1.Stainless steel T-shaped locking plate for repair of proximal clavicle fractures and sternoclavicular joint dislocation
Baozhu SUN ; Zhenhua ZHANG ; Gang HE
Chinese Journal of Tissue Engineering Research 2015;19(21):3414-3418
BACKGROUND:Internal fixation methods for traditional proximal clavicle fractures and sternoclavicular joint dislocation include Kirschner wire, Kirschner wire with tension band, clavicular hook plate and ordinary T-shaped plate fixation. However, al of these are easy to fal off, damage nerves and blood vessels and affect the fine motion of the sternoclavicular joint. OBJECTIVE:To investigate the therapeutic effects of internal fixation with T-shaped stainless steel locking plate on proximal clavicular fractures and sternoclavicular joint dislocation as wel as to observe the biocompatibility of materials with the host. METHODS: Twelve patients with proximal clavicular fractures and sternoclavicular joint dislocation were enroled at Shanxian Central Hospital from March 2011 to January 2014, including seven cases of proximal clavicular fractures and five cases of sternoclavicular joint dislocation. Al of patients were subject to open reduction and internal fixation with T-shaped locking plate. RESULTS AND CONCLUSION:Al the 12 patients were folowed up for 3-14 months, with an average of 9 months. Al incisions healed wel, with no local eminence. No major substernal blood vessels and organ damage occurred. X-ray films showed that fractures healed without further dislocation and steel plate fracture. At the last folow-up, Rockwood scoring system showed that the excelent rate of shoulder function was 100%. These findings indicate that the internal fixation with stainless steel T-shaped locking plate is reliable and effective in the treatment of proximal clavicle fractures and sternoclavicular joint dislocation, with low risks and satisfactory outcomes, by which, patients can maximize the recovery of shoulder function.
2.Role of high mobility group protein box 1 in pulmonary vascular remodeling in a rat model of acute lung injury
Huanliang WANG ; Liping PENG ; Manyi SUN ; Wenjuan CHEN ; Weifu LEI ; Baozhu SUN ; Jianbo WU ; Wenhua ZHANG
Chinese Journal of Anesthesiology 2012;(10):1278-1280
Objective To investigate the role of high mobility group protein box 1 (HMGB1) in pulmonary vascular remodeling in a rat model of acute lung injury (ALI).Methods Thirty healthy pathogen free male Wistar rats weighing 220-250 g were randomly divided into 3 groups (n =10 each) ∶ group control (group C) ;group LPS (group M) and group LPS + HMGB1 antibody (group H).The animals were anesthetized with intraperitoneal 10% chloral hydrate 7 ml/kg.ALI was induced with LPS 1 mg/kg infused iv over 30 min in groups M and H.In group H HMGB1 antibody 2 mg/kg was injected iv at 12,24 and 36 h after LPS administration respectively.The animals were sacrificed at 72 h after LPS administration.The left lung was removed for microscopic examination,measurement of the thickness of the medial layer (tunica media) of pulmonary arterioles and determination of the expression of PCNA (by immune-histochemistry) and HMGB1 protein (by Western blotting).Results The medial layer of pulmonary arterioles was significantly thicker and the expression of PCNA and HMGB1 higher in group M than in group C.LPS also induced significant inflammatory cell infiltration within the alveoli and damage to the septa.In group H HMGB1 antibody significantly attenuated the above-mentioned LPS-induced changes.Conclusion HMGB1 may play an important role in the LPS-induced pulmonary vascular remodeling.
3.Clinical analysis of 34 cases of bullous pemphigoid with non-bullous lesions as initial manifestation
Caihong SUN ; Hongqin TU ; Yuying KANG ; Mei JU ; Baozhu CHANG ; Heng GU
Chinese Journal of Dermatology 2008;41(10):647-649
Objective To analyse the clinical and therapeutic features as well as laboratory findings in bullous pemphigoid with non-bullous lesions as initial manifestation. Methods Clinical data on 34 cases of bullous pemphigoid with non-bullous lesions as initial manifestation were retrospectively analyzed. Results The male to female ratio was 1.83 :1, with a mean age of onset at 59.79±15.63 years. Before typical bullae appeared, patients presented with erythema, papules, papulovesicles' plaques" wheals, nodules,or erythema muitiforme-like lesions, with the most common lesions being erythematous papules and plaques (occumng in 35.29% of these patients). Conclusions Among these patients, nearly 1/3 displayed various skin lesions at the onset; simultaneous erythematous papules and plaques are the most common initial manifestation.
