1.Sequential invasive-noninvasive mechanical ventilation weaning strategy for patients after tracheostomy
Xue-Xue PU ; Jiong WANG ; Xue-Bo YAN ; Xue-Qin JIANG
World Journal of Emergency Medicine 2015;6(3):196-200
BACKGROUND: Because the continuity and integrity of the trachea are likely damaged to some extent after tracheostomy, the implementation of sequential ventilation has certain difficulties, and sequential invasive-noninvasive ventilation on patients after tracheostomy is less common in practice. The present study aimed to investigate the feasibility of invasive-noninvasive sequential weaning strategy in patients after tracheostomy. METHODS: Fifty patients including 24 patients with withdrawal of mechanical ventilation (conventional group) and 26 patients with sequential invasive-noninvasive weaning by directly plugging of tracheostomy (sequential group) were analyzed retrospectively after appearance of pulmonary infection control (PIC) window. The analysis of arterial blood gases, ventilator-associated pneumonia (VAP) incidence, the total duration of mechanical ventilation, the success rate of weaning and total cost of hospitalization were compared between the two groups. RESULTS: Arterial blood gas analysis showed that the sequential weaning group was better than the conventional weaning group 1 and 24 hours after invasive ventilation. The VAP incidence was lowered, the duration of mechanical ventilation shortened, the success rate of weaning increased, and the total cost of hospitalization decreased. CONCLUSION: Sequential invasive-noninvasive ventilator weaning is feasible in patients after tracheostomy.
2.Phytoestrogens in application prospect of treatment of myocardial ischemia/reperfusion injury.
Guang LI ; Xiao-yan XING ; Mei-shuang ZHANG ; Jin-jin SHI ; Xue-hong DENG ; Gui-bo SUN ; Xiao-bo SUN
China Journal of Chinese Materia Medica 2015;40(16):3132-3136
Reperfusion is the most effective treatment for acute myocardial infarction, markedly reducing mortality and morbidity. Reperfusion however induces necrotic and apoptotic damages to cardiomyocytes, that were viable prior to reperfusion, a process called myocardial ischemia/reperfusion injury(MI/RI). Over the past 30 years, hundreds of experimental interventions (both pharmacologic and nonpharmacologic) have been reported to protect the ischemic myocardium in experimental animals; however, with the exception of early reperfusion, none has been translated into clinical practice. The population-based survey assessed men have about twice the total incidence of morbidity and mortality of women, and the sex gap in morbidity tends to diminish after age 45 years. So hormone replacement therapy (HRT) is given to treat the MI/RI, and lots of studies shows that the side effect is greater for estrogen, compared with phyestrogen. In this article, we review the important pathogenesis of myocardial ischemia reperfusion injury, the prevention and limitations of HRT. And we highlight the mechanism of phyestrogens treatment the MI/RI in experiment. The aim is to provide the theoretically new way of develop the safe and effective products for the researchers.
Animals
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Humans
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Myocardial Ischemia
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drug therapy
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Myocardial Reperfusion Injury
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drug therapy
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Phytoestrogens
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administration & dosage
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Plant Extracts
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administration & dosage
3.Tiamcinolone acetonide and indocyanine green-assisted vitrectomy combined with inner limiting membrane peeling for idiopathic macular hole
Bo, JIN ; Xue-min, JIN ; Hai-yan, ZHU ; Peng-yi, ZHOU ; Xian-guo, ZENG
Chinese Journal of Experimental Ophthalmology 2012;30(3):239-241
BackgroundWhether the peeling of the inner limiting membrane (ILMP) increase the closure rate of idiopathic macular hole is still in controversy.Some ophthalmologist recommend vitrectomy combined with inner limiting membrane peeling for the treatment of idiopathic macular hole.However,the removal of ILMP is difficult because of its similar appearance to adjacent tissues.Objective This study was to investigate the efficacy of triamcinolone acetonide(TA) and indocyanine green(ICG) double staining-assisted vitrectomy combined with ILM peeling during the surgery.Methods A consecutive case- observational study was designed.The standardized vitrectomy was performed in 25 eye of 23 cases with IMH.During the vitrectomy,TA and ICG were injected into posterior pole vitreous to visualize and assist the ILM peeling.The dying effectiveness was observed,and the closure rate of macular hole,visual acuity,intraocular pressure and complications were evaluated after surgery.Written informed consent was obtained from each patient prior to operation.Results Posterior vitreous cortex and ILM were visible and the residual vitreous and cortex were removed clearly after dying of TA and ICG in all the 25 eyes.During the following-up duration of 3-8 months,the completely anatomical reattachment of the macular area was in 22 eyes ( 88.0% ) and partially reattachment in 3 eyes( 12.0% ).The best corrected vision was 0.07-0.60 in all of the operated eyes 2 months after surgery.Conclusions TA and ICG- assisted vitrectomy combined with ILM peeling appears to be a safe and effective method for IMH repair.
