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Background/Aims@#Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is widely accepted as a radical surgery for refractory ulcerative colitis (UC). Definite results on the appropriate pouch length for an evaluation of the risk-to-benefit ratio regarding technical complications and long-term quality of life (QOL) are still scarce. @*Methods@#Data on UC patients who underwent IPAA from 2008 to 2022 in four well-established pouch centers affiliated to China UC Pouch Center Union were collected. @*Results@#A total of 208 patients with a median follow-up time of 6.0 years (interquartile range, 2.3 to 9.0 years) were enrolled. The median lengths of the patients’ short and long pouches were 14.0 cm (interquartile range, 14.0 to 15.0 cm) and 22.0 cm (interquartile range, 20.0 to 24.0 cm), respectively. Patients with a short J pouch configuration were less likely to achieve significantly improved long-term QOL (p=0.015) and were prone to develop late postoperative complications (p=0.042), such as increased defecation frequency (p=0.003) and pouchitis (p=0.035). A short ileal pouch was an independent risk factor for the development of late postoperative complications (odds ratio, 3.100; 95% confidence interval, 1.519 to 6.329; p=0.002) and impaired longterm QOL improvement (odds ratio, 2.221; 95% confidence interval, 1.218 to 4.050, p=0.009). @*Conclusions@#The length of the J pouch was associated with the improvement in long-term QOL and the development of late post-IPAA complications. A long J pouch configuration could be a considerable surgical option for pouch construction.
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Objective To explore and understand limitations and needs of support for conducting clinical research among clinicians in China.Methods The in-service clinician in our hospital were enrolled in as survey participants,survey questionnaires were designed and filled up by target audience in the questionnaire star platform.Results Main problems identified as restrictions for conducting clinical studies including lack of data platform,have ideas but not protocols,lack of research funding and project management.On the other hand,identified needs for support including research-related technical support,project management facilitation,training,external communication and exchange,as well as quality risk management.Conclusions Hospital should establish Clinical Research Unit to help clinicians to improve research quality by training,providing technical support and administrative service of clinical research.
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Objective:To construct assessment and evaluation system of clinical research and its application in practice. To explore the reliability, validity and discrimination of this index system, and evaluate its effect.Methods:The cluster was randomly sampled from 54 clinical departments. Taking the department as units, all individuals in each department was conducted a questionnaire survey for empirical analysis. Cronbach's coefficient and factor analysis were used to verify the reliability and validity of the index system. The correlation coefficient method was used to analyze the discrimination. The t-test method was used to calculate the discrimination. Extreme grouping method was used to compare the difference between high grouping and low grouping to validate the difference of each index.Results:Cronbach′s α of the whole index system is 0.840. Through exploratory factor analysis, four common factors were extracted, and the cumulative contribution rate is 56.278%. Through correlation coefficient method and t-test method, results show that except for the " concluding situation" , " number of visitors to clinical scientists workstation" and " personnel selected into talent category clinical research program" , the differences of other indicators were statistically significant ( P<0.05), and the distinguish index was between 0.31 and 0.64. Conclusions:The clinical research assessment system has good reliability and validity. And the discrimination is good. The index system can accurately assess the clinical research situation. It can be used for reference in assessment of clinical efficiency.
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Objective To summarize the practical experiences of Clinical Research Unit (CRU) platform established by Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine,provide reference for domestic institutions that have prepared or to prepare to establish CRU platform.Methods Oriented by demand,this platform has set up six modules including project management module,methodology support module,data management module,quality risk management module,project transformation module and training and international exchange module.Besides,it also establishes and improves the corresponding module system,quality assurance,technical support and information data platform system.Results With this platform,the enthusiasm of departments to carry out clinical research has been continuously enhanced,the talent pool of clinical research has been expanded;the awareness of clinical research cooperation has been improved and the international cooperation fields have been further extended;the number of clinical research projects and funding have increased rapidly.Conclusions CRU Platform in Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine provides all-dimensional technical support and whole-process informatization management to improve clinical research quality and efficiency.While learning from the advanced international concepts,we still need to explore and improve the platform construction and management mode in line with general research-oriented hospitals in China,further to enhance the academic research internationally.
