1.Clinical research of anticoagulant intervention in the treatment of acute exacerbation of chronic obstructive pulmonary disease
Clinical Medicine of China 2011;27(10):1046-1049
Objective To investigate the intervention of low molecular weight heparin on lung function and coagulation function of patients experiencing acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods Senventy patients,hospitalized in our department from 2009 -2010,with acute exacerbation of COPD,were randomly divided into control group ( 32 patients) and anticoagulation group ( 38 patients).The control group was treated with oxygen inhalation,antibiotics,antispasmodic asthma,relieving cough and phlegm.The anticoagulation group received low molecular weight heparin 4100 IU AXa/times by abdominal subcutaneous injection at 12 h intervals addition to that of control group.Ten days were considered as a course of treatment in both groups.All patients received pulmonary function and blood coagulation testing before and after treatment.Results After treatment,lung function and arterial blood gas indices were significantly improved in both groups ( the anticoagulation group:t =8.2064,6.9207,9.4351,7.5845,7.5241 ; the control group t =5.5588,3.0795,3.9374,2.8488,2.7726,all P < 0.01 ),but the patients in anticoagulation group were improved more significantly than the control group( t =3.2732 4.0167,7.3392,2.2528,3.0008,Pall < 0.01 ) ;anticoagulation treatment greatly improved the plasma D-dimer ( D-dimer,DD) content and the coagulation parameters in anticoagulation group ( comparing with that before treatment,t =5.721,23.235,25.318,23.841,11.354,Pall < 0.01 ; comparing with that of control,t =7.738,19.365,23.373,21.008,9.712,Pall < 0.01 ),while the control group did not produce significant improvement after treatment (t =1.9409,8.0000,1.1592,1.6562,1.2726,P all > 0.05 ).There were had no serious adverse reactions in the anticoagulation treatment group.Conclusion Although the conventional treatment can improve the symptoms of the patients with COPD,but it can't effectively improve the patient's blood hypercoagulability.Conventional therapy combined with low molecular weight heparin anticoagulant therapy is able to improve the blood coagulation hence the lung function in COPD patients.
2.Risk factor analysis of feeding intolerance in very low birth weight infants
Lin WANG ; Lihong HAO ; Shang BA ; Qingrong MA ; Jing GUO
Clinical Medicine of China 2011;27(10):1108-1110
Objective To investigate the risk factors associated with feeding intolerance in very low birth weight infants (VLBWI) and to investigate the beneficial factors for preventing feeding intolerance.Methods Retrospectively analysis was carried out in 151 VLBWI cases in our hospital from January 2005 to November 2010.Logistic regression analysis was performed to find the risk factors of feeding intolerance.Results The overall rate of feeding intolerance in VLBWI was 47.7 % (72/151).Dysporia and infection were associated with feeding intolerance in VLBWI (Wald x2 =7.748 and 4.555,P =0.05 and 0.033 respectively).Gender,multifetation were not associated with feeding intolerance(Ps >0.05).Conclusion The feeding intolerance is associated with dysporia and infection in VLBWI.
3.Analysis of clinical treatment of pancreatic benigntumors: a report of 23 cases
Xin ZHAO ; Dechun LI ; Dongming ZHU ; Hua ZHAO ; Zixiang ZHANG
Clinical Medicine of China 2011;27(10):1092-1094
Objective To discuss the diagnosis and treatment of the benign tumors of pancreas,especially the surgical options and the prevention and cure of the postoperative complications.Methods Clinical data of 23 patients with benign lesions of the pancreas were retrospectively analyzed in our hospital from Jan.2004 to Dec.2009.All of the patients underwent surgical operation.Five patients were treated with pancreatic enucleation,8 patients were treated with distal pancreatectomy with splenectomy,1 patient was treated with central pancreatectomy,5 patients were treated with pancreaticoduodenectomy,4 patients were treated with pancreatic cyst- jejunum R-Y anastomosis.Eighteen patients were treated with somatostatin analogue.Results The pathological diagnosis included pancreatic cyst in 8,islet cell tumor in 4,mucous cystadenomas in 6,serous cystadenomas in 3,solid-pseudopapillary tumor in 2.Seven of 10 cases having pancreatic leak occoured secondary abdominal infection.One patient died of multiple organ dysfunction syndrome after pancreaticoduodenectomy.Conclusion There is no specific symptoms and serologic laboratory examinations for pancreatic benign tumors.CT and ERCP is very helpful for diagnosis and treatment.Surgical option is according to the location of the lesion and the judgement of the tumor whether being benign or malignant.Pancreaticoduodenectomy,central pancreatectomy,distal pancreatectomy with or without splenectomy and pancreatic enucleation is the reasonable surgical option.Pancreatic leakage is the main post-operation complication.Ligation the pancreatic duct reliably,treating the pancreatic raw surface appropriately,external drainage of the pancreatic fluid can reduce the rate of pancreatic leakage.
