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Aim To investigate the dynamic time-course changes in neuronal cytoskeleton after acute ischemia and reperfusion in rats. Methods Reperfusion was performedin rats by blocking the middle cerebralarteryfor 90 min, then therats wereobserved and collected at different time points. The brain damage wasobserved by Nissl staining,and neurobehavioural function was evaluated with neurological deficit score and forelimb placement test. The cellular changes in the alternations of cytoskeletal elements including microtubule associated protein 2 (MAP2) and neurofilament heavy chain (NF-H) were observed by immunohistochemistry staining and Western blot. Impaired axons, dendrites and cytoskeletal alternations were detected by electron microscope. Results Brain damage and neurobehavioural function were gradually aggravated with the prolongation of reperfusion. Brain damage appeared earlier and more severe in striatum than in cortex. Moreover, decreased MAP2-related and increased NF-H-related immunoreactive intensities were found in the ischemic areas. Impaired cytoskeletal arrangement and reduced dense were indicated. Damaged cytoskeletal components such as microtubules and neurofilament arrangement, decreased axonal filament density, and swelled dendrites were observed after cerebral ischemia reperfusion by ultrastructural observations. Conclusions Different brain regions have diverse tolerance to ischemia-reperfusion injury. Major elements of neuronal cytoskeleton show dynamic responses to ischemia and reperfusion, which may further contribute to brain damage and neurological impairment following MCAO and reperfusion.
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Objective:To explore the value of early dynamic changes of platelet count (PLT) in evaluating the prognosis of sepsis patients.Methods:A retrospective study was conducted to select sepsis patients admitted to the Emergency Intensive Care Unit (EICU) of the First Affiliated Hospital of Wenzhou Medical University from January 2013 to December 2017. The sepsis patients were divided into the survival group and death group according to the 28-day prognosis after EICU admission. The basic and clinical data of the two groups of patients were compared, and the risk factors for the 28-day prognosis of sepsis patients were screened, and the value of platelet change (ΔPLT) in the prognosis of sepsis was evaluated.Results:A total of 549 sepsis patients were included, 184 died within 28 days, and 365 survived, with a 28-day mortality rate of 33.5%. Compared with the survival group, the death group had a higher proportion of males, were older, and had more chronic diseases and tumors such as chronic obstructive pulmonary disease (COPD); simplified acute physiology score Ⅱ (SAPS-Ⅱ), sequential organ failure score (SOFA), procalcitonin, C-reactive protein, blood urea nitrogen, fibrinogen, and mean arterial pressure were lower, the PLT was lower on d1-5, the value of ΔPLT d2-5 were decreased more significantly, and the platelet to lymphocyte ratio (PLR) value was higher, and the difference was statistically significant ( P<0.05). However, there was no significant difference in mean platelet volume and platelet distribution width between the two groups (all P>0.05). Multivariate logistic regression analysis showed that COPD ( OR=4.167, 95% CI: 1.769-9.815, P<0.001), malignant tumor ( OR=1.815, 95% CI: 1.034-3.817, P=0.038), SAPS-Ⅱ score ( OR=1.071, 95% CI: 1.046-1.096, P<0.001), SOFA score ( OR=1.060, 95% CI: 1.001-1.021, P=0.041), and PLR value ( OR=1.001, 95% CI: 1.001-1.002, P<0.001) were independent risk factors affecting the 28-day prognosis of sepsis patients. PLT d1 ( OR=0.996, 95% CI: 0.995-0.998, P<0.001) was a protective factor for better prognosis in sepsis patients. The ROC curve analysis showed that the SAPS-Ⅱ score and SOFA score could predict the 28-day ICU prognosis of sepsis patients, and the SAPS-Ⅱ score had the largest area under the ROC curve (AUC=0.726). The AUC (0.678) of ΔPLT d4 was greater than those of the other days. When the optimal critical value was -26.5×10 9/L, the sensitivity was 57.8% and the specificity was 71.7%. Conclusions:The early dynamic changes of PLT are closely related to the prognosis of sepsis patients, which is worthy of clinical reference and promotion.
