1.Effects of high-frequency oscillatory ventilation on brain injury in preterm infants with respiratory distress syndrome
Xinzhu LIN ; Jing HUANG ; Yao ZHU ; Lixia TANG ; Lian WANG ; Chao CHEN
Chinese Journal of Perinatal Medicine 2017;20(8):611-617
Objective To investigate the association between high-frequency oscillatory ventilation (HFOV) and the incidence of brain injury in premature infants(BIPI) with respiratory distress syndrome (RDS).Methods A total of 136 premature infants who were diagnosed as RDS and treated with mechanical ventilation between January 1,2014 and June 30,2016 were enrolled.Atter stratified by gestational age of 36-34 weeks,33-32 weeks,31-28 weeks and ≤ 27 weeks,the neonates were randomly divided into two groups (68 cases each):conventional mechanical ventilation (CMV) and HFOV groups.Duration of ventilation and changes in blood gas parameters following 24,48 and 72 hours of ventilation were monitored and compared between the two groups.Incidences of BIPI and complications in the two groups were calculated and their associations with gestational age and birth weight were analyzed.Moreover,incidences of cure rates in the two groups were comparatively analyzed.Independent samples t-test,two-way analysis of variance,Chi-square test or Fisher's exact test was used for statistical analysis.Results (1)Significant difference was observed neither in the perinatal factors (prenatal glucocorticoid usage,and incidences of premature rupture of membrane and gestational diabetes mellitus),nor in the severity of RDS between the two groups (all P>0.05).(2) The average duration of ventilation in the CMV group was higher than that of the HFOV group [(68.44±10.3) vs (64.7±8.5) h,t=2.285,P<0.05].No significant difference in the values of pH,partial pressure of carbon dioxide (PaCO2) or partial pressure of oxygen (PaO2) before and after 24,48 or 72 hours of ventilation treatment was found between the two groups (all P>0.05).(3) Neither the incidence of hemorrhagic brain injury nor that of non-hemorrhagic brain injury showed any significant difference between the CMV and HFOV groups [36.8% (25/68) vs 39.7% (27/68);16.2% (11/68)vs 14.7% (10/68),both P>0.05].The total incidence of BIPI showed no significant difference [44.1%(30/68) vs 45.8%(33/68),22=0.266,P=0.606].The smaller gestational age at birth and the lower birth weight,the higher incidence of BIPI,although no significant difference was shown in the incidence of BIPI when compared among different gestational age groups and different birth weight groups (all P>0.05).(4) The incidence of complications in the CMV group was higher than that in HFOV group [25.0%(17/68) vs 11.8%(8/68),22=3.970,P=0.044],while the cure rate of RDS was similar [94.1%(64/68) vs 95.6%(65/68),x2=0.151,P=0.703].Conclusions HFOV is a safe and reliable therapy for preterm infants with RDS.Compared with CMV,HFOV can shorten the duration of ventilation and reduce the incidence of complications without increasing the risk of BIPI.However,the cure rate of RDS is not increased by HFOV.
