1.Roles of dexamethasone on nucleotide -binding oligomerization domain -like receptor 1 and 2 mRNA of asthma
Junyun DING ; Zhengying RUAN ; Xiasheng TONG ; Zhenfeng JIANG ; Enzhi WANG
Chinese Journal of Primary Medicine and Pharmacy 2017;24(1):72-75
Objective To investigate the potential roles of nucleotide -binding oligomerization domain (NOD)-like receptor in the pathogenesis of asthma.Methods Through rat asthma model,24 rats were randomly divided into three groups on average,named asthma group,control group and dexamethasone group.Expression levels of NOD1 and NOD2 mRNA were detected by Real -time PCR in lung tissues.Results The expression levels of NOD1 mRNA in the asthma group,control group and dexamethasone group were (0.62 ±0.34)RQ value,(1 .00 ± 0.00)RQ value,(0.65 ±0.33 )RQ value respectively.The levels of NOD1 mRNA in the asthma group was significantly lower than that in the control group(F =4.75,P <0.05 ),while there was no statistically significant difference of NOD1 mRNA level between the dexamethasone group and asthma group(P >0.05).Moreover,expression levels of NOD2 mRNA in the asthma group,control group and dexamethasone group were (0.92 ±0.32)RQ value, (1 .00 ±0.00)RQ value,(1 .50 ±0.56)RQ value,respectively.There was no statistically significant difference of NOD2 mRNA level between the asthma group and control group (P >0.05 ),but level of NOD2 mRNA in the dexamethasone group was significantly higher than that in the asthma group(F =5.64,P <0.01 ).And there was no significant correlation between level of NOD1 and NOD2 mRNA(r =0.1 5,P >0.05).Conclusion Expression of NOD -like receptor subtype was not at the same level,and their reaction to dexamethasone were different either.
2.The effects of dexmedetomidine for different loading dose on blood pressure of SICU patients conscious-sedation derivative phase
Zhengying JIANG ; Guixin WU ; Ning ZHANG ; Jianguo YUAN
Chongqing Medicine 2014;(5):516-517,520
Objective To observe the effects of dexmedetomidine for different loading dose on blood pressure of surgery inten-sive care unit(SICU) patients conscious-sedation derivative phase .Methods 60 patients after general anaesthesia were divided into routine dose group(dexmedetomidine 1 .00 μg/kg ,group C) ,middle dose group(dexmedetomidine 0 .75 μg/kg ,group M ) and low dose group(dexmedetomidine 0 .50 μg/kg ,group L) ,and the loading time were reset 10 min .sedative effect was evaluated by Ram-say sedation score .Record the mean arterial blood pressure of everyone before administration ,5 min after ,15 min after ,30 min af-ter ,60 min after .Results All patients achieved good conscious-sedation .Compared with pro-administration ,the mean arterial blood pressure of group C descend significantly .The mean arterial blood pressure of group M and L descend significantly ,and then they were recover over time .60 min after the treatment ,the mean arterial blood pressure in group C was significantly lower than group L and goup M (P<0 .05) .Conclusion Small dose dexmedetomidine can achieved good conscious-sedation for SICU patients .It has less influence on hemodynamics .
3. Advances in the research of treatment of burns in the elderly
Zhengying JIANG ; Dinghong MIN ; Guanghua GUO
Chinese Journal of Burns 2017;33(4):251-254
With our country going into the aging society, burns in the elderly often occur. Studies have shown that the number of elderly burn patients has reached 13% to 20% of the total number of burn patients. As the sensory and cognitive functions are low, skin is thinning, the functions of heart, lung, and kidney are reduced, the immunity is impaired, and other physiological characteristics exist in the elderly, the wounds of elderly burn patients often heal slowly, and the mortality is high. At present, there is still a lack of enough attention to the elderly burn patients. In this review, according to the physiological characteristics of the elderly, for reference to our peers, we make a summary of the treatment of elderly burn patients, such as fluid resuscitation, wound treatment, acute kidney injury management, infection management, and nutritional support.
4. Advances in the research of diagnosis and treatment of ventilator-induced lung injury after burn
Jinxiu ZHOU ; Zhengying JIANG ; Mingzhuo LIU ; Guanghua GUO
Chinese Journal of Burns 2020;36(2):137-141
As one of the important means for saving severely burned patients, mechanical ventilation can not only improve the function of important organs such as heart, lung, and kidney, but also stabilize the homeostasis of the body, thus promoting the recovery of patients. Improper use of mechanical ventilation, however, can lead to many complications, among which the ventilator-induced lung injury (VILI) is one of the most common and serious complications, accompanying with a high mortality rate. The target of preventing VILI is to minimize the risk of lung injury caused by mechanical ventilation. This article reviews the pathogenesis, diagnosis, and early prevention and treatment of VILI caused by mechanical ventilation in burned patients.
