1.Research Progress on Human Defensin 5
Chinese Journal of Bases and Clinics in General Surgery 2003;0(04):-
Objective To review the characteristics of human defensin 5 (HD 5), including molecular structure, antibacterial activity and gene expression, and to show its development prospect as a new drug in the treatment of enterogenic infection. Methods The published papers about HD 5 were reviewed to summarize its research progress. Results Being a 3-5 KDa cationic peptide rich in cysteine and arginine, especially without glycosylated side chain, HD 5 plays its antibacterial role against positive and negative Gram's bacterium, fungi, spirochete, protozoan and enveloped virus with the special active center composed of three disulfide bonds. HD 5 encoding gene alpha defensin 5 (DEFA 5) localizes at the 8th chromosome P21 pter with 449 bp, which includes five pieces of sequence: 5′ untranslated region (1-40),signal peptide (41-97), propiece (98-226), mature peptide (227-322),and Poly A (433-438).Conclusion As a broad spectrum and effective endogenous antimicrobial peptide, HD 5 would be a promising alternative peptide against enterogenic infection if the accessibility to its mass production is settled.
2.The effect of high-level of glucose on ghrelin expression in human umbilical vein endothelial cells
Guangkuo LI ; Wen ZHAO ; Yong LIU
Tianjin Medical Journal 2017;45(6):576-579
Objective To investigate the influence of high-level of glucose on the expression of ghrelin in human umbilical vein endothelial cells (HUVECs). Methods After 12 h glucose free culturing, the effects of different concentrations of glucose and different incubation times on expressions of ghrelin were observed in HUVECs. ( 1) The cells were treated with 0, 5, 10, 15, 20 mmol/L glucose for 2 h, then ghrelin mRNA expression levels were detected by RT-PCR, and the protein levels of ghrelin were detected by ELISA. (2) The cells were treated with 10 mmol/L glucose for 0, 0.5, 1, 2, 6, 12 hours, ghrelin mRNA and protein levels were detected respectively. Results (1) The expression levels of ghrelin mRNA and protein decreased along with increased glucose concentrations, which showed no obvious changes when the glucose was above 15 mmol/L. (2) The expression levels of ghrelin mRNA and protein decreased with the prolonged incubation time. But more than 6 h culturing time showed no further effect on reducing the expression level of ghrelin. Conclusion High levels of glucose can inhibit the expression level of ghrelin, which may be one of the mechanisms of atherosclerosis.
3.Effects of antiplatelet drugs on the incidence of no-reflow after percutaneous coronary intervention in patients with coronary heart disease
Zhikuan LUO ; Yong LIU ; Guangkuo LI ; Huanming LI
Chinese Journal of Geriatrics 2013;(4):379-382
Objective To observe the effects of antiplatelet drugs on the incidence of no reflow,main adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD).Methods From January 2010 to February 2011,a total of 84 CHD patients with no-reflow after PCI were selected and randomly divided into observed group and control group (n=42 each group).Patients with no/slow-reflow in observed group were injected with tirofiban through coronary artery with a guiding catheter.If invalid,patients were injected with tirofiban by catheterization again with a micro-pump continuous pumping for 24 h.Patients with no/slow reflow in control group were injected with verapamil by catheterization.If invalid,patients were injected with verapamil by catheterization again.Results The numbers of patients with Thrombolysis in Myocardial Infarction (TIMI) 3 in the first and last angiography after drug administration were much more in observed group than in control group [26 cases (61.9%) vs.17 cases (40.5%),35 cases (83.3%) vs.23 cases (54.8%),respectively,x2 =3.86,8.02,both P<0.05].The first TIMI frame count (TFC) after drug administration was significantly lower in observed group than in control group,and the difference between groups became larger in the last TFC (t=-3.44,-12.41,both P<0.05).The number of patients with TIMI myocardial perfusion grade (TMPG) 3 in the first and last angiography after drug administration were much more in observed group than in control group [24 cases (57.1%) vs.13 cases (31.0%),31 cases (73.8%) vs.20 cases (47.6%),respectively,x2=5.84,6.04,both P<0.05].After 60 days of follow up,there was a significant difference in the incidence of endpoint events between observed and control group [23.8% (10 cases) vs.52.3% (12 cases),x2 =7.27.P<0.01].The predisposing factors of no reflow were age,acute myocardial infarction (AMI),diabetes,hyperlipidemia and hypertension.Conclusions Tirofiban can effectively and safely reduce the incidence of no-reflow after percutaneous coronary intervention in patients with CHD.
