ABSTRACT
OBJECTIVE@#To explore the predictive value of acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), quick sequential organ failure assessment (qSOFA) and modified early warning score (MEWS) in evaluating the prognosis of patients in intensive care unit (ICU) of secondary hospitals, and to provide guidance for clinical application.@*METHODS@#The clinical data of adult critical patients admitted to the ICU of Wanzhou District First People's Hospital from October 2022 to April 2023 were retrospectively analyzed. According to the clinical outcome of ICU, the patients were divided into improvement group and death group. The general information, blood routine, heart, liver and kidney function indicators, coagulation indicators, blood gas analysis, APACHE II score, SOFA score, qSOFA score, MEWS score at the time of admission to the ICU, the number of cases of invasive mechanical ventilation (IMV) and continuous blood purification (CBP) were compared between the two groups. Univariate analysis was performed, and multivariate Logistic regression analysis was used to analyze the related factors of death. Receiver operator characteristic curve (ROC curve) was used to analyze the predictive value of the four scores in ICU patients.@*RESULTS@#A total of 126 patients were included, of which 45 patients died in the ICU and 81 patients improved and transferred out. Univariate analysis of death-related critically ill patients showed that procalcitonin (PCT), serum creatinine (SCr), blood urea nitrogen (BUN), albumin (ALB), prothrombin time (PT), activated partial prothrombin time (APTT), D-dimer, pH value, HCO3-, blood lactic acid (Lac), number of patients treated with IMV and CBP, APACHE II score, SOFA score, qSOFA score and MEWS score were significantly different between the two groups (all P < 0.05). Multivariate Logistic regression analysis showed that the APACHE II score [odds ratio (OR) = 1.115, 95% confidence interval (95%CI) was 1.025-1.213, P = 0.011], SOFA score (OR = 1.204, 95%CI was 1.037-1.398, P = 0.015), MEWS score (OR = 1.464, 95%CI was 1.102-1.946, P = 0.009), and APTT (OR = 1.081, 95%CI was 1.015-1.152, P = 0.016) were independent risk factors affecting the mortality of critically ill patients in the ICU. ROC curve analysis showed that APACHE II, SOFA, qSOFA, and MEWS scores could predict the prognosis of critically ill ICU patients, among which SOFA score had the strongest predictive effect, and the area under the curve (AUC) was 0.808. There was a statistically significant difference in the time required for the four scores (F = 117.333, P < 0.001), among which the MEWS scoring required the shortest time [(1.03±0.39) minutes], and the APACHE II scoring required the longest time [(2.81±1.04) minutes].@*CONCLUSIONS@#APACHE II, SOFA, qSOFA, and MEWS scores can be used to assess the severity of critically ill patients and predict in-hospital mortality. The SOFA score is superior to other scores in predicting severity. The MEWS is preferred because its assessment time is shortest. Early warning score can help secondary hospitals to detect potentially critical patients early and provide help for clinical rapid urgent emergency decision-making.
Subject(s)
Adult , Humans , Sepsis/diagnosis , ROC Curve , Retrospective Studies , Critical Illness , Early Warning Score , Organ Dysfunction Scores , Intensive Care Units , Prognosis , HospitalsABSTRACT
Objective To explore the value of Helicobacter pylori( Hp) drug sensitivity test for clinical treatment of Hp infection and peptic ulcer. Methods Selected from February 2013 to October 2014 gastroenterology clinic in the hospital inpatient treatment and 120 patients( Steering Group) , of which 69 cases of gastric ulcer, duodenal ulcer 51 patients, mucosal lesions in patients took tissue culture Hp, Hp strain cultured to antibiotic susceptibility testing by disk diffusion method and based on susceptibility testing to guide treatment , alternative 120 cases of peptic ulcer patients as a routine group, ulcer treatment effect was observed between two groups and Hp eradication therapy.Results Steering group of 120 patients, 75 patients were successfully cultured Hp, susceptibility test results: the most sensitive to gentamicin(94.67%), followed furazolidone(88.00%), the lowest sensitivity to metronidazole(8.00 %);reviewed 4 weeks after treatment, ulcer healing rate of steering group of patients 93.33% was significantly higher than the end of treatment 4 weeks after the ulcer healing rate of regular group of 81.67%, steering group of patients with abdominal pain short time (3.5 ±1.5)d was significantly shorter than conventional group of patients(4.3 ±1.7) d; Hp eradication of steering group patients was 89.17%significantly higher than conventional group were 78.33% and the difference was statistically significant ( P<0.05 ) .Conclusion According Hp susceptibility testing, can choose Hp sensitive proton pump inhibitor combination of antibiotics amoxicillin treatment, can achieve more significant clinical effect.
