Analysis on the current situation and influencing factors of discharge readiness of patients with arteriosclerosis obliterans / 中国实用护理杂志

Objective:To explore the latent profile of discharge readiness of patients with lower extremity arteriosclerosis obliterans and analyze its influencing factors, so as to provide theoretical basis for individualized management of discharge readiness in patients with lower limb arteriosclerosis obliterans.Methods:From February 2022 to December 2022, 194 patients with arteriosclerosis obliterans of lower limbs who received surgical treatment in the vascular surgery department of Shandong Provincial Hospital Affiliated to Shandong First Medical University were investigated by using general information questionnaire, Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale and Family APGAR Index for a cross-sectional survey. Latent profile analysis was used to identify different categories, and Logistic regression analysis was used to explore its influencing factors.Results:Totally 182 valid questionnaires were collected, of which 127 males and 55 females, and patients over 60 years old were the majority, accounting for 81.9%. Three latent profile models were identified in this study, namely, low discharge readiness group (27.47%), medium discharge readiness-high expected support group (41.21%) and high discharge readiness group (31.31%). Logistic regression analysis showed that first hospitalization ( OR=19.218, 95% CI 2.949-125.237), the quality of discharge guidance ( OR=0.896, 95% CI 0.857-0.937) were the predictive factors of medium discharge readiness-high expected support group ( P<0.05); family function ( OR=0.185, 95% CI 0.097-0.353) and the quality of discharge guidance ( OR=0.823, 95% CI 0.764-0.888) were the predictive factors of the low discharge readiness group of patients with arteriosclerosis obliterans (all P<0.05). Conclusions:There are different types of discharge readiness of patients with arteriosclerosis obliterans, and patients with poor quality of discharge guidance and poor family function are more likely to have a trend of low discharge readiness. Patients with low quality discharge guidance and first hospitalization are more likely to have a trend of moderate discharge readiness-high expected support. For this kind of patients, medical staff should take corresponding measures to improve their readiness for discharge.

Clinical characteristics and prognosis analysis of 53 cases of drowning in children / 中国小儿急救医学

Objective:To summarize the clinical characteristics and first aid measures of children with drowning，and to provide scientific basis for the treatment and prevention of drowning in children.Methods:The clinical data of drowning children admitted to the Children's Medical Center of the First Affiliated Hospital of Hunan Normal University（Hunan Provincial People's Hospital）from January 2011 to December 2021 were retrospectively summarized. Baseline characteristics，prehospital emergency care and prognosis of the included children were analyzed.According to the time span, drowning children were divided into two stages, the first stage (2011-2016) and the second stage (2017-2021). According to cerebral performance category assessment scale,drowning children with cardiac arrest were divided into two groups: a group with good neurological prognosis and a group with poor neurological prognosis. The baseline characteristics,pre-hospital emergency care, and prognosis of drowning children during different periods and with different prognosis were analyzed.Results:A total of 53 children were enrolled during the study period，with 24 cases in the first phase（2011-2016）and 29 cases in the second phase（2017-2021）.Boys accounted for 73.6%（39/53）of the cases, the age ranged from 1 month and 24 days to 14 years old，with 1-4 years old being the most common，accounting for 58.5%（31/53）, and the season in which drowning occurred was more common in the summer（39.6%, 21/53）.Six cases (11.3%) had significant neurological sequelae, and the mortality rate was 3.8%（2/53）.There was a decrease in the proportion of drowning with water control in the second stage compared to the first stage（37.5% vs. 13.79%, P=0.046）.Thirty-two（60.4%）children experienced on-site cardiopulmonary resuscitation(CPR) after drowning，with 24 cases in the group with good neurological prognosis and 8 cases in the group with poor neurological prognosis.Children in the poor neurological prognosis group required CPR for a long duration [10.00（1.50, 25.00）min]，had lower body temperature，Glasgow Coma Score，pH and higher blood glucose levels on admission（all P < 0.05）. Conclusion:Drowning is most common in preschool children，common in boys，and drowning prevention measures for young children deserve focused attention. Children found to be in cardiac arrest at the time of drowning have a long duration of drowning and CPR，which predicts a poor neurological prognosis，and timely and effective on-site CPR is the key to reducing the drowning rate.