2.In vitro study of safety and co-efficiency of the transbronchial coagulation techniques
Chong BAI ; Yu-Chao DONG ; Xiao-Lian SONG ; Yi HUANG ; Hui SHI ; Zhen-Li HU ; Qiang LI
Chinese Medical Journal 2013;(1):124-128
Background The usual transbronchial coagulation techniques include microwave,argon plasma coagulation (APC),electrocautery and cryotherapy.However,there are serious clinical problems in the safety of each.By analyzing the experimental data and clinical observations,we observed the variable effects of different coagulation techniques via bronchofibroscopy,to look for an optimal interventional management of luminal bronchus diseases,and evaluate the safety and the equivalent point.Methods Four kinds of coagulation techniques under bronchoscopy were performed on the fresh bronchus of healthy sheep,and the pathologic changes in all groups were observed under the microscope.The different treatment parameters were as follows:microwave 60 W×1 second,3 seconds,5 seconds and 40 W×1 second,3 seconds,5 seconds; APC 40 W×1 second,3 seconds,5 seconds; electrocautery 40 W×1 second,3 seconds,5 seconds;cryotherapy 100 Ω×60 seconds,120 seconds.Results After treatment,ovine bronchial mucosa in all groups showed pathologic changes such as local necrosis and amotio of the mucosa lining epithelium,local submucosa coagulative necrosis or tissue defects,while inflammation in the surrounding tissue was not obvious.Under the same output power and action time,different methods had different outcomes.The damage by APC was the most superficial,microwave was the second,and electrocautery caused the worst damage.The study also found that effects of electrocautery at 40 W×3 seconds,microwave at 40 W×5 seconds or 60 W×3 seconds,APC at 40 W×5 seconds and cryotherapy at 100 Ω×120 seconds were the equivalent point conditions.The appearance included mucosa absence,partial submucosa absence,and collagen fiber coagulation in treatment areas.Conclusions Each coagulation technique has its own characteristic.It is very important to choose the appropriate power and action time of the suitable method according to the therapy requirement.
3.Analysis of Pareto diagram on irrational prescription in our hospital
Yue CHEN ; Li-Chao LIAN ; Jing HUANG ; Wan-Yu FENG
The Chinese Journal of Clinical Pharmacology 2015;(13):1325-1327
Objective To analyze the situation of irrational drug use in our hospital .Methods The irrational prescriptions were classified into 8 kinds.The Pareto diagram analysis was used to make irrational prescrip-tions classification .The factors of primary , secondary and common were analyzed.Results Three primary factors about irrational prescriptions were in unsuitable drugs , Indication and no identifies use anti -biotics. The secondary factors were inappropriate combined drugs and repeated administration.Common factors were unsuitable usage and amount , ultra instruction, frequency and unsuitable route of administration . Conclusion Clinical pharmacist should intervene effectively according to irrational types , raising the level of rational use of medicines develop appropriate interventions , control primary and secondary factors .
4.A mouse model based on replication-competent Tiantan vaccinia expressing luciferase/HIV-1 Gag fusion protein for the evaluation of protective efficacy of HIV vaccine.
Yang HUANG ; Chao QIU ; Lian-xing LIU ; Yan-meng FENG ; Ting ZHU ; Jian-qing XU
Chinese Medical Journal 2009;122(14):1655-1659
BACKGROUNDDeveloping an effective vaccine against human immunodeficiency virus type 1 (HIV-1) remains a grand challenge after more than two decades of intensive effort. It is partially due to the lack of suitable animal models for screening and prioritizing vaccine candidates. In this study, we aim to develop a mice model to test HIV-1 vaccine efficacy.
METHODSWe constructed a recombinant vaccinia expressing firefly luciferase and HIV-1 Gag fusion protein based on Tiantan strain, an attenuated but replication-competent poxvirus (rTTV-lucgag). By quantifying the luciferase activity as its read out, we defined the biodistribution of Tiantan strain poxvirus in mice inoculated intraperitoneally and attempted to apply this model to evaluate the HIV-1 vaccine efficacy.
RESULTSOur data demonstrated that the rTTV-lucgag was able to express high level of luciferase (< or = 10(6) relative luciferase units (RLU)/mg protein) and HIV-1 Gag (> 3 folds increase comparing to the control). After intraperitoneal inoculation, this virus had dominant replication in the ovary, uterus, and cervix of mice and the luciferase activities in those organs are significantly correlated with viral titers (r(2) = 0.71, P < 0.01). Pre-immunization with an HIV gag DNA vaccine reduced the luciferase activity in ovary from (6006 +/- 3141) RLU/mg protein in control group to (1538 +/- 463) RLU/mg protein in vaccine group (P = 0.1969).
