Polymerized human placenta haemoglobin attenuates myocardial injury and aortic endothelial dysfunction in a rat model of severe burns

A prediction model to predict in-hospital mortality in patients with acute type B aortic dissection

BACKGROUND

Acute type B aortic dissection (ABAD) is a life-threatening cardiovascular disease. A practicable and effective prediction model to predict and evaluate the risk of in-hospital death for ABAD is required. The present study aimed to construct a prediction model to predict the risk of in-hospital death in ABAD patients.

METHODS

A total of 715 patients with ABAD were recruited in the first affiliated hospital of Xinjiang medical university from April 2012 to May 2021. The information on the demographic and clinical characteristics of all subjects was collected. The logistic regression analysis, receiver operating characteristic (ROC) curve analysis, and nomogram were applied to screen the appropriate predictors and to establish a prediction model for the risk of in-hospital mortality in ABAD. The receiver operator characteristic curve and calibration plot were applied to validate the performance of the prediction model.

RESULTS

Of 53 (7.41%) subjects occurred in-hospital death in 715 ABAD patients. The variables including diastolic blood pressure (DBP), platelets, heart rate, neutrophil-lymphocyte ratio, D-dimer, C-reactive protein (CRP), white blood cell (WBC), hemoglobin, lactate dehydrogenase (LDH), procalcitonin, and left ventricular ejection fraction (LVEF) were shown a significant difference between the in-hospital death group and the in-hospital survival group (all P < 0.05). Furthermore, all these factors which existed differences, except CRP, were associated with in-hospital deaths in ABAD patients (all P < 0.05). Then, parameters containing LVEF, WBC, hemoglobin, LDH, and procalcitonin were identified as independent risk factors for in-hospital deaths in ABAD patients by adjusting compound variables (all P < 0.05). In addition, these independent factors were qualified as predictors to build a prediction model (AUC > 0.5, P < 0.05). The prediction model was shown a favorable discriminative ability (C index = 0.745) and demonstrated good consistency.

CONCLUSIONS

The novel prediction model combined with WBC, hemoglobin, LDH, procalcitonin, and LVEF, was a practicable and valuable tool to predict in-hospital deaths in ABAD patients.

Characteristics of New Oxygen-Carrying Plasma and Its Application Prospects in the Treatment of Severe Acute Pancreatitis

ABSTRACT

Oxygen-carrying plasma, a new type of colloid substitute, is composed of hydroxyethyl starch and acellular hemoglobin-based oxygen carriers. It can supplement colloidal osmotic pressure and rapidly improve the body's oxygen supply. The resuscitation effect of the new oxygen-carrying plasma in animal shock models is better than that of hydroxyethyl starch or hemoglobin-based oxygen carriers alone. It can reduce the histopathological damage and mortality associated with severe acute pancreatitis, and it is expected to become an interesting treatment method for severe acute pancreatitis. This article reviews the characteristics of the new oxygen-carrying plasma, its role in fluid resuscitation, and its application prospects in the treatment of severe acute pancreatitis.

Protective effect and mechanism of low P50 haemoglobin oxygen carrier on isolated rat heart

The protection of the isolated heart is very important in heart transplantation surgery, meanwhile, the ischaemia/reperfusion (I/R) of the isolated heart is the main cause of its damage. A timely supply of oxygen can significantly improve the prevention of myocardial ischaemia, however, the cardioprotective solution does not have an oxygen supply function. Haemoglobin Based on Oxygen Carriers (HBOCs) is a kind of nano-oxygen drug, which can effectively and timely supply oxygen to hypoxic organs and tissues. However, the oxygen-carrying and releasing capacity (P50) is different with different HBOCs. The aim of our study was to investigate whether STS (a kind of cardioprotective solution, St Thomas Solution) +different P50 HBOCs provide superior myocardial protection and decrease myocardial injury compared to only STS in rats Langendorff isolated heart perfusion model. The results showed that STS + HBOCs can improve cardiac function at 37 °C for 35 min and 120 min, and reduce myocardial infarctions, pathological changes, and apoptosis of cardiomyocytes, and the STS + low P50 HBOCs is more effective than the other two higher P50 HBOCs. We further demonstrated the outstanding protective effect of STS + low P50 HBOCs on cardiac function, reducing myocardial infarctions and apoptosis of cardiomyocytes in rat Langendorff isolated heart perfusion model.

Umbilical Cord Mesenchymal Stem Cells for Inflammatory Regulation After Excision and Grafting of Severe Burn Wounds in Rats

Severe burns predispose to shock and necessitate escharectomy and skin grafting. Previous studies show that mesenchymal stem cells are effective for burn wound healing and immune regulation. In this study, we combined escharectomy and skin grafting after burn injury with stem cell application, so as to examine the immune regulation of stem cells and the effect on the transplanted skin graft. SD rats were randomly divided into normal group, sham group, normal + hUCMSCs group, and normal + SB203580 group. Normal saline, hUCMSCs, and SB203580 were injected into the tail vein of each group, and serum inflammatory factors were detected by ELISA. The expression of p38 MAPK/NF-κB pathway proteins in rat liver was detected by western blot. Skin activity was detected by Trypan blue staining and western blot. Skin graft inflammatory infiltration was detected by histological analysis. We found that hUCMSCs could regulate the phosphorylation levels of P38MAPK and NF-B P65 proteins in the liver to reduce the inflammatory response. These effects could continue to reduce the production of inflammatory factors HMGB-1, IL-6, and TNF-α, and increase the anti-inflammatory factor IL-10. The infiltration of inflammatory cells in skin graft was significantly reduced in the normal + hUCMSCs group, and the macrophages in the hUCMSCs group polarized to the anti-inflammatory M2 direction in 3 days. However, the changes of skin graft activity and necroptosis markers protein RIP3 were not observed. The present study demonstrates the immunomodulatory effects of hUCMSCs on the systemic and skin graft microenvironment after excision.

Protective effect of puerarin against burn-induced heart injury in rats

The present study evaluated the potential protective effects of puerarin and its associated mechanism on burn-induced myocardial damage. A total of 40 healthy adult Wistar rats were randomly divided into four groups: i) Sham; ii) burn; iii) burn + puerarin; and iv) puerarin. Serum levels of interleukin (IL)-1β, tumor necrosis factor-α (TNF-α) and IL-6 were measured using ELISA. Myeloperoxidase (MPO) activity and malondialdehyde (MDA) levels were determined in myocardial homogenates using a commercial assay kit. TUNEL staining and western blot analysis of cleaved and pro-caspase-3 were also performed to assess apoptosis. Activation of p38-MAPK, ERK, JNK and AKT were measured using western blot analysis. Left ventricular systolic pressure, maximum rates of increase/decrease in left ventricular pressure, creatine kinase MB activity and cardiac troponin T levels were found to be altered in the burn group 12 h after burn, which were reversed by puerarin treatment. Injection of puerarin following burn injury also reduced heart water content. Serum levels of IL-1β, TNF-α and IL-6 were significantly higher in the burn group compared with those in the sham group. Puerarin treatment reduced serum levels of IL-1β, TNF-α and IL-6, in addition to reducing MPO activity and MDA levels in myocardial tissues. Puerarin inhibited the activation of caspase-3, p38, ERK and JNK following severe burn, but elevated Akt activation following severe burn. In conclusion, puerarin improved cardiac function in rats following severe burn injury, which may be due to reduced myocardial injury, inhibition of cardiomyocyte apoptosis and reduced oxidative inflammatory stress; the MAPK and AKT signaling pathways are proposed to the underlying mechanism of these findings.