Circulating Mitochondrial DNA is an Early Indicator of Severe Illness and Mortality from COVID-19

Mitochondrial DNA (MT-DNA) are intrinsically inflammatory nucleic acids released by damaged solid organs. Whether the appearance of cell-free MT-DNA is linked to poor COVID-19 outcomes remains undetermined. Here, we quantified circulating MT-DNA in prospectively collected, cell-free plasma samples from 97 subjects with COVID-19 at the time of hospital presentation. Circulating MT-DNA were sharply elevated in patients who eventually died, required ICU admission or intubation. Multivariate regression analysis revealed that high circulating MT-DNA levels is an independent risk factor for all of these outcomes after adjusting for age, sex and comorbidities. Additionally, we found that circulating MT-DNA has a similar or superior area-under-the curve when compared to clinically established measures of systemic inflammation, as well as emerging markers currently of interest as investigational targets for COVID-19 therapy. These results show that high circulating MT-DNA levels is a potential indicator for poor COVID-19 outcomes.

Effect of surgery under ketamine anesthesia during mid-pregnancy on cognitive function of offspring rats / 中华麻醉学杂志

Objective To evaluate the effects of surgery under ketamine anesthesia during mid-pregnancy on cognitive function of offspring rats.Methods Thirty healthy pregnant Sprague-Dawley rats at14 days of gestation,aged 9-10 weeks,weighing 270-310 g,were assigned to 3 groups (n=10 each)using a random number table method:exploratory laparotomy under ketamine anesthesia group (KSgroup),ketamine anesthesia group (K group) and control group (C group).In KS group,ketamine 20mg/kg was injected via the caudal vein,and then ketamine was continuously infused at a rate of 130mg · kg-1 · h-1 after loss of right reflex to maintain anesthesia for 2 h,and exploratory laparotomy was per-formed after anesthesia was stable.Group K received no exploratory laparotomy and the other treatmentswere similar to those previously described in group KS.The equal volume of normal saline was given insteadin group C.The cliff avoidance,passive avoidance,and Morris water maze tests were used to evaluate the spatial perception and learning and memory ability of the offspring rats on postnatal days 7,23 and 30.Hippocampal tissues of rat offsprings were obtained at 24 h after the end of Morris water maze test to determine neural precursor cell-expressed developmentally downregulated protein 9 (NEDD9) and postsynaptic density 95 (PSD-95) protein and mRNA expression by quantitative polymerase chain reaction or Western blot.Results Compared with group C,the score of cliff avoidance was significantly decreased,the results of Morris water maze test showed that the escape latency was significantly prolonged,the platform-crossing times were decreased,the time spent in the second quadrant was shortened,the expression of NEDD9 and PSD-95 was down-regulated (P ＜ 0.05),and no significant changes were found in the expression of NEDD9 and PSD-95 mRNA in KS group,and no significant changes were found in the indexes mentioned above in K group (P＞0.05).There was no significant difference in the numberof errors in passive avoidance test among the three groups (P＞0.05).Conclusion Ketamine anesthesia during mid-pregnancy exerts no effect on the cognitive function of offspring rats,abdominal surgery under ketamine anesthesia impairs the spatial perception and learning and memory ability of offspring rats,and the mechanism is related to down-regulating the expression of NEDD9 and PSD-95 in hippocampi of offspring rats.

Effects of dexmedetomidine, propofol and etomidate on the intraoperative wake-up in the cerebral functional area under the guidance of entropy index.

