Background Acute kidney injury （AKI） has been recognized as a major healthcare problem affecting millions of patients worldwide.However,epidemiologic data concerning AKI in China are still lacking.The objectives of ...Background Acute kidney injury （AKI） has been recognized as a major healthcare problem affecting millions of patients worldwide.However,epidemiologic data concerning AKI in China are still lacking.The objectives of this study were to characterize AKI defined by RIFLE criteria,assess the association with hospital mortality,and evaluate the impact of AKI in the context of other risk factors.Methods This prospective multicenter observational study enrolled 3,063 consecutive patients from 1 July 2009 to 31 August 2009 in 22 ICUs across China's Mainland.We excluded patients who were admitted for less than 24 hours （n=1623）,younger than 18 years （n=127）,receiving chronic hemodialysis （n=29）,receiving renal transplantation （n=1） and unknown reasons （n=28）.There were 1255 patients in the final analysis.AKI was diagnosed and classified according to RIFLE criteria.Results There were 396 patients （31.6％） who had AKI,with RIFLE maximum class R,I,and F in 126 （10.0％）,91 （7.3％）,and 179 （14.3％） patients,respectively.Renal function deteriorated in 206 patients （16.4％）.In comparison with non AKI patients,patients in the risk class on ICU admission were more likely to progress to the injury class （odds ratio （OR） 3.564,95％ confidence interval （CI） 1.706-7.443,P =0.001],while patients in the risk class （OR 5.215,95％ CI 2.798-9.719,P ＜0.001） and injury class （OR 13.316,95％ CI 7.507-23.622,P ＜0.001） had a significantly higher probability of deteriorating into failure class.The adjusted hazard ratios for 90-day mortality were 1.884 for the risk group,3.401 for the injury group,and 5.306 for the failure group.Conclusions The prevalence of AKI was high among critically ill patients in Chinese ICUs.In comparison with non-AKI patients,patients with RIFLE class R or class I on ICU admission were more susceptibility to progression to class I or class F.The RIFLE criteria were robust and correlated well with clinical deterioration and mortality.展开更多
The effects of lodging of rice plants from 20 d after full heading to maturity on yield and grain quality were investigated with a hybrid rice combination Liangyoupeijiu and a japonica rice cultivar CY-6. The results ...The effects of lodging of rice plants from 20 d after full heading to maturity on yield and grain quality were investigated with a hybrid rice combination Liangyoupeijiu and a japonica rice cultivar CY-6. The results showed that, except for brown rice rate, almost all parameters for yield and grain quality including ratio of grain length to grain width, gelatinization temperature and gel consistency, were significantly influenced by lodging and thus deteriorated. Regression analysis suggested that, lodging one day earlier at the grain-filling stage could cause 2.66% to 2.71% of yield loss, 1.8 to 2.6 percentage points decrease of seed-setting rate, 0.26 to 0.32 g reduction of lO00-grain weight, 0.097 to 0. 155 percentage point decline of milled rice rate, as well as 0.13 to 0.27 percentage point increase of chalky grain rate, and 0.021 to 0.024 percentage point rise of protein content, and subsequently lower the eating quality.展开更多
Background: With the publication of Sepsis-3 definition, epidemiological data based on Sepsis-3 definition from middle-income countries including China are scarce, which prohibits understanding of the disease burden o...Background: With the publication of Sepsis-3 definition, epidemiological data based on Sepsis-3 definition from middle-income countries including China are scarce, which prohibits understanding of the disease burden of this newly defined syndrome in these settings. The purpose of this study was to describe incidence and outcome of Sepsis-3 in Yuetan sub-district of Beijing and to estimate the incidence rate of Sepsis-3 in China. Methods: The medical records of all adult residents hospitalized from July 1, 2012 to June 30, 2014 in Yuetan sub-district of Beijing were reviewed. Patients with sepsis-3 and severe sepsis/septic shock were identified. The incidence rates and mortality rate of sepsis-3 and sepsis/septic shock were calculated, incidence rates and in-hospital mortality rates were normalized to the population distribution in the 2010 National Census. Population incidence rate and case fatality rate between sexes were compared with the Z test, as the data conformed to Poisson distribution. Results: Of the 21,191 hospitalized patients, 935 patients were diagnosed with Sepsis-3, and 498 cases met severe sepsis/septic shock criteria. The crude annual incidence rate of Sepsis-3 in Yuetan sub-district was 363 cases per 100,000 population, corresponding to standardized incidence rates of 236 cases per 100,000 population per year, respectively. The overall case fatality rate of Sepsis-3 was 32.0%, the crude population mortality rates of Sepsis-3 was 116 cases per 100,000 population per year, the standardized mortality rate was 67 cases per 100,000 population per year, corresponding to a speculative extrapolation of 700,437 deaths in China. The incidence rate and mortality rate of Sepsis-3 were significantly higher in males, elderly people, and patients with more comorbidities. The 62.1% of patients with Sepsis-3 had community-acquired infections, compared with 75.3% of infected patients without Sepsis-3 (P < 0.001). The most common infection in patients with Sepsis-3 was lower respiratory tract infection. When comp展开更多
