1.Multi-slice spiral CT (MSCT) : value of evaluating intestinal ischemia and therapeutic strategy for patients with intestinal obstruction
Ruike WANG ; Zhichao FENG ; Tao PU ; Shengwang ZHANG
Journal of Chinese Physician 2016;18(8):1143-1147
Objective To explore early signs of strangulated bowel with multi-slice spiral CT (MSCT),and the ability of this diagnostic modality to indicate when surgical management is required for intestinal obstruction with ischemia.Methods A total of 746 patients of intestinal obstruction were investigated with MSCT scan.The final diagnosis was confirmed by surgery and/or angiography.According to the final diagnosis,those cases were divided into ischemia groups (n =70) and no ischemia group (n =676).According to surgical findings,the cases in ischemia group was divided into necrosis group (n =31) and no-necrosis group (n =39).The clinical manifestations,CT signs,and surgical/angiography findings were retrospectively evaluated in this study.Results Among the typical MSCT signs for evaluating intestinal ischemia of intestinal obstruction,no enhancement,thickening,and reduced unenhanced attenuation of bowel wall had relatively high sensitivity and specificity.However,intestinal expansion,pneumatosis and effusion was absence of high specificity,and gas in bowel wall or mesenteric vascular was absence of high sensitivity.Mesenteric congestion was another important sign for intestinal ischemia.Filling defect in mesenteric vascular was highly specific to diagnosis intestinal ischemia.The MSCT signs to assess intestinal necrosis in moderate-high risk intestinal obstruction included no enhancement of bowel wall (sensitivity 0.93,specificity 0.69),mesenteric congestion (sensitivity 0.97,specificity 0.64),filling defect in mesenteric vascular (sensitivity 0.78,specificity 0.92),and ascites (sensitivity 0.77,specificity 0.92).Conclusions MSCT is an important non-invasive examination in diagnosing intestinal blood perfusion disorder and intestinal necrosis.It is much more valuable to bowel obstruction assessment than the value of symptom and physical examinations of the patient.It can provide valuable guidance to treatment strategy of bowel obstruction patient.
2.Clinical features and endoscopic treatment for aged patients with acute hemorrhage arising from vascular malformation of colon
Feng JI ; Xiaoli CHEN ; Lin LI ; Xinjun ZHANG ; Lihua CHEN ; Shengwang WANG
Chinese Journal of Digestion 2010;30(7):448-451
Objective To investigate the clinical features of aged patients with acute hemorrhage arising from vascular malformation of colon and the efficacy of endoscopic placement of hemoclip in treatment of hemorrhage. Methods Fifty-six patients were diagnosed with acute bleeding arising from vascular malformation of colon by colonoscopy. Patients were assigned to aged group (n = 31,≧60 years of age) and control group (n = 25, <60 years of age). The clinical manifestations and the efficacy of emergent endoscopic treatment with hemoclip application were compared between two groups. Results The complications including hypertension, coronary heart disease and diabetes were higher in aged group [80. 6% (25/31)] than in control group [40. 0% (10/25) ] with significant difference (P<0. 01). The effusive bleeding accounted for 45. 2% (14/31) in aged group and 16. 0% (4/25) in control group (P<0. 05). Endoscopic treatment with hemoclip was performed in 18 and 6 patients in aged group and control group, respectively. Initial hemostasis was achieved in 17 and 6 patients in the aged group and control group, respectively (P<0. 05). Recurrent hemorrhage occurred in 2 patients in the aged group and none in the control group (P>0. 05). The mean number of hemoclips application was 5. 3 ± 2. 4 in aged group and 3. 1 ± 1. 3 in control group (P<0. 05). Conclusions The hemorrhage is more serious in aged patients with acute hemorrhage, because they often complicate with cardiovascular diseases and diabetes. The lesion of hemorrhage can be found and precisely localized using colonoscopy. Promptly endoscopic placement of hemoclip is quite effective in treatment of acute hemorrhage.
