الملخص
Extracellular matrix (ECM) has been implicated in tumor progress and chemosensitivity. Ovarian cancer brings a great threat to the health of women with a significant feature of high mortality and poor prognosis. However, the potential significance of matrix stiffness in the pattern of long non-coding RNAs (lncRNAs) expression and ovarian cancer drug sensitivity is still largely unkown. Here, based on RNA-seq data of ovarian cancer cell cultured on substrates with different stiffness, we found that a great amount of lncRNAs were upregulated in stiff group, whereas SNHG8 was significantly downregulated, which was further verified in ovarian cancer cells cultured on polydimethylsiloxane (PDMS) hydrogel. Knockdown of SNHG8 led to an impaired efficiency of homologous repair, and decreased cellular sensitivity to both etoposide and cisplatin. Meanwhile, the results of the GEPIA analysis indicated that the expression of SNHG8 was significantly decreased in ovarian cancer tissues, which was negatively correlated with the overall survival of patients with ovarian cancer. In conclusion, matrix stiffening related lncRNA SNHG8 is closely related to chemosensitivity and prognosis of ovarian cancer, which might be a novel molecular marker for chemotherapy drug instruction and prognosis prediction.
الموضوعات
Female , Humans , Cisplatin/pharmacology , Elasticity/physiology , Etoposide , Extracellular Matrix/physiology , Ovarian Neoplasms/metabolism , RNA, Long Noncoding/metabolismالملخص
The Chinese Neonatal Network(CHNN) was established in 2018 with the mission of establishing a national collaboration platform, conducting high-quality and collaborative research, and ultimately improving the quality of neonatal-perinatal care and health in China.At present, 112 hospitals across the country have joined CHNN.CHNN has established a national standardized cohort of very premature infants/very low birth weight infants with >10 000 enrollments each year, has been leading data-driven collaborative quality improvement initiatives, conducting multicenter clinical studies, and performing multi-level training programs.Guided by the principles of collaboration and sharing, data-driven, continuous improvement, and international integration, CHNN has become an important platform for clinical and research collaboration in neonatal medicine in China.
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【Objective】 To analyze the related factors affecting perioperative blood transfusionin patients undergoing totalhysterectomy, explorethe effective measures to reduce allogeneic blood transfusion and provide data for the establishment of clinical blood transfusion single-disease evaluation index of total hysterectomy. 【Methods】 747 cases of total hysterectomy from three grade-A tertiary general hospitals and onematernal and child health care hospitalin Dalian wereselected, and divided into transfusion group(n=69)and non-transfusion(n=678). Detailed information was collected and analyzed, including patient demographics, operation information, blood routine before operation, postoperative recovery and transfusion volume. 【Results】 9.2%(69/747)of total hysterectomy patients received blood transfusion, with per capita red blood usageof(0.4±2.1)U. The age, operative time, volume of intra-operationbleeding, pre-operationhemoglobin(Hb) level, length ofhospital stay, types and days of antibiotics use between transfusion group and non-transfusion groupwere (49.7±9.1)vs(53±9.5)years old, (182.7±83.5)vs(119.5±64.8)min, (603±650)vs(160±173)mL, (96±26)vs(124±18)g/L, (9.3±4.8)vs(7.3±3.9)days, (2.2±1.1)vs(1.6±0.7)kinds, (6.0±3.9)vs (4.4±2.2)days, respectively, showing significant differences(P<0.05). Transfusion volumewas associated with volume of intra-operation bleeding (r=0.004), operative time (r=0.002) and Hb level of pre-operation(r=-0.022). 【Conclusion】 Blood management of patients undergoingtotal hysterectomy should be strengthened to reduce the incidence of allogeneic blood transfusion and improve patient outcomes by raising the pre-operation Hb level, shortening the operative time and reducing the volume of intra-operation bleeding.
