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Objective:Evaluation of combined inflammatory and coagulation markers for early identification of DIC in septic patients.Methods:This study was a single-center, retrospective, observational study involving 356 patients with sepsis. Sepsis was defined by the diagnostic criteria of Sepsis version 3.0. Definition of DIC was from the International Society on Thrombosis and Hemostasis (ISTH) DIC Score. Inflammatory biomarkers, including tumor necrosis factor (TNF)-α, interleukin (IL)-1β,2R,6,8,10, etc. and biomarkers of coagulation, like platelet (PLT), international normalized ratio (INR), D-dimer, fibrinogen (Fib), etc. were included in this study.Results:Among 356 patients with sepsis, 301 patients did not develop DIC (non-DIC) during hospitalization, 32 patients had DIC on the day of admission (overt-DIC), and 23 patients developed DIC within 1 week of admission (pre-DIC). Compared to non-DIC patients, pre-DIC patients had lower platelet counts and fibrinogen ( P < 0.05), higher levels of INR and D-dimer ( P < 0.05), higher levels of cytokines (TNF-α、IL-1β、IL-2R、IL-8、IL-10) and procalcitonin ( P < 0.05), higher APACHEⅡ and SOFA scores ( P < 0.05). Using receiver operating characteristics (ROC) analysis, we found that some biomarkers of coagulation and inflammation could discriminate pre-DIC from non-DIC patients. The area under the curve (AUC) of INR in the ROC analysis was 0.773 (95% CI: 0.696-0.851), the AUC of IL-2R was 0.700 (95% CI: 0.599-0.798) which is highest among inflammation markers, the highest AUC was obtained from the combination of platelets, INR, Fib, D-dimer and IL-2R (AUC = 0.843; 95% CI: 0.758-0.928). Kaplan-Meier survival curve suggested that high level of IL-2R (> 1064.5 U/mL) was a valuable predictor of 28-day mortality in septic patients. Conclusion:Inflammatory marker, IL-2R, is related to the occurrence of DIC in septic patients and has predictive value for pre-DIC. Combination of coagulation (platelets, INR, Fib, D-dimer) and inflammatory markers (IL-2R) can help to identify pre-DIC state in septic patients.
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OBJECTIVE To systematically evaluate the effectiveness and s afety of parecoxib sodium for gynecological surgery postoperative analgesia ，and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed ， Embase，the Cochrane Library ，CNKI，VIP，Wanfang data and SinoMed during the inception to Feb. 16th，2021，randomized controlled trials （RCT） about parecoxib sodium （trial group ） versus 0.9％ sodium chloride injection （control group ） for gynecological surgery and postoperative analgesia were collected. After screening literatures ，extracting data and evaluating the quality of literatures with modified Jadad scale ，Meta-analysis，sensitivity analysis and publication bias analysis were performed by using RevMan 5.3 software. RESULTS A total of 14 RCT were included ，involving 1 120 patients. The results of Meta-analysis showed that visual analogue scale （VAS）score at 4 h after operation [MD ＝－1.65，95％CI（－2.48，－0.82），P＝0.000 1]，VAS score at 6 h after operation [MD ＝－1.03，95％CI（－1.60，－0.45），P＝0.000 5]，VAS score at 12 h after operation [MD ＝－0.98， 95％CI（－1.38， －0.59），P＜0.000 01]，the proportion of postoperative analgesia requirements [OR ＝0.14，95％CI（0.04， 0.50），P＝0.003] and the dosage of morphine [MD ＝ －17.75， com 95％CI（－20.93，－14.56），P＜0.000 01] in trial group were significantly lower than control group. There was no statistical significance in the incidence of nausea between 2 groups [OR＝ 0.68，95％CI（0.43，1.08），P＝0.10]. The results of sensitivity analysis showed that the above results were basically stable. The results of publication bias analysis showed that there was little possibility of publication bias in this study. CONCLUSIONS Parecoxib sodium is effective and safe for gynecological surgery and posto perative analgesia.
