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Objective:The Capital′s Funds for Health Improvement and Research (referred to as ″CFH″), established to address clinical medical issues, have been operating for over a decade. This study aims to comprehensively evaluate the achievements of this fund and provide empirical support and recommendations for optimizing the operational model of the clinical research fund.Methods:An online questionnaire was used to investigate the following aspects of CFH: subject area, the person in charge, derived projects, theses, patents, transformation of results, and popularization and promotion.Results:A total of 745 projects were collected through the online survey, and after rechecking for outliers, 720 completed projects were ultimately included. The top three disciplinary domains, in terms of the number of completed projects, were oncology, cardiovascular diseases, and neurological disorders. The age distribution of project leaders exhibited a left-skewed pattern, with a median age of 45 years. 319 (44%) received support from other related projects subsequently. 95% of the projects resulted in paper publication. 211 (29%) projects applied for patents and copyrights, with 141 projects being granted patent authorization. 78 (11%) projects successfully achieved technology transfer, with transfer and licensing being the most common modes. 156 (22%) projects disseminated their outputs, often targeting secondary hospitals and community health institutions.Conclusions:CFH aligns with local needs, and the outputs are substantial. In the future, consideration can be given to establishing an evaluation mechanism, increasing efforts to promote high-quality outputs, strengthening the organizational model set by the project guidelines, and further improving the rolling support mechanism.
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Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. Fat accumulation "sensitizes" the liver to insult and leads to nonalcoholic steatohepatitis (NASH). G protein-coupled receptor 35 (GPR35) is involved in metabolic stresses, but its role in NAFLD is unknown. We report that hepatocyte GPR35 mitigates NASH by regulating hepatic cholesterol homeostasis. Specifically, we found that GPR35 overexpression in hepatocytes protected against high-fat/cholesterol/fructose (HFCF) diet-induced steatohepatitis, whereas loss of GPR35 had the opposite effect. Administration of the GPR35 agonist kynurenic acid (Kyna) suppressed HFCF diet-induced steatohepatitis in mice. Kyna/GPR35 induced expression of StAR-related lipid transfer protein 4 (STARD4) through the ERK1/2 signaling pathway, ultimately resulting in hepatic cholesterol esterification and bile acid synthesis (BAS). The overexpression of STARD4 increased the expression of the BAS rate-limiting enzymes cytochrome P450 family 7 subfamily A member 1 (CYP7A1) and CYP8B1, promoting the conversion of cholesterol to bile acid. The protective effect induced by GPR35 overexpression in hepatocytes disappeared in hepatocyte STARD4-knockdown mice. STARD4 overexpression in hepatocytes reversed the aggravation of HFCF diet-induced steatohepatitis caused by the loss of GPR35 expression in hepatocytes in mice. Our findings indicate that the GPR35-STARD4 axis is a promising therapeutic target for NAFLD.
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Children are also at high risk of novel coronavirus infection. However, as children are in the developmental stage and their phylogeny is not yet complete, adult guidelines cannot be directly copied in the diagnosis and treatment of SARS-CoV-2 infection in children. Therefore, The Second Affiliated Hospital of Xi’an Jiaotong University organized relevant professionals of Children’s Hospital. Based on the "Diagnosis and Treatment Plan for SARS-CoV-2 Infection (Trial 10th Edition)" issued by the General Office of the National Health Commission of the State Administration of Traditional Chinese Medicine, the diagnosis and treatment plan suggestions for children with novel coronavirus infection in The Second Affiliated Hospital of Xi’an Jiaotong University were formulated by referring to several instructive diagnosis and treatment plans and combining our hospital’s experience in treating children with SARS-CoV-2 infection. This recommendation makes a concise and practical description from the perspectives of epidemiology, clinical manifestations, clinical typing, treatment and nursing of children infected with SARS-CoV-2, and also makes recommendations for the diagnosis and treatment of high-risk factors and complications for the reference of front-line clinical pediatricians so as to achieve timely and reasonable diagnosis and treatment of children infected with SARS-CoV-2. Early identification and active treatment of high-risk and critically patients can minimize the harm caused by complications.
