Establishment of risk prediction models of acute renal injury after cardiac surgery: a literature analysis / 中华麻醉学杂志

Acute renal injury (AKI) is one of the serious complications after cardiac surgery.The incidence of AKI after cardiac surgery was 5%-42%.It is independently associated with an increase in costs of treatment, prolongation of hospital stay, and increase in short- and long-term mortality rates.Currently, there is no effective treatment for AKI after cardiac surgery.Early identification of high-risk patients, early prevention and early treatment can reduce the incidence and severity of AKI after cardiac surgery.Risk prediction models of AKI after cardiac surgery can help clinicians identify high-risk patients and thus carry out corresponding measures.This paper aimed to provide a reference for the use of the model and to indicate the direction for further research though analyzing the literature information about the establishment of risk prediction model of AKI after cardiac surgery in recent years.

A multicenter prospective clinical study on continuous blood purification in treating childhood severe sepsis / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate efficacy of continuous blood purification (CBP) in childhood severe sepsis through the analysis of organ function, inflammatory mediators and prognosis.</p><p><b>METHOD</b>Forty-seven children with severe sepsis aged 29 days -16 years who were treated in PICU of Shanghai and Zhejiang five hospitals during October 1, 2011 and September 30, 2012 were enrolled; 30 cases treated with CBP were recorded as logged group , 17 cases without CBP as unlogged group. Changes in the cardiovascular, respiratory function, renal function, inflammatory markers, PRISM score III, PCIS and survival were observed and compared between the two groups at baseline (d0), first days (d1), second days (d2), third days (d3), fifth days (d5).</p><p><b>RESULT</b>(1) Cardiovascular function: In d3 and d5, heart rate (HR) and mean arterial pressure (MAP) were improved as compared to unlogged group (121, 119 vs. 138, 137; 71, 80 mmHg vs. 63, 62 mmHg, P < 0.05), with no statistical significance in arterial blood lactate concentration. (2) Oxygenation index (PaO₂/FiO₂) and arterial oxygen saturation (SaO₂) increased as compared to unlogged group, but did not reach statistical significance. (3) Blood urea nitrogen (BUN) and creatinine (Cr) were improved as compared with unlogged group from d1 (P < 0.05). (4) Inflammatory mediators did not show significant differences. (5) Twenty-eight days survival rate: logged group was 70.0%, unlogged group was 52.9%, but the difference was not statistically significant (P = 0.242).</p><p><b>CONCLUSION</b>CBP can improve circulatory function, oxygenation, and renal function in children with severe sepsis. No evidence was found that CBP could decrease the level of inflammatory mediators, improve critical score and 28 days survival rate.</p>

Change of serum myeloperoxidase and lipoxin A4 level in coronary heart disease patients with anxiety and/or depression / 中南大学学报(医学版)

OBJECTIVE@#To investigate the change of serum myeloperoxidase (MPO) and lipoxin A4 (LXA4) in coronary heart disease (CHD) patients with anxiety and depression and its clinical significance.@*METHODS@#From December 2010 to February 2011, 143 CHD patients and 44 non-CHD patients (the control group) hospitalized in the Department of Cardiology at the Second Xiangya Hospital were enrolled. The hospital anxiety and depression scale (HADS) was used to evaluate the psychological state of all patients and the CHD patients were assigned to an anxiety and depression group (n=57) or a non-depression and anxiety group (n=86). The serum levels of high sensitive C-reactive protein (Hs-CRP), MPO, and LXA4 were examined, and the ratio of MPO and LXA4 (M/L) was calculated.@*RESULTS@#The levels of Hs-CRP, MPO, and LXA4 as well as M/L ratios in both CHD groups were significantly higher than those in the control group (all P<0.01). Compared with the non-anxiety and depression group, the levels of MPO and LXA4, and M/L ratios in the anxiety and depression group increased (all P<0.05). Correlation analysis showed that MPO was positively correlated with the score of HADS-total (HADS-t), HADS-anxiety (HADS-a), or HADS-depression (HADS-d), while LXA4 was negatively correlated with HADS-t or HADS-d. Multiple ordinal logistic regression analysis revealed that higher HADS-t score, stable angina, unstable angina, and acute myocardial infarction were the independent impact factors for the elevation of M/L ratio.@*CONCLUSION@#Anxiety and depression may aggravate the inflammatory response in CHD patients. The imbalance between inflammation and anti-inflammation may be part of the mechanism.

Effects of cholesterol overload on visfatin secretion from adipocytes and the mechanism / 中华内分泌代谢杂志

3T3-L1 adipocytes were cultured and differentiated into mature adipocytes in vitro. The adipocytes were intervened by ACAT inhibitor( 2 μg/ml) and ox-LDL with various concentrations (0,25,50,75,and 100 μg/ml)for 48 h,ACAT inhibitor( 2 μg/ml) and ox-LDL( 50 μg/ml) at the 0,6,18,36,and 48 h,or ACAT inhibitor( 2 μg/ml),ox-LDL( 50 μg/ml),and TUDCA with various concentrations(0,100,200,and 400 μ mol/L)for 48 h,respectively.The levels of visfatin in supernatant were examined by ELISA and the expressions of protein GRP78 and CHOP in adipocytes were detected by Western blot.After the adipocytes were treated with ACAT inhibitor and ox-LDL at different concentrations for 48 h,the cholesterol concentration and the expressions of GRP78 and CHOP protein in adipocytes and the visfatin levels in the supernatant fluid were increased with the increase of the ox-LDL concentration.The differences had statistical significance in the experimental groups compared with blank control group( all P＜0.05 ).After the intervention with ACAT inhibitor and ox-LDL for different durations,the expressions of GRP78 and CHOP protein in adipocytes and the visfatin levels in the supernatant fluid were up-regulated in a timedependent manner.The differences between experimental groups and blank control had statistical significance( all P＜0.05 ).After the intervention with ACAT inhibitor,ox-LDL,and different concentrations of TUDCA for 48 hours,the expressions of GRP78 and CHOP protein in adipocytes and visfatin levels in the supernatant fluid were down-regulated in a dose-dependent manner and as compared with blank control group the difference were statistically significant( all P＜ 0.05 ).The increase of cholesterol load in adipocyte may promote the visfatin secretion,denoting that the mechanism might be due to the enhancement of endoplasmic reticulum stress in aidpocytes.

Study of the MxA protein induced by adenovirus type 3 and it' s antiviral effect against Ad3 / 中国免疫学杂志

Objective: This study aimed to investigate the induction of MxA protein in PBMC treated with various doses of adenovirus type 3(Ad3) and to test the antiviral effect of MxA protein against Ad3 in vitro.Methods:The content of MxA protein in cytoplasm of the peripheral blood mononuclear cells( PBMC) , which were treated with various dose of Ad3 was detected by flow cytometry. The antiviral effect of MxA protein against Ad3 in Hela cells was studied by the microdose cytopathogenic effect inhibition assay. Results: MxA protein that in all the cell groups that were treated with various dose of Ad3 was higher than that of control. 10 ng/ml MxA protein can resist 20TCID50 Aad3. Conclusion: It was suggest that MxA protein that can be induced by Ad3 in PBMC and recombinant MxA can resist Ad3.