Objective To study the mortality and risk factors of death of critical patients treated in emergency department for initial stabilization and life support. Method The clinical data of 1240 critical patients from January 2005 to December 2006 were retrospectively analyzed. The patients were divided into death group and survival group. The differences of demographics, symptoms, physical signs and laboratory findings of patients between two groups were analyzed by using univariate and multivariate logistic regression analysis, sex, age, visiting time after attack, the history of chronic diseases, temperature, respiratory rate, heart rate, mean arterial pressure, respiratory dysfunction, circulatory dysfunction, hepatic dysfunction, gastrointestinal dysfunction, renal dysfunction, coagulation disorders, acid base and electrolyte disturbances, lencocyte count,platelet count, Glasgow coma scale (GCS) score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ). Results There were higher mortality and morbidities of patients with diseases of respiratory, digestive, circulatory and nervous systems. The mortality of patients with the history of chronic diseases was higher (P < 0.01) ,and there were more patients with chronic obstructive pulmonary disease(COPD), chronic cardiac insufficiency, diabetes mellitus or cirrhosis of liver in death group (P < 0.05). The mortality of patients with 3 dysfunctional organs was 32.81%, and the mortality of lity of those with five dysfunctional organs was 76.67% . Logistic regression analysis indicated that male gender, age between 46 and 65, respiratory dysfunction, circulatory dysfunction, gastrointestinal dysfunction, hepatic dysfunction, low Glasgow coma scale (GCS) score and high APACHE II score were risk factors of the death of critical patients. Conclusions The mortality of patients with the history of critical diseases is higher. The more dysfunctional organs, the higher mortality is. Age between 46 and 65, male gender, and dysfunction of lung, circulation, gastrointestinal tract,and liver,and low CCS score and high APACHE II score are risk factors of the death of emergency and critical disease.

Objective To investigate the relationship between the polymorphism of human multidrug resistance 1 gene(MDR1)polymorphism and early MMF pharmacokinetics.Methods Twenty-eight Chinese primary renal transplant recipients were emrolled.On day 14 post-transplant,patients took the MMF orally on fast.Whole blood samples(2 ml)were obtained at the following time points:predose(G0)and 0.5,1,1.5,2,4,6,8,10 and 12 h(C0.5,C1,C1.5,G2,C4,C6,C8,C10,C12,respectively)postdose during the dosing interval.The MPA plasrna concentration was assayed by high performance liquid chromatography (HPLC).Pharmacokinetie parameters were determined by WINNOLIN 3.1.Three major single nucleotide polymorphisrrls(SNP),C1236 T,G2677 T/A,C3435 T of MDR1 were analyzed by PCR-RFLP.Pharmacokinetie parameters of MPA were compared between different MDR1 genotype and haplotype groups.Ailele frenqueneis were also compared in high(MPA area under concentratation-time curve 0～12 h,frequencies of 1236 TT,2677 TT/AA,3435 TT in three major MDR1 SNP positions,exons 12,21 and 26,were 0.368,0.184 and 0.211,respectively.MPA AUC was significantly higher in 1236 TT group than in 1236 CC/CT group(65.36±11.51 vs 53.33±13.77,P=0.032).On C1236 T SNP,TT genotype frequency showed significant difference between MPA high and low exposure groups(66.7%vs 15.4%,P=0.013,OR=2.526).T allele frequency was marginally higher in MPA high exposure group than that in low exposure group(83.3%vs 53.3%,P=0.072).Conclusion TT genotype on 1236 of MDR1 indicates a risk of early high exposure to MPA in Chinese renal transplant patients given by oral MMF,

Humans ; Severe Acute Respiratory Syndrome ; diagnosis ; therapy