Objective To detect the expression of proteinase activated receptor 2 (PAR-2) in the skin of patients with atopic dermatitis (AD) and to evaluate the effects of tacrolimus on the expression.Methods Six patients with acute moderate or severe AD were enrolled in this study and topically treated with tacrolimus 0.1％ ointment twice daily for 3 weeks.Tissue samples were obtained from the lesions and non-lesional skin at least 10 cm away from the lesions before and after the 3-week treatment.Skin specimens from 6 normal human controls served as the control.Patients were evaluated at the baseline,1 and 3 weeks after the beginning of treatment for clinical symptoms and signs by visual analogue scale (VAS),eczema area and severity index (EASI) and investigator's global assessment (IGA).The expression of PAR-2 in tissue specimens were determined by immunohistochemistry.Results PAR-2 was expressed throughout the whole epidermis,especially in the granular layer,hair follicles,sweat glands,endothelial cells and nerve fiber-like structures.Before treatment,the expression level (mean optical density) of PAR-2 in keratinocytes was 4339.6 ± 115.8 in lesional skin of AD patients,significantly higher than that in non-lesional skin (4189.0 t 228.9,t =2.85,P ＜0.05) and in normal skin (3864.0 ± 237.3,t =4.31,P ＜ 0.05).After the 3-week treatment with tacrolimus ointment,the expression level of PAR-2 significant decreased to 3942.4 ± 176.6 in keratinocytes from lesional skin of patients with AD (t =4.55,P ＜ 0.05).The expression level of PAR-2 was positively correlated with VAS score for itch,EASI and IGA score in the patients.Conclusions The expression of PAR-2 is enhanced in keratinocytes of lesions from AD patients,and is positively correlated with itch and lesion severity.Topical tacrolimus may suppress the overexpression of PAR-2 in keratinocytes in lesional skin of AD.

Objective To study the role of cutaneous nerve and protease activated receptor 2 (PAR2)in the development of pruritus in atopic dermatitis(AD).Methods Dermal sheets were prepared from chronically pruritic skin lesions of 7 patients with AD,as well as from the normal skin of 7 healthy human controls.Double labeled immunofluorescence was performed using mouse anti-protein gene product 9.5(PGP9.5)monoclonal antibody and rabbit anti-substance P(SP)polyclonal antibody to observe the morphological changes in cutaneous nerve fibers,and Image-Pro Plus 6 software was used to semiquantitively assess the length,diameter of nerve fibers,integral optimal density of PAR2 and SP in dermal sheets.Results Immunofluoresence double staining showed that PAR2 co-expressed with PGP9.5 or SP in cutaneous nerve fibers.Compared with the normal control skin,both the total length and average diameter of PGP 9.5-expressing nerve fibers were increased(11051.8±1900.9 μm vs 7264.0±2659.9 μm,4.23±0.15 μm vs 3.95±0.15 μm,both P＜0.01)in pruritic lesions,while only the average diameter of SP-expressing nerve fibers was up-regulated(3.99±0.20 μm vs 3.80±0.07 μm,P＜0.05),and the total length of them remained unchanged(4304.7±1455.0 μm vs 3380.0±1735.4 μm,P＞0.05).Also,increased integral optimal density was observed for SP and PAR in pruritic lesions in comparison with the normal control skin (27.71±16.52 vs 12.63±4.31.35.99±8.63 vs 22.69±9.56.both P＜0.05).Conclusion Our results indicate a hyper-plasia of cutaneous nerve fibers in chronic itchv skin lesions of AD and an increase in the expression of PAR2 and SP in the cutaneous nerve fibers,suggesting that the signal enhancement in PAR2 pathway may be related to the mechanism of pruritus in patients with AD.