4.Development of liquid bandage used for emergency care of war wound
Yingchun XUE ; Yawei WANG ; Bo YANG ; Jing LIU ; Mei LIU ; Yi LU ; Jing DUAN ; Yan QIU
Chinese Medical Equipment Journal 2017;38(5):14-17,28
Objective To develop a liquid bandage for self aid of war wound.Methods Solution A and B were prepared containing functional polymers derived from the biocompatible poly (ethylene glycol) and hyaluronic acid,which had ability of fast crosslinking reaction when they were mixed.Among them,A solution mainly comprised of mercapto group-containing hyaluronic acid derivative (HA-SH),water-solubility starch,propylene glycol,benzoic acid and etc.B solution contained pentaerythritol tetraacrylate derivative (4arm-PEG-Acrylate) and benzoic acid.The structure of mercapto group-containing hyaluronic acid derivative was confirmed by IR,1H-NMR and etc.HA-SH and 4arm-PEG-Acrylate were formulated to different concentrations (W/V) in different buffers.The two kinds of solution were mixed in different ratios,and in situ crosslinking hyaluronic acid hydrogel was obtained;the crosslinking time was recorded.The adhesive force and waterholding capacity of the hydrogel after crosslinking were measured by adding excipients such as water-solubility starch.Results In case the concentration of HA-SH and 4arm-PEG-Acrylate was 2% and pH value was 11,the hydrogel film on wound skin would be quickly formed in 20 seconds for wound dressing after spraying A and B solution onto the wound skin.Conclusion The liquid bandage has strong adhesive force,high water-holding capacity and controllable crosslinking time,so it could be used as a novel wound dressing for war wound.
5.Relationship between DJ-1 and diabetes mellitus-caused influence on cardioprotection induced by ischemic postconditioning in rats
Min LIU ; Zhongyuan XIA ; Bo ZHAO ; Yang WU ; Rui XUE ; Yan LENG
Chinese Journal of Anesthesiology 2015;(5):539-542
Objective To evaluate the relationship between DJ?1 and diabetes mellitus ( DM )?caused influence on cardioprotection induced by ischemic postconditioning in rats. Methods Adult male Sprague?Dawley rats, aged 3 months, weighing 220-250 g, were used in the study. DM was induced by intraperitoneal injection of 1% streptozotocin 60 mg∕kg and confirmed by blood glucose≥16.7 mmol∕L. Forty?eight rats with DM were randomly divided into 3 groups ( n=16 each) using a random number table:sham operation group ( group DM?S ) , myocardial ischemia?reperfusion ( I∕R ) group ( DM?IR ) and ischemic postconditioning group (DM?IPO group). Another 48 normal rats received the equal volume of citrate buffer solution instead and served as control. Those rats were randomly divided into 3 groups ( n=16 each) using a random number table: sham operation group ( S group) , myocardial I∕R group ( IR group) and ischemic postconditioning group (IPO group). At 12 weeks after streptozotocin injection, myocardial I∕R was produced by 30 min occlusion of the left anterior descending branch of the coronary artery followed by 120 min reperfusion. Ischemic postconditioning was induced by 3 cycles of 10 s reperfusion followed by 10 s limb ischemia at the end of 30 min limb ischemia. At 120 min of reperfusion, the animals were sacrificed, and hearts were removed for determination of myocardial infarction size ( using TTC ) , and expression of DJ?1, phosphatase and tensin homologue ( PTEN) protein, and phosphorylated Akt ( p?Akt) in myocardial tissues ( by Western blot) . Results The infarction size was significantly increased in diabetic and nondiabetic rats during myocardial I∕R. The expression of DJ?1, PTEN protein and p?Akt was significantly higher during myocardial I∕R in nondiabetic rats, and the expression of PTEN protein and p?Akt was up?regulated, and no significant change was found in DJ?1 expression during myocardial I∕R in diabetic rats. Ischemic postconditioning reduced infarction size during myocardial I∕R and up?regulated the expression of DJ?1 and p?Akt, and down?regulated the expression of PTEN protein in nondiabetic rats, but not in diabetic rats. Compared with nondiabetic rats, the expression of DJ?1 and p?Akt was down?regulated, and the expression of PTEN protein was up?regulated after ischemic postconditioning in diabetic rats. Conclusion The mechanism by which DM abolishes cardioprotection induced by ischemic postconditioning is associated with down?regulation of DJ?1 expression in rats.