3.Study of Lvfukang Capsules on experimental arrhythmia induced by aconitine in rats
Lihua HAN ; Zhentao WANG ; Shuyin CHEN ; Hongchao SHEN ; Ruiru LI ; Shengwang LIANG ; Huichao ZHANG
China Journal of Traditional Chinese Medicine and Pharmacy 2005;0(02):-
Objective: To observe the anti- arrhythmic effects of Lvfukang Capsules on the experimental arrhythmic models induced by aconitine in rats, and provid accordance for clinical medication. Methods: 50 rats were divided into model control group, positive control group, high, middle and low dosage groups of Lvfukang Capsules, respectively. All the dosage groups were treated with successive medication 3 days, arrhythmic models induced by aconitine for 30minutes after the last dosage. To observe and record the time of ventricular premature beat (VP) and ventricular fibrillation (VF). Results: All the dosage groups of Lvfukang Capsules significantly delayed the time of ventricular premature beat (VP) and ventricular tachycardia (VT) of arrhythmic models of rats (P
4.The diagnostic evaluation of magnetic resonance enteroclysis in inflammatory bowel disease
Xinran YE ; Jian LIAO ; Bin YE ; Shengwang ZHANG
Journal of Chinese Physician 2019;21(6):862-865,871
Objective This study aims to investigate diagnosis accuracy of magnetic resonance enteroclysis (MRE) and evaluation of image quality in inflammatory bowel disease (IBD).Methods A total of 132 patients were assumed inflammatory bowel disease and their MRE were retrospectively evaluated.Imaging feature of MRE and histopathologic results by surgery and endoscope were compared.The sensitivity,specificity and diagnostic performance were calculated and image quality of MRE were evaluated by using the quadrature method.Results A total of 530 small intestine segments were analyzed according to evaluation criteria.Imaging quality of 323,170,29 and 8 small intestine segments were graded 1,2,3 and 4 respectively.Consistency for scoring of imaging quality and evaluation of IBD in intestine segments between observers was pretty good (k =0.73).Scoring of imaging quality was the highest in distal ileum (1.12) and terminal ileum(1.15) and scoring was the lowest in duodenum (1.92) and jejunum(1.6).The sensitivity,specificity and diagnostic agreement rate of MRE in inflammatory bowel disease were 94.3%,92.6% and 94.7% respectively,including 2 false positive and 6 false negative result.Conclusions MRE can provide high performance in diagnosis of inflammatory bowel disease and good image quality.
5.Cloning and antimicrobial activity of pigeon avian beta-defensin 5.
Shengnan XIN ; Kexing ZHANG ; Mingyue ZHANG ; Zongxi HAN ; Yuhao SHAO ; Xiaoli LIU ; Shengwang LIU ; Deying MA
Chinese Journal of Biotechnology 2012;28(11):1294-1305
The objective of the study was to clone avian beta-defensin (AvBD) 5 gene from pigeon bone marrow tissues and liver tissues, to express the recombinant AvBD5 protein in E. coli, and to determine its antimicrobial activity. The mRNA of duck AvBD5 was cloned from pigeon bone marrow tissues and liver tissues by RT-PCR. In addition, phylogenetic relationships between amino acid sequence of the pigeon AvBD5, AvBDs from other avian species, and some mammalian beta-defensin-5 were analyzed. The cDNA of pigeon AvBD5 was sub-cloned into pGEX-6p-1 vector to construct recombinant plasmid pGEX-pigeon AvBD5. The recombinant protein was expressed into E. coli and purified. Antimicrobial activity and physical-chemical stability of the recombinant fusion protein were measured in vitro. The complete nucleotide sequence of both cDNAs contained 201 bp nucleotides, encoding a polypeptide of 66 amino acids. Both beta-defensins have six conserved cysteines. Phylogenetic relationships were analyzed. Both pigeon AvBDs shared the highest amino acid homology (87.9% and 78.8%) with duck AvBD5. So it was named as pigeon AvBD5alpha (bone marrow) and AvBD5beta (liver). Both recombinant plasmids were transformed into E. coli BL21 and the bacteria were induced with Isopropyl beta-D-1-Thiogalactopyranoside (IPTG). After purification, antibacterial activity of the purified was investigated. In addition, effect of ionic strength on the antibacterial activity, and hemolytic recombinant protein activity of the purified recombinant protein were investigated. A 32 kDa protein was highly expressed. Both purified recombinant pigeon AvBD5alpha and AvBD5beta exhibited extensive antimicrobial activities against 12 bacteria, including Gram-positive and Gram-negative. In high salt ions concentrations, antibacterial activity of both recombinant proteins was decreased. In addition, the hemolysis activity of recombinant protein was extremely low.
