Objective To systemically analyze the effect of continuous aspiration of subglottic suction (CASS) on the incidence of ventilator-associated pneumonia (VAP) and other outcomes in mechanical ventilated patients.Methods PubMed,Cochrane Library,Ovid,EBSCOhost,ScienceDirect,Google scholar,CNKI,CBM and Wanfang Database were searched for the RCTs about the effect of CASS on the outcomes of mechanical ventilated patients from July 1994 to July 2014,and the relevant journals were also hand-searched.Data were extracted independently by two reviewers.Meta analysis was conducted using RevMan 5.1 software.Results Data extracted from 7 RCTs with a total of 1 566 patients were analyzed.The risks of developing clinically diagnosed VAP were significantly lower among the patients receiving CASS [RR =0.54,95％ CI(0.43,0.65),P＜0.01],episodes of VAP occurred later in patients receiving CASS [MD=3.52,95％CI(1.98,5.06),P＜0.01],the duration of mechanical ventilation [MD=-2.03,95％CI(-2.23,-1.73),P＜0.01]and length of ICU stay were reduced [MD=-2.99,95％CI(-3.75,-2.23),P＜0.01],while no significant differences were detected between the two groups regarding the mortality rate [RR=0.98,95％CI (0.80,1.20),P＞0.05].Conclusion This study proved that the CASS did have effect in reducing the incidence of VAP,but it is limited by lack of enough RCTs with high quality.Large sample of high quality RCTs is necessary to examine the wider applicability of CASS.

Objective To describe the burden of caregivers of children with asthma,and to provide reference for the development of family care support program.Methods Qualitative research was used to carry out semi-structured interviews with 13 caregivers of children with asthma in the pediatric outpatient of the First Affiliated Hospital of Guangzhou Medical University.The data collected were analyzed with Colaizzi 7-step analysis method.Results The carcgiver burden was classified into 4 themes,including time and energy exhaustion,heavy economic burden,insufficient knowledge of care and negative emotions.Conclusions The burden of caregivers of children with asthma has a relatively great impact on the daily work and life,even the physical and mental health.Care workers should be concerned about the status of caregiver burden and provide targeted interventions,which could help caregiver adapt to their roles,maintain and promote the health of children patients and their families.

Objective To investigate the chromosomal and subcellular localization of DOC-1R terminal 1(DCT1),and detect its expression in human tissues.Methods Chromosome localization of DCT1 was detected by radiation hybrid.pEGFP-DCT1 was constructed,and HeLa cells were transfected with the plasmid.The subcellular localization of DCT1 protein was observed by fluorescence microscope.Real-time PCR was performed for the determination of DCT1 expression level in 16 kinds of human tissues.Results DCT1 was demonstrated to localize in 5q31,and its encoding protein was detected on the nuclear membrane.Additionally,DCT1 was proved to express universally in all the 16 kinds of human tissues and it was expressed at the highest level in spleen.Conclusion DCT1 might be a regulator in cell cycle,and ubiquitously express in human tissues.

Objective To investigate the influence of EBV infection on the expression of tumor suppressor gene p53. Methods EBER1 in 217 cases of gastric carcinoma were detected with in situ hybridization. Then, EBV positive and negative cases were selected for analysis of the expression of p53 by immunohistochemistry. Results In 217 cases of gastric carcinoma, there were 23 cases with EBER1 positive. The average area (AA), mean absorbency and integral absorbency of p53 expression were higher in EBV positive gastric carcinoma than those in EBV negative. Conclusions EBV infection of gastric carcinoma is closely related to the expression of p53 in this study.

In recent years,the prevalence of diabetes is increasing year by year with the improvement of people's living standard.The traditional oral anti-hyperglycemic drugs as well as insulin injection therapy can not block the progress of the disease course.The deterioration of glycaemic control results in various acute and chronic complications which seriously affect patients' health and bring huge economic burden.The researchers have been seeking new therapeutic regimens to improve or even reverse diabetes process.This paper focuses on the following novel treatment options such as GLP-1 receptor agonist,DPP4 inhibitors, fixed-dose combination,SGLT2 inhibitors,amylin analogues,dopamine receptor agonist,bile acid sequestrant,bariatric surgery and pancreatic stem cell transplantation.

The melanoma antigen (MAGE) family proteins are well known as tumor-specific antigens and comprise more than 60 genes, which share a conserved MAGE homology domain (MHD). Type I MAGEs are highly expressed cancer antigens, and they play an important role in tumorigenesis and cancer cell survival. Recently, several MAGE proteins were identified to interact with RING domain proteins, including a sub-family of E3 ubiquitin ligases. The binding mode between MAGEs and RING proteins was investigated and one important structure of these MAGE-RING complexes was solved: the MAGE-G1-NSE1 complex. Structural and biochemical studies indicated that MAGE proteins could adjust the E3 ubiquitin ligase activity of its cognate RING partner both in vitro and in vivo. However, the underlying mechanism was not fully understood. Here, we review these exciting advances in the studies on MAGE family, suggest potential mechanisms by which MAGEs activate the E3 activity of their binding RING proteins and highlight the anticancer potential of this family proteins.
Animals ; Humans ; Melanoma-Specific Antigens ; chemistry ; metabolism ; Protein Binding ; Protein Structure, Tertiary

