[Application of electrical impedance tomography in pulmonary rehabilitation].

Pulmonary rehabilitation is a comprehensive and individualized intervention for patients suffering from respiratory dysfunction due to various diseases. This approach has been highly valued and implemented by clinical medical professionals. However, the lack of equipment and real-time monitoring of ventilatory lung function during pulmonary rehabilitation treatment is a challenge. In addition, there is a need for improved methods that can directly guide physiotherapists to provide precise treatment. Electrical impedance tomography (EIT) is a novel medical imaging technology that allows real-time monitoring of lung ventilation status. It is currently being translated from basic research into clinical applications and is widely used in respiratory disease, particularly in critical care respiratory management. However, there is a lack of reports on pulmonary rehabilitation guidance and outcome evaluation. This article aimed to provide a comprehensive review of this field, with the aim of generating more ideas for clinical research and further improving individualized treatment in the field of pulmonary rehabilitation.

[A survey on clinical practice of tracheostomy decannulation in medical institutions at all levels across the country].

Objective: A questionnaire survey was conducted on the clinical practice of tracheostomy decannulation among medical staff in medical institutions at all levels across the country. Methods: The questionnaire was determined by literature review and expert consultation to investigate the clinical practice of tracheostomy decannulation among medical staff in comprehensive and rehabilitation hospitals of different levels across the country and the factors considered when deciding to decannulate. Statistical methods used χ² test and one-way ANOVA. Results: A total of 570 questionnaires were collected from all over the country, with 463 valid questionnaires. The survey results showed that the most important factors in clinical practice to determine the decannulation of the tracheostomy tube were upper airway patency, cough effectiveness, level of consciousness and oxygenation. Before decannulation, 220 (47.50%) would choose to change to metal cannula, and 384 (82.90%) would routinely occlude the tube. 294 (63.50%) thought that re-intubation within 24 hours after decannulation of the tracheostomy tube was failure of decannulation. The decannulation failure rate was mostly 2%-5%. Conclusions: Upper airway patency, cough effectiveness, level of consciousness and oxygenation were important factors when considering decannulation. Reintubation within 24 hours of decannulation was defined as failure by the majority of respondents.

[Clinical profiles of community-acquired Pseudomonas aeruginosa infections in children].

Objectives: To investigate clinical characteristics, outcomes and antimicrobial resistance of community-acquired Pseudomonas aeruginosa (CAPA) infections in Chinese pediatric patients. Methods: This retrospective study was conducted at 6 tertiary hospitals in China during January 2016 to December 2018. The clinical and microbiological data of CAPA infected hospitalized children in Hainan and in other regions were collected and compared, and the antimicrobial resistance patterns, clinical characteristics and antibiotic therapy were analyzed. Between different groups were compared using the Chi-square test and Mann-Whitney U test. Results: Among 91 patients, 63 cases were males, 28 cases were females, and 74 cases were from Hainan province, 17 cases were from other regians. The age of consultation was 22.5 (5.4, 44.0) months. Twenty-four cases (26%) had underlying diseases. Fever (79 cases (87%)) and cough (64 cases (70%)) were common initial symptoms. Other concomitant symptoms included wheezing 8 cases (9%), diarrhea 3 cases (3%) and vomiting 4 cases (4%). Twenty-eight cases (31%) had organ infections, including pneumonia 22 cases (24%), skin infection 5 cases (5%), meningitis, intra-abdominal infection and upper urinary tract infection each 1 case (1%). The resistance rate of CAPA isolates to cefepime (4% (4/90)), amikacin (1% (1/90)), ciprofloxacin (2% (2/90)) and levofloxacin (1% (1/89)) was low, and to ceftazidime, piperacillin, piperacillin-azobactam, carbapenem was 12% (11/90), 3/16, 18% (10/56) and 6% (5/90), respectively. Antimicrobial combination therapy accounted for 52% (47/91) of empirical therapy and 59% (52/88) of definite therapy. Two cases (2%) were hopeless discharged, and 3 cases (3%) died during hospitalization. The worse prognosis of CAPA infection is significantly different among children in other regions and in Hainan (4/17 vs. 1% (1/74), χ²=9.74, P<0.05). Conclusions: The invasive CAPA-infection has regional difference in incidence and prognosis in China. Clinical symptoms and signs are non-specific. CAPA strains isolated from pediatric patients display low level of resistance to most of the common antipseudomonal antibiotics. The proportion of poor prognostic outcome is lower in Hainan than in other regions.

MiR-204 reduces apoptosis in rats with myocardial infarction by targeting SIRT1/p53 signaling pathway.