Amino Acid Sequence
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Animals
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Anti-Infective Agents
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metabolism
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pharmacology
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Avian Proteins
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biosynthesis
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genetics
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pharmacology
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Cloning, Molecular
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Columbidae
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genetics
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Escherichia coli
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genetics
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metabolism
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Molecular Sequence Data
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Recombinant Proteins
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biosynthesis
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genetics
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pharmacology
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beta-Defensins
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biosynthesis
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genetics
;
pharmacology
6.Isolation, identification and bioactivity characterization of goose avian beta-defensin 3.
Mingyue ZHANG ; Caiyuan ZHOU ; Zongxi HAN ; Tanhao SHAO ; Shengwang LIU ; Deying MA
Chinese Journal of Biotechnology 2011;27(12):1711-1721
The objective of the study was to clone avian beta-defensin (AvBD) 3 gene from goose tissues, express the recombinant AvBD3 protein in Escherichia coli, and determine its antimicrobial activity. The mRNA of goose AvBD3 was cloned from spleen and bursa of Fabricius of the gooses by RT-PCR. The sequence analysis showed that the genefragment of AvBD3 contained 182 bp, and encoded 60 amino acids. Homology analysis showed that goose AvBD3 shared the highest percentage of amino acid homology (100%) with chicken AvBD3. The cDNA of goose AvBD3 was sub-cloned into BamH I and Sal I sites of pGEX-6p-1 vector to construct recombinant plasmid pGEX-goose AvBD3. The recombinant plasmid was transformed into E. coli BL21 and the bacteria was induced with IPTG It was demonstrated by SDS-PAGE that a 31 kDa protein which was equal to goose AvBD3 protein in molecular weight was highly expressed. The purified recombinant goose AvBD3 exhibited extensive antimicrobial activity against twelve bacteria strains, including Gram-positive and Gram-negative investigated. At high salt ions conditions, antimicrobial activity of recombinant goose AvBD3 protein against both Staphylococcus aureus and Pasteurella multocida decreased significantly. In addition, hemolysis activity of the recombinant protein was extremely low, and the recombinant protein remained antimicrobial activity under different pH values.
Amino Acid Sequence
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Animals
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Anti-Bacterial Agents
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chemistry
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metabolism
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pharmacology
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Cloning, Molecular
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Escherichia coli
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genetics
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metabolism
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Geese
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genetics
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metabolism
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Molecular Sequence Data
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Recombinant Proteins
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biosynthesis
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genetics
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pharmacology
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beta-Defensins
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genetics
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isolation & purification
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metabolism
7.Standardized construction of Party branches of university-affiliated public hospitals based on SWOT
Shengwang HAN ; Qian ZHANG ; Gang LIU ; Cui LI ; Shuai SHI ; Zhixin GENG
Modern Hospital 2024;24(2):195-198
Amid ongoing reforms in the healthcare system and the pursuit of high-quality development in public hospi-tals,the significance of party building in leading the standardization of hospital party branches has become increasingly promi-nent.Taking a university's affiliated hospital as an example,this study comprehensively analyzes the current situation of Party building on the standardized construction of party branches within university-affiliated public hospitals using the SWOT method.Meanwhile,this paper proposes targeted strategies by assessing the strengths,weaknesses,opportunities,and challenges of party building leadership.These strategies are intended to refine the framework for the role of Party building in advancing the standard-ized construction of Party branches in university-affiliated public hospitals.
