الملخص
Objective:To discuss the effect of apolipoprotein C1(APOC1)expression on the proliferation and apoptosis of the hepatocellular carcinoma cells,and to preliminarily clarify the related molecular mechanism.Methods:The expression level of APOC1 mRNA in hepatocellular carcinoma tissue and its relationship with the prognosis of the patient were analyzed by The Cancer Genome Atlas(TCGA)Database;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of APOC1 mRNA in different hepatocellular carcinoma cells;the human liver cancer HepG2 cells with low APOC1 expression were selected as the subjects.The HepG2 cells were transfected with pcDNA3.1-APOC1 plasmid to over-express APOC1(APOC1 over-expression group),and the HepG2 cells transfected with empty vector pcDNA3.1 were regarded as control group.MTS assay and 5-ethynyl-2'-deoxyuridine(EdU)staining were used to detect the proliferative activities and proliferation rates of the cells in two groups;Transwell chamber assay was used to detect the numbers of migration cells in two groups;flow cytometry and TUNEL assay were used to detect the percentages of the cells at different cell cycles and apoptotic rates in two groups;Western blotting method was used to detect the expression levels of extracellular regulated protein kinase(ERK),phosphorylated ERK(p-ERK),protein kinase B(AKT),phosphorylated AKT(p-AKT),B-cell lymphoma-2(Bcl-2),and cleaved cysteinyl aspartate specific proteinase-3(cleaved caspase-3)proteins in the cells in two groups.Results:The TCGA Database results showed that the expression level of APOC1 mRNA in hepatocellular carcinoma tissue was lower than that in normal liver tissue(P<0.05),and the patients with low expression of APOC1 mRNA had poor prognosis.The RT-qPCR results showed that the expression level of APOC1 mRNA in the HepG2 cells was the lowest,and the HepG2 cells were chosen for the subsequent research.Compared with control group,the proliferative activity and proliferation rate of the cells in APOC1 over-expression group were decreased(P<0.05 or P<0.01),the number of migration cells was decreased(P<0.01),and the percentage of the cells at S phase and the apoptotic rate were significantly increased(P<0.01).Compared with control group,the expression levels of p-ERK,p-AKT,and Bcl-2 proteins in the cells in APOC1 over-expression group were significantly decreased(P<0.05),and the expression level of cleaved caspase-3 protein was increased(P<0.01).Conclusion:High expression of APOC1 can inhibit the proliferation of the human liver cancer HepG2 cells and induce the apoptosis,and its mechanism may be related to inhibition of the expressions of p-ERK,p-AKT,Bcl-2 proteins and promotion of the expression of cleaved caspase-3 protein.
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Objective:To explore the effects of glycosylated nanoparticles on early radiation responses including the generation of reactive oxygen species (ROS), the polarization of pulmonary macrophages, and secretion of inflammatory cytokines in mice lung tissues.Methods:Twenty mice were randomly divided into control group, drug administration group, irradiation group and irradiation + drug administration group. The irradiation group and irradiation + drug administration group were subjected to whole lung irradiation with X-rays. The antioxidant ability of glycosylated nanoparticles was characterized using ROS indicator (CM-H 2DCFDA). The M2 polarization of pulmonary macrophages was detected by flow cytometry and PCR. The mRNA and protein expression levels of inflammatory cytokines were investigated by PCR and ELISA assay, respectively. Results:Compared with the irradiation group, the intensity of ROS fluorescence signals was significantly lower ( t=15.76, P < 0.05), the proportion of M2-type macrophages was significantly higher ( t=2.89, P < 0.05), the expression level of arginase 1 (ARG-1) gene was elevated, and the expression levels of tumour necrosis factor α (TNF-α), interleukin 1β (IL-1β) and interleukin 6 (IL-6) inflammatory factors were significantly reduced ( t=3.32, 2.90, 2.85, 4.55, 2.88, P < 0.05) in the lung tissues of irradiation + treatment group. Conclusions:Glycosylated nanoparticles can effectively scavenge ROS, trigger polarization of M2 macrophage, dampen inflammatory responses, and thus potentially alleviate radiation-induced lung injury.
