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Objective:To explore the predictive value of systemic immune-inflammation index (SII) and small and dense low-density lipoprotein-cholesterol (sdLDL-C) on contrast-induced acute kidney injury (CI-AKI) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI).Methods:This retrospective analysis included 674 STEMI patients who underwent emergency PCI in Affiliated Hospital of Xuzhou Medical University from November 2019 to October 2021, all patients were divided into a training cohort ( n=450) and validation cohort ( n=224) at a ratio of 2∶1 according to the chronological sequence. The patients in the training cohort were further divided into CI-AKI group ( n=92) and non-CI-AKI group ( n=358). Information at admission and emergency blood biochemical indexes were collected, and the SII was calculated. Multifactorial logistic regression analysis was used to explore the independent factors influencing the occurrence of CI-AKI in STEMI patients undergoing emergency PCI in the training cohort and a predictive model was established. Receiver operating characteristic (ROC) curve and Hosmer-Lemeshow test were used to evaluate the model discrimination and calibration. Results:The prevalence of CI-AKI was 20.4% (92/450). Age, proportion of women, sdLDL-C, urea, baseline creatinine, uric acid, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and SII were significantly higher in the CI-AKI group than in the non-CI-AKI group (all P<0.05), and left ventricular ejection fraction (LVEF), high-density lipoprotein cholesterol, estimated glomerular filtration rate (eGFR) and lymphocyte count were significantly lower in the CI-AKI group than in the non-CI-AKI group (all P<0.05). The results of multifactorial logistic regression analysis showed that age ( OR=1.046, P=0.001), LVEF ( OR=0.916, P<0.001), sdLDL-C ( OR=4.754, P<0.001), uric acid ( OR=1.012, P=0.007), eGFR ( OR=0.994, P=0.002), and lnSII ( OR=2.471, P<0.001) were independent determinants of CI-AKI after emergency PCI in STEMI patients. ROC curve analysis showed that area under the curve (AUC) for the diagnosis of CI-AKI was 0.688 with a sensitivity of 73.9% and specificity of 61.5% for the SII cut-off point of 1 179.07×10 9/L. The AUC for the diagnosis of CI-AKI was 0.709 with a sensitivity of 65.2% and specificity of 77.4% for the sdLDL-C cut-off point of 1.147 mmol/L. The AUC for the diagnosis of CI-AKI was 0.847 with a sensitivity of 88.0% and a specificity of 70.6% for the combination of SII and sdLDL-C with age, LVEF, uric acid and eGFR. The Hosmer-Lemeshow test (χ2=6.913, P=0.546) proved the goodness of fit of the model. Conclusions:SII and sdLDL-C have significant clinical value in the prediction of CI-AKI. SII and sdLDL-C combined with age, LVEF, uric acid and eGFR could further improve the predictive efficacy of CI-AKI.
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Objective:To determine the expression of T follicular helper (Tfh) cell-related molecules inducible costimulator (ICOS) and programmed cell death-1 receptor (PD-1) in skin lesions of patients with bullous pemphigoid (BP), and to explore the role of Tfh cells in the pathogenesis of BP.Methods:Twenty-one paraffin-embedded tissue specimens were collected from 21 patients with confirmed BP in Dalian Dermatosis Hospital from 2014 to 2017, including 7 females and 14 males with an average age of 72.57 years. Ten normal skin tissue specimens served as control group. Immunohistochemical SP method was used to determine the expression of ICOS and PD-1 in BP skin lesions and normal skin tissues.Results:In BP lesions, ICOS and PD-1 were mainly expressed in the basal layer, spinous layer, granular layer and stratum corneum, especially in the spinous layer in the epidermis, and also expressed in inflammatory cells in the dermis. Additionally, they were both expressed in the cytoplasm and nuclei, occasionally expressed on the cell membrane. However, ICOS and PD-1 were rarely expressed in the normal skin tissues. The expression rates of ICOS and PD-1 were significantly higher in the BP group (85.71% [18/21], 47.62% [10/21], respectively) than in the normal control group (both were 0; P < 0.001, < 0.05, respectively) .Conclusion:Tfh cell-related molecules ICOS and PD-1 may play important roles in the pathogenesis of BP.
