目的总结加速康复外科(enhanced recovery after surgery,ERAS)理念下发育性髋关节发育不良(developmental dysplasia of the hip,DDH)患儿围手术期护理的最佳证据,为临床实践提供参考。方法本研究系统检索ERAS理念下DDH患儿围手术期护...目的总结加速康复外科(enhanced recovery after surgery,ERAS)理念下发育性髋关节发育不良(developmental dysplasia of the hip,DDH)患儿围手术期护理的最佳证据,为临床实践提供参考。方法本研究系统检索ERAS理念下DDH患儿围手术期护理相关的临床决策、临床实践指南、专家共识、系统评价和原始研究,分别对其方法学质量进行评价,随后对资料进行提取、分析和归纳并汇总成最佳证据,检索时限为建库至2023年11月15日。结果最终共纳入11篇文献,包括指南3篇、证据总结2篇、专家共识3篇、系统评价2篇、随机对照试验1篇。从术前护理、术中护理及术后护理3个方面提取了20条最佳证据。结论ERAS理念下DDH患儿围手术期护理的最佳证据可为临床实践提供依据。临床应用时,应结合患儿的具体情况,加速患儿术后的康复,促进外科护理高质量发展。展开更多
BACKGROUND Glucotoxic pancreaticβcells impair glycogenesis of hepatocytes,with exosomes serving as novel mediators.miR-375-3p is the most abundant miRNA in the pancreas and critical forβ-cell function,but whether it...BACKGROUND Glucotoxic pancreaticβcells impair glycogenesis of hepatocytes,with exosomes serving as novel mediators.miR-375-3p is the most abundant miRNA in the pancreas and critical forβ-cell function,but whether it plays a role in pancreasliver crosstalk remains unclear.AIM To investigate the role of miR-375-3p,a key regulator of pancreaticβcells,in remotely regulating hepatocyte glycogenesis via exosomes.METHODS Mice fed a high-fat diet(HFD)served as animal models,and mouse primary pancreatic islet cells and theβ-cell line MIN-6 were used as cellular models.miR-375-3p expression in pancreatic cells,hepatocytes and exosomes was detected in both animal and cellular models.Transwell assays,exosome treatment,and exosome-depleted supernatant culture were used to investigate the role of exosomal miR-375-3p in pancreatic-hepatocyte crosstalk.The AKT/GSK signaling pathway and hepatic glycogen content were used as indicators to evaluate hepatocyte glycogenesis.Luciferase reporter assays were used to evaluate the downstream targets of miR-375-3p.RESULTS Increased levels of miR-375-3p were observed in both the pancreas and liver of HFD-fed mice.In contrast to the in vivo results,high-glucose treatment exclusively increased the expression of miR-375-3p in pancreatic cells but had no effect on hepatocytes.Furthermore,hepatocytes treated with the supernatant and exosomes from glucotoxic pancreatic cells presented elevated expression of miR-375-3p.Additionally,exosomal transfer of miR-375-3p from pancreatic cells to hepatocytes suppressed the AKT/GSK signaling pathway,thereby reducing the hepatic glycogen content.Luciferase analysis indicated that the recombination signal binding protein for the immunoglobulin kappa J region(Rbpj)is a target gene of miR-375-3p.Rbpj inhibition impaired hepatic glycogenesis,and Rbpj overexpression reversed the effect on glycogenesis induced by miR-375-3p.CONCLUSION Pancreatic cell-derived miR-375-3p can be delivered to hepatocytes via exosomes and inhibits hepatocyte glycogenesis by targeting Rbpj.展开更多
BACKGROUND: The bispectral(BIS) index is a processed electroencephalogram(EEG) parameter with extensive validation and demonstrated clinical utility. The study aimed to investigate the correlation between the BIS inde...BACKGROUND: The bispectral(BIS) index is a processed electroencephalogram(EEG) parameter with extensive validation and demonstrated clinical utility. The study aimed to investigate the correlation between the BIS index and the prognosis of patients with coma in the ICU.METHODS: A total of 208 patients with coma in the ICU were enrolled in this study. According to the BIS value, the patients were divided into four groups: group I, BIS value 0 to 20; group II, BIS value 21 to 40; group III, BIS value 41 to 60; and group IV, BIS value greater than 60. The difference in BIS values with the differences in prognosis of patients with coma was compared between the four groups, and the prognosis of patients with coma was stratified into consciousness, coma, vegetative state, and brain death. Subsequently, the best cut-off score of BIS values calculated for determining the correlation between BIS value and mental state was proposed.RESULTS: There are no significant differences in the age and APACHE II scores between the four groups(P>0.05). An inverse correlation was observed between BIS value and mental state(r= –0.749, P=0.00). According to the ROC curve, as BIS value was greater than 42.5, there were higher sensitivity and specificity in conscious-coma patients.CONCLUSION: BIS value is correlated with the prognosis of patients with coma in ICU, and BIS value can be a useful marker for estimating the prognosis of comatose patients.展开更多
