The selective tyrosine kinase-inhibitor nilotinib alleviates experimentally induced cisplatin nephrotoxicity and heptotoxicity

This work tested the action of nilotinib, selective inhibitor of tyrosine kinase on cisplatin (CP)-induced damage of kidney and liver in rats. Rats were assigned to 4 groups, control, nilotinib, CP, and CP plus nilotinib. Assessment of kidney and liver function, lipid peroxidation and antioxidant markers, anti-apoptotic protein Bcl2, nuclear factor- kappa B (NF-κB) immunoreactivity, and caspase 3 activity were done. CP-induced damage evidenced by histopathological changes, deterioration of renal and liver function, imbalance in oxidants/antioxidants markers, decreased Bcl2, increased caspase 3 activity, and NF-κB nuclear expression in both organs. Nilotinib treatment with CP restored kidney and liver oxidants/antioxidant levels also increased Bcl2 and decreased NF-κB immunoreactivity were evident with nilotinib treatment. In conclusions these results demonstrated a protective effect of nilotinib in experimentally induced CP kidney and liver damage that could be mediated through combating oxidative stress, reducing inflammation and anti-apoptosis in the two organs.     

Beliefs and expectations of rural hospital practitioners towards a developing trauma system: A qualitative case study

BackgroundAn understanding of stakeholders’ views is key to the successful development and operation of a rural trauma system. Scotland, which has large remote and rural areas, is currently implementing a national trauma system. The aim of this study was to identify key barriers and enablers to the development of an effective trauma system from the perspective of rural healthcare professionals.MethodsThis is a qualitative study, which was conducted in rural general hospitals (RGH) in Scotland, from April to June 2017. We used an opportunistic sampling strategy to include hospital providers of rural trauma care across the region. Semi-structured interviews were conducted, recorded, and transcribed. Thematic analysis was used to identify and group participant perspectives on key barriers and enablers to the development of the new trauma system.ResultsWe conducted 15 interviews with 18 participants in six RGHs. Study participants described barriers and enablers across three themes: 1) quality of care, 2) interfaces within the system and 3) interfaces with the wider healthcare system. For quality of care, enablers included confidence in basic trauma management, whilst a perceived lack of change from current management was seen as a barrier. The theme of interfaces within the system identified good interaction with other services and a single point of contact for referral as enablers. Perceived barriers included challenges in referring to tertiary care. The final theme of interfaces with the wider healthcare system included an improved transport system, increased audit resource and coordinated clinical training as enablers. Perceived barriers included a rural staffing crisis and problematic patient transfer to further care.ConclusionsThis study provides insight into rural professionals’ perceptions regarding the implementation of a trauma system in rural Scotland. Barriers included practical issues, such as retrieval, transfer and referral processes. Importantly, there is a degree of uncertainty, discontent and disengagement towards trauma system development, and concerns regarding staffing levels and governance. These issues are unlikely to be unique to Scotland and warrant further study to inform service planning and the effective delivery of rural trauma systems.     

Simvastatin induces the osteogenic differentiation of human periodontal ligament stem cells

Periodontal ligament stem cells (PDLSCs) are considered as potential mesenchymal stem cell sources for future clinical applications in periodontal regeneration therapy. Simvastation, widely used for lowering serum cholesterol, is known to have a bone stimulatory effect. However, it is not clear whether simvastation affects the differentiation of PDLSCs. This study examined the effects of simvastatin on human PDLSCs in vitro and in vivo. Using the limiting dilution technique, human PDLSCs were isolated and expanded. PDLSCs were cultured with simvastatin (0.01–10 μm ), and the proliferation was measured. The osteogenic differentiation was characterized by alkaline phosphatase (ALP) activity and Alizarin Red‐S staining for calcium deposition. The gene expression levels of osteogenic markers were evaluated by RT‐PCR. In addition, PDLSCs were transplanted into nude mice with ceramic bovine bone powders as carriers to observe the capacity of mineralized tissue formation in vivo. Simvastatin at concentrations <1 μm did not suppress the proliferation of PDLSCs. After the administration of 0.1 μm simvastatin, the expression of ALP, bone sialoprotein, and bone morphogenetic protein‐2 genes were significantly upregulated, and the ALP activity and mineralized nodule formation were significantly higher in the simvastatin‐treated cells than the control cells. In addition, the in vivo transplantation results showed that simvastatin treatment promoted the degree of mineralized tissue formation. Collectively, simvastatin has positive effects on osteogenic differentiation of human PDLSCs in vitro and in vivo. This suggests that simvastatin might be a useful osteogenic induction agent for periodontal bone regeneration.     

