1.Effect of Xuebijing injection on hemodynamics and endothelial function in patients with severe sepsis:a prospective study
Jianzhuo HE ; Zhanpeng TAN ; Minzhou ZHANG ; Liheng GUO
Chinese Critical Care Medicine 2015;(2):127-132
ObjectiveTo investigate the effects of Xuebijing injection on hemodynamics, cardiac function, and endothelial function in patients with severe sepsis in order to study the therapeutic effect of Xuebijing in the treatment of severe sepsis.Methods A prospective randomized controlled trial was conducted. Sixty-six severe sepsis patients admitted to the Department of Critical Care Medicine of Guangdong Hospital of Traditional Chinese Medicine from March 2013 to February 2014 were enrolled. The patients were divided into control group (n = 31) and Xuebijing group (n= 35). The patients in both groups were treated according to 2012 international guidelines for management of severe sepsis and septic shock, and the patients in Xuebijing group received Xuebijing injection of 50 mL (added with 100 mL of 0.9% sodium chloride injection) twice a day for 5 days, and those in control group received instead 150 mL of 0.9% sodium chloride injection for 5 days. The heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), and dosage of vasoactive drugs before and 1 day and 5 days after treatment were determined for hemodynamics assessment. Blood lactic acid (Lac), central venous oxygen saturation (ScvO2), and difference in arterial-venous blood carbon dioxide pressure (Pv-aCO2) were determined for microcirculation assessment. The left ventricular ejection fraction (LVEF), cardiac output (CO), left ventricular end diastolic diameter (LVEDD), the ratio of blood flow of mitral orifice between rapid filling period and atrial systole period (E/A), and B-type natriuretic peptide (BNP) were determined for cardiac function assessment. Vascular endothelial growth factor (VEGF) and soluble receptor (sFLT-1) were assessed for endothelial function assessment. The relationship among the indexes of the hemodynamics, microcirculation, cardiac function, and endothelial function was analyzed with Pearson related-analysis.Results After treatment, HR, MAP, CVP, Lac, ScvO2, and Pv-aCO2 were improved in both groups compared with those before treatment, and the dosage of norepinephrine (NE) was decreased in Xuebijing group. Compared with control group, MAP at 5 days after treatment in Xuebijing group was significantly increased [mmHg (1 mmHg =0.133 kPa): 74.9±10.7 vs. 70.2±6.6,P< 0.05], the dosage of NE was decreased [μg·kg-1·min-1: 0.01 (0.00, 0.22) vs. 0.10 (0.05, 0.80),P< 0.05], LVEF was significantly increased (0.617±0.125 vs. 0.533±0.129,P< 0.05), BNP was significantly decreased [ng/L: 117.3 (52.0, 443.0) vs. 277.2 (67.9, 2 370.2),P< 0.05], while VEGF showed no significant change (ng/L: 101.1±23.2 vs. 89.6±20.5,P> 0.05), and sFLT-1 was significantly decreased (ng/L:245.7±86.2 vs. 295.1±95.1,P< 0.05). It was shown by Pearson coefficient bivariate correlation analysis that sFLT-1 was negatively correlated with MAP and ScvO2 (r= -0.569,P= 0.000;r= -0.341,P= 0.008) 5 days after treatment, while it was positively associated with Lac and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score (r= 0.749,P= 0.000;r= 0.645,P= 0.000).Conclusions In patients with severe sepsis, there are hemodynamics disorders and effect in microcirculation perfusion. Xuebijing injection can improve hemodynamics and cardiac function in the patients with severe sepsis, and the mechanism may be related to the improvement of endothelial function.
2.The Effects of Asiaticoside on the Growth of Melanoma B16 Cells
Hong SANG ; Rongzhi NI ; Xianping SHEN ; Nan YE ; Yang CAO ; Min ZHANG ; Tong NI ; Liheng TAN
Chinese Journal of Dermatology 1994;0(02):-
Objective To study the effects of asiaticoside on the growth of melanoma B16 cell cultures in vitro. Methods Melanoma B16 cells were subcultured and the inhibition of cellular growth was investigated. The morphology of the cells was observed after inhibition. The induction of apoptosis by asiaticoside was determined by flow cytometry. Results It was found that asiaticoside could significantly inhibit the growth of B16 cell cultures in vitro in a dose-dependent manner. The annexin-v positive cells were increased, along with that cells intaking R123 marked mitochondria were decreased, and PI positive cells increased, which indicated that cellular apoptosis was induced. Conclusion Asiaticoside plays an inhibitory role in the growth of melanoma B16 cells.
3.Animal-origin osteochondral scaffold combined with bone marrow mesenchymal stem cells/chondrocytes for repair of composite osteochondral defects in rabbit knee joints
Wencheng TAN ; Zhengang ZHA ; Jiaqing ZHANG ; Liheng ZHENG ; Yaozhong LIANG ; Jisheng XIA ; Xinpei HUANG ; Hao WU ; Hongsheng LIN
Chinese Journal of Tissue Engineering Research 2011;15(12):2265-2269
BACKGROUND: Though there were many experiments addressing repairing osteochondral defects before, faulty restoration occurred at coupling interfaces. OBJECTIVE: To investigate the feasibility of repairing of osteochondral composite defects in rabbit knees with animal-origin osteochondral scaffold combined with bone marrow mesenchymal stem cells (BMSCs)/chondrocytes.METHODS: New Zealand white rabbits were randomly divided into the experimental, control and blank groups and prepared for unilateral knee joint osteochondral defects. Animal-origin osteochondral scaffold combined with BMSCs/chondrocytes, animal-origin osteochondral scaffold and no material was implanted to repair the defects in the experimental, control and blank groups, respectively. Healing condition was evaluated by gross observation, hematoxylin-eosin staining, and toluidine blue staining at 4, 8, and 12 weeks after operation. RESULTS AND CONCLUSION: At 12 weeks after operation, gross observation showed the defects were repaired completely without local depression and the regenerated tissues were fused with surrounding tissues in the experimental group. Hematoxylin-eosin staining and toluidine blue staining revealed that there were many new hyaline cartilages in the cartilage defects in which columnar cells were lined well and cartilage lacuna was obviously, also, there were many bony tissues in the bone defects. The regeneration cartilage, the underlying subchondral bone and host bone were coupled completely. The toluidine blue positive rate and histologic scores of the experimental group were superior to those of the control and blank groups (P < 0.05). It is demonstrated that animal-origin osteochondral scaffold combined with BMSCs/chondrocytes is an ideal method to repair defects between cartilage and the underlying subchondral bone.