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ObjectiveTo investigate the effect and mechanism of salvianolic acid B combined with puerarin in protecting the SH-SY5Y cells from the damage by oxygen-glucose deprivation/reoxygenation （OGD/R） based on pyroptosis. MethodSH-SY5Y cells were used to establish the model of OGD/R， and cells were classified into the control， OGD/R， 10 μmol·L-1 salvianolic acid B， 100 μmol·L-1 puerarin， 10 μmol·L-1 salvianolic acid B + 100 μmol·L-1 puerarin， and 10 μmol·L-1 NOD-like receptor protein 3 （NLRP3） inhibitor MCC950 groups. Except the control group， other groups were rapidly reoxygenated for 12 h after 6 h OGD for modeling. The cell survival rate was determined by the methyl thiazolyl tetrazolium （MTT） assay. An optical microscope was used to observe the cell morphology. A spectrophotometer was used to determine the content of lactic dehydrogenase （LDH） in culture supernatant. Cell damage was measured by Hoechst/PI staining. The mRNA levels of NLRP3， cysteinyl aspartate specific proteinase-1 （Caspase-1）， gasdermin D （GSDMD）， apoptosis-associated speck-like protein （ASC）， and interleukin-1β （IL-1β） were determined by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The protein activation of Caspase-1 and NLRP3 was detected by immunofluorescence. Western blot was employed to determine the protein levels of IL-1β， ASC， NLRP3， Caspase-1， and cleaved Caspase-1. ResultCompared with the control group， the OGD/R group showed decreased cell survival rate （P<0.01）， damaged cell morphology， increased leakage rate of LDH （P<0.01）， up-regulated mRNA levels of NLRP3， Caspase-1， GSDMD， ASC， and IL-1β （P<0.01）， and up-regulated protein levels of IL-1β， ASC， NLRP3， Caspase-1， and cleaved Caspase-1 （P<0.01）. Compared with the OGD/R group， salvianolic acid B， puerarin， and salvianolic acid B combined with puerarin improved cell survival rate （P<0.01）， and the combined treatment group outperformed salvianolic acid B and puerarin used alone （P<0.01）. Salvianolic acid B combined with puerarin and MCC950 both improved cell morphology， reduced the leakage of LDH （P<0.01）， alleviated cell damage， and down-regulated the mRNA levels of NLRP3， Caspase-1， GSDMD， ASC， and IL-1β （P<0.05， P<0.01） and also the protein levels of IL-1β， ASC， NLRP3， Caspase-1， and cleaved Caspase-1 （P<0.05， P<0.01）. ConclusionThe results indicated that salvianolic acid B combined with puerarin can alleviate the OGD/R-induced damage of SH-SY5Y cells by inhibiting pyroptosis.
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The intestine is the main site of oral drug absorption, and the epithelial cells of the intestine contain villi and microvilli, which promote secretion, cell adhesion, and absorption by increasing surface area and other factors. Traditional two-dimensional/three-dimensional (2D/3D) cell culture models and animal models have played an important role in studying drug absorption, but their application is limited due to the lack of sufficient predictability of human pharmacokinetics or ethical issues, etc. Therefore, mimicking the core structure and key functions of the human intestine based on in vitro live cells has been the focus of research on constructing a microfluidic chip-based intestinal model. The model is a microfluidic chip bionic system that simulates the complex microstructure, microenvironment, and physiological functions of the human intestine using microfabrication technology. Compared with 2D cell culture and animal experiments, the intestinal microarray model can effectively simulate the human in vivo environment and is more specific in drug screening. The research progress and applications in disease modeling, drug absorption and transport of intestinal microarray models and intestine-related multi-organ coupled microarray models at home and abroad were reviewed in this paper. The current challenges of intestinal chip simulating intestinal homeostasis and diseases were summarized，in order to provide reference for the further establishment of a more reliable in vitro intestinal chip model.
