Pub Date : 2019-10-09DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.017
宋佳, S. Jia, 王春霞, W. Chunxia, 熊熙, X. Xi, 任玉倩, R. Yuqian, 张育才, Z. Yucai
Objective To investigate the effects of methylprednisolone on STAT3-ERK1/2 signaling pathway in lipopolysaccharide (LPS)-induced acute lung injury (ALI). Methods The C57BL/6J male mice (8-week-old) were randomly(random number) divided into 4 groups: control group (control), LPS-induced endotoxemia model (LPS), only methylprednisolone (MP) administration group (MP), and intervention group with 2 mg/kg MP (LPS+MP) (n= 8 per group). The wet/dry (W/D) weight ratio of lung tissue, lung pathology by hematoxylin & eosin (HE) staining, serum and mRNA levels of TNF-α and IL-6 in lungs were determined. The protein levels of p-STAT3 and p-ERK1/2 in lungs were detected by Western blot. Statistical analyses were performed using One-way analysis of variance test to compare among multiple groups. Results (1)MP treatment significantly decreased the lung W/D weight ratio compared with the LPS group[(3.01±0.84) vs(3.87±0.17), P = 0.038]; (2) The histopathological lesions of the lung were improved in the LPS+MP group compared with the LPS group accompanied with reduced inflammatory cell infiltration and attenuated the alveolar wall thickening; (3) The serum levels of TNF-α and IL-6 in the LPS+MP group was significantly decreased compared with the LPS group[(3.17±1.64) pg/mL vs (6.61±1.27) pg/mL, P = 0.003; (1.42±0.35) pg/mL vs (3.80±1.35) pg/mL, P = 0.008, respectively], and the mRNA levels of TNF-α and IL-6 in the LPS+MP group were significantly lower than those of the LPS group [(5.10±0.81) vs (12.2±5.05), P = 0.03; (1.62±1.00) vs (11.12±6.56), P=0.026; respectively]; (4) MP therapy significantly inhibited P-STAT3 and P-ERK1/2 protein levels [(0.26±0.05) vs (0.86±0.06), P < 0.001, (0.24±0.02) vs (1.34±0.32), P < 0.001]. Conclusions Methylprednisolone protects LPS-induced acute lung injury possibly via suppressing STAT3-ERK1/2 signaling pathway and reducing TNF-α and IL-6 expression. Key words: Methylprednisolone; STAT3; ERK1/2; Lipopolysaccharide; Acute lung injury; Sepsis; TNF-α; IL-6
{"title":"Methylprednisolone alleviates LPS-induced acute lung injury by inhibiting STAT3-ERK1/2 signaling pathway","authors":"宋佳, S. Jia, 王春霞, W. Chunxia, 熊熙, X. Xi, 任玉倩, R. Yuqian, 张育才, Z. Yucai","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.017","url":null,"abstract":"Objective \u0000To investigate the effects of methylprednisolone on STAT3-ERK1/2 signaling pathway in lipopolysaccharide (LPS)-induced acute lung injury (ALI). \u0000 \u0000 \u0000Methods \u0000The C57BL/6J male mice (8-week-old) were randomly(random number) divided into 4 groups: control group (control), LPS-induced endotoxemia model (LPS), only methylprednisolone (MP) administration group (MP), and intervention group with 2 mg/kg MP (LPS+MP) (n= 8 per group). The wet/dry (W/D) weight ratio of lung tissue, lung pathology by hematoxylin & eosin (HE) staining, serum and mRNA levels of TNF-α and IL-6 in lungs were determined. The protein levels of p-STAT3 and p-ERK1/2 in lungs were detected by Western blot. Statistical analyses were performed using One-way analysis of variance test to compare among multiple groups. \u0000 \u0000 \u0000Results \u0000(1)MP treatment significantly decreased the lung W/D weight ratio compared with the LPS group[(3.01±0.84) vs(3.87±0.17), P = 0.038]; (2) The histopathological lesions of the lung were improved in the LPS+MP group compared with the LPS group accompanied with reduced inflammatory cell infiltration and attenuated the alveolar wall thickening; (3) The serum levels of TNF-α and IL-6 in the LPS+MP group was significantly decreased compared with the LPS group[(3.17±1.64) pg/mL vs (6.61±1.27) pg/mL, P = 0.003; (1.42±0.35) pg/mL vs (3.80±1.35) pg/mL, P = 0.008, respectively], and the mRNA levels of TNF-α and IL-6 in the LPS+MP group were significantly lower than those of the LPS group [(5.10±0.81) vs (12.2±5.05), P = 0.03; (1.62±1.00) vs (11.12±6.56), P=0.026; respectively]; (4) MP therapy significantly inhibited P-STAT3 and P-ERK1/2 protein levels [(0.26±0.05) vs (0.86±0.06), P < 0.001, (0.24±0.02) vs (1.34±0.32), P < 0.001]. \u0000 \u0000 \u0000Conclusions \u0000Methylprednisolone protects LPS-induced acute lung injury possibly via suppressing STAT3-ERK1/2 signaling pathway and reducing TNF-α and IL-6 expression. \u0000 \u0000 \u0000Key words: \u0000Methylprednisolone; STAT3; ERK1/2; Lipopolysaccharide; Acute lung injury; Sepsis; TNF-α; IL-6","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1266-1271"},"PeriodicalIF":0.0,"publicationDate":"2019-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47860286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.09.009
Jingjing Ni, R. Xu, Xiyu Yang, Hui Chen, Long-wang Chen, J. Lian, Guangju Zhao
Objective To investigate the effect of cycloartenyl ferulate (CF) on lipopolysaccharide (LPS)-induced apoptosis in human umbilical vein endothelial cells (HUVEC), and to explore its relative mechanism. Methods Human umbilical vein endothelial cells were cultured in vitro, and the experiment was divided into the normal group, CF group, LPS group, and LPS+CF groups at different concentrations. After the corresponding treatment of cells in each group, the cell viability and apoptosis of each group were tested by the cell counter Kit-8 (CCK-8) assay and TdT-mediated dUTP nick end labeling (TUNEL) assay. The protein expression of Bax, Bcl-2, caspase-3 and the effect of CF on the protein expression of Nrf2/HO-1 pathway were determined by Western blot. One-way ANOVA were performed in multigroup mean comparison, LSD-t test was used to compare the mean values of two samples, and P<0.05 was considered statistically significant. Results