised in the abdominal cavity of the sham-operated group bilaterally, and gastric administration was started 2 weeks after surgery, and equal volumes of distilled water were gavaged in the sham-operated and model groups. After 12 weeks of administration, blood was collected from abdominal aorta, and non-targeted metabonomics was performed on rat serum by LC-MS, and orthogonal partial least squares-discriminant analysis(OPLS-DA) was used to screen differential metabolites. Metabolic pathway analysis was performed based on Kyoto Encyclopedia of Genes and Genomes(KEGG), and the levels of key enzymes of metabolic pathways were verified by enzyme-linked immunosorbent assay(ELISA). ResultThe results of metabonomics showed that 82 differential metabolites between the model group and the sham-operated group were glycerophospholipids, fatty acyls, steroids and steroid derivatives, of which the most significant difference was glycerophospholipids. At the same time, Erxiantang could call back 65 out of 82 differential metabolites, of which 11 were statistically significant, mainly phosphatidylcholine(PC) and lysophosphatidylcholine(LysoPC) in glycerophospholipids, followed by corticosterone and 11-deoxycortisol in steroids and steroid derivatives. Metabolic pathway analysis showed that the pathways of glycerophospholipid metabolism and steroid hormone biosynthesis in model group were changed, and were recovered after the administration of Erxiantang. ELISA results showed that compared with the sham-operated group, serum levels of cholinephosphate cytidylytransferase(CCT), secretory phospholipase A2(sPLA2) and lysophosphatidylcholine acyltransferase(LPCAT), which were the key metabolic enzymes of glycerophospholipid metabolite PC and LysoPC, were significantly decreased in the model group(P<0.05, P<0.01), and choline phosphotransferase 1(CPT1) levels decreased but the difference was not statistically significant, compared with the model group, the levels of CCT, sPLA2 and CPT1 were significantly increased in Erxiantang group(P<0.01). In addition, compared with the sham-operated group, the levels of cholesterol(TC), triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) were significantly increased in the model group(P<0.01), the high density lipoprotein cholesterol(HDL-C) level was decreased(P<0.05), compared with the model group, the levels of TC, TG and LDL-C were significantly decreased and the level of HDL-C was significantly increased in Erxiantang group(P<0.01). ConclusionEndogenous metabolites and related metabolic pathways in ovariectomized rats were altered, and Erxiantang can reverse some of the different metabolites and related pathways, such as regulating glycerophospholipid metabolism by regulating metabolic enzymes CCT, sPLA2 and CPT1 to increase the levels of PC and LysoPC, and then improve the pathological changes such as lipid metabolism disorder in ovariectomized rats.
RESUMO
Simply relying on the introduction of online teaching resources on the platforms such as Chinese University Massive Open Online Course (MOOC) to carry out online teaching, it is easy to encounter problems that the teaching resources are inconsistent with the learning situation and teaching syllabus of the students majoring in medical statistics of Binzhou Medical University, the lack of interaction among students, and the untimely teaching feedback. Therefore, on the basis of integrating the MOOC resources, we established asynchronous small private online course (SPOC) online curriculum resources for medical statistics that were suitable for the students of our school. The blended teaching mode of "SPOC+QQ living broadcast" was carried out. Before and after the implementation, two rounds of questionnaires were conducted to understand students' teaching and learning needs and teaching effect evaluation of online teaching, and then the teaching mode was optimized. The results show that the blended teaching mode of "SPOC + QQ living broadcast" designed in this study has the advantages of rich teaching resources, high enthusiasm of students, flexible teaching interaction, timely teaching feedback, and diversified teaching evaluation, which provides a reference for the better development of online and offline blended teaching reform in the future.
RESUMO
Taking medical statistics major in Binzhou Medical University as an example, based on the outcome-based education theory, in order to enhance the innovation ability of university students, we put forward the systematic second classroom training system, including improving the personnel training system, implementing education, experiment teaching reform, and practice teaching reform. It has achieved outstanding results in the discipline competition, improved social service ability and high degree of employer satisfaction. The systematic second-class talent training system based on the outcome-based education theory can provide reference for other medical colleges and related applied majors.
