1.Supplemental parenteral nutrition in enhanced recovery in postoperative liver cancer patients
Kun ZHANG ; Jingde ZHU ; Xinliang LYU ; Chaoyong TU ; Chuan JIANG ; Qiaomei LIN ; Zhuokai LI ; Qingyun ZHOU ; Chuxiao SHAO
Chinese Journal of General Surgery 2019;34(8):693-695
Objective To explore the effect of supplemental parenteral nutrition (SPN) combined with early enteral nutrition (EN) for enhanced recovery in postoperative liver cancer patients.Methods From June 2015 to June 2018,liver cancer patients admitted to our hospital were randomly divided into two groups with 47 patients receiving SPN combined with early EN in the study group and 45 patients receiving early EN in the control group.Results There were no significant difference in bilirubin recovery,liver enzyme recovery,postoperative exhaust and defecation time and complication rate between the two groups (P > 0.05).In study group prealbumin (PAB) synthesis recovered faster (F =7.89,P =0.006),albumin use was significantly lower (t =-2.29,P =0.0024),and postoperative hospital stay was shorter (t =2.46,P =0.016).Conclusion In ERAS patients with liver cancer,the combination of SPN and early EN provide reasonable energy support to improve nutritional status and accelerate patient recovery.
2.Activated mTOR signaling pathway in myofibers with inherited metabolic defect might be an evidence for mTOR inhibition therapies.
Jing-Wei LYU ; Xue-Bi XU ; Kun-Qian JI ; Na ZHANG ; Yuan SUN ; Dan-Dan ZHAO ; Yu-Ying ZHAO ; Chuan-Zhu YAN
Chinese Medical Journal 2019;132(7):805-810
BACKGROUND:
Abnormally activated mechanistic target of rapamycin (mTOR) pathway has been reported in several model animals with inherited metabolic myopathies (IMMs). However, the profiles of mTOR pathway in skeletal muscles from patients are still unknown. This study aimed to analyze the activity of mTOR pathway in IMMs muscles.
METHODS:
We collected muscle samples from 25 patients with mitochondrial myopathy (MM), lipid storage disease (LSD) or Pompe disease (PD). To evaluate the activity of mTOR pathway in muscle specimens, phosphorylation of S6 ribosomal protein (p-S6) and p70S6 kinase (p-p70S6K) were analyzed by Western blotting and immunohistochemistry.
RESULTS:
Western blotting results showed that p-p70S6K/p70S6K in muscles from LSD and MM was up-regulated when compared with normal controls (NC) (NC vs. LSD, U = 2.000, P = 0.024; NC vs. MM: U = 6.000, P = 0.043). Likewise, p-S6/S6 was also up-regulated in muscles from all three subgroups of IMMs (NC vs. LSD, U = 0.000, P = 0.006; NC vs. PD, U = 0.000, P = 0.006; NC vs. MM, U = 1.000, P = 0.007). Immunohistochemical study revealed that p-S6 was mainly expressed in fibers with metabolic defect. In MM muscles, most p-S6 positive fibers showed cytochrome C oxidase (COX) deficiency (U = 5.000, P = 0.001). In LSD and PD muscles, p-S6 was mainly overexpressed in fibers with intramuscular vacuoles containing lipid droplets (U = 0.000, P = 0.002) or basophilic materials (U = 0.000, P = 0.002).
CONCLUSION
The mTOR pathway might be activated in myofibers with various metabolic defects, which might provide evidence for mTOR inhibition therapy in human IMMs.
Adolescent
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Adult
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Aged
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Blotting, Western
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Child
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Child, Preschool
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Female
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Glycogen Storage Disease Type II
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genetics
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metabolism
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Humans
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Immunohistochemistry
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In Vitro Techniques
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Lipid Metabolism, Inborn Errors
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genetics
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metabolism
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Male
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Middle Aged
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Mitochondrial Myopathies
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genetics
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metabolism
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Muscular Diseases
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genetics
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metabolism
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Signal Transduction
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genetics
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physiology
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TOR Serine-Threonine Kinases
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metabolism
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Young Adult
3. The clinical relevance of MBL2 gene polymorphism and sepsis
Shao-Wen CHENG ; Chuan-Zhu LYU ; Shao-Wen CHENG ; Jun-Yi YAO ; Li-Na XIAN ; Zhi-Xing LIN ; Xue AO ; Ying LI ; Ying-Qing LI ; Yong-Yan LI ; Xiu-Ru LI ; Wei-Cheng WANG ; Chuan-Zhu LYU
Asian Pacific Journal of Tropical Medicine 2018;11(3):251-254
Objective: To detect the clinical relevance of mannose-binding lectin 2 (MBL2) gene polymorphism and sepsis in Chinese lived in Hainan island. Methods: Blood samples from 57 patients with sepsis and 69 patients without sepsis were collected in the ICU of several large hospitals in Hainan province. Genomic DNA was extracted from whole blood and then PCR purification product was sequenced and typed by 3730 sequencing analyzer. The concentration of MBL2 in serum was detected by ELISA. Results: We found that genotype and allele distributions in two groups were in accordance with the Hardy-Weinberg Equilibrium. The frequency of GA genotype was significantly higher than that in non-sepsis group (P=0.013). A allele frequency in sepsis group was also much higher than that in non-sepsis group (P=0.028). Logister regression analysis showed that the patients who carried A allele were more prone to get sepsis than G allele carrier (P=0.014, 0R=2.550, 95%CI=1.207-5.386). The MBL2 level in serum of sepsis patients with genotype GG and GA was significantly lower than that in non-sepsis group (P<0.05). In sepsis group, the MBL2 serum level of patients with genotype GA was obviously lower than that in patients with genotype GG (P<0.05). Conclusions: The variation of rs1800450 G→A increased the incidence of sepsis and decreased the level of MBL2 in serum.
