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1.
Article in Chinese | WPRIM | ID: wpr-910126

ABSTRACT

Objective:To investigate the predictive value of echocardiography hemodynamic parameters on 30-day survival rate after veno-arterial extracorporeal membrane oxygenation in refractory cardiogenic shock.Methods:A total of 44 patients with refractory cardiogenic shock who passed VA-ECMO weaning trial were retrospectively analyzed from September 2014 to February 2021. According to their 30-day survival outcomes after VA-ECMO removal, these patients were divided into the survival group (32 cases) and the death group (12 cases). Baseline data and the change rate of echocardiographic parameters between the first day of VA-ECMO and the day on VA-ECMO removal were compared, and the ultrasonic indicators affecting the survival of VA-ECMO within 30 days after withdrawal were determined.Results:The change rate of left ventricular ejection fraction(ΔLVEF%), the change rate of velocity time integral of the left ventricular outflow tract(ΔLVOT-VTI%), the change rate of ΔSa% and the change rate of right ventricular fractional area change(ΔRVFAC%) were improved significantly in the survival group ( P<0.05). The correlation coefficients between ΔLVEF% and ΔLVOT-VTI%, ΔLVEF% and ΔSa%, ΔLVEF % and ΔRVFAC% were 0.885, 0.861, 0.675, respectively( P<0.001); The correlation coefficient between ΔLVOT-VTI% and ΔSa was 0.918( P<0.001). ROC curve showed that the cut off values of ΔLVEF%, ΔLVOT-VTI%, ΔSa% and ΔRVFAC% to predict 30-day survival rate were 23.6%, 20.1%, 22.8% and 23.2% respectively, the sensitivity was 89.5%, 93%, 89.5% and 74.6% respectively, specificity was 66.7%, 66.7%, 66.8% and 75% respectively, the area under ROC curve (AUC) was 0.841, 0.867, 0.841 and 0.768, respectively. Conclusions:ΔLVEF%, ΔLVOT-VTI%, ΔSa% and ΔRVFAC% are predictive indicators of VA-ECMO withdrawl in patients with refractory cardiac shock. ΔLVOT-VTI% is the most valuable indicator of predicting 30-day survival rate after VA-ECMO withdrawl. Patients who meet two or more VA-ECMO echocardiographic indicators are more likely to succeed in VA-ECMO withdrawl. The improvement of right ventricular systolic function is a prerequisite for survival after 30 days of VA-ECMO withdrawal, while LVEF is an important criterion for survival after 30 days of VA-ECMO withdrawal.

2.
Acta Pharmaceutica Sinica ; (12): 3285-3299, 2021.
Article in Chinese | WPRIM | ID: wpr-906851

ABSTRACT

Plant natural products (PNPs) are important sources of innovative drugs. They are mainly obtained by isolation or extraction from plants. Low content and with structural analogues in plants result in high production cost, which restricts the research and application of PNPs. While biopathway construction by synthetic biology provides an alternative for production of PNPs. By biosynthetic pathway analysis of PNPs and reconstructing the biopathway in microorganisms, we can produce PNPs in cell factories efficiently. Recently, several predominantly international reports about biosynthesis of PNPs and its synthetic biology production, triggered the researches of PNPs. Abundant traditional Chinese medicine resources and profound cultural heritage of Chinese medicine make biosynthesis pathway analysis of PNPs to be a research hotspot. And some of the studies have achieved significant progress. Here, recent progress in the biosynthesis of plant natural products and its synthetic biology was reviewed. In particular, the application of new methods and technologies in recent years were summarized and discussed. This will provide reference for the biopathway construction of plant natural products.

