Correlation between early inflammation indicators and the severity of coronavirus disease 2019 / 中华危重病急救医学

Objective:To explore the correlation between early inflammation indicators and the severity of coronavirus disease 2019 (COVID-19).Methods:A retrospective study was conducted. Patients with COVID-19 admitted to Wenzhou Central Hospital from January 17 to February 14, 2020 were enrolled. The general information, chest CT before admission, the first laboratory parameters and chest CT within 24 hours after admission were collected. Patients were followed up for 30 days after the first onset of dyspnea or pulmonary imaging showed that the lesions progressed more than 50% within 24 to 48 hours (according to the criteria for severe cases) as the study endpoint. According to the endpoint, the patients were divided into two groups: mild type/common type group and severe/critical group, and the differences in general information and inflammation index of the two groups were compared. Logistic regression was used to analyze the inflammation index and the severity of COVID-19. Receiver operating characteristic (ROC) curve was draw to evaluate the predictive value of early inflammation indicators for severe/critical in patients with COVID-19.Results:A total of 140 patients with COVID-19 were included, 74 males and 66 females; the average age was (45±14) years old; 6 cases (4.3%) of mild type, 107 cases (76.4%) of common type, and 22 cases (15.7%) of severe type, 5 cases (3.6%) were critical. There were significantly differences in ages (years old: 43±13 vs. 57±13), the proportion of patients with one chronic disease (17.7% vs. 55.6%), C-reactive protein [CRP (mg/L): 7.3 (2.3, 21.0) vs. 40.1 (18.8, 62.6)], lymphocyte count [LYM (×10 9/L): 1.3 (1.0, 1.8) vs. 0.8 (0.7, 1.1)], the neutrophil/lymphocyte ratio [NLR: 2.1 (1.6, 3.0) vs. 3.1 (2.2, 8.8)] and multilobularinltration, hypo-lymphocytosis, bacterial coinfection, smoking history, hyper-tension and age [MuLBSTA score: 5.0 (3.0, 5.0) vs. 5.0 (5.0, 7.0)] between mild/common group and severe/critical group (all P < 0.05). Univariate Logistic regression analysis showed that CRP, NLR, MuLBSTA score, age, and whether chronic diseases were associated with the severity of COVID-19 [odds ratio ( OR) and 95% confidence interval (95% CI) were 1.037 (1.020-1.055), 1.374 (1.123-1.680), 1.574 (1.296-1.911), 1.082 (1.042-1.125), 6.393 (2.551-16.023), respectively, all P < 0.01]. Further multivariate Logistic regression analysis showed that CRP and MuLBSTA score were risk factors for the development of COVID-19 to severe/critical cases [OR and 95% CI were 1.024 (1.002-1.048) and 1.321 (1.027-1.699) respectively, both P < 0.05]. ROC curve analysis showed that the area under the curve for CRP and MuLBSTA score to predict severe/critical cases were both 0.818, and the best cut-off points were 27.4 mg/L and 6.0 points, respectively. Conclusion:CRP and MuLBSTA score are related to the severity of COVID-19, and may have good independent predictive ability for the development of severe/critical illness.

Identification of novel compound heterozygous variants in a pedigree affected with hereditary coagulation factor XI deficiency / 中华医学遗传学杂志