Background Interleukin （IL）-33 is a recently identified member of the IL-1 family that binds to the receptor, ST2L. This study examined IL-33 production in mouse liver and investigated its role in hepatic ischemia/r...Background Interleukin （IL）-33 is a recently identified member of the IL-1 family that binds to the receptor, ST2L. This study examined IL-33 production in mouse liver and investigated its role in hepatic ischemia/reperfusion （I/R） injury. Methods Male BALB/c mice （（22＋3） g） were subjected to 90 minutes partial hepatic ischemia, followed by 6 hours reperfusion. First, mice were randomized into two groups： control group （laparotomy only, without blocking blood supply） and ischemia model group. IL-33 mRNA and serum protein levels were measured at 30, 60, 90 minutes after ischemia and 2 and 6 hours after reperfusion. Second, mice were randomized into four groups： control, model （injection of rabbit IgG polyclonal antibody）, recombinant IL-33 intervention and anti-ST2L antibody intervention group. Mice were sacrificed 6 hours after reperfusion. Liver pathology was observed via transmission electron microscopy. Serum aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, IL-4, IL-5, IL-13, interferon-y （IFN-y） and tumor necrosis factor-a （TNF-a） levels were measured. Results Levels of IL-33 mRNA and protein did not change during ischemia （P 〉0.05） but increased significantly during reperfusion （P 〈0.05）. After reperfusion for 6 hours, serum levels of ALT, AST, IL-4, IL-5, IL-13, IFN-~ and TNF-a were significantly increased （P 〈0.05）, and hepatocellular ultrastructure was damaged. Pretreatment with IL-33 attenuated severity of liver damage compared with controls, but pretreatment with anti-ST2L antibody increased severity. Serum levels of IL-4, IL-5 and IL-13 protein increased whereas IFN-y decreased following IL-33 pretreatment. Pretreatment with anti-ST2L antibody significantly decreased serum IL-4, IL-5, IL-13 levels and increased serum IFN-r levels compared with controls （P 〈0.05）. There was no change in the level of TNF-a. Conclusion IL-33 is produced systematically and locally in liver during I/R injury. Pretreatment with IL-33 is th展开更多
Background Cervical keratinocytes are recovered at a low numbers and frequently associated with contaminating human fibroblasts which rapidly overgrow the epithelial cells in culture with medium supplemented with 10% ...Background Cervical keratinocytes are recovered at a low numbers and frequently associated with contaminating human fibroblasts which rapidly overgrow the epithelial cells in culture with medium supplemented with 10% fetal bovine serum （FBS）. However, it is difficult to initiate keratinocyte cultures with serum-free keratinocyte growth medium alone because cell attachment can be poor. Therefore, the culture of these cells is extremely difficult. In this study, we described a modified culture medium and coated culture plastics for growing normal human cervical epithelial cells in vitro. Methods Normal cervical epithelial tissue pieces were obtained and digested with type I collagenase to dissociate the cells and a single cell suspension produced. The cells were cultured on plastic tissue culture substrate alone or substrate coated with collagen type I from rat tail, with modified keratinocyte serum-free medium （K-SFM） supplemented with 5% FBS. After attachment, the medium were replaced with K-SFM without FBS. The expression of basal keratins of the ectocervical epithelium, K5, K14 and K19 were assayed by immunofluorescence with monoclonal antibodies to identify the cell purity. Results Our results indicate that cells attached to the culture plastic more quickly in K-SFM supplemented with 5% FBS than in K-SFM alone, as well as to tissue culture plastic coated with collagen type I than plastic alone. The modified medium composed of K-SFM and 5% FBS combined with a specific tissue culture plastic coated with collagen type I from rat tail was the best method for culture of normal cervical epithelial cells. K5, K14 and K19 were assayed and keratinocyte purity was nearly 100%. Conclusion A novel, simple and effective method can be used to rapidly obtain highly purified keratinocytes from normal human cervical epithelium.展开更多