3.
Acta Pharmaceutica Sinica ; (12): 3353-3361, 2021.
Article in Chinese | WPRIM | ID: wpr-906835

ABSTRACT

italic>Aconitum pendulum is a Tibetan medicine that is rich in bioactive compounds such as aconitine-type C19-diterpenoid alkaloids. To investigate the key enzymes in the aconitine biosynthesis pathway, roots, leaves and flowers of Aconitum pendulum were subjected to a high-throughput transcriptomic sequencing analysis by Illumina HiSeqTM2000. Trinity de novo assembly yielded 47 264 unigenes with an average length of 1 140 bp and N50 of 1 678 bp, of which 30 231 unigenes (63.96%) were annotated. In the KEGG database, 542 unigenes were implicated in 17 secondary metabolic pathways; the analysis showed that 44 genes encoded 20 key enzymes in the diterpene skeleton of aconitine biosynthesis and 12 BAHD acyltransferase genes were related to the acetylation modification, with differential expression among three organs. For example, ApTPS8 was the only committed enzyme in the upstream aconitine biosynthetic pathway. The high expression level of ApTPS8 in root indicated that it is the main tissue for the production of precursors of diterpene alkaloids. Consistent with the accumulation of aconitine, we propose that ApBAHD1/2/8 is involved in the biosynthesis of 2-hydroxyaconitine, dehydrated 14-benzoylaconitine, 8-O-methyl-14-benzoylaconine, benzoyldeoxyaconitine and benzoylaconitine, and ApBAHD10 is involved in the biosynthesis of acontine, lucidusculine, 14-O-acetylneoline and 14-O-acetylvirescenin. Comparative transcriptome analysis of A. pendulum and A. carmichaeli indicates significant gene loss in the family of diterpene synthases and acyltransferases in A. pendulum, which is in accordance with the significantly fewer type and quantity of aconitine compounds in this species. Therefore, A. pendulum has proved to be an ideal material for the study of the aconitine biosynthesis pathway. This work provides basic scientific data for further study of aconitine biosynthesis, the discussion of molecular mechanisms of toxicity, and the synthesis of genuine medicinal materials.

4.
Acta Pharmaceutica Sinica ; (12): 3325-3330, 2021.
Article in Chinese | WPRIM | ID: wpr-906831

ABSTRACT

italic>NAC transcription factor genes play an important role in regulating plant adversity stress tolerance and secondary metabolism. To explore DaNAC transcription factor participation in the synthesis of asperosaponin Ⅵ in Dipsacus asper, we analyzed the expression of DaNAC genes based on full-length transcriptome data from different tissues (root, stem, leaf, flower, seed) to provide a theoretical foundation for regulating the metabolism of D. asper. RNA-seq data was used to identify open reading frames. Bioinformatic methods were used to identify the conserved domain motifs and construct an evolutionary tree. qRT-PCR was carried out to analyze tissue-specific and adversity-stressed expression. Twenty-nine DaNAC sequences were identified, all of which contain the conserved NAM domain and conserved motif 1 and motif 2 at the N terminal. Five DaNAC genes are closely related to the NAC genes in Arabidopsis thaliana and rice that are involved in adversity stress and are clustered in the Group Ⅰ subfamily. qRT-PCR revealed that DaNAC genes are differentially expressed between tissues. The expression levels were highest in leaves, followed by roots, stems and petioles, and the lowest in flowers and seeds. Compared with normal growth conditions, the expression of four NAC genes was up-regulated by treatment with low temperature (15 ℃). The expression of three genes (34564NAC2, 33883NAC48, 6727NAC14) was up-regulated and one gene (34480NAC22) was down-regulated by 150 μmol·L-1 MeJA. The results illustrate that the expression of NAC genes is induced by adversity stress, which provides a foundation for further study on the role of NAC family members in adversity stress in D. asper.

5.
Article in Chinese | WPRIM | ID: wpr-888178

ABSTRACT

The present study aimed to explore the mechanism of the sweating of Dipsacus asper on content changes of triterpene sa-ponins by detecting the total triterpene saponins and the index component asperosaponin Ⅵ in the crude and sweated D. asper, and analyzing the differentially expressed proteins by isobaric tags for relative and absolute quantification(iTRAQ) combined with LC-MS/MS. After sweating, the content of total triterpene saponins decreased manifestly, while that of asperosaponin Ⅵ increased significantly. As revealed by the iTRAQ-LC-MS/MS analysis, 140 proteins with significant differential expression were figured out, with 50 up-regulated and 90 down-regulated. GO analysis indicated a variety of hydrolases, oxido-reductases, and transferases in the differential proteins. The results of activity test on two differentially expressed oxido-reductases were consistent with those of the iTRAQ-LC-MS/MS analysis. As demonstrated by the analysis of enzymes related to the triterpene saponin biosynthesis pathway, two enzymes(from CYP450 and UGT families, respectively, which are involved in the structural modification of triterpene saponins) were significantly down-regulated after sweating. The findings suggested that sweating of D. asper presumedly regulated triterpene saponins by affecting the expression of downstream CYP450 s and UGTs in the biosynthesis pathway of triterpene saponins of D. asper.


