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1.
Rev. bras. cir. cardiovasc ; 37(1): 35-47, Jan.-Feb. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1365526

ABSTRACT

Abstract Introduction: Severe coronavirus disease 2019 (COVID-19) is characterised by hyperinflammatory state, systemic coagulopathies, and multiorgan involvement, especially acute respiratory distress syndrome (ARDS). We here describe our preliminary clinical experience with COVID-19 patients treated via an early initiation of extracorporeal blood purification combined with systemic heparinisation and respiratory support. Methods: Fifteen patients were included; several biomarkers associated with COVID-19 severity were monitored. Personalised treatment was tailored according to the levels of interleukin (IL)-6, IL-8, tumour necrosis factor alpha, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio, thrombocyte counts, D-dimers, and fibrinogen. Treatment consisted of respiratory support, extracorporeal blood purification using the AN69ST (oXiris®) hemofilter, and 300 U/kg heparin to maintain activation clotting time ≥ 180 seconds. Results: Ten patients presented with severe to critical disease (dyspnoea, hypoxia, respiratory rate > 30/min, peripheral oxygen saturation < 90%, or > 50% lung involvement on X-ray imaging). The median intensive care unit length of stay was 9.3 days (interquartile range 5.3-10.1); two patients developed ARDS and died after 5 and 26 days. Clinical improvement was associated with normalisation (increase) of thrombocytes and white blood cells, stable levels of IL-6 (< 50 ng/mL), and a decrease of CRP and fibrinogen. Conclusion: Continuous monitoring of COVID-19 severity biomarkers and radiological imaging is crucial to assess disease progression, uncontrolled inflammation, and to avert irreversible multiorgan failure. The combination of systemic heparin anticoagulation regimens and extracorporeal blood purification using cytokine-adsorbing hemofilters may reduce hyperinflammation, prevent coagulopathy, and support clinical recovery.

2.
Organ Transplantation ; (6): 120-2022.
Article in Chinese | WPRIM | ID: wpr-907042

ABSTRACT

Graft-versus-host disease (GVHD) is a major cause that prevents widespread application of allogeneic hematopoietic stem cell transplantation. GVHD is a complication that can affect all systems of the body, such as skin, liver, lung and gastrointestinal tract, among which skin is the most vulnerable organ. At present, the pathogenesis of skin GVHD has not been fully elucidated, and no effective treatment has been established. Severe or extensive chronic GVHD significantly affects the quality of life of the recipients. Consequently, it is urgent to unravel the pathogenesis of skin GVHD and explore novel therapeutic treatment. Cytokines, such as interleukin (IL)-22, IL-17, IL-6 and interferon (IFN)-γ, have been proven to play pivotal roles in the progression of skin GVHD. Nevertheless, the specific mechanism remains elusive. In this article, research progresses at home and abroad on the mechanism underlying the roles of these cytokines in skin GVHD were reviewed, aiming to provide novel ideas for the prevention and treatment of skin GVHD.

3.
Acta cir. bras ; 37(1): e370105, 2022. tab, graf
Article in English | LILACS-Express | MEDLINE, LILACSEXPRESS, LILACS, VETINDEX | ID: biblio-1364250

ABSTRACT

ABSTRACT Purpose: To evaluate how the induction of liver damage by ischemia and reperfusion affects the adipose tissue of lean and obese mice. Methods: Lean and diet-induced obese mice were subjected to liver ischemia (30 min) followed by 6 h of reperfusion. The vascular stromal fraction of visceral adipose tissue was analyzed by cytometry, and gene expression was evaluated by an Array assay and by RT-qPCR. Intestinal permeability was assessed by oral administration of fluorescein isothiocyanate (FITC)-dextran and endotoxemia by serum endotoxin measurements using a limulus amebocyte lysate assay. Results: It was found that, after liver ischemia and reperfusion, there is an infiltration of neutrophils, monocytes, and lymphocytes, as well as an increase in the gene expression that encode cytokines, chemokines and their receptors in the visceral adipose tissue of lean mice. This inflammatory response was associated with the presence of endotoxemia in lean mice. However, these changes were not observed in the visceral adipose tissue of obese mice. Conclusions: Liver ischemia and reperfusion induce an acute inflammatory response in adipose tissue of lean mice characterized by an intense chemokine induction and leukocyte infiltration; however, inflammatory alterations are already present at baseline in the obese adipose tissue and liver ischemia and reperfusion do not injure further.

4.
Braz. arch. biol. technol ; 65: e22210267, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364467

ABSTRACT

Abstract This study aims to investigate the effect of Viola tricolor extract on hippocampal neuronal death, interleukin (IL) -6 and IL-10 expression, spatial memory, anxiety, and depression in rats exposed to chronic immobilization stress. Rats were divided into groups Control, Viola300, Viola600, Stress, Stress-Viola300, and Stress-Viola600. Animals were placed in a restrainer (6 h / 21 days) to stress exposure. V. tricolor hydro-alcoholic extract was also administrated at doses of 300 and 600 mg/kg by gavage. The extract caused immobilized animals to spend more time in the target quadrant in the Morris water maze test. It also increased the percentage of entries into the open arm and the percentage of time spent in the open arm of the elevated plus-maze in immobilized rats. Treatment with the V. tricolor extract significantly reduced the immobility time of stressed rats in the forced swimming test. Furthermore, it significantly reduced neuronal death and expression of IL-6 in the hippocampus of immobilized animals but could not prevent the decrease of IL-10 expression. We concluded that V. tricolor protects rats from stress-induced behavioral damages, at least in part, by suppressing neuronal death and decreasing IL-6 expression.

