Objective　To observe the changes of glucocorticoi d receptor (GR) in hepatic cytoplasm in rats after scalding-induced pathologic al stress and its regulation. Methods　The receptor binding capa city (R0) and the apparent dissociation constant (Kd) of GR in hepatic cytopla sm of normal, low-degree and heavy-degree scalded rats were measured with rad io-ligand binding assay, with ［3H］ dexamethasone as ligand. The changes of R0 and Kd of GR were regulated by injections of anti-rat TNFα, IL-1β a ntibodies, α-melanocyte-stimulating hormone (α-MSH), and KPV peptide( Ac- D-Lys-L-Pro-D-Val) respectively in vivo. Results　The R 0 of GR in hepatic cytoplasm in rats 12 h after heavy-degree scalding ［Mass action robust: （205.52±30.14） fmol/mg; Scatchard: （208.45±30.78） fmol/mg ］were significantly lower than that of control group ［Mass action robust:（307 .86±24.22） fmol/mg;Scatchard:（306.71±27.96） fmol/mg］(P<0.01), but no s ignificant difference was found in the R0 of GR between the control and the ra ts 12 h after low-degree scalding ［Mass action robust: （285.19±16.62） fmol/ mg ; Scatchard: （296.64±16.06） fmol/mg］. The injection of anti-rat TNFα, IL-1β antibodies, α-MSH and KVP all prevented the decline of R0 of GR in h epatic cytoplasm in rats with severe scalding. Conclusion　The injections of anti-rat TNFα, IL-1β antibodies, α-MSH or KPV can attenuate the reduction of GR in rat hepatic cytoplasm caused by severe scalding-induced pathological stress to some extent.

Objective To compare the effects of different intervention methods on relieving the xerostomia and to explore the best method to relieve xerostomia in patients during anesthesia recovery period.Methods A total of 108 patients in post anesthesia care unit after general anesthesia were recruited from March 2015 to June 2016 in Chinese PLA General Hospital.They were randomly divided into the experimental group 1 (27 cases),experimental group 2 (26 cases),condition conditional group (28 cases),blank control group (27 cases) with different methods of moistening oral cavity after extubation with 2 ml at a time for every 10 minutes including lemon water sprayer,vitamin C sprayer,warm water sprayer and non-intervention.And then,the visual analogue scale (VAS) for the intensity of xerostomia and the prevalence of adverse reactions including nausea,vomiting,abdominal pain,abdominal distension and so on were compared before intervention,20 minutes and 50 minutes after intervention.Results The results showed that the scores of VAS in the experimental group 1 were lower than those in the experimental group 2,the conditional control group and the blank control group 20 minutes and 50 minutes after intervention with significant differences [(Dunnett-t =-1.200,-1.733,-1.733;P＜ 0.01;20 minutes after intervention),(Dunnett-t =-2.150,-2.500,-5.567;P＜0.01;50minutes after intervention)].Conclusions The application of the lemon water sprayer for moistening oral cavity can effectively relieve the xerostomia in patients during anesthesia recovery period.Besides,the effects of the lemon water sprayer are better than those of vitamin C sprayer and warm water sprayer.

Objective To clone and identify the differentially expressed genes of rat intestinal epithelial cell line (IEC 6) before and after exposure to high dose radiation so as to provide proof for the investigation of the molecular mechanisms in the repair of radiation damage of intestinal epithelial cells. Methods A subtractive cDNA library for differentially expressed genes was constructed by suppression subtractive hybridization (SSH) and T/A cloning technique after IEC 6 cells were exposed to radiation at the dose of 35 Gy ? ray. The expressed sequence tag (EST) library was screened by reverse Northern hybridization. Positive clones were sequenced and the similarity was searched against the DNA database in GenBank. Limited clones were identified by Northern hybridization. Results More than 2 000 white clones were harvested after the library amplification. Ninety six of them were randomly picked out for PCR amplification, and 15 positive clones which corresponded to 12 individual genes were identified by reverse Northern hybridization. These genes were involved in cell skeleton, cell stress, cell cycle control, and signal transduction, etc. In addition, a novel cDNA sequence was also obtained. Conclusion A subtractive cDNA library for differentially expressed genes in IEC 6 cells exposed to the radiation at the dose of 35 Gy ? ray has been successfully constructed with SSH and T/A clone techniques. Several positive ESTs which correspond to genes involving in cell skeleton, cell stress, cell cycle control, and signal transduction are identified. These genes may play important roles in the process of the damage and repair of the intestinal epithelial cells exposed to radiation.

