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Objective To explore the value of cytokines,procalcitonin(PCT)and neutrophil-lymphocyte ratio(NLR)in the early diagnosis and prognosis evaluation in the patients with sepsis.Methods 98 patients with sepsis admitted to the First Affiliated Hospital of Air Force Medical University from January 2020 to January 2023 were selected as research objects,including 82 patients in the sepsis non-shock group and 16 patients in the sepsis shock group.According to the death within 28 days,the patients was divided into survival group(n=82)and death group(n=16).Meantime,95 cases of non-septic infection group were included as control.The expression of interleukin(IL)-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17,tumor necrosis factor(TNF)-α,interferon(IFN)-γ,IFN-α,PCT,and NLR were detected within 24h after admission,and their relationship with sepsis was analyzed by ROC curve.Results ①The IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17,TNF-α,IFN-α,NLR and PCT in patients with sepsis were significantly higher than those in healthy subjects(Z=0.43～30.54,all P＜0.05)except IL-1β,IFN-γ.Further analysis of ROC showed that IL-8,NLR,PCT and IL-17 had strong predictive ability,with area under curve(AUC)of 0.78(95%CI:0.71～0.84),0.81(95%CI:0.75～0.87),0.83(95%CI:0.78～0.88),0.86(95%CI:0.81～0.92),respectively.Combined detection of the four indicators can effectively improve the diagnostic efficiency of sepsis,with the AUC of 0.90(95%CI:0.85～0.93).② There were no significant differences in cytokines,PCT and NLR concentration between positive and negative blood culture groups(P＞0.05),suggesting that these indexes were not affected by blood culture detection results.③Among the patients in the shock group,IL-6[122.10(10.77～10 000.00)ng/L]was significantly higher than that in non-shock group[25.56(1.02～9 096.74)ng/L],the difference was statistically significant(Z=74.55,P=0.01),with the AUC of 0.73(95%CI:0.59～0.87).The levels of IL-10[10.69(1.12～1 338.00)ng/L],IL-2[12.52(0.86～280.42)ng/L]and IL-5[9.55(0.93～259.57)ng/L]in sepsis death group were higher than those[2.55(0.34～695.13)ng/L,4.46(0.13～625.43)ng/L,2.75(0.01～117.88)ng/L]in survival group,the differences were statistically significant(Z=3.64,6.37,4.74,all P＜0.05),and the AUC were 0.69(95%CI:0.53～0.85),0.71(95%CI:0.56～0.85)and 0.72(95%CI:0.58～0.87),respectively.Conclusion The combined detection of IL-8,NLR,PCT and IL-17 is helpful for the early diagnosis of sepsis.The increase of IL-6 level can effectively predict the occurrence of septic shock,and the high expression of IL-10,IL-2 and IL-5 has a good predictive value for the death of sepsis patients.
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Objective To analyze the prognosis of children with severe mycoplasma pneumonia (MPP) and its correlation with serum SAA, PCT and SF levels, so as to provide a basis for evaluating the prognosis of children with MPP. Methods A total of 273 children with MPP admitted to our hospital from January 2020 to December 2020 were divided into mild MPP children (n=187) and severe MPP children (n=86) according to the severity of their disease. According to the prognosis, children with severe MPP were divided into survival group (n=65) and death group (n=21). Serum SAA, PCT and SF levels were determined. Pearson correlation analysis was used to analyze the correlation between serum SAA, PCT and SF levels and APACHE ⅱ score. ROC curve was used to analyze the predictive value of serum SAA, PCT and SF levels for poor prognosis of children with severe MPP. Results The levels of serum SAA, PCT and SF and APACHE II score in children with severe MPP were significantly higher than those in children with mild MPP (P<0.05). Serum SAA, PCT and SF levels and APACHE II score in death group were significantly higher than those in survival group (P<0.05). Pearson correlation analysis showed that APACHE II score was positively correlated with serum SAA, PCT and SF levels (r =0.474,0.519,0.446,P<0.05). The AUC, sensitivity and specificity of combined ROC curve analysis to predict the prognosis of severe MPP were 0.871, 85.9% and 93.6% respectively, which were higher than those of SAA, PCT and SF alone. Conclusion SAA, PCT and SF are closely related to the prognosis of severe MPP, and can be used as potential markers to predict poor prognosis of severe MPP children.