Compared with the LPS group, the survival rate of HUVECs cells in the CF group was significantly increased with different doses, and the survival rate increased significantly in the 320 μmol/L CF group [(69.85±1.2)% vs ( 100.2±1.824)%, P< 0.01]. TUNEL staining showed that compared with the LPS group, the number of apoptotic positive cells in the 320 μmol/L CF group was significantly reduced [(27.33 ± 3.40) vs (11.67 ± 2.04), P<0.01]. Compared with the LPS group, Bcl-2 protein expression level was significantly increased in the CF group at different doses (P<0.01), caspase-3 and Bax protein expression were significantly decreased (P<0.01). Nrf2 protein expression level increased significantly (P<0.01), and HO-1 protein level increased significantly (P<0.01). Conclusion CF can alleviate LPS-induced apoptosis of HUVEC, which may be related to the increase of bcl-2 expression, the decrease of caspase-3 and Bax protein expression and the activation of Nrf2/ HO-1 signaling pathway. Key words: Cycloartenyl ferulate; Lipopolysaccharide; Vascular endothelial cells; Apoptosis; Nrf2/HO-1 signaling pathway
{"title":"Protective effect of cycloartenyl ferulate on lipopolysaccharide induced endothelial cell apoptosis and its mechanism","authors":"Jingjing Ni, R. Xu, Xiyu Yang, Hui Chen, Long-wang Chen, J. Lian, Guangju Zhao","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.09.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.09.009","url":null,"abstract":"Objective \u0000To investigate the effect of cycloartenyl ferulate (CF) on lipopolysaccharide (LPS)-induced apoptosis in human umbilical vein endothelial cells (HUVEC), and to explore its relative mechanism. \u0000 \u0000 \u0000Methods \u0000Human umbilical vein endothelial cells were cultured in vitro, and the experiment was divided into the normal group, CF group, LPS group, and LPS+CF groups at different concentrations. After the corresponding treatment of cells in each group, the cell viability and apoptosis of each group were tested by the cell counter Kit-8 (CCK-8) assay and TdT-mediated dUTP nick end labeling (TUNEL) assay. The protein expression of Bax, Bcl-2, caspase-3 and the effect of CF on the protein expression of Nrf2/HO-1 pathway were determined by Western blot. One-way ANOVA were performed in multigroup mean comparison, LSD-t test was used to compare the mean values of two samples, and P<0.05 was considered statistically significant. \u0000 \u0000 \u0000Results \u0000Compared with the LPS group, the survival rate of HUVECs cells in the CF group was significantly increased with different doses, and the survival rate increased significantly in the 320 μmol/L CF group [(69.85±1.2)% vs ( 100.2±1.824)%, P< 0.01]. TUNEL staining showed that compared with the LPS group, the number of apoptotic positive cells in the 320 μmol/L CF group was significantly reduced [(27.33 ± 3.40) vs (11.67 ± 2.04), P<0.01]. Compared with the LPS group, Bcl-2 protein expression level was significantly increased in the CF group at different doses (P<0.01), caspase-3 and Bax protein expression were significantly decreased (P<0.01). Nrf2 protein expression level increased significantly (P<0.01), and HO-1 protein level increased significantly (P<0.01). \u0000 \u0000 \u0000Conclusion \u0000CF can alleviate LPS-induced apoptosis of HUVEC, which may be related to the increase of bcl-2 expression, the decrease of caspase-3 and Bax protein expression and the activation of Nrf2/ HO-1 signaling pathway. \u0000 \u0000 \u0000Key words: \u0000Cycloartenyl ferulate; Lipopolysaccharide; Vascular endothelial cells; Apoptosis; Nrf2/HO-1 signaling pathway","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1106-1111"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41787654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.09.006
Yuting Li, Hongxiang Li, Jianxing Guo, Li-Ping Gu
Objective To study the effect of mean arterial pressure (MAP) level on acute kidney injury (AKI) in patients with septic shock, and to determine the best resuscitation target MAP to prevent the occurrence or progression of sepsis- associated AKI. Methods The study subjects included 168 adult patients with septic shock (age≥65 years) who were admitted to the Department of Intensive Care Unit (ICU) of the First Hospital of Jilin University from January 2016 to January 2019. The clinical data of all enrolled patients were retrospectively analyzed. The baseline data were compared between the AKI group (n=111) and non-AKI group (n=57). Multivariate logistic regression analysis was used to determine the risk factors of AKI in patients with septic shock. Results ① The first, second, third, and forth quartile of ΔMAP (pre-resuscitation MAP minus post-resuscitation MAP) were -24.3-3.9 mmHg, 4.0-12.3 mmHg, 12.4-19.8 mmHg, and 19.9-43.5 mmHg, respectively. The second to fourth quartile interval wasΔMAP ≥4 mmHg.② There were no significant differences in age, body mass index, sex, pre-resuscitation MAP, MAP at first hour, SOFA score, positive culture ratio, negative culture ratio, hypertension, peripheral vascular disease, cerebrovascular accident, chronic obstructive pulmonary disease, gastrointestinal ulcer, liver cirrhosis, and tumor between the two groups (P>0.05). There were significant differences in post-resuscitation MAP (P=0.01), APACHEⅡ score (P=0.02), diabetes mellitus (P=0.01), fluid balance (P=0.01), and ΔMAP from the second to fourth quartile (P=0.03) between the two groups.③ ΔMAP ≥4 mmHg (OR=0.26, 95%CI: 0.12-0.57, P=0.01), diabetes (OR=6.03, 95%CI: 1.35-44.16, P=0.04), and high APACHE Ⅱ score (OR=0.96, 95%CI: 0.84-0.97, P=0.02) were closely related to the increased incidence of AKI in patients with septic shock. Post-resuscitation MAP and fluid balance had no significant effect on the incidence of AKI in patients with septic shock. Conclusions ΔMAP ≥4 mmHg, APACHE Ⅱ score and diabetes were independent risk factors for the incidence of AKI in patients with septic shock. The incidence of AKI in septic shock patients with post-resuscitation MAP 4 mmHg or more lower than pre-resuscitation MAP is significantly increased. Key words: Septic shock; Mean arterial pressure; Acute kidney injury; Risk factors
