Efficacy of Xuebijing Combined with Ulinastatin in the Treatment of Traumatic Sepsis and Effects on Inflammatory Factors and Immune Function in Patients.

Objective: To investigate the efficacy of xuebijing combined with ulinastatin in the treatment of traumatic sepsis and analyze the effects on inflammatory factors and immune function of patients. Methods: 182 patients with traumatic sepsis were selected from June 2017 to September 2021 in our hospital. The patients were divided into the control group and the observation group. Patients in both groups were given routine treatments such as initial resuscitation, blood transfusion, monitoring of lactic acid to guide fluid replacement, early control of infection source, selection of appropriate antibiotics, correction of acidosis, treatment of primary disease, prevention of hypothermia and stress ulcer, application of vasoactive drugs, application of glucocorticoid and nutritional support. The control group was treated with Xuebijing injection on the basis of routine treatment, and the observation group was given Xuebijing injection combined with ulinastatin treatment on the basis of routine treatment. The APACHE II score was applied to evaluate the patients before and after treatment, and the routine blood indicators, inflammatory factor indicators, immune function indicators and liver function indicators were tested. Results: After the treatment, the APACHE II score of the observation group was (10.35 ± 3.04) lower than that of the control group (15.93 ± 4.52) (P < 0.05). After treatment, the WBC and neutrophils in the observation group (15.19 ± 2.91) and (0.65 ± 0.04) were lower than those in the control group (16.42 ± 3.44) and (0.79 ± 0.05), and the PLT(162.85 ± 43.92) was higher than that in the control group (122.68 ± 36.89) (P < 0.05). After treatment, the levels of serum PCT, IL-6, TNF-α in the observation group were (11.38 ± 3.05), (10.74 ± 3.82) and (9.82 ± 2.35) lower than those in the control groups (17.34 ± 3.29), (15.28 ± 4.05) and (13.24 ± 3.06) (P < 0.05). After treatment, the levels of CD3+, CD4+, CD8+, CD4+/CD8+ in the observation group were (50.64 ± 4.98), (40.56 ± 4.82), (27.22 ± 3.29), (1.49 ± 0.24) higher than those in the control groups (46.08 ± 4.75), (34.69 ± 4.08), (25.14 ± 3.18), (1.38 ± 0.19) (P < 0.05). After treatment, the levels of TBIL and AST in the observation group were (12.35 ± 3.82), (25.66 ± 4.49) lower than those in the control group (18.43 ± 4.06), (34.58 ± 5.06) (P < 0.05). Conclusion: Xubijing combined with ulinastatin has a good effect in the treatment of patients with traumatic sepsis, which can effectively improve the condition, reduce the body's inflammatory response, and promote the recovery of patients' immune function and liver function.

Expression of Th17/Treg Cells in Peripheral Blood and Related Cytokines of Patients with Ulcerative Colitis of Different Syndrome Types and Correlation with the Disease.

OBJECTIVE: To explore the expression of helper T cells 17 (Th17)/regulatory T cells (Treg) in peripheral blood and related cytokines of patients with different types of ulcerative colitis (UC) and analyze their correlation with the disease. METHODS: From January 2018 to December 2019, 53 patients diagnosed with UC in our hospital were selected. According to their medical syndromes, they were divided into the damp-heat internal accumulation group (n = 35) and the spleen-kidney yang deficiency group (n = 18). 21 healthy volunteers were selected as the control group. The Mayo scoring standard was used to determine the severity of the patient's condition. The expression levels of Th17/Treg cells and related cytokines in peripheral blood were compared between the groups. Pearson correlation was used to analyze the correlation between the ratio of Th17 and Treg cells in the peripheral blood of UC patients and the ratio of TH17/Treg with Mayo score. RESULTS: The peripheral blood Th17 cell ratio and Th17/Treg ratio of the damp-heat internal accumulation and spleen-kidney yang deficiency group were higher than those of the control group; the Treg cell ratio was lower than that of the control group; the peripheral blood Th17 cell ratio and Th17/Treg ratio of the damp-heat internal accumulation group were higher those of the spleen-kidney yang deficiency group; and the proportion of Treg cells was lower than that of the spleen-kidney yang deficiency group (P < 0.05). The expression levels of serum IL-6, IL-17, IL-22, and TNF-α in the damp-heat internal accumulation and spleen-kidney yang deficiency group were higher than those of the control group; IL-10 and TGF-ß were lower than those of the control group; the levels of serum IL-6, IL-17, IL-22, and TNF-α in the damp-heat internal accumulation group were higher than those of the spleen-kidney yang deficiency group; and both IL-10 and TGF-ß were lower than those of the spleen-kidney yang deficiency group (P < 0.05). The peripheral blood Th17 cell ratio and Th17/Treg ratio in the moderately active period group and severely active period group were higher than those of the lightly active period group; the Treg cell ratio was lower than that of the lightly active period group; the peripheral blood Th17 cell ratio and Th17/Treg ratio in the severely active period group were higher than those in the moderately active period group; and the proportion of Treg cells was lower than that of the moderately active period group. Pearson correlation analysis showed that the proportion of Th17 cells and Th17/Treg in peripheral blood of UC patients were both positively correlated with Mayo score (r = 0.762, r = 0.777, P < 0.001). Treg was negatively correlated with Mayo score (r = -0.790, P < 0.001). CONCLUSION: There are differences in the expression of peripheral blood Th17/Treg cells and related cytokines among UC patients with different syndromes, and the damp-heat content is the most significant. The higher the ratio of Th17 cells in peripheral blood and the degree of Th17/Treg imbalance, the lower the ratio of Treg cells, and the more severe the condition of UC patients, which can provide a preliminary quantitative basis for the TCM classification and severity of the diagnosis of UC.

