ABSTRACT
Objective:To investigate the clinical characteristics and influencing factors of mortality in patients with intra-abdominal candidiasis (IAC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 203 IAC patients who were admitted to 7 medical centers from June 2018 to June 2020 were collected, including 54 cases in Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, 31 cases in Fujian Medical University Union Hospital, 25 cases in Beijing Hospital, 25 cases in the First Affiliated Hospital of Xi'an Jiaotong University, 24 cases in China-Japan Friendship Hospital, 22 cases in General Hospital of Eastern Theater Command of Chinese PLA and 22 cases in Chongqing University Cancer Hospital. There were 130 males and 73 females, aged (64±15)years. Observation indicators: (1) candida infection and treatment of IAC patients; (2) analysis of influencing factors for mortality of IAC patients. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate and multivariate analyses were performed by Logistic regression model. Results:(1) Candida infection and treatment of IAC patients: 134 cases of candida albicans were cultured in the initial abdominal drainage fluid or intraoperative abdominal specimens of 203 patients, and 49 cases were treated with fluconazole. Of 69 cases infected with non candida albicans, 13 cases were treated with fluconazole. The resistance rate of candida albicans to fluconazole was 5.91%(12/203). Of 203 patients, there were 68 cases with infections shock, 53 cases with renal failure, 84 cases with respiratory failure and 63 cases with multiple organ failure, respectively. There were 148 of 203 patients admitted to intensive care unit for 9 days(range, 3-20 days), and the total hospital stay was 28 days(range, 17-50 days). Of 203 patients, 86 cases were cured and discharged, 50 cases were improved and transferred to local hospitals, 32 cases gave up treatment and discharged automatically, 19 cases died, 16 cases had no follow-up data. The mortality was 25.12%(51/203). (2) Analysis of influencing factors for mortality of IAC patients. Results of univariate analysis showed that acute physiology and chronic health evaluation score, sequential organ failure assessment score, the Cr, bilirubin, albumin, procalcitonin, and PLT on the first day of candida positive culture, of the lowest value in a week and the highest in a week, heart disease, diabetes, infections shock, renal failure, respiratory failure, multiple organ failure, anti-fungal therapy were the related factors for mortality of IAC patients ( t=-2.322, Z=-2.550, -2.262, -4.361, t=2.085, Z=-3.734, -5.226, -2.394, -5.542, t=3.462, Z=-4.957, -5.632, 3.670, -5.805, t=3.966, Z=-3.734, -5.727, χ2=4.071, 4.638, 27.353, 18.818, 13.199, 26.251, 13.388, P<0.05). Multivariate analysis showed that the bilirubin, procalcitonin on the first day of candida positive culture and infections shock were independent risk factors for mortality of IAC patients ( odds ratio=1.021, 1.022, 6.864, 95% confidence interval as 1.010-1.033, 1.001-1.044, 1.858-25.353, P<0.05). Conclusions:The common fungus of IAC was candida albicans, and fluconazole can be used as the initial empirical treatment. The prognosis of patients with abdominal candidiasis is poor. Bilirubin, procalcitonin on the first day of candida positive culture and infections shock are indepen-dent risk factors for mortality of IAC patients.