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Cell metabolomics is an important branch of metabolomics, which could dynamically monitor cell response and metabolic changes after drugs acting on cells, and look for potential biomarkers. Cell metabolomics has been widely used in illustration of disease mechanism, evaluation of drug efficacy and development of new drug through elucidating the pathophysiological mechanism of the disease and the effect of drug treatment intervention. The researches process of cellular metabolomics and its application in central nervous system diseases were reviewed in order to provide theoretical basis for in-depth study of the pathogenesis and prevention and treatment of central nervous system diseases.
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Objective To construct a cardiovascular chip model for evaluating the damage of vascular glycocalyx induced by four marine toxins: okadaic acid (OA), conotoxin (CTX), tetrodotoxin (TTX) and gymnodimine (GYM), and explore the protective effect of triptolide on toxin-induced injury. Methods Human umbilical vein endothelial cells（HUVEC) were inoculated into a three-channel microfluidic chip. CCK-8 method and immunofluorescence staining were used to analyze the damage of cell viability and glycocalyx tissue induced by low, middle and high concentrations of marine toxin, as well as the protective effect of triptolide on toxin-induced injury. Results The cells in the cardiovascular chip grew well and had structurally intact glycocalyx. Compared with the control group, the activity of HUVEC cells were inhibited in group of the medium and high concentration of OA and high concentration of GYM (P<0.05). The activity of cells had not been inhibited by CTX and TTX significantly , but all the four toxins caused serious damage to the glycocalyx tissue (P<0.01). After pre-protection with triptolide, the toxicity of the four toxins to HUVEC cells and the damage rate of glycocalyx decreased significantly. Conclusion The four marine biotoxins could damage the activity and glycocalyx of HUVEC cells in a dose-dependent manner, while triptolide has a protective effect on HUVEC cells injured by toxin.
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Objective:To investigate the clinical efficacy and mechanism of Ganoderma lucidum hypoglycemic formula in the treatment of insulin resistance in patients with type 2 diabetes mellitus (T2DM) with liver and kidney yin deficiency. Methods:A total of 86 patients with T2DM with liver and kidney yin deficiency who were diagnosed and treated at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from January 2021 to February 2022 were included in this study. These patients were divided into a control group and a treatment group, with 43 patients in each group using a 1:1 ratio using the sealed envelope method. Both groups were treated with standardized Western medicine. The treatment group was also treated with the Ganoderma lucidum hypoglycemic formula. All patients were followed up for 12 weeks. The clinical symptoms, curative effect, glucose and lipid metabolism, inflammatory factors, oxidative stress change, and safety were compared between the two groups. Results:The total response rate in the treatment group was 88.4% (38/43), which was significantly higher than 53.5% (23/43) in the control group ( χ2 = 12.69, P < 0.001). After treatment, the traditional Chinese medicine syndrome score, fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, insulin resistance index, total cholesterol, triglyceride, tumor necrosis factor α, and interleukin-6 decreased in each group. The amplitudes of decrease of the above indexes were greater in the treatment group compared with the control group (all P < 0.05). C-peptide in the fasting state, C-peptide at 2 hours after a diet, and superoxide dismutase increased in each group. The amplitudes of increase of the three indexes were greater in the treatment group compared with the control group (all P < 0.05). Conclusion:Ganoderma lucidum hypoglycemic formula can greatly improve insulin resistance and glucose and lipid metabolism in T2DM patients with liver and kidney yin deficiency. The underlying mechanism may be to further reduce the inflammatory response and anti-oxidative stress by down-regulating tumor necrosis factor α and interleukin-6 levels and up-regulating superoxide dismutase level, thereby effectively alleviating insulin resistance in T2DM.
