3.Passive leg raising as an indicator of fluid responsiveness in patients with severe sepsis
Zhou-Zhou DONG ; Qiang FANG ; Xia ZHENG ; Heng SHI
World Journal of Emergency Medicine 2012;3(3):191-196
BACKGROUND: In the management of critically ill patients, the assessment of volume responsiveness and the decision to administer a fluid bolus constitute a common dilemma for physicians. Static indices of cardiac preload are poor predictors of volume responsiveness. Passive leg raising (PLR) mimics an endogenous volume expansion (VE) that can be used to predict fluid responsiveness. This study was to assess the changes in stroke volume index (SVI) induced by PLR as an indicator of fluid responsiveness in mechanically ventilated patients with severe sepsis. METHODS: This was a prospective study. Thirty-two mechanically ventilated patients with severe sepsis were admitted for VE in ICU of the First Affiliated Hospital, Zhejiang University School of Medicine and Ningbo Medical Treatment Center Lihuili Hospital from May 2010 to December 2011. Patients with non-sinus rhythm or arrhythmia, parturients, and amputation of the lower limbs were excluded. Measurements of SVI were obtained in a semi-recumbent position (baseline) and during PLR by the technique of pulse indicator continuous cardiac output (PiCCO) system prior to VE. Measurements were repeated after VE (500 mL 6% hydroxyethyl starch infusion within 30 minutes) to classify patients as either volume responders or non-responders based on their changes in stroke volume index (ΔSVI) over 15%. Heart rate (HR), systolic artery blood pressure (ABPs), diastolic artery blood pressure (ABPd), mean arterial blood pressure (ABPm), mean central venous pressure (CVPm) and cardiac index (CI) were compared between the two groups. The changes of ABPs, ABPm, CVPm, and SVI after PLR and VE were compared with the indices at the baseline. The ROC curve was drawn to evaluate the value of ΔSVI and the change of CVPm (ΔCVPm) in predicting volume responsiveness. SPSS 17.0 software was used for statistical analysis. RESULTS: Among the 32 patients, 22 were responders and 10 were non-responders. After PLR among the responders, some hemodynamic variables (including ABPs, ABPd, ABPm and CVPm) were significantly elevated (101.2±17.6 vs.118.6±23.7,P=0.03; 52.8±10.7 vs. 64.8±10.7,P=0.006; 68.3±11.7 vs. 81.9±14.4,P=0.008; 6.8±3.2 vs. 11.9±4.0,P=0.001). After PLR, the area under curve (AUC) and the ROC curve of ΔSVI and ΔCVPm for predicting the responsiveness after VE were 0.882±0.061 (95%CI 0.759–1.000) and 0.805±0.079 (95%CI 0.650–0.959) when the cut-off levels of ΔSVI and ΔCVPm were 8.8% and 12.7%, the sensitivities were 72.7% and 72.7%, and the specificities were 80% and 80%. CONCLUSION: Changes in ΔSVI and ΔCVPm induced by PLR are accurate indices for predicting fluid responsiveness in mechanically ventilated patients with severe sepsis.
4.Cytotoxicity of human doppel protein and Dpl-like protein PrPΔ32-121 to SH-SY5Y cells
Kun XU ; Xin WANG ; Chan TIAN ; Song SHI ; Guirong WANG ; Qi SHI ; Ruimin ZHOU ; Huiying JIANG ; Yonglie CHU ; Xiaoping DONG
Journal of Xi'an Jiaotong University(Medical Sciences) 2010;31(1):32-35,46
Objective To observe the biological activities of human doppel (Dpl) protein transiently expressed and Dpl-like protein PrPΔ32-121 on a human neuroblastoma cell line SH-SY5Y. Methods Recombinant mammalian expression plasmids containing human PRND gene and truncated PrPΔ32-121 fragment were generated by PCR. The expression and location of Dpl and PrPΔ32-121 post-transfection were observed by IFA. The cytotoxicity was measured by MTT analysis. Cellular apoptosis was investigated by flow cytometry and Western blot. Results Both Dpl and PrPΔ32-121 protein were expressed and mainly located on the cell membrane. Remarkable cytotoxicity was detected on SH-SY5Y cells after 24 h transfection. Meanwhile, more Annexin V/PI positively-stained cells as well as lower levels of cellular pro-caspase-3 and Bel-2 were detected in the cells receiving Dpl and PrPΔ32-121 expressing plasmids. Conclusion Dpl protein transiently expressed and PrPΔ32-121 can lead to the similar neural cytotoxicity, probably triggering the cell apoptosis program.