RESUMO
Objective:To explore the value of transapical catheter of mitral valve repair (MVR) with Memoclip device in the management of moderate to severe and severe mitral regurgitation (MR) guided by transesophageal echocardiography (TEE).Methods:Fifteen patients with moderate to severe and severe MR in Hefei High-tech Cardiovascular Hospital from December 2021 to October 2022 were prospectively selected. Mitral valve morphology and length, regurgitation severity, left ventricular ejection fraction and pulmonary venous Doppler spectra were carefully evaluated before MVR by TEE.Intraprocedural TEE was performed to guide the MVR including transseptal catheterization, alignment of the clip delivery system, assessment of leaflet capture, clip deployment, post-clip deployment assessment, and withdrawal of the clip delivery system. The position and coaptation length of the clips, the mitral orifice morphology, residual mitral valve regurgitation and pressure gradient were evaluated after MVR.Meanwhile, the complications were monitored throughout the procedure.Results:Among the 15 patients, 12 were implanted with 1 clip and 3 were implanted with 2 clips, respectively. No complications occurred. There were 13 patients with mild regurgitation and 2 showed to moderate mitral regurgitation 1 month later after MVR, and 13 remained mild and 2 maintained moderate regurgitation 3 months later. Significant differences were found in maximal MR area (MRA-max), maximal and mean mitral valve pressure gradient (MVPG-max, MVPG-mean) and mitral valve area (MVA) among the 5 observation time points (all P<0.05). MRA-max, MVA and MVPG-mean were significantly decreased immediately and 3 months after the procedure ( P<0.001). No significant stenosis was found in mitral valve after MVR. Conclusions:MVR with Memoclip is safe, effective, easy to operate in treating patients with moderate to severe and severe MR. TEE plays a key role in perioperative MVR with Memoclip through apical catheterization.
RESUMO
Objective To explore the predictive values of the initial model for end-stage liver disease (MELD) score, MELD combined with serum sodium (MELD-Na) score and MELD combined with serum lactic acid (MELD-Lac) score for early survival rate after liver transplantation in patients with liver failure. Methods Clinical data of 135 recipients undergoing liver transplantation for liver failure were retrospectively analyzed. All patients were divided into the early survival group (n=110) and early death group (n=25) according to the survival at postoperative 28 d. Clinical data were compared between two groups. The optimal cut-off values of MELD, MELD-Na and MELD-Lac scores for predicting early survival rate after liver transplantation in patients with liver failure were determined by the receiver operating characteristic (ROC) curve. The predictive values of different scores for early survival rate after liver transplantation in patients with liver failure were evaluated. Results Significant differences were observed in the initial MELD, MELD-Na and MELD-Lac scores after liver transplantation between two groups (all P < 0.05). For the initial MELD, MELD-Na and MELD-Lac scores in predicting early survival rate after liver transplantation in patients with liver failure, the AUC were 0.653 [95% confidence interval (CI) 0.515-0.792], 0.648 (95%CI 0.514-0.781) and 0.809 (95%CI 0.718-0.900), the optimal cut-off values were 18.09, 18.09 and 19.97, Youden's indexes were 0.398, 0.380 and 0.525, the sensitivity was 0.680, 0.680 and 0.840, and the specificity was 0.720, 0.700 and 0.690, respectively. The AUC of MELD-Lac score was higher than those of MELD and MELD-Na scores, and the differences were statistically significant (both P < 0.05). Conclusions Compared with the initial MELD and MELD-Na scores after liver transplantation, the initial MELD-Lac score is a more reliable index for predicting early survival rate after liver transplantation in patients with liver failure.