{"title":"Effect of mean arterial pressure on acute kidney injury in patients with septic shock","authors":"Yuting Li, Hongxiang Li, Jianxing Guo, Li-Ping Gu","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.09.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.09.006","url":null,"abstract":"Objective \u0000To study the effect of mean arterial pressure (MAP) level on acute kidney injury (AKI) in patients with septic shock, and to determine the best resuscitation target MAP to prevent the occurrence or progression of sepsis- associated AKI. \u0000 \u0000 \u0000Methods \u0000The study subjects included 168 adult patients with septic shock (age≥65 years) who were admitted to the Department of Intensive Care Unit (ICU) of the First Hospital of Jilin University from January 2016 to January 2019. The clinical data of all enrolled patients were retrospectively analyzed. The baseline data were compared between the AKI group (n=111) and non-AKI group (n=57). Multivariate logistic regression analysis was used to determine the risk factors of AKI in patients with septic shock. \u0000 \u0000 \u0000Results \u0000① The first, second, third, and forth quartile of ΔMAP (pre-resuscitation MAP minus post-resuscitation MAP) were -24.3-3.9 mmHg, 4.0-12.3 mmHg, 12.4-19.8 mmHg, and 19.9-43.5 mmHg, respectively. The second to fourth quartile interval wasΔMAP ≥4 mmHg.② There were no significant differences in age, body mass index, sex, pre-resuscitation MAP, MAP at first hour, SOFA score, positive culture ratio, negative culture ratio, hypertension, peripheral vascular disease, cerebrovascular accident, chronic obstructive pulmonary disease, gastrointestinal ulcer, liver cirrhosis, and tumor between the two groups (P>0.05). There were significant differences in post-resuscitation MAP (P=0.01), APACHEⅡ score (P=0.02), diabetes mellitus (P=0.01), fluid balance (P=0.01), and ΔMAP from the second to fourth quartile (P=0.03) between the two groups.③ ΔMAP ≥4 mmHg (OR=0.26, 95%CI: 0.12-0.57, P=0.01), diabetes (OR=6.03, 95%CI: 1.35-44.16, P=0.04), and high APACHE Ⅱ score (OR=0.96, 95%CI: 0.84-0.97, P=0.02) were closely related to the increased incidence of AKI in patients with septic shock. Post-resuscitation MAP and fluid balance had no significant effect on the incidence of AKI in patients with septic shock. \u0000 \u0000 \u0000Conclusions \u0000ΔMAP ≥4 mmHg, APACHE Ⅱ score and diabetes were independent risk factors for the incidence of AKI in patients with septic shock. The incidence of AKI in septic shock patients with post-resuscitation MAP 4 mmHg or more lower than pre-resuscitation MAP is significantly increased. \u0000 \u0000 \u0000Key words: \u0000Septic shock; Mean arterial pressure; Acute kidney injury; Risk factors","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1088-1092"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46474167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.09.005
R. Chi, Qimin Zhou, Cao-feng Li, Huifen Zhou, Meihua Liang
Objective To investigate the influence of serum creatinine (sCr) at different time-points on prognosis of critically ill patients with acute kidney injury (AKI). Methods This study was retrospectively analyzed the clinical data of critical patients with AKI who admitted to the mixed ICU of Xiaolan Hospital of Southern Medical University during March 2015 and January 2016. According to the clinical prognosis, the patients were divided into the renal replacement therapy (RRT) group and non-renal replacement therapy (non-RRT) group, 28-day renal loss group and renal recover group, hospital death group and survival group. Serum Cr at different time-points and clinical data were collected. The receiver operating characteristic (ROC) curve and the area under curve (AUC) were used to evaluate the capability of sCr at different time-points in predicting clinical prognosis. Results During the study, 85 AKI patients were enrolled. The in-hospital mortality was 20%, RRT rate was 15.3%, and renal lose at 28 days after ICU admission was 31.8%. The levels of sCr out of ICU (o-sCr) and the peak of sCr were significantly higher in the RRT group than the non-RRT group (P<0.01). The o-sCr and p-sCr predicted RRT during the hospital stay with a higher AUC value (0.806 vs 0.833) than b-sCr and a-sCr. The levels of b-sCr, a-sCr, o-sCr, and p-sCr were all significantly higher in the28-day renal loss group than the kidney recover group (P<0.01). The levels of o-sCr and p-sCr were significantly higher in the hospital death group than the survival group (P<0.05). The o-sCr predicted renal lose at 28 days and hospital death with the highest AUC value of 0.850 and 0.797, respectively. Conclusions It cannot be ignored to monitor dynamically the level of sCr at different time-points in critical patients with AKI, which can predict the clinical prognosis such as hospital death, RRT and renal lose at 28 days after ICU admission. Key words: Critical disease; Acute kidney injury; Serum creatinine; Dynamic monitoring; Prognosis
目的探讨不同时间点血清肌酐（sCr）对危重急性肾损伤（AKI）患者预后的影响。方法回顾性分析2015年3月至2016年1月入住南方医科大学小兰医院混合ICU的危重AKI患者的临床资料。根据临床预后，将患者分为肾替代治疗（RRT）组和非肾替代治疗组、28天肾功能衰竭组和肾功能恢复组、住院死亡组和存活组。收集不同时间点血清Cr及临床资料。受试者工作特性（ROC）曲线和曲线下面积（AUC）用于评估sCr在不同时间点预测临床预后的能力。结果本研究共纳入85例AKI患者。住院死亡率为20%，RRT率为15.3%，ICU入院后28天肾功能衰竭为31.8%。RRT组的ICU外sCr水平（o-sCr）和sCr峰值显著高于非RRT组（P<0.01）。o-sCr和P-sCr预测住院期间RRT的AUC值（0.806 vs 0.833）高于b-sCr和a-sCr。肾功能衰竭28天组b-sCr、a-sCr、o-sCr和p-sCr水平均显著高于肾功能恢复组（p<0.01），住院死亡组o-sCr水平显著高于存活组（p<0.05），o-sCr预测28天肾功能衰竭和住院死亡，AUC最高值分别为0.850和0.797。结论动态监测AKI危重患者不同时间点的sCr水平，可以预测ICU入院后28天的住院死亡、RRT和肾功能衰竭等临床预后，是不可忽视的。关键词：危重症；急性肾损伤；血清肌酐；动态监测；预后
