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This paper introduces the construction and application of the medical quality evaluation indicator system in clinical departments of a large general hospital.It describes the indicator system's constitution and score setting,summarize the characteristics and application practice of the assessment system,and proposes some ideas for the following improvement,which in order to provide some reference for other hospitals.
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AIM: To observe the effect of fudosteine on induced sputum cell components and lung function in patients with stable neutrophil-dominated COPD. METHODS: From October 2019 to October 2022, 53 patients with stable COPD were selected and divided into fudosteine group and placebo group. The placebo group was treated with routine treatment, and the fudosteine group was treated with fudosteine on the basis of routine treatment. The two groups were treated for 6 months. The clinical symptoms [Saint George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT) and Modified British Medical Research Council Dyspnea scale (MMRC), Breathlessness, Cough, and Sputum Scale (BCSS)], lung function index, induced sputum cytology analysis and other related examination results were recorded in detail before and after treatment. RESULTS: (1) Compared with the baseline, the forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the ratio of FEV1 to FVC (FEV1/FVC) of the two groups were improved after treatment, and the differences were statistically significant (P<0.05). However, after treatment, there was no significant difference in pulmonary function between the two groups except for the percentage of carbon monoxide diffusion in the predicted value (DLCO%pre) (DLCO%pre in the fudosteine group was higher than that in the placebo group). (2) After treatment, the total number of induced sputum cells and neutrophil counts in the fudosteine group were lower than those in the placebo group. Compared with the number of cells in each component at baseline, the total number of induced sputum cells and neutrophil count in the fudosteine group were significantly lower (P< 0.05). CONCLUSION: Fudosteine treatment in patients with stable neutrophil-dominated COPD can improve lung function, reduce the total number of induced sputum cells and the total number of neutrophils, thereby improving airway inflammation.
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Induced sputum testing is a non-invasive test that reflects the nature and extent of airway inflammation and plays an important role in the diagnosis, treatment and prognosis of chronic airway diseases. This article outlines the development history of induced sputum technology, introduces the principle and operation of induced sputum technology, evaluates its safety, summarizes the three main test components, elaborates the role of this technology in various chronic airway diseases, such as reflecting the type of airway inflammation, predicting the efficacy of medication, and combining it with transcriptomics to study disease mechanisms, and briefly summarizes its innovations and makes a vision for the future.
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More than 300 million people worldwide suffer from asthma, and the incidence is increasing year by year. As one of the most common chronic diseases, asthma is an immune-mediated inflammatory disease with complex triggering mechanisms and strong heterogeneity. With the in-depth study of physiological and pathological mechanisms, therapeutic small molecule and hormone drugs have been introduced to control and treat most patients, but about 5% - 10% of patients still suffer from various subtypes of difficult to control and treat asthma, that is, severe asthma. In the past decade, with the rapid development of bio-pharmaceutical research, protein and antibody have become the key drugs for the treatment of severe asthma with high efficacy, high specificity and high safety. However, biological drugs are usually administered by injection, they cannot be noninvasive and directly delivered into the lung to quickly absorb and take effect. Therefore, there is an urgent need for the introduction of inhaled biologics with quick effectiveness, convenience, economy and safety in clinical. The review summarizes the existing small molecule, hormone and biological therapy drugs, and summarizes the development of inhalable biological agents of asthma, and analyzes the future prospects of the inhalable biological drugs, which is designed to deepen the perception of the direction of the inhalable biological drugs research, and update the information of the field, in order to provide reference for the development of more inhalable biologics.
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Allergen specific immunotherapy (AIT) is to identify the patient's allergen, give the patient repeated exposure to the allergen extract, and gradually increase the concentration and dose until the target maintenance dose is reached, so that the patient can develop tolerance to the allergen, which is the only treatment that can regulate the pathogenesis of allergic diseases and change its natural course. In recent years, domestic and foreign scholars have made great progress in the clinical practice and research field of AIT. This article reviewed the relevant progress of the mechanism, efficacy and drug administration of AIT.