Background： The antibiotic meropenem is commonly administered pharmacokinetic, clinical, and bacteriological efficacies of continuous patients. n patients with severe sepsis and septic shock. We compared the infusion...Background： The antibiotic meropenem is commonly administered pharmacokinetic, clinical, and bacteriological efficacies of continuous patients. n patients with severe sepsis and septic shock. We compared the infusion of meropenem versus internaittent administration in such Methods： Patients admitted to the Intensive Care Unit （ICU） with severe sepsis or septic shock who received meropenem were randomly assigned to either the continuous （n = 25） or intermittent groups 01 = 25）. The continuous group received a loading dose of 0.5 g of meropenem lbllowed by a continuous infusion of 3 g/day： the intermittent group received an initial dose of 1.5 g lbllowed by 1 g lbr every 8 h. Clinical success, microbiological eradication, superinfection, ICU mortality, length of ICU stay, and duration of meropenem treatment were assessed. Serial plasma meropenem concentrations tbr the first and third dosing periods （steady state） were also measured. Results： Clinical success was similar in both the continuous （64%） and intermittent （56%） groups （P = 0.564）： the rates of microbiological eradication and superinfection （81.8% vs. 66.7% [P = 0.255] and 4% vs. 16% [P 0.157], respectively） showed improvement in the continuous group. The duration of meropenem treatment was significantly shorter in the continuous group （7.6 vs. 9.4 days; P = 0.035）, where a better steady-state concentration was also achieved. Peak and trough concentrations were significantly different between the continuous and intermittent groups both in the first （Cmax： 19.8 mg/L vs. 51.8 mg/L, P = 0.000; Cmin： 11.2 mg/L vs. 0.5 nag/L, P = 0.000） and third dosing periods （Cmax： 12.5 mg/L vs. 46.4 rag/L, P = 0.000; Cmin： 11.4 mg/L vs. 0.6 rag/L, P = 0.000）. For medium-susceptibility pathogens, continuous inthsion concentrations above the minimal inhibitory concentration were 100%, which was better than that in the intermittent group- Conclusions： Continuous infusion of meropenem provides significantly shorter t展开更多
Background::Recently,T-helper 17(Th17)cells have been proved to play an important role in promoting cervical cancer.But,till now,few study has been carried out to understand the involvement of these cells in efficacy ...Background::Recently,T-helper 17(Th17)cells have been proved to play an important role in promoting cervical cancer.But,till now,few study has been carried out to understand the involvement of these cells in efficacy of anti-tumor treatments.This study aimed to investigate the alterations in the percentage of circulating Th17 cells and related cytokines in locally advanced cervical cancer(LACC)patients before and after concurrent chemoradiotherapy(cCRT)and to analyze the correlations between the alterations in Th17 cells and treatment efficacy.Methods::A prospective study with 49 LACC(International federation of gynecology and obstetrics[FIGO]stage IIB-IIIB)patients and 23 controls was conducted.Patients received the same cCRT schedule and were followed up for 3 years.Circulating Th17 cells(CD3+CD8-interleukin[IL]-17+T cells)and related cytokines IL-17,transforming growth factor-β(TGF-β),IL-10,IL-23,IL-6,and IL-22 were detected before and after cCRT.Correlations between alterations of circulating Th17 cells and treatment efficacy were analyzed.Kaplan-Meier analysis was used for overall survival(OS)and progression-free survival(PFS).Results::We found that 40 patients finished the entire cCRT schedule and met the endpoint of this study.The percentage of circulating Th17 cells in the LACC patients was higher than that in the controls,and it significantly decreased after cCRT(P<0.05).After cCRT,patients were divided into two groups based on the average of the Th17 cells declined.The subgroup of patients with a prominent decrease in circulating Th17 cells after cCRT had a higher treatment efficacy and longer PFS and OS times.Compared with the control patients,LACC patients had higher IL-6,IL-10,IL-22,TGF-βlevels and a lower IL-23 level(P<0.05).After cCRT,IL-6,IL-10,IL-17,IL-23 level significantly increased and TGF-βlevel significantly decreased compared with the levels before cCRT(P<0.05).Conclusion::Circulating Th17 cells in the LACC patients(FIGO stage IIB-IIIB)were higher than those in the controls,but they gen展开更多
Objective:To analysis the clinical curative effect on bladder function recovery after radical hysterectomy with acupuncture and acu-physiotherapy.Methods:A total of 564 cervical cancer patients in the gynecology depar...Objective:To analysis the clinical curative effect on bladder function recovery after radical hysterectomy with acupuncture and acu-physiotherapy.Methods:A total of 564 cervical cancer patients in the gynecology department who received radical hysterectomy from January 2011 to December 2017 in Qilu Hospital of Shandong University were collected.According to the inclusion and exclusion criteria,we studied 360 case records at last,with 120 cases respectively.Patients got treatment of acupuncture[acupuncture at Zhongwan(中脘CV12),Tianshu(天枢ST25),Shuidao(水道ST28),TAichong(太冲LI3),Sanyinjiao(三阴交SP6),Zusanli(足三里ST36)and Yinlingquan(阴陵泉SP9)],or acu-physiotherapy with two large-size electrodes placed on the bladder area above the pubic symphysis besides acupuncture,from the 3 rd day after operation once a day till the14 th day that removing the indwelling catheter.And the blank group got no other auxiliary treatment except scrubbed the meatus orifice with iodophor twice a day.We tested the residual