血清Cyr61及CTGF水平对胃癌进展的诊疗意义

目的 评估血清Cyr61及CTGF水平变化与胃癌进展的关系,为早期检测胃癌进展提供依据.方法 选择自2012年6月至2014年6月于铜川矿务局中心医院就诊的胃癌患者132例,其中Ⅰ期45例、Ⅱ期36例、Ⅲ期28例、Ⅳ期23例,对各组Cyr61及CTGF、胃癌肿瘤标志物进行检测.结果 Ⅱ期较Ⅰ期Cyr61及CTGF均有升高,差异有统计学意义(P＜0.05),Ⅲ期Cyr61及CTGF较Ⅱ期、Ⅰ期升高,差异有统计学意义(P＜0.05),Ⅳ期Cyr61及CTGF较Ⅰ期、Ⅱ期、Ⅲ期均有升高,差异有统计学意义(P＜0.05).Ⅱ期较Ⅰ期CEA、CA125均有升高,差异有统计学意义(P＜0.05);Ⅲ期CEA、CA199、CA125较Ⅱ期、Ⅰ期升高,差异有统计学意义(P＜0.05),Ⅳ期CEA、CA199、CA125较Ⅰ期、Ⅱ期、Ⅲ期均有升高,差异有统计学意义(P＜0.05).Cyr61与CEA、CA125显著正相关(P＜0.05),与CA199无相关性(P＞0.05).CTGF与CEA、CA125显著正相关(P＜0.05).结论 Cyr61及CTGF与胃癌肿瘤标志物等指标具有较好的相关性,是反映胃癌恶性程度及侵袭能力的重要指标.     

高半胱氨酸蛋白61与自身免疫性疾病

高半胱氨酸蛋白61(cysteine rich 61,Cyr61)是即刻早期基因表达蛋白,受到血清生长因子刺激后可在数分钟内活化并转录。Cyr61通过直接与细胞表面整合素受体结合而发挥作用。Cyr61可参与炎性反应过程,促进血管形成或协同细胞因子间作用。Cyr61可介导滑膜细胞的增殖,促进滑膜细胞产生白细胞介素(interleukin,IL)-6、IL-8等炎性细胞因子,并在辅助性T细胞(helper T cell,Th)17分化和中性粒细胞浸润中发挥一定作用。Cyr61在炎症性肠病、IgA肾病、糖尿病肾病、Graves眼病中的作用均有研究。另外,Cyr61也不同程度参与了胚胎发育、创伤修复、血管疾病、肿瘤等过程。     

早期生长反应因子1特异诱骗寡核苷酸下调富含半胱氨酸蛋白61抑制大鼠血管平滑肌细胞迁移

目的观察早期生长反应因子1特异诱骗寡核苷酸对体外培养的大鼠血管平滑肌细胞中早期生长反应因子1和富含半胱氨酸蛋白61表达的影响,初步探讨早期生长反应因子1特异诱骗寡核苷酸抑制血管平滑肌细胞迁移的机制。方法体外培养血管平滑肌细胞并转染早期生长反应因子1特异诱骗寡核苷酸,采用逆转录聚合酶链反应和免疫组织化学法检测转染后不同时间点对照组与实验组血管平滑肌细胞中早期生长反应因子1及富含半胱氨酸蛋白61的mRNA和蛋白的表达变化,划痕法测定血管平滑肌细胞迁移距离。结果早期生长反应因子1及富含半胱氨酸蛋白61的mRNA和蛋白在对照组、诱骗组及诱骗对照组中均有表达。在不同时间点,诱骗组早期生长反应因子1及富含半胱氨酸蛋白61的mRNA和蛋白的表达均低于对照组(P<0.05)。转染后48 h,对照组、诱骗组及诱骗对照组血管平滑肌细胞的迁移距离分别为105.23±7.81μm、58.65±12.68μm、106.47±7.60μm,诱骗组血管平滑肌细胞的迁移距离明显低于其他两组(P<0.01)。结论对体外培养的血管平滑肌细胞转染早期生长反应因子1特异诱骗寡核苷酸可以抑制早期生长反应因子1及富含半胱氨酸蛋白61的mRNA和蛋白表达,从而抑制血管平滑肌细胞的迁移。     

Barriers to implementing expert safety recommendations for early mobilisation in intensive care unit during mechanical ventilation: A prospective observational study

BackgroundEarly mobilisation in the intensive care unit (ICU) has been consistently reported as feasible and safe with minimal adverse events; however, invasive mechanical ventilation patients are rarely actively mobilised. An expert consensus group developed and published recommendations using a traffic light system on safety criteria to promote active mobilisation of invasive mechanical ventilation patients.ObjectivesThe aim of this study was to determine whether, in clinical practice, the safety consensus recommendations resulted in (1) increased early mobilisation in patients assessed as appropriate to mobilise based on the risk classification and (2) early mobilisation without adverse events.MethodsA prospective observational study of 100 patients requiring invasive mechanical ventilation (IMV) for greater than 24 h admitted to the ICU at The Alfred Hospital. Patients were assessed daily (Monday to Friday) to determine their ability to perform early mobilisation.ResultsData were collected on 100 patients, resulting in 280 physiotherapy–patient interactions during IMV. Of the 100 patients, five patients actively mobilised out of bed during IMV. No adverse event occurred during active physiotherapy–patient interactions. There were 15 physiotherapy–patient interactions that had a low risk of an adverse event, and on nine (60.0%) of these physiotherapy–patient interactions, patients were actively mobilised out of bed with the main reported barrier being time constraints. Of 208 physiotherapy–patient interactions where there were significant potential risks of an adverse event identified for mobilising, active out of bed mobilisation did not occur, with sedation being reported as the main barrier in 170 (82%) patients.ConclusionsThe translation of expert consensus recommendations for early mobilisation into clinical practice was poor. Clinicians were safe and conservative in the implementation of early mobilisation during IMV.     

