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ObjectiveTo investigate the expression of Midkine （MDK） in cholangiocarcinoma （CCA） and its value in predicting the prognosis of CCA， as well as the potential mechanism of the effect of MDK on the progression of CCA. MethodsThe data of CCA samples were obtained from TCGA database to analyze the difference in the expression of MDK between cancer tissue and paracancerous tissue and its association with clinical features， and the data collected from GEO database and 11 CCA patients who underwent surgical resection in The Fifth Medical Center of Chinese PLA General Hospital from June 2018 to September 2021 were used for validation. STRING and Cytoscape were used to construct a protein-protein interaction network， and gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses were used to investigate the biological functions and tumor-related pathways involving MDK-related genes. In addition， TIMER and TISIDB databases were used to analyze the correlation between MDK expression and immune cell infiltration in CCA tissue. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the Fisher’s exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves， and the Log-rank test was used for comparison between groups. The Spearman correlation analysis was used to investigate the correlation between two variables. ResultsThe expression level of MDK in cancer tissue and paracancerous tissue of CCA patients was compared based on TCGA database， and the results of the non-paired and paired analyses showed that the expression level of MDK in CCA tumor tissue was significantly higher than that in paracancerous tissue （P<0.001）. Transcriptome sequencing was performed for the tumor tissue and its corresponding paracancerous tissue from 11 CCA patients， and the results showed that the expression level of MDK in CCA tumor tissue was significantly higher than that in corresponding paracancerous tissue （P<0.01）. High expression of MDK was associated with lymph node metastasis （P=0.045） and vascular invasion （P=0.044）. Survival analysis showed that compared with the CCA patients with low MDK expression， the CCA patients with high MDK expression had significantly shorter overall survival time （χ2=5.30， P=0.028） and disease-specific survival time （χ2=6.25， P=0.019）. The GO and KEGG enrichment analyses showed that the 30 MDK-related genes were closely associated with ubiquitin-mediated proteolysis and affected the prognosis of CCA patients. The TIMER analysis showed that the expression level of MDK was positively correlated with the infiltration of B cells （r=0.356， P=0.035 6） and dendritic cells （r=0.409， P=0.014 7） in tumor microenvironment of CCA； the TISIDB analysis showed that the expression level of MDK was positively correlated with CXCL16 （r=0.465， P=0.004 67） and was negatively correlated with CXCL12 （r=-0.389， P=0.019 7） and CXCR5 （r=-0.393， P=0.018 5）， and it was also negatively correlated with the immune checkpoint regulators VTCN1 （r=-0.393， P=0.018 3）， LTA （r=-0.380， P=0.022 7）， and PVR （r=-0.350， P=0.037 3）. ConclusionHigh expression of MDK is associated with poor prognosis in CCA patients， and MDK has the potential of being used as a molecular marker for predicting the prognosis of CCA. MDK may promote the development and progression of CCA by regulating ubiquitin-mediated proteolysis and the infiltration of B cells and dendritic cells.
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OBJECTIVES@#To investigate the attitudes and skills of grief counseling in the front-line medical workers from coronavirus disease 2019 (COVID-19) designated hospitals in Wuhan for the bereaved family members and to provide the basis for proper hospital management strategies.@*METHODS@#The convenience sampling method was applied to select 422 medical workers who kept touch with the bereaved family members in five COVID-19 designated hospitals in Wuhan from January to February 2020. Questionnaire regarding grief counseling attitudes and questionnaire regarding grief counseling skills were used to evaluate the attitudes and skills of grief counseling in medical workers. The scores of grief counseling attitudes and skills in group of different characteristics were further compared. Pearson correlation was used to analyze the attitudes and skills of grief counseling in medical workers.@*RESULTS@#The scores of grief counseling attitudes in medical workers were 15-46 (33.00±9.31). Length of service, professional title, whether or not receiving relevant training, frequency of contact with bereaved family members contributed to impacting the medical workers' attitudes of grief counseling (all <0.05). The scores of grief counseling skills in medical workers were 9-30 (19.30±4.42). Length of service, professional title, religion, whether or not receiving relevant training, frequency of contact with bereaved family members contributed to impacting the medical workers' skills of grief counseling (all <0.05). There was a significant positive correlation between the attitudes and skills of grief counseling in the medical workers (=0.608, <0.01).@*CONCLUSIONS@#The attitudes and skills of grief counseling in the medical workers from COVID-19 designated hospitals in Wuhan still need to be improved. Grief counseling group and a long-term, comprehensive training system are recommended.
