To clone and sequence analysis thioredxin redutase cDNA from human leucocyte.Methods:TR cDNA was obtained with RT-PCR and positive cloning was purified and sequenced. Results: of the 1 554 bp, I 494 bp were in an open reading frame encoding mature protein with 498 amino acids. Conclusion:The DNA encoding human leucocyte thioredxin reductase has been determined and the amino acid sequence has been predicted.

BACKGROUND: Panel reaction antibody (PRA) plays an important role in rejection of recipients undergoing solid organ transplantation, which has a positive effect on nonfunction of implant. OBJECTIVE: To evaluate the effect of thalassemic serum-specific PRA on the proliferation and differentiation of umbilical cord blood hernatopoetic stem/progenitor cells (HSC/HPCs) in children patients with thalassemia. DESIGN, TIME AND SETTING: The in vitro cytology experiment was performed at the Experimental Research Center, Second Affiliated Hospital, Zhongshan University from January 2006 to August 2007. MATERIALS: Five samples of umbilical cord blood from healthy full-term birth puerperants (each 80 100 mL) were used in this study. PRA serum samples of children patients with thalassemia after repetitive blood transfusion, five samples of AB blood grouping serum, and six samples of positive anticoagulation vein blood (10 mL) were used in the study. METHODS: Mononuclear cells were harvested from umbilical cord blood by Ficoll-Hypaque gradient centrifugation. 1 × 105 rnononuclear cells from umbilical cord blood were incubated with different levels of experimental or AB control serum (0, 50, 100 μ L) from healthy children. The mixture mentioned above was incubated with rabbit complement for semisolid colony culture.MAIN OUTCOME MEASURES: Colony-forming units (CFU) were counted and observed after 7 days and 14 days of culture under an inverted microscope.RESULTS: After incubation with HSC/HPCs PRA serum, total number of CFUs and varied CFUs decreased to different extents, of which the total number of CFUs and CFU- granulocyte-rnacrophages (CFU-GM) had significant differences (P < 0.01). Moreover, there were negative correlations between different levels of serum PRA and the followings: number of total colonies, CFU- GM, CFU- granulocyte-erythrocyte-monocyte-megakaryocytes, CFU-erythroids, burst forming unit-megakaryocytes, and CFU-megakaryocytes (P < 0.05).CONCLUSION: The thalassemic serum PRA has an apparent inhibitory effect on the proliferation and differentiation of cord blood HSC/HPCs in vitro, an effect that may be pronounced with increasing serum PRA.

Objective To investigate the accuracy of careful clinical evaluation in hemodynamic status and guidance of PiCCO monitor in clinical treatment.Methods A total of 96 hemodynamic unstable cases were evaluated prior to the insertion of the PiCCO catheter.The attending physician in charge of the patient was required to complete a questionnaire to predict the range of key hemodynamic variables for CI,GEDI,SVRI and EVLWI.Additionally,the attending was also asked to indicate a plan for therapy based on the predicted hemodynamic profile and decide if the predicted therapy plan was altered after the the first measurement of hemodynamic variables.Results The accurate prediction of hemodynamic variables was CI (55.2％),GEDI(60.4％),SVRI(63.5％) 和 EVLWI (78.1％),among which EVLWI had a higher accuracy(P ＜ 0.05).49％ doctors altered their planned therapy according to the result of the PiCCO information.Doctors had more difficulty in accurately predicting hemodynamic values in critical patients which APACHE Ⅱ scored 15 ～25 (42.3％ vs 67.9％ and 42.3 ％ vs 75.0％,x2 =4.755,5.231,P ＜ 0.05).The prediction of patients with acute myocardial infarction was more accurate than those of without acute myocardial infarction,and less to alter the planned therapy(21.1％ vs 55.8％,x2 =7.382,P =0.007).The patients of impaired oxygenation had less accurate predictions and less therapy alterations(32.3％ vs 56.9％,x2 =5.110,P =0.024).Attending was able to predict the hemodynamic status more accurately(63.9％ vs 40％,x2 =5.152,P =0.023) and alter the predicted therapy less(39.3％ vs 65.7％,x2 =6.189,P =0.013) in patients who were enrolled later.Conclusions Clinical evaluation in hemodynamic status of critically ill patients had a lower accuracy,the information obtained by PiCCO often instruct clinical doctors to choose the optimal treatment.

