Publications by authors named "Xiaolei Gong"

12 Publications

  • Page 1 of 1

MIR3142HG promotes lipopolysaccharide-induced acute lung injury by regulating miR-450b-5p/HMGB1 axis.

Mol Cell Biochem 2021 Aug 2. Epub 2021 Aug 2.

Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, No.1678 Dongfang Road, Pudong New Area, Shanghai, 200127, China.

The present study aimed to evaluate the potential roles of MIR3142HG, a novel long non-coding RNA (lncRNA) in lipopolysaccharide (LPS)-induced acute lung injury (ALI). ALI was simulated by the treatment of LPS in human pulmonary microvascular endothelial cells (HPMECs). The expression of MIR3142HG, miR-450b-5p and high-mobility group box 1 (HMGB1) was determined by real-time PCR and western blotting. Functional analysis was performed through the assessment of cell viability, apoptosis and the production of proinflammatory cytokines. The interactions among MIR3142HG, miR-450b-5p and HMGB1 were analyzed by bioinformatics methods, dual-luciferase reporter and RNA pull-down assays. Using gain- and loss-of-function approaches, the in vitro functions of MIR3142HG and miR-450b-5p were subsequently assessed. MIR3142HG expression was upregulated, while miR-450b-5p was decreased in LPS-treated HPMECs. MIR3142HG knockdown protected against ALI induced by LPS through alleviating the apoptosis and inflammation of HPMECs. MIR3142HG impaired miR-450b-5p-mediated inhibition of HMGB1. Besides, the effects of MIR3142HG silencing could be alleviated by miR-4262 inhibition or HMGB1 overexpression. MIR3142HG mediated LPS-induced injury of HPMECs by targeting miR-450b-5p/HMGB1, suggesting that MIR3142HG might serve as a therapeutic potential for the treatment of ALI.
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http://dx.doi.org/10.1007/s11010-021-04209-yDOI Listing
August 2021

Elevated Arterial-Central Venous Carbon Dioxide Partial Pressure Difference Indicates Poor Prognosis in the Early Postoperative Period of Open Heart Surgery in Infants with Congenital Heart Disease.

Pediatr Cardiol 2021 Jun 9. Epub 2021 Jun 9.

Cardiac Intensive Care Unit, Department of Cardiovascular and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China.

Background: Elevated arterial-central venous carbon dioxide partial pressure difference (AVCO) may be an important marker to predict tissue and organ hypoperfusion in adults. We analyzed the hemodynamic data of infants with congenital heart disease who underwent corrective repair with cardiopulmonary bypass (CPB) to identify whether AVCO has clinical significance in early postoperative tissue hypoperfusion, occurrence of complications, and clinical outcomes.

Methods: Infants with clinical conditions of hypoperfusion, without volume responsiveness and with ineffective initial treatment, within 3 h of cardiac surgery were enrolled in this study. A pulse contour cardiac output catheter was used to monitor the cardiac index (CI). Eight measurements of arterial blood gas and central venous blood gas were taken within 42 h after surgery. Clinical data of all patients were recorded.

Results: A total of 69 children were enrolled in this study. Arteriovenous oxygen difference, AVCO, lactic acid level, and vasoactive inotropic score in the hypoperfusion group (oxygen supply/oxygen consumption ratio [DO/VO] of ≤ 2) were significantly higher than those in the non-hypoperfusion group (DO/VO > 2), while the CI in the hypoperfusion group was significantly lower than that in the non-hypoperfusion group. The cutoff value of AVCO to predict DO/VO ≤ 2 was 12.3 within 42 h of surgery with area under the curve of 0.84. High AVCO is more likely to be associated with some complications and prolonged mechanical ventilation and length of stay in the intensive care unit.

Conclusion: Elevated AVCO within 42 h of CPB in infants is associated with tissue and organ hypoperfusion and incidence of complications. Persistent or repeated increase in AVCO indicates poor prognosis.
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http://dx.doi.org/10.1007/s00246-021-02646-6DOI Listing
June 2021

Effects of repairing ventricular septal defects with right vertical infra-axillary mini-incision on lung function and postoperative analgosedation.

