Objective:To investigate the curative effect of early enteral nutrition support in patients with COPD complicated with respiratory failure.Methods: When mechanical ventilation began,63 patients in the acute phase of COPD complicated with respiratory failure were divided into two groups: the early enteral nutrition group(EEN group,n=32) or the delayed enteral nutrition group(DEN group,n=31).After two weeks,the nutritional indexes,the times of mechanical ventilation,the incidence of complication and the mortality were observed.Results: Two weeks later,there was significant difference between EEN group and DEN group in total protein,albumin,prealbumin and hemoglobin(P

Background Exfoliation syndrome (XFS) is a systemic disease with abnormal accumulation of extracellular matrix.Researches showed that the single nucleotide polymorphisms (SNPs) of lysyl oxidase-like 1 (LOXL1) gene is associated with the pathogenesis of XFS in global population.However,the results are varied among different ethnicity and regions.Objective This study aimed to assess the association between LOXL1 gene polymorphisms and XFS in Uygur population.Methods One-hundred and fifty-two Uygur XFS patients without relativeness were enrolled from January to August in 2014,and 228 ethnicity-and gender-matched normal controls were recruited at the same period from the same region.Each individual underwent comprehensive eye examinations and 5 ml peripheral blood was collected.Genomic DNA was extracted from peripheral blood.PCR-ligase detection response (LDR) was used to determine the allele and genotype frequencies of the six SNPs rs12914489,rs4886467,rs4558370,rs4461027,rs4886761 and rs16958477 in the promoter region of LOXL1 gene.The distribution frequency between the patients and normal controls was compared by x2 test.Logistic regression analysis was used for age adjustment.This study was approved by Ethic Committe of Xinjiang Medical University,and informed consent was obtained from the subjects.Results rs12914489 site in the normal control group diverged from Hardy-Weinberg equilibrium (HWE) (P =0.033),and the rs4886467,rs4558370,rs4461027,rs4886761 and rs16958477 sites followed HWE.The frequencies of G allele and GG genotype of rs4886467 in the XFS group were lower than those in the control group (both at P =0.00) and were protective factors of XFS (OR =0.54,95 ％ CI:0.40-0.74,P =0.000;OR=0.51,95％ CI:0.33-0.78,P=0.001);the frequencies of T allele and TT genotype of rs4558370 in the XFS group were significantly higher than those in the control group (both at P=0.00) and were the risk factors of XFS (OR=1.96,95％ CI:1.23-3.11,P =0.004;OR =2.18,95％ CI:1.31-3.64,P =0.002);the frequencies of C allele and CC genotype of rs4461027 in the XFS group were significantly higher than those in the control group (both at P=0.00) and were the risk factors of XFS (OR=2.25,95％ CI:1.67-3.04,P=0.000;OR=3.06,95％ CI:1.89-4.96,P=0.000);the frequencies of T allele and TT genotype of rs4886761 in the XFS group were significantly higher than those in the control group (both at P=0.00) and were the risk factors of XFS (OR=2.44,95％ CI:1.79-3.33,P =0.000;OR =3.02,95％ CI:1.63-5.60,P =0.000);the frequencies of C allele and CC genotype of rs16958477 in the XFS group were significantly higher than those in the control group (both at P=0.00) and were the risk factors of XFS (OR =2.00,95 ％ CI:1.47-2.71,P =0.000;OR =2.37,95 ％ CI:1.31-4.27,P =0.004).Conclusions The SNPs of promoter region of LOXL1 gene are associated with hereditary susceptibility of XFS individually in Uygur population.The SNPs of rs4886467 locus are protective factor,while the SNPs of rs4558370,rs4461027,rs4886761 and rs16958477 locus are risk factors for pathogenesis of XFS.

