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1.
Article in Chinese | WPRIM | ID: wpr-940553

ABSTRACT

ObjectiveTo observe the effects of Bufei Yishen prescription on airway mucus hypersecretion and Notch signaling pathway related protein Notch3 and enhancer of split homologue 1 (HES1) in rats with chronic obstructive pulmonary disease (COPD) and to explore its action mechanism. MethodForty-eight SD rats were randomly divided into the control group, model group, Bufei Yishen prescription group, and aminophylline (APL) group,with 12 rats in each group. The stable COPD rat model was established via cigarette smoking exposure combined with Klebsiella bacterial infection for 12 weeks, and the corresponding drugs (3.7 g·kg-1·d-1 Bufei Yishen prescription and 54 mg·kg-1·d-1 APL) were administered by gavage during the next eight weeks. After the last administration at week 20, the lung tissue was sampled for observing the pathological changes and the rat lung function was detected. The tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and mucoprotein 5AC (MUC5AC) in bronchial alveolar lavage fluid and the mRNA and protein expression levels of Notch3, HES1, and MUC5AC in lung tissues were assayed. ResultCompared with the control group, the model group exhibited significantly weakened pulmonary function (P<0.05,P<0.01), reduced average number of alveoli (P<0.01), elevated mean linear intercept (P<0.01), and up-regulated TNF-α, IL-6, and MUC5AC in bronchial alveolar lavage fluid and Notch3, HES1, and MUC5AC mRNA and protein expression in lung tissue (P<0.05,P<0.01). Compared with the model group, Bufei Yishen prescription and APL remarkably enhanced pulmonary function, alleviated its pathological injury (P<0.05,P<0.01), and down-regulated TNF-α, IL-6, and MUC5AC in bronchial alveolar lavage fluid and the mRNA and protein expression levels of Notch3, HES1, and MUC5AC in lung tissues (P<0.05,P<0.01). ConclusionThe mechanism of Bufei Yishen prescription in inhibiting airway mucus hypersecretion of COPD rats was related to its regulation of Notch3 and HES1.

2.
Article in Chinese | WPRIM | ID: wpr-864225

ABSTRACT

Objective:To investigate the relationship of single nucleotide polymorphism (SNP) of high mobi-lity group protein A2 ( HMGA2) gene with prepubertal idiopathic short stature (ISS) and the efficacy of recombinant human growth hormone (rhGH) in Han population of Henan Province. Methods:A total of 120 children who were diagnosed with prepubertal ISS and treated with rhGH standards for at least one year from July 2017 to September 2019 at the Children′s Endocrinology Clinic of the Third Affiliated Hospital of Zhengzhou University were enrolled in the ISS group of this study.Meanwhile, 120 healthy children (control group) of the same age and gender whose height was within the normal range were selected as controls.Their peripheral blood was collected, and the polymorphism distributions of SNP loci(rs1042725 and rs7968682)were determined by molecular biology.Analysis was carried out to specify the annual growth rate, height standard deviation score (HtSDS), and insulin-like growth factor-1(IGF-1) of ISS children with different genotypes (before and after treatment )and those in the control group.Results:(1)In both ISS group and control group, children with CC and CT alleles at rs1042725 locus of HMGA2 had higher growth rate than those with TT allele before treatment[(4.33±0.64) cm/year, (3.95±0.45) cm/year; (6.35±0.41) cm/year, (6.12±0.32) cm/year vs.(3.76±0.52) cm/year, (5.96±0.42) cm/ year], therefore the difference were statistically significant (all P<0.05). (2)After treatment with GT genotype at the HMGA2 rs7968682 locus in children with ISS, the growth rate of age and bone HtSDS was higher than that of TT genotype [(0.74±0.30) cm/year vs. (0.63±0.24) cm/year, (0.16±0.05) cm/year vs.(0.14±0.05) cm/year], therefore the differences were statistically significant(all P<0.05). Conclusions:The polymorphism of the HMGA2 SNP locus (rs1042725) in the Han population of Henan province may be related to ISS level, while the polymorphism of the SNP locus (rs7968682) may be related to rhGH efficacy.