Objective: The study observed the efficacy and safety of dexmedetomidine, propofol and etomidate on brain functional areas in patients undergoing wake-up brain surgery under the guidance of entropy index. Methods: Sixty patients undergoing wake-up brain surgery on brain functional areas were enrolled, and randomly divided into three groups: dexmedetomidine group (group D), propofol group (group P) and etomidate group (group E), 20 in each. The vital signs, entropy indices of each time point, wake-up time, wake-up quality and adverse reaction in the wake-up period were observed and compared. Results: There were no differences in the duration of wake-up, duration of anesthesia, duration of surgery and postoperative wake-up time between the three groups (P> 0.05). The wake-up quality in group D was significantly better than group P and group E (P <0.05), group P was better than group E (P <0.05). The incidence of adverse events in group D was lower than that in groups P and E (P <0.05). The incidence of adverse events in group P was lower than that in group E (P <0.05). Conclusion: Under the guidance of entropy index, anesthesia induced by dexmedetomidine, propofol and etomidate combined with remifentanil can safely and effectively be used to the wake-up brain functional areas surgery, but the wake-up quality with use of dexmedetomidine is highest, and the incidence of adverse events is the lowest during wake-up period.

Effects of dexmedetomidine on renal function in patients with hemorrhagic shock / 临床麻醉学杂志

Objective To investigate the effects of dexmedetomidine on renal function in patients with hemorrhagic shock undergoing emergency surgery.Methods Sixty patients (27 males, 33 females) with hemorrhagic shock, aged 18-69 years, ASA physical status Ⅲ or Ⅳ, required emergency surgery under general anesthesia, were randomized into two groups (n=30 each): dexmedetomidine group (group D) and control group (group C).The patients in group D receiving a loading dose of dexmedetomidine (0.5 μg/kg within 10 min) after the induction of anesthesia followed by a continuous infusion rate of 0.4 μg·kg-1·h-1 till 30 min before the end of surgery, while those in group C received equal volume of normal saline.Venous blood were obtained immediately before beginning of surgery (T1), immediately after surgery (T2), 24 h after surgery (T3) and 72 h after surgery (T4) for detecting the concentrations of the serum creatinine (Scr) and blood urea nitrogen (BUN), the contents of neutrophil gelatinase-associated lipocalin (NGAL) and high mobility group box-1 (HMGB1).The range ability of the concentration of the serum Scr from T4 to T1 (ΔScr) and the content of the serum HMGB1 from T4 to T1 (ΔHMGB1) were also calculated and recorded.Hemodynamic index (including MAP, HR) and arterial blood gas results were recorded during surgery.Results Compared with T1, MAP, CVP and BE were increased, meanwhile, HR and Lac were decreased at T2, but there was no statistically significant difference between the two groups.No statistical difference was found in BUN at any time point between group D and group C.Compared with T1, Scr decreased in both groups at T2-T4.The ΔScr in group D was higher than that in group C at T4 (P＜0.05).The content of serum NGAL at T4 in group D was significantly dropped when compared with T1 (P＜0.01) and was lower than that in group C (P＜0.05).Compared with T1, the content of serum HMGB1 was significantly decreased in both groups at T2 (P＜0.05);the content of serum HMGB1 at T3 in group C was significantly increased and was higher than that in group D;the ΔHMGB1 in group C was higher than that in group D.Conclusion Hemorrhagic shock could induce acute kidney injury.Perioperative continuous infusion of dexmedetomidine facilitated renal function recovery after ischemia-reperfusion injury in patients with hemorrhagic shock through inhibiting the elevation of serum HMGB1.

One-stage endoscopic sphincterotomy plus laparoscopic cholecystectomy for the treatment of cholecysto-choledocolithiasis / 中华普通外科杂志

Objective To evaluate the safety and efficacy of one-stage endoscopic sphincterotomy plus laparoscopic cholecystectomy for the treatment of patients who have concurrent gallstones and CBD stones.Methods We conducted a prospective study from Mar 2008 to Nov 2011 in our department.A total of 63 consecutive patients of concurrent gallstones and CBD stones were included and divided into two groups:31 patients in test group first underwent ERCP and EST to remove CBD stones,and then during the same general anesthesia underwent laparoscopic cholecystectomy (LC) ; while 32 patients in control group first underwent ERCP and ES,and then LC 3-5 days later.Results The stone clearance rate in test group and control group were 96.9％ and 96.7％ (P ＞ 0.05),respectively.The postoperative lung infection rate in the test group and the control group were 7.1％ and 16.1％ (P ＜0.05),respectively.The length of hospital stay (LOS) of the two groups was (7.5 ± 1.7) days and (12.6 ±2.5) days,respectively (P ＜ 0.05).The total expense of hospitalization was (￥) (2 356 ± 126) and (￥) (37 056 ± 152),respectively (P ＜ 0.05).Conclusions One-stage laparoendoscopic management of patients with concurrent gallstones and CBD stones is safe,effective and more economic approach than two-stage treatment for patients suffering from concurrent gall stone and choledocholithiasis.

