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Objective:To explore the association between levels of thyroid-stimulating hormone (TSH) on admission and prognosis of patients admitted to intensive care unit (ICU).Methods:The data were collected from patients who were admitted to the ICU of the Beth Israel Deaconess Medical Center in the United States from 2001 to 2012 with available TSH test records within 24 hours after the ICU admission via the Medical Information Mart for Intensive Care-Ⅲv1.4 (MIMIC-Ⅲv1.4). Information including gender, age, ethnicity, type of admission, mechanical ventilation (MV) or renal replacement therapy (RRT) received on admission, comorbidities, and TSH test records within 24 hours after the ICU admission were collected. The sequential organ failure assessment (SOFA) score, simplified acute physiology score Ⅱ (SAPS Ⅱ) and the comorbidities index Elixhauser (SID30) score were calculated according to the parameters. The primary outcome was hospital mortality. Differences in baseline characteristics and prognosis were examined between patients with normal TSH levels and abnormal TSH levels which was determined according to a dichotomous variable provided by the data. Multivariable Logistic regression was used to analyze the association between TSH levels and prognosis after adjusting for confounding factors. A sensitivity analysis was conducted which categorized the study population as three groups (i.e., decreased, normal, and elevated TSH levels) using the range of 0.30-3.00 mU/L as the normal range of TSH.Results:A total of 3 425 ICU patients were enrolled in the study, of which 2 692 (78.60%) were with normal TSH and 733 (21.40%) were with abnormal TSH. There was no statistically significant difference in gender, age, ethnicity, type of admission and the ratio of MV between the normal TSH and abnormal TSH groups. Compared with normal TSH group, the patients in abnormal TSH had a higher SOFA, SAPS Ⅱ and SID30 scores as well as the ratio of RRT [SOFA score: 4 (2, 7) vs. 4 (2, 6), SAPS Ⅱ score: 38.02±13.76 vs. 36.53±13.75, SID30 score: 11 (4, 22) vs. 11 (0, 20), RRT ratio: 5.32% (39/733) vs. 3.49% (94/2 692), all P < 0.05]. The hospital mortality of patients in normal TSH was significantly higher than that of those in abnormal TSH [9.82% (72/733) vs. 5.94% (160/2 692), P < 0.01]. After adjusting for confounding factors, abnormal TSH was significantly associated with hospital mortality [odds ratio ( OR) = 1.71, 95% confidence interval (95% CI) was 1.24-2.35, P = 0.001]. In the sensitivity analysis in which the range of 0.30-3.00 mU/L was used as the normal range of TSH, compared with normal TSH, decreased TSH ( OR = 2.36, 95% CI was 1.40-3.97, P = 0.001) and elevated TSH ( OR = 1.44, 95% CI was 1.05-1.98, P = 0.023) were both significantly associated with increased hospital mortality. Conclusion:An abnormal level of TSH within 24 hours after admitted to ICU is an independent risk factor for hospital mortality among ICU patients.
