Dynamic changes and clinical value of serum angiopoietin-2 and surfactant protein D in pediatric acute respiratory distress syndrome / 中国小儿急救医学

Objective:To study the relationship between the dynamic changes of angiopoietin-2 (Ang-2) and surfactant protein D (SP-D) in pediatric acute respiratory distress syndrome (pARDS) and the severity and prognosis of the disease.Methods:Using nested case-control study method, 80 children with pneumonia complicated with pARDS admitted to PICU at Fujian Maternal and Child Health Hospital from June 2018 to May 2021 were selected as pARDS group, and 19 healthy children with corresponding age were selected as control group.According to the oxygenation, the children in pARDS group were divided into three subgroups: mild group (23 cases), moderate group (32 cases) and severe group (25 cases). According to the prognosis at discharge, the children in pARDS group were divided into survival group (67 cases) and death group (13 cases). Ang-2 and SP-D were detected by enzyme-linked immunosorbent assay.The levels of Ang-2 and SP-D in children with pARDS of different severity on the first day were compared; The changes of Ang-2 and SP-D levels on the 1st, 3rd and 8th day of children in survival group and death group were compared, and the receiver operating characteristic (ROC) curve was plotted to compare the predictive value of Ang-2 and SP-D for pARDS prognosis.Results:(1) The levels of Ang-2 and SP-D on the first day in pARDS group were significantly higher than those in control group( P<0.001). (2) The levels of Ang-2 and SP-D on the first day in children with pARDS of different severity levels were significantly different ( P<0.001), and the levels of Ang-2 and SP-D increased gradually with the increase of disease severity.(3) The levels of Ang-2 and SP-D in death group were significantly higher than those in survival group on the 1st, 3rd and 8th day ( P<0.05). (4) Prognostic efficacy of Ang-2 and SP-D levels in pARDS group at different time points: when the areas under the ROC curve predicted by Ang-2 on the 1st, 3rd and 8th day for inpatient mortality in children with pARDS were 0.808, 0.981 and 0.989, respectively; the optimal cut-off values were 6 000 pg/mL, 6 971 pg/mL and 4 171 pg/mL, respectively; the sensitivity was 84.6%, 92.3% and 92.3%, respectively; and the specificity was 76.1%, 97.0% and 98.5%, respectively.The areas under the ROC curve predicted by SP-D on the 1st, 3rd and 8th day for inpatient mortality in children with pARDS were 0.689, 0.993 and 0.983, respectively; the optimal cut-off values were 13544 pg/mL, 16003 pg/mL and 12294 pg/mL, respectively; the sensitivity was 84.6%, 100.0% and 100.0%, respectively; and the specificity was 46.3%, 98.5% and 97.0%, respectively. Conclusion:Serum Ang-2 and SP-D levels in children with pARDS increase with the aggravation of the disease.The dynamic changes of Ang-2 and SP-D in children with pARDS with different prognosis are different during the course of disease, and monitoring serum Ang-2 and SP-D during the course of disease has a certain predictive value for clinical outcome.

Investigation of cancer-induced fatigue in patients with lung cancer and analysis of its influencing factors / 中国基层医药

Objective:To investigate the status of cancer-related fatigue in lung cancer patients and its related influencing factors, thus to provide reference for clinical active intervention and improve the quality of life of patients.Methods:In this study, interviews and questionnaires were used to collect patient-related data.Seventy patients with lung cancer from January 2016 to January 2019 in Zhuji People's Hospital were selected in this study, and relevant information was collected and analyzed.The relevant influencing factors of cancer-related fatigue was analyzed.Results:The survey showed that the average score of cancer-related fatigue in lung cancer patients was (5.71±1.96)points, which was in moderate status, the behavioral dimension fatigue score was (5.95±2.38)points, the emotional dimension score was (5.48±2.37)points, the sensory dimension score was (5.46±2.38)points, and the cognitive/emotional dimension score was (4.79±2.11)points.Age, serum albumin level, surgery and anemia were the influencing factors of cancer-induced fatigue in patients with lung cancer( P<0.05). Sleep disorders, anxiety, depression were positively correlated with cancer-induced fatigue in patients with lung cancer( r=0.642, 0.350, 0.192, P=0.000, 0.000, 0.000). The average quality of life score of lung cancer patients was (84.14±6.52)points, which was negatively correlated with cancer-induced fatigue and functional areas, and positively correlated with symptom areas, insomnia and diarrhea( P<0.05). Conclusion:The cancer-induced fatigue of 70 patients with lung cancer in Zhuji People's Hospital is in moderate status, and the main influencing factors are age, serum albumin, surgery and anemia.The survey can provide a reference for subsequent clinical intervention for lung cancer patients.

