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Objective:To explore the clinical value of peripheral remnant lipoproteins (RLP), low density lipoprotein cholesterol particle (LDL-P) and sdLDL particle (sdLDL-P) measurement in the diagnosis of carotid plaque, so as to provide practical basis for the accurate diagnosis of carotid plaque and the control of carotid plaque related cardiovascular and cerebrovascular diseases.Methods:People who underwent carotid plaque ultrasound examination in Xingtai Third Hospital , from January 2020 to June 2021 were selected as the research object. According to the ultrasound results, they were divided into carotid plaque group ( n=146) and control group without carotid plaque ( n=149). The fasting RLP, LDL-P and sdLDL-P of the two groups were measured by vertical auto profile (VAP) centrifugal separation phase, and the fasting TG and LDL-C were detected by routine mixed phase method. The indexes were compared between the two groups and the true positive rate, true negative rate, false positive rate and false negative rate of the diagnosis of carotid plaque were analyzed. The receiver operating characteristic curve of each test index was drawn, and AUC was used to evaluate the clinical diagnostic value of each test index for carotid plaque. Results:The levels of RLP, LDL-P and sdLDL-P in carotid plaque group were significantly higher than those in non-carotid plaque group ([1.07±0.36] mmol/L vs [0.59±0.17] mmol/L,[1 300±370] nmol/L vs [781±215] nmol/L,[435±139] nmol/L vs [156±59] nmol/L, all P<0.01). The true positive rate (78.08% [114/146],81.51% [119/146]) and true negative rate (84.56% [126/149], 86.58%[129/149]) of serum RLP and LDL-P for the diagnosis of carotid plaque were significantly higher than TG (58.90%[86/146], 43.62%[65/149]) and LDL-C (59.59% [87/146], 46.98% [70/149]), and the false positive rate (15.44% [23/149], 13.42% [20/149]) and false negative rate (21.92% [32/146], 18.49% [27/146]) were significantly lower than TG (56.38% [84/149], 41.10% [60/146]) and LDL-C (53.02% [79/149], 40.41% [59/146], all P<0.01). The AUC of the ROC curve of RLP (0.890), LDL-P (0.902) and sdLDL-P (0.973) for the diagnosis of carotid plaque was higher than TG (0.682) and LDL-C (0.712). The AUC of ROC curve of the RLP combined with sdLDL-P (0.977) for the diagnosis of carotid plaque was higher than the RLP and sdLDL-P (all P<0.01). Conclusion:The serum RLP, LDL-P and sdLDL-P can be used as indicators of carotid plaque, and their clinical diagnostic value are superior to TG and LDL-C; the combined diagnostic effect of lipoprotein subclass is better than that of single index alone.
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【Objective】 To explore the effect of massive blood transfusion on inflammatory factors, islet B cell function, incidence and mortality of multiple organ dysfunction syndrome (MODS) in patients with severe traumatic hemorrhage. 【Methods】 214 traumatic hemorrhage patients who received blood transfusion and were hospitalized in the Third People′s Hospital of Xingtai from January 2015 to June 2019 were enrolled and divided into the routine blood transfusion group (n=118) and massive blood transfusion group (n=96) according to the amount and method of blood transfusion. The changes of the inflammatory factors such as TNF α and IL-6, the functional indexes of Islet B cells such as HOMA-B and Δ INS30 / Δ GLU30, and the incidence and mortality of MODS in two groups 3 d after blood transfusion were observed. 【Results】 The level of TNF α(ng/L), IL-6(ng/L), HOMA-B and Δ INS30 / Δ GLU30 were (64.21±8.41) vs (30.75±5.26), (216.52±17.99) vs (152.45±16.26) (58.55±10.23) vs (103.47±17.48) and (2.95±0.69) vs (5.87±1.30) in the massive transfusion group and routine transfusion group, respectively (P<0.01). The incidence of MODS was 63.54%(61/96) vs 40.07%(52/118)(P<0.01) while the mortality of MODS was 46.88%(40/118) vs 33.90% (P>0.05). 【Conclusion】 The massive blood transfusion could increase the incidence of MODS in patients with severe traumatic hemorrhage by promoting inflammatory reaction and dysfunction of islet B cells.