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Objective:To evaluate the effect of two-step irradiance schedule on pain control during and clinical efficacy of aminolevulinic acid (ALA) -based photodynamic therapy (PDT) for moderate to severe acne.Methods:Sixty patients with moderate to severe acne were enrolled from the Department of Dermatology, the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from January 2018 to March 2019, and equally divided into 2 groups according to the order of treatment: control group receiving conventional irradiation at a light output intensity of 65 mW/cm 2 for 20 minutes, and observation group irradiated at an initial light output intensity of 40 mW/cm 2 for 8 minutes until the irradiation energy reached 20 J/cm 2, followed by irradiation at a light output intensity of 65 mW/cm 2 for 15 minutes until the total irradiation energy reached 78 J/cm 2. During the treatment, the irradiation intensity was appropriately adjusted according to the patients′ response, and all the patients were treated once every 2 weeks for 3 consecutive sessions. The time to onset of pain and pain scores at 5, 10, 15, 20, 25, 30 and50 minutes after the start of irradiation were recorded and compared between the two groups; clinical efficacy was evaluated 1 month after the end of the treatment; other adverse reactions were recorded during the treatment and 3-month follow-up after the end of treatment. Results:The time to onset of pain was significantly different between the observation group (10.40 ± 1.13 minutes) and the control group (3.95 ± 0.77 minutes; t = 25.919, P < 0.05). During the treatment, the pain score significantly changed over time ( F = 323.631, P < 0.01), and significantly differed between the observation group and control group ( F = 89.338, P <0.01). Additionally, there was a significant interaction between the treatment duration and treatment methods ( F = 24.059, P < 0.01). At 5, 10 and 15 minutes after the start of irradiation, the pain score was significantly lower in the observation group than in the control group ( t = 21.714, 28.407, 28.286 respectively, all P < 0.05) ; at 20 minutes, there was no significant difference in the pain score between the two groups ( t = 1.505, P > 0.05) ; at 25 minutes (that is, 2 and 5 minutes after the end of irradiation in the observation group and control group respectively), 30 minutes, 50 minutes (that is, the end of the cold compress), there was also no significant difference in the pain score between the two groups ( t = 0.606, 1.038, 0.344 respectively, all P > 0.05) ; at the end of irradiation (that is, 23 and 20 minutes after the start of irradiation in the observation group and control group respectively), there was still no significant difference in the pain score between the two groups ( t = 1.968, P = 0.149). One month after the 3 sessions of treatment, there was no significant difference in the response rate between the observation group (90%, 27/30) and control group (83.3%, 25/30; χ2 = 0.577, P = 0.706). Moreover, there was no significant difference in the incidence of blisters, erythema, edema, skin dryness, desquamation, pruritus, reactive acne or pigmentation between the two groups (all P > 0.05) . Conclusion:The two-step irradiance schedule can effectively control related pain during the treatment of moderate to severe acne with ALA-PDT, especially in the initial stage of treatment, making patients successfully complete 3 sessions of ALA-PDT treatment and ensuring the clinical efficacy.
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Objective:To explore the possible role of endoplasmic reticulum aminopeptidase 1 (ERAP1), tumor necrosis factor-α receptor Ⅰ (TNFR-Ⅰ), tumor necrosis factor-α receptor Ⅱ (TNFR-Ⅱ) in the pathogenesis of psoriasis vulgaris.Methods:15 cases of normal skin and 20 cases of psoriasis vulgaris in Xinjiang Uygur Autonomous Region People's hospital were enrolled. Immunohistochemical staining techniques were used to detect the expression of ERAP1, TNFR-Ⅰ, TNFR-Ⅱ protein in the two groups. Statistical analysis was then performed to compare the difference in expression between the two groups.Results:⑴ In normal skin , ERAP1 is mainly expressed in the basal layer of the epidermis. In the psoriatic vulgaris lesions, ERAP1 was diffusely positive. The expression of ERAP1 in the psoriatic lesions was stronger than that of normal tissues, with stastically significant difference ( Z=-4.170, P<0.05). ⑵ TNFR-Ⅰ is diffusedly expressed in the normal skin tissues. However, in the epidermis of psoriatic lesions, the expression of TNFR-Ⅰ in the spinous layer was stronger than that of the basal layer (χ 2=17.740, P<0.05). ⑶ In the normal skin, TNFR-Ⅱ was not expressed; in the psoriatic lesions, TNFR-Ⅱ was diffusely expressed in the basal cell layer and acanthosis of the epidermis in varying degrees, and the difference between normal and psoriatic skin was statistically significant (χ 2=17.500, P<0.001). ⑷ The expression of ERAP1 in the epidermis of psoriasis vulgaris was negatively correlated with TNFR-Ⅰ ( rs=-0.662, P=0.001). There was no significant correlation between ERAP1 and TNFR-Ⅱ ( rs=0.343, P=0.139). Conclusions:ERAP1, TNFR-Ⅰ, and TNFR-Ⅱ may play important roles in the pathogenesis of psoriasis vulgaris. They may interact with each other to regulate the proliferation and apoptosis of keratinocyte in order to maintain the abnormal proliferation and benign proliferation of psoriasis vulgaris epidermis.