6.Effects of liuwei dihuang pills on expressions of apoptosis-related genes bcl-2 and Bax in pancreas of OLETF rats
Yaoming XUE ; Ren LUO ; Bo ZHU ; Yan ZHANG ; Yonghua PAN ; Chenzhong LI
Journal of Integrative Medicine 2005;3(6):455-8
OBJECTIVE: To investigate the effects of Liuwei Dihuang Pills (LWDHP) on expressions of apoptosis-related genes bcl-2 and Bax in pancreas of OLETF rats. METHODS: Forty male OLETF rats were randomly divided into LWDHP-treated group and untreated group. Another ten male LETO rats were included in normal control group. OLETF rats in the LWDHP-treated group were given LWDHP (2.4 g.kg(-1).d(-1)) orally since the age of 8 weeks and the rats in the other two groups were given distilled water orally. Body weights of rats were recorded weekly and blood glucose concentration was determined by oral glucose tolerance test (OGTT). Pancreas weights were recorded after rats were killed and the expression levels of bcl-2 mRNA and Bax mRNA were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: In the LWDHP-treated group, the expression of bcl-2 mRNA in the pancreas of rats at the age of 40 weeks (1.25+/-0.07) was much higher than that in the untreated group (1.01+/-0.16), P<0.01. Bax mRNA level in the LWDHP-treated group (0.57+/-0.11) was obviously lower than that in the untreated group (1.18+/-0.28), P<0.01. There was no significant difference of pancreas-to-body weight ratios between the LWDHP-treated group and the untreated group. The ability of glucose tolerance was improved in the LWDHP-treated group. CONCLUSION: LWDHP can up-regulate the expression of bcl-2 and down-regulate the expression of Bax at transcription level, which maybe contribute to the anti-apoptosis effects of LWDHP.
7.Alterations of Treg cells, Th17 cells and some related cytokines in peripheral blood of patients with hand-foot-mouth disease
Li YANG ; Shuyuan SUN ; Qingxiao XUE ; Bo LI ; Hongwei TIAN ; Xiaojin LIU ; Huimin YAN ; Erhei DAI
Chinese Journal of Microbiology and Immunology 2014;(9):697-701
Objective To investigate the alterations of Treg cells , Th17 cells and related cyto-kines in peripheral blood of patients during the early stage of hand-foot-mouth disease ( HFMD) .Methods Flow cytometry was performed to analyze the percentages of Treg cells ( CD4+CD25+Foxp3 T cells) and Th17 cells ( CD3+CD8-IL-17+T cells) in peripheral blood samples collected from 49 patients with severe HFMD , 26 patients with common HFMD and 30 healthy children.The levels of IL-6, IL-10, IL-17, IL-23 and TGF-β1 in serum samples were measured by ELISA .Results The percentages of Treg cells , ratios of Treg/Th17 cells, serum levels of TGF-β1 and IL-10 in patients with HFMD were significantly decreased as compared with those of control group (F=5.580, 6.205, 0.000, 0.014, respectively, P<0.05).Patients with se-vere HFMD showed a significantly increased Th17 cells (F=3.189 P<0.05) and a tendency of enhanced IL-17 expression , but no significant differences with the levels of IL-17 were observed .No significant differ-ences with the expression of IL-23 in the patients among each group were detected (P>0.05).The levels of IL-6 in serum samples from severe disease group were obviously increased as compared with those of common HFMD group and control group (F=7.318, P<0.05).Conclusion The results of this study demonstrated that the levels of Treg , Th17 cells and some related cytokines were varied in peripheral blood of patients dur-ing the early stage of HFMD .Inflammatory responses were enhanced to promote anti-virus activities by sup-pressing Treg cells and stimulating Th17 cells.
8.Effects of penehyclidine hydrochloride on activities of NF-κB and AP-1 during actue lung injury induced by blunt chest trauma-hemorrhagic shock and resuscitation in rats
Xiaojing WU ; Yan LENG ; Wenwei GAO ; Bo ZHAO ; Rui XUE ; Liying ZHAN ; Zhongyuan XIA
Chinese Journal of Anesthesiology 2015;35(6):751-754
Objective To investigate the effects of penehyclidine hydrochloride on activities of nuclear factor kappa B (NF-kB) and activator protein-1 (AP-1) during actue lung injury induced by blunt chest trauma-hemorrhagic shock and resuscitation (HSR) in rats.Methods Thirty male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly assigned into 3 equal groups (n =10 each) using a random number table:sham operation group (group S),blunt chest trauma-HSR group (group THSR) and penehyclidine hydrochloride group (group PHCD).The model of actue lung injury induced by blunt chest trauma-HSR was induced by dropping a 300 g weight onto a precordium in anesthetized rats.Blood was withdrawn via the femoral artery 5 min later until MAP was decreased to 35-45 mmHg within 15 min and maintained at this level for 60 min,followed by resuscitation.In PHCD group,PHCD 2 mg/kg was injected intravenously at 60 min after hemorrhagic shock.At 6 h after the model was established,blood samples were obtained for measurement of concentrations of tumor necrosis factor-alpha (TNF-α) in serum.The lungs were then removed for determination of lung water content,myeloperoxidase (MPO) activaty (by colorimetric assay),NF-κB and AP-1 activaties (using electrophoretic mobility shift assay) in lung tissues,and for microscopic examination of pathologic changes (under light microscope).The left lung was lavaged,and lung permeability index (LPI) was calculated.Results Compared with S group,lung water content,LPI,serum TNF-α level and activites of MPO,NF-κB and AP-1 were significantly increased in THSR and PHCD groups.Compared with THSR group,lung water content,LPI,serum TNF-α concentrations and activites of MPO,NF-κB and AP-1 were significantly decreased in PHCD group.The pathological damage to lung tissues was significantly reduced in PHCD group as compared with THSR group.Conclusion PHCD can inhibit activities of NF-κB and AP-1 in lung tissues,thus mitigating acute lung injury induced by blunt chest trauma-HSR in rats.
