AIM： To explore the effect of Astraga/us mongholicus polysaccharide （APS） on gene expression and mitogenactivated protein kinase （MAPK） transcriptional activity in intestinal epithelial cells （IEC）. METHODS： I...AIM： To explore the effect of Astraga/us mongholicus polysaccharide （APS） on gene expression and mitogenactivated protein kinase （MAPK） transcriptional activity in intestinal epithelial cells （IEC）. METHODS： IEC were divided into control group, lipopolysaccharide （LPS） group, LPS＋ 50 μg/mL APS group, LPS＋ 100 μg/mL APS group, LPS＋ 200 μg/mL APS group, and LPS＋ 500 μg/mL APS group. Levels of mRNAs in LPS-induced inflammatory factors, tumor necrosis factor （TNF）-α and interleukin （IL）-8, were measured by reverse transcription-polymerase chain reaction. MAPK protein level was measured by Western blotting. RESULTS： The levels of TNF-α and IL-8 mRNAs were significantly higher in IEC with LPS-induced damage than in control cells. APS significantly abrogated the LPS-induced expression of the TNF-α and IL-8 genes. APS did not block the activation of extracellular signal- regulated kinase or c Jun amino-terminal kinase, but inhibited the activation of p38, suggesting that APS inhibits LPS-induced production of TNF-α and IL-8 mRNAs, possibly by suppressing the p38 signaling pathway.CONCLUSION： APS-modulated bacterial productmediated p38 signaling represents an attractive strategy for prevention and treatment of intestinal inflammation.展开更多
Purpose:The purpose was to explore the experiences of nurses caring for patients with delirium in ICU in China.Methods:Semi-structured qualitative interviews were conducted with 14 ICU nurses in Beijing,China.Audio re...Purpose:The purpose was to explore the experiences of nurses caring for patients with delirium in ICU in China.Methods:Semi-structured qualitative interviews were conducted with 14 ICU nurses in Beijing,China.Audio recordings of the transcripts were coded and analysed thematically.Results:The emergent themes reflected clearly similar experiences and were titled as follows:Internal and external barriers to care;Care burden:workload,psychological pressure and injury;Dilemmas in decision-making:balancing risks and benefits.Conclusions:The results of this qualitative study have provided a rich description of the perceptions of a sample of nurses caring for patients with dementia in Beijing.Clearly,the nurses suffered from their work experiences in several aspects:they lacked the knowledge and skills required assessing and managing the patients as early as possible;they were physically and psychologically stressed while looking after the patients and faced with dilemmas and compromises in their decision-making.展开更多
目的基于机器学习构建和验证肝移植术后患者重症监护室(intensive care unit,ICU)住院时间延长(prolonged ICU stay,pLOS-ICU)的预测模型。方法回顾性纳入2013年4月至2024年4月的新疆医科大学第一附属医院接受肝移植并收治ICU的成年患...目的基于机器学习构建和验证肝移植术后患者重症监护室(intensive care unit,ICU)住院时间延长(prolonged ICU stay,pLOS-ICU)的预测模型。方法回顾性纳入2013年4月至2024年4月的新疆医科大学第一附属医院接受肝移植并收治ICU的成年患者。基于10种机器学习方法建立预测模型,通过比较受试者工作特征曲线下面积(area under the curve,AUC)、临床决策曲线等评估模型预测能力,使用可解释机器学习算法(shapley additive explanations,SHAP)对变量进行解释。结果本研究纳入230例患者,分为训练集162例,内部验证集68例。在训练集中对术前人口学特征、基础疾病、术中情况、术后早期实验室指标及支持治疗等共20个变量进行筛选,最终选取术后8 h中性粒细胞占比、术后8 h血红蛋白、术后8 h白蛋白、术后8 h非结合胆红素、术后24 h丙氨酸氨基转移酶(alanine aminotransferase,ALT)、术后是否使用多巴胺及术后是否使用肠外营养支持7个变量进行模型构建,其中Logistic模型为最佳模型(训练集AUC=0.797,内部验证集AUC=0.819)。采用SHAP值评估特征重要性,其中早期肝功能指标、营养指标和全身炎症反应在pLOS-ICU预测中占据核心地位。结论术后早期肝功能指标、炎症状态、循环与营养支持及基础疾病是肝移植患者PLOS-ICU的关键预测因素,SHAP值分析有助于个体化风险评估与早期干预决策。展开更多
目的:探讨不同干预措施对ICU获得性衰弱(ICU-AW)的影响,为临床实践提供依据。方法:通过系统评价与荟萃分析,计算机检索PubMed、Embase、ScienceDirect、Web of Science、中国知网等数据库,收集相关主题系统评价,设定纳入标准与排除标准...目的:探讨不同干预措施对ICU获得性衰弱(ICU-AW)的影响,为临床实践提供依据。方法:通过系统评价与荟萃分析,计算机检索PubMed、Embase、ScienceDirect、Web of Science、中国知网等数据库,收集相关主题系统评价,设定纳入标准与排除标准,经文献筛选、信息提取、质量评价、有效性评价及证据图谱制作等步骤进行研究。结果:共纳入35项研究,多数优效及方法学质量较高的干预措施集中在早期运动和神经电生理学检查,17篇早期活动的Meta分析中有11篇显示其能优效改善ICU-AW,8篇神经肌肉电刺激相关文章中有6篇显示其可优效改善。结论:早期运动和神经肌肉电刺激是改善ICU-AW有效的干预措施,但受研究局限性影响,其有效性仍需进一步验证,未来需关注研究热点变化,调整研究方向,深入研究不同干预措施联合应用潜力。展开更多
