1.Safety and efficacy of the early administration of levosimendan in patients with acute non-ST-segment elevation myocardial infarction and elevated NT-proBNP levels: An Early Management Strategy of Acute Heart Failure (EMS-AHF).
Feng XU ; Yuan BIAN ; Guo Qiang ZHANG ; Lu Yao GAO ; Yu Fa LIU ; Tong Xiang LIU ; Gang LI ; Rui Xue SONG ; Li Jun SU ; Yan Ju ZHOU ; Jia Yu CUI ; Xian Liang YAN ; Fang Ming GUO ; Huan Yi ZHANG ; Qing Hui LI ; Min ZHAO ; Li Kun MA ; Bei An YOU ; Ge WANG ; Li KONG ; Jian Liang MA ; Xin Fu ZHOU ; Ze Long CHANG ; Zhen Yu TANG ; Dan Yu YU ; Kai CHENG ; Li XUE ; Xiao LI ; Jiao Jiao PANG ; Jia Li WANG ; Hai Tao ZHANG ; Xue Zhong YU ; Yu Guo CHEN
Chinese Journal of Internal Medicine 2023;62(4):374-383
Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
Male
;
Female
;
Humans
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Aged
;
Natriuretic Peptide, Brain
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Simendan/therapeutic use*
;
Non-ST Elevated Myocardial Infarction
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Heart Failure/drug therapy*
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Peptide Fragments
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Arrhythmias, Cardiac
;
Biomarkers
;
Prognosis
2.A pathological report of three COVID-19 cases by minimal invasive autopsies
Xiaohong YAO ; Tingyuan LI ; Zhicheng HE ; Yifang PING ; Huawen LIU ; Shicang YU ; Huaming MOU ; Lihua WANG ; Huarong ZHANG ; Wenjuan FU ; Tao LUO ; Feng LIU ; Qiaonan GUO ; Cong CHEN ; Hualiang XIAO ; Haitao GUO ; Shuang LIN ; Dongfang XIANG ; Yu SHI ; Guangqiang PAN ; Qingrui LI ; Xia HUANG ; Yong CUI ; Xizhao LIU ; Wei TANG ; Pengfei PAN ; Xuequan HUANG ; Yanqing DING ; Xiuwu BIAN
Chinese Journal of Pathology 2020;49(5):411-417
Objective:To investigate the pathological characteristics and the clinical significance of novel coronavirus (2019-nCoV)-infected pneumonia (termed by WHO as coronavirus disease 2019, COVID-19).Methods:Minimally invasive autopsies from lung, heart, kidney, spleen, bone marrow, liver, pancreas, stomach, intestine, thyroid and skin were performed on three patients died of novel coronavirus pneumonia in Chongqing, China. Hematoxylin and eosin staining (HE), transmission electron microcopy, and histochemical staining were performed to investigate the pathological changes of indicated organs or tissues. Immunohistochemical staining was conducted to evaluate the infiltration of immune cells as well as the expression of 2019-nCoV proteins. Real time PCR was carried out to detect the RNA of 2019-nCoV.Results:Various damages were observed in the alveolar structure, with minor serous exudation and fibrin exudation. Hyaline membrane formation was observed in some alveoli. The infiltrated immune cells in alveoli were majorly macrophages and monocytes. Moderate multinucleated giant cells, minimal lymphocytes, eosinophils and neutrophils were also observed. Most of infiltrated lymphocytes were CD4-positive T cells. Significant proliferation of type Ⅱ alveolar epithelia and focal desquamation of alveolar epithelia were also indicated. The blood vessels of alveolar septum were congested, edematous and widened, with modest infiltration of monocytes and lymphocytes. Hyaline thrombi were found in a minority of microvessels. Focal hemorrhage in lung tissue, organization of exudates in some alveolar cavities, and pulmonary interstitial fibrosis were observed. Part of the bronchial epithelia were exfoliated. Coronavirus particles in bronchial mucosal epithelia and type Ⅱ alveolar epithelia were observed under electron microscope. Immunohistochemical staining showed that part of the alveolar epithelia and macrophages were positive for 2019-nCoV antigen. Real time PCR analyses identified positive signals for 2019-nCoV nucleic acid. Decreased numbers of lymphocyte, cell degeneration and necrosis were observed in spleen. Furthermore, degeneration and necrosis of parenchymal cells, formation of hyaline thrombus in small vessels, and pathological changes of chronic diseases were observed in other organs and tissues, while no evidence of coronavirus infection was observed in these organs.Conclusions:The lungs from novel coronavirus pneumonia patients manifest significant pathological lesions, including the alveolar exudative inflammation and interstitial inflammation, alveolar epithelium proliferation and hyaline membrane formation. While the 2019-nCoV is mainly distributed in lung, the infection also involves in the damages of heart, vessels, liver, kidney and other organs. Further studies are warranted to investigate the mechanism underlying pathological changes of this disease.
