OBJECTIVE: To observe the characteristics of changes in non-invasive hemodynamic parameters in neonates with septic shock so as to provide clinical reference for diagnosis and treatment. METHODS: A observational study was conducted. The neonates with sepsis complicated with septic shock or not admitted to neonatal intensive care unit (NICU) of the First Affiliated Hospital of Shantou University Medical College were enrolled as the study subjects, who were divided into preterm infant (< 37 weeks) and full-term infant (≥ 37 weeks) according to the gestational age. Healthy full-term infants and hemodynamically stable preterm infants transferring to NICU after birth were enrolled as controls. Electronic cardiometry (EC) was used to measure hemodynamic parameters, including heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), stroke volume index (SVI), cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR) and systemic vascular resistance index (SVRI), before treatment in the septic shock group, at the time of diagnosis of sepsis in the sepsis without shock group, and before the discharge from the obstetric department or on the day of transferring to NICU in the control group. RESULTS: Finally, 113 neonates with complete data and parental consent for non-invasive hemodynamic monitoring were enrolled, including 32 cases in the septic shock group, 25 cases in the sepsis without shock group and 56 cases in the control group. In the septic shock group, there were 17 cases at the compensated stage and 15 cases at the decompensated stage. There were 21 full-term infants (20 cured or improved and 1 died) and 11 premature infants (7 cured or improved and 4 died), with the mortality of 15.62% (5/32). There were 18 full-term infants and 7 premature infants in the sepsis without shock group and all cured or improved without death. The control group included 28 full-term infants and 28 premature infants transferring to NICU after birth. Non-invasive hemodynamic parameter analysis showed that SV, SVI, CO and CI of full-term infants in the septic shock group were significantly lower than those in the sepsis without shock group and control group [SV (mL): 3.52±0.99 vs. 5.79±1.32, 5.22±1.02, SVI (mL/m²): 16.80 (15.05, 19.65) vs. 27.00 (22.00, 32.00), 27.00 (23.00, 29.75), CO (L/min): 0.52±0.17 vs. 0.80±0.14, 0.72±0.12, CI (mL×s^-1×m^-2): 40.00 (36.67, 49.18) vs. 62.51 (56.34, 70.85), 60.01 (53.34, 69.68), all P < 0.05], while SVR and SVRI were significantly higher than those in the sepsis without shock group and control group [SVR (kPa×s×L^-1): 773.46±291.96 vs. 524.17±84.76, 549.38±72.36, SVRI (kPa×s×L^-1×m^-2): 149.27±51.76 vs. 108.12±12.66, 107.81±11.87, all P < 0.05]. MAP, SV, SVI, CO and CI of preterm infants in the septic shock group were significantly lower than those in the control group [MAP (mmHg, 1 mmHg ≈ 0.133 kPa): 38.55±10.48 vs. 47.46±2.85, SV (mL): 2.45 (1.36, 3.58) vs. 3.96 (3.56, 4.49), SVI (mL/m²): 17.60 (14.20, 25.00) vs. 25.50 (24.00, 29.00), CO (L/min): 0.32 (0.24, 0.63) vs. 0.56 (0.49, 0.63), CI (mL×s^-1×m^-2): 40.01 (33.34, 53.34) vs. 61.68 (56.68, 63.35), all P < 0.05], while SVR and SVRI were similar to the control group [SVR (kPa×s×L^-1): 1 082.88±689.39 vs. 656.63±118.83, SVRI (kPa×s×L^-1×m^-2): 126.00±61.50 vs. 102.37±11.68, both P > 0.05]. Further analysis showed that SV, SVI and CI of neonates at the compensation stage in the septic shock group were significantly lower than those in the control group [SV (mL): 3.60±1.29 vs. 4.73±1.15, SVI (mL/m²): 19.20±8.33 vs. 26.34±3.91, CI (mL×s^-1×m^-2): 46.51±20.34 vs. 61.01±7.67, all P < 0.05], while MAP, SVR and SVRI were significantly higher than those in the control group [MAP (mmHg): 52.06±8.61 vs. 48.54±3.21, SVR (kPa×s×L^-1): 874.95±318.70 vs. 603.01±111.49, SVRI (kPa×s×L^-1×m^-2): 165.07±54.90 vs. 105.09±11.99, all P < 0.05]; MAP, SV, SVI, CO and CI of neonates at the decompensated stage in the septic