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Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a life support technique for patients with severe respiratory failure. In the past, single lumen cannula was mostly used to constract the vascular pathway of extracorporeal membrane oxygenation. Compared with single-lumen cannula, double lumen cannula (DLC) can reduce recirculation fraction, reduce complications such as infection and bleeding, and facilitate patient's rehabilitation. DLC requires accurate positioning of the catheter. It has been gradually applied in China. This paper will review the key points related to the use of DLC, such as the insertion, position, and complications, etc. to provide guidance for clinical application practice.
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Objective:To develop a model of stellate ganglion block (SGB) in mice and investigate the effect of SGB on cerebral cortical blood flow.Methods:Thirty clean-grade healthy male C57BL/6 mice, aged 8-9 weeks, weighing 23-27 g, were divided into 5 groups ( n=6 each) using a random number table method: control group (group C), left SGB group (group L), left normal saline group (group SL), right SGB group (group R) and right normal saline group (group SR). Group C received no intervention.SGB was performed with 0.25% ropivacaine 0.08 ml via percutaneous posterior approach in L and R groups, while the equal volume of normal saline 0.08 ml was given instead at the location of left and right stellate ganglion in SL and SR groups, respectively.The cerebral cortical blood flow was determined using laser speckle contrast imaging system before SGB (T 0) and at 10, 30, 60, 90 and 120 min after SGB (T 1-5). Results:Mice developed ptosis on the block side, indicating that the model of SGB was successfully developed in L and R groups.There was no significant difference in cerebral cortical blood flow at each time point among C, SL and SR groups ( P>0.05), and cerebral cortical blood flow on the block side decreased at T 1, began to increase at T 2, peaked at T 3, and decreased at T 5 which was still higher than that at T 0 in group L and group R ( P<0.01). Compared with C and SL groups, the left cerebral cortical blood flow was significantly decreased at T 1, 5 and increased at T 2-4 in group L ( P<0.01). Compared with C and SR groups, the right cerebral cortical blood flow was significantly decreased at T 1, 5 and increased at T 2-4 in group R ( P<0.01). There were no significant differences in cerebral cortical blood flow at each time point between group C and group SL and between group C and group RL ( P>0.05). Conclusions:The mouse model of SGB via percutaneous posterior approach is successfully developed.Unilateral SGB can affect cerebral cortical blood flow on the block side, which shows a transitory decrease followed by a sustained significant increase.
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Objective:To study the effect of Tanhuo Formula (THW) on the expression of Glial Fibrillary Acidic Protein (GFAP), Caspase-3 and angiogenesis.Methods:Rats were divided into sham group, model group, low-dose THW group, medium-dose THW group, high-dose THW group and Ginaton group according to random number table method. Except the sham group, rats in other groups were subjected to the middle cerebral artery occlusion via a suture method. After 2 hours,rats in the low, medium and high dose of THW groups were gavaged with 0.92, 1.84 and 3.68 g/kg of THW dry extract powder solution respectively, and the Ginaton group were gavaged with 60 mg/kg of Ginaton, once every 24 hours for 3 days. Rats in sham operation group and model group were given equal volume of normal saline by gavage. The limb symmetry score was used to evaluate limb dysfunctions. The immunofluorescence staining of GFAP and Caspase-3 were applied to assess astrocyte activation and neuronal apoptosis, respectively. The double-labeled immunofluorescence staining of platelet-endothelial cell adhesion molecule (CD31) and chondroitinsulphate peoteoglycan (NG2) were performed to detect angiogenesis.Results:Compared with the model group, rats in the high-dose of THW group showed increased limb symmetry score ( P<0.01 or P<0.05), increased number of Caspase-3 (cortex: 765.0±122.4 vs. 1 131.0±392.9; striatum: 895.9±389.8 vs. 1 401.9±453.1) ( P<0.01 or P<0.05) and CD31 +/NG2 + (cortex: 1 355.0±257.9 vs. 825.4±308.1; striatum: 1 290.9±400.9 vs. 675.2±259.7) ( P<0.01) positive cells in the periinfarct cortex and striatum, and attenuated the integrated optical density of GFAP in the perilesional cortex (4 210.00±1 226.38 vs. 7 935.78±2 001.98) ( P<0.01). Conclusions:THW could ameliorate the limb functional disorders, inhibit astroglia activation, down-regulate the expression of Caspase-3, and enhanced angiogenesis in MCAO rats.
