Objective To investigate the impact of psychological nursing on time length of ventilator weaning in patients with myasthenia gravis (MG). Methods Forty-four MG patients with mechanical ventilation were enrolled to the testing group. In this group, the time of ventilator weaning was determined according to the results of basic status and blood gas analysis. Furthermore, the designed, targeted and individuated psychological care was conducted in this group at different phases. In the control group, only the programmatic method of ventilator weaning was used with the steps of CMV, SIMV, SPONT, intermittence and completely weaning. The time length of ventilator weaning and the length of stay were compared between two groups.Results The time length of weaning in testing group was 14 days comparing with 18 days in control group.Although there was no statistical significance ( P = 0.752), the time length of ventilator weaning in testing group was shorter than that in control group. The length of stay was longer in control group than that in testing group (P = 0.039). Conclusions The time length of ventilator weaning and length of stay could be shortened with the designed, targeted and individuated psychological care during different phases of ventilator weaning in patients with MG. Therefore, the nursing efficacy would be improved and the pains and economic burden of patients would be relieved.

OBJECTIVETo investigate the CVB3 RNA concentration in myocardial tissues and inhibitory effect of Chinese herbal medicine Xin-Kang oral liquid on viral RNA replication in Coxsackievirus B3 infected myocardium.

METHODSThe total RNA was extracted from the infected murine myocardium, the reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect enterovirus RNA concentration in infected mice with Coxsackievirus B3 gene band. We used "Gel works system" to scan the electrophoresis image to detect CVB3 gene band.

RESULTSThe mean concentration of myocardial CVB3 RNA of Xin-Kang oral liquid treated groups was markedly lower than that of virus control group (P>0.01), but the CVB3 RNA in myocardial tissues has not been destroyed by Xin-Kang oral liquid feed in different phase.

CONCLUSIONChinese herbal medicine Xin-Kang oral liquid could inhibit CVB3 RNA replication in myocardial tissue, but it did not destruct the virus.

Animals ; Coxsackievirus Infections ; drug therapy ; Drugs, Chinese Herbal ; pharmacology ; Enterovirus B, Human ; drug effects ; genetics ; Mice ; Myocarditis ; drug therapy ; virology ; Phytotherapy ; RNA, Viral ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Treatment Outcome ; Virus Replication ; drug effects ; genetics

INTRODUCTIONAnorectal malformations (ARMs) and low-lying spinal cord (LLC) are commonly associated owing to their common embryonic origin. LLC may lead to tethered cord syndromes (TCS), requiring surgery. This study aimed to review the incidence of LLC in children with ARMs using ultrasonography (US) and magnetic resonance (MR) imaging, the incidence of TCS and the surgical outcomes of these patients after detethering.

METHODSWe conducted a retrospective study of children who underwent surgery for ARMs in 2002-2009 at KK Women's and Children's Hospital, Singapore.

RESULTSOut of 101 (16.8%) ARM patients, 17 had LLC, of which 12 (70.6%) were high ARMs. 12 of the 17 (70.6%) patients had abnormal US and MR imaging findings. Five (29.4%) had normal US but abnormal MR imaging results; in these five patients, MR imaging was performed due to new symptoms and equivocal US findings. These 17 patients subsequently underwent surgical detethering. Three out of seven patients with TCS improved after surgery. None of the 17 patients had any complications.

CONCLUSIONLLC appeared to be associated with high ARMs, although this was not statistically significant. LLC should be investigated for whenever ARM is diagnosed, regardless of its type. Lumbar US is useful for first-line screening for LLC. Abnormal US or onset of new symptoms should subsequently be investigated with MR imaging. Equivocal US findings are also likely to benefit from further MR imaging. Surgery to detether LLC can improve outcome in TCS, while prophylactic detethering for asymptomatic patients with lipoma of the filum terminale has very low surgical risk.

Anorectal Malformations ; Anus, Imperforate ; epidemiology ; surgery ; Female ; Humans ; Incidence ; Infant ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Neural Tube Defects ; diagnosis ; diagnostic imaging ; epidemiology ; surgery ; Neurosurgical Procedures ; adverse effects ; Retrospective Studies ; Sensitivity and Specificity ; Singapore ; epidemiology ; Treatment Outcome ; Ultrasonography

OBJECTIVETo describe the characteristic of tongue images of patients with lung cancer of different Chinese medicine (CM) syndromes and to reveal the elemental rule on the changes of the tongue images.

