4.The levels of serum lactate, lactate clearance rate and transaminase in septic rats and their relationship with liver damage
Journal of Chinese Physician 2013;15(10):1353-1357
Objective To explore the serum lactic acid,transaminase and their relationship with liver pathological damage in sepsis rats,whether a correlation exists between serum lactate clearance rate and transaminase in sepsis rats,and whether they can be used as indicators for the prediction and evaluation of septic rats liver injury.Methods A total of 150 clean Sprague-Dawley (SD) rats was divided into normal group (n =50),sham operated group (n =50),and the cecal ligation and puncture (CLP) (n =50).Ten rats were killed after successful surgery at the 6th,12th,24th,48th,and 72nd hour in CLP group,respectively.At each time point,10 normal rats and 10 sham-operated rats were taken as a control in the corresponding time point.The liver tissue was obtained for pathological analysis.The levels of lactate and liver transaminase were detected and the lactate clearance rate was calculated.The levels of lactate and transaminase at each time point were statistically compared.The correlation analysis was performed among serum lactate,transaminase,and liver damage pathological changes.Results The rat hepatocytes in CLP group begin to appear at the 6th hour,and the damage was gradually enhanced at the 12th,24th,and 48th,and up to the worst damage at the 48th time point.The levels of lactate and alanine aminotransferase (ALT)in CLP group at the 12th and 24th hour were significantly elevated compared with the normal and sham operation groups (P <0.05); The level of aspartate aminotransferase (AST) in CLP group at the 6th,12th,24th,48th,and 72nd hour was significantly elevated compared with the normal and sham operation groups (P < 0.05).A positive correlation was found between the levels of ALT and lactate (r =0.766,P <0.05),and a negative correlation was found between lactate clearance rate and ALT (r =-0.712,P <0.05).Conclusions In septic rats,both lactate and lactate clearance rate were correlated with ALT,and they were correlated with liver pathological damage.The level of lactate,lactate clearance rate,and ALT could be used as the key indicators to predict liver damage in septic rats.
5.Clinical characteristics of gestational diabetes mellitus
Chinese Journal of Postgraduates of Medicine 2017;40(2):125-128
Objective To compare the clinical characteristics of pregnant women with gestational diabetes mellitus (GDM) and normal gestational glucose metabolism at the 25th weeks of pregnant. Methods Sixty-eighty patients with GDM (GDM group) and 68 patients with normal blood glucose(control group) were enrolled in this study. During 25 weeks of pregnancy, oral glucose tolerance test (OGTT), blood pressure, fasting insulin, glycosylated hemoglobin, uric acid, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol were measured and body mass index (BMI), homeostasis model of assessment for insulin resistence index (HOMA-IR), insulin sensitivity index (ISI) were computed. The results were compared between two groups. Results The age in GDM group was significantly higher than that in control group: (31.38 ± 0.54) years vs. (29.50 ± 0.56) years, P<0.05. The systolic pressure in two groups had no significant difference (P>0.05), but diastolic blood pressure in GDM group was significantly higher than that in control group:(73.2 ± 0.8) mmHg vs. (70.9 ± 0.8) mmHg, 1 mmHg=0.133 kPa, P<0.05. The body weight and BMI in GDM group were significantly higher than that in control group:(65.67 ± 1.76) kg vs. (57.76 ± 1.11) kg, (24.77 ± 0.61) kg/m2 vs. (22.11 ± 0.42) kg/m2, P<0.01. The levels of glycosylated hemoglobin, fasting insulin and HOMA- IR in GDM group were significantly higher than those in control group (5.546 ± 0.746)% vs. (5.085 ± 0.034)% , (17.870 ± 1.015) mU/L vs. (14.400 ± 0.634) mU/L, 4.192 ± 0.271 vs. 2.645 ± 0.128, but the level of ISI in GDM group was significantly lower than that in control group:0.014 ± 0.001 vs. 0.020 ± 0.001, and there were significantly differences (P<0.01). The levels of uric acid, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol in two groups had no significant differences (P>0.05). Conclusions Compared to those with normal blood glucose, the patients with GDM have the characteristics of higher age, higher body weight, higher BMI, higher diastolic blood pressure , higher level of insulin, insulin resistance and decreased insulin sensitivity.
7.Farnesoid X receptor dependent bile acid signaling regulates bile acids metabolism
International Journal of Surgery 2008;35(8):565-568
The Farnesoid X receptor (FXR) is a member of the nuclear receptor superfamily and has emerged as a key player in the control of multiple metabolic pathways. Bile acids are the major endogenous ligands for FXR, and by activating FXR have a variety of target genes, many of which are geared toward pre- venting synthesis and uptake and promoting excretion of bile acids. Here we summarized the latest results from studies on FXR target genes and functions in bile acids metabolism in this article.