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Objective:To investigate the prevalence of malnutrition in hospitalized elderly patients with cancer in China using the Global Leadership Initiative on Malnutrition (GLIM) criteria.Methods:The data of 854 elderly cancer patients were extracted from the database of multi-center investigation and research on the dynamic changes of nutritional status of hospitalized patients in China led by the Geriatric Nutritional Support Group of Chinese Society of Parenteral and Enteral Nutrition. Changes in anthropometrics, nutritional risk and malnutrition prevalence from admission were collected at discharge and were compared among patients with different cancer types.Results:The prevalence of nutritional risk (NRS 2002 score ≥ 3 points) and malnutrition diagnosed per GLIM criteria were 63.23% and 42.74% at admission, and 69.44% and 42.86% at discharge. When further graded, prevalence of moderate malnutrition decreased from 24.12% at admission to 10.07% at discharge, and that of severe malnutrition increased from 18.62% to 32.79%, both with statistical significance. There were significant differences in anthropometric and laboratory parameters between malnutrition and non-malnutrition groups diagnosed per GLIM criteria.Conclusions:The GLIM criteria is applicable for the diagnosis of malnutrition in elderly cancer patients. Elderly cancer patients should be screened for nutritional risk, and GLIM criteria can be used to diagnose malnutrition. The changes of nutritional status should be dynamically monitored during hospitalization
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Objective:To investigate the predictive value of platelet dynamics on the prognosis of 28-day in patients with extracorporeal membrane oxygenation (ECMO).Methods:From January 2017 to December 2020, 60 patients from the Emergency Medicine Center of the First Affiliated Hospital of Nanjing Medical University received ECMO for life support. The baseline data of the patients were collected, the minimum value of platelets on day 1-7 of the machine was calculated, and the platelet change value and change rate were calculated. The patients were divided into the survival group and death group according to the 28-day survival status after ECMO was installed, and the receiver operating curve (ROC) was drawn based on the platelet change value and change rate to evaluate its predictive value for prognosis.Results:Among patients receiving VV-ECMO, the platelet change value and change rate on day 7 had the best prediction effect on the patient's 28-day outcome ( AUCΔPLT7=0.772, P=0.016; AUCΔPLT7%=0.764, P=0.020), when the platelet change value was 4×10 9/L as the critical value, the sensitivity was 0.857, the specificity was 0.615, and when the platelet change rate was -28.99% as the critical value, the sensitivity was 0.857, the specificity was 0.615, and when the platelet change rate was -28.99%. The sensitivity was 0.643 with a specificity of 0.846. In patients receiving VA-ECMO, the platelet change rate on day 6 predicted the best effect on the patient's 28-day outcome ( AUCΔPLT6%= 0.707, P = 0.045). When the platelet change rate was -26.19% as the critical value, the sensitivity was 0.842 and the specificity was 0.643. Conclusions:Platelet dynamic changes of platelets are correlated with the 28-day prognosis of patients receiving ECMO, and the combination of platelet change value and the critical value of change rate can better predict the poor prognosis of patients in both ECMO modes.
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De Winter syndrome,a special electrocardiogram of acute total occlusion or subtotal occlusion of left anterior descending coronary artery,is not common in clinical practice.It has been generally considered static,whereas the electrocardiogram changes dynamically in this case.We propose that de Winter pattern may indicate a thrombotic disease and can be roughly divided into two types according to whether the electrocardiogram changes dynamically.
