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Objective:To explore the value of using risk-stratifcation of mergency department suspected sepsis score(REDS) score in the prognosis of patients with sepsis.Methods:The clinical data of sepsis patients hospitalized in Huangshan Shoukang hospital from January 2018 to February 2020 were collected for retrospective case-control study.The REDS, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and mortality in emergency department(MEDS) of all cases were calculated.To evaluate the value of REDS in prognosis of patients with sepsis by comparing REDS with APACHEⅡ and MEDS.Results:Finally 103 patients were enrolled in the study, including 65 males (63.11%) and 38 females (36.89%); the age ranged from 42 to 93 years old, the median (quartile) was 74 (65, 82) years old; 72 patients (69.91%) survived (survival group), 31 patients (30.09%) died (death group). There were significant differences between survival group and death group in REDS((5.28±2.10) score vs.(7.87±2.53) score), MEDS score ((6.64±3.32) score vs.(9.06±3.3) score), APACHE Ⅱ score ((18.96±6.72) score vs.(21.87±6.15) score) (t value were5.404, 3.381 and 2.067, respectively; P value were<0.001, 0.001 and 0.041, respectively). Youden index was biggest(0.381), when REDS was 7.5.The area under the receiver operating characteristic curve was 0.777 (95% CI: 0.678-0.876, P<0.001). When APACHE Ⅱ score was 19.5, Youden index was the largest (0.177), and the area under the ROC of APACHEⅡwas 0.614(95% CI: 0.499-0.729, P=0.068). When the MEDS score was 10.5, Youden index was the largest (0.341), and the area under the receiver operating characteristic curve was 0.696 (95% CI: 0.590-0.802, P=0.002). The area under the curve of working characteristics of the subjects with red score was larger than that of APACHE Ⅱ score ( Z=1.987, P=0.046). Conclusion:REDS has a good effect in judging the condition and prognosis of patients with sepsis, which is equivalent to MEDS score, but better than APACHEⅡ.
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Objective To analyze the intervention effect of the dose-dense schemes of temozolomide on the newly diagnosed glioblastoma compared with the standard schemes. Methods The Pubmed,Cochrane,Em-base,CNKI,CBM,Wanfang,VIP databases were used for the retrievals on the intervention effect.The quality of included papers was assessed to extract network meta-analysis data with using the statistical software Stata 13.0. Results The treatment plans were ranked according to the intervention effect from the best to the worst as follows:the dose-dense,the early,the metronomic,the standard,the RT and post-RT adjuvant temozolomide. The most common adverse effects in hematotoxicity were neutropenia,leucopenia,lymphopenia,thrombocytopenia and ane-mia. Between the different temozolomide therapeutic regimens,there was no significant difference. Conclusion The intervention effect of the dose-dense schemes with temozolomide is better than the standard therapy. It also revealed that,the hematoxicity in the different temozolomide schemes is not significantly different.
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Objective To investigate one year survival rate and life quality of patients with non-small cell lung cancer(NSCLC)treated by different arms.Methods One hundred and seventy-nine cases NSCLC patients from January 2013 to December 2014 were selected from the Third Hospital of Tanshan and followed-up,including 57 cases with surgical treatment,70 cases with the use of Navelbine plus cisplatin,52 cases with dendritic cells(DC)and cytokine induced killer cells(CIK)immune based therapy(DC/CIK)treatment.After one year period of radiotherapy and chemotherapy,the SF-36 questionnaire was used to investigate the quality of life of the surviving patients,and the quality of life was assessed from three aspects of the physiological,psychological and social functions.To quantify the quality of life score,the 100 percentage grading system was adopted,logistic regression analysis was used to adjust the influence of age and gender on survival rate,and the data were analyzed by SAS 9.2 statistical software package.Results One hundred and seventy-nine subjects were included in this study,by the end of follow-up on December 2015,there were 119 cases survived,the survival rate was 66.5％(119/179).Survival rate of surgical operation group,DC/CIK group and chemotherapy group orderly decreased(82.5％(47/57),76.9％(40/52)and 45.7％(32/70),P＜0.01).After adjusting age and gender impact,multiple logistic regression model showed that DC/CIK group survival rate was 3.96 times higher than the pure chemotherapy group(95％CI=1.78-8.80),surgical operation group was 5.58 times higher than simple chemotherapy group(95％CI=2.44-12.79).There were no significant differences between DC/CIK group and surgical operation group on physical disease,health status,emotional intelligence,mental health and social function,no significant difference(P＞0.05),but the chemotherapy group was lower(P＜0.05);physiological function in the chemotherapy group,operation group and DC/CIK group showed an increasing trend(P＜0.05).Conclusion The one year survival rate of NSCLC patients treated by different arms is 66.5％,and the life quality of patients with biological immune therapy method is better.
