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Obesity has been a worldwide problem associated with numerous chronic diseases such as cardiovascular disease, type 2 diabetes, and metabolic disorders. It may also play a role in visceral hypersensitivity, contributing to irritable bowel syndrome. (i) Adipose tissue secretes various inflammatory mediators, causing intestinal hyperpermeability and nerve endings activation. (ii) Obesity and gastrointestinal microbiota could affect each other, and microbial metabolites can increase sensitivity of the colon. (iii) Vitamin D deficiency contributes to both fat accumulation and disruption of the intestinal mucosal barrier. (iv) Brain-gut axis may be another bridge from obesity to visceral hypersensitivity.
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Diabetes Mellitus Tipo 2 , Síndrome del Colon Irritable , Humanos , Diabetes Mellitus Tipo 2/metabolismo , Intestinos , Síndrome del Colon Irritable/metabolismo , Mucosa Intestinal/metabolismo , ObesidadRESUMEN
Boron neutron capture therapy is a method based on 10B (n,α) 7Li reaction to achieve malignancy treatment. Upon entry into the human body, the 10B compound carrier can selectively enriched in tumor cells and reacts with external irradiation neutrons. Because 7Li (4 μm) and α particles (7 μm) will be deposited in a cell magnitude (10 μm), the purpose of directional local killing of tumor cells and causing less harm to normal tissue can be achieved successfully. So far, boron neutron capture therapy has been clinically studied in a variety of malignant diseases, including glioblastoma multiforme, meningeoma, head and neck cancer, lung cancer, etc. In this article, the clinical research progress of boron neutron capture treatment in head and neck carcinomas was mainly introduced.
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Boron neutron capture therapy (BNCT) is an emerging treatment modality. BNCT is performed by injecting patients with the boron containing drugs, which has strong affinity with cancer cells. After undergoing irradiation with neutrons, the boron containing drugs can yield alpha and lithium particles, which can kill tumor cells precisely. To date, clinical studies of BNCT have been conducted in a variety of tumors, including glioblastoma multiforme, meningioma, head and neck cancer, sarcoma, malignant skin tumor, malignant melanoma and recurrent cancers, etc. With continuous construction of BNCT treatment centers around the world, this new technology will be quickly and comprehensively spread. In this article, clinical research progress in the application of BNCT for glioma treatment was reviewed.
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Objective To investigate the efficacy and safety of iopromide as a contrast agent in gynecological pelvic CT examination. Methods In a retrospective study, 78 patients hospitalized from February 2018 to January 2021 who underwent contrast-enhanced gynecological pelvic CT were involved to investigate the image quality, systemic and local tolerance, and adverse reactions. Results Among the 78 cases, 97.44% had excellent image quality and 97.44% showed tolerance. Mild adverse reactions such as nausea and vomiting, dizziness, headache, local pain, and facial flushing occurred in 8.98% cases. Moderate adverse reactions included severe vomiting with generalized rash (one case) and chest tightness and shortness of breath with generalized rash (one case), and both patients returned to normal after treatment. Conclusion The non-ionic contrast agent iopromide can be used to obtain good image quality in gynecological pelvic CT examination. The incidence of adverse reactions of iopromide is lower than ionic iodine contrast agents, but higher other non-ionic contrast agents.
