1.Current situation and development trend of POCT in cardiovascular disease
Chinese Journal of Laboratory Medicine 2013;(6):494-497
Cardiovascular disease (CVD) is one of the most common diseases and the leading causes of death in China.It is of great importance to detect cardiac markers for early diagnosis,treatment and prognosis of CVD.Point of care testing (POCT) is emerging as a new test mode and development trend of laboratory medicine.Application of POCT technology in cardiovascular field is the fastest growing parts of all POCT.It promotes the application and development of POCT because of the contradiction between the important value of cardiac markers and the needs of quick results in severe CVD.With the technological diversification of POCT,the progressing innovation of test devise and standardized test results with reference to the Central Laboratory (CLT),the application of POCT will be more extensive and promote the development of laboratory medicine together with traditional test mode.
2.Effect of lobe bronchus blockade on intrapulmonary shunt during radical esophagus cancer resection
Chuanhan ZHANG ; Zhaojun CHEN ; Peng WANG
Chinese Journal of Anesthesiology 1995;0(02):-
Objective To evaluate the effect of lobe bronchus blockade with a branchial blocker on intrapulmonary shunt during radical esophagus cancer resection. Methods Twenty four ASA Ⅰ-Ⅲ patients with normal lung function aged 18-69 yrs undergoing elective radical esophagus cancer resection were randomized into 2 groups ( n = 12 each): group A one-lung ventilation (OLV) and group B lobe bronchus blockode. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring and blood sampling. Anesthesia was induced with midazolam 50 ?g?kg-1, fentanyl 4 ?g?kg-1, propofol 2 mg?kg-1 and vecuronium 0.1 mg?kg-1. In group A double-lumen tube (DLT) was used while in group B a single lumen endotracheal tube was placed first, then a bronchial blocker was inserted fiberoptically into the bronchus of lower lobe of the operated side. The patients were mechanically ventilated (FiO2= 100%, VT = 8 ml?kg-1 , RR = 10-15 bpm, I: E = 1:2). PaCO2 was maintained at 30-35 mm Hg. Anesthesia was maintained with 1.5%-2.0% isoflurane and intermittent Ⅳ boluses of fentanyl and vecuronium. BP, HR, CVP, SpO2, PETCO2 and airway pressure were monitored during operation. Blood samples were taken simultaneously from radial artery and central vein for blood gas analysis before induction of anesthesia when the patients were lying supine and breathing spontaneously (T0), after the lungs on both sides were ventilated for 30 min in lateral position (T1) and 30 min after OLV (group A) or lower lobe bronchus was blocked off (group B) in lateral position (T2). Qs/Qt was calculated (blood from central vein was used instead of mixed venous blood from pulmonary artery) . Blood concentrations of TXB2 and 6-k-PGF1 were determined by radioimmunoassay at T0, T1 and T2. Results There was no significant difference in demographic data between the two groups. At T2 the airway pressure in group A was significantly higher than that in group B. At T2 PaO2 was significantly higher in group B than in group A. Qs/Qt was significantly increased at T1 and T2 as compared to the baselines in both groups. Qs/Qt was significantly increased at T2 compared to that at T1 in group A only, while there was no significant difference between Qs/Qt at T1 and T2 in group B. The TXB2 concentration at T2 was significantly increased as compared to that at T0 and T1 in group A and was significantly higher than that at T2 in group B. Conclusion Lower lobe bronchus blockade was superior to OLV in terms of Qs/Qt and PaO2 during esophagus cancer resection.