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Objective: To investigate the effect of interleukin-8 (IL-8) on survival and apoptosis of hypoxic human umbilical vein endothelial cells (HUVECs) with its mechanisms. Methods: Hypoxic HUVECs were induced by CoCl2. HUVECs were cultured with different concentrations of CoCl2 or IL-8 and the survival rates of HUVECs were examined. Normal or hypoxic HUVECs were incubated with IL-8 or simultaneously incubated with anti-IL-8 or Akt inhibitor LY294002 for 48h. The HUVECs survival rate was detected by MTT method, apoptosis rate was measured by Annexin V-FITC/PI method, the protein expressions of Caspase-3, phosphorylated Akt (pAkt) and GSK-3βser9 (pGSK-3βser9) were evaluated by Western blot analysis. Results: By 12 h incubation with low concentration of CoCl2 (50, 100 μmol/L), HUVECs proliferation were improved, P Conclusion: IL-8 could down-regulate caspase-3 and up-regulate pAkt and pGSK-3βser9 expressions in HUVECs and therefore, inhibit the apoptosis and improve the survival of hypoxic HUVECs.
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Objective To investigate the efficacy of nedaplati docetaxel combined with radiotherapy on patients with locally advanced cervical cancer.Methods The clinical data of 99 cases with pathologically diagnosed advanced cervical cancer from Jun.2013 to jul.2014 in the Matemal and Child Health Care Hospital of Tangshan were recorded.The patients were randomly divided into the control group (45 cases only with radiotherapy) and the observation group(54 cases with nedaplati and docetaxel beside radiotherapy).Results The effective rate in observation group was 90.74％,higher than control group (71.11％,x2 =6.358,P =0.017).There were significant incidence of bone marrow suppression renal dysfunction and gastrointestinal both in two groups,but can endure.There was no significant difference in term of side effect in two groups (P ＞0.05).Conclusion The therapy of nedaplati and docetaxel combined with radiotherapy has better effect for patients with advanced cervical cancer and without significantly increasing side effect.
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Five patients after prosthetic tricuspid valve, who received pacemaker implantation via coronary sinus during Oct, 2011 and Jul, 2014, were enrolled. Pacemakers were implanted via coronary vein in 5 patients without complications. The stimulation thresholds keep stable and symptoms (such as short breath and fatigue) were disappeared during the follow-up. For patients after tricuspid valve replacement, implantation of pacemaker via coronary sinus provides a safe and invasive approach and avoids opening the chest again.
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Humanos , Procedimientos Quirúrgicos Cardíacos , Seno Coronario , Implantación de Prótesis de Válvulas Cardíacas , Marcapaso Artificial , Válvula TricúspideRESUMEN
Objective To analyze the changes of leptin and adiponectin levels in serum of patients with diabetic retinopathy and investigate their chnical significance in diabetic retinopathy (DR).Methods One hundred and twenty-one patients with type 2 diabetes mellitus as the case group who hospitalized from Nov.2012 to Nov.2013.Among the patients,41 cases of non-DR,40 cases of nonproliferative-DR,40 cases of proliferativeDR.Forty healthy were served as the control group.The levels of leptin and adiponectin in serum were detected by Enzyme-Linked Immuno Sorbent Assay (ELISA).Results The overall levels of leptin in case group was (15.25 ± 4.70) μg/L,significantly higher than the control group ((6.15 ± 1.70) μg/L; t =-11.696,P ＜0.01)).The level of adiponectin in case group was (7.39 ± 1.92) mg/L,lower than the control group ((11.10 ± 1.46) mg/L; t =11.216,P ＜ 0.01).Moreover,the levels of leptin increased successively from (10.91 ±1.21) μg/L in NDR,(15.22 ±3.75) μg/ L in NPDR and (20.50 ±3.70) μg/L in PDR.While,the adiponectin levels decreased from (9.61 ± 1.35) mg/L in NDR,(7.11 ± 1.18) mg/L in NPDR and (5.34 ± 1.36) mg/L in PDR respectively.And the differences between the groups were significant(F =149,542,291,550;P ＜0.05).The levels of leptin and adiponectin in serum showed a negative correlation (r =-0.662,P ＜0.01).Condusion Levels of leptin and adiponectin in serum associate with DR,and both of them might be the important indexes for the prediction and curative effect evaluation of DR.
