0.05),while the levels of IL-8 and IL-6 declined,but were still significantly higher than that at immediately after induction of anesthesia(P

Objective To investigate the effect of the aqueous extracts from Dioscorea nipponica Makino (AEDN) against the carbon tetrachloride (CCl4)-induced mice acute liver injury by regulating TLR4/MyD88 signal pathway.Methods 60 mice were randomly divided into control group, model group, low, medium and high dose AEDN groups according to radom number table with 10 mice in each group. Mice in low, medium and high dose AEDN groups were adiminstrated with 50, 100 and 200 mg/kg AEDN, in control and model groups were adiminstrated with solvent once a day for 7 consecutive days. Two hours after the last administration, mice were intraperitoneal injected with with 0.3% CCl4 olive oil solution to induce acute liver injury model, except for the mice in control group. Twenty-four hours after injection, the expressions of TLR4, MyD88 and NF-κB in liver tissue were evaluated by Western blot, mRNA levels were evaluated by PCR, and the AST and ALT levels in serum were also detected.Results Compared with model group, the serum AST (98.00 ± 17.75 U/L, 57.49 ± 9.66 U/L, 39.60 ± 9.49 U/Lvs. 113.40 ± 9.71 U/L) and ALT levels (76.00 ± 14.73 U/L, 50.70 ± 9.35 U/L, 35.25 ± 9.93 U/Lvs. 95.42 ± 11.64 U/L) were significantly decreased in low, medium and high dose AEDN groups (P<0.01); MyD88 (0.67 ± 0.21vs. 1.74 ± 0.42), NF-κB p65 (0.51 ± 0.09vs. 1.76 ± 0.31) and TLR4 (0.97 ± 0.25vs. 2.99 ± 0.72) levels were down-regulated in high dose AEDN group (P<0.01); the mRNA levels of IL-6 (2.22 ± 0.25, 1.76 ± 0.31vs. 5.20 ± 0.60), IL-1β (1.96 ± 0.35, 1.47 ± 0.23vs. 7.37 ± 0.99)、TNF-α (2.06 ± 0.25, 1.34 ± 0.33vs. 2.98 ± 0.50) in medium and high dose AEDN groups significantly decresed (P<0.01).Conclusions The AEDN has protective effect against CCl4-induced acute liver injury in mice via adjusting TLR4/MyD88 signal pathway.

Liver diseases are serious diseases harmful for human health. CCl4 induced liver injury, as a classic liver injury model, has been widely used in the screening of hepatoprotective drugs. This paper reviewed the research progress in the hepatoprotective effect of traditional Chinese medicines ( TCMs) on CCl4 induced acute liver injury in recent years, which can provide basis for searching TC-Ms with high efficiency and low toxicity and lay foundation for TCMs in the treatment of liver diseases.

Objective To analyze the five years change of bacterial infection adn drug resistance in PICU and to provide evidence for use of na tibiotics rationally.Methods Al the pathoeg nic bacteria from patients in PICU of our hospital from January 1 2009 to Deec mber 31 2013 were analyzed retrospectiev ly. T hey were divided into five subgroups according to differetn years.Pathogenic batc eria and drug resistance in different years wre e collected na d the changes of such bacterial infection and drug resistance were compared and summarized.Results A total of 2 201 pathogenic bacterial strains were isolated from 14 361 specimens of five-year patients in PICU.The rate of gram negative bacteria in 2009 to 2013 were 83.2%,71.0%, 59.8%,58.9%, 52.5% respe ctively.The rate of gram positive bacteria in 2009 to 2013 were 16.8%, 29.0%,40.2%, 41.1%, 47.5% respectively.Top five pathogenic bacteria were staphylocco cus aureus (16.6%,366 strains),Escherichia coli (16.2%,357 strains),klebsiella pnue moniae (15.2%,334 strains), streptococ us pneumoniae (9.2%,202 strains),haemophilus influenzae (6.8%,149 strains).The infection rate of staphylococcus aureus increased year by year(6.4% to 27.0%).Drug sensitivity tets indicated that the rate of extended-spectrum beta-lactamases ( ESBL) positive escherichia coli and klebsiella pneumoniae were 28.3%and 38.3%,respectivle y.The rate of methicillin-resistant staphylococcus aureus ( MRSA) was 26.0%.Based on non-meningitis criterion,rate of penicillin resistance streptococcus pneumonia and multiple-drugresistance streptococcus pneumonia was 19.3%and 58.9%,respectively.There were no obvious changes in resistance rate of above-mentioned bacteria during the recent five years.Conclusion In the recent five years,gram negative bacteria is still the prevalent strain in PICU of our hospital,however the rate of gram positive bacteria increases year by year and staphylococcus aureus has become one of the five most common bacteria.The rate of ESBL positive escherichia coli,ESBL positive klebsiella pneumonia and MRSA has no obvious changes.Analysis of pathogenic bacteria and drug-resistance surveillance are of vital importance to guide treatments for critically ill patients and reduce drug-resistant bacterial strains.