OBJECTlVE To observe the effect of soybean isofIavone( SI)on the expression of nephrin and investigate its protection mechanism in the kidney of diabetic rats. METHODS A diabetic rat modeI was induced after streptozocin(STZ)60 mg·kg-1 was injected into Sprague-DawIey rats. After 72 h,SI 40,120 and 360 mg·kg-1 was ip given to rats in SI groups,respectiveIy,once daiIy,for 8 weeks. The concentration of fasting bIood gIucose( FBG)was determined by a bIood gIucose meter. Urine protein(UP)of 24 h was determined using ELISA. The concentration of serum creatinine(SCr),bIood urea nitrogen(BUN),maIondiaIdehyde(mDA)and superoxide dismutase(SOD)was determined by an automatic biochemicaI anaIyzer. The expression of nephrin,tumor necrosis factor-α(TNF-α)and NF-κB protein in renaI tissue was measured by Western bIotting,respectiveIy. RESULTS Compared with normaI controI group,the concentration of FBG,24 h UP,BUN,SCr and mDA in modeI group was aII siginificantIy increased(P﹤0.05,P﹤0.01),but SOD was decreased( P﹤0.01).Compared with modeI group,BUN in SI 40,120 and 360 mg·kg-1 groups decreased from(24.3±6.3)mmoI·L-1 to(16.8±4.9), (13.4±5.4)and(7.7±1.2)mmoI·L-1 ,respectiveIy,24 h UP in SI 360 mg·kg-1 group decreased from (1.26±0.45)mg to(0.88±0.15)mg( P﹤0.01),SCr decreased from(56.4±8.4)μmoI·L-1 to(35.3± 4.3)μmoI·L-1(P﹤0.01),mDA decreased from(8.32±1.40)μmoI·L-1 to(5.33±0.95)μmoI·L-1(P﹤0.01), but SOD in SI 120 and 360 mg·kg-1 groups increased from(125.5 ±2.4)kU·L-1 to 144.2 ±9.2 and (169.2±3.2)kU·L-1(P﹤0.01). Compared with SI 120 mg·kg-1 ,SCr,BUN and mDA in SI 360 mg·kg-1 group were aII siginificantIy Iower(P﹤0.05,P﹤0.01),but SOD was higher(P﹤0.01). Compared with normaI controI group,the expression of nephrin protein greatIy decreased(P﹤0.01),whiIe the expres-sion of TNF-α protein greatIy increased in modeI group( P ﹤0.01). Compared with modeI group,the expression of nephrin protein greatIy increased in SI 40,120 and 360 mg·kg-1 groups(P﹤0.01),whiIe the expression of TNF-α and NF-κB protein greatIy decreased in SI 120 and 360 mg·kg-1 groups(P﹤0.01). CONCLUSlON The mechanism by which SI protects the kidney may be partIy reIated to anti-infIammation,antioxidation and increasing the expression of nephrin in diabetic rats.

ObjectiveTo explore the state of misdiagnosis, missed diagnosis and excesseive diagnosis related to cerebral palsy(CP).Methods389 cases were retrospectively analyzed who were misdiagnosed, missed or escessively diagnosed related to CP as the first diagnosis in the inpatient and outpatient department from July 1999 to March 2010.ResultsAmong 389 cases, 156 cases were missed or misdiagnosed as nutritional disease, and 118 cases of other diseases were misdiagnosed as CP, while 115 cases who were normal children was excessively diagnosed as CP. The false diagnosis had relativity with children's age: doctors are more prone to make misdiagonsis when the children's age are smaller, while 293 cases were misdiagnosed before 12 months old (75.3%); 102 cases (65.4%) were misdiagnosed or missed as other diseases before September, 2004, while 87 cases (75.7%) were excessively diagnosed as CP after September, 2004. Frequency of misdiagnosis as CP reduced from 2004, and the proportion dropped from 55.9% to 44.1%.ConclusionIt is very important to master the diagnostic standard of CP. Both sides of the question are important, one side is to make early diagnosis and early treatment in order to achieve the best effect of rehabilitation, and the other side is to prevent misdiagnosis and excessive diagnosis which woud delay illness, or waste medical resources, increase the financial and psychological burden.

