Objective:To evaluate the clinical efficacy of dezocine, fentanyl and sufentanil at the equivalent dose on hemodynam-ics, sedation and analgesia in fibrobronchoscope-guided. Methods:A total of ninety patients with anticipated difficult airways expected to be nasally intubated using fibrobronchoscope were enrolled and randomly divided into three groups:dezocine group ( group D) , fent-anyl group ( group F) and fentanyl group ( group S) . Ten minutes before the intubation, each group was intravenously given dezocine 0. 15mg ·kg-1 , fentanyl 3μg ·kg-1 and sufentanil 0. 2μg·kg-1 , respectively. The values of HR, MAP and SPO2 were recorded respectively at the time when the patients entered the operation room ( T0 ) , before the bronchoscopy-guided tracheal intubation ( T1 ) , after the intubation ( T2 ) and 5 minutes after the intubation ( T3 ) . The Ramsay sedation score before the intubation and adverse reac-tions during the intubation were also observed. Results: In group F and group S, HR and MAP decreased significantly at T1 ( P<0. 05). The levels of SPO2 decreased significantly at T1 and MAP increased significantly at T2 in the three groups (P<0. 05). The levels of HR, MAP and SpO2 in group F and group S were lower than those in group D (P<0. 05). The levels of HR and MAP in group F at T2 were higher than those in group D and group S, and SPO2 was dropped significantly in group F and group S (P<0. 05). The levels of HR in group S dropped significantly, and were lower than those in the other two groups. MAP in group F was higher than those in the other two groups (P<0. 05). From the Ramsay sedation analysis, the scores of the three groups increased significantly and the score in group S was higher than that in group F (P <0. 05). The incidence of nausea and respiratory depression in group F was significantly higher than that in group D (P<0. 05). The incidence of agitation in group F was significantly higher than that of group S (P<0. 05). The incidence of respiratory depression in group S was significantly higher than that of group D and group F (P<0. 05). Conclusion:Dezocine combined with surface anesthesia has a slight effect on hemodynamics during the tracheal intubation guided by bronchoscopy in the patients with difficult airways. The incidence of reverse reactions of dezocine is lower than that of fenta-nyl and sufentanil.

Objective:To establish a method for simultaneously determinating the content of 10 constituents including chlorogenic acid, puerarin, forsythoside A, liquiritin, matrine, saikosaponin A, saikosaponin D, forsythin, ammonium glycyrrhizate, indirubin in Xiao’er-Jinqiao granules by UPLC. Methods:ACQUITY UPLCTMC18 chromatographic column (100 mm × 2.1 mm, 1.7 μm) was used. The mobile phase was acetonitrile-0.05% phosphoric acid solution with gradient elution at the flow rate of 0.2 ml/min. The detection wavelength was 250 nm. The column temperature was 30 ℃. The injection volume was 2 μl.Results:The linear ranges of chlorogenic acid, puerarin, forsythoside A, liquiritin, matrine, saikosaponin A, saikosaponin D, forsythin, ammonium glycyrrhizate, indirubin were 0.789 5-15.793 4 μg ( r=0.999 6), 0.571 8-11.445 6 μg ( r=0.999 4), 0.110 7-2.214 7 μg ( r=0.999 3), 0.047 5-0.950 5 μg ( r=0.999 2), 0.269 8-5.395 8 μg ( r=0.999 7), 0.085 1-1.703 9 μg ( r= 0.999 5), 0.105 7-2.113 0 μg ( r=0.999 4), 0.065 6-1.312 1 μg ( r=0.999 3), 0.080 5-1.611 2 μg ( r=0.999 5), 0.057 7-1.153 3 μg ( r=0.999 4). The limits of quantitation were 8.322, 9.023, 9.857, 4.583, 6.872, 7.844, 8.643, 5.895, 7.568, 5.251 μg/ml. The average recovery rates were 99.11%, 98.87%, 97.83%, 98.10%, 98.17%, 98.30%, 98.10%, 98.14%, 97.99% and 98.02%, and RSDs were all below 2.0%, respectively. RSDs of precision, reproducibility and stability tests were lower than 2.0%. Conclusions:The established method of multi-component content determination is fast, accurate and reproducible. It can be used for the quality control of Xiao’er-Jinqiao granules.

OBJECTIVETo investigate the effect of losartan in regulating oxidative stress and the underlying mechanism in mice with ventilator-induced lung injury.

METHODSThirty-six male C57 mice were randomly divided into control group, losartan treatment group, mechanical ventilation model group, and ventilation plus losartan treatment group. After the corresponding treatments, the lung injuries in each group were examined and the expressions of caveolin-1 and NOX4 in the lung tissues were detected.

RESULTSThe mean Smith score of lung injury was significantly higher in mechanical ventilation model group (3.3) than in the control group (0.4), and losartan treatment group (0.3); the mean score was significantly lowered in ventilation plus losartan treatment group (2.3) compared with that in the model group (P<0.05). The expressions of caveolin-1 and NOX4 were significantly higher in the model group than in the control and losartan treatment groups (P<0.05) but was obviously lowered after losartan treatment (P<0.05). Co-expression of caveolin-1 and NOX4 in the lungs was observed in the model group, and was significantly decreased after losartan treatment.

CONCLUSIONLosartan can alleviate ventilator-induced lung injury in mice and inhibit the expression of caveolin-1 and NOX4 and their interaction in the lungs.

