RESUMO
Objective: To explore the latest clinical characteristics and development trends of posterior malleolus fracture. Methods: Clinical information of inpatients with posterior malleolus fracture in Shanghai Tongji Hospital and Karamay Central Hospital from January 2014 to December 2022 were reviewed and collected. The imaging data of patients were acquired using the Picture Archiving and Communication Systems. A statistical analysis was performed as to gender, current age, year of admission, injury mechanism, fracture type, and posterior malleolus fracture classification. Moreover, a comparative analysis was conducted on the injury mechanisms and morphological differences of posterior malleolus fracture at different periods, regions, and age groups. Results: A total of 472 patients (210 patients from Shanghai Tongji Hospital and 262 patients from Karamay Central Hospital) with posterior malleolus fracture with a mean age of (48.7±15.6) years were included in this study. The peak of posterior malleolus fracture occurs in the age group of 50-59 years. The injury mechanisms mainly involve low-energy fall and sprain (411 cases, 87.1%), followed by traffic accidents (52 cases, 11.0%), and fall injury from height (9 cases, 1.9%). The number of cases according to different fracture types showed the following descending order: trimalleolar fracture-supination extorsion (335 cases, 71.0%), bimalleolar fracture (60 cases, 12.7%), trimalleolar fracture-pronation extorsion (43 cases, 9.1%), posterior malleolus+tibial shaft fracture (19 cases, 4.0%), simple posterior malleolus fracture (15 cases, 3.2%). The numbers of cases corresponding to the Haraguchi â , â ¡ and â ¢ type of posterior malleolus fractures was 369 (78.2%), 49 (10.4%), and 54 (11.4%), respectively. The Tongji â ¡A type represented the highest number of cases (249 cases, 52.8%), followed by the â ¡B type (120 cases, 25.4%), â type (54 cases, 11.4%), â ¢B type (36 cases, 7.6%), and â ¢A type (13 cases, 2.8%). However, no obvious statistical difference was observed in the injury mechanism, Haraguchi classification, and Tongji classification of posterior malleolus fractures among different years and regions from the year of 2014 to 2022 (all P>0.05). Conclusions: The injury mechanism of posterior malleolus fracture mainly involves low-energy fall and sprain cases. The trimalleolar fracture-supination extorsion, Haraguchi â type and Tongji â ¡A type of posterior malleolus fracture are predilection fracture types, and all present an obvious incidence peak in the age group of 50-59 years. There has been no significant change in the development trend of clinical characteristics of posterior malleolus fractures in recent years.
Assuntos
Fraturas do Tornozelo , Traumatismos do Tornozelo , Entorses e Distensões , Adulto , Humanos , Pessoa de Meia-Idade , Fixação Interna de Fraturas , China/epidemiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Objective: To explore the relationship between the anatomic parameters of foramen ovale and intraluminal pressure during percutaneous balloon compression (PBC) in the treatment of primary trigeminal neuralgia. Methods: Twenty patients diagnosed with primary trigeminal neuralgia in the Department of Pain Medicine of the Third Xiangya Hospital, Central South University between November 2020 and April 2021 were enrolled. Three-dimensional (3D) high-resolution CT reconstruction of skull base was performed preoperatively to evaluate the parameters of foramen ovale. The intraluminal balloon pressure was continuously recorded during the PBC procedure. Correlation analysis was conducted between intraluminal pressure and foramen ovale parameters. Results: Eighteen patients had complete pain relief, 1 had obvious relief, and 1 had partial relief after PBC. The maximum cross-sectional length of the foramen ovale was (7.8±1.7) mm. The peak intraluminal pressure (PM) during PBC was (194±27) kPa. The intraluminal pressure was (164±28) kPa at initial compression (P0), and (135±20) kPa after compression for 120 seconds respectively. Correlation analysis showed that the P0 was positively and significantly correlated with the length of foramen ovale (r=0.56, P<0.05), but not with the width of foramen ovale (r=0.24, P>0.05), the area of foramen ovale (r=0.36, P>0.05) and the degree of balloon filling (r=-0.09, P>0.05). Similarly, P120 was significantly correlated with the length of foramen ovale (r=0.54, P<0.05). No significant correlation was observed between P120 and the width of the foramen ovale (r=0.18, P>0.05), the area of the foramen ovale (r=0.28, P>0.05) or the width of balloon filling (r=-0.13, P>0.05). Conclusions: The length of foramen ovale correlates with the intraluminal pressure during PBC procedure in trigeminal neuralgia patients. Parameters of foramen ovale obtained via preoperative high-resolution CT reconstruction of skull base may provide reference for predicting targeted intraluminal balloon pressure during PBC.
