1.Beneficial effects of hemoglobin-based oxygen carriers on early resuscitation in rats with uncontrolled hemorrhagic shock
Yu ZHU ; Jie ZHANG ; Yue WU ; Kunlun TIAN ; Xiaoyong PENG ; Xinming XIANG ; Liangming LIU ; Tao LI
Chinese Critical Care Medicine 2019;31(1):81-86
Objective To investigate the early resuscitation effect of hemoglobin-based oxygen carriers (HBOC) in rats with uncontrolled hemorrhagic shock.Methods 170 Sprague-Dawley (SD) rats were randomly divided into five groups:lactate Ringer solution (LR) control group,whole blood control group,and 0.5%,2.0%,5.0% HBOC groups,with 34 rats in each group.The uncontrolled hemorrhagic shock model in SD rats was reproduced by cutting off the splenic artery branch,and induced mean arterial pressure (MAP) reducing to 40 mmHg (1 mmHg =0.133 kPa).The corresponding solution was infused after model reproduction in each group,maintaining MAP at 50 mmHg for 1 hour,then completely ligating and hemostasis,and maintaining MAP at 70 mmHg for 1 hour and 80 mmHg for 1 hour respectively,after maintaining MAP 80 mmHg,all were supplemented with LR to 2 times blood loss volume.The survival rate and blood loss rate were observed in 16 rats in each group,hemodynamics parameters including MAP,left ventricular systolic pressure (LVSP) and the maximum rate of left ventricular pressure rise (+dp/dtmax) were determined in another 10 rats,and cardiac output (CO) and tissue oxygen supply (DO2) were observed in the rest 8 rats.Results ① When resuscitation by LR alone,the blood loss rate of animals was as high as 60% to 70%.Compared with the LR control group,whole blood recovery could significantly reduce the blood loss rate before hemostasis in uncontrolled hemorrhagic shock rats [(46.6 ± 4.5)% vs.(62.3 ± 4.0)%,P < 0.01];0.5%,2.0%,5.0% HBOC could significantly decrease the blood loss rate,especially in 5.0% HBOC group with significant difference as compared with that in the LR control group [(45.6±4.1)% vs.(62.3±4.0)%,P < 0.01].② When LR was used alone for resuscitation,the rats died quickly and survived for a short time.Only one rat survived for 12 hours,and no rat survived for more than 24 hours.Compared with the LR control group,whole blood resuscitation could improve the survival rate of uncontrolled hemorrhagic shock rats,and the survival time was significantly prolonged (hours:20.4± 4.6 vs.3.5 ± 1.1,P < 0.01);0.5%,2.0% and 5.0% HBOC also significantly prolonged the survival time of rats.The 5.0% HBOC group had the best effect,4 rats survived in 24 hours,and the survival time was significantly longer than that of the LR control group (hours:18.4 ± 4.0 vs.3.5 ± 1.1,P < 0.01),and it was the same as the whole blood control group.③ Compared with pre-shock,CO,DO2 and hemodynamic parameters of uncontrolled hemorrhagic shock rats were significantly decreased,and the above parameters were gradually increased with the prolongation of rehydration time.Compared with the LR control group,whole blood resuscitation could significantly increase CO and DO2,and improve hemodynamics in rats with uncontrolled hemorrhagic shock at different time points.Three concentrations of HBOC could also increase CO,DO2 and other hemodynamic parameters of rats at 1 hour of maintaining MAP of 80 mmHg after hemostasis and 1 hour and 2 hours after resuscitation.The effect of 5.0% HBOC group was more significant than that of the LR control group with statistically significant difference [CO (× 10-3,L/min):72.84±2.84 vs.63.11±2.38 at 1 hour of maintaining MAP of 80 mmHg,70.25±4.55 vs.59.88 ± 9.31 at 1 hour after resuscitation,71.51 ± 2.90 vs.53.24 ± 6.32 at 2 hours after resuscitation;DO2 (L· min-1 · m-2):271.9± 13.5 vs.159.1 ±25.4 at 1 hour of maintaining MAP of 80 mmHg,261.0± 15.0 vs.145.7±20.1 at 1 hour after resuscitation,249.6± 12.0 vs.107.4± 18.2 at 2 hours after resuscitation;MAP (mmHg):82.1±2.1 vs.74.0±2.8 at 1 hour of maintaining MAP of 80 mmHg,107.5±9.3 vs.64.0±5.7 at 1 hour after resuscitation,104.0±9.7 vs.73.0±4.2 at 2 hours after resuscitation;LVSP (mmHg):128.6±7.9 vs.103.8±0.8 at 1 hour of maintaining MAP of 80 mmHg,129.3±± 15.0 vs.99.4±0.0 at 1 hour after resuscitation,127.5± 11.3 vs.97.4±0.0 at 2 hours after resuscitation;+dp/dt max (mmHg/s):6 534.2±± 787.6 vs.5 074.0± 71.7 at 1 hour of maintaining MAP of 80 mmHg,5 961.5 ±± 545.4 vs.4 934.5 ± 510.2 at 1 hour after resuscitation,5 897.4± 350.5 vs.4 534.7 ±489.2 at 2 hours after resuscitation,all P < 0.05].Conclusions HBOC infusion prolonged the survival time,increased survival rate,and improved hemodynamics,cardiac function and tissue oxygen supply in a dose-dependent manner in the early stage of uncontrolled hemorrhagic shock.The recovery effect of 5.0% HBOC was similar to that of the whole blood.
2. The value of MR T2WI signal intensity related parameters for predicting pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Lijuan WAN ; Chongda ZHANG ; Hongmei ZHANG ; Yankai MENG ; Feng YE ; Yuan LIU ; Xinming ZHAO ; Chunwu ZHOU
Chinese Journal of Oncology 2019;41(11):837-843
Objective:
To evaluate the value of T2WI signal intensity related parameters that can be obtained by magnetic resonance imaging (MRI) for predicting pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanved rectal cancer (LARC).
Methods:
Signal Intensity of Tumor (SIT) and Signal Intensity of Tumor/Muscle (SIT/M) of MR T2WI before and after neoadjuvant chemoradiotherapy of 101 patients with locally advanced rectal cancer were evaluated by two experienced readers independently. Signal Intensity of Tumor Reduction Rate (SITRR) and Signal Intensity of Tumor/Muscle Reduction Rate (SIT/MRR) were calculated. The difference of related parameters of T2WI tumor signal intensity between the pCR and the non-pCR group were analyzed. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic performance for predicting pCR.
Results:
Of the 101 patients, 18 were in pCR group and 83 were in non-pCR group. In all patients, the SITpre, SITpost, SITRR, SIT/Mpre, SIT/Mpost and SIT/MRR measured by reader 1 were 197.0 (133.0), 144.2 (69.7), 0.4% (0.5%), 2.6 (0.6), 3.0 (2.3) and 0.4 (0.2)% in pCR group, and 227.0 (99.0), 205 (95.4), 0.1% (0.6%), 2.6 (0.6), 2.6 (1) in non-pCR group, respectively. SITpre, SITpost, SITRR, SIT/Mpre, SIT/Mpost and SIT/MRR measured by reader 2 were 193.0 (135.0), 143.0 (69.8), 0.4% (0.2%), 2.6 (0.6), 1.5 (0.5) and 0.39% (0.2%) in pCR group, and 234.0(108.0), 203(96.5), 0.1% (0.3%), 2.6 (0.6%), 1.7 (0.7) and 0.25% (0.2%) in non-pCR group, respectively. Between the pCR and non-pCR group, there were significant differences in SITpost, SIT/Mpost and SIT/MRR measured by both readers (all
3.The expression and significance of CD44v17 in cervical cancer and cervical intraepithelial neoplasia
Xinming YIN ; Wenlin XU ; Xiaolan ZHU ; Yueqin LIU
Chongqing Medicine 2018;47(16):2122-2125
Objective To analyse the expression and significance of CD44 variant (CD44v17) in the process of cervical intraepithelial neoplasia (CIN) to cervical cancer,and to explore the relationship of CD44v17 with CIN and cervical cancer.Methods The expressions of CD44v17,matrix metalloproteinase 9 (MMP9) and Ki67 in normal cervical tissue,CIN Ⅰ,Ⅱ,Ⅲ and cervical carcinoma tissues were detected by real-time quantitative RCR.The expressions of CD44v17,MMP9 and Ki67 in human cervical cancer cell lines HeLa and SiHa after transfecting with CD44v17 siRNA were detected,as well.The tumor-bearing nude mice were treated with lentivirus particles of CD44v17,and the influence of CD44v17 siRNA on tumorigenicity in nude mice was analysed.Results The expression level of CD44v17 increased gradually from CIN Ⅰ,Ⅱ,Ⅲ to cervical carcinoma tissues.Compared with normal cervical