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@#Objective To investigate the optimal administration combination of β-aminopropionitrile (BAPN) and Angiotensin Ⅱ (Ang-Ⅱ) in the establishment of SD rat aortic dissection (AD) model and the related complications. Methods Forty-two three-week-old male SD rats were randomly divided into 7 groups: a group A (0.25% BAPN), a group B (0.40% BAPN), a group C (0.80% BAPN), a group D [1 g/(kg·d) BAPN], a group E [1 g/(kg·d) BAPN+ 1 μg/(kg·min) saline], a group F [1 g/(kg·d) BAPN+1 μg/(kg·min) Ang-Ⅱ] and a group G (control group). There were 6 rats in each group. The intervention period was 4 weeks (groups E and F were 4 weeks+5 days). Rats were dissected immediately if they died during the experiment. After the intervention, the surviving rats were sacrificed by pentobarbital sodium, and the whole aorta was separated and retained. Hematoxylin-eosin staining was used to observe the changes of aorta from the pathological morphology. Results There was no statistical difference in the survival rate among the groups after 4 weeks of BAPN intervention (P>0.05). After 5 days of mini-osmotic pumps implantation, the survival rate of rats was higher in the group E than that in the group F (P=0.008), and the incidence of AD in the group E was lower than that in the group F (P=0.001). BAPN could affect the food and water intake of rats. After BAPN intervention for 4 weeks, the body weight of rats in the group G was higher than those in the intervention groups (P<0.05). BAPN combined with Ang-Ⅱ could make the aortic intima thick, elastic fiber breakage, arrangement disorder, and inflammatory cell infiltration in rats, which conformed to the pathological and morphological changes of AD. BAPN could also affect mental state and gastrointestinal tract. Conclusion The combination of BAPN [1 g/(kg·d)] and Ang-Ⅱ [1 μg/(kg·min)] can stably establish AD model in rats, which will provide a stable carrier for further study of the pathogenesis and therapeutic targets of AD. However, the complications in this process are an unstable factor. How to balance the influence of BAPN on other tissues and organs in the process of AD model establishment remains to be further studied.
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Objective:To investigate the perioperative complications and risk factors of postoperative death in patients with acute Stanford type A aortic dissection (ATAAD).Methods:The perioperative data of 228 patients with ATAAD who underwent continuous surgery in the Affiliated Hospital of Jining Medical University from January 2013 to July 2021 were retrospectively analyzed. The complications were analyzed. According to the survival within 30 days after surgery, they were divided into death group (24 cases) and survival group (204 cases). The risk factors of postoperative death were analyzed by univariate and multivariate logistic regression. The receiver operating characteristic (ROC) curve was drawed to evaluate the predictive efficacy of various risk factors on postoperative death of ATAAD patients.Results:The first three complications before operation were hypoxemia (10.1%, 23/228), pericardial tamponade (7.9%, 18/228), renal insufficiency (5.3%, 12/228), the first three complications after surgery were hypoxemia (75.8%, 173/228), renal insufficiency (26.8%, 61/228) and liver insufficiency (26.3%, 60/228). A total of 24 patients died, the fatality rate was 10.5%(24/228). Logistic regression analysis showed that age≥55 years old ( OR=7.733, 95% CI: 1.986-30.111, P=0.003), preoperative pericardial tamponade ( OR=5.641, 95% CI: 1.546-20.577, P=0.009), cardiopulmonary bypass time (CBP)≥200 min ( OR=1.008, 95% CI: 1.002-1.014, P=0.007) and postoperative renal insufficiency ( OR=5.875, 95% CI: 1.927-17.907, P=0.002) were independent risk factors for early death after ATAAD. The area under the ROC curves of joint prediction was 0.905 (95% CI: 0.820-0.950, P<0.01). The sensitivity and specificity of joint prediction were 88.4%, 76.5%, respectively. Conclusions:ATAAD has many perioperative complications and high mortality. Age≥55 years old, preoperative pericardial tamponade, CPB time≥200 min, and postoperative renal insufficiency were independent risk factors for postoperative death in ATAAD patients.