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Objective The changes and risk factors of FeNO, CRP and PCT in patients with bronchial asthma complicated with sleep apnea syndrome (SAS) in Shanghai area were analyzed to provide theoretical basis for the prevention and treatment of SAS in patients with bronchial asthma. Methods A total of 436 patients with bronchial asthma admitted to our hospital from January 2019 to June 2022 were selected and divided into control group and experimental group according to whether SAS occurred during hospitalization. The experimental group was divided into three subgroups according to the apnea hypopnea index (AHI) values: mild group (AHI>15 times /h or 15 times /h or 28 kg/m2(OR=5.629),allergic rhinitis(OR=6.166)and neck circumference>40 cm(OR=5.265)were independent risk factors for SAS in patients with bronchial asthma(P<0.05);Pearson correlation analysis showed that AHI was positively correlated with serum FeNO,CRP and PCT levels in patients with bronchial asthma and SAS(r=0.471,0.436,0.502,P<0.05). Conclusions Patients with old bronchial asthma in Shanghai area have a higher risk of SAS, and the severity of the disease is positively correlated with the levels of FeNO, CRP and PCT. In particular, obese patients with allergic rhinitis should be given early intervention to reduce the risk of SAS.
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【Objective】 To compare the bioactive ingredients in activated platelet-rich plasma (PRP) from cord blood and adult blood, explore its reasonable indicators reflecting the inflammatory regulation ability, in order to guide the preparation. 【Methods】 PRP was prepared and activated from 63 healthy adults (31 males, 32 females) and 61 neonates (30 males, 31 females), and 20 cytokines were measured using Luminex technology for assessing the age- and sex-based bioactive differences of PRP. High-sensitivity C-reactive protein(hs-CRP), procalcitonin and MMPs/TIMPs from each sample were measured for their correlations with the 10 inflammation-related cytokines. 【Results】 The activated cord blood PRP released 10 growth factors and chemokines more than the adult blood PRP, whereas IGF-1, HGF and 8 pro-inflammatory cytokines lower than the latter. Most cytokines of adult PRP were more in females than in males (P<0.05), except for IGF-1 and HGF, which showed no difference by gender. Compared with hs-CRP and PCT, MMPs/TIMPs ratio was more closely related with the inflammation-related cytokines, which can reflect the inflammatory regulation of PRP. 【Conclusion】 Due to the lower immunocompetence and no age or gender disturbance, cord blood PRP has the rational MMPs/TIMPs ratio and more cytokines which promote the inflammation and wound healing.
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Introduction: Sepsis has a death rate of ?25% globally and its clinical treatment presents an important clinical challenge. The Acute Physiology and Chronic Health Evaluation II (APACHE II) is the standard method for assessing sepsis. Serum PCT level can be increase in case of sepsis. With this background, the present research is aimed to study the survival among the sepsis cases and correlate them with serum procalcitonin levels, APACHE II Score and other risk factors. Methodology: The study was conducted among 75 cases diagnosed having sepsis admitted in medical ICU. APACHE II score, serum procalcitonin (PCT) and other investigation were carried out along with clinical history and examination. Data were analysed using epi-info software. Results: The cases fatality rate of sepsis cases in medical intensive care unit in our hospital was 37.3%. The mortality rate was significantly higher patients with comorbidities, especially cases with respiratory or CNS involvement. The serum PCT levels were significantly higher in the group of non survivors as compared to group of survivors. Higher APACHE II score associated with higher mortality. Serum PCT levels go on increasing along the spectrum of sepsis. A PCT level was significantly hire in culture positive cases compare to sterile cases. Conclusion: From this study we conclude that serum PCT level is useful investigation in sepsis cases to predict mortality
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This study aimed to investigate the diagnostic value of heparin-binding protein (HBP) in the cerebrospinal fluid of children with purulent meningitis (PM). This study included 118 children with PM diagnosed at our hospital from January 2018 to January 2020, 110 children with viral meningitis (VM) and 80 children with suspected meningitis who were ruled out by cerebrospinal fluid (CSF) analysis during the same period. HBP and white blood cell (WBC) count in the CSF, and inflammatory factors, including C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and procalcitonin (PCT), were measured. Receiver-operator characteristic curves were used to analyze the predictive value of HBP, CRP, PCT, and TNF-α levels in the diagnosis of PM by CSF analysis. HBP levels in the CSF of children with PM were higher, while the CRP and serum PCT and TNF-α levels were elevated in all groups (P<0.05). In addition, HBP levels in the CSF were more accurate for the diagnosis of PM than traditional diagnostic indexes. HBP levels in the CSF can be used as an important reference for early diagnosis of PM.
