过表达miR-146a通过靶向SOX5抑制胃癌MKN-45细胞增殖和侵袭

目的 探讨过表达miR-146a对胃癌MKN-45细胞增殖、侵袭的影响及可能机制.方法 利用瞬时转染将miR-146a mimics(过表达miR-146a组)和miR-NC(阴性对照组)分别转染胃癌MKN-45细胞,建立过表达miR-146a胃癌MKN-45细胞系,采用MTT法检测转染后MKN-45细胞增殖能力,Transwell实验检测转染后MKN-45细胞侵袭能力.Western blot检测转染后MKN-45细胞中SOX5蛋白表达,通过网站Targetscan预测SOX5是否为miR-146a的靶基因,双荧光素酶实验进行验证.结果 miR-146a过表达抑制MKN-45细胞增殖、侵袭能力,miR-146a过表达使MKN-45细胞中SOX5蛋白表达下降,Targetscan网站分析及双荧光素酶实验证实SOX5为miR-146a的靶基因.结论 过表达miR-146a可以抑制胃癌MKN-45细胞增殖及侵袭能力,其机制可能与下调SOX5的表达有关.     

Psychomotor therapy targeting anger and aggressive behaviour in individuals with mild or borderline intellectual disabilities: A systematic review

Background: Poor anger regulation is considered a risk factor of aggression in individuals with mild or borderline intellectual disabilities. Psychomotor therapy (PMT) targets anger regulation through body- and movement-oriented interventions. This study aims to inform practitioners on efficacy and research-base of PMT in this population.

Method: This systematic review evaluated nine studies which met inclusion criteria in terms of participants, intervention procedures, outcomes and certainty of evidence.

Results: Seven studies revealed a substantial reduction of aggressive behaviour or anger. Certainty of evidence was rated inconclusive in most cases due to absence of experimental control.

Conclusions: We can conclude that body-oriented PMT, involving progressive relaxation and meditation procedure “Soles of the Feet”, is a promising approach. However, the paucity of studies and methodological limitations preclude classifying it as an evidence-based practice. This suggests stronger methodological research and research aimed at PMT’s mechanisms of action (e.g., improved interoceptive awareness) is warranted.     

Variant analysis and genotype/phenotype association study in 42 Chinese patients with Bartter syndrome type 3

Objective To analyze the variants of 42 Chinese patients with Bartter syndrome type 3 (BS3) and explore the characteristics of genotype and phenotype. Methods Forty-two genetically diagnosed patients from 40 Han and one Hui families were collected in the Affiliated Hospital of Qingdao University and the Affiliated Qingdao Municipal Hospital of Qingdao University during the period of June 2012 to October 2018. The second-generation sequencing and multiplex ligase probe-dependent amplification (MLPA) technique were used to analyze the CLCNKB gene variation and its characteristics in children with BS3. The clinical data were collected, and the therapeutic effect and growth improvement were observed and followed up. Thirty eight patients were divided into severe (n=26) and light (n=12) groups according to the severity of genetic variation. The clinical phenotypic characteristics of the two groups were compared. Results Thirty-six variants including 16 novel ones of CLCNKB gene were found. The whole gene deletion of CLCNKB gene was the most frequent mutation (40%), and the rate of large deletions was up to 55%. The most common symptoms included development retardation (38/42), polydipsia and polyuria (35/42), constipation (31/42) and vomiting (27/42). All patients presented with hypokalemia, hypochloremia and metabolic alkalosis. After the medicine treatment that based on indomethacin and potassium chloride, most patients could achieve obvious recovery of growth rate and restoration of hypokalemia. The severe group showed more severe metabolic alkalosis than the light group. Conclusions Thirty-six variants of CLCNKB gene have been found in this study, including 16 novel ones, which enrich the human gene mutation database (HGMD) and provide valuable references to diagnosis, treatment and the genetic counseling of Chinese population.     

Medicare's hospital readmissions reduction program and the rise in observation stays

Objective

To evaluate whether Medicare's Hospital Readmissions Reduction Program (HRRP) is associated with increased observation stay use.

Data Sources and Study Setting

A nationally representative sample of fee-for-service Medicare claims, January 2009–September 2016.

Study Design

Using a difference-in-difference (DID) design, we modeled changes in observation stays as a proportion of total hospitalizations, separately comparing the initial (acute myocardial infarction, pneumonia, heart failure) and subsequent (chronic obstructive pulmonary disease) target conditions with a control group of nontarget conditions. Each model used 3 time periods: baseline (15 months before program announcement), an intervening period between announcement and implementation, and a 2-year post-implementation period, with specific dates defined by HRRP policies.

