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Objective:To investigate the analgesic time-effect characteristics and changes in concentrations of rabbit's hypothalamic 5-hydroxytryptamine (5-HT) and noradrenaline (NE) caused by buccal acupuncture in the rheumatoid arthritis (RA) rabbits,and to reveal the analgesic central mechanism of buccal acupuncture,thereby providing a theoretical basis for the treatment of pain by buccal acupuncture.Methods:Forty rabbits were randomly divided into a normal group,a model group,a body acupuncture group,and a buccal acupuncture group,with 10 rabbits in each group.No model was established in the normal group,while equal dose of normal saline was injected at the matched site and time point;rabbits in other groups were subjected to the establishment of RA models using egg protein.From the 27th day of the experiment,rabbits in each group received the designated intervention.Rabbits in the normal group and the model group were fixed for 30 min every day using the same method as those in the other groups.In the acupuncture group,Dubi (ST 35) and Zusanli (ST 36) on bilateral hind limbs were selected.Perpendicular needling (using the needles with 0.25 mm in diameter and 25 mm in length) was performed with twirling manipulation for 15 s at intervals of 5 min.The needles were retained for 30 min and acupuncture was performed once a day.In the buccal acupuncture group,the knee point in the buccal acupuncture and needles with a diameter of 0.25 mm and a length of 15 mm were selected.Oblique needling was performed with twirling manipulation for 15 s at intervals of 5 min.The needles were retained for 30 min and acupuncture was performed once a day.The thermal pain thresholds at the 0,5,15,30,60,120 and 240 min after the 1st and 10th acupuncture therapy were measured with a PL-200 thermal-inducing pain meter.After the 10th acupuncture therapy,rabbit's hypothalamus was removed,and the 5-HT and NE concentrations in the hypothalamus at the peak point of the acupuncture pain threshold curve were determined by high performance liquid chromatography (HPLC).Results:The analgesic effect was obvious at 5 min after buccal acupuncture started,peaked at 30 min,and decreased to the lowest value at 240 min.Rabbits in the body acupuncture group began to show significant analgesic effect at 15 min,which was peaked at 30 min,and began to decline at 60 min.The pain threshold at 240 min was still higher than that at 0 min.Compared with the model group,the concentrations of hypothalamic 5-HT in the buccal acupuncture group and the body acupuncture group was significantly increased,and the between-group differences were statistically significant (both P＜0.05).The NE/5-HT ratios in hypothalamus in the buccal acupuncture group and the body acupuncture group were significantly lower than the ratio in the model group,and the differences were statistically significant (both P＜0.05);difference in the decrease was statistically significant between the buccal acupuncture group and the body acupuncture group (P＜0.05).Conclusion:The analgesic effect of buccal acupuncture shows an obvious time-dependent curve.It is characterized by rapid onset of pain relief,rapid increase and decline in pain threshold.5-HT and NE levels in rabbit's hypothalamus can be affected by buccal acupuncture,with increased 5-HT concentration and reduced NE/5-HT ratio.
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Objective To evaluate the value of plasma soluble urokinase?type plasminogen activator receptor (suPAR)and D?dimer for assessing disease severity and prognosis in patients with traumatic brain injury(TBI). Methods A serial of 112 patients with traumatic brain injury admired to our hospital were divided into mild TBI (GCS score 13~15),moderate TBI(GCS score 9~12)and severe TBI(GCS score 3~8). The levels of plasma suPAR and D?dimer were monitored within 24 h after patient admission. Results The levels of suPAR and D?di?mer in TBI group were obviously higher than those in the control group(15.86±7.33 vs 2.79 ± 0.69,P<0.01;3.50 ± 2.78 vs 24 ± 0.15,P<0.01). The levels of suPAR and D?dimer in the severe TBI group were also obviously high?er than those in the moderate TBI group(P<0.05). Plasma suPAR levels and GCS score had significant negative correlation(r =- 0.854,P < 0.01). D?dimer levels and GCS score showed a negative correlation(r =- 0.738, P < 0.01). Plasma suPAR and D ? dimer was positively correlated(r = 0.753,P < 0.01). The area under the curve of D?dimer(AUC)was larger,0.854,95%CI 0.763~0.945;the AUC of suPAR was 0.801,95%CI 0.698~0.903. Conclusion Higher levels of suPAR and D?dimer in TBI patients is not only relevant to the injury sever?ity ,but also closely to the prognosis.
