Analysis of the urination behaviour in spring among college students in Hebei Province / 中国学校卫生

Objective@#To analyze the urination behavior in spring among college students in Hebei Province.@*Methods@#In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. And 156 students completed the investigation. The urine samples of 24 hour was collected for 3 consecutive days by special device, and the volume, the voids and the time of urine were measured.@*Results@#The average volume of urine per day was 1 279 mL, the average void of urine per day was 6.2, and the average volume of urine per time was 209 mL. The volume of urine and void were mainly at the time of after lunch, the volume, the proportion of the volume and void of urine were 406 mL, 31.0% and 1.7 times respectively. The volumes and the voids of urine were different in different time periods(P<0.05). The volume of urine, the proportion of the volume and the voids of urine were mainly at the time of morning, followed by the afternoon. The average volume of urine per day was 535 mL, the proportion of the volume was 44.1% and the average void of urine was 2.3, in the morning. There were significant differences in the voids of urine, the volumes of urine and the voids of urine in different time periods between boys and girls(χ2=73.71, 47.48, 34.92; 35.17, 21.30, 20.69; 37.02, 25.30, 15.32, P<0.05). The void of urine was negatively correlated with the average volume of urine per time(r=-0.61, P<0.01); the volume of urine was positively correlated with the average volume of urine per time(r=0.79, P<0.01); the void was not correlated with the volume of urine(P<0.05).@*Conclusion@#The urination behaviour of college students in Hebei Province was mainly at the time of after lunch, in the morning and in the afternoon. The college students had unhealthy urination behavior, which was in need of related health education.

Prognostic significance of plasma gelsolin in severe burn patients with sepsis / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the changes in plasma gelsolin (pGSN) levels in severe burn patients with sepsis, and to evaluate the prognosis of patients when combined with other related clinical indexes.</p><p><b>METHODS</b>Sixty-five severe burn patients with sepsis hospitalized from June 2013 to June 2015 conforming to the study criteria were divided into death group (n=24) and survival group (n=41) according to the clinical outcome on post sepsis diagnosis day (PSD) 28. The pGSN levels of patients were determined on PSD 1, 3, 7, and 14 with double antibody sandwich enzyme-linked immunosorbent assay. The serum level of C-reactive protein (CRP), serum level of procalcitonin, lactate level of arterial blood, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and Sequential Organ Failure Assessment (SOFA) score were determined or recorded on PSD 1. Data were processed with repeated measurement analysis of variance, t test, and chi-square test. On PSD 1, the pGSN level, serum level of CRP, serum level of procalcitonin, lactate level of arterial blood, APACHE II score, and SOFA score of 65 patients were collected to screen the independent risk factors related to death with single factor and multi-factor Logistic regression analysis. Receiver operating characteristic (ROC) curves of the independent risk factors related to death were plotted to evaluate the predictive power for death in 65 patients.</p><p><b>RESULTS</b>(1) The pGSN levels of patients in death group on PSD 1, 3, 7, and 14 were respectively (146±44), (85±24), (28±7), and (19±4) mg/L, obviously lower than those in survival group [(287±82), (179±51), (196±56), and (249±67) mg/L, with t values from 1.735 to 4.304, P<0.05 or P<0.01]. (2) The serum level of CRP, serum level of procalcitonin, lactate level of arterial blood, APACHE II score, and SOFA score of patients in death group on PSD 1 were respectively (56±7) mg/L, (12.54±0.82) μg/L, (2.74±0.27) mmol/L, (24.3±2.4) points, and (11.43±0.57) points, significantly higher than those in survival group [(35±4) mg/L, (2.38±0.16) μg/L, (1.83±0.12) mmol/L, (15.0±1.5) points, and (7.22±0.23) points, with t values from 1.902 to 3.883, P<0.05 or P<0.01]. (3) Multi-factor Logistic regression analysis showed that the pGSN level (odds ratio: 6.83, 95% confidence interval: 4.33-10.25, P<0.01) and APACHE II score (odds ratio: 5.27, 95% confidence interval: 2.28-9.16, P<0.01) were the independent risk factors related to death in 65 patients on PSD 1. (4) The total areas under the ROC curves of pGSN level and APACHE II score for predicting death of 65 patients on PSD 1 were respectively 0.89 and 0.86, and 142 mg/L and 21 points were respectively chosen as the optimal threshold values, with sensitivity of 87% and 83% and specificity of 86% and 89%.</p><p><b>CONCLUSIONS</b>For severe burn patients with sepsis, lowering of pGSN level and elevation of APACHE II score are obviously correlated with increase in case fatality rates. Monitoring the dynamic changes in pGSN level and APACHE II score during the early stage may be useful to predict the prognosis of severe burn patients with sepsis.</p>

