ABSTRACT
In recent years, colonic manometry has been gradually introduced into clinical practice. It helps clinicians to gain a better understanding of the physiology and pathophysiology of colonic contractile activity in healthy adults and patients with colonic dysfunction. More and more patterns of colonic motility are being discovered with the help of colonic manometry. However, the clinical significance of these findings still needs to be further investigated. This review enhances our understanding of colonic motility and the current state of development and application of colonic manometry, as well as the limitations, future directions and potential of the technique in assessing the impact of treatment on colonic motility patterns, by analyzing and summarizing the literature related to colonic manometry.
Subject(s)
Humans , Adult , Gastrointestinal Motility/physiology , Colon/physiology , Colonic Diseases , Manometry/methods , Clinical Relevance , ConstipationABSTRACT
BACKGROUND@#Myocardial ischemia-reperfusion (I/R) is a serious and irreversible injury. Bone marrow-derived mesenchymal stem cells (MSCs) is considered to be a potential therapy for I/R injury due to the paracrine effects. High-mobility group box 1 (HMGB1) is a novel mediator in MSC and regulates the response of inflammation injury. Signal Transduction and Transcription Activator 3 (STAT3) is a critical transcription factor and important for release of paracrine factors. However, the relationship between HMGB1 and STAT3 in paracrine effect of MSC remains unknown.@*METHODS@#In vitro, hypoxia/reoxygenation injury model was established by AnaeroPack System and examined by Annexin V flow cytometry, CCK8 assay and morphology observation. Detection of apoptotic proteins and protein expression of HMGB1 and STAT3 by Western blot.@*RESULTS@#The conditioned medium of MSCs with or without LPS pretreatment was cocultured with H9C2 cells for 24 h before hypoxia treatment and MSC showed obvious cardiomyocytes protect role, as evidence by decreased apoptosis rate and improved cells viability, and LPS pretreated MSC exhibited better protect role than untreated MSC. However, such effect was abolished in HMGB1 deficiency group, silencing HMGB1 decreased the secretion of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), insulin growth factor (IGF), cell viability, and the expression of STAT3. Furthermore, STAT3 silence attenuated the protective effect of LPS in MSC.@*CONCLUSIONS@#These findings suggested that LPS improved MSC-mediated cardiomyocytes protection by HMGB1/STAT3 signaling.
ABSTRACT
OBJECTIVE@#To analyze the clinical phenotype and genetic etiology for a child featuring congenital hypothyroidism (CH).@*METHODS@#Whole exome sequencing (WES), copy number variation (CNV) sequencing and chromosomal microarray analysis (CMA) were carried out for a newborn infant who had presented at Linyi People's Hospital for CH. Clinical data of the child was analyzed, in addition with a literature review.@*RESULTS@#The main characteristics of the newborn infant had included peculiar face, vulvar edema, hypotonia, psychomotor retardation, recurrent respiratory tract infection with laryngeal wheezing and feeding difficulties. Laboratory test indicated hypothyroidism. WES suggested a CNV deletion on chromosome 14q12q13. CMA further confirmed a 4.12 Mb deletion at chromosome 14q12q13.3 (32649595_36769800), which has encompassed 22 genes including NKX2-1, the pathogenic gene for CH. The same deletion was found in neither of her parents.@*CONCLUSION@#Through the analysis of clinical phenotype and genetic variant, the child was diagnosed with 14q12q13.3 microdeletion syndrome.
Subject(s)
Female , Humans , Congenital Hypothyroidism/genetics , DNA Copy Number Variations , Phenotype , Syndrome , Microarray AnalysisABSTRACT
ABSTRACT Introduction: Aerobic exercise can improve the function of the cardiovascular circulatory system, reducing morbidity and mortality from cardiovascular disease by stimulating the production of endogenous self-protection. Activating potassium channels in vascular smooth muscle cells can cause vasodilation and increase blood flow, lowering blood pressure. There is a sensitivity to intracellular ATP and ADP concentration among the variety of potassium channels distributed in vascular smooth muscle cells, which vary mainly during aerobic physical activity. Objective: Explore the effect of aerobic exercise on the vascular reactivity of the thoracic aorta in patients with obesity and hyperlipidemia. Methods: Randomized controlled trial in twenty male Wistar rats weighing 250g and two months old. The control group remained at rest while the experimental group performed aerobic exercise on a treadmill at increasing speed for eight weeks. The rats were dissected, and dilatators and vasoconstrictors drugs stimulated their blood vessels in a tamponade solution. Observation of vascular changes was measured under controlled tensioning. Results: The blockade of KATP channels in vascular smooth muscle caused tonic contraction of vascular smooth muscle cells and increased blood pressure. Conclusion: Long-term regular aerobic exercise may induce changes in rats' thoracic aortic vascular function and vascular smooth muscle reactivity. Aerobic exercise can also significantly improve the activity of KATP channels. Evidence Level II; Therapeutic Studies - Investigating the results.
