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Objective To investigate the risk factors and prognosis of persistent inflammation-immunosuppressive catabolism syndrome (PICS) in malignant tumor patients with lung infection after chemotherapy.Methods A total of 128 malignant tumor patients with pulmonary infection after chemotherapy from January 2014 to January 2018 in Jilin Cancer Hospital were collected.According to whether the patients were complicated with PICS,the patients were divided into the PICS group (44 cases) and the control group (84 cases).The clinical characteristics and prognosis of the two groups were compared,and the risk factors of PICS during hospitalization were analyzed.Results The acute physiology and chronic health evaluation (APACHE) Ⅱ score and sequential organ failure assessment (SOFA) score in the PICS group were higher than those in the control group [(18.6±3.8) vs.(15.9±4.0),t =3.598,P ＜ 0.01;(4.8±1.5) vs.(4.0±1.6),t =2.832,P =0.005].When compared with the control group,the proportion of lung cancer in the PICS group was increased [47.7％ (21/44) vs.23.8％ (20/84),x2 =8.378,P =0.006],and the albumin was decreased [(28.8±3.3) g/L vs.(30.8±2.9) g/L,t =3.695,P ＜ 0.01],the C reactive protein was increased [(60±8) mg/L vs.(45±8) mg/L,t =9.520,P ＜ 0.01],hospital duration was prolonged [(33±7) d vs.(26±7) d,t =4.820,P ＜ 0.01],hospital mortality was increased [22.7％ (10/44) vs.4.8％ (4/84),x2 =9.567,P =0.002].Multiple factor logistic regression analysis showed that the APACHE Ⅱ score ＞ 20,lung cancer and the albumin ＜ 30 g/L were the risk factors for PICS in the malignant tumor patients with lung infection after chemotherapy (all P ＜ 0.05).Conclusion The incidence of PICS in malignant tumor patients with pulmonary infection after chemotherapy is high,and the risk factors for the poor prognosis include APACHE Ⅱ score ＞20,lung cancer and the albumin ＜30 g/L.
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Objective To explore the value of hydronephrosis volume measured by 64 slice CT scan, evaluating renal function in patients with obstructive hydronephrosis.Methods The patients performed with both single photon emission computed tomography(SPECT) renal dynamic imaging and 64 slice CT scan in three days were chosen, 176 cases included finally.The images of renal dynamic imaging were divided into normal renal function group, mild renal impairment group, moderate renal impairment group and severe renal impairment group according to glomerular filtration rate (GFR) measured by SPECT.At the same time, CT three-dimensional reconstruction technique has been used to measure the volume of hydronephrosis, compare the differences of hydronephrosis volume among these groups, and future analyze the correlation of hydronephrosis volume with renal GFR value.Results The hydronephrosis volume of the four groups were respectively (31.47±3.81) cm3,(83.43±7.81) cm3,(208.53±15.47) cm3 and (577.31±61.32) cm3.There was statistical significance among these groups (P<0.01),except between normal renal function group and mild renal impairment group.The volume of hydronephrosis showed positive correlations with renal GFR (r=-0.614).Conclusion The volume of hydronephrosis measured by 64 slice CT has positive correlation with GFR measured by SPECT, which could reflect renal function to some extent.
