Objective To investigate the protective effects of recombinant human erythropoietin(rhEPO)treatment on histopathologic changes seen in hyperoxia induced lung injury.Methods Rat pups were randomly divided into four groups:Ⅰ:air-exposed control group,Ⅱ: air-exposed+rhEPO-treated group,Ⅲ:hyperoxia-exposed control group,Ⅳ:hyperoxia-exposed+rhEPO-treated group.GroupⅢ and Ⅳ rats were exposed to 85% oxygen.GroupⅡand Ⅳ rats were received rhEPO (1 200 U/kg) subcutaneously on postnatal 0 day and 2 day.On postnatal 14 day,survival curve,measurement of body weight and lung weight,radical alveolar counts(RAC),microvessel count were compared,CD_ 31 and vascular endothelial growth factor(VEGF) were performed by immunostaining to assess hyperoxia-induced changes in lung morphology.Results Treatment of hyperoxia-exposed rats with rhEPO prolonged the survival and resulted in a significant increase in the weight gain of body and lung[(25.88?2.59) vs(18.8?3.93) P

The diabetes is mainly treated by the oral administration of western medicines at present. Despite their rapid curative effect, there have been still many reports for the western medicines about their clinical adverse reactions, failure of effective prevention and treatment of complications and drug resistance. Hence, they are not suitable for long-term administration. Traditional Chinese medicines have a long history in treating diabetes mellitus (DM) , which is commonly known as Xiaokezheng in the theory of traditional Chinese medicines. In recent years, many scholars have taken extracts from traditional Chinese medicines or separated active constituents as the study objects in the expectation of developing new-type drugs for treating and preventing diabetes. Therefore, a large number of study reports have been emerged in this field. Due to their significant glucose-reducing effect and specific effect in treating complications of diabetes, traditional Chinese medicine Gardeniae Fructus and its iridoid component geniposide shall be given full attention. This paper summarized the advance in studies on the curative effect and action mechanism of Gardeniae Fructus and geniposide in preventing and treating diabetes.
Animals ; Diabetes Mellitus ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Fruit ; chemistry ; Gardenia ; chemistry ; Humans ; Hypoglycemic Agents ; administration & dosage ; chemistry

Objective To analyze the outcomes and prognostic factors associated with the death of systemic lupus erythematosus (SLE) patients admitted to the intensive care unit (ICU). Methods During June 1996 to June 2007, all SLE patients admitted to the ICU were included. Patients were excluded if the diagnosis of SLE was established at or after ICU admission. A multivariate logistic regression model was applied using variables that were associated with death in the univariate analysis. Results A total of 101 patients meeting the criteria were included. The mortality rate was 48.6%. The most common causes of admission was lung disorder with acute respiratory distress syndrome (ARDS). Multivariate logistic regression analysis suggested that SLICC/ACR DI>7.7 (OR=6.87), APACHE Ⅲ≥21 (OR=29.8), lung disorders with ARDS (OR =55.81 ), septic shock (OR =32.22 ), intracranial haemorrhage (OR =57.35 ), hypocytopenia (OR = 5.89), mean equivalent prednisone dose>25 mg/d (OR=7.65) and prolonged tracheal intubation (OR=5.98) were signi-ficantly associated with death. Whereas sex, age, SLEDAI >27, gastrointestinal bleeding, the cumulative dosage of CTX higher than 1.0 g, pulse intravenous methylprednisolone therapy were not associated with death. Conclusion The mortality rate of critically ill SLE patients in ICU is very high. SLICC/ACR DI> 7.7, APACHE Ⅲ≥21, lung disorders with ARDS, septic shock, intracraniai haemorrhage, average prednisone equivalent dosage higher than 25mg/d and prolonged tracheal intubation (longer than 4 days) are negative prognostic factors in SLE patients admitted to the ICU.