OBJECTIVE@#To analyze the phenotype and genetic basis for a pedigree affected with hereditary coagulation factor XI deficiency.@*METHODS@#Activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), FXI activity (FXI:C) and the antigen of FXI (FXI:Ag) were determined for the proband and members from his pedigree. Sanger sequencing was used to analyze all exons, exon-intronic boundaries, as well as the 5'- and 3'- untranslated regions of the F11 gene. Suspected variants were verified in her family members and confirmed by reverse sequencing. The impact of the variants on the protein function was predicted by using PolyPhen-2 and SIFT software. The protein structure and amino acid interaction were analyzed by using Swiss-PdbViewer.@*RESULTS@#The APTT, FXI:C and FXI:Ag of the proband and her sister were significantly reduced to 73.0 s, 10.0%, 15.0% and 87.1 s, 2.0% and 11.5%, respectively. APTT of some family members was slightly prolonged, and FXI:C and FXI:Ag also decreased to various extents. DNA sequencing revealed that the proband and her sister have carried compound heterozygous variants of c.738G>A (p.Trp228stop) and c.938G>T (p.Ser295Ile) respectively in exons 7 and 9 of the F11 gene. Her father, sister and daughter were heterozygous for the c.738G>A (p.Trp228stop) variant, while her mother and nephew were heterozygous for the c.938G>T (p.Ser295Ile). Both PolyPhen-2 and SIFT predicted that the p.Ser295Ile variant is likely to be deleterious and can affect the protein function. Modeling analysis indicated that the p.Ser295Ile variant may lead to disruption of a hydrogen bond, resulting in alteration of protein structure and instability.@*CONCLUSION@#The compound heterozygous c.738G>A (p.Trp228stop) and c.938G>T (p.Ser295Ile) variants of the F11 gene probably underlie the decreased FXI level in this pedigree.

Identification of compound heterozygous variants of F12 gene in a pedigree affected with inherited coagulation factor XII deficiency / 中华医学遗传学杂志

OBJECTIVE@#To explore the molecular pathogenesis for a pedigree affected with hereditary coagulation factor XII (FXII) deficiency.@*METHODS@#Potential variant of the F12 gene was analyzed by PCR and Sanger sequencing. Expression plasmids were constructed by site-directed mutagenesis based on the wild-type and transiently transfected into 293T cells. FXII:C and FXII:Ag of the expression products were determined in the supernatant and cell lysate. Western blotting was used to verify the identify of the protein.@*RESULTS@#Gene sequencing revealed that the proband has carried 46TT genetype and heterozygous p.Glu502Lys variants in exon 13, and a heterozygous p.Gly542Ser variant in exon 14 of the F12 gene. Transfection experiment suggested that the FXII:C and FXII:Ag of p.Glu502Lys variant in the supernatant were 28% and 24%, compared with the wild-type (100%) and FXII:Ag of cell lysates was 39% compared to the wild-type (100%). The FXII:C and FXII:Ag of p. Gly542Ser variant in the supernatant were 32% and 17% and the FXII:Ag of cell lysates was 59%.@*CONCLUSION@#The 46TT genetype, p.Glu502Lys and p.Gly542Ser variants of the F12 gene probably underlie the low FXII level in the proband. As shown by in vitro experiment, the p.Glu502Lys and p.Gly542Ser variants can both inhibit the synthesis and secrection of the FXII protein.

Effects of insulin caliper for blood glucose control on glucose control in patients with sepsis / 中国医师进修杂志

