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Objective:To construct the prediction model of SAP complicated with intra-abdominal hypertension (IAH), and evaluate the prediction efficiency of the model.Methods:The clinical data of 322 SAP patients admitted to the emergency department of Cangzhou Hospital of Integrated Chinese and Western Medicine in Hebei Province from January 2017 to December 2021 were retrospectively analyzed. They were divided into IAH group ( n=153) and control group ( n=169) according to whether they had IAH complications or not. The clinical characteristics and laboratory test results of the two groups were compared. Multifactor logistic step-up regression was used to analyze the risk factors of SAP patients complicated with IAH. A nomogram model for predicting SAP complicated with IAH was established by using R software. The receiver operating characteristic curve (ROC) of the model was plotted, and the area under the curve (AUC) was calculated to evaluate its prediction efficiency. Calibration chart, Hosmer-Lemesshow test and decision curve analysis were used to evaluate the prediction accuracy and clinical application value of the model. The Bootstrap method was applied to verify the model internally. Results:In IAH group, cases with body mass index, CRP, procalcitonin (PCT), WBC, acute physiological and chronic health assessmentⅡ (APACHEⅡ) score, modified CT Severity Index score (MCTSI), incidence of complications (abdominal effusion, abdominal infection, gastrointestinal dysfunction, shock, multiple organ dysfunction syndrome), mechanical ventilation, the number of high-volume fluid reactivation (24 h≥4 L) were more than those in control group; serum albumin and serum calcium in IAH group were lower than those in control group, and the differences were statistically significant (all P value <0.05). Multivariate logistic regression analysis showed that serum albumin ( OR=0.815, 95% CI 0.710-0.937), CRP ( OR=1.005, 95% CI 1.002-1.008), MCTSI ( OR=2.043, 95% CI 1.695-2.463), complication of gastrointestinal dysfunction ( OR=4.179, 95% CI 2.170-8.049), and high-volume fluid resuscitation ( OR=4.265, 95% CI 2.269-8.015) were independent risk factors for IAH in SAP.The Nomogram prediction model was established using the five factors above as parameters, and the AUC value for predicting IAH complication was 0.886. The Hosmer-Lemesshow test showed a high consistency between the prediction results and the actual clinical observation results ( P=0.189). The results of decision curve analysis showed that the prediction probability of the model was between 10% and 85%, which could bring more benefits to patients. Conclusions:The early prediction model of SAP with concurrent IAH is successfully established, which can better predict the risk of SAP with concurrent IAH.
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Objective: To observe the effect of Tongxinluo (TXL) on homocysteine-induced rat’s cardiac micro vascular endothelial cell (RCMECs) injury and to study the oxidative stress mechanism. Methods: Primary RCMECs were cultured with tissue explants process, cell morphology was observed by inverted microscope and the cell was identiifed by CD31 immunolfuorescence method. RCMEC injury model was established by Homocysteine (Hcy) induction and the cells were divided into 5 groups: Control group, with normal cells, Hcy group, the cells were treated by Hcy at 10 mmol/L, Low-dose TXL group, Hcy treated cells were cultured with TXL at 100 mg/L, Middle-dose TXL (200 mg/L) group and high-dose TXL (400 mg/L) group. Cell survival rates were detected, supernatant levels of superoxide dismutase (SOD) activity and malondialdehyde (MDA) content were examined, intracellular protein expressions of reactive oxygen species (ROS) and endothelial nitric oxide synthase (eNOS) were detected and mRNA expression of endothelin-1 (ET-1) was measured in different groups respectively. Results: Compared with Control group, Hcy group showed decreased cell survival rate (74.61 ± 2.88)% vs (100.00 ± 2.07)%, increased supernatant level of MDA (4.10 ± 0.18) nmol/ml vs (1.92 ± 0.10) nmol/ml, reduced SOD activity (7.55 ± 0.71) U/ml vs (20.77 ± 0.68) U/ml, elevated ROS level(38.17 ± 10.28) % vs (19.83 ± 2.97) %, up-regulated mRNA expression of ET-1 and down-regulated protein expression of eNOS. Compared with Hcy group, the above indexes were improved in each TXL group at different levels. Conclusion: TXL could decrease Hcy induced RCMECs injury, such protection was conducted by reducing the oxidative stress mechanism in cells.
