Predictive value of neutrophil to lymphocyte ratio on acute kidney injury after on-pump coronary artery bypass: a retrospective, single-center study.

OBJECTIVE: To investigate the predictive value of preoperative neutrophil to lymphocyte ratio (NLR) on acute kidney injury (AKI) after on-pump coronary artery bypass (ONCAB). METHODS: Patients who underwent elective ONCAB for coronary heart disease were included. NLR was calculated according to the results of preoperative routine blood test, patients were divided into non-AKI and AKI groups, and the differences in clinical baseline data between the two groups were compared. RESULTS: A total of 154 patients were included in this study, including 57 (37%) with postoperative AKI and 97 (63%) without AKI. Compared with the patients in non-AKI group, those in AKI group had higher NLR (2.63 (1.83, 3.505) vs. 2.06 (1.7, 2.56), p = 0.002), higher serum creatinine (78 (67, 98.5) vs. 70.9 ± 16.8 umol/L, p < 0.001), longer cardiopulmonary bypass time, and longer aortic cross clamp time. After dividing patient into tertiles based on NLR, those with higher NLR had higher risk of postoperative AKI than those with lower NLR (30% vs. 25% vs. 55.8%, p for trend = 0.003). Patients in Tertile2 and Tertile3 had higher NLR compared to those in Tertile1 (p < 0.05); multivariate logistic regression analysis showed patients with elevated preoperative NLR and blood creatinine had higher risk of postoperative AKI. ROC curve showed that patients' preoperative NLR combined with blood creatinine had better predictive value for postoperative AKI. CONCLUSION: Elevated preoperative NLR is associated with AKI after ONCAB, and had prognostic utility independent of other recognized risk factors.

[L-carnitine: safe and effective for asthenozoospermia].

OBJECTIVE: One of the important reasons for male infertility is asthenozoospermia, for which there is no specific cure for the time being. The authors explored the clinical effect of L-carnitine for infertile males with asthenozoospermia. METHODS: A total of 135 patients with asthenozoospermia were randomly divided into Groups A (n = 68) and B (n = 67), the former treated with L-carnitine (2 g/d) and vitamin E, while the latter with vitamin E only, both for 3 months. All the patients received semen analyses before and after the treatment, and were observed for adverse effects. The pregnancy rates of their wives were recorded. RESULTS: Group A showed a significantly increased percentage of forward motile sperm after the treatment (45.4% +/- 11.1%) as compared with pretreatment (28.6% +/- 9.2%) (P < 0.01), but no statistically significant differences were found in sperm density and the percentage of the sperm of normal morphology (P > 0.05). The rate of pregnancy was significantly higher in Group A (31.1%) than in B (3.8%) after the treatment (P < 0.01). No adverse events were found during the treatment. CONCLUSION: L-carnitine, capable of significantly improving sperm motility and raising the rate of pregnancy, is a safe and effective therapeutic option for asthenozoospermia.

The function of tumor-derived exosomes.

Exosomes, especially the tumor-derived exosomes (TDEs), are extracellular vesicles released by many kinds of cells, which are involved in several biological and pathological processes. Their contents mainly include DNA, RNA and proteins. The message could be transmitted in neighboring or distant cells by secreting extracellular vesicles (EVs). Exosomes are a main intercellular communication regulator because they are involved and interact with intracellular signaling pathways. Exosomes can be detected in the tumor microenvironment, and there is growing evidence that TDEs are active in tumor growth, angiogenesis, invasion and metastasis, as well as immune responses and drug resistance. All of the functions mentioned above make it clear that exosomes have an important role in tumors. This review focuses on the origin and structure of TDEs and their important biological functions in the environment due to cell-to-cell intercellular communication.

The protective effect of psychological suzhi on the relationship between school climate and alcohol use among Chinese adolescents.

