Objective    To investigate the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and in-hospital prognosis in patients with acute type A aortic dissection within 24 hours of admission. Methods    Fortysix patients diagnosed with type A aortic dissection were included in our hospital and their Lp-PLA2 levels within 24 hours of admission were measured between January 2017 and June 2019. According to their Lp-PLA2 levels within 24 hours of admission, 23 patients were classified into a high Lp-PLA2 group (Lp-PLA2 > 200 μg/L, 16 males and 7 females at age of 52.0±14.0 years) and 23 patients were into a low Lp-PLA2 group (Lp-PLA2 ≤200 μg/L, 15 males and 8 females at age of 53.0±11.0 years). The relationship between Lp-PLA2 level and clinical outcome was analyzed. Results    The incidences of bleeding, hospital infection, multiple organ dysfunction and mortality in the high Lp-PLA2 group were higher than those in the low Lp-PLA2 group (P<0.05). Seven (15.2%) patients died during 3 months of follow-up. The 3-month survival rate of patients with an increase of Lp-PLA2 was significantly lower than that of the patients with normal Lp-PLA2 (P<0.01), which was an independent predictor of adverse outcomes at 3 months of onset (P<0.01). Conclusion    Lp-PLA2 may be a predictor of disease progression in the patients with acute type A aortic dissection, and the patients with significantly elevated Lp-PLA2 have a higher 3-month mortality than the patients with normal Lp-PLA2.

Objective:To explore the effect of positive group psychological counselling on self-efficacy and stigma of patients with ulcerative colitis so as to provide a basis for clinical intervention.Methods:By the convenient sampling method, a total of 100 patients with ulcerative colitis who were hospitalized in the First Affiliated Hospital of Xinxiang Medical University from July 2018 to June 2019 were selected as research subjects. According to the random number table method, they were divided into the control group ( n=50) and the observation group ( n=50) . The control group was given routine nursing while the observation group was given positive group psychological counselling. Inflammatory Bowel Disease Self-Efficacy Scale (IBD-SES) and Social Impact Scale (SIS) were used to evaluate the effect of the intervention. Results:After intervention, scores of stress and emotion management, medical care management, disease management and maintenance management during remission period in the IBD-SES between the two groups had statistically significant differences ( P<0.05) . There was statistically significant difference in the score of social isolation dimension in SIS between the two groups after intervention ( P<0.05) . There were no statistically significant differences in the scores of social exclusion, economic discrimination and intrinsic shame ( P>0.05) . Conclusions:Positive group psychological counselling can improve the self-efficacy of patients with ulcerative colitis, but the effect on the stigma needs further large samples and long-term research.

Objective     To investigate the early diagnostic value of urinary neutrophil gelatinase-associated lipocalin (NGAL) for acute kidney injury (AKI) after acute Stanford type A aortic dissection. Methods     From January 2018 to December 2018, the clinical data of 50 patients who underwent open surgery for acute Stanford type A aortic dissection were analyzed in Nanjing First Hospital. Urine specimens were collected before and 2 hours after the aortic dissection surgery. Patients were divided into an AKI group (n=27) and a non-AKI group (n=23) according to the Kidney Disease Improving Global Outcomes criteria. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of urine NGAL.  Results    The incidence of postoperative AKI was 54.00% (27/50). There was a statistically significant difference between the two groups in serum creatinine concentration at 2 hours after surgery and urinary NGAL concentration before the surgery (P<0.05). The area under ROC curve of preoperative urinary NGAL concentration was 0.626. When cut-off value was 43 ng/mL, the sensitivity was 40.7%, specificity was 95.7%. The area under ROC curve of urinary NGAL concentration at 2 hours after surgery was 0.655, and when the cut-off value was 46.95 ng/mL, the sensitivity was 63.0%, specificity was 78.3%.  Conclusion     Urine NGAL can predict postoperative AKI in patients with acute Stanford type A aortic dissection, but its value is limited.

