Four criteria for evaluating biomarkers of immunosuppression in sepsis / 中华检验医学杂志

Immunosuppression is a key element of poor prognosis in patients with sepsis. The immune status assessment is a prerequisite for identifying immunosuppressed patients and clarifying the timing of immunotherapy. Exploring biomarkers for immune status assessment in sepsis has become a current hot spot. However, the availability of a large number of biomarkers in recent years has presented clinicians with a selection problem. There is four criteria for ideal biomarkers of sepsis immunosuppression for the screening of potential biomarkers of sepsis immunosuppression.

The prognostic value of myoglobin difference in sepsis related chronic critical illness / 中华内科杂志

Objective:To investigate the predictive value of myoglobin (Mb) for the prognosis of sepsis related chronic critical illness (CCI).Methods:Retrospective study was conducted on septic patients with the length of ICU stay equal or greater than 14 days, and sepsis-related organ failure assessment (SOFA) score equal or greater than 2 on the 14th day in ICU in the First Department of Critical Care Medicine at the First Affiliated Hospital of Sun Yat-sen University from January 2017 to March 2020. Patients′ clinical and laboratory data were collected on the 1st and 14th day in ICU. The survival on day 28 in ICU was recorded. According to the myoglobin levels on day 1 and day 14, all subjects were divided into myoglobin elevation group and decline group. Kaplan-Meier survival curve was used to compare the cumulative survival rate at day 28. Cox regression analysis was used to analyze the independent risk factors of mortality. Receiver operating characteristic (ROC) curve was used to analyze the prognostic value of myoglobin.Results:A total of 131 patients with sepsis related CCI were recruited, including 58 patients in the elevation group and 73 in the decline group. The Mb level in elevation group on day 1 was significantly lower than that in decline group [172.40(59.99, 430.53) μg/L vs. 413.60(184.40, 1 328.50) μg/L, Z=3.749, P=0.000], and the Mb level on day 14 was the opposite change in two groups [483.65(230.38, 1 471.75)μg/L in elevation group vs. 132.20(76.86, 274.35)μg/L in decline group, Z=5.595, P=0.000]. Kaplan-Meier survival curve analysis showed that the 28-day cumulative survival rate of the elevation group was significantly lower than that of decline group (χ2=7.051, P=0.008). Cox ratio regression analysis suggested that elevated myoglobin was an independent risk factor for 28-day mortality in septic patients with CCI ( OR=2.534, 95% CI 1.212-5.295, P=0.013). ROC curve analysis suggested that the sensitivity of myoglobin elevation in predicting mortality related to CCI within 28 days was 64.5%, and the specificity was 32.0% with area under the curve(AUC) 0.661(95% CI 0.550-0.773, P=0.007) and Jorden Index was 0.325. Conclusion:Elevated myoglobin, an independent risk factor for mortality within 28 days in ICU, can predict the prognosis of sepsis related chronic critical illness.

Practice of improving the management quality of critical care medicine based on informatization / 中华医院管理杂志

Informatization plays an important role in the management of clinical diagnosis and treatment. However, due to the specialty of the discipline, the informatization construction of critical care medicine(CCM)is faced with such problems as the inefficient application of data, the low compliance of diagnosis and treatment operation, and the lack of intelligent quality control tools. The authors discussed the new mode of CCM information management based on data driven. By upgrading clinical information system, establishing single disease control system, introducing comprehensive intelligent analysis platform and building open remote platform, the bottleneck of CCM informatization was broken. The information collection and interaction in ICU was realized, the automatic monitoring and early warning of diagnosis and treatment process was realized, the operation of medical staff according to the guidelines was effectively improved, and the ability of diagnosis and treatment and management efficiency was improved.Furthermore, the homogenization of regional critical medical information could be promoted.

Prevalence of nutritional risk among 1 500 hospitized patients with gynecologic tumor / 中华临床营养杂志

