ABSTRACT
Objective:To investigate the correlation between thyroid function index and serum visfatin in patients with acute pancreatitis (AP).Methods:Using a prospective design, 65 patients with AP treated in Binzhou People's Hospital from December 2017 to December 2019 were selected as the research subjects. They were divided into mild acute pancreatitis (MAP) group ( n = 35) and severe acute pancreatitis (SAP) group ( n = 30) according to the acute physiology and chronic health Ⅱ (APACHE Ⅱ) score ( < 8, ≥8 scores). At the same time, 40 healthy people were selected as the control group. The serum levels of free thyroxine (FT 4), free triiodothyronine (FT 3) and thyrotropin (TSH) were measured by chemiluminescence immunoassay. Radioimmunoassay was used to measure serum reverse triiodothyronine (rT 3) level, and enzyme-linked immunosorbent assay was used to measure serum visfatin level. Pearson method was used to analyze the correlation between thyroid function index and serum visfatin in patients with AP. Results:The FT 4 [(14.02 ± 3.63), (15.68 ± 3.05) pmol/L], FT 3 [(2.34 ± 0.80), (3.66 ± 0.65) pmol/L], and TSH levels [(2.78 ± 0.85), (3.10 ± 0.57) mU/L] in SAP and MAP groups were significantly lower than those in control group [(17.03 ± 3.96), (6.04 ± 1.55) pmol/L, (4.88 ± 2.30) mU/L, P < 0.05], but the rT 3 levels [(1.63 ± 1.12), (1.23 ± 0.26) nmol/L] were significantly higher than that in control group [(0.97 ± 0.28) nmol/L, P < 0.05]. There was significant difference in serum FT 3 levels between SAP and MAP groups ( P < 0.05). The serum visfatin levels of SAP, MAP and control groups were (10.75 ± 2.92), (3.70 ± 1.73), (2.30 ± 1.31) ng/ml, the difference between the three groups was statistically significant ( F = 67.174, P < 0.05). The serum visfatin levels in SAP and MAP groups were higher than that in control group, and that in SAP group was higher than that in MAP group ( P < 0.05). There were negative correlations between serum FT 3 level and visfatin level in SAP and MAP groups ( r = - 0.672, - 0.610, P < 0.05). Conclusions:The serum visfatin level and thyroid function index of AP patients are abnormal. The levels of FT 3 and visfatin are correlated with the severity of AP patients, and there is a negative correlation between the levels of FT 3 and visfatin. Detection of thyroid function index is helpful to judge the AP patient's condition.
ABSTRACT
Objective:To investigate the diagnostic value of rapid on-site evaluation (ROSE) technique in the mucosal biopsy under respiratory endoscopy in children with active tuberculosis.Methods:Clinical data of 40 patients with active tuberculosis diagnosed in Department of Respiratory Intervention, Qilu Children′s Hospital, Shandong University from June 2017 to January 2020 were retrospectively analyzed.Results:(1) There were 33 cases of tracheobronchial tuberculosis and 7 cases of tuberculous pleurisy in the 40 cases, among them 9 cases were difficult to diagnose.(2)Among 33 cases of tracheobronchial tuberculosis, 24 cases (72.7%) of caseous necrosis breaking into the lumen, and 9 cases (27.3%) of mucosal swelling and external pressure.Cytological ROSE (C-ROSE) showed granuloma, epithelioid cells and lymphocytic infiltration with all bronchial mucosal biopsies.Different positives results of microbiological ROSE (M-ROSE) in different biopsy parts: positive results were found 6 times at caseous necrosis (13.6%, 6/44 times), 4 times at granulation hyperplasia (12.5%, 4/32 times), 2 times at hyperemia and edema (22.2%, 2/18 times), 0 time at yellow-white necrosis, and 54 times at the junction between lesions and normal mucosa (81.8%, 54/66 times). The mucosal pathology showed granuloma, exudation and necrosis, including 22 cases with tuberculous granuloma, 5 cases with characteristic tuberculous nodules, and 11 cases with positive acid-fast staining.(3)Seven cases of tuberculous pleurisy, serious pleural adhesion, pleural hyperemia and edema were observed under thoracoscopy.After clearing the adhesive tape, scattered caseous miliary nodules were found in pleura in 4 cases with a difficult clinical diagnosis.The C-ROSE of smear on thoracoscopic biopsy were characterized by necrotic and histopathic cell, with multinucleated giant cells, but granuloma was rare.M-ROSE in different parts: 8 times positive for millet nodules (80.0%), 0 time positive for adhesion band, 2 times positive for congestion oedema (14.3%); biopsy pathology showed granuloma and necrosis, with 3 cases characteristic tuberculosis nodules and 2 cases positive for anti-acid staining.(4)Pathogenic microorganisms were detected in 19 children using next generation sequencing (NGS) and Mycobacterium tuberculosis/Rifampicin resistance real-time nucleic acid amplification detection technology (Xpert MTB/RIF), including 7 positive for NGS (36.8%), 8 positive (42.1%) and 5 positive for both NGS and Xpert MTB/RIF (26.3%).Conclusions:Respiratory endoscopy combined with ROSE technique has important clinical significance in early diagnosis of active tuberculosis in children, and it is worth of promotion and applying.