Primary study of heat stress inducing early expression and secretion of tissue factor in vascular endothelial cells / 解放军医学杂志

Objective To explore the pattern of early expression and secretion of tissue factor(TF)in vascular endothelial cells induced by heat stress.Methods Thirty SPF-rated C57BL/6 male mice were randomly divided into five groups:the control group and groups of indicated recovery time,including 0,3,6,and 9 h in room temperature after heat stress(n=6).Mice in the heat stress groups were exposed to an animal incubator to reach 42.5℃for core body temperature for heat stroke.We analyzed the histopathological changes in the liver,lung,and kidney tissues with HE staining.We measured the TF mRNA in mice tissues by RT-qPCR and the plasma concentration of TF in mice with a commercial ELISA kit.Human umbilical vein endothelial cells(HUVECs)were placed in a culture incubator to build an in vitro heat stress model.HUVECs were divided into five groups,including a control group and groups of indicated recovery time,including 0,3,6,and 9 h after heat stress.We quantified the expression of TF mRNA and protein in HUVEC cells by RT-qPCR,Western blotting,and immunofluorescence and measured the secreted TF with a commercial ELISA kit.Results No significant pathological injury was observed in the tissues of the control group.Mice treated with heat stress had various degrees of structural injuries and hemorrhagic and inflammatory changes in multiple tissues.Compared to control group,the expression of TF mRNA significantly increased in the kidney of heat stress-treated mice with 0 and 3 h recovery time(1.719±0.018,1.241±0.178 vs.1.000±0.063),the lung with 3 h recovery time(2.444±0.511 vs.1.000±0.106)and the liver with 6 h recovery time(7.312±0.618 vs.1.000±0.147)(P<0.05).The concentration of TF in plasma also sustainedly elevated in mice with 0,3,6,and 9 h recovery time after heat stress as compared to control group[(132.426±17.920)pg/ml,(119.400±10.267)pg/ml,(107.374±13.495)pg/ml,(163.767±22.810)pg/ml vs.(75.479±13.831)pg/ml,respectively,P<0.01].The expression levels of TF mRNA were higher in heat stress HUVECs with 6 h and 9 h recovery time than the control cells(1.905±0.354,2.564±0.297 vs.1.000±0.097,P<0.01).Secreted TF in the supernatant from HUVECs treated with heat stress and different recovery time also increased significantly[(36.309±4.101)pg/ml,(38.425±5.484)pg/ml,(41.655±4.380)pg/ml,(43.586±4.718)pg/ml vs.(14.996±0.254)pg/ml,P<0.01].Conclusion Heat stress increased early expression and secretion of TF in vascular endothelial cells.Vascular endothelial cells may be a main source of circulating TF in heat stroke.

Clinical practice of double lumen cannula for veno-venous extracorporeal membrane oxygenation in adults / 中华危重病急救医学

Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a life support technique for patients with severe respiratory failure. In the past, single lumen cannula was mostly used to constract the vascular pathway of extracorporeal membrane oxygenation. Compared with single-lumen cannula, double lumen cannula (DLC) can reduce recirculation fraction, reduce complications such as infection and bleeding, and facilitate patient's rehabilitation. DLC requires accurate positioning of the catheter. It has been gradually applied in China. This paper will review the key points related to the use of DLC, such as the insertion, position, and complications, etc. to provide guidance for clinical application practice.

Development of a mouse model of stellate ganglion block and subsequent effects on cerebral cortical blood flow / 中华麻醉学杂志

Objective:To develop a model of stellate ganglion block (SGB) in mice and investigate the effect of SGB on cerebral cortical blood flow.Methods:Thirty clean-grade healthy male C57BL/6 mice, aged 8-9 weeks, weighing 23-27 g, were divided into 5 groups ( n=6 each) using a random number table method: control group (group C), left SGB group (group L), left normal saline group (group SL), right SGB group (group R) and right normal saline group (group SR). Group C received no intervention.SGB was performed with 0.25% ropivacaine 0.08 ml via percutaneous posterior approach in L and R groups, while the equal volume of normal saline 0.08 ml was given instead at the location of left and right stellate ganglion in SL and SR groups, respectively.The cerebral cortical blood flow was determined using laser speckle contrast imaging system before SGB (T 0) and at 10, 30, 60, 90 and 120 min after SGB (T 1-5). Results:Mice developed ptosis on the block side, indicating that the model of SGB was successfully developed in L and R groups.There was no significant difference in cerebral cortical blood flow at each time point among C, SL and SR groups ( P>0.05), and cerebral cortical blood flow on the block side decreased at T 1, began to increase at T 2, peaked at T 3, and decreased at T 5 which was still higher than that at T 0 in group L and group R ( P<0.01). Compared with C and SL groups, the left cerebral cortical blood flow was significantly decreased at T 1, 5 and increased at T 2-4 in group L ( P<0.01). Compared with C and SR groups, the right cerebral cortical blood flow was significantly decreased at T 1, 5 and increased at T 2-4 in group R ( P<0.01). There were no significant differences in cerebral cortical blood flow at each time point between group C and group SL and between group C and group RL ( P>0.05). Conclusions:The mouse model of SGB via percutaneous posterior approach is successfully developed.Unilateral SGB can affect cerebral cortical blood flow on the block side, which shows a transitory decrease followed by a sustained significant increase.

