FMO3-TMAO axis modulates the clinical outcome in chronic heart-failure patients with reduced ejection fraction: evidence from an Asian population / 医学前沿

The association among plasma trimethylamine-N-oxide (TMAO), FMO3 polymorphisms, and chronic heart failure (CHF) remains to be elucidated. TMAO is a microbiota-dependent metabolite from dietary choline and carnitine. A prospective study was performed including 955 consecutively diagnosed CHF patients with reduced ejection fraction, with the longest follow-up of 7 years. The concentrations of plasma TMAO and its precursors, namely, choline and carnitine, were determined by liquid chromatography-mass spectrometry, and the FMO3 E158K polymorphisms (rs2266782) were genotyped. The top tertile of plasma TMAO was associated with a significant increment in hazard ratio (HR) for the composite outcome of cardiovascular death or heart transplantation (HR = 1.47, 95% CI = 1.13-1.91, P = 0.004) compared with the lowest tertile. After adjustments of the potential confounders, higher TMAO could still be used to predict the risk of the primary endpoint (adjusted HR = 1.33, 95% CI = 1.01-1.74, P = 0.039). This result was also obtained after further adjustment for carnitine (adjusted HR = 1.33, 95% CI = 1.01-1.74, P = 0.039). The FMO3 rs2266782 polymorphism was associated with the plasma TMAO concentrations in our cohort, and lower TMAO levels were found in the AA-genotype. Thus, higher plasma TMAO levels indicated increased risk of the composite outcome of cardiovascular death or heart transplantation independent of potential confounders, and the FMO3 AA-genotype in rs2266782 was related to lower plasma TMAO levels.

Use of veno-arterial extracorporeal membrane oxygenation in the first successful combined lung-liver transplantation patient in China / 世界急诊医学杂志（英文）

@#Extracorporeal membrane oxygenation (ECMO) is a modality of extracorporeal life support that allows for temporary support in pulmonary and/or cardiac failure refractory to conventional therapy.[1] ECMO use has been exponentially increasing over the last decade and is now considered a mainstream lifesaving treatment modality in critical care medicine. Many studies report ECMO use in patients with acute respiratory distress syndrome refractory to conventional clinical support, in-hospital cardiac arrest, and cardiogenic refractory shock.[1⇓-3] Herein, we report the use of veno-arterial ECMO (VA-ECMO) in the first successful combined lung-liver transplantation (CLLT) patient in China.

Mental Health Status and Its Influencing Factors among College Students during the Epidemic of Coronavirus Disease 2019:A Multi-center Cross-sectional Study / 中国医学科学院学报

Objective To measure the prevalence of mental health symptoms and identify the associated factors among college students at the beginning of coronavirus disease 2019(COVID-19)outbreak in China. Methods We carried out a multi-center cross-sectional study via snowball sampling and convenience sampling of the college students in different areas of China.The rates of self-reported depression,anxiety,and stress and post-traumatic stress disorder(PTSD)were assessed via the 21-item Depression-Anxiety-Stress Scale(DASS-21)and the 6-item Impact of Event Scale-Revised(IES-6),respectively.Covariates included sociodemographic characteristics,health-related data,and information of the social environment.Data pertaining to mental health service seeking were also collected.Multivariate Logistic regression analyses were performed to identify the risk factors. Results A total of 3641 valid questionnaires were collected from college students.At the beginning of the COVID-19 outbreak,535(14.69%)students had negative emotions,among which 402(11.04%),381(10.49%),and 171(4.90%)students had the symptoms of depression,anxiety,and stress,respectively.Meanwhile,1245(34.19%)college students had PTSD.Among the risk factors identified,male gender was associated with a lower likelihood of reporting depression symptoms(AOR=0.755,P=0.037],and medical students were at higher risk of depression and stress symptoms than liberal arts students(AOR=1.497,P=0.003;AOR=1.494,P=0.045).Family support was associated with lower risks of negative emotions and PTSD in college students(AOR=0.918,P<0.001;AOR=0.913,P<0.001;AOR=0.899,P<0.001;AOR=0.971,P=0.021). Conclusions College students were more sensitive to public health emergencies,and the incidence of negative emotions and PTSD was significantly higher than that before the outbreak of COVID-19.More attention should be paid to female college students who were more likely to develop negative emotions.We should strengthen positive and proper propaganda via mass media and help college students understand the situation and impact of COVID-19.Furthermore,we should enhance family support for college students.The government and relevant agencies need to provide appropriate mental health services to the students under similar circumstances to avoid the deterioration of their mental well-being.