Objective To observe the effects of insulin caliper for blood glucose control on glycemic central tendency, fluctuation and incidence of hypoglycemia in patients with sepsis, and evaluate its application value. Methods One hundred sepsis patients with significant hyperglycemia from December 2015 to December 2017 were selected. All patients needed continuous intravenous insulin infusion to maintain blood glucose. The patients were divided into caliper group and conventional group by random digits table method with 50 cases each, patients of 2 groups adopted an insulin dose modification scheme based on insulin caliper for blood glucose control and paper-based insulin dose modification scheme respectively to control blood glucose. Finally, 92 cases completed the study, including 47 cases in caliper group and 45 cases in conventional group. Blood glucose was measured every 2 hours 0 to 12 hours after intravenous insulin and every 4 hours 16 to 72 hours after intravenous insulin. The incidence of hypoglycemia, insulin dose, ICU time, total hospital stay and hospitalization cost were observed. The proportion of hypoglycemia to total blood glucose measurement, proportion of achieving the glucose control target at each time point, glycemic coefficient of variance, glycemic lability index (GLI) and mean amplitude of glycemic excursion (MAGE) were calculated. Results A total of 1 379 blood glucose values were obtained in caliper group, and a total of 1 332 blood glucose values were obtained in conventional group. There were no statistical difference in blood glucose values 0 to 12 hours after intravenous insulin between 2 groups (P＞0.05). The blood glucose values 16 to 72 hours after intravenous insulin in caliper group were significantly lower than those in conventional group, and there were statistical differences (P＜0.01 or ＜0.05). There were no statistical differences in glycemic coefficient of variance, insulin dose, incidence of hypoglycemia and proportion of hypoglycemia to total blood glucose measurement between 2 groups (P＞0.05). The GLI and MAGE in caliper group were significantly lower than those in conventional group: 12.96 (8.73, 19.58) vs. 23.27 (13.07, 44.61) and (0.66 ± 0.22) mmol/L vs. (0.87 ± 0.28) mmol/L, the proportion of achieving the glucose control target at each time point was significantly higher than that in conventional group: 41.99% (579/1 379) vs. 27.18% (362/1 332), and there were statistical differences (P＜0.01). There were no statistical differences in ICU time, total hospital stay, hospitalization cost, nosocomial infection rate and prognosis between 2 groups (P＞0.05). Conclusions For emergent and critical patients with sepsis, insulin caliper for blood glucose control presents favorable application value for achieving glucose control target, reducing glycemic fluctuation, lowering the incidence of hypoglycemia, low cost and good operability.

Establishment of a nomogram for predicting the severity of the first-onset acute pancreatitis / 中华胰腺病杂志

Objective@#To establish a visualized nomogram with early predictive value for the severity of first-onset acute pancreatitis (AP).@*Methods@#706 cases of first-onset AP patients admitted to the First Affiliated Hospital of Wenzhou Medical University within 72 hours from January 2013 to January 2016 were collected. According to the revised Atlanta classification of AP in 2012, AP patients was divided into non-severe pancreatitis (NSAP, also called mild acute pancreatitis and moderately severe acute pancreatitis) group and severe acute pancreatitis (SAP) group. The demographic data (age, body mass index and admission time, etc) and laboratory tests (serum amylase, blood sugar, albumin, white blood cells, creatinine, urea nitrogen) were collected and statistically analyzed. Logistic univariate and multivariant regression analysis were performed based on the relevant clinical indicators. The statistically significant indicators were used to obtain regression equations. The R-language software was used to obtain the visualized nomogram via LR model, which was further validated by ROC curve analysis.@*Results@#In univariate logistic regression analysis, the OR (95% CI) values of blood glucose, creatinine at admission and 24 h after admission, urea nitrogen at admission and 24 h after admission, white blood cell, albumin in NSAP group and SAP group were 1.132(1.080-1.186), 1.019(1.013-1.025), 1.026(1.020-1.033), 1.066(1.035-1.099), 1.333(1.241-1.432), 1.083(1.032-1.136), and 0.853(0.811-0.889), and all the differences were statistically significant (all P values <0.05). Multivariate logistic regression analysis showed that the regression equation of the LR model was Y=-2.657-0.116×albumin(g/L)+ 0.082×white blood cell(×109/L)+ 0.118× glycemia(mmol/L)+ 0.022× 24 h after admission creatinine (μmol/L). A total score of more than 60 points on the nomogram predicted the possibility of SAP. If the total score exceeded 130, the possibility of SAP may be up to 14% or more. Furthermore, the ROC curve analysis confirmed that the sensitivity and specificity of LR model established in this study for predicting of SAP were superior to those of urea nitrogen, creatinine and BISAP score alone by AUC, respectively.@*Conclusions@#This nomogram may be a useful clinical tool for predicting the severity of the first-onset acute pancreatitis.

