目的:探讨系统性红斑狼疮患者血清β2-微球蛋白(β2-MG)、颗粒蛋白前体(PGRN)、生长停滞基因6(Gas6)水平与疾病严重程度和肾脏损害的关系。方法:选择2017年1月至2020年12月河北医科大学第二医院风湿免疫科收治的系统性红斑狼疮患者105例...目的:探讨系统性红斑狼疮患者血清β2-微球蛋白(β2-MG)、颗粒蛋白前体(PGRN)、生长停滞基因6(Gas6)水平与疾病严重程度和肾脏损害的关系。方法:选择2017年1月至2020年12月河北医科大学第二医院风湿免疫科收治的系统性红斑狼疮患者105例,根据系统性红斑狼疮疾病活动度指数(SLEDAI)将患者分为活动期组(SLEDAI≥5分)62例,缓解期组(SLEDAI≤4分)43例。另取同期于河北医科大学第二医院接受体检的健康志愿者60例作为对照组。比较各组血清β2-MG、PGRN、Gas6、红细胞沉降率(ESR)、C反应蛋白(CRP)、血清补体、抗dsDNA抗体、血尿素氮(BUN)、血肌酐(Scr),24 h尿蛋白(24h UTP),并分析其相关性。结果:活动期组β2-MG、PGRN、ESR、CRP、抗dsDNA抗体、BUN、Scr、24 h UTP水平高于缓解期组、对照组,Gas6、血清补体C3、C4水平低于缓解期组、对照组;缓解期组β2-MG、PGRN、ESR、CRP、抗dsDNA抗体、BUN、Scr、24 h UTP水平均高于对照组,Gas6、血清补体C3、C4水平低于对照组,活动期组SLEDAI评分高于缓解期组(P<0.05)。Pearson相关性分析可得:系统性红斑狼疮患者血清β2-MG、PGRN与SLEDAI、ESR、CRP、抗dsDNA、BUN、Scr、24h UTP呈正相关,与血清补体C3、补体C4呈负相关(均P<0.05),Gas6水平与SLEDAI、ESR、CRP、抗dsDNA、BUN、Scr、24h UTP呈负相关,与血清补体C3、补体C4呈正相关(均P<0.05)。结论:系统性红斑狼疮患者血清β2-MG、PGRN水平异常升高,Gas6水平异常降低,且和患者疾病活动程度及肾脏损害密切相关,检测其水平可能为系统性红斑狼疮疾病的评估提供参考。展开更多
Hydrogen sulfide(H_2S) is regarded to be a protectant against diseases of the central nervous system and cardiovascular system.However, the mechanism by which H_2S elicits neuroprotective effects in the progression of...Hydrogen sulfide(H_2S) is regarded to be a protectant against diseases of the central nervous system and cardiovascular system.However, the mechanism by which H_2S elicits neuroprotective effects in the progression of Parkinson's disease(PD) remains unclear.To investigate the role of H_2S in delaying the pathological process of PD, we used the most common sodium hydrosulfide(Na HS) as an H_2S donor and established a mouse model of PD induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/probenecid(MPTP/p) in the present study.Our results show that H_2S reduced neuronal loss during the progression of PD.Notably, we found that H_2S exhibited protective effects on dopaminergic neurons.Excitingly, H_2S also increased the proliferation of neural stem cells in the subventricular zone.Next, we evaluated whether the neuroprotective effects of H_2S on dopaminergic neurons in PD are dependent on adult nerve regeneration by treating primary adult neural stem cells cultured ex vivo with 1-methyl-4-phenylpyridine.Our results show that H_2S could prevent nerve injury induced by 1-methyl-4-phenylpyridine, promote the growth of neurospheres, and promote neurogenesis by regulating Akt/glycogen synthase kinase-3β/β-catenin pathways in adult neural stem cells.These findings confirm that H_2S can increase neurogenesis in an adult mouse model of PD by regulating the Akt/glycogen synthase kinase-3β/β-catenin signaling pathway.This study was approved by the Animal Care and Use Committee of Nanjing Medical University, China(IACUC Approval No.1601153-3).展开更多
This study aimed to explore the characteristics of serum metabolomics in patients with non-alcoholic fatty liver disease(NAFLD)and its correlation with the severity of the disease based on gas chromatography-mass spec...This study aimed to explore the characteristics of serum metabolomics in patients with non-alcoholic fatty liver disease(NAFLD)and its correlation with the severity of the disease based on gas chromatography-mass spectrometry(GC-MS).A total of 200 NAFLD patients and 100 healthy controls were included.Serum samples were collected and analyzed by GC-MS,and the data were processed using multivariate statistical methods such as principal component analysis(PCA)and partial least squares-discriminant analysis(PLS-DA).The results showed that a total of 50 differential metabolites