4.Intestinal bacterial translocation and change in endotoxin level of portal vein blood after hepatic porta blocking
Yong YAN ; Zhiliang YIN ; Fuzhou TIAN ; Xiaojun LI ; Guangkuo LI ;
Chinese Journal of General Surgery 1993;0(01):-
Objective Abstract: Objective To study the intestinal bacterial translocation and changs in endotoxin level of portal vein blood after hepatic inflow blocking. Methods Under aseptic condition, mechanically blocking of the hepatoduodenal ligement was adopted in rabbit model, both endotoxin level of the portal blood and positive bacterial cultures in the mensenteric lymph nodes were observed at 15, 20, 30 and 60 min respectively after the blocking. Results Both endotoxin level and positive bacterial cultures increased significantly (P
5.Correlation of postoperative serum VEGF levels with platelet counts in non-small cell lung cancer.
Ying HU ; Baolan LI ; Guangli SHI ; Changli RONG ; Guangkuo GAO
Chinese Journal of Lung Cancer 2010;13(2):118-121
BACKGROUND AND OBJECTIVEIt ha been proven that serum vascular endothelial growth factor (VEGF) concentration was elevated significantly after surgery in patients of non-small cell lung cancer (NSCLC). Platelet may be the main resource of serum VEGF. The aim of this study is to investigate the correlation between postoperative dynamic changes of serum VEGF levels and platelet counts in patients of NSCLC who underwent surgery.
METHODSSerum VEGF levels were determined in 76 patients of NSCLC who were treated with surgery by ELISA (enzyme linked immunosorbent assay) method before operation and on postoperative day 1, 7. At the same day the concentrations of platelet were determined. RESULTS (1) Serum VEGF in patients of NSCLC on preoperative day, postoperative 1 day and 7 day were (842.06 +/- 527.24) pg/mL, (1 119.28 +/- 609.62) pg/mL, (1 574.09 +/- 873.38) pg/mL, respectively (P < 0.001); (2) Platelet counts in patients of NSCLC on preoperative day, postoperative 1 day and 7 day were (230.42 +/- 82.56 x 10(9)/L, (196.47 +/- 81.48) x 10(9)/L, (237.90 +/- 86.94) x 10(9)/L; the value on postoperative 1 day was the lowest (P < 0.001); (3) On postoperative 7 day, serum VEGF in the group of lower than the mean and higher than the mean were respectively (1 398.81 +/- 734.00) pg/mL and (1 842.86 +/- 1 006.63) pg/mL (P = 0.043).
CONCLUSIONSerum VEGF in patients of NSCLC after surgery were elevated. In the group of higher platelet counts, serum VEGF increased more significantly.
Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; blood ; surgery ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Lung Neoplasms ; blood ; surgery ; Male ; Middle Aged ; Platelet Count ; Postoperative Period ; Vascular Endothelial Growth Factors ; blood
6.Evaluation value of Karnofsky performance score for prognosis of elderly patients with sepsis
Xiaozhou LI ; Zeliang QIU ; Guangkuo ZHAO ; Xingqi DENG
Chinese Journal of Emergency Medicine 2022;31(11):1451-1456
Objective:To evaluate the prognostic value of Karnofsky performance scores (KPS) in elderly patients with sepsis, so as provide a basis for clinical evaluation of the condition, prognosis and corresponding treatment measures.Methods:A retrospective cohort study was conducted to collect the general information, clinical data, and follow-up data of limb motor function status and self-care ability of elderly patients with sepsis who were hospitalized in the Intensive Care Unit of our hospital from January 2018 to June 2021. Patients were divided into the survival group and death group according to whether they survived the hospitalization. Statistical analysis was performed using t-test, chi-square test, and Mann-Whitney test. The KPS score before admission, disease severity scores (APACHEⅡ and SOFA), serum procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NT-proBNP), and arterial blood lactate level on admission were compared between the two groups. Then, the factors with significance in univariate analysis were analyzed by Logistic regression method, the independent risk factors for predicting in-hospital mortality were determined, and the receiver operating characteristic (ROC) curve was drawn to evaluate the prognostic value of KPS score in elderly patients with sepsis.Results:A total of 135 patients were collected. There were 85 males and 50 females, 60 died and 75 survived during hospitalization, with a mortality rate of 44.4%. The preadmission KPS score of elderly patients with sepsis in the death group was significantly lower than that in the survival group [30 (30, 40) vs. 70 (50, 90), P<0.001]. Multivariate logistic regression analysis showed that KPS score ( OR=0.938, 95% CI: 0.914-0.963, P<0.001), SOFA score ( OR=1.255, 95% CI: 1.066-1.451, P=0.002) and arterial blood lactate ( OR=1.219, 95% CI: 1.059-1.404, P=0.006) were independent risk factors for predicting the prognosis during hospitalization. ROC curve analysis of mortality showed that compared with SOFA score and blood lactate, the area under the curve of KPS score was the largest, with AUC of 0.830 (95% CI: 0.756-0.890, P<0.001). In addition, the combination of KPS, SOFA and blood lactate had a greater predictive value for the prognosis of elderly patients with sepsis than that of the single index, with an AUC of 0.883 (95% CI: 0.826-0.940, P<0.001). Conclusions:The lower the KPS score, the worse the prognosis of elderly patients with sepsis. The KPS score can be used as a clinical indicator to predict the prognosis of elderly patients with sepsis.