Therapeutic effect of intravenous thrombolysis combined with drug therapy on mild ischemic stroke / 中国基层医药

Objective:To explore the effect of dual antiplatelet combined with calf serum deproteinized injection in the treatment of mild ischemic stroke after intravenous thrombolysis.Methods:From October 2017 to December 2018, 82 patients with mild ischemic stroke who were diagnosed in the People's Hospital of Ruian were selected.The patients were divided into control group (41 cases) and observation group (41 cases) according to random number table method.The control group was treated with aspirin after intravenous thrombolysis.On this basis, the observation group was treated with dual antiplatelet combined with calf serum deproteinized injection.The course of treatment was 3 months in both two groups.The total effective rate, the changes of hemorheological indicators, the improvement of neurological deficit, the ability of daily living and the ability of returning to society were compared between the two groups before and after treatment.The complications and prognosis were recorded.Results:The total effective rate of the observation group was 95.12% (39/41), which was higher than 78.05% (32/41) of the control group (χ 2=5.145, P<0.05). After treatment, the National Institutes of Health Stroke Score Scale (NIHSS) score, Modified Rankin Score (mRS), Barthel index (BI) score of the observation group were (0.34±0.18)points, (92.15±6.73)points, (0.87±0.36)points, respectively, which of the control group were (0.92±0.35)points, (76.05±4.86)points, (1.64±0.52)points, respectively, there were statistically significant differences between the two groups ( t=8.592, 11.308, 7.099, all P<0.05). The whole blood viscosity, plasma viscosity and platelet aggregation rate of the observation group were (4.13±0.36)mPa/s, (1.39±0.31)mPa/s, (32.35±2.61)%, respectively, which were lower than those of the control group [(8.65±0.72)mPa/s, (1.62±0.47)mPa/s, (39.07±3.25)%] ( t=32.740, 2.382, 9.400, all P<0.05). There were no cases of cerebral hemorrhage and death in the two groups, and there was no statistically significant difference in recurrence rate between the two groups (χ 2=2.565, P>0.05). Conclusion:After intravenous thrombolytic therapy for patients with mild ischemic stroke, dual antiplatelet therapy combined with calf serum deproteinized injection can improve the neurological function, life ability and hemorheological indicators of patients, with good prognosis, it is safe and effective.

Application of endoscope emergency operation in the treatment of gastric variceal bleeding / 中国基层医药

Objective To explore the clinical effect of endoscope emergency operation in the treatment of gastric variceal bleeding.Methods According to the digital table,90 patients with acute bleeding gastric varices were randomly divided into the control group and the observation group,each group 45 cases.The control group only received drug treatment,and the observation group was given endoscopic therapy.The clinical effect of the two groups were compared.Results The immediate hemostatic rate,rebleeding rate,varicose veins subsided total efficiency of the observation group were 100.00％,17.78％,86.67％,respectively,which were better than those of the control group (84.44％,44.44％,28.89％) (x2 ＝ 5.72,P ＜ 0.05).Conclusion Endoscope emergency operation combined with oral drug in treatment of gastric variceal bleeding has good effect,can achieve rapid hemostasis,prevent recurrence,and it is worthy of clinical application.

Analysis on pathogenic bacterium distribution and drug resistance of the patients with lower respiratory tract infection / 中国基层医药

ObjectiveTo analyze pathogenic bacterium distribution and drug resistance to the inpatients suffered from lower respira.tory tract infection in our hospital,and to guide adminisrration in clinical. MethodsThe inpatients' sputum specimens were collected,and automatic microorganism identification and drug resistance test were conducted,and the records were taken down and statisticly analyzed. Results Among 321 sputum examples,194strains pathogenic bacterium were isolated.And pathogenic bacterium distributed were as following: there were 126 strains gram-negative bacilli,accounting for 64.95%,there were 32 strains of gram-postive cocci,accounting for 15.98%,and there were 37 strains of fungi,accounting for 19.08%.The drug resistance of gram-negative bacilli to ampicillin,trimethoprim-sulfamethoxazol were relatively high,accounting for 87.45%～97.74% and 75.37%～91.75%,respectively.Pseudomonas aeruginosa and baumanii were resistant to selected antibiotics at high degree,and showed multiple drug resistance. ConclusionThe species of pathogenic bacterium were various.Gram-negative bacteria were the rnain pathogenic bacteria involved in respiratory tract infection.The drug resistance was high in Pseudomonas aeruginosa and baumanii.

Determination of the Plasma Concentration of Ropivacaine in Rabbits by HPLC / 中国药房

OBJECTIVE:To determinate the plasma concentration of ropivacaine in rabbits by HPLC,and study the secu?rity of ropivacaine in rabbits.METHODS:Nine rabbits were injected with ropivacaine drop by drop with a speed of1mg/(kg?min)until the rabbits died.RESULTS:The mean plasma concentration of ropivacaine in rabbits was224.54?107.45mg/L when the rabbits died.CONCLUSION:Ropivacaine has high security in rabbits.

The inhibitory action of rhTRAIL on mouse breast carcinoma / 中国病理生理杂志

AIM:To explore the inhibitory action of recombinant human tumor necrosis factor-related apoptosis-inducing ligand(rhTRAIL) on mouse breast cancer. METHODS:Each mouse was inoculated 0.2 mL (1?106) D2F2 cells subcutaneously in the right lower limb and they were divided into five groups randomly. The control group was infused PBS 0.2 mL,while the low-dose,medium,high groups received purified rhTRAIL 2.5 mg/kg,5.0 mg/kg,10.0 mg/kg,respectively,the positive group was administered cyclophosphamide 30.0 mg/kg. Every group was operated by peritoneal injection once a day for fifteen days. The mice were weighed every day. The growth state was viewed and the size of the tumor was measured every 3 d to calculate the tumor volume and tumor suppression rate. All mice were killed after 15 d. The pathologic changes of the tumor were observed under light-microscopy and electronic microscopy. The cell cycle and apoptosis index of D2F2 cells were analyzed by flow cytometry. RESULTS:The body weight and tumor volume in low-dose,medium,high groups were lower than those in control group and the restriction effect was more significant than that in the control group (P