Objective To study the relationship between mean platelet volume(MPV)and severity of acute pancreatitis.Methods MPV was examined by hematology analyzer.Relationship between MPV and the severity of acute pancreatitis and the effect of sandostatin on MPV in acute pancreatitis were analyzed.Results The MPV of severe acute pancrcatitis was significantly higher than that of controls(P＜0.05),whereas the MPV of mild acute pancreafitis was not(P＞0.05).The APACHE Ⅱ Score and MPV of GH group was significantly lower than that of SS group and control(P＜0.05).Conclusion The MPV could reflect the severity of acute pancreatitis,evaluate the prognosis of acute pancreatitis.

Objective To observe the effect of the nuclear factor (NF)-κB inhibitor on the inflammatory injury and the secondary remote damage in remote areas of the CA1 region in the right hippocampus of the focal cerebral ischemic/reperfusion rats,and the NF-κB essential modifier binding domain (NBD) peptide was used to inhibit the activation of NF-κB signaling pathway to explore the function and mechanism of the NBD peptide in restraining inflammatory injury and reducing secondary remote damage in the hippocampus CA1 region.Methods According to the random number table,the male Sprague-Dawley (SD) rats were randomly divided into a sham group (n =24),an ischemia/reperfusion (I/R)group (n =38),a NBD group (n =38) and a modified type peptide (MT-NBD) group (n =38),then at the time point of 24 h and 7 d after reperfusion,the above 4 groups were divided into 2 subgroups.The experimental models were made by middle cerebral artery occlusion (modified line plug method) for 2 hours.The NBD peptide and the MT-NBD peptide were respectively injected into the right hippocampus of the experimental groups.The injury of neurons was examined by the methods of H&E and Fluoro-Jade B-(FJB)staining.The levels of interleukin-1β (IL-1β) and IL-1Ra were detected by using enzyme-linked immunosorbent assay.The protein expressions of NF-κB p65 and IκBα were analyzed by Western blotting and the double-labelling immunofluorescence.Results Compared with the NBD group (24 h 0.206 ±0.013,7 d 0.090 ±0.012) and the sham group (24 h 0.120 ±0.007,7 d 0.100 ±0.014),the NF-κB p65 protein expression in the I/R group (24 h 2.340 ± 0.101,7 d 2.440 ± 0.081) was increased significantly (q =64.431,66.704,67.747,56.624,all P ＜ 0.05).The level of IL-1β was remarkably increased in the I/R group (24 h (1.850 ±0.192) ng/ml,7 d (1.000 ±0.178) ng/ml) compared with the NBD group (24 h (1.250 ± 0.211) ng/ml,7 d (0.560 ± 0.183) ng/ml,q =10.730,9.710,P ＜0.05).The percent of survival neurons was significantly lower in the I/R group (24 h 27.50％ ± 3.59％,7 d 28.10％ ±4.46％) and the MT-NBD group (24 h 27.30％ ±4.53％,7 d 26.30％ ±5.03％)than the NBD group (24 h 58.90％ ± 3.46％,7 d 68.40％ ±4.20％,q =19.949,19.731,2.139,22.249,all P ＜0.05).The FJB staining showed that the number of neuron degeneration in the I/R group (24 h 28.10 ±2.13,7 d 29.50 ±2.45) was higher than the NBD group (24 h 12.50 ±2.41,7 d 9.30 ±2.52,q =3.211,4.521,P ＜ 0.05).Compared with the other three groups (sham group:24 h 0.130 ± 0.008,7 d 0.150 ±0.010;I/R group:24 h 1.340 ±0.213,7 d 1.750 ±0.119;MT-NBD group:24 h 1.250 ±0.114,7 d 1.620 ±0.097),the IκBα protein expression in the NBD group (24 h 1.680 ±0.148,7 d 2.010 ±0.085) was significantly increased (q =6.348,9.139,9.414,1.711,5.277,5.555,all P ＜0.05).Compared with the I/R group (24 h (0.570 ± 0.028) ng/ml,7 d (0.430 ± 0.039) ng/ml) and the MT-NBD group (24 h (0.490 ± 0.042) ng/ml,7 d (0.380 ± 0.018) ng/ml),the level of IL-1Ra in the NBD group (24 h (1.390 ± 0.055) ng/ml,7 d (1.250 ± 0.043) ng/ml) was remarkably increased (q =4.577,6.205,9.683,6.389,all P ＜ 0.05).The results between the I/R group and the MT-NBD group were not significantly different.Conclusions The research shows that NBD peptide treatment contributes to altering the NF-κB p65/IκBα expression in nucleus effectively.And it directly regulates the NF-κB activation to alleviate the inflammatory injury in the hippocampus CA1 region after the secondary remote damage.

