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Objective:To analyze the diagnostic and prognostic values of the red blood cell distribution width-to-platelet count ratio (RPR) for hepatitis B and liver cirrhosis.Methods:The clinical data of 80 patients with hepatitis B and liver cirrhosis who were diagnosed and treated in Yiwu Central Hospital from June 2020 to August 2021 were retrospectively analyzed. These patients were included in the hepatitis B and liver cirrhosis group. They were subdivided into survival ( n = 69) and death ( n = 11) groups according to their prognosis outcomes. Eighty patients with chronic hepatitis B were included in the chronic hepatitis B group. Eighty healthy controls who concurrently underwent physical examination were included in the control group. The diagnostic and prognostic values of RPR, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis index based on four factors (FIB-4) for hepatitis B and liver cirrhosis were analyzed. Results:Red blood cell distribution width, alanine transaminase, and aspartate transaminase in the hepatitis B and liver cirrhosis group and chronic hepatitis B group were significantly higher compared with the control group (all P < 0.05). Platelet count in the hepatitis B and liver cirrhosis group and chronic hepatitis B group was significantly lower than that in the control group (both P < 0.05). Red blood cell distribution width in the hepatitis B and liver cirrhosis group was significantly higher than that in the chronic hepatitis B group [(18.25 ± 3.28)% vs. (14.67 ± 2.15)%, t = 8.16, P < 0.05]. Platelet count, alanine transaminase, and aspartate transaminase levels in the hepatitis B and liver cirrhosis group were (78.47 ± 11.43) × 10 9/L, (49.48 ± 6.85) U/L, (45.86 ± 6.28) U/L, respectively, which were significantly lower than (133.36 ± 18.42) × 10 9/L, (128.36 ± 15.40) U/L, (98.67 ± 14.41) U/L in the chronic hepatitis B group ( t = -22.65, -41.86, -30.05, all P < 0.05). PRP, APRI, and FIB-4 in the hepatitis B and liver cirrhosis group were (0.23 ± 0.05), (1.85 ± 0.44), (4.25 ± 0.81) respectively, which were significantly higher than (0.11 ± 0.02), (1.46 ± 0.33), (3.38 ± 0.63) in the chronic hepatitis B group ( t = 19.93, 6.34, 7.58, all P < 0.001). The RPR, APRI, and FIB-4 in the death group were (0.25 ± 0.08), (1.97 ± 0.48), (4.52 ± 1.31), respectively, which were significantly higher than (0.18 ± 0.05), (1.68 ± 0.40), (3.69 ± 1.21) in the survival group ( t = 3.94, 2.17, 2.09, all P < 0.05). The receiver operating characteristic curve revealed that PRP has an extremely high value in diagnosing hepatitis B and liver cirrhosis and predicting the death of patients with hepatitis B and liver cirrhosis. Conclusion:RPR has an extremely high value in diagnosing hepatitis B and liver cirrhosis and predicting the prognosis of this disease.
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Renal biopsy is a "gold standard" for establishing the diagnosis and assessing prognosis and monitoring therapy in lupus nephritis (LN) patients, but it is an invasive and inconvenient procedure. Evidences showed that interleukin-17(IL-17) and interleukin-23(IL-23) may be as alternative biomarkers for diagnosing LN, monitoring LN activity and predicting the response to treatment of LN. To analyze the roles of IL-17 and IL-23 in evaluation activity of LN and predicting active LN response to immunosuppressive treatment, by comparison between IL-17, IL-23 and clinical data of LN. Eighty patients with LN and 20 healthy volunteers were enrolled in this study. Plasma levels of IL-17 and IL-23 were detected by ELISA and clinical data were collected in patients with LN. Thirty-seven patients with active LN accepted immunosuppressive therapy and followed up to 6 months. The roles of IL-17 and IL-23 in evaluation the activity of LN and the predictability for active LN response to immunosuppressive treatment were analyzed. The ages or gender rations between LN patients and healthy controls were not significant difference at baseline. Baseline levels of IL-17 and IL-23 were higher in patients with active LN compare to them in patients with inactive LN or controls (P<0.001) and IL-23 in patients with inactive LN was higher than its in controls (P=0.004). IL-17 and IL-23 decreased significantly in active LN patients after 6 months therapy (P<0.001). The baseline level of IL-23 was significantly different in subgroups response to the immunosuppressive treatment in patients with active LN (P=0.0014). Baseline level of IL-23 in complete response group was lower than its in partial response group (P=0.0015) or nonresponse group (P=0.013). IL-17 was negative correlation with C3 (r=-0.44, P<0.001). IL-17 and IL-23 correlated with systemic lupus erythematosus (SLE) disease activity index (P<0.001). The correlation between IL-17 and LN pathological acute index (AI) was higher than the correlation between IL-23 and AI. (r=0.52, P<0.001 vs. r=0.41, P<0.001). Receiver Operation Characteristics (ROC) showed that IL-17 and IL-23 could be used to evaluate SLE disease activity index. IL-17 could be used as biomarker to evaluate pathological AI. IL-23 could be used as a predictor for predicting response to immunosuppressive treatment in patients with active LN. IL-17 and IL-23 may involve and contribute to LN. IL-17 could be used as a biomarker for LN clinical and pathological AI. IL-23 could be used as a predictor for predicting response to immunosuppressive treatment in patients with active LN.
