Objective To study the association of pulse pressure index(PPI)with insulin-like growth factor 1(IGF-1)and transforming growth factor beta 1(TGF-?1)in aged cases with essential hypertension(EH).Methods To detect serum IGF-1,TGF-?1 and to calculate left ventricular mass index(LVMI)in 160 aged patients with EH.To calculate PPI.Tow groups were divided according to the PPI:normal PPI group and high PPI group.Results The levels of IGF-1 in high PPI group were higher than that in normal PPI group(P

Objective To establish the advanced lung cancer model with effusion in the pleural cavity by implanting the lung adenocarcinoma A549 cells into the lung and pleural cavity of mice.Methods The Balb /c-nu female mice were divided into three groups and injected with the subculturing lung adenocarcinoma A549 cells to make three models in the subcutaneous (group A),the lungs (group B) and the lungs and pleural cavities (group c).The survival time,weightconsume of feeds,signs and symptoms of cachexia,growth of lung cancer and pleural effusion were observed.Results The median survival time in group C and group B were obviously reduced compared with group A.The range discrete in the group A was higher than group B and group C.There was no significant difference between group B and group C in the average survival time.The effective survival time was significant different between group B and group C.There were differences among three groups in the signs and symptoms of cachexia,the weight and consume of feeds.In 4 weeks,the rate of growing effusion in the pleural cavity was 93.3％ in group C,and only 20.0％ in group B.Conclusions The mice modal implanted the lung adenocarcinoma A549 cells into the lung aud pleural cavity of mice in the same time can be as the adwanced lung cancer model with effusion in the pleural cavity.

Objective To evaluate the use of nasojejunal tube in early enteral nutrition in severe traumatic brain injury (STBI) patients under mechanical ventilation.Methods STBI patients requiring mechanical ventilation in intensive care unit (ICU) of the First Affiliated Hospital of Bengbu Medical College admitted in 2013 were randomly divided into the jejunal tube group (n =15) and gastric tube group (n =19).We compared the 2 groups in terms of the tolerable beginning time of enteral nutrition (EN),the time before reaching target feeding volume,the incidences of gastrointestinal complications and ventilator-associated pneumonia (VAP) during EN,mechanical ventilation time,ICU hospital stay,and 28-day mortality rate.Results The tolerable beginning time of EN [(51.73 ± 9.16) hours vs.(81.11 ± 11.82) hours,t =7.920,P ＜0.05] and the time required to reach target feeding volume [(87.27 ± 9.99) hours vs.(152.05 ± 28.74) hours,t =8.320,P ＜ 0.05] in the jejunal tube group were significantly shorter than those in the gastric tube group.In the process of EN,compared with the gastric tube group,the incidences of gastric retention (6.7％ vs.57.9％,x2 =10.937,P ＜ 0.05),reflux (0％ vs.36.8％,x2 =9.566,P ＜ 0.05),vomiting (20.0％.vs.63.2％,x2 =6.642,P＜0.05),aspiration (6.7％ vs.42.1％,x2 =6.087,P＜0.05),VAP (33.3％ vs.73.7％,x2 =5.536,P ＜ 0.05) in the jejunum tube group were significantly lower.The mechanical ventilation time [(10.73 ± 4.68) days vs.(15.74 ± 2.54) days,t =3.730,P＜0.05] and the ICU hospital stay [(13.60 ± 4.80) days vs.(17.42 ± 4.05) days,t =2.497,P ＜0.05] of the jejunum tube group were significantly shorter than those of the gastric tube group.Comparison of 28-day mortality rate between the two groups revealed no statistically significant difference.Conclusion Early implementation of EN via nasojejunal tube in mechanically ventilated STBI patients can alleviate feeding intolerance,shorten the beginning time of EN and the time required to reach target feeding volume,reduce the incidence of complications,and shorten mechanical ventilation time and hospital stay in ICU.

