AIM: To analyze and identify the phosphoproteins associated with diazoxide preconditioning. METHODS: Proteomics technique was used to investigate the changes of phosphoprotein after diazoxide preconditioning. Adult rat ventricular myocytes were pretreated in the presence and absence of 200 ?mol/L diazoxide for 10 min. Phosphoproteins prepared and enriched respectively from control and diazoxide pretreated groups were then separated by two-dimensional (2D) gel electrophoresis and stained with sliver staining kit. Phosphoproteins of interest were further identified by mass spectrometry. RESULTS: Associated with diazoxide preconditioning, the proteins of chaperonin containing TCP-1 and hypothetical protein XP_346548 were phosphorylated significantly. The proteins of 94 kD glucose-regulated protein, calpactin I heavy chain and ferritin were dephosphorylated markedly (P

Objective To investigate the factors influencing the implementation status of cardiac rehabilitation by cardiovascular nurses. Methods A self-designed questionnaire titled "Survey on Factors Influencing the Implementation of Cardiac Rehabilitation by Cardiovascular Nurses" was used to survey cardiovascular nurses from tertiary hospitals in Beijing, Anhui Province, and other regions through convenience sampling. Results A total of 655 questionnaires were distributed, with 548 valid responses, yielding an effective response rate of 83.66%. The main promoting factors for nurses in cardiology departments to implement cardiac rehabilitation were nurses' experience in guiding patients through cardiac rehabilitation, the establishment of dedicated cardiac rehabilitation centers in hospitals, and the inclusion score of cardiac rehabilitation in national medical insurance of (4.32±0.79) points; the main obstacles were patients' lack of understanding of cardiac rehabilitation [(3.03±1.04) points], the high turnover rate in the department [(4.21±0.79) points], and incomplete laws and regulations related to cardiac rehabilitation [(3.56±0.88) points]. Conclusion The implementation of cardiac rehabilitation by nurses in cardiology departments is related to factors such as the nurses, patients, hospitals, and policies. Clinical importance should be given to these factors, and corresponding measures should be taken to promote the implementation of cardiac rehabilitation.

Objective To investigate the current status of knowledge-attitude-practice of cardiac rehabilitation in patients undergoing coronary artery bypass grafting(CABG) and analyze its influencing factors. Methods From July to November 2022, 288 patients with CABG in the coronary heart disease surgery center of Beijing Anzhen Hospital Affiliated to Capital Medical University were conveniently included, and general information questionnaire and cardiac rehabilitation knowledge and practice questionnaire were used to investigate the general situation and the level of knowledge-attitude-practice of cardiac rehabilitation in patients with coronary heart disease. Results A total of 290 questionnaires were sent out in this study, and 288 were effectively collected, with an effective recovery rate of 99.31%. The total score of the questionnaire was (106.81±13.35), and the total score rate was 62.83%, including the knowledge questionnaire scoring (39.34±9.13), belief questionnaire scoring (32.86±3.39) and behavior questionnaire scoring (34.61±3.54). The scoring rates of knowledge, attitude and practice questionnaire were 46.28%, 82.15% and 76.91%, respectively. Multiple linearregression analysis showed that patients who lived in rural areas, had education background of primary school or below, were farmers, had public health insurance, and had no previous coronary intervention, had lower levels of knowledge-attitude-practice of cardiac rehabilitation (P < 0.05). Conclusion The knowledge-attitude-practice of cardiac rehabilitation, especially the level of knowledge, in patients with CABG is needed to be improved. The factors that affect the level of knowledge-attitude-practice of cardiac rehabilitation in this population are diversified, suggesting that individual cardiac rehabilitation guidance should be implemented according to different people and local conditions, and diversified cardiac rehabilitation models should be established to improve the long-term and compliance of cardiac rehabilitation.

Objective To investigate the relation between the balloon occlusion test ( BOT) and the anatomy of the circle of Willis ( CW) , and to explore the role of balloon occlusion test in the treatment of internal carotid artery permanent occlusion. Methods Selected the clinical data of 49 patients (52 sides) who had BOT in our hospital from October 2009 to June 2015,and analyzed the relationship be-tween the occurrence rate of anterior communicating artery ( AcoA) / posterior communicating artery ( PcoA) and the positive rate of BOT retrospectively. Results The occurrence rate of the AcoA was 97. 9%, and the occurrence rate of PcoA in one side was 82. 7%. Negative rate BOT accounted for 92. 3% and AcoA occurred in all, while the positive rate accounted for 7. 7%, including 2 cases of right superior ar-teria cerebri anterior combined with ipsilateral PcoAs absence, 1 case of left superior arteria cerebri anterior combined with ipsilateral PcoAs absence, and 1 case of AcoA and PcoAs absence. Conclusion Before the permanent occlusion of the internal carotid artery, it’ s necessary to clarify the redistribution of the compensatory way of blood flow in the AcoA-absent cases. Implementing permanent occlusion for cases with complete circle of Willis would cause less ischemic risk.

OBJECTIVETo investigate the bacterial epidemiology in our department in recent years, so as to provide assistance to the clinical management of burn patients.

METHODSA retrospective analysis was carried out with 345 bacterial cultures from burn wound and drug-sensitivity results in 784 burn patients during 1993 to 1999 in our department.