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Objective To explore the effects of simvastatin on the protein expressions of urokinase-typeplasminogen activator (uPA) and plasminogen activator inhibitor-1 (PAI-1). Methods Male Sprague–Dawley rats were divided into saline group , LPS group and LPS plus simvastatin group , and were then pretreated with simvastatin (1 mg/kg) for 30 minutes before addition of LPS (8 mg/kg). Changes in left ventricular pressure were recorded. Ninety minutes after LPS injection, whole blood was collected from the inferior vena cava, and neutrophils were separated. The neutrophils were then lysed to detect levels of uPA and PAI-1. Results Left ventricular systolic pressure (LVSP: mmHg), maximal differential of left ventricular pressure (+dp/dtmax:mmHg/s), and heart rate (beats/min) were markedly decreased at different time points after administration of LPS, and maximal differential of left ventricular pressure increased in the rats receiving LPS as compared with those receiving saline, although the differences between the control and LPS groups were not statistically significant. LPS caused a great decline in uPA content and an elevation in PAI-1 content in neutrophils, but simvastatin diminished the impact of LPS on neutrophils. Conclusion Simvastatin plays a role in protection of cardiac function in rats with LPS-induced septic shock , and controls expressions of uPA and PAI-1 in neutrophils.
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Objective To investigate the incidence and the species distribution of catheter‐related bloodstream infection(CRBSI) in the intensive care unit(ICU) at our hospital ,and analyze the risk factors for CRBSI .Methods The hospitalized patients microbi‐ologically diagnosed as CRBSl were included in this study from January 2012 to June 2013 .Data were collected retrospectively and analyzed by software SPSS 19 .0 .Results There were 67 patients were diagnosed as nosocomial CRBSI of 987 cases ,in which 24 cases (35 .8% )died in the hospital .Eighty one strains were detected from 67 cases of CRBSI ,including 42 Gram‐positive(G+ ) bac‐teria(51 .9% ) ,36 Gram‐negative(G-)bacteria (44 .4% ) ,and 3 fungi(3 .7% ) .Staphylococcus epidermidis was predominant patho‐genic G+ bacteria ,and Acinetobacter baumannii was predominant G - bacteria .With multiple logistic regressions ,age≥65 ,high A‐PACHEⅡ score and polymicrobial CRBSI were independent predictors of worse outcome .Conclusion Within the latest 18 months , the prevalence of pathogens infection are Staphylococcus epidermidis and Acinetobacter baumannii in CRBSI in ICU .Advanced age , disease severity and polymicrobial CRBSI should be regarded as significant independent risk factor of the CRBSI patients in ICU for mortality .
