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Anticoagulation therapy stands as a key treatment for thrombotic diseases. The consequential bleeding risk tied to existing anticoagulation methods significantly impacts patient prognosis. In the intensive care unit (ICU), patients often necessitate organ support, leading to the inevitable placement of artificial devices in blood vessels, thereby requiring anticoagulation treatment to avert clot formation that might impede organ support. Nevertheless, these patients commonly encounter a heightened risk of bleeding. Hemophilia B, identified in 1953, manifests as a deficiency in coagulation factor Ⅺ (FⅪ), which focused people's perspective on the endogenous coagulation pathway, that is, the contact pathway. Upon interaction between the surface of artificial devices and FⅫ, FⅫ activates, subsequently triggering FⅪ and initiating the "coagulation cascade" within the contact pathway. Inhibitors targeting the contact pathway encompass two primary categories: FⅫ inhibitors and FⅪ inhibitors, capable of impeding this process. This article reviews the role of FⅫ and FⅪ in activating the contact pathway, seeking to illuminate their contributions to thrombus formation. By listing the relatively mature drugs and their indications, clinicians are familiar with this new anticoagulant.
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Objective@#To evaluate the influence of electronic sports games on children s acquisition of basic motor skills, so as to provide assistance for childrens acquisition of basic motor skills in the context of digital society.@*Methods@#Computer searches were conducted on CNKI, Web of Science, Cochrane Library and PubMed databases from March 2012 to March 2022. Methodological quality of included studies was evaluated using the Cochrane bias risk assessment tool RoB 2 and the extension tools RoB 2 Cluster and ROBINS-I. Publication bias assessment, heterogeneity test, subgroup analysis and Meta analysis were performed using RevMan 5.3.@*Results@#A total of 12 studies included 897 participants, 7 randomized controlled trials, 2 cohort randomized controlled trials and 3 non randomized trials. Among them, 2 items had a low risk of bias, 8 items had certain risks and 2 items had a high risk of bias. Measures of basic motor skills in children from 12 studies included object control skills, motor skills, coordination, agility and balance. The results of Meta analysis showed that electronic sports games had a positive effect on children s acquisition of basic motor skills ( SMD=0.81, 95%CI=0.46-1.17, P <0.05).@*Conclusion@#Children can generate positive interactive communication behavior through physical activity and digital screen, and then promote the development of basic motor skills.
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BACKGROUND:At present,effective preventive and therapeutic measures for hypertrophic scar are still limited.In contrast,most of botanical herbs have few side effects and abundant sources,offering new ideas and approaches for the prevention and treatment for hypertrophic scar. OBJECTIVE:To explore the potential molecular mechanism of plant-derived β-sitosterol on hypertrophic scar fibroblasts by network pharmacology and molecular docking techniques and to initially verify it by cytological experiments. METHODS:Through the network pharmacology,the relevant database and software were used to screen the drug targets of β-sitosterol and obtain the hypertrophic scar-related disease targets.The potential(intersection)targets of β-sitosterol on hypertrophic scar were obtained.Cytoscape software and STRING database were used to construct the"drug-target-disease"network and protein-protein interaction network,and screen out the core targets in the protein-protein interaction network.Gene ontology(GO)biological function and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses of intersection targets were conducted through the DAVID database,and the signaling pathways and core target genes closely related to the intersection targets were further identified through literature analysis.AutoDock software was used to perform the molecular docking of β-sitosterol and core target proteins.In vitro cellular assays were used to verify the effects of β-sitosterol on proliferation,apoptosis,cell cycle distribution and mRNA expression of core target genes in human hypertrophic scar fibroblasts. RESULTS AND CONCLUSION:There were 56 intersection targets of β-sitosterol and hypertrophic scar and 10 core targets were identified in the protein-protein interaction network,including tyrosine kinase,mitogen-activated protein kinase 3(MAPK3),cysteine protease 3(CASP3),apolipoprotein E,estrogen receptor 1,sterol regulatory element-binding transcription factor 1,peroxisome proliferator-activated receptor alpha,C-reactive protein,intercellular adhesion molecule 1,and catalase.Combined with the literatures and the functional analysis of the KEGG and GO,the MAPK signaling pathway was further identified to be closely related to the intersection targets,and MAPK3(ERK1-MAPK),CASP3,P53 and tumor necrosis factor were identified as the core targets.The molecular docking results indicated that β-sitosterol was well bound to the core target proteins.Cellular assays showed that 100 μmol/L β-sitosterol inhibited hypertrophic scar fibroblast proliferation,decreased mitochondrial membrane potential and induced apoptosis(P<0.01),increased the proportion of G1-phase cells and decreased the proportion of S-phase cells(P<0.05),upregulated the mRNA expression of CASP3,P53 and tumor necrosis factor(P<0.05),and downregulated the mRNA expression of MAPK3(P<0.001).To conclude,β-sitosterol may induce cell apoptosis in hypertrophic scar fibroblasts by activating the tumor necrosis factor pathway and upregulating the expression of CASP3 and P53,while inhibiting the ERK-MAPK pathway to arrest cell cycle and thus reduce the proliferation of hypertrophic scar fibroblasts.
