ObjectiveTo discuss the clinical efficacy of low dose heparins and low molecular weight heparins (LMWHs) in the treatment of severe traumatic disseminated intravascular coagulation (DIC).MethodsA total of 77 trauma patients (APACHE Ⅱ score for 5-10) with secondary DIC in ICU were included and randomly assigned to three groups,ie,Group A (26 patients,subcutaneously injected with LMWHs at doses of 75-150 U · kg-1 · d-1,with the average incipient dose of 4 000 U/d),Group B (25 patients,subcutaneously injected with heparins at doses of 100-250 U · kg-1 · d-1,with the average incipient dose of 5000 U/d and control group (26 patients,supplemented with simple blood coagulation factor).The injection volume was adjusted according to the level of antithrombin Ⅲ ( ATⅢ ) in each group.Within 28 days in ICU,the three groups were compared in aspects of deaths,hospital day,bleeding rate,thrombin time (TT),prothrombin time (PT),activation part thrombin time ( APTT),fibrinogen (Fg),antithrombin Ⅲ ( AT Ⅲ ) and D-dimer.Results ( 1 ) The differences of mortality were both insignificant in the control group comparel with Group A and Group B respectively at day 28 ( P ＜ 0.05 ).(2) The ICU stay of three groups showed significant differences ( P ＜ 0.01 ),with longer stay of Groups A and B than control group ( P ＜ 0.01 ) and longer stay of Group A than Group B ( P ＜ 0.05 ).( 3 ) Except for AT Ⅲ ( P ＜ 0.01 ),other blood coagulation indices showed no significant difference among three groups.(4) The differences of bleeding rate were not significant between Group A and control group (P ＞ 0.05),but significant between Group B and control group (p ＜ 0.05 ).(5) Related factor analysis indicated significant relationship between AT Ⅲ level and bleeding rate (P ＜0.01 ).ConclusionsLow dose heparins and LMWHs are beneficial to controlling traumatic DIC,but the heparin therapy adjusted by the level of AT Ⅲ with marked correlation bleeding rate shows lower bleeding rate as compared with LMWHs.

Object To provide the theoretical basis for the artificial planting of Hypericum perforatum L., the effects of light, gibberellin and ethephon on the germination of H. perforatum seeds were studied. Methods The method of direct germination was used. Results The seeds germinated to 79% in the light, while didn't germinate in the dark. Gibberellin and ethephon not only promoted the germination in the light, but also induced the germination in the dark. But ethephon inhibited the growth of seedling radicals severely. Conclusion The seed of H. perforatum is light-dependent seed, its light-dependence is related to gibberellin and ethephon.

[Objective] To observe the effect of biological fertilizers on the yield and quality of Amomum villosum (AV). [Methods] Field experiment method was used to observe the effect of different kinds and different amount of biological fertilizers on AV. Biological fertilizers were: A (mainly composed of fermented chicken manure), B (mainly composed of fermented filter of sugarcane) and C (mixed with fertilizer A and biological fertilizer at certain proportion). The fertilizer amount was 150, 112 and 75 g****m-2 per time. Content of bornyl acetate in AV was detected by gas chromatography. [Results] The three kinds of biological fertilizers increased the yield of AV but had no obvious effect on its quality; high- and moderate-amount fertilizer increased the yield of AV, in particular fertilizer A (112 g?m-2 per time). The three kinds of fertilizers had no effect on the content of bornyl acetate in AV. [Conclusion] Reasonable application of fertilizers is one of the important ways to raise the yield of AV.

Objective:To investigate the role of miR-581 overexpression on the proliferation of human colorectal cancer cell line SW620. Methods:The expression group,colorectal cancer SW620 cells were transfected with recombinant lentivirus vector ( LV-miR-581) and miR-581 mimics(miR-581),the negative control group were transfected with negative control lentiviral vector (LV-GFP) and negative control mimics (vector). The mRNA expression of miR-581 was identified by qRT-PCR. Proliferation of the cells were detected by CCK8 assary and colony forming assary. Results:The expression of miR-581 at mRNA significantly increased in LV-miR-581 group compared with control groups were detected by qRT-PCR ( P<0. 05 ) . Up-regulation of miR-581 markedly enhanced human colorectal cancer SW620 cells proliferation than those in the cells transfected with control vector ( P<0. 05 ) . Conclusion: Forced expression of miR-581 accelerates the proliferation of colorectal cancer SW620 cells.