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AIM: To observe the effect ofacacia honey (AH) on serum uric acid level and renal function in potassium oxonate modelrats after drinking AH aqueous solution. METHODS: Sixty male SD rats were selected and randomly divided into control group (CON group), potassium oxonate model group (OA model group), 10% fructose group (10% F group) and different concentration honey groups (25%, 12.5% and 6.25% AH groups). All rats were fed with normal diet.The rats in CON group were subcutaneously injected with 5% sodium carboxymethyl cellulose (CMC-Na) solution and drunk sterile water every day, while rats in other groups were injected with 100 mg / kg OA solution suspended with 5% CMC-Na subcutaneouslyand drunksterile water orfructose solution or AH solution of different concentrations every day. Before and during the 4-week test, rats were weighed and blood was taken once a week. At the end of test, urine and feces specimens or kidney tissues were collected and blood was taken from the abdominal aorta. The uric acid content in blood, urine, and feces and the levels of serum creatinine (Cre) and blood urea nitrogen (BUN) or inflammatory factors in kidney tissues were measured. Renal function and histology were evaluated. RESULTS: Compared with CON group, AH could significantly reduce the body weight of rats (P<0.05), increase the kidney organ coefficient, the levels of serum uric acid, and uric acid in urine or feces, and reduce the level of fecal uric acid (FUA) in rats. AH can down regulate the level of tumor necrosis factor alpha (TNF-a) (P< 0.05) and up regulate the expression of monocyte chemoattractant protein 1 (MCP-1) and transforming growth factor β - 1 (TGF - β1) in rats kidneys; AH can cause slight to mild dilatation of renal tubules and mild to moderate basophilic lesions of renal rubules in rat kidney in a dose dependent manner. CONCLUSION: In the doses rang of present study, AH can cause hyperuricemia, renal tubular dilatation and basophilic lesions, and lead to renal function damage in rats.
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Objective:To study the predictive value of total serum bilirubin (TSB) and the ratio of bilirubin to albumin (B/A) in neonatal acute bilirubin encephalopathy (ABE).Methods:Neonates with extremely severe hyperbilirubinemia (TSB≥425 μmol/L) treated in the Nanjing Maternal and Child Health Hospital, Maternity and Child Health Care of Guangxi Zhuang Autonomous Region, Northwest Women and Children's Hospital, Yinchuan Maternal and Child Health Hospital and Liaocheng People's Hospital from March 2018 to August 2019 were selected as prospective subjects for this study. According to the score of brain injury induced by bilirubin, the subjects were divided into ABE group and non-ABE group, and the predictive value of TSB peak and B/A for neonatal ABE were analyzed.Results:A total of 194 infants with extremely severe hyperbilirubinemia were recruited in this study, including 20 in ABE group and 174 in non-ABE group. The peak value of bilirubin ranged from 427 to 979 μmol/L. The optimal critical values of TSB peak value and B/A for ABE prediction were 530 μmol/L and 9.48, respectively. The sensitivity and specificity of ABE prediction were 85.0% and 92.8% when combined with TSB peak and B/A values.Conclusions:TSB peak combined with B/A value can effectively identify neonatal ABE. When the TSB peak value was greater than 530 μmol/L and the B/A value was greater than 9.48, the neonates had a higher risk of neonatal ABE.
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Blood-brain barrier is a natural barrier between blood and brain tissue that can protect the brain from invasion by infectious pathogens in blood and maintain the homeostasis of the brain environment. However, neurotropic viruses can escape or disrupt blood-brain barrier and then invade the brain, causing serious complications in the central nervous system such as encephalitis and meningitis, which seriously threaten human life. This paper mainly summarized the research progress in the pathogenic mechanisms of common neurotropic viruses crossing blood-brain barrier and invading the central nervous system.