Assuntos
Oclusão com Balão , Forame Oval , Neuralgia do Trigêmeo , Estudos Transversais , Humanos , Tomografia Computadorizada por Raios X , Neuralgia do Trigêmeo/terapiaRESUMO
Objective: To evaluate the therapeutic effect and prognosis of preoperative transcatheter arterial chemoembolization (TACE), transcatheter arterial chemoembolization (TAIC), preoperative intravenous chemotherapy for children with advanced stage nephroblastoma. Methods: From January 2007 to December 2018, according to different treatment protocols before surgery, children with nephroblastoma were divided into 3 groups, which were TACE group (44 cases), TAIC group (7 cases) and intravenous chemotherapy group (9 cases) in Children's Hospital, Zhejiang University School of Medicine. The imaging examination, treatment safety and long-term efficacy of these three groups before and after treatment were compared. Observed indicators include tumor debulking rate, envelope integrity rate, necrosis rate, postoperative adverse reactions and follow-up. Results: Tumor debulking rate: tumor of TACE group decreased 46.5%, TAIC group shrinked 28.3%, and intravenous chemotherapy group reduced by 23.3%, the difference of tumor shrinkage between TACE group and intravenous chemotherapy group was statistically significant (P<0.05). Tumor necrosis rate: necrotic area in TACE group was about 46.0%-95.4%, average 75.1%±12.5%, while in intravenous chemotherapy group was 65.8%±8.7%, the difference was statistically significant (P<0.01). The tumor membrane integrity rate of these three groups were 86.4%(38/44),5/7 and 6/9 respectively, and difference between TACE group and intravenous chemotherapy group was significant (P<0.05). Patients who had myelosuppression each was 5 in TACE group (5/44), 4 in TAIC group (4/7), and 8 in intravenous chemotherapy group (8/9), and there were significant differences. Follow-up time and tumor-free survival rate in each group were respectively 20 to 92 months (median time 64 months) and 95% in TACE group, 12 to 69 months (median time 30 months) and 43.0% in TAIC group, and 16 to 72 months (median 28 months) and 56.0% in intravenous chemotherapy group. Conclusions: Preoperative TACE can lead to tumor shrinkage and necrosis more obviously, systemic adverse reactions are small, also the tumor complete resection rate is higher and the operation is safer.The survival rate can be effectively improved and more suitable for clinical treatment.
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Quimioembolização Terapêutica , Neoplasias Renais/terapia , Tumor de Wilms , Criança , Terapia Combinada , Humanos , Resultado do Tratamento , Tumor de Wilms/terapiaRESUMO
Whether callose deposition is the cause or result of ovule sterility in Medicago sativa remains controversial, because it is unclear when and where changes in callose deposition and dissolution occur during fertile and sterile embryo sac formation. Here, alfalfa spontaneous multi-pistil mutant (mp1) and wild-type plants were used to compare the dynamics of callose deposition during embryo sac formation using microscopy. The results showed that both mutant and wild-type plants experienced megasporogenesis and megagametogenesis, and there was no significant difference during megasporogenesis. In contrast to the wild-type plants, in which the mature embryo sac was observed after three continuous cycles of mitosis, functional megaspores of mutant plants developed abnormally after the second round of mitosis, leading to degeneration of synergid, central, and antipodal cells. Callose deposition in both mutant and wild-type plants was first observed in the walls of megasporocytes, and then in the megaspore tetrad walls. After meiosis, the callose wall began to degrade as the functional megaspore underwent mitosis, and almost no callose was observed in the mature embryo sac in wild-type plants. However, callose deposition was observed in mp1 plants around the synergid, and increased with the development of the embryo sac, and was mainly deposited at the micropylar end. Our results indicate that synergid, central, and antipodal cells, which are surrounded by callose, may degrade owing to lack of nutrition. Callose accumulation around the synergid and at the micropylar end may hinder signals required for the pollen tube to enter the embryo sac, leading to abortion.