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【Objective】 To compare PC-12 cells’ apoptosis caused by the serotonin herbicides atrazine （ATR）， simazine （SIM） and cyanazine （CYA）. 【Methods】 The rat adrenal medullary pheochromoma PC-12 cell line was selected for routine culture. At the cell logarithmic growth phase， ATR， SIM and CYA were used at a concentration of 200 μmol/L for 24 h， respectively， and the same solvent was added in the control group. The CCK-8 method was used to detect the cell survival rate； the content of reactive oxygen species （ROS） in PC-12 cells was detected； the Real-time PCR and Western blotting methods were used to detect the mRNA and protein expressions of Bax， p53， Bcl-2 and Caspase-3. 【Results】 Compared with that in the control group， the survival rate of the cells in ATR group， SIM group and CYA group was significantly decreased. The intracellular ROS activity of the three groups was significantly increased， and the mRNA and protein expressions of Bax， p53 and Caspase-3 were increased. mRNA and protein expressions of Bcl-2 were significantly reduced （P<0.01）. Compared with that in ATR group， the cell survival rate of SIM group and CYA group was significantly increased， the intracellular ROS activity of the two groups was significantly decreased， the expressions of Bax， p53 and Caspase-3 mRNA and protein were significantly reduced， and the expressions of Bcl-2 mRNA and protein were significantly increased （P<0.01）. Compared with that of SIM group， the cell survival rate of CYA group was significantly increased， while the intracellular ROS activity was significantly decreased； the Bax， p53 and Caspase-3 mRNA and protein expressions were significantly reduced， and Bcl-2 mRNA and protein expressions were significantly increased （P<0.01）. 【Conclusion】 ATR， SIM and CYA can all promote PC-12 cells’ apoptosis； ATR has the strongest effect while CYA has the weakest effect.
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The relationship between chronic psychological stress and tumorigenesis has been well defined in epidemiological studies; however, the underlying mechanism remains underexplored. In this study, we discovered that impaired macrophage phagocytosis contributed to the psychological stress-evoked tumor susceptibility, and the stress hormone glucocorticoid (GC) was identified as a principal detrimental factor. Mechanistically, GC disturbed the balance of the "eat me" signal receptor (low-density lipoprotein receptor-related protein-1, LRP1) and the "don't eat me" signal receptor (signal regulatory protein alpha, SIRPα). Further analysis revealed that GC led to a direct, glucocorticoid receptor (GR)-dependent trans-repression of LRP1 expression, and the repressed LRP1, in turn, resulted in the elevated gene level of SIRPα by down-regulating miRNA-4695-3p. These data collectively demonstrate that stress induces the imbalance of the LRP1/SIRPα axis and entails the disturbance of tumor cell clearance by macrophages. Our findings provide the mechanistic insight into psychological stress-evoked tumor susceptibility and indicate that the balance of LRP1/SIRPα axis may serve as a potential therapeutic strategy for tumor treatment.
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Objective:To explore the application effect of SBAR (situation, background, assessment and recommendation) standard communication mode in the training of morning shift handover ability of nursing interns in gynecology and obstetrics, so as to provide reference for improving the ability of morning shift handover of nursing interns.Methods:This study included in 30 nursing interns in Xuanwu Hospital in 2018 who were selected as the observation group, and 31 nursing interns in 2017 who were selected as the control group. The control group was trained in the traditional way of teaching, while the observation group was trained with SBAR standard communication mode on the basis of traditional teaching. After one month's teaching, the evaluation standard of nursing morning shift handover formulated by our hospital was used as the evaluation index to observe the effectiveness of SBAR mode in improving the morning shift handover ability of nursing interns in obstetrics and gynecology. The scores of morning shift handover of the nursing interns in two groups were compared by independent sample t test. Results:The total average score of nursing interns in the observation group was higher than that of the control group, with statistical significance ( P<0.05). Among them, the scores of shift handover environment, complete content, reasonable process and reasonable time control were higher and the difference was statistically significant ( P<0.05), but there was no significant difference in the scores of emphasis, specialty characteristics and language fluency ( P>0.05). The total average score of bedside handover ability in the observation group was significantly higher than that in the control group, with significant difference ( P<0.05). The scores of shift handover environment, complete content, outlining key points, reflecting specialty characteristics, reasonable process, material preparation and humanistic care were higher than those of the control group, with statistical significance ( P<0.05). Conclusion:SBAR mode can improve the bedside and collective shift handover ability of obstetrics and gynecology nursing interns, and nursing managers can use SBAR mode to cultivate nursing interns' ability of morning shift handover.