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Objective:To study the effect of Huanglian-Jiedu Decoction on the white matter lesion of rats with focal cerebral ischemia and to explore the regulative role of the active fraction of Huanglian-Jiedu Decoction on NogoA/NgR. Methods:Male SD rats were randomly divided into sham operation group, model group, total alkaloid group, total flavonoid group, and total iridoid group. Except for the sham operation group, the rats in the other groups were used to establish the middle cerebral artery occlusion rat model by the suture method. 2 hours after modeling, rats in the total alkaloid group were given intragastric administration with 44 mg/kg total alkaloids; rats in the total flavonoid group were given intragastric administration 50 mg/kg total flavonoids; rats in the total iridoid group were given intragastric administration 80 mg/kg total iridoids, the sham operation group and the model group were intragastrically given equal volume of normal saline, once a day, for 7 consecutive days. The pathological changes of rat white matter were observed by HE staining, the pathological changes of rat myelin sheath were observed by Luxol fast blue (LFB) staining, and the expression of Amyloid precursor protein (APP), NogoA, and NgR in the internal and external capsule areas of the brain was detected by immunohistochemical staining. Real-time fluorescence quantitative PCR was used to detect the expression of NogoA and NgR in the tissues surrounding the ischemic infarct.Results:Compared with the model group, the total alkaloid group, total flavonoid group, and total iridoid group had lower pathological damage scores in the internal and external capsule areas of rats ( P<0.05 or P<0.01), increased integral optical density value of LFB staining ( P<0.01), decreased expression of APP and NogoA; the expression of NgR in the internal and external capsules of rats in the total alkaloid group and the total iridoid group decreased ( P<0.05 or P<0.01), and the expression of NgR in the inner capsule of rats in the total flavonoid group decreased ( P<0.01); the expression of NogoA (1.20 ± 0.17, 1.55 ± 0.30, 1.19 ± 0.38 vs. 2.22 ± 0.58) and NgR (1.98 ± 0.55, 1.48 ± 0.31, 1.58 ± 0.27 vs. 3.36 ± 0.41) genes in the tissues around the infarct focus of rats in the total alkaloid group, total flavonoid group and total iridoid group decreased ( P<0.01). Conclusion:The present study investigates the therapeutic effects of Huanglian-Jiedu Decoction, promoting white matter repair by decreasing the overexpression of NogoA and NgR in an experimental animal model of stroke.
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OBJECTIVE@#To explore the predictive value of newly diagnosed IgG levels in the recurrence of IgG-type multiple myeloma (MM) patients after initial treatment.@*METHODS@#The clinical and pathological data of 91 patients newly diagnosed IgG-type MM who were hospitalized in the Department of Hematology of the Second People's Hospital of Yichang and Department of Oncology of The Affiliated Hospital of Jianghan University from April 2010 to March 2019 were collected. According to the median IgG level at the time of initial diagnosis, patients were divided into high IgG group and low IgG group. The recurrence time after initial treatment was followed up, and the correlation between newly diagnosed IgG level and recurrence was analyzed by univariate and multivariate analysis, as well as the influencing factors of IgG levels in order to predict furtherly the potential mechanism of recurrence.@*RESULTS@#Univariate survival analysis showed that high revised international staging system (R-ISS) staging, high level of bone marrow plasma cell (BMPC), lactate dehydrogenase (LDH), creatinine, β@*CONCLUSION@#The higher the serum IgG concentration of IgG-type MM patients at first diagnosis, the earlier the recurrence, which is related to the low level of serum albumin, and can be used as a potential recurrence predictor after complete remission of IgG-type MM patients.