urine volume 6 h later after removement of indwelling catheter.Residual urine volume more than 100 mL was defined as urinary retention,and the volume less than 50 mL was defined as adequate bladder emptying.Results:We analyzed patients’age,the International Federation of Gynecology and Obstetrics(FIGO)stage,operation duration,amount of hemorrhage,depth of myometrium infiltration,cancer embolus,parametrium invasion,lymphatic metastasis,treating methods and residual urine volume recorded in case records,and there was no significant difference between every two groups(P>0.05).The incidences of urinary retention of the acupuncture group,the acu-physiotherapy group and the blank group were 24.17%,21.67%,and 44.17%,indicating that both treating methods have significant effects(P<0.05),and acupuncture group was a little better than acu-physiotherapy group.The bladder function recovery rates of the 3 groups were 44.17%,56.67%,and 40.83%correspondingly,which had significant difference between acu-physiot展开更多
Background： Urine output （UO） is an essential criterion of the Kidney Disease Improving Global Outcomes （KD1GO） definition and classification system tbr acute kidney injury （AKI）, of which the diagnostic value ...Background： Urine output （UO） is an essential criterion of the Kidney Disease Improving Global Outcomes （KD1GO） definition and classification system tbr acute kidney injury （AKI）, of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria （KDtGOLro） could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria （KDIGOscr）.Methods： We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group （CCCCTG）, which was a 2-month prospective cohort study （July 1,2009 to August 31,2009） involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGOt,o and KDlGOsc,. Hospital mortality of patients with more severe AKI classification based on KDIGOvo was compared with other patients by univariate and multivariate regression analyses. Results： The prevalence of AKl increased from 52.4% based on KDIGOscr to 55.4% based on KD1GOsc~ combined with KDIGOuo. KDIGOv~~ also restllted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AK1 classification based on KDIGOvo. Compared with non-AKI patients or those with maximum AKI classification by KDIGOscr, those with maximum AKI classification by KDIGOuo had a significantly higher hospital mortality of 58.4% （odds ratio [OR]： 7.580, 95% confidence interval [CI]： 4.141-13.873, P 〈 0.001）. In a multivariate logistic regression analysis, AKI based on KDIGOuo （OR： 2.891, 95% CI： 1.964-4.254, P 〈 0.001）, but not based on KDIGOscr （OR： 1.322, 95% CI： 0.902-1.939, P = 0.152）, was an independent risk factor for hospital mortality. Conclusion： UO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.展开更多
Over the past two years, an abnormal growth phenomenon Jiangsu Province of China. The phenomenon is described in called shrunk-grain panicle has occurred in a large area in details by figures and characters in this ar...Over the past two years, an abnormal growth phenomenon Jiangsu Province of China. The phenomenon is described in called shrunk-grain panicle has occurred in a large area in details by figures and characters in this article. The method with a japonica rice Wuyujing 3 as the experimental material, the characteristics of grain morphology distribution and the grain weight were studied. Normal and shrunk-grain panicles were sampled from several representative areas. The length, width, and weight of the normal grains were distributed as regular, continuous, and single peaks. Plant growth typically had a right-leaning tendency. On the contrary, the distribution of the grain morphology and weight were irregular and nearly double that of the shrunk-grain panicle. The proportion of the cumulative distribution in the two kinds of peaks was closely related to the degree of shrunk-grain panicle. The article discusses the phenomenon＇s symptoms, problems, and diagnosis.展开更多
Without adequate fluid replacement, patients with sepsis often experienced serious hypovolemiadue to fever, vomiting, or diarrhea before admission. To make things worse, relative and absolute intravascular volume defi...Without adequate fluid replacement, patients with sepsis often experienced serious hypovolemiadue to fever, vomiting, or diarrhea before admission. To make things worse, relative and absolute intravascular volume deficits could be exacerbated by sepsis-induced vasodilation, increased microvascular permeability and abnormal distribution of blood flow.1 Consequently, it led to poor tissue perfusion and facilitated the development of multiple organ failure. Therefore, fluid resuscitation is crucial for initial management of severe sepsis, by which the restoration and maintenance of adequate intravascular volume contribute greatly to hemodynamic stability, and attenuate poor perfusion-caused organ injuries. However, the choice of fluid remains controversial.展开更多