Aging is a gradual and irreversible pathophysiological process.It presents with declines in tissue and cell functions and significant increases in the risks of various aging-related diseases,including neurodegenerativ...Aging is a gradual and irreversible pathophysiological process.It presents with declines in tissue and cell functions and significant increases in the risks of various aging-related diseases,including neurodegenerative diseases,cardiovascular diseases,metabolic diseases,musculoskeletal diseases,and immune system diseases.Although the development of modern medicine has promoted human health and greatly extended life expectancy,with the aging of society,a variety of chronic diseases have gradually become the most important causes of disability and death in elderly individuals.Current research on aging focuses on elucidating how various endogenous and exogenous stresses(such as genomic instability,telomere dysfunction,epigenetic alterations,loss of proteostasis,compromise of autophagy,mitochondrial dysfunction,cellular senescence,stem cell exhaustion,altered intercellular communication,deregulated nutrient sensing)participate in the regulation of aging.Furthermore,thorough research on the pathogenesis of aging to identify interventions that promote health and longevity(such as caloric restriction,microbiota transplantation,and nutritional intervention)and clinical treatment methods for aging-related diseases(depletion of senescent cells,stem cell therapy,antioxidative and anti-inflammatory treatments,and hormone replacement therapy)could decrease the incidence and development of aging-related diseases and in turn promote healthy aging and longevity.展开更多
DEAD-box helicase 17(DDX17)is a typical member of the DEAD-box family with transcriptional cofactor activity.Although DDX17 is abundantly expressed in the myocardium,its role in heart is not fully understood.We genera...DEAD-box helicase 17(DDX17)is a typical member of the DEAD-box family with transcriptional cofactor activity.Although DDX17 is abundantly expressed in the myocardium,its role in heart is not fully understood.We generated cardiomyocyte-specific Ddx17-knockout mice(Ddx17-cKO),cardiomyocyte-specific Ddx17 transgenic mice(Ddx17-Tg),and various models of cardiomyocyte injury and heart failure(HF).DDX17 is downregulated in the myocardium of mouse models of heart failure and cardiomyocyte injury.Cardiomyocyte-specific knockout of Ddx17 promotes autophagic flux blockage and cardiomyocyte apoptosis,leading to progressive cardiac dysfunction,maladaptive remodeling and progression to heart failure.Restoration of DDX17 expression in cardiomyocytes protects cardiac function under pathological conditions.Further studies showed that DDX17 can bind to the transcriptional repressor B-cell lymphoma 6(BCL6)and inhibit the expression of dynamin-related protein 1(DRP1).When DDX17 expression is reduced,transcriptional repression of BCL6 is attenuated,leading to increased DRP1 expression and mitochondrial fission,which in turn leads to impaired mitochondrial homeostasis and heart failure.We also investigated the correlation of DDX17 expression with cardiac function and DRP1 expression in myocardial biopsy samples from patients with heart failure.These findings suggest that DDX17 protects cardiac function by promoting mitochondrial homeostasis through the BCL6-DRP1 pathway in heart failure.展开更多
