1.Clinical practice of sepsis-induced immunosuppression: Current immunotherapy and future options
Fei PEI ; Bin GU ; Shu-Min MIAO ; Xiang-Dong GUAN ; Jian-Feng WU
Chinese Journal of Traumatology 2024;27(2):63-70
Sepsis is a potentially fatal condition characterized by the failure of one or more organs due to a disordered host response to infection. The development of sepsis is closely linked to immune dysfunction. As a result, immunotherapy has gained traction as a promising approach to sepsis treatment, as it holds the potential to reverse immunosuppression and restore immune balance, thereby improving the prognosis of septic patients. However, due to the highly heterogeneous nature of sepsis, it is crucial to carefully select the appropriate patient population for immunotherapy. This review summarizes the current and evolved treatments for sepsis-induced immunosuppression to enhance clinicians' understanding and practical application of immunotherapy in the management of sepsis.
2.Construction and application effect of Internet + linkage model based on medical alliance
Zhemin WANG ; Hongbo ZHANG ; Liu SHEN ; Hong CHEN ; Pei HUANG ; Yan FEI ; Hui ZHU ; Meihua GU
Chinese Journal of Modern Nursing 2022;28(6):793-797
Objective:To construct an Internet + linkage model based on medical alliance and evaluate its implementation effect.Methods:From October 2020 to June 2021, convenience sampling was used to select 132 patients with malignant tumors who were treated with peripherally inserted central catheters (PICC) chemotherapy and discharged with catheters in Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine. The 67 patients who returned to the PICC outpatient clinic of Chongming Branch, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine during the treatment interval for PICC maintenance were set as the control group, and the routine maintenance method was adopted. A total of 65 patients who chose maintenance points near their residence for PICC maintenance during the treatment interval were set as the observation group. On the basis of the control group, the maintenance method based on the Internet + linkage mode of medical alliance was adopted. The PICC self-management ability, catheter-carrying satisfaction, PICC complication, average cost and average time spent on PICC maintenance during treatment were compared between the two groups.Results:There were no significant differences in the scores of daily life with catheters, exercise with catheters, catheter abnormality handling, compliance with catheter maintenance and confidence in catheter management between the two groups ( P>0.05) . There was no significant difference in the scores of Catheter Satisfaction Survey in the two groups of patients ( P>0.05) .There was also no significant difference in the incidence of PICC complications between the two groups ( P>0.05) . The registration fee, maintenance fee, and transportation fee for PICC maintenance in the observation group were lower than those in the control group, and the round-trip time and visit time were shorter than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The Internet + linkage model based on the medical alliance can ensure the quality of PICC maintenance for patients with malignant tumors undergoing PICC chemotherapy and discharged with catheters, and improve their PICC self-management ability, which has good economic and time benefits.
3.Impact of femoral or radial approach on acute renal injury induced by repeated contrast medium in patients with coronary heart disease.
Peng LI ; Yi KANG ; Zhao Feng WANG ; Chong Huai GU ; Guan Nan AI ; Yi Fei LIU ; Pei XU ; Xiao Zeng WANG ; Xin ZHAO ; Ya Ling HAN
Chinese Journal of Cardiology 2020;48(12):1053-1059
Objective: To investigate the effects of femoral approach versus radial approach on the incidence of contrast-induced acute kidney injury (CI-AKI) in patients with coronary heart disease, who received twice contrast agents within a short interval. Methods: A total of 322 patients with coronary heart disease, who admitted to the General Hospital of Northern Theater Command from January 2010 to January 2015, were included in this retrospective analysis. All patients exposed to contrast agents twice within 30 days. The patients were divided into two groups according to the approach of interventional operation: radial artery group (n=235) and femoral artery group (n=87). Serum creatinine (SCr) values were detected at 48 and 72 hours post procedure. Endpoint events were CI-AKI, which was defined as SCr increased>0.5 mg/dl (44.2 μmol/L) or relative ratio ((postoperative SCr-preoperative SCr)/preoperative SCr×100%>25%) within 72 hours after contrast agent use after excluding other causes. Clinical characteristics and the incidence of CI-AKI were compared between the two groups, multivariate logistic regression analysis was used to detect the risk factors of postoperative CI-AKI in these patients. Results: The proportion of smoking, PCI history, STEMI patients and levels of fibrinogen, fasting blood glucose, troponin T was significantly higher in femoral artery group than in radial artery group (all P<0.05). The interval between two procedure sessions was significantly longer in the femoral artery group than in the radial artery group (P=0.001). The incidence of CI-AKI tended to be higher in femoral artery group than in radial artery group after the first operation (18.6% (16/87) vs. 11.9% (28/235), P=0.133). CI-AKI incidence after the second operation was similar between the two groups (P>0.05). Multivariate logistic regression analysis showed that interventional approach was not an independent risk factor for postoperative CI-AKI in patients with coronary heart disease undergoing interventional procedures twice within 30 days (P>0.05);STEMI (OR=2.854, 95%CI 1.100-7.404, P=0.031) and diuretics use (OR=4.002, 95%CI 1.470-10.893, P=0.007) were independent risk factors for CI-AKI after the first operation. Conclusion: There is no correlation between the risk of CI-AKI and interventional approaches in patients with coronary heart disease who undergo interventional surgery twice within 30 days.
