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1.
Biomed Pharmacother ; 122: 109777, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31918261

RESUMO

Sepsis is a critical illness that contributes a high mortality, while Xijiao Dihuang decoction (XJDHT) has been used in treatment against sepsis for many years by clinical doctors. Clinical studies confirmed a good efficacy of XJDHT against sepsis. The aim of this study is to observe the efficacy of XJDHT in sepsis model rats and macrophages activated by LPS, and to verify the underlying mechanisms. The key components of XJDHT and its targets against sepsis were analyzed and selected by network pharmacology. The potential mechanisms that XJDHT regulates the progress of sepsis were verified in sepsis rats and NR8383 cell lines. XJDHT at a dose of 25 mg/kg was administrated to rats which endured cecal ligation and perforation (CLP). After MTT assay, XJDHT at a dose of 4 mg/mL was selected to treat NR8383 cell lines activated by LPS. In vivo experiment, the survival of the rats was assessed. The content of cytokine in serum were assessed by Enzyme-linked immunosorbent assays (ELISA). Contents of cytokine and key molecules in relative signaling pathway were assessed by immunohistochemical method. The pathway protein expressions were detected by Western blotting. In vitro experiment, immunofluorescence was used to assess the content of cytokine and signaling pathway. A total of 42 targets of XJDHT against sepsis were identified by network pharmacology. After eliminating overlapping compounds and proteins, there were 8 compounds in XJDHT that associating with the 42 sepsis-related targets. NF-κB and HIF-1α signaling pathway were recognized to play important role for XJDHT against sepsis. XJDHT improved survival rate in the XJDHT group compared with the model group. The contents of IL-6 increased in the model group compared with the control group with ELISA and immunohistochemistry, while XJDHT reduced the content of IL-6. The expressions of p65 and HIF-1α reduced significantly in the XJDHT group compared with the model group. In vitro study, the content of IL-6 elevated significantly after LPS stimulation, while XJDHT reduced this increase. Furthermore, expressions of protein of p65 and HIF-1α decreased significantly compared with the LPS group. To conclude, our study demonstrated that XJDHT at a dose of 25 g/kg is capable of improving the survival of sepsis via regulating the NF-κB and HIF-1α signaling pathway.

2.
J Pharm Pharmacol ; 72(2): 259-270, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31729764

RESUMO

OBJECTIVES: Our present study focused on assessing whether Sinomenine (SIN) could attenuate sepsis-induced acute lung injury (ALI). METHODS: The mice were conditioned with SIN 1 h before intraperitoneal injection of lipopolysaccharide (LPS). Lung wet/dry (W/D) ratio, inflammatory level in bronchoalveolar lavage fluid (BALF), malondialdehyde (MDA) levels, superoxide dismutase (SOD) activity and inflammatory cytokines production were detected. The expression of nuclear factor erythroid 2-like 2 (Nrf2) and autophagy-related proteins were detected by Western blot and immunohistochemical analyses. In addition, the RAW264.7 cells were treated with SIN 1 h before treatment with LPS. Inflammatory cytokines, iNOS and COX2 were detected. The expression of Nrf2 and autophagy-related proteins were explored by Western blot analysis. KEY FINDINGS: Experiments in vivo and in vitro discovered that LPS significantly increased the degree of injury, inflammatory cytokines production and oxidative stress. However, the increase was significantly inhibited by treatment of SIN. In addition, SIN was found to upregulate the expression of Nrf2 and autophagy-related proteins both in vivo and in vitro. CONCLUSIONS: Our data suggested that SIN could attenuate septic-associated ALI effectively, probably due to the inhibition of inflammation and oxidative stress through Nrf2 and autophagy pathways.

4.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(7): 878-883, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31441414

RESUMO

OBJECTIVE: To compare the influences of extracorporeal cardiopulmonary resuscitation (ECPR) and conventional or mechanical cardiopulmonary resuscitation (CCPR/MCPR) on survival rate and neurological outcome for adult patients with out-of-hospital cardiac arrest (OHCA), and to assess the effect of ECPR. METHODS: Databases such as Medline, Embase, ScienceDirect, HighWire, Cochrane Library, Wanfang Database and China National Knowledge Infrastructure (CNKI) were searched from January 2000 to October 2018 to retrieve clinical trials on comparison of the effect of ECPR and CCPR/MCPR on survival rate and neurological outcome of adult patients with OHCA. Thereafter, the studies retrieved were based on predefined inclusion and exclusion criteria. Data were extracted and the quality of the included studies was evaluated by two researchers. A meta-analysis was performed by using RevMan 5.3 software. Sensitivity analysis was used to evaluate the stability of the results, and funnel plot was used to evaluate publication bias. RESULTS: A total of 12 studies and 2 519 patients were enrolled, including 615 patients receiving ECPR and 1 904 patients receiving CCPR/MCPR. Meta-analysis showed that compared with CCPR/MCPR, ECPR could not improve the short-term (at hospital discharge or within 1 month) survival rate in patients with OHCA [odds ratio (OR) = 2.26, 95% confidence interval (95%CI) = 0.95-5.41, P = 0.07], but could increase long-term (at more than 3 months) survival rate (OR = 3.56, 95%CI = 1.65-7.71, P = 0.001), rate of good neurological outcome at hospital discharge [Glasgow-Pittsburgh cerebral performance categories (CPC) 1-2 was defined as good neurological function; OR = 3.39, 95%CI = 1.73-6.62, P = 0.000 4], and rate of good long-term neurological outcome (OR = 3.45, 95%CI = 2.24-5.32, P < 0.000 01). Sensitivity analysis showed that the overall results did not change significantly, whether using fixed-effect model and random-effect model to analyze the differences of each effect index, or excluding one study with fewer than 50 subjects for data analysis, indicating that the results were more stable. The funnel plot suggested that there was no publication bias in the studies. But due to the small number of studies, the publication bias could not be excluded. CONCLUSIONS: ECPR could not improve the short-term survival rate at hospital discharge or within 1 month in patients with OHCA, but could increase long-term survival rate at more than 3 months, good neurological outcome at hospital discharge and long-term neurological outcome.


