Battlefield internal medicine aims at the treatment of combatants and noncombatants with various internal diseases on the battlefield.The military medical research on battlefield internal diseases focuses on the patho...Battlefield internal medicine aims at the treatment of combatants and noncombatants with various internal diseases on the battlefield.The military medical research on battlefield internal diseases focuses on the pathogenesis,clinical management,and prevention of internal diseases under military war conditions.In both wartime and peacetime,the soldiers suffer from more internal diseases than surgical wounds.With the introduction of high-tech weapons,including chemical,physical,and biological agents,a large number of special internal illnesses and casualties will appear in future wars.The battles often occur in special environments,such as high or low temperatures,plateau or polar areas,and micro-or hyper-gravity.The current theories of battlefield internal medicine are mainly derived from wars decades ago and cannot meet the needs of military medical support under the conditions of modern warfare.Therefore,the military medical research on battlefield internal medicine should be based on contemporary military situations,focus on the purpose of treating battlefield internal diseases,and adhere to the actual needs of the troops in peacetime and wartime.We should investigate the pathogenesis of battlefield internal diseases and explore the threats that may arise in future wars to ensure the advancement of battlefield internal medicine.This review highlights new concepts,demands,challenges,and opportunities for the further development of military medical research on battlefield internal medicine.展开更多
Dear Editor,Three dimensional(3D)bioprinted extracellular matrix(ECM)can be used to provide both biochemical and biophysical cues to direct mesenchymal stem cells(MSCs)differentiation,and then differentiated cells wer...Dear Editor,Three dimensional(3D)bioprinted extracellular matrix(ECM)can be used to provide both biochemical and biophysical cues to direct mesenchymal stem cells(MSCs)differentiation,and then differentiated cells were isolated for implantation in vivo using surgical procedures.However,the reduced cell activity after cell isolation from 3D constructs and low cell retention in injured sites limit its application[1].Methacrylated gelatin(GelMA)hydrogel has the advantage of fast crosslinking,which could resemble complex architectures of tissue construct in vivo[2].Here,we adopted a noninvasive bioprinting procedure to imitate the regenerative microenvironment that could simultaneously direct the sweat gland(SG)and vascular differentiation from MSCs and ultimately promote the replacement of glandular tissue in situ(Fig.1a).展开更多
Soy polysaccharide(SP)has been reported to possess the properties of modulating gut microbiome diversity.Here,we aimed to explore the protective effects of SP against dextran sulphate sodium(DSS)-induced colitis.Pre-t...Soy polysaccharide(SP)has been reported to possess the properties of modulating gut microbiome diversity.Here,we aimed to explore the protective effects of SP against dextran sulphate sodium(DSS)-induced colitis.Pre-treatment with SP at a dosage of 400 mg/kg·day alleviated colitis symptoms,preventing the weight loss and colon shorten.SP suppressed DSS-induced inflammatory response and enhanced M1 to M2 macrophage polarization.Further investigation showed that SP significantly promoted the regeneration of crypt and the expansion of goblet cell production.In addition,bacterial 16S rRNA sequencing analysis showed that SP modulated the composition of fecal microbiota,including selectively increasing Lactobacillus relative abundance.Notably,SP treatment enriched the production of Lactobacillus-derived lactic acid,which was sensed by its specific G-protein-coupled receptor 81(Gpr81)/Wnt3/β-catenin signaling,and promoted the regeneration of intestinal stem cells.Fecal microbiome transplantation demonstrated that intestinal flora partially contributed to the beneficial effects of SP on preventing against colitis.In conclusion,SP exhibited the protective effects against colitis,which could be partly associated with modulating the composition of gut microbiota and enrichment of lactic acid.This study suggests that SP has potential to be developed as nutritional intervention to prevent colitis.展开更多