Background: There issome research on school climate impact on adolescent alcohol use in the Western social context; however, there is no research on school climate impact on adolescent alcohol use in China. This study aimed to explore the effect of school climate on Chinese adolescents' alcohol use, and the moderating role of psychological suzhi between them. Methods: A total of 801 adolescents (45.8% boys, 14.96±1.66 years) completed self-reports on school climate, psychological suzhi, and alcohol use. Results: Moderation analyses revealed that both school climate and psychological suzhi significantly negatively predicted adolescents' alcohol use, and the interaction of school climate and psychological suzhi significantly positively predicted adolescents' alcohol use. Moreover, the effect of school climate on adolescents' alcohol use was stronger for low psychological suzhi adolescents than high psychological suzhi adolescents. Conclusions: We can build good school climate by formulating of national level legal and regulations and good social norms, and use mature interventions or cultivation strategies to improve adolescents' psychological suzhi in order to better play its role in protection.

Assembly of a series of coordination polymers built from rigid a tetracarboxylate ligand and flexible bis(imidazole) linker: syntheses, structural diversities, luminescence sensing, and photocatalytic properties.

Hydrothermal reactions of aromatic terphenyl-4,2'',5'',4'-tetracarboxylic acid (H4tta) and transitional metal cations in the presence of two flexible N-donor ancillary ligands afforded four novel coordination polymers, namely, {[Zn(tta)0.5(m-bimb)]·H2O}n (1), [Ni2(tta)(m-bimb)2(H2O)]n (2), [Ni(H2tta)(o-bimb)·H2O]n (3), and [Cd(tta)0.5(o-bimb)]n (4), from solvothermal reactions in the presence of bis(imidazole) bridging linkers (m-bimb = 1,3-bis(imidazol-1-ylmethyl)benzene, and o-bimb = 1,2-bis(imidazol-1-ylmethyl)benzene). Their structures were determined by single-crystal X-ray diffraction analyses and further characterized by elemental analyses (EA), powder X-ray diffraction (PXRD), and thermogravimetric (TG) analyses. Compound 1 displayed a 2-fold 3D → 3D parallel entangled (4,4)-connected bbf net with the point symbol of (64·82)(66)2. Compound 2 featured a predocumented 3D (4,8)-connected (32·53·6)(34·44·59·611) net. Compound 3 exhibited a 2D 4-connected sql sheet with the point symbol of (44·62), and compound 4 showed a 2D 4-connected (32·62·72) kgm sheet. To our delight, fluorescence measurements showed that compound 1 could selectively and sensitively detect Cr3+ cations and nitrobenzene derivatives (nitrobenzene (NB), p-nitrotoluene (PNT), and p-nitroaniline (PNA)), which suggested that CPs of 1 was a promising bifunctional luminescence sensor material that could sense metal ions and small organic molecules. Moreover, 1 showed excellent photocatalytic activity.

Expression of miR-3189-3p in renal carcinoma and its effect on the proliferation and invasion of renal carcinoma cells / 国际外科学杂志

Objective:To investigate the expression difference of miR-3189-3p in renal cancer tissue and adjacent tissue and its effect on the biological function of renal cancer cells.Methods:quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression level of miR-3189-3p in renal cancer tissues and adjacent tissues, renal cancer cell lines (Caki-1, ACHN, A498, OS-RC-2) and normal renal tubular epithelial cells HK-2. miR-NC or miR-3189-3p mimics were transfected into renal cancer cells with the lowest expression of miR-3189-3p, respectively, named miR-NC group and miR-3189-3p group. The effects of miR-3189-3p on the proliferation and invasion of renal cancer cells were detected by CCK-8 method and Transwell migration experiment. miRanda and miRTarBase software was used to predict the downstream gene of miR-3189-3p. The dual luciferase reporter gene experiment was used to verify the downstream gene of miR-3189-3p. qRT-PCR and Western blotting were used to detect the expression of miR-3189-3p downstream gene. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups. Results:The relative expression of miR-3189-3p in renal cancer tissue and paracancerous tissue was 1.97±0.61 and 6.19±0.73, respectively, and the relative expression of miR-3189-3p in renal cancer tissue was lower than that in paracancerous tissue ( P<0.01). The relative expression of miR-3189-3p in renal cancer cell lines was lower than that in HK-2 cells ( P<0.05). The relative expression of miR-3189-3p in OS-RC-2 cells was the lowest ( P<0.01). The relative expression levels of miR-3189-3p in OS-RC-2 cells in the miR-NC group and miR-3189-3p group were 1.01±0.11 and 9.27±1.43, respectively, and the relative expression levels of miR-3189-3p in the miR-NC group significantly lower than the miR-3189-3p group ( P<0.01). Compared with the miR-NC group, the proliferation ability of OS-RC-2 cells with high expression of miR-3189-3p was significantly reduced ( P<0.05). The numbers of penetrating cells in the miR-NC group and miR-3189-3p group were 165.40±17.02 and 41.07±6.36, respectively, and the invasive ability of OS-RC-2 cells in the miR-3189-3p group was significantly reduced ( P<0.01). The target gene of miR-3189-3p is Aquaporin 3 ( AQP3) and miR-3189-3p can target AQP3 mRNA ( P<0.01). Compared with the miR-NC group, the expression of AQP3 gene in the high-expressing miR-3189-3p cells was significantly reduced at both the mRNA level and the protein level ( P<0.01). Conclusions:The expression of miR-3189-3p is down-regulated in renal cell carcinoma. High expression of miR-3189-3p can significantly inhibit the proliferation and invasion of renal cell carcinoma OS-RC-2 cells. The molecular mechanism is that miR-3189-5p targets and inhibits the expression of AQP3 gene.

