1.Evaluation value of iron metabolism disorders in sepsis patients in an intensive care unit
Yi JIANG ; Mengmeng AN ; Ping GONG
Chinese Journal of Emergency Medicine 2021;30(5):562-568
Objective:To evaluate iron metabolism disorders in sepsis patients and explore the effect of iron deficiency on mortality.Methods:Patients ( n=130) who were admitted to the emergency intensive care unit (ICU) of the First Affiliated Hospital of Dalian Medical University from September 2016 to July 2018 and met the diagnostic criteria of Sepsis 3.0 were selected, and sex- and age-matched healthy volunteers ( n=20) were enrolled as a control group. Peripheral venous blood samples were collected in sepsis patients on day 1, 3 and 7 after admission, or in the healthy volunteers upon enrollment, to detect iron metabolism-related indicators and interleukin-6 (IL-6); the Sequential Organ Failure Assessment (SOFA) score was calculated upon hospital admission. Iron metabolism-related indicators were compared between the groups; the correlation of plasma iron with hemoglobin, hepcidin, ferritin, IL-6, sTFR/log ferritin and the ability of plasma iron to predict 28-day death of sepsis patients were analyzed. Results:Sepsis patients developed significant anemia on day 3 after admission; plasma iron, transferrin, iron saturation, total iron binding capacity and unsaturated iron binding capacity in the first week of admission were significantly lower than those in the control group; distribution width of red blood cells, ferritin, IL-6, hepcidin and soluble transferrin receptor were significantly higher than those in the control group. Distribution width of red blood cells, ferritin and hepcidin on day 3 and 7 after admission, and plasma iron and iron saturation on day 7 after admission were significantly higher than those on day 1. However, total iron binding capacity and unsaturated iron binding power on day 7, and sTFR/log ferritin on day 3 were significantly lower than those on day 1. Patients in the survival and non-survivor groups in the first week of admission had significant anemia on day 3 and 7, but the anemia was worse in the non-survivor group. Transferrin, total iron binding capacity, and unsaturated iron binding capacity in the non-survivor group in the first week of admission, and plasma iron in the non-survivor group on day 3 and 7, were significantly lower than those in the survival group. Ferritin, IL-6 and hepcidin in the non-survivor group in the first week of admission, and iron saturation on day 7 were significantly higher than those in the survival group. Spearman correlation analysis showed that plasma iron was negatively correlated with IL-6 ( r=-0.391, P<0.01), ferritin ( r=-0.293, P=0.001) and hepcidin ( r=-0.209, P=0.017), but not with hemoglobin ( r=0.005, P=0.958). The area under the operation curve (AUC) for plasma iron for predicting 28-day mortality in sepsis patients was 0.524 (95% CI: 0.416-0.631, P=0.656). Conclusions:Sepsis patients have significant anemia and iron metabolism disorders in the early stage, while non-survival patients are more severe. Reduced plasma iron level has no capacity to predict 28-day mortality of sepsis patients. In addition, decreased plasma iron level is not related to decreased hemoglobin, and thus iron supplementation should be cautious in sepsis patients.
