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BACKGROUND:Warm-needling moxibustion can effectively treat knee osteoarthritis.Degeneration,injury and fracture of the anterior cruciate ligament can affect the local stability of the knee joint,and then induce the formation of knee osteoarthritis.Whether warm-needling moxibustion can repair the injured cruciate ligament and the mechanism of action are still unclear. OBJECTIVE:To observe the effects of warm-needling moxibustion on the morphology of the anterior cruciate ligament and the expression of insulin growth factor-1 and transforming growth factor-β in rabbits with knee osteoarthritis and to clarify the mechanism of anterior cruciate ligament repair by warm-needling moxibustion. METHODS:Thirty New Zealand rabbits were randomly divided into blank group,model group and warm-needling moxibustion group,with 10 rabbits in each group.Knee osteoarthritis model was established by plaster cast immobilization.The blank group was not intervened.Rabbits in the model group rabbits were fixed in a rabbit holder for 15 minutes every day.The warm-needling moxibustion group was treated with warm acupuncture,once a day,7 days as a course of treatment,a total of two courses.After treatment,the imaging changes of the anterior cruciate ligament were observed by MRI and MRI grading statistics were performed.Morphological changes of the anterior cruciate ligament were observed by transmission electron microscope and hematoxylin-eosin staining.mRNA and protein expressions of insulin growth factor-1 and transforming growth factor-β were detected by RT-PCR and western blot,respectively. RESULTS AND CONCLUSION:MRI examination:Compared with the blank control group,the anterior cruciate ligament in the model group was thickened,edematous,and partially torn,and the difference in grading statistics was statistically significant(P＜0.05).Compared with the model group,the anterior cruciate ligament in the warm-needling moxibustion group was slightly thickened,with mild edema and no tearing,and the difference in grading statistics was statistically significant(P＜0.05).General observation:In the model group,the surface of the anterior cruciate ligament was glossy and faded,with the edge being covered with flocculent periosteum and obvious tissue necrosis;in the warm-needling moxibustion group,the surface of the ligament was glossy,and the ligament was in a normal helical shape.Hematoxylin-eosin staining:In the model group,there was obvious tissue necrosis in the anterior cruciate ligament,a large number of new capillaries,loosely arranged fibroblasts and collagen fibers.In the warm-needling moxibustion group,there was a small amount of tissue necrosis and few new vessels in the anterior cruciate ligament,and the cells and collagen fibers were loosely and irregularly arranged.Transmission electron microscopy:In the model group,the fibers in the anterior cruciate ligament were arranged in a disordered way with uneven thickness and distribution,and there are more fibroblasts that were irregular in morphology;in the warm acupuncture group,the fibers were basically arranged longitudinally,with uneven thickness and distribution,and a small number of oval-shaped fibroblasts were observed.RT-PCR and western blot assay:mRNA and protein expressions of insulin growth factor-1 and transforming growth factor-β were significantly decreased in the model group compared with the blank control group(P＜0.05),but significant increased after treatment with warm-needling moxibustion(P＜0.05).To conclude,warm-needling moxibustion can alleviate anterior cruciate ligament injury and regulate the expression of insulin growth factor-1 and transforming growth factor-β to treat knee osteoarthritis.
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【Objective】 To investigate the effects of emotions (subjective well-being, depressed effect, worry, and guilt) on cancer (colorectal cancer, hepatic cancer, thyroid cancer, lung cancer, and breast cancer). 【Methods】 Two-sample bi-directional Mendelian randomization (MR) method was adopted. All data were based on summary data from genome-wide association studies (GWAS). Inverse variance weighting (IVW) was used to generate the main results, and weighted median (WM) and MR-Egger methods were employed to calculate supplementary results. The outcome measure was odds ratio (OR), and sensitivity analysis was conducted. 【Results】 For depressed effect, a significant association with lung cancer (OR=1.005, 95% CI: 1.001-1.009, P=0.015) was found. For worry, a significant association with breast cancer (OR=1.199, 95% CI: 1.011-1.423, P=0.038) was observed. For guilt, a significant association with thyroid cancer (OR=2.083, 95% CI: 1.080-4.017, P=0.029) was identified. After removing all potentially pleiotropic SNPs detected by MR PRESSO, the association between worry and breast cancer showed no statistical difference (P=0.064), while the association between worry and colorectal cancer remained significant (OR=0.739, 95% CI: 0.571-0.956, P=0.021). No causal relationship was found between cancer and emotions. 【Conclusion】 There is a causal relationship between depression and increased lung cancer incidence, guilt and increased thyroid cancer incidence, as well as anxiety and decreased colorectal cancer incidence.