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Humans , Coronary Angiography , Coronary Vessels , Electrocardiography , SeasonsABSTRACT
Objective Pulmonary function testing is a commonly used indicator for clinical evaluation of the degree of pulmonary fibrosis in patients. This paper aims to investigate the dynamic changes of lung function in mice with pulmonary fibrosis and to establish a range of reference values for lung function parameters in normal Kunming mice. Methods Twenty-eight SPF Kunming mice were randomly divided into normal control group (n=14) and model group (n=14). After anesthesia with 10% chloral hydrate, the normal control group only underwent tracheal puncture. The model group received intratracheal puncture and injection of bleomycin (BLM) (5 mg/kg body weight), and the lung function indicators of all mice were detected in the same order on the 1st, 2nd, 3rd and 4th weekends after modeling: Ti, Te, PIF, PEF, TV, EV, RT, MV, f, Penh and EF50. Results After intratracheal BLM injection, mice in the model group showed decreased hair softness and smoothness, hair loss and decreased activity after the 2nd week. Compared with the control group, Ti, Te and RT values in the model group significantly increased at week 4 (P<0.05), while the values of PEF, RT, MV, f and EF50 decreased significantly at the same week (P<0.05). Compared with the model group at week 1, the differences in Ti, Te, RT and f values at week 2, 3 and 4 were statistically significant (P<0.05); the differences in MV and EF50 values at week 3 and 4 were statistically significant (P<0.05); while the PIF values only showed differences at week 4 (P<0.001). Compared with the Penh values in the control group at week 2, 3 and 4 (0.553±0.189, 0.662±0.164, 0.712±0.189), the differences of the model group (0.820±0.205, 0.936±0.188, 1.053±0.236) showed statistical significance (P<0.001). Compared with the model group at week 1, the differences of Penh values in the model group only showed statistical significance at week 3 and 4 (P<0.05). Through four-week lung function test, various parameters were obtained, among which the normal range of the main index Penh value was 0.27-0.88. Conclusion The lung function detected by the non-invasive whole body plethysmography system was stable and reliable with good effects; the lung function in mice with the BLM-induced pulmonary fibrosis continued to decrease within four weeks. Penh, which reflects airway resistance, can be used for overall screening of the lung function among the test mice after two weeks of modeling.
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Objective To investigate the dynamic characteristic changes of gastrointestinal mucosa and its relationship with disease progression in rats with acute cerebral infarction. Methods Fifty-six male Wistar rats were selected as the study subjects, and they were divided into three groups: normal control, sham operation and cerebral infarction model groups by random number table method. The middle cerebral artery occlusion (MCAO) model was prepared by the modified Longa thread embolic method. The levels of gastrin (GAS) were monitored in each group after modeling for 24 hours, 4 days and 7 days; after the rats were killed, the sections of gastric antrum and small intestine were taken and stained with hematoxylin-eosin (HE) staining method, the histopathological changes of gastric and small intestinal mucosa were observed under light microscope, in the mean time the gastric and small intestinal mucosal pathological scores were also performed, and the differences of pathological scores among the three groups were compared. Results There were no statistical significant differences in GAS, gastrointestinal mucosa and small intestinal mucosal pathological scores between the normal control group and sham operation group at each time point (all P > 0.05); the GAS level in cerebral infarction model group was decreased gradually with time prolongation, reaching the lowest level 7 days after modeling, but the GAS level in cerebral infarction model group was significantly higher than that in normal group and shamoperation group (ng/L: 205.02±7.68 vs. 130.51±8.03, 145.29±7.68, both P < 0.05). The pathological scores of gastrointestinal mucosa and small intestinal mucosa in the cerebral infarction model group were increased first and then decreased with time prolongation, peaked on 4th day and decreased significantly on 7th day, the pathological scores of gastrointestinal mucosa and small intestinal mucosa in the cerebral infarction model group at each time point were significantly higher than those in the normal control group and sham-operated group (gastric mucosal pathological score: 82.50±2.95 vs. 21.38±1.57, 36.10±3.41; small intestinal mucosal pathological score: 62.00±2.78 vs. 18.25±1.39, 25.55±1.75, all P < 0.05). Under light microscopy, the normal control group showed complete normal morphological appearance, normal structure, orderly arrangement of villi and no infiltration of inflammatory cells; in shamoperation group, inflammatory cells infiltrated the lamina propria at each time point, and there were villi slightly uneven, enlarged stroma, congestion, edema occasionally seen and no obvious ulcer; in cerebral infarction model group, the various layers of gastrointestinal mucosal were not very clear, the glands were arranged irregularly and the capillaries dilated, and in part of tissues, congestion, hemorrhage, edema and inflammatory cell infiltration were seen obviously. Conclusion The injury of gastrointestinal mucosa in acute stage of cerebral infarction should be related to the stress stimulation and disease progress of cerebral infarction itself, not due to the abnormal secretion of GAS.