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Aim To observe the effect of“Ying-nutrient and Wei-defense unblocking collaterals prescription”on the carotid sympathetic nerve in early atherosclero-sis. Methods The rabbits were randomly divided into 6 groups:Control group, high-fat group, Complex mod-el group, GSTL-H group, GSTL-L group and ATO group. The control group was fed with common food-stuffs, High-fat group with high-fat diet to build early atherosclerosis model, and all the other groups with high-fat diet combined with carotid artery cannula to build early atherosclerosis carotid artery injury rabbit model. All groups were given corresponding medicines intragastrically once a day for 4 weeks. The GSTL-H and GSTL-L group was given Guishaotongluo ultrafine powder 0. 6 g·kg-1·d-1, 0. 3 g·kg-1·d-1, and the ATO group was given suspension of atorvastain so-lution 2. 5 mg · kg-1 · d-1 . Biochemical method was used to detect blood lipid change. HE staining was ap-plied to observe the pathological morphology of intima-media, The content of NE in the carotid arterial was detected by ELISA. The immunohistochemical staining was used to detect the protein expression of NGF, TH around the carotid arterial. The expression of NGF, TH in the carotid artery adventitia was detected by Western blot. Results Compared with normal group, the levels of TC,TG and LDL-C in high-fat group and complex model group were significantly increased( P<0. 01). The degree of the intimal hyperplasia,the con-tent of NE and sympathetic density ( NGF, TH protein expression and distribution ) of the cartoid artery in complex model group were heavier compared with those in high-fat group; the lipid levels, degree of the inti-mal hyperplasia and sympathetic density ( NGF, TH protein expression and distribution ) in the GSTL-H, GSTL-L group were milder in varying degrees compa-ring with those in the complex model group(P<0. 05, P<0. 01 ) . Conclusion “Ying-nutrient and Wei-de-fense unblocking collaterals prescription” can reduce rabbit carotid atherosclerosis, and the mechanism may be related to regulating the sympathetic nerve of arterial wall.
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Aim To determine the effects of Qiliqian-gxin injected into lateral ventricle on Cardiac function, angiotensin Ⅱ( Ang Ⅱ) , angiotensin converting en-zyme(ACE), angiotensin type 1 receptor(AT1R) and the sympathetic nervous system in the hypothalamic pa-raventricular nucleus of rats with chronic heart failure. Methods Rat model of heart failure was prepared by acute myocardial infarction that was induced by ligation of the left anterior descending coronary artery. Four weeks after heart failure, Qiliqiangxin and Losartan were continuously administered via a syringe pump in-jector connected to lateral ventricle. After four weeks, echocardiogram was used to evaluate the cardiac func-tion and HE was used to observe myocardial tissue morphology, and enzyme linked immunosorbent assay was used to measure plasma norepinephrine( NE) , ser-um NT-proBNP and Ang Ⅱ in the paraventricular nu-cleus. The expression of ACE and AT1 R at mRNA and protein levels in the paraventricular nucleus was deter-mined by Real-time PCR and Western blot, and the RSNA was measured by PowerLab in anesthetized rats. Results Compared with the sham control, the cardiac function was significantly lower while the AngII, ACE, AT1 R expression in the paraventricular nucleus and RSNA were significantly increased in rats with heart failure. Compared with heart failure control, Qiliqian-gxin and Losartan decreased the RSNA and the AngII, ACE, AT1 R expression in the paraventricular nucleus. Conclusion Giving traditional Chinese medicine to the lateral ventricles can decrease the activation of the RAS system, reduce the renal sympathetic nerve activi-ty and improve cardiac function.
