Objective To investigate the expression levels of serum tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein β(14-3-3β)and clara's cell secretory protein 16(CC16)in patients with chronic obstructive pulmonary disease(COPD)complicated by respiratory failure,and their relationship with prognosis.Methods A total of 232 patients with COPD complicated with respiratory failure admitted to Yantian Hospital of Southern University of Science and Technology from April 2020 to October 2023 were enrolled in the COPD complicated with respiratory failure group.According to the severity of the disease,they were divided into mild group(n=67),moderate group(n=73)and severe group(n=92).According to the 28-day prognosis,they were divided into death group(n=73)and survival group(n=159).In addition,80 patients with simple COPD(COPD group)and 80 healthy subjects(control group)were selected at the same time.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression of serum 14-3-3β and CC16.Multivariate Logistic regression analysis was used to analyze the factors of death in patients with COPD complicated with respiratory failure.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum 14-3-3β and CC16 expression on the death of patients with COPD complicated with respiratory failure.Results The expression of serum 14-3-3β in COPD complicated with respiratory failure group was higher than that in COPD group and control group(U=3.894,11.417),the expression of CC16 was lower than that in COPD group and control group(t=5.845,14.306),and the differences were statistically significant(all P<0.05),respectively.The expression of serum 14-3-3β in severe group was higher than that in moderate group and mild group(U=5.179,8.234),the expression of CC16 was lower than that of moderate group and mild group(t=4.090,9.281),and the differences were statistically significant(all P<0.05),respectively.The 28-day mortality rate of 232 COPD patients with respiratory failure was 31.47%(73/232).The expression of serum 14-3-3β in the death group was higher than that in the survival group,and the expression of CC16 was lower than that in the survival group,the differences were statistically significant(U/t=6.790,8.265,all P<0.05).The age of the death group was older than that of the survival group,the degree of airflow limitation and the number of acute exacerbations within 1 year were higher than those of the survival group,and the differences were statistically significant(t/χ2/U=3.895,7.202,3.360,all P<0.05).Age,severe airflow limitation,extremely severe airflow limitation,and the number of acute exacerbations within 1 year,elevated 14-3-3β were independent risk factors for death in patients with COPD complicated with respiratory failure(Wald χ2=3.914～22.668,all P<0.05),and elevated CC16 was an independent protective factor(Wald χ2=23.675,P<0.05).The area under the curve(AUC)of serum 14-3-3β combined and CC16 expression in predicting the death of patients with COPD complicated with respiratory failure which was greater than that of serum 14-3-3β and CC16 expression alone,the differences were statistically significant(Z=3.995,3.813,all P<0.01).Conclusion The increase of serum 14-3-3β expression and the decrease of CC16 expression in patients with COPD complicated by respiratory failure are closely related to the aggravation of the disease and poor prognosis.The combination of serum 14-3-3β and CC16 expression is of high value in predicting the death of patients with COPD complicated with respiratory failure.

BACKGROUND: The benefits of ideal cardiovascular-health metrics (ICVHMs) in patients with renal insufficiency remain unclear. This study aimed to investigate the associations between ICVHM and prognosis in a renal insufficiency population. METHODS: The trial enrolled 29,682 participants from the US National Health and Nutrition Examination Survey (NHANES), 2007-2018, with mortality follow-up through December 31, 2019. Participants were divided into three groups based on estimated glomerular filtration rates. Cardiovascular health was assessed using new "Life's Essential 8" metrics. Cox regression analyses based on NHANES data were used to determine the associations between ICVHMs and cardiovascular mortality in patients with renal insufficiency. RESULTS: During a mean follow-up of 6.58 years, ideal cardiovascular health (hazard ratio [HR] = 0.42; 95% confidence interval [CI]; 0.25-0.70) and ideal health behavior (HR = 0.53; 95% CI; 0.39-0.73) reduced cardiovascular mortality in participants with renal insufficiency. For each one ICVHM increment, a 25% reduction in cardiovascular mortality was recorded (95% CI; 0.69-0.82). When compared with participants with normal renal function, for those with mild renal insufficiency, the HR for cardiovascular mortality gradually decreased from 1.47 (95% CI; 0.85-2.52) in those who had ≤1 ICVHMs to 0.30 (95% CI; 0.12-0.77) in participants who had >6 ICVHMs. CONCLUSIONS From an ICVHM perspective, enhanced cardiovascular benefits were observed in individuals with renal insufficiency, coupled with a reduced risk of all-cause mortality. Furthermore, when compared with individuals with normal renal function, increased ICVHMs can mitigate adverse risks associated with renal impairment.
Humans ; Male ; Female ; Nutrition Surveys ; Middle Aged ; Renal Insufficiency/physiopathology* ; Aged ; Prognosis ; Adult ; Cardiovascular Diseases/mortality* ; Glomerular Filtration Rate/physiology* ; Proportional Hazards Models

