1.Predictive value of SAVE score combined with 24-h lactate on the prognosis of patients with extracorporeal cardiopulmonary resuscitation
Yue ZOU ; Yi ZHU ; Zhongman ZHANG ; Di AN ; Yu XIA ; Tao DING ; Yutong SHI ; Yong MEI ; Jinru LV ; Wei LI ; Xufeng CHEN
Chinese Journal of Emergency Medicine 2022;31(11):1486-1490
Objective:To explore the prognostic value of survival after veno-arterial ECMO (SAVE) score combined with 24-h lactate on the machine in patients with extracorporeal cardiopulmonary resuscitation (ECPR).Methods:Totally 59 patients treated with ECPR in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University from April 2017 to June 2021 were retrospectively analyzed. According to the 28-day prognosis, the patients were divided into the death group ( n=36) and the survival group ( n=23). The differences in baseline data were analyzed, and multivariate logistic regression was performed to identify the influencing factors of 28-day mortality in patients with ECPR. The receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of SAVE score, 24-h lactate and their combined detection for predicting 28-day mortality risk in patients with ECPR. Results:The 28-day survival rate of patients with ECPR was 39% (23/59). SAVE score of the death group was significantly lower than that of the survival group (-11.67±4.60 vs. -2.43±4.77, P<0.001), and the 24-h lactate in the death group was significantly higher than that in the survival group [5.94 (3.37, 12.40) mmol/L vs. 1.65 (1.07, 3.15) mmol/L, P<0.001]. Multivariate logistic regression analysis showed that SAVE score ( OR=0.703, 95% CI: 0.566-0.873, P=0.001) and 24-h lactate ( OR=1.608, 95% CI: 1.025-2.523, P=0.039) were independent influencing factors of 28-day mortality in ECPR patients. ROC curve analysis showed that the best cut-off value of SAVE score was -6, the sensitivity was 78.30% and specificity was 91.70%. The best cutoff value of 24-h lactate was 4.7 mmol/L, the sensitivity was 63.90% and specificity was 100.00%. The sensitivity and specificity of the combined detection of SAVE score and 24-h lactate were 82.60% and 100.00%, respectively. The area under the curve (AUC) of SAVE score combined with 24-h lactate for predicting the 28-day mortality risk in patients with ECPR was larger than that of SAVE score and 24-h lactate alone (0.952 vs. 0.917; 0.952 vs. 0.847). Conclusions:Lower SAVE score and higher 24-h lactate are independently risk factors of 28-day mortality in patients with ECPR, and SAVE score combined with 24-h lactate on the machine has a good predictive value for the prognosis of patients with ECPR.
2.Anti-aggregation Effect and Short-term Safety Evaluation of Low-dose Aspirin Therapy in the Elderly Chinese Population: a Multicenter Randomized Controlled Clinical Trial
Xia-Huan CHEN ; Mei-Lin LIU ; Ming-Fang QIN ; Yan-Mei SUN ; Tao TIAN ; Jin-Qiao LI ; Qing-Tan ZHANG ; Jun LI ; Yong-Jun MAO ; Zhi-Sheng JIA ; Zhi-Yong FANG ; Zhi-Ping LV ; Lian-Qi CUI ; Chun-Hui GAO ; Li-Na WANG ; Yong-Ming HUI ; Pei-Yan SHAN ; Xiao-Ping CHEN ; Peng-Fei YIN
Chinese Circulation Journal 2018;33(5):457-462
Objectives: This study aimed to observe the change of arachidonic acid-induced platelet aggregation rate (AA-Ag) and short-term adverse reactions after taking 50 or 100 mg/d aspirin(enteric-coated sustained-release formulation) or 100 mg/d aspirin (enteric-coated aspirin tablet)in the elderly Chinese population (aged 60 years or older). Methods: A total of 1 194 participants aged 60 or older, who should be recommended to take aspirin therapy due to medical reasons, were recruited and randomly assigned into three groups to receive enteric-coated sustained-release aspirin tablet (50 mg, once daily, group A), or 100 mg, once daily (group B) or enteric-coated aspirin tablet 100 mg once daily (group C), respectively. AA-Ag was measured after (14±3)days of aspirin treatment. Adverse events and bleeding events were recorded during the (28±3)days of follow-up. Results: The AA-Ag in group A (n=347), B (n=338) and C (n=332) post 14-day aspirin therapy were 6.65 (4.03,10.84)%, 5.89(3.22,10.03) % and 6.00(3.68,10.09) %, respectively (P>0.05). During the 28 days follow-up, the adverse events rate of group A (n=388), B (n=387) and C (n=385) was 3.87%,3.36%, and 7.95%, and the mild bleeding events rate was 3.09%, 2.33%, and 6.23%, respectively. Adverse events rate and mild bleeding events rate were significantly higher in group C than in group A and B (P<0.05). Conclusions: Compared with 100 mg-dose aspirin, 50 mg-dose aspirin achieves similar anti-platelet aggregation effect in this elderly Chinese population. The short-term adverse events and mild bleeding risk of aspirin with enteric-coated sustained-release formulation were fewer than that of enteric-coated formulation.
