Value of neutrophil-lymphocyte count ratio in diagnosing bloodstream infection / 基础医学与临床

Objective To explore the diagnostic value of five infection markers in bloodstream infection.Methods Randomly selected 110 bloodstream infection patients with positive blood cultures and 30 bacterial infection patients with negative blood cultures.Blood was simultaneously drawn with blood cultures;the complete blood count and C-reactive protein (CRP) levels were measured.The white blood cell count (WBC),neutrophil count (NEU),lymphocyte count (LMY),CRP level and neutrophil-lymphocyte count ratio (NLCR) were compared between the two groups.Results The levels of WBC,NEU,NLCR and CRP in bloodstream infection group were significantly higher than those in control group (P＜0.05),while LYM was significantly lower than that in control group (P＜ 0.05).Among these five infection markers,the area under the receiver operating characteristic curve (ROC-AUC) was the highest for NLCR (0.808) and LMY (0.756);when the cutoff value for NLCR was ＞9.33,sensitivity was 63.6％,specificity was 93.3％;and the cutoff value for LYM was ≤0.97,sensitivity was 58.2％,specificity was 86.7％.Furthermore,the NLCR of patients with gram-negative bloodstream infection was higher than those in patients with gram-positive bloodstream infection.NLCR showed important clinical significance in distinguishing strains of different bloodstream infections.Conclusions NLCR is the better predictors than routine parameters in diagnosing bloodstream infection.

Efficacy and Safety of Shenmai Injection in Adjuvant Therapy of Angina Pectoris:A Systematic Review / 中国药房

OBJECTIVE:To evaluate the therapeutic efficacy and safety of Shenmai injection in adjuvant therapy of angina pectoris,and to provide evidence-based reference in clinic.METHODS:Retrieved from CJFD,Wanfang database,VIP and PubMed,randomized control trials (RCTs) about Shenmai injection combined with routine plan (trial group) vs.routine plan sole (control group) in the treatment of angina pectoris were collected.Meta-analysis was conducted by using Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane systematic evaluator manual 5.1.0.RESULTS:A total of 25 studies were included,involving 2 093 patients.Meta-analysis showed that clinical efficacy rate [RR=I.31,95％ CI(1.25,1.37),P＜0.001] and ECG total response rate [RR=1.42,95％CI(1.31,1.54),P＜0.001] of trial group were significantly higher than those of control group,with statistical significance.Results of subgroup analysis showed that among high-dose subgroup(＞40 mL/d) and low-dose subgroup(≤40 mL/d),clinical efficacy rate [high dose:RR=1.26,95％ CI (1.19,1.34),P＜0.001;low dose:RR=1.36,95％ CI (1.27,1.45),P＜0.001] and ECG total response rate [high dose:RR=1.39,95％CI(1.22,1.60),P＜0.001;low dose:RR=1.43,95％ CI (1.30,1.58),P＜0.001] of trial group were significantly higher than those of control group,with statistical significance.There was no statistical significance in the incidence of ADR between 2 groups [RR=0.66,95％CI(0.32,1.40),P=0.28].CONCLUSIONS:Shenmai injection in adjuvant therapy of angina pectoris shows good therapeutic efficacy and safety in the treatment of angina pectoris.It is suggested to its clinical application start from the low dose.

Hypouricemic and Nephroprotective Effects of Emodinol in Oxonate-Induced Hyperuricemic Mice are Mediated by Organic Ion Transporters and OIT3.

Emodinol, 1ß,3ß,23-trihydroxyolean-12-en-28-acid, as the main active ingredient firstly extracted from the rhizomes of Elaeagus pungens by our research group, has been demonstrated to exhibit uricosuric activity by our previous study. The aim of this study was to evaluate the uricosuric and nephroprotective effects of emodinol and explore its possible mechanisms in potassium oxonate-induced hyperuricemic mice with renal dysfunction. Mice were orally administrated 250 mg/kg of potassium oxonate once daily for 7 consecutive days to induce hyperuricemia with renal dysfunction. Emodinol was given at doses of 25, 50, and 100 mg/kg on the same day 1 h after oxonate treatment, and allopurinol (10 mg/kg) was given as a positive control. After 1 week, serum uric acid, serum creatinine, urine uric acid, urine creatinine, blood urea nitrogen, and hepatic xanthine oxidase activity were determined. The mRNA and protein levels of urate transporter 1, glucose transporter 9, ATP-binding cassette subfamily G member 2, organic anion transporter 1, oncoprotein-induced transcript 3, and organic cation/carnitine transporters in the kidney were detected by real-time polymerase chain reaction and Western blot analysis. In addition, urinary and renal Tamm-Horsfall glycoprotein concentrations were examined by ELISA assays. Emodinol significantly reduced serum urate levels, increased urinary urate levels and fractional excretion of uric acid, and inhibited hepatic xanthine oxidase activity in hyperuricemic mice. Moreover, potassium oxonate administration led to dys expressions of renal urate transporter 1, glucose transporter 9, ATP-binding cassette subfamily G member 2, organic anion transporter 1, and oncoprotein-induced transcript 3 as well as alternations of uromodulin concentrations, which could be reversed by emodinol. On the other hand, treatment of emodinol caused upregulated expressions of organic cation/carnitine transporters, resulting in an improvement of renal function characterized by decreased serum creatinine and blood urea nitrogen levels. Emodinol exhibited hypouricemic and nephroprotective actions by inhibiting xanthine oxidase activity and regulating renal ion transporters and oncoprotein-induced transcript 3, which may be a potential therapeutic agent in hyperuricemia and renal dysfunction.

A rational recognition of interventional teatment for diabetic foot / 介入放射学杂志

According to program of vascular examination of diabetic foot, the first choice is vascular ultrasonography as the general survey, followed by CTA and MRA for assessment of bilateral lower extremities arterial morphological changes. Lastly, arterial angiography including DSA still remain as the gold standard for estimation. The main pathologic changes of diabetic foot including arteriolar and microvascular disorders induce the extemely important interventional treatment especially the local thrombolytic infusion to be the real practical management besides local PTA and stenting are furthermore in consideration. As a general metabolic disease, the serial treatment should also include promoting blood flow, removing blood stasis and improving microcirculation . Evaluation of interventional treatment for diabetic foot should undertake not only the vascular stenosis and restenosis ,but also the relief of clinical symptom and improvement of amputation level.

Judicious use of ethanol embolization to improve the curative rate of vascular malformations / 介入放射学杂志

The incidence of vascular malformations is very low, and its clinical manifestations are infinite in variety, from an asymptomatic birthmark to life-threatening massive bleeding, even to congestive heart failure. The pathogenesis of vascular malformations is still unknown, therefore, its effective treatment is a real challenge. With the development of interventional technology and the accumulation of clinical experience in ethanol embolization, in local direct puncture injection and in endovascular embolization, the ethanol embolization will hopefully become the therapy of first choice for this kind of complicate and intractable disorders.

Percutaneous sacroplasty / 介入放射学杂志

Percutaneous sacroplasty is a technique, derived from percutaneous vertebroplasty, with minimal invasion and better safety for refractory sacroiliac pain. The procedure is involved with bone cement injected into the diseased sacral body under fluoroscopic or computed tomography guidance and in turn for stabilizing and strengthening the vertebral body with outcome of decrease or even complete relief of pain. The author introduces and comprehends the definition, preoperative imaging examinations, indications, contraindications, techniques and complications of the procedure.

The effect of TACE plus PSE on the liver function of hepatic cancer with portal hypertension and hypersplenism / 介入放射学杂志

0.05) but remarkable change after therapy was shown at one week later (P