METHODSA total of 207 patients with lung cancer were divided into four syndrome groups according to the theory of CM: Fei and Shen deficiency syndrome (Group A, 72 cases), Pi deficiency and phlegm deficiency and phlegm) and Shen (deficiency and phlegm) deficiency syndrome (Group A, 72 cases), Pi (deficiency and phlegm) deficiency and phlegm dampness syndrome (Group B, 57 cases), phlegm-heat retention in Fei (Group C, 36 cases) and yin asthenia generating intrinsic heat syndrome (Group D, 42 cases). The tongue parameters were detected by tongue image digital analysis instrument, and the tongue images were described with qualitative, tongue color and quantitative analysis, respectively. The International Commission on Illumination (CIE) L·a·b (CIELAB) color model was used for the quantitative classification.

RESULTSThere was a significant statistical difference between different syndrome groups of lung cancer on tongue color, coating color, and thickness of tongue coating (P<0.01), and there was significant statistical difference between the four syndrome groups on Lab values of the tongue and coating (P<0.05). The correct identification rate of discriminant function on the raw data was 65.7%, including 72.2% for Group C, 69.4% for Group A, 69.0% for Group D and 54.4% for Group B.

CONCLUSIONSA tongue image digital analysis instrument can objectively describe the tongue features of patients with different syndromes of lung cancer. The tongue diagnosis is very important to syndrome differentiation in CM. Tongue diagnosis should be combined with some important characteristics of syndromes in the future to establish a "combination of four examination methods, including inspection, auscultation, interrogation, and pulse-feeling and palpation" in the tongue diagnostic system.

Color ; Discriminant Analysis ; Humans ; Lung Neoplasms ; pathology ; Medicine, Chinese Traditional ; Tongue

Alveolar epithelial type II (AT II) cells are essential for lung development and remodeling, as they are precursors for type I cells and also produce other non-repair cells (fibroblasts). Progenitor cells are believed to possess capability of multi-potent transdifferentiation, which is closely related to the niche, suggesting the importance of establishment of a lung progenitor cell niche model. We hypothesized that pulmonary surfactant-associated protein A (SPA) suicide gene system would cause AT II cell to kill itself through apoptosis and leave its niche. In vitro, the recombinant adeno-associated virus vectors-SPA-thymidine kinase (rAAV-SPA-TK) system was established to get targeted apoptotic AT II cells. The apoptosis of AT II cells was detected by using MTT. The results showed that cloned SPA gene promoter had specific transcriptional activity in SPA high expression cells, and SPA high expression cells (H441) transfected with TK gene had higher sensitivity to ganciclovir (GCV) than SPA low expression cells (A549). In vivo, increased apoptosis of AT II cells induced by GCV in rAAV-SPA-TK system was observed by TUNEL. Finally, the successful packaging and application of rAAV-SPA-TK system provide experimental basis to get specific lung progenitor cell (AT II) niche in vitro and in vivo.

Objective To study the relation between stroke and both plasma leptin level and polymorphism of leptin receptor gene. Methods Ninty-nine patients with stroke and 97 patients with other diseases (controls), admitted to our hospital from January 2007 to December 2008, were chosen in the experiment. Polymerase chain reaction-restriction fragment length polymorphism (LEPR) examination was performed to detect the leptin receptor gene (Gln223A rg gene) polymorphism in these patients. The level of serum leptin was analyzed by enzyme linked immunosorbent assay. Results The genotype frequencies of GG, GA and AA in Gln223Arg gene in patients with stroke were 66.67%, 20.20% and 13.13%, respectively, while those in controls were 78.35%, 15.46% and 6.19%, respectively; those in these 2 groups were not significantly different (P＞0.05). The allele frequencies of A and G in patients with stroke were 76.77% and 25.23%, while those in controls were 86.08% and 13.92%; those in the 2 groups were significantly different (P＜0.05). The level ofleptin in patients with stroke was markedly higher that that in controls (P＜0.05). Binary regression analyses showed that history of hypertension, elevated fasting blood glucose and cholesterol, increased plasma leptin level were associated with stroke. Conclusion The allele frequencies of A in Gln223A rg gene, hypertension, elevated fasting blood glucose and cholesterol and increased plasma leptin level might be correlated with the increased risk of stroke.