Objective To determine whether stroke volume variation (SVV) in relation to volume loading in mechanically ventilated patients with septic shock.Methods Data of thirty-two mechanically ventilated patients with septic shock admitted from Dec 2009 to May 2012 were prospectively analyzed.Cardiac index (CI),stroke volume (SV),systemic vascular resistance index (SVRI) and stroke volume variation (SVV) were measured by FloTrac/Vigileo before and after fluid resuscitation (250 mL saline in 10 min).Patients with an increase in SV (△SV) ≥ 10％ and ＜ 10％ after fluid volume loading were classified as responders and non-responders,respectively.The comparisons between these two sorts of patients were assessed by using two sample Student' s t-test,and comparisons between changes before and after fluid challenge were assessed by using a paired Student' s t-test.A Pearson' s correlation analysis was employed for evaluate the correlation between △SV and other haemodynamic variables.The roles of SVV,central venous pressure (CVP),mean artery pressure (MAP) and the changes of CVP (△CVP),MAP (△MAP) after fluid administration in predicting volume responsiveness were evaluated by receiver operating characteristic (ROC) curve.Results Thirty-two patients with septic shock were included in this study.There were 54 instances of fluid challenge performed,among which 35 instances were defined as response group.Significantly increased SV induced by fluid challenge was assigned into response group (83.6 ± 15.6) mL vs.(68.5 ± 14.2) mL,P ＜0.01,while in non-response group,there were no significant change in SV (P ＞0.05).SVV was significantly correlated with SV before fluid loading (r =0.522,P ＜ 0.01).The area under the ROC curve (AUC) for stroke volume variation (SVV) was 0.898 (95％ CI:0.796-1.000).Using SVV ≥ 11.5％ as the threshold to predict fluid responsiveness,the sensitivity was 94％ and specificity was 84％.Conclusions SVV can be used to predict fluid responsiveness in patients with septic shock.

Objective To analyze the incidence,risk factors and pathogens of stroke associated pneumonia (SAP) in patients with acute stroke in the intensive care unit (ICU).Methods One hundred and forty-two patients with acute stroke admitted in ICU from January 2012 to December 2013 were retrospectively studied.The data of medical history of patients,treatment,prognosis,and pathogens of SAP were collected.Data were analyzed by t test,Mann-Whitney U test,Pearson x2 test and muhivariable logistic regression.Results Of 142 patients,94 (66.2％) were contracted SAP of which 54.3％ were early-onset pneumonia (EOP≤72 h) and 45.7％ were late-onset pneumonia (LOP ＞72 h).The most common pathogens isolated from EOP were Staphylococcus aureus and Klebsiella pneumonia,while the most common pathogens isolated from LOP were Acinetobacter baumanii,Staphylococcus aureus and Pseudomonas aeruginosa.Multivariate logistic regression analysis demonstrated that hemorrhagic apoplexy,history of stroke,higher APACHE score,dysphagia,prolonged use of mechanical ventilation,prolonged stay in ICU,and hyperglycemia were the independent risk factors of SAP,and the odds ratios (OR) with 95％ confidence intervals (CI) were 10.917 (1.834-60.959),15.223 (1.947-96.969),1.607 (1.253-2.062),5.321 (1.225-26.519),1.809 (1.208-2.709),1.391 (1.085-1.783),1.534 (1.l01-2.138),respectively.While plasma albumin level was negatively associated with SAP (OR =0.809,95％ CI:0.674-0.971).The common risk factors of EOP and LOP were higher APACHE score and prolonged use of of mechanical ventilation.The independent risk factors of EOP were dysphagia (OR =4.331,95％ CI:1.330-14.098),history of stroke (OR =13.690,95％ CI:2.198-85.277) and chronic bronchitis (OR =12.907,95％ CI:1.203-138.542),While those of LOP were prolonged stay in ICU (OR =1.687,95 ％ CI:1.131-2.517),hemorrhagic apoplexy (OR =21.657,95％ CI:1.559-106.752) and low plasma albumin level (OR =0.782,95％ CI:0.637-0.961).There was no significant difference in mortality between EOP (49％) and LOP (44.2％) (P ＞ 0.05),but the mortality of SAP was significantly higher than that of non-SAP group.Conclusions The incidence rate and mortality of SAP are quite high in ICU.The pathogens and risk factors are different between EOP and LOP.This observation results suggest it is important to identify high-risk stroke patients,and to develop a novel treatment strategy and prophylactic measures facilitating limiting the complications of stroke.