4.Assessment value of thromboelastogram for thrombus risk in patients with coronary heart disease complicated hypertension
Yan LI ; Baozhu WANG ; Xinrong ZHOU ; Mahemuti MHSUM ; Fapeng LI ; Jian ZHANG ; Huiping SUN
Chinese Journal of cardiovascular Rehabilitation Medicine 2017;26(3):334-337
Objective: To observe assessment effects of thromboelastogram (TEG) on patients with coronary heart disease (CHD) complicated hypertension.Methods: A total of 120 CHD patients were selected from our hospital.According to complicated with hypertension or not, they were divided into pure CHD group (n=58) and CHD + hypertension group (n=62).TEG indexes were compared between two groups.Results: Compared with pure CHD group, there were significant reductions in blood clot formation duration [K: (2.53±0.72)min vs.(1.82±0.64)min], coagulation reaction duration [R: (8.66±1.86)min vs.(7.18±1.85)min], arachidonic acid pathway-induced platelet activity [AA: (57.36±16.91)% vs.(46.73±20.73)%], and significant rise in maximum amplitude after clot formation [MA: (57.31±7.75)mm vs.(64.36±7.85)mm] and included angle value between the tangent from the blood clot forming point to the maximum curve radian of the chart and the horizontal line [Angle: (53.26±7.78) vs.(64.38±7.85)] in CHD + hypertension group, P<0.01 all.Spearman correlation analysis indicated that blood pressure level was significantly positive correlated with Angle and MA (r=0.607, 0.405, P<0.01 both), and significantly inversely correlated with R and K (r=-0.256,-0.541, P<0.01 both) in CHD + hypertension patients.Conclusion:Thrombosis possesses higher risk for CHD + hypertension patients, which is easier to cause acute cardiovascular events.Therefore, attention should be paid to coagulation function monitoring in order to prevent adverse cardiac events in these patients.
5.Risk factor analysis for death during hospitalization in patients with acute myocardial infarction
Xiaoqing ZHU ; Baozhu WANG ; Huiping SUN ; Xinrong ZHOU ; Long ZHAO ; Jie JIANG ; Maihemuti MAISUMU
Chinese Journal of cardiovascular Rehabilitation Medicine 2015;24(2):148-153
Objective:To explore the independent risk factors of death during hospitalization in patients with acute myocardial infarction (AMI) .Methods :Clinical data of 614 cases ,who were diagnosed as AMI during hospitaliza‐tion in our hospital from 2011 to 2013 ,were retrospectively analyzed .According to AMI patients'survival or not during hospitalization ,they were divided into death group (n=62) and survival group (n=552) ,single and multi-variable Logistic regression analysis were used to analyze the relationship among baseline feature factors and thera‐peutic methods of all patients and hospital mortality .Results:The mean age was (66.58 ± 12.87) years and there were 39 males (62.9% ) among the 62 dead patients .Hospital mortality was 10.10% (62/614) .Multi‐variable Lo‐gistic regression analysis screened following factor were independent risk factors related to AMI hospital mortality :age (OR= 3.065 ,95% CI:1.188~ 7.915) ,female (OR= 2.775 ,95% CI :1.200~ 6.419) ,heart rate (OR=2.836 ,95% CI:1.405~ 5.722) ,blood glucose (OR = 1.943 ,95% CI :1.186 ~ 3.184) ,Killip class IV (OR=1.744 ,95% CI:1.211~2.513) and left main or triple -vessel coronary disease (OR= 3.157 ,95% CI :1.244 -8.014) . P < 0.05 ~ < 0.01 .Conclusion : Advanced age ,female ,rapid heart rate ,elevated blood glucose level at hospitalization ,Killip class IV and left main or triple‐vessel coronary disease may be independent risk factors of death during hospitalization in patients with acute myocardial infarction .
