ObjectiveTo investigate the effect of pediatric medical transport network on transport and treatment for children in Sichuan province. MethodA total of 4647 pediatric patients transported to West China Second University Hospital were recruited from January 2011 and December 2013 in our study, among whom 1 948 were admitted before the establishment of the transport network (January 2011 to August 2012) and 2 699 were admitted after the establishment of the transport network (September 2012 to December 2013). Transport modes, patient disposition and fatality were analyzed to evaluate the role of transport network in the transport and treatment for pediatric patients. ResultsThe transported patients increased significantly after the establishment of transport network (an average of 97 cases increased to 169 cases per month). After transport network was established, valid communication and telephone contact also increased significantly (the proportion increased from 20.64% to 45.28%, P<0.001). There were significant differences in the composition of patients' destination after the establishment of the transport network (P<0.001). After the establishment of transport network, the patients' hospitalized rate and admission rate increased dramatically (from 17.86% to 37.53%, 12.11% to 41.13%, respectively). The fatality decreased from 6.83% to 3.04% (P<0.001). ConclusionsRegional pediatric transport network will contribute to the treatment of pediatric patients within the region, and decrease fatality.
Objective To investigate the early diagnostic value of urinary neutrophil gelatinase-associated lipocalin (NGAL) for acute kidney injury (AKI) after acute Stanford type A aortic dissection. Methods From January 2018 to December 2018, the clinical data of 50 patients who underwent open surgery for acute Stanford type A aortic dissection were analyzed in Nanjing First Hospital. Urine specimens were collected before and 2 hours after the aortic dissection surgery. Patients were divided into an AKI group (n=27) and a non-AKI group (n=23) according to the Kidney Disease Improving Global Outcomes criteria. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of urine NGAL. ResultsThe incidence of postoperative AKI was 54.00% (27/50). There was a statistically significant difference between the two groups in serum creatinine concentration at 2 hours after surgery and urinary NGAL concentration before the surgery (P<0.05). The area under ROC curve of preoperative urinary NGAL concentration was 0.626. When cut-off value was 43 ng/mL, the sensitivity was 40.7%, specificity was 95.7%. The area under ROC curve of urinary NGAL concentration at 2 hours after surgery was 0.655, and when the cut-off value was 46.95 ng/mL, the sensitivity was 63.0%, specificity was 78.3%. Conclusion Urine NGAL can predict postoperative AKI in patients with acute Stanford type A aortic dissection, but its value is limited.
Sodium-glucose cotransporter (SGLT) -2 inhibitors is a new type of oral sugar-lowering drug. Instead of relying on insulin, it lowers blood sugar by inhibiting the reabsorption of near-curvy tube glucose, which is drained from the urine. SGLT-2 inhibitors not only have a sugar-lowering effect, but also benefit significantly in cardiovascular disease, and this drug has the advantages of permeable diuretic, reducing capacity load, and improving ventricular remodeling. SGLT-2 inhibitors can improve the diastolic function of patients with heart failure with preserved ejection fraction (HFpEF) and reduce the risk of adverse cardiovascular events. SGLT-2 inhibitors can benefit patients with HFpEF. Therefore, this article will discuss the progress of SGLT-2 inhibitors in HFpEF.
Objective To explore the effect of ghrelin on insulin secretion and expression of glucose transporter protein-2 （Glut-2） in isolated pancreas of rats. Methods Twenty five Wistar rats were randomly devided into normal control group （NC group）， high concentration of glucose group （HCG group）， high concentration of glucose with high concentration of ghrelin group （10-8mol/L， HCG＋HCGh group）， medium concentration of ghrelin group（10-9mol/L， HCG＋MCGh group）， and low concentration of ghrelin group （10-10mol/L， HCG＋LCGh group） with 5 rats in each group. The rat isolated pancreas perfusion models were established firstly， then from the distal end of abdominal aortas， the models were perfused with low concentration of glucose （5.5mmol/L）， high concentration of glucose （33.3mmol/L） or high concentration of glucose added with different concentrations of ghrelin. Levels of insulin outflowed from portal vein were tested by ELISA method， expression levels of Glut-2 protein were tested by immunohistochemical method，and ultrastructure changes of islet β cell were observed under the transmission electron microscope. Results There were no significant difference on levels of fasting blood glucose （FBG）， fasting insulins （FINS）， homeostasis model of assess-ment for insulin resistence index （HOMA-IR）， and homeostasis model of assessment for pancreatic β cell function （HOMA-β），（P＞0.05）. There were no significant difference on insulin levels of effluent from portal vein of 5 groups （P＞0.05） when isolated pancreas perfused with 5.5mmol/L glucose， while had 2 secretion peaks in 3min and 10-12min after 33.3 mmol/L glucose perfusion， where HCG＋HCGh group at the top. The mean density value of Glut-2 protein in NC group was higher than that of other 4 groups （P＜0.05）. The results of transmission electron microscopy showed that apoptosis was lighter in NC group than that of other 4 groups， and apoptosis of HCG＋HCGh group was lighter than that of HCG＋MCGh group and HCG＋LCGh group. Conclusions In isolated pancreas of rats， ghrelin promotes high concentration of glucose-stimulated insulin secretion， decreases expression of Glut-2 protein， and protects the islet β cell.