Putting the Squeeze on Lead Chromate Nanorods.

We have studied by means of X-ray diffraction and Raman spectroscopy the high-pressure behavior of PbCrO4 nanorods. We have found that these nanorods follow a distinctive structural sequence that differs from that of bulk PbCrO4. In particular, a phase transition from a monoclinic monazite-type PbCrO4 to a novel monoclinic AgMnO4-type polymorph has been discovered at 8.5 GPa. The crystal structure, Raman-active phonons, and compressibility of this novel high-pressure phase are reported for the first time. The experimental findings are supported by ab initio calculations that provide information not only on structural and vibrational properties of AgMnO4-type PbCrO4 but also on the electronic properties. The discovered phase transition triggers a band gap collapse and a subsequent metallization at 44.2 GPa, which has not been observed in bulk PbCrO4. This suggests that nanoengineering can be a useful strategy to drive metallization under compression.

Discovery of a hexagonal ultradense hydrous phase in (Fe,Al)OOH.

A deep lower-mantle (DLM) water reservoir depends on availability of hydrous minerals which can store and transport water into the DLM without dehydration. Recent discoveries found hydrous phases AlOOH (Z = 2) with a CaCl2-type structure and FeOOH (Z = 4) with a cubic pyrite-type structure stable under the high-pressure-temperature (P-T) conditions of the DLM. Our experiments at 107-136 GPa and 2,400 K have further demonstrated that (Fe,Al)OOH is stabilized in a hexagonal lattice. By combining powder X-ray-diffraction techniques with multigrain indexation, we are able to determine this hexagonal hydrous phase with a = 10.5803(6) Šand c = 2.5897(3) Šat 110 GPa. Hexagonal (Fe,Al)OOH can transform to the cubic pyrite structure at low T with the same density. The hexagonal phase can be formed when δ-AlOOH incorporates FeOOH produced by reaction between water and Fe, which may store a substantial quantity of water in the DLM.

Negative Linear Compressibility in Organic Mineral Ammonium Oxalate Monohydrate with Hydrogen Bonding Wine-Rack Motifs.

Negative linear compressibility (NLC) is a relatively uncommon phenomenon and rarely studied in organic systems. Here we provide the direct evidence of the persistent NLC in organic mineral ammonium oxalate monohydrate under high pressure using synchrotron X-ray powder diffraction, Raman spectroscopy and density functional theory (DFT) calculation. Synchrotron X-ray powder diffraction measurement reveals that ammonium oxalate monohydrate shows both positive and negative linear compressibility along b-axis before 11.5 GPa. The red shift of the external Raman modes and abnormal changes of several selected internal modes in high-pressure Raman spectra further confirmed the NLC. DFT calculations demonstrate that the N-H···O hydrogen bonding "wine-rack" motifs result in the NLC along b-axis in ammonium oxalate monohydrate. We anticipate the high-pressure study of ammonium oxalate monohydrate may represent a promising strategy for accelerating the pace of exploitation and improvement of NLC materials especially in organic systems.