RESUMO
Objective:To explore the effect of mini-clinical evaluation exercise (Mini-CEX) combined with simulation teaching + case-based learning (CBL) in pediatric clinical teaching.Methods:A total of 60 medical students who practiced in Department of Pediatrics, Affiliated Hospital of Jining Medical College from August 2019 to August 2020 were selected as the research objects. According to different teaching methods, they were divided into control group ( n=30) and observation group ( n=30). The control group received traditional teaching, and the observation group received Mini-CEX combined with simulated teaching + CBL. The assessment results, comprehensive ability of medical interview, critical thinking ability and teaching satisfaction of the two groups were compared. SPSS 20.0 was performed for t-test and Chi-square test. Results:The test scores and total scores of the observation group were significantly higher than those of the control group ( P<0.05). After teaching, the Mini-CEX scores, the CTDI-CV (critical thinking disposition inventory Chinese version) scores and the total scores of the two groups increased significantly, and the above scores were significantly higher in the observation group than the control group ( P<0.05). The scores of the teaching program satisfaction questionnaire in the observation group were significantly higher than those in the control group ( P<0.05). Conclusion:The application of Mini-CEX combined with simulation teaching + CBL in pediatric clinical teaching can help to cultivate the medical interview ability, clinical practice ability and critical thinking ability of interns, improve the examination results, and improve the teaching satisfaction.
RESUMO
Gilbert's syndrome (GS) could lead to the high bilirubin, and gestational diabetes mellitus might reverse this index. A primigravida with a pregnancy of 38 weeks and 4 days was identified having gestational diabetes mellitus (GDM) with Gilbert's syndrome. General laboratory tests were normal except mild unconjugated hyperbilirubinaemia and hyperglycemia. The delivery process was going well with completely delivered placenta and fetal membrane, and I° turbid amniotic fluid. The newborn was noted to have high bilirubin level which reversed after a few days of treatment. Gilbert's syndrome is rare in obstetric practice with the virtually decreased activity of uridine diphosphate glucuronosyl transferase (UDPGT). This is the first report to confirm that pregnant women with Gilbert's syndrome and gestational diabetes could give birth normally without significant adverse symptoms, except for jaundice.
RESUMO
BACKGROUND AND AIMS: Early detection of acute kidney injury (AKI) is crucial for the prognosis of patients after liver transplantation (LT). This passage aims to analyze the perioperative clinical markers of AKI after LT and establish predictive models based on clinical variables for early detection of AKI after LT. METHODS: We prospectively collected 109 patients with LT, and compared the differences of perioperative clinical markers between the AKI group and non-AKI group. The scoring system and decision tree model were established through the risk factors. Another 163 patients who underwent LT in the same center from 2017 to 2018 were retrospectively collected to verify the models. RESULTS: In multiple comparisons of risk factors of post-LT AKI, pre-operative factors were excluded automatically, intraoperative and post-operative factors including operating time, intraoperative hypotension time, post-operative infection, the peak of post-operative AST, and post-operative shock were the independent risk factors for post-LT AKI. The scoring system established with the risk factors has good predictive power (AUC = 0.755) in the validation cohort. The decision tree also shows that post-operative shock was the most important marker, followed by post-operative infection. CONCLUSION: Five intraoperative and post-operative factors are independently associated with post-LT AKI rather than pre-operative factors, which indicates that operation technique and post-operative management may more important for the prevention of post-LT AKI. The scoring system and decision tree model could complement each other, and provide quantitative and intuitive prediction tools for clinical practice of early detection of post-LT AKI.
Assuntos
Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , Árvores de Decisões , Transplante de Fígado/efeitos adversos , Adulto , Feminino , Humanos , Hipotensão/etiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Retrospectivos , Medição de Risco/métodos , Fatores de RiscoRESUMO
Objective:To explore the association between left-behind status, screen time (ST) and behavior of autism in rural preschool children.Methods:Cross section study was used in this study.A sample of 3 636 rural preschool children aged from 3 to 6 years old in 26 kindergartens were selected from four counties in Anhui province of China.The contents of the questionnaire include: basic information questionnaire, self-made left behind status questionnaire, self-made screen time questionnaire, Clancy autism behavior scale.EpiData 3.2 and SPSS 23.0 software were used for data entry and statistical analysis.Chi-square test was used to analyze the difference of positive rate of autism behavior.Logistic regression analysis was used to further explore the relationship between left-behind status, screen time and autism behavior of rural preschool children.Results:Compared with non-left-behind children (NLBC), the risk of autism behavior for left-behind children (LBC) increased 36%.The risk of autism behavior increased by 40% for 1 h/d <ST≤ 2 h/d and 85% for ST>2 h/d when compared with ST ≤ 1 h/d.While comparing to NLBC with ST ≤ 1 h/d, the risk of autism behavior increased by 97% in LBC with 1 h/d <ST ≤2 h/d and 159% in LBC with ST>2 h/d.Conclusions:There is an additive effect on the risk of autism behavior when left-behind experience and excessive ST combined together.The daily ST should be strictly controlled within 2 h/d for NLBC, and within 1 h/d for LBC in order to reduce the risk of autism behavior in preschool children of rural areas.
