Predictive value of plasma TMAO combined with NT-proBNP on the prognosis and length of hospitalization of patients with ischemic heart failure / 中华心血管病杂志

Objective: To explore the value of the assessment of plasma trimethylamine N-oxide (TMAO) combined with N-terminal pro-B-type natriuretic peptide (NT-proBNP) on predicting the all-cause mortality, length of hospitalization, and hospital cost in ischemic heart failure (IHF) patients. Methods: This prospective cohort study included 189 patients (157 males, mean age (64.0±10.5) years) with a left ventricular ejection fraction<45% caused by coronary artery disease, who hospitalized in our department from March 2016 to December 2020. Baseline data, including demographics, comorbid conditions and laboratory examination, were analyzed. The cumulative rate of all-cause mortality was evaluated using the Kaplan-Meier method and compared between the groups according to the log-rank test. Relative risks were reported as hazard ratios (HR) and 95% confidence interval (95%CI) calculated using the Cox proportional-hazards analysis, with stepwise adjustment for covariables. Spearman correlation analysis was then performed to determine the relationship between TMAO combined with NT-proBNP and length of hospitalization and hospital cost. Results: There were 50 patients in the low TMAO+low NT-proBNP group, 89 patients in high TMAO or high NT-proBNP group, 50 patients in high TMAO+high NT-proBNP group. The mean follow-up period was 3.0 years. Death occurred in 70 patients (37.0%), 27 patients (54.0%) in high TMAO+high NT-proBNP group, 29 patients (32.6%) in high TMAO or high NT-proBNP group and 14 patients (28.0%) in low TMAO+low NT-proBNP group. TMAO, in combination with NT-proBNP, improved all-cause mortality prediction in IHF patients when stratified as none, one or both biomarker(s) elevation, with the highest risk of all-cause mortality in high TMAO+high NT-proBNP group (HR=3.62, 95%CI 1.89-6.96, P<0.001). ROC curve analysis further confirmed that TMAO combined with NT-proBNP strengthened the prediction performance on the risk of all-cause death (AUC=0.727(95%CI 0.640-0.813), sensitivity 55.0%, characteristic 83.1%). Spearman correlation analysis showed that IHF patients with high TMAO and high NT-proBNP were positively associated with longer duration of hospitalization (r=0.191,P=0.009), but not associated with higher hospital cost (r=0.030, P=0.686). Conclusions: TMAO combined with NT-proBNP are valuable prediction tool on risk stratification of patients with IHF, and those with two biomarkers elevation face the highest risk of mortality during follow-up period, and are associated with the longer hospital stay.

The mechanisms of inhibitory effect of adenovirus-mediated wild-type PTEN gene on the proliferation in activated hepatic stellate cells in vitro / 中华肝脏病杂志

<p><b>OBJECTIVE</b>Using an adenoviral vector, the wild-type PTEN gene was transduced into activated hepatic stellate cell (HSC) cultured in vitro and cell cycle markers and were detect. Thereby, the potential mechanisms of inhibitory effect of the wild-type PTEN overexpression on the proliferation in activated HSC was investigated.</p><p><b>METHODS</b>The wild type PTEN gene was transduced into activated HSC (HSC-T6 ) cultured in vitro mediated by adenoviral vector. PTEN expression in HSC was measured by Western blot and Real-time fluorescent quantitation PCR. Flow cytometry (FCM) was then used to detect cell cycle phase of activated HSC. And the expressions of cyclinD1 and cyclin dependent kinase 4 (CDK4) in HSC were determined by Western blot.</p><p><b>RESULTS</b>The data showed that exogenous wild type PTEN gene was successfully transduced and expressed in activated HSC cultured in vitro. The over-expression of wild type PTEN resulted in the increased number of HSC at G0/G1 phase ( P less than 0.01), and the number of HSC at S phase and G2/M phase were decreased significantly, P less than 0.01. Furthermore, there were decreased cyclinD1 and CDK4 expression in HSC infected with Ad-PTEN, P less than 0.01.</p><p><b>CONCLUSION</b>The over-expression of wild type PTEN inhibit transition of activated HSC in vitro from G1 to S phase and arrest cell cycle of them at G0/G1 phase via the down-regulated expressions of cyclinD1 and CDK4, and then inhibit HSC proliferation.</p>

