To investigate the dynamic regulation of self-assembled aggregations (SAA) in Coptidis Rhizoma decoction on the permeability of intestinal tissue and the mechanism underlying.The effects of SAA on berberine (Ber) absorption were respectively analyzed in an in situ intestinal perfusion model and in an Ussing Chamber jejunum model with or without Peyer's patches (PPs). The expression levels of ZO-1, Occludin and Claudin-1 were detected by immunofluorescence to evaluate the tight junction (TJ) between intestinal epithelium cells. The expression levels of T-box-containing protein expressed in T cells, signal transducers and activators of tranion-6, retinoic acid receptor-related orphan receptor γt and forkhead box P3 in PPs were detected by the reverse transcription-polymerase chain reaction and the secretions of interferon-γ (IFN-γ), interleukin-4 (IL-4), interleukin-17 (IL-17) and transforming growth factor-β (TGF-β) in PPs were evaluated by immunohistochemistry, to reflect the differentiation of T lymphocyte in PPs to helper T (Th) cell 1, Th2, Th17 and regulatory T (Treg) cell. To confirm the correlation between SAA in Coptidis Rhizoma decoction, PPs-associated immunity and intestinal epithelium permeability, SAA were administrated on an Ussing Chamber jejunum model with immunosuppressed PPs and evaluated its influences on intestinal tissue permeability and TJ proteins expression.SAA in Coptidis Rhizoma decoction could dose-dependently promote Ber absorption in jejunum segment, with the participation of PPs. The dose-dependent and dynamical regulations of SAA on permeability of intestinal tissue and TJ proteins expression level between intestinal epithelium cells occurred along with the dynamically changed T lymphocyte differentiation and immune effectors secretion in PPs. The administration of SAA on immunosuppressed PPs exhibited dose-dependent PPs activation, inducing dynamic promotion on intestinal tissue permeability and inhibition on TJ proteins expression.SAA can improve the Ber absorption in small intestine, through the PPs-associated immunity induced dynamic regulation on intestinal tissue permeability and TJ proteins expression. These findings might enlighten the research of traditional Chinese medicine decoction.
Plexiform angiomyxoid myofibroblastic tumor (PAMT) is a recently described gastric tumor with a peculiar plexiform pattern, bland spindle cells and a myxoid stroma rich in arborizing blood vessels. PAMT of the stomach is a very rare tumor without distinctive clinical manifestations. In this study, we report a new case of PAMT which is the first Chinese case in English literature. A 47-year-old Chinese woman was admitted with a 6-month history of intermittent epigastric discomfort, and abdominal pain for 2 months. Gastroscopy showed an elevated mass in the anterior wall of the gastric antrum. Endoscopic ultrasound revealed a focal hypoechoic lesion protruding into the lumen. A laparoscopic distal gastrectomy was performed, and the patient made an uneventful recovery and remains well 1.5 years later. A diagnosis of PAMT was made by histopathology and immunochemistry.
Abstract Objective This study aimed to analyze the characteristics of laryngopharyngeal reflux (LPR) by using narrow band imaging (NBI) endoscopy. Study Design A prospective study. Setting A large‐volume practice with tertiary care providers. Methods A total of 67 patients with suspected LPR who underwent 24‐hour multichannel intraluminal impedance–pH monitoring were included from June 2020 to March 2022. Manifestations of NBI endoscopy included submucosal clustered brownish microvessels (CBMs), spotted brownish microvessels, and no special microvessels; the latter 2 formed the non‐CBM group. The manifestations of all patients and their changes were observed after 8 weeks of proton pump inhibitor and symptomatic treatment for patients with LPR, and symptomatic treatment for patients without LPR. Results According to the results of 24‐hour multichannel intraluminal impedance–pH monitoring, the incidence of submucosal CBMs was significantly higher in patients with LPR (30 cases) than in those without LPR (37 cases, P < .001), particularly in the posterior cricoid area ( P < .001). Besides Reflux Finding Score, the incidence of signs such as subglottic edema and vocal fold edema was significantly higher in the CBM group than the non‐CBM group ( P < .05). Finally, 22 patients with LPR (91.7%) and only 2 patients without LPR (28.6%) underwent a transformation from CBMs to spotted brownish microvessels after continuous medication for 8 weeks in the CBM group (χ 2 = 15.916, P < .001), while no significant change was observed in patients with or without LPR in the non‐CBM group ( P > .05). Conclusion Submucosal CBMs in the posterior cricoid area under NBI endoscopy may be a characteristic of LPR. Level of Evidence: 4.
Since the prognosis of renal cell carcinoma (RCC) patients with bone metastasis (BM) is poor, this study is aimed at using big data to build a machine learning (ML) model to predict the risk of BM in RCC patients.A retrospective study was conducted on 40,355 RCC patients in the SEER database from 2010 to 2017. LASSO regression and multivariate logistic regression analysis was performed to determine independent risk factors of RCC-BM. Six ML algorithm models, including LR, GBM, XGB, RF, DT, and NBC, were used to establish risk models for predicting RCC-BM. The prediction performance of ML models was weighed by 10-fold cross-validation.The study investigated 40,355 patients diagnosed with RCC in the SEER database, where 1,811 (4.5%) were BM patients. Independent risk factors for BM were tumor grade, T stage, N stage, liver metastasis, lung metastasis, and brain metastasis. Among the RCC-BM risk prediction models established by six ML algorithms, the XGB model showed the best prediction performance (AUC = 0.891). Therefore, a network calculator based on the XGB model was established to individually assess the risk of BM in patients with RCC.The XGB risk prediction model based on the ML algorithm performed a good prediction effect on BM in RCC patients.