{"title":"Influence of serum creatinine at different time-points on prognosis of critically ill patients with acute kidney injury","authors":"R. Chi, Qimin Zhou, Cao-feng Li, Huifen Zhou, Meihua Liang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.09.005","url":null,"abstract":"Objective \u0000To investigate the influence of serum creatinine (sCr) at different time-points on prognosis of critically ill patients with acute kidney injury (AKI). \u0000 \u0000 \u0000Methods \u0000This study was retrospectively analyzed the clinical data of critical patients with AKI who admitted to the mixed ICU of Xiaolan Hospital of Southern Medical University during March 2015 and January 2016. According to the clinical prognosis, the patients were divided into the renal replacement therapy (RRT) group and non-renal replacement therapy (non-RRT) group, 28-day renal loss group and renal recover group, hospital death group and survival group. Serum Cr at different time-points and clinical data were collected. The receiver operating characteristic (ROC) curve and the area under curve (AUC) were used to evaluate the capability of sCr at different time-points in predicting clinical prognosis. \u0000 \u0000 \u0000Results \u0000During the study, 85 AKI patients were enrolled. The in-hospital mortality was 20%, RRT rate was 15.3%, and renal lose at 28 days after ICU admission was 31.8%. The levels of sCr out of ICU (o-sCr) and the peak of sCr were significantly higher in the RRT group than the non-RRT group (P<0.01). The o-sCr and p-sCr predicted RRT during the hospital stay with a higher AUC value (0.806 vs 0.833) than b-sCr and a-sCr. The levels of b-sCr, a-sCr, o-sCr, and p-sCr were all significantly higher in the28-day renal loss group than the kidney recover group (P<0.01). The levels of o-sCr and p-sCr were significantly higher in the hospital death group than the survival group (P<0.05). The o-sCr predicted renal lose at 28 days and hospital death with the highest AUC value of 0.850 and 0.797, respectively. \u0000 \u0000 \u0000Conclusions \u0000It cannot be ignored to monitor dynamically the level of sCr at different time-points in critical patients with AKI, which can predict the clinical prognosis such as hospital death, RRT and renal lose at 28 days after ICU admission. \u0000 \u0000 \u0000Key words: \u0000Critical disease; Acute kidney injury; Serum creatinine; Dynamic monitoring; Prognosis","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1083-1087"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46258159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.09.011
Peng Chen, Ruixiong Li, W. Lu, Yanling Zhong, Haoqiang Qin, Qiaohua Xie, Sheng Wang, Wei-zhou Yang
Objective To investigate the feasibility of parameter-optimized magnetic resonance imaging (MRI) as the first choice for imaging examination in patients with acute ischemic stroke (AIS), and to assess the effects of quality improvement (QI) measures on shortening the door-to-needle time (DNT). Methods A retrospective case-control study was conducted. A total of 69 AIS patients hospitalized at the Department of Neurology of the People's Hospital of Wuzhou from August 2015 to July 2018 were enrolled in the study, and the head MRI was used as the first choice for imaging examination. All patients received the intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA). Patients with AIS undergoing intravenous thrombolysis from August 2015 to March 2017 were included in the control group, and those receiving intravenous thrombolysis after QI measures from April 2017 to July 2018 were included in the experimental group. QI included informing the stroke team in advance by emergency physicians, treatment process changing from serial procedure to the parallel one, optimization of MRI scanning parameters, and use of rapid test instruments. The MRI scanning time was compared between the two groups. The DNT of the two groups was compared, and paired-samples t test was used. The proportion of patients who underwent MRI scan and DNT<60 min was compared between the two groups, and the χ2 test was used. Results Compared with the control group, the proportion of patients undergoing MRI scan in the experimental group was increased (82% vs 58%, χ2=4.58, P=0.032); MRI scanning time was shortened (4 min 37 s vs 10 min 21 s); DNT (min) was shortened (59.32±10.19 vs 93.48±24.81, t=7.189, P<0.01); and the proportion of patients with DNT<60 min was significantly increased (68% vs 6%, χ2=27.190, P<0.01). Conclusion Parameter-optimized MRI as the first choice for imaging examination in AIS patients with the onset time <4.5 h was feasible, and the DNT was significantly shortened by QI measures. Key words: Magnetic resonance imaging; Acute ischemic stroke; Door-to-needle time; Quality improvement
目的探讨参数优化磁共振成像(MRI)作为急性缺血性脑卒中(AIS)患者首选影像学检查的可行性，并评价质量改善(QI)措施对缩短进门到针时间(DNT)的效果。方法采用回顾性病例对照研究。选取2015年8月至2018年7月在梧州市人民医院神经内科住院的AIS患者69例，采用头部MRI作为首选影像学检查。所有患者均接受重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗。2015年8月至2017年3月行静脉溶栓的AIS患者为对照组，2017年4月至2018年7月行QI措施后静脉溶栓的患者为实验组。QI包括急诊医生提前通知卒中团队、治疗过程由串行程序改为并行程序、优化MRI扫描参数和使用快速测试仪器。比较两组患者的MRI扫描时间。比较两组的DNT，采用配对样本t检验。比较两组患者接受MRI扫描及DNT<60 min的比例，采用χ2检验。结果与对照组相比，实验组接受MRI扫描的患者比例增加(82% vs 58%， χ2=4.58, P=0.032);MRI扫描时间缩短(4 min 37 s vs 10 min 21 s);DNT (min)缩短(59.32±10.19 vs 93.48±24.81,t=7.189, P<0.01);DNT<60 min的患者比例显著增加(68% vs 6%， χ2=27.190, P<0.01)。结论参数优化MRI作为发病时间<4.5 h的AIS患者影像学检查的首选是可行的，QI措施可显著缩短DNT。关键词:磁共振成像;急性缺血性中风;Door-to-needle时间;质量改进
