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Objective:To explore whether barium chloride (BaCl 2) preconditioning has the protective effect on lipopolysaccharide (LPS)-induced acute respiratory distress syndrome (ARDS) model in mice and the possible mechanism. Methods:Sixty 8-12 week old healthy C57BL/6 male mice were randomly divided into control group, ARDS model group and BaCl 2 pretreatment group, with 20 mice in each group. The BaCl 2 pretreatment group was continuously injected with BaCl 2 (4 mg/kg through the tail vein) for 3 days before ARDS model establishment. ARDS model was established by intratracheally injecting (3 mg/kg) LPS. The control group was intratracheally given the same volume of 0.9% normal saline. On 24th hour after ARDS model establishment, some mice were sacrificed for obtaining fresh lung tissue. And the right lower lobe of the lung was separated for observing the pathological changes of lung tissue while the left lung tissue was used to measure the wet/dry weight ratio (W/D) of the lung. Some mice were sacrificed for observing pulmonary microvascular permeability at 2nd hours after injecting Evans blue (EB) through tail vein. The left mice were killed for alveolar lavage to measure the levels of tumor necrosis factor-α (TNF-α) via enzyme linked immunosorbent assay (ELISA). Results:Comparing with the control group, ARDS model group showed typical ARDS pathological changes, which included the increased W/D ratio (4.951±0.161 vs. 3.449±0.299, P < 0.01) and the content of EB in the lung tissue (μg/g: 0.130±0.027 vs. 0.085±0.011, P < 0.01), the damaged alveolar wall structure, lung congestion and exudates in the alveoli, as well as amounts of inflammatory cells. The pathological score of lung injury (10.33±1.15 vs. 1.67±0.58) and the level of TNF-α in BALF (ng/L: 900.85±247.80 vs. 68.21±5.79) were significantly increased in the ARDS model group (both P < 0.01). Comparing with the ARDS model group, the lung W/D ratio (4.620±0.125 vs. 4.951±0.161) and the EB content in the lung tissue (μg/g: 0.108±0.011 vs. 0.130±0.027) of BaCl 2 pretreatment group were significantly reduced (both P < 0.01). And the damaged pulmonary structural BaCl 2 pretreatment group were significantly alleviated. In addition, the pulmonary pathological score (5.00±1.00 vs. 10.33±1.15) and the level of TNF-α in BALF (ng/L: 169.16±73.33 vs. 900.85±247.80) were significantly decreased (both P < 0.01). Conclusion:Barium chloride pretreatment can improve the lung histopathological changes of ARDS model mice induced by LPS by reducing the permeability of pulmonary capillaries and local inflammatory reaction.Barium chloride has the protective effect against LPS attack in mice model of ARDS.
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Objective The objective of this study was to study LGI1 limbic encephalitis (LE). Methods We performed a retrospective analysis on the clinical features,laboratory findings,imaging profiles and treatment outcomes of 17 patients with LGI1. Results The study included 14 male and 3 female cases. The median age was 61 years old. The clinical manifestations includes 14 cases with cognitive dysfunction, 11 cases with faciobrachial dystonic seizures (FBDS), 10 cases with focal seizures, 8 cases with generalizedtonic-clonic seizure and 9 cases with mental and behavioral disorder. Among 17 examined patients, there were 16 patients with positive and 1 with negative serum LGI1 antibody (but whose CSF LGI1 antibody was positive). Among 16 examined patients, there were 14 patients with positive cerebrospinal fluid LGI1 antibody. All patients had good responses to the first-line treatment and 2 patients experienced recurrence. During more than one-year follow-up, the recurrence rate was 33％ and no patient died. Conclusion LGI1 LE is an autoimmune encephalitis, which is mainly unidirectional progression and can relapse. FBDS and focal seizures usually are first symptoms, followed by cognitive dysfunction. Patients are responded to immunotherapy well and have good prognosis.
