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Objective To evaluate the efficacy and further analyze the application prospects of the combined multitarget fecal FIT-DNA assay in the early screening of colorectal cancer. Methods Subjects were selected from a population attending the Inner Mongolia Medical University Hospital. Each subject underwent a combined multi-target fecal FIT-DNA test (experimental group), a serum tumor marker test and enteroscopy (control group). The pathological results were used as the gold standard to evaluate the efficacy of novel fecal molecular testing techniques for colorectal cancer screening with timely intervention given to screen positive individuals. Results The data of 115 individuals were analyzed. Serum tumor markers test had a sensitivity of 63.2% (43/68) and a specificity of 74.5% (35/47). The enteroscopy had a sensitivity of 97.1% (66/68) and a specificity of 80.7% (38/47); the combined multitarget fecal FIT-DNA test had a sensitivity of 89.7% (61/68) and a specificity of 87.2% (41/47). Conclusion The sensitivity and specificity of multitarget fecal FIT-DNA combined detection are better than those of serum tumor marker detection. Although its sensitivity is lower than enteroscopy, its operation is simpler and can be tested at home.
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Objective:To evaluate the effect of dexmedetomidine on the thioredoxin-interacting protein (TXNIP)/apoptosis signal-regulated kinase 1 (ASK1) signaling pathway in a mouse model of intestinal ischemia-reperfusion (I/R).Methods:Thirty-two SPF healthy adult male C57BL/6J mice, aged 8-10 weeks, weighing 18-22 g, were divided into 4 groups ( n=8 each) using a random number table method: sham operation group (Sham group), intestinal I/R group (I/R group), TXNIP inhibitor resveratrol group (Res group) and dexmedetomidine group (Dex group). The mouse model of intestinal I/R injury was developed by clamping the superior mesenteric artery for 45 min followed by 120-min reperfusion in anesthetized animals. Resveratrol 30 mg/kg was intraperitoneally injected before developing the model in Res group, and dexmedetomidine 25 μg/kg was intraperitoneally injected at 30 min before ischemia in Dex group. Blood samples were collected by cardiac puncture at the end of 120-min reperfusion, then the mice were sacrificed, and the small intestine tissues were removed for microscopic examination and for determination of the serum diamine oxidase (DAO) concentration (by enzyme-linked immunosorbent assay) and expression of TXNIP, ASK1 and cleaved-caspase-3 in small intestinal tissues (by Western blot). The apoptosis rate of intestinal epithelial cells was calculated. The intestinal damage was assessed and scored according to Chiu. Results:Compared with group Sham, the Chiu′s score, serum DAO concentrations and apoptosis rate of intestinal epithelial cells were significantly increased, and the expression of TXNIP, ASK-1 and cleaved-caspase-3 was up-regulated in group I/R ( P<0.05). Compared with group I/R, the Chiu′s score, serum DAO concentration and apoptosis rate of intestinal epithelial cells were significantly decreased, and the expression of TXNIP, ASK-1 and cleaved-caspase-3 was down-regulated in group Res ( P<0.05). Compared with I/R group, the Chiu′s score, serum DAO concentration and apoptosis rate of intestinal epithelial cells were significantly decreased, and the expression of TXNIP, ASK-1 and cleaved-caspase-3 was down-regulated in Dex group ( P<0.05). Conclusions:The mechanism by which dexmedetomidine alleviates intestinal I/R injury may be related to inhibition of the TXNIP/ASK1 signaling pathway and reduction of cell apoptosis in mice.
