Objective:To systematically evaluate the effect of hydrocortisone combined with vitamin C and vitamin B1 on the efficacy of patients with sepsis or septic shock.Methods:Databases including CNKI, Sino Med, VIP, Wanfang, PubMed, the Cochrane Library, and Embase were searched from inception to January 2021 for the randomized controlled trial (RCT) about hydrocortisone combined with vitamin C and vitamin B1 to treat sepsis or septic shock. The experimental group was given intravenous injection of hydrocortisone, vitamin B1 and vitamin C based on conventional treatment; the control group was given conventional treatment or placebo/hydrocortisone/hydrocortisone+vitamin B1 based on conventional treatment. Outcome indicators included sequential organ failure assessment (SOFA), mortality, the duration of vasoactive drugs, new acute kidney injury (AKI) patients, length of stay in intensive care unit (ICU) and in hospital. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies. RevMan 5.3 software was then used to perform Meta-analysis. Funnel plot was used to test publication bias.Results:A total of 6 articles involving 816 patients were included, with 411 patients in the experimental group and 405 patients in the control group. The Meta-analysis results showed that the duration of vasoactive drugs in the experimental group was significantly shorter than that in the control group [mean difference ( MD) = -24.02, 95% confidence interval (95% CI) was -32.36 to -15.68, P < 0.000 01]. However, there were no significant differences in SOFA, mortality, new AKI patients, the length of ICU stay and hospital stay between the two groups [SOFA: MD = -0.14, 95% CI was -1.15 to 0.87, P = 0.79; mortality: relative risk ( RR) = 0.99, 95% CI was 0.81 to 1.21, P = 0.92; new AKI patients: RR = 1.10, 95% CI was 0.42 to 2.87, P = 0.84; length of ICU stay: MD = 1.33, 95% CI was -2.22 to 4.89, P = 0.46; length of hospital stay: MD = 1.02, 95% CI was -0.66 to 2.69, P = 0.23]. The funnel plot showed that most of the points were symmetrical and showed an inverted funnel shape, suggesting that the publication bias among the studies was small. There was no significant publication bias on this Meta-analysis. Conclusions:Hydrocortisone combined with vitamin C and vitamin B1 can shorten the duration of vasoactive drugs in patients with sepsis or septic shock, but it cannot effectively reduce the SOFA score, mortality, new AKI patients, length of stay in ICU and in hospital. Limited by the number and quality of the included studies, further large-scale, multi-center, blinded, RCT are still needed for verification.