Objective:To investigate the prevalence of nutritional risk among hospitalized patients with gynecologic tumor and provide a reference for nutritional intervention.Methods:Hospitalized patients with gynecologic tumor in a grade A class 3 hospital in Beijing were consecutively enrolled from December 2016 to December 2017. Nutritional risk was measured by nutritional risk screening 2002(NRS 2002)within the first 24 h after admission. The relevant influencing factors were analyzed.Results:A total of 1 500 hospitalized patients who met entry criteria and obtained informed consent were consecutively enrolled. The prevalence of nutritional risk was 23.1%, and 53.1 % patients had at least one nutrition-related problem. The analysis of relevant influencing factors showed that patients of age under 30 years and over 50 years( χ2=108.014, P<0.01), malignancy( χ2=112.197, P<0.01), low differentiation pathological type( χ2=251.392, P<0.01), chemotherapy( χ2=339.999, P<0.01)accompanied with vomiting( χ2=121.402, P<0.01), diarrhea( χ2=49.920, P<0.01)had the relatively high prevalence rate of nutritional risk. Pathological stage and operation had no significant effect( P>0.05). Conclusions:The prevalence of nutritional risk among hospitalized patients with gynecologic tumor is relatively high. The main relevant influencing factors include age, kinds of diseases, pathological type, chemotherapy, vomiting and diarrhea.

Correlation between oxidative stress factors and prognosis of patients with sepsis / 中华危重病急救医学

Objective To investigate the relationship between plasma oxidative stress factors levels and organ damage parameters as well as prognosis in patients with sepsis. Methods A case-control study was conducted. Twenty-five patients admitted to surgical intensive care unit (ICU) of the First Affiliated Hospital of Sun Yat-sen University from March to December in 2016 and diagnosed as sepsis were enrolled as study subjects. Another 15 patients without sepsis admitted to surgical ICU in the same period were enrolled as controls. General demographic data, main diagnoses, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score within 24 hours, clinical laboratory indicators [alanine aminotransferase (ALT), aspartate transaminase (AST), serum creatinine (SCr), blood urea nitrogen (BUN), C-reactive protein (CRP), procalcitonin (PCT), white blood count (WBC)] and oxidative stress indicators [superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide (NO)] as well as length of ICU stay, total hospital stay and 28-day mortality were recorded. Spearman or Pearson correlation method was used to analyze the correlation between oxidative stress indicators and organ damage indicators as well as prognosis in patients with sepsis. Receiver operator characteristic (ROC) curve was plotted to evaluate the predictive value of oxidative stress indicators for 28-day mortality in patients with sepsis. Results The length of ICU stay in sepsis group was significantly longer than that in non-sepsis group [days: 7.0 (5.5, 11.0) vs. 4.0 (1.0, 11.0), P < 0.05], and AST, BUN, CRP, PCT, plasma MDA and NO levels were significantly higher than those in non-sepsis group [AST (U/L): 50.76±19.53 vs. 28.53±14.02, BUN (mmol/L): 9.99±5.26 vs. 6.97±4.32, CRP (mg/L): 109.28±42.79 vs. 60.33±46.68, PCT (μg/L): 5.4 (0.3, 24.0) vs. 0.6 (0.1, 1.5), MDA (ng/L): 488.31±76.68 vs. 399.30±50.23, NO (ng/L): 5.08±0.89 vs. 4.42±0.88, all P < 0.05]. There was no significant difference in gender, age, APACHEⅡ score, total hospital stay, 28-day mortality, ALT, SCr, WBC or plasma SOD activity between the two groups. The correlation analysis between oxidative stress parameters and organ damage parameters as well as prognosis in patients with sepsis showed that MDA and NO were positively correlated with SCr (r value was 0.426 and 0.431, respectively, both P < 0.05), and there was a positive correlation between MDA and NO (r = 0.990, P < 0.01); plasma SOD activity was negatively correlated with 28-day mortality (r = -0.468, P < 0.05), while MDA and NO levels were positively correlated with 28-day mortality (r value was 0.598 and 0.611, respectively, both P < 0.01). ROC curve analysis showed that plasma SOD, MDA and NO levels had a good independent predictive effect on 28-day mortality, the area under ROC curve (AUC) was 0.816±0.087, 0.904±0.078 and 0.912±0.071, and the best cut-off value was 40.76% (sensitivity 68.4%, specificity 100%), 487.93 ng/L (sensitivity 83.3%, specificity 89.5%) and 5.31 ng/L (sensitivity 83.3%, specificity 89.5%), respectively. Conclusions The plasma levels of oxidative stress factors in patients with sepsis are significantly increased, which is closely related to organ damage and poor prognosis. The plasma SOD, MDA and NO levels can be used as independent bio-marker to predict the 28-day mortality of patients with sepsis.

