Application value of nucleic acid testing in syphilis screening reactive blood / 中国输血杂志

【Objective】 To evaluate the application value of nucleic acid testing (NAT) by studying the NAT-yield of syphilis screening reactive blood from five blood centers. 【Methods】 The blood samples and demographic information of syphilis screening positive donors were collected from five domestic blood centers, i. e. Chongqing, Guangxi, Luoyang, Liuzhou, Mianyang and Urumqi. The treponema pallidum particle agglutination (TPPA) and the established SYBR Green qPCR method were used to analyze the difference between the results of NAT and the other two test results. 【Results】 Among 1 679 reactive blood samples for syphilis screening, 819 were confirmed positive by TPPA, accounting for 49%, with the false positive rate exceeded 50%. As to NAT results, the NAT-yield of syphilis screening reactive samples and confirmed positive samples was the same (both 2.20%); the NAT-yield of TPPA-positive and TPPA-negative samples were 2.20% and 2.74%, respectively. 【Conclusion】 Primary syphilis screening by ELISA has high sensitivity, but also presents high false positive rate. Although TPPA confirmatory test has strong specificity, it cannot reflect the existence of T. pallidum. Therefore, NAT may be used as a supplementary test for syphilis screening so as to more effectively ensure the safety of blood transfusion and blood supply.

Prevalence of blood donation related vasovagal reactions in China: a systematic review and Meta-analysis / 中国输血杂志

【Objective】 To systematically evaluate the incidence of donation related vasovagal reactions (DRVR) in China by Meta-analysis method and discuss the risk factors of DRVR, so as to provide scientific basis for the prevention and control of DRVR. 【Methods】 Cochrane Library, PubMed, WanFang Data CNKI and other electronic databases were retrieved to collect research literature concerning the incidence and risk factors of DRVR among whole blood donors in mainland China, with the publishing duration setting from 1998 to 2020. Two reviewers independently screened the literature, extracted the data, and evaluated the methodological quality of the included studies according to the inclusion and exclusion criteria. Then Stata was used for Meta-analysis. 【Results】 A total of 63 studies involving 6 043 945 donors were included. The prevalence of DRVR was 1.0% (95% confidence interval [CI], 0.9%~1.1%, I2=99.7%, P<0.01). The prevalence of DRVR in females (1.4%, 95% CI: 1.0-1.8%, I2=99.6%, P<0.01) was higher than that in males (1.1%, 95 % CI: 0.8-1.4%, I2=99.6%, P<0.01). The incidence of DRVR was 1.3% (95%CI: 0.8-1.8, I2=97.9%, P<0.01), 0.8% (95%CI: 0.5-1.0, I2=95.0%, P<0.01), 0.4% (95%CI: 0.3-0.5, I2=88.5%, P<0.01) and 0.3% (95%CI: 0.1-0.6, I2=96.1%, P<0.01) in the age groups of 18-25, 26-35, 36-45 and 46-55, respectively, and the incidence of DRVR decreased with age(P<0.01). From 1998 to 2020, the incidence of DRVR decreased year by year (P<0.01). The prevalence in first-time donors (1.5%, 95% CI: 1.3-1.8, I2=98.6%, P<0.01) was higher than that of regular donors (0.6%, 95% CI: 0.5-0.7%, I2=97.2%, P<0.01). Anxiety was the major risk factor for DRVR. 【Conclusion】 Our results indicate that blood centers should strengthen the monitoring of DRVR. More attention should be paid to young women, more comfort given to first-time blood donors, and a more perfect system developed to reduce the occurrence of DRVR.

Elevated levels of platelet-to-lymphocyte ratio may predict the reduced risk of MPO-ANCA associated vasculitis in Chinese patients with end stage of renal disease / 中南大学学报(医学版)