Acute Kidney Injury/epidemiology*
;
Contrast Media/adverse effects*
;
Coronary Disease
;
Femoral Artery/surgery*
;
Humans
;
Incidence
;
Percutaneous Coronary Intervention/adverse effects*
;
Radial Artery
;
Retrospective Studies
;
Risk Factors
4.Situation analysis of mental disorders in females with systemic lupus erythematosus
Fei-fei YUAN ; Hong WANG ; Zi-wei DAI ; Zhi-hui WANG ; Yuan-yuan DONG ; Ming-ming GU ; Xiang-pei LI ; Dong-qing YE ; Bin WANG
Chinese Journal of Disease Control & Prevention 2019;23(3):324-327,350
Objective To study the influences of mental disorders on female systemic lupus erythematosus(SLE)and analyze the factors. Methods We used symptom check list -90 (SCL-90) as a basis for judging mental disorders disease activity. Disease activity, social support and depreciation - discrimination were used as possible influencing factors. Social support and discomfort – discrimination were possible influencing factors. Multivariate unconditional logistic regression model was used to analyze the influencing factors of mental disorders. Results The total score of SCL-90 of patients with female SLE was significantly higher than that of norm models [(136.39±48.66) vs (129.96±38.76)] (P<0.05), in 289 SLE patients, the number of patients with mental disorders was 128 (44.3%). High monthly income(OR=0.770, 95% CI:0.604-0.981, P=0.034) was a protective factor for mental disorders. High disease activity (OR=1.792, 95% CI:1.023-3.138, P=0.042)and high discomfort–discrimination (OR=1.100, 95% CI:1.035-1.169, P=0.002)were risk factors for mental disorders. Conclusions Female SLE patients have a higher risk of mental disorders than the general population. And eliminating self-depreciation, reducing social discrimination, active employment, increasing monthly income, standardizing treatment and reducing disease activity may effectively alleviate mental disorders in SLE patients.
5.Clinical significance of beta-catenin and matrix metalloproteinase-13 in synovial tissue of osteoarthritis
Yue-Jun LI ; Wei-Guo ZHU ; Qin-Zheng FANG ; Pei-Lun GU ; Peng GAO ; Yong-Zhi JIAN ; Peng-Fei YANG ; Jin-Bo DONG
Chinese Journal of Tissue Engineering Research 2018;22(16):2472-2477
BACKGROUND: Role of Wnt/β-catenin signaling pathway in the pathogenesis of osteoarthritis has been proved by numerous animal experiments and human specimen trials. Wnt/β-catenin signaling pathway and matrix metalloproteinase 13 (MMP-13) play important roles in pathological process of osteoarthritis, and they may be related with each other. OBJECTIVE: To detect the expression levels of β-catenin and MMP-13 in the synovial tissue of osteoarthritis, and to investigate the relationship between β-catenin and MMP-1 in the pathogenesis of osteoarthritis. METHODS: Synovial tissues were obtained from the 54 patients undergoing total knee arthroplasty or knee arthroscopic diagnosis and treatment surgery and 12 healthy patients suffering from amputation caused by trauma. The samples were divided into non-, mild-, medium-and severe-osteoarthritis groups based on advanced Mankin scores. The expression levels of β-catenin and MMP-13 in the synovial tissues were detected by immunohistochemistry, and correlation analysis was conducted. RESULTS AND CONCLUSION: Immunohistochemistry results showed that MMP-13 was negative in the non-osteoarthritis group, positive in 5 (50%) samples in the mild-osteoarthritis group, positive in 11 (65%) samples in the medium-osteoarthritis group and positive in 23 (85%) samples in the severe-osteoarthritis group. β-Catenin was positive in 1 (8%) sample in the non-osteoarthritis group, positive in 7 (70%) samples in the mild-osteoarthritis group, positive in 14 (82%) samples in the medium-osteoarthritis group and positive in 25 (93%) samples in the severe-osteoarthritis group. The expression levels of β-catenin and MMP-13 in the synovial tissues presented a positive correlation (r=0.806, P < 0.001), and the levels increased with joint degeneration becoming severe. These results imply that there is a significant increase in the expression levels of β-catenin and MMP-13 in the synovial tissues of osteoarthritis compared with the non-osteoarthritis group, and β-catenin and MMP-13 exert effects in development of osteoarthritis. Beta-catenin and MMP-13 are closely associated with pathological changes such as cartilage degeneration and synovial inflammation, thus providing new theoretical direction and experimental basis for targeted gene therapy of osteoarthritis.
6.Effect of Jianpi Bushen Qingchang Huashi Recipe on Proliferation of Bone Marrow Mesenchymal Stem Cells.
Lei ZHU ; Hong SHEN ; Li LIU ; Pei-qing GU ; Jia-fei CHENG ; Lu ZHANG
Chinese Journal of Integrated Traditional and Western Medicine 2016;36(2):191-195
OBJECTIVETo observe the effect of Jianpi Bushen Qingchang Huashi Recipe (JBQHR) on proliferation and migration of bone marrow mesenchymal stem cells (BMSCs).
METHODSBMSCs were isolated and cultured in vitro with adherence screening method to prepare cell suspension. No drug intervention was given to BMSCs in the vehicle control group. JBQHR at 0.39, 0.78, 1.56 µg/mL was added in BMSCs of low, mid, and high dose JBQHR groups for co-incubation. Its effect on the proliferation of BMSCs was detected by CCK-8. BMSCs migration and chemotactic ability was detected using Transwell method. Each dose JBQHR combined ERK kinase inhibitor U0126 was set up as control. The phosphorylation of extracellular regulated protein kinase (ERK) and CAMP responsive element-binding protein (CREB) were detected by Western blot.
RESULTSCompared with the vehicle control group, the proliferation of BMSCs and BMSCs migration number could be promoted in the 3 JBQHR groups (P < 0.05). Besides, the proliferation of BMSCs was better in mid and high dose JBQHR groups than in the low dose JBQHR group (P < 0.05). Compared with the vehicle control group, the phosphorylation of ERK and CREB could be elevated in the 3 JBQHR groups (P < 0.05), and could be inhibited by U0126 (P < 0.01). Compared with the low dose JBQHR group, the phosphorylation of ERK increased in mid and high dose JBQHR groups with statistical difference (P < 0.05).
CONCLUSIONJBQHR could promote the proliferation and migration of BMSCs, and its mechanism might be related to ERK/CREB signaling pathway
Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Humans ; MAP Kinase Signaling System ; Mesenchymal Stromal Cells ; cytology ; drug effects
7.Effect of Baicalin on Expression of NF-κB in Ulcerative Colitis Rats
Lei ZHU ; Hong SHEN ; Pei-Qing GU ; Yin JIANG ; Un Ya-j LIU ; Lu ZHANG ; Jia-Fei CHENG
Journal of Nanjing University of Traditional Chinese Medicine 2016;32(5):447-450
ABSTRACT:OBJECTIVE To explore the effect of Baicalin in vivo of the expression of NF-κB and cytokines in ulcerative coli-tis rats.METHODS The colitis model of mice were established with TNBS methord.Mice were randomly divided into control group,model group,Baicalin group,and SASP group.After continuous administration for 10 days,observed the colon gross morphological changes,the colon tissue level of TNF-α,IL-8 and IL-1 were detected using ELISA,and the protein expression of NF-κB in the colon tissues of mice were detected using Western Blot.RESULTS Compared with the model group,Baicalin(100 mg∕kg) group could significantly improve the colon gross morphological form,the Baicalin(25,50,100 mg∕kg)groups could in-hibit the secretion of inflammatory factors dose-dependently,the high dose group could reduce IL-1,IL-8 and TNF-αexpression (P <0.05),no significant difference occured between the SASP group.Compared with the model group,.Baicalin high dose group could reduce NF-kB levels,promote IkBαlevel(P <0.05) .CONCLUSION Baicalin can inhibit NF-κB activation,and thus play its anti-inflammatory effect in ulcerative colitis mice.