Objective To investigate the value of anti-HI antibody screening and identification in clinical blood transfusion . Methods 4 cases of anti-HI antibody positive in our hospital from February 2016 to November were selected as the research subjects .The irregular antibodies screening and identification were performed by adopting the anti-human globulin and saline test tube method ,then the blood transfusion effect was evaluated .Results Four cases were ABO blood group ,in which 2 cases were group A RhD positive and 2 cases were group AB RhD positive .The screening results of anti-human globulin method were weak positive , while which of saline test tube method were positive .Under the saline medium condition ,the reaction results of serum with 16 spectrum cellular reaction in 4 cases were positive ,while which with autoerythrocytes were negative ;under the anti-human globulin medium condition ,the reaction results of serum with 16 spectrum cellular reaction in 4 cases were negative except 1 case of weak positive ,while which with autoerythrocytes were negative .After blood transfusion in 2 cases of treatment blood use ,Hb increase reached the expected effect without blood transfusion adverse reactions occurrence .Conclusion In blood transfusion for the patients with anti-HI antibody positive ,the blood of same type ABO and compatible results in both saline test tube method and anti-human globulin tests should be selected .

Objective: To explore the management effects of health knowledge-attitude-practice education on phosphorous control in peritoneal dialysis patients with hyperphosphatemia. Methods: A total of 64 peritoneal dialysis patients with hyperphosphatemia with long-term stable follow-up in the People’s Hospital of Quzhou from 2016 to 2018 were selected, and randomly divided into control and intervention groups. The groups received regular health education and health knowledge-attitude-practice education for 3 months, respectively. T-test and paired t-test were used to analyze the difference in the two groups, before and after intervention, in the score of knowledge-attitude-practice, serum phosphorus level, daily dietary phosphorous, and dosage of phosphate binder. Results: Before the health education intervention,there was no significant difference between the two groups’ questionnaire score of knowledge-attitude-practice of hyperphosphatemia, serum phosphorus, intact parathyroid hormone (iPTH), daily dietary phosphorous, dosage of phosphorus binder, and weekly urea clearance index in gender, age, and other general information. After 3 months of health education, the total score, knowledge, and behavior scores were higher in both groups than before intervention, and the scores of the intervention group were significantly higher than the control group. The scores increased by 16.64, 6.15, and 9.52 points respectively in the control group, and by 26.26, 11.67, and 13.56 points respectively in the intervention group. There was no significant difference in attitudes and beliefs between the groups before and after the intervention. After the intervention, the serum phosphorus level decreased, dosage of phosphate binder increased in both groups, the daily dietary phosphorous and iPTH decreased in the intervention group. These differences were statistically significant. The serum phosphorus level of the intervention group (1.86±0.42) mmol/L was lower than the control group (1.97±0.33) mmol/L, and the daily dietary phosphorous of the intervention group (831.22±187.85) mg/d was lower than the control group (928.23±192.81) mg/d. The difference in dosage of phosphate binder and iPTH of the groups was not statistically significant. Conclusions Health knowledge-attitude-practice education in peritoneal dialysis patients with hyperphosphatemia can improve their level of knowledge-attitude-practice, and promote the reduction of serum phosphorus.

Skin microbiota is associated with various skin diseases. Scalp hair follicles penetrate deeply into the skin, and carry complex microbial communities distinct from those on the skin surface. Local imbalance of microbial communities may impair the skin barrier function, leading to a variety of hair and scalp diseases. This review discusses changes in microbial diversity and colonization by specific microorganisms in various hair diseases, including dandruff, folliculitis decalvans, etc., and provides new ideas for exploring the pathogenesis of and therapeutic strategies for various hair and scalp diseases.

