Clinical value of pulse indicator continuous cardiac output monitoring in treating acute kidney injury due to sepsis / 新乡医学院学报

Objective To evaluate the clinical value of pulse indicator continuous cardiac output monitoring in treating acute kidney injury(AKI) due to sepsis.Methods Sixty-two patients with AKI due to sepsis in the Central Hospital of Zhumadian from August 2013 to August 2016 were rolled in and divided into control group (34 cases) and observation group (28 cases) according to whether adopted pulse indicator continuous cardiac output monitoring.Six hours and 24 hours after fluid resuscitatinn,resuscitation fluid volume,heart rate(HR),central venous pressure(CVP),mean arterial pressure(MAP),vasoactive drugs dose of the two groups were observed.Treatment times,daily filtration volume of continuous renal replacement therapy and independent urine volume,serum creatinine level,the survival rate after treating for seven days in the two groups were compared.Results There was no significant difference in the HR,central venous pressure,mean arterial pressure at six hours after fluid resuscitation between the two groups(P ＜ 0.05).At 24 hours after fluid resuscitation,there was no siguificant difference in the HR in the control group compared with that at six hours after fluid resuscitation (P ＜ 0.05),the CVP and MAP were higher than those at six hours after fluid resuscitation(P ＜ 0.05);the HR in the observation group was lower than that at six hours after fluid resuscitation (P ＜ 0.05),MAP was higher than that at six hours after fluid resuscitation (P ＜0.05),but there was no significant difference in the CVP in the control group compared with that at six hours after fluid resuscitation (P ＜ 0.05).The HR and CVP at 24 hours after fluid resuscitation in the observation group were lower than those in the control group(P ＜0.05),while there was no no significant difference in the MAP between the two groups(P ＜ 0.05).There was no significant difference in the fluid resuscitation volume,the dose of noradrenaline and dobutamine after treating for six hours between the two groups (P ＜ 0.05).Twenty four hours after fluid resuscitation resuscitation fluid volume and dobutamine dose in the observation group were significantly lower than those in the control group (P ＜ 0.05).The duration of renal replacement therapy,the daily filtration volume and the blood creatinine after treating for seven days in the observation group were significantly lower than those in the control group (P ＜ 0.05),but the independent urine volume after treating for seven days in the observation group was significantly higher than that in the control group (P ＜ 0.05).After treating for seven days,there were 28 cases survival,the survival rate was 82.4％ (28/34),while there were 25 cases survival,the survival rate was 89.3％ (25/28);the difference of survival rate between the two groups was not statistically significant (x2 =0.59,P ＜ 0.05).Conclusion In patients with AKI due to sepsis,pulse indicator continuous cardiac output monitoring can be used to optimize fluid management,and it can improved the renal function.

Antioxidant effect of salvianolic acid B on hippocampal CA1 neurons in mice with cerebral ischemia and reperfusion injury / 中国结合医学杂志

<p><b>OBJETIVE</b>To investigate the neuroprotective effects and underlying mechanisms of salvianolic acid B (Sal B) extracted from Salvia miltiorrhiza on hippocampal CA1 neurons in mice with cerebral ischemia reperfusion injury.</p><p><b>METHODS</b>Forty male National Institute of Health (NIH) mice were randomly divided into 4 groups with 10 animals each, including the sham group, the model group, the SalB group (SalB 22.5 mg/kg) and the nimodipine (Nim) group (Nim 1 mg/kg). A mouse model of cerebral ischemia and reperfusion injury was established by bilateral carotid artery occlusion for 30 min followed by 24-h reperfusion. The malondialdehyde (MDA) content, the nitric oxide synthase (NOS) activity, the superoxide dismutase (SOD) activity and total antioxidant capability (T-AOC) of the pallium were determined by biochemistry methods. The morphologic changes and Bcl-2 and Bax protein expression in hippocampal CA1 neurons were observed by using hematoxylineosin staining and immunohistochemistry staining, respectively.</p><p><b>RESULTS</b>In the SalB group, the MDA content and the NOS activity of the pallium in cerebral ischemia-reperfusion mice significantly decreased and the SOD activity and the T-AOC significantly increased, as compared with the model group (P<0.05 or P<0.01). The SalB treatment also rescued neuronal loss (P<0.01) in the hippocampal CA1 region, strongly promoted Bcl-2 protein expression (P<0.01) and inhibited Bax protein expression (P<0.05).</p><p><b>CONCLUSIONS</b>SalB increases the level of antioxidant substances and decreases free radicals production. Moreover, it also improves Bcl-2 expression and reduces Bax expression. SalB may exert the neuroprotective effect through mitochondria-dependent pathway on hippocampal CA1 neurons in mice with cerebral ischemia and reperfusion injury and suggested that SalB represents a promising candidate for the prevention and treatment of ischemic cerebrovascular disease.</p>

Long-term clinical outcome of patients with diabetes and chronic total occlusion underwent drug-eluting stents implantation / 中华心血管病杂志