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Objective To study the clinical significance of monitoring the urine iodine level in pregnant women.Methods The urine iodine levels were detected in 391 cases of pregnant women.The relativity was analyzed among the pregnancy gestation,pregnancy complications and the urine iodine levels.The corresponding health educa-tion of iodine nutritional knowledge was conducted according to the results of the determination.Results (1 )The urine iodine value was (124.73 ±70.61)μg/L in 391 pregnant women.The severe deficiency iodine rate,deficiency iodine rate and appropriate iodine rate of pregnant women were 37.85%,64.70% and 25.06%,respectively.(2) There was no significant difference in values of urine iodine among the pregnant women during the first,second and third trimester of pregnancy[(121.76 ±71.81)μg/L,(125.52 ±69.28)μg/L,(129.30 ±75.19)μg/L](t≤0.59, all P >0.05).The mean values were all lower than the appropriate values of WHO(150 ~249 μg/L).The low iodine rates were 67.20%,63.23% and 65.12%,respectively.There was no significant difference among them(χ2 =0.56, P >0.05 ).(3 )The urine iodine value of the pregnant women complicated with hyperthyroidism [(85.76 ± 53.09)μg/L]was significantly lower than that of primary hypothyroidism combined with pregnancy [(133.65 ± 73.41)μg/L],pregnancy combined with subclinical hypothyroidism[(136.50 ±79.19)μg/L]and no pregnancy complication[(119.34 ±66.43)μg/L](t≥2.76,P <0.01).The rate of iodine deficiency(87.88%)was highest (χ2 =8.72,P <0.05).(4)The urine iodine value after iodine nutrition intervention was significantly higher than those before in 77 pregnant women[(129.74 ±68.04)μg/L vs.(107.01 ±74.36)μg/L,t =1.98,P <0.05].The iodine deficiency rate dropped from 79.22% to 63.64%(χ2 =4.58,P <0.05).Conclusion In order to improve the appropriate iodine rate of pregnant women,it should be very important significance on monitoring the urine iodine level of pregnant women in particular with a complication of pregnancy and conducting iodine nutrition intervention in whole pregnancy gestation.
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Objective To investigate the clinical value of the decfion of percentage of pulmonary perfusion defect score (PPDS％) in patients with pulmonary embolism (PE).Methods A retrospective study was carried out on PPDs％ data of patients(n =36) with clinical confirmed PE.The patients were divided into three levels:low (PPDS％ ＜30％),medial (30％ ≤PPDS％ ＜50％) and high (PPDS％ ≥50％) risk groups,according to the standard of PPDs％ diagnosis.the PPDS％ and the incidence rate of the clinical adverse events were compared in mild,moderate and severe risk PE.The therapeutic results were compared with the PPDS％ changes.Results The mild,moderate and severe risk patients with PE were 15 cases,13 cases and 8 cases respectively,according to the standard of PPDS％ diagnosis.16 cases,12 cases and 8 cases respectively,according to the standard of 2008 ESC APE diagnosis and treatment guidelines.The uniform rate was 94.4％ for two methods,the uniform rate was 100.0％ in which high risk of PE.The PPDS％ of PE was (46.2 ± 4.6) ％ before treatment.The data was significantly higher than that post treatment (31.6％ ± 1.8％) (t =17.38,P ＜ 0.01).The scores of low,medial and high risk patients were (25.9 ± 3.9) ％,(45.6 ± 4.3) ％ and (58.4 ± 4.9) ％ (t =6.18,P ＜ 0.01),respectively.The mild,moderate and severe risk PE according to the PPDS％ standard with clinical adverse events for were 1 cases (6.5％),3 cases (23.0％) and 5 cases (62.5 ％) respectively,with a significant difference (x2 =8.71,P ＜ 0.05).Conclusion PPDS％ could be used as an important reference index for risk stratification of diagnosis,evaluating therapeutic efficiency and predicting the prognosis in patients with PE.
