ABSTRACT
Objective:To investigate the value of growth differentiation factor-15 (GDF-15) and extravascular lung water index (EVLWI) in severity grading and prognosis prediction of patients with acute respiratory distress syndrome (ARDS).Methods:Patients with ARDS aged 18-75 years admitted to the department of respiratory intensive care unit (RICU) of Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2019 to February 2020 were enrolled. All patients were treated with conventional therapies such as mechanical ventilation, anti-infection, stabilization of water, electrolytes and acid-base environment, blood purification and nutritional support according to their conditions. Besides, the pulse-indicated continuous cardiac output (PiCCO) was performed after admission to the department, and EVLWI before treatment and at 24, 48 and 72 hours of treatment were recorded. Serum GDF-15 level was measured by enzyme linked immunosorbent assay (ELISA) during the same period. Patients were classified as mild, moderate, and severe degree according to the 2012 Berlin Definition of ARDS, and EVLWI and GDF-15 levels in patients with different disease levels before and after treatment were compared. In addition, the length of intensive care unit (ICU) stay, ICU mortality, and 28-day mortality of patients with different GDF-15 or EVLWI levels were analyzed comparatively, with the GDF-15 3 458 ng/L and EVLWI 15 mL/kg as the cut point.Results:A total of 82 patients with ARDS were enrolled, including 22 patients with mild ARDS, 28 patients with moderate ARDS, and 32 patients with severe ARDS. The GDF-15 and EVLWI levels in patients with moderate and severe ARDS at each time point before and after treatment were higher than those in patients with mild ARDS. Both GDF-15 and EVLWI levels in patients with severe ARDS were higher than those in the patients with moderate ARDS. The differences were statistically significant at all the time points except for the difference of GDF-15 levels at 24 hours after treatment (ng/L: 3 900.41±546.43 vs. 3 695.66±604.73, P > 0.05). [GDF-15 (ng/L): 3 786.11±441.45 vs. 3 106.83±605.09 before treatment, 3 895.48±558.96 vs. 3 333.29±559.66 at 48 hours, 3 397.33±539.56 vs. 3 047.53±499.57 at 72 hours; EVLWI (mL/kg): 19.06±1.91 vs. 14.31±1.50 before treatment, 18.56±2.23 vs. 13.26±1.69 at 24 hours, 17.23±1.76 vs. 12.45±1.36 at 48 hours, 15.47±1.81 vs. 11.13±2.19 at 72 hours, all P < 0.05]. According to the cut-off value, there were 23 patients with GDF-15 ≥ 3 458 ng/L and GDF-15 < 3 458 ng/L respectively and there were 23 patients with EVLWI ≥ 15 mL/kg and EVLWI < 15 mL/kg respectively. The length of ICU stay and 28-day mortality in patients with high GDF-15 were significantly higher than those in patients with low GDF-15 [length of ICU stay (days): 21.22±2.69 vs. 15.37±3.14, 28-day mortality: 56.5% vs. 21.7%, both P < 0.05]. The length of ICU stay and 28-day mortality in patients with high EVLWI were also significantly higher than those in patients with low EVLWI [length of ICU stay (days): 18.45±2.61 vs. 14.98±2.75, 28-day mortality: 47.8% vs. 17.4%, both P < 0.05]. Conclusion:To some extent, GDF-15 and EVLWI levels reflect the severity of patients with ARDS, and high GDF-15 and EVLWI levels are significantly associated with poor prognosis in patients with ARDS.
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Objective To investigate the efficacy and safety ofQingre Huoxue Mixture in the treatment of blood heat type psoriasis vulgaris.Methods The patients were divided into treatment group and control group according to random number table method, with 52 cases in treatment group and 50 cases in the control group, 10 cases failed to complete the trial. Treatment group was givenQingre Huoxue Mixture, and the control group received oral administration of compoundQingdaiCapsule. The treatment lasted for 8 weeks. PASI score, TCM syndrome integrals, DLQI score, serum IFN-γ and IL-10 were detected, and hematuria routine and liver and kidney function were under safety testing before and after treatment.Results After treatment, PASI score, DLQI score and TCM syndrome integrals in the treatment group decreased significantly (P<0.001); the expression of serum IFN-γ decreased significantly (P<0.001); the expression of serum IL-10 increased significantly (P<0.001), with the total effective rate of 100% (52/52). After the treatment, TCM syndrome integrals in the both groups decreased significantly (P<0.001). After the treatment, the rash burning and itching scores in the treatment group were lower than the control group, with statistical significance (P<0.001). In terms of safety, the treatment group had no abnormal indicators.ConclusionQingre Huoxue Mixture has obvious curative effect, which can reduce the patients with psoriasis, improve the life quality of patients, and improve the clinical symptoms of rash burning and itching, reduce serum IFN-γ, and increase serum IL-10.
ABSTRACT
Psoriasis is a kind of immune-mediated chronic inflammatory disease, characterized with skin and joints. This paper reviewed the effect of traditional Chinese medicine on thepsoriasis related cytokines, such as interleukin, interferong, tumor necrosis factorα, colony stimulating factor, chemokines and transforming factor, in order to provide theoretical reference for TCM treatment of psoriasis.