Effect of hydrocolloid dressing on pressure ulcer in patients with non-invasive positive pressure ventilation: A meta-analysis.

This study systematically evaluated the effect of hydrocolloid dressings on facial pressure ulcers in patients receiving non-invasive positive pressure ventilation (NIPPV). The Embase, PubMed, Cochrane Library, CNKI, VIP, Chinese Biomedical Literature Database and Wanfang databases were searched for randomised controlled trials on the use of hydrocolloid dressings in patients receiving NIPPV published from the inception of each database to August 2023. The literature was independently screened, data were extracted by two authors based on the inclusion and exclusion criteria, and the quality of the included literature was assessed. The meta-analysis was performed using Stata 17.0. Thirteen studies including 1248 patients were included, with 639 patients in the intervention group and 609 patients in the control group. Meta-analysis showed that the hydrocolloid dressing significantly reduced the incidence of facial pressure ulcers in patients with NIPPV (odds ratio = 0.16, 95% confidence intervals: 0.11-0.24, p < 0.001). Hydrocolloid dressings are effective in reducing the incidence of facial pressure ulcers in patients receiving NIPPV. However, because of the small number of included studies, this conclusion needs to be confirmed with larger samples and high-quality clinical studies.

Surgical retrieval of PICC-related right atrial thrombus in a child with acute lymphoblastic leukemia: a case report.

BACKGROUND: Peripherally inserted central catheters (PICCs) are widely used in cancer patients for administering chemotherapy drugs, antibiotics, and nutrients. PICC-related thrombi are not uncommon and may result in pulmonary embolism and the formation of thrombi in the right atrium. The latter are associated with an increased risk of subsequent morbidity or mortality because of their potential for embolization in the pulmonary vasculature. CASE PRESENTATION: A 16-year-old male with acute lymphoblastic leukemia (ALL) was admitted to our hospital after an echocardiographic examination revealed a ring-like structure in the right atrium that was still present after 6 months' anticoagulation treatment with aspirin. The boy had had a PICC inserted 2 years previously for chemotherapy; the PICC was intact and successfully removed 18 months after insertion when chemotherapy is finished. Subsequent computer tomography and radiography differentiated right atrial ring-shaped mass with a diameter of approximately 15 mm. Cardiac surgery was performed to remove the mass which was found to be a calcified thrombus. CONCLUSION: Although this is a rare occurrence, recognition of the possibility of a calcified thrombus may minimize the misdiagnosis of PICC-related thrombus and allow surgical retrieval if the thrombus is sufficiently large.

The Effect of Diagnostic Blood Loss on Anemia and Transfusion Among Postoperative Patients With Congenital Heart Disease in a Pediatric Intensive Care Unit.

PURPOSE: To evaluate whether diagnostic blood loss can lead to anemia and consequent blood transfusion among postoperative patients with congenital heart disease (CHD) in the pediatric intensive care unit (PICU). DESIGN AND METHODS: This prospective observational study was conducted in a university-affiliated tertiary hospital between January and August 2016. CHD patients aged <12years, undergoing cardiac surgery, with a PICU stay >48h were included (n=205). Multivariate logistic regression analyses were used to determine the effect of diagnostic blood loss on anemia and transfusion. RESULTS: The mean daily phlebotomy volume was 5.40±1.94mL/d during the PICU stay (adjusted for body weight, 0.63±0.36mL/kg/d). Daily volume/kg was associated with cyanotic CHD, Pediatric Risk of Mortality III score, and Pediatric Logistic Organ Dysfunction (PELOD)-2 score. In total, 101 (49.3%) patients presented with new or more severe anemia after admission to PICU, which was not associated with phlebotomy volume. Forty-one (20.0%) children received one or more RBC transfusions during their PICU stay. Multivariate analysis indicated that PELOD-2 score>5, new or more severe anemia, and daily volume/kg of phlebotomy >0.63mL/kg/d were significantly associated with transfusion after 48h of admission to PICU. CONCLUSIONS: Our findings indicate that diagnostic blood loss is not related to postoperative anemia in children with CHD; however, this factor does correlate with blood transfusion, since it somewhat reflects the severity of illness. PRACTICE IMPLICATIONS: Strategies should be applied to reduce diagnostic blood loss, as appropriate.

[Inhibitory effect of miR-20b on airway inflammation in asthmatic mice].

OBJECTIVE: To explore the effect of miR-20b in inhibiting airway inflammation in a mouse model of asthma. METHODS: Female BALB/c mouse models of asthma, established by sensitizing and challenging the mice with a mixture of ovalbumin and aluminum hydroxide, were subjected to intranasal instillation of 20 µg miR-20b mimics or a miR-20b scramble every 3 days. On day 49, bronchoalveolar lavage fluid (BALF) was collected from the mice to examine the counts of total cells and different cell populations; HE staining was used to observe the pathological changes of the lung tissue, and the concentration of vascular endothelial growth factor (VEGF) in BALF was detected by ELISA. RESULTS: Treatment of the asthmatic mice with miR-20b mimics decreased not only the counts of the total leukocytes, neutrophils and eosinophils in the BALF but also mucus secretion in the airway and inflammatory cell infiltration around the bronchus, and lessened thickening of the airway mucosa. Instillation with miR-20b mimics significantly reduced the concentration of VEGF in BALF from 28.55±3.42 pg/mL in the asthma model group to 18.19±3.67 pg/mL (P<0.01). CONCLUSION: MiR-20b can inhibit airway inflammation in asthmatic mice possibly by reducing the expression of VEGF.

