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Objective:To investigate the relationship between the changes of immune indexes and prognosis in patients with sepsis.Methods:Based on the hospitalization information from 2008 to 2019 in the American Medical Information Mart for Intensive Care-Ⅳ v2.0 (MIMIC-Ⅳ v2.0), the hospitalized data including CD3 count, CD4 count, CD8 count, CD4/CD8 ratio, immunoglobulins (IgA, IgG, IgM) levels and lymphocyte counts, gender, age, body mass index (BMI), sequential organ failure assessment (SOFA), and prognosis of patients with coronary heart disease, hypertension, diabetes mellitus, underlying diseases, and 28-day prognosis were collected. The immunological indexes affecting the prognosis of patients with sepsis were compared and analyzed. The receiver operator characteristic curve (ROC curve) was drawn to analyze the value of immunological indexes in predicting the 28-day prognosis of patients with sepsis.Results:A total of 33 745 patients were enrolled in the study, including 1 509 cases of sepsis and 32 236 cases without sepsis. Among the patients with sepsis, there were 1 084 cases alive and 425 cases died within 28 days. BMI (kg/m 2: 33.25±28.71 vs. 28.90±15.28) and IgA levels within 3 days and 7 days after admission in sepsis group were significantly higher than those in the non-sepsis group [within 3 days after admission: (275.01±216.96) mg/L vs. (85.99±75.76) mg/L; within 7 days after admission: (275.01±216.96) mg/L vs. (85.99±75.76) mg/L, all P < 0.05]. CD3 count, CD8 count within 3 days and 7 days after admission in sepsis group were significantly lower than that in the non-sepsis group [within 3 days after admission: CD3 counts were (1 080.74±849.23)/μL vs. (1 242.91±889.24)/μL, CD8 counts were (558.07±368.77)/μL vs. (625.07±529.66)/μL; within 7 days after admission: CD3 counts were (1 079.69±850.61)/μL vs. (1 242.48±889.23)/μL, CD8 counts were (556.70±467.23)/μL vs. (624.93±429.78)/μL, all P < 0.05]. The proportion of patients with hypertension, diabetes and coronary heart disease were significantly higher than those in the non-sepsis group [hypertension: 10.07% (152/1 509) vs. 2.47% (796/32 236), diabetes: 50.10% (756/1 509) vs.15.18% (4 895/32 236), coronary heart disease: 31.21% (471/1 509) vs. 19.19% (6 186/32 236), all P < 0.05]. In the sepsis group, the CD3 count, CD4 count and CD4/CD8 ratio in the survival group were significantly higher than those in the death group within 3 days and 7 days after admission [within 3 days after admission: CD3 counts were (1 127.20±857.14)/μL vs. (938.26±810.50)/μL, CD4 counts were (559.76±507.18)/μL vs. (338.75±267.11)/μL, CD4/CD8 ratios were 1.87±0.80 vs. 1.02±0.12; within 7 days after admission: CD3 count were (1 124.01±810.53)/μL vs. (943.78±808.21)/μL, CD4 count were (559.56±507.36)/μL vs. (341.95±266.56)/μL, CD4/CD8 ratios were 1.88±0.79 vs. 1.03±0.13, all P < 0.05]. The area under the ROC curve (AUC) of CD4/CD8 ratio within 3 days after admission in predicting the prognosis of septic patients at 28 days was 0.615 [95% confidence interval (95% CI) was 0.555-0.671], the sensitivity was 70.83%, and the specificity was 52.49%. Conclusions:Hypertension, coronary heart disease and diabetes are more likely to induce sepsis. The changes of immune indexes in patients with sepsis will occur in the early stage. Early CD4/CD8 index can predict the prognosis of patients with sepsis to a certain extent.
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OBJECTIVE@#To observe the efficacy of acupuncture combined with @*METHODS@#A total of 180 children with cerebral palsy were randomly divided into a combined group (60 cases, 2 cases dropped off), an acupuncture group (60 cases, 4 cases dropped off) and a Chinese medication group (60 cases, 5 cases dropped off). On the basis of conventional treatment, the children in the combined group were treated with acupuncture [Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Benshen (GB 13), 30 min each time, twice a day] and @*RESULTS@#The total effective rate was 91.4% (53/58) in the combined group, which was higher than 80.4% (45/56) in the acupuncture group and 78.2% (43/55) in the Chinese medication group (@*CONCLUSION@#Acupuncture combined with
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Child , Humans , Acupuncture Points , Acupuncture Therapy , Cerebral Palsy/drug therapy , Powders , Treatment OutcomeABSTRACT
Background: Although clear cell renal cell carcinoma (ccRCC) is the most common histological variety of malignant renal tumor, histological variants are often encountered in clinical practice which behaves differently. Paucity of such tumors makes them a subject of interest worldwide. As per European Association of Urology, since ccRCC is a non-designation, they included all non-clear cell RCC under one nomenclature as rare kidney cancer (RKC). The objective of our study is to determine influence of inflammatory markers on the prognosis of RKC.Methods: Data from cancer registry was retrieved and all rare kidney cancer patient’s data were analysed particularly the markers of inflammation like neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic inflammatory immune index (SIII) and C reactive protein (CRP) to albumin ratio and their probable influence on cancer free survival (CFS), progression free survival (PFS) and overall survival (OS).Results: Data of 33 cases of rare kidney cancers were included in this study. The follow up duration ranges from 6.8 months to 38.6 months. In the univariate analysis, NLR had a significant influence on CFS, PFS and OS (cutoff value-3.2, 95% confidence interval [CI], CFS: p<0.05; PFS: p=0.05; OS: p<0.05), PLR in respect to CFS (cutoff value-67.5, 95% CI, p<0.05) and SIII had a significant impact on CFS and OS (cutoff value-8.67, 95% CI, 11.10-19.57, CFS: p<0.05; OS: p<0.05).Conclusions: Inflammation markers such as NLR, PLR, SII Index and CRP or albumin ratio could be independent predictors of clinical outcome and prognostics factors in rare kidney cancers. However, this needs to be validated by multicentre randomised studies.