3.
Article in Chinese | WPRIM | ID: wpr-791837

ABSTRACT

Objective To explore whether therapeutic dosing timing of proteasome inhibitor bortezomib(BZ) would impact its clinical efficacy .Methods From 2012 to 2018 ,35 biopsy-confirmed cases of acute antibody-mediated kidney transplant rejection (AMR) were collected .They received intravenous immunoglobulin (IVIG) plus sirolimus (Sir) plus bortezomib (BZ) .Three groups were assigned according to dosing timing of BZ .After a diagnosis of AMR ,ET (early treatment ) group began BZ dosing within 7 days (n=16) while DT (delayed treatment) group within 8-14 days (n=11) and LT (late treatment) group > 14 days (n= 8).Their clinical parameters and incidence of complications were analyzed .Results DSA reversal rate of ET ,DT and LT groups was 87 .5% , 45 .5% and 25 .0% (P=0 .006) while DSA declining rate 93 .8% ,90 .9% and 50% respectively (P=0 .019);recurrent rate of AMR was lower in ET/DT group than LT group (6 .6% vs 10% vs 75% , P=0 .042) .No significant differences existed in blood perfusion score of allograft at 1 month post-dosing among three groups .In three groups ,creatinine (Cr) of ET group was lower than DT group at month 1/3/12 while DT group was lower than LT group .No significant difference existed in the incidence of adverse reactions among 3 groups .Conclusions More likely to enter the window period , early dosing of BZ is more effective for treating acute AMR .An earlier intervention yields a better efficacy .

4.
Article in Chinese | WPRIM | ID: wpr-777502

ABSTRACT

To study the chemical constituents from the rhizome of Menispermum dauricum,fifteen compounds,N-methylcorydaldine( 1),thalifoline( 2),stepholidine( 3),acutumine( 4),daurisoline( 5),acutumidine( 6),dauricicoline( 7),bianfugecine( 8),6-O-demethylmenisporphine( 9),bianfugedine( 10),dauricoside( 11),eleutheroside D( 12),aristolactone( 13),aristoloterpenateⅠ( 14) and aristolochic acid( 15) were isolated from 75% ethanol extract of Menispermi Rhizoma by using thin layer chromatography and column chromatography methods. Their structures were identified based on their physicochemical properties and spectral data. Among them,compounds 12-15 were obtained from the genus Menispermum for the first time. Six alkaloids with higher contents were subjected to evaluate the anti-hypoxic activities by using MTT method. As a result,six alkaloids exhibited significant anti-hypoxia activities.


Subject(s)
Alkaloids , Humans , Hypoxia , Menispermum , Plant Extracts , Rhizome
5.
Article in Chinese | WPRIM | ID: wpr-777489

ABSTRACT

This study based on~1H-NMR urine metabolomics technique combined with biochemical indicators to focus on studying the acute hepatotoxicity mechanism of Artemisia argyi essential oil( AAEO). In order to further explore the acute hepatotoxicity mechanism of AAEO,the researchers collected the urine nuclear magnetic data of rats in different periods of high and low doses of olive oil and AAEO group. Using the principal component analysis( PCA) and orthogonal partial least squares-discrimination analysis( OPLSDA) to analyze the endogenous small molecule metabolites in rat urine to study the effects of AAEO on the metabolic process of normal rats. The results showed there was a significant difference between the olive oil group and the AAEO group,the PCA scores chart demonstrated that there was no obvious separation tendency in the urine of olive oil group rats 0-6,6-12,12-24 h,and the metabolic components were distributed in aggregation pattern. The urinary metabolic trajectory of the rats in the AAEO group was conspicuously separated at 0-6,6-12,12-24 h. The experiments proved that the analysis of metabolites by~1H-NMR found that AAEO caused metabolic disorders in rats and produced acute hepatotoxicity. After metabolite differential comparison,it was speculated that the mechanism of acute hepatotoxicity may be involved in the tricarboxylic acid cycle and energy metabolism,while the citrate and oleanolic acid would be the potential biomarkers. This study discussed that the acute hepatotoxicity mechanism of AAEO was used to provide the experimental data for the clinical prescription of Artemisia argyi.