Objective:To design a Checklist for quality control in intensive care unit and observe the effect of clinical application.Methods:By consulting guidelines and literature, such as Critical care medicine professional medical quality control index (2015 edition), the quality control Checklist of intensive care unit was designed. It included four parts: quality control data collection, medical record quality verification, special diagnosis and treatment, and hospital infection prevention and control supervision. Every month, a doctor with a senior professional title served as the quality control director, and was responsible for the quality control of the department's medical care, including collecting data of the past 24 hours during the morning handover, discussing and registering special diagnosis and treatment behaviors that would be performed on the day, and coordinating with the nursing team leader, controlling the quality of the whole department throughout the day, such as supervising each medical staff if they had unreasonable behaviors, checking the running and discharge medical records, and inspecting the status of the staff on duty. The data in 2018, 2019 (Checklist implemented) and 2017 (Checklist not implemented) were retrospectively analyzed, including the status of admitted patients, department management information, length of intensive care unit (ICU) stay, and the incidence of three-tube infection [ventilator-associated pneumonia (VAP), catheter-related bloodstream infection (CRBSI), catheter-associated urinary tract infection (CAUTI)], and standardized mortality, etc. Results:From 2017 to 2019, the number of patients admitted was 373, 446, and 480, with annual growth of 19.57% and 7.62% in 2018 and 2019, respectively, and an increase of 28.69% in 2019 compared with 2017. There was no statistically significant difference in the average age and acute physiology and chronic health evaluationⅡ (APACHEⅡ) of patients in the three years. Compared with 2017, the length of ICU stay of patients in 2018 and 2019 were significantly shortened (days: 8.99±6.12, 9.14±7.02 vs. 10.20±7.21), and the incidence of VAP, CRBSI and CAUTI were significantly reduced [VAP (cases/1 000 ventilation days): 12.97±3.60, 9.62±3.14 vs. 17.48±4.89, CRBSI (cases/1 000 catheter days): 3.75±2.19, 3.87±1.87 vs. 6.19±3.13, CAUTI (cases/1 000 catheter days): 3.29±2.18, 3.28±1.87 vs. 5.61±3.18]. The standardized mortality were also significantly reduced [(77.27±7.24)%, (70.61±7.49)% vs. (84.41±9.05)%], the number of non-compliance with hospital infection prevention per month decreased significantly (person times: 54.00±6.30, 41.08±10.76 vs. 72.08±19.68), and the number of special diagnosis and treatment per month increased significantly (person times: 1 056.67±235.27, 1 361.75±278.48 vs. 722.25±145.96), the rate of etiology submission before antimicrobial treatment [(93.21±3.68)%, (96.59±2.49)% vs. (87.86±5.28)%] and deep vein thrombosis (DVT) prevention rate [(91.13±6.36)%, (96.23±2.99)% vs. (85.58±7.68)%] were significantly improved, and all the differences were statistically significant (all P < 0.05). All medical records in the three years were Grade A, but the average scores in 2018 and 2019 were higher than those in 2017 (96.82±2.84, 96.73±2.94 vs. 93.70±3.33, both P < 0.01). Compared with 2018, the incidence of VAP, the rate of etiology submission before antimicrobial treatment, the DVT prevention rate, and the standardized mortality rate in 2019 were further improved, and the number of non-compliance with hospital infection prevention per month decreased and the number of special diagnosis and treatment per month increased, and the differences were statistically significant (all P < 0.05). Conclusion:The application of quality control Checklist in intensive care unit can build an effective quality control system, reduce the incidence of three-tube infection, standardized mortality and length of ICU stay, improve the quality control awareness and execution of medical staff, and promote the improvement of medical quality.