Ulcerative colitis(UC)is a common inflammatory disease of the gastrointestinal tract.Traditional Chinese medicine(TCM)has long been used in Asia as a treatment for UC and Puerariae Radix(PR)is a reliable anti-diarrhea...Ulcerative colitis(UC)is a common inflammatory disease of the gastrointestinal tract.Traditional Chinese medicine(TCM)has long been used in Asia as a treatment for UC and Puerariae Radix(PR)is a reliable anti-diarrheal therapy.The aims of this study were to investigate the protective effect of PR using the dextran sulfate sodium salt(DSS)-induced UC model in mice and identify molecular mechanisms of PR action.The chemical constituents of PR via ultra-performance liquid chromatography/tandem mass spectrometry and identified potential PR and UC targets using a network pharmacology(NP)approach were obtained to guide mouse experiments.A total of 180 peaks were identified from PR including 48 flavonoids,46 organic acids,14 amino acids,8 phenols,8 carbohydrates,7 alkaloids,6 coumarins and 43 other constituents.NP results showed that caspase-1 was the most dysregulated of the core genes associated with UC.A PR dose of 0.136 mg/g administered to DSS treated mice reversed weight loss and decreased colon lengths found in UC mice.PR also alleviated intestinal mucosal shedding,inflammatory cell infiltration and mucin loss.PR treatment suppressed upregulation of NOD-like receptor protein 3(NLRP3),cysteinyl aspartate-specific proteases-1(caspase-1),apoptosis-associated speck-like(ASC)and gasdermin D(GSDMD)at both the protein and m RNA expression levels.The addition of a small molecule dual-specificity phosphatase inhibitor NSC 95397 inhibited the positive effects of PR.These results indicated that PR exerts a protective effect on DSS-induced colitis by inhibiting NLRP3 inflammasome activation in mice.展开更多
Assessment of digestion colonic flora lactulose can be induced to produce hydrogen and prove lactulose with a potential anti-inflammatory effects. Methods： We established a mouse model of human ulcerative colitis （U...Assessment of digestion colonic flora lactulose can be induced to produce hydrogen and prove lactulose with a potential anti-inflammatory effects. Methods： We established a mouse model of human ulcerative colitis （UC） by supplying mice with water containing dextran sulfate sodium （DSS）. At 7-day, DSS-induced pathogenic outcomes, including loss of body weight, increase of colitis score, pathogenic shortening of colon length, elevated level of TNF-ct, IL-lβ, malondialdehyde （MDA） and myeloperoxidase （MPO） deficiency in colon lesions, were significantly suppressed by lactulose administration and intraperitoneally injected hydrogen water. Results： After eliminating colon microflora by antibiotics, the anti-inflammatory effects of lactulose were significantly compromised. Histological analysis also revealed that the DSS mediated colonic tissue destruction accompanied by neutrophils infiltration was remarkably suppressed by lactulose and hydrogen water. Conclusion：The present study indicated that lactulose can prevent the development of DSS-induced colitis and alleviate oxidative stress state in colitis.展开更多
To find out the normal lumbar facet joints between 13 and 18 years old,in order to provide anatomical basis for early diagnosis and therapy of lumbar disc herniation.CT imagings of 32 subjects with lumbar disc herniat...To find out the normal lumbar facet joints between 13 and 18 years old,in order to provide anatomical basis for early diagnosis and therapy of lumbar disc herniation.CT imagings of 32 subjects with lumbar disc herniation aged from 13 to 18 years old in Inner Mongolia have been collected as the ALDH group,and 62 healthy subjects in the equal period had been chosen as the normal group.Continuous scanning lumbar tomography pix were imported into Mimics 21.0 for evaluation and size in DICOM format.展开更多
BACKGROUND:This study aimed to establish an eff ective nomogram to predict the survival of heat stroke(HS)based on risk factors.METHODS:This was a retrospective,observational multicenter cohort study.We analyzed patie...BACKGROUND:This study aimed to establish an eff ective nomogram to predict the survival of heat stroke(HS)based on risk factors.METHODS:This was a retrospective,observational multicenter cohort study.We analyzed patients diagnosed with HS,who were treated between May 1 and September 30,2018 at 15 tertiary hospitals from 11 cities in Northern China.RESULTS:Among the 175 patients,32 patients(18.29%)died before hospital discharge.After the univariate analysis,mechanical ventilation,initial mean arterial pressure<70 mmHg,maximum heart rate,lab results on day 1(white blood cell count,alanine aminotransferase,creatinine),and Glasgow admission prediction score were included in multivariate analysis.Multivariate Cox regression showed that invasive ventilation,initial mean arterial pressure<70 mmHg(1 mmHg=0.133 kPa),and Glasgow admission prediction score were independent risk factors for HS.The nomogram was established for predicting 7-d and 14-d survival in the training cohort.The nomogram exhibited a concordance index(C-index)of 0.880(95%confidence interval[95%CI]0.831-0.930)by bootstrapping validation(B=1,000).Furthermore,the nomogram performed better when predicting 14-d survival,compared to 7-d survival.The prognostic index cut-off value was set at 2.085,according to the operating characteristic curve for overall survival prediction.The model showed good calibration ability in the internal and external validation datasets.CONCLUSION:A novel nomogram,integrated with prognostic factors,was proposed;it was highly predictive of the survival in HS patients.展开更多
