2.Heparin for treatment of sepsis: a systemic review
Zhiyong LIU ; Hong ZHU ; Xiaochun MA
Chinese Critical Care Medicine 2014;26(3):135-141
Objective To systemically review the efficacy and safety of heparin for treatment of sepsis.Methods Database search of IM/MEDLINE,Cochrane Library,SCIE,CBM,CNKI,VIP Data,WanFang Data (from January 2000 to June 2012) was conducted.The quality of included randomized controlled trials (RCTs) about heparin for treatment of sepsis was assessed,and relevant data were extracted according to the inclusion and exclusion criteria.Then meta analysis was performed using RevMan 5.1.Results 17 trials with 1 167 participants were included.The results of meta-analysis showed:compared with the control group,heparin significantly decreased 28-day mortality in patients with sepsis [odds ratio (OR) =0.59,95% confidence interval (95%CI) 0.45-0.77,P=0.0001] ; heparin did not deteriorate coagulation disorders,but corrected sepsis-induced platelet (PLT) count reduction [mean difference (MD) =13.94,95% CI 10.15 to 17.72,P<0.000 01],while it had no significant effect on the activated partial thromboplastin time (APTT) and prothrombin time (PT,APTT:MD=-3.18,95%CI-6.88 to 0.53,P=0.09; PT:MD=-0.68,95% CI-1.48 to 0.12,P=0.09).There was no significant difference between the two groups in the incidence of bleeding either.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score of heparin group was significantly lower than that of the control group (MD=-2.58,95%CI-3.29 to-1.87,P<0.000 01),and the incidence of multiple organ dysfunction syndrome (MODS) was significantly lower than that of the control group (OR=0.32,95%CI 0.17 to 0.61,P=0.000 6).In addition,heparin could shorten intensive care unit (ICU) stay (MD=-4.43,95%CI-6.79 to-2.07,P=0.000 2),whereas it showed no significant effect on the total length of hospital stay.Conclusions Heparin can ameliorate sepsis,and has high degree of safety and lower hospital expense.Due to limitation of the quality of included studies,larger sample and well-designed RCTs are needed to further support this conclusion.
3.Effects of sevoflurane pretreatment on the nuclear factor kappa B-DNA binding activity of leukocyte in peripheral blood of the patients undergoing cardiac valve replacement with cardiopulmonary bypass
Junchao ZHU ; Hong MA ; Junke WANG
Chinese Pharmacological Bulletin 1987;0(03):-
Aim To investigate the effect of sevoflurane pretreatment on the nuclear factor kappa B(NF-?B)-DNA binding activity of leukocyte in peripheral blood of the patients undergoing cardiac valve replacement under cardiopulmonary bypass(CPB).Methods Twenty patients undergoing cardiac valve replacement under CPB were divided randomly into two groups:control group(group C)and sevoflurane pretreatment group(group S).All patients were induced with midazolam 0.08~0.12 mg?kg-1,fentanyl 5~10 ?g?kg-1 and vecuronium 0.1 mg?kg-1.After endotracheal intubation,mechanical ventilation was conducted with 100% oxygen.Anesthesia in group C was maintained with intermittent intravenous fentanyl and midazolam,while in group S maintained with 2MAC sevoflurane besides fentanyl and midazolam intermittently before CPB.The anesthesia depth was kept to maintain the systolic pressure within 90~120 mmHg in both groups.Sevoflurane was discontinued at the initiation of CPB,and the following anesthetic regimen was the same as that in group C.To examine the NF-?B-DNA binding activity,the arterial blood samples were withdrawn at the following time point:after endotracheal intubation and before inhaling sevoflurane(T0),30 min(T1),1 h(T2),2 h(T3),6 h(T4)after aortic de-clamping.Electrophoretic mobility shift assay(EMSA)was used to measure the NF-?B-DNA binding activity of leukocyte.The dosage of fentanyl,midazolam,dopamine,sodium nitroprusside and the rate of spontaneous heart resuscitation in both groups were recorded.Results The NF-?B-DNA binding activity in group C was increased significantly after aortic de-clamping,and it reached to maximum at T1,but it was not changed significantly in group S from T0 to T4.The value of EMSA at all time points was lower in group S except T0 than that in group C(P
4.Effects of volatile isoflurane on rat heart ischemia-reperfusion injury in vitro
Junchao ZHU ; Hong MA ; Junke WANG
Chinese Pharmacological Bulletin 1986;0(06):-