Objective To investigate the effect and mechanism of interfering the nicotinamide mononucleotide adenylyltransferase 1(NMNAT1)gene in Parkinson's disease(PD)mouse models. Methods Thirty mice were randomly assigned to three groups: the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)group, the small interfering nicotinamide mononucleotide adenylyltransferase 1 (siNMNAT1)+MPTP group, and the control group, with 10 mice in each group.After injecting siRNA-green fluorescent protein(GFP)lentivirals directly into substantia nigra(SN),mice received intraperitoneal injections of MPTP, which was the siNMNAT1 +MPTP group.While the MPTP group was only with injections of MPTP,and the control group was with neither siRNA nor MPTP.Then we assessed the motor coordination ability firstly.To observe the variation of nigrostriatal pathway, the counts of dopamanergic neurons in SN were measured by tyrosine hydroxylase(TH)immunofluorescence staining.And the expression of TH in striatum, which was used to estimate the dopaminergic neurons axonal variation, was analyzed by RT-PCR.Then the expression of TH, SOD1, Bcl2, Bax, Bcl2/Bax in SN was estimated through Western blotting.Results Compared with the control group,the siNMNAT1+MPTP group and the MPTP group decreased significantly in motor coordination ability(creep down time: siNMNAT1 +MPTP group(62.8 ±15.7)s,MPTP group(77.9 ±13.5)s, control group(122.0 ±25.2)s), dopamanergic neuron counts(siNMNAT1 +MPTP group 45.0 ±6.7, MPTP group 68.0 ±11.3, control group 93.0 ± 12.8)and the striatal TH expression(Creep down time: t=-6.291, P=0.000; t=-4.865, P=0.000.Dopamanergic neuron counts:t=-10.482,P=0.000;t=-4.624, P=0.000.TH expression:t=-9.117,P=0.000;t=-5.716, P=0.000).Although the siNMNAT1+MPTP group showed lower coordination ability than the MPTP group, there was no statistically significant difference.Whereas the counts of dopamanergic neurons in SN(t=-5.487, P=0.000), the expression of TH in striatum(t=-5.146,P=0.003),SOD1(t=-4.143, P=0.001)and Bcl2/Bax(t=-6.303, P=0.000)were obviously decreased in the siNMNAT1+MPTP group,in which Bax increased significantly(t=3.550,P=0.002).Conclusions Interfering the expression of NMNAT1 aggravated the neurodegeneration in PD, and the mechanism might be related to oxidative stress and programmed cell death.

Objective To investigate the correlation of possible risk factors with acute renal injury (AKI) after coronary artery bypass surgery (CABG) and explore if the incidence of AKI could be lower by off-pump CABG for kidney protection.Methods Two hundred and nine patients who underwent coronary artery bypass surgery in Nanjing First Hospital from September 2010 to November 2013 were recruited.The patients were divided into AKI group (fifty-five cases) and non-AKI group (one hundred and fifty-four cases) according to the AKI criteria and compared the possible risk factors between two the groups by univariate analysis and multivariate analysis.Results The index of female gender,body mass index,age,hypertension,basic serum creatinine,ejection fraction,the number of coronary atherosclerosis,cardiopulmonary bypass,IABP for circulatory support,postoperative low cardiac output,lactate in AKI group were higher than that in non-AKI group by univariate analysis (P ＜ 0.05).And basic serum creatinine,ejection fraction,cardiopulmonary bypass,postoperative low cardiac output showed a significantly statistical difference between two group by multivariate analysis.Conclusions Cardiopulmonary bypass,basic serum creatinine,ejection fraction,postoperative low cardiac output were independent risk factors.Off-pump CABG could benefit for kidney protection.

Objective To investigate the effects of dexmedetomidine on the inflammatory response during the aortic dissection perioperative period.Methods 53 patients with the type A aortic dissection who needed surgical treatment were randomly divided into the study group and the control group.Patients in the study group (group A) received dexmedetomidine (0.2-0.7 μg · kg-1 · h-1) while patients in the control group (group B) received morphine 0.2-0.6 mg/h to ease pain after they were admitted and continued to 48 h after the operation.The serum levels of TNF-α,MMPs,NE,NT-proBNP and CRP were measured in the patients at the time enrolled taking none of the two drugs(T0),before the operation(T1),immediately after the operation (T2) and 12 h (T3),24 h (T4),48 h (T5),72 h (T6) after the operation.MODS score and the length of stay in ICU were observed about the two groups of patients.Difference between the two groups was determined by the Student' s t-test.Single factor analysis of variance was used within the group.P ＜ 0.05 was considered statistically significant.Results Compared with the patients in group B,the MMPs levels in group A at 24、48 and 72 h after the operation were significantly lower.The patients in group A had lower levels of NT-proBNP and NE both at 48 h and 72 h after the operation.Lower levels of TNF-α and CRP were also found at 24 h and 48 h in this group.The MODS score at the fifth 、tenth and 15th day after the surgery were both significantly lower than that of the first day in patients of group A.Conclusion Dexmedetomidine can inhibit the inflammatory response during the aortic dissection perioperative period and can reduce the acute injury of organs caused by the excessive systemic inflammatory response.

