Lung injury is the main manifestation of paraquat poisoning. Few studies have addressed brain damage after paraquat poisoning. Ulinastatin is a protease inhibitor that can effectively stabilize lysosomal membranes, pr...Lung injury is the main manifestation of paraquat poisoning. Few studies have addressed brain damage after paraquat poisoning. Ulinastatin is a protease inhibitor that can effectively stabilize lysosomal membranes, prevent cell damage, and reduce the production of free radicals. This study assumed that ulinastatin would exert these effects on brain tissues that had been poisoned with paraquat. Rat models of paraquat poisoning were intraperitoneally injected with ulinastatin. Simultaneously, rats in the control group were administered normal saline. Hematoxylin-eosin staining showed that most hippocampal cells were contracted and nucleoli had disappeared in the paraquat group. Fewer cells in the hippocampus were concentrated and nucleoli had dis- appeared in the ulinastatin group. Western blot assay showed that expressions of GRP78 and cleaved-caspase-3 were significantly lower in the ulinastatin group than in the paraquat group. Immunohistochemical findings showed that CHOP immunoreactivity was significantly lower in the ulinastatin group than in the paraquat group. Terminal deoxynucleotidyl transferase-medi- ated dUTP nick end labeling staining showed that the number of apoptotic cells was reduced in the paraquat and ulinastatin groups. These data confirmed that endoplasmic reticular stress can be induced by acute paraqnat poisoning. Ulinastatin can effectively inhibit this stress as well as cell apoptosis, thereby exerting a neuroprotective effect.展开更多
AIM: To investigate the efficacy and safety of ulinastatin for patients with acute lung injury(ALI) and those with acute respiratory distress syndrome(ARDS).METHODS: A systematic review of randomized controlled trials...AIM: To investigate the efficacy and safety of ulinastatin for patients with acute lung injury(ALI) and those with acute respiratory distress syndrome(ARDS).METHODS: A systematic review of randomized controlled trials(RCTs) of ulinastatin for ALI/ARDS was conducted. Oxygenation index, mortality rate [intensive care unit(ICU) mortality rate, 28-d mortality rate] and length of ICU stay were compared between ulinastatin group and conventional therapy group. Meta-analysis was performed by using Rev Man 5.1.RESULTS: Twenty-nine RCTs with 1726 participants were totally included, the basic conditions of which were similar. No studies discussed adverse effect. Oxygenation index was reported in twenty-six studies(1552 patients). Ulinastatin had a significant effect in improving oxygenation [standard mean difference(SMD) = 1.85, 95%CI: 1.42-2.29, P < 0.00001, I2 = 92%]. ICUmortality and 28-d mortality were respectively reported in eighteen studies(987 patients) and three studies(196 patients). We found that ulinastatin significantly decreased the ICU mortality [I2 = 0%, RR = 0.48, 95%CI: 0.38-0.59, number needed to treat(NNT) = 5.06, P < 0.00001], while the 28-d mortality was not significantly affected(I2 = 0%, RR = 0.78, 95%CI: 0.51-1.19, NNT = 12.66, P = 0.24). The length of ICU stay(six studies, 364 patients) in the ulinastatin group was significantly lower than that in the control group(SMD =-0.97, 95%CI:-1.20--0.75, P < 0.00001, I2 = 86%). CONCLUSION: Ulinastatin seems to be effective for ALI and ARDS though most trials included were of poor quality and no information on safety was provided.展开更多
BACKGROUND Severe acute pancreatitis(AP)is one of the most common diseases of the gastrointestinal tract and carries a significant financial burden with high disability and mortality.There are no effective drugs in th...BACKGROUND Severe acute pancreatitis(AP)is one of the most common diseases of the gastrointestinal tract and carries a significant financial burden with high disability and mortality.There are no effective drugs in the clinical management of severe AP,and there is an absence of evidence-based medicine concerning the treatment of severe AP.AIM To explore whether ulinastatin(UTI)can improve the outcome of severe AP.METHODS The present research included patients who were hospitalized in intensive critical care units(ICUs)after being diagnosed with severe AP.Patients received UTI(400000 IU)or placebos utilizing computer-based random sequencing(in a 1:1 ratio).The primary outcome measures were 7-d mortality,clinical efficacy,inflammatory response,coagulation function,infection,liver function,renal function,and drug-related adverse effects were evaluated.RESULTS A total of 181 individuals were classified into two groups,namely,the placebo group(n=90)and the UTI group(n=91).There were no statistically significant differences in baseline clinical data between the two groups.The 7-d mortality and clinical efficacy in the UTI group were remarkably improved compared with those in the placebo group.UTI can protect against hyperinflammation and improve coagulation dysfunction,infection,liver function,and renal function.UTI patients had markedly decreased hospital stays and hospitalization expenditures compared with the placebo group.CONCLUSION The findings from the present research indicated that UTI can improve the clinical outcomes of patients with severe AP and has fewer adverse reactions.展开更多
