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【Objective】 To determine the reference red blood cells with weak agglutination intensity of low positive quality control products by comparing RhD antigen expression intensity difference according to the serological results. 【Methods】 The RhD(+ ) red blood cells were detected by microcolumn gel method with 1 500 times diluted anti-D typing reagent. The samples with weak and strong RhD antigen expression intensity were selected as the reference red blood cells for weak agglutination intensity of low positive quality control products, and verification was performed. 【Results】 Ten RhD(+ ) red blood cells were detected with diluted anti-D typing reagent, of which 8 were 1+ and 2 were ±. Red blood cells with agglutination intensity of 1+ were used as the benchmark to determine the maximum dilution ratio of anti-D typing reagent when their agglutination intensity was 1+. As the preparation standard of low positive quality control products, the agglutination intensity of red blood cells with low RhD antigen expression intensity was extremely weak ±, which was difficult to ensure the stability of its control limit properties. Based on red blood cells with agglutination intensity of ±, the maximum dilution ratio of anti-D typing reagent with agglutination intensity of 1+ was re-determined as the preparation standard of low positive quality control products, and the results met the requirements of quality control product setting. 【Conclusion】 Using red blood cells with low RhD antigen expression intensity as the benchmark to set the weak agglutination intensity of the low positive quality control products can avoid the loss of control due to the low target value.
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【Objective】 To monitor the effectiveness and accuracy of the blood transfusion compatibility test system by self-made weakly positive internal quality control products. 【Methods】 Red blood cells from DAT(-) healthy subjects were selected, and B/RhD(-)E(-) red blood cells were selected as tube 1. A/RhD(+ )E(+ ) was selected as tube 2 to prepare blood group quality control products according to the principle of blood group antigen compatibility, and red blood cell preservation solution and corresponding ABO blood group reagent antibody were added to make the agglutination intensity of microcolumn gel method in reverse blood typing reach a low positive value (1+ ). Tube 3 and tube 4 were prepared with five different preservation media: plasma, serum, antibody diluent, mixture of equal plasma and antibody diluent, and mixture of equal serum and antibody diluent, respectively. IgM anti-E antibody was added to tube 3, and IgG anti-D antibody was added to tube 4, so that the agglutination intensity of microcolumn gel method reached a low positive value (1+ ). 【Results】 Comparison between the 5 different preservation media showed that the preservation medium of antibody diluent was the most stable for weakly positive antibody (F=11.35, P<0.05), Agglutination intensity 1+ is assigned 5 points by AABB Technical Manual, and its score was 5.25±1.75 points. 【Conclusion】 The use of self-made weakly positive quality control products can improve the effectiveness, accuracy and sensitivity of the monitoring system, thus achieving internal quality control and ensuring the safety of clinical blood use.
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Objective@#We previously found that the incidence of sarcopenia increased with declining glucose metabolism of muscle in patients with treatment-naïve diffuse large B-cell lymphoma (DLBCL). This study aimed to investigate the relationship between sarcopenia and muscle glucometabolism using 18 F-FDG PET/CT at baseline and end-of-treatment, analyze the changes in these parameters through treatment, and assess their prognostic values. @*Materials and Methods@#The records of 103 patients with DLBCL (median 54 years [range, 21–76]; male:female, 50:53) were retrospectively reviewed. Skeletal muscle area at the third lumbar vertebral (L3) level was measured, and skeletal muscle index (SMI) was calculated to determine sarcopenia, defined as SMI < 44.77 cm 2 /m 2 and < 32.50 cm 2 /m 2 for male and female, respectively. Glucometabolic parameters of the psoas major muscle, including maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean), were measured at L3 as well. Their changes across treatment were also calculated as ΔSMI, ΔSUVmax, and ΔSUVmean; Δbody mass index was also calculated. Associations between SMI and the metabolic parameters were analyzed, and their associations with progression-free survival (PFS) and overall survival (OS) were identified. @*Results@#The incidence of sarcopenia was 29.1% and 36.9% before and after treatment, respectively. SMI (P = 0.004) was lower, and sarcopenia was more frequent (P = 0.011) at end-of-treatment than at baseline. The SUVmax and SUVmean of muscle were lower (P < 0.001) in sarcopenia than in non-sarcopenia at both baseline and end-of-treatment. ΔSMI was positively correlated with ΔSUVmax of muscle (P = 0.022). Multivariable Cox regression analysis showed that sarcopenia at end-of-treatment was independently negatively associated with PFS (adjusted hazard ratio [95% confidence interval], 2.469 [1.022–5.965]), while sarcopenia at baseline was independently negatively associated with OS (5.051 [1.453–17.562]). @*Conclusion@#Sarcopenic patients had lower muscle glucometabolism, and the muscular and metabolic changes across treatment were positively correlated. Sarcopenia at baseline and end-of-treatment was negatively associated with the prognosis of DLBCL.
