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Detection bias is an information bias.It was first proposed by Horwitz from the study investigating the association of the administration of estrogen after menopause with the occurrence of endometrial cancer, which still prevails in most epidemiological studies.We use the Directed Acyclic Graph to analyze the effect of a given exposure on a specific outcome with the association estimates between the measured exposure and outcome.Detection bias occurs when there is additional open paths irrelevant to the target path of interest which is originated from measured exposure to measured outcome.We further analyzed how the detection bias was formed under different study designs, including cohort study, randomized clinical trial and case-control study in order to further investigate its potential influence on the effect/association estimation.
ABSTRACT
Detection bias is an information bias.It was first proposed by Horwitz from the study investigating the association of the administration of estrogen after menopause with the occurrence of endometrial cancer, which still prevails in most epidemiological studies.We use the Directed Acyclic Graph to analyze the effect of a given exposure on a specific outcome with the association estimates between the measured exposure and outcome.Detection bias occurs when there is additional open paths irrelevant to the target path of interest which is originated from measured exposure to measured outcome.We further analyzed how the detection bias was formed under different study designs, including cohort study, randomized clinical trial and case-control study in order to further investigate its potential influence on the effect/association estimation.
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There are 486 kinds of health food with Puerariae Lobatae Radix as the main raw material, mainly including health food for protecting liver, health food for regulating blood lipid, health food for adjusting blood pressure, health food for regulating blood sugar, and health food for regulating immunity.Based on the establishment of a health food recipe database with Puerariae Lobatae Radix as the main raw material, the Apriori algorithm in association rules was used to explore the formula rule of health food of Puerariae Lobatae Radix.The results showed that among the 174 kinds of hepatoprotective health food, the most used raw materials were Noveniae Fructus and Schisandrae Chinensis Fructus;the common combinations of three raw materials were Puerariae Lobatae Radix-Gardeniae Fructus-Paeoniae Radix Alba, Puerariae Lobatae Radix-Gynostemmatis Pentaphylli Herba-Cassiae Semen, etc.Among the 91 kinds of health food for regulating blood lipid, the most widely used raw materials were Cassiae Semen and Gynostemmatis Pentaphylli Herba;the common combinations of three raw materials were Puerariae Lobatae Radix-Cassiae Semen-Chrysanthemi Flos, Puerariae Lobatae Radix-Alismatis Rhizoma-Mori Folium, etc.Among the 41 kinds of health food for regulating blood pressure, the most widely used raw materials were Eucommiae Cortex and Salviae Miltiorrhizae Radix et Rhizoma;the common combinations of the three raw materials were Puerariae Lobatae Radix-Cassiae Semen-Ostreae Concha, Puerariae Lobatae Radix-Salviae Miltiorrhizae Radix et Rhizoma-Sophorae Flos, etc.Among the 105 kinds of health food for regulating blood sugar, the most widely used raw materials were Dioscoreae Rhizoma and Astragali Radix;the common combinations of three raw materials were Puerariae Lobatae Radix-Notoginseng Radix et Rhizoma-Lycii Cortex, Puerariae Lobatae Radix-Dioscoreae Rhizoma-Poria, Puerariae Lobatae Radix-Dioscoreae Rhizoma-Lycii Cortex, etc.Among the 75 kinds of health food for regulating immunity, the most widely used raw materials were Astragali Radix and Lycii Fructus;the common combinations of three raw materials were Puerariae Lobatae Radix-Gastrodiae Rhizoma-Eucommiae Cortex, Puerariae Lobatae Radix-Mori Fructus-Lonicerae Japonicae Flos, Puerariae Lobatae Radix-Panacis Quinquefolii Radix-Crataegi Fructus, etc.