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Flores/genética , Glucanos/biossíntese , Medicago sativa/genética , Sementes/crescimento & desenvolvimento , Gametogênese Vegetal/genética , Glucanos/genética , Medicago sativa/embriologia , Meiose/genética , Mitose/genética , Mutação , Óvulo Vegetal/genética , Óvulo Vegetal/crescimento & desenvolvimento , Tubo Polínico/genética , Tubo Polínico/crescimento & desenvolvimento , Sementes/genéticaRESUMO
The role of polygalacturonase (PG) in the development, ripening, and softening of fruit from two strawberry cultivars with different flesh firmness and softening characteristics was compared. Changes in PG activity and gene expression during development, ripening and softening were measured. The PG genes from each cultivar were cloned and analyzed, and were classified with other PG genes using phylogenetic analysis. In Toyonoka fruit, PG activity increased gradually, reaching a peak during the pink stage, and remained at this level during post-harvest softening. Changes in PG gene expression were consistent with PG activity in these softer fruits. In the firmer Sweet Charlie fruits, PG activity was detected during the initial development stage, reaching a peak at the white stage, thereafter decreasing gradually with ripening and remaining at this lower level throughout softening. Changes in PG gene expression and PG activity were not consistent in these fruit. For both Toyonoka and Sweet Charlie PG genes (FaTPG and FaSCPG, respectively), the open reading frame was 1218 bp, encoding 405 amino acids. Five different nucleotide sites were observed between the two sequences, leading to two amino acid sequence mutations. FaTPG, FaSCPG, and PG genes from the Fragaria vesca genome were classified into three clades using phylogenetic analysis. The clade containing PG genes involved in fruit softening had functional similarity but there were no functional differences between FaTPG and FaSCPG. Differences in PG activity, gene sequence, and gene expression may have led to different roles of PG during ripening and softening in strawberries with different textures.
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Fragaria/enzimologia , Frutas/embriologia , Poligalacturonase/metabolismo , Fragaria/genética , Fragaria/fisiologia , Frutas/genética , Frutas/fisiologia , Regulação da Expressão Gênica de Plantas/genéticaRESUMO
We investigated neovasculization effects of embolus-carried human vascular endothelial cell growth factor 165 (VEGF165)-encoded adenovirus (Ad) vector in the hindlimbs of rats with thromboangiitis obliterans (TAO). Rats were equally divided into blank control (I), TAO model (II), embolus (III), Ad-VEGF165 intravascular treatment (IV), Ad-VEGF165 intramuscular treatment (V), and embolus-carried Ad-VEGF165 (VI) groups. After interventional treatment, the neovasculization effect of the test gene was observed using immunohistochemistry. At 1 week after administration, compared with group II, groups V and VI had significantly increased microvessel densities, but no significant difference was observed between groups V and VI. At 2 weeks, groups V and VI exhibited significantly increased microvessel densities. At 1 week after administration, compared with group II, both groups V and VI showed a significant difference in the ratio between the α-smooth muscle actin count and the muscle fiber count, whereas no significant difference was observed between them. At 2 weeks, groups V and VI also exhibited significant differences in these ratios compared with the other groups. We conclude that Ad-VEGF165 promotes neovasculization in ischemic limbs. Embolus-carried Ad- VEGF165 had the most pronounced effect.