Objective To explore the gender difference in clinical features and outcomes of elderly patients with coronary true bifurcation lesions after percutaneous coronary intervention (PCI).Methods A total of 169 consecutive patients were included in the study, who were diagnosed coronary true bifurcation lesions by coronary angiography (CAG)and received PCI in our hospital from December 2013 to December 2015.All patients were divided into 2 groups according to their gender (71 femals and 98 males).Angiographic characteristics of the coronary lesions and clinical data were analyzed in both groups.Clinical outcomes during follow up were recorded and studied.Results The levels of total cholesterol (TC), triglyceride (TG),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) in the female group were significantly higher than in the male group (all P<0.05).The levels of BUN,Cr,UA,CyC and TBIL in the female group were significantly lower than in the male group (all P<0.05).Comorbidity rates of hypertension and diabetes were higher in female patients without significant differences (P>0.05).The median follow-up time was 17 months and the incidence rate of overall adverse events in women was higher than that of men (25.4% vs.11.2%, P<0.05).Conclusions The clinical outcomes of elderly patients with coronary true bifurcation lesions after PCI had gender differences.The rates of adverse events in female patients was found significantly higher than male patients.

Objective To investigate the predictive value of systemic immune-inflammation index(SII)and N-terminal pro-brain natriuretic peptide(NT-proBNP)level in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)developing contrast-induced acute kidney injury(CIAKI)after PCI.Methods A total of 1085 elderly STEMI patients undergoing emergency PCI in the Affiliated Hospital of Xuzhou Medical University from January 2018 to March 2023 were consecutively recruited as a training set,and another 287 elderly STEMI pa-tients receiving emergency PCI in the East Branch of the Affiliated Hospital from January 2021 to June 2023 were included as a verification set.According to the diagnostic criteria of CIAKI,they were divided into CIAKI group(n=95)and non-CIAKI group(n=990).Based on the results of restricted cubic spline(RCS)analysis,the patients from the training set were assigned into low-risk subgroup(n=292),moderate-risk group(n=515)and high-risk group(n=278).Multivari-ate logistic regression analysis was used to analyze the independent risk factors of CIAKI in elder-ly STEMI patients after PCI,and ROC curve was plotted to analyze the predictive value of combi-nation of SII and NT-proBNP.The risk of CIAKI was compared among the patients at different risk grades.Results Age,SII,baseline serum creatinine,NT-proBNP,fasting blood glucose and use of diuretics were independent risk factors for CIAKI after primary PCI in elderly STEMI patients(P＜0.05,P＜0.01).The AUC value of SII combined with NT-proBNP in predicting CIAKI was 0.801(95％CI:0.761-0.842,P＜0.01),with a sensitivity of 83.2％and a specificity of 67.5％,both superior to that of SII or NT-proBNP alone.RCS analysis revealed an increased risk of CIAKI at SII ≥1084.97 × 109/L and NT-proBNP ≥296.12 ng/L.The incidence of CIAKI was increased with the increase of risk grades(1.71％vs 6.41％vs 20.50％).Conclusion SII and NT-proBNP are independent risk factors for CIAKI after emergency PCI in elderly STEMI pa-tients.And their combination has better predictive value for CIAKI.

Objective:To explore and analyze the characteristics and causes of intensive nursing needs of COVID-19 patients.Methods:This was a cross-sectional study. Critical patients′ treatment and care information were extracted through the HIS system of a designated hospital from critical patients with COVID-19. We used statistical descriptions to analyze patient general information, nursing degree, and therapeutic intensive care needs. The chi-square test or Fisher′s exact test was used to analyze the differences between characteristics of patients and nursing degree.Results:A total of 1 849 cases of critical patients were collected, including special grade nursing care 697(37.70%), grade I nursing care(62.30%). There were 893(48.30%)patients aged≥65 years, and 853(46.13%)patients with one or more complications. All patients required the nursing routine of infection department, and the therapeutic intensive care followed was vein blood collection(99.62%), oxygen inhalation(98.92%), oral medication(98.65%), finger pulse oxygen monitoring(77.07%)and pharyngeal swab collection(71.93%). The nursing degree of the patients with different gender, age, admission mode, body position and complications were statistically significant( P<0.05). Conclusions:The intensive care nursing needs of COVID-19 patients are complex, which are special in treatment, life and psychology, and the tasks of nursing are heavy, difficult and professional. Special attention should be paid to elderly patients and patients with complications. Our hospital has established a provisional nursing department during the COVID-19 outbreak, coordinated nursing manpower and quality of nursing management, and set up a nursing expert consultation team to further enhance the quality of nursing care for critical COVID-19 patients.