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Objective:To investigate the correlation between serum gastrin, C-reactive protein (CRP), tumor necrosis factor α (TNF-α) and the degree of peptic ulcer bleeding.Methods:The clinical data of 90 peptic ulcer bleeding patients (test group) from April 2019 to September 2020 in Hangzhou Hospital of Zhejiang Medical and Health Group were retrospectively analyzed, including 15 cases with low-risk, 40 cases with intermediate-risk and 35 cases with high-risk of Blatchford score; 40 physical examination volunteers were selected as the control group during the same period. The serum levels of CRP and TNF-α were measured by enzyme-linked immunosorbent assay, and the serum level of gastrin was measured by radioimmunoassay. The correlation between CRP, TNF-α, gastrin and the Blatchford score was analyzed by Pearson method; the independent risk factors affecting high-risk peptic ulcer bleeding were analyzed by multivariate Logistic regression; the value of CRP, TNF-α and gastrin in predicting high-risk peptic ulcer bleeding was analyzed by the receiver operating characteristic (ROC) curve.Results:The CRP, TNF-α and gastrin in test group were significantly higher than those in control group: (19.69 ± 3.41) mg/L vs. (2.28 ± 0.64) mg/L, (26.63 ± 4.24) ng/L vs. (1.35 ± 0.31) ng/L and (149.77 ± 21.41) μg/L vs. (72.65 ± 12.39) μg/L, and there were statistical differences ( P<0.01). The hemoglobin and platelets in intermediate-risk and high-risk patients were significantly lower than those in low-risk patients: (59.21 ± 4.63) and (28.94 ± 4.69) g/L vs. (89.68 ± 5.12) g/L, (162.14 ± 12.47) and (122.05 ± 10.39) × 10 9/L vs. (213.58 ± 16.98) × 10 9/L, the indexes in high-risk patients were significantly lower than those in intermediate-risk patients, and there were statistical differences ( P<0.05); the prothrombin time, CRP, TNF-α and gastrin in intermediate-risk and high-risk patients were significantly higher than those in low-risk patients: (13.98 ± 1.29) and (16.97 ± 1.15) s vs. (11.00 ± 2.07) s, (18.87 ± 4.68) and (22.69 ± 2.96) mg/L vs. (15.45 ± 5.54) mg/L, (27.43 ± 5.05) and (31.02 ± 4.56) ng/L vs. (21.39 ± 8.54) ng/L, (140.89 ± 22.36) and (160.58 ± 25.52) μg/L vs. (121.39 ± 15.17) μg/L, the indexes in high-risk patients were significantly higher than those in intermediate-risk patients, and there were statistical differences ( P<0.05). Multivariate Logistic regression analysis result showed that hemoglobin, platelets, CRP, TNF-α and gastrin were independent risk factors for high-risk peptic ulcer bleeding ( OR = 0.224, 0.321, 3.687, 3.058 and 4.051; 95% CI 0.004 to 0.894, 0.121 to 8.547, 1.912 to 5.525, 3.012 to 10.609 and 2.012 to 7.525; P<0.05 or <0.01). Pearson correlation analysis result showed that CRP, TNF-α and gastrin were positive correlation with the Blatchford score ( r = 0.501, 0.526 and 0.542; P<0.01). ROC curve analysis result showed that the areas under the curve of CRP, TNF-α and gastrin for predicting high-risk peptic ulcer bleeding was 0.890, 0.825 and 0.901, with optimal cut-off values of 17.95 mg/L, 22.16 ng/L and 135.36 μg/L, sensitivity of 97.14%, 94.29% and 82.86%, and specificity of 80.00%, 66.67% and 86.67%. Conclusions:CRP, TNF-α and gastrin are correlated to the degree of peptic ulcer bleeding, and can be used as indexes to evaluate the bleeding degree of peptic ulcer.
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Objective To analyze the clinical value of combined detection of tuberculous T cell enzyme-linked immuno spot assay (T-SPOT.TB) and adenosine deaminase (ADA) in tuberculous pleurisy patients of different ages.Methods From February 2014 to February 2018,three hundred and thirty-six patients with pleural effusion were admitted to Hebei Thoracic Hospital.Among them,two hundred and fifty five cases were diagnosed as tuberculous pleurisy and 81 cases were diagnosed as non-tuberculous pleurisy.The patients were divided into two groups according to their age.The younger group (214 cases) was 16-59 years old and the older group (122 cases) was over 60 years old.The sensitivity and specificity of T-SPOT.TB combined with ADA in the diagnosis of tuberculous pleurisy were compared between the two groups.Results The sensitivity and specificity of T-SPOT.TB were 85.5％ (153/179) and 71.4％ (25/35) in the young and middle-aged group,73.7％ (56/76) and 58.7％ (27/46) in the old group,respectively.The sensitivity of the young and middle-aged group was significantly higher than that of the old group (x2 =4.990,P =0.045).The sensitivity and specificity of T-SPOT.TB combined with ADA were 98.9％ (177/179) and 94.3％ (33/35) in the young and middle-aged group,96.1％ (73/76) and 89.1％ (41/46) in the elderly group,respectively.There was no significant difference in sensitivity and specificity between the two groups (x2 =0.256,P=0.393、x2=0.655,P=0.218).Conclusion The diagnostic efficacy of T-SPOT.TB combined with ADA in patients with tuberculous pleurisy at different ages has been improved,especially for those who can not tolerate pleural biopsy and elderly patients.
