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Objective@#To retrospectively explore the effects of modified dosage of calcium gluconate (CG) on the patients with hydrofluoric acid burns not in hands or feet.@*Methods@#One hundred and sixty patients with hydrofluoric acid burns not in hands or feet were hospitalized in our burn ward from January 2004 to December 2017. Based on the dosage of CG at different admission time, 76 patients hospitalized from January 2004 to December 2012 were included in traditional group, and 84 patients hospitalized from January 2013 to December 2017 were included in modified group. For patients in the two groups, subcutaneous injection of CG solution at one time was immediately conducted on admission in topical treatment. In traditional group, the injection was CG solution with mass concentration of 100 g/L. For wounds of superficial partial-thickness and above degree, CG solution was prescribed at the dosage of 50 mg/cm2. Wounds of superficial-thickness or mass fraction of hydrofluoric acid less than 20.0% did not receive injection. In modified group, the mass concentration of CG solution for injection was diluted with normal saline to 25 g/L. For wounds of deep partial-thickness and above degree, CG solution was prescribed at the dosage of (50×mass fraction of hydrofluoric acid) mg/cm2. For wounds of superficial partial-thickness, CG solution was prescribed at the dosage of (25×mass fraction of hydrofluoric acid) mg/cm2. For wounds of superficial-thickness, CG solution was prescribed at the dosage of 2.5 mg/cm2. For systemic treatment, the injection velocity of CG solution via venous access was adjusted according to the level of serum calcium namely total serum calcium of patients in traditional group. In modified group, serum ionized calcium was additionally detected through automatic blood gas analyzer by the bed to regulate the injection velocity of CG via venous access. The incidence rate of hypercalcemia and mortality of patients after treatment in the two groups, and the situation about treatment of survivors in the two groups were analyzed. Data were processed with chi-square test, Fisher′s exact probability test, t test, and Mann-Whitney U test.@*Results@#(1) After treatment, 9 patients (11.8%) had hypercalcemia, while the other 67 patients (88.2%) did not have hypercalcemia in traditional group. Two patients (2.4%) had hypercalcemia, while the other 82 patients (97.6%) did not have hypercalcemia in modified group. The incidence rate of hypercalcemia of patients in traditional group was significantly higher than that in modified group (χ2=5.579, P=0.02). (2) There were two deaths (2.6%) and 74 survivors (97.4%) in traditional group, while there were two deaths (2.4%) and 82 survivors (97.6%) in modified group. The mortalities of patients in the two groups were close (P>0.05). (3) The ratios of eschar excision and skin grafting and hyperplastic scar formation, wound healing time, and ratio of esophageal scar stenosis of survivors in the two groups were close (χ2=0.002, 0.054, Z=0.66, P>0.05).@*Conclusions@#Hydrofluoric acid is highly dangerous. The early management of patients with hydrofluoric acid burns emphasizing specialized dosage of CG for treatment can be helpful to reduce incidence of complications and improve the safety of treatment.