BACKGROUND Primary peritoneal cancer(PPC)patients with BRCA mutations have a good prognosis;however,for patients with BRCA mutations who are diagnosed with PPC after prophylactic salpingo-oophorectomy(PSO),the prognos...BACKGROUND Primary peritoneal cancer(PPC)patients with BRCA mutations have a good prognosis;however,for patients with BRCA mutations who are diagnosed with PPC after prophylactic salpingo-oophorectomy(PSO),the prognosis is poor,and survival information is scarce.CASE SUMMARY We treated a 56-year-old woman with PPC after bilateral mastectomy,hysterectomy,and bilateral salpingo-oophorectomy.This patient had primary drug resistance and died 12 mo after the diagnosis of PPC.The genetic test performed on this patient indicated the presence of a germline BRCA1 mutation.We searched the PubMed,Scopus,and Cochrane databases and extracted studies of patients with BRCA mutations who developed PPC after PSO.After a detailed literature search,we found 30 cases,7 of which had a history of breast cancer,14 of which had no history of breast cancer,and 9 of which had an unknown history.The average age of PSO patients was 48.86 years old(range,31-64 years).The average time interval between the diagnosis of PPC and preventive surgery was 61.03 mo(range,12-292 mo).The 2-year survival rate for this patient population was 78.26%(18/23),the 3-year survival rate was 50.00%(9/18),and the 5-year survival rate was 6.25%(1/16).CONCLUSION Patients with BRCA mutations who are diagnosed with PPC after preventative surgery have a poor prognosis.Prevention measures and treatments for these patients need more attention.展开更多
目的探讨微创加压螺钉固定术不同入路治疗腕舟骨骨折的疗效及安全性。方法前瞻性选取2011年1月—2016年1月上海中冶医院确诊并微创加压螺钉固定术治疗的腕舟骨骨折患者50例,依据入路方法分为背侧入路组和掌侧入路组,每组25例。采用改良M...目的探讨微创加压螺钉固定术不同入路治疗腕舟骨骨折的疗效及安全性。方法前瞻性选取2011年1月—2016年1月上海中冶医院确诊并微创加压螺钉固定术治疗的腕舟骨骨折患者50例,依据入路方法分为背侧入路组和掌侧入路组,每组25例。采用改良Mayo腕关节功能评分法(Mayo)得分评估腕功能,电话和复诊随访12个月,统计分析所有患者术中出血量、手术时间、骨性愈合时间、并发症和术后6、12个月腕功能情况。结果掌侧入路组与背侧入路组术中出血量(16.47±3.01)m L vs.(22.87±3.11)m L、并发症发生率(6.00%vs.32.00%)、骨性愈合时间(8.97±0.95)个月vs.(9.74±1.04)个月,掌侧入路组明显低于背侧入路组;掌侧入路组与背侧入路组手术时间(35.87±6.54)min vs.(30.48±5.98)min、术后6个月Mayo得分(85.76±8.24)分vs.(76.24±7.94)分、腕功能优良率(84.00%vs.56.00%),掌侧入路组明显高于背侧入路组,差异有统计学意义(P<0.05);但背侧入路组和掌侧入路组术后12个月Mayo得分(96.65±6.21)分vs.(95.94±6.17)分、腕功能优良率(96.00%vs.92.00%)基本相同,差异无统计学意义(P>0.05)。结论与背侧入路比较,掌侧入路可有效提高微创加压螺钉固定术治疗腕舟骨骨折的安全性,有利于改善患者骨性愈合和近期疗效,值得临床进一步推广。展开更多
文摘Background Acute kidney injury （AKI） has been recognized as a major healthcare problem affecting millions of patients worldwide.However,epidemiologic data concerning AKI in China are still lacking.The objectives of this study were to characterize AKI defined by RIFLE criteria,assess the association with hospital mortality,and evaluate the impact of AKI in the context of other risk factors.Methods This prospective multicenter observational study enrolled 3,063 consecutive patients from 1 July 2009 to 31 August 2009 in 22 ICUs across China's Mainland.We excluded patients who were admitted for less than 24 hours （n=1623）,younger than 18 years （n=127）,receiving chronic hemodialysis （n=29）,receiving renal transplantation （n=1） and unknown reasons （n=28）.There were 1255 patients in the final analysis.AKI was diagnosed and classified according to RIFLE criteria.Results There were 396 patients （31.6％） who had AKI,with RIFLE maximum class R,I,and F in 126 （10.0％）,91 （7.3％）,and 179 （14.3％） patients,respectively.Renal function deteriorated in 206 patients （16.4％）.In comparison with non AKI patients,patients in the risk class on ICU admission were more likely to progress to the injury class （odds ratio （OR） 3.564,95％ confidence interval （CI） 1.706-7.443,P =0.001],while patients in the risk class （OR 5.215,95％ CI 2.798-9.719,P ＜0.001） and injury class （OR 13.316,95％ CI 7.507-23.622,P ＜0.001） had a significantly higher probability of deteriorating into failure class.The adjusted hazard ratios for 90-day mortality were 1.884 for the risk group,3.401 for the injury group,and 5.306 for the failure group.Conclusions The prevalence of AKI was high among critically ill patients in Chinese ICUs.In comparison with non-AKI patients,patients with RIFLE class R or class I on ICU admission were more susceptibility to progression to class I or class F.The RIFLE criteria were robust and correlated well with clinical deterioration and mortality.
基金supported by the Independent Innovation Program of Agricultural Science and Technology in Jiangsu Province,China (Grant No.CX(10)226)
文摘The effects of lodging of rice plants from 20 d after full heading to maturity on yield and grain quality were investigated with a hybrid rice combination Liangyoupeijiu and a japonica rice cultivar CY-6. The results showed that, except for brown rice rate, almost all parameters for yield and grain quality including ratio of grain length to grain width, gelatinization temperature and gel consistency, were significantly influenced by lodging and thus deteriorated. Regression analysis suggested that, lodging one day earlier at the grain-filling stage could cause 2.66% to 2.71% of yield loss, 1.8 to 2.6 percentage points decrease of seed-setting rate, 0.26 to 0.32 g reduction of lO00-grain weight, 0.097 to 0. 155 percentage point decline of milled rice rate, as well as 0.13 to 0.27 percentage point increase of chalky grain rate, and 0.021 to 0.024 percentage point rise of protein content, and subsequently lower the eating quality.
