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The clinical significance of the change of plasma BNP levels in patients with grades sepsis

Ling TENG ; Yinghe XU ; Zhencang ZHENG ; Yi JIN ; Qingxin SHI ; Cheng YANG ; Aixiang YANG ; Huijuan WU ; Peng CHEN

Journal of Chinese Physician.2011;13(2):184-187. doi:10.3760/cma.j.issn.1008-1372.2011.02.012

Objective To study the clinical significance of the change of plasma BNP levels in patients with grades sepsis and its correlation with the left ventricular ejection fraction.Methods One hundred patients of sepsis who were admitted in intensive care unit of Taizhou hospital were selected.It was divided into four groups:30 patients with septic shock,40 patients with severe sepsis,30 patients with sepsis and 20 persons without disease as control group.The concentration of plasma BNP was determined using sandwich immunoflurescence,and ultrasonic cardiogram was used to evaluate heart function and clinical features in all groups.To compare with the differences of the concentration of plasma BNP and the correlation between the concentration of Plasma BNP and LVEF in all groups,the data of clinical features,28-day mortality,prognostic values of BNP and the length of stay (ROG) in ICU were collected and compared.Result Plasma BNP levels in patients with septic shock[ (976.3 ± 160.7) pg/ml] were obvious higher than severe sepsis[ (648.4 ± 267.3) pg/ml ],sepsis [ (217.2 ± 89.7) pg/ml ] and control group [ (50.3 ± 25.4)pg/ml] (P ＜0.01).LVEF in patients with septic shock [ (48.2 ±9.6)% ] was obvious lower than severe sepsis[ (52.8 ±9.4)% ],sepsis[ (61.3 ± 8.9)% ] and control group[ (66.4 ±9.3)% ] (P ＜0.05 or P ＜0.01).It appeared to be inverse relationship between LVEF and the plasma BNP levels (r =-0.876,-0.724,P ＜0.01).BNP levels were significantly higher in non-survivors compared with survivors[ (1367.6±506.4)pg/ml vs (420.3 ±82.6)pg/ml,P ＜0.01 ].The receiver operating characteristic (ROG) curves indicated that values of areas under the curve of plasma BNP levels for 28-days mortality were 0.918(P ＜0.01).Conclusion The concentration of plasma BNP in patients was different in different grades of sepsis.It appeared to be negative correlation between the concentration of plasma BNP and LVEF.Plasma BNP levels had predictive value to the patients with sepsis.

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Diversity of serum levels of high mobility group box-1 in patients with hepatitis B and its clinical significance

Hongying YU ; Huanyu GONG ; Zhengyuan FU

Journal of Chinese Physician.2011;13(2):173-176. doi:10.3760/cma.j.issn.1008-1372.2011.02.009

Objective To investigate the clinical significance of high mobility group box-1 protein (HMGB1) in chronic,severe hepatitis B patients and liver cirrhosis.Methods The contents of HMGB1 was measured by enzyme-linked immunoassay (ELISA) in the patients (include 40 patients with chronic hepatitis B and 18 severe hepatitis B patients and 18 liver cirrhosis patients) and 20 health controls.The levels of relative biochemical indicators,prothrombin time activity percentage (PTA) and the hepatic fibrosis were determined by biochemical methods.Results The contents of HMGB1 was significantly increased in severe hepatitis patients in comparison with that in chronic hepatitis B patients(P ＜0.01).The contents of HMGB1 in the chronic hepatitis were significantly increased in health controls(P ＜0.01).The contents of HMGB1 had significant difference among the liver cirrhosis patients,the severe hepatitis patients and the chronic hepatitis(P ＜0.01).There was positive correlation among the contents of HMGB1 and total bilirubin (TBIL),the proportionality of aspartate aminotransferase and alanine aminotransferase (AST/ALT),hyaluronic acid (HA) and procollagen Ⅲ N-terminal peptide (P Ⅲ NP) (r = 0.865,0.646,0.783,0.662,P ＜ 0.01).There was negative correlation among the contents of HMGB1 and prothrombin time activity percentage (PTA) and albumin (ALB) (r =-0.915,-0.852,P ＜0.01).Conclusion The contents of serum HMGB1 were closely associated with disease severity in chronic hepatitis B patients.HMGB1 was an index to auxiliary diagnosis hepatic fibrosis.