shock group were significantly lower than those in the control group [MAP (mmHg): 35.13±6.08 vs. 48.54±3.21, SV (mL): 2.89±1.17 vs. 4.73±1.15, SVI (mL/m²): 18.50±4.99 vs. 26.34±3.91, CO (L/min): 0.41±0.19 vs. 0.65±0.15, CI (mL×s^-1×m^-2): 43.34±14.17 vs. 61.01±7.67, all P < 0.05], while SVR and SVRI were similar to the control group [SVR (kPa×s×L^-1): 885.49±628.04 vs. 603.01±111.49, SVRI (kPa×s×L^-1×m^-2): 114.29±43.54 vs. 105.09±11.99, both P > 0.05]. CONCLUSIONS Full-term infant with septic shock exhibit a low cardiac output, high vascular resistance hemodynamic pattern, while preterm infant with septic shock show low cardiac output and normal vascular resistance. At the compensated stage the hemodynamic change is low output and high resistance type, while at the decompensated stage it is low output and normal resistance type. Non-invasive hemodynamic monitoring can assist in the identification of neonatal septic shock and provide basis for clinical diagnosis and treatment.
Humans ; Shock, Septic/physiopathology* ; Infant, Newborn ; Hemodynamics ; Female ; Male ; Case-Control Studies ; Infant, Premature

Humans ; Early Detection of Cancer ; Endoscopy ; Esophageal Neoplasms/epidemiology* ; Risk Factors ; Mass Screening

Objective To investigate the effect and mechanism of shikonin on the proliferation,migration,invasion and apoptosis of human gastric cancer MGC803 cells.Methods The MGC803 cells in the logarithmic growth phase were randomly divided into the blank control group,shikonin group,shikonin+insulin-like growth factor-1(IGF-1)group,and shikonin+LY294002 group.Cells in the blank control group were cultured in drug-free medium,cells in the shikonin group were cultured in the medium containing shikonin with a final concentration of 10 μmol·L-1,cells in the shikonin+IGF-1 group were cultured in the medium containing shikonin with a final concentration of 10 μmol·L-1 and IGF-1 with a final concentration of 10 μmol·L-1,and cells in the shikonin+LY294002 group were cultured in the medium containing shikonin with a final concentration of 10 μmol·L-1 and LY294002 with a final concentration of 30 μmol·L-1.After 24 h of culture,the cell proliferation was detected by cell counting kit-8,the cell apoptosis was detected by flow cytometry,the cell migration was detected by scratch assay,and the cell invasion was detected by Transwell assay.The expression levels of B cell lymphoma-2(Bcl-2),Bcl-2 related X protein(Bax),cytochrome C(Cyt C),cleaved caspase-3,cleaved caspase-9,phosphoinositide 3 kinase(PI3K),phosphorylated PI3K(p-PI3K),protein kinase B(PKB),and phosphorylated PKB(p-PKB)proteins were measured by using Western blot.Results The MGC803 cell proliferation inhibition rate and apoptosis rate in the shikonin group were significantly higher than those in the blank control group(P＜0.05);the MGC803 cell proliferation inhibition rate and apoptosis rate in the shikonin+IGF-1 group were significantly lower than those in the shikonin group(P＜0.05);and the MGC803 cell proliferation inhibition rate and apoptosis rate in the shikonin+LY294002 group were significantly higher than those in the shikonin group(P＜0.05).The MGC803 cell scratch healing rate and the number of invasive cells in the shikonin group were significantly lower than those in the blank control group(P＜0.05);the MGC803 cell scratch healing rate and the number of invasive cells in the shikonin+IGF-1 group were significantly higher than those in the shikonin group(P＜0.05);and the MGC803 cell scratch healing rate and the number of invasive cells in the shikonin+LY294002 group were significantly lower than those in the shikonin group(P＜0.05).The relative expression level of Bcl-2 protein in MGC803 cells in the shikonin group was significantly lower than that in the blank control group(P＜0.05),while the relative expression levels of Bax,Cyt C,cleaved caspase-3 and cleaved caspase-9 proteins and the Bax/Bcl-2 