Clinical study on continuous plasma filtration absorption treatment for burn sepsis / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effects of continuous plasma filtration absorption (CPFA) treatment on burn sepsis.</p><p><b>METHODS</b>Thirty burn patients with sepsis hospitalized in Beijing Fengtai You'anmen Hospital from July 2009 to October 2012 were treated by CPFA for twice besides routine treatment. The blood samples were collected at five sites (A, B, C, D, and E, respectively) of blood purification equipment before and after CPFA, before and after hemoabsorption, and before hemofiltration. The plasma levels of TNF-α, IL-1β, IL-6, IL-10, interleukin-1 receptor antagonist (IL-1RA), soluble tumor necrosis factor receptor (sTNFR) I , and sTNFR-II from sites A, C, and E were determined with ELISA before CPFA was performed for the first time, and those from sites B and D were determined with ELISA after CPFA was performed for the first time. Plasma levels of the above-mentioned cytokines from sites A and B were determined with ELISA before CPFA and after CPFA was performed for the second time. The data of plasma levels of IL-1βP3, IL-1RA, sTNFR-I, sTNFR-II, and TNF-α before CPFA and after CPFA was performed for the second time were collected for calculation of the ratios of IL-1RA to IL-1β and sTNFR-I plus sTNFR-II to TNF-α. The expression rate of human leukocyte antigen DR (HLA-DR) on the CD14 positive monocytes, acute physiology and chronic health evaluation (APACHE) II score, body temperature, pulse, respiratory rate, and leukocyte count of patients were evaluated or recorded before CPFA and after CPFA was performed for the second time. Patients'condition was observed. Data were processed with paired t test.</p><p><b>RESULTS</b>The plasma levels of TNF-α, IL-1β, IL-6 and IL-10 from site B after CPFA was performed for the second time were significantly lower than those from site A before CPFA was performed for the first time (with t values respectively 7.05, 5.23, 4.73, 2.37, P values below 0.01). After CPFA was performed for the first time, the plasma levels of TNF-α, IL-1β, and IL-6 from site D were significantly lower than those from site C before CPFA was performed for the first time (with t values respectively 5.48, 2. 17, 1.78, P < 0.05 or P <0.01). The plasma levels of all cytokines were close between site B after CPFA was performed for the first time and site E before CPFA was performed for the first time (with t values from 0.04 to 1.05, P values above 0.05). The plasma levels of TNF-α, IL-1β, and IL-6 from site B after CPFA was performed for the second time were significantly lower than those from site A before CPFA was performed for the second time (with t values from 1.87 to 5.93, P <0.05 or P <0.01). The ratios of IL-1RA to IL-1β and sTNFR-I plus sTNFR-II to TNF-α, and expression rate of HLA-DR were increased significantly after CPFA was performed for the second time as compared with those before CPFA (with t values from 3.99 to 7. 80, P values below 0.01). APACHE II score after CPFA was performed for the second time was 11 ± 6, which was lower than that before CPFA (22 ± 7, t =4.63, P <0.01). After CPFA was performed for the second time, body temperature, pulse, and respiratory rate of patients were improved (with t values from 1.95 to 3.55, P values below 0.05) , and the leukocyte count was significantly decreased (t =4.36, P <0.01) as compared with those before CPFA. All patients survived and were discharged with length of stay of (27 ± 31) d, and no adverse effects occurred during CPFA treatment.</p><p><b>CONCLUSIONS</b>CPFA, which combines hemoabsorption and hemofiltration, can facilitate the treatment of burn sepsis by decreasing the level of pro-inflammatory cytokines efficiently, alleviating systemic inflammatory response, and improving the immune status.</p>