CONCLUSIONSThe luciferase activity in ovary could represent viral replication in vivo; this rTTV-lucgag/mice model may be suitable to assess the protective efficacy of cytotoxic T-cell responses to HIV Gag with less tedious work and high through-put.
AIDS Vaccines ; genetics ; Animals ; Female ; HIV Infections ; immunology ; prevention & control ; HIV-1 ; genetics ; Humans ; Kinetics ; Luciferases ; genetics ; metabolism ; Mice ; Mice, Inbred BALB C ; Poxviridae ; genetics ; Recombinant Proteins ; genetics ; metabolism ; Virus Replication ; genetics ; gag Gene Products, Human Immunodeficiency Virus ; genetics
5.Clinical characteristics and microbiological tests analysis of 18 patients with Talaromyces marneffei infection
ZOU Sheng-hua ; FANG Mei-lan ; LIN Zhen-li ; CHEN Xin-chao ; HUANG Ming-xiang ; GUAN Hong-lian ; WANG Xin-hang
China Tropical Medicine 2023;23(2):139-
Abstract:Objective To investigate the clinical characteristics and early diagnostic methods of patients with Talaromyces marneffei infection, so as to reduce the mortality of patients. Methods The clinical characteristics and microbiological analysis data including fungal culture, smear examination and mass spectrometry were collected from 18 patients with Talaromyces marneffei infection in the Department of Respiratory Medicine, Department of Tuberculosis, and Department of Critical Respiratory Medicine in Fuzhou Pulmonary Hospital from January 2017 to December 2021, and descriptive analysis was conducted. Results All the 18 patients were confirmed to be infected with Talaromyces marneffei by conventional culture and matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MS). The main infection sites of 18 patients with Talaromyces marneffei infection were lungs and lymph nodes, and the patients were accompanied by clinical manifestations such as cough, sputum and fever. The imaging features such as patchy shadows, mediastinal lymph node shadows and nodular shadows were common. Microbiological testing showed a statistically significant difference between smear and culture with a higher positive culture rate (χ2=13.74, P<0.05). The positive rate of blood culture in microbiological test was 60.0% (9/15), the positive rate of bronchial lavage fluid culture was 26.7% (4/15), the positive rate of sputum culture was 5.6% (1/18), one case each of pus, bone marrow, pleural fluid and cerebrospinal fluid was positive for culture and the other cases were negative, one case of sputum and one case of pus were positive for smear and the rest were negative. Colony characteristics showed that the colony morphology was mycelial phase at 25 ℃, producing red pigment, and the branching pattern of the penicillus was seen microscopically as monoverticillate or biverticillate; At 35 ℃, the yeast phase appeared at the initial stage, and then the mycelium phase changed after 5-6 days; the yeast phase was observed at 37 ℃, and yeast-like cells were seen under the microscope. All 18 patients with Talaromyces marneffei infection got better after using antifungal drugs. Compared with non-HIV patients with Talaromyces marneffei infection, leukopenia and anemia were common in HIV patients with Talaromyces marneffei infection, and the differences were statistically significant (P<0.05). Conclusions The infection of Talaromyces marneffei can be divided into localized type and disseminated type, which usually invade the lungs, skin, lymph nodes and other places. The main manifestations of patients are fever, cough, phlegm and other atypical symptoms. At present, the diagnosis of Talaromyces marneffei infection is mostly based on the fungal culture test, and the application of MALDI-TOF MS method can effectively shorten the diagnosis time of Talaromycosis marneffei. Clinical characteristics combined with microbiological analysis provide an objective basis for early diagnosis of patients with Talaromyces marneffei infection, and timely use of antifungal therapy can improve the prognosis of patients.
6.Rapamycin-loaded poly (lactic-co-glycolic) acid nanoparticles for intraarterial local drug delivery: preparation, characterization, and in vitro/in vivo release.
