Objective To investigate the effect of goal-directed fluid treatment (GDT) on prognosis during emergency operation for craniocerebral trauma patients.Methods Thirty craniocerebral trauma patients treated with emergency craniotomy from January 2015 to October 2015 were divided into control group (n =15) and GDT group (n =15),according to the random number table.In control group,the patients [ten males and five females,age of (40.3 ± 12.1) years and weighting (62.1 ± 9.1) kg] were given conventional fluid therapy based on the intraoperative mean arterial pressure,heart rate,central venous pressure,etc.In GDT group,the patients [eleven males and four females,age of (44.5 ± 9.6) years and weighting (64.0 ± 6.9) kg] received GDT based on the stroke volume variation (SVV) under Vigileo monitor.Serum levels of neuronspecific enolase (NSE) and S100-β were respectively detected by electrochemical luminescence and ELISA method before anesthesia induction (T1),1 h after dura incision(T2),immediately after surgery (T3),6 h after operation(T4),24 h after operation(T5) and 48 h after operation (T6).Intracranial pressure and cerebral perfusion pressure (CPP) were detected at all time points,and Glasgow Coma Score (GCS) at T1,T5 and T6.Postoperative infection,brain edema,hospital stay in ICU,total hospital stay and death rate were recorded.Results Compared with control group,levels of NSE in GDT group were decreased at T4,T5 and T6 and levels of S100-β in GDT group were decreased at T3,T4,T5 and T6 (all P ＜ 0.05).Intracranial pressure in GDT group was not significantly different from that in control group (P ＞ 0.05).GCS at T6 was higher in GDT group than that in control group (P ＜ 0.05).Length of ICU stay and length of total hospital stay in GDI group were (4.5 ± 2.1) d and (14.3 ± 3.6) d respectively,shorter than (6.3 ± 1.9) d and (18.3 ± 4.0) d in control group (P ＜ 0.05).None experienced infection,brain edema and death after operation.Conclusion Compared with conventional fluid therapy,GDT is beneficial to the prognosis of craniocerebral trauma patients undergoing emergency craniotomy without increasing intracranial pressure and brain edema,and GDT can reduce hospital stay.

Objective To evaluate the value of volume rendering technique of MSCT in the diagnosis of pediatric pectus carinatum. Methods MSCT data of 36 children with pectus carinatum were collected.Volume rendering and multiplanar reformation recon-struction techniques were adopted at a postprocessing station.Results There were 35 cases of chondrogladiolar variant and 1 case of chondromanubrial variant,27 cases were symmetric and other 9 cases were asymmetric.VR technique clearly demonstrated the abnormal changes of sternum,costae and costal cartilages.Conclusion VR technique of MSCT can fully display the three-dimension morpho-logical changes of pediatric pectus carinatum,which can supply accurate information for minimally invasive treatment procedure.

Objective: To investigate the regulating effect of Krüppel-like transcription factor 8 (KLF8) on the expression of vascular endothelial growth factor A (VEGFA) in hepatocellular carcinoma (HCC) and its potential mechanism. Methods: The expressions of KLF8 and VEGFA proteins and their correlation in paired HCC and adjacent paracancerous tissues were detected by immunohistochemistry staining. The KLF8 expression plasmid pcDNA3.1-KLF8 and the control plasmid were transfected into HCC SMMC7721 cells, respectively. The expressions of VEGFA and phosphoinositide-3-kinase (PI3K)/Akt pathway-related molecules including phospho-Akt (p-Akt), phospho-phosphoinositide-dependent kinase 1 (p-PDK1) and phospho-phosphatase and tensin homolog deleted on chromosome 10 (p-PTEN) in SMMC7721 cells were detected by real-time fluorescent quantitative PCR and Western blotting. The effect of PI3K/Akt pathway inhibitor LY294002 on the expression of VEGFA protein in SMMC7721 cells with KLF8 overexpression was detected by Western blotting. Chicken chorioallantoic membrane (CAM) model was used to detect the inducing effect of SMMC7721 cells with up-regulation of KLF8 expression on angiogenesis in chicken embryos. Results: The expression levels of KLF8 and VEGFA proteins were much higher in HCC tissues than those in the adjacent paracancerous tissues (P < 0.01). KLF8 protein expression was positively correlated with VEGFA protein expression in HCC tissues (r = 0.622, P < 0.01). The expression levels of KLF8, VEGFA, p-Akt, p-PDK1 and p-PTEN proteins were up-regulated in SMMC7721 cells transfected with pcDNA3.1-KLF8 plasmids (P < 0.05). LY294002 inhibited VEGFA expression in SMMC7721 cells with KLF8 overexpression (P < 0.05). The SMMC7721 cells with KLF8 overexpression had a higher potential in inducing angiogenesis in chick embryos (P < 0.01). Conclusion: KLF8 gene induces VEGFA expression and angiogenesis in HCC via PI3K/Akt signal pathway.