Exp Ther Med 2021 Apr 29;21(4):302. Epub 2021 Jan 29.

Department of Cardiac Intensive Care Unit, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China.

The present study aimed to assess the effects of repairing ventricular septal defects (VSDs) with right vertical infra-axillary mini-incision (RVAI). A total of 116 patients with VSDs were prospectively enrolled and underwent cardiac surgery between June 2017 and December 2018 at the cardiac intensive care unit of Shanghai Children's Medical Center (Shanghai, China). Of these, 58 patients underwent the RVAI procedure and 58 patients matched 1:1 underwent the standard median sternotomy incision (MSI) procedure and were designated as the control group. The demographic data and clinical outcomes intra- and postoperatively were compared. A bedside lung ultrasound was performed to evaluate the degree of lung injury and the number of B-lines was quantified and compared between the two groups. The sedation and analgesia levels were also assessed after the operation. No significant difference was identified between the two groups regarding the overall cardiopulmonary bypass or aortic cross-clamp time. All patients were extubated within 8 h. The RVAI group had shorter incision lengths (median, 4.6 cm) and less drainage (median, 15 ml) than the MSI group. Furthermore, compared to the MSI group, the RVAI group had a significantly higher number of B-lines in the right lung regions immediately after surgery and at 12 h postsurgery (24.1 and 5.2%, respectively) but eventually exhibited no differences at 24 and 36 h postsurgery; by contrast, there were no differences in the left lung regions. The bedside bispectral index score and the Face, Legs, Activity, Cry, Consolability scale score exhibited no significant differences after the operation. In conclusion, the RVAI procedure appears to be a safe alternative for repairing VSDs in addition to satisfactory cosmetic results and the incision does not interfere with postoperative analgosedation.
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http://dx.doi.org/10.3892/etm.2021.9733DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885067PMC
April 2021

NBS/DBU-Promoted One-Pot Three-Component Cycloaddition of Malonic Acid Derivatives, Nitrosoarenes, and Alkenes: Synthesis of Isoxazolidines.

J Org Chem 2021 01 21;86(1):1096-1107. Epub 2020 Dec 21.

Department of Biomedical Engineering, Taiyuan University of Technology, 79 West Yingze Street, Taiyuan 030024, People's Republic of China.

A general DBU-mediated one-pot three-component cycloaddition reaction of easily accessible malonic acid derivatives, nitrosoarenes, and alkenes has been successfully established with the aid of NBS to provide direct access to highly functionalized isoxazolidine derivatives with generally good to excellent yields, broad functional group tolerance, and excellent regio- and diastereo-selectivities under mild conditions. The mechanism study shows that the NBS-mediated formation of bromomalonic acid derivatives from malonic acid derivatives and DBU-promoted synthesis of nitrone intermediates the reaction of bromomalonic acid derivatives with nitrosoarenes are key steps.
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http://dx.doi.org/10.1021/acs.joc.0c02567DOI Listing
January 2021

Computational Evaluation of Surgical Design for Multisegmental Complex Congenital Tracheal Stenosis.

Biomed Res Int 2020 20;2020:3509814. Epub 2020 Apr 20.

Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.

Multisegmental complex congenital tracheal stenosis (CTS) is an uncommon but potentially life-threatening malformation of the airway. Staged surgery is indicated for the complex pathophysiology of the abnormal trachea. Surgical intervention to fix the stenotic segments may result in different postoperative outcomes. However, only few studies reported the design of surgical correction for multisegmental CTS. We used computer-aided design (CAD) to simulate surgical correction under different schemes to develop a patient-specific tracheal model with two segmental stenoses. Computational fluid dynamics (CFD) was used to compare the outcomes of different designs. Aerodynamic parameters of the trachea were evaluated. An obvious interaction was found between the two segments of stenosis in different surgical designs. The surgical corrective order of stenotic segments greatly affected the aerodynamic parameters and turbulence flows downstream of tracheal stenosis and upstream of the bronchus. Patient-specific studies using CAD and CFD minimize the risk of staged surgical correction and facilitate quantitative evaluation of surgical design for multiple segments of complex CTS.
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http://dx.doi.org/10.1155/2020/3509814DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191439PMC
February 2021

