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1.
Journal of Clinical Hepatology ; (12): 124-128, 2022.
Article in Chinese | WPRIM | ID: wpr-913125

ABSTRACT

Objective To investigate the association of ideal cardiovascular health metrics with the incidence rate of nonalcoholic fatty liver disease (NAFLD), and to provide a basis for the prevention and control of NAFLD. Methods A prospective cohort study was conducted for the data of 50 511 employees of Kailuan Group who participated in physical examination from July 2006 to June 2007, and the onset of NAFLD was observed during follow-up once every two years. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the Kruskal-Wallis H test used for comparison of continuous data with skewed distribution between multiple groups; the chi-square test was used for comparison of categorical data between groups. The subjects were divided into four groups according to the quartile of cardiovascular health score (CHS), and person-year incidence rate was used to calculate the incidence rate of NAFLD in each group. Restricted cubic spline (RCS) curve was used to calculate the dose-response relation between continuous variables and outcome events; the Cox proportional hazards model was used to analyze hazard ratio ( HR ) and 95% confidence interval ( CI ) in each group and investigate the effect of ideal cardiovascular health metrics on the incidence rate of NAFLD. Results During the mean follow-up time of 5.58 years, a total of 15 265 cases of NAFLD were observed, and the incidence rate of NAFLD was 77.88/1000 person-year in the Q1 group, 61.33/1000 person-year in the Q2 group, 46.37/1000 person-year in the Q3 group, and 33.69/1000 person-year in the Q4 group. RCS results showed a non-linear relationship between CHS continuous variable and the risk of NAFLD ( P < 0.05). The multivariate Cox proportional risk model analysis showed that compared with the Q1 group in terms of the risk of NAFLD, the Q2, Q3, and Q4 groups had an HR of 0.78 (95% CI 0.74~0.81), 0.57 (95% CI 0.54~0.59), and 0.38 (95% CI 0.36~0.41), respectively, and similar results were observed in subjects stratified by sex and age. The analysis of each component showed that ideal body mass index ( HR =0.37, 95% CI : 0.36~0.39), ideal blood glucose ( HR =0.80, 95% CI : 0.77~0.84), ideal blood pressure ( HR =0.72, 95% CI : 0.69~0.75), ideal cholesterol ( HR =0.86, 95% CI : 0.83~0.89), and ideal diet ( HR =0.94, 95% CI : 0.90~0.99) were protective factors against NAFLD. Conclusion Ideal cardiovascular health metrics are protective factors against NAFLD, and maintaining a healthy lifestyle may help to prevent the onset of NAFLD.

2.
Article in Chinese | WPRIM | ID: wpr-907745

ABSTRACT

Objectives:To investigate the relationship between heart rate adjusted QT dispersion (QTcd) and soluble growth stimulating gene 2 protein (sST2) and the severity and prognosis of patients with acute carbon monoxide toxic heart disease.Methods:Retrospective analysis was performed on 135 patients with acute carbon monoxide toxic heart disease admitted to the Emergency Medical Department of our hospital from January 2017 to 2020. Blood sST2, creatine kinase isoenzyme (CK-MB) and troponin I(cTnI) concentrations were recorded at 3 h, 12 h, 2 d and 3 d immediately after admission.The patient was measured and calculated on the day of admission,2 d,3 d and QTcd at discharge.According to the toxicity of carbon monoxide in heart disease severity was divided into mild heart disease group (58 cases), moderate heart disease group (45 cases), severe heart disease group (32 cases), according to whether severe heart disease were divided into severe group (32 cases) and non severe group (103 cases), according to whether the patients death in patients with severe heart disease.Results:Thirty-two of the 135 patients had severe toxic heart disease, with an incidence of 23.7%.In the severe group, sST2, cTnI and CK-MB increased from 24 h and 2 d after admission, and the detected values were all higher than those of the non-severe group and the normal control group, with statistically significant differences ( P<0.05).Before treatment, there were statistically significant differences in sST2 and QTcd between the toxic group and the non-severe group and the normal control group ( P<0.05).After 2 d and 3 d poisoning, there were statistically significant differences between the two groups ( P<0.05). ROC curve analysis showed that the area under the sST2 curve was 0.726, 95% CI was 0.555-0.898, sensitivity was 56.3%, specificity was 94.1%, and truncation was 88.5 ng/mL.The area under the QTcd curve was 0.745, 95% CI was 0.602-0.889, sensitivity was 56.3%, specificity was 82.4%, and truncation value was 68.5 ms.The area under the combined detection curve was 0.939, 95% CI was 0.874-1.000, sensitivity was 81.3%, specificity was 91.2%. Conclusions:In patients with acute carbon monoxide toxic heart disease, the level of sST2 increased earlier than THAT of cTnI and CK-MB, and the combined observation of sST2 and QTcd can be used as an indicator for early prediction of acute carbon monoxide toxic heart disease and its severity.