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Objective:To explore the scientific and technological innovation environment faced by hospitals in the context of great health, and the measures to promote the sustainable development of the independent innovation capacity of the third class hospitals.Methods:Combined with the development trend of scientific and technological innovation in the new era, this paper illustrates the practice of using existing resources to improve the level of clinical diagnosis and treatment technology and release the vitality of scientific and technological innovation, and puts forward some thoughts and suggestions for the work in combination with practice.Results:According to the measurements of " platform building, talent supporting and mechanism development" , the hospital integrated its internal resources, strengthened the integrated development of clinical disciplines within the platform resources, and strengthened the construction of hospital innovation connotation and the improvement of scientific research strength in many aspects.Conclusions:It is suggested to further clarify the development mode and direction of discipline innovation, continue to expand the construction of full-time scientific research teams, broaden and deepen the construction of public platforms, improve the multi-dimensional evaluation mechanism, and promote the establishment of a sustainable development system of scientific and technological innovation.
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Objective:To investigate the function and mechanism of CXC chemokine receptor 7 (CXCR7) in neuronal cells of ischemic stroke.Methods:The expression of CXCR7 in human neuroblastoma SH-SY5Y cells was interfered by small interfering RNA (si-RNA) technique. Oxygen-glucose deprivation/reoxygenation (OGD/R) injury model was constructed in SH-SY5Y cells. CXCR7 protein expression and cell cycle were detected by flow cytometry (FCM). The protein expression of CXCR7 and Akt signaling pathway was detected by Western blotting.Results:After 6 hours of OGD/R, the expression of CXCR7 was significantly decreased compared with OGD/R 0 hour (CXCR7/GAPDH: 0.483±0.098 vs. 1.000±0.000 by Western blotting and 0.686±0.0524 vs. 1.000±0.000 by FCM, both P < 0.01), cell cycle arrest in G0/G1 phase (1.190±0.040 vs. 1.000±0.000, P < 0.01). After CXCR7 si-RNA interference with SH-SY5Y cells, OGD/R was constructed again for 6 hours. Compared with negative control group (si-NC group) under the same environment, the expression of CXCR7 and phosphorylated Akt (p-Akt) was significantly decreased (CXCR7/GAPDH: 0.471±0.051 vs. 1.000±0.000, p-Akt/GAPDH: 0.616±0.027 vs. 1.000±0.000, both P < 0.001) and cell cycle arrest in G0/G1 phase (1.105±0.033 vs. 1.000±0.000, P < 0.05). Conclusion:The CXCR7 could regulate the cycle of neuronal cells in ischemic stroke through Akt signaling pathway, which has a protective effect on neuronal cells.
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Objective To establish a new N-stage system combining the number of metastatic lymph nodes and the ratio of metastatic lymph nodes for postoperative M0 stage inflammatory breast cancer patients. Methods Based on the data of inflammatory breast cancer patients in the SEER database, the number of metastatic lymph nodes and the ratio of metastatic lymph nodes were calculated.A new N-staging system was established and compared with the 8th edition of AJCC TNM staging system of breast cancer.The nomograph prognostic model was constructed and validated. Results The prediction performance of the new N-staging system for postoperative survival of M0 inflammatory breast cancer patients was better than the traditional N-staging system.The nomograph prognostic model showed an excellent clinical efficacy with a consistency index of 0.711. Conclusion The new N-staging system has good predictive performance for postoperative survival of M0 inflammatory breast cancer patients and can accurately reflect the prognosis.
