The role of C-reactive protein to prealbumin ratio for diagnosis and prognosis evaluation of sepsis / 中国医师进修杂志

Objective:To explore the application of C-reactive protein(CRP) to prealbumin (PA) ratio(CRP/PA) for diagnosis and prognosis evaluation of sepsis.Methods:By a retrospective study, a total of 95 sepsis patients (sepsis group) and 100 local infection patients(non-sepsis group) treated in Dongying People′s Hospital from September 2021 to September 2022 were enrolled. Sepsis patients were divided into survival group(57 cases) and death group (38 cases) according to the 28-day outcome. The clinical data were collected and CRP/PA was calculated. Multivariate Logistic regression and Cox regression were used to analyze the relationship between various indicators and the occurrence and prognosis of sepsis, and receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic and prognostic value of CRP/PA for sepsis. Kaplan-Meier survival analysis was used to evaluate the prognostic value of different CRP/PA ratios for patients with sepsis.Results:The systolic blood pressure, diastolic blood pressure, prealbumin were lower and heart rate, respiratory rate, CRP, CRP/PA, procalcitonin were higher in the sepsis group compared to the non-sepsis group: (117.27 ± 11.65) mmHg (1 mmHg = 0.133 kPa) vs. (123.26 ± 10.71) mmHg, (69.42 ± 8.58) mmHg vs. (75.44 ± 6.53) mmHg, (174.09 ± 24.77) g/L vs. (207.13 ± 34.31) g/L, (97.87 ± 12.73) bpm vs. (86.90 ± 10.19) bpm, 22.0(20.00, 25.00) times/min vs. 21.00(19.00, 23.00) times/min, (93.96 ± 19.64) mg/L vs. (77.56 ± 22.54) mg/L, 0.54(0.44, 0.65) vs. 0.37(0.28, 0.46), 3.35(2.16, 4.17) μg/L vs. 1.52(0.81, 2.16) μg/L, there were statistical differences ( P<0.05). Multivariate Logistic regression analysis showed that CRP/PA and procalcitonin were risk factors for sepsis ( P<0.05). The results of ROC curve showed that the area under the curve (AUC) of CRP/PA in diagnosis of sepsis was 0.821, the specificity and sensitivity was 76.0% and 93.7%, respectively. The diastolic blood pressure, prealbumin, neutrophil were higher and the heart rate, respiratory rate, CRP, CRP/PA, lymphocytes, procalcitonin were lower in the survival group compared to the death group: (71.76 ± 8.86) mmHg vs. (67.86 ± 8.10) mmHg, (181.46 ± 24.35) g/L vs. (163.05 ± 21.28) g/L, (63.46 ± 9.88) × 10 9/L vs.(57.13 ± 8.64) × 10 9/L, (95.68 ± 13.48) times/min vs. (101.16 ± 10.88) times/min, 22.00(19.50, 24.00) times/min vs. 24.00(20.00, 28.00) times/min, (88.09 ± 19.35) mg/L vs. (102.76 ± 16.75) mg/L, 0.46(0.41, 0.58) vs. 0.63(0.55, 0.72), 21.00(16.00, 30.00) ×10 9/L vs. 29.50(18.00, 37.30) ×10 9/L, 2.94(2.10, 3.97) μg/L vs. 3.82(2.21, 4.77) μg/L, there were statistical differences ( P<0.05). Multivariate Cox regression analysis showed that CRP/PA and procalcitonin were independent risk factors for the prognosis of sepsis ( P<0.05). The AUC of CRP/PA in predicting the prognosis of sepsis was 0.827, the specificity and sensitivity was 92.1% and 63.8%, respectively. Grouped by the cut-off of CRP/PA (0.48), the 28-day mortality rate of patients in the CRP/PA>0.48 was significantly higher than that of patients in the CRP/PA≤0.48, there was statistical difference ( P<0.01). Conclusions:CRP/PA ratio can be used as an index for diagnosis and prognosis evaluation of sepsis.

