Objective:To further optimize the nutritional support program for elderly neurocritical patients, analyze the changes and influencing factors of serum albumin levels in elderly neurocritical patients after surgery, and explore the impact on prognosis.Methods:A retrospective cohort study was conducted to investigate the medical records of neurosurgical intensive patients in Shanghai Tenth People's Hospital from May 2015 to September 2019. All the patients were treated for at least 5 days after operation. Patients with severe liver and kidney dysfunction, mental illness and incomplete medical records were not included in the study. Patients aged ≥65 years were included as the experimental group and patients aged <65 years served as the control group. Generalized estimating equation and other models were used to analyze the difference in the trend of albumin level and its influencing factors between the two groups. Automated machine learning was used to explore the influence of factors such as albumin level, nutrition mode, age, sex, diagnosis, preoperative consciousness level on the prognosis of patients.Results:A total of 284 patients were included in the study, including 85 in the experimental group and 199 in the control group. There were no significant differences in baseline data such as sex, age, and proportion of nutritional patterns between the two groups. Generalized estimating equation and generalized mixed additive equation showed that albumin level in both groups reached the minimum on the 3rd day after operation, and the average level in the experimental group was significantly lower than that in the control group ( P=0.03). Cerebral hemorrhage, emergency surgery, and low preoperative albumin were risk factors ( P<0.05); intravenous supplementation of human albumin might have an adverse effect on the experimental group ( P = 0.047). Machine learning models suggested that the higher the serum albumin level at discharge, the better the prognosis at 1 month after surgery. The area under ROC curve was 0.906, the specificity was 93.7%, and the sensitivity was 67.0%. Conclusions:The changes of albumin level in elderly patients with neurological critical illness after surgery are basically the same as those in young patients, with the lowest albumin level on the 3rd day after surgery, and the albumin levels even lower on the 3rd day after surgery in patients with cerebral hemorrhage, emergency surgery and preoperative low albumin. The higher the albumin level at discharge, the better the prognosis of patients may be.

Objective To investigate the effect of human hepatocellular carcinoma HepG2 cell-derived Exosome on the differentiation of mesenchymal stem cells(MSC)into cancer-associated myofibroblasts(CAF)and the impacts of CAF on liver cancer cell proliferation,migration,and invasion. Methods The protein expression of HepG2 cell-derived Exosome was detected by Western blotting. MSCs were separated from human adipose tissue and cultured with HepG2 cell-derived Exosome(100 ng/nl)to initiate differentiation. The expressions of mesenchymal markers and several interleukins were also detected by Western blotting. HepG2 cells were co-cultured with the conditioned media(CM),in which HepG2 Exosome induced the differentiation of MSC into CAF. The expressions of epithelial and mesenchymal markers were detected by real-time polymerase chain reaction(PCR)and Western blotting. Cell proliferation was assessed using MTS assay. Transwell chambers were used in the in vitro migration and invasion assay. Results HepG2 cell-derived particles expressed CD63,70 kilodalton heat shock proteins,and 90 kilodalton heat shock proteins. With the treatment of HepG2 cell-derived Exosome,the expressions of mesenchymal marker α-smooth muscle actin,fibroblast activation protein α,interleukin(IL)-6,IL-8,and IL-1β were up-regulated,while vascular endothelial growth factor had no significant change. The conditioned media which HepG2 Exosome induced MSC differentiation CAF(CAF-CM)could significantly promote HepG2 cells proliferation(1.075±0.104),compared to BSA control(0.874±0.066,P=0.023)and MSC-CM(0.649±0.034,P=0.0005). CAF-CM could significantly enhance cell migration [(42.5±9.1) cells vs.(18.5±3.1) cells,P=0.001] and invasion [(29.0±3.5) cells vs.(13.1±3.7) cells,P=0.009] compared to its control group. Moreover the conditioned medium which HepG2 Exosome induced MSC to differentiate into CAF could also promote the expressions of mesenchyme-related genes Smad interacting protein 1(P=0.040),β-catenin(P=0.038),fibronectin(P=0.029),and Vimentin(P=0.013)and inhibit the expression of epithelial related genes zonula ocdudens-1(P=0.010).Conclusions Exosome extracted from HepG2 cells can induce human adipose-derived MSC to differentiate into cancer-associated myofibroblasts. CAF-like cells can promote the migration of the liver cancer cell line HepG2.