tissue,the expression levels of CD44v1 7,MMP9 and Ki67 were significantly increased in CIN Ⅱ,Ⅲ and cervical carcinoma tissues (P<0.05),while no significant difference was found between normal cervical tissue and CIN Ⅰ tissue (P>0.05).The expression levels of MMP9 and Ki67 in human cervical cancer cell lines HeLa and SiHa were decreased significantly after transfecting with CD44v17 siRNA (P<0.01).The tumor volume and weight were decreased by treatment with CD44v17 siRNA transfection (P<0.01),and the tumorigenicity in nude mice was decreased.Conclusion CD44v17 may promote the development of CIN to cervical cancer.It is expected to be an indicator in predicting malignant potential of CIN.
4.Determination of Amines in Particulate Matter by Gas Chromatography-Mass Spectrometry
Fengxian LIU ; Xinhui BI ; Zhaofang REN ; Guohua ZHANG ; Xinming WANG ; Pingan PENG ; Guoying SHENG
Chinese Journal of Analytical Chemistry 2017;45(4):477-482
A method was developed for determination of thirteen amines including seven aliphatic amines, two heterocyclic amines and four aromatic amines in atmospheric particulate matter (PM) by gas chromatography-mass spectrometry (GC-MS). Samples were ultrasonically extracted with ultra-pure water and derivatized with benzenesulfonyl chloride (BSC) under alkaline conditions. The derivatives were extracted with dichloromethane and then detected by GC-MS using DB-5MS chromatographic column. The method detection limit (S/N=3) and quantitation limit (S/N=10) were 0.00008-0.017 μg/mL and 0.00026-0.0565 μg/mL respectively, and the correlation coefficients were 0.9903-0.9996, which indicated that the standard curve had good linear correlation. In addition, the relative standard deviation was less than 30% and the average recovery was 54.4%-159.7% except for methylamine and benzylamine at spiked level of 1.0 μg/mL, showing high precision and accuracy. 9 kinds of amines were detected in the PM2.5 samples collected in Guangzhou city by this method, among which dimethylamine and butylamine accounted for 90% of the total nine amines, which indicated that they were primary amines in PM2.5; while propylamine exhibited the lowest level in PM2.5 with the concentration less than 1.0 ng/m3.
5.The expression and significance of TNF-α,IL-6, HMGB1 in the cervix uteri after the prior cervical conization
Xinming YIN ; Xiaolan ZHU ; Jian WEN ; Li ZHU ; Weiwei TAN ; Songping LIU
Chongqing Medicine 2017;46(11):1472-1475
Objective To investigate the dynamic changes and its significance of inflammatory factors in cervical secretions and prior cervical tissues after cervical conical resection.Methods Women who received prior cervical conization during December 2013 and December 2015 in this hospital were selected,then the cervical tissue and secretion were collected regular interval after the conization.The expression of tumor necrosis factor-α(TNF),interleukin 6 (IL-6) and high mobility group protein 1 (HMGB1) were quantitative detected and analyzed.The expression and infiltration of inflammatory cell were detected by HE and immunohistochemical staining.Results The expression of TNF-α,IL-6 and HMGB1 in cervical tissues and secretions increased gradually after priorcervical conization,which reached the peak at 1 to 2 weeks after priorcervical conization,and then gradually decreased,the differences were statistically significant when compared with the preoperative control group (P<0.05).The inflammatory cell infiltration and the inflammatory response were most severe at 1st week after the conization.The expression of TNF-α,IL 6 and HMGB1 was at 1st week after the conization were significantly higher than that of the 4thweek group.Conclusion The cervical inflammatory were most severe after the prior cervical conization about 1-2weeks,and the hysterectomy should be avoided at this stage.