6.Efficacy of clemastine fumarate in antagonizing atracurium-induced release of histamine in patients undergoing surgery under general anesthesia
Yonghao HOU ; Jianbo WU ; Baozhu SUN ; Cuiping WANG ; Peng WANG ; Junzhang DU ; Jingui YU
Chinese Journal of Anesthesiology 2016;36(12):1431-1434
Objective To evaluate the efficacy of clemastine fumarate in antagonizing atracuriuminduced release of histamine in the patients undergoing surgery under general anesthesia.Methods Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 21-59 yr,with body mass index of 17-26 kg/m2,scheduled for elective modified radical mastectomy,were divided into 2 groups (n=40 each) using a random number table:control group (group C) and clemastine fumarat group (group CF).Clemastine fumarate 2 mg was injected intramuscularly at 20 min before induction of anesthesia.Anesthesia was induced with iv midazolam 0.1 mg/kg,etomidate 0.3 mg/kg,fentanyl 4-6 μg/kg and atracurium 0.8 mg/kg.The patients were mechanically ventilated after insertion of the larygeal mask airway.Anesthesia was maintained with inhalation of 2% sevoflurane.Before administration of clemastine fumarate,at 20 min after administration,immediately before administration of atracurium,and at 2,5,10 and 20 min after administration of atracurium,arterial blood samples were taken for determination of plasma histamine concentrations,and the peak airway pressure and degree of cutaneous color were recorded.The development of histaminemia and adverse cardiovascular events was assessed.Steward recovery scores and Ramsay sedation scores were recorded at 10 min after removal of the laryngeal mask airway.Results The incidence of histaminemia was 60% and 8% in C and CF groups,respectively.Compared with group C,the plasma histamine concentrations,incidence of histaminemia,degree of cutaneous color,and incidence of hypotension and tachycardia were significantly decreased (P<0.05),and no significant change was found in the peak airway pressure,Steward recovery scores and Ramsay sedation scores in group CF (P>0.05).Conclusion For atracurium-induced release of histamine in the patients undergoing surgery under general anesthesia,clemastine fumarate 2 mg injected intramuscularly before operation can not only antagonize histamine at H1 level,but also reduce histamine release,and exerts no influence on recovery from anesthesia and produces good antihistamine efficacy.
7.Pharmacological inhibition of STING signaling attenu-ates MPTP-induced neuroinflammation and neurode-generation in experimental models of Parkinson's disease
Baozhu WANG ; Jingru QIU ; Shuyan YU ; Deqing SUN ; Haiyan LOU
Chinese Journal of Pharmacology and Toxicology 2023;37(7):506-506
OBJECTIVE To investigate the effects of pharmacological inhibition of STING by C-176,a STING selective inhibitor,in experimental model of Parkinson's disease.METHODS The acute and sub-acute mice mod-els of Parkinson's disease(PD)were established by in-traperitoneal injection of 1-methyl-4-(2′-methylphenyl)-1,2,3,6-tetrahydrophine(MPTP).The selective STING inhibitor C-176 was administered by intraperitoneal injec-tion.The potential neuroprotective effects of C-176 were evaluated by behavioral test,tyrosine hydroxylase(TH)immunostaining,Nissl staining,Western blotting,qPCR and immunofluorescence.For in vitro study,the effects of C-176 on LPS/MPP+-induced inflammatory responses in BV2 microglial cells were determined by real time RT-PCR and Western blotting analysis.RESULTS Our study revealed that C-176 significantly inhibited STING signaling activation,ameliorated MPTP-induced dopami-nergic neurotoxicity,motor deficit and associated neuroin-flammation.Furthermore,pharmacological inhibition of STING in BV2 microglia treated with LPS/MPP+ exhibited decreased inflammatory responses.More importantly,C176 also reduced NLRP3 inflammasome activation both in vitro and in vivo.CONCLUSION The results of our study suggest that pharmacologic inhibition of STING protects against neuroinflammation that may act at least in part through suppressing NLRP3 inflammasome acti-vation and thus ameliorated dopaminergic neurodegener-ation.STING signaling may holds great promise for the development of new treatment strategy for PD as an effective therapeutic target.
