1.Ghrelin, adiponectin, leptin and true insulin levels in human milk from mothers with gestational diabetes mellitus and its relationship with infant growth
Xiujing SUN ; Xinting YU ; Ming LI ; Danhua WANG
Chinese Journal of Perinatal Medicine 2015;(4):258-262
Objective To evaluate the levels of ghrelin, adiponectin, leptin and true insulin in human milk from mothers with and without gestational diabetes mellitus (GDM), and to assess the effects of these parameters on infant growth. Methods Fifty-two GDM mothers and their healthy infants (GDM group) and 49 non-GDM mothers and their healthy infants (control group) were enrolled from Beijing Obstetrics and Gynecology Hospital and Peking Union Medical College Hospital from January 2010 to August 2010. The levels of ghrelin, adiponectin, leptin and true insulin in colostrum and human milk 90 days postpartum (mature milk) were determined by enzyme-linked immunosorbent assay. Infant weight, length and head circumference at birth and at 90 days old were measured. The two-sample t-test, sum-rank test and Spearman correlation analysis were used for statistical analysis. Results Compared with the control group, ghrelin was significantly lower in human milk from GDM mothers both in colostrum [136.7 (102.7-181.4) vs 175.4 (137.5-235.0) ng/L, t= -2.737] and mature milk [111.8 (77.5-184.2) vs 210.9 (147.3-381.9) ng/L, t= -3.268]. Adiponectin was also significantly lower in human milk from GDM mothers both in colostrum [21.7 (14.6-51.8) vs 57.0 (23.1-113.9)μg/L, t=-2.858] and mature milk [11.7 (8.4-14.4) vs 15.1 (11.9-18.5)μg/L, t=-2.625], however, true insulin level was higher in colostrum [22.8 (13.4-50.2) vs 20.4 (7.8-30.8) mU/L, t=-2.007] and mature milk [33.6 (22.5-54.1) vs 23.5 (13.5-31.6) mU/L, t=-2.009]. The differences were statistically significant (all P < 0.05). (2) In the colostrums of the GDM group, true insulin level was negatively associated with ghrelin (r=-0.342), but positively associated with adiponectin (r=0.305). In the control group, the level of true insulin in mature milk was positive associated with leptin in colostrums( r=0.456)and mature milk(r=0.629). The differences were statistically significant (all P < 0.05). (3) In the GDM group, adiponectin level in colostrum was negatively associated with neonatal birth weight (r= - 0.323, P=0.025); the leptin/adiponectin ratio was negatively associated with neonatal birth weight (r= -0.403, P=0.005) and head circumference (r= -0.327, P=0.039) at birth. Adiponectin level in mature milk was negatively associated with infant length 90 days postpartum (r=-0.406, P=0.040). In the control group, the leptin/adiponectin ratio in colostrum was negatively associated with neonatal head circumference at birth (r= -0.370, P=0.024). Adiponectin level in mature milk was positively associated with infant weight 90 days postpartum (r=0.432, P=0.007). Conclusion Women with GDM have different levels of ghrelin, adiponectin and true insulin in their milk from the normal controls, which may affect infant growth.
2.Correlation factor analysis on constipation in long-term ventilated patients in intensive care unit: a prospective observational cohort study
Mingying DAI ; Huimin WANG ; Kun LI ; Bangxu YU ; Xinting PAN
Chinese Critical Care Medicine 2017;29(1):75-80
Objective To explore the factors associated with delayed defecation in long-term ventilated patients in intensivecare unit (ICU) and their potential effect on prognosis.Methods A prospective observational cohort study was conducted. The patients admitted to general ICU of the Affiliated Hospital of Qingdao University from October 1st in 2013 to September 30th in 2015 who underwent mechanical ventilation (MV) for ≥6 days were enrolled, and they were divided into early defecation group (< 6 days) and late defecation group (≥6 days). At admission, clinical nutritional support were given as usual, and gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, admission reasons, MV reasons, the usage of morphine and epinephrine/norepinephrine, the highest positive end-expiratory pressure (PEEP), the lowest oxygenation index (PaO2/FiO2) and the lowest systolic blood pressure were collected. Logistic regression analysis was used to analyze the influencing factors of the first defecation time. ICU mortality, the length of ICU stay, central venous catheter (CVC) indwelling time, duration of MV, ICU acquired bacterial infection rate, and the incidence of ventilator associated pneumonia (VAP) were compared between early defecation group and late defecation group. Logisticorgan dysfunction system (LOD) scores and gastric residual volume per day were recorded at the different time of MV.Results Totally 189 patients were enrolled, 39 patients did not satisfied the inclusion criteria and 13 patients gave up treatment or referrals were excluded. Finally 137 patients were enrolled in the analysis, 83 patients in late defecation group and 54 in early defecation group. There were no significant differences in the baseline characteristics such as gender, age, APACHE Ⅱ score, LOD score at 1 day of MV, admission reasons, MV reasons, disgorging and gastric residual volume per day during the first 5 days of MV, enteral nutrition, lactulose treatment in patients with hepatic encephalopathy during the first 5 days of MV, and blood purification treatment between the two groups (allP > 0.05). Compared with the early defecation group, late defecation group had less patients with loose stools or watery stool at first time [15.7% (13/83) vs. 33.3% (18/54)], more patients using morphine and the usage of epinephrine/norepinephrine more than 24 hours [48.2% (40/83) vs. 40.7% (22/54), 42.2%(35/83) vs. 29.6% (16/54)], higher the maximum PEEP level [cmH2O (1 cmH2O = 0.098 kPa): 7.9±3.7 vs. 6.7±3.5], lower the minimal systolic blood pressure [mmHg (1 mmHg = 0.133 kPa): 74.8±28.1 vs. 88.9±30.2] and more severe of hypoxemia [PaO2/FiO2 < 150 mmHg, 54.2% (5/83) vs. 44.4% (24/53)], all of which had significant differences (allP < 0.05). Factors found statistical significances by single factor analysis were enrolled in the multiple regression analysis, which showed that PaO2/FiO2 < 150 mmHg and systolic blood pressure < 90 mmHg were independently associated with a delay in defecation in patients undergoing long-term MV [PaO2/FiO2 < 150 mmHg: adjusted hazard rate: 1.415, 95% confidence interval (95%CI) = 1.061-1.590,P = 0.026; systolic blood pressure 70-89 mmHg:HR = 1.461, 95%CI = 1.164-1.788, P = 0.002; systolic blood pressure ≤ 69 mmHg: adjusted hazard rate= 1.273, 95%CI = 1.010-1.587,P = 0.034). ICU mortality, the length of ICU stay, CVC indwelling time, duration of MV, ICU acquired bacterial infection rate, and the incidence of VAP at 7 days of MV in late defecation group were significantly higher than those of early defecation group [ICU mortality rate: 15.7% (13/83) vs. 7.4% (4/54), the length of ICU stay (day): 17.0 (14.0, 23.0) vs. 15.0 (13.8, 20.0), CVC indwelling time (days): 12.0 (10.0, 14.0) vs. 10.0 (9.0, 11.3), duration of MV (days): 14.0 (10.0, 20.0) vs. 11.0 (9.8, 15.3), ICU acquired bacterial infections rate: 60.2% (50/83) vs. 14.8% (8/54), the incidence of VAP: 32.5% (27/83) vs. 14.8% (8/54); allP < 0.05]. There was no significant difference in LOD score between both groups. The LOD scores at 4 days and 9 days of MV in late defecation group were significantly higher than those of early defecation group (6.41±4.37 vs. 5.21±3.12, 4.33±2.20 vs. 3.50±2.90, bothP < 0.01).Conclusions PaO2/FiO2 < 150 mmHg and systolic blood pressure < 90 mmHg during the first 5 days of MV were independently associated with a delay in defecation in patients undergoing long-term MV. The results suggest that constipation is associated with adverse outcomes in long-term ventilated patients.
