1.Tolerance for intestinal ischemia of mouse by astragalus preconditioning
Gangjian LUO ; Xi CHEN ; Weifeng YAO ; Chaojin CHEN ; Shan WU
The Journal of Practical Medicine 2016;32(11):1760-1763
Objective To investigate the protective effects of astragalus preconditioning on the tolerance of ischemia time of mouse small intestine . Methods C57BL/6 mice were randomly divided into 5 groups (n = 7): sham operation group (Sham group),intestinal ischemia reperfusion group (IR group) and astragalus preconditioning group (ASIR group). IR group and ASIR group include 2 sub-groups respectively, specifically, 2 h reperfusion was performed 45 min (ASIR1) and 60 min (ASIR1) after blocking superior mesenteric artery. Intestinal terminal morphology was observed by light microscope after HE coloration . Serum levels of LPS , DAO and intestinal mucosa TNF-α were measured by ELISA. Intestinal Cyto C expression were detected by immunofluorescence. Results Astragalus preconditioning reduces Chiu′s score significantly. Expression of Cyto C was significantly down-regulated in astragalus preconditioning groups, and levels of LPS, DAO and TNF-αsignificantly decreased. The damages in IR2 group is obviously severe than in IR1, but there were no significant differences between this two groups after pretreatment with astragalus. Conclusion Astragalus preconditioning has obvious protective effects to intestinal ischemia reperfusion, and enhances the tolerance to longer time of ischemia.
2.Association Between the Red Blood Cell Distribution Width and 30-Day Mortality in Intensive Care Patients Undergoing Cardiac Surgery: A Retrospective Observational Study Based on the Medical Information Mart for Intensive Care-IV Database
Weiqiang CHEN ; Peiling YU ; Chao CHEN ; Shaoyan CAI ; Junheng CHEN ; Chunqin ZHENG ; Chaojin CHEN ; Liangjie ZHENG ; Chunming GUO
Annals of Laboratory Medicine 2024;44(5):401-409
Background:
Millions of patients undergo cardiac surgery each year. The red blood cell distribution width (RDW) could help predict the prognosis of patients who undergo percutaneous coronary intervention or coronary artery bypass surgery. We investigated whether the RDW has robust predictive value for the 30-day mortality among patients in an intensive care unit (ICU) after undergoing cardiac surgery.
Methods:
Using the Medical Information Mart for Intensive Care-IV Database, we retrieved data for 11,634 patients who underwent cardiac surgery in an ICU. We performed multivariate Cox regression analysis to model the association between the RDW and 30-day mortality and plotted Kaplan–Meier curves. Subgroup analyses were stratified using relevant covariates. Receiver operating characteristic (ROC) curves were used to determine the predictive value of the RDWs.
Results:
The total 30-day mortality rate was 4.2% (485/11,502). The elevated-RDW group had a higher 30-day mortality rate than the normal-RDW group (P < 0.001). The robustness of our data analysis was confirmed by performing subgroup analyses. Each unit increase in the RDW was associated with a 17% increase in 30-day mortality when the RDW was used as a continuous variable (adjusted hazard ratio = 1.17, 95% confidence interval, 1.10–1.25). Our ROC results showed the predictive value of the RDW.
Conclusions
An elevated RDW was associated with a higher 30-day mortality in patients after undergoing cardiac surgery in an ICU setting. The RDW can serve as an efficient and accessible method for predicting the mortality of patients in ICUs following cardiac surgery.
3.Association Between the Red Blood Cell Distribution Width and 30-Day Mortality in Intensive Care Patients Undergoing Cardiac Surgery: A Retrospective Observational Study Based on the Medical Information Mart for Intensive Care-IV Database
Weiqiang CHEN ; Peiling YU ; Chao CHEN ; Shaoyan CAI ; Junheng CHEN ; Chunqin ZHENG ; Chaojin CHEN ; Liangjie ZHENG ; Chunming GUO
Annals of Laboratory Medicine 2024;44(5):401-409
Background:
Millions of patients undergo cardiac surgery each year. The red blood cell distribution width (RDW) could help predict the prognosis of patients who undergo percutaneous coronary intervention or coronary artery bypass surgery. We investigated whether the RDW has robust predictive value for the 30-day mortality among patients in an intensive care unit (ICU) after undergoing cardiac surgery.
Methods:
Using the Medical Information Mart for Intensive Care-IV Database, we retrieved data for 11,634 patients who underwent cardiac surgery in an ICU. We performed multivariate Cox regression analysis to model the association between the RDW and 30-day mortality and plotted Kaplan–Meier curves. Subgroup analyses were stratified using relevant covariates. Receiver operating characteristic (ROC) curves were used to determine the predictive value of the RDWs.