Assuntos
Reanimação Cardiopulmonar , Parada Cardíaca Extra-Hospitalar/epidemiologia , Adulto , China/epidemiologia , Humanos , Taxa de Sobrevida , Resultado do Tratamento
5.
PLoS One ; 14(7): e0215266, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31348788

RESUMO

Tourist congestion at hot spots has been a major management concern for UNESCO World Heritage Sites and other iconic protected areas. A growing number of heritage sites employ technologies, such as cameras and electronic ticket-checking systems, to monitor user levels, but data collected by these monitoring technologies are often under-utilized. In this study, we illustrated how to integrate data from hot spots by camera-captured monitoring and entrance counts to manage use levels at a World Heritage Site in Southeastern China. 6,930 photos of a congestion hotspot (scenic outlook on a trail) were collected within the park at a 10-minute interval over 105 days from January to November 2017. The entrance counts were used to predict daily average and maximum use level at the hotspots. Results showed that the average use level at the congestion hotspot did not exceed the use limit mandated by the park administration agency. However, from 9:20 am to 12:00 pm, the use level at hotspots exceeded visitor preferred use level. Visitor use level was significantly higher at the hotspot during a major Chinese "Golden Week". The daily entrance counts significantly predicted the average and maximum use level at the hotspot. Based on our findings, park managers can achieve the management goals by permitting the corresponding number of visitors passing the entrances. The gap manifested the complexities in visitor capacity management at high-use World Heritage Sites and other protected areas and calls for innovative monitoring and management strategies.

6.
J Transcult Nurs ; 30(6): 597-602, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31068099

RESUMO

Introduction: The aim of this study was to assess the attitudes of registered nurses toward older adults in China. Method: An online questionnaire was sent to registered nurses of five hospitals. The sample included 1,367 registered nurses in this study. Kogan's Attitudes toward Older People Scale and Facts of Aging Quiz were used to collect data. Descriptive statistics, independent t-tests, one-way analysis of variance and logistic regression were used for data analysis. Results: Registered nurses held a positive attitude toward older adults (155.09 ± 21.94). The experience of being cared by older adults (odds ratio [OR] = 1.545, p = .007) and relationship with older adults (OR = 2.440, p = .000) were associated with the attitudes of registered nurses. Discussion: Registered nurses in China held a positive attitude toward older adults. The results contribute to care practice for the older adults in hospitals.

7.
Crit Care ; 23(1): 168, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088524

RESUMO

BACKGROUND: Catecholamines, especially norepinephrine, are the most frequently used vasopressors for treating patients with septic shock. During the recent decades, terlipressin, vasopressin V1A agonist, and even Ca2+ sensitizer were increasingly used by physicians. The aim of this study is to compare the efficacy of such different kinds of vasoactive medications on mortality among patients with septic shock. METHODS: Relevant randomized controlled trials were identified by searching PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials updated to February 22, 2018. A network meta-analysis was performed to evaluate the effect of different types of vasoactive medications. The primary outcome was 28-day mortality. Intensive care unit (ICU) mortality, hospital and ICU length of stay (LOS), and adverse events were also assessed. RESULTS: A total of 43 trials with 5767 patients assessing 17 treatment modalities were included. Treatments ranking based on surface under the cumulative ranking curve values from largest to smallest were NE/DB 85.9%, TP 75.1%, NE/EP 74.6%, PI 74.1%, EP 72.5%, VP 66.1%, NE 59.8%, PE 53.0%, DA 42.1%, DX 38.2%, SP 27.0%, PA 24.3%, EX 22.8%, LE 21.5%, and DB 13.3% for 28-day mortality. Treatments ranking for ICU mortality were TP/NE 86.4%, TP 80.3%, TP/DB/NE 65.7%, VP/NE 62.8%, NE 57.4%, VP 56.5%, PE 48.4%, DA 33.0%, PA 27.5%, LE 22.1%, and DB 9.9%. The incidence of myocardial infarction was reported with NE/EP 3.33% (n = 1 of 30), followed by EP 3.11% (n = 5 of 161), and then VP 3.10% (n = 19 of 613), NE 3.03% (n = 43 of 1417), DA 2.21% (n = 19 of 858), NE/DB 2.01% (n = 4 of 199), LE 1.16% (n = 3 of 258), and PA 0.39% (n = 1 of 257). The incidence of arrhythmia was reported with DA 26.01% (n = 258 of 992), followed by EP 22.98% (n = 37 of 161), and then NE/DB 20.60% (n = 41 of 199), NE/EP 20.0% (n = 6 of 30), NE 8.33% (n = 127 of 1525), LE 5.81% (n = 15 of 258), PA 2.33% (n = 6 of 257), and VP 1.67% (n = 10 of 600). CONCLUSIONS: The use of norepinephrine plus dobutamine was associated with lower 28-day mortality for septic shock, especially among patients with lower cardiac output.


