Objective To investigate influence of nutritional status on prognosis in patients with systemic inflammatory response syndrome (SIRS). Methods Retrospective analysis for clinical data of 533 patients who hospitalized at the Internal Medicine Department of Beijing Social Welfare Hospital and the Emergency Department of Chaoyang Hospital, Beijing during 2005 to 2010 were performed. All the patients were divided into SIRS (323 cases) and non-SIRS (210 cases) groups based on diagnostic criteria of SIRS and pyemia, and groups of the survival (431 cases) and the dead ( 102 cases) based on their end outcomes.Patients of SIRS were further divided into sub-groups of pyemia (287 cases) and non-pyemia (36 cases)based on their infection status. The Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ ),serum levels of prealbumin ( PAB), albumin ( ALB), total cholesterol (CHOL) and C-creative protein (CRP) were measured for all the patients on the 1st, 3rd, 7th days after admission, before discharge and prior to death, respectively. Results Scores of APACHE Ⅱ were significantly higher in SIRS and the dead groups than those in non-SIRS and the survival groups (P ＜0. 05 ). Serum level of albumin was significantly lower in SIRS and the dead groups than that in non-SIRS and the survival groups on the 7th day after admission (SIRS vs. non-SIRS: F=9.812, P=0.035; the dead vs. the survival: F =45.285, P=0. 003). Change in serum level of prealbumin was the same as the level of albumin, with significant difference between various groups since the 3rd day after admission ( P ＜ 0. 05 ). Significant time effects could be found in the dead and survival groups (for the dead group: F = 19. 188, P = 0. 000; and for the survival group: F = 47. 250, P ＜ 0. 01 ). Multiple regression analysis showed that serum levels of prealbumin and total cholesterol correlated with scores of APACHE Ⅱ[with a regression formula of scores of APACHE Ⅱ = 52.032-21.407 PAB-8.971 CHOL (R2 =0.801, F=48.016, P =0.023)]. Logistic regression analysis showed that low level of prealbumin and high scores of APACHE Ⅱ both were predictors for survival of SIRS patients, with an overall accuracy of 77. 1 percent, 73.5 percent for survival and 79. 5 percent for death prediction. Conclusions Severe malnutrition can be found in patients with SIRS and serum level of prealbumin can be used to evaluate their nutritional status and severity of the disease. High scores of APACHE Ⅱ combined with low serum level of prealbumin can predict prognosis of the patients.

Objective To study the effect of Kanglaite combined with comprehensive therapy on advanced non-small cell lung cancer.Methods Sixty-one patients with advanced non-small cell lung cancer were randomly divided into treatment group ( n=31 ) and control group ( n=30 ).Both groups were given comprehensive therapy.Treatment group were additionally treated with intravenous injection of 200 ml Kanglaite.Clinical efficacy,quality of life,pain relief and adverse reactions of the two groups were observed.Results ( 1 ) Quality of life was improved in 20 cases (64.5％ ),stabled in 8 cases (25.8％),declined in 3 cases ( 9.7％ ) of treatment group,and in the control group there were 9 cases ( 30.0％ ) improved,9 cases ( 30.0％ ) stabilized,12 cases (40.0％ ) declined respectively.Quality of life in treatment group was higher than in control group ( U=2.91,P＜0.01 ).( 2 ) Pain relief:the number of patients with complete remission,partial remission,no change,and progression were 5 cases ( 16.1％ ),16 cases ( 51.6 ％ ),16 cases (51.6％ ),6 cases (19.4％) and 4 cases (12.9％ ) in treatment group,and in control group they were 2 cases(6.7％ ),9 cases (30.0％ ),11 cases(36.7％ ) and 8 cases(26.7％ ) respectively.The effect of treatment on pain relief in treatment group was better than that in control group ( U=2.32,P＜0.05 ).(3) Clinical efficacy:in the treatment group there were 12 cases (38.7％) with partial remission,14 cases (45.2％) stabilized,and 5 cases (16.1％ ) progressed,and in control group the numbers were 8 cases (26.7％ ),8 cases (26.7％ ) and 14 cases (46.7％ ) respectively.The clinical efficacy in treatment group was better than that in the control group( U=2.04,P＜0.05).(4) There were significant difference on the change of white blood cell count and gastrointestinal reactions Ⅲ and Ⅳ degrees between treatment group and contrl group [22.6％ (7/31) vs.53.3％(16/30),x2=6.139 P＜0.05;19.4％ (6/31) vs.46.7％ (14/30),x2=5.161,P＜0.05].Conclusion Kanglaite injection combined with comprehensive therapy can improve clinical efficacy of therapy for advanced non-small cell lung cancer,reduce the toxic adverse reaction,protect immunity system and improve the quality of life of patients.