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Objective To study the clonal heterogeneity in differentiation potential of immortalized mesenchymal stem cells in vitro and in rive.Methods The monoclonal cell lines were performed with limiting dilution cloning,and were induced to adipocytic,asteogenic and neuronal differentiation in vitro.After transplanted the monoclonal cell lines into SCID mice,the xenotransplants were removed and evaluated by immunohistochemistry.Results From the parental HMSC-TERT,32 single-cell derived clones were established,of which the differentiation properties varied considerably in vitro.The cells grow in different plating densities during expansion in culture:HMSC-TERT-2 expressed more strongly in LCA,GFAP and vimemin;HMSC-TERT-C19 expressed more strongly in keratinose than HMSC-TERT-2,HMSC-IERT-20,and MSC-H;HMSC-TERT-C2 expressed more strongly in actin than HMSC-TERT-2.Conclusions The HMSC-TERT monoclone cells are heterogeneity in differentiation petential in vitro and in vivo,suggesting that standard in vitro culture and in vivo inoculate procedure phy an important role in the clinical application of stem cells.
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Objective To investigate and compare the effect of valsartan and indapamide on inflammatory cytokines in hypertension. Methods Forty-one untreated patients with mild to moderate hypertension and 20 age- and sex-matched normotensives were enrolled in this study. Hypertensives were treated with indapamide 1.5 mg/d (n=20) or valsartan 80 mg/d (n=21) for 4 weeks, and blood samples for determining monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 (MIP-1α), sP-selectin, asymmetric dimethylarginin (ADMA), angiotensin Ⅱ (AngⅡ), and 6-keto-PGF1α were collected before the treatment and 4 weeks after the treatment. Results Hypertensives exhibited significantly higher blood pressure, as well as elevated plasma levels of MCP-1, MIP-1α, sP-selectin and serum level of ADMA compared with the normotensives. Nevertheless, there was no significant difference in serum 6-keto-PGF1α and AngⅡ between the hypertensives and the normotensives. After the treatment with indapamide or valsartan for 4 weeks, both the systolic and diastolic blood pressures, though still higher than those of the normotensives, decreased markedly. After the treatment with indapamide for 4 weeks, MCP-1, MIP-1α and sP-selectin slightly decreased, but not statistically significant (P＞0.05). Those cytokines decreased significantly after being treated with valsartan for 4 weeks [(19.16±3.11) pg/mL vs (16.08±2.67) pg/mL, P＜0.05; (27.74±8.36) pg/mL vs (17.64±7.59) pg/mL, P＜0.05; (2.67±3.18) pg/mL vs (6.15±2.94) pg/mL, P＜0.01]. In the 2 treatment groups, 6-keto-PGF1α markedly increased [(61.96±20.81) pg/mL vs (96.72±25.89) pg/mL, P＜0.05; (63.25±16.92) pg/mL vs (143.22±43.45) pg/mL, P＜0.01]; ADMA decreased significantly [(1.35±0.74) pg/mL vs (0.98±0.56) μmol/L, P＜0.05; (1.31±0.68) pg/mL vs (0.71±0.52) μmol/L, P＜0.01]. Though AngⅡ slightly increased, no statistical significance was found (P＞0.05). Conclusion The levels of MCP-1, MIP-1α, sP-selectin and ADMA were elevated in mild to moderate hypertensives. Valsartan and indapamide have similar blood pressure lowering effect. Valasartan exerts more significant effect on cytokines than indapamide does.
