不同剂量瑞舒伐他汀对冠脉介入术后急性心肌梗死患者心室重构、心功能、炎症反应及血脂的影响

目的探究不同剂量瑞舒伐他汀对冠脉介入术后急性心肌梗死患者心室重构、心功能及血脂的影响。方法选取2021年4月至2023年4月在内蒙古医科大学附属医院行冠脉介入术的患者为研究对象,依据患者使用药物剂量分为低剂量组、中剂量组和高剂量组。各组患者均给予常规药物阿司匹林及氯吡格雷治疗,在此基础上低剂量组、中剂量组和高剂量组睡前分别服用5 mg、10 mg和20 mg的瑞舒伐他汀。治疗前后通过超声心动图评估患者的心功能,记录左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)和左室射血分数(LVEF);检测空腹静脉血清C反应蛋白(CRP)、基质金属蛋白酶-9(MMP-9)、脑钠素(BNP)以评估心室重构情况;检测空腹血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)以评估对血脂的影响;检测各组患者治疗前后血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)以评估炎症反应。结果共纳入120例患者,每组40例。治疗后,3组患者LVEDD、LVESD、LVEDV、LVESV、LVEF、CRP、MMP-9、BNP、TC、TG、LDL-C、TNF-α和IL-6水平差异均有统计学意义(P<0.05)。相比低剂量组和中剂量组,高剂量组患者LVEDD、LVESD、LVEDV、LVESV、CRP、MMP-9、BNP、TC、TG、LDL-C、TNF-α和IL-6水平均显著降低,LVEF水平则显著升高(P<0.05)。结论不同剂量瑞舒伐他汀对冠脉介入术后急性心肌梗死患者心室重构、心功能及血脂的影响有一定的差异。相比常用的5 mg·d^(-1)和10 mg·d^(-1)剂量,使用20 mg·d^(-1)剂量瑞舒伐他汀预防心肌重塑改善心功能效果更佳。

MMP-1 Over-expression Promotes Malignancy and Stem-Like Properties of Human Osteosarcoma MG-63 Cells In Vitro

Osteosarcoma is the most common primary malignant bone tumor in childhood,and it maintains a high level of recurrence.Matrix metalloproteinase-1(MMP-1)was found to contribute to cancer progression.The present study was to investigate the in vitro effects of MMP-1 over-expression on the proliferation,invasion,metastasis and stem-like properties of osteosarcoma MG-63 cells.The MG-63 cells were cultured and had a full length MMP-1 cDNA inserted by the tentiviral vector (MG-63^MMP-1+).MG-63 negative control and MG-63 blank control groups were established as well.MMP-1 expression was detected in MG-63^MMP-1+,MG-63 negative control and MG-63 blank control cells using qPCR,Western blotting and immunofluorescence after 24h of culture. The cell proliferation assay was performed with a camera attached to a bioreactor,which was programmed to photograph five regions of each well every 10 min over a period of 48 h.The cell invasion assay was conducted with Matrigel to assess the invasive potential,of MG-63 cells over 24h,the qPCR analysis to measure stem cell markers,including Oct4, Sox-2,Nanog,and Pax-7,and Western blot analysis to detect invasive and metastatic potential markers TIMP-1,VEGF and BMP2/4,after 24h of culture.Immunofluorescence was used to investigate the presence of the stem cell marker Pax-7 after 24-h culture. The results showed that over-expression of MMP-1 after transfection could significantly increase minor cell proliferation and invasion (P<0.05,MG-63^MMP-1+ versus controls).Pax-7 was highly expressed in MG-63^MMP-1+ cells,with no significant changes of Oct-4,Sox-2, and Nanog observed (P<0.05).MG-63^MMP-1+ cells showed higher expression of VEGF and BMP 2/4 proteins and lower expression of TIMP-1 protein than controls (P<0.05).It was concluded that MMP-1 over-expression in MG-63 cells contributed to the proliferation, invasion,metastasis and stem-like properties of osteosarcoma cells.Future studies should focus on in vivo effects of MMP-1 over-expression and the application of MMP-1 and Pax-7 inhibition in vivo to osteosarcoma theraoies.