Objective To observe the effects of Huoxue Bushen Anshen Prescription on energy metabolism of H9c2 cardiomyocytes with oxidative stress injury.Methods H9c2 cardiomyocytes oxidative stress model was established with H2O2 to simulate myocardial injury.CCK-8 method was used to select the best conditions for modeling and the appropriate concentration of drugs.Cells were divided into normal group,model group,trimetazidine hydrochloride group and Huoxue Bushen Anshen Prescription group.Na+-K+-ATPase activity,real-time ATP generation rate,mitochondrial pressure,gycolysis rate,and long-chain fatty acid oxidationl pressure on H9c2 cardiomyocytes after treatment were performed,and the changes in energy metabolism of cardiomyocytes were observed.Results Compared with the normal group,the Na+-K+-ATPase activity,glycolytic ATP production rate,mitochondrial ATP production rate,basal oxygen consumption,non mitochondrial oxygen consumption,ATP production capacity,cellular reserve respiratory capacity and maximum respiratory capacity of H9c2 cells in the model group decreased,the glycolytic rate slowed down,long chain fatty acid basal respiration,acute response and maximum respiratory value decreased(P<0.05,P<0.01).Compared with the model group,the H9c2 cells in Huoxue Bushen Anshen Prescription group showed an increase in Na+-K+-ATPase activity,an increase in glycolytic ATP production rate and mitochondrial ATP production rate,an increase in basal oxygen consumption,non mitochondrial oxygen consumption,ATP production capacity,cellular reserve respiratory capacity and maximum respiratory capacity,an increase in basal glycolysis rate,and an increase in long-chain fatty acid basal respiration,acute response and maximum respiratory value(P<0.05,P<0.01).Conclusion Huoxue Bushen Anshen Prescription can significantly improve the activity of Na+-K+-ATPase in cH9c2 ardiomyocytes with oxidative stress injury,increase the rate of ATP production,improve mitochondrial pressure,glycolysis rate and oxidation pressure of long chain fatty acids,and improve the energy metabolism of cardiomyocytes.