4. Effect of emodin on mobility signal transduction system of gallbladder smooth muscle in Guinea pig with cholelithiasis
Bang-Jiang FANG ; Jun-Yi SHEN ; Shuang ZHOU ; Hua ZHANG ; Chuan-Zhu LYU ; Yi-Qiang XIE
Asian Pacific Journal of Tropical Medicine 2016;9(10):1013-1018
Objective To study the effect of emodin on protein and gene expressions of the massagers in mobility signal transduction system of cholecyst smooth muscle cells in guinea pig with cholesterol calculus. Methods The guinea pigs were randomly divided into 4 groups, such as control group, gall-stone (GS) group, emodin group and ursodeoxycholic acid (UA) group. Cholesterol calculus models were induced in guinea pigs of GS, emodin and UA groups by lithogenic diet, while emodin or UA were given to the corresponding group for 7 weeks. The histomorphological and ultrastructure change of gallbladder were detected by microscope and electron microscope, the content of plasma cholecystokinin (CCK) and [Ca
5. Albiflorin Granule significantly decreased the cholesterol gallstone formation by the regulation of insulin transduction signal
Bang-Jiang FANG ; Jun-Yi SHEN ; Shuang ZHOU ; Hua ZHANG ; Chuan-Zhu LYU ; Yi-Qiang XIE
Asian Pacific Journal of Tropical Medicine 2016;9(9):877-881
Objective To study the mechanism of insulin resistance in the cholesterol gallstone formation from insulin signal transduction pathway so as to reveal the possible mechanism and the effective role of Albiflorin Granule on preventing the cholesterol gallstones. Methods Serum triglycerides (TG), free fatty acid (FFA), and total cholesterol (TC) from different groups were measured and liver cells InsR, PKB, IKK-β protein expression levels were detected by western blotting. Results Albiflorin significantly decreased the cholesterol gallstone formation rate, increased glucose infusion rate in gallstone guinea pigs and improved insulin resistance. Compared with the normal group, insulin receptor and PKB protein expression in GS group were significantly reduced. IKK-β protein in the GS group increased significantly and Albiflorin could reduce IKK-β protein expression in guinea pig liver cells. Conclusions The model of insulin resistance in cholesterol gallstone guinea pig was successfully established, which plays an important role in the cholesterol gallstone formation. All aspects of insulin signaling pathway are involved in gallstone formation. Albiflorin can regulate various aspects of insulin signal transduction pathway to prevent the formation of gallbladder.
6. Pregnane receptor gene polymorphisms, pathogenic bacteria distribution and drug sensitivity, and TCM syndrome differentiation in patients with cholelithiasis
Yi-Qiang XIE ; Jing-Zhe ZHANG ; Hua ZHANG ; Lei PENG ; Li-Zhuo LI ; Chuan-Zhu LYU ; Shuang ZHOU ; Bang-Jiang FANG
Asian Pacific Journal of Tropical Medicine 2016;9(4):307-312
Objective: To investigate the distribution of pathogens and drug resistance in bile and the association between the pregnane X receptor (PXR) gene polymorphisms, traditional Chinese medicine (TCM) syndromes and the risk of cholesterol gallstone disease (CGD). Methods: A total of 392 samples were enrolled in this study from January 2014 to February 2015, among which 192 patients were with CGD, and 200 samples were healthy. Strains were isolated and susceptibility testing was the disk diffusion method susceptibility testing. The patients were divided into hepatochlic hygropyrexia, stagnation of liver-qi, and the accumulation of damp. The PXR gene polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism. The association between the PXR gene polymorphisms and the risk of CGD was examined by logistic regression analysis. Results: A total of 192 cases were detected in 230 of bile culture pathogens, including Gram-negative bacteria 133 (57.83%), Gram-positive bacteria 76 (33.04%), and fungi 21 (9.13%). The top five pathogens were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, Candida albicans, and Enterococcus feces, of which 110 cases was of single infection, 48 cases of mixed infection of two strains, eight cases of mixed infection of three bacteria. Among 59 Escherichia coli, the yield extended-spectrum beta-lactamases had 40 (67.80%). The hepatochlic hygropyrexia was the most TCM syndrome, followed by stagnation of liver-qi, and the accumulation of damp was least. Different pathogens and the rs6785049 genotypes distributed differently in cholelithiasis patients with different TCM syndromes (P < 0.05). In hepatochlic hygropyrexia patients the Gram-negative bacteria was most. There was significant differences between CGD group and control group in rs6785049 (P < 0.001). Comparison with wild-type portable GG, GA genotype increased the risk of the occurrence of gallstones (OR = 0.40, 95%CI: 0.16-0.79); likewise, carrying the GA+AA genotype also increased the risk (OR = 0.38, 95%CI: 0.19-0.81). There was no significant differences in rs2276707, rs3814055 site polymorphic loci alleles in CGD group and control group. Conclusions: In the treatment of cholelithiasis, bile samples should be collected for bacterial culture and sensitivity test, and drugs should be strictly chosen based on the results. The rs6785049 polymorphisms in PXR gene may increase the risk of gallstones ontogeny, and gallstones can be early detected and prevented by detecting genotypes. rs6785049 polymorphisms in PXR gene may has relationship with TCM syndromes.
