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Objective:To investigate the mechanism of levosimendan on acute kidney injury after cardiopulmonary resuscitation (CPR) in rats.Methods:Twenty-five healthy adult male SD rats were randomly divided into three groups: control group ( n=5), levosimendan group ( n=10) and experimental group ( n=10). A cardiac arrest-cardiopulmonary resuscitation model was established using smothering method in the experimental group and levosimendan group. The levosimendan group was treated with levosimandan during and after resuscitation, while the experimental group was given equivalent volume of saline solution during and after resuscitation, and the control group was only given equivalent volume of saline without performance of CPR. The rats in the three groups were sacrificed at 6 h after resuscitation. The serum and kidney tissue samples were collected. Serum biochemical indicators [serum creatinine (Scr), blood urea nitrogen (Bun), interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)] were measured. HE staining and Paller score were used to identify the degree of kidney damage. Apoptosis was estimated by TUNEL staining. Western blot was used to detect the expression levels of phosphorylation of extracellular regulated protein kinases (p-ERK). One-way analysis of variance was used to compare the mean values of normally distributed measurement data between groups. Comparisons between groups were performed using the least significant difference t-test. Results:Scr (85.02±1.31) μmol/L, Bun (7.36±0.13) mmol/L, Paller score (7.3±0.2), IL-1β (302.20±17.35) pg/mL, IL-6 (564.60±23.24) pg/mL and TNF-α (1346±83.73) pg/mL in the experimental group were significantly higher than those of the control group [(15.94±0.96) μmol/L, (2.95±0.18) mmol/L, (0.7±0.2), (7.27±0.44) pg/mL, (51.30±2.87) pg/mL, and (10.39±0.52) pg/mL] (all P<0.01). Compared with the experimental group, Scr (63.88±2.01) μmol/L, Bun (5.45±0.47) mmol/L, paller score (4.8±0.2), IL-1β (78.61±3.66) pg/mL, IL-6 (297.90±13.64) pg/mL and TNF-α (276.2±20.18) pg/mL were significantly decreased in the levosimendan group (all P<0.01). TUNEL staining showed that levosimendan could improve the apoptosis of renal cells ( P<0.01). The expression of p-ERK protein in the levosimendan group was significantly higher than that in the experimental group ( P<0.01). Conclusions:Lovosimendan could attenuate acute kidney injury following cardiac arrest and cardiopulmonary resuscitation via suppression apoptosis. The mechanism of levosimendan protective effect might be associated with activation of ERK signaling pathway.
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Hierarchical diagnosis and treatment system is an important measure to rationally allocate medical resources and promote the homogenization of basic medical services. The medical alliance is an important service mode and service system of hierarchical diagnosis and treatment, whose role is to perfect the up-down linkage and meet the patient′s medical needs. Informatization construction is an important starting point to promote the services of the medical alliance. In order to solve the problem of connectivity, the medical alliance needs to establish a regional referral platform and realize the integrated service of all medical institutions. Renji Hospital, Shanghai Jiaotong University School of Medicine, has built a blockchain based referral system for hierarchical diagnosis and treatment, incorporating the S2B2C mode concept, and using the traceability, tamper proof and distributed accounting features of blockchain technology, realized independent storage of data in hospitals, realized real-time information sharing and interconnection, and provided a feasible solution for medical alliance management.
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Objective To explore the protective effects of cannabinoid analogues WIN55212-2 on paraquat poisoned mice. Methods Totally 35 healthy male C57BL/6 mice were randomly(random number) divided into four groups: PQ group (paraquat poisoned, n=10), WIN 1 mg group (PQ+WIN55212-21 mg n=10), WIN 2 mg group (PQ+WIN55212-22 mg, n=10), control group (n=5).The PQ poisoned animal models were established in the PQ group, WIN 1 mg group and WIN 2 mg group by intraperitoneally injection of paraquat with a concentration of 20 mg/kg. Intraperitoneal injection of WIN55212-2 (containing Tween 80 cosolvent) at the concentration of 1 mg/kg and 2 mg/kg was performed 1 h before PQ exposure in the two interfered groups. Equivalent volume of saline was given to the control group. WIN55212-2 was injected twice a week from the second week. In the acute phase (14 d), 5 mice were randomly sacrificed in the PQ group, WIN 1 mg group and WIN 2 mg group, and 3 mice were sacrificed in the control group to obtain blood sample, bronchoalveolar lavage fluid (BALF) and lung tissue. All the remaining mice were executed on day 28, and the tissue samples were collected as mentioned above. HE staining and Masson staining were performed to observe the changes of lung tissues after PQ poisoning. Changes of TNF-α, IL-6 and TGF-β in plasma and BALF were measured by ELISA. Results In the acute phase, the pathological sections of lung tissues in the PQ group, WIN 1 mg group and WIN 2 mg group showed diffuse inflammation, which was improved after the intervention of WIN5522-2, especially in the WIN 1 mg group. IL-6 levels of BALF in the PQ group, WIN 1 mg group, WIN 2 mg group and the control group were (1024.77±124.74)U/L, (620.48±99.76)U/L, (823.29±157.88) U/L, and (180.42±20.22)U/L, respectively. IL-6 levels in the WIN 1 mg group and the WIN 2 mg group were statistically lower than those in the PQ group (P=0.021, P=0.016). However, no difference was found between the two intervention groups(P=0.114). The similar condition was also found in TNF-α in BALF and plasma. In the chronic phase, mice in the PQ group, WIN 1 mg group and WIN 2 mg group showed fibrosis in tissue by HE and Masson staining, and the inflammatory condition was improved after the intervention of WIN5522-2, which was more obvious in the WIN 1 mg group. In BALF, TNF-α level was (321.64±50.54)U/L, (260.23±48.19)U/L, (278.89±29.40)U/L, (89.76 ± 10.87)U/L in the PQ group, WIN 1 mg group, WIN 2 mg group and the control group. Differences were found between the WIN 1 mg group and the control group and the WIN 2 mg group. Similar differences were also observed in plasma TNF-α, but not in TGF-β. Conclusions A small dose of WIN55212-2 can improve the general condition of PQ poisoning mice, and reduce the inflammatory and fibrosis-related cytokines levels in PQ poisoning mice.
