ABSTRACT
To determine expression levels of glial fibrillary acidic protein in patients of sepsis-associated encephalopathy (SAE) and its clinical significance. Methods: Patients, admitted to intensive care units and diagnosed as sepsis, were recruited to our study from October 2016 to August 2018 in the Third Xiangya Hospital, Central South University. SAE is defined as a brain dysfunction secondary to sepsis and without evidence of a primary central nervous system infection or encephalopathy due to other reasons. The SAE group and non-SAE group were classed by Confusion Assessment Method for the ICU (CAM-ICU) score. We measured the levels of serum GFAP, S100β and neuron-specific enolase (NSE) within 24 hours after diagnosis of sepsis, and compared the patients' general clinical data, ICU stay time, 28-day and 180-day mortality. Results: Among 152 enrolled patients, 58 and 94 were assigned to the SAE group and the non-SAE group, respectively. There were a significantly higher Sequential Organ Failure Assessment (SOFA) scores, 28-day mortality rate, as well as 180-day mortality rate in the SAE group (all P<0.001). The levels of GFAP, NSE and S100β in the SAE group were significantly higher than those in the non-SAE group (all P<0.001). The diagnostic values of GFAP was 0.67 μg/L, with sensitivity at 75.9% and specificity at 77.7%. Area under the receiver operating characteristic curve (AUROC) of GFAP, NSE and S100β were 0.803, 0.795 and 0.750, respectively. Pearson analysis showed that serum GFAP level was positively correlated with Acute Physiology and Chronic Health Evaluation II (APACHE II) score, but it was negatively correlated with Glasgow Coma Scale (GCS) score, 28-day survival rate and 180-day survival rate. Conclusion: The level of serum GFAP is significantly increased in SAE, which shows certain correlation with incidence, severity and prognosis of the disease.
Subject(s)
Humans , APACHE , Glial Fibrillary Acidic Protein , Blood , Intensive Care Units , Organ Dysfunction Scores , Prognosis , ROC Curve , Sepsis , Sepsis-Associated Encephalopathy , DiagnosisABSTRACT
Objective To investigate the diagnostic value of bronchoscopy in smear negative pulmonary tuberculosis.Methods 65 cases with cavernous and 35 non -cavernous negative smear pulmonary tuberculosis were examined by bronchoscopy.Results The positive rates of sputum examination in the empty group,the non empty group and the total sputum examination were 49.2%,17.1% and 38%,respectively.There was statistically signifi-cant difference in sputum positive rate between empty group and non empty group (χ2 =9.942,P =0.002).The posi-tive rate of sputum was 28%.The positive rate of sputum negative and sputum positive rate was 10% after operation. Microscopically visible tracheal and bronchial abnormalities,tracheal inflammatory change rates of empty group and non empty group were 52.3%,40.0%,the difference between the two groups had no statistically significant difference (χ2 =1.381,P =0.240).The tracheal stenosis rates of hole group and non empty group were 9.0% and 11.4%,the difference between the two groups had no statistically significant difference (χ2 =0.122,P =0.727).The overall trachea abnormal changes rate was 58.0%,including inflammatory change rate 48.0% and 10.0% stenosis rate. Conclusion Bronchoscopy has significant clinical value in smear negative pulmonary tuberculosis,especially with cavernous.The positive rate will be promoted after bronchoscopy,and can find abnormal changes of tube.
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Objective To investigate the expression and clinical significance of Ku70 in nasopha ryngeal oarcinoma(NPC).Methods The expression of Ku70 protein in 223 specimens of nasopharyngeal carcinoma was examined by immunohistochemistry.Based on the levels of ku70 immunoreactivities,the 223 specimens were divided into high Ku70 expression group and low Ku70 expression group.The correlation of Ku70 expression with clinicopathologic features and prognosis of NPC was analyzed according to the clinical data. Results The rate of high Ku70 expression was 63.7%.Univariate survival analysis suggested that the overall survival rate was significantly lower in high KuTO expression group than in low Ku70 expression group (X2 = 7.88,P = 0.005).Cox multivariate analysis indicated that T stage,N stage and M stage were the independent prognostic predictors (X2 = 8.02,7.22,36.86;P =0.005,0.007,0.000),but not with gender, age or pathological type(X2 = 0.08 ,1.04,2.34;P = 0.780,0.308,0.126),the influence of Ku70 on the o verall survival rate was close to critical value(P = 0.085).Conclusions Ku70 is positively expressed in the majority of NPC.KuT0 expression has significant correlations with T stage and N stage.The results of our study suggest that Ku70 is a valuable prognostic factor of NPC.
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To summarize the etiological factor and to assess the therapeutic effect for neovascular glaucoma(NVG).Methods A retrospective study of 28 cases (29 eyes) with NVG was performed. The mean age, proportion of sex and primary ocular disease, incidence of symptom, sign and postoperative complication were analyzed. Results 78 6% of the patients were over 40 years old. 62% of the patients were secondary to the ocular ischemic disease such as central retina vein occlusion and proliferative diabetic retinopathy. The clinical characters included intraocular pressure (IOP) increasing, pain, mixed conjunctival congestion and rubeosis iridis. The mean IOP reduction was 19.5 mmHg in 29 eyes after antiglaucomatous drags treatment and 19.13mmHg in 23 eyes after Hunan aqueous humor drainage (HAD) implantation. The common postoperative complications were flat anterior chamber and choroidal detachment. The success rate of HAD implantation was 87%.Conclusions NVG was commonly secondary to ocular ischemic disease. Although prevention was the principal, reducing IOP and ameliorating ischemic situation were as the same important.