ABSTRACT
Objective To explore the expression of Octamers binding transcription factor 4 (Oct4) and its relationship with clinicopathological parameters in the non-small cell lung cancer (NSCLC) tissues .Methods From September 2013 to December 2016 ,100 cases of NSCLC patients with lung cancer (group NSCLC ,n=100) and their corresponding normal paracancerous tissues (the control group ,n=100) were selected as the samples .The expression of Oct4 mRNA and protein in two groups of tissue samples were detected by fluores-cence quantitative PCR ,immunohistochemistry and western blot .The relationship between the level of Oct4 expression and the clinicopathological parameters of the patients was analyzed ,and the prognosis of the Oct4 positive and negative patients in the NSCLC group was compared .Results The expression of Oct4 mRNA in NSCLC group was (3 .21 ± 0 .18) ,protein expression was (0 .74 ± 0 .11) and the positive rate was 74 .00％ , which were significantly higher than those of control group [(1 .47 ± 0 .11) ,(0 .10 ± 0 .03) ,10 .00％ ,P<0 .05] .The positive rate of Oct4 expression in NSCLC patients was not related to sex ,age ,smoking index and tumor size (P>0 .05) ,but related to pathological type ,degree of differentiation ,and TNM staging ,in which the positive rates of Oct4 in patients with adenocarcinoma ,low differentiation and TNM stage Ⅲ stage were significantly higher than those of non adenocarcinoma ,middle-high differentiation degree ,Ⅰ - Ⅱ TNM stage patients (P< 0 .05) .In NSCLC patients ,compared with Oct4 negative patients ,the distant metastasis rate (64 .86％ ) ,pulse tube infiltration rate (47 .30％ ) in Oct4 positive patients were significantly higher ,and the 1 year survival rate (67 .57％ ) decreased (P<0 .05) .Conclusion The expression of Oct4 in NSCLC tissue is closely related to its clinicopathological parameters .Oct4 is highly expressed in adenocarcinoma ,and with thedecrease of differentiation and progression of tumor stages ,the expression increases and affects the prognosis . Oct4 can be used as a specific diagnostic marker of NSCLC .
ABSTRACT
Objective To discuss the clinical value of Dimethicone power applied under endoscopy in examination of upper gastrointestinal tract. Methods 800 patients who received common endoscopy examination from Nov. 2014 to Nov. 2015 were recruited into the study and randomly divided into two groups: experimental group and control group. Fifteen minutes before the examination, the experimental group took Dimethicone power 5 g and 30 ml pure water. At the same time, the control group took 30 ml pure water only. According to the clarity of the endoscopic field of vision, the examination results were classified into 4 levels (A, B, C, D), and the inspect time of each patient was recorded. Results In experimental group, endoscopic vision was significantly higher than control group ( <0.05), and the inspect time was significantly shorter than control group ( < 0.05). Conclusion Dimethicone power can significantly improve the clarity of the endoscopic field of vision and alleviate the suffering of patients with short-er inspect time, which can be used as an adjuvant before routine endoscopy examination.
ABSTRACT
Objective To observe the effects of dexmedetomidine for different loading dose on blood pressure of surgery inten-sive care unit(SICU) patients conscious-sedation derivative phase .Methods 60 patients after general anaesthesia were divided into routine dose group(dexmedetomidine 1 .00 μg/kg ,group C) ,middle dose group(dexmedetomidine 0 .75 μg/kg ,group M ) and low dose group(dexmedetomidine 0 .50 μg/kg ,group L) ,and the loading time were reset 10 min .sedative effect was evaluated by Ram-say sedation score .Record the mean arterial blood pressure of everyone before administration ,5 min after ,15 min after ,30 min af-ter ,60 min after .Results All patients achieved good conscious-sedation .Compared with pro-administration ,the mean arterial blood pressure of group C descend significantly .The mean arterial blood pressure of group M and L descend significantly ,and then they were recover over time .60 min after the treatment ,the mean arterial blood pressure in group C was significantly lower than group L and goup M (P<0 .05) .Conclusion Small dose dexmedetomidine can achieved good conscious-sedation for SICU patients .It has less influence on hemodynamics .
ABSTRACT
Objective:To investigate the expression of livin and survivin induced by 5-Fu agent,and determine the role of livin and survivin in anti-chemotherapy of hepatocellular carcinoma(HCC). Methods:Low concentration of 5-Fu was added in cultured HepG2 cells.The expression of livin and survivin was detected by RT-PCR and western-blot on 24h and 48h after 5-Fu treatment.Results:Livin and survivin mRNA 1eve1 was increased by 0.6 ,1.1 and 1.5,2.2 times,respectively.and thant of the protein expression was increased by 1.3 ,2.7 and 0.9,1.9 times,respectively.Conclusion:livin and survivin was expression in HepG2.A high expression level of livin and survivin was induced in HepG2 by 5-Fu,which reduced to apoptosis by 5-Fu.It's valuable to study the curative effect of 5-Fu to hepatocelluar carcinoma further.