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Humans , Bone Marrow , Hematopoietic Stem Cell Transplantation , Immunoglobulin G , Multiple Myeloma/therapy , Transplantation, AutologousABSTRACT
This article sorts out the evolution and policies of development status of health nursing by traditional Chinese medicine (TCM). It analyzes the reasons for the problems, such as the lack of industry standards and norms, the imperfect regulatory system, and the unclear institutional boundaries. The suggestion helps to explore and put forward detailed supporting policy measures, promote innovation of traditional Chinese medicine inheritance, accelerate standardization and standardization construction, strengthen the training of professional talents and standardize and maintain them, and continue to promote the healthy and orderly development of health care services of TCM.
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In recent years, the use of aluminum-containing additives in the food has received wide public attention. Many studies have shown that excessive exposure to aluminum can cause health damage to human body. This paper will review and evaluate the research progress of aluminum toxicity, domestic and international dietary aluminum exposure assessment, and the feasibility of the control measures on the aluminum intake, to provide relevant evidence for the health risk assessment of aluminum in food.
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Objective@#To analyze the clinical characteristics of fatal cases with confirmed severe adenovirus pneumonia in children in order to improve the diagnosis and treatment.@*Methods@#The fatal cases of severe adenovirus pneumonia admitted to Pediatric Intensive Care Unit of Hunan Provincial People′s Hospital from January 2019 to July 2019 were collected, whose clinical features, diagnosis, treatment, and the causes of death were analyzed retrospectively.@*Results@#A total of eight children were enrolled, and the age ranged from 3 months to 3 years old, and five cases were between 6 months to 2 years old.Three cases had underlying diseases.Adenovirus genotype identification was performed on six patients, and the results showed that all patients were infected with adenovirus type 7.All patients presented persistent high fever, with a peak temperature between 39.8℃ to 41.0℃, which persisted 10 to 37 days.Blood routine test before admission PICU showed that four cases had the decrease in white blood count and hemoglobin concentration, accompanied byincreased serum ferritin levels.Seven cases complicated with infection.Four cases had parainfluenza virus type 3 infection.Six cases had bacterial infection, and Gram-negative bacilli were predominant.One had fungal septicemia.Conventional mechanical ventilation were performed in all patients in this group.Four cases in this group died of severe acute respiratory distress syndrome.The other four cases died of disseminated intravascular coagulation associated with massive gastrointestinal bleeding, pulmonary hemorrhage, heart failure and septic shock combined with multiple organ failure.@*Conclusion@#Fatal adenoviruspneumonia mostly apppears in children between 6 months to 2 years old or with underlying diseases.Adenovirus type 7 was the main serotype.The occurrence of reactive hemophagocytic phenomenon should be worsen progression of the disease.Co-infection may be an important cause of death.