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AIM:To explore the mechanism of ATP synthase mitochondrial F0 complex H+ transporting,sub-unit F6(ATP5J)in affecting the metastasis of hepatoma carcinoma cells by regulating mitochondrial function-mediated cy-toskeletal remodeling.METHODS:Hepatocellular carcinoma cells Li-7 were used to construct the ATP5J overexpression and knockdown models.JC-1 staining was used to detect the mitochondrial membrane potential in each group,reactive oxygen species(ROS)levels were examined by DCHF-DA,and mitochondrial ATP fluorescence probe was used to assess mito-chondrial function.Cytoskeletal remodeling was detected with a microfilament green fluorescent probe(Actin-Tracker Green-488).Transwell assay was used to assess cell invasion ability.The expression levels of ATP5J and translocase of outer mitochondrial membrane 20(TOMM20)were determined by Western blot.RESULTS:Overexpression of ATP5J up-regulated mitochondrial membrane potential and mitochondrial ATP fluorescence intensity,induced cytoskeletal re-modeling,promoted cell invasion and TOMM20 expression,and inhibited ROS production(P＜0.01).On the contrary,knockdown of ATP5J significantly decreased mitochondrial membrane potential and mitochondrial ATP fluorescence inten-sity,significantly decreased cell invasion ability and TOMM20 expression,promoted ROS production and blocked cyto-skeletal remodeling(P＜0.01).CONCLUSION:ATP5J regulates mitochondrial energy transformation in hepatocellular carcinoma cells,and affects metastasis of hepatoma carcinoma cells by regulating mitochondrial membrane potential and mitochondrial ATP production-mediated cytoskeletal remodeling through TOMM20.
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Objective@#To analyze the hotspots, frontiers, and future research trends related to puberty development among children and adolescents from 2013 to 2022, and to provide a reference for subsequent research related to puberty development.@*Methods@#Data related to puberty development from 2013 to 2022 were retrieved from the Web of Science core collection with the search formula "puberty timing (title) OR puberty development (title) OR pubertal timing (title) OR pubertal development (title) OR puberty timing (abstract) OR puberty development (abstract) OR pubertal timing (abstract) OR pubertal development (abstract)". The CiteSpace was used for visual analysis.@*Results@#A total of 6 684 publications were obtained and an upward trend could be seen in the number of publications in the field of puberty development in the last 10 years. Researchers with a high number of publications were Juul Anders, Brix Nis, and Ernst Andreas, in addition, the United States had the highest number of publications ( 2 125 ) and the highest betweenness centrality (0.23) in this field. In the last decade, research hotspots had focused on the timing of pubertal initiation, biological mechanisms of pubertal development, and sex differences in pubertal development. Research on environmental endocrine disruptors and the mechanisms of pubertal development were at the forefront of research and future research trends.@*Conclusion@#Scholars can refer to the research hotspots and research trends in this field and focus on the issues related to environmental endocrine disruptors and pubertal development mechanisms.
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Medical cases are an important mean to record the clinical treatment process for TCM doctors. With the help of big data processing technology and other means, digging and using of medical cases information is of great significance for the inheritance of TCM. TCM Cases Cloud integrates voice recognition, optical character recognition (OCR), four-diagnosis instrument of TCM and other intelligent information collection technologies, as well as abundant algorithms such as association analysis, Bayes, hierarchical clustering, etc. to dig the laws of syndrome differentiation, selection of prescriptions, medication, acupoint, etc. of famous TCM doctors in medical records. This article briefly introduced the platform from five aspects: the excavation of the experience of famous TCM doctors in modern times, the summary of the academic thoughts of ancient medical cases, the analysis of the law of diagnosis and treatment of specialized diseases, the regularity of a single drug and drug pairs, and the exploration of the compatibility of TCM prescriptions.
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Objective:To explore the therapeutic effect on transposition of peroneal longus tendon in reconstruction of long segment defects of chronic Achilles tendon.Methods:From November 2013 to November 2018, 17 patients with long segment defects of chronic Achilles tendon(greater than 5.0 cm of defect) were admitted in the Department of Trauma and Micro-orthopaedics of Zhongnan Hospital of Wuhan University. The patients were 14 males and 3 females, aged 19-55 years old, with an average of 34.7 years old. Eleven patients had defects on left Achilles tendon and 6 on the right. The chronic defects lasted over 1-12 months with an average of 3.8 months. The broken ends of the Achilles tendon located at 0-5.0 cm from the insertion point. The defects were at 5.0-9.0 cm in length, after debridement of the broken ends. After thoroughly debridement of the scar tissue over the broken end of an Achilles tendon, an autologous peroneal tendon transposition was performed for reconstruction of an Achilles tendon. Postoperative follow-ups were conducted to observe wound healing and complications. Arner Lindholm score was employed to evaluate the therapeutic efficacy before surgery and at the final follow-up. Ankle-hindfoot score of American Orthopedic Foot and Ankle Society(AOFAS) and Achilles Tendon Total Rupture Score(ATRS) were used to evaluate functional recovery. At the final follow-up, heel raise of single affected foot and the maximum circumference of both calves were observed, gait analyses for plantar stress assessment as well as review of ankle CT and MRI scans were conducted for assessment of therapeutic efficacy. Using t test in SPSS 22.0 software to compare preoperative and postoperative AOFAS and ATRS scores, P<0.05 indicates a statistically significant difference. Results:Wounds healed in one stage, except 1 diabetic patient who had haematoma in the wound after surgery and healed after debridement combined with VSD treatment. All the 17 patients had completed the postoperative follow-up that lasted for 24-48 months, with an average of 33 months. According to Arner Lindholm score for efficacy evaluation, 11 patients were in excellent and 6 in good. The postoperative AOFAS scores increased from 62.94 ± 6.51 before surgery to 93.71 ± 6.15 after the surgery. ATRS increased from 29.00 ± 3.54 before surgery to 92.29 ± 3.02 after the surgery, and the score difference between before and after surgery was staistically significant ( P<0.05). No patient experienced a complication such as Achilles tendon rupture, wound infection or nerve injury. During follow-up, ankle functions recovered well, valgus was found powerful as well as heel raise on single foot. The circumference of the affected calf was smaller than that of the healthy side by no more than 1.5 cm. Gait analysis showed balanced distribution of plantar stress. No corpus callosum formation was found in both of the affected and the healthy feet. No obvious sign of osteoarthritis of ankle showed review in CT scans. Ankle MRI scans showed good continuity of the reconstructed Achilles tendons, which become significantly thicker after the surgery. Conclusion:The transposition of the long peroneal tendon is a relatively simple and effective surgical technique for reconstruction of a chronic Achilles tendon rupture or defect in a longer length or a rupture at the insertion point.