5.Cytotoxicity of human doppel protein and Dpl-like protein PrP?32-121 to SH-SY5Y cells
Kun XU ; Xin WANG ; Chan TIAN ; Song SHI ; Guirong WANG ; Qi SHI ; Ruimin ZHOU ; Huiying JIANG ; Yonglie CHU ; Xiaoping DONG
Journal of Xi'an Jiaotong University(Medical Sciences) 1982;0(01):-
Objective To observe the biological activities of human doppel(Dpl) protein transiently expressed and Dpl-like protein PrP?32-121 on a human neuroblastoma cell line SH-SY5Y.Methods Recombinant mammalian expression plasmids containing human PRND gene and truncated PrP?32-121 fragment were generated by PCR.The expression and location of Dpl and PrP?32-121 post-transfection were observed by IFA.The cytotoxicity was measured by MTT analysis.Cellular apoptosis was investigated by flow cytometry and Western blot.Results Both Dpl and PrP?32-121 protein were expressed and mainly located on the cell membrane.Remarkable cytotoxicity was detected on SH-SY5Y cells after 24 h transfection.Meanwhile,more Annexin V/PI positively-stained cells as well as lower levels of cellular pro-caspase-3 and Bel-2 were detected in the cells receiving Dpl and PrP?32-121 expressing plasmids.Conclusion Dpl protein transiently expressed and PrP?32-121 can lead to the similar neural cytotoxicity,probably triggering the cell apoptosis program.
6.Interaction of human oral microbial community.
West China Journal of Stomatology 2010;28(1):1-4
Human body is inhabited by large number of microbial organisms that form complex ecosystems. Oral cavity is one of the major sites for microbial colonization. Oral microbial diversity is huge as the compositions vary among different oral cavities, different locations within the same oral cavity, or same location at different time points. The differences in compositions and varieties determine the balance of human oral microbial ecosystem, which is directly associated with oral disease or health. This review focuses on the history and new progress of the studies on human oral microbial communities.
Ecosystem
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Humans
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Mouth
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microbiology
7.One case report: cervical necrotizing fasciitis with descending mediastinitis.
Jia-li SHI ; Jia-qing ZHOU ; Jia-dong WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2012;47(12):1037-1038
Aged
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Fasciitis, Necrotizing
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complications
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Female
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Humans
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Mediastinitis
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complications
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Neck
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pathology
8.Human oral microbial community and dental plaque biofilm.
West China Journal of Stomatology 2010;28(2):115-118
Dental plaque is structurally a kind of biofilm which contains a variety of micro-organisms. The interreaction of oral micro-organisms may affect the nature, forms, and toxicity of the dental plaque biofilm, as well as the localization and field planting of bacteria inside the biofilm. The signal transduction existed between the bacterium has an important effect on the formation and virulence of bacterial biofilm. This reviewing paper focuses on the latest research progress of human oral microbial community and dental plaque biofilm.