BACKGROUND: Previous studies have confirmed that embryonic stem cells call be induced to differentiate into insulin-producing cells, but the induction process takes a long time. Most of the processes take about one month.OBJECTIVE: Activin A, all-trans retinoic acid (ATRA), basic fibroblast growth factor (bFGF) and nicotinamide were applied in vitro in combination to observe whether mouse embryonic stem cells could be induct to differentiate into insulin-producing cell in a relatively short time.DESIGN: Cell observation experiment.SETTING: Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.MATERIALS: This study was performed at Shanghai Institute of Endocrine and Metabolic Diseases from October 2004 to February 2006. Two mice of clean grade and of 12.5-14.5 days of gestational age were provided by Shanghai SLAC Laboratory Animal Co., Ltd (Permission No. 2004A034). The protocol was performed in accordance with ethical guidelines for the use and care of animals. Mouse embryonic stem cell lines were supplied by Dr Changxian Zhang (CNRS UMR5641, France). Activin A was the product of the R & D Corporation. ATRA and nicotinamide were supplied by the Sigma Corporation, USA. BFGF was supplied by Gibco Corporaion. METHODS: Head and viscera were removed from embryos of the pregnant mouse. The remaining tissues were cut into pieces and digested with trypsin. Cell suspension was centrifuged and inoculated at 3×108L-1. The cells could be used as mouse feeder layer after 2-3 times of passage. The mouse embryonic stem cells (ESCs) were inoculated onto the feeder layer in knockout Dulbecco's modified Eagle medium (DMEM) supplemented with leukemia inhibitory factors (LIF). ESCs were passaged at 1:3-1:6 after 2-3 days of culture. Culture medium with serum was added into the culture dishes to terminate the digestion. Cell fluid was centrifuged and supernatant was discarded. The sediments were prepared into suspension and inoculated at 2.5×104 with LIF-free culture medium. After 24-48 hours, embryonic bodies (EBs) were collected and replated in 1% Matrigel-coated dishes. When began to adhere to the dishes, EBs were cultured in 10% FBS/DMEM supplemented with 100μg/L activin A for 24 hours. Then EBs were switched to 10% FBS/DMEM for 6-8 hours as an interval. After this interval. EBs differentiated were cultured in 10% FBS/DMEM with 10<-6mol/L RA for another 24 hours followed by culture in 10% FBS/DMEM supplemented with 10μg/L bFGFs for 3-5 days. Finally, EBs differentiated were cultured in DMEM/F12 supplemented with N2 supplement, B27 supplement, 1μg/L laminin, 10μg/L bFGFs, and 10mmol/L nicotinamide for 3-5 days. Dithizone (DTZ) staining, inununofluorescent staining and reverse transcription-polymerase chain reaction (RT-PCR) were applied to detect insulin expression in the differentiated cells.MAIN OUTCOME MEASURES: Induction of ESCs, DTZ staining and immunofluorescent staining as wel as RT-PCR detection.RESULTS: Mouse ESCs growing on a feeder layer formed many colonies with clear boundary and dense structure. However, there was no obvious outer limit between these ESCs. EBs began to adhere to the dishes, which were coated with matrigel, on the 2nd day. After activin A and ATRA interval induction, EBs spread, and most of the living cells were epithelial cell-like when cultured in 10% FBS/DMEM supplemented with 10μg/L bFGFs. After culturing in DMEM/F12 supplemented with N2, B27, nicotinamide, bFGFs and laminin, the cells formed small clusters. The insulin-producing cells were stained dark red with DTZ, and the cells stained with primary antibody to insulin were insulin-positive. After 2 weeks of induction of activin A, ATRA, bFGFs and nicotinamide, the insulin-producing cells expressed insulin 2, Pdxl, Nkx6.1, Nkx2.2, PP, IAPP, Glut2, Somastatin, Hnf3β and Neuro D mRNA but did not express insulin 1 mRNA.CONCLUSION: Mouse ESCs call be induced to differentiate into insulin-producing cells by activin A, ATRA, bFGFs and nicotinamide in vitro. Induction time call be shortened to 2 weeks.

