1.Comparison of simplified acute physiology score Ⅲ and other scoring systems in prediction of 28-day ;prognosis in patients with severe sepsis
Chinese Critical Care Medicine 2015;(6):454-459
Objective To investigate the power of the simplified acute physiology score Ⅲ ( SAPSⅢ) for prediction of outcome for patients with severe sepsis admitted to the intensive care unit ( ICU ). Methods A retrospective study was conducted. 677 severe sepsis patients with age ≥ 18 years old and the survival time in emergency ICU≥24 hours admitted to the emergency ICU of Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2008 to December 2011 were enrolled. The acute physiology and chronic health evaluationⅡ ( APACHEⅡ), sequential organ failure assessment ( SOFA ), SAPSⅡ, SAPSⅢ, and mortality in emergency department sepsis ( MEDS ) scores were recorded based on the poorest value within 24 hours of ICU admission. The 28-day result as denoted as survival or death was considered as the end point of the study. The ability to predict mortality by the score systems was assessed by using receiver operating characteristic ( ROC ) curve analysis and binary logistic regression models. Results Among the 677 patients with severe sepsis, 284 cases died within 28 days after admission, and the mortality rate was 41.9%. Compared with survivors, the patients in non-survival group was older with higher APACHEⅡ, SOFA, SAPSⅡ, SAPSⅢ, and MEDS scores and higher ratio of underlying diseases, such as primary hypertension and renal dysfunction, and they had more organ injury, higher ratio of lung infection and bacterial infection ( P < 0.05 or P < 0.01 ). It was identified by logistic regression that the APACHEⅡ, SOFA, SAPSⅡ, SAPSⅢand MEDS scores were significantly independent factors in 28-day death prediction in patients with severe sepsis ( all P=0.000 ). The rank of areas under the ROC curve ( AUC ) from high to low were MEDS ( 0.970 ), APACHEⅡ( 0.893 ), SAPSⅢ ( 0.875 ), SOFA ( 0.871 ), and SAPSⅡ ( 0.860 ), respectively. SAPSⅢ score and APACHEⅡ, SOFA, SAPSⅡscores were found to have an equivalent capacity in predicting the prognosis ( all P>0.05 ). The MEDS score in predicting the prognosis was obviously better than that of APACHEⅡ, SOFA, SAPSⅡ, and SAPSⅢscores ( all P<0.05 ). The MEDS score showed the best sensitivity ( 91.5%), and specificity ( 89.1%). The 28-day mortality in cases of MEDS≥11 was 85.8%. Conclusions ①For patients with severe sepsis who were admitted to ICU, MEDS was superior to APACHEⅡ, SOFA, SAPSⅡ, and SAPSⅢscores in predicting prognosis. MEDS≥11 may indicate a higher mortality rate.②SAPSⅢscore has comparable predictive capability with APACHEⅡ, SOFA and SAPSⅡscores may be recommended for prediction of the prognosis of patients with severe sepsis in ICU. But the SAPSⅢscore is unsuitable for predicting the prognosis of patients with acute sepsis in ICU options, and it is not superior to that of SAPSⅢscore in predicting prognosis of patients with sepsis in the emergency ICU than other score systems.
