Cardiac molecular markers of programmed cell death are activated in end-stage heart failure patients supported by left ventricular assist device

BackgroundCardiomyocyte apoptosis increases in heart failure (HF) and is implicated in disease progression. The apoptotic cell is not inevitably committed to death, and appropriate therapy like left ventricular assist device (LVAD) support could offer a rescue of cellular functions. Literature data regarding the modulation of the apoptotic process during LVAD support are still controversial.MethodsTo assess whether LVAD implantation modifies the apoptotic profile in the heart, cardiac tissue was collected from end-stage HF patients before LVAD implant (pre-LVAD, n=22) and at LVAD removal (post-LVAD, n=6) and from stable HF patients on medical therapy without prior circulatory support (HTx, n=7) at heart transplantation as control. Caspase (Casp)-3, Bax, Bcl-2, and Hsp72 cardiac mRNA and protein expression were evaluated by real-time polymerase chain reaction and Western blotting (WB) in the three groups of patients. Immunohistochemical analysis, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay, and DNA laddering analysis were performed; cellular size and interstitial fibrosis content were also determined.ResultsAll the apoptotic indices were increased in the post-LVAD group compared to pre-LVAD, specially antiapoptotic Hsp72 and proapoptotic Bax (Hsp72: 3.27±0.41 vs. 0.76±0.14, P<.001; Bax: 2.15±0.38 vs. 1.10 ± 0.29, P=.035; post-LVAD vs. pre-LVAD, respectively). The significant increase in Hsp72 was confirmed by WB and immunohistochemical analysis.ConclusionLVAD appears to induce an activation of apoptotic mediators, mainly at the mitochondrial level, while the following activation of Casp-3 is reduced by the significant increase of Hsp72, whose enhancement could be an important factor in cardiac remodeling associated with LVAD support.     

床边血液灌流治疗急性有机磷农药中毒的研究分析

目的：探讨床边血液灌流治疗急性有机磷农药中毒的临床效果。方法选取本院ICU 2011年1月~2014年10月收治的急性有机磷农药中毒患者60例，随机分为实验组和对照组，对照组给予常规治疗，实验组在常规治疗的基础上加用床边血液灌流治疗，比较两组患者的昏迷时间、呼吸机脱机时间、阿托品用量、血清胆碱酯酶(CHE)恢复时间、住院时间以及并发症发生率和治愈率。结果实验组患者昏迷时间、呼吸机脱机时间、CHE恢复时间及住院时间均短于对照组，阿托品用量少于对照组，差异有统计学意义(P<0.05)。实验组并发症发生率为10.0%，低于对照组的30.0%，差异有统计学意义(P<0.05)。实验组治愈率为93.3%，高于对照组的76.7%，差异有统计学意义(P<0.05)。结论在常规阿托品等药物治疗的基础上加用床边血液灌流治疗急性有机磷农药中毒可快速改善患者的临床症状，提高治愈率，降低病死率。     

护士精神薪酬满意度与其工作绩效的相关性研究

目的调查护士精神薪酬满意度和工作绩效现状,为提高护士工作绩效提供新的思路。方法采用护士精神薪酬满意度问卷和护士工作绩效量表对389名护士进行问卷调查。结果精神薪酬满意度总分为(27.07±3.79)分,工作绩效总分为(155.77±9.23)分;精神薪酬满意度总分与工作绩效总分呈正相关(P0.01);聘用方式、职称和精神薪酬满意度为护士工作绩效的预测因素(P0.01)。结论护士精神薪酬满意度和工作绩效均处于中等水平,精神薪酬满意度为护士工作绩效的影响因素,护理管理者可从提高护士精神薪酬满意度的角度提高其工作绩效。     

间苯三酚对结石性肾绞痛患者疼痛缓解的影响

目的探究间苯三酚对结石性肾绞痛(stone renal colic,SRO)患者疼痛缓解的影响。方法选取2015年1月至2017年12月本院收治的SRO患者126例,依据随机数字表法分为间苯三酚组与对照组,各63例。对照组给予双氯芬酸钠盐酸利多卡因注射液联合黄体酮治疗,间苯三酚组给予间苯三酚联合双氯芬酸钠盐酸利多卡因注射液治疗。比较两组治疗前及治疗1 h后疼痛得分及肾积水量、肾绞痛发作次数、缓解时间、结石排出情况、不良反应等指标。结果治疗后1 h,间苯三酚组疼痛得分低于对照组(P<0.05)。间苯三酚组肾绞痛发作次数少于对照组,缓解时间短于对照组(P<0.05)。间苯三酚组结石排出率、总有效率均高于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论间苯三酚治疗SRO可快速缓解患者疼痛,促进结石排出,临床疗效显著,无明显不良反应,值得临床推广。     

Comparative analysis of preemptive analgesic effect of tramadol chlorhydrate and nimesulide following third molar surgery

The aim of this prospective, randomized, controlled, paired trial was to perform a comparative analysis of the preemptive analgesic effect of nimesulide and tramadol chlorhydrate during third molar surgery. The study was carried out between March and November 2009, involving 94 operations in 47 male and female patients with bilateral impacted lower third molars in comparable positions. The sample was divided into two groups. Group A received an oral dose of 100 mg of nimesulide 1 h prior to surgery. Group B received an oral dose of 100 mg of tramadol chlorhydrate 1 h prior to surgery. The following aspects were evaluated in the postoperative period: adverse effects of the drugs; amount of rescue medication used (acetaminophen 750 mg); and pain 5, 6, 24, 36, 48, 60, 72 and 84 h after surgery using a visual analog pain scale. Peak pain occurred 5 h after surgery in both groups, with a mean pain score of 2.3 in Group A and 3.0 in Group B; this difference did not achieve statistical significance (p > 0.141). Based on the sample studied, nimesulide and tramadol chlorhydrate demonstrate similar preemptive analgesic effects when used in lower third molar surgeries.