Objective To construct a pelvic floor muscle training program for patients undergoing radical prostatectomy,and to provide a reference for clinical practice.Methods The evidence related to pelvic floor muscle training in patients undergoing radical prostatectomy was systematically searched and the quality was evaluated.The draft of pelvic floor muscle training program for patients undergoing radical prostatectomy was constructed based on the KAP theory and it was demonstrated and revised by expert meetings.From February to March 2023,Delphi method was used to determine the final scheme.37 patients were selected as the control group and 38 patients as the experimental group to implement the scheme and evaluate the application effect.Results 2 rounds of Delphi consultations were conducted among 17 experts,and the recovery rate of the questionnaire was 100％.The expert authority coefficient was 0.89.The Kendall harmony coefficients of the importance and feasibility of the second round of consultation were 0.270 and 0.209(P＜0.001).The coefficient of variation of importance and feasibility of items were 0～0.18 and 0～0.20.The final program included 3 first-level items,8 second-level items and 29 third-level items.1 month after surgery,there was no significant difference in urinary incontinence score(P=0.242)and there was significant difference in pelvic floor muscle training compliance(P=0.011)between 2 groups.Conclusion The program was applied preliminary in clinical practice and it was confirmed with scientific and practical meaning,so it can provide a reference for clinical nursing.

Background: Ferroptosis, which is caused by an iron-dependent accumulation of lipid hydroperoxides, is a type of cell death linked to diabetic kidney disease (DKD). Previous research has shown that fatty acid binding protein 4 (FABP4) is involved in the regulation of ferroptosis in diabetic retinopathy. The present study was constructed to explore the role of FABP4 in the regulation of ferroptosis in DKD. Methods: We first detected the expression of FABP4 and proteins related to ferroptosis in renal biopsies of patients with DKD. Then, we used a FABP4 inhibitor and small interfering RNA to investigate the role of FABP4 in ferroptosis induced by high glucose in human renal proximal tubular epithelial (HG-HK2) cells. Results: In kidney biopsies of DKD patients, the expression of FABP4 was elevated, whereas carnitine palmitoyltransferase-1A (CP-T1A), glutathione peroxidase 4, ferritin heavy chain, and ferritin light chain showed reduced expression. In HG-HK2 cells, the induction of ferroptosis was accompanied by an increase in FABP4. Inhibition of FABP4 in HG-HK2 cells changed the redox state, sup-pressing the production of reactive oxygen species, ferrous iron (Fe2+), and malondialdehyde, increasing superoxide dismutase, and reversing ferroptosis-associated mitochondrial damage. The inhibition of FABP4 also increased the expression of CPT1A, reversed lipid deposition, and restored impaired fatty acid β-oxidation. In addition, the inhibition of CPT1A could induce ferroptosis in HK2 cells. Conclusion Our results suggest that FABP4 mediates ferroptosis in HG-HK2 cells by inhibiting fatty acid β-oxidation.

Objective:To study the clinical manifestations, pathologic features, diagnosis and differential diagnosis, treatment and prognosis of lymphoplasmacytic lymphoma/Waldenstr?m′s macroglobulinemia (LPL/WM).Methods:Twenty-seven cases of LPL from January 2016 to December 2020 at Guangdong Provincial People′s Hospital were collected. The clinical data, histomorphology, immunophenotype, MYD88 L265P mutation, treatment and prognosis were analyzed retrospectively.Results:There were 19 males and 8 female patients, with median age of 63 years. The most common initial symptoms were fatigue related to anemia. Bone marrow was involved in all cases, lymphadenopathy was seen in 11 cases and splenomegaly in 10 cases. Monoclonal IgM type protein was detected in 25 cases, meeting the diagnostic criteria of WM. Microscopically, bone marrow and lymph nodes were infiltrated by small lymphocytes, plasmacytoid lymphocytes or plasma cells. The cells expressed pan B-cell markers and showed immunoglobulin light chain restriction. There was no expression of CD5, and low expression of CD23 and CD10; Ki-67 index was usually low. The positive rate of MYD88 L265P mutation was 73.9% (17/23). Most of the patients were treated with rituximab combined with alkylating agents, nucleoside analogues or immunomodulators, and the few patients with relapse or progression were treated with Ibutinib. During the 3-168 months′ follow-up period, recurrence or progression were seen in nine cases. Thrombocytopenia, elevated β2-microglobulin and high-risk group were associated with recurrence or progression of the disease ( P<0.05). The overall survival (OS) and progression-free survival (PFS) of the high-risk patients were significantly lower than those of the low-medium risk patients ( P<0.05). Conclusions:LPL/WM is an exclusive diagnosis; the detection of MYD88 L265P mutation has high diagnostic value, but it is not specific. These cases should be assessed comprehensively for their clinical manifestation, serum IgM protein level and immunophenotype. The overall prognosis of LPL/WM is good, but there are still a small number of high-risk patients with rapid progress, and so the symptomatic patients should be diagnosed accurately and treated in a timely manner.