2.Comparison of SAPS 3-PIRO score with other four scoring systems for assessing sepsis
Chinese Journal of Emergency Medicine 2015;24(1):55-61
Objective To investigate the feasibility of SAPS 3-PIRO score for prediction of outcomes in severe sepsis patients in the intensive care units (ICU).The optimal scoring system was also evaluated in this study.Methods Data of 677 patients with sepsis,treated in ICU of the emergency department at the Beijing Chaoyang Hospital between January 2008 and December 2011,were analyzed.The inclusion criteria were:age ≥18 years and the diagnostic criteria of severe sepsis and organ damage recommended by the International Sepsis Definitions Conference in Washington DC,USA in 2001,as well as the criteria developed by the Conference as a reference.The patients,who did not meet the criteria were excluded from the study.Age,gender,underlying disease,main infection site,and duration of ventilator support of all cases were recorded.Vital signs,hematological findings (gases,biochemistry,coagulation) and causative pathogens and organ damage on day-1 in the ICU were also recorded.According to the data of the most unfavorable findings in the ICU on day-1,scores got from APACHE Ⅱ,SOFA (sequential organ failure assessment),SAPS Ⅲ(simplified acute physiological score Ⅲ),SAPS 3-PIRO (predisposition,infection,response,organ failure/dysfunction) and MEDS (mortality in emergency department sepsis score) scoring systems were calculated.All patients were followed up for 28 days.The outcome of survival and death at 28 days were the endpoints of this study.SPSS V13.0 (SPSS,Chicago,IL,USA) was used to analyze data.Continuous variables with normal distribution were expressed as mean ± standard deviation.The independentsample t test was applied when normality (and homogeneity of variance) assumptions were fulfilled otherwise the t' test would be used.The distribution of categorical variables in two groups was tested using the x2 test.Binary logistic regression models were also used according to the survival status.The values of scoring system in predicting outcomes and the determination of dividing value in predicting death were analyzed using receiver operating characteristic (ROC) curves.The area under the receiver operating characteristic (AUROC) curves was compared using Z test.P values less than 0.05 were considered statistically significant.Results The total 28-day mortality was 41.9%.APACHE Ⅱ,SOFA,SAPS Ⅲ,SAPS 3-PIRO and MEDS scoring systems were used to find the independent predictive factors of death within 28 hours in patients with severe sepsis.By using ROC curve and AUROC curve to compare the validity of these scoring systems,SAPS 3-PIRO score had comparable predictive capability in comparison with APACHE Ⅱ,SOFA and SAPS Ⅲ scores,and MEDS was superior to SAPS 3-PIRO,APACHE Ⅱ,SOFA and SAPS Ⅲ score.Conclusions For patients with severe sepsis admitted in ICU,MEDS was superior to SAPS 3-PIRO,APACHE Ⅱ,SOFA and SAPS Ⅲ score in predicting prognosis.MEDS has favorable capability in predicting death within 28 days.MEDS ≥ 11 was the sign of increased mortality.SAPS 3-PIRO score has comparable predictive capability in comparison with APACHE Ⅱ,SOFA and SAPS Ⅲ score and it may be suggested for clinical practice.
3.Study on Mongolian Medicine Prescription Classification Method Based on Fuzzy C-means Algorithm
Chunsheng ZHANG ; Tuya BAO ; Yan LI
Chinese Journal of Information on Traditional Chinese Medicine 2017;24(8):99-103
Objective To classify Mongolian medicine prescription by using fuzzy c-means algorithm (FCM) and hard c-means algorithm (HCM); To explore the rationality of two kinds of clustering algorithm. Methods 27 Mongolian medicine prescriptions for treating Heiyi disease from Chuan Tong Meng Yao Yu Fang Ji were set as experimental data, and the data were preprocessed first. MS Visual Studio 2010 platform was used, and C# language was used for research and development. Chinese version and Mogolian version were implemented with WindowFrom and WPF technology, respectively. The medicine prescriptions were classified into 3, 4, 5, and 6 types by using FCM and HCM. Results All categorization with zero classification showed the existence of inclusion phenomena. The medicine in the classification results obtained by the two kinds of clustering algorithm did not exist cross. FCM could produce clustering results with smaller quantity difference and the more uniform classification compared with HCM. Conclusion The two algorithms are correct and reasonable, in which FCM algorithm has better clustering effect, and can be widely used in Mongolian prescription analysis, with a purpose to provide data supports for the research and development of new medicine.
4.The Associating Rules of Mongolian Medical Prescriptions Based on Reduced Binary Matrix
Chunsheng ZHANG ; Ya TU ; Yan LI
World Science and Technology-Modernization of Traditional Chinese Medicine 2017;19(2):365-369
The associating rules have been widely used in traditional Chinese medical (TCM) prescription data mining research work,while Mongolian medical prescription data mining work hardly carried out.In this study,Apriori algorithm based on reduced binary matrix was adopted for the data mining of Mongolian medical prescriptions with the provision of the decision support for research and development of new drugs.Twenty-seven Mongolian medical prescriptions for He Yi disease were involved in the data mining with Apriori algorithm based on reduced binary matrix.It was found that Aquilaria agallocha,Myristica fragrans,Zhen He Yi,or Aquilaria agallocha combined with Myristica fragrans,or Zhen He Yi combined with Myristica fragrans were determined as the Mongolian drugs frequently used in He Yi disease,with 80% confidence level and 60% support,and two algorithms were output,[Myristica fragrans-->Zhen He Yi,0.83] and [Aquilaria agallocha-->Myristica fragrans,1.00].In conclusion,some potential associating rules and drugs with high frequency in the Mongolian medical prescriptions can be fast mined using Apriori algorithm based on reduced binary matrix,providing a new way for unveiling the medication rules of Mongolian medical prescriptions.