Effects of different ventilation modes for one-lung ventilation anesthesia on respiratory function and F(A)/F(I) changes during sevoflurane inhalation / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of different ventilation modes for one lung ventilation anesthesia on arterial blood-gas, airway pressure, intrapulmonary shunt, and F(A)/F(I) changes in patients receiving sevoflurane inhalation.</p><p><b>METHODS</b>Thirty ASA class II-III patients with lung cancer undergoing pulmonary lobectomy were randomized into 3 equal groups. The patients in group A received volume-controlled ventilation (VCV) without positive end-expiratory pressure (PEEP) (VT=8 ml/kg, Rf=12/min), and those in group B, after a preceding VCV stabilize the airway pressure, had pressure-controlled ventilation with maintenance of an identical peak pressure (Ppeak) (Rf=12/min, PEEP=0). In group C, the patients received small tidal volume ventilation with PEEP (VT=6 ml/kg, Rf=16/min, PEEP=5 cm H(2)O). Blood gas analysis was carried out at 10 min after TLV and at 20, 45 and 70 min after one lung ventilation (OLV); the heart rate (HR), mean arterial pressure (MAP), SpO(2) and Ppeak were also recorded and blood samples collected from the artery and jugular vein at these time points. Inhalation of 1.5% sevoflurane for 20 min started at 20 min of OLV.</p><p><b>RESULTS</b>Compared with those in TLV, the Ppeak increased, lung compliance decreased, arterial oxygenation (PaO(2)) decreased and intrapulmonary shunt (Qs/Qt) increased during OLV. Group B showed the fastest increase of F(A)/F(I) in the initial 8 min, followed by groups A and C, but the curves became similar with the passage of time.</p><p><b>CONCLUSIONS</b>During OLV, the 3 ventilation modes result in similar F(A)/F(I) changes during sevoflurane inhalation but PCV can increase pulmonary compliance.</p>

Differential proteomic analysis on osteoblasts stimulated by mechanical strain / 医用生物力学

Objective To identify the differentially expressed proteins and clarify the major proteins involved in the molecular mechanism of osteoblasts under mechanical strain loading. Method Saos 2 osteoblastic cells were subjected to 12% elongation for 24 hours by using Flexcell strain loading system. Proteins extracted from Saos 2 cells were separated by two dimensional electrophoresis (2 DE). Differential expressed protein spots among groups were submitted to matrix assisted laser desorption/ionization time of flight mass spectrometer (MALDI TOF MS) assay and peptide mass fingerprinting (PMF) identification. The Swiss Prot and NCBI databases were used to obtain further information about proteins identified. Results Saos 2 stimulated by mechanical strain showed a significant difference in 2 DE system compared with the control group. A total of (1031±41) or (928±25) protein spots were resolved by 2 DE of controls or experimental groups extractions respectively. 17 significant up regulated proteins were identified. These associated proteins fell into 6 groups, including stress reaction, energy metabolism, cell proliferation, reconstruction of cytoskeleton, signaling and osteogenesis. Conclusions The Saos 2 can express differential proteins stimulated by mechanical strains and these proteins may play an important role in molecular mechanism of osteoblasts under mechanical strain loading.

Changes of cell adhesion molecules and proinflammatory cytokines during cardiopulmonary bypass and the effect of intervention / 中南大学学报(医学版)

OBJECTIVE@#To investigate the changes of the cell adhesion molecules and proinflammatory cytokines during cardiopulmonary bypass, and to observe the effect of intervention with ulinastatin.@*METHODS@#Twenty-two ASA II-III patients (9 males, 13 females), aged 20-60 years, undergoing cardiac operation with CPB were randomly divided into 2 groups: the control group (Group C, n=11) and the ulinastatin group (Group W, n=11). In Group W, patient received ulinastatin 1.2 x 10(4) U/kg, and half of the dose was given intravenously after the induction of anesthesia, while the same amount of ulinastatin added into the primary solution. And in Group C, normal saline was given instead of ulinastatin. Blood samples were taken from radial artery before the operation (T1), 20 min after the initiation of CPB (T2), 1 h (T3), 6 h (T4 ), 24 h (T5) after the CPB for the determination of plasma TNF-alpha, IL-6, sICAM-1 and sP-Selectin concentrations.@*RESULTS@#The concentrations of TNF-alpha, IL-6 increased significantly at T2-T4 in both groups compared with T1 (P < 0.05), and returned to the baseline level at Ts in Group W. The concentrations of TNF-alpha, IL-6 in Group C at T2-T5 were higher than that in Group W (P < 0.01). The concentrations of sICAM-1, sP-Selectin increased significantly at T3, T4 in both groups compared with that at T1 (P < 0.05). But at T5, the concentrations of sICAM-1, sP-Selectin decreased, especially in Group W the concentrations of sICAM-1, sP-Selectin returned to the baseline level. The sI-CAM-1, sP-Selectin concentrations in group C at T4, T5 were higher than that in group W (P < 0.05).@*CONCLUSION@#Ulinastatin can reduce the increase of the cell adhesion molecules and proinflammatory cytokines during cardiopulmonary bypass and effectively weaken the inflammatory response to CPB.