Objective To investigate the cytotoxic effects of IL-2 combined with different dosages of sorafenib on renal cellular carcinoma cell line 786-0. Methods Renal carcinoma cell 786-0 was cultured. Then , IL-2 (20 μmol/L) combined with different dosages of sorafenib (6.9, 13.8, 20.8 μmol/L) were used to treat tumor cell 786-0. The inhibitory effect on cell proliferation was determined by MTT assay. Cell apoptosis was measured by Annexin V-FITC kit. The tumor-bearing mice models were established and divided into four groups. Results The tumor cell growth was inhibited with the time-course correlation in all groups. In the 48-hour high doses group, the inhibitory rate was up to (74.67±1.87) %. The rates of cell proliferation inhibition and cell apoptosis were higher in the high dosages group than those in the other groups. Conclusions Immunotherapy combined with target therapy could significantly inhibit the growth of renal cellular carcinoma. But we should find a proper dosage, which could improve the clinical effect and reduce the adverse effect.

OBJECTIVETo analyze the reason and treatment of the complications of 61 cases of extracorporeal membrane oxygenation (ECMO) in order to improve survival rate of ECMO treatment.

METHODSECMO records from January 2007 to December 2014 in Shanghai Chest Hospital were investigated retrospectively focusing on complications. There were included 43 male and 18 female patients, age 3 to 66 years. Indications for ECMO included post-operative low cardiac output, viral myocarditis, bridge to heart transplantation, acute respiratory distress syndrome and myocardial infarction. There were 49 cases of veno-arterial ECMO and 12 cases of veno-venous ECMO.

RESULTSECMO duration was 2 to 61 days. Among 43 patients, 37 patients weaned from ECMO successfully and 28 survived to discharge. Various complications occurred to 56 patients, including oxygenator plasma leakage(4 case times), circuit emboli (7), hemolysis (4), bleeding (34), infection (8), acute kidney injury (35), lower limb ischemia (8) and neurologic complications (6). There were 49 cases times of complications in survivors, while 61 cases times in death group. Bleeding (10 time cases) and acute kidney injury (33 time cases) happened in the death group. Progresses in ECMO technique had influences on complications in some parts. For instance, incidence of lower limb ischemia was 6/7 in cutdown cannulating group, but reduced to 2/42(4.8%) when semi-open technique was applied.

CONCLUSIONSComplications in ECMO are relative to patients' outcome intimately. Appropriate prevention and treatment of complication play a major role in the success of ECMO support. The incidences of certain complications reduce significantly due to progresses of equipment and medical experiences.

Acute Disease ; Acute Kidney Injury ; etiology ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; Extracorporeal Membrane Oxygenation ; adverse effects ; Female ; Heart Transplantation ; Hemorrhage ; etiology ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; Myocarditis ; virology ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective: To explore the influence of comprehensive sexuality education (CSE) course based on International Technical Guidance onthe sexual psychological health of middle school students during puberty, and to provide a reference for mental health promotion. Methods: This study used Adolescent Sexual Psychological Health Questionnaire as measuring tool and self-made textbook on sexuality education entitled Love and Life: Junior High School Students’ Sexual Health Education Textbook as intervention. Measurements were set before and after the first semester together with the end of the second semester, respectively were pretest, intermediate test and posttest. Results: The sexual psychological health of middle school students was in the medium level, and girls(3.51±0.40) were generally better than boys(3.44±0.37)(t=3.62, P<0.05). According to one-way analysis of variance, the main effect of three dimensions of sexual health-sexual cognition(3.31±0.81, 3.68±0.80, 4.37±0.61), sexual values(3.43±0.51, 3.55±0.54, 3.85±0.58) and sexual adaptation(3.63±0.41, 3.85±0.49, 4.09±0.58) and the total score(3.51±0.39, 3.74±0.46, 4.10±0.47) before, during and after the acceptance of comprehensive sexuality education was significant(F=252.18, 281.68, 113.54, 114.60, P<0.05). Conclusion Comprehensive sexuality education course has a significant effect on improving sexual psychological health among junior high school students.

Objective:To explore the relationship between workplace procrastination and illegitimate tasks in-kindergarten teachersand the role of work disengagement and coworker support in their relationship.Methods:A to-tal of 245 kindergarten teachers were selected from 3 cities in Zhejiang Province.They were assessed with the Workplace Procrastination Scale(WPS),Bern Illegitimate Tasks Scale(BITS),Work Disengagement Scale(WDS),Colleague Support Scale(CSS).The models were tested by using Process macro for SPSS,and non-para-metric percentile bootstrap method was used to analyze the mediating effect and moderating effect.Results:There were significant differences in the total scores of workplace procrastination among kindergarten teachers in different marital status,age,teaching age,education level,teaching gradeand kindergarten level(Ps＜0.05).Work disengage-ment played a significant mediating role between workplace procrastination and illegitimate tasks(indirect effect=0.26,95％CI:0.16-0.37).Coworker support played a significant moderating role in the impact of illegitimate tasks on work disengagement(simple slope=0.72,0.39;P＜0.001).Conclusion:It suggests that workplace pro-crastination is related to illegitimate tasksin kindergarten teachers.Work disengagement plays a mediating role in their relationship,and coworker support plays a moderating role in the first half of this mediating role.

