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OBJECTIVE:To observe the effects of Alprostadil dried emulsion for injection combined with Butylphthalide soft capsules on nerve function,inflammatory factor and coagulation function of patients with severe ischemic stroke. METHODS:A total of 66 patients with severe ischemic stroke selected from our hospital during Jun. 2015-Oct. 2017 were divided into control group and observation group according to random number table,with 33 cases in each group. On the basis of routine treatment, control group was additionally given Butyphthalide soft capsules 0.2 g/time,orally at fasting state,tid. On the basis of control group,observation group was additionally given Alprostadil dried emulsion for injection 10 μg added into 0.9% Sodium chloride injection 10 mL,via slow infusion or slow dripping with pipkin,qd. Both groups were treated for 14 days. NIHSS and Barthel index scores,the levels of serum inflammatory factors(CRP,PCT)and coagulation function indexes(D-D,TT,PT,APTT, FIB)were observed in 2 groups before and after treatment,and the occurrence of ADR was also recorded. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05).After treatment,NIHSS scores,the levels of CRP,PCT,D-D and FIB in 2 groups were deceased significantly,while Barthel index scores were increased significantly,TT,PT,APTT were prolonged significantly;observation group was significantly better than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Alprostadil dried emulsion for injection combined with Butylphthalide soft capsules can effectively improve nerve function and coagulation function of patients with severe ischemic stroke,and reduce the levels of inflammatory factor with good safety.
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OBJECTIVE:To investigate risk factors of multidrug-resistant organisms (MDROs) infection in elderly patients of ICU,and to provide reference for formulation and implementation of MDROs prevention and control measures.METHODS:A total of 146 elderly patients were selected from ICU of our hospital during Dec.2013-Jun.2016.Throat swab,sputum swab and anal swab specimens (1 copy,respectively) were collected to conduct active screening of MRSA and ESBLs-producing Enterobacteriaceae.Risk factors of MDROs infection,pathogen distribution and drug resistance were analyzed.RESULTS:Among samples of 146 patients,there were 34 MRSA positive samples in throat swab with positive rate of 23.3％;there were 30 MRSA positive samples in sputum swab with positive rate of 20.5％;there were 99 ESBLs-producing bacteria positive samples in anal swab (containing 50 ESBLs-producing Escherichia coli positive samples and 49 ESBLs-producing Klebsiella pneumoniae positive samples) with positive rate of 67.8％.The positive rate of throat swab MRSA screening was not correlated with patient's gender,age,tracheal intubation or mechanical ventilation (P＞0.05),but it was related with hospitalization time in ICU (P＜0.05).The positive rate of sputum swab MRSA screening was not correlated with patient' s gender,tracheal intubation or mechanical ventilation;the positive rate of anal swab ESBLs-producing bacteria screening were not related with patient's gender(P＞0.05).But they were related with age and hospitalization time in ICU (P＜0.05).Compared with negative patients,there was no statistical significance in the times of fiberoptic bronchoscopy in throat/sputum swab MRSA screening positive patients (P＞0.05).The times of enema,the times of bladder irrigation,the times of urethral catheterization and the duration of indwelling catheter in anal swab ESBLs-producing bacteria screening positive patients were significantly more or longer than negative patients,with statistical significance (P＜0.05).Binary Logistic regression analysis showed that hospitalization time in ICU was risk factor of positive active screening of throat swab in elderly patients of ICU[OR=1.119,95 ％ CI (1.071,1.385),P=0.021];age was risk factor of positive active screening of sputum swab[OR=1.893,95 ％ CI (1.232,4.042),P=0.032];age and hospitalization time in ICU were risk factors of positive active screening of anal swab [OR were 1.046,1.022,95％CI were (1.005,1.088) (1.006,3.283),P were 0.027,0.031].A total of 163 strains of MDROs were detected,among which there were 64 strains of MRSA,50 strains of ESBLs-producing E.coli and 49 strains of ESBLs-producing K.pneumoniae.They were generally highly resistant to compound preparation containing enzyme inhibitors.CONCLUSIONS:The results of MDROs active screening in elderly patients of ICU are related with age,hospitalization time in ICU,the times of enema,the times of bladder irrigation,the times of urethral catheterization and the duration of indwelling catheter.Age and hospitalization time in ICU were risk factors of MDROs infection.The pathogens are mainly ESBLs-producing Enterobacteriaceae,and drug resistance is severe.For elderly critical patients with MDROs infection,clinical prevention and intervention measures should be taken to prevent and control the prevalence and spread of MDROs in ICU.