Effect of Xielitang on TLR4/NF-κB/HIF-1α Signaling Pathway in Mice with Ulcerative Colitis / 中国实验方剂学杂志

ObjectiveTo explore the protective effect of Xielitang on ulcerative colitis （UC） mice induced by dextran sodium sulfate （DSS） and its possible mechanism. MethodSixty C57BL/6 mice were randomly divided into normal group， model group， sulfasalazine group and and low-， medium-， and high-dose Xielitang groups. Free drinking DSS solution to build the chronic UC model mice. Except for normal group， other groups were given 1.5% DSS for 3 cycles of drinking （days 1-7， days 22-28 and days 43-49） and distilled water for the rest of the time （days 8-21， days 29-42 and days 50-63）. After the first cycle， corresponding drugs were given for 42 days. The changes of general condition， body weight and disease activity index （DAI） score of mice were daily recorded during the experiment. At the end of the treatment， serum and colon tissue samples were collected， colon length was measured， intestinal weight index and colonic mucosal injury （CMDI） score were calculated. The pathological status of colon tissue was observed by hematoxylin-eosin （HE） staining. The levels of interleukin-6 （IL-6）， interleukin-10 （IL-10） and tumour necrosis factor-α （TNF-α） were measured by enzyme-linked immunosorbent assay （ELISA）. The gene and protein expressions of Toll like receptor 4 （TLR4）， nuclear transcription factor-κB （NF-κB） and hypoxia inducible factor-1α （HIF-1α） in colon tissue was detected by Real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultCompared with the normal group， the body weight， colon length and IL-10 content in the model group were significantly decreased （P<0.01）， DAI score， intestinal weight index， CMDI score， IL-6 and TNF-α contents， and mRNA and protein expression levels of TLR4， NF-κB and HIF-1α in the model group were significantly increased （P<0.01）. Moreover， the structure of colonic mucosa was destroyed and inflammatory cells infiltrated in the model group. Compared with model group， body weight， colon length and IL-10 content in each dose group of Xielitang were significantly increased （P<0.05， P<0.01）， DAI score， intestinal weight index and CMDI score， IL-6 and TNF-α contents， mRNA and protein expression levels of TLR4， NF-κB and HIF-1α were notably decreased （P<0.05， P<0.01）. The pathological injury of colon was obviously alleviated. ConclusionXielitang can significantly improve the inflammatory response of UC mice induced by DSS， and its mechanism may be related to the regulation of TLR4/NF-κB/HIF-1α signaling pathway.

Hemodynamic Analysis on Proximal End of the Aortic Dissection with Different Rupture Shapes / 医用生物力学

Objective To explore hemodynamic performance of the aortic dissection after lesions, so as to provide a more scientific basis for patient treatment. Methods Based on computed tomography angiography (CTA) image data from a patient with complex Stanford B-type aortic dissection, the personalized aortic dissection models with different rupture shapes (H-type, O-type, and V-type) at proximal end of the aortic dissection were established. Combined with computational fluid dynamics (CFD) and morphological analysis method, distributions of the velocity at rupture section, the blood flow, the wall pressure and the wall shear stress (WSS) were analyzed. Results The flow velocity, the highest pressure difference and the WSS proportion at entrance of the H-shaped rupture showed larger hemodynamic parameters than those of the other two types. The risk of dissection rupture for type H was the largest, while type V was in the middle, and type O was the smallest. Conclusions This study provides an effective reference for further numerical analysis the cases and formulation of treatment plans.

