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Objective:To analyze the prognostic risk factors of patients with traumatic pancreatitis (TP) and establish an early combined prediction of multiple indicators model for TP.Methods:Patients admitted to the ICU of the First Affiliated Hospital of Zhengzhou University from June 2017 to June 2022 were collected retrospectively. Based on their prognosis, the patients were divided into two groups: the good prognosis group and the poor prognosis group. The general data such as sex, age, underlying diseases, Glasgow Coma Scale (GCS), acute physiology and chronic health evaluationⅡ (APACHEⅡ), injury severity score (ISS), bedside index for severity in acute pancreatitis (BISAP), and clinical test indices such as blood routine, blood coagulation, blood gas analysis, and liver and kidney function at admission were compared between the two groups. Univariate analysis and multivariate logistic regression analysis were used to screen the early independent predictors of poor prognosis of TP, and the prediction model of TP was established by combining all of the independent indicators. The receiver operating characteristic (ROC) curve of each independent predictor and prediction model was drawn, and the area under the curve (AUC), sensitivity, specificity, and optimal cut-off value were calculated to examine the diagnostic impact of each independent predictor and the combined prediction model.Results:There were statistically significant differences in the complication rate of mental disorders, GCS, APACHE II, combined craniocerebral injury, combined chest injury, activated partial thromboplastin time, fibrin(pro)degradation products, lactate, aspartate aminotransferase, glomerular filtration rate, amylase, lipase, NT-proBNP, myoglobin, procalcitonin, ISS, and BISAP between the good and poor prognosis groups (all P<0.05). Multivariate logistic regression analysis showed that lactate ( OR=1.636, 95% CI: 1.046-2.559), lipase ( OR=1.005, 95% CI: 1.001-1.008), and ISS ( OR=1.161, 95% CI: 1.064-1.266) were independent risk factors influencing the prognosis of patients with TP. Based on the risk factors listed above, a prediction model was created: Logit P=-9.260+0.492×lactate+0.005×lipase+0.149×ISS, and the ROC curve was plotted. The AUC curve of the prediction model was 0.96 (95% CI: 0.91-1.00). Conclusions:Lactate, lipase, and ISS are early independent risk factors associated with the prognosis of TP. Their combined multi-indicator prediction model has an excellent clinical prediction effect, which can provide a clinical reference for early prediction and treatment of TP.
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Objective@#To explore positive psychological wellbeing of outstanding impoverished college students, and to provide reference for targeted mental health education.@*Methods@#By using in depth interview, twenty two outstanding impoverished college students from an undergraduate university in Dongguan were recruited and interviewed during April to May 2021.@*Results@#Qualitative analysis showed 9 characteristics in positive psychological wellbeing among these outstanding impoverished college students:gratitude( n =20), independence( n =15), sincerity( n =13), hard working( n =12), friendliness( n =11), studious( n =11), self cognitive adjustment( n =11), self discipline( n =11) and persistence( n =11), among which gratitude and independence were the core attributes. Factors associated with these positive psychological wellbeing mainly included the following aspects:family related factors [family function( 72.7 %), family teaching(63.6%), family emotional support(59.1%), parental attention in education( 36.4 %)], and family function scored the highest; peer related factors [peer influence(45.5%) and peer emotional support( 45.5 %)]; and teacher related factors [teachers emotional support(40.9%) and teachers teaching(27.3%)]. In addition, other factors such as personal practical experience, national policy support and school atmosphere also had certain impacts.@*Conclusion@#Outstanding impoverished college students demonstrate positive psychological wellbeing. It should pay more attention to the positive psychological characteristics of impoverished college students, to explore factors associated with positive psychological qualities from various aspects, to pay attention to the role of social and emotional support, and to implement education to enhance positive psychological traits among impoverished college students.
