Exploring the Process of Neutrophil Transendothelial Migration Using Scanning Ion-Conductance Microscopy.

The dynamics of neutrophil transendothelial migration was investigated in a model of experimental septicopyemia. Scanning ion-conductance microscopy allowed us to determine changes in morphometric characteristics of endothelial cells during this process. In the presence of a pyogenic lesion simulated by Staphylococcus aureus, such migration was accompanied by both compensatory reactions and alteration of both neutrophils and endothelial cells. Neutrophils demonstrated crawling along the contact sites between endothelial cells, swarming phenomenon, as well as anergy and formation of neutrophil extracellular traps (NETs) as a normergic state. Neutrophil swarming was accompanied by an increase in the intercellular spaces between endothelial cells. Endothelial cells decreased the area of adhesion to the substrate, which was determined by a decrease in the cell projection area, and the cell membrane was smoothed. However, endothelial cell rigidity was paradoxically unchanged compared to the control. Over time, neutrophil migration led to a more significant alteration of endothelial cells: first, shallow perforations in the membrane were formed, which were repaired rather quickly, then stress fibrils were formed, and finally, endothelial cells died and multiple perforations were formed on their membrane.

The Role of C-reactive Protein Estimation in Determining the Duration of Antibiotic Therapy in Neonatal Sepsis.

INTRODUCTION: Septicemia is globally considered the most important cause of neonatal morbidity and fatality. Serum C-Reactive Protein (CRP) is an acute phase reactant, which is brought out in response to the inflammatory reaction. It is prophesied to drop down speedily after the coherent weeding out of microbial incitation due to the short half-life of CRP. CRP levels reflect the individual's association between microbial infection and defensive mechanisms.  Methods: This hospital-based cross-sectional study included 150 admitted patients with suspected sepsis in the Department of Pediatrics, Rajendra Institute Medical Sciences (RIMS), Ranchi, India, over a study period of one year (2020 to 2021). CRP was estimated on the day of admission and repeated after 72 hours, on the fifth day, and on the seventh day for serial values of CRP, and the findings were compared by making three groups. Further, the research participants were designated to three different groups according to the CRP estimation levels. RESULTS: Out of the 150 assumed neonatal septicemia patients, antibiotics were paused in 42 neonates (28%) within 72 hours. In group 2, 8% of neonates' antibiotics were stopped in five days, and a total of 102 neonates (68%) could be discharged on the seventh day of antibiotic therapy as their CRPs became negative on the third day and seventh day consecutively, along with negative blood culture reports. In group 3, antibiotics of 48 neonates (32%) were continued beyond seven days. CONCLUSION: CRP has a skyscraping specificity and negative predictive values (NPV); thus, by estimating serial CRPs, the antibiotic therapy duration can be determined, which further helps determine the period of hospitalization.

Fabrication of fasudil hydrochloride modified graphene oxide biocomposites and its defensive effect acute renal injury in septicopyemia rats.

This investigation aspired to the impacts of intraperitoneal injection of suspended graphene oxide-bovine serum albumin (GO-BSA) biocomposite blended in fasudil (FSD)-against intense renal damage in septicopyemia rodent's models. It was picked a model of acute renal injury by an intraperitoneal organization of fasudil. Our outcomes demonstrated that few markers of renal capacity, for example, blood urea nitrogen (BUN), creatinine (SC), and intratubular waste levels were altogether diminished essentially in fasudil blended GO-BSA intraperitoneally infusion groups during the first week, showing that GO-BSA has an uncommon ability to ensure FSD discharges. Additionally, surprisingly, while rats got GO-BSA intraperitoneally, biomedical examination demonstrated the fruitful decrease of blood urea nitrogen and creatinine blood factors showing that GO-BSA has an uncommon ability alone to repair the acute renal injury. It appears that GO-BSA can adsorb ECM proteins and encourages their exchange to the intense renal damage tissue and expands its repair speed, in addition, GO-BSA ensures the FSD and along these lines the helpful adequacy of the FSD in intense renal damage enhanced by the grip of living cells to GO-BSA biocomposites. It could be inferred that GO-BSA material improves the rate of achievement of FSD conveys in intense renal damage in septicopyemia animals.

Early diagnosis of bacterial infection in patients with septicopyemia by laboratory analysis of PCT, CRP and IL-6.