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BACKGROUND:Hypertrophic scar is a skin fibrosis disease characterized by excessive proliferation of fibroblasts,epidermal thickening,and stratum corneum dysfunction.At present,the pathogenesis of Hypertrophic scar is still unclear. OBJECTIVE:To screen the core(Hub)genes and important signaling pathways in hypertrophic scar-related datasets based on bioinformatics,and then verify them by cell experiments to predict small molecule drugs that may have therapeutic effects on hypertrophic scar. METHODS:Datasets related to hypertrophic scar were searched from Gene Expression Omnibus(GEO)database,and differentially expressed genes were identified by R software analysis.Gene ontology and KEGG enrichment analyses were performed for differentially expressed genes.Protein-protein interaction network of differentially expressed genes was constructed using String online platform.Then,the key genes and core modules in the protein-protein interaction network were screened by Cytohubba and MCODE plugin-in Cytoscape software respectively,and the Hub genes were obtained by the intersection of the above key genes and the genes that formed the core module.Real-time fluorescent quantitative PCR was used to verify the difference in Hub gene mRNA expression between human hypertrophic scar and normal skin epidermal stem cells.The histological data from the Human Protein Atlas were used to verify the differences in the expression and distribution of Hub gene-encoded proteins in the two kinds of human tissues.Finally,the potential drugs for hypertrophic scar were predicted by the connectivity map database. RESULTS AND CONCLUSION:Among the identified differentially expressed genes,102 genes were up-regulated and 702 genes were down-regulated.Gene ontology and KEGG analysis showed that the enriched signaling pathways and biological processes were mainly involved in tight junction,arachidonic acid metabolism,extracellular matrix receptor interaction,epidermal development and keratinization.Eight Hub genes were found to be closely related to the mevalonate pathway that regulates cholesterol metabolism,including HMGCS1,DHCR7,MSMO1,FDPS,MVK,HMGCR,MVD and ACAT2.Compared with the normal skin group,the mRNA expression of HMGCS1,DHCR7,MSMO1,FDPS,HMGCR,MVD and ACAT2 in the hypertrophic scar group decreased significantly(P<0.05),while MVK mRNA expression had no significant change(P>0.05).Except for MVK,the expression levels of other Hub gene-encoded proteins in normal skin tissue were higher than those in hypertrophic scar tissue(P<0.05).The top 10 candidate drugs included protein kinase A inhibitor(H-89),serine protease inhibitor(Dabigatran-Etexilate),FLT3 inhibitor(sunitinib),among which resveratrol and β-sitosterol are plant extracts.To conclude,Hub genes closely related to mevalonate metabolism may affect the structure and function of the epidermis by regulating lipid metabolism,which may an important pathogenesis of hypertrophic scar.The small-molecule compounds identified in this study can be used as candidate drugs for the treatment of hypertrophic scar.
