5.The effect of direct hemoperfusion with neutral resin on patients with septic shock caused by gram-negative bacteria infection
Wei SU ; Zhi YANG ; Donglin XU ; Zili YANG
Chinese Journal of Emergency Medicine 2012;21(7):746-750
Objective To evaluate clinical effect and safety of direct hemoperfusion with neutral resin (NS-DHP) on patients with septic shock caused by Gram-negative bacteria infection.Methods A total of 42 patients were enrolled in the study and randomly ( random number) divided into two groups.Patients of control group ( n =24) received sepsis bundle therapy,and patients of group D ( n =18 ) were treated with NS-DHP in addition to sepsis bundle therapy.HA330 hemoperfusion device were used in each patient of group D.The procedure of hemoparfusion lasted 2.5 hours and carried out trice a 24 hours.Clinical data including APCHE Ⅱ score,PO2/FiO2 (OI),mean arterial pressure (MAP),dopamine usage (DA),plasma level of endotoxin (ET),C-reactive protein (CRP),TNF-α,IL-6 and IL-10 were recorded during the treatment.Results Patients well tolerated NS-DHP without any complication in group D.All patients in both two groups did not receive long-term renal replacement therapy.At 24 h,48 h and 72 h after the initiation of treatment,APACHE Ⅱ score,O1,MAP,DA,ET,CRP,TNF-α and IL-6 improved obviously both groups (P <0.05),but there was no significant ditterence in serum levels of IL-10 in both groups.In the group D,APCHE Ⅱ score,OI,MAP,DA,CRP,TNF-α and IL-6 were improved more obviously than those in the group C (P <0.05) ).There was no significant difference in plasma levels of ET in both groups during the treatment.Conclusions NS-DHP can improve APACHE Ⅱ score,PO2/FiO2 and MAP in patients with septic shock caused by gram-negative bacteria infection and reduce the levels of CRP,TNF-α and IL-6,but has no effect on the levels of ET and IL-10 as well as on 28-day mortality and ICU stay.
6.The relationships of clinical pathological characteristics with the expressions of epidermal growth factor receptor and protein kinase B in the gastric carcinomas
Zhi DUAN ; Hui CHEN ; Di WANG ; Qimei XU ; Meiyan WEI
Journal of Chinese Physician 2012;(11):1486-1489
Objective To explore the association between clinical pathological characteristics and the expressions of epidermal growth factor receptor (EGFR) and protein kinase B (AKT) in gastric carcinomas.Methods The expressions of EGFR and AKT were measured with immunohistochemical method in the cancer tissues and cancer-adjacent normal tissues from 153 cases of patients with gastric cancer.The association between clinical pathological characteristics and their expressions were analyzed.Results The expressions of AKT and EGFR in gastric cancer tissues had no relationship with gender,age,pathological type,and the degree of differentiation (P > 0.05).A positive correlation was existed between the EGFR and TNM stages (x2 =5.43,P <0.05).The AKT was positively related to the size,T stage,and TNM stage of the tumor,respectively (x2 =4.73,4.95,5.32,P <0.05 orP <0.01).The levels of AKT (x2=4.83,4.75,P <0.05) and EGFR(x2 =4.67,4.58,P <0.05) in the gastric cancer tissues with lymph node and/or distant metastasis were significantly higher than the gastric cancer tissues without metastasis,respectively.Conclusions The over-expressions of AKT and EGFR would benefit the diagnosis and stages of a gastric cancer and the determination of its metastasis.
7.Effect of leptin on plasma cholesterol in mice with hyperlipemia.
Wei-qiang CHEN ; Dian-xin LIU ; Zhi-qin XU
Chinese Journal of Applied Physiology 2003;19(2):206-207
Animals
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Cholesterol
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blood
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Hyperlipidemias
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blood
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drug therapy
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Leptin
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pharmacology
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therapeutic use
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Male
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Mice
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Mice, Inbred Strains
10.Study of etiology and esophageal motility characteristics of esophagogastric junction outlet obstruction patients.
Kun WANG ; Zhi Jie XU ; Ying GE ; Zhi Wei XIA ; Li Ping DUAN
Journal of Peking University(Health Sciences) 2020;52(5):828-835
OBJECTIVE:
To analyze the causes of the esophagogastric junction outlet obstruction (EGJOO) patients, to discuss the differences of the clinical manifestation and esophageal motility characteristics between the anatomic EGJOO (A-EGJOO) and functional EGJOO (F-EGJOO) subgroups, and to search the diagnostic values of the specific metrics for differentiating the subgroups of EGJOO patients.
METHODS:
For the current retrospective study, all the patients who underwent the esophageal high resonance manometry test were retrospectively analyzed from Jan 2012 to Oct 2018 in Peking University Third Hospital. The EGJOO patients were enrolled in the following research. The clinical characteristics, such as symptoms and causes of the patients were studied. Then the patients were divided into two subgroups as A-EGJOO subgroup and F-EGJOO subgroup. The clinical symptoms and the main manometry metrics were compared between these two subgroups. The significant different metrics between the two groups were selected to draw receiver operating characteristic (ROC) curves and the diagnostic values were analyzed in differentiating the A-EGJOO and F-EGJOO subgroups.
RESULTS:
The most common symptom of EGJOO was chest pain or chest discomfort (30.63%), then the dysphagia (29.73%), and acid regurgitation/heartburn (27.03%). Non-erosive reflux disease (36.04%) was the most popular cause for EGJOO, then the reflux esophagitis (17.12%). Besides the intra-EGJOO and extra-EGJOO lesions, the connective tissue disease (6.31%) and central nervous diseases (2.70%) were found to be the etiology of EGJOO. The causes of the rest 19 EGJOO were unknown. A-EGJOO patients presented significantly higher intra bolus pressure (IBP) than that of F-EGJOO [6.80 (5.20, 9.20) mmHg vs. 5.10 (3.10, 7.60) mmHg, P=0.016]. The area under curve of IBP was 0.637. When IBP≥5.15 mmHg, the sensitivity was 78.60% and specificity 50.70% to differentiate A- or F-EGJOO.
CONCLUSION
Chest pain or chest discomfort was the most common symptom in EGJOO patients. Besides the intraluminal structural disorders, the extra-luminal causes were found in EGJOO patients. A-EGJOO presented higher IBP than that of F-EGJOO patients. The cutoff value of IBP to differentiate A-EGJOO from EGJOO was 5.15 mmHg with sensitivity 78.06% and specificity 50.70%. However for the low area under curve, the diagnostic value of IBP was limited.
Deglutition Disorders
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Esophageal Motility Disorders/diagnosis*
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Esophagogastric Junction
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Humans
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Manometry
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Retrospective Studies