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Objective To investigate the predictive value of central venous-to-arterial carbon dioxide difference (Pcv-aCO2) on the prognosis of elderly patients with sepsis.Methods 208 elderly patients who met the diagnostic criteria of the Sepsis-3 and with the age of more than 60 years old, and admitted to intensive care unit (ICU) of Guangdong General Hospital from January to December in 2017 were enrolled. According to the prognosis, the patients were divided into death group (n = 46) and survival group (n = 162). The Pcv-aCO2, central venous oxygen saturation (ScvO2), serum procalcitonin (PCT), C-reactive protein (CRP), sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluationⅡ (APACHEⅡ) were collected for all patients. The differences of each index between the two groups were compared. The correlations between Pcv-aCO2 and ScvO2, PCT, CRP, SOFA, APACHEⅡscores were analyzed respectively with Pearson correlation. The prognostic value of Pcv-aCO2 in elderly patients with sepsis was assessed by receiver operating characteristic curve (ROC).Results Compared with survival group, the Pcv-aCO2, PCT, CRP, SOFA and APACHEⅡscores in death group were significantly increased [Pcv-aCO2 (mmHg, 1 mmHg = 0.133 kPa): 6.13±3.33 vs. 4.40±2.65, PCT (μg/L): 31.41±12.83 vs. 3.01±2.69, CRP (mg/L): 130.51± 42.23 vs. 104.46±50.12, SOFA: 12.01±2.25 vs. 9.05±2.06, APACHEⅡ: 29.52±5.03 vs. 20.01±3.21, allP < 0.05], and ScvO2 in death group was significantly decreased (0.571±0.136 vs. 0.685±0.106,P < 0.01). Correlation analysis showed that the Pcv-aCO2 was negatively correlated with ScvO2 (r = -0.762,P = 0.001) and was positively correlated with PCT, CRP, SOFA and APACHEⅡscores (r value was 0.737, 0.625, 0.738, 0.713, respectively, allP < 0.05). ROC curve analysis showed that the area under the ROC curve (AUC) of Pcv-aCO2 prediction of death in patients with sepsis was 0.826, the cut-off was 6.62 mmHg, the sensitivity was 84.7％, the specificity was 77.5％, the positive likelihood ratio was 3.76, and the negative likelihood ratio was 0.19.Conclusion Pcv-aCO2 has a great value in evaluating the prognosis of elderly patients with sepsis and can accurately determine the prognosis of sepsis.
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Objective To investigate the effect of Simo decoction oral liquid on inflammatory in acute respiratory distress syndrome (ARDS) mouse serum and the bronchoalveolar lavage fluid (BALF) and to explore the mechanism.Methods Fifty BALB/c mice were divided into normal control group, ARDS model group, small, moderate and large dose Simo decoction oral liquid-treated groups (simplified as Simo groups) according to random number table method (n=10, in each group). The ARDS model mice were replicated by lipopolysaccharide (LPS) tracheal instillation, and the mice in normal control group were given the same amount of normal saline. Immediately after the success of modeling, the mice were gavaged with 1, 2, 4 times the equivalent dose Simo decoction oral liquid of 7.56 mL·kg-1·d-1 in small, moderate or large dose Simo groups respectively, and there was no intervention in the normal control group or ARDS model group. All the mice were sacrificed at 24 hours after the respective drug amount or normal saline was given in various groups. The lung samples were taken for histologic evaluation, and BALF and serum samples were analyzed for the tumor necrosis factor-α(TNF-α), interleukin (IL-1β, IL-6), and in the mean time the level of serum superoxide dismutase (SOD) was detected.Results The pathological observation of lung tissue showed: there was no obvious inflammatory exudation in lung tissue of mice in normal control group; the inflammatory exudation in lung tissue of mice was increased significantly, the level of TNF-α (ng/L: 1759±303 vs. 104±27, 2506±674 vs. 507±46), IL-1β(ng/L: 209±16 vs. 114±11, 7325±826 vs. 3513±498) and IL-6 (ng/L: 144±38 vs. 47±7, 126±38 vs. 15±7) in serum and BALF were significantly increased, and the content of SOD (kU/L: 40.26±2.54 vs. 50.68±3.75) in serum was significantly decreased in ARDS model group (allP < 0.05), indicating that animal model of ARDS was set up successfully. Compared with ARDS model group, in small, moderate and large dose Simo groups, the inflammation exudation in lung tissue of mouse was reduced, the levels of TNF-α, IL-1βand IL-6 in serum and BALF were reduced, and the content of SOD in serum was increased [serum: TNF-α(ng/L) was 1642±276, 1126±154, 817±102 vs. 1759±303, IL-1β(ng/L)was 198±12, 170±11, 141±13 vs. 209±16, IL-6 (ng/L) was 127±22, 82±16, 41±15 vs. 144±38, SOD (kU/L) was 42.11±1.64, 48.09±1.23 vs. 40.26±2.54; BALF: TNF-α(ng/L) was 2479±446, 1632±330, 1067±223 vs. 2506±674, IL-1β(ng/L): 6939±725, 5398±625, 4401±210 vs. 7325±826, IL-6 (ng/L): 106±30, 68±13, 34±10 vs. 126±38, allP < 0.05], showing the Simo decoction inhibiting the lung inflammation and the above levels of indexes inserum and BALF was in a dose-dependent manner, and the changes in large dose Simo group was the most significant 45.18±1.15, .Conclusions Simo decoction oral liquid can inhibit the inflammatory response of ARDS, reduce the oxidative stress and decrease the lung injury of mice with ARDS.
