Objective:To systematically review the risk factors of delayed healing of venous leg ulcer (VLU) so as to provide a guide for developing the personalized nursing strategies.Methods:The Cochrane Library, PubMed, Web of Science, ScienceDirect, Clinicaltrials.gov, ProQuest and Open Grey was retrieved with the English keywords of "varicose ulcer/venous ulcer, non-healing/delayed healing/poor healing, factor/risk factor/influence factor"; the China Biological Medicine (CBM) , Chinese National Knowledge Infrastructure (CNKI) , WanFang Data and VIP was retrieved with the English keywords of "venous leg ulcer/venous ulcer, delayed healing/refractory, risk factors/influencing factors"; the retrieval time ranged from building database to 1st April 2019. Two researchers independently screened literatures, extracted data and assessed the quality of included literatures. The RevMan 5.3 was used to the meta-analysis.Results:Finally, a total of 11 literatures were included and involved 3 894 subjects, 520 cases lost to follow up, 914 cases in case group and 2 460 in control group. Meta-analysis showed that there were 7 risk factors related to delayed healing of VLU including the ages [ OR=1.02, 95% CI (1.01, 1.03) , P<0.01], range of motion of ankle [ OR=4.77, 95% CI (1.79, 12.73) , P<0.01], size of ulcer [ OR=1.27, 95% CI (1.10, 1.47) , P<0.01], duration of ulcer [ OR=1.08, 95% CI (1.01, 1.16) , P=0.03], history of deep vein thrombosis (DVT) [ OR=2.21, 95% CI (1.06, 4.63) , P=0.03], ankle-brachial index<0.8 [ OR=8.71, 95% CI (4.22, 17.99) , P<0.01]and rheumatoid arthritis [ OR=1.37, 95% CI (1.08, 1.73) , P<0.01]with statistical differences, and factors irrelevant to delayed healing of VLU including the body mass index (BMI) [ OR=0.98, 95% CI (0.83, 1.16) , P=0.82], >50% wound covered with fibrin [ OR=1.88, 95% CI (0.99, 3.57) , P=0.06], diabetes mellitus [ OR=1.10, 95% CI (0.70, 1.75) , P=0.67], history of hip or knee replacement [ OR=1.73, 95% CI (0.50, 6.00) , P=0.39]. Conclusions:Evidence shows that the independent risk factors of delayed healing of VLU include the ages, range of motion of ankle, size of ulcer, duration of ulcer, history of DVT, ankle-brachial index<0.8 and rheumatoid arthritis. Those evidences can help to identify the clinical high-risk population of delayed healing of VLU and provide targeted nursing intervention to reduce the healing time of VLU and improve patients' quality of life.

Objective:To analyze the hepatic hemodynamics changes after partial splenic embolization in patients with cirrhosis and hypersplenism.Methods:A total of 26 patients with cirrhosis and hypersplenism who underwent partial splenic embolization in the General Hospital of Ningxia Medical University from April 2018 to June 2019 were included in this study. The clinical data was retrospectively studied. The study objects consisted of 19 males and 7 females with an average of 55 years. Whole-liver perfusion enhanced CT imaging scan was performed for all patients. Changes in laboratory indexes and the blood perfusion of the liver sections including hepatic arterial perfusion, portal venous perfusion, total liver perfusion and hepatic arterial perfusion indexes before PSE and postoperative 1 month were compared.Results:The postoperative leukocyte and platelet counts increased, and the prothrombin time decreased in the 26 patient, and the differences were significant ( P<0.05). The hepatic arterial perfusion of the left lateral section, left medial section, right anterior section and right posterior section increased in postoperative 1 month, from 10.0 (7.0, 13.5) ml·min -1·(100 ml) -1, 9.3 (5.4, 12.8) ml·min -1·(100 ml) -1, 8.0 (6.0, 11.2) ml·min -1·(100 ml) -1, 10.7 (7.1, 13.8) ml·min -1·(100 ml) -1 to 7.7 (4.2, 11.0) ml·min -1·(100 ml) -1, 6.9 (2.6, 10.2) ml·min -1·(100 ml) -1, 7.1 (4.1, 8.7) ml·min -1·(100 ml) -1, 5.9 (4.4, 8.5) ml·min -1·(100 ml) -1, respectively. The differences were all significantly different ( P<0.05). There were no significant difference in portal venous perfusion and total liver perfusion before and after operation ( P>0.05). The hepatic arterial perfusion index of left lateral section, right anterior section and right posterior section increased after operation ( P<0.05). Conclusion:For patients with cirrhosis and hypersplenism who underwent partial splenic embolization, the state of hypersplenism was relieved, the hepatic arterial blood flow increased, and the liver function improved.

