Objective:To investigate the influences of lupinol on the proliferation,apoptosis and invasion of cer-vical cancer cells by regulating autophagy mediated by phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)pathway.Methods:The proliferation rate of human cervical cancer cell line HeLa cells treated with 0,10,25,50,70,90 μmol/L lupinol was determined,and the appropriate concentration of lupinol was screened out.HeLa cells cultured in vitro were randomly grouped into control group,low-dose lupinol group,high-dose lupinol group,740 Y-P group(PI3K activator),and high-dose lupinol+740 Y-P group.After group intervention with lupinol and 740 Y-P,MDC fluorescence staining was used to detect the forma-tion of autophagic vacuolation of HeLa cells in each group;western blot was used to detect the expression of au-tophagy and PI3K/AKT/mTOR pathway-related proteins in HeLa cells in each group.HeLa cells cultured in vitro were randomly grouped into control group,low-dose lupinol group,high-dose lupinol group,high-dose lupinol+rapamycin(Rapa),and high-dose lupinol+3-methyladenine(3-MA)group.After the intervention of high dose of lupinol,Rapa and 3-MA,the proliferation of HeLa cells in each group was detected by MTT assay and plate colony formation assay;flow cytometry was used to detect the apoptosis of HeLa cells in each group;transwell assay was used to detect the invasion of HeLa cells in each group;western blot was used to detect the expressions of proliferation,apoptosis and epithelial-mesenchymal transition-related proteins in HeLa cells in each group.Re-sults:Compared with the control group,the relative content of autophagic vacuoles,the protein expressions of Mi-crotubule-associated protein 1A/1 B-light chain 3(LC3)Ⅱ/LC3Ⅰ,and Beclin-1 in the low and high dose lupinol groups were all increased(P＜0.05),the phosphorylated PI3K(p-PI3K)/PI3K,phosphorylated AKT(p-AKT)/AKT,and phosphorylated mTOR(p-mTOR)/mTOR decreased(P＜0.05);the relative content of autophagic vac-uoles,the protein expressions of LC3Ⅱ/LC3Ⅰ,and Beclin-1 in the high-dose lupinol group were further increased compared with the low-dose lupinol group(P＜0.05),the p-PI3K/PI3K,p-AKT/AKT,and p-mTOR/mTOR were further decreased(P＜0.05);the relative content of autophagic vacuoles,the protein expressions of LC3Ⅱ/LC3Ⅰ,and Beclin-1 in 740 Y-P group decreased compared with the control group(P＜0.05),the p-PI3K/PI3K,p-AKT/AKT,and p-mTOR/mTOR increased(P＜0.05).Compared with the high-dose lupinol group,the relative content of autophagic vacuoles,the protein expressions of LC3Ⅱ/LC3Ⅰ,and Beclin-1 in the high-dose lupinol+740 Y-P group decreased(P＜0.05),the p-PI3K/PI3K,p-AKT/AKT,and p-mTOR/mTOR increased(P＜0.05).Com-pared with the control group,the cell proliferation rate,colony formation rate,invasion number,and the protein ex-pressions of proliferating cell nuclear antigen(PCNA),B cell lymphoma 2(Bcl-2)and Vimentin in the low and high dose groups of lupinol were all decreased(P＜0.05),the apoptosis rate,and the protein expressions of Bcl-2 as-sociated x protein(Bax)and zonula occludens protein 1(ZO-1)were all increased(P＜0.05);compared with the low-dose lupinol group,the cell proliferation rate,colony formation rate,invasion number,and the protein expres-sions of PCNA,Bcl-2 and Vimentin in the high-dose lupinol group were further decreased(P＜0.05),the apopto-sis rate,and the protein expressions of Bax and ZO-1 were further increased(P＜0.05).Compared with the high-dose lupinol group,the cell proliferation rate,colony formation rate,invasion number,and the protein expres-sions of PCNA,Bcl-2 and Vimentin in the high-dose lupinol+Rapa group were increased(P＜0.05),the apopto-sis rate,and the protein expressions of Bax and ZO-1 were decreased(P＜0.05);the cell proliferation rate,colo-ny formation rate,invasion number,and the protein expressions of PCNA,Bcl-2 and Vimentin in the high-dose lu-pinol+3-MA group were decreased(P＜0.05),the apoptosis rate,and the protein expressions of Bax and ZO-1 were increased(P＜0.05).Conclusions:Lupinol induces protective autophagy by inhibiting the PI3K/AKT/mTOR pathway,thereby promoting the apoptosis of cervical cancer cells and inhibiting their proliferation and inva-sion.Activation of autophagy attenuates the effects of lupinol on the proliferation,apoptosis and invasion of cervi-cal cancer cells.