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Objective:To investigate the clinicopathological features, differential diagnosis, treatment and prognosis of undifferentiated embryonal sarcoma of the liver (UESL).Methods:Five UESL cases operated on at Hunan Provincial People's Hospital from 2014 to 2021 were retrospectively analyzed. H&E and immunohistochemical staining were done for pathological observation.Results:The 5 UESL patients(two boys,three girls) were 0.5 to 15 years old, all underwent radical surgical resection. In 3 cases tumors located in right liver, 1 in left liver, 1 in both lobes. Radiographically and visually, the tumor is a large cystic solid mass, microscopically composed of myxoid stroma and undifferentiated stromal cells, with pleomorphic tumor giant cells and characteristic eosinophilic bodies. All 5 patients are now alive after surgical resection: 1 patient achieved disease-free survival of more than 91 months after surgery alone. Two patients had recurrence after surgery and received surgical resection plus chemotherapy or chemotherapy alone. They achieved survival of more than 35 and 16 months, respectively. Two patients were treated with chemotherapy or chemotherapy plus radiotherapy after surgery and survived more than 49 and 31 months without recurrence, respectively.Conclusions:UESL is a rare and highly malignant mesenchymal tumor with characteristic pathologic morphology. Radical resection is the key to the treatment for UESL, and chemotherapy and radiotherapy should be carried out after surgery.
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Objective:To study the effect of continuous subcutaneous insulin infusion(CSII)on the emotional disorder of children and adolescents with type 1 diabetes mellitus(T1DM)and their parents.Methods:A total of 72 children and adolescents with T1DM were divided into CSII group( n=40)and multiple daily injection(MDI)group( n=32).There were 58 healthy children and adolescents with their parents selected as control group.The emotional condition of children and adolescents in T1DM group and control group was evaluated by Depression Self-rating Scale for Children(DSRS)and the Screen for Child Anxiety Related Emotional Disorders(SCARED)respectively, and Symptom Checklist-90(SCL-90)was used for evaluating the mental health of all parents. Results:The average glycated hemoglobin A1c(HbA1c)of T1DM group was at the optimal level(7.406±1.294)%.The average HbA1c of CSII group was significantly lower than that of MDI group[(7.040±1.082)% vs(7.863±1.404)%, t=2.728, P=0.008].The depression rate of children and adolescents in T1DM group increased significantly than that of control group(31.9% vs 15.5%, χ2 =4.671, P=0.031).There were statistically significant differences among CSII group, MDI group and control group(20.0% vs 46.9% vs 15.5%, χ2 =11.591, P=0.003).The depression rate of children and adolescents in MDI group increased significantly than that of CSII group and control group(all P<0.05).CSII group showed similar results as compared with control group( P>0.05).Concerning the anxiety in children and adolescents, there was no significant difference between T1DM group and control group(19.4% vs 13.8%, χ2=0.730, P=0.393), and there were no significant differences among CSII group, MDI group and control group(15.0% vs 25.0% vs 13.8%, χ2=1.994, P=0.369).The emotional disorder prevalence of parents in T1DM group was remarkably higher than that of the control group(31.9% vs 5.2%, χ2=52.927, P<0.01).The factor scores of obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, paranoia and psychotic symptoms in T1DM group were higher than that of control group( P<0.05).There were statistically significant differences among CSII group, MDI group and control group(17.5% vs 50.0% vs 5.2%, χ2=26.126, P<0.01).The emotional disorder prevalence of parents in MDI group increased significantly than that of CSII group and control group(all P<0.05).But CSII group was same as that of control group( P>0.05). Conclusion:The children and adolescents with T1DM and their parents were high-risk population of emotional disorder.CSII can reduce not only the depression in the children and adolescents with T1DM, but also emotional disorder of their parents, thus CSII can improve the mental health in families suffering from T1DM.
