1.The lung protective effect of Tongfu Xiefei method in rats with sepsis
Hua JIANG ; Jiang ZHOU ; Mingqi CHEN ; Xing WANG ; Jun LU
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2015;22(3):248-252
Objective To observe the lung protective effect of Tongfu Xiefei method (TFXF) in rats with sepsis, and to discuss its possible mechanism.Methods Forty-two Sprague-Dawley (SD) rats were randomly divided into blank control group (n = 6), model group (n = 18) and TFXF group (n = 18). Sepsis model was reproduced by cecal ligation and puncture (CLP) in rats of model group and TFXF group. After the reproduction of sepsis model, rats in TFXF group received Tongfu Xiefei granules 0.01 mL/g by gavge, while those in model group were given equal dose of normal saline by the same way. The rats in blank control group received no treatment. At 3, 6, 12 hours after CLP, abdominal aorta blood was collected for blood gas analysis and inferior vena cava blood was collected for determination of the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Bronchoalveolar lavage fluid (BALF) was collected for measurement of concentrations of total protein (TP), total phospholipid (TPL), and desaturated phosphatidyl choline (DSPC). The ratio of wet/dry lung weight ratio (W/D) was measured, and malondialdehyde (MDA) and myeloperoxidase (MPO) in lung tissues were determined. The pathologic changes in their lungs were observed with light microscopy.Results Compared with those in blank control group, the levels of pH value, arterial oxygen partial pressure (PaO2), HCO3-, base excess (BE) were lowered, and partial pressure of carbon dioxide of arterial blood (PaCO2) was increased in model group. The serum concentrations of TNF-α and IL-6 were gradually increased after the reproduction of sepsis model. Compared with those in blank control group, the levels of TP, TPL, and DSPC/TPL in model group were decreased, while the levels of W/D, MDA and MPO were increased. Compared with those in model group, pH value was elevated in TFXF group at 3 hours (7.27±0.04 vs. 7.18±0.07,P < 0.05). PaO2 (mmHg, 1 mmHg = 0.133 kPa) was improved at 3, 6, 12 hours (3 hours: 128.00±16.05 vs. 106.78±10.73, 6 hours: 98.46±15.97 vs. 72.80±16.33, 12 hours: 90.70±9.31 vs. 74.28±12.19, allP < 0.05). The serum concentrations of TNF-α (ng/L) in TFXF group were significantly lower than those in model group at 12 hours (508.20±94.08 vs. 756.60±138.77,P < 0.05), and the serum concentrations of IL-6 (ng/L) in TFXF group were significantly lower than those in model group at 6 hours and 12 hours (6 hours: 687.80±35.00 vs. 849.40±148.28, 12 hours: 728.80±214.41 vs. 917.00±245.96, bothP < 0.05). Compared with those of model group, the levels of TP (g/L) in BALF in TFXF group were significantly decreased at 12 hours (1.01±0.23 vs. 1.60±0.47,P < 0.05), and the levels of TPL (mg/L) in TFXF group were significantly increased at 12 hours (86.40±11.33 vs. 62.40±16.33,P < 0.05). The levels of DSPC/TPL in TFXF group were significantly higher than those in model group at 6 hours and 12 hours (6 hours: 0.58±0.13 vs. 0.38±0.10, 12 hours: 0.45±0.13 vs. 0.24±0.07, bothP < 0.05). The levels of W/D in TFXF group were significantly higher than those in model group at 3 hours (3.84±0.25 vs. 2.99±0.50,P < 0.01), but lower than those in model group at 12 hours (3.21±0.53 vs. 4.89±1.14,P < 0.05). The levels of MDA (nmol/mg) in TFXF group were significantly lower than those in model group at 6 hours and 12 hours (6 hours: 4.04±2.58 vs. 8.89±2.61, 12 hours: 11.31±3.60 vs. 20.60±8.10, bothP < 0.05), while the levels of MPO (U/g) in TFXF group were lower than those in model group at 12 hours (4.79±0.66 vs. 7.22±1.76,P < 0.05). Compared with model group, the lungs in TFXF group showed less morphological changes under light microscopy, such as pulmonary edema, congestion, effusion and fibrosis.Conclusions The method of Tongfu Xiefei may improve hypoxemia and metabolic acidosis, alleviate lung edema and ameliorate pulmonary pathological changes in rat sepsis model. Tongfu Xiefei method shows a protective effect in sepsis by the way of reducing peroxidative damage, inhibiting the release of proinflammatory factors and abating degradation of lung surfactant.