Assuntos
Terapia Genética , Neovascularização Patológica/genética , Tromboangiite Obliterante/genética , Fator A de Crescimento do Endotélio Vascular/genética , Adenoviridae/genética , Animais , Embolia/genética , Embolia/terapia , Células Endoteliais/patologia , Extremidades/patologia , Técnicas de Transferência de Genes , Humanos , Isquemia/genética , Isquemia/terapia , Ratos , Tromboangiite Obliterante/patologia , Tromboangiite Obliterante/terapia , Fator A de Crescimento do Endotélio Vascular/biossínteseRESUMO
This study assessed the clinical efficacy of lamivudine and adefovir dipivoxil combined with autologous bone marrow stem cell transplantation as treatment for patients with hepatitis B and decompensated liver cirrhosis. In total, 77 patients with hepatitis B and decompensated liver cirrhosis were randomly divided into two groups. Under general symptomatic and supportive treatment, the patients in group A (37 cases) were treated with lamivudine and adefovir dipivoxil, whereas those in group B (40 cases) were treated with autologous bone marrow stem cell transplantation in combination with lamivudine and adefovir dipivoxil. After 4 weeks of treatment, the liver function indicators and clinical signs and symptoms of the patients in group B improved more significantly than those of patients in group A. Lamivudine and adefovir dipivoxil in combination with autologous bone marrow stem cell transplantation effectively prevented hepatitis B virus infection and bone marrow stem cell damage. This combination treatment facilitates the differentiation of bone marrow stem cells into normal liver cells to restore liver structure and improve liver function, thereby improving the quality of life of patients.
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Adenina/análogos & derivados , Vírus da Hepatite B/efeitos dos fármacos , Lamivudina/uso terapêutico , Cirrose Hepática/tratamento farmacológico , Cirrose Hepática/virologia , Organofosfonatos/uso terapêutico , Transplante de Células-Tronco , Adenina/efeitos adversos , Adenina/farmacologia , Adenina/uso terapêutico , Colinesterases/metabolismo , Terapia Combinada , Feminino , Humanos , Lamivudina/efeitos adversos , Lamivudina/farmacologia , Cirrose Hepática/fisiopatologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Organofosfonatos/efeitos adversos , Organofosfonatos/farmacologia , Tempo de Protrombina , Transplante de Células-Tronco/efeitos adversos , alfa-Fetoproteínas/metabolismoRESUMO
Objective: To systematically evaluate and integrate the real experience of burn patients during rehabilitation, and to provide theoretical guidance for the continual nursing care for burn patients. Methods: The systematic evaluation method was adopted. Databases including the China National Knowledge Internet, Wanfang Database, China Biology Medicine disc were retrieved with the search terms in Chinese version of "/, //, ////", and PubMed, Embase, CINAHL, PsycINFO, Cochrane Library were retrieved with the search terms of "burn/burns, rehabilitation/recovery/survivor/survive, experience/views/perceptions/, qualitative/phenomenon/interview/grounded theory". The qualitative studies on the real experience of burn patients during rehabilitation published from the establishment of each database to June 2020 were searched. The quality of the included studies was evaluated according to the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The research country, research method, research object, research content, and main research result were summarized, and meta-synthesis of the research results was conducted with the aggregative integration method. Results: A total of 12 studies were included, and the quality of all the studies was grade B. The studies were conducted in 8 countries including Australia, Canada, Norway, etc., the research method mainly was phenomenological research method, and all the studies were focused on adult burn patients. A total of 46 specific themes were extracted with totally 10 new categories formed after summarization, and 3 integrated results were obtained as follows: burn patients suffered from both physical and psychological burdens, and their normal life was broken; burn patients gained post-traumatic growth and could actively adjust to cope with life difficulties; burn patients had multiple needs. Conclusions: Burn patients experience both physical and psychological pains during rehabilitation, so they long for multiple support from family and society. Medical staff, social groups, and family members should pay attention to the psychological experience and needs of burn patients with different characteristics during rehabilitation, and build a multi-directional social support system to help patients return to the society and rebuild their lives.
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Adaptação Psicológica , Queimaduras , Adulto , Austrália , China , Humanos , Pesquisa QualitativaRESUMO
Exotic species especially Asteraceae plants severely invade wetlands in Shenzhen Bay, an important part of the coast wetland in Guangdong-Hong Kong-Macau Bay Area, China. However, the reasons causing their expansion are unclear. The leaf traits and expansion indices of six invasive Asteraceae plants from the Overseas Chinese Town (OCT) wetland were studied and the results showed that nearly 45% of the total plant species (31 out of 69 species) in the OCT wetland, belonging to 15 families and 27 genera, were exotic invasive species. The expansion indices of six Asteraceae species negatively correlated with their leaf construction cost based on mass (CCM), caloric values and carbon concentration, but their relations with ash content were positive. Multiple linear regression analysis revealed that CCM was the most important factor affecting the expansion of an exotic species, indicating CCM may be an important reason causing the expansion of exotic species in coastal wetlands.
