1.Effect of normal mesenteric lymph on multiple organ injury in mice with endotoxic shock
Huibo DU ; Wen SONG ; Limin ZHANG ; Liqiang XING ; Hui ZHANG ; Zigang ZHAO ; Chunyu NIU
Chinese Journal of Pathophysiology 2014;33(4):686-692
AIM:To observe the effects of normal mesenteric lymph (NML) on the lung, heart and liver inju-ries and the phosphorylation levels of p 38 mitogen-activated protein kinase ( MAPK) , extracellular signal-regulated kinase (ERK) 1/2 and c-Jun N-terminal kinase (JNK) in the mice with endotoxic shock (ES).METHODS: The NML was drained form health male BALB/c mice for the intervention of ES after the removal of cellular constituent .Lipopolysaccha-ride (LPS, 35 mg/kg) was intraperitoneally injected into the mice for the establishment of ES model .After 60 min of LPS injection, the administration of NML (1/15 of whole blood volume) was performed through the femoral artery in NML +ES group.Meanwhile, the mean arterial pressure (MAP) was monitored during the experiment .At 6 h after intraperitoneal in-jection of LPS or the corresponding time point , blood samples were harvested from the heart through apical centesis for de-termination of the biochemical indexes to reflect myocardial and hepatocyte injuries .Simultaneously , the lung , heart and liver tissue specimens from a fixed location were harvested for the observation of histomorphology and the measurement of phosphorylation levels of p38 MAPK, ERK1/2 and JNK.RESULTS:Compared with sham shock (SS) group, MAP in ES group and NML+ES group remarkably decreased at multiple time points after intraperitoneal injection of LPS .However, MAP in NML+ES group at 80 min, 90 min, 190 min, 210 min, 240 min, 250 min, 340 min, 350 min, and 360 min were significantly increased compared with ES group .There were normal structures in the lung , liver and myocardium of the mice in SS group, while the morphological damages of these tissues appeared in ES group .Meanwhile, the damages were attenuated in the mice of NML +ES group.The activities of AST , ALT and CK-MB in the plasma in ES group were remark-ably higher than those in SS group .The CK-MB activity in NML+ES group was also increased compared with SS group , and the activities of AST and LDH-1 were lower than those in ES group .At 6 h after LPS injection , the phosphorylation levels of p38 MAPK, ERK1/2 and JNK in the lung tissues were remarkably increased .Meanwhile , no statistical difference of these indexes between the myocardial and hepatic tissues was observed .NML intervention decreased the phosphorylation levels of p38 MAPK in the lung tissues , and p38 MAPK, ERK1/2 and JNK in the myocardial tissues .CONCLUSION:The NML administration alleviates multi-organ injuries and reduces the phosphorylation level of p 38 MAPK in the lung tis-sues in the mice subjected to ES .
2.Correlation between matrix metalloproteinases and brain natriuretic peptide in patients with chronic heart failure
Liguo JIAN ; Qingbo FAN ; Tongbin DING ; Liqiang SUN ; Shichao LIU ; Shaohui NIU
Chinese Journal of Geriatrics 2017;36(7):739-741
Objective To investigate the changes in serum matrix metalloproteinase(MMP)-2 and MMP-9 and their relationship with serum B-type brain natriuretic peptide(BNP)in patients with chronic heart failure.Methods MMP-2,MMP-9 and serum BNP levels were measured in 184 patients with chronic heart failure and 61 healthy controls.The relationship between changes in MMP-2 and-9 and serum BNP was analyzed.Results Chronic heart failure was categorized into grade Ⅱ,Ⅲ and Ⅳ according to NYHA.In grade Ⅱ,Ⅲ and Ⅳ and the control group,the levels of MMP-2 were(309.1±60.1)nmol/L,(422.6±89.6)nmol/L,(694.8±126.2)nmol/L and(217.2±26.3)nmol/L respectively,and the levels of MMP-9 were (321.2±63.2)nmol/L,(454.4±96.3)nmol/L,(634.1±51.2)nmol/L and(210.8±23.6)nmol/L respectively.The levels of MMP-2 and MMP-9 were significantly higher in chronic heart failure subgroups than in the control group(F=3.65,12.52;P=0.000,0.000).According to the pairwise comparison among the chronic heart failure subgroups,the levels of serum MMP-2 and MMP-9 were significantly higher in NYHA Ⅳ grade than in NYHA Ⅲ grade,and higher in NYHA Ⅲ grade than in NYHA Ⅱ grade(all P<0.05).In patients with chronic heart failure groups,MMP-2 was positively correlated with serum BNP(r=0.866,P=0.000),and with MMP-9(r=0.516,P=0.001).Conclusions MMP-2 and MMP-9 levels might be closely correlated with chronic heart failure and show an upward trend with the progression of chronic heart failure.The levels of MMP-2 and MMP-9 are associated with BNP,which indicates that clinical monitoring of the serum level changes can provide a certain reference for diagnosis,treatment and prognosis in patients with chronic heart failure.