Effect of Tanhuo Formula on the expression of Caspase-3, GFAP, and angiogenesis in rats with cerebral ischemia / 国际中医中药杂志

Objective:To study the effect of Tanhuo Formula (THW) on the expression of Glial Fibrillary Acidic Protein (GFAP), Caspase-3 and angiogenesis.Methods:Rats were divided into sham group, model group, low-dose THW group, medium-dose THW group, high-dose THW group and Ginaton group according to random number table method. Except the sham group, rats in other groups were subjected to the middle cerebral artery occlusion via a suture method. After 2 hours,rats in the low, medium and high dose of THW groups were gavaged with 0.92, 1.84 and 3.68 g/kg of THW dry extract powder solution respectively, and the Ginaton group were gavaged with 60 mg/kg of Ginaton, once every 24 hours for 3 days. Rats in sham operation group and model group were given equal volume of normal saline by gavage. The limb symmetry score was used to evaluate limb dysfunctions. The immunofluorescence staining of GFAP and Caspase-3 were applied to assess astrocyte activation and neuronal apoptosis, respectively. The double-labeled immunofluorescence staining of platelet-endothelial cell adhesion molecule (CD31) and chondroitinsulphate peoteoglycan (NG2) were performed to detect angiogenesis.Results:Compared with the model group, rats in the high-dose of THW group showed increased limb symmetry score ( P<0.01 or P<0.05), increased number of Caspase-3 (cortex: 765.0±122.4 vs. 1 131.0±392.9; striatum: 895.9±389.8 vs. 1 401.9±453.1) ( P<0.01 or P<0.05) and CD31 +/NG2 + (cortex: 1 355.0±257.9 vs. 825.4±308.1; striatum: 1 290.9±400.9 vs. 675.2±259.7) ( P<0.01) positive cells in the periinfarct cortex and striatum, and attenuated the integrated optical density of GFAP in the perilesional cortex (4 210.00±1 226.38 vs. 7 935.78±2 001.98) ( P<0.01). Conclusions:THW could ameliorate the limb functional disorders, inhibit astroglia activation, down-regulate the expression of Caspase-3, and enhanced angiogenesis in MCAO rats.

Relationship between GNRI and perioperative rehabilitation of elderly patients with gastric cancer / 安徽医科大学学报

Objective @#To explore the relationship between geriatric nutritional risk index( GNRI) and perioperative nutritional status，postoperative recovery and complications in elderly patients with gastric cancer．@*Methods @#In this retrospective study，212 elderly patients ( aged ≥60 years ) with gastric cancer who underwent gastrectomy were recruited．GNRI was used to retrospectively assess the patients' preoperative nutritional status ，and analyze the relationship between GNRI and perioperative nutritional status，postoperative recovery and complications．The ROC curve was applied to explore the value of GNRI in predicting postoperative complications. @*Results @#The inci- dence of preoperative nutritional risk in elderly patients undergoing gastric cancer surgery was 45. 07%．Compared with the patients whose GNRI＞98 points，the patients whose GNRI≤98 points had different degrees of decrease in serum total protein，albumin，prealbumin，hemoglobin and lymphocyte counts before surgery，day 1 and day 5－8 after surgery (P ＜0. 05) ．The patients whose GNRI ＜92 points had longer postoperative hospital stay than those with GNRI＞98 points (P＜0. 05) ．With the decrease of GNRI scores，the incidence of complications showed an upward trend(P＜0. 001) ．The multivariate analysis of the relationship between GNRI and postoperative complica- tions showed that TNM staging of III －IV and GNRI ＜92 points were independent risk factors for complications. GNRI had a good predictive value for the occurrence of complications (AUC = 0. 639，95% CI : 0. 570－0. 703，P = 0. 001，Cut-off value : 92. 21) ．@*Conclusion @#GNRI can be used for preoperative nutritional assessment for eld- erly gastric cancer patients．Patients with GNRI＜92. 21 points should be actively given nutritional therapy to im- prove perioperative nutritional status，speed up postoperative recovery，and reduce the occurrence of complications.

