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Objective:To evaluate the predictive value of age-adjusted Charlson comorbidity index (ACCI) for in-hospital mortality and 1-year mortality in patients with acute type A aortic dissection (ATAAD).Methods:This was a retrospective cohort study, and the clinical data of ATAAD patients admitted to Wuhan Union Hospital from January 1, 1999 to December 31, 2018 were collected for analysis. All the patients were confirmed by computed tomography angiography or magnetic resonance imaging of the aorta and the onset time was less than 14 days. Patients who survived at discharge were followed up to obtain 1-year survival information. The ACCI score was calculated for patients based on their comorbidities and age at admission, and they were divided into three groups of 0, 1 and ≥2 according to the ACCI score. The in-hospital mortality and 1-year mortality of the three groups were compared. Logistic regression analysis was applied to determine the independent predictors for in-hospital mortality and 1-year mortality.Results:Among 1 133 ATAAD patients, 383, 357 and 393 patients had ACCI score of 0, 1, and ≥2, respectively. The in-hospital mortality and 1-year mortality of patients with ACCI score ≥2 were significantly higher than those of patients with ACCI score of 0 (25.4% vs. 17.0%, 30.0% vs. 19.6%, both P<0.05). Multivariate Logistic regression analysis showed that ACCI score ≥2 was an independent risk factor for in-hospital mortality ( OR=1.670, 95% CI: 1.176-2.370, P=0.004) and 1-year mortality ( OR=1.762, 95% CI: 1.264-2.456, P<0.001). Age (per 10-year increase) and cerebrovascular diseases were independent risk factors for in-hospital mortality and 1-year mortality, while diabetes mellitus was a protective factor for in-hospital mortality. Conclusions:ACCI can predict the in-hospital mortality and 1-year mortality of ATAAD patients, and patients with ACCI score ≥2 have a poorer prognosis.
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Objective:Analyze the epidemiological data and the clinical data of local foodborne botulism, summarize the influencing factors and clinical characteristics of the foodborne botulism, mitigate future misdiagnosis.Methods:An epidemiological investigation was conducted to a local outbreak with botulism, which involved 24 individuals consuming homemade bean curd and 14 cases with foodborne botulism through analyzing the influencing factors of the poisoning. For 14 patients with botulism, their clinical manifestations, first laboratory test and imaging data, treatment and prognosis, were documented and explored.Results:All 14 cases were diagnosed as type A foodborne botulism, of which 2 were misdiagnosed. The incidence of the foodborne botulism was reduced by 81.7% in alcoholic drinkers ( P=0.009). The median incubation period of the 14 patients with botulism was 2.0 (1.0~3.0) days. The initial clinical symptom of 10 patients was diplopia, while that of the other 4 patients was blurred vision. Nine patients subsequently suffered from paralysis of oropharyngeal muscles, leading to dysphagia, speech impairment, etc. Four patients progressed to dyspnea and chest tightness due to respiratory muscle involvement. All of the patients had clear consciousness without sensory abnormalities, no fever and abdominal symptoms such as diarrhea and abdominal pain. There were no obvious abnormal findings in 14 patients with laboratory tests and cranial CT/MRI assessment. 14 patients with the poisoning were relieved after injection of botulinum antitoxin for 8.0 (7.0~8.5) days. Follow-up of all the patients 6 months later found that 9 patients still had slight blurred vision. Conclusions:The typical clinical manifestation of foodborne botulism was symmetric descending flaccid paralysis. Drinking liquor could reduce the incidence of foodborne botulism. Botulinum antitoxin was effective in the treatment of botulism and should be used as early as possible.
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Objective To investigate the effect of different doses of pralidoxime chloride on clinical outcome including recovery rate and mortality in patients with acute organophosphorus pesticide poisoning.Methods According to the total amount of pralidoxime chloride administered over the first 24 hours or entire duration of hospitalization,a cohort of 163 organophosphorus pesticide poisoning patients,admitted from February 2004 to December 2014 were assigned to different groups followed by a retrospective analysis.Comparisons of recovery rate,mortality rate,mean length of hospital stay,and duration of mechanical ventilation were made among groups.SPSS 18.0 was used to analyze categorical variables between the data of groups with x2 test/Fisher exact probability method and numerical variables with t test or One-way ANOVA,and statistical significance was set as P ＜ 0.05.Results According to the amount of pralidoxime chloride given over the first 24 hours,the recovery rate and the mortality rate were significantly improved in the experimental group (pralidoxime chloride ＞ 2 g) than in the control group (pralidoxime chloride ＜ 2 g) (P =0.04).There was no significant difference in mean length of hospital stay between the experimental group and the control group (P =0.171),and there were statistically significant differences in recovery rate and mortality rate among the four dose-response subgroups (total dosage administered in 24 hours in group A ＜ 1 g,in group B ＜2 g,in group C ＜4 g and in group D ＞4 g) (P =0.034).Based on the total amount of pralidoxime chloride prescribed in the entire duration of hospital stay,the recovery rate and mortality rate were significantly better in the experimental group than those in control group (P =0.002),and among the three dose-response subgroups,the significant difference in recovery rate and mortality rate were also observed (P =0.006).Conclusions Increased amounts of pralidoxime chloride prescribed in the first 24 hours and in the whole hospitalized period can improve the recovery rate and reduce the mortality rate in organophosphorus pesticide poisoning patients.
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This study examined the effect of resveratrol on the secretion of vascular endothelial growth factor (VEGF) and subsequent proliferation of human leukemia U937 cells, and explored the mechanisms involved. Human leukemia U937 cells were treated with resveratrol of different concen- trations (12.5-200 μmol/L) for different time lengths (12-48 h). The proliferation of the U937 leu- kemic cells was determined by MTT assay. Apoptosis was observed by Annexin-Ⅴ-FIFC/PI double staining and flow cytometry (FCM). Cells cycle was analyzed by PI staining and FCM. The content of VEGF was determined by ELISA. Human umbibical vein endothelial cells were examined for vasoformation in vitro after exposures to resveratrol of various concetrations. The results showed that resveratrol inhibited the proliferation of U937 leukemia cells in a dose- and time-dependent manner. Resveratrol induced apoptosis and S-phase cell cycle arrest in human leukemic U937 cells. Resvera-trol inhibited the secretion of VEGF in U937 cells. Resveratrol inhibited the vasoformation of human vein endothelial cells in a dose-dependent manner. It was concluded that resveratrol could down-regulate the secretion of VEGE induce apoptosis and suppress the proliferation of U937 cells.
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This study examined the effect of resveratrol on the secretion of vascular endothelial growth factor (VEGF) and subsequent proliferation of human leukemia U937 cells, and explored the mechanisms involved. Human leukemia U937 cells were treated with resveratrol of different concentrations (12.5-200 micromol/L) for different time lengths (12-48 h). The proliferation of the U937 leukemic cells was determined by MTT assay. Apoptosis was observed by Annexin-V-FIFC/PI double staining and flow cytometry (FCM). Cells cycle was analyzed by PI staining and FCM. The content of VEGF was determined by ELISA. Human umbilical vein endothelial cells were examined for vasoformation in vitro after exposures to resveratrol of various concentrations. The results showed that resveratrol inhibited the proliferation of U937 leukemia cells in a dose-and time-dependent manner. Resveratrol induced apoptosis and S-phase cell cycle arrest in human leukemic U937 cells. Resveratrol inhibited the secretion of VEGF in U937 cells. Resveratrol inhibited the vasoformation of human vein endothelial cells in a dose-dependent manner. It was concluded that resveratrol could down-regulate the secretion of VEGF, induce apoptosis and suppress the proliferation of U937 cells.