ABSTRACT
Objective To establish the extraction process of Zhechong Chuangyu Capsule. Methods The difference of analgesic effect of water extraction and alcohol extraction in mice was observed by body-torsion test to determine the extract solvent. With the rate of aqueous extraction, n-butyl alcohol extraction and asperosaponin Ⅵ as evaluating indicator, the influencing factors including solvent volume, time and times of extraction were investegated to evaluate extracting procedure by orthogonal experiment. Results There was no obvious difference in analgesic effect between water extraction and alcohol extraction. Given the requirement of produce, aqueous extraction was a better choice. The optimum extracting condition was extracted 3 times with 20 folds volume of solvent, and extraction time was 150 minutes. Conclusion The extraction process is feasible to be applied into production.
ABSTRACT
The second class is not only a useful supplement to the first class but also an effective way to improve the comprehensive quality and ability of students.Through the deliberate research training and laboratory work,the second class of scientific research facilitates the medical students' developing scientific thinking,expanding professional knowledge,enhancing the ability to do scientific research and cultivating the spirit of teamwork.
ABSTRACT
Objective:The present study was designed to test the hypothesis that inflammation is involved in the end-organ damage(EOD) induced by sinoaortic denervation(SAD) in rats.Method:SAD was performed in male Sprague-Dawley rats at the age of 10 weeks.Under anaesthesia,aortic nerves were cut and the sinus region of the carotid artery was stripped and painted with 10% phenol.Pathological evaluation of EOD and the determination of plasma or tissue levels of the factors related to inflammation,including thromboxane B2(TXB2) interleukin-1(IL-1),tumour necrosis factor α(TNF-α) and reactive oxygen species(ROS) were performed at 16 weeks after SAD.Pathological evaluation of EOD included heart weigh ratio,myocardial and blood vessel hydroxyproline and collagen volume fraction,glomerular injury score and number of infiltrating inflammatory cells.Indomethacin(20 mg/kg per day,orally) or vitamin E(100 mg/kg per day,orally) was administered for 12 weeks,beginning from4 weeks after SAD,to observe their effects on SAD-induced EOD.Results:There were significant fibrosis and inflammatory infiltration in the myocardium and blood vessels,represented by higher hydroxyproline and collagen volume fraction,and a large amount of inflammatory cells in the tissues of SAD rats.Heart weight and kidney glomerular injury score were significantly higher in ed significantly after SAD.Indomethacin and vitamin E significantly decreased the contents of some factors related to inflammation in SAD rats.Both drugs also alleviated myocardial and vessel fibrosis,inflammatory infiltration and kidney damage.Conclusion:Inflammation is involved in the organ damage induced by SAD in rats.
ABSTRACT
Objective: To study the role of glucocorticoid i n the integration of sympathetic nervous system and cardiovascular activity. Methods: Neurons in the rostral ventrolateral medulla (RVLM) were extracelluarly recorded and identified as the presympathetic neurons of adult rats. The spontaneous discharge of the presympathetic neurons in the RVLM were observed by bolus intravenous injection of corticosterone (50, 100, 150 μg/kg） . Results: The firing rate of 12 presympathetic neurons was incr eased by intravenous application of corticosterone (P<0.05), and this effect showed a dose-dependent manner. The latency of excitatory effect was (104±2 5) s. Conclusion: Corticosterone can rapidly excite the presym pathetic neurons in the RVLM, this action might be involved in the integration o f sympathetic nervous system through the “rapid membrane effects”.