Aim To investigate the effects of Isofluraneon function,metabolism,ATPase activity and free radicals in isolated ischemia /reperfusion(I/R) rat hearts.Methods 56 SD rats were randomly divided into 7 small groups(n=7),or 2 big groups according to given drug.In a normal thermal isolated Langendorff rat heart model,Myocardial Adenosine triphosphate(ATP),Malodialdehyde(MDA),Activity of Ca2+-ATPase,Na+,K+-ATPase and Superoxide Dismutase(SOD)were determined.Results In isoflurane group,LVDP and dp/dt decreased,CF and ATP increased while the activity of Na+,K+-ATPase remained unchanged.The myocardial ATP content decreased slowly in isoflurane group.At the end of reperfusion,ventricular function,CF,myocardial ATP content and the activity of Ca2+-ATPase and SOD in isoflurane group were significantly higher while myocardial MDA was significantly lower than those in control group.Conclusion Isoflurane can depress myocardial systolic function and activity of Ca+-ATPase in normal myocardium,improve the recovery of function and metabolism,and increase CF and the activity of Ca2+-ATPase and Na+,K+-ATPase.
5.Ultrasound Contrast Agent Injection Volume in Evaluating Tubal Patency
Jingli MA ; Qi CHENG ; Shasha WANG ; Xiansheng ZHU ; Hong WANG
Chinese Journal of Medical Imaging 2013;(12):932-935
Purpose To explore the association between ultrasound contrast agent injection volume as well as regurgitation and tubal patency. Methods SonoVue contrast agent was used for 515 cases of infertility transvaginal four-dimensional ultrasound imaging hysterosalpingography, recorded the amount of contrast agent injection, regurgitation, and compared contrast agent injection volume and regurgitation in different patency. Results The ultrasound contrast agent injection volume between bilateral patency with bilateral passable and one side patency one side passable as well as one side patency one side barrier, between one side patency one side passable and one side patency one side barrier had no significant difference (U=1467.0-4843.0, P>0.05);and it had statistical difference between any other two conditions (U=273.5-6160.0, P<0.05). The regurgitation between bilateral passable and bilateral barrier, one side passable one side barrier, between bilateral barrier and one side patency one side barrier, one side passable one side barrier, between one side patency one side passable and one side patency one side barrier had no statistical difference (U=949.5-6378.5, P>0.05), and it had statistical difference between any other two conditions (U=919.5-5126.5, P<0.05). Conclusion Ultrasound contrast agent injection volume and regurgitation in hysterosalpingography are associated with tubal patency, which can be used as objective indexes for assessing tubal patency, and provide basis for tubal patency.
6.Analysis of respirtory virus IgM antibodies detection in patients with respiratory tract infection in emergency wards
Fengquan JIANG ; Junyi MA ; Hong ZHU ; Yanan GU ; Yanjie CHENG
International Journal of Laboratory Medicine 2017;38(10):1360-1362
Objective To understand the distribution situation of respiratory viral infection among adult inpatients with respiratory infection in the emergency department.Methods The detection results data of 5 kinds of viruses RSV,IVA,IVB,PIV1,PIV2,PIV3 and ADV by indirect immune fluorescence assay in 384 adults patients with respiratory infection in the emergency department of our hospital from January 2014 to December 2015 were collected.The epidemic characteristics of different viruses were analyzed.Results Among 384 specimens,208 cases were positive in respiratory virus IgM antibody,the viral infection positive rate was 54.17%.The mixed virus infection and influenza B virus infection were most common,their viral positive rates were 26.56% and 23.44% respectively,In the mixed viral infection,the positive rate of IVA + IVB mixed infection was highest,accounting for 87.25%,which was higher than that of other kinds of mixed viral infection.The viral infection positive rate had no statistical difference between different genders(P>0.05).The viral infection rate was higher in autumn and winter,which were 66.06% and 68.37% respectively and higher than 42.31% and 34.25% in spring and summer,the difference was statistically significant(P<0.05).The viral infection rates of youth (18-45 years old) and middle-aged (>45-60 years old) were 64.94% and 63.86% respectively,which were higher than 48.45%,44.92% and 55.56% in pre-elderly (>60-75 years old),elderly (>75-90 years old) and longevous elderly (>90 years old),the differences were statistically significant(P<0.05).Conclusion The respiratory virus mixed infection and IVB infection are most common in the emergency wards,moreover the viral infection situation shows the seasonal and age characteristics,but which is not affected by sex factor.