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Objective To study the values of glycosylated hemoglobin in screening for patients with prediabetic state in Guang-zhou region .Methods 525 Guangzhou people who had accepted health examination were enrolled and were subjected to oral glucose tolerance test(OGTT) .BIO-RAD D-10 automatic glycosylated hemoglobin analyzer was employed to detect their glycosylated he-moglobin A1c(GHbA1c) .OGTT results were served as diagnostic criteria ,Receiver operator characteristic (ROC) curve analysis was performed to obtain the optimal threshold of GHbA1c in diagnosing impaired glucose regulation (IGR) .Results The optimal threshold of GHbA1c in diagnosing IGR was 5 .95% .The sensitivities of GHbA1c≥5 .95% and GHbA1c≥5 .7% in diagnosing IGR were 53 .3% and 84 .8% ,respectively ,while their specificities were 72 .8% and 31 .0% ,respectively .The difference of sensitivity between GHbA1c≥5 .95% combined with FPG≥5 .6 mmol/L and GHbA1c≥5 .7% alone in diagnosing IGR showed no statistical significance(P= 0 .406) ,while the specificity increased obviously (P= 0 .000) .Conclusion The criteria of GHbA1c≥5 .7% can be used for prediabetic state screening but not for diagnosis .GHbA1c≥5 .95% combined with FPG≥5 .6 mmol/L can be used effectively for prediabetic state screening in Guangzhou people .
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Objective To investigate the effects of mitochondrial DNA (mtDNA) on the pathopoiesis mechanisms of paraquat poisoning in vitro.Methods Firstly,the survival rate of A549 cells (human type Ⅱ alveolar epithelial cells) was measured with cell counting kit-8 after exposure to paraquat.Afterwards,the concentration of mtDNA in supernant of culture medium for culturing A549 and the chauge of mitochondrial membrance potential were detected with absolute quantitative PCR and confocal laser microscopy,respectively.Then,The chemotactic activity of mtDNA in peripheral blood mononuclear cells (PBMC) and neutrophils (PMN) were detected by transwell chemotaxis,and the subtype of chemotactic cells was measured with flow cytometry.Meanwhile,the role of mtDNA in vascular permeability was measured by using Xcelligence system and in vitro using vascular permeability kits.Finally,the effects of mtDNA in cell proliferation were to verify.Results The 50％ of lethal concentration (LD50) of paraquat for A549 was 600 μmol/L.Cell viability and concentration of mtDNA following challenge of PQ revealed in a concentration-and time-dependent manner (P ＜ 0.05).The mtDNA had a power in aggregating PBMC nonspecifically,but there was no effect on the vascular permeability was found.Moreover,the proliferation of human fibroblasts was not stimulated directly by mtDNA,but TGF-β1 (transforming growth factor-beta 1),a major pro-fibrotic factor,was increased compared to control group (P ＜ 0.05).Conclusions The mtDNA could play an important role in the inflammatory and proliferation responses to paraquat poisoning.