{"title":"A feasibility study of parameter-optimized MRI as the first choice for imaging examination in patients with acute ischemic stroke","authors":"Peng Chen, Ruixiong Li, W. Lu, Yanling Zhong, Haoqiang Qin, Qiaohua Xie, Sheng Wang, Wei-zhou Yang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.09.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.09.011","url":null,"abstract":"Objective \u0000To investigate the feasibility of parameter-optimized magnetic resonance imaging (MRI) as the first choice for imaging examination in patients with acute ischemic stroke (AIS), and to assess the effects of quality improvement (QI) measures on shortening the door-to-needle time (DNT). \u0000 \u0000 \u0000Methods \u0000A retrospective case-control study was conducted. A total of 69 AIS patients hospitalized at the Department of Neurology of the People's Hospital of Wuzhou from August 2015 to July 2018 were enrolled in the study, and the head MRI was used as the first choice for imaging examination. All patients received the intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA). Patients with AIS undergoing intravenous thrombolysis from August 2015 to March 2017 were included in the control group, and those receiving intravenous thrombolysis after QI measures from April 2017 to July 2018 were included in the experimental group. QI included informing the stroke team in advance by emergency physicians, treatment process changing from serial procedure to the parallel one, optimization of MRI scanning parameters, and use of rapid test instruments. The MRI scanning time was compared between the two groups. The DNT of the two groups was compared, and paired-samples t test was used. The proportion of patients who underwent MRI scan and DNT<60 min was compared between the two groups, and the χ2 test was used. \u0000 \u0000 \u0000Results \u0000Compared with the control group, the proportion of patients undergoing MRI scan in the experimental group was increased (82% vs 58%, χ2=4.58, P=0.032); MRI scanning time was shortened (4 min 37 s vs 10 min 21 s); DNT (min) was shortened (59.32±10.19 vs 93.48±24.81, t=7.189, P<0.01); and the proportion of patients with DNT<60 min was significantly increased (68% vs 6%, χ2=27.190, P<0.01). \u0000 \u0000 \u0000Conclusion \u0000Parameter-optimized MRI as the first choice for imaging examination in AIS patients with the onset time <4.5 h was feasible, and the DNT was significantly shortened by QI measures. \u0000 \u0000 \u0000Key words: \u0000Magnetic resonance imaging; Acute ischemic stroke; Door-to-needle time; Quality improvement","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1118-1122"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44839721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To observe the effect of curcumin on myocardial mitochondrial related gene (mtATP6), high mobility group box 1(HMGB1) mRNA expression and plasma HMGB1 level in rats with sepsis, and to explore a new strategy for protection of myocardial injury in sepsis. Methods A rat sepsis model was established by cecal ligation and puncture (CLP). Thirty male Sprague-Dawley rats were randomly (random number) divided into the sham operation group (sham group), sepsis group (CLP group), and curcumin intervention group (Cur group), with 10 rats in each group. Rats in the Cur group were treated with curcumin by intraperitoneal injection at 100 mg/kg, and normal saline was injected into rats in the sham and CLP groups. Five rats were randomly (random number) sacrificed at 6 h and 24 h after modeling. The pathological changes of myocardial tissue were observed under light microscope. The levels of CK and CK-MB in serum were detected. The HMGB1 level in plasma was detected by ELISA. Real-time PCR was used to detect the expression of HMGB1 mRNA and mtATP6 in myocardial tissue. One-way ANOVA were performed in multigroup mean comparison, LSD-t test was used to compare the mean values of two samples, and P<0.05 was considered statistically significant. Results The pathological score of myocardial tissue in the Cur group was lower than those in the CLP group at 6 h and 24 h (P 0.05). Conclusion Curcumin protects acute myocardial injury by affecting HMGB1 release and translocation down-regulation of extracellular levels and regulation of mtATP6 expression in CLP model rats. Key words: Sepsis; Myocardial injury; High mobility group box 1; Mitochondrial gene; Curcumin; Rat
{"title":"Effect of curcumin on mitochondrial gene and high mobility group box 1 protein in sepsis myocardial injury of rats","authors":"Yanjun Liu, Ying Yu, Xinping Zhang, Shuangjie Li, Yimin Zhu, Zhenghui Xiao, Xiulan Lu, Haipeng Yan","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.09.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.09.008","url":null,"abstract":"Objective \u0000To observe the effect of curcumin on myocardial mitochondrial related gene (mtATP6), high mobility group box 1(HMGB1) mRNA expression and plasma HMGB1 level in rats with sepsis, and to explore a new strategy for protection of myocardial injury in sepsis. \u0000 \u0000 \u0000Methods \u0000A rat sepsis model was established by cecal ligation and puncture (CLP). Thirty male Sprague-Dawley rats were randomly (random number) divided into the sham operation group (sham group), sepsis group (CLP group), and curcumin intervention group (Cur group), with 10 rats in each group. Rats in the Cur group were treated with curcumin by intraperitoneal injection at 100 mg/kg, and normal saline was injected into rats in the sham and CLP groups. Five rats were randomly (random number) sacrificed at 6 h and 24 h after modeling. The pathological changes of myocardial tissue were observed under light microscope. The levels of CK and CK-MB in serum were detected. The HMGB1 level in plasma was detected by ELISA. Real-time PCR was