文摘Background: With the publication of Sepsis-3 definition, epidemiological data based on Sepsis-3 definition from middle-income countries including China are scarce, which prohibits understanding of the disease burden of this newly defined syndrome in these settings. The purpose of this study was to describe incidence and outcome of Sepsis-3 in Yuetan sub-district of Beijing and to estimate the incidence rate of Sepsis-3 in China. Methods: The medical records of all adult residents hospitalized from July 1, 2012 to June 30, 2014 in Yuetan sub-district of Beijing were reviewed. Patients with sepsis-3 and severe sepsis/septic shock were identified. The incidence rates and mortality rate of sepsis-3 and sepsis/septic shock were calculated, incidence rates and in-hospital mortality rates were normalized to the population distribution in the 2010 National Census. Population incidence rate and case fatality rate between sexes were compared with the Z test, as the data conformed to Poisson distribution. Results: Of the 21,191 hospitalized patients, 935 patients were diagnosed with Sepsis-3, and 498 cases met severe sepsis/septic shock criteria. The crude annual incidence rate of Sepsis-3 in Yuetan sub-district was 363 cases per 100,000 population, corresponding to standardized incidence rates of 236 cases per 100,000 population per year, respectively. The overall case fatality rate of Sepsis-3 was 32.0%, the crude population mortality rates of Sepsis-3 was 116 cases per 100,000 population per year, the standardized mortality rate was 67 cases per 100,000 population per year, corresponding to a speculative extrapolation of 700,437 deaths in China. The incidence rate and mortality rate of Sepsis-3 were significantly higher in males, elderly people, and patients with more comorbidities. The 62.1% of patients with Sepsis-3 had community-acquired infections, compared with 75.3% of infected patients without Sepsis-3 (P < 0.001). The most common infection in patients with Sepsis-3 was lower respiratory tract infection. When comp
文摘Background Interleukin （IL）-33 is a recently identified member of the IL-1 family that binds to the receptor, ST2L. This study examined IL-33 production in mouse liver and investigated its role in hepatic ischemia/reperfusion （I/R） injury. Methods Male BALB/c mice （（22＋3） g） were subjected to 90 minutes partial hepatic ischemia, followed by 6 hours reperfusion. First, mice were randomized into two groups： control group （laparotomy only, without blocking blood supply） and ischemia model group. IL-33 mRNA and serum protein levels were measured at 30, 60, 90 minutes after ischemia and 2 and 6 hours after reperfusion. Second, mice were randomized into four groups： control, model （injection of rabbit IgG polyclonal antibody）, recombinant IL-33 intervention and anti-ST2L antibody intervention group. Mice were sacrificed 6 hours after reperfusion. Liver pathology was observed via transmission electron microscopy. Serum aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, IL-4, IL-5, IL-13, interferon-y （IFN-y） and tumor necrosis factor-a （TNF-a） levels were measured. Results Levels of IL-33 mRNA and protein did not change during ischemia （P 〉0.05） but increased significantly during reperfusion （P 〈0.05）. After reperfusion for 6 hours, serum levels of ALT, AST, IL-4, IL-5, IL-13, IFN-~ and TNF-a were significantly increased （P 〈0.05）, and hepatocellular ultrastructure was damaged. Pretreatment with IL-33 attenuated severity of liver damage compared with controls, but pretreatment with anti-ST2L antibody increased severity. Serum levels of IL-4, IL-5 and IL-13 protein increased whereas IFN-y decreased following IL-33 pretreatment. Pretreatment with anti-ST2L antibody significantly decreased serum IL-4, IL-5, IL-13 levels and increased serum IFN-r levels compared with controls （P 〈0.05）. There was no change in the level of TNF-a. Conclusion IL-33 is produced systematically and locally in liver during I/R injury. Pretreatment with IL-33 is th
基金This study was supported by a grant from the National Natural Science Foundation of China （No. 81072122）.
文摘Background Cervical keratinocytes are recovered at a low numbers and frequently associated with contaminating human fibroblasts which rapidly overgrow the epithelial cells in culture with medium supplemented with 10% fetal bovine serum （FBS）. However, it is difficult to initiate keratinocyte cultures with serum-free keratinocyte growth medium alone because cell attachment can be poor. Therefore, the culture of these cells is extremely difficult. In this study, we described a modified culture medium and coated culture plastics for growing normal human cervical epithelial cells in vitro. Methods Normal cervical epithelial tissue pieces were obtained and digested with type I collagenase to dissociate the cells and a single cell suspension produced. The cells were cultured on plastic tissue culture substrate alone or substrate coated with collagen type I from rat tail, with modified keratinocyte serum-free medium （K-SFM） supplemented with 5% FBS. After attachment, the medium were replaced with K-SFM without FBS. The expression of basal keratins of the ectocervical epithelium, K5, K14 and K19 were assayed by immunofluorescence with monoclonal antibodies to identify the cell purity. Results Our results indicate that cells attached to the culture plastic more quickly in K-SFM supplemented with 5% FBS than in K-SFM alone, as well as to tissue culture plastic coated with collagen type I than plastic alone. The modified medium composed of K-SFM and 5% FBS combined with a specific tissue culture plastic coated with collagen type I from rat tail was the best method for culture of normal cervical epithelial cells. K5, K14 and K19 were assayed and keratinocyte purity was nearly 100%. Conclusion A novel, simple and effective method can be used to rapidly obtain highly purified keratinocytes from normal human cervical epithelium.
文摘Background： The antibiotic meropenem is commonly administered pharmacokinetic, clinical, and bacteriological efficacies of continuous patients. n patients with severe sepsis and septic shock. We compared the infusion of meropenem versus internaittent administration in such Methods： Patients admitted to the Intensive Care Unit （ICU） with severe sepsis or septic shock who received meropenem were randomly assigned to either the continuous （n = 25） or intermittent groups 01 = 25）. The continuous group received a loading dose of 0.5 g of meropenem lbllowed by a continuous infusion of 3 g/day： the intermittent group received an initial dose of 1.5 g lbllowed by 1 g lbr every 8 h. Clinical success, microbiological eradication, superinfection, ICU mortality, length of ICU stay, and duration of meropenem treatment were assessed. Serial plasma meropenem concentrations tbr the first and third dosing periods （steady state） were also measured. Results： Clinical success was similar in both the continuous （64%） and intermittent （56%） groups （P = 0.564）： the rates of microbiological eradication and superinfection （81.8% vs. 66.7% [P = 0.255] and 4% vs. 16% [P 0.157], respectively） showed improvement in the continuous group. The duration of meropenem treatment was significantly shorter in the continuous group （7.6 vs. 9.4 days; P = 0.035）, where a better steady-state concentration was also achieved. Peak and trough concentrations were significantly different between the continuous and intermittent groups both in the first （Cmax： 19.8 mg/L vs. 51.8 mg/L, P = 0.000; Cmin： 11.2 mg/L vs. 0.5 nag/L, P = 0.000） and third dosing periods （Cmax： 12.5 mg/L vs. 46.4 rag/L, P = 0.000; Cmin： 11.4 mg/L vs. 0.6 rag/L, P = 0.000）. For medium-susceptibility pathogens, continuous inthsion concentrations above the minimal inhibitory concentration were 100%, which was better than that in the intermittent group- Conclusions： Continuous infusion of meropenem provides significantly shorter t
基金the National Key Research and Development Program of China(No:2016YFC1302904)the National Natural Science Foundation of China(No:81572559)the Key Research Project of Shandong Province(No:2017CXGC1210).