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With Coptis chinensis in high-yielding soil as the object,the growth regularity of plant and dynamic change of alkaloid content was studied. The plant growth model of C. chinensis was constructed. The plant height equation was =3.030 9+0.732 6-0.009 6²,the number of leaves equation was =111.882 6-2 234.881 7/+15 218.960 8/²-31 740.960 8/³,the leaf area equation was =-217.136 1+30.552 2-0.359 0²,the roots talk biomass equation was =-2.748 8+0.210 3+0.006 4²,the number of rootstalk equation was =-1.246 0+0.192 6+0.000 8²,the fibrous root biomass equation was =-4.973 5+0.589 4 -0.002 6². The results indicated that the number of leaves and leaf area were increasing continuously after seedling transplanting,the leaf area of 3-year-old C. chinensis reached a maximum value of 425.83 cm²/plant,after declining.The number of leave of 5-year-old C. chinensis reached a maximum value of 70.91. With the increasing of years of growth, the number of rootstalk and rootstalk biomass of C. chinensis was increasing continuously. The biomass growth of 3-year-old and 4-year-old rootstalk was the fastest in the whole development stage of C. chinensis,the annual increase of more than 300%. The change curve of rootstalk number, rootstalk biomass and fibrous root biomass in the whole growth stage was a s-type.The dry matter partition of leafwas the highest in 1-year-old C. chinensis, and then gradually decreased,the change trend of dry matter partition of rootstalk was just the opposite, the dry matter partition of fibrous root increases with the increase of the growing year, reaching the maximum value in 3-year-old, then gradually lower trend. The root-shootratio of 1-year-old C. chinensis was the smallest, then gradually increases, the growth center gradually shifted to the roots from stems and leaves, The weight of underground part of 3-year-old C. chinensis exceeded the aboveground part, the 5-year-old C. chinensis root-shoot ratio reached the maximum value of 1.91:1.With the increasing of years of growth, the contents of coptisine, berberine, epiberberine and palmatine in rootstalk was increasing continuously. The jatrorrhizine content in 2-year-old C. chinensis was significantly lower than that in other years, the content was no significant change after that. The columbamine content reached a maximum value in 3-year-old C. chinensis,then the decreased gradually. The content of magnoflorine gradually increased and reached maximum value in 5-year-old C. chinensis.
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Alkaloids , Biomass , Coptis , Chemistry , Phytochemicals , Plant Leaves , Plant RootsABSTRACT
[Objective] To observe the dynamic changes of intestinal IL-17,occludin,and ZO-1 in mice with postinfectious irritable bowel syndrome (PI-IBS).[Methods] Forty C57BL/6 mice were randomly divided into 5 groups:control group and infection groups (2 weeks,4 weeks,6 weeks,and 8 weeks after trichinella infection).Infection groups were given by gavaging of 400～500 Trichinella spiralis in 0.2 mL of normal saline.The body weight of mice were recorded at week 2,4,6,and 8 after infection.The visceral sensitivity of mice was measured by the abdominal withdrawal reflex (AWR).The stool was collected continuously for 8 hours to calculate the percentage of fecal water content.Pathological changes of gut were observed by HE staining.The expressions of IL-17,occludin,and ZO-1 in ileocecus and colon were detected by immunohistochemistry and Western blotting.[Results] At week 2 after infection,the acute inflammation of the intestinal tract was observed and the body weight of mice were significantly decreased (P=0.000).Until week 8 after infection,the intestinal inflammation and body weight of mice recovered to normal.When the colorectal dilatation capacity was 0.35 and 0.5 mL,the AWR scores in the infection groups were significantly higher than those in the control group (P＜0.01).The percentages of fecal water content in the infection groups were significantly higher than those in the control group (P＜0.05).Compared with the control group,the expressions of IL-17 were significantly decreased in week 2 group (P＜0.05) and increased in week 8 group (P＜0.05).The expressions of occludin and ZO-1 in the infection groups were significantly lower than those in the control group (P＜0.05).[Conclusion] The dynamic changes of IL-17 and the decrease of Tight junction proteins may be one of the mechanisms of visceral hypersensitivity and increased percentages of fecal water content.They may be involved in the development of PI-IBS.