Objective To investigate the effect of volume resuscitation with normal saline (NS) at 37 ℃ on the coagulation function and microcirculation of neonates with septic shock. Methods Children with septic shock admitted to neonatal intensive care unit (NICU) of the First Affiliated Hospital of Gannan Medical University were enrolled. Twenty-four newborns with septic shock were divided into two groups by random number table method (12 in each group), and were resuscitated with 10 mL/kg at 25 ℃ NS and 37 ℃ NS respectively on the basis of routine treatment. FactorⅡ,Ⅴ,Ⅶ,Ⅷ,Ⅸ,Ⅹ, and prothrombin time (PT), thrombin Time (TT), fibrinogen (FIB), activated partial thromboplastin time (APTT), D-Dimer (DD), lactic acid (Lac) were detected before treatment and 6 hours and 12 hours after treatment. Results The levels of coagulation factors Ⅱ,Ⅴ,Ⅶ,Ⅷ,Ⅸ,Ⅹ were not significantly changed before and after treatment in the two groups, and there was no significant difference between the two groups. After treatment, PT and APTT in both groups were gradually shortened, DD and Lac were gradually decreased, FIB were gradually increased, while TT had no significant change. Among them, PT, APTT, DD and Lac at 6 hours after treatment in 37 ℃NS group were significantly lower than those before treatment [PT (s): 14.07±1.02 vs. 17.08±1.54, APTT (s):54.83±12.39 vs. 69.17±16.36, DD (mg/L): 2.40±0.63 vs. 4.18±0.88, Lac (mmol/L): 2.84±0.82 vs. 5.98±1.17, all P < 0.05]; DD and Lac at 6 hours after treatment in 25 ℃ NS group were significantly lower than those before treatment [DD (mg/L): 3.13±0.84 vs. 4.16±1.04, Lac (mmol/L): 4.83±0.64 vs. 5.69±0.74, both P < 0.05], and PT at 12 hours after treatment was significantly shorter than that before treatment (s: 14.63±1.14 vs. 16.48±1.61, P < 0.01); FIB in both 25 ℃ NS group and 37 ℃ NS group at 12 hours after treatment were significantly higher than those before treatment (g/L: 2.83±0.83 vs. 1.58±0.43, 2.87±0.87 vs. 1.47±0.41, both P < 0.01), but TT had no significant change. The comparison between groups showed that PT, DD and Lac in the 37 ℃ NS group were significantly lower than those in the 25 ℃ NS group at 6 hours after treatment [PT (s): 14.07±1.02 vs. 15.69±1.21, DD (mg/L): 2.40±0.63 vs. 3.13±0.84, Lac (mmol/L): 2.84±0.82 vs. 4.83±0.64, all P < 0.05]; at 12 hours after treatment, PT, APTT and DD in the 37 ℃NS group were significantly lower than those in the 25 ℃ NS group [PT (s): 13.26±0.91 vs. 14.63±1.14, APTT (s):37.08±10.43 vs. 54.75±14.96, DD (mg/L): 1.20±0.59 vs. 2.06±0.69, all P < 0.01], and FIB was significantly higher than that in the 25 ℃ NS group (g/L: 2.87±0.87 vs. 2.83±0.83, P < 0.05). Conclusion Volume resuscitation at 37 ℃ can improve the coagulation function and microcirculation of newborns with septic shock.

Objective To evaluate the effects of pulmonary recruitment (RM) in severe acute respiratory distress syndrome (ARDS) with different body position and positive end-expiratory pressure (PEEP) mode in stage of mechanical ventilation. Methods From June 2013 to June 2016, 80 cases of ICU hospitalized patients with clinical data were enrolled, and they lay in the prone or supine position (prone position group and supine position group, each of 40 cases). The hemodynamic parameters including heart rate (HR), central venous pressure (CVP) and peripheral arterial pressure, respiratory mechanics index including respiratory rate (RR), respiratory system compliance (Crs) and platform pressure (Pplate), and the changes of blood gas analysis index were monitored to observe the effects of RM in different positions with positive end expiratory pressure increasing method. Results The levels of oxygenation index and arterial partial pressure of oxygen (PaO2) were improved 3, 5 and 7 d after treatment compared with those 1 d after treatment (P<0.05), and they were improved significantly in prone position group than those in supine position group 3 and 5 d after treatment (P<0.05). The levels of RR, Crs and Pplate 15 min, 30 min, 1 h, 6 h, 12 h and 24 h after RM had significant differences compared with those before RM (P<0.01). The levels of HR, CVP, peripheral arterial pressure 15 min, 30 min, 1 h, 6 h, 12 h and 24 h after RM had no significant differences compared with those before RM (P>0.05). Conclusions For patients with severe ARDS, early implementation of prone position ventilation combined with PEEP increasing method re-expansion treatment is safe and reliable. It can effectively improve oxygenation level and help to improve the survival rate.