3.
Article in Chinese | WPRIM | ID: wpr-921794

ABSTRACT

In this paper, the newly isolated tannins were sorted after a review of the literature concerning tannins in recent 10 years, and their research progress was summarized in terms of extraction, isolation, pharmacological activity and metabolism. Hydrolysable tannins and condensed tannins are the main structural types. Modern research shows that tannins have many pharmacological effects, such as bacteriostasis, antioxidation, antitumor, antivirus and blood glucose reduction, and have broad development prospects. They are usually extracted by water, ethanol and acetone and isolated and purified by macroporous resin and gel column chromatography. The packings commonly adopted for the column chromatography mainly included Sephadex LH-20, Diaion HP-20, MCI-gel CHP-20 and Toyopearl HW-40. Modern analytical techniques such as nuclear magnetic resonance spectroscopy(NMR), fast atom bombardment mass spectrometry(FAB-MS) and circular dichroism(CD) are generally used for the structural identification of tannins. Howe-ver, their isolation, purification and structural identification are still challenging. It is necessary to use a variety of high-throughput screening methods to explore their pharmacological activities and to explore the material basis responsible for their functions through experiments in vivo.


Subject(s)
China , Hydrolyzable Tannins , Medicine, Chinese Traditional , Proanthocyanidins , Tannins
4.
Article in Chinese | WPRIM | ID: wpr-921777

ABSTRACT

A HPLC method was established for simultaneous determination of two organic acids(chlorogenic acid and ferulic acid) and five phthalides(senkyunolide I, senkyunolide H, senkyunolide A, ligustilide, and butylidenephthalide) in Angelicae Sinensis Radix and its processed products to clarify the underlying material transferring rules. The analysis was performed on a Welch Ultimate C_8 column(4.6 mm×250 mm, 5 μm) with acetonitrile(A)-0.085% phosphoric acid water(B) as the mobile phase in a gradient elution mode at the flow rate of 1.1 mL·min~(-1), the column temperature of 25 ℃, the detection wavelength of 280 nm, and the injection volume of 10 μL. Under these conditions, the content of the above-mentioned seven components was analyzed in 15 batches of Angelicae Sinensis Radix and its processed products, and the transfer rate of each compound was calculated. As a result, in the processed products, the average content of chlorogenic acid was slightly decreased and that of ferulic acid was equivalent to the medicinal materials. The content of senkyunolide I, senkyunolide H, senkyunolide A, and butylidenephthalide showed an increasing trend in the processed products as compared with the medicinal materials. The mass fraction of ligustilide in the medicinal materials was above 0.7%(0.94% on average), meeting the requirement of 0.6% in the Hong Kong Chinese Materia Medica Standards, but was 0.47% on average in the processed products, which was decreased by 50% approximately. Further investigation showed that the content of ligustilide in freshly made processed products of Angelicae Sinensis Radix did not change significantly compared with that in the medicinal materials, indicating that the loss of ligustilide in the processed products mainly occurred in the storage. Therefore, Angelicae Sinensis Radix is suitable for storing in the form of medicinal materials and the freshly made processed products should be used except for special cases. Additionally, it is recommended to control the content of volatile oils or ligustilide in medicinal materials and processed products of Angelicae Sinensis Radix to ensure its effectiveness in clinical medication.


Subject(s)
Angelica sinensis , Chlorogenic Acid , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Plant Roots
5.
Article in Chinese | WPRIM | ID: wpr-921693

ABSTRACT

Polygalae Radix has long been used in China for calming the mind, promoting intelligence, communicating the heart and kidney, eliminating phlegm, and reducing swelling. At present, it is used to treat amnesia, insomnia, and malaise. Modern research has revealed that Polygalae Radix mainly contains triterpenoid saponins, xanthone, oligosaccharide esters, etc., with the activities of improving memory, resisting dementia, protecting the brain, relieving cough, and removing phlegm, as well as sedation and hypnosis. The present study reviews the research progress on chemical composition, pharmacological action, quality control, and metabolism of Polygalae Radix in the past 30 years, to provide a theoretical basis for further research and development.


Subject(s)
Drugs, Chinese Herbal , Oligosaccharides , Plant Roots , Polygala , Quality Control
6.
Article in Chinese | WPRIM | ID: wpr-921641

ABSTRACT

To obtain the chemical profile of Tibetan medicinal plant ″Bangga″, the present study established the HPLC fingerprint of ″Bangga″ and inferred common chemical constituents of its two original plants, Aconitum tanguticum and A. naviculare by LC-MS. The HPLC analysis was performed on a Kromasil 100 C_8 column(4.6 mm×250 mm, 5 μm) with acetonitrile(A)-0.1% formic acid in water(B) as mobile phase in a gradient elution mode. Besides, the flow rate was set at 1 mL·min~(-1) and the column temperature was 35 ℃. The detection wavelength was set at 255 nm and the injection volume was 10 μL. Seventeen batches of ″Bangga″ samples were analyzed and the HPLC fingerprint was established under the above conditions. Similarity evaluation was performed using Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine(2012). As a result, 16 common peaks were selec-ted and the similarity values of 17 batches of ″Bangga″ were in the range of 0.702-0.966. Furthermore, one batch of A. tanguticum and one batch of A. naviculare were analyzed by LC-MS/MS and 74 common compounds were inferred, including 10 phenolic acids, 26 flavonoids, and 38 alkaloids. The established method, with good separation and strong specificity, is simple and feasible, and can be used for the quality control of ″Bangga″ and identification of its two original plants. A. tanguticum and A. naviculare are similar in chemical composition and component content, but are quite different in the content of flavonoids.