Effects of Different Modes of Mechanical Ventilation on Aerodynamics of the Patient-specific Airway: A Numerical Study

Annu Int Conf IEEE Eng Med Biol Soc 2019 Jul;2019:4961-4964

Mechanical ventilation (MV) is an effective management strategy for neonates with critical congenital heart disease or congenital tracheal stenosis (CTS). However, there is no standard for patient-specific mode selection. This study numerically investigated the aerodynamic effects of tracheal model with severe stenosis when by different levels of ventilator assist during Pressure Support Ventilation (PSV) and Neurally Adjusted Ventilatory Assist (NAVA). Based on medical images, a three-dimensional (3D) tracheal model with insertion of a cuffed endotracheal tube was reconstructed. The technology of Computational Fluid Dynamics (CFD) was applied to simulate the airflow in the trachea. The aerodynamic parameters, including pressure drop (PD), streamlines and rate of energy loss (ELR), were compared to assess the MV effects. The results indicated that high assist level, accompanied by high airflow velocity, should be the main cause of aerodynamic disorders in the airway during MV. Lower PD, ELR and relatively steady velocity of NAVA was observed. Compare with PSV, it was inferred that preserved auto-regulation of respiration during NAVA may have potential advantages for flow rate regulation in patient with CTS. CFD analysis is a potential noninvasive tool for obtaining tracheal aerodynamics, which will be helpful for making decisions of appropriate MV mode.
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http://dx.doi.org/10.1109/EMBC.2019.8856357DOI Listing
July 2019

Soluble triggering receptor expressed on myeloid cells-1 as a useful biomarker for diagnosing ventilator-associated pneumonia after congenital cardiac surgery in children.

Exp Ther Med 2019 Jan 31;17(1):147-152. Epub 2018 Oct 31.

Department of Infectious Disease, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China.

The present study aimed to assess the usefulness of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in the diagnosis of ventilator-associated pneumonia (VAP) in paediatric patients with congenital heart disease (CHD) following cardiac surgery. The current prospective study enrolled 48 patients with congenital heart diseases who were suspected of having VAP; these patients were undergoing cardiac surgery between August 2016 and October 2017 in the Cardiac Intensive Care Unit of Shanghai Children's Medical Center (Shanghai, China). A total of 31 patients were diagnosed with VAP using a polymerase chain reaction (PCR) assay, while 17 patients without VAP were designated as the Non-VAP group. A bronchoscopy was performed and samples were collected for measurement on the day that VAP was diagnosed. The sTREM-1 levels were measured in bronchoalveolar lavage fluid (BALF) and exhaled ventilator condensate (EVC). BALF specimens were also sent to the microbiology laboratory for PCR assays and quantitative culturing. The positive detection rate of bacteria using the PCR assay and traditional culture was 64.6% (31/48) and 39.6% (19/48). sTREM-1 was significantly higher in the BALF (146.21 pg/ml vs. 118.06 pg/ml) and EVC (125.29 pg/ml vs. 120.48 pg/ml) of patients with VAP demonstrated compared with the patients without VAP. The findings suggest that the detection of sTREM-1 in BALF and EVC samples may be useful for the diagnosis of VAP following heart surgery in children.
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http://dx.doi.org/10.3892/etm.2018.6905DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307413PMC
January 2019

Removal mechanism of di-n-butyl phthalate and oxytetracycline from aqueous solutions by nano-manganese dioxide modified biochar.

Environ Sci Pollut Res Int 2018 Mar 30;25(8):7796-7807. Epub 2017 Dec 30.

School of Environmental and Chemical Engineering, Tianjin Polytechnic University, No. 399 Binshui West Road, Xiqing District, Tianjin, 300387, China.