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Objective To understand the epidemiology of clinically isolated Acinetobacter baumannii(A.bauma-nnii)in Hunan Province.Methods Bacterial antimicrobial resistance surveillance was carried out according to the requirements of the technical program of National Antimicrobial Resistance Surveillance System.Clinical data of Acinetobacter spp.reported to Hunan Provincial Antimicrobial Resistance Surveillance System by multiple centers in Hunan Province from 2012 to 2021 were summarized and analyzed with reference to the standards of the American Clinical and Laboratory Standards Institute.Results A total of 169 438 strains of Acinetobacter spp.were detected during the 10-year period,with the detection rate of A.baumannii being the highest(82.74％).70 923 strains(53.63％)of carbapenem-resistant A.baumannii(CRAB)and 58 149 strains(43.97％)of carbapenem-sensitive A.baumannii(CSAB)were detected respectively.Both CRAB and CSAB were detected most frequently in the age group＞70 years,which were 34.44％and 32.02％,respectively.The percentage of CRAB and CSAB detected in the intensive care unit were 34.80％and 11.31％,respectively.CRAB and CSAB were mainly isolated from spu-tum/bronchoalveolar lavage fluid,followed by pus/secretion,urine,and blood.The resistance rates of CRAB to commonly used antimicrobial agents didn't change much during the 10-year period.Resistance rates of CRAB to ceftazidime and cefepime were both＞84％,to ampicillin/sulbactam and piperacillin/tazobactam were both＞82％,to aminoglycosides and quinolones were both＞59％,to minocycline and polymyxin B were 15.9％-25.0％and 1.3％-6.9％,respectively.CSAB were sensitive to commonly used antimicrobial agents.Conclusion The isolation rate of CRAB is high and there is no significant change in resistance to commonly used antimicrobial agents.
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OBJECTIVE@#To explore the diagnosis and treatment of acute cerebral infarction following extracorporeal membrane oxygenation (ECMO) therapy in patients with cardiogenic shock to review the literature.@*METHODS@#The clinical data of two patients with cardiogenic shock treated with veno-arterial ECMO (VA-ECMO) complicated with acute cerebral infarction admitted to department of intensive care unit (ICU) of Affiliated Hospital of Guizhou Medical University were retrospectively analyzed and the treatment experience was shared.@*RESULTS@#Case 1 was a 46-year-old male patient who was admitted to the hospital on September 16, 2021, due to "repeated chest tightness, shortness of breath, syncope for 2+ years, and worsened for 15 days. Coronary artery angiography showed 3-vessel coronary artery disease lesions. On October 15, 2021, coronary artery bypass grafting (CABG), pericardial fenestration and drainage, thoracic closed drainage, femoral bypass, thoracotomy exploration, and sternal internal fixation were performed under support of extracorporeal circulation. After surgery, the heart rate was 180-200 bpm, the blood pressure could not be maintained, and the improvement was not obvious after active drug treatment. The right femoral artery and femoral vein were intubated, VA-ECMO support treatment was performed, and the patient was transferred to the ICU. Intra-aortic balloon pump (IABP) was treated on the day of transfer because the circulation could not be maintained. Due to acute cerebral infarction in the left hemisphere and right parieto-occipital lobe, subfalcine herniation, tentorial herniation, the patient ultimately died after withdrawing from ECMO. Case 2 was a 43-year-old male patient who was admitted to the hospital on June 29, 2021, with "fever for 8 days and vomiting for 4 days". Bedside ultrasound showed cardiac enlargement and diffuse wall motion reduction in the left and right ventricles. On June 30, 2021, the patient underwent catheterization through the right femoral artery and femoral vein, VA-ECMO support, and was transferred to ICU for treatment. Acute cerebral infarction on both sides of the cerebellum occurred, and after treatment, the patient was discharged with mild impairment of daily living ability.@*CONCLUSIONS@#Strengthen monitoring of anticoagulation; regular neurological examination of patients undergoing ECMO therapy; ECMO under light sedation or awake can be performed if the condition permitsif the condition permits, perform light sedation or awake ECMO, which helpful for the early detection of nervous system injury.
