1.Assessment of the significance of cysteine proteinase inhibitor C and β2 microgiobulin in the diagnosis and prognosis of sepsis-induced acute kidney injury
Chinese Journal of General Practitioners 2012;11(2):124-127
ObjectiveTo assess the significance of serum cysteine proteinase inhibitor C (Cys-C) and β2 microglobulin (β2MG) concentrations in the diagnosis and prognosis of sepsis-induced acute kidney injury.Methods Two hundred and fifty patients presenting to the Emergency Department of Beijing Chaoyang Hospital from October 2008 to October 2009 with sepsis were assessed.Serum creatinine (SCr),β2MG and Cys-C concentrations and Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ ) scores were determined when the septic patients presented to the hospital. The 28-day mortality was recorded.The study patients were retrospectively divided into acute kidney injury ( n =63 ) and no acute kidney injury groups (n =187 ).The predictive accuracies of Cys-C and β2MG for acute kidney injury were analyzed by plotting a relative operating characteristic (ROC) curve.The Spearman interclass correlation method was used to analyze the correlation between Cys-C concentration and APACHE Ⅱ score in sepsisinduced acute kidney injury.ResultsCys-C and β2 MG concentrations were significantly greater in the acute than in the no acute kidney injury group [ ( 1189 ± 214) μg/L vs.(678 ± 118) μg/L,P =0.007 ; (3705 ±599)μg/L vs.(2365 ±446) μg/L,P =0.004,respectively].SCr concentrations and APACHE Ⅱ scores were significantly greater in the acute than in the no acute kidney injury group [ (145 ±49) vs.(73 ±25),P=0.013,(19 ±4) vs.(13 ±4),P=0.016].There was a significant correlation between Cys-C concentration and APACHEII score in the acute kidney injury group (P <0.01).The 28-day mortality was significantly greater in the acute than in the no acute kidney injury group.The areas under the ROC curve for Cys-C and β2MG concentrations were 0.909 ( OR =1.006,95% CI =1.002 - 1.009) and 0.82 ( OR =1.001,95% CI =1.000 -1.001),respectively.ConclusionsMonitoring of Cys-C and β2MG concentrations can effectively predict the occurrence of acute kidney injury in septic patients.Cys-C concentration is a more accurate predictor of this diagnosis than β2MG concentration.An increasing Cys-C concentration is an indicator of poor prognosis.
2.Acoustic Evaluation of Three Vocal Fold Diseases in Pre - and Post - Laryngeal Microsurgery
Journal of Audiology and Speech Pathology 1998;0(03):-
Objective To evaluate acoustic effects of laryngeal microsurgery on vocal polyp, vocal cyst and vocal leuko- plakia. Methods 300 cases in vocal fold diseases were measured acoustically pre - and post - microsurgery. Results After openation, jitter, shimmer and NNE decreased statistically in vocal polyp and vocal cyst patients, and did not improve in vocal leukoplakia patients. Whether or not the surgery was done, F0 of all patients did not change Conclusion Laryngeal microsurgery had definite effect on clearing benign focus. After surgery, vocal functioin improved in vocal polyp and cyst patients, and in vocal leukoplakia, there was no improvement in such a short time as one week.
3.The positive detection rate of cystatin C in patients with sepsis and its prognostic significance
Chinese Journal of Emergency Medicine 2012;21(8):858-862
ObjectiveThe difference of Cys-C ( serum cysteine proteinase inhibitor C) among sepsis group,systemic inflammatory response syndrome (SIRS) group,and non -SIRS group were explored in this study.The significance of mortality and the relationship between Cys-C and acute physiology and chronic health evaluation (APACHE)Ⅱ score were under discussed. Methods After excluding the individual whose survival less than 24 hours,two hundred and fifty patients sought medical care in the emergency department of Beijing Chaoyang Hospital of the Capital Medical University were selected as samples from October 2008 to October 2009.They were classified into three groups:SIRS group ( n =121 ),non-SIRS group (n =74) and sepsis group ( n =55 ).The serum Cys-C level and APACHE Ⅱ score were determined for each patient.The positive detection rate of Cys-C ( > 830 ng/ml) was calculated and then a 28-day mortality was recorded according to this study result.The positive detection rate and 28-day mortality were also compared with chi-square test.The prognostic values of Cys-C,APACHE Ⅱ score for the 28-daymortality were evaluated by logistic regression analysis.Results There was significant change observed between sepsis group and non-SIRS group (41.38% vs. 13.57%,P =0.007 ) for the positive detection rate of Cys-C,as well as that between SIRS group and non-SIRS group ( 32.79% vs. 13.57%,P =0.005).However,a contrary result was obtained when compared sepsis group with SIRS group (41.38% vs.32.79%,P =0.346) ).Significant difference was noticed in the 28-day mortality of the patients from sepsis group and SIRS group in comparison to those of non-SIRS group (41.6% vs. 17.2%,P < 0.01 ;36.91% vs. 17.2%,P < 0.05).Cys-C level in patient with sepsis indicated a positive correlation to APACHE Ⅱ score ( P <0.0001 ).ConclusionsThe positive rate of Cys-C in SIRS group and septic group were significantly higher than that of non-SIRS patients,and this is an index for poor prognosis in sepsis patients.