Graphene oxide(GO)nanosheets possess several advantages,such as a large surface,outstanding biocompatibility,and straightforward chemical modification capability.They also have great potential as a drugcarrier.In this...Graphene oxide(GO)nanosheets possess several advantages,such as a large surface,outstanding biocompatibility,and straightforward chemical modification capability.They also have great potential as a drugcarrier.In this article,we radiolabeled GO nanosheets with99mTc,which satisfies the potential needs of microSPECT imaging probes in pre-clinical and clinical research.GO nanosheets were synthesized through the modified Hummers’method,then GO nanosheets with azide group covalently functionalized in two steps were conjugated to DOTA(1,4,7,10-tetraazacyclododecane-N,N,N,N-tetraacetic acid)and functionalized with an alkynyl group by means of click chemistry.Then through the addition and reduction of technetium-99m,the99mTc-DOTA-GO were attained.DOTA-conjugated GOs with lateral dimensions of 500–600 nm were synthesized.Both atomic force microscopy(AFM)and FT-IR were performed to characterize the GO-DOTA.Labeling efficiency of GO-DOTA with99mTc was>90%and radiochemical purities were>96%with purification.We successfully synthesized graphene oxide derivatives,DOTA-conjugated GOs,via Click Chemistry,and it was labeled with99mTc for SPECT imaging.High radiolabeling efficiency makes GO nanosheets suitable platforms for future molecular imaging research.展开更多
BACKGROUND Myocardial ischemia-reperfusion(I/R) is a serious and irreversible injury. Bone marrow-derived mesenchymal stem cells(MSCs) is considered to be a potential therapy for I/R injury due to the paracrine effect...BACKGROUND Myocardial ischemia-reperfusion(I/R) is a serious and irreversible injury. Bone marrow-derived mesenchymal stem cells(MSCs) is considered to be a potential therapy for I/R injury due to the paracrine effects. High-mobility group box1(HMGB1) is a novel mediator in MSC and regulates the response of inflammation injury. Signal Transduction and Transcription Activator 3(STAT3) is a critical transcription factor and important for release of paracrine factors. However, the relationship between HMGB1 and STAT3 in paracrine effect of MSC remains unknown.METHODS In vitro, hypoxia/reoxygenation injury model was established by Anaero Pack System and examined by Annexin V flow cytometry, CCK8 assay and morphology observation. Detection of apoptotic proteins and protein expression of HMGB1and STAT3 by Western blot.RESULTS The conditioned medium of MSCs with or without LPS pretreatment was cocultured with H9C2 cells for 24 h before hypoxia treatment and MSC showed obvious cardiomyocytes protect role, as evidence by decreased apoptosis rate and improved cells viability, and LPS pretreated MSC exhibited better protect role than untreated MSC. However, such effect was abolished in HMGB1 deficiency group, silencing HMGB1 decreased the secretion of vascular endothelial growth factor(VEGF), hepatocyte growth factor(HGF), insulin growth factor(IGF), cell viability, and the expression of STAT3. Furthermore, STAT3 silence attenuated the protective effect of LPS in MSC.CONCLUSIONS These findings suggested that LPS improved MSC-mediated cardiomyocytes protection by HMGB1/STAT3signaling.展开更多
Collecting cervical MSCT thin layer scanning image data of 52 cases of pediatric specimen from three hospitals, and 16 cases of childpediatric specimen and using Mimics to measure morphological indicators to make stat...Collecting cervical MSCT thin layer scanning image data of 52 cases of pediatric specimen from three hospitals, and 16 cases of childpediatric specimen and using Mimics to measure morphological indicators to make statistical analysis according to side sexand age, to provide the anatomical basis for clinical diagnosis and treatment of related diseases, internal fixationmode selection, auxiliary orthopaedic equipment designing and manufacturing and so on, The width, height andlength of the C_(3)-C_(7) pedicle, lateral mass pedicle length, pedicle axis length and the interpediculate distance ofchildren aged 0-6 years showed an overall increasing trend with the increase of age, but the range of theanteroposterior cervical spinal canal diameter was different.展开更多