Design of Scalable Model of Cochlear Scala Tympani / 中国医疗器械杂志

For cochlear implant training and robotic cochlear implant experiments, the design method of scalable scala tympani model was proposed. The mathematical model of the cochlea was used as the central curve of scala tympani channel. Referring to the clinical anatomy data, the contour of the scala tympani cross-section was approximated as an ellipse. The profile was placed along the central curve, and the angle was adjusted to determine the position and orientation of the profile in three dimensions such that the central curve passes through its center. The data was imported into Matlab to generate a three-dimensional mathematical model of scala tympani, which can be expanded by setting different scale factors. The virtual scala tympani model was generated in SolidWorks, and the 2:1 fully transparent scala tympani model were fabricated by 3D printing to replace the specimen for experiment.

Effect of different structural parameters of filter rod on mechanical properties of new vena cava filter / 生物医学工程学杂志

The dynamic analysis of the implantation process of a new vena cava filter was carried out by finite element analysis method to reveal the influence of the angle, length, width and thickness of the filter rod on its mechanical properties and the inner wall of the blood vessel. The results showed that the high-stress and high-strain areas of the filter were mainly concentrated in the connection between the filter rod and the filter wire. With the increase of the angle of the filter rod, the maximum equivalent stress and the maximum elastic strain on the filter wall decreased, while the maximum equivalent stress on the vascular wall increased. With the increase of the length of the filter rod, the maximum equivalent stress and strain peak of the filter wall increased, but the maximum equivalent stress of the vessel wall decreased. With the increase of the width and thickness of the filter rod, the maximum equivalent stress of the filter wall, the maximum elastic strain and the maximum equivalent stress of the vessel wall all showed an upward trend. The static safety factor of all filter models was greater than 1, and the structure after implantation was safe and reliable. The results of this study are expected to provide a theoretical basis for the structural optimization and deformation mechanism of the new type vena cava filter.

Hemodynamic analysis of a new retrievable vena cava filter / 生物医学工程学杂志

Vena cava filter is a filter device designed to prevent pulmonary embolism caused by thrombus detached from lower limbs and pelvis. A new retrievable vena cava filter was designed in this study. To evaluate hemodynamic performance and thrombus capture efficiency after transplanting vena cava filter, numerical simulation of computational fluid dynamics was used to simulate hemodynamics and compare it with the commercialized Denali and Aegisy filters, and in vitro experimental test was performed to compare the thrombus capture effect. In this paper, the two-phase flow model of computational fluid dynamics software was used to analyze the outlet blood flow velocity, inlet-outlet pressure difference, wall shear stress on the wall of the filter, the area ratio of the high and low wall shear stress area and thrombus capture efficiency when the thrombus diameter was 5 mm, 10 mm, 15 mm and thrombus content was 10%, 20%, 30%, respectively. Meanwhile, the thrombus capture effects of the above three filters were also compared and evaluated by in vitro experimental data. The results showed that the Denali filter has minimal interference to blood flow after implantation, but has the worst capture effect on 5 mm small diameter thrombus; the Aegisy filter has the best effect on the trapping of thrombus with different diameters and concentrations, but the low wall shear stress area ratio is the largest; the new filter designed in this study has a good filtering and capture efficiency on small-diameter thrombus, and the area ratio of low wall shear stress which is prone to thrombosis is small. The low wall shear stress area of the Denali and Aegisy filters is relatively large, and the risk of thrombosis is high. Based on the above results, it is expected that the new vena cava filter designed in this paper can provide a reference for the design and clinical selection of new filters.

Study on mechanical properties of nitinol iliac vein stent and animal test under different release scales / 生物医学工程学杂志

The mechanical properties of nitinol iliac vein stent (NIVS) have been studied by many scholars at home and abroad, but the study on the mechanical properties of iliac vein stent under different release scales has not been reported yet. Based on the finite element analysis method, the mechanical properties of three self-developed NIVS were studied to reveal the influence of stent diameters (12, 14, 16 mm) and different release scales (80%, 90%) on its strength, fatigue life and vein wall biomechanical properties. With an increases in the release scales, the equivalent elastic strain, fatigue strength safety factors, and vessel wall equivalent stress exhibited a downward trend, while the most stressed cross-section coincided with the arc of stent-connecting rods. Through 30, 60 and 90 days' animal test, a narrowed vascular model was established in the iliac veins of 12 pigs, and the developed iliac vein stents were implanted to comprehensively evaluate the safety and effectiveness of the stent, and at the same time the mechanical properties of stents were verified to provide important reference for the type inspection and clinical trials of follow-up products.