3.Observation on the Clinical Effect of Seretide and Noninvasive Positive Pressure Ventilation on the COPD Combined with Respiratory Failure
Wenli CHU ; Liqiang SONG ; Ruina YAN ; Huifang WANG ; Panxia NIU ; Li ZHOU
Progress in Modern Biomedicine 2017;17(23):4483-4486,4540
Objective:To analyze the clinical efficacy of Seretide combined with noninvasive positive pressure ventilation (NIPPV) in the treatment of chronic obstructive pulmonary disease (COPD) complicated with type 2 respiratory failure (RF).Methods:120 patients of COPD complicated with type 2 RF were randomly divided into the observation group and the control group.All patients were treated with routine,symptomatic and supportive treatment,based on that NIPPV was used in the control group,and the observation group was treated with Seretide on the basis of NIPPV.The levels of arterial blood gas,inflammatory factors,pulmonary function and CAPS score before and after treatment were compared and analyzed.Results:After treatment,the pH,PaO2 and SaO2 of both groups were significantly increased,PaCO2 levels weresignificantly decreased,serum IL-33,TNF-oα and sICAM-1 levels were significantly decreased,FVC,PEFR,FEV1% and FEV1/FVC were significantly decreased,and the CAPS scores were significantly decreased;the changes of all the index mentioned above in the observation group were more statistically significant (P<0.05).Conclusion:Seretide com bined with NIPPV could more effectively decrease the levels of inflammatory factors and improve the blood gas and lung function in the patients of COPD with type 2 respiratory failure.
4.The relationship between orthostatic hypotension and the risk of myocardial infarction in the elderly
Liguo JIAN ; Shaohui NIU ; Tongbin DING ; Liqiang SUN ; Shichao LIU ; Xianen FA
Chinese Journal of Geriatrics 2017;36(5):487-491
Objective To investigate the relationship between the systolic/diastolic orthostatic hypotension(OH S/OH-D) and myocardial infarction (MI) in the elderly.Methods 200 subjects without myocardial infarction (MI) aged 60 years and over in our urban district were selected.The orthostatic and supine blood pressure and heart rate were measured in supine position after resting for more than 5 minutes and at 0 and 2 minutes after standing.All eases were divided into systolic orthostatic hypotension(OH-S)or diastolic orthostatic hypotension(OH-D)groups based on the results of orthostatic hypotension,and followed up by telephone with mean period of 325 days.The primary endpoint was MI occurrence for analyzing the correlation between OH-S/OH-D and MI incidence.Results The prevalence rate of OH in this cohort was 38%,with OH-S 20% and OH-D 18%.In the very elderly group(≥80 years)versus the elderly group,the occurrences of 0H and OH-S were(27% vs.21 %,P =0.036;22 % vs.15 %,P =0.020),respectively,while no significant difference was found in OH-D between the two groups.After 325 day follow up,the prevalence of MI was significantly(P< 0.05)higher in the OH positive subjects than in the 0H negative subjects,which result was the same as the prevalence of MI in OH-S or and OH-D group.After adjusting for age,supine blood pressure,creatinine and cerebrovascular history,logistic regression analysis showed that MI was correlated with OH(HR 15.72,95%CI 3.29~74.23,P=0.002),OH-S(HR 8.552,95%CI 2.51~30.21,P=0.004)and OH-D(HR 3.80,95 %CI 1.14~13.80,P=0.042).Compared with OH-D,OH-S had more significant correlation with MI.Conclusions Orthostatic hypotension,particularly systolic orthostatic hypotension,is common in elderly patients.The OH-S and OH-D have a significant correlation with MI.
5.Efficacy evaluation of acupuncture combined with acupoint application in the treatment of intestinal dysfunction secondary to mechanical ventilation in elderly patients with emergency sepsis
Li LI ; Jun YAN ; Caijun WU ; Linqin MA ; Guangming ZHENG ; Haifeng GUO ; Jian WANG ; Zhe YANG ; Liqiang NIU
Journal of Chinese Physician 2022;24(4):486-489
Objective:To compare the efficacy of conventional Western medicine alone and acupuncture combined with acupoint application in treating intestinal dysfunction secondary to mechanical ventilation in elderly patients with emergency sepsis.Methods:A retrospective analysis was performed on 111 elderly patients with mechanical ventilation for sepsis admitted to the emergency department of Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2019 to June 2021. They were divided into two groups according to the time of admission: Western medicine treatment group alone (patients from January 2019 to December 2019, n=47) and acupuncture combined with acupoint application group (patients from January 2020 to June 2021, n=64). Acupuncture combined with acupoint application group was treated with acupuncture combined with acupoint application on the basis of conventional Western medicine. The intestinal dysfunction score, abdominal circumference and mortality after 4 weeks were compared between the two groups. Results:The abdominal circumference and intestinal dysfunction score in acupuncture combined with acupoint application group were significantly lower than those before treatment [(100.56±9.34)cm vs (106.25±9.74)cm; (0.92±0.72)point vs (2.31±0.69)point, all P< 0.05], while there was no significant difference in the above indexes before and after treatment in the Western medicine treatment group (all P>0.05). The abdominal circumference, intestinal dysfunction score and mortality after 4 weeks in the acupuncture combined with acupoint application group were significantly lower than those in the Western medicine treatment group [(100.56±9.34)cm vs (108.09±10.52)cm; (0.92±0.72)point vs (2.43±0.62)point; (29.7%, 19/64) vs (48.9%, 23/47), all P<0.05]. Conclusions:The curative effect of acupuncture combined with acupoint application in the treatment of intestinal dysfunction secondary to mechanical ventilation in elderly patients with sepsis in emergency is better than that of routine treatment of Western medicine alone. The gastrointestinal function and prognosis of patients have been significantly improved, which is worthy of clinical promotion.