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Objective To evaluate the effect of preoperative pulmonary artery pressure on perioperative prognosis of the recipients with end-stage heart failure undergoing heart transplantation. Methods Clinical data of 105 recipients receiving heart transplantation were retrospectively analyzed. The mean pulmonary artery pressure (mPAP) was used as the diagnostic criterion. The optimal cut-off value of mPAP for predicting perioperative prognosis of heart transplant recipients was determined. According to the optimal cut-off value of mPAP, all recipients were divided into the low mPAP group (n=66) and high mPAP group (n=39). Intraoperative indexes (cardiopulmonary bypass time, aortic occlusion time, assisted circulation time and cold ischemia time of donor heart) and postoperative indexes [intra-aortic balloon pump (IABP) support rate, IABP support time, extracorporeal membrane oxygenation (ECMO) support rate, ECMO support time, mechanical ventilation time, length of ICU stay, incidence of moderate and severe tricuspid regurgitation and perioperative mortality rate] were compared between the low and high mPAP groups. The prognosis of the two groups was compared. Results The optimal cut-off value of mPAP in predicting clinical prognosis of heart transplant recipients was 30.5 mmHg. In the high mPAP group, the ECMO support rate and perioperative mortality rate were higher than those in the low mPAP group (both P < 0.05). No significant differences were observed in the cardiopulmonary bypass time, aortic occlusion time, assisted circulation time, cold ischemia time of donor heart, IABP support rate, IABP support time, ECMO support time, mechanical ventilation time, length of ICU stay and incidence of moderate and severe tricuspid regurgitation between two groups (all P > 0.05). No significant differences were noted in the 1-, 2-, 3- and 4- survival rates between two groups (all P > 0.05). Conclusions Preoperative mPAP in patients with end-stage heart failure is intimately correlated with perioperative prognosis of heart transplant recipients. The optimal cut-off value of mPAP in predicting perioperative prognosis of heart transplant recipients is 30.5 mmHg. In the high mPAP group, perioperative ECMO support rate and perioperative mortality rate are high, which do not affect the medium and long-term prognosis of the recipients undergoing heart transplantation.
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The global coronavirus disease 2019 epidemic is still in a pandemic state. Aging population with underlying diseases is prone to become severe, and have a higher mortality. The treatment capacity of the critical care department directly determines the treatment success rate of critical illness. At present, there is still a certain gap between domestic and foreign countries in intensive care unit (ICU), which is not only in the allocation of medical staff, but also in the beds and settings. The current medical model cannot fully meet the needs of development. The experience and lessons of many major public health emergencies suggested that " dual track of peace and war" approach in discipline construction of critical care is the best medical model. Following the concept of "combination of peace and war", strengthening the discipline construction of critical care department in municipal and district designated hospitals, allocating reasonable standard ICU, step-down ICU and combat readiness ICU, establishing rapid response team, and strengthening regular training and scientific management may be the key measures to deal with the epidemic.
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Objective To study the relationship between heparin-binding protein(HBP) and β2 integrin on the surface of neutrophil in acute lung injury.Methods A total of 30 mice from animal center of Tongji University were divided into control group,CLP group and antibody-treatment group by random number method.Acute lung injury animal model was established by cecal Ligation and puncture in the mice of CLP group and antibody-treatment group.Sham operations were performed on the mice in control group.Mice in antibody-treatment group received anti-CD18 antibody injected via tail vein 30 min before establishing acute lung injury animal model.Twenty-four hours after operation,mice were sacrificed and lung tissue was taken.After HE staining,lung injury were evaluated by Smith score.Lung tissue wet/dry weight ratio,BALF protein level,plasma HBP level and β2 integrin on neutrophil were measured.T test were used to compare the difference among groups.Pearson correlation was used to study the correlation between HBP,integrin and lung injury index.Results Compared with control group,mice in CLP group had higher Smith score(t=10.607,P<0.01),lung wet/dry ratio(t=3.968,P=0.001),BALF protein level(t=4.331,P<0.01) and as well as higher plasma HBP(t=3.515,P=0.002) and β2 integrin(t=4.816,P<0.01) level.After CD18 antibody treatment,anti-treat group mice had lower Smith score (t=2.307,P=0.033),lung wet/dry ratio(t=3.080,P=0.006),BALF protein level(t=2.484,P=0.023) and as well as higher plasma HBP level(t=2.218,P=0.046) than mice in CLP group.Pearson correlation analysis showed HBP had obvious correlation with wet/dry ratio(r=0.527,P=0.017),BALF protein(r=0.508,P=0.022) and as well as β2 integrin(r=0.674,P=0.001).Conclusions Both HBP and β2 integrin involved in the lung injury pathogenesis.HBP level is interrelated with the severity of lung injury.The β2 integrin is associated with the release of HBP by neutrophil.Inhabiting the function of integrin could decrease HBP level and alleviate the severity of lung injury.