Subject(s)
Chromatography, High Pressure Liquid , Chromatography, Liquid , Drugs, Chinese Herbal , Plants, Medicinal , Tandem Mass Spectrometry , Tibet
7.
Cancer Research and Treatment ; : 1113-1122, 2021.
Article in English | WPRIM | ID: wpr-913808

ABSTRACT

Purpose@#The influence of fasting blood glucose (FBG) and cholesterolemia primary liver cancer (PLC) in china was analyzed via a large prospective cohort study based on a community population, and the combined effects between them were investigated. @*Materials and Methods@#Overall, 98,936 staff from the Kailuan Group who participated in and finished physical examinations between 2006 and 2007 were included in the cohort study. Their medical information was collected and they were followed up after examination. The correlations of serum FBG or TC with PLC were analyzed. Then, we categorized all staff into four groups: normal FBG/ non-hypocholesterolemia, normal FBG/hypocholesterolemia, elevated FBGon-hypocholesterolemia, elevated FBG/hypocholesterolemia and normal FBG/ non-hypocholesterolemia was used as a control group. The combined effects of elevated FBG and hypocholesterolemia with PLC were analyzed using the Age-scale Cox proportional hazard regression model. @*Results@#During 1,134,843.68 person*years follow up, a total of 388 PLC cases occured. We found the elevated FBG and hypocholesterolemia increases the risk for PLC, respectively. Compared with the non-hypocholesterolemiaormal FBG group, the risk of PLC was significantly increased in the non-hypocholesterolemia/elevated FBG group (HR=1.19,95%CI 0.88–1.62) and hypocholesterolemiaormal FBG group (HR=1.53,95%CI 1.19–1.97), and in the hypocholesterolemia/elevated FBG group (HR=3.16 95%CI2.13-4.69). And, a significant interaction effect was found of FBG and TC on PLC. All results were independent from the influence of liver disease. @*Conclusion@#Elevated serum FBG and hypocholesterolemia are risk factors for PLC, especially when combined. Thus, for the prevention and treatment of PLC, serum FBG and TC levels should be investigated.

8.
Cancer Research and Clinic ; (6): 572-578, 2021.
Article in Chinese | WPRIM | ID: wpr-912926

ABSTRACT

Objective:To investigate the expression of glutathione peroxidases 4 (GPX4) in colon adenocarcinoma and its relationship with clinicopathological features and prognosis of patients.Methods:The data set of colon adenocarcinoma was obtained from The Cancer Genome Atlas (TCGA) database to analyze the expression of GPX4 in colon adenocarcinoma tissues and its predictive value for overall survival (OS). A total of 93 colon adenocarcinoma tissues and 87 adjacent mucosa tissues after operation from November 2009 to May 2010 provided by the National Human Genetic Resources Sharing Service Platform were selected. The expression of GPX4 protein was detected by using tissue chip immunohistochemistry. The relations between the expression of GPX4 protein and the clinicopathological features and OS of colon adenocarcinoma patients were analyzed. Cox proportional hazards regression model was used to analyze the factors affecting the prognosis. The nomogram for predicting OS rate was established and drawn.Results:The analysis of data from TCGA database showed that in 380 cases of colon adenocarcinoma, the expression of GPX4 in colon adenocarcinoma tissues were higher than that in the normal colonic mucosa tissues [the value of fragments per kilobase of exon per million fragments mapped (FPKM): 85.654 (20.351-356.237) vs. 56.230 (48.783-63.931)], and the difference was statistically significant ( Z = -6.150, P<0.05). The OS in GPX4 high-expression group (FPKM ≥83.614) were poorer than that in GPX4 low-expression group (FPKM < 83.614) (median OS time: 84.40 months vs. 94.03 months, 5-year OS rate: 58.6% vs. 72.7%), and the difference was statistically significant ( P<0.05). Tissue chip immunohistochemical staining results show that the high-expression rate of GPX4 protein in colon adenocarcinoma tissues was higher than that in adjacent normal tissues [38.0% (35/92) vs. 7.3% (6/82)], and the difference was statistically significant ( χ2 = 22.727, P<0.01); the high-expression rate of GPX4 protein in left colon adenocarcinoma tissues was higher than that in right colon adenocarcinoma tissues [47.2% (25/53) vs. 25.6% (10/39), and the difference was statistically significant ( χ2 = 4.42, P = 0.036); the 5-year OS rate of patients in GPX4 high-expression group was lower than that in GPX4 low-expression group (25.7% vs. 57.9%), and the difference was statistically significant ( χ2 = 9.051, P<0.05). Multivariate Cox proportional hazards regression model analysis showed that lymph node metastasis (stage N 1-N 3) ( HR = 2.241, 95% CI 1.242-4.046, P = 0.007) and high expression of GPX4 ( HR = 2.783, 95% CI 1.598-4.848, P<0.01) were independent factors affecting the poor prognosis of colon adenocarcinoma patients. The above factors were used to establish a nomogram for predicting the prognosis of patients with colon adenocarcinoma, the C index was 0.739, indicating that the nomogram had good predictive performance. Conclusion:The expression of GPX4 is up-regulated in colon adenocarcinoma tissues, and its high expression is related to the malignant biological behavior of the tumor and poor prognosis.