were identified,including fatty acids such as palmitic acid and oleic acid,amino acids such as glutamine and glycine,and organic acids such as lactate and citrate.The level of palmitic acid was increased while the level of glutamine was decreased in the patient group.Moreover,some of the metabolites were significantly correlated with the severity of the disease.For example,palmitic acid was positively correlated with the severity of NAFLD,while glutamine was negatively correlated.This study indicates that serum metabolomics can effectively distinguish NAFLD patients from healthy individuals,and the characteristic metabolites play a crucial role in the pathogenesis of NAFLD.Furthermore,they have the potential to serve as biomarkers for disease diagnosis and monitoring,providing a basis for a deeper understanding of NAFLD and the development of novel diagnostic and therapeutic strategies.展开更多
Background:Dermatomyositis-associated interstitial lung disease(DM-ILD)represents a severe and insidious complication of dermatomyositis(DM).The study aimed to investigate the association between DM-ILD and arterial b...Background:Dermatomyositis-associated interstitial lung disease(DM-ILD)represents a severe and insidious complication of dermatomyositis(DM).The study aimed to investigate the association between DM-ILD and arterial blood gas indices,serum ion levels,and the timing of interstitial lung disease onset,with the goal of identifying potential predictors for DM-ILD.Methods:The investigation involved the collection of basic data from 89 patients with DM hospitalized at the Chinese PLA General Hospital between January 2019 and April 2022,and 43 normal control patients hospitalized for physical examinations during the same period.Analyses were conducted to explore the relationship between DM-ILD,arterial blood gas indices,disease duration,and serum ions.A regression model to predict DM-ILD was developed using these indices,and a receiver operating characteristic curve was generated.Results:Significant differences were observed in pH and PaO_(2) between the control group and the disease group(p<0.05).The DM group exhibited higher levels of pH,actual bicarbonate,and base excess(BE)compared with the control group.In contrast,pH and BE levels were lower in the DM-ILD group than in the DM group,with these differences being statistically significant(p<0.05).Interstitial lung disease was correlated with the duration of the disease and pH levels(p<0.05).The cutoff values for age,disease duration,pH,and Cl^(-) were 55.5 years,5.5 years,7.432,and 101.5 mmol/L,respectively.The model demonstrated a prediction sensitivity and specificity for DM-ILD of 0.809 and 0.722,respectively,with an area under the curve of 0.809.Conclusion:Arterial blood gas analysis and serum Cl^(-) levels may assist in predicting DM-ILD.A combined monitoring approach involving arterial blood gas pH,disease duration,age,and serum Cl^(-) levels could enhance the accuracy of DM-ILD predictions and hold significant clinical evaluation potential.展开更多