Knockdown of Nestin inhibits proliferation and migration of colorectal cancer cells

Nestin, a member of type VI intermediate filament protein family, is widely expressed in mammalian nervous tissue and stem/precursor cells of non-neuronal normal tissues. Nestin has also been investigated to determine possible tumor-promoting functions. However, whether Nestin is involved in colorectal cancer (CRC) cells remains unclear. In this report, Nestin expression was upregulated in stromal cells of human CRC tissues. Endogenous Nestin expression in CRC cell lines SW480 and HCT116 was knocked down by a lentivirus. MTT and colony formation assays revealed that Nestin deletion significantly inhibits the proliferation of CRC cell lines; flow cytometer analysis showed that Nestin deletion causes cell cycle arrest at S phase. Transwell chamber and wound healing scratch assays also revealed that Nestin deletion suppresses cell migration. Our findings indicated that Nestin plays an essential role in CRC progression; thus, Nestin can be applied as a therapeutic target of CRC.     

慢性便秘继发肠系膜上动脉压迫综合征(李氏三联征)的诊断与治疗

目的归纳按“李氏三联征”概念指导诊断和治疗慢性便秘继发肠系膜上动脉压迫综合征(SMAS)的经验。方法“李氏三联征”的概念包括:(1)临床症状:便秘、营养不良、上消化道梗阻(呕吐、进食困难)三联症状;(2)解剖学表现:具有横结肠下垂、脾曲升高和肠系膜上动脉压迫三联解剖异常;(3)治疗:均给予肠内营养支持、胸膝位、菌群移植三联治疗。根据“李氏三联征”概念,采用描述性病例系列研究方法,前瞻性纳入2014年6月至2018年11月期间,同济大学附属第十人民医院和东部战区总医院收治的78例慢性便秘继发SMAS患者的病例资料,包括基本信息、症状体征、影像学资料、营养指标、胃肠生活质量指数和Wexner排粪评分,按上述“李氏三联征”的标准进行评估和治疗,对临床症状和解剖学特征指标进行随访,记录治疗后1、3、6和12个月的变化。结果治疗前所有患者均有“李氏三联征”特征,均存在严重便秘、营养不良及上消化道梗阻的临床表现,均具有肠系膜上动脉压迫征象和明显的脾曲升高的解剖学表现。经肠内营养支持、胸膝位及菌群移植三联治疗后,69例(88.5%)症状明显改善,9例治疗无效行手术治疗。69例非手术患者经12个月随访,结果显示,所有患者均恢复正常进食,1个月后便秘相关指标改善,至12个月后时,每周自主排粪次数从治疗前(1.0±0.8)次增加至(5.0±1.6)次,胃肠生活质量指数由治疗前(52.7±8.5)分增加至(93.2±7.5)分,Wexner排粪评分由治疗前(19.1±2.5)分下降至(6.2±2.1)分,差异均有统计学意义(均P<0.001)。随访1个月后营养指标改善,至12个月后时,体质指数从治疗前(17.9±1.8)kg/m2增加至(21.0±1.3)kg/m2,总蛋白由(65.2±5.7)g/L增加至(68.3±4.2)g/L,白蛋白从(32.1±5.1)g/L增加至(40.4±3.0)g/L,纤维蛋白原从(1.9±0.5)g/L增加至(2.4±0.5)g/L,前白蛋白从(163.2±5.3)mg/L增加至(259.1±45.6)mg/L;差异均有统计学意义(均P<0.001)。上消化道造影及肠系膜上动脉成像均显示十二指肠受压征象解除,肠系膜上动脉与腹主动脉夹角从治疗前(17.4±3.8)°增加至(37.8±5.8)°(t=-22.26,P<0.001)。结论慢性便秘继发SMAS患者具有“李氏三联征”的异常三联临床症状和解剖学表现时,应给予肠内营养支持、胸膝位及菌群移植三联治疗。     

对我国多媒体健康教育项目发展的思考与启示

系统分析国外多媒体技术在病人健康教育中的应用研究,总结归纳多媒体项目设计特征与应用效果,以期为我国多媒体健康教育项目成功建设提供一定借鉴。     

剖宫产术后实施早期乳房推拿的效果观察

[目的]观察剖宫产术后实施早期乳房推拿对乳汁分泌的影响。[方法]将71例剖宫产病人按床号的不同分为观察组35例和对照组36例。观察组在常规护理早吸吮、按需哺乳等基础上,从术后24h起对产妇进行乳房推拿疗法(每次10min～15min,每天3次或4次,连续2d),对照组在常规护理早吸吮、按需哺乳等基础上,从48h起即乳房充盈胀痛时对产妇进行乳房推拿疗法(每次10min～15min,每天3次或4次,连续2d),比较两组推拿前及推拿48h后乳房胀痛发生率、血清泌乳素、乳房体积及始乳时间的变化。[结果]观察组乳房胀痛发生率明显低于对照组(P<0.05),血清泌乳素水平明显高于对照组(P<0.01),始乳时间早于对照组(P<0.01),乳房体积大于对照组(P<0.01)。[结论]剖宫产术后实施早期乳房推拿疗法,可有效防治乳房胀痛,促进泌乳。