Assuntos
Catecolaminas/normas , Choque Séptico/tratamento farmacológico , Catecolaminas/uso terapêutico , Dopamina/normas , Dopamina/uso terapêutico , Humanos , Mortalidade/tendências , Norepinefrina/normas , Norepinefrina/uso terapêutico , Razão de Chances , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Terlipressina/normas , Terlipressina/uso terapêutico , Vasopressinas/normas , Vasopressinas/uso terapêutico
8.
Biomed Pharmacother ; 115: 108971, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31102910

RESUMO

Sepsis, as life-threatening organ dysfunction caused by a dysregulated host response to infection, is characterized by the extensive release of cytokines and other mediators. Sini decoction (SND), a traditional Chinese prescription medicine, has been used clinically for the treatment of sepsis. But its explicit mechanism of action is still unclear. The present study aims to evaluate the potential protective effects of SND on sepsis-induced acute lung injury (ALI). After SND intervention, the lung tissues of each experimental group were collected. H&E sections were used to observe the pathological changes of lung tissue, and alveolar lavage fluid was collected to detect the infiltration of inflammatory cells. Level of inflammatory factors in lung tissue were analyzed by qRT-PCR. The change of Renin angiotensin system (RAS), as well as downstream MAPK/NF-κB signaling pathways were measured by Western blot. For in vitro experiments, human umbilical vein endothelial cells (HUVECs) were pretreated with lipopolysaccharide (LPS) and treated with SND. Subsequently, the expression levels of RAS and MAPK/NF-κB signaling pathways were measured by Western blot. In vivo, we found that SND significantly attenuated sepsis-induced pathological injury in the lung. SND also inhibited LPS-mediated inflammatory cell infiltration, the expression of pro-apoptotic proteins and the production of IL-6, IL-1ß, TNF-α and MCP-1. In vitro, experiments using a co-culture of HUVECs with SND showed that there was a decrease in pro-apoptotic protein and pro-inflammatory mediator. In this research, we also found that SND protective action could be attributed to the regulation of renin-angiotensin system (RAS). MAPKs and NF-κB pathways. To conclude, our study demonstrated that SND ameliorates sepsis-induced-ALI via regulating ACE2-Ang (1-7)-Mas axis and inhibiting the MAPK signaling pathway.


Assuntos
Lesão Pulmonar Aguda/prevenção & controle , Angiotensina I/metabolismo , Medicamentos de Ervas Chinesas/uso terapêutico , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Fragmentos de Peptídeos/metabolismo , Peptidil Dipeptidase A/metabolismo , Proteínas Proto-Oncogênicas/metabolismo , Receptores Acoplados a Proteínas-G/metabolismo , Sepse/prevenção & controle , Lesão Pulmonar Aguda/etiologia , Lesão Pulmonar Aguda/metabolismo , Animais , Líquido da Lavagem Broncoalveolar/química , Modelos Animais de Doenças , Medicamentos de Ervas Chinesas/administração & dosagem , Células Endoteliais da Veia Umbilical Humana , Humanos , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Pulmão/patologia , Masculino , Camundongos Endogâmicos ICR , Sepse/complicações , Sepse/metabolismo
9.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(1): 73-80, 2019 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-30707873

