1.Changes of serum procalcitonin level and its significance in patients with traumatic brain injury
Yuanyuan ZHAO ; Yufeng LIAN ; Yunbiao GU ; Lin LOU ; Gang LU
Chinese Journal of Trauma 2015;31(5):395-399
Objective To determine the dynamic change of serum procalcitonin (PCT) level after traumatic brain injury and the rclated clinical significance.Methods Serum levels of PCT and adrenocorticotropic hormone (ATCH) in 137 patients with traumatic brain injury and 20 normal volunteers were measured by electrochemiluminescence assay.Correlation between serum PCT level and severity of traumatic brain injury was evaluated.Results Percentage of serum PCT level at low inflammatory-risk threshold detected from day 1 to day 14 after admission was descended from 80.3% to 63.5%.Meanwhile,the percentage of serum PCT level at high inflammatory-risk threshold was a rising-fall-rising trend,but the percentages of serum PCT level at median and definite inflammatory-risk thresholds showed sustained increase from 13.9% to 27.0% and 0.7% to 3.7% separately.Based on the Glasgow Coma Scale (GCS),the dynamic change of serum PCT level demonstrated a distinct bimodal pattern in severe injury group,a gradual falling after rising mode in middle injury group which was significantly and positively correlated with GCS (r =0.463,P < 0.05),and a rising-falling-slight rising tendency in minorinjury group.In addition,the GCS in each group only closely related to the positive detections of serum PCT level detected at days 3 and 7 (x2 =10.32,16.31 respectively P < 0.01).Serum ATCH level at day 1 was far higher than that at day 14 in severe injury group and was significantly higher in severe injurygroup compared with minor and middle injury groups (P < 0.01 or 0.05).Conclusions Positive serum PCT may be predictive of the traumatic brain injury and injury degree within 3-7 days after the injury.The dynamic change of serum PCT is associated with the specialized mechanism of traumatic brain injury and neuronendocrine response,and it may be a useful parameter to assess posttraumatic stress response and prognosis.
2.The cost analysis of capsule endoscopy in diagnosing small bowel bleeding
Zhi-Zheng GE ; Jing-Li GU ; Yun-Jie GAO ; Haiying CHEN ; Yunbiao HU ; Shudong XIAO ;
Chinese Journal of Digestion 1998;0(06):-
Objective To analyze the cost of capsule endoscopy in diagnosing small bowel bleeding and to compare it with traditional diagnostic methods.Methods The patients suspected with small bowel bleeding were divided into group A(n=58,collected during 1998 to 2005)diagnosed with traditional processes and group B (n=93,collected during 2002 to January 2005)diagnosed with capsule endoscopy.The diagnostic yield,specific treatments,examination costs and other accumulated costs of two groups was compared.The examination cost ratio and the integration cost ratio were evaluated.The sensitivity analysis was performed.Results The diagnostic yield of small bowel bleeding in group A and group B were 22.4%(13/58) and 86%(80/93),respectively.The total of examination costs were 133 750 RMB and 790 500 RMB,respectively.The examination costs in group B(RMB 9881.3/each) was slightly lower than group A(RMB 10 288.5/each).Furthermore,as the diagnostic yield of group B was significantly higher than group A(P=0.001).The specific treatments based on the results of the diagnosis was 37.4% higher in group B(49.5%) than group A(12.1%).That means the cost of repeat- ed consultations,emergencies room visit,examinations,supporting treatments and hospitalizations in group B were significantly decreased.After the adjustment,the cost in group B(RMB 9881/patient) was lower than group A(16 361.5 RMB in one month—97 424.0 over 5 years/patient).The total cost of each patient in group A was 6480.2—87 542.7 RMB more than group B,which represented 1.7—9.9 folds increase.Conclusions The patients who suspected with small bowel bleeding and had a negative results of gastroscopy and colonoscopy were recommended to have capsule endoscopy which yields early diagnosis and less cost.
3.The influence of recombinant human growth hormones on the systemic metabolism after severe burn.
Zhongyong CHEN ; Caizhi GU ; Zhixue WANG ; Xiangbai YE ; Xihua WANG ; Huijie LI ; Yunbiao SHEN ; Jinxi LI
Chinese Journal of Burns 2002;18(3):183-185
OBJECTIVETo explore the influence of recombinant human growth hormones (rhGH) postburn systemic metabolism.
METHODSTwenty-four burn patients were randomly and equally divided into treatment and control groups. Same amount of rhGH (9 U/d) or isotonic saline was injected subcutaneously to respective patients during 3 approximately 17 postburn days (PBDs). Blood samples were harvested at 3, 10 and 17 PBDs for the determination of serum growth hormone, insulin-like growth factor (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), serum proteins, plasma insulin, plasma glucagons and blood glucose, which were then compared and analyzed between two the groups.
RESULTSThe serum levels of GH, IGF-1, IGFBP-3, serum prealbumin and transferrin in rhGH treatment group were evidently higher than those in control groups at 10 and 17 PBDs (P < 0.05 approximately 0.01). But there was no obvious difference in serum albumin, plasma insulin, glucagon and blood glucose (P > 0.05).
CONCLUSIONSmall dose of rhGH could promote systemic protein synthesis with no side effects on blood glucose levels.
Adolescent ; Adult ; Blood Proteins ; drug effects ; metabolism ; Burns ; blood ; Female ; Growth Hormone ; blood ; pharmacology ; Humans ; Insulin ; blood ; Insulin-Like Growth Factor I ; analysis ; drug effects ; Male ; Middle Aged ; Recombinant Proteins ; pharmacology