Scutellarin improves LPS + ATP induced inflammation and pyroptosis of endothelial cells by inhibiting NLRP3/caspase-l signaling pathway / 中国药理学通报

Aim To investigate whether Scutellarin ( Seu ) could alleviate LPS + ATP induced inflammation and pvrolysis and the underlying mechanisms.Meth¬ods Primary human umbilical vein endothelial cells (HUVCEs) were pretreated with different concentra¬tions of Scu for 1 h, 2.5 mg • L 1 LPS treatment for 5.5 h, and then 2.5 mmol • L 1 ATP was activated for 0.5 h.The damage rate and activity of endothelial cells were detected by MTT method and determination of LDH content in cell supernatant.ELISA was used to detect the contents of IL-ip,lL-18 and HMGB-1 in su-pernatant.The expression levels of inflammation and pyroptosis related proteins including NLRP3 , ASC , pro- caspase-1 , caspase-1 p20 and GSDMD-NT were detec¬ted by WB method.The expression of pro-caspase-1 , caspase-1 p20 and GSDMD-NT protein and the contents of IL-ip,IL-18 and HMGB-1 in supernatant were de¬tected by Scu and pan caspase receptor inhibitor ( Z-YVAD-FMK).Results Compared with LPS + ATP group, Scu concentration-dependently improved ATP- induced cytotoxic damage, increased cellular activity, reduced the release of 1L-1(3, IL-18, HMGB-1 , down- regulated NLRP3, ASC, pro-caspase-1 , GSDMD-NT protein level to inhibit the activation of pro-caspase-1 , and the effect was comparable to Z-YVAD-FMK.The inhibitory effect of Scu on pro-caspase-1 activation was not significantly different from that of Scu/Z-YVAD- FMK combined group, but significantly inhibited the production of pro-caspase-1.Conclusions Scutellarin can reduce the formation of NLRP3 inflammasome com¬positions and inhibit pro-caspase-1 activation to im¬prove LPS + ATP induced endothelial cell inflammation injury and pyrolysis, which provides a new basis for the clinical prevention and treatment of atherosclerosis.

Predictive Value of Newly Diagnosed IgG Level in Patients with IgG-type Multiple Myeloma after Initial Treatment / 中国实验血液学杂志

OBJECTIVE@#To explore the predictive value of newly diagnosed IgG levels in the recurrence of IgG-type multiple myeloma (MM) patients after initial treatment.@*METHODS@#The clinical and pathological data of 91 patients newly diagnosed IgG-type MM who were hospitalized in the Department of Hematology of the Second People's Hospital of Yichang and Department of Oncology of The Affiliated Hospital of Jianghan University from April 2010 to March 2019 were collected. According to the median IgG level at the time of initial diagnosis, patients were divided into high IgG group and low IgG group. The recurrence time after initial treatment was followed up, and the correlation between newly diagnosed IgG level and recurrence was analyzed by univariate and multivariate analysis, as well as the influencing factors of IgG levels in order to predict furtherly the potential mechanism of recurrence.@*RESULTS@#Univariate survival analysis showed that high revised international staging system (R-ISS) staging, high level of bone marrow plasma cell (BMPC), lactate dehydrogenase (LDH), creatinine, β@*CONCLUSION@#The higher the serum IgG concentration of IgG-type MM patients at first diagnosis, the earlier the recurrence, which is related to the low level of serum albumin, and can be used as a potential recurrence predictor after complete remission of IgG-type MM patients.

Effect of the active fraction of Huanglian-Jiedu Decoction on white matter injury in rats with cerebral ischemia by inhibiting NogoA/NgR expression / 国际中医中药杂志