Objective To explore the effects of intermittent catheterization conducted by bladder safe capacity on bladder function rehabilitation among patients with spinal injury.Methods A total of 60 patients with spinal injury and neurogenic bladder of Rehabilitation Department of Spine were selected as subjects by convenience sampling from January 2015 to January 2016. They were randomly divided into intervention group (intermittent catheterization conducted by the bladder capacity scanner) and control group (routinely regular intermittent catheterization). And then, this study compared the recovery of bladder function and the incidence of urinary tract infection of patients in two groups.Results At the fourth week, there were 9 patients with reflex bladder in intervention group more than that (4 patients) in control group with a significant difference (P<0.05). At discharge, there were 18 patients with reflex bladder in intervention group, while there were 14 patients in control group with a significant difference (P<0.05). After intervention, the residual urine volume of intervention group was significantly higher than that of control group (P<0.05). There was no statistically significant difference in bladder compliance between two groups (P>0.05). The difference on cases with urinary tract infection in control group (66 times) and intervention group (35 times) was significant (P<0.05). The times of reflex urination for the first time and bladder functional reconstruction in intervention group were lower than those in control group with significant differences (P<0.05).Conclusions Intermittent catheterization based on individual bladder safe capacity can effectively shorten the times of reflex urination for the first time and bladder functional reconstruction, reduce the residual urine and decrease the incidence of urinary infection.

Objective To explore the influencing factors of urinary tract infection in patients with spinal cord injury in rehabilitation period, so as to provide the basis to minimize urinary tract infection.Methods The patients' information and the incidence of urinary tract infection (UTI) during the rehabilitation period of 503 cases of spinal cord injury admitted to the First Affiliated Hospital of PLA General Hospital from January 2013 to December 2015 were retrospectively analyzed. Logistic regression analysis was used to analyze the influencing factors of UTI in patients with spinal cord injury during rehabilitation period.Results The degree of injury, the site of injury, the way of urination, and the course of the disease were the factors affecting the incidence of UTI in the patients with spinal cord injury during the rehabilitation period (P<0.05). Conclusions The degree of injury, the location of injury, the way of micturition and the duration of disease are the influencing factors of UTI in patients with spinal cord injury during rehabilitation. As the course of disease goes on, we need to choose intermittent catheterization as a way of micturition according to the bladder function of patients with spinal cord injury.

Humans ; Lung Neoplasms ; Pulmonary Blastoma

BACKGROUND: In recent years, a number of clinical trials have shown that immunocheckpoint inhibitors (ICI) have brought survival benefits to patients with advanced non-small cell lung cancer (NSCLC), however, such clinical trials comprise cohorts selected based on strict and complex entry and exclusion criteria, and the results cannot fully reflect the real world situation. The purpose of this study was to investigate the clinical efficacy and safety of immunotherapy in the real world, as well as possible prognostic factors. METHODS: Patients with advanced NSCLC receiving immunotherapy in Beijing Chest Hospital from January 2017 to July 2019 were retrospectively collected, and the following information were collected: curative effect, progression-free surival (PFS) and adverse reactions. The occurrence of adverse reactions and clinical curative effect and prognosis factors that may be relevant were explored. RESULTS: 34 patients were enrolled in this study, median PFS was 5.66 months (95%CI: 4.48-6.84), grade 1-2 and 3-4 incidence of adverse events was 61.71% (22/34) and 14.71% (5/34), there were 3 patients (8.82%) experienced fatal immune related adverse events (irAE), 2 cases were immune associated pneumonia, 1 case was immune related myocarditis. Univariate analysis showed that tumor-node-metastasis (TNM) stage and metastatic site were correlated with median PFS (P<0.05), and multivariate analysis showed that patients with extrapulmonary metastasis (OR=6.42, P=0.029) and pleural metastasis (OR=14.14, P=0.006) had shorter median PFS. CONCLUSIONS In the real world, immunotherapy has good efficacy in patients with advanced NSCLC, but the incidence of severe irAE is also higher. Distant metastasis and pleural metastasis are poor prognostic factors for advanced NSCLC patients receiving immunotherapy.