In this study,we used micro-CT to scan hyoid specimens and observe the microscopic anatomy of the hyoid bone,study the variation of the trabecular bone inside the hyoid bone,and analyze the internal structure of the h...In this study,we used micro-CT to scan hyoid specimens and observe the microscopic anatomy of the hyoid bone,study the variation of the trabecular bone inside the hyoid bone,and analyze the internal structure of the hyoid bone and possible influencing factors of related diseases.Micro-CT was used to assess 22 hyoid bones and observe changes in the internal bone trabeculae with 3D reconstructions and analyze the fine anatomical structure of the tongue bone.Micro CT images showed the microstructure of various parts of the hyoid bone.展开更多
Benign prostatic hyperplasia (BPH) is highly prevalent among older men, impacting on their quality of life, sexual function, and genitourinary health, and has become an important global burden of disease. Transurethra...Benign prostatic hyperplasia (BPH) is highly prevalent among older men, impacting on their quality of life, sexual function, and genitourinary health, and has become an important global burden of disease. Transurethral plasmakinetic resection of prostate (TUPKP) is one of the foremost surgical procedures for the treatment of BPH. It has become well established in clinical practice with good efficacy and safety. In 2018, we issued the guideline “2018 Standard Edition”. However much new direct evidence has now emerged and this may change some of previous recommendations. The time is ripe to develop new evidence-based guidelines, so we formed a working group of clinical experts and methodologists. The steering group members posed 31 questions relevant to the management of TUPKP for BPH covering the following areas: questions relevant to the perioperative period (preoperative, intraoperative, and postoperative) of TUPKP in the treatment of BPH, postoperative complications and the level of surgeons’ surgical skill. We searched the literature for direct evidence on the management of TUPKP for BPH, and assessed its certainty generated recommendations using the grade criteria by the European Association of Urology. Recommendations were either strong or weak, or in the form of an ungraded consensus-based statement. Finally, we issued 36 statements. Among them, 23 carried strong recommendations, and 13 carried weak recommendations for the stated procedure. They covered questions relevant to the aforementioned three areas. The preoperative period for TUPKP in the treatment of BPH included indications and contraindications for TUPKP, precautions for preoperative preparation in patients with renal impairment and urinary tract infection due to urinary retention, and preoperative prophylactic use of antibiotics. Questions relevant to the intraoperative period incorporated surgical operation techniques and prevention and management of bladder explosion. The application to different populations incorporating the efficacy and safety of TUPKP in the treatment of normal volume (< 80 ml) and large-volume (≥ 80 ml) BPH compared with transurethral urethral resection prostate, transurethral plasmakinetic enucleation of prostate and open prostatectomy;the efficacy and safety of TUPKP in high-risk populations and among people taking anticoagulant (antithrombotic) drugs. Questions relevant to the postoperative period incorporated the time and speed of flushing, the time indwelling catheters are needed, principles of postoperative therapeutic use of antibiotics, follow-up time and follow-up content. Questions related to complications incorporated types of complications and their incidence, postoperative leukocyturia, the treatment measures for the perforation and extravasation of the capsule, transurethral resection syndrome, postoperative bleeding, urinary catheter blockage, bladder spasm, overactive bladder, urinary incontinence, urethral stricture, rectal injury during surgery, postoperative erectile dysfunction and retrograde ejaculation. Final questions were related to surgeons’ skills when performing TUPKP for the treatment of BPH. We hope these recommendations can help support healthcare workers caring for patients having TUPKP for the treatment of BPH.展开更多
Granulomatous lobular mastitis(GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patien...Granulomatous lobular mastitis(GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence.Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions,etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology.The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidencebased consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.展开更多
基金the National Natural Science Foundation of China(81871516 and 81571841)the Youth Special Project of Chinese PLA General Hospital(QNC19052).