RESUMO Introdução: O exercício aeróbico pode melhorar a função do sistema circulatório cardiovascular, reduzindo a morbidade e mortalidade de doenças cardiovasculares estimulando a produção de autoproteções endógenas. A ativação de canais de potássio nas células musculares lisas vasculares pode causar vasodilatação e aumentar o fluxo sanguíneo, diminuindo a pressão sanguínea. Há uma sensível a concentração de ATP intracelular e ADP dentre a variedade de canais de potássio distribuídos em células musculares lisas vasculares, que variam principalmente durante a atividade física aeróbica. Objetivo: Explorar o efeito do exercício aeróbico na reatividade vascular da aorta torácica em pacientes com obesidade e hiperlipidemia. Métodos: Estudo randomizado controlado em vinte ratos Wistar machos de 250g e 2 meses de idade. O grupo controle permaneceu sob repouso enquanto o experimental realizava exercícios aeróbicos em esteira com velocidade crescente durante 8 semanas. Os ratos foram dissecados e seus vasos sanguíneos estimulados com drogas vasoconstritoras e dilatadoras em solução tampão. A observação das alterações vasculares foi mensurada sob tensionamento controlado. Resultados: O bloqueio dos canais KATP no músculo liso vascular causou contração tônica das células musculares lisas vasculares e aumento da pressão arterial. Conclusão: Exercícios aeróbicos regulares de longo prazo podem induzir alterações na função vascular da aorta torácica e reatividade do músculo liso vascular em ratos. O exercício aeróbico também pode melhorar significativamente a atividade dos canais KATP. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: El ejercicio aeróbico puede mejorar la función del sistema circulatorio cardiovascular, reduciendo la morbilidad y la mortalidad de las enfermedades cardiovasculares al estimular la producción de autoprotección endógena. La activación de los canales de potasio en las células del músculo liso vascular puede causar vasodilatación y aumentar el flujo sanguíneo, reduciendo la presión arterial. Existe una sensibilidad a la concentración intracelular de ATP y ADP entre la variedad de canales de potasio distribuidos en las células del músculo liso vascular, que varían principalmente durante la actividad física aeróbica. Objetivo: Explorar el efecto del ejercicio aeróbico sobre la reactividad vascular de la aorta torácica en pacientes con obesidad e hiperlipidemia. Métodos: Ensayo controlado aleatorio en veinte ratas Wistar macho de 250 g y 2 meses de edad. El grupo de control permaneció en reposo mientras que el grupo experimental realizó ejercicios aeróbicos en una cinta de correr a velocidad creciente durante 8 semanas. Las ratas fueron disecadas y sus vasos sanguíneos fueron estimulados con fármacos vasoconstrictores y dilatadores en solución amortiguada. La observación de los cambios vasculares se midió bajo tensión controlada. Resultados: El bloqueo de los canales KATP en el músculo liso vascular provocó una contracción tónica de las células del músculo liso vascular y un aumento de la presión arterial. Conclusión: El ejercicio aeróbico regular a largo plazo puede inducir cambios en la función vascular de la aorta torácica y en la reactividad del músculo liso vascular en ratas. El ejercicio aeróbico también puede mejorar significativamente la actividad del canal KATP. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.