Subject(s)
Humans , Attitude of Health Personnel , Betacoronavirus , China , Coronavirus Infections , Psychology , Counseling , Grief , Health Personnel , Psychology , Hospitals , Pandemics , Pneumonia, Viral , PsychologyABSTRACT
Objective To analyze the correlation between the clinical characteristics and the incidence of postoperative hepatic encephalopathy in patients with cirrhosis who received transjugular intrahepatic portosystemic shunt ( TIPS) . Methods The clinical data of 80 patients with liver cirrhosis hospitalized in the Fifth Medical Center of PLA General Hospital from March 2015 to March 2017 were retrospectively analyzed. The related factors of hepatic encephalopathy complications after TIPS treatment were analyzed. Results The cumulative incidence of hepatic encephalopathy was about 23. 75%(19／80) in one year after TIPS operation. Through single factor analysis and multi factor Logistic regression analysis,it was found that the two factors of preoperative platelet level and the location of tips blood shunt were closely related to the occurrence of hepatic encephalopathy after TIPS operation. The ROC curve suggested that the AUC of preoperative platelet level and the location of tips blood shunt were 0. 657 and 0. 668, respectively. The sensitivity and specificity of the former were 70. 0%,52. 6% and the cutoff value was 51 ×109／L, respectively, while those of the latter were 70. 5% and 63. 2%, respectively. Conclusion Preoperative platelets level＞51×109／L or shunting of the left branches of the portal vein may indicate a lower incidence of hepatic encephalopathy.
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Objective To develop an HPLC method for simultaneous determination of jasminoidin, baicalin, berberine hydro-chloride and emodin in Zhizi Jinhua(ZZJH) Pills. Methods The analysis was performed on a Zorbax Eclipse XDB-C18(4.6 mm×150 mm, 5 μm) with gradient elution by using the mobile phase of acetonitrile-0.2% phosphoric acid solution. The column temperature was maintained at room temperature and the flow rate was 1.0 ml/min. The detection wavelengths were set at 240 nm and 275 nm, respectively. Results The calibration curves were linear within the range of 0.056~0.3360 μg (r=0.9998) for gardenoside, 0.208~0.624μg (r=0.9990) for baicalin, 0.116~0.696μg (r=0.9994) for berberine hydrochloride, and 0.040~0.240 μg (r=0.9993) for emodin, respectively. The recoveries of gardenoside, baicalin, berberine hydrochloride and emodin were 91.18 %(RSD=1.60%)、91.55%(RSD=0.75%)、91.19%(RSD=1.08%) and 92.29%(RSD=1.98%), respectively. Conclusion The method is convenient, fast, sensitive and reproducible, with good precision, specificity and accuracy. So it can be used for simultaneous determination of jasminoidin, baicalin, berberine hydrochloride and emodin in ZZJH Pills.
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Olfaction is one of the ancient sensing capabilities and plays an important role in monitoring environment. Although olfactory loss is common, it's obviously underappretiated by medical community generally. In order to help patients with those problems, the author gives an brief review about the characters of common etiologies, treatment and prognosis of Olfactory Dysfunction. It's concluded that most usual causes resulting in dysos- mia are upper-respiratory-tract infections, trauma, and chronic rhinosinusitis; and our understanding of the olfaction mechanism grows, but frustratingly, aside from the possible therapeutic potential of systemic steroids, no method has been proved to have solid evidence for curing olfactory loss; so we need more new basic and clinic research to develop effective therapeutic intervention.