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Objective:To observe the sedative effect of dexmedetomidine(DEX) on patients with acute craniocerebral injury(ACI), and to explore its influences on cerebral blood flow(CBF) and cerebral oxygen metabolism.Methods:A total of 68 ACI patients were randomly divided into control group( n=34) and observation group( n=34) according the random digital table method.The patients in both two groups were transferred to intensive care unit(ICU) for routine comprehensive treatment after surgery.On this basis, the observation group was given intravenous injection of 0.5 μg·kg -1·h -1 DEX for 3d.The changes of mean arterial pressure(MAP), heart rate(HR), respiration rate(RR), blood oxygen saturation(SpO 2), scores of Ramsay and Glasgow Coma Scale(GCS), CBF, jugular bulb venous oxygen saturation(SjvO 2), arteriovenous oxygen content difference(AVDO 2) and cerebral oxygen extraction rate(CERO 2) were compared between the two groups. Results:At 24h and 72h after being transferred to ICU, MAP[(89.05±10.91)mmHg, (90.24±9.40)mmHg], HR[(82.42±9.51)times/min, (81.18±8.26)times/min] and RR[(27.03±5.20)times/min, (26.38±4.75)times/min] in the observation group were significantly lower than those in the control group[(109.49±10.41)mmHg, (103.63±11.68)mmHg, (109.52±8.37)times/min, (104.46±9.16)times/min, (32.76±5.71)times/min, (29.59±4.40)times/min]( t=7.904, 5.208, 12.473, 11.006, 4.326, 2.891, all P<0.05). There was no statistically significant difference in SpO 2 between the two groups( P>0.05). At 72h, the Ramsay score in the observation group was lower than that in the control group[(2.72±0.35)points vs.(3.42±0.40)points], while the GCS score was higher than that in control group[(11.92±1.81)points vs.(10.14±2.28)points], and there were statistically significant differences between the two groups( t=7.679, 3.565, all P<0.05). At 72h, the CBF, AVDO 2 and CERO 2 were lower than those at 0h in the observation group( t=2.406, 4.908, 6.291, all P<0.05), which were significantly lower than those in the control group( t=2.087, 5.493, 6.423, all P<0.05). At 72h, the SjvO 2 was higher than that at 0h in the observation group[(61.27±4.70)% vs.(51.44±3.48)%]( t=9.801, P<0.05), which was significantly higher than that in the control group[(53.32±3.64)%]( t=7.798, P<0.05). Conclusion:DEX can improve postoperative sedation effect of ACI patients, stabilize vital signs, reduce cerebral oxygen consumption and improve cerebral oxygen metabolism disorders.
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Based on an analysis of the compensation policy and its problems of the primary medical and health institutions, this paper put forward the corresponding reform framework in Zhejiang province. It proposed to change the compensation policy of " predefining revenue and expenditure, subsidizing its gap after performance appraisal" into " a mixed system of special subsidy and pay for performance". Related policies were also described including governmental functions, special subsidies for input-based payments, classified payments for output services, precautions against financial risks, etc. This paper also suggested that we focus on dealing with the six pairs of balance, such as that between subsidy for the supply and demand sides, and that between internal market and external market.
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BACKGROUND: Thawed allografts are usually discarded for various reasons. Whether these discarded allografts can be refrozen for later use and their histological changes in vivo have not been reported. OBJECTIVE: To investigate the histological characteristics of anterior cruciate ligament (ACL) reconstructed with the repetitive freeze-thawing allogenic Achilles tendon in New Zealand white rabbits. METHODS: Allogenic Achilles tendons were harvested from adult male New Zealand white rabbits, and were stored at -8 ℃ and thawed at 20 ℃ for 1, 2, 3 and 10 times, respectively, after sealed package and 60Co irradiation. Twenty-four adult male New Zealand white rabbits were enrolled: the left and right knees of 12 rabbits were respectively reconstructed with 1 (control group) and 2 times of freeze-thawing allogenic Achilles tendon, and another 12 rabbits underwent reconstruction with 3 and 10 times of freeze-thawing allogenic Achilles tendon, respectively. Three specimens from each group were evaluated with modified histology grading scores at 6, 12 and 24 weeks to assess the cell morphology, cell quantity, matrix staining intensity, fibrocartilage formation, new bone formation, tendon healing and cartilage injury. RESULTS AND CONCLUSION: The cell morphology, matrix staining intensity and total scores of the 10 times group were significantly higher than those of the other groups at 6 weeks (P 0.05). ACL reconstructed with 10 times of repetitive freeze-thawing allogenic Achilles tendons had higher histological scores at 6 weeks after modeling, but no significant differences were shown at 12 and 24 weeks after modeling. To conclude, our study only testifies better histological scores on the multiple times of freezethawing Achilles tendon than the less times of freeze-thawing Achilles tendon at the early period after operation.