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Objective:To explore the application effect of small private online course (SPOC) teaching mode in nursing graduation internship of surgery department.Methods:The Batch 101 undergraduate nursing students who participated in the graduation internship of surgery department were randomly divided into control group ( n = 36) and experimental group ( n = 36), and all nursing students signed the informed consent form. The control group adopted the traditional practice teaching mode, and the experimental group adopted the SPOC teaching mode containing four modules: teaching ward-rounds and specialized disease knowledge, common basic nursing operation videos, testing, and expanded learning, and online and offline mixed teaching methods were adopted. SPSS 22.0 was used for t test and chi-square test. Results:At the end of the internship, the experimental group's theoretical assessment score, bedside nursing procedure ability assessment score, and comprehensive quality evaluation were better than the control group's ( P < 0.05). The questionnaire survey of the experimental group nursing students showed a good acceptance of the SPOC teaching mode. Conclusion:The SPOC teaching mode is helpful to improve the comprehensive quality of nursing students and their post competency, which is worthy of further promotion in nursing graduation internship.
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Enterovirus is a common cause of neonatal virus infection, which is primarily transmitted by fecal-oral and respiratory routes and can cause nosocomial infection and outbreak in nursery or neonatal intensive care unit.Most infants with enterovirus infection are asymptomatic or just have mild self-limiting symptoms.Severe infection is less common but with significantly increased mortality, and may be complicated by the encephalitis/meningoencephalitis, myocarditis and/or hepatitis.Early recognition and prompt isolation of infants with enterovirus infection are important strategies for nosocomial infection control.
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Objective@#To identify the therapeutic target of multidrug resistance of breast cancer by investigating the regulatory mechanism of the abnormal expression of miR-34a and FUT8 on the multidrug resistance of breast cancer. @*Methods@#The expression levels of miR-34a and FUT8 in MCF-7 and MCF-7/ADR cells were detected by the real-time PCR and western blot. The transfection efficiency of miR-34a in breast cancer cells was determined by the real-time PCR. The targeting relationship between miR-34a and FUT8 was predicted by the bioinformatics method, and further verified by the dual-luciferase reporter assay. After the expression of miR-34a was specifically regulated, the changes of FUT8 mRNA and protein levels in transfected cells were detected by the real-time PCR, Western blot and immunofluorescence staining, respectively. After the expression of miR-34a was specifically regulated, the proliferation and multidrug resistance of MCF-7 and MCF-7/ADR cells were determined by the CCK8 and immunofluorescence assays. @*Results@#The expression levels of miR-34a in MCF-7 cells were significantly higher than that in MCF-7/ADR cells ( P =0.002 6). The expression levels of FUT8 gene in MCF-7/ADR cells were significantly higher than that in MCF-7 cells ( P =0.001 6). FUT8 was the target of miR-34a regulating the drug resistance of breast cancer ( P =0.001 9). The up-regulation of miR-34a in MCF-7/ADR cells could significantly inhibit the expression of FUT8 , and the multidrug resistance and proliferation of MCF-7/ADR cells. While, the down-regulation of miR-34a increased the expression of FUT8 , and enhanced the multidrug resistance and proliferation of MCF-7 cells. @*Conclusion@#MiR-34a mediates the multidrug resistance of breast cancer by regulating the expression of downstream gene FUT8 .
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Objective To investigate the correlation of miR-181a and miR-181b with fucosyltransferase FUT1, the functional mechanism was elucidated in a colorectal cancer ( CRC).Methods It collected 32 pairs of tissue samples , 18 males and 14 females in the first affiliated hospital of Dalian Medicinal University, from March 2014 to January 2016.The expression of miR-181a and miR-181b was detected by RT-PCR in CRC tissues , adjacent tissues , serum of colorectal cancer patients and healthy people, and CRC cell lines SW620 and SW480 with differently metastatic ability.The relationship of FUT1 and miR-181a, miR-181b expression were verificated by Pearson's correlation curve.FUT1 was identified the target of miR-181a and miR-181b by Network prediction softwares ( TargetScan Human 7.1, microRNA.org and Starbase v2.0) and luciferase assay.The effects of miR-181a and miR-181b expression on the proliferation, migration, invasion and angiogenesis of SW 480 and SW620 cells were further detected by CCK8, wound healing, transwell and tube foramtion assays.T-test was used for comparison between two independent samples , and one-way anova was used for comparison between multiple samples . Pearson correlation coefficient was used for correlation analysis .Results The levels of miR-181a and 181b in CRC tissues were much lower than in tumor-adjacent tissues (3.12 ±1.88 vs 6.44 ±2.32, t=11.74;3.16 ± 1.77 vs 5.52 ±2.45, t=3.24 ;P<0.05).The levels of miR-181a and 181b in serum of colorectal cancer patients were much lower than in healthy people (1.32 ±0.25,2.57 ±0.48,t=10.26;0.91 ±0.14,1.63 ± 0.29,t=5.19;P<0.05 ) .The levels of miR-181a and miR-181b in SW620, SW480 CRC cells were detected to be much lower than in normal colorectal epithelial cells [(0.65 ±0.10, 0.50 ±0.09) vs 1.0;(0.60 ±0.12,0.42 ±0.03)vs 1.0;t=3.08, P<0.05].FUT1 was highly expressed in CRC tissues and SW620 (t=5.23, P<0.05).Based on the network prediction softwares and luciferase assays , FUT1 was the common target of miR-181a and miR-181b.Over expression of miR-181a or miR-181b inhibited FUT1 level and attenuated the capacity of cell migration , invasion and proliferation in SW 620.Down-regulation of miRNAs in SW480 increased FUT1 expression and promoted the capability of cell migration , invasion and proliferation.Downregulation of the two miRNAs attenuated the capability of cell invasion in SW 480, which was blocked by the reductive FUT1.Conclusion MiR-181a and miR-181b mediated the progression of CRC cells by targeting FUT1.