8.Effects of different routes of heparin on instant blood-mediated inflammatory reaction after portal vein islet transplantation.
Shengwang ZHANG ; Haixiong YAN ; Xiaoqian MA ; Wei ZHENG ; Wei WANG
Journal of Central South University(Medical Sciences) 2022;47(1):1-7
OBJECTIVES:
Heparin is mainly used as an anticoagulant in clinic, and it also has a certain anti-inflammatory effect. At present, after portal vein islet transplantation in diabetic patients, heparin is mainly infused through the peripheral veins of the limbs to achieve the purpose of anticoagulation and protection of the graft, rather than through the portal vein. In this study, animal experiments were conducted to investigate the effect of heparin infusion via the portal vein and marginal ear vein on the instant blood-mediated inflammatory reaction (IBMIR) after portal vein islet transplantation, which is the choice of anticoagulation methods for clinical islet transplantation to provide a basis for decision-making.
METHODS:
A total of 50 neonatal pigs (Xeno-1 type, 3-5 days) were selected. Islets were isolated and purified from the pancreas of neonatal pigs. Ten non-diabetic Landrace pigs (1.5-2.0 months) served as recipients, and 12 000 IEQ/kg neonatal porcine islets were transplanted into the liver through the portal vein. All recipients received bolus injection of 50 U/kg of heparin 10 minutes before transplantation. After the bolus injection of heparin, the experimental group received heparin via the portal vein [10 U/(kg·h), 5 recipients], and the control group received heparin via the marginal ear vein [10 U/(kg·h), 5 recipients]. The superior vena cava blood was collected from the 2 groups pre-operation at 1, 3, 24 h post-operation of the transplantation. The portal vein blood was collected from the experimental group at 1 and 3 h after the transplantation as well. The levels of complement C3a, C5a, thrombin-antithrombin complex (TAT), β-thromboglobulin (β-TG), and D-dimer as well as activated partial thromboplastin time (APTT) in superior vena cava blood from 1 and 3 h post-transplantation were detected in the 2 groups, and the levels of anti-Xa and anti-IIa in the portal vein and superior vena cava blood from 1 and 3 h post-transplantation in the experimental group were detected. Twenty four hours after the transplantation, the liver tissues in the 2 groups were collected for pathological examination to observe the inflammatory cell infiltration and peripheral thrombosis around the islets graft in liver.
RESULTS:
Before transplantation, there was no statistically significant difference in C3a, C5a, TAT, β-TG, D-dimer levels and APTT between the 2 groups (all P>0.05). At 1 and 3 h after transplantation, the C3a, TAT, and D-dimer levels in the experimental group were significant decreased than those in the control groups (all P<0.05), and at 3 h after transplantation the C5a was significant decreased than that in the control group (P<0.05). At 1 and 3 h after transplantation, the anti-Xa and anti-IIa levels in the portal vein blood were significantly increased than those in the superior vena cava blood in the experimental group (all P<0.05). Pathological results showed the presence of islet cell clusters in the liver blood vessels. The thrombus formation and neutrophil infiltration around islet graft was not obvious in the experimental group, while massive thrombus formation and neutrophil infiltration in the control group.
CONCLUSIONS
Compared with marginal ear vein infusion of heparin, the direct infusion of heparin in the portal vein has a certain inhibitory effect on complement system, coagulation system activation and inflammatory cell infiltration in portal vein islet transplantation, which may attenuate the occurrence of IBMIR.
Animals
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Anticoagulants/therapeutic use*
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Heparin/therapeutic use*
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Humans
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Islets of Langerhans/pathology*
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Islets of Langerhans Transplantation/physiology*
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Portal Vein
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Swine
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Vena Cava, Superior
9.Protective effect of necrostatin1 on the damage of pancreas islet cells induced by TNFα.