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Male , Humans , Middle Aged , Adult , Shock, Cardiogenic/therapy , Extracorporeal Membrane Oxygenation , Retrospective Studies , Coronary Artery Bypass/adverse effects , Cerebral Infarction/therapyABSTRACT
Objective:To analyze the factors influencing pulmonary infections in elderly neurocritical patients in the intensive care unit (ICU) and to explore the predictive value of risk factors for pulmonary infections.Methods:The clinical data of 713 elderly neurocritical patients [age ≥ 65 years, Glasgow coma score (GCS) ≤ 12 points] admitted to the department of critical care medicine of the Affiliated Hospital of Guizhou Medical University from 1 January 2016 to 31 December 2019 were retrospectively analyzed. According to whether or not they had HAP, the elderly neurocritical patients were divided into hospital-acquired pneumonia (HAP) group and non-HAP group. The differences in baseline data, medication and treatment, and outcome indicators between the two groups were compared. Logistic regression analysis was used to analyze the factors influencing the occurrence of pulmonary infection.The receiver operator characteristic curve (ROC curve) was plotted for risk factors and a predictive model was constructed to evaluate the predictive value for pulmonary infection.Results:A total of 341 patients were enrolled in the analysis, including 164 non-HAP patients and 177 HAP patients. The incidence of HAP was 51.91%. According to univariate analysis, compared with the non-HAP group, mechanical ventilation time, the length of ICU stay and total hospitalization in the HAP group were significantly longer [mechanical ventilation time (hours): 171.00 (95.00, 273.00) vs. 60.17 (24.50, 120.75), the length of ICU stay (hours): 263.50 (160.00, 409.00) vs. 114.00 (77.05, 187.50), total hospitalization (days): 29.00 (13.50, 39.50) vs. 27.00 (11.00, 29.50), all P < 0.01], the proportion of open airway, diabetes, proton pump inhibitor (PPI), sedative, blood transfusion, glucocorticoids, and GCS ≤ 8 points were significantly increased than those in HAP group [open airway: 95.5% vs. 71.3%, diabetes: 42.9% vs. 21.3%, PPI: 76.3% vs. 63.4%, sedative: 93.8% vs. 78.7%, blood transfusion: 57.1% vs. 29.9%, glucocorticoids: 19.2% vs. 4.3%, GCS ≤ 8 points: 83.6% vs. 57.9%, all P < 0.05], prealbumin (PA) and lymphocyte count (LYM) decreased significantly [PA (g/L): 125.28±47.46 vs. 158.57±54.12, LYM (×10 9/L): 0.79 (0.52, 1.23) vs. 1.05 (0.66, 1.57), both P < 0.01]. Logistic regression analysis showed that open airway, diabetes, blood transfusion, glucocorticoids and GCS ≤ 8 points were independent risk factors for pulmonary infection in elderly neurocritical patients [open airway: odds ratio ( OR) = 6.522, 95% confidence interval (95% CI) was 2.369-17.961; diabetes: OR = 3.917, 95% CI was 2.099-7.309; blood transfusion: OR = 2.730, 95% CI was 1.526-4.883; glucocorticoids: OR = 6.609, 95% CI was 2.273-19.215; GCS ≤ 8 points: OR = 4.191, 95% CI was 2.198-7.991, all P < 0.01], and LYM, PA were the protective factors for pulmonary infection in elderly neurocritical patients (LYM: OR = 0.508, 95% CI was 0.345-0.748; PA: OR = 0.988, 95% CI was 0.982-0.994, both P < 0.01). ROC curve analysis showed that the area under the ROC curve (AUC) for predicting HAP using the above risk factors was 0.812 (95% CI was 0.767-0.857, P < 0.001), with a sensitivity of 72.3% and a specificity of 78.7%. Conclusions:Open airway, diabetes, glucocorticoids, blood transfusion, GCS ≤ 8 points are independent risk factors for pulmonary infection in elderly neurocritical patients. The prediction model constructed by the above mentioned risk factors has certain predictive value for the occurrence of pulmonary infection in elderly neurocritical patients.
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Objective:To evaluate the effect of pancreatic duct stenting in the treatment of severe acute pancreatitis (SAP).Methods:The clinical data of 68 patients with SAP admitted to the Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University from January, 2019 to July, 2020 were retrospectively analyzed, including 38 males and 30 females, aged (44.85±8.51) years old. The patients were divided into two groups according to the treatment modality: the conservative group ( n=41) which received the conservative management, and the stent group ( n=27) which underwent pancreatic duct stent implantation and conservative management. The basic information, parenteral nutrition support time, fasting days, and other clinical data of patients were collected. Serum amylase, white blood cell count, acute physiology and chronic health (APACHE) II score and CT score were compared between the two groups at admission and 48 hours after treatment. Results:The serum amylase, white blood cell count, APACHE II score and CT score of the two groups were significantly lower after treatment (all P<0.05). Compared with the conservative group, the APACHE II score [(5.52±2.15) vs. (8.76±2.50)] and CT score [(4.85±1.96) vs. (6.18±1.07)] of patients were lower in the stent group after treatment (both P<0.05). Pancreatic duct stents were successfully implanted in all 27 patients of the stent group. Intubation to the main pancreatic duct failed in one patient, while the accessory pancreatic duct was alternatively intubated through the accessory nipple. No severe complications such as iatrogenic pancreatitis, bleeding, and perforation occurred after endoscopic retrograde cholangiopancreatography. The incidence of postoperative local complications was lower [18.52%(5/27) vs. 41.46%(17/41)], the proportion of antibiotic use>3 types [29.63%(8/27) vs. 56.10%(23/41)] decreased, and the analgesic episodes decreased [2(1, 3) vs. 4(3, 6)] in the stent group. The antibiotic usage duration [8(3, 11) d vs. 13(10, 19) d], the parenteral nutrition time [7(4, 15)d vs. 15(8, 18)d], the fasting time [5(3, 11) d vs. 11(6, 13)d] and the hospital stay [10(5, 16) d vs. 15(13, 23)d] were all shortened (all P<0.05). Conclusion:Both conservative management and pancreatic duct stenting can alleviate the clinical symptoms of SAP, and pancreatic duct stenting could help reduce local complications, relieve symptoms, and shorten hospital stay.