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Eugenia caryophyllata,a plant of Myrtle family,has a long history of cultivation and application in China.It is a medicinal and edible homologous plant with rich pharmacological activities.At present,there have been reports on the pharmacological effects and chemical components of Caryophylli Flos,but the clinical research progress was less.Therefore,this paper was to summarize the studies on the chemical composition and pharmacological action of Caryophylli Flos,through literature review,this paper introduced the record of Caryophylli Flos in traditional Chinese medicine(TCM) and Mongolian medicine,the application frequency of Caryophylli Flos in traditional Mongolian medicine and its compatibility of drug-pair were analyzed with computer software.In addition,the use of Caryophylli Flos in Mongolian medicine was discussed from the aspects of their medicinal property,functional treatment and clinical application,so as to provide reference for the subsequent studies on Caryophylli Flos.
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Objective To learn the second child bearing desire and its influencing factors among people of reproductive age and to provide reference for the newborn population prediction, effective population policy promotion and health-care resource allocation. Methods The married people at the age of 20 to 49 years in Keqiao District from April to June in 2017 were selected by the multi-stage random sampling method. A face-to-face questionnaire survey was used to investigate the second child bearing desire. Logistic regression model was used to analyze the influencing factors for the second child bearing desire. Results A total of 655 questionnaires were issued, with 612 valid (93.43%) . Among the 612 respondents, 386 were willing to bear the second child and the rate was 63.07% . The results of the logistic regression analysis showed that age between 30 and 40 years old (OR=2.073-2.131, all P ＜0.05) , engaged in workers, farmers, household/unemployed and self-employed/business (OR=1.816-4.543, all P＜0.05) , respondents were not only children (OR=2.200, P＜0.05) , couples both were not only children (OR=2.119, P＜0.05) and the first child was a girl were the promotive factors for having the second child; higher education level (OR=0.203-0.505, all P＜0.05), the average working time was 8 h (OR=0.556, P＜0.05), and the marriage age was more than 25 years old (OR=0.172-0.349, all P ＜ 0.05) were obstructive factors for having the second child. Conclusion The people of reproductive age in Keqiao are more willing to bear second child. Age, education level, occupation, daily work time, the only child or not, family structure, marriage age and gender of the first child are associated with the second child bearing desire.
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Objective To evaluate the effectiveness of intensive lifestyle intervention on rural residents with metabolic syndrome (MS) . Methods A total of 253 patients with MS selected from cross-sectional survey were divided into intensive lifestyle intervention and conventional management group incomplete randomly. Aimed to control weight, patients in the intervention group were treated with dietary control and exercise guidance. Besides, their compliances were assessed. In conventional management group, patients were disposed according to chronic disease management specification. Anthropometric measurements and biochemical markers detection were carried out in both groups at baseline and at the end of 6 months. Results These main anthropometric measurements and biochemical markers have no significant difference between the intervention group and conventional management group at the baseline (P>0.05) . After 6 months intensive lifestyle modification, the prevalence of MS did not significantly differ between the two groups: it was 67.14% in the intervention group and 60.95% in the conventional management group (P>0.05) .In the intervention group, the body weight, BMI and the waist circumference were decreased by 3.11 kg, 1.50 kg/m2, 4.29 cm, respectively, and 1.23 kg, 0.47 kg/m2, 1.22 cm in the conventional management group. The changes were significantly larger in the intervention group than in the conventional management group (P<0.01) .Uric acid, triglyceride were decreased by 14.30 μmol/L, 0.01 mmol/L, respectively, in the intervention group and in the conventional management group they were increased by 18.17 μmol/L and 0.41 mmol/L conversely. While the high density lipoprotein cholesterol was increased by 0.02 mmol/L, it was decreased by 0.10 mmol/L in the conventional management group (P<0.01) . Body weight and BMI decreased by 3.93kg and 1.40 kg/m2 in the high compliance group, compared to low compliance group, there was statistically difference with regard to this change between the two groups (P<0.05) . While the body fat% was decreased by 2.27%, and it was increased by 1.01% in the conventional management group (P<0.05) . Conclusion For rural residents, the beneficial effects of intensive lifestyle intervention are improving metabolic risk factors. The compliance is the main factor of the effects of intervention.