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Aberrant maternal inflammation and oxidative stress are the two main mechanisms of pathological pregnancy. The silence information regulator (sirtuin) family is a highly conserved family of nicotinamide adenine dinucleotide (NAD)-dependent deacylases. By regulating the post-translational modification of proteins, sirtuin is involved in various biological processes including oxidative stress and inflammation. Nowadays, emerging evidence indicates that sirtuin may be closely related to the occurrence and development of pathological pregnancy. The down-regulation of sirtuin can cause spontaneous preterm delivery by promoting uterine contraction and rupture of fetal membranes, cause gestational diabetes mellitus through promoting oxidative stress and affecting the activity of key enzymes in glucose metabolism, cause preeclampsia by reducing the proliferation and invasion ability of trophoblasts, cause intrahepatic cholestasis of pregnancy by promoting the production of bile acids and T helper 1 cell (Th1) cytokines, and cause intrauterine growth restriction through inducing mitochondrial dysfunction. Moreover, the expression and activation of sirtuin can be modulated through dietary interventions, thus sirtuin is expected to become a new target for the prevention and treatment of pregnancy complications. This article reviews the role of the sirtuin family in the occurrence and development of pathological pregnancy and its influence on the development of the offspring.
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Female , Humans , Pregnancy , Diabetes, Gestational , Premature Birth , TrophoblastsABSTRACT
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 study the effect of evidence-based nursing in patients with cerebral apoplexy in ICU by blind bedside spiral nasointestinal tube application.Methods To choose between September 2016 and September 2017 in our hospital ICU were 140 cases of patients with cerebral apoplexy as analysis object,randomly divided into two groups,two groups all use bedside blind spiral nose long intestinal tube technology,the control group using conventional nursing method for nursing,observation group using evidence-based nursing intervention,compared two groups of a success rate of catheter,accident to take off the tube (unscheduled decannulation rate),reflux hiccups,vomiting incidence of aspiration and patient satisfaction.Results The success rate of catheterization in the observation group was higher than that in the control group,and the incidence of accidental catheterization was lower than that in the control group.The incidence of reflux hiccup and vomiting aspiration was significantly lower than that in the control group,and the patient satisfaction was higher than that in the control group (all P＜0.05).Conclusion For patients with cerebral apoplexy in the ICU bed of blind plug spiral nasal bowel technology combined evidence-based nursing intervention,clinical effect is remarkable,improve the success rate of catheter,reduces the surprise success rate of tube,unscheduled tube drawing number,reduces the incidence of reflux hiccups,vomiting aspiration,improve patient satisfaction and quality of life.
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Objective To build demand scale for Post-hospital intestinal colostomy patients and test the reliability and validity. Methods Through the investigation of relevant literature at home and abroad,Based on the Maslow's Need Hierarchy Theory, in combination with intestinal colostomy patients psychological scale, using qualitative research, a semi-structured interview was conducted in 12 patients with colostomy A thorough understanding of colostomy patients Post-hospital care needs content (interview time as follows:September-October 2015), to analysis the interview recording data, the item pool of the scale for post-hospital care needs in patients with colostomy was constructed. Choosing 200 patients from the department of Proctology of third-grade class-A hospitals of Jilin province, and carries on the scale of clinical testing, after collecting the relative data , and make use of Critical Ration、the correlation coefficient method and the internal consistency coefficient method、further concludes that the scale items should be added or not, and picking up the internal consistency reliability 1/2 reliability retest reliability content validity and structure validity to analysis each item. Results The demand scale for Post-hospital intestinal colostomy patients included 6 dimensions and 24 items. The total content validity index (S-CVI) of the scale was 0.968, and the content validity index (I-CVI) of each item was 0.78-1.00. By exploratory factor analysis, 6 principal components were extracted, and the cumulative explanation variation of 6 principal components was 91.753％. This indicated that the scale had good validity. The total Cronbach a coefficient of the scale was 0.751, and the Cronbach a coefficient of each dimension was 0.968-0.974, all above 0.7, which indicated that the internal consistency was good. The half-fold reliability and retest reliability of the scale were 0.794 and 0.827 respectively. Conclusion The scale designed in this study has good reliability and validity, and can be used as an effective assessment tool for nursing needs of patients after discharge from enterotomy.
