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AIM: To investigate the effect of unilateral endoscopic dacryocystorhinostomy on binocular surface indexes.METHODS: Totally 45 cases with monocular primary acquired nasolacrimal duct obstruction(PANDO)who successfully underwent endoscopic dacryocystorhinostomy between 1 December 2022 and 31 July 2023 were enrolled in the study. Ocular surface indexes, including the non-invasive tear break-up time(NIBUT), Sjögren's International Collaborative Clinical Alliance ocular staining score(SICCA OSS), Korb score of lid wiper and Schirmer test scores, were collected preoperatively and at 0.5, 1 and 3 mo post-operatively. Subsequently, various indexes were compared at each time point between the operated and healthy eyes pre- and post-operatively.RESULTS: There was no significant differences between operated and healthy eyes in NIBUT, SICCA OSS, Korb scores and Schirmer test(all P>0.05). Furthermore, the Korb scores of operated eye at 0.5, 1 and 3 mo post-operatively were significantly lower than the preoperative value(P=0.034, 0.044, 0.027). Moreover, the Schirmer test score of the operated eye at 1 mo post-operatively was significantly lower than the preoperative value(P=0.0461).CONCLUSION:After a successful endoscopic dacryocystorhinostomy, tear drainage is restored, however, ocular surface damage worsens. These changes typically peak at 1 mo post-operatively before gradually improving.
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Objective:To evaluate the development of fetal cerebral sulci and gyrus and the blood perfusion in pregnant women with gestational diabetes mellitus(GDM) by ultrasound.Methods:A total of 1 540 pregnant women with 28-34 weeks of pregnancy who underwent systematic screening in Henan Provincial People′s Hospital from January 2022 to October 2022 were prospectively selected, 100 pregnant women with GDM were selected as the GDM group. According to the effect of blood glucose control, the GDM group was divided into 2 groups: the satisfied control group (GDM group 1), and the dissatisfied control group (GDM group 2), with 50 cases in each group. At the same period, 50 healthy pregnant women at 28-34 weeks of gestation were enrolled as the control group. The differences of the sylvian fissure, parietooccipital sulci, calcarine sulci and cinguli sulci among the 3 groups were statistically analyzed. And the correlations between the deep of the brain cerebral sulci and gyrus and controlled blood glucose levels were evaluated. The umbilical artery pulsation index(UAPI), middle cerebral artery pulsation index(MCAPI) and ductus venosus pulsation index(DVPI) among the 3 groups were compared, and the differences in fetal blood perfusion among the 3 groups were evaluated.Results:There were no significant differences in the depths of the sylvian fissure, parietooccipital sulci, calcarine sulci and cinguli sulci between the control group and the GDM group 1 (all P>0.05), and they were larger than those of the GDM group 2 (all P<0.05). The depths of lateral fissure, parieto-occipital sulcus, cingulate sulcus and calcarine sulcus were negatively correlated with fasting blood glucose, 1 h and 2 h postprandial blood glucose (all P<0.05). There were no significant differences in MCAPI, UAPI and DVPI between the control group and GDM1 group (all P>0.05). The MCAPI in GDM 2 group was lower than that in the control group and GDM 1 group, and the UAPI and DVPI values were higher than those in the control group and GDM1 group(all P<0.05). Conclusions:The maturity of fetal cerebral sulci and gyrus in GDM pregnant women is related to the blood glucose control of pregnant women. The change of blood perfusion caused by persistent hyperglycemia in pregnant women and intrauterine hypoxia may cause the development retardation of cerebral sulci and gyrus.
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Objective:To analyze the association between visceral fat area (VFA) and fatty liver based on quantitative CT (QCT) in people receiving health examination with normal body mass index (BMI).Methods:A cross-sectional study. A total of 1 305 physical examiners who underwent chest CT and QCT examination in the Department of Health Management of Henan Provincial People′s Hospital from January to December 2021 were retrospectively selected as subjects. The physical components at the central level of the lumbar two cone were measured with QCT, including subcutaneous fat area (SFA), VFA and liver fat content (LFC). And the metabolic indexes, such as blood lipids and blood glucose, were collected. The t-test and χ2 test were used to analyze the correlation between the detection rate of fatty live and LFCr and age and gender. According to level of VFA (<100 cm 2, 100-150 cm 2 and≥150 cm 2), the subjects were divided into three groups, and one-way ANOVA and χ2 test were used in comparison between groups. Multiple linear regression was used to analyze the correlation between VFA and metabolic indexes and LFC. Results:Of the 1 305 subjects, there were 634 males and 671 females. The detection rate of fatty liver in normal BMI population was 65.67%, and it was 72.71% and 59.02% respectively in men and women ( χ2=27.12, P<0.001), and the detection rate of fatty liver and LFC increased with age (both P<0.05). With the increase of VFA, the age, BMI, SFA, LFC, total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), alanine aminotransferase (ALT), blood uric acid and prevalence of fatty liver increased (all P<0.05), and the low-density lipoprotein cholesterol (HDL-C) decreased ( P<0.001). Multiple linear regression analysis showed that after adjustment for age factors, regardless of male or female, LFC was independently positively related with VFA, BMI, and ALT (male β=0.206, 0.145, 0.174, female β=0.194, 0.150, 0.184; all P<0.05). FBG was positively correlated with male independently ( β=0.134; P<0.001). The indicators related to female independently were TC, TG, and blood uric acid ( β=-0.121, 0.145, 0.141, all P<0.05) Conclusion:In the population receiving health examination with normal BMI, the VFA measured by QCT technique is closely related to fatty liver.