ratio were significantly higher than those in the blank control group(P＜0.05);the relative expression level of Bcl-2 protein in MGC803 cells in the shikonin+IGF-1 group was significantly higher than that in the shikonin group(P＜0.05),while the relative expression levels of Bax,Cyt C,cleaved caspase-3 and cleaved caspase-9 proteins and the Bax/Bcl-2 ratio were significantly lower than those in the shikonin group(P＜0.05);and the relative expression level of Bcl-2 protein in MGC803 cells in the shikonin+LY294002 group was significantly lower than that in the shikonin group(P＜0.05),while the relative expression levels of Bax,Cyt C,cleaved caspase-3 and cleaved caspase-9 proteins and the Bax/Bcl-2 ratio were significantly higher than those in the shikonin group(P＜0.05).The relative expression levels of p-PI3K and p-PKB proteins and the ratios of p-PI3K/PI3K and p-PKB/PKB in MGC803 cells in the shikonin group were significantly lower than those in the blank control group(P＜0.05),and there was no statistically significant difference in the relative expression levels of PI3K and PKB proteins in MGC803 cells between the shikonin group and the blank control group(P＞0.05);the relative expression levels of p-PI3K and p-PKB proteins and the ratios of p-PI3K/PI3K and p-PKB/PKB in MGC803 cells in the shikonin+IGF-1 group were significantly higher than those in the shikonin group(P＜0.05),and there was no statistically significant difference in the relative expression levels of PI3K and PKB proteins in MGC803 cells between the shikonin+IGF-1 group and the shikonin group(P＞0.05);and the relative expression levels of p-PI3K and p-PKB proteins and the ratios of p-PI3K/PI3K and p-PKB/PKB in MGC803 cells in the shikonin+LY294002 group were significantly lower than those in the shikonin group(P＜0.05),and there was no statistically significant difference in the relative expression levels of PI3K and PKB proteins in MGC803 cells between the shikonin+LY294002 group and the shikonin group(P＞0.05).Conclusion Shikonin can inhibit the proliferation,migration and invasion and promote the apoptosis of human gastric cancer MGC803 cells,which may be related to its inhibition of the PI3K/PKB signaling pathway.

Aristolochic acid (AA), extracted from Aristolochiaceae plants, plays an essential role in traditional herbal medicines and is used for different diseases. However, AA has been found to be nephrotoxic and is known to cause aristolochic acid nephropathy (AAN).AA-induced acute kidney injury (AKI) is a syndrome in AAN with a high morbidity that manifests mitochondrial damage as a key part of its pathological progression. Melatonin primarily serves as a mitochondria-targeted antioxidant. However, its mitochondrial protective role in AA-induced AKI is barely reported. In this study, mice were administrated 2.5 mg/kg AA to induce AKI. Melatonin reduced the increase in Upro and Scr and attenuated the necrosis and atrophy of renal proximal tubules in mice exposed to AA. Melatonin suppressed ROS generation, MDA levels and iNOS expression and increased SOD activities in vivo and in vitro. Intriguingly, the in vivo study revealed that melatonin decreased mitochondrial fragmentation in renal proximal tubular cells and increased ATP levels in kidney tissues in response to AA. In vitro, melatonin restored the mitochondrial membrane potential (MMP) in NRK-52E and HK-2 cells and led to an elevation in ATP levels. Confocal immunofluorescence data showed that puncta containing Mito-tracker and GFP-LC3A/B were reduced, thereby impeding the mitophagy of tubular epithelial cells. Furthermore, melatonin decreased LC3A/B-II expression and increased p62 expression. The apoptosis of tubular epithelial cells induced by AA was decreased. Therefore, our findings revealed that melatonin could prevent AA-induced AKI by attenuating mitochondrial damage, which may provide a potential therapeutic method for renal AA toxicity.