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Objective:To investigate the protective effect of overexpressed tripartite motif containing (TRIM27) on severe acute pancreatitis (SAP) in mice and its possible mechanism.Methods:Twenty-four mice were randomly divided into the sham operation + control virus group (AAV-GFP group), sham operation + overexpression of TRIM27 group (AAV-TRIM27 group), SAP + control virus group (SAP+AAV-GFP group), SAP + overexpression of TRIM27 group (SAP + AAV-TRIM27 group), with 6 mice in each group. SAP model of mice was established by intraperitoneal injection of L-arginine (4 mg/kg). The sham operation group was injected with equal volume of normal saline, and the virus group was injected with control or TRIM27 overexpression adeno-associated virus (2×10 11 μg/ per mice). The serum and pancreatic tissue samples were collected 72 h after modeling. The levels of serum amylase, lipase, tumor necrosis factor α (TNF-α), interleukin-1b (IL-1b), IL-6, macrophage chemoattractant protein-1 (MCP-1) and the expression of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH) in pancreatic tissue were detected by enzyme-linked immunosorbent assay. Hematoxylin eosin staining was used to observe the pathological damage of pancreatic tissue. The expressions of myeloperoxidase (MPO) and Ly6g positive inflammatory cells in mouse pancreas were observed by immunohistochemistry. The expression of p-p65, p65, p-ASK1, ASK1, p-JNK, JNK, p-p38 and p38 in pancreatic tissue were detected by Western blot. Results:The expression of TRIM27 in pancreatic of mice was significantly down regulated after SAP ( P<0.05); after overexpression of TRIM27 by adeno-associated virus, the expression of TRIM27 in mouse pancreas was significantly up-regulated ( P<0.05). There was no significant difference in the indexes of mice between the AAV-GFP group and AAV-TRIM27 group ( P>0.05). Compared with the SAP + AAV-GFP group, the levels of serum amylase, lipase, TNF-α, IL-1b, IL-6 and MCP-1 in mice of the SAP + AAV-TRIM27 group were significantly decreased, MDA in pancreatic tissue was decreased, SOD and GSH were increased, MPO and Ly6g inflammatory cells were significantly decreased, and p-p65, p-ASK1, p-JNK, and p-p38 protein expression were down regulated. Conclusions:Overexpression of TRIM27 alleviates SAP in mice by inhibiting inflammatory response and oxidative stress, and its mechanism may be through inhibiting NFκB/MAPK signaling pathway.
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Objective:To investigate the predictive value of dynamic platelet and hemagglutination-related parameters in patients with acute pancreatitis (AP).Methods:The patients admitted to the Department of Emergency Surgery in the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2020 were analyzed. According to the inclusion criteria and exclusion criteria, patients with AP were retrospectively enrolled. According to the Chinese Guidelines for the Diagnosis and Treatment of Acute Pancreatitis (Shenyang, 2019), the patients were divided into two groups: severe acute pancreatitis (SAP group) and non-severe acute pancreatitis (non-SAP group) [including mild acute pancreatitis (MAP) and moderate severe acute pancreatitis (MSAP)]. A normal distribution of the maximum and mean aggregation rates of dynamic platelets (arachiidonic acid), plateletcrit (PCT) and bedside index for severity in acute pancreatitis (BISAP) scores and other measurement data were tested by t test, while measurement data of prothrombin time (PT), fibrinogen (FIB) and D-dimer that did not conform to normal distribution were tested by Mann-Whitney U test. χ 2 test was used for the counting data such as sex, age and etiology of patients in the two groups. The prognostic value of statistically significant indicators for non-SAP group and SAP group was further analyzed by receiver operating characteristic (ROC) curve. Results:A total of 146 patients with AP were enrolled, including 50 patients in SAP group and 96 in non-SAP group. The maximum and average aggregation rates of dynamic platelet (aracidonic acid) in the SAP group were (71.76±17.62) % and (67.91±18.10) %, PT (12.02±1.33) s, FIB (4.76±2.08) g/L, D-dimer (3.75±6.04) μg/L, PCT (0.23±0.08) %, and BISAP scores (1.42±1.18), which were all significantly higher than those in the non-SAP group [the maximum and average aggregation rates of dynamic platelet (arachiidonic acid) (46.65±20.11) % and (42.50±20.71) %, PT (11.50±1.51) s and FIB (3.91±1.48) g/L, D-dimer (1.00±1.37) μg/L, PCT (0.19±0.06) %, BISAP scores (0.45±0.66)] (all P<0.05). According to area under the ROC curve, the maximum and average aggregation rates of dynamic platelets (arachiidonic acid) in serum of patients with SAP were 0.83 and 0.82, respectively, and the sensitivities were 0.56 and 0.68, respectively. The specificity was 0.99 and 0.81, respectively, which was better than PT, FIB, D-dimer, PCT and BISAP scores in predicting the severity of AP. Conclusions:The maximum and average aggregation rates of dynamic platelets (arachidonic acid), PT, FIB, D-dimer, PCT and BISAP scores can be used as predictors of the severity of acute pancreatitis. The maximum and average aggregation rates of dynamic platelets (arachiidonic acid) were the best in predicting the severity of AP.