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OBJECTIVE To analyze the traditional Chinese medicine （TCM） emergency management policy texts in China， reveal the characteristics， problems and improvement directions of Chinese medicine emergency management policies in China， and provide references and lessons for improving the level of Chinese medicine emergency management. METHODS Twenty-four TCM emergency management policy texts issued at the central level from 2016 to 2023 were coded and analyzed using Nvivo11 software to construct a three-dimensional analysis framework based on policy tools， stakeholders and policy strength. RESULTS In the policy tools dimension， the environmental type was the most （46.74%）， the supply type was the second （31.80%）， and the demand type was the least （21.46%）； in the stakeholder dimension， there were more healthcare institutions （40.63%） and government departments （31.25%）， and fewer healthcare workers （14.84%） and residents （13.28%）； in the policy strength dimension， the overall policy strength was poor， and the differences in effectiveness across policy instruments and stakeholders were more significant. The cross-cutting results showed that there was a certain degree of mismatch in policy instruments， stakeholders and policy strength. CONCLUSIONS The use of supply-oriented policy tools is slightly lacking， and the use of policy tools should be optimized in a coordinated manner； the distribution of stakeholders is relatively unbalanced， and synergies among stakeholders should be enhanced； the overall strength of policies is poor， and the top-level design of relevant policies should be improved.
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【Objective】 To explore the effect of lactate and alkali deficiency on the need for red blood cell transfusion in emergency of patients with traumatic hemorrhagic shock. 【Methods】 A total of 126 patients with traumatic hemorrhagic shock in our hospital from January 2019 to December 2021 were retrospectively analyzed, and the 99 cases with effective treatment were divided into two groups according to the outcome of blood transfusion within 24 hours after admission: non-transfusion group (n=36) and transfusion group (n=63). The changes of lactic acid (Lac), alkali deficiency (BE), hemoglobin (Hb), hematocrit (Hct) at admission, hemoglobin (Hb), hematocrit (Hct) 24 hours after admission and the length of stay in ICU were compared between the two groups. The binary logistic regression was used to analyze the risk factors of whether there was a need for blood transfusion at the time of emergency admission. The correlation between individual and combined indicators of each risk factor and the need for blood transfusion were analyzed by the receiver operating curve (ROC). 【Results】 The mean level of Lac (2.90±1.82) in the non-transfusion group at admission was lower than that in the transfusion group (5.80±2.83) (P0.05)The maximum AUG of Lac and BE(0.875, 0.766) in predicting the need for emergency red blood cell transfusion in patients with traumatic hemorrhagic shock was significantly better than that of Hb and Hct (0.692, 0.682); the optimal threshold for Lac was >3.6 mmol/L, while the optimal threshold for Hb is ≤106 g/L; the maximum AUG obtained by ROC curve analysis combined with Lac, BE, Hb and Hct was 0.910, which was higher than that of the sole virable. Comparative predictive value using the optimal thresholds of Lac and Hb as indications for transfusion showed that Lac had better predictive value than Hb. 【Conclusion】 Lac and be can be instructive for patients with traumatic hemorrhagic shock as to whether they need red blood cell transfusion in an emergency setting, and combination of Lac, BE, Hb and Hct may help to determine the transfusion needs of patients more timely and accurately and optimize the transfusion management of emergency patients.