文摘Battlefield internal medicine aims at the treatment of combatants and noncombatants with various internal diseases on the battlefield.The military medical research on battlefield internal diseases focuses on the pathogenesis,clinical management,and prevention of internal diseases under military war conditions.In both wartime and peacetime,the soldiers suffer from more internal diseases than surgical wounds.With the introduction of high-tech weapons,including chemical,physical,and biological agents,a large number of special internal illnesses and casualties will appear in future wars.The battles often occur in special environments,such as high or low temperatures,plateau or polar areas,and micro-or hyper-gravity.The current theories of battlefield internal medicine are mainly derived from wars decades ago and cannot meet the needs of military medical support under the conditions of modern warfare.Therefore,the military medical research on battlefield internal medicine should be based on contemporary military situations,focus on the purpose of treating battlefield internal diseases,and adhere to the actual needs of the troops in peacetime and wartime.We should investigate the pathogenesis of battlefield internal diseases and explore the threats that may arise in future wars to ensure the advancement of battlefield internal medicine.This review highlights new concepts,demands,challenges,and opportunities for the further development of military medical research on battlefield internal medicine.
基金supported by the Science Fund for National Defense Distinguished Young Scholars(2022-JCJQ-ZQ-016)the Key Basic Research Projects of the Foundation Strengthening Plan(2022-JCJQZD-096-00)+2 种基金the National Key Research and Development Program of China(2022YFA1104604)the National Natural Science Foundation of China(32000969)the Key Support Program for Growth Factor Research(SZYZ-TR-03).
文摘Dear Editor,Three dimensional(3D)bioprinted extracellular matrix(ECM)can be used to provide both biochemical and biophysical cues to direct mesenchymal stem cells(MSCs)differentiation,and then differentiated cells were isolated for implantation in vivo using surgical procedures.However,the reduced cell activity after cell isolation from 3D constructs and low cell retention in injured sites limit its application[1].Methacrylated gelatin(GelMA)hydrogel has the advantage of fast crosslinking,which could resemble complex architectures of tissue construct in vivo[2].Here,we adopted a noninvasive bioprinting procedure to imitate the regenerative microenvironment that could simultaneously direct the sweat gland(SG)and vascular differentiation from MSCs and ultimately promote the replacement of glandular tissue in situ(Fig.1a).
基金funded by National Natural Science Foundation of China(NSFC32372350)the Knowledge Innovation Program Funding of Institute of Food Science and Technology(CAASASTIP2021-IFST)+1 种基金China Agriculture Research System(CARS-04)Agricultural Science and Technology Innovation Program of Institute of Food Science and Technology,Chinese Academy of Agricultural Sciences(CAAS-ASTIP-G2022-IFST-06).
文摘Soy polysaccharide(SP)has been reported to possess the properties of modulating gut microbiome diversity.Here,we aimed to explore the protective effects of SP against dextran sulphate sodium(DSS)-induced colitis.Pre-treatment with SP at a dosage of 400 mg/kg·day alleviated colitis symptoms,preventing the weight loss and colon shorten.SP suppressed DSS-induced inflammatory response and enhanced M1 to M2 macrophage polarization.Further investigation showed that SP significantly promoted the regeneration of crypt and the expansion of goblet cell production.In addition,bacterial 16S rRNA sequencing analysis showed that SP modulated the composition of fecal microbiota,including selectively increasing Lactobacillus relative abundance.Notably,SP treatment enriched the production of Lactobacillus-derived lactic acid,which was sensed by its specific G-protein-coupled receptor 81(Gpr81)/Wnt3/β-catenin signaling,and promoted the regeneration of intestinal stem cells.Fecal microbiome transplantation demonstrated that intestinal flora partially contributed to the beneficial effects of SP on preventing against colitis.In conclusion,SP exhibited the protective effects against colitis,which could be partly associated with modulating the composition of gut microbiota and enrichment of lactic acid.This study suggests that SP has potential to be developed as nutritional intervention to prevent colitis.