Bacteria
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Bacterial Adhesion
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Biofilms
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Dental Plaque
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Humans
9.Clinicopathological and prognostic analysis of insulin like growth factor 1 receptor protein expression in primary gastrointestinal stromal tumors
Lei SHI ; Hao WANG ; Wei ZHAO ; Yu ZHOU ; Xinxin LIU ; Dong LIANG ; Ping CHEN
Chinese Journal of General Surgery 2017;32(4):340-343
Objective To investigate the clinicopathological significance of expression of insulin like growth factor 1 receptor (IGF1R) protein in primary gastrointestinal stromal tumors (GIST) and their impacts on prognosis.Methods Between January,2005 and January,2011,84 primary GIST patients underwent surgery.Immunohistochemical analysis was performed based on tissue microarray to estimate expression pattern of IGF1R in tumor cells and nomal controls.Association of IGF1R expression with clinicopathological features and relapse-free survival (RFS) were also analyzed.Results The negative,weakly positive,positive,and strong positive expression rates of IGF1 R protein in GIST group were 20%,14%,48% and 18%,respectively;while in the control group were 32%,40%,20% and 8%,respectively (x2 =30.663,P < 0.001).The 5-year overall survival (OS) rate was 93%.1-year,3-year and 5-year RFS rate were 99%,76% and 60%,respectively.As shown by univariate analysis the following factors were poor prognostic indicators for RFS,non-gastric tumor location (P =0.017),large tumor size (P =0.022),high mitotic index (P < 0.001),high cellularity (P =0.012),tumor rupture (P =0.013),absent or low expression of IGF1R (P =0.022).Tumor size (HR5.1-10 ≤5 cm =1.86,95% CI:0.67-5.15;HR>10 ≤5cm =6.71,95% CI:0.67-5.15,overall P =0.023),and mitotic index (HR5.1-10/50HPFsvs.≤5/50HPFs =5.72,95% CI:2.09-15.64;HR>10/50HPF ≤5/50HPFs =3.44,95% CI:1.13-10.45,overall P =0.002) were negative independent risk predictors by multivariate analysis.Conclusions High expression of IGF1R may be involved in the occurrence,development and poor prognostic of primary GIST.Expression of IGF1 R is correlated with high risk potential and may predict early recurrence.
10.Reversal effect of neferine on resistance to vincristine in human multidrug-resistant gastric carcinoma cell line SGC7901/VCR
Lin DONG ; Xiaoqing TANG ; Jianguo CAO ; Shuhong SHI ; Yingzhi ZHUANG ; Jianguo ZHOU
Chinese Journal of Pathophysiology 2000;0(08):-
AIM: To investigate the effect of neferine (Nef) on human gastric carcinoma cell line with multidrug resistance (MDR). METHODS: The cytotoxic effect of vincristine (VCR) was evaluated by MTT assay. The cell apoptosis induced by VCR was determined by flow cytometry, and the expression of P-glycoprotein (P-gp) and multidrug-resistance-associated protein (MRP) in cells was examined by immunofluorescence flow cytometry. RESULTS: MTT assay showed that Nef at the concentration of 5 ?mol?L~(-1) to 10 ?mol?L~(-1) have no cytotoxicity to parent human gastric carcinoma cell line (SGC7901) and its VCR-resistant variant cell line (SGC7901/VCR). The IC_(50) value of VCR to SGC7901 cell line was 0.06 mg?L~(-1)and that of to SGC7901/VCR cell line was 2.32 mg?L~(-1), which indicated SGC7901/VCR cell line were 39 times more resistant to VCR in comparison with the parent SGC7901 cell line. After treatment with Nef at the concentrations of 2.5, 5 and 10 ?mol?L~(-1), the IC_(50) value of VCR to SGC7901/VCR cell line decreased to 0.34, 0.12 and 0.05 mg?L~(-1), respectively and those increased by 6.8-, 18.1- and 43.8- fold in the chemosensitivity, respectively. Flow cytometry showed that SGC7901/VCR cells were resistant to apoptosis induced by VCR. After 24 h treatment with Nef (2.5, 5 and 10 ?mol?L~(-1)) and VCR, the apoptosis of SGC7901/VCR cells increased, which indicated Nef could abolish resistance of SGC7901/VCR cells to VCR-induced apoptosis. Furthermore, the action of Nef was more potent than verapamil. The expression of P-glycoprotein and multidrug resistance associated protein was strongly positive in SGC7901/VCR cells, and the expression level of P-gp and MRP in SGC701/VCR cells was significantly down-regulated at 24 h after treatment with Nef (10 ?mol?L~(-1)). CONCLUSIONS: Nef can reverse MDR in multidrug-resistant human gastric carcinoma SGC7901/VCR cell line. Its mechanism might be associated with down-regulation of expression of P-gp and MRP in SGC7901/VCR cells.