Diabetic ketoacidosis complicated by acute myocardial infarction and upper gastrointestinal bleeding: a case report and literature review / 中国基层医药

Objective:To report one case of diabetic ketoacidosis complicated by acute myocardial infarction and upper gastrointestinal bleeding, and make a certain summary to its diagnosis and treatment in order to improve the treatment of these critically ill patients.Methods:One patient was admitted to Guizhou Aerospace Hospital on November 14, 2021 due to fatigue and vomiting for 2 days, and worsened symptoms accompanied by poor consciousness for 1 day. The patient was diagnosed with diabetic ketoacidosis complicated by acute myocardial infarction and upper gastrointestinal bleeding. The clinical symptoms, signs, laboratory examinations, and follow-ups of the patient were analyzed systematically and retrospectively.Results:After volume state assessment using a combined way, the patient was treated with appropriate fluid replacement, hypoglycemic, antiplatelet, anticoagulant, and acid inhibition strategies. After treatment, ketoacidosis and upper gastrointestinal bleeding were corrected, blood glucose gradually stabilized, and myocardial necrosis markers troponin and N-terminal brain natriuretic peptide precursor became normal.Conclusion:Treatments of diabetic ketoacidosis, acute myocardial infarction, and upper gastrointestinal bleeding are contradictory. Therefore, analyzing this patient's diagnosis and treatment is of great significance for improving treatment and reducing the mortality of these critically ill patients.

Unexpected antibody distribution among tumor patients: analysis of 111 483 cases / 中国输血杂志

【Objective】 To analyze the distribution of unexpected antibodies in tumor patients retrospectively and explore the clinical significance. 【Methods】 Unexpected antibody screening was performed on inpatients with blood preparation and blood transfusion in our hospital from January 2004 to December 2022, with 1 176 cases tested positive, and the types of unexpected antibodies and distribution characteristics were statistically analyzed. 【Results】 Unexpected antibodies were screened in 1 176 cases, with the positive rate at 1.05% (1 176/111 483). The unexpected antibodies were mainly anti-E 16.33%(192/1 176), anti-M 7.99% (94/1 176), anti-Mur 5.70% (67/1 176) and anti-Lea 4.76% (56/1 176). Among the 1 176 cases, gastrointestinal tumors accounted for 27.99% (329/1 176), gynecological tumors accounted for 24.84% (292/1 176), respiratory tumors accounted for 16.67% (196/1 176) . 【Conclusion】 The influencing factors of unexpected antibodies in tumor patients were disease type, blood transfusion history and blood type. Therefore, it is necessary for clinical departments to carry out unexpected antibody screening and perform Rh blood type matched transfusion for tumor patients to avoid alloantibody production.

Mapping of SARS-CoV-2 Brain Invasion and Histopathology in COVID-19 Disease

The coronavirus SARS-CoV-2 (SCV2) causes acute respiratory distress, termed COVID-19 disease, with substantial morbidity and mortality. As SCV2 is related to previously-studied coronaviruses that have been shown to have the capability for brain invasion, it seems likely that SCV2 may be able to do so as well. To date, although there have been many clinical and autopsy-based reports that describe a broad range of SCV2-associated neurological conditions, it is unclear what fraction of these have been due to direct CNS invasion versus indirect effects caused by systemic reactions to critical illness. Still critically lacking is a comprehensive tissue-based survey of the CNS presence and specific neuropathology of SCV2 in humans. We conducted an extensive neuroanatomical survey of RT-PCR-detected SCV2 in 16 brain regions from 20 subjects who died of COVID-19 disease. Targeted areas were those with cranial nerve nuclei, including the olfactory bulb, medullary dorsal motor nucleus of the vagus nerve and the pontine trigeminal nerve nuclei, as well as areas possibly exposed to hematogenous entry, including the choroid plexus, leptomeninges, median eminence of the hypothalamus and area postrema of the medulla. Subjects ranged in age from 38 to 97 (mean 77) with 9 females and 11 males. Most subjects had typical age-related neuropathological findings. Two subjects had severe neuropathology, one with a large acute cerebral infarction and one with hemorrhagic encephalitis, that was unequivocally related to their COVID-19 disease while most of the 18 other subjects had non-specific histopathology including focal {beta}-amyloid precursor protein white matter immunoreactivity and sparse perivascular mononuclear cell cuffing. Four subjects (20%) had SCV2 RNA in one or more brain regions including the olfactory bulb, amygdala, entorhinal area, temporal and frontal neocortex, dorsal medulla and leptomeninges. The subject with encephalitis was SCV2-positive in a histopathologically-affected area, the entorhinal cortex, while the subject with the large acute cerebral infarct was SCV2-negative in all brain regions. Like other human coronaviruses, SCV2 can inflict acute neuropathology in susceptible patients. Much remains to be understood, including what viral and host factors influence SCV2 brain invasion and whether it is cleared from the brain subsequent to the acute illness.

