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Late-onset circulatory collapse(LCC)in preterm infants is characterized by sudden onset of hypotension and/or oliguria after the first week of life, which is resistant to volume expanders and inotropes but responds rapidly to timely glucocorticoids treatment.LCC should be managed promptly and properly, or it may cause respiratory, digestive complications and life-long neurological problems.Relative adrenal insufficiency is considered the most likely cause of LCC, but its pathophysiology remains unclear.This review summarizes the current reserch about LCC regarding its pathophysiology, clinical features, diagnosis, treatment, and prognosis.
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Objective:To observe the effect of arsenic trioxide (ATO) on the expression of NKG2D ligand UL16 binding protein 1(ULBP1) in acute myeloid leukemia KG1a cells, and explore the molecular mechanism for its regulation of ULBP1 expression.Methods:KG1a cells were cultured in vitro.Then, the inhibition of KG1a cell proli-feration by different concentrations of ATO was detected by cell counting kit-8(CCK8) assay, and the expression of ULBP1 mRNA and surface protein in KG1a cells were examined by real-time RT-PCR and flow cytometry, respectively.After that, the blocking effects of ataxia telangiectasia mutated and RAD3-related kinase (ATM/ATR) inhibitor caffeine on ATO-upregulated expression of ULBP1 mRNA and surface protein expressions were investigated, and the effects of ATO on the expression of CHK1 and CHK2 proteins and their phosphorylation in KG1a cells were observed by Western blot method. Results:Different concentrations (1, 2, 3, 4, 5 μmol/L) of ATO could inhibit the proliferation of KG1a cells, which was concentration dependent, and the half inhibitory (IC 50) concentration to KG1a cells was 2.7 μmol/L.The expression of ULBP1 mRNA on KG1a cells were increased when incubated with ATO at concentration 1, 2, 3, 4, 5 μmol/L, compared without ATO group, ULBP1 mRNA expression level relatively increased respectively to (1.86±0.30) times, (3.02±0.71) times, (3.16±0.75) times, (4.80±0.70) times and (3.70±0.89) times, and the differences were statistically significant (all P<0.05). Furthermore, ATO (1, 2, 3, 4 and 5 μmol/L) upregulated ULBP1 protein expression on KG1a cells compared with that in the group without caffeine, and the differences were statistically significant (all P<0.05). After caffeine pretreat KG1a cell 2 h and ATO incubate KG1a cell 24 h, ULBP1 mRNA and protein expression levels were significantly reduced.When caffeine concentration was 8 mmol/L, ULBP1 mRNA expression level relatively reduces from (9.55±0.38) times to (6.36±0.93) times compared with that in the group without caffeine, and the difference was statistically significant ( P<0.05). When caffeine concentration was 2, 4 and 8 mmol/L respectively, the expression of ULBP1 protein was reduced from that in the group without caffein treatment (3.50±0.08) times to (2.17±0.07) times, (2.02±0.06) times and (1.75±0.06) times, respectively, and the differences were statistically significant (all P<0.05). The expression of CHK1 and CHK2 proteins decreased with the increase of ATO concentration, while p-CHK1 and p-CHK2 are increased as ATO. Conclusions:ATO upregulate the expression of ULBP1 mRNA and protein in KG1a cells, and the ATM/ATR-CHK1/CHK2 pathway may be involved in it.
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Background: Gastroscopy is an effective method for screening early gastric cancer (EGC), which is mainly relied on expensive imported endoscopic equipment. Aims: To evaluate the performance of domestic made high definition magnifying gastroscopy for diagnosis of gastric flat lesions. Methods: A total of 99 patients with focal flat gastric mucosal lesions detected by conventional white-light endoscopy at Shanghai Renji Hospital from Jan. 2018 to Dec. 2018 were enrolled. Magnifying gastroscopy was performed using domestic made AOHUA AQ-200 endoscopic system. Nature of the lesion was assessed according to VS classification. Using pathological diagnosis as gold standard, the diagnostic performance of the domestic made gastroscopy for gastric flat lesions was evaluated, and the consistency of endoscopic and pathological results was analyzed. Results: The sensitivity, specificity and accuracy of domestic made high definition magnifying gastroscopy for diagnosis of EGC/precancerous lesions were 92.9%, 98.8% and 98.0%, respectively; the positive predictive value and negative predictive value were 92.9% and 98.8%, respectively. The endoscopic diagnosis was highly consistent with the pathological results with a kappa value of 0.917. The incidence of demarcation line, irregular or disappeared microvascular morphology, and irregular or disappeared microsurface glandular structure in EGC/precancerous lesions was significantly higher than those in non-EGC/precancerous lesions (P<0.05). Conclusions: Domestic made high definition magnifying gastroscope can meet the requirements of endoscopic diagnosis and treatment, which allows the primary care institutions to carry out the job of screening, diagnosis and treatment of EGC.
