Cardiotoxicity induced in mice by long term ketamine and ketamine plus alcohol treatment

Increased use of ketamine as a recreational drug in rave party has raised lots of social concerns. Although its toxicity on the central nervous system (CNS) and urinary system had been reported, its potential adverse effects on the heart is still not addressed. Using our long term ketamine addiction model in which, 1-month-old ICR mice were given ketamine intraperitoneally (i.p. 30 mg/kg) for different study periods (6 weeks, 16 weeks and 28 weeks). The electrocardiogram (ECG) and the level of troponin as well as the presence of lactate dehydrogenase were used together to determine the cardiac function of mice. ST elevations were observed in 30% of mice from 6 weeks onwards. Concomitant increase in troponin in serum and presence of lactate dehydrogenase positive cardiac cells were taken together to indicate cardiac damages. The potential interactive effects of alcohol (ethanol) and ketamine were also addressed and 0.5 ml of 10% ethanol was administrated additionally to the mice daily and orally for the last 4 weeks in the 28-week long-term ketamine treated animals. The cardiac functions of these mice deteriorated more severely as indicated by further rise in troponin levels. In addition, high number of lactate dehydrogenase positive cardiac cells and abnormal ECGs in both ketamine and ketamine plus alcohol treated models also gave coherent conclusions.     

Tannic acid ameliorates doxorubicin-induced cardiotoxicity and potentiates its anti-cancer activity: potential role of tannins in cancer chemotherapy

Doxorubicin, an anthracycline antibiotic, is widely used in the treatment of various solid tumors including breast cancer. However, its use is limited due to a variety of toxicities including cardiotoxicity. The present study aimed to evaluate the effect of tannic acid, a PARG/PARP inhibitor and an antioxidant, on doxorubicin-induced cardiotoxicity in H9c2 embryonic rat heart myoblasts and its anti-cancer activity in MDA-MB-231 human breast cancer cells as well as in DMBA-induced mammary tumor animals. Doxorubicin-induced cardiotoxicity was assessed by measurement of heart weight, plasma LDH level and histopathology. Bcl-2, Bax, PARP-1 and p53 expression were examined by western blotting. Our results show that tannic acid prevents activation of PARP-1, reduces Bax and increases Bcl-2 expression in H9c2 cells, thus, preventing doxorubicin-induced cell death. Further, it reduces the cell viability of MDA-MB-231 breast cancer cells, increases p53 expression in mammary tumors and shows maximum tumor volume reduction, suggesting that tannic acid potentiates the anti-cancer activity of doxorubicin. To the best of our knowledge, this is the first report which shows that tannic acid ameliorates doxorubicin-induced cardiotoxicity and potentiates its anti-cancer activity both in vitro (H9c2 and MDA-MB-231 cells) as well as in in vivo model of DMBA-induced mammary tumor animals.     

动态监测血乳酸对危重症患儿预后评价的意义

目的 探讨血乳酸水平与小儿危重病评分（PCIS）之间的相关性及血乳酸动态监测指标与患儿预后的关系.方法 比较乳酸升高组及乳酸正常组的住院情况;按PCIS评分分组,探讨血乳酸值与PCIS评分的相关性;根据预后将乳酸升高的危重患儿分为死亡组和存活组,比较两组患儿的乳酸指标和反映脏器/系统功能的临床指标的差异,利用Logistic回归分析的方法找出与预后显著相关的指标.结果 血乳酸升高组患儿的PCIS评分显著降低,休克发生率、MODS发生率及住院病死率明显上升,与乳酸正常组相比差异有统计学意义;随着PCIS评分降低,入ICU乳酸值、乳酸峰值明显增高,与PCIS评分有显著的线性相关关系（r分别为-0.455、-0.504,P＜0.01）;高乳酸血症患儿中,乳酸峰值、12 h乳酸清除率与患儿的预后明显相关.结论 血乳酸水平与PCIS评分存在明显线性相关关系,乳酸峰值、12 h乳酸清除率是评价患儿预后的良好指标.     

早期乳酸清除率对呼吸衰竭患者预后评估的作用

目的探讨早期乳酸清除率对呼吸衰竭患者预后评估的作用。方法收集呼厥内科重症监护室（RICU）内入院时血乳酸升高的呼吸衰竭患者117例,检测治疗前、治疗后12h、24h、48h及72h动脉血乳酸值及动脉血气,计算12h乳酸清除率,并作入院时及入院后12h急性生理学及慢性健康状况评价II（APACHEII）评分。比较血乳酸恢复正常时间与患者预后的关系;比较不同预后患者的临床特征;以血乳酸清除率10％为界分为高乳酸清除率组（〉10％）和低乳酸清除率组（〈10％）,比较两组患者的预后及相关指标的差异。结果血乳酸值24h内恢复正常组与血乳酸值72h内未恢复正常组比较,预后有明显差异（P〈0．001）;存活组12h乳酸清除率（43．6％±26．8％）明显高于死亡组（12．3％±39．1％,P〈0．01）;高乳酸清除率组病死率（25．8％）明显低于低乳酸清除率组（71．4％,P〈0．01）。结论早期乳酸清除率可作为判断呼吸衰竭患者预后的一个指标。     