Objective To establish the time-resolved fluoroimmunoassay(TRFIA)of CA199 based on Mag-netic Microspheres(Nano-TRFIA).Methods Based on a sandwich-type immunoassay format,analytes in sam-ples were captured by magnetic particles coated with anti-CA199 antibody B1 and"sandwiched"by anti-CA199 antibody B7 labeled with europium chelates.A total of 90 serum samples were analysed by this new method. Results The sensitivity was 0.2 U/mL,the intra.and inter.assay CV of the Nano-TRFIA were 4.84% and 8.32% respectively,and the average recovery rate was 97.91%.The cross-reacting rates with alpha fetopro-tein and CA125 were negligible.The labeled B1 with Magnetic Microspheres was at least stable for three months at 4 ℃.Serum samples from patients and healthy blood donors were analyzed,the linear correlation of TRFIA and ECLIA measurements was positive(Y = 0.969 8X+ 4.015 3).As the gold standard of ECLIA, Nano-TRFIA had two false positive.Conclusion The newly developed Nano-TRFIA based on Magnetic Mi-crospheres technique was highly sensitive,stable and specific in the immuno-determination of serum CA199. The results showed that the methods of Nano-TRFIA based on Magnetic Microspheres could be used for the clinic.

Objective:To examine the blood protective effect of autologous platelet-rich plasma separation for cardiac valve replacement under cardiopulmonary bypass.Methods:Sixty patients who underwent cardiac valve replacement under cardiopulmonary bypass from August 2018 to May 2019 in Shanghai Chest Hospital, Shanghai Jiao Tong University were randomly divided into control and treatment groups(each 30 cases). There were 33 males and 27 females, aged (52.0±8.4) years (range: 35 to 65 years). Autologous platelet separation was performed in the treatment group after anaesthesia administration and was completed before systemic heparinisation. Platelet separation was not performed in the control group. The thromboelastogram, blood routine, blood coagulation, perioperative fluid infusion, allogeneic blood transfusion, postoperative pleural fluid volume and postoperative fibrinogen were recorded before the operation, and 1 hour and 24 hours post operation. The two groups′ data was compared by t test, Kruskal-Wallis test, Mann-Whitney U test or χ 2 test. Repeated measurement analysis of variance was used to compare platelet and coagulation indexes at different times. Results:The perioperative red blood cell transfusion of 0, 1~2, 3~4,>4 units with 6, 11, 1, 12 cases in treatment group and 14, 8, 6, 2 cases in control group ( Z=-2.516, P=0.012). The postoperative fibrinogen of 0, 1, 2 units with 19, 2, 9 cases in treat group and 26, 2, 2 cases in control group ( Z=-2.190, P=0.029). There was no significant difference in the cost of blood transfusion between the two groups during admission ((1 732±1 275) yuan vs. (1 176±941) yuan; t=-1.570, P=0.125). Conclusion:The use of autologous platelet-rich plasma separation can reduce the amount of allogeneic blood transfusion during valvular surgery under cardiopulmonary bypass.

Objective:To investigate the clinical effect of homemade adjustable mirabilite vest in patients with severe acute pancreatitis and supply reference for clinical nursing.Methods:This was a randomized controlled study. One hundred patients with acute severe pancreatitis admitted to Putuo Hospital, Shanghai University of Traditional Chinese Medicine from January 2021 to June 2022 were selected, and were divided into the pocket group and the vest group according to the order of admission with 50 cases in each group. The pocket group used traditional mirabilite bag for external application, the vest group used adjustable mirabilite vest for external application. The other treatment measures were the same for both two group. The comfort degree, itching severity and average length of hospital stay of these two groups were compared.Results:The basic data of the two groups were homogeneous. The difference were not statistically significant( P>0.05). After intervention, the comfort degree of the pocket group was (65.90 ± 7.95) points while the comfort degree of the vest group was (77.04 ± 5.96) points. The difference was statistically significant ( t = 7.93, P<0.01). The degree of pruritus was (12.72 ± 3.95) points in the pocket group and (8.00 ± 1.20) points in the vest group.The difference was statistically significant ( t = 8.08, P<0.05). The mean length of hospital stay in the pocket group was (15.86 ± 5.83) days and (11.02 ± 3.38) days in the vest group. The difference was statistically significant ( t = 5.08, P<0.01). Conclusions:When using topical mirabilite for patients with acute severe pancreatitis, the use of adjustable mirabilite vest can significantly improve patients′ comfort, reduce itching, and reduce the number of hospital days, which has the value of promotion and use.