Effects of Human Immunodeficiency Virus-positive Mothers Receiving Antiretroviral Therapy to Prevent Mother-to-child Transmission on the Growth and Development of 18-month-old Children in Lingshan County of Guangxi / 中国医学科学院学报

Objective To evaluate the effects of antiretroviral therapy(ART)for the prevention of mother-to-child transmission(PMTCT)of acquired immune deficiency syndrome(AIDS)on the growth and development of 18-month-old children born by human immunodeficiency virus(HIV)-positive pregnant women in Lingshan County,Guangxi Zhuang Autonomous Region,and provide scientific evidence for improving the ART medication plan for PMTCT.Methods Lingshan County,ranking the first in the HIV-epidemic counties of Guangxi,was selected as the research site.According to the design of retrospective case-control study,we assigned all the subjects into the case group and the control group:(1)The case group included the HIV-positive pregnant women who had received ART for PMTCT and their HIV-negative infants in Lingshan County from 2010 to 2017.The historical cards and PMTCT data of them were collected from the national PMTCT database.(2)The control group included the healthy pregnant women and their healthy babies born in the Lingshan Maternity and Infant Hospital in 2017,and the children's growth and development data were collected.The stunted growth in children was defined as at least one of the three main indicators of body height,body weight,and head circumference below the normal range.Results The number of HIV-positive mothers and their infants in the case group was 391 and 368,respectively,and 87.21%(341/391)and 95.38%(351/368)of mothers and infants respectively received ART medication.The HIV positive rate,mortality rate,and mother-to-child transmission rate of 18-month-old children were 1.36%(5/368),4.35%(16/368),and 2.01%(5/249),respectively.The incidence of stunted growth of 18-month-old children in the case group and the control group was 42.12%(155/368)and 23.06%(101/438),respectively,with significant difference(

Analysis of high-risk factors and clinical characteristics of sepsis-related liver injury / 中华危重病急救医学