Objective:To study the effect of Huanglian-Jiedu Decoction on the white matter lesion of rats with focal cerebral ischemia and to explore the regulative role of the active fraction of Huanglian-Jiedu Decoction on NogoA/NgR. Methods:Male SD rats were randomly divided into sham operation group, model group, total alkaloid group, total flavonoid group, and total iridoid group. Except for the sham operation group, the rats in the other groups were used to establish the middle cerebral artery occlusion rat model by the suture method. 2 hours after modeling, rats in the total alkaloid group were given intragastric administration with 44 mg/kg total alkaloids; rats in the total flavonoid group were given intragastric administration 50 mg/kg total flavonoids; rats in the total iridoid group were given intragastric administration 80 mg/kg total iridoids, the sham operation group and the model group were intragastrically given equal volume of normal saline, once a day, for 7 consecutive days. The pathological changes of rat white matter were observed by HE staining, the pathological changes of rat myelin sheath were observed by Luxol fast blue (LFB) staining, and the expression of Amyloid precursor protein (APP), NogoA, and NgR in the internal and external capsule areas of the brain was detected by immunohistochemical staining. Real-time fluorescence quantitative PCR was used to detect the expression of NogoA and NgR in the tissues surrounding the ischemic infarct.Results:Compared with the model group, the total alkaloid group, total flavonoid group, and total iridoid group had lower pathological damage scores in the internal and external capsule areas of rats ( P<0.05 or P<0.01), increased integral optical density value of LFB staining ( P<0.01), decreased expression of APP and NogoA; the expression of NgR in the internal and external capsules of rats in the total alkaloid group and the total iridoid group decreased ( P<0.05 or P<0.01), and the expression of NgR in the inner capsule of rats in the total flavonoid group decreased ( P<0.01); the expression of NogoA (1.20 ± 0.17, 1.55 ± 0.30, 1.19 ± 0.38 vs. 2.22 ± 0.58) and NgR (1.98 ± 0.55, 1.48 ± 0.31, 1.58 ± 0.27 vs. 3.36 ± 0.41) genes in the tissues around the infarct focus of rats in the total alkaloid group, total flavonoid group and total iridoid group decreased ( P<0.01). Conclusion:The present study investigates the therapeutic effects of Huanglian-Jiedu Decoction, promoting white matter repair by decreasing the overexpression of NogoA and NgR in an experimental animal model of stroke.

The current situation, problems and suggestions of Chinese medicine health care development / 国际中医中药杂志

This article sorts out the evolution and policies of development status of health nursing by traditional Chinese medicine (TCM). It analyzes the reasons for the problems, such as the lack of industry standards and norms, the imperfect regulatory system, and the unclear institutional boundaries. The suggestion helps to explore and put forward detailed supporting policy measures, promote innovation of traditional Chinese medicine inheritance, accelerate standardization and standardization construction, strengthen the training of professional talents and standardize and maintain them, and continue to promote the healthy and orderly development of health care services of TCM.

Advances in research on toxicity and dietary exposure of aluminum / 公共卫生与预防医学

In recent years, the use of aluminum-containing additives in the food has received wide public attention. Many studies have shown that excessive exposure to aluminum can cause health damage to human body. This paper will review and evaluate the research progress of aluminum toxicity, domestic and international dietary aluminum exposure assessment, and the feasibility of the control measures on the aluminum intake, to provide relevant evidence for the health risk assessment of aluminum in food.

Effects of probiotics on gastrointestinal function, nutrition status and inflammatory reaction in critically ill patients with enteral nutrition support / 中国中西医结合急救杂志

Objective To explore the effects of probiotics on intestinal function, nutritional status and inflammatory response in critically ill patients with enteral nutrition (EN) support. Methods A total of 90 critically ill patients admitted to Intensive Care Unit (ICU) of the First Affiliated Hospital of Anhui Medical University from July 2016 to November 2018 were enrolled, and they were divided into a probiotics combined with EN group (27 cases) and an simple EN group (63 cases) according to random number table method. The patients in the simple EN group were treated with conventional nutrient preparations such as fresubin or fresubin energy fibre; the patients in probiotics combined with EN group were supplemented with probiotics on the basis of conventional EN support for consecutive 7 days in both groups. The changes of gastrointestinal function, nutritional index and inflammatory response index after treatment were observed in both groups. Results After treatment, the subjective global assessment (SGA) method was used to identify the gradation of the patients, it was shown that the proportion of SGA-B grade patients in simple EN group had an upward trend; while the proportion of SGA-B grade patients in probiotics combined with EN group had no significant change; and there was no significant difference in the proportion of SGA-B patients between simple EN group and probiotics combined with EN group after treatment [20.6% (13/63) vs. 7.4% (2/27),P > 0.05]. Compared with those before treatment, the levels of hemoglobin (Hb), white blood cell count (WBC), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukins (IL-6, IL-12) in both groups were significantly decreased, while the levels of albumin (Alb), pre-albumin (PA), total lymphocyte count (TLC) in both groups were increased after treatment, and the changes of Hb, TNF-α, IL-6 in probiotics combined with EN group were more significant than those in the simple EN group [Hb (g/L): 95.0 (78.0, 107.0) vs. 93.0 (80.0, 107.0), TNF-α (pg/L): 21.2±4.0 vs. 28.0±5.7, IL-6 (pg/L): 161.3±37.6 vs. 186.2±51.8];the differences in levels of Hb, CRP, TNF-α before and after treatment between the probiotics combined with EN group and simple EN group were statistically significant [Hb (g/L): 1.0 (-4.0, 12.0) vs. 11.0 (1.0, 20.0), CRP (mg/L): 44.3 (13.7, 57.7) vs. 7.5 (-20.1, 62.4), TNF-α (pg/L): 13.3±6.3 vs. 7.9±5.5, all P < 0.05]. There were no statistical significant differences in the other indicators between the two groups (all P > 0.05). Conclusion Probiotics can improve the gastrointestinal function and inflammatory status of critically ill patients with EN support, regretfully, in a short term, the improvement of nutritional status of such patients is not obvious, but probiotics has certain significance in preventing the risk of aggravation of malnutrition and reduction of Hb level.