5.Nano-hydroxyapatite is non-toxic to human umbilical cord vein endothelial cells
Guangcun CHENG ; Zhongya YAN ; Chunsheng LI ; Yu YAN ; Xiaoyong WEI
Chinese Journal of Tissue Engineering Research 2015;19(16):2534-2539
BACKGROUND:Pulsed laser deposition synthesis technology has been used to prepare new nano-hydroxyapatite thin film coating by colagen deposition on artificial mechanical heart valve. OBJECTIVE: To investigate the toxicity of new nano-hydroxyapatite thin film on human umbilical vein endothelial cels. METHODS: Human umbilical vein endothelial cels were cultured with nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, high-density polyethylene and phenol solution. Within 72 hours, cel growth was observed under the inverted phase contrast microscope. At 7 days after culture, cel proliferation and toxicity grading were detected using Cel Counting Kit-8. RESULTS AND CONCLUSION:At 24 hours after culture, cels grew wel, showed fusiform shape, and had strongrefraction in the nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, high-density polyethylene groups, and no significant differences in cel morphology and number were detected among above groups. Cels in the phenol solution group were suspended, round, pyknotic and dead. At 48 hours, except phenol solution group, cel number increased significantly, and cel grew densely in other three groups. At 72 hours, cels grew strongly, and the gap became smal obviously. Within 7 days after culture, cel proliferation activity was not significant in the nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, and high-density polyethylene groups, which was significantly higher than in the phenol solution group (P < 0.05). The toxicity of nano-hydroxyapatite film graded 0 to 1. These results suggested that nano-hydroxyapatite artificial mechanical heart valve has good histocompatibility, but no toxicity.
6.Nano-hydroxyapatite film as a support to improve the proliferation of human umbilical vein endothelial cells
Guangcun CHENG ; Zhongya YAN ; Chunsheng LI ; Yu YAN ; Xiaoyong WEI
Chinese Journal of Tissue Engineering Research 2015;(12):1852-1857
BACKGROUND:A new type of nano-hydroxyapatite artificial mechanical heart valve has been developed using pulsed laser deposition technology at the Department of Materials, Hefei University and Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, China. OBJECTIVE:To investigate the compatibility of nano-hydroxyapatite artificial mechanical heart valve with human umbilical vein endothelial cels. METHODS:Human umbilical vein endothelial cels were in vitroisolated, cultured and passaged to the 2-4 generations, and then the cel suspension was inoculated onto the nano-hydroxyapatite artificial mechanical heart valve. After 3, 7, 12 days of culture, the cel growth on the artificial mechanical heart valve was observed under scanning electron microscope. In addition, the human umbilical vein endothelial cels were respectively cultured in room-temperature and high-temperature extract liquids of nano-hydroxyapatite artificial mechanical heart valve, high-density polyethylene and phenol solution extracts for 72 hours, and then, the proliferation of cels was detected by MTT method. RESULTS AND CONCLUSION:Under the scanning electron microscope, the human umbilical vein endothelial cels were fusiform- or polygon-shaped with protuberances adhered to the artificial mechanical heart value at 3 days of culture; the cels were stretched thoroughly and fused at 7 days of culture; and the cels were confluent to pieces that tightly overlaid the heart valve surface and the extracelular matrix was formed localy at 21 days of culture. Results from MTT test displayed that the nano-hydroxyapatite artificial mechanical heart valve had no cytotoxicity to the human umbilical vein endothelial cels, indicating a good cytocompatibility.