5. Effects of aerosol inhalation of recombinant human keratinocyte growth factor 2 on the lung tissue of rabbits with severe smoke inhalation injury
Zhonghua FU ; Zhengying JIANG ; Wei SUN ; Zhenfang XIONG ; Xincheng LIAO ; Mingzhuo LIU ; Bin XU ; Guanghua GUO
Chinese Journal of Burns 2018;34(7):466-475
Objective:
To investigate the effect of recombinant human keratinocyte growth factor 2 (rhKGF-2) on lung tissue of rabbits with severe smoke inhalation injury.
Methods:
A total of 120 New Zealand rabbits were divided into 5 groups by random number table after being inflicted with severe smoke inhalation injury, with 24 rats in each group. Rabbits in the simple injury group inhaled air, while rabbits in the injury+phosphate buffer solution (PBS) group inhaled 5 mL PBS once daily for 7 d. Rabbits in injury+1 mg/kg rhKGF-2 group, injury+2 mg/kg rhKGF-2 group, and injury+5 mg/kg rhKGF-2 group received aerosol inhalation of 1 mg/kg, 2 mg/kg, and 5 mg/kg rhKGF-2 (all dissolved in 5 mL PBS) once daily for 7 d, respectively. On treatment day 1, 3, 5, and 7, blood samples were taken from the ear central artery of 6 rabbits in each group. After the blood was taken, the rabbits were sacrificed, and the tracheal carina tissue and lung were collected. Blood pH value, arterial oxygen partial pressure (PaO2), arterial blood carbon dioxide pressure (PaCO2), and bicarbonate ion were detected by handheld blood analyzer. The expressions of pulmonary surfactant-associated protein A (SP-A) and vascular endothelial growth factor (VEGF) in lung tissue were detected by Western blotting. Pathomorphology of lung tissue and trachea was observed by hematoxylin-eosin staining. Data were processed with analysis of variance of two-way factorial design and Tukey test.
Results:
(1) Compared with those in simple injury group, the blood pH values of rabbits in the latter groups on treatment day 1-7 had no obvious change (
6. Effects of non-muscle myosin ⅡA silenced bone marrow mesenchymal stem cells on lung damage of rats at early stage of smoke inhalation injury
Mingzhuo LIU ; Junjie WANG ; Zhonghua FU ; Yucong LI ; Zhengying JIANG ; Wei SUN ; Guanghua GUO ; Feng ZHU
Chinese Journal of Burns 2017;33(12):766-771
Objective:
To investigate the effects of non-muscle myosin ⅡA (NMⅡA) silenced bone marrow mesenchymal stem cells (BMSCs) on the lung damage of rats at early stage of smoke inhalation injury.
Methods:
Forty Sprague-Dawley rats were divided into control, simple injury, NMⅡA-BMSCs, and BMSCs groups according to the completely random method, with 10 rats in each group. Rats in control group inhaled air normally, while rats in the latter 3 groups inhaled smoke to reproduce model of smoke inhalation injury. At 30 min post injury, rats in simple injury group were injected with 1 mL normal saline via caudal vein, and rats in group BMSCs were injected with 1 mL the fifth passage of BMSCs (1×107/mL), and rats in group NMⅡA-BMSCs were injected with 1 mL NMⅡA silenced BMSCs (1×107/mL). At post injury hour (PIH) 24, abdominal aorta blood and right lung of rats in each group were harvested, and then arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), and pH value were detected by blood gas analyzer. Ratio of wet to dry weight of lung was determined by dry-wet weight method. Pathological changes of lung were observed with HE staining. Bronchoalveolar lavage fluid (BALF) were collected, and then tumor necrotic factor-α (TNF-α) and interleukin-10 (IL-10) content of BALF was determined by enzyme-linked immunosorbent assay. Data were processed with one-way analysis of variance, Kruskal-Wallis
7.Roles of intestinal microecological preparations in intra-abdominal infection
Yi LONG ; Guixin WU ; Mengting CHEN ; Rui LI ; Xiaoming LI ; Yongpeng HE ; Zhengying JIANG
Chinese Journal of Digestive Surgery 2023;22(11):1300-1305
Intra-abdominal infection is the second common infectious disease in intensive care unit and inhospital patients, with the mortality rate of 20%-30%. Advances in medicine have not improved the outcomes of patients with intra-abdominal infection, and the increasing multi-drug resistance organism may lead to a deterioration in the prognosis of patients with intra-abdominal infection. Gut microbiota dysbiosis and abdominal cavity infections show an interdependent and mutually aggravating relationship. Intestinal microecological preparations regulate gut flora and are potential therapeutic measures for intra-abdominal infections. The authors review the changes in gut flora during intra-abdominal infection, the effect of gut flora on the prognosis of intra-abdominal infections and the role of intestinal microecological preparations in intra-abdominal infections.