ABSTRACT
Objective:To investigate the normal range of fetal ventricles and posterior cranial fossa development in the second and third trimesters and their variations with gestational age using quantitative MRI analysis.Methods:This retrospective study enrolled 675 pregnant women who underwent prenatal MRI examination with an average gestational week of 29.0±8.5 in the Third Affiliated Hospital of Guangzhou Medical University from January 2016 to January 2020. MRI data of all the subjects were collected and analyzed, including left lateral ventricle trigonometric width (LLVTW) and right lateral ventricle trigonometric width (RLVTW), third ventricle width (TVW), fourth ventricle width (FVW), the anterior-posterior diameter of the fourth ventricle (APDFV), cavum septum pellucidum width (CSPW), cisterna magna width (CMW), etc. Spearman, Pearson correlation analysis, and t-test were used for the statistical analysis. Results:(1) Totally 675 fetuses were recruited, including 392 female and 283 male fetuses. No statistical difference of gestational weeks at MRI was found between male and female fetuses. (2)The mean value of TVW and CMW of the female fetuses were significantly higher than those of male fetuses [(0.60±0.05) vs (0.63±0.04) cm, t=－5.059; (0.57±0.14) vs (0.67±0.15) cm, t=－7.445; both P<0.001]. Spearman correlation analysis showed that TVW and CMW were negatively correlated with fetal gender ( r=－0.179 and－0.312, both P<0.001). (3)Pearson correlation analysis showed that LLVTW, RLVTW, TVW, FVW, APDFV, CSPW, and CMW were all positively correlated with gestational weeks ( r=0.310, 0.267, 0.205, 0.801, 0.829, 0.216 and 0.284, all P<0.001). FVW and APDFV were significantly linearly correlated with gestational weeks (r=0.801 and 0.829, both P<0.001). (4) There was no significant change in LLVTW and RLVTW in the second trimester, but a slight increase was found in the third trimester. TVW showed a scattered distribution in the second and third trimesters and increased slightly with the gestational week at 26 to 27 +6 gestational weeks. FVW and APDFV increased linearly while. CSPW increased slowly with gestational weeks in the second and third trimesters. CMW increased slightly with gestational weeks in the second and third trimesters but showed little change in the third trimester. Conclusions:The development of fetal ventricles and posterior cranial fossa in the second and third trimesters show a growth trend of varying degrees with the increase of gestational weeks. TVW and CMW are significantly negatively correlated with the fetal gender.
ABSTRACT
@#AIM: To explore the efficacy and safety of foldable capsular vitreous body(FCVB)in the treatment of severe ocular trauma and silicone oil dependent eyes.<p>METHODS:A retrospective study. Totally 20 patients who were underwent FCVB implantation due to severe ocular trauma and silicone oil reliance conducted in our hospital from May 2018 to October 2019 were select as observation group, 10 previous severe eye trauma patients without FCVB implantation as control group. The visual acuity(VA), intraocular pressure(IOP), exophthalmos, eye axis length, retinal reattachment, and complications of preoperative and postoperative in observation group and control group were recorded. A 1a follow-up was carried out to compare the changes in the observation indicators of each group so as to evaluate the effectiveness and safety of the FCVB.<p>RESULTS: Before and 1a after operation, there were no statistically significant differences in VA, eyeball protrusion, and axial length of the observation group, but IOP was significantly increased. The preoperative eyeball protrusion and axial length of the control group were larger than those of the observation group, but they were smaller than those of the observation group during the 1a follow-up. The eyeball protrusion and axial length of the control group were also significantly reduced 1a after the operation compared with the preoperative baseline. Retinas were well attached, silicone oil emulsification, secondary glaucoma, endophthalmitis and any other severe adverse event were not even occurred in the observation group.<p>CONCLUSION:FCVB could effectively and safely prevent eyeball atrophy in the treatment of severe eye trauma and silicone oil dependent eyes.
ABSTRACT
@#AIM: To explore the efficacy and safety of foldable capsular vitreous body(FCVB)in the treatment of severe ocular trauma and silicone oil dependent eyes.<p>METHODS:A retrospective study. Totally 20 patients who were underwent FCVB implantation due to severe ocular trauma and silicone oil reliance conducted in our hospital from May 2018 to October 2019 were select as observation group, 10 previous severe eye trauma patients without FCVB implantation as control group. The visual acuity(VA), intraocular pressure(IOP), exophthalmos, eye axis length, retinal reattachment, and complications of preoperative and postoperative in observation group and control group were recorded. A 1a follow-up was carried out to compare the changes in the observation indicators of each group so as to evaluate the effectiveness and safety of the FCVB.<p>RESULTS: Before and 1a after operation, there were no statistically significant differences in VA, eyeball protrusion, and axial length of the observation group, but IOP was significantly increased. The preoperative eyeball protrusion and axial length of the control group were larger than those of the observation group, but they were smaller than those of the observation group during the 1a follow-up. The eyeball protrusion and axial length of the control group were also significantly reduced 1a after the operation compared with the preoperative baseline. Retinas were well attached, silicone oil emulsification, secondary glaucoma, endophthalmitis and any other severe adverse event were not even occurred in the observation group.<p>CONCLUSION:FCVB could effectively and safely prevent eyeball atrophy in the treatment of severe eye trauma and silicone oil dependent eyes.