3.Rapid screening for Klinefelter syndrome with a simple high-resolution melting assay: a multicenter study.
Dong-Mei FU ; Yu-Lin ZHOU ; Jing ZHAO ; Ping HU ; Zheng-Feng XU ; Shi-Ming LV ; Jun-Jie HU ; Zhong-Min XIA ; Qi-Wei GUO
Asian Journal of Andrology 2018;20(4):349-354
Klinefelter syndrome (KS) is the set of symptoms that result from the presence of an extra X chromosome in males. Postnatal population-based KS screening will enable timely diagnosis of this common chromosomal disease, providing the opportunity for early intervention and therapy at the time point when they are most effective and may prevent later symptoms or complications. Therefore, through this study, we introduced a simple high-resolution melting (HRM) assay for KS screening and evaluated its clinical sensitivity and specificity in three medical centers using 1373 clinical blood samples. The HRM assay utilized a single primer pair to simultaneously amplify specific regions in zinc finger protein, X-linked (ZFX) and zinc finger protein, Y-linked (ZFY). In cases of KS, the ratios of ZFX/ZFY are altered compared to those in normal males. As a result, the specific melting profiles differ and can be differentiated during data analysis. This HRM assay displayed high analytical specificity over a wide range of template DNA amounts (5 ng-50 ng) and reproducibility, high resolution for detecting KS mosaicism, and high clinical sensitivity (100%) and specificity (98.1%). Moreover, the HRM assay was rapid (2 h per run), inexpensive (0.2 USD per sample), easy to perform and automatic, and compatible with both whole blood samples and dried blood spots. Therefore, this HRM assay is an ideal postnatal population-based KS screening tool that can be used for different age groups.
DNA/genetics*
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Dried Blood Spot Testing
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Humans
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Infant
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Infant, Newborn
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Karyotyping
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Klinefelter Syndrome/diagnosis*
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Kruppel-Like Transcription Factors/genetics*
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Male
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Mass Screening/methods*
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Polymerase Chain Reaction
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Reproducibility of Results
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Sensitivity and Specificity
4.Effect of miR-155 on AngII-induced Mice Vascular Smooth Muscle Cell Phenotype Switching With its Mechanism
wei Zi ZHANG ; xia Li YANG ; lin Jin LV ; mei Xian WANG ; hua Zhi YANG ; hong Ni LU
Chinese Circulation Journal 2017;32(10):1019-1023
Objective: To observe the effect of miR-155 on angiotensin Ⅱ (AngⅡ)-induced mice vascular smooth muscle cell (VSMC) phenotype switching with its possible mechanism. Methods: Primary cultured mice VSMCs were treated by AngⅡ at different concentrations and time periods, relevant expressions of miR-155 were examined by RT-PCR. qRT-PCR was conducted to determine miR-155 changes in Blank control group, miR-155 mimics group, miR-155 mimics negative control (NC) group, miR-155 inhibitor group and miR-155 inhibitor NC group. Western blot analysis was performed to measure the effect of miR-155 on AngⅡ-enforced ERK1/2 and mTOR signaling pathway in Blank control group, AngⅡ group, miR-155 mimics group, AngⅡ+miR-155 mimics group, miR-155 inhibitor group and AngⅡ+miR-155 inhibitor group; to detect the impact of miR-155, rapamycin (Rap) and U0126 on AngⅡ promoted VSMC phenotype switching in Blank control group, AngⅡ group, miR-155 mimics group, AngⅡ+miR-155 mimics group, AngⅡ+U0126 group and AngⅡ+Rap group, and to detect protein expressions of SM22α, α-SM-actin (contractile phenotype marker protein) and OPN (synthetic phenotype marker). Results: AngⅡ decreasing miR-155 expression was in a dose- and time-dependent manner. miR-155 could reduce the basal and AngⅡ-promoted ERK1/2, mTOR signaling pathway, while miR-155 inhibitor could elevate the above effect. Rap, U0126 and miR-155 could inhibit AngⅡ-attenuated expressions of SM22α, α-SM-actin and meanwhile inhibit AngⅡ-enforced expression of OPN. Conclusion: miR-155 could inhibit mice AngⅡ-promoted VSMC phenotype switching which might be via inhibiting the activations of mTOR and ERK1/2.