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Objective To explore the association between estimated glomerular filtration rate (eGFR) and metabolic syndrome (MS) . Method The data were from the China Health and Nutrition Survey (CHNS) . The data included the physical measurement and biochemical markers of adults of CHNS in 2009. Finally, 7309 individual observations were included in the analysis. Results According to the criteria of MS, 2034 patients were diagnosed as MS, and the prevalence was 27.83%. There were 1508 (74.14%) patients had moderate reduced eGFR in MS patients, and 3357 individuals (63.64%) were diagnosed as moderate reduced eGFR in non-MS patients. There was significant difference between two groups (X2=72.13, P<0.001) . The incident of moderate reduced eGFR was positively associated with fasting plasma glucose (OR=1.22, 95%CI: 1.06-1.42, P=0.005), triglyceride (OR=1.21, 95%CI: 1.05-1.38, P=0.005) and negatively associated with HDL-C (OR=1.23, 95% CI: 1.06-1.41, P=0.004) . Conclusion The MS and its components might be the influencing factors of developing moderate reduced eGFR, and the screening should be focused on the population with MS.
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Objective To evaluate the intervention effect of nutrition related knowledge,attitude and behavior among the prison police in Zhejiang Province . Methods Stratified cluster sampling method was used and investigation on knowledge,attitude and behavior was conducted.Nutrition education was carried out targeted to the problem found in the investigation for 6 months.Intervention effect was evaluated by comparison the scores of KAP before and after the intervention.Results The average score of KAP before the intervention was 70. 27 ±1 0. 90,including the average score for knowledge,attitude and behavior was 27. 38 ±6. 97,1 8. 07 ±3. 24 and 24. 82 ±3. 96,respectively.After the intervention, the average score of KAP was 91 . 1 9 ±4. 1 1 ,including the average score for knowledge,attitude and behavior was 37. 03 ±2. 97,1 9. 71 ±0. 71 and 34. 45 ±2. 74,respectively,higher than that before the intervention (P<0. 01 ).Conclusion Nutrition education could improve the awareness of nutrition among prison police .It was an effective method to develop dietary behavior of prison police.
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<p><b>OBJECTIVE</b>Aberrant expression of ten-eleven translocation 1 (TET1) plays a critical role in tumor development and progression. We systematically summarized the latest research progress on the role and mechanisms of TET1 in cancer biology.</p><p><b>DATA SOURCES</b>Relevant articles published in English from 1980 to April 2016 were selected from the PubMed database. The terms "ten-eleven translocation 1," "5mC," "5hmC," "microRNA," "hypoxia," and "embryonic stem cell" were used for the search.</p><p><b>STUDY SELECTION</b>Articles focusing on the role and mechanism of TET1 in tumor were reviewed, including clinical and basic research articles.</p><p><b>RESULTS</b>TET proteins, the key enzymes converting 5-methylcytosine to 5-hydroxymethylcytosine, play vital roles in DNA demethylation regulation. Recent studies have shown that loss of TET1 is associated with tumorigenesis and can be used as a potential biomarker for cancer therapy, which indicates that TET1 serves as tumor suppressor gene. Moreover, besides its dioxygenase activity, TET1 could induce epithelial-mesenchymal transition and act as a coactivator to regulate gene transcription, such as developmental regulator in embryonic stem cells (ESCs) and hypoxia-responsive gene in cancer. The regulation of TET1 is also correlated with microRNA in a posttranscriptional modification process. Hence, it is complex but critical to comprehend the mechanisms of TET1 in the biology of ESCs and cancer.</p><p><b>CONCLUSIONS</b>TET1 not only serves as a demethylation enzyme but also plays multiple roles during tumorigenesis and progression. More studies should be carried out to elucidate the exact mechanisms of TET1 and its associations with cancer before considering it as a therapeutic tool.</p>
Subject(s)