3.Enzyme Used to Wash Medical Apparatus and Instruments: What Question Should Be Paid Attention
Jijiang SUO ; Liheng JIANG ; Hua WEI ; Yubin XING ; Yune YUAN
Chinese Journal of Nosocomiology 2006;0(09):-
OBJECTIVE To attend to the importance and issues of using the enzyme cleaner for the reprocessing of medical instrument. METHODS The principle, usage, precautions, and the selection of enzyme cleaner were analyzed. RESULTS The cleaning of the medical instrument must use the liquid enzyme detergent that has the following characters: clear solution, no or low foam, free rinsing, flexibilities to the water temperature, and no limitation to the water quality. CONCLUSIONS For successful cleaning of the medical instrument the use of the high-quality enzyme cleaner is required. A complete cleaning of the medical instrument is the first step to assure the quality of disinfection, sterilization, and the infection control.
4.Effect of chemokine CXCL12 and its receptor CXCR4 on proliferation,migration and invasion of epithelial ovarian cancer cells
Yu-Ping JIANG ; Xiao-Hua WU ; Han-Ying XING ; Xing-Yan DU ;
Chinese Journal of Obstetrics and Gynecology 2001;0(06):-
Objective To explore the effect of chemokine CXCL12 and its receptor CXCR4 on proliferation,migration and invasion of epithelial ovarian cancer cells.Methods CXCR4 and CXCL12 mRNA and protein expression of human ovarian cancer cell line CAOV3 was detected by RT-PCR and immunocytochemistry.Integrin ?1 and vascular endothelial growth factor-C(VEGF-C)mRNA expression were detected in CAOV3 cells stimulated by CXCL12.The CAOV3 cells were divided into 6 groups:control group(un-stimulated),experimental group 1(stimulated by 100 ng/ml CXCL12),experimental group 2 (stimulated by 10 ng/ml CXCL12),experimental group 3(100 ng/ml CXCL12 and 10 ?g/ml neutralizing CXCR4 antibody),experimental group 4(100 ng/ml CXCL12 and 1 ?g/ml CXCR4 antagonist AMD3100),experimental group 5(10 ?g/ml neutralizing CXCR4 antibody or ascites).Methyl thiazolyl tetrazolium(MTT)was used to analyze the effects of different concentrations of CXCL12 on CAOV3 cell proliferation.Transwell invasion chamber and reconstructed basement membrane(Matrigel)were used to evaluate effect of various concentrations of CXCL12 and ascites on CAOV3 cell migration and invasion. Results CAOV3 cells expressed CXCR4 mRNA(0.70?0.10)and protein,but did not express CXCL12 mRNA or protein.Immunostaining of CXCR4 was mainly located in cytoplasm.CXCR4 mRNA was up- regulated after 100 ng/ml CXCL12 stimulation(1.24?0.14;t=-7.1088,P=0.0021).Integrin ?1 mRNA was greatly increased at 3 hours by stimulation of 100 ng/ml CXCL12(before and after stimulation 0.53?0.10,1.53?0.16;P0.05).Experimental group 1 stimulated the migration and invasion of CAOV3 cells in chemotaxis assay compared with control group and experimental group 2(number of cell migration respectively 523.3?25.2,108.0?7.2,211.7 ?24.7,number of cell invasion respectively 39.3?4.0,4.0?1.0,15.7?3.1;P
5.Susceptibility-weighted imaging for the assessment of chronic renal injury
Zhenxing JIANG ; Zhaoyu XING ; Jie CHEN ; Jiule DING ; Yu WANG ; Shengnan YU ; Hua ZHOU ; Jia DI ; Wei XING
Chinese Journal of Radiology 2017;51(8):597-601