Objective: To investigate the effect of intensive insulin therapy on the immune function and prognosis of severe thoracic injuries patients with stress hyperglycemia. Methods: A retrospective case control study was performed to analyze the clinical data of 60 patients with severe chest trauma and stress-induced hyperglycemia admitted to Chongqing People's Hospital from October 2016 to October 2018. There were 31 males and 26 females, aged 25-61 years [(46.1±4.0)years]. The abbreviated injury scale (AIS) range was 3-5 points. Thirty patients received routine insulin therapy (routine treatment group) and thirty patients received intensive insulin therapy (intensive treatment group). Venous blood was collected from two groups of patients before treatment, 1 day, 3 days, 5 days and 7 days after treatment respectively. Level of inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP)], and lymphocyte count (CD₁₄^＋, CD₄^＋ and CD₄^＋/CD₈^＋) were detected respectively. The incidence of nosocomial infection, length of hospital stay, mortality and incidence of hypoglycemia were compared between the two groups. Results: There were no significant differences in plasma TNF-α, IL-6 and CRP levels between the two groups before treatment (P>0.05). After treatment (1-7 days), the levels of serum TNF-α, IL-6 and CRP in the intensive treatment group were lower than those of routine treatment group (P<0.05 or 0.01). Compared with these before treatment, the levels of TNF-α, IL-6 and CRP in both groups increased to varied degrees, reaching a peak on day 3, followed by a gradual decline (P<0.05 or 0.01). There were no statistically significant differences in CD₁₄^＋, CD₄^＋、CD₄^＋/CD₈^＋ lymphocyte counts between the two groups before treatment (P>0.05). On days 3, 5, and 7 after treatment, the counts of CD₁₄^＋ lymphocytes [3 d: (0.61±0.08)×10⁹ vs. (0.55±0.09)×10^9, 5 d: (0.68±0.05)×10⁹ vs. (0.63±0.05)×10^9, 7 d: (0.77±0.07)×10⁹ vs. (0.71±0.06)×10⁹], CD₄^＋ lymphocytes [3 d: (0.29±0.04)×10⁹ vs. (0.25±0.03)×10^9, 5 d: (0.32±0.04)×10⁹ vs. (0.30±0.05)×10^9, 7 d: (0.34±0.03)×10⁹ vs. (0.32±0.06)×10⁹], CD₄^＋/CD₈^＋ lymphocytes [3 d: (0.28±0.04)×10⁹ vs. (0.26±0.06)×10^9, 5 d: (0.33±0.03)×10⁹ vs. (0.31±0.06)×10^9, 7 d: (0.35±0.03)×10⁹ vs. (0.32±0.06)×10⁹] in the intensive treatment group were higher than those in the routine treatment group. Compared with before treatment, the counts of CD14⁺ , CD4⁺ , CD4⁺ /CD8⁺ lymphocytes in the two groups were raised to different degrees after treatment for 3 days, with significant differences (P<0.05 or 0.01). Compared with routine treatment group, patients in intensive treatment group had lower incidence of nosocomial infection [57%(17/30) vs. 30%(9/30)], shorter duration of mechanical ventilation [(12.8±2.4)vs. (7.4±1.2)days], and lower hospital mortality rate [27%(8/30) vs. 10%(3/30)]. There was no significant difference in the incidence of hypoglycemia between the two groups(P>0.05). Conclusion For severe chest trauma patients with stress hyperglycemia, intensive insulin therapy can effectively improve the immunity, inhibit the inflammatory reaction, reduce the complication incidence, restore ventilation function and improve survival rate.