7.Effect of fenugreek seeds on renal MMP-2 activity in diabetic rats
Chunsheng MIAO ; Yan SHI ; Xiaoyan YU ; Cai LI
Journal of Jilin University(Medicine Edition) 2006;0(01):-
Objective To explore the effect of boiled fenugreek seeds on renal matrix metalloproteinase-2(MMP-2) activity in diabetic rats.Methods The model of diabetes was built with STZ in rats.The model rats were randomly divided into diabetes control groups (DM ) (n=10) and fenugreek seeds groups(FN) (n=10,and while normal control group (N) (n=10)rats was used.Diabetic rats were treated with fenugreek seeds for 12 weeks,the renal morphology and MMP-2 activity were observed in three groups .Results After diabetic rats were treated with fenugreek seeds for 12 weeks,optical microscopic examination indicated that the glomerular structure in N group was normal,the glomerular lesions in rats of DM groups were seriously and the pathologic changes of glomerular in rats of FN groups were alleviated significantly.Immunohistochemical results showed that the Col Ⅳ expression in glomerular ECM was increased in DM group compared with N group,and was decreased in FN group.The activity of MMP-2 was increased in FN group (1.41?0.18) compared with DM group (1.05?0.19) (P
8.Effects of fluvastatin on proliferation and apoptosis of HL-60 cells
Liyan ZHAO ; Yan SHI ; Zhongshan WANG ; Chunsheng MIAO
Journal of Jilin University(Medicine Edition) 2006;0(02):-
Objective To observe the effects of fluvastatin on proliferation and apoptosis of HL-60 cells,and to offer the theoretical evidence for tumor treatment.Methods HL-60 cells were divided into:fluvastatin groups(0.5,5.0,10.0 and 20.0 ?mol?L-1),HL-60 control group,positive control group(treated with 10.0 ?mol?L-1ATRA).The live cell number was counted for cell proliferation assay.The growth inhibitory rate of HL-60 cells was detected using CCK-8 kit.The cell cycle distribution and apoptotic rate were measured using flow cytometry assay.Results Compared with control group,after HL-60 cells were treated with 0.5,5.0,10.0 and 20.0 ?mol?L-1of fluvastatin for 1-4 d,the number of live cells decreased in different level(P
9.Effects of different doses of propofol on traumatic brain injury in rats
Chunsheng WANG ; Jinhai MENG ; Fei LIU ; Yan WU
Chinese Journal of Anesthesiology 2014;(3):376-379
Objective To evaluate the effects of different doses of propofol on traumatic brain injury in rats .Methods Forty-eight healthy male Sprague-Dawley rats , aged 7-8 weeks , weighing 270-320 g , were randomly divided into 6 groups ( n=8 each ) using a random number table :sham operation group (group S ) , traumatic brain injury group (group I) ,fat emulsion group (group F) and low-dose propofol group (group L) , medium-dose propofol group (group M ) ,and high-dose propofol group (group H ) .Traumatic brain injury model was established according to the method described by Feeney .In group S ,0.9% normal saline was infused into the left femoral vein at 3.49 ml·kg-1 ·h-1 .In I ,F ,L ,M and H groups ,0.9% normal saline ,20% fat emulsion 3.49 ml·kg-1 ·h-1 ,and propofol 17.46 ,34.92 and 69.84 mg·kg-1 ·h-1 were infused into the left femoral vein ,respectively .Blood samples were collected from the right common carotid artery at 15 and 60 min of infusion (T1-2 ) for determination of serum S100β protein concentrations . The rats were then sacrificed after collecting blood samples at T2 and brains were removed for microscopic examination of the pathological changes of the cerebral cortex (light microscope ) and ultrastructure of neurons in the cerebral cortex (transmission electron microscope) .Results The serum S100β protein concentrations were significantly higher at T1 ,2 in the other five groups than in group S ( P<0.05 ) .Compared with I and F groups ,the serum S100βprotein concentrations were significantly decreased at T1 ,2 in L ,M and H groups ( P<0.05) .Compared with group L ,the serum S100βprotein concentrations were significantly decreased at T2 in M and H groups , and the serum S100β protein concentrations were increased at T1 in H group ( P< 0.05 ) . The serum S100β protein concentrations were significantly higher at T1 ,2 in H group than in group M ( P<0.05 ) .Light microscopic examination showed that nucleus condensation , cell necrosis , and cell edema were significantly attenuated in L ,M , and H groups as compared with group I;normal neurons could be found in group M .Transmission electron microscopic examination showed that the severity of neuronal damage was significantly attenuated in L ,M ,and H groups as compared with group I .Conclusion Different doses of propofol can reduce traumatic brain injury in rats .
10.Optimization of the Extraction Technology of Bushen Huoxue Capsules by Central Composite Design-re-sponse Surface Method
Jia YIN ; Jian YIN ; Yan ZHU ; Bingqi XING ; Chunsheng FU
China Pharmacy 2016;27(16):2276-2278
OBJECTIVE:To optimize the extraction technology of Bushen huoxue capsules. METHODS:Central composite de-sign-response surface method was used to optimize the extraction technology with the amount of water and boiling time as main fac-tors using normalized value of the contents of icariin and salvianolic acid B,the yield of dry extract as index. Validation test was al-so conducted. RESULTS:The optimal extraction technology was as follows as 15-fold water,reflux extracting for 75 min,extract-ing for 2 times. The deviation of measured value and predicted value was 0.000 3% in validation test. CONCLUSIONS:The cen-tral composite design-response surface method can be used to optimize the extraction technology of Bushen huoxue capsules with good prediction,and the technology is simple and stable.