1.Mechanism of warmed malate ringer's solution in fluid resuscitation in improving the lethal triad of severe trauma
Yinyu WU ; Han SHE ; Yunxia DU ; Yuxi ZHANG ; Xiaowei ZHOU ; Qinghui LI ; Tao LI ; Yi HU ; Qingxiang MAO ; Yaling WANG
Journal of Army Medical University 2025;47(3):216-225
Objective To explore the role and mechanism of warm malate ringer's solution(MR)in resuscitation of the lethal triad caused by severe trauma.Methods A rat model of severe trauma was established in SPF-grade SD rats(half male and half female,weighing 200~220 g)using combined multiple injuries and hemorrhagic shock,and the rats were randomly divided into 8 groups(n=8):Sham group,only arterial and venous catheterization;Trauma(Tra)groups with different time points(10,30,60,90,120,180 min)and a Trauma group that were observed without any treatment for 180 min after model establishment.The changes of activated clotting time(ACT),reaction time(R),maximum amplitude(MA),and rate of blood clot formation(Angle)at different time points were detected by using thromboelastography,and tail bleeding,core body temperature and arterial blood gas parameters,were also observed and detected.The plasma von Willebrand Factor(vWF)level,mitochondrial respiratory control ratio in pulmonary venous endothelium,and expression levels of vascular endothelial cadherin(VE-Cadherin),peroxisome proliferator activating receptor gamma coactivator 1α(PGC1α),dynamin-related protein 1(Drp1),p-Drp1,and mitofusin 2(Mfn2)were detected to evaluate the vascular endothelial injury and mitochondrial dysfunction.Another group of SD rats were randomly divided into severe trauma group(no treatment for 180 min after injury),and MR solution at room temperature and at 37 ℃ groups.MR solution at room temperature or at 37 ℃ was given to the rats using a medical blood transfusion apparatus at 60 min post-trauma.Above indicators were observed and detected to investigate the resuscitation effect of the MR solution.Results Compared with the Sham group,the severely traumatic rats at 180 min after injury had significantly prolonged ACT and R values(P<0.05),shortened MA and decreased Angle values(P<0.05),extended tail bleeding time(P<0.05),lower partial pressure of carbon dioxide(PCO2)and HCO3-and base excess(BE)levels(P<0.05),and continuously increasing K+(P<0.05)and decreasing Na+(P<0.05)and Ca2+levels(P<0.05).Additionally,plasma vWF level(P<0.05)and protein levels of VE-cadherin,PGC1α and Mfn2 in pulmonary vein endothelium were significantly reduced(P<0.05),the expression of p-Drp1 was enhanced and the mitochondrial respiration control rate was declined in the rats at 180 min after injury(P<0.05).MR solution resuscitation shortened tail bleeding time(P<0.05),increased core body temperature(P<0.05),elevated plasma vWF level(P<0.05),increased protein levels of VE-cadherin,PGC1α and Mfn2(P<0.05),and decreased that of p-Drp1 protein expression(P<0.05)when compared with the rats at 180 min after severe traumatic injury.The above effects were more significant in the rats infused with the solution at 37 ℃ than those at room temperature.Conclusion Warm MR solution significantly improves the lethal triad in rats after severe trauma,which may be associated with its improving mitochondrial function and attenuating vascular endothelial damage.
2.Comparative study of hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating acute radiation proctitis
Guangjun WU ; Xiuqing HAN ; Xiaowei ZHANG ; Ying BA ; Yuefei ZHANG ; Liang LIU ; Qinghui DU
Chinese journal of nautical medicine and hyperbaric medicine 2022;29(3):326-330
Objective:To compare the clinical efficacy of hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating acute radiation proctitis(ARP),and to statistically analyze their rates of acceptance and satisfaction.Methods:A total of 64 patients with ARP after radiotherapy for cervical cancer treated in Linyi Central Hospital from June 2016 to December 2021 were selected and divided into observation group( n=32)and control group( n=32)according to the number table method. The control group was treated with(Smecta and Kangfuxin solution)retention enema combined with hyperbaric oxygen,and the observation group was treated with herbal cake-separated moxibustion on umbilicus combined with hyperbaric oxygen. The degree of rectal injury before and after radiotherapy was evaluated according to the criteria of the Radiation Therapy Oncology Group(RTOG),and the clinical efficacy was analyzed. The symptom score and total score of ARP patients were calculated by international scoring standards for long-term complication of radiotherapy,and the satisfaction rate and acceptance rate of the two groups were analyzed. Results:After four courses of treatment,compared with the same group before treatment,the classifications of clinical symptoms in both the observation group and the control group were significantly improved( P < 0.01),but there was no significant difference between the observation group and the control group( P > 0.05). The acceptance rate and satisfaction rate of patients treated with herbal cake-separated moxibustion on umbilicus in the observation group was significantly higher than that in the control group( P < 0.01). Conclusion:Both hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating ARP can achieve good clinical therapeutic effect. As a non-invasive approach,the herbal cake-separated moxibustion on umbilicus can avoid aggravating rectal mucosa and perianal injury caused by repeated drug enema. Meanwhile,the herbal cake-separated moxibustion on umbilicus is simple and easy to operate,with less pain for patients,high rates of acceptability and satisfaction,which can be popularized and applied.