Li-fu MIAO ; Jing YANG ; Chao-lian HUANG ; Cun-xian SONG ; Yu-jie ZENG ; Lian-feng CHEN ; Wen-ling ZHU
Acta Academiae Medicinae Sinicae 2008;30(4):491-497
OBJECTIVETo sought to engineer and characterize a biodegradable nanoparticles (NPs) containing rapamycin which use poly (lactic-co-glycolic) acid (PLGA) as the carrier matrix and to assess its in vivo release characteristics by local drug delivery system intravascularly.
METHODSRapamycin-loaded PLGA NPs were prepared by an emulsification/solvent evaporation technique, and NPs size distribution was assessed by submicro laser defractometer. The particle morphology was observed by scanning electron microscopy. In vitro release from the NPs was performed in TE buffer at 37 degrees C under rotation utilizing double-chamber diffusion cells on a shake stander. In vivo NPs intravascular local delivery were performed by DISPATCH catheter in New Zealand rabbit abdominal aorta and Chinese experimental mini-pigs coronary artery models.
RESULTSBiodegradable rapamycin loaded PLGA NPs were constructed successfully by emulsification solvent-evaporation technique. The diameter of rapamycin-PLGA NPs was around 246.8 nm with very narrow size distribution, and rapamycin-NPs showed good spherical shape with smooth uniform surface. Rapamycin loaded in NPs were around was 19.42%. Encapsulation efficiency of drug was over 77.53%. The in vitro release of rapamycin from NPs showed that 75% of the drug was sustained released over 2 weeks and controlled release in a linear pattern. After a single 10 minutes infusion of rapamycin-PLGA NPs suspension (5 mg/ml) under 20.27 kPa through DISPATCH catherter in vivo, the mean rapamycin levels at 7 day and 14 day were (2.438 +/- 0.439) and (0.529 +/- 0.144) microg/mg of the dry-weight of the artery segments (2 cm) which local delivery were administrated.
CONCLUSIONSPLGA NPs controlled drug delivery system for intraarterial local anti-proliferative drug delivery can potentially improve local drug concentration and prolong drug residence time in animal model in vivo. It should be appropriate for further study of its therapy efficiency in human.
Animals ; Aorta, Abdominal ; drug effects ; Coronary Vessels ; drug effects ; Drug Carriers ; chemistry ; Drug Delivery Systems ; methods ; Infusions, Intra-Arterial ; Lactic Acid ; chemistry ; Nanoparticles ; chemistry ; Particle Size ; Polyglycolic Acid ; chemistry ; Rabbits ; Sirolimus ; administration & dosage ; pharmacokinetics ; Swine ; Swine, Miniature
7.Effects of rapamycin-loaded poly(lactic-co-glycolic) acid nanoparticles on distribution of cell cycle, expression of p27 protein, and proliferation of human umbilical arterial vascular smooth muscle cell in vitro.
Li-fu MIAO ; Chao-lian HUANG ; Lian-feng CHEN ; Wen-ling ZHU ; Jing YANG ; Yi-guang WANG ; Hua ZHANG ; Pei-mao LIU ; Ming-peng SHE ; Cun-xian SONG
Acta Academiae Medicinae Sinicae 2010;32(1):32-38
OBJECTIVETo evaluate the effects of rapamycin (RPM)-loaded poly (lactic-co- glycolic) acid (PLGA) nanoparticles (NPs) on the proliferation, distribution of cell cycle, and expression of p27 protein in human umbilical arterial vascular smooth muscle cell (HUASMC) in vitro.
METHODSThe primarily culture model of HUASMC was successfully established by explant-attached method in vitro. The cells were administrated with different doses of RPM, and RPM-PLGA NPs were observed as treat groups compared with PLGA NPs and M231-SMGs medium cultured group. The effect of RPM-PLGA NPs on proliferation of HUASMC was assessed using 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) colorimetry method. The influences of RPM-PLGA NPs on the cell cycle and cellular growth kinetics of HUASMCs were tested by flow cytometry. The effect of RPM-PLGA NPs on the expression of p27 protein of HUASMCs was assessed through an immunohistochemical method.