Subject(s)
Chromatography, Liquid , Dipsacaceae , Humans , Saponins , Sweating , Tandem Mass Spectrometry , Triterpenes
6.
Acta Pharmaceutica Sinica ; (12): 1478-1485, 2021.
Article in Chinese | WPRIM | ID: wpr-887073

ABSTRACT

In this study, the fatty acid desaturase gene FAD2 was cloned from Coix lacryma-jobi L. and its molecular structure and function were studied. The results showed that the full-length cDNA sequence of FAD2 gene was 936 bp encoding 311 amino acid residues. Bioinformatics prediction results showed that the protein encoded by the FAD2 gene was an alkaline hydrophilic unstable protein with a molecular weight of 34.87 kDa. It contained three transmembrane helix domain, and did not contain the signal peptide splicing site, and was most likely to be located in plasmid membrane. Compared with other similar genes in plants, it has only a histidine conserved site, His Box Ⅲ histidine site (HXXHH), suggesting its activity may be reduced. Phylogenetic tree analysis showed that FAD2 was closely related to monocotyledonous plants, especially Maize and Oryza sativa japonica Group, but farther from dicotyledonous plants. Therefore, it was inferred that FAD2 might have similar functions with similar genes in Maize and Oryza sativa japonica Group. In addition, the expression of FAD2 gene could be detected in Coix lacryma-jobi L. with high oil content, but not in low oil content of Coix lacryma-jobi L. In order to clarify the function of FAD2, the gene was heterologously expressed in sporomyces cerevisiae. The results showed that the protein encoded by FAD2 gene did not catalyze the formation of C18∶1 unsaturated fatty acid into C18∶2 unsaturated fatty acid. Therefore, it was speculated that the deletion of histidinine conserved site of FAD2 gene might lead to the decrease of protein activity or even inactivation. This study provides reference value for further understanding the molecular structure characteristics of fatty acid desaturase. At the same time, it laid a foundation for elucidating the biosynthetic pathway of Coix lacryma-jobi L.

7.
Acta Pharmaceutica Sinica ; (12): 2302-2307, 2021.
Article in Chinese | WPRIM | ID: wpr-887049

ABSTRACT

We investigated the effect of methyl jasmonate (MeJA) on the content of asperosaponin VI and the expression of genes involved in its synthesis. Dipsacus aspero seedlings were treated with MeJA at different concentrations of 50, 100, 150, 200 and 300 μmol·L-1, and leaves and roots were sampled following treatment for 1, 3 and 5 days. The content of asperosaponin VI and superoxide anion in the roots, malondialdehyde (MDA) content in leaves and superoxide dismutase were determined. The results show that 150 μmol·L-1 MeJA significantly increased the accumulation of asperosaponin VI in roots. The content of asperosaponin VI was greatest after treatment for 3 days, and was 2.16 times higher than the control. After MeJA treatment, SOD activity decreased and MDA content increased in leaves. Moreover, superoxide anion content in roots increased. The expression of squalene epoxidase (DaSE1) and geranyl diphosphate synthase (DaGPS), key enzymes in the synthesis of asperosaponin VI, were up-regulated compared with the control group. These results indicate that an optimal concentration of 150 μmol·L-1 MeJA increases the accumulation of asperosaponin VI by up-regulating the expression of key enzymes involved in the synthesis of asperosaponin VI, which facilitates resistance to adversity stress stimulated by MeJA.