Objective:To establish training system for postoperative delirium (POD) assessment and evaluate the efficacy of training for anesthesia nurses.Methods:Sixteen nurse anesthetists of both sexes in our hospital were selected and received the systemic training for POD assessment.The training system included questionnaire survey, theoretical teaching, simulated visit, clinical observation, independent evaluation, centralized question-answering, evaluation of efficacy and random inspection.The level of POD knowledge tests were performed before the training and at the end of the fourth week of independent evaluation, respectively.At week 1 and 4 of independent evaluation, the diagnostic rate of POD and sensitivity and specificity of the assessment were calculated, and Kappa consistency analysis was used to assess the consistency between anesthesia nurses and training group in diagnosis of POD.In the first week of the third month after the end of training, the evaluation results were randomly inspected, the POD diagnosis rate was calculated between the anesthesia nurses and the training group, and the consistency analysis was conducted.Results:Compared with the scores of POD knowledge questionnaire and sensitivity of the assessment of the anesthesia nurses in the first week of training, the scores were significantly increased ( P<0.05), and no significant change was found in the POD diagnosis rate in the fourth week of training ( P>0.05). Compared with the training group, the diagnosis rate of POD of anesthesia nurses was significantly decreased in the first week of training ( P<0.05), and no significant change was found at the fourth week of training ( P>0.05). In the first and fourth weeks of training, the Kappa value of anesthesia nurses and the training group was 0.676 and 0.954 ( P<0.001), respectively.In the first week of the third month after the end of training, the Kappa value between anesthesia nurses and the training group in diagnosis of POD was 0.862 ( P<0.05). Conclusion:The training system of POD assessment has been successfully established, and the standardized anesthesia nurses training of POD has been achieved with good results.

Objective:To evaluate the relationship between prognostic nutritional index (PNI) and myocardial injury after non-cardiac surgery (MINS).Methods:This was a retrospective cohort study. The clinical data of adult patients ( n=2 203) who underwent liver resection surgery with general anesthesia at our center from January 2016 to August 2019 were retrospectively collected. The predictive value of preoperative PNI for MINS and the optimal cut-off value of PNI were evaluated and determined according to the receiver operating characteristic curve, and the patients were divided into 2 groups based on the cut-off value: high PNI group and low PNI group. Logistic regression analyses were applied to investigate the relationship between preoperative PNI and MINS. According to the same inclusion and exclusion criteria, the clinical data of patients at our center from January 2022 to December 2023 were collected as the validation set ( n=2 525), and they were grouped using the same PNI cutoff value. Logistic regression analyses were used to verify the relationship between PNI and MINS. Results:The receiver operating characteristic curve analysis showed that the area under the curve of preoperative PNI for predicting MINS was 0.651 (95% confidence interval [ CI] 0.602-0.699), with an optimal cut-off value of 46.193, and the specificity and sensitivity were 0.729 and 0.519 respectively. The integer 46 was considered as the optimal cutoff value for PNI, and the patients were divided into low PNI group (PNI<46, n=606) and high PNI group (PNI≥46, n=1 597). Both univariate and multivariate logistic regression analyses showed that preoperative low PNI was an independent risk factor for the occurrence of MINS (univariate: OR=2.873, 95% CI 2.063-4.003, P<0.001; multivariate: OR=1.844, 95% CI 1.241-2.600, P=0.003). The results in the validation set were still robust (univariate: OR=2.694, 95% CI 1.890-3.833, P<0.001; multivariate: OR=1.602, 95% CI 1.071-2.385, P=0.021). Conclusions:Preoperative low-level PNI is an independent risk factor for MINS, with a certain predictive value.

Based on 18 hospitals including the Chinese People's Liberation Army General Hospital and Peking University People's Hospital, and based on the "Specifications for Perioperative Data", explore the construction and application of perioperative multi-center data centers in the era of medical big data. The use of data ferry technology avoids hidden safety hazards in hospitals, realizes the integration and sharing of perioperative medical data of various medical institutions, and forms a complete data chain combining patient medical data and follow-up data.
Hospitals, Military ; Humans ; Military Personnel ; United States