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Objective:To explore indicators related to visceral fat index by constructing a random forest model.Methods:In this cross-sectional study, the laboratory measures and body composition analysis records of 617 hospital employees (in-service and retired) who underwent physical examination in Heilongjiang Provincial Hospital Health Management Center from March to September 2021 were selected. The subjects were divided into a training set ( n=411) and a test set ( n=206) with the ratio of 2∶1. A total of 110 predictors were included in the model. The model was constructed with the training set and was evaluated with the test set. The optimal number of nodes and decision trees were selected to evaluate the prediction performance of the optimal model. And the top 10 relatively important factors were selected for further investigation. The 617 participants were further divided in to groups according to the visceral fat index: the normal or high visceral fat index group, and the differences of the top 10 relatively important factors were further compared between the two groups. Results:The optimal number of nodes of the final random forest model was 39 and the number of decision trees was 300. The accuracy, precision, sensitivity and specificity of the model was 83.3%, 73.9%, 89.4% and 78.7%, respectively. The area under the receiver operating characteristic curve and 95% confidence interval of the model was 0.881 (0.832-0.931). The top 10 relatively important factors in the model were body mass index, gender, age, serum uric acid, red blood cell count, monocyte cell count, C-peptide, carcinoembryonic antigen, glycosylated hemoglobin and glutamyl transpeptidase. There were significant differences in the up-mentioned 10 indicators between the subjects with normal and high visceral fat index (all P<0.05). Conclusions:The random forest model built in this study has good performance in predicting visceral fat index, and visceral fat is related with changes in liver function, pancreas function and immune function.
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Oxidative stress plays a crucial role in cadmium (Cd)-induced myocardial injury. Mitsugumin 53 (MG53) and its mediated reperfusion injury salvage kinase (RISK) pathway have been demonstrated to be closely related to myocardial oxidative damage. Potentilla anserina L. polysaccharide (PAP) is a polysaccharide with antioxidant capacity, which exerts protective effect on Cd-induced damage. However, it remains unknown whether PAP can prevent and treat Cd-induced cardiomyocyte damages. The present study was desgined to explore the effect of PAP on Cd-induced damage in H9c2 cells based on MG53 and the mediated RISK pathway. For in vitro evaluation, cell viability and apoptosis rate were analyzed by CCK-8 assay and flow cytometry, respectively. Furthermore, oxidative stress was assessed by 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) staining and using superoxide dismutase (SOD), catalase (CAT), and glutathione/oxidized glutathione (GSH/GSSG) kits. The mitochondrial function was measured by JC-10 staining and ATP detection assay. Western blot was performed to detect the expression of proteins related to MG53, the RISK pathway, and apoptosis. The results indicated that Cd increased the levels of reactive oxygen species (ROS) in H9c2 cells. Cd decreased the activities of SOD and CAT and the ratio of GSH/GSSG, resulting in decreases in cell viability and increases in apoptosis. Interestingly, PAP reversed Cd-induced oxidative stress and cell apoptosis. Meanwhile, Cd reduced the expression of MG53 in H9c2 cells and inhibited the RISK pathway, which was mediated by decreasing the ratio of p-AktSer473/Akt, p-GSK3βSer9/GSK3β and p-ERK1/2/ERK1/2. In addition, Cd impaired mitochondrial function, which involved a reduction in ATP content and mitochondrial membrane potential (MMP), and an increase in the ratio of Bax/Bcl-2, cytoplasmic cytochrome c/mitochondrial cytochrome c, and Cleaved-Caspase 3/Pro-Caspase 3. Importantly, PAP alleviated Cd-induced MG53 reduction, activated the RISK pathway, and reduced mitochondrial damage. Interestingly, knockdown of MG53 or inhibition of the RISK pathway attenuated the protective effect of PAP in Cd-induced H9c2 cells. In sum, PAP reduces Cd-induced damage in H9c2 cells, which is mediated by increasing MG53 expression and activating the RISK pathway.