8.
Chinese Critical Care Medicine ; (12): 329-333, 2021.
Article in Chinese | WPRIM | ID: wpr-883882

ABSTRACT

Objective:To explore the monitoring value of left ventricular functional parameters obtained by bedside ultrasound combined with clinically relevant indicators in patients with veno-arterial extracorporeal membrane oxygenation (VA-ECMO).Methods:A retrospective study was conducted. A total of 24 patients receiving VA-ECMO adjuvant support in Renmin Hospital of Wuhan University from June 2018 to January 2020 were selected. The bedside ultrasound was performed on the first day of ECMO support, the day before weaning, the clinical indicators before weaning were obtained. The differences in clinical indicators and the left ventricular functional parameters between the two groups of whether weaning successfully were compared; univariate Logistic regression analysis was used to screen out the related factors affecting weaning.Results:Sixteen patients were successful weaned and 8 patients failed. Compared with the weaning failure group, patients in the weaning success group required less continuous renal replacement therapy (CRRT, cases: 4 vs. 6, P < 0.05), mean arterial pressure (MAP) before weaning was higher [mmHg (1 mmHg = 0.133 kPa): 84.64±9.55 vs. 62.30±8.79, P < 0.05], and the pulse oxygen saturation (SpO 2) was also higher (0.966±0.670 vs. 0.866±0.061, P < 0.05), while vasoactive-inotropic score (VIS), serum creatinine (SCr) and serum lactic acid (Lac) were lower [VIS score: 7.27±1.42 vs. 16.93±8.52, SCr (μmol/L): 123.60±83.64 vs. 213.10±117.39, Lac (mmol/L): 1.94±0.91 vs. 5.62±5.48, all P < 0.05]. Univariate Logistic regression analysis showed that the MAP, VIS, SCr, Lac, SpO 2 before weaning were the related factors affecting weaning [odds ratio ( OR) were 0.306, -0.740, -0.011, -0.632, -4.069; 95% confidence interval (95% CI) were 1.065-1.732, 0.235-0.899, 0.979-0.999, 0.285-0.992 and 0.001-0.208; P values were 0.014, 0.022, 0.038, 0.047, 0.002]. In the weaning success group, left ventricular ejection fraction (LVEF), velocity of mitralannulus in systolic (LatSa), maximum flow velocity of aortic valve (AV-Vmax), velocity-time integral (VTI), left ventricular global longitudinal strain (LVGLS), left ventricular global longitudinal strain rate (LVGLSr) were all increased on the day before ECMO weaning compared with the first day of ECMO support [LVEF: 0.40±0.05 vs. 0.28±0.07, LatSa (cm/s): 6.81±0.91 vs. 4.62±1.02, AV-Vmax (cm/s): 104.81±33.98 vs. 64.44±16.85, VTI (cm): 14.56±3.11 vs. 7.96±1.98, LVGLS: (-8.95±2.59)% vs. (-5.26±1.28)%, LVGLSr (1/s): -0.48±0.11 vs. -0.29±0.09], whereas the ECMO flow was significantly reduced (L/min: 1.46±0.47 vs. 2.64±0.31), the differences were statistically significant (all P < 0.05). There was no significant difference in left ventricular functional parameters between the first day of ECMO support and the day before ECMO weaning in the weaning failure group. Compared with the weaning failure group, the weaning success group had higher LVEF, LatSa, AV-Vmax, VTI, LVGLS, LVGLSr on the day before ECMO weaning [LVEF: 0.40±0.05 vs. 0.26±0.07, LatSa (cm/s): 6.81±0.91 vs. 4.31±1.03, AV-Vmax (cm/s): 104.81±33.98 vs. 67.67±18.46, VTI (cm): 14.56±3.11 vs. 7.75±2.77, LVGLS: (-8.95±2.59)% vs. (-4.81±1.81)%, LVGLSr (1/s): -0.48±0.11 vs. -0.30±0.10, all P < 0.05] and lower ECMO flow (L/min: 1.46±0.47 vs. 2.20±0.62, P < 0.05). Conclusion:Bedside echocardiographic left ventricular function parameters (LVEF, LatSa, AV-Vmax, VTI, LVGLS, LVGLSr) combined with clinical indicators (MAP, VIS, SCr, Lac, SpO 2) were helpful to evaluate the therapeutic effect of patients receiving VA-ECMO support and can provide important guiding value in the selection of VA-ECMO weaning timing and the judgment of prognosis.

9.
Article in Chinese | WPRIM | ID: wpr-882719

ABSTRACT

Objective:To investigate the expression of MST1 in ovarian cancer (OV) , its relationship with the clinicopathological characteristics, and the potential molecular mechanism.Methods:62 OV patients admitted to Chongqing Emergency Medical Center and the Fifth People’s Hospital of Chongqing from Mar. 2016 to Feb. 2020 were selected. The expression levels of mRNA were detected by quantitative real-time polymerase chain reaction. [MST1 over-expression group: 24 h: (0.31±0.02) , 48 h: (0.44±0.03) , 72 h: (0.62±0.02) ; Blank group:24 h: (0.32±0.02) , (0.55±0.02) , (0.74±0.02) ;MST1 empty vector group:24 h: (0.32±0.03) , 48 h: (0.56±0.02) , 72 h: (0.77±0.02) ]Results:The expression of MST1 was lower in OV than in adjacent tissues[ (0.52±0.12) vs (1.18±0.21) ]. MST1 expression level was not related to age, but significantly correlated with the size of the tumors[ (0.46±0.12) vs (0.58±0.10) , P=0.00], TNM[ (0.57±0.10) vs (0.43±0.12) , P=0.00], TNM stage 9 (0.57±0.10) vs (0.43±0.12) , P=0.00] and lymph node metastasis[ (0.47±0.14) vs (0.56±0.09) , P=0.003]. Over-expression of MST1 obviously inhibited cellular proliferation in OV (MST1 over-expression group: 24 h: 0.31±0.02, 48 h: 0.44±0.03, 72 h: 0.62±0.02; blank group: 24 h: 0.32±0.02, 0.55±0.02, 0.74±0.02; empty vector group: 24 h: 0.32±0.03, 48 h: 0.56±0.02, 72 h: 0.77±0.02) . MST1 over-expression could promote FOXO3 expression, ,the expression level of FOXO3 in Mst1 overexpression group and control group were[ (0.61±0.04) vs (0.41±0.03) ]. MST1 inhibited proliferation of OV cells through upregulating the expression of FOXO3. Conclusions:The expression of MST1 is closely related to the clinicopathological features of OV patients, and MST1 may restrain OV by positively regulating FOXO3 expression.