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Objective@#To evaluate the effectiveness and safety of the use of noninvasive high-frequency oscillation ventilation (nHFOV) in very low birth weight infants.@*Method@#A total of 36 cases received nHFOV between January 2016 and October 2016 in Children′s Hospital, Zhejiang University School of Medicine, including 24 males and 12 females, with the gestational age of (27.5±2.5) weeks and birth weight of(980±318)g. The data of the ventilator settings, side effects, and changes of the respiratory function before and after nHFOV were collected and analyzed retrospectively. Nonparametric tests or t tests or χ2 tests were used.@*Result@#Thirty-two (89%) out of the 36 cases successfully avoided intubation or re-intubation after using of nHFOV. nHFOV was used as the rescue treatment after failure of other noninvasive ventilation in 17 cases, and as the prophylactical treatment preventing re-intubation after extubation in the remaining 19 cases. There were significant decreases in the incidences of apnea and desaturation(SpO2<0.85), the level of PaCO2, and the FiO2 24 h after the initiation of the nHFOV as the rescue therapy((1.2±1.1)vs.(6.3±2.1)episodes , (1.1±1.2) vs.(4.3±1.5) episodes, (43±8) vs.(56±10) mmHg, 0.30±0.07 vs. 0.39±0.11, respectively; 1 mmHg=0.133 kPa, t=7.562, 8.913, 4.179, 3.437 respectively, all P<0.01). No significant changes were found in FiO2 and PaCO2 levels 24 h after initiation of nHFOV as the prophylactical therapy after extubation (0.42±0.12 vs.0.40±0.10, (49±8)vs.(48±7)mmHg, t=0.872 and 0.501 respectively, both P>0.05), except for the significant decreases in the mean airway pressure ((7.9±2.6)vs.(9.6±1.6)cmH2O, 1 cmH20=0.098 kPa, t=2.198, P=0.041). There were 4 cases suffered from nasal septum injury, while no other nHFOV related complications were noted.@*Conclusion@#nHFOV can be applied in preterm infants as a rescue treatment after the failure of other noninvasive ventilation, or prophylactically used in patients who have high risk of re-intubation.
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Objective To explore the role of combined respiratory function combined with drug therapy in the rapid recovery of lung cancer patients, and to provide reference for clinical treatment. Methods Forty patients with early non-small cell lung cancer (NSCLC) who underwent surgical treatment from January 2012 to December 2015 were selected as subjects and were randomly divided into intervention group and control group (n=20) according to the order of admission. All patients were treated with routine chemotherapy on the basis of routine chemotherapy of lung cancer, and routine perioperative care was carried out. The intervention group received comprehensive respiratory function exercise on the basis of them. There were psychological nursing, health education, perioperative respiratory function exercise and so on. The incidence of postoperative pulmonary complications, quality of life improvement and postoperative rehabilitation were compared between the two groups. Results The incidence of pulmonary complications in the intervention group was 5% (1/20, only one case of pneumonia), the incidence of pulmonary complications in the control group was 35% (7/20, 4 cases of pneumonia, two cases of atelectasis, one case of hypoxemia),the incidence of postoperative pulmonary complications in the intervention group was significantly lower than that in the control group (P<0.05). The scores of SF-36 in the intervention group were higher than those in the control group, the difference was statistically significant (P<0.05). The extubation time and postoperative hospital stay in the intervention group were shorter than in the control group. The 6-minute walking test (6MWK) was longer than the control group, the difference was statistically significant (P<0.05).Conclusion Comprehensive respiratory function combined with treatment with etestin hydrochloride can reduce the early postoperative pulmonary complications in patients with early non-small cell lung cancer, improve its quality of life and promote rapid postoperative rehabilitation.