Objective To investigate the correlation between serum cystatin C(Cys-C)and renal function in patients with renal damage secondary to cirrhosis.Methods 129 patients with liver cirrhosis were selected,according to the measured glomerular filtration rate (GFR) as the gold standard for evaluation of renal function,patients were divided into group A(cirrhosis with normal renal function),group B(cirrhosis following renal insufficiency),group C (cirrhosis secondary to renal failure).The concentration of Cys-C was compared among three groups,and the serum creatinine(Scr),serum proteins ball micro β2 (β2-MG),creatinine clearance (Ccr) were detected.Results Cys-C,Scr,β2-MG,Ccr and other indicators of A,B,C three groups increased or decreased with the severity of impaired renal function(t =6.65,6.85,6.58,4.54,all P ＜ 0.05).The abnormal detection rates of Cys-C,Scr,Ccr,β2-MG in A group were 31.1％,11.1％,8.9％,26,7％,those in B group were 83.7％,30.2 ％,34.9％,46.5％,those in C group were 100.0％,85.4％,87.8％,95.1％.Conclusion Serum Cys-C concentration is a sensitive marker to evaluate glomerular filtration,it has accurate and reliable clinical significance in the early diagnosis of liver cirrhosis secondary to kidney damage.

Antineoplastic Agents ; pharmacology ; Autophagy ; drug effects ; Disulfides ; pharmacology ; Gene Expression Regulation, Neoplastic ; Glycogen Synthase Kinase 3 ; genetics ; metabolism ; HCT116 Cells ; Humans ; Piperazines ; pharmacology ; Proto-Oncogene Proteins ; genetics ; metabolism ; Proto-Oncogene Proteins p21(ras) ; Signal Transduction ; ras Proteins ; genetics ; metabolism

Objective To test the hypothesis that interleukin-18 (IL-18) in the urine and serum sample are early biomarker for acute kidney injury (AKI) in patients after coronary artery bypass graft surgery (CABG).Methods Eighty patients who underwent CABG were recruited.The patients were divided into AKI group and non-AKI group according to the AKI criteria.The urine and serum sample were collected at pre-operation and 2 h,4 h,6 h,8 h,12 h,24 h after the CABG.The urine and serum IL-18 value were test by ELISA method.Receiver-operating characteristic cue(ORC) and the area under the cure(AUC) asses the sensitivity and specificity of IL-18 for AKI.Results Thirteen of eighty cases(16.25％) developed postoperative AKI according to the AKI criteria.Diagnosis with creatinine was only 24-48 hours after CABG.The serum and urinary concentrations of IL-18 at mostly each time point after CABG in AKI patients were significantly higher than those in non-AKI patients(P ＜ 0.01).Urinary and serous concentrations of IL-18 peaked at 4 h after CABG in AKI patients.ROC curve showed AUC in urinary and serous concentrations of IL-18 at 2 h ＞ 0.8 ; Concentrations of IL-18 in urine and serum at 2 h were the powerful independent predictors of AKI by logistic regression analysis.Conclusion IL-18 in urine and serum after CABG surgery were the powerful independent predictors of AKI.

Objective To evaluate the hypothesis that neutrophil gelatinase-associated lipocalin(NGAL) ,kidney injury molecule-1(KIM-1)and Interleukin-18(IL-18) are early biomarker for acute kidney injury (AKI) in patients after coronary artery bypass graft surgery(CABG) .Methods 80 patients were recruited during September 2011 to May 2012 .The patients were divided into two groups according to the AKI criteria ,patients developed postoperative AKI in AKI group ;others did not postoperative developed AKI in non-AKI group .Before and 2 ,4 ,6 ,8 ,12 ,24 h after the CABG surgery ,the urine and serum sample were collected ,serum creatinine ,the urine and serum IL-18、NGAL、KIM-1 value were test by ELISA method .Results 13 of 80 cases(16 .25% )developed postoperative AKI according to the AKI criteria ,diagnosis with serum creatinine was only 12-48 h after cardiac surgery .Concen-trations of NGAL 、IL-18 in urine and serum at 2 h after CABG surgery ,concentrations of KIM-1 in urine and serum at 6 h were the powerful independent predictors of AKI by logistic regression analysis and ROC curve .Conclusion IL-18 in urine and serum at 2 h after CABG surgery were the powerful independent predictors of AKI ,and concentrations of KIM-1 in urine and serum at 6 h were the powerful independent predictors of AKI .Serous NGAL and IL-18 is better than urinary NGAL and IL-18 in diagnosis of AKI . Urinary KIM-1 was better than serous KIM-1 in diagnosis of AKI at 6 h .