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1.
Article in Chinese | WPRIM | ID: wpr-928090

ABSTRACT

This study investigated the mechanism of baicalin on lipopolysaccharide(LPS)/interferon γ(IFN-γ)-induced inflammatory microglia based on the triggering receptor expressed on myeloid cells 2(TREM2)/Toll-like receptor 4(TLR4)/nuclear factor kappaB(NF-κB) pathway. Specifically, LPS and IFN-γ were used to induce inflammation in mouse microglia BV2 cells. Then the normal group, model group, low-dose(5 μmol·L~(-1)) baicalin group, medium-dose(10 μmol·L~(-1)) baicalin group, high-dose(20 μmol·L~(-1)) baicalin group, and minocycline(10 μmol·L~(-1)) group were designed. Cell viability was detected by CCK-8 assay and cell morphology was observed under bright field. The expression of interleukin-1β(IL-1β), interleukin-4(IL-4), inducible nitric oxide synthase(iNOS), interleukin-6(IL-6), interleukin-10(IL-10), and arginase-1(Arg-1) mRNA was detected by real-time quantitative PCR, the protein expression of tumor necrosis factor-α(TNF-α), IL-1β, TREM2, TLR4, inhibitor kappaB-alpha(IκBα), p-IκBα, NF-κB p65 and p-NF-κB p65 by Western blot, and transfer of NF-κB p65 from cytoplasm to nucleus by cellular immunofluorescence. Compared with the normal group, most of the BV2 cells in the model group tended to demonstrate the pro-inflammatory M1 amoeba morphology, and the model group showed significant increase in the mRNA levels of IL-1β, IL-6, and iNOS, decrease in the mRNA levels of IL-4, IL-10, and Arg-1(P<0.01), rise of the protein expression of TNF-α, IL-1β, TLR4, p-IκBα, and p-NF-κB p65(P<0.01), reduction in TREM2 protein expression, and increase in the expression of NF-κB p65 in nucleus. Compared with the model group, baicalin groups and minocycline group showed the recovery of BV2 cell morphology, significant decrease in the mRNA levels of IL-1β, IL-6 and iNOS, increase in the mRNA levels of IL-4, IL-10, and Arg-1(P<0.01), reduction in the protein expression of TNF-α, IL-1β, TLR4, p-IκBα, and p-NF-κB p65(P<0.05), rise of TREM2 protein expression, and decrease in the expression of NF-κB p65 in nucleus. In summary, these results suggest that baicalin can regulate the imbalance between TREM2 and TLR4 of microglia and inhibit the activation of downstream NF-κB, thus promoting the polarization of microglia from pro-inflammatory phenotype to anti-inflammatory phenotype.


Subject(s)
Animals , Flavonoids , Inflammation/genetics , Interferon-gamma , Lipopolysaccharides/adverse effects , Mice , NF-kappa B/metabolism , Toll-Like Receptor 4/metabolism
2.
Article in Chinese | WPRIM | ID: wpr-913069

ABSTRACT

Objective To investigate the epidemiology of echinococcosis in Serthar County, Sichuan Province, so as to provide insights into optimization of echinococcosis control measures. Methods The prevalence of human echinococcosis was surveyed among permanent residents living in Serthar County at ages of over 2 years from 2016 to 2019, and the prevalence of Echinococcus infections was surveyed in owned dogs, yaks and rodents in 2019. The epidemiological features of echinococcosis in humans and animals were descriptively analyzed. Results The overall prevalence of human echinococcosis was 3.72% (1 613/43 362) in Serthar County from 2016 to 2019, and the prevalence rates of cystic echinococcosis, alveolar echinococcosis and mixed infections of cystic echinococcosis and alveolar echinococcosis were 1.72% (745/43 362), 1.98% (860/43 362) and 0.02% (8/43 362), respectively. The prevalence of human echinococcosis was higher in pastoral areas (4.13%, 1 577/38 149) than in semi-agricultural and semi-pastoral areas (0.69%, 36/5 213) (χ2 = 151.82, P < 0.05); however, there was no significant difference in the prevalence between men (3.76%, 819/21 787) and women (3.68%, 794/21 575) (χ2 = 0.19, P > 0.05). Cystic echinococcosis was the predominant type in students with echinococcosis (93.78%, 422/450), while alveolar echinococcosis was the predominant type in herders with echinococcosis (72.16%, 801/1 110). There was a significant difference in the constituent ratio of echinococcosis types between students and herders (χ2 = 588.57, P < 0.05). In addition, higher prevalence of echinococcosis was detected in nomadic populations (4.58%, 1 008/22 021) than in community-dwelling populations (2.83%, 605/21 341) (χ2 = 91.88, P < 0.05). The Echinococcus copro-antigen-positive rate was 0.19% (4/2 157) in owned dogs, and the detection rate of echinococcosis was 8.00% (16/200) in yaks and 3.10% (31/1 000) in rodents in 2019. Conclusions Echinococcosis is highly prevalent in Serthar County, Sichuan Province. Sustained management of source of Echinococcus infections, improved treatment of echinococcosis patients and timely health education for nomadic populations are recommended.