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Objective To study diaphragmatic strength in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) during mechanical ventilation (MV), and to explore the predictive value of maximal transdiaphragm pressure (Pdi max) for successful extubation. Methods A prospective study was conducted. Twenty-one patients with AECOPD receiving MV admitted to intensive care unit (ICU) of Shanghai East Hospital of Tongji University of School Medicine from February 2015 to May 2017 were enrolled. Pdi max value was measured by using esophageal and gastric balloon catheters within 24 hours of intubation until the day the patient underwent extubation or died. In addition, the C-reactive protein (CRP), serum albumin (Alb) and prealbumin (PA) during MV were recorded. Pearson correlation was used to analyze the correlations between Pdi max and CRP, Alb and PA. The receiver operating characteristic curve (ROC) was used to cumulate Pdi max value of the successful weaning. Results Tracheotomy was done in 2 patients, and 2 patients quit the study. The remaining 17 patients were included in the investigative protocol. Six of the 17 patients died and 11 patients were successfully extubated. ① Mean Pdi max decreased progressively over time in 17 patients of AECOPD during MV. There were no significant changes in Pdi max at 1-2 days of MV. Mean Pdi max at 7 days was significantly lower than that at 3 days [cmH2O (1 cmH2O = 0.098 kPa): 20.2±4.2 vs. 28.1±4.4, P < 0.01]. By the end of the evaluation period at 11 days of MV, mean Pdi max decreased about 38.7% to the 1 day of MV (cmH2O: 19.8±4.7 vs. 32.3±3.9, P < 0.01). During MV, CRP, Alb and PA showed a downward trend. ② Mean Pdi max and the Pdi max before extubation in patients with difficulty extubation from MV was lower than that in successful weaning [Mean Pdi max (cmH2O): 25.2±5.4 vs. 28.9±5.8, Pdi max before extubation (cmH2O): 16.9±2.8 vs. 26.8±6.6, both P < 0.01]. ③ There was significantly negative correlation between Pdi max value and CRP (r = -0.799, P = 0.000). There was significantly positive correlation between Pdi max value and serum Alb (r = 0.613, P = 0.008) and PA (r = 0.661,P = 0.004). ④ ROC curve analysis showed that the area under the ROC curve (AUC) for predicting weaning success in the patients with AECOPD was 0.902. The sensitivity of the diagnosis was 81.8% and the specificity was 100% when cut-off value of Pdi max was 23.2 cmH2O. Conclusions MV induced the reduction of diaphragmatic contractility in a time-dependent manner. The Pdi max in patients with difficult extubation from MV was lower than that in successful weaning. The Pdi max could be a parameter to predict the successful extubation in patients with AECOPD during MV.
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Diaphragm is the principal respiratory muscle.Diaphragm dysfunction resulting from mechanical ventilation,chronic cardiopulmonary disease,medicine,cardio-thoracic surgery,septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay.Traditionally,the method of assessment of diaphragm structure and function was invasive,lacking specific,and was difficult to be used bedside.A number of recent studies have been suggested that ultrasonographic evaluation has been proposed as an accurate,safe and noninvasive method of quantification of diaphragm structure and function.This article reviews the related researches of technique and the clinical applications of ultrasonography in the evaluation of diaphragmatic structure and function,which may possibly result in timely identification of patients with diaphragm dysfunction and improve the assessment of recovery from diaphragm weakness.
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Objective To investigate the effects of botulinum toxin type A on the proliferation,apoptosis and ERK/MAPK signaling pathway of human hypertrophic scar fibroblasts in vitro.Methods Fibroblasts were isolated from human hypertrophic scar and cultured by tissue explant method.The cells were divided into control and botulinum toxin type A groups.The botulinum toxin group A was cultured in DMEM medium containing 0.4U/L botulinum toxin type A.The control group was cultured with DMEM alone.Cell proliferation was measured by CCK8 kit at days 1,3,5 and 7 and compared within groups.Apoptosis of fibroblasts was detected by flow cytometry which treated with botulinum toxin and control group.Western blot was used to detect the relative expression of collagen Ⅰ,p-ERK1/2 and total ERK protein in fibroblasts of control,botulinum toxin type A and U0126 groups.Results Botulinum toxin type A could significantly inhibit the proliferation of fibroblasts,the number of cells was only 68.9% in the control group at 7th days.The apoptotic rate of botulinum toxin type A was 35.9%,which was significantly higher than that of the control group.ERK 1/2 protein expression in the three groups was not significantly different (P > 0.05),while p-ERK 1/2 expression in the control group was still significantly higher,but the p-EKR 1/2 in botulinum toxin type A and U0126 group was significantly inhibited.Collagen Ⅰ was highly expressed in the control group,which was significantly higher than that in the botulinum toxin type A and U0126 groups (P < 0.05).Conclusion Botulinum toxin type A can inhibit the ERK/MAPK signaling pathway and increased fibroblasts apoptosis,decreased proliferation activity and collagen Ⅰ secretion.