ObjectiveTo investigate the protective effect and mechanism of Artemisia capillaris Thunb. decoction (YCHT), a classic heat-clearing and cholagogic traditional Chinese medicine (TCM) prescription, on rats with severe acute pancreatitis (SAP) induced by sodium taurocholate. MethodsA total of 30 Sprague-Dawley rats were randomly divided into sham-operation (SO) group, SAP model group, and YCHT (4.0 g/kg) treatment group, with 10 rats in each group. At 24 hours after successful modeling, pancreatic tissue and plasma samples were collected for analysis. HE staining was used to observe pathological injury of the pancreas; ELISA was used to measure the plasma levels of amylase, tumor necrosis factor-α (TNFα), and interleukin-1β (IL-1β); immunofluorescent staining was used to measure the fluorescence intensity of LC-3 protein, and TUNEL was used to measure cell apoptosis. Western blot was used to measure the protein expression of LC-3, Beclin-1, X-linked inhibitor of apoptosis protein (XIAP), caspase-3, and nuclear factor-kappa B (NF-κB) in the pancreas, and quantitative real-time PCR was used to measure the expression levels of lncRNA PVT1 and miRNA-30a-5p. A one-way analysis of variance and the Tukey’s test were used to analyze the differences between multiple independent samples. ResultsYCHT significantly alleviated the pathological injury of the pancreas of SAP rats, such as edema, necrosis, hemorrhage, and inflammatory cell infiltration. Compared with the SO group, the SAP group had significant increases in the plasma levels of amylase and the inflammatory factors TNFα and IL-1β, and there were significant reductions in the plasma levels of amylase, TNFα, and IL-1β after YCHT treatment (all P＜0.05). Compared with the SO group, the SAP group had significant increases in LC-3II/LC-3I ratio and the protein expression of Beclin-1, XIAP, caspase-3, and NF-κB, and compared with the SAP group, the YCHT group had significant reductions in LC-3II/LC-3I ratio and the protein expression of Beclin-1, XIAP, and NF-κB (all P＜0.05). Compared with the SO group, the SAP group had a significant increase in the expression of lncRNA PVT1 and a significant reduction in the expression of miRNA-30a-5p in the pancreas (both P＜0.05), and compared with the SAP group, the YCHT group had a significant reduction in the expression of lncRNA PVT1 and a significant increase in the expression of miRNA-30a-5p (both P＜0.05). ConclusionCell autophagy and apoptosis mediated by lncRNA PVT1/miRNA-30a-5p may be a drug target for YCHT treatment of SAP, which provides experimental and theoretical bases for further development of the TCM prescription YCHT for the treatment of SAP.

Objective:To analyze the potential role and prognostic value of platelet-to-lymphocyte ratio (PLR) at an early stage in arterial-venous extracorporeal membrane oxygenation (VA -ECMO).Methods:Totally 83 adult patients with VA-ECMO from June 2018 to June 2020 treated at Emergency Department of Jiangsu Provincial Hospital were retrospectively analyzed. Baseline characteristics between survivors ( n=46) and non-survivors ( n=37) were compared. Logistic regression analysis was used to predict the risk factors associated with 28-day mortality in VA-ECMO patients. The cut-off value was calculated by the receiver operating characteristic (ROC) curve. Results:PLR48-h ( OR=1.018,95% CI: 1.001-1.036, P=0.039) and continuous renal replacement therapy (CRRT) ( OR=7.095,95% CI: 1.099-45.799, P=0.039) were relevant risk factors of 28-day mortality in VA-ECMO patients. The cut-off value of PLR48-h was 156.3 [sensitivity: 57.8%, specificity: 86.1%, and area under the curve (AUC): 0.756]. Compared with the high PLR group (>156.3), the incidences of acute kidney injury (AKI) ( P<0.001) and bleeding events ( P=0.013) were significantly higher in the low PLR group (<156.3). Conclusions:The early PLR reduction and CRRT application during VA-ECMO support are related to poor prognosis.