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Objective@#To evaluate peripheral vein puncture assisted with Eyes-On vascular imaging glasses in vulneralis shock.@*Methods@#Between February 2017 and June 2018, 110 patients in vulneralis shock were distributed to treatment group, and 128 patients between January 2016 and January 2017 were distributed to control group. Peripheral vein puncture were underwent in treatment group assisted with Eyes-On vascular imaging glasses, and with traditional operation in control group. Successful rate of first puncture, second puncture, puncture more than three times, and failure rate, operating time, rate of complications were recorded.@*Results@#Successful rate of first puncture in treatment group and control group were 97.03% (98/101) and 9.38% (12/128). There was significant difference between two groups (χ2=173.771, P=0.001). Operating time of treatment group and control group were (1.16±0.41), (5.01±1.03) min, there was significant difference between two groups (t=7.693, P<0.01). In the observation group, puncture was successful while in the control group, puncture failed in 5 cases, with a failure rate of 3.91%(5/128). And there was no significant difference in failure rate of puncture (P >0.05). Regard as complications, there were no significant differences in leakage and bleeding (P>0.05), but there were significant differences in blockage and hematoma which were 5.94%(6/101), 1.98%(1/101) and 21.09%(27/128), 11.71%(15/128)(χ2=10.510, 7.791, P<0.01).@*Conclusion@#Eyes-On vascular imaging glasses can operated easily and vein imaging directly, and nurses can independently proceed puncture quickly and effectively in vulneralis shock. Eyes-On glasses is a recommended device.
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Objective To evaluate peripheral vein puncture assisted with Eyes-On vascular imaging glasses in vulneralis shock. Methods Between February 2017 and June 2018, 110 patients in vulneralis shock were distributed to treatment group, and 128 patients between January 2016 and January 2017 were distributed to control group. Peripheral vein puncture were underwent in treatment group assisted with Eyes-On vascular imaging glasses, and with traditional operation in control group. Successful rate of first puncture, second puncture, puncture more than three times, and failure rate, operating time, rate of complications were recorded. Results Successful rate of first puncture in treatment group and control group were 97.03% (98/101) and 9.38% (12/128). There was significant difference between two groups (χ2=173.771, P=0.001). Operating time of treatment group and control group were (1.16 ± 0.41), (5.01±1.03) min, there was significant difference between two groups (t=7.693, P<0.01). In the observation group, puncture was successful while in the control group, puncture failed in 5 cases, with a failure rate of 3.91% (5/128). And there was no significant difference in failure rate of puncture (P >0.05). Regard as complications, there were no significant differences in leakage and bleeding (P>0.05), but there were significant differences in blockage and hematoma which were 5.94% (6/101), 1.98% (1/101) and 21.09% (27/128), 11.71% (15/128) ( χ2=10.510, 7.791, P<0.01). Conclusion Eyes-On vascular imaging glasses can operated easily and vein imaging directly, and nurses can independently proceed puncture quickly and effectively in vulneralis shock. Eyes-On glasses is a recommended device.
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Objective:To investigate the role of scavenger receptor BⅡ(SR-BⅡ) in the oxidized low density lipid(ox-LDL) induced foam cells formation promoted by porphyromonas gingivalis(P.g).Methods:Peritoneal macrophages were stimulated with P.g and ox-LDL,and then foam cells formation were checked.The expression of SR-BⅡ was detected by Western blot and real-time PCR.Next,siRNA targeting SR-BⅡ was used to detect the change of foam cells formation.Results:After being stimulated with P.g and ox-LDL,the foam cells formation was significantly increased.During the process of foam cells formation,P.g infection increased the expression of SR-BⅡ.And the knockdown of SR-BⅡ by siRNA significantly reduced the foam cells formation.Conclusion:P.g infection can increase the expression of SR-BⅡ and the regulation of SR-BⅡ expression can change the foam cells formation.