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Objective@#To investigate the clinical characteristics of patients with hydrofluoric acid (HF) burns.@*Methods@#Clinical data of 316 patients with HF burns admitted to Zhejiang Quhua Hospital from January 2004 to December 2016 were retrospectively analyzed. Patients were divided into non and mild poisoning group (NMP, n=157), moderate poisoning group (MP, n=120), and severe and fatal poisoning group (SFP, n=39) based on the severity of poisoning. Occurrences of hypocalcemia, hypomagnesemia, hypokalemia, and hyperkalemia of patients within 24 hours after admission were recorded. Values of emergency urinary fluoride of patients on admission were recorded. Values of urinary fluoride of patients admitted to hospital in 4 hours post injury in groups MP and SFP at post injury hour 4, 12, and 24 and on post injury day 2, 3, 4, 5, 6, and 7 were also recorded. Electrocardiographic abnormalities of patients within 24 hours after admission were recorded. Data were processed with chi-square test, Kruskal-Wallis H test, and Mann-Whitney U test.@*Results@#(1) Hypocalcemia, hypomagnesemia, and hypokalemia occurred in some patients in each of the three groups, but no patient had hyperkalemia. Taking serum calcium namely total serum calcium as reference, the incidence rate of hypocalcemia of patients in group NMP was close to that in group MP (χ2=0.05, P>0.05). The incidence rate of hypocalcemia of patients in group SFP was significantly higher than that in group NMP or group MP (χ2=10.53, 7.92, P<0.01). The incidence rates of hypokalemia in the three groups were close (χ2=0.63, P>0.05). Taking serum ionized calcium as reference, the incidence ratio of hypocalcemia of patients in group NMP was close to that in group MP (χ2=0.01, P>0.05), while there were statistically significant differences in incidence ratio of hypocalcemia of patients between group SFP and each of group NMP and group MP (χ2=4.66, 4.47, P<0.05). Taking serum calcium as reference, the incidence rate of hypocalcemia of patients was 7.3% (23/316). Taking serum ionized calcium as reference, the incidence rate of hypocalcemia of patients was 60.0% (42/70), which was significantly higher than that of taking serum calcium as reference (χ2=113.74, P<0.01). The incidence rates of hypomagnesemia of patients in groups MP and NMP were close (χ2=0.02, P>0.05). The incidence rate of hypomagnesemia of patients in group SFP was significantly higher than that in group NMP or group MP (χ2=14.69, 9.94, P<0.01). (2) The urinary fluoride levels were tested in 288 patients, with the value of emergency urinary fluoride of patients on admission 0.2-590.0 mg/L. The values of urinary fluoride of 202 patients were above the normal value. The values of emergency urinary fluoride of patients in groups NMP, MP, and SFP were 2.15 (1.11, 4.30), 5.89 (1.72, 14.25), and 36.0 (13.2, 103.2) mg/L, respectively. The values of emergency urinary fluoride of patients in groups MP and SFP were significantly higher than the value in group NMP (χ2=23.28, 66.03, P<0.01). The value of emergency urinary fluoride of patients in group SFP was significantly higher than that in group MP (χ2=39.23, P<0.01). The value of urinary fluoride of 33 patients admitted to hospital within 4 hours post injury in groups MP and SFP reached the top at 4 hours post injury and then gradually declined, which returned to normal on about 5 days post injury. The values of urinary fluoride of patients in group SFP at 4, 12, and 24 hours post injury and on 2, 3, 4, 5, 6, and 7 days post injury were significantly higher than those in group MP (Z=-4.28, -4.15, -3.81, -4.21, -2.48, -2.06, -2.31, -2.68, -3.03, P<0.05 or P<0.01). (3) Twenty-seven patients had electrocardiographic abnormality. There were 12 patients with T wave changes (the most common), 8 patients with ST-T changes, 6 patients with ventricular arrhythmias, 6 patients with conduction block, and 1 patient with broadened QRS waveform. There was no patient with prolonged Q-T interval. The ratios of patients with the above electrocardiographic abnormalities in group SFP were higher than those in group NMP and group MP.@*Conclusions@#Clinical manifestations of patients with HF burn are hypocalcemia, hypomagnesemia, hypokalemia, and electrocardiographic abnormality. In addition to routine serum electrolyte and electrocardiogram monitoring, the levels of serum ionized calcium and urinary fluoride can be helpful to evaluate the severity of illness of the patients.
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Cervical cancer has become the second leading cause of female cancer death around the world.The main treatment methods include surgery,radiotherapy and chemotherapy. The way to apply various treatment strategies more scientifically and rationally is the key to improve the curative effect. Comprehensive application of several treatment methods can reduce the adverse effects of radiotherapy and chemotherapy,and enhance the sensitivity to achieve the prospective therapeutic effect, and greatly improve the cure rate combined with survival rate.