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Objective To explore the correlation between platelet function and immunity index in patients with sepsis. Methods The platelet function and immune indexes of one hundred and one patients with sepsis treated in Shanxi Dayi Hospital from July 1st, 2016 to October 31st, 2017 were analyzed retrospectively. According to their shock,they were divided into shock group (34 cases) and non shock group (67 cases). Another 50 healthy people in the same period in our hospital were selected as control group. The relationship between platelet function and immune indexes was compared. Results ( 1) the incidence of maximum blood block intensity decreased in the thrombus map of the septic shock group was higher than that in the non shock group, and the difference was statistically significant ( 65. 67%( 44/67 ) vs. 23. 53%(8/34),χ2＝41. 28,P＜0. 05); (2) the CD4+T lymphocyte and C3 in the septic shock group were all lower than those in the non shock group ((47. 28%±7. 78) vs. (54. 93%±11. 26),t＝3. 554,P＜0. 05; (0. 42 ±0. 23) g/L vs. (0. 75±0. 19) g/L,t＝－3. 057,P＜0. 05),the ratio of CD4+/CD8+T lymphocyte was higher than that in non shock group ((2. 68±0. 18) vs. (2. 45±0. 07),t＝7. 18,P＜0. 001)). (3) the maximum intensity of blood clots was correlated with the percentage of CD4+T lymphocyte,CD4+/CD8+T lymphocyte ratio,complement C3,acute physiology and chronic health status score system II score,and sequential organ failure score ( r ＝ 0. 617, 0. 411, 0. 563,－ 0. 631,－ 0. 547, P＜ 0. 01, or P＜ 0. 05 ) . Conclusion Thrombocytopenia is present in septic patients,which is correlated with changes in immune indices.
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Objective:To compare the immunology parameters and stress hormone in two groups of patients with lung cancer after radical operation and provide reference to clinical surgery.Methods:From March 2015 to March 2016, 72 cases in our hospital were accepted surgical treatment for lung cancer and divided into observation group and control group. Among them 36 cases of video-assisted thoracoscopy lung cancer radical surgery for the treatment of patients in mind as the observation group, 36 cases of open chest lung cancer radical operation were recorded as control group, respectively comparing two groups of patients with preoperative and postoperative 3 days red cell immune index, index of cellular immunity, stress hormone level and blood rheology index.Results:3 days after operation, the observation group in terms of RBC-C3b, RFER levels were significantly higher than those of control group and RBC-IC and RFER were significantly lower than those in the control group. 3 days after operation, the observation group CD3+, CD4+, CD3+CD4+ were significantly higher than those of the control group, while CD8+ was significantly lower than that of the control group. 3 days after operation, the observation group NE, Cor, angiotensin II (ANG II) was significantly higher than that of the control group (t=2.181,t=10.320,t=5.924;P<0.05). 3 days after operation in observation group, the plasma viscosity, erythrocyte sedimentation equation K value were significantly lower than those in the control group. The differences were statistically significant (t=29.698,t=7.411;P<0.05).Conclusion:The side-effect of thoracoscopy radical resection of lung cancer is small, and it has more advantages compared with open chest lung cancer radical operation.
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Objective To observe the clinical efficacy of Wenshen Xiaochuan Paste Recipe (WXPR) in preventing bronchial asthma, and to explore the mechanism. Methods Eighty patients were randomly divided into treatment group and control group. Each group had 40 patients. The control group was treated by conventional western medicine such as inhalation of steroid, and the treatment group was given oral use of WXPR based on the treatment for the control group. Treatment for both groups covered 60 days, and the follow-up lasted 10 months. The clinical outcomes included the clinical efficacy and immune indexes of peripheral blood T lymphocyte subsets CD3+, CD4+, CD8+and CD4+/CD8+ratio, and the serum IgE level. Results (1) After treatment and 12 months later, the scores of asthma control test (ACT ) in the two groups were increased obviously as compared with those before treatment, and there were statistically significant differences (P0.05) , but were significant ( P0.05). The improvement of immune indexes in the treatment group was superior to that in the control group ( P<0.05). Conclusion WXPR has good clinical efficacy in preventing and treating bronchial asthma. The mechanism is related with the inhibition of airway inflammation and improvement of immune function probably through regulating T lymphocyte subsets and lowering serum IgE level in asthma patients.
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No abstract available.