The aim of the present study was to investigate the early diagnostic values of measuring procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (lL-6) levels in patients with bacterial infections and septicopyemia. Ninety-two patients with septicopyemia who were diagnosed and treated in the First Affiliated Hospital of Fujian Medical University between December 2012 and October 2013 were randomly selected. Based on results of hemoculture, the patients were divided into the Gram-negative bacterial infection group (n=47) and the Gram-positive bacterial infection group (n=45). Immune nephelometry was used for measuring serum CRP levels, electrochemiluminescence assay was used to measure serum PCT and IL-6. The levels of serum CRP, PCT, and IL-6 in the Gram-negative bacterial infection group were significantly higher than in the Gram-positive group. Analysis with Spearman's correlation coefficient showed that there were positive correlations between the levels of PCT and CRP, and between PCT and IL-6 (P<0.05). The diagnosis of Gram-negative bacterial infections was as follows: The area under the PCT curve was 0.974 (P<0.05) with sensitivity and specificity of 96.8 and 93.5%, respectively. The area under the CRP curve was 0.953 (P<0.05) with sensitivity and specificity of 94.2 and 91.7%, respectively. The area under the IL-6 curve was 0.925 (P<0.05) with sensitivity and specificity of 93.6 and 90.5%, respectively. The diagnosis of Gram-negative bacterial infections was as follows: The area under the PCT curve was 0.854 (P<0.05) with sensitivity and specificity of 92.7 and 91.8%, respectively. The area under the CRP curve was 0.832 (P<0.05) with sensitivity and specificity of 90.2 and 89.3%, respectively. The area under the IL-6 curve was 0.817 (P<0.05) with sensitivity and specificity of 89.4 and 81.5%, respectively. In conclusion, PCT, CRP, and lL-6 can act as early diagnostic markers for bacterial infections in patients with septicopyemia.

Effect of daptomycin on serum copeptin and procalcitonin in septicopyemia induced by MRSA / 中国生化药物杂志

Objective To investigate the effect of daptomycin on the serum levels of proclacitonin (PCT) and copeptin in septicopyemia patients induced by methicillin-resistant Staphylococcus aureus (MRSA). Methods 54 cases septicopyemia patients induced by MRSA were selected and divided into two groups, 27 cases in each group. The two groups received fluid replacement therapy and nutrition support, the control group received vancomycin (0.5g per times, three times daily) with intravenous drip, and the study group received daptomycin (6mg/kg, once daily) with intravenous drip. The serum PCT, proclacitonin levels pre-and post-treatment in two groups were detected, the acute physiology and chronic health evaluationⅡ (APACHEⅡ) and sepsis-related organ failure assessment (SOFA) were used to evaluate the patients' condition, the clearance time of pathogenic bacteria was recorded and the clinical efficacy was compared between two groups. Results Compared with before treatment, serum PCT, C-reactive protein (CRP), interleukin-1β(IL-1β) and IL-6 in two groups decreased(P<0.01), the count of WBC, NE% and copeptin decreased (P<0.01), the APACHEⅡ and SOFA score were lower(P<0.05); compared with the control group, the PCT, CRP, IL-1 beta and IL-6 in study group were lower(P<0.05), the count of WBC, NE% and copeptin level were lower(P<0.05), APACHEⅡ and SOFA score were lower(P<0.05), the pathogen clearance rate was higher(P<0.05), clearance time was shorter(P<0.05), the total efficiency was higher(P<0.05). Conclusion Daptomycin can reduce serum PCT and copeptin in patients with septicopyemia induced by MRSA, and remove pathogenic bacteria rapidly, inhibit the inflammatory reaction, safe and reliable.

Correlation analysis between red cell volume distribution width and the mortality rate in ARDS patients after renal transplantation / 器官移植

Objective To investigate the correlation between red cell volume distribution width (RDW) and the mortality rate of acute respiratory distress syndrome (ARDS) patients after renal transplantation. Methods Clinical data of 106 ARDS patients undergoing renal transplantation were retrospectively analyzed. According to RDW, all patients were assigned into the normal (≤15.0%, n=68) and increasing RDW groups (>15.0%, n=38). Baseline data and the incidence of adverse events were statistically compared between two groups. Kaplan-Meier survival curve was adopted to compare the 50 d-mortality rate between two groups. Cox's proportional hazards regression model was utilized to identify the risk factors of the mortality of ARDS patients. Results Among 106 patients, the 50 d-mortality rate was calculated as 43.4% (46/106). The sequential organ failure assessment (SOFA) score, serum creatinine, hemoglobin and platelet count significantly differed between two groups (all P<0.05). In the increasing RDW group, the 50 d-mortality rate and the incidence of infectious shock were significantly higher than those in the normal RDW group (both P<0.05). Kaplan-Meier survival curve demonstrated that the 50 d-mortality rate significantly differed between two groups (P<0.01). Cox's proportional hazards regression model univariate analysis revealed that hemoglobin level<100 g/L, serum creatinine>133 μmol/L, platelet count<100×109/L, severe ARDS and RDW>15.0% were the potential risk factors of the 50 d-mortality rate in ARDS patients (all P<0.05). Multivariate analysis demonstrated that severe ARDS [odd ratio (OR)=12.77, 95%confidence interval (CI) 11.63-15.39, P<0.001] and RDW>15.0% (OR=2.01, 95%CI 1.02-3.94, P<0.043) were the independent risk factors of the 50 d-mortality rate in ARDS patients. Conclusions RDW elevation is correlated with the severity of disease and 50 d-mortality rate in ARDS patients following renal transplantation. RDW can serve as a clinical parameter to predict the prognosis of ARDS patients after renal transplantation.