Objective To investigate the relationship between abnormal expression of serum heart-type fatty acid-binding protein(H-FABP)and silent mating type information regulation 2 homo-log-1(SIRT1)and ventricular remodeling in elderly patients with ischemic cardiomyopathy.Meth-ods A total of 200 elderly patients with ischemic cardiomyopathy admitted to our hospital from August 2022 to December 2023 were enrolled as the study group,and another 100 healthy individ-uals who took physical examinations at the same time were recruited as the control group.Accord-ing to ventricular remodeling occurred or not,the patients from the study group were divided into a ventricular remodeling subgroup(38 cases)and a non ventricular remodeling subgroup(162 cases).Serum H-FABP and SIRT1 levels were detected and compared in above groups and sub-groups.Pearson correlation analysis was used to analyze the relationship between serum H-FABP and SIRT1 levels and ventricular remodeling,and ROC curve was plotted to analyze the serum H-FABP and SIRT1 levels in diagnosing ventricular remodeling.The influencing factors of ven-tricular remodeling were analyzed by logistic regression.Results The serum H-FABP level was significantly higher,and that of SIRT1 was obviously lower in the study group than the control group(P＜0.01).The ventricular remodeling subgroup had higher serum H-FABP level but lower SIRT1 level when compared with the non ventricular remodeling subgroup(P＜0.01).Pearson correlation analysis showed that serum H-FABP level was negatively correlated with LVMI(r=-0.569,P=0.001),while serum SIRT1 level was positively correlated with LVMI(r=0.511,P=0.001).ROC curve analysis indicated that the AUC value of serum H-FABP and SIRT1 levels in diagnosing ventricular remodeling was 0.872(95％CI:0.821-0.933)and 0.848(95％CI:0.786-0.897),respectively.Logistic regression analysis suggested that serum H-FABP(OR=1.848,95％CI:1.068-3.262,P=0.032)was a risk factor,while SIRT1 was a protective factor(OR=0.687,95％CI:0.409-0.935,P=0.015)for ventricular remodeling in elderly patients with ischemic cardiomyopathy.Conclusion Elderly patients with ischemic cardiomyopathy have abnor-mally high expression of serum H-FABP and abnormally low expression of SIRT1.The expres-sion levels are correlated with the severity of ventricular remodeling,and are influencing factors for ventricular remodeling,and show good diagnostic value for ventricular remodeling.

Objective:To retrospectively analyze the clinical characteristics and drug resistance among COVID-19 patients with bacterial and fungal infections.Methods:Clinical data of COVID-19 patients whose blood, urine, sputum and alveolar lavage fluid samples were positive for bacteria and fungi were collected in Tongji Hospital from February 10 to March 31, 2020. WHONET5.6 software was used to analyze drug susceptibility test results.Results:A total of 95 COVID-19 patients positive for pathogenic bacteria were enrolled and among them, 23 were non-critical patients and 72 were critical patients. The main symptoms in these patients included fever, cough with sputum, fatigue and dyspnea. Male and female critical patients accounted for 63.89% and 36.11%, respectively. Most of the patients with bacterial and fungal infections were critical type, accounting for 23.61%. The mortality rates of non-critical and critical patients were 13.04% and 61.11%, respectively. A total of 179 strains of pathogenic bacteria were isolated. The positive rate of Escherichia coli in non-critical patients was 37.50%, which was higher than that in critical patients. However, the positive rates of Acinetobacter baumannii and Klebsiella pneumoniae in critical patients were both 29.87%, higher than those in non-critical patients. There was no significant difference in the positive rate of gram-positive bacteria or fungi between non-critical and critical patients. It was noteworthy that the positive rate of Candida parapsilosis in blood samples of critical patients was relatively high, reaching 36.40%. Drug susceptibility test results showed that no carbapenem-resistant Escherichia coli stains were detected and 60.87% of Klebsiella pneumoniae strains were resistant to carbapenems. Acinetobacter baumannii strains were 100% resistant to three antimicrobial drugs. Methicillin-resistant Staphylococcus aureus strains accounted for 71.43%, but no vancomycin-resistant gram-positive cocci were found. Conclusions:Critical COVID-19 patients were mostly male and prone to multiple bacterial and fungal infections. The mortality of critical patients was higher than that of non-critical patients. Critical COVID-19 was often complicated by hospital acquired infections caused by bacteria including Acinetobacter baumannii and Klebsiella pneumoniae with high drug resistance.