9.
Chinese Journal of Digestion ; (12): 765-769, 2021.
Article in Chinese | WPRIM | ID: wpr-912229

ABSTRACT

Objective:To summarize the clinical features of intestinal Beh?et′s disease, so as to provide reference for the diagnosis of the disease.Methods:From April 1 2014 to January 31 2019, the clinical data of 47 patients diagnosed as intestinal Beh?et′s disease at the Second Hospital of Hebei Medical University were retrospectively analyzed, which included initial symptoms, gastrointestinal symptoms, complications, erythrocyte sedimentation rate (ESR), the levels of C reactive protein (CRP), hemoglobin, serum albumin, results of acupuncture test, gastrointestinal involved site and ulcer shape. At the same time, gender differences of clinical manifestations were compared. Chi-square test was used for statistical analysis.Results:Among 47 patients with intestinal Beh?et′s disease, the initial symptoms of 26 (55.3%) cases were gastrointestinal symptoms. Abdominal pain was the most common symptom, the others were diarrhea, anorexia, abdominal distension and perianal abscess, and the incidence rate was 80.9%(38/47), 46.8% (22/47), 42.6% (20/47), 36.2% (17/47) and 2.1% (1/47), respectively. The main complications were gastrointestinal bleeding, perforation and obstruction, and the incidence rates was 40.4% (19/47), 4.3% (2/47) and 4.3% (2/47), respectively. Thirty-seven (78.7%) patients had different degrees of hypoalbuminemia (serum albumin<35 g/L). The CRP level of 36(76.6%) patients increased. The ESR of 36 (76.6%) patients increased. Twenty-two (46.8%) patients had mild anemia (hemoglobin<90 g/L). The acupuncture test was positive in 25 (53.2%) patients. The involved sites of gastrointestinal tract were terminal ileum and ileocecal junction, colon, esophagus, duodenum and jejunum, stomach, and rectum, the proportion was 57.4% (27/47), 27.2% (13/47), 23.4% (11/47), 23.4% (11/47), 17.0% (8/47) and 8.5% (4/47), respectively. All 47 (100.0%) patients had oral ulcers. 62.1%(18/29) patients presented with multiple ulcers under endoscope. The shape of ulcer was round ulcer, irregular ulcer, and longitudinal ulcer, the proportion was 48.3% (14/29), 34.5% (10/29) and 17.2 (5/29), respectively. The incidence rate of genital ulcer of female patients with intestinal Beh?et′s disease was higher than that of male patients with intestinal Beh?et′s disease (85.7%, 18/21 vs. 30.8%, 8/26), and the difference was statistically significant ( χ2=14.189, P<0.01). There were no significant differences between the female group and the male group in the incidence rate of oral ulcer, abdominal pain, diarrhea, and positive rate of acupuncture test (100.0%, 21/21 vs. 100.0%, 26/26; 85.7%, 18/21 vs. 76.9%, 20/26; 42.9%, 9/21 vs. 50.0%, 13/26; 52.4%, 11/21 vs. 58.3%, 14/26, all P>0.05). Conclusions:The common clinical symptoms of intestinal Beh?et′s disease are oral ulcers, abdominal pain, diarrhea and genital ulcer. Female patients with intestinal Beh?et′s disease are more likely to develop genital ulcer than male patients with intestinal Beh?et′s disease. Multiple ulcers are more common under endoscopy, which are round ulcer, irregular ulcer and longitudinal ulcer. The most common sites are the terminal ileum and ileocecal junction, followed by colon, esophagus and other parts.

10.
Article in Chinese | WPRIM | ID: wpr-912110

ABSTRACT

Objective:To understand the molecular characteristics of Escherichia coli producing Shiga toxin 2e subtype isolated from different sources in China. Methods:Three human-derived, 13 animal-derived and eight food-derived stx2e-positive Escherichia coli strains which were isolated during 2012 to 2018 were analyzed by antimicrobial susceptibility testing and whole genome sequencing. The stx subtype, serotype, multi-locus sequence type, virulence genes and antimicrobial resistance genes of each strain were determined by whole genome sequences. The phylogenetic relationship and genetic composition of Shiga-toxin prophage were explored. Results:Twenty-four stx2e-STEC strains were typed into 19 O∶H serotypes and 19 sequence types (STs). Each strain carried at least one kind of antimicrobial resistance gene and 19 out of 24 strains were resistant to at least one kind of antimicrobials. Three human-derived strains were heterogenous in serotypes and STs, but there were several animal and food-derived strains shared the same serotype or ST with human strains and showed close relationship in the phylogenetic analysis. The sequences of stx2e among all strains were highly conserved (similarity >99.7%), but there were significant differences in the size and the gene composition of Shiga toxin prophage genome. Conclusions:This is report about the characteristics of rare human-derived Stx2e-STEC strains in China. Comparing human isolates with animal-and food-derived strains, it indicates that Stx2e-STEC strains are highly genetic diversity and have the potential to infect humans.

