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OBJECTIVES@#To study the effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia.@*METHODS@#A retrospective analysis was performed on the medical data of the neonates with asphyxia who were admitted to 52 hospitals in Hubei Province of China from January to December, 2018 and had blood glucose data within 12 hours after birth. Their blood glucose data at 1, 2, 6, and 12 hours after birth (with an allowable time error of 0.5 hour) were recorded. According to the presence or absence of brain injury and/or death during hospitalization, the neonates were divided into a poor prognosis group with 693 neonates and a good prognosis group with 779 neonates. The two groups were compared in the incidence of glucose metabolism disorders within 12 hours after birth and short-term prognosis.@*RESULTS@#Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of neonates from secondary hospitals (48.5% vs 42.6%, @*CONCLUSIONS@#Recurrent hyperglycemia in neonates with asphyxia may suggest poor short-term prognosis, and it is necessary to strengthen the early monitoring and management of the nervous system in such neonates.
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Humans , Infant, Newborn , Asphyxia , Asphyxia Neonatorum/epidemiology , Hyperglycemia , Prognosis , Retrospective StudiesABSTRACT
Objective:To detect serum levels of immunoglobulin E (IgE), soluble version of the IgE-binding alpha-chain of Fcepsilon-RI (sFcεRIα), immunoglobulin G (IgG) anti-IgE, IgG anti-FcεRI in patients with chronic urticaria(CU), and to evaluate their relevanceMethods:Forty-three newly diagnosed patient with CU were enrolled. Thirty-seven patients with dermatitis or eczema and 51 healthy subjects were selected as the disease control (DC) and normal control (NC) group, respectively.Serum IgE was detected by immunoturbidimetry; serum anti-IgE, anti-FcεR Ⅰ and sFcεR Ⅰ α were determined byenzyme-linked immunosorbent assay (ELISA) methods. Statistical analysis was carried out by non-parametric test for comparisons of the above variables between groups, and by Spearman correlation analysis for assessment of relationships between the variables as well as between the variables and disease severity, and by receiver operating characteristic curve to analyze the diagnostic value of the variables.Results:Serum IgE, anti-IgE and anti-FcεRI in CU were significantly higher than that of NC.Their medians are 65.70 IU/ml vs 17.10 IU/ml,χ 2=28.541, P=0.001;0.61 vs 0.39,χ 2=27.408, P=0.001;0.64 vs 0.51, χ 2=29.102, P<0.001.Serumanti-FcεRI in CU was significantly lower than that in NC(0.64 vs 0.83,χ 2=25.869, P=0.007).The medians of serum sFcεRIα in CU, DC and NC groups were 5.74,5.38,4.50 ng/ml, respectively. The difference was not statistically significant,χ 2=3.463, P=0.177.There was a positive correlation between IgE and sFcεR Ⅰ α, anti-IgE and anti-FcεRI( r=0.455, P<0.001; r=0.611, P<0.001).No significant correlation was showed between the four variables and the course of disease or the severity of symptoms, P>0.05. The diagnostic performances of IgE, anti-FcεRI for CU were similar (AUC=0.72),which were better than that of sFcεRIα (AUC=0.61).The highest diagnostic efficacy (AUC=0.83) can be achieved by four joint tests.Anti-FcεRI is of value in differential diagnosis of CU and DC, AUC=0.7, P=0.002. Conclusion:The levels of serum IgE, anti-IgE, anti-FcεRI were significantly increased in CU patients, and these mast cell activation-related molecules have the potential to be diagnostic markers for CU.