5.
Rev. bras. neurol ; 57(4): 5-8, out.-dez. 2021. tab
Article in English | LILACS | ID: biblio-1359194

ABSTRACT

BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease marked by fluctuating course of muscle weakness. OBJECTIVES: The current study was designed to evaluate plasma levels of cytokines (IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ, and IL17A) in patients with MG and controls and to investigate whether cytokines levels are associated with clinical parameters. This study was conducted at the Neuromuscular Diseases Outpatient Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Brazil. METHODS: Peripheral blood was drawn, and plasma levels of cytokines were measured by cytometric bead array (CBA) in 80 treated patients with MG and 50 controls. The MG Composite (MGC) was used to evaluate muscle weakness and severity of typical motor symptoms of MG. RESULTS: Patients with MG undergoing treatment exhibit lower levels of all evaluated cytokines compared to controls. There was a negative correlation between IL-6 levels and the MG Composite score, indicating that higher levels of IL-6 were associated with better control of the disease. CONCLUSION: This exploratory study suggests that IL-6 is associated with MG clinical status, as assessed by the MGC.


INTRODUÇÃO: A Miastenia Gravis (MG) é uma doença autoimune caracterizada por fraqueza muscular flutuante. OBJETIVOS: avaliar os níveis plasmáticos de citocinas (IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ, e IL-17A) em pacientes com MG e controles e investigar se essas citocinas estão associadas com parâmetros clínicos. Este estudo foi conduzido no ambulatório de doenças neuromusculares do Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Brasil. MÉTODOS: Foi coletado sangue periféricos e os níveis plasmáticos das citocinas foram medidos por citometria em 80 pacientes com MG tratados e em 50 controles. O MG composite (MGC) foi utilizado para avaliar a fraqueza muscular e a gravidade dos sintomas motores típicos da MG. RESULTADOS: Os pacientes com MG em tratamento apresentaram menores níveis de todas as citocinas avaliadas comparados ao controle. Houve uma correlação negativa entre os níveis de IL-6 e o MGC, indicando que altos níveis de IL-6 estão associados com melhor controle da doença. CONCLUSÃO: este estudo exploratório sugere que a IL-6 está associada com o status clínico da MG, quando avaliado pelo MGC.


Subject(s)
Humans , Male , Female , Adult , Cytokines/blood , Interleukin-6 , Myasthenia Gravis/diagnosis , Myasthenia Gravis/immunology , Myasthenia Gravis/drug therapy , Prednisone/therapeutic use , Blood Specimen Collection , Muscle Weakness
6.
Rev. Hosp. Ital. B. Aires (2004) ; 41(4): 171-175, dic. 2021. tab
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1366760

ABSTRACT

Introducción: la amiloidosis AA puede ser una complicación de ciertos trastornos inflamatorios crónicos, aunque entre el 21% y 50% puede ser idiopática. No existe un tratamiento específico. El tocilizumab, dirigido contra el receptor de IL-6 y orientado a disminuir la producción de SAA, podría ser eficaz. Métodos: en este estudio informamos datos de 6 pacientes con amiloidosis AA tratados con tocilizumab monoterapia subcutáneo en el período 2011-2018. Los criterios de valoración principales fueron la mejora clínica y bioquímica de los órganos afectados y los parámetros bioquímicos marcadores de inflamación. Resultados: el riñón estaba afectado en todos los pacientes, manifestándose con caída del filtrado glomerular y síndrome nefrótico. La hemorragia digestiva se presentó en un paciente y otro tenía afectación pulmonar en la biopsia. Luego del posterior al tratamiento, todos mejoraron el hematocrito, la albúmina sérica y el índice de masa corporal. El SAA disminuyó en 5 pacientes. Un paciente mejoró su función renal, mientras 4 se mantuvieron estables. Tres pacientes disminuyeron los valores de proteinuria. Conclusión: el tratamiento con tocilizumab podría ser eficaz en el tratamiento de los pacientes con amiloidosis AA. (AU)


Introduction: AA amyloidosis can be a complication of certain chronic inflammatory disorders, although between 21% and 50% can be idiopathic. There is no specific treatment. Tocilizumab, directed against the IL-6 receptor and aimed at decreasing SAA production, could be effective. Methods: in this study, we report data from 6 patients with AA amyloidosis treated with subcutaneous tocilizumab monotherapy between the period 2011-2018. The main endpoints were the clinical and biochemical improvement of the affected organs and the biochemical parameters markers of inflammation. Results: the kidney was affected in all patients, manifesting with a fall in glomerular filtration rate and nephrotic syndrome. Gastrointestinal bleeding occurred in one patient and another had lung involvement on biopsy. After treatment, all improved hematocrit, serum albumin, and body mass index. SAA decreased in 5 patients. One patient improved his kidney function, while 4 remained stable. Three patients decreased proteinuria values. Conclusion: treatment with tocilizumab could be effective in the treatment of patients with AA amyloidosis. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Serum Amyloid A Protein/drug effects , Antibodies, Monoclonal, Humanized/therapeutic use , Amyloidosis/drug therapy , Body Mass Index , Receptors, Interleukin-6/drug effects , Antibodies, Monoclonal, Humanized/administration & dosage , Glomerular Filtration Rate/drug effects , Gastrointestinal Hemorrhage/complications , Amyloidosis/blood , Inflammation/complications , Lung Diseases/complications , Nephrotic Syndrome/complications
7.
Arch. Clin. Psychiatry (Impr.) ; 48(5): 229-230, Sept.-Oct. 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364287

