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OBJECTIVE@#To explore the effect of interleukin-17A (IL-17A) on liver and kidney injury and prognosis in septic mice.@*METHODS@#A total of 84 SPF male C57BL/6 mice were randomly divided into sham operation group (Sham group), cecal ligation and puncture (CLP) induced sepsis model group (CLP group), and IL-17A intervention group. IL-17A intervention group were then divided into five subgroups according to the dose of IL-17A (0.25, 0.5, 1, 2, 4 μg). Mice in the IL-17A intervention group were intraperitoneally injected with the corresponding dose of IL-17A 100 μL immediately after surgery. The other groups were intraperitoneally injected with 100 μL phosphate buffer solution (PBS). The survival rate of mice was observed at 7 days, and peripheral blood and liver, kidney and spleen tissues were collected. According to the 7-day survival, another 18 mice were randomly divided into Sham group, CLP group, and 1 μg IL-17A intervention group. Peripheral blood samples were collected at 12 hours and 24 hours after CLP, and the mice were sacrificed to obtain liver, kidney, and spleen tissues. The behavior and abdominal cavity of each group were observed. The levels of peripheral blood liver and kidney function indexes and inflammatory factors were detected. The histopathological changes of liver and kidney were observed under light microscope. The peripheral blood and spleen tissues were inoculated in the medium, the number of bacterial colonies was calculated, and the bacterial migration of each group was evaluated in vitro.@*RESULTS@#Except for the Sham group, the 7-day survival rate of mice in the 1 μg IL-17A intervention group was the highest (75.0%), so this condition was selected as the intervention condition for the subsequent study. Compared with Sham group, the liver and kidney functions of CLP group were significantly damaged at each time point after operation. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN) and serum creatinine (SCr) reached the peak at 24 hours after operation, and the liver and kidney pathological scores reached the peak at 7 days after operation, the levels of inflammatory cytokines interleukin (IL-17A, IL-6, IL-10) reached the peak at 12 hours after operation, and tumor necrosis factor-α (TNF-α) reached the peak at 24 hours after operation. In addition, a large number of bacteria proliferated in the peripheral blood and spleen, which reached the peak on day 7. Compared with the CLP group, exogenous administration of 1 μg IL-17A significantly delayed the rising trend of each index in the early stage of sepsis [24-hour ALT (U/L): 166.95±5.20 vs. 271.30±6.11, 24-hour AST (U/L): 599.42±7.25 vs. 1 013.27±3.37, 24-hour BUN (mg/L): 815.4±26.3 vs. 1 191.2±39.4, 24-hour SCr (μmol/L): 29.34±0.87 vs. 60.75±3.83, 7-day liver pathological score: 2.50 (2.00, 3.00) vs. 9.00 (8.50, 9.00), 7-day kidney pathological score: 1.00 (1.00, 2.00) vs. 5.00 (4.50, 5.00), 12-hour IL-17A (ng/L): 105.21±0.31 vs. 111.28±1.37, 12-hour IL-6 (ng/L): 83.22±1.01 vs. 108.88±0.99, 12-hour IL-10 (ng/L): 731.54±3.04 vs. 790.25±2.54, 24-hour TNF-α (μg/L): 454.67±0.66 vs. 576.18±0.76, 7-day peripheral blood colony count (CFU/mL): 600 (400, 600) vs. 4 200 (4 200, 4 300), 7-day spleen tissue colony count (CFU/g): 4 600 (4 400, 4 600) vs. 23 400 (23 200, 23 500), all P < 0.05].@*CONCLUSIONS@#Appropriate dose (1 μg) of exogenous IL-17A can reduce the lethal inflammatory response induced by CLP and improve the ability of bacterial clearance, thereby alleviating liver and kidney injury and improving the 7-day survival rate of septic mice.
Subject(s)
Animals , Male , Mice , Interleukin-10 , Interleukin-17/pharmacology , Interleukin-6 , Kidney/physiopathology , Liver/physiopathology , Mice, Inbred C57BL , Prognosis , Sepsis , Tumor Necrosis Factor-alphaABSTRACT
Objective:To investigate the curative efficacy and application value of convalescent plasma (CP)in severe and critical coronavirus disease 2019 (COVID-19) caused by Delta variant.Methods:The treatment process and results of CP therapy for a patient with critical COVID-19 caused by Delta variant were reported. The clinical application value of CP for COVID-19 caused by Delta variant was analyzed along with the literature review.Results:Our case was a 50-year-old male, who was imported from abroad and had not been vaccinated against COVID-19. The novel coronavirus nucleic acid test was negative before entry. On the second day after entry, fever occurred, novel coronavirus nucleic acid test was positive. Chest CT images showed bilateral multiple mottling and ground-glass opacity with symptoms of nausea, headache, loss of appetite, diarrhea, but no running nose, nasal obstruction, dyspnea, abnormal smell and taste. The infection rapidly developed from medium to critical. On the basis of standard treatment, Delta variant CP was intravenous dripped on the 10th day of hospital admission (the 6th day after becoming severe). The patient's condition improved rapidly.Conclusion:The curative efficacy evaluation of this patient proved that CP therapy is of great value in the treatment of severe and critical COVID-19.