【Objective】 To explore the effect of massive blood transfusion on inflammatory factors, islet B cell function, incidence and mortality of multiple organ dysfunction syndrome (MODS) in patients with severe traumatic hemorrhage. 【Methods】 214 traumatic hemorrhage patients who received blood transfusion and were hospitalized in the Third People′s Hospital of Xingtai from January 2015 to June 2019 were enrolled and divided into the routine blood transfusion group (n=118) and massive blood transfusion group (n=96) according to the amount and method of blood transfusion. The changes of the inflammatory factors such as TNF α and IL-6, the functional indexes of Islet B cells such as HOMA-B and Δ INS30 / Δ GLU30, and the incidence and mortality of MODS in two groups 3 d after blood transfusion were observed. 【Results】 The level of TNF α(ng/L), IL-6(ng/L), HOMA-B and Δ INS30 / Δ GLU30 were (64.21±8.41) vs (30.75±5.26), (216.52±17.99) vs (152.45±16.26) (58.55±10.23) vs (103.47±17.48) and (2.95±0.69) vs (5.87±1.30) in the massive transfusion group and routine transfusion group, respectively (P<0.01). The incidence of MODS was 63.54%(61/96) vs 40.07%(52/118)(P<0.01) while the mortality of MODS was 46.88%(40/118) vs 33.90% (P>0.05). 【Conclusion】 The massive blood transfusion could increase the incidence of MODS in patients with severe traumatic hemorrhage by promoting inflammatory reaction and dysfunction of islet B cells.

BACKGROUND: There is no uniform standard for acromioclavicular dislocation. Clavicular hook plate fixation is a commonly used fixation method clinically, but minimally invasive ligament reconstruction technology and arthroscopic surgery have become a research hotspot. OBJECTIVE: To observe the application value of suture bridge with thread anchor under arthroscopy in the treatment of acromioclavicular dislocation. METHODS: Patients with Tossy type III acromioclavicular dislocation who were admitted to Department of Orthopedic Surgery of General Hospital of Jizhong Energy Xingtai Mining Group between January 2016 and April 2018 were selected as the subjects. The patients were randomly divided into two groups. The patients in the arthroscopy group were treated with arthroscopic suture bridge technique with suture anchor for reduction and fixation, while those in the clavicle hook plate group were treated with clavicular hook plate for internal fixation. The length of surgical incision, duration of surgery, hospitalization time and time to return to work of both groups were recorded. The shoulder function was evaluated according to the Lazzcano criterion of curative effect at 3, 6 and 12 months after surgery. The visual analogue scale score of shoulder pain, abduction and raising, forward bend and raising were compared between the two groups. All patients were followed up for 1 year to record the occurrence of complications. This study was approved by the Medical Ethics Committee of General Hospital of Jizhong Energy Xingtai Mining Group. All subjects signed the informed consent. RESULTS AND CONCLUSION: (1) There was no significant difference in the duration of surgery between the two groups (P > 0.05). The surgical incision, hospitalization time and time to return to work of the arthroscopy group were significantly better than those of the clavicle hook plate group (P < 0.01). (2) According to the Lazzcano criterion of curative effect, the excellent and good rate of curative effect in the arthroscopy group (84%) was significantly better than that in the clavicle hook plate group (66%) at 3 months after surgery (P < 0.05). The excellent and good rates of curative effect in the arthroscopy group at 6 and 12 months after surgery were higher than those in the clavicle hook plate group (P > 0.05). (3) Visual analogue scale scores of the two groups showed a decreasing trend at 3, 6 and 12 months after surgery (P < 0.01). The visual analogue scale score of arthroscopy group was significantly lower than that of the clavicle hook plate group at the same time point (P < 0.01). (4) Angles of abduction and raising, forward bend and raising of both groups showed an increasing trend at 3, 6 and 12 months after surgery (P < 0.01). The angles of abduction and raising, forward bend and raising of the arthroscopy group were larger than those of the clavicle hook plate group at the same time point (P < 0.01). (5) The 1-year follow-up results showed that the incidence of complications in the arthroscopy group (6%) was significantly lower than that in the clavicle hook plate group (63%) (P < 0.01). (6) Compared with clavicular hook plate fixation, the technique of suture anchors under arthroscopy has the advantages of small trauma, quick recovery, fewer complications and no need to remove endografts again. Meanwhile, the surgery can also clearly diagnose the concomitant lesions in the joints and treat them when necessary, so as to improve the treatment effect.