Bin YE ; Pengfei RONG ; Liang LIU ; Wei WANG ; Shengwang ZHANG
Journal of Central South University(Medical Sciences) 2020;45(7):752-758
OBJECTIVES:
To investigate whether necrostatin-1 (Nec-1) can protect islet cells from the damage induced by TNF-α.
METHODS:
After isolation and purification, the neonatal porcine islet cell clusters (NICCs) were divided into 3 groups (islets 10 000 IEQ/group): a Nec-1 group (Nec-1+TNF-α was added to the culture medium), a TNF-α group (TNF-α was added to the culture medium), and a control group (pure medium). The number of cells was observed after 48 h of co-culture. The cell death was evaluated by AO/EB staining. Insulin secretion and DNA of islets were detected by chemiluminescence and nucleic acid quantitative analysis. RT-PCR assay was used to examine the mRNA expressions of insulin gene, glueogan gene and somatostatin gene. Flow cytometry analysis was used to detect the viability of B cells.
RESULTS:
The number of islets in Nec-1 group, TNF-α group and the control group were (8 425±2 187), (4 325±778), and (7 122±1 558) IEQ, respectively. Compared to the other two groups, the number of dead cells in TNF-α group was greatly increased. The insulin/DNA values in the Nec-1 group, TNF-α group and blank control group were (13.21±3.15), (2.47±0.45), and (7.44±0.97) mIU/mg, respectively. Compared to the TNF-α group and the control group, the mRNA relative expression levels of insulin gene (6.73±1.07), glucagon gene (10.13±1.98), somatostatin gene (8.57±1.11) were significantly increased in the Nec-1 group (all <0.05), the rate of live cells (97.32±1.87)% and live B cells (90.86±3.68)% were increased significantly in the Nec-1 group (all <0.05).
CONCLUSIONS
TNF-α can induce neonatal porcine islet cells damage, which is attenuated in the presence of Nec-1. Nec-1 can increase the content of endocrine cells in NICCs.
Animals
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Imidazoles
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Indoles
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Insulin
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Islets of Langerhans
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Swine
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Tumor Necrosis Factor-alpha
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genetics
10.Application of intravoxel incoherent motion diffusion weighted imaging for assessment of early chronic allograft nephropathy.
Shengwang ZHANG ; Wei WANG ; Zhimin YAN ; Feng PENG ; Ting LI ; Pengfei RONG
Journal of Central South University(Medical Sciences) 2019;44(5):501-506
To investigate the feasibility and clinical application of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) technique in non-invasive assessment for early chronic allograft nephropathy (CAN).
Methods: A total of 23 renal allograft recipients were recruited from inpatients or outpatients according to the inclusion and exclusion criteria for this study. Recipients were divided into a CAN group (n=12, pathologically confirmed early CAN patients) and a control group (n=11, volunteers with long-term stable renal function). Abdominal MRI was performed on patients of renal allograft with a multi-b value DWI sequence. IVIM2b-new software was used for obtaining the IVIM-DWI quantitative parameter pseudo-color maps and the values of IVIM-DWI of renal parenchyma, including the pure diffusion coefficient (D), perfusion correlation diffusion coefficient (D*) and perfusion fraction (f). The IVIM quantitative parameters between the two groups were compared using independent sample t test. ROC analysis was performed when the differences in parameter were statistically significant and the area under curve (AUC) was calculated.
Results: In IVIM bi-exponential analysis, The D value was significantly decreased in the CAN group compared with the control group (P<0.05), whereas there are no significantly difference in value of D* and f between the two groups (all P>0.05). The AUC of D value for distinguishing the early CAN from the control were 0.784 with sensitivity and specificity at 58.3% and 90.9%, respectively.
Conclusion: The IVIM-DWI quantitative parameter D can non-invasively assess early CAN to some extent. IVIM-DWI technique is expected to be an effective, easy and non-invasive method to detect early CAN, and assist early diagnose as well as dynamically monitor CAN.
Allografts
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Diffusion Magnetic Resonance Imaging
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Humans
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Kidney Diseases
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surgery
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Kidney Transplantation
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Magnetic Resonance Imaging
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Motion