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Sarcopenia, characterized as the progressive decrease in skeletal muscle mass, strength, and function, has been becoming one of chronic musculoskeletal diseases in aging people. In basic research studies, a reliable experimental model would be vital significance for deeply understanding pathophysiological mechanism of sarcopenia and developing novel drugs. This review provided a preliminary summary on the potential mechanisms involved in senescence-induced sarcopenia, followed by a discussion on research progress on pharmacology models based on molecular mechanism of senescence, especially from in vitro cell models and in vivo animal models.
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Objective:To evaluate the correlation between elevated cTnI level and 28-day mortality after liver transplantation.Methods:A retrospective study was conducted in adult patients admitted to ICU after liver transplantation from Jun 2015 to March 2019 at Beijing Chao-Yang Hospital. The cardiac troponin Ⅰ levels within 48 h after surgery were examined. Patients outcome was followed up,the primary end point was mortality within 28-day. Univariate and multivariate logistic regression models were used to look for predictors of 28-day mortality.Results:Three hundred and eighteen patients were included in our analyses. Twenty-six patients died and 292 survived within 28 days after LT. Two hundred and forty-three of 318 (76.4%) cases presented elevated cTnI in the early stage after LT. Thirty-seven of 318 (11.6%) patients presented a moderate elevation of cTnI level (5-10 times over normal upper limit), 75 (23.6%) of them presented severe cTnI elevation (10 times over normal upper limit). Univariate and multivariate logistic regression model shows severe cTnI elevation was the independent prognostic factors associated with 28-day mortality [Odds Ratio (95% confidence interval)=3.151(1.218-8.150), P=0.018]. Conclusion:Early cTnI elevation is common after liver transplantation, and severe cTnI elevation is significantly associated with 28-day mortality.
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Epigenetic modification includes DNA methylation, histone modification, non-coding RNA, etc., and is crucial in determining gene expression. A growing number of recent studies have shown that epigenetic regulation may play a central role in the pathogenesis of sepsis. Due to its explicit mechanism and relatively mature technic, DNA methylation has received extensive attention in sepsis-related researches. By examining recent studies on septic DNA methylation mechanism, this review elucidates the key role in sepsis occurrence and progression that DNA methylation plays from etiology, immunology and other aspects, as well as its application potential in the diagnosis, prognosis and treatment of sepsis before pointing out the direction for further research.
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Objective Based the previous studies, the present study was performed to investigate the antagonistic effects of different doses of Astragaloside IV on the immune function of Treg mediated by HMGB1 in vitro and its potential mechanism.Methods CD4+CD25-T cells isolated from the spleens of male BABL/c mice by magnetic beads were seeded on 48-well cell culture plates and were randomly divided into four groups as follows(12 holes per group). Normal control group: CD4+CD25-T cells were cultured merely. Treg group: Tregs(100μl) and CD4+CD25-T cells were co-cultured in ratio of 1:10. HMGB1+Treg group: Tregs(100μl) stimulated by HMGB1(1μg/ml) for 72 h and CD4+CD25-T cells were co-cultured in ratio of 1∶10. HMGB1+AST IV+Treg group: Tregs(100μl) stimulated by HMGB1(1μg/ml) and AST IV(100μg/ml)for 72 h were co-cultured with CD4+CD25-T cells in ratio of 1:10. CD4+CD25-T cells and supernatants were again collected on post-culture 72 hour. The proliferation of CD4+CD25- T cells was analyzed by MTT test, the activity of NFAT and the contents of cytokines of IL-2 released into supernatants were also determined by means of ELISA. Results When CD4+CD25-T cells were co-cultured with Tregs, the cell proliferation(0.166±0.039) and the levels of NFAT(0.156±0.035) and IL-2(2.38±0.58) in supernatant were markedly decreased as compared with those in the control group(P<0.01). However, the contrary results were found when CD4+CD25-T cells were co-cultured with Treg stimulated by HMGB1. Compared with those in the(HMGB1+Treg) group, the contrary results were showed with a dose-dependent in the(HMGB1+ASTⅣ+Treg) group.Conclusion ASTⅣcan rivalry the effects of HMGB1 on immune function of Treg in vitro, this result indicate that ASTⅣhas the therapeutic action on inflammation promoted by HMGB1.
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Objective To evaluate the renal protective effect of targeted abdominal perfusion pressure (APP) treatment in intra-abdominal hypertension (IAH) and further investigate its related mechanisms.Methods Twelve healthy pigs were randomly divided into experimental group and control group,each group had 6 pigs.All animals were collected urine volume each hour,continuously monitored mean arterial pressure (MAP) and renal cortical blood flow after anesthesia.IAH models were established by intraperitoneally injecting carbon dioxide in all animals,the baseline MAP,intra-abdominal pressure (IAP)and APP were obtained before IAH models established.In both groups,IAP was raised gradually from 0 mm Hg to 10 mm Hg,20 mm Hg and 30 mm Hg.In control group,IAP was maintained at 30 mm Hg for 8 hours with-out any other interventions.In experimental group,the animals were intravenously given with norepinephrine in order to get a target level of APP equal to its baseline values after 15 minutes of the onset of 30 mm Hg IAP.Changes of renal cortical blood flow,serum creatinine,TNF-α,IL-6 and urine IL-18 with the alteration of IAP in both groups were explored.Animals were then sacrificed for renal histopathology after 8 hours of the onset of 30 mm Hg IAP.Results With the increase of IAP,renal cortical blood flow in both groups was significantly decreased (P ＜ 0.01).Compared to its baseline,serum Cr and urinary IL-18 were significantly up-regulated after the maintenance of IAP at 30 mm Hg for 6 hours in both groups (P ＜ 0.05).However,in experimental group,which utilized a strategy of targeted APP,significant improvement of the renal cortical blood flow was observed (P ＜ 0.01),and urinary IL-18 was significantly lower than the control group (P ＜ 0.05).Renal histopathological examination found no obvious abnormalities either in control group or in experimental group.Conclusions The targeted APP treatment may have some renal protective function within the first 8 hours of IAH by improving renal cortical blood flow rather than affecting systemic inflammatory response.