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Objective To investigate the changes of erythrocyte parameters and the value of differential diagnosis in pregnant women with β-mediterranean anemia.Methods A total of 300 pregnancy women from July 2014 to December 2015 in Center Hospital of Longgang were recruited in this study,100 pregnant women with β-mediterranean anemia in β-mediterranean anemia pregnancy group,100 healthy pregnant women in normal pregnancy group,100 pregnant women with iron deficiency anemia in iron deficiency anemia pregnancy group.Mean red cell volume(MCV),mean erythrocyte hemoglobin(MCH),reticulocyte percentage(Ret%) were detected and compared in the three groups.Results Compared with the normal pregnancy group and iron deficiency anemia pregnancy group,the MCV,MCH significantly reduced,and Ret% significantly rised in the β-mediterranean anemia pregnant group,the differences were significant(P<0.05).The best cut-off value of Ret% was 1.7% in differential diagnosis of β-mediterranean anemia pregnancy and iron deficiency anemia pregnancy,the sensitivity was 63.00%,the specificity was 74.00%,the area under of receiver operating characteristic curve was 0.841.The sensitivity of joint detection including MCV,MCH and Ret% in differential diagnosis of β-mediterranean anemia pregnancy and iron deficiency anemia pregnancy was 84.00%,the specificity was 90.00%.Conclusion MCV,MCH and Ret% in pregnancy women with β-mediterranean anemia changes significant compared with normal pregnancy group and iron deficiency anemia pregnancy group,the joint detection including MCV,MCH and Ret% could significantly improve the differential diagnosis of β-mediterranean anemia and iron deficiency anemia in pregnancy women.
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Objective To explore the variations and prognostic factors of hyperhomocysteinaemia in ischemic cerebral apoplexy for the youth who administrated vitamin B6,vitamin B12 and folic acid at pretherapy and post-treatment.Methods One hundred and twenty cases of young patients with ischemic cerebral apoplexy in the Pinggu Hospital of Capital University from January 2003 to December 2013 as case group(intervention group,60 cases and 60 cases of non-intervention group),while 120 youth volunteers with the same period and age without neurological diseases as a control group.Both groups patients were detected for hyperhomocysteinaemia,folic acid and vitamin B12.The non-intervention group was administrated basic treatment,while the intervention group administrated vitamin B6,vitamin B12 and folic acid on this basis.The hyperhomocysteinaemia,folic acid and vitamin B12 were detected repetitively after four weeks.Results Compared with control group,the hyperhomocysteinaemia in ischemic cerebral apoplexy group for the youth had increased significantly ((10.2 ± 3.1) μmmol/L vs.(21.3 ± 4.5) μmmol/L,P ＜ 0.05).The hyperhomocysteinaemia,folic acid and vitamin B12 had no significant differences between intervention group and non-intervention group (P ＞ 0.05).After replenished vitamin B6,vitamin B12 and folic acid,the hyperhomocysteinaemia had decreased significantly ((10.5 ± 3.0) μmnol/L) in intervention group.Folic acid ((6.5±2.8)μg/L) and vitamin B12(450.2±155.6) ng/L) had increased significantly(P＜0.05).Conclusion The hyperhomocysteinaemia increased in ischemic cerebral apoplexy for the youth.It is that hyperhomocysteinaemia decreased by replenished vitamin B6,vitamin B12 and folic acid which make for prognosis in ischemic cerebral apoplexy for the youth.
