Objective To examine whether lipoxin A4(LXA4) has an antagonistic effect on interleukin (IL)-1?-induced synthesis of IL-6 in glomerular mesangial cells, and to explore its mechanism. Methods Cultured glomerular mesangial cells (GMCs) of rat were treated with IL-1?, with or without preincubation with LXA4. Protein secretion of IL-6 in supernatants was examined analyzed by enzyme-linked immunosorbent assay (ELISA). Expression of IL-6 mRNA was determined by RT-PCR. The expression of Src homology 2 (SH2) containing protein-tyrosine phosphatase 2 (SHP-2) was assessed by immunoblotting. Activities of DNA-binding of nuclear factor-kappa B (NF-?B) were measured by electrophoretic mobility shift assay (EMSA). Results The secretion of protein and expression of mRNA of IL-6 in GMCs stimulated by IL-1? were inhibited by LXA4 in a dose-dependent manner. LXA4 reduced the phosphorylation of SHP-2 and activities of NF-?B. Pretreatmnet of GMCs with NF-?B inhibitor pyrrolidine dithio-carbamate (PDTC) blocked both the secretion of IL-6 protein and activation of NF-?B induced by IL-13- Conclusion LXA4 antagonists IL-1?-induced synthesis of IL-6 in GMCs through the pathway of SHP-2/NF-?B signal transduction.

Objective To examine whether lipoxin A4(LXA4) induces apoptosis of rat renal interstitial fibroblasts and explore the mechanism concerned.Methods Rat renal interstitial fibroblasts (NRK 49F cells)were incubated in RPMI 1640 medium supplemented with 5%fetal calf serum and exposed to LXA4 at the concentration of 10 nmol/L, 100 nmol/L or 1 ?mol/L for 24 hours. Prior to experiment,some NRK 49F cells were transfected with Smac antisense oligodeoxynucleotide. Apoptosis of NRK 49F cells was recognized by double staining using fluorescent dye acridine orange and ethidium bromide,and observed under laser scanning confocal microscopy and counted by flow cytometry following propidium iodide and annexin staining. Activity of caspase 3 was measured by colorimetric assay. The expression of Smac was determined by Western blotting analysis.Results LXA4 at the concentration of 100 nmol/L or 1 ?mol/L induced apoptosis of 9 83%or 33 82%of NRK 49F cells respectively, and reduced the cells of S and G2～M phase and increased the cells of G0～G1 phase in a dose dependent manner. Treatment of NRK 49F cells with LXA4 up regulated the expression of Smac protein and increased the activity of caspase 3. The transfection with Smac antisense oligodeoxynucleotide inhibited the LXA4 induced apoptosis and expression of Smac in NRK 49F cells. Conclusion LXA4 at high concentration can induce apoptosis of rat renal interstitial fibroblasts via the up regulation of Smac expression.

OBJECTIVETo investigate the pathogenesis of thromboembolism in patients with mitral stenosis in a pre-thrombotic state.

METHODSThe biochemical markers' levels in plasma for platelet activity [soluble P-selectin (GMP-140)], states of thrombin generation [antithrombin III (AT III) and protein C (PC)], fibrinolysis [D-dimer (DD), plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator (t-PA) and FDP] and von Willebrand factor (vWF) were determined from blood specimens obtained from the femoral veins and arteries and the right and left atria of 43 consecutive patients (20 with atrial fibrillation and 23 with sinus rhythm) with mitral stenosis (MS), undergoing percutaneous mitral valvuloplasty. The same parameters were compared with those of 15 control subjects, who had no detectable heart disease, but with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation of the left accessory pathway through a transseptal passage.

RESULTSBlood from the left atrium contained an excessive amount of platelet activity, thrombin generation and fibrinolysis compared with the blood from the right atrium, and the femoral veins and arteries. However blood from the right atrium was much lower in these activities when compared with those from the left atrium, and the femoral veins and arteries in both groups. Compared with those in the control subjects, GMP-140 in the left atrium was significantly higher (P < 0.05) and AT III was significantly lower (P < 0.05) in patients with MS. Compared with the patients with MS and spontaneous left atrial echocontrast (LASEC) /= 2 had significantly higher levels of GMP-140 in plasma (P < 0.05), and significantly lower levels of AT III (P < 0.05) and PC (P < 0.01) levels in the left atrium. However, there were no significant differences between patients with atrial fibrillation and those with sinus rhythm regarding amounts of plasma coagulation markers in the left atrium. Univariate regression analysis revealed that LASEC was negatively correlated with plasma levels of blood from the left atria in the patients with MS.