10.
Acta Pharmaceutica Sinica ; (12): 610-617, 2021.
Article in Chinese | WPRIM | ID: wpr-873774

ABSTRACT

As a key gene in the regulation of long-chain fatty acid biosynthesis, 3-ketoacyl-CoA synthase (KCS) plays an important role in the growth and development of Coix lacryma-jobi L. In this study, the KCS gene was cloned from cDNA of Coix lachryma-Jobi L. and bioinformatics analysis was performed. Results showed that the full length KCS gene was 1 548 bp encoding 515 amino acids. Bioinformatics analysis indicated that the gene encoded a 58 608.12 Da protein with an isoelectric point of 9.20 containing two transmembrane helical structure domains and lacking a signal peptide, with a likely subcellular localization in main plastid membranes. The results of multiple sequence comparisons and evolutionary tree analysis revealed that KCS had three identical conserved sequences and was closely related to KCS from monocotyledons such as Sorghum bicolor, Zea mays, Setaria italica, Panicum miliaceum, Oryza brachyantha, Hordeum vulgare, Aegilops tauschii subsp. Tauschii. We speculated that the evolution of the gene was similar among these plants of the same family. In addition, gene expression analysis showed that the KCS gene was significantly different in Coix lacryma-jobi L. isolates having different lipid content. This work will facilitate further study of the regulatory mechanism of this enzyme in fatty acid synthesis.

11.
Article in Chinese | WPRIM | ID: wpr-872724

ABSTRACT

Objective:Arrange long-term toxicity experiments by a uniform design method, so as to explore the effect of different extracts of Psoraleae Fructus on liver toxicity in rats and mice, and find the drug factors that cause psoralen liver toxicity. Method:Based on the factors of processing, extraction technology, dosage and treatment course, each experimental group was arranged by uniform design method. A total of 220 SD rats and 220 Kunming mice with half male and half female were divided into normal groups and drug groups 1 to 8. The corresponding drugs (50% alcohol extract of salt Psoraleae Fructus in rats 2.57 g·kg-1, mice 5.14 g·kg-1, 95% alcohol extract of Psoraleae Fructus in rats 0.51 g·kg-1, mice 1.02 g·kg-1, 70% alcohol extract of salt Psoraleae Fructus in rats 1.71 g·kg-1, mice 3.42 g·kg-1, water extract of Psoraleae Fructus in rats 1.03 g·kg-1, mice 2.06 g·kg-1, water extract of salt Psoraleae Fructus in rats 1.03 g·kg-1, mice 2.06 g·kg-1, 70% alcohol extract of Psoraleae Fructus in rats 1.71 g·kg-1, mice 3.42 g·kg-1, 95% alcohol extract of salt Psoraleae Fructus in rats 0.51 g·kg-1, mice 1.02 g·kg-1, 50% alcohol extract of Psoraleae Fructus in rats 2.57 g·kg-1, mice 5.14 g·kg-1) were administered by gavage daily. The body weight and food intake of the rats and mice were measured once a week. After the treatment course, the rats were anesthetized with sodium pentobarbital, and blood was taken from the abdominal aorta, and the mice were sacrificed by removing the eyeballs, and the liver and brain were taken to calculate the organ coefficients. Serum was taken to determine liver function-related indicators, and the liver was taken for histopathological examination by hematoxylin-eosin (HE) staining. Result:The liver visceral-brain ratio of female rats in group 3 were significantly increased (P<0.05). The liver quality, visceral-body ratio and visceral-brain ratio of male mice in groups 1 to 3 were significantly increased (P<0.05, P<0.01). Histopathological manifestations in mice were more obvious than those in rats. Histopathology showed hepatocyte hypertrophy in the central area of liver lobules in mice, in particular in group 3. According to the multiple regression equation, there were interactions between extraction technology, processing, dosage and treatment course, and the extraction technology was positively correlated with the pathological score of liver injury. Based on the results of visual analysis and other indicators, it is concluded that the extraction technology factor is most relevant to psoralen liver toxicity of Psoraleae Fructus. Conclusion:Psoraleae Fructus has the hepatotoxicity, which is related to ethanol extraction technology; alcohol extraction is more toxic than water extraction, and 70% ethanol extraction is the most toxic. Besides, there are species differences, with a more significant hepatotoxicity in mice than that in rats.