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Objective@#The accurate measurement of anti-IgE levels in patients′ serum helps for make diagnosis of chronic urticaria (CU). An indirect ELISA method for quantitative detection of IgG anti-IgE, were established.@*Methods@#The serum samples and the clinical data of 75 first-diagnosed CU patients and 120 healthy controls were collected at Shanghai General Hospital during the year of 2018. In the indirect ELISA system to measure the IgG (anti-human IgE), the antigen, Human IgE Myeloma, was coated on the plate; Omalizumab (a humanized anti-human IgE antibody) was the standard, and horse radish peroxidase (HRP)-labeled anti-human IgG was the tracer. The optimum concentrations of serum and HRP-labeled anti-human IgG were determined by chessboard titration, and method evaluation was conducted. The comparison of serum anti-IgE levels in CU patients and healthy people were analyzed by Mann-Whitney U test and chi-square test. Receiver operating characteristic (ROC) curves were applied to establish the diagnostic performance of serum anti-IgE for CU.@*Results@#The coating concentration of IgE was 5.0×10-4 mg/ml; serum dilution was 1∶300; enzyme-labeled antibody dilution was 1∶100 000. Standard curve was in good linearity with R2=0.996. The intra-and inter-assay coefficient of variation were 3.9%-7.5% and 6.0%-8.2%, and the recovery rate of low and high concentration samples were 95.9% and 108.4%, respectively. When hemoglobin≤1.3 g/L, triglyceride≤4.6 mmol/L, bilirubin≤171 μmol/L, no interference were observed. The limit of blank, limit of detection, and limit of quantitation were 5.8×10-4, 1.8×10-3, and 2.0×10-3 mg/ml. The linearity range was from 2.0×10-3 to 354.4 mg/ml. No Hook effect was found until anti-IgE reached 354.4 mg/ml. The anti-IgE remained stable after serum storage at 4 ℃ overnight or treated with 6 repeated freeze-thaw cycles. The anti-IgE levels in CU patients [19.0(1.9, 58.6)mg/ml] were significantly higher than those in healthy controls [0.7(0.002, 11.1)mg/ml] with P<0.001. When cut-off value was set as 15.3 mg/ml, in this method, the positive rate of CU patients (54.7%) was significantly higher than these of healthy controls (18.3%) (P<0.001, AUC=0.736).@*Conclusions@#The indirect ELISA method for serum anti-IgE measurement was successfully established. Anti-IgE autoantibodies in serum would be used in the diagnosis of CU.
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Objective The accurate measurement of anti-IgE levels in patients' serum helps for make diagnosis of chronic urticaria (CU). An indirect ELISA method for quantitative detection of IgG anti-IgE, were established. Methods The serum samples and the clinical data of 75 first-diagnosed CU patients and 120 healthy controls were collected at Shanghai General Hospital during the year of 2018. In the indirect ELISA system to measure the IgG (anti-human IgE), the antigen, Human IgE Myeloma, was coated on the plate;Omalizumab (a humanized anti-human IgE antibody) was the standard, and horse radish peroxidase (HRP)-labeled anti-human IgG was the tracer. The optimum concentrations of serum and HRP-labeled anti-human IgG were determined by chessboard titration, and method evaluation was conducted. The comparison of serum anti-IgE levels in CU patients and healthy people were analyzed by Mann-Whitney U test and chi-square test. Receiver operating characteristic (ROC) curves were applied to establish the diagnostic performance of serum anti-IgE for CU. Results The coating concentration of IgEwas 5.0 × 10-4 mg/ml; serum dilution was 1:300; enzyme-labeled antibody dilution was 1:100000. Standard curve was in good linearity with R2=0.996. The intra-and inter-assay coefficient of variation were 3.9％-7.5％ and 6.0％-8.2％, and the recovery rate of low and high concentration samples were 95.9％ and 108.4％, respectively. When hemoglobin≤1.3 g/L, triglyceride≤4.6 mmol/L, bilirubin≤171μmol/L, no interference were observed. The limit of blank, limit of detection, and limit of quantitation were 5.8 × 10-4, 1.8 × 10-3, and 2.0 × 10-3 mg/ml. The linearity range was from 2.0 × 10-3 to 354.4 mg/ml. No Hook effect was found until anti-IgE reached 354.4 mg/ml. The anti-IgE remained stable after serum storage at 4℃overnight or treated with 6 repeated freeze-thaw cycles. The anti-IgE levels in CU patients [19.0(1.9, 58.6)mg/ml] were significantly higher than those in healthy controls [0.7(0.002, 11.1)mg/ml] with P<0.001. When cut-off value was set as 15.3 mg/ml, in this method, the positive rate of CU patients (54.7％) was significantly higher than these of healthy controls (18.3％) (P<0.001, AUC=0.736). Conclusions The indirect ELISA method for serum anti-IgE measurement was successfully established. Anti-IgE autoantibodies in serum would be used in the diagnosis of CU.