Analysis of prognostic evaluation value of prognostic nutrition index in elderly patients with cerebral apoplexy / 中国实用护理杂志

Objective:To explore the prognostic evaluation value and influencing factors of prognostic nutritional index (PNI) in elderly patients with stroke, and to analyze the value of PNI as an indicator of stroke outcome and prognosis.Methods:The clinical data of 356 elderly patients with cerebral apoplexy treated in hospital from December 2015 to June 2019 were analyzed retrospectively. According to PNI index, there were 154 cases of PNI≥45 and 154 cases of PNI.Results:General data showed that patients with PNI < 45 had higher age, body mass index (BMI), TP, ALB, lymph, TG, Glu, BMI and Mrs scores than those with PNI≥45, The difference was statistically significant ( χ2 values were 0.005-0.083, t values were 0.037-1.455, P<0.05). The results of multivariate analysis showed that PNI ( HR value was 1.43, 95% CI 0.94-2.25 , P<0.01, standardized partial regression coefficient was 0.051) had the highest contribution and was an independent risk factor for prediction of postoperative risk. Moreover, kappa coefficient indicated that PNI was consistent with MRS ( P<0.01). Conclusions:PNI is an independent factor affecting the prognosis of elderly patients with CS, which is of great significance to the evaluation of prognosis and analysis of influencing factors in elderly patients with CS.

Incidence and Survival Changes in Patients with Esophageal Adenocarcinoma during 1984-2013.

PURPOSE: The morbidity of esophageal adenocarcinoma (EAC) has significantly increased in Western countries. We aimed to identify trends in incidence and survival in patients with EAC in the recent 30 years and then analyzed potential risk factors, including race, sex, age, and socioeconomic status (SES). METHODS: All data were collected from the Surveillance, Epidemiology, and End Results or SEER database. Kaplan-Meier analysis and the Cox proportional hazards model were conducted to compare the differences in survival between variables, including sex, race, age, and SES, as well as to evaluate the association of these factors with prognosis. RESULTS: A total of 16,474 patients with EAC were identified from 1984 to 2013 in the United States. Overall incidence increased every 10 years from 1.8 to 3.1 to 3.9 per 100. Overall survival gradually improved (p < 0.0001), which was evident in male patients ((hazard ratio (HR) = 1.111; 95% confidence interval (CI) (1.07, 1.15)); however, the 5-year survival rate remained low (20.1%). The Cox proportional hazards model identified old age, black ethnicity, and medium/high poverty as risk factors for EAC (HR = 1.018; 95% CI (1.017, 1.019; HR = 1.240, 95% CI (1.151,1.336), HR = 1.000, 95% CI (1.000, 1.000); respectively). CONCLUSIONS: The incidence of EAC in the United States increased over time. Survival advantage was observed in white patients and patients in the low-poverty group. Sex was an independent prognostic factor for EAC, but this finding has to be confirmed by further research.

The establishment of a novel method of nano-immunomagnetic separation and Real-time PCR for detecting Vibrio cholerae from seafood / 中华预防医学杂志

<p><b>OBJECTIVE</b>A novel method of Nano-Immunomagnetic Separation (Nano-IMS) plus Real-time PCR was established for detecting Vibrio cholerae.</p><p><b>METHODS</b>The Nano-Immunomagnetic Beads were created by using the monoclonal antibody of Vibrio cholerae, which was named Nano-IMB-Vc. Nano-IMB-Vc has specific adsorption of Vibrio cholerae, combined with Real-time PCR technology, a method for rapid detection of Vibrio cholerae was established. The capture specificity of Nano-IMB-Vc was tested by using 15 bacteria strains. The specificity of Real-time PCR method was tested by using 102 targets and 101 non-targets bacteria strains. The sensitivity of Nano-IMS plus Real-time PCR were tested in pure culture and in artificial samples and compared with NMKL No.156.</p><p><b>RESULTS</b>The capture ratio of Nano-IMB-Vc was reached 70.2% at the level of 10(3) CFU/ml. In pure culture, the sensitivity of Nano-IMS plus Real-time PCR was reached at 5.4×10(2) CFU/ml. The specific of Real-time PCR method was tested by using 102 targets and 101 non-targets bacteria. The results showed that 102 strains of Vibrio cholerae test results were all positive, and the rest of the 101 strains of non-target bacteria test results were negative. No cross-reaction was founded. Add 1 CFU vibrio cholerae per 25 g sample, it could be detect with Nano-IMS plus Real-time PCR method after 8 hours enrichment.</p><p><b>CONCLUSIONS</b>The Nano-IMS plus Real-time PCR method of Vibrio cholerae established in this study has good specificity and sensitivity, which could be applied to the rapid detection of Vibrio cholerae.</p>

Application and evaluation of loop-mediated isothermal amplification method for detecting of Listeria monocytogenes in food / 中华预防医学杂志