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Objective:To investigate the function and mechanism of CXC chemokine receptor 7 (CXCR7) in neuronal cells of ischemic stroke.Methods:The expression of CXCR7 in human neuroblastoma SH-SY5Y cells was interfered by small interfering RNA (si-RNA) technique. Oxygen-glucose deprivation/reoxygenation (OGD/R) injury model was constructed in SH-SY5Y cells. CXCR7 protein expression and cell cycle were detected by flow cytometry (FCM). The protein expression of CXCR7 and Akt signaling pathway was detected by Western blotting.Results:After 6 hours of OGD/R, the expression of CXCR7 was significantly decreased compared with OGD/R 0 hour (CXCR7/GAPDH: 0.483±0.098 vs. 1.000±0.000 by Western blotting and 0.686±0.0524 vs. 1.000±0.000 by FCM, both P < 0.01), cell cycle arrest in G0/G1 phase (1.190±0.040 vs. 1.000±0.000, P < 0.01). After CXCR7 si-RNA interference with SH-SY5Y cells, OGD/R was constructed again for 6 hours. Compared with negative control group (si-NC group) under the same environment, the expression of CXCR7 and phosphorylated Akt (p-Akt) was significantly decreased (CXCR7/GAPDH: 0.471±0.051 vs. 1.000±0.000, p-Akt/GAPDH: 0.616±0.027 vs. 1.000±0.000, both P < 0.001) and cell cycle arrest in G0/G1 phase (1.105±0.033 vs. 1.000±0.000, P < 0.05). Conclusion:The CXCR7 could regulate the cycle of neuronal cells in ischemic stroke through Akt signaling pathway, which has a protective effect on neuronal cells.
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Objective:To investigate the effect of early enteral nutrition in patients with severe traumatic brain injury requiring exploratory abdominal surgery.Methods:The clinical data of 104 patients with severe traumatic brain injury requiring exploratory abdominal surgery treated in the PLA Army 72th Group Military Hospital from January 2016 to December 2020 were retrospectively analyzed. Among them, 47 patients were given early enteral nutrition (24-48 hr) as the observation group, and 57 patients were given delayed enteral nutrition (>48 hr), as the control group. The levels of hemoglobin, albumin, prealbumin, total bilirubin, alanine transaminase, C-reactive protein, white blood cells, postoperative infectious complications and clinical outcomes were compared between the two groups on the 1st, 7th and 14th days after surgery.Results:On the 14th day after operation, the prealbumin level of the observation group was higher than that of the control group, and the leukocyte level of the observation group was lower than that of the control group, with statistical significance ( P=0.020, P=0.013). The hospital stay and hospitalization costs of the observation group were lower than those of the control group ( P=0.017, P=0.032). The incidence of pulmonary infection in the observation group was 10.6%, which was lower than 29.8% in the control group ( P=0.017). Conclusions:Early postoperative enteral nutrition in patients with severe traumatic brain injury requiring exploratory abdominal surgery can significantly improve the nutritional status of patients, reduce the incidence of pulmonary infection, the hospital stay and the hospitalization cost.