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ObjectiveTo explore the protective effect of Salviae Miltiorrhizae Radix et Rhizoma and Puerariae Lobatae Radix （SP） extract on oxygen-glucose deprivation/reoxygenation （OGD/R）-injured SH-SY5Y cells based on oxidative stress and apoptosis. MethodThe extracts of the two medicinal materials mixed in different ratios were prepared. Human neuroblastoma SH-SY5Y cells were cultured in vitro and the injury was induced by OGD/R. Cell counting kit-8 （CCK-8） assay was used to screen the optimal ratio of the two medicinals and then the extract was used for further experiment. SH-SY5Y cells were classified into normal control group， OGD/R group， and low-， medium-， and high-dose SP （2∶1） extract groups （10， 30， 100 mg·L-1， respectively）. Cells in the groups， except the normal control group， were rapidly reoxygenated for 12 h after 4 h OGD for modeling. Then cell viability was detected by CCK-8 and cell morphology was observed under the microscope. The release rate of lactate dehydrogenase （LDH）， superoxide dismutase （SOD） activity， and content of glutathione （GSH） and malondialdehyde （MDA） were determined by spectrophotometry. The level of reactive oxygen species （ROS） was detected with 2，7-dichlorodihydrofluorescein diacetate （DCFH-DA） and mitochondrial membrane potential with JC-1 assay. The nuclear morphology was observed based on Hoechst 33342 staining， and apoptosis was examined by flow cytometry combined with Annexin V-FITC/PI staining. ResultThe viability of the cells was highest in the presence of the extract of the two medicinals mixed at the ratio of 2∶1. Compared with normal control group， OGD/R group showed damaged cell morphology， high release rate of LDH and levels of ROS and MDA （P<0.01）， low SOD activity and GSH level （P<0.01）， low mitochondrial membrane potential， and high apoptosis rate （P<0.01）. Compared with OGD/R group， SP extract improved cell viability and cell morphology and reduce cell LDH release rate in a concentration-dependent manner （P<0.01）. In addition， SP extract at 30， 100 mg·L-1 reduced the level of intracellular ROS and increased SOD activity and GSH level （P<0.05， P<0.01）， and SP extract at 100 mg·L-1 decreased the content of MDA （P <0.05）. Moreover， SP extract increased mitochondrial membrane potential， and SP extract at 30， 100 mg·L-1 lowered the apoptosis rate （P<0.01）. ConclusionThe extract of Salvia miltiorrhiza Bunge and Radix Puerariae mixed at 2∶1 shows better protective effect on OGD/R-injured SH-SY5Y cells. The mechanism is the likelihood that it alleviates oxidative damage of cells and inhibits cell apoptosis.
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ObjectiveTo explore the protective effect of Salviae Miltiorrhizae Radix et Rhizoma and Puerariae Lobatae Radix （SP） extract on oxygen-glucose deprivation/reoxygenation （OGD/R）-injured SH-SY5Y cells based on oxidative stress and apoptosis. MethodThe extracts of the two medicinal materials mixed in different ratios were prepared. Human neuroblastoma SH-SY5Y cells were cultured in vitro and the injury was induced by OGD/R. Cell counting kit-8 （CCK-8） assay was used to screen the optimal ratio of the two medicinals and then the extract was used for further experiment. SH-SY5Y cells were classified into normal control group， OGD/R group， and low-， medium-， and high-dose SP （2∶1） extract groups （10， 30， 100 mg·L-1， respectively）. Cells in the groups， except the normal control group， were rapidly reoxygenated for 12 h after 4 h OGD for modeling. Then cell viability was detected by CCK-8 and cell morphology was observed under the microscope. The release rate of lactate dehydrogenase （LDH）， superoxide dismutase （SOD） activity， and content of glutathione （GSH） and malondialdehyde （MDA） were determined by spectrophotometry. The level of reactive oxygen species （ROS） was detected with 2，7-dichlorodihydrofluorescein diacetate （DCFH-DA） and mitochondrial membrane potential with JC-1 assay. The nuclear morphology was observed based on Hoechst 33342 staining， and apoptosis was examined by flow cytometry combined with Annexin V-FITC/PI staining. ResultThe viability of the cells was highest in the presence of the extract of the two medicinals mixed at the ratio of 2∶1. Compared with normal control group， OGD/R group showed damaged cell morphology， high release rate of LDH and levels of ROS and MDA （P<0.01）， low SOD activity and GSH level （P<0.01）， low mitochondrial membrane potential， and high apoptosis rate （P<0.01）. Compared with OGD/R group， SP extract improved cell viability and cell morphology and reduce cell LDH release rate in a concentration-dependent manner （P<0.01）. In addition， SP extract at 30， 100 mg·L-1 reduced the level of intracellular ROS and increased SOD activity and GSH level （P<0.05， P<0.01）， and SP extract at 100 mg·L-1 decreased the content of MDA （P <0.05）. Moreover， SP extract increased mitochondrial membrane potential， and SP extract at 30， 100 mg·L-1 lowered the apoptosis rate （P<0.01）. ConclusionThe extract of Salvia miltiorrhiza Bunge and Radix Puerariae mixed at 2∶1 shows better protective effect on OGD/R-injured SH-SY5Y cells. The mechanism is the likelihood that it alleviates oxidative damage of cells and inhibits cell apoptosis.
