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The local microenvironment is essential to stem cell-based therapy for ischemic stroke, and spatiotemporal changes of the microenvironment in the pathological process provide vital clues for understanding the therapeutic mechanisms. However, relevant studies on microenvironmental changes were mainly confined in the acute phase of stroke, and long-term changes remain unclear. This study aimed to investigate the microenvironmental changes in the subacute and chronic phases of ischemic stroke after stem cell transplantation. Herein, induced pluripotent stem cells (iPSCs) and neural stem cells (NSCs) were transplanted into the ischemic brain established by middle cerebral artery occlusion surgery. Positron emission tomography imaging and neurological tests were applied to evaluate the metabolic and neurofunctional alterations of rats transplanted with stem cells. Quantitative proteomics was employed to investigate the protein expression profiles in iPSCs-transplanted brain in the subacute and chronic phases of stroke. Compared with NSCs-transplanted rats, significantly increased glucose metabolism and neurofunctional scores were observed in iPSCs-transplanted rats. Subsequent proteomic data of iPSCs-transplanted rats identified a total of 39 differentially expressed proteins in the subacute and chronic phases, which are involved in various ischemic stroke-related biological processes, including neuronal survival, axonal remodeling, antioxidative stress, and mitochondrial function restoration. Taken together, our study indicated that iPSCs have a positive therapeutic effect in ischemic stroke and emphasized the wide-ranging microenvironmental changes in the subacute and chronic phases.
Subject(s)
Animals , Rats , Cell Differentiation , Disease Models, Animal , Ischemic Stroke , Proteomics , Stem Cell Transplantation/methods , Stroke/therapyABSTRACT
Objective:To assess the nursing care experiences and curative effects of the application of wound care technologies combined with other multiple treatments in the hepatolithiasis patient who suffered from postoperative severe intestinal fistula.Methods:The wound care difficult points were analyzed,the wound care technologies combined with other multiple treatments including multiple debridement methods were applied according to the severity of the intestinal fistula:multiple debridement, new skin protection, continuous flushing and drainage with double cannula, improved negative pressure closure drainage and wound pull-in technology, combined with systemic treatment and nursing intervention.Results:The intestinal fistula was treated for 12 days, and the wound infection was controlled for 24 days. Finally the wound was healed after 43 days and patient was discharged from hospital.Conclusions:In the case of severe intestinal fistula after hepatolithiasis operation, the application of wound nursing technology combined with treatment scheme provides a new treatment idea and scheme for intestinal fistula and wound healing.
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Objective:To compared the positive rate of anal swab nucleic acid test and clinical characteristics of critical and general coronavirus disease 2019 (COVID-19) patients.Methods:Clinical data of 18 patients with COVID-19 admitted to the First People's Hospital of Lianyungang City from February to March 2020 were retrospectively analyzed. The patients were divided into general group ( n = 11) and critical ill group ( n = 7) according to the severity of the disease. The differences of gender, age, epidemiological characteristics, fever duration after admission, underlaying disease, positive rate of anal swab nucleic acid test at admission and two times of negative pharyngeal swab test were compared between the two groups. Results:There were no significant differences in gender, age, fever duration after admission or underlaying disease between the two groups. The number of anorectal swab positive cases in critically ill group was significantly higher than that in general group (cases: 4 vs. 1, P = 0.047). After two negative pharyngeal swab nucleic acid test, the number of anal swab positive cases in critical illness group was still higher than that in general group (cases: 2 vs. 0), but the difference was not statistically significant ( P = 0.137). The number of non-local infection in critical ill group was significantly higher than that in general group (cases: 4 vs. 0, P = 0.047). All of the 4 non-local infected patients had a history of living in Wuhan. Conclusions:The patients with anorectal swab nucleic acid positive may have a more serious condition. It may be a risk to transfer ill patients out of the isolation ward by the criteria of only two times of negative pharyngeal swab nucleic acid test. Patients returning to our city after infection in Wuhan may be more serious.