Objective: To retrospectively analyze the distribution of non-fermentative bacteria causing bloodstream infection in hospitalized patients in Sichuan Province and their drug susceptibility to common antibiotics for better understanding their epidemiological characteristics. Methods: From January 1, 2015 to December 31, 2017, all of the non-fermentative bacteria isolated from patients with bloodstream infection in nine hospitals in Sichuan Province were collected. Species distribution and drug resistance test results were retrospectively analyzed. Results: A total of 6 291 strains of pathogenic bacteria were isolated, including 3 674 strains of gram-negative bacteria (58.4%) and 2 617 strains of gram-positive bacteria (41.6%). The gram-positive bacteria were 1 895 strains of Staphylococcus (30.1%), 372 strains of Streptococcus (5.9%), 317 strains of Enterococcus (5.1%) and 33 strains of other gram-positive bacteria (0.5%). The gram-negative bacteria were 3 191 Enterobacteriaceae strains (50.7%), 389 non-fermentative strains (6.2%) and 94 other gram-negative strains (1.5%). The isolated non-fermentative bacteria were mainly Pseudomonas aeruginosa (136 strains, 35.0%), Acinetobacter baumannii (126 strains, 32.0%) and Stenotrophomonas maltophilia (33 strains, 8.5%). There were 167 (42.9%), 112 (28.8%) and 82 (21.1%) non-fermentative bacteria isolated in internal medicine departments, ICUs and surgery departments, respectively. The drug resistance rates of Pseudomonas aeruginosa to cefepime, ciprofloxacin and gentamicin were 16.5%, 10.7% and 9.9%, respectively. Carbapenems-resistant Pseudomonas aeruginosa (CR-PA) accounted for 13.6%. No polymyxin-resistant Pseudomonas aeruginosa was found. The resistance rates of Acinetobacter baumannii to all antibiotics were over 30% except for minocycline and polymyxin and 75.7% of carbapenem-resistant Acinetobacter baumannii (CR-AB) were isolated. The drug resistance rates to levofloxacin, trimethoprim/sulfamethoxazole and ceftazidime were 0%, 0% and 37.0% in Stenotrophomonas maltophilia isolates and 10.5%, 4.2% and 19% in Burkholderia cepacia isolates, respectively. Conclusions Non-fermentative bacteria causing 6.2% of bloodstream infection in Sichuan, mainly by Pseudomonas aeruginosa and Acinetobacter baumannii. There were significant differences in the isolation rate of non-fermentative bacteria in different departments and most of the strains were isolated in internal medicine departments. The detection rate of Acinetobacter baumannii with multiple drug resistance was high, while other non-fermentative bacteria had good sensitivity to antibiotics.

Objective To investigate the correlations of serum total bilirubin level with infarct volume,severity and etiological typing in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke admitted to hospital from January 2012 to January 2014 were used as subjects of study.Their clinical and imaging data were collected,and serum total bilirubin levels were detected.The correlations of the serum total bilirubin levels with the infarct volume,severity and etiological typing were analyzed.Results A total of 290 patients with acute ischemic stroke were enrolled in the study.The patients were divided into either a large infarction group (≥1.8 cm3,n =145) or a small infarction group (＜ 1.8 cm3;n =145)according to the median cerebral infarction volume.The total bilirubin level of the large infarction group was significantly higher than that of the small infarction group (16.896± 7.761 μmol/L vs.13.039±4.477 μmol/L;t =5.185,P ＜ 0.001).Multivariate logistic regression analysis showed that the bilirubin highest quantile group (＞ 17.893 μmol/L) was an independent risk factor for large infarction (odds ratio [OR] 2.754,95％ confidence interval [CI] 1.028-7.375;P =0.044).According to the National Institutes of Health Stroke Scale (NIHSS) score,the patients were divided into a mild stroke group (NIHSS score ＜8;n =210) and a moderate to severe stroke group (NIHSS score≥ 8,n =80).The total bilirubin level of the moderate to severe stroke group was significantly higher than that of the mild stroke group (16.861 ±7.689)μmol/L vs.14.246 ± 6.019 μmol/L;t =3.052,P =0.002).Multivariate logistic regression analysis showed that the total bilirubin level was not an independent risk factor for moderate to severe stroke.Small artery occlusive stroke,large artery atherosclerotic stroke,and other definite causes of stroke were combined into non-cardioembolic stroke group (n =244).The total bilirubin level in the cardioembolic stroke group (n=46) was significantly higher than that in the non-cardioembolic stroke group (19.639±8.409 μmol/L vs.14.087 ±5.831 μmol/L;t =5.479,P＜0.001).Multivariate logistic regression analysis showed that the bilirubin highest quartile group (＞ 17.893 μmol/L) was an independent risk factor for cardioembolic stroke (OR 8.405,95％ CI 1.719-41.106,P =0.009).Conclusions The increased serum total bilirubin level is an independent risk factor for larger infarction and cardioembolic stroke.As an oxidative stress index,serum total bilirubin in acute stage can provide help for early identification of infarct volume and etiological subtype in patients with ischemic stroke.