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Objective To investigate correlation between the fear related to childbirth and the social support in pregnant women in order to provide evidence for clinical intervention. Methods A total of 351 pregnant women from 2 hospitals were recruited from July to December, 2014 in city of Guangzhou. They were investigated with the self- designed questionnaire of general conditions measurement, the childbirth Attitudes Questionnaires and the perceived Social Support Scale. Results The total scores of the fear related to childbirth and the social support in pregnant women were 32.29±6.25 and 46.59±7.13, respectively. Scores of the total scale and the factors of the fear related to childbirth and the social support were negatively correlated (r=-0.798--0.134,P < 0.05). Conclusions Negative correlation exists between the fear related to childbirth and the childbirth self-efficacy in pregnant women. To reduce the fear related to childbirth, their families should be encouraged to provide more support for pregnant women.
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Objective To assess the effects of PI3K/mTOR dual inhibitor NVP-BEZ235 on the distribution and degranulation of perivascularmast cells in the lung of hypobaric hypoxia rats.Methods SD male rats in the hypoxia group were raised in the specific hypoxic incubator (50.5 kPa).The intervene group received NVP-BEZ235 training (35 mg/kg) intervention once every two days.The control group was fed in the conditions comparable to the other groups at local pressure and normoxia environment.After 21 days, all rats were sacrificed with injection of 5％ pentobarbital sodium.Lung tissues were fixed and embedded in paraffin for further hematoxylin-eosin staining and toluidine blue staining.Results Compared with the control group, the number of pulmonary perivascular mast cells in the hypoxia group increased significantly.Hypoxia group had more mast cell accumulation and larger degranulation ratio around different diameters of pulmonary vessels (less than 50 μm, 50-100 μm, larger than 100 μm) than the control group (P< 0.05).The mast cell numbers decreased in NVP-BEZ235 intervention group compared with hypoxia group (P<0.05).The degranulation ratio of pulmonary vascular mast cells around 50-100 μm in the intervention group was smaller than the hypoxia group (P=0.000 3).Conclusion NVP-BEZ235 inhibits the aggregation of pulmonary perivascular mast cells and degranulation ratio of median diameter pulmonary perivascular mast cells in hypobaric hypoxia rats.
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The control handles( including financing, provider payment, organization, regulation and behavior) proposed by World Bank in health policy research as the basic framework,and the nature and positioning of family doctors′ contract-based service as the precondition, we recommended the system framework of such a mechanism, comprising one contract, three regulations, five control handles and seven supporting policies. Such a framework can serve as the cornerstone for family doctors′ contract-based service experiment in Zhejiang province for the sake of hierarchical medical system.
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Objective To investigate the value of fractional contrast medium bolus injection in improving the quality of CT portography.MethodsA total of 42 patients were randomly divided into two groups which were all given iohexol (350mgI/mL) as the contrast medium.20 patients in the group A were injected with conventional method (dosage of 100ml, rate of 4mL/s).The group B (22 patients) were treated with fractional contrast medium bolus injection, the first phase with 60mL contrast medium (rate of 4mL/s) and the second phase (10s delayed) with 40mL contrast medium (rate of 4m/s).The tube was washed by 20mL saline with the same rate of injection at both phases.The CT values and the image quality of the branches of the portal vein were evaluated according to the original and postprocessed images.Independent samples test was used to compare the CT values of the portal vein, splenic vein, superior mesenteric vein, hepatic parenchyma and portal vein-liver parenchyma.The subjective evaluation scores of the image quality were compared by wilcoxon.ResultsThe CT values of the portal vein, splenic vein and portal vein-liver parenchyma in the group B were significantly higher than that in the group A (t=3.317,3.523,P<0.01).There was no significant difference in CT values of hepatic parenchyma and superior mesenteric vein between the two groups.Subjective quality score in the group B was superior to that in the group A, and the difference was statistically significant.T The two evaluation physicians agreed well.ConclusionThe technique of fractional contrast medium bolus injection can significantly improve the image quality of CT portograghy.