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Objective To investigate the implementation situation of scientific research projects in large general hospital,analyze the quantitative evaluation parameters to explore the improvement measures.Methods Sampling survey of all levels of research projects from one general hospital in Shanghai.Based on parameter index quantization,the progress of projects in different levels was com pared and analyzed.Results The progress index and achievement index are reliable quantitative indexes,and there is a linear correlation between these two indexes.Based on progress index,forecast for SCI publication of project can be carried out.There was no significant difference in the progress situa tion of all levels of projects.Higher level of project showed better SCI publication.Conclusions For the process management of scientific research projects at different levels,the quantitative indexes can be used to facilitate the early warning and supervision.Classified assessment should be implied to SCI publication for research projects at different levels.
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Objective: To explore the regulative role of extracellular regulated protein kinase-5 (ERK5)/Bcl-2 interacting mediator of cell death (Bim) pathway in hypothermal stimulation induced neonatal rat’s cardiomyocytes (CMs) damage and apoptosis. Methods: CMs were cultured for hypothermal stimulation and the speciifc siRNA was used to down-regulate the ERK5 or Bim in CMs. The cell apoptosis was detected by lfow cytometry, protein expression was examined by Western blot analysis, the intracellular Ca2+, reactive oxygen species (ROS) and mitochondrial membrane potential (ΔΨm) were evaluated by lfuorescent labeling and lfow cytometry. Results: In hypothermal stimulated CMs, ERK5 siRNA could promote Bim protein expression, but Bim siRNA could not inlfuence ERK5, while attenuated p-ERK5 expression. ERK5 siRNA induced higher apoptosis rate, while Bim siRNA could decrease such effect. ERK5 siRNA increased the intracellular Ca2+overloading, ROS activation andΔΨm damage, while Bim siRNA played the role to against those effects in hypothermal stimulated CMs. Conclusion: Our study revealed that ERK5/Bim pathway played the important regulative roll in hypothermal stimulation induced neonatal rat’s CMs damage and apoptosis.
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OBJECTIVE: To purify hVEGF_(121)/EGFP fusion protein using transfected BMSCs as culture media, in addition, to detect the function of hVEGF_(121)/EGFP fusion protein in vitro.METHODS: The pEGFP-N_2-hVEGF_(121) recombinant plasmid, which was constructed in the preliminary work of our study group,was used to extract the plasmid DNA. BMSCs were transfected with pEGFP-N2-hVEGF_(121) by positive ionic liposome transfection method. Under a fluorescent microscopy, the expression of hVEGF_(121)/EGFP fusion protein was detected. The hVEGF_(121)/EGFP fusion protein was purified with Am icon ultrafiltration centrifuge tube and the expression of fusion protein was detected by Western-Blotting method.RESULTS: The BMSCs, which transfected with pEGFP-N2-hVEGF_(121), was observed under the fluorescent microscope. Western blotting confirmed that pEGFP-N_2-hVEGF_(121) fusion protein expressed in the culture media of transfected BMCS. MTT results showed the number of human umbilical vein endothelial cells in the fusion protein team was significantly greater than that in the control group (P < 0.05), and Miles test confirmed that pEGFP-N_2-hVEGF_(121) fusion protein increased the permeability of the blood vessel wall.CONCLUSION: ①This study successfully confirmed the pEGFP-N_2-hVEGF_(121) recombinant plasmid, which carrying VEGF_(121)/EGFP fusion protein, can be expressed in BMSCs.②The VEGF_(121)/EGFP fusion protein have the function of wild-type VEGF in vitro.
الملخص
Integrin-linked kinase (ILK) is a widely expressed protein kinase that relate to cellular growth and differentiation. It is most abundant in the heart. Recently, many researches revealed that ILK is highly relevant to cardiac response to biomechanical stresses. Also, ILK plays important roles in regulation of the occurrence and development of cardiac hypertrophy, dilated cardiomyopathy, viral myocarditis and myocardial senescence via correlation to several classical signal transduction pathway. Meanwhile, ILK functions in protection after myocardial infarction. This article will try to summarize the effects and relevant mechanism of ILK in above-mentioned aspects, overall reveals the roles of ILK in heart and its potential clinical significance.