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Systemic sclerosis(SSc)is an autoimmune disease characterized by vascular lesions and skin fibrosis,which causes structural and functional damage to multiple organs.The pathogenesis of SSc is complex and may be related to genetic and environmental factors as well as abnormal immune mechanisms.Autophagy is an evolutionarily conserved process of self-degradation in the body and participates in the pathogenesis of autoimmune diseases through various pathways.This article reviews the research progress on the role of autophagy in the angiopathy and fibrosis of SSc by regulating immune cells and mediating signaling pathways.
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Objective @#To investigate the imunomodulatory effects of umbilical cord mesenchymal stem cells(UC⁃MSCs) modified by miR⁃125b⁃5p through JAK2/STAT3 pathway on systemic lupus erythematosus(SLE) . @*Methods@#UC⁃MSCs were isolated and cultured under aseptic conditions ; Peripheral blood mononuclear cells ( PBMCs)were separated from SLE patients by density gradient centrifugation. The relative expressions of IL⁃17A , Foxp3 ,IFN⁃γ , IL⁃4 genes in PBMCs cultured with UC⁃MSCs for 48 h were detected by RT⁃qPCR; The relative expressions of JAK2 , p ⁃JAK2 , STAT3 , p ⁃STAT3 and IL⁃18 proteins in kidney tissues of MRL/lpr mice were detected by west⁃ern blot. @*Results @#Compared with the PBMCs culture group , the expression of IFN⁃γ and IL⁃17A and the propor⁃tion of Th17/Treg cells were significantly down⁃regulated in UC⁃MSCs + miR⁃125b⁃5p group , UC⁃MSCs + miR⁃NC group and UC⁃MSCs group(P < 0. 01) , the expression of the proportion of Th1/Th2 cells (P < 0. 05) was down⁃regulated in UC⁃MSCs + miR⁃125b⁃5p group and UC⁃MSCs + miR⁃NC group ; Compared with the untreated group of MRL/lpr mice , the relative expressions of JAK2 , p ⁃JAK2 , STAT3 , p ⁃STAT3 and IL⁃18 proteins in kidney tissues of MRL/lpr mice were significantly down⁃regulated in UC⁃MSCs + miR⁃125b⁃5p group (P < 0. 01) , and the rela⁃tive expressions of IL⁃18 proteins was significantly down⁃regulated in UC⁃MSCs + miR⁃NC group and UC⁃MSCs group (P < 0. 01) .@*Conclusion@#miR⁃125b⁃5p plays a synergistic role in UC⁃MSCs ,which regulates the differenti⁃ation of Th2 cells in PBMCs of SLE patients and the relative expressions of p ⁃JAK2/JAK2 , p ⁃STAT3/STAT3 , and IL⁃18 proteins in kidney tissues of MRL/lpr mice. UC⁃MSCs modified by miR⁃125b⁃5p may play immunomodulato⁃ry effect on SLE by JAK2/STAT3 signaling pathway.