Objective To explore the value of susceptibility-weighted imaging (SWI) for the assessment of chronic renal injury. Methods Thirty-nine patients with clinical diagnosis of chronic renal injury (RI group) who underwent routine renal MRI and SWI examination were retrospectively analyzed. They were divided into mild injured group (15 cases) and moderate to severe injured group (24 cases) by estimated glomerular filtration rate (eGFR). At the same time, 17 volunteers without chronic renal injury who had normal serum creatinine (Scr) and blood urea nitrogen were recruited as control group. All subjects underwent routine renal MRI and SWI examination. The ratios of cortex to medulla were measured and calculated in both kidneys' magnitude image and susceptibility weighted image, which were indicated as C/MMAG and C/MSWI. Independent sample t test was used to compare the differences of C/MMAG and C/MSWI between control group and RI group, and paired sample t test was used to compare the differences betweenC/MMAG and C/MSWI in each group. One-way ANOVA was used to compare the difference of C/MMAG and C/MSWI between the control group and the different RI groups. ROC was employed to assess the diagnostic efficacy of C/MMAG and C/MSWI in renal injury. Pearson linear correlation analysis was used to evaluate the correlation between C/MMAG, C/MSWI and eGFR, Scr in patients with renal injury. Results The C/MMAG and C/MSWI in the RI group were 1.101±0.039 and 1.071±0.046, respectively. C/MSWI was obviously lower than C/MMAG, and the difference was statistically significant (t=5.056, P<0.01). There was no significant difference between C/MMAG and C/MSWI in the control group (P>0.05). The C/MMAG and C/MSWI in the RI group were obviously lower than those in the control group, and the difference was statistically significant (t=4.564, 6.122;P<0.01).The C/MMAG and C/MSWI in the mild injured group and the moderate to severe injured group were significantly lower than those in the control group, the difference was statistically significant (P<0.05). While the differences of those between mild injured group and moderate to severe injured group showed no statistical significance (P>0.05). The area under ROC of C/MMAG and C/MSWI in diagnosis of renal injury were 0.853 and 0.952, respectively. C/MMAG was positively correlated with eGFR (r=0.460,P<0.01). Conclusions Susceptibility-weighted imaging can be used to assess chronic renal injury. Although it cannot reflect the degree of renal function damage, it has some value in the early diagnosis of mild renal injury.
6.Changes of P_(300) and Mismatch Negativity in the Treatment of First Episode Depression
hui, SU ; kai-da, JIANG ; fei-ying, LOU ; xing-shi, CHEN ; jian-hua, LIANG
Journal of Shanghai Jiaotong University(Medical Science) 2006;0(04):-
Objective To study P300 of the first episode depression and mismatch negativity(MMN) changes after antidepressant treatment. Methods Sixty-four patients with first episode depression were evaluated by HAMD 17, and P300 and MMN tests were performed at the baseline and week 12. The cognitive potentials were compared with those of control group(N=36). Results Compared with the control group, depressive patients had longer latency of P300 and MMN,lower amplitude of P300 and MMN before treatment (P
7.Clinical Characteristics and Current Treatment Status in Patients With Chronic Heart Failure at Different Grade Hospitals in Xinjiang Area
Hua JIANG ; Hongwei ZHANG ; Xianhui ZHOU ; Yaodong LI ; Jianghua ZHANG ; Qiang XING ; Baopeng TANG
Chinese Circulation Journal 2015;(12):1186-1190
Objective: To observe the clinical characteristics and current treatment status in patients with chronic heart failure (CHF) at different grade hospitals in Xinjiang Area.