Objective To approach the correlation between angiopoietin-2 (Ang-2) levels and degree of lung injury and prognosis and its clinical significance in patients with acute respiratory distress syndrome (ARDS). Methods A prospective observation was conducted. Fifty-three ARDS patients admitted to Department of Critical Care Medicine of Third Affiliated Hospital of Anhui Medical University from January 2012 to March 2014 were enrolled. According to the criteria of the Berlin Definition of ARDS,the patients were divided into mild group (n=15),moderate group(n=22)and severe group(n=16). Meanwhile,ARDS patients were further divided into survival group(n=29)and non-survival group(n=24)according to 28-day outcomes. Twenty cases of non-ARDS patients were served as control. The acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,sequential organ failure assessment(SOFA)score,oxygenation index(PaO2/FiO2),lung injury score(LIS)were recorded within 24 hours after admission. And the plasma levels of Ang-2,interleukin-6(IL-6)and C-reaction protein (CRP)were measured. The independent risk factors of ARDS were analyzed by univariate and multivariable logistic regression. Receiver operating characteristic curve(ROC)was plotted to evaluate the value of Ang-2 in predicting ARDS. Results Compared with non-ARDS group,APACHEⅡ score,SOFA score,LIS score,mortality were significantly increased,PaO2/FiO2 was significantly decreased,and plasma Ang-2,IL-6,CRP were significantly elevated〔APACHEⅡscore:20.7±5.0 vs. 14.1±5.3,SOFA score:7.7±3.5 vs. 3.5±2.1,LIS score:1.69±0.71 vs. 0.28±0.27,PaO2/FiO2(mmHg,1 mmHg=0.133 kPa):159.5±61.3 vs. 394.0±63.2,mortality:45.3%(24/53) vs. 20.0%(4/20),Ang-2(μg/L):4.73(2.59,6.99)vs. 1.22(0.61,1.52),IL-6(ng/L):56.50(27.15,139.90)vs. 13.05(4.38,15.55),CRP(mg/L):95.75(41.74,189.72)vs. 10.56(3.92,21.36),P<0.05 or P<0.01〕. Each index increased or decreased more significantly with the aggravation of the disease. It was shown by correlation analysis that the plasma levels of Ang-2 was significantly positive correlated with IL-6(r=0.468,P=0.000),CRP(r=0.492,P=0.000),APACHEⅡscore(r=0.560,P=0.000),SOFA score(r=0.508,P=0.000)and LIS score (r=0.588,P=0.000),significantly negatively correlated with PaO2/FiO2(r=-0.685,P=0.000). Factors, APACHEⅡ score,LIS score,PaO2/FiO2,Ang-2 and IL-6 founded statistical significance in univariate analysis were analyzed using multivariable logistic regression. High APACHEⅡscore at admission〔odds ratio(OR)=1.316, 95% confidence interval(95%CI)=1.040-1.633,P=0.022〕and increased plasma Ang-2 levels(OR=1.287, 95%CI=1.041-1.760,P=0.038)were the independent prognostic factors for the 28-day mortality in ARDS. The area under the ROC curve of Ang-2 was 0.964,the optimal critical value of Ang-2 was 1.79μg/L,the specificity was 90.0%,and sensitivity was 92.5%. Plasma levels of Ang-2 was better in predicting ARDS than APACHEⅡscore, SOFA score and IL-6. Conclusions The plasma level of Ang-2 was significantly increased in patients with ARDS. The plasma level of Ang-2 was correlated with the severity of acute lung injury and had important prognosis evaluation.

