1.The clinical value of combining early peak temperature with 48 h-△sequential organ failure assessment score in predicting prognosis for patients with sepsis in emergency department
Chinese Journal of Emergency Medicine 2016;25(1):68-72
Objective To investigate the joint value of early peak temperature and 48 h-△sequential organ failure assessment (SOFA) score in predicting the prognosis for patients with sepsis in emergency department.Methods Two hundred and thirty-one patients with sepsis admitted from January 2013 to January 2015 in Emergency Intensive Care Unit of the First Affiliated Hospital of China Medical University were enrolled.Clinical features,early peak temperature,SOFA scores,the length of stay in EICU and the mortality in 28 days were studied.The patients were divided into two groups according to the 48 h-△SOFA.Each group were divided into three subgroups according to the early peak temperature.For example,hypothermia subgroup had temperature below 36 ℃,normothermia subgroup had temperature between 36 ℃ and 38 ℃,and hyperthermia subgroup had temperature above 38 ℃.The relationship between peak temperature plus 48 h-△SOFA and the length of stay in EICU as well as mortality were analyzed.Results Of 231 patients,in 48 h-△SOFA>0 group (n =142) 27 (19.0%) patients died,and in 48 h-△SOFA≤0 group (n =89) 33 (37.1%) patients died (P < 0.05).Hypothermia subgroup had a higher odds ratio value in predicting nonsurvival in 48 h-△SOFA≤0 group (OR =4.51,95%CI:1.33-2.17,P =0.01).Hyperthermia subgroup had a longer stay in EICU than hypothermia subgroup and normothermia subgroup (P < 0.05).Conclusion The combination of the early peak temperature and 48h-△SOFA score is an effective indicator to evaluate the prognosis and to stratify patients with sepsis in emergency department.More attention should be paid to the patients with an early peak temperature < 36 ℃ and 48 h-△SOFA ≤0 because of higher mortality.The condition of patients should be reassessed and try to make a more rational treatment for the patients with an early peak temperature >38 ℃ and 48 h-△SOFA >0 because of its longer stay in EICU.
2.The clinical value of combining early urine paraquat clearance rate with severity index of paraquat poisoning in predicting the prognosis for acute paraquat poisoning patients
Chinese Journal of Emergency Medicine 2017;26(7):795-801
Objective To investigate the clinical value of combining early urine paraquat early clearance rate (UPCR) with severity index of paraquat poisoning (SIPP) in predicting the prognosis for paraquat poisoning patients.Methods In this retrospective research,a total of 425 cases diagnosed with acute paraquat poisoning from March 2014 to March 2016 in Emergency Intensive Care Unit,First Affiliated Hospital of China Medical University were enrolled.The general data of patients,the results of rapid qualitative test of paraquat in blood and urine,the concentration of paraquat in blood / urine,the poisoning time,the concentration of blood lactic acid and the APACHE Ⅱ score were collected.The early UPCR and SIPP were measured at different time intervals,and the ratio of 6-SIPP and 12 h-UPCR were calculated.These patients were divided into death groups and survival groups according to the 28-day mortality.The relationship between these factors and the mortality were analyzed.Results Of all the 425 patients,268 cases (63.1%) died,157 cases (36.9%) survived;the blood concentration of paraquat,the lactate concentration,SIPP values and the APACHE Ⅱ scores were significant difference between the two groups (P < 0.05).The mortality of 2-6 hour paraquat rapid qualitative test result positive patients was higher (96.4%) than that of the negative patients (3.6%) (P < 0.05);the mortality of 12-24 hour paraquat rapid qualitative test result negative patients was lower (11.5%) than that of the positive patients (88.5%) (P<0.05).The 2-6 hour SIPP value was 19.8 ±6.7 in death group,which was higher than that in survival group (4.9±3.1) (P<0.05);the 2-6 hour UPCR value was (41.7±9.3) indeath group,which was lower than that in survival group (86.3 ± 15.8) (P < 0.05).There was no significant difference in the 2-6 hour UPCR value and 12-24 hour UPCR value between two groups (P >0.05).The 6 h-SIPP/12 h-UPCR value was (41.94 ±5.9) in death group,which was higher than that in survival group (5.27 ± 3.6) (P < 0.05).Conclusion The combined use of early UPCR and SIPP values is an effective indicator of the prognosis of patients with acute paraquat poisoning and is helpful for the early stratification.We should pay more attention to the patients whose rapid qualitative blood test is positive because of their high mortality risk;for the patients whose 12 h urinequalitative test was negative,the hemoperfusion therapy might be stopped because the toxin was completely excluded,and the medical resources can be saved reasonably.The UPCR might indicate the excretion of toxins,and SIPP might indicate the severity of poising.
3.Comparison of clinical effect between video-assisted thoracoscopy plus minithoracotomy and limited axillary thoracotomy for the treatment of lung cancer
Yang YANG ; Yanfeng LIU ; Ruibin XU
Chinese Journal of Primary Medicine and Pharmacy 2013;20(8):1189-1191
Objective To compare the efficacy of video-assisted thoracoscopy plus minithoracotomy(VAMT) and limited axillary thoracotomy(LAT) for the treatment of lung cancer.Methods 85 consecutive lung cancer patients were treated by either VAMT or LAT.The operative time,blood loss during operation,postoperative chest drainage time,and hospital stay time and postoperative complication were compared between the two groups.Results There was no death in two groups.The operative time and blood loss during operation were significant less in VAMT than inLAT(t =6.514,2.413,all P <0.05).But postoperative chest drainage time,and hospital stay time and postoperative complication were no significant difference between the two groups (t =0.490,0.338,all P > 0.05).Conclusion VAMT is a safe and less traumatic procedure in the treatment of lung cancer,which is worthy of promotion and application.