Objective To investigate the expression levels of serum tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein β(14-3-3β)and clara's cell secretory protein 16(CC16)in patients with chronic obstructive pulmonary disease(COPD)complicated by respiratory failure,and their relationship with prognosis.Methods A total of 232 patients with COPD complicated with respiratory failure admitted to Yantian Hospital of Southern University of Science and Technology from April 2020 to October 2023 were enrolled in the COPD complicated with respiratory failure group.According to the severity of the disease,they were divided into mild group(n=67),moderate group(n=73)and severe group(n=92).According to the 28-day prognosis,they were divided into death group(n=73)and survival group(n=159).In addition,80 patients with simple COPD(COPD group)and 80 healthy subjects(control group)were selected at the same time.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression of serum 14-3-3β and CC16.Multivariate Logistic regression analysis was used to analyze the factors of death in patients with COPD complicated with respiratory failure.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum 14-3-3β and CC16 expression on the death of patients with COPD complicated with respiratory failure.Results The expression of serum 14-3-3β in COPD complicated with respiratory failure group was higher than that in COPD group and control group(U=3.894,11.417),the expression of CC16 was lower than that in COPD group and control group(t=5.845,14.306),and the differences were statistically significant(all P<0.05),respectively.The expression of serum 14-3-3β in severe group was higher than that in moderate group and mild group(U=5.179,8.234),the expression of CC16 was lower than that of moderate group and mild group(t=4.090,9.281),and the differences were statistically significant(all P<0.05),respectively.The 28-day mortality rate of 232 COPD patients with respiratory failure was 31.47%(73/232).The expression of serum 14-3-3β in the death group was higher than that in the survival group,and the expression of CC16 was lower than that in the survival group,the differences were statistically significant(U/t=6.790,8.265,all P<0.05).The age of the death group was older than that of the survival group,the degree of airflow limitation and the number of acute exacerbations within 1 year were higher than those of the survival group,and the differences were statistically significant(t/χ2/U=3.895,7.202,3.360,all P<0.05).Age,severe airflow limitation,extremely severe airflow limitation,and the number of acute exacerbations within 1 year,elevated 14-3-3β were independent risk factors for death in patients with COPD complicated with respiratory failure(Wald χ2=3.914～22.668,all P<0.05),and elevated CC16 was an independent protective factor(Wald χ2=23.675,P<0.05).The area under the curve(AUC)of serum 14-3-3β combined and CC16 expression in predicting the death of patients with COPD complicated with respiratory failure which was greater than that of serum 14-3-3β and CC16 expression alone,the differences were statistically significant(Z=3.995,3.813,all P<0.01).Conclusion The increase of serum 14-3-3β expression and the decrease of CC16 expression in patients with COPD complicated by respiratory failure are closely related to the aggravation of the disease and poor prognosis.The combination of serum 14-3-3β and CC16 expression is of high value in predicting the death of patients with COPD complicated with respiratory failure.