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Humans , Child , Meningitis, Bacterial/diagnosis , Meningitis, Viral , C-Reactive Protein , Blood Proteins , Antimicrobial Cationic Peptides , ProcalcitoninABSTRACT
Objective:To explore the early warning of blood growth differentiation factor-15 (GDF15) as a new stress indicator.Methods:A total of 53 armed police soldiers selected to participate in high-intensity training, measuring the soldiers' serum GDF15, high-sensitivity C-reactive protein (S-CRP), and C-reactive protein (CRP) before and after the high-intensity training , Interleukin-6 (IL-6), Procalcitonin (PCT) levels, compare the coefficient of variation of each index; use SPSS 24 software for statistical analysis, measurement data are expressed as mean ± standard deviation (Mean±SD), The comparison of measurement data adopts group t test. Results:The GDF15 level of fighters after high-intensity training was (176.28±97.45) pg/mL, which was higher than (120.35±69.87) pg/mL before high-intensity training. The difference was very significant ( P <0.001). After high-intensity training, IL-6 and CRP levels were lower than before high-intensity training, the difference was statistically significant ( P<0.05); there was no statistically significant difference in S-CRP and PCT before and after high-intensity training ( P>0.05). The coefficient of variation of GDF15 index is smaller than S-CRP, CRP, IL-6, PCT. Conclusion:Blood growth differentiation factor-15 (GDF15) is of great significance in warning the stress state after high-intensity training. It has higher sensitivity than other conventional stress indicators like S-CRP, CRP, IL-6 and PCT.
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Fluid Attenuated Inversion Recovery (FLAIR) MRI of brain is sensitive in detecting parenchymal lesions, extra axial lesions such as meningoencephalitis, and leptomeningeal tumoural disease. We wanted to compare gadolinium enhanced T2W FLAIR with PC-T1W (post contrast T1 weighted) MRI sequence in detection and evaluation of meningeal and parenchymal lesions. We also wanted to compare gadolinium enhanced T1W FLAIR with PC-T1W MRI sequence in detection and evaluation of meningeal and parenchymal lesions.METHODS65 patients with clinical diagnosis of cerebral meningitis or intracranial tumoural disease were scanned on 1.5 T 16 channel MRI scanner. A standard brain protocol was used, followed by PC-T1W and post contrast FLAIR, with PC-T1W MR preceding post contrast FLAIR. Images were assessed independently by 2 radiologists who marked the technique they thought had made the meningeal and parenchymal disease more conspicuous. In case of disagreement the radiologists made a consensus determination.RESULTSPC-T2 FLAIR showed better enhancement in 100% of the intra axial lesions compared to PC-T1W images. However, PC-T1 FLAIR showed better enhancement than PC-T1W images in only 81% of the same. PC-T2 FLAIR showed better enhancement in 100% of the extra-axial lesions compared to PC-T1W images. However, PC-T1 FLAIR showed less enhancement in all the extra axial lesions.CONCLUSIONSContrast enhanced T2 FLAIR MRI showed better enhancement of parenchymal and meningeal lesions. PC-T2 FLAIR detected more number of lesions when compared to PC-T1W, aided better delineation of extra-axial mass lesions due to superior enhancement, and had a better demarcated dural tail. Post-contrast T2 FLAIR images should be included in routine protocol for contrast MRI brain study.