ABSTRACT
Objective:To investigate and analyze the clinical characteristics of chronic liver injury and glutathione treatment in patients with coal-burning-borne arsenism.Methods:A total of 71 patients with liver injury caused by coal-burning-borne arsenism admitted to Binzhou People's Hospital from March 2017 to December 2018 were randomly divided into observation group (37 cases) and control group (34 cases) by lottery. Both groups of patients were given routine treatment, including intravenous infusion of compound amino acids, oral administration of B vitamins, etc., and intravenous infusion of 5.0 g of vitamin C mixture dissolved in 250 ml of 5% glucose, once a day, treatment for 4 weeks. In addition, the observation group was given an intravenous infusiondrip of 1.8 g of glutathione dissolved in 250 ml of 5% glucose, once a day, for 4 weeks. The clinical characteristics of the patients were observed, and the changes of liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL)], serum antioxidant indexes [malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)], and clinical efficacy before and after the treatment were compared between the two groups.Results:In 71 coal-burning-borne arsenism patients with liver injury, the abnormal rate of electrocardiogram (ECG) examination was 64.79% (46/71), and the abnormal rate of chest X-ray examination was 26.76% (19/71). After treatment, the liver function indexes ALT, AST, TBIL and DBIL decreased in both groups [observation group before treatment: (131.82 ± 25.62), (109.84 ± 26.28) U/L, (81.47 ± 20.93), (57.38 ± 15.25) μmol/L; observation group after treatment: (58.93 ± 12.03), (51.20 ± 10.57) U/L, (25.66 ± 7.94), (16.49 ± 4.92) μmol/L; control group before treatment: (128.95 ± 31.20), (107.39 ± 29.81) U/L, (83.21 ± 17.95), (55.39 ± 16.30) μmol/L; control group after treatment: (76.42 ± 15.73), (74.33 ± 14.80) U/L, (36.72 ± 9.32), (23.74 ± 7.35) μmol/L, P < 0.05], and the liver function indexes in the observation group were significantly lower than those in the control group after treatment ( P < 0.05). The serum antioxidant indexes MDA, SOD and GSH-Px in the two groups were significantly increased after treatment [observation group before treatment: (25.47 ± 3.98) μmol/L, (85.72 ± 23.54), (1 729.84 ± 379.50) U/L; observation group after treatment: (46.31 ± 7.49) μmol/L, (122.31 ± 28.53), (2 410.29 ± 512.31) U/L; control group before treatment: (26.02 ± 4.11) μmol/L, (84.95 ± 21.03), (1 749.52 ± 405.28) U/L; control group after treatment: (38.92 ± 6.27) μmol/L, (103.12 ± 25.68), (2 097.42 ± 478.52) U/L, P < 0.05], and the serum antioxidant indexes in the observation group were significantly higher than those in the control group after treatment ( P < 0.05). The total effective rate of the observation group was significantly higher than that of the control group [91.89% (34/37) vs 76.47% (26/34), χ 2 = 4.254, P < 0.05]. Conclusions:Coal-burning-borne arsenism patients with chronic liver injury may have multiple system injury at the same time. Glutathione can effectively improve the clinical symptoms and liver function of patients. Its effect may be related to the improvement of antioxidant function, which is worthy of clinical promotion.
ABSTRACT
Objective To explore the relationship between the expression of HBx protein in HBV-related HCC samples and the clinical implications.Methods Elivision two-step was used in this study to detect the expression level of HBx protein in 40 HCC tissues,corresponding para-tumorous tissues from patients with HBV-related HCC undergoing curative hepatectomy.The relationship between HBx protein and clinical parameters (such as gender,age,TNM stage,HBV-DNA load,AFP,liver cirrhosis,a merger of vascular invasion,tumor infiltrating lymphocytes,Edmondson-Steiner histopathological grading,with or without relapse within 24 months) were analyzed.Results (1) The expression of HBx protein in the tumorous tissues was significantly lower than that of para-tumorous tissues (P ＜ 0.05).(2) In the tissues of para-tumorous,the expression of HBx protein in group HBV-DNA ＜ 500 IU/ml was significantly lower than that of group HBV-DNA≥500 IU/ml (P ＜0.05).There were no significant differences in the expression of HBx protein irrespective of gender,age,cirrhosis and the AFP level.(3) In the tissues of tumorous,the expression of HBx protein in group with vascular invasion was significantly higher than that of group without vascular invasion (P ＜ 0.05).However,there were no significant differences in the expression of HBx protein among the factors of TNM stage and Edmondson-Steiner histopathology grading.(4) In para-tumorous tissues,the expression of HBx protein in group of lymphocytic infiltration was significantly higher than that without lymphocytic infiltration (P ＜ 0.05).In the tissues of tumorous,the expression of HBx protein in disease-free survival (DFS) ＜ 24M patients was significantly higher than DFS ≥ 24M (P ＜ 0.05).Conclusions High HBx expression in tumor tissues indicates poor prognosis while that in para-tumorous tissues predicts a better prognosis.