Subject(s)
Animals , Artemisia , Chemical and Drug Induced Liver Injury , Metabolomics , Oils, Volatile , Proton Magnetic Resonance Spectroscopy , Rats
6.
Chinese Journal of Traumatology ; (6): 216-223, 2018.
Article in English | WPRIM | ID: wpr-691005

ABSTRACT

<p><b>PURPOSE</b>To evaluate the quality of life among survivors after sepsis in 2 years, comparing with critical patients without sepsis and the general people, analyze the changes and the predictors of quality of life among septic survivors.</p><p><b>METHODS</b>This prospective case-control study screened the intensive care unit (ICU) patients in Tianjin Third Central Hospital from January 2014 to October 2017, and the Chinese general population in the previous studies was also included. According to inclusion criteria and exclusion criteria, 306 patients with sepsis were enrolled as the observation group, and another 306 patients without sepsis in ICU during the same period, whose ages, gender and Charlson Comorbidity Index matched with observation group, were enrolled as the control group. At 3 mo, 12 mo, and 24 mo after discharge, the Mos 36-item Short Form Health Survey (SF-36), the Euroqol-5 dimension (EQ-5D), and the activities of daily living (ADL) were evaluated in face-to-face for the quality of life among survivors.</p><p><b>RESULTS</b>There were 210 (68.6%) septic patients and 236 (77.1%) non-septic critically ill patients surviving. At 3 months after discharge, the observation and control groups had the similar demographic characteristics (age: 58.8 ± 18.1years vs. 57.5 ± 17.6 years, p = 0.542; male: 52.0% vs. 51.4%, p = 0.926). However, the observation group had higher acute physiology and chronic health evaluation II (APACHEII) scores, higher sequential organ failure assessment (SOFA) scores, longer hospital stay, and longer ICU stay than the control group did (p < 0.05). There were no significant differences in the eight dimensions of the SF36 scale, the EQ-5D health utility scores, and the activities of daily life scores between septic survivors and non-septic survivors (p > 0.05). In addition, compared with the quality of life of the Chinese general population (aged 55-64 years), the quality of life of septic patients were significantly lower at 3 months after discharge (p < 0.05). Comparing the quality of life of the ill patients who had been discharged at 3 mo and 24 mo, the general health improved statistically (p = 0.000) and clinically (score improvement > 5 points). Older age (OR, 1.050; 95% CI, 1.022-1.078, p = 0.000), female (OR, 3.375; 95% CI, 1.434-7.941, p = 0.005) and longer mechanical ventilation time (OR, 3.412; 95% CI, 1.413, 8.244, p = 0.006) were the risk factors for the quality of life of septic survivors.</p><p><b>CONCLUSION</b>The long-term quality of life of septic survivors was similar to that of non-sepsis critically ill survivors. After discharge, the general health of sepsis improved overtime. Age, female and mechanical ventilation time (>5 days) were the predictors of the quality of life after sepsis.</p>


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Prospective Studies , Quality of Life , Risk Factors , Sepsis , Mortality , Psychology , Survivors
7.
Article in Chinese | WPRIM | ID: wpr-698300

ABSTRACT

BACKGROUND:Mesenchymal stem cells have unique homing,immunoregulation and anti-inflammatory properties.After intravenous injection,mesenchymal stem cells can home to the damaged target organs and tissues,and function to repair damaged tissues.OBJECTIVE:To observe the pathological changes of lung tissues in rats with emphysema after mesenchymal stem cells transplantation.METHODS:Twenty-four female Wistar rats were randomly divided into experimental group,control group and healthy control group.In the first two groups,the model of pulmonary emphysema was established by the method of dropping porcine pancreatic elastase.BrdU-labeled mesenchymal stem cells were injected into the tail vein of the rats in the experimental group,and PBS was injected in the control group.After 14 days,the pathological changes of lung tissues were observed.Tumor necrosis factor-α level,alveolar wall apoptotic index,anti-CD34 and anti-BrdU immunohistochemical changes in the bronchoalveolar lavage fluid were detected.RESULTS AND CONCLUSION:Compared with the healthy control group,the tumor necrosis factor-α level and apoptotic index of alveolar wall cells increased (P < 0.01),and the relative areas of anti-Brdu and anti-CD34 decreased (P < 0.01) in the control group.Compared with the control group,the level of tumor necrosis factor-α and apoptotic index of alveolar wall cells decreased (P < 0.01),and the relative area of anti-Brdu and anti-CD34 increased (P < 0.01) in the experimental group.The histopathological findings showed that both the control group and the experimental group showed emphysema-like changes,but these changes were milder in the experimental group than the control group.To conclude,mesenchymal stem cells can inhibit inflammatory response and apoptosis in experimental emphysema,improve the pathological changes of the lung,and moreover,bone marrow mesenchymal stem cells can differentiate into lung vascular endothelial cells.