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Objective To evaluate the effects of modified early goal directed therapy (EGDT )on the prognosis of patients with septic shock .Methods Clinical data of 116 patients with septic shock admitted to ICU during January 2011 to March 2013 were retrospectively analyzed .Patients were divided into modified early goal‐directed therapy group (n=57) and traditional early goal‐di‐rected therapy group (n=59) according to different methods of treatment ,the patients′28‐day survival rates of these 2 groups were compared .Modified early goal‐directed therapy are divided into survival group (n=46) and non‐survival group (n=11) according to 28‐day prognosis .Acute physiology and chronic health evaluation Ⅱ (APACHEⅡ ) score ,sequential organ failure assessment (SOFA) ,multiple organ dysfunction syndrome (MODS) score and other relevant indicators of survival group and non‐survival group were compared .Results The 28‐day survival rate in modified early goal‐directed therapy group had increased approximately 18 .9% higher than that of the traditional early goal‐directed therapy group(P< 0 .05) .The APACH Ⅱ score ,SOFA score and MODS score in non‐survivors were significantly higher than those of survivors in modified EGDT group ,which were[(29 .36 ± 1 .57)d vs .(24 .30 ± 3 .27)d] ,[(13 .45 ± 0 .52)d vs .(12 .78 ± 1 .33)d] ,[(9 .00 ± 0 .00)d vs .(4 .04 ± 1 .94)d]separately .And vaso‐pressors time and mechanical ventilation time was significantly longer in non‐survivors than survivors(P<0 .05) .Conclusion Mod‐ified early goal directed therapy could improve 28‐day survival rate ,and it show s beneficial effects on outcome of critical patients w ith septic shock .
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Objective To explore the changes in cardiac index and oxygenation index in sepsis piglets after nitric oxide (NO) gas inhalation. Methods A piglet model of sepsis was induced by intravenous infusion of Gram-negative bacterial endotoxin (LPS), then the piglets were randomly divided into two groups. NO group (n=8) was administered with inhaled nitric oxide of 80ppm via volume control (VC) mechanical ventilation for one hour, while the control group (n = 4) received mechanical ventilation with VC and was observed for one hour to assess the stability of the model. The parameters of oxygenation and hemodynamics were measured by PICCO and arterial blood gas analysis every fifteen minutes for one hour. Results Injection of endotoxin induced a stable pig model of sepsis. PH, HCO3-, arterial oxygen pressure (PaO2), mean arterial pressure (MAP) and cardiac index in this model were significantly lower the baseline values (P < 0.01). Arterial oxygen pressure and cardiac index were significantly higher in N0 group than in the control group (P<0.01). Heart rate (HR), central venous pressure (CVP), global end-diastolic volume index (GEDI) and intrathoracic blood volume index (ITBI) did not significantly differ between NO group and the control group. Conclusions Inhalation of nitric oxide gas can significantly improve oxygenation and cardiac function in piglets with sepsis.
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BACKGROUND:Urokinase-type plasminogen activator (uPA) and urokinase-type plasminogen activator receptor (uPAR) are known as important factors, which mediate a variety of functions in terms of vascular homeostasis, inflammation and tissue repair. However, their role in systemic inflammatory response syndrome (SIRS) has been less well studied. This study aimed to test the hypothesis that the abnormalities of fibrinolysis and degradation of extracellular matrix mediated by uPA and uPAR are directly related to the patients with SIRS. We therefore analyzed their role and clinicopathological significance in patients with SIRS.METHODS:A case-control study was conducted with 85 patients who were divided into two groups according to the diagnostic criteria of SIRS:SIRS group (n=50) and non-SIRS group (n=35). The SIRS group was divided into MODS group (n=26) and non-MODS group (n=24) by their severity, and survival group (n=35) and non-survival group (n=15) by their prognosis. Another 30 healthy adults served as normal controls. uPA and uPAR in plasma were detected by commercial enzyme-linked immunosorbent assay (ELISA) kits.RESULTS:The plasma level of uPA was lower in the SIRS group than in the non-SIRS group and controls (P<0.001 andP<0.001). It was lower in sepsis patients and the MODS group than in the non-sepsis patients and the non-MODS patients (allP<0.05). However, there was no difference in uPA level between survivors and non-survivors (P>0.05). The plasma level of uPAR increased in the SIRS group compared with the non-SIRS group and controls (P<0.001 andP<0.001). There was a significant elevation of uPAR in sepsis patients, MODS patients and non-survivors as compared with non-sepsis patients, non-MODS patients and survivors respectively (allP<0.05). Plasma uPAR levels were positively correlated with APACHE II score (r=0.575,P<0.001) and SOFA score (r=0.349,P=0.013). AUCs for the prediction of SIRS mortality were 0.67 and 0.51, respectively, for uPA and uPAR.CONCLUSION:uPAR could be a predictor of poor outcome in patients with SIRS.
