Objective To study the myocardial apoptosis in septic rats and its correlation with the expression of Bcl-2 proteins. Methods The sepsis model was established by cecal ligation and acupuncture. The myocardial apoptosis was detected by electron microscopy and TdT-mediated dUTP Nick End Labeling (TUNEL). The expression of Bcl-2 protein was detected by immunohistochemistry method. The correlations were analyzed by SPSS 10.0 statistical software. Results Within certain period,the myocardial apoptosis rates in septic rats were higher than that in normal and sham-operated control group (P0.05). The expression of Bcl-2 protein was lower than normal and sham-operated control group (P0.05). Their trends were parallel with the change detected by TUNEL assay. Conclusion Myocardial apoptosis may be a cause of myocardial injury in sepsis. The decreased expression of the anti-apoptosis gene Bcl-2 may be a symbol of myocardial injury. Bcl-2 gene may be used for the intervention of sepsis and the prognosis of sepsis.
To study the anti-endotoxin therapy on the plasma levels of nitric oxide, prostacyclin, tumor necrosis factor-alpha in patients with liver cirrhosis after hepatitis.Thirty patients with decompensated liver cirrhosis accepted anti-endotoxin therapy with oral Amoxycillin and Smedta for 2 weeks. Plasma levels of endotoxin, nitric oxide, prostacyclin and tumor necrosis factor-alpha were detected before and after therapy in study group and control group, respectively. The relationship between endotoxin and vasoactive substances and between the four substances and the status of patients were analyzed.The four substances were all increased significantly (P<0.01) in patients with liver cirrhosis compared with control group and decreased obviously after treatment for 2 weeks (endotoxin from 0.546X10(21) U/L to 0. 347X10(21) U/L, no from 56.498 mumol/L to 31.256 mumol/L, 6-keto-PGF1 alpha from 716.964 ng/L to 539.867ng/L, and TNF-alpha from 3.090 mug/L to 1.750 mug/L (P<0.01).The plasma levels of nitric oxide, prostacyclin and tumor necrosis factor-alpha increased because of endotoxemia. Amoxycillin and Smecta can clear endotoxin out effectively.
Objective To investigate the clinical features of venous catheter associated Flavimonas oryzihabitans sepsis.Methods Bacterial cultures from peripheral blood and intravenous catheter blood samples of patients with catheter-related sepsis were immediately performed.The contents and apex of catheters were also sent for bacterial culture after the catheters were removed.Results There were no inflamed,painful and secretive symptoms at catheter porch in all 15 patients.The most important clinical manifestation was sudden-onset of irregular fever and chilling.The temperature was ranged from 37.8℃ to 40℃.Eleven cases(73.3%) had a body temperature of over 38.5℃.Two patients(13.3%) had cough and mucous purulent sputum.Flavimonas oryzihabitans was found in peripheral blood and intravenous catheter blood samples of these 15 patients.Seven cases of catheter apex showed positive bacterial culture.All 15 strains of Flavimonas oryzihabitans were sensitive to Piperacilly,Ticarcillin/Clavulanate,Amikacin,Ceftazidime,Cefoperazone /Sulbactam,Imipenem /Cilastatin and Ofloxacin,but not to Cefoxitin,Cefuroxime sodium,Cefazolin,Aztreonam.Three isolated strains were resistant to Amoxicillin and 2 strains were resistant to Cefalotin and Ceftiaxone.Twelve cases were cured and 3 cases of dead.Conclusion Venous catheter associated Flavimonas oryzihabitan sepsis was mostly developed in patients with other underlying diseases and immunodeficiency.Isolated bacterial strains were generally highly resistant to the 1st and 2nd generations Cephalosporins and Aztreonam.