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Objective To evaluate the efficacy and safety of terlipressin for septic shock.Methods A randomized double-blind placebo-controlled pilot study was carried out in the general ICU of the First Affiliated Hospital of Zhengzhou University from June 1st 2015 to May 31st 2016.The septic shock patients with a mean arterial pressure below 65 mmHg despite adequate volume resuscitation were enrolled.Patients were randomized (random number) to give continuous infusions of either terlipressin[0.6-2.6 μg/(kg·h)] or norepinephrine(7-30 μg/min).Open label norepinephrine or other catecholamines were additionally infused if the mean arterial pressure failed to reach 65 mmHg.Treatment was continued until shock corrected,death or withdrawn from this study.Correcting rate of shock was the primary end point,the secondary end points included open labeled norepinephrine requirements,the 28 d survival rate and adverse events.The quantitative data of the two groups were compared by t test or Wilcoxon rank sum test.The enumeration data were compared by chi square test or Fisher exact probability method,and the survival data were analyzed by Kaplan-Meier method.Results A total of 28 patients were enrolled.The full analysis set was 28,the per-protocol set was 25,and the safety set was 28.The key demographics and baseline characteristics were similar between the two groups(P＞0.05).The results for the per-protocol set were followed up.The correcting rate of shock between the two groups were similar at the end of treatment[81.82％(9/11)vs.57.14％(8/14),P=0.190].The open label norepinephrine requirements of the trial group and control group for the 0,6,12,24,48 h time point were 0.661,0.921,1.583,1.241,2.143,1.371,1.071,1.261,0.370,1.001 μg/(kg·min),respectively with no significant difference(P＞0.05).The 28 d survival rate of the trial group and control group were 63.64％(7/11)and 50.00％(7/14) respectively with no statistical significance(P＞0.05).There was no significant difference in 28 d survival analyzed using Kaplan-Meier plot between two groups(P=0.470).There were two patients with ischemia of fingers,one patient with hyponatraemia and one patient with ischemia of intestine accompanied by hyponatraemia occurred after treatment with terlipressin,and one patient with isehemia of fingers occurred after treatment with norepinephrine.The incidence of adverse event for the trial group and control group were 30.77％(4/13) and 6.67％(1/15) with no significant difference(P=0.122).Conclusions Terlipressin is an effective agent for treating septic shock.The total adverse event rate of terlipressin was similar to that ofnorepinephrine.
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Objective To explore whether a single bout of exhaustive exercise can activate autophagy in mice skeletal muscles and to investigate the effect and possible mechanisms of exercise-induced autophagy on antioxidant defense function in vivo.Methods Thirty healthy 4-week-old male C57BL/6 mice were randomly divided into a control group(n=6) and an exercise group(n=24).The latter was subjected to a single bout of exhaustive treadmill exercise.Gastrocnemius muscles of 6 mice on both sides were then isolated right after,as well as 6h,12h and 24h after the running.The manganese super oxide dismutase(MnSOD),total superoxide dismutase(T-SOD) and Copper-Zinc superoxide dismutase (CuznSOD) activities were determined using the xanthine oxidase method and the content of the total anti-oxygen capability(T-AOC) using the colorimetric method.The expression of Beclin1,P62 and Bcl2 mRNAs,as well as their proteins were determined using the fluorescent quantitative PCR and Western blotting.Results The expression of Beclin1 mRNA in gastrocnemius muscles of the exercise group increased more significantly than that of the control group right after the exercise,as well as 6 hours later(P＜0.01).P62 mRNA expression also increased significantly(P＜0.01) 24h after the exercise.In contrast,the expression of P62 protein at 0h,12h and 24h after the exercise decreased more significantly(P＜0.05 or P＜0.01) than that of the control group.Similarly,the expression of Bcl2 protein at 0h,6h and 12h increased significantly(P＜0.05 or P＜0.01).The MnSOD and CuznSOD activity increased significantly right after the exercise(P＜0.05).The T-SOD activity decreased significantly(P＜ 0.01) 6h after the exercise.T-AOC content increased significantly 6h,12h and 24h after the exercise (P＜0.05 or P＜0.01).The P62 protein expression was negatively correlated with T-AOC content.Conclusion The single bout of exhaustive treadmill exercise can activate the expression of such autophagyrelated factors as Beclin1 mRNA and P62 protein and increase the autophagy to a certain extent to maintain antioxidant defensive function of the skeletal muscle.