3.Clinical effect analysis of supraclavicular lymph node metastasis of esophageal cancer by chemoradi-ation therapy
Guifang ZHANG ; Lingxin MENG ; Zhaojun DING
Journal of Chinese Physician 2015;(z2):8-12
Objective To evaluate the clinical curative effect,survival rate and adverse reactions of three-dimensional conformal radiotherapy(3D-CRT )in combination with chemotherapy on lymph nodes metastasis of esophageal carcinoma.Methods Using supraclavicular 3D-CRT combined with chemotherapy on and simple 3D-CRT supraclavicular lymph node metastasis of esophageal cancer patients,3D-CRT com-bined synchronous chemotherapy (treatment group),51 cases,only 3D-CRT 49 cases (control group).3D-CRT combined synchronous chemotherapy 51 cases (treatment group),simple 3D-CRT 49 cases (control group).These patients 3D-CRT were given the total dose of 50 ~60Gy/25 ~30F.TN chemotherapy regi-mens were applied:paclitaxel 135 mg/m2 ,d1;Nedaplatin 25 mg/m2 ,d1,1 ~3,21 days cycle in fist week and fourth week.Results Local control and treatment group survival rates in 1,2 year were significantly higher than that of control group (P <0.05).Treatment group adverse reaction rate is higher than the con-trol group,but there was no statistically significant difference.Conclusions The recent curative effect and survival rate could be significantly improved by 3D-CRT joint TN synchronous chemotherapy regimen for pa-tients with supraclavicular lymph node metastasis of esophageal cancer,but the relatively high incidence of adverse reactions,clinical application should be considered comprehensively according to actual situation.
4.Application and development of point-of-care testing in domain of tumor markers
Lahong ZHANG ; Yuhua LIU ; Zhaojun CHEN
Chinese Journal of Laboratory Medicine 2014;(11):808-811
Malignant tumors are the most common lethal diseases in China.Because of complexity of etiology and pathogenesis , and the lack of specific markers for early diagnosis , delayed diagnosis and treatment of cancer , the fatality rate is high.With the development of basic research , more and more early specific markers were found , but the current detection mostly depend on the professional laboratories , time-consuming , high price and have a number of inconveniences to patients on time and money.Meanwhile , it′s difficult to extend to zoon of medicine resources deficient.Recently, point-of-care testing (POCT) has been rapidly developed , because of its portability , getting results quickly , can be operated in basic medical units and economic backward areas , so it′s benefit to cancer screening in human.By the application in tumor markers, POCT can be done for the cancer early detection , early diagnosis and early treatment , so then cuts the death rate.
5.Effects of direct peritoneal resuscitation with sodium pyruvate from hemorrhagic shock on intestinal injury in rats
Jingjing ZHANG ; Yanlin WANG ; Zhaojun QIN
Chinese Journal of Anesthesiology 2013;33(11):1393-1396
Objective To investigate the effects of direct peritoneal resuscitation (DPR) with sodium pyruvate from hemorrhagic shock (HS) on intestinal injury in rats.Methods Fifty SPF male Sprague-Dawley rats,weighing 200-250 g,were used in this study.The animals were anesthetized with 1% pentobarbital sodium 40 mg/kg,tracheostomized and mechanically ventilated.Femoral artery was cannulated for mean arterial pressure (MAP) monitoring,blood-letting,blood sampling and fluid infusion.HS was induced according to the method described by Wiggers.MAP was maintained at 35-40 mm Hg for 60 min.The animals were then randomly and equally divided into 5 groups:sham operation group (group S) ; conventional resuscitation group (group CR) ; DPR with different fluid groups (DPRt-3 groups).In group CR,at 1 h after HS,the animals were resuscitated with infusion of the blood withdrawn and normal saline (the volume was 2 times volume of blood loss).In DPR1-3 groups,conventional resuscitation was performed,at the same time,1.5 % glucose-based peritoneal dialysis solution containing lactate,1.5% glucose-based peritoneal dialysis solution containing lactate (40.00 mmol/L),and 1.5% glucosebased peritoneal dialysis solution containing high lactate (80.00 mmol/L) 20 ml were infused intraperitoneally over 30 min,respectively.MAP was recorded before blood letting,at 5,30 and 60 min of HS,and at 5,30,60,90 and 120 min after the end of resuscitation.At 120 min after the end of resuscitation,the lactate level in the arterial blood was measured.The animals were then sacrificed.Small intestinal samples were obtained for determination of malondialdehyde (MDA) content,myeloperoxidase (MPO) activity and tumor necrosis factor-α (TNF-α) expression,and for microscopic examination.The damage to the small intestinal mucosa was assessed and scored.Results Compared with MAP before blood letting,MAP during HS was significantly decreased,and no significant change in MAP was found after resuscitation in CR and DPR1-3 groups (P < 0.05).The lactate level in the arterial blood,MDA content,MPO activity,TNF-α expression and intestinal mucosal damage scores were significantly higher in CR and DPR1-3 groups than in S group (P < 0.05 or 0.01),while lower in DPR1-3 groups than in CR group (P <0.01),and in DPR2,3 groups than in DPR1 group (P < 0.05 or 0.01).The lactate level in the arterial blood,MDA content and TNF-α expression were significantly lower in DPR3 group than in DPR2 group (P < 0.05 or 0.01).Conclusion Direct peritoneal resuscitation with sodium pyruvate can reduce the intestinal injury induced by HS and inhibition of lipid peroxidation and inflammatory responses is involved in the mechanism in rats.