Objective:To analyze the risk factors and clinical characteristics of liver injury in patients with sepsis and to provide a reference for early recognition, early diagnosis, early intervention, and improve the survival rate of patients.Methods:The clinical data of sepsis patients admitted to the department of general intensive care unit (ICU) of the Second Affiliated Hospital of Zhejiang University School of Medicine from July 2014 to October 2020 were retrospectively analyzed. According to the occurrence of acute liver injury, patients with sepsis were divided into the liver injury group and the non-liver injury group, and the differences of demographic data, history, history of primary diseases, laboratory indicators on the first time of admission, treatments, the severity of the disease and other indicators were compared and analyzed. Logistic regression was used to analyze the risk factors for sepsis-related liver injury.Results:A total of 527 patients with sepsis were enrolled, and 129 patients with acute liver injury, accounting for 24.48%. Compared with the non-liver injury group, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), sequential organ failure assessment (SOFA), pro-brain natriuretic peptide (pro-BNP), serum MB isoenzyme of creatine kinase (CK-MB), total bile acid (TBA), serum creatinine (SCr), blood urea nitrogen (BUN), lactic acid (Lac), lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin (PCT) in liver injury group were significantly increased [APACHEⅡ score: 23.00±10.40 vs. 16.10±8.10, SOFA score: 9.17±4.29 vs. 5.90±3.12, pro-BNP (ng/L): 5 500.0 (1 166.0, 16 865.0) vs. 1 377.2 (448.8, 6 136.5), CK-MB (U/L): 23.0 (13.0, 55.0) vs. 18.0 (13.0, 31.0), TBA (μmol/L): 5.0 (2.4, 12.9) vs. 2.6 (1.4, 4.9), SCr (μmol/L): 146.0 (75.0, 222.0) vs. 71.0 (52.0, 125.8), BUN (mmol/L): 13.4 (8.8, 20.2) vs. 7.9 (4.9, 11.6), Lac (mmol/L): 2.0 (1.4, 4.4) vs. 1.4 (1.0, 2.2), LDH (μmol·s -1·L -1): 6.43 (3.76, 11.99) vs. 4.55 (3.38, 6.63), CRP (mg/L): 113.0 (61.8, 201.0) vs. 95.0 (37.3, 170.1), PCT (μg/L): 3.8 (1.0, 23.3) vs. 0.8 (0.2, 6.4)], prothrombin time (PT), international standard ratio (INR) and activated partial thrombin time (APTT) were significantly longer [PT (s): 19.4±7.6 vs. 16.0±4.0, INR: 1.7±1.0 vs. 1.3±0.5, APTT (s): 54.0±25.8 vs. 44.1±15.1], plasma fibrinogen (FIB), platelet count (PLT), albumin (ALB), and cholesterol (CHOL) were decreased [FIB (g/L): 4.2±2.3 vs. 4.9±1.8, PLT (×10 9/L): 116.3±74.3 vs. 182.7±108.6, ALB (g/L): 25.4±5.5 vs. 27.6±5.5, CHOL (mmol/L): 2.5±1.2 vs. 3.2±1.3], the probability of shock was significantly increased (91.47% vs. 59.19%), and the duration of shock was prolonged [days: 5.0 (2.0, 9.0) vs. 1.0 (0.0, 3.0)], positive rate of microbial culture (81.40% vs. 71.11%), probability of occurrence of drug-resistant bacteria (67.44% vs. 47.99%) were significantly higher, mechanical ventilation time [days: 6.0 (2.0, 12.7) vs. 2.4 (0.0, 6.9)], continuous renal replacement therapy (CRRT) time [days: 1.2 (0.0, 5.0) vs. 0.0 (0.0, 0.0)], the length of intensive care unit (ICU) stay [days: 9.0 (5.0, 18.0) vs. 7.0 (3.0, 13.0)] were significantly longer, 28-day mortality was significantly higher (80.62% vs. 28.89%), and the differences were statistically significant (all P < 0.05). Further Logistic regression analysis showed that PLT decline, PT prolongation, CRRT duration, shock duration and 28-day mortality were correlated with sepsis-related liver injury [odds ratios ( OR) and 95% confidence interval (95% CI) were 0.992 (0.987-0.998), 3.103 (1.507-6.387), 1.198 (1.074-1.336), 1.196 (1.049-1.362), and 0.213 (0.072-0.633), respectively, all P < 0.05]. Conclusions:Prolonged PT and decreased PLT are independent risk factors for sepsis complicated with liver injury. The long duration of CRRT, long duration of shock, and high mortality are independent clinical characteristics of patients with sepsis-related liver injury.

Progress in Chinese medicine-probiotics compound microecological preparations for livestock and poultry / 生物工程学报

Chinese medicine-probiotics compound microecological preparation for livestock and poultry is a new type of animal microecological preparations that combine probiotics with traditional Chinese medicine by modern fermentation technology. It could exert synergistic effects of both probiotics and traditional Chinese medicine, with the purpose of improving immune function of livestock and poultry and protect their health. By investigating the literature on probiotics and Chinese medicine microecological preparations in recent years, we summarized the background and strain characteristics of Chinese medicine-probiotics compound microecological preparations (CPCMP) for livestock and poultry in this paper. Furthermore, we elaborated the mechanisms of CPCMP for livestock and poultry and introduced the application of CPCMP in livestock and poultry breeding. Finally, we pointed out the existing problems and proposed the suggestions on the development of CPCMP. This review is expected to provide reference and basis for further research on CPCMP for livestock and poultry.