8.Clinical characteristics and influencing factors for mortality of patients with intra-abdominal candidiasis: a multicenter retrospective study
Huijun ZHENG ; Cunrong CHEN ; Haoteng LUO ; Zhigang CHANG ; Zhe FENG ; Jingyao ZHANG ; Shuo ZHAO ; Jun DUAN ; Tao LI ; Weiqin LI ; Lu KE ; Zhihui TONG ; Zhengying JIANG ; Guixin WU ; Zhiyong LIU ; Junwei ZHANG ; Na YANG ; Donghai WANG ; Feng GUO
Chinese Journal of Digestive Surgery 2021;20(11):1177-1183
Objective:To investigate the clinical characteristics and influencing factors of mortality in patients with intra-abdominal candidiasis (IAC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 203 IAC patients who were admitted to 7 medical centers from June 2018 to June 2020 were collected, including 54 cases in Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, 31 cases in Fujian Medical University Union Hospital, 25 cases in Beijing Hospital, 25 cases in the First Affiliated Hospital of Xi'an Jiaotong University, 24 cases in China-Japan Friendship Hospital, 22 cases in General Hospital of Eastern Theater Command of Chinese PLA and 22 cases in Chongqing University Cancer Hospital. There were 130 males and 73 females, aged (64±15)years. Observation indicators: (1) candida infection and treatment of IAC patients; (2) analysis of influencing factors for mortality of IAC patients. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate and multivariate analyses were performed by Logistic regression model. Results:(1) Candida infection and treatment of IAC patients: 134 cases of candida albicans were cultured in the initial abdominal drainage fluid or intraoperative abdominal specimens of 203 patients, and 49 cases were treated with fluconazole. Of 69 cases infected with non candida albicans, 13 cases were treated with fluconazole. The resistance rate of candida albicans to fluconazole was 5.91%(12/203). Of 203 patients, there were 68 cases with infections shock, 53 cases with renal failure, 84 cases with respiratory failure and 63 cases with multiple organ failure, respectively. There were 148 of 203 patients admitted to intensive care unit for 9 days(range, 3-20 days), and the total hospital stay was 28 days(range, 17-50 days). Of 203 patients, 86 cases were cured and discharged, 50 cases were improved and transferred to local hospitals, 32 cases gave up treatment and discharged automatically, 19 cases died, 16 cases had no follow-up data. The mortality was 25.12%(51/203). (2) Analysis of influencing factors for mortality of IAC patients. Results of univariate analysis showed that acute physiology and chronic health evaluation score, sequential organ failure assessment score, the Cr, bilirubin, albumin, procalcitonin, and PLT on the first day of candida positive culture, of the lowest value in a week and the highest in a week, heart disease, diabetes, infections shock, renal failure, respiratory failure, multiple organ failure, anti-fungal therapy were the related factors for mortality of IAC patients ( t=-2.322, Z=-2.550, -2.262, -4.361, t=2.085, Z=-3.734, -5.226, -2.394, -5.542, t=3.462, Z=-4.957, -5.632, 3.670, -5.805, t=3.966, Z=-3.734, -5.727, χ2=4.071, 4.638, 27.353, 18.818, 13.199, 26.251, 13.388, P<0.05). Multivariate analysis showed that the bilirubin, procalcitonin on the first day of candida positive culture and infections shock were independent risk factors for mortality of IAC patients ( odds ratio=1.021, 1.022, 6.864, 95% confidence interval as 1.010-1.033, 1.001-1.044, 1.858-25.353, P<0.05). Conclusions:The common fungus of IAC was candida albicans, and fluconazole can be used as the initial empirical treatment. The prognosis of patients with abdominal candidiasis is poor. Bilirubin, procalcitonin on the first day of candida positive culture and infections shock are indepen-dent risk factors for mortality of IAC patients.