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Testicular aging is mainly characterized by a gradual decline in the capability of testosterone synthesis and spermatogenesis, which not only affects male fertility, but also correlates with aging-related chronic diseases intimately. Therefore, delaying testicular aging plays a significant role in improving the health and quality of life of middle-aged and elderly men. Stem cells are a cell group with potent self-renewal capability and multi-directional differentiation potential. In recent years, the research of stem cells in basic and clinical application has been carried out in-depth, which has accelerated the development of cell therapy. Currently, stem cell transplantation has been employed to treat multiple diseases, which has captivated widespread attention in the field of aging and regenerative medicine. Stem cell transplantation has demonstrated promising prospects in the treatment of testicular aging. In this article, research profile and progress of stem cell transplantation in the treatment of testicular aging were reviewed, and bottleneck issues encountered in clinical translation and strategies for optimizing clinical efficacy were discussed, aiming to provide novel ideas for the research and development and clinical translation of stem cell therapy for testicular aging.
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Guanxin Tongluo capsule is a compound traditional Chinese medicine preparation for the treatment of coronary heart disease. The underlying mechanism may be related to expanding coronary artery, increasing coronary artery blood flow, reducing myocardial oxygen consumption, and decreasing whole blood viscosity, plasma viscosity, and hematocrit. This paper reviews the clinical research progress of Guanxin Tongluo capsule in the treatment of coronary heart disease from the aspects of etiology, pathogenesis, pharmacological research, and clinical research, providing evidence for scientific research and clinical application of Guanxin Tongluo capsule.
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Objective @#To explore the effect of sericin on podocyte epithelial-mesenchymal transition induced by high glucose.@*Methods @#Conditional immortalized mouse podocytes were used as the research object to construct podocyte injury model by high glucose stimulation.The podocytes were divided into normal (NG) group ,hyperton- ic control (MG) group ,high glucose injury ( HG) group ,low ,medium and high dose sericin ( LS ,MS ,HS) group.CCK-8 method was used to determine the viability of podocytes in each group ; the morphological structure of podocytes in each group was observed by ordinary optical inverted microscope.The migration ability was detected by Transwell and cell scratch test.Western blot was used to detect the expression levels of EMT-related mesenchy- mal phenotype factors Snai1,α-SMA,FSP-1,MMP-9 and epithelial phenotype factors Nephrin,E-cadherin,and WT-1 in podocytes of each group. @*Results @#Compared with NG group,HG group showed lower podocyte activity (P<0. 01) ,worse podocyte status and enhanced podocyte migration ability,up-regulated Snai1,α-SMA,FSP-1 and MMP-9 protein expressions (P <0. 01) ,and down-regulated Nephrin,E-cadherin and WT-1 protein expres- sions (P<0. 01) .Compared with HG group,the viability of podocytes in sericin group increased (P<0. 05) ,the state of podocytes was improved ,the migration ability of podocytes was weakened ,the expression of Snai1 ,α - SMA,FSP-1 and MMP-9 was down-regulated (P<0. 05) ,and the expression of Nephrin,E-cadherin and WT-1 was up-regulated (P <0. 05 ) .@*Conclusion @#Sericin can alleviate podocyte epithelial-mesenchymal transition in- duced by high glucose.
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Objective:To evaluate the clinical efficacy of multi-disciplinary single center's CCCG-HB-2016 regimen in the treatment of hepatoblastoma (HB) in children.Methods:Clinical data of 36 HB patients treated with CCCG-HB-2016 program from Aug 2016 to March 2020 were analyzed.Results:These 36 patients included 20 boys and 16 girls. The serum AFP was all higher than 2 792 ng/ml,there was a correlation between AFP and tumor risk stratification ( H=14.973, P<0.05). Twenty eight cases (77.78%) were epithelial type and 8 cases (22.22%) were mixed epithelial mesenchymal type.All children were treated by tumor resection combined with chemotherapy, and there was a correlation between tumor risk stratification and surgical resection of liver lobe ( H=8.847, P<0.05). The probability of bone marrow suppression in the low-risk group was 58.33% (35/60),that in the intermediate-risk group was 73.49% (61/83) and in the high-risk group was 80.23% (69/86).All 36 cases were followed up to March 31, 2020,with an average follow-up of 21.9 months and the median survival was 22.5 months.The overall survival rate (OS) and event-free survival rate (EFS) were 97.2% and 83.3% respectively. Conclusions:The multidisciplinary CCCG-HB-2016 regimen was with a high success rate and along with a high incidence of bone marrow suppression.