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Objective@#To investigate the reference level of surface radiation dose of digital radiography (DR) among adult examinees in Beilun District, Ningbo City, so as to provide insights into the optimization of the parameters of DR systems and rational management of the radiation dose.@*Methods@#Based on the cloud imaging system covering 14 DR systems in 11 public hospitals in Beilun District, the diagnosis of adults receiving DR and DR systems check were collected from May 2020 to April 2021. The air kerma-area product ( PKA ) was selected as a measure, and the local diagnostic reference level ( LDRL ), the regional median dose ( RMD ), the regional lowest dose predicted level ( LDPL ) and the typical dose in the DR imaging room were defined using the quartile method according to the examination site, projection direction and radiography positions. The PKA value was transformed into incident air kerma ( Ka, e ), and compared with the recommended value in the Requirements for Radiological Protection in Diagnostic Radiology ( GBZ 130-2020 ).@*Results@#DR was performed among 133 065 person-times from May 2020 through April 2021 in Beilun District. The greatest RMD was found on abdomen AP DR in the supine position ( 120 μGy·m2 ), and the lowest RMD was seen on chest PA DR in the standing position ( 17 μGy·m2 ). The maximums of typical dose in the DR imaging room on chest PA ( 33 vs. 30 μGy·m2 ), abdomen AP ( 161 vs. 153 μGy·m2 ) and pelvis AP DR ( 164 vs. 162 μGy·m2 ) were greater than LDRL in the supine position, and the minimums of typical dose on chest PA ( 10 vs. 11 μGy·m2 ) and chest LAT DR ( 33 vs. 34 μGy·m2 ) were lower than LDPL in the standing position. Following transformation into Ka, e, the LDRL ranged from 0.27 to 3.80 mGy, and the maximums of typical dose ranged from 0.25 to 3.55 mGy, which was much lower than the recommended dose proposed in the national criteria.@*Conclusions@#The reference level of surface radiation dose of DR is established among adults in Beilun District, which is lower than the recommended dose in the national criteria of China. Such a reference level may be employed by medical institutions for optimization of the parameters of DR systems. Key words: digital radiography radiation dose diagnostic reference level air kerma-area product
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【Objective】 To analyze the clinical features and gene mutation characteristics of four children with pyridoxine-dependent epilepsy (PDE) in order to provide evidence for early diagnosis of this rare disease. 【Methods】 The clinical data of four cases of PDE were collected from January 2016 to June 2019 in The Second Affiliated Hospital of Xi’an Jiaotong University. We collected data of the laboratory examination, electroencephalogram, and magnetic resonance imaging (MRI). Peripheral venous blood was collected from children and parents, genomic DNA was extracted from white blood cells, and primers were designed to amplify the aldehyde dehydrogenase 7 family member A1(ALDH7A1) on the long arm of chromosome 5 using PCR; exon and the junction of exon and intron were also amplified to determine whether there is a gene mutation. 【Results】 All the 4 cases had a full-term birth and no history of birth asphyxia. ① Clinical features: onset time from 8 days after birth to 6 months after birth. Type of seizure: 1 case with myoclonus onset, then converted to spasm; 1 case for generalized seizures; 2 cases for partial seizures, then converted to generalized seizures; 3 cases were prone to epileptic seizures; 1 case was significantly worse after infection; MRI: 3 cases showed no abnormalities, 1 case showed non-specific abnormalities; EEG: One case was fragmentary hypsarrhythmia, 3 cases of multifocal epileptiform discharge; Treatment: a small dose of vitamin B6 could control the seizure, 1 of them was controlled at a tiny dose, and 3 cases were controlled by a small dose. ② Genetic analysis results: There were 4 cases of ALDH7A1 gene mutation, of which 3 cases were known gene mutations and 1 case was new mutation. 【Conclusion】 PDE has an early onset, often in the neonatal or small infancy, is prone to epilepticus and has an increased severity after infection. There is no specificity in seizure type, EEG or MRI. The analysis of ALDH7A1 gene and vitamin B6 load test can help to confirm the diagnosis, small dose of Vitamin B6 can control the seizures so as to provide reference for the dose of vitamin B6. However, the number of cases is small, and a large sample size is still needed for verification.