الملخص
Objective:To investigate the role of miRNA-4298/PADI4/p53 signal axis in mediating 4f-induced apoptosis of leukemia cells.Methods:The cell growth density was observed under inverted microscope and the proliferation of leukemia cells was detected by CCK-8 counting assay. The expression of PADI4 and P53 at mRNA level was detected by qRT-PCR. Cell cycle and apoptosis were measured with flow cytometry. The expression of PADI4, P53, Bcl-2, Bax, caspase-3 and caspase-9 at protein level was detected by Western blot. Differential miRNA and mRNA expression profiles was detected by next generation sequencing. Databases such as TargetScan were used to predict the potential upstream and downstream genes of PADI4. A luciferase reporter assay was used to detect the 3′UTR of PADI4 targeted by miRNA-4298. Cell transfection assay was used to detect the effect siRNA, PADI4 vector, miRNA mimics and miRNA inhibitor in interference and rescue.Results:Nuclear factor erythroid 2-related factor 2 (Nrf2) inhibitor 4f could inhibit the proliferation of THP-1, K562 and U937 cells, and induce the apoptosis of these leukemia cells. It downregulated the expression of PADI4 mainly through the binding activity of miRNA-4298 to miRNA sponges, which resulted in the proliferation inhibition and apoptosis of leukemia cells. The inhibited proliferation and apoptosis of leukemia cells by 4f were associated with the increase of P53 expression after the decrease of PADI4 expression. The PADI4-dependent upregulation of P53 led to the ratio inversion of downstream Bcl-2/Bax, which activated caspase-3 or caspase-9 to induce the apoptosis of leukemia cells.Conclusions:The apoptosis of leukemia cells induced by Nrf2 inhibitor 4f was mainly associated with the miRNA-4298/PADI4/p53 axis, suggesting that it might be a novel signaling pathway for targeted therapy.
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Objective:To observe any effects of contralateral repeated transcranial magnetic stimulation (rTMS) of the swallowing motor cortex on the swallowing and brainstem auditory evoked potentials (BAEPs) of stroke survivors with dysphagia.Methods:A total of 83 stroke survivors with dysphagia were randomly divided into an ipsilesional stimulation group ( n=22), a contralesional stimulation group ( n=21), a bilateral stimulation group ( n=20), and a control group ( n=20). In addition to their conventional dysphagia training, those in the three stimulation groups received 3Hz rTMS while the control group was given fake stimulation. The treatment was administered daily for 20 minutes, 6 days a week, for 5 consecutive weeks. Before and after the treatment, swallowing function was assessed videofluoroscopically and using the Dysphagia Outcome and Severity Scale (DOSS). The oral and pharyngeal stages of swallowing were evaluated using the videofluoroscopic dysphagia scale (VDS). Brain stem conduction was assessed using BAEPs. Results:After treatment the average DOSS scores of all 4 groups were significantly better than before the treatment. The average DOSS scores of the contralesional and bilateral sti-mulation groups were then significantly better than those of the other two groups. The sub-item and total VDS scores of all 4 groups had decreased significantly, but the average score of the bilateral stimulation group was significantly lower than the control group′s average. Ipsilesional stimulation significantly improved the VDS sub-item scores for the triggering of pharyngeal swallowing, laryngeal elevation, and pharyngeal transit time compared with the control group. In the contralesional stimulation group the average total score and the VDS sub-item scores for apraxia, premature bolus loss, oral transit times, the triggering of pharyngeal swallowing, vallecular residue, laryngeal elevation, coating on the pharyngeal wall, and pharyngeal transit time were significantly lower than those of the control group, on average. After the treatment the latencies of BAEP waves I, III and V and the I-III, III-V and I-V interpeak intervals had decreased significantly in all four groups, but the average latencies and intervals of the bilateral and contralesional groups were significantly shorter than those of the control group. The latencies and intervals of the bilateral stimulation group were then significantly shorter than those in the ipsilesional stimulation group on average. The average latency of wave V in the bilateral stimulation group (6.53±0.73ms) was significantly shorter than that in the contralesional stimulation group after the treatment.Conclusion:Bilateral rTMS over the swallowing motor cortex combined with conventional dysphagia training can significantly improve the swallowing of dysphagic stroke survivors.
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Systemic sclerosis (SSc) is a complex and chronic autoimmune disease causing fibrosis in multiple tissues and organs. The cause of fibrosis may be related to the production of extracellular matrix (ECM) such as type Ⅰ and Ⅲ collagens, elastin and fibronectin resulting from the transformation of activated fibroblasts (FB) into muscle-forming fibroblasts (MFB). ECM could seriously damage the skin, lung, heart, kidney and other organs. At present, many studies have shown that several signaling pathways including TGF-β, mTOR, JAK/STAT, Wnt/β-Catenin, Hedgehog and Notch are involved in the proliferation of FB and the transformation of FB to MFB, which led to the production and deposition of a great quantity of ECM. Therefore, this article reviewed the relationship between these signaling pathways and fibrosis in SSc, hoping to provided reference for the development of effective treatments for SSc.
