Deregulated microRNA-22-3p in patients with sepsis-induced acute kidney injury serves as a new biomarker to predict disease occurrence and 28-day survival outcomes

Background

Acute kidney injury (AKI) is a common and serious complication of sepsis. MicroRNA-22-3p (miR-22-3p) has been found to be involved in septic AKI progression. The purpose of this study was to analyze both the serum and urinary expression of miR-22-3p in septic AKI patients, and evaluated the clinical value of miR-22-3p in the diagnosis and prognosis of sepsis-induced AKI.

Methods

Serum and urinary expression of miR-22-3p was examined using qRT-PCR. The risk factors related with septic AKI onset were assessed using logistic analysis. A receiver-operating characteristic (ROC) curve was constructed to evaluate the diagnostic performance of miR-22-3p, and the Kaplan–Meier survival curves and Cox regression analysis were used to evaluate the predictive value of miR-22-3p for the 28-day survival of septic AKI patients.

Results

Both serum and urinary miR-22-3p expression was decreased and negatively correlated with kidney injury biomarkers in septic AKI patients. MiR-22-3p expression was a risk factor for AKI onset and had diagnostic accuracy in septic AKI patients. The expression of both serum and urinary miR-22-3p was lower in patients who died, and served as a prognostic biomarker to predict 28-day survival in septic AKI patients.

Conclusion

Serum and urinary miR-22-3p was reduced in sepsis-induced AKI patients, and served as a biomarker to predict AKI occurrence and 28-day survival in sepsis patients.

     

Clinicopathological patterns of bladder carcinoma over 1 year: experience from University Hospital of Nepal

Purpose

To define the clinical and pathological patterns of urinary bladder carcinoma from the University Hospital of Nepal.

Methods

This is a retrospective analytical study. Patients with bladder mass who underwent surgery over 1 year and who had data record were included in the study. Demographic profile, type of surgery, findings on clinical examination, cystoscopy findings, histopathological report, tumor stage, and post-surgery adjuvant therapy were analyzed.

Results

Out of 86 patients who underwent transurethral resection of bladder tumor, 77 patients had biopsy-proven malignant bladder tumor. Urothelial cancer was present in 96.1%. Male were 78.6%. The mean age of diagnosis was 65.5?±?11.8 years. Non-muscle-invasive bladder cancer (NMIBC) was 3.7 times more common than muscle-invasive bladder cancer (MIBC). High-grade tumors (58.6%) were more common than low grade (41.4%). The detrusor muscle was present inthe biopsy specimen of 48 patients (64%). Re-TURBT within 2–6 weeks was considered based on histopathology reports for about half of the patients (45.3%). Upstaging and upgrading of the tumor was present in 5.8 and 5.8% of the patients, respectively. Residual tumor without upstaging and upgrading was present in 23.5%. One patient (1.3%) had Clavien–Dindo grade 1, three (4%) patients had grade 2 and two patients (2.7%) had grade 3b.

Conclusion

In the present study, patients with bladder cancer are younger than reported in other studies. Smokers are strongly predisposed. The histological pattern is similar to the Western and Asian populations. NMIBC and MIBC occur in proportion to that described as in other studies. We had a lower rate of recurrence, upstaging and upgrading. We had a lesser rate of acceptance for radical cystectomy in our patients.

     

肾上腺淋巴管瘤的诊治分析

总结分析17例肾上腺淋巴管瘤的临床诊治经验,探讨该病的影像特点及病理类型。结果显示,肾上腺淋巴管瘤的影像学检查无特异性,表现与一般的囊肿相似,但囊腔密度略高于单纯性囊肿,部分病例囊壁可见钙化,少数可显示腺瘤样表现。本病确诊主要靠病理检查。对于肿瘤最大径≥4.0 cm、有内分泌功能、可疑恶性,或有明显临床症状者,推荐手术治疗。     