Abstract?AlM:To investigate the effects of the MUC5AC levels and ocular function of the patients with glaucoma and cataract with combined surgery.? METHODS: Twenty - eight patients treated with glaucoma and cataract combined surgery were chosen as the observation group from December 2011 to June 2014 in our hospital, and other 28 cases of glaucoma and cataract did not undergo surgical treatment were selected as the control group, 30 healthy subjects were as healthy control group. the MUC5AC level and ocular surface score of the three subjects before surgery 1d, after 3 and 6mo were compared.?RESULTS: The NUC5AC of the two groups of patients was significantly lower than that of the healthy control group before surgery (P<0. 05), the ocular function score was significantly higher than the healthy control group ( P<0. 05). After 1mo, the MUC5AC of the observation group were significantly lower than that of before surgery ( P<0. 05), after 3mo MUC5AC content gradually increased to preoperative levels, after 6mo the MUC5AC were significantly higher than before surgery (P<0. 05). After 1mo, ocular function scores were significantly higher than the preoperative ( P< 0. 05 ), while after 3mo, ocular function scores decreased after 6mo of ocular surface function scores were significantly lower than the preoperative (P<0. 05). While the control group after 6mo, with the passage of time, the MUC5AC content gradually reduce, ocular function score increased gradually. ?CONCLUSlON:To treat the patients with glaucoma and cataract with combined surgery, the level of MUC5AC can temporary decrease. Ocular function score can temporary increase in, but after 3mo, it can be gradually improved.

Objective To investigate the diagnostic significance of endoscopic findings in Henoch-Schonlein purpura(HSP),especially when abdominal pain preceded the cutaneous lesions.Methods The clinical data and gastroscopic findings in 37 cases of children with HSP were studied and analysed retrospectively in order to detect the pathological changes in the stomach and duodenum mucosa.The biopsy was taken in the pathological changeing place,and the relationship between clinical and endoscopic findings was analyzed.Results Detection rate of the pathological changes in the stomach and duodenum mucosa was 62.2%,31.3% of which experienced only cutaneous lesions,100% of which presented the acute abdominal pain.Three patients were not checked up the pathological changes.Of them,1 had arthritis,2 had Henoch-Schonlein nephritis.Characteristically endoscopic findings in the stomach and duodenum mucosa were found.The endoscopic findings included anabrosis,hyperemia,edema and hemorrhage.Conclusions Detection rate of the pathological changes in the stomach and duodenum mucosa is higher.Endoscopy is very helpful to the early diagnosis of HSP in children,especially abdominal pain presented firstly.

Advances in mechanism and application of the heating effect in breeding of microorganism are reviewed in this paper. Heat produces mutagenesis effect and screening effect. Heating mutagenesis effect is occurred through the substitution of G-C base pair induced by heat, and heating screening effect produces higher forward mutation rate induced by other mutagens.

Objective To observe skin test results of tetanus antitoxin prepared by different solvents.Methods Patients who needed injecting tetanus antitoxin as required by trauma were randomly divided into two groups, Group A and Group B, respectively. Group A was administered with tetanus antitoxin prepared by water for injection, while Group B with tetanus antitoxin prepared by saline. Skin test results were observed, the incidence of positive skin test results and self-inductance of pain intensity were compared.Results The incidence of positive skin test results in Group A was significantly higher than that in Group B (34.19% vs 17.50%,χ2=8.631,P<0.01), and the self-inductance of pain intensity were also greater than that in Group B. Patients with positive skin test results (40 patients) in Group A, were later injected tetanus antitoxin prepared by saline, 42.50% of them (17 patients) shown negative skin test results.Conclusions There might be a high false positive rate by using tetanus antitoxin prepared by water for injection; therefore tetanus antitoxin prepared by saline is recommended, for it could decrease the false positive rate, reduce unnecessary desensitization injections, alleviate patients' pain and improve nurses' work efficiency.

OBJECTIVETo study the effects of core proteoglycan on the transdifferentiation of human renal tubular epithelial cell induced by transforming growth factor beta1 (TGF-beta1) in vitro.

METHODThe cultured HK-2 cells were divided into six groups: A. negative control group; B. 10 ng/ml TGF-beta1 group; C. 10 ng/ml core proteoglycan treated group; D. 100 ng/ml core proteoglycan treated group; E. 10 ng/ml TGF-beta1 + 10 ng/ml core proteoglycan group; F. 10 ng/ml TGF-beta1 + 100 ng/ml core proteoglycan group. The changes in configuration of HK-2 cells were inspected 48 hours after adding the stimulating factor. At the same time, changes in mRNA of keratin, alpha-smooth muscle actin, vimentin were analyzed.

