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Objective To investigate the value of extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) in the diagnosis and treatment of acute respiratory distress syndrome(ARDS).Methods From February 2015 to October 2016,selected 80 patients with ARDS in Danzhou Municipal People's Hospital,including 19 cases mild patients,28 cases moderate cases and 33 cases severe cases.The patients' EVLWI,PVPI,acute physiology and chronic health score system Ⅱ (APACHE Ⅱ)score,lung injury score (LIS) were detected.Results The score of APACHE Ⅱ in severe group was 22.81(21.91,25.40) points,significantly higher than that in mild group (19.81 (18.12,21.10) points) and moderate group(20.07 (19.01,22.02),P =0.002).The LIS,EVLWI and PVPI in Severe group were 2.01(1.83,2.11) points,17.01 (14.82,23.02) ml/kg and 3.82 (3.01,5.01),significantly higher than that in mild group (1.01 (0.98) points,1.7412.71 (10.89,13.67) ml/kg,2.71 (2.36,2.94)) and moderate group (1.52 (1.36,1.91) points,14.21 (13.10,16.60) ml/kg,3.01 (2.52,3.03),P ＜ 0.05),LIS,EVLWI and PVPI in moderate group were significantly higher than the mild group (P＜0.05).The mortality rate of 28 d in moderate and severe group was 32.14％ (9/28) and 51.52％ (17/33),which was significantly higher than that in mild group 0.00％(0/19) (P＜0.05).EVLWI and PVPI were 19.12(17.22,22.96) ml/kg and 3.71(3.08,5.22) in patients with death,which were significantly higher than those in survival 14.19 (11.20,16.59) ml/kg and 2.97(2.31,3.10) (P=0,021 and 0.016);EVLWI was positively correlated with PVPI,LIS and APACHE Ⅱ score(rs =0.411,0.323 and 0.304,P＜ 0.001).PVPI was positively correlated with LIS and APACHE Ⅱ score (rs =0.346,0.297,P＜0.001).No correlation between LIS and APACHE Ⅱ score (P＞0.05).Conclusion EVLWI and PVPI have certain apphcation value in the diagnosis and treatment of ARDS,and it is related to the patient's condition and prognosis.
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OBJECTIVE:To compare the clinical efficacy and safety of imipenem and cislastatin sodium and meropenem in the treatment of acute leukemia granulocytopenic phase combined with severe lung infection. METHODS:A total of 64 patients with acute leukemia granulocytopenic phase combined with severe lung infection were selected from our hospital during Jul. 2015-Jul. 2016 as study objects. They were divided into trial group(odd number)and control group(even number)according to admis-sion order,with 32 cases in each group. Control group was given Meropenem for injection 1 g+0.9％ Sodium chloride injection 100 mL,ivgtt(about 30 min),q8 h. Trial group was given Imipenem and cislastatin sodium for injection 1 g+0.9％ Sodium chlo-ride injection 100 mL,ivgtt(about 30 min),q12 h. Both groups were treated for 14 d. Clinical efficacies as well as blood gas pa-rameters [p(O2),p(CO2),SaO2] and pathogenic clearance were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:The total response rate of trial group(78.13％)was significantly higher than that of control group(71.88％),with sta-tistical significance (P0.05). After treatment,the levels of p(O2) and SaO2 in 2 groups were in-creased significantly,while the level of p(CO2) was decreased significantly;there was statistical significance compared to be-fore treatment(P>0.05). There were 27 cases of pathogenic clearance in trial group(clearance rate of 84.38％),which was sig-nificantly more than control group (26 cases,clearance rate of 81.25％),without statistical significance (P>0.05). The inci-dence of ADR in trial group(9.38％)was significantly lower than control group(15.63％),without statistical significance(P>0.05). CONCLUSIONS:Imipenem and cislastatin sodium and meropenem show good clinical efficacy for acute leukemia granu-locytopenic phase combined with severe lung infection,blood gas parameters improvement and pathogenic clearance effect,both of them have good safety.
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Objective:To investigate the different function of dendritic cells between patients with lupus nephritis and healthy control,and discuss the pathogenesis of the disease.Methods: Choose 50 healthy controls,50 patients with lupus nephritis,and isolation of blood dendritic cells.Then samples were induced with GM-CSF and IL-4,and cells were collected on day 7.DC maturity was evaluated using the following methods:fluorescence-activated cell sorting analysis for cell surface markers;enzyme-linked immunosorbent assay for cytokine production;cell proliferation assay for induction of T cell proliferation.Results: Compared with the control group,lupus nephritis group had increased MHC Ⅱ,CD86,CD80,and CD40 expression(P<0.05);displayed the increased IL-12 and TNF-αlevels(P<0.05);displayed a increased ability to drive lymphocyte cells proliferation (P<0.05).Conclusion:Compared with the control group ,dendritic cells in lupus nephritis group displayed the mature condition ,which indicates that dendritic cells play the important role in the pathogenesis of lupus nephritis.