8.
China Pharmacy ; (12): 2549-2553, 2017.
Article in Chinese | WPRIM | ID: wpr-619859

ABSTRACT

OBJECTIVE:To develop a method for simultaneous determination of geniposide,baicalin,aloe-emodin,rhein, emodin,chrysophanol and physcion in Zhizi jinhua dispersible tablets. METHODS:HPLC method was adopted. The determination was performed on Dimonsil C18 column with mobile phase consisted of methanol-0.05%phosphoric acid(gradient elution)at the flow rate of 0.8 mL/min. The detection wavelength was set at 254 nm,and the column temperature was 25℃. The sample size was 20 μL. RESULTS:The linear ranges of geniposide,baicalin,aloe-emodin,rhein,emodin,chrysophanol and physcion were 0.0323-0.323 μg (r=0.9998),0.1374-1.374μg(r=0.9999),0.00372-0.0372μg(r=0.9997),0.0069-0.069μg(r=0.9995),0.00332-0.0332μg (r=0.9997),0.00864-0.0864 μg(r=0.9997) and 0.00122-0.0122 μg(r=0.9995),respectively. The limits of quantitation were 0.0321,0.1374,0.00372,0.0067,0.00330,0.00864,0.00122 μg,respectively. The limits of detection were 0.0095, 0.0041,0.0012,0.0020,0.0010,0.0026,0.0003 μg,respectively. RSDs of precision,stability and reproducibility tests were all lower than 3%. The average recoveries were 96.54%-99.52%(RSD=1.17%,n=6),97.23%-101.23%(RSD=1.36%,n=6), 97.22%-101.25%(RSD=1.83%,n=6),97.32%-100.23%(RSD=1.09%,n=6),97.99%-102.71%(RSD=1.73%,n=6), 96.99%-100.23%(RSD=1.21%,n=6),96.99%-103.01%(RSD=2.31%,n=6),respectively. CONCLUSIONS:The methods is simple and reproducible. It can be used for the content determination of 7 components in Zhizi jinhua dispersible tablets.

9.
Article in Chinese | WPRIM | ID: wpr-608031

ABSTRACT

Objective To seek for the differentially-expressed proteins in patients with kidney-yin deficiency syndrome and to screen out the specific proteins,so as to provide evidence for the establishment of objective standard of kidney deficiency syndrome of traditional Chinese medicine (TCM).Methods Five patients with typical kidney-yin deficiency syndrome and 6 normal healthy volunteers were enrolled into the study.Plasma proteins in both groups were detected by antibody chip,and then the plasma proteins profile was compared and analyzed.Results A total of 25 differentially-expressed proteins between kidney-yin deficiency group and normal control group were found,of which 2 were up-regulated and 23 were down-regulated.Conclusion The differentially-expressed proteins in patients with kidney-yin deficiency syndrome are mainly related to immune disorder,protein biosynthesis,metabolism,oxidative stress,cell apoptosis,signal transduction,and so on.

10.
Article in Chinese | WPRIM | ID: wpr-662753

ABSTRACT

BACKGROUND: Physiologic Anchorage Spee's-wire System (PASS) is a new appliance for orthodontic treatment in recent years. It has its superiority in support control, torque domination and friction control, and it is also unique in opening bite. OBJECTIVE: To build a three-dimensional finite element model of PASS with intrusion arch, and to analyze its effects on intrusion of the anterior teeth and on enhancing anchorage of the molars.METHODS: The CT scan data were imported into software of Mimicsl7.0 to obtain a three-dimensional model of the teeth and jaw bone. A series of modeling software such as Geomagic Studio, NX, ANSYSl5.0 were used to obtain the three-dimensional model of the maxillary dentition with PASS and intrusion arch. The overall force of the dentition and movement of the anterior teeth were analyzed when the intrusion arch was located at the mesial side of the central incisor and lateral incisor as well as the distal side of the lateral incisor.RESULTS AND CONCLUSION: It was efficient to accomplish the intrusion of the anterior teeth when the arch was located between central incisors. Labial inclination of the anterior teeth was achieved when the arch was ligated at the mesial side of the lateral incisor. Lingual inclination and intrusion of the anterior teeth was found when the arch was located at the distal side of the lateral incisor. Under these three kinds of conditions, the trend of molar retrodisplacement became remarkable. The maximum movement trend of the incisors was achieved, when the arch was ligated at the mesial side of the central incisor, mainly due to the intrusion of the incisors. The molar retrodisplacement was improved under the three conditions. This experiment simulated the stress distribution and displacement trend of the teeth, which is beneficial to the clinical understanding and application of the PASS technology with intrusion arch.

