1.Protective effects of recombinant human erythropoietin against acute liver injury induced by sepsis in rats
Zhenzhen SANG ; Yun XU ; Yingjie SHENG ; Dong JIA ; Shuai JIN ; Pengsi ZHANG ; Min ZHAO
Chinese Journal of Emergency Medicine 2014;23(12):1327-1332
Objective To investigate the protective effects of recombinant human erythropoietin (rHuEPO) on caecal ligation and puncture (CLP)-induced acute liver injury.Methods Ninety-six healthy male Sprague-Dawley rats weighing 250-300 g were randomly divided into 3 groups:normal control group (sham group,n =32),CLP model group (sepsis group,n =32) and rHuEPO treatment group (n =32).The rat model of sepsis was established by caecal ligation and puncture.In treatment group,rats were treated with rHuEPO 5000 U/kg administered through caudalis vein after CLP procedure.Continuous observation was carried out until 24 h after modeling.Of each group,8 rats were sacrificed at 2 h,6 h,12 h and 24 h,respectively,and then the liver tissue samples and blood samples were collected.Blood samples were assayed for determining the levels of serum cytokines [tumor necrosis factor-alpha (TNF-α)],and inducible nitric oxide synthase (iNOS) by using the enzyme-linked immunoadsorbentassay (ELISA) method.The levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also detected.Histopathological changes of liver tissues were observed under optical and transmission electron microscopy.Results (①)The levels of ALT,AST,TNF-a,iNOS in serum of rats in control group were lower than those in model group and rHuEPO group (P <0.01).The levels of TNF-α,IL-6 and iNOS in serum of rats in rHuEPO group were decreased significantly compared with model group (P < 0.01).(②) The optical microscopy and the transmission electron microscopy showed hepatocyte edema,liver focal necrosis,inflammatory cell infiltration in portal area and severe congestion of interlobular veins,hepatocyte karyopyknosis,mitochondrial and endoplasmic reticulum (ER) obviously decreased in sepsis group at 24 h.Hepatic injury was attenuated after employment of rHuEPO.Conclusions Recombinant human erythropoietin can inhibit the levels of ALT,AST,TNF-a,iNOS in serum,thus modifying the inflammatory response and providing protective effects against acute liver injury in the wake of infection.
2.Research of systolic blood pressure at admission on in-hospital outcomes in patients with ST elevated acute myocardial infarction
Shuai JIN ; Zhenzhen SANG ; Dong JIA ; Yun XU ; Pengsi ZHANG ; Min ZHAO
Chinese Journal of Emergency Medicine 2014;23(8):898-902
Objective To investigate the impact of systolic blood pressure (SBP) at admission on in-hospital outcomes in patients with ST elevated acute myocardial infarction (STEMI).Methods Data of 336 STEMI patients admitted from September 2008 to May 2011 were retrospectively analyzed.Total of 336 STEMI patients were classified into 4 groups as per the level of SBP at admission:group A (< 101 mmHg,n =59) ; group B (101-120 mmHg,n =109) ; group C (121-140 mmHg,n =98) and group D (> 140 mmHg,n =69).And clinical features,coronary angiography (CAG) findings,the strategy of treatment,complications and hospital mortality were compared among 4 groups with SPSS version 18.0 software.Results The mortality rates of the four groups were 18.64%,1.83%,4.08%,1.45%,respectively.The patients with SBP < 106 mmHg were in greater risk of in-hospital mortality,Killip class ≥ 3 at admission,shock and refractory arrhythmias,and more patients in this group needed pacemaker and intraaortic balloon pump (IABP) treatment than patients in other 3 groups.While there was no significant difference in mortality rate between other three groups.Multivariate logistic regression analysis demonstrated SBP < 101 mmHg (OR =6.368,P =0.002) and peak value of troponin Ⅰ (OR =3.781,P =0.008) were independent risk factors of in-hospital death in STEMI patients.Conclusions The STEMI patients with SBP < 101 mmHg at admission had higher mortality rate and low SBP at admission had great prognostic value in short-term outcomes of STEMI.