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<p><b>OBJECTIVE</b>To study the effects of environmental multi-media lead pollution on blood lead and sex hormone levels among lead exposed males engaged in E-waste dismantling, and the correlation between confounding factors and sex hormone levels.</p><p><b>METHODS</b>An E-waste dismantling area in Taizhou of Zhejiang Province was selected as the research site. One hundred and fifty two samples were collected from the groundwater, soil, rice, corn, chicken, and pork in the dismantling area. The effects of the multi-media lead pollution on the male blood lead and sex hormone levels of FSH, LH, and T, as well as the correlation with confounding factors, were studied.</p><p><b>RESULTS</b>The blood lead concentrations in the males aged under 31, from 31 to 45 and from 46 to 60 were 98.55, 100.23, and 101.45 μg/L, respectively. Of all the environmental media lead exposures, the groundwater, rice and soil were main contributing factors to the lead accumulation in humans. FSH and LH levels increased with the age while the T levels decreased with the age instead. There was a significant correlation between the FSH and LH levels and wearing masks.</p><p><b>CONCLUSION</b>There was correlation between the FSH, LH, and T levels, and the mean values of lead concentrations in environmental media, and the sex hormone levels were correlated with the confounding factor of wearing masks.</p>
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Adult , Humans , Male , Middle Aged , Electronic Waste , Environmental Monitoring , Environmental Pollutants , Blood , Chemistry , Follicle Stimulating Hormone , Blood , Gonadal Steroid Hormones , Blood , Lead , Blood , Chemistry , Luteinizing Hormone , Blood , Occupational Exposure , Refuse Disposal , Methods , Testosterone , BloodABSTRACT
BACKGROUND: This study aimed to determine the plasma levels of urokinase-type plasminogen activator (uPA), urokinase-type plasminogen activator receptor (uPAR), D-dimer, IL-6 and TNF-α, and observe the relations among uPA, uPAR, D-dimer, IL-6 and TNF-α in patients with systemic inflammatory response syndrome (SIRS). METHODS: A prospective, clinical case-control study was conducted in patients with SIRS at age of more than 55 years old treated during 2008-2010 at Wuhan Central Hospital. Venous blood samples were collected by routine venipuncture. Eighty-five patients were divided into two groups according to diagnostic criteria of SIRS: SIRS patients from intensive care units (n=50), and non-SIRS patients from medical wards (n=35). Thirty healthy blood donors who visited the General Health Check-up Division at Wuhan Central Hospital served as controls. Excluded from the study were (1) those patients with pregnancy; (2) those with cancer; (3) those died after admission into the ICU in 7 days; (4) those received cardiopulmonary resuscitation; (5) those who had previous blood system diseases; and (6) those with SIRS before admission into the ICU. The levels of uPA, uPAR, D-D, IL-6 and TNF-α in blood were detected by commercial enzyme-linked immunosorbent assay (ELISA) kit. The data were analyzed using SPSS version 17.0 and expressed as mean ± standard. Student's t test and the Mann-Whitney U test were used in the analysis. The relations of uPA, uPAR and D-dimer, IL-6 TNF-α levels were analyzed using Spearman's rank-order correlation coefficient test. RESULTS: The plasma levels of uPA , uPAR, D-dimer,IL-6 and TNF-α in the patients with SIRS were obviously higher than those in the non-SIRS patients and controls (P<0.001). Correlation analysis showed a positive correlation between uPAR and IL-6 levels (r=0.395, P=0.004) and between uPAR and TNF-α levels (r=0.606, P<0.001), but no correlation between uPAR and D-dimer levels (r=0.069, P=0.632). No correlation was observed between uPA, D-dimer, IL-6 and TNF-α levels (P>0.05). The establishment of ROC curve was based on the levels of uPAR, D-dimer, IL-6 and TNF-αin 24 hours for the diagnosis of multiple organ dysfunction syndrome (MODS), and the ROC areas under the curve were 0.76, 0.58, 0.86 and 0.83, respectively. CONCLUSIONS: uPA and uPAR play a major role in patients with SIRS in the process of coagulation disorder, but the mechanism of SIRS is not the same. uPAR may play a central role in the development of SIRS to MODS.