乳酸及乳酸清除率对急性呼吸窘迫综合征患者预后的预测作用

目的评价乳酸及乳酸清除率对急性呼吸窘迫综合征(ARDS)患者预后的预测作用。方法观察183例ARDS患者入重症监护病房(ICU)即刻及24 h血乳酸水平、24 h乳酸清除率、临床及预后相关资料。按28 d预后情况将患者分为28 d死亡组和存活组,比较其差异性,并用受试者工作曲线(ROC曲线)评价24 h乳酸清除率与ARDS患者预后的关系;进一步将存活患者分为乳酸升高组和正常组,比较其差异性。结果死亡组患者急性生理学与慢性健康状况评分系统Ⅱ评分显著高于存活组(P<0.05),但两组即刻血乳酸值无统计学意义;死亡组患者24 h乳酸清除率较存活组明显下降(P<0.05);以24 h乳酸清除率>30%作为生存预测的界点,灵敏度为64.1%,特异度为81.7%。在存活患者中,血乳酸升高组的ICU住院天数及机械通气时间明显长于正常组(P<0.05)。结论血乳酸水平及24 h乳酸清除率与ARDS患者预后相关,其可以预测ARDS患者的预后。     

巨幼细胞贫血和骨髓增生异常综合征患者血清LDH、α-HBDH活性的测定及其意义

目的探讨血清乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)水平,高低对鉴别MA和MDS的临床指导意义。方法应用生化自动分析仪检测36例MA和30例MDS患者血清中LDH、α-HBDH水平。结果 MA组血清LDH、α-HBDH水平明显高于MDS组,差异有统计学意义(P<0.01)。结论血清LDH、α-HBDH水平对临床鉴别MA和MDS具有临床指导意义。     

乳酸和乳酸脱氢酶测定在不同类型脑膜炎中的鉴别作用分析

目的探讨乳酸和乳酸脱氢酶测定在不同类型脑膜炎中的鉴别作用。方法选择80例患者,其中化脓性脑膜炎和病毒性脑膜炎各40例,在急性期和恢复期均行腰椎穿刺术后提取脑脊液2mL,送检脑脊液常规、生化检查,比较患者脑脊液中乳酸和乳酸脱氢酶变化情况。结果化脓性脑膜炎和病毒性脑膜炎患者脑脊液乳酸脱氢酶在急性期显著高于恢复期（P〈0.05）,且化脓性脑膜炎患者脑脊液乳酸脱氢酶水平高于病毒性脑膜炎患者（P〈0.05）;化脓性脑膜炎患者脑脊液乳酸脱氢酶在急性期显著高于恢复期（P〈0.05）,且高于病毒性脑膜炎患者（P〈0.05）。结论对不明类型的脑膜炎患者进行脑脊液乳酸和乳酸脱氢酶测定能起到一定的鉴别诊断作用。     

LDH、ADA、CEA、CRP联合检测在良恶性胸腔积液鉴别诊断中的意义

目的探讨乳酸脱氢酶（LDH）、腺苷脱氨酶（ADA）、癌胚抗原（CEA）、C反应蛋白（CRP）在良恶性胸腔积液鉴别诊断中的意义。方法使用AU2700全自动生化分析仪用速率法测定LDH、ADA,用免疫比浊法测CRP,用电化学发光法测CEA。按《肺结核诊断与治疗指南》的相关标准将100例胸腔积液患者分为结核性胸腔积液组和恶性肿瘤性胸腔积液组,分别为良性和恶性胸腔积液组,每组50例患者。结果恶性胸腔积液组CRP、ADA水平明显低于良性胸腔积液组（P〈0.05）,LDH、CEA水平明显高于良性胸腔积液组（P〈0.05）。结论 LDH、ADA、CEA、CRP联合检测有助于对良恶性胸腔积液进行鉴别诊断。     

灯盏花素对脑出血患者氧化应激的影响

目的：探讨中药灯盏花素注射液对脑出血患者氧化应激的影响。方法：实验分成两组,以30例健康人为对照组,以25例早期脑出血患者为实验组,采用灯盏花素进行治疗,观察治疗前后两组血液中 SOD、LDH的活性及 MDA的含量。结果：与对照组相比,治疗前实验组 SOD 活性降低,而LDH的活性和MDA的含量升高。采用灯盏花素治疗后,实验组SOD显著升高,LDH的活性和 MDA的含量降低;与对照组相比,无明显差异。结论：灯盏花素可通过抑制中性粒细胞产生呼吸爆发、脱颗粒,增强机体清除氧自由基的能力,并降低脂质过氧化损伤,可应用于治疗早期脑出血。     

Severe abnormalities in microvascular perfused vessel density are associated to organ dysfunctions and mortality and can be predicted by hyperlactatemia and norepinephrine requirements in septic shock patients

Purpose

The aims of this study are to determine the general relationship of perfused vessel density (PVD) to mortality and organ dysfunctions and to explore if patients in the lowest quartile of distribution for this parameter present a higher risk of bad outcome and to identify systemic hemodynamic and perfusion variables that enhances the probability of finding a severe underlying microvascular dysfunction.

Materials and Methods

This is a retrospective multicenter study including 122 septic shock patients participating in 7 prospective clinical trials on which at least 1 sublingual microcirculatory assessment was performed during early resuscitation.

Results

Perfused vessel density was significantly related to organ dysfunctions and mortality, but this effect was largely explained by patients in the lowest quartile of distribution for PVD (P = .037 [odds ratio {OR}, 8.7; 95% confidence interval {CI}, 1.14-66.78] for mortality). Hyperlactatemia (P < .026 [OR, 1.23; 95% CI, 1.03-1.47]) and high norepinephrine requirements (P < .019 [OR, 7.04; 95% CI, 1.38-35.89]) increased the odds of finding a severe microvascular dysfunction.

Conclusions

Perfused vessel density is significantly related to organ dysfunctions and mortality in septic shock patients, particularly in patients exhibiting more severe abnormalities as represented by the lowest quartile of distribution for this parameter. The presence of hyperlactatemia and high norepinephrine requirements increases the odds of finding a severe underlying microvascular dysfunction during a sublingual microcirculatory assessment.