RESUMO
Objective To explore the relationship between MRI findings and defecation function after laparoscopic?assisted anorectal pull?through for anorectal malformations. Methods A retrospective cohort study focused on the findings of MRI performed after laparoscopic?assisted anorectal pull?through for anorectal malformations and no spinal deformity was present in all patients who are currently older than 3 years. Forty?two patients aged from 3 to 16 years (median age was 4 years), whom accepted operation at 3 months to 13 years old(median age was 5 months), and MRI was carried out in 2 to 5 months after operation (median time was 3 months). The MRI manifestations including the relationship between the anorect and the high muscle complex(RAHMC), anorectal angle(AA); the relationship between the anorect and the low muscle complex(RALMC), the rectal maximum diameter(RMD), the fat tissue interposition(FTI) and the development of pelvic floor muscle(PFM) were reviewed and summarized. Statistically, the differences of MRI manifestations in different defecation function index, including the degree of voluntary bowel movements, soiling, constipation and Krickenbeck score were evaluated respectively with Chi?square test or rank sum test. Results statistically, There was significant differences among the groups with different degree of voluntary bowel movements, soiling and Krickenbeck score in the RAHMC (P<0.05), and AA was correlated with the degree of voluntary bowel movements, soiling, constipation and Krickenbeck score(P<0.05), but no significant differences was found among the groups with different defecation function index in the RALMC, the RMD, the FTI and the development of PFM(P>0.05). Conclusions The deviation of the anorect from the high muscle complex which showed in the postoperative MRI pictures suggested the poor prognosis, and well?developed pelvic floor muscles which indicated in the MRI was not the sufficient predictor for good outcome. Postoperative anorectal angle obtained in the MRI can be used as an objective indicator of prognosis.
RESUMO
Objective@#To analyze the epidemiological and spatial-temporal distribution of Brucellosis, epidemic encephalitis B and hemorrhagic fever with renal syndrome (HFRS) in Gansu province during 2014-2018 so as to provide evidence for the prevention and control of those diseases.@*Methods@#A database was established in Gansu province from 2014 to 2018, using the geographical information system. A spatial distribution map was drawn, with trend analysis and space-time clustering used to study the 3-dimention of the diseases, by using both ArcGIS 10.5 and SaTScan 9.6 softwares.@*Results@#Results from the trend surface analysis showed that the incidence of Brucellosis decreased gradually from north to south parts while the U type curve could reflect the distribution from the east to the west areas. Incidence of epidemic encephalitis B decreased significantly from south to north areas in the province, with incidence higher in the eastern than in the mid-west region. Difference on the incidence of HFRS was not significantly visible in the eastern and western regions, while the incidence was slightly higher in the southern than the northern parts of the province. Spatial and space-time clustering did exist among the 3 diseases in Gansu from 2014 to 2018. The areas with clusters of Brucellosis appeared in the eastern parts during 2014-2015, including 19 counties. The areas with secondary clusters of Brucellosis were seen in the Hexi district, including 4 counties, during 2017-2018. The areas with high incidence of epidemic encephalitis B were clustered in the middle and southeast areas, including 32 counties, during 2017-2018. Areas with most clusters of HFRS appeared in Min county of Dingxi city in 2018, with the areas of secondary clusters in 8 counties of the eastern areas in 2018.@*Conclusions@#The overall incidence rates of the 3 natural focus diseases were in a upward trend and showing obvious characteristics on spatial clustering. According to the distributive characteristics, effective measures should be developed accordingly.