Effect of bronchoalveolar lavage on the use of antibiotics in patients with severe pneumonia / 中华急诊医学杂志

Objective@#To investigate the difference between bronchoalveolar lavage fluid (BALF) and tracheal aspirate (TA) on the use of antibiotics in patients with severe pneumonia.@*Methods@#Patients with severe pneumonias admitted to the Department of General Intensive Care Unit of Second Affiliated Hospital of Zhejiang University School of Medicine, between December 2014 and March 2019 were retrospectively analyzed. The difference of effects of BLAF and TA on the use of antibiotics in patients with severe pneumonia were compared and analyzed, as well as the effects of antibiotic de-escalation on patient’s mortality were evaluated. The quantitative data were analyzed by independent sample t test, and the enumeration data were determined by Chi-square test or Fisher exact probability method.@*Results@#Among the 120 patients, more bacteria were detected in BALF than in TA (82 vs 60, P<0.05). More fungi were detected in BALF than in TA (20 vs 3, P<0.05). Compared with TA, BALF results were more likely to guide the adjustment of antibiotic regimens (41 vs 16, P<0.05), including guidance for antibiotics de-escalation (27 vs 9, P<0.05). There was no significant difference in the 14-day mortality, 28-day mortality, hospital stay and duration of mechanical ventilation between the two groups (all P<0.05).@*Conclusions@#Compared with TA, BALF, as a pathogens detection method for severe pneumania, has more advantages in guiding antibiotics administration, including antibiotic de-escalation, which will not increase the mortality of patients.

Applying telemedicine to electronic ICU: a new paradigm in critical care / 中华医院管理杂志

The remote monitoring of patients at intensive care units(ICU), known as tele-ICU technology, is as yet a new concept in China. The authors introduced the efforts made by the Second Affiliated Hospital in working with a hospital in Xinjiang to provide the tele-ICU model. In this model, telemedicine medical workers cooperate with bedside healthcare providers of the hospital in Xinjiang in co-care of the patients. Such a practice can elevate the critical care medicine of the latter hospital, worthy of further promotion.

Applying telemedicine to electronic ICU:a new paradigm in critical care / 中华医院管理杂志

The remote monitoring of patients at intensive care units (ICU),known as tele-ICU technology,is as yet a new concept in China.The authors introduced the efforts made by the Second Affiliated Hospital in working with a hospital in Xinjiang to provide the tele-ICU model.In this model,telemedicine medical workers cooperate with bedside healthcare providers of the hospital in Xinjiang in cocare of the patients.Such a practice can elevate the critical care medicine of the latter hospital,worthy of further promotion.

Effect of bronchoalveolar lavage on the use of antibiotics in patients with severe pneumonia / 中华急诊医学杂志

Objective To investigate the difference between bronchoalveolar lavage fluid(BALF)and tracheal aspirate(TA)on the use of antibiotics in patients with severe pneumonia.Methods Patients with severe pneumonias admitted to the Department of General Intensive Care Unit of Second Affiliated Hospital of Zhejiang University School of Medicine,between December 2014 and March 2019 were retrospectively analyzed.The difference of effects of BLAF and TA on the use of antibiotics in patients with severe pneumonia were compared and analyzed,as well as the effects of antibiotic de-escalation on patient's mortality were evaluated.The quantitative data were analyzed by independent sample t test and the enumeration data were determined by Chi-square test or Fisher exact probability method.Results Among the 120 patients more bacteria were detected in BALF than in TA(82 vs 60,P＜0.05).More fungi were detected in BALF than in TA(20 vs 3,P＜0.05).Compared with TA,BALF results were more likely to guide the adjustment of antibiotic regimens(41 vs 16,P＜0.05),including guidance for antibiotics de-escalation(27 vs 9,P＜0.05).There was no significant difference in the 14-day mortality,28-day mortality,hospital stay and duration of mechanical ventilation between the two groups(al P＜0.05).Conclusions Compared with TA,BALF,as a pathogens detection method for severe pneumonia,has more advantages in guiding antibiotics administration,including antibiotic de-escalation,which will not increase the mortality of patients.

Evaluation of the teaching environment among the primary and secondary schools in China / 中国学校卫生

