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Objective:To evaluate the prognostic accuracy of the sequential organ failure assessment (SOFA), quick sequential organ failure assessment (qSOFA) and systemic inflammatory response syndrome (SIRS) criteria in predicting the mortality in patients with infection or suspected infection by using network Meta-analysis.Methods:Five databases including Wanfang Data, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), PubMed, Web of Science were searched from February 23, 2016 to September 5, 2020 to identify the relevant literatures comparing the prognostic accuracy of two or more scores for mortality in patients with infection or suspected infection. The literatures screening, data extraction and the quality assessment of the included studies were all conducted independently by two reviewers. Stata 14.0 software was used to test the heterogeneity between the original studies of pairwise comparison of each of the three scoring systems. Ring inconsistency test was used to judge the consistency between direct comparison and indirect comparison. Then network Meta-analysis was performed and the results were ranked. The predictive ability of the three scoring systems was evaluated by surface under cumulative ranking curve (SUCRA). A "comparison-correction" funnel plot was drawn to assess whether there was publication bias in the included studies.Results:A total of 38 studies were enrolled, the overall quality was high. Network meta-analysis showed that SOFA had a great prognostic performance in predicting mortality for patients with infection or suspected infection, which was followed by qSOFA [mean difference ( MD) = 0.07, 95% confidence interval (95% CI) was 0.05-0.09] and SIRS scores ( MD = 0.16, 95% CI was 0.14-0.18), and the qSOFA score was better than SIRS score ( MD = 0.09, 95% CI was 0.07-0.11). In the order of predicting the death risk of patients with infection or suspected infection, SOFA score had higher predictive value, followed by qSOFA score, and SIRS score was the lowest, with SUCRA values of 1.0, 0.5 and 0, respectively. Funnel plot showed that all the studies were distributed on both sides of the midline, but the distribution was not symmetrical, suggesting that there was a high possibility of publication bias and small sample effect. Conclusions:SOFA score had the best prognostic performance in predicting mortality of patients with infection or suspected infection as compared with qSOFA score and SIRS score. However, the funnel plot showed that included literatures may exist small sample effects or publication bias. So the final results should be validated by more prospective studies with multicenters and large samples.
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Objective To optimize the purification technology of total flavonoids from the Tripterospermi Chinensis Herba by macroporous resin. Methods The purification abilities of six kinds of macroporous adsorption resins for total flavonoids from Tripterospermi Chinensis Herba were studied with the adsorption and desorption rates as the index by static adsorption and desorption experiments. The column liquid concentration, adsorption rate, and the loaded amount were studied by using dynamic adsorption experiments. The optimal desorption technology was examined by orthogonal experiment. Results AB-8 macroporous resin was found to have good adsorption and desorption effects. The optimal purification conditions were as follows:the column liquid concentration was 5.285 mg/mL, adsorption rate was 2 BV/h;the loaded amount was 17.62 mg/mL. The sample was eluted by 10%ethanol with 4 BV and 50%ethanol of 5 BV at a flow rate of 4 BV/h. The purity of total flavonoids increased to 61.95% after the purification, and the yield was 87.28%. Conclusion This optimized process was stable, feasible and suitable for separation and purification of total flavonoids from Tripterospermi Chinensis Herba.
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Objective To explore the role of viral infection in the development of drug eruption in patients with HIV infection, and to evaluate the efficacy of antiviral treatment. Methods This study enrolled 87 HIV-positive patients, including 11 with and 76 without drug eruption, all of whom received highly active antiretroviral therapy(HAART). Clinical data on, baseline CD4+ and CD8+ T cell counts and CD4/CD8 ratio in these subjects were retrospectively analyzed. Results The severity of drug eruption was mild in the 11 HIV-positive patients, with a mean latency period of (14.00 ± 8.10)(range, 8 - 34)days. Of the 11 patients with drug eruption, 7 had liver function impairment, which was not in accordance with the severity of skin lesions. Drug eruption was controlled in all the 11 patients after anti-anaphylactic treatment without withdrawal of antiviral drugs. Compared with 75 HIV-positive patients without drug eruption, the 11 HIV-positive patients with drug eruption showed significantly increased baseline CD4 + T cell counts (493.00 ± 245.68 (range, 42 - 810)/μl vs. 347.81 ± 167.00 (range, 11 - 814)/μl, t = 647.50, P 0.05), CD4/CD8 ratio(0.40 ± 0.27 vs. 0.29 ± 0.16, P > 0.05), or percentage of patients with a CD4/CD8 ratio below the lower limit of normal (9/10 vs. 68/69 (98.55%), P >0.05). Conclusions The latency period of drug eruption seems to be long in HIV-positive patients receiving HAART, and mild drug eruption can be complicated by liver function impairment in the patients. Relatively high CD4 + counts may be a risk factor for the development and aggravation of drug eruption in HIV-positive patients.
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Objective To study the adsorption technology of piceid on macroporous resin. Methods The extraction condition of piceid, the types of macroporous resin, the concentration of the sample of Rhizoma Polygoni cuspidati extract, the flow velocity of samples during adsorption were investigated and the leak curve was drawed to ascertain the optimal sample quantity. Results Resin D101 gave a better adsorption performance in the following technological conditions:the concentration of the sample of Rhizoma Polygoni cuspidati extract was 0.7774 mg/mL, the flow velocity of sample during adsorption 3BV/h, the optimal adsorption capacity of the resin was 10.88 mg/mL. Conclusion The procedure was simple, feasible and can be applied to industrial production.
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OBJECTIVE:To optimize the extraction process for the preparation of Paeonia lactiflora formula granules and establish an HPLC method for the determination of Paeoniflorin in the samples.METHODS:The optimum water extraction process was selected by the L9(34)orthogonal design and the content of Paeoniflorin in formula granules was analyzed by HPLC.The HPLC assay was performed on a crosmosil C18-MS-II(250mm? 4.6mm,5? m)column.The mobile phase was employed by using acetonitrile-0.1% phosphoric acid(14∶ 86).The detection wavelength was set at 230 nm and the system was operated at 25℃.RESULTS:The optimum extraction conditions were to reflux for 3 times with 12 fold water and each time for one hour.The extraction rate of Paeoniflorin was 85.7% and the dried extraction yield was 34.4%.The peak area had a good linearity with the concentration of Paeoniflorin and the linear range was 0.128～ 0.640? g(r=0.999 8).The average recovery was 100.76% and RSD was 1.26%.CONCLUSION:The preparation process of Paeonia lactiflora formula granules was stable and feasible.The HPLC method for quality control was accurate and suitable.