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Objective:To establish a performance validation method for mNGS applied in BALF samples.Method:Hela cells were used as a representative of host cells, and simulated BALF samples were prepared by adding different concentrations of Hela cells, seven species of isolated pathogens (including Streptococcus pneumonia, Hemophilus influenza, Klebsiella pneumonia, Candida albicans, Cryptococcus neoformans, Aspergillus fumigatus, and Adenovirus), and interfering substances to sterile normal saline. Clinical BALF samples were collected simultaneously, and the results of mNGS were evaluated using traditional detection methods as a reference. The limit of detection (LOD), precision, anti-interference ability, stability, and accuracy of mNGS were determined. Results:In the simulated samples, the LOD of Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Candida albicans, Cryptococcus neoformans, Aspergillus fumigatus, and Adenovirus were 150, 262, 102, 67, 96, 83 CFU/ml, and 439 copies/ml, respectively. The repeatability of the detection results for all pathogens of simulated positive BALF samples was 100%. The anti-interference test showed that the higher the concentration of human DNA, the fewer pathogen sequences detected by mNGS. Escherichia coli and Shigella sonnei were used to evaluate the ability of mNGS to distinguish closely related species. The results showed that the system could stably distinguish Escherichia coli and Shigella sonnei when the concentration of Shigella sonnei was 4, 000 CFU/ml. The stability test results showed that there was no significant change in the number of pathogen sequences detected whether after 1 to 3 freeze-thaw cycles or storage at 4 ℃, -20 ℃, or -80 ℃ for 36 h. Compared with traditional detection methods, the accuracy of 17 clinical samples was 82.4%(14/17). Continuous evaluation of clinical BALF samples simultaneously tested by mNGS and traditional methods at Tongji Hospital from October 25, 2021, to September 14, 2022, showed that the accuracy of mNGS compared to bacterial culture, fungal culture, mycobacterial culture, Mycobacterium tuberculosis culture, and conventional PCR techniques was 67.5%(472/699), 81.5%(570/699), 92.3%(335/363), 96.4%(350/363), and 86.8%(132/152), respectively. Compared with conventional PCR techniques, the accuracy of mNGS for detecting Pneumocystis jirovecii, Adenovirus, and Mycoplasma pneumoniae was 89.4%(84/94), 93.3%(56/60), and 87.1%(61/70), respectively. Conclusion:By preparing simulated BALF samples and using traditional detection methods as a reference, the performance characteristics of mNGS in detecting BALF samples can be preliminarily evaluated.
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Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.
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Objective:To evaluate and summarize the best evidence of energy and protein intake targets and calculation in adult critically ill patients, and to provide evidence-based basis for critical nutrition management.Methods:Evidence related to energy and protein intake targets and calculation of adult critically ill patients, including guideline, expert consensus, systematic review and evidence summary, were systematically searched in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Library, UpToDate, BMJ Best Practice, Joanna Briggs Institute (JBI), Web of Science, SinoMed, Medive, China National Knowledge Infrastructure, Wanfang database, VIP database, Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), National Guideline Clearinghouse (NGC), Registered Nurses Association of Ontario (RNAO), and Society of Critical Care Medicine (SCCM) from January 2012 to June 2022. Two researchers independently evaluated the quality of the included literatures using the JBI Evidence-based Health Care Center evaluation tool and the Appraisal of Clinical Practice Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ), extracted and summarized the best evidence for the nutritional intake goal and calculation of adult critically ill patients, and described the evidence.Results:A total of 18 literatures were included, including 5 clinical guidelines, 8 expert consensus, 3 systematic reviews and 2 evidence summaries. After literature quality evaluation, 18 articles were all enrolled. The evidence was summarized from the four aspects, including energy target calculation method, dose body weight, energy and protein intake target, and calculation method, 24 pieces of the best evidence were finally formed.Conclusions:The best evidence of energy and protein intake targets and calculation for critically ill patients was summarized based on evidence-based. Clinical medical staff can choose indirect calorimetry to calculate energy goals when equipment is available. Patient's height, body weight should be recorded accurately, dose body weight can be determined by body mass index (BMI). Meanwhile, blood urea nitrogen (BUN) loss, fat-free body weight, simple formulas and other methods should be used to continuously evaluate and adjust protein intake targets, to achieve the purpose of optimizing intensive nutrition support.