Objective: To explore the effect of cluster skin management (SSKIN) on reducing the incidence of stress skin injury in children with congenital heart disease during perioperative period. Methods: Delphi method was used to establish cluster skin management specialty to formulate SSKIN. Skin outcomes of 863 children before SSKIN implementation (control group) and 819 children after SSKIN implementation (experimental group) were analyzed and compared through personnel training, program application and supervision. Results: The incidence of stress skin injury, stage I stress skin injury and occipital pressure injury were 5.1% (44/863), 4.4% (38/863), 2.5% (22/863) in the control group and 2.3% (19/819), 2.2% (18/819), 0.7% (6/819) in the experimental group, respectively. There were significant differences between the two groups (χ² = 8.999, 6.350, 8.472, P < 0.01 or 0.05). The incidence of stress skin injury in delayed chest closure and continuous positive airway pressure were 27.9%(17/61), 23.4%(18/77) in the control group and 11.5%(6/52), 8.9%(7/79) in the experimental group, respectively. There were significant differences between the two groups(χ²=4.618, 6.105, P<0.05). Conclusions The SSKIN is effective at prevent congenital heart disease patients with high risk of stress skin injury. It can improve the skin outcomes in children.

Objective To study the role of pancreatic renin-angiotensin system (RAS) on insulin secretion, proliferation, apoptosis, oxidative stress, and fibrosis of β-cells. Methods The effect of angiotensin Ⅱ on βTC3 cells was studied and the role and mechanism of AT1 R were analyzed with RNAi technology. The expression of AT1 R was measured by Western Blotting. The change of intracellular calcium was detected by microfluorimetry with Furo3-1oaded cells. Peroxide-sensitive fluorescent probe DCFH-DA was used to analyze intracellular ROS by flow cytometry. Real-time PCR was performed to evaluate mRNA levels related to proliferation and fibrosis in βTC3 cells. Apoptosis was detected by flow cytometry and Tunel method. Results Insulin secretion was significantly increased up to four fold and the level of intracellular calcium was sharply increased in response to high glucose in βTC3 cells. Angiotensin Ⅱ has no direct effect on insulin secretion in βTC3 cells and its role in secretion was associated with the role in proliferation. Oxidative stress in βTC3 cells caused by angiotensin Ⅱ may be partially mediated through AT1R, protein kinase C and NAD(P) H. With the decrease of AT1R expression by RNAi technology, apoptosis, and fibrosis of βTC3 cells induced by angiotensin Ⅱ might be ameliorated.Conclusions By means of AT1R, angiotensin Ⅱ plays an important role in insulin secretion, proliferation,apoptosis, oxidative stress and fibrosis in β-cells.

Objective: To improve the clinical outcomes and critical care quality for pediatric extracorporeal membrane oxygenation (ECMO), the multidisciplinary team including doctors, nurses and respiratory therapist designed a daily checklist for patients with ECMO and evaluated the effect of the checklist. Methods: A daily checklist for ECMO patients was designed based on the expert consensus and multi-centers relevant researches. ECMO patients from January 2015 and May 2017 in the pre-application group, while the other patients from June 2017 to December 2018 in the post-application group were compared in the clinical outcomes. Results: All 78 pediatric patients used the venoarterial extracorporeal membrane oxygenation (VA-ECMO) including 27 patients in the pre-application group and the other 51 patients in the post-application group. The mortality rate was 49.02%(25/51) in the post-application group and 81.48%(22/27) in the pre-application group, the differences were significant (χ²=7.768, P=0.005). The rates of central line-associated bloodstream infection, pressure injury and the body weight change was 2/5, 4/5, -2.70(-3.50--2.05) in the pre-application group and 3.85%(1/26), 26.92%(7/26), -0.09(-1.00-0.00) in the post-application group,the differences were significant (χ²=4.505, 5.161, Z=3.252, P<0.05 or 0.01). Conclusions It is helpful for clinical staff to follow up the progress of the multiple organs when using the daily checklist, to facilitate team communication for, and to improve nursing management through setting the daily targets for individual VA-ECMO patients.

Mindfulness training has shown beneficial effects on cognitive functions in older adults.Howev-er,the studies on this topic have used different methods and populations,and their results were inconsistent.No sys-tematic review has synthesized and evaluated these findings.This review aims to address this gap by categorizing the studies based on the training methods and cohorts of older adults,and summarizing the effects of mindfulness training on cognitive function.The review finds that mindfulness training had different effects depending on the lev-el of cognitive decline and the training method.Both standardized and unstandardized training methods improved cognitive performance in older adults with normal or subjective cognitive decline.However,the effect of mindful-ness training diminished as cognitive decline worsened,being inconsistent in mild cognitive impairment and non-sig-nificant in dementia.The review also discusses the possible mechanisms and suggested directions for future re-search.

