ABSTRACT
adrenocorticalcarcinoma；cortisolhypersecretion；hypokalemia；prognosis@#【Objective】To analyze the prognostic determinants of adreno cortical carcinoma（ACC）inadults.【Methods】Alladult patients who were admitted to SunYat-sen Memorial Hospital，SunYat-sen University from December 2011 to March 2017 and pathologically diagnosed ACC were included in this study.Thec linical data and preoperative laboratory examinations of those patients were analyzed retrospectively. Overall survival or disease-free survival was calculated and survivalcurves were plotted by Kaplan-Meier and compared by log-rank test. Harzardratios（HRs） with their 95% confidenceintervals（CIs） were calculated by univariate and multivariate Coxregression model.【Results】The study included 20 adult patients with ACC， with a median follow-up of 13months （6~73 months）. The mean survival time of those patients was 49.2 months（6~73months），with a 1-year survival rate of 70.0%. The results of multivariate Coxregression analysis revealed that the presense of cortisol hypersecretion（HR=23.60，95%CI：2.49-223.79，P=0.006） and hypokalemia（HR=23.60，95%CI：2.49-223.79，P=0.006）were predictors of poorprognosis of ACC. Moreover，in 18 patients with completely resected ACC，the presense of hypokalemia resulted in a worse disease-free survival.【Conclusion】The presense of cortisol hypersecretion and hypokalemiaare independent risk factors associated with poorprognosis of ACC in adults.
ABSTRACT
Objective To observe the effects of Qingyuan Shenghua Decoction on cardiovascular indexes and illness severity in sepsis patients after severe bone trauma. Methods Forty-eight sepsis patients after severe bone trauma were randomly divided into control group(22 cases)and treatment group(26 cases). The two groups were given routine treatment of western medicine according to International Guidelines for Management of Severe Sepsis and Septic Shock (2012). Additionally,the treatment group was treated with oral use or intranasal use of Qingyuan Shenghua Decoction, a herbal medicine recipe mainly composed of Radix Astragali, Radix Salviae Miltiorrhizae,Radix Angelicae Sinensis,Radix Paeoniae Rubra,Radix et Rhizoma Rhei,Rhizoma Curcumae, and Flos Carthami. Before and after treatment,we observed the mean arterial pressure(MAP),central venous pressure(CVP), heart rate(HR), arterial blood lactic acid(Lac), central venous blood oxygen saturation (ScvO2),central venous-arterial blood carbon dioxide partial pressure difference (Pcv-aCO2),acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ) scores , sequential organ failure assessment (SOFA) scores, and oxygenation index (PaO2/ FiO2) of the two groups. Results With the prolongation of medication time,MAP,CVP,ScvO2,and Pcv-aCO2 of the two groups were increased gradually,and HR and Lac were decreased gradually (P < 0.05 or P < 0.01 compared with those before treatment) . Compared to the control group at the same time period, the treatment group had higher MAP, ScvO2, Pcv-aCO2 and PaO2/FiO2, and had lower HR, Lac, APACHEⅡ scores and SOFA scores 7 days after treatment, the difference being significant(P < 0.05). Conclusion Qingyuan Shenghua Decoction is effective on improving the abnormal hemodynamics and microcirculation, enhancing the efficient utilization of oxygen, protecting the function of multiple viscera,and alleviating the severity of disease in sepsis patients after severe bone trauma.