5.Clinical value of noninvasive cardiac index test in the evaluation of neonatal congenital heart disease complicated with heart failure
Yonghua YUAN ; Aimin ZHANG ; Xuehua HE ; Jun XU ; Furong HUANG ; Liping LIU ; Zhenyu LIU ; Xiaohui XIA ; Mei LV ; Aitong QIANLI ; LI ZHU
Journal of Clinical Pediatrics 2017;35(10):747-750
Objective To explore the clinical value of the monitoring of electronic cardiac index (CI) in the evaluation of neonatal congenital heart disease complicated with heart failure. Methods Sixty neonates with congenital heart disease treated in neonatal department from March 1, 2016 to December 30, 2016 were selected, and divided into severe group (n=11), moderate group (n=15), mild group (n=34), and no heart failure group (n=10) according to the modified Ross heart failure score. CI was measured by electronic force measurement. Left ventricular ejection fraction (LVEF) and pulmonary arterial pressure (PAP) were measured by echocardiography. Venous blood sampling was collected to detect the N-terminal type B brain natriuretic peptide (NT-proBNP). Results The neonates in the severe group were mainly under 2-week-old, while those in the mild group and the moderate group were more than 2-week-old. The differences of CI, LVEF, NT-proBNP, and PAP among the groups were statistically different. The CI and LVEF values were lowest in the severe group, followed by moderate group and mild group, and the highest in no heart failure group. The NT-proBNP and PAP values were the highest in the severe group, followed by moderate group and mild group, and the lowest in no heart failure group. Correlation analysis showed that CI was positively correlated with LVEF (r=0.845, P<0.001), and negatively correlated with NT-proBNP (r=-0.886, P<0.001); CI and PAP were weakly negatively correlated (r=-0.595, P<0.001). Conclusions CI reflects the degree of heart failure to some extent and has some clinical value.
6.Baicalin attenuates high fat diet-induced insulin resistance and ectopic fat storage in skeletal muscle, through modulating the protein kinase B/Glycogen synthase kinase 3 beta pathway.
You-Li XI ; Hong-Xia LI ; Chen CHEN ; Ya-Qun LIU ; Hong-Mei LV ; Shi-Qi DONG ; Er-Fei LUO ; Ming-Bo GU ; Hua LIU
Chinese Journal of Natural Medicines (English Ed.) 2016;14(1):48-55
Insulin resistance is the pathophysiological basis of many diseases. Overcoming early insulin resistance highly significant in prevention diabetes, non-alcoholic fatty liver, and atherosclerosis. The present study aimed at evaluating the therapeutic effects of baicalin on insulin resistance and skeletal muscle ectopic fat storage in high fat diet-induced mice, and exploring the potential molecular mechanisms. Insulin resistance in mice was induced with a high fat diet for 16 weeks. Animals were then treated with three different doses of baicalin (100, 200, and 400 mg·kg(-1)·d(-1)) for 14 weeks. Fasting blood glucose, fasting serum insulin, glucose tolerance test (GTT), insulin tolerance test (ITT), and skeletal muscle lipid deposition were measured. Additionally, the AMP-activated protein kinase/acetyl-CoA carboxylase and protein kinase B/Glycogen synthase kinase 3 beta pathways in skeletal muscle were further evaluated. Baicalin significantly reduced the levels of fasting blood glucose and fasting serum insulin and attenuated high fat diet induced glucose tolerance and insulin tolerance. Moreover, insulin resistance was significantly reversed. Pathological analysis revealed baicalin dose-dependently decreased the degree of the ectopic fat storage in skeletal muscle. The properties of baicalin were mediated, at least in part, by inhibition of the AMPK/ACC pathway, a key regulator of de novo lipogenesis and activation of the Akt/GSK-3β pathway, a key regulator of Glycogen synthesis. These data suggest that baicalin, at dose up to 400 mg·kg(-1)·d(-1), is safe and able to attenuate insulin resistance and skeletal muscle ectopic fat storage, through modulating the skeletal muscle AMPK/ACC pathway and Akt/GSK-3β pathway.