3.A study on prolonging survival time of rats following 90% hepatectomy
Yilei MAO ; Zhuo YU ; Xinting SANG ; Xin LU ; Shouxian ZHONG
Chinese Journal of General Surgery 1994;0(05):-
Objective To observe the effects of atorvastatin and cytokine signaling inhibitor AG490 on the residual liver function and the survival time of 90% hepatectomy rats. Methods Rats were divided randomly into three groups after surgery: control group without treatment; Ato group administrated with atorvastatin (20 mg?kg -1?d -1) through NG tube one day before and three days after the surgery and AG490 group, intraperitoneally given AG490 (1 mg?kg -1?12h -1) beginning intraoperatively for 4 times. The health status and liver regeneration were observed and recorded. Results All rats in control group died within 24 hours. Both atorvastatin and AG490 significantly prolonged the survival time of rats after surgery (25.6 h & 30.6 h vs. 10.7 h,P
4.Recombinant human erythropoietin combined with bone marrow mesenchymal stem cell transplantation for myocardial damage in sepsis rats
Jinlong TENG ; Dan LI ; Haichu YU ; Shanglang CAI ; Xinting PAN
Chinese Journal of Tissue Engineering Research 2014;(28):4530-4534
BACKGROUND:Erythropoietin and bone marrow mesenchymal stem cells have been shown to affect myocardial apoptosis. However, few studies concerned their combined application to sepsis-related myocardial injury. OBJECTIVE:To observe the effects of the combination of erythropoietin and bone marrow mesenchymal stem cells on pathology and apoptosis of sepsis rat cardiomyocytes. METHODS:A total of 50 Sprague-Dawley rats were randomly selected and assigned to five groups (n=10). Sepsis models were established by cecal ligation perforation method. Rat models in the bone marrow mesenchymal stem cellgroup, erythropoietin group and erythropoietin+bone marrow mesenchymal stem cellgroup were respectively treated with bone marrow mesenchymal stem cells, erythropoietin and erythropoietin+bone marrow mesenchymal stem cells immediately after model induction via intraperitoneal injection or caudal vein. Model group received cecum ligation and puncture. Control group did not undergo any treatment after the abdomen was opened. Model and control groups were infused with an equal volume of physiological saline via caudal vein. At 24 hours, experimental animals were sacrificed by anesthesia. Myocardial specimens were col ected. Myocardial appearance was observed using hematoxylin-eosin staining. Bax, Caspase-3 and Bcl-2 were tested by western blot assay. RESULTS AND CONCLUSION:Hematoxylin-eosin staining:cardiomyocytes were regularly arranged, showing integrated structure in the control group. Extensive myocardial fiber breakage, disordered arrangement, cardiomyocyte swel ing or shrinkage, and vacuolar degeneration were observed in the model group. Moreover, myocardial interstitial vascular congestion, edema, and inflammatory cellinfiltration were visible. Myocardial tissue was similar between erythropoietin and bone marrow mesenchymal stem cellgroups, with the presence of mild inflammatory cellinfiltration and scattered normal cardiomyocytes. In the erythropoietin+bone marrow mesenchymal stem cellgroup, cardiomyocytes were slightly damaged. Interstitial vascular congestion was not apparent, and a few inflammatory cells infiltrated. Western blot assay results demonstrated that Bcl-2 protein expression was significantly higher (P<0.01), but Bax and Caspase-3 protein expression was lower (P<0.05) in the erythropoietin+bone marrow mesenchymal stem cellgroup than in the erythropoietin, model and control groups. The combination of erythropoietin and bone marrow mesenchymal stem cells in treatment of sepsis-related myocardial injury could lessen myocardial pathological changes, and inhibit cardiomyocyte apoptosis. The mechanisms maybe exert by upregulating anti-apoptotic protein expression and downregulating apoptotic protein expression.
5.A clinical evaluation of CRRT coupled with ultrasound-guided percutaneous transhepatic gallbladder drainage for the treatment of severe acute biliary pancreatitis
Qingyun ZHU ; Yunbo SUN ; Xinting PAN ; Hongqiao WANG ; Zhengbin WANG ; Ning YU ; Liandi LI ; Bangxu YU ; Kun LI ; Na SUI
Chinese Journal of Emergency Medicine 2017;26(6):669-673
Objective To investigate the value of continuous renal replacement therapy (CRRT) coupled with minimally invasive ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) for the treatment of severe acute biliary pancreatitis.Methods Hospitalized patients with severe acute biliary pancreatitis were recruited from the intensive care unit (ICU) of the Mfiliated Hospital of Qingdao University from June 2010 to June 2015,and divided into conventional CRRT alone group (n =30) and CRRT + PTGD group (n =30).Comparisons of postoperatively symptoms (time required for abdominal pain relief,time consumed for,gastrointestinal decompression),laboratory findings (WBC,PLT,PCT,CRP,AMS,TBIL,ALT,ALB,Lac) and acute physiology and chronic health evaluation score (APACHE Ⅱ,Balthazar CT,MODS) were carried out between two groups.The occurrence of complications (ARDS,abdominal infection,bile leakage,abdominal hemorrhage,intestinal injury,catheter translocation,catheter dislocation) was observed.The differences in duration of ventilator support,the length of stay in ICU,and fatality rate were compared between the two groups.Results Compared with the conventional CRRT alone group,the postoperative symptoms were significantly relieved,and time required for abdominal pain relief and time consumed for gastrointestinal decompression were evidently shortened in the CRRT + PTGD group (P < 0.05).There were statistically significant differences in laboratory findings (WBC,PLT,PCT,CRP,AMS,TBIL,ALT) between two groups (P < 0.05).The differences in APACHE Ⅱ,Balthazar CT and MODS score between the two groups also presented statistical significance (P < 0.05).The comparisons of the duration of ventilator support [(6.1 ± 1.3) d vs.(9.5 ± 1.4) d] andthe length of stay [(15.7 ± 1.1) dvs.(21.1 ± 2.5) d] between thetwo groups revealed statistical significance (P < 0.05).Conclusions CRRT coupled with PTGD for the treatment of severe acute biliary pancreatitis can effectively eliminate the inflammatory mediators and toxins from patients.On this basis,the coupled therapy with gallbladder puncture and drainage is capable of decompressing the biliary tract,improving liver function,effectively relieving clinical symptoms,minimizing the changes of laboratory findings an,d APACHE Ⅱ score,and thereby optimizing the prognosis of patients.