Objective:To study the expression and regulation of TLR2/4 in mycobacterium tuberculosis heat shock proteins 16. 3 (mycobacterium tuberculosis heat shock proteins 16. 3,MTB Hsp16. 3) effect on mouse bone marrow-derived macrophages in vitro. Methods:Bone marrow cells were isolated from tibia and femurs of BALB/c mice and incubated with GM-CSF,then detected the expression of CD11b and F4/80 with flow cytometry and observed morphology. The M0 macrophages were stimulated with MTB Hsp16. 3 for 0 h,12 h,24 h,36 h,48 h and 72 h. Real-time PCR detected the expression of TLR2/4 in intracellular at different time point. Silencing macrophages cell surface TLR2/4 molecules by siRNA technology which stimulated with MTB Hsp16. 3 for 0 h,12 h,24 h,36 h,48 h and 72 h. Real-time PCR detected the expression of TLR2/4,Ym-1,Fizz1,IL-10,TNF-α,iNOS and TGF-βin intracellular at different time point. Results:Morphology analysis showed that MTB Hsp16. 3 stimulated macrophages were round cells stretching out pseudopodia,whereas MTB Hsp16. 3 stimulated silencing TLR2/4 macrophages had elongated fibroblastoid. Real time PCR detected the expression of TLR2/4 were upregulated after MTB Hsp16. 3 stimulated M0 macrophages. MTB Hsp16. 3 stimulated silencing TLR2/4 macrophages the expression of IL-6, TNF-α, iNOS were upregulated, whereas IL-10, TGF-β, Ym-1 and Fizz1 were downregulated. Conclusion:MTB Hsp16. 3 may stimulated M0 macrophages to M2 macrophages and suppress M1 macrophages through binding with TLR2/4 receptor,which may be involved the progresss of MTB evaded macrophage phagocytosis.

Cilia and flagella on eukaryotic cells are polarized organelles extending from the surfaces of cells, which participate not only in cell motility, but also in signal transduction and other processes. Structural or functional abnormalities of cilia can cause various human diseases, termed ciliopathies. Bardet-Biedl syndrome (BBS) is a ciliopathic human genetic disorder, and the pathogenesis is that mutated BBS genes result in abnormal cilia function. In order to study the pathogenic genes BBS8, we screened bbs8 mutant in Chlamydomonas reinhardtii and did a lot of physiology and biochemistry experiments. We affirmed that BBS8 protein was a cilia protein and had specific localization in the basal body by immunofluorescence (IF). The bbs8 mutant lost photokinesis, and it was defective in flagella shortening with drug induction. The results of silver staining and mass spectrometric analysis showed aberrant accumulation of flagellar proteins in the mutant flagella. We concluded that the BBS8 protein plays a significant role in flagellar membrane proteins transport, and the BBS8 protein might mediate retrograde transport to exert physiological function in the process.
Bardet-Biedl Syndrome ; Chlamydomonas reinhardtii ; Cilia ; Flagella ; Humans ; Protein Transport

Objective To investigate the change of the nutritional status of elderly patients in Chinese major hospitals dynamically with nutritional risk screening 2002 (NRS 2002) and subjective global assessment (SGA) during hospitalization.Methods A prospective,multi-center survey was conducted on over 65 years old patients who were admitted in departments of gastroenterology,respiratory medicine,general surgery,geriatrics,thoracic surgery,neurology,orthopedics and medical oncology of 9 large hospitals in China for 7-30 days between June 2014 and September 2014.On admission and within 24 hours after discharge,the clinical data were recorded,physical indices were measured,and laboratory examination were conducted.NRS 2002 and SGA were used to make an evaluation.The nutritional supports and clinical outcomes were also recorded and then the correlation between nutritional status and clinical outcomes were analyzed.Results A total of 2558 patients above 65 years old were included into the study.Compared with their status on admission,their grip strength,upper arm circumference and crural circumference were reduced significantly at discharge (P＜0.05).The total protein,albumin and hemoglobin levels were significantly lower than those on admission (P＜0.05).The incidence of nutritional risk (NRS 2002 score ≥ 3) and malnutrition (SGA B + C) on admission were lower than those at discharge (51.1％ vs 53.0％,32.6％ vs 35.6％).The hospitalization time and medical expenses were higher in patients with malnutrition on admission than in those with normal nutrition intakes.The nutritional status at discharge was negatively correlated with hospitalization time and medical expenses.61.3％ patients having nutritional risk did not take nutritional support during the hospital stay,while utilization rate of parenteral nutrition was higher than that of enteral nutrition in patients receiving nutritional support (19.6％ vs 11.9％).Conclusion Elderly patients have higher possibilities of facing nutritional risk or malnutrition on admission,these are associated with poor clinical outcomes and their nutritional status will not improve significantly at discharge.Therefore,the screening and evaluation of nutritional status in elderly patients during hospitalization should be conducted and their nutritional intervention should be standardized so as to improve the clinical outcomes.