Luminescence Properties of Compressed Tetraphenylethene: The Role of Intermolecular Interactions.

Mechanochromic materials with aggregation-induced enhanced emission (AIEE) characteristic have been intensively expanded in the past few years. In general, intermolecular interactions invariably alter photophysical processes, while their role in the luminescence properties of these AIEE-active molecules is difficult to fully recognize because the pressurized samples possess amorphous nature in many cases. We now report the high-pressure studies on a prototype AIEE-active molecule, tetraphenylethene, using diamond anvil cell technique with associated spectroscopic measurements. An unusual pressure-dependent color, intensity, and lifetime change in tetraphenylethene has been detected by steady-state photoluminescence and time-resolved emission decay measurements. The flexible role of the aromatic C-H···π and C-H···C contacts in structural recovery, conformational modification, and emission efficiency modulation upon compression is demonstrated through structure and infrared analysis.

Clinical analysis of concomitant valve replacement and bipolar radiofrequency ablation in 191 patients.

OBJECTIVE: The study objective was to evaluate the safety and efficacy of concomitant bipolar radiofrequency ablation and heart valve replacement in patients with rheumatic heart disease and atrial fibrillation. METHODS: A total of 191 patients with rheumatic heart disease and chronic atrial fibrillation underwent valve replacement with concomitant bipolar radiofrequency ablation. There were 78 male and 113 female patients with a mean age of 46.0 ± 9.1 years and an atrial fibrillation duration of 43.7 ± 15.4 months. Valve replacement surgery included mitral valve replacement in 121 patients, mitral and aortic valve replacement in 59 patients, mitral and tricuspid valve replacement in 8 patients, and triple valve replacement in 3 patients. All patients received oral antiarrhythmic drugs for 3 to 6 months postoperatively. Follow-up electrocardiography and color Doppler echocardiography were performed postoperatively. RESULTS: The mean aortic crossclamping time was 84.0 ± 25.5 minutes, and cardiopulmonary bypass time was 139.4 ± 39.1 minutes. There was no abnormal bleeding due to bipolar radiofrequency ablation. Three patients (1.57%) died of low cardiac output syndrome in hospital at 2, 3, and 5 days after surgery. Major perioperative complications include reoperation for bleeding (n = 1), reoperation for wound infection (n = 1), intra-aortic balloon pump placement (n = 2), and renal failure (n = 2). All other patients were discharged without complications. The mean follow-up time was 17.4 ± 11.8 months with a follow-up rate of 95.3%. There were no cases of late death, complete atrioventricular block, or anticoagulation-induced complications. Of 158 patients who were followed up for 1 year, sinus rhythm was maintained in 125 (79.11%). CONCLUSIONS: Concomitant bipolar radiofrequency ablation is an effective and safe technique for treating atrial fibrillation in patients with rheumatic heart disease undergoing valve replacement, with promising follow-up results.

Exploration of the pyrazinamide polymorphism at high pressure.

We report the high-pressure response of three forms (α, δ, and γ) of pyrazinamide (C(5)H(5)N(3)O, PZA) by in situ Raman spectroscopy and synchrotron X-ray diffraction techniques with a pressure of about 14 GPa. These different forms are characterized by various intermolecular bonding schemes. High-pressure experimental results show that the γ phase undergoes phase transition to the ß phase at a pressure of about 4 GPa, whereas the other two forms retain their original structures at a high pressure. We propose that the stabilities of the α and δ forms upon compression are due to the special dimer connection that these forms possess. On the other hand, the γ form, which does not have this connection, prefers to transform to the closely related ß form when pressure is applied. The detailed mechanism of the phase transition together with the stability of the three polymorphs is discussed by taking molecular stacking into account.

[Impact of tricuspid annuloplasty on changes of right atrioventricular diameter and annulus in patients with mitral valve replacement].