used to detect the expression of HMGB1 mRNA and mtATP6 in myocardial tissue. One-way ANOVA were performed in multigroup mean comparison, LSD-t test was used to compare the mean values of two samples, and P<0.05 was considered statistically significant. \u0000 \u0000 \u0000Results \u0000The pathological score of myocardial tissue in the Cur group was lower than those in the CLP group at 6 h and 24 h (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Curcumin protects acute myocardial injury by affecting HMGB1 release and translocation down-regulation of extracellular levels and regulation of mtATP6 expression in CLP model rats. \u0000 \u0000 \u0000Key words: \u0000Sepsis; Myocardial injury; High mobility group box 1; Mitochondrial gene; Curcumin; Rat","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1100-1105"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43365344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.09.004
Yang Yu, Hao Xu, Cui-mei Wang, Liang Chen
Objective To identify prognostic factors for mortality in patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). Methods A retrospective study was conducted in 138 patients with initiated CRRT due to AKI who were admitted to the Emergency Intensive Care Unit of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May 2012 to December 2016. According to whether these patients survived after 28 days, they were divided into the death group (58 cases) and survived group (80 cases). Demographic and clinical parameters were retrieved and compared between the two groups. Logistic multivariate regression analysis was performed to determine the risk factors related to mortality. Results Of the 138 patients included, 58 patients (42.0%) died after 28 days. Patients in the death group were older, more likely to be male, had a higher score on the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), higher serum lactate level and lower serum creatinine level on admission, higher prevalence of coronary artery disease, and were more likely to be mechanically ventilated or treated with vasopressors. Multivariate logistic regression analysis revealed that age (OR=1.064, 95%CI: 1.022-1.108, P=0.002), APACHEⅡ score (OR=1.127, 95%CI: 1.003-1.265, P=0.044), mechanical ventilation (OR=7.432, 95%CI: 2.183-25.308, P=0.001) and use of vasopressors (OR=24.558, 95%CI: 7.651-78.825, P<0.01) were independent risk factors for mortality. Conclusions Older age, higher APACHEⅡ score, mechanical ventilation and use of vasopressors are risk factors for mortality in EICU patients with acute kidney injury requiring CRRT. Key words: Acute kidney injury; Continuous renal replacement therapy; Prognosis; ICU; Risk factors
{"title":"Prognostic factors in patients with acute kidney injury requiring continuous renal replacement therapy","authors":"Yang Yu, Hao Xu, Cui-mei Wang, Liang Chen","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.09.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.09.004","url":null,"abstract":"Objective \u0000To identify prognostic factors for mortality in patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted in 138 patients with initiated CRRT due to AKI who were admitted to the Emergency Intensive Care Unit of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May 2012 to December 2016. According to whether these patients survived after 28 days, they were divided into the death group (58 cases) and survived group (80 cases). Demographic and clinical parameters were retrieved and compared between the two groups. Logistic multivariate regression analysis was performed to determine the risk factors related to mortality. \u0000 \u0000 \u0000Results \u0000Of the 138 patients included, 58 patients (42.0%) died after 28 days. Patients in the death group were older, more likely to be male, had a higher score on the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), higher serum lactate level and lower serum creatinine level on admission, higher prevalence of coronary artery disease, and were more likely to be mechanically ventilated or treated with vasopressors. Multivariate logistic regression analysis revealed that age (OR=1.064, 95%CI: 1.022-1.108, P=0.002), APACHEⅡ score (OR=1.127, 95%CI: 1.003-1.265, P=0.044), mechanical ventilation (OR=7.432, 95%CI: 2.183-25.308, P=0.001) and use of vasopressors (OR=24.558, 95%CI: 7.651-78.825, P<0.01) were independent risk factors for mortality. \u0000 \u0000 \u0000Conclusions \u0000Older age, higher APACHEⅡ score, mechanical ventilation and use of vasopressors are risk factors for mortality in EICU patients with acute kidney injury requiring CRRT. \u0000 \u0000 \u0000Key words: \u0000Acute kidney injury; Continuous renal replacement therapy; Prognosis; ICU; Risk factors","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1078-1082"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47892623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.09.007
石国翠, Shi Guocui, 马申懋, M. Shenmao, 马希刚, M. Xi-gang