8.Effect of flurbiprofen postconditioning on permeability of blood brain barrier in a rat model of focal cerebral ischemia-reperfusion injury
Lili HOU ; Lin CHEN ; Xiaomei YANG ; Xinbing WEI ; Xiumei ZHANG ; Baozhu SUN
Chinese Journal of Anesthesiology 2020;40(7):813-816
Objective:To evaluate the effect of flurbiprofen postconditioning on the permeability of blood brain barrier in a rat model of focal cerebral ischemia-reperfusion (I/R) injury.Methods:Eighty healthy male Wistar rats, aged 8-9 weeks, weighing 280-320 g, were divided into 4 groups ( n=20 each) using a random number table method: sham operation group (group Sham), focal cerebral I/R group (group I/R), lipo-microballoons group (group V) and flurbiprofen 10 mg/kg group (group F). Focal cerebral I/R model was established by left middle cerebral artery occlusion for 2 h followed by 24-h reperfusion in anesthetized rats.Flurbiprofen 10 mg/kg (group F), the equal volume of lipo-microballoons (group V) or the equal volume of normal saline (group Sham and group I/R) was injected via the tail vein at the onset of reperfusion.The rats were sacrificed at 24 h of reperfusion, brains were immediately removed, and cerebral tissues were obtained for measurement of brain water content, Evans blue content, expression of matrix metalloproteinase-9 (MMP-9) in ischemic penumbra (by immuno-histochemistry), and expression of phosphorylated p38 mitogen-activated protein kinase (p-p38 MAPK) and inducible nitric oxide synthase (iNOS) in ischemic penumbra (by Western blot). Results:Compared with Sham group, brain water content and Evans blue content in brain tissues were significantly increased, and the expression of MMP-9, p-p38 MAPK and iNOS in ischemic penumbra was up-regulated in I/R, V and F groups ( P<0.05). Compared with group I/R, brain water content and Evans blue content in brain tissues were significantly decreased, and the expression of MMP-9, p-p38 MAPK and iNOS in ischemic penumbra was down-regulated in group F ( P<0.05), and no significant change was found in the above parameters in group V ( P>0.05). Conclusion:Flurbiprofen postconditioning can decrease the permeability of blood brain barrier during focal cerebral I/R in rats, and the mechanism may be related to inhibiting the activation of p38 MAPK/iNOS signaling pathway and down-regulating the expression of MMP-9.
9.Different calcium ion concentrations affect epithelial mesenchymal transformation of human peritoneal mesothelial cells via endoplasmic reticulum stress
Baozhu GUO ; Jinxiu CHENG ; Xin JIN ; Yutao HE ; Xianmin SUN
Chinese Critical Care Medicine 2024;36(1):50-55
Objective:To study the effects of different calcium ion concentrations on epithelial mesenchymal transformation (EMT) of human peritoneal mesothelial cell (HPMC) via endoplasmic reticulum stress (ERS).Methods:HPMC cell line HMrSV5 was cultured in vitro and treated in groups. The cells in the control group, high calcium group 1, and high calcium group 2 were treated with medium containing calcium ion concentrations of 1.25, 1.75, and 2.25 mmol/L, respectively. The solvent control group was treated with medium containing 1.25 mmol/L physiological calcium ion concentration and 0.1% dimethyl sulfoxide (DMSO), the high calcium+solvent group was treated with medium containing 2.25 mmol/L calcium ion concentration and 0.1% DMSO, the