1.A clinical research of Xuebijing for treatment of blood capillary leak syndrome
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2017;24(3):274-277,299
Objective To explore the safety and therapeutic effect of Xuebijing injection for treatment of patients with capillary leak syndrome (CLS).Methods Seventy-seven patients with clinical diagnosis of CLS admitted to Intensive Care Unit (ICU) of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine (TCM) from November 2015 to October 2016 were enrolled, they were divided into a control group (35 cases) and a Xuebijing group (42 cases) according to random number table method. The conventional treatment was given and at the same time the primary disease was actively treated in the control group; while in the Xuebijing group, on the basic treatment of the control group, additionally, Xuebijing injection 100 mL+ 0.9% normal saline (100 mL) was intravenously dripped, twice a day, 5 days constituting one therapeutic course. Before and after treatment for 5 days, the white blood cell count (WBC), neutrophils percentage (N), alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN), serum creatinine (SCr), procalcitonin (PCT), pH value, partial pressure of blood oxygen (PaO2), blood lactic acid value (Lac), activated partial thromboplastin time (APTT), prothrombin time (PT), blood platelet count (PLT) in the patients of the two groups were compared; and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was recorded; the length of stay in ICU, mechanical ventilation time, and 28-day survival rate were statistically calculated in two groups.Results After treatment, the levels of WBC, N, PCT, ALT, AST, BUN, SCr, Lac, APACHE Ⅱ score in Xuebijing group were lower than those in the control group [WBC(×109/L): 9.85±0.61 vs. 13.87±2.58, N: 0.75±0.08 vs. 0.90±0.10, PCT (μg/L): 1.13±0.71 vs. 4.99±1.38, ALT (U/L): 79.56±30.85 vs. 84.21±27.32, AST (U/L): 91.98±38.10 vs. 110.28±35.79, BUN (mmol/L): 7.35±0.82 vs. 8.57±1.43, SCr (μmol/L): 111.67±43.96 vs. 132.51±55.10, Lac (mmol/L): 1.88±1.01 vs. 3.31±1.46, APACHE Ⅱ score: 11.34±3.59 vs. 17.65±4.77]; the PaO2, PLT, 28-day survival rate in Xuebijing group were higher than those in the control group [PaO2 (mmHg, 1 mmHg = 0.133 kPa): 75.47±21.10 vs. 54.22±15.23, PLT (×109/L): 211.54±58.25 vs. 153.27±49.69, 28-day survival rate: 85.71% (36/42) vs. 71.43% (25/35), allP < 0.05]; the PT, APTT, ICU hospitalization time and mechanical ventilation time in Xuebijing group were shorter than those in the control group [PT (s): 13.62±2.11 vs. 18.45±4.26, APTT (s): 31.33±4.27 vs. 36.85±5.56, length of stay in ICU (days): 12.4±3.7 vs. 20.5±4.1, mechanical ventilation time (days): 10.5±4.9 vs. 18.7±5.5, allP < 0.05].Conclusion The application of Xuebijing injection for treatment of patients with CLS can relieve their disease situation, reduce inflammatory indicators, improve the blood coagulation function and hypoxemia, shorten the ICU hospitalization time and mechanical ventilation time, elevate the 28-day survival rate, and has no harmful effects on liver and kidney functions.
2.Expression changes of HSP90α in cardiac muscles in rats with severs hemorrhagic shock by the treatment of different resuscitating fluid
Xiaokun YANG ; Mingyuan XU ; Guisen XU
Chongqing Medicine 2013;(32):3932-3934
Objective To explore the expression changes of HSP90αin cardiac muscles and survival rates in rats by using the different fluids to resuscitate the severs hemorrhagic shocked rats ,and provide reference for the clinical treatment of hemorrhagic shock with different resuscitation fluids .Methods Uncontrolled hemorrhagic shock rats model was established ,using lactic acid salinger liquid ,poly peptide injection gelatin ,hypertonic sodium chloride dextran for fluid resuscitation respectively ,and then checked the HSP90αexpression changes and survival rates in rats .Results the expressions of HSP90αin myocardial tissue and the mortality in rats were different after using different resuscitation fluids in severe hemorrhagic shock rats ,difference was statistically significant(P<0 .05) .Conclusion the expression of HSP90α in cardiac muscles of rats could be induced by severe hemorrhagic shock ,the HSP90αexpressed differently and regularly after using different resuscitating fluids ,it implied that the HSP90α played an important role in the hemorrhagic rats cardiac as a regulating fator .