Objective: Platelet-to-lymphocyte ratio (PLR) has recently been investigated as a new inflammatory marker in many inflammatory diseases, including systemic lupus erythematosus and immunoglobulin A vasculitis. However, there were very few reports regarding the clinical role of PLR in patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. This study was thus undertaken to investigate the relationship between inflammatory response and disease activity in Chinese patients with myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis. Furthermore, we evaluated whether PLR predicts the progression of end stage of renal disease (ESRD) and all-cause mortality.Methods:The clinical, laboratory and pathological data, and the outcomes of MPO-ANCA associated vasculitis patients were collected. The Spearman correlation coefficient was computed to examine the association between 2 continuous variables. Cox regression analysis was used to estimate the association between PLR and ESRD or all-cause mortality. Results:A total of 190 consecutive patients with MPO-ANCA associated vasculitis were included in this study. Baseline PLR was positively correlated with CRP (r=0.333, P<0.001) and ESR (r=0.218, P=0.003). PLR had no obvious correlation with Birmingham Vasculitis Activity Score (BVAS). Patients having PLR≥330 exhibited better cumulative renal survival rates than those having PLR<330 (P=0.017). However, there was no significant difference in the cumulative patient survival rates between patients with PLR≥330 and those with PLR<330 at diagnosis (P>0.05). In multivariate analysis, PLR is associated with the decreased risk of ESRD (P=0.038, HR=0.518, 95％CI 0.278 to 0.963). We did not find an association between PLR with all-cause mortality using multivariate analysis (HR=1.081, 95％CI 0.591 to 1.976, P=0.801).Conclusion: PLR is positively correlated with CRP and ESR. Furthermore, PLR may independently predict the risk of ESRD.

High levels of platelet-to-lymphocyte ratio may predict reduced risk of end stage of renal disease in Chinese patients with MPO-ANCA associated vasculitis / 中南大学学报(医学版)

OBJECTIVES@#Platelet-to-lymphocyte ratio (PLR) has recently been investigated as a new inflammatory marker in many inflammatory diseases, including systemic lupus erythematosus and immunoglobulin A vasculitis. However, there were very few reports regarding the clinical role of PLR in patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. This study was thus undertaken to investigate the relationship between inflammatory response and disease activity in Chinese patients with myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis. Furthermore, we evaluated whether PLR predicts the progression of end stage of renal disease (ESRD) and all-cause mortality.@*METHODS@#The clinical, laboratory and pathological data, and the outcomes of MPO-ANCA associated vasculitis patients were collected. The Spearman correlation coefficient was computed to examine the association between 2 continuous variables. Cox regression analysis was used to estimate the association between PLR and ESRD or all-cause mortality.@*RESULTS@#A total of 190 consecutive patients with MPO-ANCA associated vasculitis were included in this study. Baseline PLR was positively correlated with CRP (r=0.333, P<0.001) and ESR (r=0.218, P=0.003). PLR had no obvious correlation with Birmingham Vasculitis Activity Score (BVAS). Patients having PLR≥330 exhibited better cumulative renal survival rates than those having PLR<330 (P=0.017). However, there was no significant difference in the cumulative patient survival rates between patients with PLR≥330 and those with PLR<330 at diagnosis (P>0.05). In multivariate analysis, PLR is associated with the decreased risk of ESRD (P=0.038, HR=0.518, 95% CI 0.278 to 0.963). We did not find an association between PLR with all-cause mortality using multivariate analysis (HR=1.081, 95% CI 0.591 to 1.976, P=0.801).@*CONCLUSIONS@#PLR is positively correlated with CRP and ESR. Furthermore, PLR may independently predict the risk of ESRD.

Increased frequency of Th22 cells and CCL27/CCR10 axis in lgA nephropathy patients with tonsillitis / 中华肾脏病杂志

Objective:To analyze the changes of helper T cell 22 (Th22) and related cytokines and chemokines in patients with IgA nephropathy (IgAN) and tonsillitis, and explore its relationship with clinical pathological changes.Methods:IgAN patients who were diagnosed at the Xiangya Hospital of Central South University from June 2015 to June 2016 were included. They were divided into IgAN and tonsillitis (IgAN+tonsillitis) group, IgAN group, mesangial proliferative glomerulonephritis (MsPGN) group and control group (HC) group according to renal pathology and whether associated with tonsillitis. Flow cytometry was used to detect the percentage of peripheral blood Th17, Th22 cells, CC-type chemokine receptor (CCR) 4, CCR6 and CCR10 cells. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of interleukin (IL)-22, IL-1β, IL-6, TNF-α, CCL22, CCL20 and CCL27. Immunohistochemical method (IHC) was used to detect the expression of CCL22, CCL20 and CCL27 in kidney tissue. The differences of clinicopathological indicators, the proportion of Th22 cells and related chemokine in each group were compared and analyzed.Results:A total of 44 IgAN patients were included, including 14 patients complicated with tonsillitis. Ten MsPGN patients and 16 healthy people were also included. There was no statistically significant difference in gender, age, blood pressure, kidney function, blood lipid and other biochemical indicators among the groups (all P>0.05). The peripheral blood Th22 cells and CCR10 positive cells in the IgAN group, MsPGN group, and IgAN+tonsillitis group were significantly higher than those of the control group, and serum IL-22, IL-1β, IL-6, TNF-α, CCL20, CCL22 and CCL27 levels were also significantly higher (all P<0.05). All above indexes reached the highest levels in IgAN patients combined with tonsillitis. The changes of CCL20, CCL22 and CCL27 in renal tissues were consistent with those in peripheral blood. The percentage of Th22 cells increased in hematuria-positive and higher MEST scores patients. Conclusions:Th22 cells cooperated with CCL27/CCR10 axis are involved in the pathogenesis of IgAN. Tonsillitis exacerbates clinical severity and kidney injury of IgAN.