6.The value of the enzyme-linked immunospot assay detecting spot forming cells in the diagnosis of latent tuberculosis infection
Fei LIU ; Zongde ZHANG ; Fengjiao DU ; Xinting YANG ; Xi CHEN ; Yang LIU ; Hongyan JIA ; Shuxiang GU ; Yu MA
Chinese Journal of Laboratory Medicine 2009;32(8):900-904
stinguish active tuberculosis and healthy cases with tuberculosis exposure history according SFC count.
7.Expression and clinical implications of hMSH2 gene in sporadic insnlinomns
Mei MEI ; Yuanjia CHEN ; Chongmei LU ; Liming ZHU ; Haiyan WU ; Xin LU ; Xinting SANG ; Zhiying YANG ; Miao YU ; Hongding XIANG ; Fie CHEN
Chinese Journal of Pancreatology 2009;9(1):5-8
Objective To investigate the role of hMSH2 in the pathogenesis of sporadic insulinomas and to determine whether the expression of hMSH2 could be used to differentiate benign sporadic insulinomas from malignant ones. Methods Fifty-five sporadic insulinomas (40 benign and 15 malignant tumors) resected from 50 patients were obtained. Expression of hMSH2 was detected by immunohistochemistry staining. DNA was obtained from micradissected tissue. Loss of heterozygnsity (LOH) of hMSH2 gene was detected by PCR-LOH. 6 microsatellite markers were selected on 3 chromosomes, and microsatellite instability (MSI) status of tumor tissue were detected by PCR. The findings were analyzed in relation to the clinicopathological characteristics. Results Down-regulation of hMSH2 expression was found in 13% of 55 sporadic insulinomas. LOH of the hMSH2 gene was not present in 55 insulinomas. High frequency MSI (MSI-H, MSI occurred in at least 2 out of 6 sites) was present in 36% (20/55) of all the insulinomas. Down-regulation of hMSH2 expression was found in 33% of the 15 malignant tumors, while it was 5% in benign tumors (P < 0. 05). Conclusions Down-regulation of mismatch repair gene hMSH2 may be correlated with the degree of tumor malignancy. The expression of hMSH2 could be used as a potential marker for distinguishing benign insulinoma from malignant ones.
8.Assay of adiponectin, leptin, true insulin and ghrelin levels in preterm human milk, and its relationship with infants growth.
Luyan HAN ; Ming LI ; Xinting YU ; Xiujing SUN ; Danhua WANG
Chinese Journal of Pediatrics 2014;52(7):510-515
OBJECTIVETo understand adiponectin, leptin, insulin and ghrelin levels in preterm colostrum and mature milk and their influence on the growth and development of the premature infant.
METHODThe study subjects were divided into two groups: preterm group and control group. Specimens of colostrum and mature milk on 42nd day after delivery were collected, the general situation of maternal and infants growth parameters at birth and at postnatal 42 days were recorded. Leptin, adiponectin, insulin and ghrelin levels in colustrum and mature milk were determined and compared.