Objective@#To evaluate the current status of the primary and secondary schools’ teaching environment in China and associated factors,and to provide the support for making differentiated interventional stategies.@*Methods@#Data regarding to information of the primary and secondary schools was obtained by random inspection from the National Health and Family Planning Commission in 2018. Chi-square test was used to compare differences of qualified rates between groups. Spearman correlation analyses was applied to examine the correlations among population density, per capita GDP and qualified rates.@*Results@#Among the total of 37 531 schools, the overall qualified rate of teaching environmental sanitation of primary and secondary schools in 2018 was 59.1%. The qualifying rate in urban areas (60.3%) was higher than that of rural areas (59.4%) and towns (56.7%). Primary schools (59.8%) had higher qualifying rates than junior high schools (58.2%) and senior high schools (51.8%). In terms of each evaluation item, the qualifying rates of school furniture equipment including desks and chairs were the lowest, while the qualifying rates of dormitory ventilation ranked highest. Large variations among provinces were observed for the qualifying rates for school furniture equipment, as well as blackboard illumination. Those provinces with higher per capita GDP and higher population density had higher the qualifying rates for school furniture equipment.@*Conclusion@#The overall qualifying rate of Chinese primary and secondary schools’ teaching environment is low. Among all the evaluation measures, qualifying rates of dormitory ventilation are relatively good, while school furniture equipment needs to be improved. Notably, strengthened and targeted management should be applied to improve schools’ teaching environment in new era.

Influencing factorsof aortic pulse wave velocity in hypertensive patients / 心血管康复医学杂志

Objective : To analyze influencing factors of aortic pulse wave velocity (APWV) in patients with essential hypertension (EH).Methods : The 336 EH patients from our hospital were divided into elevated APWV group (n＝281) and normal APWV group (n＝55)- Clinical data were compared between two groups ,and multi-factor Logis-tic regression was used to analyze influencing factors of APWV in EH patients .Results : Compared with normal AP-WV group ,there were significant rise in age [ (56-71 ± 11-45) years vs-(62-98 ± 12-36) years] ,percentages of di-abetes mellitus (5-45% vs- 19-22%) ,obesity (18-18% vs- 23-84%) ,smoking (16-36% vs- 30-60%) , EH stage 3 (12-73% vs- 32-03%) ,body mass index [BMI , (22-53 ± 2-07) kg／m2 vs-(23-28 ± 2-04) kg／m2 ] ,systolic blood pressure SBP [ (139-64 ± 12-85) mmHg vs.(147-39 ± 13-30 ) mmHg] ,diastolic blood pressure DBP [ (93-18 ± 8-73) mmHg vs .(96-43 ± 9-14 ) mmHg] , TC [ (5-18 ± 0-91 ) mmol／L vs-(5-65 ± 1-03 ) mmol／L ] , LDL-C [ (3-00 ± 0-68 ) mmol／L vs-(3-24 ± 0-72 ) mmol／L ] ,serum creatinine SCr [ (110-71 ± 52-39 ) μmol／L vs-(138-52 ± 63-65) μmol／L] ,serum uric acid SUA [ (318-73 ± 102-62) μmol／L vs-(354-28 ± 108-35) μmol／L] , and significant reduction in level of HDL-C [ (1-19 ± 0-32) mmol／Lvs-(1-09 ± 0-30) mmol／L] in elevated AP-WV group , P＜0-05 or ＜0-01- Multi-factor Logistic regression analysis indicated that age ,diabetes mellitus ,SBP , TC ,SCr and EH stage were independent risk factors for APWV (OR＝2-826 －3-732 , P＜0-05 all).Conclusion :Age ,diabetes mellitus ,SBP ,TC ,SCr and EH stage are risk factors for APWV in EH patients- Therefore ,corre- sponding preventive and therapeutic measures should be taken to improve prognosis .

Serum hsCRP level and expression of CX3CR1 on peripheral blood mononuclear cells in patients with coronary heart disease and its clinical significance / 心血管康复医学杂志

