Objective To evaluate the modification of C_(60) on the radiation effects of ~(60)Co-γ irradiation on zebrafish.Methods The adult and embryonic zebrafish were used as model organisms to examine the potential of C_(60) to elicit oxidative stress responses on the surviving rate,hatching rate and malformation occurrence,both upon exposure to light or in the dark.Reactive oxygen species (ROS) production and DNA damage were examined as the possible underlying mechanism.Results 500 × 10~(-9) nano-C_(60) waterborne exposure could enhance the γ-irradiation effects by decreasing adult fish survival upon light exposure,which resulted in ROS and DNA damage increasing.The hatching rates were also inhibited with higher malformation,though dark exposure did not make any enhancement,except that the 5000× 10~(-9) C_(60) would inhibit larvae hatching and induced more malformation.Conclusions Waterborne nano-C_(60) exposure may enhance the radiation effects on zebrafish,ROS production and DNA damage increasing may be the underlying mechanism.

OBJECTIVE: To detect the serum level of a novel autoantibody, anti-tubulin-α-1C, in patients with systemic sclerosis (SSc) and to investigate its clinical significance. METHODS: Anti-tubulin-α-1C antibody levels were determined by enzyme-linked immunosorbent assay (ELISA) in 62 patients with SSc, 38 systemic lupus erythematosus (SLE), 24 primary Sjögren's syndrome (pSS) patients, and 30 healthy controls (HCs). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), immunoglobulin A(IgA), immunoglobulin M (IgM), immunoglobulin G (IgG), C3, C4, rheumatoid factor (RF), antinuclear antibody(ANA), anti-centromere antibodies(ACA), anticardiolipin (aCL), anti-dsDNA antibody, anti-Sm antibody, anti-RNP antibody, anti-Scl-70 antibody, anti-Ro52 antibody, anti-SSA antibody, anti-SSB antibody, centromere protein A(CENP-A), centromere protein B (CENP-B) were measured by standard laboratory techniques. Raynaud's phenomenon and modified Rodnan skin score(MRSS) were recorded to evaluate the disease status of SSc. Independent sample t test, Chi square test, Mann-Whitney U test, Spearman rank correlation were used for statistical analyses. RESULTS: The serum anti-tubulin-α-1C antibody concentration in SSc group was 81.24±34.38, the serum anti-tubulin-α-1C antibody concentration in SLE group was 87.84±38.52, the serum anti-tubulin-α-1C antibody concentration in pSS group was 59.79±25.24, and the serum anti-tubulin-α-1C antibody concentration in healthy group was 39.37±18.7. Multivariate analysis revealed that anti-tubulin-α-1C antibody levels were significantly increased in the SSc and SLE patients. The expression level of anti-tubulin-α-1C antibody in SSc was higher compared with the pSS group and the health control group (P < 0.01). Further analysis demonstrated that the elevated anti-tubulin-α-1C antibody were correlated with the SSc inflammation and disease activity markers ESR(r=0.313, P=0.019), The levels of anti-tubulin-α-1C antibody were also significantly correlated with MRSS(r=0.636, P < 0.01). The best cut-off value for the diagnose of SSc was 76.77 as mean+2SD value. The proportion of Raynaud's phenomenon was higher in the group of anti-tubulin-α-1C autoantibody-postive SSc patients than that in anti-tubulin-α-1C autoantibody negative group(71.4% vs. 37.5%, P=0.039). The proportions of anti-Scl-70 antibody, anti-CENP antibody and anti-cardiolipin antibody were higher in the group of anti-tubulin-α-1C autoantibody-postive SSc patients than in the anti-tubulin-α-1C autoantibody negative group (37.9% vs. 15.2%, 34.5% vs. 12.1%, 13.8 vs. 0, respectively, all P < 0.05). CONCLUSION Based on this explorative stu-dy, the level of anti-tubulin-α-1C antibody increased in the serum of the patients with SSc. There were correlations between anti-tubulin-α-1C autoantibody and clinical and laboratory indicators of the SSc patients. It may become a novel biomarker indicative of active SSc and could be applied in future clinical practice.
Antibodies, Antinuclear ; Autoantibodies ; Humans ; Lupus Erythematosus, Systemic ; Scleroderma, Systemic ; Sjogren's Syndrome

