1.Expression of TGF-?_1 and CDK4 in Normal Esophageal Mucosa and Esophageal Squamous Cell Carcinoma
Junhua LIU ; Gongsheng SHI ; Jiahai SHI
Journal of Chinese Physician 2001;0(01):-
Objective To study the roles of TGF-? 1 and CDK4 in esophageal squamous cell carcinoma (SCC).Methods The expression of TGF-? 1 and CDK4 was examined in 50 cases of esophageal squamous cell carcinoma and 10 cases of normal esophageal mucosa with SABC immunohistochemical technique. All the samples were stained by HE to confirm their pathologic characters. The number of positive cells was counted under microscope. The data were analyzed with x 2 tests and t test.Results TGF-? 1 and CDK4 positive cells were significantly higher in esophageal SCC than those in the normal esophageal mucosa (P
2.Reliability of using tslew of intramyocardial electrogram to diagnose acute rejection after heart transplantation in rats
Jiahai SHI ; Xu MENG ; Jie HAN ; Haibo ZHANG ; Yangtian CHEN ; Yixin JIA
Chinese Journal of Thoracic and Cardiovascular Surgery 2011;27(1):35-38
Objective This study aimed to evaluate the reliability of Tslew in survelliance of allograft rejection after heart transplantations in rats. Methods Forty rats underwent modified Ono's heterotopic heart transplantation. The autonomous IMEG and VER were recorded with epicardiac pacing leads fixed at right ventricular outflow tracts, left ventricular apex and free wall. Tslews were detected daily in these 10 syngeneic and 30 allogeneic transplants. Syngeneic transplants were sacrificed on 7th postoperative day and allogeneic transplants were sacrificed on 3rd, 5th and 7th postoperative days, respectively.Histopathologic studies were performed at the same time. Results On the 3rd ,5th and 7th postoperative days Tslews depressed gradually in the allogeneic group. The depressions between 3rd and 5th, 3rd and 7th were obvious( P <0.05 ). No significant differences were observed in the syngeneic group. Tslews differed between the two groups at 5th and 7th postoperative days ( P <0.05 ). The Depression correlated with histopathologic results. Area under ROC( receiver operating characteristic) curve (AUC) of Tslew was 0.9474 and the 95% confidence interval(CI) was (0. 8753 -1. 0000 ). At the cutoff point of 92% ( ≤92% considered positive), Tslew had a sensitivity (Se) 100%, specificity (Sp) 63.64%, positive predictive value (PV + )82.61%, negative predictive value (PV-) 100%, respectively. At the cutoff point 85%, Sp 90.91%, Se 78.95%, PV +93.75 %, PV- 71. 43%. At the best cutoff point 90%, Tslew had a Se 94.74%, Sp 81. 82%, PV + 82.61%, PV- 90%.Whereas QRS had a Se 68.42%, Sp 90.91%, PV + 92.86%, PV- 62.50% at the best cutoff point of 72.3%. Conclusion Tslew of VER are reliable indexs to monitor acute allograft rejection after heart transplantations in rats. Having great diagnostic value, Tslew may be used as a replacement for EMB at the best cutoff point when EMB can' t be performed. At cutoff point of 92%, Tslew may be used as a screening index.
3.Reliability of autonomous intramyocardial electrogram and ventricular evoked response to monitor acute allograft rejection after human heart transplantation
Jiahai SHI ; Xu MENG ; Jie HAN ; Yangtian CHEN ; Haibo ZHANG ; Jiangang WANG ; Yixin JIA ; Chunlei XU
Chinese Journal of Organ Transplantation 2010;31(8):459-462
Objective To investigate the reliability of intramyocardial electrogram (IMEG) in monitoring acute rejection after human heart transplantation. Methods From June 2004 to March 2009, 32 patients underwent orthotopic heart transplantations. During the operation telemetric pacemakers were placed under the skin of the body with connected bipolar electrodes implanted into epimyocardium. Postoperative IMEGs, including the autonomous IMEG and ventricular evoked response (VER) were recorded routinely. The endomyocardium biopsy (EMB) was taken routinely and performed once again when positive IMEG results or other positive signs were observed. Results Totally 523 IMEGs has been produced, 41 of VERs were recorded together with autonomous IMEGs and EMBs, in which 17 EMB specimens were confirmed positive and 24 negative. AUC of QRS was 0.7537, Se was 88.24%, Sp was 62. 50%; AUC of Tslew was 0. 9081, Se was 94. 12%, Sp was 87. 50%. QRS and Tslew had significant difference in AUC of ROC, with x2 = 4. 22, P<0. 05; AUC of combined diagnostic index (positive when either QRS or Tslew is positive and negative when both values are negative) was 0. 7917, Se was 100.00%, Sp was 58. 33%. Conclusion QRS amplitude of the autonomous IMEGs, Tslew of VERs and combined diagnostic index are reliable indexes for monitoring acute allograft rejection after human heart transplantation. Furthermore, Tslew has a better prognostic value than QRS.
