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Objective To explore the value of Oxford acute severity of illness score in evaluating the severity and prognosis of critical illness patients.Methods All adult patients admitted to the Department of Critical Care Medicine from August 2012 to July 2014 were retrospectively analyzed.The severity in survivors and non-survivors was evaluated by using Oxford acute severity of illness score and APACHE Ⅲ score,and then statistic analysis were performed.Results Of 470 patients,321 (68.297％) were male,the range of age and ((x) ±s) age were 18 to 97 years and (59 ± 18) years respectively,and 123 patients (26.170％) were in non-survivors group and 347 patients in survivors group.The area under the ROC of Oxford acute severity of illness score was 0.760 (95％ CI:0.712-0.808,P ＜ 0.001),and Youden index was biggest when Oxford acute severity of illness score was 30.5.The area under the ROC of APACHE Ⅲ score was 0.844 (95％ CI:0.806-0.882,P ＜ 0.01),and Youden index was biggest when APACHE Ⅲ score was 70.5.Mortality was high (above 70％) as Oxford acute severity of illness score increased (＞ 40),and Spearman r was 0.976 (P ＜ 0.01).Conclusions Oxford Acute Severity of Illness Score was useful to evaluating the severity and prognosis of critical illness patients and it was easy in clinical practice.
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Objective To launch systematic research on long-term asymptomatic hyperuricemia (HUA) from hemorheological viewpoint,so as to provide references for clinical treatment of asymptomatic HUA.Methods Twenty rats were randomly and evenly divided into normal control group and model group.The rats were intraperitoneally injected with 250 mg/(kg · d) oxonate for 8 weeks to induce the model of asymptomatic HUA.The blood samples were obtained to measure the serum uric acid,hemorheological parameters,oxidative and anti-oxidative indices.Results The aggregation index,haemolysis rate,serum xanthine oxidase (XOD),plasma fibrinogen and blood viscosity significantly increased,while the orientation index,electrophoresis rate,serum superoxide dismutase (SOD),activated partial thromboplastin time (APTT) and prothrombin time (PT) significantly induced.Conclusions The asymptomatic HUA can lead to more serious oxidative stress,deteriorate the hemorheological parameters of red blood cells in rats,and induce higher blood viscosity and coagulation status.The research findings indicate that asymptomatic HUA should be correctly understood and timely intervened in clinical diagnosis.
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Hyperuricemia is a risk factor for various diseases, but knowledge on acute hyperuricemia is still not sufficient. The present study was aimed to investigate the effect of acute hyperuricemia on red blood cells from hemorheological point of view, and to provide the reference for clinical treatment. The rats were gavaged with 500 mg/kg hypoxanthine and intraperitoneally injected with 100 mg/kg oxonate to induce the model of acute hyperuricemia. The same volume of blood samples were drawn within time period of 0, 1, 2, 3 and 6 h, respectively, from the inner canthus of rats to measure the serum uric acid, hemorheological parameters and the malondialdehyde level. It was found that in each period of 1, 2 and 3 h, the rats had significantly higher levels of uric acid. The integrated deformation index and relax index were increased. The hemolysis rate was significantly reduced. The plasma malondialdehyde level was obviously decreased at the end of 2 h. The results suggested that short-term elevated uric acid could improve the hemorheological parameters and the lipid oxidative level in red blood cells.
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Animals , Rats , Erythrocytes , Hemorheology , Hyperuricemia , Blood , Malondialdehyde , Blood , Rats, Sprague-Dawley , Uric Acid , BloodABSTRACT
Objective To explore the application value of pulse induced contour cardiac output (PiCCO) monitoring in diagnosis and treatment of patients with neurogenic pulmonary edema (NPE).Methods With review of literature, the data of 4 patients of severe neurological disease complicated by NPE admitted into Department of Critical Care Medicine of Huangshan People's Hospital Affiliated to Wannan Medical College from 2011 to 2013 were retrospectively analyzed and discussed in their PiCCO hemodynamic characteristics and processes of treatment.Results The PiCCO of 4 patients with NPE showed that the extravascular lung water index (EVLWI) was increased significantly (EVLWI was 12 - 42 mL/kg on admission and 10 - 22 mL/kg after hospitalization for 24 hours), all revealing a high permeability pulmonary edema type. The capacity balance of the first 24 hours in the 4 cases was all of positive balance (+1 130, +1 200, +1 750, +1 120 mL respectively). In the treatment, the supplementary colloid was strengthened, the vasoactive drugs such as, dopamine, dobutamine, milrinone, etc were applied to improve the circulatory oxygenation, then the EVLWI was declined; finally the disease situation in 3 cases was improved and one died.Conclusions The clinical diagnosis and treatment of NPE is complex, and many contradictions appear in the therapeutic course. PiCCO monitoring is valuable in early diagnosis, identification of pulmonary edema type, guidance in fluid supplement and vascular active drug application, and assessment of disease severity and prognosis.
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Objective To explore the value of waring score of potential critical disease in predicting changes in condition of patients with multiple injuries. Methods From January 1, 2013 to July 31, 2013, all patients with multiple injuries were included prospectively. Patients were observed as soon as ICU admission. The waring score of potential critical disease and MEWS of all patients and the rates of changes in condition of patients were calculated then statistic analysis was performed. Results Of 50 patients enrolled, 44 were survived and 6 were died and 295 changes were found. The maximum , minimum median (P25, P75) of waring score of potential critical disease were 22, 0, 5 (3, 7). The maximum, minimum median (P25, P75) of MEWS were 12, 0, 4 (2, 6). The area under the ROC of waring score of potential critical disease was 0.880 (95% CI, 0.813-0.947, P < 0.001). Youden index was the biggest when waring score of potential critical disease was 6.5. The area under the ROC of MEWS was 0.767 (95% CI, 0.661-0.873, P < 0.001). Youden index was the biggest when MEWS was 5.5. Conclusion The waring score of potential critical disease was effective to predict changes in conditions of patients with multiple injuries and better than MEWS.
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This paper reports an in vivo study on the biophysics characteristics of reticulocytes. Anemia was induced by injection of phenylhydrazine in rabbits. The measurements, including electrophoresis rate, hematolytic rate, fluorescent polarization and the changing anisotropic value, were performed in vivo for 72 hours in the process of reticulocytes growing into erythrocytes. It was shown that there were obvious changes in the biophysics characteristics of reticulocytes in this course. Therefore, the findings are of significance to basic, theoretical and clinical studies.
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Animals , Rabbits , Anemia, Hemolytic , Blood , Biophysical Phenomena , Biophysics , Erythrocyte Deformability , Erythrocyte Membrane , Physiology , Phenylhydrazines , Reticulocytes , Metabolism , PhysiologyABSTRACT
The changes in the cellular main components of the mouse erythroleukemia cell line MEL for TFAR19 gene transfection were studied by the technology of Fourier transform infrared spectroscopy (FTIR). Using the method of gene transfection with liposome, we obtained MEL-TF19 cell line, which stably carries TFAR19, a novel apoptosis-related gene. The expression of the gene on mRNA level was confirmed by RT-PCR. Then, FTIR spectra of the cells were measured in the course of apoptosis induced by serum deprivation. Our results indicated that after being transfected with TFAR19 gene, MEL-TF19 cells exhibited relatively higher protein content, higher transcriptional activity, and relatively lower phospholipid content as compared with those exhibited by MEL cells. All the above changes reflect the apoptosis-promoting effect of TFAR19 gene, and maybe account for the cellular rheological changes after TFAR19 gene transfection, which were discovered in our previous study.