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Objective:To explore the relationship between the change of blood cholesterol and prognosis in patients with sepsis.Methods:The clinical data of 236 patients with sepsis (observation group) admitted to Nanjing Hospital Affiliated to Nanjing Medical University from February 2014 to December 2018 were analyzed retrospectively.The general clinical data, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) of the two groups were compared with 236 patients without sepsis in the same period as the control group, high density lipoprotein cholesterol (HDL-C) and other biochemical indexes; sepsis patients were divided into survival group and death group according to the prognosis, and the related factors affecting the prognosis were analyzed by multi factor Logistic regression.Results:The survival rate of sepsis patients was 60.6% (143/236), the mortality rate was 39.4% (93/236), 143 cases in survival group and 93 cases in death group.Compared with control group, the levels of serum TC ((2.51±1.20) mmo/L vs.(3.42±1.33) mmo/L, t=6.385) and HDL-C ((1.62±0.91) mmo/L vs.(2.53±0.79) mmo/L, t=5.526) in observation group were significantly lower (all P<0.05), and that of LDL-C showed no statistically significant difference((1.95±0.93) mmo/L vs.(2.11±0.84) mmo/L, t=0.958, P>0.05). In observation group, the patients in death group were older than those of the survival group ((75.4±10.3) years vs.(64.3±16.0) years, t=4.984, P<0.05), serum creatinine (SCr) was higher than that of survival group((252.3±65.2) μmol/L vs.(168.3±47.8) μmol/L, t=5.604, P<0.05), the levels of serum TC ((2.20±1.46) mmo/L vs.(2.91±1.12) mmo/L, t=6.157, P<0.05), HDL-C ((1.41±0.51) mmo/L vs.(1.95±0.65) mmo/L, t=5.090, P<0.05) and LDL-C ((1.71±0.67) mmo/L vs.(2.02±0.84) mmo/L, t=4.525, P<0.05) were significantly lower than those of survival group.Logistic regression analysis showed that age was the risk factor of death in sepsis patients ( OR=1.035, 95% CI 1.012-1.049, P=0.008), and TC was the protective factor on the prognosis of sepsis patients ( OR=0.748, 95% CI 0.693-0.822, P=0.015). Conclusion:TC and HDL-C were significantly decreased in sepsis patients, while those who died were further decreased than those who survived.As a protective factor TC can be an effective biochemical index to evaluate the prognosis of patients with sepsis.
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Objective@#To explore the relationship between the change of blood cholesterol and prognosis in patients with sepsis.@*Methods@#The clinical data of 236 patients with sepsis (observation group) admitted to Nanjing Hospital Affiliated to Nanjing Medical University from February 2014 to December 2018 were analyzed retrospectively.The general clinical data, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) of the two groups were compared with 236 patients without sepsis in the same period as the control group, high density lipoprotein cholesterol (HDL-C) and other biochemical indexes; sepsis patients were divided into survival group and death group according to the prognosis, and the related factors affecting the prognosis were analyzed by multi factor Logistic regression.@*Results@#The survival rate of sepsis patients was 60.6% (143/236), the mortality rate was 39.4% (93/236), 143 cases in survival group and 93 cases in death group.Compared with control group, the levels of serum TC ((2.51±1.20) mmo/L vs.(3.42±1.33) mmo/L, t=6.385) and HDL-C ((1.62±0.91) mmo/L vs.(2.53±0.79) mmo/L, t=5.526) in observation group were significantly lower (all P<0.05), and that of LDL-C showed no statistically significant difference((1.95±0.93) mmo/L vs.(2.11±0.84) mmo/L, t=0.958, P>0.05). In observation group, the patients in death group were older than those of the survival group ((75.4±10.3) years vs.(64.3±16.0) years, t=4.984, P<0.05), serum creatinine (SCr) was higher than that of survival group((252.3±65.2) μmol/L vs.(168.3±47.8) μmol/L, t=5.604, P<0.05), the levels of serum TC ((2.20±1.46) mmo/L vs.(2.91±1.12) mmo/L, t=6.157, P<0.05), HDL-C ((1.41±0.51) mmo/L vs.(1.95±0.65) mmo/L, t=5.090, P<0.05) and LDL-C ((1.71±0.67) mmo/L vs.(2.02±0.84) mmo/L, t=4.525, P<0.05) were significantly lower than those of survival group.Logistic regression analysis showed that age was the risk factor of death in sepsis patients (OR=1.035, 95%CI 1.012-1.049, P=0.008), and TC was the protective factor on the prognosis of sepsis patients (OR=0.748, 95%CI 0.693-0.822, P=0.015).@*Conclusion@#TC and HDL-C were significantly decreased in sepsis patients, while those who died were further decreased than those who survived.As a protective factor TC can be an effective biochemical index to evaluate the prognosis of patients with sepsis.