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Objective To observe the influence of IL-12,IL-15 on CIK cell in the normal culture;to observe the anti-tumor effect in the circumstance of different combination of cytokines,and to provide a new insight for preparing high effective and qualified CIK cell in vitro.Methods The optimal concentrations of IL-2,IL-12 and IL-15 were determined,respectively.After the peripheral blood from healthy blood donors was collected,monocytes were selected and co-cultured with different cytokines into different groups,as group A(IL-2 normal culture group),group B(IL-2 and IL-12 group),group C(IL-2 and IL-15 group),group D(IL-2,IL-12 and IL-15 group),and group E(cytokine control group).The monocytes in different groups were calculated by globulimeter,the activity of cells was detected by Trypan blue staining,positive ratio of CD3,CD8,CD56 on the celluar membrane was detected by flow cytometry,and the anti-tumor effect of CIK to SMMC-7721 was detected by MTSmethod,inthedayof0,5,10,15,20 after the culture.Results Statistical analysis indicated that,the proliferation multiplication of CIK cells was significantly higher in group B,group C and group D after 10,15 and 20 days of culture than those in group A(P＜0.05);and group D had higher proliferation multi-plication than that of group C(P＜0.05).The percentage of CD3 + CD8 +,CD3 + CD56+ in CIK cell membrane in group B,C,D was significantly higher than that in group A after 15 and 20 days of culture (P＜0.05).The percentage of CD3+ CD8+,CD3+ CD56+ in CIK cell membrane in group D was significantly higher than that in group B after 15 and 20 days of culture (P＜0.05).The killing rate of CIK cells for liver cancer in each group at 10,15,20 days of culture was significantly higher than that of group A when the target target ratio was 5 ∶ 1 (P＜0.05).The killing rate of CIK cells for liver cancer in group D,C at 10,15,20 days of culture was significantly higher than that of group B(P＜0.05).Conclusion IL-12and IL-15 could improve the proliferation of CIK cells,and IL-15 also has the effect of enhancing CIK cells the tumor-killing to SMMC-7721 activity.
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Objective To analyse the relationships between islet β-cell function and infection,inflammation and major organ function in multiple organ dysfunction syndrome (MODS) patients with severe traumatic hemorrhage.Methods A total of 187 cases of MODS patients hospitalized in the 94th Hospital of PLA from January 2013 to January 2016 were selected,and were divided into the MODS survival group (MODS-S group,104 cases) and MODS dead group (MODS-D group).Other 100 healthy subjects were selected as the control group.The fasting blood glucose (GLU0) and insulin (INS0) levels,blood glucose (GLU30) and insulin (INS30) levels after 30 min of glucose loading,and levels of soluble triggering receptor expressedon myeloid cells-1 (sTREM-1),tumor necrosis factor-α (TNF-a),interleukin-6 (IL-6),alanine aminotransferase (ALT),creatinine (Cre) and creatine kinase isoenzyme (CK-MB) in different groups were determined.The insulin-β-cell function was evaluated by homeostasis model assessment of β-cell function (HOMA-β) index and ratio of insulin increment and blood glucose increment after 30 min of glucose loading (ΔINS30/ΔGLU30),and their relationships to other indexes,including sTREM-1,TNF-α,IL-6,GLU0,ALT,Cre and CK-MB,in MODS patients with severe traumatic hemorrhage were analysed.Results The HOMA-β and AINS30/AGLU30 ratio in the MODS-D group were lower than those in the MODS-S group,and levels of sTREM-1,TNF-α,IL-6,ALT,Cre and CK-MB in the MODS-D group were higher than those in the MODS-S group,there were statistically significant differences (P＜0.01).In MODS patients with severe traumatic hemorrhage,HOMA-β and ΔINS30/AGLU30 was both negatively correlated with sTREM-1,TNF-α,IL-6,GLU0,ALT,CreandCK-MB (r=-0.356 4,-0.532 1,-0.345 8,-0.772 1,-0.762 5,-0.684 8,-0.606 4;r=-0.428 5,-0.567 8,-0.487 0,-0.743 6,-0.781 7,-0.717 6,-0.640 1,P＜0.01).Conclusion MODS patients with severe traumatic hemorrhage have islet β-cell dysfunction which may be used as a prognostic and diagnostic indicator.