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Objective To test plasma levels of uPA,uPAR,D-dimer,IL-6 and TNF-α,and observe the relationships between uPA,uPAR and D-dimer,IL-6,TNF-αin patients with SIRS.Methods A prospective,clinical case-control study was adopted.Cases were collected from our hospital in January 2008 to January 2010,and all were ＞ 55 years of age.Venous blood samples were collected via routine venipuncture.Eighty-five patients were divided into two groups according to diagnostic criteria of SIRS:SIRS group collected from Intensive Care Unit ( n =50) and non SIRS group collected from medical ward ( n =35).The control group comprised 30 unrelated healthy blood donors who visited the General Health Checkup Division at our hospital.Patients with (1) pregnant women; (2) cancer; (3) died after admitted into ICU in 7 days; (4) after cardiopulmonary resuscitation ; ( 5 ) with previous blood system diseases; (6) patients with SIRS before admitted into ICU were excluded from the study.uPA,uPAR,D-D,IL-6 and TNF-α in blood were detected by commercial enzyme-linked immunosorbent assay (ELISA) kits.The data was analyzed using SPSS version17.0.Data accorded with normal distribution of measurement was expressed as mean ± standard,and analyzed by independent-samples t test; non-normal distribution of measurement data,expressed by median,was analyzed with Mann-Whitney test.Relationships between plasma levels of uPA,uPAR and D-dimer,IL-6 TNF-α were analyzed using Spearman rank correlation test.To compare with blood level of uPA,uPAR,IL-6 and TNF-α in SIRS patients in the application of diagnostic value of MODS,we constructed the receiver operating characteristic curve ( ROC curve) for blood levels of uPA,uPAR,IL-6 and TNF-α in 24 h.Results The plasma levels of uPA,uPAR,D-dimer,IL-6 and TNF-αin patients of SIRS were obviously higher compared with non-SIRS and normal controls ( all P ＜ 0.01 ).Correlation analysis showed that there was positive correlation between uPAR level and IL-6 level (r =0.395,P =0.004) ; there was positive correlation between uPAR level and TNF-αlevel ( r =0.606,P ＜0.01 ).There was no correlation between uPAR levd and D-dimer level ( r =- 0.069,P =0.632).There was no correlation between uPA level and D-dimer,IL-6 or TNF-α ( all p ＞ 0.05).There ROC curve were made based on the abilities of uPAR,D-dimer,IL-6 and TNF-αlevels in 24 hours to diagnose MODS,and the ROC areas under the curves were 0.76,0.58,0.86,0.83 respectively.Conclusions These results demonstrate that uPA and uPAR play a major contributory role in patients with SIRS in the process of coagulation disorders,but the mechanism in SIRS is not the same.uPAR may play a central rolein the development of SIRS to MODS.
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Objective To evaluate the efficacy and safety of linezolid in the treatment of severe lung infections caused by methicillin-resistant Staphylococcus aureus (MRSA).Methods Fifteen patients admitted to ICU due to severe lung infection caused by MRSA received linezolid treatment. WBC, lactic acid (LAC), IL-1β, IL-6, and TNF-α levels were measured before and after treatment. Results Clinical efficacy rate was 73.3%. The level of WBC, LAC and inflammatory cytokines decreased significantly after linezolid treatment (P<0.01).Conclusions Linezolid shows good efficacy in the treatment of severe lung infections caused by MRSA.