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Objective:To compare the effect and safety of continuous veno-venous hemofiltration (CVVH)+double plasma molecular absorption (DPMA)+hemoperfusion (HP), CVVH+HP, and CVVH+plasma exchange (PE) in treatment of patient with severe wasp stings injury.Methods:Multicenter, historical cohort study and superiority test were used. From July 2020 to October 2022, patients with wasp sting injury and multiple organ damage admitted to the intensive care units (ICU) of five hospitals were consecutively screened and recruited into the CVVH+DPMA+HP group (intervention group). Propensity score matching was used to establish historical cohorts. Patients with severe wasp sting injury who hospitalized from January 2016 to June 2020 in each ICU were collected and matched 1∶1 with the intervention group, and divided into CVVH+HP group and CVVH+PE group according to their actual hemopurification protocols (historical control groups). The primary outcome was the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score on days 3 and 7 after initiation of treatment. Secondary outcomes included complications, length of ICU and hospital stays, and all-cause mortality. Multivariate Cox proportional risk regression was used to analyze the prognosis of patients.Results:After propensity score matching, 56 patients in intervention group and each of the two historical control groups were matched successfully. There were no significant differences in age, gender, comorbidities, biochemical test indices and critical illness scores among the groups. After treatment, APACHE Ⅱ score markedly declined in all groups, and the decrease was faster in the intervention group; treatment with DPMA [hazard ratio ( HR) = 1.04, 95% confidence interval (95% CI) was 1.02-1.08, P = 0.00], the decreased levels of body temperature ( HR = 1.02, 95% CI was 1.00-1.03, P = 0.02), serum creatine kinase (CK; HR = 0.98, 95% CI was 0.96-1.00, P = 0.05) and myoglobin (MYO; HR = 2.88, 95% CI was 1.24-6.69, P = 0.01) were independent risk factors for APACHE Ⅱ score decline to the target value (15 scores). There were no significant differences in the incidence of bleeding complications, filter or perfusion thrombosis, blood pressure reduction, catheter-related infection and anaphylaxis among the groups. Conclusion:CVVH+DPMA+HP regimen can significantly reduce the APACHE Ⅱ score of patients with severe wasp sting injury, and the efficacy is superior to CVVH+HP and CVVH+PE regimens, with safety.
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Cystic kidney disease is a major disease which can cause kidney cystic change in children. Cystic kidney disease refers to a series of congenital or acquired diseases with one or multiple cysts in the kidney due to different causes. With the development and wide application of ultrasound technology,it is better than CT and magnetic resonance imaging in reflecting the renal cystic disease,and more and more recognized by pediatricians. Now,the ultrasonographic findings of common cystic kidney disease in children were summarized and analyzed,in order to provide help for clinical diagnosis.
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Objectives: To investigate the impact of high-salt diet on plasma level of vascular endothelial growth factor C (VEGF-C) in healthy subjects and hypertension patients; to explore the relationship between VEGF-C level and blood pressure (BP). Methods: Our research included in 2 groups: Essential hypertension (EH) group, 75 patients treated in our hospital from 2013 to 2014 and Control group, 98 healthy subjects at the same period. Using salt-intake 6 g/day as the borderline, both groups were respectively divided into High-sodium diet (HS) subgroups and Low-sodium diet (LS) subgroups. The age, gender, creatinine clearance (CCr), UA, fast blood glucose (FBG), body mass index (BMI), blood lipids (TC, TG, HDL-C, LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), heart rate (HR) and CF-PWV were compared between EH group and Control group, HS subgroups and LS subgroups. Results: Compared with Control group, EH group had increased plasma level of VEGF-C, (3 940.8±1 141.1) pg/ml vs (2 938.0±987.0) pg/ml, P<0.001; the age, BMI, SPB, DBP, PP, MAP and CF-PWV were different between 2 group, all P<0.005. In ES group, compared with LS subgroup, HS subgroup showed the higher VEGF-C (4 208.8±113.1) pg/ml vs (3 515.8±1 070.1) pg/ml, P=0.009; the age, SBP, DBP and PP were different between 2 group, all P<0.005. In Control group, compared with LS subgroup, HS subgroup showed the higher VEGF-C (3 158.7±917.2) pg/ml vs (2 655.7±1 011.3) pg/ml, P=0.012; the age BMI and CCr were different between 2 group, all P<0.005, while BP was similar between 2 subgroups. Spearman correlation study presented that with adjusted confounding factors, no matter in all participates and in EH group or Control group, MAP were positively related to plasma levels of VEGF-C (r=0.536, P<0.001 and r=0.546, P=0.002 or r=0.291, P=0.006) respectively. Conclusions: High-sodium diet could increase plasma VEGF-C level in either healthy subjects or hypertension patients, VEGF-C level was positively related to BP.
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Based on previous report that the Chinese herb Ligustrum lucidum (LL) extract directly inhibited hepatitis C virus (HCV) replicase (NS5B) activity, the active components of LL extract to inhibit HCV NS5B activity and their inhibition mode were investigated in this study. LL extract was separated using ethyl acetate and thin layer chromatography (TLC). The inhibitory activity of separated fractions on HCV NS5B was analyzed by the inhibitory assay of NS5B activity. The results showed that only fractions 1 and 2 inhibited NS5B activity, and fraction 2 possessed higher inhibitory activity than fraction 1. HPLC analysis combined with inhibitory assays indicated that ursolic acid and oleanolic acid are the active components within fractions 1 and 2 to inhibit NS5B activity, separately. Moreover, oleanolic acid possessed higher inhibitory activity than ursolic acid. Further inhibition mode analysis found that both oleanolic acid and ursolic acid suppressed NS5B activity as noncompetitive inhibitors. The Ki values of ursolic acid and oleanolic acid were about 4.7 microg x mL(-1) (10 micromol x kg(-1)) and 2.5 microg x mL(-1) (5.5 micromol x kg(-1)), respectively. Taken together, these results demonstrated that oleanolic acid and ursolic acid suppressed NS5B activity as noncompetitive inhibitors, implying that the two natural products have potential value for HCV therapy.
Subject(s)
Humans , Antiviral Agents , Pharmacology , Chromatography, High Pressure Liquid , Dose-Response Relationship, Drug , Drugs, Chinese Herbal , Pharmacology , Hep G2 Cells , Ligustrum , Chemistry , Oleanolic Acid , Pharmacology , Plants, Medicinal , Chemistry , Triterpenes , Pharmacology , Viral Nonstructural Proteins , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To analyze the forces of rotational wall vessel (RWV) bioreactor on small tissue pieces or microcarrier particles and to determine the tracks of microcarrier particles in RWV bioreactor.</p><p><b>METHODS</b>The motion of the microcarrier in the rotating wall vessel (RWV) bioreactor with both the inner and outer cylinders rotating was modeled by numerical simulation.</p><p><b>RESULTS</b>The continuous trajectory of microcarrier particles, including the possible collision with the wall was obtained. An expression between the minimum rotational speed difference of the inner and outer cylinders and the microcarrier particle or aggregate radius could avoid collisions with either wall. The range of microcarrier radius or tissue size, which could be safely cultured in the RWV bioreactor, in terms of shear stress level, was determined.</p><p><b>CONCLUSION</b>The model works well in describing the trajectory of a heavier microcarrier particle in rotating wall vessel.</p>