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Objective To study the differences between the animal model of pulmonary injury/ fibrosis induced by using paraquat and that induced by using bleomycin in mice in order to establish an ideal mouse pulmonary fibrosis model.Methods Thirty healthy and 8 ～ 10 weeks old male C57BL/6J (C57) mice were randomly (random number) divided into paraquat group (n =10),bleomycin group (n =10),and control group (n =10).Paraquat ( 10 mg/kg) was given to mice intraperitoneally once every three days for 5 times in paraquat group.Bleomycin was injected into trachea of mice in a dose of 3 mg /kg in bleomycin group.The mice were sacrificed 7 days,14 days and 21 days after administration of drug.The general physical condition,body weight and pulmonary pathological changes were observed.Data were analyzed with SPSS13.0 statistical package.The comparison was made between two groups with mann -whitney U- test.Results Both agents could induce pulmonary injury and fibrosis.After comparison of survival rate,body weight,pulmonary histopathological change and rate of successful modelling,the repeated low - dose of paraquat injected intraperitoneally was proved to be a method of more simple and effective with high success rate of modeling in comparison with the conventional technique of intratracheal injection of bleomycin.Conclusions By the comparison between two methods of establishing pulmonary injury and fibrosis models in mice,the method of repeated low - dose intraperitoneal injection of paraquat is superior over the bleomycin - induced method in respect of higher rate of successful modelling.
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Objective To evaluate the modified early warning score (MEWS) system in the assessment of the severity and prognosis in acute pancreatitis (AP). Method Ninety two AP patients had been recruited from the Department of Emergency Medicine during November, 2007 to May, 2008. All patients fulfilled at least 2 of the three criteria of American AP clinical guideline, (1) typical abdominal pain; (2) serum amylase level ≥3times of upper normal limit; (3) typical ultrasound or CT findings for AP. Patients with cardiac, pulmonary, hepatic , renal insufficiency or other comorbidities were ruled out. Each patient was evaluated MEWS at day 1,2, and 3 after admission, and subsequently stratified into two groups: high risk group with MEWS ≥4 and moderate risk group with MEWS < 4. The clinical course, end organ failure, and mortality rate was compared between two groups. Other parameters including Ranson score, APACHE Ⅱ score were also obtained. Spearman correlation,group student t test, or Chi square tests were used. Results High risk group has significant prolonged clinical course ( P < 0.05 ) , higher end organ failure rate (P < 0.01) , compared to low risk group. Patients who can not achieve MEWS improvements after interventions have the highest mortality rate (P < 0.01). The MEWS positively correlated with Ranson and APACHE Ⅱ scores ( r = 0.486, and 0.583, respectively, P <0.05). Conclusions MEWS is a valid and simple tool to evaluate severity and prognosis of AP in early stage.
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Objective To investigate the expression of transforming growth factor β1,transforming growth factor beta receptor(TBR)Ⅰ,TβR Ⅱ,Smad4 and C-Jun in rats with nonalcoholic fatty liver disease(NAFLD)and to find out the mechanisms of liver fibrosis in patients with NAFLD.Methods A total of 18 male SD rats were randomly divided into normal control group(n=9)and model group(n=9).The rats in control group were fed with normal diet,and those in model group were fed with fat-rich diet(consisted of 10%lard oil+2%cholesterol).An rats were sacrificed at the 20th week.The levels of TGFβ1,TβR Ⅰ and TβR Ⅱ mRNA were examined by RT-PCR.The expressions of TGFβ1 and Smad4 in liver tissue were detected by immunohistochemistry.The expression of C-Jun protein was detected by Western blotting.Results The NAFLD model was successfully established.The immunohistochemistry examination revealed that TGFβ1 and Smad4 were expressed weekly in control group,but strongly expressed in model group.RT-PCR showed that A values of TGFβ1,TβR Ⅰ and TβR Ⅱ mRNA were 0.46±0.12,5.z4±2.70 and 3.35±1.95,respectively,in model group,which were higher than those in control group(0.21±0.09,1.36±0.77 and 0.52±0.19,all P values＜0.01).The Western blotting results demonstrated that the expression of C-Jun protein in model group(0.93±0.41)was higher than that in control group (0.32±0.25,P=0.001).Conclusion TGFβ1/Smad4 signal pathway might be involved in the development of hepatic fibrosis in NAFLD.Blocking TGFβ1/Smad4 signal pathway will be helpful in treatment of NAFLD.
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OBJECTIVE To study the effects of levofloxacin on QT correction dispersion(QTcd) interval in elderly patients hospitalized with acute exacerbations of COPD(AECOPD).METHODS Totally 124 patients received IV levofloxacin(500 mg qd) for 10-14 days.Evaluations included of 12-lead ECGs at baseline and blood examination before treatment,day 5 and after treatment.RESULTS QT correction(QTc) interval was no significant changes,but the QTcd interval was with significant prolongation.CONCLUSIONS IV levofloxacin could not cause QTc interval prolongation,but could make QTcd interval prolongation,which is a potential risk of arrhythmia in elderly patients with AECOPD.
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0.05).After 30 minutes treatment,93% patients in labetalol group reached goal blood pressure(0.05).However,tachycardia was significantly(P
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0.05).CONCLUSIONS Levofloxacin 500mg orally administered is effective in the treatment of acute suppurative tonsillitis.