Objective: To investigate the influencing factors of fertility outcome after laparoscopic conservative surgery for tubal pregnancy. Methods: From October 2010 to October 2016, 253 cases of tubal pregnancy treated by laparoscopic conservative surgery in General Hospital of Jizhong energy Fengfeng Group Hospital were analyzed retrospectively.All patients were followed up from 24 to 36 months after operation to observe the intrauterine pregnancy.Logistic regression was used to analyze the influencing factors of intrauterine pregnancy. Results: After 24-36 months follow-up, the patients were not contraception and pregnant under the guidance of doctors.Among the 253 cases, 182 (71.1%) were intrauterine pregnancy, 37 (14.6%) were ectopic pregnancy, and 34 (13.4%) were not pregnant.The results of logistic regression showed that high level of hCG, severe pelvic adhesions, obstruction of fallopian tube and history of ectopic pregnancy were the risk factors of intrauterine pregnancy (OR (95%CI) 1.982 (1.075-3.149), 2.410 (1.279-5.069), 2.485 (1.071-3.594), 5.071 (1.094-9.081), P<0.05 or P<0.01). Conclusion The reproductive outcome of laparoscopic conservative surgery for tubal pregnancy is influenced by many factors.The high level of hCG in preoperative blood, severe pelvic adhesions, obstruction of tubal and ectopic pregnancy history are the risk factors of postoperative pregnancy.

Objective To compare the clinical outcomes of selective artery (SAC) with main artery (MAC) clamping of robotic partial nephrectomy (RPN) in patients with early-stage (cTiN0M0) renal masses.Methods Between October 2016 and September 2018,a total of 343 cT1 renal mass patients receiving RPN with SAC (n =21) or MAC (n =322) in our center,were retrospectively analyzed.There were 13 males and 8 females in SAC group with a mean age of (53.1 ± 10.6) years old,mean tumor size of (2.5 ±0.7)cm,and mean R.E.N.A.L.score of 6.2 ± 1.5.There were 149 males and 173 females in MAC group,with a mean age of (51.6 ± 12.3) years old,mean tumor size of(3.5 ± 1.4)cm,and mean R.E.N.A.L.score of 7.9 ± 1.6.There was statistical significance between two groups in tumor size and R.E.N.A.L score(P ＜ 0.001).The group covariates were balanced through propensity score matching (PSM) using 1:2 nearest neighbor matching method.After matching,mean age,tumor size,R.E.N.A.L.score and preoperative eGFR in the SAC and MAC groups were (3.1 ± 10.6) vs.(52.7 ± 10.2) years,(2.5 ± 0.7) vs.(2.6±0.7) cm,6.2 ±1.5 vs.6.2 ±0.9,and (101.7 ± 19.8)vs.(101.6 ±20.3) ml/(min · 1.73m2),respectively (P ＞ 0.05).Perioperative outcomes and follow-up data were compared between the two matched groups.Results There was no significant differences resulted regarding operating time [(127.0 ±54.8)min vs.(130.0 ±49.9) min],blood loss[(166.0 ± 173.5)ml vs.(124.0 ± 101.0)ml],ischemia time [(18.9 ± 6.4) vs.(18.1 ± 5.8) min],hospital stay [(8.7 ± 3.4) d vs.(8.5 ± 2.5) d],incidences of complications (28.6％ vs.19.0％),surgical conversions (0 vs.2.4％),transfusions (4.8％ vs.2.4％) or positive surgical margin(0 vs.0) and malignant pathological outcomes(95.2％ vs.92.9％).The follow-up durations ranged from 3 to 24 months with a mean duration of 9.1 and 12.4 months in SAC and MAC,respectively.At the end of follow-up,the two groups had similar decrease in estimated glomerular filtration rate [(7.5 ± 17.2) ％ vs.(12.1 ± 18.2) ％,P =0.466],but the difference was statistically significant with ECT-GFR both of function reduction in the operated kidney [(21.6 ± 14.6) ％ vs.(38.4 ± 20.7)％,P =0.001] and in two kidneys [(2.5 ±16.4)％ vs.(14.8 ±20.0)％,P =0.002].Conclusions Robotic partial nephrectomy with selective vascular control lead to better postoperative renal function compared with main vascular clamped PN techniques and does not lead to a higher surgical risk following a strict patient selection criteria.