3.Analysis of inter-species cross-contamination in 160 non-human cell lines
Xiao-Cui BIAN ; Zhen-Li YANG ; Chun-Xia ZUO ; Fang-Ying ZHOU ; Yu-Qin LIU
Basic & Clinical Medicine 2018;38(5):632-637
Objective To analyze interspecies cross-contamination of 160 non-human cell lines.Methods One hundred and sixty common non-human cell lines were collected and their species were identified by PCR.For the suspicious cells,chromosome analysis was further used to confirm their species.Results Six in 160 non-human cell lines were cross-contaminated.A rat cell line was mixed by a human cell line,and 5 were totally cross-con-taminated,and were indentified as wrong species.Conclusions Species identification is an indispensable part of cell quality control.Each cell line should undergo a full QA(Quality Assurance)assessment before it is used for research.
4.The relationship between the thrombospondin-1 and the carotid atherosclerosis in patients with type 2 diabetic
ying Zhi BIAN ; yun Yan HU ; Jun WANG ; Qian SUN ; jing Hai QIE ; cui Xin ZHAO ; xin Yan XIAO ; Chao YIN
Tianjin Medical Journal 2017;45(12):1316-1319
Objective To investigate the relationship between the thrombospondin-1 (TSP-1) and carotid atherosclerosis and its related indicators in patients with type 2 diabetes mellitus (T2DM). Methods A total of 101 T2DM patients were divided into T2DM group (A group, n=52) and T2DM with carotid artery atherosclerosis group (B group, n=49) according to whether complicated with carotid artery atherosclerosis, and 50 normal healthy persons were used as the normal group (C group , n=50). The TSP-1 and other clinical indicators were detected including fasting blood sugar (FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fibrinogen (Fib) and homocysteine (homocysteine). The differences between TSP-1 and other related indicators were analyzed. Results There were no significant differences in diastolic blood pressure (DBP) and body mass index (BMI) between the 3 groups (P>0.05). The level of systolic blood pressure (SBP) was significantly higher in group B than that of group A and group C (P<0.01), but there was no significant difference between group A and group C (P>0.05). There were no significant differences in TC, TG and HDL-C between three groups (P>0.05). The values of TSP-1 and Hcy were increased sequentially in group B, group A and group C (P <0.05). There were significant differences in FPG, HbA1c, Fib, FINS and LDL-C between three groups (P<0.05). TSP-1 was positively correlated with FPG, FINS, HbA1c, Fib and Hcy (r= 0.585, 0.341, 0.701, 0.409 and 0.351, P < 0.05). Linear regression analysis showed that TSP-1 was affected by FINS, HbA1c and Fib, and HbA1c was more important. Conclusion TSP-1 is associated with the occurrence and development of diabetic macrovascular complications. It has good clinical value for early detection, early treatment and delaying the progress of diabetic macrovascular diseases.
5.Growth inhibition of combined pathway inhibitors on KRAS mutated non-small cell lung cancer cell line.
Zhan-wen LI ; Zhen-li YANG ; Hai-liang FENG ; Xiao-cui BIAN ; Yan-yan LIU ; Yu-qin LIU
Chinese Journal of Pathology 2013;42(5):330-335
OBJECTIVETo investigate the effect of the selective PI3K inhibitor and MEK inhibitor on KRAS and PTEN co-mutated non-small cell lung cancer cell line NCI-H157 and the relevant mechanisms.
METHODSNCI-H157 was cultured routinely and treated with different concentrations of the two inhibitors. Cell proliferation was detected by MTT cell cycle assay. Based on the MTT results the cells were divided into four groups: the control group, PI3K inhibitor group (GDC-0941, 0.5 and 5.0 µmol/L), combination group I (0.5 µmol/L AZD6244 + 0.5 µmol/L GDC-0941) and combination group II (5.0 µmol/L AZD6244 + 5.0 µmol/L GDC-0941). Colony formation assay was performed to detect colony formation efficiency. The cell cycle and apoptosis were analyzed by flow cytometry. The expression of protein related to apoptosis was tested with Western blot.