11.
Chinese Journal of Dermatology ; (12): 891-897, 2021.
Article in Chinese | WPRIM | ID: wpr-911538

ABSTRACT

Objective:To investigate Chinese dermatologists′ perceptions of the correlation between diet and psoriasis, and to analyze factors influencing their perceptions.Methods:An exploratory survey study was conducted among Chinese dermatologists via the WeChat and Umer doctor platforms. The questionnaire consisted of 3 sections including career background characteristics (11 items) , dietary suggestions (3 items) and perceptions of effects of diet on psoriasis (19 items) . The results were expressed in frequency, assessed by chi-square test, and variables with significant differences were subjected to binary logistic regression analysis.Results:A total of 3 905 valid questionnaires were received. Among these responders, 91% believed psoriasis could be affected by dietary factors, and most believed certain diets could aggravate the severity of psoriasis; most dermatologists (80.1%) suggested patients avoid some foods or drinks, and the top 5 foods or drinks suggested to be avoided were seafood (2 950, 94.34%) , spicy food (2 599, 83.11%) , wine (2 588, 82.76%) , mutton (1 995, 63.8%) and beef (1 979, 63.29%) . Logistic regression analysis revealed that doctors with a college degree, practitioners of traditional Chinese medicine or integrated traditional Chinese and Western medicine, and those from hospitals of traditional Chinese medicine were more likely to suggest food or drink avoidance (all P < 0.001) ; practitioners of Western medicine ( P < 0.001) and those specializing in psoriasis ( P < 0.001) were more likely to inform that there was no need for food or drink avoidance, while those from municipal or county hospitals were less likely to inform that ( P = 0.025, 0.042, respectively) . Practitioners of traditional Chinese medicine ( P < 0.001) or integrated traditional Chinese and Western medicine ( P = 0.004) were more likely to believe that foods could aggravate the disease condition, while clinicians with working experience of more than 20 years ( P < 0.01) and those with a doctor degree ( P = 0.008) were less likely to think so; doctors with a college degree, and those from traditional Chinese medicine hospitals were more likely to believe that drinks could aggravate the disease condition (both P < 0.05) ; practitioners of traditional Chinese medicine or integrated traditional Chinese and Western medicine, those with intermediate and senior professional titles, those working at psoriasis specialty clinics and those engaged in psoriasis basic research were more likely to believe that foods could relieve the disease condition (all P < 0.05) ; doctors from traditional Chinese medicine hospitals, those with working experience of > 5 years, those with a college degree, and those engaged in psoriasis basic research were more likely to believe that drinks could relieve the condition (all P < 0.05) . Conclusion:A relatively high proportion of Chinese dermatologists had the viewpoints that diets were correlated with the severity of psoriasis and there was a need for food or drink avoidance, and this perception was related to academic degree, practicing category of clinicians, as well as the type and location of the hospital.

12.
Chinese Journal of Dermatology ; (12): 819-821, 2021.
Article in Chinese | WPRIM | ID: wpr-911527

ABSTRACT

Objective:To investigate quality of life and its influencing factors among patients with non-melanoma skin cancers (NMSC) .Methods:From June 2017 to January 2020, demographic, clinical and behavioral data were collected from 153 inpatients with NMSC, who received surgeries in Department of Plastic Surgery, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, by using a self-made questionnaire and the dermatology life quality index (DLQI) scale, and DLQI score was calculated to evaluate the quality of life of the patients. Chi-square test, Kruskal-Wallis H test, and multivariate logistic regression model were used to analyze factors influencing the quality of life of NMSC patients. Results:A total of 146 (95.4%) valid questionnaires were collected. The 146 patients were 31-92 years old, and 101 (69.2%) of them were over 60 years old, and 59 (40.4%) had a history of long-term ultraviolet exposure. There were 66 cases (45.2%) of basal cell carcinoma (BCC) , 57 (39.0%) of invasive squamous cell carcinoma (SCC) , 16 (11.0%) of extramammary Paget disease and 7 (4.8%) of Bowen disease. The median DLQI score ( M[ P25, P75]) was 3 (1, 7) . The quality of life were affected in 99 (67.8%) patients, including 52 (35.6%) mildly affected, and 47 (32.2%) moderately to extremely severely affected. Multivariate logistic regression analysis showed that the skin cancer type, long-term ultraviolet exposure history, and having 3 or more children affected the quality of life of the patients with NMSC. Conclusion:NMSC decrease the quality of life of the patients, and the type of skin cancers, history of long-term ultraviolet exposure and number of children are the factors influencing the quality of life of patients with NMSC.

13.
Chinese Journal of Geriatrics ; (12): 722-726, 2021.
Article in Chinese | WPRIM | ID: wpr-910905

ABSTRACT

Objective:To investigate clinical value of early cerebral oxygen utilization(O 2UCc)combined with the bispectral index(BIS)for monitoring delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)in elderly patients. Methods:This was a retrospective analysis.A total of 90 elderly patients with acute severe carbon monoxide poisoning(ASCMP)treated in Harrison International Peace Hospital from Nov.2018 to Jan.2020 were considered as research objects.Patients were divided into the DEACMP group(n=25)and the good prognosis group(n=65)according to their prognosis.Oxygen quantity absorbed into UCC(O 2UCc)and Bispectral index(BIS)at different times in the early stages were compared between the two groups.Correlations of O 2UCc and BIS with the occurrence of DEACMP were analyzed.Clinical significance of O 2UCc or BIS alone and of the two parameters in combination for the prediction of DEACMP was investigated. Results:O 2UCc was higher and BIS was lower in the DEACMP group than in the good prognosis group at 0 h, 6 h, 12 h, and 24 h after admission(all P<0.01). Pearson correlation analysis showed that O 2UCc was negatively correlated with DEACMP( r0 h=-0.482, r6 h=-0.534, r12 h=-0.587, r24 h=-0.514, all P<0.01), BIS was positively correlated with DEACMP( r0 h=0.348, r6 h=0.583, r12 h=0.679, r24 h=0.489, all P<0.01), and the correlation was the strongest at 12h after admission.ROC curve analysis was performed with O2UCc, BIS and the combined predictors at 12 h, and the results showed that the areas under the ROC curve of O 2UCc, BIS and the two in combination for DEACMP prediction were 0.845, 0.850 and 0.909, respectively, the sensitivities were 78.5%, 90.8% and 96.9% and the specificities were 80.0%, 76.0% and 84.0%, respectively. Conclusions:Early detection of O 2UCc or BIS has a good clinical value for predicting the development of ASCMP to DEACMP, and their combined value is even better.