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With the increasing understanding of the unique tumor microenvironment in the brain, immunotherapy have emerged as a new and promising treatment for brain metastases. Radiotherapy and immunotherapy have a synergistic effect, and it is of great value to understand its mechanism in the treatment of breast cancer brain metastases. At present, the study of immune checkpoint inhibitors combined with radiotherapy in breast cancer brain metastases is being actively carried out, bringing new hope to patients with breast cancer brain metastases.
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Objective:To investigate the therapeutic effect of different prone position ventilation (PPV) on patients with severe acute respiratory distress syndrome (ARDS) at high altitude.Methods:The severe ARDS patients who met the Berlin standard admitted to the department of intensive care unit (ICU) of Qinghai Provincial People's Hospital from January 2017 to January 2020 were enrolled. The patients with classic PPV treatment (i.e. alternate prone supine position, about 16 hours per day) were included in the discontinuous PPV group; the patients with modified PPV treatment (i.e. alternate left and right prone positions 20°-30°, every 4 hours and continuous treatment for 24 hours per day) were included in the continuous PPV group. The oxygenation index (PaO 2/FiO 2), mechanics of breathing, ventilator parameters before treatment and 72 hours after treatment, and mechanical ventilation time, the length of ICU stay, and related complications between the two groups were analyzed. Results:Eighteen cases were treated with continuous PPV and 20 cases were treated with discontinuous PPV. There were no significant differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), PaO 2/FiO 2, lung compliance, driving pressure (ΔP) and positive end expiratory pressure (PEEP) before treatment between the two groups. Compared with before treatment, PaO 2/FiO 2 in discontinuous PPV group and continuous PPV group was increased significantly after 72-hour treatment [mmHg (1 mmHg = 0.133 kPa): 99.7±15.4 vs. 55.5±6.3, 121.8±25.3 vs. 55.1±7.1, both P < 0.05], lung compliance was improved significantly (mL/cmH 2O: 36.8±2.4 vs. 28.0±2.0, 43.4±6.7 vs. 27.7±2.1, both P < 0.05), and ΔP was decreased significantly [cmH 2O (1 cmH 2O = 0.098 kPa): 10.5 (10.0, 12.0) vs. 13.0 (12.3, 14.0), 10.0 (8.0, 12.0) vs. 13.0 (12.0, 14.0), both P < 0.05], PEEP was also decreased [cmH 2O: 12 (12, 14) vs. 14 (13, 14), 10 (8, 10) vs. 14 (12, 15), both P < 0.05], and the indexes in continuous PPV group were improved more significantly than those in discontinuous PPV group [PaO 2/FiO 2 (mmHg): 121.8±25.3 vs. 99.7±15.4, lung compliance (mL/cmH 2O): 43.4±6.7 vs. 36.8±2.4, ΔP (cmH 2O): 10.0 (8.0, 12.0) vs. 10.5 (10.0, 12.0), PEEP (cmH 2O): 10 (8, 10) vs. 12 (12, 14), all P < 0.05]. The duration of mechanical ventilation and the length of ICU stay in the continuous PPV group were significantly shorter than those in the intermittent PPV group [days: 6.0 (5.0, 7.3) vs. 8.0 (7.0, 9.0), 9.7±1.5 vs. 12.1±2.2, both P < 0.01]. During the PPV treatment, there were 3 cases of cheek skin damage and 2 cases of ear skin damage in the continuous PPV group, and 3 cases of facial skin damage in the intermittent PPV group. There was no significant difference in the incidence of complications between the two groups ( χ2 = 0.321, P = 0.571). All patients were repaired normally after PPV, without adverse consequences. Conclusion:Continuous PPV is more effective than discontinuous PPV in the treatment of severe ARDS patients at high altitude, and the related complications are did not increased in prolonged time of PPV.
