Prediction of contrast-induced nephropathy in diabetics undergoing elective percutaneous coronary intervention: role of the ratio of contrast medium volume to estimated glomerular filtration rate / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Diabetic patients undergoing percutaneous coronary intervention (PCI) have a higher incidence of contrast-induced nephropathy (CIN) than nondiabetic patients, and no pharmacological approach has been demonstrated to offer consistent protection. Therefore, identifying individuals who are at increased risk becomes essential. This study was designed to assess the predictive role of the ratio of contrast medium volume to estimated glomerular filtration rate (CMV/eGFR) in diabetic patients undergoing elective PCI who developed CIN.</p><p><b>METHODS</b>We retrospectively investigated clinical factors associated with the development of CIN in 114 diabetic patients who had undergone elective PCI. The risk factors for CIN included age, gender, body mass index (BMI), left ventricular ejection fraction (LVEF), hemoglobin (Hb), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), volume of contrast medium, basic levels of serum creatinine (Scr), the number of treated vessels and the number of stents used. We conducted a stepwise regression analysis to evaluate the predictive role of these risk factors in the incidence of CIN.</p><p><b>RESULTS</b>The incidence of CIN was 18.4% (21/114). There were no significant differences in age, gender, BMI, LVEF, Hb, FPG, HbA1c, and incidence of hypertension and number of acute myocardial infarction (AMI) in patients between the CIN (n = 21) and the non-CIN (n = 93) groups. However, the eGFR was significantly lower ((72.0 ± 12.5) ml·min(-1)·1.73 m(-2) vs. (82.0 ± 16.5) ml·min(-1)·1.7 m(-2), P = 0.010), and the basic serum creatinine level ((1.07 ± 0.12) mg/dl vs. (0.97 ± 0.19) mg/dl P = 0.014) was significantly higher in the CIN group. In addition, the volume of contrast medium was significantly larger ((253 ± 75) ml vs. (211 ± 71) ml, P = 0.017) and the CMV/eGFR ratio was significantly greater (3.64 ± 1.26 vs. 2.70 ± 1.11, P = 0.001) in the CIN group. Stepwise regression analysis showed that the CMV/eGFR ratio was a significant independent predictor for the development of CIN (P = 0.001). At a cut-off point of > 3.1, the CMV/eGFR ratio exhibited 71% sensitivity and 70% specificity for detecting CIN.</p><p><b>CONCLUSION</b>The CMV/eGFR ratio could be a valuable predictor of CIN for diabetic patients after elective PCI. At a cut-off point of > 3.1, the CMV/eGFR ratio was an optimal predictor for the incidence of CIN.</p>

Changes of p38 MAPK and nuclear factor-kappa B in lung tissue of acute paraquat poisoned rats / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate NF-kappaB activity and the expression of phosphorylated p38 MAPK protein in lung tissue of acute paraquat poisoned rats and the effect of MT.</p><p><b>METHODS</b>One hundred and twenty-eight Sprague-Dawley (SD) rats were randomly divided into three experimental groups: poisoned group, MT group and control group. On the 1st, the 3rd, the 7th and the 14th day after exposure, levels of malondialdehyde (MDA) in serum were detected, NF-kappaB activity in the lung tissues was assessed by electrophoresis mobility shift assay (EMSA), the expression of the phosphorylated p38 MAPK was evaluated by Western blot method, the lung pathological changes of rats were observed.</p><p><b>RESULTS</b>The level of malondialdehyde (MDA) in serum increased significantly in poisoned group on the 1st day (4.45 +/- 1.23), the 3rd day (3.77 +/- 1.12) and the 7th day (2.84 +/- 0.96) nmol/ml compared with that in control group (1.36 +/- 0.52) nmol/ml (P < 0.01). There was a significant decrease in MT group on the 1st day (2.68 +/- 0.85), the 3rd day (1.97 +/- 0.74) and the 7th day (1.53 +/- 0.62) nmol/ml compared with poisoned group (P < 0.05). The expression of the phosphorylated p38 MAPK and NF-kappaB activity in lung tissue of poisoned group significantly increased compared with control group (P < 0.01). There was a significant decrease in NF-kappaB activity and expression of the phosphorylated p38 MAPK in the lung tissues in MT group compared with poisoned group (P < 0.05).</p><p><b>CONCLUSION</b>NF-kappaB and p38 MAPK could play an important role in lung injury of poisoned rats. MT may inhibit the expression of NF-kappaB and phosphorylated p38 MAPK, and therefore might have the therapeutical effect on acute paraquat poisoning.</p>

The clinical significance of the epithelial cellular adhesion molecule(Ep-CAM)expression in esophageal squamous cell carcinoma(SCC) / 肿瘤研究与临床

