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Objective To investigate the clinical value of bone metabolism biochemical marker N-MID,TP1NP and beta-CTx combined with whole body bone scintigraphy in early diagnosis of bone metastasis of tumor.Methods The concentration of the 3 markers were measured by the electrochemical luminescence analysis method in 30 cases of healthy control group and 210 cases of patients with malignant tumor,which were divided into non bone metastasis group(45 cases) and bone metastasis group(165 cases).The bone metastasis group were divided into 4 grades(0-grade Ⅲ) by Soloway classification according to whole body bone imaging.Results The levels of serum N-MID,TP1NP and beta-CTx in 165 malignant tumor patients with bone metastasis were significantly higher than in 45 malignant tumor patients with bone metastasis and in 30 healthy control group,the difference was statistically significant(P<0.05).With the increase of the number of metastatic lesions in the bone metastasis group,the serum levels of N-MID,TP1NP,and beta-CTx were increased gradually,and they were positively correlated with the progression of the disease.According to the analysis of ROC curve,the cut-off value,sensitivity and specificity in the diagnosis of tumor bone metastasis were 17.59 ng/mL,70.3％,88.9％ for serum N-MID,43.04 ng/mL,78.2％,95.6％ for TP1NP,and 0.48 ng/mL,73.9％,93.3％ for beta-CTx.Under the ROC curve(AUC) was 0.831 for serum N-MID,0.890 for TP1NP,and 0.869 for beta-CTx.The sensitivity and specificity of three bone metabolic markers in the diagnosis of bone metastasis of malignant tumor were significantly higher.Conclusion Bone metabolism biochemical markers:Serum N-MID,TP1NP and beta-CTx for diagnosis of bone metastasis of malignant tumor are sensitive,accurate and simple,which can significantly improve the efficiency of diagnosis of bone metastasis,and can be combined with whole-body bone scintigraphy in early diagnosis of bone metastasis with malignant tumor.
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Objective To study the value of prealbumin(PAB) ,C reactive protein(CRP) and apolipoprotein A1(Apo A1) in e-valuating the prognosis of patients with severe pneumonia .Methods 63 cases of patients with severe pneumonia were selected ,and the fasting serum level of prealbumin ,C-reactive protein and apolipoprotein A1 were detected in 24 hours at the admission day ,and APACHE Ⅱ score was calcumulated .The patients were divided into group A (APACHEⅡscore <20) and group B(APACHEⅡscore≥20) ,with the incidence of MODS and mortality rate compared .The patients were divided into non-MODS group and MODS group .In addition ,the patients were divided into survival group and death group according to the prognosis .PAB ,CRP and Apo A1 in each group were compared .Results The incidence of MODS and mortality rate in group B (57 .9% ,47 .4% ) were higher than that in group A(24 .0% ,16 .0% )(P<0 .01 ,P<0 .05) .PAB and Apo A1 of patients in MODS group[(134 .13 ± 36 .20)mg/L , (0 .62 ± 0 .21)g/L] and death group[(129 .05 ± 52 .24)mg/L ,(0 .76 ± 0 .29)g/L] were respectively lower than that in non-MODS group[(215 .03 ± 72 .08)mg/L ,(1 .06 ± 0 .39)g/L] and survival group[(185 .52 ± 57 .63)mg/L ,(1 .15 ± 0 .36)g/L](P<0 .05) , while the CRP in MODS group(102 .37 ± 35 .65)mg/L and death group(96 .37 ± 34 .72)mg/L were higher than that in non-MODS group(69 .68 ± 32 .92)mg/L and survival group(62 .94 ± 38 .36)mg/L (P<0 .05) .Conclusion The measurement of PAB ,CRP and Apo A1 are valuable to evaluate the prognosis of the patients with severe pneumonia .
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Objective To study the clinical effects of Ditan Xingnao Chengqi soup for treatment of patients with sepsis brain dysfunction. Methods Sixty-two cases of sepsis brain dysfunction were divided into treatment group(32 cases)and control group(30 cases)according to random digits table. Both groups received general clinical treatment,while the treatment group additionally accepted Ditan Xingnao Chengqi soup through nasal feeding. The changes of C-reactive protein(CRP)of two groups before treatment and after treatment for 12,24,48,72 hours and 1 week were observed. Besides,the Glasgow Outcome Scale(GOS)was used to assess the curative effect of two groups, and its clinical significance was judged. Meanwhile,the hospitalization costs,the times staying in hospital and total effective rates of the two groups after treatment were observed. In addition,cost-effectiveness analysis was carried out. Results With the extension of therapeutic time,the levels of CRP(mg/L)in the two groups were reduced effectively in comparison with those before treatment,and the change was more obvious in the treatment group;after treatment for 24 hours,the difference in the level of CRP between the two groups began to be statistically significant(106.5±22.3 vs. 201.6±25.4,P0.05).The ratio of cose effectiveness analysis in treatment group was smaller than that of control group(497.42 vs. 855.80,P<0.05). Conclusions Ditan Xingnao Chengqi soup has a relatively good effect on antagonizing inflammatory factors,controlling excessive inflammatory response and improving disturbance of consciousness. The early intervention with this agent for a patient with sepsis cognitive impairment can control the disease situation,improve the patient's prognosis and reduce his or her hospitalization costs.