Cross-sectional study of the educational background and trauma knowledge of trainees in the “China trauma care training” program

Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.Methods:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in China.All participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the hospitals.Results:There were 955 males(78.9%)and 256 females(21.1%)enrolled.Among them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=0.031.The score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),P<0.0001.The score of the individuals who attended experts’trauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=0.001.The mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,P<0.001.The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant difference(P<0.05).Conclusions:The level of trauma knowledge of trauma care providers was associated with their department,professional position and previous participation in related academic conferences.Trauma care experience and participation in academic lectures and training program including CTCT may effectively improve individuals’level of trauma knowledge.

Correlations between quality indexes of chest compression

BACKGROUND:Cardiopulmonary resuscitation(CPR) is a kind of emergency treatment for cardiopulmonary arrest,and chest compression is the most important and necessary part of CPR.The American Heart Association published the new Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care in 2010 and demanded for better performance of chest compression practice,especially in compression depth and rate.The current study was to explore the relationship of quality indexes of chest compression and to identify the key points in chest compression training and practice.METHODS:Totally 219 healthcare workers accepted chest compression training by using Laerdal ACLS advanced life support resuscitation model.The quality indexes of chest compression,including compression hands placement,compression rate,compression depth,and chest wall recoil as well as self-reported fatigue time were monitored by the Laerdal Computer Skills and Reporting System.RESULTS:The quality of chest compression was related to the gender of the compressor.The indexes in males,including self-reported fatigue time,the accuracy of compression depth and the compression rate,the accuracy of compression rate,were higher than those in females.However,the accuracy of chest recoil was higher in females than in males.The quality indexes of chest compression were correlated with each other.The self-reported fatigue time was related to all the indexes except the compression rate.CONCLUSION:It is necessary to offer CPR training courses regularly.In clinical practice,it might be better to change the practitioner before fatigue,especially for females or weak practitioners.In training projects,more attention should be paid to the control of compression rate,in order to delay the fatigue,guarantee enough compression depth and improve the quality of chest compression.

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chin ese Trauma Surge on Associati on orga nized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries.Eleven questions regarding the use of VSD in abdominal surgeries were addressed:(1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions?(2) Can VSD be preventively used for a high-risk abdominal incision w让h primary suture?(3) Can VSD be used in severely contaminated/infected abdominal surgical sites?(4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome?(5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage?(6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula?(7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess?(8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects?(9) Does VSD in crease the risk of bleeding?(10) Does VSD increase the risk of intestinal wail injury?(11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

Current trauma care system and trauma care training in China

损伤是威胁生活的现代疾病。结果能被成本效率、迅速的损伤照顾仅仅优化，它除了损伤照顾系统的造成分裂的革新开始必要能力和概念的革命的改进。根据来自发达国家的经验，系统的损伤照顾训练在损伤照顾上是归纳和改进的奠基石，例如进展损伤生活支持(ATLS ) 。当前，医院前紧急情况医疗服务(他们) 是在中国的健康服务的基础结构的必要元素之一，它对损伤照顾系统也基本。在此，有独立知识产权权利的训练的中国损伤照顾(CTCT ) 被开始了并且由中国损伤外科医生协会发射了也在损伤照顾的地里扩大新概念和技术在惯例增强通常接受得好的标准化协议。这篇文章考察损伤照顾系统以及训练的损伤照顾的当前的地位。

Trauma care system in China

与现代社会的发展，高精力的损伤成为了一个增加的趋势，它为损伤照顾带大挑战。由医院前和在里面医院照顾是镇静的一个跑得好的损伤照顾系统被证明了到死亡和残疾损伤病人评估的减少。然而，在中国的损伤照顾系统的建立仍然在起始的阶段。在美国和德国代表的中国和发达国家的损伤照顾系统在这篇文章分别地被介绍。地区性、层次的损伤中心的建设，特定的损伤照顾队和综合损伤营救模型的性能训练在中国被推荐。