BACKGROUND: Previous studies demonstrated that proliferation of cancer cells can be inhibited via RNA interference on the expression of vascular endothelial growth factor (VEGF). However, few studies report RNA interference on the expression of VEGF in gallbladder carcinoma, OBJECTIVE: To design and screen shRNA targeting VEGF, and to observe the effect of small interfering RNA targeting on proliferation of gallbladder cancer cells. METHODS: The VEGF-shRNA fragment was synthetized and connected with pCYU6/GFP/Neo-shRNA plasmid vector, shRNA was transfected into gallbladder cancer cells. The gallbladder carcinoma models of nude mice were prepared and randomly divided into blank control, negative control and experimental groups, With 6 animals in each group. ShRNA was injected into tumor. Cell growth was detected by fluorescence microscope MTT. The RNA interference efficiency was examined by fluorescent quantitative RT-PCR. Changes of tumor volume were also observed. RESULTS AND CONCLUSION: Gallbladder cancer cells ware shrunk with round shapes and a part of cells were dead after RNA interference on VEGF. shRNA-VEGF1 and shRNA-VEGF2 could signiticently inhibit mRNA gene expression of VEGF, the inhibition ratio was 86% and 82%, respectively. The tumor volume of the experimental group was smaller than the other groups, with slowly growth (P < 0.05). No obvious changes were found in the blank control and negative control groups. The constructed hVEGF-shRNA vector markedly decreases VEGF gene expression and inhibits cellular proliferation, eventually, to treat gallbladder cancer.

Objectives To study the effect of total flavones of Bidens pilosa L (TFB) on cytokines production in liver fibrosis rats. Methods Rat liver fibrosis was induced by CCl450%, 0.1 ml?(100 g)-1 body weight twice a week for 18 weeks. TFB (160,80,40 mg?kg-1) was used daily via gastrogavage at 9 week. Levels of TNF-? and IL-1? in serum were determinate by radioimmunoassay. Liver samples were collected after experiments and stained by immuninochemistry of TGF-?1 and NF-?B. Moreover TGF-?1 mRNA expression in liver tissue was detected by RT-PCR technology. Results TFB (160, 80 mg?kg-1) could significantly reduce serum TNF-? and IL-1? contents; TFB(160, 80, 40 mg?kg-1) could effectively prevent the expression of NF-?B,as was TGF-?1 of TFB(160, 80 mg?kg-1). Moreover TFB (160, 80 mg?kg-1) could significantly reduce TGF-?1 mRNA in liver fibrosis rats. Conclusion TFB had protective effect on liver fibrosis by its inhibition of cytokine production.

Objective To investigate ACEI ( benazepril ) and tranilast exert renoprotective properties in diabetic nephropathy( DN) through the inhibition of thioredoxin( Trx) . Methods Forty male SD rats were randomly divided into normal control group,model control group,tranilast group and benazepril group (n=10 each).Normal control group was fed with normal diet. Other groups were fed with high-glucose high-fat diet to make DN models. Rats in model control, tranilast, and benazepril groups were fed with normal diet,400 mg??kg-1??d-1 tranilast plus normal diet,and 10 mg??kg-1??d-1 benazepril plus normal diet,respectively,via oral gavage for 12 weeks.The 24-hour proteinuria,blood glucose(BG),blood urea nitrogen (BUN),serum creatinine ( Scr) and renal pathology changes were detected. Expression of Trx was measured by Western-blot. Results The 24 h urine protein, BG, BUN, Scr, kidney/body weight, and glomerular sclerosis index were significantly decreased in tranilast group and benazepril group,as compaired with model control group ( P<0.05) ,but there was no statistical difference between the two drug groups (P>0.05).Both tranilast and benazepril can reduce renal pathological changes,and can increase the expression of Trx of DN rats, but benazepril had a more significant effect on increasing Trx expression. Conclusion Both tranilast and benazepril have renoprotective function in DN, and benazepril is more effective than tranilast in delaying the progression of diabetic nephropathy by increasing Trx expression and decreasomg oxidative stress.