Ever since its earliest reports, portal venous gas (PVG) has been associated with numerous intraabdominal catastrophes and has served as an indication for urgent surgical exploration. It is traditionally regarded to b...Ever since its earliest reports, portal venous gas (PVG) has been associated with numerous intraabdominal catastrophes and has served as an indication for urgent surgical exploration. It is traditionally regarded to be an ominous finding of impending death, with highest mortality reported in patients with underlying bowel ischemia. Today, computed tomography has demonstrated a wider range of clinical conditions associated with PVG, some of which are ‘benign’ and do not necessarily require surgery, unless when there are signs of intraabdominal catastrophe or systemic toxicity. One of these ‘benign’ conditions is Crohn’s disease. The present report describes a 19-year-old Chinese boy with Crohn’s pancolitis who presented with septic shock associated with PVG and portal vein thrombosis, and was successfully managed surgically. To our knowledge, this is the fi rst report of PVG and portal vein thrombosis associated with Crohn’s disease in a Chinese patient. In addition, we have also reviewed the reports of another 18 Crohn’s patients with PVG previously described in the English literature. Specifi c predisposing factors for PVG were identified in 8 patients, including barium enema, colonoscopy, blunt abdominal trauma, and enterovenous f istula. The patients who developed PVG following barium enema and blunt trauma were all asymptomatic and no specifi c treatment was necessary. Eleven patients (58%) who presented with signs of intraabdominal catastrophe or systemic toxicity required either immediate or eventual surgery. The overall mortality rate among the 19 patients was only 11%. The present literature review has shown that the f inding of PVG associated with Crohn’ s disease does not always mandate surgical intervention. It is the clinical features and the related complications that ultimately determine the treatment approaches. The overall outcome of PVG associated with Crohn’s disease has been favourable.展开更多
OBJECTIVE: To investigate the impact of proportional assist ventilation (PAV) on tolerance and breathlessness in ventilated chronic obstructive pulmonary disease (COPD), and to describe the patient-ventilator interact...OBJECTIVE: To investigate the impact of proportional assist ventilation (PAV) on tolerance and breathlessness in ventilated chronic obstructive pulmonary disease (COPD), and to describe the patient-ventilator interaction, hemodynamic state, breathing pattern and work of breath during PAV and pressure support ventilation (PSV). METHODS: Ten intubated COPD patients on weaning from mechanical ventilation were studied. Elastance and resistance were measured by both the inspiratory-hold technique during a brief period of volume control ventilation and runaway technique during PAV. Each assistance level of PAV (80%, 60% and 40%) and PSV was selected randomly. Patients' response, hemodynamics, blood gas and lung mechanics were monitored. RESULTS: Tidal volume and respiratory rate didn't change in a consistent manner as the level of assist was decreased (P > 0.05). With the level of assist increasing, peak inspiratory pressure was increasing significantly (P展开更多
文摘目的:探讨系统性红斑狼疮患者血清β2-微球蛋白(β2-MG)、颗粒蛋白前体(PGRN)、生长停滞基因6(Gas6)水平与疾病严重程度和肾脏损害的关系。方法:选择2017年1月至2020年12月河北医科大学第二医院风湿免疫科收治的系统性红斑狼疮患者105例,根据系统性红斑狼疮疾病活动度指数(SLEDAI)将患者分为活动期组(SLEDAI≥5分)62例,缓解期组(SLEDAI≤4分)43例。另取同期于河北医科大学第二医院接受体检的健康志愿者60例作为对照组。比较各组血清β2-MG、PGRN、Gas6、红细胞沉降率(ESR)、C反应蛋白(CRP)、血清补体、抗dsDNA抗体、血尿素氮(BUN)、血肌酐(Scr),24 h尿蛋白(24h UTP),并分析其相关性。结果:活动期组β2-MG、PGRN、ESR、CRP、抗dsDNA抗体、BUN、Scr、24 h UTP水平高于缓解期组、对照组,Gas6、血清补体C3、C4水平低于缓解期组、对照组;缓解期组β2-MG、PGRN、ESR、CRP、抗dsDNA抗体、BUN、Scr、24 h UTP水平均高于对照组,Gas6、血清补体C3、C4水平低于对照组,活动期组SLEDAI评分高于缓解期组(P<0.05)。Pearson相关性分析可得:系统性红斑狼疮患者血清β2-MG、PGRN与SLEDAI、ESR、CRP、抗dsDNA、BUN、Scr、24h UTP呈正相关,与血清补体C3、补体C4呈负相关(均P<0.05),Gas6水平与SLEDAI、ESR、CRP、抗dsDNA、BUN、Scr、24h UTP呈负相关,与血清补体C3、补体C4呈正相关(均P<0.05)。结论:系统性红斑狼疮患者血清β2-MG、PGRN水平异常升高,Gas6水平异常降低,且和患者疾病活动程度及肾脏损害密切相关,检测其水平可能为系统性红斑狼疮疾病的评估提供参考。