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Asteraceae , Áreas Alagadas , China , Hong Kong , Humanos , Macau , Folhas de PlantaRESUMO
OBJECTIVE: The aim of this study was to investigate whether microRNA-625-3p participated in the malignant progression of gastric cancer and inhibited GCa metastasis by regulating EZH2 (Enhancer of zeste homolog 2). PATIENTS AND METHODS: Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was performed to examine the expression of microRNA-625-3p in 36 pairs of GCa tissues and para-cancerous tissues. The interplay between microRNA-625-3p level and clinical indexes or prognosis of GCa patients was analyzed. MicroRNA-625-3p mimics and inhibitors, as well as their negative controls, were transfected into GCa cell lines to establish microRNA-625-3p overexpression and down-regulation models in vitro, respectively. QRT-PCR was applied to further verify the transfection efficiency. Cell counting kit-8 (CCK-8), colony formation, and transwell assays were performed to analyze the impact of microRNA-625-3p on the proliferative and invasiveness abilities of GCa AGS and SGC-7901 cells. Finally, the regulatory mechanism of microRNA-625-3p on the downstream gene EZH2 was explored by cell reverse experiment. RESULTS: QRT-PCR results revealed that microRNA-625-3p expression level in GCa tissues was remarkably lower than that of adjacent tissues, and the difference was statistically significant (p<0.05). Compared with patients with high expression of microRNA-625-3p, the incidence of lymph node or distant metastasis was significantly higher in patients with low expression of miR-625-3p, whereas the overall survival rate was lower (p<0.05). Compared with GCa cells in NC inhibitor group, the proliferative ability and invasiveness of cells in microRNA-625-3p inhibitor group were remarkably promoted (p<0.05). However, the opposite results were observed in microRNA-625-3p mimics group. Our findings further demonstrated that the expression of EZH2 increased remarkably in GCa cell lines and tissues (p<0.05). Meanwhile, its expression level was negatively correlated with microRNA-625-3p level. Cell reverse experiment showed that EZH2 could offset the influence of microRNA-625-3p on the proliferation and metastasis GCa cells, thereby affecting the malignant progression of GCa. CONCLUSIONS: MicroRNA-625-3p was remarkably correlated with lymph node or distant metastasis and poor prognosis of GCa patients. In addition, microRNA-625-3p might inhibit the malignant progression of GCa via modulating EZH2.
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Proteína Potenciadora do Homólogo 2 de Zeste/biossíntese , MicroRNAs/biossíntese , Neoplasias Gástricas/metabolismo , Idoso , Linhagem Celular Tumoral , Proteína Potenciadora do Homólogo 2 de Zeste/antagonistas & inibidores , Proteína Potenciadora do Homólogo 2 de Zeste/genética , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , MicroRNAs/genética , Pessoa de Meia-Idade , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologiaRESUMO
Laguncularia racemosa and Sonneratia apetala are fast-growing exotic mangrove species in Southern China and widely used for afforestation. However, the invasiveness of the two exotic species is still unclear. We compared structural and physiological traits and energy-use related traits between L. racemosa and S. apetala, and with two natives (Kandelia obovata and Aegiceras corniculatum) in northern Fujian. Results showed that leaf construction cost based on mass (CCM) and caloric values of L. racemosa were significantly lower than S. apetala, and the two natives had highest CCM. Because lower CCM, L. racemosa grew faster with a taller height (4.83 m) and wider ground diameter circumference (40.03 cm) than S. apetala (4.43 m tall and 35.63 cm wide) and the two natives (2.42 m tall and 26.78 cm wide). These findings indicated that L. racemosa could be more invasive than S. apetala in mangrove forests in northern Fujian, China where it still grew well, which deserves more attention.
