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Objective:To investigate the efficacy of phenolamine in the treatment of sepsis-induced myocardial dysfunction and its effect on cardiac function, myocardial injury index, and hemodynamics in patients.Methods:The clinical data of 79 patients with sepsis-induced myocardial dysfunction who received treatment in Huangshi Central Hospital, Edong Healthcare Group from February 2017 to February 2020 were retrospectively analyzed. These patients were divided into a control group (without phenolamine treatment, n = 41) and an observation group (with phenolamine treatment, n = 38) according to whether they received phenolamine treatment or not. Clinical efficacy, cardiac function, myocardial injury index, and hemodynamic index pre- and post-treatment were compared between the two groups. Results:There was no significant difference in 28-day mortality rate between the two groups ( P > 0.05). Intensive care unit length of stay and mechanical ventilation duration in the observation group were (9.33 ± 3.52) days and 83.00 (28.50, 138.00) hours, which were significantly shorter than (12.17 ± 4.15) days and 111.00 (47.50, 169.00) hours in the control group ( t = 3.26, Z = -2.27, both P < 0.05). The response rate in the observation group was significantly higher than that in the control group [81.58% (31/38) vs. 60.98% (25/41), χ2 = 4.05, P < 0.05]. After 7 days of treatment, the left ventricular ejection fraction in each group was significantly increased, and the left ventricular end-diastolic diameter and left ventricular end-systolic diameter in each group were significantly decreased compared with before treatment (all P < 0.05). After 7 days of treatment, the left ventricular ejection fraction in the observation group was significantly higher than that in the control group ( t = 3.29, P < 0.05), and left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly lower than those in the control group ( t = 5.94, 11.21, both P < 0.05). N-terminal pro-brain natriuretic peptide and cardiac troponin I levels in each group were significantly decreased with time (both P < 0.05). At 24 and 72 hours and 7 days after treatment, N-terminal pro-brain natriuretic peptide and cardiac troponin I levels in the observation group were significantly lower than those in the control group (both P < 0.05). After 7 days of treatment, heart rate in each group decreased significantly compared with that before treatment (both P < 0.05), mean arterial pressure, cardiac index, and stroke output index in each group increased significantly compared with those before treatment (all P < 0.05). After 7 days of treatment, heart rate in the observation group was significantly lower than that in the control group ( t = 4.90, P < 0.05), and mean arterial pressure, cardiac index, and stroke output index in the observation group were significantly higher than those in the control group ( t = 4.37, 3.23, 6.01, all P < 0.05). Conclusion:Phentolamine can improve hemodynamics, reduce myocardial injury and improve cardiac function in patients with sepsis-induced myocardial dysfunction.
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Objective:To analyze blood transfusion and prognostic factors of extracorporeal membrane pulmonary oxygenation (ECMO) for the treatment of respiratory and circulatory failure.Methods:The clinical data of 80 patients with respiratory and circulatory failure who received treatment in Huangshi Central Hospital from March 2016 to July 2021 were retrospectively analyzed. According to 28-day prognosis, these patients were divided into death group ( n = 44) and survival group ( n = 36). The general data, blood transfusion during the process of ECMO, vital signs, laboratory indicators, ventilation time, and length of hospital stay were compared between the two groups. The factors affecting death during the process of ECMO were analyzed. Results:There were no significant differences in sex, age, body mass index, complications, the cause of respiratory and circulatory failure, and the mode of ECMO between the two groups (all P > 0.05). Preoperative Acute Physiology and Chronic Health Evaluation II score, creatinine, procalcitonin and lactic acid levels in the survival group were (22.36 ± 3.71) points, (79.17 ± 9.29) μmol/L, (2.77 ± 0.79) ng/L, (2.74 ± 0.36) mmol/L, respectively, which were significantly lower than (34.27 ± 