3.
Article in Chinese | WPRIM | ID: wpr-906265

ABSTRACT

Objective:To investigate the neuroprotective effects of Danggui Shaoyaosan (DSS) on APP<sub>swe</sub>/PS1<sub>ΔE9 </sub>transgenic (APP/PS1) mice and its mechanism related to circular RNA (circRNA). Method:Totally twenty 6-month-old APP/PS1 mice were divided into model group and DSS group, and 10 C57BL/6 wild-type mice were set as the normal control group. The normal group and model group received the same volume of normal saline, and DSS group received drug by gavage administration, all for 8 weeks. The differentially expressed circRNA of APP/PS1 mice before and after DSS intervention was analyzed by circRNA sequencing to construct circRNA-miRNA mRNA interaction network. The results of cricRNA sequencing were then verified by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). The protein expression levels of phosphoinositide 3-kinase (PI3K), p-PI3K, protein kinase B1 (Akt1), p-Akt1, B lymphocytoma-2 (Bcl-2), and Bcl-2-Associated X protein (Bax) in the hippocampus were detected by immunoblotting (Western blot). The protein expression of Caspase-3 in the hippocampus was detected by immunohistochemistry and the level of apoptosis in the hippocampus was detected by the TUNEL method. Result:Compared with the model group, there were 90 differentially expressed circRNA after intervention with DSS, of which 46 were up-regulated and 44 down-regulated. Compared with the normal group, the expression levels of circRNA1398 and circRNA1399 in the model group decreased, and the expression levels of miR-103-3p, miR-153-3p, miR-143-3p, and miR-143-5p increased. Compared with the model group, the expression levels of circRNA1398 and circRNA1399 in the DSS group were up-regulated, while the expression levels of miR-103-3p, miR-153-3p, miR-143-3p, and miR-143-5p were down-regulated. Compared with the normal group, the expression of p-PI3K, Akt1, p-Akt1, and Bcl-2 in the model group decreased (<italic>P</italic><0.05,<italic> P</italic><0.01), and the expression of Bax and Caspase in the model group increased (<italic>P</italic><0.01). Compared with the model group, the expression of p-PI3K, Akt1, p-Akt1, and Bcl-2 in the hippocampus of the DSS group increased (<italic>P</italic><0.01), and the protein expression of Bax and Caspase decreased (<italic>P</italic><0.01). Compared with the normal group, the apoptosis level in the hippocampus of the model group increased, with an apoptosis rate of (43.76±2.92)%. Compared with the model group, the apoptosis rate of DSS group was (24.64±3.39)%. Conclusion:DSS can activate PI3K/Akt pathway and inhibit apoptosis in hippocampal neurons of APP / PS1 mice, and play a neuroprotective role. The specific mechanism may be related to the regulation of circRNA1398 and circRNA1399 expression and the corresponding miRNA expression.

4.
Article in Chinese | WPRIM | ID: wpr-906095

ABSTRACT

Objective:To explore the key gens of peripheral blood mononuclear cells in hepatocellular carcinoma(HCC-PBMC) and potentially effective Chinese herbs based on bioinformatics, and to verify the clinical efficacy of these Chinese herbs via a systematic review. Method:The chips GSE58208 and GSE36076 of HCC-PBMC were downloaded from the Gene Expression Omnibus (GEO), followed by the identification of differentially expressed genes (DEGs) using RStudio. After protein-protein interaction (PPI) analysis by STRING, the DAVID was employed for gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The DEGs of HCC-PBMC were visualized by Cytoscape. The key genes of HCC-PBMC were calculated by CytoHubba plug-in and mapped with those in Coremine Medical for screening out the potential Chinese herbs for the treatment of HCC, which were then included for subsequent systematic review. Result:A total of 203 DEGs were obtained (194 up-regulated and nine down-regulated). As revealed by DAVID analysis, the DEGs were mainly enriched in such biological processes and signaling pathways as transcriptional regulation of DNA template, hydrolysis of ribonucleic acid phosphodiester bond, positive regulation of intranuclear mitosis and division, skeletal muscle fiber development, activation of mitogen-activated protein kinase(MAPK)activity, Fanconi anemia pathway, and metabolic pathway. The key genes of HCC-PBMC were calculated by Cytoscape to be<italic> </italic>GTPase IMAP family member 1 (GIMAP1), GTPase IMAP family member 4 (GIMAP4), GTPase IMAP family member 6 (GIMAP6), GTPase IMAP family member 7 (GIMAP7), GTPase IMAP family member 8 (GIMAP8), interleukin-1<italic>β </italic>(IL-1<italic>β)</italic>, CX3C chemokine receptor 1 (CX3CR1), C-C chemokine receptor type 2 (CCR2), Toll-like receptor 7(TLR7), and epidermal growth factor(EGF). Through Coremine Medical analysis, it was concluded that Ginseng Radix et Rhizoma, Curcumae Longae Rhizoma, Centellae Herba, and Hedyotidis Herba were closely related to the key genes. Ginseng Radix et Rhizoma has the effects of tonifying and benefiting lung and spleen and enhancing strength, suitable for the liver depression and spleen deficiency syndrome or Qi-Yin deficiency syndrome of HCC. Hence, Si Junzitang with Ginseng Radix et Rhizoma as the sovereign medicinal was included for systematic review. It has been confirmed that Ginseng Radix Et Rhizoma was superior to western medicine alone in improving the overall clinical efficacy, alleviating TCM syndrome, elevating serum CD4<sup>+ </sup>and CD4<sup>+</sup>/CD8<sup>+ </sup>levels, and reducing the serum CD8<sup>+ </sup>and TBIL levels (<italic>P</italic><0.01), with high safety. Conclusion:This study conducted at the gene level has provided new ideas for clinical diagnosis and treatment of HCC. The systematic review of Ginseng Radix Et Rhizoma against HCC provides a basis for the clinical prevention and treatment of HCC with TCM.