Animals , Humans , Biomarkers , Metabolism , Carcinogenesis , Genetics , Metabolism , Pathology , MicroRNAs , Genetics , Mixed Function Oxygenases , Genetics , Metabolism , Proto-Oncogene Proteins , Genetics , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To detect human bocavirus (HBoV) and investigate its genetic and evolutionary characteristics in children with acute respiratory infection in Tianjin, China.</p><p><b>METHODS</b>A total of 1,259 samples of nasopharyngeal aspirates were collected from children with a confirmed diagnosis of acute respiratory infection between January and December, 2012. Viral nucleic acid was extracted, HBoV was detected by real-time quantitative PCR, and the gene segments of nucleocapsid protein of HBoV in positive samples were amplified by PCR. Several products were randomly selected and sequenced.The sequence obtained was compared with the known sequence of HBoV, and a phylogenetic analysis was performed. All the samples were examined to detect for other common respiratory tract viruses.</p><p><b>RESULTS</b>Among the 1,259 samples, the positive rate of HBoV was 4.53% (57/1,259), and among the 57 samples with positive HBoV, 75% (43/57) were positive in children with an age of 6-36 months. The positive rate of HBoV in children peaked in summer (from June to August), and there was a mixed infection with other viruses. Sequence analysis was performed for the PCR products from 36 positive samples, and the presence of HBoV was confirmed, with a higher homology to the known sequence of HBoV.</p><p><b>CONCLUSIONS</b>In Tianjin, acute respiratory infection in some children may be associated with HBoV infection, which is commonly seen in infants with an age of 6-36 months. The peak of HBoV infection occurs in summer. The phylogenetic analysis shows a high homology to the known sequence of HBoV, with few gene sequence variations.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Bocavirus , Classification , Child, Hospitalized , Phylogeny , Polymerase Chain Reaction , Respiratory Tract Infections , Virology , SeasonsABSTRACT
<p><b>OBJECTIVE</b>To investigate the value of blood lactic acid (BLA) in evaluating disease severity and prognosis in children with sepsis.</p><p><b>METHODS</b>A total of 484 children with sepsis were enrolled and divided into common sepsis group (n=310), severe sepsis group (n=105), and septic shock group (n=69). BLA level was measured before treatment, and the results of BLA re-examination after early fluid resuscitation were collected for children with septic shock and a BLA level of >2 mmol/L.</p><p><b>RESULTS</b>The BLA level increased with the increasing severity of sepsis. The analysis of the receiver operating characteristic curve showed that the cut-off value of BLA for the diagnosis of septic shock was 2.25 mmol/L, with a sensitivity of 82.6% and a specificity of 79.8%. The fatality rates in the BLA ≤1 mmol/L, BLA 1.1-2 mmol/L, BLA 2.1-4 mmol/L, and BLA >4 mmol/L groups were 8.5%, 9.4%, 27.2%, and 67.6%, respectively, and the risk of death in the BLA >4 mmol/L group was 22.4 times that in the BLA ≤1 mmol/L group. In children with septic shock who had a BLA level of >2 mmol/L before treatment and whose BLA levels were ≤2 mmol/L or >2 mmol/L after resuscitation, the fatality rates were 33.3% and 69.2%, respectively.</p><p><b>CONCLUSIONS</b>BLA can be used to evaluate disease severity and prognosis in children with sepsis, and a BLA level of 2.25 mmol/L has a high value in diagnosing septic shock. Early resuscitation helps BLA level return to normal and can improve the prognosis of children with septic shock.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Lactic Acid , Blood , Prognosis , Sepsis , Blood , Mortality , Severity of Illness IndexABSTRACT
Objective To investigate the incidence and risk factors of hearing loss among the workers exposed to non -stationary noise.Methods A cross -sectional study was conducted among the participants.571 male workers without any history of ear disorder were enrolled in this study.They had been exposed to non -stationary noise for one year or more. The history of noise exposure,smoking and drinking behavior were interviewed by using a questionnaire.The noise exposure in the workplace was measured at eight -hour equivalent noise level (LEX.8h )and the thresholds of hearing at 500,1 000,2 000,3 000,4 000 and 6 000 Hz were detected.Results The prevalence of high -frequency hearing loss of two ears was 52.54%,while the prevalence of hearing loss of one ear was 71.98%.There were significant differences of prevalence among different groups of workers in LEX.8h ,duration of noise exposure and the cumulative noise exposure (CNE)(P <0.01).There was a dose response relationship between noise exposure and the risk of hearing loss (P <0.01).Conclusion Non -stationary noise exposure may contribute to hearing loss of workers.There is a good dose -effect relationship between the hearing loss and non -stationary noise.