Background:In the pathogenesis of chronic gastritis,the changes of biological factors can affect the physiological barrier of gastric mucosa,increase the risk of injury of intercellular junctions,leading to disruption of mucosal barrier. Aims:To investigate the expressions of occludin and zonula occluden-1 (ZO-1)in chronic gastritis and their significance. Methods:A total of 82 patients with chronic gastritis from October 2014 to October 2017 at the First People's Hospital of Xiaochang were enrolled and divided into chronic non-atrophic gastritis (CNAG)group and chronic atrophic gastritis (CAG)group according to the endoscopic biopsy pathology. Forty healthy subjects were served as normal controls. Expressions of occludin and ZO-1 were examined by immunohistochemistry. Patients positive for Helicobacter pylori (Hp) infection received eradication therapy,and expressions of occludin and ZO-1 were reexamined after Hp eradication. Results:The positivity rates of occludin and ZO-1 proteins in CNAG and CAG groups were significantly lower than those in normal control group (P＜0.05). The positivity rates of occludin and ZO-1 proteins in CNAG group were significantly higher than those in CAG group (P＜0.05). The positivity rates of occludin and ZO-1 proteins in Hp-positive CNAG patients were significantly lower than those in Hp-negative CNAG patients (P＜0.05). The positivity rate of ZO-1 protein in Hp-positive CAG patients was significantly lower than that in Hp-negative CAG patients (P＜0.05). Expressions of occludin and ZO-1 proteins showed a linear trend correlation with activity of gastric inflammation (P ＜0.05);their expressions decreased significantly with the increase in activity of inflammation. The positivity rates of occludin and ZO-1 proteins in CNAG patients increased significantly after Hp eradication (P＜0.05). Conclusions:Expressions of occludin and ZO-1 are decreased in chronic gastritis,especially in CAG,and are correlated with Hp infection and activity of gastric inflammation.

To explore the influences of the sterile injectors with different sources while the same capacity on the infusion precision of the syringe pump. With six injects with two brands were selected as the subjects and an electronic pump for measuring, flow test was carried out with the brands marked on the pump or not. There was significant difference between the flows from the syringe pumps marked with the injector brands and those without the mark of the brands. The sterile injector has to be set before using the syringe pump.

Objective To investigate the effects of bone marrow stromal cell (BMSC) transplantation on axonal and glial scarring after spinal cord injury (SCI).Methods Thirty New Zealand white rabbits were randomly assigned to a sham operation group (group A),a saline treatment group (group B) or a BMSC treatment group (group C).Group A served as controls,in which the canal was opened without damage to the spinal cord.In groups C and B SCI models were established with aneurysm clips and the rabbits of groups C and B were then given injections of BMSCs and saline solution respectively via the intra-intercostal artery at 1 week post injury.At 1 day,1 week,2 weeks and 4 weeks post injury,Basso Beattie-Bresnahan (BBB) scores were assessed to evaluate the recovery of locomotor function in the hind limbs.Spinal cord samples were harvested for HE and Nissl staining,and immunohistochemistry and image analysis were used to detect any changes in neurofilament (NF200) and glial fibrillary acidic protein (GFAP) in the injured spinal cords.Results The average BBB scores of group A were significantly higher those that of groups B and C at each time point,and those of group C were significantly better than those of group B at the 2nd and 4th week post injury.At the 4th week post injury,HE staining showed there was no glial scarring or cavities in group A,but that there was glial cellular proliferation,glial scarring and cavity formation at the injury site in groups B and C.In group C all were obviously less than in group B.Nissl staining indicated there were more typical neurons in group A,while there were a larger number of ruptured neurons,more degradation,and irregular remaining neurons in groups B and C.These abnormalities were again significantly more prevalent in group C.Immunohistochemical examination showed significant increases in NF200 positive neurons and GFAP in groups B and C compared with group A.The number of NF200 positive neurons was significantly higher in group C than in group B,but the GFAP positive area was significantly smaller in group C than in group B.Conclusion BMSC transplantation via the intercostal arteries can effectively improve axonal regeneration,attenuate glial cellular proliferation and reduce glial scar formation,promoting functional recovery after SCI,at least in rabbits.

Objective To summarize and explore the clinical value of selective partial neurotomy of muscular branch of triceps in the treatment of spastic talipes equines.Methods Forty-two cases were included in our study from Aug.2000 to Des.2007,all these cases accepted the operation of selective partial neurotomy muscular branch of triceps.In this study,29 cases were male,13 cases were female.Muscle force of legs,muscular tension,pathologic reflex,gesture and function of legs after operation were compared with that of before operation.Results The mean fallow-up was 18 months.During the fallow-up of this study,muscular tension degraded,the function of ankle joints and the gesture of extremitas inferior were improved obviously.The effective power was about 90% after 12 months follow-up.Conclusions Selective partial neurotomy of muscular branch of triceps is a effective method for the treatment of spastic talipes equines.The operation procedure is simple and effective,and could be generalized in the primary level hospital.