Objective: To explore and analyze the effects of airway management team (AMT) in the treatment of severely mass burn patients combined with inhalation injury. Methods: The clinical data of 58 severely burned patients combined with inhalation injury hospitalized in our unit from January 2012 to August 2014, conforming to the inclusion criteria, were retrospectively analyzed. According to whether airway management was implemented by AMT or not, patients hospitalized from January 2012 to July 2014 were divided into control group (n=27), while patients in Kunshan factory aluminum dust explosion accident hospitalized on 2nd August 2014 were divided into observation group (n=31). Patients in control group received regular airway nursing carried out by nurses on duty, while patients in observation group received specialized airway concentration nursing implemented by AMT. The concrete implementation included overall assessment of patients′ airway, elaborate airway care, and controlled management of mechanical ventilation. Arterial blood gas indexes and oxygenation index of patients in the two groups on post injury day (PID) 1, 7, and 14 were compared. Sputum viscosity, ventilator-associated pneumonia (VAP) occurrence rate, and ventilation time of patients in the two groups in post injury week(s) 1, 2, and 3 after admission were monitored and recorded. Survival rates of patients in the two groups were compared. Data were processed with analysis of variance for repeated measurement, t test and Bonferroni correction, chi-square test, and Wilcoxon rank sum test. Results: (1) There were no statistically significant differences in pH value, arterial partial pressure of oxygen (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂), arterial oxygen saturation (SaO₂), and oxygenation index of patients in the two groups on PID 1 (t=0.595, -0.166, 1.518, -0.828, 0.458, P>0.05). The pH values of patients in observation group on PID 7 and 14 were 7.327±0.050 and 7.367±0.043, respectively, significantly better than those in control group (7.304±0.021 and 7.390±0.029, respectively, t=-2.385, 2.391, P<0.05). The PaO₂ values of patients in observation group on PID 7 and 14 were (95.1±6.7) and (106.3±7.8) mmHg (1 mmHg=0.133 kPa), respectively, significantly higher than those in control group [(91.6±5.7) and (102.0±8.3) mmHg, respectively, t=-2.109, -2.059, P<0.05]. The PaCO₂ values of patients in observation group on PID 7 and 14 were (41±4) and (40±4) mmHg, respectively, significantly lower than those in control group [(43±5) and (43±4) mmHg, respectively, t=2.220, 2.304, P<0.05]. The SaO₂ values of patients in observation group on PID 7 and 14 were 0.95±0.04 and 0.96±0.04, respectively, significantly higher than those in control group (0.93±0.05 and 0.94±0.05, respectively, t=-2.201, -2.016, P<0.05). The oxygenation indexes of patients in observation group on PID 7 and 14 were (286±18) and (329±20) mmHg, significantly higher than those in control group [(277±14) and (306±58) mmHg, respectively, t=-2.263, -2.022, P<0.05]. (2) Sputum viscosity of patients in observation group in post injury week(s) 1, 2, and 3 were superior to that in control group (Z=-2.096, -2.076, -2.033, P<0.05). (3) VAP occurrence rate of patients in observation group was lower than that in control group, and time of mechanical ventilation of patients in observation group was shorter than that in control group (χ²=4.244, t=2.425, P<0.05). (4) Survival rate of patients in observation group was higher than that in control group (χ²=4.244, P<0.05). Conclusions The special intensive care of airway management by AMT can effectively improve the oxygenation status of severely burned patients combined with inhalation injury, alleviate the sputum viscosity, reduce the occurrence of VAP, and shorten the time of mechanical ventilation, thus benefits the treatment of severely mass burn patients combined with inhalation injury.