Protective effects of P2X7 receptor inhibition in cerebral ischemia/reperfusion injury in rats / 中南大学学报(医学版)

To investigate the protective effects of P2X7 receptor (P2X7R) inhibitor against cerebral ischemia/reperfusion (I/R) injury in rats and the possible mechanisms.
 Methods: The neurological deficit of rats was evaluated by Longa score. The infarct volume was examined by 2, 3, 5-triphenyltetrazolium chloride (TTC) staining. The expression levels of extracellular signal-regulated kinase (ERK), phosphorylation extracellular signal-regulated kinas p-ERK), connexin 43 (Cx43), Bax, Bcl-2 and cleaved caspase-3 were detected by Western blot.
 Results: Compared with sham group, the neurobehavioral score (P<0.05) and cerebral infarct volume (P<0.01) of rats in I/R group was increased. Compared with I/R group, brilliant blue G (BBG, the antagonist of P2X7R) or PD98059 (the inhibitor of EKR kinase) could reduce the neurobehavioral score (P<0.01) and cerebral infarct volume significantly (P<0.05). The neurobehavioral score and cerebral infarct volume was further decreased (P<0.05) when rats were treated with both BBG and PD98059. Compared with I/R group, the expression levels of p-ERK, Cx43, cleaved caspase-3 and the ratio of Bax/Bcl-2 were decreased by BBG or PD98059 pretreatment, and the protective effects were further enhanced when rats were treated with both BBG and PD98059 (P<0.05).
 Conclusion: Inhibition of P2X7R reduces the cerebral I/R injury of rats. ERK inhibition is probably involved in the protective effects of P2X7R inhibitor against cerebral I/R injury, which may be related to the reduction of Cx43 and cleaved caspase-3, and the ratio of Bax/Bcl-2.

Separation and Extraction of Total Flavonoids from Dendrobium nobile Leaves and Study on Its Anti-Alzheimer's Disease Activity in vitro / 中国药房

OBJECTIVE: To separate and isolate total flavonoids from Dendrobium nobile leaves, and to investigate its anti-Alzheimer's disease (AD) activity in vitro. METHODS: Total flavonoids were obtained by ultrasonic extraction method and extracted by chloroform, ethyl acetate and butyl alcohol after the obtained extract was dispersed with water. Qualitative analysis was carried out with color reaction and TLC. The content of total flavonoids in extracts was analyzed quantitatively by Aluminum nitrate-sodium nitrite method. Antioxidant activity of extract was investigated by DPPH radical scavenging assay; the inhibitory effect of each extract on Aβ42 protein aggregation was investigated by Thioflavin T assay. Metals (Cu2+, Fe3+, Zn2+) chelating property was studied by UV-vis spectrum scanning to investigate the anti-AD activity in vitro. RESULTS: The flavonoids were found in ethyl acetate, butyl alcohol and aqueous extracts, and their flavonoids contents were 0. 03, 0. 12, 0. 05 mg/mL, respectively. IC50 of three extracts to DPPH free radicals were 0. 021, 0. 011, 0. 013 mg/mL. Inhibitory rates of them to Aβ42 protein aggregation were 43. 77％, 52. 28％, 38. 42％, respectively. Three extracts exerted metal chelating ability which was best in Cu2+. CONCLUSIONS: The total flavonoids from D. nobile leaves have good antioxidant activities, Aβ42 aggregation inhibitory activities and metal chelating activity, show certain anti-AD activity in vitro especially in butyl alcohol extract.

Application of endoscopy-guided titanium clip placement in precision radiotherapy for early esophageal cancer / 中华放射肿瘤学杂志

Objective To evaluate the application of the placement of titanium clips in the upper and lower tumor margins in precision radiotherapy for early esophageal cancer. Methods:Seventeen patients with early esophageal cancer underwent endoscopy-guided implantation of titanium clips to mark the upper and lower tumor margins. CT-based simulation was performed to delineate the gross tumor volume ( GTV) . The application value of this technology in precision radiotherapy was evaluated. Results:For all patients (including 13 cases with initial treatment and 4 patients requiring radiotherapy after endoscopic resection), the esophageal tumors were not explicitly displayed on CT and barium meal images and the GTV range could not be accurately determined. The esophageal tumors were marked by successful placement of at least one titanium clip in the upper and lower tumor margins. Subsequently, the esophageal tumors were successfully displayed on CT simulation and the target area was accurately delineated. No grade 3-4 adverse events, such as bleeding and perforation occurred. Conclusion Endoscopy-guided titanium clip placement is convenient and feasible for early esophageal cancer, which is of clinical significance for determining the target area of radiotherapy.