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Objective To observe the effect of E light combined with 595 nm pulsed dye laser in patients with erythromelanosis follicularis of face and neck. Methods The clinical data of 44 patients with erythromelanosis follicularis of face and neck from 2015 to 2017 in Dalian Dermatosis Hospital were retrospectively analyzed. Among the patients, 22 patients were treated with 595 nm pulsed dye laser (control group) and 22 cases were treated with E light combined with 595 nm pulsed dye laser (treatment group). Efficacy was assessed 1 month after treatment, including telangiectasia, pigmentation and follicular papule. Results The total effective rates of telangiectasia, pigmentation and follicular papule in treatment group were significantly higher than those in control group: 86.4% (19/22) vs. 68.2% (15/22), 54.5% (12/22) vs. 9.1% (2/22) and 50.0% (11/22) vs. 13.6% (3/22), and there were statistical differences (P＜0.05). No significant adverse reactions occurred during and after treatment in 2 groups. Conclusions E light combined with 595 nm pulsed dye laser is better and safer than 595 nm pulsed dye laser alone in the treatment of erythromelanosis follicularis of face and neck.
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Objective :To explore the correlation among plasma level of N terminal pro brain natriuretic peptide (NT—proBNP) and echocardiographic indexes in patients with chronic heart failure (CHF).Methods : Clinical data of 154 CHF patients treated in our hospital were regard as CHF group (NYHA classⅡ ～ Ⅳ).Another 154 cases undergo—ing physical examination in our hospital simultaneously were regarded as normal control group .Serum NT—proBNP level ,left ventricular ejection fraction (LVEF) ,left atrial diameter (LAD) ,left ventricular end—diastolic dimension (LVEDd) ,and heart failure echocardiographic index (HFEI ) were observed and compared between two groups , and correlation among NT—proBNP level and echocardiographic indexes were analyzed .Results : Compared with normal control group ,there were significant rise in serum NT—proBNP level ,LAD ,LVEDd and HFEI ,and signifi—cant reduction in LVEF in CHF group ,and along with NYHA class rose ,there were significant rise in serum NT—proBNP level ,LAD ,LVEDd and HFEI ,and significant reduction in LVEF , P＝0.001 all.Pearson correlation a—nalysis indicated that lgNT—proBNP was significant positively correlated with NYHA class ,LAD ,LVEDd and HFEI ( r＝0. 814～0. 877 , P＜0. 05 all) ,and significant inversely correlated with LVEF ( r＝ －0. 807 , P＝0.009).Con—clusion : NT—proBNP detection combined echocardiography is a frequent method for diagnosis and risk stratification of CHF ,and they are significantly correlated with each other ,so it is worth adopting .
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Objective To detect levels of C?X?C chemokine receptor type 5 (CXCR5) and inducible costimulator(ICOS)in blister fluid of patients with bullous pemphigoid(BP), and to explore their significance in the pathogenesis of BP. Methods Blister fluid samples were collected from 15 patients with BP(experimental group)and 15 patients with second?degree burns(control group). Enzyme?linked immunosorbent assay(ELISA)was performed to detect the levels of CXCR5 and ICOS in the 2 groups. Results The level of CXCR5 was significantly higher in the experimental group than in the control group(219 ± 145.31 vs. 147 ± 23.83 ng/L, t=4.577, P 0.05). Conclusion The expression of CXCR5 may be associated with the occurrence of BP, but further researches are needed to determine the relationship between ICOS and the occurrence of BP.
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Objective To study the role of CXC chemokine receptor 5 (CXCR5) in the pathogenesis of bullous pemphigoid (BP) by detecting the expression of CXCR5 on follicular helper T (Tfh) cells in skin lesions of BP.Methods An immunohistochemical procedure was used to detect CXCR5 expression in biopsy specimens from skin lesions of 16 patients with BP and normal skin of 10 healthy individuals.Results CXCR5 was mainly expressed in the cytoplasm and membrane of Tfh cells in the basal cell layer of normal skin as well as in both basal cell layer and prickle cell layer of BP lesions.The number of CXCR5-positive ceils per high power field (× 400) was 11.16 ± 4.47 in normal skin specimens,significantly lower than that in lesional skin specimens (35.70 ± 12.20,t =6.07,P ＜ 0.01).Conclusion CXCR5 may be involved in the pathogenesis of BP.