ABSTRACT
AIM To study the roles of non-genomi c mechanism of glucocorticoid in the integration of sympathetic nervous system. METHODS The spontaneous discharge of the identified cardiovascula r neurons in the rostral ventrolateral medulla (RVLM) were extracellularly recor ded in urethane-anaesthetized rats. The effects of microiontophoresis of cortic ostersone sulfate (CORT) on the discharge of the cardiovascular neurons in the RVLM were observed. The responses of RU 486 (a blocker for cytosolic glucocortic oids) to the effects of CORT on the cardiovascular neurons were investigated. RESULTS Totally 33 cardiovascular neurons in the RVLM were recorded , the firing rate of 25 (76%) cardiovascular neurons increased by microiontophor esis of CORT. The effects of CORT were also positively correlated with the curre nt. In 8 (24%) cardiovascular neurons, microiontophoresis of CORT had no effect on their spontaneous discharge. In 12 of 33 cardiovascular neurons, which discha rge increased by CORT, microiontophoresis of RU 486 had no responses to the base line discharge of these cardiovascular neurons (P>0.05), but completely (3 neurons) or partially (9 neurons) blocked the excitatory effect induced by CORT. CONCLUSION CORT had rapid excitatory effects on the cardiovascul ar neurons in the RVLM. RU 486 had no responses to the baseline activity of the cardiovascular neurons, and but completely or partially blocked the effect of CO RT on the cardiovascular neurons.
ABSTRACT
Objective:To explore the roles of the caudal ventrolateral medulla(CVLM) in the central anti-hypertensive mechanism. Methods : In 20 urethane-anesthetized SD rats, the effects of I1-imidazoline receptor and ?2-adrenceptor antagonists (microinjection into the CVLM) on the cardiovascular responses induced by intravenous clonidine were observed. Results: Prior bilateral microinjection of mixed antagonist idazoxan (I1-imidazoline receptor and a2-adrenceptor) into the CVLM not only decreased the mean arterial pressure [(-17. 3 ? 6. 9) mmHg, 1 mmHg = 0. 133 kPa, P
ABSTRACT
0.05), but completely (3 neurons) or partially (9 neurons) blocked the excitatory effect induced by CORT. CONCLUSION CORT had rapid excitatory effects on the Caldiovascular neuronsin the RVLM. RU 486 had no responses to the baseline activity of the cardiovascular neurons, and but completely or partially blocked the effect of CORT on the cardiovascular neurons.
ABSTRACT
In 23 cats of either sex anesthetized with nembutal, the AEPs(Averaged evoked potentials) were recorded in the paramedian midbrain area which either the HDM (Hypothalamic dorsomedial nucleus) or HP (Posterior hypothalamic nucleus) or HL (Lateral hypothalamic nucleus) and nearby structures were being stimulated. The responsive characteristics of the AEPs were tested with PST (Paired Stimuli) of defferent frequenencies. It was found that there are "spike-like" responses and "slow wave" in the cat's midbrain during hypothalamic stimulation . According to its responsiveness to electrical stimuli of increasing strength, the AEPs could be classified into two types: "graded" and "all or none" like. Of 75 AEPs elicited by stimulating the HDM, 24 could follow a PST with a freqency of more than 500Hz, 31 a PST with a frequency of 200-499Hz and 20 a PST with a frequency of less 199Hz. The midbrain responsive loci were mainly distributed in an area including central gray and adjacent tegmentum,but seldom in the tectum. On the basis of calculation of the conduction distance between the stimulating and recording sites and that of ahe latency of the response which could follow a PST with more than 500Hz, the conduction velocity over the path was estimated to be about 0.65-8.18m/sec., which was in the range of conduction velocity of thin myelinated and nonmyelinated fibers in the peripharal nerve. Results of the similar kind were obtained with HP or HL stimulations.But HL-MFB(medial forebrain bundle) stimulations elicited a AEP with a longer duration. These results were in agreement with those abtained in the rat, they showed some responsive characteristics belonging to the cat's brain, i.e. the wider spectrum of conduction velocity, the more restricted area for the appearance of a given midbrain response, and the predominant distribution of responsive loci within the central gray and ventral tegmentum adjacent to it.
