Objective To explore the relationship between central venous-to-arterial carbon dioxide difference/arterial-to-venous oxygen difference ration [P(cv-a)CO2/C(a-cv)O2] and arterial lactate in patients with sepsis. Methods A retrospective analysis was carried on 36 septic patients who were admitted to the Intensive Care Unit of Nanjng Drum-tower Hospital affiliated to Medical School of Nanjing University from May 2013 to November 2013. Cardiac index was measured by transpulmonary thermodilution. At the same time, femoral artery and central venous blood were collected to measure the value of arterial lactate and central venous oxygen saturation (ScvO2) by blood gas analysis and calculate central venous-to-arterial carbon dioxide difference [P(cv-a)CO2], arterial-to-venous oxygen difference [C(a-cv)O2], and their ration [P(cv-a)CO2/C(a-cv)O2], oxygen delivery (DO2) and oxygen consumption (VO2). The subjects were divided intoahyperlactatemia group (≥2 mmol/L) andanormal lactate group (< 2 mmol/L) according to arterial lactate value. P(cv-a)CO2/C(a-cv)O2 and other oxygen metabolism parameters were compared between two groups. Receiver operating characteristic (ROC) curve was used to evaluate the accuracy of P(cv-a)CO2/C(a-cv)O2 and other parameters for diagnosis of hyperlactatemia. Results A total of 36 patients with 119 data were collected. Compared with the normal lactate group, P(cv-a)CO2/C(a-cv)O2 was significantly higher [(1.38±0.76)mm Hg/mL vs. (2.31±1.01) mm Hg/mL, P < 0.01], ScvO2, DO2 and VO2 were significantly lower in the hyperlactatemia group [ScvO2: (74.26±9.13)% vs. (70.29±9.72)%; DO2: (505.52±208.39) mL/(min·m2) vs. (429.98±173.63) mL/(min·m2)]; VO2: (129.01±54.94) mL/(min·m2) vs. (109.99±38.79) mL/(min·m2), P < 0.05]. P(cv-a)CO2 had no significant difference between two groups [(5.76±3.70) mm Hg vs. (6.59±3.70) mm Hg, P > 0.05]. P(cv-a)CO2/C(a-cv)O2 was positively correlated with lactate (r=0.646, P < 0.01). ScvO2 was negatively correlated with lactate (r=-0.277, P < 0.01). DO2 and VO2 had no significant correlation with lactate (P > 0.05). The area under ROC curve (AUC) of P(cv-a)CO2 /C(a-cv)O2 for diagnosis of hyperlactatemia was 0.820, with 95% confidence interval (95%CI) of 0.715 - 0.925(P < 0.001); The AUC of ScvO2 was 0.622, with 95%CI of 0.520 - 0.724(P=0.025). Conclusion Compared with the traditional oxygen metabolism parameters, P(cv-a)CO2/C(a-cv)O2 can accurately diagnose hyperlactatemia, and isareliable parameter to reflect oxygen metabolism in patients with sepsis.
Objective To determine the concentration of int erleukin-12(IL-12),interleukin-2(IL-2) and tumor necrosis factor(TNF)and the irpossible role in the pathogenesis of proliferative vitreoretinopathy(PVR) ． Methods Patients were divided into 3 groups:18 with PVR,7 with simples retinal detachment caused by macular hole and 4 samples from normal eyes were used as control.Sample s of vitreous were obtained by aspiration through pars plana before cryotherapy ,vitrectomy and gas injection and stored in liquid nitrogen at －70℃ within 30 minites for ELISA. Results ①The levels of IL-12,IL-2，and TNF in the vitreous of PVR were positively correlated with the degree of severity of disease.②The levels of IL-12, IL-2,and TNF in the PVR were higher than those in simple retinal detachment caused by macular hole and those in control group(Plt;0.01 ).③The levels of IL-12,IL-2，and TNF in retinal detachment caused by macular hole were also higher than those in the control group(Plt;0.01). Conclusion IL-12,IL-2，and TNF may play a role at lease to some extent in the pathogenesis of PVR. (Chin J Ocul Fundus Dis,1999,15:75-77)
Objective To observe the changes in tear film after minimal vitreoretinal surgery in patients with hypertension. Methods One hundred and thirty-three eyes of 133 patients (47 patients with systemic hypertension as group A and 86 eyes without systemic hypertension as group B) underwent 23gauge or 25gauge vitreous microsurgery were enrolled in this study. The contralateral eyes were regarded as the control group. Uncomfortable symptoms score, breakup time (BUT), Schirmer′s Ⅰ test (SⅠT) and corneal fluorescein staining (CFS) were recorded before and after surgery in all patients. Data were analyzed with a Wilcoxon rank sum test, KruskalWallis oneway ANOVA and independent samples t test. Results Comparison between non surgery eyes of group A and group B indicated no statistical difference in CFS and BUT score at each followup (Z=-3.229, -2.780, -2.018, -2.379, -3.374, -3.213: t=-2.452, -2.963, -2.580, -3.018, -2.339, -2.374; P＞0.05). However, statistical difference of SⅠT between the two groups was found either 1 day before surgery or 10 days after surgery (t=-4.668, -5.384; P＜0.05). Comparing the CFS and BUT in group A at 1, 3 days after operation with 1 day before surgery, the differences were statistically significant (Z=-5.229, -4.780; P＜0.05; t=-5.633, -4.884; P=0.001). The statistical significance was noticed in SⅠT between l day before surgery and 1 day after surgery (t=-4.743, P=0.001). Comparison between uncomfortable symptoms scores of operated eyes in group A and group B revealed no significant difference between 1 and 3 days after surgery. Nineteen patients (14%) complained of pain and red eye. There was no statistical difference between CFS score at each follow-up（Z=-3.123, -3.730, -2.198, -3.379, -3.434, -2.393; P＞0.05）. There were significant differences between BUT scores of operated eyes in two groups at 1 and 3 days after operation （t=-5.537, -5.014;P＜0.05). There was also a significant statistical difference between SⅠT 1 and 3 days after operation between groups （t=-3.653, -4.371; P＜0.05). Conclusion The stability of tear film in hypertension patients is poorer than normal patients. The secretion of tears in hypertension patients declines and the tear film recovers slowly after the surgery.