7.Influence of body mass index on serum prostate-specific antigen in male younger than 50 years
Ming LIU ; Ling ZHU ; Gang WAN ; Xin CHEN ; Hong MA ; Lanjun MA ; Jie PAN ; Weiwei JIANG ; Jianye WANG
Chinese Journal of Urology 2009;30(12):852-855
Objective To analyse the correlation of age and BMI with prostate-specific antigen (PSA)in male younger than 50 years of age. Methods The routine health examination data of 6808 males, younger than 50 years of age, were collected and reviewed. The height and weight were measured, so as to calculate the body mass index (BMI). Serum PSA was also examined. Eligible men were classified into age groups spanning 10 years. BMI was categorized as normal (BMI 18. 5 - 22. 9) , overweight (BMI 23. 0-24. 9), obese (BMI 25. 0 - 29. 9) , and very obese (BMI≥30. 0) according to the re-defined World Health Organization criterion for the Asia Pacific Region. PSA levels were stratified by age and BMI category. Results The mean age was (39. 2±7. 0)years, mean BMI (25. 6± 4. 7)kg/m~2 and mean PSA (0. 89±0. 56)ng/ml for the whole population. The PSA level in 10 - 19 age group was significantly lower than the other three groups (P<0. 01) and no significant difference was found among the other three groups. The BMI had negative correlated with PSA even when comparing in sub-age groups, except the 10-19 age group. Spearman analysis also found PSA had significant positive correlation with age and negative correlation with BMI. Conclusions Serum PSA level changes significantly with age in adolescence whereas quite slowly between 20-50 years of age. BMI has negative influence on PSA in male younger than 50 years of age.
8.Effects of flower bud removal and artificial pollination on growth and yield of Tulipa edulis.
Yuan-Yuan MIAO ; Zai-Biao ZHU ; Qiao-Sheng GUO ; Hong-Liang MA ; Ying YANG ; Li-Fang ZHU
China Journal of Chinese Materia Medica 2014;39(11):2016-2018
The study was conducted to explore the response of growth and yield of Tulipa edulis to flower bud removal and artificial pollination. And flower bud removal and artificial pollination were carried out in the squaring period and bloom stage respectively. The morphological index and biomass indicators were determined and the yield was counted in harvest time. Result showed that flower bud removal was beneficial to the growth of T. edulis, resulting in increasing growth index, biomass as well as the yield of bulb. The diameter and dry weight of T. edulis fruit by artificial pollination were increased significantly compared with the control. Seed setting percentage increased to 100%, and the number of seed as well as the single grain weight increased by 69.03% and 16.48%, respectively, which did not significantly affect the bulb production. In conclusion, Flower bud removal treatment accelerates bulb biomass increase, so as to improve its yield. Artificial pollination raised significantly seed setting percentage, seed number as well as the single grain weight.