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CCL20 and CCR6 are chemokines produced by a variety of cells. CCL20 and CCR6 combine to stimulate a series of downstream pathways, participate in the occurrence and development of various malignant tumors, and also play an important role in the invasion and metastasis of breast cancer and the process of chemotherapy resistance. Epithelial-mesenchymal transformation (EMT) is a key step in the process of tumor cell metastasis, which is characterized by loss of cell adhesion, down-regulation of E-cherherin expression, up-regulation of mesenchymal markers and fibrinectin expression, and enhancement of cell motor ability and invasion ability. This article reviews the research of CCL20-CCR6 biological axis and EMT on invasion and metastasis of breast cancer cells.
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Objective:To analyze the clinical characteristics of late-onset epileptic spasm (LOS), thus providing basis for its early identification and treatment.Methods:Clinical data[electroencephalogram(EEG), imaging, treatment and prognosis]of LOS patient hospitalized in the Department of Pediatrics, the Second Affiliated Hospital of Xi′an Jiaotong University from January 2017 to June 2019 were retrospectively analyzed.Results:The age of onset of spasm in 35 children with LOS ranged from 18 months to 11 years old, with a median of 42 months.There were 21 cases of symptomatic LOS (60.0%) and 14 cases of cryptogenic LOS (40.0%). Epileptic spastic seizures, generalized seizures, partial seizures and myoclonic seizures as the first onset were reported in 13 cases (37.1%), 11 cases (31.4%), 10 cases (28.6%), and 1 case (2.9%), respectively.There were 15 cases (43.9%) of flexion type, 11 cases (30.4%) of extension type and 9 cases (25.7%) of mixed type.Spastic seizures can be presented as genera-lized or focal seizures.Among the 35 cases of LOS, 12 cases (34.3%) had normal EEG background, 18 cases (51.4%) had slow EEG background, and 5 cases (14.3%) had high EEG irregularity.Three cases were in accor-dance with Lennox-Gastaut syndrome and the other 32 cases were not in accordance with the defined epileptic syndrome.Eighteen cases were treated with antiepileptic drugs, and sodium channel blockers were added in 9 cases; 17 cases were treated with glucocorticoid.Eight cases did not have seizures at the last follow-up.There were 17 children with seizure reduction ≥ 50%, 3 cases with seizure reduction < 50%, and 7 cases with no reduction of seizure.Conclusions:LOS is mostly symptomatic and often associated with other types of seizures.Most of cases do not have high irregularity in the EEG, and the focal discharges are mainly in the temporal region or frontotemporal region, with refractory epilepsy mainly.The onset age, etiology and EEG characteristics of LOS differ from those of West syndrome, which should be detected and treated as soon as possible to improve the prognosis in pediatric patients.
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Objective:At present, the reform direction is to break all kinds of " only" (particular standard-centric) academic evaluation, clinical research evaluation is also in urgent need for more optimization. This study focuses on clinical research, analyzes the current situation and the key points of evaluation in the future. Meanwhile, calls for more attention to broader content in clinical research.Methods:Through the analysis of clinical research status, combined with many years of medical management practice. This study analyzes the status and role of clinical research in the whole medical research, the content and current situation of clinical research evaluation in China and abroad, and the trend of clinical research evaluation. Finally, suggestions on the clinical research are proposed.Results:Clinical research evaluation should pay more attention to the social benefits, the ability to solve complicated diseases, and the international influence in the research field.Conclusions:Hospitals and clinical research teams should have systematic layout and clear research direction, continuously improve scientific research capacity in clinical work, have professional technical support team, as well as focus on the quality and standard of clinical research. The evaluation of clinical research should pay more attention to its essential attributes.