4.CD98 in lung cancer
Yang LIU ; Wentao YUE ; Shaofa XU
Journal of International Oncology 2011;38(12):927-929
CD98 is a transmembrane heterodimer of cell surface.It regulates cell signaling pathway by activating some correlated proteins,and controls cell polarization,proliferation,adhesion and migration.CD98 plays an important role in the development of cancer and may be a novel tumor marker for diagnosis and prognosis in lung cancer.
5.Effects of high concentration of glucose on activity and protein expression of endothelial nitric oxide synthase (eNOS) in cultured human umbilical vein endothelial cells (HUVECs)
Shenqi YANG ; Biao XU ; Yunhai LIU
Chinese Journal of Diabetes 2008;16(1):50-52
The activity of eNOS was singificantly depressed by a high concentration of glucose in a concentration-and time-dependent manners after incubation of HUVECs with different concentrations of glucose and with high glucose plus insulin for different times.The physiological concentration of insulin can partially reverse the inhibitions of the activity and expression of eNOS induced by high concentration of glucose.
6.Effects of Quercetin on Human Umbilical Vein Endothelial Cell Undergoing Endothelial-to-mesenchymal Transition Induced by TGF-β1
Chinese Journal of Information on Traditional Chinese Medicine 2017;24(2):65-69
Objective To investigate the effectsof quercetin on human umbilical vein endothelial cell (HUVEC)-12 undergoing endothelial-to-mesenchymal transition (EndMT) induced by TGF-β1; To discuss its mechanism of action. Methods Cell activity of intervening by quercetin with different concentrations and TGF-β1 for 72 h was detected by CCK-8 method;RT-PCR and immunofluorescence staining were used to detect the transition of endothelial and stromal markers; Western blot was used to detect the signal transduction pathway; RT-PCR was performed to detect the transcription factors that play crucial roles in the process of transformation. Results The results of RT-PCR and immunofluorescence double staining showed that TGF-β1 (10 ng/mL) stimulated HUVEC-12 cells for 72 h to induce fibroblast phenotype, showing more interstitial markers and less endothelial markers;Western blot and RT-PCR results showed that quercetin inhibited the phosphorylation of smad2/3 in a concentration-dependent manner;After TGF-β1 stimulation, the downstream transcription factors EndMT of snail1, twist1, twist2, ZEB1, and ZEB2 significantly increased, while 100 μmol/L quercetin could down-regulate the five downstream transcription factors. Conclusion Quercetin has anti-fibrosis effects through inhibiting HUVEC-12 cells undergoing EndMT.
7.Effects of interleukin-1? on discharge of neurons in paraventricular nuclei of rat hypothalamus
yang, LV ; rong, XU ; bao-yu, LIU
Journal of Shanghai Jiaotong University(Medical Science) 2006;0(12):-
Objective To observe the effects of interleukin-1 ?(IL-1?) on spontaneous electrical activity of neurons in paravenrticular nuclei,and discuss the possible mechanism.MethodsExtracellular recording technique was employed to observe the effects of IL-1? on spontaneous electrical activity of neurons in paravenricular nuclei in rat hypothalamic slices,and the influence of losartan on the electrical activity induced by IL-1? was examined.ResultsAfter exposure to IL-1?(1?10-7 mol/L),the discharge frequency was significantly increased in 46 of the 59 discharge units(78%) of neurons(P
8.Application of Doppler Tissue Imaging in Assessment of Cardiac Function of Patients after Percutaneous Coronary Intervention for Myocardial Infarction: One Year Follow-up
Changfu LIU ; Yong XU ; Tingshu YANG
Chinese Journal of Rehabilitation Theory and Practice 2007;13(5):460-461
Objective To evaluate the application of Doppler tissue imaging (DTI) in assessment of cardiac function after percutaneous coronary intervention (PCI) for myocardial infarction (MI) for long term follow-up. Methods 86 patients with MI were divided in PCI group (45 cases) and conventional therapy group (41 cases). All the patients received two-dimensional echocardiography (2DE) and DTI measurements. The left ventricular ejection fraction (LVEF), peak E, peak A wave velocities and peak E versus peak A (E/A) of 2DE were recorded, as well as the velocity of systolic wave(s), early diastolic filling wave(e), late filling wave(a) and wave e versus wave a (e/a ) of DTI. Results The LVEF and the average velocity of systolic wave (s) of mitral annulus was increased after PCI (P<0.05). S wave was related to LVEF, but the sensitivity of s wave is better than that of LVEF. There was no difference in the pulse Doppler trans mitral flow velocity E/A before and after PCI (P>0.05) , but the average velocity of mitral annulus (e/a ) was remarkably increased after PCI (P<0.01).Conclusion The left ventricular systolic and diastolic function in MI patients be improved after PCI. DTI is a sensitive method to detect the cardiac function after MI and PCI.
9.Review on Pharmacological Study of Archen
Tao LIU ; Qialing XU ; Shuyu YANG
International Journal of Traditional Chinese Medicine 2009;31(1):79-81
Archen,a kind of Anthraquinone,is one of active ingredients of Chinese herb Rhubarb.The researches showed that archen has ideal therapeutic effects on diseases of circulatory system,digestive system,nervous system and tumor. The paper reviewed related researches on pharmacology of archen from year 2004 to 2008 and made a summary of the researching development of it.