RESUMO
Objective To investigate the clinical efficacy and mechanism of rosuvastatin combined with telmisartan in the treatment of persistent atrial fibrillation. Methods One hundred and twenty patients with persistent atrial fibrillation admitted to Cangzhou Central Hospital from February 2015 to February 2018 were enrolled and they were divided into study group and control group by random envelope method, with 60 patients in each group. The patients in study group were treated with rosuvastatin combined with telmisartan; and in control group they were treated with telmisartan, and after treatment for 6 weeks the clinical efficacy was observed. Resting heart rates were observed in two groups. The left atrial inner diameter, left atrium left and right diameter, left atrial sphericity index and left ventricular end diastolic volume, left ventricular end systolic volume, left ventricular posterior wall thickness of two groups were detected by ultrasond before and after treatment; the levels of serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were tested by enzyme linked immunosorbent assay (ELISA) in two groups before and after treatment; and the level of serum hypersensitive C-reactive protein (hs-CRP) was detected by immunoturbidimetry;the level of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) was tested by immunoluminometric assay. Results Resting heart rate was significantly decreased in study group after treatment compared with that before treatment (bpm: 76.37±7.25 vs. 89.76±8.79, P < 0.05), while in control group, the comparison of resting heart rate before and after treatment was of no statistical significant differences (bpm: 90.71±8.56 vs. 87.80±6.26, P > 0.05), resulting that the post-treatment resting heart rate of study group was significantly lower than that of control group (bpm:76.37±7.25 vs. 87.80±6.26, P < 0.05). After treatment, the left atrial inner diameter, left atrium left and right diameter, left atrial sphericity index and left ventricular end diastolic volume were increased compared with those before treatment in both groups; after treatment, above various index levels in study group were lower than those of control group [left atrial inner diameter (mm): 40.68±3.86 vs. 41.99±3.97, left atrium left and right diameter (mm): 41.07±2.85 vs. 42.69±2.90, left atrial sphericity index: 0.77±0.08 vs. 0.86±0.07, left ventricular end diastolic volume (mL): 107.48±32.90 vs. 118.98±35.75, all P < 0.05]. There were no statistical significant differences between the two groups in left ventricular end systolic volume and posterior wall thickness of left ventricle after treatment [study group: left ventricular end systolic volume (mL) was 38.59±12.37 vs. 39.81±12.03, posterior wall thickness of left ventricle (mm) was 11.34±2.39 vs. 12.80±3.27, control group: left ventricular end systolic volume (mL) was 39.90±11.54 vs. 40.65±11.50, posterior wall thickness of left ventricle (mm) was 11.90±2.57 vs. 12.99±3.16, all P > 0.05]. Besides, the serum levels of TNF-α, IL-6 and hs-CRP were obviously decreased in two groups after treatment (all P < 0.05), after treatment, above indexes in study group were significantly lower than those in control group [TNF-α (ng/L): 29.76±5.31 vs. 36.63±5.11, IL-6 (ng/L): 14.37±3.36 vs. 22.65±4.58, hs-CRP (mg/L): 13.68±2.75 vs. 20.63±2.69, all P < 0.05]. Plasma NT-proBNP was increased in control group after treatment compared with that before treatment (μg/L: 431.80±42.54 vs. 365.89±39.81, P < 0.05), whereas there was no significant difference in the study group between pre- and post-treatment (μg/L: 351.80±38.76 vs. 346.89±35.82, P > 0.05), resulting in post-treatment plasma NT-proBNP significantly lower in study group (P < 0.05). Conclusions Rosuvastatin combined with telmisartan can prevent left atrial remodeling in patients with persistent atrial fibrillation and delay the dysfunction of left ventricular pump. The therapeutic mechanism was related to the decrease in the levels of serum inflammatory factors in patients treated with such therapy.