OBJECTIVE:To verify the safe dose of cephradine in intravitreal injection. METHODS:After injecting different doses of cephradine(100mu;g,200mu;g,250mu;g,300mu;g,400mu;g)into vitreous cavity of different group of rabbits the activities of the retinal enzymes (SDH,LDH )on different time (Id,3d, 7d ) were determined respectively, and the histological and ultrastructural changes of retinas were also observed simuhaneously. RESULTS:The activity of rellnal SDH and LDH was found to be decreased gradually with tbe icreasing of the dosage of intravitreal cephradine. The activities of SDH and LDH were found in the lowest level on tile 3rd and lsl day,but they recover to normal levels on tile 7th day after intravitreal in}eetion in 100mu;g,200mu;g groups,and still lower tban normal in the other groups. Histologically,retinal edema was found both in 100mu;g and 200mu;g groups,but degradation of retinal cells,and loss of cones and rods were round in the 250mu;g, 300mu;g and 400mu;g groups. CONCLUSION: The safe dose of intravitreal injection of cepbradlnc is 200mu;g. （Chin J Ocul Fundus Dis,1997,13:139-142 ）
Objective To investigate the ingestion, metabolism and subcellular localization of indocyanine green (ICG) in human retinal epithelial (R PE) cells.Methods RPE cells were incubated with 0.25 mg/ml ICG under the condition of 37oC in the camera. The ICG granule and ultrastructure of RPE cells were observed under the electron microscopy after 1, 4, and 24hour incubation, and the ICG autofluorescence was detected by fluorescence microscopy after the incubation for 1, 2, 4, 8, 12, 24, and 48 hours, respectively. The ab sorbency (A value) of ICG solution was measured at 805 nm with ultraviol et/v isible specrtrometer. The standard curve of concentration of ICG was drawn and the related equation of concentration of ICG and the A value was calculated. After being incubated for 1, 2, 4, 8, 12, 24, 48, and 72 hours, respectively, the A value of supernatant fluid was calculated according to the equation. Aft er incubated with ICG for 24 hours, one sample was observed under electron microscope and fluorescence microscope per week to evaluate the metabolizable period of ICG .Results ICG granules were distributed evenly after entering the RPE cells. After incubated with 0.25 mg/ml ICG for 24 hours, no significant change of the ultrastructure of the RPE cells was found. ICG granules accu mulated in the cells as the time goes by and reached the peak after 24 hours, and then they decreased because of the slowdown of the metabolism. Few ICG was still remained in the cells 1 week later Conclusions RPE cells may take in ICG actively. ICG metabolizable period in RPE cells is long, which may be one of the mechanisms of the toxicity of ICG to the retina in the vitreous operation.(Chin J Ocul Fundus Dis，2004，20：179-181)
Objective To investigate the effect of advanced glycation end products (AGEs) on the catalase activity and the levels of malondialdehyde in cultured bovine retinal capillary pericytes (BRPs), and to investigate the relationship between oxidative stress and diabetic retinopathy. Methods Cultured BRPs were exposed to AGEs (0, 8, 32, 125, 500, 2 000 μg/ml) for four days. Activity and the levels of catalase and malondialdehyde in cultured BRPs were examined by spectrophotometry. Results AGEs decreased the catalase activity, whereas increased the levels of malondialdehyde of cultured BRPs in a dose-dependent manner (r=-0.714, r=0.748, P＜0.01).There were significant differences between BRPs cultured in 32 μg/ml AGEs and in control group (P＜0.01), while no significant differences between BRPs cultured in non-glycated bovine serum albumin and absence of bovine serum albumin were found. Conclusion Oxidative stress may be one of the reasons why the pericyte disappears in diabetic retinopathy. (Chin J Ocul Fundus Dis, 2002, 18: 143-145)
Objective To study the effect of indirect calorimetry-guided nutritional support on energy metabolism, cellular immunity and oxidative stress in patients with colorectal cancer after laparoscopic surgery. Methods A total of 96 patients with colorectal cancer after laparoscopic surgery in our hospital from December 2019 to December 2021 were selected and randomly divided into the control group (used the formula prediction method to guide enteral nutrition support, n=48) and the observation group (used indirect calorimetry to guide enteral nutrition support, n=48). The target resting energy expenditure (REE) value and nutritional support energy intake were compared between the two groups. The cellular immune indexes (CD3+, CD4+, CD8+, CD4+/CD8+) and oxidative stress indexes [serum superoxide dismutase (SOD), malondialdehyde (MDA), the changes of glutathione peroxidase (GSH-Px)], and the changes of REE at different time points (1 day before operation and 1, 2 and 3 days after operation) of the two groups were compared. The incidence of complications in the