RESULTSCell growth was inhibited by the two inhibitors. Combination groups led to stronger cell proliferation inhibition: combination group Ishowed synergistic effect of their actions and combination group II showed an additive effect; in both groups, there were decreased colony number [(77.2 ± 1.54)/well vs (61.50 ± 2.12)/well, P < 0.01] and [(51.00 ± 4.00)/ well vs (22.50 ± 3.53)/well, P < 0.01]; and enhanced apoptotic ratios [(18.30 ± 0.82)% vs (21.32 ± 0.56)%, P < 0.01] and [(27.14 ± 1.58)% vs (42.45 ± 4.42)%, P < 0.01]. In addition, compared to the PI3K inhibitor alone group, the NCI-H157 cells in the combination groups showed increased G0/G1 phase and decreased S phase (P < 0.01). Western blotting showed that the combination groups demonstrated significantly decreased expression of cyclin D1 and cyclin B1, increased p21 and cleaved PARP and decreased bcl-2/bax ratio, compared to the PI3K inhibitor only group.
CONCLUSIONThe combined inhibition of PI3K (AZD6244) and MEK (GDC-0941) has synergistic effects on the proliferation of NCI-H157 cells, but such effects appear to be in a dose-dependent manner.
Apoptosis ; drug effects ; Benzimidazoles ; administration & dosage ; pharmacology ; Carcinoma, Non-Small-Cell Lung ; genetics ; pathology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cyclin B1 ; metabolism ; Cyclin D1 ; metabolism ; Dose-Response Relationship, Drug ; Drug Synergism ; Humans ; Indazoles ; administration & dosage ; pharmacology ; Lung Neoplasms ; genetics ; pathology ; Mitogen-Activated Protein Kinase Kinases ; antagonists & inhibitors ; metabolism ; Mutation ; PTEN Phosphohydrolase ; genetics ; Phosphatidylinositol 3-Kinases ; antagonists & inhibitors ; metabolism ; Poly(ADP-ribose) Polymerases ; metabolism ; Proto-Oncogene Proteins ; genetics ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Proto-Oncogene Proteins p21(ras) ; metabolism ; Signal Transduction ; Sulfonamides ; administration & dosage ; pharmacology ; bcl-2-Associated X Protein ; metabolism ; ras Proteins ; genetics
6.Analysis on the diagnosis and treatment of a cluster of cases infected by new bunyavirus.
Xiao-Yan TANG ; Ning CUI ; Kai KANG ; Hai-Feng WANG ; Ai-Guo YOU ; Guo-Hua ZHAO ; Jia-Qiang YANG ; Xue-Yong HUANG ; Yan-Hua DU ; Hao-Min CHEN ; Guo-Hua LIU ; Bian-Li XU
Chinese Journal of Preventive Medicine 2012;46(2):110-113
OBJECTIVETo analyze and summarize the clinical characteristics, experience of diagnosis and treatment of cases infected by new bunyavirus, which occurred in Henan province in 2010.
METHODSThe clinical characteristics and effect of diagnosis and treatment of 5 cases were analyzed using descriptive epidemiological method. Blood specimens were detected by RT-PCR and pathogen separation.
RESULTSPCR testing was positive for all 5 cases. New bunyavirus were isolated from 2 cases. In 5 cases, fever (5/5), the whole body aches (5/5), fatigue (5/5), anorexia (5/5), nausea (5/5), the chills (4/5), cough (4/5), expectoration (4/5), vomiting (3/5), conjunctival hyperemia (3/5); Leukocyte reduction (5/5), thrombocytopenia (5/5), elevated alanine aminotransferase (4/5), elevated aspartate aminotransferase (4/5), elevated lactate dehydrogenase (5/5), creatine kinase elevations (4/5), urinary protein (3/5). By symptomatic and supportive treatment and prophylactic antibiotics, the first case died and the other 4 cases were cured. The average course of disease was 15.4 days.
CONCLUSIONCases infected by new bunyavirus have complicated clinical feature and multiple organ damage. If symptomatic treatment is in time, prognosis will be good.
Adult ; Bunyaviridae Infections ; diagnosis ; therapy ; virology ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Orthobunyavirus ; Prognosis ; Young Adult
7.Triterpenoids from Inonotus obliquus protect mice against oxidative damage induced by CCl4.