Effect of dexmedetomidine on the renal function and expression of tight junction protein ZO-1 and occludin in the kidney of rats with septicopyemia / 中国比较医学杂志

Objective To investigate the effect of dexmedetomidine on the renal function and the expression of tight junction protein ZO-1 and occluding in the kidney of rats with septicopyemia induced by lipopolysaccharide.Methods Thirty adult male SD rats were randomly divided into 3 groups ( n=10 each):control group( group C) , LPS group ( group M) , and dexmedetomidine group ( group Dex ) .In the groups Dex and LPS, the rats were infused with saline and lipopolysaccharide (5 mg/kg, i.v.) respectively.In the Dex group, after intravenous injection of lipopolysaccharide (5 mg/kg) , the rats were firstly infused the loaded dose of dexmedetomidine (7μg/kg) for 15 minutes, and then changed to 5 μg/kg· min for 30 minutes.Blood samples were collected at 24 h later for measuring TNF-α, IL-1β, Scr and BUN.The kidney tissues were examined by histopathology.The expression of ZO-1 and occludin was detected by Western blot. Results Compared with the group C, the kidney tissue of group M was extensively damaged with tubular dilatation and inflammation, while reduced in the group Dex.Compared with the group C, the expressions of Scr, BUN, IL-1βand TNF-αwere all enhanced in the groups M and Dex ( P <0.05 ) , while the inflammatory factors in the group Dex were significantly lower than those of the group M ( P <0.05 ) .The Results The Western blot analysis showed that the expressions of protein ZO-1 and occludin in the group Dex were significantly higher than those of the group M (P<0.05). Conclusions Dexmedetomidine can improve the renal function of rats with septicopyemia, inhibit the acute renal injury and inflammation, increase the expression of protein ZO-1, and exert certain protective effect on the kidneys.

Study on relationship between changes of blood lipid and lactic acid level with prognosis in children patients with septicopyemia / 国际检验医学杂志

Objective To investigate the relationship between the changes of blood lipid 4 indexes and lactic acid level with prog‐nosis in children patients with septicopyemia .Methods Ninety‐five children patients with septicopyemia in our hospital from Janu‐ary 2013 to December 2014 were selected ,including 30 death cases(death group and) and 65 survival cases(non‐death group) .To‐tally 60 age‐and gender‐matched healthy children were enrolled as control group .The levels of serum cholesterol (TC) ,triglyceride (TG) ,high density lipoprotein cholesterol (HDL‐C) ,low density lipoprotein cholesterol(LDL‐C) and arterial blood lactate acid (LAC) were measured ,and the results were compared among the three groups .Results The TC and HDL‐C levels in the death group and the non‐death group were lower than those in the control group (P<0 .05) ,the LDL‐C level of the death group was low‐er than that the control group and survival group(P<0 .05) ,while the TG level in the death group and the non‐death group was higher than that in the control group(P<0 .05) ,moreover the TG level in the death group was increased significantly (P<0 .01) . In the excessive inflammation reaction ,the levels of TC ,HDL‐C and LDL‐C were dropped ,which were also decreased with the dis‐ease development ,but the TG level was increased .The LAC level in the death group was higher than that in the control group and the non‐death group ,which in the non‐death group was recovered to the normal level with the disease condition improvement ,while which in the death group was increased with the disease condition progression ,moreover the difference between on 1 d and 3 d had statistical difference(P<0 .05) .Conclusion Monitoring the levels of the blood lipid and lactic acid has an important significance to judge the severity and prognosis in children patients with septicopyemia .