OBJECTIVETo study the effect of angiogenesis inhibitor YH-16 in combination with 5-FU on liver metastasis of colorectal cancer.

METHODSIn vitro, the inhibitory effects of YH-16 and 5-FU on the growth of vascular endothelial cells and colorectal cancer cells were examined by MTT assay. In vivo, colorectal cancer cells were transplanted into BALB/c mice, and the mice were divided into six groups randomly:control group, low-dose YH-16 group, middle-dose YH-16 group, high-dose YH-16 group, 5-FU group and combination group. The number of liver metastases, the size of primary tumor and the toxicity were examined after 2 weeks postoperatively. The expression of vascular endothelial growth factor (VEGF) in liver metastases was detected by immunohistochemistry, and tumor microvessel density (MVD) was measured by immunostaining with CD34 and factor VIII (monoclonal antibodies.

RESULTSIn vitro, YH-16 inhibited the growth of colon cancer cells and vascular endothelial cells, with the IC50 at (2.16+/-0.28) microg/ml and (0.64+/-0.10) microg/ml respectively. In vivo high-dose YH-16 and 5-FU had a remarkable inhibitory effect on liver metastasis, and the combination group showed significant enhancement on this effect (P< 0.05). The combination group and 5-FU group could inhibit the growth of primary tumor, but not found in YH-16 group. The toxicity of YH-16 was lower than that of 5-FU (P< 0.05), and the difference was not found in the toxicity between combination group and 5-FU group (P > 0.05). Expression of VEGF in liver metastases was clearly inhibited by YH-16 in combination with 5-FU or 5-FU alone compared to the control group, and MVD in middle-dose and high-dose YH-16 group, 5-FU group and combination group was lower than that in control group (P< 0.05).

CONCLUSIONSThe angiogenesis inhibitor YH-16 can inhibit liver metastasis of colorectal cancer through inhibiting the growth of vascular endothelial cells. YH-16 in combination with 5-FU has additive effect on inhibitory activity against liver metastasis.

Angiogenesis Inhibitors ; therapeutic use ; Animals ; Cell Line, Tumor ; Colorectal Neoplasms ; drug therapy ; pathology ; Drug Therapy, Combination ; Female ; Fluorouracil ; therapeutic use ; Liver Neoplasms ; prevention & control ; secondary ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVE Although it is generally believed that nicotine accounts for the beneficial effect of smoking on ulcerative colitis, the underlying mechanisms remain not well understood. Our previous finding that nicotine inhibits inflammatory responses through inducing miRNA-124 prompted us to ask whether the miRNA is involved in the protective action of nicotine on UC. METHODS MiR-124 expres-sion in colon tissues and cells was determined by q-PCR and in situ hybridization.The effect of miR-124 on protective role of nicotine in ulcerative colitis was evaluated in DSS-treated mice and IL-6-treated Caco-2 colon epithelial cells. Expression of p-STAT3/STAT3 was detected by immunohistochemistry and Western-blot analysis. RESULTS miR-124 expression is upregulated in colon tissues from UC patients and DSS-induced colitis mice. Nicotine treatment further elevated miR-124 level in lympho-cytes isolated from human ulcerative colonic mucosa and ulcerative colon tissues from DSS mice,both in infiltrated lymphocytes and epithelial cells. Administration of nicotine also reduced weight loss, improved DAI and decreased HE score in DSS-induced colitis mice.Moreover,knockdown of miR-124 in vivo significantly diminished the beneficial effect of nicotine on murine colitis, and in vitro on IL-6-treated Caco-2 colon epithelial cells.Further analysis indicated that nicotine inhibited STAT3 activation in vivo and in IL-6-treated Caco-2 colon epithelial cells and Jurkat human T lymphocytes,in which miR-124 knockdown led to increased activation of STAT3. Blocking STAT3 activity alone is beneficial for DSS colitis and also abolished nicotine′s protective effect in this model.CONCLUSION These data indicated that nicotine exerts its protective action in UC through inducing miR-124 and its effect on STAT3, and suggest that the miR-124/STAT3 system is a potential target for the therapeutic intervention of UC.