6.Effects of Dexmedetomidine Hydrochloride on Glutamate-induced Neurotoxicity in Rats
Xinming LI ; Songze LI ; Hongtao LIU
Journal of China Medical University 2017;46(4):302-305
Objective To investigate the effects and mechanism of dexmedetomidine hydrochloride preconditioning against glutamate-induced neurotoxicity.Methods The model of glutamate-induced neurotoxicity was established by the injection of glutamate into lateral cerebral ventricle.Thirty-six SD rats were randomly divided into control group (C group),glutamate-induced neurotoxicity group (G group),Dex1 group and Dex2 group.Dex1 group and Dex2 group received intraperitoneal injection of dexmedetomidine respectively at a dose of 50 μg/kg or 100 μg/kg before glutamate application.Two hours later,the rats were sacrificed and hippocampus was separated to measure the level of SOD and MDA.The rest of each brain was used to measure the degree of brain edema.Pathological changes were observed under microscope with Nissl's staining.Results In contrast to G group,brain edema and MDA concentration in Dex1 group and Dex2 group were significant lower,while SOD concentrations were significantly increased and the pathological change in Dex1 group and Dex2 group were relieved obviously compared to glutamate-induced neurotoxicity group.Conclusion Dexmedetomidine preconditioning can significantly attenuate glutamate-induced neurotoxicity,which is properly related to the inhibition of oxidative-stress reaction.
7.Fracture restoration technique based on 3D printing used in distal tibiofibular fractures
Wenxi ZHANG ; Xinming WANG ; Yueping JI ; Dong LI ; Jie LIU ; Shuai WANG
Chinese Journal of Orthopaedic Trauma 2017;19(7):589-595
Objective To explore a 3D printing model of fracture restoration which can be used in preoperative planning and design for distal tibiofibular fractures.Methods A retrospective analysis was performed of the 35 patients with distal tibiofibular fracture who had been treated from October 2015 to September 2016 at our department.Bilateral tibiofibular CT scan was performed in all the cases to obtain Dicom data.Using Mimics 15.0 software,cross sections were created at 5 cm,10 cm and 15 cm above the knee joint at the bilateral upper tibiae and marked as PT5,PT10 and PT15.The long and short axles on the left and right sides were measured and compared (LL vs.RL;LS vs.RS).After the STL files for 3D models were generated using Mimics 15.0 software,a real-sized 3D model of the distal tibiofibular fracture and a mirror model of the contralateral tibiofibula were printed.The fracture lines were drawn and preoperative manoeuvre was performed on the mirror 3D printed model.The real operation used the implants preoperatively designed;the actual screw lengths were measured and compared radiographically with those designed in the preoperative manoeuvre.Results All the data were collected of the long and short axles on the 3 cross-sections (PT5,PT10 and PT15) of the left and right sides of the proximal tibia.The samples were paired into 6 groups.The correlation coefficients of paired samples were greater than 0.95,showing an extremely strong correlation.The differences between the left and right sides showed no statistically significance in paired samples of LR-RL and LS-RS groups on PT5,PT10 and PT15 cross-sections (P > 0.05).All the 35 cases received surgical operation.The postoperative X-ray review showed fine agreement between actual surgery and preoperative design in terms of screw length and accuracy.The deviations were in an allowable range,leading to satisfactory internal fixation.Conclusions A mirror 3D model of the healthy side is of clinical value to some extent because it can serve as one for an anatomically reduced fracture which can be used for preoperative manoeuvre and preparation of implants.The contrasts between the long and short axles on the 3 cross-sections may simplify and facilitate comparisons of bilateral similarity,avoid the blindness in direct application of the health side mirror model for preoperative planning.