Summary What is already known about this topic?Anisodus tanguticus belongs to the Solanaceae family.The plant is toxic due to the tropane alkaloids it contains and can cause poisoning when it is ingested or used inapp...Summary What is already known about this topic?Anisodus tanguticus belongs to the Solanaceae family.The plant is toxic due to the tropane alkaloids it contains and can cause poisoning when it is ingested or used inappropriately.What is added by this report?A poisoning outbreak involved 10 patients,and one death was caused by Anisodus tanguticus.The etiological association of plant exposure and poisoning was confirmed with evidence from an epidemiological investigation,clinical manifestations,plant identification and a toxin analysis.展开更多
文摘AIM： To explore the effect of Astraga/us mongholicus polysaccharide （APS） on gene expression and mitogenactivated protein kinase （MAPK） transcriptional activity in intestinal epithelial cells （IEC）. METHODS： IEC were divided into control group, lipopolysaccharide （LPS） group, LPS＋ 50 μg/mL APS group, LPS＋ 100 μg/mL APS group, LPS＋ 200 μg/mL APS group, and LPS＋ 500 μg/mL APS group. Levels of mRNAs in LPS-induced inflammatory factors, tumor necrosis factor （TNF）-α and interleukin （IL）-8, were measured by reverse transcription-polymerase chain reaction. MAPK protein level was measured by Western blotting. RESULTS： The levels of TNF-α and IL-8 mRNAs were significantly higher in IEC with LPS-induced damage than in control cells. APS significantly abrogated the LPS-induced expression of the TNF-α and IL-8 genes. APS did not block the activation of extracellular signal- regulated kinase or c Jun amino-terminal kinase, but inhibited the activation of p38, suggesting that APS inhibits LPS-induced production of TNF-α and IL-8 mRNAs, possibly by suppressing the p38 signaling pathway.CONCLUSION： APS-modulated bacterial productmediated p38 signaling represents an attractive strategy for prevention and treatment of intestinal inflammation.
基金This study was financially supported by the Capital Foundation of Traditional Medicine and Nursing Research(approval number:10ZYH14)Funding Project for Academic Human Resources Development in Institutions of Higher Learning under the Jurisdiction of Beijing Municipality(PHR201107114)。
文摘Purpose:The purpose was to explore the experiences of nurses caring for patients with delirium in ICU in China.Methods:Semi-structured qualitative interviews were conducted with 14 ICU nurses in Beijing,China.Audio recordings of the transcripts were coded and analysed thematically.Results:The emergent themes reflected clearly similar experiences and were titled as follows:Internal and external barriers to care;Care burden:workload,psychological pressure and injury;Dilemmas in decision-making:balancing risks and benefits.Conclusions:The results of this qualitative study have provided a rich description of the perceptions of a sample of nurses caring for patients with dementia in Beijing.Clearly,the nurses suffered from their work experiences in several aspects:they lacked the knowledge and skills required assessing and managing the patients as early as possible;they were physically and psychologically stressed while looking after the patients and faced with dilemmas and compromises in their decision-making.
文摘目的:探讨不同干预措施对ICU获得性衰弱(ICU-AW)的影响,为临床实践提供依据。方法:通过系统评价与荟萃分析,计算机检索PubMed、Embase、ScienceDirect、Web of Science、中国知网等数据库,收集相关主题系统评价,设定纳入标准与排除标准,经文献筛选、信息提取、质量评价、有效性评价及证据图谱制作等步骤进行研究。结果:共纳入35项研究,多数优效及方法学质量较高的干预措施集中在早期运动和神经电生理学检查,17篇早期活动的Meta分析中有11篇显示其能优效改善ICU-AW,8篇神经肌肉电刺激相关文章中有6篇显示其可优效改善。结论:早期运动和神经肌肉电刺激是改善ICU-AW有效的干预措施,但受研究局限性影响,其有效性仍需进一步验证,未来需关注研究热点变化,调整研究方向,深入研究不同干预措施联合应用潜力。
文摘Summary What is already known about this topic?Anisodus tanguticus belongs to the Solanaceae family.The plant is toxic due to the tropane alkaloids it contains and can cause poisoning when it is ingested or used inappropriately.What is added by this report?A poisoning outbreak involved 10 patients,and one death was caused by Anisodus tanguticus.The etiological association of plant exposure and poisoning was confirmed with evidence from an epidemiological investigation,clinical manifestations,plant identification and a toxin analysis.