RESUMO

OBJECTIVE: To systematically review the effect of Qingre Jiedu and Liangxue Sanyu method in patients with sepsis, and to discuss its effect in the treatment of sepsis. METHODS: The randomized controlled trials (RCTs) on the treatment of Qingre Jiedu and Liangxue Sanyu method for sepsis published on PubMed, Embase, Web of Science, CNKI and Wanfang database from the construction to December 31st, 2017 were searched by electronical way. Conventional treatment measures for sepsis, such as fluid resuscitation, maintenance of hemodynamic stability, anti-infection, improvement of tissue perfusion, maintenance of organ function and nutritional support were used in the control group. While traditional Chinese medicine treatment based on Qingre Jiedu and Liangxue Sanyu method were applied in the experimental group besides the conventional treatment, including Chinese patent medicine or Chinese herbal medicine. The main outcome was 28-day mortality, and the second outcome was acute physiology and chronic health evaluation II (APACHE II), coagulation function, inflammatory mediators, procalcitonin (PCT), lactic acid (Lac), and the length of intensive care unit (ICU) stay. Two researchers independently searched literatures, collected data and evaluated risk bias. The statistical analysis was completed by RevMan 5.3 and STATA 13.0 software. The funnel plot and Egger test were used to evaluate the potential publication bias of the main outcomes. RESULTS: A total of 20 RCTs were enrolled in this Meta-analysis, including 1 347 patients, with 667 patients in the control group and 680 patients in the experimental group. Comprehensive risk bias assessment showed that the risk bias of 11 RCT items was unknown, and the risk bias of 9 RCT items was high. Meta-analysis results showed that compared with the control group, the 28-day mortality of the experimental group was significantly lowered [relative risk (RR) = 0.54, 95% confidence interval (95%CI) = 0.45-0.65, P < 0.000 01], the 7-day APACHE II score was significantly lowered [mean difference (MD) = -3.86, 95%CI = -4.82 to -2.90, P < 0.000 01], the 7-day prothrombin time (PT) and activated partial thromboplastin time (APTT) were significantly shortened (PT: MD = -1.72, 95%CI = -2.29 to -1.14, P < 0.000 01; APTT: MD = -4.36, 95%CI = -5.81 to -2.91, P < 0.000 01), the 7-day D-dimer was slightly improved (MD = -0.13, 95%CI = -0.37-0.11, P = 0.29), the 10-day interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were significantly decreased (IL-6: MD = -40.33, 95%CI = -59.55 to -21.11, P < 0.000 1; TNF-α: MD = -7.26, 95%CI = -11.31 to -3.21, P = 0.000 4), the 7-day Lac was significantly declined (MD = -1.30, 95%CI = -1.91 to -0.68, P < 0.000 1), but no significance in PCT (MD = -1.57, 95%CI = -3.25-0.11, P = 0.07) or the length of ICU stay (MD = -4.02, 95%CI = -8.60-0.56, P = 0.09) was found. The results of publication bias assessment showed that 19 studies reported 28-day mortality were basically "funnel-shaped" distribution without potential publication bias (P = 0.336). CONCLUSIONS: The Meta-analysis showed that Qingre Jiedu and Liangxue Sanyu method may reduce the release of inflammatory mediators, improve the coagulation function, and reduce the 28-day mortality in patients with sepsis.


Assuntos
Sepse/terapia , APACHE , Humanos , Unidades de Terapia Intensiva , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
Am J Alzheimers Dis Other Demen ; 34(1): 57-62, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30301358

RESUMO

We aim to investigate whether a popular hand exercise could be used to improve the action of eating in patients with Alzheimer's disease (AD). A 6-month intervention was conducted in 60 patients with AD who live in a nursing home. They were divided into hand exercise and control groups. Patients of the control group maintained their daily routine. The improvement of Edinburgh Feeding Evaluation in Dementia scale in hand exercise group was significantly greater than in the control group ( P = .003). Significant differences in time of autonomous eating and time of simulated eating between patients in the hand exercise and control groups ( P < .05) were noted. The improvements in accuracy of eating action and coordination of eating action from baseline were significant in hand exercise group compared to the control group ( P = .020 and .014, respectively). Hand exercise is a safe and effective intervention to improve the feeding and eating of people with AD.

11.
Microb Pathog ; 140: 103956, 2019 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-31891794

RESUMO

Our work used cecal ligation and puncture (CLP) mice model and 16S rDNA sequencing to explore whether the therapeutic mechanism of Sini Decoction (SND) on sepsis was related to the intestinal flora currently of concern. Twenty-four hours after surgery, tissues and serum from three groups (Control, CLP and CLP + SND) were collected for further analysis and colon contents were isolated for 16S rDNA analysis. Mortality, histological examination and inflammatory cytokines levels confirmed that the sepsis model was induced successfully and resulted in serious pathological damage, while all of these could be reversed by SND. In intestinal flora analysis, the microbial richness and abundance were recovered after SND treatment. Furthermore, at the phylum level, the abundance of Proteobacteria showed drastic increase after CLP. Similarly, CLP surgery significantly disrupted the balance of intestinal flora, with a huge increase of Escherichia-Shigella, a Gram-negative genus that might release lipopolysaccharide (LPS) and other genera. And these shifts could be defused by SND, indicating its function of regulating gut microbiota. This study demonstrates that SND could ameliorate the symptoms and pathology associated with sepsis in CLP model via modulating the flora in intestinal tract, which enriches a possible mechanism of SND's therapeutic effect.