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Background@#An in vitro study on rapid culturing method of human gingival fibroblast cells (HGFCs) was established to investigate the potential use of the leukocyte-platelet rich fibrin (L-PRF) in tissue engineering technology, different medical fields, including periodontology and implantology. @*Methods@#Eight biopsies were obtained from eight different donors and a modified culturing technique was developed to obtain HGFCs. The modified 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide MTT assay was used to compare the cell viability when the modified culturing method was used in comparison to the standard method. Blood samples were collected from the same patients and L-PRF was isolated using a standard protocol. The releases of platelet-derived growth factor-AA and transforming growth factor-beta1 at various time intervals were observed using enzyme-linked immunosorbent assay (ELISA) kit. The proliferative effect of L-PRF on HGFCs was assessed by the cell counting kit—8 assay. @*Results@#A simple and rapid modified method for in vitro HGFC culture yielded a cellular monolayer within three to nine days after cell culture. L-PRF with three-dimensional polymer fibers released growth factors that peaked during the first three hours and continued to produce up to 10 days. The L-PRF presented a dose-dependent effect on HGFCs proliferation where HGFCs proliferation increased with an increase in L-PRF concentration. @*Conclusion@#The modified technique for the culture of HGFCs might be useful for the development of future experimental and clinical studies, besides L-PRF has great therapeutic potential in oral surgery fields.
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Objective:To investigate the current practice environment of male nurses in Qinghai province, and understand the professional environment and turnover intention of male nurses, provide ideas and theoretical basis for continuous improvement of the working environment of male nurses in hospitals.Methods:From September to October 2020, the practice environment and turnover intention of male nurses in Qinghai Province were investigated by using the method of convenience sampling and using the general data questionnaire, the Nurse Practice Environment Assessment Scale and the turnover intention table.Results:A total of 155 registered male nurses in Qinghai Province participated in this survey, and the overall evaluation score of the practicing environment of nurses in Qinghai Province was (74.38±22.63) points, among which the highest score was that nurses could write nursing records in time (85.24±20.99) points, and the lowest score was that nurses had the opportunity to participate in the internal management of the hospital (55.03±30.55) points. The total score of resignation intention was (14.34±4.35) points.Conclusion:The overall evaluation of the practicing environment of male nurses in Qinghai Province is fair, and their turnover intention is high. Nursing managers should attach importance to the cultivation of male nurses' feelings towards hospitals and professions, so as to reduce their turnover intention and stabilize the nursing team of male nurses.
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Background@#An in vitro study on rapid culturing method of human gingival fibroblast cells (HGFCs) was established to investigate the potential use of the leukocyte-platelet rich fibrin (L-PRF) in tissue engineering technology, different medical fields, including periodontology and implantology. @*Methods@#Eight biopsies were obtained from eight different donors and a modified culturing technique was developed to obtain HGFCs. The modified 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide MTT assay was used to compare the cell viability when the modified culturing method was used in comparison to the standard method. Blood samples were collected from the same patients and L-PRF was isolated using a standard protocol. The releases of platelet-derived growth factor-AA and transforming growth factor-beta1 at various time intervals were observed using enzyme-linked immunosorbent assay (ELISA) kit. The proliferative effect of L-PRF on HGFCs was assessed by the cell counting kit—8 assay. @*Results@#A simple and rapid modified method for in vitro HGFC culture yielded a cellular monolayer within three to nine days after cell culture. L-PRF with three-dimensional polymer fibers released growth factors that peaked during the first three hours and continued to produce up to 10 days. The L-PRF presented a dose-dependent effect on HGFCs proliferation where HGFCs proliferation increased with an increase in L-PRF concentration. @*Conclusion@#The modified technique for the culture of HGFCs might be useful for the development of future experimental and clinical studies, besides L-PRF has great therapeutic potential in oral surgery fields.
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【Objective】 To study the serological and genetic characteristics of a case of B(A) blood group. 【Methods】 Serological and genetic ABO blood group typing were used to analyze the ABO subtype and family inheritance of the probands and her 8 family members. The B(A) blood type sample was used as the blood recipient, and the B-type and O-type donors were selected for cross-matching using microcolumn gel anti-human globulin method to evaluate the blood transfusion strategy. 【Results】 5 out of 9 family blood samples were B(A) phenotype, carrying B(A)04 allele. Among them, 1 was B(A)04/O1 type, and 4 were B(A)04/B type. The primary blood matching of B(A) blood type samples with type B and O recipients were all negative. 【Conclusion】 A total of 5 cases of B(A)04 blood type were found in this family investigation, and there were differences in serological manifestations. Washed RBCs with B and O type can be used for B(A) blood type transfusion, and type B suspended RBCs can be considered in case of emergency.