Immunological activity change of regulatory T cells and its relation with outcome of patients with severe burn / 中华创伤杂志

Objective To investigate the immunological activity change of regulatory T cells (Treg) and discuss its significance in the outcomes of patients with multiple organ dysfunction syndrome (MODS) and severe burn. Methods A total of 106 patients with total burn surface area (TBSA) larger than 30% were included in the study and randomly divided into three groups according to the burn area: Group Ⅰ (TBSA of 30%-49%, n = 41), Group Ⅱ (TBSA of 50% -69%, n = 34) and Group Ⅲ (TBSA of 70%-99%, n = 31). According to the development of MODS, patients were divided into MODS group (n =21) and non-MODS group (n =85). The patients with MODS were further divided into non-survival group (n = 16) and survival group (n = 5) based on their outcomes. Healthy volunteers were served as normal control (n = 25). Peripheral blood samples were collected at days 1,3,7, 14 and 21 postburn. The immunomagnetic separation technique was applied to separate and purify CD4+ CD25+Tregs in peripheral blood, and phenotypes (CTLA-4) were analyzed by flow cytometry and the contents of interleukin-10 released in the supernatants were determined by ELISA. Results Expression of CTLA-4 and level of IL-10 were significantly increased in burn patients compared with normal control group, with statistical differences. The expression of CTLA-4 and level of IL-10 were significantly increased in patients with severe burns at all time points. The expression of CTLA-4 and level of IL-10 in MODS group were much higher than those in non-MODS group at days 3-21 postburn (P ＜ 0.01). Among the MODS patients, the expression of CTLA-4 and level of IL-10 in the survival group were obviously lower than those in the non-survival group at days 3-21 postburn (P ＜ 0.05 or P ＜ 0.01). Conclusions After severe burn injury, expressions of the markers on CD4 + CD25 + Treg surface and secretion of cytokines produced by CD4 + CD25 + Tregs show significant difference in patients with different born areas, MODS development and survival state. CD4 + CD25 + Treg may play an important role in the pathogenesis of immunoregulation, MODS and mortality of burn patients through secretion of inhibitory cytokines.

THE EFFECTS OF ESCHARECTOMY DURING BURN SHOCK STAGE ON THE mRNA EXPRESSION OF INTERCELLULAR ADHESION MOLECULE-1 AND TUMOR NECROSIS FACTOR-? IN RAT LIVER / 解放军医学杂志

To investigate the changes in the expression of intercellular adhesion molecule 1(ICAM 1) ,tumor necrosis factor ?(TNF ?) mRNA and MPO activity in rat liver after burns and the effects of escharectomy during burn shock stage on the expression of these parameters. One hundred and seventy six Wistar rats with 30% TBSA full thickness thermal injury were used. The mRNA expression of ICAM 1 and TNF ? were detected by reverse transcription polymerase chain reaction(RT PCR) in liver tissues at various intervals after burns with or without escharectomy during shock stage. Both expression of ICAM 1 and TNF ?mRNA in rat liver after burns began to increase at 4h postburn and peaked at 12h and 24h, respectively. Afterwards in groups of escharectomy at 8h and 24h postburn, the expressions of both ICAM 1 and TNF ? increased again, though the expression values were lower than the first peak values, and they returned to normal range at 96h postburn. But in groups of burn control and escharectomy at 96h postburn, their expressions still remained high on 7d postburn. In addition, MPO activity returned to normal levels at 96h postburn in groups with escharectomy during shock stage, while in groups burn control and escharectomy at 96h postburn, a high value of MPO activity persisted till 7d postburn. Our findings suggest that eschar could induce the production of inflammatory mediators such as ICAM 1 and TNF ? which damaged endothelial cells. Therefore, escharectomy as early as possible may play an important role in preventing the expression and release of adhesion molecules and the development of systemsc lnflammatory response syndrome.