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Objective To analyse the relationships between islet β-cell function and infection,inflammation and major organ function in multiple organ dysfunction syndrome (MODS) patients with severe traumatic hemorrhage.Methods A total of 187 cases of MODS patients hospitalized in the 94th Hospital of PLA from January 2013 to January 2016 were selected,and were divided into the MODS survival group (MODS-S group,104 cases) and MODS dead group (MODS-D group).Other 100 healthy subjects were selected as the control group.The fasting blood glucose (GLU0) and insulin (INS0) levels,blood glucose (GLU30) and insulin (INS30) levels after 30 min of glucose loading,and levels of soluble triggering receptor expressedon myeloid cells-1 (sTREM-1),tumor necrosis factor-α (TNF-a),interleukin-6 (IL-6),alanine aminotransferase (ALT),creatinine (Cre) and creatine kinase isoenzyme (CK-MB) in different groups were determined.The insulin-β-cell function was evaluated by homeostasis model assessment of β-cell function (HOMA-β) index and ratio of insulin increment and blood glucose increment after 30 min of glucose loading (ΔINS30/ΔGLU30),and their relationships to other indexes,including sTREM-1,TNF-α,IL-6,GLU0,ALT,Cre and CK-MB,in MODS patients with severe traumatic hemorrhage were analysed.Results The HOMA-β and AINS30/AGLU30 ratio in the MODS-D group were lower than those in the MODS-S group,and levels of sTREM-1,TNF-α,IL-6,ALT,Cre and CK-MB in the MODS-D group were higher than those in the MODS-S group,there were statistically significant differences (P＜0.01).In MODS patients with severe traumatic hemorrhage,HOMA-β and ΔINS30/AGLU30 was both negatively correlated with sTREM-1,TNF-α,IL-6,GLU0,ALT,CreandCK-MB (r=-0.356 4,-0.532 1,-0.345 8,-0.772 1,-0.762 5,-0.684 8,-0.606 4;r=-0.428 5,-0.567 8,-0.487 0,-0.743 6,-0.781 7,-0.717 6,-0.640 1,P＜0.01).Conclusion MODS patients with severe traumatic hemorrhage have islet β-cell dysfunction which may be used as a prognostic and diagnostic indicator.
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OBJECTIVE:To study the therapic effect of soluble cluster of differentiation (sCD14) and soluble tumor necrosis factor receptor-P55(sTNFR-P55) on the inflammation,insulin resisitance and insulin secretion of serious scalded mice. METHODS: The lecels of mortality, peripheral white blood cell(WBC), Homeostasis Assessment-Insulin Resistance (HOMA-IR) and Homeostasis Assessmen-?(HOMA-?),fasting glucose, fasting lactic acid of the scalded mice treated individually by infusion with sCD14,sTNFR-P55,and both the sCD14 and sTNFR-P55, were examined compared with that of the control. RESULTS: The mortality of the scalded mice treated both by infusion with both of sCD14 and sTNFR-p55,were lower than that of the control(P
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OBJECTIVE:To study the effects of soluble cluster differentiation 14 (sCD14) on serum pro-and anti-inflammatory cytokines in mice with serious scald endotoxemia. METHODS: A total of 60 healthy Kunming mice were randomly assigned to sCD14 (5 mg?kg-1) group, treatment control group (normal saline) and normal control group (normal saline). The first two groups were established into scald model (scald of 30% body surface area, Ⅲ degree scald) followed by intravenous injection of the corresponding drugs in every 12 h via vena caudalis for 3 consecutive days. On day 4, the model mice were sacrificed to obtain the serum sample for the detection of levels of proinflammatory cytokines (TNF?, IL-6) and anti-inflammatory cytokines (IL-4 and IL-10). RESULTS: In sCD14 treatment group, serum levels of TNF?, IL-6 were significantly lower than in treatment control group (P
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OBJECTIVE:To evaluate the effects of the individualized treatment with GIK(Glucose-insulin-potassium)polarized solution on the discharged surgical patients with hyperglycemia.METHODS:2 287 surgical patients with hyperglycemia(including 125 who had diabetes before hospitalization)receiving individualized treatment with GIK(Glucose-insulin-potassium)polarized solution and who had been discharged from hospital for 1 year were surveyed by questionnaire to collect the data of adverse drug reactions of the polarized solution.RESULTS:None of the patients had secondary diabetes mellitus,hypertension,hypoglycemia or psychological dependence on insulin;0.6% worried about the sequela of GIP;98.5% of the patients who had diabetes prior to hospitalization and have been taking insulin after been discharged from hospital agreed that the symptom of their diabetes was greatly lessened by insulin;100.0% of the patients who had diabetes prior to hospitalization and received no insulin after been discharged from hospital agreed that taking large dose of insulin during hospitalization had no effect on the symptom of their diabetes or hypertension;99.3% of patients received supplemental nutrition of polarized solution;96.9% given hyperglycemia control;38.3% received antiinflammation therapy,5.5% received protective therapy for ? cell function.CONCLUSION:Individual treatment with GIK on the surgical glycemia patients is a safe remedy without sequela.But a few of surgical glycemia patients are afraid of the ADR of the polarized solution,suggesting the importance of publicizing the use of GIK.
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Objective To investigate the relationship of hyperglycemia to trauma score,infection,MODS and survival time of the dead patients caused by trauma.Methods A total of 455 cases of dead trauma patients selected randomly from our hospital,were divided into two groups with normal blood glucose(n=57) or hyperglycemia(n=298).The RTC,GCS and the cases of infection and MODS as well as the survival time of two groups were recorded,and the coefficients of relationship between the blood glucose and the indexes of MODS in the dead trauma patients were calculated.Results The levels of RTC,GCS in the group with hyperglycemia were higher than that with normal blood glucose(P