基金financially supported by the National Natural Science Foundation of China(32172897)Central Significant Changes in the Project at the Corresponding Level(Valuable Resources Capacity-Building for Sustainable Utilization of Traditional Chinese Medicine Program)(2060302)Chinese Herbal Medicine Industry Innovation Team of Shandong Province Agricultural Technology System(SDAIT-20-06)。
文摘Ulcerative colitis(UC)is a common inflammatory disease of the gastrointestinal tract.Traditional Chinese medicine(TCM)has long been used in Asia as a treatment for UC and Puerariae Radix(PR)is a reliable anti-diarrheal therapy.The aims of this study were to investigate the protective effect of PR using the dextran sulfate sodium salt(DSS)-induced UC model in mice and identify molecular mechanisms of PR action.The chemical constituents of PR via ultra-performance liquid chromatography/tandem mass spectrometry and identified potential PR and UC targets using a network pharmacology(NP)approach were obtained to guide mouse experiments.A total of 180 peaks were identified from PR including 48 flavonoids,46 organic acids,14 amino acids,8 phenols,8 carbohydrates,7 alkaloids,6 coumarins and 43 other constituents.NP results showed that caspase-1 was the most dysregulated of the core genes associated with UC.A PR dose of 0.136 mg/g administered to DSS treated mice reversed weight loss and decreased colon lengths found in UC mice.PR also alleviated intestinal mucosal shedding,inflammatory cell infiltration and mucin loss.PR treatment suppressed upregulation of NOD-like receptor protein 3(NLRP3),cysteinyl aspartate-specific proteases-1(caspase-1),apoptosis-associated speck-like(ASC)and gasdermin D(GSDMD)at both the protein and m RNA expression levels.The addition of a small molecule dual-specificity phosphatase inhibitor NSC 95397 inhibited the positive effects of PR.These results indicated that PR exerts a protective effect on DSS-induced colitis by inhibiting NLRP3 inflammasome activation in mice.
基金Supported by Creativity and Innovation Training Program of Second Military Medical University(ZD2010009)
文摘Assessment of digestion colonic flora lactulose can be induced to produce hydrogen and prove lactulose with a potential anti-inflammatory effects. Methods： We established a mouse model of human ulcerative colitis （UC） by supplying mice with water containing dextran sulfate sodium （DSS）. At 7-day, DSS-induced pathogenic outcomes, including loss of body weight, increase of colitis score, pathogenic shortening of colon length, elevated level of TNF-ct, IL-lβ, malondialdehyde （MDA） and myeloperoxidase （MPO） deficiency in colon lesions, were significantly suppressed by lactulose administration and intraperitoneally injected hydrogen water. Results： After eliminating colon microflora by antibiotics, the anti-inflammatory effects of lactulose were significantly compromised. Histological analysis also revealed that the DSS mediated colonic tissue destruction accompanied by neutrophils infiltration was remarkably suppressed by lactulose and hydrogen water. Conclusion：The present study indicated that lactulose can prevent the development of DSS-induced colitis and alleviate oxidative stress state in colitis.
文摘To find out the normal lumbar facet joints between 13 and 18 years old,in order to provide anatomical basis for early diagnosis and therapy of lumbar disc herniation.CT imagings of 32 subjects with lumbar disc herniation aged from 13 to 18 years old in Inner Mongolia have been collected as the ALDH group,and 62 healthy subjects in the equal period had been chosen as the normal group.Continuous scanning lumbar tomography pix were imported into Mimics 21.0 for evaluation and size in DICOM format.
文摘BACKGROUND:This study aimed to establish an eff ective nomogram to predict the survival of heat stroke(HS)based on risk factors.METHODS:This was a retrospective,observational multicenter cohort study.We analyzed patients diagnosed with HS,who were treated between May 1 and September 30,2018 at 15 tertiary hospitals from 11 cities in Northern China.RESULTS:Among the 175 patients,32 patients(18.29%)died before hospital discharge.After the univariate analysis,mechanical ventilation,initial mean arterial pressure<70 mmHg,maximum heart rate,lab results on day 1(white blood cell count,alanine aminotransferase,creatinine),and Glasgow admission prediction score were included in multivariate analysis.Multivariate Cox regression showed that invasive ventilation,initial mean arterial pressure<70 mmHg(1 mmHg=0.133 kPa),and Glasgow admission prediction score were independent risk factors for HS.The nomogram was established for predicting 7-d and 14-d survival in the training cohort.The nomogram exhibited a concordance index(C-index)of 0.880(95%confidence interval[95%CI]0.831-0.930)by bootstrapping validation(B=1,000).Furthermore,the nomogram performed better when predicting 14-d survival,compared to 7-d survival.The prognostic index cut-off value was set at 2.085,according to the operating characteristic curve for overall survival prediction.The model showed good calibration ability in the internal and external validation datasets.CONCLUSION:A novel nomogram,integrated with prognostic factors,was proposed;it was highly predictive of the survival in HS patients.