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Objective:This study aimed to investigate and analyze the application effect of cross-field training of clinical, prevention, and management in health management talent training.Methods:The simple random sampling method was used. 30 clinical, prevention, and management students were randomly selected as the cross-training group from 2013 to 2017 in the Second Affiliated Hospital of Dalian Medical University, and 30 students in the same class were randomly selected as the control group. The cross-training group conducted case analysis teaching, symposium, and scientific research ability training practice. After the internship, subjective practice effect and health management knowledge test were conducted for each group. TOPSIS method was adopted to evaluate the subjective effect of cross-teaching and routine practice training.Results:The cross-training group had higher scientific research ability, development, satisfaction, and flexibility scores than the management group[3.0(3.0,3.0) vs 2.0(2.0,3.0), (2.8±0.6) vs (2.4±0.5), 3.0(3.0,3.3) vs 2.0(2.0,3.0), 3.0(3.0,3.0) vs 2.0(2.0,3.0), respectively]; higher participation, communication ability, development scores than the prevention group[(2.8±0.7) vs (2.4±0.6), (3.1±0.6) vs (2.6±0.5), (2.8±0.6) vs (2.4±0.5), respectively]; and higher suitability degree and strain ability score than the clinical group[(2.9±0.6) vs (2.5±0.7), 3.0(3.0,3.0) vs 3.0(2.0,3.0), respectively]. Health management test scores of cross-training students were significantly higher than the clinical group[(7.1±1.3分) vs (6.1±1.9分)]. Differences were statistically significant ( P<0.05). After TOPSIS model evaluation, the results of comprehensive subjective evaluation in the cross-group ranked first, followed by the prevention group, clinical group, and management group. Conclusion:The cross-field of clinical, prevention, and management is better than conventional practice training, which is beneficial for promoting the training of health management talents to meet the needs of social health.
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Objective:To obtain an accurate understanding of the true perceptions and potential needs of physical examination population on the services provided by the health management center, so as to improve the quality of the services provided.Methods:All of 250 subjects were randomly selected from those who underwent physical examinations in the health management center of the second affiliated hospital of Dalian medical university. Based on the perceived service quality theory, the Servqual model scale was to evaluate the service quality with five dimensions and 25 items for tangibility, reliability, responsiveness, assurance, and empathy. This measure can be used in service quality evaluation, evaluation of physical examinations to the expectations of service quality, and perceived value in the screening, and computing service quality measurement value (SQ). A two-dimensional quadrant diagram was used to analyze the results of the survey.Results:A total of 234 valid questionnaires were collected with an effective recovery rate of 93.6%. The mean age of the 234 physical examinees was 42.0±7.3 years, including 114 males (48.7%) and 120 females (51.3%). The results of the Servqual scale showed that SQ was -0.44, expectation was 4.45, and perceived value was 4.01. Of the 25 evaluation items, only 1 evaluation item (complete convenience of services of the health management center) SQ was positive, while the other 24 evaluation items were all negative. The average perceived value of service quality of the 25 evaluation items were higher than 3.5. As per the two-dimensional quadrant diagram analysis, 7 items in quadrantⅠwere in the “charm” area, and the expectation of the medical and perceived values were higher than average; 6 items located in quadrant Ⅱ were in the “surprise” area, and the medical expectation and perception values were higher than average and below average; 7 items in quadrant Ⅲ were in the “potential” area, while the expectation of the physical examination and perception values were lower than average; 5 items were in the quadrant Ⅳ “region” area, while physical examination expectations than average perception value is lower than the average.Conclusion:The expectations of physical examinees based on each attribute of the service in the health management center of our hospital is high, and there is a gap between the perceived value and the expected value. Therefore, the service level should be improved according to the four regions in the two-dimensional quadrant diagram to enhance the brand competitiveness of the health management center.
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Objective:To investigate the relationship between TP53 gene mutation and overall survival (OS) time of myelodysplastic syndrome (MDS).Methods:Databases, including PubMed, Cochrane Library and Embase were searched for relevant studies published up to 20 October, 2019. The corresponding hazard ratio ( HR) and their 95% confidence interval ( CI) for OS from multivariate Cox proportional hazard models were extracted. The combined HR with their 95% CI was calculated by using fixed or random effect models. Meta-analysis was performed by using Revman 5.3 software. Results:A total of 1 033 patients from 6 studies were enrolled. Meta-analysis results showed that OS time in TP53 gene mutation group was shorter than that in wild type group for patients with MDS ( HR = 2.16, 95% CI 1.52-3.07, P < 0.01). The prognostic risk for post-transplantation patients with MDS ( HR = 2.69, 95% CI 1.63-4.43, P < 0.01) was lower compared with that for patients treated by azacitidine( HR = 2.89, 95% CI 1.37-6.08, P = 0.005). Conclusion:TP53 gene mutation is a risk factor affecting OS of MDS patients.