Results:
The total 30-day mortality rate was 4.2% (485/11,502). The elevated-RDW group had a higher 30-day mortality rate than the normal-RDW group (P < 0.001). The robustness of our data analysis was confirmed by performing subgroup analyses. Each unit increase in the RDW was associated with a 17% increase in 30-day mortality when the RDW was used as a continuous variable (adjusted hazard ratio = 1.17, 95% confidence interval, 1.10–1.25). Our ROC results showed the predictive value of the RDW.
Conclusions
An elevated RDW was associated with a higher 30-day mortality in patients after undergoing cardiac surgery in an ICU setting. The RDW can serve as an efficient and accessible method for predicting the mortality of patients in ICUs following cardiac surgery.
4.Association Between the Red Blood Cell Distribution Width and 30-Day Mortality in Intensive Care Patients Undergoing Cardiac Surgery: A Retrospective Observational Study Based on the Medical Information Mart for Intensive Care-IV Database
Weiqiang CHEN ; Peiling YU ; Chao CHEN ; Shaoyan CAI ; Junheng CHEN ; Chunqin ZHENG ; Chaojin CHEN ; Liangjie ZHENG ; Chunming GUO
Annals of Laboratory Medicine 2024;44(5):401-409
Background:
Millions of patients undergo cardiac surgery each year. The red blood cell distribution width (RDW) could help predict the prognosis of patients who undergo percutaneous coronary intervention or coronary artery bypass surgery. We investigated whether the RDW has robust predictive value for the 30-day mortality among patients in an intensive care unit (ICU) after undergoing cardiac surgery.
Methods:
Using the Medical Information Mart for Intensive Care-IV Database, we retrieved data for 11,634 patients who underwent cardiac surgery in an ICU. We performed multivariate Cox regression analysis to model the association between the RDW and 30-day mortality and plotted Kaplan–Meier curves. Subgroup analyses were stratified using relevant covariates. Receiver operating characteristic (ROC) curves were used to determine the predictive value of the RDWs.
Results:
The total 30-day mortality rate was 4.2% (485/11,502). The elevated-RDW group had a higher 30-day mortality rate than the normal-RDW group (P < 0.001). The robustness of our data analysis was confirmed by performing subgroup analyses. Each unit increase in the RDW was associated with a 17% increase in 30-day mortality when the RDW was used as a continuous variable (adjusted hazard ratio = 1.17, 95% confidence interval, 1.10–1.25). Our ROC results showed the predictive value of the RDW.
Conclusions
An elevated RDW was associated with a higher 30-day mortality in patients after undergoing cardiac surgery in an ICU setting. The RDW can serve as an efficient and accessible method for predicting the mortality of patients in ICUs following cardiac surgery.
5.Association Between the Red Blood Cell Distribution Width and 30-Day Mortality in Intensive Care Patients Undergoing Cardiac Surgery: A Retrospective Observational Study Based on the Medical Information Mart for Intensive Care-IV Database
Weiqiang CHEN ; Peiling YU ; Chao CHEN ; Shaoyan CAI ; Junheng CHEN ; Chunqin ZHENG ; Chaojin CHEN ; Liangjie ZHENG ; Chunming GUO
Annals of Laboratory Medicine 2024;44(5):401-409
Background:
Millions of patients undergo cardiac surgery each year. The red blood cell distribution width (RDW) could help predict the prognosis of patients who undergo percutaneous coronary intervention or coronary artery bypass surgery. We investigated whether the RDW has robust predictive value for the 30-day mortality among patients in an intensive care unit (ICU) after undergoing cardiac surgery.
Methods:
Using the Medical Information Mart for Intensive Care-IV Database, we retrieved data for 11,634 patients who underwent cardiac surgery in an ICU. We performed multivariate Cox regression analysis to model the association between the RDW and 30-day mortality and plotted Kaplan–Meier curves. Subgroup analyses were stratified using relevant covariates. Receiver operating characteristic (ROC) curves were used to determine the predictive value of the RDWs.
Results:
The total 30-day mortality rate was 4.2% (485/11,502). The elevated-RDW group had a higher 30-day mortality rate than the normal-RDW group (P < 0.001). The robustness of our data analysis was confirmed by performing subgroup analyses. Each unit increase in the RDW was associated with a 17% increase in 30-day mortality when the RDW was used as a continuous variable (adjusted hazard ratio = 1.17, 95% confidence interval, 1.10–1.25). Our ROC results showed the predictive value of the RDW.
Conclusions
An elevated RDW was associated with a higher 30-day mortality in patients after undergoing cardiac surgery in an ICU setting. The RDW can serve as an efficient and accessible method for predicting the mortality of patients in ICUs following cardiac surgery.
6.Role of α2A adrenergic receptors in dexmedetomidine-induced inhibition of TLR4/NF-κB signaling pathway activation during hypoxia-reoxygenation-caused injury to alveolar type Ⅱ epithelial cells
Peibin LIU ; Weidan QIN ; Chaojin CHEN ; Weifeng YAO ; Fang TAN ; Yingqing DENG ; Xinjin CHI ; Jun CAI
Chinese Journal of Anesthesiology 2019;39(2):167-169
Objective To evaluate the role of α2A adrenergic receptor (α2AAR) in dexmedetomidine-induced inhibition of TLR4/NF-κB signaling pathway activation during hypoxia-reoxygenation (H/R)caused injury to alveolar type Ⅱ epithelial cells.Methods Type Ⅱ] alveolar epithelial cells of rats RLE6TN cells cultured in vitro were divided into 4 groups (n =6 each) using a random number table method:control group (group C),H/R injury group (group H/R),dexmedetomidine group (group D) and α2A AR small interfering RNA (siRNA) plus dexmedetomidine group (group α2AAR-siRNA+D).H/R was produced by exposing cells to 1% O2-5% CO2-94% N2 for 24 h followed by 4-h reoxygenation.Cells were incubated for 1 h with dexmedetomidine at the final concentration of 1 nmol/L,and then H/R model was established in group D.In group α2AAR-siRNA+D,cells were transfected with 50 nmol/L α2AAR-siRNA,48 h later dexmedetomidine at the final concentration of 1 nmol/L was added,cells were incubated for 1 h,and then H/R model was established.The cell viability was measured using CCK-8 method,cell apoptosis rate was determined by flow cytometry,and the expression of TLR4 and NF-κB was detected by immunofluorescence.Results Compared with group C,the cell viability was significantly decreased,the apoptosis rate was increased,and the expression of TLR4 and NF-κB was up-regulated in group H/R (P<0.05),and no significant change was found in the parameters mentioned above in group D (P>0.05).Compared with group H/R,the cell viability was significantly increased,the apoptosis rate was decreased,and the expression of TLR4 and NF-κB was down-regulated in group D (P<0.05),and no significant change was found in the parameters mentioned above in group α2AAR-siRNA+D (P>0.05).Compared with group D,the cell viability was significantly decreased,the apoptosis rate was increased,and the expression of TLR4 and NF-κB was up-regulated in group α2AAR-siRNA+D (P<0.05).Conclusion The mechanism by which dexmedetomidine inhibits TLR4/NF-κB signaling pathway activation may be related to activating α2AAR during H/R-caused injury to alveolar type Ⅱ epithelial cells.
7.Medical Expenses for Hospitalized Patients with Cervical Cancer Before and After the Implementation of the DRG Payment Policy
Aimin WANG ; Chaojin CHEN ; Mujun WANG ; Ruhao WANG ; Jingjing LYU
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1077-1082
To analyze the cost changes of cervical cancer inpatients after the implementationof diagnosis related group (DRG) payment in public grade-A tertiary hospitals, and to provide reference for public hospitals to improve management strategies and optimize the utilization of medical insurance funds. Case data of cervical cancer patients discharged from a public grade-A tertiary hospital in Shandong Province from April to December 2021 (before the implementation of DRG) and from April to December 2022 (after the implementation of DRG) were retrospectively collected. Patients with medical insurance were treated as the policy group and patients with full self-payment were treated as the control group. The changes in the relevant indicators such as total hospitalization costs, drug costs and consumable costs of cervical cancer patients before and after the implementation of the DRG policy were analyzed using the double difference-in-difference (DID) method. A total of 10 383 hospitalized patients with cervical cancer were enrolled in this study, including 9711 cases in the policy group (including 5418 cases before the implementation of DRG and 4293 cases after the implementation of DRG) and 672 cases in the control group (including 426 cases before the implementation of DRG and 246 cases after the implementation of DRG). Compared with the pre-DRG policy implementation, there were no significant changes in the complication rate, mortality rate, unplanned rehospitalization rate within 30 days, and length of hospital stay between the patients in the policy group and the control group after the DRG policy implementation. However, the total cost of the policy group decreased from ¥11 453.49 to ¥8780.94 (a decrease of 23.33%), in which the cost of medicines decreased by ¥617.37 (a decrease of 25.17%), and the cost of consumables decreased by ¥28.93(a decrease of 28.49%). The results of the double DID mode showed that the total cost of hospitalization in the policy group decreased by 14.40%( The implementation of DRG policy can reasonably reduce the cost of disease groups and achieve more effective utilization of medical resources on the basis of ensuring accurate clinical diagnosis and high treatment standards.