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Objective To analyze the clinical characteristics of fatal cases with confirmed severe ad﹣enovirus pneumonia in children in order to improve the diagnosis and treatment. Methods The fatal cases of severe adenovirus pneumonia admitted to Pediatric Intensive Care Unit of Hunan Provincial People′s Hospital from January 2019 to July 2019 were collected,whose clinical features,diagnosis,treatment,and the causes of death were analyzed retrospectively. Results A total of eight children were enrolled, and the age ranged from 3 months to 3 years old,and five cases were between 6 months to 2 years old. Three cases had underly﹣ing diseases. Adenovirus genotype identification was performed on six patients,and the results showed that all patients were infected with adenovirus type 7. All patients presented persistent high fever,with a peak temper﹣ature between 39. 8℃ to 41. 0℃,which persisted 10 to 37 days. Blood routine test before admission PICU showed that four cases had the decrease in white blood count and hemoglobin concentration,accompanied by﹣increased serum ferritin levels. Seven cases complicated with infection. Four cases had parainfluenza virus type 3 infection. Six cases had bacterial infection,and Gram﹣negative bacilli were predominant. One had fun﹣gal septicemia. Conventional mechanical ventilation were performed in all patients in this group. Four cases in this group died of severe acute respiratory distress syndrome. The other four cases died of disseminated intra﹣vascular coagulation associated with massive gastrointestinal bleeding, pulmonary hemorrhage, heart failure and septic shock combined with multiple organ failure. Conclusion Fatal adenoviruspneumonia mostly app﹣pears in children between 6 months to 2 years old or with underlying diseases. Adenovirus type 7 was the main serotype. The occurrence of reactive hemophagocytic phenomenon should be worsen progression of the disease. Co﹣infection may be an important cause of death.
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Objective To explore the effects of probiotics on intestinal function, nutritional status and inflammatory response in critically ill patients with enteral nutrition (EN) support. Methods A total of 90 critically ill patients admitted to Intensive Care Unit (ICU) of the First Affiliated Hospital of Anhui Medical University from July 2016 to November 2018 were enrolled, and they were divided into a probiotics combined with EN group (27 cases) and an simple EN group (63 cases) according to random number table method. The patients in the simple EN group were treated with conventional nutrient preparations such as fresubin or fresubin energy fibre; the patients in probiotics combined with EN group were supplemented with probiotics on the basis of conventional EN support for consecutive 7 days in both groups. The changes of gastrointestinal function, nutritional index and inflammatory response index after treatment were observed in both groups. Results After treatment, the subjective global assessment (SGA) method was used to identify the gradation of the patients, it was shown that the proportion of SGA-B grade patients in simple EN group had an upward trend; while the proportion of SGA-B grade patients in probiotics combined with EN group had no significant change; and there was no significant difference in the proportion of SGA-B patients between simple EN group and probiotics combined with EN group after treatment [20.6% (13/63) vs. 7.4% (2/27),P > 0.05]. Compared with those before treatment, the levels of hemoglobin (Hb), white blood cell count (WBC), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukins (IL-6, IL-12) in both groups were significantly decreased, while the levels of albumin (Alb), pre-albumin (PA), total lymphocyte count (TLC) in both groups were increased after treatment, and the changes of Hb, TNF-α, IL-6 in probiotics combined with EN group were more significant than those in the simple EN group [Hb (g/L): 95.0 (78.0, 107.0) vs. 93.0 (80.0, 107.0), TNF-α (pg/L): 21.2±4.0 vs. 28.0±5.7, IL-6 (pg/L): 161.3±37.6 vs. 186.2±51.8];the differences in levels of Hb, CRP, TNF-α before and after treatment between the probiotics combined with EN group and simple EN group were statistically significant [Hb (g/L): 1.0 (-4.0, 12.0) vs. 11.0 (1.0, 20.0), CRP (mg/L): 44.3 (13.7, 57.7) vs. 7.5 (-20.1, 62.4), TNF-α (pg/L): 13.3±6.3 vs. 7.9±5.5, all P < 0.05]. There were no statistical significant differences in the other indicators between the two groups (all P > 0.05). Conclusion Probiotics can improve the gastrointestinal function and inflammatory status of critically ill patients with EN support, regretfully, in a short term, the improvement of nutritional status of such patients is not obvious, but probiotics has certain significance in preventing the risk of aggravation of malnutrition and reduction of Hb level.