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Objective:To investigate the relationship between TP53 gene mutation and overall survival (OS) time of myelodysplastic syndrome (MDS).Methods:Databases, including PubMed, Cochrane Library and Embase were searched for relevant studies published up to 20 October, 2019. The corresponding hazard ratio ( HR) and their 95% confidence interval ( CI) for OS from multivariate Cox proportional hazard models were extracted. The combined HR with their 95% CI was calculated by using fixed or random effect models. Meta-analysis was performed by using Revman 5.3 software. Results:A total of 1 033 patients from 6 studies were enrolled. Meta-analysis results showed that OS time in TP53 gene mutation group was shorter than that in wild type group for patients with MDS ( HR = 2.16, 95% CI 1.52-3.07, P < 0.01). The prognostic risk for post-transplantation patients with MDS ( HR = 2.69, 95% CI 1.63-4.43, P < 0.01) was lower compared with that for patients treated by azacitidine( HR = 2.89, 95% CI 1.37-6.08, P = 0.005). Conclusion:TP53 gene mutation is a risk factor affecting OS of MDS patients.
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Objective@#This study aimed to investigate and analyze the application effect of cross-field training of clinical, prevention, and management in health management talent training.@*Methods@#The simple random sampling method was used. 30 clinical, prevention, and management students were randomly selected as the cross-training group from 2013 to 2017 in the Second Affiliated Hospital of Dalian Medical University, and 30 students in the same class were randomly selected as the control group. The cross-training group conducted case analysis teaching, symposium, and scientific research ability training practice. After the internship, subjective practice effect and health management knowledge test were conducted for each group. TOPSIS method was adopted to evaluate the subjective effect of cross-teaching and routine practice training.@*Results@#The cross-training group had higher scientific research ability, development, satisfaction, and flexibility scores than the management group[3.0(3.0,3.0) vs 2.0(2.0,3.0), (2.8±0.6) vs (2.4±0.5), 3.0(3.0,3.3) vs 2.0(2.0,3.0), 3.0(3.0,3.0) vs 2.0(2.0,3.0), respectively]; higher participation, communication ability, development scores than the prevention group[(2.8±0.7) vs (2.4±0.6), (3.1±0.6) vs (2.6±0.5), (2.8±0.6) vs (2.4±0.5), respectively]; and higher suitability degree and strain ability score than the clinical group[(2.9±0.6) vs (2.5±0.7), 3.0(3.0,3.0) vs 3.0(2.0,3.0), respectively]. Health management test scores of cross-training students were significantly higher than the clinical group[(7.1±1.3分) vs (6.1±1.9分)]. Differences were statistically significant (P<0.05). After TOPSIS model evaluation, the results of comprehensive subjective evaluation in the cross-group ranked first, followed by the prevention group, clinical group, and management group.@*Conclusion@#The cross-field of clinical, prevention, and management is better than conventional practice training, which is beneficial for promoting the training of health management talents to meet the needs of social health.
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Objective@#To analyze the relationship between dormitory environment and respiratory tract infection among college students.@*Methods@#A total of 890 dormitory rooms and 1 727 college students were investigated on symptoms including cough, hemoptysis and dyspnea or chest pain, as well as room sanitation(wet stain, mildew, damp, water loss and suspicious windows condensate), cleaning frequency and resident population. The data were analyzed by descriptive statistics, correlation analysis and Logistic regression analysis by SPSS.@*Results@#63.0% of the school dorms were found of dampness, mustiness and water loss, 67.3% of students had the subjective perception of odor. Except for the dryness of air, the rate of subjective perception of odor of the damp dorms was higher than that of dry dorms, and the differences were of statistical significance(P<0.01). Factors such as sex, age, dorm orientation, bathroom equipment, were partially related to symptoms of students’ self-perception and diseases confirmed by the doctors(P<0.05). High humidity were significantly related to symptoms including cough, expectoration, dyspnea, asthma and bronchiectasia(P<0.05), while subjective perception of odor associated with risk of respiratory infections and symptoms.@*Conclusion@#Multipe dormitory evvironmental problems may cause respiratory tract infection and symptoms of college students, dorm sanitation should be promoted among college students.