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Type 1 diabetes mellitus(T1DM), which is an autoimmune disease, mostly affect people with hereditary susceptibility under the joint participation of environmental factors.It is known to coexist with other autoimmune disorders such as celiac disease(CD). The prevalence of CD is higher in patients with type 1 diabetes compared with the general population.Most patients affected with both T1DM and CD are atypical for CD at diagnosis, and may be misdiagnosed and subsequently suffered from the delayed treatment.These patients are more likely to develop symptomatic hypoglycemia, or poor blood glucose control, leading to an increased risk of chronic complications and seriously affecting the quality of their life.Thus, screening for CD is recommended in patients with T1DM.Anti-tissue transglutaminase antibody is the preferred biomarker for CD screening in children and adolescents over 2 years of age, with a sensitivity of 95% to 100% and a specificity of 94% to 100%.And a low-carbohydrate diet is often combined with a gluten-free diet.
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Indocyanine green (ICG) fluorescence imaging technology has been applied in laparoscopic surgery. It is possible to highly visualize the tumor cutting edge and liver segment boundary during laparoscopic hepatectomy. Although the application of this technique in liver tumor surgery has become more and more mature, the factors affecting the quality of fluorescence imaging are still not completely clear. In this paper, we analyzed and summarized the effects of different factors such as ICG administration scheme, imaging acquisition, tumor characteristics of patients and preoperative liver function indexes on the quality of intraoperative ICG imaging, in order to provide new ideas and practical experience for clinical practice and research.
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Objective@#To investigate alteration of proteins profile in malignant transformation bronchial epithelial cells(16HBE-T) induced by hexavalent chromium[(Cr(VI))] and analyze the expression level of SET protein, then to provide some new insights for the carcinogenesis mechanism of Cr(VI).@*Methods@#Total protein was extracted from 16HBE cells and was alkylated and desalinated before digested into peptides. The products were labeled with Tandem Mass Tag (TMT) and identified using LC-ESI-MS/MS.@*Results@#A total of 3 517 proteins were found, expression differences greater than 1.5 or less 0.67 times were to found have 185 and 201 proteins, respectively. Gene enrichment analysis revealed that differential proteins were mainly involved in autophagy, DNA damage repair, RNA processing and other biological processes. Western blot results showed the expression level of SET was significantly increased while downregulated in histone H3K18/27 acetylation and p53 protein.@*Conclusion@#Proteins involved in multiple biological processes altered in 16HBE-T cells and regulation mode of SET inhibiting histone H3K18/27 acetylation regulating transcriptional activity of p53 may paly an important role in Cr(VI)-association carcinogenesis.
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Objective@#To explore the trichloroethylene-induced alteration of methylation on the promoter region of SET and related mechanisms in hepatic L-02 cells.@*Methods@#L-02 cells were treated with different concentrations of TCE(0 mmol/L, 1 mmol/L, 2 mmol/L, 4 mmol/L, 8 mmol/L) for 24 h. The genomic DNA were then extracted and modified by bisulfite sodium. The DNA methylation was then analyzed using bisulfite sequencing PCR (BSP).@*Results@#The overall methylation on promoter region of SET was decreased along with the increased concentrations of TCE in hepatic L-02 cells. Moreover, 73 CpG islands were found abnormally altered, among which 9 were predicted in transcriptional factor binding regions.@*Conclusion@#The decreased levels of CpG islands in the transcriptional factor binding region may contribute to the elevation of SET in TCE-induced hepatotoxicity.