8.Clinical value of serum endocan and procalcitonin in early diagnosis and prognosis evaluation of sepsis
Chinese Critical Care Medicine 2017;29(4):321-326
Objective To investigate the clinical value of serum endocan and procalcitonin (PCT) in early diagnosis and prognosis evaluation of sepsis.Methods The patients with systemic inflammatory response syndrome (SIRS,n = 26) and sepsis (n = 78) admitted to intensive care unit (ICU) of the Third Hospital of Hebei Medical University from December 2014 to December 2016 were enrolled. According to the severity of disease, the sepsis patients were divided into general sepsis group (n = 20), severe sepsis group (n = 24), and septic shock group (n = 34). The cases were divided into survival group (n = 55) and non-survival group (n = 23) according to 28-day mortality. The serum endocan, PCT, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and sequential organ failure assessment (SOFA) score were recorded when the patients were admitted into ICU. The differences in endocan, PCT, APACHE Ⅱ, SOFA score between SIRS and sepsis groups and within sepsis subgroups were compared. Spearman correlation analysis was used to analyze the correlation between the indexes of sepsis patients. Receiver operation characteristic curve (ROC) was used to evaluate the value of endocan and PCT for the diagnosis and prognosis of sepsis.Results ① Serum endocan, PCT, APACHE Ⅱ, SOFA score and 28-day mortality in the sepsis group were significantly higher than those in the SIRS group [endocan (μg/L): 4.28 (10.64) vs. 1.03 (0.69), PCT (μg/L): 3.94 (10.75) vs. 0.43 (0.39), APACHE Ⅱ:18.81±9.17 vs. 9.35±3.78, SOFA: 9.00 (7.20) vs. 4.50 (1.50), 28-day mortality: 29.49% vs. 11.54%, allP < 0.01]. The area under the ROC curve (AUC) of endocan, PCT, APACHE Ⅱ, SOFA score for sepsis diagnosis were 0.887, 0.842, 0.822, 0.835, respectively. When the cut-off value of endocan was 1.26μg/L, the sepsis diagnostic sensitivity was 87.2% and specificity was 81.8%. When the cut-off value of PCT was 0.75μg/L, the sepsis diagnostic sensitivity was 85.9% and specificity was 81.8%. ② With the severity of the disease increased, the index showed an increasing trend in patients with sepsis. Serum endocan, PCT, APACHE Ⅱ, SOFA score and 28-day mortality in septic shock group were significantly higher than those in severe sepsis group or general sepsis group [endocan (μg/L): 13.02 (6.70) vs. 3.33 (3.05), 1.60 (0.98); PCT (μg/L): 8.10 (17.68) vs. 5.47 (8.92), 1.57 (2.78); APACHE Ⅱ: 25.00 (9.50) vs. 18.00 (9.00), 9.50 (5.75); SOFA: 13.00 (4.50) vs. 8.00 (3.00), 5.00 (3.50); 28-day mortality: 52.94% vs. 20.83%, 0%; allP < 0.01]. There was a significantly positive correlation between endocan, PCT, APACHE Ⅱ, SOFA, indicating that the endocan and PCT can be used to assess the severity of sepsis. ③ Serum endocan, PCT, APACHE Ⅱ and SOFA score in non-survival group were significantly higher than those in the survival group [endocan (μg/L): 15.05 (9.23) vs. 2.32 (4.81), PCT (μg/L):18.40 (16.99) vs. 3.10 (6.67), APACHE Ⅱ: 28.13±7.56 vs. 14.91±6.64, SOFA: 14.70±3.65 vs. 7.38±3.26, allP < 0.01]. The AUC of endocan, PCT, APACHE Ⅱ, SOFA score for the prediction of non-survival sepsis were 0.915, 0.763, 0.899, 0.930. When the cut-off value of endocan was 4.37μg/L, the septic death prediction sensitivity was 95.7% and specificity was 70.9%. When the cut-off value of PCT was 7.68μg/L, the septic death prediction sensitivity was 65.2% and specificity was 78.2%.Conclusions Serum endocan is more clinically valuable than PCT in early diagnosis and prognosis assessment of sepsis.
9.The surgical treatment of varicose veins of lower extremity with primary deep venous insufficiency
Chinese Journal of General Surgery 1993;0(01):-
0.05). ConclusionsWhen varicose veins of the lower extremity with deep vein insufficiency exists, patients should undergo high ligation and stripping of the great saphenous vein, additional correction of the deep vein reflux provides no further effect.
10.Study on Epidermal Growth Factor in Plasma and Its Receptor in Placenta in Severe Pregnancy Induced Hypertension
Chinese Journal of Perinatal Medicine 1998;0(01):-
Objective To study the relationship of epidermal growth factor (EGF) and pregnancy induced hypertension (PIH), the role of EGF in PIH and fetal growth restriction (FGR), and the effect of EGF on the fetal development in PIH. Methods Thirty-five severe PIH (SPIH, 17 with FGR and 20 without FGR) and twenty-two normal pregnancies were selected . The concentrations of EGF in plasma were analyzed by RIA. The expressions of the EGF receptor (EGFR) in placenta were assayed by immunohistochemistry. Results (a) The EGF concentration in plasma. EGF concentration (96?46 ng/L) was found significantly lower in SPIH than that (144?36 ng/L) in normal pregnancy. P0.05. (b) The levels of HPL in serum were positively correlated with the concentrations of EGF. (c) The immunostaining of EGFR in placenta. The EGFR immunostaining was more highly impressed in SPIH placent than that in normal (P0.05. Conclusion The level of EGF in plasma in SPIH is lower than that in normal pregnancy. But the expression of EGFR is higher. The long existence of lower EGF level in SPIH might lead to the depressed placental function and the occurrence of FGR.