4.The correlation of notch-1 expression and comprehensive analysis with prognosis in small cell lung cancer
Weihua XIAO ; Haifen MA ; Junqiang LI ; Jihong YU ; Ji HE ; Guorong CHEN
Clinical Medicine of China 2011;27(10):1100-1103
Objective To investigate the clinical significance of Notch-1 expression in small cell lung cancer(SCLC) and non-small cell lung cancer(NSCLC),and analyze the role of it in prognosis.Methods SP immunohistochemistry was used to detect the expression of Notch-1 antibody in 43 of SCLC and 40 of NSCLC tissues.Further analysis was carried out to interpret the association of Notch-1 antibody expression with clinicopathological features,lymph node metastasis and prognosis in SCLC.Results The positive rate of Notch-1 expression was 20.93% ( 9/43 ) in SCLC,while 65.00% ( 26/40 ) in NSCLC.The expression of Notch-1 antibody was associated with clinical stage and lymph node metastasis ( x2 =5.42,P < 0.05 ; x2 =4.88,P < 0.05respectively),but was not associated with age,sex,tumor location,tumor size ( Ps > 0.05 ).Compared with NSCLC,the expression rates of Notch-1 antibody were significantly higher in SCLC ( x2 =16.50,P < 0.05 ).Kaplan-Meier survival analysis indicated that the survival time of patients with positive Notch-1 expression was significantly longer than that of patients with negative staining( x2 =19.87,P < 0.05 ).Cox regression analysis showed that Notch-1 antibody could significantly reduce the risk of death in patients with SCLC.Conclusion The positive expressions of Notch-1 were significantly different in SCLC and NSCLC,which linked to the clinicalstage,lymph node metastasis and poor prognosis.Accordingly,the expression of Notch-1 may have good value in diagnosis and prognosis.
5.Expression of caveolin-1 in osteosarcoma and its significance for clinicopathological features
Jichen WANG ; Shixin BAO ; Manxi BAO ; Hai LI
Clinical Medicine of China 2011;27(10):1097-1099
Objective By detecting the expression of caveolin-1 in osteosarcoma tissues,to explore its possible roles in the occurrence,progress and metastasis of osteosarcoma and its relationship with clinicopathological features.Methods The expression level of caveolin-1 protein in 48 osteosarcoma tissues and 24 normal bone tissues were detected by immunohistochemistry of SP method.Its relationship with clinical and pathological features were also analyzed.Results among the 48 osteosarcomas examined,38 were stained weak or negative for caveolin-1,whereas the strong caveolin-1 staining was observed in all the 24 normal bone tissues.The absorbent optical density value of caveolin-1 protein in osteosarcoma tissues and normal bone tissues were(0.2292 ± 0.0329) and(0.6428 ± 0.0028),respectively.The expression of caveolin-1 in osteosarcoma tissues was significantly lower than that in normal bone tissues (t =21.48,P < 0.01 ).Caveolin-1 protein expression was significant correlated with the pulmonary metastasis of tumors ( t =11.84,P < 0.05 ),but had no correlation with nge,sex,tumor size and pathologic grades.Conclusion The low expression of caveolin-1 may participate in osteosarcoma invasion and metastasis,and may be a new prognostic molecular marker for osteosarcoma and a new therapeutic target for tumor.