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Cell membrane camouflaged nanoparticles have been widely used in the field of drug leads discovery attribute to their unique biointerface targeting function. However, random orientation of cell membrane coating does not guarantee effective and appropriate binding of drugs to specific sites, especially when applied to intracellular regions of transmembrane proteins. Bioorthogonal reactions have been rapidly developed as a specific and reliable method for cell membrane functionalization without disturbing living biosystem. Herein, inside-out cell membrane camouflaged magnetic nanoparticles (IOCMMNPs) were accurately constructed via bioorthogonal reactions to screen small molecule inhibitors targeting intracellular tyrosine kinase domain of vascular endothelial growth factor recptor-2. Azide functionalized cell membrane acted as a platform for specific covalently coupling with alkynyl functionalized magnetic Fe3O4 nanoparticles to prepare IOCMMNPs. The inside-out orientation of cell membrane was successfully verified by immunogold staining and sialic acid quantification assay. Ultimately, two compounds, senkyunolide A and ligustilidel, were successfully captured, and their potential antiproliferative activities were further testified by pharmacological experiments. It is anticipated that the proposed inside-out cell membrane coating strategy endows tremendous versatility for engineering cell membrane camouflaged nanoparticles and promotes the development of drug leads discovery platforms.
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Objective:To analyze the correlation between quantified body fat distribution measured by computed tomography (CT) and blood lipids in overweight and obese individuals undergoing physical examinations.Methods:In this retrospective cohort study, a total of 3 463 physical examination subjects who underwent chest CT combined with quantified CT examination in the Department of Health Management at Henan Provincial People′s Hospital from January to December 2021 were selected using a comprehensive sampling method. The subjects were divided into three groups: normal group (1, 424 cases), overweight group (1, 531 cases), and obese group (508 cases) based on their body mass index: 18.5 to <24.0 kg/m 2, 24.0 to <28.0 kg/m 2, and≥28.0 kg/m 2, respectively. General information, blood lipid parameters, and different body fat distributions measured by quantified CT (subcutaneous fat area, visceral fat area, total abdominal fat area, liver fat content, muscle fat content) were collected in the three groups. One-way analysis of variance was used to compare differences in body fat distribution and blood lipid parameters, and Pearson correlation analysis was performed to evaluate the correlation between body fat distribution and blood lipids. Results:In the obese group, compared to the normal and overweight groups, subcutaneous fat area, visceral fat area, total abdominal fat area, liver fat content, muscle fat content, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels were significantly higher [males: (152.80±49.27) vs (72.94±22.68), (103.79±28.30) cm 2; (287.95±57.55) vs (156.36±49.40), (224.67±53.10) cm 2; (440.75±72.44) vs (229.31±62.01), (328.46±62.77) cm 2; (12.92±8.61)% vs (6.82±3.31)%, (9.39±4.88)%; (9.06±9.34)% vs (4.55±5.06)%, (6.70±6.73)%; (6.52±0.94) vs (4.87±1.03), (6.27±0.96) mmol/L; (3.05±0.76) vs (2.92±0.86), (2.97±0.77) mmol/L; (2.34±1.42) vs (1.53±0.82), (1.99±1.28) mmol/L; females: (213.82±46.87) vs (104.69±30.62), (155.05±34.90) cm 2; (184.88±46.54) vs (90.67±34.09), (138.92±42.06) cm 2; (398.71±71.28) vs (195.37±55.32), (293.97±57.05) cm 2; (11.36±6.34)% vs (5.51±3.02)%, (7.98±4.77)%; (7.44±7.60)% vs (3.70±3.90)%, (5.56±5.94)%; (5.27±0.96) vs (5.04±0.86), (5.11±0.96) mmol/L; (3.26±0.84) vs (2.92±0.79), (3.01±0.74) mmol/L; (1.74±0.69) vs (1.27±0.65), (1.57±0.77) mmol/L], while high-density lipoprotein cholesterol (HDL-C) was significantly lower [males: (1.17±0.19) vs (1.38±0.28), (1.25±0.25) mmol/L; females: (1.36±0.22) vs (1.59±0.32), (1.42±0.27) mmol/L] (all P<0.001). In males, the visceral fat area and total abdominal fat area in the overweight group were positively correlated with triglycerides ( r=0.175, 0.113) and negatively correlated with HDL-C ( r=-0.125, -0.113), while liver fat content was positively correlated with total cholesterol, LDL-C, and triglycerides ( r=0.083, 0.075, 0.206) and negatively correlated with HDL-C ( r=-0.093) (all P<0.05). In the obese group, the liver fat content was positively correlated with triglycerides ( r=0.170) and negatively correlated with HDL-C ( r=-0.166) in males (both P<0.05). In females, the visceral fat area and total abdominal fat area in the overweight group were positively correlated with total cholesterol, LDL-C, and triglycerides (visceral fat area: r=0.129, 0.160, 0.348; total abdominal fat area: r=0.121, 0.130, 0.283) and negatively correlated with HDL-C ( r=-0.264, -0.173), while liver fat content was positively correlated with triglycerides ( r=0.352) and negatively correlated with HDL-C ( r=-0.195) (all P<0.05). In the obese group, the visceral fat area was positively correlated with triglycerides ( r=0.213) and negatively correlated with HDL-C ( r=-0.223) in females (both P<0.05). Conclusion:Blood lipids are correlated with body fat distribution in overweight and obese individuals undergoing physical examinations, and the degree of correlation varies between different genders and body regions, with triglycerides showing the strongest correlation with liver fat content.