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<p><b>OBJECTIVE</b>To investigate the effects of lead exposure on the copper concentration in the brain and serum and the expression of copper transporters in the choroid plexus among rats.</p><p><b>METHODS</b>Sixty specific pathogen-free Sprague-Dawley rats were randomly divided into a control group and three lead-exposed groups, with 8 mice in each group. The lead-exposed groups were orally administrated with 500 (low-dose group)), 1 000 (middle-dose group), and 2 000 mg/L (high-dose group) lead acetate in drinking water for eight weeks. And the rats in control group were given 2 000 mg/L sodium acetate in drinking water. The content of lead and copper in the serum, hippocampus, cortex, choroid plexus, bones, and cerebrospinal fluid (CSF) was determined by inductively coupled plasma-mass spectrometry (ICP-MS). Confocal and real-time PCR methods were applied to measure the expression of copper transporters including copper transporter 1 (Ctr1), antioxidant protein 1 (ATX1), and Cu ATPase (ATP7A).</p><p><b>RESULTS</b>Compared with the control group, the lead-exposed groups showed significantly higher lead concentrations in the serum, cortex, hippocampus, choroid plexus, CSF, and bones (P < 0.05) and significantly higher copper concentrations in the CSF, choroid plexus, serum, and hippocampus (P < 0.05). Confocal images showed that Ctr1 protein was expressed in the cytoplasm and cell membrane of choroid plexus in control group. However, Ctr1 migrated to CSF surface microvilli after lead exposure. Ctr1 fluorescence intensity gradually increased with increasing dose of lead, except that the middle-dose group had a higher Ctr1 fluorescence intensity than the high-dose group. In addition, the middle- and high-dose groups showed a lower ATX1 fluorescence intensity compared with the control group. Real-time PCR data indicated that the three lead-exposed groups showed significantly higher mRNA levels of Ctr1 and ATP7A compared with the control group (P < 0.05).</p><p><b>CONCLUSION</b>Copper homeostasis in the choroid plexus is affected by lead exposure to induce copper homeostasis disorders in brain tissue, which may be one of the mechanisms of lead neurotoxicity.</p>
Subject(s)
Animals , Rats , Adenosine Triphosphatases , Brain , Cation Transport Proteins , Choroid Plexus , Metabolism , Copper , Metabolism , Homeostasis , Organometallic Compounds , Toxicity , RNA, Messenger , Rats, Sprague-DawleyABSTRACT
Objective Vertigo is the main clinical feature and cerebral atherosclerosis is the major etiological factor and pathogenesy of posterior circulation ischemia (PCIV).The objective of this study was to observe the clinical effect of butylphthalide combined with naloxone on PCIV and hemodynamics . Methods One hundred and sixty two patients with PCIV were classified into treatment group and control group .In the treatment group , butylphthalide soft capsules were administrated by oral and naloxone 2.4 mg were administrated by intravenous drip per day .In the control group , Xueshuantong at the dose of 300 mg was given by intravenous drip per day.All the treatment lasted for 14 days.Transcranial doppler (TCD) examination was performed for all patients before and after the treatment.The mean velocity (Vm) and the systolic velocity (Vs) of bilateral vertebral arteries were recorded .Clinical cure rate was evaluated . Results Basilar artery Vm and Vs increased after treatment in the control group compared with those before treatment ([30.15 ±3.84])cm/s vs ([26.95 ±3.72])cm/s, ([40.87 ±4.54])cm/s vs ([37.16 ±4.72])cm/s.Basilar artery Vm and Vs increased after treatment compared with before treatment in the treatment group ([34.47 ±3.53]) cm/s vs ([27.53 ± 3.68])cm/s, ([42.25 ±5.29])cm/s vs ([35.87 ±4.85])cm/s, (P<0.05).Basilar artery Vm and Vs increased in the treatment group compared with the control group after the treatment ([34.47 ±3.53])cm/s vs ([30.15 ±3.84])cm/s, ([42.25 ±5.29])cm/s vs ([40.87 ±4.54])cm/s, (P<0.05).The cure rate and total effective rate in the treatment group (58.8%, 93.8%) were higher than thoes in the control group, respectively (31.7%, 75.6%)(P<0.05). Conclusion Butylphthalide soft capsules combined with naloxone have definite clinical curative effect and few side for PCIV treatment.
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Objective To evaluate the changes in and the regularity of brainstem evoked potentials (BA-EPs) in Parkiuson's disease (PD) as an objective criterion for early diagnosis and assessment. Methods Thirty-five healthy SD rats were divided into two groups at random. Twenty-two rats were in the experimental group and 13 in the control group. The rats were injected with 8 μg of 6-OHDA solution in the right substantia nigra pars compacta (SNc) and the right ventral tegmentum area (VTA) to create a PD model. The BAEPs of the rats in the experimental group were recorded in a quiet shielded room before the 6-OHDA injection, and one week and two weeks after injec-tion. The control group rats were injected with saline (Ns) and their BAEPs were recorded at the corresponding times. One week and two weeks later, the model rats were injected with apomorphine (APO) and their rotating cycles were counted. Results The Ⅱ , Ⅳ, andV PLs and the Ⅲ-Ⅴ IPLs on the fight ears of the experimental group were prolonged significantly compared with the control group one week after APO injection. There was no significant differ-ence in the BAEPs of the left ears after the first week. After two weeks, the Ⅱ , Ⅳ, and Ⅴ PLs and the Ⅲ-Ⅴ, and Ⅰ-Ⅴ IPLs of the right ears in the experimental group were prolonged significantly compared with the controls and the Ⅳ, and Ⅴ PLs and the Ⅲ -Ⅴ , and Ⅰ-Ⅴ IPLs on their left ears were prolonged significantly. Conclusion In the early course of a PD model in rats, their BAEPs show abnormal changes, which indicates that BAEP could be an ob-jective criterion for early diagnosis and assessment of PD. BAEP may serve as one index of damage in PD. The Ⅲ-Ⅴ PL and Ⅰ-Ⅴ iPL are sensitive indices of PD.
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Patients with eczema were treated by acupuncture and collateral-pricking and cupping,according to the principle of clearing away heat and eliminating dampness, enriching the blood and moistening dryness. Main acupoints were Quchi (LI 11), Baichongwo (Ex-LE), Hegu (LI 4), Sanyinjiao (SP 6), Xinjian (LR 2) and Neiting (ST 44). Among 54 patients, 23 cases recovered, 24 cases got effectiveness and 7 case had no change after the treatment. The curative effect rate was 87.0%.