14.
Article in Chinese | WPRIM | ID: wpr-910137

ABSTRACT

Objective:To investigate the ultrasonic features, contrast-enhanced ultrasound findings and long-term follow-up results of melanocytoma of the optic disc(MCOD).Methods:The data of 35 patients (35 eyes, 35 lesions) diagnosed with MCOD in Beijing Tongren Ophthalmic Center, Beijing Tongren Hospital from September 2012 to October 2020 were retrospectively analyzed. The B-mode ultrasonography and color Doppler flow imaging (CDFI) were performed on them. The size, morphology, internal echo and secondary changes of the lesions were analyzed. Contrast-enhanced ultrasound was performed on 13 patients. At the same time, 9 patients were followed up for long-term observation.Results:Six lesions (17.1%) showed hemispherical high echo, and 29 lesions (82.9%) showed limited uplift high echo. The largest base diameter of the lesions was (4.0±0.8)mm, average height was(1.9±0.4)mm. Internal echo characteristics: 8 lesions (22.9%) showed uniform echo and 27 lesions (77.1%) showed uneven echo.Lesion boundary: 35 lesions (100%) showed clear lesion boundary. Fifheen lesions (42.9%) showed secondary vitreous opacity. CDFI: blood flow signals could be detected inside the lesions in 19 lesions(54.3%), and not in 16 lesions(45.7%). Contrast-enhanced ultrasound showed 11 of the 13 lesions (84.6%) were completely filled with contrast agent.Conclusions:MCOD has certain ultrasonographic characteristics, which can provide a reliable basis for clinical diagnosis and differential diagnosis. There is no significant change in tumor size after long-term follow-up.

15.
Article in Chinese | WPRIM | ID: wpr-910092

ABSTRACT

Objective:To analyze the perfusion characteristics of choroidal metastasis using contrast-enhanced ultrasound, and compare with choroidal hemangioma.Methods:This was a retrospective study.From January 2016 to February 2018 in Beijing Tongren Hospital, a total of 21 eyes from 21 patients who were clinically diagnosed as choroidal metastasis were included as the choroidal metastasis group and 46 eyes from 46 patients who were diagnosed as choroidal hemangioma during the same period were included as the choroidal hemangioma group. All patients underwent contrast-enhanced ultrasound examination, and Sonoliver was used to obtain the data on quantitative parameters of the tumor and the adjacent normal orbital tissues, including maximum of intensity (IMAX), rise time (RT), time to peak (TTP), and mean transit time (mTT). The quantitative parameters between choroidal metastasis and normal orbital tissues were compared. And the quantitative parameters between choroidal metastasis and choroidal hemangioma were compared. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance.Results:The IMAX of choroidal metastasis was significantly higher than that of normal orbital tissues, while RT, TTP and mTT were significantly shorter than these of normal orbital tissues (all P<0.01). The IMAX of choroidal metastasis was lower than that of choroidal hemangioma, and RT, TTP and mTT were shorter than choroidal hemangioma (all P<0.01). The ROC curve analysis showed that area under curves of the IMAX, RT, TTP and mTT were 0.775 (95% CI=0.666-0.884), 0.970 (95% CI=0.896-0.996), 0.729 (95% CI=0.607-0.831) and 0.992 (95% CI=0.931-1.000) respectively. The sensitivities were 71.7%, 95.7%, 76.1% and 95.7%, and the specificities were 85.7%, 90.5%, 66.7% and 95.2%, respectively. Conclusions:Contrast-enhanced ultrasound can reflect the differences in perfusion characteristics between choroidal metastasis and choroidal hemangioma. RT and mTT are useful parameters in differential diagnosis between the two types of tumors.

16.
Clinical Medicine of China ; (12): 312-316, 2021.
Article in Chinese | WPRIM | ID: wpr-909749

ABSTRACT

Kidney transplantation can improve the quality of life of end-stage renal disease patients and is the most effective treatment.But renal transplantation is also a high risk factor for bladder cancer.Bladder cancer is a common malignant tumor in department of urology.Bacillus Calmette-Guerin intravesical instillation is a first-line therapy for high-risk non muscle invasive bladder cancer, which can directly kill bladder cancer cells.We reviewed the mechanism and clinical application of BCG in the treatment of bladder cancer after renal transplantation, in order to provide references for better utilization of Bacillus Calmette-Guerin in adjuvant treatment of bladder cancer after renal transplantation.