Subject(s)
Interleukin-17/metabolism , Interleukin-23/metabolism , Lupus Nephritis/metabolism , Adult , Cytokines/metabolism , Disease Management , Female , Humans , Lupus Erythematosus, Systemic/complications , Lupus Nephritis/diagnosis , Lupus Nephritis/etiology , Lupus Nephritis/therapy , Male , Middle Aged , ROC Curve , Severity of Illness IndexABSTRACT
Objective To investigate the application of low molecular weight heparin modified injection in the nursing of patients with acute myocardial infarction. Methods A total of 90 patients with myocardial infarction who underwent subcutaneous injection of low molecular weight heparin from May 2017 to May 2018 were enrolled in the study. The patients were divided into the control group and the observation group according to the different injection and treatment methods. The control group used the traditional injection method of low molecular weight heparin, and the observation group used the low molecular weight heparin modified injection method. Forty-five patients were observed and compared for the degree of subcutaneous hemorrhage, incidence of induration and pain. Results The incidence of subcutaneous induration and subcutaneous hemorrhage in the observation group were 10.16% (64/630) and 19.84% (125/630), respectively. The control group was 16.19% (102/630) and 31.11% (196/630), respectively. The difference between the groups was statistically significant (χ2 =10.019, 21.073, both P<0.05). The pain score of the observation group was 1.29±0.21, and the control group was 1.86±0.28. The difference between the two groups was statistically significant (t=40.877, P<0.05); the subcutaneous mild, moderate, and severe bleeding in the observation group were 17.30% (109/630), 2.54% (16/630), and 0, respectively, and the control group was 21.90% (138/). 630), 8.41% (53/630), 0.79% (5/630), the difference between the two groups was statistically significant (χ2=4.235, 20.990, 4.019, all P<0.05). Conclusions Low molecular weight heparin modified injection method for myocardial infarction patients can effectively reduce the incidence of subcutaneous hemorrhage and induration, reduce the degree of subcutaneous hemorrhage and pain, suitable for clinical promotion.
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Objective@#To investigate the application of low molecular weight heparin modified injection in the nursing of patients with acute myocardial infarction.@*Methods@#A total of 90 patients with myocardial infarction who underwent subcutaneous injection of low molecular weight heparin from May 2017 to May 2018 were enrolled in the study. The patients were divided into the control group and the observation group according to the different injection and treatment methods. The control group used the traditional injection method of low molecular weight heparin, and the observation group used the low molecular weight heparin modified injection method. Forty-five patients were observed and compared for the degree of subcutaneous hemorrhage, incidence of induration and pain.@*Results@#The incidence of subcutaneous induration and subcutaneous hemorrhage in the observation group were 10.16% (64/630) and 19.84% (125/630), respectively. The control group was 16.19% (102/630) and 31.11% (196/630), respectively. The difference between the groups was statistically significant (χ2=10.019, 21.073, both P<0.05). The pain score of the observation group was 1.29±0.21, and the control group was 1.86±0.28. The difference between the two groups was statistically significant (t=40.877, P<0.05); the subcutaneous mild, moderate, and severe bleeding in the observation group were 17.30% (109/630), 2.54% (16/630), and 0, respectively, and the control group was 21.90% (138/). 630), 8.41% (53/630), 0.79% (5/630), the difference between the two groups was statistically significant (χ2=4.235, 20.990, 4.019, all P < 0.05).@*Conclusions@#Low molecular weight heparin modified injection method for myocardial infarction patients can effectively reduce the incidence of subcutaneous hemorrhage and induration, reduce the degree of subcutaneous hemorrhage and pain, suitable for clinical promotion.
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Objective:To investigate the application of Balanced Scorecard (BSC) in the performance evaluation system of government procurement in medical colleges and universities based on the analysis of the current government procurement process.Methods: According to the theoretical and methodological analysis of BSC, the performance evaluation is divided into four major aspects of assessment indicators, learning and growth, business process, customer and finance, which breaks the traditional performance evaluation way of only focusing on the of financial indicators. Delphi method has been involved to determine the weights.Results: Based on the theory of BSC, the specific evaluation index and weight of the government procurement performance evaluation system in medical colleges and universities are put forward and proved by practice.Conclusion: A reasonable evaluation of the performance system established according to BSC will help to improve the beneficial results, efficiency and economy output of the procurement funds, and the management of government procurement in medical colleges.
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Experiment Ⅰ. Twenty-eight rats were randomly assigned into Near-Infrared Information Radiation (NIIR) group and control group. Two weeks later each rat was innoculated intraperitoneally with Salmonella typhosa H antigen (HAg) and cyclophosphamide (CY). Peripheral lymphocyte counts in the NIIR group were significantly higher than those in the control group on the fifth day after administration of CY. Experiment Ⅱ, Fifty-four rats were randomly divided into NIIR group given CY and H Ag intraperitoneally, CY and H Ag group and H Ag group for treatment. By the end of the fourth week, the survival rate and serum IgG level in the NIIR group were significantly higher than those in the CY and HAg group. By the end of 2nd week, the titer of the anti-H antibody of the HAg group and NIIR group was significantly higher than that of the CY and HAg group. Experiment Ⅲ. Thirty rats were randomly allocated to NIIR group and control group. Spleen cells were taken and cultured with Con A for 24h to induce IL-2 and the activity of IL-2 in the NIIR group was significantly higher than that in the control group. The NK activity in NIIR group was higher but not significant and ADCC in the NIIR group was significantly higher than that in the control group. The results suggest that NIIR is capable of enhancing immunoreaction in immunosuppressive bodies by promoting the function recovery of T helper cells, therefore NIIR is effective to regulate the immunological function on chronic active hepatitis.