Clinical Observation of Shenmai Injection Combined with Insulin in the Intensive Treatment of Stress Hy-perglycemia in the Septicopyemia Patients / 中国药房

OBJECTIVE:To observe the efficacy of Shenmai injection combined with insulin in the intensive treatment of stress hyperglycemia in the septicopyemia patients. METHODS:The data of 156 septicopyemia patients with stress hyperglycemia was collected Retrospectively,according to the different medication divided into control group (78 cases) and observation group (78 cases).All patients determined the pathogenic bacteria and received related anti-infection treatment,improving ventilation state, adequate fluid resuscitation support,immune therapy,nutritional support and other conventional treatment;based on it,control group received different dosages of insulin [1 U/ml,intravenous micro pump,with speed of 0.1 U/(kg·h)] based on different blood glucose levels;observation group additionally received 40 ml Shenmai injection,adding into insulin mixed solution,intrave-nous micro pump. Endpoint events(mortality),recovering time of blood glucose,total dosage of insulin,basic indicators [Acute physiology and chronic health(24 APACHE-Ⅱ)score,mechanical ventilation time,hospitalization days in ICU and frequency of hypoglycaemia] and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total mortality rate in observa-tion group was significantly lower than control group,recovering time of blood glucose was significantly shorter than control group,the total dosage of insulin was significnatly less than control group,mechanical ventilation time was significantly shorter than control group,hospitalization days in ICU was significantly less than control group,the differences were statistically significant (P0.05);after treat-ment,the 24 APACHE-Ⅱ score in 2 groups were significantly reduced,and observation group was lower than control group,the differences were statistically significant(P<0.05). And there were no obvious adverse reactions in 2 groups during treatment. CON-CLUSIONS:Based on conventional treatment,Shenmai injection combined with insulin shows good efficacy in the intensive treat-ment of stress hyperglycemia in the septicopyemia patients,it can decrease total dosage of insulin,reduce mortality rate and 24 APACHE-Ⅱscore,shorten mechanical ventilation time and decrease hospitalization days in ICU,with good safety.

Protective effect of fasudil hydrochloride against acute renal injury in septicopyemia rats.

OBJECTIVE: To observe the protective effect of fasudil hydrochloride against acute renal injury in septicopyemia rats. METHODS: A total of 60 Wister rats were included in the study and divided into control group (n = 10), model group (n = 25) and treatment group (n = 25). Model group and treatment group received intraperitoneal injection of endotoxin (ET) to establish acute renal injury models while the control group only received daily intraperitoneal injection of normal saline 1 mL. Five rats were taken out of model group and treatment group respectively at 1 h (T1), 6 h (T2), 12 h (T3), 24 h (T4) and 48 h (T5), for intraperitoneal injection of ET 30 mg/kg. Treatment group received intraperitoneal injection of fasudil hydrochloride 30 mg/kg 1 h before injection of ET. For three groups, 5 mL blood samples were collected from postcava for determination of serum creatinine and urea nitrogen levels at different time points. Concentrations of serum tumor necrosis factor α and ET-1 were determined by using ELISA. The renal pathologic changes were observed under the microscope. RESULTS: Serum creatinine levels in both model group and treatment group were significantly higher than control group at T2-T5 (P < 0.05) while the levels in treatment group were significantly lower than control group at T3-T5 (P < 0.05). At T2-T5, blood urea nitrogen levels in model group and treatment group were significantly higher than control group (P < 0.05) while the levels in treatment group were significantly lower than model group at T3-T5 (P < 0.05). Concentrations of serum tumor necrosis factor α in model group and treatment group were significantly higher than control group at T1-T5 (P < 0.05) while the levels in treatment group were significantly lower than model group at T1-T5 (P < 0.05). Serum ET-1 concentrations in model group and treatment group were significantly higher than control group at T1-T5 (P < 0.05) while the levels in treatment group at T1-T4 were significantly lower than model group (P < 0.05). Rats in control group showed no swelling or hyperemia in kidney cells but normal structure and normally arranged renal tubular epithelial cells. Obvious injury was observed in model group at T3 and renal tubular epithelial cells in disorder and at swelling condition, hyperemia and angiectasis in glomerulus, degenerative opacities and vacuolar degeneration, and maximized injury were observed at T4. Injury in renal tissue in treatment group was significantly milder than model group. CONCLUSIONS: Fasudil hydrochloride has the significantly protective effect against acute renal injury in septicopyemia rats.

