目的系统分析老年髋关节置换术患者发生术后谵妄的危险因素,为临床护理实践提供参考。方法在PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据、维普数据库、中国生物医学文献数据库中搜集相关文献,检索时限为建...目的系统分析老年髋关节置换术患者发生术后谵妄的危险因素,为临床护理实践提供参考。方法在PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据、维普数据库、中国生物医学文献数据库中搜集相关文献,检索时限为建库至2022年11月1日,由2名研究者对文献进行筛选、资料提取和质量评价后,采用RevMan 5.4软件进行Meta分析。结果共纳入23篇文献,包括19298例患者。Meta分析结果显示,年龄、男性、股骨颈骨折、术后低氧血症、糖尿病、卒中史、痴呆/术前认知功能障碍、全身麻醉、ASA分级高、术后VAS疼痛评分>3分、低水平血红蛋白、受伤至手术时间>3 d是老年髋关节置换术后谵妄的危险因素(均P<0.05)。结论老年髋关节置换术后发生谵妄受较多因素影响,医护人员应针对谵妄危险因素,进行早期筛查、及早干预。但受纳入研究所限,上述结论尚需要更多高质量研究予以验证。展开更多
BACKGROUND Crohn’s disease(CD)is an incurable intestinal disorder with unclear etiology and pathogenesis.Currently,there is a lack of specific biomarkers and drug targets for CD in clinical practice.It is essential t...BACKGROUND Crohn’s disease(CD)is an incurable intestinal disorder with unclear etiology and pathogenesis.Currently,there is a lack of specific biomarkers and drug targets for CD in clinical practice.It is essential to identify the precise pathophysiological mechanism of CD and investigate new therapeutic targets.AIM To explore a new biomarker and therapeutic target for CD and verify its role in the CD pathological mechanism.METHODS Proteomics was performed to quantify the protein profile in the plasma of 20 CD patients and 20 matched healthy controls.Hub genes among the selected differentially expressed proteins(DEPs)were detected via the MCODE plugin in Cytoscape software.The expression level of one hub gene with an immunoregulatory role that interested us was verified in the inflamed intestinal tissues of 20 CD patients by immunohistochemical analysis.After that,the effects of the selected hub gene on the intestinal inflammation of CD were identified in a CD cell model by examining the levels of proinflammatory cytokines by enzymelinked immunosorbent assays and the expression of the NF-κB signalling pathway by quantitative real-time PCR analysis and Western blot assays.RESULTS Thirty-five DEPs were selected from 393 credible proteins identified by proteomic analysis.Among the DEPs,fibrinogen-like protein 1(FGL1),which attracted our attention due to its function in the regulation of the immune response,had 1.722-fold higher expression in the plasma of CD patients and was identified as a hub gene by MCODE.Furthermore,the expression of FGL1 in the intestinal mucosal and epithelial tissues of CD patients was also upregulated(P<0.05).In vitro,the mRNA levels of FGL1 and NF-κB;the protein expression levels of FGL1,IKKα,IKKβ,p-IKKα/β,p-IκBα,and p-p65;and the concentrations of the proinflammatory cytokines IL-1β,IL-6,IL-17,and TNF-αwere increased(P<0.05)after stimulation with lipopolysaccharide,which were reversed by knockdown of FGL1 with siRNA transfection(P<0.05).Conversely,FGL1 overexpression enhanced the abovementioned results(P<0.05).CONCLUSION FGL1 can induce intestinal inflammation by activating the canonical NF-κB signalling pathway,and it may be considered a potential biomarker and therapeutic target for CD.展开更多
基金Supported by National Natural Science Foundation of China,No.82074431The Open Projects of the Discipline of Chinese Medicine of Nanjing University of Chinese Medicine Supported by the Subject of Academic Priority Discipline of Jiangsu Higher Education Institutions,No.ZYX03KF034Suzhou Municipal Science and Technology Bureau,No.SYSD2020253 and No.SS202085.
文摘BACKGROUND Crohn’s disease(CD)is an incurable intestinal disorder with unclear etiology and pathogenesis.Currently,there is a lack of specific biomarkers and drug targets for CD in clinical practice.It is essential to identify the precise pathophysiological mechanism of CD and investigate new therapeutic targets.AIM To explore a new biomarker and therapeutic target for CD and verify its role in the CD pathological mechanism.METHODS Proteomics was performed to quantify the protein profile in the plasma of 20 CD patients and 20 matched healthy controls.Hub genes among the selected differentially expressed proteins(DEPs)were detected via the MCODE plugin in Cytoscape software.The expression level of one hub gene with an immunoregulatory role that interested us was verified in the inflamed intestinal tissues of 20 CD patients by immunohistochemical analysis.After that,the effects of the selected hub gene on the intestinal inflammation of CD were identified in a CD cell model by examining the levels of proinflammatory cytokines by enzymelinked immunosorbent assays and the expression of the NF-κB signalling pathway by quantitative real-time PCR analysis and Western blot assays.RESULTS Thirty-five DEPs were selected from 393 credible proteins identified by proteomic analysis.Among the DEPs,fibrinogen-like protein 1(FGL1),which attracted our attention due to its function in the regulation of the immune response,had 1.722-fold higher expression in the plasma of CD patients and was identified as a hub gene by MCODE.Furthermore,the expression of FGL1 in the intestinal mucosal and epithelial tissues of CD patients was also upregulated(P<0.05).In vitro,the mRNA levels of FGL1 and NF-κB;the protein expression levels of FGL1,IKKα,IKKβ,p-IKKα/β,p-IκBα,and p-p65;and the concentrations of the proinflammatory cytokines IL-1β,IL-6,IL-17,and TNF-αwere increased(P<0.05)after stimulation with lipopolysaccharide,which were reversed by knockdown of FGL1 with siRNA transfection(P<0.05).Conversely,FGL1 overexpression enhanced the abovementioned results(P<0.05).CONCLUSION FGL1 can induce intestinal inflammation by activating the canonical NF-κB signalling pathway,and it may be considered a potential biomarker and therapeutic target for CD.
