1.High-throughput screening of human soluble epoxide hydrolase inhibitors.
Shoubao WANG ; Jing GUO ; Xiaoming YU ; Guanhua DU
Acta Pharmaceutica Sinica 2010;45(11):1367-72
To screen potential human soluble epoxide hydrolase (hsEH) inhibitors, a high-throughput screening model in 384-well microplate with total volume of 50 microL was established. Recombinant hsEH was cloned and expressed in E. coli. and its specific substrate PHOME was synthesized. The HTS model was based on fluorescence analysis with enhanced sensitivity and specificity (Z' = 0.65). A total of 47 360 samples (including 25 040 compounds and 22 320 natural products) were screened, of which 950 samples with inhibition greater than 80% were selected for further rescreening. Finally, two compounds with high inhibitory activity were identified, whose IC50 value were 8.56 and 4.31 micromol x L(-1), separately. The results indicated that the method was stable, sensitive, reproducible and also suitable for high-throughput screening.
2.Effect of preoperative prophylactic parenteral nutrition on prognosis of advanced gastric cancer
Dingming ZHOU ; Dong LUO ; Guanhua LI ; Tianjin CHEN ; Can GUO
Chinese Journal of Geriatrics 2015;34(4):397-399
Objective To investigate the effect of preoperative prophylactic parenteral nutrition on prognosis of advanced gastric cancer.Methods A total of 159 patients with advanced gastric cancer in our hospital were collected,and randomly divided into experimental group and control group.80 cases in experimental group were treated with prophylactic parenteral nutrition,and 79 cases in control group were treated with traditional nutrition.The partial indexes of liver function,complications and mortality rate were compared between the two groups before and after surgery.Results The levels of aspartate aminotransferase (AST),alanine aminotransferase (ALT),total bilirubin (TBIL) and direct bilirubin (DBIL) were much lower in experimental group than in control group at 8 days after surgery (t=6.542,6.460,5.634,5.275,all P<0.001).The levels of ALB and PAB were much higher in experimental group than in control group at 2 and 8 days after surgery (t=12.580,12.471,6.757,12.821,all P<0.001).The incidence of complications and mortality rate were much lower in experimental group than in control group (x2 =23.409,4.818,P<0.001 or 0.05).Conclusions Preoperative prophylactic parenteral nutrition can speed up the recovery of liver function and reduce the complications and mortality rate after surgery in patients with advanced gastric cancer.
3.Clinical effect analysis in the treatment of acute limb arterial critical ischemia
Guanhua XUE ; Changning HAO ; Lei LYU ; Hui XIE ; Xiangjiang GUO ; Xiaozhong HUANG ; Meng YE ; Lan ZHANG
International Journal of Surgery 2016;43(12):814-817
Objective To discuss the therapeutic effect in the treatment of the acute limb arterial critical ischemia.Methods Collect thirty-nine cases of acute limb arterial critical ischemia in Renji Hospital from Janary 2014 to July 2016.According to the patients' manifestation,these operations were porfermed including thrombectomy,cathetery-directed thrombolysis,mechanical suction bolt,percutaneous angioplasty and stenting.The effect and complications were observed.Results The eighteen patients in 39 cases (46.2%) were dead,including 5 cases without operation,13 operation.The eight cases were amputated during 34 cases of operations.In the 21 out-patients safely,2 cases were not followed up.The time of follow-up was from 3 to 27 months,on average 14.3 months.During the 21 patients,5 cases died from heart cerebrovascular or tumor diseases,3 cases with footdrop,2 cases with toe amputations,3 cases with distal leg and foot anesthesias.Conclusions The patiens with acute limb arteries critical ischemia must be treated as early as,and reinforced the management of multiple organ function,which may improve the diseases' therapeutic effect.
4.The reliability and validity of simplified COMFORT scale in assessment of sedation levels in children on mechanical ventilation
Yuguang FENG ; Liping SUN ; Zhuheng WANG ; Yuwei LI ; Qinghua GUO ; Guanhua ZHOU
Journal of Clinical Pediatrics 2014;(12):1158-1161
Objective To compare the scores from the simpliifed COMFORT scale with those from the bispectral index (BIS) and analyze the variation among different evaluators in children in an intensive care unit, and to investigate the reliability;validity of simpliifed COMFORT scale. Methods Twenty children between 3 and 16 years of ages on mechanical ventilation and sedation were simultaneously classiifed based on the BIS and the simpliifed COMFORT scale evaluated by 4 independent evalua-tors. The Kappa test was performed and the correlation between the two methods (Pearson correlation) was tested. Results In to-tal, 70 observations were performed on 20 patients. Based on the Kappa coefifcient, the agreement among evaluators ranged from 0.62 to 0.77 (P<0.001). There was a correlation between the BIS and the simpliifed COMFORT scale (r=0.53-0.61,P<0.01). Conclusions Due to the strong consistency between the independent evaluators and the correlation between the two methods, the reliability and validity of simpliifed COMFORT scale are preferable and simpliifed COMFORT scale is useful in classifying the level of sedation in children on mechanical ventilation.