ABSTRACT

ABSTRACT Peripheral and central cytokine interleukin-6 (IL-6) levels play an important role in the pathophysiology of major depression (MD). We investigated the association between serum levels of IL-6 and brain-derived neurotrophic factor (BDNF) in drug-naïve, first-episode patients with MD. This study included 28 patients (male/female: 11/17; mean [standard deviation] age, 46.7 [11.9] years) who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for MD without any physical diseases. We evaluated the severity of depression using the Hamilton Rating Scale for Depression. No associations were found between serum levels of IL-6 and BDNF (r=-0.102, P =0.605). These results suggest that IL-6 does not influence BDNF and vice versa, but both act in a peripheral manner.

8.
Bol. latinoam. Caribe plantas med. aromát ; 20(4): 394-405, jul. 2021. ilus
Article in English | LILACS | ID: biblio-1352427

ABSTRACT

In this study, it was aimed to determine the antioxidant and anticancer activities of Sideritis perfoliata methanolic extract (SPE) on cervical cancer cells (HeLa). Different doses (25, 50,100 and 200 µg/mL) of SPE were used to determine proliferation of HeLa cells by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide (MTT) staining method. Induction of apoptosis was determined by Annexine-V and propidium iodide staining method. Interleukin (IL) 6-8 levels were measured by ELISA method. Antioxidant activities of SPE were determined by DPPH, DNA (plasmid pBR322) protecting and cellular antioxidant activity tests. Some phytochemicals of SPE were also screened by LC-MS-MS. It was determined that SPE reduced the proliferation of HeLa cells and also induced apoptosis. IL6-8 levels importantly decreased at 200 µg/mL. SPE exhibited moderately antioxidant activities in tests used. Among the phenolics identified, vanillic acid had the highest amount. As a result, it was determined to have the anticancer activity of SPE by decreasing cell proliferation, inducing apoptosis and decreasing IL6-8 in HeLa cells.


En este estudio, se tuvo como objetivo determinar las actividades antioxidantes y anticancerígenas del extracto metanólico de Sideritis perfoliata (SPE) en las células de cáncer de cuello uterino (HeLa). Se utilizaron diferentes dosis (25, 50, 100 y 200 µg/mL) de SPE para determinar la proliferación de células HeLa mediante el método de tinción con bromuro de 3-[4,5-dimetiltiazol-2-il] -2,5-difenil-tetrazolio (MTT). La inducción de apoptosis se determinó mediante el método de tinción con anexina-V y yoduro de propidio. Los niveles de interleucina (IL) 6-8 se midieron mediante el método ELISA. Las actividades antioxidantes de SPE se determinaron mediante pruebas de DPPH, protección de ADN (plásmido pBR322) y actividad antioxidante celular. Algunos fitoquímicos de SPE también se analizaron mediante LC-MS-MS. Se determinó que SPE redujo la proliferación de células HeLa y también indujo apoptosis. Los niveles de IL6-8 disminuyeron de manera importante a 200 µg/mL. SPE mostró actividades moderadamente antioxidantes en las pruebas utilizadas. Entre los fenólicos identificados, el ácido vainílico tuvo la mayor cantidad. Como resultado, se determinó que tenía la actividad anticancerígena de SPE al disminuir la proliferación celular, inducir apoptosis y disminuir la IL6-8 en las células HeLa.


Subject(s)
Plant Extracts/administration & dosage , Uterine Cervical Neoplasms , Sideritis/chemistry , Cell Proliferation/drug effects , Antioxidants/administration & dosage , Phenols/analysis , Plant Extracts/chemistry , Cell Survival , Interleukin-8/analysis , Interleukin-6/analysis , Apoptosis/drug effects , Gas Chromatography-Mass Spectrometry , Antineoplastic Agents , Antioxidants/chemistry
9.
Infectio ; 25(2): 94-100, abr.-jun. 2021. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1250074

ABSTRACT

Resumen La infección por SARS-CoV-2 es hoy el principal problema de salud pública en el mundo. No es claro el papel de las citoquinas en la fisiopatología del COVID-19,que en algunos individuos presenta una progresión rápida, severa y mortal asociada con proinflamación sistémicos relacionada con coagulopatías y fallas multiorgánicas. En este estudio, evaluamos los niveles séricos de citoquinas y su correlación con IgM, IgG e IgA, en 24 muestras de individuos positivos y 8 muestras de individuos negativos, para SARS-CoV-2. Hallamos concentraciones significativamente menores de IFN-g, TNF, IL-2 e IL-4 y un aumento significativo de IL-6 en el grupo de infectados hospitalizados respecto a los no infectados, así como una tendencia significativa al aumento, para IgG e IgA en el mismo grupo de individuos, respecto a infectados asintomáticos. Nuestros datos soportan el papel de la IL-6 en la severidad de la enfermedad destacando su potencial papel como biomarcador en la prognosis de esta patología. También, soportan la hipótesis sobre la función de los anticuerpos en el control efectivo del patógeno; se observa una respuesta inmune humoral más débil, frente a la proteína de la nucleocápside viral, en individuos con un mejor curso de la enfermedad.