4.98) points, (94.16 ± 10.23) μmol/L, (3.69 ± 1.10) ng/L, (5.18 ± 0.42) mmol/L, respectively in the death group ( t = -11.89, -6.79, -5.62, -27.53, all P < 0.001). There were no significant differences in preoperative respiratory frequency, diastolic pressure, systolic pressure, heart rate, oxygenation index (PaO 2/FiO 2) and C-reactive protein between the two groups (all P > 0.05). The volume of blood transfused on the day of undergoing ECMO, the volume of blood transfused on the day of withdrawing ECMO, the volume of blood transfused during the whole process of ECMO, duration of ventilation, and the incidence of complications related to ECMO were(98.74 ± 16.28) mL, (37.23 ± 10.36) mL, (398.79 ± 67.81) mL, (210.39 ± 20.21) hours, 38.89% (14/36), respectively, which were significantly lower than (160.17 ± 23.14) mL, (48.26 ± 12.25) mL, (600.23 ± 70.12) mL, (320.14 ± 18.21) hours, 79.55% (35/44), respectively in the death group ( t = -13.43, -4.29, 4.94, 25.25, χ2 = 13.79, all P < 0.001). The length of hospital stay in the survival group was longer than that in the death group [(20.14 ± 5.36) days vs. (14.17 ± 4.23) days, t = 5.56, P < 0.001). Acute Physiology and Chronic Health Evaluation II score, procalcition level, the volume of blood transfused on the day of ECMO, duration of ventilation, and the volume of blood transfused during the whole process of ECMO are risk factors for death after ECMO, while length of hospital stay is a protective factor for ECMO. Conclusion:Preoperative evaluation of Acute Physiology and Chronic Health Evaluation II score, continuous blood transfusion during the whole process of ECMO, grasping the opportunity of ventilation and preventing against complications of ECMO are the keys to increasing the survival rate of patients with respiratory and circulatory failure.
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Objective To transfect the recombinant mIL-28A adenovirus vector into lung adenocarcinoma cell line LA795 and research its anticancer activity. Methods Transfected the constructed mouse IL-28(mIL-28) recombinant adenovirus vector into LA795 cell line, detected with PCR, immunocytal fluorescence, Tunel, Annexin V and MTT. Results Transfected with rAd-mlL-28A into the LA795 cells, mIL-28A gene expression products mRNA increased obviously, IL-28 expression was detected in cells obviously,apoptosis cell number increased, and the growth of LA795 cells transfected with rAd-mIL-28A were inhibited obviously. Conclusion The recombinant miL-28A adenovirus vector we have constructed, which expresses IL-28 when transfected to lung adenocarcinoma cell line LA795, inhibits growth of carcinoma cell to some extent, and may work by promoting the apoptosis of cancer cells.
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Objective To express mouse IFN-λ2 stably and study its biological activity. Methods Full-length of mIFN-λ2 cDNA was obtained by using RT-PCR from cells of mouse spleen stimulated by ve-sicular stomatitis virus(VSV) and then subcloned to eukaryotic expressing vector PCAGG-EGFP. The recom-binant was transfected into CHO cells. VSV * GFP-B16 system was used to measure the antivirus activity. The constructed cell line MDBK-Mxp-Luc was used to study the character of Mx1 protein induced by the mIFN-λ2. Results The recombinant pMD18-T-mIFN-λ2 was digested by two kinds of enzyme, Sac I and Xho I, to produce the fragment was of 582 bp, and of which the sequence analysis of sequence shows it was entirely consistent with the nucleotide sequences reported in GenBank. PCAGG-EGFP-mIFN-λ2 eukaryotic expressing vector was constructed successfully and expressed stably in CHO cells, and the mRNA of mIFN-λ2 was verified expressing in CHO-PCAGG-EGFP-mIFN-λ2 cell line by RT-PCR. The antivirus activity of in the supernatant secreted by the CHO-PCAGG-EGFP-mIFN-λ2 cell line was 10~4 AU/ml. The mIFN-λ2 pro-tein can could induce the expression of the antivirus protein Mx1, and the expression of Mx1 protein induced by mIFN-λ2 enhanced with time going, 9 to 12 hours achieved the peak, 24 hours vanished. Conclusion Gene cloning of mIFN-λ2 was successful. The eukaryotic expressing vector of mIFN-λ2 was constructed suc-cessfully and expressed stably in CHO cells, and its product has obvious antivirus activity in vitro. And the antivirus activity of the product was closely correlated with inducing expression of antivirus protein Mx1.