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Objective To analyze the medical service capacity of primary healthcare in Zhejiang province since the ongoing healthcare reform and put forward suggestions. Methods Key indicators of healthcare resources and medical service utilization from 2009 to 2015 reflecting the primary healthcare were identified,for a quantitative analysis in terms of the structure-process-outcome dimensions. Results In terms of structural service capacity,the average headcount growth rate of primary healthcare′s technical personnel was 5. 7% per year; the personnel competence structure kept improving; the hospital beds at primary institutions and their ratio among all were slightly decreased,with better devices and informatization. In terms of procedural service capacity,the proportion of primary institutions with contract-based services amounted to 89. 9%,with the standard contract signing rate up to 18. 8%. In terms of consequential service capacity,the average growth rate of the number of outpatient visits at primary institutions was 6. 3%. The amount and proportion of inpatients were slightly decreased,while the hospital bed utilization ratio was increased slightly. Conclusions It is necessary to further strengthen the training and introduction of primary healthcare professionals. The functional orientation of hospitals at various levels should be clarified, encouraging contract-signing of general practitioners, promote the medical insurance payment reform featuring the capitation payment at primary level,and improve the income distribution and incentive mechanism.
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Objective To analyze the spatial distribution of the incidence of tuberculosis (TB)in China from 2012 to 2014 and provide evidence for the prevention and control of TB.Methods The database of TB in China from 2012 to 2014 was established by using geographical information system,the spatial distribution map was drawn,trend analysis and spatial autocorrelation analysis were conducted to explore the spatial distribution pattern of TB and identify hot areas.Results The trend surface analysis showed that the incidence of TB decreased gradually from the west to the east in China,and the U type curve could reflect the TB distribution from the south to the north;Global spatial autocorrelation analysis showed the 2012-2014 global Moran's I were 0.366,0.364 and 0.358(P＜0.01),suggesting that the incidence of TB had a spatial clustering in China;Local Getis-OrdGi spatial autocorrelation analysis by ArcGIS software showed that there was 11 cluster areas,3 high incidence areas (Xinjiang,Tibet,Qinghai) and 8 low incidence areas (Beijing,Tianjin,Shanghai,Hebei,Inner Mongolia,Shanxi,Shandong,Jiangsu).Conclusion The incidence of TB had obviously spatial clustering characteristic,the areas at high risk were mainly in the northwestern and plateau area in China.
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Objective To analyze the spatial distribution of the incidence of tuberculosis (TB)in China from 2012 to 2014 and provide evidence for the prevention and control of TB.Methods The database of TB in China from 2012 to 2014 was established by using geographical information system,the spatial distribution map was drawn,trend analysis and spatial autocorrelation analysis were conducted to explore the spatial distribution pattern of TB and identify hot areas.Results The trend surface analysis showed that the incidence of TB decreased gradually from the west to the east in China,and the U type curve could reflect the TB distribution from the south to the north;Global spatial autocorrelation analysis showed the 2012-2014 global Moran's I were 0.366,0.364 and 0.358(P＜0.01),suggesting that the incidence of TB had a spatial clustering in China;Local Getis-OrdGi spatial autocorrelation analysis by ArcGIS software showed that there was 11 cluster areas,3 high incidence areas (Xinjiang,Tibet,Qinghai) and 8 low incidence areas (Beijing,Tianjin,Shanghai,Hebei,Inner Mongolia,Shanxi,Shandong,Jiangsu).Conclusion The incidence of TB had obviously spatial clustering characteristic,the areas at high risk were mainly in the northwestern and plateau area in China.