2.Effect of lovastatin on shedding of heparan sulfate proteoglycan and syndecan-1 in lung tissues of rats with sepsis-induced acute lung injury
Xinyi XIE ; Hongguang BAO ; Yanna SI ; Mengmeng CAI ; Weiqing JIANG
Chinese Journal of Anesthesiology 2015;35(2):222-225
Objective To evaluate the effect of lovastatin on shedding of heparan sulfate proteoglycan (HSPG) and syndecan-1 (SDC-1) in the lung tissues of rats with sepsis-induced acute lung injury.Methods One-hundred and twenty male Wistar rats aged 8-12 weeks,weighing 325-425 g,were randomly divided into 3 groups (n =40 each) using a random number table:sham operation group (group S),cecal ligation and puncture (CLP) group and lovastatin group (group L).Lovastatin 4 mg/kg was injected once a day for 5 consecutive days in S and L groups,while the equal volume of 0.5% CMC (the solvent) was given in CLP group.Sepsis was produced by CLP on 5th day of administration in CLP and L groups.The left lung was lavaged at 24 h after operation.The broncho-alveolar lavage fluid (BALF) was collected for determination of protein concentrations,white blood cell (WBC) count and percentage of neutrophils.Blood samples were collected for determination of the concentrations of HSPG and SDC-1 in serum (by ELISA).Evans blue was injected at 24 h after operation in the remaining 20 rats of each group.The lungs were removed for examination of the pathological changes and for measurement of HSPG and SDC-1 mRNA and protein expression (using Western blot and PCR),and Evans blue content (reflecting pulmonary capillary permeability) in the lung tissue.Results Compared with group S,the protein concentrations,WBC count and percentage of neutrophils in BALF,Evans blue content in lung tissues and the concentrations of HSPG and SDC-1 in serum were significantly increased,and HSPG and SDC-1 mRNA and protein expression was down-regulated in CLP and L groups.Compared with group CLP,the protein concentrations,WBC count and percentage of neutrophils in BALF,Evans blue content in lung tissues and the concentrations of HSPG and SDC-1 in serum were significantly decreased,and HSPG and SDC-1 mRNA and protein expression was up-regulated in group L.The pathological changes of lungs were significantly attenuated in group L as compared with group CLP.Conclusion The mechanism by which lovastatin attenuates acute lung injury induced by sepsis may be related to reduced shedding of HSPG and SDC-1 in lung tissues and improved function of pulmonary vascular endothelium in rats.
3.Construction of recombinant adenovirus vector pAV.Ex1 d-Hiwi using Gateway technology
Ning MA ; Xiaoyan DONG ; Yanfang JIANG ; Mengmeng LIU ; Ziling LIU
Journal of Jilin University(Medicine Edition) 2014;(4):898-903
Objective To obtain the Hiwi gene encoding full-length and construct human Hiwi adenoviral vectors carrying green luorescence protein (GFP), and to establish foundation for a further study on Hiwi function and mechanism of inducing leukemia stem cell differentiation and apoptosis.Methods All coding areas of human Hiwi gene full length were amplified using method of overlapping extension PCR technology, and the full length coding aeras were inserted into the vector of Flag-IRES-hrGFP carrying GFP with Gateway technology to construct pDown-Hiwi-3 × flag-IRES-hrGFP. The cloning vector pDown-Hiwi-3 × flag-IRES-hrGFP and expression vector pAV. Des1d were used for homologous recombination reaction to obtain recombinant adenovirus vector pAV.Ex1d-Hiwi-3× flag-IRES-hrGFP.The positive clones were selected by PCR to extract the recombinant adenovirus plasmid and to pack into recombinant Ad-Hiwi-3 × flag-IRES-hrGFP adenovirus. Results The human recombinant Hiwi was successfully cloned and the recombinant adenovirus vector pAV.Ex1d-Hiwi-3×flag-IRES-hrGFP was found to be successfully constructed via restriction enzyme digestion and sequencing methods. The adenovirus vector pAV.Ex1d-Hiwi-3×flag-IRES-hrGFP was transfected into the HEK293A cells using lipofectamine mediated gene transfection method. Under fluorescence microscope, the transfected cells with green fluorescence could be observed.Conclusion The expression plasmid of adenovirus vector pAV.Ex1d-Hiwi-3 × flag-IRES-hrGFP is successfully constructed and it can express in HEK293A cells.
4.Clinical significance of serum TK1 levels for patients with non-small-cell lung cancer undergoing chemotherapy
Renfei HUANG ; Qian JIANG ; Mengmeng JIN ; Yin LIU ; Ting DU ; Yanbei ZHANG
The Journal of Practical Medicine 2016;32(17):2840-2843
Objective To investigate the dynamic change and its clinical significance of serum thymidine kinase 1 (STK1) in patients with non-small-cell lung cancer (NSCLC) when undergoing 4 cycles of chemotherapy. Methods We detected STK1 levels of 59 patients with NSCLC throughout 4 cycles of chemotherapy using Enhanced Chemiluminescence Western Blot and analyze its relationship with chemotherapy responses . Results STK1 levels with different chemotherapy regimens had no significant difference. STKK1 levels in patients with effective response were significantly lower after 4 cycles of chemotherapy. STK1 levels in patients with effective response were significantly lower than those in non-responders throughout 4 cycles of chemotherapy. The positive rates of STK1 in those with effective response were lower than those in non-responders after the last two cycles of chemotherapy. STK1 levels between lung squamous carcinoma and lung adenocarcinoma had no significant difference. Conclusion The detection of the changes of serum TK1 in patients with NSCLC undergoing chemotherapy is useful in evaluating the effect of chemotherapy and the later therapeutic schedule.