Rapid Surface-Enhanced Raman Spectroscopic Detection of Blood Cyanide Based on Pinhole Shell-Isolated Nanoparticleand Online Lysis-Purging and Trapping Approach / 分析化学

A rapid and simple method for the determination of cyanide in blood was developed based on pinhole shell-isolated nanoparticles (pinSHINs)-enhanced Raman spectroscopy and an online lysis-purging and trapping approach.In the online lysis-purging and trapping device, the bound cyanide in blood can be cleaved through sulfuric acid acidification, and transferred into HCN volatile gas, then purged into alkaline solution to form NaCN solution, thus high-efficient liberation and entrapment of cyanide from the methemoglobin-bound form can be achieved.The pinSHINs substrate is quite stable to weaken the gold-dissolution effect caused by cyanide under strong alkaline condition, and therefore the detection window can be prolonged to 1 h comparing with 5 min of AuNPs.A limit of detection down to 10 μg/L and a linear range from 100-2000 μg/L in blood were achieved in this method.This method was further applied to rapid measurement of blood samples of cyanide exposed rats and clinic poisoned patients, which provided a sensitive, selective and reliable way for rapid detection of cyanide poisoning.

Investigation and Analysis of Internships and Employment Intention of Pharmacy Junior Students in Our University / 中国药房

OBJECTIVE:To provide evidence for strengthening education and training before clinical practice and employment guidance among pharmacy junior students of our university. METHODS:Anonymous questionnaire survey was conducted for our university. Questionnaire survey included student employment intention and internship units,relationship of internships with employ-ment,the tendency of employment after graduation,personal attitude about pharmaceutical professional development prospect,ex-pected monthly income in the first year of their career,etc. RESULTS:Totally 71 questionnaires were sent out,71 were effectively received. Among all respondents,74.3%(52 students)believed employment intention had great relationship with internship units;24.3%(17 students)thought employment intention had not great relationship with internship units;moreover,one student thought employment intention had no any relationship with internship units. Most students(94.3%,66 students)with good attitude on in-ternships believed it could accumulate work experience;32.9%(23 students) thought they could stay in the internship unit after practice;moreover,17.1%(12 students) believed practice had little effect on employment. Among them,94.0%(63 students) tended to be employed after graduation,and only 6.0% chose a graduate school to continue their studies. Among the students who chose employment after graduation,76.1%(51 students)tended to engage in pharmaceutical related work,while 17.9%(12 stu-dents) tended to be engaged in work nothing to do with pharmacy or self-employed. The majority (69.6%,48 students) believed that pharmaceutical major prospect was general and pharmaceutical major development varied from person to person;17.4%(12 students)thought pharmaceutical major had good prospect and was promising;13.0%(9 students)believed that pharmaceutical ma-jor had no good prospect and didn't know its prospect. Most of the students(78.2%,54 students)expected a monthly income of 2500-5000 yuan in the first year of their career;18.9%expected a monthly income more than 5000 yuan(13 students);the minor-ity expected a monthly income of 1500-2500 yuan or more than 8000 yuan. CONCLUSIONS:The view of students on internship and employment have a certain gap with the social situation. Related departments of colleges and universities need to adjust the thought of students and strengthen guidance.

Learning curve for transesophageal echocardiography applied in mechanically ventilated patients in intensive care unit / 中国中西医结合急救杂志