Analysis of eight fatal cases of severe adenovirus pneumonia in children / 中国小儿急救医学

Objective To analyze the clinical characteristics of fatal cases with confirmed severe ad﹣enovirus pneumonia in children in order to improve the diagnosis and treatment. Methods The fatal cases of severe adenovirus pneumonia admitted to Pediatric Intensive Care Unit of Hunan Provincial People′s Hospital from January 2019 to July 2019 were collected,whose clinical features,diagnosis,treatment,and the causes of death were analyzed retrospectively. Results A total of eight children were enrolled, and the age ranged from 3 months to 3 years old,and five cases were between 6 months to 2 years old. Three cases had underly﹣ing diseases. Adenovirus genotype identification was performed on six patients,and the results showed that all patients were infected with adenovirus type 7. All patients presented persistent high fever,with a peak temper﹣ature between 39. 8℃ to 41. 0℃,which persisted 10 to 37 days. Blood routine test before admission PICU showed that four cases had the decrease in white blood count and hemoglobin concentration,accompanied by﹣increased serum ferritin levels. Seven cases complicated with infection. Four cases had parainfluenza virus type 3 infection. Six cases had bacterial infection,and Gram﹣negative bacilli were predominant. One had fun﹣gal septicemia. Conventional mechanical ventilation were performed in all patients in this group. Four cases in this group died of severe acute respiratory distress syndrome. The other four cases died of disseminated intra﹣vascular coagulation associated with massive gastrointestinal bleeding, pulmonary hemorrhage, heart failure and septic shock combined with multiple organ failure. Conclusion Fatal adenoviruspneumonia mostly app﹣pears in children between 6 months to 2 years old or with underlying diseases. Adenovirus type 7 was the main serotype. The occurrence of reactive hemophagocytic phenomenon should be worsen progression of the disease. Co﹣infection may be an important cause of death.

Analysis of eight fatal cases of severe adenovirus pneumonia in children / 中国小儿急救医学

Objective@#To analyze the clinical characteristics of fatal cases with confirmed severe adenovirus pneumonia in children in order to improve the diagnosis and treatment.@*Methods@#The fatal cases of severe adenovirus pneumonia admitted to Pediatric Intensive Care Unit of Hunan Provincial People′s Hospital from January 2019 to July 2019 were collected, whose clinical features, diagnosis, treatment, and the causes of death were analyzed retrospectively.@*Results@#A total of eight children were enrolled, and the age ranged from 3 months to 3 years old, and five cases were between 6 months to 2 years old.Three cases had underlying diseases.Adenovirus genotype identification was performed on six patients, and the results showed that all patients were infected with adenovirus type 7.All patients presented persistent high fever, with a peak temperature between 39.8℃ to 41.0℃, which persisted 10 to 37 days.Blood routine test before admission PICU showed that four cases had the decrease in white blood count and hemoglobin concentration, accompanied byincreased serum ferritin levels.Seven cases complicated with infection.Four cases had parainfluenza virus type 3 infection.Six cases had bacterial infection, and Gram-negative bacilli were predominant.One had fungal septicemia.Conventional mechanical ventilation were performed in all patients in this group.Four cases in this group died of severe acute respiratory distress syndrome.The other four cases died of disseminated intravascular coagulation associated with massive gastrointestinal bleeding, pulmonary hemorrhage, heart failure and septic shock combined with multiple organ failure.@*Conclusion@#Fatal adenoviruspneumonia mostly apppears in children between 6 months to 2 years old or with underlying diseases.Adenovirus type 7 was the main serotype.The occurrence of reactive hemophagocytic phenomenon should be worsen progression of the disease.Co-infection may be an important cause of death.