Objective: To systematically evaluate the influencing factors for medication compliance in patients with comorbidities of chronic diseases, so as to provide the evidence for improving medication compliance. Methods: Literature on influencing factors for medication compliance in patients with comorbidities of chronic diseases were retrived from CNKI, Wanfang Data, VIP, SinoMed, PubMed, Web of Science, Cochrane Library and Embase from inception to January 20, 2024. After independent literature screening, data extraction, and quality assessment by two researchers, a meta-analysis was performed using RevMan 5.4 and Stata 16.0 softwares. Literature were excluded one by one for sensitivity analysis. Publication bias was assessed using Egger's test. Results: Initially, 7 365 relevant articles were retrieved, and 35 of them were finally included, with a total sample size of about 150 000 individuals. There were 30 cross-sectional studies and 5 cohort studies; and 11 high-quality studies and 24 medium-quality studies. The meta-analysis showed that the demographic factors of lower level of education (OR=2.148, 95%CI: 1.711-2.696), lower economic income (OR=1.897, 95%CI: 1.589-2.264), male (OR=0.877, 95%CI: 0.782-0.985), living alone (OR=2.833, 95%CI: 1.756-4.569) and unmarried (OR=2.784, 95%CI: 1.251-6.196); the medication treatment factors of polypharmacy (OR=1.794, 95%CI: 1.190-2.706), potentially inappropriate medication (OR=2.988, 95%CI: 1.527-5.847), low frequency of daily medication (OR=0.533, 95%CI: 0.376-0.754) and adverse drug reactions (OR=3.319, 95%CI: 1.967-5.602); the disease factors of long course of disease (OR=2.118, 95%CI: 1.643-2.730), more comorbidities (OR=1.667, 95%CI: 1.143-2.431) and cognitive impairment (OR=2.007, 95%CI: 1.401-2.874); and the psychosocial factors of poor belief in taking medication (OR=1.251, 95%CI: 1.011-1.547), poor self-rated health (OR=1.990, 95%CI: 1.571-2.522) and being guided by healthcare professionals (OR=0.151, 95%CI: 0.062-0.368) were the influencing factors for medication compliance in patients with chronic comorbidities. Conclusion The medication compliance in patients with comorbidities of chronic diseases is associated with demographic factors, pharmacological factors, disease factors and psychosocial factors, mainly including living alone, adverse drug reactions, course of disease, number of comorbidities and medication beliefs.

Objective To explore the regulatory effects of HTLV-1 ( human T-cell leukemia virus type 1 ) Tax protein on the expression of HMGB 1 ( high mobility group box 1 ) gene in T cells .Methods Total RNA and protein were extracted from Tax +-T cells ( TaxP ) , Tax--T cells ( TaxN ) and Jurkat cells which were stably transfected with pCMV-Tax and pCMV-Neo, respectively.Then, the expression levels of HMGB1 mRNA and protein in different CD 4+T cells were analyzed by real-time PCR and Western blot (WB).By using liposome-mediated method, pGL3-HMGB1-luc reporter genes and pGL3-neo-luc were tran-siently transfected into TaxP and TaxN cells and the basal transcriptional activity was observed in different T cells.Additionally, pCMV-Tax and pGL3-HMGB1-luc reporter genes were also co-transfected into Jurkat cells and the regulatory effects of Tax protein on HMGB 1 gene was detected .The chromatin immunoprecipi-tation (ChIP) assay was used to identify HMGB1 genomic sites directly targeted by Tax .Results The ex-pression levels of HMGB1 mRNA and protein in Tax+-T cells ( TaxP) were higher than those in Tax--T cells (TaxN).The transcription regulation trends for HMGB1 gene in TaxN and TaxP cells were similar but not identical in diverse T cells.pHLuc3 (containing -504-+83 HMGB1) showed the highest transcriptional ac-tivity of HMGB1 gene in both TaxP and TaxN cells , but HMGB1 transcriptional activity of pHLuc 6 in TaxP cells was significantly stronger than that in TaxN cells .Luciferase assays also showed that Tax protein promo-ted the transcription of HMGB1 gene in a dose-dependent manner .The ChIP assay further confirmed that Tax protein enriched at the HMGB1 region of -1163--1043.Conclusion The region of nt -504--383 is essen-tial for the basal promoter activity of -1163-+83 HMGB1 gene originated from pHLuc 6 reporter plasmid , and Tax protein enriched probably at the HMGB 1 site of -1163--1043 enhances HMGB1 transcription.