Changes in serum IL-22 level in patients with hypertensive renal damage and its clinical significance / 中南大学学报(医学版)

To observe the changes in serum interleukin-22 (IL-22) level and its correlation with other clinical indexes in patients with essential hypertension and hypertensive renal damage, and to investigate its effects and clinical significance.
 Methods: A total of 97 essential hypertension (EH) patients and 40 healthy control were enrolled in this study. The EH patients were divided into a simple hypertension (SH) group (n=45) and a hypertensive renal damage (HRD) group (n=52) according to 24 h urinary protein (24 h-UPRO) level. Basic clinical data were collected; serum IL-22 level was detected by enzyme-linked immunosorbent assay (ELISA); the proportion of Th22 cells in peripheral blood was evaluated by flow cytometry (FCM); and serum high sensitivity C-reactive protein (hs-CRP) concentration was measured by immune turbidimetry. Correlation analysis was applied between serum IL-22 level and other indexes.
 Results: Serum IL-22 level and Th22 cell proportion in patients with hypertension were significantly higher than those in the healthy controls (all P<0.01). Compared with the SH group, serum IL-22 level and Th22 cell proportion were significantly elevated in the HRD group (P<0.01, P<0.05, respectively). Bivariate linear correlation analysis revealed that serum IL-22 level was positively correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hsCRP (r=0.367, P<0.01; r=0.402, P<0.01; r=0.329, P<0.05); there was also a positive correlation between serum IL-22 concentration and Th22 cell proportion (r=0.478, P<0.01) in the SH group. Serum IL-22 level was positively correlated with 24 h-UPRO level (r=0.318, P<0.05) in the HRD group.
 Conclusion: Serum IL-22 level and peripheral blood Th22 cells are significantly increased in the HRD group compared with the SH group. Serum IL-22 level is closely correlated with extent of hypertensive renal damage, indicating that serum IL-22 level may involve in the pathogenesis of hypertensive renal damage.

Modified strategy of anesthesia for laparoscopic radical resection of rectal carcinoma: ultrasound-guided anterior quadratus lumborum block combined with general anesthesia / 中华麻醉学杂志

Objective To evaluate the efficacy of ultrasound-guided anterior quadratus lumborum block combined with general anesthesia for laparoscopic radical resection of rectal carcinoma. Methods A total of 80 patients of both sexes, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 40-64 yr, scheduled for elective laparoscopic radical resection of rectal carcinoma, were divided into 2 groups ( n=40 each) using a random number table method: anterior quadratus lumborum block combined with general anesthesia group ( group QG) and general anesthesia group ( group G) . In group QG, anteri-or quadratus lumborum block was performed with 0. 33％ ropivacaine 25 ml and dexamethasone 5 mg under ultrasound guidance before operation, and the same procedure was performed on the other side. Combined intravenous-inhalational anesthesia was applied, propofol 3-5μg∕ml and remifentanil 3-5 ng∕ml were given by target-controlled infusion, and cisatracurium was intermittently injected in two groups. Patient-controlled intravenous analgesia with sufentanil 2μg∕kg was used for postoperative analgesia. The analgesic pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval. Bruggrmann comfort scale ( BCS) scores were recorded at 1, 6, 12, 24 and 48 h after operation ( T1-5 ) . Tramadol was used for rescue analgesic after operation. The consumption of remifentanil and sufentanil, requirement for tramadol, occurrence of adverse reactions and patients' satisfaction with postoperative analgesia were recorded. The emergence time, first ambulation time, time to first flatus∕poo and length of hospital stay were also recorded. The develop-ment of anterior quadratus lumborum block-related complications was recorded. Results Compared with group G, BCS scores were significantly increased at T4,5 , the consumption of remifentanil, requirement for tramadol and incidence of nausea and vomiting were decreased, patients' satisfaction with postoperative an-algesia was increased, and the emergence time, first ambulation time, time to first flatus∕poo and length of hospital stay were shortened in group QG (P<0. 05). Conclusion Ultrasound-guided anterior quadratus lumborum block combined with general anesthesia can reduce the consumption of opioids in the perioperative period and is helpful in improving outcomes when used for laparoscopic radical resection of rectal carcinoma.