Objective To investigate the incidence and the risk factors for hospital-acquired pneumonia(HAP)in the elderly in Shanghai.Methods This was a muhicenter prospective clinical cohort study.A total of 5299 patients more than 65 years old.admitted into 31 secondary or tertiary hospitals in Shanghai,were enrolled.Measurements of the demographic and potential risk factors reflecting illness severity,nutrition,drug exposure,surgery and ventilation were performed.Pneumonia was classified by the definition of Chinese Medical Association.Risk factors were analyzed by univariate Pearson Chi-squared test and multivariable logistic regression analysis with backward(Likelihood ratio).Resuits Of the enrolled patients,2805 male and 2494 female,255(4.81%)developed hospital-acquired pneumonia.The incidence was 46.75/1000 hospitalizations.Among them 38 died:and the rough mortality was 14.90%.The incidence of HAP was higher in ICU(21.43%),hematology(12.17%),chest surgery(11.41%),and respiratory medicine(7.92%)departments.The mean of acute physiology and chronic health evaluation (APACHE Ⅱ)score was 8.3±3.4(5-31).Multivariable logistic regression analysis with backward (Wald)method found that admission into secondary hospitals.admission into ICU,history of chronic obstructive pulmonary disease≥10 years,immunosuppression,administration of antibiotics,insertion of nasogastric tube,mechanical ventilation,administration of H-2 antagonists or antacid and≤7 d,central nervous system diseases,depressed level of consciousness,supine position,albumin＜35g/L were independent risk factors of HAP in the elderly.Conclusion Hospital-acquired pneumonia in the elderly was the usual type of nosocomial infections.The risk factors identified from this study may prove useful to target future clinical interventions to prevent HAP in the elderly.

OBJECTIVETo study the effect of Panax notoginseng saponins (PNS) on expression of alpha-aecretase mRNA in the brains of senescence-accelerated SAMP8 mice.

METHODSAMP8 mice were randomly divided into the control group, the PNS high-dosage group (200 mg x kg(-1)), the PNS low-dosage group (100 mg x kg(-1)) and the huperzine A group (0.3 mg x kg(-1)), with eight mice in each group. The control group and each administration group were orally administered with the same volume of double distilled water once for consecutively two months. The expression of alpha-secretase (ADAM 9, ADAM10, ADAM17) mRNA was assayed by real-time fluorescence quantitative polymerase chain reaction (Real-time PCR).

RESULTThe expression of ADAM9 mRNA in PNS high-dosage group and huperzine A group were significantly higher than that of the control group (P < 0.05). The expression of ADAM10 in the PNS high-dosage group, the PNS low-dosage group and the huperzine A group showed no significant difference from the control group.

CONCLUSIONPNS can up-regulate expressions of ADAM9 mRNA and down-regulate expressions of ADAM10 mRNA in the brains of SAMP8 mice.

ADAM Proteins ; genetics ; ADAM10 Protein ; Alzheimer Disease ; drug therapy ; metabolism ; Amyloid Precursor Protein Secretases ; genetics ; Animals ; Disease Models, Animal ; Gene Expression Regulation, Enzymologic ; drug effects ; Membrane Proteins ; genetics ; Mice ; Panax notoginseng ; RNA, Messenger ; analysis ; Saponins ; pharmacology

OBJECTIVE: To introduce peratrial device closure of secundum atrial septal defects (ASD) under the guidance of transesophageal echocardiography (TEE) without cardiopulmonary bypass (CPB) in children, and to summarize the clinical experiences. METHODS: A total of 115 children with secundum ASD (the occlusion group) underwent peratrial device closure of atrial septal defects through a small sternotomy under TEE guidance without cardiopulmonary bypass. Children were followed up closely for 1-13 months. Another 59 children (the bypass group) had closed atrial septal defects under cardiopulmonary bypass during the same period. The differences in the operation duration, convalescence and complication between the 2 groups were compared. RESULTS: Except 1 patient was operated under the CPB, the rest 114 patients in the occlusion group were successfully closed by the occluders. The duration of the operation, mechanical ventilation, intensive care and hospitalization, and the rate of blood-transfusion in the occlusion group were significantly lower than those in the bypass group (P<0.01), with no difference in complications in the 2 groups (P>0.05). CONCLUSION Minimally invasive peratrial device closure of ASD without CPB is a relatively simple, safe and effective operation under the guidance of TEE for children. The short and mid-term clinical outcomes are promising. Long-term follow-up is indispensable.
Child ; Child, Preschool ; Echocardiography, Transesophageal ; methods ; Female ; Follow-Up Studies ; Heart Septal Defects, Atrial ; diagnostic imaging ; surgery ; Humans ; Infant ; Male ; Minimally Invasive Surgical Procedures ; methods ; Septal Occluder Device ; Ultrasonography, Interventional