Association of genetic variants in the IRAK-4 gene with susceptibility to severe sepsis

BACKGROUND:The association of genetic variation in the IRAK-1 gene with sepsis outcome has been proved.However,few studies have addressed the impact of the IRAK-4 gene variants on sepsis risk.This study aimed to determine whether the polymorphisms in the IRAK-4 gene are associated with susceptibility to and prognosis of severe sepsis in the Chinese Han ethnic population.METHODS:In this case-control study,192 patients with severe sepsis hospitalized in the emergency department of Zhongshan Hospital from February 2006 to December 2009 and 192healthy volunteers were enrolled.Exclusion criteria included metastatic tumors,autoimmune diseases,AIDS or treatment with immunosuppressive drugs.This study was approved by the ethical committee of Zhongshan Hospital,Fudan University.Sepsis patients were divided into a survival group(n=124)and a non-survival group(n=68)according to the 30-day mortality.Primer 3 software was used to design PCR and sequencing primers.Genomic DNA was extracted from peripheral blood mononuclear cells.Seven tagSNPs in IRAK-4 were selected according to the data of the Chinese Han population in Beijing from the Hapmap project and genotyped by direct sequencing.The chi-square test was used to evaluate the differences in genotype and allele frequencies between the two groups.RESULTS:The distributions of all tagSNPs were consistent with Hardy-Weinberg equilibrium.The allele and genotype frequencies of rs4251545(G/A)were significantly different between the severe sepsis and healthy control groups(P=0.015,P=0.035,respectively).Carriers of the rs4251545A had a higher risk for severe sepsis compared with carriers of the rs4251545G(OR=1.69,95%CI:1.10-2.58).The allele and genotype frequencies of all SNPs were not significantly different between the survival group and non-survival group.CONCLUSION:These findings indicate that the variants in IRAK-4 are significantly associated with susceptibility to severe sepsis in the Chinese Han ethnic population.

Effect of propofol intravenous anesthesia on hemorheology, hemodynamics and immune function in patients with colorectal cancer after radical operation

Objective:To investigate the effect of Propofol Intravenous Anesthesia on hemorheology, hemodynamics and immune function in patients with colorectal cancer after radical operation.Method: A total of 100 patients with colorectal cancer treated in our hospital from September 2015 to August 2017 were randomly divided into observation group and control group according to random number table. The control group was inhaled sevoflurane anesthesia, observation group propofol intravenous anesthesia. The changes of hemorheology, hemodynamics and immune function were compared between the two groups.Results: There was no significant difference in hemorheology index, hemodynamic index, T lymphocyte subsets CD45RA+, CD45RO+, CD45RA+/CD45RO+ levels between the two groups before anesthesia. Anesthesia 1.5 h after, the levels of LBV, HBV, PV, EAI and EDI in the two groups were significantly decreased, but there was no significant difference between the observation group and the control group. At 1.5 h after anesthesia induction, the HR and SBP levels of the observation group did not change significantly compared with anesthesia before, while the HR and SBP levels of the 1.5 h after anesthesia induction in the control group were significantly lower than those before anesthesia and significantly lower than the corresponding level HR level (86.43±13.25) times/min, SBP level (110.84±15.41) mmHg in the observation group. At the end of surgery, the levels of CD45RA+ and CD45RO+ in the observation group were significantly decreased, but increased at 72 h after operation.Conclusion: After operation, CD45RA+ and CD45RO+ levels in the control group were significantly decreased, and preoperatively, which can significantly improve the hemorheology and reduced hemodynamic effects, and contribute to the recovery of patients with immune function, is worth clinical promotion.

Effects of etomidate maintenance anesthesia on immunoglobulin and stress response levels in patients with gastric cancer after operation

Objective: To investigate the effect of etomidate maintenance anesthesia on immune function and stress response in patients with gastric cancer after the operation. Methods: 160 patients with gastric cancer in our hospital were randomly divided into control group and observation group, with 80 cases in each group. Both of the groups underwent radical gastrectomy, in which the control group was injected propofol anesthesia, while the observation group was injected etomidate anesthesia. The levels of immunoglobulin A, immunoglobulin M, immunoglobulin G, cortisol(Cor), aldosterone(ALD), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), tumor necrosis factor-α (TNF-α) and hypersensitive C-reactive protein (hs-CRP) were detected and compared before and after treatment. Results: After treatment, the serum levels of immunoglobulin A, immunoglobulin G and immunoglobulin M of the patients in the control group were significantly decreased. But in the observation group, these serum level did not change significantly and were higher compared with the control group. The serum levels of Cor, ALD, SOD, and GSH-Px in both groups after treatment were significantly decreased, while the levels of MDA, TNF-α and hs-CRP were significantly increased. The serum levels of Cor, ALD, MDA, TNF-α, and hs-CRP of patients in the observation group were significantly lower than those in the control group, and the levels of SOD and GSH-Px were significantly higher than those in the control group. Conclusion: Etomidate can enhance the immune function and antioxidant capacity of patients with gastric cancer, alleviate inflammation, and has a good clinical effect. But it is not suitable for patients with severe impairment of adrenocortical function.