5.
Article in Chinese | WPRIM | ID: wpr-878887

ABSTRACT

In this study, the antioxidant property changes in fermented Ziziphi Spinosae Semen(FZSS) with Poria cocos were analyzed by DPPH, ABTS and FRAP methods. Then the content determination of active ingredients and ~1H nuclear magnetic resonance(~1H-NMR) spectroscopy were also used to investigate the mechanism of FZSS with P. cocos in enhancing the antioxidant activity. The results showed that the content of active ingredients such as total phenols, total saponins and total polysaccharides were significantly increased during the fermentation time. The results of ~1H-NMR metabonomics showed that the contents of amino acids such as leucine, lysine, valine and alanine, nitrogen compounds such as creatine, creatinine, and betaine, and secondary metabolites, for instance, jujuboside A and spinosin were higher after fermentation, and above components showed positive correlation with antioxidant capacity in Pearson correlation analysis. Therefore, it was inferred that the enhancement of antioxidant activity of FZSS may be the result of the joint action of various chemical components. This study preliminarily clarified the mechanism of FZSS in enhancing the antioxidant activity, and provided new research ideas for the product development and utilization of FZSS.


Subject(s)
Antioxidants , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Poria , Semen , Wolfiporia , Ziziphus
6.
Acta Pharmaceutica Sinica ; (12): 38-44, 2020.
Article in Chinese | WPRIM | ID: wpr-780564

ABSTRACT

Physiologically based pharmacokinetic (PBPK) modeling is an important tool to predict pharmacokinetic or pharmacodynamic profiles in special populations, especially in children and infants where designing and conducting clinical studies is difficult. The application of PBPK modeling can effectively promote the development of pediatric drugs and their clinical use. At present, PBPK modeling of pediatric populations is mainly applied in clinical trial design, drug-drug interaction (DDI) risk assessment, and dose selection in children. This review discusses the advantages of PBPK modeling in pediatric drug research and summarizes how to extrapolate a PBPK model from adults to children. The theoretical basis for pediatric PBPK models, the modelling process and important physiological parameters during the modeling process are introduced. Some successful applications of PBPK modeling in pediatric drug research and development are also presented. This review also analyzes the current limitations and future directions of pediatric PBPK modeling.

7.
Article in Chinese | WPRIM | ID: wpr-846596

ABSTRACT

Objective: To reduce or avoid the volatilization loss of camphor (CA) in the industrialized preparation of cataplasm, using the inclusion technology of HP-β-CD. Methods: The HP-β-CD inclusion compound of CA (CA-HP-β-CD) was prepared by the constant temperature stirring method. The preparation processing of CA-HP-β-CD was optimized with inclusion efficiency as an index, and the pharmaceutical properties of CA-HP-β-CD were characterized by DSC, UV and SEM. The CA and CA-HP-β-CD were prepared to cataplasm at the industrial-scale production respectively, then the content of CA was determined and the statistical analysis was carried out. Results: The inclusion efficiency of CA-HP-β-CD for CA was (68.57 ± 1.26)% when the CA-HP-β-CD was prepared with the mass ratio of CA to HP-β-CD 1:3, the working temperature at 35 ℃ and stirring at 300 r/min for 4.0 h. The DSC, UV and SEM scans showed that there was a good compatibility between CA and HP-β-CD, and CA could be fully encapsulated by HP-β-CD and formed a stable inclusion complex of CA-HP-β-CD. Results of industrial-scale production of cataplasm for CA and CA-HP-β-CD revealed that the retention rate (actual content/feeding quantity) were (80.13 ± 1.05)% and (39.45 ± 1.38)%, respectively. And there was a statistically significant difference between them (t-test, P < 0.01), indicating that the HP-β-CD inclusion complex effectively reduce the volatilization loss of camphor CA. Conclusion: The volatilization loss of CA at the industrial-scale production of cataplasm was effectively reduced by the CA-HP-β-CD, which improves the utilization rate of CA and reduces the cost, and provides ideas and reference for the research and development of cataplasm of volatile drugs.

8.
Chinese Journal of Biotechnology ; (12): 849-860, 2020.
Article in Chinese | WPRIM | ID: wpr-826891

ABSTRACT

Recently, with the development and the continuous improvement of various CRISPR systems represented by CRISPR/Cas9, gene editing technology has been gradually improved, and widely applied to the preparation of animal models of human diseases. The gene edited animal models provide important materials for the study of pathogenesis, pathological process, prevention and treatment of human diseases. At present, the gene edited animal models used in human disease research include mainly the rodent models represented by mice and rats, and large animal models represented by pigs. Among them, rodents differ greatly from humans in all aspects of their bodies and have short life span as well, which cannot provide effective evaluation and long-term tracking for the research and treatment of human diseases. On the other hand, pig is closer to human in physiology, anatomy, nutrition and genetics, which provides an important animal model in the field of organ transplantation and human disease research. In this paper, the application of the gene edited animal models was summarized in the researches of 5 human diseases such as neurodegenerative diseases, familial hypertrophic cardiomyopathy, cancer, immunodeficiency diseases and metabolic diseases. We hope this paper will provide a reference for the research of human diseases and the preparation of relative animal models.