Effect of ultrasound-guided transverse abdominal plane block on postoperative analgesia in patients undergoing orthotopic liver transplantation under general anesthesia / 中华麻醉学杂志

Objective To evaluate the effect of ultrasound-guided transverse abdominal plane block (TAPB) on postoperative analgesia in patients undergoing orthotopic liver transplantation under general anesthesia.Methods Forty American Society of Anesthesiologists physical status Ⅲ-V patients,with body mass index of 18-24 kg/m2,aged 18-64 yr,undergoing elective modified piggy-back orthotopic liver transplantation,were divided into 2 groups (n =20 each) by a random number table method:TAPB combined with general anesthesia group (TAPB-GA group) and general anesthesia group (GA group).In TAPB-GA group,two-point TAPB was performed below bilateral costal margins under ultrasound guidance after induction of general anesthesia,and a mixture of 0.33％ ropivacaine 15 ml plus 0.5％ dexamethasone 0.5 ml was injected into each point.The equal volume of normal saline was injected into each point instead in group GA.Patient-controlled intravenous analgesia was performed with sufentanil 2 μg/kg after operation in both groups.Sufentanil 5 μg was intravenously injected as rescue analgesic,and the visual analog scale score was mainrained ≤3 within 48 h after operation.The intraoperative consumption of remifentanil and extubation time after operation were recorded.The requirement for sufentanil as rescue analgesic and development of nausea and vomiting,itching and respiratory depression were recorded within 48 h after surgery.Results Compared with group GA,the intraoperative consumption of remifentanil and requirement for sufentanil as rescue analgesic within 48 h after surgery were significantly reduced,the time of extubation was shortened,and the incidence of nausea and vomiting,itching and respiratory depression was decreased in group TAPB-GA (P＜ 0.05).Conclusion Ultrasound-guided TAPB can provide better efficacy of postoperative analgesia with fewer adverse reactions in patients undergoing orthotopic liver transplantation under general anesthesia.

Effects of sevoflurane on HIF-1α/EMT pathway activity and invasion of lung cancer in rats undergoing one lung ventilation / 实用医学杂志

Objective To investigate the effects of sevoflurane on HIF-1α/epithelial mesenchymal transition (EMT)pathway activity and invasion of lung cancer in rats undergoing one lung ventilation (OLV). Methods Lung cancer model of SD rats was established. Rats were randomly divided into 4 groups:group control(group C), group two lungs ventilation(TLV)(group T),group one lungs ventilation(group O),and group sevoflurane +one lungs ventilation(group SO). Two lung ventilation was performed after endotracheal intubation for 2.5 h in group T. OLV was performed after endotracheal intubation for 2 h in group O and SO. The end-expiratory concentration of sevoflurane of rats in group SO was maintained 2.6% during OLV period. Left lung cancer tissues were harvested at 0.5 h of TLV. The protein levels of HIF-1α,Vimentin and Fibronectin in lung cancer were determined by Western blot. The mRNA levels of MMP-2 and MMP-9 in lung cancer were evaluated by RT-PCR. Results The expres-sions of HIF-1α,Vimentin,Fibronectin,MMP-2,and MMP-9 in group O and group SO were significantly higher than those in group C and group T(P<0.05). The expressions of HIF-1α,Vimentin,Fibronectin,MMP-2,and MMP-9 were decreased significantly in group SO as compared with group O(P<0.05). Conclusion Sevoflurane inhibits the elevation of HIF-1α/EMT pathway activity and invasion ability induced by OLV.

The protective effect of dexmedetomidine atdifferent doses combined with ulinastatin in lung resection pa-tients with one lung ventilation / 实用医学杂志