Objective: To research the effectiveness of ulinastatin in combination with continuous renal replacement therapy in treating sepsis acute kidney injury and its effect on systemic inflammation, immune function and miRA...Objective: To research the effectiveness of ulinastatin in combination with continuous renal replacement therapy in treating sepsis acute kidney injury and its effect on systemic inflammation, immune function and miRAN expression. Methods: The 84 patients who were diagnosed with sepsis complicated by acute kidney injury in our hospital between May 2020 and June 2022 were chosen and randomly assigned to the study group (n = 42) and the control group (n = 42). Ulinastatin in combination with continuous renal replacement therapy was administered to the study group, whereas the control group was administered with continuous renal replacement therapy alone. Both groups’ clinical effects were observed. The levels of blood urea nitrogen (BUN), serum creatinine (SCr), tumor necrosis factor-α (TNF-α), high sensitivity Creactive protein (hs-CRP), vascular cell adhesion molecule-1 (VCAM-1), IgG, IgA, IgM, expression levels of miR-233 and miR-10a were compared among both the groups, pre-, and post-treatment. Results: The study group’s overall effectiveness rate was higher that is 95.24%, in comparison to the control group’s 78.57%, and this difference was statistically significant (P α, hs-CRP, VCAM-1, and miR-233 and miR-10a expression levels in both the study and control groups were decreased, however, the study group had reduced levels in comparison to the control group, with statistically significant differences (P P Conclusion: Ulinastatin in combination with continuous renal replacement therapy for treating sepsis acute kidney injury exhibits a positive effect and can significantly improve the systemic inflammation and immune function in patients.展开更多
Objective:To study the effect of ulinastatin combined with antibiotics on systemic inflammatory response and stress hormone secretion in patients with acute severe pneumonia. Methods: A total of 78 patients with acute...Objective:To study the effect of ulinastatin combined with antibiotics on systemic inflammatory response and stress hormone secretion in patients with acute severe pneumonia. Methods: A total of 78 patients with acute severe pneumonia in our hospital between December 2014 and January 2017 were randomly divided into routine group and ulinastatin group, each with 39 cases. Routine group were treated with conventional antibiotics, ulinastatin group were treated with ulinastatin and antibiotics, and the treatments lasted for 2 weeks. The differences of serum acute phase proteins, inflammatory factors and stress hormones were compared between the two groups before and after treatment.Results: Before treatment, there were no significant differences in serum contents of acute phase proteins, inflammatory factors or stress hormones between the two groups. After 2 weeks of treatment, serum acute phase protein prealbumin (PA) content in ulinastatin group was higher than that in routine group whereas C-reactive protein (CRP) content was lower than that in routine group;serum inflammatory cytokines interleukin-1β (IL-1β), interleukin-2 (IL-2) and interleukin-6 (IL-6) contents in ulinastatin group were lower than those in routine group;serum stress hormones NE, Cor and AngII contents in ulinastatin group were lower than those in routine group. Conclusion:Ulinastatin combined with antibiotics for acute severe pneumonia can inhibit the systemic inflammatory response and stress response.展开更多
Objective: To investigate the effects of ulinastatin on immune function, oxidative stress and related factors in patients with acute pancreatitis. Methods: 120 patients with acute pancreatitis admitted to digestive de...Objective: To investigate the effects of ulinastatin on immune function, oxidative stress and related factors in patients with acute pancreatitis. Methods: 120 patients with acute pancreatitis admitted to digestive department of our hospital from May 2016 to May 2018 were randomly divided into control group and observation group, 60 cases in each group. Patients in the control group were given routine treatment, while patients in the observation group were given ulinastatin on the basis of the treatment of patients in the control group. The levels of Kim-1, Cys C, BUN, IgA, IgM, IgG, SOD, NO, TAC, PCT and CRP of patients in the two groups were detected and compared before and after treatment. Results: After treatment, the serum levels of Kim-1, Cys C, BUN, NO, PCT and CRP of patients in the control group and the observation group decreased significantly and the serum levels of IgA, IgG, IgM, SOD and TAC increased significantly. The change trend of these indexes in the serum of patients in the observation group was more obvious than those of patients in the control group (P<0.05). Conclusion: Ulinastatin in the treatment of acute pancreatitis can significantly alleviate kidney injury, enhance immune function and antioxidant capacity of patients, alleviate inflammation.展开更多
Objective: To study the effect of ulinastatin combined with anti-infective therapy on systemic inflammatory response and oxidative stress response in patients with acute severe pneumonia. Methods: A total of 50 patien...Objective: To study the effect of ulinastatin combined with anti-infective therapy on systemic inflammatory response and oxidative stress response in patients with acute severe pneumonia. Methods: A total of 50 patients with acute severe pneumonia who were treated in the hospital between September 2014 and December 2016 were collected and divided into control group and observation group according to the random number table method, 25 cases in each group. Control group received conventional therapy, and the observation group received ulinastatin combined with conventional therapy. The differences in inflammatory response and oxidative stress response in serum were measured before treatment and 10 d after treatment. Results:Before treatment, differences in serum levels of inflammatory response indexes and oxidative stress indexes were not statistically significant between the two groups. After treatment, serum IL-2, IL-6, PCT, HMGB1, CRP, IL-4, IL-10, IL-13, MDA, AOPP and ROS levels of both groups of patients were lower than those before treatment while SOD, T-AOC, GSH-Px and LHP levels were higher than those before treatment, and serum IL-2, IL-6, PCT, HMGB1, CRP, IL-4, IL-10, IL-13, MDA, AOPP and ROS levels of observation group were lower than those of control group while SOD, T-AOC, GSH-Px and LHP levels were higher than those of control group. Conclusion: Ulinastatin combined with anti-infective therapy can effectively reduce the systemic inflammatory response and oxidative stress response and optimize the overall condition in patients with acute severe pneumonia.展开更多