Prognostic value of human papillomavirus infection and p53, p16, epidermal growth factor receptor and p34cdc2 expression in patients with salivary adenoid cystic carcinoma.

The aim of this study was to explore the correlation between HPV infection, p53, p16, epidermal growth factor receptor (EGFR), p34cdc2 protein expression and prognosis in patients with adenoid cystic carcinoma of salivary gland. Totally 78 cases of adenoid cystic carcinoma of salivary gland specimens were selected from January 1, 2004 to December 31, 2013 in Tangshan Union Hospital. PCR-reverse dot blot hybridization was used to detect infection of human papilloma virus (HPV), and SP immunohistochemical method was adopted to detect the expression of p53, p16, EGFR and p34cdc2 protein in the carcinoma tissues. Clinical data were collected and the patients were followed up. Results showed that the infection rate of HPV in adenoid cystic carcinoma tissues was 0% (0/78). The expression rate of p53, p16, EGFR and p34cdc2 protein in carcinoma tissues were 75.6% (59/78), 57.7% (45/78), 60.1% (47/78) and 64.1% (50/78), respectively. Expression of p53, p16, EGFR and p34cdc2 proteins was not significantly correlated with patients' age, gender, disease location, TNM classification and histological type (P > 0.05). Kaplan-Meier analysis showed that EGFR-positive patients had a lower median overall survival than EGFR-negative ones (58 months vs. 75 months, respectively. P = 0.001). The result of median progression-free survival was virtually the same for both EGFR-positive and EGFR-negative patients (43 months vs. 49 months, respectively. P = 0.002). p34cdc2-positive patients had a lower median overall survival than p34cdc2-negative ones (61 months vs. 71 months, respectively. P = 0.027). Median progression-free survival was also almost the same for both p34cdc2-positive and p34cdc2-negative patients (44 months vs. 51 months, respectively. P = 0.011). Cox regression analysis showed that expression of EGFR and p34cdc2 was independent risk factors for the prognosis of patients with adenoid cystic carcinoma of salivary gland (relative risk = 13.199, 11.466, P < 0.001). In conclusion, HPV infection is not detected in salivary adenoid cystic carcinoma tissues. p53, p16, EGFR and p34cdc2 protein are positively expressed in most salivary adenoid cystic carcinoma tissues. p16 is unsuitable as a surrogate for HPV infection status in patients with adenoid cystic carcinoma of salivary gland. Expression of EGFR and p34cdc2 is independent risk factors in the prognosis of patients with salivary gland adenoid cystic carcinoma. Patients with EGFR or p34cdc2 positive expression should be followed up closely.