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Background: Science and technology are two desirable elements for the economic and social development of a country. Biotechnology has a particularly important potential for economic development. Nevertheless, patent production in Latin America remains underdeveloped, which creates the need to analyze its trend and the efforts made to promote patent production. Therefore, the purpose of this study was, on the one hand, to determine trends in biotechnology-related PCT (Patent Cooperation Treaty) applications in Chile, Mexico, Argentina, Brazil, and Cuba from 1999 to 2015, and, on the other hand, to determine whether there is a relationship between the gross domestic expenditure on research and experimental development as a percentage of gross domestic product (GERD/GDP) and PCT applications for biotechnological inventions from 2007 to 2015 (in this case, the period under study was limited from 2007 to 2015, due to data availability for GERD/GDP in the five selected countries). Results: The first part of this study shows that the growth in biotechnology PCT applications has been moderate and gradual and the trend was fitted to a linear model. The second set of results shows that GERD/GDP is associated with biotechnology-related PCT applications issued during the study period with a significance level of α = 0.01. Conclusions: Even though results indicate a gradual and modest progress, it is necessary that these five representative Latin American nations continue acting toward the protection of intellectual property in the area of biotechnology, especially by configuring strategies for further progress based on investments on research and development.
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Biotechnology/trends , Biotechnology/statistics & numerical data , Patents as Topic/statistics & numerical data , Argentina , Research , Brazil , Technological Development , Technological Development/statistics & numerical data , Chile , Cuba , International Cooperation , Latin America , MexicoABSTRACT
Penetrating injuries to the “cardiac box“ are amongst the most lethal traumatic injuries with an estimated 6% of the patients arriving to the hospital 1 alive . We report the benign presentation of a 79 year-old female with penetrating injury to the cardiac box. Post-operative course was unremarkable. In this report, we discuss the surgical implications of penetrating injury to the cardiac box
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Objective To analyze the diagnostic value of serum procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) in the detection of incision infection after breast cancer surgery. Methods A total of 152 breast cancer patients admitted to our hospital from June 2016 to April 2018 were enrolled. All patients were given surgery.According to whether the wound infection occurred after operation, the patients were divided into control group (not infected, n=114) and observation group (infected, n=38). The serum levels of PCT, CRP and IL-6 were measured in the two groups on the 2 nd postoperative day. Results The average operation time and hospital stay in the observation group were longer than those in the control group (P<0.05). The serum levels of PCT, CRP and IL-6 in the observation group were higher than those in the control group (P<0.05). The positive rate of the observation group was higher than that of the control group (P<0.05). Conclusion In patients with breast cancer surgery, serum PCT, CRP and IL-6 detection can provide a good reference for the prediction of postoperative incision infection.
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Objective@#To investigate the clinical significance of plasma amino-terminal pro-brain natriuretic peptide(NT-proBNP) in children with bacterial meningitis.@*Methods@#From April 2013 to March 2017, 32 children with bacterial meningitis in PICU of the Second People′s Hospital of Liaocheng Affiliated to Taishan Medical College were selected.The patients were evaluated the severity of the disease by Glasgow coma scale(GCS). Thirty-five cases who admitted to the hospital in the same period were selected as the control group, excluding congenital heart disease, chronic cardiac dysfunction, cardiomyopathy, myocarditis, heart failure, chronic renal insufficiency.The blood samples were collected from the hospital in 24h, and the levels of the plasma NT-proBNP, procalcitonin(PCT), C-reactive protein(CRP) and Na ions were determined.@*Results@#Compared with the control group, the levels of the plasma NT-proBNP was significantly increased[(7 123.97±6 901.60)ng/L vs.(39.29±19.41)ng/L, t=5.839, P<0.01], the level of PCT was significantly increased[(25.14±2.35)ng/dL vs.(0.63±0.15ng/dL, t=10.820, P<0.01], the level of CRP was significantly increased[(97.89±4.63mg/dL vs.(5.23±1.22mg/dL, t=21.130, P<0.01], and the GCS was significantly decreased(t=18.132, P<0.01) in children with bacterial meningitis group.The plasma NT-proBNP level of children with GCS<8points[(13 328.08±7 938.85)ng/L]was significantly higher than that in children with GCS 8~14points[(3 401.50±1 526.75)ng/L](t=5.816, P<0.01) and GCS≥15points[(39.74±18.64)ng/L](t=5.816, P<0.01). There was a significant positive correlation between the level of plasma NT-proBNP and PCT(r=0.969, P<0.01), also a significant positive correlation between the level of plasma NT-proBNP and CRP(r=0.961, P<0.01), while a significant negative correlation between the level of plasma NT-proBNP and sodium ions(r=0.886, P<0.01) in children with bacterial meningitis by Pearson correlation test.@*Conclusion@#Detection of the plasma NT-proBNP has significant clinical significance for early diagnosis and assessment of the severity of the illness of children with bacterial meningitis.