Objective To investigate the clinical feature,therapeutic effect and prognosis of rhabdomyolysis with acute renal failure(RM-ARF) .Methods Twenty patients of rhabdomyolysis with acute renal failure(RM-ARF) were analyzed.Results Among these 20 cases,there were 14 patients with anuria and 4 with oliguria.All 20 patients had protein and occult blood in their urine.The levels of serum myohemoglobin,creatinine,aspartate aminotransferase,glutamate-pyruvate transaminase,creatine phosphokinases(CPK) ,and CPK-MB were(2 961.2±285.3) mg/L,(823.7±184.1) μmol/L,(712.3±82.6) U/L,(978.4±71.9) IU/L,(12 753.5±18.2) U/L and(138.4±25.8) U/L,respectively.15 patients(75%) had hyperkalemia.After the treatments of fluid supplement and hemodiafiltration,18 patients(90%) survived and 2 patients(10.0%) died of multiple organ dysfunction syndrome.All survivors detached hemodiafiltration when they were discharged.Their levels of sero-enzymes were restored to normal.14 survivors recovered with normal serum creatinine level.Conclusion Oliguria and hyperkalemia were often showed in RM-ARF.The levels of sero-enzymes and serum myohemoglobin were increased significantly and could be used as markers for diagnosis.Hemodiafiltration was effective in treating RM-ARF.Most of the survivors recovered with normal renal function.
Objective To investigate the relationship between the levels of macrophage migration inhibition factor(MIF) and high-sensitive C-reactive protein (hs-CRP),and the incidence of carotid atherosclerosis and acute cerebral infarction. Method One hundred and three patients with first-ever cerebral infarction and 40 normal control subjects were studied. The levels of serum MIF were determined by double antibody enzyme-linked immunosorbent assay,and the levels of serum hs-CRP were measured by immunonephelometric assay. The thickness of carotid intima-media was assessed by carotid ultrasonography.Neurological deficit scores were determined in patients with acute cerebral infarction. Result The levels of serum MIF and hs-CRP in patients with acute cerebral infarction were significantly higher than the normal control subjects (P 0.01).The levels of serum MIF and hs-CRP in unstable plaque groups (mixed and soft plaque group) were significantly higher than those in stable plaque group (hard plaque group) and rough intima group (P0.01). The levels of serum MIF and hs-CRP were positively correlated with the neurological deficit scores in patients with acute cerebral infartion. Conclusion The levels of serum MIF and hs-CRP in patients with acute cerebral infarction may reflect the features and stability of carotid artery plague. It may be used as an index to indicate the severity of cerebral infarction in clinical practice.
Objective To investigate the expressions and clinical significanees of suppressors of cytokine signaling-1 (SOCS-1) and SOCS-3 in myocardium of patients with sudden cardiac death (SCD). Method This study included myocardial autopsy specimens of 24 patients admitted between 2005 and 2006. Of them, 9 cases had the findings of autopsy examination consistent with coronary atberosclerosis (non-myocardial infarction) leading to SCD (non-MI group), 7 patients died of acute myocardial infarction (MI group) and 8 patients died of traffic accidents and trauma The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the myocardium of non-MI and con-trol group were detected by using RT-PCR. The levels of SOCS-1 protein and SOCS-3 protein were detected by us-ing immunohistochemistry. Statistical analysis were performed by using SPSS version 13.0 software and the data were processed with ANOVA test. Results The expressions of SOCS-1 mRNA and SOCS-3 mRNA in non-MI and MI groups were were significantly higher than those in control group (0. 788±0. 101) and (0. 741±0.111) vs.(0.436±0.044) (P <0.01); (0.841±0.092) and (0.776±0.070) vs.(0.454±0.076), P <0.01, re-spectively). The antibody-positive cells of SOCS-1 protein in myocardium of non-MI group and MI group were significantly higher than those in myoeardium of control group (320.00±48.48) and (347.14±70.88) vs.(42.50±10.35) (P < 0.01), respectively. The antibody-positive cells of SOCS-3 protein in myoeardium of non-MI group and MI group were significantly higher than those in myocardium of control group (381.11±59.25) vs.(40.00±10.69), (P < 0.01)and (332.86±111.91) vs. (40.00±10.69), (P =0.001). Conclusions The expressions of SOCS rnRNA and SOCS-3 mRNA in myoeardium of patients with SCD from coronary diseases are significantly increased contributing to the pathogenesis of SCD.
