ABSTRACT
Objective:To evaluate the clinical efficacy of sepsis in children by dynamic monitoring of serum procalcitonin (PCT) and hypersensitive C-reactive protein (hs-CRP).Methods:Seventy-five children with sepsis hospitalized in Taihe County People′s Hospital from January 2015 to April 2019 were selected as the sepsis group, and 75 healthy children in the same period were selected as the control group. The values of PCT and hs-CRP in two groups were detected by chemiluminescence and immunoturbidimetry respectively, and the levels of serum PCT and hs-CRP were compared between the two groups. According to the PCT, hs-CRP value and APACHE Ⅱ score at 72 h after treatment, children in sepsis group can be divided into two groups: good curative effect group (APACHE Ⅱ <27 scores)and poor curative effect group with (APACHE Ⅱ ≥27 scores).The changes of serum PCT, hs-CRP and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score in two group were monitored dynamically at different time points, and data were analyzed by SPSS 18.0 software.Results:The levels of PCT and hs-CRP in sepsis group were significantly higher than those in control group [(5.37 ± 1.56) μg/L vs. (0.32 ± 0.10) μg/L, (64.6 ± 9.5) mg/L vs. (4.2 ± 1.2) mg/L] ( P<0.01). At 1, 3 and 5 d after treatment, the levels of PCT, hs-CRP value and APACHE Ⅱ scores in good curative effect group were significantly reduced. However, the levels of PCT, hs-CRP and APACHE Ⅱ scores in poor curative effect group did not decrease significantly or even continued to increase, and the levels of PCT, hs-CRP and APACHE Ⅱ scores in good curative effect group at different time point were significantly higher than those in poor curative effect group ( P<0.01). In sepsis group, the level of PCT had positive correlation with hs-CRP and APACHE Ⅱ ( r=0.846, P<0.05; r=0.531, P<0.05), and the level of hs-CRP had positive correlation with APACHEⅡ( r=0.558, P<0.05). The sensitivity and specificity of PCT combined with hs-CRP in diagnosis of sepsis was 98.7% and 93.5%. Conclusions:PCT combined with hs-CRP detection is helpful for the early diagnosis of sepsis, and through the dynamic monitoring of PCT and hs-CRP values, the therapeutic efficacy of children can be evaluated.
ABSTRACT
This paper analyzed medical dispute litigation from the view of game theory.The adoption of mediation strategy for both hospital and patient was the Pareto optimal of this model.The adoption of court decision for both hospital and patient was the Nash equilibrium and its overall benefit was the Pareto suboptimal of this model.The communication of patient's lawyer can prompt the reconciliation between hospital and patient.On the one hand,it let the hospital realize the responsibilities they should bear,on the other hand let patients be willing to make concessions on the basis of the original claims,and finally made the two sides reach a reconciliation agreement,thus to make conflict between hospital and patient end in litigation and the overall benefits maximize.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze p-coumaril acid, trans-6-O-p-coumaroyl scandoside methyl ester and its metabolites in rat plasma after intragastric administration of exocarpium Diffusa effective extracts.</p><p><b>METHOD</b>Rat blood samples were collected 1.0 h after oral administration of 0.4 g x kg(-1) exocarpium Diffusa effective extracts, and then were analyzed by using HPLC-Q-TOF-MS.</p><p><b>RESULT</b>In rat plasma, only one metabolite was detected. The structure was identified by reference substance to be p-coumaril acid.</p><p><b>CONCLUSION</b>The methyl glucoside metabolite in rat from the main component parts of trans-6-O-p-coumaroyl scandoside methyl ester droppings of vines in Diffusa effective extracts is p-coumaril acid. This experiment provides a theortical basis for studying chemical compositions and pharmacodynamic action of Diffusa.</p>