Methods: A total of 5357 patients with CHF diagnosis discharged from 20 different grade hospitals in Xinjiang area from 2011-01 to 2012-02 were enrolled. The age, gender, nationality, etiology of CHF, cardiac function, complications and current medication status in all patients were systemically studied.
Results:①There were 2295/5357 (42.8%) patients with Han nationality, 2255 (42.1%) with Uyghur nationality and 8.07 (15.1%) with other nationalities. The average age of patients was at (64.60 ± 12.77) years.②The etiology of CHF were, in turn, as: coronary artery disease (CAD) 50.8%, hypertension (31.8%), dilated cardiomyopathy (7.2%).③ The ratios of patients with NYHA III-IV in county hospital 440/682 (64.5%), in regional hospital 1180/1557 (75.8%) were higher than that that in grade A class 3 hospital 967/3118 (31.0%), ( =1390.362,P=0.000).④The patients in county hospital, regional hospital showed increased left atrial diameter (44.7 ± 8.8) mm, (39.5 ± 8.1) mm and left ventricular end-diastolic diameter (60.6 ± 11.1) mm, (56.9 ± 11.1) mm than those in grade A class 3 hospital (37.3 ± 7.1) mm and (53.8 ± 9.7) mm; while decreased LVEF (41.9 ± 10.5) %, (42.3 ± 13.0) % than that in grade A class 3 hospital (46.5 ± 12.8), allP<0.001.⑤The medication status in different grade hospitals as ACEI/ARB, β-blocker, aldosterone antagonist, diuretics, digitalis were at 72.8%, 66.8%, 46.6% , 45.5% and 26.8% respectively. The application of ACEI/ARB and β-blocker in county hospital (61.4% and 51.5%) and in regional hospital (72.3% and 58.3%) were lower than those in grade A class 3 hospital (75.6% and 74.3%); while the application of aldosterone antagonist in county hospitals (57.9%) and in regional hospital (73.8%) were higher than that in grade A class 3 hospital (30.6%), allP<0.001.
Conclusion: The etiology of CHF were mainly as CAD and hypertension in Xinjiang area, the patients in county and regional hospitals had more severe conditions than that in grade A class 3 hospital, which implying the distance between the guideline standard and real practice especially in basic level hospitals.
8.Statin in the treatment of ALI/ARDS: a systematic review and Meta-analysis basedon international databases
Mingqi CHEN ; Jun LU ; Qiuhua CHEN ; Lu CHENG ; Yanxia GENG ; Hua JIANG ; Xing WANG
Chinese Critical Care Medicine 2017;29(1):51-56
Objective To confirm the effects of statin therapy on mortality of patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Methods PubMed/Medline, Embase, Web of Science andCochrane Central Register of Controlled Trials were searched for articles using the terms acute lung injury, ALI,acute respiratory distress syndrome, ARDS, statin, simvastatin and rosuvastatin updated to November 17,2015. Randomized controlled trial (RCT) or observational cohort studies investigating the effects of statin therapy onmortality in patients with ALI or ARDS were all identified, without date or language restriction. The control group wasgiven conventional treatment, while the experimental group was treated with statins additionally. The primary outcomewas in-hospital mortality. Meanwhile, ventilator-free day, intensive care unit (ICU)-free day, ICU length of stay (LOS)and ICU mortality were also analyzed. RevMan 5.2 and STATA 13 software were used for systematic review and Metaanalysis, and funnel plot was used to analyze the publication bias. Results A total of five trials including threerandomized controlled trials and two observational studies were included. Among 1636 patients enrolled in the study,there were 739 patients in experimental group, and 897 in control group. It was shown by Meta analysis that there was nosignificant difference in in-hospital mortality between experimental group and control group [relative risk (RR) = 0.96,95% confidence interval (95%CI) = 0.79-1.15, P = 0.63]. The subgroup analysis based on RCT and cohort study, or thesubgroup analysis of different statins showed that there was no significant difference in in-hospital mortality betweenthe experimental group and the control group (both P > 0.05). There were no significant differences in ventilator-freedays [mean difference (MD) = 1.41, 95%CI = -0.32-3.13, P = 0.11], ICU-free days (MD = -0.23, 95%CI = -1.61-1.15,P = 0.75), ICU length of stay (MD = -1.03, 95%CI = -6.55-4.50, P = 0.72), or ICU mortality (RR = 0.88, 95%CI =0.68-1.14, P = 0.33) between the experimental group and the control group. It was shown by funnel plot that there was nopublication bias in in-hospital mortality. Conclusion The systematic review and meta-analysis suggests that statin may not be associated with a significant reduction in mortality, ventilator-free day, ICU-free day and ICU length of stayin patients with ALI/ARDS.