Long-term results of video-assisted thoracoscopic extended thymectomy for non-thymomatous myasthenia gravis / 中华胸心血管外科杂志

Objective The aims of this study were to assess the efficacy of video-assisted thoracoscopic extended thymectomy(VATET) as a treatment for non-thymomatous myasthenia gravis (NTMG) and to identify prognostic factors for thymectomy.Methods Retrospectively analyzed clinical datas of 112 patients received VATET for the treatment of NTMG.Clinical efficacy and variables influencing outcome were evaluated by Kaplan-Meier method and Cox proportional hazards regression analysis.Results At 3.2 years averaged (1.5-6.2 years) of follow-up,none of these patients were lost to follow up.According to the MGFA post-intervention status,54 patients(48.2％) obtained complete stable remission during follow-up,21 patients(18.8％) obtained pharmacologic remission,10 patients (8.9％) obtained minimal manifestations,7 patients (6.3％) improved,20 patients(17.8％) unchanged,and none of these patients were worse or died of MG.By multivariate analysis,the chance of complete stable remission was significantly increased when age ＜ 40 years (P ＜ 0.01,OR =3.468),symptom duration ＜ 12 months(P ＜ 0.01,OR =3.203) and the presence of thymic hyperplasia (P ＜ 0.01,OR =3.064).Conclusion Video-assisted thoracoscopic extended thymectomy achieved satisfactory long-term results in patients with nonthymomatous myasthenia gravis,while age,symptom duration,the presence of thymic hyperplasia correlated with response to operation.

Distribution and clinical significance of EGFR mutations in phase Ⅰ non-small-cell lung cancer / 中华胸心血管外科杂志

Objective To investigate the distribution and clinical significance of EGFR mutations in phase Ⅰ non-smallcell lung cancer(NSCLC).Methods We examined 272 consecutive phase Ⅰ NSCLC patients' tumor samples for EGFR mutations in exons 18,19,20 and 21 using the Amplification Refractory Mutation System(ARMS).Results 154 patients (56.62％)were identified with mutations in the series of 272.Of all the mutations identified,2 (1.3％) were aminoacidic substitutions (G719 S) in exon 18,53 (34.4 ％) were in frame deletions (19-del) in exon 19,6 (3.9 ％) were insertional mutations (20-ins) in exon 19 and 97 (63.9 ％) were aminoacidic substitutions (L858 R) in exon 21.There were 11 patients with coexisting mutations in other exons.The probability of the coexisting resistance mutations (20-ins) in exon 21 was significantly higher than that in exon 19 (P ＜ 0.05).Mutations in adenocarcinoma samples (148/223,66.4％) were more frequent than that in squamous carcinoma(2/40,5％),while mutations in adeno-squamous carcinoma were highest in all histologic types (P ＜ 0.05).Conclusion EGFR mutations in phase Ⅰ NSCLC in Shanghai and surrounding areas were 56.62％.Mutations were more frequent in particular histologic types,e.g.adenocarcinoma and adeno-squamous carcinoma.Exon 19 deletion mutations and the substitution mutation L858R in exon 21 are the most frequent in NSCLC.And the probability of coexisting 20-ins mutations in exon 21 was significantly higher than which in exon 19.