Abstract The emergency caused by the infection in humans of SARS-COV-2 and the clinical syndrome resulting from the infection (COVID-19) is a major public health crisis with global repercussions. Currently, the role of different cytokine profiles in the infection pathophysiology and its outcome remains unclear despite the coordina ted efforts of the scientific community. COVID-19 shows a rapid progression where the disease severity and mortality are linked to systemic pro-inflammatory pro cesses associated to a dysregulation in the cytokine production balance, resulting in blood clothing disorders and multiorgan failure. Here we evaluate the serum concentration for a cytokine panel as well as the antibody titers of IgM, IgG and IgA from 24 individuals who tested positive for SARS-CoV-2 by RT-PCR (divided into three separate groups according to disease severity) and eight RT-PCR-negative controls. Significantly lower concentrations of IFN-g, TNF, IL-2 and IL-4, and a higher production of IL-6 were observed in hospitalized COVID-19 patients when compared to SARS-CoV-2-negative individuals. Furthermore, a significant and sustained increase in the levels of IgG and IgA was found for the group of hospitalized patients compared to asymptomatic SARS-CoV-2-positive individuals. Our data support previous findings on the role of cytokines like IL-6 in the severity of the disease and highlight their potential use as biomarkers for the prognosis of COVID-19. Finally, we provide evidence supporting the potential function of the antibody response in the effective control of the virus, showing that a somehow weaker humoral immune response can be associated to milder forms of COVID-19.


Subject(s)
Humans , Male , Cytokines , SARS-CoV-2 , COVID-19 , Biomarkers , Colombia , Immunity , Anti-Inflammatory Agents
10.
Acta Pharmaceutica Sinica B ; (6): 2859-2879, 2021.
Article in English | WPRIM | ID: wpr-888891

ABSTRACT

Parkinson's disease (PD) is the second most common neurodegenerative disease, but none of the current treatments for PD can halt the progress of the disease due to the limited understanding of the pathogenesis. In PD development, the communication between the brain and the gastrointestinal system influenced by gut microbiota is known as microbiota-gut-brain axis. However, the explicit mechanisms of microbiota dysbiosis in PD development have not been well elucidated yet. FLZ, a novel squamosamide derivative, has been proved to be effective in many PD models and is undergoing the phase I clinical trial to treat PD in China. Moreover, our previous pharmacokinetic study revealed that gut microbiota could regulate the absorption of FLZ

11.
Acta Pharmaceutica Sinica B ; (6): 1767-1788, 2021.
Article in English | WPRIM | ID: wpr-888834

ABSTRACT

Ischemic stroke is a cerebrovascular disease normally caused by interrupted blood supply to the brain. Ischemia would initiate the cascade reaction consisted of multiple biochemical events in the damaged areas of the brain, where the ischemic cascade eventually leads to cell death and brain infarction. Extensive researches focusing on different stages of the cascade reaction have been conducted with the aim of curing ischemic stroke. However, traditional treatment methods based on antithrombotic therapy and neuroprotective therapy are greatly limited for their poor safety and treatment efficacy. Nanomedicine provides new possibilities for treating stroke as they could improve the pharmacokinetic behavior of drugs

12.
Asian Journal of Andrology ; (6): 85-90, 2021.
Article in English | WPRIM | ID: wpr-879713

ABSTRACT

Prostate cancer (PCa) is one of the most common malignancies in Western countries. Studies have shown that androgen contributes to the progression of PCa, but how androgen promotes PCa remains largely unknown. Here, we demonstrated that androgen suppressed the expression of miR-760 depending on the interaction between androgen and androgen receptor (AR). miR-760 was downregulated in prostate cancer tissues compared with normal tissues. Functional experiments showed that miR-760 downregulation promoted the proliferation and growth of LNCaP and 22rv1 cells. In contrast, miR-760 ectopic expression inhibited the proliferation of LNCaP and 22rv1 cells. DNA synthesis was suppressed by miR-760. Mechanistically, miR-760 bound to the 3'UTR of interleukin 6 (IL6 ). A mutation in the binding site disrupted their interaction. In addition, silencing ofIL 6 suppressed the proliferation of LNCaP and 22rv1 cells. IL6 was upregulated in PCa tissues. Our study reveals that androgen downregulates miR-760 to promote the growth of PCa cells by regulating IL6.

13.
Journal of Chinese Physician ; (12): 1176-1180, 2021.
Article in Chinese | WPRIM | ID: wpr-909683

ABSTRACT

Objective:To investigate the role and mechanism of interleukin (IL)-6/signal transducer and activator of transcription 3 (STAT3) signaling pathway in proliferation, invasion and apoptosis of cervical cancer cells infected by high-risk human papillomavirus (HPV).Methods:HPV-18 positive HeLa cells cultured in vitro were divided into control group (normal cultured), IL-6 group (stimulated with 50 ng/ml IL-6 for 24 h) and IL-6 + AG490 group (stimulated with 50 ng/ml IL-6 and 100 μmol/L STAT3 signaling pathway inhibitor AG490 for 24 h). Methyl thiazolyl tetrazolium (MTT) assay was used to detect the cell survival rate. The ability of cell clone formation was detected by plate clone formation assay. The cell invasion was detected by transwell chamber assay. The cell apoptosis was detected by flow cytometry. Western blot was used to detect the protein expression levels of STAT3, phosphorylation of (p)-STAT3, B-cell lymphoma-2 gene (Bcl-2), CyclinD1 and matrix metalloproteinase-9 (MMP-9). Results:Compared with those in the control group, the cell survival rate, clone formation rate, number of invasive cells and the protein expression levels of p-STAT3, Bcl-2, CyclinD1 and MMP-9 in IL-6 group were significantly higher, while the apoptosis rate was significantly lower ( P<0.05); at the same time, compared with those in IL-6 group, the cell survival rate, clone formation rate, the number of invasive cells and the protein expression levels of p-STAT3, Bcl-2, CyclinD1 and MMP-9 in IL-6 + AG490 group were significantly lower, while the apoptosis rate was significantly higher ( P<0.05). Conclusions:IL-6/STAT3 signaling pathway plays an important role in the malignant progression of high-risk HPV infected cervical cancer cells, and its mechanism may be related to the up-regulation of CyclinD1, MMP-9, Bcl-2 protein expressions.

