Study on warfarin dose adjustment strategy at different stages after mechanical valve replacement of mitral valve / 中国胸心血管外科临床杂志

@#Objective    To explore the anticoagulant strategy of adjusting the dose of warfarin at different stages after mechanical valve replacement of mitral valve. Methods    Clinical data of a total of 302 patients, including 76 males and 226 females, with an average age of 50.1±10.1 years, who underwent mechanical mitral valve replacement in the Chinese adult cardiac surgery database from 2013 to 2017 were retrospectively analyzed. According to the dose adjustment strategy of taking warfarin, the patients were divided into a D group (adjusting warfarin dose in days) and a W group (adjusting warfarin dose in weeks) to evaluate the anti-coagulation effect of warfarin. Results    The total follow-up time was 423 277 d (1 159.7 years). There was no significant difference in the overall anticoagulant strength, and the warfarin dose adjusted in days was better in the early postoperative period (P<0.05), especially in patients over 60 years. It was better to adjust warfarin dose in weeks in the middle and long periods (P<0.05), especially in patients ≤40 years. In terms of the stability of anticoagulation, it was better to adjust the dosage of warfarin in weeks (P<0.05). It was better to adjust the dosage of warfarin in weeks for early, middle- and long-term anticoagulant therapy after operation (P<0.05), especially in the females aged >40 and ≤50 years. Conclusion    Within the target range of international normalized ratio (1.5-2.5), the anticoagulant strategy of adjusting warfarin dose in days after mechanical valve replacement of mitral valve can   achieve a better anticoagulant strength, and adjusting the dosage of warfarin in weeks is better in the middle- and long-term after operation. In general, the anticoagulant effect is more stable in the short term when warfarin dose is adjusted on a weekly basis.

Erratum: Cyclin Dependent Kinase 1 (CDK1) Activates Cardiac Fibroblasts via Directly Phosphorylating Paxillin at Ser244.

An error appeared in the article entitled "Cyclin Dependent Kinase 1 (CDK1) Activates Cardiac Fibroblasts via Directly Phosphorylating Paxillin at Ser244" by Chen Sai, Jiang Yunhan, Jian Zhao, Zhu Yu, Zhu Yun, Cao Zhezhe, Tang Fuqin, Xiao Yingbin, and Ma Ruiyan (Vol. 60, No. 2, 374-83, 2019). The Figure 2C on page 378 should be replaced by the following figure.

Coagulation and immune function indicators for monitoring of coronavirus disease 2019 and the clinical significance / 中南大学学报(医学版)

OBJECTIVES@#To explore the significance of coagulation and immune function indicators in clinical diagnosis and treatment of coronavirus disease 2019 (COVID-19).@*METHODS@#All patients with COVID-19 diagnosed and treated in First People's Hospital of Yueyang from January to March 2020 were enrolled. The general data of patients were collected. The patients were assigned into a light group (=20), an ordinary group (=33), a severe group (=23), and a critically severe group (=7) according to the severity of the disease. Coagulation and immune function indicators of each group were compared, and the relevance of coagulation and immune function indicators was analyzed.@*RESULTS@#The age of COVID-19 patients in Yueyang City was mainly between 45 and 65 years old. There was a significant difference in the coagulation function and immune-related indicators in each group of patients (all <0.05).@*CONCLUSIONS@#There are some abnormalities in coagulation and immune function in patients with COVID-19, which possess significance for clinical diagnosis and treatment of the disease.

Effect of Mmu-circRNA_016901 on the Radiosensitivity of Bone Marrow Mesenchymal Stem Cells / 中国实验血液学杂志