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Objective:To observe and investigate the effects of real-time dynamic glucose monitoring, continuous subcutaneous insulin infusion combined with Carelink management software analysis on blood glucose control in newly diagnosed type 2 diabetic patients.Methods: 64 cases of patients with newly diagnosed with type 2 diabetes were selected from our hospital, and randomly divided into observation group and control group. The observation group were treated by real-time dynamic blood sugar monitoring and continuous subcutaneous insulin infusion joint Carelink management software analysis system, while the control group by continuous subcutaneous insulin infusion in combination with the real-time dynamic blood sugar monitoring. We compared serum C peptide, the rise of serum insulin levels and the decrease of blood glucose after ten days of treatment. At the same time, insulin resistance index (HOMA - IRI) and hypoglycemic events were compared between the two groups.Results: After treatment, the decrease range of blood glucose, postprandial blood glucose and HOMA-IRI in the observation group were significantly better than those in the control group (t=4.362,t=3.254,t=4.289; P<0.05). At the same time, the increase range of elevated fasting insulin, postprandial insulin, fasting C peptide and sugar after C peptide in the observation group were significantly better than those in the control group (t=3.712,t=4.115,t=3.831,t=3.889;P<0.05). The standard number of days of the blood glucose in the control group were significantly higher than those in the observation group (t=4.583,P<0.05).Conclusion: For patients with type 2 diabetes treated by real-time continuous glucose monitoring and continuous treatment of infusion combined with subcutaneous insulin Carelink management software can effectively reduce blood glucose, improve the insulin resistance of patients, reduce hypoglycemia and increased insulin sensitivity, meanwhile also can better protect the islet beta cell function.
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Objective To investigate the therapeutic effectiveness of Xiyanping aerosol inhalation for pulmonary infection in patients with acute stroke. Methods Sixty-three patients with pulmonary infection after acute stroke were enrolled and randomly allocated to either a treatment group or a control group. The control group was treated with anti-infective and apophlegmatisant on the basis of standardized stroke treatment, the treatment group was treated with Xiyanping aerosol inhalation on the basis of the treatment in the control group. All patients were treated for 14 days. The resolution times of symptom and signs, and the changes of inflammatory parameters were compared. Results The total effective rate in the treatment group was significantly higher than that in the control group (93.75%vs. 74.19%;χ2=4.510, P=0.034). The resolution times of symptom and signs, such as cough and excessive phlegm (5.94 ± 1.25 d vs. 6.73 ± 1.48 d;t=2.292, P=0.025),fever (2.72 ± 0.11 d vs. 3.25 ± 0.18 d;t=12.046, P<0.01), pulmonary rale (5.22 ± 1.15 d vs. 7.21 ± 1.21 d;t=6.693, P<0.01), and dyspnea (1.17 ± 0.49 d vs. 2.82 ± 0.61 d;t=11.855, P<0.01) in the treatment group were significantly shorter than those in the control group. White blood cell count (2.55 ± 1.02 ×109/L vs. 3.91 ± 1.25 ×109/L;t=4.738, P<0.01), granulocyte proportion (4.92% ± 1.32% vs. 6.25% ± 1.16%; t=4.738, P<0.01) and lymphocyte proportion (58.62%± 6.15%vs. 65.94%± 6.17%;t=4.716, P<0.01) in the treatment group were significantly lower than those in the control group. Conclusions Xiyanping aerosol inhalation can shorten the resolution times of symptom and signs, and improve the therapeutic effectiveness in patients with pulmonary infection after acute stroke.
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ObjectiveTo evaluate the curative effect of local massage with safflower oil in patients with phlebitis following peripheral intravenous catheters.MethodsA total of 71 patients with phlebitis following peripheral intravenous catheters wererandomly divided into 2 groups, a safflower oil group with 36 cases, and a magnesium sulfate group with 35 cases. The magnesium sulfate group was treated by local external application of 33% magnesium sulfate on phlebitis at the puncture site, while the safflower oil group was treated by external application of safflower oil 3~5 cm around the peripheral vein puncture site and massage. Both groups were treated for 48 h. Visual Analog Scale (VAS) was used to assess pain degree, marking method to label the localred swelling area.ResultsThe VAS score (0.81±0.13vs.0.94±0.11;t=4.543,P<0.01) at 48 h after the treatment, and the local red swelling area at 24 h (3.62±1.22 cm2vs.4.42±1.72 cm2;t=2.335, P=0.022) and 48 h (1.07±0.25 cm2vs.3.26±1.07cm2;t=11.952,P<0.01) after the treatment in the safflower oil group were significant lower or smaller than the magnesium sulfate group.ConclusionsLocal massage with safflower oil can effectively alleviate the severity of phlebitis, relieve symptoms, reduce the score of VAS and local red swelling area, and promote the damaged tissue to restore normal.