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The diagnostic value of apparent diffusion coefficient in monitoring the development of cerebral infarction

Jianmin SHEN ; Xianwu XIA ; Wugen KANG ; Jiangjun YUAN ; Liang SHENG

Journal of Chinese Physician.2011;13(2):170-172. doi:10.3760/cma.j.issn.1008-1372.2011.02.008

Objective To study the values of apparent diffusion coefficient (ADC) changing with time and space in cerebral infarction,and to provide the evidence in defining the infarction stages.Methods 117 work-ups in 98 patients with cerebral infarction (12 hyperacute,43 acute,29 subacute,10 steady,and 23 chronic infarctions) were imaged with both conventional MRI and diffusion weighted imaging.The average ADC values,the relative ADC (rADC) values,and the ADC values or rADC values from the center to the periphery of the lesion were calculated.Results The average ADC values and the rADC values of hyperacute and acute infarction lesion depressed obviously.rADC values in hyperacute and acute stage was minimized,and progressively increased as time passed and appeared as "pseudonormal" values in approximately 8 to 14 days.Thereafter,rADC values became greater than normal in chronic stage.There was positive correlation between rADC values and time[ (174 ±3.47)% vs (58±6.75)%,t =2.03,P ＜0.05 ].The ADC values and the rADC values in hyperacute and acute lesions had gradient signs that these lesions increased from the center to the periphery.The ADC values and the rADC values in subacute lesions had adverse gradient signs that these lesions decreased from the center to the periphery.Conclusion The ADC values of infarction lesions have evolution rules with time and space.The evolution rules with time and those in space can be helpful to provide the evidence in guiding the treatment or judging the prognosis in infarction.

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Effect of HbA1c meeting the standard or not on microalbuminuria,blood lipids and liver enzymes in patients with type 2 diabetes

Keying ZHANG ; Peng CAO ; Jian DU ; Yinan YU ; Yun LI ; Hongfei LUO

Journal of Chinese Physician.2011;13(2):167-169. doi:10.3760/cma.j.issn.1008-1372.2011.02.007

Objective To investigate the effect of HbA1c meeting the standard or not on microalbuminuria,blood lipids and liver enzymes in patients with type 2 diabetes.Methods A retrospective analysis was performed on 457 subjects who had type 2 diabetes.They were divided into substandard group and standard group according to HbA1c result.The general information and relevant laboratory indicators of patients were.collected and compared between two groups.Results The microalbuminuria,serum triglyceride and liver enzymes (glutamyl transpeptidase,alkaline phosphatase,aspertate aminotransferase) were significantly different between two groups [ (189.8 ± 235.3) mg/dl vs (38.9 ± 85.5) mg/dl,(2.64 ± 2.99) mmol/L vs (2.02 ± 1.50)mmol/L,(41.7 ±52.9)U/L vs (29.7 ±24.9)U/L,(83.6 ±28.6) U/L vs (74.3 ±25.8)U/L,(26.7 ±19.1)U/L vs (22.0 ±10.5) U/L,P ＜0.05].HbA1c level was positively correlated with microalbuminuria,glutamyl transpeptidase and alkaline phosphatase (r =0.209,0.115,0.11,P ＜0.01).The microalbuminuria was an independent risk factor of affecting HbA1c to reach the standard (OR = 1.009,P ＜0.05).Conclusions HbA1c meeting the standard or not can influence many factors except blood glucose.

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Effects of azithromycin on airway remodeling and transforming growth factor-β1 in asthmatic mice

Meimei ZHENG ; Yong JIANG ; Wujin WEN ; Fangjian WANG ; Chengcheng DUAN ; Xiaohua PAN ; Liyan DONG

Journal of Chinese Physician.2011;13(2):158-161. doi:10.3760/cma.j.issn.1008-1372.2011.02.005

Objective To investigate the effects of azithromycin on airway remodeling and the expression of transforming growth factorβ1 (TGF-β1) in asthmatic mice.Methods BALB/c male mice were random divided into 3 groups:control group(A),asthma group (B),and azithromycin treated group (C),with 10 mice in each group.Bronchoalveolar lavage fluid was collected to count the number of white blood cells and eosinophilic granulocytes EOS.The morphological parameters of the bronchi were measured by computer image analysis and the pathologic changes of the bronchi and lung tissue were observed by HE staining.The expressions of TGF-β1 were detected by immunohistochemistry.Results The number of EOS in B group was significantly higher than that in control group(8.12 ±0.54 vs 0.70 ±0.40;8.12 ±0.54 vs 0.87 ±0.25,P ＜0.01).WAt and WAi and WAm in group C was significantly lower than that in group B (10.15 ±0.95 vs 15.36 ±0.85,4.16 ±0.32 vs 10.64 ± 1.03,3.77 ±0.15 vs 7.97 ±0.17,P ＜0.01)but higher than that in group A.The expression of TGF-β1 in group C was significantly lower than that in group B but higher than that in group A.TGF-β1 expression of lung tissue in C group was significantly correlated with EOS,(r =0.840,P ＜0.01) and WAt(r =0.735,P ＜0.01) and WAm (r =0.870,P ＜0.01).Conclusion Azithromycin inhibited airway remodeling in asthmatic mice,which might possibly be achieved through inhibiting the expression of TGF-β1.