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Objective:To explore the application effect of formative assessment combined with Ladder type teaching on the teaching of standardized training of nephropathy and endocrinology.Methods:A total of 39 residents who rotated in the Department of Nephrology and Endocrinology, Sichuan Science City Hospital from March 2019 to March 2020 were included in the control group and were taught routinely, and another 42 residents who rotated from April 2020 to April 2021 were classified as a research group and were given formative assessment and Ladder type teaching. The out-department assessment results between the two groups were compared, and the mini-clinical exercise evaluation (Mini-CEX), normal performance assessment and 360-degree evaluation results of the research group when entering and exiting the department were compared. The students' satisfaction with teaching between the two groups was also compared. SPSS 24.0 was used for t test, chi-square test and rank sum test. Results:The scores of theory, skill manipulation and case analysis in the research group were higher than those in the control group, and the differences were statistically significant ( P<0.05). The Mini-CEX score, usual performance assessment score and 360-degree evaluation score in the research group when exiting the department were all higher than those when entering the department, with statistically significant difference ( P<0.05). There were significant differences in the grades distribution of teaching satisfaction degrees between the two groups ( P<0.05), and the total satisfaction rate of the research group was higher than that of the control group. Conclusion:The use of formative assessment combined with Ladder type teaching in the standardized training of nephropathy and endocrinology can significantly improve the scores of the residents and their clinical comprehensive literacy, and increase the satisfaction of teaching, with great value of popularization and application.
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Exosomes are extracellular vesicles containing a variety of cell membrane molecules and related protein. They have been found to act as important intercellular messengers carrying functional RNAs, proteins and lipids that can induce phenotypic changes in recipient cells and promote cell activation or inhibition effect. In recent years, some studies have shown that exosomes can not only play an immune activation role to trigger antiviral immune response after viral infection, but also help to spread virus among cells, thus contributing to viral immune escape. Exosomes can either spread or limit an infection depending on the type of pathogen and the features of source cells, and can be studied as potential targets for development of antiviral drugs and vaccines. This review summarized the role of exosomes in viral infections with an emphasis on their potential contribution to pathogenesis.
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Objective@#To investigate the risk factors of deep venous thrombosis (DVT) of lower extremities after hip fracture and provide reference for the prevention of DVT.@*Methods@#A retrospective case-control study was conducted to analyze the clinical data of 167 patients with hip fracture admitted to Daping Hospital of Army Medical University from January 2016 to December 2016, including 75 males and 92 females, aged 18.7-90.3 years [(70.4±17.7)years]. Using the positive results of ultrasound as the standard for confirming the diagnosis of DVT, 79 patients (47.3%) were assigned to the DVT group, and 88 patients (52.7%) to the non-DVT group. Patients' age, gender, body mass index (BMI), smoking history, D-dimer level, osteoporosis, venous thrombosis risk stratification score (RAPT), coronary heart disease, hypertension, diabetes history, anesthesia method (general anesthesia or nerve blocking), type of surgery (joint replacement or internal fixation), operation time were included in the analysis. The correlation between DVT and the above indices was explored through univariate analysis, followed by logistic regression analysis to determine the risk factors of lower extremities DVT after hip fracture.@*Results@#The univariate analysis showed that smoking history, D-dimer level, BMI, RAPT score, hypertension, diabetes, coronary heart disease, anesthesia method and operation time were significantly associated with lower extremities DVT after hip fracture. According to the logistics regression analysis, smoking (OR=9.403, P<0.05). D-dimer (OR=0.999, P<0.01), BMI(OR=0.603, P<0.01), RAPT score (OR=0.499, P<0.05), hypertension (OR=28.965, P<0.01), diabetes(OR=6.948, P<0.05), coronary heart disease (OR=17.185, P<0.01), operation time (OR=36.830, P<0.01) were significantly correlated with newly formed lower extremities DVT after hip fracture.@*Conclusions@#Smoking, D-dimer level, obesity (BMI≥25 kg/m2), RAPT score, hypertension, diabetes, coronary heart disease and operation time (≥150 minutes) are independent risk factors for lower extremities DVT after hip fracture. D-dimer level detection shows early diagnostic value for hip fracture with DVT. RAPT score can effectively evaluate DVT in trauma patients, thus guiding and preventing the occurrence of DVT.