文摘Background::Recently,T-helper 17(Th17)cells have been proved to play an important role in promoting cervical cancer.But,till now,few study has been carried out to understand the involvement of these cells in efficacy of anti-tumor treatments.This study aimed to investigate the alterations in the percentage of circulating Th17 cells and related cytokines in locally advanced cervical cancer(LACC)patients before and after concurrent chemoradiotherapy(cCRT)and to analyze the correlations between the alterations in Th17 cells and treatment efficacy.Methods::A prospective study with 49 LACC(International federation of gynecology and obstetrics[FIGO]stage IIB-IIIB)patients and 23 controls was conducted.Patients received the same cCRT schedule and were followed up for 3 years.Circulating Th17 cells(CD3+CD8-interleukin[IL]-17+T cells)and related cytokines IL-17,transforming growth factor-β(TGF-β),IL-10,IL-23,IL-6,and IL-22 were detected before and after cCRT.Correlations between alterations of circulating Th17 cells and treatment efficacy were analyzed.Kaplan-Meier analysis was used for overall survival(OS)and progression-free survival(PFS).Results::We found that 40 patients finished the entire cCRT schedule and met the endpoint of this study.The percentage of circulating Th17 cells in the LACC patients was higher than that in the controls,and it significantly decreased after cCRT(P<0.05).After cCRT,patients were divided into two groups based on the average of the Th17 cells declined.The subgroup of patients with a prominent decrease in circulating Th17 cells after cCRT had a higher treatment efficacy and longer PFS and OS times.Compared with the control patients,LACC patients had higher IL-6,IL-10,IL-22,TGF-βlevels and a lower IL-23 level(P<0.05).After cCRT,IL-6,IL-10,IL-17,IL-23 level significantly increased and TGF-βlevel significantly decreased compared with the levels before cCRT(P<0.05).Conclusion::Circulating Th17 cells in the LACC patients(FIGO stage IIB-IIIB)were higher than those in the controls,but they gen
文摘Objective:To analysis the clinical curative effect on bladder function recovery after radical hysterectomy with acupuncture and acu-physiotherapy.Methods:A total of 564 cervical cancer patients in the gynecology department who received radical hysterectomy from January 2011 to December 2017 in Qilu Hospital of Shandong University were collected.According to the inclusion and exclusion criteria,we studied 360 case records at last,with 120 cases respectively.Patients got treatment of acupuncture[acupuncture at Zhongwan(中脘CV12),Tianshu(天枢ST25),Shuidao(水道ST28),TAichong(太冲LI3),Sanyinjiao(三阴交SP6),Zusanli(足三里ST36)and Yinlingquan(阴陵泉SP9)],or acu-physiotherapy with two large-size electrodes placed on the bladder area above the pubic symphysis besides acupuncture,from the 3 rd day after operation once a day till the14 th day that removing the indwelling catheter.And the blank group got no other auxiliary treatment except scrubbed the meatus orifice with iodophor twice a day.We tested the residual urine volume 6 h later after removement of indwelling catheter.Residual urine volume more than 100 mL was defined as urinary retention,and the volume less than 50 mL was defined as adequate bladder emptying.Results:We analyzed patients’age,the International Federation of Gynecology and Obstetrics(FIGO)stage,operation duration,amount of hemorrhage,depth of myometrium infiltration,cancer embolus,parametrium invasion,lymphatic metastasis,treating methods and residual urine volume recorded in case records,and there was no significant difference between every two groups(P>0.05).The incidences of urinary retention of the acupuncture group,the acu-physiotherapy group and the blank group were 24.17%,21.67%,and 44.17%,indicating that both treating methods have significant effects(P<0.05),and acupuncture group was a little better than acu-physiotherapy group.The bladder function recovery rates of the 3 groups were 44.17%,56.67%,and 40.83%correspondingly,which had significant difference between acu-physiot
文摘Background： Urine output （UO） is an essential criterion of the Kidney Disease Improving Global Outcomes （KD1GO） definition and classification system tbr acute kidney injury （AKI）, of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria （KDtGOLro） could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria （KDIGOscr）.Methods： We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group （CCCCTG）, which was a 2-month prospective cohort study （July 1,2009 to August 31,2009） involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGOt,o and KDlGOsc,. Hospital mortality of patients with more severe AKI classification based on KDIGOvo was compared with other patients by univariate and multivariate regression analyses. Results： The prevalence of AKl increased from 52.4% based on KDIGOscr to 55.4% based on KD1GOsc~ combined with KDIGOuo. KDIGOv~~ also restllted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AK1 classification based on KDIGOvo. Compared with non-AKI patients or those with maximum AKI classification by KDIGOscr, those with maximum AKI classification by KDIGOuo had a significantly higher hospital mortality of 58.4% （odds ratio [OR]： 7.580, 95% confidence interval [CI]： 4.141-13.873, P 〈 0.001）. In a multivariate logistic regression analysis, AKI based on KDIGOuo （OR： 2.891, 95% CI： 1.964-4.254, P 〈 0.001）, but not based on KDIGOscr （OR： 1.322, 95% CI： 0.902-1.939, P = 0.152）, was an independent risk factor for hospital mortality. Conclusion： UO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.