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Objective To investigate the morphological characteristics and proliferation ability of diabetes mellitus-derived adipose-derived stem cells (ADSCs) by comparing with normal-derived ADSCs.Methods The ADSCs could be achieved from diabetes mellitus' adipose tissue by the similar method of normal ADSCs isolation and culture,and then the differnce was compared between the two groups about their morphologies under microscope,and the proliferation ability of two groups was determined by CCK-8.Results ADSCs in patients with diabetes were obvious hypertrophy and irregular in morphology.A values of ADSCs in diabetes and non-diabetes were 0.210+0.002 and 0.390+0.006 in 1st day;0.250+0.015 and 0.443+0.023 in 2nd day;0.368+0.014 and 0.726+0.033 in 3rd day;0.368+0.014 and 0.726+0.033 in 4th day;1.767+0.072 and 3.153+0.067 in 5th day and 1.810+0.072and 3.170+0.021 in 6th day,respectively.The difference was statstically significant at the beginning from 4th day (P<0.05).Conclusions There is obvious difference of the microscopic morphology between the diabetes mellitus-derived ADSCs and normal-derived ADSCs.The proliferation ability of the diabetes mellitus-derived ADSCs is lower than normal-derived ADSCs.These difference could be closely related to ulcerous non-healing wounds in patients with diabetes mellitus.
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Background. To explore the effect of ASMq on proliferation and migration ability of the fibroblast derived from HS of donor (HSFbs) in vitro. Methods. The HSFbs were cultured from tissue specimens and passaged to the 3~4 generation, which were treated with the different concentrations of ASMq and 5-Fu from 1 to 11 days. The difference of HSFbs proliferation activity was analyzed by the CCK-8 method. The HSFbs migration ability in ASMq (0.4 mg/mL) was analyzed by the Cell Scratch method. Results. Transmission electron microscope result shows ASMq concentration significantly increases and fibroblast cell structure markedly change in the experimental group. The proliferation activity of the HSFbs was obviously weakened in ASMq groups than those of the group A (P < 0.05) at seven days. The group C (0.4 mg/mL) is better suitable than other three ASMq treatment groups. Cell Migration Assay shows that the migration ability HSFbs was significantly reduced in ASMq (0.4 mg/mL) treatment group compared with those of blank control group at both 24 h and 48 h (P < 0.05). Conclusions. These results suggest that ASMq effectively restrains the proliferation and migration ability of the HTSFbs in vitro, which can be one of the mechanisms for the prevention and treatment of HS.
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OBJECTIVE: To investigate the clinical effect of steroids on reducing postoperative edema in rhinoplasty. METHODS: Cochrane, Medline data, Pubmed date, were searched and updated on October 2013. Randomized controlled trials(RCTS) studies were included to assess the efficacy of steroids on decreasing postoperative edema after rhinoplasty. The methodological quality of the included studies was evaluated, and date analyses were performed using the Cochrane Collaboration's software RevMan 5.2. RESULTS: A total of 4 RCTS involved 172 patients with rhinoplasty, including 87 patients in the experimental group( steroid) and 85 paitents in control group (placebo). Meta analysis results showed the edema in experimental group was significantly less than that in the control group on postoperative day 1 and 3 (P < 0.01), while the difference was not significant on postoperative day 7 (P = 0.19). CONCLUSIONS: Perioperative application of steroid in rhinoplasty can significantly reduce periorbital edema in the first postoperative day. The edema can completely be relieved after application of steroid for 3 days. It is a safe and effective way to reduce the postoperative edema.
