Objective To investigate the comprehensive prevention strategy in the prevention of oral mucositis (OM) during allogeneic hematopoietic stem cell transplantation (HSCT). Methods A total of 721 patients who received HSCT from January 2010 to December 2011 at the Institute of Hematology, Peking University were enrolled. All the patients received the comprehensive prevention strategy of OM. Results A total of 315 patients (43.7 percents) suffered from OM during HSCT, the median time from HSCT to OM occurrence was 5 days. There were 173 (54.9 percents), 91(28.9 percents), 37(11.7 percents), and 14(4.4 percents) patients suffered from gradeⅠ,Ⅱ,Ⅲ, and IV OM, respectively. Tongue OM was most common. A total of 111 patients suffered from multiple OM (≥2 locations). Multiplicity showed that duration of agranulocytosis≥15 days was the only independent risk factor of OM in HSCT [ hazard ratio (HR) value 1.5, P<0.05 ]. Neutrophil engraftment time≥12 days was significantly associated with prolonged OM (≥8 days) (HR=2.1, P<0.05). Patient age ≥20 was independent risk factor for occurrance of grade Ⅲ-Ⅳ OM (HR=2.7, P<0.05). Conclusions Comprehensive prevention strategy can overcome the risk factors of OM and prevent the occurrence of OM during HSCT.

Objective To investigate the epidemiology of viral infection in elderly patients to contract acute exacerbations of chronic obstructive pulmonary disease (AECOPD)in Minhang district of Shanghai from 2010 to 2012,and to study the relationships between viral infection and clinical features.Methods The elderly patients (age >70 year old)with AECOPD admitted from September 2010 to November 2012 were enrolled for study.The patients who couldn't complete lung function test were excluded.The pharyngeal swabs (PS)were taken from each patient within the first 24 h after admission.Nine respiratory viruses and their subtypes from pharyngeal swabs were detected by the nested multiplex polymerase chain reaction (PCR)method,including influenza virus A (FluA),2009 influenza A (H1N1 )virus (09FluH1 ), influenza virus B (FluB),respiratory syncytial virus A (RSVA)and B (RSVB),human coronavirus-229E (hCOV-229E),human coronavirus-NL63 (hCOV-NL63 ),human coronavirus-OC43 (hCOV-OC43 ), human coronavirus-HKU1 (hCOV-HKU1),human parainfluenza virus 1-4 (hPIV1-4),human adenovirus (hAdV),human boca virus (hBoV),human metapneumo-virus (hMPV)and human rhinovirus (hRV). According to the PCR results,all patients were divided into positive viral infection group and negative viral infection group.The relationships between viral infection and clinical features were analyzed.Results Sixty patients were eligible for study.Of them,14 patients were found to be positive for virus infection including a triple infected patient (FluB,hRV and hROV)and 46 patients were negative for virus infection.The viral pathogens detected in the positive viral group were:9 cases of hRV (15.00%),2 cases of hPIV (3.33%),2 cases of hCOV (3.33%),2 cases of FluB (3.33%)and 1 cases of RSV (1.67%).The mortality in the positive viral group was higher than that in the negative viral group.However,the other clinical characteristics between the two groups had no significant differences. Conclusions Human rhinovirus was the most common viral pathogen in elderly patients with AECOPD.Viral infection might be associated with the prognosis.However,the patients with viral infection are lack of specific clinical characteristics,therefore,the prompt diagnosis before careful study would be difficult.

OBJECTIVETo explore the clinical significance of high-sensitivity C-reactive protein (hsCRP) in the development of chronic hepatitis B (CHB).

METHODSA total of 182 patients with untreated CHB and 50 healthy individuals (controls) participated in the study. Correlation analysis was performed to determine the association of serum hs-CRP with the age,sex,medical history,serum hepatitis B virus (HBV) DNA, liver function parameters,liver stiffness measure (LSM) and hepatic fibrosis; in addition, correlation analysis was carried out for the associations of degree of liver damage with grade of hepatic fibrosis, LSM and the serum levels of hs-CRP.

RESULTSCHB patients showed significantly higher serum hs-CRP levels than healthy controls (2.38 ± 2.79 vs.0.78 ± 1.07; t =2.495, P < 0.05). Serum hs-CRP levels were significantly correlated with HBV DNA (r = 0.159), liver function parameters (total bilirubin, r = 0.271; alanine aminotransferase, r = 0.298; aspartate aminotransferase, r = 0.389), and LSM, r = 0.562) (all P < 0.05). The correlations with liver function (r = 0.340), LSM (r = 0.292) and hepatic fibrosis grade were positive (r = 0.434) (all P < 0.01).

CONCLUSIONSerum hs-CRP levels in CHB patients can reflect degree of liver damage and of liver fibrosis.