5.Pharmacokinetic Study of Baicalein and Its Major Metabolites after iv Administration in Dogs
Shuo TIAN ; Lida DU ; Shoubao WANG ; Guorong HE ; Tao YANG ; Xiaoxiu LI ; Jing GUO ; Guanhua DU
Chinese Herbal Medicines 2011;03(3):196-201
Objective To develop and validate a simple,rapid,sensitive,and reproducible HPLC method for simultaneous determination of baicalein and its metabolite baicalin in dog plasma and for the subsequent pharmacokinetic study after iv administration to dogs.Methods An accurate and reproducible HPLC-UV method was developed and validated for simultaneous determination of baicalein and baicalin in dog plasma,using luteolin as internal standard.The analytes were separated by an Agilent Zorbax SB-C<,18> column(250 mm×4.6 mm,5μm)and the column temperature was maintained at 40 ℃.The mobile phase was a binary mixture of acetonitrile and water(27:73),containing 0.05% phosphoric acid in water,with a flow rate of 1.0 mL/min.The UV detector was set al 276 nm.Results Linear relationships were validated over the range of 0.05-25 μg/mL for baicalein and 0.05-20 μg/mL for baicalin.The intra-and inter-day precision values for all samples were within 8.0%,using relative standard deviation.This method was successfully applied to the pharmacokinetic studies in dogs after iv administration of baicalein.Baicalein was converted to baicalin quickly.Cmax values were 21.13 μg/mL at 0.05 h for baicalein and 1.57 μg/mL at 0.5 h for baicalin,areas under the plasma concentration-time curve were 4.97 h.μg/mL for baicalein and 0.63 h.μtg/mL for baicalin,and the elimination half-life is 0.50 h for baicalein and 0.75 h for baicalin,respectively.Conclusion The method is able and sufficient to be used in drug metabolism and pharmacoklnetic studies of baicalein.
6.Value of wound blush in predicting ulcer healing in patients with critical limb ischemia after endovascular revascularization
Hui XIE ; Xiangjiang GUO ; Lei LYU ; Rundan DUAN ; Kejia KAN ; Haozhe QI ; Meng YE ; Lan ZHANG ; Guanhua XUE
International Journal of Surgery 2017;44(6):379-382,封3
Objective To explore the value of wound blush in predicting patients' ulcer healing whom with critical limb ischemia after revascularization.Methods Retrospectively analyze the clinical data of 173 cases of critical limb ischemia with ischemic ulcers under thetreatment of endovascular therapy followed the concept of angiosome.According to the condition of wound blush after endovascular therapy,by compared the difference of limb salvage rate and ulcer healing time,and try to analyze the value of wound blush in predicting ulcer healing in patients.Results Included in the study with a total of 173 cases (173 limbs),group wound blush(+) 109 patients,group wound blush (-) 64 cases,the age,proportion of male patients,smoking history,diabetes,coronary heart disease,chronic renal insufficiency,pre and post operative ankle brachial index,were no statistical difference between the two groups.The ulcer healing time of group wound blush (+) was significantly shorter than that of group wound blush(-) (P < 0.05).The rate of ulcer healing in group wound blush(+) was significantly higher than that in group wound blush(-) (P < 0.05).In group wound blush(+),the cumulative rate of limb salvage was statisticallyhigher than group wound blush (-) (P < 0.05).By logistic regression analysis,wound blush(-) (OR =4.5,P < 0.05),IRc revascularization (OR =2.6,P < 0.05) were independent risk factors of ulcer healing.Conclusions The resoult of wound blush(+) shows a good distal perfusion of foot.It can be used as a predictive factor for critical limb ischemia ischemic ulcer healing,and wound blush (-) was an independent risk factor for ulcer nonhealing.