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Objective:To investigate the modulatory function of interleukin-7 (IL-7)/CD 127 signaling pathway on CD 8+T cells in patients with myasthenia gravis (MG). Methods:Fifty-seven treatment-naive MG patients who were hospitalized in Department of Neurology, Nanyang Central Hospital between 2017 and 2020 as well as 35 healthy controls were enrolled. Peripheral blood was collected, while plasma and peripheral blood mononuclear cells were isolated. Plasma IL-7 and soluble CD 127 (sCD 127) were measured by enzyme linked immunosorbent assay (ELISA). Membrane-bound CD 127 (mCD 127) percentage in CD 8+T cells was measured by flow cytometry. The differences of above indices between different gender, onset age, afflicting with thymoma, or different Osserman type and their correlation with Quantitative Myasthenia Gravis (QMG) score were analyzed. Purified CD 8+T cells from MG patients were stimulated with recombinant human IL-7 (5 μg/L). Changes of sCD 127 and mCD 127 level were analyzed. Levels of perforin, granzyme B, interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α) in the cultured supernatants were measured by ELISA. Immune checkpoint molecules mRNA in CD 8+T cells was semi-quantified by real-time fluorescence quantitative polymerase chain reaction. Results:Plasma IL-7 level was up-regulated in MG patients compared with controls [(293.4±74.7) pg/ml vs (233.8±70.8) pg/ml, t=3.78, P<0.001], while sCD 127 level was down-regulated in MG patients compared with controls [(102.7±13.7) pg/ml vs (131.2±20.9) pg/ml, t=7.91, P<0.001]. Peripheral CD 8+T cells percentage was up-regulated in MG patients compared with controls (35.4%±7.1% vs 30.2%±7.5%, t=3.31, P=0.001), and mCD 127+CD 8+T cell percentage was also elevated (45.5%±7.7% vs 34.7%±11.5%, t=5.44, P<0.001). There were no significant differences of above indices between different gender, onset age, afflicting with thymoma, or different Osserman type. There was no significant correlation between above indices and QMG score. There were no significant differences of sCD 127 in cultured supernatants, mCD 127+CD 8+T cell percentage, or immune checkpoint molecules mRNA expression between CD 8+T cells from MG patients with and without IL-7 stimulation. IL-7 stimulation promoted the secretion of perforin [(208.1±67.2) pg/ml vs (168.8±46.2) pg/ml, t=2.16, P=0.038], granzyme B [(941.8±273.9) pg/ml vs (782.4±137.2) pg/ml, t=2.33, P=0.025], and IFN-γ [(19.1±5.2) pg/ml vs (15.3±4.5) pg/ml, t=2.47, P=0.018] by CD 8+T cells. However, there was no remarkable difference of TNF-α production between CD 8+T cells with and without IL-7 stimulation. Conclusion:Elevated IL-7-mediated signaling pathway enhanced the secretion of cytotoxic molecules and cytokines by CD 8+T cells, leading to increased activity of CD 8+T cells in MG patients.
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Ventilators are currently the most commonly used auxiliary mechanical ventilation equipment in clinical practice, and play an important role in the treatment of hypoxemia. Ventilator-associated pneumonia (VAP) is a special type of pulmonary parenchymal inflammation of nosocomial infection in patients with mechanical ventilation, which leads the increase of mortality and affects the prognosis of patients. The non-standard management of ventilator pipeline joints and the aerosol formed by bacterial condensate splashed from ventilator pipeline pollute the air, resulting in cross infection, which are the important reasons for VAP. The existing ventilator pipeline joint cap can achieve the effect of preventing pollution, but the clinical application compliance is not high. Based on the above factors, teachers, students and medical staff of the School of Public Health and Management, Guangxi University of Chinese Medicine and other units have designed a device for preventing pollution and air pollution of the ventilator pipeline joint, and obtained the national utility model patent of China (ZL 2020 2 1361981.X). The device is composed of a model lung, a mask body, a suspension part and a beam mouth part, etc. The use method is simple, and can be applied to the pollution avoidance of invasive ventilator and non-invasive ventilator pipeline joints, to reduce the occurrence of VAP in patients and the occupational exposure of medical staff.