Effects of Remifentanil combined with Propofol anesthesia on neurological function, inflammatory response and stress state in patients undergoing craniotomy

Objective:In this study, the effects of combined anesthesia with Remifentanil and Propofol on the hemodynamics and stress state indexes at different times in patients undergoing craniotomy were studied, and the effects of combined anesthesia with Remifentanil and Propofol on neurological function and inflammatory response in patients undergoing craniotomy were explored.Methods:A total of 92 patients who underwent craniotomy in our hospital from January 2017 to February 2019 were collected and divided into observation group and control group according to their anesthesia methods. 45 patients in the control group received propofol to maintain anesthesia. In the observation group, 47 cases were treated with remifentanil combined with propofol to maintain anesthesia. Changes in hemodynamics (HR, SpO2, MAP) of the two groups were monitored at different times throughout the operation. At the same time by ria method detection in patients with two groups of T0, T1, T2, T3, T4 in serum stress state index (AngⅡ, NE, ALD) changes. The changes of nerve function indexes (NSE, S100) and inflammatory factors (CRP, TNF-α) before and after surgery were compared between the two groups.Results:There were no significant differences in hemodynamics and stress state indicators of T0 between the two groups, and there were no significant differences in preoperative inflammatory reaction and neurological function indicators between the two groups. In the observation group, the changes of HR, SpO2 and MAP at each time point during the operation were less than those in the control group, and the hemodynamic state of the observation group was more stable than that of the control group. The level of AngⅡ, NE, ALD in Control patients in T1, T2, T3, T4 were higher than T0. The level of AngⅡ, NE, ALD of the two groups in T1, T2, T3, T4 are higher than T0. Observation group of patients with T1, T2, T3, T4 AngⅡ level obviously is higher than the control group with time. In the observation group, the levels of NE and ALD were higher at T2, T3 and T4 than at T0. The levels of NE and ALD in T3 and T4 were lower in the observation group than in the control group. Postoperative neurological function (NSE, S100) and inflammatory factors (CRP, TNF-α) were significantly higher in the two groups than in the control group.Conclusion: Combined anesthesia with Remifentanil and Propofol can stabilize the hemodynamic state of patients undergoing craniotomy, reduce cardiovascular stress response and inflammatory response, reduce nerve damage, and play a role in brain protection.

Effect of dexmedetomidine on the immune function, serum inflammatory factors and hemodynamics in elderly patients with gastric cancer

Objective: To investigate the effect of dexmedetomidine on the immune function, serum inflammatory factors and hemodynamics in elderly patients with gastric cancer. Method: A total of 84 elderly patients with gastric cancer treated in our hospital from September 2015 to March 2017 were randomly divided into the control group and the observation group, each with 42 cases. The control group received intravenous infusion of Sodium Chloride Injection before anesthesia induction, and the observation group received dexmedetomidine intravenous infusion. The levels of hemodynamic indexes HR and MAP levels, serum inflammatory factors levels of CRP, IL-2, IL-10 levels and T lymphocyte subsets levels were compared between the two groups. Results: Compared with induction of anesthesia before, the HR level of two groups were both significantly increased at 6 h after operation, the MAP level of control group was significantly increased at 6 h after operation while was not changed significantly in the observation group. According comparison between groups at 6 h after operation, the levels of HR, MAP in observation group were significantly lower than those of the control group. Compared with induction of anesthesia before, the CRP level was significantly increased at each postoperative time point in two groups;the IL-2 level at 24 h after operation of two groups were decreased significantly, while both increased back and significantly higher than that before induction of anesthesia;the IL-10 level at 24 h after operation of two groups were increased significantly, while both decreased back and significantly lower than that before induction of anesthesia. Compared with the control group at the same time point, the CRP, IL-10 level of observation group were significantly lower than those of the control group and the IL-2 level of observation group was significantly higher than that of the control group. Compared with induction of anesthesia before, the levels of CD3+, CD4+, CD4+/CD8+ of control group were significantly decreased at 6 h, 24 h, 72 h after operation and significantly decreased at 24 h after operation in observation group. 72 h after operation, the levels of CD3+, CD4+, CD4+/CD8+ of observation group increased back and were not changed significantly compared with induction of anesthesia before. Compared with the control group at the same time point, 6 h, 24 h, 72 h after operation, the levels of CD3+, CD4+, CD4+/CD8+ of observation group were significantly higher than that of the control group. Conclusion: Dexmedetomidine for elderly patients with gastric cancer assisted anesthesia can reduce the stress caused by surgical trauma, improve the immune level, reduce the inflammatory response, and stabilize hemodynamics of patients in the perioperative period significantly. It is worthy of clinical promotion.

A pilot study of the differentiated landscape of peripheral blood mononuclear cells from children with incomplete versus complete Kawasaki disease

Kawasaki disease(KD)is a disorder of immune responses.The prevalence of KD among 100,000 children aged 0-4 years was 71.9-110.0 in China,170.9-194.9 in Korea,and 18.1-21.3 in the USA[1].The most severe complication of KD is coronary artery lesions(CALs),including coronary dilatation and coronary aneurysms,which may even lead to myocardial ischemia,myocardial infarction,and sudden death.

Synergistic effect of chloride ion and albumin on the corrosion of pure magnesium

In this work, we report on synergistic effect of chloride ion and albumin on the corrosion of pure magnesium through corrosion tests. We show that the adsorption of albumin mainly affects the anodic polarization behavior of pure magnesium in NaCl solution. Low concentration of albumin enhances the reaction reactivity of pure magnesium and the initial evolvement of hydrogen at the initial immersion time. Addition of I glL albumin provides limited corrosion control for pure magnesium in NaCl solution. In comparison with low concentration albumin, addition of 10 g/L albumin can effectively inhibit the further dissolution of pure magnesium in test solutions with NaCI concentration of 0.2-0.8 wt. %, but this effect lowers gradually with increasing the concentration of chloride ion.