3.Comparative study of hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating acute radiation proctitis
Guangjun WU ; Xiuqing HAN ; Xiaowei ZHANG ; Ying BA ; Yuefei ZHANG ; Liang LIU ; Qinghui DU
Chinese journal of nautical medicine and hyperbaric medicine 2022;29(3):326-330
Objective:To compare the clinical efficacy of hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating acute radiation proctitis(ARP),and to statistically analyze their rates of acceptance and satisfaction.Methods:A total of 64 patients with ARP after radiotherapy for cervical cancer treated in Linyi Central Hospital from June 2016 to December 2021 were selected and divided into observation group( n=32)and control group( n=32)according to the number table method. The control group was treated with(Smecta and Kangfuxin solution)retention enema combined with hyperbaric oxygen,and the observation group was treated with herbal cake-separated moxibustion on umbilicus combined with hyperbaric oxygen. The degree of rectal injury before and after radiotherapy was evaluated according to the criteria of the Radiation Therapy Oncology Group(RTOG),and the clinical efficacy was analyzed. The symptom score and total score of ARP patients were calculated by international scoring standards for long-term complication of radiotherapy,and the satisfaction rate and acceptance rate of the two groups were analyzed. Results:After four courses of treatment,compared with the same group before treatment,the classifications of clinical symptoms in both the observation group and the control group were significantly improved( P < 0.01),but there was no significant difference between the observation group and the control group( P > 0.05). The acceptance rate and satisfaction rate of patients treated with herbal cake-separated moxibustion on umbilicus in the observation group was significantly higher than that in the control group( P < 0.01). Conclusion:Both hyperbaric oxygen combined with herbal cake-separated moxibustion on umbilicus and retention enema in treating ARP can achieve good clinical therapeutic effect. As a non-invasive approach,the herbal cake-separated moxibustion on umbilicus can avoid aggravating rectal mucosa and perianal injury caused by repeated drug enema. Meanwhile,the herbal cake-separated moxibustion on umbilicus is simple and easy to operate,with less pain for patients,high rates of acceptability and satisfaction,which can be popularized and applied.
4.An analysis of prognostic factors in patients suffering from acute lung injury/acute respiratory distress syndrome complicated with Yangming Fushi syndrome:a report of 206 cases from multiple centers
Lina YAN ; Qiang FU ; Chao DU ; Yangzi YU ; Jing LI ; Qingquan LIU ; Chengrui XUE ; Qinghui QI ; Jianping LI
Chinese Critical Care Medicine 2015;(7):548-551
ObjectiveTo investigate the risk factors of patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) complicated with Yangming Fushi syndrome.Methods A prospective study was conducted. From August 2009 to July 2013, 206 patients with Yangming Fushi syndrome combined with ALI/ARDS were enrolled in the intensive care units ( ICUs ) of the following five hospitals: Tianjin Nankai Hospital, Dongzhimen Hospital Affiliated to Beijing Traditional Chinese Medicine University, General Hospital of Tianjin Medical University, the First Affiliated Hospital of Dalian Medical University, and Wuxi Third People's Hospital in Jiangsu Province. According to the mortality occurring in ICU, the patients were divided into death group and survival group. The gender, age, acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) score within the first 24 hours after admission, the length of invasive mechanical ventilation, usage of vasoactive agents, ratio of operative intervention, the length of stay in ICU, application of continuous renal replacement therapy ( CRRT ), amount of blood transfusion, the level of C-reactive protein ( CRP ), lactulose/mannitol ( L/M ) ratio, the number of organs with dysfunction, oxygenation index ( PaO2/FiO2 ), levels of lactate and serum creatinine ( SCr ) of both groups were recorded. Logistic regression analysis was used to look for the independent risk factors of death of patients. Results There were 124 cases with severe acute pancreatitis ( SAP ), which was the most common disease with manifestation of Yangming Fushi syndrome combined with ALI/ARDS, accounting for 60.19% of all the patients. During the period