14.
Journal of Chinese Physician ; (12): 1034-1038, 2021.
Article in Chinese | WPRIM | ID: wpr-909663

ABSTRACT

Objective:To investigate the value of serum trimethylamine N-oxide (TMAO) level in evaluating the severity and short-term clinical prognosis of patients with sepsis.Methods:A prospective case-control study was conducted. Patients in the case group were admitted to the emergency intensive care unit of Shanghai Putuo District People′s Hospital Affiliated to Tongji University from March 2018 to December 2019. According to the diagnosis criteria of sepsis 3.0 in 2016, the patients in the case group were divided into sepsis non shock group (33 cases) and septic shock group (12 cases). They were divided into survival group and death group according to 28 day outcome; Healthy volunteers were selected as control group (30 cases). The levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), Acute Physiology And Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and the sequential organ failure assessment (SOFA), serum TMAO were compared. The relationship between serum TMAO, sepsis severity and short-term clinical prognosis were analyzed.Results:The serum IL-6, CRP, PCT, scores of SOFA and APACHE Ⅱ in septic shock group were significantly higher than those in normal sepsis group ( P<0.01). The serum IL-6, PCT, scores of SOFA and APACHE Ⅱ in the death group of sepsis patients were significantly higher than those in the survival group ( P<0.01). The serum TMAO level of the sepsis group on 1st day was significantly higher than that of the healthy control group ( P<0.01). The serum TMAO level in the septic shock group on the 1st, 3rd and 7 th day was higher than that in the normal sepsis group, with statistically significant difference ( P<0.01). The serum TMAO level in the septic shock group and normal sepsis group on the third day were significant different with the first day ( P<0.01). The serum TMAO level in the death group on the 1st, 3rd and 7th day was higher than that in the survival group, with statistically significant difference ( P<0.05). And the serum TMAO level in the death group and survival group on the third day were significant different with the first day ( P<0.01). The serum TMAO level of sepsis patients was positively correlated with APACHE Ⅱ score ( r=0.848, P<0.01). The level of TMAO was positively correlated with serum IL-6 ( r=0.956, P<0.01). Conclusions:Serum TMAO is closely related to the severity and recent clinical prognosis of patients with sepsis, and is a risk factor for the death of patients with sepsis.

15.
Chinese Critical Care Medicine ; (12): 979-984, 2021.
Article in Chinese | WPRIM | ID: wpr-909438

ABSTRACT

Objective:To observe the protective effect of Angong Niuhuang pill on brain function of rats with sepsis, explore its protective mechanism, and provide the experimental basis for clinical application of Angong Niuhuang pill in the treatment of sepsis-associated encephalopathy (SAE).Methods:Thirty male Sprague-Dawley (SD) rats were divided into sham operation group, sepsis model group and Angong Niuhuang pill group according to random number table method, with 10 rats in each group. The sepsis model was established by cecal ligation and puncture (CLP); rats in sham operation group received open and closed abdomen. The rats in the Angong Niuhuang pill group were given Angong Niuhuang pill (0.3 g/kg) by gastric irrigation daily for 3 days before CLP, and the drugs were administrated 12 hours after modeling again. After 24 hours of CLP, the neuroreflex scores were evaluated, white blood cell count (WBC), the levels of serum neuron-specific enolase (NSE) and S100β were detected. Then the brain tissue was harvested. After hematoxylin-eosin (HE) staining, the pathological changes of brain tissue were observed under the light microscope. The mRNA expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in brain tissue were detected by polymerase chain reaction.Results:Compared with the sham operation group, the total score of neuroreflex scores in the sepsis model group and the Angong Niuhuang pill group were significantly reduced (4.43±1.40, 6.57±1.90 vs. 9.40±0.84, both P < 0.05), WBC, serum NSE, S100β were significantly increased [WBC (×10 9/L): 8.07±1.32, 5.84±0.94 vs. 3.60±0.32; NSE (μg/L): 1.04±0.14, 0.61±0.07 vs. 0.16±0.04; S100β (ng/L): 255.624±30.25, 97.72±15.41 vs. 46.88±12.03, all P < 0.05], and the mRNA expressions of IL-6 and TNF-α in brain tissue were significantly increased [IL-6 mRNA (2 -ΔΔCt): 5.668±2.195, 3.605±1.014 vs. 0.997±0.329; TNF-α mRNA (2 -ΔΔCt): 18.996±0.913, 1.746±0.710 vs. 0.674±0.132, all P < 0.05]. Compared with the sepsis model group, the total score of neuroreflex scores in the Angong Niuhuang pill group was significantly increased (6.57±1.90 vs. 4.43±1.40, P < 0.05), WBC, serum NSE, S100β concentration, and the mRNA expressions of IL-6 and TNF-α in the brain were significantly reduced [WBC (×10 9/L): 5.84±0.94 vs. 8.07±1.32, NSE (μg/L): 0.61±0.07 vs. 1.04±0.14, S100β (ng/L): 97.72±15.41 vs. 255.62±30.25, IL-6 mRNA (2 -ΔΔCt): 3.605±1.014 vs. 5.668±2.195, TNF-α mRNA (2 -ΔΔCt): 1.746±0.710 vs. 18.996±0.913, all P < 0.05]. Brain histopathological observation showed that the hippocampal neurons in the sepsis model group were disordered arrangement, a large number of neuronal nuclei were contracted, and the tissue was loose with obvious edema. Compared with the sepsis model group, the Angong Niuhuang pill group had less nuclear shrinkage and tissue edema. Conclusions:The pretreatment of the Angong Niuhuang pill can improve the brain dysfunction of septic rats and reduce the expression of pro-inflammatory cytokines in the brain. It is speculated that the Angong Niuhuang pill can protect the brain function in sepsis by inhibiting the inflammatory reaction in the brain.