5.Correlation of sarcopenia and metabolic risk factors
Yu WANG ; Mingxia JIANG ; Qi XU ; Mengmeng WU ; Yinan ZHOU ; Xinyuan DONG ; Jinfeng ZHENG
Journal of Medical Postgraduates 2017;30(2):181-185
Objective Sarcopenia and metabolic syndrome share similar pathophysiological mechanisms. The aim of this study was to investigate the prevalence of sarcopenia among health examination population, and to analyze the relationship between sar-copenia and blood pressure, blood glucose, uric acid and lipids. Methods Physical examination data of 1191 healthy persons in the medical examination center of the hospital from Mar 2011 to Jun 2011 were collected. The weight, skeletal muscle, body fat, body mass index ( BMI) , waist circumference,body fat percentage, waist-hip ratio and visceral fat area were analyzed by human body compositionanalyzer and the prevalence of sarcopenia was observed. At the same time, triglyceride (TG), total cholesterol (TC), high density lipo-protein-cholesterol ( HDL-C ) , low density lipoprotein-cholesterol ( LDL-C) , uric acid and fasting blood glucose were also detected. Results The prevalence rate of sarcopenia of the subjects was 5.21%, and the highest incidence was found in ≥60 years group( 11.11%) . The prevalence rates of overweight and obesity were 33.8% and 10.2%, respectively. The prevalence of sarcopenia is grad-ually higher along with increasing BMI. The prevalence rates of sarcopenia of overweight and obesity subjects were 5.47% and 26.23%, respectively. Compared with the normal control group, the level of weight[(66.34±11.75)kg vs (76.71±12.84)kg ], BMI[(23.37± 3.13) vs (28.05±3.66)], body fat percentage[(25.33±6.06)% vs (36.76±4.47)%], waist circumference[(83.19±9.56)cm vs (95.45±13.74)cm] and visceral fat area[(88.96±29.74)cm2 vs (136.91±25.56)cm2] were higher in the sarcopenia group (P<0.05). Compared with the normal control group, the incidence of systolic blood pressure[(125.59±30.04)mmHg vs (139.39±19.79) mmHg], diastolic blood pressure[(75.82±11.95)mmHg vs (82.34±10.96)mmHg ] TG[(1.56±1.12)mmol/L vs (1.98±1.72)mmol/L] and uric acid[(313.75±83.07)mmol/L vs (335.55±96.07)mmol/L] were higher in the sarcopenia group (P<0.05). Compared with the normal subjects, the detectable rates of abnormal diastolic blood pressure, fasting blood glucose, uric acid, and LDL-C were increased in the sarcopenia, obesity and sarcopenia combined with obesity subjects (P<0.05). The odds ratio of abnormal systolic blood pressure, diastolic blood pressure, uric acid, and LDL-C increased in the sarcopenia, obesity and sarcopenia combined with obe-sity subjects using logistic regression analyses after correction of gender and age. Conclusion The sarcopenia may have some con-nection with metabolic risk factors. Early detection of sarcopenia can help to distinguish people predisposed to metabolic syndrome, and it has important significance for prevention of chronic disease.