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Objective:To investigate the clinical features and prognosis of duodenal lateral fistula (DLF), and to explore the high-risk factors affecting its prognosis, so as to improve its treatment outcome.Methods:The regression study was conducted based on the database of the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections. DLF patients who were hospitalized from January 1, 2018 to December 31, 2018 and had complete clinical data in the database were selected as the research object. The clinical data included patient gender, age, length of hospital stay, hospitalization costs, intensive care unit (ICU) admission, underlying diseases, primary diseases, direct causes of DLF, complications, treatment and outcomes.Results:A total of 142 patients with DLF were enrolled, including 97 males and 45 females, with a median age of 54 years. The top three primary diseases of DLF were gastrointestinal ulcers and perforations in 33 cases (23.2%), biliary tract disease in 27 cases (19.0%), and trauma in 24 cases (16.9%). There were 117 cases (82.4%) with single DLF, and 25 cases (17.6%) were combined with other fistula. Among the 142 patients, 127 were healed (49 by surgery and 78 self-healing) and 15 (10.6%) died. 14 cases (9.9%) underwent percutaneous catheter drainage, and 18 cases underwent laparotomy drainage. Univariate prognostic analysis showed that advanced age (≥60 years old) (χ 2=6.891, P=0.009), primary diseases as gastrointestinal ulcers/perforations (χ 2=8.515, P=0.004), combined with other fistula (χ 2=5.798, P=0.016), malnutrition (χ 2=5.595, P=0.018), pulmonary infection (χ 2=12.449, P<0.001), hemorrhage (χ 2=6.466, P=0.011), multiple organ dysfunction syndrome(MODS ) (χ 2=37.258, P<0.001), underwent laparotomy drainage (χ 2=6.466, P=0.011) were associated with mortality. Multivariate prognostic analysis confirmed that age ≥60 years old ( OR=44.375, 95% CI: 2.676-735.822, P=0.008), combined with other fistula ( OR=16.54, 95% CI: 1.744-156.913, P=0.015) and MODS ( OR=238.447, 95% CI: 9.496-5 987.78, P=0.001) were independent risk factors of the death for DLF patients. Conclusions:The mortality rate of DLF is still relatively high. Iatrogenic duodenal injury (surgical operation, endoscopic treatment) is the main direct cause of fistula. Advanced age, combined with other fistula and MODS significantly increases the risk of death of patients.
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Objective:To clarify the distribution and composition of drug-resistant genes of carbapenem-resistant Klebsiella pneumoniae (CRKP) in Qingdao City and to provide rationale for clinical application of antibacterial treatment by screening for carbapenemase phenotype and detecting resistance genes of CRKP. Methods:Fifty-four clinically isolated non-repeating CRKP from five Third Grade & Class A Hospitals in Qingdao City from October 2016 to September 2019 were collected. Kirby-Bauer method was used for drug sensitivity tests of commonly used antibacterial drugs; modified Hodge test was used for carbapenemase phenotypic screening; and polymerase chain reaction (PCR) was used to amplify blaKPC-2, blaNDM-1, blaOXA-48, blaIMP, blaVIM target genes. The amplified products were subjected to agarose gel electrophoresis. Results:Drug susceptibility tests showed that CRKP had the lowest resistance rate to amikacin (35.2%), followed by compound sinomine (53.7%), gentamicin (55.6%), levofloxacin (75.9%), and imipenem-cilastatin (88.9%); piperacillin-tazobactam, meropenem, cefotaxime, and cefoperazone-sulbactam were all higher than 90%. There were 43 positive strains in the modified Hodge test (the positive rate was 79.63%) and 11 negative strains. A total of 40 strains with carbapenemase resistance were detected by PCR resistance gene detection. The detection rate of target drug-resistant genes was 74.07%. Among them, 35 strains carry the KPC-2 gene, 7 strains carry the OXA-48 gene, 4 strains carry the NDM-1 gene, and 1 strain carries the IMP gene. All strains carrying the OXA-48 gene also carried the KPC-2 gene, which was not detected. Strains carrying the VIM gene were identified, and the remaining 14 strains did not detect the target carbapenem gene.Conclusion:The carbapenem-producing genes carried by CRKP in five hospitals in Qingdao City are mainly KPC-2, followed by OXA-48 and NDM-1.
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Objective To study the effects of Shen-fuinjection onthe activity of β-adrenoreceptor in SD rats with cardiopulmonary resuscitation. Method The exprimerit was done at emergency medical lab of Shanghai Changzheng hospital.Cardiac arrest was induced thngh asphyxiation(succinylcholine)and ice-cold 0.5 mol/L KCI in rats,and resuscitation began at five minutes after cardiac orrest.In this experiment,seventy-two male SD rats were randomizly divided into 9 groups:control group(sham group),routine treatment(O.5 h,2 h,4 h,6 h) groups.and Shen-fu treatment(O.5 h,2 h,4 h,6 h),and each group had 8 rats.Rats of Shen-fh treatment groups were injected with shen-fu(20 mL/kg,20 mL/h)during CPR.3H-prazosln Wag used to determine the activity of β-adrenoreceptor in myocyte. The data of the statistic analysiswere presentedin the for mofmeaj14-standard(4-5)deviation.One-way ANOVA was used for muhig Toup comparison,and t-test for comprarison between two groups.Results[3-adrenoreeeptor reached peak at0.5 h after CPR(247.81±8.91)fmol/mg,reached the lowest level at 4 h(104.17 4-13.87)fmol/mg,and returned to the normal level at 6 h(178.53±10.42)fmol/mg.In the eady period.-adrenorecepter activity in control group[O.5 h:(259.91-4-18.09)finol/mJ was similar to that in Shenfu treatment groups(P>O.05).In the late phase,adrenoreeeptor activity in the Shen-fu treatment groups[2 h:(173.04±18.77)fmol/mg,4 h:(148.72±13.88)finoL/mg]was significantly hi#er than that in the control groups(P<0.05).Conclusiom After CPR, ceplor activity firstly rises and then declines,and Shenfu injection Call significantly increase adrenoreceptor activity of mrs in the later period after CPR.