Objective:To explore serum level of high sensitive C reactive protein(hsCRP)and expression of CX3C chemokine receptor 1(CX3CR1)on peripheral blood mononuclear cells(PBMC)in patients with coronary heart disease(CHD)and its clinical significance.Methods:A total of 153 CHD patients treated in our hospital from Mar 2016 to Mar 2017 were selected,including 50 cases with stable angina pectoris(SAP),52 cases with unstable angina pectoris(UAP)and 51 cases with acute myocardial infarction(AMI);according to coronary lesion degree assessed by Gensini score,153 CHD patients were divided into mild coronary disease group(n=43),moderate coronary dis-ease group(n=56)and severe coronary disease group(n=54).Another 45 healthy subjects were selected as healthy control group during the same period.Serum hsCRP level and CX3CR1 expression on PBMC were measured and compared among all groups,the correlation among serum hsCRP level,CX3CR1 expression and Gensini score were analyzed.Results:Compared with healthy control group,there were significant rise in serum hsCRP level[(2.36 ± 1.67)mg/L vs.(5.07 ± 2.16)mg/L vs.(13.59 ± 5.23)mg/L vs.(27.46 ± 8.24)mg/L]and CX3CR1 expression on PBMC[(0.48 ± 0.25)% vs.(11.13 ± 5.42)% vs.(20.56 ± 9.73)% vs.(37.49 ± 12.82)%]in SAP group,UAP group and AMI group,and AMI group> UAP group> SAP group,there was significant difference between any two groups,P=0.001 all.Compared with mild coronary disease group,there were significant rise in serum hsCRP level[(6.31 ± 1.83)mg/L vs.(17.42 ± 6.58)mg/L vs.(35.26 ± 9.74)mg/L]and CX3CR1 expression on PBMC [(6.59 ± 1.43)% vs.(25.86 ± 9.37)% vs.(42.57 ± 13.28)%]in moderate and severe coronary disease group,and those of severe coronary disease group were significantly higher than those of moderate coronary disease group,P=0.001 all.Linear correlation analysis indicated that serum hsCRP level and CX 3CR1 expression on PBMC were sig-nificantly correlated with Gensini score(r=0.768,0.897,P=0.001 both).Conclusion:Serum hsCRP level and CX3CR1 expression significantly rise in CHD patients along with the aggregation of coronary disease,which are ex-pected to be reference indexes predicting severity of CHD.

IL-35-producing regulatory T cells regulate intestinal inflammatory immune response / 中华微生物学和免疫学杂志

Objective To evaluate the function of interleukin-35 (IL-35)-producing regulatory T cells (IL-35-Treg) in regulating intestinal inflammatory immune response. Methods The percentages and characteristics of IL-35-Treg in the intestinal lamina propria of transgenic mice expressing IL-35 were ana-lyzed by flow cytometry. A mouse model of inflammatory bowel disease ( IBD) was established by giving 1. 5％ DSS in drinking water. Influences of IL-35-Treg depletion on mouse weight, pathological injury and the secretion of IFN-γ were analyzed. Results IL-35-Treg were enriched in the intestinal lamina propria, and mainly derived from thymic Treg (tTreg). Intestinal IL-35-Treg expressed high levels of programmed death 1 (PD-1). Depletion of IL-35-Treg in mice with DSS-induced IBD resulted in an aggravation through up-regulating the expression of IFN-γ. Conclusion IL-35-Treg might play an important role in the regula-tion of intestinal inflammatory immune response.

Protective effects of miR-34a on brain function of mice with sepsis by regulating Notch-1/NF-κB signaling pathway / 中华急诊医学杂志