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Inflammatory bowel disease (IBD) is a type of multi-etiology-induced, abnormal immune-mediated chronic recurrent inflammation of the intestine, which includes ulcerative colitis (UC) and Crohn's disease,(CD). IL-22 is a cytokine with unique biological properties. In the intestine, IL-22 has the ability to promote the expression of antimicrobial peptides and mucins that promote mucosal barrier integrity by activating the STAT3 pathway, and may promote intestinal epithelial cell regeneration and enhance intestinal epithelial cell barrier function. IL-22 is significantly increased in the intestinal mucosa of IBD patients. IL-22 can promote the repair of intestinal inflammatory damage, but with environmental changes, such as the level of expression of IL-23, T-bet, IL-22 binding protein, IL-22displayed dural characteristic, on the one hand, it can promote the repair of inflammatory injury, on the other hand it will increase the inflammatory injury response. This article mainly explains the origin of IL-22, its mode of action, and its application prospects in clinical treatment.
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Objective To understand the clinical characteristics of traumatic brain injury (TBI) patients and provide fundamental data for reducing the incidence of TBI and improving its treatment efficacy.Methods Medical histories of TBI inpatients from January 2011 to December 2016 were collected from the TBI database of Neurosurgical Department at Tianjin Medical University General Hospital.Information including gender,age,causes of TBI,injury severity,sources of the inpatients,interval from injury to treatment,diagnosis,and treatment were analyzed retrospectively.Results A total of 2 368 TBI patients were enrolled,aged mainly 30-60 years.There were more male patients (n =1 741) than female patients (n =627) (2.78 ∶ 1),while the gender ratio was reversed among patients above 60 years old (2.09 ∶ 1) (P ＜ 0.05).Traffic accident (60.14％) remained the major cause of TBI,while the proportion of electric motorcycle accident was 17.35％,followed by fall from height (13.64％).The proportion of mild TBI patients from suburb counties was lower than that of patients from the six urban areas (P ＜ 0.05),while the proportion of heavy TBI patients from other provinces was higher than those of both urban and suburb counties (P ＜ 0.05).The average interval from injury to specialist treatment was 7.53 hours.Patients who received treatment within 3 hours had better improvement than those who were treated 3 hours after TBI (P ＜ 0.05).The main injuries were skull fracture (33.07％) and brain contusion (30.32％).A total of 783 patients (33.07％) underwent surgery,among which 693 patients received the most common procedure of craniotomy hematoma evacuation (including decompressive craniectomy).The improvement rate of patients with intracranial pressure monitoring was higher than those without intracranial pressure monitoring (P ＜ 0.05).The improvement rate of the surgery group was significantly higher than that of the non surgery group (P ＜0.05).Conclusions The ratio of elderly female TBI patients is on the rise;TBI presents an increase in traffic accidents;mild TBI patients choose to receive treatment in close hospitals while those with severe TBI choose comprehensive hospitals;and the interval from injury to treatment is long.The following strategies including improving the traffic facilities,strengthening the education of traffic safety on elderly females and pedestrians,and optimizing the TBI medical treatment process would reduce the incidence of TBI and improve the efficiency of treatment.
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Inflammatory bowel disease (IBD)is an autoimmune disease leading to diarrhea,abdominal pain,and weight loss. The pathogenesis of diarrhea remains unclear,however,increasing evidence has shown that the epithelial sodium channel (ENaC)is associated with diarrhea. ENaC is crucial in the control of sodium homeostasis,extracellular fluid volume,blood pressure. This article reviewed advances in study on relationship between ENaC and IBD.
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Objective To explore the implementation styles on the therapeutic effects on the neurosurgical intensive care unit (NICU) patients. Methods Patients were enrolled during February 3, 2015 to February 3, 2016. The key point time was August 3, 2015 when the treatment in our NICU was fully implemented by NICU professional doctors. Based on this time point, all the enrolled patients were divided into non-NICU professional doctor implementing (NNPDI) group and NICU professional doctor implementing (NPDI) group. Thus non-NICU professional doctors and professional doctors were the leaders of diagnosis and treatment in tow groups. The length of hospital stay, complications, prognosis and other therapeutic outcomes were compared between two groups. Results The length of hospital stay was longer in NPDI group than that in NNPDI group (P0.05). The proportion of referral to other wards and fatality rate were both lower in NPDI group than those in NNPDI group (P0.05). Conclusion The NICU professional doctor implementing may be contribute to, at least in part, the improving of prognosis of NICU patients without obvious advantages in most complications. The level of professional management remains to be improved.
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10.3969/j.issn.2095-4344.2013.24.026