OBJECTIVETo investigate the effect of Chinese herbal medicine Xin-kang oral liquid on interferon (IFN)-induction and its antiviral activity in Coxsackievirus B3 virus strain (CVB3) infected mice.

METHODSThe Xin-kang oral liquid was given orally to mice two days prior to the challenge of CVB3 virus to induce myocarditis. Two dosages of Xin-kang oral liquid crude herbal medicine 30 g x kg(-1) x d(-1) and 12 g x kg(-1) x d(-1) were given to the mice of different treatment groups respectively, sterilized water was given to the mice of virus control group. IFN-alpha 10(6) U x kg(-1) x d(-1) S.C was given to the infected mice as positive drug control group. The mice were sacrificed on 5th, 10th and 20th day of infection for evaluation, the levels of serum interferon (IFN) were titrated with vesicular stomatitis virus (VSV) and cardiac tissue was fixed and sectioned. The quantitative histological changes at various stages of myocarditis were observed.

RESULTSIn the infected mice fed with 30 g x kg(-1) x d(-1) or 12 g x kg(-1) x d(-1) of Xin-kang oral liquid orally for 5, 10 and 20 days, the mean titer of serum IFN of Xin-Kang oral liquid treated group was markedly higher (29.3 U/0.1 ml) than that of virus control group (12.6 U/0.1 ml). The level of serum IFN in IFN treated positive control mice was lower than that of Xin-kang treatment groups. The histological examination showed extensive myocardial necrosis and cellular infiltration in virus control group, but necrosis and cellular infiltration were less severe in Xin-kang treatment goups of mice. It is demonstrated that there were close correlation between the degree of myocardial lesions and the level of IFN-induction in treated mice.

CONCLUSIONXin-kang oral liquid could facilitate the induction of endogenous interferon that exerted its antiviral activity in CVB3 infected mice. This can help us to understand better the mechanism of anti-CVB3 effect of Xin-Kang oral liquid.

Animals ; Animals, Newborn ; Cell Line ; Coxsackievirus Infections ; blood ; drug therapy ; virology ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; therapeutic use ; Enterovirus B, Human ; drug effects ; Interferons ; blood ; Mice ; Myocarditis ; blood ; drug therapy ; virology ; Myocardium ; pathology ; Phytotherapy

Alveolar epithelial type II (AT II) cells are essential for lung development and remodeling, as they are precursors for type I cells and also produce other non-repair cells (fibroblasts). Progenitor cells are believed to possess capability of multi-potent transdifferentiation, which is closely related to the niche, suggesting the importance of establishment of a lung progenitor cell niche model. We hypothesized that pulmonary surfactant-associated protein A (SPA) suicide gene system would cause AT II cell to kill itself through apoptosis and leave its niche. In vitro, the recombinant adeno-associated virus vectors-SPA-thymidine kinase (rAAV-SPA-TK) system was established to get targeted apoptotic AT II cells. The apoptosis of AT II cells was detected by using MTT. The results showed that cloned SPA gene promoter had specific transcriptional activity in SPA high expression cells, and SPA high expression cells (H441) transfected with TK gene had higher sensitivity to ganciclovir (GCV) than SPA low expression cells (A549). In vivo, increased apoptosis of AT II cells induced by GCV in rAAV-SPA-TK system was observed by TUNEL. Finally, the successful packaging and application of rAAV-SPA-TK system provide experimental basis to get specific lung progenitor cell (AT II) niche in vitro and in vivo.
Antiviral Agents ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Survival ; drug effects ; Cells, Cultured ; Dependovirus ; genetics ; Dose-Response Relationship, Drug ; Electrophoresis, Polyacrylamide Gel ; Epithelial Cells ; cytology ; drug effects ; metabolism ; Ganciclovir ; pharmacology ; Gene Expression Regulation, Neoplastic ; Genes, Transgenic, Suicide ; genetics ; Genetic Vectors ; genetics ; Humans ; In Situ Nick-End Labeling ; Luciferases ; genetics ; metabolism ; Promoter Regions, Genetic ; genetics ; Pulmonary Alveoli ; cytology ; metabolism ; Pulmonary Surfactant-Associated Protein A ; genetics ; metabolism ; Thymidine Kinase ; genetics ; metabolism