12.
Zhen Ci Yan Jiu ; 43(12): 793-6, 2018 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-30585458

RESUMO

OBJECTIVE: To observe the therapeutic effect of electroacupuncture (EA) at Zusanli (ST 36) and Neiguan (PC 6) on stress responses of patients undergoing gastrointestinal surgery. METHODS: A total of 40 patients undergoing gastrointestinal surgery were randomized into conventional treatment group (control) and EA group (n=20 in each group). Patients of the EA group received conventional treatment (pre- and post-surgical fasting, measures for gastrointestinal decompression, parenteral nutrition support, and patient controlled analgesia pump, etc.) and EA stimulation (2 Hz, 30 min) of bilateral ST 36 and PC 6 (twice after surgery, at an interval of 6 h), and patients of the control group received conventional treatment only. The visual analogue scale (VAS) score was used to assess the patients' pain severity and the blood glucose levels were detected once every 4-6 h within 24 h after operation. Serum cortisol (Cort) and adrenocorticotropic hormone (ACTH) levels were detected by chemiluminescence method, and serum D-lactic acid level (for assessing gastrointestinal mucosal injury) was assayed by ELISA. RESULTS: After the treatment, the levels of serum Cort, ACTH, D-lactate acid and the highest blood glucose were significantly lower in the EA group than those in the control group (P<0.05, P<0.01), suggesting a reduction of stress reactions after EA. But no significant difference was found between the control and EA groups in the VAS score (P>0.05). CONCLUSION: EA at ST 36 and PC 6 can alleviate stress responses and reduce intestinal mucosal damage in patients undergoing gastrointestinal surgery.


Assuntos
Analgesia por Acupuntura , Procedimentos Cirúrgicos do Sistema Digestório , Eletroacupuntura , Pontos de Acupuntura , Hormônio Adrenocorticotrópico , Humanos , Estresse Fisiológico
13.
Biomed Pharmacother ; 107: 696-702, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30138891

RESUMO

Acute lung injury (ALI) is a common disease characterized by pulmonary inflammation and oxidative stress. Sinomenine (SIN) is an alkaloid originally extracted from the Chinese medicinal plant Sinomenium acutum. It has been shown to have anti-inflammatory and anti-oxidative effect. However, it's unclear whether SIN can alleviate ALI. In this study, we assessed the effect of SIN on Escherichia coli (E.coli)-induced ALI mouse model. Mice were conditioned with SIN or placebo 1 h before intratracheally instilled with E.coli. Lung water content, malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, Myeloperoxidase (MPO) levels and inflammatory cytokines production were measured. Immunohistochemistry and western blot were performed to measure target protein expression. E.coli induced histological changes indicating tissues damage and increased W/D ratio, MPO activity, MDA content, and inflammatory cytokines production in the Lung. Whereas in mice pretreated with SIN, these changes were absent. E.coli-induced NF-κB activation was also inhibited by SIN. In addition, SIN increased the expression of HO-1, NQO1 and Nrf2 in lung tissues. Our results suggest that SIN attenuates ALI through the inhibition of inflammation and oxidative stress.


Assuntos
Lesão Pulmonar Aguda/metabolismo , Lesão Pulmonar Aguda/microbiologia , Escherichia coli/efeitos dos fármacos , Morfinanos/farmacologia , Fator 2 Relacionado a NF-E2/metabolismo , NF-kappa B/metabolismo , Substâncias Protetoras/farmacologia , Transdução de Sinais , Lesão Pulmonar Aguda/sangue , Lesão Pulmonar Aguda/patologia , Animais , Líquido da Lavagem Broncoalveolar , Citocinas/metabolismo , Feminino , Inflamação/patologia , Pulmão/patologia , Malondialdeído/sangue , Camundongos Endogâmicos ICR , Estresse Oxidativo/efeitos dos fármacos , Proteína Quinase C/metabolismo , Transdução de Sinais/efeitos dos fármacos , Superóxido Dismutase/sangue
14.
Life Sci ; 208: 139-148, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-29990483

RESUMO

AIMS: Acute respiratory distress syndrome (ARDS), one of the serious form of acute lung injury (ALI), is the primary cause of death in patients with ALI. Sini decoction (SND) is a widely used Traditional Chinese Medicine (TCM). However, the application of SND in ALI is rarely reported. Previous studies have found that renin-angiotensin-aldosterone system (RAAS) played vital and bidirectional roles in ALI. Therefore, the aim of the present study was to investigate protective effect of SND on ALI model induced by E. coli, as well as to further explore relations between RAAS and SND. MATERIALS AND METHODS: The ALI model was evaluated by morphological observations and biochemical assays. The expression levels of angiotensin converting enzyme (ACE), Angiotensin II type 1 receptor (AT1R) and angiotensin converting enzyme 2 (ACE2) were examined by Western blotting. The expression levels of angiotensinII (AngII) and angiotensin-(1-7) (Ang-(1-7)) were measured through ELISA. MasR, IL-6, IL-1ß and TNFα were all measured using qRT-PCR. KEY FINDINGS: SND significantly ameliorated E. coli-induced ALI, including reducing inflammatory factors in lung tissue and the activity of MPO in serum. Furthermore, SND could obviously decrease the expression of ACE, AngII and AT1R, which were induced by E. coli. On the other hand, SND could markedly activate ACE2-Ang-(1-7)-Mas pathway. SIGNIFICANCE: In this paper, we demonstrated that SND alleviates E. coli induced acute lung injury in mice via equilibrating ACE-AngII-AT1R and ACE2-Ang-(1-7)-Mas axis.