4.Expression, purification and activity analyses of three Bcl-2 family proteins.
Cuixia ZHU ; Xun LI ; Wenwen LI ; Zhimin SHI ; Jiahai ZHOU ; Renxiao WANG
Journal of Biomedical Engineering 2010;27(4):834-841
Bcel-2 family proteins (Bcl-x(L), Bcl-2, Mel-1 etc.) are key regulators of some life processes, including apoptosis and autophagy. They are currently considered as promising targets for developing new anti-tumor therapies. In our study, the human Bcl-2/Bcl-x(L) chimeric gene and the human/mouse Mel-1 chimeric gene were designed and cloned, and the prokaryotic expression vectors for expressing glutathione S-transferase (GST) fusion proteins and histidine tag fusion proteins were constructed respectively. These two proteins as well as the GST-Bcl-x(L) fusion protein were all successfully expressed in E. coli and subsequently purified. In addition, we measured the binding of these Bcl-2 family proteins to the Bid BH3 peptide by fluorescence polarization-based assay. The dissociation constants (Kd) obtained by us were in general agreement with the data reported in literature. The Kd values of all three proteins with or without the GST tag were almost identical. All these results validate the biological functions of these Bcl-2 family proteins obtained by us. These proteins can be used in the experimental screening of small-molecule regulators of Bcl-2 family proteins in vitro.
Escherichia coli
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genetics
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metabolism
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Fluorescence Polarization
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methods
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Glutathione Transferase
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biosynthesis
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genetics
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Humans
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Myeloid Cell Leukemia Sequence 1 Protein
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Proto-Oncogene Proteins c-bcl-2
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biosynthesis
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genetics
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isolation & purification
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Recombinant Fusion Proteins
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biosynthesis
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genetics
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isolation & purification
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bcl-X Protein
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biosynthesis
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genetics
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isolation & purification
5.The influence of duration of intra-abdominal hypertension on the prognosis of critically ill patients
Jianshe SHI ; Jialong ZHENG ; Jiahai CHEN ; Yeqing AI ; Huifang LIU ; Bingquan GUO ; Zhiqiang PAN ; Qiulian CHEN ; Mingzhi CHEN ; Yong YE ; Rongkai LIN ; Chenghua ZHANG ; Yijie CHEN
Chinese Journal of Emergency Medicine 2022;31(4):544-550
Background:In the clinical setting, the effect of intra-abdominal hypertension on the human body is dependent on time, but its role is not yet clear.Objective:To investigate the effect of the duration of intra-abdominal hypertension (IAH) on the prognosis of critically ill patients.Methods:This prospective cohort study enrolled 256 IAH patients who were admitted to the Surgical ICU of 10 Grade A hospitals in Fujian Province from January 2018 to December 2020. The duration of IAH (DIAH) was obtained after monitoring IAP, and ICU length of stay, duration of mechanical ventilation, duration of continuous renal replacement therapy (CRRT) and average daily energy intake from enteral nutrition during ICU stay were observed and recorded. The correlation was analyzed by Spearman rank correlation. The patients were divided into the survival group and the death group according to their survival state at 60 days after enrollment. Thereafter, clinical characteristics between the two groups were compared. Multivariable logistic regression was used to study and validate the relationship between DIAH and 60-day mortality. The receiver operating characteristics (ROC) curve was established to evaluate the predictive abilities of DIAH on the mortality risk.Results:In critically ill patients, DIAH was positively correlated with duration of mechanical ventilation ( r=0.679, P<0.001), duration of CRRT ( r=0.541, P<0.001) and ICU length of stay ( r=0.794, P<0.001), respectively. In addition, there was a negative correlation between DIAH and average daily energy intake from enteral nutrition ( r=-0.669, P<0.001). After multivariable adjustment, DIAH was an independent risk factor for 60-day mortality in critically patients with IAH ( OR=1.05, 95% CI: 1.01-1.12; P = 0.012), and exhibited a linearity change trend relationship with mortality risk. The ROC curve analysis of DIAH showed that the area under ROC curve (AUC) was 0.825 (95% CI: 0.763~0.886, P<0.01). When the cut-off value was 16.5 days, the sensitivity was 78.4% and the specificity was 75.4%. Conclusions:DIAH is an important risk factor for prognosis in critically ill patients. Early identification and rapid intervention for the etiology of IAH should be performed to shorten DIAH.
