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OBJECTIVE:To study the mechianism of inhibitory effect of ulinastain on inflammatory factors of patients during cardiopulmonary bypass(CPB)cardiac surgery. METHODS:Totally 40 patients underwent selective CPB cardiac surgery collected from our hospital during Jul. 2012-Jul. 2016 were divided into control group and observation group according to random number ta-ble,with 20 cases in each group. Observation group was given 300000 U of ulinastatin at 2.5 mL/min by intravenous pump within 20 min after anesthesia induction, then given 700000 U of ulinastatin at 0.2 mL/min by continuous intravenous pump until opera-tion finish. Control group was given equal volume of normal saline. Blood samples of patients were collected before anesthesia in-duction (before surgery) and 6,12,24 h after CPB (after surgery),respectively. The expression of miR-155 and its target gene MyD88 in peripheral blood mononuclear cells of each group were detected by Real-time PCR and Western blot. The expression of TNF-α,IL-6 and IL-8 were measured by ELISA. The correlation of miR-155 with the expression of TNF-α,IL-6 and IL-8 in pa-tients of observation group 24 h after surgery were analyzed by using Pearson correlation analysis. RESULTS:Compared with con-trol group,the expression of miR-155 in observation group was significantly increased,while the expression of its target gene MyD88 was significantly decreased;the expression of TNF-α,IL-6 and IL-8 were reduced significantly,with statistical signifi-cance(P<0.01). The expression of miR-155 was significantly negative correlation with the expression of TNF-α,IL-6 and IL-8 in the patients of observation group 24 h after surgery(P<0.01). CONCLUSIONS:Ulinastatin can inhibit the release of inflammatory factors TNF-α,IL-6 and IL-8 by inducing the expression of miR-155,which may be a new mechanism for the anti-inflammatory ef-fect of the drug in CPB cardiac surgery.
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Objective: To compare the clinical effect of Xuebijing or ulinastain combined with the conventional treatment for chronic obstructive pulmonary disease with acute exacerbation (AECOPD) complicated with systemic inflammatory response syndrome(SIRS).Methods: Totally 82 AECOPD patients with SIRS were randomly divided into group A and group B with 41 ones in each and both groups were treated with the conventional therapy.Group A was treated with ulinastatin (dissolved in 100 ml 0.9% sodium chloride injection, intravenous infusion, once daily), group B was given 50ml Xuebijing injection (mixed with 100 ml saline, intravenous infusion, twice a day).The lung function test, blood gas analysis and inflammatory factors were carried out in both groups.Results: After treatment, the lung function indices of FEV, FEV1 and FEV1/FVC in group A and B were significantly higher than those of before treatment (P0.05).Conclusion: The clinical effect of Xuebijing or ulinastain combined with the conventional treatment is promising for AECOPD complicated with SIRS.Xuebijing injection combined with the conventional treatment shows better effect on the improvement of lung function and blood gas, and the levels of inflammatory cytokines can be reduced more significantly, which is also safe in the clinical application.
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Objective To evaluate the antiinflammatory effect of ulinastain( UTI) with ghrelin( GHL) on amelioration of small intestine dysfunction and its possible mechanisms in endotoxemia rats. Methods Animals were received intraperitoneal injection with lipopolysaccha-ride(LPS,15 mg/kg)as a endotoxemia model. 60 male SD rats were randomly divided into control group(CON group),LPS group,UTI group,GHL group,and UTI+GHL group. Microstructure of small intestinal submucosa was observed with HE staining. Dextran blue-2000 (BD-2000)was drenched for calculation of propulsion rate of the small intestine. The level of tumor necrosis factorα(TNF-α),IL-6 and HMGB1 in serum and small Intestinal mucosal tissue were determined by enzyme linked immunosorbent assay( ELISA) . RealTime-PCR was administrated for detection of rat defensin-5 mRNA(RD-5)and trefoil factor family-3(TFF-3)mRNA. All above measurement were taken re-spectively at 12 hours and 24 hours after LPS injection. Results HE staining shows that UTI+GHL group significantly alleviate the damage of intestinal microtructure caused by LPS when compared with UTI group and GHL group. The UTI+GHL group markedly increased expres-sion of RD-5 and TFF3 mRNA than those of UTI and GHL group in small Intestinal mucosal tissue (P<0. 05). Both the GHL group and the UTI+GHL group significantly enhanced the function of intestine motility,but the propulsion rate of UTI+GHL group was significant higher than that of GHL group(P<0. 05). In LPS group,the level of TNF-α、IL-6 and HMGB1 both in serum and intestinal mucosa tissue were markedly increased(P<0. 05),but those of UTI group,GHL group and UTI+GHL group were significantly decreased when compare to LPS group after the drugs administration at 12 and 24 hours. Conclusion UTI combined with GHL can significantly improve the intestinal func-tion of mucosal barrier and the motor through the inhibition of both systemic and intestinal mucosal inflammatory reaction in the process of en-dotoxemia.