文摘Over the past two years, an abnormal growth phenomenon Jiangsu Province of China. The phenomenon is described in called shrunk-grain panicle has occurred in a large area in details by figures and characters in this article. The method with a japonica rice Wuyujing 3 as the experimental material, the characteristics of grain morphology distribution and the grain weight were studied. Normal and shrunk-grain panicles were sampled from several representative areas. The length, width, and weight of the normal grains were distributed as regular, continuous, and single peaks. Plant growth typically had a right-leaning tendency. On the contrary, the distribution of the grain morphology and weight were irregular and nearly double that of the shrunk-grain panicle. The proportion of the cumulative distribution in the two kinds of peaks was closely related to the degree of shrunk-grain panicle. The article discusses the phenomenon＇s symptoms, problems, and diagnosis.
文摘Without adequate fluid replacement, patients with sepsis often experienced serious hypovolemiadue to fever, vomiting, or diarrhea before admission. To make things worse, relative and absolute intravascular volume deficits could be exacerbated by sepsis-induced vasodilation, increased microvascular permeability and abnormal distribution of blood flow.1 Consequently, it led to poor tissue perfusion and facilitated the development of multiple organ failure. Therefore, fluid resuscitation is crucial for initial management of severe sepsis, by which the restoration and maintenance of adequate intravascular volume contribute greatly to hemodynamic stability, and attenuate poor perfusion-caused organ injuries. However, the choice of fluid remains controversial.
文摘BACKGROUND Primary peritoneal cancer(PPC)patients with BRCA mutations have a good prognosis;however,for patients with BRCA mutations who are diagnosed with PPC after prophylactic salpingo-oophorectomy(PSO),the prognosis is poor,and survival information is scarce.CASE SUMMARY We treated a 56-year-old woman with PPC after bilateral mastectomy,hysterectomy,and bilateral salpingo-oophorectomy.This patient had primary drug resistance and died 12 mo after the diagnosis of PPC.The genetic test performed on this patient indicated the presence of a germline BRCA1 mutation.We searched the PubMed,Scopus,and Cochrane databases and extracted studies of patients with BRCA mutations who developed PPC after PSO.After a detailed literature search,we found 30 cases,7 of which had a history of breast cancer,14 of which had no history of breast cancer,and 9 of which had an unknown history.The average age of PSO patients was 48.86 years old(range,31-64 years).The average time interval between the diagnosis of PPC and preventive surgery was 61.03 mo(range,12-292 mo).The 2-year survival rate for this patient population was 78.26%(18/23),the 3-year survival rate was 50.00%(9/18),and the 5-year survival rate was 6.25%(1/16).CONCLUSION Patients with BRCA mutations who are diagnosed with PPC after preventative surgery have a poor prognosis.Prevention measures and treatments for these patients need more attention.
文摘目的探讨微创加压螺钉固定术不同入路治疗腕舟骨骨折的疗效及安全性。方法前瞻性选取2011年1月—2016年1月上海中冶医院确诊并微创加压螺钉固定术治疗的腕舟骨骨折患者50例,依据入路方法分为背侧入路组和掌侧入路组,每组25例。采用改良Mayo腕关节功能评分法(Mayo)得分评估腕功能,电话和复诊随访12个月,统计分析所有患者术中出血量、手术时间、骨性愈合时间、并发症和术后6、12个月腕功能情况。结果掌侧入路组与背侧入路组术中出血量(16.47±3.01)m L vs.(22.87±3.11)m L、并发症发生率(6.00%vs.32.00%)、骨性愈合时间(8.97±0.95)个月vs.(9.74±1.04)个月,掌侧入路组明显低于背侧入路组;掌侧入路组与背侧入路组手术时间(35.87±6.54)min vs.(30.48±5.98)min、术后6个月Mayo得分(85.76±8.24)分vs.(76.24±7.94)分、腕功能优良率(84.00%vs.56.00%),掌侧入路组明显高于背侧入路组,差异有统计学意义(P<0.05);但背侧入路组和掌侧入路组术后12个月Mayo得分(96.65±6.21)分vs.(95.94±6.17)分、腕功能优良率(96.00%vs.92.00%)基本相同,差异无统计学意义(P>0.05)。结论与背侧入路比较,掌侧入路可有效提高微创加压螺钉固定术治疗腕舟骨骨折的安全性,有利于改善患者骨性愈合和近期疗效,值得临床进一步推广。