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Observation of oxidative stress condition and macular edema in patients of early diabetic retinopathy treated by probucol

Zhongping CHEN ; Jianghua LIU ; Deyong JIANG ; Ruming ZHANG ; Suping JIANG

Journal of Chinese Physician.2011;13(2):154-157. doi:10.3760/cma.j.issn.1008-1372.2011.02.004

Objective To study the influence of probucol on the diabetic mellitus patients with non-proliferative diabetic retinopathy (NPDR) about blood lipids,serum level of the total antioxidant capacity (TAOC),malondialdehyde (MDA),superoxide dismutase (SOD) and macular edema,so as to provide clinical basis for the prevention and treatment of early DR by probucol.Methods 66 type 2 diabetes patients with 127 NPDR eyes were included.Patients were random divided into control and treatment groups,the control group was treated by intensive therapy of blood glucose and blood pressure control,and the treatment group was treated with the intensive therapy and probucol 0.375g,2 times a day for 12 months.Before and after treatment,the blood lipids,oxidative stress indicators and fundus fluorescein angiography in both groups had been determined.Results 62 cases with 120 eyes were enrolled in this study.Probucol obviously decreased levels of total cholesterol (TC) [ (3.6 ± 0.58) mmol/L VS (4.71 ± 0.61)mmol/L,t = 7.65,P ＜ 0.01 ],triglyceride (TG) [ (1.07 ± 0.35) mmol/L VS (1.23 ± 0.43) mmol/L,t = 2.02,P ＜ 0.05 ],low density lipoprotein cholesterol (LDLC) [ (2.0 ± 0.47) mmol/L VS (2.55 ±0.56)mmol/L,t =4.18,P ＜0.01] and MDA[ (10.35 ±2.97)nmol/L VS (14.83 ±2.75)nmol/L,t =6.18,P ＜0.01] in plasma of the patients.Levels of TAOC [(19.25±4.11)u/ml VS (16.63 ±3.27)u/ml,t =3.57,P ＜0.01 ]and SOD[ (94.52 ± 10.28)u/ml VS (75.37 ± 9.87) u/ml,t =8.62,P ＜0.01]were significantly improved in the probucol group,and the macular edema was significantly reduced in patients of the probucol group(x2 =4.219,P ＜0.05).Conclusion Probucol regulated serum lipids,and it had the apparent action of antioxidant,and it decreased the incidence of macular edema.Probucol had a therapeutic effect in patients with NDPR.

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Inhibition effect of adiponectin on the levels of PC Ⅲ and HA in HSC-T6 cell

Fujun YU ; Peihong DONG ; Xufei FAN ; Yongping CHEN ; Ji LI

Journal of Chinese Physician.2011;13(2):150-153. doi:10.3760/cma.j.issn.1008-1372.2011.02.003

Objective To observe the effects of adiponectin on mRNA and protein expressions of connective tissue growth factor (CTGF) in hepatic stellate cells (HSCs) and the levels of procollagen type Ⅲ (PC Ⅲ) and hyaluronic acid (HA).Methods Cultured rat HSCs were treated with different concentrations of adiponectin.CTGF mRNA and protein expressions were analyzed by reverse transcription polymerase chain reaction (RT-PCR) and Western Blot.The levels of PCⅢ and HA were detected by enzymelinked immunosorbent assay (ELISA).Results Compared with the control group,the result of RT-PCR showed that the four groups had different degrees of inhibitory effect,of which group D exhibited the strongest inhibitory effect.The absorbance ratio was 1.54 ±0.18,1.21 ±0.14,0.96 ±0.10,and 0.79 ± 0.08,respectively (t =2.42,P ＜0.05;t =2.73,P ＜0.05;t =3.28,P ＜0.01;t =4.67,P ＜0.01).Western Blot also indicated that four groups had different degrees of inhibitory effect,of which D group exhibited the strongest inhibitory effect.The ratio of integral absorption was 1.54 ± 0.18,1.21 ±0.14,0.96±0.10,and 0.79 ±0.08,respectively (t =2.84,P ＜0.01;t =4.05,P ＜0.01;t =6.25,P ＜0.01;t =9.72,P ＜0.01).The levels of PCⅢ and HA secreted in culture media were also decreased.It was significantly decreased with the concentration of adiponectin increased.Conclusion Adiponectin can inhibit the levels of PC Ⅲ and HA,which may be achieved through reducing CTGF mRNA and protein expressions.