7.Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture (version 2023)
Zhonghua XU ; Lun TAO ; Zaiyang LIU ; Yang LI ; Jie LI ; Jun ZHANG ; Xia ZHANG ; Min WANG ; Changqing LI ; Guangxing CHEN ; Liu YANG ; Dawei ZHANG ; Xiaorui CAO ; Guoqiang ZHANG ; Pingyue LI ; Nirong BAO ; Chuan LI ; Shenghu ZHOU ; Zhengqi CHANG ; Bo WU ; Wenwei QIAN ; Weiguo WANG ; Ming LYU ; Hao TANG ; Hu LI ; Chuan HE ; Yunsu CHEN ; Huiwu LI ; Ning HU ; Mao NIE ; Feng XIE ; Zhidong CAO ; Pengde KANG ; Yan SI ; Chen ZHU ; Weihua XU ; Xianzhe LIU ; Xinzhan MAO ; Jie XIE ; Xiaogang ZHANG ; Boyong XU ; Pei YANG ; Wei WANG ; Xiaofeng LI ; Eryou FENG ; Zhen ZHANG ; Baoyi LIU ; Jianbing MA ; Hui LI ; Yuanchen MA ; Li SUN ; Zhifeng ZHANG ; Shuo GENG ; Guanbao LI ; Yuji WANG ; Erhu LI ; Zongke ZHOU ; Wei HUANG ; Yixin ZHOU ; Li CAO ; Wei CHAI ; Yan XIONG ; Yuan ZHANG
Chinese Journal of Trauma 2023;39(11):961-973
Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.
9.Research progress of CRISPR/Cas biosensors based on different signal amplification strategies.
Ben Shun TIAN ; Yun Jian WU ; Xu Xia CUI ; Jing Wen LYU ; Ming Hui CHEN ; Chuan ZHU ; Bing GU
Chinese Journal of Preventive Medicine 2023;57(1):112-119
CRISPR/Cas(the clustered regularly interspaced short palindromic repeats-CRISPR associated)system exists in most bacteria and all archaea. It is an important strategy for bacteria and archaea to resist foreign nucleic acid invasion and use for self-defense. The CRISPR/Cas system is a simple, fast, and specific diagnostic tool, which is widely used in agriculture, industry, animal husbandry, and medicine. This article mainly introduces and discusses recently advantages and limitations of biosensors combining CRISPR/Cas system with fluorescence, visualization and surface enhanced raman related technologies, as well as future research directions.
Animals
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CRISPR-Cas Systems
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Bacteria/genetics*
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Archaea
10. Clinical features and laboratory data analysis of Aeromonas bacteremia with hematological diseases
Chunhui XU ; Qingsong LIN ; Yanxia LYU ; Guoqing ZHU ; Zhiying TIAN ; Chao WANG ; Fujun SUN ; Hongjing YAO ; Chuan WANG
Chinese Journal of Hematology 2019;40(12):1035-1039
Objective:
To investigate the clinical and laboratory features of Aeromonas bacteremia in patients with hematological diseases, and provide evidence for the prevention and treatment of Aeromonas infection.
Methods:
A retrospective study of patients with bloodstream infection of Aeromonas in our hospital from January 2014 to December 2018 was carried out. The clinical characteristics, antimicrobial susceptibility, infection seasons, antimicrobial therapy and evolution were analyzed.
Results:
A total of 42 patients with hematological diseases had Aeromonas bloodstream infection within 5 years. Among them, 39 cases (92.9%) of bloodstream infection occurred in the stage of neutropenia. The median time of fever was 4 (1-27) d, 22 (52.4%) patients only had fever, 6 (14.3%) with gastrointestinal symptoms (abdominal pain, diarrhea, nausea, upper gastrointestinal bleeding) , 8 (19.0%) with pulmonary infection, 13 (31.0%) with skin and soft tissue infections. Seven patients (16.7%) died with skin and soft tissue infection. The resistance of Aeromonas to carbapenems was 68.3%-70.7%, while the resistance rate to cephalosporins, quinolones and aminoglycosides were less than 10%.
Conclusions
Aeromonas bacteremia in patients with hematological diseases mainly occur in the neutropenia stage, usually with symptom like fever. The mortality is increased when accompanied by skin and soft tissue infection. Antibiotic use should be based on susceptibility results, and avoid the use of carbapenems.