1.Expression and significance of endothelial cell-derived extracellular vesicles in peripheral blood of patients with sepsis-induced cardiomyopathy
Bin ZHANG ; Lei CHEN ; Zhenxin JI ; Meimei WU ; Changfang LIU
Journal of Clinical Medicine in Practice 2025;29(5):112-116,121
Objective To investigate the expression characteristics and clinical significance of endothelial cell-derived extracellular vesicles(EC-EVs)in the peripheral blood of patients with sep-sis-induced cardiomyopathy(SIC).Methods A total of 143 sepsis patients were enrolled and divid-ed into cardiomyopathy group(n=72)and non-cardiomyopathy group(n=71)based on occurrence of SIC.Peripheral blood samples were collected from patients in both groups upon admission for isola-tion and identification of EC-EVs.The number of EC-EVs,apoptosis,and the activity and expression levels of caspase-1 in EC-EVs were compared between the two groups.Spearman correlation analysis was used to assess the correlations of the number of EC-EVs,caspase-1 activity,and N-terminal pro-brain natriuretic peptide(NT-proBNP)with cardiac troponin Ⅰ(cTnⅠ).Multivariable Logistic regres-sion analysis was conducted to explore the factors influencing the occurrence of SIC in sepsis patients.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of the number of EC-EVs and caspase-1 activity for SIC.Results EC-EVs with a diameter of approximately 100 nm,intact membrane structure,and expression of extracellular vesicles(EVs)marker molecules(CD9,CD63,CD81)were successfully isolated from samples in both groups.The cardiomyopathy group had significantly higher numbers of EC-EVs in peripheral blood,EC-EV apoptosis levels,caspase-1 activity,and protein expression levels compared to the non-cardiomyopathy group(P<0.05).Spearman correlation analysis revealed positive correlations between the number of EC-EVs and NT-proBNP(r=0.603,0.685,P<0.001),and between caspase-1 activity and cTnⅠ(r=0.474,0.711,P<0.001).Multivariable Logistic regression analysis showed that the number of EC-EVs,caspase-1 activity,NT-proBNP levels,and cTnⅠ levels were all independent influencing factors for the occurrence of SIC in sepsis patients(P<0.05).The ROC curves indicated that the areas under the curve for predicting SIC based on the number of EC-EVs and caspase-1 activity in peripheral blood were 0.721 and 0.858,respectively.Conclusion The number of EC-EVs and caspase-1 activity in EC-EVs in the peripheral blood of SIC patients are significantly increased,and are closely related to cardiac function and myocardial injury in sepsis patients.Thus,they have the potential to become biomarkers for predicting SIC.
2.Efficacy observation of glutathione on prevention of acute radiation enteritis in pelvic radiation therapy
Zhenchao MA ; Zhenxin ZHOU ; Haibing ZHANG ; Pengtian JI ; Genhua YU
Chinese Journal of Primary Medicine and Pharmacy 2016;23(20):3151-3154
Objective To observe the prevention effect of glutathione on acute radiation enteritis in pelvic radiation therapy.Methods All 80 pelvic tumor patients treated with radiotherapy were randomly assigned to the control group (40 patients)and the treatment group (40 patients)by the number table method.40 cases in the con-trol group treated with radiation were not treated with preventive drugs,but the patients in the treatment group were treated with glutathione.The occurrence time of acute radiation enteritis and the severity of acute radiation enteritis after treatment were evaluated.Results 15.0% of the treatment group suffered from acute radiation enteritis in the second week and 72.5% in the third week.however,62.5% of the control group were suffered from acute radiation enteritis in the second week and 27.5% in the third week.The difference was statistically significant (χ2 =18.775, 15.998,all P <0.001).Glutathione delayed the occurrence time of acute radiation enteritis.The grade 1 and grade 2 acute radiation enteritis effective rate in the treatment group were 77.5% and 17.5%,and that in the control group were 20.0% and 72.5%,the difference between the two groups was significant(χ2 =26.136,24.139,all P <0.001).The glutathione could reduce the incidence of acute radiation enteritis extent.Conclusion Glutathione could delay the occurrence time of acute radiation enteritis and reduce the incidence of acute radiation enteritis extent.It is worth clinical application.

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