RESULTSCompared with the control group, the proliferation of HUASMCs was inhibited by 50 microg/L and higher concentration of RPM-PLGA NPs in a dose-dependent manner (P < 0.05). The numbers of cells entering cell cycle of S/G2/M phases were significantly lower in RPM-PLGA NPs and RPM treated groups. Histologically, the expression of p27 were up-regulated in 500 microg/L RPM-PLGA NPs and 100 microg/L RPM treated group (all P < 0.01 ) when compared with the control group.
CONCLUSIONSRPM-PLGA NPs has a similar effects as RPM in inhibiting the growth of in vitro cultured HUASMC. It can remarkably suppress the expression of in vitro cultured HUASMC p27 protein, arrest its cell cycle at G1/S phase, and inhibit its proliferation.
Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cyclin-Dependent Kinase Inhibitor p27 ; metabolism ; Drug Carriers ; Humans ; Lactic Acid ; Muscle, Smooth, Vascular ; cytology ; Myocytes, Smooth Muscle ; cytology ; drug effects ; metabolism ; Nanoparticles ; Polyglycolic Acid ; Sirolimus ; administration & dosage ; pharmacology ; Umbilical Arteries ; cytology
8.Association of MMP14 gene polymorphisms and osteoporosis in Zhuang men from Baise region of Guangxi.
Qing-hui ZHOU ; Xiu-feng HUANG ; Jin-hua WANG ; Chao-wen LIN ; Yuan-yuan YANG ; Chang-sheng HUANG ; Lian-tao WU ; Yu-mei WU
Chinese Journal of Medical Genetics 2012;29(3):309-313
OBJECTIVETo assess the association between membrane type 1 matrix metalloproteinase gene (MT1-MMP, MMP14) polymorphisms and osteoporosis in Zhuang men from Baise region of Guangxi.
METHODSGenotypes of 5 loci (rs1003349, rs3751488, rs2269213, rs2236303 and rs743257) of MMP14 gene in 301 Zhuang men were determined with single base extension methods, and bone mineral density (BMD) at left calcaneus was evaluated with quantitative ultrasound with measured values of broadband ultrasonic attenuation (BUA). The subjects were divided according to BMD into osteoporosis group, osteopenia group and normal bone density group.
RESULTSAll selected loci were in Hardy-Weinberg equilibrium (P> 0.05). By multiple linear stepwise regression analysis, polymorphisms of the five loci were not associated with BUA. But a significant higher risk of osteoporosis was found in individuals with MMP14 rs1003349 GT genotype (vs. GG genotype; P<0.05) and rs2236303 CC and CT genotypes (vs. TT genotype; P<0.05). Genetic linkage between rs1003349 and rs2236303 was also discovered (D'= 0.839, r(2) = 0.458, P<0.01). Compared with the normal bone density group, the frequency of a G-T haplotype of rs1003349 and rs2236303 was significantly lower in the osteoporosis group (P<0.05). And the risk of osteoporosis for individuals with G-C and T-C haplotypes was 2.556 (95% CI: 1.029-6.349, P = 0.038) and 5.111 (95% CI: 1.341-19.485, P = 0.011) compared with G-T haplotype.
CONCLUSIONPolymorphisms of rs1003349 and rs2236303 loci of MMP14 gene are associated with the susceptibility of osteoporosis in Zhuang men in Guangxi. G-C and T-C haplotypes for loci rs1003349 and rs2236303 may increase the disease risk.
Adult ; Aged ; Bone Density ; genetics ; China ; Genetic Linkage ; Genetic Predisposition to Disease ; Haplotypes ; genetics ; Humans ; Male ; Matrix Metalloproteinase 14 ; genetics ; Middle Aged ; Osteoporosis ; enzymology ; genetics ; Polymorphism, Genetic
9.Prenatal diagnosis of two pregnancies with risk of chromosomal disorders.