Objective To explore the mechanism of Huoxue Bushen Anshen Prescription in improving the oxidative damage of H9c2 cells based on AhR-JDP2-Nrf2 axis.Methods H9c2 cells were divided into normal group,model group,TCM group,trimetazidine group,empty plasmid group,overexpression group,TCM+overexpression group and trimetazidine+overexpression group.The oxidative stress model of H9c2 cells was induced with H2O2 to imitate myocardial injury,and the cells were transfected with JDP2 overexpressed gene,intervened with Huoxue Bushen Anshen Prescription and trimetazidine hydrochloride respectively.Apoptosis was detected by flow cytometry,the contents of MDA,SOD and NADPH in cell supernatant were detected by kits,the protein expression of AhR,JDP2,Nrf2 and HO-1 were detected by Western blot,the mRNA expression of AhR,JDP2,Nrf2 and HO-1 were detected by RT-qPCR.Results Compared with the normal group,the early apoptosis rate,late apoptosis rate and total apoptosis rate of H9c2 cells in the model group increased(P<0.01),the contents of MDA,SOD and NADPH in cell supernatant increased(P<0.05),the expression of AhR,JDP2,Nrf2,HO-1 protein and mRNA increased(P<0.05).Compared with the model group,the early apoptosis rate,late apoptosis rate and total apoptosis rate of H9c2 cells in the TCM group and the trimetazidine group significantly decreased(P<0.01),the contents of MDA,SOD and NADPH decreased(P<0.05),the expression of AhR,JDP2,Nrf2 and HO-1 protein and mRNA decreased in the TCM group(P<0.05).Compared with the empty plasmid group,the overexpression group showed an increase in early apoptosis rate,late apoptosis rate and total apoptosis rate of H9c2 cells(P<0.01),an increase in MDA and NADPH content in cell supernatant(P<0.01),an decrease in SOD content(P<0.01),and an increase in the expressions of AhR,JDP2,Nrf2,HO-1 protein and mRNA in H9c2 cells(P<0.05).Compared with the overexpression group,the early apoptosis rate,late apoptosis rate and total apoptosis rate of H9c2 cells in the TCM+overexpression group and the trimetazidine+overexpression group were significantly decreased(P<0.05,P<0.01),the MDA and NADPH contents in cell supernatant were decreased(P<0.01),the SOD content increased(P<0.01),and the expressions of AhR,JDP2,Nrf2,HO-1 protein and mRNA in H9c2 cells decreased(P<0.05).Conclusion Huoxue Bushen Anshen Prescription can regulate the AhR-JDP2-Nrf2 axis by regulating the expression of JDP2,alleviate the oxidative damage of H9c2 cells,reduce the apoptosis of cardiomyocytes,and protect cardiomyocytes.

This article reviews the concept of telenursing, the application status of telenursing in elderly cancer patients and its influencing factors, and puts forward the suggestions that improve the application ability of intelligent technology in elderly cancer patients, improve the operability of intelligent system, enrich the types and contents of telenursing services, ensure the quality of information, protect privacy security, increase social support and improve social participation so as to provide reference for the application of telenursing in elderly cancer patients.

Optical coherence tomography (OCT) is a new imaging technique capable of obtaining high-resolution intravascular images and has been used in interventional cardiology. However, an application of OCT in pulmonary arteries had seldom been documented. In this case, OCT imaging is performed in peripheral pulmonary arteries and shows mural red thrombi. Subsequently, the red thrombi are aspirated and confirmed by a histological examination. These findings suggest that OCT may be a useful tool to depict peripheral pulmonary artery thrombi.
Adult ; Angiography ; Humans ; Male ; Pulmonary Artery/*pathology/radiography ; Pulmonary Embolism/*diagnosis ; Tomography, Optical Coherence/*methods ; Tomography, X-Ray Computed