16.
Article in Chinese | WPRIM | ID: wpr-909269

ABSTRACT

Objective:To investigate the analgesic efficacy of dexmedetomidine combined with fentanyl citrate injection in patients undergoing laparoscopic appendectomy and its effects on inflammatory factor level.Methods:200 patients with appendicitis who underwent laparoscopic appendectomy in Hangzhou Dajiangdong Hospital from April 2017 to March 2019 were included in this study. They were randomly assigned to receive postoperative anesthesia either with fentanyl citrate injection alone (control group, n = 100) or fentanyl citrate injection combined with dexmedetomidine (observation group, n = 100). At different time points after surgery, Visual Analogue Scale (VAS) score was compared between the two groups. Inflammatory factors C-reactive protein, interleukin-6, and tumor necrosis factor-α levels before and after surgery, and the incidence of adverse reactions were compared between the two groups. Results:At 6, 12, 24 and 48 hours after surgery, VAS score in the observation group was significantly lower than that in the control group ( t = 4.671, 9.594, 10.877 and 12.358, all P < 0.001). Before surgery, there were significant differences in C-reactive protein, interleukin-6, and tumor necrosis factor-α levels between the two groups ( t = 0.224, 0.188, 0.421, all P > 0.05). At 24 hours after surgery, C-reactive protein, interleukin-6, and tumor necrosis factor-α levels in each group were significantly increased compared with before surgery, and C-reactive protein, interleukin-6, and tumor necrosis factor-α levels in the observation group were significantly lower than those in the control group ( t = 2.496, 2.209, 3.165, all P < 0.05). There was no significant difference in the incidence of adverse reactions between the control and observation groups [8.00% (8/100) vs. 10.00% (10/100), χ2 = 0.244, P > 0.05]. Conclusion:Dexmedetomidine combined with fentanyl citrate injection exhibits good and anesthesic and analgesic effects during laparoscopic appendectomy, helps inhibit the expression of inflammatory factors, reduces the level of inflammatory factors, leads to less adverse reactions, and is highly safe.

17.
Article in Chinese | WPRIM | ID: wpr-909243

ABSTRACT

Objective:To investigate the effect of Naoxintong capsule combined with butylphthalide injection on inflammatory factors, oxidative stress response and hemorheology in patients with acute cerebral infarction. Methods:Eighty-six patients with acute cerebral infarction who received treatment in Zhuji Hospital of Traditional Chinese Medicine from December 2017 to December 2019 were included in this study. Thrombolysis and thrombectomy were contraindicated in these patients. They were randomly assigned to receive treatment either with butylphthalide injection (control group, n = 43) or butylphthalide injection and Naoxintong capsule (observation group, n = 43) for 2 weeks. Therapeutic effects, Barthel Index, inflammatory factors (C-reactive protein, intercellular adhesion molecule-1 and interleukin-6), oxidative stress response (malondialdehyde and superoxide dismutase) and hemorheology (whole blood viscosity at high and low shear rates, plasma viscosity and fibrinogen) were compared between the two groups. Results:Total effective rate in the observation group was significantly higher than that in the control group (93.02% vs. 72.09%, χ2 = 6.541, P < 0.05). After treatment, Barthel Index in the observation group was significantly higher than that in the control group [(61.51 ± 5.24) points vs. (50.43 ± 4.81) points, t = 10.215, P < 0.05). After treatment, serum levels of C-reactive protein, intercellular adhesion molecule-1, and interleukin-6 in the observation group were (4.42 ± 1.03) mg/L, (84.23 ± 5.05) μg/L and (94.33 ± 10.22) μg/L, respectively, which were significantly lower than those in the control group [(8.32 ± 1.71) mg/L, (103.51 ± 6.35) μg/L, (118.92 ± 13.31) μg/L, t = 12.810, 15.583, 9.609, all P < 0.05]. After treatment, serum malondialdehyde level in the observation group was significantly lower than that in the control group [(3.76 ± 0.78) μmol/L vs. (4.94 ± 0.90) μmol/L, t = 6.497, P < 0.05]. Serum superoxide dismutase level in the observation group was significantly higher than that in the control group [(35.76 ± 2.65) U/L vs. (30.34 ± 2.11) U/L, t = 10.492, P < 0.05]. After treatment, whole blood viscosity at high and low shear rates, plasma viscosity and fibrinogen levels in the observation group were (4.10 ± 0.51) mPa · s, (9.31 ± 1.36) mPa · s, (1.24 ± 0.26) mPa · s and (2.71 ± 0.40) g/L respectively, which were significantly lower than those in the control group [(5.72 ± 0.76) mPa · s, (11.49 ± 1.59) mPa · s, (2.21 ± 0.32) mPa · s and (3.92 ± 0.54) g/L, t = 11.607, 6.832, 15.427 11.807, all P < 0.05). Conclusion:Naoxintong capsule combined with butylphthalide injection is highly effective in the treatment of acute cerebral infarction. It can reduce inflammatory reaction and improve oxidative stress response and hemorheological changes.

