IRX1 ameliorates sepsis-induced acute kidney injury in mice by promoting CXCL14

Background Sepsis-induced acute kidney injury is a general critical complication having high relevance to kidney inflammation. In spite of advances in clinical and critical care, the specific and effective therapies for acute kidney injury are still insufficient. The present study aimed to investigate the protective effect of Iroquois homeobox genes (IRX) on sepsis-induced kidney dysfunction in mice. Methods In order to gain insight into sepsis-related actions in acute kidney injury, the cecal puncture-induced kidney injury animal model was established. The hematoxylin and eosin staining was used to measure the pathology of kidney tissues. The kidney function-related biomarkers, including neutrophil gelatinase-associated lipocalin, creatinine, kidney injury molecule-1, blood urea nitrogen, and inflammatory cytokines, which included tumor necrosis factor α, interleukin 1β (IL-1β), IL-6, and monocyte chemotactic protein 1, were detected by automated biochemical analyzer or their corresponding test kits. The protein expression was measured using Western blot analysis, and the apoptotic rate of kidney tissue was measured by terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Results The present study revealed the protective ability of IRX1 in sepsis-induced acute kidney injury. This study also determined the potential mechanism of IRX1 on sepsis-induced inflammatory response and cell apoptosis. Finally, it highlighted that IRX1 exerted a protective influence on CLP-induced acute kidney injury by suppressing the activation of chemokine (C-X-C motif) ligand 14 (CXCL14). Conclusion To conclude, the results suggest that overexpression of IRX1 could promote survival rate and suppress the CLP-induced apoptosis, inflammatory response, and kidney dysfunction through the activation of CXCL14. IRX1 and CXCL14 are essential to elucidate the mechanism of acute kidney injury. These findings may help to identify the promising targets for clinical sepsis therapy (AU)

The role of SBAR communication model combined with scenario simulation in clinical teaching of blood purification center / 中华医学教育探索杂志

Objective:To explore the effect of SBAR (situation, background, assessment, recommendation) communication model combined with scenario simulation in clinical teaching of blood purification center.Methods:Sixty interns in the blood purification center from March 2019 to March 2020 were collected in the study, and randomly divided into experimental group ( n=30) and control group ( n=30). The two groups of students studied in two different treatment groups in the blood purification center. The control group used the method of traditional teaching, while the experimental group used SBAR communication combined with situational simulation for teaching on the basis of traditional teaching, with a total clinical practice time of two months. All trainees underwent theoretical examination, clinical operation examination, self-efficacy evaluation and teaching satisfaction survey after training. SPSS 22.0 was performed for t test. Results:Through SBAR communication model combined with situational simulation teaching, the scores of theoretical examination [(88.13±3.22) vs. (85.51±3.17)], clinical operation assessment [(91.31±3.48) vs. (84.17±4.94)], self-efficacy evaluation [(11.13±1.08) vs. (9.21±1.89)], teaching satisfaction [(95.71±2.87) vs. (91.18±3.08)], and communication ability [(12.27±1.13) vs. (8.63±1.45)] in the experimental group were higher than those in the control group; while there was no significant difference in the scores of theoretical assessment between the two groups ( P<0.05). Conclusion:SBAR communication model combined with situational simulation teaching can improve the learning ability, operation ability and comprehensive application ability of special training trainees, especially in communication ability, which is worthy of popularization and application in clinical teaching.

Importance of standardization of Stark cesarean section——664 cases analysis / 中华围产医学杂志

Objective To investigate the process of Stark cesarean section (CS) and analyze its key procedures and patients outcomes in order to understand its advantages and promote its standardization. Methods Elective Stark CS cases were divided into two groups according to time sequence and procedure difference. Group A refered to cases underwent modified approaches before standardization (n=362), and group B refered to cases afterward (n= 302). Duration of operation, time interval from incision to delivery, intraoperative hemorrhage, postoperative flatus time, postoperative morbidity, duration of retained urinary catheter, urinary tract irritation, wound infection, and abdominopelvie adhesion in the second operation were compared between the two groups. Results The average duration of the operations and time interval from incision to delivery in group B, which were (27.7± 10. 8) min and (4.92±1.21) min, respectively, were significantly shorter than those in group A, which were (35.6±15.2) min and (7.81±2. 79) min, respectively (P<0. 05). No significant differences was found with regard to average intraoperative hemorrhage between group A and B [(214.34±62. 1) ml vs (201.54-53.1) ml, P>0.05]. Postoperative flatus time in group B was significantly shorter than that in group A [(16.85±11.8) h vs (25.9±12. 7) h, P<0. 05]. Postoperative morbidity in group B was significantly lower than that in group A [1.3%(4/302) vs 4.7%(17/362), P<0.05]. The average duration of retained urinary catheter in group B was significantly shorter than that in group A [(15.6±5.3)h vs (26. 2±6.1)h, P<0. 05], and the urinary tract irritation rate in group B was also lower than that in group A [2. 5%(9/362) vs 0(0/302), P < 0. 05)], No incisional infection or delayed healing was found in either group. Rectus muscles, fascia and peritoneum adhesions were found in three cases with second surgery in group A and none in group B. No omentum, peritoneum and visceral peritoneum adhesion was found in either group. Conclusions Compared to the modified Stark operation, standardized procedure decreases operation associated complications and improves maternal outcomes. Therefore, standardized Stark CS should be promoted for better operative outcomes.