8.Role of TLR4 in Lung Injury Induced by Paraquat Poisoning
Wei LIU ; Xuesong DONG ; Xiaowei LIU ; Xinming CHEN ; Huanzhi LIU ; Zhi LIU
Journal of China Medical University 2017;46(1):7-10,16
Objective To investigate the role of Toll?like receptor 4(TLR4)in acute lung injury induced by paraquat(PQ)poisoning. Meth?ods Twenty wild?type mice(C57BL/6J)and TLR4 knockout mice(C57BL/10ScN)were randomly divided into 4 groups:WT group,WT+PQ group,TLR4 gene knockout(TLR4?ko)group and TLR4?ko+PQ group,with 10 mice in each group. After paraquat treatment for 24 hours,mice were euthanized and sacrificed. TLR4 expression and pro?inflammatory cytokines were evaluated. Results After 24 hours of intraperitoneal injec?tion of PQ,wild?type mice showed significant acute lung injury,including decreased oxygen tension in blood gas,pathological changes in the acute stage of lung injury and increased TLR4 expression(accompanied by increased levels of TNF?α,IL?1βand NF). TLR4?deficient mice exhibited significantly reduced level of paraquat?induced lung injury. Conclusion TLR4 may be required as a mediator and play an important role in acute lung injury induced by paraquat. Inhibition of TLR4 signaling has protection of lung injury induced by PQ.
9.Expression and significance of ABCG2 and ALDH1 in malignant transformation of ovarian endometriosis
Songping LIU ; Xin TIAN ; Jian WEN ; Xinming YIN
Chongqing Medicine 2017;46(14):1912-1914
Objective To investigate the expression and significance of ABCG2 and ALDH1 in malignant transformation of ovarian endometriosis.Methods The protein expressions of ABCG2 and ALDH1 were detected with immunohistochemistry in 38 cases of malignant transformation of ovarian endometriosis(EMs malignant transformation group),35 cases of endometriosis(EMs group)and 30 cases of normal endometrium(control group).Results The positive rates of ABCG2 and ALDH1 expressions in EMs malignant transformation group were significantly higher than those in EMs group and control group(P<0.05).The expressions of ABCG2 and ALDH1 were significantly associated with the serum CA125 level,differentiation and clinical stage of malignant transformation of ovarian endometriosis (P<0.05),but were not related to the patient′s age,dysmenorrhea history and pathology type(P>0.05).There was no correlation between the expression of ABCG2 and ALDH1 in malignant transformation of ovarian endometriosis(P>0.05).Conclusion The expressions of ABCG2 and ALDH1 might be involved in malignant transformation of ovarian endometriosis.
10.Outcome of fast track surgery after intercostal nerve block during thoracoscopic resection of lung bullae: A randomized controlled trial
LIU Dan ; QU Xinming ; QIN Wei ; GAO Ke
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2017;24(9):696-700
Objective To analyze the outcome of fast track surgery after intercostal nerve block (INB) during thoracoscopic resection of lung bullae. Methods We recuited 76 patients who accepted thoracoscopic resection of lung bullae from February 2013 to March 2015. They were randomly divided into two groups: an intercostal nerve block and intravenous patient-controlled analgesia (INB+IPCA) group, in which 38 patients (30 males, 8 females, with a mean age of 23.63±4.10 years) received INB intraoperatively and IPCA postoperatively, and a postoperative intravenous patient-controlled analgesia (IPCA) group, in which 38 patients (33 males, 5 females, with a mean age of 24.93±6.34 years) only received IPCA postoperatively. Their general clinical data and the postoperative pain visual analogue scale (VAS) were recorded. Analgesia-associated side effects, rate of the pulmonary infection were observed. Expenses associated with analgesia during hospital were calculated. Results The score of VAS, the incidence of nausea and vomiting, fatigue and other side effects, pulmonary atelectasis and the infection rate in the INB+IPCA group were significantly lower than those in the IPCA group. Postoperative use of analgesic drugs was significantly less than that in the IPCA group. Medical expenses did not significantly increase. Conclusion INB+IPCA is beneficial for fast track surgery after thoracoscopic resection of lung bullae.

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