RESULTA total of 128 mother-infant pairs were involved. There were 128 specimens of colostrums (80 from preterm group, 48 from control group) and 94 specimens of mature milk(50 from premature group, 44 from control group). The levels of colostrum, mature milk adiponectin, leptin, and insulin were not significantly different between the 2 groups; ghrelin levels in colostrum and mature milk of premature group were significantly lower than those in control group (P = 0.038), adiponectin and leptin levels in colostrum were higher than those of the mature milk (P < 0.05), colostrum ghrelin levels were lower than those of mature milk (P < 0.05). Adiponectin, leptin, and ghrelin showed no significant difference between different gestational age groups ( ≤ 34 weeks group vs. > 34 weeks group). True insulin level of mature milk in 34 weeks group was higher than that of > 34 weeks group (29.3 vs. 21.6 mU/L, P = 0.045); true insulin level in colostrums in ≤ 34 weeks group was lower than that in mature milk (21.7 vs. 29.3 mU/L, P = 0.000). Adiponectin levels in colostrum and 42 days weight gain were negatively correlated (r = -0.362, P = 0.025) . Insulin level in mature milk had a negative correlation with birth weight (r = -0.319, P = 0.029) . Ghrelin levels in colostrum and birth weight, length, head circumference, head circumference on 42(nd) day were positively correlated (r = 0.271,0.261,0.360, P < 0.05); weight, length at 42(nd) day and ghrelin levels showed borderline positive correlation (P = 0.050, 0.058).
CONCLUSIONMany bioactive hormones in milk might participate in the regulation of suitable growth after birth. Premature birth affects hormone levels in breast milk. Breast feeding is very important in preterm infants.
Adiponectin ; analysis ; Birth Weight ; physiology ; Breast Feeding ; Colostrum ; chemistry ; Female ; Gestational Age ; Ghrelin ; analysis ; Humans ; Infant ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Infant, Premature ; growth & development ; Insulin ; analysis ; Leptin ; analysis ; Male ; Milk, Human ; chemistry ; Weight Gain ; physiology
9. The relationship between mental stimulation level of life events and suicide attempt of rural residents in Shandong Province
Baopeng LIU ; Xinting WANG ; Jie ZHANG ; Jie CHU ; Yanfei PAN ; Pengpeng YU ; Yanxin WEI ; Cunxian JIA
Chinese Journal of Preventive Medicine 2019;53(9):896-899
Objective:
To explore the relationship between the level of mental stimulation and the suicide attempts of rural residents in Shandong Province.
Methods:
A 1:1 matched case-control study was designed to collect 1 200 cases from a survey of three suicide attempts in rural areas of Shandong Province. Controls were selected according to the following matched factors: age difference within 3 years, same gender, same village or neighboring village, no blood relationship, no suicide history. The basic characteristics of all subjects were collected through the questionnaire, and the level of mental stimulation of life events was measured. Multivariate conditional logistic regression model was used to analyze the relationship between the level of mental stimulation of life events and suicide attempts.
Results:
The mean age of the case group and the control group was both (36.6±0.3) years old, and 35.8% (430/1 200) were males in each group. The low-medium level of mental stimulation of negative life events in the case group was 16.7% (200/1 200) and 61.7% (740/1 200), respectively, which was higher than that in the control group, about 2.5% (30/1 200) and 29.3% (352/1 200) (all
10.Cryomaze ablation in treatment of elderly patients with mitral valve diseases combined with persistent or long-term persistent atrial fibrillation: A propensity-score matching study
Xinting CHEN ; Huishan WANG ; Jinsong HAN ; Zongtao YIN ; Yingjie ZHANG ; Yu LUO ; Hanqing LIANG ; Zhipeng GUO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(06):748-754
Objective To evaluate the safety and efficacy of mitral valve surgery and cryoablation in elderly patients with mitral valve disease and persistent or long-term persistent atrial fibrillation. Methods From May 2014 to July 2018, 144 patients with mitral valve diseases combined with persistent or long-term persistent atrial fibrillation in the Department of Cardiothoracic Surgery, General Hospital of Northern Theater Command were selected. Among them, there were 69 patients in a non-elderly group (<60 years) including 18 males and 51 females aged 52.07±5.56 years, and 75 patients in an elderly group (≥60 years) including 32 males and 43 females aged 65.23±4.29 years. A propensity-score matching (PSM) study was conducted to eliminate confounding factors. Both groups underwent mitral valve surgery and cryoablation at the same time. A 2-year follow-up was conducted after discharge from the hospital, and the perioperative and postoperative efficacy indexes were compared between the two groups. Results After PSM analysis, there were 56 patients in each group. The sinus rhythm conversion rate of the two groups at each follow-up time point was above 85%, and the cardiac function was graded asⅠorⅡ, which was significantly improved compared with that before the surgery, but there was no statistical difference between the two groups (P>0.05). Among the perioperative indicators of the two groups, the elderly group had more coronary artery bypass graft surgeries and longer postoperative ICU stay time compared with the non-elderly group (P<0.05), and the differences in other indicators were not statistically different (P>0.05). Conclusion The mitral valve surgery and cryoablation in elderly patients with mitral valve diseases combined with persistent or long-term persistent atrial fibrillation are safe, and the short-term outcome is satisfactory.