The biodiversity of the mycobiome, an important component of the oral microbial community, and the roles of fungal-bacterial and fungal-immune system interactions in the pathogenesis of oral lichen planus (OLP) remain largely uncharacterized. In this study, we sequenced the salivary mycobiome and bacteriome associated with OLP. First, we described the dysbiosis of the microbiome in OLP patients, which exhibits lower levels of fungi and higher levels of bacteria. Significantly higher abundances of the fungi Candida and Aspergillus in patients with reticular OLP and of Alternaria and Sclerotiniaceae_unidentified in patients with erosive OLP were observed compared to the healthy controls. Aspergillus was identified as an "OLP-associated" fungus because of its detection at a higher frequency than in the healthy controls. Second, the co-occurrence patterns of the salivary mycobiome-bacteriome demonstrated negative associations between specific fungal and bacterial taxa identified in the healthy controls, which diminished in the reticular OLP group and even became positive in the erosive OLP group. Moreover, the oral cavities of OLP patients were colonized by dysbiotic oral flora with lower ecological network complexity and decreased fungal-Firmicutes and increased fungal-Bacteroidetes sub-networks. Third, several keystone fungal genera (Bovista, Erysiphe, Psathyrella, etc.) demonstrated significant correlations with clinical scores and IL-17 levels. Thus, we established that fungal dysbiosis is associated with the aggravation of OLP. Fungal dysbiosis could alter the salivary bacteriome or may reflect a direct effect of host immunity, which participates in OLP pathogenesis.
Adult ; Bacteria ; isolation & purification ; Case-Control Studies ; Dysbiosis ; complications ; microbiology ; Female ; Humans ; Lichen Planus, Oral ; complications ; microbiology ; Male ; Microbiota ; Middle Aged ; Mouth Mucosa ; microbiology ; Mycobiome ; Saliva ; microbiology

In the paper, the study was reviewed on the infrared temperature characteristics of acupoints in recent 10 years. CNKI, WANFANG, VIP, SciVerse ScienceDirect and Springer databases were retrieved, with"infrared thermal imaging" and "acupoint" as the key words. The retrieving time was from January 1, 2006 to December 31, 2016. Totally, 468 relevant papers were searched and 169 papers of them were read carefully on acupoint infrared temperature. In terms of physiological condition, pathological condition and the stimulation methods such as acupuncture, moxibustion,, embedding therapy and cupping therapy, the general situation was reviewed on the infrared temperature characteristics of acupoints separately. It was found that the study on infrared temperature characteristics of acupoints in physiological condition was limited and the characteristics discovered were not enough to systematically review the physiological and physical properties of acupoints. The study in terms of the pathological condition objectively reflected the effects and rules of diseases. It was showed in the study of acupoint infrared temperature characteristics after stimulation that the changes of infrared thermal imaging tempe-rature at some specific region induced by different therapies and parameters might be used to deduce the potential mechanism and optimal parameters or schemes of intervention method and contributed to the formation and deve-lopment of quantitative diagnosis and treatment. The authors believe that the study on infrared temperature characteristics of acupoint provides the active significance in the exploration on the physiological and physical characteristics of acupoint, the effects and rules of diseases as well as the quantitative diagnosis and treatment.