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Objective To investigate the current status of nursing undergraduate students′ self-differentiation and career adaptability and analyze the correlation of the two, so as to provide a reference for nursing educators to offer employment guidance. Methods The Undergraduate Self-Differentiation Scale and The College Students′Career Adaptability Questionnaire were used to investigate 341 nursing undergraduates. Results The mean scores of the self-differentiation and the career adaptability were (3.70±0.60) points and (3.60±0.42) points, respectively. It showed that the total score of self-differentiation and its each dimension were positively correlated with career adaptability, the Pearson correlation coefficients were career adjustment 0.26, career interpersonal 0.38, career curiosity 0.32, career confidence 0.39, career concerns 0.27, career control 0.46, and the coefficients between two total scales were 0.46 (all P<0.05). Conclusions The self-differentiation level of nursing undergraduates could affect their career adaptation level, and clinical nursing educators can take corresponding measures to improve their career adaptability based on the characteristics of nursing students′self-differentiation.
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BACKGROUND:Laryngeal cartilage defect has a higher incidence, mainly presenting with pain, sweling, and dysfunction after onset. Currently, surgical treatment is the most used in clinical treatment of laryngeal cartilage defect. Although conventional materials can effectively improve symptoms, there is a poor long-term efficacy. In recent years, there are many clinical studies on cartilage tissue engineering, but less about the actual use in the otorhinolaryngology department. OBJECTIVE:To investigate the effect of polyhydroxyalkanoate polymer carrying chondrocytes on the repair of alogeneic laryngeal cartilage defects. METHODS:Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHH) served as the extracelular matrix. Tissue engineering technology was used to prepare cel-material composite. Primary tissue-engineered cartilage tissue was transplanted directly into rabbit thyroid cartilage defect (experimental group A), or implanted into a more mature tissue-engineered cartilage for the repair of thyroid cartilage defect (experimental group B). In the experiment, PHBHH group and simple chondrocyte group were set as controls. Repairing effects on thyroid cartilage defect were evaluated through gross and histological observation. RESULTS AND CONCLUSION:Chondrocytes in the primary tissue-engineered cartilage tissues were beaded under scanning electron microscope, and after 4 weeks of culture, a large amount of jely-shaped substrates were visible. Findings from electron microscope observation showed that the cels were distributed on the surface of composite material and cavernous voids, displaying a plurality of smal round projections. Surgical treatment was successful in al the rabbits, and there was no dyspnea and eating difficulties after surgery. One rabbit appeared to have brief wheezing in the experimental group A, two rabbits died of diarrhea in the experimental B group at 2 weeks after surgery. PHBHH composite carrying chondrocytes had certain hardness. At 4 weeks after subcutaneous implantation, mature cels were shaped as white sheets, and the material had elasticity. After 4 and 8 weeks, the space between repair zone and original cartilage tissue was smooth and plain, but the repair zone was colored yelow. In the simple PHBHH and chondrocyte groups, the repair zones were both depressed, only the connective tissues could be seen. Rabbits in the two experimental groups showed less adverse reactions compared with the two control groups (P < 0.05). These findings indicate that PHBHH composite carrying chondrocytes has better effects to repair alogeneic laryngeal cartilage defects.
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Objective To investigate effect of Xiaoyao pill on superoxide dismutase (SOD), malondialdehyde (MDA), interleukin family and clinical efficacy in patients with pelvic inflammation.Methods 75 cases with pelvic inflammation were selected and divided into experimental group and control group randomly according to random number table method.37 cases in control group were treated with conventional anti-inflammatory and Qianjin pill, 38 cases in experimental group were treated with conventional anti-inflammatory and Xiaoyao pill, 14 days for a course.SOD, MDA and interleukin family were compared and the effective rate and adverse reaction rate were compared.Results Compared with control group post-treatment, SOD in serum in experimental group was higher(P<0.05),MDA in serum was lower(P<0.05);IL-1 and IL-8 were lower(P<0.05);IL-4 and IL-10 were higher(P<0.05).The total efficiency of experimental group was significantly higher than that of control group, the adverse reactions were lower (P<0.05).Conclusion Xiaoyao pill has good curative effect on the patients with pelvic inflammatory disease,the mechanism may be related to the elevation of serum SOD,IL-4, IL-10 levels and reduce the levels of MDA,IL-1,IL-8.