AMP-Activated Protein Kinases
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metabolism
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Acetyl-CoA Carboxylase
;
metabolism
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Adipose Tissue
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metabolism
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Animals
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Diet, High-Fat
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Flavonoids
;
pharmacology
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Glycogen Synthase Kinase 3 beta
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physiology
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Insulin Resistance
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Male
;
Mice
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Mice, Inbred C57BL
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Muscle, Skeletal
;
metabolism
;
Proto-Oncogene Proteins c-akt
;
physiology
;
Signal Transduction
;
physiology
7.Histological subtypes of lung cancer in Chinese males from 2000 to 2012.
Xiao Nong ZOU ; Dong Mei LIN ; Xia WAN ; Ann CHAO ; Qin Fu FENG ; Zhen DAI ; Gong Huan YANG ; Ning LV
Biomedical and Environmental Sciences 2014;27(1):3-9
OBJECTIVETo characterize the histological and epidemiological features of male lung cancer patients in China.
METHODSThe demographic and histological information about male lung cancer patients identified from 2000-01-01 to 2012-12-31, was collected from the Cancer Hospital of the Chinese Academy of Medical Sciences. Relative frequencies (RF) were estimated for major histological subtypes and compared according to the years of diagnosis and birth.
RESULTSThe RF of adenocarcinoma (ADC) increased from 21.96% to 43.36% and the RF of squamous cell carcinoma (SCC) decreased from 39.11% to 32.23% from 2000 to 2012 in the 15 427 male lung cancer patients included in this study (Z=17.909, P<0.0001; Z=-6.117, P<0.0001). The RF of ADC increased from 28.72% in 2000-2004, 36.88% in 2005-2008 to 48.61% in 2009-2012 in patients born after 1960. The age-adjusted RF of ADC in 2007-2012 increased consistently in all the investigated areas.
CONCLUSIONThe increased RF of ADC in male lung cancer patients highlights the need for further investigation of the etiologic factors of these tumors. Smoke-free policies rather than modifying tobacco products should be enforced.
Adult ; Aged ; Aging ; Carcinoid Tumor ; epidemiology ; etiology ; Carcinoma, Adenosquamous ; epidemiology ; etiology ; China ; epidemiology ; Humans ; Lung Neoplasms ; classification ; epidemiology ; etiology ; Male ; Middle Aged ; Smoking ; adverse effects ; Time Factors
8.Comparison on polysaccharide content and PMP-HPLC fingerprints of polysaccharide in stems and leaves of Dendrobium officinale.
Gui-Fen ZHOU ; Min-Xia PANG ; Su-Hong CHEN ; Gui-Yuan LV ; Mei-Qiu YAN
China Journal of Chinese Materia Medica 2014;39(5):795-802
In order to provide scientific basics for exploitation and sufficient application of Dendrobium officinale leaves resources, the phenol-sulfuric acid method was applied to determine the polysaccharide content. The monosaccharides were derivated by PMP and the derivatives were identified by HPLC-DAD-ESI-MS(n) and the contents of mannose and glucose were determined simultaneously. Similarity evaluation system for chromatographic fingerprint of traditional Chinese medicine (2004A) was employed to generate the mean chromatogram and similarity analysis of the samples was carried out. The results demonstrated that polysaccharide content, monosaccharide compositions and composition ratio had an obvious difference between stems and leaves. The polysaccharide content of stems was higher than that of leaves. Monosaccharide composition in leaf was significantly different from that in stem. The polysaccharide from stems was composed of mannose and glucose, however the polysaccharide of leaves was acid heteropolysaccharide and was mainly composed of five monosaccharides, including mannose, galacturonic acid, glucose, galactose and arabinose. The similarity value of the 14 batches was above 0.9, indicating that similarity of fingerprints among different samples was high. The study can provide evidence for expanding the medicinal parts of D. officinale.
Chromatography, High Pressure Liquid
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Dendrobium
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chemistry
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Mass Spectrometry
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Plant Extracts
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chemistry
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Plant Leaves
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chemistry
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Plant Stems
;
chemistry
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Polysaccharides
;
chemistry
9.Quality of life in women with cervical precursor lesions and cancer: a prospective, 6-month, hospital-based study in China.