Assuntos
Lesão Pulmonar Aguda/tratamento farmacológico , Angiotensina II/metabolismo , Angiotensina I/metabolismo , Medicamentos de Ervas Chinesas/farmacologia , Infecções por Escherichia coli/complicações , Fragmentos de Peptídeos/metabolismo , Peptidil Dipeptidase A/metabolismo , Proteínas Proto-Oncogênicas/metabolismo , Receptor Tipo 1 de Angiotensina/metabolismo , Receptores Acoplados a Proteínas-G/metabolismo , Lesão Pulmonar Aguda/metabolismo , Lesão Pulmonar Aguda/microbiologia , Angiotensina I/genética , Angiotensina II/genética , Animais , Escherichia coli/patogenicidade , Infecções por Escherichia coli/microbiologia , Regulação da Expressão Gênica/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos ICR , Fragmentos de Peptídeos/genética , Peptidil Dipeptidase A/genética , Proteínas Proto-Oncogênicas/genética , Receptor Tipo 1 de Angiotensina/genética , Receptores Acoplados a Proteínas-G/genética , Sistema Renina-Angiotensina
15.
Biomed Pharmacother ; 106: 491-498, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29990837

RESUMO

In the pathogenesis of diabetes mellitus (DM), islet microvasculares are severely damaged due to glucolipotoxicity and other reasons. Vascular endothelial growth factor (VEGF) is an indispensable and specific angiogenic factor in the pathogenesis and treatment of diabetic islet microvascular disease. Mesenchymal stem cells (MSCs) are regarded as a promising treatment of diabetes because of their immunosuppressive effect and multipotential differentiation potency. In this study, we tested whether MSCs over-expressing VEGF conditioned medium (MSC-VEGF-CM) could ameliorate pancreatic islet endothelial cells (MS-1) dysfunction induced by a common diabetic inducer palmitate (PA). We found that cell survival and migration were restrained by PA and partly repaired by the pro-protected of MSC-VEGF-CM. Meanwhile, PI-3K/AKT/m-TOR/eNOS and p38/MAPK signaling pathways were also up-regulated. Though apoptosis-related proteins, caspase-3 and caspase-9, had no significantly suppressed between MSC-VEGF-CM and MSC-CM alone, the expression levels of vascular surface factors such as CD31, VE-cadherin, occludin and ICAM-1, were remarkably up-regulated by the pro-protected of MSC-VEGF-CM. Our data suggested that MSC-VEGF-CM had therapeutic effect on the PA-induced dysfunction through the re-activation of PI-3K/AKT/m-TOR/eNOS and p38/MAPK signaling pathways.


Assuntos
Meios de Cultivo Condicionados/metabolismo , Angiopatias Diabéticas/enzimologia , Células Endoteliais/efeitos dos fármacos , Células-Tronco Mesenquimais/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Ácido Palmítico/toxicidade , Fosfatidilinositol 3-Quinase/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Serina-Treonina Quinases TOR/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Animais , Apoptose/efeitos dos fármacos , Linhagem Celular , Movimento Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Angiopatias Diabéticas/patologia , Angiopatias Diabéticas/cirurgia , Relação Dose-Resposta a Droga , Células Endoteliais/enzimologia , Células Endoteliais/patologia , Transplante de Células-Tronco Mesenquimais , Camundongos , Comunicação Parácrina , Transdução de Sinais/efeitos dos fármacos , Fatores de Tempo , Regulação para Cima , Fator A de Crescimento do Endotélio Vascular/genética
16.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 30(6): 578-582, 2018 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-30009735

RESUMO

OBJECTIVE: To investigate the effect of Qingfeihuayutongfu prescription on oxygenation and pulmonary fibrosis in patients with sepsis-associated acute respiratory distress syndrome (ARDS). METHODS: A prospective randomized controlled trial was performed. Patients with moderate to severe ARDS admitted to intensive care unit (ICU) of Affiliated Hospital of Nanjing University of Chinese Medicine from July 2015 to February 2017 were enrolled, and randomly divided into Qingfeihuayutongfu prescription group (observation group, 200 mL of Qingfeihuayutongfu prescription was given through nasal feeding on the first day after admission, one dose per day for 7 days) and placebo control group. Routine treatment of ARDS in both groups was the same. The oxygenation index (PaO2/FiO2), levels of serum procollagen III (PC III) and prolidase (PLD) were measured at 1, 3, 7, 14 and 28 days after treatment, duration of mechanical ventilation, the length of ICU stay and 60-day survival rate were recorded. RESULTS: A total of 32 patients with ARDS were selected, with 16 in each group, and their baseline data were balanced and comparable. As time went on, PaO2/FiO2 in both groups was decreased gradually, and serum levels of PC III and PLD were increased gradually. Compared with placebo control group, PaO2/FiO2 was significantly increased at 14 days and 28 days after treatment in observation group [mmHg (1 mmHg = 0.133 kPa): 185.81±65.07 vs. 137.19±55.72, 250.56±102.72 vs. 178.25±80.97, both P < 0.05], the levels of serum PC III were significantly decreased at 14 days and 28 days after treatment (µmol/L: 197.13±26.61 vs. 240.81±45.27, 169.06±36.34 vs. 234.75±46.30, both P < 0.01), the levels of serum PLD was significantly decreased at 28 days after treatment (U/L: 1 166.31±304.84 vs. 1 468.81±387.65, P < 0.05), duration of mechanical ventilation (days: 18.20±5.20 vs. 23.38±7.57) and the length of ICU stay (days: 23.7±5.7 vs. 31.0±7.9 ) were significantly shortened (both P < 0.05). Kaplan-Meier survival curve analysis showed that there was no significant difference in the 60-day survival rate between the observation group and placebo control group [81.25% (13/16) vs. 68.75% (11/16), χ2 = 0.667, P = 0.505]. CONCLUSIONS: The Qingfeihuayutongfu prescription may improve oxygenation of ARDS patients, reduce the levels of serum PC III and PLD, and inhibit pulmonary fibrosis, thus improve prognosis.