The clinical study of Nutric score system and nutritional assessment in neurological critical ill patients / 中国基层医药

Objective To investigate the clinical utility of critical nutrients nutrition risk assessment (Nutric score) in neurological critical ill patients,laying the foundation for clinical nutrition support.Methods From July 2016 to March 2017,59 ICU patients with neurological critical ill in the First Affiliated Hospital of Anhui Medical University were divided into low score group (Nutric score 0-4) and high score group (Nutric score 5-9) according to Nutric score system.On the first and seventh day after ICU admission,the body mass index(BMI),triceps skinfold thickness (TSF),mid-upper ann circumference (MAC) and mid-upper ann muscle circumference (MAMC) were measured.The serum albumin(ALB),prealbumin (PA),hemoglobin (Hb) and lymphocyte (LY) were detected as nutritional indicators.And at the same time,recorded the 28-day outcomes,and made the SGA evaluation.Results At the first day admission in ICU,there were no statistically significant differences between the two groups in TSF,MAC and MAMC (all P ＞0.05).But at the seventh day,the TSF,MAC,MAMC of the high score group were (0.943 ± 0.484) cm,(24.143 ± 3.203) cm,(21.187 ± 2.625) cm,respectively,which were significantly lower than those of the low score group [(1.185 ± 0.403) cm,(26.981 ± 2.731) cm,(23.265 ± 2.327) cm],there were statistically significant differences between the two groups (t =2.090,3.672,3.223,all P ＜ 0.05).At the first day after admission,the serum levels of ALB and Hb in the high score group were (34.5 ± 7.3)g/L,(103.68 ± 13.5)g/L,which of the low score group were (39.0 ± 6.9) g/L,(122.29 ± 20.4) g/L,respectively,and there were statistically significant differences between the two groups(t =2.466,4.168,all P ＜ 0.05).And at the seventh day after admission,the serum levels of ALB,PA,Hb and Ly in the high score group were (30.6 ± 5.1) g/L,(146.0 ± 77.0) mg/L,(83.9 ± 11.9) g/L,(1.123 ± 0.535) x 109/L,respectively,which were significantly lower than those in the low score group [(35.8 ± 5.5) g/L,(209.9 ± 105.1) mg/L,(105.8 ± 19.2) g/L,(1.709 ± 1.377) x 109/L].Compared with the first day after admission,the ALB,Hb levels in the two groups at the seventh day after admission were significantly decreased (t =2.29,2.002,5.817,3.286,all P ＜0.05);the PA level in the low score group had no statistically significant difference at the seventh day after admission,but the PA level in the high score group was decreased significantly (t =2.024,P ＜ 0.05).The incidence rate of malnutrition,mortality of the high score group were 32.1％,32.1％,respectively,which were significantly higher than those in the low score group (9.7％,6.5％) (x2 =4.583,6.402,all P ＜ 0.05).Conclusion The Nutric score system can be used in the purpose of early nutrition assessment in neurological critical ill patients,and it is benefit for clinical early nutritional support.

Antioxidant Activities of Maca Polysaccharides in vitro and Protective Effect on H2O2-induced Injury in SH-SY5Y Cells / 中国药师

Objective:To investigate the antioxidant activity of Maca polysaccharides in vitro.Methods:A chemical reaction system was established to explore the scavenging activity of Maca polysaccharides within the concentration range of 0.18-5.00 mg ·ml-1on hydroxyl radicals (·OH),superoxide anion free radicals (O2-·) and DPPH·,and then the total antioxidant capacity was calculated. The protective effects of Maca polysaccharides on H2O2-induced damage in SH-SY5Y cells were determined. SH-SY5Y cells were divided into the control group,H2O2model group and Maca polysaccharide groups(25,50,100 μg·ml-1). In the Maca polysaccharide groups,SH-SY5Y cells were pre-protected by Maca polysaccharides for 24 h, and then incubated in the presence of 300 μmol·L-1H2O2for 6 h. The detection index was SH-SY5Y cell viability detected by MTT assay. Results:Maca polysaccharide within the concentration range of 0.18-5.0 mg·ml-1all exhibited strong scavenging activity on·OH,O2-· and DPPH·in a dose-dependent manner. When the concentration of Maca polysaccharides reached 2.5 mg·ml-1,the scavenging rate was 60.36% for DPPH·,34.66% for O2-·and 36.01% for·OH,the total antioxidant activity was equivalent to 0.179 μmol FeSO4. Maca polysaccharides at the concentration of 25, 50 and 100 μg·ml-1all showed significant protective effects on H2O2-induced injury in SH-SY5Y cells, and the cell survival rate was 61.71 ± 2.45%,61.73 ± 4.51% and 60.98 ± 3.12%, respectively,which were all significantly higher than those in the model group (P < 0.05). Conclusion:Maca polysaccharides has good antioxidant activity,which is worthy of further research and development as a natural antioxidant.