NF‐κB activation mediates LPS‐or zymosan‐induced hypotension and inflammation reversed by BAY61‐3606, a selective Syk inhibitor,in rat models of septic and non‐septic shock

We have previously demonstrated that the activation of the spleen tyrosine kinase (Syk)/inhibitory‐κB (IκB)‐α/nuclear factor‐κB (NF‐κB) p65 signalling pathway contributes to hypotension and inflammatory response in a rat models of zymosan (ZYM)‐induced non‐septic shock. The purpose of this study was to further examine the possible mechanism underlying the effect of inhibition of Syk by BAY61‐3606 via NF‐κB activity at the level of nuclear translocation regarding the production of vasodilator and proinflammatory mediators in lipopolysaccharide (LPS) (septic)‐ and ZYM (non‐septic)‐induced shock. Administration of LPS (10 mg/kg, ip) or ZYM (500 mg/kg, ip) to male Wistar rats decreased mean arterial pressure and increased heart rate that was associated with an increase in the activities of cyclooxygenase and nitric oxide synthase, tumour necrosis factor‐α, and interleukin‐8 levels, and NF‐κB activation and nuclear translocation in sera and/or cardiovascular and renal tissues. BAY61‐3606 (3 mg/kg, ip), the selective Syk inhibitor, given 1 hour after LPS‐ or ZYM injection reversed all the above‐mentioned effects. These results suggest that Syk contributes to the LPS‐ or ZYM‐induced hypotension and inflammation associated with transactivation of NF‐κB in septic and non‐septic shock.     

Banded versus nonbanded Roux-en-Y gastric bypass: a systematic review and meta-analysis of randomized controlled trials

BackgroundBariatric surgery is remarkably effective in achieving weight loss and improving obesity-related co-morbidities; however, efforts still continue to improve its long-term outcomes. Particularly, banded Roux-en-Y gastric bypass (RYGB) has been scrutinized in comparison to standard (nonbanded) RYGB in terms of benefits and postoperative complications.ObjectivesThis study aims to compare the safety and efficacy of banded versus nonbanded RYGB.SettingMeta-analysis of randomized controlled trials (RCTs).MethodsA meta-analysis of high-quality studies that compared banded and nonbanded RYGB was conducted through February 2019 by systematically searching multiple electronic databases. Published RCTs comparing these 2 procedures were included to pool the data on excess weight loss, food tolerability, and postoperative complications.ResultsThree RCTs were eligible to be included in this meta-analysis, comprising a total of 494 patients (247 in each group). Two of the RCTs provided 2-year postoperative data, and 1 study reported 5-year outcome. Age ranged from 21 to 50 years, and body mass index ranged from 42 to 65 kg/m². Percentage of excess weight loss was significantly greater with banded RYGB than with nonbanded RYGB (mean difference 5.63%; 95% CI 3.26–8.00; P < .05). Postoperative food intolerance, emesis, and dysphagia were more common after banded RYGB (odds ratio 3.76; 95% CI 2.27–6.24; P < .001). Nevertheless, major postoperative complications did not significantly differ between the 2 groups.ConclusionFindings of this meta-analysis of RCTs indicate that in a medium-term follow-up, excess weight loss with banded RYGB would be 5% greater than that with the nonbanded RYGB (about 1 point difference in body mass index) at the expense of more food intolerance and postoperative vomiting; however, the frequency of postoperative complications would not be significantly different.     

Gli1抑制剂GANT61对小鼠牙胚体外发育的影响

目的:研究外源性Gli1抑制剂GANT61对小鼠磨牙胚体外发育的影响.方法:采用小鼠磨牙胚体外培养系统,运用体视镜、组织学HE染色方式观察小鼠磨牙胚被Gli1抑制剂GANT61影响后的发育情况,并对牙胚构成部分进行测量.结果:在Gli1抑制剂GANT61作用下,实验组相对于对照组出现下磨牙牙胚发育速度减慢,成釉器凹陷且...     

Breaking Barriers: Mobile Health Interventions for Cardiovascular Disease

Cardiovascular disease (CVD) is a leading global cause of death and morbidity and prevention needs to be strengthened to tackle this. Mobile health (mHealth) might present a novel and effective solution in CVD prevention, and interest in mHealth has grown dramatically since the advent of the smartphone. In this review, we discuss mHealth interventions that target multiple cardiovascular risk factors simultaneously in the context of primary as well as secondary prevention. There is some evidence that mHealth interventions improve a range of individual CVD risk factors, but a relative paucity of evidence on mHealth interventions improving multiple CVD risk factors simultaneously. The existing data suggest mHealth programs improve overall CVD risk, at least in the short term. Interpretation of the evidence is difficult in the context of poor methodology and mHealth modalities often being a part of large complex interventions. In this review we identify a number of unanswered questions including: which mode of mHealth (or combination of interventions) would be most effective, what is the durability of intervention effects, and what degree of personalization and interactivity is required.