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Cadmium/metabolism , Caspase 3/metabolism , Potentilla/metabolism , Glycogen Synthase Kinase 3 beta/pharmacology , Proto-Oncogene Proteins c-akt/metabolism , Cytochromes c/metabolism , Glutathione Disulfide/pharmacology , Oxidative Stress , Myocytes, Cardiac , Reactive Oxygen Species/metabolism , Reperfusion Injury/metabolism , Apoptosis , Polysaccharides/pharmacology , Adenosine Triphosphate/metabolismABSTRACT
Objective@#To analyze the association between sleep duration and social anxiety in Chinese children and adolescents to provide evidence for promoting healthy lifestyle and mental health in children and adolescents.@*Methods@#A total of 1 145 children and adolescents aged 7-16 were recruited by cluster random sampling in Beijing in 2020, and received a series of body measurements and questionnaire survey. Social Anxiety Scale for Children (SASC) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the social anxiety symptoms and sleep duration of children and adolescents. T test was used to compare the differences of social anxiety level in different groups, and multivariate linear regression analysis was used to analyze the relationship between sleep duration and social anxiety.@*Results@#The average score of social anxiety was (5.47±4.18). The social anxiety score of girls, participants aged 13-16, with insufficient physical activity and insufficient sleep duration were higher ( t =-4.34, -6.14, 3.35, 2.93, P < 0.05). The results of multivariate linear regression model showed that after adjusting confounding factors, social anxiety decreased by 0.78 for each additional hour of sleep duration ( β =-0.78, 95% CI =-1.03--0.54, P <0.01), with 0.60 in boys (95% CI = -0.95 --0.25), 0.90 in girls (95% CI =-1.24--0.56), 0.75 among participants aged 7-12 (95% CI =-1.11--0.40) and 0.76 among participants aged 13~16 (95% CI =-1.11--0.41)( P <0.01), respectively. Social anxiety among participants who were not over weight or obese decreased by 0.78(95% CI =-1.09--0.48) and 0.81 among overweight and obese group (95% CI =-1.22- -0.41 )( P <0.01) for each additional hour of sleep duration, respectively.@*Conclusion@#Substantial differences in social anxiety are observed in children and adolescents by gender, age group and nutritional status. Sufficient sleep duration is significantly related to the decrease of social anxiety, and improve the overall level of student mental health.
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Objective@#To analyze the association between sleep duration and social anxiety in Chinese children and adolescents to provide evidence for promoting healthy lifestyle and mental health in children and adolescents.@*Methods@#A total of 1 145 children and adolescents aged 7-16 were recruited by cluster random sampling in Beijing in 2020, and received a series of body measurements and questionnaire survey. Social Anxiety Scale for Children (SASC) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the social anxiety symptoms and sleep duration of children and adolescents. T test was used to compare the differences of social anxiety level in different groups, and multivariate linear regression analysis was used to analyze the relationship between sleep duration and social anxiety.@*Results@#The average score of social anxiety was (5.47±4.18). The social anxiety score of girls, participants aged 13-16, with insufficient physical activity and insufficient sleep duration were higher ( t =-4.34, -6.14, 3.35, 2.93, P < 0.05). The results of multivariate linear regression model showed that after adjusting confounding factors, social anxiety decreased by 0.78 for each additional hour of sleep duration ( β =-0.78, 95% CI =-1.03--0.54, P <0.01), with 0.60 in boys (95% CI = -0.95 --0.25), 0.90 in girls (95% CI =-1.24--0.56), 0.75 among participants aged 7-12 (95% CI =-1.11--0.40) and 0.76 among participants aged 13~16 (95% CI =-1.11--0.41)( P <0.01), respectively. Social anxiety among participants who were not over weight or obese decreased by 0.78(95% CI =-1.09--0.48) and 0.81 among overweight and obese group (95% CI =-1.22- -0.41 )( P <0.01) for each additional hour of sleep duration, respectively.@*Conclusion@#Substantial differences in social anxiety are observed in children and adolescents by gender, age group and nutritional status. Sufficient sleep duration is significantly related to the decrease of social anxiety, and improve the overall level of student mental health.
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Objective:To explore the regulatory effect of cellular FLICE-like inhibitory protein (cFLIP) on myocardial ischemia-reperfusion injury based on the RIPK1/RIPK3/MLKL-mediated necroptosis pathway.Methods:The cardiomyocyte hypoxia/reoxygenation (H/R) model was constructed by hypoxia for 4 h/reoxygenation for 12 h, and the rat ischemia reperfusion (I/R) model was constructed by ligating the left anterior descending artery for 30 min and reperfusion for 3 h. CCK-8 method was used to detect the viability of cardiomyocytes in each group. DAPI/PI double staining was used to observe changes in necrosis rate of myocardial cell. STRING database was used to predict the protein interaction network of cFLIP. TTC staining was used to detect the area of myocardial infarction in each group of rats, and the protein expression of cFLIPL, cFLIPS, p-RIPK1, p-RIPK3 and p-MLKL were detected by Western blot.Results:In cardiomyocyte H/R injury and myocardial tissue I/R injury, the protein expressions of cFLIPL and cFLIPS were significantly down-regulated, while the levels of p-RIPK1, p-RIPK3 and p-MLKL were increased significantly. Up-regulating the protein expression of cFLIPL and cFLIPS could significantly reduce the damage of cardiomyocytes and the rate of cell necrosis induced by H/R, and decrease the area of myocardial infarction caused by I/R. STRING database results showed that cFLIP had direct protein interactions with RIPK1 and RIPK3. Overexpression of cFLIP in cardiomyocyte and myocardial tissue significantly inhibited H/R or I/R induced the phosphorylation levels of RIPK1, RIPK3 and MLKL.Conclusions:Overexpression of cFLIP can significantly inhibit the RIPK1/RIPK3/MLKL-mediated necroptosis, thereby reducing myocardial cell damage and decreasing the area of myocardial infarction.