6.Effects of ageing on the expression of peroxisome proliferator-activated recept or ? and the relation to insulin resistance
Xiujin ZHANG ; Ping YE ; Zhaojun WANG
Chinese Journal of Geriatrics 1995;0(02):-
Objective To investigate the effects of ageing on the expression of peroxisome proliferat or-activated receptor (PPAR)? and explore the relation with insulin resistance (IR).Methods Minimal model technique of Bergman was used to estimate the insulin sensitivity of young (10-12 weeks) and aged (24 months) SD rat. The PPAR?mRNA levels of omental fat were measured by reverse transcription-polymerase chain reaction(RT -PCR) and PPAR? protein level were determined by western blotting respectively . Results The level of IR in the aged group was significantly increased compared with tha t of the young group(IR: 11 49?6 92 vs 5 28?1 94,P
7.Role of parecoxib in protection of learning and memory ability in rats with transient global cerebral ischemia/reperfusion inj ury
Pengchong XIAO ; Li MEI ; Zhaojun WANG ; Guangyan ZHANG ; Jianxiu CUI
The Journal of Practical Medicine 2014;(24):3922-3925
Objective To explore the role of parecoxib in protection of learning and memory ablility in rats with global cerebral ischemia/reperfusion injury. Methods Male Wistar rats were randomly divided into a sham group (S group), a ischemia/reperfusion group (I/R group), and a ischemia/reperfusion with parecoxib group (I/R+PA group). Global cerebral ischemia was induced by Pulsinelli 4-vessel occlusion. 72 h after reperfusion, Morris water maze was used to assess spatial learning and memory ability for consecutive five days. The histological changes in the hippocampus were detected by Nissl staining. Results As compared with the I/R group, rats in S guoup and I/R+PA group had a significantly shortened escape latency (P<0.05), and had significantly longer dwelling time in the former platform quadrant and more frequent cross-platform movement in the Morris water maze test. Conclusions Parecoxib plays a role in protection of learning and memory ability in rats with global cerebral ischemia/reperfusion injury.
8.Hyperbaric oxygen for limb ischemia-reperfusion with no reflow phenomenon:expression of vascular endothelial growth factor and intracellular adhesion molecule 1
Zhaojun FU ; Minhua XIANG ; Jian WEI ; Chen ZHANG
Chinese Journal of Tissue Engineering Research 2014;(42):6800-6804
BACKGROUND:Clinical limb ischemia-reperfusion with no reflow phenomenon after vascular injury repair seriously affects the prognosis of patients. Therapeutic effect of hyperbaric oxygen in myocardial ischemia reperfusion is exactly confirmed, but hyperbaric oxygen is rarely reported in the treatment of limb ischemia-reperfusion.
OBJECTIVE:To detect the expression of vascular endothelial growth factor and intracellular adhesion molecule 1 and to investigate the effect of hyperbaric oxygen on the prognosis of limb ischemia-reperfusion with no reflow phenomenon.
METHODS:By clinical screening, cases of main arterial injury of the limbs were selected and subjected to vascular repair for restoring limb blood supply. After surgery, al the cases were randomly divided into two groups (Combined treatment group and surgical group), 16 cases in each group. Combined treatment group was treated with hyperbaric oxygen combined with clinical anticoagulant, antiplatelet treatment;surgical group treated with only postoperative clinical treatment. Another 16 adult healthy volunteers were selected to receive hyperbaric oxygen as hyperbaric oxygen group. Expressions of vascular endothelial growth factor and intracellular adhesion molecule 1 were detected using enzyme-linked immunosorbent assay at 8, 72 hours and 7 days after surgery.