Hepatocyte proliferation and collagen I (COLI) secretion are important processes during liver regeneration. This study aimed to investigate the role of CXCL6 in hepatocyte proliferation and COLI secretion. Serum CXCL6 levels in patients with chronic hepatitis B (CHB) were examined and the effects of CXCL6 on the proliferation of L02 hepatocytes and the secretion of COLI from LX2 human hepatic stellate cells were evaluated. We found that serum CXCL6 levels increased gradually with disease progression of CHB, and there was positive correlation between serum CXCL6 level and alanine transaminase (ALT) and aspartate transaminase (AST). In vitro, CXCL6 promoted L02 proliferation but this was blocked upon CXCR1 knockdown. The level of phospho-IκBα was upregulated by CXCL6 but downregulated by CXCR1 siRNA in L02 cells. CXCL6 inhibited the secretion of COLI by LX2 cells, dependent on CXCR1 and CXCR2. Taken together, these data suggest that increased expression of CXCL6 during CHB could promote hepatocyte proliferation through the CXCR1-NFκB pathway and inhibit the secretion of COLI by hepatic stellate cells.
This study aims to investigate the effect of Zhishi Xiebai Guizhi Decoction on the phenotypic transformation of pulmonary artery smooth muscle cells(PASMCs) in rats with hypoxic pulmonary hypertension(HPH). Healthy SPF SD rats were randomly assigned to five groups: control group, hypoxia model group, hypoxia + low-dose Zhishi Xiebai Guizhi Decoction group(440 mg·kg~(-1)·d~(-1)), hypoxia + high-dose Zhishi Xiebai Guizhi Decoction group(880 mg·kg~(-1)·d~(-1)), and hypoxia + sildenafil group(30 mg·kg~(-1)·d~(-1)), with right rats in each group. Rats in the hypoxia model and hypoxia + drug groups were exposed to a hypobaric oxygen chamber with a simulated altitude of 5 000 m to induce the PH model. The control group was fed under standard conditions. The hypoxia + drug groups received Zhishi Xiebai Guizhi Decoction and sildenafil once daily for 28 days. After the experiment, the ratio of pulmonary acceleration time to pulmonary ejection time(PAT/PET) was measured in rats from each group using echocardiography. Additionally, the mean pulmonary artery pressure(mPAP) in rats from each group was determined through right heart catheterization. Hematoxylin-eosin(HE) staining was employed to observe pathological changes in lung tissue, while Western blot was utilized to detect the expression levels of proteins associated with the phenotypic transformation of pulmonary artery tissue. At the in vitro level, primary PASMCs were cultured using the type Ⅱ collagenase digestion method and identified through immunocytochemistry staining. SPF SD rats were administered Zhishi Xiebai Guizhi Decoction, and drug-containing serum was collected. Cell counting kit-8(CCK-8) was utilized to determine the optimal intervention concentration of drug-containing serum on PASMCs under hypoxic conditions. The cells were categorized into the normoxia control group, hypoxia control group, and hypoxia + drug-containing serum groups(10% and 15% drug-containing serum). 5-ethynyl-2'-deoxyuridine(EdU) was employed to assess cell proliferation in each group. Cell migration was evaluated through Transwell and cell scratch experiments, while Western blot was used to analyze the expression levels of proteins associated with the phenotypic transformation of PASMCs in each group. In vivo results indicated that the expression of PAT/PET and contraction-rela-ted proteins of pulmonary artery tissue was significantly decreased in the hypoxia model group compared to the control group, while the expression of mPAP, pulmonary vessel wall thickness, and synthetic-related proteins was significantly increased. Furthermore, compared to the hypoxia model group, the expression of PAT/PET and contraction-related proteins of the pulmonary artery tissue of rats in the drug groups increased, along with a significant decrease in mPAP, pulmonary vessel wall thickness, and synthetic-related proteins. In vitro results demonstrated that hypoxia induction significantly up-regulated the proliferation and migration abilities of PASMCs, as well as the expression of synthetic-related proteins while decreasing the expression of contraction-related proteins compared to the normoxia control group. Additionally, compared to the hypoxia control group, serum with Zhishi Xiebai Guizhi Decoction was found to inhibit the proliferation and migration of PASMCs induced by hypoxia, reduce the expression of synthetic-related proteins, and up-regulate the expression of contraction-related proteins. In conclusion, Zhishi Xiebai Guizhi Decoction could inhibit the excessive proliferation and migration of PASMCs in a hypoxic environment, providing a protective effect on rats with HPH. This mechanism may involve the regulation of protein expression levels associated with the phenotypic transformation of PASMCs.
Objective
The incidence of sharp injury in nursing trainees was reduced, in order to protect the safety of nursing interns and reduce the brain drain.
Methods
The quality control circle was established in October 2015. According to the activity steps of the quality control circle, nursing trainees working in Shaanxi Provincial People's Hospital from July 2015 to May 2016 were examined and analyzed for the occurrence of sharp injury. The objectives were set and the countermeasures were made for the real causes. Finally, self-criticism and improvement were made and the results were evaluated.
Results
In one month the incidences of sharp injury in nursing trainees decreased from 58.7% before the improvement to 22.7% after the improvement.
Conclusions
Quality control circle activities can effectively reduce the incidence of sharp injuries in nursing trainees and ensure the occupational safety of nursing trainees.
Key words:
Nursing care; Teaching; Trainee; Sharp injury
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