三级甲等教学医院临床护理教师培训课程的构建

目的构建临床护理教师培训课程,为提升临床护理教学效果奠定基础。方法通过文献回顾、前期调研和小组讨论的形式确定临床护理教师培训课程专家咨询表,采用Delphi法对18名三级甲等教学医院专家进行2轮咨询,以确定最终课程。结果临床护理教师培训课程包括一级指标4项(职业素质、专业能力、教学能力、科研能力)、二级指标10项、三级指标33项。2轮专家咨询的问卷回收率均为100%。专家权威系数为0.752。专家肯德尔协调系数分别为0.314、0.478(均P<0.01)。结论构建的三级甲等教学医院临床护理教师培训课程合理可靠,经临床护理教学验证后可作为临床护理教师培训课程。     

益气养阴通络方联合康复训练治疗气阴两虚型帕金森病临床研究

目的：观察自拟益气养阴通络方联合康复训练治疗气阴两虚型帕金森病（PD）的临床疗效。方法：将120例PD患者纳入研究,按随机奇偶数法分为对照组和治疗组各60例。对照组给予多巴丝肼片治疗,治疗组采用益气养阴通络方联合康复训练治疗。治疗3个月后评定2组临床疗效、颤证功能障碍积分、自主神经症状自评量表（SCOPA-AUT）评分、PD运动功能量表（MDRSPD）评分及血清神经营养因子[脑源性神经营养因子（BDNF）、胰岛素样生长因子1 (IGF-1)、人神经营养因子3 (NT-3)]水平。结果：治疗组总有效率为93.33%,高于对照组80.00%,2组比较,差异有统计学意义（P<0.05）。治疗前,2组颤证功能障碍积分比较,差异无统计学意义（P>0.05）;治疗后,2组颤证功能障碍积分均较治疗前降低（P<0.05）,且治疗组颤证功能障碍积分低于对照组（P<0.05）。治疗前,2组SCOPA-AUT、MDRSPD评分比较,差异无统计学意义（P>0.05）;治疗后,2组上述2项评分较治疗前明显降低（P<0.05）,且治疗组2项评分均低于对照组（P<0.05）...     

腰椎过伸位MRI在腰椎管狭窄诊断中的临床应用

目的：通过腰椎过伸位MRI检查,研究腰椎过伸位下椎管狭窄程度的变化,评估腰椎过伸位MRI扫描对腰椎管狭窄的诊断价值。方法：2018年9月至2020年2月,纳入26例腰椎管狭窄进行腰椎中立位和过伸位MRI扫描,男11例,女15例;年龄43~85（64.00±10.37）岁。由于6例患者在过伸位下诱发并加重了腰腿痛症状,无法采集到合格的MRI数据,最终完成检查共采集到20例患者的合格数据,采用Mimics 21.0医学图像处理软件测量腰椎管狭窄的相关诊断参数,统计分析其变化规律,评价过伸位下腰椎管的狭窄程度和神经受压情况。结果：腰椎管矢径及横截面积不随体位发生明显变化;硬膜囊矢径、盘黄间隙在过伸位时均有不同程度变小。结论：对于腰椎管狭窄的影像学诊断,腰椎过伸位MRI扫描可较好地补充常规中立位MRI检查,对腰椎管狭窄程度的临床诊断更具敏感性。     

Sediment Records of Polybrominated Diphenyl Ethers (PBDEs) from the Anhui Province Section of Yangtze River,China

This study investigated the temporal changes of PBDEs in the sediment cores from the Anhui Province section of Yangtze River (YR), China. The dramatic increase of ∑Br₃-Br₉-BDEs and BDE-209 concentrations in cores in the period of ca. 1990–2008 was consistent with the booming of regional and national production and consumption of household appliances and electronics. Following declines in BDE-209 and ∑Br₃-Br₉-BDEs concentrations can be associated with the deceasing use of legacy commercial PBDE mixtures in recent years. Compared with the different regions around the world, sediments in the YR were moderately polluted by PBDEs. The levels and the detection rates of BDE-209 were highest among the detected PBDEs single congener. The composition analysis indicated that Deca-BDE, Octa-BDE, and Penta-BDE were the dominant forms in the YR. The increasing trends of both BDE-209 and ∑Br₃-Br₉-BDEs in the YR during 1990s and 2000s largely reflected the time periods for transferring PBDE sources from the developed countries to China. TOC and finer particles were strongly correlated with distributions of PBDEs in sediments.