Objective:To study the effect of ulinastatin combined with CRRT therapy on the endothelial oxidative damage and inflammatory injury in patients with acute respiratory distress syndrome (ARDS).Methods: A total of 60 pa...Objective:To study the effect of ulinastatin combined with CRRT therapy on the endothelial oxidative damage and inflammatory injury in patients with acute respiratory distress syndrome (ARDS).Methods: A total of 60 patients with ARDS who were treated in our hospital between April 2011 and April 2016 were collected and divided into the control group (n=29) who received pure CRRT therapy and the combined treatment group (n=31) who received ulinastatin combined with CRRT therapy after the therapy and related laboratory examination were reviewed. Before treatment and after 5d of treatment, enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of endothelial function indexes and inflammation indexes in serum and exhaled breath condensate;RIA method was used to detect the levels of oxidative stress indexes in serum and exhaled breath condensate.Results: Before treatment, the differences in the endothelial function, oxidative stress and inflammation indexes in serum and exhaled breath condensate were not statistically significant between two groups of patients. After treatment, endothelial function index NO levels in serum and exhaled breath condensate of observation group were higher than those of control group while ET-1 levels were lower than those of control group;oxidative stress indexes CAT and SOD levels in serum and exhaled breath condensate of observation group were higher than those of control group while MAO levels were lower than those of control group;inflammation indexes PCT, IL-1β and HMGB1 levels in serum and exhaled breath condensate of observation group were lower than those of control group.Conclusion: Ulinastatin combined with CRRT therapy can improve the endothelial function and reduce the oxidative stress and inflammatory injury in patients with ARDS.展开更多
Objective:To study the effect of ulinastatin on vasoactive substances, oxidative stress and inflammatory response in patients with acute exacerbation of COPD.Methods:Patients with acute exacerbation of COPD who were t...Objective:To study the effect of ulinastatin on vasoactive substances, oxidative stress and inflammatory response in patients with acute exacerbation of COPD.Methods:Patients with acute exacerbation of COPD who were treated in Chengdu Fifth People's Hospital between August 2013 and July 2016 were selected as the research subjects and randomly divided into ulinastatin group and normal control group who received ulinastatin combined with conventional therapy and conventional therapy respectively. The serum contents of vasoactive substances, stress response hormones, oxidative stress products and inflammatory response mediators were detected before treatment and 7 d after treatment.Results: 7 d after treatment, serum D-D, AT-II, pro-BNP, ACTH, FC, NE, MDA, 8-iso-PG, HSP27, HSP70, PCT, CRP, CCL18 and MSP contents of both groups of patients were significantly lower than those before treatment while TT3 and TT4 contents were significantly higher than those before treatment;serum D-D, AT-II, pro-BNP, ACTH, FC, NE, MDA, 8-iso-PG, HSP27, HSP70, PCT, CRP, CCL18 and MSP contents of ulinastatin group 7 d after treatment were significantly lower than those of normal control group while TT3 and TT4 contents were significantly higher than those of normal control group.Conclusion:Ulinastatin therapy can correct the disturbance of vasoactive substances, and inhibit the oxidative stress and inflammatory response in patients with acute exacerbation of COPD.展开更多
BACKGROUND With the continuous growth of the modern elderly population,the risk of fracture increases.Hip fracture is a common type of fracture in older people.Total hip arthroplasty(THA)has significant advantages in ...BACKGROUND With the continuous growth of the modern elderly population,the risk of fracture increases.Hip fracture is a common type of fracture in older people.Total hip arthroplasty(THA)has significant advantages in relieving chronic pain and promoting the recovery of hip joint function.AIM To investigate the effect of ulinastatin combined with dexmedetomidine(Dex)on the incidences of postoperative cognitive dysfunction(POCD)and emergence agitation in elderly patients who underwent THA.METHODS A total of 397 patients who underwent THA from February 2019 to August 2022.We conducted a three-year retrospective cohort study in Shaanxi Provincial People’s Hospital.Comprehensive demographic data were obtained from the electronic medical record system.We collected preoperative,intraoperative,and postoperative data.One hundred twenty-nine patients who were administered Dex during the operation were included in the Dex group.One hundred fifty patients who were intravenously injected with ulinastatin 15 min before anesthesia induction were included in the ulinastatin group.One hundred eighteen patients who were administered ulinastatin combined with Dex during the operation were included