8.A rare case of Silver-Russell syndrome in adult and literature review.
Pei-ying LU ; Wei GU ; Xiao-hong PANG ; Peng-fei SHAN ;
Journal of Zhejiang University. Medical sciences 2015;44(3):335-338
Silver-Russell syndrome (SRS) is a rare genetic disorder with non-specific manifestations and severity, so that the clinical diagnosis of SRS remains difficult. We reported a 23-year-old female patient with SRS characterized with short body stature, asymmetry, obesity, fifth finger clinodactyly and dislocation of hip. The patient had a past history of lengthening operation on the right lower limb at the age of 10. Chromosome analysis revealed (46, XX). The patient was admitted due to severe asymmetry in low extremities caused by right-side obesity. After successful orthopedic surgery in the right hips and thighs the symptoms of patient were relieved.
Female
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Humans
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Silver-Russell Syndrome
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Young Adult
9.A rare case of Silver-Russell syndrome in adult and literature review
Pei-Ying LU ; Wei GU ; Xiao-Hong PANG ; Peng-Fei SHAN
Journal of Zhejiang University. Medical sciences 2015;(3):335-338
Silver-Russell syndrome ( SRS ) is a rare genetic disorder with non-specific manifestations and severity , so that the clinical diagnosis of SRS remains difficult.We reported a 23-year-old female patient with SRS characterized with short body stature , asymmetry, obesity, fifth finger clinodactyly and dislocation of hip .The patient had a past history of lengthening operation on the right lower limb at the age of 10.Chromosome analysis revealed (46, XX).The patient was admitted due to severe asymmetry in low extremities caused by right-side obesity .After successful orthopedic surgery in the right hips and thighs the symptoms of patient were relieved .
10.Penehyclidine hydrochloride inhibits glutamate release and related research in global brain ischemia/reperfusion rats.
You SHANG ; Pei-fei GU ; Yu SHANG ; Yue LI
Chinese Journal of Applied Physiology 2011;27(3):353-356
OBJECTIVETo investigate the effect of penehyclidine hydrochloride on glutamate (Glu)release and N-methyl-D-aspartate receptor (NMDAR)1 expression in hippocampus CA1 with global cerebral ischemia/reperfusion rats.
METHODSSixty male Wistar rats were randomly allocated into three groups; group A received sham operation; group B received ischemia/reperfusion; group C received penehyclidine hydrochloride treatment (2 mg/kg) before ischemia/reperfusion (n=20). Global cerebral ischemia was induced according to Pulsinelli-Brierley method. All animals were divided into two experiments: (I) Microdialysis plus HPLC/FD were used to detect Glu level after reperfusion 1 h, 3 h, 6 h. (II) After reperfusion 3 h, the animals were decapitated on ice and the brains were immediately removed to detect NMDAR1 expression in CA1 area by immunohistochemistry.
RESULTSAfter penehyclidine hydrochloride treatment, extracellular Glu level in CA1 were significantly decreased compared with those of control group (P < 0.05 or 0.01); Total integrated OD, average gray value and positive-cell area of NMDAR1 in CA1 were also significantly decreased compared with those of control group (P < 0.05 or 0.01).
CONCLUSIONPenehyclidine hydrochloride might has protective effect in hippocampus CA1 on global cerebral ischemia/reperfusion animals. The protective mechanism might be involved in inhibiting Glu release and NMDAR1 expression.
Animals ; Brain Ischemia ; metabolism ; physiopathology ; CA1 Region, Hippocampal ; metabolism ; Cholinergic Antagonists ; pharmacology ; Glutamic Acid ; metabolism ; Male ; Quinuclidines ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism ; Reperfusion Injury ; metabolism ; prevention & control

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