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Objective:To observe the effect of goal-oriented management of continuous monitoring of regional cerebral oxygen saturation (rSO 2) on early postoperative neurocognitive disorders (PND) in elderly spinal surgery patients. Methods:From November 2018 to July 2019, 60 patients undergoing posterior lumbar interbody fusion in the Second Hospital of Shanxi Medical University were selected and randomly divided into control group and intervention group, 30 cases in each group. RSO 2 was recorded before anesthesia induction (T 0), 10 min after anesthesia induction (T 1), 10 min after prone position (T 2), 10 min after spinal decompression (T 3), 30 min after spinal decompression (T 4) and 10 min after extubation (T 5); The basic value of rSO 2, the minimum value of rSO 2 (rSO 2min), the average value of rSO 2 (rSO 2mean) and the maximum percentage of decrease of rSO 2 (rSO 2% max) were recorded. When rSO 2 <55% or rSO 2% max >10% and the duration was longer than 15 s, the intervention group took measures such as adjusting head position, adjusting blood pressure, increasing FiO 2 and respiratory parameters, increasing P ETCO 2 until rSO 2 returned to the required range; The control group did not interfere with the intraoperative rSO 2. Neuropsychological tests were used to evaluate the cognitive function of the two groups 7 days after operation. The patients were followed up 30 days after operation with the revised cognitive function telephone questionnaire (TICS-M). The incidence of postoperative neurocognitive impairment (PND) was recorded. The perioperative data and postoperative adverse reactions of the two groups were recorded. Results:At T 3 and T 4, the rSO 2 of the intervention group was significantly higher than that of the control group ( P<0.01), the intraoperative rSO 2min and rSO 2mean of the intervention group were higher than the control group, and the rSO 2%max was lower than the control group ( P<0.05). The incidence of PND 7 days after surgery, extubation time, postanesthesia care unit (PACU) stay time, hospital stay and postoperative adverse reactions in the intervention group were lower than those in the control group ( P<0.05). There was no significant difference in the incidence of PND 30 days after operation between the two groups ( P>0.05). Conclusions:The goal-oriented management of rSO 2 can reduce the incidence of early postoperative PND in elderly spine surgery patients, which is conducive to the rapid recovery of patients after surgery.
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Objective To explore the relationship between organizational innovation atmosphere and nurses′job satisfaction in China. Methods 300 nurses were sampled during January-February 2018 using convenience sampling method, for a questionnaire survey with the general information questionnaire, nurse organizational innovation atmosphere scale and Minnesota satisfaction scale. Results 282 valid questionnaires were recovered out of 300 questionnaires issued, accounting for 94% of valid recovery rate. The score of organizational innovation atmosphere was 81.35 ± 14.51, and that of job satisfaction was 69.85 ± 14.91, proving a correlation between organizational innovation atmosphere and job satisfaction (P<0.01). A hierarchical regression analysis showed that, with demographic data under control, the regression model can explain 52% of the variance in nurses′ job satisfaction.Conclusions Organizational innovation atmosphere and nurses′ job satisfaction of the hospital are both at a higher level. Good organizational innovation atmosphere contributes to higher job satisfaction of nurses.
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Through the analysis of current situation of the tension relationship between doctor and patient,this paper expounded that the harmonious management organization theory took the cooperation order as the core of the development of the group organization,and emphasized the running-in process of the internal staffs in the collective group.And it pointed out that the internal cooperation between doctor and patient had the certain cooperation order,and also had obstacles that might cause conflict in cooperation from the perspective of the harmonious management organization theory.This paper analyzed and understood the process of doctor-patient coordination at the group level of harmonious management organization theory,explored and analyzed the obstacles that might cause the conflict during the cooperation process and the reasons in the view of innovation,explored and concluded relevant measures to ease the tension of the doctor-patient relationship,and finally achieved the outcome of maximization of common interests and optimization of treatment effect.