Objective To investigate the effect of leflunomide on the superficial costimulatory molecules expression of T lymphocytes in patients with lupus nephritis ( LN ). Methods The peripheral blood mononuclear cells (PBMCs) of female active LN patients and healthy female were separated by density gradient centrifugation, and cultured by phytohemagglutinin (PHA) or leflunomide active metabolites(A771726).The CD28, CD40L, CTLA-4 and LFA-1a expressions on the peripheral blood T lymphocytes were detected by double-colored flow cytometry. The differences of the means were tested by analysis of variance( ANOVA ) and SNK q test. Results Comparing with healthy controls, there were significantly higher expressions of CD28,CD40L, LFA-1a and CTLA-4 on the peripheral blood T cells in active LN patients (CD28:33.4±6.5 vs14.4±3.2; CD40L: 13.2±3.2 vs 5.4±2.3; LFA-1a: 8.5±2.3 vs2.2±1.1; CTLA-4:4.6±1.5 all P＜0.01) as well as CD28 and CD40L expression on the peripheral blood T cells from healthy controls induced by PHA (CD28:26.8±6.7 vs14.4±3.2; CD40L: 13.9±4.9 vs 5.4±2.3 all P＜0.01 ), but not CTLA-4 and LFA-1a expression.However, CD28, CD40L, LFA-1a and CTLA-4 expressions on T cells stimulated by PHA increased in active LN patients(all P＜0.05 ). A771726 could significantly inhibit over-expression of LFA-1a and CD40L on the T cells from active LN patients (CD40L:8.2±2.0 vs13.3±3.2;LFA-1a:5.1±1.3 vs8.5±2.3 all P＜0.01 ), but not CD28 and CTLA-4 expression. A771726 did not inhibit CD28, CD40L, LFA-1a and CTLA-4 expression on the T cells in healthy controls. Furthermore, A771726 could markedly inhibit the over-expression of all of the above molecules induced by PHA on the T cells of active LN patients (all P＜0.05). Conclusion One of the major mechanisms for LEF treatment of LN is that LEF can down-regulate CD40L and LFA-1a expression but not CD28 and CTLA-4 expression on the peripheral blood T cells in active LN patients.

Objective:To summarize the feasibility and clinical experience of various types of aortic surgery through upper hemisternotomy.Methods:From June 2016 to October 2019, 63 patients underwent various types of aortic operations through upper hemisternotomy in our department. Among them, there were 51 males and 12 females with an average age of(49.7±12.7) years. All kinds of major vascular operations include: 33 cases of aortic dissection procedure; 9 cases of Bentall procedure; 7 cases of wheat procedure; 2 cases of Ross procedure; 2 cases of David procedure; 2 cases of simple ascending aorta replacement procedure; 3 cases of redo thoracic Bentall procedure; 2 cases of redo thoracic wheat operation; 1 case of redo thoracic aortic root leakage repair procedure; 2 cases of redo thoracic ascending aorta procedure, innominate artery, left common carotid artery replacement and removal of intravalvular vegetation procedure; 1 case of Bentall plus pulmonary valve and pulmonary artery replacement procedure. Among them, aortic dissection included 11 cases of ascending and total arch replacement plus descending aortic stent implantation procedure; 2 cases of AVR plus ascending and total arch replacement procedure; 5 cases of ascending and semi-arch replacement procedure; 4 cases of David plus ascending and total arch replacement plus descending aortic stent implantation procedure; 1 case of redo thoracotomy David plus ascending and total arch replacement with descending aortic stent implantation procedure; 1 case of David plus ascending and total arch replacement procedure; 6 case of AVP/AVR/Bentall plus ascending and total arch replacement and descending aortic stent implantation procedure; 2 cases of redo total arch replacement and descending aortic stent implantation procedure and aortic root vascular graft wrapping plus ascending aorta and 1 case of total arch replacement with descending aortic stent implantation procedure.Results:All 63 cases of operation were successfully completed without transforming to middle sternotomy; 1 case with acute renal failure was treated by dialysis, and then complicated with septic shock and intracranial hemorrhage, and died of ineffective rescue; 2 cases were treated by thoracotomy exploration and hemostasis; 9 cases with pericardial effusion needed pericardiocentesis; 2 cases with lower extremity muscle weakness after operation: one treated by drainage of spinal fluid and the muscle strength of the lower extremities was restored, another one complicated with infection, acute renal failure and hypoxemia was treated by anti-infection, continuous CRRT, gamma globulin infusion and rehabilitation exercise, the muscle strength of the lower extremities was eventually restored. Except for one death in hospital, all the other patients were cured and discharged.Conclusion:Well exposure of aortic root, ascending aorta and descending part of arch can be obtained through upper hemisternotomy and various types of aortic proceduer can be done with satisfactory results through this approach.