Subject(s)
Animals , CRISPR-Cas Systems , Clustered Regularly Interspaced Short Palindromic Repeats , Disease Models, Animal , Gene Editing , Humans
9.
Journal of Medical Postgraduates ; (12): 238-240, 2020.
Article in Chinese | WPRIM | ID: wpr-818411

ABSTRACT

ObjectiveMiRNA can regulate the occurrence and development of many inflammatory diseases, which is one of the hot spots in the research of inflammatory diseases. Bronchial asthma is a chronic inflammation, and the role of microRNA-19a in the regulation of bronchial asthma is still unclear. This paper discusses the expression changes of microRNA-19a /PI3K/AKT/PTEN pathway in rat asthma model.Methods(1) The rat model of chronic bronchial asthma was established. (2) The expression levels of AKT, p-AKT and PTEN in lung tissues were detected by western blot. (3) microRNA-19a expression in lung tissue of the model was detected by real-time fluorescence quantitative PCR.Results(1) HE, MASSON, PSA and immunohistochemistry of lung tissues in the model were combined to determine the successful establishment of the model of chronic bronchial asthma. (2) Western blot results showed that the expression levels of AKT (0.434±0.012) and p-AKT (1.086±0.026) in asthma group were higher than those in control group and demi group. The decreased expression of PTEN (0.371±0.007) was statistically significant (P<0.05). (3)The expression of microRNA-19a in the lung tissues of the asthmatic rat model was significantly increased in the asthma group (6.22±1.61) and in the gedi group (1.93±0.54). Pair-comparison between the three groups was statistically significant (P<0.05).ConclusionThe microRNA-19a /PI3K/AKT/PTEN pathway may be involved in the pathophysiological process of bronchial asthma.

10.
Article in Chinese | WPRIM | ID: wpr-817720

ABSTRACT

@#【Objective】 To find out the possible marker for early warning or therapeutic target of severe dengue disease ,we studied B cell responses during natural dengue virus(DENV)infection and their association with disease severity.【Methods】Sixty-two cases and their blood samples were collected from the patients hospitalized during September to December in 2014 and three groups were designated as mild dengue(DF,n=33),severe dengue(SD,n=29)and control group(Control ,n=6). Multicolor flow cytometrywas used to analyze the dynamic changes of B cells and plasmablasts in the peripheral blood of patients during the acute phase and the critical phase. The plasmablasts in a succession of samplesfrom the same infected patients (including 3 mild and 3 severe cases) were further analyzed. We also observed the changes of B cells and their subsets ,including naive B cells ,memory B cells and plasmablasts,during primary and secondary infections. 【Results】 The expansion of B cells in the severe group was significantly higher than that in the mild group(P=0.013),especially on day 5 and day 6 after the symptom onset(P = 0.017 and 0.002,respectively). Compared with those in the control group,the plasmablasts in the mild and severe groups showed significant proliferation(P=0.011 and 0.032,respectively),but no statistical difference was observed between these two groups. The analysis of the serial blood samples showed that the plasmablasts,in mild cases,peaked on day 7 and 8 and returned to baseline on day 10,whereas in the severe group,peaked on day 7 to 9,and still existed at a certain rate after day 10. In mild dengue group,more proliferative B cells,less naive B cells and memory B cells were found in secondary infection than in primary infection(P = 0.028,0.010 and 0.037,respectively),but plasmablasts revealed no difference. In severe dengue group, only naïve B cells significantly decreased in secondary infection (P = 0.018). 【Conclusion】 B cell responses between mild and severe dengue after DENV- 1 infection present different trends. The significant proliferation of B cells in the early stage of the disease and the persistent existence of plasmablasts may be related to the severity of the dengue disease.

11.
Article in Chinese | WPRIM | ID: wpr-751591

ABSTRACT

Objective To investigate the efficacy and safety of endovascular therapy for small unruptured intracranial aneurysms (sUIAs). Methods Patients with unruptured intracranial aneurysms who underwent endovascular therapy in the Department of Neurology, Guangzhou First People's Hospital from January 2008 to January 2018 were retrospectively included. According to the size of the aneurysms, they were divided into the sUIAs group (diameter <5 mm) and the non-sUIAs group (diameter ≥5 mm). Demographics, vascular risk factors, aneurysm characteristics, and treatment method, effectiveness, perioperative complications, and outcomes of endovascular therapy were compared between the two groups. Results A total of 80 patients with unruptured intracranial aneurysms were enrolled, including 33 patients with sUIAs (41.25% ) and 47 patients with non-sUIAs. The age of patients (51.1 ± 9.7 years vs. 61.2 ± 8.1 years; t=5.058, P<0.001), and the maximum diameter (3.6 ± 1.1 mm vs. 8.2 ± 3.2 mm; t=7.923, P<0.001) and neck width (3.1 ± 0.5 mm vs. 4.5 ± 2.5 mm; t=3.167, P=0.002) of aneurysms as well as the proportion of patients with wide-neck aneurysm (3.0% vs. 21.3% ; χ2 =7.213, P=0.007) and stent-assisted embolization (6.1% vs. 23.4% ; χ2 =4.285, P=0.038) in the sUIA group were significantly less than those of the non-sUIAs group. The embolization results, the perioperative complication rate and the good outcome rate were comparable between the two groups. Conclusion For sUIAs, endovascular therapy is effective and safe, comparable to endovascular therapy for non-sUIAs.