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Objective To investigate the clinical significance of plasma amino －terminal pro －brain natriuretic peptide(NT－proBNP) in children with bacterial meningitis.Methods From April 2013 to March 2017, 32 children with bacterial meningitis in PICU of the Second People′s Hospital of Liaocheng Affiliated to Taishan Medical College were selected.The patients were evaluated the severity of the disease by Glasgow coma scale (GCS).Thirty－five cases who admitted to the hospital in the same period were selected as the control group ,excluding congenital heart disease,chronic cardiac dysfunction ,cardiomyopathy,myocarditis,heart failure,chronic renal insufficiency.The blood samples were collected from the hospital in 24h, and the levels of the plasma NT －proBNP, procalcitonin (PCT),C－reactive protein(CRP) and Na ions were determined.Results Compared with the control group ,the levels of the plasma NT－proBNP was significantly increased [(7 123.97 ±6 901.60)ng／L vs.(39.29 ±19.41)ng／L,t＝5.839,P＜0.01],the level of PCT was significantly increased [(25.14 ±2.35) ng／dL vs.(0.63 ±0.15ng／dL,t ＝10.820,P＜0.01],the level of CRP was significantly increased [(97.89 ±4.63mg／dL vs.(5.23 ±1.22mg／dL,t＝21.130,P＜0.01],and the GCS was significantly decreased (t＝18.132,P＜0.01) in children with bacterial meningitis group.The plasma NT －proBNP level of children with GCS ＜8points [( 13 328.08 ±7 938.85 ) ng／L ] was significantly higher than that in children with GCS 8～14points[(3 401.50 ±1 526.75)ng／L](t＝5.816,P＜0.01) and GCS≥15points [(39.74 ±18.64) ng／L] ( t ＝5.816,P＜0.01).There was a significant positive correlation between the level of plasma NT －proBNP and PCT ( r ＝0.969, P ＜0.01), also a significant positive correlation between the level of plasma NT －proBNP and CRP (r＝0.961,P＜0.01),while a significant negative correlation between the level of plasma NT－proBNP and sodium ions(r＝0.886,P＜0.01) in children with bacterial meningitis by Pearson correlation test.Conclusion Detection of the plasma NT－proBNP has significant clinical significance for early diagnosis and assessment of the severity of the illness of children with bacterial meningitis .
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Objective To study the relationship between the serum levels of procalcitonin (PCT) and pulmonary function in patients with chronic obstructive pulmonary disease (COPD).Methods From January 2016 to May 2107,88 cases of patients with COPD and 100 cases of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were chosen as the object of study,pulmonary function was measured in all patients,grouped according to the standard of pulmonary function classification,and detected the serum levels of PCT by immunoturbidimetry.Results The serum levels of PCT were not statistically different among the COPD patients (F=1.401,P＞0.05).But among the AECOPD patients,the serum levels of PCT in the Ⅳ class of pulmonary function were significantly higher than that in the Ⅰ,Ⅱ class and Ⅲ class and this difference was statistically significant (F=9.128,P＜0.05).Conclusion The serum levels of PCT had significant reference value for the judgement of the severity of pulmonary function impairment in AECOPD patients.