Objective To observe the protective effect of dexmedetomidine(Dex)at different doses com-bined with ulinastatin in lung resection patients with one lung ventilation. Methods 80 patients having undergone unilateral lung resection were divided into four groups randomly:control group(C group)and groups Dex 1-3,20 cases in each group.One lung ventilation(OLV)was used in all the groups during operation.The patients in groups Dex 1-3 were treated with 0.5,1.0,2.0 μg/kg combined with ulinastatin,and the C group with amount of normal sa-line instead.The comparisons were done among the four groups in terms of SOD,L-6,IL-10,serum malondialde-hyde(MDA)concentration at 5 min after endotracheal intubation(T0),30 min(T1),60 min(T2),120 min (T3)as well as the levels of FVC,FEVl and FEVl/FVC at 24 h,48 h and 72 h after surgery. Results In the groups C and Dex 1,SOD decreased at T1-4 and IL-6,MDA and IL-10 at T2-4 rose.SOD decreased at T2-4 in groups Dex 2-3 and MDA,IL-6 and IL-10 rose.Compared with group C,the levels of SOD and IL-10 at T2-4 in groups Dex 1-2 and at T1-4 in group Dex 3 rose. In groups Dex 1-3,postoperative FVC,FEVl and FEVl/FVC rose.Compared with group Dex 1 or 2 respectively,SOD and IL-10 at T2-4 in group Dex 3 significantly rose,but MDA and IL-6 significantly declined;FVC,FEVl and FEVl/FVC significantly rose 48 h and 72 h after surgery (P<0.05). Conclusion Dex combined with ulinastatin has a protective effect for patients with one lung ventila-tion after lung resection,with the best-suggested dose of 1.0 μg/kg.

Role of PI3K∕Akt signaling pathway in propofol?induced invasion of human liver cancer cell line HepG2 / 中华麻醉学杂志

Objective To evaluate the role of phosphatidylinositol 3?kinase(PI3K)∕serine?threo?nine kinase(Akt)signaling pathway in propofol?induced invasion of human liver cancer cell line HepG2. Methods HepG2 cells were cultured in RPMI 1640 medium supplemented with 10% fetal bovine serum in a 5% CO2incubator at 37℃. HepG2 cells at the logarithmic growth phase were divided into 6 groups(n=18 each)using a random number table: control group(group C), propofol group(group P), PI3K∕Akt signaling pathway agonist IGF?1 group(group IGF), PI3K∕Akt signaling pathway inhibitor LY294002 group(group LY), IGF?1 plus propofol group(group IGF+P)and LY294002 plus propofol group (group LY + P). Propofol 120 μg∕ml was added in group P. IGF?1 10 nmol∕L was added in group IGF. LY294002 10 μmol was added in group LY. In group IGF+P, 10 nmol∕L IGF?1 was added, cells were in?cubated for 24 h, and then 120 μg∕ml propofol was added. In group LY+P, 10 μmol LY294002 was add?ed, cells were incubated for 24 h, and then 120 μg∕ml propofol was added. The invasion of cells was measured by Transwell invasion assay at 24 h of incubation. The expression of PI3K and Akt mRNA in cells was determined by real?time polymerase chain reaction. The expression of Akt, PI3K and phosphorylated Akt(p?Akt)was detected by using Western blot. Results Compared with group C, the invasive cell count was significantly reduced, the expression of PI3K protein and mRNA was down?regulated, p?Akt∕Akt ratio was decreased, and the expression of Akt mRNA was down?regulated in P, P+IGF, LY and P+LY groups, and the invasive cell count was significantly increased, the expression of PI3K protein and mRNA was up?regulated, p?Akt∕Akt ratio was increased, and the expression of Akt mRNA was up?regulated in group IGF(P<0.05). Compared with group P, the invasive cell count was significantly increased, the expression of PI3K protein and mRNA was up?regulated, p?Akt∕Akt ratio was increased, and the expres?sion of Akt mRNA was up?regulated in group P+IGF, and the invasive cell count was significantly reduced, the expression of PI3K protein and mRNA was down?regulated, p?Akt∕Akt ratio was decreased, and the ex?pression of Akt mRNA was down?regulated in group P+LY(P<0.05). The invasive cell count was signifi?cantly reduced, the expression of PI3K protein and mRNA was down?regulated, p?Akt∕Akt ratio was de?creased, and the expression of Akt mRNA was down?regulated in group P+IGF as compared with group IGF (P<0.05)and in group P+LY as compared with group LY(P<0.05). Conclusion The mechanism by which propofol inhibits invasion of HepG2 cells is related to inhibiting activation of PI3K∕Akt signaling path?ways.