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Objective To evaluate the significance of color Doppler EUS in the pancreatic pseudo-cysts drainage. Methods EUS - guided cystoenterostomy was performed in 3 patients. A needle and drainage tube was inserted in a one - step procedure into the cyst through the accessory channel of echoendoscope under EUS. The nasal plastic drainage tube was released immediately after insertion. Results When gastric ulcer and bleeding or the bulge of stomach were not found endoscopically in all patients . The needle with its stylet inserted through the gastric wall into the cyst at the site with minimal distance between them . The mean size of the pseudocysts was approximately 8 cm located at pancreatic tail ,body or the junction of them. In 3 cases but one, the blood flow signal around the cyst was not found . No significant echo of laminated structure between gastric and cyst wall was found . After aspiration or installation of naso-cystic drainage catheter, abdominal pain remitted at 2 days, 2 days and 3 days; the sonography demonstrated that cyst size decreased began from 3rd day ,and the cyst obliterated at 14 and 30 days after drainage. The only complication was found in one patient with gastric mucosal ooze, which recovered after noradrenaline spray . Infection or perforation never occurred. No recurrence of pseudocysts observed at a mean follow - up period of 3. 6 months (range 2-7 months). Conclusions The EUS-guided drainage of pancreatic pseudocysts in one-step is a rather simple and practical procedure with minimal risk of hemorrhage and infection.
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Objective Endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) of pancreatic lesions is being increasingly used. The aim of the study was to evaluate its safety, accuracy, and clinical utility in the diagnosis of pancareatic diseases. Methods EUS-guided FNA was performed in 21 patients (13 men and 8 women) with pancreatic lesions (16 head/neck, 5 body/ tail) detected by CT scanining, unltrasonography or clinically suspected diagnosis.Three patients with unresectable pancreatic cancer underwent EUS-guided celiac plexus neurolysis(CPN) for pain-relieving. Results The lesions detected by CT scanning (19 cases) and ultrasonography(16 cases) were all confirmed by EUS. Adequate specimens were obtained by EUS-guided FNA in 18 of 21 lesions and final diagnosis in these subjects was pathologically confirmed. EUS-guided FNA had a sensitivity of 85.0%, specificity of 100.0% and accuracy of 85.7% for diagnosis of pancreatic lesions. The final diagnosis was not obtained in three patients due to inadequate specimens. Three patients with pancreatic carcinoma were decreased in pain scores after EUS-CPN. Two cases with complication of mild pancreatitis or post-FNA fever were found. Conclusions EUS-guided FNA of the pancreas was a safe and effective modality for diagnosis and treatment of pancreatic lesions.
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AIM:To develop the quality standard for Capsicum Rheumatism Gel(Fructus Capsici extract,menthol,borneol). METHODS:HPLC was used to determine capsaicin in Capsaicum Rheumatism Gel.The se-(paration) was performed on zorbax C_(18) column with methanol-water-phosphoric acid (70∶30∶0.085) as a mobile phase.The flow rate was 0.8 mL/min,and the detection wavelength was at 280 nm.Menthol and borneol contents in Capsaicum Rheumatiosm Gel were determined by GC and naphthalene was adopted as internal standard substance. RESULTS:There was a good linear relationship for capsaicin at a range of 0.082 65-0.578 55 ?g and the average revovery was 97.86% with RSD=1.28%.There were good liner relationships for menthol and borneol at a range of 0.081 0-1.053 ?g,0.080 8-1.050 4 ?g and the average revovery was 98.668%,97.536%. CONCLUSION:The method proves to be simple,precise and reproducible and is suitable for quantitative control of Capsicum Rheumatism Gel.