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Objective:To investigate the role of macrophage migration inhibitory factor (MIF) in severe acute pancreatitis (SAP) associated lung injury in mice.Methods:Totally 32 mice were randomly divided into 4 groups ( n=8/per group): wild type control group (WT+CON group), wild type SAP group (WT+SAP group), MIF gene knockout control group (KO+CON group), and MIF gene knockout SAP group (KO+SAP group). SAP model was established by intraperitoneal injection of L-arginine (4 mg/g). The expression of serum amylase, IL-6, TNF-α and MIF were detected by ELISA. The pathological changes of pancreatic and lung tissues were observed by HE staining. The expression of IL-6 and TNF-α in lung tissue was detected by immunohistochemistry. The expression of NF-κB in lung tissue was detected by Western blot. For measurement data, t test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups. Results:Compared with the WT+CON group, pathological score of pancreatic and lung injury, serum amylase, TNF-α and IL-6 expression in serum and lung tissues were significantly increased in the WT+SAP group ( P<0.05), while the above indexes were significantly decreased in the KO+SAP group ( P<0.05). In addition, the expression of NF-κB protein in KO+SAP group was significantly lower than that in the WT+SAP group ( P<0.05). Conclusions:MIF gene knockout can alleviate severe acute pancreatitis associated acute lung injury in mice, and its mechanism may be related to NF-κB.
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OBJECTIVE@#To study the correlation between DNA methylation patterns and gene expression in Down syndrome (DS).@*METHODS@#Induced pluripotent stem cells (iPSCs) derived from normal controls and DS patients were subjected to whole genome bisulfite sequencing and differentially methylated region (DMR) screening. Statistical analysis for chromosomal and gene element distribution were carried out for DMR. Gene ontology (GO) and enrichment-based cluster analysis were used to explore the molecular function of differentially expressed genes.@*RESULTS@#A total of 1569 DMR were identified in iPSCs derived from DS patients, for which the proportion of hypermethylation in promoter regions was significantly greater than that of the genebody. No DMR enrichment was noted on chromosome 21. Hypermethylation of the promoter and genebody was predicted to be inhibitory for gene expression. Functional clustering revealed the pathways related to neurodevelopmental, stem cell pluripotency and organ size regulation to be significantly correlated with differentially methylated genes.@*CONCLUSION@#Extensive and stochastic anomalies of genome-wide DNA methylation has been discovered in iPSCs derived from DS patients, for which the pattern and molecular regulation of methylation were significantly different from those of normal controls. Above findings suggested that DNA methylation pattern may play a vital role in both the pathogenesis of neurodevelopmental disorders and other phenotypic abnormalities during early embryonic development.
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Female , Humans , Pregnancy , DNA Methylation , Down Syndrome/genetics , Induced Pluripotent Stem Cells , Promoter Regions, Genetic , Whole Genome SequencingABSTRACT
OBJECTIVE@#To investigate the optimal dose range of immunosuppressants in patients with autosomal dominant polycystic kidney disease (ADPKD) after renal transplantation.@*METHODS@#A cohort of 68 patients with ADPKD who received their first renal transplantation between March, 2000 and January, 2018 in our institute were retrospectively analyzed, with 68 non-ADPKD renal transplant recipients matched for gender, age and date of transplant as the control group. We analyzed the differences in patient and renal survival rates, postoperative complications and concentrations of immunosuppressive agents between the two groups at different time points within 1 year after kidney transplantation. The concentrations of the immunosuppressants were also compared between the ADPKD patients with urinary tract infections (UTI) and those without UTI after the transplantation.@*RESULTS@#The recipients with ADPKD and the control recipients showed no significantly difference in the overall 1-, 5-, and 10- year patient survival rates (96.6% 96.0%, 94.1% 93.9%, and 90.6% 93.9%, respectively; > 0.05), 1-, 5-, and 10-year graft survival rates (95.2% 96.0%, 90.8% 87.2%, and 79.0% 82.3%, respectively; > 0.05), or the incidences of other post- transplant complications including acute rejection, gastrointestinal symptoms, cardiovascular events, pneumonia, and neoplasms ( > 0.05). The plasma concentrations of both tacrolimus and mycophenolate mofetil (MPA) in ADPKD group were significantly lower than those in the control group at 9 months after operation ( < 0.05). The incidence of UTI was significantly higher in ADPKD patients than in the control group ( < 0.05). In patients with ADPKD, those with UTI after transplantation had a significantly higher MPA plasma concentration ( < 0.05).@*CONCLUSIONS@#In patients with ADPKD after renal transplant, a higher dose of MPA is associated with a increased risk of UTI, and their plasma concentrations of immunosuppressants for long-term maintenance of immunosuppression regimen can be lower than those in other kidney transplantation recipients.