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Objective To investigate the changes and clinical correlation of IL-4 in patients with HBV infection.Methods Sixty cases with chronic asymptomatic HBV carriers,60 cases with chronic hepatitis B,60 cases with liver cirrhosis,60 cases with hepato-cellular carcinoma and 50 healthy controls were collected for serum.ELISA was used for detection of cytokine IL-4 levels;The a-mount of HBV DNA was measured by fluorescence quantitative PCR;Liver function was tested by automatic biochemical analyzer. Results Compared with the healthy controls[(1.64±0.17)ng/mL],IL-4 levels of patients with CHB,LC and HCC were signifi-cantly increased[(4.18±0.48),(4.71±0.42),(3.62±0.31)ng/mL,P <0.05].LC group have the highest IL-4 levels,while ASC was the lowest.Compared with the ASC group,IL-4 levels of patients with CHB,LC and HCC were significantly increased(P <0.05).Compared with the HCC group,IL-4 levels of patients with LC were significantly increased(P <0.05).IL-4 level was posi-tively correlated with TBIL levels in LC patients(r=0.529,P <0.01),while the IL-4 level was positively correlated with ALT and TBIL level in HCC patients(r=0.263,0.323,P <0.05).Conclusion IL-4 may play an important role in chronic HBV infection, the levels of IL-4 can be used as an important indicator to assess the severity of chronic hepatitis B.
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Objective To explore changes of levels of interferon‐γ(IFN‐γ) ,interleukin‐32(IL‐32) and interleukin‐6(IL‐6) in pe‐ripheral blood and the correlation between peripheral IFN‐γ,IL‐32 ,IL‐6 and liver function level and hepatitis B virus(HBV) DNA load in HBV carriers .Methods Sixty HBV carriers ,including 39 cases of chronic HBV carriers and 21 cases of inactive hepatitis B surface antigen(HBsAg) carriers ,and 50 healthy individuals were collected .Serum levels of IFN‐γ,IL‐32 and IL‐6 ,the amount of HBV DNA and liver function were detected ,and clinical correlations were analysed .Results Compared with the control group ,ser‐um levels of IFN‐γ,IL‐32 and IL‐6 of chronic HBV carriers and inactive HBsAg carriers were significantly increased (P0 .05) .There was positive correlation between IL‐32 level and ALT level (r=0 .32 ,P<0 .05) ,and negative correla‐tion between IL‐32 level and ALB level(r= -0 .27 ,P<0 .05) .Conclusion IFN‐γ,IL‐32 and IL‐6 may play important roles in chro‐nic HBV infection ,the levels of IFN‐γ,IL‐32 and IL‐6 could be used as important indicators to assess the severity of inflammation in HBV carriers .
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Objective To investigate the correlations on hepatitis B virus (HBV) preS1‐antigen (pre‐S1Ag) with HBV‐DNA , HBV markers(HBV M) and liver function in the patients with hepatitis B .Methods The markers ,preS1‐Ag ,HBV‐DNA and liver function were determined by CLIA and PCR in 905 patients with hepatitis B (HBV infection group ) and 100 healthy persons (healthy control group) .Results Among 905 samples ,the positive rates of preS1‐Ag and HBV DNA were 68 .51% (620/905) and 67 .96% (615/905) ,there was no statistically significant difference between them (χ2 =30 .064 ,P>0 .05);the positive rates of pre‐S1Ag in 570 patients with HBeAg positive were 85 .08% (485/570) ,which was significantly higher than 40 .30% (135/335) in 335 patients with HBeAg negative ,the difference was statistically significant (χ2 =108 .881 ,P<0 .01) .The abnormal rates of ALT and AST in the Pre‐S1 Ag positive and negative groups were 53 .22% ,25 .96% and 51 .29% ,32 .98% ,respectively ,the differences be‐tween them were statistically significant (χ2ALT =53 .148 ,P<0 .001 ,χ2AST =66 .635 ,P<0 .001) .Conclusion Pre‐S1Ag is a reliable index of the HBV infection and duplication and is highly correlated with HBV‐DNA positive ,which is important supplement and strengthening and can provide more timely and reliable experiment basis for guiding the clinical treatment .