文摘目的总结加速康复外科(enhanced recovery after surgery,ERAS)理念下发育性髋关节发育不良(developmental dysplasia of the hip,DDH)患儿围手术期护理的最佳证据,为临床实践提供参考。方法本研究系统检索ERAS理念下DDH患儿围手术期护理相关的临床决策、临床实践指南、专家共识、系统评价和原始研究,分别对其方法学质量进行评价,随后对资料进行提取、分析和归纳并汇总成最佳证据,检索时限为建库至2023年11月15日。结果最终共纳入11篇文献,包括指南3篇、证据总结2篇、专家共识3篇、系统评价2篇、随机对照试验1篇。从术前护理、术中护理及术后护理3个方面提取了20条最佳证据。结论ERAS理念下DDH患儿围手术期护理的最佳证据可为临床实践提供依据。临床应用时,应结合患儿的具体情况,加速患儿术后的康复,促进外科护理高质量发展。
基金Supported by Beijing Natural Science Foundation,No.7252124National High Level Hospital Clinical Research Funding,No.BJ-2024-219,No.BJ-2025-125 and No.BJ-2023-236+1 种基金National Natural Science Foundation of China,No.82370584,No.82470395 and No.81600618National Key R&D Program of China,No.2021YFE0114200.
文摘BACKGROUND Glucotoxic pancreaticβcells impair glycogenesis of hepatocytes,with exosomes serving as novel mediators.miR-375-3p is the most abundant miRNA in the pancreas and critical forβ-cell function,but whether it plays a role in pancreasliver crosstalk remains unclear.AIM To investigate the role of miR-375-3p,a key regulator of pancreaticβcells,in remotely regulating hepatocyte glycogenesis via exosomes.METHODS Mice fed a high-fat diet(HFD)served as animal models,and mouse primary pancreatic islet cells and theβ-cell line MIN-6 were used as cellular models.miR-375-3p expression in pancreatic cells,hepatocytes and exosomes was detected in both animal and cellular models.Transwell assays,exosome treatment,and exosome-depleted supernatant culture were used to investigate the role of exosomal miR-375-3p in pancreatic-hepatocyte crosstalk.The AKT/GSK signaling pathway and hepatic glycogen content were used as indicators to evaluate hepatocyte glycogenesis.Luciferase reporter assays were used to evaluate the downstream targets of miR-375-3p.RESULTS Increased levels of miR-375-3p were observed in both the pancreas and liver of HFD-fed mice.In contrast to the in vivo results,high-glucose treatment exclusively increased the expression of miR-375-3p in pancreatic cells but had no effect on hepatocytes.Furthermore,hepatocytes treated with the supernatant and exosomes from glucotoxic pancreatic cells presented elevated expression of miR-375-3p.Additionally,exosomal transfer of miR-375-3p from pancreatic cells to hepatocytes suppressed the AKT/GSK signaling pathway,thereby reducing the hepatic glycogen content.Luciferase analysis indicated that the recombination signal binding protein for the immunoglobulin kappa J region(Rbpj)is a target gene of miR-375-3p.Rbpj inhibition impaired hepatic glycogenesis,and Rbpj overexpression reversed the effect on glycogenesis induced by miR-375-3p.CONCLUSION Pancreatic cell-derived miR-375-3p can be delivered to hepatocytes via exosomes and inhibits hepatocyte glycogenesis by targeting Rbpj.
文摘BACKGROUND: The bispectral(BIS) index is a processed electroencephalogram(EEG) parameter with extensive validation and demonstrated clinical utility. The study aimed to investigate the correlation between the BIS index and the prognosis of patients with coma in the ICU.METHODS: A total of 208 patients with coma in the ICU were enrolled in this study. According to the BIS value, the patients were divided into four groups: group I, BIS value 0 to 20; group II, BIS value 21 to 40; group III, BIS value 41 to 60; and group IV, BIS value greater than 60. The difference in BIS values with the differences in prognosis of patients with coma was compared between the four groups, and the prognosis of patients with coma was stratified into consciousness, coma, vegetative state, and brain death. Subsequently, the best cut-off score of BIS values calculated for determining the correlation between BIS value and mental state was proposed.RESULTS: There are no significant differences in the age and APACHE II scores between the four groups(P>0.05). An inverse correlation was observed between BIS value and mental state(r= –0.749, P=0.00). According to the ROC curve, as BIS value was greater than 42.5, there were higher sensitivity and specificity in conscious-coma patients.CONCLUSION: BIS value is correlated with the prognosis of patients with coma in ICU, and BIS value can be a useful marker for estimating the prognosis of comatose patients.