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Vertical transmission is the major route of HCV infection in children and draws much attention recently. With the development of assisted reproductive technology (ART), more and more HCV-serodiscordant infertile couples seek assisted reproduction treatment. Vertical transmission of HCV in ART cannot be avoided. Understanding the state of HCV infection of oocyte and embryo is helpful to solve the fertility problem and to control mother-to-child transmission.
Subject(s)
Female , Humans , Pregnancy , Hepatitis C , Infectious Disease Transmission, Vertical , Reproductive Techniques, AssistedABSTRACT
<p><b>OBJECTIVE</b>To evaluate the value of pancreatic stone protein/regenerating protein (PSP/reg) in severity evaluation and prognosis prediction for children with sepsis.</p><p><b>METHODS</b>In this prospective case-control study, 159 children with sepsis (106 cases in the sepsis group; 53 cases in the severe sepsis group, including 12 cases of septic shock) and 20 children without sepsis (control group) were enrolled. ELISA was applied to measure plasma PSP/reg levels on days 1, 3, and 7 of admission to the PICU. The Spearman rank correlation test was applied to assess the correlations between plasma PSP/reg level and serum procalcitonin (PCT), CRP, WBC count, and pediatric critical illness score (PCIS). The area under the receiver operating characteristic curve (AUC) was used to assess the value of each index in determining severity and predicting prognosis for children with sepsis.</p><p><b>RESULTS</b>On day 1 of admission to the PICU, plasma PSP/reg levels in the sepsis and severe sepsis groups were significantly higher than in the control group (P<0.05), and the severe sepsis group had a significantly higher plasma PSP/reg level than the sepsis group (P<0.05). On day 1 of admission to the PICU, the survival group (n=132) had a significantly lower plasma PSP/reg level than the non-survival group (n=27) (P<0.05). On day 1 of admission to the PICU, plasma PSP/reg level in children with sepsis was positively correlated with WBC count and serum PCT level (rs=0.212 and 0.548, respectively; both P<0.05), and negatively correlated with PCIS score (rs=-0.373; P<0.05). The AUCs of plasma PSP/reg level and serum PCT for determination of severe sepsis, septic shock, and death were higher than 0.7 (P<0.05).</p><p><b>CONCLUSIONS</b>PSP/reg is closely related to infection, and has a certain clinical value in risk stratification of sepsis and prognosis evaluation.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Calcitonin , Blood , Calcitonin Gene-Related Peptide , Case-Control Studies , Lithostathine , Blood , Prognosis , Prospective Studies , Protein Precursors , Blood , Sepsis , Blood , Severity of Illness IndexABSTRACT
<p><b>OBJECTIVE</b>To investigate the role of Pediatric Critical Illness Score (PCIS) in evaluating the prognosis and severity of severe hand-foot-mouth disease (HFMD).</p><p><b>METHODS</b>This study included 424 children with severe HFMD, consisting of 390 survivors and 34 deceased patients. Related physiological parameters and clinical data were collected for calculating PCIS scores. The area under receiver operating characteristic curve (AUC) was employed to assess the performance of PCIS in evaluating the complications and outcomes.</p><p><b>RESULTS</b>The median of PCIS scores for survivors was higher than that for deceased patients (P<0.01). Of the 424 children with severe HFMD, only 26 (6.1%) had critical illness according to the severity assessment using PCIS. The AUC (95%CI) of PCIS was 0.74 (0.66, 0.82) in predicting pulmonary edema, 0.82 (0.74, 0.90) in predicting pulmonary hemorrhage, and 0.83 (0.75, 0.92) in predicting death.</p><p><b>CONCLUSIONS</b>PCIS can predict the complications and prognosis in children with severe HFMD. However, the existing scoring system of PCIS cannot fully assess the severity of HFMD.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Critical Illness , Hand, Foot and Mouth Disease , Diagnosis , PrognosisABSTRACT