Objective To explore the clinical effect of corticosteroids combined with Chinese medicine sequential therapy of Guishao Dihuang pill and Yupingfeng granules on children nephrotic syndrome (NS) with yin deficiency of liver and kidney.Methods Fifty patients (the loss of children during the course of treatment were not included in the statistical analysis) with definitely diagnosed NS accompanied by yin deficiency of the liver and kidney admitted to the First Affiliated Hospital of Gannan Medical University from January 2012 to June 2016 were enrolled,and they were divided into control group and observation group by random number table,25 cases in each group.Conventional treatment of western medicine and long-term treatment of corticosteroids were given to the two groups.In addition,sequential therapy of Guishao Dihuang pills and Yupingfeng granules was given to the observation group on the bases of conventional treatment.The changes of platelet aggregation rate (PAT),cholesterol,cortisol,T cell subsets CD3,CD4,CD4/CD8 were observed before and after treatment for 8 weeks and 6 months,then the clinical efficacy and infection,etc.complications were compared between the two groups.Results There were no statistical significant differences in cholesterol,cortisol and curative effect compared between the two groups before treatment and after treatment for 8 weeks and 6 months (all P ＞ 0.05).Mter treatment for 8 weeks and 6 months,the PAT,cholesterol,cortisol of two groups were significantly decreased compared with those before treatment,while CD3,CD4 were obviously higher than those before treatment,and the degrees of changes of PAT,CD3,CD4 in the observation group were more remarkable than those of the control group [PAT:treatment after 8 weeks was (63.01 ± 6.99)％ vs.(66.62 ± 4.65)％,treatment after 6 months was (51.42 ± 7.74)％ vs.(57.01 ± 6.77)％,CD3:treatment after 8 weeks was 0.56 ± 0.06 vs.0.52± 0.06,treatment after 6 months was 0.61 ± 0.05 vs.0.58 ± 0.03,CD4:treatment after 8 weeks was 0.33 ± 0.06 vs.0.30 ± 0.05,treatment after 6 months was 0.39 ± 0.05 vs.0.33 ± 0.06,all P ＜ 0.05].CD4/CD8 ratio was significantly higher in observation group after treatment for 8 weeks and 6 months than those before therapy (1.68 ± 0.76,1.82 ± 0.95 vs.1.16 ± 0.67,both P ＜ 0.05);the number of patients with infection in observation group was obviously lower than that of the control group (86 cases vs.175 cases,P ＜ 0.05).Conclusions The therapeutic effect of corticosteroids combined with Chinese medicine sequential therapy of Guishao Dihuang pills and Yupingfeng granules for treatment of children NS with yin deficiency of the liver and kidney is better than that of using western medicine therapy alone,as the combined sequential therapy has good effects on reduction of infection,anti-thrombosis and elevation of immunity.

Objective:To study the possible immune escape mechanisms of HCoV-OC43 from human dendritic cells(DC).Methods:HCoV-OC43 was isolated from clinical specimen using BSC-1 cells and identified by Real-time PCR,and the cytopathic effect was observed by phase contrast microscope.DCs were induced in vivo using hu-GM-CSF and IL-4 cytokines,and after 7 days of differentiation,DCs were infected by HCoV-OC43.The morphology of HCoV-OC43 infected DC was observed by transmission electron microscope,and the cytokines related to DC functions were detected by Real-time PCR after infection.DC proportion and function related co-stimulatory molecules were analyzed by flow cytometry.Results:In vitro HCoV-OC43 infected human DC model was successfully built.HCoV-OC43 can infect DC and generate immune response of DC in vitro,but no virus nucleonic acid could be detected in culture supernatant.The DC expression of IFN-α,IFN-β,CCL3 and CCL5 were significant decreased when infected with HCoV-OC43,but the expression of costimulatory molecules including HLA-DR,CD1c and CD86 were not affected by HCoV-OC43 infection.Conclusion:Human DC could be infected by HCoV-OC43 and generate immune response,but could not produce progeny virus.HCoV-OC43 may escape from immune response by suppressing the expression of IFN-α and other inflammatory cytokines and chemokines in DC.

Objective: To investigate the molecular evolution characteristics of human coronavirus (HCoV) subtypes in patients with fever and respiratory tract infection in Guangzhou from 2010 to 2012. Methods: Partial fragments of NP, RdRp and S genes of HCoV-OC43, HCoV-229E and HCoV-NL63 positive samples were amplified by RT-PCR and sequencing. Bioinformatics software, including Bio-edit, Mega4.0 and Clustal1.83 were used for comparison and analysis of NP, RDRp and S gene sequences. Molecular evolutionary tree of different gene regions of HCoV-OC43, HCoV-229E and HCoV-NL63 were built. Results: No remarkable variation or recombinant strain of HCoV-OC43, HCoV-229E and HCoV-NL63 was found in Guangzhou during 2010—2012. The HCoV-OC43 substrains were genetically closest to the strains found in Belgium and Hong Kong (GenBank accession number JN129834 and AY903460). HCoV-229E substrains were genetically closest to those found in Amsterdam (GenBank accession number JX503060) and HCoV-NL63 most genetically close to those in Amsterdam and Beijing (GenBank accession number JX104161 and DQ445911). The NP and RDRp genes of all subtypes were highly conserved, while S gene was more variable. Conclusions There were at least 3 substrains of HCoV-OC43, HCoV-229E and HCoV-NL63 epidemic in Guangzhou during 2010—2012, and no remarkable variation or recombinant viral strain was found. The NP and RDRp genes of all subtypes were highly conserved and can be used in virus detection, while S gene was more variable and suitable for phylogenetic and variation study.