4.Analysis of the treatment result of total hip arthroplasty on the osteoarthritis secondary to developmental dysplasia hip
Ruiyu LIU ; Kunzheng WANG ; Chunsheng WANG
Orthopedic Journal of China 2006;0(21):-
[Objective]To explore the result of total hip arthroplasty(THA) performed in patients with osteoarthritis secondary to developmental dysplasia of the hip(DDH) and the degree of hip dysplasia on the treatment result. [Method]Forty-seven cases(55 hips) with osteoarthritis secondary to DDH were treated with THA.According to the classification of Crowe,23 hips were in classⅠ,19 in classⅡand 13 in class Ⅲ/Ⅳ.Before operation,the morphological changes of acetabula and femurs were evaluated with helical CT.During the operation,the acetabula were reconstructed at the level of real acetabula,the femoral canal was carefully enlarged and the small and straight femoral protheses were employed.The Harris hip score was conducted in each patients preoperatively and postoperatively.[Result]The Harris hip score in class Ⅰ,Ⅱand Ⅲ/Ⅳ were from 50.7?7.6,44.9?6.2 and 41.1?8.2 preoperative to 90.6?3.7,87.3?4.5 and 82.7?7.3 postoperative,respectively.There was significant difference between them(P
5.Effects of nutritional status in patients of systemic inflammatory response syndrome on its prognosis
Baolan YUAN ; Chunsheng LI ; Shuo WANG
Chinese Journal of General Practitioners 2011;10(9):645-649
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.
6.Influence of long cold ischemia preservation time on ultrastructural morphology of donor heart
Zhaohua YANG ; Tao HONG ; Chunsheng WANG
Fudan University Journal of Medical Sciences 2009;36(6):731-733
Objective To investigate the impacts of long cold ischemic preservation time on the ultrastructural changes of donor heart and to provide the data for expanding the heart donor pool. Methods Heart was obtained from brain dead donor and preserved in the the University of Wisconsin (UW) solution at 4℃. Cardiac tissues were harvested at different time points of cold ischemic preservation (6, 8, 10, 12, 14 h) and observed under electron miscroscope. Results Donor heart did not have significant pathologied and ultrastructural changes when cold ischemic preservation time was 6 h. After that, time related impairment of myocardia and endothelium of coronary artery was seen.When ischemic time was longer than 12 h, focal myocardial necrosis and complete loss of the endothelium were detected. Conclusions Myocardial ultrastructure is an important index to evaluate the donor heart quality. Heart, which underwent 10 h of cold ischemia preservation time, causes no significant irreversible and pathological ultrastructural changes, and could be used for heart transplantation. When ischemia time was over 10 h, the donor heart presented with irreversible change and was nolonger unsuitable for transplantation.
7.EGG Measurement of Unilateral Vocal Cord Paralysis
Chunsheng WEI ; Feng CHEN ; Wei WANG
Journal of Audiology and Speech Pathology 1998;0(03):-
To study the effect of unilateral vocal cord paralysis on vocal vibration, EGG parameters of 46 patients were analysed. EGG of most patients were abnormal, CQ decreasing while CI, CQP and CIP increasing. The incidence of normal EGG in patients whose vocal cord located in the middle was higher than that in the para - middle. Inversely, the incidence of abnormal EGG - CQ of the former was lower than that of the latter. EGG of the group in the intermediate was abnormal. The position of paralyzed vocal cord had no effect on CI,CQP and CIP. EGG reflects the characteristics of per vibratory cycle, and is a potential technique to study the irregular vocal vibration.