7.Prognostic value of left ventricular ejection fraction on admission in patients with septic cardiomyopathy
Xiaozhou LI ; Guangkuo ZHAO ; Zeliang QIU ; Xingqi DENG ; Qianqian YIN
Chinese Critical Care Medicine 2023;35(8):839-843
Objective:To investigate the prognostic value of cardiac ultrasound left ventricular ejection fraction (LVEF) on admission in patients with septic cardiomyopathy.Methods:A retrospective cohort study was conducted. The patients with septic cardiomyopathy hospitalized in the intensive care unit of Zhoupu Hospital Affiliated to Shanghai Health College from January 2019 to March 2023 were enrolled. The general information including gender and age, LVEF on admission, severity of illness scores within 24 hours after admission [acute physiology and chronic health evaluationⅡ (APACHEⅡ) score and sequential organ failure assessment (SOFA) score], procalcitonin (PCT), cardiac biomarkers [N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), and MB isoenzyme of creatine kinase (CK-MB)], mitochondria related indicators [aspartate aminotransferase (AST), AST/alanine aminotransferase (ALT) ratio], blood lactate (Lac), the usage of vasoactive drugs and mechanical ventilation, and the prognosis during hospitalization were collected. The differences in above clinical data between the two groups were compared. The variables with statistically significant differences in univariate analysis were incorporated into multivariate Logistic regression analysis to analyze the independent risk factors for death during hospitalization in patients with septic cardiomyopathy. Receiver operator characteristic curve (ROC curve) was drawn to evaluate the prognostic value of LVEF by echocardiography on admission in patients with septic cardiomyopathy during hospitalization.Results:A total of 62 patients were enrolled, including 36 males and 26 females. Thirty-nine cases died and 23 cases survived during hospitalization, and the mortality was 62.90%. Compared with the survival group, the LVEF of patients on admission was lower in the death group [0.51 (0.40, 0.57) vs. 0.56 (0.51, 0.63), P < 0.01], APACHEⅡ score, SOFA score, Lac, NT-proBNP, CK-MB within 24 hours after admission were higher [APACHEⅡ score: 22.18±8.38 vs. 17.39±8.22, SOFA score: 9.90±3.87 vs. 7.09±3.27, Lac (mmol/L): 5.10 (2.63, 11.50) vs. 2.00 (1.40, 5.00), NT-proBNP (μg/L): 5.24 (2.84, 11.29) vs. 2.53 (0.35, 6.63), CK-MB (U/L): 1.88 (0.21, 5.33) vs. 0.17 (0.02, 1.62), all P < 0.05], and the proportion of vasoactive drug application was higher (82.05% vs. 47.83%, P < 0.01). Multivariate Logistic regression analysis showed that LVEF on admission was an independent risk factor for predicting the prognosis of patients with septic cardiomyopathy during hospitalization [odds ratio ( OR) = 0.920, 95% confidence interval (95% CI) was 0.855-0.990, P = 0.025]. ROC curve analysis showed that the area under the ROC curve (AUC) of LVEF on admission for predicting the death of patients with septic cardiomyopathy was 0.715 (95% CI was 0.585-0.845, P = 0.005). When LVEF ≤ 0.52, the sensitivity was 73.9%, and the specificity was 61.5%. Conclusions:The lower cardiac ultrasound LVEF on admission, the worse the prognosis of patients with septic cardiomyopathy. The cardiac ultrasound LVEF on admission can be used as a clinical index to evaluate the severity of the condition and predict the prognosis of patients with septic cardiomyopathy.