Thirty-six critical cases of emergency helicopter transferring between hospitals / 中华危重病急救医学

Objective:To summarize critical cases of emergency helicopter transferring between hospitals and improve the quality and safety of critical care.Methods:The task records of Guangxi Aviation Medical Rescue Training Base from September 2017 to September 2020 were retrieved. The mission acceptance, implementation results, disease spectrum composition, pre-transfer preparation and medical intervention on board were summarized.Results:① General information: a total of 168 patients of helicopter transfer requests were registered, of which 36 patients were transferred, 35 patients were successful, 1 patient had cardiac arrest during the landing phase, and died several hours after continuous resuscitation. Of the 36 patients 30 were males and 6 were females, with median age of 50.5 (29.8, 66.0) years old, the average transfer time was (54.95±17.89) minutes, and the average transfer distance was (205.74±74.68) km. ② Disease spectrum included 11 cases of stroke (30.55%), 7 cases of trauma (19.45%), 5 cases of severe pneumonia (13.89%), 5 cases of heart and macro-vascular diseases (13.89%), 5 cases of abdominal emergency (13.89%), and 3 other conditions (8.33%).③ Severity: 31 patients (86.11%) were severe (≥15) according to acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score; 19 patients (52.78%) were high-risk emergency transport (≥6) according to Hamilton early warning score (HEWS); 6 patients (85.71% of trauma patients) were severe trauma (≥16) according to injury severity score (ISS). ④ Preparation before transfer: remote consultation was carried out to evaluate the latest state of the patient's condition, especially the respiratory and circulatory conditions. Relevant items were reviewed and emergency treatments were implemented when necessary. Targeted preparation was made for accidents that might occur during transfer, such as electrocardiogram (94.44%), blood gas analysis (94.44%), brain CT (36.11%) and other auxiliary examinations, endotracheal intubation or tracheotomy (72.22%), deep vein catheterization (91.67%), placement of gastric tube (86.11%) and urinary tube (88.89%), adjustment of sedative (38.89%), vasoactive drugs (58.33%) and drugs for dehydration and lowering intracranial pressure (33.33%), and fixation of fracture (11.11%), etc. ⑤ On-board medical intervention: cardiac monitoring, blood pressure, respiration and blood oxygen monitoring were carried out in all patients. The parameters of patients using ventilator were adjusted in time (66.67%). The dosage of patients using micropump was adjusted in time (91.67%). Other aspects included the use of sedative and analgesics (38.89%), sputum suction nursing (75.00%), all kinds of catheter nursing (endotracheal intubation/incision nursing of 72.22%, indwelling catheter nursing of 88.89%), and cardiopulmonary resuscitation for patient with cardiac arrest (2.78%).Conclusion:As the patients transferred by helicopter are mainly those of critically ill at this stage, the requirements for airborne medical equipment and rescue technology are high, and there is an urgent need to establish technical specifications and personnel training standards.

[Preventive effects and mechanism of heme oxygenase-1 activation on acute respiratory distress syndrome in rats].

OBJECTIVE: To explore the possible mechanism of heme oxygenase-1 (HO-1) induction for its protective effects on acute respiratory distress syndrome (ARDS). METHODS: The production of HO-1 was induced by hemoglobin (Hb) injection into oleic acid (OA) induced ARDS rats. Western blot and RT-PCR techniques were used to observe the induction of HO-1 in vivo. Both the levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-8 (IL-8) in serum and bronchoalveolar lavage fluid (BALF) were measured by enzyme linked immunosorbent assay (ELISA). Combined with blood gas analysis and other indexes, the effect of HO-1 on ARDS could be clearly manifested. RESULTS: The expression of HO-1 mRNA was increased significantly 16 h after Hb injection, and the protein expression of HO-1 was also obviously increased 24 h later (P < 0.01). The levels of TNF-alpha and IL-8 in both serum and BALF were significantly lower in Hb + OA group than in OA group (P < 0.01). Arterial blood PaO(2), oxygen saturation, and oxygenated index in Hb + OA group [(56.28 +/- 6.71) mm Hg, (79.53 +/- 5.82)%, and (258.81 +/- 29.37) mm Hg respectively] were higher than in OA group [(35.08 +/- 4.59) mm Hg, (55.80 +/- 12.76)%, and (167.86 +/- 21.94) mm Hg]. Lung wet and dry weight, and pathological changes were also improved. CONCLUSION: The production of HO-1 was successfully induced by hemoglobin in vivo. Protective effects of HO-1 on ARDS might be related to the decreasing in inflammatory factors, such as TNF-alpha and IL-8.