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Objective To investigate the expression and clinical significance of proapoptotic genes HtraA2 in acute myeloid leukemia.Methods 78 cases of AML patients were divided into newly diagnosed AML group,complete remission group and hard flag group,and another 25 cases treated at the same period were set as the control group.The boue marrow and peripheral blood samples were collected from all the groups for total RNA extraction and detection of expressed HtrA2.The HtrA2 expressions were compared among thc groups.Finally 17 patients were followed up for 1~56 months.Results The HtrA2 expression levels of 3 groups were significantly different (x2 =35.13,P < 0.05),with the ratio of maximum to minimum values up to 68.76.There were no statistically significant differences in the relative expression of gcnes HtrA2 among the FAB type (F =0.004,P > 0.05).HtrA2 gene expression after treatment was significantly higher than before treatment in the patients followed up (P > 0.05).HtrA2 gene might affect the survival time of patients (Wald =4.979,P < 0.05),but age and gender had no influence on survival states (Wald =2.426 and 0.833,P > 0.05).Survival curve analysis showed that the median smvival time was 34.50 months in the patients followed up.Conclusion The expression level of HtrA2 can be beneficial for the diagnosis,treatment and prognostic evaluation of AML.
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Objective To explore the risk factors for acute kidney injury (AKI) in patients with acute heart failure (AHF).Methods A total of 254 patients with AHF admitted in the emergency department of Peking University People's Hospital from January 2015 to September 2016 were enrolled for retrospective study.Exclusion criteria included:age < 18 years old,end stage renal disease or long-term dialysis,length of hospital stay < 2 days,only one renal function test available during hospitalization,patients discharged by themselves and lacking essential medical records.Data of demographics,past medical history,general conditions at admission,accessory examinations and treatments,etc,were collected.Patients were divided into AKI group and non-AKI group according to Kidney Disease:Improving Global Outcomes (KDIGO) criteria.Univariate comparison analyses were performed to evaluate the differences between the two groups.Results Of 254 eligible patients,there were 78 (30.7%) in AKI group and 176 (69.3%) in non-AKI group.The mortality rates of AKI group and non-AKI group were 34.6% and 11.9% (P < 0.05),respectively.Compared with the non-AKI group,baseline serum creatinine,C-reactive protein,the peak level of B-type natriuretic peptide,the proportion of proteinuria,cardiac function grade Ⅳ,the daily dose of intravenous furosemide dose ≥ 80 mg,the use of nesiritide,cardiac inotropic agents and renal replacement therapy in the AKI group were significantly higher;the estimated glomerular filtration rate was significantly lower (P < 0.05).Conclusions The incidence of AKI in patients with AHF was high and the prognosis of patients with AHF developing to AKI was poor.The baseline serum creatinine,estimated glomerular filtration rate,proteinuria,C-reactive protein,cardiac function grade Ⅳ,the peak level of B-type natriuretic peptide,the daily dose of intravenous furosemide dose ≥ 80 mg,the use of nesiritide,cardiac inotropic agents and renal replacement therapy were the significant risk factors of AKI in patients with AHF.