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Objective To investigate the relationship between snoring and newly-diagnosed type 2 diabetes mellitus among elderly urban and rural residents in Renqiu of Hebei province.Methods By random clustered sam-pling inspection,the residents aged 60 to 70 years old were selected in the study,the questionnaire investigation by an-thropometric measurements and laboratory tests were performed in 5 010 elderly people.Screen for 3 604 people who had no previous history of diabetes and currently not to control blood sugar by diet,exercise,medication.The average age was (64.32 ±3.06)years,including 1 608 male(44.6%) and 1 996 female cases(55.4%),snorers 994 cases (27.6%),non-snorers 2 610 cases(72.4%).The patients were followed up for one year.The correlation between snoring and newly-diagnosed type 2 diabetes mellitus was analyzed.Results There were 217 cases(6.0%) of new-ly-diagnosed type 2 diabetes mellitus,which accounted for 79 cases of snoring(36.4%),3 387 cases of non-dia-betic group,which accounted for 915 cases of snoring(27.0%),the difference between the two groups was significant (χ2 =9.003,P<0.05).Took the newly-diagnosed type 2 diabetes mellitus as the dependent variable,univariate analysis showed that gender(OR=0.479,95% CI:0.639~0.852),history of hypertension(OR=1.463,95% CI:1.111~1.927),family history of diabetes(OR=1.768,95% CI:1.259~2.183),history of stroke or TIA(OR=1.549,95%CI:1.106~2.168),central obesity(OR=1.658,95% CI:1.016 ~1.448),BMI≥28kg/m2 (OR=1.063,95% CI:1.025 ~1.102),fasting glucose(OR=2.065,95% CI:1.854 ~2.299),fasting insulin levels (OR=1.021,95%CI:1.008 ~1.035),cholesterol(OR=1.216,95% CI:1.051 ~1.407),triglycerides(OR=1.188,95%CI:1.089~1.296),snoring(OR=1.547,95% CI:1.161 ~2.060) were related with newly-diag-nosed type 2 diabetes mellitus.Multivariate logistic regression analysis showed that gender(OR=0.595,95% CI:0.368~0.963),history of stroke or TIA(OR=1.586,95%CI:1.085~2.318),fasting glucose(OR=2.059,95%CI:1.833~2.312),snoring(OR=1.592,95% CI:1.089~2.328) were independent risk factor for newly-diag-nosed type 2 diabetes mellitus.Conclusion People aged 60 to 70 in Renqiu suffered newly-diagnosed type 2 diabe-tes mellitus population prevalence of snoring, snoring is closely related to the occurrence and development of type 2 diabetes,type 2 diabetes is increased independent risk factor.Positive and effective screening and control on snoring can effectively reduce the incidence of type 2 diabetes.
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Objective To investigate waist-to-height ratio(WHtR) and body mass index(BMI) for the screening and prediction of metabolic syndrome and explore the best indicator for predicting metabolic syndrome(MS) in the elderly.Methods A cluster random sampling method was used.5 010 cases aged 60-70 years old of Renqiu permanent residents were selected as a screening subjects.The face to face health questionnaires,anthropometric measurements,and laboratory testing were conducted.Receiver operatiug characteristic (ROC) was used to analyze and calculate the area under the curve(AUC).Results WHtR predict the best point of tangency of MS were 0.54 (men),0.5 5 (women),BMI predict the best point of tangency of MS were 25.25kg/m2 (men),2 5.0 5 kg/m2 (women).In the same gender,the contrast of WHtR and BMI in predicts MS area under the curve,WHtR area under the curve of the larger,WHtR was higher than BMI,WHtR was a better indicator in predicted of MS.Conclusion WHtR and BMI have important roles in the screening and prediction of MS,and WHtR seems to be the best parameter in the screening and prediction of MS in the elderly.
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Objective To investigate the predictive value of serum albumin level in patients with severe sepsis .Methods One hundred and twenty cases of patients with severe sepsis admitted to Qilu Hospital ,Shandong University from April 2014 to October 2014 were prospectively enrolled .The serum albumin levels were measured and the laboratory and clinical data were collected at the onset of severe sepsis .Acute Physiology and Chronic Health Evaluation (APACHE ) Ⅱ score and Sequential Organ Failure Assessment (SOFA) score were calculated .Patients were grouped according to the prognosis by day 28 or stratified by albumin level . Prognostic factors were analyzed by multivariable Logistic regression .Results A total of 120 patients were enrolled with mean age of (57 .6 ± 18 .3) years ,among which 75 were male .The mean duration of hospitalization was (20 .1 ± 17 .8) days .The 28‐day mortality was 25 .8% (31/120) .The most common infection sources were respiratory tract (56 .7% ) ,abdominal/pelvis (19 .2% ) and bloodstream (9 .2% ) .Serum albumin level in survival group was significantly higher than that in death group ([32 .1 ± 6 .4] g/L vs [27 .5 ± 5 .5] g/L ,t=3 .562 ,P=0 .001) .Compared with survival group ,the patients in death group had higher APACHE Ⅱ and SOFA scores (22 .0 ± 9 .1 vs 13 .4 ± 7 .2;7 .1 ± 3 .7 vs 4 .3 ± 3 .5 ;t= —5 .372 and —3 .690 ,both P<0 .05) .Along with the decrease of serum albumin level ,the incidence of bloodstream infection ,solid tumor ,septic shock ,acute kidney injury and liver injury significantly increased .Patients with lower albumin level had significantly higher SOFA scores and 28‐day mortality (all P<0 .05) .Multivariable regression analysis showed that albumin level lower than 28 g/L and higher APACHE Ⅱ score were independent risk factors for mortality (OR=4 .156 ,95% CI:1 .198—14 .415 ;OR=1 .121 ,95% CI:1 .039—1 .210;both P<0 .05) .Conclusions A significantly lowered serum albumin level would increase the risk of mortality in patients with severe sepsis .The combination of albumin level and APAHCE Ⅱ score might be beneficial to evaluate the prognosis .