Establishment of a nomogram for predicting the severity of the first-onset acute pancreatitis / 中华胰腺病杂志

Objective To establish a visualized nomogram with early predictive value for the severity of first-onset acute pancreatitis ( AP ) . Methods 706 cases of first-onset AP patients admitted to the First Affiliated Hospital of Wenzhou Medical University within 72 hours from January 2013 to January 2016 were collected. According to the revised Atlanta classification of AP in 2012, AP patients was divided into non-severe pancreatitis ( NSAP, also called mild acute pancreatitis and moderately severe acute pancreatitis) group and severe acute pancreatitis ( SAP) group. The demographic data ( age, body mass index and admission time, etc) and laboratory tests (serum amylase, blood sugar, albumin, white blood cells, creatinine, urea nitrogen) were collected and statistically analyzed. Logistic univariate and multivariant regression analysis were performed based on the relevant clinical indicators. The statistically significant indicators were used to obtain regression equations. The R-language software was used to obtain the visualized nomogram via LR model, which was further validated by ROC curve analysis. Results In univariate logistic regression analysis, the OR ( 95％CI) values of blood glucose, creatinine at admission and 24 h after admission, urea nitrogen at admission and 24 h after admission, white blood cell, albumin in NSAP group and SAP group were 1. 132(1. 080-1. 186), 1. 019(1. 013-1. 025), 1. 026(1. 020-1. 033), 1. 066(1. 035-1. 099), 1. 333(1. 241-1. 432), 1. 083 (1.032-1.136), and 0.853(0.811-0.889), and all the differences were statistically significant (all P values <0. 05). Multivariate logistic regression analysis showed that the regression equation of the LR model was Y= -2. 657-0. 116 × albumin(g/L) +0. 082 × white blood cell( × 109/L) +0. 118 × glycemia(mmol/L) +0. 022 × 24 h after admission creatinine (μmol/L). A total score of more than 60 points on the nomogram predicted the possibility of SAP. If the total score exceeded 130, the possibility of SAP may be up to 14％ or more. Furthermore, the ROC curve analysis confirmed that the sensitivity and specificity of LR model established in this study for predicting of SAP were superior to those of urea nitrogen, creatinine and BISAP score alone by AUC, respectively. Conclusions This nomogram may be a useful clinical tool for predicting the severity of the first-onset acute pancreatitis.

Rh-BNP combined with sodium nitroprusside in acute decompensated heart failure patients with loss of blood flow dynamics, the effects on heart function and circulating factor level / 中国生化药物杂志

Objective To investigate the effect of rh-BNP combined with sodium nitroprusside in acute decompensated heart failure patients with loss of blood flow dynamics, the effects on heart function and circulating factor levels.MethodsSelect Wenzhou Institute of Physiology from February 2014 to January 2016 admitted during the period of 120 cases of acute decompensated heart failure patients, according to random number table method to all of the patients were randomly divided into two groups, control group and test group with the control group patients were given conventional treatment of heart failure treatment, while the experimental group patients give tome sodium nitrate joint treatment with recombinant human brain natriuretic peptide, compare two groups of patients 12 h level of circulating factors, cardiac function and hemodynamics.ResultsTwo groups of patients after the hemodynamics after 24 h treatment was significantly lower than that after the treatment of 12h(P<0.05), the control group of patients after treatment of 12h and 24h after pulmonary capillary wedge pressure and right atrial pressure and central venous pressure index were significantly higher than those in the test group (P<0.05) for the treatment of 24h.After the control group of patients with left ventricular GSRa, GSRe, GSRs, ROTR, ROT, GCS, GLS levels were significantly lower than those in the test group (P<0.05).After treatment of 12h patients in the control group were hsCRP, ST2, IL-6 and blood The levels of cTn I and NT-proBNP were significantly higher than those in the experimental group (P<0.05).ConclusionRh-BNP combined with sodium nitroprusside in patients with acute decompensated heart failure treatment can effectively optimize the circulation of patients with factor level and heart function and hemodynamics, it is worth to be popularized in clinical use.