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Objective:To describe the trends of loss of muscle fiber thickness of the arm and calf.Methods:From April 2019 to July 2019, 58 patients admitted to ICU of Qinghai Provincial People's Hospital were enrolled. During ICU stay, the muscle fiber thickness in bilateral upper arm (biceps brachii) and bilateral calf (gastrocephus muscle) were measured by bedside color ultrasound every day.Results:The muscle fiber thickness of biceps and gastrocnemius on the left and right were (1.52 ± 0.37), (1.50 ± 0.34), (1.53±0.39), (1.51 ± 0.37) mm, respectively. The thickness of muscle fibers were (1.45 ± 0.35), (1.46 ± 0.37), (1.44±0.33), (1.41 ± 0.32) mm, which were significantly decreased in 48 h admitted to ICU ( t values were 2.106-4.711, P<0.05 or 0.01); and (1.43 ± 0.36), (1.44 ± 0.36), (1.44±0.32), (1.39 ± 0.32) mm in 72 h, which were significantly decreased than 24 h admitted to ICU ( t values were2.029-4.504, P<0.05 or 0.01). During 1 week admission to ICU , the muscle fiber thickness showed a continuous trend of decline, and the muscle fiber thickness of the left biceps, right biceps, left gastrocnemius and right gastrocnemius decreased by 8.38% (0.13/1.55), 10.19% (0.16/1.57), 9.87% (0.15/1.52), 11.11% (0.17/1.53), respectively compared with the ICU admission. The muscle fiber thickness of the left biceps, right biceps, left gastrocnemius and right gastrocnemius decreased by 9.87% (0.15/1.52), 9.33% (0.14/1.50), 9.15% (0.14/1.53), 11.26% (0.17/1.51), respectively. Conclusion:Muscle attenuation can be observed within 48h after ICU entry, and it tends to decrease with the extension of the length of hospital stay.
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Objective@#To explore the effective application of ventilation at prone position on patients with severe acute respiratory distress syndrome(ARDS) at high altitude.@*Methods@#A total of 19 severe ARDS patients in ICU of Qinghai Province People's Hospital were enrolled from February in 2016 to February. in 2018, all of them ventilated at the prone position, several indicators were assessed:heart rate (HR), respiratory (R), mean arterial pressure (MAP); blood gas indicators: arterial oxygen partial pressure (PaO2), inhaled oxygen concentration (FiO2), carbon dioxide partial pressure (PaCO2), blood oxygen saturation (SpO2), oxygenation index (PaO2/FiO2), PH, lung compliance, PEEP and so on, which assessed before and 12h, 24h, 48h, 72h after the ventilation.@*Results@#FiO2 and PEEP significantly declined at 12 h, 24 h, 48 h, 72 h after ventilation at the prone position. HR, MAP, R, PaO2, PaCO2, SPO2, PaO2/FiO2, pH and lung compliance significantly improved (F=32.30,24.73, P < 0.05).@*Conclusions@#It was an effective method for ARDS patients to improve the oxygenation status and vital signs at the plateau with ventilation used at the prone position and probably nursing intervention, which have clinical application value.
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Objective To explore the effective application of ventilation at prone position on patients with severe acute respiratory distress syndrome(ARDS) at high altitude. Methods A total of 19 severe ARDS patients in ICU of Qinghai Province People's Hospital were enrolled from February in 2016 to February. in 2018, all of them ventilated at the prone position, several indicators were assessed:heart rate (HR), respiratory (R), mean arterial pressure (MAP); blood gas indicators: arterial oxygen partial pressure (PaO2), inhaled oxygen concentration (FiO2), carbon dioxide partial pressure (PaCO2), blood oxygen saturation (SpO2), oxygenation index (PaO2/FiO2), PH, lung compliance, PEEP and so on, which assessed before and 12h, 24h, 48h, 72h after the ventilation. Results FiO2 and PEEP significantly declined at 12 h, 24 h, 48 h, 72 h after ventilation at the prone position. HR, MAP, R, PaO2, PaCO2, SPO2, PaO2/FiO2, pH and lung compliance significantly improved (F=32.30,24.73, P<0.05). Conclusions It was an effective method for ARDS patients to improve the oxygenation status and vital signs at the plateau with ventilation used at the prone position and probably nursing intervention, which have clinical application value.