7.Circulating Pro-angiogenic miRNAs in Predicting the Risk and Severity of Coronary Artery Disease
Guanhua GUO ; Ziming HUANG ; Liping CHEN
Journal of China Medical University 2018;47(3):268-274
Objective To evaluate the correlations of pro-angiogenic miRNAs with risk and severity in patients with coronary artery disease (CAD). Methods After angiographic documentation, 10 patients with CAD and 10 healthy controls (HCs) were enrolled for screening the differently expressed microRNAs (DEMs) (exploration stage). Blood samples of 142 patients with CAD and 140 age- and gender-matched HCs with the same eligibility were collected (validation stage). And the plasma levels of DEMs were measured by real-time qPCR. Results In the exploration stage, miR-19a, miR-92a, miR-126, miR-130a, miR-210, miR-296, and miR-378 expression levels were higher, but miR-221 expression was lower in patients with CAD than in HCs. In the validation stage, plasma expression levels of miR-126, miR-130a, miR-210, and miR-378 were decreased in patients with CAD. Multivariate logistic regression revealed that miR-19a, miR-126, miR-130a, miR-210, and miR-378 were independent protective factors for CAD. Receiver operating characteristic (ROC) analysis displayed that testing of a combination of miR-19a, miR-126, miR-130a, miR-210, and miR-378 was of good value in predicting the risk of CAD, with an AUC of 0. 768. Additionally, miR-126 and miR-210 were negatively associated with Gensini scores. Conclusion miR-126, miR-130a, miR-210, and miR-378 could serve as promising biomarkers for predicting the risk and severity of CAD.
8.Short-term deep sedation strategy in patients with spontaneous intracerebral hemorrhage: a randomized controlled trial
Zhuheng WANG ; Chunzhi SHI ; Liping SUN ; Qinghua GUO ; Wei QIAO ; Guanhua ZHOU
Chinese Critical Care Medicine 2017;29(11):1004-1009
Objective To evaluate the efficacy and safety of short-term deep sedation strategy in patients with spontaneous intracerebral hemorrhage (ICH) after surgery. Methods A perspective, randomized, parallel-group study was conducted. Adult patients with spontaneous ICH and undergoing craniotomy admitted to Daxing Teaching Hospital of Capital Medical University from December 2015 to November 2016 were enrolled. The patients who received surgery were randomly divided into a short-term deep sedation and a slight and middle sedation group. Sufentanil was used as an analgesic drug in all patients and midazolam was used as a sedative after the operation. The patients in the slight and middle sedation group received midazolam 0.05-0.10 mg/kg with a goal of mild sedation [Richmond agitation and sedation scale (RASS) score of -2-1]. The patients in the short-term deep sedation group received midazolam 0.1-0.2 mg/kg with a goal of deep sedation (RASS score of -4 to -3) and a duration of no more than 12 hours. Postoperative sedation, blood pressure changes, laboratory indexes, residual hematoma and clinical outcomes were recorded in two groups. Results During the study, a total of 183 patients with spontaneous ICH were collected, excluding who was older than 65 years, with shock, and with preoperative Glasgow coma score (GCS) of 3. 106 patients were enrolled in this study, and 53 patients were assigned to the short-term deep sedation group and slight and middle sedation group, respectively. In the slight and middle sedation group, 4 patients received reoperation because of repeated hemorrhage and no patient operated repeatedly in the short-term deep sedation group, and there was a significant difference between the two groups (χ2= 4.000, P = 0.045). The number of patients undergoing tracheotomy in the short-term deep sedation group was significantly lower than that in the slight and middle sedation group (9 cases vs. 21 cases,P < 0.05). RASS score within 12 hours after operation of the patients in the short-term deep sedation group was lower than that in slight and middle sedation group [-4 (-4, -2) vs. -2 (-3, -1) at 4 hours, -4 (-4, -2) vs. -1 (-2, 0) at 8 hours,-3 (-4, -2) vs. 0 (-2, 1) at 12 hours, all P < 0.01], sudden restlessness was significantly reduced [times: 1 (0, 1) vs. 3 (2, 3), P < 0.01], and postoperative sedation duration was significantly prolonged [hours: 14.0 (8.3, 20.8) vs. 8.9 (3.4, 15.3), P < 0.05]. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) within 12 hours after operation in the short-term deep sedation group were significantly lower than those of the slight and middle sedation group [SBP (mmHg, 1 mmHg = 0.133 kPa): 136.8±30.5 vs. 149.1±33.5, DBP (mmHg): 85.0 (70.8, 102.3) vs. 89.0 (69.2, 116.7), both P < 0.05]. There were no significant differences in the arterial blood gas, routine blood test or coagulation function between the two groups at 24 hours after operation. The volume of residual hematoma at 2, 7 and 14 days after operation in the short-term deep sedation group was significantly decreased as compared with slight and middle sedation group (mL: 16.4±15.6 vs. 38.2±22.2 at 2 days, 9.6±8.7 vs. 20.6±18.6 at 7 days, 1.2±1.0 vs. 4.4±3.6 at 14 days, all P < 0.05), number of deaths in 3 months were significantly less (5 cases vs. 13 cases), and the patients with favorable prognosis were increased significantly (39 cases vs. 12 cases, both P < 0.05). Conclusion The study results showed that short-term deep sedation strategy after surgery can reduce the incidence of adverse events and improve the prognosis of patients with spontaneous ICH, so it is safe and effective.