<p><b>OBJECTIVE</b>To investigate the association between IL-18 polymorphisms and the risk of unexplained recurrent spontaneous abortion (URSA).</p><p><b>METHODS</b>The polymorphism of rs187238, rs360718 and rs360717 in IL-18 was determined by PCR in combination with DNA sequencing in 207 patients with URSA and 144 women with normal pregnancy.</p><p><b>RESULTS</b>The frequency of gene types GG, GC+CC of rs187238 (-137 G/C) in URSA group and control group was 77.3%, 22.7%, and 95.8%, 4.2%, respectively (χ²=22.767, P<0.001). The frequency of allele C in URSA group was significantly higher than that in control groups (13.04% vs 2.1%, χ²=26.102, P<0.001) . The risk of spontaneous abortion in C allele carriers was 7.050 times higher than that in G allele carriers (OR=7.050, 95%CI: 2.990-16.622). No significant difference in genotype frequency and allele frequency of rs360718 and rs360717 polymorphism was noticed between URSA group and control group (χ²=1.497, P=0.221; χ²=0.858, P=0.354).</p><p><b>CONCLUSION</b>GC+CC genotype and C allele of Rs187238 in IL-18 gene are associated with the susceptibility of recurrent spontaneous miscarriage. Rs360718 and rs360717 in IL-18 may not be associated with URSA.</p>
Subject(s)
Adult , Female , Humans , Young Adult , Abortion, Habitual , Genetics , Genetic Predisposition to Disease , Interleukin-18 , Genetics , Polymorphism, GeneticABSTRACT
BRAP (BRCA1 associated protein) is one of BRCA1 (Breast cancer suppressor protein) associated cytoplasmic proteins. BRAP gene has been found to be associated with the risk of some cancers, and the associations between BRAP and cardiovascular diseases and metabolic syndrome is gradually attracting much attention. However, the explicit mechanisms involved remain to be fully elucidated. We reviewed the association between BRAP gene and cardiovascular diseases and metabolic syndromes and the biologic mechanisms in the regulation of metabolism, hoping to provide clues on our future researches.
Subject(s)
Humans , Cardiovascular Diseases , Genetics , Ubiquitin-Protein Ligases , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To observe the expression of tumor necrosis factor-alpha (TNF-α) protein in the lung tissue of rats with chronic obstructive pulmonary disease (COPD), and to evaluate the intervention and mechanism of Heche Chongcao Capsule (HCC).</p><p><b>METHODS</b>The COPD rat model was prepared by exposure to cigarettes smoke plus intratracheal injecting lipopolysaccharide (LPS). Forty successfully modeled SD rats were randomly divided into the COPD model group, the control group, the low dose HCC group, the medium dose HCC group, and the high dose HCC group, 8 in each group. Meanwhile, a normal control group consisting of 6 rats was also set up. HCC at 0.25, 0.5, and 1.0 g/kg was administered to rats in the 3 dose HCC groups respectively by gastrogavage combined with Theophylline Sustained Release Tablet (TSRT). Rats in the control group were administered with TSRT by gastrogavage at 4.5 mg/kg, 1 mL/100 g each time, once daily. All medication lasted for 4 successive weeks. Equal volume of distilled water was administered by gastrogavage to rats in the COPD model group and the normal control group. Morphological changes of the lung tissue were observed under microscope. The expression of TNF-α protein in the lung tissue were also detected using Real-time PCR.</p><p><b>RESULTS</b>Under electron microscope, the cilium in the tracheal epithelium was disorderly arranged, type I and II alveolar cells were degenerated, endoplasmic reticulum and mitochondria were swollen, the lamellar body was emptied, and free fragment could be seen inside alveolar space. Compared with the model group, all lesions were somewhat ameliorated in all medicated groups, especially in the medium dose HCC group. Compared with the model group, the expression of TNF-α protein decreased in all medicated groups, especially in the medium and low dose HCC groups (P < 0.05, P < 0.01). Compared with the control group, the expression of TNF-α protein decreased in the medium and low dose HCC groups (P < 0.05).</p><p><b>CONCLUSION</b>HCC could effectively regulate the expression of TNF-α protein and inhibit airway inflammation reaction in COPD rats.</p>