Objective To analyze the expression of synaptophysin (SY) in hippocampal dentate gyrus of rats with hypoxic-ischemic brain damage(HIBD) after the injection of bone marrow stromal cells(BMSCs) and its supernatant into the lateral ventricle and to explore the mechanism of potential effects. Methods Eighty 7-day-old sprague-dawley(SD) rats were randomly divided into sham group, control group, cell group and supernatant group, with 20 rats in each group. The HIBD model was established via the ligation of left carotid arteries followed by 2-hour hypoxia. One week later, control group was injected with 0.01 mol/L PBS via the left ventricle. Meanwhile, cell and supernatant group were injected with BMSCs and supernatant harvested from BMSC culture, respectively, via the same route. For spam group, the left carotid arteries were separated but not ligated, and no hypoxia treatment was imposed on this group. They also received 0.01mol/L PBS injection one week post surgery. After 8 weeks, the expression of SY in the dentate gyrus of rats was measured. Results Compared with sham group, model group showed significantly lower IOD (integral optical density) of SY positive material in the dentate gyrus(P < 0.05). Compared with model group, supernatant group and cell group exhibited significantly increased IOD values (P < 0.05), but there was no significant difference between cell group and supernatant group (P > 0.05). Conclusions BMSCs and supernatant injected via the lateral cerebral ventricle can increase SY expression in the hippocampal dentate gyrus of HIBD rats and promote synapse formation. The mechanism of this effect may be related to cytokine secretion by BMSCs which promotes synapse formation.

Objective To investigate the feasibility and effectiveness of internal jugular vein (IJV) intervention therapy in patients with cerebral venous sinus thrombosis (CVST)with color Doppler ultrasound (CDU). Methods Twelve patients with CVST diagnosed by CDU and the 13 IJV lesions (localized luminal stenosis in 9 cases,venous long-segment slender in 2 cases,and right IJV localized luminal stenosis,and long-segment slender on the left in 1 case)confirmed by magnetic resonance venography (MRV)and/ or digital subtraction angiography (DSA)were enrolled retrospectively. CDU examinations were used at 1 week before and after IJV intervention therapy,6 months,1 year,and 2 years. The changes of the maximum diameter and the maximum velocity (V max )of the IJV were compared. The success rate and the long-term efficacy of the intervention therapy were analyzed. Results One week after treatment,the CDU examinations showed that the diameter of IJV stenosis in 13 IJV were increased significantly compared with those before procedure (4. 7 ± 2. 1 mm vs. 2. 3 ± 1. 3 mm;t = 5. 325,P < 0. 01). The velocity of blood flow of IJV was improved compared with before procedure (localized stenosis in 10 IJV[50 ± 15 cm/ s vs. 87 ± 24 cm/ s];t = 6. 285,P < 0. 01). Six of the 12 patients were followed up for a mean of 18 ± 7 months, two patients had restenosis after balloon dilatation. Conclusions For CVST patients with IJV lesions,the preliminary observation has indicated that IJV intervention therapy may improve the lesion lumen and hemodynamics. However,the intervention therapy,especially after balloon dilatation,the incidence of restenosis is higher. CDU can be used as an objective evaluation means for the long-term efficacy of IJV stenosis.