18.
Article in Chinese | WPRIM | ID: wpr-909237

ABSTRACT

Objective:To investigate the effects of hydromorphone on early postoperative recovery, postoperative analgesia and stress response in patients undergoing laparoscopic radical resection of colorectal cancer.Methods:120 patients with colorectal cancer who underwent laparoscopic radical resection of colorectal cancer in Taizhou Hospital of Zhejiang Province from June 2019 to June 2020 were included in this study. They were randomly assigned to undergo either postoperative patient-controlled intravenous analgesia with hydromorphone (observation group, n = 60) or postoperative patient-controlled intravenous analgesia with sugentanil (control group, n = 60). The changes of perioperative indexes, postoperative recovery, Visual Analogue Scale score at 3, 12 and 24 hours post-surgery, stress response [norepinephrine, interleukin-6 and cortisol] before and 3 days after surgery were compared between the two groups. Results:There were no significant differences in operative time and intraoperative blood loss between the two groups (both P > 0.05). The time to intestinal peristalsis, the time to getting out of bed, and the time to drainage tube removal in the observation group were (57.83 ± 8.98) hours, (43.12 ± 2.34) hours, and (121.38 ± 10.29) hours, which were significantly shorter than those in the control group [(65.21 ± 7.45) hours, (45.46 ± 2.19) hours and (150.28 ± 13.42) hours, t = 4.899, 5.656 and 13.238, all P < 0.05]. Visual Analogue Scale score in the observation group at 12 and 24 hours after surgery was (1.89 ± 0.27) points and (1.45 ± 0.23) points, respectively, which was significantly lower than that in the control group [(2.19 ± 0.24) points, (1.84 ± 0.20) points, t = 6.433, 9.911, both P < 0.05]. At 3 days after surgery, serum levels of norepinephrine, interleukin-6 and cortisol in the observation group were (185.49 ± 18.29) ng/L, (59.91 ± 6.89) ng/L, and (109.21 ± 15.46) μg/L, respectively, which were significantly lower than those in the control group [(235.41 ± 16.57) ng/L, (73.24 ± 7.68) ng/L, (128.39 ± 10.32) μg/L, t = 15.668, 10.008, 7.993, all P < 0.05]. Conclusion:Hydromorphone exhibits a good effect on laparoscopic radical resection of colorectal cancer because it can promote early postoperative recovery, has an obvious postoperative analgesic effect and little influence on stress response.

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Article in Chinese | WPRIM | ID: wpr-909219

ABSTRACT

Objective:To investigate the clinical effect of compound Xianzhuliye combined with compound ipratropium bromide in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease. Methods:160 patients with acute exacerbation of chronic obstructive pulmonary disease who received treatment in Zhejiang Putuo Hospital from December 2019 to December 2020 were included in this study. They were randomly assigned to receive either routine treatment combined with compound ipratropium bromide (control group, n = 80) or routine treatment, compound ipratropium bromide and compound Xianzhuliye in combination (observation group, n = 80) for 14 successive days. Curative effects, blood gas analysis indexes (arterial partial pressure of oxygen, oxygenation index and arterial partial pressure of carbon dioxide), respiratory mechanics indexes (peak airway pressure, airway resistance and mean airway pressure), changes in lung function [percentage of predicted forced expiratory volume in 1 second forced expiratory volume in one second (FEV 1%), FEV 1/forced vital capacity], inflammatory factors (C-reactive protein, interleukin-6 and procalcitonin) before and after treatment were compared between the control and observation groups. Results:Total effective rate in the observation group was significantly higher than that in the control group [90.00% vs. 76.25%, χ2 = 5.391, P < 0.05]. After treatment, arterial partial pressure of oxygen and oxygenation index in the observation group were (62.17 ± 6.19) mmHg and (258.83 ± 25.45) mmHg, respectively, which were significantly higher than those in the control group [(53.86 ± 5.46) mmHg, (210.93 ± 23.12) mmHg, t = 9.005, 12.460, both P < 0.05]. After treatment, arterial partial pressure of carbon dioxide in the observation group was significantly lower than that in the control group [(46.89 ± 5.25) mmHg vs. (57.12 ± 4.12) mmHg, t = 13.711, P < 0.05]. After treatment, peak airway pressure in the observation group was significantly higher than that in the control group [(37.87 ± 3.25) cmH 2O vs. (30.82 ± 4.26) cmH 2O, t = 11.768, P < 0.05]. After treatment, airway resistance and mean airway pressure in the observation group were (6.75 ± 1.82) cm H 2O/L/s and (7.34 ± 1.30) cm H 2O, respectively, which were significantly lower than those in the control group [(9.82 ± 2.10) cm H 2O/L/s and (9.12 ± 1.23) cm H 2O, t = 9.881, 8.896, both P < 0.05). After treatment, FEV 1%, FEV 1/ forced vital capacity in the observation group were (67.31 ± 4.56)% and (61.23 ± 3.67)%, respectively, which were significantly higher than those in the control group [(58.98 ± 3.67)%, (52.18 ± 4.68)%, t = 12.729, 13.610, both P < 0.05). After treatment, C-reactive protein, interleukin-6 and procalcitonin in the observation group were (8.86 ± 1.53) mg/L, (65.87 ± 12.90) ng/L and (0.15 ± 0.04) μg/L, respectively, which were significantly lower than those in the control group [(19.90 ± 3.56) mg/L, (109.32 ± 19.76) ng/L and (0.34 ± 0.07) μg/L, t = 25.484, 16.469, 21.079, all P < 0.05). Conclusion:Compound Xianzhuliye combined with compound ipratropium bromide in the treatment of acute exacerbation of chronic obstructive pulmonary disease can acquire good clinical curative effects through improving blood gas analysis indexes, respiratory mechanics indexes and lung function, and reduce inflammatory reactions.