17.
Chinese Critical Care Medicine ; (12): 1088-1093, 2021.
Article in Chinese | WPRIM | ID: wpr-909458

ABSTRACT

Objective:To investigate the predictive neutrophil/lymphocyte ratio (NLR) combined with soluble growth stimulating expression gene 2 protein (sST2) on in-hospital major adverse cardiovascular events (MACE) in patients with myocardial injury following moderate-severe acute carbon monoxide poisoning (ACOP).Methods:A single-cente prospective observational approach was conducted. Moderate-severe ACOP patients with myocardial damage from November 2016 to February 2020 in department of emergency medicine of Harrison International Peace Hospital Affiliated to Hebei Medical University were enrolled. The baseline data of the patients, NLR and sST2 (T0 sST2) on admission, sST2 at 3 days after admission (T3 d sST2), and the other myocardial injury and biochemical indicators were collected. According to whether MACE occurred, the patients were divided into MACE group and non-MACE group. The clinical data of the two groups were compared. Pearson correlation analysis was used to analyze the correlation of each index. Binary Logistic regression was used to analyze the independent risk factors of in-hospital MACE in patients with moderate-severe ACOP myocardial injury. The receiver operator characteristic curve (ROC curve) was drawn and area under ROC curve (AUC) was calculated to analyze the predictive value of NLR, sST2, and NLR combined with sST2 for the occurrence of in-hospital MACE in patients with moderate-severe ACOP myocardial injury.Results:A total of 278 patients with moderate-severe ACOP myocardial injury were included in the final analysis, and the incidence of MACE was 11.51% (32/278). Cardiac troponin I (cTnI), lactic acid (Lac), NLR, and T3 d sST2 in the MACE group were significantly higher than those in the non-MACE group [cTnI (μg/L): 0.83±0.15 vs. 0.46±0.37, Lac (mmol/L): 2.96±1.14 vs. 2.43±1.35, NLR: 13.14±4.37 vs. 9.49±4.21, T3 d sST2 (μg/L): 59.88±23.42 vs. 39.83±12.60, all P < 0.05], there was no significant difference in T0 sST2 between the MACE group and the non-MACE group (μg/L: 269.09±90.89 vs. 240.14±113.02, P > 0.05). Pearson correlation analysis showed that there were significantly positive correlations in NLR with acute physiology and chronic health evaluationⅡ(APACHEⅡ), T3 d sST2 with APACHEⅡ, and NLR with T3 d sST2 ( r values were 0.226, 0.209, 0.193, all P < 0.01). Binary Logistic regression analysis showed that T3 d sST2 and NLR were both independent risk factors for MACE in moderate-severe ACOP patients with myocardial injury [odds ratio ( OR) and 95% confidence interval (95% CI) respectively was 1.064 (1.039-1.090), 1.176 (1.066-1.298), both P < 0.01]. ROC curve analysis showed that the predictive efficacy of NLR combined with T3 d sST2 for the occurrence of in-hospital MACE in patients with ACOP myocardial injury (AUC = 0.876) was better than that of NLR (AUC = 0.754) and T3 d sST2 (AUC = 0.813). When the optimal critical value of NLR was 10.02 and that of T3 d sST2 was 43.50 μg/L, the sensitivity of predicting the occurrence of MACE in patients with moderate-severe ACOP myocardial injury was 69.8% and 86.2% respectively, and the specificity was 74.3% and 70.4%, respectively. The specificity and sensitivity of the combined detection was 83.4% and 79.8%, respectively. Conclusions:NLR and T3 d sST2 were independent predictors of in-hospital MACE in moderate-severe ACOP patients with myocardial injury, and combined application of NLR and T3 d sST2 had good predictive value. For patients with moderate-severe ACOP myocardial injury with NLR > 10.02 and T3 d sST2 > 43.50 μg/L, the occurrence of in-hospital MACE should be alert.

18.
Article in Chinese | WPRIM | ID: wpr-908012

ABSTRACT

Objective:To explore the effect of Vancomycin on immune hemolysis and coagulation in children with non-Hodgkin′s lymphoma (NHL), thus providing the basis for the diagnosis and treatment of hemolytic anemia and coagulation dysfunction caused by Vancomycin, and guiding the rational use of drugs in children with NHL.Methods:From January 2018 to January 2019, 31 children with NHL treated with monotherapy of Vancomycin in Beijing Children′s Hospital, Capital Medical University were collected.Plasma samples within 1 week of Vancomycin medication were collected for detecting the anti-Vancomycin antibody by microcolumn gel method.The laboratory diagnostic and coagulation function indexes of hemolytic anemia before and after Vancomycin medication were analyzed using the paired sample t test. Results:Fourteen out of 31 children with NHL were positive for the anti-Vancomycin antibody, and among them, 10 cases had positive direct antiglobulin test (DAT). In NHL children with positive anti-Vancomycin antibody, their red blood cell count (RBC)[(2.75±0.07)×10 12/L vs.(3.18±0.07)×10 12/L], platelet count (PLT)[64.29±14.87)×10 9/L vs.(91.36±16.84)×10 9/L] and hematocrit (HCT)[(23.02±0.83)% vs.(29.19±1.98)%] were significantly reduced after Vancomycin medication than those before treatment (all P<0.01). On the contrary, total bilirubin (TB) [(51.96±15.52) μmol/L vs.(39.34±13.40) μmol/L], direct bilirubin (DB)[(31.30±13.98) μmol/L vs.(26.38±12.61) μmol/L], indirect bilirubin (IB)[(21.81±2.89) μmol/L vs.(13.75±1.63) μmol/L] and lactate dehydrogenase (LDH)[(208.6±16.85) U/L vs.(60.93±16.00) U/L] in them were significantly enhanced after Vancomycin medication than those before treatment (all P<0.05). Prothrombin time (PT)[(13.94±0.58) s vs.(11.66±0.30) s] and partial thromboplastin time (APTT)[(36.01±2.64) s vs.(28.09±0.98) s] were significantly prolonged in them after vancomycin medication than those before treatment (all P<0.01). A higher international normalized ratio (INR)(1.25±0.05 vs.1.05±0.02) was detected in NHL children with positive anti-Vancomycin antibody after medication ( P<0.000 1). In NHL children with negative anti-Vancomycin antibody, significantly higher PT (12.99±0.35) s vs.(11.82±0.27) s and INR (1.18±0.03 vs.1.07±0.03) were detected after Vancomycin medication (all P<0.000 1), while other indexes were similar before and after treatment. Conclusions:The anti-Vancomycin antibody may cause immune hemolysis and coagulation dysfunction in children with NHL.In order to prevent serious adverse events caused by drug antibodies, comprehensively clinical symptoms should be considered, drug antibodies and laboratory test results should be detected.