high calcium+4-phenylbutyric acid (4-PBA) group was treated with medium containing 2.25 mmol/L calcium ion concentration and 1 mmol/L ERS inhibitor 4-PBA, and each group was treated for 48 hours. Morphological changes of cells in each group were observed under light microscope. The expressions of epithelial cell phenotype marker zonula occluden-1 (ZO-1) and mesenchymal cell phenotype marker α-smooth muscle actin (α-SMA) in the cells were observed by immunofluorescence staining. The expressions of EMT marker genes E-cadherin, ZO-1, α-SMA and Vimentin were detected by fluorescence quantitative polymerase chain reaction (PCR). The expressions of ERS marker proteins phosphorylated protein kinase R-like endoplasmic reticulum kinase (p-PERK), phosphorylated eukaryotic initiation factor 2α (p-eIF2α), transcription activating factor 4 (ATF4) and C/EBP homologous protein (CHOP) were detected by Western blotting. Results:Compared with the control group, the morphology of HMrSV5 cells became slender and fibrotic, the fluorescence intensity of ZO-1 increased, and the fluorescence intensity of α-SMA decreased in high calcium 1 and high calcium 2 groups, indicating that the cells transformed from epithelial cells to mesenchyme cells. The mRNA expressions of E-cadherin and ZO-1 were significantly decreased, while the mRNA expressions of α-SMA and Vimentin and the protein expressions of p-PERK, p-eIF2α, ATF4 and CHOP were significantly increased, moreover, the expressions of the above marker genes or proteins in the high calcium 2 group was more obvious than those in the high calcium 1 group [E-cadherin mRNA (2 -ΔΔCt): 0.53±0.05 vs. 0.75±0.09, ZO-1 mRNA (2 -ΔΔCt): 0.42±0.06 vs. 0.69±0.06, α-SMA mRNA (2 -ΔΔCt): 1.81±0.16 vs. 1.32±0.14, Vimentin mRNA (2 -ΔΔCt): 2.05±0.22 vs. 1.48±0.16, p-PERK protein (p-PERK/β-actin): 0.81±0.09 vs. 0.59±0.06, p-eIF2α protein (p-eIF2α/β-actin): 0.87±0.10 vs. 0.50±0.06, ATF4 protein (ATF4/β-actin): 0.93±0.10 vs. 0.72±0.06, CHOP protein (CHOP/β-actin): 0.79±0.09 vs. 0.46±0.04, all P < 0.05]. Compared with the solvent control group, the morphological changes of cells, the expressions of EMT marker genes and ERS marker proteins after high calcium ion concentration of 2.25 mmol/L were consistent with those in the high calcium 2 group than control group. Compared with the high calcium+solvent group, the cell morphology recovered the characteristics of polygonal and pebble-like epithelial cells in the high calcium+4-PBA group, the fluorescence intensity of ZO-1 increased, the fluorescence intensity of α-SMA decreased, and the mRNA expressions of E-cadherin and ZO-1 in the cells were significantly increased [E-cadherin mRNA (2 -ΔΔCt): 0.86±0.09 vs. 0.57±0.04, ZO-1 mRNA (2 -ΔΔCt): 0.81±0.06 vs. 0.48±0.05, both P < 0.05], the mRNA expressions of α-SMA and Vimentin and the protein expressions of p-PERK, p-eIF2α, ATF4 and CHOP were significantly decreased [α-SMA mRNA (2 -ΔΔCt): 1.21±0.13 vs. 1.77±0.15, Vimentin mRNA (2 -ΔΔCt): 1.30±0.14 vs. 1.94±0.20, p-PERK protein (p-PERK/β-actin): 0.38±0.04 vs. 0.92±0.11, p-eIF2α protein (p-eIF2α/β-actin): 0.34±0.05 vs. 1.05±0.13, ATF4 protein (ATF4/β-actin): 0.57±0.06 vs. 0.97±0.11, CHOP protein (CHOP/β-actin): 0.51±0.04 vs. 0.90±0.12, all P < 0.05]. Conclusion:High calcium ion concentrations of 1.75 mmol/L and 2.25 mmol/L promote EMT of HPMC via activating ERS.