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Objective To investigate the risk factors of deep venous thrombosis ( DVT) of lower extremities after hip fracture and provide reference for the prevention of DVT. Methods A retrospective case-control study was conducted to analyze the clinical data of 167 patients with hip fracture admitted to Daping Hospital of Army Medical University from January 2016 to December 2016, including 75 males and 92 females, aged 18. 7-90. 3 years [(70. 4 ± 17. 7)years]. Using the positive results of ultrasound as the standard for confirming the diagnosis of DVT, 79 patients (47. 3％) were assigned to the DVT group, and 88 patients (52. 7％) to the non-DVT group. Patients' age, gender, body mass index ( BMI), smoking history, D-dimer level, osteoporosis, venous thrombosis risk stratification score ( RAPT ) , coronary heart disease, hypertension, diabetes history, anesthesia method ( general anesthesia or nerve blocking), type of surgery (joint replacement or internal fixation), operation time were included in the analysis. The correlation between DVT and the above indices was explored through univariate analysis, followed by logistic regression analysis to determine the risk factors of lower extremities DVT after hip fracture. Results The univariate analysis showed that smoking history, D-dimer level, BMI, RAPT score, hypertension, diabetes, coronary heart disease, anesthesia method and operation time were significantly associated with lower extremities DVT after hip fracture. According to the logistics regression analysis, smoking (OR=9. 403, P<0. 05). D-dimer (OR=0. 999, P<0. 01), BMI(OR=0. 603, P<0. 01), RAPT score (OR=0. 499, P<0. 05), hypertension (OR=28. 965, P<0. 01), diabetes (OR=6. 948, P<0. 05), coronary heart disease (OR=17. 185, P<0. 01), operation time (OR=36. 830, P<0. 01) were significantly correlated with newly formed lower extremities DVT after hip fracture. Conclusions Smoking, D-dimer level, obesity ( BMI≥25 kg/m2 ) , RAPT score, hypertension, diabetes, coronary heart disease and operation time (≥150 minutes) are independent risk factors for lower extremities DVT after hip fracture. D-dimer level detection shows early diagnostic value for hip fracture with DVT. RAPT score can effectively evaluate DVT in trauma patients, thus guiding and preventing the occurrence of DVT.
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Objective To construct a core competency-based curriculum for master of geriatric nursing specialist. Methods On the basis of literature review and theoretical analysis,the curriculum for master of geriatric nursing specialist was set up,and through 6 experts'modification with Delphi method,the final entries were confirmed.Results Through two-round consultation,the training course system formaster of geriatric nursing was established to consist of 9 entries and 33 sub-entries.The response coefficients of the two-round consultations were 100%,and the authority coefficients of the experts were 0.86 and 0.92 respectively.The coordination coefficients for overall entries were 0.534 and 0.593 respectively with P<0.001,indicating statistically significant differences. Conclusion The curriculum for master of geriatric nursing is reliable and valid,which can provide practical basis.