12.
Chinese Journal of Neurology ; (12): 310-314, 2019.
Article in Chinese | WPRIM | ID: wpr-745929

ABSTRACT

Objective To investigate the application of myelography including digital subtraction angiography myelogram (DSM) and computed tomography myelogram (CTM) in patients with spontaneous intracranial hypotension.Methods The myelography results including DSM and CTM of 10 patients with spontaneous intracranial hypotension form Guangzhou First People's Hospital between January 2013 and June 2018 were retrospectively analyzed.Some patients were treated with targeted epidural blood patch on the basis of myelography.Results Myelography (including DSM and CTM) showed cerebrospinal fluid leakages in all the 10 patients.There were one to 16 leak sites with an average of nine sites (totally 90 leak sites).Forty-two sites (47%) were located in cervical vertebra,19 sites (21%) in thoracic vertebra,22 sites (24%) in lumbar vertebra,and seven sites (8%) in sacral vertebra.On DSM and CTM,cerebrospinal fluid leakage was characterized by the diffusion of contrast agent along one side or the bilateral sides of nerve root,enlargement of the nerve sleeves and paraspinal collections of hyper-demity contrast medium.Two patients whose cerebrospinal fluid leakage occurred in long sections showed more cerebrospinal fluid leakage on CTM than on DSM.Two patients responded well to targeted epidural blood patch on the basis of myelography.The cerebrospinal fluid leakage was completely settled on myelography after the treatment of epidural blood patches.Conclusions Myelography has been shown to assist the diagnosis of spontaneous intracranial hypotension and accurately define the location and extent of cerebrospinal fluid leakages.Myelography can be used to guide targeted epidural blood patch and applied in the reexamination of cerebrospinal fluid leakages after treatment.More cerebrospinal fluid leakages are detected by CTM than by DSM.

13.
Article in English | WPRIM | ID: wpr-776855

ABSTRACT

Five new polyhydroxylated furostanol saponins were isolated from the roots and rhizomes of Tupistra chinensis, and their structures were determined as tupistrosides J-N (1-5), together with four known furostanol saponins (6-9), on the basis of physico-chemical properties and spectral analysis. Among them, compounds 3 and 5 showed cytotoxicity against human cancer cell lines SW620 with IC values of 72.5 ± 2.4 and 77.3 ± 2.5 μmol·L, respectively. Compound 4 showed cytotoxicity against human cancer cell line HepG2 with IC value of 88.6 ± 2.1 μmol·L.

14.
Article in English | WPRIM | ID: wpr-776829

ABSTRACT

Thibetanosides E-H (1-4), four new steroidal constituents including three rare sulfonates (2-4), were isolated from the roots and rhizomes of Helleborus thibetanus, together with nine known steroidal compounds (5-13). Their structures were elucidated by detailed spectroscopic analysis, including 1D and 2D NMR techniques and chemical evidence. In this study, compounds 2-13 were evaluated for their cytotoxic activities against HCT116, A549 and HepG2 tumor cell lines in vitro. Among them, compound 8 (thibetanoside C) showed cytotoxicities against A549 cells(IC 39.6 ± 1.9 μmol·L) and HepG2 cells(IC 41.5 ± 1.1 μmol·L), respectively. Compound 9 (23S, 24S)-24-[(O-β-D-fucopyranosyl)oxy]-3β, 23-dihydroxy-spirosta-5, 25(27)-diene-1β-ylO-(4-O-acetyl- α-L-rhamnopyranosyl)-(1→2)-O-[β-D-xylopyranosyl-(1→3)]-α-L-arabinopyranoside) showed cytotoxicity against HCT116 cells(IC 33.6 ± 2.1 μmol·L).

15.
Article in Chinese | WPRIM | ID: wpr-816508

ABSTRACT

OBJECTIVE: To understand the current status of surgical site infection(SSI)after emergency abdominal surgery(EAS) in China,and to discuss the risk factors.METHODS: The study included 293 adult patients who underwent EAS in 26 hospitals in China in May 2018. The basic information, perioperative data, and microbial culture results of infected incisions were collected prospectively. The primary outcome measure was the incidence of surgical site infection within 30 days after surgery. Secondary outcome variables were postoperative hospital stay,ICU occupancy,ICU stay,treatment costs,and postoperative30-day mortality.RESULTS: Twenty-two(7.5%) patients developed SSI after surgery.The main pathogen of SSI is Escherichia coli [culture positive rate was 36.4%(8/22)]. Patients with SSI had a significantly longer overall hospital stay and ICUstay,and ICU occupancy and treatment were significantly higher. Multivariate logistic regression analysis showed thatmales(P=0.030) and operative time(P=0.007) were risk factors for SSI. Laparoscopic surgery(P=0.022)was aprotective factor for SSI.CONCLUSION: The incidence of SSI after EAS in China is 7.5%,and SSI leads to a significantincrease in the medical burden of patients. Choosing laparoscopic surgery can reduce the incidence of SSI after EAS.Controlling preoperative blood glucose may have positive significance in preventing SSI after EAS.