Zhi-Mei ZHAO ; Xiong-Fei PAN ; Si-Han LV ; Yao XIE ; Shao-Kai ZHANG ; You-Lin QIAO ; Xiao-Rong QI ; Chun-Xia YANG ; Fang-Hui ZHAO
Chinese Journal of Cancer 2014;33(7):339-345
The overall survival of patients with cervical cancer has improved due to detection at an early stage and availability of comprehensive treatments in China. As patients' lives prolonged, it is important to understand their health-related quality of life (QoL) during and after treatment. We used the EQ-5D questionnaire to assess QoL of 194 patients with cervical lesions at Sichuan University West China Second Hospital between May 2010 and January 2011. Patients were surveyed before primary treatment and at 1, 3, and 6 months after primary treatment. Results showed a consistent decline in EQ-5D scores in the spectrum of cervical lesions at each time point after treatment (all P < 0.05). For patients with precursor lesions, there was an increasing trend along the timeline of treatment (P < 0.01). For patients with early-stage cervical cancer, EQ-5D scores declined in the first month (P = 0.01) and gradually increased to higher levels at 6 months post-treatment than those before treatment (P < 0.01). EQ-5D scores followed a similar trend in patients with advanced cervical cancer (P = 0.04), though they did not statistically rebound after 6 months (0.84 ± 0.19 vs. 0.86 ± 0.11, P = 0.62). Regarding advanced cervical cancer, EQ-5D scores for women above 40 years of age appeared to recover more rapidly and reached higher levels than those for women below 40 years (P = 0.03). Caution and extra care are recommended in the early period of cervical cancer treatment given the slight deterioration in the QoL, and in particular, for younger cervical cancer patients. Our study implies that health care providers may need to improve the health-related QoL of cervical cancer patients.
Age Factors
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China
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Female
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Humans
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Neoplasm Staging
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Prospective Studies
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Quality of Life
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Surveys and Questionnaires
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Uterine Cervical Dysplasia
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Uterine Cervical Neoplasms
10.Berberine inhibits norepinephrine-induced apoptosis in neonatal rat cardiomyocytes via inhibiting ROS-TNF-α-caspase signaling pathway.
Xiu-xiu LV ; Xiao-hui YU ; Hua-dong WANG ; Yu-xia YAN ; Yan-ping WANG ; Da-Xiang LU ; Ren-Bin QI ; Chao-Feng HU ; Hong-Mei LI
Chinese journal of integrative medicine 2013;19(6):424-431
OBJECTIVETo determine the effect of berberine (Ber) on norepinephrine (NE)-induced apoptosis in neonatal rat cardiomyocytes.
METHODSThe cultured neonatal rat cardiomyocytes were treated with NE in the presence or absence of Ber. The activity of lactate dehydrogenase (LDH) in the culture medium was examined, and apoptosis of cardiomyocytes was assessed by Hoechst 33258, isothiocyanate (FITC)-conjugated annexin-V, and propidine iodide (PI) staining. In addition, the activities of caspases-2 and-3 were measured by a fluorescent assay kit. The level of secreted tumor necrosis factor α (TNF-α) and production of intracellular reactive oxygen species (ROS) were also determined.
RESULTSNE at a concentration of 50 μ mol/L induced an obvious increase in the activity of LDH in the culture medium (P<0.05), which was inhibited by coincubation with 0.5, 1.0, or 2.0 μ mol/L Ber (P<0.05). Ber also significantly attenuated NE-induced apoptosis in a dose-dependent manner (P<0.01). Moreover, Ber at a dose of 2 μ mol/L markedly decreased the ROS and TNF-α productions (P <0.05) and inhibited the activation of caspases-2 and -3 in cardiomyocytes exposed to NE (P<0.05)h.
CONCLUSIONThe present study suggested that Ber could reduce NE-induced apoptosis in neonatal rat cardiomyocytes through inhibiting the ROS-TNF-α-caspase signaling pathway.
Animals ; Animals, Newborn ; Annexin A5 ; metabolism ; Apoptosis ; drug effects ; Berberine ; pharmacology ; Caspase 2 ; metabolism ; Caspase 3 ; metabolism ; Caspases ; metabolism ; Cell Nucleus ; drug effects ; metabolism ; Cell Shape ; drug effects ; DNA ; metabolism ; Enzyme Activation ; drug effects ; Flow Cytometry ; Fluorescein-5-isothiocyanate ; metabolism ; Immunohistochemistry ; L-Lactate Dehydrogenase ; metabolism ; Myocytes, Cardiac ; drug effects ; enzymology ; pathology ; Norepinephrine ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Signal Transduction ; Tumor Necrosis Factor-alpha ; metabolism

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