Value of intraoperation bile leakage test in preventing postoperation bile leakage after liver resection / 中国综合临床

Objectiye To evaluate the value of intraoperative bile leakage test during liver resection in preventing postoperation bile leakage. Methods Eighty-one cases were randomly divided into two groups,in the test group (41 cases) white fat emulsion(sterilized) was injected into common bile tract through cyst bile duct,the leakage points on the transect surface were observed and disposed. In the control group (40 cases) the transect surface were disposed by regular methods. The rate of postoperation bile leakage in the two groups were analyzed. Results The rate of postoperation bile leakage in the test group was 2. 4% (n=1), and the rate of postoperation bile leakage in the control group was 15% (n = 6). There was significant difference between the two groups (x2=4.04, P＜0.05). Conclusion The white bile leakage test is effective in preventing the postoperation bile leakage during liver resection and does not increase other complications.

Massive hemobilia: a clinical study of 20 patients / 中华肝胆外科杂志

ObjectiveTo investigate the etiology, diagnosis and choice of treatment for massive hemobilia. MethodsA retrospective analysis was made on the clinical data of 20 patients with massive hemobilia treated from August 1998 to August 2008. ResultsInitially conservative therapy was used on 20 patients and bleeding stopped in 4 patients. For the seven patients who were treated with hepatic artery angiography and embolization, bleeding stopped in 6 patients. 10 patients were treated by operation and bleeding stopped in all these patients. No patient died in this series. ConclusionsHepatic artery angiography and embolization should be used to treat patients with massive hemobilia. Surgery should be offered if conservative therapy and hepatic artery embolization fail.

Function of Contour in the sphincter-preserving surgery in low rectal cancer / 中国综合临床

Objective To study the function of Contour stapler in the sphincter-preserving surgery in 121 cases with low rectal cancer. Methods One hundred and twenty-one cases enrolled were divided into 2 groups randomly and accepted Contour or other kinds of staplers after operation respectively. Further comparison were performed on the rate of sphincter-preserving,anastomosis stricture and leakage,infection of incision and stool frequency between two groups. Results We found no significant differences in the comparison of rate of anastomosis stricture or leakage,stool frequency,but the Contour group had significant higher rate of sphincter-preserving (98. 3%)than other stapler group(68. 9%),and lower rate of infection of incision(3.94%)than control(11.9%)(P ＜0. 05 respectively). Conclusions It is secure,reliable and practical to use Contour stapler in operation on low rectal cancer,which can increase the opportunity of sphincter-preserving,decrease the the rate of infection of incision.

Comparison of stage Ⅰ bronchioloalveolar carcinoma and adenocarcinoma of the lung: clinical charteristics, recurrences, and survival / 中华胸心血管外科杂志

Objective To compare the clinic characteristics, recurrences and prognosis in patients with stage Ⅰ bronchioloalveolar carcinoma (BAC) and adenocarcinoma of the lung. Methods The data of 56 patients with stage Ⅰ BAC and 169 patients with stage Ⅰ adenocarcinoma were analyzed retrospectively. Results The overall 1-, 3-, 5- year survival rates were 94.7%, 83.5% and 61.2%, respectively. Compared with adenocarcinoma of the lung, BAC showed a better survival rate(x2 =6.36, P =0.012). After surgery patients with BAC were prone to develop intrathoracic recurrence, and adenocarcinoma was equal between intrathoracic recurrence and extrathoracic metastasis. The rate of intrathoracic recurrence and extrathoracic metastasis between BAC and adenocarcinoma was significantly different (14/16 vs. 27/59, x2 =8.85, P=0.004). In both group, preoperative asymptomatic patients had better survival rate(x2 = 7.28, P = 0.007; x2 = 6.07, P = 0. 014). Univariate analysis indicated that sex, age(< 60 years and ≥60 years), location of tumor and smoking history did not significantly influence survival in patients with stage Ⅰ BAC or adenocarcinoma (P > 0.05). Conclusion The prognosis of stage Ⅰ BAC is superior to that of stage Ⅰ adenocarcinoma. BAC is prone to develop intrathoracic recurrence, and adenocarcinoma is equal between intrathoracic recurrence and extrathoracic metastasis. Early diagnosis of lung cancer could improve long-term survival.