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Combretaceae , Rhizophoraceae , China , Florestas , Folhas de PlantaRESUMO
OBJECTIVE: Pancreatic cancer (PC) possesses a very poor prognosis, and its pathogenesis is not fully understood. Evidence has suggested that microRNAs play important roles in cancer development and progression, the present study was designed to study the function of miR-1271 in PC. PATIENTS AND METHODS: PC tissues and adjacent normal tissues were collected from 17 patients. MiR-1271 and PDK1 expression were quantified by quantitative reverse-transcriptional polymerase chain reaction (RT-PCR). AKT/MTOR signaling activity and PDK1 protein expression were determined by Western blot. Cell viability and apoptosis were assessed by MTT assay and enzyme-linked immunosorbent assay (ELISA). Luciferase assay was used to verify whether miR-1271 directly targets PDK1. RESULTS: MiR-1271 was significantly down-regulated in PC tissues compared with that in the paired normal adjacent tissue, and its expression was up-regulated dose-dependently upon cisplatin treatment in PC cells. Overexpression of miR-1271 in these cells produced a pro-apoptotic effect, similar to what caused by cisplatin treatment. Moreover, overexpression of miR-1271 inhibited AKT/MTOR signaling, which was due to the targeting relationship between miR-1271 and PDK1. Finally, knockdown of PDK1 exerted a similar effect on apoptosis to that of miR-1271 overexpression. CONCLUSIONS: MiR-1271 is a potent tumor suppressor in PC, its pro-apoptotic function was partially mediated by reduced AKT/MTOR signaling. Targeting miR-1271 may represent an effective strategy for PC treatment.
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MicroRNAs/genética , Neoplasias Pancreáticas/patologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Serina-Treonina Quinases TOR/metabolismo , Apoptose/genética , Linhagem Celular Tumoral , Proliferação de Células , Sobrevivência Celular/genética , Regulação para Baixo , Técnicas de Silenciamento de Genes , Humanos , Neoplasias Pancreáticas/genética , Prognóstico , Proteínas Serina-Treonina Quinases/genética , Piruvato Desidrogenase Quinase de Transferência de Acetil , Transdução de Sinais/genética , Regulação para CimaRESUMO
Introduction Shivering is one of the most frequent complications of operation during the postanaesthesia period. Ondansetron has been proved to be valid in preventing postanaesthesia shivering (PAS) in several studies. However, its efficiency and safety are still disputable. We therefore performed an updated meta-analysis of randomised controlled trials (RCTs) for evaluation and to clarify this issue. Methods A literature search using the PubMed, Embase™ and Cochrane Library databases was performed (from inception to January 2015). RCTs that evaluated the efficiency and safety of ondansetron in the prevention of PAS were included in the meta-analysis. The primary outcome measure was incidence of PAS, and secondary outcomes included subgroup analysis and the side effects of ondansetron. Results A total of 8 RCTs containing 905 subjects were identified as suitable for this review. Compared with placebo, ondansetron was associated with a significant reduction of PAS (relative risk [RR]: 0.33, 95% confidence interval [CI]: 0.19-0.58, p=0.0001) while no difference was detected between ondansetron and pethidine (RR: 0.89, 95% CI: 0.41-1.94, p=0.78). There was no significant difference between ondansetron and placebo or pethidine in terms of risk of bradycardia but ondansetron was associated with a lower risk of hypotension (RR: 0.26, 95% CI: 0.08-0.79, p=0.020) than placebo. There was no difference in hypotension when ondansetron was compared with pethidine. Conclusions Ondansetron can prevent PAS effectively and reduce the risk of hypotension.