in the Dex+ulinastatin group.The patients’perioperative conditions,hemodynamic indexes,postoperative Mini-Mental State Examination(MMSE)scores,Ramsay score,incidence of POCD,and serum inflammatory cytokines were evaluated.RESULTS There was a significant difference in the 24 h visual analogue scale score among the three groups,and the score in the Dex+ulinastatin group was the lowest(P<0.05).Compared with the Dex and ulinastatin group,the MMSE scores of the Dex+ulinastatin group were significantly increased at 1 and 7 d after the operation(all P<0.05).Compared with those in the Dex and ulinastatin groups,incidence of POCD,levels of serum inflammatory cytokines in the Dex+ulinastatin group were significantly decreased at 1 and 7 d after the operation(all P<0.05).The observer’s assessment of the alertness/sedation score and Ramsay score of the Dex+ulinastatin group were significantly different from those of the Dex and ulinastatin groups on the first day after the operation(all P<0.05).CONCLUSION Ulinastatin combined with Dex can prevent the occurrence of POCD and emergence agitation in elderly patients undergoing THA.展开更多
Accurate ultra-short-term prediction of the Earth rotation parameters(ERP)holds paramount impor-tance for real-time applications,particularly in reference frame conversion.Among them,diurnal rota-tion(UT1-UTC)which ca...Accurate ultra-short-term prediction of the Earth rotation parameters(ERP)holds paramount impor-tance for real-time applications,particularly in reference frame conversion.Among them,diurnal rota-tion(UT1-UTC)which cannot be directly estimated through Global Navigation Satellite System(GNSS)techniques,significantly affects the rapid and ultra-rapid orbit determination of GNsS satellites.Pres-ently,the traditional LS(least squares)+AR(autoregressive)and LS+MAR(multivariate autoregressive)hybrid methods stand as primary approaches for UT1-UTC ultra-short-term predictions(1-10 days).The LS+MAR hybrid method relies on the UT1-UTC and LOD(length of day)series.However,the correlation between LOD and first-order-difference UT1-UTC is stronger than that between LOD and UT1-UTC.In light of this,and with the aid of the first-order-difference UT1-UTC,we propose an enhanced LS+MAR hybrid method to UT1-UTC ultra-short-term prediction.By using the UT1-UTC and LOD data series of the IERS(International Earth Rotation and Reference Systems Service)EOP 14 C04 product,we conducted a thorough analysis and evaluation of the improved method's prediction performance compared to the traditional LS+AR and LS+MAR hybrid methods.According to the numerical results over more than 210 days,they demonstrate that,when considering the correlation information between the LoD and the first-order-difference UT1-UTC,the mean absolute errors(MAEs)of the improved LS+MAR hybrid method range from 21 to 934μs in 1-10 days predictions.In comparison to the traditional LS+AR hybrid method,the MAEs show a reduction of 7-53μs in 1-10 days predictions,with corresponding improvement percentages ranging from 1 to 28%.Similarly,when compared to the traditional LS+MAR hybrid method,the MAEs have a reduction of 5-42μs in 1-10 days predictions,with corresponding improvement percentages ranging from 4-20%.Additionally,when aided by GNSS-derived LOD data series,the MAEs of improved LS+MAR hybrid method experience further reduction.展开更多
This study investigated if the variation in the effect of anti-cholesterol(AC)treatment on individual mice are related to gut microbiome composition.The bile salt hydrolase(BSH)activity of 23 commercial fermented milk...This study investigated if the variation in the effect of anti-cholesterol(AC)treatment on individual mice are related to gut microbiome composition.The bile salt hydrolase(BSH)activity of 23 commercial fermented milk products was examined to select a fermented milk product for AC treatment.Mice were fed to different diets for 6 weeks:high-fat(60%of total calories from fat;D1),high-dietary fibre(20%cellulose;D2),and low-fat(17.2%of total calories from fat;D3)diets to change their gut microbiomes.Subsequently,faecal microbiome was transplanted(FMT)into mice treated with high cholesterol diet contained 2%cholesterol,followed by AC or non-AC(sterile tap water,STW)treatments.Control groups with normal(NC)and highcholesterol diets(PC)were prepared for both AC and STW treatment.All experimental groups were subjected to serum and liver cholesterol,cholesterol metabolism-related(CMR)gene expression,and intestinal microbiome analyses.D3-FMT mice showed the most significant enhancements in cholesterol ratio and decreased hepatic cholesterol levels with AC treatment.Moreover,upregulation of the Cyp7a1 gene expression was observed in this group.Furthermore,the intestinal microbiome analysis indicated higher abundances of BSH-producing Eubacterium,Bifidobacterium,and Parabacteroides in the D3-FMT+AC group compare to others,potentially contributing to increased bile acid synthesis.展开更多
Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate...Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate the efficacy and safety of ulinastatin in the treatment of septic shock patients.Methods:Three English databases(Embase,Medline,and Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure,Wanfang data,SinoMed,and VIP)were searched for published randomized controlled trials.Stata 16.0 software was used to conduct the meta-analysis.Results:A total of 48 articles were included(Chinese article 47,1 in English).The results show that the treatment of ulinastatin could reduce mortality(risk ratio=0.63,95%confidence interval(CI)(0.55,0.72)),multiple organ dysfunction syndrome(risk ratio=0.6,95%CI(0.53,0.68)),length of intensive care unit stay(mean difference(MD)=-3.92,95%CI(-4.65,-3.18)),length of hospital stay(MD=-4.39,95%CI(-6.63,-2.15))and decrease Acute Physiology and Chronic Health Evaluation II score(MD=-4.55,95%CI(-5.63,-3.47))and Sequential Organ Failure Assessment score(MD=-2.02,95%CI(-2.59,-1.44))with P<0.001.Moreover,it lowers TNF-α(standardized mean difference(SMD)=-1.78,95%CI(-2.24,-1.32)),Interleukin-6(SMD=-1.17,95%CI(-1.55,-0.8)),C reactive protein(SMD=-1.49,95%CI(-1.99,-0.99)),hypersensitive C-reactive protein(SMD=-1.9,95%CI(-2.87,-0.94))and procalcitonin(SMD=-0.89,95%CI(-1.12,-0.67))levels in the body.Conclusions:Available evidence shows that ulinastatin reduces case mortality rate,multiple organ dysfunction syndrome,length of intensive care unit stay,and length of hospital stay and decreases Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score.Moreover,it also lowers TNF-α,Interleukin-6,C reactive protein,hypersensitive C-reactive protein,and procalcitonin levels in the body.展开更多
基金supported by a grant from the National Key Specialty Construction Project in China in 2012,No.[2012]650
文摘Lung injury is the main manifestation of paraquat poisoning. Few studies have addressed brain damage after paraquat poisoning. Ulinastatin is a protease inhibitor that can effectively stabilize lysosomal membranes, prevent cell damage, and reduce the production of free radicals. This study assumed that ulinastatin would exert these effects on brain tissues that had been poisoned with paraquat. Rat models of paraquat poisoning were intraperitoneally injected with ulinastatin. Simultaneously, rats in the control group were administered normal saline. Hematoxylin-eosin staining showed that most hippocampal cells were contracted and nucleoli had disappeared in the paraquat group. Fewer cells in the hippocampus were concentrated and nucleoli had dis- appeared in the ulinastatin group. Western blot assay showed that expressions of GRP78 and cleaved-caspase-3 were significantly lower in the ulinastatin group than in the paraquat group. Immunohistochemical findings showed that CHOP immunoreactivity was significantly lower in the ulinastatin group than in the paraquat group. Terminal deoxynucleotidyl transferase-medi- ated dUTP nick end labeling staining showed that the number of apoptotic cells was reduced in the paraquat and ulinastatin groups. These data confirmed that endoplasmic reticular stress can be induced by acute paraqnat poisoning. Ulinastatin can effectively inhibit this stress as well as cell apoptosis, thereby exerting a neuroprotective effect.
文摘AIM: To investigate the efficacy and safety of ulinastatin for patients with acute lung injury(ALI) and those with acute respiratory distress syndrome(ARDS).METHODS: A systematic review of randomized controlled trials(RCTs) of ulinastatin for ALI/ARDS was conducted. Oxygenation index, mortality rate [intensive care unit(ICU) mortality rate, 28-d mortality rate] and length of ICU stay were compared between ulinastatin group and conventional therapy group. Meta-analysis was performed by using Rev Man 5.1.RESULTS: Twenty-nine RCTs with 1726 participants were totally included, the basic conditions of which were similar. No studies discussed adverse effect. Oxygenation index was reported in twenty-six studies(1552 patients). Ulinastatin had a significant effect in improving oxygenation [standard mean difference(SMD) = 1.85, 95%CI: 1.42-2.29, P < 0.00001, I2 = 92%]. ICUmortality and 28-d mortality were respectively reported in eighteen studies(987 patients) and three studies(196 patients). We found that ulinastatin significantly decreased the ICU mortality [I2 = 0%, RR = 0.48, 95%CI: 0.38-0.59, number needed to treat(NNT) = 5.06, P < 0.00001], while the 28-d mortality was not significantly affected(I2 = 0%, RR = 0.78, 95%CI: 0.51-1.19, NNT = 12.66, P = 0.24). The length of ICU stay(six studies, 364 patients) in the ulinastatin group was significantly lower than that in the control group(SMD =-0.97, 95%CI:-1.20--0.75, P < 0.00001, I2 = 86%). CONCLUSION: Ulinastatin seems to be effective for ALI and ARDS though most trials included were of poor quality and no information on safety was provided.
基金Supported by Wuxi Science and Technology Development Fund,No.WX03-02B0205-072001-10.
文摘BACKGROUND Severe acute pancreatitis(AP)is one of the most common diseases of the gastrointestinal tract and carries a significant financial burden with high disability and mortality.There are no effective drugs in the clinical management of severe AP,and there is an absence of evidence-based medicine concerning the treatment of severe AP.AIM To explore whether ulinastatin(UTI)can improve the outcome of severe AP.METHODS The present research included patients who were hospitalized in intensive critical care units(ICUs)after being diagnosed with severe AP.Patients received UTI(400000 IU)or placebos utilizing computer-based random sequencing(in a 1:1 ratio).The primary outcome measures were 7-d mortality,clinical efficacy,inflammatory response,coagulation function,infection,liver function,renal function,and drug-related adverse effects were evaluated.RESULTS A total of 181 individuals were classified into two groups,namely,the placebo group(n=90)and the UTI group(n=91).There were no statistically significant differences in baseline clinical data between the two groups.The 7-d mortality and clinical efficacy in the UTI group were remarkably improved compared with those in the placebo group.UTI can protect against hyperinflammation and improve coagulation dysfunction,infection,liver function,and renal function.UTI patients had markedly decreased hospital stays and hospitalization expenditures compared with the placebo group.CONCLUSION The findings from the present research indicated that UTI can improve the clinical outcomes of patients with severe AP and has fewer adverse reactions.