12.
Cancer Research and Clinic ; (6): 727-729, 2020.
Article in Chinese | WPRIM | ID: wpr-872579

ABSTRACT

Gastric cancer is one of the most common malignant tumors worldwide, and the 5-year survival rate of patients is extremely low. In spite of several advances have been made in surgery and chemoradiotherapy, the survival rate of gastric cancer patients has slightly improved. In recent years, significant progress has been made in antiangiogenic therapy for gastric cancer. This article reviews the research progress of antiangiogenic therapy for gastric cancer in recent years, so as to provide a certain reference for clinical practice.

13.
Acta Pharmaceutica Sinica ; (12): 1573-1589, 2020.
Article in Chinese | WPRIM | ID: wpr-823295

ABSTRACT

Most of the active ingredients of herbs are secondary metabolites of plants. Cytochrome P450s (P450s) are hemoglobin-containing monooxygenases encoded by a super-gene family, which play important roles in the metabolic network of plants. This review focuses on the role of P450s on biosynthesis of secondary metabolites such as terpenoids, alkaloids, flavonoids and phenylpropanoids. This will provide references for biosynthesis and regulation of secondary metabolites in medicinal plants.

14.
Article in Chinese | WPRIM | ID: wpr-868003

ABSTRACT

Objective:To explore the feasibility of three-dimensional(3D) printing combined with mock circulatory system of flexible mitral valve model for hemodynamic testing in vitro based on ultrasound image data, making the transformation of 3D printing valve model from static to dynamic and from anatomical to functional, as well as assisting surgical plan for mitral valve diseases. Methods:A total of 10 subjects underwent three-dimensional transesophageal echocardiography (3D-TEE) and proved to be without mitral diseases were collected as mitral normal group from February 2017 to December 2018 in Renmin Hospital of Wuhan University, 10 mitral stenosis patients were collected as mitral stenosis group, and 10 mitral regurgitation patients were collected as mitral regurgitation group. Hemodynamic parameters of velocity (peak E), pressure gradient were obtained by two-dimensional transthoracic echocardiography in three groups, and the degree of mitral valve stenosis and regurgitation were also evaluated. Then 3D-TEE was performed to obtain the 3D volume image of mitral valve. After image post-processing and 3D modeling, the valve mold was printed with soluble material polyvinyl alcohol (PVA). The mixture of human skin silicone, silicone oil, starch and curing agent were poured into the mitral valve mold in a certain proportion to make flexible silicone mitral valve model. Then, the compliant valve model was placed in mock circulatory system (MCS), regularly opening and closing as it in vivo in the heart cycle. The hemodynamic parameters of mitral valve were measured again in vitro and the degree of stenosis and regurgitation was also evaluated respectively. Paired t test was used for statistical analysis of in vivo and in vitro measurements in two groups, and the consistency test was performed. Results:The mitral valve 3D-TEE images of all patients were successfully post-processed, mitral valve molds were printed and flexible models were made. In vitro hemodynamic tests were all completed. The opening and closing state of the valve model in vitro was similar to that in vivo. Mitral valve regurgitation was detected in mitral regurgitation group in vitro, with degree to that in vivo. There were no statistically significant differences in hemodynamic parameters measured in vivo and in vitro models (all P>0.05), with a high consistency ( r=0.76). Among the 10 patients with mitral stenosis and 10 patients with mitral regurgitation, 18 patients were evaluated as same degree as in vivo. Conclusions:3D printing of compliant mitral valve model based on ultrasound image is feasible, which reproduced hemodynamic features of mitral valve in vitro, setting foundation for further surgery simulation and clinical decision-making.

15.
Article in Chinese | WPRIM | ID: wpr-860875

ABSTRACT

Objective:To explore the impact factors of the outcome of venous-arterial extracorporeal membrane oxygenation (V-A ECMO) in patients with cardiogenic shock. Methods: Totally 37 cardiogenic shock patients who received V-A ECMO support were retrospectively analyzed. The patients were divided into tolerance group and intolerance group according to results of tolerance tests, and those in tolerance group were then divided into successful weaning subgroup (weaning and survival within 30 days) and failed weaning subgroup. The baseline data of patients in tolerance group and intolerance group were compared. The hemodynamic parameters measured with echocardiography were compared between successful weaning subgroup and failed weaning subgroup at the lowest flow during the weaning trial. Results: There were 32 patients in tolerance group and 5 in intolerance group. Among tolerance group, there were 22 cases in successful weaning subgroup and 7 in failed weaning subgroup,while 3 patients died within 30 days. Age (P=0.04) and bleeding rate (P0.05). During the weaning trial, venous oxygen saturation (SvO2), left ventricular outflow tract velocity-time integral (LVOT-VTI), left ventricular ejection fraction (LVEF) and mitral annulus lateral wall systolic velocity (Sa) of successful weaning subgroup were all higher than those of failed weaning subgroup (all P<0.05). Conclusion: SvO2, LVOT-VTI, LVEF and Sa were the impcat factors of outcome of V-A ECMO in patients with cardiogenic shock.