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objective:To observe the effect of high-flow nasal cannula (HFNC) oxygen therapy on patients with acute respiratory failure after gastrointestinal operation under general anesthesia and its efficacy on prognosis.Methods:Totally 107 patients with acute respiratory failure after gastrointestinal operation under general anesthesia in ICU of our hospital were selected from January 2017 to June 2019. Patients were randomly divided into the HFNC group ( n=57) and non-invasive ventilation (NIV) group ( n=50). The changes of pH, PaO 2, PaCO 2, PaO 2/FiO 2, SpO 2, heart rate (HR), respiration rate (RR), and intra-abdominal pressure (IAP) before and after oxygen treatment were compared. The differences of comfort level, duration of oxygen treatment, re-intubation rate, 48-h pulmonary infection rate, incidence of anastomotic fistula, length of stay in ICU, length of hospital stay, hospitalization cost, and 28-day mortality were compared between the two groups. The t test of two independent samples was used for the comparison of normal measurement data. Non-normal data were expressed by median (quartile), fractional count data by case number (percentage), and comparison between the two groups by Chi-square test. Results:PaO 2, PaCO 2, PaO 2/FiO 2 and SpO 2 were not significantly different after 2-h oxygen therapy. PH of the HFNC group was lower than that of the NIV group (7.39 ± 0.04 vs. 7.42 ± 0.03), PaO 2, PaCO 2, PaO 2/FiO 2 and SpO 2 were higher than that of the NIV group [ (89.22 ± 8.70) vs. (84.99± 9.76) mmHg, (41.3 ± 3.43) vs. (39.34 ± 4.21) mmHg, (250.07 ± 18.34) vs. (237.89±19.38) mmHg, (96.14 ± 2.19) vs. (94.78 ± 2.76)%, P <0.05]; pH, PaO 2, PaCO 2, PaO 2 /FiO 2 and SpO 2 were significantly higher in the HFNC group than those in the NIV group [ (7.39 ± 0.04) vs. (7.36 ± 0.04) ; (97.2 ± 12.45) vs. (93.82 ± 12.54) mmHg; (40.84 ± 5.22) vs. (45.10 ± 6.40) mmHg; (277.16 ± 13.98) vs. (248.86 ± 12.81) mmHg, (98.14 ± 1.64)% vs. (95.48 ± 2.71) %] after 12 h oxygen treatment. The HR, RR and IAP of the HFNC group were lower than those of the NIV group, and the differences were statistically significant ( P <0.05). The duration of oxygen therapy in the HFNC group was shorter than that in the NIV group [(32.01 ± 7.57) vs. (40.88 ± 8.89) h], the reintubation rate was lower than that in the NIV group (1.75% vs. 12%), the pulmonary infection rate within 48 h oxygen therapy was lower than that in the NIV group (8.78% vs.30%), and the length of stay in ICU was shorter than that in the NIV group [(5.61 ± 1.73) vs. (7.60 ± 2.31) d], and the hospitalization cost was lower than that in the NIV group ( t = 4.822, P <0. 05). Conclusions:HFNC can improve the oxygenation index of patients with hypoxemia after gastrointestinal operation under general anesthesia, reduce oxygen treatment time, reduced reintubation rate, reduce pulmonary infection rate within 48 h, and improve the prognosis.
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Objective To investigate the causes of disease condition changes after the patients' transfer from intensive care unit (ICU) into the general wards. Methods From January 2013 to December 2018, the patients with improvement of disease condition in comprehensive ICU were transferred into the general wards of the First People's Hospital of Lianyungang and their clinical data were retrospectively analyzed. The general information of patients was collected, such as gender, age, underlying diseases, heavy smoking, acute physiology and chronic health evaluationⅡ(APACHEⅡ) and Glasgow coma score (GCS) in 24 hours, length of stay in ICU, average levels of oxygenation index and respiratory rates during the stay in ICU and on the day transfer from ICU, GCS score on the day of transfer from ICU, presence or absence of invasive ventilation,the time of invasive ventilation, sepsis or its absence, the situation of community or hospital acquired pneumonia, etc, and the classification of the disease changes after transfer. The patients were divided into a disease situation change group (change group) and a disease situation stable group (stable group) according to whether there was any change in the disease situation in the general ward or not, the patients were divided into respiratory complications group and non-respiratory complications group. The risk factors that may influence the change of the disease condition were analyzed by multiple-factor Logistic regression. Results From January 2013 to December 2018, there were 2 451 patients treated in comprehensive ICU, of that 1 293 were transferred into the general wards for further treatment. Among the patients transferred to the general ward, 628 cases' conditions were changed.① The respiratory complications were the most common changes (345 cases, 54.9%) in patients after the transfer from ICU, followed by cardiovascular complications (118 cases, 18.8%) and surgery-related complications (96 cases, 15.3%).