Objective To evaluate the value of prenatal ultrasound in the interrupted aortic arch (IAA), and analyze the reasons of misdiagnosis and improve diagnostic ratio of this kind of defects. Methods Ultrasonic characteristics were analyzed in 16 fetuses with aortic arch anomalies, which were compared with ultrasound image and autopsy results of the normal fetus. The relativity of fetal IAA and abnormal chromosome was also analyzed. Results Among the 16 cases, 15 cases were confirmed by anatomy and the accuracy of ultrasound diagnosis was 94% (15/16), of which one case was serious constriction of aortic arch, one case was error type, three cases were obtained explicit type due to unsatisfactory results of prenatal ultrasound. The coincidence rate of ultrasonic type was 73% (11/15). All of the corrected diagnosed cases were detected with ventricular septal, of which 5 cases were detected with complete endocardial cushion defect, 9 cases were found extra cardiac malformations. Among the 7 karyotype check cases, 3 cases were diagnosed with Trisomy 18, 1 case Trisomy 13, while the rest 3 cases normal. The incidence rate of Trisomy 18 was 43 % (3/7). Conclusions Prenatal ultrasound shows a high accuracy in diagnosing fetal interrupted aortic arch (IAA ), but there’s a need to be improved in explicit typing. It is difficult to identify fetal interrupted aortic arch (IAA) and serious constriction of aortic arch (COA). The incidence rate of Trisomy 18 in the abnormal chromosome of fetal IAA is high.

ObjectiveTo study the effect of fluorine on proliferation of osteoblast through extra cellular signal-regulated protein kinase(ERK) signaling pathway.MethodsMouse osteoblasts(MC3T3-E1) were cultured in vitro with different concentrations of fluoride for 24 and 48 h (the concentrations of Fˉ were 0,200,400,600,1000,2000,4000,8000,10 000 μmol/L,respectively).The optimum concentration for promotion of cell proliferation was determined by methylthiophene tetrazolium(MTT) assay.According to the optimum concentration,the cells were randomly divided into three groups:control group (0 μmol/L Fˉ); fluorine group (400 μmol/L Fˉ); fluorine and MAPK inhibitor PD98059 group(400 μ mol/L Fˉ + 10 μ mmol/L PD98059).Cell cycle was detected by flow cytometry after 48 h culture.The expression of P-ERK protein was determined by Western blotting and immunofluorescence.ResultsThe optimum concentration of fluorine for proliferation of osteoblasts was 400 μ mol/L.Compared with the control group[(76.12 ± 10.08)％,(2.06 ± 0.31)％],the number of cells in G0/G1 phase[(63.04 ± 8.12)％] reduced and the number of cells in S phase[(9.13 ± 2.08)％] increased in fluorine group (all P ＜ 0.05) ; but the number of cells in G0/G1 phase [(92.11 ± 9.01 ) ％] in fluorine and mitogen-activated protein kinases (MAPK) inhibitor PD98059 group was significantly increased(P ＜ 0.05 ).Western blotting results showed that:compared with the control group[(100.00 ± 0.00)％],the expression of P-ERK protein in fluorine group[(131.24 ± 13.88)％] was significantly higher(P ＜ 0.05 ),but the expression of P-ERK protein in fluorine and MAPK inhibitor PD98059 group [(91.33 ± 9.68 )％] was not significantly changed(P ＞ 0.05).The results of immunofluorescence were similar to that of Western blotting.ConclusionsFluorine at the concentration of 400 μmol/L can promote the proliferation of osteoblasts.ERK signaling pathway has played a key role in the proliferation of osteoblasts.

Objective To compare the effectiveness of hyperbaric oxygen (HBO) therapy and normal pressure oxygen inhalation for lung infection in patients with severe brain injury and tracheotomy.Methods Sixty lung infection patients with severe brain injury and tracheotomy were stratified by age and Glasgow coma scale (GCS) score into an HBO group (30) and a conventional therapy group (30).Both groups were given treatments to reduce intracranial hypertension and protect the brain,surgery,antibiotics,and symptomatic and support therapy.In the conventional group the patients received oxygen therapy at normal oxygen pressure by tracheal cannula.In the HBO group,the patients received HBO therapy through self-made oxygen devices by the authors.The body temperature,cough and expectoration,respiratory sounds and white blood cell (WBC) count were compared between the groups.Results There were statistically significant differences in body temperature,cough and expectoration,respiratory sounds and the normalized time for the count and classification of WBC between the groups.Conclusion HBO had good treatment effectiveness for excretion and expectorant in lung infection patients with severe brain injury and tracheotomy.