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During 2 years,a 6-year-old girl was hospitalized for 2 times with recurrent onset of episodes of vomiting,weakness and fever after eating dessert at the Department of Neurology & Endocrine Pediatrics,the Affiliated Hospital of Qingdao University.The arterial blood gas analysis revealed severe hypoglycemia,lacticacidemia and metabolic acidosis,the urine ketone body was positive.After intravenous infusion of glucose,bicarbonate and antibiotics,there was a dramatic clinical improvement in a short time.Physical examination showed tachypnea and mild hepatomegaly,and she had normal physical and mental development.The laboratory findings revealed transient hyperuricacidemia.Urine organic acids analysis repeatedly showed an elevation of lactic acid,ketone and glycerol.Glyceroluria was a very distinctive trait.The literatures in PubMed was searched with glyceroluria as keyword.Three related diseases were identified:FBPase deficiency,glycerol kinase (GK) deficiency and complex GK deficiency.Further reading of related literatures to understand the characteristics of diseases and laboratory tests,the clinical diagnosis of GK deficiency and complex GK deficiency was excluded.The mutation analysis of FBPase gene (FBP1) was performed by Sanger sequencing and a novel compound heterozygous mutations of c.355G >A and c.960delG was discovered.Full analysis of disease-related traits and targeted gene testing is one of the effective methods for accurate diagnosis and treatment of inherited metabolic disorders.
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Objective@#To investigate DNA damage in the transformed human bronchial epithelial cells (16HBE) induced by hexavalent chromium (Cr6+) and further elucidate the potential carcinogenesis mechanism of Cr6+.@*Methods@#16HBE were treated with different concentration of Cr6+ (0, 0.625, 1.25, 2.5 μmol/L) for 15 weeks. The malignant degrees of transformed cells were identified by the assays for anchorage-independent growth and tumorigenicity. According to the single cell gel electrophoresis (SCGE) assay, the DNA damage rate was calculated. The expression level of 53BP1 was determined by Western blot.@*Results@#Chromium-treated cells could form colonies in soft agar and tumors in nude mice. Compared with the control group, colony formation efficiency of 1.25μmol/L and 2.5 μmol/L Cr6+-treated cells in soft agar showed significant increases (p<0.05) . The 2.5 μmol/L Cr6+-treated cells also formed tumors subcutaneously in nude mice. Cr6+ could cause different degree of DNA damage to 16HBE cells in a dose-dependent manner. In addition, Western blot analyses showed that 53BP1 was aberrantly down-regulated at 2.5 μmol/L dose and has no significant changes at 0.625 μmol/L and 1.25 μmol/L dose under the treatment of Cr6+.@*Conclusion@#The declined expression of 53BP1 may mediate Cr6+-induced DNA damage and further involved in the cell malignant transformation.
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To explore the mechanism for the role of autophagy in endometriosis, and to provide a theoretical basis for prevention and treatment of endometriosis. Methods: The endometrial CRL-7566 cells were treated with ATG5 siRNA, autophagic activator rapamycin and autophagic inhibitor 3-MA, respectively. The cell proliferation and invasion were detected by clonal formation, cell growth curve and MTT assay. The clinical specimens of endometriosis were collected from 20 cases. The expression of autophagy marker LC3II and autophagy substrate protein P62 were detected. Results: Rapamycin inhibited the proliferation and clonal formation of CRL-7566 cells, while autophagy inhibitor 3-MA and ATG5 siRNA showed opposite effect. Moreover, rapamycin inhibited filopodia growth in endometriosis, whereas overexpression of filopodia-relevant protein fascin-1 inhibited the decrease in invasiveness caused by rapamycin. In clinical samples, we also found a significant decrease of LC3II while an increase in P62 compared with the control group. Conclusion: Autophagy inhibition may contribute to an increase in endometrial cell proliferation and invasiveness. Autophagy activation could be a potential strategy for endometriosis therapy.