Fen-Qin ZHAO ; Lin YAN ; Xian-Hong CUI ; Sheng LIN ; Cong WANG ; Hui ZHANG ; Xiao-Yan KANG ; Bian-Sheng JI
Acta Pharmaceutica Sinica 2012;47(5):680-684
To investigate the effects of lanosterol (1), inotodiol (2) and trametenolic acid (3) from Inonotus obliquus against oxidative damage induced by CCl4 in mice, 1, 2 and 3 (20, 10 and 5 mg x kg(-1)) were respectively administered to mice, once a day for 3 days. Then the mice were induced to oxidative damage by CCl4 on the third day 30 min after the administration. The activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX) and the content of malondialdehyde (MDA) and reductive glutathione (GSH) in serum and liver homogenate were determined. And the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and interleukin-6 (IL-6) concentration in serum were detected. The results showed that treatment with compound 1, 2 and 3 could significantly increase the activities of SOD, CAT and GSH-PX in serum and liver homogenate. Furthermore, the content of GSH in serum and liver homogenate increased and MDA content decreased markedly. In addition, compound 1, 2 and 3 could significantly inhibit the activities of ALT and AST in serum, and decrease the IL-6 concentration in serum remarkably. So, compound 1, 2 and 3 can protect mice against oxidative stress injury induced by CCl4. Furthermore, compound 1, 2 and 3 can protect cells from damage through inhibition on ALT, AST and the expression of IL-6.
Alanine Transaminase
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blood
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Animals
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Aspartate Aminotransferases
;
blood
;
Carbon Tetrachloride
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Catalase
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blood
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metabolism
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Female
;
Glutathione
;
blood
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metabolism
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Glutathione Peroxidase
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blood
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metabolism
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Interleukin-6
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blood
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Lanosterol
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analogs & derivatives
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isolation & purification
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pharmacology
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Liver
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metabolism
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Male
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Malondialdehyde
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blood
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metabolism
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Mice
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Oxidative Stress
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drug effects
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Polyporaceae
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chemistry
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Protective Agents
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isolation & purification
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pharmacology
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Random Allocation
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Superoxide Dismutase
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blood
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metabolism
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Triterpenes
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isolation & purification
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pharmacology
8.Comparison of whole genome sequences and replication ability in cell cultures between two avian leukosis viruses of subgroup B.
Zhuan-Chang WU ; Mei-Zhen ZHU ; Xiao-Ming BIAN ; Cheng-Tai MA ; Peng ZHAO ; Zhi-Zhong CUI
Chinese Journal of Virology 2011;27(5):447-455
The purpose of this study was to compare the whole genome sequences and replication dynamics in cell cultures of two Avian leukosis viruses of subgroup B (ALV) isolates, SDAU09E3 and SDAU09C2. Comparison of the amino acid sequences indicated that the gp85 identity of these two subgroup B isolates was 95.4%, the identity with other three ALV-B reference strains was 91.0%-94.9%, and less than 87.9% with ALV subgroup A, C, D, E and J. Comparison of the nucleotide sequence of gag and pol genes indicated that homologies of gag gene and pol gene of these two ALV-B isolates with all compared reference strains of different subgroups were above 93%. Homologies of LTR sequence of these two ALV-B isolates with other exogenous ALVs subgroups A, B, C, D and J were 72.6%-88.3%, but only 51.5% when compared with endogenous ALV subgroup E. The identity of LTR between these two ALV-B strains was only 74.8%, which was far lower than the identity of other genes. The identity of U3 region of LTR between these two ALV-B isolates was only 68.8% and there were obvious differences in the number CAAT Boxes. Replication dynamics in DF-1 cell indicated that the value of TCID50 was similar between 2 isolates but the concentration of nucleocapsid protein p27 antigen of SDAU09E3 was significantly higher than SDAU09C2 in cell culture supernatant, which indicated there was no parallel relationship between p27 antigen concentration and infectious virus particles. Whether such difference was resulted from the diversity of U3 region of LTR, further studies with their recombinant infectious clones is necessary.