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AIM: To explore schisandrin B (Sch B) pretreatment reduces intestinal ischemia reperfusion injury (IIRI) through inhibiting apoptosis by activation of Nrf2/HO-1 signing pathway in mice by network pharmacology and in vivo experiment. METHODS: (1) The targets of Sch B and IIRI were searched from online databases, Drawing Venn diagram to obtain the common target of them. Cytoscape software was imported to construct the protein-protein interaction (PPI) network to establish the "Drugs-Disease-core target gene" network. The mechanism of Sch B against IIRI was predicted through GO and KEGG enrichment analysis. (2) Thirty-six C57BL/6J mice were randomly divided into six groups (n = 6). The model of IIRI was established in four groups except the sham operation group. Three of the groups were pretreated with Sch B, Nrf2 inhibitor ML385, and Sch B + ML385, respectively. After the experiment, intestinal tissue samples were taken for HE staining, Chiu ' s score, apoptosis staining, immunohistochemistry (IHC), and immunoblotting (Western blot). RESULTS: A total of 412 Sch B related tar- gets, 2 166 IIRI related targets and 153 common targets were screened out through network pharmacology. There were 88 "Sch B-IIRI-core target gene" included NFE2L2 (Nrf2), HMOX1 (HO-1), BCL2, CASP3 (caspase 3), and so on. KEGG enrichment analysis screened 163 related pathways, apoptosis pathway ranked high showing that the pathway may play a key role in the treatment of IIRI by Sch B. The animal experiment had shown that Sch B reduced the Chiu's score and apoptotic while upregulating Nrf2, HO-1, Bcl-2 protein expression levels and Bcl-2/Bax, downregulating Bax, and cleaved caspase-3 expression levels, thereby reducing IIRI in mice, and that Nrf2 inhibitor ML385 reversed this process (P < 0.05). CONCLUSION: This study reveals that Sch B has the characteristics of multi-target and multi-pathway in the reduction of IIRI, and Sch B can reduce IIRI through inhibiting apoptosis by activation of Nrf2/ HO-1 pathway.
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Autophagy is being increasingly recognized as an important regulator of intestinal ischemia-reperfusion(I/R)injury, but its exact role is still debated. Emerging evidence suggests that miR-146a-5p is involved in the initiation and development of I/R injury, but its role in intestinal I/R injury remains unclear. The present study generated an intestinal I/R mouse model and an oxygen glucose deprivation/reoxygenation (OGD/R) Caco-2 cell model and found that autophagy was increased and contributed to the intestinal injury and cell death induced by I/R and OGD/R. In addition, in both I/R and OGD/R models, the miR-146a-5p expression level was decreased and accompanied by an increase in TXNIP expression. By transfecting cells with an miR-146a-5p inhibitor or mimic, we observed that miR-146a-5p inhibits autophagy during OGD/R by targeting TXNIP; this was confirmed by the dual luciferase reporter gene assay. Additionally, through overexpression and knockdown cell lines, we established that TXNIP regulates autophagy during intestinal I/R via the PRKAA/mTOR pathway. The interaction between TXNIP and p-PRKAA was verified by immunofluorescence co-localization and immunoprecipitation assays. Moreover, we confirmed that TXNIP is indispensable for miR-146a-5p-mediated cell protection. Finally, we observed that miR-146a-5p overexpression inhibits autophagy and attenuates intestinal I/R injury via the PRKAA/mTOR pathway by targeting TXNIP in vivo. In conclusion, this study highlights the role of miR-146a-5p in regulating autophagy by targeting TXNIP, suggesting that miR-146a-5p may be a novel drug target for intestinal I/R therapy.
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Proteínas Quinases Ativadas por AMP/metabolismo , Proteínas de Transporte/biossíntese , Intestinos/metabolismo , MicroRNAs/biossíntese , Traumatismo por Reperfusão/metabolismo , Serina-Treonina Quinases TOR/metabolismo , Tiorredoxinas/biossíntese , Animais , Autofagia/fisiologia , Células CACO-2 , Humanos , Intestinos/irrigação sanguínea , Intestinos/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Traumatismo por Reperfusão/patologia , Traumatismo por Reperfusão/prevenção & controle , Transdução de Sinais/fisiologiaRESUMO
Short-chain fatty acids (SCFAs) are organic acids with no more than 6 carbon atoms produced during the anaerobic fermentation of dietary fiber in the intestinal tract, which can regulate intestinal flora, repair intestinal mucosal barrier, and reduce intestinal injury.Ischemia-reperfusion injury (IRI) is the main cause of various diseases, and the pathological mechanisms involved are intricate, among which inflammation, oxidative stress, apoptosis and autophagy are the most common. According to current studies, SCFAs can affect the occurrence and development of IRI in various organs by regulating different cell signal transduction. In this paper, the role and mechanism of SCFAs in alleviating tissue and organ ischemia-reperfusion injury were preliminarily summarized, providing theoretical reference for clinical prevention and treatment of IRI.