Calcium antagonists protect cardiac microvascular endothelialcells against hypoxia/reoxygenation injury through iPLA2 / 中国药理学通报

Aim To investigate the effects of classic calcium antagonists verapamil(Ver),nifedipine(Nif),diltiazem(Dil)and the novel calcium antagonist N-n-butyl haloperidol iodide(F2)which was synthesized by our lab by regulating Ca2+-independent phospholipase A2(iPLA2)on hypoxia/reoxygenation(H/R)injury of cardiac microvascular endothelial cells(CMECs)and the mechanisms.Methods The CMECs were isolated from SD neonatal rats.The H/R model was established,then cells were treated with different concentrations of calcium antagonists and F2.The content of LDH in the cell supernatant was measured by colorimetric method.The levels of IL-6 and AA in cell supernatant were measured by ELISA;and late-stage apoptosis was measured by TUNEL.The mRNA and protein expression levels of iPLA2 in CMECs were examined by real time-PCR and Western blot analysis.Results Calcium antagonists except Dil decreased the generation of LDH,IL-6 and AA in a dose-dependent manner(P<0.05),and reduced the apoptosis(P<0.05).F2 and Ver decreased the mRNA and protein expression of iPLA2 in a dose-dependent manner,while there were no such effects for Nif and Dil.Conclusions Calcium antagonists except Dil have protective effects against H/R injury.F2 and Ver protect CMECs against H/R injury partly through iPLA2.

Investigation of status for vascular access in hemodialysis patients at Xiangya Hospital of Central South University / 中南大学学报(医学版)

Objective:To investigate the status of vascular access in hemodialysis patients in our center.Methods:The general information of hemodialysis patients and types and complications of vascular access at Xiangya Hospital of Central South University from April 2015 to April 2016,were retrospectively analyzed.Results:Among 258 prevalent patients,87.60％ of them had arteriovenous fistula (AVF),while 12.40％ showed tunneled cuffed catheter.Of the 61 incident patients,80.33％ of them initiated dialysis with a non-tunneled and non-cuffed catheter,8.19％ with an AVF,9.84％ with a tunneled cuffed catheter,and 1.64％ with needle puncture.The types of AVF access included 76.55％ of wrist radiocephalic fistula,7.08％ of mid-forearm cephalic fistula,11.06％ of elbow brachiocephalic fistula,and 5.31％ of antecubital fistula and transposed basilic fistula.Seventy-seven (34.07％) patients with AVF suffered complications and wherein aneurysms accounted for 24.34％.Conclusion:In maintenance hemodialysis patients,autologous AVF is the prevalent vascular access.In the beginners for dialysis,non-tunneled and non-cuffed catheter are their choice.Additional efforts and incentives may be necessary to improve vascular access during the initiation ofhemodialysis.

Cordyceps sinensis protects HK2 cells from ischemia-reperfusion injury through SirtⅠ pathway / 中南大学学报(医学版)

Objective:To investigate the effects of Cordyceps sinensis (CS) on cellular apoptosis and Sirt1 expression in HK2 cells followed by ischemia-reperfusion (I/R).Methods:HK2 cells were incubated with different concentrations of CS (10,20,40,80,160,320 mg/L) for 24 hours,and the optimal concentration of CS was selected by measuring cell proliferation.The confluent HK2 cells were incubated with 0.01 μmol/L antimycin A for 2 hours to induce ischemia in vitro,and then the reperfusion was achieved by incubating cells with glucose-replete complete growth medium for 24 hours.HK2 cells were divided into 4 groups:a control group,an I/R group,an I/R+CS (160 mg/L) group,and an I/R+CS (160 mg/L)+Sirtinol (25 μtmol/L) group.Twenty-four hours later,total RNA and protein were collected.The cell proliferation was evaluated by MTT assay;the mRNA and protein expression of Sirtl and the cleaved caspase-3 were measured by qRT-PCR and Western blot,respectively.The cellular apoptosis rate was determined by Annexin V-FITC/PI double staining and flow cytometry.Results:Certain concentrations (10-160 mg/L) of CS did not show effect on the proliferation of HK2 cells (P＞0.05),while 320 mg/L of CS inhibited cell proliferation significantly (P＜0.01);compared with the control group,the mRNA and protein expressions of Sirtl and the cleaved caspase-3 in the I/R group were up-regulated (P＜0.01) and the apoptosis rate was extremely high;compared with the I/R group,CS significantly up-regulated Sirt1 mRNA and protein expression (P＜0.01) while down-regulated cleaved caspase-3 mRNA and protein levels (P＜0.01),and reduced apoptosis rate (P＜0.05).The effects of CS were blocked in the presence of sirtinol,an inhibitor of CS.Conclusion:CS protects HK2 cells from I/R injury through activation of Sirt 1 pathway.