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Nowadays there are still a lot of controversies about indications methods and timing for tracheotomy in the patients who need long-term mechanical ventilation.Some recent studies have shown that early tracheostomy can increase patient comfort compliance and may reduce the use of sedatives,decrease ventilator associated pneumonia occurrence,reduce duration of mechanical ventilation and ICU stay.Presently we consider that the early tracheostomy may benefit patients needing long-term mechanical ventilation,and percutaneous dilational tracheostomy is a better way of tracheotomy,however we need to correctly grasp the indications.
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OBJECTIVE To summarize the clinical characteristics,diagnositic and therapeutic strategies of severe cytomegaloviral (CMV) pneumonia after kidney transplantation. METHODS To analyze retrospectively pertinent clinical information of 6 cases of severe cytomegaloviral pneumonia after kidney transplantation, including developing process of disease, clinical manifestation of pre-and post-hospitalization ,various assistant examination,therapeutic procedures and prognosis. RESULTS 6 cases had similar characters of episode as follows:CMV pneumonia occurred after 1～3 months after kidney transplantation. Major clinical symptoms included fever, coughing,few sputum without obvious manifestation of breathholding.Peripheral white blood cell was normal or less than normal range, serum CMVpp65 was finally positive during hospital stay. Radiological image of the lung presented inflammatory infiltration and obvious interstitial lesion after 7～10 days of fever, which went worse rapidly. Renal function descended with deterioration of pulmonary infection. All of patients had been treated with multiple antibiotics,glucocorticoid and mechanical ventilation, Etiological diagnosis of the 3th～6th cases were earlier than 1th～2th cases , the 3th～6th cases who finally survived were treated with longer and higher doses of antivirus and glucocorticoid, than 1th～2th cases who died of refractory hypoxemia and acute renal failure during hospital stay. CONCLUSIONS Severe cytomegaloviral pneumonia had similar clinical characteristics of episode. early diagnosis of etiology,continuous application of antivirus and glucocorticoid were crucial for Severe cytomegaloviral pneumonia after kidney transplantation.
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Objective To observe the safety and efficiency of SpO_2 -Allen's test in peri -puncture radial artery cannulation for invasive blood monitor. Methods 50 patients were selected for the radial artery cannulation in surgical intensive care unit(SICU). All of them were still sober. All of the patients were examined by SpO_2 -Allen's test and Allen's test before radial artery cannulation, 3 days after puncture and after pulling out the cannula. Resluts The results of Allen's test of 42 patients were negative,while those of 49 patients were negative in SpO_2 - Allen's test. Statistics difference existed between group of SpO_2 - Allen's text and group of Allen's text(P
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0.05).Conclusions The patients with sepsis lasting more than 7 days had high mortality (50%). While percentage of CD14 and CD14MFI of peripheral blood are increased,the total scores of SOFA and numbers of MOF are decreased.The improvement of monocytes function indicates good prognosis. The changes of expression of ICAM-1,serum TNF-? and IL-10 can not reflect prognosis in septic patients.
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Objective: To study the relation between hyperglycemia and mechanical ventilatory time, the days in the intensive care unit,infection rate,mortality . Methods: 572 patients' blood glucose levels in the morning were measured,and divided into two groups by the level of 7.78 mmol/L.The mechanical ventilatory time, days in the intensive care unit,infection rate and mortality were compared between two groups. Results: The mechanical time,stay in ICU and infection rate in the group with blood glucose level below 7.78 mmol/L were significantly less than in the group with blood glucose level above 7.78 mmol/L(P
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Objectives:To evaluate the use of needle catheter jejunostomy for early enteral nutrition in liver transplant recipients . Methods:Five liver transplant recipients who had indication were performed with needle catheter jejunostomy before abdominal wall closure.The Flocare jejunokath was inserted on the small bowel at the point 20 cm distal to the ligament of Treitz,continued to go ahead in the wall of the bowel for a distance of about 4～5 cm,and then pierced into bowel lumen.Enteral nutrition was given through jejunostic tube at postoperative 1st day. Results:The time for placing needle catheter jejunostomy during operation was (9.2?2.3)min.The jejunostic tube was used well and pulled out from 14 to 46 days after operation.One patient occurred with jejunostic tube obstruction, and the tube was reused after treatment.No other complication occurred associated with needle catheter jejunostomy. Conclusions:Needle catheter jejunostomy may become the preferable method for early enteral nutrition in indicated liver transplant recipients.
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0.05). Serum IL-10 and IL-10/TNF? ratio in the dead were significantly higher than that in the survivors( P 0.05). Conclusions The septic patients with high serum IL-10 or IL-10/TNF? ratio fared with poor prognosis.
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0.05). Blood lactate levels in surviving group gradually went down to the normal, while it consistently deteriorated in fatal group.ConclusionsSeptic shock patients had defective oxygen consumption. Patients with higher initial DO 2 had a good outcome. Contineous elevation in blood lactate levels predicts a poor prognosis.