Assuntos
Período de Recuperação da Anestesia , Ondansetron/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Antagonistas da Serotonina/uso terapêutico , Estremecimento , Humanos , Hipotensão/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
OBJECTIVE: In order to understand the current management status on education/training and needs for training among new employees working at the provincial CDC in China during 2012-2014, so as to provide basis for setting up related programs at the CDC levels. METHODS: Based on data gathered through questionnaire surveys run by CDCs from 32 provincial and 5 specifically-designated cities, microsoft excel was used to analyze the current status on management of education and training, for new employees. RESULTS: There were 156 management staff members working on education and training programs in 36 CDCs, with 70% of them having received intermediate or higher levels of education. Large differences were seen on equipment of training hardware in different regions. There were 1 214 teaching staff with 66 percent in the fields or related professional areas on public health, in 2014. 5084 new employees conducted pre/post training programs, from 2012 to 2014 with funding as 750 thousand RMB Yuan. 99.5% of the new employees expressed the needs for further training while. 74% of the new staff members expecting a 2-5 day training program to be implemented. 79% of the new staff members claimed that practice as the most appropriate method for training. CONCLUSIONS: Institutional programs set for education and training at the CDCs need to be clarified, with management team organized. It is important to provide more financial support on both hardware, software and human resources related to training programs which are set for new stuff members at all levels of CDCs.
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Saúde Pública , China , Órgãos Governamentais , Humanos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Our previous work has shown that preconditioning can promote the recovery of cardiac function in patients having an open heart procedure. Because preconditioning is regarded as the most powerful form of endogenous myocardial protection, we tested the hypothesis that preconditioning protects against myocardial ischemia-reperfusion injury in patients undergoing prolonged cold crystalloid cardioplegic arrest. METHODS: Thirty patients who had rheumatic heart disease and required both aortic and mitral valve replacement were studied. Patients were randomly divided into two equal groups. Preconditioning was accomplished using two cycles of 2-minute occlusion of the vena cava and aorta followed by 3 minutes of reperfusion under cardiopulmonary bypass. All hearts were arrested with 4 degrees C St. Thomas' Hospital cardioplegic solution. Myocardial protective effects were assessed by changes in myocardial levels of adenosine triphosphate, electrocardiographic activity, leakage of myocardial enzymes, and myocardial contractility. RESULTS: The adenosine triphosphate content in ischemic myocardium was higher in the preconditioning group than in the control group (p < 0.05 90 minutes after ischemia), and there was a significant reduction in release of the myocardial-specific isoenzyme of creatine kinase in the preconditioning group. Preconditioning improved the recovery of myocardial contractility (first derivative of left ventricular developed pressure, 1,490 +/- 102 mm Hg/s versus 1,250 +/- 97 mm Hg/s 30 minutes after reperfusion; p < 0.05), and there was also a protective effect on electrocardiographic activity. CONCLUSIONS: Our results suggest that ischemic preconditioning protects the myocardium in humans from the severe ischemia-reperfusion injury produced after prolonged arrest with cold crystalloid cardioplegia.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Valvas Cardíacas/cirurgia , Precondicionamento Isquêmico Miocárdico , Trifosfato de Adenosina/análise , Adulto , Creatina Quinase/metabolismo , Eletrocardiografia , Feminino , Parada Cardíaca Induzida , Implante de Prótese de Valva Cardíaca , Humanos , Isoenzimas , Masculino , Contração Miocárdica , Reperfusão Miocárdica , Miocárdio/metabolismo , Pressão VentricularRESUMO
AIM: To identify hepatitis C virus(HCV) core protein epitopes recognized by HLA-A2 restricted cytotoxic T lymphocyte (CTL). METHODS: Utilizing the method of computer prediction followed by a 4h(51)Cr release assay confirmation. RESULTS: The results showed that peripheral blood mononuclear cells (PBMC) obtained from two HLA-A2 positive donors who were infected with HCV could lyse autologous target cells labeled with peptide "ALAHGVRAL (core 150-158)". The rates of specific lysis of the cells from the two donors were 37.5% and 15.8%, respectively. Blocking of the CTL response with anti-CD4 mAb caused no significant decrease of the specific lysis. But blocking of CTL response with anti-CD8 mAb could abolish the lysis. CONCLUSION: The peptide (core 150-158) is the candidate epitope recognized by HLAA2 restricted CTL.