Key words:
Sudden cardiac death; Myocardial infarction; Suppressor of eytokine signaling-1; Suppressor of cytokine signaling-3
Objective:To investigate the expression and significance of p53 and Bcl2 gene in myocardial cell apoptosis in infarct area in senile patients with sudden death caused by acute myocardial infarction (AMI) or other causes.Methods:Terminal deoxynucleotidyl transferasemediated dUTP nick end labeling (TUNEL) was applied to detected the myocardial cell apoptosis in 15 senile patients with sudden death caused by AMI or 10 senile control patients with other causes.p53 and Bcl2 mRNA expressions were measured by reverse transcription PCR using cDNA sample as an internal standard.Results:The permillage of myocardial cell apoptosis in infarct area in senile patients with sudden death caused by AMI was significantly higher than that in control group ( P =0 000).The values of p53 mRNA expression in senile AMI group were significantly higher than that in control group ( P =0 000),and amount of myocardial cell apoptosis in infarct area was positively correlated to logarithmic value of p53 mRNA expression ( r =0 883, P 0 001).The expression of Bcl2 mRNA in myocardial cells of infarct area in senile AMI group was lower than that in control group ( P =0 000),and the amount of myocardial cell apoptosis in infarct area was negatively correlated to logarithmic value of Bcl2 mRNA expression ( r= 0 907, P 0 001).In addition,a significant negative correlation was found between logarithmic value of p53 mRNA expression and Bcl2 mRNA expression in myocardial cells of infarct area ( r =0 849, P 0 001).No differences,however,were found between two groups in respect to the permillage of myocardial cell apoptosis,permillage of p53 and Bcl2 protein expression,the amount of p53 and Bcl2 mRNA expression in 1vessel,2vessel,and 3vessel diseases.Conclusions:Remarkable apoptosis could be evident in myocardial cells of infarct area in senile AMI patients with sudden death,which might be associated with upregulation of p53 gene and downregulation of Bcl2 gene.
To improve cost-efficiency, discriminant functions in stepwise method was founded for the differential diagnosis of angina pectoris by detecting the serum level of high-sensitivity C-reactive protein (hs-CRP), macrophage migration inhibitory factor (MIF), interleukin-4 (IL-4) and interleukin-10 (IL-10) in patients with stable angina pectoris (SAP) and unstable angina pectoris (UAP).Thirty-nine SAP patients and 47 UAP patients were enrolled into the study, while 39 healthy volunteers were enrolled into the controlled group forming the entire set of training samples. The serum levels of hs-CRP, MIF, IL-4 and IL-10 were measured by enzyme linked immunosorbent assay (ELISA). Data was analyzed by software to define discriminant functions in the ways of "entering" and "stepwise". Both functions were evaluated by the results of validation.By the way of "enter independent together", the following discriminant functions were defined based on the data of training samples' age, hs-CRP, MIF, IL-4, IL-10: healthy control group =-129.858 + 2.869×age -2.451×hs-CRP + 1.393×MIF + 6.001×IL-4 + 4.848×IL-10; SAP group=-161.037 + 2.896×age-2.022×hs-CRP + 1.662×MIF + 6.703×IL-4 + 6.287×IL-10; UAP group=-199.087 + 2.468×age-1.440×hs-CRP + 3.404×MIF-13.875×IL-4 + 7.752×IL-10. Retrospective validation showed 4.8% of total miss-grouping, while cross-validation showed 5.6% of total miss-grouping. By the way of "stepwise", the above data was screened by software and training samples' age, MIF and IL-10 were suggested to define the following functions: healthy control group = - 125.218 + 2.659 × age + 0.599×MIF + 5.040 × IL-10; SAP group=-157.864 + 2.721×age + 1.008×MIF + 6.468×IL-10; UAP group=- 197.327 + 2.360×age + 2.932×MIF + 7.640×IL-10. Both retrospective and cross validation showed 6.4% of total miss-grouping. Both sets of discriminant functions had the same efficiency (100%) for differential diagnosis of SAP and UAP.The discriminant functions based on samples' age, MIF and IL-10, which were screened and suggested by stepwise method, may contribute to the differential diagnosis of atypical SAP and UAP, and therefore demonstrate better cost-efficiency.
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