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Objective To evaluate the clinical value of the upper extremital artery supply and vein running back in the patients after peripheral vascular surgery by Na99mTcO4 trace imaging(TTI).Methods SPECT static imaging was performed on 36 patients after peripheral vascular surgery in vein injecting Na99mTcO4 740 MBq 5min.The radioactivity uptake of operated limb(finger)/normal limb(finger) ratio(T/NT) was analyzed using region of interest analysis.0,Ⅰ,Ⅱand Ⅲ scales were classified according to their radionuclide distribution and T/NT,were divided into A,B,C and D group,respectively.Localy warming and anticontrctive therapy were only given in A and B group for 30min,routine therapy in C group,and raising operated limb (finger) and reductive pressure treatment in D group.Then,exploratory surgery was performed on 0 scales and Ⅲ scales of TTI again.Results A,B,C and D group were 11,7,13 and 5 patients,their T/NT was (0.142 ± 0.058),(0.384 ± 0.046),(0.794 ± 0.072) and (1.12 ±0.076),respectvely,and there were significant differences among the groups(t =2.33a,4.33b,6.90b,2.59a,5.73b,2.12a,aP ＜ 0.05,b P ＜ 0.O1) ;TTI again showed:there were 7 cases of 0 scales (arterial thrombosis was confirmed by exploratory surgery) and 4 cases of Ⅰ scales in A group,3 cases of Ⅰ scales and 4 cases of Ⅱ scales in B group,all 13 cases of Ⅱ scales in C group,4 cases of Ⅱ scales and 1 case of Ⅲ scales(vein thrombosis was confirmed by exploratory surgery) in D group.Conclusion TTI could play an important role in economical,simple and notraumatic diagnosing the extremital artery supply and vein running back in the patients after peripheral vascular surgery.
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Objective To investigate the clinical value of percentage of pulmonary perfusion defect score ( PPDs％ ) for risk stratification and prognosis evaluation in patients with acute pulmonary embolism (APE).Methods A retrospective study was carried out on PPDs％ data of patients( n =21 ) with confirmed APE from January 2001 to December 2008.The patients were divided into three levels,low( n =10),medial( n =7) and high risk groups( n =4),according to 2008 ESC APE diagnosis and treatment guidelines.The reference index in predicting risk stratification by PPDs％ was ascertained.34 patients with confirmed APE were divided into three levels ( mild,moderate and severe risk levels) according to the standard of PPDS％ diagnosis from January 2009 to June 2011.A prospective study on the incidence rate of the clinical adverse events was performed.Results The PPDs％ of low,medial and high risk levels according to 2008 ESC guidelines were (25.94 ± 3.95 ) ％,(45.63 ± 4.38 ) ％ and ( 58.42 ± 4.96 ) ％ respectively,with a significant difference ( t ≥4.755,P ＜ 0.01 ).The standard of PPDS％ diagnosis for risk stratification was confirmed in APE:low risk levels:PPDs％ ＜ 30％,moderate:30％ ≤ PPDs％ ＜50％,and high:PPDs％ ≥50％.The mild,moderate and severe risk patients with APE were 17cases,11cases and 6cases respectively,according to the standard of PPDs％ diagnosis,or 15cases,13cases and 6cases respectiveldy,according to the standard of 2008 ESC guidelines.The uniform rate was 94.11％ for two methods; the uniform rate was 100.00％ in which high risk of APE.The mild,moderate and severe risk patients with APE according to the standard of PPDs％ standard with clinical adverse events for were 1case (5.89％ ),3cases (27.27％ ) and 4cases (66.67％ ) respectively,with a significant difference ( x2 =9.23,P ＜0.01 ).Conclusions PPDs％ could be used as an important reference index for risk stratification of diagnosis,selecting therapeutic programs,evaluating therapeutic efficiency and predicting the prognosis in patients with APE.
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Objective To evaluate the effect of early limited fluid resuscitation in treatment of severe pelvic fracture accompanied with traumatic hemorrhagic shock. Methods A retrospective study was done on 96 patients with severe pelvic fractures accompanied with traumatic hemorrhagic shock admitted into hospital from January 2002 to December 2006. Of all, 55 patients ( routine resuscitation group)were dealt with routine fluid resuscitation and 41 (limited resuscitation group) with limited fluid resuscitation. The injury severity, degree of shock, start time of resuscitation, transfusion volume were statistically analyzed and compared in two groups. Results Routine resuscitation group received transfusion volume of (3 432 ± 1 156) ml, with cure rate of 64% and mortality rate of 36% ; while limited resuscitation group received transfusion volume of (2 685 ± 524) ml, with cure rate of 83% and mortality rate of 17%. There was statistical difference between both groups ( P ＜ 0.05 ). Conclusion Limited fluid resuscitation can improve cure rate of severe pelvic fracture accompanied with traumatic hemorrhagic shock.