ABSTRACT
@#AIM: To explore the efficacy and safety of foldable capsular vitreous body(FCVB)in the treatment of severe ocular trauma and silicone oil dependent eyes.<p>METHODS:A retrospective study. Totally 20 patients who were underwent FCVB implantation due to severe ocular trauma and silicone oil reliance conducted in our hospital from May 2018 to October 2019 were select as observation group, 10 previous severe eye trauma patients without FCVB implantation as control group. The visual acuity(VA), intraocular pressure(IOP), exophthalmos, eye axis length, retinal reattachment, and complications of preoperative and postoperative in observation group and control group were recorded. A 1a follow-up was carried out to compare the changes in the observation indicators of each group so as to evaluate the effectiveness and safety of the FCVB.<p>RESULTS: Before and 1a after operation, there were no statistically significant differences in VA, eyeball protrusion, and axial length of the observation group, but IOP was significantly increased. The preoperative eyeball protrusion and axial length of the control group were larger than those of the observation group, but they were smaller than those of the observation group during the 1a follow-up. The eyeball protrusion and axial length of the control group were also significantly reduced 1a after the operation compared with the preoperative baseline. Retinas were well attached, silicone oil emulsification, secondary glaucoma, endophthalmitis and any other severe adverse event were not even occurred in the observation group.<p>CONCLUSION:FCVB could effectively and safely prevent eyeball atrophy in the treatment of severe eye trauma and silicone oil dependent eyes.
ABSTRACT
The training of clinical theory and scientific research thinking is very important for postgraduates of neurology,however,of which,problems are existing,such as the low level of scientific research and the imperfect system.Based on the experience of postgraduate training in the hospital,the authors put forward some improving measures,specifically,to arouse the interest of scientific research,to build the scope of scientific research,to improve the comprehensive strength of personal scientific research,to establish the guarantee mechanism of scientific research and to perfect the system of graduation evaluation.Practice shows that these measures has promoted the enthusiasm and subjective initiative of neuroscience academic postgraduates for scientific research,improved the quality of postgraduate education,and formed a certain basic and clinical research output.
ABSTRACT
Chronic cerebral hypoperfusion (CCH) is a common pathological change of central nervous system diseases and is closely associated with cognitive impairment. A number of studies have shown that inflammation is involved in the pathogenesis and progression of CCH-induced cognitive impairment. In the condition of CCH, the activation of inflammatory response in the brain can lead to a variety of pathological injuries, such as white matter lesions, blood-brain barrier destruction, degeneration and necrosis of hippocampal neurons, etc. Therefore, inhibition of inflammatory response is expected to provide a new therapeutic target for CCH-induced cognitive impairment. This article reviews the mechanism of inflammation in CCH-induced cognitive impairment.
ABSTRACT
N6-methyladenosine (m6A) modification is one of the most common modifications of eukaryotic mRNA, and has become a hotspot in the field of life sciences in recent years. m6A modification is dynamically reversible in mammalian cells and regulated by m6A methyltransferase (writers), demethylase (erasers), and "reader" proteins. m6A can regulate various biological processes of mRNA such as RNA splicing, nuclear export, protein translation and degradation. Recent studies indicated that m6A is important for the initiation and development of cancer. The present review summarized biological functions of m6A on mRNA and discussed its roles in cell proliferation, migration, invasion, cell mentalism, and angiogenesis. Further, the m6A can regulate the development of various cancers including acute myelocytic leukemia (AML), breast, liver and colorectal cancer. Nowadays, the inhibitors of m6A related enzymes including fat-mass and obesity-associated protein and AlkB homolog 5 are being developed. We further discussed the potential values of m6A and its related targets on cancer therapy and treatment.
ABSTRACT
In the original publication, the author name was incorrectly published as "Lifeng Chen".
ABSTRACT
Zinc-α2-glycoprotein (ZAG), encoded by the AZGP1 gene, is a major histocompatibility complex I molecule and a lipid-mobilizing factor. ZAG has been demonstrated to promote lipid metabolism and glucose utilization, and to regulate insulin sensitivity. Apart from adipose tissue, skeletal muscle, liver, and kidney, ZAG also occurs in brain tissue, but its distribution in brain is debatable. Only a few studies have investigated ZAG in the brain. It has been found in the brains of patients with Krabbe disease and epilepsy, and in the cerebrospinal fluid of patients with Alzheimer disease, frontotemporal lobe dementia, and amyotrophic lateral sclerosis. Both ZAG protein and AZGP1 mRNA are decreased in epilepsy patients and animal models, while overexpression of ZAG suppresses seizure and epileptic discharges in animal models of epilepsy, but knowledge of the specific mechanism of ZAG in epilepsy is limited. In this review, we summarize the known roles and molecular mechanisms of ZAG in lipid metabolism and glucose metabolism, and in the regulation of insulin sensitivity, and discuss the possible mechanisms by which it suppresses epilepsy.