MicroRNAs (miRNAs) are critical for both development and function of the central nervous system. Significant evidence suggests that abnormal expression of miRNAs is associated with neurodevelopmental disorders. MeCP2 protein is an epigenetic regulator repressing or activating gene transcription by binding to methylated DNA. Both loss-of-function and gain-of-function mutations in the MECP2 gene lead to neurodevelopmental disorders such as Rett syndrome, autism and MECP2 duplication syndrome. In this study, we demonstrate that miR-130a inhibits neurite outgrowth and reduces dendritic spine density as well as dendritic complexity. Bioinformatics analyses, cell cultures and biochemical experiments indicate that miR-130a targets MECP2 and down-regulates MeCP2 protein expression. Furthermore, expression of the wild-type MeCP2, but not a loss-of-function mutant, rescues the miR-130a-induced phenotype. Our study uncovers the MECP2 gene as a previous unknown target for miR-130a, supporting that miR-130a may play a role in neurodevelopment by regulating MeCP2. Together with data from other groups, our work suggests that a feedback regulatory mechanism involving both miR-130a and MeCP2 may serve to ensure their appropriate expression and function in neural development.
Animals ; Dendrites ; genetics ; metabolism ; Dendritic Spines ; genetics ; metabolism ; Down-Regulation ; physiology ; Methyl-CpG-Binding Protein 2 ; biosynthesis ; genetics ; MicroRNAs ; genetics ; metabolism ; Rats

Objective In order to discuss the evaluation of generalized sterization for dental handpieces. Methods The generalized sterization for dental handpieces were used inclued collection dental handpieces, automatically cleaned, dried and distilled with oil, packed with paper or plastics and sterized with pulse-vuccum. Results All the indexes were fitted to the standard after the generalized sterization among the dental handpieces. The valid rate was 100%. Conclusions Generalized sterization for dental handpieces are effective measures to guarantee the clinical sterization quality.

OBJECTIVE To reinforce the administration in the management of reusable medical appliances,and to ensure the quality of sterile.METHODS Every step of the integral sterilization were monitored.RESULTS The quality of every link in the course and the end quality of the reusable medical appliances were assured.All the pass-rates of routine examination and sample examination of our hospital and CDC in Zhuhai were 100%.CONCLUSIONS The process of integral sterilization in the management of reusable medical appliances can ensure the quality of sterile materials,and can prevent the nosocomial infections and guarantee the safety of patients.

OBJECTIVE To investigate the clinical degree of satisfaction to sterilizing-supplying center,and to consummate the development of the transition of its decentralized administration to centralized pattern.METHODS We designated the questionnaire of degree of satisfaction(DOS) and carried out the investigation.RESULTS The initiated DOS was 90.6%,the DOS in mid-stage(2006-2007) was 97.3%,and the DOS in the latest stage(2008) was 99.1%.CONCLUSIONS Centralized administration is effective pattern for the development of sterilizing-supplying center and important to ensure the quality of sterile materials and service for clinical medicine.