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Objective:To analyze the value of serum related cytokines in predicting intestinal mucosal injury in patients with severe acute pancreatitis (SAP) and its correlation with intestinal mucosal injury.Methods:A total of 92 patients with SAP admitted to the First Hospital of Qinhuangdao from January 2020 to December 2021 were included in the study. According to the presence or absence of intestinal mucosal barrier dysfunction, the patients were divided into intestinal mucosal barrier dysfunction group (33 cases) and non-intestinal mucosal barrier dysfunction group (59 cases). Another 100 healthy subjects were selected as the control group. Clinical data of the subjects were collected. Serum levels of procalcitonin (PCT), D-lactic acid (D-L), endotoxin, diamine oxidase (DAO), citrulline and intestinal fatty acid binding protein (I-FABP) of the three groups were compared, and the correlation between the above indexes was analyzed by Pearson correlation analysis. Receiver operating characteristic (ROC) curve was used to analyze the value of each indicator in predicting intestinal mucosal barrier dysfunction in SAP patients.Results:The levels of serum PCT, D-L, endotoxin, DAO and I-FABP in intestinal mucosal barrier dysfunction group, non-intestinal mucosal barrier dysfunction group and control group showed a downward trend, while the level of serum citrulline showed an upward trend, with statistically significant difference (all P<0.05). Pearson correlation analysis showed that serum citrulline was negatively correlated with serum PCT, D-L, and endotoxin levels ( r=-0.740, -0.629, -0.310, all P<0.05); There was a positive correlation between serum DAO and serum PCT, D-L and endotoxin levels ( r=0.482, 0.779, 0.338, all P<0.05); There was a positive correlation between serum I-FABP and serum PCT, D-L and endotoxin levels ( r=0.613, 0.421, 0.341, all P<0.05). The ROC curve results showed that the area under the curve (AUC) of serum PCT, D-L, endotoxin, DAO, citrulline, and I-FABP predicting intestinal mucosal injury in SAP patients were 0.816, 0.789, 0.732, 0.801, 0.812, and 0.857, respectively. The AUC of the combination of the above indicators predicting intestinal mucosal barrier dysfunction in SAP patients was 0.909, significantly higher than that predicted by each index alone (all P<0.05). Conclusions:The occurrence of intestinal mucosal barrier dysfunction in SAP patients may be related to the increase of serum PCT, D-L, endotoxin, DAO, I-FABP levels and the decrease of citrulline levels. It may be considered to predict the risk of intestinal mucosal injury by detecting the levels of various indicators in patients′ serum.
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Objective:To determine the risk factors of extubation failure and its effect on the prognosis of patients who had successfully passed a spontaneous breathing trial (SBT).Methods:The clinical data of patients with mechanical ventilation more than 24 hours who passed SBT admitted to department of intensive care unit (ICU) of First Hospital of Qinhuangdao from November 2018 to November 2019 were retrospectively analyzed. According to the outcome of weaning within 48 hours after weaning, patients were divided into weaning success group and weaning failure group. The baseline data, the presence of basic cardiopulmonary diseases, B-type natriuretic peptide (BNP), fluid balance, albumin and hemoglobin within 24 hours before weaning, the time of mechanical ventilation before weaning, rapid shallow breathing index (RSBI) during SBT, oxygenation index, cough peak flow at the end of SBT, and prognostic indicators were collected. The outcome of weaning was taken as the dependent variable, and the observation factors were taken as the independent variable for univariate analysis. The factors with statistical significance in univariate analysis were analyzed by binary Logistic regression to determine the influencing factors of weaning failure.Results:Of the 204 patients, 167 (81.9%) were successfully weaned, and 37 (18.1%) failed. Compared with the weaning success group, the total duration of mechanical ventilation and the length of ICU stay in the weaning failure group were significantly longer [days: 13.0 (7.5, 23.5) vs. 5.0 (3.0, 8.0), 17.0 (12.5, 31.0) vs. 10.0 (6.0, 15.0), both P < 0.01], and the tracheotomy rate and mortality were significantly higher (32.4% vs. 0%, 51.4% vs. 0%, both P < 0.01). Univariate analysis showed that there were significant differences in age, proportion of patients with cardiopulmonary diseases, BNP and cough peak flow between weaning failure group and weaning success group [age (years old): 70.65±15.78 vs. 62.69±15.82, cardiopulmonary diseases: 62.2% vs. 24.6%, BNP (ng/L): 416.87 (32.70, 1 225.80) vs. 45.36 (10.00, 273.60), cough peak flow (L/min): 59.89±9.06 vs. 83.84±16.52, all P < 0.01]. However, there were no significant differences in gender, acute physiology and chronic health evaluationⅡ (APACHEⅡ) at admission, mechanical ventilation time before weaning, albumin, hemoglobin, oxygenation index, RSBI and fluid balance 24 hours before weaning between weaning failure group and weaning success group [male: 51.4% vs. 68.3%, APACHEⅡ: 16.70±6.65 vs. 15.67±6.28, mechanical ventilation time before weaning (days): 6.0 (2.5, 11.0) vs. 5.0 (3.0, 8.0), albumin (g/L): 27.78±4.15 vs. 27.76±4.46, hemoglobin (g/L): 102.43±15.80 vs. 100.61±17.19, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 359.33±79.83 vs. 365.75±78.23, RSBI (times·L -1·min -1): 50.73±24.97 vs. 46.76±15.53, positive fluid balance: 70.3% vs. 69.5%, all P > 0.05]. The results of binary Logistic regression analysis showed that age ≥ 75 years old [odds ratio ( OR) = 3.099, 95% confidence interval (95% CI) was 1.003-9.574, P = 0.049], presence of cardiopulmonary diseases ( OR = 3.599, 95% CI was 1.126-11.498, P = 0.031), BNP within 24 hours before weaning ( OR = 1.002, 95% CI was 1.000-1.003, P = 0.005) were the risk factors of extubation failure, while cough peak flow at the end of SBT was the protective factor ( OR = 0.869, 95% CI was 0.823-0.917, P = 0.000). Conclusions:For patients who had successfully passed SBT, age ≥ 75 years old, the presence of cardiopulmonary diseases and an increased level of BNP within 24 hours were the risk factors of extubation failure. In addition, the higher the cough peak flow at the end of SBT, the lower the risk of weaning failure will be.