文摘Objective: To research the effectiveness of ulinastatin in combination with continuous renal replacement therapy in treating sepsis acute kidney injury and its effect on systemic inflammation, immune function and miRAN expression. Methods: The 84 patients who were diagnosed with sepsis complicated by acute kidney injury in our hospital between May 2020 and June 2022 were chosen and randomly assigned to the study group (n = 42) and the control group (n = 42). Ulinastatin in combination with continuous renal replacement therapy was administered to the study group, whereas the control group was administered with continuous renal replacement therapy alone. Both groups’ clinical effects were observed. The levels of blood urea nitrogen (BUN), serum creatinine (SCr), tumor necrosis factor-α (TNF-α), high sensitivity Creactive protein (hs-CRP), vascular cell adhesion molecule-1 (VCAM-1), IgG, IgA, IgM, expression levels of miR-233 and miR-10a were compared among both the groups, pre-, and post-treatment. Results: The study group’s overall effectiveness rate was higher that is 95.24%, in comparison to the control group’s 78.57%, and this difference was statistically significant (P α, hs-CRP, VCAM-1, and miR-233 and miR-10a expression levels in both the study and control groups were decreased, however, the study group had reduced levels in comparison to the control group, with statistically significant differences (P P Conclusion: Ulinastatin in combination with continuous renal replacement therapy for treating sepsis acute kidney injury exhibits a positive effect and can significantly improve the systemic inflammation and immune function in patients.
文摘Objective:To study the effect of ulinastatin combined with antibiotics on systemic inflammatory response and stress hormone secretion in patients with acute severe pneumonia. Methods: A total of 78 patients with acute severe pneumonia in our hospital between December 2014 and January 2017 were randomly divided into routine group and ulinastatin group, each with 39 cases. Routine group were treated with conventional antibiotics, ulinastatin group were treated with ulinastatin and antibiotics, and the treatments lasted for 2 weeks. The differences of serum acute phase proteins, inflammatory factors and stress hormones were compared between the two groups before and after treatment.Results: Before treatment, there were no significant differences in serum contents of acute phase proteins, inflammatory factors or stress hormones between the two groups. After 2 weeks of treatment, serum acute phase protein prealbumin (PA) content in ulinastatin group was higher than that in routine group whereas C-reactive protein (CRP) content was lower than that in routine group;serum inflammatory cytokines interleukin-1β (IL-1β), interleukin-2 (IL-2) and interleukin-6 (IL-6) contents in ulinastatin group were lower than those in routine group;serum stress hormones NE, Cor and AngII contents in ulinastatin group were lower than those in routine group. Conclusion:Ulinastatin combined with antibiotics for acute severe pneumonia can inhibit the systemic inflammatory response and stress response.
文摘Objective: To investigate the effects of ulinastatin on immune function, oxidative stress and related factors in patients with acute pancreatitis. Methods: 120 patients with acute pancreatitis admitted to digestive department of our hospital from May 2016 to May 2018 were randomly divided into control group and observation group, 60 cases in each group. Patients in the control group were given routine treatment, while patients in the observation group were given ulinastatin on the basis of the treatment of patients in the control group. The levels of Kim-1, Cys C, BUN, IgA, IgM, IgG, SOD, NO, TAC, PCT and CRP of patients in the two groups were detected and compared before and after treatment. Results: After treatment, the serum levels of Kim-1, Cys C, BUN, NO, PCT and CRP of patients in the control group and the observation group decreased significantly and the serum levels of IgA, IgG, IgM, SOD and TAC increased significantly. The change trend of these indexes in the serum of patients in the observation group was more obvious than those of patients in the control group (P<0.05). Conclusion: Ulinastatin in the treatment of acute pancreatitis can significantly alleviate kidney injury, enhance immune function and antioxidant capacity of patients, alleviate inflammation.
文摘Objective: To study the effect of ulinastatin combined with anti-infective therapy on systemic inflammatory response and oxidative stress response in patients with acute severe pneumonia. Methods: A total of 50 patients with acute severe pneumonia who were treated in the hospital between September 2014 and December 2016 were collected and divided into control group and observation group according to the random number table method, 25 cases in each group. Control group received conventional therapy, and the observation group received ulinastatin combined with conventional therapy. The differences in inflammatory response and oxidative stress response in serum were measured before treatment and 10 d after treatment. Results:Before treatment, differences in serum levels of inflammatory response indexes and oxidative stress indexes were not statistically significant between the two groups. After treatment, serum IL-2, IL-6, PCT, HMGB1, CRP, IL-4, IL-10, IL-13, MDA, AOPP and ROS levels of both groups of patients were lower than those before treatment while SOD, T-AOC, GSH-Px and LHP levels were higher than those before treatment, and serum IL-2, IL-6, PCT, HMGB1, CRP, IL-4, IL-10, IL-13, MDA, AOPP and ROS levels of observation group were lower than those of control group while SOD, T-AOC, GSH-Px and LHP levels were higher than those of control group. Conclusion: Ulinastatin combined with anti-infective therapy can effectively reduce the systemic inflammatory response and oxidative stress response and optimize the overall condition in patients with acute severe pneumonia.