RESULTS(1) Among all the bacteria, gram negative (G(-)) bacilli accounted for 56.8%, while gram positive (G(+)) cocci and fungi in 3.8%. (2) Among all the G(+) cocci, 65.4% were Staphylococcus aureus, in which MRSA was identified in 53.9% during 1993 - 1999 and in 64.3% during 1998 - 1999. Pseudomonus aeruginosa accounted for 37.2% of all G(-) bacilli. (3) The 3rd generation of cephalosporins shew excellent anti-bacterial capabilities, but the bacterial resistance to them increased significantly. (4) MRSA was very sensitive to both vancomycin and norvancomycin with no report of antibiotic resistance to them.

CONCLUSIONG(-) bacilli were still predominant bacteria in our burn department when compared to G(+) cocci. The 3rd generation cephalosporins are the routine antibiotics for the present. But resistant bacteria are on the increase. There are also more and more MRSAs isolated from burn wounds. For this, vancomycin and norvancomycin should be preferably used.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; Burns ; microbiology ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Pseudomonas aeruginosa ; drug effects ; Retrospective Studies ; Staphylococcus aureus ; drug effects

Pancreaticoduodenectomy (PD) is an established surgical treatment for pancreatic and periampullary diseases. Abdominal drainage after PD has been routinely used for many years to early detect complications and to promote rapid recovery of patients. However, with the introduction of enhanced recovery after surgery, controversies exist on the safety and effectiveness of routine use of abdominal drainage after PD. This article reviewed the controversies on whether routine abdominal drainage are necessary after PD, how to place abdominal drains, and when to remove abdominal drains.

Objective:To evaluate the impact of lymph node dissection in radical surgery on the prognosis for patients with stage T2b gallbladder cancer.Methods:Forty-seven patients undergoing radical surgery for T2b gallbladder cancer at Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2009 to May 2020 were retrospectively analyzed, including 17 males and 30 females, aged 68(58, 72) years old. According to the extent of lymph node dissection, patients were divided into the regional lymph node dissection group ( n=28) and extended lymph node dissection group ( n=19). Clinical data including the level of carbohydrate antigen 19-9 (CA19-9), fashions of liver parenchymal resection, and postoperative complications were recorded. Survival follow-up was conducted through telephone or outpatient review. Survival analysis was conducted using Kaplan-Meier method and compared using the log-rank test. Cox regression analysis was used to identify the risk factors of overall survival. Results:Compared to regional lymph node dissection, the extended lymph node dissection group had a longer operative time [195(167, 220) min vs. 165(152, 175) min] and a greater number of lymph nodes dissected [12(9, 14) vs. 8(7, 9)] (both P<0.05). The postoperative complication rates of the two groups were 14.3%(4/28) and 21.1%(4/19), respectively ( P=0.697). The cumulative postoperative 1-, 3-, and 5-year survival rates were 96.4%, 59.4%, and 52.8% in regional lymph node dissection group, and 84.2%, 62.7%, and 43.0% in extended lymph node dissection group, respectively, with no significant difference ( P=0.643). Multivariate Cox regression analysis indicated that CA19-9>40 IU/ml ( HR=2.98, 95% CI: 1.24-7.18, P=0.014), wedge resection of the liver ( HR=4.01, 95% CI: 1.36-11.87, P=0.011), and positive lymph node ( HR=2.99, 95% CI: 1.22-7.34, P=0.016) were independent risk factors for poor prognosis in patients with stage T2b gallbladder cancer. Conclusion:Compared with regional lymphadenectomy, extended lymphadenectomy does not improve the overall survival of patients with stage T2b gallbladder cancer.

Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.

BACKGROUND: Gallbladder cancer (GBC) is the most common malignant tumor of biliary tract. Isoliquiritigenin (ISL) is a natural compound with chalcone structure extracted from the roots of licorice and other plants. Relevant studies have shown that ISL has a strong anti-tumor ability in various types of tumors. However, the research of ISL against GBC has not been reported, which needs to be further investigated. METHODS: The effects of ISL against GBC cells in vitro and in vivo were characterized by cytotoxicity test, RNA-sequencing, quantitative real-time polymerase chain reaction, reactive oxygen species (ROS) detection, lipid peroxidation detection, ferrous ion detection, glutathione disulphide/glutathione (GSSG/GSH) detection, lentivirus transfection, nude mice tumorigenesis experiment and immunohistochemistry. RESULTS: ISL significantly inhibited the proliferation of GBC cells in vitro . The results of transcriptome sequencing and bioinformatics analysis showed that ferroptosis was the main pathway of ISL inhibiting the proliferation of GBC, and HMOX1 and GPX4 were the key molecules of ISL-induced ferroptosis. Knockdown of HMOX1 or overexpression of GPX4 can reduce the sensitivity of GBC cells to ISL-induced ferroptosis and significantly restore the viability of GBC cells. Moreover, ISL significantly reversed the iron content, ROS level, lipid peroxidation level and GSSG/GSH ratio of GBC cells. Finally, ISL significantly inhibited the growth of GBC in vivo and regulated the ferroptosis of GBC by mediating HMOX1 and GPX4 . CONCLUSION ISL induced ferroptosis in GBC mainly by activating p62-Keap1-Nrf2-HMOX1 signaling pathway and down-regulating GPX4 in vitro and in vivo . This evidence may provide a new direction for the treatment of GBC.
Animals ; Mice ; Carcinoma in Situ ; Chalcones/pharmacology* ; Ferroptosis ; Gallbladder Neoplasms/genetics* ; Glutathione Disulfide ; Kelch-Like ECH-Associated Protein 1 ; Mice, Nude ; NF-E2-Related Factor 2/genetics* ; Reactive Oxygen Species ; Humans