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[ ABSTRACT] AIM:To investigate the transient outward potassium channel protein expression in paraventricular nucleus (PVN) and its contribution to renal sympathetic nerve activity (RSNA) in rats with chronic heart failure (CHF). METHODS:A rat model of CHF was prepared by acute myocardial infarction that was induced by ligation of the left ante -rior descending coronary artery .Four weeks after heart failure , echocardiogram was applied to identify the CHF model and plasma norepinephrine (NE), serum NH2-terminal pro-brain natriuretic peptide (NT-proBNP) were detected by ELISA. The expression of ransient outward potassium channel proteins Kv 4.2 and Kv4.3 at mRNA and protein levels was deter-mined by real-time PCR and Western blot .The mean arterial pressure ( MAP) , heart rate ( HR) and RSNA were measured in anesthetized rats with PVN microinjection of potassium channel blockers 4-AP.RESULTS:In CHF group , the rat car-diac function and Kv4.2 and Kv4.3 expression in PVN were obviously lower while plasma NE and serum NT-proBNP were obviously higher than those in sham group .Microinjection of 4-AP into PVN induced an increase in MAP , HR and RSNA in both sham and CHF rats , while the CHF rats exhibited smaller responses to 4-AP than sham-operated rats .CONCLU-SION:Downregulation of Kv4.2 and Kv4.3 expression in the PVN may be a potential mechanism for sympathoexciation in the rats with chronic heart failure .
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Aim To observe the effect of Guishao-tongluo ( GSTL ) on the angiogenesis of vasa vasorum and oxidative stress in the early stage of atherosclero-sis. Methods The rabbits ( n =84 ) were randomly divided into 7 groups (n=12):control group,high-fat group, adventitial injury group, GSTL high(GH)and medium ( GM ) dose group, atorvastain group ( ATO ) , and Tongxinluo group ( TXL ) . The normal group was fed with common foodstuffs, and high-fat foodstuffs for the high-fat group to establish an early model of hyper-lipidemia, and all the other groups were fed with high-fat diet combined with carotid artery cannula to build early atherosclerosis carotid artery injury rabbit mod-els. The GSTL high and medium dose was given Guishaotongluo ultrafine powder 4. 16,2. 08 g·kg-1 · d-1 respectively. The atorvastain group and Tongxinluo group were given suspension of atorvastain solution 2. 5 mg·kg-1 ·d-1 , Tongxinluo supermicro powder 0. 6 g ·kg-1 ·d-1 . All groups were treated with gastric per-fusion for 4 weeks. Biochemical method was applied to detect blood lipid change. HE staining was used to ob-serve the pathological morphology of intima-media. Aactivity of serum superoxide dismutase( SOD) ,malon-dialdehyde ( MDA ) content and the total antioxidant capacity ( T-AOC ) in artery serum were detected. NADPH subunits p22phox mRNA, gp91phox mRNA in carotid arteries were located and semi-quantitated by fluorescence in situ hybridization. The expression of VEGF, VEGFR-2 in the carotid artery adventitia was detected by Western blot. Results Compared with normal group,the contents of TC,TG and LDL-C were significantly increased, and VEGF, VEGFR-2 protein levels were remarkly increased in high-fat and adventi-tial injury group. The carotid artery injuries,the degree of angiogenesis of vasa vasorum and NADPH subunits p22phox, gp91phox mRNA in adventitia tissue of the GH,GM, ATO and TXL group were milder in varying degrees compared with those of the vasa injury group. Also the activity of SOD,T-AOC increased,while MDA content,VEGF,VEGFR-2 protein levels were remarkly decreased ( P < 0. 5 or P < 0. 01 ) . Conclusions GSTL can inbibit adventitial neovascularization in the early stage of atherosclerosis, and its mechanism might be related to the increase of total antioxidant capacity of the vascular system and adventitia tissue.