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Currendy,the incidence of breast cancer ranks first at home and abroad of female cancer and the age of onset tends to be younger.Due to the local changes of the tumor residual cavity after the breast conserving surgery,we can't accurately delineate the irradiation range using traditional breast conserving surgery combined with external irradiation of whole breast and tumor bed plus the amount,and the course of treatment is longer.Intra-operative radiation therapy(IORT) can avoid the impact of respiratory motion and postural changes.Meanwhile,it can immediately irradiate the tumor bed during operation accurately.For patients,IORT can shorten the cycle of radiotherapy and reduce irradiation on the skin and subcutaneous tissue.So IORT is convenient,easy to be accepted,and has relatively few complications,good cosmetic results and so on.In recent years,more and more Cancer Center choose breast conserving surgery combined with IORT for treatment of early stage breast cancer and make relative researches in terms of the indications,methods,dosage,efficacy and prognosis of IORT.
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Currently,the incidence of breast cancer ranks first at home and abroad of female cancer and the age of onset tends to be younger.Due to the local changes of the tumor residual cavity after the breast conserving surgery,we can't accurately delineate the irradiation range using traditional breast conserving surgery combined with external irradiation of whole breast and tumor bed plus the amount,and the course of treatment is longer.Intra-operative radiation therapy (IORT) can avoid the impact of respiratory motion and postural changes.Meanwhile,it can immediately irradiate the tumor bed intraoperative accurately.For patients,IORT can shorten the cycle of radiotherapy and reduce irradiation on the skin and subcutaneous tissue.So IORT is convenient,easy to be accepted,and it has relatively few complications,good cosmetic results and so on.In recent years,more and more Cancer Center choose breast conserving surgery combined with IORT for the treatment of early stage breast cancer and do researches to the indications,methods,dosage,efficacy and prognosis of IORT.
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ObjectiveTo evaluate the effect of sufentanil preconditioning on acute lung injury induced by intestinal ischemia-reperfusion (I/R) in rats and the role of opioid receptors.MethodsForty-eight male Wistar rats weighing 200-250 g were randomly divided into 6 groups ( n =8 each):sham operation group (group S) ; I/R group; sufentanil preconditioning group (group SPC) ; COTP (μ receptor antagonist) + SPC group; NTD (δ receptor antagonist) + SPC group and nor-BNI (κ receptor antagonist) + SPC group.Intestinal I/R was produced by occlusion of the superior mesenteric artery for 45 min followed by 2 h reperfusion in groups I/R,SPC,COTP +SPC,NTD + SPC and nor-BNI + SPC.Sufentanil 10 μg/kg was injected intravenously at 10 min before ischemia in groups SPC,COTP + SPC,NTD + SPC and nor-BNI + SPC.COTP 1 mg/kg and NTD 5 mg/kg were injected intravenously at 10 min before sufentanil injection in groups COTP + SPC and NTD + SPC respectively,while nor-BNI 5 mg/kg was injected intravenously at 15 min before sufentanil administration in group nor-BNI + SPC.The animals were sacrificed at 2 h of reperfusion,the intestinal tissue was removed for microscopic examination and intestinal damage was assessed and scored according to Chiu.Left lung tissue was also removed for microscopic examination (1 =normal,4 =severely injured).The apoptosis in lung cells was detected using TUNEL and apoptosis index (AI) was calculated.The expression of Bcl-2 and Bax proteins in lung tissues was detected using immuno-histochemistry and Bcl-2/Bax ratio was calculated.ResultsCompared with group S,Chiu's score,lung injury score and AI were significantly increased,expression of Bcl-2 and Bax proteins was up-regulated,Bcl-2/Bax ratio was significantly decreased in the other groups ( P ＜ 0.01 ).Compared with group I/R,Chiu' s score,lung injury score and AI were significantly decreased,Bcl-2 protein expression was up-regulated,Bax protein expression was downregulated,and Bcl-2/Bax ratio was significantly increased in group SPC (P ＜ 0.01 ).Compared with group SPC,Chiu's score,lung injury score and AI were significantly increased,Bcl-2 protein expression was down-regulated,Bax protein expression was up-regulated,and Bcl-2/Bax ratio was significantly decreased in groups COTP + SPC,NTD + SPC and nor-BNI + SPC ( P ＜ 0.01 ).ConclusionSufentanil preconditioning can attenuate lung injury induced by intestinal I/R by activation of opioid receptors in rats.