基金Supported by Strategic Priority Research Program of the Chinese Academy of Sciences(No.XDA02030000)National Natural Science Foundation of China(Nos.81360227 and 10875163)
文摘Graphene oxide(GO)nanosheets possess several advantages,such as a large surface,outstanding biocompatibility,and straightforward chemical modification capability.They also have great potential as a drugcarrier.In this article,we radiolabeled GO nanosheets with99mTc,which satisfies the potential needs of microSPECT imaging probes in pre-clinical and clinical research.GO nanosheets were synthesized through the modified Hummers’method,then GO nanosheets with azide group covalently functionalized in two steps were conjugated to DOTA(1,4,7,10-tetraazacyclododecane-N,N,N,N-tetraacetic acid)and functionalized with an alkynyl group by means of click chemistry.Then through the addition and reduction of technetium-99m,the99mTc-DOTA-GO were attained.DOTA-conjugated GOs with lateral dimensions of 500–600 nm were synthesized.Both atomic force microscopy(AFM)and FT-IR were performed to characterize the GO-DOTA.Labeling efficiency of GO-DOTA with99mTc was>90%and radiochemical purities were>96%with purification.We successfully synthesized graphene oxide derivatives,DOTA-conjugated GOs,via Click Chemistry,and it was labeled with99mTc for SPECT imaging.High radiolabeling efficiency makes GO nanosheets suitable platforms for future molecular imaging research.
基金supported by grants from the Natural Science Foundation of Liaoning Province(No.2023-MS-268)Educational Committee Foundation of Liaoning Province(LJKZ0868)+1 种基金Funds for young and middle-aged disciplinary backbones of the Second Hospital of Dalian Medical University(No.dy2yxkgg 202002)partially supported by United Fund of the Second Hospital of Dalian Medical University and Dalian Institute of Chemical physics Chinese Academy of Sciences(No.UF-QN-202005).
文摘BACKGROUND Myocardial ischemia-reperfusion(I/R) is a serious and irreversible injury. Bone marrow-derived mesenchymal stem cells(MSCs) is considered to be a potential therapy for I/R injury due to the paracrine effects. High-mobility group box1(HMGB1) is a novel mediator in MSC and regulates the response of inflammation injury. Signal Transduction and Transcription Activator 3(STAT3) is a critical transcription factor and important for release of paracrine factors. However, the relationship between HMGB1 and STAT3 in paracrine effect of MSC remains unknown.METHODS In vitro, hypoxia/reoxygenation injury model was established by Anaero Pack System and examined by Annexin V flow cytometry, CCK8 assay and morphology observation. Detection of apoptotic proteins and protein expression of HMGB1and STAT3 by Western blot.RESULTS The conditioned medium of MSCs with or without LPS pretreatment was cocultured with H9C2 cells for 24 h before hypoxia treatment and MSC showed obvious cardiomyocytes protect role, as evidence by decreased apoptosis rate and improved cells viability, and LPS pretreated MSC exhibited better protect role than untreated MSC. However, such effect was abolished in HMGB1 deficiency group, silencing HMGB1 decreased the secretion of vascular endothelial growth factor(VEGF), hepatocyte growth factor(HGF), insulin growth factor(IGF), cell viability, and the expression of STAT3. Furthermore, STAT3 silence attenuated the protective effect of LPS in MSC.CONCLUSIONS These findings suggested that LPS improved MSC-mediated cardiomyocytes protection by HMGB1/STAT3signaling.