3.Clinical Analysis of Death Causes in 100 Burn Patients
Xusheng LIU ; Hong YAN ; Xiaokun YANG
Journal of Chinese Physician 2000;0(11):-
Objective To analyze the death causes of the burn patients so as to explore the effective procedures which can raise burn management level. Methods One hundred patients died of burn injury during the past 20 years were enrolled in the study. The died patients were grouped as A (1984~1993) and B (1994~2003) groups, each group containing 50 cases. The mortality, burn area and depth, etiology, pre-hospital treatment, admission time, survival time, tracheostomy, the application of respirator and fibrobronchoscope, operation times, continuous renal replace treatment (CRRT), the incidence of inhalation injury and the pathogenesis of burn death were analyzed and compared between A and B groups. Results There were no differences in burn severity (area and degree), etiology and causes of burn death between the two groups. But the mortality in B group (1%) was evidently lower than that in A group (2%, P
4.Analysis and determination of bacterial resistance of clinical isolates
Yufu YANG ; Xiaokun GAO ; Xianghong HUA ;
Chinese Journal of Clinical Pharmacology and Therapeutics 2002;0(05):-
AIM: To analyze the bacterial resistance of clinical isolates in a hospital. METHODS: Susceptibility of 285 strains of G - bacillus and 133 strains of G + bacillus was observed in 18 kinds of antibiotics. RESULTS: Resistance increased in most G - bacilli to the third generation cephalosporin. The resistance rate was 28.4 % in the 74 strains of staphylococcus aureus, and 3.4 % in enterococci to vancomycin. No vancomycin resistant strain was found. Extend spectrum ? lactamases of E.coli and klebsiella (ESBLs) accounted for 34.0 % and 29.7 %, respectively. CONCLUSION: The drug resistance is severe in antibiotics, indicating that susceptibility determination is important in selection of antibiotics.
5.The establishment of the three-dimensional culture model of the human skin squamous-celled carcinoma and their biological evaluation of the high-invasive squamous carcinoma cells
Xiaokun YANG ; Yadong YANG ; Guihong YANG ; Shuqian TANG ; Jinjin WU
Chongqing Medicine 2013;(29):3465-3467,3471
Objective To establish the three-dimensional culture model of the human skin squamous-celled carcinoma ,and isolate the highly invasive cell subsets ,and compare their biological characteristics .Methods By using the composite chitosan tissue engi-neering skin ,the three-dimensional culture model of the human skin squamous-celled carcinoma was successfully established , through digestion ,we divided and got the high-invasive squamous carcinoma cells subsets .After that ,the different invasive proper-ties of subpopulations of cells in nude mice tumor effects were compared .Results Different concentrations of cinnamaldehyde and interferon on skin squamous-celled carcinoma cell proliferation inhibition had statistical significance (P<0 .01) ,the different invasive characteristics of skin squamous cells carcinoma between subpopulations of cells proliferation inhibition also was statistically signifi-cant(P<0 .01) ,and the two different invasive properties of subpopulations of cells in the tumor characteristics also had statistical significance(P<0 .01) .Conclusion We established the three-dimensional culture model of the human skin squamous-celled carcino-ma successfully ,by using this model ,we could screen the higher invasive cells subsets .