Objective:To observe the efficacy of Dabigatran etexilate anticoagulation therapy and analyze its influencing factors in elderly patients.Methods:The clinical data of the elderly patients using Dabigatran etexilate anticoagulation for prevention or treatment of thrombosis in the Department of Geriatrics, Peking University First Hospital were collected.Changes of coagulation indexes and its influencing factors were analyzed when taking Dabigatran in different doses.Results:A total of 142 patients receiving Dabigatran therapy were collected, with an average age of(79.0±7.5)years.Among them, 128 patients had atrial fibrillation and 14 had deep venous thrombosis and/or pulmonary embolism.After taking Dabigatran, the trough values of activated partial thromboplastin time(APTT)and thrombin time(TT)were increased significantly in all patients compared with that before administration( P<0.001). In patients taking Dabigatran 110 mg once a day, APTT was(32.4±3.0)s before administration, with a trough value of(41.4±5.4)s and a peak value of(53.9±9.8)s.In patients taking Dabigatran 110 mg twice a day, APTT was(31.0±3.1)s before administration, with a trough value of(42.4±5.5)s and a peak value of(48.7±7.3)s.Compared with patients taking Dabigatran 220 mg/d, those who took Dabigatran 110 mg/d were older( P<0.0001), often women( P<0.0001), had lower body weight( P=0.001), body mass index( P=0.018)and creatinine clearance rate( P<0.001), and higher basal( P=0.008)and peak values( P=0.002)of APTT, but with similar trough values.Multivariate analysis showed that the APTT trough values were significantly related with APTT basal value( β=0.885, P<0.001), creatinine clearance rate( β=-0.121, P<0.001), dosage of Dabigatran( β=0.037, P<0.001)and combined amiodarone( β=3.784, P=0.022). Conclusions:There are individual differences in the anticoagulant effect of Dabigatran etexilate.The APTT trough value is higher in patients with high APTT basal value, high Dabigatran dose, low creatinine clearance rate and combined use of amiodarone.Dabigatran 110 mg/d was often used in women, elderly patients, and those with low body weight, and decreased renal function, and with a similar trough value and a high peak value of APTT compared with patients on Dabigatran 220 mg/d.

Objective To investigate the effect of reducing antipsychotic dose on clinical symptoms in patients with stable schizophrenia. Methods Seventy-five patients with stable schizophrenia taking olanzapine or risperidone were enrolled. Patients were randomly divided into dose reduction group (37 cases) and maintenance group (38 cases). The dose of the risperidone or olanzapine was gradually reduced by 50％ in the dose reduction group within six months whereas remained unchanged in the maintenance group. The Positive and Negative Symptom Scale (PANSS), Calgary Depression Scale (CDRS), Personal and Social Performance Scale (PSP), Insight and Treatment Attitude Questionnaire (ITAQ) and Extrapyramidal Side Effects Scale (RSESE) were assessed at baseline, 3 months, 6 months and 12 months. Results There were one and two cases dropped out due to the relapse in dose reduction group and in maintenance group, respectively. The recurrence rates were 2.7％ in dose reduction group and 5.3％ in maintenance group (P<0.05). The interaction effects of PANSS positive symptoms, negative symptoms and general pathological symptoms, ITAQ,RSESE, PSP were significant (P<0.05). The main effect of PANSS negative symptoms and PSP group was significant (P<0.05). Compared with the maintenance group, PANSS negative symptoms of the dose reduction group were significantly lower at 6 and 12 months (P<0.05). PSP scores were significantly higher in the dose reduction group than in maintenance group (P<0.05) at 3, 6 and 12 months. Conclusion Reducing the dose of risperidone or olanzapine slowly in patients with stable schizophrenia within six months reduces negative symptoms and adverse reaction, improves social function without increasing positive symptoms.

Objective To know the situation of postoperative pain and the satisfaction with pain management in patients who suffered osteonecrosis of the femoral head ( ONFH ) and accepted free vascularized fibular grafting ( FVFG ) , and analyze the influencing factors of satisfaction with pain management. Methods By convenience sampling method, 140 inpatients who underwent FVFG for 72 hours were recruited in this study. These patients were admitted in the orthopedic department of the Sixth People′s Hospital of Shanghai from January to October 2016, and were investigated by the general information questionnaire, the brief pain inventory, and the pain treatment satisfaction scale. The influencing factors of satisfaction with pain nursing were analyzed. Results The score of the most severe pain intensity of the 140 patients reached ( 4. 92 ± 1. 36 ) . The total score of patients′ satisfaction with pain management was (81. 81±9.09), among which, the dimension of professional skills earned the highest average score of (4.00± 0.61), followed by the dimension of trust, which was up to (3. 90±0.53). The dimension of the relation of education got the lowest score of (3.77±0.30). The analysis of single factor showed that the age and the education levels affected the satisfaction of pain management ( P<0. 05 ) . The stepwise multiple regression analysis reviewed that there were five factors having influences on the satisfaction of pain management, and they were: the most severe pain intensity after FVFG, the influences of pain on functional exercise, the degree of pain relief, the education level of patients, and the influences of pain on patients′sleeping. These can successfully explain 70.8% of the variation of the satisfaction ( R2=0.708) . Conclusions Patients are overall satisfied with postoperative pain treatment. Factors such as the most severe pain intensity after FVFG, the influences of pain on functional exercise, the degree of pain relief, the education level of patients, and the influences of pain on patients′sleeping will affect the degree of satisfaction.