Objective To analyze the expression of glial fibrillary acidic protein(GFAP) in hippocampal of rats with hypoxic-ischemic brain damage(HIBD) after injection of bone marrow stromal cells(BMSCs) supernatant into the lateral ventricle of the neonate rats,assess the ability of learning and memory,and explore the mechanism.Methods 7-day-old SD rats were randomly divided into sham operation group,model group,cells and supernatant group,with 20 rats in each group.The HIBD model was established via the ligation of left carotid arteries followed by 2-hour hypoxia.One week later,rats in control group were injected with 0.01 mol/L PBS 2 μl via the left ventricle.Meanwhile,the cell and the supernatant groups were injected with BMSCs and supernatant harvested from BMSC culture,respectively,via the same route.In the sham operation group,the left carotid arteries were separated but not ligated,and no hypoxia treatment was imposed on this group.They also received 0.01 mol/L PBS injection 2 μl per weak post surgery.8 weeks later,Morris water maze test was performed to assess the learning and memory,and the expression of GFAP in the dentate gyrus of rats was measured by immunohistochemistry.Results Morris water maze showed that the searching time of the probe trail(T1:(15.40±2.80) s) and reversal probe trail (T2:(16.45± 1.16) s) of the model group was shorter than that of the sham operation group (T1:(19.96±2.57) s,T2:(2:25.32±2.54)s,P＜0.05),while the searching time of the cell group(T1:(17.54± 1.80)s,T2:(18.99± 1.47) s) and supernatant group (T1:(17.40±2.37) s,T2:(17.96± 1.09) s) was prolonged compared with that of the model group (P＜0.05).No significant difference between the cell group and the supernatant group (P＞0.05).The integral optical density (IOD) value of GFAP positive cells was higher in the model group than that in the sham operation group(15.26±1.49 vs 12.82±2.56,P＜0.05),while the IOD of cell group(18.13±1.97) and that of the supernatant group(17.38± 1.64) were higher than that of the model group (P＜0.05).However,there was no significant difference between the cell group and the supernatant group (9＞0.05).Conclusion BMSC supernatant injected through lateral ventricle can improve the HIBD rats' abilities of learning and memory.The mechanism might be that MSCs secrete some cytokines to promote central nervous system repair.

OBJECTIVETo study genome-wide gene expression changes in gastric cancer cells after iodine-125 ¹²⁵(I) particle irradiation.

METHODS¹²⁵I particles were used to irradiate three gastric cancer cell lines of various differentiation levels:high (BGC-823) , medium (AGS) and low (NCI-N87) .Whole-genome gene expression was investigated with microarray. The gene expression in iodine-125 irradiated and untreated cancer cells was compared, and the genes with transcript levels altered for at least 2 folds (P < 0.05) were selected. The change in gene expression levels was verified by using quantitative real-time (qRT) -PCR.

RESULTSThe three gastric cancer cell lines received the same dose rate of ¹²⁵I particle irradiation. Cluster analysis showed that the Gene Ontology (GO) categories did not change in the three cell lines, but changes in gene expression levels were evident for many genes. After ¹²⁵I particle irradiate NCI-N87 cells, 895 genes were up-regulated, 786 genes were down-regulated; AGS was irradiated by ¹²⁵I seed, there were 124 genes upregulated, 161 genes were down-regulated; BGC-823 cells were treated by ¹²⁵I seed irradiation, 2 412 genes upregulated, 3 243 downregulated genes. After ionizing radiation can cause very complex transcriptional regulation changes, KEGG pathway analysis shows that these differentially expressed genes overlap in a particular cell pathway. Four genes, TRAF3IP2-AS1, SDC1, RABL2B and NOM, were found having at least 2-fold difference in expression (P < 0.05) , and the gene expression alteration was confirmed by qRT-PCR.

CONCLUSIONS¹²⁵I particle irradiation caused gene expression changes in gastric cancer cells. The expressions of TRAF3IP2-AS1, SDC1, RABL2B and NOM are altered significantly in all three cell lines studied, indicating that these genes may play an important role in the ¹²⁵I seed treatment of gastric cancer. These genes could be potential targets for developing anti-cancer drugs in the future.

Cell Line, Tumor ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; radiation effects ; Humans ; Iodine Radioisotopes ; adverse effects ; Stomach Neoplasms ; metabolism ; pathology