6.Clinical efficacy and prognostic influencing factors of open abdomen technique for acute pancreatitis with abdominal compartment syndrome
Jianshe SHI ; Bingquan GUO ; Jiahai CHEN ; Jialong ZHENG ; Qingfu HU ; Huifang LIU ; Xiuyong MA ; Yeqing AI ; Zhiqiang PAN ; Xin TIAN ; Yong YE ; Yijie CHEN ; Qingmao WANG ; Zhenshuang DU ; Chenghua ZHANG
Chinese Journal of Digestive Surgery 2022;21(4):520-529
Objective:To investigate the clinical efficacy and prognostic influencing factors of open abdomen technique for acute pancreatitis with abdominal compartment syndrome (ACS).Methods:The retrospective cohort study was conducted. The clinical data of 186 patients of acute pancreatitis with ACS who were admitted to 6 hospitals, including 65 cases in the 910th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army, 46 cases in the First Affiliated Hospital of Wenzhou Medical University, 33 cases in the Fujian Provincial Hospital, 31 cases in the Second Affiliated Hospital of Fujian Medical University, 7 cases in the People′s Hospital Affiliated to Quanzhou Medical College, 4 cases in the Shishi General Hospital, from January 2013 to December 2020 were collected. There were 142 males and 44 females, aged (43±8)years. Observation indica-tors: (1) patients conditions after being treatment with open abdomen technique; (2) analysis of clinical characteristics in patients with different treatment outcomes; (3) changing trend of the volume of urine output, levels of lactic acid, levels of enteral nutrient intake and the sequential organ failure score in patients with different treatment outcomes; (4) influencing factors for prognosis of patients. Measurement data with normal distribution were represented as Mean± SD, and compari-son between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test or the continuity correction chi-square test. Repeated measurement data were analyzed using the repeated ANOVA. Spearman correlation analysis was used for correlation analyses. The COX regression model was used for univariate analysis and COX regression model with forward regression was used for multivariate analysis. Results:(1) Patients conditions after being treatment with open abdomen technique. Intra-abdominal pressure, oxygena-tion index, levels of lactic acid and sequential organ failure score of the 186 patients were (23.3±1.9)mmHg (1 mmHg=0.133 kPa), (121±24)mmHg, (5.0±3.4)mmol/L and 10.4±3.6 before the treatment with open abdomen technique and (11.2±2.9)mmHg, (222±38)mmHg, (3.2±2.1)mmol/L and 4.4±2.3 at postoperative 168 hours, showing significant differences in time effects before and after the treatment ( Ftime=855.26,208.50, 174.91,208.47, P<0.05). (2) Analysis of clinical characteristics in patients with different treatment outcomes. Of the 186 patients, 166 cases survived and were discharged, and 20 cases died during hospitalization. Age, sequential organ failure score, duration of ACS and levels of lactic acid during hospitalization before the treatment with open abdomen technique were (41±7)years, 9.4±3.4, 13(10,21)hours and (4.2±0.6)mmol/L in surviving patients, versus (45±6)years, 11.5±2.4, 65(39,84)hours and (5.2±0.5)mmol/L in dead patients, respectively, showing significant differences between them ( t=-2.10, -2.71, Z=-5.36, t=-7.16, P<0.05). Duration of postoperative acute gastro-intestinal injury, duration of continuous renal replacement therapy, time to liberation from mech-anical ventilation, duration of vasoactive drugs therapy, cases undergoing early abdominal closure, cases without intestinal fistula or with postoperative high-order intestinal fistula and low-order intestinal fistula during hospitalization after