Objective:To explore the effect of improved skin cleaning method combined with Incontinence-Associated Dermatitis Intervention Tool (IADIT) in the treatment of incontinence-associated dermatitis in critically ill patients.Methods:By convenience sampling, we selected the patients in Peking University Third Hospital as subjects. A total of 92 critically ill patients with fecal incontinence from March 2017 to February 2018 were set as the control group while 63 critically ill patients with fecal incontinence from March 2018 to February 2019 were set as the experimental group. Patients in the control group received routine care, and those in the experimental group received IADIT care. The incidence, curative effects and healing time of incontinence-associated dermatitis were compared between the two groups.Results:After the intervention, the incidence of incontinence-associated dermatitis in the experimental group was 30.16% (19/63) , which was lower than 44.57% (41/92) in the control group, and the difference between the two groups was statistically significant ( P<0.05) . The effective rate of incontinence-associated dermatitis in the experimental group was 94.74% (18/19) , which was higher than 65.86% (27/41) in the control group, and the difference between the two groups was statistically significant ( P<0.05) . The healing time of incontinence-associated dermatitis in the experimental group was (6.33±3.14) d, which was lower than (11.55±3.41) d in the control group, and the difference between the two groups was statistically significant ( P<0.01) . Conclusions:Compared with traditional empirical nursing methods, targeted interventions based on IADIT for critically ill patients with fecal incontinence can effectively reduce the incidence of incontinence-associated dermatitis, improve the cure rate of incontinence-associated dermatitis and shorten the healing time.

Studies on coat protein I (COPI) have contributed to a basic understanding of how coat proteins generate vesicles to initiate intracellular transport. The core component of the COPI complex is coatomer, which is a multimeric complex that needs to be recruited from the cytosol to membrane in order to function in membrane bending and cargo sorting. Previous structural studies on the clathrin adaptors have found that membrane recruitment induces a large conformational change in promoting their role in cargo sorting. Here, pursuing negative-stain electron microscopy coupled with single-particle analyses, and also performing CXMS (chemical cross-linking coupled with mass spectrometry) for validation, we have reconstructed the structure of coatomer in its soluble form. When compared to the previously elucidated structure of coatomer in its membrane-bound form we do not observe a large conformational change. Thus, the result uncovers a key difference between how COPI versus clathrin coats are regulated by membrane recruitment.
ADP-Ribosylation Factor 1 ; chemistry ; metabolism ; Animals ; Coatomer Protein ; chemistry ; metabolism ; Cytosol ; chemistry ; metabolism ; GTPase-Activating Proteins ; chemistry ; metabolism ; Humans ; Membranes, Artificial ; Rats

Metabolic reprogramming is a hallmark of cancer, including lung cancer. However, the exact underlying mechanism and therapeutic potential are largely unknown. Here we report that protein arginine methyltransferase 6 (PRMT6) is highly expressed in lung cancer and is required for cell metabolism, tumorigenicity, and cisplatin response of lung cancer. PRMT6 regulated the oxidative pentose phosphate pathway (PPP) flux and glycolysis pathway in human lung cancer by increasing the activity of 6-phospho-gluconate dehydrogenase (6PGD) and α-enolase (ENO1). Furthermore, PRMT6 methylated R324 of 6PGD to enhancing its activity; while methylation at R9 and R372 of ENO1 promotes formation of active ENO1 dimers and 2-phosphoglycerate (2-PG) binding to ENO1, respectively. Lastly, targeting PRMT6 blocked the oxidative PPP flux, glycolysis pathway, and tumor growth, as well as enhanced the anti-tumor effects of cisplatin in lung cancer. Together, this study demonstrates that PRMT6 acts as a post-translational modification (PTM) regulator of glucose metabolism, which leads to the pathogenesis of lung cancer. It was proven that the PRMT6-6PGD/ENO1 regulatory axis is an important determinant of carcinogenesis and may become a promising cancer therapeutic strategy.