ABSTRACT
Objective To get the knowledge of the diagnosis and treatment of acute pulmonary embolism (APE)in primary hospital.Methods The clinical data of the patients diagnosed with APE were retrospectively reviewed.The patients were clarified into different risk-group by revised Geneva score and Wells score according to the clinical records.Results 17 patients were diagnosed with APE in this time slot,in which male 10 cases and female 7 cases,average age was (51.8 ±18.4)years old,and among them,4 cases with 4 scores of revised Geneva score,9 cases with 4 to 10 scores,4 cases with more than 11,6 cases with less than 4 Wells score,11 cases with more than 4,2 cases with low risk and 15 cases with intermediate risk.The length of hospital stay was (10.9 ±5.4)days in average.In this group,one patient was dead,seven cases improved,six cases remarkably improved and three cases were recued.Fourteen patients received anticoagulation agents and three cases without any.Eleven patients were given thrombolystic therapy,one case was operated and six cases were given interventional treatment.Conclusion Clinicians know APE and keep alert gradually.However,it should be improved in respects of treating and following the APE patients.
ABSTRACT
Objective To investigate concentration of plasma neutrophil gelatinase -associated lipocalin ( NGAL) and its clinical significance in ICU populations with sepsis.Methods Fourteen ICU patients diagnosed with sepsis and twenty-four patients with non-sepsis were enrolled in the study,and seventeen healthy adults were selected as healthy control.Blood samples were drawn from patients to measure NGAL, and Acute Physiology and Chronic Health Evaluation ( APACHE ) II and Sequential Organ Failure Assessment ( SOFA ) were performed, the outcome was recorded.Plasma NGAL concentration was measured by enzyme -linked immunosorbent assay ( ELISA) .Results On admission to ICU, the pNGAL concentrations of septic and non -septic patients were (131.4 ±116.4)ng/mL and (48.7 ±30.8)ng/mL respectively,which of healthy control was (39.07 ±12.74)ng/mL.The pNGAL was significantly higher in sepsis than non-sepsis and healthy control ( t=-3.280,3.313,P=0.003,0.021 respectively).Otherwise,no differences of white blood cell (WBC) count [(12.6 ±5.7) ×109/L vs (15.6 ±5.8) ×109/L] and SOFA scores [(7.7 ±3.3)points vs (8.6 ±3.4)points] were found in septic and non-septic patients (t=-1.554,-0.802,P=0.129,0.428).On the admission to ICU,areas under the receiver oper-ating characteristic curves ( ROC curves) of NGAL and WBC for predicting sepsis were 0.740 [95%confident inter-val(CI) 0.566,0.913,P =0.015] and 0.345 ( 95%CI 0.158,0.533,P =0.116) respectively.If pNGAL of 99.4ng/mL as the threshold for predicting sepsis, the sensitivity and the specificity was 50.0% and 85.2%. Conclusion The concentrations of NGAL in septic patients significantly increased compared with that in non-sepsis and in healthy adults.And the NGAL levels maybe another sensitive biochemical marker for predicting infection.