CONCLUSIONCoagulability is increased in the left atria of patients with MS and is positively correlated with LASEC.

Adult ; Antithrombin III ; analysis ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Heart Atria ; chemistry ; Humans ; Male ; Mitral Valve Stenosis ; complications ; P-Selectin ; blood ; Plasminogen Activator Inhibitor 1 ; blood ; Protein C ; analysis ; Regression Analysis ; Thromboembolism ; etiology ; Thrombophilia ; blood ; complications ; von Willebrand Factor ; analysis

Inflammatory bowel disease is chronic intestinal inflammatory disease with unknown etiology, which may be associated with environmental , genetic and immune factors.The personalized or accurate diagnosis and treatment are a new development trend for IBD clinical management .The detection of biomarkers is very important in the diagnosis , treatment and clinical management of IBD .In addition to the traditional biomarkers , the emerging new markers based on genetics , epigenetics , microbial and metabolomics have also shown better future applications in several areas , such as the applications of biomarkers in diagnosis and differential diagnosis of IBD .The determination of disease activity , severity and complications.The selection for treatments in IBD and prediction of therapeutic effects .These biomarkers will also contribute to personalized clinical management of IBD .

Objectives To explore the genetic diagnosis of fructose 1,6 diphosphatase deficiency and analysis of mutation sites of its pathogenic genes. Methods The clinical data and the related results of gene panel screening in one child with fructose 1, 6 diphosphatase (FBPase) deficiency were retrospectively reviewed. Results The 2-year-old girl suffered repeated infection, nausea, vomiting, mental illness, and drowsiness, accompanied by intermittent convulsions. Blood biochemical tests sμggested hypoglycemia and acidosis.The FBP1 gene had a missense mutation,c.355G>A,p.Asp119Asn(isozygoty).Both her parents carried the locus variation (heterozygous). Conclusions Fructose 1, 6 diphosphatase deficiency should be considered when child with hypoglycemia after repeated infection, acidosis, and ketosis.

Objective To explore the risk factors of hospital-acquired pneumonia from the point of view of experts′experiences with the method of expert questionnaire .Methods The questionnaire on the risk factors of hospital-acquired pneumonia , which was made based on the literature consultation and group discussion , were distributed to 210 experts selected from the whole city .The degree of mean , the coefficient of variation ( CV) and the cumulative percent of the risk factors were surveyed .Results The survey distributed 210 cases of questionnaires in all .The effective retrieving rate was 96.2%.The mean value of degree of mean , the cumulative percent and CV were 3.80, 86.7% and 0.30 respectively.Male, aerosol inhalation, low hemoglobin production and cognitive disorder were excluded , according to the discussed criteria .The resting 27 items were considered as the risk factors of hospital acquired pneumonia .Conclusions This study determines the risk factors of hospital-acquired pneumonia by conducting expert questionnaire , which can be a complementary solution to previous retrospective case control study and afford the foundation to further prevention of hospital -acquired pneumonia .

Objective To explore the satisfaction of inpatients in general hospital and special hospital of grade-Ⅲ in Shanghai, thus to provide the basis for policy making to improve nursing service quality. Methods Inpatients of 13 grade-Ⅲ general hospitals and 5 grade-Ⅲspecial hospitals in Shanghai were drawn-off by random sampling method and underwent questionnaires by recruited and the third party group. The satisfaction of inpatients was evaluated by relevant data analysis. Results A total of 1 377 calls were dialled in this investigation, but just 689 questionnaires were returned,so the return-rate was 50. 04%, among which 551 questionnaires were valid (valid return rate was 40. 01%). There was statistically significant difference between general hospital and special hospital of grade-Ⅲ in terms of daily care, awareness of patient′s needs during nursing round, nursing skill, communication before nursing care, privacy and health education before discharge by χ2 test (P<0. 05). The mean score of overall satisfaction in general hospital was 99. 42, and 99. 75 for special hospitals, which was of statistically significant difference (P<0. 05). Conclusions Survey of inpatient satisfaction between different level hospitals is beneficial for detecting the difference between general hospital and special hospital of grade-Ⅲ and finds out the shortcomings of different types hospitals, so as to provide the evidence to improve the quality of care targeted.