Objective To summarize and analyze the pathological data of 431 cases of renal biopsy from Quzhou, Zhe-jiang and to discuss the epidemiological characters via pathological distribution in Quzhou. Methods A total of 431 patients with kidney diseases hospitalized between January 2012 and December 2014 by our hospital were reviewed and their epidemiological characters and distribution of pathological patterns were analyzed. Results Among the 431 speci-mens, 181 cases were from males (42.0%), and 250 were females (58.0%, male/female=1:1.38). As to the clinical types of disease, the most common disease was nephrotic syndrome (NS, 178 cases, 41.3%), followed by chronic glomeru-lonephritis (CGN, 142 cases, 32.9%). As to the etiologic classification, a majority of 342 cases were primary glomeru-lonephritis (PGN, 79.3%), 77 cases were secondary glomerulonephritis (SGN, 17.9%), 11 cases were tubulo-interstitial disease(TID, 2.6%), and 1 case was renal transplantation disease(0.2%). Among the PGN patients, IgA nephropathy (IgAN) and membranous nephropathy(MN) were most commonly observed, accounting for 32.7%and 24.5%, respectively. Of the SGN patients, lupus nephritis(LN) was most common, accounting for 40.2%, which was followed by Henoch-Schonlein purpura nephritis (HSPGN, 18.2%) and hepatitis b virus-associated glomerulonephritis (HBVGN, 13.0%). Conclusion PGN is the most common etiological factor of kidney biopsy, with IgAN and MN at most. LN is the main type of SGN, followed by HSPGN and HBVGN. In Quzhou, Zhejiang, the incidence rate is higher in young adults, indi-cating that special attention should be paid on IgAN, MN and LN in prevention and treatment of kidney diseases.

Objective : To investigate the effect of high concentration of Caerulomycin A (Cae A) on HK2 in renal tubular epithelial cells and to explore the role of cytoplasmic nucleotide⁃binding oligomerization domain⁃like receptor protein 3 (NLRP3) in this process. Methods : The effect of different concentrations of Cae A on the viability of HK2 cells was determined by MTT; the expression of kidney injury molecule (KIM⁃1) and NLRP3 was detected by real⁃time quantitative PCR , Western blot and immunofluorescence , while the effect of Cae A on the mRNA expression of IL⁃1β , IL⁃18 , IL⁃33 , MCP⁃1 , TNF⁃α was also measured by real⁃time quantitative PCR. HK2 cells were divided into control group , high concentration of Cae A group and high concentration of Cae A plus NLRP3 inhibitor CY⁃09 group , and the expression of KIM⁃1 and NLRP3 protein was detected by Western blot. Results : The results of MTT showed that high concentration of Cae A could inhibit HK2 cell viability. Real⁃time quantitative PCR , Western blot and immunofluorescence assays showed that high concentration of Cae A upregulated the expression of KIM⁃1 and NLRP3 , as well as the mRNA levels of IL⁃1β , IL⁃18 , IL⁃33 , MCP⁃1 , TNF⁃α , while CY⁃09 could down⁃regulate the expression of NLRP3 and KIM⁃1. Conclusion High concentration of Cae A significantly inhibited the viability of HK2 cells and induced damage and inflammatory response to HK2 with some nephrotoxicity that might be achieved via NLRP3 pathway.