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@#AIM: To evaluate the therapeutic effect of intravitreal injection of ranibizumab(IVR)combined with extra panrentinal photocoagulation(E-PRP)for diabetic neovascularization on the disc(DNVD). <p>METHODS: A total of 36 eyes of 32 patients with DNVD underwent IVR combined with E-PRP. The examinations of visual acuity, funds fluorescein angiography(FFA)and optical coherence tomography(OCT)were performed on all of the patients before and 6mo after the treatment; the result of the examinations before and after the treatment were compared and analyzed. <p>RESULTS: Before the treatment, best corrected visual acuity(BCVA, LogMAR)was 0.89±0.35, 6mo after treatment was 0.42±0.13; the difference was significant(<i>P</i><0.01). After the treatment, BCVA was improved in 19 eyes(53%), unchanged in 14 eyes(39%)and decreased in 3 eyes(8%). Retinal nerve fiber layer(RNFL)was 110.64±12.06μm at 6mo after IVR+E-PRP, which was significantly different to those before treatment and 7d after treatment(<i>t</i>=5.612, 3.304; <i>P</i><0.05). Neovascularization regressed in 32 eyes(89%), and unchanged or aggravated in 4 eyes(11%). The results of FFA after E-PRP showed that the one-off efficiency of E-PRP was 69%(25 eyes), 7 eyes(19%)need an additional laser, in which 4 eyes(11%)underwent vitreous surgery. <p>CONCLUSION: IVR combined with E-PRP as a treatment for DNVD may improve the regression of retinal neovascularization and the reduction of vascular permeability, and improve the therapeutic effect and safety.
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Objective:To investigate the antioxidant activity of Maca polysaccharides in vitro.Methods:A chemical reaction system was established to explore the scavenging activity of Maca polysaccharides within the concentration range of 0.18-5.00 mg ·ml-1on hydroxyl radicals (·OH),superoxide anion free radicals (O2-·) and DPPH·,and then the total antioxidant capacity was calculated. The protective effects of Maca polysaccharides on H2O2-induced damage in SH-SY5Y cells were determined. SH-SY5Y cells were divided into the control group,H2O2model group and Maca polysaccharide groups(25,50,100 μg·ml-1). In the Maca polysaccharide groups,SH-SY5Y cells were pre-protected by Maca polysaccharides for 24 h, and then incubated in the presence of 300 μmol·L-1H2O2for 6 h. The detection index was SH-SY5Y cell viability detected by MTT assay. Results:Maca polysaccharide within the concentration range of 0.18-5.0 mg·ml-1all exhibited strong scavenging activity on·OH,O2-· and DPPH·in a dose-dependent manner. When the concentration of Maca polysaccharides reached 2.5 mg·ml-1,the scavenging rate was 60.36% for DPPH·,34.66% for O2-·and 36.01% for·OH,the total antioxidant activity was equivalent to 0.179 μmol FeSO4. Maca polysaccharides at the concentration of 25, 50 and 100 μg·ml-1all showed significant protective effects on H2O2-induced injury in SH-SY5Y cells, and the cell survival rate was 61.71 ± 2.45%,61.73 ± 4.51% and 60.98 ± 3.12%, respectively,which were all significantly higher than those in the model group (P < 0.05). Conclusion:Maca polysaccharides has good antioxidant activity,which is worthy of further research and development as a natural antioxidant.
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Objective To establish Metrigel-VEGF-SW982 complexes and use the complexes to produce animal models of synovial sarcoma so as to provide new ideas for establishing other models of soft tissue tumors. Methods After the SW982 cells were cultured and collected,they were resuspended with Metrigel,and VEGF was added.The suspension was seeded into transwell to establish the scaffold complexes of Metrigel-VEGF-SW982.The complexes were cultured overnight.Cryosections were made and HE staining was carried out to observe the cell scaffold complexes.We randomly divided 10 female SCID mice(4 week old)into scaffold group and control group. The mice in the scaffold group were transplanted with cell-scaffold complexes,and the control group with cell suspension.After 8 weeks,the success rate of modeling was compared between two groups.The mice were sacrificed and the tumors were obtained.HE staining was carried out to observe the histopathological features of tumors in both scaffold group and control group.Results The SW982 cells were cultured with Matrigel in a 3D way,which could simulate the growth condition of cells in vivo.Establishing synovial sarcoma animal model with cell scaffold complex could increase the success rate.The tumors in scaffold group had a larger volume,higher density of tumor cells and greater vascularization(P＜0.05).Conclusion Establishing synovial sarcoma animal model with Metrigel-VEGF-SW982 complex can greatly improve the success rate of modeling,which can provide basis for the study of synovial sarcoma.