Ganoderma lucidum immunomodulatory protein(Lz-8) expressed in Pichia pastoris and the identification of immunocompetence / 生物工程学报

Fungi immunoregulatory proteins family is effective in immunological regulation and anti-tumor. We used Pichia pastoris expression system for recombinant expression of Lz-8, an immunomodulatory protein isolated from fruiting body of Ganoderma lucidum. The Gs115 (mut+) strains of P. pastoris was used as host cells. PCR and sequencing of DNA showed that Lz-8 cDNA was successfully integrated into the P. pastoris genome. Electrophoresis (SDS-PAGE), matrix assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF-MS) and immunological techniques were used to identify recombinant Lz-8 (rLz-8). Lz-8 expressed in Escherichia coli, the Pichia system requires further optimization to obtain more active fungi immunomodulatory protein. Lz-8 was expressed in P. pastoris successfully, and polyacrylamide gel electrophoresis in the presence of SDS-PAGE gave a single band with an apparent Mr=14,000 D. MALDI-TOF-MS also showed that molecular weight of rLz-8 was 12,722 D. Aggregation was observed from sheep red blood cells in the presence of purified rLz-8 within the concentration range of 12.5-50 microg/mL. However, no aggregation was seen at concentration greater than 50 microg/mL for any type of human red blood cell. The dose at 0.5 mg/kg of rLz-8 induced macrophage cytophagocytesis, and set interferon as control at 0.5 mg/kg. These results suggested that active and stable rLz-8 was obtained in P. pastoris expression system.

Preparation of arbidol hydrochloride multi-layers controlled-released and evaluation of its release rate in vivo and in vitro / 吉林大学学报(医学版)

Objective To study the development of Arbidol hydrochloride(Ahyd) multi-layers controlled-released preparation and evaluate its release rate in order to provide the basis for Ahyd pharmacodynamics reseach.Methods Ahyd multi-layers was used as experiment group and Ahyd single-layer as control,high performance liquid chromatography(HPLC) was used to examine releasing level of two groups for calculating parameters of drug metabolism and bioavailability.Results Compared with Ahyd single-layer,the multi-layers controlled-released preparation had several significant advantages as below:Cmax fell remarkably(P

Study about pharmacodynamics of radix notoginseng flavones on viral myocarditic models / 中国药理学通报

Aim To observe the antiviral function of Radix Notoginseng flavone on a virus infection model caused by COXB_3 virus in vitro and in vivo. Methods To establish an experimental in vitro model of viral myocarditics based on primary culture of myocardial cells of newborn Wistar rats and a Balb/c mouse model of viral myocarditics through intraperitoneal injection. Results In vitro Radix Notoginseng flavone obviously inhibited pathologic change of cultured cardiac cells; it reduced release of enzymes from myocardial cells, and increased the level of interferon in mouse spleen, and inhibited inflammatory cells infiltration among cardiac cells in Balb/c mice infected by COXB_3 virus; survival rate of mice in treated groups increased. Conclusion Radix Notoginseng flavonoe has therapeutic efficacy on viral myocarditis caused by COXB_3 virus.

Inhibiting and apoptosis-inducing effects of recombinant Ganoderma Lucidum immunoregulatory protein on HL60 cells / 中国免疫学杂志

Objective:To investigate the inhibiting and apoptosis-effects inducing of the recombinant Ganoderma Lucidum immunoregulatory protein(rLZ-8) on HL60 cells.Methods:HL60 cells were cultured and the inhibited rate of HL60 cells was measured by means of MTT assay.Apoptosis rate was detected with annexinV/PI.The Calcium ion level was analyzed by Fluo-3/AM stain.Caspase-3 activity was assessed by caspase-3 colorimetric assay.Results:The experiments indicated that rLZ-8 could induce the HL60 cells apoptosis.The calcium ion level was increased and caspase-3 activity elevated in HL60 cells after treated by rLZ-8.Conclusion:rLZ-8 could inhibit the proliferation and induce apoptosis of HL60 cells efficiently.The mechanism may be related to increased calcium ion level and elevation of caspase-3 activity.