Subject(s)
Animals , Humans , Adipocytes , Metabolism , Brain , Metabolism , Carrier Proteins , Metabolism , Epilepsy , Metabolism , Glucose , Metabolism , Glycoproteins , Metabolism , Insulin Resistance , Lipid Metabolism , Neurons , Metabolism , Signal TransductionABSTRACT
BACKGROUND@#Peritoneal fibrosis is the primary reason that patients with end-stage renal disease (ESRD) have to cease peritoneal dialysis. Peritonitis caused by Gram-negative bacteria such as Escherichia coli (E. coli) were on the rise. We had previously shown that matrine inhibited the formation of biofilm by E. coli. However, the role of matrine on the epithelial-mesenchymal transition (EMT) in peritoneal mesothelial cells under chronic inflammatory conditions is still unknown.@*METHODS@#We cultured human peritoneal mesothelial cells (HPMCs) with lipopolysaccharide (LPS) to induce an environment that mimicked peritonitis and investigated whether matrine could inhibit LPS-induced EMT in these cells. In addition, we investigated the change in expression levels of the miR-29b and miR-129-5p.@*RESULTS@#We found that 10 μg/ml of LPS induced EMT in HPMCs. Matrine inhibited LPS-induced EMT in HPMCs in a dose-dependent manner. We observed that treatment with matrine increased the expression of E-cadherin (F = 50.993, P < 0.01), and decreased the expression of alpha-smooth muscle actin (F = 32.913, P < 0.01). Furthermore, we found that LPS reduced the expression levels of miR-29b and miR-129-5P in HPMCs, while matrine promoted the expression levels of miR-29b and miR-129-5P.@*CONCLUSIONS@#Matrine could inhibit LPS-induced EMT in HPMCs and reverse LPS inhibited expressions of miR-29 b and miR-129-5P in HPMCs, ultimately reduce peritoneal fibrosis. These findings provide a potential theoretical basis for using matrine in the prevention and treatment of peritoneal fibrosis.
Subject(s)
Humans , Actins , Metabolism , Alkaloids , Therapeutic Uses , Cadherins , Metabolism , Cells, Cultured , Epithelial-Mesenchymal Transition , Epithelium , Fibrosis , Genetics , Metabolism , Lipopolysaccharides , Toxicity , MicroRNAs , Metabolism , Peritoneal Fibrosis , Drug Therapy , Quinolizines , Therapeutic UsesABSTRACT
Objective: To study and create the algorithm for the diversity (AD) of extensible markup language (XML) tree map, and provide a new tool for the identification of Artemisiae Annuae Herba. Method: According to the literature research, the key information of Artemisiae Annuae Herba was selected from the macroscopic, mesoscopic and microscopic information, etc. Based on the key information, the relevant upper standards of domestic and foreign professional fields were cited to assign the unique identification independent of language for each data element, and the coding rules of relevant data elements were established. The digital coding technology was applied to the flexible structure editor, and the tree map was created, which could be returned as the 5th version of hypertext markup language (HTML5) or XML format. Based on the diversity related algorithms, the authors innovatively developed the AD of XML tree map of Artemisiae Annuae Herba, which took into account both of topology and semantics, and the expression model of related mathematical functions of Artemisiae Annuae Herba was established. By comparing the calculation results with the reality, the algorithm model was debugged continuously until the convergence of the core-culvert algorithm model. Result: Through the research on AD, the diversity between two XML tree maps could be calculated, and the discrimination or identification model of Artemisiae Annuae Herba also could be finally optimized and established. After calculation and analysis of the tested tree maps, the effective rate of the model was 100%. Conclusion: In this study, the establishment of the AD of XML tree map can effectively assist in the identification of Artemisiae Annuae Herba, which provides certain technical support and theoretical guidance for the research on intelligent application of traditional Chinese medicine.
ABSTRACT
Objective To compare and analyze the high risk factors of liver injury, and to explore the application of thermal texture maps (TTM) technology in the diagnosis and screening of liver injury. Methods A total of 3582 medical examiners were selected as subjects, and their general clinical data, the related physical and chemical test results and TTM results were collected. The relationship between TTM results and general clinical data and related physical and chemical results was statistically analyzed. The general clinical data and physical and chemical results of subjects with TTM negative and TTM positive liver injury were compared from the sample value statistics and the sample group comparison. Results The differences in the degree of liver damage and the main related indicators between the two groups were statistically significant (all P<0.05), except for the body mass and low-density lipoprotein cholesterol level. When using aminotransferase as the standard, the diagnostic sensitivity of TTM for liver injury was 93.18％, the specificity was 68.34％, the positive predictive value was 54.34％, and the negative predictive value was 90.32％. Conclusions TTM examination can not only reflect the state of liver injury, but also reflect the degree of injury. TTM is an important index and necessary supplement for evaluating liver injury.
