ABSTRACT
Objective:The present study aimed to explore the clinical value of neutrophil to lymphocyte and platelet ratio (NLPR) for acute kidney injury (AKI) in elderly patients with sepsis.Methods:This was a retrospective analysis of 360 elderly patients with sepsis or septic shock who were admitted to Intensive Care Unit (ICU) of Zhongnan Hospital of Wuhan University. They were divided into AKI and non-AKI groups based on the KDIGO-AKI criteria. The independent risk factors of AKI were identified via logistic regression analysis, and the calculation of the receiver-operating characteristic (ROC) curves were used to evaluate the diagnostic capability of NLPR for AKI and the short-term outcome of sepsis patients.Results:Total of 195 (54.2%) patients were attributed to the AKI group, while 165 (45.8%) patients were allocated to the non-AKI group. The median of NLPR was significantly higher in the AKI group compared with the non-AKI group ( Z=8.640, P<0.001). Compared with the non-AKI group, the in-hospital death and the length of ICU stay increased (all P<0.05). Patients with AKI required more vasoactive drugs, mechanical ventilation, and renal replacement therapy (all P<0.05). After adjusting the demographic and clinical variables, multivariate logistic regression analysis showed that NLPR was an independent risk factor of AKI ( OR=1.016, 95% CI 1.002-1.030, P=0.027). The ROC curves showed the excellent clinical value of NLPR and which was significantly higher than the neutrophil to lymphocyte ratio (NLR) and serum creatinine. In addition, the present study revealed that the NLPR was also positively correlated with the stage of AKI ( r=0.525, P<0.001). Conclusions:The NLPR is derived from a complete blood cell count, as a new comprehensive inflammatory parameter that is simple and easily available, it is an independent risk factor for AKI in elderly sepsis patients, and should be paid attention in the clinical practice.
ABSTRACT
BACKGROUND: Clinical ligation of traditional brackets by stainless steel ligature wires has greater randomness among doctors, and previous studies have mainly concerned on brackets and wires. There are less studies on the differential frictional force due to tight or loose ligation, and moreover, how to define tight ligation or loose ligation is rarely reported. OBJECTIVE: To compare the frictional force of different archwires in multiple brackets with various ligations. METHODS: A plaster model with moderate crowded malocclusion was randomly selected, and copied by 3D digital scanning technologies and Objet30 OrthoDesk3D printing technologies. Then, the models were bonded with Damon Clear brackets, Damon 3MX brackets, 3M traditional MBT brackets and Habit monocrystal brackets. Frictional forces of different brackets on models combined with two types of low frictional NiTi archwires which were 0.30 mm (0.012 inch) and 0.36 mm (0.014 inch) were measured by microcomputer servo dynamometer. Traditional brackets were ligatured by tight ligation and loose ligation, respectively. RESULTS AND CONCLUSION: (1) When low-friction NiTi archwires of 0.30 mm were used, significant differences in the frictional force were found between different brackets with various ligations except for Damon Clear bracket versus 3M bracket with loose ligation as well as Damon Clear bracket versus Damon 3MX bracket (P ＜ 0.05). (2) When low-friction NiTi archwires of 0.36 mm were used, similarity in the frictional force was found between 3M bracket with loose ligation, Damon Clear bracket and Damon 3MX bracket, while there were no significant differences between 3M bracket with loose ligation and Damon 3MX, between 3M bracket with tight ligation and Habit bracket with loose ligation, as well as between Damon Clear bracket and 3M bracket with loose ligation (P ＞ 0.05). Comparing two kinds of archwires, the friction force showed no statistical difference between Damon Clear bracket and 3M bracket with loose and tight ligation (P ＞ 0.05), but a statistical difference was found between Damon 3MX bracket and Habit bracket (P ＜ 0.001), whatever two conventional brackets with tight ligation or loose ligation. To conclude, conventional MBT bracket with loose ligation can reduce frictional force as similar as self-ligating bracket in the alignment phase, and the reduction in the friction force is impacted by archwire size and bracket material.
ABSTRACT
AlM: To explore a formula between the diopter , cornea diopter ( CD ) , anteriou chamber depth ( ACD ) , lens thickness ( LENS ) , vitreous depth ( VlTR ) , and ocular axis longitude ( AL ) of high school students in certain middle school, and to predict the diopter with the biometry data of refractive factors on the students. METHODS: The related ocular examinations were performed to 364 eyes of 182 high school students in certain middle school by cluster sampling method. Optometry was for diopter and A-ultrasonic biometry was for ACD, LENS, VlTR, and AL. The data were analyzed with SPSS to sum up a poly-variation liner regression formula that can express their quantitative relationship.RESULTS: A poly-variation liner regression was got. The formula was D=69. 750-0. 724×CD-0. 630×ACD-2. 207× LENS-1. 728×VlTR (r=0. 87).CONCLUSlON: The diopter of high school students seems able to be predicted through biometric data of CD, ACD, LENS and VlTR.
ABSTRACT
A 90-year-old Chinese man was transferred to the Emergency Department of the Affiliated Shantou Hospital of Sun Yat-sen University for treatment of an acute myocardial infarction. He suffered chest pain with three days of cough, dyspnea and fever. A diagnosis of Takotsubo cardiomyopathy was made in normal coronary arteries from urgent coronary angiography and characteristic apical dyskinesis and basal hyper contractility in left ventriculography. The patient died from severe multi-organ failure on the second day of hospitalization.