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Objective To investigate the value and clinical significance of CD4+CD25+ regulatory T cells (Treg) ,inteleukin‐18 , interferon‐γand transforming growth factor‐βin patients with hepatitis B virus (HBV) infection .Methods A total of 175 patients with HBV infection were divided into chronic type B hepatitis (CHB) group and chronic asympotomatic HBV carrier (ASC) group , which were further divided into hepatitis B e antigen (HBeAg) positive and negative groups .CD4+ CD25+ Treg ,cytokines levels and liver function were measured .Healthy subjects were enrolled into control group .Results Proportion of CD4+CD25+ Treg were without significant difference among healthy controls ,HBeAg(+ ) and HBeAg(-) ASC groups ,and HBeAg(+ ) and HBeAg(-) CHB groups (P>0 .05) .Compared with control group ,cytokines levels were significant higer in CHB and ASC group (P<0 .05) . CD4+CD25+ Treg level was significant positive correlation to alanine aminotransferase and ratio of aspartate aminotransferase to plateles in HBeAg(+ )ASC group (P<0 .05) .Conclusion CD4+CD25 + Treg and related cytokines could play important roles in the course of CHB ,while CD4+CD25+ Treg expressing might be correlated with inflammatory degree of hepatitis .
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Objective To investigate the correlation between the liver fibrosis markers laminin(LN),hyaluronan acid(HA),col-lagen Ⅳ(CⅣ)and procollagen type Ⅲ N-terminal peptide(PⅢNP)with the replication of hepatitis B virus(HBV)DNA in the pa-tients with chronic HBV in Lanzhou.Methods Real-time PCR and chemiluminescent immunoassay(CLIA)were used to quantita-tively measure serum HBV-DNA and liver fibrosis markers in 724 cases of HBV infection in Lanzhou with the different clinical classifications and the natural history stage as the background.Results The values of the liver fibrosis indicators and HBV-DNA level in all clinical types were higher than normal levels,and reached to maximum in the liver cirrhosis goup;CⅣ and PⅢNp were highest in the HBeAg (+)CHB group;according to the hepatitis B natural history stage,the PⅢNP and CⅣ values reached the peak value in the immune clearance phase,moreover the CⅣmean value in the HBeAg and HBV-DNA (+)group was higher than that in the HBV-DNA and HBeAg (-)group.4 indicators in the HBeAg (+)CHB group were higher than those in the HBeAg (-)CHB group,but only HA had statistical difference(P <0.01 ).Conclusion There is certain correlation between CⅣ with HBV-DNA and HBV-M,indicating that which can indirectly reflect the degree of liver damage and viral replication level.
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Objective:To observe the changes of glyeemia, urine protein, serum creatinine, blood urea nitrogen and glycosylated hemoglobin in diabetic nephropathy rats and treating effects of Xiaokekang. Methods: Streptozotocin (STZ) was abdominally administered and was feeded by high lipid diet to establish diabetic nephropathy model in rats. Animals were divided into three groups: model group, Xiaokekang treatment group and normal group. Changes in glycemia, serum lipids, serum creatinine, blood urea nitrogen were measured at the 8th, 12th and 16th week after STZ injection. Glycosylated hemoglobin was measured at the 16th weeks after STZ injection. Results: Glycemia, serum lipids, serum creatinine were higher at the 8th, 12th and 16th week compared with normal group. Serum creatinine was higher at the 12th and 16th week, and glycosylated hemoglobin was also highter than that of the normal group. Xiaokekang reduced these changes. Conclusion: Xiaokekang can reduce glycemia, serum lipids and protect renal function.