The clinical effect of treatment of severe carbon monoxide poisoning with Naoxingjing injection combined with naloxone / 中国生化药物杂志

Objective To investigate the clinical effect of treatment of severe carbon monoxide poisoning with Naoxingjing injection combined with naloxone.Methods Emergency department of affiliated theorem clinical college, hospital 70 patients diagnosed with severe carbon monoxide poisoning from emergency department in June 2014 to December 2016, were randomly divided into observation group and control group 35 cases.In the control group were treated with naloxone treatment, observation group were treated based on the use Naoxingjing injection treatment.The two groups were observed and recorded recovery time, mortality, the incidence of delayed encephalopathy, Glasgow Coma Score(GCS)and serum levels of IL-1β.Results The patients in the observation group total effective rate of 97.14% was significantly higher than 77.14%, and the difference was statistically significant(P<0.05);the recovery time was observed in patients(2.25 ± 0.88)h, significantly shorter than the control group(3.46 ± 1.10)h, and the difference was statistically significant(P<0.05);and follow-up observation group mortality rates were delayed encephalopathy(1.43%, 8.57%)than the control group(17.14%, 25.71%), and the difference was statistically significant(P<0.05);④ observation group were GCS score was (12.77±1.89), significantly better than the control group, and the difference was statistically significant(P<0.05);⑤ observed in patients IL-1β is(65.41±9.93)ng / L was significantly lower than the control group(89.86±10.74)ng / L, and the difference was statistically significant(P<0.05).Conclusion Naoxingjing injection combined with naloxone treatment of severe carbon monoxide poisoning exact clinical effect, can effectively reduce patient recovery time, reduce mortality and morbidity.

Preliminary study of the level of visfatin and the relationship with insulin resistance in Chinese patients with chronic hepatitis C

Many studies have suggested that visfatin expression is closely related to the occurrence of insulin resistance [IR], while the precise role of visfatin in the regulation of IR in chronic hepatitis C [CHC] is not clear. We investigated fasting glucose, fasting insulin [FINS], C peptide, visfatin, visfatin mRNA, interleukin [IL]-6, tumor necrosis factor [TNF]-alpha, C-reactive protein [CRP] and other parameters of 315 patients with CHC and 150 control cases in China. Meanwhile we collected clinical and other laboratory data for further analysis. Compared with the control group, the CHC group had a significant increase in alanine aminotransferase [ALT], aspartate aminotransferase [AST], the AST to platelet ratio index [APRI], ratio of AST to ALT [AAR], gammaglutamyl trans-peptidase, IL-6, TNF-alpha, visfatin, visfatin mRNA, FINS, fasting C peptide, and IR index. The visfatin, visfatin mRNA, insulin, IR index, Homabeta cell function index [HBCI], and fasting beta-cell function index [FBCI] of the subjects with high body mass index [BMI] from the CHC sub-group were significantly higher than the normal BMI sub-group of CHC patients. We found a positive correlation between visfatin, visfatin mRNA and BMI, IL-6, TNF-alpha, and IR index. Our data suggest that visfatin may be related to IR in Chinese CHC patients

An in vitro study of thrombomodulin-protein C-EPCR system coagulation function in hemorrahgic shock rats / 中华急诊医学杂志