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Objective To investigate the dynamic changes and clinical significanes of TNF?α,IL?1,IL?10 and HMGB?1 in patients with tuberculosis. Methods Fifty?nine patients with active tuberculosis were enrolled in this study. The patients received the standard chemotherapy and the curative effect of the patient was evaluat ed according to the outcome classification in our country. The peripheral blood serum from the patients during the treatment and 12 healthy volunteers were collected. The concentrations of serum TNF?α,IL?1,IL?10 and HMGB?1 were detected by ELISA tests. Results Significant decreases of the concentrations of serum TNF?α,IL?1 and HMGB?1 were shown in patients from the initial treatment,to retreatment and extra?pulmonary tuberculosis (P0.05). At the end of the treatment , the levels of serum TNF?α,IL?1 and HMGB?1 of the uncompleted treatment group were significantly higher than the normal levels (P<0.01) ,but the level of IL?10 was significantly lower than the normal level (P<0.01). Conclusion The dynamic testing of the inflammatory cytokines contributes to evaluation and judgement of the curative effect and the condition of patients with the active tuberculosis.
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Objective To analyze and explore the dynamic changes of postoperative serum TNF-α,IL-6,IgG,IgM and C3 levels in patients with craniocerebral injury,and to study the effect and evaluation on clinical significance.Methods Eighty-two patients who were diagnosed as craniocerebral injury and treated in our hospital from March 2015 to March 2017 were selected as the clinical research subjects,and the patients were randomly divided into the infection group and the non-infection group,41 cases in each group.The dynamic changes of postoperative serum TNF-α,IL-6,IgG,IgM and C3 levels of two groups were compared.Results Serum TNF-α and IL-6 levels at 1,3 and 7 days after operation in the infection group were higher than those in the non-infection group,and the differences were statistically significant(P<0.05).Serum IgM,IgG and C3 levels at 1,3 and 7 days after operation in the infection group were lower than those in the non-infection group,and the differences were statistically(P<0.05).At 7 days postoperatively,the serum IgG level in the infection group was restored to the levels in the non-infection group,and there was no significant difference(P>0.05).Conclusion Monitoring the postoperative serum TNF-α,IL-6,IgG,IgM and C3 levels in patients with craniocerebral injury is helpful for early diagnosis of postoperative infection,and has a high value in judging the severity of the disease.
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Objective: To establish a method for the determination of six active ingredients in Eucommia ulmoides male flowers, and analyze the dynamic changes of male flower development and active ingredients content of E. ulmoides. Methods: The active ingredients were extracted by the ultrasound-assisted process, the content of total flavonoids was determined by AlCl3 colorimetric method and other six ingredients were determined by HPLC, the samples were separated on a Thermal hypersil gold column (250 mm × 4.6 mm, 5 μm) with gradient elution of methanol-0.5% phosphoric acid at a flow rate of 1.0 mL/min, the UV wavelength was set at 206 nm (0-15 min), 236 nm (15-55 min), and 255 nm (55-100 min). Results: Flower diameter, flower height, fresh weight, dry weight, stamen length and stamen number all reached the maximum at full bloom stage; The contents of total flavonoids, chlorogenic acid and total active ingredients were the highest at the bud stage and the lowest at the initial flowering stage; The content of aucubin showed a tendency of graudal decreasement; The content of geniposidic acid was the lowest at the bud stage and reached the highest at full bloom stage, and decreased at the end of flowering phase; The content of geniposide, isoquercitrin and astragaline were the highest at full bloom stage and the lowest at the initial flowering stage. Conclusion: Flowering stage had a great impact on morphology, yield, active ingredients content and quality of E.ulmoides male flowers, which could provide important information for quality control and product development of E.ulmoides male flowers.
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AIM To study the dynamic changes of color and five constituents during processing of Gardeniae Fructus.METHODS Camera and Adobe Photoshop software were applied to collecting images and obtaining chromatic values (L,a,b) of processed products,respectively.HPLC was adopted in the content determination of genipin-1-β-D-gentiobioside,geniposide,crocin-Ⅰ,crocin-Ⅱ,crocin-Ⅲ.Then the correlation between color and constituent contents was investigated by linear regression and partial least squares method.RESULTS With the process of processing,the chromatic values of epicarp and seed pellets expelled showed decreasing trends,especially for that of the former.On the whole,the contents of geniposide,crocin-Ⅰ and crocin-Ⅱ were decreased,while those of genipin-1-β-D-gentiobioside and crocin-Ⅲ were first increased and then decreased.The chromatic values of epicarp and seed pellets expelled showed significant correlations with crocin-Ⅰ content.CONCLUSION Color and crocin-Ⅰ can be considered as control index and monitoring index during processing of Gardeniae Fructus,respectively.