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Objective:To investigate the effects of insulin resistance induced by long-term high-fat diet on cognitive function and brain phosphorylated Tau protein in pR5 MAPT Tau transgenic mice.Methods:Eight-week-old female pR5 MAPT transgenic mice were divided into standard diet(STD) group (pR5 STD, n=8) and high-fat diet(HFD) group (pR5 HFD, n=8). Female wild-type C57BL/6 mice fed with STD were used as control group (WT STD, n=8). The experiment was carried out for 30 weeks until the mice were old.During the experiment, the weight of mice was measured once a week and fasting blood glucose was measured once every two weeks.Thirty weeks later, glucose tolerance test and insulin tolerance test were carried out.Forced swimming test and tail suspension test were used to evaluate the depressive behavior of mice, and elevated plus maze test was used to evaluate the anxiety behavior, Morris water maze test was used to evaluate spatial memory behavior.The levels of total Tau protein and phosphorylated Tau proteins H7-tau, p-tau-Ser396 and p-tau-Thr231 were detected by Western blot.SPSS 17.0 software was used for statistical analysis, repeated measurement ANOVA was used for the data of glucose tolerance test and insulin tolerance test, one-way ANOVA was used for multi group comparison, and LSD test was used for further pairwise comparison. Results:After 30 weeks of high-fat diet, there were significant differences in body weight and fasting blood glucose among the three groups ( F=808.31, 1 117.18, both P<0.01). The body weight of mice in pR5 HFD group ((54.35±2.52)g) was higher than those in pR5 STD group ((24.95±1.15) g) and WT STD group ((23.86±1.10) g) (both P<0.01), and the fasting blood glucose of mice in pR5 HFD group ((8.12±0.24) mmol/L) was significantly higher than those in pR5 STD group ((4.64±0.13) mmol/L) and WT STD group ((4.45±0.22) mmol/L) (both P<0.01). Glucose tolerance test showed that within 120 minutes after injection of glucose, there was a significant time and group interaction in the blood glucose value among the three groups ( F=113.30, P<0.01). After glucose injection, the peak value of blood glucose in pR5 HFD group was delayed, suggesting that glucose tolerance in pR5 HFD group was impaired.The insulin tolerance test showed that there was a significant interaction between time and group in the insulin tolerance among the three groups ( F=209.92, P<0.01). After injection of insulin, the blood glucose in pR5 HFD group decreased slowly, reaching the valley value at 60 min, and then the blood glucose increased significantly, suggesting that the sensitivity of pR5 HFD group mice to insulin decreased significantly.There were significant differences in the percentage of forced swimming immobility time and tail suspension immobility time among the three groups ( F=37.05, 59.29, both P<0.01). The two indexes of pR5 STD group and pR5 HFD group were both higher than those of WT STD group (all P<0.01), and those of pR5 HFD group were both higher than those of pR5 STD group (both P<0.01). The results of elevated plus maze showed that there were significant differences in the activity distance and time in open arm among the three groups ( F=7.82, 10.37, both P<0.05) .The activity distance ((0.40±0.21) m) and activity time ((27.38±8.80) s) of pR5 HFD group were significantly lower than those of pR5 STD group ((2.31±1.74) m, (63.56±27.52)s) (both P<0.05). The space exploration test showed that the residence time in the target quadrant of pR5 HFD group ((15.56±1.16)s) was less than that of pR5 STD group((19.18±0.64)s)( P<0.01), and the time of entering the platform area of pR5 HFD group((1.43±0.06)s) was less than that of pR5 STD group((1.66±0.12)s)( P<0.01). Western blot showed that there were significant differences in the levels of total Tau protein, H7-tau, p-tau-Ser396 and p-tau-Thr231 protein among the three groups ( F=101.50, 80.60, 55.47, 30.89, all P<0.05). Further pairwise comparison showed that the levels of the four Tau proteins showed: the levels of the proteins in pR5 STD group and pR5 HFD group were all higher than those of WT STD group (all P<0.01), and those in pR5 HFD group were all higher than those in pR5 STD group (all P<0.05). Conclusion:Long-term high fat diet causes obesity, hyperglycemia and peripheral insulin resistance, and promotes the cognitive impairment of MAPT mice, which is related to the increase of Tau protein phosphorylation in the brains of MAPT mice.
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At present, the extension tube of the ventilator, a long corrugated tube used in clinical practice, needs to be disconnected from the endotracheal tube when performing open sputum suction. Under positive pressure, the condensed water containing pathogenic microorganisms in the ventilator will be splashed. Some will form aerosol suspended in the air, pollute the air, increase the risk of cross-infection and operator pollution, while the ventilator will emit a corresponding alarm sound, resulting in noise pollution. Based on the above factors, a ventilator pipeline extension tube was designed by the medical staff of department of critical care medicine of the Eighth Medical Center of People's Liberation Army General Hospital and department of critical care medicine of Beijing Friendship Hospital of Capital Medical University, and was obtained the National Utility Model Patent of China (ZL 2020 2 1476518.X). The device consists of the main pipe, first pipe sleeve, second pipe sleeve, valve body, joystick, axial sleeve, etc., which can not only effectively avoid air pollution and reduce the risk of cross-infection, but also reduce noise pollution and the negative impact of loud noise on patients and medical staff.