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AIM: To investigate the effect of tumor necrosis factor receptor associated factor 6 (TRAF6) on proliferation, apoptosis and invasion of retinoblastoma Y79 cells. METHODS: The Y79 cells were divided into three groups:blank control group, negative control group and TRAF6 siRNA group. After TRAF6 siRNA transfection, the levels of TRAF6 mRNA and protein in Y79 cells were examined by RT-PCR and Western blotting. MTT assay was used to detect cell proliferation. Flow cytometry was employed to detect changes in cell cycle and apoptosis. Cell invasiveness was detected by the Transwell method. RESULTS: Expression of TRAF6 mRNA and protein in the TRAF6 siRNA group significantly decreased compared with the negative and blank control groups. Following the silencing of TRAF6,cell proliferation was inhibited and the apoptosis rate increased; the cell cycle was arrested at G0/G1 phase; the number of cells in S phase was reduced, while the invasion ability of cancer cells decreased. CONCLUSION: Silencing TRAF6 may inhibit the proliferation of Y79 cells, promote cell apoptosis, arrest the cell cycle at G0/G1 phase and decrease the invasive ability. Thus,TRAF6 may be a potential target in therapy for retinoblastoma.
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·AIM:To investigate the effect of calcium dobesilate in the treatment of non-proliferative diabetic retinopathy (NPDR) after panretinal laser photocoagulation. ·METHODS: A total of 40 patients (62 eyes) with clinically diagnosed severe NPDR were randomly divided into control group (22 cases,31 eyes) and study group (18 cases,31eyes). Two groups were all given pan-retinal photocoagulation treatment,while the study group continued to receive calcium dobesilate for 12mo after treatment. After 12mo, before treatment and 12mo after treatment, the changes of best corrected visual acuity (BCVA),average threshold sensitivity, and retinal nerve fiber layer(RNFL) thickness were compared between two groups. · RESULTS: The response rate was 55% and 84%, respectively in the control group and study group, the difference was statistically significant(P<0.05). Compared to the pre-treatment measurement,the average threshold sensitivity and RNFL were reduced at 12mo after treatment in control group, the difference were statistically significant(P<0. 05). Compared to the pre-treatment measurement,the average threshold sensitivity and RNFL were reduced at 12mo after treatment in study group,the difference were not statistically significant(P>0.05). At 12mo after treatment, the difference of the average threshold sensitivity and RNFL between two groups were statistically significant(P<0.05). ·CONCLUSION: calcium dobesilate could be effective in preventing the retina from damage of retinal photocoagulation in DR. Compared with simple laser photocoagulation, panretinal laser photocoagulation combined with calcium dobesilate can improve curative effect and visual acuity in NPDR patient.