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Objective To investigate the role of sufentanil on intestinal ischemia-reperfusion model of liver cell apoptosis and bel-2/Bax expression,and the opioid receptor-mediated effects in the process.Methods Seventy two healthy adult Wistar rats,weight 200-250 g,either male or female,were randomly divided into 9 groups(n=8),sham operation group(S),ischemia-reperfusion group(IR),sufentanil treated group (SPC),three kinds of opioid receptor antagonist,NTD(δ receptor antagonist,),nor-BNI(κ receptor antagonist),CTOP(μ receptor antagonist)in the intervention groups(NTD + SPC,nor-BNI + SPC,CTOP + SPC),three kinds of opioid receptor antagonist control groups(NTD,nor-BNI,CTOP).by clamping the superior mesenteric artery production model of intestinal ischemia-reperfusion injury,after the end of the experiment,immediately take the left lobe of liver specimens.Immunohistochemical detection of bcl-2/Bax protein expression,terminal transferase labeling(TUNEL)assay of liver cell apoptosis index(AI).Results Compared with IR group,SPC Group bcl-2 expression increased(0.277±0.014 vs 0.230±0.013)(P＜0.05),bcl-2/Bax ratio increased(1.375±0.113 vs 0.819±0.102)(P＜0.05),Bax down regulation(0.202±0.013 vs 0.283±0.025)(P＜0.05),liver cell AI reduced(6.491±1.191vs10.094±1.051)(P＜0.05).Compared with the SPC group,NTD + SPC group,nor-BNI +SPC group,CTOP+SPC group bcl-2 expression decreased(F=59.698,P＜0.05),bcl-2/Bas ratio decreased(F=40.349,P＜0.05),Bax expression was elevated(F=53.765,P＜0.05),liver cells AI elevated(F=76.728,P＜0.05).Conclusion Sufentanil pretreatment inhibit rat intestinal ischemia-reperfusion liver cell apoptosis.δ,κ,μthree kinds of opioid receptor mediate the protective effect of sufentanil,and the effects are equal.
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To study the effect of soybean isoflavone on liver oxidative stress resulting from 60Co-gamma rays. Methods: Totally 80 normal female Kunming mice were evenly randomized into 5 groups according to body weight: 3 intervention groups, single irradiation group and normal control group. The normal group and single irradiation groups were given 0.5% CMC-Na, and the 3 intervention groups were given different doses of soybean isoflavone (50 mg/kg, 100 mg/kg, 400 mg/kg) respectively for 14 d. The whole body of single irradiation group and intervention groups were subjected to 4.56 Gy 60Co-γ radiation once on the 7th day, and then the mice were killed on the 2nd day and the 7th day after radiation. Results: The CAT activity of liver tissue of 100,400 mg/kg intervention groups and 3 SI groups were significantly increased on the 2nd day and 7th day after irradiation(P<0.05), respectively; the GSH-Px activity of 100 mg/kg SI group was significantly increased(P<0.05) on the 7th day after irradiation; the T-SOD activity of 50 mg/kg SI group was significantly decreased (P<0.05) on the 2nd day after irradiation,while no difference was observed among remaining groups. The MDA content of 100 mg/kg group was significantly decreased on the 7th day after radiation compared with control group, and MDA content of each group subjected to irradiation were increased on the 2nd day after irradiation,but 3 SI groups nearly decreased to normal level on the 7th day after irradiation. Conclusion: The soybean isoflavone can enhance the antioxidant capability of mice, but it does not show a dose-effect relationship.
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Objective:To investigate the influence of high expression of Retn gene on glucose uptake by 3T3-L1 cells and to study its mechanism in inducing insulin resistance.Methods:(1)Radioimmunoassay was used to determine the glucose uptake by 3T3-L1 cells with low-,normal-and high-level Retn expression under basal and insulin-stimulated states.(2)RT-PCR and real-time RT-PCR were used to determine the mRNA levels of several glucose transport proteins in 3T3-L1 cells with different expression of Retn,including insulin receptor substrate-1(IRS-1),phosphatidylinositol 3-kinase(PI-3K),AKT-2,glucose transporter-4(GLUT-4),p38 mitogen-activated protein kinase(p38MAPK),and glycogen synthase kinase-3?(GSK-3?).(Results:) The uptake of glucose decreased with the increase of Retn expression under basal and insulin-stimulated conditions.The mRNA expression of 2 signal protein PI-3K and AKT-2 decreased with the increase of Retn expression;and the expression of GSK-3? and p38MAPK increased with the increase of Retn expression.Conclusion: Resistin protein can induce insulin resistance in adipocytes,which might be related to the expression changes of some proteins in PI-3K and Ras pathways.