9.The value of A-waves in diagnosis of Guillain-Barr? Syndrome
Jin-Hua ZHANG ; Chao-Yan ZHOU ; Hong JIANG ; Jin WANG ; Xing-Yue HU ;
Chinese Journal of Physical Medicine and Rehabilitation 2003;0(07):-
0.05).However,A-waves were recorded in 7 patients who were with normal F-waves.Conclusion The occur- rence of A-waves,especially of multiple type,in the ulnar and median nerves might be helpful for the early diagnosis of Guillain-Barr?Syndrome.
10.Combination chemotherapy with etoposide and cisplatin for high-risk,chemorefractory and recurrent gestational trophoblastic neoplasia
Jie JIANG ; Fang-Fang NAN ; Xing-Sheng YANG ; You-Zhong ZHANG ; Bo WANG ; Bei-Hua KONG ;
Chinese Journal of Obstetrics and Gynecology 2000;0(09):-
Objective To evaluate the feasibility and effectiveness of combination chemotherapy with etoposide and cisplatin(EP)regimen on the patients with high-risk,chemorefractory and recurrent gestational trophoblastic neoplasia(GTN).Methods Thirty-nine patients with gestational trophoblastic tumors were analyzed retrospectively,25 of 39 patients were of high-risk,9 patients were chemorefractory and 5 patients were recurrent.All 39 patients were administrated with EP regimen,and 10 patients were assisted with surgery.All the patients were followed up.Clinical response,toxicity,the occurrence of secondary tumors of all patients,and the fertility of 30 patients whose fertility function was preserved were investigated. Results Thirty-nine GTN patients underwent a total of 221 cycles of the EP regimen.The average number of courses for each patient was 5.7.The total complete remission rate of the regimen was 74%(29/39). Twenty-five patients with high-risk GTN received a total of 139 cycles and the average number of courses was 5.6.Nineteen patients achieved complete remission and 6 patients showed drug-resistant.The complete remission rate of the high-risk group was 76%(19/25).Nine patients with chemorefractory GTN obtained a total of 55 cycles and the average number of courses was 6.1.Six patients achieved complete remission and 3 patients showed drug-resistant again.The complete remission rate of the chemorefractory group was 6/9. Five patients with recurrent GTN received 27 cycles and the average number of courses was 5.4.Four patients achieved complete remission,1 patient showed drug-resistance and died.Bone marrow toxicity, gastrointestinal reaction and alopecia were the main side effects of the EP regimen,but the bone marrow toxicity was slight and no grade Ⅳ side effect occurred.No fatal effect was found.Eight of 30 patients whose fertility faction was preserved had become pregnant after recovery,with a total of 8 pregnancies.Among them,2 were terminated by induced abortion,and 6 underwent normal term delivery and gained 6 infants who had no congenital malformation.All the 6 children had normal growth and development after childbirth. None of the women developed secondary tumors.Conclusion The EP regimen is effective and safe for the treatment of high-risk,chemorefractory and recurrent GTN.