Assuntos
Antígeno HLA-A2/genética , Hepatite C/imunologia , Linfócitos T Citotóxicos/imunologia , Proteínas do Core Viral/genética , Sequência de Aminoácidos , Anticorpos Antivirais/imunologia , Linfócitos B/citologia , Linhagem Celular , Mapeamento de Epitopos , Antígeno HLA-A2/imunologia , Hepacivirus/imunologia , Humanos , Fragmentos de Peptídeos/imunologia , Fragmentos de Peptídeos/farmacologia , Valor Preditivo dos Testes , Linfócitos T Citotóxicos/virologia , Proteínas do Core Viral/imunologiaRESUMO
UNLABELLED: T-lymphocyte subsets of peripheral blood were examined by flow cytometry (FCM) in 20 cases of unexplained habitual abortion (UHA) before and after active immunization treatment, with 10 normal pregnant (NP) women and 20 normal nonpregnant (NNp) women as control. THE RESULTS: there was no difference in the percentage of CD3 cells between the UHA cases and NNP. Before immunization the percentage of CD8 cells was significantly lower (P < 0.001) and the ratio of CD4/CD8 was increased (P < 0.05) in UHA as compared with the NNP. However, after immunization, the percentage of CD8 cells greatly increased (P < 0.05) and CD4/CD8 ratio decreased significantly (P < 0.05) nearly to that of NP. These findings suggest that: (1) the increase of CD4/CD8 ratio due to the decreasing CD8 cells is the underlying immunomechanism of UHA; (2) immunization may induce the proliferation of CD8 cells and the lowering of CD4/CD8 ratio. Therefore, CD8 cells might play an important role in maintaining the balance of fetal-maternal immunological relationship; (3) the ratio of CD4/CD8 may served as parameter for observing the clinical efficacy of immunization therapy.
Assuntos
Aborto Habitual/imunologia , Imunoterapia Ativa , Subpopulações de Linfócitos T/imunologia , Aborto Habitual/terapia , Adulto , Relação CD4-CD8 , Feminino , Citometria de Fluxo , Humanos , GravidezRESUMO
31 cases of traumatic diaphragmatic injury were treated in our department from Jan. 1977 to Jan. 1986. Among them, 18 were caused by blunt trauma and 13 by penetrated wound. 17 of the cases accompanied with diaphragmatic hernia. 80% of the cases (25/31) were complicated trauma. As a result, 28 of them recovered with only 3 died. The authors described the mechanism and characteristics of diaphragmatic trauma as well as its diagnosis and treatment.
Assuntos
Diafragma/lesões , Hérnia Diafragmática Traumática/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Diafragma/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
AIMS: Periostin (POSTN) is implicated in cancer development and progression. The aim of this study was to evaluate the diagnostic and prognostic significance of serum POSTN in patients with hepatocellular carcinoma (HCC) receiving curative surgery. METHODS: Enzyme-linked immunosorbent assay was performed to determine serum POSTN levels in 69 healthy volunteers, 30 patients with hepatolithiasis, 27 patients with cirrhosis, and 56 HCC patients. The relationships between serum POSTN and clinicopathologic features were analyzed. Receiver operating characteristics analysis was used to calculate diagnostic accuracy of serum POSTN, serum alpha-fetoprotein (AFP), and their combination. The prognostic impact of serum POSTN on overall survival (OS) and relapse-free survival (RFS) was also investigated. RESULTS: The median serum POSTN level was significantly (P < 0.05) increased in HCC patients, compared to healthy controls, patients with hepatolithiasis, and patients with liver cirrhosis. Elevated serum POSTN was only significantly associated with Edmondson grade (P = 0.007). The combination of serum POSTN and AFP had a markedly higher area under the curve (0.805 (95% confidence interval [CI]: 0.677-0.932)) than POSTN (0.582 (95% CI: 0.427-0.736)) or AFP (0.655 (95% CI: 0.504-0.806)) alone. Kaplan-Meier analysis indicated that elevated serum POSTN was associated with OS (P = 0.031) and RFS (P = 0.027). Moreover, multivariate analysis revealed elevated serum POSTN as an independent poor prognostic marker for OS and RFS. CONCLUSIONS: Preoperative serum POSTN has limited diagnostic value in distinguishing HCC from non-malignant liver diseases, but serves as independent prognostic biomarker in HCC patients.