the treatment with open abdomen technique were 4(2,6)days, 4(3,7)days, 34(21,41)days, 3(2,6)days, 126, 131, 23, 12 in surviving patients, versus 13(10,17)days, 10(8,18)days, 0(0,3)days, 8(6,12)days, 1, 2, 15, 3 in dead patients, respectively, showing significant differences between them ( Z=-5.60, -3.75, -3.64, -3.06, χ2=41.43, 45.86, P<0.05). (3) Changing trend of the volume of urine output, levels of lactic acid, levels of enteral nutrient intake and the sequential organ failure score in patients with different treatment outcomes. The volume of urine output, levels of lactic acid, levels of enteral nutrient intake and the sequential organ failure score in surviving patients during hospitalization were (0.29±0.10)mL/(kg·h), (4.2±0.6)mmol/L, 0.0 kcal/(kg·d) and 9.4±3.4 before the treatment with open abdomen technique and (2.22±0.15)mL/(kg·h), (1.9±0.7)mmol/L, (20.7±2.9)kcal/(kg·d) and 3.7±2.2 at postoperative 168 hours. The above indicators in dead patients during hospitalization were (0.28±0.08)mL/(kg·h), (5.2±0.5)mmol/L, 0.0kcal/(kg·d) and 11.5±2.4 before the treatment with open abdomen technique and (0.28±0.09)mL/(kg·h), (7.7±0.8)mmol/L, (4.6±1.8)kcal/(kg·d) and 12.4±2.1 at postoperative 168 hours. There were significant differences in time effects in the above indicators in surviving patients and dead patients before and after the treatment with open abdomen technique ( Ftime=425.57, 188.59, 394.84, 37.52, P<0.05). There were interactive effects between the above indicators and the treatment outcome at different time points ( Finteraction=383.14, 233.04, 169.83, 36.61, P<0.05). There were signifi-cant differences in the change trends of the above indicators between the surviving patients and the dead patients during hospitalization ( Fgouprs=2 739.56, 877.98, 542.05, 240.85, P<0.05). (4) Influen-cing factors for prognosis of patients. Results of univariate analysis showed that age, sequential organ failure score, duration of ACS before surgery, procalcitonin, lactic acid, postoperative high-order intestinal fistula, abdominal hemorrhage, duration of postoperative acute gastrointestinal injury, duration of continuous renal replacement therapy, duration of vasoactive drugs therapy, early abdominal closure were related factors influencing prognosis of patients under-going treatment with open abdomen technique ( hazard ratio=1.07, 1.18, 1.39, 1.16, 8.25, 12.26, 2.83, 1.29, 1.56, 1.41, 0.02, 95% confidence interval as 1.00-1.15, 1.45-2.27, 1.22-1.57, 1.02-1.32, 1.75-38.90, 7.37-41.23, 1.16-6.93, 1.22-1.37, 1.23-1.99, 1.08-1.84, 0.00-0.16, P<0.05). Results of multivariate analysis showed that extended duration of ACS before surgery, postoperative high-order intestinal fistula and extended duration of postoperative acute gastrointestinal injury were independent risk factors influencing prognosis of patients undergoing treatment with open abdomen technique ( hazard ratio=1.05, 7.95, 1.17, 95% confidence interval as 1.01-1.32, 2.05-30.87, 1.13-1.95, P<0.05) and early abdominal closure was an independent protective factor ( hazard ratio=0.10, 95% confidence interval as 0.01-0.89, P<0.05). Results of Spearman correlation analysis showed that duration of ACS was positively correlated with sequential organ failure score before surgery ( r=0.71, P<0.05). Conclusions:Open abdomen technique is effective for acute pancreatitis with ACS. Extended duration of ACS before surgery, postoperative high-order intestinal fistula and extended duration of postoperative acute gastrointestinal injury are independent risk factors for prognosis of patients during hospitalization and early abdominal closure is an independent protective factor.