Animals ; Caveolin 1 ; metabolism ; Losartan ; pharmacology ; Lung ; metabolism ; physiopathology ; Male ; Mice ; Mice, Inbred C57BL ; NADPH Oxidase 4 ; NADPH Oxidases ; metabolism ; Oxidative Stress ; Respiration, Artificial ; Ventilator-Induced Lung Injury ; drug therapy ; metabolism

Objective To systematically evaluate the risk factors associated with the occurrence of nosocomial infections(NI)in patients undergoing extracorporeal membrane oxygenation(ECMO)support.Methods A computerized systematic search was performed aross the Chinese databases including CNKI,Wanfang Database,China Biomedical Literature Database(CBMdisc),and Weipu,as well as the English databases such as PubMed,EMBase,Web of Science,and the Cochrane Library for case-control or cohort studies on the risk factors of hospital-acquired infections in patients undergoing ECMO support from the time of database construction to February 2023.The relevant literatures were screened by two researchers independently.Meta-analysis was performed using RevMan 5.4 software.Results A total of 20 papers,including 2 746 patients and 16 risk factors,were included.Meta-analysis results showed that older age[>50 years:odds ratio(OR)= 2.87,95％ confidence interval(95％ CI)was 1.24-6.63,P = 0.01;>65 years:OR = 1.66,95％ CI was 1.22-2.26,P = 0.001],combined hypertension(OR = 1.48,95％ CI was 1.01-2.15,P = 0.04),combined diabetes mellitus(OR = 1.40,95％ CI was 1.02-1.94,P = 0.04),sequential organ failure assessment(SOFA)was higher(OR = 1.06,95％ CI was 1.02-1.10,P = 0.000 7),the installation of ECMO in the intensive care unit(ICU,OR=1.48,95％ Ciwas 1.11-1.99,P=0.008),ECMO course(OR=1.27,95％ Ciwas 1.05-1.54,P = 0.01),ventilator-assistance for >48 hours(OR = 4.91,95％ CI was 2.40-10.05,P<0.000 1),and tracheotomy(OR = 9.56,95％ CI was 3.60-25.35,P<0.000 01)were identified as ECMO risk factors for hospital-acquired infections in patients.Conclusion Older age,combined hypertension,diabetes mellitus,higher SOFA,ECMO installation site in ICU,ECMO course,ventilator assistance>48 hours,tracheotomy are the risk factors for the occurrence of hospital-acquired infections in patients with ECMO,healthcare professionals should promptly identify the risk factors related to hospital-acquired infections,and take active and effective measures against controllable risk factors,including early intervention to prevent the occurrence of NI in ECMO patients.

OBJECTIVE: To observe the effect of exosomes secreted by lipopolysaccharides (LPS)-stimulated macrophages on hepatic stellate cell activation and migration and explore the underlying molecular mechanism. METHODS: Human monocyte THP-1 cells were induced to differentiate into macrophages using propylene glycol methyl ether acetic acid (PMA, 100 ng/mL, 24 h) followed by stimulation with LPS, and the culture supernatant of macrophages was collected for extraction of the exosomes by ultracentrifugation. The expression of miR-155-5p in the exosomes was detected using qRT-PCR. A Transwell co-culture system was used to observe the effects of the macrophage-derived exosomes on LX2 cell (a hepatic stellate cell line) proliferation, migration, oxidative stress and the expression of fibrosis biomarkers, which were also observed in LX2 cells transfected with miR-155-5p-mimics or miR-155-5p-inhibitors. Western blotting was used to detect the expressions of SOCS1 and its downstream signal pathway proteins. RESULTS: Treatment with the exosomes from LPS-stimulated macrophages significantly enhanced the proliferation and migration ability of LX2 cells and increased the levels of oxidative stress and expressions of the fibrosis markers such as type Ⅰ collagen (P < 0.05). The expression of miR-155-5p in the exosomes secreted by macrophages was significantly increased after LPS treatment (P < 0.01). LX2 cells overexpressing miR-155-5p also exhibited significantly enhanced proliferation and migration with increased oxidative stress levels and expression of type Ⅰ collagen (P < 0.05), and interference of miR-155-5p expression produced the opposite effects. Western blotting showed that miR-155-5p overexpression obviously inhibited SOCS1 expression and promoted p-Smad2/3, Smad2/3 and RhoA protein expressions in LX2 cells (P < 0.05). CONCLUSION LPS stimulation of the macrophages increases miR-155-5p expression in the exosomes to promote activation and migration and increase oxidative stress and collagen production in hepatic stellate cells.
Humans ; Hepatic Stellate Cells ; Lipopolysaccharides/pharmacology* ; Collagen Type I ; Exosomes ; Macrophages ; MicroRNAs

Objective:To investigate the latent classes and influencing factors of vicarious posttraumatic growth among emergency nurses.Methods:Convenience sampling method was used to select the 498 emergency nurses of 20 public general hospitals in Anhui province as the survey objects. The general information questionnaire and Posttraumatic Growth Inventory were used to investigate. Latent class analysis was used to classify vicarious posttraumatic growth of emergency nurses, and the influencing factors of latent classes were analyzed by binary logistic regression.Results:There were two latent classes of vicarious posttraumatic growth of emergency nurses including high growth-high fluctuation group (24.1%, 120/498) and low growth group (75.9%, 378/498). Binary logistic regression analysis showed that professional title, average monthly income and self-rated health status were the factors influencing the latent classes (all P<0.05). Conclusions:There are obvious classification characteristics of vicarious posttraumatic growth among emergency nurses. Nursing managers should formulate and implement targeted intervention measures according to the classification characteristics and influencing factors to improve their vicarious posttraumatic growth level.