Objective To investigate the learning curve of transesophageal echocardiography (TEE) applied in mechanically ventilated patients in intensive care unit (ICU).Methods A prospective observation study was conducted. A total of 60 consecutive patients necessary for mechanical ventilation and TEE examination admitted to the Department of Surgical ICU of the First Affiliated Hospital of Sun Yat-Sen University from December 2016 to June 2017 were enrolled. The TEE examination was performed by the same ICU physician who was skilled in transthoracic echocardiography (TTE). The TEE probe intubation (trial numbers of TEE intubation, the duration for a successful intubation at the first attempt, the total time for successful intubation), TEE examination (the scores of TEE examination, the duration of TEE examination), and the complication during examination were observed, with learning curve established. According to the date of examination, a statistical analysis was carried out for each group of 12 cases. Through the learning curve, that TEE examinations in how many cases should be performed by the ICU physician to master the skill was observed.Results With the increase of TEE examinations performed by the physician, the duration for a successful intubation at the first attempt and the total time for successful intubation were gradually reduced; the scores of TEE examination were gradually increased, and the duration of TEE examination gradually reduced. ① TEE intubation: there was no statistical significant difference among the 60 patients in the number of intubation attempts (F = 0.258,P = 0.904). After the SICU doctor completed TEE intubations in 12 cases, the duration for a successful intubation at the first attempt was significantly reduced (seconds: 22.24±18.37 vs. 34.88±1.65,P < 0.05) and then tended to stabilize in the 16 - 23 seconds. The learning curve indicated that the physician could basically master the intubation skills after performing TEE intubations in 24 cases. ② TEE examination: after the physician completed TEE intubations in 24 cases, the TEE examination scores were increased significantly (40.08±7.27 vs. 23.67±9.70,P < 0.05), and then tended to stabilize in the 40 - 47 scores; after TEE intubations were performed in 24 cases, the examination duration was significantly shortened (minutes: 39.97±6.67 vs. 58.22±14.19,P < 0.05), and after 36 cases were completed, the duration could be further shortened (minutes:31.04±7.84 vs. 39.97±6.67,P < 0.05). The learning curve indicated that the ICU physician could basically master the examination skills when TEE examinations were completed in 36 cases. In addition, no serious complications occurred during the TEE examination.Conclusions A SICU physician with skilled TTE experience can basically master the TEE technology through 36 times of examinations, and reach full mastery after 48 times, the duration for a successful intubation at the first attempt could be stabilized at 20 seconds, and the examination duration could be stabilized at 30 minutes.

Role of epidermal growth factor in ocular diseases / 眼科新进展

Epidermal growth factor (EGF) is a multifunctional growth factor,which is widely expressed in most ocular tissues including cornea,retina and sclera.It may regulate the growth and proliferation of various ocular cells with the interaction of epidermal growth factor receptor in vitro or in vivo.This article reviews the role of EGF in pathological and physiological processes of ocular diseases,including corneal injury,retinal proliferative diseases,myopia,pterygium,glaucoma,cataract,and eye tumors.

Preparation of divinylsulfone-glutathione adducts and their reactive activities with DNA in vitro / 中国药理学与毒理学杂志

OBJECTIVE To prepare the glutathione adducts of divinylsulfone (DVS), which is an important oxidative metabolism product of SM in vivo, and to investigate their reactive capability with DNA in vitro. METHODS The mustard sulfoxide (SMO) and mustard sulfone (SMO2) were prepared by oxidation reaction using HNO3 and KMnO4 as oxidants, respectively. Then, DVS was prepared through dechlorination reaction using CaCO3 under alkaline conditions. Furthermore, the DVS-GSH adduct and DVS-GSH-purine adducts were prepared and identified using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS/MS) and nuclear magnetic resonance (NMR). Finally, the adduct reac?tion process of DVS with GSH was monitored using UPLC-MS/MS. RESULTS The DVS-GSH and GSH-DVS-purine adducts were obtained through preparative HPLC and characterized using NMR and high-resolution MS. In aqueous solution, the reactive activity of DVS with GSH was significantly higher than that of SM, and the DVS-GSH adduct had high or reactive activity, which could produce a series of adducts with adenine and guanine in DNA, and the abundance of the adenine adducts was higher than that of the guanine. CONCLUSION DVS-GSH adducts still have high reactive activity with DNA, and more attention should be paid to its potential damage to DNA.

Inhitory effect of electroacupuncture on acetylcholine M1 receptor expression in visual cortex of guinea pigs with lens-induced myopia / 中华实验眼科杂志