6.The effects of rosmartnic acid on the urine toxins,urinary protein ,serum MDA and SOD in the rats with the 5/6 nephrectomy
Weiyuan LIN ; Ronggui HUANG ; Xingzhong ZHENG
Clinical Medicine of China 2011;27(10):1075-1077
Objective To investigate the effects of rosmarinic acid on the kidney function,urinary protein,serum MDA and SOD in rats with the 5/6 nephrectomy.Methods We established the rat model with chronic renal dysfunction and randomized them into normal control group,model control group and rosmarinic acid treatment group.There were 6 rats in each group.The blood creatinine level was recorded 2 weeks after operation.We detected the effects of rosmarinic acid on urinary protein,urine creatinine,blood creatinine,serum MDA and SOD in rats with the 5/6 nephretomy which was established by Ponseau S method.The treatment group received rosmarinic acid as an intervention.Results ( 1 ) Compared with control group,the creatinine and The creatinine clearance rate ( Ccr ) of rosmarinic acid treatment group increased ( F =38.912,P < 0.01 ;F =19.968,P < 0.05 ) after treatment,; (2) Rosmarinic acid improved the 24 h urine protein in rats with renal dysfunction significantly(F =16.288 P <0.01); (3) Rosmarinic acid had no effect on serum MDA and SOD in rats.Conclusion Rosmarinic acid can decrease urine protein and blood creatinine,increase the Ccr and alleviate kidney failure,but has no effects on MDA and SOD in rat model.
7.Pathogenesis and early drugs therapy of symptoms after concussion
Hengxing YOU ; Wei YANG ; Jiandong QIU ; Xiaowen LIAN ; Zixiang FAN ; Liangjie LI ; Xianghong FANG
Clinical Medicine of China 2011;27(10):1072-1075
Objective To study the pathogenesis and the effect of early drugs therapy of symptoms after concussion.Methods One-hundred and thirteen patients with symptoms after suffered concussion enrolled in the study and divided randomly into three groups.The patients of different groups were treated respectively with drugs,i.e.erigeron breviscapus,nimodipine,energy mixture.Symptom Check-List 90 ( SCL-90 ) and electroencephalogram(EEG) and cerebral blood flow of trancranial Doppler(TCD) were examined in the early and late stage of post-concussion.Normal population were recruited as control.All examination results and the effect of treatment were compared between treatment group and control group.Results In the scores of SCL-90,the factor scores of somatization symptom,compulsion,depressive disorder,anxiety disorders,and hostile symptom in 113 post-concussion patients in early stage were all higher than those in the normal( t =10.78,2.08,9.53,11.09 and 2.52,P <0.01or P <0.05),and as well as that of somatization symptom,depressive disorder,anxiety disorders,terror and mental disorder symptom in 12 post-concussion patients in late stage compared to normal( t =3.21,6.85,3.07,3.14 and 4.73,Ps < 0.01 ).The test of EEG was abnormal in 57.4 % of patients in early stage and in 33.3% in the late stage.Of all TCD results,67.0 % was abnormal in the early stage and 25.0% in the late stage,The disappearance rate of post-concussion symptoms in the 14th day was significantly higher in the erigeron breviscapus group ( 45.0% ) than in the nimodipine group ( 23.7% ) ( x2 =3.91,P <0.05 ) and in the energy mixture group ( 20.0% ) ( x2 =5.25,P < 0.05 ).The disappearance rate of postconcussion symptoms in the 30th day in the energy mixture group(40.0% ) was significantly lower than those in nimodipine group( 68.4% )( x2 =5.94,P < 0.05 ) and in erigeron breviscapus group( 75.0% )( x2 =9.43,P < 0.01 ).The occurrence rate of post-concussion sequelae was higher in the energy mixture group ( 22.9% )than in the nimodipine group ( 5.2% ) ( x2 =4.77,P < 0.05 ) and in the erigeron breviscapus group (5.0% )( x2 =5.15,P < 0.05 ) three month after injuries.Conclusion The occurrence of symptoms originated from the organic damage of brain tissue.However,its changes were influenced by psychologic factors after concussion.Early vasodilative drugs therapy could improve the recovery of patients with post-concussion symptoms in time and decrease the occurrence of post-concussion sequelae.