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The rapidly developing resistance of cancers to chemotherapy agents and the severe cytotoxicity of such agents to normal cells are major stumbling blocks in current cancer treatments. Most current chemotherapy agents have significant cytotoxicity, which leads to devastating adverse effects and results in a substandard quality of life, including increased daily morbidity and premature mortality. The death receptor of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) can sidestep p53-dependent pathways to induce tumor cell apoptosis without damaging most normal cells. However, various cancer cells can develop resistance to TRAIL-induced apoptosis via different pathways. Therefore, it is critical to find an efficient TRAIL sensitizer to reverse the resistance of tumor cells to TRAIL, and to reinforce TRAIL's ability to induce tumor cell apoptosis. In recent years, traditional Chinese medicines and their active ingredients have shown great potential to trigger apoptotic cell death in TRAIL-resistant cancer cell lines. This review aims to collate information about Chinese medicines that can effectively reverse the resistance of tumor cells to TRAIL and enhance TRAIL's ability to induce apoptosis. We explore the therapeutic potential of TRAIL and provide new ideas for the development of TRAIL therapy and the generation of new anti-cancer drugs for human cancer treatment. This study involved an extensive review of studies obtained from literature searches of electronic databases such as Google Scholar and PubMed. "TRAIL sensitize" and "Chinese medicine" were the search keywords. We then isolated newly published studies on the mechanisms of TRAIL-induced apoptosis. The name of each plant was validated using certified databases such as The Plant List. This study indicates that TRAIL can be combined with different Chinese medicine components through intrinsic or extrinsic pathways to promote cancer cell apoptosis. It also demonstrates that the active ingredients of traditional Chinese medicines enhance the sensitivity of cancer cells to TRAIL-mediated apoptosis. This provides useful information regarding traditional Chinese medicine treatment, the development of TRAIL-based therapies, and the treatment of cancer.
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Objective To compare the efficacy and safety of closed reduction and percutaneous Kirschner wire fixation and Kirschner wire fixation in the treatment of children with supracondylar fracture of humerus. Methods 88 children with supracondylar fracture of humerus in our hospital were randomly selected. And they were divided into closed group ( n =44 ) and open group ( n =44 ) by taking computer random sequence method. The closed group was treated with closed reduction and percutaneous Kirschner wire fixation,the open group was treated with Kirschner wire fixation. The treatment effect and safety of the two groups were compared. Results The operation time [(59.47 ±12.23)min],hospitalization time [(3.46 ±1.44) d],fracture healing time[(32.46 ±7.41)d] of the closed group were significantly shorter than those of the open group (t=5. 238,5. 395,7. 841,all P<0. 05). The amount of bleeding[(15.48 ±8.48)mL] of the closed group was significantly less than that of the open group (t=4. 867,P<0. 05). The effective rate of the closed group (90. 91%) was significantly better than the open group (χ2 =5. 096,P<0. 05). The incidence rate of complication between the two groups had no significant difference (6. 82%vs. 9. 09%,χ2 =0. 155,P>0. 05). Conclusion Compared with open reduction and Kirschner wire internal fixation, closed reduction and percutaneous Kirschner wire fixation in the treatment of children with supracondylar fracture of humerus has significant curative effect,it is safe and reliable,which is worthy of promotion in clinic.
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Objective To compare the efficacy and safety of closed reduction and percutaneous Kirschner wire fixation and Kirschner wire fixation in the treatment of children with supracondylar fracture of humerus. Methods 88 children with supracondylar fracture of humerus in our hospital were randomly selected. And they were divided into closed group ( n =44 ) and open group ( n =44 ) by taking computer random sequence method. The closed group was treated with closed reduction and percutaneous Kirschner wire fixation,the open group was treated with Kirschner wire fixation. The treatment effect and safety of the two groups were compared. Results The operation time [(59.47 ±12.23)min],hospitalization time [(3.46 ±1.44) d],fracture healing time[(32.46 ±7.41)d] of the closed group were significantly shorter than those of the open group (t=5. 238,5. 395,7. 841,all P<0. 05). The amount of bleeding[(15.48 ±8.48)mL] of the closed group was significantly less than that of the open group (t=4. 867,P<0. 05). The effective rate of the closed group (90. 91%) was significantly better than the open group (χ2 =5. 096,P<0. 05). The incidence rate of complication between the two groups had no significant difference (6. 82%vs. 9. 09%,χ2 =0. 155,P>0. 05). Conclusion Compared with open reduction and Kirschner wire internal fixation, closed reduction and percutaneous Kirschner wire fixation in the treatment of children with supracondylar fracture of humerus has significant curative effect,it is safe and reliable,which is worthy of promotion in clinic.