8.Effects of undiluted and diluted amiodarone on defibrillation and haemodynamics in a ventricular fibrillation pig model
Junyuan WU ; Chunsheng LI ; Shengqi WANG
Chinese Journal of Emergency Medicine 2010;19(10):1040-1044
Objective Amiodarone was diluted to release the side effect of hypotension in clinic, but this maybe unsuitable during cardiopulmonary resuscitation (CPR). This study was designed to observe the effects of undiluted amiodarone, diluted amiodarone, and CPR alone on ventricular fibrillation (VF) in a pig model. MethodsVF was induced in 21 pigs. The animals were randomly (random mumber) divided into 3 groups after VF 3 min.① CPR group ( n= 7): standard CPR; ② undiluted amiodarone group ( n= 7): undiluted amiodarone (5 mg/kg)bolus within 3 s, then 20 mL saline flush into the peripheral vein, CPR was started after observed 30 s; ③ diluted amiodarone group ( n = 7): amiodarone was dissolved in 20 mL saline and bolus with 30 s. Defibrillation was attempted at VF 5 min. Results The restoration of spontaneous circulation (ROSC) of CPR and undiluted amiodarone groups were higher than diluted group (85.7% vs. 71.4% vs. 42.9%), but the differences were not significant (all P >0.05). The defibrillation energy and timesof CPR group were higher than that of undiluted amiodarone (P= 0.009) and diluted group ( P = 0. 170). The mean arterial pressure of undiluted amiodarone were lower than diluted and CPR groups at ROSC 10 min (all P <0.05), but the differences of undiluted and diluted groups were not significant after ROSC 0.5 h. Conclusions In this study, undiluted amiodaronecan effectively reduced the defibrillation times and energy. Although diluted amiodaronecan release the side effect of hypotension which was transient, it didn't significantly improved cardiac electric activity and delayed to start CPR.
9.Activation-induced cell death in peripheral blood T-lymphocytes from patients with chronic hepatitis B
Chunsheng HOU ; Guiqiang WANG ; Shulan LU
Chinese Journal of Infectious Diseases 2001;0(03):-
Objective To study the activation induced cell death(AICD) in peripheral blood T lymphocytes(PBL T) from patients with chronic hepatitis B(CHB), and the role of AICD in the pathogenesis of chronic hepatitis B. Methods The PBL Ts of 14 patients were isolated with negative selection by magnetic beads, and cultured with or without anti CD3 mAb in the presence of PMA and ionomycin. The apoptosis of PBL T was observed by TUNEL staining and assessed by Flow Cytometry. Results In CHB patients, the apoptotic rate of PBL T activated with anti CD3 mAb was significantly higher than that of without activation (16.73%?0.99% vs. 9.74%?1.14%, P 0.05), and a negative correlation existed between the level of INF? and apoptotic rate of T cell( r =-0.87126, P
10.Effects of Electroglottography on Screening Vocal Fold Disorders
Chunsheng WEI ; Wei WANG ; Xiaoling CHEN
Journal of Audiology and Speech Pathology 1998;0(01):-
Objective To study the effects of Electroglottography(EGG) on screening vocal fold disorders.Methods 134 cases of glottal carcinoma and 167 benign vocal diseases and 62 healthy volunteers were measured. EGG waveform and variables were analyzed to investigate the sensitivity and specificity of EGG measurement.Results Compared with healthy people, the majority of EGG waveform and variables of vocal fold disorders were abnormal. The differences were significant statistically either between healthy people and vocal fold disorders or between benign vocal diseases and malignancy. In benign vocal diseases, the differences of EGG waveform and variables among vocal polyp and cyst and leukoplakia were insignificant statistically, and nor were the differences among various clinical T stages in glottal carcinoma.Conclusion EGG measurement is sensitive to screen vocal fold disorders, and is specific to distinguish benign and malignant diseases, but it couldn not be used to identify the types or clinical stage of the diseases.