ABSTRACT
Objective@#To observe how glutamine affect the skeletal muscle membrane repair in severely burned mice through promoting the mitsugumin 53 (MG53) dimerization in skeletal muscle and to explore its functional mechanism.@*Methods@#(1) Animal experiments. A total of 179 BALB/c male mice aged 6 to 8 weeks were divided into sham injury group (n=43), burn group (n=73) and burn+ glutamine group (n=63) according to the random number table (the same grouping method below). Mice in sham injury group were sham injured on the back, and mice in burn group and burn+ glutamine group were inflicted with 30% total body surface area full-thickness scald (hereinafter referred to as burn) on the back. Mice in burn+ glutamine group were intragastrically administered with glutamine (1 mg/kg), and the other two groups were given the same amount of amino acid solution once per day for 14 days. On post burn hour 12, 10 mice from burn group were taken for preparation of burn serum, which is used in the following cell experiments. Blood samples were collected from the hearts to prepare serum from 10 mice in sham injury group immediately after burn and from 10 mice in burn group and burn+ glutamine group on post burn day (PBD) 5, 10, and 14, respectively. And then the whole gastrocnemius muscle was harvested after the mice were sacrificed. On PBD 10, the whole flexor brevis digitorum was harvested from 6 mice in the 3 groups respectively after the mice were sacrificed. On PBD 5, 10, and 14, the whole gastrocnemius muscle tissue was harvested from another 9 mice in the 3 groups respectively after the mice were sacrificed. The mass of the whole gastrocnemius muscle of mice was weighed. The total protein content of gastrocnemius muscle of mice was detected by coomassie brilliant blue method. The repair function of myolemma of flexor brevis digitorum of mice was detected by two-photon laser fiber membrane perforating. The serum content of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) of mice was determined with radioimmunoassay. The expressions of MG53 dimer and monomer in gastrocnemius of mice were determined with non-reductive electrophoresis-Western blotting. The protein expressions of endoplasmic reticulum stress sign proteins CCAAT/enhancer binding protein homologous protein (CHOP) and glucose-regulated protein 78 (GRP78) in gastrocnemius of mice were determined with Western blotting. (2) Cell experiments. Mice skeletal muscle precursor cells C2C12 were cultured in vitro, and cells of the second passage were selected for the experiments. The cells were divided into normal control group, burn serum group, and burn serum+ glutamine group, with 3 dishes in each group and 1×103 cells in each dish. Cells in normal control group were cultured with 1 mL Dulbecco′s modified Eagle medium (DMEM) with fetal bovine serum of volume fraction 10%, cells in burn serum group were cultured with 1 mL DMEM with burn serum of volume fraction 10%, and cells in burn serum+ glutamine group were cultured with 1 mL DMEM with burn serum of volume fraction 10% and 4 μL glutamine with a final molar concentration of 8 mmol/L. After 24 hours of culturing, the repair function of myocyte membrane after differentiation of skeletal muscle precursor cells in mice was detected with the same method before. Another cells were grouped and cultured as before, with 3 wells in each group and 1×105 cells in each well. After 24 hours of culturing, the expressions of MG53 dimer and monomer and endoplasmic reticulum stress marker proteins in the cells were detected as before. Data were processed with analysis of variance of factorial design, one-way analysis of variance, least significant difference t test, and Student Newman Keuls test.@*Results@#Animal experiments. (1) Compared with those in sham injury group, the mass and total protein content of gastrocnemius muscle of mice in burn group were significantly decreased on PBD 5, 10, and 14 (P<0.05). Compared with those in burn group, the mass and total protein content of gastrocnemius muscle of mice in burn+ glutamine group were significantly increased on PBD 5, 10, and 14 (P<0.05). (2) Compared with that in sham injury group (0.9±0.4), the fluorescence intensity of FM1-43 in myofiber of mice in burn group (7.8±0.4) was significantly increased on PBD 10 (t=7.75, P<0.05). Compared with that in burn group, the fluorescence intensity of FM1-43 in myofiber of mice in burn+ glutamine group (4.0±0.4) was significantly decreased on PBD 10 (t=-4.31, P<0.05). (3) Compared with that in sham injury group, the serum content of TNF-α and IL-6 of mice in burn group was significantly increased on PBD 5, 10, and 14 (P<0.05). Compared with that in burn group, the serum content