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Objective: To investigate the value of joint detection of soluble triggering receptor expresses on myeloid cells-1(sTREM-1) and procalcitonin (PCT) in the early diagnosis of children with sepsis. Methods: 78 children with sepsis were selected into the sepsis group, 23 children with common infection were selected into the normal infection group. In addition, 25 healthy children selected into the health control group. The levels of sTREM-1, PCT, and C reactive protein (CRP) among the three groups were compared, respectively. And then, the sepsis group were further divided into general sepsis subgroup (32 cases), severe sepsis subgroup (26 cases) and septic shock subgroup (20 cases) according to the degree of sepsis. The levels of sTREM-1, PCT and CRP among the three sepsis subgroups were compared. And the receiver operating characteristic (ROC) curve was adopted to analyze the value that diagnosed children with sepsis by using the three indicators. Results: The levels of sTREM-1, PCT and CRP of sepsis group were significantly higher than those of common infection group and health control group (t=22.071, t=21.508, t=17.870, t=55.167, t=52.070, t=30.359, P<0.05). The differences of sTREM-1 and PCT among various sepsis subgroups were significant (H=22.082, H=39.449, P<0.05), but the difference of CRP level between septic shock subgroup and severe sepsis subgroup was no significant. As the compared result of AUC of ROC of diagnosing sepsis, the AUC of sTREM-1 was maximum (0.88), and its 95% confidence interval (CI) was 0.78-0.98. At the optimum cutoff value of sTREM-1, the sensitivity and specificity were 83.33% and 68%, respectively, and they were higher than those of PCT and CRP, respectively. Besides, the cutoff values of sTREM-1 and PCT were used as standard to carry out joint diagnosis for children with sepsis, and the sensitivity and specificity were 91.03% and 64%, respectively, at this joint diagnosis. Conclusion: The joint detection of sTREM-1 and PCT has higher sensitivity in the early diagnosis of children with sepsis and it has a certain clinical application value.
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To avoid the abuse and misuse of antibiotics, procalcitonin (PCT) and C-reactive protein (CRP) have been used as new approaches to identify different types of infection. Multiple databases were adopted to search relevant studies, and the articles that satisfied the inclusion criteria were included. Meta-analyses were conducted with Review Manager 5.0, and to estimate the quality of each article, risk of bias was assessed. Eight articles satisfied the inclusion criteria. The concentrations of both PCT and CRP in patients with bacterial infection were higher than those with non-bacterial infection. Both PCT and CRP levels in patients with G− bacterial infection were higher than in those with G+ bacterial infection and fungus infection. In the G+ bacterial infection group, a higher concentration of CRP was observed compared with fungus infection group, while the difference of PCT between G+ bacterial infection and fungus infection was not significant. Our study suggested that both PCT and CRP are helpful to a certain extent in detecting pneumonia caused by different types of infection.
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Humans , C-Reactive Protein/analysis , Calcitonin/blood , Pneumonia, Bacterial/microbiology , Lung Diseases, Fungal/microbiology , Biomarkers/blood , Sensitivity and SpecificityABSTRACT
Objective To investigate the effect of ulinastatin in adjuvant treatment of ventilator-associated pneumonia(VAP)and preliminary clinical efficacy of the therapy mechanism.Methods 76 patients with ventilator-associated pneumonia from January 2015 to February 2016 in Qingyuan People's Hospital of Zhejiang Province were selected and randomly divided into control group and observation group,38 cases in each group.Two groups were given mechanical ventilation,phlegm,anti infection,rehydration,nutritional support and other conventional treatment,the observation group on the basis of routine treatment for ulinastatin adjuvant therapy,comparison of two groups of treatment,the simultaneous determination of serum interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)and tumor necrosis factor alpha(TNF-alpha)levels were measured before and after treatment.Results The total efficiency of the observation group was 94.74％,significantly higher than the control group 78.95％,the difference was statistically significant(P<0.05),the two groups after treatment of serum CRP and PCT levels were decreased significantly compared with before treatment,the observation group after treatment,serum CRP and PCT levels were(45.19+5.79)mg/L and(1.08+0.36)μg/L was significantly lower than that before treatment and control group after treatment,the difference was statistically significant(P<0.05),the two groups after treatment of serum IL-6 and TNF-α levels were decreased significantly compared with before treatment,the observation group after treatment,serum IL-6 and TNF-α levels were(165.29+19.23)pm/mL and(1.16+0.25)pm/mL,was significantly lower than that before treatment and control group after treatment,the difference was statistically significant(P<0.05).Conclusion The inflammatory reaction in patients with ventilator-associated pneumonia ulinastatin can effectively reduce auxiliary patients,reduce inflammatory factors on lung injury,can alleviate the disease progression and to improve its prognosis.