Background It has not been reported that if the visual cortex M receptor changed during the development of myopia and how it changed if given acupuncture treatment.Objective The aim of this study was to observe the effect of electroacupuncture stimulation on the expression of acetylcholine receptors M1 (AchRM1) in visual cortex of guinea with lens-induced myopia (LIM).Methods Forty-eight three-week-old healthy guinea pigs were randomized into the normal control group,the LIM model group and the LIM electroacupuncture group.The right eyes of the guinea pigs were selected as the experimental eyes.LIM was created by monocularly wearing of-10 D lens for 4 weeks in the right eyes in the LIM model group and LIM electroacupuncture group,and then the acupuncture at the temple and hegu point was performed for 30 minutes per day for consequent 4 weeks,in the LIM electroacupuncture group.The fellow eyes of the guinea pigs were used as the self-control eyes.The refractive power and axial length were examined with retinoscopy and A-type sonography before and 4 weeks after modeling,respectively.The animals were sacrificed by excessive anesthesia at the fourth week after acupuncture and visual vertex tissue was obtained.The expression of M1 receptor mRNA in visual vertex was detected by fluorescence quantitative PCR,and the content of M1 receptor protein in visual vertex was assyed by ELISA.The study protocal was approved by Animal Ethic Committee of Shandong University of Traditional Chinese Medicine,and the use and care complied with Statement of the Association for Research in Vision and Ophthalmology.Results At the fourth week after modeling,the mean diopters were (-3.24±0.28) D and (-3.30±0.45) D in the LIM model group and the LIM eleetroacupuncture group,which were significantly higher than (0.83 ±0.86)D in the normal control group (both at P=0.000),and there was no significant difference in the diopter between the LIM model group and the LIM electroacupuncture group (t =0.200,P =0.659).The mean axial lengths were (8.67 ±0.14) mm and (8.60±0.06) mm in the LIM model group and the LIM electroacupuncture group,which were considerably increased in comparison with (8.33±0.08)mm in the normal control group (both at P＜0.05).The relative expression levels of AchRM1 mRNA in visual cortex were 0.79±0.18,1.36±0.23 and 1.13±0.13 in the normal control group,LIM model group and LIM electroacupuncture group,and the relative expression level of AchRM1 mRNA in the LIM electroacupuncture group was significantly higher than that of the normal control group and lower than that of the LIM model group (both at P＜0.05).In addition,the contents of AchRM1 receptor protein in the visual cortex were 248.00±33.31,455.17±42.40 and 396.17±47.57 in the normal control group,LIM model group and the LIM electroacupuncture group,with a similar pattern among the groups (both at P＜0.05).Conclusions A electroacupuncture stimmulation do not affect the myopic diopter and axial length in LIM model.The AchRM1 and AchRM1 receptor in the visual cortex up-regulate in LIM eyes,infering that electroacupuncture stimmulation can improve vision by decreasing the level of AchRM1 receptor in visual cortex in LIM eyes in guinea pigs.

The value of passive leg raising test in predicting fluid responsiveness in patients with sepsis-induced cardiac dysfunction / 中华危重病急救医学

ObjectiveTo assess the value of passive leg raising (PLR) test in predicting fluid responsiveness in patients with sepsis-induced cardiac dysfunction.Methods A prospective observational cohort study was conducted. Thirty-eight patients under mechanical ventilation suffering from sepsis-induced cardiac dysfunction admitted to Department of Surgical Intensive Care Unit of First Affiliated Hospital of Sun Yat-Sen University from September 2013 to July 2014 were enrolled. The patients were studied in four phases: before PLR (semi-recumbent position with the trunk in 45°), PLR (the lower limbs were raised to a 45° angle while the trunk was in a supine position), before volume expansion (VE, return to the semi-recumbent position), and VE with infusing of 250 mL 5% albumin within 30 minutes. Hemodynamic parameters were recorded in every phase. The patients were classified into two groups according to their response to VE: responders (at least a 15% increase in stroke volume,ΔSVVE≥15%), and non-responders. The correlations among all changes in hemodynamic parameters were analyzed by linear correlation analysis, and the receiver operating characteristic curve (ROC) was plotted to assess the value of hemodynamic parameters before and after PLR in predicting fluid responsiveness.Results Of 38 patients, 25 patients were responders, and 13 non-responders. There was no significant difference in the baseline and hemodynamic parameters at semi-recumbent position between the two groups. The changes in SV and cardiac output (CO) after PLR (ΔSVPLR andΔCOPLR) were significantly higher in responders than those of non-responders [ΔSVPLR: (14.7±5.7)%vs. (6.4±5.3)%,t = 4.304,P = 0.000;ΔCOPLR: (11.2±7.5)% vs. (3.4±2.3)%,t = 3.454,P = 0.001], but there was no significant difference in the changes in systolic blood pressure, mean arterial pressure, pulse pressure, and heart rate after PLR (ΔSBPPLR,ΔMAPPLR,ΔPPPLR andΔHRPLR) between two groups.ΔSVVE in responders was significantly higher than that of the non-responders [(20.8±5.5) % vs. (5.0±3.7) %,t = 8.347,P = 0.000]. It was shown by correlation analysis thatΔSVPLR was positively correlated withΔSVVE (r = 0.593,P = 0.000),ΔCOPLR was positively correlated withΔSVVE (r = 0.494,P = 0.002). The area under ROC curve (AUC) ofΔSVPLR≥8.1% for predicting fluid responsiveness was 0.860±0.062 (P = 0.000), with sensitivity of 92.0% and specificity of 70.0%; the AUC ofΔCOPLR≥5.6% for predicting fluid responsiveness was 0.840±0.070 (P = 0.000), with sensitivity of 84.0%and specificity of 76.9%; the AUC ofΔMAPPLR≥6.9% for predicting fluid responsiveness was 0.662±0.089, with sensitivity of 68.0% and specificity of 76.9%; the AUC ofΔSBPPLR≥6.4% for predicting fluid responsiveness was 0.628±0.098, with sensitivity of 76.0% and specificity of 61.5%; the AUC ofΔPPPLR≥6.2% for predicting fluid responsiveness was 0.502±0.094, with sensitivity of 56.0% and specificity of 53.8%; the AUC ofΔHRPLR≥-1.7%for predicting fluid responsiveness was 0.457±0.100, with sensitivity of 56.0% and specificity of 46.2%.Conclusion In patients with sepsis-induced cardiac dysfunction, changes in SV and CO induced by PLR are accurate indices for predicting fluid responsiveness, but the changes in HR, MAP, SBP and PP cannot predict the fluid responsiveness.