② The proportions of underlying diseases and heavy smoking in the change group were significantly higher than those in the stable group [24.4% (153/628) vs. 7.8% (52/665), 40.3% (253/628) vs. 24.2% (161/665), all P < 0.05]. Compared with the stable group, the average oxygenation index [mmHg (1 mmHg = 0.133 kPa): 238.91±71.14 vs. 291.74±63.64], and the turn-out day oxygenation index (mmHg: 261.23±58.11 vs. 301.00 ±58.25) were lower in the change group, while the proportion of applying invasive ventilation [64.2% (403/628) vs. 47.4% (315/665)], and the duration of invasive ventilation [days: 5 (2-9) vs. 3 (2-7)] were higher in the change group, the differences being all statistical significant (all P < 0.05). ③ Compared with the non-respiratory complications group, the average oxygenation index in the respiratory complications group was lower (mmHg: 216.43±67.17 vs. 264.85±78.46), the turn-out day oxygenation index was lower (mmHg: 250.72±74.93 vs. 274.87±81.79), and invasive ventilation ratio was higher [77.4% (267/345) vs. 48.1% (136/283)], the differences being statistically significant (all P < 0.05).④ Logistic regression analysis showed that the underlying diseases [odds ratio (OR) = 1.522], heavy smoking (OR = 2.314), and average oxygenation index (OR = 1.821) were the independent risk factors for patients in the general wards occurring disease situation changes after transfer from ICU (all P < 0.05). Conclusions The patients with following factors: underlying diseases, heavy smoking, low average oxygenation index during ICU stay, low oxygenation level on the day of transfer, application of invasive ventilation and long ventilation time are more easily to occur complications of respiratory system in the general wards after transfer from ICU; among the above related factors, the underlying diseases, heavy smoking and average oxygenation index are the independent risk factors for patients' occurrence of disease situation changes after transfer from ICU. Therefore, the patients with these risk factors, the evaluation and monitoring of the disease situation should be strengthened before and after patients' transfer from ICU. and the changes of patients' condition are mostly respiratory complications. Among them, combined underlying diseases, severe smoking and average oxygenation index are the independent risk factors for patients who have condition changes transferred from ICU. For patients with these risk factors, evaluation and monitoring should be strengthened before and after patients are transferred from ICU.
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AIM:To investigate the effect of NF-κB binding element deletion on transcriptional regulation of (NOX1).METHODS:pGL3-Basic vector inserted with the NOX1 proximal promoter, and the same vector inserted with the NOX1 proximal promoter in the absence of the positive NF-κB binding element, were constructed.After cloning, diges-tion and purification, NOX1 proximal promoter (≈1 415 bp) was inserted into the multicloning site of the pGL3-Basic vec-tor and then sequenced ( pGL3-NOX1-1415) .NF-κB binding elements in the NOX1 promoters were predicted by Alibaba 2.1 software.The positive element was deleted by overlapping PCR.The deletion mutant was inserted into the pGL3 vector in the same way (pGL3-NOX1-1327).The plasmids were transfected into A549 cells, and then the cells were stimulated with TNF-α.The luciferase activity was monitored on MD SpectraMax M5 enzyme-labeled instrument.RESULTS:The se-quences of pGL3-NOX1-1415 and pGL3-NOX1-1327 were identified to be correct.Compared with control group, the lucif-erase activity was significantly higher in the cells transfected with pGL3-NOX1-1327 (P<0.05), but it was significantly lower than that in the cells transfected with pGL3-NOX1-1415 (P<0.05).CONCLUSION: NF-κB plays an essential role in the transcriptional regulation of NOX1 in TNF-α-induced A549 cells.Activated NF-κB binds to specific elements in NOX1 promoter regions to control the transcription.
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Objective To analyse the nutrients of Acaudina leucoprocta and explore its hypolipidemic effect. Method The nutrients constituents of Acaudina leucoprocta were analyzed by high-performance liquid chromatography,and was compared with Apstichopus japonicus. The hyperlipidemia model was estabolished by feeding SD male mice with high fat feed. The change of liver index and fat coefficient as well as the effects on serum lipid,antioxidant capacity of serum in rats were observed. Results The fat content of Acaudina leucoprocta was only 0.43%,significantly lower than that of Apstichopus japonicus. The content of amino acids in Acaudina leucoprocta was higher than that of Apstichopus japonicus. Acaudina leucoprocta would decrease the liver index,fat coefficient and TC,TG,LDL-C,LDL-C/HDL-C in serum significantly,and increase HDL-C and HDL-C/TC. MDA and NEFA contents were effectively reduced. GSH-Px activitives were enhanced. Conclusion Acaudina leucoprocta is very rich in protein,and low in fat content. It has hypolipidemic and antioxidative effects,and may reduce the oxidative damage caused by high fat diet. Acaudina leucoprocta may be used as a functional food.