of TNF-α and IL-6 of mice in burn+ glutamine group was significantly decreased on PBD 5, 10, and 14 (P<0.05). (4) Compared with 56.97±2.82, 44.89±4.72, 42.46±1.06, 14.26±0.99, 62.36±2.74, and 29.45±0.84 in sham injury group, the expressions of MG53 dimer and monomer in gastrocnemius of mice were significantly decreased in burn group on PBD 5, 10, and 14 (6.16±0.25, 26.09±1.22, 28.86±1.53, 5.63±0.25, 26.74±0.79, 4.41±0.52, P<0.05). Compared with those in burn group, the expression of MG53 dimer of gastrocnemius of mice in burn+ glutamine group was significantly increased on PBD 10 and 14 (36.79±1.44, 43.96±1.62), and the expression of MG53 monomer of gastrocnemius muscle of mice in burn+ glutamine group was significantly increased on PBD 14 (13.16±2.17, P<0.05). Compared with those in sham injury group, the protein expressions of CHOP and GRP78 in gastrocnemius muscle of mice in burn group were significantly elevated on PBD 5, 10, and 14 (P<0.05). Compared with those in burn group, the protein expressions of CHOP and GRP78 in gastrocnemius of mice in burn+ glutamine group were significantly reduced on PBD 5, 10 (P<0.05). Cell experiments. (1) Compared with that in normal control group (1.76±0.25), the fluorescence intensity of FM1-43 in cells in burn serum group (9.46±1.22) was significantly increased after 24 hours of culturing (t=12.28, P<0.05). Compared with that in burn serum group, the fluorescence intensity of FM1-43 in cells in burn serum+ glutamine group (4.71±0.45) was significantly decreased after 24 hours of culturing (t=-7.59, P<0.05). (2) The expressions of MG53 monomer of cells were similar in normal control group, burn serum group, and burn+ glutamine group after 24 hours of culturing (P>0.05). Compared with 58.5±1.8 in normal control group, the expression of MG53 dimer of cells in burn serum group was significantly decreased after 24 hours of culturing (14.1±1.4, P<0.05). Compared with that in burn serum group, the expression of MG53 dimer of cells in burn serum+ glutamine group was significantly increased after 24 hours of culturing (30.9±0.6, P<0.05). Compared with those in normal control group, the protein expressions of CHOP and GRP78 of cells were significantly elevated in burn serum group after 24 hours of culturing (P<0.05). Compared with those in burn serum group, the protein expressions of CHOP and GRP78 of cells were significantly reduced in burn serum+ glutamine group after 24 hours of culturing (P<0.05).@*Conclusions@#Glutamine can promote MG53 dimerization by alleviating endoplasmic reticulum stress in severely burned mice. Thus it can accelerate skeletal muscle membrane repair, reduce the local inflammatory reaction of skeletal muscle and consumption of skeletal muscle.
ABSTRACT
Objective@#To analyze the relationship between serum lactic acid value and risk of death in patients with extensive burn during shock stage and the related influencing factors.@*Methods@#Clinical data of 127 patients (111 males and 16 females) with extensive burn admitted to Institute of Burn Research of the First Affiliated Hospital of Army Medical University from January 2009 to December 2013 and Department of Plastic Surgery and Burns of the Affiliated Hospital of Southwest Medical University from January 2016 to December 2018, who met the admission criteria, were retrospectively analyzed. The patients aged 21 to 62 years, with total burn area more than 50% total body surface area. All patients were treated with antishock therapy after admission. (1) According to the treatment outcome, the patients were divided into survival group (n=98) and death group (n=29). The gender, age, total burn area, partial-thickness burn area, full-thickness burn area, abbreviated burn severity index (ABSI), admission time after injury, number of patients with inhalation injury, number of patients with acute renal failure, and serum lactic acid values on admission and at post admission hour (PAH) 12, 24, 36, and 48 were recorded. (2) According to the optimal positive cut-off value of serum lactic acid 48 hours after admission, the patients were divided into high lactic acid group and normal lactic acid group. Age, gender, total burn area, indexes at PAH 48 including urea nitrogen, creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total serum bilirubin, alkaline phosphatase (ALP), albumin, white blood cell count, platelet count, lymphocyte count, prothrombin time (PT), hematocrit value, oxygenation index, respiratory index (RI), the alveolar-arterial oxygen partial pressure difference, mean arterial pressure (MAP) at PAH 48, the average urine volume within 48 hours after admission, the total volume of intravenous fluid infusion within 48 hours after admission, the