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Objective To analyze the recurrence risk of patients single post-stroke epilepsy. Methods Fifty-eight cases of epilepsy after stroke in Pinggu District Hospital of Beijing were enrolled in this study and their history clinical information were retrospectively collected. All patients were divided into single attack group (A group)and two or more attack group(B group). Results There were 3. 67%(58/1580)stroke patients were developed epilepsy. Among them,0. 38%(6/58)of patients were developed seizures in early stage,and 3. 29%(52/58)in late stage. Thirty-one cases occurred epilepsy once within one years in A group and 27 cases occurred epilepsy more than twice with one year in B group. Initiate epilepsy onset of 2 cases(A1)was at early stage and 29 cases(A2)at late stage in A group. Initiate epilepsy onset of 3 case(B1)was at early stage and 24 cases(B2)at late stage in B group. There was no significant difference in term of types of epilepsy between two groups(χ2 =0. 001,P﹥0. 05). The lesions site of 13 cases was located cortex and 18 cases was located in below cortex in A group,in B group,the lesions site was located in cortex of 17 cases or below cortex of 10 cases,and the difference was not significant(χ2 =2. 555,P﹥0. 05). The hemorrhagic stroke and ischemic stroke were 12 and 19 cases in A group,10 and 17 cases in B group,and there was no significant difference between two groups (χ2 =0. 017,P﹥0. 05). Rhythm of slow wave and the epileptiform discharges were 11 and 2 cases in A group, 11 and 13 cases in B group. About 51. 8% of the patients with recurrence of epilepsy had history of infection in B group. Conclusion For stroke patients,especially hemorrhagic stroke,first seizure is late-onset epilepsy cases. If the electrical activity of the brain is abnormal slow rhythm or epileptiform discharges,close to the cortex is more likely to cause epilepsy recurrence. It is supposed to giving positive antiepileptic drug treatment in the first epilepsy after stroke.
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<p><b>OBJECTIVE</b>To explore the effects of different concentrations of putrescine on the proliferation, migration and apoptosis of human skin fibroblasts (HSF).</p><p><b>METHODS</b>HSF cultured in the presence of 0.5, 1.0, 5.0, 10, 50, 100, 500, and 1000 µg/ putrescine for 24 h were examined for the changes in the cell proliferation, migration, and apoptosis using MTS assay, Transwell migration assay, and flow cytometry, respectively.</p><p><b>RESULTS</b>Compared with the control cells, HSF cultured with 0.5, 1.0, 5.0, and 10 µg/ putrescine showed significantly increased cell proliferation (P<0.01), and the effect was the most obvious with 1 µg/ putrescine, whereas 500 and 1000 µg/ putrescine significantly reduced the cell proliferation (P<0.01); 50 and 100 µg/ did not obviously affect the cell proliferation (P>0.05). Putrescine at 1 µg/ most significantly enhanced the cell migration (P<0.01), while at higher doses (50, 100, 500, and 1000 µg/) putrescine significantly suppressed the cell migration (P<0.05); 0.5, 5.0, and 10 µg/ putrescine produced no obvious effects on the cell migration (P>0.05). HSF treated with 0.5, 1.0, 5.0, and 10 µg/ putrescine obvious lowered the cell apoptosis rate compared with the control group (P<0.01), and the cell apoptosis rate was the lowest in cells treated with 1 µg/ putrescine; but at the concentrations of 100, 500, and 1000 µg/, putrescine significantly increased the cell apoptosis rate (P<0.01), while 50 µg/ml putrescine produced no obvious effect on cell apoptosis (P>0.05).</p><p><b>CONCLUSION</b>Low concentrations of putrescine can obviously enhance the proliferation ability and maintain normal migration ability of HSF in vitro, but at high concentrations, putrescine can obviously inhibit the cell migration and proliferation and induce cells apoptosis, suggesting the different roles of different concentrations of putrescine in wound healing.</p>
Subject(s)
Humans , Apoptosis , Cell Movement , Cell Proliferation , Cells, Cultured , Fibroblasts , Cell Biology , Flow Cytometry , Putrescine , Pharmacology , Skin , Cell Biology , Wound HealingABSTRACT