Objective:To investigate the clinical significance of the acute physiology and chronic health evaluationⅡ (APACHEⅡ) combined with different systematic inflammation markers (SIMs) including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)-in adult patients with venous-arterial extracorporeal membrane oxygenation (VA-ECMO).Methods:A total of 89 adult patients with VA-ECMO ( ≥ 3 d) in the Emergency Department of Jiangsu Provincial People's Hospital from January 2017 to June 2020 were retrospectively analyzed. Patients were divided into two groups: survivors ( n=39) and non-survivors ( n=50). The baseline APACHE Ⅱscore and PLR, NLR, LMR before ECMO implantation and at 1, 2, 3 day after ECMO were recorded. Binary logistic regression was used to analyze the risk factors of 28-day mortality in patients with VA-ECMO. The utility of APACHEⅡ score and SIMs alone or combination for predicting clinical prognosis was evaluated using receiver operating characteristic (ROC) curve analysis. The patients were divided into the high risk group and the low risk group according to the best cut-off value, and the difference of ECMO-related complications between the two groups was compared. Results:When combined APACHEⅡ score with SIMs, APACHEⅡ + PLR 48 h + LMR 24 h + LMR 72 h demonstrated the greatest predictive ability with an AUC of 0.833. Compared with the high-risk group, the low-risk group has a lower incidence of acute renal injury, infection, bleeding complications, the use of continuous renal replacement therapy, mechanical ventilation, and a higher hospital survival rate.Conclusions:The combination of APACHEⅡ score and SIMs-PLR, LMR- is better than a single one for death prediction, and it is expected to be a new predictive model for early identification of the risk of death or poor prognosis in patients with VA-ECMO.

With the intensify of aging population,accurate assessment of brain health becomes more and more important.Brain age can reflect brain health and cognitive function.Based on different algorithms,modal data and central datasets,imaging is helpful for predicting brain age.The progresses of imaging researches for predicting brain age were reviewed in this article.

Pancreatic cancer (PC) is a devastating malignant tumor with high incidence and mortality rate worldwide. Meanwhile, the surgical approaches and drugs of this disease remain challenging. In recent years, reactive oxygen species (ROSs) study has become a hotspot in the field of PC research. ROSs may regulate tumor mic roenvironment (TME), cancer stem cells (CSCs) renewal and epithelial-mesenchymal transition (EMT), which result in drug-resistance and recurrence of the PC. Currently, TME that includes immune infiltrates, fibroblasts, vascular vessels and extracellular matrix has become a hotspot in the cancer research. Meanwhile, numerous researches have shown that ROSs-mediated TME plays a central role in the occurrence and development of PC. Targeting ROSs may be promising therapeutic treatments for the PC patients. Therefore, the purposes of the review were manifold: (1) to summarize the regulations of ROSs in tumorigenesis and drug-resistance of PC; (2) to investigate the modulation of ROSs in signaling cascades in PC; (3) to study the effects of ROSs in stromal cells in PC; (4) to generalize the potent therapies targeting ROSs in PC. Overall, this review summarized the current status of ROSs in PC research and suggested some potential anti-PC drugs that may target ROSs.
Epithelial-Mesenchymal Transition ; Humans ; Neoplastic Stem Cells ; Pancreatic Neoplasms ; Reactive Oxygen Species ; Tumor Microenvironment

Objective:To investigate the safety of early whole body computed tomography (WBCT) combined with coronary angiography (CAG) in patients with extracorporeal cardiopulmonary resuscitation (ECPR) and its application value in the diagnosis of cardiac arrest and complications of cardiopulmonary resuscitation (CPR).Methods:This was a retrospective study. Patients who underwent ECPR in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2021 were enrolled in this research. Patients younger than 18 years or with incomplete clinical data were excluded. The results of WBCT and CAG examinations after ECPR were collected.Results:A total of 89 patients with ECPR, aged (47±17) years, were enrolled in the study, all underwent WBCT examination, and no adverse events such as ECMO and tracheal tube shedding occurred. WBCT found 7 cases of pulmonary embolism, 3 cases of aortic dissection and 2 cases of cerebral hemorrhage. WBCT identified CPR-related complications in 42 cases, including rib fractures ( n=20), pneumothorax ( n=5), mediastinal emphysema ( n=5), subcutaneous emphysema ( n=6), and hematoma or swelling at puncture site ( n=6). Fifty-five patients underwent CAG examination, the most common culprit vessels were the left anterior descending branch disease (58.2%) followed by the left circumflex branch disease (27.3%), the right coronary artery disease (21.8%) and left main artery disease (12.7%). Conclusions:Early WBCT and CAG examinations are of great significance and safety for the guidance of treatment in ECPR patients.