Subject(s)
Animals , Rats , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Lipopolysaccharides , Lung , Metabolism , Pulmonary Disease, Chronic Obstructive , Drug Therapy , Metabolism , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
Objective To study the early diagnostic value of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) for acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in children and its influence on prognosis.Methods Fifty-two children with ALI/ARDS were selected as the experiment group,and 36 children with cardiac disease merging dyspnea were selected as the control group.The serum levels of NT-pro-BNP were measured in the 2 groups.The pediatric critical illness score(PCIS),lung injury score (LIS) and 28-day mortality were analyzed in the experiment group.The serum level of NT-pro-BNP,and the different condition and prognosis were compared in 2 groups,and the difference of the NT-pro-BNP levels were compared in children with ALI/ARDS.Results The NT-proBNP levels in experiment group were significantly higher than the control group (P ＜ 0.05).But the NT-pro-BNP levels in children with cardiaogenic pulmonary edema were significantly higher than ALI/ARDS(P ＜ 0.05).The NT-pro-BNP levels of the children who died in 28 d,or with LIS ＞ 2.5 scores or PCIS≤70 scores were higher than that of children who were survived,or with LIS ≤ 2.5 scores or PCIS ＞ 70 scores (P =0.001,0.013,0.002).The NT-pro-BNP levels were negatively correlated with PCIS(P ＜ 0.05),and the NT-pro-BNP levels were positively correlated with the 28-day mortality and LIS(all P ＜ 0.05).Conclusions The measurement of serum NT-pro-BNP can help to evaluate the severity and prognosis of ALI/ARDS children.
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<p><b>OBJECTIVE</b>To analyze the variation of serum insulin levels in critically ill children and investigate the underlying mechanism and clinical significance to provide the basis for treatment.</p><p><b>METHOD</b>Totally 332 critically ill children admitted in pediatric intensive care unit (PICU) of Hunan Children's Hospital from Nov., 2011 to April, 2012 were studied. The high insulin group (n = 332) was defined as insulin levels within 24 h > 11.1 mU/L and was divided into 2 groups: mildly elevated group (n = 194): 11.10 - 33.30 mU/L, increased three times group (n = 138): > 33.3 mU/L. Insulin, C-peptide and blood glucose were measured within 24 hours after admission, on day 3 and 7. Other results of inflammatory markers, lactate, cardiac enzymes, amylase, pancreatic ultrasound, hepatic and renal function as well as indicators related to severity and prognosis were recorded after admission.</p><p><b>RESULT</b>The peak of insulin level was seen on day 1, then presented a downward trend and reached the normal level on day 7. The peaks of blood glucose and C-peptide level were seen on day 1 then declined, the levels on day 7 were still slightly higher than normal level. The insulin level on admission (41.47 ± 30.85) mU/L were positively correlated with lactic acid (2.29 ± 1.81) mmol/L and procalcitonin level (5.08 ± 6.70) ng/ml (r = 0.370, P = 0.000; r = 0.168, P = 0.002) (P < 0.01). The insulin level on admission in children with 1 organ failure (41.24 ± 22.60) mU/L or 2 or multiple organ failure (48.98 ± 22.17) mU/L was higher than that in children with non-organ failure (34.11 ± 29.84) mU/L (U = 1621.001, P = 0.000;U = 1300.000, P = 0.000) (P < 0.01). The insulin level on admission in death group (52.99 ± 32.34) mU/L was higher than that in survival group (32.85 ± 24.10) mU/L (U = 1585.000, P = 0.000) (P < 0.01). Ten cases in death group were complicated with pancreatic damage and the average insulin level on admission was (65.29 ± 50.53) mU/L.</p><p><b>CONCLUSION</b>The high insulin level was correlated with the degree of inflammatory response, ischemia and hypoxia. The high insulin level in critically ill children was relevant to the pancreatic damage, the severity of the disease, organ dysfunction, and evaluation of prognosis.</p>