Comparison of cisplatin-resistant testicular cancer cell lines established by two methods / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the biological behaviors of two drug-resistant testicular cancer cell lines established by different methods.</p><p><b>METHODS</b>Drug-resistance was induced in testicular cancer cell lines exposure of the cells to increasing concentrations of or a high dose of cisplatin (I-10/DDPi and I-10/DDPh cell lines, respectively). The morphological characteristics of the two cell lines were observed microscopically. The resistance index of the cells was determined with MTT assay, and the cell growth curves were drawn. The cellular expression of resistance-associated proteins MDR1 and P-gp was detected by Western blotting. The cell invasion ability was assessed with Transwell assay.</p><p><b>RESULTS</b>Normal testicular cancer cell line I-10 and the two resistant cell lines all showed an adherent growth pattern. Compared with I-10 cells, I-10/DDP cells exhibited slightly heterogenous cell sizes, irregular shapes, the presence of microvilli tentacles on the cell surface, and a scattered arrangement. The cisplatin resistance index of I-10/DDPi and I-10/DDPh cells were 3.924 and 3.099, respectively. Compared with I-10, the drug-resistant cell lines showed extended doubling time with increased expressions of MDR1 and P-gp and increased cell invasiveness, which was especially obvious in I-10/DDPi cells.</p><p><b>CONCLUSION</b>Both increasing dose exposure and high-dose exposure to cisplatin can induce cisplatin resistance in testicular cancer cells, and the resistant cells established by the latter method better mimics clinical drug-resistant tumor cells.</p>

Effects of different doses in continuous veno-venous hemofiltration on plasma lactate in critically ill patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many studies have shown that continuous renal replacement therapy (CRRT) could clean lactate and treat the hyper-lactatemia. On the contrary, some other studies found that filter lactate clearance only accounted for a very small part of total lactate clearance and the hemofilter's contribution to the overall lactate clearance was negligible. The objective of this study was to evaluate the effects of various doses of continuous veno-venous hemofiltration (CVVH) on plasma lactate elimination in critically ill patients.</p><p><b>METHODS</b>Patients were divided into three groups according to their incipient plasma lactate concentration. Group A: lactate ≤ 2 mmol/L, group B: lactate 2-5 mmol/L, group C: lactate ≥ 5 mmol/L. Three different doses (20 ml × kg(-1)× h(-1), 35 ml × kg(-1)× h(-1) and 45 ml × kg(-1)× h(-1)) of CVVH were applied to critically ill patients who experiencing CVVH. The concentrations of plasma lactate in pre-(A), post-dialyzer (V) sites and ultrafiltrate were measured after each dosage of CVVH was carried out for 30 minutes. Rate of lactate clearance by the filter (RLC) and filter lactate clearance (FLC) and Lactate-Sieving Coefficient (LSC) were calculated under different circumstances, including different doses of CVVH and different incipient lactate levels.</p><p><b>RESULTS</b>Fifteen patients were enrolled and 104 blood samples were drawn and lactate concentrations were measured in this study. RLC was found increased ((9.36 ± 9.73) mmol/h, (13.92 ± 12.56) mmol/h and (16.52 ± 12.71) mmol/h, P < 0.05 respectively) with the dose of CVVH increased. RLC was also increased ((3.46 ± 1.46), (10.38 ± 5.50) and (24.53 ± 14.69) mmol/h, P < 0.05 respectively) with the incipient lactate increased. FLC was increased ((1.95 ± 0.63), (2.95 ± 0.74) and (3.45 ± 0.54) L/h, P < 0.05 respectively) with the dose of CVVH increased. There was no significant difference of LSC in different doses of CVVH and different incipient lactate levels.</p><p><b>CONCLUSIONS</b>Plasma lactate can be eliminated by CVVH and different doses of CVVH affect the rate of lactate clearance in critically ill patients.</p>