基金supported by funds from the National Key R&D Program of China(2018YFC2000100 and 2021YFE0114200)the National Natural Science Foundation of China(81770228,81770858,81600618,and 82271597)+1 种基金the Beijing Natural Science Foundation(7212086)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-050).
文摘Aging is a gradual and irreversible pathophysiological process.It presents with declines in tissue and cell functions and significant increases in the risks of various aging-related diseases,including neurodegenerative diseases,cardiovascular diseases,metabolic diseases,musculoskeletal diseases,and immune system diseases.Although the development of modern medicine has promoted human health and greatly extended life expectancy,with the aging of society,a variety of chronic diseases have gradually become the most important causes of disability and death in elderly individuals.Current research on aging focuses on elucidating how various endogenous and exogenous stresses(such as genomic instability,telomere dysfunction,epigenetic alterations,loss of proteostasis,compromise of autophagy,mitochondrial dysfunction,cellular senescence,stem cell exhaustion,altered intercellular communication,deregulated nutrient sensing)participate in the regulation of aging.Furthermore,thorough research on the pathogenesis of aging to identify interventions that promote health and longevity(such as caloric restriction,microbiota transplantation,and nutritional intervention)and clinical treatment methods for aging-related diseases(depletion of senescent cells,stem cell therapy,antioxidative and anti-inflammatory treatments,and hormone replacement therapy)could decrease the incidence and development of aging-related diseases and in turn promote healthy aging and longevity.
基金supported by grants from the National Key R&D Program of China(2021YFE0114200,2018YFC2000100)the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(2021-I2M-1-050)+4 种基金the Project funded by China Postdoctoral Science Foundation(2023M732704)the National Natural Science Foundation of China(81770228,82370584,81470427 and U23A20470)the Beijing Natural Science Foundation(7232141,7212086)the Beijing Hospital Clinical Research 121 Project(121-2016004)the National High Level Hospital Clinical Research Funding(BJ-2021-199,BJ-2023-156,BJ-2019-159).
文摘DEAD-box helicase 17(DDX17)is a typical member of the DEAD-box family with transcriptional cofactor activity.Although DDX17 is abundantly expressed in the myocardium,its role in heart is not fully understood.We generated cardiomyocyte-specific Ddx17-knockout mice(Ddx17-cKO),cardiomyocyte-specific Ddx17 transgenic mice(Ddx17-Tg),and various models of cardiomyocyte injury and heart failure(HF).DDX17 is downregulated in the myocardium of mouse models of heart failure and cardiomyocyte injury.Cardiomyocyte-specific knockout of Ddx17 promotes autophagic flux blockage and cardiomyocyte apoptosis,leading to progressive cardiac dysfunction,maladaptive remodeling and progression to heart failure.Restoration of DDX17 expression in cardiomyocytes protects cardiac function under pathological conditions.Further studies showed that DDX17 can bind to the transcriptional repressor B-cell lymphoma 6(BCL6)and inhibit the expression of dynamin-related protein 1(DRP1).When DDX17 expression is reduced,transcriptional repression of BCL6 is attenuated,leading to increased DRP1 expression and mitochondrial fission,which in turn leads to impaired mitochondrial homeostasis and heart failure.We also investigated the correlation of DDX17 expression with cardiac function and DRP1 expression in myocardial biopsy samples from patients with heart failure.These findings suggest that DDX17 protects cardiac function by promoting mitochondrial homeostasis through the BCL6-DRP1 pathway in heart failure.