OBJECTIVE@#To explore the effect of mmu-circRNA_016901 on the regulation of radiation injury of bone marrow stem cells and its mechanism.@*METHODS@#Bone marrow stem cells were exposed to different dose of X-ray, then the expression level of mmu-circRNA_016901 in bone marrow cells treated with different doses of X-ray was detected. The luciferase reporter gene assay was used to confirm that miRNA1249-5p is the target of mmu-circRNA_016901, and RNA Binding Protein Immunoprecipitation was used to confirm that TGF-β3 is the targeted on miRNA1249-5p，the expression of TGF-β3 and cell proliferation were detected after the expression of mmu-circRNA_01690 was regulated.@*RESULTS@#When the irradiation dose＜6 Gy, there were significant difference in the expression of mmn-circRNA-016901 after the bone marrow mesenchymal stem cells were treated by different doses of irradiation, which showed a statistically significant (P＜0.05). The luciferase reporter gene detection and co-immunoprecipitation experiments confirmed that Mmu-circRNA_016901 could binds to miRNA1249-5p specifically, and overexpression of mmu-circRNA_016901 could regulate miRNA1249-5p negatively, which resulted in a significant increase in TGF-β3 expression and promoting of cell proliferation.@*CONCLUSION@#mmu-circRNA_016901 affects the expression of TGF-β3 through miRNA1249-5p, and thus participates in the regulation of the radiation damage mechanism of bone marrow mesenchymal stem cells.

Cyclin Dependent Kinase 1 (CDK1) Activates Cardiac Fibroblasts via Directly Phosphorylating Paxillin at Ser244.

Atrial fibrillation has caused severe burden for people worldwide. Differentiation of fibroblasts into myofibroblasts, and consequent progress in atrial structural remodeling have been considered the basis for persistent atrial fibrillation, yet little is known about the molecular mechanisms underlying the process. Here, we show that cyclin-dependent kinase 1 (CDK1) is activated in atrial fibroblasts from patients with atrial fibrillation (AFPAF) and in platelet derived growth factor BB (PDGF-BB)-treated atrial fibroblasts from patients with sinus rhythm (AFPSR). We also demonstrate that inhibition of CDK1 suppresses fibroblast differentiation and focal adhesion (FA) complex formation. The FA protein paxillin is phosphorylated directly at Ser244 by CDK1. Importantly, transfection of a paxillin construct harboring a Ser to Ala mutation causes FA complex disassembly and greatly inhibits fibroblast activation. AFPSRs applied with a lentiviral vector carrying the shRNA sequence of paxillin dramatically prevents PDGF-BB induced functional activation. Taken together, all these results suggest that phosphorylation of paxillin at Ser244 by CDK1 is a key mechanism in fibroblast differentiation and could eventually assist atrial fibrosis.

Atorvastatin prevents postoperative atrial fibrillation in patients undergoing cardiac surgery.

BACKGROUND: Observational studies have suggested that statins might reduce postoperative atrial fibrillation (AF) in patients undergoing cardiac surgery. However, a number of retrospective studies have shown equivocal results. We aimed to evaluate whether different statins can reduce the risk for AF at different doses. METHODS: We searched PubMed, EMBASE, and the Cochrane Database for all published randomized controlled trials (RCTs) that examined the effects of statin therapy on AF up to June 2016. A random-effects model was used when there was substantial heterogeneity. RESULTS: Eighteen published studies that included 4003 statin-naive patients (2009 receiving satins and 1994 receiving regime) with sinus rhythm before cardiac surgeries were identified for inclusion in the analysis. Thirteen studies investigated the prevention of AF by atorvastatin, two studies investigated the prevention of AF by rosuvastatin, two studies investigated the prevention of AF by simvastatin, and one study investigated the prevention of AF by pravastatin. The remaining two studies compared the effects of different doses of atorvastatin on the prevention of AF in patients undergoing coronary artery bypass grafting (CABG). Overall, statin therapy was associated with a significant decrease in the risk for AF (relative risk [RR]: 0.57, 95% confidence interval [CI]: 0.45-0.73, P = 0.000). However, subgroup analyses showed that only atorvastatin reduced the risk for new-onset AF in patients after cardiac surgery (RR: 0.53, 95% CI: 0.41-0.69, P = 0.000). Patients undergoing CABG possibly received more benefits from statin therapy (RR: 0.52, 95% CI: 0.39-0.68).Statin therapy in a moderate dose may be optimal (RR: 0.42, 95% CI: 0.28-0.64). CONCLUSIONS: This meta-analysis suggests that statin therapy has an overall protective effect against postoperative AF, among which atorvastatin in a moderate dose was significantly associated with a decreased risk for new-onset AF in patients after CABG. Moreover, simvastatin may also exert a significant protective effect against the AF recurrences in patients undergoing cardiac surgeries; hence, further prospective studies are warranted.