11.
Chinese Journal of Infection Control ; (4): 946-948,952, 2017.
Article in Chinese | WPRIM | ID: wpr-661773

ABSTRACT

Objective To understand healthcare-associated infection(HAI)in group burn/trauma patients,and explore its risk factors.Methods HAI occurred among 25 hospitalized patients with group burn/trauma during a bus deflagration event on May 12,2014 were monitored and analyzed.Results Of 25 burn/trauma patients,7 de-veloped 10 times of HAI,incidence and case incidence of HAI were 28.00% and 40.00% respectively;the main in-fection sites were wound and lower respiratory tract,accounting for 60.00% and 30.00% respectively.30 strains of pathogens were isolated from 7 patients with HAI,including 16 strains (53.34%)of gram-negative bacteria,13 strains(43.33%)of gram-positive bacteria,and 1 fungus (3.33% ).Risk factors for HAI were large burned area, high degree of inhalation injury,arteriovenous catheterization,urinary tract catheterization,tracheotomy,use of ventilator,and surgery.Conclusion Incidence of HAI is high in the group burn/trauma patients,corresponding in-tervention measures should be formulated according to the risk factors,so as to reduce the occurrence of HAI.

12.
Article in Chinese | WPRIM | ID: wpr-660668

ABSTRACT

BACKGROUND: Physiologic Anchorage Spee's-wire System (PASS) is a new appliance for orthodontic treatment in recent years. It has its superiority in support control, torque domination and friction control, and it is also unique in opening bite. OBJECTIVE: To build a three-dimensional finite element model of PASS with intrusion arch, and to analyze its effects on intrusion of the anterior teeth and on enhancing anchorage of the molars.METHODS: The CT scan data were imported into software of Mimicsl7.0 to obtain a three-dimensional model of the teeth and jaw bone. A series of modeling software such as Geomagic Studio, NX, ANSYSl5.0 were used to obtain the three-dimensional model of the maxillary dentition with PASS and intrusion arch. The overall force of the dentition and movement of the anterior teeth were analyzed when the intrusion arch was located at the mesial side of the central incisor and lateral incisor as well as the distal side of the lateral incisor.RESULTS AND CONCLUSION: It was efficient to accomplish the intrusion of the anterior teeth when the arch was located between central incisors. Labial inclination of the anterior teeth was achieved when the arch was ligated at the mesial side of the lateral incisor. Lingual inclination and intrusion of the anterior teeth was found when the arch was located at the distal side of the lateral incisor. Under these three kinds of conditions, the trend of molar retrodisplacement became remarkable. The maximum movement trend of the incisors was achieved, when the arch was ligated at the mesial side of the central incisor, mainly due to the intrusion of the incisors. The molar retrodisplacement was improved under the three conditions. This experiment simulated the stress distribution and displacement trend of the teeth, which is beneficial to the clinical understanding and application of the PASS technology with intrusion arch.

14.
Chinese Journal of Infection Control ; (4): 946-948,952, 2017.
Article in Chinese | WPRIM | ID: wpr-658854

ABSTRACT

Objective To understand healthcare-associated infection(HAI)in group burn/trauma patients,and explore its risk factors.Methods HAI occurred among 25 hospitalized patients with group burn/trauma during a bus deflagration event on May 12,2014 were monitored and analyzed.Results Of 25 burn/trauma patients,7 de-veloped 10 times of HAI,incidence and case incidence of HAI were 28.00% and 40.00% respectively;the main in-fection sites were wound and lower respiratory tract,accounting for 60.00% and 30.00% respectively.30 strains of pathogens were isolated from 7 patients with HAI,including 16 strains (53.34%)of gram-negative bacteria,13 strains(43.33%)of gram-positive bacteria,and 1 fungus (3.33% ).Risk factors for HAI were large burned area, high degree of inhalation injury,arteriovenous catheterization,urinary tract catheterization,tracheotomy,use of ventilator,and surgery.Conclusion Incidence of HAI is high in the group burn/trauma patients,corresponding in-tervention measures should be formulated according to the risk factors,so as to reduce the occurrence of HAI.