ABSTRACT
AEPs were recorded at 1046 paramedian midbraih sites in 31 cats of both sexes when electrical stimulations were applied to 46 points within the HVMs after the cats had been anesthetized with nembutal and paralyzed with flaxedil. In the 103 responsive sites where AEPs were recorded, 151 fast wave responses were obtained. When the HVM was stimulated with electrical pulses of increasing intensity, two types of midbrain responses were recorded:"graded" and "all or none". Responsiveness of AEPs was tested for using paired stimui (PST) of different frequencies. Of the 111 AEPs tested, 38 could follow PST above 500Hz, 27 between 200-499Hz, and 46 under 199Hz. In order to test the responsiveness of AEPs further, short trains of pulses were applied. The results suggested that there might be both transsynaptic and direct connections between the two brain regions. According to calculations,the conduction velocity over this path was about 0. 29-4. 1m/sec., similar to the conduction velocity in thin myelinated and nonmyelinated fibers of the peripheral nerve. On the basis of the electrophysiological and histological data, it is suggested that there might be a topographical organization between HVM and mesencephalic central gray in dorsal-dorsal ventral-ventral direction. Some characteristics of responses which may belong to central axons are described. Advantages of the method of combining PST test with short train test in the evaluation of responsveness of the neural tissues are discussed..
ABSTRACT
To observe the changes of endothelin(ET) and atrial natriuretic peptide(ANP) lev-els in chronic hypoxic pulmonary hypertensive rats and discuss their mechanism. Methods: We duplicatedthe models of chronic hyp0xic pulmonary hypertensive rats and tested the concentrations of ET and ANP ofplasma and cardiac tissue by radioimmunoassey. Results: In pulmonary hypertension group, plasma ET,plasma ANP and myocardial ET levels increased more significantly than those of controls,except that my-ocardial ANP concentration decreased. There were positive c0rrelati0ns between plasma ET level and plas-ma ANP level and between plasma ET level and myocardial ET level, but a negative correlation betweenplasma ANP level and myocardial ANP level. C0nclusion: It is suggested that the synthesis and secretionof ET and ANP increase in pulmonary hypertension,and therefore provides reference to clinical diagnosisand therapy.
ABSTRACT
Objective: To observe the expression of the G-protein-coupled-receptor 14 (GPR14), urotensinⅡreceptor, in the cardiovascular system and brain of SD rats. Methods: Semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the GPR14 mRNA. Results: In cardiovascular system, GPR14 mRNA was detected in the left ventricle, left atrium, thoratic aorta and carotid aorta. The highest level of expression was found in the left ventricle. In the brain, GPR14 mRNA was detected in cortex, hippocampus, hypothalamus and cerebellum, and higher level of expression was found in the cerebellum. Conclusion: GPR14 mRNA expression is found in the cardiovascular and neural tissues of tested rat, suggesting that urotensinⅡ may play an important role in cardiovasculature and central nervous activity.
ABSTRACT
To evaluate the role of the vagal afferents in the generation and formation of high frequency oscillation (HFO), effect of selective electrical stimulation of A?-? afferent fiber groups of the vagus nerve (0.4-0.5 V, 0.1ms, 5-160 Hz), applied at three respiratory phases: inspiratory phase (IS), expiratory phase (ES), and continuous phase throughout both IS and ES (CS), on the phrenic HFO was quantitatively assessed on ether-anesthetized, vagotomized, paralyzed and artificially ventilated rabbits. After calculation of the power spectrum of the efferent phrenic nerve activity, the mean square values (MSV), representing total amount of HFO-output, and the peak frequency of the HFO were estimated by means of curve-fitting method. Regardless of the mode of the stimulation, the MSV decreased in a stimulus-frequency dependent fashion. The CS was most potent, then IS, and ES was less effective, though the reduction was significant (p