6.Treatment of bilateral hydronephrosis caused by prostate cancer
Yinhuai WANG ; Gan YAO ; Xiaokun ZHAO ; Ren LIU ; Luoyan YANG
Chinese Journal of Urology 2008;29(7):486-488
Objective To evaluate the treatment of bilateral hydronephrosis caused by prostate cancer. Methods Twenty-four eases with mean age of 71 years old (ranging from 64--81 years old) were diagnosed with bilateral hydronephrosis caused by prostate cancer and treated with complete androgen deprivation. Surgical castration plus Bicalutamide 50 mg/d was offered to 18 eases and medical castration (Goserelin, 3. 6 mg/month) plus Bicalutamide 50 mg/d was offered to 6 cases. There were 19 cases developed severe lower urinary tract symptoms. Among these 19 cases, 13 cases had accepted Foley catheter and 6 cases accepted suprapubic tube drainage. Results Before and after the treatment, the prostate volume decreased from (70. 3±11.2)ml to (42.6±15.8)ml(P=0. 001). Total PSA decreased from (40. 3±27.2)ng/ml to (9.5±8.3)ng/ml(P=0.02). Of the 24 cases, hydrone phrosis improved in 18 cases, remained unchanged in 3 cases and deteriorated in 3 cases. There were 14 patients developed renal insufficiency. After the treatment, Serum urea nitrogen decreased from (12. 8±6. 5) mmol/L to (6. 3 ± 4. 2) mmol/L (P = 0. 004) and serum ereatinine decreased from (206.8±152.3)μmol/L to (85.3±43.6)μmol/L(P=0.03), respectively. For those 6 cases with hy dronephrosis unchanged or deteriorated during the treatment, 4 cases accepted percutaneous nephros tomy and 2 cases accepted chtaneous ureterostomy. Conclusion The combination of complete androgen deprivation and bladder drainage through Foley catheter or suprapubic tube is an effective option in the treatment of bilateral hydronephrosis caused by prostate cancer.
7.Meta-analysis of antibiotic prophylaxis use in transrectal prostatic biopsy
Minggen YANG ; Xiaokun ZHAO ; Zhiping WU ; Ning XIAO ; Chen LV
Journal of Central South University(Medical Sciences) 2009;34(2):115-123
ObjectiveTo determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in men undergoing transrectal prostatic biopsy (TPB) who had sterile preoperative urine.MethodsMEDLINE, EMBASE, Cochrane Collaboration Reviews, Chinese Medical Current Contents (CMCC), and National Knowledge Infrastructure (CNKI) were searched for rando-mized controlled trials that compared the effect of antibiotic prophylaxis with placebo or active controls for men undergoing TPB with preoperative sterile urine. Two reviewers independently extracted the data of patient characteristics and outcomes based on a prospectively developed protocol.ResultsA total of 12 trials (3 placebo controlled, 3 non-treatment controlled, and 6 activly controlled) involving 1 987 patients, met the inclusion criteria. Prophylactic antibiotic use in patients at low risk undergoing TPB significantly decreased bacteriuria and middle degree fever incidence, but could not decrease the incidence of bacteremia. The relative risk for post-TPB bacteriuria, middle degree fever, and bacteremia were 0.32 (95% CI 0.23 to 0.46), 0.37 (95% CI 0.17 to 0.77), and 0.96 (95% CI 0.61 to 1.50), respectively. Effective antibiotic classes included quinolone, co-quinolone and nitroimidazole, and co-trimethoprim and sulfamethoxazole. Treatment protocols of any duration were effective.ConclusionAntibiotic prophylaxis obviously decreases the incidence of bacteriuria and middle degree fever but not bacteremia in men with preoperative sterile urine undergoing TPB. A significant decrease in bacteriuria incidence can be achieved with a range of antibiotic agents, including quinolones and co-quinolone and nitroimidazole. Treatment protocols of any duration are effective with no heterogeneity.
8.Urine bladder tumor antigen stat in bladder tumor diagnosis: a meta-analysis
Minggen YANG ; Xiaokun ZHAO ; Zhiping WU ; Yi HOU
Chinese Journal of Urology 2010;31(3):185-189
Objective To systematic review bladder tumor antigen(BTA) stat in the diagnosis of bladder cancer. Methods MEDLINE, EMBASE, Cochrane Library, CMCC and CNKI were searched for studies about BTA stat in the diagnosis of bladder cancer. The search strategy was made according to the Collaborative Review Group search strategy. Data were extracted by two reviewers using the designed extraction form. The software MetaDiScl. 4 was used to review management and data analysis. Results Seventy-one relevant studies were searched, of which 20 studies were included with 5929 patients involved and 51 studies were excluded. Heterogeneity (except for threshold effect) was found within these studies. A meta-analysis was performed using random effect model. Pooled accuracy indicators like sensitivity, specificity, positive likelihood ratio (LR), negative LR and diagnostic odds ratio (dOR) were 0. 64(95%CI 0. 62-0. 66), 0. 72(95%CI 0. 70-0. 73) , 2. 33(95% CI 2. 03-2. 68), 0. 48(95%CI 0.42 -0.55) and 5.12(95%CI 3. 88-6. 75), respectively. The sensitivity increased with tumor grades. The sensitivity of primary tumors was higher than the recurrent tumors. Area under curve (AUC) of SROC curve was 0. 7500 and Q* index was 0. 6934. Conclusions The performance of urine BTA stat is moderate in the diagnosis of bladder tumor. It can be an optional non-invasive test and an important adjunct test in preoperative detecting and postoperative monitoring of bladder tumor.