Protective effect of fasudil hydrochloride against acute renal injury in septicopyemia rats

OBJECTIVE@#To observe the protective effect of fasudil hydrochloride against acute renal injury in septicopyemia rats.@*METHODS@#A total of 60 Wister rats were included in the study and divided into control group (n = 10), model group (n = 25) and treatment group (n = 25). Model group and treatment group received intraperitoneal injection of endotoxin (ET) to establish acute renal injury models while the control group only received daily intraperitoneal injection of normal saline 1 mL. Five rats were taken out of model group and treatment group respectively at 1 h (T1), 6 h (T2), 12 h (T3), 24 h (T4) and 48 h (T5), for intraperitoneal injection of ET 30 mg/kg. Treatment group received intraperitoneal injection of fasudil hydrochloride 30 mg/kg 1 h before injection of ET. For three groups, 5 mL blood samples were collected from postcava for determination of serum creatinine and urea nitrogen levels at different time points. Concentrations of serum tumor necrosis factor α and ET-1 were determined by using ELISA. The renal pathologic changes were observed under the microscope.@*RESULTS@#Serum creatinine levels in both model group and treatment group were significantly higher than control group at T2-T5 (P < 0.05) while the levels in treatment group were significantly lower than control group at T3-T5 (P < 0.05). At T2-T5, blood urea nitrogen levels in model group and treatment group were significantly higher than control group (P < 0.05) while the levels in treatment group were significantly lower than model group at T3-T5 (P < 0.05). Concentrations of serum tumor necrosis factor α in model group and treatment group were significantly higher than control group at T1-T5 (P < 0.05) while the levels in treatment group were significantly lower than model group at T1-T5 (P < 0.05). Serum ET-1 concentrations in model group and treatment group were significantly higher than control group at T1-T5 (P < 0.05) while the levels in treatment group at T1-T4 were significantly lower than model group (P < 0.05). Rats in control group showed no swelling or hyperemia in kidney cells but normal structure and normally arranged renal tubular epithelial cells. Obvious injury was observed in model group at T3 and renal tubular epithelial cells in disorder and at swelling condition, hyperemia and angiectasis in glomerulus, degenerative opacities and vacuolar degeneration, and maximized injury were observed at T4. Injury in renal tissue in treatment group was significantly milder than model group.@*CONCLUSIONS@#Fasudil hydrochloride has the significantly protective effect against acute renal injury in septicopyemia rats.

Protective effect of fasudil hydrochloride against acute renal injury in septicopyemia rats

Objective: To observe the protective effect of fasudil hydrochloride against acute renal injury in septicopyemia rats. Methods: A total of 60 Wister rats were included in the study and divided into control group (n = 10), model group (n = 25) and treatment group (n = 25). Model group and treatment group received intraperitoneal injection of endotoxin (ET) to establish acute renal injury models while the control group only received daily intraperitoneal injection of normal saline 1 mL. Five rats were taken out of model group and treatment group respectively at 1 h (T1), 6 h (T2), 12 h (T3), 24 h (T4) and 48 h (T5), for intraperitoneal injection of ET 30 mg/kg. Treatment group received intraperitoneal injection of fasudil hydrochloride 30 mg/kg 1 h before injection of ET. For three groups, 5 mL blood samples were collected from postcava for determination of serum creatinine and urea nitrogen levels at different time points. Concentrations of serum tumor necrosis factor α and ET-1 were determined by using ELISA. The renal pathologic changes were observed under the microscope. Results: Serum creatinine levels in both model group and treatment group were significantly higher than control group at T2-T5 (P < 0.05) while the levels in treatment group were significantly lower than control group at T3-T5 (P < 0.05). At T2-T5, blood urea nitrogen levels in model group and treatment group were significantly higher than control group (P < 0.05) while the levels in treatment group were significantly lower than model group at T3-T5 (P < 0.05). Concentrations of serum tumor necrosis factor α in model group and treatment group were significantly higher than control group at T1-T5 (P < 0.05) while the levels in treatment group were significantly lower than model group at T1-T5 (P < 0.05). Serum ET-1 concentrations in model group and treatment group were significantly higher than control group at T1-T5 (P < 0.05) while the levels in treatment group at T1-T4 were significantly lower than model group (P < 0.05). Rats in control group showed no swelling or hyperemia in kidney cells but normal structure and normally arranged renal tubular epithelial cells. Obvious injury was observed in model group at T3 and renal tubular epithelial cells in disorder and at swelling condition, hyperemia and angiectasis in glomerulus, degenerative opacities and vacuolar degeneration, and maximized injury were observed at T4. Injury in renal tissue in treatment group was significantly milder than model group. Conclusions: Fasudil hydrochloride has the significantly protective effect against acute renal injury in septicopyemia rats.