Effects of calcium dobesilate in the treatment of non - proliferative diabetic retinopathy after panretinal laser photocoagulation / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To investigate the effect of calcium dobesilate in the treatment of non-proliferative diabetic retinopathy (NPDR) after panretinal laser photocoagulation. ·METHODS: A total of 40 patients (62 eyes) with clinically diagnosed severe NPDR were randomly divided into control group (22 cases,31 eyes) and study group (18 cases,31eyes). Two groups were all given pan-retinal photocoagulation treatment,while the study group continued to receive calcium dobesilate for 12mo after treatment. After 12mo, before treatment and 12mo after treatment, the changes of best corrected visual acuity (BCVA),average threshold sensitivity, and retinal nerve fiber layer(RNFL) thickness were compared between two groups. · RESULTS: The response rate was 55% and 84%, respectively in the control group and study group, the difference was statistically significant(P<0.05). Compared to the pre-treatment measurement,the average threshold sensitivity and RNFL were reduced at 12mo after treatment in control group, the difference were statistically significant(P<0. 05). Compared to the pre-treatment measurement,the average threshold sensitivity and RNFL were reduced at 12mo after treatment in study group,the difference were not statistically significant(P>0.05). At 12mo after treatment, the difference of the average threshold sensitivity and RNFL between two groups were statistically significant(P<0.05). ·CONCLUSION: calcium dobesilate could be effective in preventing the retina from damage of retinal photocoagulation in DR. Compared with simple laser photocoagulation, panretinal laser photocoagulation combined with calcium dobesilate can improve curative effect and visual acuity in NPDR patient.

Effect of silencing TRAF6 gene on proliferation, apoptosis and invasion of retinoblastoma Y79 cells / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of tumor necrosis factor receptor associated factor 6 (TRAF6) on proliferation, apoptosis and invasion of retinoblastoma Y79 cells. METHODS: The Y79 cells were divided into three groups:blank control group, negative control group and TRAF6 siRNA group. After TRAF6 siRNA transfection, the levels of TRAF6 mRNA and protein in Y79 cells were examined by RT-PCR and Western blotting. MTT assay was used to detect cell proliferation. Flow cytometry was employed to detect changes in cell cycle and apoptosis. Cell invasiveness was detected by the Transwell method. RESULTS: Expression of TRAF6 mRNA and protein in the TRAF6 siRNA group significantly decreased compared with the negative and blank control groups. Following the silencing of TRAF6,cell proliferation was inhibited and the apoptosis rate increased; the cell cycle was arrested at G0/G1 phase; the number of cells in S phase was reduced, while the invasion ability of cancer cells decreased. CONCLUSION: Silencing TRAF6 may inhibit the proliferation of Y79 cells, promote cell apoptosis, arrest the cell cycle at G0/G1 phase and decrease the invasive ability. Thus,TRAF6 may be a potential target in therapy for retinoblastoma.

Establishment of Metrigel-VEGF-SW982 complexes and application of the complexes in synovial sarcoma model in mice / 西安交通大学学报(医学版)

Objective To establish Metrigel-VEGF-SW982 complexes and use the complexes to produce animal models of synovial sarcoma so as to provide new ideas for establishing other models of soft tissue tumors. Methods After the SW982 cells were cultured and collected,they were resuspended with Metrigel,and VEGF was added.The suspension was seeded into transwell to establish the scaffold complexes of Metrigel-VEGF-SW982.The complexes were cultured overnight.Cryosections were made and HE staining was carried out to observe the cell scaffold complexes.We randomly divided 10 female SCID mice(4 week old)into scaffold group and control group. The mice in the scaffold group were transplanted with cell-scaffold complexes,and the control group with cell suspension.After 8 weeks,the success rate of modeling was compared between two groups.The mice were sacrificed and the tumors were obtained.HE staining was carried out to observe the histopathological features of tumors in both scaffold group and control group.Results The SW982 cells were cultured with Matrigel in a 3D way,which could simulate the growth condition of cells in vivo.Establishing synovial sarcoma animal model with cell scaffold complex could increase the success rate.The tumors in scaffold group had a larger volume,higher density of tumor cells and greater vascularization(P＜0.05).Conclusion Establishing synovial sarcoma animal model with Metrigel-VEGF-SW982 complex can greatly improve the success rate of modeling,which can provide basis for the study of synovial sarcoma.