Public hospitals in the face of COVID-19, should prioritize medical services of patients as the topmost task. In order to ensure the smooth progress of diagnosis and treatment, and prevent the occurrence of nosocomial infection, the hospital took an overall response strategy featuring " logistics support mode 3+ 1" . This strategy requires to make facilities ready by transforming isolation wards, overall management and deployment of protection supplies, optimizing logistics service flow, strict sterilization and isolation of medical wastes and environment, optimizing catering service within the hospital to reduce the gathering and flow of personnel. It also enhanced personnel training, to eliminate staff panic and to stabilize the logistics support team. Meanwhile, the logistics department took over the hospital access screening work for tight access control, which maximize the safety and reliability of the logistics support within the hospital, and ensure the smooth progress of the epidemic prevention work.

OBJECTIVE: To investigate the interventional effect of the Chinese herbal preparation Xi Fu Pai Chen(XFPC) on pulmonary inflammation and fibrosis in rats with silicosis. METHODS: A total of 144 adult specific pathogen free male SD rats were randomly divided into 6 groups: blank control group, silicosis model group, drug administration control group and groups of low-dose,medium-dose and high-dose XFPC, with 24 rats in each group. Lung silicosis model was established by single inhalation tracheal instillation method, which was treated with 50.0 g/L silica suspension, in groups except in the blank control group. On the 7 th day of modeling, the rats in the drug administration control group were orally given tetrandrine(5 mg/kg body weight), while those in the low-, medium-and high-dose groups were given 43, 86 and 192 g/L of XFPC by atomization inhalation once a day for 20 minutes, 5 days a week for 4 weeks. At the end of drug administration, the histopathological changes of the lung were observed. The number and classification of cells in bronchoalveolar lavage fluid(BALF)were examined, and the levels of malondialdehyde(MDA) and interferon-gamma(IFN-γ) in BALF were measured by enzyme-linked immunosorbent assay. RESULTS: On the 7 th day after modeling, the body weight in the drug administration control group and XFPC high-dose group decreased compared with the blank control group(P<0.05). On the 35 th day after modeling, the body weights of rats in the other 5 groups were lower than that in the blank control group(P<0.05). The pathological changes of lung tissue(infiltration of inflammatory cells, fibrosis and size of silicon nodule) in drug administration control group and XFPC low-dose group were better than those in silicosis model group by naked eyes and under light microscope. The lung coefficient, the proportion of neutrophils and the level of MDA and IFN-γ in BALF of the drug administration control group and XFPC low-dose group decreased(P<0.05), and the proportion of macrophages in BALF increased(P<0.05) compared with the silicosis model group. There was no significant difference in lung coefficients and the relevant indices of BALF between XFPC medium-, high-dose groups and silicosis model group(P>0.05). CONCLUSION: Low dosage XFPC can improve pulmonary fibrosis and inflammation in rats with silicosis, and its mechanism of action may be related to reducing the levels of IFN-γ and MDA in BALF.

Nowadays hospitals have been at the forefront fighting against novel coronavirus pneumonia, with diagnosing and treating of patients as a top priority. In order to ensure the smooth progress of diagnosis and treatment, and prevent the occurrence of nosocomial infection, logistics support needs to make allowances for the isolation ward in time from the perspectives of logistics, facilities and equipment, and to transform the in-and-out double channels of ward access as required, thus setting up the partition of the three zones. Secondly, logistics support needs to optimize the logistics service workflow, including the medical waste management, the environmental disinfection isolation, and to optimize the catering service within hospitals to reduce the gathering and flow of personnel. Thirdly, logistics support needs to increase personnel training, and to eliminate psychological panic as well as to stabilize the logistics support team by putting logistics management cadres on the front line. Meanwhile, the logistics department needs to take over the hospital access screening work, strictly manage those who enter the hospital, maximize the safety and reliability of the logistics support within the hospital, and ensure the smooth progress of the epidemic prevention work.