Objective To investigate the coagulant function of Thrombomodulin-Protein C-EPCR System in rats with hemorrhagic shock in virto study.Methods In this study,30 rats were divided into three groups,with each group 10 rats:control group,the sham shock group,hemorrhagic shock group.Hemorrhagic shock model was subjected to computer-controlled arterial hemorrhage to 40 mm Hg for 60 min The rat blood serum samples were obtained from rats in sham shock group and shock group after maintaining 3 hours,and fetal bovine serum (FBS) was used as control group.Then medium contained fore-mentioned serums cultured with SV40-transformed aortic rat endothelial cells for 6 hours,12 hours and 18hours.The messenger RNA (mRNA) expression of thrombmodulin (TM),Endothelial cell protein C receptor in the SV40-transformed aortic rat endothelial cells which were treated with serums were detected by reverse-transcription polymerase chain reaction.Results Compared to control group,SVARECs were incubated for 6hrs with shock serum,the mRNA expression of TF,TM and t-PA was significantly higher,and continued elevating at the time of 18 hours (P ＜ 0.01).Conclusions Serums from hemorrhagic shock rats upregulate TMmRNA EPCRmRNA expression on the endothelial cells surface.It is suggested that Thrombomodulin-Protein C-EPCR System pay a key role of anticoagulation,the protection of endothelial function.

Effects of the serum in shock rats and shenfu injection on the endothelial cell protein C receptor / 中华急诊医学杂志

Objective To investigate the effects of the serum from rats with hemorrhagic shock and Shenfu injection, on the expression of endothelial cell protein C receptor (EPCR) in human umbilical vein endothelial cells (HUVECs) cultured with rat serum. Method The soluble endothelial protein C receptor (sEPCR) in supernatant, the expression of EPCR mRNA and protein level of EPCR in HUVECs were detected by using enzyme linked immunosorbent assay ( ELISA), reverse transcription polymerase chain reaction (RT-PCR), and western bloting (WB) in normal control group, hemorrhagic shock serum (3 h, 12 h, 24h, 72 h) group, and Shenfu-treated (3 h, 12 h, 24 h, 72 h) group, respectively. Results The mean levels of sEPCR and the expression of EPCR mRNA were significantly higher in hemorrhagic shock serum (12 h, 24 h) group, and Shenfu -treated(24 h)group than those in normal control group (all P ＜0.01 ),the mean levels of sEPCR and the expressions of EPCR mRNA were significantly higher in Shenfu-treated ( 12 h) group than those in normal control group ( all P ＜0. 05 ), while the levels of protein were lower in hemorrhagic shock serum ( 12 h, 24 h) group and in Shenfu-treated(24 h)group than those in normal control group ( both P ＜0.01 ), and the level of EPCR protein was lower in Shenfu-treated( 12 h) group than that in normal control group ( P ＜ 0. 05) . The mean levels of sEPCR and the expressions of EPCR mRNA were significantly lower in Shenfu-treated ( 12 h, 24 h) group than those in hemorrhagic shock serum ( 12 h,24 h) group (all P ＜0.05), while the levels of EPCR protein were higher in Shenfu-treated ( 12 h, 24 h)group than those in hemorrhagic shock serum ( 12 h, 24 h) group ( P ＜ 0.05 ). Conclusions These data suggest that Shenfu injectio could affect the expression of EPCR mRNA and the level of EPCR protein, thereby it might be effective in prevention of development of hemorrhagic shock.

Effects of bone marrow-derived mesenchymal stem cells on mRNA and protein expression of toll like receptor of rat alveolus macrophages / 中华创伤杂志