基金supported by the National Natural Science Foundation of China, Nos.81803505(to CQ), 81803498(to LXW)Min Wang,the Natural Science Foundation of Jiangsu Province of China, No.BK20170564(to CQ)Yong Talents Training Program of Jiangsu University of China, No.5521470000(to JY)。
文摘Hydrogen sulfide(H_2S) is regarded to be a protectant against diseases of the central nervous system and cardiovascular system.However, the mechanism by which H_2S elicits neuroprotective effects in the progression of Parkinson's disease(PD) remains unclear.To investigate the role of H_2S in delaying the pathological process of PD, we used the most common sodium hydrosulfide(Na HS) as an H_2S donor and established a mouse model of PD induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/probenecid(MPTP/p) in the present study.Our results show that H_2S reduced neuronal loss during the progression of PD.Notably, we found that H_2S exhibited protective effects on dopaminergic neurons.Excitingly, H_2S also increased the proliferation of neural stem cells in the subventricular zone.Next, we evaluated whether the neuroprotective effects of H_2S on dopaminergic neurons in PD are dependent on adult nerve regeneration by treating primary adult neural stem cells cultured ex vivo with 1-methyl-4-phenylpyridine.Our results show that H_2S could prevent nerve injury induced by 1-methyl-4-phenylpyridine, promote the growth of neurospheres, and promote neurogenesis by regulating Akt/glycogen synthase kinase-3β/β-catenin pathways in adult neural stem cells.These findings confirm that H_2S can increase neurogenesis in an adult mouse model of PD by regulating the Akt/glycogen synthase kinase-3β/β-catenin signaling pathway.This study was approved by the Animal Care and Use Committee of Nanjing Medical University, China(IACUC Approval No.1601153-3).
文摘This study aimed to explore the characteristics of serum metabolomics in patients with non-alcoholic fatty liver disease(NAFLD)and its correlation with the severity of the disease based on gas chromatography-mass spectrometry(GC-MS).A total of 200 NAFLD patients and 100 healthy controls were included.Serum samples were collected and analyzed by GC-MS,and the data were processed using multivariate statistical methods such as principal component analysis(PCA)and partial least squares-discriminant analysis(PLS-DA).The results showed that a total of 50 differential metabolites were identified,including fatty acids such as palmitic acid and oleic acid,amino acids such as glutamine and glycine,and organic acids such as lactate and citrate.The level of palmitic acid was increased while the level of glutamine was decreased in the patient group.Moreover,some of the metabolites were significantly correlated with the severity of the disease.For example,palmitic acid was positively correlated with the severity of NAFLD,while glutamine was negatively correlated.This study indicates that serum metabolomics can effectively distinguish NAFLD patients from healthy individuals,and the characteristic metabolites play a crucial role in the pathogenesis of NAFLD.Furthermore,they have the potential to serve as biomarkers for disease diagnosis and monitoring,providing a basis for a deeper understanding of NAFLD and the development of novel diagnostic and therapeutic strategies.
