Risk factors for mortality in patients with tuberculosis admitted to intensive care units.

OBJECTIVE: The purpose of this study is to investigate the mortality of patients with tuberculosis (TB) who need to be admitted to the intensive care unit (ICU) and to analyze the risk factors for mortality. PATIENTS AND METHODS: A retrospective analysis was conducted to collect clinical data of patients with TB who were hospitalized in the ICU at Hebei Chest Hospital between 2015 and 2020. Subsequent to data collection, a rigorous statistical analysis was conducted. RESULTS: A total of 99 patients with TB were admitted to the ICU of Hebei Chest Hospital from 2015 to 2020. After 28 days, 78 of the 99 eligible participants in this study died, while 21 survived. The mortality rate of patients with TB in the ICU was 78.79%. There was a significant difference in the length of stay in ICU, shock, drug, acute physiology, and chronic health evaluation (APACHE) II, procalcitonin, C-reactive protein, and albumin (p < 0.05). Further analysis indicated that the length of stay in the ICU, shock, APACHE II, and albumin were considered independent risk factors for mortality. CONCLUSIONS: In China, the mortality rate of patients with TB requiring admission to the ICU is very high. In these patients, a prolonged ICU stay, a high APACHE II score, the onset of shock in the ICU, and a low albumin level have a significant impact on the risk of mortality.

[Delayed effect of liver injury and metabolism of dimethylformamide after high exposures in rats].

Objective: To investigate the delayed effect of liver injury and metabolism of dimethylformamide (DMF) after high exposures in rats. Methods: A total of 12 rats were randomly divided into four groups and 3 rats were in each group. Rats in 1d DMF+2 d delayed group were dosed for 1 day and rested for 2 days, and sacrificed at the 4th day. Rats in 3 d DMF group were dosed for 3 days and sacrificed at the 4th day. Rats in 3 d DMF+3 d delayed group were dosed for 3 days and rested for 3 days, and sacrificed at the 7th day. Rats in control group were administrated with water for 3 days, sacrificed at the 7th day. The administrated dose was 1 000 mg/kg (body weight·d) DMF by oral. The daily observation and body weight were recorded during the study period. After the experiment, the blood biochemistry, including alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , lactic dehydrogenase (LDH) , alkaline phosphatase (ALP) , total bilirubin (TBIL) etc. were detected. Liver weight, kidney weight, liver/body ratio, kidney/body ratio and pathologic examination of liver and kidney were investigated. The concentrations of hemoglobin-adduct (NMHb) were detected. Results: During the period of 1~3 d, body weight growth rate of rats in each treated group had no significant difference with control rats. In the 4~6 th day of the period, rats in group 3 became thinner than before, and the body weight was negative growth (-4.22±3.29 g/d) and significant lower than that of control rats (10.33±3.21 g/d, F=30.07, P<0.05) . AST and LDH levels of 3 d DMF group were significant higher than control group (P<0.05) . Liver/body ratio in 3 d DMF+3 d delayed group were significant higher than control group (P<0.05) . The gross inspection showed 1 rat and 3 rats were observed liver injury in 3 d DMF group and 3 d DMF+3 d delayed group, respectively. Histopathological lesions of 1d DMF+2 d delayed group, 3 d DMF group and 3 d DMF+3 d delayed group were mainly spotty necrosis, focal necrosis and large necrosis of liver cells, respectively. Only NMHb level of control group was undetectable. NMHb levels in 3 d DMF+3 d delayed group were significantly higher than 3 d DMF group (F=135.46, P<0.05) . Conclusion: The DMF-induced liver injury and DMF metabolism may be delayed after high DMF exposures in rats.

[Studies on human cytokine responses before and after praziquantel chemotherapy in an endemic area of schistosomiasis japonica].

OBJECTIVE: To observe the cellular immune responses in a population of an endemic area of schistosomiasis japonica and the influence of praziquantel treatment. METHODS: Blood was taken from 129 residents (64 cases were egg-positive, 65 cases were egg-negitive) of an endemic area of Poyang Lake before and 45 days after praziquantel treatment. Cytokines induced by the schistosome soluble egg antigen (SEA) and soluble worm antigen preparations (SWAP) in the peripheral blood cells including IL-5, IL-10 and IFN-gamma were measured. RESULTS: Among 129 cases, the cytokine levels were found much higher in egg negative individuals than in egg-positive individuals. The cytokine levels induced by both antigens were increased significantly after praziqantel treatment especially IL-5 and IFN-gamma. CONCLUSION: The cellular immune responses in the population in schistosomiasis japonica endemic area exhibited a general trend of down-regulation and were elevated significantly after praziquantel treatment.