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Objective To explore the imaging characteristics of ovarian fibroma on CT and MRI.Methods The CT and MRI findings of 12 patients with ovarian fibroma proved by surgery and pathology,including 12 cases of CT scan and 5 cases of MRI scan,were retrospectively analyzed.Results All of 12 patients with ovarian fibroma showed solitary masses with well defined margin and roughly round or mildly lobulated shape.On CT plain imaging,3 ovarian fibromas were homogeneous or roughly homogeneous solid masses,8 mixed masses with cystic and solid parts,and 2 mainly cystic masses.5 masses with MRI showed isointensity or mildly hypointensity on T1WI and significantly inhomogeneous intensity on T2WI with stripy and flaky hypointensity in solid parts.The solid parts of mass were enhanced slightly and gradually after intravenous administration of contrast material,and 4 masses showed complete envelopes on enhanced MRI.10 cases showed little of ascites concomitantly.Conclusion The CT and MRI findings of ovarian fibroma are characteristic to some extent.Masses with well defined margin and roughly round or mildly lobulated shape,slight and gradual enhancement,hypointensity of solid part on T2WI and complete envelope showed on MRI,suggest the possible diagnosis of ovarian fibroma.
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Objective To observe the clinical effect of compound remifentanil etomidate on gastrointestinalendoscopy and treat-ment among aged patients .Methods Divided 400 aged patients who got painless gastrointestinalendoscopy and treatment into two groups ,where one was observation group(200 aged patients) that got compound remifentanil etomidate ,while the other was control group which got fentanyl combined propofol .Compared and observed two groups on oxyhemoglobin saturation ,heart rate ,systolic-pressure ,diastolic pressure ,incidence of adverse reaction ,recovery time ,and time of leaving operating room .Results There was no obvious difference between observation group and control group on oxyhemoglobin saturation ,heart rate ,systolicpressure ,diastolic pressure before examination(P>0 .05);while there was distinct difference between examining and reviving ,which showed statisti-cal significance(P<0 .05) .The incidences of bucking ,dysphoria ,respiratory depression ,nausea and vomiting ,and dizziness in the two groups respectively were 3% 、2% 、5% 、3% 、11% and 8% 、11% 、13% 、8% 、27% ,which indicated the incidence of adverse reac-tion in observation group was obviously lower than that of control group ,where there was statistical significance (P<0 .05) .The time of recovery and the time of leaving operating room in two groups respectively were (3 .5 ± 1 .3)min、(9 .5 ± 1 .5)min and (7 .5 ± 3 .4)min、(18 .5 ± 4 .6)min ,which showed the time of observation group was lesser than that of control group ,where there was sta-tistical significance(P<0 .05) .Conclusion During the gastrointestinalendoscopy to aged patients ,compound fentanyl etomidate was safety ,less adverse reaction ,efficiency ,and strong controllability .
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Objective To evaluate the effects of dexmedetomidine on lung ischemia-reperfusion (I/R) injury in rats.Methods Ninety-six healthy SPF male Wistar rats,weighing 250-350 g,aged 8-12 weeks,were randomly divided into 4 groups (n =24 each):sham operation group (S group),I/R group,low dose dexmedetomidine group (DL group) and high dose dexmedetomidine group (DH group).In DL and DH groups,dexmedetomidine 100 and 500 μg· kg-1 · d-1 were injected intraperitoneally once a day for 2 consecutive days,while the equal volume of normal saline was given in S and I/R groups.Lung·I/R was induced by clamping the left hilum of lung for 45 min followed by reperfusion at 30 min after administration on 2nd day.At 45 min of ischemia,and 60 and 120 min of reperfusion,6 rats were sacrificed,and lungswere removed for determination of TNF-α (tumor necrosis factor-a) content and myeloperoxidase (MPO) activity in lung tissues.The percentage of damaged alveolar in lung tissues was detected at 120 min of reperfusion.Another 6 rats were lavaged and the broncho-alveolar lavage fluid (BALF) was colleted for determination of the total protein concentrations.Results Compared with S group,the TNF-α content,MPO activity,percentage of damaged alveolar,and total protein concentrations in BALF were significantly increased in I/R,DL and DH groups.Compared with I/R group,the TNF-α content,MPO activity,percentage of damaged alveolar,and total protein concentrations in BALF were significantly decreased in DL and DH groups.Conclusion Dexmedetomidine can alleviate the lung I/R injury in rats,and the mechanism is related to inhibiton of the inflammatory responses.