16.
Chinese Journal of Burns ; (6): 615-623, 2018.
Article in Chinese | WPRIM | ID: wpr-810175

ABSTRACT

Objective@#To observe the clinical effects of sequential treatments of pulsed dye laser (PDL) and ablative fractional carbon dioxide laser on early stage hypertrophic burn scars.@*Methods@#From January 2016 to December 2017, 221 patients with 228 hypertrophic scars in all parts of body within 6 months post healing, conforming to the study criteria and treated in our department, were included in this prospective study. They were first treated by PDL, repeated at an interval of one month until the vascularity score of scar fell below 2 points, and then treated by ablative fractional carbon dioxide laser, repeated at an interval of 3 months. Their start time and numbers of treatment and follow-up time were recorded. Before the first treatment (hereinafter referred to as before treatment) and at the last follow-up (hereinafter referred to as after treatment), the vascularity, thickness, and pliability of scars were scored by a self-made scar rating scale. The scores of patients with the observation time between 6 to18 months post healing were compared among scars of patients grouped by age, body site of scar, starting time of treatment and numbers of treatment. The laser speckle contrast imaging technique was used to measure the blood flow value of scars. The itching symptom of the scars was evaluated by the Verbal Rating Scale. The satisfaction to the final effects of the doctors and patients was investigated and scored separately by Likert scale after treatment. The therapeutic or adverse reactions were recorded during the treatment. Data were processed with paired t test, Mann-Whitney U test, Wilcoxon signed rank sum test, Kruskal-Wallis H test, and Spearman rank correlation analysis.@*Results@#(1) The patients were treated on (64±36) d post healing, by PDL for (2.5±1.3) times and by ablative fractional carbon dioxide laser for (2.2±1.2) times. The follow-up time was (331±189) d. (2) The vascularity, thickness, pliability scores and total scores of scars were (1.4±0.9), (2.0±0.8), (1.7±0.8), and (5.0±2.1) points respectively after treatment, which were significantly lower than those before treatment [(4.1±0.7), (3.1±0.8), (3.0±0.9), and (10.2±2.0) points respectively, t=43.332, 24.968, 28.063, 46.394, P<0.01]. (3) Among the 123 scars from 120 patients with observation time between 6 to 18 months post healing, there were no statistically significant differences in the vascularity, thickness, pliability scores and total scores of scars among patients with different ages after treatment (χ2=4.339, 1.826, 1.375, 2.879, P>0.05). There was only significant difference in the pliability scores of scars among different body sites (χ2=13.530, P<0.05). There were statistically significant differences in the vascularity, thickness, pliability scores and total scores of scars with different starting time of treatment (χ2=30.725, 25.233, 25.119, 35.798, P<0.01). There were significantly positive correlation between starting time of treatment and the vascularity, thickness, pliability scores and total scores of scars (r=0.492, 0.442, 0.446, 0.532, P<0.01). There were statistically significant differences in the vascularity, pliability scores and total scores of scars with different numbers of treatment (Z=4.883, 4.910, 5.049, P<0.05). There were significantly negative correlation between number of treatment and the vascularity, thickness, pliability scores and total scores of scars (r=-0.176, -0.131, -0.191, -0.201, P<0.05). (4) The blood flow values were determined in 18 scars of 18 patients. The results showed that the blood flow values of scars after treatment were significantly decreased compared with those before treatment (t=7.230, P<0.01). (5) The pruritus scores of scars of patients after treatment were significantly decreased compared with those before treatment (Z=12.818, P<0.01). (6) There were significant differences between the satisfaction scores of doctors and the scores of patients after treatment (t=12.130, P<0.01). (7) After PDL treatment, there were some edema and purpura reactions for all the patients, and 11 (5.0%) patients had blisters. After ablative fractional carbon dioxide laser treatment, 4 (1.8%) patients had blisters, 5 (2.3%) patients suffered inflammatory reaction and erosion, and 9 (4.1%) patients suffered pigmentation.@*Conclusions@#The scores of hypertrophic burn scars can be obviously improved by sequential treatments of PDL and ablative fractional carbon dioxide laser. The effects can be more obvious with the earlier starting time and more numbers of treatment. The laser treatments can also decrease the blood flow values and alleviate the pruritus of scars, with high satisfaction of both patients and doctors.