16.
Article in Chinese | WPRIM | ID: wpr-847259

ABSTRACT

BACKGROUND: In this study, we investigated the types and characteristics of bacterial infections in kidney transplant recipients, and analyzed the distribution of pathogenic bacteria for nosocomial infections and the changes in bacterial resistance after kidney transplantation, with the attempt to provide accurate and effective measures for prevention and treatment of bacterial infection and achieve the rational clinical use of antimicrobial drugs for kidney transplant recipients. OBJECTIVE: To investigate the epidemiological characteristics of nosocomial infection in renal transplant recipients. METHODS: A total of 422 patients with pathogenic bacteria infection after kidney transplantation in the Center of Kidney Transplantation, Zhengzhou People’s Hospital were investigated from August 2014 to August 2019, including specimen types, distribution of pathogenic bacteria and drug resistance of pathogens. The implementation of this study complied with the relevant ethical requirements of Zhengzhou People’s Hospital. RESULTS AND CONCLUSION: Positive specimens of pathogenic bacteria infection after kidney transplantation were from sputum, urine and peripheral blood mainly. Of the 422 strains of pathogenic bacteria, 274 strains (64.9%) were gram-negative, 75 strains (17.8%) were gram-positive and 73 strains (17.3%) were fungi. Among them, gram-negative bacteria were isolated from Klebsiella pneumoniae, Acinetobacter and Escherichia coli. Staphylococcus aureus, Enterococcus faecium and Staphylococcus epidermidis had higher isolation rate of gram-positive bacteria. The resistance rate of gram-negative bacteria to most antimicrobial agents was high. The gram-positive bacteria tested had different degrees of resistance to the other antimicrobial agents besides being completely sensitive to vancomycin, teicoplanin and linezolid. To conclude, gram-negative bacteria are the main pathogenic bacteria in kidney transplantation recipients. Most of the pathogenic bacteria are highly resistant to many antibiotics, and some of them have developed multiple resistance. We should strengthen the supervision of drug resistance of recipients after kidney transplantation and rationally use antibiotics.

17.
Article in Chinese | WPRIM | ID: wpr-798764

ABSTRACT

Objective@#To study the synergistic and additive effects of commonly used antibiotics on multi-drug resistant Gram-negative bacilli and to establish a database of combined pharmacodynamics in vitro.@*Methods@#Seven antibiotics including fosfomycin (PHOS), levofloxacin (LEV), ceftazidime (CAZ), compound sulfamethoxazole (SMZ), piperacillin/tazobactam (TZP), cefoperazone/sulbactam (SCF) and imipenem (IMP) were selected and grouped into 21 drug pairs. Based on the results of extended spectrum β-lactamases (ESBLs) test and modified carbapenem inactivation method (mCIM), a total of 172 strains of multidrug-resistant Gram-negative bacilli were divided into four groups: 20 strains of carbapenem-resistant Klebsiella pneumoniae (group A), 50 strains of pan-resistant Acinetobacter baumannii (group B), 62 strains of ESBLs-producing Enterobacter (group C) and 40 strains of carbapenem-resistant Pseudomonas aeruginosa (group D). Chessboard dilution method was used to detect the in vitro combined efficacy of 21 drug pairs on drug-resistant bacteria from the four groups. Whonet 5.6 was used for statistical analysis.@*Results@#All 172 strains were single drug resistant to the seven antibiotics. Results of the combined drug efficacy test showed that no antagonism was found in the four groups. In group A, ten drug pairs, especially the combination of PHOS+ LEV (30%, 6/20), had synergistic effects and 14 showed partial synergistic effects, but no additive effect was detected. Synergistic effects, partial synergistic effects and additive effects were respectively achieved by 12, ten and three drug pairs in group B. The LEV+ SMZ combination had synergistic effects against 56% (28/50) of the strains, which was the highest among all combinations. There were 14, 17 and 16 drug pairs showing synergistic effects, partial synergistic effects and additive effects in group C, respectively, and the strongest synergistic effects were achieved by the IMP+ LEV combination (30.6%, 19/62). There were 12, 14 and 13 drug pairs having synergistic effects, partial synergistic effects and additive effects in group D, respectively, and the strongest synergistic effects were achieved by the IMP+ LEV combination (20%, 8/40).@*Conclusions@#The combined use of quinolones, carbapenems, sulfonamides and PHOS could have good synergistic effects against multi-drug-resistant gram-negative bacilli. Monitoring the in vitro combined efficacy before treatment would improve the accuracy of antibiotic use and is of great clinical value.