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China national medical centers and national regional medical centers are the key entities to expand the availability of quality medical resources and ensure they are better distributed among regions. It is of great significance for the centers′ high-quality development to understand the key issues in the construction and progression of centers by evaluating the performance of their function fulfillment. The evaluation framework of this study was based on the " structure-process-outcome" model. The study was divided into three stages, including centers′ self-evaluation, data reporting, and on-site investigation and evaluation. The team conducted the evaluation on 15 entity hospitals supporting 6 national medical centers and 5 national regional medical centers that had been approved by October 2020. As the results showed, the funding and policy support for these centers from governments at all levels were increased, the internal and external management mechanism of the centers were preliminarily set up, the functions of the centers were executed properly, and the " radiation effect" of the centers was in place gradually. The key problems hindering the fulfillment of functions concern the mechanisms that were not sound and need to be further refined, which included the field of financial investment and policy guarantee for the entity hospitals, internal and external management of centers, introduction and cultivaton of the talented, and the innovation and transformation of scientific achievements which facilitates breakthroughs in core technologies. To promote the efficient implementation of functional tasks of the centers, the authors proposed four suggestions. First, the " commission and province co-construction" mechanism should be further improved to augment investment and policy guarantee from the government. Second, the internal organization and management mechanism of each centers should be optimized. Third, the reform and innovation in the training and management system of the talented medical personnel should be accelerated. Last, the health needs oriented mechanism for scientific research innovation and achievements transformation should be established.
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Biomimetic nanoengineering presents great potential in biomedical research by integrating cell membrane (CM) with functional nanoparticles. However, preparation of CM biomimetic nanomaterials for custom applications that can avoid the aggregation of nanocarriers while maintaining the biological activity of CM remains a challenge. Herein, a high-performance CM biomimetic graphene nanodecoy was fabricated via purposeful surface engineering, where polyethylene glycol (PEG) was used to modifying magnetic graphene oxide (MGO) to improve its stability in physiological solution, so as to improve the screening efficiency to active components of traditional Chinese medicine (TCM). With this strategy, the constructed PEGylated MGO (PMGO) could keep stable at least 10 days, thus improving the CM coating efficiency. Meanwhile, by taking advantage of the inherent ability of HeLa cell membrane (HM) to interact with specific ligands, HM-camouflaged PMGO showed satisfied adsorption capacity (116.2 mg/g) and selectivity. Finally, three potential active components, byakangelicol, imperatorin, and isoimperatorin, were screened from Angelica dahurica, whose potential antiproliferative activity were further validated by pharmacological studies. These results demonstrated that the purposeful surface engineering is a promising strategy for the design of efficient CM biomimetic nanomaterials, which will promote the development of active components screening in TCM.
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Objective:To investigate the application value of bedside lung ultrasound in the diagnosis of acute dyspnea.Methods:Sixty-four patients with acute dyspnea who received treatment in Jincheng General Hospital from January 2020 to January 2021 were included in this study. These patients underwent bedside lung ultrasound, chest X-ray examination, and CT scan. The value of bedside lung ultrasound in the diagnosis of lung consolidation, pleurisy, pleural effusion, and pulmonary edema was analyzed.Results:The diagnostic rate of lung consolidation, pleurisy, pleural effusion, and pulmonary edema by bedside lung ultrasound was 34.4% (22/64), 64.1% (41/64), 67.2% (43/64), and 57.8% (37/64), respectively, which was slightly, but not significantly, different from that by chest CT scans [42.2% (27/64), 57.8% (37/64), 64.1% (41/64), 68.8% (44/64), all P > 0.05]. The diagnostic rate of lung consolidation, pleurisy, pleural effusion, and pulmonary edema by bedside lung ultrasound was significantly higher than that by chest X-ray examination [17.2% (11/64), 26.6% (17/64), 34.4% (22/64), 37.5% (37/64), χ2 = 4.94, 18.16, 13.78, 5.293, all P < 0.05]. Conclusion:Bedside lung ultrasound can help diagnose and screen patients with acute dyspnea quickly, accurately, and timely. Bedside lung ultrasound has a higher rate in the diagnosis of lung consolidation, pleurisy, pleural effusion, and pulmonary edema than chest X-ray examination, which is worthy of clinical application.