<p><b>OBJECTIVE</b>The aim of this study was to assess the long-term clinical outcome of patients with diabetes mellitus and chronic total occlusion (CTO) underwent drug-eluting stents (DES) implantation.</p><p><b>METHODS</b>Data of 143 consecutive eligible patients from January, 2006 to May, 2007 were retrospectively analyzed. The endpoint of the study was the major adverse cardiac events (MACE), including death, myocardial infarction, target lesion revascularization. The patients were divided into two groups, event group and non-event group, according to the result of follow-up.</p><p><b>RESULTS</b>Long-term follow-up was finished in 139 (97.2%) patients. Mean follow-up duration was (19.8 + or - 5.1) months. MACE rate was 10.5% during follow-up: 3 deaths, 1 myocardial infarction and 11 repeated target lesion revascularization with PCI. Compared with the non-event group, the percentage of residual lesion [(17.7 + or - 1.8)% vs. (15.4 + or - 5.0)%, P = 0.001] was significantly higher in the event group, however, the final minimal luminal diameter [(2.14 + or - 0.22)% vs. (2.89 + or - 0.37)%, P = 0.004] was lower. Cox regression analysis showed that final luminal diameter (OR: 0.097, 95%CI: 0.013 - 0.694, P = 0.020) was the only dependent predictor at follow-up.</p><p><b>CONCLUSION</b>Final minimal luminal diameter is an independent predictor of MACE during follow-up for patients with diabetes and CTO underwent DES implantation.</p>

Effect of buxu huayu qutan decoction on anti-oxidative capacity in aged patients with stable angina pectoris of coronary heart disease / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the acting mechanism of Buxu Huayu Qutan Decoction (BHQD) for impacting the anti-oxidative capacity in aged patients with stable angina pectoris of coronary heart disease (AP-CHD).</p><p><b>METHODS</b>Forty patients of AP-CHD, Chinese medicine diagnosed as Xiong-bi, were equally assigned to the treatment group and the control group. Superoxide dismutase (SOD) activity and lipid peroxide (LPO) contents in blood, and mRNA expression of manganese-containing superoxide dismutase (MnSOD) in peripheral mononuclear cells were determined before and after treatment by biochemical and molecular biologic techniques.</p><p><b>RESULTS</b>No significant change of plasma SOD and LPO was found in the control group after treatment (P >0.05), while the plasma SOD activity increased and LPO content lowered in the treatment group significantly (P<0.01). Moreover, mRNA expression of MnSOD in the treatment group after treatment was obviously higher than that in the control group (P <0.01).</p><p><b>CONCLUSIONS</b>The acting mechanism of BHQD for AP-CHD treatment might partially due to its effects in inducing gene expression of MnSOD in mononuclear cells, enhancing SOD activity, decreasing LPO content, maintaining oxidation/antioxidation equilibrium in myocardial cells, blocking the chain reaction of lipid peroxidation, intervening the production and enhancing the scavenging of oxygen free radicals.</p>

ST-elevated acute myocardial infarction happening 1 month post stent implantation: late thrombosis in-stents or new lesions? / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>ST-elevated acute myocardial infarction (STEAMI) happening in the first month post percutaneous coronary intervention (PCI) is almost related to acute thrombosis or subacute thrombosis in-stents. This study aimed to investigate the possible causes of myocardial infarction one month later.</p><p><b>METHODS</b>Patients who had a history of successful PCI, and received coronary angiography or re-PCI due to STEAMI were included in this study. The AMI-related lesions and previous angiographic findings such as the number of lesions, the degree of the stenosis, the type of stents and acute results of last PCI were recorded. If the AMI-related lesion was localized in-stents or at the edge of stents (distance apart from the edge < or = 5 mm), it was defined to be late thrombosis; otherwise as a new-lesion induced AMI.</p><p><b>RESULTS</b>One hundred and ninety-two patients aged 40 - 79 years were included in this study. New lesions, as the cause of STEAMI, were found in 144 patients (Group A, 75%), and late thrombosis in 48 patients (Group B, 25%). Almost all newly built thromboses were found at the sites of previous insignificant lesions (diameter stenosis < 50%). There was a significant difference in the average time from previous PCI to AMI ((30.1 +/- 12.4) vs (20.3 +/- 11.9) months) between the two groups. Diabetes mellitus (DM) and drug-eluting stent (DES) utilization were associated with markedly higher morbidity of late thrombosis in adjusted Logistic regression (hazard ratio (HR) 3.4, 95% confidence interval (CI) 1.1 - 10.9 and 5.3, 95% CI 1.1 - 26.5).</p><p><b>CONCLUSIONS</b>STEAMIs happening 1 month after PCI are more likely to develop from previous insignificant lesion rupture than from late thrombosis in-stents. Moreover, DM and DES are associated with the high incidence of late thrombosis, which may indicate that intensive antiplatelet therapy should be considered in patients with diabetes.</p>