ObjectiveTo investigate the effect of bone marrow-derived mesenchymal stem cells (MSCs) on gene and protein expression of toll-like receptor, TLR2/4 of the rat alveolus macrophages so as to discuss the effect of MSCs transplantation on the early inflammatory mediators and the regulatory mechanism of the inflammatory cascade.MethodsThe alveolus macrophages were randomly divided into the PBS control group (n = 24), MSCs control group (n = 24), lipopolysaccharide (LPS) control group (n=24) and LPS + MSCs treatment group (n =24).All groups were taken time-points of 1, 3,6, 12 hours.Positive cell rate of MSCs with surface mark and the expression level of TLR2/4 protein on macrophage were detected by flow cytometry.The mRNA level of TLR2/4 expression on macrophage was detected by RT-PCR and the concentrations of TNF-o in cell culture supernatants by ELISA at the different time points.ResultsCompared with the PBS control group and MSCs control group, TLR2/4 mRNA and protein levels were significantly up-regulated, markedly increased at one hour and peaked at 12 hours (P ＜0.01) and the TNF-α concentrations in cell culture supernatants were significantly up-regulated and peaked at 6 hours in the LPS control group (P ＜ 0.01).Compared with the LPS control group, mRNA and protein level of TLR2/4 and TNF-o concentrations in the cell culture supernatants of the LPS + MSCs group were markedly down-regulated (P ＜ 0.01).ConclusionsWith LPS stimulation, TLR2/4 mRNA and protein expressions as well as TNF-αt concentration increase, when the peak of the TNF-αt concentration appears slightly earlier, indicating that there may be a positive feedback loop between TLR2/4 expression and TNF-ot.MSCs can significantly reduce TLR2/4 mRNA and protein expressions as well as TNF-α concentration after LPS stimulation, indicating that MSCs can break up the positive feedback loop.

Effect of Omegaven on blood clotting system and inflammatory reaction in ICU patients with parenteral nutrition / 肠外与肠内营养

Objective: To observe the changes of blood coagulation factors and inflammatory factors and the regulatin effect of Omegaven.Methods: Thirty ICU patients were randomly allocated into two groups: Omegaven group and control group.Serum concentrations of NF-κB、PGF1α、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 were measured before and after parenteral nutrition.Results: Patients in control group had significantly higher NF-κB、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 concentration,lower PGF1α concentration.Patients treated with Omegaven had significantly lower NF-κB、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 concentration,higher PGF1α concentration.Conclusion: Omegaven can suppress inflammatory reaction and improve coagulopathy.

Dynamic changes and significance of antithrombin and fibrinolytic function in advanced lung cancer patients during chemotherapy / 中国肺癌杂志

<p><b>BACKGROUND</b>The prethrombotic state can be observed in advanced lung cancer patients. The aim of this study is to determine the dynamic changes and significance of antithrombin and fibrinolytic function in advanced lung cancer patients during chemotherapy.</p><p><b>METHODS</b>Antithrombin activity (AT:A), fibrinogen (FIB), D-dimer (D-D), plasminogen activity (PLG), tissue plasminogen activator antigen (t-PA:Ag) and plasminogen activator inhibitor-1 antigen (PAI-1:Ag) were measured in 33 advanced lung can-cer patients before and after chemotherapy, and 30 healthy people as controls.</p><p><b>RESULTS</b>Before chemotherapy, lung cancer patients had significantly lower AT:A (P < 0.01) and higher D-D, PLG:A, PAI-1:Ag and FIB (P < 0.01) than those of controls. There was no significant difference in t-PA:Ag between lung cancer patients and controls (P > 0.05). During the chemotherapy, AT:A, D-D and t-PA:Ag of lung can-cer patients remarkably decreased (P < 0.01), and PLG:A, PAI-1:Ag and FIB remarkably increased (P < 0.01) compared to those before chemotherapy.</p><p><b>CONCLUSIONS</b>Chemotherapy may enhance the prethrombotic state in advanced lung cancer patients. Dynamic observation of antithrombin and fibrinolytic function during chemotherapy might be useful for preventing pulmonary hemorrhage and pulmonary infarct and estimating prognosis of those patients.</p>

Hospital-acquired Septicemia in ICU :A Clinical Anylasis of 76 / 医学研究杂志

Objective To study the clinical characteristics、risk factors and preventive measures in the patients of hospital-acquired septicemia in ICU.Methods Retrospective survey was carried out in 76 patients with hospital-acquired septicemia from 2002 to 2005.Results The hospital-acquired septicemia was related to the underlying disease、aggressive procedure and long duration of combined antibiotics.The most bacteria were Gram-negative bacilli.Fungemia must be given reconstruction.Conclusions It is important to reduce the aggressive procedures and reasonably use antibiotics in the prevention of the hospital-acquired septicemia for patients.