ABSTRACT
This review summarised and compared the contents and methods of America,s Health Rankings (AHR)and the County Health Rankings(CHR)in the United States by using literature review.AHR and CHR are the currently widely used population health assessment index ranking systems in the United States,respectively,which provided an analysis of population health on a state-by-state basis and a county-by-county basis by evaluating a histori-cal and comprehensive set of health outcomes and health determinants data to determine the health benchmarks and state/county rankings.The selection criteria of each indicator take into account of reliability, availability, stability, and intervention.The determination of weights of each indicator took into considerations the literature review,a histori-cal perspective,weights used by other rankings,internal analyses of the variation in outcomes explained by each factor, and pragmatic issues involving communications and stakeholder engagement.By comparison, it was found that AHR and CHR have a higher level of accuracy in the classification as they are well -defined by population demographics and geography respectively.The evaluation of health cities and health villages and towns in China is more complicated. There are few studies on village and town health rankings systems.This article reviewed the evaluation methods of AHR and CHR with a view to providing a reference for research on the evaluation system of City Health Rankings and the Village and Town Health Rankings in China.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the protection of Qingyuan Shenghua Decoction (QSD) on multiple organs of sepsis patients after bone trauma, and to preliminarily explore its mechanism.</p><p><b>METHODS</b>Totally 60 sepsis patients after bone trauma were randomly assigned to the treatment group and the control group according to random digit table, 30 in each group. All patients received routine Western medical treatment. Patients in the treatment group additionally took QSD or were nasally fed with QSD, one dose per day for 1 week. Changes of WBC, oxygenation index (PaO2/FiO2), serum creatinine (SCr), total bilirubin (TBIL), aspartate aminotransferase (AST), fibrinogen (FIB), D-dimer (DD), activated partial thromboplastin time (APTT), pro-calcitonin (PCT), C-reactive protein (CRP), heart rate (HR), mean arterial pressure (MAP), intra-abdominal pressure, scores for Acute Physiology and Chronic Health Evaluation II (APACHE II), sequential organ failure assessment (SOFA) scores were observed before treatment and on day 1, 3 and 7 after treatment.</p><p><b>RESULTS</b>Compared with the control group at the same time point, MAP increased at post-treatment day 1 and 3; CRP, APTT, HR, SCr, TBIL, AST, intra-abdominal pressure at post-treatment day 3 obviously decreased in the treatment group (P < 0.05, P < 0.01). WBC, SOFA scores, PCT, CRP, APACHE II, APTT, D-D, HR, SCr, TBIL, AST and intra-abdominal pressure significantly decreased; FIB, MAP and PaO2/FiO2 obviously increased at post-treatment day 7 (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>QSD had good protective effect on multiple organ function in sepsis patients after bone trauma, and its mechanism might be related with effectively clearing endotoxin, alleviating inflammatory reactions, and fighting against coagulation dysfunction.</p>
Subject(s)
Humans , APACHE , Blood Coagulation , Bone Diseases , C-Reactive Protein , Metabolism , Calcitonin , Metabolism , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Fibrin Fibrinogen Degradation Products , Metabolism , Inflammation , Partial Thromboplastin Time , Protein Precursors , Metabolism , Sepsis , Drug TherapyABSTRACT
<p><b>BACKGROUND</b>Single nucleotide polymorphisms (SNPs) in the deoxycytidine kinase (dCK) gene are associated with chemosensitivity to nucleoside analogs. 2',2'-Difluoro 2'-deoxycytidine (gemcitabine) is a first-line nucleoside analog drug in the treatment of pancreatic cancer. However, the association between SNPs in the dCK gene and chemosensitivity to gemcitabine has not been fully established. Therefore, the present study aimed to investigate the relationship between SNPs in the dCK gene and chemosensitivity to gemcitabine in human pancreatic cancer cell lines.</p><p><b>METHODS</b>Seven SNPs in the dCK gene were sequenced in six human pancreatic cancer cell lines. The chemosensitivity of these six cell lines to gemcitabine were evaluated in vitro with a Cell Counting Kit-8 (CCK-8) test. Inhibition rates were used to express the chemosensitivity of pancreatic cancer cell lines to gemcitabine.</p><p><b>RESULTS</b>The genotype of the A9846G SNP in the dCK gene was determined in six human pancreatic cancer cell lines. The cell lines BxPC-3 and T3M4 carried the A9846G SNP genotype AG, whereas cell lines AsPC-1, Mia PaCa2, SW1990 and SU86.86 carried the GG genotype. Cell lines with the AG genotype (BxPC-3 and T3M4) were more sensitive to gemcitabine compared with cell lines with the GG genotype (AsPC-1, Mia PaCa2, SW1990 and SU86.86) and significantly different inhibition rates were observed between cell lines carrying the AG and GG genotypes (P < 0.01).</p><p><b>CONCLUSIONS</b>Variants in the A9846G SNP of the dCK gene were associated with sensitivity to gemcitabine in pancreatic cancer cell lines. The dCK A9846G SNP may act as a genetic marker to predict chemotherapy efficacy of gemcitabine in pancreatic cancer.</p>