Enhanced expression of CD40L cDNA on ovarian cancer cell line OVHM induces the secretion of Th1 cytokines from dendritic cells / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To examine whether the enhanced expression of CD40L cDNA on murine ovarian cancer (OVHM) cells could induce the secretion of Th1 cytokines from dendritic cells (DC).</p><p><b>METHODS</b>OVHM cells were transfected with the full-length mouse CD40L cDNA by lipofectamine 2000 and then G418 resistant cells as positive cells were selected. They were examined for their expression of CD40L with flow cytometry. Bone marrow cells were firstly depleted of erythrocytes, macrophages, T and B cells with PE-conjugated magnetic beads, and then cultured in 10% FCS RPMI 1640 medium supplemented with recombinant mouse GM-CSF and IL-4 for 10 days. PKH67-labeled tumor cells were cultured with DC, and then the stained cells were analyzed for the expression of MHC-I, MHC-II, CD80, CD86, CCR7 in DC with flow cytometry. The expression of p40, p19, p35, p28, EBI3 subunits, IL-18, IFN-gamma, Mig gene in cocultured DC-tumor cells were detected by RT-PCR.</p><p><b>RESULTS</b>The CD40L cDNA was successfully transfected into OVHM cells. Bone marrow-derived DCs, when cultured with CD40L/OVHM, formed clusters with the tumors and showed an upregulated expression of MHC- I, MHC-II, CD80, CD86, CCR7. Expression of the IL-12, IL-23, IL-27, IL-18, interferon-gamma (IFN-gamma) and Mig (monokine induced by IFN-gamma) genes was induced in the DCs that were cultured with CD40L/OVHM but not with OVHM cells.</p><p><b>CONCLUSION</b>These data directly showed that the expression of CD40L on ovarian cancer cells facilitates the interaction between DCs and tumors, enhances the maturation of DCs, induces secretion of Th1 cytokines, especially for IL-12, IL-23 and IL-27, which maybe one of the possible antitumor mechanism for CD40L-transfected ovarian cancer cell line.</p>

Effect of salvianolic acid B on brain energy metabolism and hydrocephalus of cerebral ischemia in mice at different time / 药学学报

Mice pathological model of acute cerebral ischemia was established. In order to observe the effect of salvianolic acid B (Sal B) on brain energy metabolism and hydrocephalus in the brain of mice at different ischemic times, the energy charge (EC), content of phosphocreatine (PCr), level of lactic acid (Lac), activity of Na+ -K+ -ATPase, brain index and water content of brain were measured at 6, 12, 18, 24, and 30 min, separately after ligating bilateral common carotid arteries in mice. NIH mice were randomly divided into sham-operated group (sham), cerebral ischemia group (ischemia), Sal B-treated group (Sal B) and nimodipine-collated group (Nim). At 6 min after cerebral ischemia, EC, content of PCr and activity of Na +-K -ATPase began to decrease, while level of Lac, brain index and water content of brain increased gradually. However, Sal B (22.5 mg x kg(-1) improved pathophysiological changes at different ischemic times. Especially at 30 min after cerebral ischemia in Sal B group, EC (P < 0.01), content of PCr (P < 0.01 and activity of Na+ -K+ -ATPase ( < 0.05) increased significantly. Meanwhile, level of Lac (P < 0.01, brain index (P < 0.01) and water content of brain (P < 0.05) were lower obviously than those of cerebral ischemia group. Sal B could alleviate hydrocephalus by the improvement of energy metabolism in mice with acute cerebral ischemia, that provides scientific evidence that Sal B can be used for the clinical application of ischemic diseases.

Influence of morphine on expression of nestin in ependymal epithelia,central gray and hippocampal formations of mice / 第二军医大学学报

Objective:To study the influence of morphine on the expression of nestin in the ependymal epithelia,central gray and hippocampal formations in mice.Methods:Twenty health mice were evenly randomized into control group and experiment group.Mice in the control group were injected with normal saline(0.1 ml daily)and those in the experimental group were injected with morphine (0.1 ml,1 mg daily).Thirty days later,the mice brain samples were harvested and made into paraffin sections.Immumohistochemical ABC technique was used to observe the expression of nestin under light microscope.The images were analyzed with the image analytical system.Results:In the control group,the ependymal epithelia,the central gray,the periventricular gray substances and the hippocampal formations had weak expression of the nestin,with a mean gray scale of 150.98?13.31;there were 5 kinds of nestin-positive cells:(1) the basal cells of ependymal epithelium,(2)cells distributed in the periventricular gray substance and the deep lamella of central gray, (3)cells distributed in the superficial lamella of central gray,the subiculum,the parahippocampal gyrus and the cortex inⅡ,Ⅲlayers of the entorhinal area,(4)cells frequently seen in the rectum of midbrain and the subiculum,and(5)cells distributed in the tectum of midhrain,the hippocampus,gyrus dentatus,parahippocampal gyrus and the cortex in V layer of the entorhinal area;the density of nestin in the subiculum and entorhinal area was(7.20?1.23)mm~2.In the experiment group,the ependymal epithelia,the central gray,the periventricular gray substances and the hippocampal formations had positive expression of the nestin,with the mean gray scale being 133.03?22.28;the density of the above-mentioned 5 kinds of cells increased;the density of nestin in the subiculum and entorhinal area was(10.50?1.43)mm~2.The mean value of gray scale and nestin-positive neurons were significantly different between the 2 groups (P