[Application of peripherally inserted central catheter for parenteral nutrition in critically ill neonates].

OBJECTIVE: To apply peripherally inserted central catheter (PICC) in critically ill neonates who require long-term parenteral nutrition. METHODS: A retrospective review of 98 critically ill neonates who had a PICC inserted and received long-term parenteral nutrition from March to December 2011 was performed. RESULTS: The PICC insertion succeeded in 74.5% (73/98) of the cases at the first attempt. The catheter remained for an average of (19.7 +/- 2.0) days. Of the 98 cases, 92 underwent planned extubation after enteral nutrition was fully established; 10 developed complications within the follow-up period of 956 days. The PICC-associated complications occurred at a rate of 10. 5 per 1000 catheter-days, including infection (n=0), phlebitis (n=1), accidental dislodgement (n=3), catheter occlusion (n=3), and hemorrhage in puncture point (n=3). CONCLUSION: PICC can be used as a safe venous access for critically ill neonates for long-term parenteral nutrition. PICC-associated complications can be reduced through improving nursing skills, especially for catheter-related infection.

Blocking tumorigenic activities of colorectal cancer cells by a splicing RON receptor variant defective in the tyrosine kinase domain.

Altered expression of the RON receptor tyrosine kinase, accompanied by generation of splicing variants, contributes to the pathogenesis of epithelial cancers such as invasive growth of colorectal caners. In this study, we have studied a novel RON variant (designated as RONdelta170) that regulates tumorigenic activities of colorectal cancer cells by blocking RON-mediated tumorigenic signals. RONdelta170 is a splicing variant with a deletion of exon 19 that encodes 46 amino acids in the catalytic kinase domain. This deletion also causes a reading-frame shift and creates a new stop codon, which effectively eliminates the multi-functional docking site and truncates the RON C-terminus. As a RON variant without kinase activities and the C-terminal docking domain, RONdelta170 acts as a variant receptor that negatively regulates biochemical and biological activities mediated by RON or its oncogenic variant RONdelta160. In NIH3T3 expressing RONdelta160, RONdelta170 formed a complex with RONdelta160 and prevented RONdelta160-mediated activation of signaling proteins such as Erk1/2 and AKT. These effects resulted in decreased cell proliferation, reduced colony formation, and diminished cell migration. These negative activities were also observed in colorectal cancer cells naturally expressing RON or RONdelta160 including HT-29, HCT116 and SW620. Introduction of RONdelta170 into HCT116 cells blocked MSP-induced Erkl/2 and AKT phosphorylation, reduced cytoplasmic beta-catenin accumulation, restored glycogen synthase kinase-beta activity, and attenuated various tumorigenic activities. Moreover, RONdelta170 expression significantly reduced SW620 cell-mediated tumor growth in vivo. Thus, RONdelta170 is a naturally occurring variant with dominant negative activities and has potential for inhibiting RON-mediated tumorigenic activities in colorectal cancer cells.

Agonistic monoclonal antibodies potentiate tumorigenic and invasive activities of splicing variant of the RON receptor tyrosine kinase.

Ligand-dependent or independent activation of the RON receptor tyrosine kinase is essential in transducing invasive signals leading to increased tumorigenic activities. In this study, we characterized two monoclonal antibodies (mAbs) specific to the extracellular domains of human RON and studied their agonistic effect on tumorigenic activities mediated by oncogenic variant RONDelta160. The mAb Zt/g4 and Zt/c1 are specific to human RON. They bind to RON with high affinities and recognized different epitopes on the RON extracellular domain. Because of their reactivity with native RON, Zt/g4 and Zt/c1 are useful in various applications such as immunoprecipitation, immunofluorescent analysis, and immunohistochemical staining. Functional studies revealed that Zt/g4 and Zt/c1 are capable of inducing RON phosphorylation which activates signaling proteins such as Erk1/2 and Akt. In NIH3T3 cells expressing RONDelta160, both mAbs significantly enhanced RONDelta160-mediated tumorigenic activities including cell proliferation, focus formation, and anchorage-independent growth. Cell shape changes with increased motile and invasive activities were also observed. Studies in vivo further demonstrated that Zt/g4 and Zt/c1 increase RONDelta160-mediated tumor growth in nude mice with a shortened time of onset and enlarged tumor volume. Thus, by recognizing specific epitopes on the RON extracellular domains, Zt/g4 and Zt/c1 have abilities to elicit a full array of RON-mediated responses. These mAbs will be useful in studying mechanisms underlying RON activation which lead to increased tumorigenic activities.