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Effect of perindopril on the expression of scavenger receptor A gene in diabetic nephropathy

Jianghua WEN ; Xiaochun SHU ; Xiaojun MENG ; Fang HU ; Daichan YIN ; Qiong YANG ; Yingjuan ZENG ; Liao SUN

Journal of Chinese Physician.2011;13(2):145-149. doi:10.3760/cma.j.issn.1008-1372.2011.02.001

Objective To explore the effect of ACE-inhibitor perindopril on the expression of scavenger receptor A (SR-A) gene in the kidney of diabetic rats.Methods Diabetes were induced in male Sprague-Dawley rats by peritoneal injection with streptozotocin (60mg/kg).The rats were then random di vided into normal control group, diabetes group and ACEI treatment group [4mg/(kg·d) for 24 weeks].Blood glucose concentration and 24h urinary albumin excretion were determined.The renal morphological change was observed.Immunohistochemistry was used to analyze CD68 positive macrophages,and the Mrna of SR-A in renal tissue was detected by quantitative real-time PCR.Results Compared with normal control group,blood glucose concentration,24h urinary albumin excretion and the number of CD68 positive macrophages were significantly increased [(5.3 ± 0.6) mmol/L vs (26.7 ± 3.3) mmol/L;(2.7 ± 1.3) mg/24h vs (26.7 ± 1.8)mg/24h;(0.77 ±0.24)/gcs vs (2.55 ±0.46)/gcs;(6.13 ±0.50)/HPF vs (11.9 ±2.12)/HPF;P ＜0.05],and the expression of SR-A Mrna were significantly up-regulated in diabetes group [ (5.6 ± 1.2 vs 1.5 ±0.2),P ＜0.05].After intervention with ACE-inhibitor,the up-regulations of the above mentioned parameters,except blood glucose concentration,were all significantly inhibited [ (3.6 ±1.4)mg/24h;(1.03±0.37)/gcs;(8.28±1.19)/HPF;3.4±0.7;P ＜0.05].Conclusion ACE-inhibitor might have renoprotective effects of diabetic nephropathy,it probably was associated with inhibiting the expression of SR-A gene.

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Clinical significance of visfatin and VE-cadherin and their association with kawasaki disease

Wei LI ; Youmin HUANG ; Yongqin ZHOU ; Jiaoguo ZHANG

Journal of Chinese Physician.2011;13(2):203-205. doi:10.3760/cma.j.issn.1008-1372.2011.02.018

Objective To explore the levels and clinical significance of visfatin and VE-cadherin in the serum of children with Kawasaki diseases (KD).Methods Serum levels of visfatin and VE-cadherin were measured in 90 children with KD and 30 healthy children (control group) by ELISA,the outcome was estimated in combination with clinical symptoms.Results The serum levels of visfatin [ (32.35 ± 4.82)μg/L ] and VE-cadherin[ (5.03 ± 1.06)mg/L] in children with KD were obviously higher than those in control group[ (16.83 ±4.36) μg/L,(2.86 ± 1.02) mg/L] (t = 15.23,12.47,P ＜0.01).The serum levels of visfatin[ (36.61 ±5.22) μg/L] and VE-cadherin [ (6.14 ± 1.23) mg/L] in children with KD and CAL were obviously higher than children of KD without CAL[ (28.16 ± 4.67)g/L,(4.02 ± 1.01)mg/L] (t =8.38,7.16,P ＜0.01).In children with KD,the serum levels of visfatin and VE-cadherin were significantly correlated (r = 0.65,P ＜ 0.05).Conclusions Serum levels of visfatin and VE-cadherin increased in the acute phase of KD,and it was significantly increased in those KD children with CAL.Visfatin and VE-cadherin may be used as an important serological indicator of KD with CAL.

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Correlation between plasma visfatin levels and type 2 diabetes mellitus with carotid atherosclerosis

Zhaoliang LI ; Juan XU

Journal of Chinese Physician.2011;13(2):194-196. doi:10.3760/cma.j.issn.1008-1372.2011.02.015

Objective To investigate the relationship between plasma visfatin levels and type 2 diabetes mellitus patients with carotid atherosclerosis.Methods 60 subjects were divided into 3 groups,T2DM no carotid atherosclerosis group (20 cases),T2DM with carotid atherosclerosis group (20 cases)and normal control group (20cases).Carotid IMT,plasma visfatin,waist circumference (WC),fasting plasma glucose (FPG),HbA1C,blood lipids,fasting serum insulin (FINS) were assayed or measured in all subjects.Results Plasma visfatin levels in T2DM with carotid atherosclerosis were significantly higher than those in normal control group and T2DM group [ (50.85 ± 20.14) ng/ml vs (18.50 ± 4.60) ng/ml,(50.85 ±20.14) ng/ml vs (35.52 ± 10.18) ng/ml,F = 105.983,P ＜0.01].Correlation analysis showed that plasma levels of visfatin were positively correlated with carotid IMT(r =0.476,P ＜0.01),TG (r =0.328,P ＜0.01),WC (r =0.206,P ＜0.05) and it was negatively correlated with HDL-C(r=-0.298,P ＜0.01).Conclusion Plasma visfatin was correlated with the development of macrovascular complications in T2DM patients,and it might be involved in the atherosclerotic pathological and physiological basis.

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