16.
Article in Chinese | WPRIM | ID: wpr-256572

ABSTRACT

<p><b>OBJECTIVE</b>To assess the effect of Guifu Dihuang Wan (GFDHW) in the treatment of yang deficiency and explore the underlying molecular mechanism.</p><p><b>METHODS</b>Sixty-two participants without diseases were randomized into control group (n=31) and experimental group (n=31) and were given lifestyle intervention additional GFDHW treatment for a month. NMR technology was used for metabonomics analysis.</p><p><b>RESULTS</b>Intervention with GFDHW resulted in significantly decreased conversion scores of yang deficiency in the experimental group compared with the control group (P<0.005). The concentrations of lactate, valine, proline, arginine and 3-hydroxybutyrate were increased in the plasma of yang-deficient subjects after lifestyle intervention. GFDHW treatment with lifestyle intervention significantly increased the concentrations of lactate, valine, proline, arginine and 3-hydroxybutyrate and also the levels of alanine, glutamine, alpha glucose, isoleucine, betaine and propylene glycol.</p><p><b>CONCLUSION</b>GFDHW treatment improves yang deficiency possibly by increasing the concentrations of alanine, glutamine, alpha glucose, isoleucine, betaine and propylene glycol and promoting energy metabolism of the body.</p>

17.
Chinese Journal of Burns ; (6): 105-108, 2016.
Article in Chinese | WPRIM | ID: wpr-327364

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the predictive value of a combination of anatomy scoring system and physiological scoring system for the diagnosis of multiple organ dysfunction syndrome (MODS) in patients with severe trauma.</p><p><b>METHODS</b>The clinical data of 539 patients with severe trauma hospitalized in ICUs of the First Affiliated Hospital of Chengdu Medical College, Daping Hospital of the Third Military Medical University, and the Affiliated Hospital of Zunyi Medical College from January 2010 to December 2014, conforming to the study criteria, were retrospectively analyzed. The patients were divided into MODS group (n=361) and non-MODS group (n=178) according to the diagnostic criteria of MODS. The data of Injury Severity Score (ISS), New Injury Severity Score (NISS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, ISS+ APACHE II score, and NISS+ APACHE II score of patients on the first day of ICU admission were calculated and compared between the two groups. Data were processed with t test, chi-square test, and receiver operating characteristic (ROC) curves of the various scoring systems in 539 patients with severe trauma were plotted, and DeLong-DeLong non parametric test was used to evaluate the predictive ability for MODS of the various scoring systems.</p><p><b>RESULTS</b>The scores of ISS, NISS, APACHE II, ISS+ APACHE II, and NISS+ APACHE II of patients in MODS group were respectively (26±8), (36±12), (21±7), (47±10), and (56±14) points, and they were significantly higher than those of patients in non-MODS group [respectively (24±6), (28±7), (16±5), (39±8), and (44±9) points, with t values from 4.970 to 12.120, P values below 0.01]. The total areas under ROC curves (95% confidence interval) of ISS, NISS, APACHE II score, ISS+ APACHE II score, and NISS+ APACHE II score in MODS prediction of patients with severe trauma were respectively 0.611 (0.569-0.653), 0.693 (0.652-0.731), 0.719 (0.679-0.756), 0.727 (0.687-0.764), and 0.764 (0.726-0.799). The total areas under ROC curves of NISS, APACHE II score, ISS+ APACHE II score, and NISS+ APACHE II score were significantly larger than the total area under ROC curve of ISS (with Z values from 3.505 to 7.179, P values below 0.001). The total areas under ROC curves of APACHE II score and ISS+ APACHE II score were larger than the total area under ROC curve of NISS, but there were no significant differences (with Z values respectively 0.931 and 1.657, P values above 0.05), while the total area under ROC curve of NISS+ APACHE II score was significantly larger than that of NISS (Z=5.478, P<0.001). The total area under ROC curve of ISS+ APACHE II score was larger than that of APACHEⅡ score, but there was no significant difference (Z=0.450, P=0.653), and the total area under ROC curve of NISS+ APACHE II score was significantly larger than that of APACHE II score (Z=2.554, P<0.05). The total area under ROC curve of NISS+ APACHE II score was significantly larger than that of ISS+ APACHE II score (Z=2.989, P<0.01).</p><p><b>CONCLUSIONS</b>The combination of NISS and APACHE II score is more significant than ISS, NISS, APACHE II score, and ISS+ APACHE II score in prediction of MODS in patients with severe trauma.</p>