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Objective To analyze the composition of and drug resistance in bacteria isolated from the lesions of patients with squamous cell carcinoma of the face and head.Methods Lesional tissue or discharges were obtained from 246 patients with squamous cell carcinoma of the face and head,and subjected to conventional bacterial culture.The isolated bacteria were identified by VITEK TWO automated microbiology system.Antimicrobial susceptibility testing was carried out by Kirby-bauer method.WHONET 5.3 software was utilized for statistical analysis.Results Totally,294 bacterial strains were isolated,including 168 Gram-negative bacteria (57.1％)and 126 Gram-positive bacteria(42.9％).The bacterial isolates were predominated by Staphylococcus aureus(21.4％),followed by Escherichia coli(20.4％),Staphylococcus epidermidis(18.4％),Klebsiellapneumoniae(15.4％)and Pseudomonas aeruginosa(9.5％).The prevalence was 40％,26.7％,42.9％ and 55.6％ respectively for extended spectrum β lactamases-producing E.coli and K.pneumoniae,methicillinresistant staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative S.epidermidis(MRCNS)respectively.P.aeruginosa,E.coli and K.pneumoniae were highly susceptible to imipenem and meropenem,and favorably sensitive to β-lactam and β-1actamase inhibitor combination.No resistance was observed for vancomycin,teicoplanin or linezolid in staphylococci.Conclusions The bacterial isolates from squamous cell carcinoma tissue on the head and neck are predominated by conditional pathogenic bacteria,and the proportion of Gram-negative bacteria is higher than that of Gram-positive bacteria.These isolates seem to be highly resistant to common antibiotics.
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Objective To study the topical application of Tuhuai decoction and its disassembled prescriptions on skin function of mice with epidermal hyperplasia, and to provide a theoretical basis for the treatment of psoriasis. Methods According to the Denda method, skin barrier function in mice was destructed with tape, to produce epidermal hyperplasia model. Tuhuai decoction and its disassembled prescriptions with different concentrations of water and alcohol extracts were external applied on the mice. Since the beginning of the treatment, loss of skin moisture of both sides the trunk was detected with Multi-functional instrument at every day before using the medicine. Results Tuhuai decoction had function of reducing the amount of water loss of skin. The disassembled prescriptions, such as Angelica group, safflower group, Danshen root group, and water and ethanol extracts of Prtmella group can reduce the amount of water loss of skin effect. Conclusion Water and ethanol extracts of Tuhuai decoction has the functions of reducing water loss of skin and resisting hyperplasia,suitable for treating psoriasis by external application, setting a foundation for clinical treatment of psoriasis.
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Objective To investigate the methods for repairing skin defects after excision of small cutaneous malignant tumors at the lower one third part of nose and their clinical effects.Methods Lesions of small cutaneous malignant tumors at lower one third part of the nose were removed in 54 patients.Intraoperative pathology was performed to confirm the absence of survival carcinoma tissues after resection.According to the site,size,shape and neighborous skin status of defects,bilobed flaps,two-side rotation flaps and nasolabial flaps were selected to repair nasal skin tissue defects.Results There were 39(72.22%) cases of basal cell carcinoma, 9(16.67%) squamous cell carcinoma, 6(11.11%) keratoacanthoma.Skin defects after tumor removal were situated at the lower one third part of nose in all cases with less than 2.0 cm in diameter.Bilobed flaps were used to repair skin defects in 20 cases.rotation flaps in 2 cases,and nasolabial flap in 32 cases.As a result,all flaps survived and no obvious deformation of nose was observed in these cases.No recurrence occurred in a 5-year follow-up.Conclusion A satisfactory repair of skin defects at the lower one third part of nose with a diameter of less than 2.0 cm is achieved with bilobed flaps,two-side rotation flaps and nasolabial flaps.
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Using wavelet transforms method, time-frequency characteristics of pulse signals from 15 heroin addicts and 15 healthy persons were analyzed. According to 3-D and contour plots used to display discrete dyadic wavelet transforms, the significant difference of time-frequency characteristics between the signals of heroin addicts and healthy persons were revealed. A primary criterion was also obtained,with the criterion, 15 heroin addicts were entirely identified, while two healthy subjects were misidentified. The research result shows that the wavelet-based multiresolution analysis is a very effective method to extract characteristics of pulse signals. It is valuable to the diagnosis and therapy for heroin addicts.