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Previous studies have shown that poisoning is a major threat to human health. Inhalation of acute toxic gas has been linked to serious health consequences. Among the antidotes for poisoning currently used, supportive care is the most common intervention in clinical practice. Severe acute respiratory distress syndrome (ARDS) and/or refractory cardiogenic shock or cardiac arrest caused by toxins are associated with high mortality and are difficult to treat. Extracorporeal membrane oxygenation (ECMO) is an aggressive supportive measure used to manage severely poisoned patients. This study presents two cases of acute toxic gases inhalation, severe ARDS and circulatory instability induced by bromine inhalation, and ARDS induced by nitric acid inhalation which were successfully treated with ECMO. The ECMO techniques used in the animal models and in human cases to treat severe poisoning are described as well as the indications, contraindications, complications, and weaning of ECMO.
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OBJECTIVE：To study the imp rovement effects of 2-dodecyl-6-methoxycyclohexa-2，5-diene-1，4-dione（DMDD） from Averrhoa carambola on H 9c2 myocardial cell injury induced by high glucose and its mechanism. METHODS ：H9c2 myocardial cells were divided into normal group ，high glucose group ，osmotic pressure control group ，DMDD high ，medium and low concentration groups （8，4，2 μmol/L）. Normal group and high glucose group were treated with low glucose DMEM medium （containing 5.5 mmol/L glucose ，similarly hereinafter ） and high glucose DMEM medium （containing 33.3 mmol/L glucose ， similarly hereinafter ）for 48 h，respectively. The cells in osmotic pressure control group were cultured in low glucose DMEM medium containing 27.5 mmol/L mannitol for 48 h. In DMDD groups ，cells were cultured in high glucose DMEM medium for 24 h， and then in high glucose DMEM medium containing corresponding concentration of DMDD for 24 h. At the end of cell culture ，MTT metho d was used to detect the cell survival rate. The activities of ROS ， GSH-Px and LDH in cellsupernatant were detected by using related kits. ELISA assay was used to detect the levels of TNF-α and IL-6 in cell supernatant. Cell apoptosis was d etected by acridine orange/ethidium bromide （AO/EB）staining. Western blot assay was used to detect the expression of apoptosis related proteins （cleaved caspase- 3，Bcl-2，Bax）and the phosphorylation level of nuclear factor κB （NF-κB）/NF-κB suppressor protein α（IκBα）signaling pathway related proteins （NF-κB p65，IκBα）. RESULTS ：Compared with the normal group ，survival rate ，the activity of GSH-Px and protein expression of Bcl- 2 in high glucose groups were decreased significantly（P＜0.01）；the activities of ROS and LDH ，the levels of TNF-α and IL-6，the protein expression of Bax and cleaved caspase-3，and the phosphorylation level of NF-κB p65 and IκBα were increased significantly（P＜0.01）；the cells showed orange yellow fluorescence ，and the number of cells with fuzzy morphology increased significantly ，showing an obvious apoptotic state. There was no statistical significance in above indexes of osmotic pressure control group compared with normal group. Compared with high glucose group ，the activities or levels of above indexes （except for cell survival rate an LDH activity in low concentration group ）were reversed significantly in DMDD groups （P＜0.05 or P＜0.01）；the orange yellow fluorescence in the cells decreased significantly ，and the cell morphology was relatively complete. CONCLUSIONS ：DMDD can significantly improve H9c2 myocardial cell injury induced by high glucose ；the mechanism of which may be associated with suppressing oxidative stress and inflammatory response ，regulating the expression of apoptosis related protein and NF-κB/IκBα pathway related protein.
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Cardiopulmonary resuscitation (CPR) guidelines emphasize that external chest compressions should be started as soon as possible when CPR is performed in patients with cardiac arrest. Moreover, those guidelines stress on fast and hard compressions to make the chest fully rebound and minimize non-pressing time. Current mechanical recovery device has several problems such as displacement of the pressing position, high price, difficult to move, and easy dislocation of piston. Because of the physical loss of high-intensity unarmed CPR, the depth and frequency of external chest compression will decrease with the extension of CPR time, leading to CPR failure. Besides, there are other problems caused by non-professional staff, such as the deviation of compression position, the inaccuracy of compression depth and the unsatisfactory rebound of the chest wall. Based on the above factors, the medical staff from the intensive care unit of the Eighth Medical Center of the Chinese People's Liberation Army General Hospital designed a portable external chest cardiac compressor based on international CPR guidelines which obtained the National Utility Model Patent of China (ZL 2018 2 1173254.3). The portable external chest cardiac compressor is composed of a positioning sucker, elastic body, mounting shell, and pressing components. Rapid and accurate compression positioning, visible compression depth and full chest rebound can be achieved. This device is mobile, easy to operate, and suitable for a broad crowd and various occasions.