3.Recombinant human erythropoietin as a novel agent with pleiotropic effects against sepsis-induced acute kidney injury
Zhenzhen SANG ; Yun XU ; Yingjie SHENG ; Pengsi ZHANG ; Jianbo SUN ; Dong JIA ; Shuai JIN ; Min ZHAO
Chinese Journal of Nephrology 2012;(12):961-967
Objective To investigate the protective effects of recombinant human erythropoietin (rHuEPO) on caecal ligation and puncture (CLP)-induced acute kidney injury (AKI).Methods A total of 260 healthy male Sprague-Dawley rats (250-300 g) were randomly divided into 6 groups:normal control group,sham group,CLP model group,the large dose rHuEPO (5000 U/kg)group,the middle dose rHuEPO (1000 U/kg) group,and the small dose rHuEPO (500 U/kg) group.The rat models of sepsis were established by CLP.In treatment groups,rats were treated with rHuEPO through caudalis injection after CLP surgery.Each group was divided into 2-,6-,12-,24-,36-hour subgroups with 10 rats.Rats were sacrificed and the tissue samples including kidney and blood samples were collected.The kidney function,plasma cytokines [interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α)],kidney injury moleclue 1 (KIM-1) and inducible nitric oxide synthase (iNOS)were measured.Cytokines were determined by ELISA method.The expression of nuclear factor-kappaB (NF-κB) protein in kidneys were detected by immnunohistochemistry method.Pathological changes of kidney tissues were observed by light and transmission electron microscopy for cytokine content and apoptosis.Results Compared with CLP model group,renal function,the levels of TNF-α,IL-6,KIM-1 and iNOS in serum,the expression of NF-κB,significantly decresed in large dose rHuEPO group (all P < 0.05).rHuEPO also lessened the histological changes in large dose group.rHuEPO did not lessen the histological changes in others.Conclusion rHuEPO can inhibit the levels of TNF-α,IL-6 and iNOS in serum,thus modify the inflammatory response and provide protective effects against acute kidney injury induced by sepsis.
4.Effects of PAS therapy on the serum levels of Hcy and RBP4 in patients with diabetes mellitus complicated with cerebral infarction
Yue FANG ; Meng ZHANG ; Pengsi ZHANG ; Dongmei PEI
Journal of Chinese Physician 2020;22(4):490-494
Objective:To investigate the effect of probucol + aspirin + atorvastatin (PAS) therapy on the serum levels of homocysteine (Hcy) and retinol binding protein 4 (RBP4) in patients with diabetes mellitus complicated with cerebral infarction.Methods:126 cases of cerebral infarction patients complicated with diabetes mellitus in our hospital were recruited during January 2014 to May 2017, and then all of them were randomly divided into control group and observation group, 63 cases in each group. The control group was treated with atorvastatin combined with aspirin on the basis of routine treatment (AS therapy), and the observation group received the probucol on that basis of control group (PAS therapy). The clinical efficacy, neurological function, complications, changes of serum inflammatory factors, Hcy and RBP4 were evaluated in both groups before and after treatment.Results:After treatment, the National Institute of Health Stroke Scale (NIHSS) score of both groups were decreased and the NIHSS score of the observation group was lower than that in the control group ( P<0.05). After treatment, the effective rate of clinical treatment in observation group and control group were respectively 87.3%, 68.3%, the effective rate of observation group was significantly higher than control group ( P<0.05). After treatment, the serum levels of tumor necrosis factors-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), Hcy and RBP4 in both groups were decreased significantly ( P<0.05); the serum levels of TNF-α, hs-CRP, Hcy and RBP4 in observation group were significantly lower than those in control group ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:PAS therapy is safe and effective in the treatment of type 2 diabetes mellitus complicated with cerebral infarction, which can effectively reduce serum levels of Hcy and RBP4, relieve inflammatory injury and improve neurological function.