文摘Objective:To study the effect of ulinastatin combined with CRRT therapy on the endothelial oxidative damage and inflammatory injury in patients with acute respiratory distress syndrome (ARDS).Methods: A total of 60 patients with ARDS who were treated in our hospital between April 2011 and April 2016 were collected and divided into the control group (n=29) who received pure CRRT therapy and the combined treatment group (n=31) who received ulinastatin combined with CRRT therapy after the therapy and related laboratory examination were reviewed. Before treatment and after 5d of treatment, enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of endothelial function indexes and inflammation indexes in serum and exhaled breath condensate;RIA method was used to detect the levels of oxidative stress indexes in serum and exhaled breath condensate.Results: Before treatment, the differences in the endothelial function, oxidative stress and inflammation indexes in serum and exhaled breath condensate were not statistically significant between two groups of patients. After treatment, endothelial function index NO levels in serum and exhaled breath condensate of observation group were higher than those of control group while ET-1 levels were lower than those of control group;oxidative stress indexes CAT and SOD levels in serum and exhaled breath condensate of observation group were higher than those of control group while MAO levels were lower than those of control group;inflammation indexes PCT, IL-1β and HMGB1 levels in serum and exhaled breath condensate of observation group were lower than those of control group.Conclusion: Ulinastatin combined with CRRT therapy can improve the endothelial function and reduce the oxidative stress and inflammatory injury in patients with ARDS.
文摘Objective:To study the effect of ulinastatin on vasoactive substances, oxidative stress and inflammatory response in patients with acute exacerbation of COPD.Methods:Patients with acute exacerbation of COPD who were treated in Chengdu Fifth People's Hospital between August 2013 and July 2016 were selected as the research subjects and randomly divided into ulinastatin group and normal control group who received ulinastatin combined with conventional therapy and conventional therapy respectively. The serum contents of vasoactive substances, stress response hormones, oxidative stress products and inflammatory response mediators were detected before treatment and 7 d after treatment.Results: 7 d after treatment, serum D-D, AT-II, pro-BNP, ACTH, FC, NE, MDA, 8-iso-PG, HSP27, HSP70, PCT, CRP, CCL18 and MSP contents of both groups of patients were significantly lower than those before treatment while TT3 and TT4 contents were significantly higher than those before treatment;serum D-D, AT-II, pro-BNP, ACTH, FC, NE, MDA, 8-iso-PG, HSP27, HSP70, PCT, CRP, CCL18 and MSP contents of ulinastatin group 7 d after treatment were significantly lower than those of normal control group while TT3 and TT4 contents were significantly higher than those of normal control group.Conclusion:Ulinastatin therapy can correct the disturbance of vasoactive substances, and inhibit the oxidative stress and inflammatory response in patients with acute exacerbation of COPD.
文摘BACKGROUND With the continuous growth of the modern elderly population,the risk of fracture increases.Hip fracture is a common type of fracture in older people.Total hip arthroplasty(THA)has significant advantages in relieving chronic pain and promoting the recovery of hip joint function.AIM To investigate the effect of ulinastatin combined with dexmedetomidine(Dex)on the incidences of postoperative cognitive dysfunction(POCD)and emergence agitation in elderly patients who underwent THA.METHODS A total of 397 patients who underwent THA from February 2019 to August 2022.We conducted a three-year retrospective cohort study in Shaanxi Provincial People’s Hospital.Comprehensive demographic data were obtained from the electronic medical record system.We collected preoperative,intraoperative,and postoperative data.One hundred twenty-nine patients who were administered Dex during the operation were included in the Dex group.One hundred fifty patients who were intravenously injected with ulinastatin 15 min before anesthesia induction were included in the ulinastatin group.One hundred eighteen patients who were administered ulinastatin combined with Dex during the operation were included in the Dex+ulinastatin group.The patients’perioperative conditions,hemodynamic indexes,postoperative Mini-Mental State Examination(MMSE)scores,Ramsay score,incidence of POCD,and serum inflammatory cytokines were evaluated.RESULTS There was a significant difference in the 24 h visual analogue scale score among the three groups,and the score in the Dex+ulinastatin group was the lowest(P<0.05).Compared with the Dex and ulinastatin group,the MMSE scores of the Dex+ulinastatin group were significantly increased at 1 and 7 d after the operation(all P<0.05).Compared with those in the Dex and ulinastatin groups,incidence of POCD,levels of serum inflammatory cytokines in the Dex+ulinastatin group were significantly decreased at 1 and 7 d after the operation(all P<0.05).The observer’s assessment of the alertness/sedation score and Ramsay score of the Dex+ulinastatin group were significantly different from those of the Dex and ulinastatin groups on the first day after the operation(all P<0.05).CONCLUSION Ulinastatin combined with Dex can prevent the occurrence of POCD and emergence agitation in elderly patients undergoing THA.
基金supported by China Natural Science Fund,China(No.42004016)the science and technology innovation Program of Hunan Province,China(No.2023RC3217)+1 种基金Research Foundation of the Department of Natural Resources of Hunan Province(Grant No:20240105CH)HuBei Natural Science Fund,China(No.2020CFB329).
