[Efficacy and prognosis of phentolamine in the treatment of patients with myocardial injury due to sepsis]

Objective: To explore the effect of phenolamine on the outcome and prognosis of patients with myocardial injury due to sepsis. Methods: From January 2015 to December 2017, 62 septic patients with myocardial injury were randomly divided into study group (n=32) and control group (n=30). Two groups were given conventional treatment, while the study group was treated with phentolamine. The NT-pro brain natriuretic pepitide (NT-proBNP), cardiac troponin I (cTnI), lactate dehydrogenase (LDH), creatine kinase isoenzymes (CK-MB) and tumor necrosis factor (TNF)-α, high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-1β, IL-6 were detected at 0,12, 24, 48, 72 h and 7 d after hospitalization. And left ventricular ejection fraction (LVEF), e', E and A in each time period were observed. The 28 d survival rate and length of ICU stay were observed in both groups. The data were compared with single sample t test between the two groups. Results: After 12, 24, 48, 72 h and 7 d, NT-proBNP, cTnI, LDH, CK-MB, TNF-α, hs-CRP, IL-1β, IL-6 in the study group were all significantly lower than those in the control group (all P<0.05). The cardiac function indexes of LVEF, E/A and E/e' in the study group were all significantly improved when compared with those in the control group (all P<0.05). The length of ICU stay and 28-day mortality in the study group were significantly lower than those in the control group ((9.8±3.6) d vs (13.0±4.1) d, t=3.152, P=0.004; 21.9% vs 36.7%, χ(2)=5.078, P=0.021). Conclusion: Combined application of phentolamine can significantly improve the outcome of sepsis patients with myocardial injury and improve the survival rate.

[Brain alteration in neonates with congenital heart disease using apparent diffusion coefficient histograms]

Objective: To evaluate the value of apparent diffusion coefficient (ADC) histogram in neonatal brain alteration with congenital heart disease (CHD). Methods: MRIs of 60 neonates with CHD confirmed by echocardiography were retrospectively analyzed in Children's Hospital of Nanjing Medical University from January 2012 to December 2016.Twenty-two MRIs of neonates with mild pneumonia or scalp hematoma who were suspicious of brain disease but normal MRI findings were enrolled as normal control.MRIcron and ImgJ softwares were used to acquire ADC histogram.The correlation between the gestational age and ADC histogram values were calculated respectively.Then t-test was used to analyze the differences of the histogram values and the diagnostic efficacy of different parameters was analyzed using the receiver operating characteristic curve. Results: The ADC values were significantly correlated with the gestational age (P<0.05). The 70th-90th ADC, skewness, kurtosis and variance were statistically significant (P<0.05). The area under the curve of the 90th ADC value was the largest at 0.698. Conclusions: The ADC histogram can quantify and objectively provide more diffusion information of brain tissue. It is a rapid and feasible quantitative method to identify brain changes in neonates with CHD.

Pre-injury neuro-psychiatric medication use, alone or in combination with cardiac medications, may affect outcomes in trauma patients

BACKGROUND

Recent review of older (≥45-years-old) patients admitted to our trauma center showed that more than one-third were using neuro-psychiatric medications (NPMs) prior to their injury-related admission. Previously published data suggests that use of NPMs may increase patients' risk and severity of injury. We sought to examine the impact of pre-injury NPM use on older trauma patients' morbidity and mortality.

MATERIALS AND METHODS

Retrospective record review included medication regimen characteristics and NPM use (antidepressants-AD, antipsychotics-AP, anxiolytics-AA). Hospital morbidity, mortality, and 90-day survival were examined. Comparisons included regimens involving NPMs, further focusing on their interactions with various cardiac medications (beta blocker - BB; angiotensin-converting enzyme inhibitor/angiotensin receptor blocker - ACE/ARB; calcium channel blocker - CCB).

RESULTS

712 patient records were reviewed (399 males, mean age 63.5 years, median ISS 8). 245 patients were taking at least 1 NPM: AD (158), AP (35), or AA (108) before injury. There was no effect of NPM monotherapy on hospital mortality. Patients taking ≥3 NPMs had significantly lower 90-day survival compared to patients taking ≤2 NPMs (81% for 3 or more NPMs, 95% for no NPMs, and 89% 1-2 NPMs, P < 0.01). Several AD-cardiac medication (CM) combinations were associated with increased mortality compared to monotherapy with either agent (BB-AD 14.7% mortality versus 7.0% for AD monotherapy or 4.8% BB monotherapy, P < 0.05). Combinations of ACE/ARB-AA were associated with increased mortality compared to ACE/ARB monotherapy (11.5% vs 4.9, P = 0.04). Finally, ACE/ARB-AD co-administration had higher mortality than ACE/ARB monotherapy (13.5% vs 4.9%, P = 0.01).

CONCLUSIONS

Large proportion of older trauma patients was using pre-injury NPMs. Several regimens involving NPMs and CMs were associated with increased in-hospital mortality. Additionally, use of ≥3 NPMs was associated with lower 90-day survival.

Electrospun collagen-chitosan nanofiber: a biomimetic extracellular matrix for endothelial cell and smooth muscle cell

Electrospinning of collagen and chitosan blend solutions in a 1,1,1,3,3,3-hexafluoroisopropanol/trifluoroacetic acid (v/v, 90/10) mixture was investigated for the fabrication of a biocompatible and biomimetic nanostructure scaffold in tissue engineering. The morphology of the electrospun collagen-chitosan nanofibers was observed by scanning electron microscopy (SEM) and stabilized by glutaraldehyde (GTA) vapor via crosslinking. Fourier transform infrared spectra analysis showed that the collagen-chitosan nanofibers do not change significantly, except for enhanced stability after crosslinking by GTA vapor. X-ray diffraction analysis implied that both collagen and chitosan molecular chains could not be crystallized in the course of electrospinning and crosslinking, and gave an amorphous structure in the nanofibers. The thermal behavior and mechanical properties of electrospun collagen-chitosan fibers were also studied by differential scanning calorimetry and tensile testing, respectively. To assay the biocompatibility of electrospun fibers, cellular behavior on the nanofibrous scaffolds was also investigated by SEM and methylthiazol tetrazolium testing. The results show that both endothelial cells and smooth muscle cells proliferate well on or within the nanofiber. The results indicate that a collagen-chitosan nanofiber matrix may be a better candidate for tissue engineering in biomedical applications such as scaffolds.