Objective To observe the dynamic changes of TNF-α,IL-1β,IL-6,IL-10,and expressions of Notch-1,NF-κB mRNA and their protein levels in the brain tissue of septic mice and intervention effects of intrathecal injection of lentiviral vector of miR-34a gene for regulating Notch-1/NF-κB signaling pathway.Methods A total of 54 mice of clean grade were divided randomly (random number) into four groups,namely sham group (n =9),in which sham-operated laparotomy was performed;CLP group (n=15),in which the cecum ligation operation (CLP) was performed;NC group (n =15),in which intrathecal injection of lentivirus 5 μL (concentration 5 × 108 TU/mL),one time per day,for 3 days,then CLP was performed on the seventh day;intervention group (n =15),in wihch intrathecal injection of miR-34a lentivirus 5 μL (concentration 5 × 108 TU/mL),one time per day,for 3 days,then CLP was performed on the seventh day.The mice of four groups were sacrificed 24 h after modeling or operation.The changes of behavior of mice was observed and the neurological scores were assessed 24 h after CLP.The levels of TNF-α,IL-1β,IL-6 and IL-10 in the brain were measured by ELISA method.The mRNA expression and protein levels of Notch-1 and NF-κB in the brain tissue were measured by real-time PCR and Western blot method,respectively.Pathological changes of brain tissue were observed under light microscope.Results The neurological scores,the cerebral TNF-α,IL-6 levels,the mRNA expression and protein level of NF-κB (P＜0.01),and IL-1β levels (P ＜0.05) in CLP group 24 h after modeling were higher than those in sham group.The cerebral IL-10 level and the mRNA expression and protein level of Notch-1 (P ＜ 0.01) in CLP group 24 h after modeling were lower than those in sham group.The neurological scores,the cerebral TNF-α and IL-1β levels,and the protein level of NF-κB (P ＜0.01),and IL-6 (P ＜ 0.05) in NC group 24 h after modeling were higher than those in sham group.The cerebral IL-10 level,the mRNA expression and protein level of Notch1 in NC group 24 h after modeling were lower than those in sham group.There were no significant difference in neurological socres,IL-1β and IL-6 levels between intervention group and CLP group (P ＞ 0.05).The IL-10 level (P ＜ 0.05) and the mRNA expression (P ＜ 0.05) and protein level (P ＜ 0.01) of Notch-1 in intervention group 24 h after modeling were lower than those in CLP group.There were no significant difference in biomarkers between NC group and CLP group (P ＞ 0.05).The degree of cerebral damage found under light microscope was also ameliorated in intervention group compared with CLP group 24 h after modeling.Conclusions The effects of miR-34a via regulating Notch-1/NF-κB signaling pathway on brain function exerts cerebral protective effects in septic mice.

Clinical study of the influence of continuous hemofiltration on gastrointestinal dysfunction of the patients with intra-abdominal hypertension / 中华急诊医学杂志

Objective To investigate the effects of continuous hemofihration on gastrointestinal dysfunction for treating patients with intra-abdominal hypertension.Methods A total of 37 patients were divided into two groups randomly (random number),namely control group (n =17) and continuous blood filtration (CBF) group (n =20).The patients of control group were treated with routine treatment,and the patients of CBF group were given CBF for 72 hours in addition to the routine treatment.The intra-abdominal pressure (IAP),gastrointestinal (GI) symptoms,and SOFA score were documented at 0 hour,24 hours,72 hours and 7 days after treatment.Results The MAP of patients in the CBF group was not significantly changed (P =0.218),while the IAP was decreased significantly (P =0.001) and the abdominal perfusion pressure (APP) increased significantly after CBF (P =0.036).Compared with the control group,there were more than 2 GI symptoms markedly relieved after CBF for 24 hours (P =0.049).The SOFA score of CBF group decreased significantly (P =0.037).There were no differences in 28-day and 60-day mortality between two groups.Conclusions The CBF can decrease IAP,increase APP,improve splanchnic blood circulation,and ameliorate gastrointestinal dysfunction.But CBF does not reduce the mortality in comparison with routine treatment.

Γ-secretase inhibitor DAPT prevents neuronal death and memory impairment in sepsis associated encephalopathy in septic rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Brain dysfunction is a frequent complication of sepsis, usually defined as sepsis-associated encephalopathy (SAE). Although the Notch signaling pathway has been proven to be involved in both ischemia and neuronal proliferation, its role in SAE is still unknown. Here, the effect of the Notch signaling pathway involved γ-secretase inhibitor DAPT on SAE in septic rats was investigated in a cecal ligation and puncture (CLP) model.</p><p><b>METHODS</b>Fifty-nine Sprague-Dawley rats were randomly divided into four groups, with the septic group receiving the CLP operation. Twenty-four hours after CLP or sham treatment, rats were sacrificed and their hippocampus was harvested for Western blot analysis. TNF-α expression was determined using an enzyme-linked immunosorbent assay (ELISA) kit. Neuronal apoptosis was assessed by TUNEL staining, and neuronal cell death was detected by H&E staining. Finally, a novel object recognition experiment was used to evaluate memory impairment.</p><p><b>RESULTS</b>Our data showed that sepsis can increase the expression of hippocampal Notch receptor intracellular domain (NICD) and poly (adenosine diphosphate [ADP]-ribose) polymerase-1 (PARP-1), as well as the inflammatory response, neuronal apoptosis, neuronal death, and memory dysfunction in rats. The γ-secretase inhibitor N-[N-(3,5-difluorophenacetyl)-1-alanyl]-S-phenylglycine t-butyl ester (DAPT) can significantly decrease the level of NICD and PARP-1, reduce hippocampal neuronal apoptosis and death, attenuate TNF-α release and rescue cognitive impairment caused by CLP.</p><p><b>CONCLUSION</b>The neuroprotective effect of DAPT on neuronal death and memory impairment in septic rats, which could be a new therapeutic approach for treating SAE in the future.</p>