Objective:Using real-world data to analyze whether the administration of carbapenems within 7 days before the treatment or during the treatment will reduce the effectiveness of sodium valproate in patients with status epilepticus (SE) and seizure clusters (SC).Methods:The clinical data of SE and SC patients who received intravenous administration of sodium valproate in the Department of Emergency of Zhongshan Hospital, Fudan University from 2017 to 2021 were collected. The main endpoint was the failure to terminate epileptic seizures after sodium valproate injection. Univariate analysis and multivariate Logistic regression model were used to analyze whether the carbapenems was an independent risk factor for the failure of sodium valproate treatment.Results:Finally, 142 SE patients and 181 SC patients were included. Univariate analysis revealed that the use of carbapenems within 7 days before or during the treatment was a risk factor for the failure of sodium valproate treatment in SC patients (χ 2=5.498, P=0.019), but was not a risk factor for the failure of sodium valproate treatment in SE patients (χ 2=3.015, P=0.082). Through multiple factor analysis, it was found that the use of carbapenems was an independent risk factor for the seizures not terminatd by sodium valproate in SC patients ( OR=3.462, 95% CI 1.180-10.157); the interval between onset and medication≥4 hours increased the risk of sodium valproate treatment failure in SE patients ( OR=4.591, 95% CI 1.443-14.607); simultaneously using benzodiazepines could reduce the risk of sodium valproate treatment failure in SE patients ( OR=0.300, 95% CI 0.128-0.703). Conclusions:The use of carbapenems by SC patients within 7 days before or during treatment may lead to the failure of sodium valproate treatment. In clinical practice, the use of sodium valproate as a medication to terminate seizures in SC patients can be determined based on their medication records.

Objective To explore the biological function and downstream mechanism of ETS1 in glioma.Methods Bioinformatics and immunohistochemistry were used to analyze the differential expression characteristics of ETS1 in gliomas;qRT-PCR was employed to detect the expression level of ETS1 mRNA and lncRNA X-inactive specific transcript(XIST).CCK-8 and 5-ethyl-2′-deoxyuridine experiments were conducted to detect cell growth.Western blot was used to detect the expression of apoptosis-related proteins(Bax,Bak,Bcl-2).PROMO database was utilized to predict the binding sites between ETS1 and XIST promoter.Dual-luciferase reporter gene assay and chromatin immunoprecipitation-quantitative polymerase chain reaction assays were performed to verify the binding relationship between ETS1 and the XIST promoter region.cBioPortal database was used to analyze the correlation between the expression of ETS1 mRNA and XIST in glioma tissues.Results The expression levels of ETS1 mRNA and protein were significantly upregulated in glioma(P<0.05).The depletion of ETS1 significantly inhibited the proliferation of glioma cells and promoted cell apoptosis(P<0.05).ETS1 could target and bind with the XIST promoter and promote the expression of XIST(P<0.05).The overexpression of XIST reversed the effects of ETS1 on the proliferation of glioma cells and the promotion of cell apoptosis(P<0.05).Conclusion ETS1 is highly expressed in glioma tissues.It could promote the expression of lncRNA XIST,boost the proliferation of glioma cells,and inhibit cell apoptosis.

Objective:To develop a prone position management program and evaluate its effectiveness in preventing ventilator-associated pneumonia (VAP) in children with congenital heart disease combined with acute respiratory distress syndrome, in order to provide experience for clinical application.Methods:This was a quasi-experimental study. Convenient sampling method was used to select children with congenital heart defect who underwent mechanical ventilation in the Cardiothoracic Surgical Care Unit of Shanghai Children′s Medical Center, Shanghai Jiao Tong University, School of Medicine from June 2018 to December 2021 as the study subjects. The control group consisted of 80 hospitalized children from June 2018 to December 2019. They were used general nursing interventions to prevent VAP. The 42 hospitalized children from January 2020 to December 2021 were the intervention group, who usd the prone position management program on the basis of the control group. The differences in the incidence of VAP, duration of mechanical ventilation, duration of ICU stay, oxygenation index and the incidence of adverse events between the two groups were compared.Results:The incidence of VAP and mechanical ventilation duration in the intervention group were 4.8% (2/42) and 67.50 (55.00/101.50), which were lower than 35.0% (28/80) and 92.50 (68.00/142.00) of the control group, and the differences were statistically significant ( χ2=11.98, Z=3.40, both P<0.01). And the trend of increasing oxygenation index with the intervention group was better than the control group ( F=8.38, P<0.05). There was no statistical difference in the incidence of adverse events between the two groups (all P>0.05). Conclusions:The application of prone ventilation program with congenital heart disease children complicated with acute respiratory distress syndrome is safe and can significantly improve the oxygenation index, shorten the duration of mechanical ventilation and reduce the incidence of VAP.