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9.Levothyroxine dosage and related factors in the treatment of pregnant women with subclinical hypothyroidism
Heng SU ; Xiulian REN ; Shan MA ; Hong CHEN ; Yuanming XUE ; Yun ZHANG ; Baosheng ZHU
Chinese Journal of Endocrinology and Metabolism 2012;28(10):826-829
Objective To study the levothyroxine doses and related factors in the treatment of pregnant women with subclinical hypothyroidism (SCH).Methods Fifty-six pregnant women with SCH (diagnosed before 12 weeks of gestation) were recruited and divided into 2 groups according to the baseline TSH levels,SCH group 1 (2.5 mIU/L ≤ TSH ≤ 5.0 mIU/L,n =24) and SCH group 2 (TSH>5.0 mIU/L,n =32).Thyroid autoantibodies [thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb)] were detected.All the subjects were treated with levothyroxine and the doses were adjusted according to the TSH level.The therapeutic target was to keep the TSH levels under control,0.3 to 2.5 mIU/L for the first trimester and 0.3 to 3.0 mIU/L for the second and third trimesters.Results There was a positive correlation between the levothyroxine doses and baseline TSH levels (r =0.533,P<0.01) in pregnant women with SCH.A significant difference in the levothyroxine doses between SCH group 1 and SCH group 2 was found [(0.583 ± 0.341) vs (0.961 ± 0.405) μg/kg,t =-3.695,P< 0.01].The levothyroxine doses in SCH group 2 were 64.84% higher than those in group 1.There was a significant difference in the levothyroxine doses between thyroid autoantibody negative and positive subjects [(0.680 ± 0.370) vs (0.918 ±0.440) μg/kg,t =-2.197,P =0.032].The levothyroxine doses in thyroid autoantibody positive subjects were 35 % higher than those in the negative subjects.In addition,there was a significant difference in the levothyroxine doses between subjects with negative and positive thyroid autoantibody [(0.421 ± 0.192) vs (0.720 ± 0.385)μg/kg,t =-2.331,P =0.029] in SCH group 1.While in SCH group 2,the difference did not reach statistical significance.Conclusion The baseline TSH levels and status of thyroid autoantibodies may affect the levothyroxine dosage in pregnant women with SCH.
10.Diagnostic value of serum NGAL and Cys-C for early renal damage in aged patients with chronic heart ;failure of coronary heart disease
Hong ZHU ; Lina MA ; Wei YANG ; Ruojin CAO ; Yuying QIAN ; Ming FENG
Chinese Journal of cardiovascular Rehabilitation Medicine 2014;23(2):170-175
Objective:To explore the relationship among serum neutrophil gelatinase associated lipocalin (NGAL), cystatin C (Cys-C) levels and cardiac, renal function;and diagnostic value of NGAL and Cys-C for early renal damage in aged patients With coronary heart disease (CHD).Methods:According to NYHA cardiac function classi-fication,a total of 84 aged CHD patients Were divided into class I group (n=30),class Ⅱ group (n=28)and classⅢ-Ⅳ group (n=26).Another 31 aged healthy objects Were selected as healthy control group.Serum N terminal pro B-type natriuretic peptide (NT-proBNP),NGAL and Cys-C etc. levels Were measured,and the correlation a-mong serum NGAL,Cys-C levels and cardiac function,estimated glomerular filtration rate (eGFR)Were analyzed. The accuracy of serum NGAL and Cys-C diagnosing renal insufficiency Was evaluated by receiver operator character-istic curve (ROC).Results:Along With NYHA class increased,there Were significant increase in serum levels of NGAL [(36.96±21.23)μg/L vs.(87.80±61.40)μg/L vs.(141.21±92.96)μg/L vs.(198.15±98.46)μg/L] and Cys-C [(0.75±0.64)mg/L vs.(1.40±1.88)mg/L vs.(2.33±2.03)mg/L vs.(3.45±1.81)mg/L]in healthy control group,NYHA I,Ⅱ,Ⅲ-Ⅳ groups,and they Were highest in NYHA class Ⅲ-Ⅳ group,there Was significant difference in serum NGAL level betWeen any tWo groups among the four groups (P<0.01),and so Was serum Cys-C level (P<0.05 or <0.01)except healthy control group and NYHA class I group (P>0.05). Pearson correlation analysis indicated that serum NGAL and Cys-C levels Were positively correlated With NT-proBNP (r=0.842,0.718,P<0.01 both),and negatively correlated With eGFR (r=-0.689,-0.448,P<0.01 both), and serum NGAL level had closer correlation With NT-proBNP and eGFR.Area under ROC of serum NGAL and Cys-C Were 0.884 and 0.744 respectively in diagnosing renal insufficiency.Conclusion:Serum NGAL and Cys-C lev-els have good correlation With cardiac and renal function in aged CHD patients,Which are sensitive and accurate in-dexes for diagnosing early renal damage.