Alanine Transaminase ; Aspartate Aminotransferases ; C-Reactive Protein ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis

Objective: To investigate the application of microlecture in clinical practice teaching of cardiovascular internal medicine. Methods: A total of 98 students who received practice teaching in Department of Cardiology, the Second Affiliated Hospital of Xi’an Jiaotong University, from January to September, 2016, were randomly divided into control group and observation group. The students in the control group received traditional practice teaching, and those in the observation group received microlecture combined with the traditional practice teaching. The two groups were compared in terms of the scores of theoretical and skill examinations, and the degree of satisfaction with practice teaching was surveyed. Results: The observation group had a significantly higher score of clinical skill examination than the control group (P<0.05). The observation group had a significantly higher degree of satisfaction with the teaching methods of cardiovascular internal medicine than the control group (P<0.05). Conclusion The introduction of microlecture into the clinical practice teaching of cardiovascular internal medicine can significantly enhance students' mastery of clinical operation skills and improve their satisfaction with practice teaching of cardiovascular internal medicine.

Recent research indicates that lactate promotes the switching of vascular smooth muscle cells (VSMCs) to a synthetic phenotype, which has been implicated in various vascular diseases. This study aimed to investigate the effects of lactate on the VSMC phenotype switch and the underlying mechanism. The CCK-8 method was used to assess cell viability. The microRNAs and mRNAs levels were evaluated using quantitative PCR. Targets of microRNA were predicted using online tools and confirmed using a luciferase reporter assay. We found that lactate promoted the switch of VSMCs to a synthetic phenotype, as evidenced by an increase in VSMC proliferation, mitochondrial activity, migration, and synthesis but a decrease in VSMC apoptosis. Lactate inhibited miR-23b expression in VSMCs, and miR-23b inhibited VSMC's switch to the synthetic phenotype. Lactate modulated the VSMC phenotype through downregulation of miR-23b expression, suggesting that overexpression of miR-23b using a miR-23b mimic attenuated the effects of lactate on VSMC phenotype modulation. Moreover, we discovered that SMAD family member 3 (SMAD3) was the target of miR-23b in regulating VSMC phenotype. Further findings suggested that lactate promotes VSMC switch to synthetic phenotype by targeting SMAD3 and downregulating miR-23b. These findings suggest that correcting the dysregulation of miR-23b/ SMAD3 or lactate metabolism is a potential treatment for vascular diseases.

Objective:To explore the short-term outcomes of 3D-printing stand-alone artificial vertebral body(AVB)in the surgical procedure of anterior cervical corpectomy and fusion(ACCF).Methods:Following the proposal of IDEAL(idea,development,exploration,assessment,and long-term follow-up)framework,we designed and conducted this single-armed,retrospective cohort study.The patients with cervical spondylotic myelopathy were recruited,and these patients exclusively received the surgical procedure of single-level ACCF in our single center.After the process of corpectomy,the size was tailored using different trials and the most suitable stand-alone AVB was then implanted.This AVB was manufactured by the fashion of 3D-printing.Two pairs of screws were inserted in an inclined way into the adjacent vertebral bodies,to stabilize the AVB.The participants were regularly followed-up after the operation.Their clinical data were thoroughly reviewed.We assessed the neurological status according to Japanese Orthopedic Association(JOA)scale.We determined the fusion based on imaging examination six months after the operation.The recorded clinical data were analyzed using specific software and they presented in suitable styles.Paired t test was employed in comparison analysis.Results:In total,there were eleven patients being recruited eventually.The patients were all followed up over six months after the operation.The mean age of the cohort was(57.2±10.2)years.The mean operation time was(76.1±23.1)min and the median bleeding volume was 150(100,200)mL.The postoperative course was uneventful for all the cases.Dysphagia,emergent hematoma,and deterioration of neurological func-tion did not occur.Mean JOA scores were 13.2±2.2 before the operation and 16.3±0.8 at the final follow-up,which were significantly different(P＜0.001).The mean recovery rate of neurological func-tion was 85.9％.By comparing the imaging examinations postoperatively and six months after the opera-tion,we found that the average subsidence length was(1.2±1.1)mm,and that there was only one ca-ses(9.1％)of the severe subsidence(＞3 mm).We observed significant improvement of cervical lor-dosis after the operation(P=0.013).All the cases obtained solid fusion.Conclusion:3D-printing stand-alone AVB presented favorable short-term outcome in one-level ACCF in this study.The fusion rate of this zero-profile prosthesis was satisfactory and the complication rate was relatively low.