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A femal patient with 16 loss and the residual bone height of 4 mm at posterior maxilla was treated by"two steps"sinus evaluation via transcrestal approach with the add of endoscope to enable the operation to be performed visibly. Platelet rich fibrin was used to insulate the osteotome and Schneiderian membrane to decrease the risk of membrane perforation, the dental abutment was simultaneously implanted, 3 months after operation uper part for 16 dental implant was restore.
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Objective To investigate the diagnostic and prognostic value of immunoglobulin (Ig)G isotype rheumatoid factors (IgG-RF) in rheumatoid arthritis (RA).Methods Five hundred patients with RA were enrolled randomly.IgG-RF antibody was detected by enzyme-linked immunosorbent assay (ELISA).The correlations between serum IgG-RF antibody and clinical features,disease activities,laboratory of RA patients were evaluated.The comparison of continuous variables was performed by using the Student t-test or Mann-Whitney U test in accordance with normality testing.Chi-square test was performed for categorical variables.A value of P less than 0.05 was considered statistically significant.Results ① IgG-RF was positive in 41.0％ (205/500) of RA patients.In patients with anti-citrullinated protein/peptide autoanti-bodies (ACPA) negative,RF negative or the seronegative patients (both ACPA and RF were negative),the positive rate of IgG-RF was 22.4％(24/107),13.2％(17/129) and 9.1％(5/55),respectively.② Compared with patients with negative IgG-RF,patients with positive IgG-RF had higher rates of joint deformity [(58.5％(120/205) vs 39.3％(116/295),x2=17.918] and bone erosion [(75.6％(118/156) vs 60.3％(140/232),x2=9.796] (P＜0.01,respectively).③ The patients with positive IgG-RF had higher rates of elevated ESR(86.3％ vs 67.8％,x2=22.426),IgG(29.9％ vs 20.0％,x2=6.310),compared to patients with negative IgG-RF (P＜0.05,respectively),and levels of ESR [(59±35) mm/1 h vs (47±32) mm/1 h,t=3.989] and CRP [(390±450) mg/L vs (290±340) mg/L,t=3.004] was higher in IgG-RF positive group than the negative (P＜0.01,respectivelys).④ Compared with the IgG-RF negative patients,the positive group had higher smoking rates (22.9％ vs 12.5％,x2=9.227),higher current smoking rates (16.6％ vs 7.1％,x2=11.119) and higher smoking index [(107±238) vs (49±161),t=3.199](P＜0.05,respectively).Conclusion IgG-RF had its clinical values in RA diagnosis.IgG-RF is significantly associated with joint deformity,bone erosions and smoking.
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Objective To evaluate pelvic peritoneum reconstruction with barbed suture and irrigation and negative pressure drainage in laparoscopy rectal anterior resection for locally advanced rectal cancer.Methods From 2014 to 2018 159 locally advanced rectal cancer patients treated by laparoscopy were derided into study group (n =76),and those received gravity drainage without pelvic peritoneum reconstruction (n =83).Results There were not significant difference in the operation time between the two groups [(165 ± 18) min vs.(160 ± 17) min,t =0.098,P =0.069].There were significant differences in postoperative drainage tube indwelling duration [(5.7 ± 2.4) d vs.(7.4 ± 3.7) d,t =3.309,P =0.001],intraabdominal infection (7％ vs.17％,x2 =3.991,P =0.046) and anastomotic leakage (4％ vs.13％,x/2 =4.280,P =0.039).There was no significant difference in anastomotic stenosis (5％ vs.10％,x2 =1.088,P =0.297) and intestinal obstruction (9％ vs.11％,x2 =0.117,P =0.732) between the two groups.Conclusion It is simple,safe and reliable to perform pelvic peritoneal reconstruction using barbed suture,combined with irrigation and negative pressure drainage,it can decrease drainage tube indwelling duration,reduce the incidence of intraabdominal infection and anastomotic leakage.