OBJECTIVETo screen childhood ALL related microRNAs (miRNAs), analyze association of miRNAs expression profiles with prognosis and relapse in childhood acute lymphoblastic leukemia (ALL) and explore new indicator for predicting relapse and prognosis.

METHODSmiRNAs expression profile was analyzed by gene chip in 49 newly diagnosed childhood ALL and 12 primary immune thrombocytopenia (ITP) cases (as control group). Abnormal expression of miRNAs was verified by qRT-PCR. The correlation of miRNAs expression pattern with indicators predicting early prednisone response and relapse within a year was analyzed.

RESULTSSpecific expression of miRNAs profiles associated with prednisone response and early relapse in childhood ALL was identified. Eight miRNAs (miR-18a, miR-532, miR-218, miR-625, miR-193a, miR-638, miR-550 and miR-633) could distinguish prednisone sensitive from insensitive. The early relapse of newly diagnosed patients with either high-risk or non-high-risk clinical types had some characteristics of abnormal expression of miRNAs, including miR-7, miR-216 and let-7i upregulated, while miR-486, miR-191, miR-150, miR-487 and miR-342 downregulated.

CONCLUSIONSThe initial screening reveals miRNAs differentially expressed from normal in ALL suggesting the potential roles of them in leukemogenesis. MiRNAs expression signatures may be useful for predicting prognosis and relapse in childhood ALL and directing personalized treatment.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; MicroRNAs ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; genetics ; pathology ; Prognosis ; Recurrence ; Transcriptome

OBJECTIVETo explore the clinical value of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) detection in the diagnosis of diastolic heart dysfunction.

METHODSNinety patients with diastolic heart dysfunction and left ventricular ejection fraction (LVEF)>or=45% were divided into 3 groups according to the findings by conventional echocardiography and/or tissue Doppler imaging, namely impaired relaxation pattern group (n=58), pseudonormal pattern group (n=22) and restrictive filling pattern group (n=10). Ten patients with normal heart function served as the control group. Plasma NT-proBNP level was determined in all the subjects and its correlation to diastolic heart dysfunction was analyzed.

RESULTSCompared with the control group, all the 3 case groups had significantly higher plasma NT-proBNP level (P<0.01). Plasma NT-proBNP level increased gradually with the severity of diastolic dysfunction. Spearman rank correlation analysis indicated that lg(NT-proBNP) was positively correlated to the severity of diastolic dysfunction. Simple linear regression showed that 52.7% of the total variation of lg(NT-proBNP) was correlated to the severity of the condition. The ROC curve demonstrated a sensitivity of 80%, specificity of 90%, positive predictive value of 84.2% and the negative predictive value of 87.1% for NT-proBNP level of 133 ng/L in predicting diastolic heart dysfunction regardless of the clinical manifestations, and the sensitivity was 81.7% and specificity was 75% for NT-proBNP level at 280.25 ng/L in predicting symptomatic diastolic heart dysfunction; the sensitivity was 81.2% and the specificity was 92.6% for NT-proBNP at 655 ng/L in predicting moderate to severe diastolic heart dysfunction.

CONCLUSIONPlasma NT-proBNP level increases gradually with the severity of diastolic dysfunction and has a high clinical value in severity rating and assisting the diagnosis of diastolic dysfunction.

Aged ; Diastole ; Female ; Heart Failure ; blood ; diagnosis ; physiopathology ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Stroke Volume

A 90-year-old Chinese man was transferred to the Emergency Department of the Affiliated Shantou Hospital of Sun Yat-sen University for treatment of an acute myocardial infarction. He suffered chest pain with three days of cough, dyspnea and fever. A diagnosis of Takotsubo cardiomyopathy was made in normal coronary arteries from urgent coronary angiography and characteristic apical dyskinesis and basal hyper contractility in left ventriculography. The patient died from severe multi-organ failure on the second day of hospitalization.
Aged, 80 and over ; Coronary Angiography ; Fatal Outcome ; Humans ; Male ; Takotsubo Cardiomyopathy ; diagnosis ; diagnostic imaging