10.Comparison of the effects between low-level assisted ventilation and T-piece method on respiratory mechanics during weaning of mechanically ventilated patients
Shiya WANG ; Zhenjie JIANG ; Baozhu ZHANG ; Guangsheng LU ; Zhimin WANG ; Zhimin LIN ; Qiang CHEN ; Chun YANG ; Qingwen SUN ; Honglian RUAN ; Yuanda XU
Chinese Critical Care Medicine 2021;33(6):697-701
Objective:To compare the difference of low-level assisted ventilation and T-piece method on respiratory mechanics of patients with invasive mechanical ventilation during spontaneous breathing trial (SBT) within 3 days before extubation.Methods:A retrospective observational study was conducted. Twenty-five patients with difficulty in weaning or delayed weaning from invasive mechanical ventilation who were admitted to department of critical care medicine of the First Affiliated Hospital of Guangzhou Medical University from December 2018 to June 2020, and were in stable condition and entered the weaning stage after more than 72 hours of invasive mechanical ventilation were studied. A total of 119 cases of respiratory mechanical indexes were collected, which were divided into the low-level assisted ventilation group and the T-piece group according to the ventilator method and parameters used during the data collection. The different ventilation modes related respiratory mechanics indexes such as the esophageal pressure (Pes), the gastric pressure (Pga), the transdiaphragmatic pressure (Pdi), the maximum Pdi (Pdimax), Pdi/Pdimax ratio, the esophageal pressure-time product (PTPes), the gastric pressure-time product (PTPga), the transdiaphragmatic pressure-time product (PTPdi), the diaphragmatic electromyography (EMGdi), the maximum diaphragmatic electromyography (EMGdimax), PTPdi/PTPes ratio, Pes/Pdi ratio, the inspiratory time (Ti), the expiratory time (Te) and the total time respiratory cycle (Ttot) at the end of monitoring were recorded and compared between the two groups.Results:Compared with the T-piece group, Pes, PTPes, PTPdi/PTPes ratio, Pes/Pdi ratio and Te were higher in low-level assisted ventilation group [Pes (cmH 2O, 1 cmH 2O = 0.098 kPa): 2.84 (-1.80, 5.83) vs. -0.94 (-8.50, 2.06), PTPes (cmH 2O·s·min -1): 1.87 (-2.50, 5.93) vs. -0.95 (-9.71, 2.56), PTPdi/PTPes ratio: 0.07 (-1.74, 1.65) vs. -1.82 (-4.15, -1.25), Pes/Pdi ratio: 0.17 (-0.43, 0.64) vs. -0.47 (-0.65, -0.11), Te (s): 1.65 (1.36, 2.18) vs. 1.33 (1.05, 1.75), all P < 0.05], there were no significant differences in Pga, Pdi, Pdimax, Pdi/Pdimax ratio, PTPga, PTPdi, EMGdi, EMGdimax, Ti and Ttot between the T-piece group and the low-level assisted pressure ventilation group [Pga (cmH 2O): 6.96 (3.54,7.60) vs. 7.74 (4.37, 11.30), Pdi (cmH 2O): 9.24 (4.58, 17.31) vs. 6.18 (2.98, 11.96), Pdimax (cmH 2O): 47.20 (20.60, 52.30) vs. 29.95 (21.50, 47.20), Pdi/Pdimax ratio: 0.25 (0.01, 0.34) vs. 0.25 (0.12, 0.41), PTPga (cmH 2O·s·min -1): 7.20 (2.54, 9.97) vs. 7.97 (5.74, 13.07), PTPdi (cmH 2O·s·min -1): 12.15 (2.95, 19.86) vs. 6.87 (2.50, 12.63), EMGdi (μV): 0.05 (0.03, 0.07) vs. 0.04 (0.02, 0.06), EMGdimax (μV): 0.07 (0.05, 0.09) vs. 0.07 (0.04, 0.09), Ti (s): 1.20 (0.95, 1.33) vs. 1.07 (0.95, 1.33), Ttot (s): 2.59 (2.22, 3.09) vs. 2.77 (2.35, 3.24), all P > 0.05]. Conclusions:When mechanically ventilated patients undergo SBT, the use of T-piece method increases the work of breathing compared with low-level assisted ventilation method. Therefore, long-term use of T-piece should be avoided during SBT.