OBJECTIVE: To compare and analyze the effect of unplanned versus planned admission to the intensive care unit (ICU) on the prognosis of high-risk patients after surgery, so as to provide a clinical evidence for clinical medical staff to evaluate whether the postoperative patients should be transferred to ICU or not after surgery. METHODS: The clinical data of patients who were transferred to ICU after surgery admitted to the Affiliated Hospital of Guizhou Medical University from January to December in 2021 were retrospectively analyzed, including gender, age, body mass index, past history (whether combined with hypertension, diabetes, pulmonary disease, cardiac disease, renal failure, liver failure, hematologic disorders, tumor, etc.), acute physiology and chronic health evaluation II (APACHE II), elective surgery, pre-operative hospital consultation, length of surgery, worst value of laboratory parameters within 24 hours of ICU admission, need for invasive mechanical ventilation (IMV), duration of IMV, length of ICU stay, total length of hospital stay, ICU mortality, in-hospital mortality, and survival status at 30th day postoperative. The unplanned patients were further divided into the immediate transfer group and delayed transfer group according to the timing of their ICU entrance after surgery, and the prognosis was compared between the two groups. Cox regression analysis was used to find the independent risk factors of 30-day mortality in patients transferred to ICU after surgery. RESULTS: Finally, 377 patients were included in the post-operative admission to the ICU, including 232 in the planned transfer group and 145 in the unplanned transfer group (42 immediate transfers and 103 delayed transfers). Compared to the planned transfer group, patients in the unplanned transfer group had higher peripheral blood white blood cell count (WBC) at the time of transfer to the ICU [×10⁹/L: 10.86 (7.09, 16.68) vs. 10.11 (6.56, 13.27)], longer total length of hospital stay [days: 23.00 (14.00, 34.00) vs. 19.00 (12.00, 29.00)], and 30-day post-operative mortality was higher [29.66% (43/145) vs. 17.24% (40/232)], but haemoglobin (Hb), arterial partial pressure of carbon dioxide (PaCO₂), oxygenation index (PaO₂/FiO₂), and IMV requirement rate were lower [Hb (g/L): 95.00 (78.00, 113.50) vs. 98.00 (85.00, 123.00), PaCO₂ (mmHg, 1 mmHg ≈ 0.133 kPa): 36.00 (29.00, 41.50) vs. 39.00 (33.00, 43.00), PaO₂/FiO₂ (mmHg): 197.00 (137.50, 283.50) vs. 238.00 (178.00, 350.25), IMV requirement rate: 82.76% (120/145) vs. 93.97% (218/232)], all differences were statistically significant (all P < 0.05). Kaplan-Meier survival curve showed that the 30-day cumulative survival rate after surgery was significantly lower in the unplanned transfer group than in the planned transfer group (Log-Rank test: χ² = 7.659, P = 0.006). Univariate Cox regression analysis showed that unplanned transfer, APACHE II score, whether deeded IMV at transfer, total length of hospital stay, WBC, blood K⁺, and blood lactic acid (Lac) were associated with 30-day mortality after operation (all P < 0.05). Multifactorial Cox analysis showed that unplanned transfer [hazard ratio (HR) = 2.45, 95% confidence interval (95%CI) was 1.54-3.89, P < 0.001], APACHE II score (HR = 1.03, 95%CI was 1.00-1.07, P = 0.031), the total length of hospital stay (HR = 0.86, 95%CI was 0.83-0.89, P < 0.001), the need for IMV on admission (HR = 4.31, 95%CI was 1.27-14.63, P = 0.019), highest Lac value within 24 hours of transfer to the ICU (HR = 1.17, 95%CI was 1.10-1.24, P < 0.001), and tumor history (HR = 3.12, 95%CI was 1.36-7.13, P = 0.007) were independent risk factors for patient death at 30 days post-operative, and the risk of death was 2.45 times higher in patients unplanned transferred than in those planned transferred. Subgroup analysis showed that patients in the delayed transfer group had significantly longer IMV times than those in the immediate transfer group [hours: 43.00 (11.00, 121.00) vs. 17.50 (2.75, 73.00), P < 0.05]. CONCLUSIONS The 30-day mortality, WBC and total length of hospital stay were higher in patients who were transferred to ICU after surgery, and PaO₂/FiO₂ was lower. Unplanned transfer, oncology history, use of IMV, APACHE II score, total length of hospital stay, and Lac were independent risk factors for patient death at 30 days postoperatively, and patients with delayed transfer to ICU had longer IMV time.
Humans ; Retrospective Studies ; Respiration, Artificial ; Hospitalization ; Prognosis ; Intensive Care Units