RESUMO
Objective To analyze the correlation between CT characteristics and epidermal growth factor receptor (EGFR)mutations in pulmonary adenocarcinoma.Methods 82 patients (87 lesions)with pulmonary adenocarcinoma were retrospectively collected.All patients were underwent CT examination before operation,and EGFR gene were determined after operation.Results EGFR mutations were found in 44 of 87 lesions (50.57%).The EGFR mutations rate was 50.00% in females and 47.50% in males,there was no statistical difference between genders (P=0.821).The EGFR mutations rate was 46.55% in the right lung and 58.62% in the left lung,while no statistically significant difference was found (P=0.289).Among all the CT characteristics,the mutations rate was 63.89% in spiculated lesions and 60.71% in lesions with pleural indentation,the differences was statistically significant (P<0.05).The mutations rate was 59.25% in lesions containing solid component and 36.36% in pure ground glass opacity lesions,the difference was statistically significant (P=0.011). There were no statistically differences in lobulation,cavitation and lymphadenectasis (P>0.05).The pleural indentation was the highest in sensitivity (77.27%)and negative predictive value (67.74%).The spiculation was the highest in specificity (69.77%)and positive predictive value (63.89%).Conclusion Among all the CT characteristics,pleural indentation,spiculation and the lesion containing solid component are prone to EGFR mutations.
RESUMO
Objective To optimize the warning threshold values of common communicable diseases in Gansu province,and improve the early warning effect.Method An early warning model was set up for influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method.By calculating the sensitivity,specificity,predictive value of positive test,predictive value of negative test,Youden'index and receiver-operating characteristic curve,the optimum early warning threshold values for communicable diseases in Gansu were selected.Results The optimum early warning boundary values of influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,and viral hepatitis type E were P90,P80,P95,P90,P80 and P90 respectively.The optimum early warning parameters of HFMD were k =1.2,H=5σ.Under the optimum early warning boundary values/parameters,the early warning sensitivities of influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,viral hepatitis type E and HFMD were 86.67%,100.00%,91.67%,100.00%,100.00%,100.00% and 100.00%,the specificities were 86.49%,62.22%,75.00%,100.00%,97.92%,89.13% and 74.47%.The predictive values of positive test were 72.22%,29.17%,52.38%,100.00%,80.00%,54.55% and 29.41%,and the predictive values of negative test were 94.12%,100.00%,96.77%,100.00%,100.00%,100.00% and 100.00%,and the Youden'indexes were 0.73,0.62,0.67,1.00,0.98,0.89 and 0.74.Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram.Conclusion The early warning thresholds of influenza,other infectious diarrheal diseases,dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.
RESUMO
The pathogenesis of the second major neurodegenerative disorder, Parkinson's disease (PD), is closely associated with the dysfunction of potassium (K) channels. Therefore, PD is also considered to be an ion channel disease or neuronal channelopathy. Mounting evidence has shown that K channels play crucial roles in the regulations of neurotransmitter release, neuronal excitability, and cell volume. Inhibition of K channels enhances the spontaneous firing frequency of nigral dopamine (DA) neurons, induces a transition from tonic firing to burst discharge, and promotes the release of DA in the striatum. Recently, three K channels have been identified to protect DA neurons and to improve the motor and non-motor symptoms in PD animal models: small conductance (SK) channels, A-type K channels, and K7/KCNQ channels. In this review, we summarize the physiological and pharmacological effects of the three K channels. We also describe in detail the laboratory investigations regarding K channels as a potential therapeutic target for PD.