A comparative study on the construction of medical teams in public primary and secondary schools after multi-channel distribution mode in Guangzhou / 中国学校卫生

Objective@#To understand the situation of school medical staff in Guangzhou after adopting multichannel medical model, and to provide reference for school medical team construction.@*Methods@#A total of 1 099 primary and secondary schools in Guangzhou participated in this study through questionnaire survey regarding school medical personnel, basic situation of school medical personnel and work situation.@*Results@#Among the 1 099 primary and secondary schools surveyed, 638(58.05%) of them consisted of 707 full-time school doctors, the eligible rate was 28.20%. The recruitment of school doctors was still based on independent recruitment(55.87%), and 44.13% of the purchase service modes (community deployment, hospital purchase services, and school clinic custody) were deployed. Most of school medical professionals majored in nursing(56.86%), followed by clinical medicine (26.03%) and preventive medicine (9.76%); In terms of professional titles, junior, intermediate and senior certificates accounted for 52.47%, 37.34%, and 1.27%, respectively; More than 68.74% of school doctors worked for less than 5 years; On average, 68.60% of training were provided every six months. About 33.95% of the school doctor were satisfied with salary, 20.79% were not satisfied. Compared with the year 2016, no significant changes were noticed in academic qualifications, professional titles, and working conditions of school medical team, however, increased proportion of staffs with nursing certificate instead of clinical medicine certificate increased, workload and satisfaction towards salary decreased(P<0.01).@*Conclusion@#After adopting the multi-channel deployment model, the construction of school health workforce in Guangzhou has made breakthrough progress. It is proposed to improve the guidelines for the standardization of school doctors, to strengthen the professional skills training of school doctors, and to better improve the overall level of school health work in the city.

Acupoint catgut embedding therapy in treatment of anal fissure at Ⅰ and Ⅱ stages:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the difference in the clinical therapeutic effects on anal fissure at Ⅰ and Ⅱ stages between the acupoint catgut embedding therapy and western medication.</p><p><b>METHODS</b>Sixty patients of anal fissure at Ⅰ and Ⅱ stages were randomized into an embedding therapy group and a western medication group, 30 cases in each one. In the embedding therapy group, the acupoint catgut embedding therapy was applied at bilateral Tianshu (ST 25), Changqiang (GV 1), bilateral Chengshan (BL 57) and Tigangxue (Extra), once a week. In the western medication group, the external inunctum on the wound was given with 0.2% nitroglycerin ointment, once every morning and evening a day. The treatment lasted for 4 weeks continuously in the two groups. The follow-up visit was done for 3 months after treatment. The visual analogue scale (VAS) and anal pain duration were observed and recorded before treatment and on the 3rd day and the 7th day of treatment separately. The clinical therapeutic effects were compared between the two groups.</p><p><b>RESULTS</b>After treatment, on the 3rd day and the 7th day of treatment, VAS score and anal pain duration were all reduced significantly as compared with those before treatment in the patients of the two groups (all<0.01). The differences in the embedding therapy gruop were better than those in the western medication group before and after treatment (<0.01,<0.05). In the 2nd and 4th weeks after treatment, the clinical therapeutic effects in the embedding therapy group were better than those in the western medication group (both<0.05). In 3-month follow-up, the recurrent case in the embedding therapy group was one, and the recurrent case in the western medication group was six.</p><p><b>CONCLUSIONS</b>The acupoint catgut embedding therapy is safe and effective in the treatment of anal fissure at Ⅰ and Ⅱ stages and its recurrent case is lower as compared with the treatment of western medication.</p>

Perioperative psychological management of 11 male patients with breast cancer / 现代临床护理

Objective To summarize the experience of peri-operative emotion management of male patients with breast cancer. Methods The clinical data of 11 male patients with breast cancer were analyzed to summarize methods for the emotion management before, during and after chemo-radiotherapy. Result All the patients took a good attitude and complete the therapy after implementation of emotion management. Conclusion Peri-operative psychological management is of help for their alleviating the negative moods of helplessness, strengthening their confidence, stabilizing and improving the emotions, and finally making them cooperative in the treatment and nursing.

An evaluation of therapeutic effect of idarubicin combined with CAG regimen on previously untreated elderly patients with acute myeloid leukemia / 中国中西医结合急救杂志

10.3969/j.issn.1008-9691.2013.03.017