Changes of cardiac function and myocardial apoptosis in rabbits after limb ischemia reperfusion / 中华急诊医学杂志

Objective To investigate the changes of cardiac function and myocardial apoptosis after limb ischemia reperfusion in rabbits.Methods Thirty rabbits were randomly divided into 3 groups:sham-operated control group (group SC),ischemia group (groupⅠ,8 hours of bilateral hind limb ischemia) and ischemia reperfusion group (group IR,4 hours of bilateral hind limb ischemia and 4 hours of reperfusion).Immunohistochemical studies and TUNEL were done to evaluate cell apoptosis.The SOD activity and MDA content in myocardial tissue and plasma LDH activity were determined. The left ventricular function were observed by physiology recording instrument.The cardiac histopathologic changes in experimental rabbits were observed.Results In group IR,the apoptosis index and expression of Bax were significantly increased compared with the other two groups.Similarly,ischemia reperfusion reduced SOD activity and enhanced LDH activity and MDA level,and the left ventricular function decreased in group IR.There was a positive correlation among the MDA content and the LDH activity,the expression of bax,the number of apoptosis cells.Under light microscope, myocardial impairment was found in group IR.Conclusion The myocardial injury occured and the left ventrieular function decreased after limb ischemia reperfusion,and they were associated with oxidative damage and apoptosis.

Methods and Consideration on Clinical Teaching in ICU / 中华医学教育探索杂志

The clinical teaching of ICU is a new challenge.According to the problem encountered in the practice we should improve and better the teaching methods such as asking students to pay more attention to the combination of substructural subjects and critical medicine and having a clinical macrocosm thinking,good responsibility,and the "intensive" concept during their work so that student can learn more initiatively and get more as well.

Monitor and Treatment of Circulation System after Liver Transplantation Infarction / 医学研究杂志

Objective To discuss the monitor and treatment of patients' abnormal condition of circulation system after liver transplantation.Methods Dynamic monitor of 23 patients' circulation system after liver transplantation.Variables include haemodynamics index,plasma albumin,coagulation function,temperature,urinary volume,electrolyte,et al.Results The patients with liver transplantion are in high haemodynamics.Some of them undergo pulmonary hypertension,hypoproteinemia,hypothermia,hypourocrinia,kaliopenia.Conclusion Pay attention to the abnormal condition of circulation system after liver transplantation,take protective the restoration of graft function actively.

The tolerance and safety of nasogastric tube feeding and naso-jejunum tube feeding and incidence of aspiration pneumonia in ICU enteral nutrition patients / 肠外与肠内营养

0.05).Conclusion: Enteral nutrition may improve the nutrition status.The naso-jejunum tube feeding has no advantage to nasogastric tube feeding in our patients.The route of enteral nutrition should be selected according to the individual condition and local nosocomial experience.

The dynamic changes of antithrombase and Dbrinolytic function in the critical patients / 中华麻醉学杂志

Objective To evaluate the dynamic change of the antithrombase and fibrinolytic function in the critical patients.Methods Eighty-seven patients hospitalized in ICU were studied. According to the clinical manifestation, all patients were divided into systemic inflammatory response syndrome (SIRS) group ( n = 68) and non-SIRS group ( n = 19), or multiple organ dysfunction syndrome (MODS) group ( n = 37) and non-MODS group (n = 50) respectively. Thirty-one healthy volunteers were selected for control in the same period. The intravenous blood samples were taken 1,3 and 5 days after ICU admission to measure platelet,count (PLT) , and the plasma levels of antithrombase activity (AT: A), plasminogen activity (PLG: A), fibrinogen (FIB) and D-dimer (D-D) concentrations.Results AT: A, PLG: A and PLT were lower and FIB and D-D levels higher in all patients than control levels (P