Objective To survey the awareness and knowledge of Helicobacter pylori (Hp) infection among medical staff in Shanghai.Methods A questionnaire survey was conducted among 316 medical staff in Shanghai,including 74 gastroenterologists (GI),158 general practitioners (GP),and 68 gastroenterology nurses(GN),from October 2014 to September 2015.The questionnaire was designed according to the Fourth Helicobacter Pylori Infection Treatment Consensus Report of China (the Consensus).There were 4 parts and 29 questions in the questionnaire,including the knowledge and performance of the Consensus (8 questions),the indications of Hp eradication (8 questions),detection methods of Hp infection (7 questions)and the therapy of Hp eradication (6 questions).Results Total 300 valid questionnaires were received with a response rate of 94.9％ (300/316).The awareness rate of the Consensus in GI,GP and GN groups was 81.1％ (60/74),57.6％ (91/158) and 26.4％ (18/68),respectively (χ2 =43.67,P=0.001).GI had higher awareness rate than GP and GN in indications of Hp eradications (for peptic ulcer,mucosa-associated lymphoid malignancies,post-resection patients of early gastric cancer,and family history of gastric cancer,the χ2 values were 16.68,35.60,33.46 and 39.22,respectively;all P ＜0.05).In part of Hp infection detection methods,the responses of GI,GP and GN groups in C14 or C13 urea breathing test were 97.3％ (72/74),47.5％ (75/158) and 82.1％ (55/68),respectively (χ2 =72.38,P =0.001);in gastric mucosa tissue rapid urease test were 70.3％ (52/74),13.9％ (22/158) and 25.4％ (17/68),respectively (χ2 =78.22,P =0.001);in serological test were 58.1％ (43/74),20.9％ (33/158)and 44.8％ (30/68),respectively (χ2 =40.30,P =0.001);in gastric mucosa tissue section staining were 56.8％ (42/74),13.3％ (21/158) and 22.4％ (15/68),respectively (χ2 =50.35,P =0.00).In part of Hp eradication therapy the responses of GI,GP and GN groups in recommended bismuth quadruple therapy were 71.6％ (53/74),47.5％ (75/158) and 40.3％ (25/62),respectively (χ2 =15.93,P =0.001);in triple therapy were 27.0％ (20/74),51.6％ (81/158) and 42.0％ (26/62),respectively (χ2 =12.42,P =0.002);in 10 or 14 d for treatment duration were 78.4％ (58/74),78.5％ (124/158)and 67.6％ (46/68),respectively (χ2 =3.36,P =0.186).Conclusion Gastroenterologists are more likely to adhere with the Consensus than general practitioners and gastroenterological nurses in the management of Hp infection.The survey suggests that more attention should be paid for popularization and implementation of Hp infection guidelines and consensus among Shanghai medical staff,especially for GP and nurses.

OBJECTIVE: To explore the genetic basis for a child with mental retardation. METHODS: Whole exome sequencing was carried out for the child. Candidate variant was screened based on his clinical features and verified by Sanger sequencing. RESULTS: The child was found to harbor a c.995_1002delAGACAAAA(p.Asp332AlafsTer84) frameshift variant in the SYNGAP1 gene. Bioinformatic analysis suggested it to be pathogenic. The same variant was not detected in either parent. CONCLUSION The c.995_1002delAGACAAAA(p.Asp332AlafsTer84) frameshift variant of the SYNGAP1 gene probably underlay the mental retardation in this child. Above finding has expanded the spectrum of SYNGAP1 gene variants and provided a basis for the diagnosis and treatment for this child.
Child ; Humans ; Intellectual Disability/genetics* ; Frameshift Mutation ; High-Throughput Nucleotide Sequencing ; Computational Biology ; Heterozygote ; Mutation ; ras GTPase-Activating Proteins/genetics*

Objective To explore the correlation of RELL1 expression with clinical pathological features and prognosis of patients with colon cancer.Methods Immunohistochemical experiments of the RELL1 protein were performed on tissue chips from 80 colon cancer tissues and 80 adjacent tissues.The relationship between different expression levels of RELL1 protein and clinical pathological parameters was compared.Univariate and multivariate Cox risk proportional regression analyses were conducted on factors affecting the survival of patients with colon cancer.Kaplan-Meier survival curve analysis was conducted on the survival rates of patients with colon cancer and different levels of RELL1 expression.Log rank test was performed to evaluate differences in survival rates.Results The expression of RELL1 in colon cancer tissues was lower than that in adjacent tissues(P<0.05).The expression of RELL1 in cancer tissues is correlated with TNM stage and N stage(P<0.05).The 3-year overall survival(OS)rate of colon cancer patients with high RELL1 expression was higher than that of patients with low RELL1 expression(P<0.05).Multivariate Cox regression analysis showed that low RELL1 expression,advanced age,and high TNM stage were risk factors for poor prognosis in patients with colon cancer(P<0.05).Conclusion The expression of RELL1 is downregulated in colon cancer tissue,and the low RELL1 expression,advanced age,and high TNM stage can lead to adverse outcomes in patients.