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Humans , Graft Survival , Immunosuppressive Agents , Kidney Transplantation , Polycystic Kidney, Autosomal Dominant , Retrospective StudiesABSTRACT
As a common clinical syndrome, portal hypertension can cause severe complications including gastroesophageal varices, ascites, and hepatic encephalopathy in patients with chronic liver diseases, which indirectly affects the prognosis of cirrhotic patients. At present, hepatic venous pressure gradient (HVPG) is the gold standard for the evaluation of portal hypertension, but its clinical application is limited by invasiveness and high cost. Therefore, the development of noninvasive and accurate measurements for portal pressure is crucial in the diagnosis, risk stratification, outcome monitoring, and prognosis prediction. This article reviews the latest advances in noninvasive examinations of portal hypertension in clinical practice and emphasizes the research and development of noninvasive techniques, HVPG standardization, and precise risk stratification management.
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Objective To provide theoretic rationales and clinical experience for post-transplant lymphoproliferative disorder (PTLD ) by comparing the characteristics of PTLD in kidney and hematopoietic stem cell transplant recipients and reviewing the relevant literature reports .Methods Twenty-seven adult PTLD patients from 2000 to 2017 were retrospectively reviewed .There were 11 kidney transplant recipients (KT group) and 16 hematopoietic stem cell transplant recipients (HSCT group) .Clinical characteristics and outcomes were analyzed between two groups .Cox's proportional hazard model was utilized for evaluating the prognostic factors .Results The incidence of PTLD for KT and HSCT groups were 0 .5 ％ and 1 .1 ％ respectively .PTLD patients of KT group had a later onset than that of HSCT group (105 .1 vs 3 .1 months , P<0 .01) .Also Epstein-Barr virus was less frequently detected in KT group (36 .4 ％ vs 81 .3 ％ , P< 0 .05) .The 5-year overall survival was (46 .8％ ± 10 .5％ ) .According to Cox analysis ,application of antithymocyte globulin (ATG) and high ECOG scores were risk factors for a poor prognosis of PTLD .Conclusions Most cases of KT-PTLD have a late onset . In contrast , HSCT-PTLD has an earlier onset and a higher incidence of EBV infectious .And application of ATG and high ECOG scores are poor prognosis factors of PTLD .
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Objective To study the influence of prebiotics and probiotics combined with early enteral nutrition (EN) on the recovery of gastrointestinal function, improvement of nutritional status and prognosis in postoperative patients with pancreatic trauma. Methods A retrospective analysis of the clinical data of pancreatic injury patients admitted to our hospital from January 2012 to December 2017 was carried out, and those patients were divided into 3 groups: group A (control group), patients treated with operation and routine treatment; group B, patients treated with prebiotics and probiotics in addition to surgery and routine treatment; group C, patients treated as group B in addition to early EN. Comparisons of blood biochemical markers, mortality, time required for resolution of abdominal pain, length of hospital stay, hospitalization expenses and complication rate among three groups. Results The time required for resolution of abdominal pain, length of hospital stay, hospital costs in group C were significantly lower than those in other groups (P＜ 0.05). The score of gastrointestinal dysfunction at one week after surgery in group C was significantly lower than that in group A and group B (P＜0.05). Serum amylase, lipase and CRP levels were significantly lower in group C than those in other groups (P＜ 0.05). Plasma albumin level significantly higher in group C than that in other groups (P＜ 0.05). Conclusion Prebiotics and probiotics combined with early EN treatment have certain advantages in patients with pancreatic injury.