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Objective To systematically evaluate the efficacy and safety of immune checkpoint inhibitors in the treatment of advanced gastric cancer or gastroesophageal junction cancer (GC/GEJC). Methods CNKI, Wanfang, PubMed, EMBASE, ClinicalTrials, Cochrane Library and other databases were searched to collect the clinical trials of immune checkpoint inhibitors in the treatment of advanced GC/GEJC. The retrieval time was from the inception to Nov. 2019. Outcome measures mainly included ORR, DCR, PFS, OS and toxicities. The adoption rate difference and hazard ratio were effect measures. Meta-analysis was performed using RevMan 5.3 software. Results We included seven literatures with a total of 1949 patients. Meta-analysis showed that for the patients with advanced GC/GEJC, the second-line or later immune checkpoint inhibitor therapy improved the overall survival rate at 12 and 18 months; the OS of the patients was prolonged, compared with chemotherapy/placebo therapy (all P < 0.05). The incidence of adverse reactions of any grade or ≥grade 3 caused by immune checkpoint inhibitor therapy was lower than that caused by chemotherapy/placebo. Conclusion Immune checkpoint inhibitor treatment could improve survival endpoints in some patients with advanced GC/GEJC, and the incidence of common adverse reactions is low.
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Objective:To explore the effect of the location and size of region of interest (ROI) on the measurement of liver fat by means of quantitative computed tomography (QCT).Methods:A total of 98 subjects who were examined with QCT for bone mineral density examination from December 25, 2019 to January 17, 2020 were recruited continuously from the Department of Health Management of Henan Provincial People′s Hospital. The liver fat content was measured by QCT workstation. The ROI was located respectively in the left lobe, the right anterior lobe and the right posterior lobe of the liver, and it was measured independently by the A measurer and B measurer. The central position of the ROI was fixed and the diameter was increased, and it was measured by the A measurer. In this study, Friedman test was used to compare the differences of measurement results in different positions or sizes of ROI, and intra-class correlation coefficients (ICC) was used to evaluate the repeatability of inter-measurers.Results:There was a significant difference for liver fat content under different positions of ROI (χ2=62.306, P<0.001), but no difference under different seizes of ROI (χ2=1.088, P=0.581). The ICC values of the inter-measurers repeatability analysis of the A measurer and B measurer in the left lobe, right anterior lobe and right posterior lobe of the liver were 0.847, 0.917 and 0.874, all more than 0.75, and the reproducibility was good. Conclusions:When QCT technique is applied to the measurement of liver fat content, the location conditions of ROI may affect results, so it is necessary to select multiple ROI in the whole liver for measurement. The inter-measurers repeatability of QCT in different parts of the liver is good.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have resulted in a number of severe cases of COVID-19 and deaths worldwide. However, knowledge of SARS-CoV-2 infection, diseases and therapy remains limited, underlining the urgency of fundamental studies and drug development. Studies have shown that induction of autophagy and hijacking of autophagic machinery are essential for infection and replication of SARS-CoV-2; however, the mechanism of this manipulation and function of autophagy during SARS-CoV-2 infection remain unclear. In the present study, we identified ORF3 as an inducer of autophagy and revealed that ORF3 localizes to the ER and induces FAM134B-related ERphagy through the HMGB1-Beclin1 pathway. As a consequence, ORF3 induces ER stress and inflammatory responses through ERphagy and sensitizes cells to ER stress-induced cell death, suggesting that SARS-CoV-2 ORF3 hijacks ERphagy and then harms ER homeostasis to induce inflammatory responses through excessive ER stress. These findings reveal a sequential induction of ERphagy, ER stress and acute inflammatory responses during SARS-CoV-2 infection and provide therapeutic potential for ERphagy and ER stress-related drugs for COVID-19 treatment and prevention. ImportanceSARS-CoV-2 infection and replication require autophagosome-like double-membrane vacuoles. Inhibition of autophagy suppresses viral replication, indicating the essential role of autophagy in SARS-CoV-2 infection. However, how SARS-CoV-2 hijacks autophagy and the function of autophagy in the disease progression remain unknown. Here, we reveal that SARS-CoV-2 ORF3 induces ERphagy and consequently induces ER stress to trigger acute inflammatory responses and enhance sensitivity to ER stress-induced apoptosis. Our studies uncover ERphagy-induced inflammatory responses during SARS-CoV-2 infection and provide a promising therapeutic approach for treating SARS-CoV-2 infection and inflammatory responses in COVID-19 by manipulating autophagy and ER stress.