18.
Acta Pharmaceutica Sinica B ; (6): 1511-1520, 2020.
Article in English | WPRIM | ID: wpr-828793

ABSTRACT

Development of rapid analytical methods and establishment of toxic component limitation standards are of great importance in quality control of traditional Chinese medicine. Herein, an on-line extraction electrospray ionization mass spectrometry (oEESI-MS) coupled with a novel whole process integral quantification strategy was developed and applied to direct determination of nine key aconitine-type alkaloids in 20 proprietary Chinese medicines (APCMs). Multi-type dosage forms (, tablets, capsules, pills, granules, and liquid preparation) of APCM could be determined directly with excellent versatility. The strategy has the characteristics of high throughput, good tolerance of matrix interference, small amount of sample (∼0.5 mg) and reagent (∼240 μL) consumption, and short analysis time for single sample (<15 min). The results were proved to be credible by high performance liquid chromatography-mass spectrometry (LC-MS) and electrospray ionization mass spectrometry, respectively. Moreover, the limitation standard for the toxic aconitines in 20 APCMs was established based on the holistic weight toxicity (HWT) evaluation and the severally, and turned out that HWT-based toxicity evaluation results were closer to the real clinical applications. Hence, a more accurate and reliable APCM toxicity limitation was established and expected to play an important guiding role in clinics. The current study extended the power of ambient MS as a method for the direct quantification of molecules in complex samples, which is commonly required in pharmaceutical analysis, food safety control, public security, and many other disciplines.

19.
Article in Chinese | WPRIM | ID: wpr-827950

ABSTRACT

With the advancement of the aging process, cerebrovascular disease has become China's first cause of death. Injection of Breviscapine is a type of traditional Chinese medicine injections published in the Chinese Pharmacopoeia of 2015 Edition and the National Basic Medical Insurance, Industrial Injury Insurance and Maternity Insurance Drug Catalogue, and used to treat ischemic cerebrovascular disease in clinic. In order to further improve clinicians' understanding of the drug and guidance of its rational clinical use, we gave full consideration of clinical research evidences and expert experience, followed the procedures developed based on expert consensus of Chinese Academy of Traditional Chinese Medicine, and then offered recommendations for clinical problems summarized by clinical first-line investigations and evidence-based clinical problems according to internationally accepted evidence grading and recommendation standards, i.e. Grade. As for clinical problems without evidence, we reached through nominal group method, and formed consensus recommendations. Safety issues of Injection of Breviscapine, such as indication, syndrome, dosage, course of treatment, precautions, suggestions and contraindications, were defined to improve clinical efficacy, promote rational drug use and reduce drug risks. This consensus needs to be revised in the future based on emerging clinical issues and evidence-based updates in practical applications.


Subject(s)
China , Consensus , Drugs, Chinese Herbal , Female , Flavonoids , Humans , Medicine, Chinese Traditional , Pregnancy
20.
Article in English | WPRIM | ID: wpr-827791

ABSTRACT

Triterpenoids have been described in Andrographis paniculata. Oleanolic acid exhibits high biological activity and is widely used in the clinic, and β-sitosterol not only has good biological activity but also plays an important physiological role in plants. However, analysis of the biosynthetic pathway of triterpenoids in Andrographis paniculata has not been reported. Here, we provide the first report of the isolation and identification of nine 2, 3-oxidosqualene cyclases (ApOSC3 to ApOSC11) from A. paniculata. The results showed that ApOSC4 represented a monofunctional synthase that could convert 2, 3-oxidosqualene to β-amyrin. ApOSC5 as a bifunctional 2, 3-oxidosqualene cyclases, could transfer 2, 3-oxidosqualene to β-amyrin and α-amyrin. ApOSC6 to ApOSC8 composed the multifunctional 2, 3-oxidosqualene cyclases that could convert 2, 3-oxidosqualene to β-amyrin, α-amyrin and one or two undetermined triterpenoids. This study provides a better understanding of the biosynthetic pathway of triterpenoids in A. paniculata, and the discovery of multifunctional 2, 3-oxidosqualene cyclases ApOSC5 to ApOSC8 of the facilitates knowledge of the compounds diversity in A. paniculata.

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