N-n-butyl haloperidol iodide protectsH9c2 cardiac myocytes against hypoxia/reoxygenationinjury through mitochondria-dependent apoptotic pathway / 中国药理学通报

Aim To investigate the effect of N-n-butyl haloperidol iodide(F2) on mitochondria-dependent apoptotic pathway of H9c2 cardiac myocytes during hypoxia/reoxygenation(H/R) injury.Methods The H/R models of H9c2 cardiac myocytes were established.The H9c2 cardiac myocytes were randomly divided into five groups: control group(C group), hypoxia/reoxygenation group(H/R group), F2 low concentration group(L), F2 medium concentration group(M), F2 high concentration group(H).Apoptotic rate was evaluated by flow cytometry(FCM).The levels of Cyto C, Bcl-2, Bax were observed by Western blot.Caspase-3 activity was measured with colorimetry.Results Compared with H/R group, F2 low, medium and high concentrations group could significantly decrease apoptosis rate and increase the ratio of Bcl-2 to Bax proteins and inhibit the release of Cyto C into the cytosolic fraction, and decrease caspase-3 activity.Conclusion F2 can protect H9c2 cardiac myocytes against H/R-induced injury through interfering in mitochondria-dependent pathway.

Effect of acute normovolemic hemodilution combinded with enhanced recovery after surgery on immune function in patients undergoing hepatic lobectomy / 实用医学杂志

Objective To observe the effect of acute normovolemic hemodilution(ANH)combined with enhanced recovery after surgery(ERAS)on immune function in patients undergoing hepatic lobectomy. Methods 80 patients were divided into two groups:ERAS group(group E),ANH combined with ERAS group(group AE). bleeding volume,blood transfusion,infused fluid volume,urine output during operation and clinical index after surgery were recorded. Exhaust and defecation time ,fluid intake time and hospitalization duration were also record-ed. Blood samples were obtained from the patients at 30 min before anesthesia induction(T1),immediately(T2), 24 h(T3),3 d(T4)and 7 d(T5)after the end of operation for determination of the expression of CD3+,CD4+, CD8+ on T cells and natural killer cell. Results In group E ,CD3+,CD4+ T-lymphocytes and NK cells at T2-3 decreased as compared with T0. Compared with group E ,no allogeneic blood transfusion cases were found and clinical index duration was shorter in group AE. CD3+,CD4+T-lymphocytes and NK cells at T2-3 increased in group AE as compared with those in Group E. The difference is significant (P < 0.05). Conclusion ANH combined with ERAS can decrease allogenic blood transfusion and increase post-operation immunologic function ,shorten the postoperative hospitalization time.

Correlations of FGF23 and Klotho with cardiovascular injury in chronic kidney disease patients / 中南大学学报(医学版)

Objective:To analyze the levels of serum calcium,phosphate,fibroblast growth factor 23 (FGF23),and Klotho proteins in patients with chronic kidney disease (CKD),and to investigate the correlations of FGF23 and Klotho proteins with cardiac complicates in patients with chronic kidney disease-mineral and bone disorder (CKD-MBD).Methods:A total of 180 CKD-MBD patients were enrolled for this study.Among them,60 patients underwent regular hemodialysis,60 patients did not undergo renal replacement therapy and 60 patients were diagnosed as second hyperparathyroidism (SHPT).Thirty age and gendermatched health volunteers served as controls.Serum samples were collected and tested,and the demographical,clinical and biochemical data were all recorded.FGF23 and Klotho levels in serum samples were analyzed by enzyme-linked immunosorbent assay.Data of echocardiography and plain abdominal X rays were collected as well.The influential factors for cardiovascular injury,the relationship between biochemical indexes and ectopic calcification,and the correlations of FGF23 and Klotho with cardiac complicates were analyzedResults:Patients,who kept hemodialysis,especially those with SHPT,exhibited an increase in serum FGF23 level while a decrease in serum Klotho protein levels (P＜0.01).Patients with higher levels of serum FGF23 were more likely to have ectopic calcification (OR=4.667),while patients with lower levels of serum Klotho had high risks to get myocardial hypertrophy (OR=3.496).Receiver operator characteristic (ROC) curve analysis showed that the area under the curve (AUC) for FGF23 was 0.778 (P＜0.01) while for Klotho was 0.715 (P＜0.01).Conclusion:Patients,who kept hemodialysis,especially those with SHPT,have a significant increase in serum FGF23 protein levels and a significant decrease in serum Klotho protein levels.Serum FGF23 and Klotho protein levels are closely correlated with left ventricular enlargement and hypertrophy.Serum FGF23 and Klotho protein are risk factors for heart.