Objective To evaluate the clinical significance of epithelial cellular adhesion molecule (Ep-CAM)expression in esophageal squamous cell carcinoma(SCC).Methods The Ep-CAM expression was immunohistochemically investigated in 70 normal esophageal mucosas,SCCs and 72 lymph nodes.Results Ep-CAM expression was observed in 94.3% of the tumors,but no expression in the normal mucosa.The Ep- CAM expression was not significantly different between different tumor scales and tumors invading depths,its expression level was relevant with the tumors differentiation and lymph node metastases(P

Propofol protecting rats from paraquat induced lung injury / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the protective efficacy of propofol against paraquat induced lung injury.</p><p><b>METHODS</b>One hundred and twenty-eight male Wistar rats were randomizedly divided into three groups: the control group (n = 8), the intoxication group (n = 60) and the propofol group (n = 60). One hundred and twenty rats were once administered with 5 mg/kg paraquat (PQ) by the intragastrical injection to establish the model of PQ induced lung injury. The propofol of 10 mg/kg was administered intraperitoneally in the propofol group (60 rats) twice a day for four consecutive days one hour after the rats were intoxicated while the normal saline of the same amount as propofol in the propofol group was administered in the intoxication group (60 rats) one hour after the rats were intoxicated. The intragastrical injection of 1 mg/kg normal saline was administered once in the control group (8 rats). On the first, the third, the seventh, the 14th and the 28th day after treating, the level of malondialdehyde (MDA) in plasma, bronchoalveolar lavage fluid (BALF) and lung homogenate, and the content of hydroxyproline (HPY) in lung homogenate, the cell count of BALF were detected. Meanwhile, pathological changes of lung were examined under optical microscope.</p><p><b>RESULTS</b>The level of MDA in plasma on the first, the third and the seventh day and in BALF and lung homogenate on the first and the third day in the propofol group [in plasma: (4.31 +/- 0.94), (4.04 +/- 0.87) and (3.24 +/- 1.14) nmol/ml; in BALF: (3.47 +/- 1.09) and (2.79 +/- 1.11) nmol/ml; in lung homogenate: (7.54 +/- 0.63) and (8.41 +/- 1.23) nmol/ml] were significantly lower than those in the intoxication group [in plasma: (10.15 +/- 3.15), (6.97 +/- 1.6 5) and (5.44 +/- 0.66) nmol/ml; in BALF: (5.58 +/- 1.19) and (4.86 +/- 1.89) nmol/ml; in lung homogenate: (10.20 +/- 2.43) and (10.71 +/- 171) nmol/ml, P < 0.05 or P < 0.01]. The total cell count of BALF on the first, the third and the seventh day after intoxication in the propofol group was significantly less than that in the intoxication group respectively (P < 0.05). The histological changes such as alveolar edema, hemorrhage and inflammatory cell infiltration in the propofol group were less than those in the PQ group.</p><p><b>CONCLUSION</b>Propofol could reduce the level of MDA and relieve paraquat induced lung injury.</p>

Influence of ambroxol on paraquat-induced lung tissue injury and change of pulmonary surfactant-associated protein A in the experimental rats / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the influence of ambroxol on paraquat poisoning induced acute lung tissue injury and the change of pulmonary surfactant associated protein A in the experimental rats.</p><p><b>METHODS</b>One hundred and twenty healthy adult male Sprague-Dawley rats were randomizedly assigned into normal saline (NS) group (n = 24), paraquat poisoning induced lung tissue injury model (PQ) group (n = 48) and ambroxol treatment (AT) group (n = 48). The indexes were observed among the three groups comprising the mortality rate, the change of arterial blood PaCO(2) and PaO(2), the ratio of wet to dry lung tissue (W/D), the change of the lung tissue under light and electric microscope respectively, and the expression of pulmonary surfactant associated protein A.</p><p><b>RESULTS</b>The mortality rate of rats in the PQ group was 50.0% on the seventh day while the mortality rate in the AT group was 25.0%. The level of arterial blood PaCO(2) in the PQ group (6.94 +/- 0.8) kPa was significantly higher than that in the AT group (6.12 +/- 0.5) kPa and the NS group (4.6 +/- 0.4) kPa. The level of arterial blood PaO(2) in the PQ group (6.98 +/- 1.1) kPa was significantly lower than that in the AT group (8.25 +/- 0.7) kPa and the NS group (12.7 +/- 0.8) kPa. There were significant differences among the groups (P < 0.05). The degree of lung tissue injury was severe in PQ group and relieved in AT group. The expression of pulmonary surfactant associated protein A was significantly decreased in PQ group 13.22% +/- 2.21% on the seventh day, compared with that in the AT group (21.82% +/- 3.67%) (P < 0.05). The expression of pulmonary surfactant associated protein A in AT group was significantly higher in the AT group (18.97% +/- 0.91%) than that in the PQ group on the seventh day (P < 0.05).</p><p><b>CONCLUSION</b>Ambroxol plays a role in facilitating synthesis and secretion of pulmonary surfactant protein A and relieves the lung tissue injury induced by paraquat poisoning.</p>