Interfacility transport of critically ill children is an important part of pre-hospital emergency care. The development of 5th generation mobile networks has brought revolutionary changes to emergency medicine, which can realize real-time sharing of information between hospitals and transfer ambulance units. In order to give full play to the advantages of superior medical institutions in diagnosis and treatment technology, equipment resources, and realize the safe and fast transfer of critically ill children, the technical specifications for the construction of interfacility transport of critically ill children’s ambulances with 5th generation mobile networks are specially formulated to standardize the team building, equipment and materials, transport process and quality control requirements for critically ill children’s ambulance transport, so as to reduce the fatality rate of critically ill children and improve the prognosis.
Objective To validate the different expressions of human fxyd6 gene between normal bile duct tissues and malignant tumor tissues, and to observe the subcellular localization of human fxyd6 gene in human cholangiocarcinoma cells. MethodsThe different expressions between normal bile duct tissues and malignant tumor tissues were identified by RT-PCR. In situ polymerase chain reaction （IS-RT-PCR） was applied to detect the subcellular localization of fxyd6 gene in paraffin sections of human cholangiocarcinoma cells. Image analysis software was used to semiquantitatively determine the difference between normal and malignant tissues. ResultsHuman fxyd6 gene was highly expressed in cholangiocarcinoma tissues and lowly expressed in normal ones. There was a significant difference between the expressions of carcinoma cells and normal cells （P＜0.05）. IS-RT-PCR showed that fxyd6 gene localized in the kytoplasma of epithelial cells of human cholangiocarcinoma. ConclusionHuman fxyd6 gene may act as an essential component of the malignant transformation process in human cholangiocarcinoma.
Objective To investigate the disease-causing gene of Stargardt disease. Method Fifteen patients with Stargardt disease were analyzed with 11 primers of the 11 exons of ABCR gene by using PCR-SSCP and DNA direct sequencing techniques. Results Three newly detected disease-causing mutations were found. Among those mutations, one is a frameshift mutation and others are single base transition. Conclusion This research confirmed that ABCR gene is associated with Stargardt disease, and 3 new mutations of ABCR gene were found. (Chin J Ocul Fundus Dis,2000,16:240-243)
Objective To investigate the clinical significance of the three iodide transporters in thyroid diseases. Methods Literatures about the Na+/I- symporter (NIS), pendrin and human apical iodide transporter (hAIT) in recent years were reviewed and their expressions in different thyroid diseases were also analyzed. Results NIS proteins express at the basolateral membrane of thyrocytes in normal thyroid tissue, while pendrin and hAIT proteins are limited to the apical membrane of thyrocytes lining in the follicular lumen. In the tissues of thyroid carcinomas, it was found that the NIS proteins expressed in the cytoplasm and their expressions decreased; The mutation of NIS gene may be one of the main causes of congenital hypothyroidism. The expression of prendrin protein may be related to the function of follicles: its expression level increased significantly both in Graves diseases and toxic adenomas, but significantly decreased in differentiated thyroid carcinoma. However, the correlation between the decrease and the degrees of differentiation of carcinoma cell line are still disputable. The expression of hAIT protein does not significantly altered in hyperfunctioning tissues. It only slightly decreased occasionally in hypofunctioning adenomas, but it decreased significantly in thyroid carcinomas. Conclusion The abnormal expressions of the three iodide transporters may be related closely with the type of thyroid diseases. However, their pathogenic mechanisms and the causes of their abnormal expression are still unknown, which need to be studied further.