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Edema/tratamiento farmacológico , Rinoplastia/efectos adversos , Edema/etiología , Humanos , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Objective To explore the clinical efficacy of early surgery combined with electron linac therapy on keloid.Methods The keloid patients with stable phase were selected;complete resection of keloid and relaxation suture were performed;after the surgery within 24 hours 6 MeV with Varian 2300CD radiotherapy was given,each measuring 4 Gy,total dose of 20 Gy.Results 860 cases of patients were colected for a period of 3 months to 36 months of regular follow-up,which recovered in 802 cases (cure rate was 93.26%),effective results were observed in 41 cases (effective rate of 4.77%),including 17 cases of recurrence (recurrence rate 1.98%),the total efficiency (cure plus effective) was 98.02%.Conclusions More accurately immediate radiotherapy after surgery can effectively reduce the recurrence rate,which is a safe and effective method in the treatment of keloids.
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ObjectiveTo investigate the role of lymphocyte apoptosis and endoplasmic reticulum stress (ERS) on the development of sepsis and their association with the prognosis of sepsis patients.Methods A prospective cohort study was conducted. Seventy septic patients admitted to intensive care unit (ICU) of Shanghai East Hospital of Tongji University were enrolled. Blood samples were collected on days 1, 3 and 7 to measure percentage of circulating apoptotic lymphocyte with flow cytometry analysis. The relative expressions of endoplasmic reticulum specific glucose regulated protein 78 (GRP78) mRNA and transcription factor CHOP mRNA were measured by real-time reverse transcription-polymerase chain reaction (RT-PCR). The correlation between CHOP mRNA expression and percentage of circulating apoptotic lymphocyte was analyzed by Spearman relative analysis. The patients were divided into death (n = 23) and survival subgroups (n = 47). Twenty healthy volunteers during the same period were selected as the healthy control group.Results① Rate of lymphocyte apoptosis: compared with healthy control group [(2.86±0.66)%], septic patients, either survival or death subgroup, exhibited higher rate of lymphocyte apoptosis on days 1, 3 and 7 [survival subgroup: (12.44±4.43)%, (8.57±3.38)%, (6.78±3.35)%; death subgroup: (14.42±2.01)%, (11.32±2.53)%, (8.87±3.62)%, allP 0.05], and GRP78 mRNA expression in the death subgroup was gradually lowered, but it was still higher than that in the healthy control group [3 days: (7.27± 3.64)×10-3, 7 days: (5.23±1.94)×10-3, bothP< 0.01].④ Spearman relative analysis showed that the expression of CHOP mRNA was positively correlated with the rate of lymphocyte apoptosis (r = 0.414,P = 0.000 ).Conclusion The increase in the rate of lymphocyte apoptosis and activation of ERS play an important role in the development of sepsis, and it is associated with worse outcome in the septic patients.
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Objective To investigate the effect of calpeptin on diaphragmatic injury and atrophy under controlled mechanical ventilation in rats.Methods A total of 24 SPF Sprague-Dawley (SD) rats were randomly divided into anesthetized control group (CON group),24-hour controlled mechanical ventilation group (CMV group),and 24-hour CMV + treatment with calpeptin group (CMVC group),with 8 rats in each group.Animals in the CON group received an intraperitoneal injection of pentobarbital sodium without CMV and continuous infusion of pentobarbital sodium.A small-animal ventilator was used for 24 hours in rats of CMV group.Rats of CMVC were treated with a specific calpain inhibitor calpeptin (4 mg/kg).The drug was injected subcutaneously 2 hours before and 8,15 and 23 hours after mechanical ventilation.Changes in diaphragm ultrastructure,light microscopic picture,and myosin heavy chain (MHC) expression were observed.Results ① Alignment of myofilaments and normal Z-band,and the shape of mitochondria were maintained in CON group as revealed by electron microscope.The signs of misalignment of myofibrils,disruption of Z-band and vacuolar mitochondria were found in CMV group,and they were obviously improved in CMVC group.The density of muscle injury (× 10-2/μm2) in CMV group was significantly higher than that in control group (36.8 ± 13.7 vs.6.4 ± 6.3,t=6.373,P=0.001),and that in CMVC group was significantly lowered (17.6 ± 9.1 vs.36.8 ± 13.7,t=3.694,P=0.002).② In CON group,the diaphragm fibers appeared regular in cross section without pathologic change under light microscopy.Fuzzy muscle striations,irregular muscle fibers,centralized nuclei and swelling of capillary endothelial cells were observed in CMV group,while pathological changes in the CMVC group were milder significantly.③ In CMV group,the density of MHCslow and MHCfast was lower compared with that of CON group,and the gray value was lowered by 61.1% (t=8.138,P=0.001) and 77.1% (t=8.844,P=0.001),respectively,especially in MHCfast.However,the gray values of MHCslow and MHCfast were increased by 1.51 folds (t=4.601,P=0.010),and 1.33 folds (t=2.859,P=0.011),respectively,after treatment with calpeptin,and the elevation was more significantly in MHCslow.Conclusions Diaphragmatic injury and atrophy were found after CMV for 24 hour.Calpeptin could reverse the detrimental effects of CMV,and it suggested that calpain plays an important role in modulating the ventilator-induced dysfunction of the diaphragm.