Objective:To describe a systematic approach on identification of poisonous mushroom by investigating two cases of Omphalotus guepiniformis poisoning in Jianyang district, Nanping, Fujian province. Methods:Two incidents of food poisoning on 10 migrant workers were investigated. The remaining suspected mushroom samples were collected and the same fresh mushroom specimens were also collected in the following field investigations from the same dead tree and fallen trunk. These mushroom specimens were identified based on morphological and phylogenetic analyses.Results:On November 24 and 26, 2018, 8 and 2 migrant workers from Jianyang District, Nanping ate wild mushrooms and developed acute nausea, vomiting, abdominal pain and other symptoms within 10 to 90 min after consumption. They were diagnosed as mushroom poisoning, with gastroenteritis as the main manifestation. Further analysis showed that the more poisonous mushroom were consumed, the shorter latency and longer duration of nausea and vomiting were resulted. After admission, gastric lavage, catharsis, acid preparation, gastric protection, fluid replenishment and other symptomatic support treatments were given in time, all patients were discharged in 1-3 d. Based on morphological and phylogenetic analyses, the samples were identified as O. guepiniformis. Conclusions:The two incidents were caused by accidental consumption of O. guepiniformis. Awareness education about poisonous mushroom should be provided to migrant workers to prevent more such poisoning incidents in the future.

Objective: To explore the short-term efficacy and prognosis of palliative surgical treatment for malignant bowel obstruction (MBO) caused by peritoneal metastasis of colorectal cancer (mCRC). Methods: A retrospective cohort study was conducted. The inclusion criteria for patients were as follows: (1) primary colorectal cancer; (2) massive peritoneal metastasis; (3)obstructive site located below Treitz ligament by imaging; (4) obstruction refractory to conservative treatment; (5) estimated rese survival time more than 2 months; (6) patients and their families had strong willingness for operation; (7) surgical treatment included stoma/bypass and debulking surgery. In accordance with the above criteria, clinicopathological data of 46 patients undergoing palliative surgery at Peking University Gastrointestinal Cancer Center, Unit III from January 2016 to October 2018 were retrospectively collected. Postoperative symptomatic relief rate, morbidity of complication within 30 days, complication classification (Clavien-Dindo classification), mortality and survival after operation were analyzed. Kaplan-Meier method was used to evaluate survival and Cox regression analysis was used to identify prognostic factors. Results: Among 46 patients, 30 were male and 16 were female with median age of 63 (19-87) years; 23 patients received stoma/bypass surgery (stoma/bypass group), and 23 cases received tumor debulking surgery (debulking group). The overall symptom relief rate was 76.1% (35/46), while symptom relief rate in the debulking group was 91.3% (21/23), which was significantly higher than 60.9% (14/23) in the stoma/bypass group (χ²=4.301, P=0.038). Postoperative complications occurred in 25 patients. The complication rate was 52.2% (12/23) in the debulking group and 56.5% (13/23) in the stoma/bypass group, without statistically significant difference (χ²=0.088, P=0.767). Morbidity of complication beyond grade III was 8.7% (2/23) and 13.0% (3/23) in the debulking group and stoma/bypass group respectively, without statistically significant difference (χ²=0.224, P=0.636). Four patients died within 30 days after operation, 2 (8.7%) in each group. Twenty-four patients underwent 1-8 cycles of chemotherapy ± targeting therapy (regimens: CapeOX ± Bevacizumab, FOLFOX/FOLFIRI ± Bevacizumab/Cetuximab), including 10 cases in the stoma/bypass group and 14 cases in the debulking group. Two patients of debulking group received postoperative radiotherapy and chemotherapy (50.6 Gy/22 f, with concurrent oral capecitabine). Till the last follow up of April 2019, 34 patients died (34/46, 73.9%) with a median overall survival time of 6.4 months, and the 6-month and 1-year survival rate was 54.5% and 29.2% respectively. The median survival time in the debulking group was significantly longer than that in the stoma/bypass group (11.5 months vs. 5.2 months, χ²=5.117, P=0.024). The median survival time of the 35 patients with symptomatic relief after operation was significant longer than that of 11 patients without relief (7.1 months vs 5.1 months, χ²=3.844, P=0.050). Multivariate analysis showed stoma/bypass surgery (HR=2.917, 95%CI:1.357-6.269, P=0.006) and greater omental metastasis (HR=4.060, 95%CI:1.419-11.617, P=0.009) were independent risk factors associated with prognosis of patients with MBO caused by peritoneal mCRC. Conclusions For patients of MBO caused by peritoneal mCRC, tumor debulking surgery may achieve higher symptom relief rate and prolong survival. Greater omental metastasis indicates poor prognosis.