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Objective To evaluate the psychological distress of patients with retinal detachment and analyze its causes and related factors. Method We adopted a general information questionnaire and psychological distress thermometer (DT) to do a cross-sectional survey among patients undergoing retinal detachment reduction surgery between February 2016 and May 2017 in West China Hospital in Sichuan Province. Results The average score of psychological pain in the patients with retinal detachment was 4.3 ±2.0. Significant psychological distress was observed in 83 cases, which accounted for 67.5% (DT score was greater than 4). The top 5 factors for the psychological distress caused by the retinal detachment were edema, physical activity restricted, worry, bathing/dressing, and sleep problem. Multivariate linear regression analysis showed that age, sports, time of retinal detachment and combination of chronic diseases had an effect on psychological pain score (all P＜0.05). Conclusions The psychological distress of patients treated in retinal detachment reduction surgery is severe, and the physical problems are the main causes of psychological distress. In order to effectively prevent the emergence of psychological problems, psychological intervention measures should be taken in patients at young age, long time of retinal detachment, doing sports, and combination with other chronic diseases.
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Sepsis is an uncontrolled host's response to infection and leads to life-threatening organ dysfunction. Traditional prognostic indicators for short-term mortality, such as intensive care unit (ICU) mortality, hospital mortality, cannot reveal the real and final outcome of sepsis patients. Sepsis patients remain high mortality even several years after hospital discharge, at the same time the quality of life, and the cognitive function were also damaged at varying degrees. Nowadays, studies about long-term quality of life for sepsis were still sparse and further study was still needed. This article aims to explore the epidemiology, short-term and long-term outcome so that it can provide some reference for assessment and intervention of long-term outcome of sepsis.
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Objective To explore whether albumin corrected anion gap (ACAG) is associated with long-term mortality of sepsis patients.Methods Adult patients with a diagnosis of sepsis within the first 24 hours (from December 2013 to December 2014) admitted to the intensive care unit (ICU) were included via the Sepsis database of West China Hospital Sichuan University. To record their long-term survival, patients were followed up by telephone interview one year after enrollment. ACAG was calculated according to the anion gap (AG) level within the first 24 hours admitted to ICU, and patients were divided into normal ACAG group (ACAG 12-20 mmol/L) and high ACAG group (ACAG > 20 mmol/L), and clinical characteristics and 1-year mortality were compared between groups. Patients were also divided into survivors and non-survivors according to the 1-year survival outcome, and multivariate logistic regression analysis was conducted to find independent risk factors for long-term mortality of sepsis patients.Results A total of 296 sepsis patients were enrolled in the study, with 191 (64.5%) in the high ACAG group and 105 (35.5%) in the normal ACAG group. There were no significant differences in age, gender, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), Charlson cormobidity index (CCI) and other background variables between groups. Compared with the normal ACAG group, patients who suffered from multiple organ dysfunction syndrome (MODS) in the high ACAG group were more prone to develop renal and gastrointestinal injury (43.5% vs. 25.7%, 52.9% vs. 33.3%, respectively), had significantly higher serum creatinine [SCr (μmol/L): 89.0 (61.0, 148.0) vs. 67.1 (48.0, 86.0)], greater need for continuous renal replacement therapy (CRRT, 16.8% vs. 6.7%), and significantly shorter length of ICU stay and hospital stay [days: 11 (5, 22) vs. 16 (18, 31), 21 (14, 39) vs. 28 (20, 47)], with statistically significant differences (allP < 0.05). It was shown by Kaplan-Meier survival analysis that 1-year cumulative survival for the high ACAG group was significantly lower than that of the normal ACAG group (55.0% vs. 67.7%,P = 0.046). It was shown by multivariate logistic regression that ACAG [odds ratio (OR) = 1.201, 95% confidence interval (95%CI) = 1.115-1.293,P = 0.000], APACHE Ⅱ (OR = 1.053, 95%CI = 1.011-1.098, P = 0.014), the incidence of septic shock (OR = 2.203, 95%CI = 1.245-3.898,P = 0.007), fungus infection (OR = 3.107, 95%CI = 1.702-5.674,P = 0.000), acute renal failure (OR = 2.729, 95%CI = 1.134-6.567,P = 0.025) and complicated with malignancy (OR = 2.929, 95%CI = 1.395-6.148,P = 0.005) were independent risk factors contributing to increased 1-year mortality among sepsis patients.Conclusion ACAG was an independent risk factor for 1-year mortality of sepsis patients.