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Objective To explore the risk factors for acute kidney injury (AKI) in patients with acute heart failure (AHF).Methods A total of 254 patients with AHF admitted in the emergency department of Peking University People's Hospital from January 2015 to September 2016 were enrolled for retrospective study.Exclusion criteria included:age < 18 years old,end stage renal disease or long-term dialysis,length of hospital stay < 2 days,only one renal function test available during hospitalization,patients discharged by themselves and lacking essential medical records.Data of demographics,past medical history,general conditions at admission,accessory examinations and treatments,etc,were collected.Patients were divided into AKI group and non-AKI group according to Kidney Disease:Improving Global Outcomes (KDIGO) criteria.Univariate comparison analyses were performed to evaluate the differences between the two groups.Results Of 254 eligible patients,there were 78 (30.7%) in AKI group and 176 (69.3%) in non-AKI group.The mortality rates of AKI group and non-AKI group were 34.6% and 11.9% (P < 0.05),respectively.Compared with the non-AKI group,baseline serum creatinine,C-reactive protein,the peak level of B-type natriuretic peptide,the proportion of proteinuria,cardiac function grade Ⅳ,the daily dose of intravenous furosemide dose ≥ 80 mg,the use of nesiritide,cardiac inotropic agents and renal replacement therapy in the AKI group were significantly higher;the estimated glomerular filtration rate was significantly lower (P < 0.05).Conclusions The incidence of AKI in patients with AHF was high and the prognosis of patients with AHF developing to AKI was poor.The baseline serum creatinine,estimated glomerular filtration rate,proteinuria,C-reactive protein,cardiac function grade Ⅳ,the peak level of B-type natriuretic peptide,the daily dose of intravenous furosemide dose ≥ 80 mg,the use of nesiritide,cardiac inotropic agents and renal replacement therapy were the significant risk factors of AKI in patients with AHF.
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Objective To explore the risk factors for acute kidney injury (AKI)in patients with acute myocardial infarction (AMI).Method The medical data of hospitalized patients with AMI admitted from October 2013 to May 2014 were reviewed.All patients were divided into AKI group and non-AKI group.The univariate comparison analysis were performed to obtain the AKI risk factors.Results A total of 565 patients were enrolled.The incidence of AKI (n =91 )was 16.1% and there were 474 non-AKI patients.The mortality of AKI group was 19.8% and mortality of non-AKI group was 0.4% (P <0.01). Univariate analysis demonstrated that the risk factors of AKI were age,hypertension,previous myocardial infarction,heart failure history,chronic kidney disease,cerebral infarction history,peripheral vascular disease;ventricular fibrillation,heart rate,Killip grade ≥3 stage,left ventricular ejection fraction,serum creatinine,eGFR,hemoglobin,blood urea nitrogen,troponin I,B-type natriuretic peptide and C-reactive protein,fasting glucose,albumin,maximum daily dose of furosemide,non-use of ACEI /ARB and statins, the use of intra-aortic balloon pump, temporary pacemaker and pulmonary mechanical ventilation, implementation of PCI and coronary artery bypass graft surgery.Conclusions These risk factors for AKI after AMI were found to identify high-risk patients,helping the clinicians to make decision for preventive intervention.
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ObjectiveTo explore and analyze the effect of simulation-based learning combined with debriefing in neonatal resuscitation training.MethodsA total of 114 clinical medical staffs attended the neonatal resuscitation training course hold by Department of Neonatology, Quzhou Maternal and Child Health Hospital from November 2014 to May 2015, and were randomly assigned to observation (n=60) and control group (n=84) by coin tossing. Staffs in the observation group adopted to training skills with simulation-based learning combined with debriefing,while those in the control group were educated with traditional method. The examinations on theoretical knowledge were taken before and after the training. Operational exam and self-confident questionnaire for all staffs on each procedure taught in the course were taken at last. Scores of the exams and self-confident questionnaire were compared between the two groups witht-test and Mann-WhitneyU test.ResultsThe mean score of theoretical test rose up significantly after the training in both observation and control group (25.19±2.62 vs 20.17±3.71,t=7.725,P<0.01; 25.44±2.64 vs 18.90±4.27,t=11.170,P<0.01), but no difference was found in this score after the training between the two groups (t=0.492,P=0.624). The practical operation examination score in the observation group was higher than that in the control (34.05±1.34 vs 31.32±4.10,t=4.183,P<0.01). All questionnaires sent to the staffs were retrieved (100%), and the total values after the training in the observation group were higher than in the control (mean rank: 92.81 vs 57.99; rank sum:5 569 vs 4 872,Z=-4.96,P<0.01).ConclusionsSimulation-based learning combined with debriefing is a much more effective teaching methods for neonatal resuscitation training, which might quickly improve the resuscitation skills of clinical staffs.