In this work, nano-manganese dioxide (nMnO)-modified biochar (BC) was synthesized in order to improve BC's adsorption capacity for di-n-butyl phthalate (DBP) and oxytetracycline (OTC). The results showed that nMnO on the BC surface exhibited a poor crystallinity and oxidation state (Mn (IV)). Sorption experiments showed that, compared to BC, DBP sorption capacity of nMnO-BC (1:20) and OTC sorption capacity of nMnO-BC (1:10) were 0.0364 and 0.0867 mmol/g, respectively, which are significantly higher than that of BC (0.0141 and 0.0151 mmol/g). Kinetics and isotherm experiments indicated that physical adsorption and chemical interactions have both exerted their impacts on the adsorption process. Further X-ray photoelectron spectroscopy (XPS) analysis showed that part of the Mn (IV) in nMnO-BC was reduced to Mn (III) and Mn (II) after DBP or OTC adsorption. Therefore, we suggest the nMnO also acted as an oxidizer on modified BC, which may accelerate the degradation of DBP and OTC.
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http://dx.doi.org/10.1007/s11356-017-1089-5DOI Listing
March 2018

Comparison of the effect of high versus low mean arterial pressure levels on clinical outcomes and complications in elderly patients during non-cardiothoracic surgery under general anesthesia: study protocol for a randomized controlled trial.

Trials 2017 Nov 21;18(1):554. Epub 2017 Nov 21.

Clinical Medical Research Center, The Second Clinical Medicine College, Jinan University, Shenzhen, 518001, China.

Background: Intraoperative blood pressure (BP) is a concern in daily clinic anesthesia and contributes to the differences in clinical outcome. We conducted a randomized controlled trial (RCT) to compare the effect of high vs. low mean arterial pressure (MAP) levels on clinical outcomes and complications in elderly patients under general anesthesia (GA).

Methods: In this multicenter, randomized, parallel-controlled, open-label, assessor-blinded clinical trial, 322 patients aged more than 65 years will be randomized for a low-level MAP (60-70 mmHg) or high-level MAP (90-100 mmHg) during non-cardiothoracic surgery under GA. The primary outcome will be the incidence of postoperative delirium. The secondary outcomes will include the delirium duration days, intraoperative urine volume, intraoperative blood loss, specific postoperative complications, and all-cause 28-day mortality.

Discussion: Results of this trial will help clarify whether BP management is beneficial for elderly patients under GA and will make clear whether the effect of high-level MAP can reduce the postoperative complication compared to low-level MAP.

Trial Registration: ClinicalTrials.gov, NCT02857153 . Registered on 15 July 2016.
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http://dx.doi.org/10.1186/s13063-017-2233-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5698923PMC
November 2017

Mechanical Ventilation After Bidirectional Superior Cavopulmonary Anastomosis for Single-Ventricle Physiology: A Comparison of Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist.

Pediatr Cardiol 2016 Aug 18;37(6):1064-71. Epub 2016 Apr 18.

Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland.

We evaluated the effects of different respiratory assist modes on cerebral blood flow (CBF) and arterial oxygenation in single-ventricle patients after bidirectional superior cavopulmonary anastomosis (BCPA). We hypothesized that preserved auto-regulation of respiration during neurally adjusted ventilatory assist (NAVA) may have potential advantages for CBF and pulmonary blood flow regulation after the BCPA procedure. We enrolled 23 patients scheduled for BCPA, who underwent pressure-controlled ventilation (PCV), pressure support ventilation (PSV), and NAVA at two assist levels for all modes in a randomized order. PCV targeting large V T (15 mL × kg(-1)) resulted in lower CBF and oxygenation compared to targeting low V T (10 mL × kg(-1)). During PSV and NAVA, ventilation assist levels were titrated to reduce EAdi from baseline by 75 % (high assist) and 50 % (low assist). High assist levels during PSV (PSVhigh) were associated with lower PaCO2, PaO2, and O2SAT, lower CBF, and higher pulsatility index compared with those during NAVAhigh. There were no differences in parameters when using low assist levels, except for slightly greater oxygenation in the NAVAlow group. Modifying assist levels during NAVA did not influence hemodynamics, cerebral perfusion, or gas exchange. Targeting the larger V T during PCV resulted in hyperventilation, did not improve oxygenation, and was accompanied by reduced CBF. Similarly, high assist levels during PSV led to mild hyperventilation, resulting in reduced CBF. NAVA's results were independent of the assist level chosen, causing normalized PaCO2, improved oxygenation, and better CBF than did any other mode, with the exception of PSV at low assist levels.
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http://dx.doi.org/10.1007/s00246-016-1392-9DOI Listing
August 2016

Iloprost for children with pulmonary hypertension after surgery to correct congenital heart disease.