Ying-Xia CUI ; Bei HUANG ; Yi-Chao SHI ; Hong-Yong LU ; Xin-Yi XIA ; Lian-Jun PAN ; Yu-Feng HUANG
National Journal of Andrology 2007;13(7):624-627
OBJECTIVETo report the prenatal diagnosis of 2 cases of pregnancy with the risk of chromosomal disorders. In Case 1, the pregnant woman had a daughter with testicular regression syndrome and a segmental duplication of Ypter --> Yp11.2 and a deletion of Yq11.23 --> Yqter. In Case 2, both the pregnant woman and her husband were carriers of chromosomal balanced translocation.
METHODSTwo samples of amniotic fluid were obtained at the 19th week of gestation for fetal karyotype analysis. For Case 1, FISH with a probe of Xp/Yp subtelomere was performed on the metaphase of the amniotic fluid, genomic DNA of the amniotic fluid extracted and multiplex PCR conducted for AZF regions. Both the pregnant women underwent sonography to confirm the karyotypic diagnosis.
RESULTSCytogenetic, FISH and multiplex PCR analysis of the cultured amniotic fluid cells from Case 1 showed a normal male karyotype, and ultrasound scan of the fetus showed normal male external genitalia and normal development. Cytogenetic analysis of the cultured amniotic fluid cells from Case 2 revealed a karyotype of balanced translocation with t(13 ; 14) from the father, and no abnormality of the fetus was found by ultrasound scan.
CONCLUSIONIt is helpful to perform cytogenetical and molecular prenatal diagnosis in combination with ultrasound scan for the fetus with the risk of chromosomal disorders and subsequently for genetic counseling.
Adult ; Amniotic Fluid ; cytology ; Chromosome Disorders ; diagnosis ; genetics ; Female ; Fetal Diseases ; diagnosis ; genetics ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Pregnancy ; Prenatal Diagnosis ; Translocation, Genetic
10.Myocardial blush grade, ST-segment elevation resolution and prognosis in acute myocardial infarction patients with or without diabetes mellitus post primary percutaneous coronary intervention.
Yong ZENG ; Chao-Lian HUANG ; Li-Hua SHANG ; Shu-Yang ZHANG ; Quan FANG
Chinese Journal of Cardiology 2007;35(5):439-442
OBJECTIVESTo investigated the prognosis of primary percutaneous coronary intervention (PCI) in acute myocardial infarction patients with or without diabetes mellitus (DM) in terms of myocardial blush grade (MBG) and ST-segment elevation resolution (STR).
METHODSMBG and STR were measured in AMI patients with (n = 95) and without (n = 192) diabetes mellitus after successful primary PCI.
RESULTSPost-procedural TIMI grade 3 flow (>95%) were similar between two groups. Compared to non-DM patients, DM patients were more likely to have absent myocardial perfusion (MBG 0/1, 56.0% vs. 41.1%, P = 0.019) and absent STR (43.2% vs. 30.7%, P = 0.038). MACE rate was also higher in DM patients than that in non-DM patients during follow-up (27.4% vs. 16.1%, P = 0.025). Multivariate analysis showed DM was an independently factor related to the risk of poor prognosis (RR 1.83, 95% CI 1.04 - 3.36], P = 0.01).
CONCLUSIONDespite similar TIMI-3 flow after primary PCI, DM patients are more likely to have abnormal myocardial perfusion as assessed by both incomplete STR and reduced MBG and poor prognosis compared to non-DM patients. Poor prognosis in DM patients with AMI post PCI might be related to more disturbed micro-vascular perfusion.
Aged ; Angioplasty, Balloon, Coronary ; Diabetes Complications ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; physiopathology ; therapy ; Myocardial Reperfusion ; Prognosis