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Objective To study the renal protective effects of ulinastatin in rats with multiple organ dysfunction syndrome(MODS). Methods Thirty-six Wistar rats were divided into 3 groups:control group ,model group and treatment group. The MODS models were produced by injecting lipopolysaccharide(LPS) through the sublingual vein into the rats. Ulinastatin was injected into the sublingual vein of the rats in treatment group, LPS was injected into rats in the same way after 10 minutes. On the second hour and the sixth hour after treatment, serum and renal tissue samples were collected from the rats to determine the level of TNF-?,IL-6, IL-1?, iNOS by RIA.The pathologic changes of renal tissue was examined. Results The levels of TNF-?,IL-6, IL-1?, iNOS of serum and renal tissue in treatment group were obviously lower than in model group (P
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Objective To investigate the effect of oxygen free radicals on the myocardial injury in acute MODS.Methods Thirty-six SD rats were randomly divided into two groups.The rats of experimental group were peritoneally injected with the suspension of zymosan-parogen.The rats of control group were injected with steriled saline at the same volume.The dynamtic change of LPO,SOD,myocardial enzyme in plasma and MDA,SOD in myocardial tissue at different time point were detected.The pathologic change of myocardial tissue by HE staining was observed.Results Compared with the control group,the LPO,MDA,CKMB,LDH,GOT in plasma and myocardial tissue increased at 6 hours (P
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Objective To study the effects of chloroquine on proliferation and cell cycle of hepatocellular carcinoma cell line HepG2 cultured in vitro and provide basis for research on chloroquine in therapy for liver cancer.Methods HepG2 cells were divided into six groups:control group and chloroquine (8.00,16.00,32.00,64.00 and 128.00 mmol?L-1 )groups.The cell viability was determined by MTT,the cell cycle and apoptosis were detected by flow cytometry.Results Compared with control group,the cell viabilities were inhibited significantly 24 h after treated with chloroquine (32.00-128.00 mmol?L-1) or 48-72 h after treated with chloroquine (8.00-128.00 mmol?L-1) ( P
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Aim To study protective effects of ulinastatin on injury of organs in rats induced by endotoxin.Methods 36 Wistar rats were divided into 3 groups: control group,model group and treatment group.The model of injury of organs were induced by injecting lipopolysaccharide(LPS) through the sublingual vein into rats.Ulinastatin was injected into the sublingual vein of rats in treatment group,LPS was injected into rats in the same way after 10 minutes.At the second hour or the sixth hour after treatment,serum and lung,liver and renal samples were cellected from rats to determine levels of TNF-?,IL-6,IL-1?and iNOS by RIA.Pathologic changes of lung,liver and renal organ were examined.Results Levels of TNF-?,IL-6,IL-1?,iNOS of serum and renal organs in treatment group were obviously reduced than those in model group(P
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Objective To evaluate the clinical diagnostic criteria of latent autoimmune diabetes of adults(LADA).Methods A total of 268 subjects consisted of 168 patients with type 2 diabetes(T2DM) and of 100 normal controls were involved in the study.The body mass index(BMI) was calculated by formula(kg/m~2) and the levels of fasting blood glucose(FBG),postprandial blood glucose(PBG),fasting C-peptide(FC-P),postprandial Cpeptide(PC-P),GAD antibody(GADA),ICA,IAA and IA-2 antibody were detected. The patients with positive antibody in T2DM group were considered as LADA and the others in T2DM group still as T2DM.Results The GADA,ICA,IA-2 antibody and IAA antibody were detected in 21.18%,14.29%,1.19% and 0.60% of patients with T2DM,respectively.The indexes such as the age of onset ≤ 40 years old,overt symptom,ketosis,without chronic complication and hypertension,BMI90.00%).Conclusion The GADA is the most specific antibody in the diagnosis of patients with autoimmune diabetes.The indexes such as the age of onset≤40 years,overt symptom,ketosis,without chronic complication and hypertension,BMI