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Objective:By analyzing visually field of standardized residency training from 2008 to 2018, and exploring the field research hotspots and the frontier trend, to provide direction and reference for the field of standardized residency training in our country.Methods:Using CiteSpace visualized analysis software as a research tool, a statistical analysis was conducted on 1 120 pieces of literature in the field of standardized residency training retrieved from the core database of Web of Science.Results:The research strength of standardized residency training was mainly concentrated in the United States, with a total output of 697 papers, accounting for 62.23% of the total number of articles published in the past decade. High yield author Gillespie C published 8 papers, and highly cited author Aggarwal R's paper was cited 54 times. Acad Med, a highly cited journal, was cited the most frequently, with 470 citations in past 10 years. High frequency key words were "resident", "education", "performance", etc. Mutators included "system", "older adult", "operating room", and so on.Conclusion:The research hotspots in the field of standardized residency training in recent ten years include the teaching of residents, the assessment of clinical ability of residents, the standardized patients, etc. Frontier trends focus on resident self-assessment system, surgical training, resident professional core competences, etc.
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Objective:To analyze and screen the key genes of sepsis secondary to pulmonary infection by bioinformatics, and to provide theoretical basis for the basic research of the disease and find an ideal animal model program.Methods:Experiment 1 (bioinformatics analysis): gene expression data sets of pulmonary infection secondary sepsis patients and multiple sepsis animal models were screened by Gene Expression Omnibus (GEO) Database, and gene differences were analyzed by R software. Differential genes were analyzed by gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Correlation analysis was conducted between differential genes and clinical symptoms in the data set of pulmonary infection secondary sepsis, and the correlation heat map between differential genes and clinical symptoms was drawn. Key genes were screened by weighted gene co-expression network analysis (WGCNA) and protein-protein interaction network analysis (PPIN) clustering. Experiment 2 (sepsis animal model preparation): male mice weighing 21-25 g were randomly divided into the key genes group and the control (Sham) group. And cecal ligation and puncture (CLP) was used to establish mouse sepsis model, while the mice in sham group were performed by exposure of cecum. And all the mice were scarified 24 hours after surgery to extract the total RNA from lung tissue, real time fluorescent quantitative polymerase chain reaction (RT-qPCR) was used to detect mRNA expression of key genes.Results:Experiment 1 (bioinformatics analysis): 319 differential genes were showed by GSE 134364 and GSE 65682 data set analysis of pulmonary infection secondary sepsis. And there was no genetic difference between community acquired pneumonia (CAP) and hospital acquired pneumonia (HAP) in patients with pulmonary infection secondary to sepsis. Obvious differences existed between differential genes in animal models, and there was no common differential gene. Differential genes in patients and animal models were similarly enriched in GO function, mainly in cell differentiation, regulation of cell process, and regulation of cellular response to stimuli, there were significant differences in pathway enrichment, among which, CLP animal models showed higher consistency with patients. The key genes obtained by WGCNA and PPIN analysis were MAPK14, NLRC4 and LCN2. Experiment 2 (sepsis animal model preparation): animal experiment results showed that the mRNA expressions of MAPK14, NLRC4 and LCN2 in lung tissue of CLP model mice were significantly up-regulated compared with the sham group.Conclusions:MAPK14, NLRC4 and LCN2 are key genes involved in the regulation of biological processes of pulmonary sepsis secondary to infection, and are potential research directions of this disease. What's more, CLP animal model can better reflect the biological characteristics of patients with pulmonary infection secondary sepsis, and is one of the ideal animal model schemes for pulmonary infection secondary sepsis.
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Objective:To explore the effect of collaborative teaching on anesthesia nursing.Methods:A total of 50 anesthesiology nursing undergraduates were randomly selected from the Batch 2018 of Harbin Medical University as experimental group and control group respectively. The two groups completed the teaching tasks in the same teaching hours. The control group was taught by traditional teaching method. The experimental group was jointly taught by the teaching team composed of anesthesia nursing teachers, humanistic medicine teachers and ideological and political teachers. After the completion of teaching, the two groups of students were surveyed by questionnaire to evaluate the teaching effect. SPSS 22.0 was used Fisher's exact probability test.Results:The questionnaire results showed that in the evaluation of collaborative teaching, the evaluation of expanded ideological, political and humanistic knowledge (96.00%, 48/50), strengthened the understanding of theoretical knowledge (88.00%, 44/50), improved doctor-patient communication ability (90.00%, 45/50), improved clinical strain ability (94.00%, 47/50), and improved professional identity (86.00%, 43/50) of the experimental group was significantly higher than that of the control group ( P<0.05). Conclusion:The collaborative teaching method in anesthesiology nursing course can not only strengthen students' mastery of clinical skills, but also cultivate lofty sense of mission and professional spirit, strengthen doctors' benevolent belief, improve medical students' comprehensive quality in an all-round way, and promote the development of new medical education.