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Objective To study the role of heparin-binding protein (HBP) in sepsis-associated acute respiratory distress syndrome (ARDS),and to evaluate the prognostic value of HBP in ARDS.Method Sixty seven sepsis patients were enrolled in the prospective study.According to whether present ARDS,patients were divided into two groups:ARDS group and non-ARDS group.Blood samples were obtained within 2 hours after patients were diagnosed with sepsis.We measured the level of interleukin-6,interleukin8 and HBP by ELISA,counted the number of polymorphonuclear neutrophils (PMN),and calculated Acute Physiology and Chronic Health Evaluation Ⅱ score.We compared interleukin-6,interleukin-8,PMN and HBP between two groups by Student's t test.Correlation analysis was studied between HBP and other indicators by Spearman rank correlation coefficient.We also studied the early prognostic value on sepsisassociated ARDS by establishing receiver operating characteristic (ROC) curve.Results Interleukin-6 (t=4.25,P<0.01),interleukin-8 (t=10.10,P<0.01),PMN (t=3.47,P=0.0009) and HBP (t =0.0225,P =2.336,all showed significant difference between ARDS group and non-ARDS group.Interleukin-6 (r=0.535,P=0.002),interleukin-8 (r=0.419,P=0.017) and PMN (r=0.419,P =0.017) all had positive correlation with HBP.The area under curve (AUC) of HBP predicting ARDS was 0.796.Conclusions HBP level elevated in sepsis-associated ARDS patients and were correlated with interleuki-6,interleuki-8 and PMN.HBP show a high value on predicting emergence of sepsis-associated ARDS.HBP may play an important role in sepsis-associated ARDS pathological process.From this study we can conclude one of possible ARDS pathogenesis:inflammatory mediators,such as interleuki-6,interleuki8,activate PMN.Subseqoently PMN releases HBP.Then HBP resolts in vascolar leakage,which is one of the basic ARDS pathology.
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Objective To study the variation and prognostic value of serum heparin-binding protein (HBP),a potent inducer of vascular leakage in septic shock.Methods A total of 82 sepsis patients admitted to central ICU from August 2011 to July 2012 were enrolled in the prospective study.Eighty-two sepsis patients were divided into septic shock group (group A,n =39) and sepsis without shock group (group B,n =43).At the same time,another 30 shock patients without sepsis were enrolled as group C and 35 patients without sepsis and shock were enrolled as group D.Blood samples obtained within 24 hours after enrollment,and the concentrations of HBP were measured by ELISA and lactate by electrode method.Comparisons of HBP,lactate and APACHE Ⅱ score between groups were carried out by Studers't test,and the early prognostic value in septic shock and mortality was studied by receiver operating characteristic (ROC) curve.Results Patients in group A (t =3.862,P<0.001) and group B(t =5.193,P< 0.001) both had higher HBP level than patients in group D.HBP level in group A patients was also higher than that of group B (t =3.270,P =0.002).Septic shock patients (group A) had higher HBP than patients of group C (t =3.029,P =0.004).The area under curve (AUC) of HBP predicting septic shock patients was 0.834,with sensitivity 0.795,specificity 0.795.The AUC of HBP predicting 28-day mortality of all enrolled patients was was 0.680,and the AUC of predicting 28-day mortality of sepsis patients was 0.784.Conclusions HBP levels were increased in septic patients,especially in septic shock patients.HBP is a better predictor than traditional predictors like lactate and APACHE Ⅱ score for predicting septic shock.HBP is a good and specific evaluation marker for predicting septic shock and the mortality of sepsis patients.The measurement of HBP during the early stage of disease presents valuable information about diagnosis and treatment.
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Abnormal savda munziq could be used as an effective drug for treatment of hypertrophic scar.