Objective To investigatethe role of NF-κB played in the process of the cord blood monocytes differentiating into dendritic cells(DCs)induced by astragalus polysaccharide(APS)and to explore the signal transduction pathway involved in this process.Methods Umbilica]cord blood was collected in aseptic conditions.The cord blood monocytes were obtained by density gradient centrifugation and were divided into three groups afterwards.In the control group.cells were cultivated in the RPMI 1640 complete medium.In the APS group.cells were cultivated in the RPMI 1640 complete medium containing 100 mg/L APS.In the PDTC group:cells were treated with 10 μmol/L disulfide carbamate(PDTC).NF-κB inhibitor in 30 min followed by cultivalion in the RPMI 1640 complete medium containing 100 mg/L APS.,The morphological changes were observed during the process of cultivation by the optical microscope and transmission electron microscopy.Cells were collected 12 d later and the cellular immunophenotyping was assayed by FCM.,The activation and migration of NF-κB fluorescence in the cells was examined by the immunoflouresce microscopy.Results (1)Cells in the control group grown up without cluster forformation and were found fusiform and macrophage-like in 12 d.Cells in the APS group grown up in clnstem,and morphological changes were found from the circular shape to a typical dendritic cells-like shape.Cells in the inhibitor group grown up slowly and without cluster formation,and cell morphdogy had no significant change.(2)The expression of DCs-specific antigen CD80,CD83 and CD86 in the APS group was higher than that in the control group and inhibitom group(P<0.01).The expression of those antigen in the control group and PDTC group was similar and had no statistically significance(P>0.05).(3)NF-κB fluorescence in the nuclei was examined by the immunoflourescence microscopy and was much higher in the APS group than that in khe other groups,especially in 72 h with the activation rate of NF-κB (75.20±7.37)%,while(13.20±3.46)% of PDTC group and(8.20 ±1.92)%,respectively(P<0.01).Conclusion Astragalus polysaccharide can induce the differentiation of umbilical cord blood cells into DCs,and NF-κB is the key component of the signal transduction pathway involved in this process.

Objective: To compare the long-term outcomes in ST-elevation myocardial infarction (STEMI) patients who underwent early or late delayed percutaneous coronary intervention (PCI) using drug-eluting stents (DES). Methods: This study was a retrospective, observational and single-center study. Consecutive STEMI patients (n=977), who admitted to Fuwai Hospital in 2013 and underwent successful selective PCI using drug-eluting stents (DES) within 3 to 35 days after symptom onset were enrolled and divided into the early delayed PCI (3-14 d) group (n=495) and the late delayed PCI (15-35 d) group (n=482). General clinical data of the patients and related data of coronary angiography and interventional therapy were collected, and the endpoint events were followed up. The primary endpoint was 2-year major adverse cardiac and cerebrovascular events (MACCE) including cardiac death, recurrent myocardial infarction, definite or probable stent thrombosis and ischemic stroke. The secondary endpoint was 2-year ischemia-driven target vessel revascularization. The incidence of endpoint events of the two groups was compared, and it was compared again after the primary baseline characteristics such as age and gender were matched by the propensity scoring method at a 1∶1 ratio. Results: A total of 910 (93.1%) patients who underwent delayed PCI were transferred from other hospitals, and 292 (29.9%) patients received thrombolysis before PCI. The time interval before PCI was 14 (10, 20) days. The incidence of 2-year MACCE (3.0%(15/495) vs. 2.3%(11/482), P=0.468) and ischemia-driven target vessel revascularization (3.8%(19/495) vs. 5.0%(24/482), P=0.385) were similar between the two groups. The incidence of 2-year MACCE (3.3%(15/453 vs. 2.4%(11/453), P=0.426) and ischemia-driven target vessel revascularization (4.2% (19/453) vs. 4.9%(22/453), P=0.632) were also similar between the two groups after matching propensity score. Conclusion The long-term clinical outcomes after early delayed PCI using DES is statistically equivalent to those of late delayed PCI using DES for STEMI patients who missed the time window for emergency PCI.

Increased intestinal barrier permeability, leaky gut, has been reported in patients with autism. However, its contribution to the development of autism has not been determined. We selected dextran sulfate sodium (DSS) to disrupt and metformin to repair the intestinal barrier in BTBR T⁺tf/J autistic mice to test this hypothesis. DSS treatment resulted in a decreased affinity for social proximity; however, autistic behaviors in mice were improved after the administration of metformin. We found an increased affinity for social proximity/social memory and decreased repetitive and anxiety-related behaviors. The concentration of lipopolysaccharides in blood decreased after the administration of metformin. The expression levels of the key molecules in the toll-like receptor 4 (TLR4)-myeloid differentiation factor 88 (MyD88)-nuclear factor kappa B (NF-κB) pathway and their downstream inflammatory cytokines in the cerebral cortex were both repressed. Thus, "leaky gut" could be a trigger for the development of autism via activation of the lipopolysaccharide-mediated TLR4-MyD88-NF-κB pathway.
Mice ; Animals ; NF-kappa B ; Myeloid Differentiation Factor 88/metabolism* ; Lipopolysaccharides/pharmacology* ; Toll-Like Receptor 4/metabolism* ; Autistic Disorder/metabolism* ; Signal Transduction/physiology*