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BACKGROUND: Cardiopulmonary resuscitation (CPR) is a sudden emergency procedure that requires a rapid and efficient response, and personnel training in lifesaving procedures. Regular practice and training are necessary to improve resuscitation skills and reduce anxiety among the staff. As one of the most important skills mastered by medical volunteers serving for Mt. Taishan International Mounting Festival, we randomly selected some of them to evaluate the quality of CPR operation and compared the result with that of the untrained doctors and nurses. In order to evaluate the functions of repeating standard CPR training on performance qualities of medical volunteers for Mt. Taishan International Mounting Festival, their performance qualities of CPR were compared with those of the untrained medical workers working in emergency departments of hospitals in Taian. METHODS: The CPR performance qualities of 52 medical volunteers (Standard Training Group), who had continually taken part in standard CPR technical training for six months, were tested at random and were compared with those of 68 medical workers (Compared Group) working in emergency departments of hospitals in Taian who hadn't attended CPR training within a year. The QCPR 3535 monitor (provided by Philips Company) was used to measure the standard degree of single simulated CPR performance, including the chest compression depth, frequency, released pressure between compressions and performance time of compression and ventilation, the results of which were recorded in the table and the number of practical compression per minute was calculated. The data were analyzed by x2 Test and t Test. The factors which would influence CPR performance, including gender, age, placement, hand skill, posture of compression and frequency of training, were classified and given parameters, and were put to Logistic repression analysis. RESULTS: The CPR performance qualities of volunteers were much higher than those of the compared group. The overall pass rates were respectively 86.4% and 31.9%; the pass rates of medical volunteers in terms of the chest compression depth, frequency, released pressure between compressions were higher than those of the compared group, which were 89.6%, 94.2%, 95.8% vs 50.3%, 53.0%, 83.1%, P<0.01; there were few differences in overall performance time, which were (118.4 ± 13.5s) vs (116.0 ± 10.4s), P>0.05; the duration time of ventilation in each performance section was much shorter than that in the compared group, which were (6.38 ± 1.2) vs (7.47 ± 1.7), P<0.01; there were few differences in the number of practical compression per minute, which were (78.2 ± 3.5) vs (78.8 ± 12.2), P>0.05); the time proportion of compression and ventilation was 2.6:1 vs 2.1:1. The Logistic repression analysis showed that CPR performance qualities were clearly related to hand skill, posture of compression and repeating standard training, which were respectively OR 13.12 and 95%CI (2.35~73.2); OR 30.89, 95%CI (3.62~263.5); OR 4.07,95%CI (1.16~14.2). CONCLUSION: The CPR performance qualities of volunteers who had had repeating standard training were much higher than those of untrained medical workers, which proved that standard training helped improve CPR performance qualities.
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Reanimação Cardiopulmonar/educação , Reanimação Cardiopulmonar/normas , Serviços Médicos de Emergência/normas , Qualidade da Assistência à Saúde , Voluntários/educação , Adulto , Distribuição de Qui-Quadrado , Competência Clínica , Tratamento de Emergência/normas , Feminino , Férias e Feriados , Humanos , Modelos Logísticos , Masculino , Montanhismo , Análise e Desempenho de Tarefas , Recursos HumanosRESUMO
Objective To investigate the most suitable anaesthesia method for the tension-free herniorrhaphy.Methods A total of 422 unilateral inguinal hernia cases from 2002 to 2005 were collected and randomly divided into the local anaesthesia group and epidural anaesthesia group. Observation indices and some relative data, such as operative duration, date of ambulation, date of foodintake, length of hospital stay, operation-correlated complications, anaesthesia complications, usage rate of ancillary drug, satisfactory rate for anesthesia, cost of hospitalization, were included and recorded in the questionnaire, and all the patients who took the tension-free herniorrhaphy were asked to answer it as the follow-up research. Results It was found that the occurrence of postoperative anaesthetic complications, the cost of hospitalization, length of stay of local anaesthesia group were significantly less than those of epidural anaesthesia group, and the date of moving and the date of foodintake were also significantly earlier than those of the other group (P0.05). Conclusion The local anaesthesia is suitable for most of the tension-free herniorrhaphy, and it may be used as the conventional anaesthetic method.
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The countermeasures for the research and management of medical equipment in military hospital are discussed based on the characteristics of military hospital and the analysis of actual situation in medical support and clinical medical service, combining the characteristics and directions of medical equipment research. The viewpoint of objective is put forward including methods, technical objective, management and achievement evaluation of medical equipment research etc, which can provide reference to enhance the research of medical support and the scientific research management capability.