Genetic Counseling ; United States

Objective To investigate the inhibitory effects of medicinal serum of Shenqi Yiliu Formula on cell proliferation of gastric cancer MGC-803 cells;To discuss relevant mechanism. Methods After treated with different concentrations of medicinal serum of Shenqi Yiliu Formula, gastric cancer MGC-803 cells were tested by the following methods: MTT was employed to test the proliferation of gastric cancer MGC-803 cells; Flow cytometry was used to detect cell cycle; qRT-PCR was used to detect the genetic expressions of CDKN1B and CDKN1C;Western blot was employed to test the protein expressions of p27 and p57. Results When 3%, 5%and 10%medicinal serum of Shenqi Yiliu Formula was treated to MGC-803 cells for 24 h, 48 h and 72 h, proliferation of cells decreased significantly (P<0.01), with time- and dosage-dependent relationship. When 3%, 5% and 10% medicinal serum of Shenqi Yiliu Formula was treated to MGC-803 cells for 24 h, cells in G0/G1 increased, decreased in S. qRT-PCR results showed that compared with the blank control group and the negative control group, mRNA expressions of CDKN1B and CDKN1C of MGC-803 cells in medicinal serum all dose group increased significantly (P<0.01). Western blot results showed that compared with the blank control group, protein expressions of p27 and p57 of MGC-803 cells in medicinal serum all dose group increased significantly (P<0.01). Conclusion Medicinal serum of Shenqi Yiliu Formula can inhibit MGC-803 cells proliferation and the mechanism may be through adjusting CDKN1B, CDKN1C mRNA and proteins expression to intervene in the cell cycle.

Objective To compare clinical data of the death in different intensive care unit,in order to provide the medical strategies for patients in EICU.Methods The clinical data of lethal cases from January 1,2013 to December 31,2014 in EICU,SICU and MICU of the First Affiliated Hospital of Sun Yat-sen University were compared.EICU (252 cases),SICU (93 cases) and MICU (80 cases) were enrolled.The demographics of each patient,clinical condition such as critical score (APACHE Ⅱ score),length of stay,overall costs,and the patient families' different opinions to the treatment in each ICU were analyzed.The data was analyzed with SPSS 13.0 software,averaged value was presented as mean ± standard and the non-normal distributions were expressed as median (25％,75％).The one-way analysis of variance was followed by the Tukey post hoc test for pairwise comparisons and chi-square test was used for comparison of percentage between two groups.Results Two hundred and fifty-two cases in EICU had gender ration of 148/96 (male/female),92 cases in SICU 68/24,80 cases in MICU 56/24.Ages of the fatal were EICU 72 ± 17 years,SICU 56 ± 17 years,and MICU 63 ± 20 years,respectively.Age of the fatal in EICU was significantly older than that of the SICU (P ＜ 0.01) and the MICU (P ＜ 0.01).APACHE Ⅱscores were 33 ± 8 in EICU,34 ± 10 in SICU,29 ± 10 in MICU,respectively.The severity scores in EICU patients were higher than those in MICU patients and SICU patients (P =0.01 and 0.021).Lengths of stay were 2 days (1,46) in EICU,14 days (1,84) in SICU,12 days (1,77) in MICU,respectively.EICU hospitalization time was significantly shorter than that of SICU (P ＜ 0.01) and the MICU (P ＜ 0.01).Total costs of hospitalization were 9 777 yuan (400,164 126) yuan in EICU,100 628 yuan (13 639,964 783) yuan in SICU,119 463 yuan (5 650,590 903) yuan in MICU,and that in EICU was significantly less than the total cost of hospitalization in SICU (P ＜ 0.01) and in MICU (P ＜ 0.01).The opinion of patient families was proposed to give up treatment associated with 165 dead cases in EICU,18 death cases in SICU and 20 dead cases in MICU,and the rate of discontinuous treatment in EICU patients was significantly greater than that in SICU (P ＜ 0.01) and in MICU (P ＜ 0.01).There were no significant differences in invasive procedures,invasive hemodynamic monitoring,mechanical ventilation,blood purification and deep vein puncture among three groups.The 5 leading causes in EICU were severe sepsis,stroke,sudden cardiac arrest,acute myocardial infarction and advanced malignancy.Conclusions The death of patients were due to advanced age with severe disease,poor prognosis,and the request of patient family members to give up treatment.The 5 leading causes were severe sepsis,stroke,sudden cardiac arrest,acute myocardial infarction and advanced tumors suggesting the establishment of corresponding treatment scheme to be made and preparation of abundant medical resources to be ready.Timely communication with the patients' families and let them participate in end-stage treatment decisions was the best strategies to improve the successful rate of treating severe patients and use EICU resource effectively.

As an effective training method in improving the team cooperation and communication of medical workers,constructing the patient safety culture and improving the medical quality,team resource management (TRM),was widely applied and promoted in medical and clinical treatment. The conception and application of TRM at home and abroad were reviewed in this paper,to demonstrate that,in complex and volatile environment,TRM could promote the team cooperation and communication,reduce clinical errors,improve the prognosis of patients and the medical quality,and provide basis for the improvement,construction and development of medical safety culture.