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Objective To explore the training model of nurse specialists in geriatric and study its practical effect. Methods Forty-two nurse specialist participating in the training courses in geriatrics were enrolled in the study. The training was divided into 2 stages: the first one was for 1 month theoretical study together with 2 months clinical practice; the second was for 9 months clinical research on a specific topic. The examinations were done both at the two stages. They were interviewed on their views on theoretical study and internship at the end of first stage. Results The degree of satisfaction with the theoretical course was 91.6%, and the satisfaction degree of internship was 92.9%. The average scores at the end of the final examination and graduation examination were more than 85 points. Toally they were funded with 4 muncipal scientific research programs and 3 municipal patents, and published 9 academic papers. Conclusions The standardized training model is accessible for the nursing because of the training content and form. This model is feasible and effective, and it is worth applying and popularizing in the training of nurse specialist in the future.
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Objective To evaluate the feasibility, safety, and outcome of hepatectomy by hand-assisted laparoscopic surgery (Lapdisc system) in patients with hepatic hemangioma. Methods Eight patients with hepatic hemangioma underwent hand-assisted laparoscopic hepatectomy. Procedures included introduction of Lapdisc system, isolation of the liver from the ligments, occlusion of the hepatic porta, dissection of the hepatic parenchyma by harmonic scaple and removal of the samples. ResultsIn all patients, the hand-assisted laparoscopic hepatectomy were successfully performed. The operation time was(196.3?81.2)min. Blood loss was (307.5?224.7)ml, and postoperative hospital stay was (7.9?2.9)d. There was no significant postoperative complication such as bile leakage, bleeding or infection. ConclusionsLapdisc system could be safely used for hepatectomy in cases of hepatic hemangioma.
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Objective To investigate the alternation and significance of P-selectin in plasma during traumatic shock.Methods 24 rats were randomly assigned to three groups;control group, shock group and L-Arg group. The rats were subjected to induce traumatic shock ,and to determine the plasma P-selectin with ELISA after shock 30 min and 4 hour.Results P-selectin was expression in plasma of normal rats. 30 min after shock, P-selectin in sera was higher than in the control nontraumatized,but no statistical significance;4h after shock, the P-selectin was significantly increased. The P-selectin of L-Arg group in L-Arg group was obviously decreased than those of shock group.Conclusions Traumatic shock could induce P-selectin hyperexpression.It is related to remarkable microcirculatory perturbation and endothelial dysfunction during shock.L-Arg maybe decrease the expression of P-selectin through promoting the synthesis of the endothelial NO.
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Objective: To study the effect of angiogenesis inhibitor TNP-470 combination with 5-FU on liver metastasis of human colon cancer. Methods: Human colon cancer cell line, LOVO cells, were injected intrasplenically into BALB/c nude mice to produce diffuse liver metastases. Mice were randomly divied into four groups; TNP-470 treated group, 5-FU treated group, TNP-470 +5-FU treated group and control group. Animals were sacrificed after 4 weeks, and their livers were processed for histological examination. Liver metastatic rate and tumor foci in liver were counted. Tumor microvessel density (MVD) and vascular endothelial growth factor (VEGF) were determined by immunohistochemistry SABC method with image analyse system. Results: TNP-470 in combination with 5-FU and TNP-470 alone display a significant inhibitory effect on liver metastasis compared to the control ( P
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Objective To evaluate the selectively killing effect of adenovirus (Ad) mediated double suicide gene driven by KDR promoter on vein endothelial ECV304 cells.Methods KDR producing cells ECV304 and the KDR nonproducing cells LS174T were infected by Ad respectively, followed by treatment with 5-FC and GCV.Killing effects were evaluated and bystander effects were analyzed.Distribution of cell cycle was detected by flow cytometric assay and pathological character of cells was observed by electron microscopy.Results The infection rate of the resultant recombinant Ad to all the cells was not apparently different, and it increased gradually with the addition of multiple of infection (MOI) of Ads.ECV304 cells infected with Ad-KDR-CDglyTK were sensitive highly to the prodrugs, but the LS174T cells infected with Ad-KDR-CDglyTK appeared to be unsensitive to the two prodrugs ( P