<p><b>OBJECTIVE</b>The loop-mediated isothermal amplification (LAMP) detection method was applied to detect Listeria monocytogenes in food. The specificity and sensitivity of this method were evaluated through comparing it with Real-time PCR and conventional detection method.</p><p><b>METHODS</b>The LAMP primers were designed based on hly gene of Listeria monocytogenes. The LAMP method was applied to detect 88 Listeria monocytogenes, 1 reference strain ATCC 15313 of Listeria monocytogenes and 33 non-targets bacteria strains; base-material addition test and practical food samples detection were also conducted. Both of Real-time PCR and ISO 11290-1 methods were used as parallel detection method in addition to LAMP. The three kinds of methods were compared by specificity, sensitivity, detection limit and the detection result of practical food samples.</p><p><b>RESULTS</b>Both detection results of LAMP and Real-time PCR for 89 Listeria monocytogenes were positive (100%, 89/89), 33 non-targets bacteria strains were negative (100%, 33/33). The sensitivity of LAMP was 2 × 10² CFU/ml, which was consistent with Real-time PCR method (2 × 10² CFU/ml) and better than ISO 11290-1 method (2 × 10² CFU/ml). Base-material addition test result showed that the detection limit of the three kinds of methods were 3 CFU/25 g samples. And the result of practical food samples displayed the same detection rate of 4% in the three methods (2/45).</p><p><b>CONCLUSION</b>The LAMP method of Listeria monocytogenes established in this study has good specificity and sensitivity, which can be applied to the rapid detection of Listeria monocytogenes.</p>

Regulation of bone morphologenetic protein 4/Smad signaling pathway on the apoptosis of mouse primordial follicle oocytes / 解剖学报

Objective To explore the effect and mechanism of the bone morphologenetic protein 4 (BMP4)/Smad signaling pathway on the apoptosis of mouse primordial follicle oocytes .Methods Three-day-old Kunming mouse ovarine tissues were digested by the two-step enzymatic method to extract and purify oocytes .The cultured oocytes were divided into three groups: the normal culture medium (Con group), the medium with BMP4 (BMP4 group), and the medium with BMP4 and BMP4 inhibitor ( BMP4+inhibitor group ) .TUNEL was used to examine the effects of BMP 4 on the survival of the primordial follicle oocyte;Immunohistochemical staining and Real-time quantitative PCR were performed to investigate the expressions of p-Smad1/5/8, sohlh2, c-kit and foxo3a;siRNA interference, sohlh2 plasmid transfection and LY294002 treatments were performed to explore the mechanism of the BMP 4/Smad signaling pathway on the apoptosis of oocytes . Results TUNEL results demonstrated that the ratio of apoptotic oocytes in BMP 4 group was significantly lower than that in the Con group ( P <0.05 ) and the BMP4 +inhibitor group ( P <0.05 ); BMP4 significantly promoted the nuclear translocation of Smad and inhibited the nuclear translocation of foxo 3a, the mRNA and protein levels of sohlh2 and c-kit remarkably increased in BMP4 group.The effect of BMP4 on the oocyte survival was significantly repressed after sohlh 2 siRNA transfection.Sohlh2 overexpression up-regulated the expression of p-foxo3a, and this activity was abolished by LY 294002.Conclusion BMP4/Smad signaling pathway may inhibit primordial follicle oocyte apoptosis , via up-regulation of the expression of sohlh2 and c-kit, and then down-regulation of the nuclear translocation of foxo 3a.

Effect of ionizing irradiation on expressions of TLR4 and adaptor protein MyD88 in peritoneal macrophages of mice / 吉林大学学报(医学版)

Objective To observe the effect of ionizing radiation on the expressions of TLR4 and adaptor protein MyD88 in mouse peritoneal macrophages in the Toll-mediated signal transduction pathways.Methods 160 male Kunming white mice were randomly divided into 16 groups(ten each group):sham-irradiation and five groups after 4,8,16,24 and 48 h X-ray irradiation for time-course experiments;sham-irradiation and nine groups after 0.05,0.075,0.100,0.200,0.500,1.000,2.000,4.000,6.000 Gy irradiation for dose-effect experiments.Flow cytometry was used to detect the expressions of TLR4 and MyD88 after whole body irradiation (WBI) with X-rays.Results Both of TLR4 and Myd88 expressed more than shamirradiation after 0.075 and 2.000 Gy WBI for 4 h,and the expressions of them reached the peak at 16 h or 4 h after WBI(P

Effect of LPS with different doses on CD14 surface expression in J774A.1 cell line / 吉林大学学报(医学版)

Objective To study the dose-and time-effect relationship between lipopolysaccharide(LPS) and CD14 expression in the cell line J774A.1 of mouse macrophages. Methods The cell line J774A.1 was stimulated with different doses of LPS,and the CD14 surface-positive cells from the cell line J774A.1 were detected by flow cytometry(FCM)45 min after stained with FITC-CD14 monoclonal antibody. The changes of CD14 surface expression in the cell line J774A.1 at different time(1,2,4,8 and 16 h)after stimulated with LPS were observed.After the best stimulant time was selected,the cell line J774A.1 was treated with different doses(1,10,50,100,500 and 1 000 ?g?L~(-1))of LPS and the changes of CD14 surface expression were observed.(Results In view) of time-effect,compared with control group(the positive rate was 12.50?3.71),LPS significantly enhanced the CD14 expression at 1,2 and 4 h after stimulation(the positive rates were 23.80?5.07,(23.04?)2.88 and 28.22?1.54,respectively) when the dose of LPS was 1 ?g?L~(-1)(P