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Femenino , Humanos , Autofagia , Genética , Proteínas Portadoras , Genética , Metabolismo , Línea Celular , Proliferación Celular , Endometriosis , Endometrio , Biología Celular , Regulación de la Expresión Génica , Proteínas de Microfilamentos , Genética , Metabolismo , Proteínas Asociadas a Microtúbulos , Genética , Proteínas de Unión al ARN , Genética , Sirolimus , FarmacologíaRESUMEN
Background Endoplasmic reticulum stress (ERS) specific caspase-12 dependent pathway plays a key role in cell apoptosis,and apoptosis is an important characteristic of diabetic retinal neuron degeneration.Sericin is a potentially effective therapy for retinal neuron apoptosis.However,whether sericin has neuroprotection effects on caspase-12 pathway-associated retinal cells in diabetic retinopathy (DR) process is not unelucidated.Objective This study was to investigate the effects of sericin on the inhibition of retinal neuron apoptosis-associated with ERS specific caspase-12 dependent pathway in diabetic rat.Methods The diabetic models were established by feeding high lipid foods and intraperitoneal injection of streptozotocin for 3 consecutive days in 30 SPF SD rats aged 2-3 months.Twenty-four successful model rats were randomized into sericin-treated group and diabetic model group according to computer number allocation,and another 12 matched rats served as normal control group.The normal saline solution and sericin solution dissolved with normal saline solution 2.4 g/(kg · d) was used for 35 days in gavage method in the diabetic model group and sericin-treated group,respectively.The rats were sacrificed and retinal sections were prepared.TUNEL staining was employed to detect retinal neuron apoptosis.The expressions of glucose regulated protein 78 (GRP78),an ERS marker,and caspase-12 and caspase-3 in retinas in protein and transcription levels were detected by Western blot and reverse transcription PCR,respectively.The use and care of the rats complied with Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission and ARVO Statement.Results Diabetic models were successfully established in 24 of total 30 rats,with the successful rate of 80%.Apoptotic cells were found in the rats of various groups,mostly locating in retinal ganglion cell layer and inner nuclear layer.The apoptotic index (AI) was 0.028 4±0.002 3,0.215 1 ± 0.020 9 and 0.115 0±0.018 1 in the normal control group,diabetic model group and sericin-treated group,respectively,and the AI was significantly lower in the sericin-treated group than that in the diabetic control group (P< 0.05).Compared with the diabetic model group,the relative expression levels of GRP78,caspase-12 and caspase-3 proteins in rat retinas were significantly elevated in the sericin-treated group (0.523±0.029 vs.0.924±0.039,1.118 ± 0.051 vs.1.468±0.037,0.315±0.024 vs.0.554±0.032) (all at P<0.05),and the relative expression levels of GRP78,caspase-12 and caspase-3 mRNA in rat retinas were significantly reduced in the sericin-treated group (0.816± 0.022 vs.1.218±0.033,0.216±0.023 vs.0.407±0.012,0.322±0.022 vs.0.531 ±0.029) (all at P<0.05).Conclusions Sericin can inhibit ERS-related retinal neuron apoptosis by down-regulating the expressions of GRP78,caspase-12 and caspase-3 in ERS specific caspase-12 dependent pathway in diabetic rats.
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Objective:To study the effects of antimicrobial therapy on the maturation and function of dendritic cells(DCs) in the infected microenvironment of rabbit buccal VX-2 squamous cell carcinoma.Methods:The inflammatory models were obtained by mechanical trauma and high sugar diet on the basis of rabbit buccal VX-2 squamous cell carcinoma models which were established by particle implantation of the tumor tissue.The model rabbits were divided into 3 groups (n =6).In group A the rabbits with buccal VX-2 squamous cell carcinoma and local inflammation were given antibiotics by gavage and intramuscular injection for 3 consecutive days;the rabbits in group B with buccal VX-2 squamous cell carcinoma and local inflammation were given normal saline by gavage and intramuscular injection;the rabbits in group C with tumor and without inflammation were given normal saline by gavage and intramuscular injection.The tumor specimens were collected 3 days after treatment,and made into tissue homogenate,supernatant was collected after centrifugation.Normal rabbit peripheral blood mononuclear cells were separated and co-cultured with the supernatant obtained from the 3 groups respectively.Expressions of DCs surface markers HLA-DR,CD83 and CD86 were detected by flow cytometry.the function of DCs was tested by mixed lymphocyte reaction.Results:The positive rate of HLA-DR,CD83,CD86 and stimulate index were group C > group A > group B (P < 0.05).Conclusion:Antimicrobial therapy can promote the maturation and function of DCs in the infected microenvironment of rabbit buccal VX-2 squamous cell carcinoma.