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Objectives To detect the carotid artery intima-media thickness (CIMT)with color Doppler ultrasound and to investigate the relationship between CIMT and new ischemic cerebrovascular disease. Methods From May 2012 to October 2013,the cluster random sampling method was used to consecutively enroll 4 412 60 -70 year old residences in Reqiu City for prospective study,including face to face health questionnaire survey,human body measurement,laboratory test,and neck vascular color Doppler ultrasonography. According to whether having new ischemic cerebrovascular disease,the patients who had ischemic cerebrovascular disease in 2013 were divided into either a case group (n = 251)or a control group (n =4 161). The single factor analysis,such as baseline data and CIMT levels in both groups were compared, and the related risk factors for ischemic cerebrovascular disease were analyzed. Results (1)The detection rates of hypertension,cerebrovascular disease,taking antiplatelet agents,carotid artery plaque of the case group were higher than those of the control group (62. 2% [n = 156]vs. 44. 2% [n = 1 838],45. 0%[n = 113]vs. 14. 9% [n = 622],55. 0% [n = 138]vs. 40. 0% [n = 1 663],and 65. 7% [n = 165]vs. 54. 5% [n = 2 266],all P < 0. 05). The systolic blood pressure,insulin,and CIMT levels were higher than those of the control group (158 [141,177]mmHg vs. 152 [137,169]mmHg,8. 07 [4. 77,12. 48]μU/ L vs. 6. 93 [4. 27,11. 60]μU/ L,0. 950 [0. 900,1. 000]mm vs. 0. 925 [0. 900,1. 000]mm,all P <0. 05). The cholesterol level was lower than that of the control group (4. 59 [4. 17,5. 26]mmol/ L vs. 4. 78 [4. 20,5. 36]mmol/ L,P < 0. 05). There were significant differences between the 2 groups. (2)Multivari-ate logistic regression analysis showed that histories of hypertension and cerebral vascular disease and CIMT thickening were the independent risk factors for new ischemic cerebrovascular disease (hypertension:OR, 1. 534,95% CI 1. 166 -2. 017,P = 0. 002;history of cerebral vascular disease:OR,3. 940,95% CI 2. 997 -5.180,P =0.000;and CIMT thickening:OR,12.122,95%CI 2. 327 -63. 163,P =0. 003). Conclusion CIMT, hypertension,and cerebrovascular disease are the independent risk factors for ischemic cerebrovascular disease in Renqiu City,and the monitoring of CIMT is very important.
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Objective To investigate the hyperuricemia(HUA)and the correlation of blood lipids of the 60 -70years peple in Renqiu area,and to provide the basis for guiding prevention and treatment of the elderly disease the region.Methods According to the cluster random sampling method,Renqiu permanent residents with the age of 60 to 70 years were selected as a screening object.In the total 5 010 cases screened object,2 163 were male(43.2%),2 847 were female(56.8%),with an average age of(64.29 ±3.05)years.The data of blood uric acid and total cholesterol(TC), triglyceride(TG),high -density lipoprotein(HDL -C),low -density lipoprotein(LDL -C)were collected.The rela-tionship between blood uric acid and blood lipids were analyzed.Logistic regression method was used to analysis the relationship between the hyperuricemia and lipids components.Results The overall prevalence of hyperuricemia in Renqiu was 6.1%(9.8% in male,3.2% in female).In men HUA group,the levels of blood uric acid,TG and LDL-L were 464.10(438.00 -508.65)μmol/L,1.54(1.00 -2.19)mmol/Land 2.66(2.25 -3.22)mmol/L,which were higher than those of normal uric acid group of 294.00(249.90 -338.08)μmol/L,1.13(0.84 -1.65)mmol/L and 2.57(2.12 -3.01)mmol/L(P <0.05).In women HUA group,the levels of blood uric acid,TG and LDL -L were 454.15(434.15 -480.78)μmol/L,2.14(1.47 -3.18)mmol/L and 2.96(2.52 -3.76)mmol/L,which were higher than those of normal uric acid group of 250.80(209.00 -299.80)μmol/L,1.53(1.10 -2.20)mmol/L and 2.87(2.40 -3.33)mmol/L(P <0.05).Logistic multi -factor regression analysis showed that TG was an independ-ent risk factor for hyperuricemia,and that HDL -L and gender were protective factors.Conclusion Hyperuricemia is closely associated with blood lipid,especially with TG and HDL -L,so we could screening HUA by blood lipid,which can reduce the occurrence of cardiovascular disease effectively.
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Objective To study the relationship between metabolic syndrome (MS) and anterior circulation infarction (ACI). Methods 271 ACI patients (166 men and 105 women) who fulfilled the diagnostic criteria of China Guideline for Cerebrovascular Disease Prevention and Treatment were enrolled. 147 control subjects (67 men and 80 women) without the clinical signs of cerebral infarction but with detailed case history, physical examination and CT or MRI were also selected. The prevalence and risk of MS were observed in the ACI and control group. MS was defined with the modified criteria in Chinese. Results The prevalence of MS in the ACI group and control subjects was respectively 43.17% and 19.05%. The prevalence of MS was significantly higher in the ACI group as compared with the control subjects (P<0.01). The component level of MS were significandy different between the two groups (P< 0.05). MS was associated with a 3.7 fold higher risk of ACI (P<0.01). Conclusions There is a close relationship between MS and ACI. MS is an important risk factor of ACI.