Effects of cyclin-dependent kinase 9 ( CDK9) on lytic replication of Kaposi′s sarcoma-associated her-pesvirus ( KSHV) / 中华微生物学和免疫学杂志

Objective To investigate the role of cyclin-dependent kinase 9 ( CDK9) in regulating lytic replication of Kaposi′s sarcoma-associated herpesvirus ( KSHV) .Methods Percentages of red fluores-cent protein (RFP) positive cells were counted after treating and stimulating iSLK .219 cells with FIT-039, a CDK9 specific inhibitor , and doxycycline ( Dox ) , respectively , or transfecting and stimulating them with CDK9 siRNA (si-CDK9) and Dox, respectively.Quantitative real-time PCR was used to detect the expres-sion of KSHV genes at mRNA level in TREx-K-Rta BCBL-1 cells treated with FIT-039 or transfected with si-CKD9 in the presence of Dox.Chromatin immunoprecipitation (ChIP) assay was used to examine the enrich-ment of RNA polymerase Ⅱ( RNA PolⅡ) and phosphorylated CTD-S2 of RNA PolⅡon the PAN promot-er in TREx-K-Rta BCBL-1 cells treated with FIT-039.Results Both FIT-039 intervention and CDK9 knockdown dramatically deceased the percentage of RFP-positive iSLK.219 cells and suppressed the expres-sion of ORF50, PAN and K2 in TREx-K-Rta BCBL-1 cells at mRNA level.Furthermore, FIT-039 signifi-cantly inhibited the enrichment of RNA Pol Ⅱand phosphorylated CTD-S2 of RNA Pol Ⅱon the PAN pro-moter in TREx-K-Rta BCBL-1 cells.Conclusion CDK9 is involved in regulating the lytic replication of KSHV through promoting the phosphorylation of CTD-S2 of RNA Pol Ⅱ.

Effect of Prophylactic Pancreatic Duct Stenting on Post-ERCP Pancreatitis in Patients With Risk Factors / 胃肠病学

Background:Pancreatitis is the main complication of ERCP,and a variety of risk factors will increase its risk. Studies showed that temporary pancreatic duct stent can reduce the incidence of post-ERCP pancreatitis (PEP). Aims:To study the efficacy and safety of prophylactic pancreatic duct stenting on preventing PEP in patients with risk factors. Methods:Patients undergone ERCP and accompanied with one or more PEP-associated risk factors from November 2013 to November 2016 at Huaibei People's Hospital were enrolled,and were divided randomly into pancreatic duct stenting group (observation group)and non-stenting group (control group). Serum levels of amylase at 4,24 and 48 hours after the procedure and incidence of PEP were compared between the two groups. Results:A total of 297 patients were enrolled, and 147 patients were in observation group,and 150 patients in control group. No significant differences in gender,age and ERCP disease spectrum were found between the two groups (P > 0. 05). Incidence of PEP was significantly decreased in observation group than in control group (6. 1％ vs. 16. 0％,P 0. 05). Conclusions:Prophylactic pancreatic duct stenting may decrease the incidence of PEP in patients accompanied with PEP-associated risk factors, especially could decrease the severity of PEP. However, the incidence of hyperamylasemia is not decreased.