Objective To explore the correlation between brainstem auditory evoked potential (BAEP) combined with mesencephalic morphology and the prognosis of coma patients with severe craniocerebral injury.Methods Forty-seven coma patients with severe craniocerebral injury were examined with BAEP and moaitored dynamically in early period of coma,and all these patients got head CT scans and the ratio of anteroposterior diameter and transverse diameter of mesencephalon were measured at the same time.Results There was a significantly negative relationship between the first BAEP classification and GOS score at the end of the follow-up (r =-0.755,P =0.000 ).Among all of the patients,there were 27 patients with the ratio of anteroposterior diameter and tansverse diameter of mesencephalon from 0.9 to 1.1,19 patients (70.4％,19/27) with good prognosis;20 patients with the ratio ＞1.1 or ＜ 0.9,6 patients (30.0％,6/20 ) with good prognosis.The rate of good prognosis between the two had significant difference ( x2 =7.521,P =0.006).The sensitivity and specificity were 73.7％(14/19),82.6％ (19/23) at the first BAEP combined with mesencephalic morphology,88.2％ (15/17),100.0％ (21/21) at the second BAEP combined with mesencephalic morphology.Conclusion BAEP combined with mesencephalic morphology can evaluate effectively the prognosis of coma patients with severe craniocerebral injury.

OBJECTIVEBronchopulmonary dysplasia (BPD) is a multifactorial disease resulting from the impact of injury (including oxygen toxicity, barotrauma, volutrauma, and infection) on the immature lung. Oxygen toxicity is thought to be a major contributing factor in the pathogenesis in BPD. Previous animal studies have shown that exposure to hyperoxia in the neonatal period causes lung structural changes that are similar to the histology seen in human infants with BPD. Erythropoietin (EPO) has pleiotropic actions including antioxidant, anti-apoptotic, anti-inflammatory and angiogenic effects. Animal experiments reveal that EPO may have protective effects on hyperoxic lung injury, but the mechanisms remain unknown. The aim of the study was to evaluate the anti-inflammatory effects and understand mechanism of action of EPO on the hyperoxia-induced BPD in newborn rats.

METHODSeveral litters of Wistar pups were pooled together within 12 hours after birth and randomly divided into four groups: I. air-exposed control group, II. air-exposed human recombinant erythropoietin (rhEPO)-treated group, III. hyperoxia-exposed placebo group and IV. hyperoxia-exposed rhEPO-treated group . Group III and IV rats were exposed to 85% oxygen. Group II and IV rats received rhEPO (1200 IU/kg) subcutaneously on postnatal days 0 and 2. Group I and III received 0.9% saline in the same way. Pups from each group were sacrificed on days 3, 7, and 14. Blood hemoglobin concentration, hematocrit and platelet count were determined by blood cell analyzer. Total protein content in bronchoalveolar lavage fluid (BALF) and myeloperoxidase (MPO) were measured by biochemical assay. Changes of monocyte chemoattractant protein-1 (MCP-1) and cytokine-induced neutrophil chemoattractant-1 (CINC-1) mRNA expressions were measured by RT-PCR.

RESULTIn group III, there were a few inflammatory cells infiltrations in interstitium on day 3 and inflammatory response worsened on day 7. Alveolar and capillary hypoplasia and interstitial fibrosis were evident on day 14. The pathological changes were ameliorated greatly in group IV and the survival was prolonged. There were no abnormal raises of hemoglobin concentration, hematocrit and platelet count in group IV compared with group I. Total protein concentration in BALF was measured as a marker for capillary leakage. MPO is a major constituent of neutrophil cytoplasmic granules and its activity therefore is a direct measure of neutrophil presence and an indirect indicator of lung injury. Total protein concentration and MPO in BALF were greatly depressed in group IV compared with group III, P<0.05, P<0.001. The upregulation of genes of CINC-1 and MCP-1 was closely related with lung inflammation caused by oxidative stress. MCP-1 and CINC-1 mRNA expression were detected and it was found that their changes were in line with the degree of lung inflammation. MCP-1 and CINC-1 mRNA expression increased in group III compared with group I especially on day 7, P<0.01 or <0.001. The changes of MCP-1 and CINC-1 mRNA were positively correlated with changes of MPO in BALF covering all groups on days 3, 7 and 14, respectively (r = 0.391, P<0.05; r = 0.701, P<0.01; r = 0.600, P<0.01; r = 0.471, P<0.01; r = 0.789, P<0.01; r = 0.588, P<0.01).

CONCLUSIONEPO could significantly reduce the lung inflammatory cell infiltration, and capillary endothelial cell injury in hyperoxic lung injury in newborn rats. The mechanism may be related with the inhibition of MCP-1 and CINC-1 gene expression by EPO.

Animals ; Animals, Newborn ; Chemokine CCL2 ; metabolism ; Disease Models, Animal ; Erythropoietin ; pharmacology ; Female ; Hyperoxia ; complications ; pathology ; Lung ; drug effects ; metabolism ; pathology ; Lung Injury ; etiology ; metabolism ; pathology ; Male ; Rats ; Rats, Wistar ; Recombinant Proteins