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Based on the relation of efficacy and toxicity, this study mined the dosage rules and characteristics of Aconitum herbs in oral prescriptions from 48 traditional ancient books from Eastern Han dynasty to Qing dynasty, to provide the basis for strengthening the clinical risk pharmacovigilance. In the 48 traditional ancient books, 4 521 prescriptions with clear daily oral dosage were included to establish a database. SPSS 20.0 software was used for statistics and analysis of the daily dosage characteristics with different kinds of herbs, indications, dose forms, processing, use in special population, and other aspects. The results showed that 67% prescriptions contained Aconitum carmichaeli(Fuzi), and 90% of them was less than 14.87 g·d⁻¹; The dosage of A. carmichaeli(Chuanwu) and A. kusnezoffii(Caowu) were less than 3.14 g·d⁻¹. In the prescriptions for treating typhoid, epidemic, edema and phlegm, the dosage of Aconitum was larger. There dosage in the decoction and vinum was significantly higher than that in the pill and powder. With the dynastic evolution, the dosage of Aconitum herbal medicines prescriptions and the application percentage of superposition drug also had decreased. For the special populations that with different metabolism process, such as old people, children, pregnant and lactating women, the application of Aconitum was not only with relatively small ratio, but also with lower dose. Therefore, based on the data-mining of ancient books, the dosage of Aconitum should not exceed the limit prescribed by the current China Pharmacopoeia, and also should be strictly controlled by considering various factors, which will ensure the balance of efficacy and toxicity.
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Humans , Aconitum , Chemistry , Toxicity , China , Data Mining , Dose-Response Relationship, Drug , Drugs, Chinese Herbal , Toxicity , Medicine, Chinese TraditionalABSTRACT
Objective To investigate the clinical utility of critical nutrients nutrition risk assessment (Nutric score) in neurological critical ill patients,laying the foundation for clinical nutrition support.Methods From July 2016 to March 2017,59 ICU patients with neurological critical ill in the First Affiliated Hospital of Anhui Medical University were divided into low score group (Nutric score 0-4) and high score group (Nutric score 5-9) according to Nutric score system.On the first and seventh day after ICU admission,the body mass index(BMI),triceps skinfold thickness (TSF),mid-upper ann circumference (MAC) and mid-upper ann muscle circumference (MAMC) were measured.The serum albumin(ALB),prealbumin (PA),hemoglobin (Hb) and lymphocyte (LY) were detected as nutritional indicators.And at the same time,recorded the 28-day outcomes,and made the SGA evaluation.Results At the first day admission in ICU,there were no statistically significant differences between the two groups in TSF,MAC and MAMC (all P ＞0.05).But at the seventh day,the TSF,MAC,MAMC of the high score group were (0.943 ± 0.484) cm,(24.143 ± 3.203) cm,(21.187 ± 2.625) cm,respectively,which were significantly lower than those of the low score group [(1.185 ± 0.403) cm,(26.981 ± 2.731) cm,(23.265 ± 2.327) cm],there were statistically significant differences between the two groups (t =2.090,3.672,3.223,all P ＜ 0.05).At the first day after admission,the serum levels of ALB and Hb in the high score group were (34.5 ± 7.3)g/L,(103.68 ± 13.5)g/L,which of the low score group were (39.0 ± 6.9) g/L,(122.29 ± 20.4) g/L,respectively,and there were statistically significant differences between the two groups(t =2.466,4.168,all P ＜ 0.05).And at the seventh day after admission,the serum levels of ALB,PA,Hb and Ly in the high score group were (30.6 ± 5.1) g/L,(146.0 ± 77.0) mg/L,(83.9 ± 11.9) g/L,(1.123 ± 0.535) x 109/L,respectively,which were significantly lower than those in the low score group [(35.8 ± 5.5) g/L,(209.9 ± 105.1) mg/L,(105.8 ± 19.2) g/L,(1.709 ± 1.377) x 109/L].Compared with the first day after admission,the ALB,Hb levels in the two groups at the seventh day after admission were significantly decreased (t =2.29,2.002,5.817,3.286,all P ＜0.05);the PA level in the low score group had no statistically significant difference at the seventh day after admission,but the PA level in the high score group was decreased significantly (t =2.024,P ＜ 0.05).The incidence rate of malnutrition,mortality of the high score group were 32.1％,32.1％,respectively,which were significantly higher than those in the low score group (9.7％,6.5％) (x2 =4.583,6.402,all P ＜ 0.05).Conclusion The Nutric score system can be used in the purpose of early nutrition assessment in neurological critical ill patients,and it is benefit for clinical early nutritional support.