of hospitalization in ICU, 171 patients survived and 35 died, and the mortality rate was 16.99%. The risk factors of the two groups were analyzed by variable analysis, and it was shown that compared with those in survival group, the age ( years: 57.26±16.23 vs. 48.07±13.48, t = 3.544, P = 0.000 ), APACHE Ⅱ score ( 20.83±9.73 vs. 12.61±6.63, t = 4.777, P = 0.000 ), the length of invasive mechanical ventilation ( days: 10.97±7.71 vs. 6.91±2.48, t = 2.555, P = 0.015 ) and the number of dysfunction organs ( 3.11±1.21 vs. 1.60±1.34, t = 6.222, P = 0.000 ) in death group were significantly higher. The level of PaO2/FiO2 [ mmHg ( 1 mmHg = 0.133 kPa ): 218.56±64.90 vs. 244.58±85.10, t = -2.024, P = 0.044 ] in the death group was significantly lower than that of the survival group, while the length of ICU stay ( days: 14.33±10.81 vs. 9.11±7.37, t = 2.600, P = 0.010 ), the usage rates of CRRT [ 28.57% ( 10/35 ) vs. 15.20% ( 26/171 ), χ2 = 3.968, P = 0.046 ], vasoactive agents [ 28.57% ( 10/35 ) vs. 12.28% ( 21/171 ), χ2 = 6.511, P = 0.011 ], and blood transfusion ratio [ 42.86% ( 15/35 ) vs. 23.39% ( 40/171 ), χ2 = 7.042, P = 0.008 ] were all obviously higher in the death group than those in the survival group. There were no statistically significant differences in gender, number of operation, the levels of CRP, L/M ratio, lactate and SCr between the two groups ( all P > 0.05 ). Multivariate logistic regression analysis showed that age [ odds ratio ( OR ) = 0.938, 95% confidence interval ( 95%CI ) = 0.898-0.980, P = 0.004 ], APACHE Ⅱ score ( OR = 0.914, 95%CI = 0.839-0.996, P = 0.041 ), the number of dysfunction organs ≥ 3 ( OR = 0.223, 95%CI = 0.066-0.754, P = 0.016 ), and the level of PaO2/FiO2 ( OR = 0.990, 95%CI = 0.982-0.998, P = 0.015 ) were independent risk factors for mortality. Conclusions The age, APACHE Ⅱ score, number of dysfunction organs ≥ 3 and the level of PaO2/FiO2 are of significance in predicting the prognosis of patients with Yangming Fushi syndrome combined with ALI/ARDS. Patients with risk factors of high mortality should be more carefully monitored and treated aggressively.
5.Development of Android Platform Based Portable Trace Heavy Metal Ions Detector
Shanluo HUANG ; Yan JIN ; Hui GUO ; Qi CAI ; Xiaowei DU ; Qinghui JIN ; Jianlong ZHAO
Chinese Journal of Analytical Chemistry 2015;(7):1098-1103
Based on the Android platform, a portable electrochemical analyzer was designed for the detection of heavy metal ions. Its output voltage range was ±3 V with accuracy of 0. 1% and resolution of <1 mV. The current acquisition range was±10 mA with accuracy of 0. 1% and the minimum resolution of 10 pA. With the human-computer interaction advantage of Android smart devices, professional and fast detection mode which could meet the needs of professional and ordinary users respectively were developed to simplify the complex process of electrochemical detection and analysis. Some common heavy metal ions including copper, cadmium, lead and mercury were detected with this detector. The results of linearity, repeatability and accuracy were satisfactory.
6.Human carcinoembryonic antigen-related cellular adhesion molecules 1 mediated susceptibility of Neisseria gonorrhoeae to mouse
Guocai LI ; Qinghui DU ; Xiaohong WANG ; Jinsong WANG ; Feng YU ; Shuangxi LIU ; Rushan XIE ; Hongmei JIAO ; Hua YAN ; Mingchun JI
Chinese Journal of Microbiology and Immunology 2011;31(10):907-911
ObjectiveTo develop a transgenic mouse model for N.gonorrhoeae researches.Methods Human carcinoembryonic antigen-related cellular adhesion molecules 1 (hCEACAM1) eukaryotic expression vector,pCDPGICAM1,was used to generate transgenic mice by microinjection.The funder mice were screened by PCR,sequence analysis,Western blot and fluorescence-activated cell sorting analysis,respectively.The transgenic mice expressing hCEACAM1 were inoculated with N.gonorrhoeae intravaginally.Adhesion and infection of gonococci to mice were analyzed by bacteria culture and microscopy.Results Four (lines 50,53,54,and 59) of the 22 F0 generation transgenic mice were found to carry the transgene.The hCEACAM1 protein was expressed on the cell membrane of various tissues in the line 53 transgenic mouse.Compared with normal mice,N.gonorrhoeae can successfully infect and cause inflammation in the transgenic mice.Conclusion The hCEACAM1 transgenic mouse can be used as an animal model for gonococcal infections.

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