文摘Background:Dermatomyositis-associated interstitial lung disease(DM-ILD)represents a severe and insidious complication of dermatomyositis(DM).The study aimed to investigate the association between DM-ILD and arterial blood gas indices,serum ion levels,and the timing of interstitial lung disease onset,with the goal of identifying potential predictors for DM-ILD.Methods:The investigation involved the collection of basic data from 89 patients with DM hospitalized at the Chinese PLA General Hospital between January 2019 and April 2022,and 43 normal control patients hospitalized for physical examinations during the same period.Analyses were conducted to explore the relationship between DM-ILD,arterial blood gas indices,disease duration,and serum ions.A regression model to predict DM-ILD was developed using these indices,and a receiver operating characteristic curve was generated.Results:Significant differences were observed in pH and PaO_(2) between the control group and the disease group(p<0.05).The DM group exhibited higher levels of pH,actual bicarbonate,and base excess(BE)compared with the control group.In contrast,pH and BE levels were lower in the DM-ILD group than in the DM group,with these differences being statistically significant(p<0.05).Interstitial lung disease was correlated with the duration of the disease and pH levels(p<0.05).The cutoff values for age,disease duration,pH,and Cl^(-) were 55.5 years,5.5 years,7.432,and 101.5 mmol/L,respectively.The model demonstrated a prediction sensitivity and specificity for DM-ILD of 0.809 and 0.722,respectively,with an area under the curve of 0.809.Conclusion:Arterial blood gas analysis and serum Cl^(-) levels may assist in predicting DM-ILD.A combined monitoring approach involving arterial blood gas pH,disease duration,age,and serum Cl^(-) levels could enhance the accuracy of DM-ILD predictions and hold significant clinical evaluation potential.
文摘Ever since its earliest reports, portal venous gas (PVG) has been associated with numerous intraabdominal catastrophes and has served as an indication for urgent surgical exploration. It is traditionally regarded to be an ominous finding of impending death, with highest mortality reported in patients with underlying bowel ischemia. Today, computed tomography has demonstrated a wider range of clinical conditions associated with PVG, some of which are ‘benign’ and do not necessarily require surgery, unless when there are signs of intraabdominal catastrophe or systemic toxicity. One of these ‘benign’ conditions is Crohn’s disease. The present report describes a 19-year-old Chinese boy with Crohn’s pancolitis who presented with septic shock associated with PVG and portal vein thrombosis, and was successfully managed surgically. To our knowledge, this is the fi rst report of PVG and portal vein thrombosis associated with Crohn’s disease in a Chinese patient. In addition, we have also reviewed the reports of another 18 Crohn’s patients with PVG previously described in the English literature. Specifi c predisposing factors for PVG were identified in 8 patients, including barium enema, colonoscopy, blunt abdominal trauma, and enterovenous f istula. The patients who developed PVG following barium enema and blunt trauma were all asymptomatic and no specifi c treatment was necessary. Eleven patients (58%) who presented with signs of intraabdominal catastrophe or systemic toxicity required either immediate or eventual surgery. The overall mortality rate among the 19 patients was only 11%. The present literature review has shown that the f inding of PVG associated with Crohn’ s disease does not always mandate surgical intervention. It is the clinical features and the related complications that ultimately determine the treatment approaches. The overall outcome of PVG associated with Crohn’s disease has been favourable.
文摘OBJECTIVE: To investigate the impact of proportional assist ventilation (PAV) on tolerance and breathlessness in ventilated chronic obstructive pulmonary disease (COPD), and to describe the patient-ventilator interaction, hemodynamic state, breathing pattern and work of breath during PAV and pressure support ventilation (PSV). METHODS: Ten intubated COPD patients on weaning from mechanical ventilation were studied. Elastance and resistance were measured by both the inspiratory-hold technique during a brief period of volume control ventilation and runaway technique during PAV. Each assistance level of PAV (80%, 60% and 40%) and PSV was selected randomly. Patients' response, hemodynamics, blood gas and lung mechanics were monitored. RESULTS: Tidal volume and respiratory rate didn't change in a consistent manner as the level of assist was decreased (P > 0.05). With the level of assist increasing, peak inspiratory pressure was increasing significantly (P
