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Objective To study the relationship between growth hormone,insulin-like growth factor-1 (IGF-1) and immunity during sepsis.Methods A total of 42 sepsis patients with complete data were selected to detect serum growth hormone,IGF-1,T cells in peripheral blood,and humoral immunity.Multifactor repeated measurement variance analysis was applied to compare various markers between sepsis group and the control group.Partial correlation analysis was used to analyze the relationship between growth hormone,IGF-1 and immunity.Results Serum growth hormone of patients in sepsis group was obviously higher than that in the control group (P =0.013 7,0.012 3,0.011 5),while IGF-1 was obviously lower in sepsis group compared with control group (P=0.014 4,0.013 5,0.013 2).Meanwhile,CD3+ (P =0.0095,0.0089,0.0092),CD4+ (P=0.0163,0.013,0.0158),CD8+ (P=0.010 1,0.019 3,0.015 5),NK (P=0.023 4,0.029 3,0.025 5) and CD19+ cell (P=0.011 3,0.010 2,0.010 0),IgA (P =0.019 3,0.017 8,0.015 7),IgG (P =0.047,0.006 9,0.005 9),and complement C3 (P =0.039 3,0.037 8,0.045 6) in peripheral blood of patients in sepsis group were obviously lower than those in control group.There were positive correlations between IGF-1 and CD3+,CD4+,CD8+,CD19+,NK cells,IgA,IgG,complement C3 (P=0.01 3,0.036,0.015,0.008,0.002,0.005,0.009,0.001) in sepsis patients.Conclusions There were abnormalities in serum growth hormone,IGF-1,cell-mediated immunity and humoral immunity found in sepsis patients.IGF-1 had the correlation with immune function affecting the prognosis of patients with sepsis.
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Objective To explore the effects of sepsis on the ultrastructure and function of thyroid in rats.Methods This study was performed in the Animal Department of Fujian Medical University,the Key Laboratory of Fujian Provincial Cardiovascular Institute and the Electron.Microscopic Department of Fujian Medical University.Thirty-two pathogen-free male Sprague-Dawley rats weighing 180-220 g selected,and were randomly (random number) divided into control group (C group,n =8),12 hour group (n =8),24 hour group (n =8) and 36 hour group (n =8).The 12 h group,24 h group and 36 h group were established to be sepsis groups.The sepsis model was made by cecal ligation and puncture (CLP).The samples of blood and thyroid tissue of rats in 12 h group were taken 12 hours after modeling,and then the same procedure was done in the rats of 24 h group and 36 h group separately 24 hours and 36 hours after modeling.Blood serum was obtained by centrifugation to detect the thyroid function using measurement of different of kinds of hormones (T3,T4,fT3,fT4,TSH).Thyroid tissue was available to determine the expression of caspase-3,cell apoptosis and change of ultra-microstructure.Raw data were analyzed using SPSS19.0 software.Caspase-3 grey value was determined by Image J software.Thyroid hormone levels were presented as mean ± standard deviation.The differences in levels of different kinds of thyroid hormone among all the groups were determined by one-way ANOVA.TUNEL positive staining and caspase-3 expression were presented as median (P25,P75).Results Compared to the control group,the T4 decreased significantly (P＜0.05) in the 12 h group,the 24 h group and the 36 h group,both the tT3 and the fT4 decreased significantly in the 24 h group and the 36 h group (P ＜0.05),and the T3 decreased significantly in the 36 h group (P ＜ 0.05).The expression of caspase-3 in the 24 h group was higher than that in the C group (P ＜ 0.05).There was significant difference in rate of celt apoptosis in thyroid tissue among those four groups,and both the 24 h group and the 36 h group had higher rate of cell apoptosis than the C group significantly (P ＜0.05).In those sepsis groups,a series of pathological ultrastructural changes were found in thyroid follicular epithelial cells as following:the nucleus became smaller and more distinctly stained,and quite a few vacuoles were visualized in cell.Furthermore,the cell membrane was broken,and nuclei showed pyknosis.Conionclus In sepsis rats,the significant changes of different kinds of thyroid hormone in serum are similar to those found in the thyroidal illness syndrome,the expression of caspase-3 and cell apoptosis in thyroid tissue increase,and pathological change of thyroid follicular epithelial cells can be observed under electron microscopy.
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Objective To clarify the relationship between the serum prolactin (PRL),immunity and prognosis of the critical patients.Methods The data of 80 patients with complete clinical data in the Intensive Care Unit of the Fujian Provincial Hospital during October 1,2010 to October 1,2011 were collected.The patients were divided into 2 groups according to the prognosis:death group and survival group.Fasting blood is extracted respectively on the morning of the 2nd day after they were admitted,the 4th day and the 8th day.Chemiluminescence immunoassay system was used to detect the serum PRL,flow cytometers to test peripheral blood T-lymphocyte subsets,and immunization rate nephelometry to check the 5 items for bumoral immunity in peripheral blood.The multi-factor repeated measure analysis of variance was used in the comparison of the two groups.Results Compared with those of the survival group,the serum PRL (P=0.037,0.036,0.030),the percentages of CD3+ (P=0.034,0.023,0.023),CD4+ (P =0.046,0.003,0.046) and CD8+ (P =0.040,0.039,0.045) cells of the death group were significantly lower.However,positive correlation exists between the value of serum PRL and the percentages ofCD3+,CD4+ and CD8+ cells (P=0.004,0.043,0.003):the higher the former,the higher the latter.Conclusions The change of cellular immunity is important for the prognosis of the patients.Downgradationof the cellular innunity indicates an undesirable prognosis.The serum PRL may work positively on cellular immunity.
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Objective To explore the clinical characteristics of multiple organs dysfunction syndrome (MODS) complicated with injury of pancreas.Methods A prospective study was carried out.From January 2011 to December 2012,a total of 69 patients with MODS in Department of Medical Intensie Care Unit,Fujian Provincial Hospital,Fujian Medical University were divided into 2 groups at admission.Patients of group A were suffered from MODS complicated with pancreas injury while patients of group B had MODS without complicatios.They were compared and evaluated by acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,6-hour clearance rate of lactic acid,incidence of shock,fluid resuscitation in the first 24 and 48 hours,bladder pressure and 28-day accumulative mortality.Results APACHE Ⅱ score in group A was significantly higher than that in group B (P ＜ 0.01).Compared with group B,the 6-hour clearance rate of lactic acid was lower,the incidence of shock increased obviously,and larger volume of fluid resuscitation was needed in the first 24 and 48 hours in the group A (P ＜ 0.05).Bladder pressure,incidence of feeble bowel sounds and the mortality in the group A were higher than those in group B,but the difference had no statistical significance (P＞0.05).Conclusions MODS complicated with pancreas injury is more severe than MODS without complications thereby resulting in higher incidence of shock and the poorer response to fluid resuscitation.