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Objective:To investigate the utilization status and awareness of digital hospital construction among medical staff in critical care department of primary hospitals, so as to promote the process of digital medical health.Methods:One to two doctors and nurses (in the department on that day) from public hospitals in 88 counties and urban areas in 9 cities of Guizhou Province were enrolled of field investigation. The questionnaires form were filled in on-site and sorted out and analyzed by special personnel.Results:A total of 297 medical staff from the department of critical care medicine of 146 hospitals were included. All the questionnaires were filled in with their real names, including 152 doctors and 145 nurses. There were 24 class Ⅲ Grade A hospitals and 122 class Ⅱ and all the hospitals had implemented digital information management. The awareness of hospital digital information management system was generally low among the surveyed medical staff, and the awareness of hospital information system (HIS) was the highest (86.5%), followed by laboratory information management system (LIS, 41.4%) and image archiving and communication system (PACS, 40.7%). The awareness of hospital management system (HERP) was the lowest (7.7%). The total number of remote consultations conducted by hospitals using big data Internet was 25 428 times in 2020, with a median of 24.5 (88.0, 240.0) times in each hospital. From 2018 to 2020, the total number of patients admitted to the intensive care unit of the hospital was 50 473, 57 565 and 57 907, respectively, of which the number of patients over 65 years old accounted for 37.47%, 41.26% and 43.31%, respectively (all P > 0.05). There were 4 242 cases of remote consultation using big data Internet in the department every year, with a median of 257.50 (96.50, 958.25) cases. 12.12% of the departments had independent critical monitoring systems, and 8.75% of them could capture data automatically to form tables. 96.30% of the medical staff participated in systematic and professional training on basic knowledge, basic theory and basic medical care skills through the Internet platform, and the number of meetings, studies and training in the provinces and prefectures were 282 and 357 times per year, respectively. More than 90% of the departments initiated remote consultation, arranged referral or admitted patients who had improved status after treatment in superior hospitals through the Internet platform. Most of the patients (69.02%) were from the lower level of the hospital. The total number of out-patient consultations was 2 959 times per year, with a median of 296 (185 473) times. 54.79% of the departments had fixed service villages, and 28.08% of the departments had fixed service population. The median furthest visit distance was 52.5 (30.0, 80.0) kilometers, and the median average visit distance was 30.0 (20.0, 50.0) kilometers. 54.88% of medical staff believed that the biggest difficulties encountered during house visits were insufficient energy and too large service groups or regions. More than 90% of medical staff had been exposed to cloud learning and cloud training, and most of the surveyed medical staff believed that cloud learning and cloud training greatly improved medical service capacity and service efficiency of medical institutions (71.04% and 67.01%, respectively). Meanwhile, they believe that "Internet + health big data" projects from various aspects brought advantage to medical institutions, but there are also low utilization rate of Internet medical equipment by village doctors, low acceptance for telemedicine and mobile hospitals by farmers. Conclusions:Guizhou public hospitals have implementation of digital information management at the grass-roots level, the surveyed health care workers have a relatively low awareness of the digital information management system, hospital use big data Internet for remote consultation is uneven, intensive care medicine is a clinical discipline used in most remote consultation information system, and can complete two-way referrals. In the past three years, the discipline operation showed an upward trend year by year. Medical staff use artificial intelligence devices such as cloud learning and training to improve medical service capacity and efficiency. The digital transformation of primary hospitals is being continuously improved.
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OBJECTIVE@#To identify traditional Chinese drugs that contain active ingredients for treatment of myocardial infarction (MI) and explore their therapeutic mechanisms using network pharmacology and molecular docking technology.@*METHODS@#The TCMSP database was used for screening the traditional Chinese drugs containing active ingredients for treating MI, and the related targets of MI and the candidate drugs were obtained from Genecards, OMIM, PharmGkb and PharmMapper databases. The common target network of the drug targets and disease targets was established using Venny2.1.0 software. GO and KEGG signal pathway enrichment analysis of the common targets was performed, and the protein-protein interaction (PPI) network was constructed for the targets. The targets in the PPI network were analyzed to identify the key targets, for which GO and KEGG pathway enrichment analyses were performed. Molecular docking was performed for the candidate ingredients and the key targets, and a total score ≥6 was used as the criteria for screening the therapeutic ingredients and their docking binding with key targets was verified. A human umbilical vein endothelial cell (HUVEC) model of oxygen-glucose deprivation (OGD) was used to validate the candidate ingredients and the key therapeutic targets for MI by Western blotting.@*RESULTS@#Our analysis identified Salvia miltiorrhiza and Dalbergiae odoriferae as the candidate drugs rich in active ingredients for treatment of MI. These ingredients involved 16 key therapeutic targets for MI, which participated in such biological processes as inflammatory response, angiogenesis, energy metabolism and oxidative stress and the pathways including HIF-1, VEGF, and TNF pathways. Sclareol and PTGS2 in Salvia miltiorrhiza and formononetin and KDR in Dalbergiae odoriferae all had high docking total scores. Western blotting showed that at medium and high doses, sclareol significantly inhibited PTGS2 expression and formononetin promoted KDR expressions in the cell models in a dose-dependent manner (P < 0.05).@*CONCLUSION@#Both Salvia miltiorrhiza and Dalbergiae odoriferae have good therapeutic effects on MI. Sclareol in Salvia miltiorrhiza and formononetin in Dalbergiae odoriferae regulate the expressions of KDR and PTGS2, respectively, to modulate the inflammatory response, angiogenesis, oxidative stress and energy metabolism and thus produce myocardial protective effects.