Objective To investigate the effect of TNF-α on the expressions of tight junction protein ZO-1 and Claudin-4 in rat alveolar epithelial typeⅡ cells (AEC-Ⅱ). Methods Rat AEC-Ⅱ cells were cultured in vitro and divided into the control group, and TNF-α 24 h, 48 h, 72 h groups. The control group was cultured with DME F12 medium containing fetal bovine serum, and the TNF-α groups were intervened by TNF-α with a concentration of 10 ng/mL for 24 h, 48 h, and 72 h, respectively. After co-culture, the transmission electron microscopy was used to identify and observe the ultrastructural changes of rat AEC-Ⅱ cells. The cell inhibition rate was determined by MTT assay, and the cell apoptosis rate was measured by flow cytometry. The expression and distribution of tight junction protein ZO-1 and Claudin-4 in each group were observed by immunofluorescence method. The transcriptional levels of ZO-1 and Claudin-4 were detected by real-time fluorescent quantitative PCR. The expressions of ZO-1 and Claudin-4 were detected by Western blot. One-way analysis of variance (ANOVA) was used for comparisons among groups and SNK-q test was used for pairwise comparisons between groups. The non-parametric test of rank transformation was used when homogeneity of variance were not met. The value of P<0.05 was considered significantly different. Results Transmission electron microscopy showed that the AEC-Ⅱ cells in the control group obtained characteristic lamellar bodies of different sizes. The lamellar bodies in each TNF-α group were gradually emptied and apoptotic cells were observed under the visual field. The cell inhibition rate and early apoptosis rate of each TNF-α group were significantly higher than those of the control group (all P 0.05). However, the mRNA level of ZO-1 in the TNF-α 48 h group (0.28±0.06) and 72 h group (0.13±0.07) were significantly lower than those in the control group. And their protein levels of TNF-α 48 h group (0.44±0.09) and of TNF-α 72 h group (0.2±0.01) were lower than that of the control group (0.69±0.12). Compared with the control group, the transcription level (24 h: 0.16±0.03; 48 h: 0.04±0.01; 72 h: 0.01±0.00 vs 1.00±0.00) and expression (24 h: 0.49±0.08; 48 h: 0.34±0.05; 72 h: 0.04±0.01 vs 0.96±0.13) of Claudin-4 in each TNF-α group were significantly decreased, and showed a decreasing trend with time (all P<0.05). Conclusions TNF-α can damage the pulmonary epithelial barrier by damaging alveolar epithelial typeⅡ cells and down-regulating the expression and distribution of ZO-1 and Claudin-4. Key words: Tumor necrosis factor-α; Tight junction proteins; Acute lung injury; Pulmonary epithelial barrier; Apoptosis
目的探讨TNF-α对大鼠肺泡上皮Ⅱ型细胞紧密连接蛋白ZO-1和Claudin-4表达的影响。方法体外培养大鼠AEC-Ⅱ细胞，分为对照组和TNF-α24、48、72 h组。对照组用含有胎牛血清的DME F12培养基培养，TNF-α组分别用浓度为10ng/mL的TNF-α干预24小时、48小时和72小时。共培养后，用透射电镜观察大鼠AEC-Ⅱ细胞的超微结构变化。MTT法测定细胞抑制率，流式细胞仪测定细胞凋亡率。免疫荧光法观察各组紧密连接蛋白ZO-1和Claudin-4的表达和分布。实时荧光定量PCR检测ZO-1和Claudin-4的转录水平。免疫印迹法检测ZO-1和Claudin-4的表达。单因素方差分析（ANOVA）用于组间比较，SNK-q检验用于组间配对比较。当不满足方差齐性时，使用秩变换的非参数检验。P＜0.05的值被认为有显著差异。结果透射电镜观察，对照组AEC-Ⅱ细胞获得不同大小的具有特征性的片层体。TNF-α组片层体逐渐排空，视野下可见凋亡细胞。各TNF-α组的细胞抑制率和早期凋亡率均显著高于对照组（均P＜0.05），而TNF-α48 h组（0.28±0.06）和72 h组（0.13±0.07）的ZO-1 mRNA水平均显著低于对照组。α48 h组（0.44±0.09）和72 h组（0.2±0.01）蛋白水平均低于对照组（0.69±0.12），α组Claudin-4的转录水平（24 h:0.16±0.03；48 h:0.04±0.01；72 h:0.01±0.00 vs 1.00±0.00）和表达（24 h=0.49±0.08；48 h=0.34±0.05；72 h0.04±0.01 vs 0.96±0.13）均显著降低，结论TNF-α可通过损伤肺泡上皮Ⅱ型细胞、下调ZO-1和Claudin-4的表达和分布来破坏肺上皮屏障。关键词：肿瘤坏死因子-α；紧密连接蛋白；急性肺损伤；肺上皮屏障；细胞凋亡
{"title":"Effect of tumor necrosis factor-α on the expression of tight junction proteins ZO-1 and Claudin-4 in rat alveolar epithelial cells","authors":"石国翠, Shi Guocui, 马申懋, M. Shenmao, 马希刚, M. Xi-gang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.09.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.09.007","url":null,"abstract":"Objective \u0000To investigate the effect of TNF-α on the expressions of tight junction protein ZO-1 and Claudin-4 in rat alveolar epithelial typeⅡ cells (AEC-Ⅱ). \u0000 \u0000 \u0000Methods \u0000Rat AEC-Ⅱ cells were cultured in vitro and divided into the control group, and TNF-α 24 h, 48 h, 72 h groups. The control group was cultured with DME F12 medium containing fetal bovine serum, and the TNF-α groups were intervened by TNF-α with a concentration of 10 ng/mL for 24 h, 48 h, and 72 h, respectively. After co-culture, the transmission electron microscopy was used to identify and observe the ultrastructural changes of rat AEC-Ⅱ cells. The cell inhibition rate was determined by MTT assay, and the cell apoptosis rate was measured by flow cytometry. The expression and distribution of tight junction protein ZO-1 and Claudin-4 in each group were observed by immunofluorescence method. The transcriptional levels of ZO-1 and Claudin-4 were detected by real-time fluorescent quantitative PCR. The expressions of ZO-1 and Claudin-4 were detected by Western blot. One-way analysis of variance (ANOVA) was used for comparisons among groups and SNK-q test was used for pairwise comparisons between groups. The non-parametric test of rank transformation was used when homogeneity of variance were not met. The value of P<0.05 was considered significantly different. \u0000 \u0000 \u0000Results \u0000Transmission electron microscopy showed that the AEC-Ⅱ cells in the control group obtained characteristic lamellar bodies of different sizes. The lamellar bodies in each TNF-α group were gradually emptied and apoptotic cells were observed under the visual field. The cell inhibition rate and early apoptosis rate of each TNF-α group were significantly higher than those of the control group (all P 0.05). However, the mRNA level of ZO-1 in the TNF-α 48 h group (0.28±0.06) and 72 h group (0.13±0.07) were significantly lower than those in the control group. And their protein levels of TNF-α 48 h group (0.44±0.09) and of TNF-α 72 h group (0.2±0.01) were lower than that of the control group (0.69±0.12). Compared with the control group, the transcription level (24 h: 0.16±0.03; 48 h: 0.04±0.01; 72 h: 0.01±0.00 vs 1.00±0.00) and expression (24 h: 0.49±0.08; 48 h: 0.34±0.05; 72 h: 0.04±0.01 vs 0.96±0.13) of Claudin-4 in each TNF-α group were significantly decreased, and showed a decreasing trend with time (all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000TNF-α can damage the pulmonary epithelial barrier by damaging alveolar epithelial typeⅡ cells and down-regulating the expression and distribution of ZO-1 and Claudin-4. \u0000 \u0000 \u0000Key words: \u0000Tumor necrosis factor-α; Tight junction proteins; Acute lung injury; Pulmonary epithelial