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Objective To investigate the clinical effect of large dosage of Methylprednisolone on epilespy combined with electrical status epilepticus during sleep(ESES) in children.Methods Forty-six epielpsy patients with ESES were treated with additive large dosage of Methylprednisolone.The seizures and video electroencephalogram discharges were observed before and after using Methylprednisolone.The Methylprednisolone effect in eliminating the methylprednisolone of ESES and controlling of clinical seizures and improving cognitive function were analyzed.Results Two cases were lost and 44 cases were included,male 30,female 14,the age at onset was (5.37 ±2.52) (2-9) years old.The duration of follow-up was (4.12 ± 2.00)(1-9) years old.The age at diagnosis of ESES was (8.17 ± 2.09) (4.0-12.5) years old.The efficacy of Methylprednisolone on seizures was 72.7% (32/44 cases),while the efficacy of Methyl prednisolone on electroencephalograph (EEG) was 59.1% (26/44 cases).For patients who were resistant to Levetiracetam or Clonazepam,Methylprednisolone was still effective.Intelligence quotient had no significant changes before and after treatment(P > 0.05).The earlier onset age,the worse effect of Methylprednisolone.The efficacy of methylprednisolone for atypical benign epilepsy with cento-temporal spike(BECT) was higher than other syndromes.Conclusions Large dosage of Methyl prednisolone therapy for children with ESES,especially for those resistant to traditional or new antiepileptic drug for ESES,was effective and safe.The onset age and syndrome classification may have a certain value for prognosis and prediction of the effect of Methylprednisolone treatment.
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Objective To study the effect of cyclooxygenase-2 (COX-2)selective inhibitor Celecoxib on the expression of P-glycoprotein(P-gp)in the brain of rats with status epilepficus,in order to assess the therapeutic value of intractable epilepsy.Methods Sixty adult male SD rats were randomly divided into blank control group,the epilepsy model group and Celecoxib intervention group.The status epilepticus was induced in rats by injecting Lithium pilocarpine.Forty-eight rats were included in the experiment.There were 16 rats in each of the blank control group,epilepsy model group and Celecoxib intervention group,respectively.Immunohistochemical method and Western blot method were used to detect the expression of P-gp in experimental group in the frontal cortex and hippocampus.Results Immunohistochemistry result showed that the expression of P-gp was significantly higher in epilepsy model group than the blank control group,and the difference was statistically significant (P < 0.01);The P-gp expression in the Celecoxib intervention group was lower than that in the epilepsy model group,and the difference was statistically significant (P <0.01).Western blot results suggested that the expression of P-gp could be found both in the frontal cortex and hippocampus in each group.Compared with the blank control group,the P-gp expression was significantly higher than that in the epilepsy model group,and the expression of the P-gp was lower after the Celecoxib intervention than that in the epilepsy model group,and the difference was statistically significant (P < 0.05).Conclusions COX-2 inhibitor Celecoxib could decrease the expression of P-gp in brain tissue with status epilepticus,which may provide a new method for the treatment of intractable epilepsy.
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Objective To explore the effect of continuous subglottic irrigation and aspiration in patients with artificial airway. Methods One hundred and twenty-eight patients with mechanical ventilation were randomly divided into observation group and control group with 64 cases in each group.The observation group was treated by continuous subglottic irrigation and aspiration,and the control group received traditional nursing.The two groups were observed and compared in terms of incidence of aspiration and ventilator-associated pneumonia.Result The incidences of ventilator associated pneumonia(VAP)and aspiration in the observation group were significantly lower than that in the control group(P<0.05).Conclusion Continuous subglottic irrigation and aspiration can effectively prevent aspiration and VAP among patients with artificial airway.