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Objective:To analyze dynamic change and severity of IL-1 beta, TNF alpha, COX-2 detected by automatic enzyme immunoassay analyzer on patients with acute gout.Methods: Ninety cases of acute gout patients selected according to the different degrees of severity, and were divided into three observed groups. Thirty health people were treated as the control group. IL-1β, TNF-α, COX-2 levels of dynamic change were recorded and compared within the four groups of patients.Results: The serum IL-1β, TNF-α, COX-2 levels in the 1st, 3rd, 7th, 10th day in the observation group 1 and group 2 in acute gout attacks were significantly higher than the control group; The serum levels of IL-1β, TNF-α, COX-2 levels in the 7th 10th day in observation group 1 in acute gout was significantly higher than observation group 2; The serum IL-1β, TNF-α,COX-2 levels in observation group 3 have not significant difference with control group 2; The serum IL-1β, TNF-α, COX-2 levels in observation group1,2,3 in acute gout attacks in the 14th days have not significant difference with control group.Conclusion: After analgesic drugs for the treatment of acute gout patients from 10 to 14 days, the inflammatory cytokines can be completely back to normal. The results provided important evidence for the introduction of analgesic drugs in patients with acute gout treatment.
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Objective To investagate the change of creatine kinase MB isoenzymes ( CK-MB ) in children with rotavirus diarrhea and to explore the value of CK-MB/CK in the diagnosis of myocardial damage. Methods A retrospective analysis of the clinical manifestation, laboratory test data and treatment was per-formed in children with rotavirus diarrhea and high CK-MB hospitalized in department of infectious disease, Si-hong Children Hospital. We investigated the dynamic changes of CK-MB in the rotavirus diarrhea patients with and without myocardial damage. Within the non-myocardial damage group, the fluctuation of CK-MB was compared between patients with nutrition therapy and patients with conventional therapy. Receiver operating characteristic ( ROC) curve was used to explore the predictive value of CK-MB/CK for the myocardial dam-age. Results A total of 603 patients (369 males, 234 females, aged 2~48 months) with high CK-MB were enrolled in this study ( 36 cases with myocardial damage ) . There were 54. 6% of enrolled patients showing higher CK-MB and 3. 3% of patients had myocardial damage. The levels of serum CK-MB in non-myocardial damage group reached the peak on day 7 and decreased to normal in 14 days. The levels of serum CK-MB in myocardial damage group reached the peak on day 14 and maintained at fairly high level for 8 weeks and then decreased to normal . Time for CK-MB to achieve peak is different between these two groups. There was no statistical significance in the levels of serum CK-MB on day1 to day 14 between patients with or without myocar-dial protection ( P >0. 05 ) . The ROC curves were constructed with area under the ROC curves of 0. 697 (0. 611, 0. 784, 95%CI). Conclusion Intrinsic dynamics of CK-MB existed in patients with rotavirus diar-rhea. The diagnostic value of CK-MB is limited in patients with myocardial damage.
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This paper was aimed to study the dynamic changes of San-Ao(SA) decoction in different compatibility of ephedrine hydrochloride,pseudoephedrine hydrochloride,amygdalin and glycyrrhizic acid.HPLC was used to simultaneously determinate the transfer rate of SA decoction of ephedrine hydrochloride,pseudoephedrine hydrochloride,amygdalin and glycyrrhizic acid.Kromasil C18 (4.6 mm×250 mm,5μm) column was selected with methanol and 0.1% phosphoric acid as a mobile phase to gradient.The flow rate was 1 mL·min-1.The column temperature was 30℃.The injection volume was 10μL.Ephedrine hydrochloride,pseudoephedrine hydrochloride and amygdalin were detected at the wavelength of 208 nm.The glycyrrhizic acid was detected at the wavelength of 250 nm.The results showed that the transfer rate of ephedrine hydrochloride in decoction was more than that of the single preparation.The transfer rate of pseudoephedrine hydrochloride was the highest in the combination of ephedra and bitter almond.The transfer rate of amygdalin was the highest in the combination of ephedra and bitter almond.The transfer rate of glycyrrhizic acid in decoction was more than that of the single preparation.It was concluded that there were dynamic changes in the boiling process during herbal decoction preparation.The effectiveness and stability of Chinese medicine should be improved according to these changes.