Pediatr Pulmonol 2015 Jun 9;50(6):588-95. Epub 2014 Mar 9.

Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Congenital heart disease (CHD) can cause pulmonary hypertension (PH) in children, and surgery to correct CHD may be complicated by postoperative pulmonary hypertensive crises (PHC). Clinical data regarding the use of inhaled iloprost to treat children with PH are scarce. Our aim was to determine the efficacy and safety of iloprost in children with PH following surgery to correct CHD. This was a randomized, placebo-controlled study of 22 children (median age 7 months) undergoing surgery to achieve biventricular repair. The combined clinical endpoint was a decrease of more than 20% in the ratio of systolic pulmonary arterial pressure to systolic arterial pressure or pulmonary resistance to systemic resistance, with no PHC or death. Patients were randomized to receive low-dose iloprost (30 ng/kg/min), high-dose iloprost (50 ng/kg/min), or placebo, for 10 min every 2 hr in the first 48 hr after surgery. PHC were experienced by two patients who received placebo and one patient treated with high-dose iloprost. The combined clinical endpoint was reached by six patients administered low-dose iloprost (P = 0.005) and four administered high-dose iloprost (P = 0.077), compared with none in the placebo group. Patients treated with iloprost showed a significant reduction from baseline in mean pulmonary vascular resistance index (-2.2 Wood units, P < 0.05), whereas patients who received placebo showed no significant change. This study supports the use of iloprost to treat children with PH following surgery to correct CHD.
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http://dx.doi.org/10.1002/ppul.23032DOI Listing
June 2015

Elevated plasma B-type natriuretic peptide and C-reactive protein levels in children with restrictive right ventricular physiology following tetralogy of Fallot repair.

Congenit Heart Dis 2014 Nov-Dec;9(6):521-8. Epub 2014 Feb 13.

Cardiac Intensive Care Unit, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Objectives: This study aimed to compare the levels of plasma B-type natriuretic peptide (BNP) and C-reactive protein (CRP) in relation to oxygen transport between patients with restrictive right ventricle (rRV) and those without (non-rRV) early after tetralogy of Fallot (TOF) repair.

Methods: Eighty patients (30 in the rRV group) underwent TOF repair in 2011 and 2012. BNP and CRP were repeatedly measured during postoperative day (POD) 7, along with oxygen transport variables including arterial and superior vena cava oxygen saturation (SaO2 and SvO2 ), oxygen extraction ratio (ERO2 ), and lactate. Demographic data included age and durations of cardiopulmonary bypass (CPB), aortic cross-clamping (ACC), mechanical ventilation, and ICU and hospital stays.

Results: During POD 7, BNP did not change in either of the two groups but was consistently higher in the rRV group (P < .0001). CRP increased from POD 1 to POD 2 and decreased thereafter. The decrease was slower in the rRV group (P = .04). The increase in SvO2 and the decrease in ERO2 were slower in the rRV group (P < .05). Lactate decreased in both groups (P < .05) but was consistently higher in the rRV group (P = .03). BNP was negatively correlated with SvO2 and preoperative SaO2 and positively correlated with ERO2 and lactate (P < .05). No correlation was found between CRP and oxygen transport variables. The rRV group was older and required longer CPB, ACC, mechanical ventilation, and ICU and hospital stays compared with the non-rRV group (P < .05 for all).

Conclusions: rRV physiology is associated with significantly higher BNP and CRP levels with poorer balance of systemic oxygen transport. Information about these pathophysiological changes may help to identify appropriate treatment strategies in this difficult group of patients.
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http://dx.doi.org/10.1111/chd.12166DOI Listing
August 2015
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