RESULTSCompared with group A, group B showed great changes in the morphology of cells, most cells converted into spindle shape, like fibroblast; groups E and F, especially group F showed significantly reduced spindle shape cells. Compared with group A, groups C and D had no significant changes in morphology of cells Compared with 10 ng/ml TGF-beta1 group and negative control, the mRNA expression of alpha-smooth muscle actin and vimentin had significant increase, but that of keratin reduced (P < 0.05). However, after combined treatment with TGF-beta1 and core proteoglycan, alpha-smooth muscle actin and vimentin expression were reduced significantly, while expression of keratin was up-regulated. Single core proteoglycan treated group and negative control group had no dramatic differences (P > 0.05).

CONCLUSIONTGF-beta1 can induce the transdifferentiation of human renal tubular epithelial cell and core proteoglycan has some inhibitory effect on transdifferentiation of human renal tubular epithelial cell induced by TGF-beta1 in vitro.

Actins ; physiology ; Bone Morphogenetic Protein 7 ; metabolism ; Cadherins ; metabolism ; Cell Differentiation ; drug effects ; physiology ; Cell Line ; Cell Shape ; Cell Transdifferentiation ; Cells, Cultured ; Connective Tissue Growth Factor ; pharmacology ; Epithelial Cells ; cytology ; drug effects ; physiology ; Fibroblasts ; drug effects ; pathology ; Humans ; Kidney ; pathology ; Kidney Tubules ; pathology ; Kidney Tubules, Proximal ; pathology ; Proteoglycans ; chemistry ; pharmacology ; Transforming Growth Factor beta ; genetics ; pharmacology ; Transforming Growth Factor beta1 ; chemistry ; pharmacology ; Vimentin ; metabolism

This paper analyzed the limitation of electronic sphygmomanometer based on oscillometry, and according to the characteristics of pulse signal, the author proposed a new method of the characteristic parameter detection based on wavelet transform, and improved its recognition ability on fixed-scale, via resampling rate according to the heartbeat. And the prototype test has been proved that this method is more adaptability for individuals and stability for operation.
Blood Pressure Monitoring, Ambulatory ; instrumentation ; Individuality ; Signal Processing, Computer-Assisted ; instrumentation

OBJECTIVETo find out a simple and reproductive prognostic index in gastric cancer patients,which can be used as a comparable parameter among different regions of China.

METHODSThe perigastric metastatic lymph nodes(PGMLN) with long-term survival data were retrospectively evaluated in 148 gastric cancer patients, undergone potentially curative resections.

RESULTSThe 3-year cumulative survival rate was 62.8% and the survival rate decreased significantly with the increase of PGMLN, especially when the PGMLN was more than 6. The PGMLN had a clear linear relationship with total positive lymph nodes(r=0.94, P<0.01), while it had little correlation with total resected lymph nodes(r=0.18,P=0.2).

CONCLUSIONSPGMLN is a convenient and reliable prognostic factor in gastric cancer patients, which may be a good candidate of comparable parameters among different regions of China.

Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; mortality ; pathology ; Survival Rate

OBJECTIVETo investigate the clinical characteristics, surgical procedures and prognosis of duodenal gastrointestinal stromal tumors (GISTs).

METHODSThe clinical data of 18 GIST patients, collected from 1995 to 2004, were retrospectively analyzed.

RESULTSThe lesions of duodenal GISTs mainly located in the descending duodenum (13/18), unusually in the horizontal part (2/18), ascending part (1/18), and the bulb (2/18). Pathological examination revealed 1 case of benign tumor, 2 cases of borderline tumors and 15 cases of malignant tumors, Microscopically, the tumors were composed of spindle cells (14 cases), epithelial cell (1 case), and mixed cell types (3 cases). The clinical manifestations were non-specific, mostly was melena (7/18), as well as abdominal pain (6/18), fullness (5/18), and anemia (3/18). The diagnoses were performed by upper gastrointestinal radiography, gastroscopy, endoscopic ultrasonography and CT scan. All of the 18 patients received surgical treatment, including 9 pancreaticoduodenectomies, 5 local resections, 3 segmental resections of duodenum, and 1 distal subtotal gastrectomy. 1 and 3 year survival rates were 100% and 86.7% respectively.

CONCLUSIONMost duodenal GISTs are malignant, and the choices of surgical procedures are mainly determined by the location and size of the tumors.

Adult ; Aged ; Duodenal Neoplasms ; diagnosis ; pathology ; surgery ; Female ; Gastrointestinal Stromal Tumors ; diagnosis ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies