Objective To explore the mechanism of reversal of mutidrug resistance of GBC-SD cell lines by grape seed polyphenols(GSP).Methods GBC-SD cell lines were used to determine the effect of GSP.MTT assay was adopted to evaluate the cytotoxity(IC_(50)),RT-PCR were used to determine MDR1mRNA,(P-gp),bcl-2 and cellular adriamycin was measured by flow cytometry.Results In non-toxic(3?g/mL) and low toxic(6?g/mL) comcentration of GSP treated group(P

Objective: To investigate effect of exogenous wild-type p53 gene on the cell growth and tumorigenicity of human gallbladder cancer cell lines. Methods: After identification of the genetic status of p53 gene of GBC-SD cell lines with the immunocytochemistry staining and the direct sequencing technique of PCR products, eukaryotic expressing plasmid pCMV-p53 was introduced by lipofectamine-mediated into GBC-SD cell lines. Growing transfected cells were selected by G418. The presence and expression of exogenous p53 gene was detected by PCR, RT-PCR and Western blot. The cellular proliferating ability was assessed using the cell growth curve and cloning assay. The xenograft in nude mice was performed to examine the effect of tumorigenicity. Results: P53 protein overexpression was showed in GBC-SD cell lines. A transversion of TAC→AAC at codon 126 of exon 5 was confirmed. PCR, RT-PCR and Western blot showed exogenous p53 gene had successfully transfected into GBC-SD cells and obtained high expression. The growth and proliferation of the cells were greatly decreased, and the tumorigenicity was significantly inhibited after transfection wtp53. Conclusion: The expression of exogenous wild-type p53 gene could effectively inhibit the growth of gallbladder cancer GBC-SD cells in vitro and in vivo.

Objective:To explore influence of position of myocardial infarction and coronary artery lesions in patients with acute ST elevation myocardial infarction (STEMI) ,and the relationship among heart failure ,arrhythmia and severity of coronary artery lesion .Methods :Clinical data of 224 patients ,who hospitalized in our hospital because of STEMI and received coronary angiography from Jan 2009 to Jun 2011 ,were retrospectively analyzed .General data of patients were collected ,and SYNTAX score was used to reflect severity of coronary artery lesion ,and the rela‐tionship among heart failure ,arrhythmia and SYNTAX scores were analyzed .Results:Incidence rate of heart fail‐ure in patients with infarction relate artery left anterior descending artery (LAD) AND/or left main coronary artery (LM) was significantly higher than that of patients with right coronary artery (RCA) (57.0% vs .39.7% , P=0.017) ,incidence rate of arrhythmia in patients with RCA was significantly higher than that of patients with left circumflex artery (LCX) (37.0% vs .6.3% , P=0.016);incidence rates of arrhythmia (48.4% ) ,shock (54.8% ) were highest in patients with inferior wall/right ventricle than those of other position , P<0.05 or <0.01.SYNTAX scores in patients with heart failure and arrhythmia were significantly higher than those of patients without heart failure and arrhythmia respectively [ (18.7 ± 9.1) scores vs .(15.4 ± 8.6) scores ,(19.7 ± 9.0) scores vs .(16.1 ± 8.8) scores , P<0.01 both] .Conclusion:Incidence rates of heart failure ,cardiogenic shock and arrhythmia are related to coronary artery lesions position and degree and myocardial infarction position in STEMI patients .

ObjectiveTo explore the role of peripheral blood intermediate monocytes in the pathogenesis of preeclampsia.MethodsFifty-two patients with established preeclampsia in Binhai County People's Hospital from October 2014 to October 2015, 42 healthy pregnant women and 42 healthy non-pregnant women were enrolled in this study. The percentage of intermediate monocyte subsets, ratio of positive cells and mean fluorescence intensity (MFI) of Toll-like receptor (TLR) 2, TLR4, CD64, and triggering receptor expressed on myeloid cell-1(TREM-1), and MFI of intracellular tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 were evaluated by flow cytometry. The concentrations of IL-6, IL-8, IL-1β, IL-12P70 and TNF-α in serum were analyzed using Luminex liquid phase chip technology. Independent two samplest-test, analysis of variance, Mann-WhitneyU test, Kruskal-Wallis test and Pearson correlation analysis were used for statistical analysis.ResultsPercentage of intermediate monocytes was higher in preeclampsia patients [10.4%(5.3%-19.9%)]than in healthy pregnant women [6.6%(4.9%-7.8%)], and both were higher than in non-pregnant women [3.8%(2.4%-5.0)%](allP<0.05). The ratio of TLR4 and CD64 positive intermediate monocytes [(60.1±12.5)%vs (24.9±8.8)%; (85.3±5.4)% vs (67.4±7.5)%](t were 15.416 and 13.437, bothP<0.05), and MFI of TLR4 (50.3±10.2 vs 26.8±8.6), TREM-1(35.6±4.1 vs 28.6±4.7) and CD64 (39.8±5.2 vs 28.9±4.8) (t were 11.898, 7.707 and 10.454, allP<0.05) were higher in preeclampsia patients than in healthy pregnant women. MFI of intracellular IL-6 (32.3±4.7 vs 28.6±3.5) and TNF-α (44.6±6.3 vs 36.7±8.3) in intermediate monocytes of preeclampsia patients was also significantly higher than that of healthy pregnant women (t were 4.239 and 5.245, bothP<0.05). Serum concentrations of IL-6, IL-8 and TNF-α were higher in preeclamptic patients than in healthy pregnant women and non-pregnant women (allP<0.05). Furthermore, a positive correlation was found between the percentage of intermediate monocytes and the serum levels of IL-6 and TNF-α in preeclamptic patients (r were 0.397 and 0.347, bothP<0.05).ConclusionsMonocyte subpopulations from preeclamptic patients are abnormally skewed toward intermediate monocytes which have high expressions of TLR4, TREM-1 and CD64, and secret more proinflammatory cytokines such as IL-6 and TNF-α. Therefore, intermediate monocytes are specifically altered in preeclamptic patients and may play a role in the pathophysiology of preeclampsia.

Objective To explore the clinical effect and safety of rhBNP in the treatment of patients with critical illness complicated with heart failure. Methods Twenty patients with acute heart failure who were given rhBNP as an assisted treatment from the department of critical care medicine in our hospital from January to August 2013 were selected. Changes of heart rate,respiratory rate,blood pressure,24-hour urine volume,hepatic and renal functions,NT-proB-NP in the patients before the treatment, 72 hours and 7 days after the treatment were observed. Results 19 patients showed obvious improvement of heart function, with the total effective rate of 95%. Patients'respiratory rate and heart rate 30 minutes after the treatment showed significant improvement(P<0.05),and the improvement continued 72 hours and 7 days after the treatment (P<0.05); urine volume increased significantly 3 days after the treatment with rhBNP(P<0.05). The volume remained stable after 7 days, but some patients significantly reduced their dosage of diuretics;blood pressure decreased 30 minutes after the treatment, and it recovered to normal level after 72 hours and 7 days(P>0.05);NT-proBNP reduced obviously 72 hours after the treatment(P<0.05),and the reduction became significant after 7 days. There were no significant changes in patients' serum creatinine, urea nitrogen and glutamic-pyruvic transaminase (P>0.05). Transient low blood pressure and arrhythmia could be detected in the treatment, but the inci-dence was low. Conclusion RhBNP has favorable effect on acute heart failure in a short period without any significant negative effect on hepatic and renal functions.

Objective: To investigate the value of pulse indicator continuous cardiac output (PiCCO) monitoring in the treatment management of patients with severe heart failure. Methods: Sixty patients of severe heart failure admitted to intensive care unit (ICU) of Fujian Provincial Hospital from August 2017 to February 2019 were enrolled, and they were divided into control group and treatment group according to random number table method, with 30 in each group. The treatment group used bedside PiCCO to carry out minimally invasive hemodynamics monitoring, according to the monitoring data target guidance for vasoactive drugs and liquid management. The control group was based only on traditional electrocardiogram (ECG) monitoring and lung sound, urine volume of vasoactive drugs and liquid management. The changes of cardiac index (CI), global end diastolic volume index (GEDVI), extravascular lung water index (EVLWI), systemic vascular resistance index (SVRI), invasive mean arterial pressure (MAP) and central venous pressure (CVP) were observed before and 72 hours after treatment in the treatment group. The 7-day total effective rate, the length of ICU stay and 28-day mortality were compared between the two groups. Results: Compared with before treatment, CI and MAP in the treatment group were significantly increased after treatment [CI (mL·s^-1·m^-2): 53.34±16.67 vs. 35.01±13.34, MAP (mmHg, 1 mmHg = 0.133 kPa): 72.6±10.6 vs. 62.5±10.3, both P < 0.05], GEDVI, EVLWI, SVRI, CVP were significantly decreased [GEDVI (mL/m²): 760.3±90.2 vs. 960.2±110.3, EVLWI (mL/kg): 6.5±1.3 vs. 12.5±6.2, SVRI (kPa·s·L^-1·m^-2): 297.3±35.1 vs. 434.1±58.8, CVP (mmHg): 10.1±2.6 vs. 12.2±3.4, all P < 0.05]. Compared with the control group, the 7-day total effective rate of the treatment group was significantly higher (90.0% vs. 80.0%), the length of ICU stay was significantly shorter (days: 8.2±4.5 vs. 10.3±2.5), and the 28-day mortality was significantly lower, with statistically significant difference (all P < 0.05). Conclusion PiCCO monitoring is a goal-oriented treatment management for patients with severe heart failure, which is helpful to individualized accurate treatment, shorten the length of ICU stay and improve short-term prognosis.

OBJECTIVE: To evaluate the difference and correlation between continuous non-invasive arterial pressure (CNAP) monitor and pulse indicated continuous cardiac output (PiCCO) monitor on determination of hemodynamic parameters in mechanically ventilated critically ill patients, and to assess the feasibility of non-invasive monitoring of hemodynamics with CNAP. METHODS: A prospective observation self-control study was conducted.The critically ill patients with mechanical ventilation who needed hemodynamics monitoring, and admitted to the fourth department of intensive care unit (ICU) of Fujian Provincial Hospital from June 2018 to March 2019 were enrolled. PiCCO catheter were inserted immediately after admission, the hemodynamic indexes were measured by thermodilution method, and mean arterial pressure (MAP_PiCCO), cardiac index (CI_PiCCO), pulse pressure variation rate (PPV_PiCCO) and systemic vascular resistance index (SVRI_PiCCO) were obtained at 0 hour and 24 hours respectively. Meanwhile, the above indexes (MAP_CNAP, CI_CNAP, PPV_CNAP and SVRI_CNAP) were measured with CNAP. All measurements were repeated thrice and average values were reported. The differences in above parameters between the two methods were evaluated. Pearson test was used for the correlation analysis and Bland-Altman analysis method was used for consistency test. RESULTS: Thirty-eight patients were enrolled into this study. One patient died within 24 hours was excluded, 2 patients were excluded due to withdrawing treatment within 24 hours, 2 patients were excluded because of atrial fibrillation, and 1 patient's data was lost due to technical problems. Thus, data from 32 patients were available for final analysis. There were 12 females and 20 males, aging 26-84 years old with the mean of (66.8±19.1) years old, body mass index (BMI) of (23.7±3.9) kg/m², acute physiology and chronic health evaluation II (APACHE II) score of 19.5±5.3, sepsis-related organ failure assessment (SOFA) score of 9.7±4.1. There were no significant differences in CI or PPV between CNAP and PiCCO groups [CI (mL×s^-1×m^-2): 59.8±12.6 vs. 58.5±14.2, PPV: (14.7±6.8)% vs. (14.0±6.8)%, both P > 0.05]. MAP and SVRI measured by CNAP were significantly higher than those measured by PiCCO [MAP (mmHg, 1 mmHg = 0.133 kPa): 65.6±9.4 vs. 60.1±9.2, SVRI (kPa×s×L^-1×m^-2): 206.2±53.9 vs. 179.5±57.8, both P < 0.01]. The correlation analysis showed that MAP, CI, PPV and SVRI measured by the two methods were significantly positively correlated (r value was 0.624, 0.864, 0.835 and 0.655 respectively, all P < 0.05). Bland-Altman analysis showed that CNAP and PiCCO had a good consistency for the measurement of CI and PPV, the average differences were 1.2 mL×s^-1×m^-2 and 0.5% respectively, while the 95% confidence interval (95%CI) were -12.8-15.3 mL×s^-1×m^-2 and -7.1%-8.2% respectively. However, the consistency of MAP and SVRI measured by those two methods was poor, the average differences were 5.5 mmHg and 26.8 kPa×s×L^-1×m^-2 respectively, while the 95%CI was -10.4-21.3 mmHg and -64.5-118.0 kPa×s×L^-1×m^-2 respectively. CONCLUSIONS CNAP was comparable with PiCCO when monitoring CI and PPV in mechanically ventilated critically ill patients; while the results of MAP and SVRI might be inaccurate, which should be interpreted correctly and carefully.
Adult ; Aged ; Aged, 80 and over ; Arterial Pressure ; Cardiac Output ; Critical Illness ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Prospective Studies ; Respiration, Artificial

OBJECTIVE: To investigate the value of pulse indicator continuous cardiac output (PiCCO) monitoring in the treatment management of patients with severe heart failure. METHODS: Sixty patients of severe heart failure admitted to intensive care unit (ICU) of Fujian Provincial Hospital from August 2017 to February 2019 were enrolled, and they were divided into control group and treatment group according to random number table method, with 30 in each group. The treatment group used bedside PiCCO to carry out minimally invasive hemodynamics monitoring, according to the monitoring data target guidance for vasoactive drugs and liquid management. The control group was based only on traditional electrocardiogram (ECG) monitoring and lung sound, urine volume of vasoactive drugs and liquid management. The changes of cardiac index (CI), global end diastolic volume index (GEDVI), extravascular lung water index (EVLWI), systemic vascular resistance index (SVRI), invasive mean arterial pressure (MAP) and central venous pressure (CVP) were observed before and 72 hours after treatment in the treatment group. The 7-day total effective rate, the length of ICU stay and 28-day mortality were compared between the two groups. RESULTS: Compared with before treatment, CI and MAP in the treatment group were significantly increased after treatment [CI (mL×s^-1×m^-2): 53.34±16.67 vs. 35.01±13.34, MAP (mmHg, 1 mmHg = 0.133 kPa): 72.6±10.6 vs. 62.5±10.3, both P < 0.05], GEDVI, EVLWI, SVRI, CVP were significantly decreased [GEDVI (mL/m²): 760.3±90.2 vs. 960.2±110.3, EVLWI (mL/kg): 6.5±1.3 vs. 12.5±6.2, SVRI (kPa×s×L^-1×m^-2): 297.3±35.1 vs. 434.1±58.8, CVP (mmHg): 10.1±2.6 vs. 12.2±3.4, all P < 0.05]. Compared with the control group, the 7-day total effective rate of the treatment group was significantly higher (90.0% vs. 80.0%), the length of ICU stay was significantly shorter (days: 8.2±4.5 vs. 10.3±2.5), and the 28-day mortality was significantly lower, with statistically significant difference (all P < 0.05). CONCLUSIONS PiCCO monitoring is a goal-oriented treatment management for patients with severe heart failure, which is helpful to individualized accurate treatment, shorten the length of ICU stay and improve short-term prognosis.
Cardiac Output ; Extravascular Lung Water ; Heart Failure/therapy* ; Heart Rate ; Hemodynamics ; Humans ; Prospective Studies

Obj ective To explore the significance of serum lipoprotein and high sensitivity C-reactive protein (hs-CRP)level for the patients with type 2 diabetic nephropathy.Methods 174 patients with type 2 diabetic mellitus were divided into diabetic mellitus group,early diabetic nephropathy group and clinical diabetic nephropathy group,according to the urinary albumin excre-tion rate (UAER).60 healthy individuals were chosen as control group.Lipoprotein (α)[Lp(α)], high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C)and hs-CRP were detected,and the results were analyzed statistically.Results The level of Lp (α), hs-CRP were significantly higher in patients with diabetic mellitus than those in control group (P<0.05).Among the three groups with diabetic mellitus,the level of Lp(α)and hs-CRP got progres-sively significant higher with the increase of UAER (P<0 .05 )whereas the level of HDL-C and LDL-C did not find significant difference(P>0 .05 ).There were linear positive correlation between Lp(α),hs-CRP and UAER levels(r= 0.8069,0.8989).Conclusion Lp(α),hs-CRP levels may be related to the progression of diabetic nephropathy,and their detection had important clinical sig-nificance in early diagnosis and prognostic evaluation of type 2 diabetic nephropathy.

Obj ective To explore the significance of serum lipoprotein and high sensitivity C-reactive protein (hs-CRP)level for the patients with type 2 diabetic nephropathy.Methods 174 patients with type 2 diabetic mellitus were divided into diabetic mellitus group,early diabetic nephropathy group and clinical diabetic nephropathy group,according to the urinary albumin excre-tion rate (UAER).60 healthy individuals were chosen as control group.Lipoprotein (α)[Lp(α)], high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C)and hs-CRP were detected,and the results were analyzed statistically.Results The level of Lp (α), hs-CRP were significantly higher in patients with diabetic mellitus than those in control group (P<0.05).Among the three groups with diabetic mellitus,the level of Lp(α)and hs-CRP got progres-sively significant higher with the increase of UAER (P<0 .05 )whereas the level of HDL-C and LDL-C did not find significant difference(P>0 .05 ).There were linear positive correlation between Lp(α),hs-CRP and UAER levels(r= 0.8069,0.8989).Conclusion Lp(α),hs-CRP levels may be related to the progression of diabetic nephropathy,and their detection had important clinical sig-nificance in early diagnosis and prognostic evaluation of type 2 diabetic nephropathy.