Assuntos
Animais , Humanos , Doença de Parkinson , Metabolismo , Canais de Potássio , MetabolismoRESUMO
Objective To investigate the clinical significance of the levels of serum C-reactive protein (CRP), peripheral blood ratio of neutrophil to lymphocyte (N/L) and plasma D-dimer in patients with different types of atrial fibrillation (AF) and the predictive value of the above index levels in occurrence of complicated left atrial appendage thrombosis in such patients. Methods A prospective study was conducted, one hundred and forty patients with non-valvular AF admitted to Cangzhou Central Hospital from May 2013 to December 2016 were enrolled, including 57 patients with paroxysmal AF in paroxysmal AF group and 83 patients with persistent AF in persistent AF group; in the mean time, 40 healthy persons having passed physical examination with normal sinus rhythm were volunteers assigned in a healthy control group. 83 patients with persistent AF were followed up for 1 year, and by the esophageal echocardiography, 13 cases with left atrial appendage thrombosis (AF combined with thrombosis group) and 70 cases with non-thrombotic patients (simple AF group) were found. In the morning on the day of entrance into the respective group, fasting venous blood was taken from the patients, and the peripheral blood N/L ratio, serum CRP, plasma D-dimer and B-type natriuretic peptide (BNP) levels were checked; the left atrial diameter (LAD), left atrial ejection fraction (LAEF), left atrial peak strain rate (LASRs) during left ventricular systolic phase, early diastolic peak blood flow velocity of mitral annulus/mitral annulus root side wall velocity peak value (E/Ea) ratio were measured by the trans-thoracic echocardiography, and the differences in above indexes were compared among various groups; the risk factors of persistent AF associated with left atrial appendage thrombosis were analyzed by multivariate Logistic regression; the receiver operation characteristic (ROC) curve was used to analyze the predictive value of D-dimer and BNP levels for persistent AF associated with left atrial appendage thrombosis. Results The peripheral blood N/L ratio (2.68±0.58, 2.59±0.62 vs. 1.82±0.29), CRP (mg/L: 19.87±3.28, 20.74±4.31 vs. 8.65±1.06), BNP (ng/L: 364.79±54.18, 145.86±51.90 vs. 139.40±48.29), LAD (mm: 40.79±3.90, 34.28±2.13 vs. 33.90±2.51), LAEF (0.16±0.07, 0.39±0.08 vs. 0.56±0.10), LASRs (s-1: -1.65±0.23, -1.98±0.32 vs. -3.49±0.53), E/Ea ratio (4.38±0.48, 4.29±0.52 vs. 4.09±0.64) levels in the persistent AF group and the paroxysmal AF group were significantly higher than those of healthy control group, and BNP, LAD, LAEF in persistent AF group were significantly higher than those of the paroxysmal AF group (all P < 0.05). N/L ratio (3.19±0.47 vs. 2.62±0.58), serum CRP (mg/L:24.38±5.26 vs. 18.92±3.45), plasma D-dimer (mg/L: 2.56±0.41 vs. 1.57±0.39), BNP (ng/L: 659.35±78.29 vs. 381.22±69.43) and LAD (mm: 42.12±4.28 vs. 36.78±3.42), E/Ea ratio (6.79±0.62 vs. 4.59±0.59) in AF combined with thrombosis group were significantly higher than those in simple AF group (all P < 0.05), and LAEF (0.29±0.05 vs. 0.30±0.06), LASRs (-1.79±0.27 vs. -1.86±0.39) were lower than those in simple AF group, but the differences were of no statistical significance (all P > 0.05). Multivariate Logistic regression analysis showed: plasma D-dimer [odds ratio (OR) = 2.458, 95% confidence interval (95%CI) = 1.764 - 3.016, P = 0.035], BNP (OR = 2.631, 95%CI =1.589 - 3.127, P = 0.021), LAD (OR = 5.572, 95%CI = 4.031 - 6.452, P = 0.001) and E/Ea ratio (OR = 1.995, 95%CI =1.674 - 3.851, P = 0.003) were the independent risk factors for persistent AF combined with left atrial appendage thrombosis. The ROC curve showed: when plasma D-dimer and BNP levels could predict the patients with persistent AF complicated with left atrial appendage thrombosis, the area under the ROC curve (AUC) was 0.872 and 0.741, respectively, and when the plasma D-dimer was 1.45 mg/L and BNP was 569.33 ng/L respectively, the sensitivity of diagnosis for the above patients was 67.81%, 62.25%, and the specificity was 75.90% and 57.62% respectively. Conclusions The levels of serum inflammatory markers, plasma biological markers and left atrial function were different in patients with different types of AF. The left atrial enlargement, left ventricular diastolic dysfunction, elevation of plasma D-dimer and plasma BNP levels are the independent risk factors for patients with persistent AF complicated with left atrial appendage thrombosis. When diastolic dysfunction occurs in the left ventricle, the elevated levels of plasma D-dimer and natriuretic peptide have predictive value for left atrial appendage thrombosis.