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OBJECTIVE:To observe therapeutic efficacy and safety of cinobufacini capsules combined with paclitaxel and cisplatin in the treatment of middle and advanced cervical cancer.METHODS:A total of 92 patients with middle and advanced cervical cancer were randomly divided into observation group (46 cases) and control group (46 cases).Both groups received pelvic intensity-modulated radiotherapy (IMRT)+interstitial brachytherapy.Control group was additionally given Paclitaxel injection 135 mg/m2,d1+Cisplatin injection 75 mg/m2,d1,21 d as a treatment course,and received chemotherapy for 2 cycles since the fnrst day of radiotherapy.Observation group was additionally given Cinobufacini capsules 0.5 g orally since the first day of radiotherapy,3 times a day,until the end of radiotherapy.Clinical efficacies as well as platelet count,KPS score,body weight,pain relief and the recovery of platelet abnormality were observed in 2 groups,and the occurrence of toxic reaction was recorded.RESULTS:The complete remission rate,the rate of platelet count abnormality recovery as well as remission rate and total remission rate of pain after 3 weeks of treatment in observation group were significantly higher than control group,with statistical significance (P＜0.05).There was no statistical significance in the total response rate and remission rate after 4,5 weeks of treatment between 2 groups (P＞0.05).After treatment,platelet count of 2 groups were significantly lower than before,and the observation group was significantly lower than the control group;KPS score of 2 groups and body weight of observation group were significantly higher than before treatment;body weight of control group was significantly lower than before,and the observation group was significantly higher than the control group,with statistical significance (P＜0.05).The incidence of grade Ⅲ-Ⅳ neutropenia,nausea and vomiting,grade Ⅰ-Ⅱ diarrhea in observation group were significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:Based on conventional treatment,cinobufacini capsules combined with paclitaxel and cisplatin show significantly therapeutic efficacy for middle and advanced cervical cancer,improve blood hypercoagulation and survival quality,relieve pain and reduce the occurrence of toxic reaction.
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Objective To establish and evaluate the method to collect the rat gingival crevicular fluid (GCF)by using absorbent paper points, and to lay foundation for analysis on GCF.Methods 20 healthy male rats were selected and randomly divided into GCF group and saliva group.The GCF of the right upper molar gingival trough of the rats in GCF group and the saliva of the rats in saliva group were collected by using 1 5# absorbent paper points.The SDS-PAGE analysis and abundance detection were applied to analyze the protein bands of the samples in two groups.Results The SDS-PAGE analysis identified the proteins at 77 000,66 000,55 000,51 000,and 28 000,especially 66 000 in GCF group.While saliva group had lower brightness protein bands at 66 000,60 000, and 48 000.The data of protein abundance of 66 000 between two groups had statistically significant difference (P<0.05).Conclusion The number and types of the protein bands are different between GCF Group and saliva group,so using 15# absorbent paper points can collect the rat GCF successfully.
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Objective To compare the retromolar space (RMS) between different antero-posterior (A-P) skeletal patterns, and explore the relationship between the status of third molar eruption/impaction with the different A-P skeletal patterns. Methods A total of 90 orthodontic patients (25-35 years old) were investigated from dental pantomograms (DPTs) and lateral cephalograms (LC). The subjects were divided into three groups according to their ANB angle:skeletal classⅠ, skeletal classⅡ, and skeletal classⅢ. Each group was subdivided into impacted and erupted subgroups. Values of DPT and LC were traced, and the following variables were measured including mandibular body length, third molar angulation and ret-romolar space width. Results The retromolar space width was significantly smaller in classⅡsubjects than that in classⅢsubjects, and RMS was significantly smaller in impacted group than that in erupted group, respectively (P<0.05). There was no significant difference in the mandibular angle in erupted subgroup (P<0.05). There was a smaller mandibular body length in impacted subjects (P<0.05). Conclusion There is a relationship between different morphological characteristics of sagittal skeletal pattern and the impacted status. Patients with shorter mandibular body length and decreased RMS width are more inclined to impaction.