9.Effects of esketamine for multimodal analgesia on opioid consumption and gastric motility in mechanically ventilated non-surgical ICU patients
Yi LONG ; Qian LIU ; Rui LI ; Guixin WU ; Aiting HE ; Zhengying JIANG
China Pharmacy 2024;35(4):468-471
OBJECTIVE To investigate the effects of esketamine for multimodal analgesia on opioid consumption and gastric motility in mechanically ventilated non-surgical intensive care unit (ICU) patients. METHODS Forty cases of mechanically ventilated non-surgical patients in the ICU of our hospital from February 1st, 2023 to July 31st, 2023 were selected and randomly divided into control group and esketamine (S-K) group using grouping method with opaque envelopes, with 20 cases in each group. Control group was given sufentanil, and S-K group was infused with Esketamine hydrochloride injection at a constant rate of 0.2 mg/(kg·h)+ sufentanil. The treatment period length, analgesic compliance rate, sedation level, analgesic and sedative consumption, and gastric motility indexes were compared between the two groups. RESULTS There was no statistically significant difference in the treatment period length, analgesic compliance rate, sedation level, or the consumption of propofol and midazolam between the two groups (P>0.05). The consumption of sufentanil in the S-K group was significantly less than control group (P< 0.05). Compared with 1 h after randomization, the antral contraction frequency, antral contraction amplitude and antral motility index of patients in the S-K group were significantly higher at 72 h after randomization and were significantly higher than control group (P<0.05). CONCLUSIONS Esketamine may reduce opioid consumption and improve gastric motility in mechanically ventilated non-surgical ICU patients while ensuring a level of analgesic sedation.
10.Trend analysis of morbidity and mortality of colorectal cancer in China from 1988 to 2009.
Tian'an GUO ; Li XIE ; Jiang ZHAO ; Wang SONG ; Weixing DAI ; Fangqi LIU ; Ying ZHENG ; Ye XU ;
Chinese Journal of Gastrointestinal Surgery 2018;21(1):33-40
OBJECTIVETo explore the trend change of the morbidity and mortality of colorectal cancer in China in order to provide reference to the prevention and control of colorectal cancer.
METHODSAccording to the 1-3 volumes of "Pathogenesis and death of malignancies in pilot program city and county of China", "Pathogenesis and death of cancer in China"(2003-2007) and "Registration annual report of tumor in China" published in 2011 and 2012, data of pathogenesis and death of colorectal cancer from 10 tumor registration spots, including Beijing urban, Shanghai urban, Wuhan urban, Harbin urban (defined as city urban), and Hebei Ci County, Jiangsu Qidong District, Zhejiang Jiashan District, Guangxi Fusui County, Fujian Changle District, Henan Lin County (defined as rural district), between 1988 and 2009 were collected. The morbidity and mortality were elucidated with world population standardized rate. Ratio of pathogenesis to death was calculated with crude rate of morbidity and mortality. Data of 22 years were enrolled into the linear regression analysis to calculate the annual change rate of morbidity and mortality statistically.
RESULTS(1) Colon cancer: morbidity presented increasing trend; male morbidity in city urban increased faster; mortality presented increasing trend as well; no significant difference of increasing velocity was observed between city urban and rural district; morbidity and mortality in city urban were higher compared to rural district; morbidity and mortality of males were higher compared to females; except stable Fujian Changle District, ratio of pathogenesis to death presented decreased trend in Shanghai urban and Hebei Ci County, and increased trend in other 7 spots (all P<0.05). (2) Rectal cancer: morbidity presented increasing trend, and its increasing velocity of city urban was faster compared to rural district; mortality presented decreased trend, especially in females, and this trend in rural district was worse compared to city urban; morbidity and mortality of males were higher compared to females, while no significant difference was observed between city urban and rural district; morbidity and mortality of males and females in Zhejiang Jiashan District were all decreased (all P<0.05); except stable Harbin city, ratio of pathogenesis to death presented increased trend in other 9 spots (all P<0.05). (3) Ratio analysis of morbidity and mortality showed that percentage of colon cancer increased gradually in all 10 spots between 1988-2009.
CONCLUSIONSIn the past 2 decades, the overall morbidity and mortality of colorectal cancer are higher in city urban and in male as compared with rural district and female. Colon cancer has higher morbidity than rectal cancer and its morbidity and mortality present increased trend, while morbidity of rectal cancer presents increased trend but its mortality presents decreased trend.