Objective:To examine the blood protective effect of autologous platelet-rich plasma separation for cardiac valve replacement under cardiopulmonary bypass.Methods:Sixty patients who underwent cardiac valve replacement under cardiopulmonary bypass from August 2018 to May 2019 in Shanghai Chest Hospital, Shanghai Jiao Tong University were randomly divided into control and treatment groups(each 30 cases). There were 33 males and 27 females, aged (52.0±8.4) years (range: 35 to 65 years). Autologous platelet separation was performed in the treatment group after anaesthesia administration and was completed before systemic heparinisation. Platelet separation was not performed in the control group. The thromboelastogram, blood routine, blood coagulation, perioperative fluid infusion, allogeneic blood transfusion, postoperative pleural fluid volume and postoperative fibrinogen were recorded before the operation, and 1 hour and 24 hours post operation. The two groups′ data was compared by t test, Kruskal-Wallis test, Mann-Whitney U test or χ 2 test. Repeated measurement analysis of variance was used to compare platelet and coagulation indexes at different times. Results:The perioperative red blood cell transfusion of 0, 1~2, 3~4,>4 units with 6, 11, 1, 12 cases in treatment group and 14, 8, 6, 2 cases in control group ( Z=-2.516, P=0.012). The postoperative fibrinogen of 0, 1, 2 units with 19, 2, 9 cases in treat group and 26, 2, 2 cases in control group ( Z=-2.190, P=0.029). There was no significant difference in the cost of blood transfusion between the two groups during admission ((1 732±1 275) yuan vs. (1 176±941) yuan; t=-1.570, P=0.125). Conclusion:The use of autologous platelet-rich plasma separation can reduce the amount of allogeneic blood transfusion during valvular surgery under cardiopulmonary bypass.

Objective To analyse the gene expression profile microarrays of lung adenocarcinoma patients by bioinformatics methods,to study the mechanisms affecting the development of lung adenocarcinoma,and to explore new therapeutic targets for lung adenocarcinoma.Methods The mRNA and miRNA expression data were downloaded from The Cancer Genome Atlas database,key genes were screened by R language and survival analysis and verified by the survival module of the database,and high-expression pathway enrichment analysis was performed for prognostic related genes.Finally,the correlation between key genes and immune cells was analyzed.Results The key disulfide death gene SLC3A2 and key nuclear activation miRNA(hsa-miR-1293)were identified by screening.SLC3A2 was positively correlated with hsa-miR-1293,and the higher the expression,the worse the prognosis of lung adenocarcinoma patients.The most relevant enrichment pathway for SLC3A2 is aminoacyl transfer RNA biosynthesis.SLC3A2 was positively correlated with 4 kinds of differential immune cells and negatively correlated with 4 kinds of differential immune cells.Conclusion Hsa-miR-1293 positively regulates the expression of SLC3A2,a disulfide death gene,to promote the occurrence and development of lung adenocarcinoma,which may provide ideas for developing new therapeutic targets for lung adenocarcinoma.

Objective To investigate the diagnostic value of photoplethysmography (PPG) in the detection of obstructive sleep apnea syndrome (OSAS) among critically ill patients with respiratory or cardiocerebrovascular diseases accompanied by snoring. Methods A total of 91 critically ill patients with respiratory or cardiocerebrovascular diseases accompanied by snoring, admitted to the internal medicine ward of Subei People's Hospital from January 2019 to October 2023 were enrolled. After informed consent, overnight polysomnography (PSG) and PPG were performed. The consistency of the sleep apnea parameters obtained of the two methods by sensitivity, specificity, positive predictive value, negative predictive value, and the area under the receiver operating characteristic (ROC) curve. Results There were no statistically significant differences in apnea-hypopnea index (AHI), total sleep time, lowest oxygen saturation, and time with oxygen saturation below 90% between PPG and PSG (P>0.05). When AHI≥ 5 times/h and AHI≥15 times/h, the diagnostic sensitivity of the patients in this group was 94.37% and 93.10%, respectively, with specificities of 73.68% and 90.91%, positive predictive values of 91.78% and 94.74%, and negative predictive values of 77.78% and 88.23%, and areas under the ROC curves were 0.961 and 0.982, respectively. For critically ill patients with respiratory diseases, the diagnostic sensitivity was 89.29% and 87.10%, respectively, with specificities of 84.62% and 80.00%, positive predictive values of 92.59% and 93.10%, and negative predictive values of 78.57% and 72.72%, and the areas under the ROC curves were 0.978 and 0.987, respectively. For critically ill patients with cardiocerebrovascular diseases, the diagnostic sensitivity was 87.18% and 90.32%, respectively, with specificities of 83.33% and 89.47%, positive predictive values of 91.89% and 99.63%, and negative predictive values of 78.57% and 85.56%, and the areas under the ROC curves were 0.942 and 0.986, respectively. Conclusion PPG monitoring results show high consistency with PSG in critically ill patients with respiratory and cardiocerebrovascular diseases combined with OSAS.