9.Relationship between condition of hypoxia and prognosis in patients with renal clear cell carcinoma
Ya ZHOU ; Ran XU ; Minggen YANG ; Songchao LI ; Xiaokun ZHAO
Chinese Journal of Urology 2012;33(8):598-602
Objective To explore the relationship between condition of hypoxia and prognosis in patient with renal clear cell carcinoma (RCCC).Methods The expression of hypoxia-inducible factor-lo( HIF-1 α) protein in cancer tissue of 89 RCCC cases was examined by streptavidin-biotin complex immunohistochemistry.Clinical and pathological data and prognosis of 89 cases were analyzed retrospectively.There were 66 males and 23 females,with an average age of 57 years.The patients were divided into two groups,the chronic pulmonary disease (CPD) group ( 19 cases) and non CPD (NCPD) group (70 cases),with 46cases in clinical stage I,15 cases in stage Ⅱ,26 cases in stage Ⅲ,and 2 cases in stage Ⅳ.The relationship between survival time and clinicopathological variables including the presence of CPD,the positive rate of HIF-1α protein,smoking history and hemoglobin level were evaluated by the Kaplan-Meier method.And the Cox proportional hazards regression model was build to analyze the correlation between each variable and survival time.Results The 89 cases were followed up for a median time of 19 months (6 to 84 months).Twenty cases died,and 69 cases survived.Between the CPD group and NCPD group,clinical stage,hemoglobin level and the degree of expression of HIF-1 α were significantly different (P < 0.05 ).The median survival time was 44 and 71 months in CPD group and NCPD group,respectively,and the difference was significant ( P < 0.05 ).The median survival time was 43 and 70 months in Hb≤ 110 g/L group and Hb > 110 g/L group,respectively,and the difference was significant ( P < 0.05).The stronger the degree of expression of HIF-lα was,the shorter the overall survival was.And the difference was significant ( P <0.05 ).Associated with CPD,hemoglobin level,the expression of H1F-1α were independent factors affecting overall survival of the patients (P <0.05 ).CPD and HIF-1 α expression were positively related to disease-free survival time,and hemoglobin level was negatively related to disease-free survival time.Conclusions Systemic hypoxia caused by CPD may aggravate the hypoxie state in the organization of the patients with RCCC.The condition of hypoxia and prognosis in patient with RCCC is negatively correlated.
10.Anti-GITR antibody inhibits L615 leukemia in mouse
Xiaokun YANG ; Junsong ZHENG ; Xin ZHANG ; Xiaoyun PU
Journal of Third Military Medical University 2003;0(18):-
Objective To investigate the effect and the mechanism of the GITR-antibody(glucocorticoid-induced tumor necrosis factor receptor-ligand antibody) on the mouse leukemia model induced by L615.Methods The mouse leukemia models induced by L615 cells were divided into 4 groups: negative controls(peritoneal injection of normal saline,0.2 ml/d),GITR group(GITR,100,infused through caudal vein 2 d before leukemic lymphocytes inoculation,again at dose of 50 ?g/each mouse after inoculation),Cyclophosphamide group(200 mg?kg~(-1)?d~(-1),intraperitoneal injection from the 3~(rd) day after inoculation for 3 d),GITR+ Cyclophosphamide group(100 mg?kg~(-1)?d~(-1) Cyclophosphamide instead).The survival time,leukocyte counting in the peripheal blood,liver and spleen index were calculated and the pathological examination of liver,spleen were performed.Results GITR-ligand could prolong the survival time of mouse leukemia model,lead the necrosis and apoptosis of leukemic cells in bone marrow,decrease the liver and spleen index,decrease and relieve the leukocyte increase of peripheal blood and the irregular swelling of liver and spleen.Conclusion Through immunoregulation,GITR-antibody can inhibit the L615 leukemic cells effectively,therefore inhibit the progress of leukemia to some extent.