Subject(s)
APACHE , Humans , Injury Severity Score , Intensive Care Units , Multiple Organ Failure , Diagnosis , Organ Dysfunction Scores , Outcome Assessment, Health Care , Predictive Value of Tests , ROC Curve , Retrospective Studies , Sensitivity and Specificity
18.
Chinese Critical Care Medicine ; (12): 291-294, 2015.
Article in Chinese | WPRIM | ID: wpr-464640

ABSTRACT

ObjectiveTo compare the predictive value of anatomic scoring system, physiological scoring system, and the combination of two systems in death prediction of patients with severe trauma in intensive care unit (ICU). Methods A retrospective analysis of patients with severe trauma admitted to department of critical care medicine of Daping Hospital, the Third Military Medical University, and Zunyi Medical University from January 2011 to December 2014 was conducted. The patients meeting the following criteria were enrolled: over 16 years old, admitted to hospital shorter than 24 hours after trauma, length of ICU stay≥48 hours, and injury severity score (ISS)≥16. Patients were divided into two groups: survivors and non-survivors. The data of anatomic scoring system, including ISS and new injury severity score (NISS), and physiological scoring system, including acute physiology and chronic health evaluationⅡ(APACHEⅡ) score were collected. The predictive power for death of the scoring system alone or combination in patients with severe trauma was evaluated.Results A total of 614 patients with severe trauma were enrolled, and there were 153 deaths with a mortality rate of 24.9%. ISS, NISS, APACHEⅡ, ISS+ APACHEⅡ, NISS+ APACHEⅡ of non-survivors were significantly higher than those of survivors (ISS: 29.15±7.75 vs. 24.31±6.50, NISS: 41.96±12.01 vs. 29.64±8.19, APACHEⅡ: 23.71±6.58 vs. 17.02±5.49, ISS+ APACHEⅡ: 52.86±10.00 vs. 41.33±8.70, NISS+ APACHEⅡ: 65.67±13.46 vs. 46.66±10.43, allP< 0.01). The area under receiver operating characteristic curve (AUC) of ISS, NISS, APACHEⅡ, ISS+ APACHEⅡ, NISS+ APACHEⅡ was 0.687, 0.792, 0.782, 0.809, and 0.860, respectively. Both of ISS+ APACHEⅡ and NISS+ APACHEⅡ had higher AUC than that of ISS, NISS or APACHEⅡ alone; and the AUC of NISS+ APACHEⅡ was significantly larger than that of ISS+ APACHEⅡ(allP< 0.05). NISS+ APACHEⅡ showed the largest AUC in death prediction of severe trauma patients. The cut-off value, sensitivity, specificity, positive predict value (+PV), negative predict value (-PV), positive likelihood ratio (+LR), negative likelihood ratio (-LR), and Youden index of NISS+ APACHEⅡ, which had the greatest AUC, were 56, 75.2%, 82.0%, 58.1%, 90.9%, 4.17, 0.30, and 0.572, respectively.Conclusion The combination of anatomic scoring system and physiological scoring system is better than single scoring system for death prediction in patients with severe trauma in ICU, and it may be considered to be a new method for early identification of death risk in patients with severe trauma.