Identification of osteo-adipo progenitor cells in fat tissue

OBJECTIVES

In this study, a group of cells that expressed both osteogenic and adipogenic characters was identified from murine adipose stromal cells.

MATERIALS AND METHODS

These cells could be enriched in the Sca-1-1 population and express both osteogenic and adipogenic genes. Osteogenic induction enhanced expression of osteogenic genes and inhibited expression of adipogenic genes, while adipogenic induction enhanced expression of adipogenic genes and inhibited expression of osteogenic genes. These cells have been called osteo-adipo progenitors (OAPs).

RESULTS

OAPs expressed transcription factor runt-related transcription factor 2 (RUNX2) and peroxisome proliferator-activated receptor-gamma (PPAR-gamma) proteins in cytoplasm. When OAPs were cultured in adipogenic medium, PPAR-gamma moved to the nucleus and the cells differentiated into adipocytes, while the RUNX2 remained in the cytoplasm. In contrast, when OAPs were cultured in osteogenic medium, RUNX2 moved to the nucleus and the cells differentiated to osteocytes, while the PPAR-gamma remained in the cytoplasm.

CONCLUSIONS

These experiments suggest that osteoblasts and adipocytes share a common predecessor, the OAP, in murine adipose stromal cells.

A novel nude mice model of human extranodal nasal type NK/T-cell lymphoma

A novel nude mice model of human extranodal nasal type NK/T-cell lymphoma was established by subcutaneously implanting the sample taken from the patient with secondary extranodal nasal type NK/T-cell lymphoma of the stomach into the right axillary region of a BALB/c (nu/nu) nude mouse. This model had been successfully transplanted in vivo for thirty-two generations with a stable growth cycle. The survival rates of both resuscitation and transplantation were 100%. Histologically, the tumor cells were medium to large size and arranged in sheets, with a little mesenchyma, and disseminated almost in all passages of the lymphoma-bearing nude mice. Immunologically, the tumor cells were positive for CD56, cytoplasmic CD3, granzyme B or TIA-1 and LMP1, sometimes for CD8 but negative for surface CD3, CD7, CD20 and CD1a. EBER1/2 was found. No T-cell receptor gamma gene rearrangement was detected in the transplanted tumors. Furthermore, both human sequencing-tagged sites SY14 and Y chromosome were detected by PCR or fluorescent in situ hybridization, respectively, in the transplanted tumor. The transplanted tumor in this novel nude mice model maintained the essential features of human extranodal nasal type NK/T-cell lymphoma, and it would be an ideal tool in vivo for further research of the tumor.

Therapeutic Potential of Human Umbilical Cord–Derived Stem Cells in Ischemic Diseases

Recent advances suggest human umbilical cord is a new source for stem cells. Our laboratory has established a method to readily isolate and expand stem cells from human umbilical cord tissues. The aim of this study was to investigate the therapeutic potential of human umbilical cord-derived stem (UCDS) cells in ischemic diseases. The UCDS cells were characterized by flow cytometry and differentiation into osteogenic and adipogenic cells. Unilateral hind limb ischemia was surgically induced by femoral artery ligation in nude mice. The animals were intramuscularly injected with 10(6) UCDS cells or control phosphate-buffered saline. Blood perfusion of ischemic limbs was detected by laser Doppler perfusion imaging. Transplantation of UCDS cells to the ischemic limbs of nude mice significantly improved the blood flow to the affected limbs. Thus, transplantation of UCDS cells may potentially be a promising treatment for human ischemic diseases.

Electrospun P(LLA-CL) nanofiber: a biomimetic extracellular matrix for smooth muscle cell and endothelial cell proliferation

Poly(L-lactide-co-epsilon-caprolactone) [P(LLA-CL)] with L-lactide to epsilon-caprolactone ratio of 75 to 25 has been electrospun into nanofibers. The relationship between electrospinning parameters and fiber diameter has been investigated. The fiber diameter decreased with decreasing polymer concentration and with increasing electrospinning voltage. The X-ray diffractometer and differential scanning colorimeter results suggested that the electrospun nanofibers developed highly oriented structure in CL-unit sequences during the electrospinning process. The biocompatibility of the nanofiber scaffold has been investigated by culturing cells on the nanofiber scaffold. Both smooth muscle cell and endothelial cell adhered and proliferated well on the P(LLA-CL) nanofiber scaffolds.

[Clinical and experimental studies on analgesic effects of ipsilateral and contralateral stimulations with electro-acupuncture]

Through the treatment of 65 cases of painful diseases with electroacupuncture, in comparing with the analgesic effect of contralateral stimulation (CS) and ipsilateral stimulation (IS), it was verified that IS and CS had the similar effect on pain-relieving, while CS was better in improving motor impairment. By testing the rat's pain threshold and recording the neuronal activity in the D-PAG, it was found that neither IS nor CS could increase the pain threshold in the unilateral D-PAG lesioned rats, and the excited neuronal discharge was recorded in the unilateral D-PAG by stimulating rat's Zusanli (ST 36) at each side. It indicates that IS and CS might share the same high level afferent pathway in acupuncture analgesia in CNS.