Pulmonary embolism after greater saphenous vein ligation and stripping / 中华普通外科杂志

Objective To analyze characteristics and prophylaxis of pulmonary embolism (PE) after greater saphenous vein ligation and stripping.Methods We retrospectively analyzed the clinical characteristics and treatment of 11 inpatients with postoperative PE in Anhui Provincial Hospital and other hospitals from January 2008 to June 2013.Results In this group 6 patients died after failed cardiopulmonary resuscitation (CPR) and other treatments,the mortality was 54.5％.5 patients recovered after anticoagulation,thrombolysis and other treatments.During the process of thrombolysis,floating thrombus was found within the femoral vein in 2 patients and inferior vena cava filter was implanted.After 8-25 months follow-up,all 5 patients were free of difficulty of breathing,chest tightness,chest pain and other symptoms.Among many clinical manifestations,dyspnea (90.9％) was the most common,other clinical manifestations included chest pain (27.3％),syncope (18.2％),sudden death (18.2％).There was no typical triad of dyspnea,chest pain and hemoptysis in these patients.Conclusions Early diagnosis and early treatment of PE are most important to decrease mortality and to improve the prognosis of patients suffering from postoperative PE.

Postoperative complications of endovascular repair of abdominal aortic aneurysms in poor-risk patients / 中华普通外科杂志

Objective To review the complications after endovascular aneurysm repair (EVAR) of high-risk abdominal aortic aneurysms in our medical center.Methods Fifty eight elective high-risk EVAR cases from January 2008 to December 2013 were analyzed retrospectively.Results The technical success rate was 96.6％ (56 of 58 patients).The overall complication rate in perioperative period was 32.8％ (19/58).Eleven systemic complications (19.0％),16 primary endoleaks (27.6％),7 access of site complications(12.1％) were observed.The follow-up rate was 86.2％ (51/58).During the follow up period,the mortality was 7.8％ (4/51),the re-intervention rate was 7.8％ (4/51).The overall complication rate was 29.4％ (15/51),including systemic complications (2/51),secondary endoleak (9.8％) and graft-related complications (11.8％,6/51).Conclusions Endoleak,graft-related complications continue to be the main causes of re-intervention in high-risk aneurysm patients after EVAR.

The Effects of 14-3-3 Phosphorylation Induced by JNK on Ischemic Brain Injury in Rats / 天津医药

Objective To investigate the effects of 14-3-3 phosphorylation (p-14-3-3) induced by C-Jun N-termi-nal kinase (JNK) on ischemic brain injury in rats. Methods Twenty rats were divided into 4 groups:sham operation group, ischemia-reperfusion group, SP600125 group and solvent control group. The rat model of cerebral ischemia was established. The p-14-3-3, the binding of 14-3-3 and Bax and the protein expression of Bax in cytoplasm and mitochondria in hippo-campal CA1 region were detected by immunoprecipitation (IP) and immunoblotting 12-hour after ischemia-reperfusion in four groups. Results Compared with the sham operation group, protein expression levels of p-14-3-3 in cytoplasm and Bax in mitochondria were significantly increased, the binding of 14-3-3 and Bax was significantly decreased in ischemia-re-perfusion group, solvent control group and SP600125 group. The protein expressions of p-14-3-3 and Bax were significantly lower in SP600125 group than those of ischemia-reperfusion group and solvent control group. The binding of 14-3-3 and Bax was significantly higher in SP600125 group than that of ischemia-reperfusion group and solvent control group (P <0.05). Conclusion 14-3-3 phosphorylation induced by JNK plays important effects on ischemic brain injury in rats.