two groups were observed. Results The target REE value of the observation group was lower than that of the control group (P＜0.05), and there was no significant difference in the enteral energy intake and parenteral energy intake compared with the control group (P＞0.05). After treatment, CD3+, CD4+ and CD4+/CD8+ in the two groups were lower than those before treatment (P<0.05), and CD8+ was higher than before treatment (P<0.05). The levels of CD3+, CD4+ and CD4+/CD8+ in the observation group after treatment were higher than those in the control group (P<0.05) , while the level of CD8+ in the observation group was lower than that in the control group (P<0.05). After treatment, the levels of SOD and GSH-Px in the two groups were lower than those before treatment (P<0.05), and the levels of MDA were higher than those before treatment (P<0.05). The levels of GSH-Px and SOD in the observation group were higher than those in the control group (P<0.05), while the level of MDA in the observation group was lower than that in the control group (P<0.05). There was no significant difference in the REE value between the two groups at 1 day before operation (P>0.05); compared with the 1 day before operation, the REE values of the two groups at 1, 2, and 3 days after operation were significantly increased, and there was a statistically significant difference between the two groups at each time point (P<0.05), but the REE value at 3 days after operation was significantly lower than that at 1 and 2 days after operation (P<0.05). The REE values in the observation group were lower than those in the control group at 1, 2 and 3 days after operation (P<0.05). The incidence of complications in the observation group was 6.25%, which was lower than 20.83% in the control group (P<0.05). Conclusion Enteral nutrition support guided by indirect calorimetry in colorectal cancer patients after laparoscopic surgery can help reduce postoperative energy consumption, improve cellular immune function and oxidative stress response, and reduce the risk of postoperative complications, which is worthy of promotion.
Endocrinology is closely related to lipid metabolism. Lipotoxicity affects the abnormal function of various endocrine organs, and leads to diabetes, fatty liver, metabolic syndrome and other endocrine and metabolic diseases. It is an important strategy to prevent the lipid toxicity. Endocrine disorders can also cause dyslipidemia. Studies have found that thyroid and gonadal glands play an important role in lipid metabolism. Their molecular mechanisms are gradually revealed and will be a new therapeutic target for dyslipidemia. Lipid metabolism disorders play an important role in the development of endocrine and metabolic diseases.
Objective\ To study the mechanism of myocardial protection of exogenous creatine phosphate (CP) against ischemia reperfused injury in modified isolated perfused working rat heart model.\ Methods\ Seventy two rats were divided into five groups.The rat hearts of five groups undergone Langendorff perfused were arrested and made totally ischemic for 40 minutes at 37℃ and reperfused for 20 minutes. St.Thomas cardioplegic solution wasn’t used in group A;It was used immediately after ischemia in group B and grou...
ObjectiveTo investigate the role of apelin, glycosylated hemoglobin (HbA1c), cholesterol (TC), triglyceride (TG), High density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC) in the development and progress of diabetic retinopathy (DR). MethodsThe serum concentration of apelin, HbA1c, TC, TG, HDLC and LDLC were measured in 30 normal control subjects and 90 patients with type 2 diabetic mellitus, including 30 cases without DR (NDR), 30 with non-proliferative DR (NPDR), 30 with proliferative DR (PDR). These data were analyzed by SPSS for windows 13.0. ResultsThe serum concentration of apelin, HbA1c, TC, HDLC, LDLC were significantly higher in NDR, NPDR, PDR group than those in control group (F=403.06, 5.45, 4.27, 201.56, 4.90;P < 0.05). The serum concentration of TG has no significantly difference (F=2.19, P > 0.05). The serum concentration of apelin, HbA1c, TC, LDLC were significantly higher in NDR, NPDR, PDR group than those in control group (t=0.30, 0.58, 0.79;P < 0.05), the serum concentration of HDLC were significantly lower than those in control group(t=0.79, P < 0.01). There were significantly positive correlation between the progression of DR and the serum concentration of apelin, HbA1c, TC, LDLC(r=0.962, 0.562, 0.935;P < 0.05). There were significantly negative correlation between the progression of DR and the serum concentration of HDLC(r=-0.753, P < 0.01). There were correlation between apelin and HbA1c, LDLC and HDLC(r=0.956, 0.741, -0.691;P < 0.01). ConclusionOur data demonstrated that serum apelin levels increased significantly in patients with diabetic retinopathy, and are closely related to blood sugar, blood lipid metabolic abnormalities.