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Purpose To evaluate left ventricular systolic function of patients with obstructive sleep apnea syndrome (OSAS).Materials and Methods Sixty OSAS patients were divided into 16 cases in mild OSAS group,18 cases in medium OSAS group and 26 cases in severe OSAS group in line with polysomnography results.20 healthy people were in the control group.Two-dimensional speckle tracking imaging was adopted to measure left ventricular global longitudinal strain (GLS),global radial strain (GRS),global circumferential strain (GCS),Endo-LS,Mid-LS and Epi-LS of left ventricular long axial section and EndoCS,Mid-CS and Epi-CS of short axial section in OSAS group and control group.Results ① There was no obvious change of GLS and GCS in mild OSAS group and compared with those in control group (P＞0.05),GRS was increased (P＜0.05).GLS,GRS and GCS in medium OSAS group was decreased when compared with those in control group,and the difference was of statistical significance (P＜0.05).GLS in severe OSAS group was reduced compared with that in control group,mild and medium OSAS group and GRS and GCS were also reduced compared with that in control group and mild OSAS group.The difference was of statistical significance (P＜0.05).② OSAS group was represented by Endo-LS reduction and as OSAS worsened,Endo-LS reduced section was enhanced.③ Starting from medium OSAS group,myocardial circumference strain began to decrease,which was represented by Endo-CS and Mid-CS reduction.Conclusion Adoption of two-dimensional speckle tracking imaging for left ventricular global and layered myocardial strain could figure out early stage left ventricular systolic function disorder in OSAS patients,providing more valuable information for clinical activities and guidance of early intervention for OSAS patients.
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<p><b>OBJECTIVE</b>To explore the disease-causing mutations in a patient suspected for giant axonal neuropathy(GAN).</p><p><b>METHODS</b>Target sequence capture sequencing was used to screen potential mutations in genomic DNA extracted from peripheral blood sample of the patient. Sanger sequencing was applied to confirm the detected mutation. The mutation was verified among 400 GAN alleles from 200 healthy individuals by Sanger sequencing. The function of the mutations was predicted by bioinformatics analysis.</p><p><b>RESULTS</b>The patient was identified as a compound heterozygote carrying two novel pathogenic GAN mutations, i.e., c.778G>T (p.Glu260Ter) and c.277G>A (p.Gly93Arg). Sanger sequencing confirmed that the c.778G>T (p.Glu260Ter) mutation was inherited from his father, while c.277G>A (p.Gly93Arg) was inherited from his mother. The same mutations was not found in the 200 healthy individuals. Bioinformatics analysis predicted that the two mutations probably caused functional abnormality of gigaxonin.</p><p><b>CONCLUSION</b>Two novel GAN mutations were detected in a patient with GAN. Both mutations are pathogenic and can cause abnormalities of gigaxonin structure and function, leading to pathogenesis of GAN. The results may also offer valuable information for similar diseases.</p>
Subject(s)
Child , Humans , Male , Amino Acid Sequence , Computational Biology , Cytoskeletal Proteins , Genetics , Giant Axonal Neuropathy , Genetics , Molecular Sequence Data , Mutation , Sequence Analysis, DNAABSTRACT
Aim: To establish the HPLC and LC-MC methods for the quality analysis of the different species of Radix Paeoniae Alba cultivated in Bozhou. Methods: The LC-MS method was applied to analyze the chemical composition of the cultivated species, the HPLC method was applied to determine the contents of paeoniforin, ben-zoic acid and paeonivayin in crude drugs and processing products. Results: 10 characteristic peaks were identified by LC-MS with reference standards. The significant difference was observed in the chemical compositions of 3 cultivated species. The significant difference was observed in the chemical compositions of 3 cultivated species. The content of paeoniflorin was increased significantly after traditional processing. The results indicated the 4-year-old pubang and 5-year-old xiantiao are the best cultivated species. Conclusion: The methods are simple, rapid and precise to assess and control the quality of different species of Radix Paeoniae Alba cultivated in Bozhou.
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AIM: To establish a HPLC method for determing naringin,rhein,emodin,chrysophanol,honokiol and magnolol in Da,Xiao-Chengqi Decoction bought from Taiwan. METHODS: The seperation was performed on Licrospher C_(18) column(150 mm?4.6 mm,5 ?m) with acetonitrile-0.5% HAc(gradient elution) as mobile phase and the detection wavelength was set at 270 nm. RESULTS: In the eight samples measured the content of naringin was from 0.54 to 44.20 mg/g;rhein from 0.51 and 2.10 mg/g;honokiol from 0.44 to 6.65 mg/g;emodin from 0.02 to 0.23 mg/g;magnolol from 1.09 to 2.29 mg/g,chrysophanol from 0.09 to 2.70 mg/g.However,honokiol and magnolol were not detected in some samples. CONCLUSION: This established method is fully validated with respect to linearity,precision,reproducibility and accuracy and successfully applied to quantifying the six constituents in eight commercial samples.The overall results demonstrate that this proposed method is simple,reliable,and suitable for the quality control of Da,Xiao-Chengqi Decoction.