Subject(s)
Aged, 80 and over , Humans , Male , Coronary Angiography , Fatal Outcome , Takotsubo Cardiomyopathy , Diagnosis , Diagnostic ImagingABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical value of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) detection in the diagnosis of diastolic heart dysfunction.</p><p><b>METHODS</b>Ninety patients with diastolic heart dysfunction and left ventricular ejection fraction (LVEF)>or=45% were divided into 3 groups according to the findings by conventional echocardiography and/or tissue Doppler imaging, namely impaired relaxation pattern group (n=58), pseudonormal pattern group (n=22) and restrictive filling pattern group (n=10). Ten patients with normal heart function served as the control group. Plasma NT-proBNP level was determined in all the subjects and its correlation to diastolic heart dysfunction was analyzed.</p><p><b>RESULTS</b>Compared with the control group, all the 3 case groups had significantly higher plasma NT-proBNP level (P<0.01). Plasma NT-proBNP level increased gradually with the severity of diastolic dysfunction. Spearman rank correlation analysis indicated that lg(NT-proBNP) was positively correlated to the severity of diastolic dysfunction. Simple linear regression showed that 52.7% of the total variation of lg(NT-proBNP) was correlated to the severity of the condition. The ROC curve demonstrated a sensitivity of 80%, specificity of 90%, positive predictive value of 84.2% and the negative predictive value of 87.1% for NT-proBNP level of 133 ng/L in predicting diastolic heart dysfunction regardless of the clinical manifestations, and the sensitivity was 81.7% and specificity was 75% for NT-proBNP level at 280.25 ng/L in predicting symptomatic diastolic heart dysfunction; the sensitivity was 81.2% and the specificity was 92.6% for NT-proBNP at 655 ng/L in predicting moderate to severe diastolic heart dysfunction.</p><p><b>CONCLUSION</b>Plasma NT-proBNP level increases gradually with the severity of diastolic dysfunction and has a high clinical value in severity rating and assisting the diagnosis of diastolic dysfunction.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Diastole , Heart Failure , Blood , Diagnosis , Natriuretic Peptide, Brain , Blood , Peptide Fragments , Blood , Stroke VolumeABSTRACT
<p><b>OBJECTIVE</b>To express endotoxin binding peptide and its mutant in E coli DH5alpha and detect the antiendotoxin activity of the purified peptides.</p><p><b>METHODS</b>(1 ) E coli DH5at containing pinpointXa3-EBP and pinpointXa3-mEBP was activated by IPTG to express biotin fusion protein. The fusion proteins were purified, and then digested by factor Xa for isolation of EBP and mEBP. The target peptide was purified with affinity chromatography and reversed-phase HPLC. Sequences of 10 amino acids at N-terminal were used for identification of mEBP. (2) PBMCs were isolated from blood of normal people, and they were stimulated with 5 mg/L FITC-LPS plus 2.0,5. 0 and 12. 5 mg/L EBP or mEBP. Then the mean fluorescent intensity was detected. PBMC was also stimulated with 1 mg/L LPS plus 2.0, 5.0 and 12.5 mg/L EBP or mEBP for 5 hours for the detection of the TNF-alpha and IL-6 level in the supernatant. (3) Thirty-five Kunming mice were randomized into normal control ( n = 5, with intraperitoneal injection of 0. 2 ml isotonic saline) , model group(n = 5, with intraperitoneal injection of LPS and 20% TBSA full-thickness burns), and treatment group (n = 15, with intraperitoneal injection of 5 mg/kg PMB or 10 mg/kg EBP or mEBP after burns). The serum contents of TNF-a and IL-6, and TNF-alpha mRNA level in hepatic tissue in each group were determined 6 hours after treatment.</p><p><b>RESULTS</b>( 1 ) EBP and mEBP were obtained after Xa digestion of biotin fusion protein, with purity reaching above 98% . The sequence of 10 amino acid at N-terminal was in accord with what expected. (2) The fluorescent intensity was decreased followed by an increase in mEBP or EBP concentration. Compared with normal PMBC, IL-6 and TNF-alpha level in the supernatant were obviously lowered in 1 mg/L LPS + 12.5 mg/L EBP group and I mg/L LPS +2. O0 , 5. 0, 12. 5 mg/L mEBP groups ( P < 0.01). (3) The serum level of IL-6 and TNF-ca in the therapeutic groups were obviously lower than that in model group ( P < 0.01 ) , and the levels of these cytokines were significantly lower in 10 mg/kg mEBP group than that in 10 mg/kg EBP group ( P <0. 01) , but they were similar to that in 5 mg/kg PMB treatment group ( P >0.05). (4) Relative optical density of TNF-alpha. mRNA in control, model, 10 mg/kg mEBP, 10 mg/kg EBP and 5 mg/kg PMB groups was 0.25, 0.93, 0.51 , 0.77 and 0.43, respectively.</p><p><b>CONCLUSION</b>Endotoxin binding peptides can be obtained by procaryon expression. Both EBP and mEBP have anti-LPS activity, but mEBP is more effective.</p>