<p><b>OBJECTIVE</b>To explore the effects of different concentrations of putrescine on proliferation, migration, and apoptosis of human umbilical vein endothelial cells (HUVECs).</p><p><b>METHODS</b>HUVECs were routinely cultured in vitro. The 3rd to the 5th passage of HUVECs were used in the following experiments. (1) Cells were divided into 500, 1 000, and 5 000 µg/mL putrescine groups according to the random number table (the same grouping method was used for following grouping), with 3 wells in each group, which were respectively cultured with complete culture solution containing putrescine in the corresponding concentration for 24 h. Morphology of cells was observed by inverted optical microscope. (2) Cells were divided into 0.5, 1.0, 5.0, 10.0, 50.0, 100.0, 500.0, 1 000.0 µg/mL putrescine groups, and control group, with 4 wells in each group. Cells in the putrescine groups were respectively cultured with complete culture solution containing putrescine in the corresponding concentration for 24 h, and cells in control group were cultured with complete culture solution with no additional putrescine for 24 h. Cell proliferation activity (denoted as absorption value) was measured by colorimetry. (3) Cells were divided (with one well in each group) and cultured as in experiment (2), and the migration ability was detected by transwell migration assay. (4) Cells were divided (with one flask in each group) and cultured as in experiment (2), and the cell apoptosis rate was determined by flow cytometer. Data were processed with one-way analysis of variance, Kruskal-Wallis test, and Dunnett test.</p><p><b>RESULTS</b>(1) After 24-h culture, cell attachment was good in 500 µg/mL putrescine group, and no obvious change in the shape was observed; cell attachment was less in 1 000 µg/mL putrescine group and the cells were small and rounded; cells in 5 000 µg/mL putrescine group were in fragmentation without attachment. (2) The absorption values of cells in 0.5, 1.0, 5.0, 10.0, 50.0, 100.0, 500.0, 1 000.0 µg/mL putrescine groups, and control group were respectively 0.588 ± 0.055, 0.857 ± 0.031, 0.707 ± 0.031, 0.662 ± 0.023, 0.450 ± 0.019, 0.415 ± 0.014, 0.359 ± 0.020, 0.204 ± 0.030, and 0.447 ± 0.021, with statistically significant differences among them (χ(2) = 6.86, P = 0.009). The cell proliferation activity in 0.5, 1.0, 5.0, and 10.0 µg/mL putrescine groups was higher than that in control group (P < 0.05 or P < 0.01). The cell proliferation activity in 500.0 and 1 000.0 µg/mL putrescine groups was lower than that in control group (with P values below 0.01). The cell proliferation activity in 50.0 and 100.0 µg/mL putrescine groups was close to that in control group (with P values above 0.05). (3) There were statistically significant differences in the numbers of migrated cells between the putrescine groups and control group (F = 138.662, P < 0.001). The number of migrated cells was more in 1.0, 5.0, and 10.0 µg/mL putrescine groups than in control group (with P value below 0.01). The number of migrated cells was less in 500.0 and 1 000.0 µg/mL putrescine groups than in control group (with P value below 0.01). The number of migrated cells in 0.5, 50.0, and 100.0 µg/mL putrescine groups was close to that in control group (with P values above 0.05). (4) There were statistically significant differences in the apoptosis rate between the putrescine groups and control group (χ(2)=3.971, P=0.046). The cell apoptosis rate was lower in 0.5, 1.0, 5.0, and 10.0 µg/mL putrescine groups than in control group (with P values below 0.05). The cell apoptosis rate was higher in 500.0 and 1 000.0 µg/mL putrescine groups than in control group (with P values below 0.01). The cell apoptosis rates in 50.0 and 100.0 µg/mL putrescine groups were close to the cell apoptosis rate in control group (with P values above 0.05).</p><p><b>CONCLUSIONS</b>Low concentration of putrescine can remarkably enhance the ability of proliferation and migration of HUVECs, while a high concentration of putrescine can obviously inhibit HUVECs proliferation and migration, and it induces apoptosis.</p>