RESUMO
Objective: To optimize the warning threshold values of common communicable diseases in Gansu province, and improve the early warning effect. Method: An early warning model was set up for influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method. By calculating the sensitivity, specificity, predictive value of positive test, predictive value of negative test, Youden' index and receiver-operating characteristic curve, the optimum early warning threshold values for communicable diseases in Gansu were selected. Results: The optimum early warning boundary values of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, and viral hepatitis type E were P(90), P(80), P(95), P(90), P(80) and P(90) respectively. The optimum early warning parameters of HFMD were k=1.2, H=5σ. Under the optimum early warning boundary values/parameters, the early warning sensitivities of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and HFMD were 86.67%, 100.00%, 91.67%, 100.00%, 100.00%, 100.00% and 100.00%, the specificities were 86.49%, 62.22%, 75.00%, 100.00%, 97.92%, 89.13% and 74.47%. The predictive values of positive test were 72.22%, 29.17%, 52.38%, 100.00%, 80.00%, 54.55% and 29.41%, and the predictive values of negative test were 94.12%, 100.00%, 96.77%, 100.00%, 100.00%, 100.00% and 100.00%, and the Youden' indexes were 0.73, 0.62, 0.67, 1.00, 0.98,0.89 and 0.74. Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram. Conclusion: The early warning thresholds of influenza, other infectious diarrheal diseases, dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.
Assuntos
Humanos , China , Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis/epidemiologia , Notificação de Doenças , Surtos de Doenças/prevenção & controle , Modelos Teóricos , Vigilância da População/métodosRESUMO
Objective@#To investigate the effect of biology and mTOR pathway activity of down-regulated TSC2 gene expression on U937 leukemia cells.@*Methods@#Gene expression was down-regulated by lentivirus induced RNA interference on TSC2 high expressed U937 cell line; the proliferation, apoptosis and differentiation were detected by CCK-8 assay, colony formation assay and flow cytometry; the gene expression level and protein kinase activity were detected by qRT-PCR and Western blot.@*Results@#Down-regulated expression of TSC2 gene promoted U937 cell proliferation and colony formation ability (P<0.05) . The proportion in G0/G1 phase of TSC2 down-regulated U937 cell was much lower than that of the control cells [ (52.53±3.75) % vs (75.10±4.33) %, t=6.829, P=0.002], the S phase [ (22.43±1.00) % vs (15.47±1.20) %, t=-5.581, P=0.019] and G2/M phase [ (25.03±4.34) % vs (14.33±0.91) %, t=-5.413, P=0.013] was remarkably higher than that of the control cells (P<0.05) . There were no statistically significant differences in cell apoptosis and differentiation (P>0.05) . Down-regulation of TSC2 led to the increased activity of mTOR, 4EBP1 and S6K1, but did not influence the activity of AKT. The expressions of proliferation related cyclinD1, c-myc and PTEN were also up-regulated after TSC2 silenced, but the expressions of P27KIP and BCL-XL were not changed.@*Conclusion@#Downregulation of TSC2 could promote the proliferation of U937 cells through up-regulation of mTOR activity.
RESUMO
<p><b>OBJECTIVE</b>To construct srtA-gene deletion mutant of Streptococcus mutans (S. mutans) UA159 with IFDC2 cassette through overlapping polymerase chain reaction (PCR) and allelic homologous recombination.</p><p><b>METHODS</b>First, the upstream and downstream fragments surrounding the srtA and IFDC2 cassette were PCR amplified and ligated through overlapping PCR. The resulting amplicon was transformed into UA159, and positive transformants were selected on BHI plates containing erythromycin. Second, upstream and downstream fragments of srtA with overlap regions were generated by PCR and were overlapped to create upΔ-down amplicon. Then, the upΔ-down amplicon was transformed into the aforementioned positive transformants and selected on BHI plates containing p-Cl-Phe.</p><p><b>RESULTS</b>The PCR analysis and DNA sequencing results indicated that the coding region of the srtA was completely deleted, and the upstream and downstream regions flanking the srtA were ligated seamlessly.</p><p><b>CONCLUSIONS</b>The markerless srtA-deletion mutant of S. mutans was constructed successfully, which laid a foundation for further study of its biological function and influence on the biofilm formation of S. mutans.</p>