OBJECTIVE: The aim of this study was to investigate the influence of micro ribonucleic acid (miR)-204 on rats with myocardial infarction by targeting the silent information regulator 1 (SIRT1)/p53 signaling pathway. MATERIALS AND METHODS: A total of 36 Sprague-Dawley rats were randomly divided into three groups, including: sham-operation group (n=12), model group (n=12) and miR-204 mimics group (n=12). The rats in the sham-operation group only underwent thoracotomy, without myocardial infarction injury. Meanwhile, the rats in model group and miR-204 mimics group were utilized to establish the models of myocardial infarction, and then, intervened with normal saline and miR-204 mimics, respectively. The morphology of myocardial tissues was observed via hematoxylin-eosin (HE) staining. Immunofluorescence was performed to detect the expression of Caspase-3. Target genes of miR-204 were analyzed using bioanalysis software. Western blotting (WB) assay was applied to measure the relative protein expression of SIRT1. MiR-204 expression and the messenger RNA (mRNA) expressions of SIRT1 and p53 were measured via quantitative Polymerase Chain Reaction (qPCR). Furthermore, cell apoptosis was determined through terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. RESULTS: HE staining showed that the morphology of myocardial tissues was normal in sham-operation group. Severe myocardial tissue injury was visible in model group, and the injury was relieved in miR-204 mimics group when compared with model group. The results manifested that the positive expression of Caspase-3 in cardiac tissues increased remarkably in the model group and miR-204 mimics group in comparison with sham-operation group (p<0.05). Meanwhile, it was evidently lower in miR-204 mimics group than model group (p<0.05). Based on the analysis via bioanalysis software, SIRT1 was the target gene of miR-204. WB results revealed that the relative protein expression level of SIRT1 was elevated notably in the other two groups compared with the 2sham-operation group (p<0.05). However, it was markedly lowered in miR-204 mimics group in contrast with model group (p<0.05). QRT-PCR results demonstrated that the model group and miR-204 mimics group exhibited distinctly lower expression of miR-204 but higher mRNA expressions of SIRT1 and p53 than sham-operation group (p<0.05). However, miR-204 mimics group exhibited prominently higher expression of miR-204 but lower mRNA expressions of SIRT1 and p53 than model group (p<0.05). Finally, the results of TUNEL assay demonstrated that the apoptosis rate increased remarkably in the model group and miR-204 mimics group when compared with sham-operation group (p<0.05). However, it decreased notably in miR-204 mimics group in comparison with model group (p<0.05). CONCLUSIONS: MiR-204 reduces the apoptosis level in rats with myocardial infarction via targeted inhibition of the SIRT1/p53 signaling pathway.

Norwalk virus genome cloning and characterization.

Major epidemic outbreaks of acute gastroenteritis result from infections with Norwalk or Norwalk-like viruses. Virus purified from stool specimens of volunteers experimentally infected with Norwalk virus was used to construct recombinant complementary DNA (cDNA) and derive clones representing most of the viral genome. The specificity of the clones was shown by their hybridization with post- (but not pre-) infection stool samples from volunteers infected with Norwalk virus and with purified Norwalk virus. A correlation was observed between the appearance of hybridization signals in stool samples and clinical symptoms of acute gastroenteritis in volunteers. Hybridization assays between overlapping clones, restriction enzyme analyses, and partial nucleotide sequence information of the clones indicated that Norwalk virus contains a single-stranded RNA genome of positive sense, with a polyadenylated tail at the 3' end and a size of at least 7.5 kilobases. A consensus amino acid sequence motif typical of viral RNA-dependent RNA polymerases was identified in one of the Norwalk virus clones. The availability of Norwalk-specific cDNA and the new sequence information of the viral genome should permit the development of sensitive diagnostic assays and studies of the molecular biology of the virus.

lncRNA-RMRP promotes proliferation, migration and invasion of bladder cancer via miR-206.

OBJECTIVE: The incidence of bladder cancer (BC) is common in the world, but its detail mechanisms for occurrence and development remain unclear. Recently, long non-coding RNAs (lncRNAs) have been observed to play an important role in many different diseases. In this research, we mainly explored the role of the RNA component of mitochondrial RNA processing endoribonuclease (lncRNA-RMRP) in bladder cancer. MATERIALS AND METHODS: We used qRT-PCR to detect the expression of lncRNA-RMRP in bladder cancer patients and tumor cells, and the clinical significance was also analyzed. The methyl thiazolyl tetrazolium (MTT) assay was used to detect the cell proliferation, and we used transwell to detect the migration and invasion, after the lncRNA RMRP was inhibited. Western-blot was used to measure the relative protein expression level in bladder cancer cells after transfection with siRNA-NC or siRNA-RMRP. RESULTS: We found that the lncRNA RMRP was highly expressed in bladder cancer tissue, compared with adjacent tissue. We also found that the expression of RMRP was closely related with the size, lymph node metastasis and survival time of patients. What's more, RMRP could promote the proliferation, migration and invasion of BC cell lines via regulating miR-206 as a sponge. CONCLUSIONS: According to the results, we found that lncRNA RMRP was closely related to the progression of bladder cancer, which could be a potential target for treating BC patients.

In situ hybridization for quantitative assay of infectious hepatitis A virus.

A method of in situ hybridization using single-stranded RNA probes of opposite polarity for quantitative enumeration of hepatitis A virus (HAV) in infected cells has been developed. Kinetic experiments showed that foci of infected cells appeared as early as day 2 postinfection. The absence of foci in cells examined immediately after virus adsorption indicated that foci detected subsequently were related to viral replication. Foci were detected by hybridization with RNA probes complementary to HAV genomic RNA but not with RNA probes identical to HAV genomic RNA. The number of foci observed was linearly related to the HAV dose inoculated. Focus formation was reduced when a virus inoculum was pretreated with guinea pig anti-HAV hyperimmune serum but not when it was pretreated with preimmune serum. The high resolution of hybridization signals and relative rapidity of the test indicated that this technique will be useful for measuring serum neutralizing antibodies and for quantitative assay of infectious HAV.