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Objective To construct a human tumor necrosis factor (hTNF-a) plasmid and identify it to optimize the fermentation conditions of hTNF-α protein so as to achieve high expression in Escherichia coli.Methods The gene of hTNF-a was cloned into pET24a vector to obtain the pET24a-hTNF-a expression plasmid that was transformed into Escherichia coli BL21(DE3),and the expression conditions of BL21 (DE3) were optimized.Results The plasmid of pET24a-hTNF-α was successfully constructed and identified by PCR and digestion,which was consistent with the target fragment hTNF-α.The plasmid was transformed into Escherichia coli BL21(DE3),the best induced expression conditions of Escherichia coli BL21 (DE3) were as follows:M9+LB medium,37℃,0.5 mmol/L IPTG,pH =7.5,and induction time was 5 h.The results showed that dry weight of the cells and the rate of TNF were increased by 2.56 times and 3.68 times,respectively,and the expression rate of hTNF-α was increased by 3.49 times from 9.38％ to 32.74％.Conclusion The optimal conditions for the expression of plasmid pET24a-hTNF-α in Escherichia coli were determined.
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Objective To detect the expression of IL-17 in renal transplant recipients by Luminex and evaluate the relationship between the level of serum IL 17 and early acute renal allograft rejection.Methods 38 kidney transplant recipients and healthy controls (HC,healthy volunteers,n =20) were selected in this study from January 2009 to October 2011.All patients were divided into two groups according to their allograft outcome as acute rejection group (ARG,n-18) and non-rejection group (NRG,n=20).The expression of serum IL-17 was detected by Luminex technique in two groups of kidney transplant recipients and HC.To evaluate the correlation between the level of serum IL-17 and early acute renal allograft rejection.Results The mean level of IL-17 in all renal transplant recipients 1.3 ± 1.9 pg/ml at the pre-transplantation was significantly lower than that in HC (6.9± 8.5 pg/ml,t=3.968,P＜0.001).The results highlighted that the level of serum IL-17 in ARG 3.4±5.8 pg/ml was significantly higher than that in NRG (0.5±0.4 pg/ml) on the 7th days post Kidney transplantation (post KTx,t=2.242,P =0.031).Kaplan-Meier survival analysis showed that the probability of rejectionfree survival in the higher levels group of IL-17 on the 7th days post-KTx was significant lower than that in the lower levels group (P＜0.001).The results of receiver operating characteristic curve showed that the sensitivity and specificity of the combined IL-17 to predict acute rejection were 66.67％ and 100％,respectively.Conclusion The serum IL-17 levels in renal transplant recipients on the 4th and 7th post-KTx days can predict early renal transplant rejection.
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Objective To investigate the effect of stem cells transplantation on immune function,liver function and related indexes in the patients with end-stage liver disease(ESLD).Methods A total of 163 cases of ESLD in Nanyang Municipal Central Hospital of Affiliated Hospital of Zhengzhou University were selected and divided into 2 groups by the randomized single blind method.Eighty-one cases in the control group were given the conventional symptomatic treatment,while 82 cases in the observation group received bone marrow mesenchymal stem cell(BMSC) transplantation based on the control group.The changes of immune function,liver function,alpha fetoprotein(AFP),rate of prothrombin activity(PTA) and plasma total protein(TP) level before and after treatment were observed in the two groups.Results The immune function indexes CD3+,CD4+,CD8+,CD4+/CD8+,TP and PTA levels after treatment in the observation group were significantly higher than those before treatment and in the control group (P＜0.05),while the levels of AFP,alanine aminotransferase (ALT),aspartate aminotransferase (AST) and total bilirubin (TBIL)were lower than those before treatment in the same group and the control group(P＜0.05).There was no statistically significant difference in complication occurrence rate between the two groups(P＞0.05).Conclusion BMSC transplantation for treating ESLD can improve the immune function,improves the liver function and reduces the AFP level.