Diagnostic value and prognostic evaluation of presepsin for acute respiratory distress syndrome (ARDS) / 复旦学报（医学版）

Objective To assess the diagnostic and prognostic value of measuring presepsin in patients with acute respiratory distress syndrome (ARDS).Methods Plasma prsepsin was collected from 81 patients with ARDS,27 patients with cardiogenic pulmonary edema (CPE) and 20 healthy volunteers at enrollment.Levels of presepsin were measured using the PATHFAST(R) analysis system based on a chemiluminescent enzyme immunoassay (CLEIA).The differences of plasma prsepsin were compared between different groups.The 28-day mortality were followed in ARDS patients,and the characteristics of the surviors and non-surviors were compared.Results ARDS patients had significantly higher median levels of presepsin compared to CPE patients [926.89 (485.41-2 662.32)pg/mL vs.376.21 (247.16-568.52) pg/mL,P＜0.001] at enrollment.The difference between infected and non-infected ARDS patients did not showed statistical significance [(934.74 (456.44-3 322.51) pg/mL vs.798.12 (485.41-2 561.40) pg/mL,P--0.079).In ARDS patients,the presepsin levels of non-survivors was significantly higher than that of survivors [3 158.3 (963.91-4 489.33) pg/mL vs.729.09 (398.05-1 467.24) pg/mL,P＜0.001],and multivariate Logistic regression showed that presepsin (OR =1.51,P =0.027) was the independent predictor for 28-day mortality in ARDS patients with acute lung injury (ALI).Conclusions Presepsin was an effective indicator in diagnosing ARDS,and it also was a strong prognostic marker for short-term mortality in ARDS.

The prognostic value of sCD163 in patients with acute respiratory distress syndrome / 复旦学报（医学版）

Objective To investigate the diagnostic and prognostic value of plasma soluble CD163 (sCD163) levels in patients with acute respiratory distress syndrome (ARDS).Methods A total of 124 individuals,83 patients with ARDS,20 patients with cardiogenic pulmonary edema (CPE),and 21 healthy controls,were enrolled in this study.ARDS patients were classified into survivors and nonsurvivors according to 28-day mortality.The concentration of plasma sCD163 was measured by enzymelinked immunosorbent assay (ELISA).Receiver operating characteristic (ROC) curves were employed to evaluate the accuracy of sCD163 in diagnosing ARDS and predicting 28-day ICU outcome.Cumulative survival curve was carried out by Kaplan-Meier survival analysis.Logistic regression analysis was assessed by univariate and multivariate analysis to identify independent predictors of outcome controlling for reported risk factor of mortality.Results Patients with ARDS had significantly higher median levels of sCD163 compared to patients with CPE [496.7(421.8-577.5) ng/mL vs.284.5(141.7-459.2) ng/mL,P＜0.001] upon admission to ICU.The sCD163 levels of non-survivors was significantly higher than that of survivors [577.5 (503.7-623.4) ng/mL vs.479.6 (395.4-520.8) ng/mL,P＜0.001].Multivariate logistic regression showed sCD163 (OR =1.02,P =0.001)was the independent predictor for 28-day mortality in patients with ARDS.Conclusions Plasma sCD163 is a potential biomarker for diagnosis of ARDS and differenting the severity of ARDS.Meanwhile,sCD163 was an independent prognostic marker for 28-day mortality in ARDS patients.

Possible Mechanism of Therapeutic Effect of 3-Methyl-1-phenyl-2-pyrazolin-5-one and Bone Marrow Stromal Cells Combination Treatment in Rat Ischemic Stroke Model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The functional improvement following bone marrow stromal cells (BMSCs) transplantation after stroke is directly related to the number of engrafted cells and neurogenesis in the injured brain. Here, we tried to evaluate whether 3-methyl-1-phenyl-2-pyrazolin-5-one (MCI-186), a free radical scavenger, might influence BMSCs migration to ischemic brain, which could promote neurogenesis and thereby enhance treatment effects after stroke.</p><p><b>METHODS</b>Rat transient middle cerebral artery occlusion (MCAO) model was established. Two separate MCAO groups were administered with either MCI-186 or phosphate-buffered saline (PBS) solution to evaluate the expression of stromal cell-derived factor-1 (SDF-1) in ischemic brain, and compared to that in sham group (n = 5/ group/time point[at 1, 3, and 7 days after operation]). The content of chemokine receptor-4 (CXCR4, a main receptor of SDF-1) at 7 days after operation was also observed on cultured BMSCs. Another four MCAO groups were intravenously administered with either PBS, MCI-186, BMSCs (2 × 106), or a combination of MCI-186 and BMSCs (n = 10/group). 5-bromo-2-deoxyuridine (BrdU) and Nestin double-immunofluorescence staining was performed to identify the engrafted BMSCs and neuronal differentiation. Adhesive-removal test and foot-fault evaluation were used to test the neurological outcome.</p><p><b>RESULTS</b>MCI-186 upregulated the expression of SDF-1 in ischemic brain and CXCR4 content in BMSCs was enhanced after hypoxic stimulation. When MCAO rats were treated with either MCI-186, BMSCs, or a combination of MCI-186 and BMSCs, the neurologic function was obviously recovered as compared to PBS control group (P < 0.01 or 0.05, respectively). Combination therapy represented a further restoration, increased the number of BMSCs and Nestin+ cells in ischemic brain as compared with BMSCs monotherapy (P < 0.01). The number of engrafted-BMSCs was correlated with the density of neuronal cells in ischemic brain (r = 0.72 , P < 0.01) and the improvement of foot-fault (r = 0.70, P < 0.01).</p><p><b>CONCLUSION</b>MCI-186 might promote BMSCs migration to the ischemic brain, amplify the neurogenesis, and improve the effects of cell therapy.</p>