Assuntos
Sepse , Humanos , Estudos Prospectivos , Respiração Artificial , Síndrome do Desconforto Respiratório do Adulto , Método Simples-Cego
17.
J Surg Res ; 228: 314-321, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29907227

RESUMO

BACKGROUND: Sepsis is a major health care problem, which affects millions of people around the world. Glucose metabolic reprogramming of immune cells plays a crucial role during advancement of sepsis. However, the association between glucose metabolic reprogramming and mortality in patients with sepsis is unclear. Lactate dehydrogenase (LDH) catalyzes the last step of glycolysis. Investigating the relationship between LDH and mortality is important to understand the effect of metabolic reprogramming on prognosis of patients with sepsis. METHODS: A total of 192 patients with sepsis were included in our study. Data on characteristics of patients, biochemical variables, and inflammatory mediator were collected. Association between the level of serum LDH and 28-day mortality was also analyzed. The correlations between serum LDH, interleukin-1ß, creatinine, PaO2/FiO2, and lactate were also observed. The association between LDH and the risk of death was further analyzed. Moreover, receiver operating characteristic curve was depicted to compare the accuracy in prediction of LDH and other variables. RESULTS: There were statistic difference in 28-day mortality between elevated LDH group and normal LDH group (P = 0.021). Level of serum LDH was an independent risk factor for death of patients with sepsis (hazard ratio 1.005, 95% confidence interval 1.002-1.007, P = 0.001). There were significant correlations between LDH, interleukin-1ß (r = 0.514, P = 0.000), creatinine (r = 0.368, P = 0.000), PaO2/FiO2 (r = -0.304, P = 0.000), and lactate (r = 0.560, P = 0.000). The receiver operating characteristic curves showed that the area under the LDH curve for prediction for mortality was 0.783. CONCLUSIONS: Serum LDH is probably associated with 28-day mortality in patients with sepsis.


Assuntos
Mortalidade Hospitalar , L-Lactato Desidrogenase/sangue , Sepse/mortalidade , APACHE , Idoso , Feminino , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Sepse/sangue , Sepse/diagnóstico , Sepse/terapia , Análise de Sobrevida , Taxa de Sobrevida
18.
Artigo em Chinês | MEDLINE | ID: mdl-28459404

RESUMO

OBJECTIVE: To confirm the effects of statin therapy on mortality of patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS). METHODS: PubMed/Medline, Embase, Web of Science and Cochrane Central Register of Controlled Trials were searched for articles using the terms "acute lung injury", "ALI", "acute respiratory distress syndrome", "ARDS", "statin", "simvastatin" and "rosuvastatin" updated to November 17, 2015. Randomized controlled trial (RCT) or observational cohort studies investigating the effects of statin therapy on mortality in patients with ALI or ARDS were all identified, without date or language restriction. The control group was given conventional treatment, while the experimental group was treated with statins additionally. The primary outcome was in-hospital mortality. Meanwhile, ventilator-free day, intensive care unit (ICU)-free day, ICU length of stay (LOS) and ICU mortality were also analyzed. RevMan 5.2 and STATA 13 software were used for systematic review and Meta analysis, and funnel plot was used to analyze the publication bias. RESULTS: A total of five trials including three randomized controlled trials and two observational studies were included. Among 1 636 patients enrolled in the study, there were 739 patients in experimental group, and 897 in control group. It was shown by Meta analysis that there was no significant difference in in-hospital mortality between experimental group and control group [relative risk (RR) = 0.96, 95% confidence interval (95%CI) = 0.79-1.15, P = 0.63]. The subgroup analysis based on RCT and cohort study, or the subgroup analysis of different statins showed that there was no significant difference in in-hospital mortality between the experimental group and the control group (both P > 0.05). There were no significant differences in ventilator-free days [mean difference (MD) = 1.41, 95%CI = -0.32-3.13, P = 0.11], ICU-free days (MD = -0.23, 95%CI = -1.61-1.15, P = 0.75), ICU length of stay (MD = -1.03, 95%CI = -6.55-4.50, P = 0.72), or ICU mortality (RR = 0.88, 95%CI = 0.68-1.14, P = 0.33) between the experimental group and the control group. It was shown by funnel plot that there was no publication bias in in-hospital mortality. CONCLUSIONS: The systematic review and meta-analysis suggests that statin may not be associated with a significant reduction in mortality, ventilator-free day, ICU-free day and ICU length of stay in patients with ALI/ARDS.


