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Objective:To explore the value of the age, atrial fibrillation, dysphagia, sex, stroke severity (A2DS2) score, the prestroke independence, sex, age, National Institutes of Health stroke scale (ISAN) score, acute ischemic stroke-associated pneumonia score (AIS-APS), and intracerebral hemorrhage associated pneumonia score without hematoma volume included (ICH-APS-A) in predicting risk of stroke-associated pneumonia (SAP).Methods:From January to June 2019, 304 patients with acute stroke who were hospitalized in the Lianyungang Hospital Affiliated to Xuzhou Medical University were analyzed retrospectively. There were 164 patients with acute ischemic stroke (AIS), including 82 patients with SAP. And there were 140 patients with intracerebral hemorrhage (ICH), including 70 patients with SAP. They were divided into SAP group (152 cases) and non-SAP group (152 cases) depending on whether they had SAP. The area under the receiver operating characteristic curve (AUC) was used to compare the predictive value of the four scores.Results:When predicting risk of SAP in patients with the stroke, the A2DS2 score had the largest AUC compared to the ISAN score, AIS-APS score, and ICH-APS-A score. When predicting risk of SAP in patients with AIS, the AUC (0.875, 95% CI 0.815 to 0.922) of the A2DS2 score was greater than the AIS-APS score and the ISAN score. When predicting risk of SAP in patients with ICH, the AUC (0.950, 95% CI 0.900 to 0.980) of the A2DS2 score was greater than the ICH-APS-A score and the ISAN score. When predicting risk of SAP in patients with AIS and ICH: 0.911 (95% CI 0.873 to 0.94) vs. 0.882 (95% CI 0.840 to 0.916), Z = 2.319, P = 0.020, the A2DS2 score was significantly better than the ISAN score ( P<0.05). When predicting risk of SAP in patients with AIS, the A2DS2 score, ISAN score, and AIS-APS score all have good predictive value ( P>0.05). When predicting SAP in patients with ICH, the A2DS2 score, ISAN score, and ICH-APS-A score all have good predictive value ( P>0.05). Conclusions:When predicting risk of SAP in patients, the A2DS2 score is a reliable prediction tool, with good predictive value.
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Objective:To discuss the risk factors, treatment process and prevention strategy of the cases of acute pulmonary embolism after cerebral hemorrhage, so as to improve the attention and level of the disease.Methods:The data of a patient with cerebral hemorrhage and acute pulmonary embolism treated in Lianyungang First People's Hospital were analyzed retrospectively, and the literature related to intracerebral hemorrhage complicated with acute pulmonary embolism was reviewed.Results:One week after intracerebral hemorrhage, the patient was diagnosed with acute pulmonary embolism and given anticoagulant treatment with low molecular weight heparin. The condition was alleviated without aggravating intracerebral hemorrhage. Lying in bed after intracerebral hemorrhage, limb braking, use of dehydration, diuresis, hemostasis and other drugs were the high-risk factors of pulmonary embolism.Venous thromboembolism can be prevented clinically by physical methods and drugs.Conclusions:Venous thromboembolism is easy to occur after intracerebral hemorrhage. Clinically, the incidence can be reduced by pneumatic therapy or anticoagulant drugs. In treatment, it is necessary to weigh the risk of death of pulmonary embolism and rebleeding. After comprehensive evaluation, we can formulate an individualized treatment plan. It may be safe and effective to use low molecular weight heparin to treat pulmonary embolism after the intracerebral hemorrhage hematoma is stable.
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Objective:To explore the reference interval of urinary iodine concentration(UIC)/urinary creatinine(UCr) ratio evaluating the iodine nutritional status in early pregnancy women.Methods:A reference interval of UIC/UCr ratio was determined among 5 609 early pregnant women with normal thyroid function, negative thyroid autoantibodies, and no history of diseases or taking drug that may affect thyroid function. Then we verified the reliability of this reference interval in a group of 7 514 women in early pregnancy.Results:We determined the UIC/UCr ratio of 75-149 μg/g as the reference interval. In the reference interval, thyroglobulin antibody(TgAb), thyroid peroxidase antibody(TPOAb), and thyroglobulin(Tg) were all at lower levels, and the overall distributions were approximately U-shaped. The prevalence of thyroid dysfunction, the positive rates of antibodies and the proportion of Tg>40 μg/L were the lowest within the reference interval, while higher on both sides of the interval.Conclusion:The reasonable reference interval of the UIC/UCr ratio in iodine-sufficient regions is 75-149 μg/g in early pregnerty women.
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Objective To explore the ef fi cacy and safety of long-term use of low dose glucocorticoids in acute respiratory distress syndrome (ARDS). Methods Fifty ARDS patients were randomly divided into two groups. The control group(25 patients)received non-invasive or invasive mechanical ventilation,antibiotics and support treatments. The glucocorticoids group(25 patients)received the same treatments plus long-term use of low dose glucocorticoids. Results The mortality in glucocorticoids group(32％(8/25))was much lower than that in the control group(60％(15/25))(P < 0.05). The ventilator-free days and organ failure-free days within 28d in glucocorticoids group were significantly higher than those in the control group (P < 0.05). The oxygenation index and the serum IL-8 levels in glucocorticoids group at 14d and 28d were higher than those in the control group(P<0.05). Compared to the control group ,long-term use of low dose glucocorticoids in ARDS did not increase fasting blood-glucose at 7d,gastrointestinal bleeding and hospital infections within 28d. Conclusions Long-term use of low dose glucocorticoids in ARDS could reduce the serum IL-8 levels and improve the prognosis.