RESULTS AND CONCLUSION:In the combined treatment and surgical groups, patients exhibited higher expressions of vascular endothelial growth factor and intracellular adhesion molecule 1 than those in the hyperbaric oxygen group (P<0.01). After 72 hours, the expression of vascular endothelial growth factor was significantly higher in the combined
treatment group than the surgical group (P<0.01). At 8 and 72 hours, the expression of intracellular adhesion molecule 1 was lower in the combined treatment group than the surgical group (P<0.05). These findings suggest that hyperbaric oxygen can induce high expression of vascular endothelial growth factor and inhibit intracellular adhesion molecule 1, which is crucial for improving growth of blood capil ary, formation of endothelial cells, reducing no reflow phenomenon.
9.The expression changes of peripheral endothelial progenitor cells and Ang-1/Tie2 in patients with pulmonary arterial hypertension
Xiao FENG ; Dayong ZHANG ; Feng PAN ; Hongping LOU ; Zhaojun CHEN
Chinese Journal of Laboratory Medicine 2015;38(2):115-119
Objective To observe the expression changes of peripheral endothelial progenitor cells (EPCs) and Ang-1/Tie2 in patients with pulmonary arterial hypertension (PAH).Methods From Jun 2011 to Dec 2012,45 patients with PAH charged in Affiliated Hospital of Hangzhou Normal University were divided into 3 groups according to mean pulmonary arterial blood pressure (15 per group):mild(Group L),moderate(Group M),and severe(Group S),with another 15 normal people as control group(Group C).The EPCs were isolated from peripheral blood of every patient,number counting using fluorescence activated cell sorter (FACS),function test using cell culture in vitro.Expression of Ang-1 and Tie2 in the peripheral EPCs were measured by RT-PCR or Western-blot.Non normal data was analyzed by non parametric statistical test.Results The statistical discrepancy existed among Group L,M,S and the control in the number of EPCs [32.0 (27.0,37.0),26.0 (19.0,31.0),24.0 (22.0,26.0) vs 40.0 (37.0,51.0),P < 0.05].The ability of migration [32.1 (26.5,37.5),26.8 (22.4,35.4),21.0 (17.8,34.0) vs 39.0 (33.3,42.4),P<0.05] and adhesion of the EPCs [57.1(50.9,61.8),51.8(45.2,58.7),46.0 (37.2,55.1) vs 64.1 (56.2,75.0),P < 0.05] among study groups and control group was different in statistic,the same with the proliferation activity of EPCs in different groups [0.6 (0.5,0.7),0.5 (0.4,0.6),0.4(0.3,0.5) vs 0.7(0.6,0.8),P <0.05].The mRNA expression of Ang-1 and Tie2 in Group M & S were significantly reduced compared with control [4.33 (2.49,4.62) and 2.89 (2.39,3.44) vs 5.31(3.78,6.22),P<0.05],Tie2 mRNA[1.32(1.23,1.34)and 1.23(1.08,1.42)vs 1.49(1.25,1.66),P < 0.05],and the protein expression of the phosphorylated Tie 2 in Group M &S were decreased [0.16 (0.15,0.24) and 0.12 (0.08,0.18) vs 0.22 (0.19,0.28),P < 0.05].No significant difference of Ang-1 and Tie2 expression was observed between Group L and control [5.42 (4.72,5.95),1.54 (1.43,1.66) and0.23(0.19,0.33),P=0.674,0.867 and 0.674].Conelusion With the severity of PAH,the number and function of circulating EPCs decreased,as consistent with Ang-1 and Tie2 expression changes,suggesting that function decrease of EPCs in patients with PAH may be associated with the decrease of Ang-1/Tie2 expression.
10.tk gene mutation of L5178Y cells induced by sulfur mustard
Qihui LI ; Mingxue ZHU ; Liming ZHANG ; Zhaojun DONG ;
Journal of Third Military Medical University 2003;0(16):-
Objective To detect the mutagenicity of sulfur mustard in the tk gene of L5178Y3.7.2c tk +/- mouse lymphoma cells. Methods The plating efficiency and the mutant frequency were detected by the microtiter procedure. Results Sulfur mustard induced tk locus mutation with mutation frequency 2-15 times higher than that of spontaneous mutation frequency of L5178Y3.7.2c tk +/- cells. There were two different phenotypes of mutation colonies induced, which were large and small colonies, but most of them were small colonies. Conclusion Sulfur mustard is characterized by marked mutagenic activity and cytotoxicity. The compound may result in large range of DNA damage.