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Objective To study the effects of large dose anisodamine (654-2) combined with ulinastain on severe acute pancreatitis (SAP).Methods 100 healthy adult SD rats which were fasted 12 hours before experiment and were allowed drinking water freely,were divided to 5 groups randomly (random number):normal control group,SAPgroup,SAP + Ulinastain group,SAP + Anisodamine group,SAP +Ulinastain + Anisodamine,there were 20 rats in every group.To observe the levels of diastase,phospholipase A2 (PLA2) and endotoxin and pathology of rats in every group.Another cohort of 60 SD rats were divided into 3 groups:SAP group,SAP + Ulinastain group,SAP + Ulinastain + large dose Anisodamine group,survival periods were observed.Results The levels of diastase,PLA2 and endotoxin in SAP rats were higher than those in 3 SAP with treatment groups (P ＜ 0.05).The histopathological changes were most severe in SAP group.All of 3 markers in 3 SAP with treatment groups decreased obviously,and anisodamine alone was effective to treat SAP,but the effect of UTI + 654-2 was better than UTI or 654-2 alone,and histopathological changes were mild in this group treated with UTI + 654-2.Conclusions Anisodamine could effectively relax the Oddi sphincter thereby decreasing the hydrostatic pressure inside the bile duct and pancreatic duct.Ulinastain is a kind of proteinase inhibitor suppressing many kinds of enzymes and in tern to stabilize lysosomal membrane and inhibit the release of lysosomal enzyme.Combination of the large dose Anisodamine with Ulinastain could inhibit the overexpression of inflammationarv factors in SAP,thereby lessening the severity of viscera injury.
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ObjectiveLevosimendan,a new calcium ion sensitizer,is currently used in the treatment of heart failure and as an option for patients with injury to the left heart or at high risk for surgery.The study tried to evaluate the effects of levosimendan and ulinastain for protecting myocardium from ischemia-reperfusion (I/R) injury to the isolated immature rabbit hearts and investigate the possible mechanism.MethodsFifty New Zealand long-ear white immature rabbits were anesthetized and heparinized.Their hearts were rapidly removed and mounted on modified Langendorff apparatus.A left ventricle pressure monitoring line was inserted through the left atrial and mitral valve.The hearts were equilibrated with oxygenated K-H solution at 37℃ for 10 minutes.The rabbit hearts were randomly divided into 5 groups with 10 hearts in each group.Hearts in group C were perfused with K-H solution,in group U were perfused with ulinastain (50000 U/kg),in group LI were perfused with Levosimendan 0.1 μmol/L,in group L2 were perfused with Levosimendan 0.3 μmol/L,and in group L + U were perfused with Ulinastain (50 000 U/kg) and Levosimendan 0.1μmol/L.The hearts were arrested with St-Thomas solution for 30 min.Hearts in each group underwent 30 min-reperfusion with the same solutions after 30 min-global myocardial ischemia.Heart rate ( HR) Jeft ventricular pressure ( LVP) and LVdp/dtMax were monitored.Effluent from coronary sinus was collected at time of ischemia /reperfusion for measuring the concentration of TNF-α,IL-6,CK and cTnI.ResultsLVP and LVdp/dt in group L1,L2 and L + U were better than those in group C and U.But the heart rates in group L2 were higher than in other groups.Concentrations of CK,cTnI,TNF-α and IL-6 in the effluent from coronary sinus at 0、10 and 30 min of reperfusion were significantly lower in group L + U than in the other groups.ConclusionLevosimendan may have the similar effects with ulinastain in reducing the reperfusion injury to the immature myocardium.The protective effect of levosimendan (0.1 μmol/L) in combination with ulinastain (50 000 U/kg) was better than that of levosimendan or ulinastain alone.
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Objective To investigate the effect of microcireulation blood flow and altering immunity by Chuanxiongqin,ulinastain and thymosin α1 on sepsis patients.Methods 90 patients were randomly divided into 3 groups(n=30),namely ICU group,Chuanxiongqin group,ulinastain and thymosin α1 group.HLA-DR/CD14+and IL-6,TNF-α,Lac,DD were measured.Results (1)DD showed no significant difference at every time point between ICU group and ulinastain+thymosin α1 group(P＞0.05).DD decreased in Chuanxiongqin group,and was significantly different from the others on the third day.(2)Lac unchanged significantly at every time point in ICU group(P＞0.05).Lac in Chuanxiongqin group and ulinastain+thymeain α1 group tended to decrease,and was statistically different from ICU group on the second day.(3)IL-6 and TNF-α tended to increase at every time point in ICU group(P＜0.05).In ulinastain+thymosin α1 group,IL-6 and TNF-α returned to the level before treatment,HLA-DR/(D14+increased significantly,and was higher than Chuanxiongqin group and ICU group statistically.Conclusion Chuanxiongqin could ameliorate circulation;ulinastsin and thymosin α1 could depress IL-6,TNF-α.So ulinastain and thymosin α1 might protect the immunity of sepsis patients.
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Objective To investigate the incidence of systemic inflammatory response syndrome(SIRS) after cardiopulmonary resuscitation(CPR) and to observe the effect of Ulinastain in inhibition of inflammatory mediator.Methods Forty patients surviving more than 48 hours after CPR were divided into Ulinastain and control groups randomly. Activity of nuclear factor kappa B(NF-?B), IL-6,TNF-? of the patients was detected .All patients were evaluated by SIRS diagnosis standard and their general organ function was examined. All data were compared between two groups.Results Activities of NF-?B, IL-6,TNF-? of patients after CPR was significantly higher than that of normal people (P
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Objective To investigate the incidence of systemic inflammatory response syndrome(SIRS)after cardiopulmonary resuscitation(CPR)and to observe the effect of ulinastain in inhibition of inflammatory mediator.Methods Thirty-two patients surviving more than 72 hours after CPR were divided into ulinastain group and control group randomly.Activity of TNF-? and IL-6 of these patients was detected.In the meantime,all patients were evaluated by SIRS diagnosis and all data were compared between two groups.Results Activities of TNF-? and IL-6 in patients after CPR were significantly higher than that of normal people(P