Clinical analysis of retroperitoneal laparoscopic partial nephrectomy on patient with incidental renal cell carcinoma / 中国综合临床

Objective To evaluate the safety and clinical efficacy of retroperitoneal laparoscopic partial nephrectomy (LPN) in patients with incidental renal cell carcinoma.Methods Twenty-six patients with T1 incidental renal cell carcinoma treated with retroperitoneal LPN from Dec.2011 to Oct.2013 were analyzed retrospectively.The operation time,warm ischemia time,intraoperative blood loss,complications and prognosis of perioperative periods were collected.Results All 26 cases were operated successfully without conversion to open or other surgery.The operation period was 90-190 minutes.Blockage of renal artery was applied in all 26 cases,and the warm ischemia time was 15-30 minutes.The intraoperative blood loss was 100-360 ml.The drainage was removed 3-7 days postoperatively,and the hospitalization period was 7-12 days.All cases were clear cell renal cell carcinoma by pathological examinations,and showed negative surgical margins.No complications such as postoperative bleeding,inflammation and leakage of urine were occurred.All cases had normal renal function during the follow-up of 3-25 months without local recurrence or distant metastasis.Conclusion Retroperitoneal LPN for the treatment of T1 incidental renal cell carcinoma is worthy of application with the advantages of safety,minimal invasiveness,fewer complications,quick recovery and good nephron-sparing functional recovery.

SDF-1 combined with peripheral blood endothelial progenitor cells transplantation for the treatment of hindlimb ischemia in nude mice / 中华普通外科杂志

Objective To explore the effect of stromal cell-derived factor-1 ( SDF-1 ) in combination with transplantation of peripheral blood endothelial progenitor cells (EPCs) for the treatment of nude mice hindlimb ischemia. Methods Hindlimb ischemia model was established in nude mice, mice were then divided into five groups randomly: ischemic control group, peripheral blood EPCs transplantation group, SDF-1 local application group, SDF-1 combined with EPCs group, SDF-1 combined with AMD3100 treated EPCs group. Local CD34+VEGFR+ cells in the hind gastrocnemius were detected at day 3,7 after transplantation. The intensity of neovasculorization were evaluated at day 28. Results The double-positive cells number of control group, EPCs group, SDF-1 group, SDF-1 + EPCs group, SDF-1 + AMD3100 EPCs group were 0.00 ±0.00,5. 30 ±0.65,0.00 ±0.00,10. 31 ±0. 63,1. 86 ±0. 17 at day 3 and 0. 00 ±0. 00, 7.05 ±0. 18,0. 00 ±0. 00,11. 81 ±0. 53,2. 83 ±0. 48 at day 7. The number of new capillaries were 3. 00 ± 0.13,6.15 ± 0. 04,6. 20 ± 0. 10,10. 65 ± 0.08,6. 21 ±0. 08 at day 28. SDF-1 increased the CD34 + VEGFR+ cells (P ＜0. 05) and the number of new vessels (P ＜0.05). SDF-1 combined EPCs further increased the number of new vessels (P ＜ 0. 05 ). Conclusions SDF-1 enhances blood vessel formation and promotes angiogenesis by promoting EPCs homing, which could be blocked by AMD3100.

Percutaneous Transluminal Angioplasty and Stent Placement for the Treatment of Long Segmental Atherosclerotic Occlusive Disease of Lower Limb / 医学研究杂志

Objective To evaluate the clinical effects of endovascular angioplasty and stenting for the treatment of TASC B,C arteriosclerotic occlusion(ASO) of lower extremity.Methods After the identification of the occlusion by angiography via femoral artery access by Seldinger method,the occluded arteries (mean length 7.5cm; range 1~20 cm) in 40 patients(47limbs) were treated by percutaneous transluminal angioplasty and stent placement. Results The primary recanalization was successful in 45 of 47 limbs. The technical successful rate was 96%. Thirty one self-expanding stents were deployed. PTA without stent placememt was performed in 16 limbs(of them,11 were blow knee).The ankle brachial pressure index (ABI) increased from (0.36?0.14) preoperatively to (0.82?0.15) on the 7th postoperative day. All patients were follow-uped for 1 to 48 months. Stents were occluded in 4 patients. Restenosis was observed in 1 limbs. All of the rest remained patent in the follow-up period.Conclusion Endovascular angioplasty and stenting can be an effective method for the treatment of long segmental (including below-knee) arteriosclerotic occlusion of lower extremities.