6.The expression of plasma heat shock protein HSP90α and its clinical significance for lung cancer patients
Qian JIANG ; Mengmeng JIN ; Rui HUANG ; Yin LIU ; Ting DU ; Yanbei ZHANG
The Journal of Practical Medicine 2016;32(13):2129-2132
Objective To explore the expression plasma heat shock protein HSP90αand its clinical signifi-cance for lung cancer patients . Methods Plasma levels of HSP90α protein of 60 patients with lung cancer and 24 healthy individuals are detected by ELISA analysis . Results The average plasma levels of HSP90αprotein [(190.338 ± 105.861) ng/mL] in patients with lung cancer were significantly higher than in healthy con-trols [(41.020 ± 19.736) ng/mL, t = 10.480, P < 0.001]. The sensitivity of HSP90α is higher than CEA, NSE, CYFRA21-1. The sensitivity of HSP90α, CEA, NSE, CYFRA21-1 and STK1 is 100%. HSP90α is correlated with STK1 and metastasis (χ2 = 4.656, P = 0.031). Conclusions This study demonstrates that the plasma level of HSP90αprotein is a useful diagnostic biomarker in lung cancer. The sensitivity is much higher when HSP90αcom-bined with CEA, NSE, CYFRA21-1 and STK1.
7.The role ofΔ133p53 during 5-FU inhibition experiments on the growth of gastric cancer cell line MKN45
Ai GUO ; Wansheng JI ; Qiqi JIANG ; Mengmeng LI ; Bingqian YANG ; Zhixing GAO
China Oncology 2015;(1):25-30
Background and purpose:Δ133p53 can promote tumor cell growth, but the exact mechanism is not clear. This study was aimed to observe the expression and signiifcant of the p53 isoformsΔ133p53 and p53 gene downstream molecules MDM2 and cyclin G1 genes by 5-FU-MKN45 gastric cancer cell line model. Methods:Af-ter using different concentrations of 5-FU (50μg/mL, 100μg/mL) to human gastric cancer cell line MKN45, inhibition rate should be detected by MTT assay, the changes ofΔ133p53 mRNA, MDM2 mRNA and cyclin G1 mRNA express-ing were detected by reverse transcription-polymerase chain reaction (RT-PCR). Differences between these groups were analyzed by ANOVA, comparisons within groups were analyzed by t-test, bivariate correlation was analyzed by Pearson linear correlation. Results:MTT results showed that with the increased concentration of 5-FU and the extension of time, the cell inhibition rates increased gradually. The inhibition rates of 50μg/mL 5-FU were 41.10%, 54.79%and 68.48%, for culturing 24, 48 and 72 hours. There were statistically signiifcant differences between the groups(F=45.52, P=0.00). The inhibition rates of 100μg/mL 5-FU were 69.53%, 78.21%and 86.92%, for culturing 24, 48 and 72 hours. There were statistically signiifcant differences between the groups(F=85.58,P=0.00). The inhibition rates of 50 and 100μg/mL were 41.10%and 69.53%, for culturing 24 hours. There were statistically signiifcant differences between the groups(F=51.29, P=0.00). The inhibition rates of 50 and 100μg/mL were 54.79%and 78.21%, for culturing 48 hours. There were statistically signiifcant differences between the groups(F=51.29, P=0.00). The inhibition rates of 50 and 100μg/mL were 68.48%and 86.82%, for culturing 72 hours. There were statistically signiifcant differences between the groups(104.91, P=0.00). RT-PCR results showed that with the increase of the concentration of 5-FU, theΔ133p53 mRNA, MDM2 mRNA and cyclin G1 mRNA expression gradually declined in gastric cancer cell line MKN45 cells, and there were statistically signiifcant differences between the groups(F=738.532, 1 396.607, 2 785.56,P=0.00). Cor-relation analysis showed that the expressions ofΔ133p53 mRNA and MDM2 mRNA in gastric cancer were positively correlated (r=0.871, P=0.01), while the expression of cyclin G1 mRNA and p53 mRNA had no obvious relevance (P=0.13). Conclusion:In the 5-FU-MKN45 gastric cancer cell line model, anti-tumor pathway ofΔ133p53 isomers is related with MDM2 but was not related with cyclin G1.