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Chimeric antigen receptor T-cell (CAR-T) technology is based on genetic modification technology to express T-cell expression tumor specific chimeric antigen receptor bind tumor antigen in an antigen-dependent anti-MCH way. Single chain antibody fragment (scFv) of tumor-associated antigen (TAA) combines with up-stream activating sequence of T-cell in vitro. The forming recombinant plasmid transfects the purified and large scale proliferating T-cell in vitro by transfection technique. This process starts and activates specific killing reaction of tumor. The clinical application of cell therapy shows high efficiency and good anti-tumor effect in treatment of malignant neoplasm, such as leukemia, lymphoma, melanoma, which made CAR-T become the mainstream method of cell therapy.
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OBJECTIVE:To study the effects of simvastatin on oxidative stress and cell apoptosis in aged mice with myocardi-al ischemia-reperfusion (IR). METHODS:Aged mice were randomly divided into sham operation group (phosphate buffer solu-tion),model group(phosphate buffer solution)and simvastatin low-dose,medium-dose and high-dose groups(2.5,5 and 20 mg/kg) with 14 mice in each group. Those groups were given relevant medicine intraperitoneally before modeling for 7 d,once a day. IR model was induced in those groups except for sham operation group. The area ratio of myocardial infarction,myocardial cell apop-tosis rate,activity of myocardial tissue apoptosis gene Caspase-3,the protein expression of Bax and Bcl-2,Akt phosphorylation, serum concent of MDA and activity of SOD were all detected. RESULTS:Compared with sham operation group,the area ratio of myocardial infarction,myocardial cell apoptosis rate,Caspase-3 activity,the protein expression of Bax and MDA content were all increased in model group,while the protein expression of Bcl-2,Akt phosphorylation and SOD activity were decreased(P0.05). CONCLUSIONS:Simvastatin can relieve myocardial IR injury in aged mice,and the mechanism of which may be associated with inhibiting myocardial cell apoptosis and the generation of oxidative stress.
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BACKGROUND:It is unclear about dexamethasone effect on the regulation of microRNA-155 expression in macrophages. OBJCTIVE:To explore whether dexamethasone can regulate the expression of microRNA-155 in macrophages. METHODS:(1) Lipopolysaccharide stimulation of mouse macrophages: mouse macrophage cel lines, Raw264.7 cels, were culturedin vitro and stimulated by lipopolysaccharide. Cultured cels were colected at 0, 0.5, 2, 6 hours after culture to detect the dynamical expression of microRNA-155. (2) Dexamethasone intervention for macrophages: Macrophages were divided into four groups: control group treated with phosphate buffer; lipopolysaccharide group stimulated by lipopolysaccharide; combined group given intervention with dexamethasone and lipopolysaccharide; dexamethasone group cultured with dexamethasone. At 6 hours after culture, cel supernatant was colected to detect the expression of tumor necrosis factor α and interleukin-6 using ELISA method. Real-time fluorescence quantitative PCR was used to detect the expression of microRNA-155 in the Raw264.7 macrophages. RESULTS AND CONCLUSION:Lipopolysaccharide significantly increased the expression of tumor necrosis factor α, interleukin-6 and microRNA-155 after 6 hours of culture (P < 0.05). Combined use of dexamethasone and lipopolysaccharide slightly increased the expression of tumor necrosis factor α, interleukin-6 and microRNA-155 (P< 0.05). Dexamethasone alone had no influence on the expression of tumor necrosis factor α and interleukin-6, but significantly decreased the expression of microRNA-155 (P < 0.05). These findings indicate that dexamethasone can inhibit the expression of microRNA-155 in the macrophages induced by lipopolysaccharide.