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Adulto , Femenino , Humanos , Masculino , Algoritmos , Diagnóstico por Computador , Análisis de Fourier , Dependencia de Heroína , Diagnóstico , Medicina Tradicional China , Pulso Arterial , Procesamiento de Señales Asistido por ComputadorRESUMEN
Objective:To observe the effect of internal and external use of Chinese material medica with syndrome differentiation on acne vulgaris.Methods:200 patients with acne vulgaris were randomly divided into treatment group(110 cases)and control group(90 cases).Treatment group were given acne facial mask,oral medicine decoction,and the control group were treated with13-cis-Retinoic Acid Capsules,topical Clindamycin Gel,7 weeks for a course of treatment,the clinical effect were compared.Results:The effect on facial lesion in treatment group and control group had significant difference(P
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In this paper, the method of power spectral estimation is used to analyze the heart rate variability (HRV) signals for 15 heroin addicts and 15 healthy persons. The analysis result shows that there is a significant difference of the locations of the high-frequency peaks between the power spectra of heroin addicts' HRV signals. It means that the locations for heroin addicts lie in 0.437 +/- 0.064 Hz and the locations for healthy persons lie in 0.325 +/- 0.052 Hz.
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Adolescente , Adulto , Femenino , Humanos , Masculino , Sistema Nervioso Autónomo , Frecuencia Cardíaca , Fisiología , Dependencia de Heroína , Procesamiento de Señales Asistido por ComputadorRESUMEN
Objective:We clarify the relationship between dysfunction of gastric motility and the plasma motilin,in order to study the pathogenesis,diagnosis and therapy of the hepatocirrhosis with dyspepsia.Methods:The liquid gastric emptying (GE),electrogastrograpgy(EGG) and plasma motilin were examined in 51 patients with hepatocirrhosis.Results:The dysfunction of gastric motility is associated with the liver function,gastric rhythm and upper gastrointestinal symptom.The plasma motilin concentration increased significantly in patients with hepatocirrhosis as compared with that of controls (P<0.01).The sorbefacient prokinetic drug (prepulsid) can improve the function of gastric power,but the lever of motilin no change.Conclusion:The patients with hepatocirrhosis have the dysfunction of gastric motility,and gastric emptying delayed,and there is a relation between GE and the liver function.We evaluate that this disorder is associated with the low sensitivity about stomach to the plasma molitin in this case.We can judge the degree of the liver damage,gastric emptying delayed.gastric rhythm by testing the gastric motilin.Drug can deal it.
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Objective To observe the changes of CD_(28) and soluble CD_(27)(sCD_(27)) among HIV-1-infected Chinese patients receiving highly active antiretroviral therapy(HAART) and to explore their clinical significance.Methods The HIV-RNA viral load(VL) and cell counts of CD_3~+CD_4~+,CD_3~+CD_8~+,CD_4~+CD_(45)RA~+CD_(62)L~+,CD_4~+CD_(28)~+,CD_8~+CD_(28)~+ and the content of sCD_(27) were determined in 28 cases of HIV-1-infected patients at the baseline and 12,24 and 48 weeks respectively after the treatment with three drug regimens based on two nucleoside reverse transcriptase inhibitors(NRTIs) and an Non-NRTI(NNRTI) for 1 year.Results The average of HIV-RNA VL before the treatment was 5.25 logs,and decreased to 3.30,1.92 and 1.74 logs after the treatment for 12,24 and 48 weeks respectively.The cell counts of CD_3~+CD_4~+,CD_3~+CD_8~+,CD_4~+CD_(45)RA~+62L~+,CD_4~+CD_(28)~+,CD_8~+CD_(28)~+ before the treatment were(236?85),(917?345),(58?15),(175?63) and(285?87) cells/?l,and changed into(327?112),(803?343),(114?25),(286?132) and(387?201) cells/?l after the treatment for 48 weeks respectively.The content of sCD_(27) decreased from(475?123) U/ml to(174?77) U/ml after the treatment for 48 weeks.The HIV RNA VL had significantly negative correlation with cell counts of CD_4~+T,CD_4~+CD_(28)~+ and CD_8~+CD_(28)~+,and there was positive correlation between HIV RNA VL and the level of sCD_(27).Conclusion The immune reconstitution and activation depend on the efficacy of antiretroviral therapy.The HIV RNA VL and cell counts of CD_4~+T are the representative parameters of immunologic and viral responses of HAART.The cell counts of CD_4~+CD_(28)~+ and CD_8~+CD_(28)~+ and their percentages show concomitant changes with viral load,and play an effective role in the progression and prognosis of AIDS.The level of sCD_(27) is positively correlated with HIV RNA VL and negatively with counts of CD_4~+T cell.The detection of sCD_(27) by enzyme linked immunosorbent assay(ELISA),which is much more convenient and cheaper than RT-PCR and flow cytometry,may serve as an important parameter to judge the pathogenetic condition of HIV-1-infected patients and to examine the therapeutic effects of HAART in the medical resource-limited area.