8.Comparison study of time course of DKI and DTI in stroke
Di ZHANG ; Peigong ZHANG ; Xingyue JIANG ; Feng ZHAI ; Changbin ZHAI ; Mengmeng YU ; Qinglei SHI
Chinese Journal of Medical Imaging Technology 2017;33(5):683-687
Objective To evaluate the changes of diffusion kurtosis imaging (DKI) parameters with time in cerebral in farction patients,and contrast with diffusion tensor imaging (DWI).Methods DWI and DKI scans were performed in 95 patients of cerebral infarction.The patients were divided into five groups according to the time of cerebral infarction:Hyperacute phase (n=10),acute phase (n=12),early subacute phase (n =33),late subacute phase (n =20) and chronic phase (n =20).Parameters of DKI were obtained,and the parameters and percentage change of diffusion metrics from normal to ischemic tissue were compared.The evolution rule of parameter with time was analyzed.Results Mean kurtosis (MK),axial kurtosis (K//),radial kurtosis (K⊥) of DKI parameters increased after infarction,and reached the peak at acute phase,and decreased gradually with the prolonging of time.Mean diffusion (MD),axial diffusion (D//),radial diffusion (D⊥) of DTI parameters decreased after infarction,and reached the lowest at the acute phase,and increased gradually with the prolonging of time.The percentage change of MK,K//,K⊥ were higher than those of MD,D//,D⊥,and percent change along the axial direction were significantly larger than that along the radial direction.Conclusion DKI is superior to DTI in evaluating cerebral infarction,and can analyze the changes of microstructure of cerebral infarction comprehensively.
9.Comparison between indocyanine green fluorescence imaging plus methylene blue and plus carbon nanoparticles suspension injection for sentinel lymph node biopsy in breast cancer patients
Weiwei ZOU ; Yu BAI ; Xilong WANG ; Kai CHENG ; Hongguang SUN ; Mengmeng WU ; Jingru JIANG ; Zhenlin YANG
The Journal of Practical Medicine 2017;33(11):1857-1860
Objective To investigate the differences between indocyanine green (ICG) fluorescence imaging plus methylene blue and plus Carbon Nanoparticles Suspension Injection for sentinel lymph node biopsy (SLNB)in breast cancer patients. Methods A total of 134 cases of early breast cancer patients performed SLNB from November 2013 to November 2016 were involved,of which 48 cases were performed with ICG fluorescence imaging plus methylene blue,and another 86 cases plus Carbon Nanoparticles Suspension Injection. Results There was no significant difference between ICG plus Methylene Blue group and ICG plus nano carbon group in terms of detection rate(P>0.05),detected numbers(P>0.05),sensitivity(P>0.05),accuracy(P>0.05)and false negative rate(P > 0.05). Age,and body mass index(BMI)exerted no influence on the detection rate and accuracy of SLNB in two groups(P>0.05). Conclusion ICG Fluorescence Imaging plus Methylene Blue showed similar detection rate , detected numbers , sensitivity , accuracy and false negative rate as it plus Carbon Nanoparticles Suspension Injection for SLNB in breast cancer patients ,and both of them can be performed easily and conveniently.
10.Prevalence of rhinitis and related factors among college students in Urumqi,the Xinjiang Uygur Autonomous Region
Mengmeng YANG ; Chunxiang ZHAO ; Ci YAN ; Yuanyuan FANG ; Hao ZHANG ; Mamatali AHMATJAN ; Li GAO ; Xiaofang JIANG
Chinese Journal of Primary Medicine and Pharmacy 2016;23(14):2103-2106
Objective To investigate the prevalence and the related factors of allergic rhinitis in Xinjiang College students.Methods Five universities'students in Urumqi were chosen as the research subjects,the question-naire survey was conducted by the method of cluster sampling,and the results were analyzed.Results 1 609 ques-tionnaires were valid from 2 000 questionnaires.The prevalence rate of allergic rhinitis was 36.8% in the five univer-sities in Urumqi.Prevalence rate increased with grade.The prevalence rates of drinking,regular cleaning nasal cavity, scrubbing their nose in allergic rhinitis were 43.2%,40.7%,53.8% respectively,which were higher than those in not drinking,not regular cleaning nasal cavity,not scrub nose,the differences were statistically significant (χ2 =6.945,9.679,100.845,all P <0.05 ).There was no significant differences in the prevalence of allergic rhinitis among college students and gender,nationality and BMI(all P >0.05).Conclusion Allergic rhinitis not only closely related to the grades and the environmental factors,but also has some connections with living habits(drink,clean nasal cavity and scrub noses).