Experimental study of therapeutic time window of L-serine against focal cerebral ischemia/reperfusion injury in rats / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To observe the therapeutic time window of L-serine against focal cerebral ischemia/reperfusion injury in rats, and related mechanisms.</p><p><b>METHODS</b>Sprague-Dawley rats were randomly divided into six groups (n=6), sham-operation group, vehicle group, 3, 6, 12 and 24 h treatment group of L-serine. Focal cerebral ischemia was induced with the method of middle cerebral artery occlusion (MCAO) in rats, and reperfusion was emerged by removing the thread 2 h later. The treatment of L-serine (200 mg/kg ip) was begun at 3, 6, 12 and 24 h after MCAO respectively, and subsequently repeated once 12 h. The vehicle group was intraperitoneally injected with isodose normal saline. The neurological behavior score and cerebral infarction volume was measured 48 h after reperfusion. In addition, the contents of malondialdehyde (MDA), activity of superoxide dismetase (SOD), the levels of inflammatory cytokines (TNF-alpha, IL-6) and ultrastructure of neuron in brain tissue were investigated.</p><p><b>RESULTS</b>Compared with the vehicle group, treatments with L-serine both 3 and 6 h after MCAO decreased the neurology deficit score and infarct volume. Only neurology deficit score had been reduced 12 h after MCAO, while no neuropmrotective effects had been observed during 24 h. Furthermore, L-serine elevated the content of SOD, decreased the level of MDA, TNF-alpha and IL-6 in ischemic brain tissue, and alleviated the injury of the neuronal ultrastructure.</p><p><b>CONCLUSION</b>L-serine exerted a time-dependent neuroprotective effect on the brain after MCAO in rat. This effect might be possibly mediated through following mechanisms: lessening oxidative stress and reducing the release of inflammatory cytokines.</p>

Expressions of Bcl-2 and Caspase-3 in the internal organs of rats when tetramine was administered / 法医学杂志

OBJECTIVE@#To find whether Bcl-2 and Caspase-3 take part in the pathophysiological mechanism of tetramine toxification.@*METHODS@#Sixty Sprague-Dawley rats were divided into normal control group, the sham poisoned group, high dose poisoned group, low dose poisoned group. High dose poisoned group were administered 1.0 mg/kg weight body tetramine by mouth, however low dose poisoned group was administered tetramine 0.1 mg/kg weight body by mouth. The rats of the sham poisoned group were administered water, and rats of normal control group were given nothing. Bcl-2 and Caspase-3 were detected by immunohistochemistry staining and the results were assessed by image analysis system.@*RESULTS@#The expressions of Bcl-2 and Caspase-3 in all organs were similar, ie, Bcl-2 and Caspase-3 expressed obviously in all organs of high dose poisoned group; in all organs of low dose poisoned group, they were hardly detected at 30 min after administration, however, at 3 h after administration, they could be detected obviously; Bcl-2 got to peak at 6 h-3 d after administration and Caspase-3 got to peak at 24 h-3 d after administration.@*CONCLUSION@#Bcl-2 and Caspase-3 take part in the pathophysiological procedure of tetramine poisoned rats.

Clinical Analysis of Intrauterine Occupational Disease in 71 Cases / 上海第二医科大学学报

Objective To diagnose the intrauterine occupational disease by vaginal ultrasonography or hysteroscopy, and to evaluate the diagnostic values of these two methods. Methods One hundred and fifty patients were detected by vaginal ultrasonography and hysteroscopy from Jan 2004 to Dec 2004, and a total of 71 cases were confirmed intrauterine occupational disease. Tissue hysteroscopy or bioposy were performed during the hysterosocopy in order to analyse the tissue pathology. Results In these 71 patients, 47 were no less than 46 years old. Most of them had abnormal uterine bleeding.Thirty-three cases (46.48%) were suggested by vaginal ultrasonography, and 49 (69.01%) by hysteroscopy. Thirty-eight cases (53.52%) were in line with the pathological result.There were significant differences between vaginal ulterasonography and hysteroscopy in diagnosing the intrauterine occupational disease (P