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Objective:To explore the early diagnostic value of serum procalcitonin(PCT),C-reactive protein (CRP) and endotoxin in patients with sepsis caused by bacterial bloodstream infection.Methods:Retrospectively analyzed 123 cases of patients diagnosed with sepsis induced by bacterial bloodstream infection in our hospital from May 2010 to May 2015,detected their serum PCT,CRP and endotoxin levels,and analyzed the evaluation value of these three indexes for sepsis induced by bacterial bloodstream infection by receiver-operating characteristic curve (ROC).Results:Blood sample culture results showed that 123 cases of bacterial bloodstream infections caused by sepsis patients in the presence of infection of G+bacteria were 35 cases,G-bacteria infection of 88 cases;The levels of three index in the G+bacteria group were significantly lower than that in the G-bacteria group (P＜0.05);The serum PCT,CRP and endotoxin levels was positive correlated with each other among G+bacteria group,G-bacteria group and all bacteria group;ROC curves showed that the cutoff value of serum PCT,CRP and endotoxin for diagnosis of patients with sepsis induced by G+bacteria bloodstream infection were 1.58 μg/L,95.25 mg/L and 16.71ng/L,and their sensitivity and specificity were (65.92％,88.37％),(67.39％,84.38％) and (56.34％,78.93％) respectively;and the cutoff value for diagnosis of patients with sepsis induced by G-bacteria bloodstream infection were 2.45 μg/L,79.45 mg/L and 15.54 ng/L,their sensitivity and specificity were (78.73％,97.13％),(68.89％,92.38％) and (65.39％,95.33％)respectively.Conclusion:Detecting the serum PCT,CRP and endotoxin levels is helpful to identify patients with sepsis induced by G+ or G-bacteria bloodstream infection,with high sensitivity and specificity,which can be used in the early diagnosis of sepsis induced by bacterial bloodstream infection.
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Objective To compare the clinical effect of vascularized fibular flap transplantation and vancomycin sulfate calcium on chronic osteomyelitis of the tibia and bone defects.Methods A total of 35 cases with chronic tibial osteomyelitis and bone defect were involved and divided into group A with 21 cases receiving anastomosis of vascularized fibular flap transplantation and group B with 14 cases recciving vancomycin sulfate calcium.Infection control rate and Enneking score were compared in both groups.Simultaneous detection of two groups preoperative,postoperative 2 weeks,1 month and 3 months of the levels of CRP and PCT were conducted.Results Postoperative CRP and PCT were under control in both groups.No statistical significance was found in the comparison of CRP and PCT preoperative and postoperative 2 weeks,1 month and 3 months.In terms of infection control rate,two groups had no signiticant difference (P ＞ 0.05) and there was statistical significance of the comparison of postoperative Enneking score (P ＜ 0.05).Conclusions The clinical results of the two methods are satisfied.The infection degree and the length of the bone defect are decisive factors in choosing the treatment method and sometimes the combination of two treatment methods may be a better choice.
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Objective To investigate the predictive value of serum lactate combined with PIRO (Predisposition,Infection,Response and Organ dysfunction) score in the development of multiple organs dysfunction syndrome (MODS) in septic patients and to study procalcitonin (PCT),in order to provide guidelines for clinical care.Methods From April 2015 to July 2016,a total of 752 sepsis patients were enrolled and divided into MODS group (n =488) and non-MODS group (n =264) according to the criteria of MODS.At 28 d after admission,these patients were divided into survival group (n =477) and death group (n =275).PCT and lactate levels in serum were measured,and PIRO score of these patients was calculated.Then the differences in levels of PCT and lactate in serum were compared among patients at different PIRO score categories.ROC was constructed to observe the clinical values of the biomarkers,PIRO score and lactate combined with PIRO score in predicting prognosis.Result PCT,lactate levels in serum and PIRO score were significantly higher in MODS group and death group,showing significant positive correlation.The areas under ROC curves (AUCs) of serum lactate combined with PIRO score for predicting MODS were 0.906,which was significantly higher than that of serum PCT (0.716),serum lactate (0.851) and PIRO score (0.840) alone (all P ＜ 0.05).Serum PCT,serum lactate and PIRO score were the independent predictors of MODS.Conclusions Serum lactate in combination with PIRO score was a valuable indicator in predicting development of MODS in septic patients.