volume of fluid infusion per kilogram of body mass within the first 24 hours after admission, the volume of fluid infusion per one percent of body surface area per kilogram of body mass within the first 24 hours after admission, the volume of urine per kilogram of body mass per hour within the first 24 hours after admission, and the percentage of hospital death were recorded. Data were processed with t test, chi-square test, and Fisher′s exact probability test. Cox regression analysis was used to screen independent risk factors affecting the prognosis of patients. Receiver operating characteristic curve (ROC) of serum lactic acid value at PAH 48 of 127 patients was drawn to predict patients′ death and determine the optimal positive cut-off value. Multivariate logistic regression analysis was used to screen independent risk factors causing increase of serum lactic acid.@*Results@#(1) There were significantly statistical differences in total burn area, full-thickness burn area, and ABSI of patients between survival group and death group (t=6.257, 4.476, 5.727, P<0.01), while other indexes between the two groups were close. (2) The serum values of lactic acid of patients in death group on admission and at PAH 12, 24, 36, and 48 were (4.00±0.28), (4.50±0.26), (4.02±0.31), (3.48±0.22), (3.40±0.19) mmol/L, respectively, which were significantly higher than those in survival group [(3.30±0.21), (3.20±0.19), (2.33±0.17), (1.85±0.18), (1.50±0.09) mmol/L, t=14.552, 29.603, 38.133, 40.648, 74.973, P<0.05 or P<0.01]. (3) Cox regression analysis showed that the serum value of lactic acid at PAH 48 was the independent risk factor affecting the prognosis of patients, with risk ratio of 1.853 and 95% confidence interval of 1.342-2.559, P<0.01. (4) The total area under ROC of serum value of lactic acid at PAH 48 to predict death of 127 patients was 0.811, with 95% confidence interval of 0.699-0.924, P<0.01. The optimal positive cut-off value of serum value of lactic acid was 1.75 mmol/L, with sensitivity of 75.0% and specificity of 79.5% for predicting death. (5) There were significantly statistical differences in total burn area, ALT, AST, ALP, PT, total serum bilirubin, total volume of intravenous fluid infusion within 48 hours after admission, volume of fluid infusion per kilogram of body mass within the first 24 hours after admission, and percentage of hospital deaths of patients between high lactic acid group (n=34) and normal lactic acid group (n=93), t=3.592, 6.797, 10.367, 2.089, 2.880, 4.517, 2.984, 4.044, χ2=58.498, P<0.05 or P<0.01, while other indexes were close between the two groups. (6) Multivariate logistic regression analysis showed that AST and total serum bilirubin were independent risk factors for increase of serum lactic acid, with odds ratios of 1.021 and 1.064 and 95% confidence intervals of 1.001-1.040 and 1.001-1.132, P<0.05.@*Conclusions@#Serum value of lactic acid at PAH 48 can independently predict the death of patients with extensive burns. Liver injury is an important risk factor causing hyperlacticemia during burn shock stage. Widespread increase of vascular permeability and large amount of fluid resuscitation are the core factors leading to aggravation of abdominal organ injury.
ABSTRACT
Nutrition therapy represents one of the most important parts of burn comprehensive treatment and plays a key role in severe burn care, but its curative effect needs to be further improved. With the deepening understanding of body metabolic rules after burn injury, the principle and method of nutrition therapy have been changed. On the one hand, nutrition therapy needs to adapt to the metabolic change post burn. On the other hand, nutrition should regard regulating body metabolism, protecting organ function, and maintaining internal environment stability as the core goals. Hence, some key points such as energy supplement, nutritional opportunity, and nutrition pathway need to be adjusted, in order to improve nutrition efficacy and patient prognosis.
ABSTRACT
Due to the potent bactericidal activity and low incidence of drug resistance, the novel cyclic lipopeptide antibiotic - daptomycin has emerged as one of the first line antimicrobial agents in the treatment of serious infections caused by gram-positive resistant pathogens. This review summarizes the research advances of daptomycin in recent years, mainly including spectrum of antimicrobial activity, biosynthesis, mode of action, mechanism of drug resistance, structure-activity relationships, surotomycin and siderophore-daptomycin conjugate to kill multidrug resistant Acinetobacter baumannii. The findings summarized in this review highlight the directions of next-generation of daptomycin derivatives.