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Objective To explore the prevention and treatment principles of different types of iodine contrast agents.Methods 240 patients with CT enhancement were divided into two groups according to the contrast agent type: 80 patients with ionic contrast agent (control group), 160 cases with non-ionic contrast agent (observation group).The allergic reaction was evaluated according to the ADR classification.The constituent ratio of the allergic reaction was observed in the two groups.The contrast ratio of the hypersensitive reaction was observed.The clinical manifestations of the allergic reaction were observed.Results In the control group, there were 8 cases of mild allergic patients,7 cases of mild allergic patients in the observation group,7 cases of moderate allergic patients in the control group,6 cases of moderate allergic patients in the observation group,4 cases of severe allergic patients.There were 2 cases of severe allergic patients in the observation group.In the observation group, there were 15 cases of total allergies and 19 cases of total allergies in the control group.The number of allergies in the observation group was lower than that in the control group (x2=9.063,P<0.05).80 cases of contrast agent induced 19 cases of allergic reaction;non-ionic contrast agent iodopromide 79 cases, induced 9 cases of allergic reactions;non-ionic contrast agent iodohydrin contrast 81 cases.Allergy symptoms such as skin rash, malaise, chills and fever, eyelid edema, throat discomfort and voice, such as nausea and vomiting, dizziness, chest tightness, cardiovascular symptoms such as shock, blood pressure changes and so on.Conclusion Non-ionic iodine contrast agent is superior to ionic contrast agent in the incidence of allergic reaction.However, it is an important measure to reduce the patients' injury caused by different types of hypersensitivity reaction.It is worth the attention of clinicians.
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Objective To investigate whether serum sclerostin level is an indicator of the prognosis in patients with maintenance hemodialysis(MHD).Methods The clinical data of MHD patients treated in Yan′an University Affiliated Hospital in recent 3 years were collected to record their basic information and routine blood biochemical indexes.Serum Sclerostin levels were measured by ELISA calcaneus,while bone mineral density(BMD)was measured by quantitative ultrasound(QUS);correlation analysis was applied to screen the indicators affecting BMD.Logiest regression was used to look for protective factors and risk factors of low bone density;The correlation between serum sclerostin level and bone mineral density was analyzed,and ROC curve was used to explore whether serum sclerostin level could be used to predict low level bone mineral density.Results The median serum sclerostin concentration of 62 patients was 166.74(105.87,311.90)pmol/L.Spearman correlation analysis showed that serum sclerostin levels were positively correlated with BMI,serum calcium and 25(OH)VitD levels(r= 0.327,0.323,0.257,P= 0.010,0.049,0.044),while negatively correlated with lg[iPTH],spKt/v,triglyceride(TG),low density lipoprotein cholesterol(LDL-C)(r=-0.254,-0.279,-0.186,-0.314,P=0.046,0.012,0.027,0.031).Serum Sclerostin level was not related with serum phosphorus,alkaline phosphatase(AKP),high density lipoprotein cholesterol(HDL-C)and LDL(P>0.05) .Correlation analysis showed serum sclerostin levels were significantly and positively correlated with BMD(r=0.328,P=0.009).Logistic regression showed that serum sclerostin level was a risk factor for BMD(OR=1.17,95%CI(0.928~1.474);P=0.008).The ROC curve was established,and the area under the curve of serum sclerostin diagnosis was 87.9%.Conclusion Serum sclerostin levels are positively correlated with bone mineral density.And serum sclerostin levels may become a marker to predict the prognosis in MHD patients.