Data Collection/Extraction Methods

We derived a 20% random sample of all hospitalizations for beneficiaries continuously enrolled for 12 months before hospitalization (N = 7,162,189).

Principal Findings

Observation stays increased similarly for the initial HRRP target and nontarget conditions in the intervening period (0.01% points per month [95% CI −0.01, 0.3]). Post-implementation, observation stays increased significantly more for target versus nontarget conditions, but the difference is quite small (0.02% points per month [95% CI 0.002, 0.04]). Results for the COPD analysis were statistically insignificant in both policy periods.

Conclusions

The increase in observation stays is likely due to other factors, including audit activity and clinical advances.     

老年脓毒症患者临床特征及预后影响因素

 目的 探讨老年脓毒症患者临床特征及影响预后的危险因素。方法 选取2020年7月-2021年9月某三级甲等医院收治的老年脓毒症患者为研究对象，记录患者的临床及实验室资料，根据患者28天预后情况分为存活组和死亡组，比较各临床指标在两组间的差异，应用二元logistic回归分析法分析影响老年脓毒症患者预后的独立危险因素，进一步绘制受试者工作特征（ROC）曲线，评估不同指标预测患者预后的价值。结果 共纳入121例患者，其中74例为脓毒症，47例为脓毒性休克。存活组92例，死亡组29例。与存活组相比，死亡组患者发生脓毒性休克、合并症个数 ≥ 2的比例均较高（P<0.05）；序贯器官衰竭评估（SOFA）评分和急性生理与慢性健康状况评估（APACHEⅡ）评分也较高，白细胞介素6（IL-6）、胱抑素C（Cys-C）、降钙素原（PCT）、凝血酶原时间（PT）和D -二聚体（D -D）表达水平均增高（均P<0.05），而淋巴细胞绝对计数（ALC）和清蛋白（ALB）表达水平降低（均P<0.01）。二元logistic回归分析显示脓毒性休克、SOFA评分、D -D及Cys-C表达水平是影响老年脓毒症患者28天预后的独立危险因素。ROC曲线分析显示SOFA评分（AUC=0.758）、D -D（AUC=0.774）、Cys-C（AUC=0.650）预测患者的预后均有一定的价值（均P<0.01），与单个指标相比，三个指标的联合检测显示出更高的预测价值（AUC=0.882）。结论 发生脓毒性休克、SOFA评分增高、D -D及Cys-C表达水平增加是导致老年脓毒症患者病死率上升的独立危险因素，SOFA评分、D -D和Cys-C的联合检测可进一步提高脓毒症患者预后的预测价值，为临床治疗和预后评估提供参考依据。     

Influence Factors and Prediction Model of Bond Strength of Tunnel Fireproof Coating under Freeze–Thaw Cycles

The freeze–thaw resistant performance of a tunnel fireproof coating (TFC) has an important impact on bonding property and durability. The influence of redispersible emulsion powder, polypropylene fiber and air-entraining agent on TFCs was studied. Transverse fundamental frequency and ultrasonic sound velocity were used to evaluate the damage degree of TFC, and the mechanism was revealed by SEM and pore structure. The results show that the most beneficial effect on bond strength of TFC is redispersible emulsion powder, followed by air-entraining agent, and then polypropylene fiber. After freeze–thaw cycles, the cumulative pore volume of micropores in the TFC increases obviously, while the porosity of macropores does not change significantly. A prediction model was proposed, which can calculate the bond strength from the damage degree of TFC under freeze–thaw cycles. The achievement can promote the application of TFC in cold regions.     

Wnt/β⁃catenin信号通路参与马蹄内翻足畸形形成的研究

目的　探讨Sox9（sex determining region Y-box9）和β-catenin对先天性马蹄内翻足（congenital talipes equinovarus，CTE）的影响以及Wnt/β-catenin信号通路作用机制。 方法　将孕10 d的SD大鼠随机均分为实验组及对照组，以135 mg/kg全反式维甲酸溶于矿物油对实验组大鼠进行灌胃制作胎鼠CTE模型，对照组予以等量矿物油灌胃处理，取大鼠足踝部组织，通过免疫组化、RT-PCR、Western blot检测β-catenin、Sox9以及磷酸化β-catenin-S552的表达水平。 结果　与对照组相比，HE染色可见CTE模型组织中有较多的胶原组织沉积，免疫组化结果显示实验组标本Sox9与β-catenin表达增高，RT-qPCR表明实验组Sox9与β-catenin的mRNA水平显著增高，Western blot结果显示实验组Sox9与β-catenin的表达增高而磷酸化β-catenin-S552表达降低。 结论　CTE大鼠的足踝部组织中Sox9高表达受Wnt/β-catenin信号通路调控，该通路参与先天性马蹄内翻足畸形的形成。