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Objective To investigate the effect of community comprehensive intervention on health behavior and self-rated health status among family caregivers of disabled elderly.Methods One hundredand twenty family caregivers of disabled elderly were selected from community health service centers of Beijing Dongcheng District,and were given 6 month-comprehensive community intervention (intervention group);121 family caregivers of disabled elderly from another community were selected as the control group.The knowledge and skills of caregiving,health behaviors (daily exercise time,daily relaxation time) and self-rated health status were evaluated before and 6 months after intervention.Results The knowledge and skill scores in intervention group were improved by 50.781 points,the daily exercise time and daily relaxation time were prolonged by 0.491 h and 0.837 h,respectively after the intervention (all P＜0.05).There was no significant difference in self-rated health status of two groups before and after intervention (P ＞0.05).Conclusion Community comprehensive intervention improves the knowledge and skills of caregiving,and the health behaviors among family caregivers of disabled elderly,but the intervention measures does not impact the self-rated health status of family caregivers.
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Objective To investigate the expressions of p15,p16,and p21 in skin of uygur patients with psoriasis and its significance in the development of psoriasis.Methods The expressions of p15,p16,and p21 were studied with immunohistochemical method in the Xinjiang Uygur psoriatic and normal Uygur skins.Results The positive expression rate of p16 gene was 12.5％ in skin lesions of patients with psoriasis Uygur,and 66.67％ in the normal group.The positive expressions of p15,and p21 genes in skin lesions of patients with psoriasis and healthy Uygur population were higher.Conclusions There is a significant correlation between the development of uygur psoriasis vulgaris and abnormal expression of p16.
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Objective To explore the relationship between care burden and social support among family caregivers of disabled elders in Beijing urban area.Methods A cross-sectional survey based on convenience sampling was conducted among 744 family caregivers in Dongcheng District in Beijing urban area.All subjects were interviewed by the Zarit Burden Interview (ZBI),Social Support Rating Scale (SSRS) and general social and demographical material lists.And then we analyzed the correlation between social support and care burden.Results The mean scores of ZBT and SSRS were (40.3 ± 15.2) and (31.1 ± 6.9)respectively.And a negative correlation existed between the level of caregiver burden and total social support.The care burden of disability elders was negatively associated with objective support,subjective support and social support availability (P ＜ 0.05).Conclusions There is a close relationship between care burden and social support among family caregivers of disabled elders.The more objective support,subjective support and social support availability the caregivers acquire,the less burden they bear.
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Objective To explore the relationship between acceptance of disability and hope level in patients with total laryngectomy.Methods Totally 84 patients with total laryngectomy were recruited and investigated with the general information questionnaire,Acceptance of Disability Scale (ADS)and Herth Hope Index (HHI).Results The total score of ADS was (85.82±12.64),which showed medium level acceptance of disability.The total score of Herth Hope Index (HHI) was (35.50±8.12),which showed high level HHI.Significantly positive correlation was found between acceptance of disability and HHI.Conclusions Nurses should pay more attention to the acceptance of disability in patients with total laryngectomy,and provide effective psychological intervention to improve the patients' menial health and quality of life.
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Objective:To evaluate the effectiveness of psychological intervention on improving the survival quality of patients with endometrial cancer during the operation. Methods:Sixty-two patients included in the eligible subjects were randomly divided into experimental group (n=31) and control group (n=31). The control group was given routine nursing intervention and the experimental group was given psychological intervention. Admission, discharge and discharge after one year follow-up measurement of quality of life were recorded. Results:Two patients discharged from the SF-36 scale score difference were statistically significant (t=11.3152, P<0.05), statistically significant long-term effect one year after the score difference (t=9.2025, P<0.05), the test group was better than control group. Conclusion:Psychological intervention is effective to improve the quality of life of patients with endometrial cancer during operation period and long-term.