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Objective To compare the curative effects of multi-level puncture versus single-level puncture percutaneous vertebroplasty(PVP) for treatment of multiple-level osteoporotic vertebral body compression fractures(OVCF) in senile patients.Methods From June 2008 through November 2014,89 senile patients with fresh multiple-level OVCF underwent PVP guided by C-arm fluoroscopy in prone position.Of them,51 received PVP in which the vertebrae of multiple levels were simultaneously punctured for bone cement injection while the other 38 received PVP in which the vertebrae of multiple levels were punctured one by one for bone cement injection.The 2 groups were compatible with no significant differences in preoperative demographic data (P ＞ 0.05).The 2 groups were compared in terms of visual analgesic scale (VAS),operation time for a single vertebra,fluoroscopy times for a single vertebra,bone cement injection amount for a single vertebra,and extraosseous cement leakage.Results PVP procedures were successful in both groups without serious complications.The VAS scores in both groups at 2 days post-operation were significantly lower than those at pre-operation(P ＜ 0.05).The operation time and fluoroscopy times for a single vertebra in the multi-level puncture PVP group were significantly less than those in the single-level puncture PVP group (P ＜ 0.05).There were no significant differences between the 2 groups in bone cement injection amount for a single vertebra or extraosseous cement leakage (P ＞ 0.05).Conclusions The curative effects of multi-level puncture and single-level PVP are satisfactory for senile OVCF,but multi-level puncture PVP may lead to less operation time and less X-ray exposure.
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Aim To study targeting capability of anti-CD19 (Fab)-LDMto CD19 +B lymphoma cells in vi-vo and in vitro.Methods Flow cytometry was em-ployed to determine the affinity of Cy5 labeled anti-CD19 (Fab)-LDP to human lymphoma Raji cells.And the optical imaging system was used to analyze the dis-tribution of Cy5-anti-CD19 (Fab )-LDP in lymphoma-transplanted xenograft nude mice in vivo.Results The results of flow cytometry demonstrated that Cy5-an-ti-CD19(Fab)-LDP had remarkable affinity with lym-phoma Raji cells;Raji lymphoma xenograft model was established successfully in nude mice and in vivo fluo-rescence imaging analysis indicated that the antibody-drug conjugates could specially be localized in the tar-get tumor.Conclusion The experiments in vivo and vitro confirm that anti-CD19 (Fab)-LDP has remarka-ble affinity to targeting CD19 +lymphoma cells,and the antibody drugs anti-CD19 (Fab )-LDP have the probability to be new drugs for the treatment of malig-nant lymphoma.
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Objective To investigate the growth inhibition and DNA damage of energized fusion protein anti-CD20(Fab)-LDM on B JAB cells in vitro.Methods The binding activity of fusion protein anti-CD20 (Fab)-LDP to B JAB cells was studied by flow cytometry and confocal laser scanning microscopy.MTT assay was used to study the energized fusion protein anti-CD20(Fab)-LDM on cell growth of B JAB cells.Comet assay was employed to detect DNA damage in B JAB cells.The cell growth cycle of BJAB was analyzed by FACS.Results The recombinant fusion protein anti-CD20 (Fab)-LDP possessed an significant target affinity towarded BJAB cells.The energized fusion protein anti-CD20(Fab)-LDM showed obvious inhibition on proliferation,as well as induced potent DNA damage in B JAB cells in vitro compared with lidamycin.B JAB cells treated with energized fusion protein anti-CD20 (Fab)-LDM showed S phase cell cycle.Conclusion The energized fusion protein anti-CD20 (Fab)-LDM could target binding to BJAB cells and significantly inhibit the proliferation of B JAB cells by inducing DNA damage and S phase arrest.