17.
Chinese Journal of Burns ; (6): 522-525, 2018.
Article in Chinese | WPRIM | ID: wpr-807198

ABSTRACT

Objective@#To observe the clinical effects of recombinant human growth hormone (rhGH) on children with severe burn.@*Methods@#Clinical data of 94 children with severe burn, hospitalized in our burn unit from April 2012 to December 2016, conforming to the study criteria, were retrospectively analyzed. According to the use of rhGH, children were divided into rhGH group (n=50) and control group (n=44). Children in control group received conventional treatment, while children in rhGH group received both conventional and rhGH treatment. The rhGH treatment was started 3 to 5 days post injury in dosage of 0.2-0.4 U·kg-1·d-1, by way of subcutaneous injection, and the course of treatment was (11±5) d. The plasma albumin and prealbumin levels, heart rate, alanine aminotransferase (ALT), and serum creatinine level in 2 weeks post injury, times of skin grafting operation, hospitalization time, total hospitalization treatment cost, and sepsis and death of children were compared between the 2 groups. Data were processed with independent sample t test, Mann-Whitney U test, and Fisher′s exact test.@*Results@#(1) In 2 weeks post injury, the plasma albumin level [(36±4) g/L] and prealbumin level [(94±34) g/L] of children in rhGH group were significantly higher than those in control group [(33±4) and (73±20) g/L, t=3.666, 3.401, P<0.05]. (2) In 2 weeks post injury, the heart rate of children in rhGH group was (123±11) times per minute, which was slower than (130±14) times per minute of children in control group (t=2.839, P<0.05). There was no significant difference in ALT level of children between the 2 groups (Z=0.868, P>0.05). The blood creatinine levels of children in the 2 groups were within normal range. (3) The times of skin grafting operation of children in rhGH group was 0.3±0.5, which was significantly less than 0.5±0.6 in control group (Z=2.234, P<0.05). The hospitalization time of children in rhGH group was (22±8) days, which was shorter than (28±10) days in control group (t=2.837, P<0.05). The total hospitalization treatment cost of children in rhGH group was (41±15) thousand yuan, which was significantly less than (53±25) thousand yuan in control group (t=2.878, P<0.05). (4) There were 2 cases of sepsis in control group and 1 case of sepsis in rhGH group, with no significant difference between the 2 groups (P>0.05). No children died in the 2 groups.@*Conclusions@#rhGH treatment of children with severe burn can correct post-injury hypoproteinemia, improve cardiac function, reduce the times of skin grafting operation and hospitalization treatment cost, shorten hospitalization time, with no significant effect on kidney and liver function, sepsis, and death.

18.
Chinese Journal of Burns ; (6): 14-20, 2018.
Article in Chinese | WPRIM | ID: wpr-805941

ABSTRACT

Objective@#To analyze the changes and relationship of early hemodynamic indexes of patients with large area burns monitored by pulse contour cardiac output (PiCCO) monitoring technology, so as to assess the guiding value of this technology in the treatment of patients with large area burns during shock period.@*Methods@#Eighteen patients with large area burns, confirming to the study criteria, were admitted to our unit from May 2016 to May 2017. Pulse contour cardiac output index (PCCI), systemic vascular resistance index (SVRI), global end-diastolic volume index (GEDVI), and extravascular lung water index (EVLWI) of patients were monitored by PiCCO instrument from admission to post injury day (PID) 7, and they were calibrated and recorded once every four hours. The fluid infusion coefficients of patients at the first and second 24 hours post injury were calculated. The blood lactic acid values of patients from PID 1 to 7 were also recorded. The correlations among PCCI, SVRI, and GEDVI as well as the correlation between SVRI and blood lactic acid of these 18 patients were analyzed. Prognosis of patients were recorded. Data were processed with one-way analysis of variance, single sample ttest and Bonferroni correction, Pearson correlation analysis, and Spearman rank correlation analysis.@*Results@#(1) There was statistically significant difference in PCCI value of patients from post injury hour (PIH) 4 to 168 (F=7.428, P<0.01). The PCCI values of patients at PIH 4, 8, 12, 16, 20, and 24 were (2.4±0.9), (2.6±1.2), (2.2±0.6), (2.6±0.7), (2.8±0.6), and (2.7±0.7) L·min-1·m-2, respectively, and they were significantly lower than the normal value 4 L·min-1·m-2(t=-3.143, -3.251, -11.511, -8.889, -6.735, -6.976, P<0.05 or P<0.01). At PIH 76, 80, 84, 88, 92, and 96, the PCCI values of patients were (4.9±1.5), (5.7±2.0), (5.9±1.7), (5.5±1.3), (5.3±1.1), and (4.9±1.4) L·min-1·m-2, respectively, and they were significantly higher than the normal value (t=2.277, 3.142, 4.050, 4.111, 4.128, 2.423, P<0.05 or P<0.01). The PCCI values of patients at other time points were close to normal value (P>0.05). (2) There was statistically significant difference in SVRI value of patients from PIH 4 to 168 (F=7.863, P<0.01). The SVRI values of patients at PIH 12, 16, 20, 24, and 28 were (2 298±747), (2 581±498), (2 705±780), (2 773±669), and (3 109±1 215) dyn·s·cm-5·m2, respectively, and they were significantly higher than the normal value 2 050 dyn·s·cm-5·m2(t=0.878, 3.370, 2.519, 3.747, 3.144, P<0.05 or P<0.01). At PIH 4, 8, 72, 76, 80, 84, 88, 92, and 96, the SVRI values of patients were (1 632±129), (2 012±896), (1 381±503), (1 180±378), (1 259±400), (1 376±483), (1 329±385), (1 410±370), and (1 346±346) dyn·s·cm-5·m2, respectively, and they were significantly lower than the normal value (t=-4.593, -0.112, -5.157, -8.905, -7.914, -5.226, -6.756, -6.233, -7.038, P<0.01). The SVRI values of patients at other time points were close to normal value (P>0.05). (3) There was no statistically significant difference in the GEDVI values of patients from PIH 4 to 168 (F=0.704, P>0.05). The GEDVI values of patients at PIH 8, 12, 16, 20, and 24 were significantly lower than normal value (t=-3.112, -3.554, -2.969, -2.450, -2.476, P<0.05). The GEDVI values of patients at other time points were close to normal value (P>0.05). (4) There was statistically significant difference in EVLWI value of patients from PIH 4 to 168 (F=1.859, P<0.01). The EVLWI values of patients at PIH 16, 20, 24, 28, 32, 36, and 40 were significantly higher than normal value (t=4.386, 3.335, 6.363, 4.391, 7.513, 5.392, 5.642, P<0.01). The EVLWI values of patients at other time points were close to normal value (P>0.05). (5) The fluid infusion coefficients of patients at the first and second 24 hours post injury were 1.90 and 1.39, respectively. The blood lactic acid values of patients from PID 1 to 7 were 7.99, 5.21, 4.57, 4.26, 2.54, 3.13, and 3.20 mmol/L, respectively, showing a declined tendency. (6) There was obvious negative correlation between PCCI and SVRI (r=-0.528, P<0.01). There was obvious positive correlation between GEDVI and PCCI (r=0.577, P<0.01). There was no obvious correlation between GEDVI and SVRI (r=0.081, P>0.05). There was obvious positive correlation between blood lactic acid and SVRI (r=0.878, P<0.01). (7) All patients were cured except the one who abandoned treatment.@*Conclusions@#PiCCO monitoring technology can monitor the changes of early hemodynamic indexes and volume of burn patients dynamically, continuously, and conveniently, and provide valuable reference for early-stage comprehensive treatment like anti-shock of patients with large area burns.