8.The clinical research on the vacuum sealing drainage technique in treating the severe diabetic foot Gangrene
Shibai WU ; Xiaohong GUAN ; Liangchen WANG ; Min WANG ; Yongdong ZHAO ; Ao TONG ; Hong TANG ; Caizhe YANG ; Luning WANG ; Li XIAO ; Zhuhong WANG
Clinical Medicine of China 2011;27(10):1066-1069
Objective To investigate the clinical effects and indications of the vacuum sealing drainage (VSD) in the treatment of severe diabetic foot gangrene.Methods We randomly recruited 60 cases,who had suffered from diabetic foot gangrene(DFG) at the grade of 3 -5,according to Wagner scale into VSD treatment groups and treated them with VSD methods.At the same time,62 DFG cases who had given routine drainage treatment one year ago were retrospectively analyzed as control group.The observed items included the wound healing time,number of dressing,outcome of treatment ( healing rate),the average days in hospital,total expenses of hospitalization and so on.Results The wound healing time of VSD treatment group and routine treatment group were ( 30.5 ± 6.8 ) days and ( 53.8 ± 5.5 ) days,respectively ( t =2.636,P < 0.01 ).The numbers of dressing were( 15.0 ± 4.7) days and ( 29.5 ± 6.1 ) days,respectively ( t =2.374,P < 0.01 ).The healing rates were 96.7% (58/60) and 87.1% (54/62),respectively(P <0.01 ).The average period in hospitalization were (20.1 ± 3.5 ) days and ( 36.5 ± 4.6 ) days,respectively ( t =2.564,P < 0.01 ).Total expenses of hospitalization were(20 155.6 ± 153.8) yuan RMB and(41 465.5 ± 146.6) yuan RMB,respectively(t =2.873,P <0.01 ).All the differences were statistically significant.Conclusion The VSD method is effective for the treatment of severe diabetic foot gangrene(DFG).It is able to reduce the time of wound healing significantly,increase the healing rate,shorten the hospitalization period and cut the general expenses during hospitalization.It' s an effective method for the treatment of DFG.
9.Hepatic expression of cannabinoid receptor 1 and 2 in C57 mice with experimental cirrhosis
Lihong YE ; Chongkui WANG ; Yunyan LIU ; Li YANG ; Zhaoxia ZHAO ; Huiqing JIANG ; Erhei DAI
Clinical Medicine of China 2011;27(10):1015-1018
Objective To investigate hepatic expressions and significances of cannabinoid receptor 1 (CB1) and cannabinoid receptor 2(CB2) in C57 mice with experimental cirrhosis.Methods Thirty C57 mice were randomly divided into three groups,i.e.normal control group,model control group and model colchicine group.Hepatic fibrosis model was prepared by intraperitoneal injection of carbon tetrachloride.The expressions of CB1 and CB2 in liver tissue of mice were observed by immunohistochemistry.The scores of inflammation grade (G) and fibrosis stage (S) were simultaneously performed.Results The scores of G and S in model control group and model colchicine group were significantly higher than those in normal control group( F =125.41,P =0.00; F =99.18,P =0.00).The scores of G and S in model control group were significantly higher than those in model colchicine group(P <0.01 ).The scores of CB1 and CB2 expressions in model control group and model colchicine group were significantly higher than those in normal control group ( F =29.27,P =0.00; F =36.99,P =0.00).The scores of CB1 and CB2 in model control group were significantly higher than those in model colchicine group( P < 0.05 or P < 0.01 ).There were significant relationships among scores of CB1,CB2,G and S in model control group and model colchicine group(Ps <0.05).As the scores of G and S became higher,the expressions of CB1 and CB2 gradually became more intensive.Conclusion The hepatic expressions of CB1 and CB2 in C57 mice with experimental cirrhosis increased significantly and have significant relationship with the grades of liver tissue inflammation and fibrosis.
10.Polypeptide cSN50 inhibits the expression of NF-κB and its downstream factor via Importin α in HepG2 cells
Boting CHEN ; Hu XUE ; Yaomin FAN
Clinical Medicine of China 2011;27(10):1049-1054
Objective To investigate whether polypeptide cSN50,as a transmembrane peptides,can inhibit NF-κB nuclear translocation and its downstream gene expression to play a role to protect cells by blocking the combination of NF-κB with the importinα3 during the alcohol and endotoxin-induced inflammation and apoptosis.Methods Flow cytometry method was used to observe the apoptosis rate of HepG2 by different concentration of alcohol and/or endotoxin.Spectrophotometer method was used to detect Caspase-3 activity.TNF- α in cell culture supernatant was detected by ELISA assay.p50,importinα3,and IκBαunder the stimulation of alcohol and/or endotoxin at selected optimal concentration were detected by Western blot.Indirect immunofluorescence assay was used to measure the activation of p50,IκBα,and importinα3.Results The change of TNF-α and Caspase-3 in the dose-effect course,compared with control group,was significant (P <0.05 ).p50 was increased in the nucleus ( P < 0.05 ),and IκBα was decreased in the cytoplasm ( P < 0.05 ).cSN50( 100 μmol/L) partially blocked nuclear translocation of p50 and its downstream factor( P < 0.05 ).Conclusion NF-κB nuclear translocation may play an important role in acute alcoholic liver injury.cSN50 can effectively inhibit NF-κB activity and its downstream gene expression in HepG2 cells.