Clinical observations on the efficacy of point-injection with NGF in treatment of infantile cerebral palsy / 中国基层医药

Objective To discuss the clinical efficacy of point-injection with nerve growth factor (NGF) in treatment of infantile cerebral palsy.Methods According to the time order,50 cases with cerebral palsy were randomly divided into the treatment group(30 cases) and the control group (20 cases).Both groups were given the conventional treatment of Bobath mainly exercise therapy,homework therapy and the language therapy.In addition,the treatment group was given the treatment of point-injection with NGF.Gesell scale was used to evaluate all the patients before and after treatment.Results After treatment,the Gesell evaluation of the treatment group was higher than control group,and the difference was statistically significant (t =-2.096,-2.187,-2.048,-2.053,-2.225,all P ＜0.05).Conclusion On the basis of rehabilitation training,point-injection with NGF could improve intelligence,motor function and language in children with cerebral palsy,and the efficacy was obvious.

The experimental study of ginkgolide B effectual on neuronal cell apoptosis in the rat with intracerebral hemorrhage / 中华急诊医学杂志

Objective To investigate the effects of ginkgolide B on neuronal cell apoptosis,superoxide dismutase activity,malondialdehyde,interleukin-1beta,tumor necrosis factor-alpha,and interleukin-6 levels in serum of rats with intracerebral hemorrhage in order to explore the role of ginkgolide B in suppressing the neuronal cell apoptosis.Methods A total of 175 male Wistar rats were randomly (random number)divided into sham operation group,intracerebral hemorrhage group,as well as low,medium and high dose treatment groups.The rat model of intracerebral hemorrhage was made with infusion of autologous whole blood to caudate nucleus in the right basal ganglia region.Ginkgolide B in dose of 5 mg/kg,10 mg/kg and 20 mg/kg was given to rats in the low,middle and high dose treatment groups by intraperitoneal injection once a day for 5 days after intracerebral hemorrhage.The rats with intracerebral hemorrhage in the sham operation groups received intraperitoneal administration of 1 mL saline.Animals were sacrificed by decapitation 2,6,12,24,48,72 h and 5 days after intracerebral hemorrhage.Brains were taken and blood samples were collected.Neuronal cell apoptosis was measured by using terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling(TUNEL),and superoxide dismutase activity in serum was determined by using xanthine oxidase method,and serum malondialdehyde level was detected by using thiobarbituric acid reactive substance assay,and interleukin-1beta,tumor necrosis factor-alpha,and interleukin-6 levels in serum were assayed with enzyme linked immunosorbent assay(ELISA).Statistical analysis was carried out by using one-way analysis of variance and least-significant difference test.Results As 2 h,6 h,12 h,24 h,48 h,72 h,and 5 days after intracerebral hemorrhage,the differences in the number of apoptotic neuronal cell,superoxide dismutase activity in serum,serum malondialdehyde,interleukin-1 beta,tumor necrosis factor-alpha and interleukin-6 levels between the low dose treatment group and intracerebral hemorrhage group were not significant statistically(P ＞0.05).As 12 h,24 h,72 h,and 5 days after intracerebral hemorrhage,the number of apoptotic neuronal cell,superoxide dismutase activity in serum,serum malondialdehyde,interleukin-1 beta,tumor necrosis factor-alpha and interleukin-6 levels in the medium dose and high dose treatment groups were significantly statistically lower than those in the intracerebral hemorrhage group(P ＜ 0.05),but these differences in above biomarkers were not significant statistically among these three groups 2 and 6 hours after intracerebral hemorrhage(P ＞ 0.05).Conclusions Ginkgolide B may lessen neuronal cell apoptosis by means of inhibition of free radical production and inflammatory reactions after intracerebral hemorrhage.