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Objective To explore the relationship between early changes of central venous-toarterial carbon dioxide difference (Pcv-aCO2) and the prognostic in patients with septic shock.Methods One hundred and three patients with septic shock were retrospectively analyzed.The patients were divided into death group (37 cases) and survival group (66 cases) according to prognosis.The patients were divided into four groups according to the changes of 0 and 6 h Pcv-aCO2:Pcv-aCO2 persistently high group (16 cases),Pcv-aCO2 increased group (19 cases),Pcv-aCO2 decreased group (22 cases),Pcv-aCO2 persistently normal group (46 cases).All the patients were treated with early goal-directed therapy (EGDT),and central venous oxygen saturation (ScvO2) ≥0.70 was the target.The acute physiology and chronic health evaluation (APACHE) Ⅲ score,sepsis related organ failure assessment (SOFA) and mortality were compared.Results There was no statistical difference in 0 h Pcv-aCO2 (P ＞ 0.05).The Pcv-aCO2 in 6,12 and 24 h in survival group was significantly lower than that in death group [(5.0 ± 1.8) mmHg (1 mmHg =0.133 kPa) vs.(6.8 ± 2.3) mmHg,(4.7 ± 2.3) mmHg vs.(7.2 ± 3.0) mmHg,(3.2 ± 1.5) mmHg vs.(7.5 ± 3.3) mmHg],and there was statistical difference (P ＜ 0.05 or ＜ 0.01).The APACHE Ⅲ score in survival group was significantly lower than that in death group [(51.6 ± 23.8) scores vs.(87.7 ± 35.9) scores],and there was statistical difference (P ＜ 0.05).The time of mechanical ventilation,APACHE Ⅲ score,SOFA,length of stay in hospital and mortality in Pcv-aCO2 persistently high group and Pcv-aCO2 increased group were significantly higher than those in Pcv-aCO2 decreased group and Pcv-aCO2 persistently normal group,and there were statistical differences (P ＜ 0.05 or ＜ 0.01).Conclusion The Pcv-aCO2 persistently high during the early resuscitation of septic shock is associated with multi-organ dysfunction and worse prognosis,and provides guidance for clinical treatment.
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Objective To observe the change of serum smooth muscle myosin heavy chain (smMHC) level in the patients with aortic dissection (AD),and evaluate the effect of smMHC in the early diagnosis and prognosis of AD.Methods Forty-two patients with AD were selected as AD group,30 healthy subjects were selected as control group.Blood samples were collected at four time periods (within 3 h of onset,6 h,12 h,24 h),and serum smMHC level were measured by enzyme-linked immunosorbent assay.Results Serum smMHC level of AD group,which collected (within 3 h of onset,6 h,12 h) were significantly higher than that of control group [(88.6 ±21.7),(59.4 ± 18.7),(41.3 ± 10.7) ng/L vs.(17.2 ± 8.3) ng/L,P ＜ 0.01].There was no significant difference between the serum smMHC level of AD group and control group at 24 h after onset [(18.9 ±9.5) ng/L vs.(17.2 ±8.3) ng/L,P ＞ 0.05].Serum smMHC level of Stanford A type group (25 cases) was higher than that of Stanford B type group (17 cases) within 3 h of onset [(95.4 ± 17.8) ng/L vs.(78.5 ± 18.3) ng/L,P＜0.01],and there was no significant difference bewteen the two groups which collected at 6,12 h and 24 h after onset (P ＞ 0.05).Preoperative serum smMHC level was significantly higher than that after intracavitary isolation operation [(58.6 ± 15.9) ng/L vs.(30.1 ± 12.5) ng/L,P ＜ 0.01].Serum smMHC level decreased rapidly after the operation,and there was no significant difference between the two grougs when 12 h after operation [(18.7 ± 8.9) ng/L vs.(17.2 ± 8.3) ng/L,P ＞ 0.05].The serum smMHC level of the deaths (7 cases),which collected within 3 h of onset,6 h,12 h,was significantly higher than that of the survivors (35 cases) [(101.2 ± 20.7) ng/L vs.(86.1 ± 18.9) ng/L,(65.2 ± 16.7) ng/L vs.(58.2 ± 14.2) ng/L,(50.4 ± 10.8) ng/L vs.(39.5 ± 8.3) ng/L,P ＜ 0.05],and there was no significant difference at 24 h after onset (P ＞ 0.05).Detecting serum smMHC level within 3 h of onset,the area under the receiver operating characteristic curve was 0.913,with 51.7 ng/L as a diagnostic critical value,sensitivity and specificity respectively was 88.1％ (37/42) and 96.7％ (29/30).When detecting at 6 h after onset,the area under the curve was 0.865,with 38.5 ng/L as a diagnostic critical value,sensitivity and specificity respectively was 90.4％(38/42) and 90.0％ (27/30).Conclusions The level of serum smMHC in patients with AD increase rapidly after onset,and detecting serum smMHC level within 6 h of onset have important clinical significance in early diagnosis and prognosis of AD.