文摘Accurate ultra-short-term prediction of the Earth rotation parameters(ERP)holds paramount impor-tance for real-time applications,particularly in reference frame conversion.Among them,diurnal rota-tion(UT1-UTC)which cannot be directly estimated through Global Navigation Satellite System(GNSS)techniques,significantly affects the rapid and ultra-rapid orbit determination of GNsS satellites.Pres-ently,the traditional LS(least squares)+AR(autoregressive)and LS+MAR(multivariate autoregressive)hybrid methods stand as primary approaches for UT1-UTC ultra-short-term predictions(1-10 days).The LS+MAR hybrid method relies on the UT1-UTC and LOD(length of day)series.However,the correlation between LOD and first-order-difference UT1-UTC is stronger than that between LOD and UT1-UTC.In light of this,and with the aid of the first-order-difference UT1-UTC,we propose an enhanced LS+MAR hybrid method to UT1-UTC ultra-short-term prediction.By using the UT1-UTC and LOD data series of the IERS(International Earth Rotation and Reference Systems Service)EOP 14 C04 product,we conducted a thorough analysis and evaluation of the improved method's prediction performance compared to the traditional LS+AR and LS+MAR hybrid methods.According to the numerical results over more than 210 days,they demonstrate that,when considering the correlation information between the LoD and the first-order-difference UT1-UTC,the mean absolute errors(MAEs)of the improved LS+MAR hybrid method range from 21 to 934μs in 1-10 days predictions.In comparison to the traditional LS+AR hybrid method,the MAEs show a reduction of 7-53μs in 1-10 days predictions,with corresponding improvement percentages ranging from 1 to 28%.Similarly,when compared to the traditional LS+MAR hybrid method,the MAEs have a reduction of 5-42μs in 1-10 days predictions,with corresponding improvement percentages ranging from 4-20%.Additionally,when aided by GNSS-derived LOD data series,the MAEs of improved LS+MAR hybrid method experience further reduction.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT)(2019R1A2C2004356).
文摘This study investigated if the variation in the effect of anti-cholesterol(AC)treatment on individual mice are related to gut microbiome composition.The bile salt hydrolase(BSH)activity of 23 commercial fermented milk products was examined to select a fermented milk product for AC treatment.Mice were fed to different diets for 6 weeks:high-fat(60%of total calories from fat;D1),high-dietary fibre(20%cellulose;D2),and low-fat(17.2%of total calories from fat;D3)diets to change their gut microbiomes.Subsequently,faecal microbiome was transplanted(FMT)into mice treated with high cholesterol diet contained 2%cholesterol,followed by AC or non-AC(sterile tap water,STW)treatments.Control groups with normal(NC)and highcholesterol diets(PC)were prepared for both AC and STW treatment.All experimental groups were subjected to serum and liver cholesterol,cholesterol metabolism-related(CMR)gene expression,and intestinal microbiome analyses.D3-FMT mice showed the most significant enhancements in cholesterol ratio and decreased hepatic cholesterol levels with AC treatment.Moreover,upregulation of the Cyp7a1 gene expression was observed in this group.Furthermore,the intestinal microbiome analysis indicated higher abundances of BSH-producing Eubacterium,Bifidobacterium,and Parabacteroides in the D3-FMT+AC group compare to others,potentially contributing to increased bile acid synthesis.
基金funded Secondary Classroom Project fund of Capital Medical University (Project Number:D2KT 2021092).
文摘Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate the efficacy and safety of ulinastatin in the treatment of septic shock patients.Methods:Three English databases(Embase,Medline,and Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure,Wanfang data,SinoMed,and VIP)were searched for published randomized controlled trials.Stata 16.0 software was used to conduct the meta-analysis.Results:A total of 48 articles were included(Chinese article 47,1 in English).The results show that the treatment of ulinastatin could reduce mortality(risk ratio=0.63,95%confidence interval(CI)(0.55,0.72)),multiple organ dysfunction syndrome(risk ratio=0.6,95%CI(0.53,0.68)),length of intensive care unit stay(mean difference(MD)=-3.92,95%CI(-4.65,-3.18)),length of hospital stay(MD=-4.39,95%CI(-6.63,-2.15))and decrease Acute Physiology and Chronic Health Evaluation II score(MD=-4.55,95%CI(-5.63,-3.47))and Sequential Organ Failure Assessment score(MD=-2.02,95%CI(-2.59,-1.44))with P<0.001.Moreover,it lowers TNF-α(standardized mean difference(SMD)=-1.78,95%CI(-2.24,-1.32)),Interleukin-6(SMD=-1.17,95%CI(-1.55,-0.8)),C reactive protein(SMD=-1.49,95%CI(-1.99,-0.99)),hypersensitive C-reactive protein(SMD=-1.9,95%CI(-2.87,-0.94))and procalcitonin(SMD=-0.89,95%CI(-1.12,-0.67))levels in the body.Conclusions:Available evidence shows that ulinastatin reduces case mortality rate,multiple organ dysfunction syndrome,length of intensive care unit stay,and length of hospital stay and decreases Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score.Moreover,it also lowers TNF-α,Interleukin-6,C reactive protein,hypersensitive C-reactive protein,and procalcitonin levels in the body.