The primary cause of injury and death in the elderly has been reflected in fall the elderly, so the application of reasonable and effective prevention strategies has great significance in reducing the risk of fall in the elderly. The research progress of virtual reality technology applied in preventing fall in the elderly at home and abroad over the years was systematically reviewed in this study. The mechanism of the technology in preventing fall in the elderly was mainly elaborated from five aspects of improving balance ability, gait disturbance, cognitive impairment, muscle strength and the fear psychology of falling. The purpose of this thesis is to broaden the research ideas of medical personnel on the prevention of fall of the elderly, provide more effective clinical practice plans, reduce the occurrence of fall, and guarantee the safety of the elderly.
Aged ; Humans ; Gait ; Muscle Strength ; Technology ; Virtual Reality

Objective:To compare the effect of the 2% chlorhexidinegluconate disinfectant and 0.5% iodophor disinfectant on the maintenance of central venous catheter (CVC) in patients with immunodeficiency.Methods:The patients were randomly divided into two groups. 2% chlorhexidinegluconate disinfectant was used in the experimental group, and 0.5% iodophor disinfectant was used in the control group. The CVC was sterilized once a week and continuously maintained for 3 weeks. According to the condition of catheter, the dressing was changed in time in case of any problem,and the reason and time for the catheter nursing care were recorded. The duration of changing the catheter dressing in different disinfectant, incidence rate of dressings looseness and incidence of catheter-related infections in two groups were analyzed.Results:The duration of skin drying and duration of caring in the experimental group were (0.62±0.10)min, (11.67±0.33) min, significantly shorter than the control group [(1.97±0.18) min, (14.48±0.33) min]( t values were 63.044, 57.296, P<0.01).In term of the adverse effects on CVC,there were no statistical differences between two groups ( P> 0.05). Conclusions:Both 2% chlorhexidinegluconate and 0.5% iodophor disinfectant have similar disinfection effect on CVC caring, but 2% chlorhexidinegluconate disinfection is more efficient and worthy of application in clinical settings.

BACKGROUNDUrotensin II (UII), a potent vasoconstrictive peptide, is able to stimulate phenotypic differentiation of adventitial fibroblasts. This study aimed to determine the effect of UII on monocyte chemoattractant protein-1 (MCP-1) expression in rat aortic adventitial fibroblasts, so as to explore possible mechanisms in the development of vascular inflammation.

METHODSGrowth-arrested adventitial fibroblasts were incubated in serum-free medium with UII (10(-10)-10(-7) mol/L) and inhibitors of signal transduction pathways for 1 to 24 hours. MCP-1 mRNA and protein expression and secretion were determined by RT-PCR, Western blotting analysis and enzyme-linked immunosorbent assay (ELISA), respectively.

RESULTSUII dose- and time-dependently promoted MCP-1 mRNA and protein expression and secretion in cells, with maximal effect at 10(-8) mol/L at 3 hours for mRNA expression, 24 hours for protein expression in the cells, and 12 hours for protein secretion from the cells. Furthermore, the UII effects were significantly inhibited by treatment with its receptor antagonist SB710411, Rho kinase inhibitor Y27632, protein kinase C (PKC) inhibitor H7, mitogen-activated protein kinase inhibitor PD98059, calcineurin inhibitor cyclosporine A, and the Ca(2+)channel blocker nicardipine.

CONCLUSIONUII may stimulate MCP-1 expression in rat aortic adventitial fibroblasts through its receptor and Rho kinase, PKC, mitogen-activated protein kinase, calcineurin and Ca(2+) channel signal transduction, thus contributing to adventitial inflammation.

Adventitia ; cytology ; Animals ; Aorta ; cytology ; Cells, Cultured ; Chemokine CCL2 ; genetics ; metabolism ; Fibroblasts ; drug effects ; metabolism ; Male ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Urotensins ; pharmacology

【Objective】 To investigate the inhibitory effects of magnesium citrate (MgCit) on oxidative stress in chronic renal failure (CRF). 【Methods】 SD rats were divided into CRF model group, MgCit groups (375 and 750 mg/kg), normal control group, and MgCit control group (750 mg/kg). The morphology of mitochondria in thoracic artery vascular smooth muscle cells (VSMCs) was observed by transmission electron microscopy. The content of superoxide dismutase (SOD) and malonaldehyde (MDA) in rat aorta and plasma was detected by the kit. The VSMCs were divided into normal control group, CRF model group, and MgCit groups (1.5 and 3 mmol/L). The levels of superoxide anion (DHE) and apoptosis were quantitatively detected by flow cytometry. 【Results】 Compared with the control groups, the mitochondria were swollen and the cristae fractured or disappeared in the model group; MgCit intervention could reduce mitochondrial swelling, but not cristae fracture. In the model group, SOD level in aorta and plasma decreased (P<0.05) while MDA level increased (P<0.05). MgCit intervention could increase SOD in aorta and plasma, but decrease MDA level (P<0.05). In the CRF environment, the DHE content of VSMCs and apoptosis in CRF model group increased (P<0.05). MgCit intervention could decrease DHE content and inhibit apoptosis (P<0.05). 【Conclusion】 MgCit inhibits oxidative stress levels in vivo and in vitro in CRF.