9.Acute kidney injury is a risk factor for the long-term prognosis of cardiac surgery
Shang LIU ; Miaolin CHE ; Bo XIE ; Song XUE ; Mingli ZHU ; Jiaqi QIAN ; Zhoohui NI ; Yucheng YAN
Chinese Journal of Nephrology 2011;27(6):416-422
Objective To investigate the long-term prognosis and possible risk factors of acute kidney injury(AKI)following cardiac surgeries. Methods Clinical data of 941 patients undergoing open heart surgery from January 2004 to June 2007 were retrospectively analyzed.Survival and renal function of above patients were informed through telephone or clinic follow-up till February 2010.Long-term survival was analyzed using risk-adjusted Cox proportional hazards regression model. Results Of the 941 patients after cardiac surgery,275(29.2%)developed AKI and 666(70.8%)did not.Survival was worse in patients with AKI(67.8%vs 85.6%,P<0.01)and was proportional to its severity (AKIN 1,2 and 3 stages:70.7%,62.3%and 58.6%,P<0.01).Although 90.5% of patients had complete renal recovery after AKI at discharge of hospital,they still had an increased risk for death during follow-up compared with patients without AKI (69.6% vs 85.6%,P<0.01).In the Cox proportional hazards regression model,age(HR=2.238),anemia (HR=1.625),prolonged operation time (HR=1.153),AKI severity (HR=1.473)were independent risk factors for long-term prognosis after cardiac surgery.At the end of the follow-up,patients with AKI had statistically higher Scr than non-AKI patients(107.6 μmol/L vs 83.0 μmol/L,P=0.014),and among those AKI patients,34.0%progressed into CKD 3-5 stages,34.8%developed double serum creatinine. Conclusions AKI is a risk factor for the long-term prognosis of cardiac surgery.Patients with complete renal recovery after AKI still has an increased risk for death and poor renal function compared with patients without AKI.
10.The impact of head cooling on regional homogeneity during passive hyperthermia
Yan XUE ; Bo LI ; Ruijie ZHANG ; Shaowen QIAN ; Kai LIU ; Lexia DU ; Gang SUN
Journal of Practical Radiology 2017;33(8):1163-1166
Objective To explore the impact and protective mechanisms of head cooling on neural activity during passive hyperthermia.Methods Sixteen subjects were randomly exposed for 1 h to three different conditions: normal (25℃), hot (50℃) and head cooling (chamber:50℃,cold packs:5℃),after environment exposure, rs-fMRI were performed.Regional homogeneity(ReHo) datum at three different conditions were analyzed by REST2.0 to obtain brain areas with statistical difference.Brain voxel with statistical difference were selected as ROIs to ReHo values and were analyzed by One-Way ANOVA with SPSS18.0.Neural activity of brain areas with statistical difference were compared in any two groups by Post hoc.Results The brain regions showing differences among three groups included right orbital frontal cortex,left middle frontal gyrus,bilateral amygdala,left middle temporal gyrus,left hippocampus,bilateral parietal inferior, left precentral gyrus.Compared with normal group, ReHo increased in right orbital frontal cortex, and decreased in left precentral gyrus,left middle frontal gyrus,left parietal inferior,but no changed in bilateral amygdala,left middle temporal gyrus,left hippocampus,right parietal inferior in head cooling group.Compared with hot group,head cooling group showed increased ReHo in left middle temporal gyrus,left hippocampus,right parietal inferior,and decreased ReHo in bilateral amygdala,left parietal inferior,unchanged ReHo in right orbital frontal cortex, left precentral gyrus, left middle frontal gyrus.Conclusion The specified alterations of ReHo may reflect that the head cooling could partially eliminate the impact of passive hyperthermia, and is closely linked with emotional function.