19.
Article in Chinese | WPRIM | ID: wpr-907992

ABSTRACT

Objective:To assess the left ventricular function and hemodynamic status in infantile pneumonia by ultrasonic cardiac output monitor (USCOM).Methods:The clinical data of 74 children with infantile pneumonia hospitalized in the Department of Pediatrics of Affiliated Hospital of North Sichuan Medical College from October 2018 to January 2020 were collected in this study, and those cases were divided into the mild pneumonia group (45 cases) and the severe pneumonia group (29 cases). USCOM was employed to measure such data of patients in both groups as heart rate (HR), flow time corrected (FTc), stroke volume variability (SVV), stroke volume index (SVI), cardiac index (CI), inotropy index(INO), and systemic vascular resistance index (SVRI). The specific values of CI and SVRI in all ages were employed to determine the hemodynamic type.According to values of CI, they were grouped into normal, high and low output; according to values of SVRI, they were grouped into normal, high and low resistance.The left ventricular function and hemodynamic status of infants with pneumonia in both groups were compared.Results:(1) In the mild pneumonia group, 42.22% of infants (19/45 cases) presented with abnormal hemodynamic status, of which 94.74% were high-output and low-resistance type.In the severe pneumonia group, 79.31%(23/29 cases) of infants presented with abnormal hemodynamic status, of which 86.96%(20/23 cases) were non-high-output and non-low-resistance type.The proportion of different hemodynamic types from high to low in order is as follows: low-output and high-resistance (39.13%), high-output and normal-resistance (26.09%), low-output and low-resistance (13.04%), and normal-output and low-resistance (8.70%). (2)Before treatment, HR, SVI, CI, INO and SVRI in the severe pneumonia group and the mild pneumonia group were (153.2±19.3) times/min, (32.0±5.8) mL/m 2, (4.3±1.0) L/(min·m 2), (1.1±0.4) W/m 2, (1 139.0±280.6) d·s·cm -5·m 2 and(140.2±13.2) times/min, (39.2±4.1) mL/m 2, (5.1±0.8) L/(min·m 2), (1.4±0.2) W/m 2, and (904.7±175.8) d·s·cm -5·m 2, respectively.SVI, CI and INO in the severe pneumonia group were lower than those in the mild pneumonia group, which indicated that the difference was statically significant (all P<0.05). HR and SVRI in the severe pneumonia group were higher than those in the mild pneumonia group, which indicated that the difference was statically significant (all P<0.05). There was no significant difference in cardiac preload between both groups before treatment ( P>0.05). HR in the severe pneumonia group after treatment[(137.6±9.3) times/min] were significantly lower than before treatment, while SVI and CI[(36.2±3.4) mL/m 2, (4.7±0.3)L/(min·m 2)] were higher than before treatment, which indicated that the differences were statistically significant (all P<0.05). Conclusions:The USCOM provided a rapid approach for the dynamic measurement of left ventricular function and hemodynamic status.As per the findings with USCOM, more infants with mild pneumonia presented with hemodynamic abnormalities, and most of them were high-output and low-resistance types.The majority of infants with severe pneumonia presented with different types of hemodynamic abnormalities, and most of them were non-high-output and non-low-resistance types, which can return to normal after treatment.

20.
Article in Chinese | WPRIM | ID: wpr-907560

ABSTRACT

There are four methods for fecal detection of colorectal cancer (CRC) markers: fecal occult blood test, fecal DNA test, fecal microRNA test, and fecal fusobacterium nucleatum (Fn) test. Fecal immunochemical test has been recommended by experts at home and abroad as the first choice for CRC screening. Fecal DNA test, due to its high price, has not yet been screened for large samples of people in China, so it is recommended as the second level of CRC screening. Fecal microRNA detection has been paid more and more attention by researchers. In recent years, the detection of fecal microbial markers has become more and more popular, especially fecal Fn detection, which is expected to become a microbial indicator for CRC screening.

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