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Objective To explore the therapeutic effect influencing factors of intra-aortic balloon pump(IABP) support during cardiac surgery perioperative period and countermeasures.Methods Clinical data of 42 patients using IABP in the cardiac surgery was analyzed retrospectively.The patients were classified into 2 groups:living group (32 patients) and died group (10 patients).The time of IABP implantation,preoperative cardiac function,the duration of cardiopulmonary bypass(CPB) and aorta block,mean arterial pressure (MAP) and inotropic score (IS) before using IABP and postoperative complications were recorded and compared.Results In died group,2 patients were used IABP preoperatively,1 patient was used intraoperatively,7 patients were used postoperatively,8 patients were in NYHA cardiac function class Ⅲ or Ⅳ preoperative,the duration of CPB and aorta block were (144.43 ± 49.03),(97.29 ± 39.99)min respectively,MAP and IS before using IABP were (57.34 ±7.25) mm Hg (1 mm Hg =0.133 kPa) and (28.22 ±17.72) scores,IABP time was (86.00 ±52.31) min.Compared with living group,all above comparisons showed significant difference [(100.43 ± 35.03) min,(60.45 ± 20.55) min,(69.34 ± 8.05)mm Hg,(10.82 ± 15.75) scores,(49.00 ± 25.23) min] (P ＜ 0.05).Postoperative complications in died group included 7 patients of ventilator dependency,6 patients of acute renal failure,5 patients of refractory metabolic acidosis,2 patients of malignant arrhythmia,1 patient of acute myocardial infarction,significantly higher than those in living group (0,4,2,0,0) (P ＜ 0.05).Conclusions Erroneously choose the timing of using IABP,poor preoperative cardiac function,prolonging CPB and aorta block time,MAP less than 60 mm Hg and high dose positive inotropic agent before using IABP,and postoperative complications are main influencing factors for clinical outcomes of IABP in cardiac surgery.Reasonably choosing adaptive indication and timing of IABP,preventing and treating postoperative complications effectively can improve effects of IABP in cardiac surgery.
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Objective To explore the changes of placental growth factor (PLGF) in patients with acute coronary syndrome (ACS).Methods One hundred and twelve patients were divided into four groups according to clinical data and coronary angiography:non-coronary artery disease (non-CAD) group (27 cases),stable angina (SA) group (28 cases ),unstable angina (UA) group (29 cases) and acute myocardial infarction (AMI) group (28 cases).Fifty-seven patients with ACS were divided into single lesion group (19 cases),twice lesion group ( 16 cases) and triple lesion group (22 cases) by coronary angiography,and 0-7 scores group (23 cases),8-15 scores group (27 cases) and 16-32 scores group (7 cases) by Jenkins scores.The serum PLGF levels of all the cases were determined on admission.The serum PLGF levels of 40 cases receiving percutaneous coronary intervention (PCI) were determined at 30 min before operation,the first and second day after operation.Results The serum PLGF levels of AMI group and UA group were (38.33 ±10.14) ng/L and (37.44 ± 13.32) ng/L respectively,which were significant higher than that of SA group [(20.90 ± 3.88) ng/L] and non-CAD group [(20.34 ±4.53) ng/L](P＜ 0.01),and there was no significant difference between AMI group and UA group,SA group and non-CAD group (P ＞0.05).There was no significant difference in the serum PLGF level among triple lesion group,twice lesion group and single lesion group (P ＞ 0.05 ).There was no significant difference in the serum PLGF level among 0-7 scores group,8-15scores group and 16-32 scores group (P ＞ 0.05).The serum PLGF level of patients receiving PCI on the first day after operation [ (32.03 ± 7.41 ) ng/L] was significantly higher than that before operation [ (23.86 ± 6.91 ) ng/L](P＜ 0.05 ),and on the second day after operation the serum PLGF level [ (29.37 ± 6.99) ng/L] was less than that on the first day after operation,showing a fall tendency(P＞ 0.05).Pearson correlation analysis showed that the serum PLGF levels in patients with ACS were not related with cardiac troponin T and creatine kinase isozyme-MB (r =-0.158,P=0.421;r =0.302,P=0.118).Conclusion The serum PLGF level of ACS patients is an inflammatory marker reflecting coronary atherosclerotic plaque destabilizing or plaque ruptured,and may also play an important role in early diagnosis of the borderline case of ACS.