19.
Chinese Critical Care Medicine ; (12): 110-114, 2015.
Article in Chinese | WPRIM | ID: wpr-461032

ABSTRACT

ObjectiveTo observe protective effects of agmatine (AGM) on inflammatory response and spleen immune function in mice with trauma.Methods Forty-eight adult male C57BL/6 mice were randomly divided into three groups (n= 16 each), including control group, model group (bilateral femoral fracture and removal of 35% of the total blood volume), and AGM group (trauma/hemorrhage & AGM 200 mg/kg). Eight mice in each group were sacrificed at 3 hours and 24 hours, respectively, after modeling, and blood samples and tissue homogenate of spleen and liver were collected. The contents of tumor necrosis factor-α (TNF-α), interleukins (IL-6, IL-1β) in serum and liver tissue were determined with enzyme linked immunosorbent assay (ELISA). Serum aspartate transaminase (AST), alanine aminotransferase (ALT) and lactic dehydrogenase (LDH) were determined with automatic biochemistry analyzer. Spleen proliferation response stimulated with concanavalin A (ConA) was evaluated with methyl thiazolyl tetrazolium colourimetry (MTT).γ-interferon (IFN-γ) and IL-2 releases were determined with ELISA.Results Compared with control group, 3 hours after trauma/hemorrhage, the levels of serum TNF-α, IL-6, and IL-1β in model group were significantly elevated [TNF-α (ng/L): 145.38±31.50 vs. 23.06±11.14, IL-6 (ng/L): 496.94±50.76 vs. 47.13±17.47, IL-1β (ng/L): 321.31±43.02 vs. 29.25±16.24,allP< 0.01]. It was found that AGM treatment could alleviate the increase in serum pro-inflammatory mediators induced by trauma/hemorrhage, such as TNF-α (ng/L:111.56±25.47 vs. 145.38±31.50), IL-6 (ng/L: 412.56±44.33 vs. 496.94±50.76), IL-1β (ng/L: 273.38±45.25 vs. 321.31±43.02,P< 0.05 orP< 0.01). Twenty-four hours after trauma/hemorrhage, serum pro-inflammatory mediators were recovered to the levels in control group. There was no significant difference in TNF-α and IL-6 levels at 3 hours after trauma/hemorrhage among groups. Compared with control group, the expressions of liver TNF-α and IL-6 in model group were increased at 24 hours following trauma [TNF-α (ng/mg): 32.93±4.90 vs. 26.58±2.33, IL-6 (ng/mg): 11.20±1.66 vs. 8.38±0.89,bothP< 0.01]. However, AGM inhibited the level of TNF-α (ng/mg:28.92±3.16 vs. 32.93±4.90) and IL-6 (ng/mg: 9.03±1.28 vs. 11.20±1.66) in the liver as induced by trauma/hemorrhage (P< 0.05 andP< 0.01). At 24 hours after modeling, model group and AGM group had distinctly higher serum AST, ALT, LDH levels than those of control group [AST (U/L): 405.9±31.2, 245.7±22.1 vs. 128.2±15.9; ALT (U/L): 92.1±6.3, 51.6±5.0 vs. 30.1±3.2; LDH (U/L): 606.7±36.3, 478.7±25.3 vs. 384.0±16.6, allP< 0.01]. Nevertheless,the increase in serum AST, ALT and LDH was alleviated in AGM group (allP< 0.01). Meantime, trauma/hemorrhage produced a noticeable depression of proliferation of splenic cells and IFN-γ and IL-2 release stimulated with ConA compared with control group [proliferation rate: (40.97±4.13)% vs. (89.99±7.76)%, IFN-γ(ng/L): 91.6±12.3 vs. 353.2±21.5,IL-2 (ng/L): 53.4±6.4 vs. 91.0±12.2,allP< 0.01]. In contrast, AGM notably restored the capacity of proliferation response of splenic cells [proliferation rate: (74.86±5.75)% vs. (40.97±4.13)%, P< 0.01],enhanced the release of IFN-γ and IL-2 stimulated with ConA [IFN-γ (ng/L): 327.8±23.6 vs. 91.6±12.3, IL-2 (ng/L): 74.8±10.4 vs. 53.4±6.4, bothP< 0.01].Conclusion AGM can dramatically alleviate spleen immunosuppression, excessive inflammation and organ damage induced by trauma/hemorrhage.

20.
Article in Chinese | WPRIM | ID: wpr-499980

ABSTRACT

Objective To evaluate the efficacy and safety of retroperitoneal laparoscopic pyelolithotomy ( RLP) combined with holmium laser lithotripsy under flexible cystoscopy in the treatment of complicated nephrolithiasis. Methods The retrospective analysis was made on the clinical data of 37 patients who underwent RLP and holmium laser lithotripsy under flexible cystoscopy for complicated nephrolithiasis from January 2013 to January 2014. The clinic parameters involved basic data of patients,operational time,blood loss,post-operative hospital stay,the status of stone-free,perioperative complications,and the follow-up data of patients were observed. Results No patient was converted to open surgery. The mean stone size was (2. 8 ± 0. 9) cm in diameter,operational time was (89 ± 24) min,blood loss was (21. 3 ± 7. 7) mL,post-operative hospital stay was (6. 8 ± 1. 7) d,the stone removal rate in one session was 94. 6%. One case occurred urinary leakage,1 case occurred fever after operation,who were all recovered through conservative treatment. All cases were followed up at the sixth months after operation. Conclusion RLP combined with holmium laser lithotripsy under flexible cystoscopy is effective and safe for the treatment of com-plicated nephrolithiasis.

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