Animals
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Antibodies, Viral
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immunology
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Avian Leukosis Virus
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classification
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genetics
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physiology
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Base Sequence
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Cell Line
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Cells, Cultured
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Chick Embryo
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Chickens
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Genome, Viral
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genetics
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Molecular Sequence Data
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Phylogeny
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Poultry Diseases
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virology
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Sequence Alignment
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Sequence Homology, Nucleic Acid
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Viral Matrix Proteins
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genetics
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Virus Replication
;
physiology
9.Novel mutations of cardiac troponin T in Chinese patients with hypertrophic cardiomyopathy
Jie YANG ; Wen-Ling LIU ; Da-Yi HU ; Tian-Gang ZHU ; Song-Na YANG ; Cui-Lan LI ; Lei LI ; Yi-Hong SUN ; Wen-Li XIE ; Jin-Gang YANG ; Tian-Chang LI ; Hong BIAN ; Qi-Guang TONG ; Jie XIAO
Chinese Journal of Cardiology 2011;39(10):909-914
Objective To screen the cardiac troponin T (TNNT2) mutations in Chinese patients with hypertrophic cardiomyopathy (HCM) and to analyze the potential link between the genotype and the phenotype.Methods Clinical features of 100 probands with HCM and some family members were evaluated,200 unrelated normal subjects served as control.The exons and flanking introns of TNNT2 were amplified with PCR and direct sequencing was used to screen TNNT2 mutations/ polymorphisms.Results Two novel missense mutations were detected in 2 HCM patients:R92W and R286H.These 2 mutations were not found in 200 non-HCM controls.A five-basepair insertion/deletion polymorphism in intron 3 of TNNT2 was identified in this HCM cohort but was not related to the phenotype.Conclusions Two missense mutations,R92W and R286H,were found in 2/100 patients with HCM,TNNT 2 mutation is relatively low in Chinese patients with HCM.
10.Effect of forced E-cadherin expression on adhesion and proliferation of human breast carcinoma cells.
Li-Juan YANG ; Yu-Qin LIU ; Bei GU ; Xiao-Cui BIAN ; Hai-Liang FENG ; Zhen-Li YANG ; Yan-Yan LIU
Chinese Journal of Pathology 2010;39(12):842-847
OBJECTIVETo investigate the role that E-cadherin (E-cad) plays on cell adhesion and proliferation of human breast carcinoma.
METHODSE-cad expression vector was transfected into an E-cad-negative human breast carcinoma MDA-MB-231 cells. G418 was used to screen positive clones. E-cad, β-catenin (β-cat) and cyclin D1 expressions of these clones were confirmed by Western blot. Their cell-cell and cell-matrix adhesion abilities were detected. E-cad/β-catenin interaction was confirmed by immunoprecipitation. Cell proliferation was evaluated by MTT. Cell apoptosis was analyzed by flow cytometry. Direct two-step immunocytochemistry was used to detect the localization of β-cat.
RESULTE-cad(+) cell strains Ecad-231-7 and Ecad-231-9 were established. When cultured in ultra-low-binding dishes Ecad-231 cells grow in suspension while Ecad-231-7 and Ecad-231-9 cells grow in large clamps. When co-cultured with HCT116 cells, the average adhesion rates at 30 min are 39.0%, 60.0% and 59.5% for MDA-MB-231, Ecad-231-7 and Ecad-231-9 respectively. The average detachment rates by EDTA for 5 min are 37.4%, 4.2% and 7.4% respectively. So E-cad expression enhanced hemotypic and heterotypic cell-cell adhesion and cell-matrix adhesion. Forced exogenously expressed E-cad could combine with endogenous β-cat, whereas down stream cyclin D1 expression was significantly decreased, as evidenced by Western blot. The rates of cell apoptosis of MDA-MB-231, Ecad-231-7 and Ecad-231-9 were 1.8%, 2.0% and 2.1%. Expression of E-cad had no obvious effect on the apoptosis of tumor cells with regular culture. β-cat increased in the cytoplasma.
CONCLUSIONSTwo monoclonal tumor cell strains (Ecad-231-7 and Ecad-231-9) stably expressing E-cad were successfully established. E-cad could enhance adhesion and inhibit proliferation of human breast carcinoma cells through a pathway involving β-cat and cyclin D1.
Apoptosis ; Breast Neoplasms ; metabolism ; pathology ; Cadherins ; genetics ; metabolism ; physiology ; Cell Adhesion ; Cell Line, Tumor ; Cell Proliferation ; Cyclin D1 ; metabolism ; Female ; Genetic Vectors ; Humans ; Plasmids ; Transfection ; beta Catenin ; metabolism

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