19.
Article in Chinese | WPRIM | ID: wpr-708949

ABSTRACT

Objective To investigate the value of PET/CT imaging of cerebral glucose metabolism (CGM)and cerebral blood flow (CBF)in evaluating chronic disorders of consciousness (CDC).Methods A total of 10 CDC patients (5 males,5 females,age (50.9 ±17.2)years)and 10 healthy controls (5 males,5 females,age (52.0±10.3)years)from January 2016 to March 2017 were recruited to perform brain PET/CT of CGMand CBF.The brain PET imaging using 13 N-Ammonia was performed and followed by 18 F-fluorodeoxyglucose (FDG)PET.The mean standardized uptake values (SUVmean )of frontal,parietal, temporal and occipital lobes as well as basal ganglia,thalamus were obtained.The SUVmean of cerebral re-gions/SUVmean of cerebellum ratios (SUVr )were acquired.The SUVr were compared between the patients and controls.The imaging characteristics of CGM and CBF were investigated,and their relationships with clinical scores were further analyzed.Two-sample t test and Pearson correlation analysis were used to analyze the data.Results The radioactive distribution in the brain of healthy controls was symmetrical.SUVr of cer-ebral regions in the affected side of patients were significantly lower than those of the controls both in CGM imaging and CBF imaging (t values:2.90-5.19,all P<0.05).In 10 CDC patients,there were 9 with hypo-metabolism in basal ganglia and thalamus,8 with hypometabolism in frontal and parietal lobes,and 7 with hypometabolism in temporal and occipital lobes.At the same time,there were 7 with parietal hypoperfusion and 6 with hypoperfusion in other cerebral regions in the CDC patients.In the frontal,parietal lobes and basal ganglia,the CGMand CBF were both correlated with the clinical scores (r values:0.473-0.606,all P<0.05).Abnormal metabolism-perfusion patterns were divided into 3 types.Type Ⅰ included 2 patients and their hypometabolism and hypoperfusion were mismatched completely.Type Ⅱ included 3 patients and their hypometabolism and hypoperfusion were matched in frontal,parietal,occipital and temporal lobes,while mismatched in basal ganglia and thalamus.Type Ⅲ included 5 patients and their hypometabolism and hypoperfusion were matched completely.The clinical scores of typeⅠ,Ⅱand Ⅲ were 10.5,8.3 and 5.6, respectively.Conclusion The PET/CT imaging of cerebral blood flow and metabolism is useful in evalua-ting the disorders of consciousness.

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Article in Chinese | WPRIM | ID: wpr-704995

ABSTRACT

Objective To investigate the expression of Wnt7b, β -catenin, and c-Myc in asthmatic mice and the intervention of the leukotriene receptor antagonist montelukast on airway remodeling. Methods The asthma model was established by ovalbumin (OVA) induction. HE staining was used to observe the pathological changes in lung tissue. Serum OVA-sIgE levels were determined by ELISA. The level of Wnt7b, β -catenin, and c-Myc protein and mRNA in the lung tissue of mice was analyzed by Western blotting and real-time PCR. The basement membrane perimeter (PBM), wall area of bronchial tube (WAt), wall area of bronchial smooth muscle (WAm), and the number of smooth muscle cells were measured using medical image analysis software and standardized based on the PBM. Results The amount of OVA-slgE in the asthma group was significantly higher than in the control and montelukast groups (P < 0. 05). Western blotting and real-time PCR showed that the expression of Wnt7b, β -catenin, and c-Myc in the asthma group was higher than the expression in the control and montelukast groups (P < 0. 05). Image analysis showed that the WAt/PBM and WAm/PBM ratios in the montelukast group were significantly lower than those in the asthma group (P < 0. 05). Conclusion The Wnt/ β -catenin signaling pathway may be an important factor in the pathogenesis of asthma; montelukast may attenuate airway remodeling in asthmatic patients by decreasing the expression of Wnt7b, β -catenin, and c-Myc.

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