20.
Article in Chinese | WPRIM | ID: wpr-909208

ABSTRACT

Objective:To investigate the effects of thrombolytic therapy time on serum inflammatory factors, cathepsin S, connective tissue growth factor (CTGF), left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) in patients with acute ST-elevation myocardial infarction.Methods:The clinical data of 119 patients with acute ST-elevation myocardial infarction who received thrombolytic therapy in the People's Hospital of Taierzhuang District of Zaozhuang from January 2019 to May 2020 were retrospectively analyzed. These patients were assigned to three groups according to different time points at which thrombolytic therapy was performed: group A (the time from onset to thrombolytic therapy ≤ 3 hours, n = 27), group B (3 hours < the time from onset to thrombolytic therapy ≤ 6 hours, n = 39), group C (6 hours < the time from onset to thrombolytic therapy ≤ 12 hours, n = 53). Recanalization rate, recanalization time, ST segment resolution rate at 2 and 12 hours, serum levels of inflammatory factors [including interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP)], cathepsin S, CTGF, LVEF, and LVEDD, and incidence of cardiovascular adverse events. Results:Recanalization time in group C was (148.73 ± 15.37) minutes, which was significantly longer than that in groups A and B [(89.34 ± 8.95) minutes, (98.76 ± 9.33) minutes]. Recanalization rate and ST segment resolution rate at 2 and 12 hours in group C were 45.28%, (40.17 ± 4.77) %, (73.92 ± 8.24) %, respectively, which were significantly lower than those in the groups A and B [96.30%, 79.49%, (47.42 ± 5.12)%; (83.68 ± 9.33)%, (43.56 ± 4.87)%, (78.73 ± 8.44)%] ( t/ χ2 = 248.088, 4.244, 20.204, 11.146, 18.508, 19.861, 6.271, 4.789, 17.995, 10.932, 3.339, 4.111, 4.100, 3.828, 3.100, 2.244, all P < 0.05). At 2 and 12 hours after thrombolytic therapy, IL-6, TNF-α and hs-CRP levels in group C were (23.29 ± 2.12) ng/L, (27.03 ± 2.75) ng/L, (6.49 ± 2.37) mg/L, (22.73 ± 2.05) ng/L, (26.24 ± 2.37) ng/L and (6.01 ± 2.53) mg/L, respectively, which were significantly higher than those in groups A and B ( t = 54.578, 54.578, 10.638, 8.584, 8.735, 5.199, 7.909, 7.171, 3.597, 1.382, 1.584, 1.008, 7.237, 5.190, 4.364, 8.829, 11.114, 2.585, 3.172, 6.815, 2.196, all P < 0.05). At 2 and 12 hours after thrombolytic therapy, cathepsin S and CTGF levels in group C were (29.97 ± 3.98) μg/L, (30.03 ± 4.79) μg/L, (28.05 ± 2.13) μg/L, (28.29 ± 4.31) μg/L, respectively, which were significantly higher than those in groups A and B [(31.74 ± 3.56) μg/L, (29.87 ± 4.91) μg/L; (20.81 ± 2.35) μg/L, (16.94 ± 3.46) μg/L; (30.95 ± 3.79) μg/L, (29.93 ± 4.95) μg/L; (26.37 ± 2.44) μg/L, (21.46 ± 4.79) μg/L, t = 93.870, 68.555, 15.039, 12.562, 6.345, 7.679, 3.096, 1.966, 13.882, 3.514, 11.863, 7.164, 9.239, 4.199, all P < 0.05). At 2 and 12 hours after thrombolytic therapy, LVEF and LVEDD in group C were (42.81 ± 4.77)%, (52.64 ± 4.71) mm, (43.13 ± 5.11)%, (51.57 ± 4.01) mm, respectively, which were significantly lower than those in groups A and B [(42.61 ± 4.58)%, (52.31 ± 4.47) mm, (46.33 ± 4.35)%, (47.75 ± 3.41) mm, (42.73 ± 4.79)%, (52.79 ± 4.76) mm, (44.79 ± 4.44)%, (49.93 ± 3.73) mm, t = 4.285, 9.193, 3.060, 4.214, 1.970, 2.953, 0.333, 1.259, 2.779, 1.626, 4.229, 1.996, 1.404, 2.416, all P < 0.05). The total incidence of cardiovascular adverse events was 7.41%, 12.82% and 33.96% in groups A, B and C, respectively ( χ2 = 4.383, all P < 0.05). Conclusion:The earlier the thrombolytic therapy time after acute ST-elevation myocardial infarction, the higher the recanalization rate and ST segment resolution rate, the milder the inflammatory reaction, atherosclerosis, the better the cardiac remodeling, the better the recovery of cardiac function, and the lower the incidence of cardiovascular adverse events.

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