9.Modified approach improves the clinical efficacy of AngioJet in treatment of whole-lower-limb acute deep vein thrombosis
Qihong NI ; Guanhua XUE ; Xiangjiang GUO ; Shuofei YANG ; Lan ZHANG ; Meng YE
Chinese Journal of General Surgery 2020;35(4):304-308
Objective:To investigate whether the clinical efficacy of mechanical pharmacothrombectomy (PMT) in treatment of whole-lower-limb acute deep vein thrombosis (DVT) could be improved by the modified approach removing popliteal vein thrombosis.Methods:From Mar 2016 to Mar 2018, 31 patients with whole-lower-limb acute DVT were enrolled and treated with PMT by AngioJet. The clinical data was retrospectively analyzed, and the clinical efficacy was evaluated.Results:26 cases were treated by contralateral common femoral vein approach and the other 5 cases by ipsilateral calf deep vein. Urokinase was given in bolus in 29 patients before thrombectomy. After PMT, 7 cases combined with catheter-directed thrombolysis. 26 cases underwent iliac vein PTA, and 14 cases underwent iliac vein stenting. The average hospitalization days was (7.6±1.8) d. The thrombus clearance rate was grade Ⅱ (50%~99%) in 16 cases (51.6%) and grade Ⅲ (100%) in 15 cases (48.4%). 30 patients were followed up and the mean follow-up time was 19.7 months. The 12-month primary patency rate was 83.3%. All the 5 patients with occlusion had different degrees of post-thrombotic syndrome (PTS), and the incidence of PTS was 16.7% (5/30).Conclusions:The modified approach to treat the whole-lower-limb acute deep vein thrombosis with PMT is safe and effective. The popliteal vein thrombosis can be cleared in one stage. The blood inflow can be improved, and the incidence of PTS is relatively low.
10.Long-term results of stent graft in the treatment of TASC C, D femoropopliteal artery occlusive disease
Meng YE ; Qihong NI ; Guanhua XUE ; Xiangjiang GUO ; Yuli WANG ; Lan ZHANG
Chinese Journal of General Surgery 2023;38(2):113-117
Objective:To evaluate the long-term outcome of Viabahn stent graft in the treatment of complex femoropopliteal occlusive lesions.Methods:From Sep 2013 to Mar 2020, clinical data of TASC C and D femoropopliteal lesions treated with Viabahn were retrospectively analyzed. Patency rates, the freedom rate from clinically-driven target lesion revascularization (F-TLR), limb salvage and survival after five years were calculated.Results:A total of 65 patients (67 lower limbs) were included. 20 limbs were TASC C lesions, 47 limbs were TASC D lesions. The mean lesion length was (29.1±9.4) cm, including 48 chronic total occlusion (CTO) lesions (71.6%) with mean lesion length of (26.1±10.4) cm. Technique success rate was 98.6%. Mean length of stent graft was (31.3±10.1) cm.Major amputation was performed in 4.2% cases within 5 years. All-cause mortality in 5 years was 23.1%. Primary patency rates at 1,3,and 5 years were 76.8%,59.4%,50.9%, Assisted primary patency rates were 88.4%, 83.4%, 83.4% and secondary patency rates were 88.4%, 85.8%, and 85.8% . F-TLR at 1, 3 and 5 year was 88.2%,76.9%,73.1% .Conclusion:Viabahn for complex and long femoropopliteal artery occlusions is an acceptable treatment with fair long-term outcome.