文摘Collecting cervical MSCT thin layer scanning image data of 52 cases of pediatric specimen from three hospitals, and 16 cases of childpediatric specimen and using Mimics to measure morphological indicators to make statistical analysis according to side sexand age, to provide the anatomical basis for clinical diagnosis and treatment of related diseases, internal fixationmode selection, auxiliary orthopaedic equipment designing and manufacturing and so on, The width, height andlength of the C_(3)-C_(7) pedicle, lateral mass pedicle length, pedicle axis length and the interpediculate distance ofchildren aged 0-6 years showed an overall increasing trend with the increase of age, but the range of theanteroposterior cervical spinal canal diameter was different.
文摘In this study,we used micro-CT to scan hyoid specimens and observe the microscopic anatomy of the hyoid bone,study the variation of the trabecular bone inside the hyoid bone,and analyze the internal structure of the hyoid bone and possible influencing factors of related diseases.Micro-CT was used to assess 22 hyoid bones and observe changes in the internal bone trabeculae with 3D reconstructions and analyze the fine anatomical structure of the tongue bone.Micro CT images showed the microstructure of various parts of the hyoid bone.
基金the National Key Research and Development Plan of China(Technology helps Economy 20202016YFC0106300)+1 种基金the National Natural Science Foundation of China(82174230)Major Program Fund of Technical Innovation Project of Department of Science and Technology of Hubei Province(2016ACAl52).
文摘Benign prostatic hyperplasia (BPH) is highly prevalent among older men, impacting on their quality of life, sexual function, and genitourinary health, and has become an important global burden of disease. Transurethral plasmakinetic resection of prostate (TUPKP) is one of the foremost surgical procedures for the treatment of BPH. It has become well established in clinical practice with good efficacy and safety. In 2018, we issued the guideline “2018 Standard Edition”. However much new direct evidence has now emerged and this may change some of previous recommendations. The time is ripe to develop new evidence-based guidelines, so we formed a working group of clinical experts and methodologists. The steering group members posed 31 questions relevant to the management of TUPKP for BPH covering the following areas: questions relevant to the perioperative period (preoperative, intraoperative, and postoperative) of TUPKP in the treatment of BPH, postoperative complications and the level of surgeons’ surgical skill. We searched the literature for direct evidence on the management of TUPKP for BPH, and assessed its certainty generated recommendations using the grade criteria by the European Association of Urology. Recommendations were either strong or weak, or in the form of an ungraded consensus-based statement. Finally, we issued 36 statements. Among them, 23 carried strong recommendations, and 13 carried weak recommendations for the stated procedure. They covered questions relevant to the aforementioned three areas. The preoperative period for TUPKP in the treatment of BPH included indications and contraindications for TUPKP, precautions for preoperative preparation in patients with renal impairment and urinary tract infection due to urinary retention, and preoperative prophylactic use of antibiotics. Questions relevant to the intraoperative period incorporated surgical operation techniques and prevention and management of bladder explosion. The application to different populations incorporating the efficacy and safety of TUPKP in the treatment of normal volume (< 80 ml) and large-volume (≥ 80 ml) BPH compared with transurethral urethral resection prostate, transurethral plasmakinetic enucleation of prostate and open prostatectomy;the efficacy and safety of TUPKP in high-risk populations and among people taking anticoagulant (antithrombotic) drugs. Questions relevant to the postoperative period incorporated the time and speed of flushing, the time indwelling catheters are needed, principles of postoperative therapeutic use of antibiotics, follow-up time and follow-up content. Questions related to complications incorporated types of complications and their incidence, postoperative leukocyturia, the treatment measures for the perforation and extravasation of the capsule, transurethral resection syndrome, postoperative bleeding, urinary catheter blockage, bladder spasm, overactive bladder, urinary incontinence, urethral stricture, rectal injury during surgery, postoperative erectile dysfunction and retrograde ejaculation. Final questions were related to surgeons’ skills when performing TUPKP for the treatment of BPH. We hope these recommendations can help support healthcare workers caring for patients having TUPKP for the treatment of BPH.
基金supported by Improving the Ability of Diagnosis and Treatment of Difficult Diseases (ZLYNXM202009)。
文摘Granulomatous lobular mastitis(GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence.Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions,etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology.The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidencebased consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.