OBJECTIVE: To observe changes of right atrioventricular diameter and annulus after mitral valve replacement (MVR) in patients with and without tricuspid annuloplasty. METHODS: A total of 112 patients who underwent MVR surgery from April 2005 to December 2006 were recruited in this study. The patients were divided into two groups. Those with maximal tricuspid annulus diameter/body surface area > or = 21 mm/m2 were given tricuspid annuloplasty (TAPG, n=56). Otherwise, no tricuspid annuloplasty were performed (NTAPG, n=56). All of the patients were followed up regularly. The echocardiography were reviewed two years after the surgery. RESULTS: An average of (25.04 +/- 5.04) months had passed when the echocardiography were reviewed. The two groups had no differences in age, gender, body surface areas and cardiac functions (P>0.05). The TVPG group had more patients with atrial fibrillation than the NTVPG group (P<0.05). In the patients in the TVPG group, the right atrioventricular diameter, and maximal and minimal tricuspid annulus diameter were significantly narrowed after the operations (P<0.05). The percent shorting of tricuspid valve annulus did not change significantly (P> 0.05). The constituent ratio of TR was significantly reduced (P<0.05). However, in the patients in the NTVPG group, the right atrioventricular diameter did not change significantly (P>0.05). The maximal and minimal tricuspid annulus diameter increased (P<0.05). The percent shorting of tricuspid valve annulus did not change significantly (P>0.05). Though the constituent ratio of TR had no significant changes, 5 (13.5%) patients developed moderate or serious TR two years after the operations. CONCLUSION: Tricuspid annuloplasty (TAP) has benefits for the patients with enlarged right atrioventricular and tricuspid annulus. For those patients without enlarged right atrioventricular and tricuspid, their tricuspid valve conditions should also be carefully assessed. Because as time lapse, these patients may also develop TR.

[Doppler echocardiographic assessment of CarboMedics prosthesis in patients with mitral valve replacement].

OBJECTIVE: To evaluate the CarboMedics (CM) prosthesis function two years after mitral valve replacement, and to compare the effective orifice area (EOA) calculated by pressure half-time (PHT) method and continuity method (CON). METHODS: Forty nine patients who underwent isolated mitral valve replacement with a CM prosthesis were recruited in this study, which included 13 cases of 25 mm CM prosthesis and 36 cases of 27 mm CM prosthesis. Two years after the mitral valve replacement, transthoracic echocardiography (TTE) was performed, measuring left ventricular ejection fraction (LVEF), stroke volume mean gradient (SV), PHT, peak early mitral diastolic velocity (E velocity), mean gradient (MG), time-velocity integral of left ventricular outflow tract/time-velocity integral of mitral valve prosthesis (TVI(MVP)/TVI(LVOT)). The function of the prosthetic valve was considered normal when PHT < 130 ms, E velocity < 2.0 m/s and TVI(MVP)/TVI(LVOT) < 2.2. RESULTS: More than half (53.1%) of the patients had normal function of the prosthetic valve. No significant differences were found in PHT, MG, TVI(MVP)/TVI(LVOT), EOA or IEOA between the patients with 25 mm valve and the patients with 27 mm valve (P > 0.05). But the patients with 25 mm valve had higher E velocity than the patients with 27 mm valve (P < 0.05). The PHT method produced greater EOA than by the CON method (P < 0.05). CONCLUSION: The function of CM prosthesis is acceptable two years after the mitral valve replacement, with most patients having PHT < 130 ms, E velocity < 2.0 m/s and TVI(MVP)/TVI(LVOT) < 2.2. PHT method produces greater EOA than CON method.

[Tricuspid valve replacement and anticoagulation therapy: a report of 70 cases].

OBJECTIVE: To evaluate the operative indication, the choice of valve prostheses, and the method of anticoagulation therapy of tricuspid valve replacement (TVR). METHODS: From May 1998 to January 2008, 70 patients underwent TVR. There were 59 cases of rheumatic heart diseases. The operations included mitral and tricuspid valve replacement for 37 cases, triple valve replacement for 18 cases, isolated TVR for 13 cases, and tricuspid and aortic valve replacement for 2 cases. All the patients received oral anticoagulant therapy (warfarin) 2 d after the operations. RESULTS: There were 3 in-hospital deaths (4.3%) and 1 late death (0.4%). The follow-up rate was 88.1%, and the cumulative follow-up was 243.5 patient-years (pty). The anticoagulation-related event rate was 2.9% pty, and the mean INR value of 643 out-patient samples was 1.87 +/- 0.68. Post-operative heart function NYHA classification: 52 cases in class I to II, and 7 cases in class III. CONCLUSIONS: TVR should be indicated for severely damaged and deformed tricuspid valve of rheumatic heart diseases. Bileaflet mechanical valve is a suitable prosthesis for TVR. The optimal anticoagulation therapy intensity of TVR needs to be investigated.