Assuntos
Lesão Pulmonar Aguda , Síndrome do Desconforto Respiratório do Adulto , Estudos de Coortes , Mortalidade Hospitalar , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases , Unidades de Terapia Intensiva , Tempo de Internação , Respiração Artificial , Sinvastatina
19.
Shock ; 48(1): 43-53, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28125527

RESUMO

PURPOSE: An open lung strategy (OLS) that includes positive end expiratory pressure and recruitment maneuvers during mechanical ventilation is probably an important treatment method in patients with acute respiratory distress syndrome (ARDS). However, the effect of OLS is unknown. We therefore hypothesized that patients with ARDS may benefit from OLS treatment. METHODS: We identified relevant randomized controlled trials by searching through PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials updated to May 22, 2016. We performed a systematic review and meta-analysis to evaluate the effect of OLS in patients with ARDS. The primary outcome was mortality. RESULTS: A total of 15 randomized controlled trials involving 1,563 patients in OLS group and 1,571 patients in control group were included. Pooled analysis showed that there was significant difference in hospital mortality (relative risk [RR], 0.88; 95% CI, 0.80-0.97; P = 0.009), 28-day mortality (RR, 0.83; 95% CI, 0.71-0.96; P = 0.010), and intensive care unit (ICU) mortality (RR, 0.77; 95% CI, 0.65-0.92; P = 0.003) between the OLS group and control group, with no substantial heterogeneity. There was no significant difference in ventilator-free days at 28-day (mean difference [MD]; 3.32 d; 95% CI, -0.49 to 7.12; P = 0.09) and ICU length of stay (MD; 1.60 d; 95% CI, -2.99 to 6.20; P = 0.49) between OLS group and control group. CONCLUSIONS: Results from this systematic review and meta-analysis suggest that OLS during mechanical ventilation significantly reduces mortality among patients with ARDS.


Assuntos
Respiração Artificial/métodos , Síndrome do Desconforto Respiratório do Adulto/terapia , Lesão Pulmonar Aguda/mortalidade , Lesão Pulmonar Aguda/terapia , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Respiração com Pressão Positiva , Ensaios Clínicos Controlados Aleatórios como Assunto , Síndrome do Desconforto Respiratório do Adulto/mortalidade
20.
J Biomed Nanotechnol ; 13(1): 54-60, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29372988

RESUMO

Energy metabolism may alter pattern differences in acute lung injury (ALI) as one of the causes but the detailed features at single-cellular level remain unclear. Changes in intercellular temperature and adenosine triphosphate (ATP) concentration within the single cell may help to understand the role of energy metabolism in causing ALI. ALI in vitro models were established by treating mice lung epithelial (MLE-12) cells with lipopolysaccharide (LPS), hydrogen peroxide (H2O2), hydrochloric acid (HCl) and cobalt chloride (CoCl2, respectively. 100 nm micro thermocouple probe (TMP) was inserted into the cytosol by micromanipulation system and thermoelectric readings were recorded to calculate the intracellular temperature based on standard curve. The total ATP contents for the MLE-12 cells were evaluated at different time intervals after treatments. A significant increase of intracellular temperature was observed after 10 or 20 µg/L LPS and HCl treatments. The HCl increased the temperature in a dose-dependent manner. On the contrary, H2O2 induced a significant decline of intracellular temperature after treatment. No significant difference in intracellular temperature was observed after CoCl2 exposure. The intracellular ATP levels decreased in a time-dependent manner after treatment with H2O2 and HCl, while the LPS and CoCl2 had no significant effect on ATP levels. The intracellular temperature responses varied in different ALI models. The concentration of ATP in the MLE-12 cells played part in the intracellular temperature changes. No direct correlation was observed between the intracellular temperature and concentration of ATP in the MLE-12 cells.


Assuntos
Lesão Pulmonar Aguda/metabolismo , Pulmão/metabolismo , Nanotecnologia/métodos , Análise de Célula Única/métodos , Termometria/métodos , Lesão Pulmonar Aguda/fisiopatologia , Trifosfato de Adenosina/metabolismo , Animais , Linhagem Celular , Cobalto/efeitos adversos , Modelos Animais de Doenças , Metabolismo Energético/efeitos dos fármacos , Metabolismo Energético/fisiologia , Ácido Clorídrico/efeitos adversos , Peróxido de Hidrogênio/efeitos adversos , Lipopolissacarídeos/efeitos adversos , Pulmão/efeitos dos fármacos , Pulmão/fisiopatologia , Camundongos , Temperatura Ambiente
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