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Apoptosis and autophagy are common life phenomenon in various cells, which widely involve in physiological and path-ological processes, and interact with one another by many factors and multiple pathways. This intricate relationship runs through a vari-ety of cardiovascular diseases, and plays an important role in the occurrence, development and prognosis of many cardiovascular disea-ses. The effects of apoptosis and autophagy and their interrelationship in cardiovascular diseases were reviewed and summarized in this paper.
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Objective To investigate the effect of extracellular histones (EH) on intestinal mucosal barrier function in mice and the correlation of EH with the pathogenesis of sepsis.Methods Twenty male C57BL/6 mice were assigned into experiment group (n =10) and control group (n =10) according to the random number table.Same dose (50 mg/kg) of EH and saline were administered through the caudal vein of mice in experiment and control groups respectively.Blood and intestinal samples in each group were collected 3 h after the administration.Morphology of intestinal mucosal tissue was detected by light scope and transmission electron microscope.Expressions of tight junction related proteins (ZO-1,Occludin and Claudin-1) were detected by western blot.Plasma levels of diamine oxidase (DAO) and intestinal fatty acid binding protein (I-FABP) were determined by ELISA method.Plasma level of endotoxin (ET) was determined by limulus test.Results Under transmission electron microscope,experiment group showed disorganized microvilli of intestinal epithelial cells with partially twisted,broken and lost,unclear tight junctions,and widened cellular space.Under light scope,experiment group showed substantial inflammatory cell infiltration in the intestinal wall,disorganized intestinal villi,edema and hemorrhage of mucosa and submucosa,and edematous goblet cells.Experimental versus control group showed significant reduction in levels of Claudin-1 (0.587 7 ±0.060 6 vs.0.677 2 ±0.038 3),Occludin (0.1277±0.0857vs.0.4306±0.0869) and ZO-1 (0.393 3±0.080 8 vs.0.812 8± 0.096 3) (P ＜ 0.05).Experimental versus control group showed significantly up-regulated plasma levels of DAO [(1.61 ±0.20) U/ml vs.(0.69 ± 0.15) U/ml],I-FABP [(548.5 ± 36.8) EU/ml vs.(178.8±26.9) EU/ml] andET [(0.182±0.076) EU/mlvs.(0.091 ±0.029) EU/ml](P＜0.05).Conclusion EH can obviously impair the integrity of intestinal mucosal barrier in mice and hence induce endotoxin translocation.
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Objective To explore the significant risk factors in patients with Tile C pelvic frac-tures.Methods We conducted a retrospective review of all patients with Tile C pelvic fractures in Nanjing First Hospital from January 2010 to December 2014.The data gathered on each patient in-cluded:age,sex,mechanism of injury,visiting time after injury,shock index,Injury severity scale (ISS),Revised trauma score (RTS),Glasgowcoma scale (GCS),lowest PaO2/FiO2 ,6 h lactate clearance rate,concomitant injures and interventious of Tile C pelvic fractures.The data were tested using Student’t-test,χ2 test and logistic regression method.Results The study include 139 consecutive patients.The total mortality was 29.5%.Among them,36 (25.9%)patients died within 48 hours after admission.Multivariate regression analysis showed that shock index (OR=2.591,95%CI 1.041-4.216), ISS (OR = 47.96,95%,CI 15.89-147.23 ),RTS (OR = 6.917,95% CI 1.147-13.862 ),GCS (OR =4.172,95%CI 2.962-6.268),lowest PaO2/FiO2 (OR= 117.016,95% CI 51.011-176.032),6 h lactate clearance rate (OR=2.785,95%CI 1.191-4.892),concurrent head (OR=6.302,95%CI 2.270-13.175)or chest (OR=12.233,95%CI 5.193-33.985)injures were associated with high morality of Tile C pelvic frac-ture (P <0.01).The performing digital subtraction angiography with intravascular embolization can cut the mortality (OR=0.887,95%CI 0.875-0.899).Conclusion In our study,high trauma score,serious shock, coma,PaO2/FiO2 decreased and 6 h lactate clearance rate decreased,combined with the head and chest inju-ry are the important reasons of mortality in patients with Tile C pelvic fracture.It’s vital to control shock actively,use trauma scale and emphasize multidisciplinary cooperation to reduce mortality in patients with Tile C pelvic fractures.
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Objective To analyze the utilization of antibiotics for special use in our hospital in order to provide references for rational use antibiotics in clinic .Methods The utilization of antibiotics for special use in our hospital from 2010 to 2011 was analyzed with defined daily dose (DDD), consumption sum, DDC, DDDs and B/A as indexes.Results 72.22%of antibiotics for special use had been used in our hospital , main in injection .The changes of consumption sum , DDDs and proportion , DDC of antibiotics for spe-cial use varied from each other .The ratio of B to A of antibiotics for special use was in a range of 0.29~9.00.Conclusion The per-formance of stratified management of antibiotics did not implement exactly .It was necessary to strictly control the introduction , intensify education of medication and rigorously implement the performance of stratified management of antibiotics .