Objective:To investigate the clinical characteristics of vasa previa (VP) with low-lying placenta (LP).Methods:A retrospective case-control study was conducted on pregnant women with VP who delivered at Guangzhou Women and Children's Medical Center from January 2015 to August 2021. According to the status of LP, these cases were classified into VP with LP (VP+LP) and VP without LP (VP-LP) group. The cases diagnosed with placenta previa (PP, n=128) during the same period were collected as control. Maternal-fetal clinical characteristics and outcomes were compared among the three groups using t-test, Mann-Whitney U test, and Chi-square test (or Fisher's exact test). Results:During the study period, 116 VP cases were diagnosed, accounting for 0.085% (116/136 450) of all deliveries. Apart from one case of intrauterine death caused by non-VP reasons in the third trimester, there were 64 in the VP+LP group and 51 in the VP-LP group. VP+LP cases accounted for about 2.9% (64/2 219) of all the cases with PP or LP. The proportions of multiparae and women with a history of cesarean section were significantly higher in the VP+LP group than in the VP-LP group [62.5% (40/64) vs 39.2% (20/51), χ 2= 6.17, P=0.013; 31.3% (20/64) vs 13.7% (7/51), χ 2= 4.85, P=0.028]. Besides, a rare type of VP (type Ⅲ) was only found in the VP+LP group (9.4%, 6/64). The median gestational age at first diagnosis by prenatal ultrasound was significantly larger in the VP+LP group than in the VP-LP group [28.3 (23.6-31.7) vs 23.9 (23.3-25.9) weeks, Z=2.61, P=0.007]. There was no significant difference in the incidence of antepartum hemorrhage between the two groups. In contrast, the amount of postpartum hemorrhage was significantly increased in the VP+LP group [550 (436-732) vs 420 (300-540) ml, Z=3.37, P=0.001]. Compared with the VP-LP group, the VP+LP group showed a lower incidence of lower neonatal Apgar score (<7 at 5 min) and hypoxic-ischemic encephalopathy [0.0%(0/64) vs 6.9%(4/58), 0.0%(0/64) vs 8.6% (5/58), Fisher's exact test, both P<0.05]. No neonatal death was reported in the VP+LP and VP-LP groups. No significant difference in the incidence of antepartum hemorrhage was found between the VP+LP group and the PP group. Still, the median time at delivery was earlier [36.0 (34.3-36.9) vs 37.0 (35.7-37.3) weeks, Z=3.79, P<0.001], and the incidence of abnormal fetal heart rate was higher [10.9% (7/64) vs 3.1% (4/128), Fisher's exact test , P=0.044] in the VP+LP group. Furthermore, the neonatal NICU admission rate and the incidence of respiratory distress syndrome were significantly higher in the VP+LP group than in the PP group [36.4% (24/66) vs 12.1% (16/132), χ 2= 16.04, P<0.001; 25.8% (17/66) vs 12.1% (16/132), χ 2= 5.89, P=0.015]. Conclusions:For VP+LP cases, there might be an additional type (type Ⅲ VP). Patients with VP+LP would have more blood loss within 24 h after delivery and a higher risk of adverse neonatal outcomes. Intensive attention should be paid to those diagnosed with LP during the third trimester to identify any VP.

BACKGROUNDBalloon release pressure may increase the incidence of no reflow after direct percutaneous coronary intervention (PCI). This randomized controlled study was designed to analyze the correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction (AMI) undergoing direct PCI.

METHODSThere were 156 AMI patients who underwent PCI from January 1, 2010 to December 31, 2012, and were divided into two groups according to the stent inflation pressure: a conventional pressure group and a high pressure group. After PCI, angiography was conducted to assess the thrombolysis in myocardial infarction (TIMI) grade with related artery. Examinations were undertaken on all patients before and after the operation including cardiac enzymes, total cholesterol, low-density lipoprotein, blood glucose, homocysteine , β-thromboglobulin (β-TG), Hamilton depression scale (HAMD) and self-rating anxiety scale (SAS). After interventional therapy, the afore-mentioned parameters in both the conventional pressure group and high pressure group were again analyzed.

RESULTSThe results showed that CK-MB, HAMD, SAS were significantly different (P < 0.05) in all patients after PCI, especially the CK-MB in the high pressure group ((25.7 ± 7.6) U/L vs. (76.7 ± 11.8) U/L). CK-MB, HAMD, SAS, and β-TG were comparative before PCI but they were significantly changed (P < 0.05) after intervention. No-reflow phenomenon occurred in 13 patients in the high pressure group, which was significantly higher than in the conventional pressure group (17.11% vs. 6.25%, P < 0.05).

CONCLUSIONIn stent implantation, using a pressure less than 1823.4 kPa balloon to release pressure may be the better choice to reduce the occurrence of no-reflow following direct PCI.

Adult ; Aged ; Blood Glucose ; metabolism ; Cholesterol ; blood ; Female ; Homocysteine ; metabolism ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; blood ; surgery ; Percutaneous Coronary Intervention ; methods

BACKGROUND: This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability. METHODS: This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability. RESULTS: STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min. CONCLUSION The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
Reproducibility of Results ; Surveys and Questionnaires ; Practice Guidelines as Topic ; Humans