barrier; Apoptosis","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1093-1099"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47152206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the expression of macrophage migration inhibitory factor (MIF) in pulmonary tissues from patients with chronic obstructive pulmonary disease (COPD) and the relationship with its clinical features. Methods One hundred and eighty patients who underwent pulmonary bullectomy lobectomy due to pneumatocele from January 2015 to September 2018 in Longgang Central Hospital were enrolled and classified into patients without COPD (control group)and patients with COPD (COPD group), with 90 patients each group. According to the lung function parameters, 90 patients with COPD were divided into the mild COPD group, the moderate COPD group, and the severe COPD group. The levels of mRNA and protein of MIF were measured with RT-PCR, ELISA and Western blot. One-way ANOVA, Pearson correlation analysis and SNK-q test were used to analyze the results with SPSS 18.0, and P<0.05 was considered statistically significant. Results The level of MIF in pulmonary tissues from the control group was obviously lower than those in the COPD group (P<0.05). The level of MIF in pulmonary tissues in the severe COPD group was obviously higher than those in pulmonary tissues in the mild COPD, moderate COPD and control groups (P<0.05). MIF was positively correlated with the lung function parameters (P<0.05). Conclusion The high expression of MIF in pulmonary tissues is closely related to the severity of COPD. Key words: Migration inhibitory factor; Chronic obstructive pulmonary disease; Real time-PCR; ELISA; Western blot
{"title":"The expression and clinical significance of migration inhibitory factor in human pulmonary tissues with chronic obstructive pulmonary disease","authors":"Bing Li, Yuan-yuan Yang, Meixia Wang, Feng Cao, Xian-fu Liu, Hongxuan Zhang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.09.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.09.012","url":null,"abstract":"Objective \u0000To investigate the expression of macrophage migration inhibitory factor (MIF) in pulmonary tissues from patients with chronic obstructive pulmonary disease (COPD) and the relationship with its clinical features. \u0000 \u0000 \u0000Methods \u0000One hundred and eighty patients who underwent pulmonary bullectomy lobectomy due to pneumatocele from January 2015 to September 2018 in Longgang Central Hospital were enrolled and classified into patients without COPD (control group)and patients with COPD (COPD group), with 90 patients each group. According to the lung function parameters, 90 patients with COPD were divided into the mild COPD group, the moderate COPD group, and the severe COPD group. The levels of mRNA and protein of MIF were measured with RT-PCR, ELISA and Western blot. One-way ANOVA, Pearson correlation analysis and SNK-q test were used to analyze the results with SPSS 18.0, and P<0.05 was considered statistically significant. \u0000 \u0000 \u0000Results \u0000The level of MIF in pulmonary tissues from the control group was obviously lower than those in the COPD group (P<0.05). The level of MIF in pulmonary tissues in the severe COPD group was obviously higher than those in pulmonary tissues in the mild COPD, moderate COPD and control groups (P<0.05). MIF was positively correlated with the lung function parameters (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The high expression of MIF in pulmonary tissues is closely related to the severity of COPD. \u0000 \u0000 \u0000Key words: \u0000Migration inhibitory factor; Chronic obstructive pulmonary disease; Real time-PCR; ELISA; Western blot","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1123-1127"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42021456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.09.013
Chendi Xu, Yanping Yang
Objective To explore the relationship between serum apolipoprotein A-1 (apoA-1) level and severity of trauma in patients with trauma. Methods Data of 138 trauma patients admitted by EICU from October 2017 to April 2018 in the Acute Trauma Emergency Center of the Sixth People's Hospital Affiliated to Shanghai Jiaotong University were collected retrospectively. Gender, age, admission time, trauma mechanism, and injury severity score (ISS) were recorded, and serum apoA-1 level was measured and recorded within 24 h after injury. Patients were divided into three groups according to the ISS score: the light injury group (47 cases, ISS < 16), the serious injury group (45 cases, 16 ≤ISS < 25), and the critical injury group (46 cases, ISS ≥ 25). The correlation between serum apoA-1 level and ISS score was verified by adopting Pearson correlation analyses, and the differences in serum lipoprotein A level within 24 h after injury were compared among 3 groups by one-way ANOVA. Results Serum apoA-1 level was negatively correlated with ISS score (r=-0.307, P<0.01). There was significant difference in serum apoA-1 level between different trauma groups (F=8.864, P<0.01), among which the difference between the light injury group and critical injury group was the largest (P<0.01). The level of serum apoA-1 in the critical injury group was lower than that in the light injury group (P<0.01) and the serious injury group (P=0.038), while the level of serum apoA-1 in the serious injury group was lower than that in the light injury group (P=0.040). Conclusions Early serum apoA-1 level in patients with trauma is closely related to the severity of trauma and may be a better indicator to evaluate the prognosis of patients with trauma. Key words: Trauma; Apolipoprotein A-1; Prognosis; Inflammation; Stress
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