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Objective To study the dynamic variation of mbisoenzyme of creatine kinase(CK-MB) in the infected course of respiratory syncytial virus and explore the value of CK-MB/CK in the diagnosis of myocardial damage.Methods A total of 577 pediatric patients (317 males,260 females,aged 2 ～ 18 months) with CK-MB/CK ＞5％ from 2010 to 2013 were enrolled in this study (44 complicated by myocardial damage).Five hundred and thirty-three patients with high values CK-MB simply were randomly divided into treatment group (n =243) and control group(n =290).The dynamic variation of CK-MB were investigated.The diagnosis analyzed by receiver operating characteristic (ROC)curve was used to explore the predictive value of differential diagnosis between the pediatric patients with myocardial damage and without myocardial damage.Results Approximately 46.5％ of cases with rotavirus diarrhea had higher CK-MB and 3.5％ of cases had myocardial damage.The time of CK-MB achieved peak and anomalous duration was different between the cases with myocardial damage and without myocardial damage.There was no statistical significance between the cases with or without protecting myocardial(P ＞ 0.05).The ROC curves were constructed with area under the ROC curves of 0.663 (95 ％ CI 0.578,0.747).Conclusion The blood levels of CK-MB in children with respiratory syncytial virus infection existed obvious dynamic variety,which contributed little value to the diagnosis of myocardial damage.
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OBJECTIVE: To find out the distribution of ursolic acid and oleanolic acid in fresh leaves, fallen leaves and flowers of Eriobotrya japonica Lindl, and to explore the variation in contents of the triterpene acids in the leaves at different harvest time. METHODS: Samples were collected in the campus once every month for 12 months. Determination of ursolic and oleanolic acid was carried out by ultra-high performance liquid cromatography (UPLC) with an acquity BEH 18 column (2.1 mm × 100 mm, 1.7 μm) using methanol-water-glacial acetic acid-triethylamine (250:50:0.10:0.05) as the mobile phase. The flow rate was 0.25 mL · min-1. The detection wavelength was set at 210 nm. RESULTS: The contents of ursolic and oleanolic acids in Erobotrya japonica leaves were significantly higher compared with those in Erobotrya japonica flowers. The contents of the two triterpene acids in the fallen leaves were higher than those in the fresh leaves. The annual curves of dynamic changes of the two triterpene acids contents in Erobotrya japonica leaves showed that the total triterpene acids contents in the Erobotrya japonica leaves collected at the different time varied from 0.874% to 0.988%. CONCLUSION: The distribution of the contents of ursolic and oleanolic acid in the fresh leaves, fallen leaves and flowers was different, and there was minor variation in the contents of the two triterpene acids in fresh Erobotrya japonica leaves collected at the different harvest time. This study therefore provides evidence that the Erobotrya japonica leaves included in Chinese Pharmacopoeia (2010 edition, Volume I) can be harvested all the year round. Furthennore, the results suggest that the optimal harvesting time oi Erobotrya japonica leaves should be between pre-defoliation period and defoliation period.