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Objective To explore the ef fi cacy and safety of long-term use of low dose glucocorticoids in acute respiratory distress syndrome (ARDS). Methods Fifty ARDS patients were randomly divided into two groups. The control group(25 patients)received non-invasive or invasive mechanical ventilation,antibiotics and support treatments. The glucocorticoids group(25 patients)received the same treatments plus long-term use of low dose glucocorticoids. Results The mortality in glucocorticoids group(32％(8/25))was much lower than that in the control group(60％(15/25))(P < 0.05). The ventilator-free days and organ failure-free days within 28d in glucocorticoids group were significantly higher than those in the control group (P < 0.05). The oxygenation index and the serum IL-8 levels in glucocorticoids group at 14d and 28d were higher than those in the control group(P<0.05). Compared to the control group ,long-term use of low dose glucocorticoids in ARDS did not increase fasting blood-glucose at 7d,gastrointestinal bleeding and hospital infections within 28d. Conclusions Long-term use of low dose glucocorticoids in ARDS could reduce the serum IL-8 levels and improve the prognosis.
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Objective To discover the vital role of Rab27B in tumor cells and its potential molecular mechanism by means of quantitative proteomics analysis of Rab27B knockdown in MHCC97H.Methods The expression of Rab27B in MHCC97H cells was knocked down by the combination of Tet-on advanced inducible expression system and RNA interference technology.Then, proteins extracted from the cells were identified by LC-MS/MS system after FASP digestion and iTRAQ 4-plex labeling. Finally, the properties of differentially expressed proteins, including the subcellular localizations, biological processes and molecular functions, were analyzed by the bioinformatics method.Results There were 448 differentially expressed proteins (|Ratio|>1.21, P<0.05) identified in MHCC97H cells after Rab27B knock-down.The expression levels of 229 or 219 proteins were positively or negatively correlated with Rab27B, respectively. These differentially expressed proteins were mainly involved in vesicle transport, macromolecule localization, cellular response to stimulus.Furthermore, there were 26 differentially expressed proteins participating in 8 tumor-related signal pathways, eleven of which were in the focal adhesion signal pathway.Conclusion The analysis of quantitative proteomics in Rab27B-knockdown MHCC97H cell line by iTRAQ suggests that Rab27B not only has an impact on the exosomal secretion of tumor cells, but also regulates master proteins in signal pathways involved in cell proliferation and migration.
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Objective To explore the role of procalcitonin (PCT) in diagnosis and antibiotics therapy of community acquired pneumonia (CAP). Methods A total of 296 patients with CAP and 221 patients with other diseases were included. PCT levels between CAP patients and non-CAP patients, aged and non-aged CAP patients were analyzed. SPSS19.0 was used to make ROC, and the maximum Youden index to determine the optimal cutoff value, the corresponding sensitivity (SEN) and specificity (SPE). Results PCT levels in CAP patients were significantly higher than those in non-CAP (P0.05). Conclusion PCT has a high value in diagnosis and antibiotics therapy of CAP.
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Objective To investigate the diagnostic value of telomerase activity and mutatioms of P53 gene in bronchoalveolar lavage fluids (BALF) in lung cancer. Methods Collect BALF from 86 patients with lung cancer and 82 patients with benign bronchial-pulmonar diseases. Telomeric Repeat Amplificaton Protocol (TRAP) and Polymerase Chain Reaction Single Strand Conformational Polymorphism(PCR-SSCP) were used in this study. Meanwhile, conduct fibrobronchoscope brush biopsy and protractor biopsy. Results ①The positive rate of telomerase in experimental group is 82.56% and that of mutatioms of P53 gene is 32.56%, which are both higher than 4.48% and 0% (P0.05) between the mutatioms of P53 and the expression of telomerase activity with respect to pathological classification of lung carcinomas. ③ In central-type lung cancer group, the combining positive rate of telomerase and mutatioms of P53 is 94.34%, the positive rate of routine fibrobronchoscope practice is 86.79%,there were no statistical differences between them. In peripheral lung cancer group, the combining positive rate of telomerase and mutatioms of P53 is 75.76%, which is higher than the positive rate of routine fibrobronchoscope practice that is 45.45%(P
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Non-motor symptoms are an important component of the manifestations of Parkinson's disease(PD);they usually include sleep disorder,neuropsychotic symptoms,autonomic dysfunction,pain,and so on.Non-motor symptoms are multifactorial and mainly involve various non-dopaminergic neurotransmitter systems.These symptoms are not only a result of disease progression,but also can appear in the early stage of the disease,and they can have a major impact on the quality of life.The early notice of these symptoms may lead to better therapeutic strategies and subsequently to the improvement of the quality of life in PD patients.