Objective To investigate and analyze whether the different types of radial head fracture and internal fixations have influence on the out comeof elbow function after surgery. Methods We reviewed the clinical data of 46 cases of radial head fractures from August 2002 to December 2008, 34 males, and 12 females, aged from 19 to 51years. All these cases underwent open reduction and internal fixation including fixation with Kirschner wire fixation, mini-plate and/or screw fixation and radial head resection. Results Forty-six cases were followed up in this study for a period of 8 months to 4 years (mean 2 yeats and 4 months).According to Mayo assessment of elbow function, the results of 35 cases were excellent or good (35/46 cases, 76.1%). Better function recovery was got in those who were preferred mini-screw internal fixation or combined with mini-plate. The same results were also found in those with Mason type Ⅱ fracture and in those underwent surgery within 2 weeks. Conclusions Good results can be got through surgical treatment as the indication of open reduction is clear, especially in cases with radial head fracture of Mason type Ⅱ and Ⅲ.The type of radial head fracture, the method of internal fixation and the timing of surgery all affect the outcome.

BACKGROUND: Several studies have demonstrated that bone marrow mcscnchymal stem cells (MSCs) can differentiate into osteoblasts after induction of bone morphogenetic protein (BMP).OBJECTIVE: This study was designed to compare the osteogenetic effects between MSCs, bBMP, and fibrin gel alone and their composite.DESIGN: A controlled observation experiment.SETTING: Second People's Hospital of Guangdong Province and Second Hospital Affiliated to Sun Yat-sen University.MATERIALS: This study was performed at the Second Hospital Affiliated to Sun Yat-sen University between January 2004 and June 2006. Healthy New Zealand rabbits were provided by the Laboratory Animal Center, Sun Yat-sen University.METHODS: Bone marrow was taken from the lilac bone. By density gradient centrifugation, autologous MSCs were in vitro cultured and amplified. A composite was made of fibrin gel and bovine bone morphogenetic protein (bBMP). After adding MSCs, another composite was made. Twelve rabbits underwent lumbar L3/4, LA/5, and LS/6 discectomy and interbody fusion via an anterior retroperitoneal approach. Three fusion sites in each animal were randomly assigned into three of four treatments: composite of MSCs and hBMP and fibrin gel (group A), composite of MSCs and fibrin gel (group B), composite of bBMP and fibrin gel (group C) and fibrin gel alone (group D). The interbodies were observed radiologically and histologically 3 months after surgery.MAIN OUTCOME MEASURES: Bone formation in the spinal interveRebral space of rabbits.RESULTS: Twelve weeks after surgery, bone formation was appasenfly greater in the Group A than in the other groups.Histological findings revealed continuous bone formation. The groups B and C showed equivalent radiological and histological changes. Bone formation was intermittent. Group D had fibrous union, but no bone formation. No residual fibrin gel was found in all groups, but a small amount of residual nucleus gelatinosus with a little cartilaginous tissue was visible in the intervertebral disc.X-ray examination results did not reveal vertebral posterior hyperplasia or spinal stenosis. There was significant difference in range of lumbar motion between the group B and the groups C and D (P ＜ 0.05). No pronounced difference in vertebral posterior height loss existed among the groups.CONCLUSION: The composite of MSCs, fibrin gel and bBMP can promote bone regeneration and achieve osseous spinal fusion.

[Objective]To discuss the indication and attentive affairs among single and combined surgical treatments for spastic cerebral palsy by analyzing the therapeutic efficacy of different operations,such as lengthening tendon,osteotomy and neurectomy,etc.[Method]Six hundred and forty-two patients(aged 10 months to 37 years)were treated with combined operations of different operations,including traditional operations on soft tissue release,osteotomy,selective posterior rhizotomy,selective rhizotomy and converse anastomosis,neurectomy,etc.The follow-up period ranged from 6 months to 4 years(mean 18 months).[Result]The traditional soft tissue release and lengthening was still the major surgical treatment to cerebral palsy.It resulted on rectifying fixed contracure and deformity,although could not decrease muscular tension.The decisive processes lied on neurectomy.Though the selective posterior rhizotomy and selective peripheral neurectomy reduced muscular strength partially in the early stage,the muscular tension was also reduced,therefore the range of motion of joints was enlarged and the functions of extremities were strengthened.[Conclusion]Classifying the types of cerebral palsy carefully,mastering the indications of all sorts of surgical treatment strictly,realizing the latent complications of different operations,combining different processes of surgical treatment can enhance therapeutic efficacy,reduce recurrence of convulsion and malformed,as well as avoiding serious complications during therapy.In addition,postoperative exercise is also the basic treatment to spastic cerebral palsy.