Identification of Brucella strain isolated from sheep blood in Jingyuan County Gansu Province / 中华地方病学杂志

Objective To identify the Brucella strains isolated from sheep blood in Jingyuan County Gansu Province,and to provide scientific basis for Brucellosis control and prevention.Methods In 2016,blood samples from suspected cases of sheep were collected in the home of Brucellosis patient of Jingyuan County,and cultured with vaccination double blood bottles via the enrichment method,and the Brucella strains isolated from sheep were identified by traditional bio-typing,genus specific Brucella surface protein 31 PCR (BSCP31-PCR) and Brucella abortus,Brucella melitensis,Brucella ovis,Brucella suis species-specific PCR (AMOS-PCR),respectively.Results The isolated strain was identified using the traditional biological classification method,bacteria could grow in thionine and fuchsin dyes,A and M factors serum agglutination tests were positive,Bk2 phage lysis test was positive,but Tb and Wb phage lysis tests were negative;and the results of BSCP31-PCR of tested strain was 223 bp band same to Brucella;the results of AMOS-PCR was 731 bp band same to Brucella melitensis.Conclusion Conventional bio-typing test assisted with molecular techniques has confirmed that the isolated Brucella strain from sheep blood is Brucella melitensis type 3 in Jingyuan County Gansu Province.

The effect of sevoflurane and propofol on postoperative cognitive function after abdominal surgery for elderly patients with diabetes / 实用医学杂志

Objective To investigate the effects of sevoflurane and propofol on postoperative cognitive function after abdominal surgery for elderly patients with diabetes. Methods Seventy diabetic patients (aged 60~75 yr, ASAⅠorⅡ) underwent abdominal surgery and are included in the research. Diabetic patients were randomly divided into two groups (n=35): sevoflurane group(group DS) and propofol group (group DP). MMSE score, the attachment test, words memory test and Stroop color word test were carried and the results were recorded before operation (T1), postoperative 24 h (T2), 48 h (T3) and 1 w (T4). Results Compared with T1, patients′ MMSE score reduced at T2 and T3. Time spent in attachment test is longer at T2 and T3. Mistaken incidences in Stroop color words test 1, 2 and 3 are higher and time longer at T2. Time spent on Stroop color words test 2 and 3 is longer in T3. Words memory test reveals decline at T2 and T3, whose difference is statistically significant (P 0.05). Conclusion Sevoflurane and propofol can result in postoperative cognitive dysfunction for elderly patients with diabetes within 48 h after abdominal surgery, there were no difference between the effects of them.

Alterations and clinical significance of peripheral blood T lymphocyte subsets in patients with septic acute kidney injury / 中国医师杂志

Objective To investigate the alterations of peripheral blood T lymphocyte subsets in patients with sepsis and septic acute kidney injury, and explore the clinical significance.Methods Fifty-five patients with sepsis and forty-three patients with septic acute kidney injury were enrolled in this study. At the same period, thirty healthy subjects were enrolled as the control group.T lymphocyte subsets inclu-ding CD3 +T, CD4 +T, CD8 +T cells, and CD4 +T/CD8 +T in peripheral blood were detected by flow cy-tometry, and acute physiology and chronic health evaluation Ⅱ( APACHE Ⅱ) were graded within twenty-four hours after admission.Then, correlation of the APACHEⅡscores and T lymphocyte subsets was ana-lyzed.Results In the septic acute kidney injury group, peripheral blood CD3 +T, CD4 +T cell percenta-ges, and CD4 +T/CD8 +T ratio were significantly lower than those in the control group and the sepsis group (all P <0.05).In the septic acute kidney injury group with stage 3, CD3+T, CD4 +T cell percentages, and CD4 +T/CD8 +T ratio in the patients were significantly lower than those in stage 1 and stage 2 ( all P <0.05).In the septic acute kidney injury group,CD3 +T, CD4 +T cell percentages, and CD4 +T/CD8 +T ra-tio were significantly lower in dead group than those in survival group (all P <0.05).APACHEⅡscores in patients with sepsis were significantly negatively correlated with peripheral blood CD4 +T cell percentages and CD4 +T/CD8 +T ratio ( r =-0.645,-0.492, allP <0.05).Conclusions There are varying de-grees of cellular immune imbalance in patients with sepsis and septic acute kidney injury, characterized by decline of circulating CD3 +T, CD4 +T cell percentages, and CD4 +T/CD8 +T ratio.CD4 +T cell percenta-ges and CD4 +T/CD8 +T ratio are closely related to the severity and prognosis of septic acute kidney injury.