On-site Detection of Sulfur Mustard Based on Pinhole Shell-Isolated Nanoparticle-Enhanced Raman Spectroscopy / 分析化学

An on-site method for the determination of sulfur mustard ( SM) was developed based on pinhole shell-isolated nanoparticle-enhanced Raman spectroscopy. By using 0. 1 mol/L MgSO4 as effective agglomeration reagent, more Raman “hot spots” were induced, and thus a limit of detection for SM at 10 μg/L was achieved with a linearity of 10-1000 μg/L and an analytical enhanced factor of 1. 1×106. This method can be directly applied in the measurement of SM in environmental water samples with good sensitivity and reproducibility, and the standard addition recovery was between 88%-114%. Good differentiation of four SM related compounds, 2-chloroethyl ethylsulfide, thiodiglycol, bis-β-chloroethyl sulphoxide and bis-β-chloroethyl sulphone, was also obtained.

Research progress of choline and dopamine signaling pathways related to myopia / 中华实验眼科杂志

It was confirmed that acetylcholine signaling pathway and dopamine signaling pathway play critical roles in refractive development.Many evidences have supported that acetylcholine and its receptor antagonists were closely related to the formation of experimental myopia.Retinal dopamine signaling could exert a significant influence on refractive development,and its upregulation induced by light comprises an important component of the retinal clock network;meanwhile,the retinal dopamine signaling could also participate in the regulation of retinal circadian rhythms.The role of intrinsic retinal circadian rhythms in the developing process of myopia is gaining increasing attention.Moreover,it was also found that both acetylcholine and dopamine signaling pathways influence the development of myopia.Therefore,the present paper summarizes the two signaling pathways in the mechanisms of regulating myopia process,which provides an insight into the pathogenesis of myopia and clinical ideas for the effective prevention and treatment of myopia.

Establishment and application of medical method for quantification of genomic DNA methylation in methotrexate drug resistance cells / 中华检验医学杂志

Objective To establish a rapid and convenient method for determination of genomic DNA methylation in cells.Methods Five standard substances (dC, mdC, dA, dT and dG) were separated by high-performance capillary electrophoresis.Bare fused-silica capillary was used and eletrophoresis buffer was 48 mmol/L NaHCO3 with 60 mmol/L SDS, pH 9.6.The temperature of separation was controlled at 25 ℃ and a voltage of 20 kV was applied.The separation of the mixture was performed at a wavelength of 256 nm with UV-Vis detection and injection time was 5 seconds at 0.7 psi.Under optimal condition,genomic DNA methylation in methotrexate drug-resistant A549 cells was detected.Results The optimal condition was made by adjusting SDS concentration(40, 60, 80 mmol/L), pH value of running buffer(9.4,9.6, 9.8), voltage(15, 17, 19, 20, 22 kV), injection time(5, 10, 15, 20, 30 s) and capillary temperature(15, 20, 25, 30 ℃).The method for determination of genomic DNA methylation in cells was established.Five substances were completely separated by high-performance capillary electrophoresis in 10 mins.Intra-day coefficient of variation was less than 0.2% and inter-day coefficient of variation was less than 2%.The minimal detection limit was 2 μmol/L.Percentage of mdC in A549 parent cells was (4.80 ±0.52) %.Percentage of mdC in 15, 30, 40 μmol/L methotrexate drug-resistant A549 cells were (4.20±0.44) %, ( 3.70 ± 0.36 ) %, (3.10±0.35 ) %, respectively.Conclusions Genomic DNA methylation can be quantificated by high-performance capillary electrophoresis efficiently, rapidly, conveniently and sensitively.Genomic DNA methylation in methotrexate drug resistance cells decreases significantly.