1.The value of serum progranulin in the clinical diagnosis of adult sepsis patients
Zhimin ZHANG ; Daolong JIANG ; Jing WANG ; Lihua WANG
Chinese Journal of Postgraduates of Medicine 2021;44(4):307-312
Objective:To investigate the value of serum progranulin (PGRN)in the clinical diagnosis of adult sepsis patients.Methods:One hundred and eighty-seveninfection patients admitted to the intensive care unit(ICU) of Affiliated Dongfeng Hospital, Hubei University of Medicinewere divided into non-sepsis group(94 patients) and sepsis group (93 patients)according to the third international consensus definitions for sepsis and septic shock. Patients in the sepsis group were divided into two subgroups according to the degrees of infection: septic shock group (46 patients) and non-septic shock group (47 patients). The levels of serum PGRN, procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and lactic acid (Lac) were compared between the two groups and subgroups within 1 h into the ICU, as well as the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) and sequential organ failure assessment (SOFA) scores within 24 h into the ICU. Logistic regression model was used to analyze the relationship between PGRN and sepsis. The receiver operating characteristic (ROC) curve of the subject was drawn. The diagnostic value of PGRN in sepsis was evaluated and compared with PCT, CRP, IL-6, TNF-α and Lac.Results:The levels of PGRN, PCT, CRP, IL-6, TNF-α, Lac and APACHEⅡ, SOFA scores in the sepsis group were higher than those in the non-sepsis group: (129.25 ± 17.81) μg/L vs. (43.17 ± 7.68) μg/L, (5.92 ± 0.82) μg/L vs. (1.34 ± 0.17) μg/L, (64.07 ± 10.51) mg/L vs. (37.18 ± 5.44) mg/L, (111.68 ± 13.17) ng/L vs. (32.41 ± 5.61) ng/L, (86.06 ± 12.19) ng/L vs. (46.44 ± 7.63) ng/L, (2.96 ± 0.45) mmol/L vs. (1.47 ± 0.22) mmol/L, (23.62 ± 4.24) scores vs. (11.74 ± 2.07) scores, (14.84 ± 2.42) scores vs. (1.36 ± 0.23) scores, and the differences were statistically significant ( P<0.05). The levels of PGRN, PCT, CRP, IL-6, TNF-α, Lac in the septic shock group were higher than those in non-septic shock group:(143.29 ± 13.54) μg/L vs. (116.59 ± 10.73) μg/L, (7.64 ± 1.17) μg/L vs. (4.24 ± 0.59) μg/L, (74.49 ± 10.46) mg/L vs. (53.89 ± 8.41) mg/L, (124.48 ± 14.37) ng/L vs.(99.16 ± 13.61) ng/L, (95.91 ± 14.75) ng/L vs. (76.42 ± 11.24) ng/L, (3.52 ± 0.46) mmol/L vs. (2.45 ± 0.39) mmol/L, and the differences were statistically significant ( P<0.05). Logistic regression analysis showed that SODA scores and serum PGRN, PCT, CRP, IL-6, Lac levels were independent risk factors for sepsis ( P<0.05). The ROC curve analysis showed that the area under the curve (AUC) of PGRN was higher than that of CRP, IL-6, TNF-α and Lac for predicting the occurrence of sepsis in infection patients ( P<0.05). The AUC of PGRN was higher than that of CRP, IL-6, TNF-α and Lac for predicting the occurrence of septic shock in infection patients ( P<0.05). Conclusions:The levels of serum PGRN is a good biomarker for the diagnosis of sepsis and could reflect the severity. It has certain clinical value.
2.Methodological evaluation of rhCNB in long-tailed macaque sera detected by Enzyme-linked Immunosorbent Assay(ELISA)
Jiping SHAO ; Caiyun ZHANG ; Buwei HU ; Xueli XIE ; Shuhong TIAN ; Richao WANG ; Daolong HUANG ; Jian FU
Chinese Journal of Immunology 2016;32(4):528-531
Objective:To validate an enzyme linked immunosorbent assay (ELISA) method for the quantification of rhCNB in long-tailed macaque sera.Methods: The linear,sensitivity,accuracy,precision and recovery were determined using ELISA.Results:The present ELISA method had high linearity within 0.195 ng/ml-12.5 ng/ml,the working curve of rhCNB was Y=15.1X-0.26, R2=0.996 8 , the method showed good sensitivity of 0.195 ng/ml, the accuracy were in the range of 91.9%-108.8%, and the Coefficient of variation ( CV) for inter-assay were 3.55%,1.39%and 4.71%,the intra-assay were 1.59%,3.2%and 3.8%,all less than 10%, the recoveries were in the range of 88.5% -108.3%, <110% .Thus the method was coincidence with requirement.Conclusion:Double antibody sandwich ELISA assay of rhCNB in long-tailed macaque sera has good sensitivity ,accuracy, precision and recovery and it can be used to measure rhCNB concentration in biological samples .
3.Interview and treatment of a case with gender dysphoria
Sichuan Mental Health 2022;35(3):287-291
This paper interviewed a case of patient with gender dysphoria via a bio-psycho-social approach. The client, a 21-year-old college student of male sex, had been into female dressing since the age of ten. As an adult, he became increasingly convinced that he should become a woman and began taking hormone therapy in secret and on an irregular basis. He felt himself trapped in a cycle of anxiety and distress, due to the concerns about the side effects of hormone therapy, and the practical problems regarding the impact on his academic and career arrangements, as well as the ways to explain himself to his parents. Through a remote psychiatric consultation, therapists provided targeted interventions based on the bio-psycho-social model.
4.Similarities and differences in the diagnostic criteria of ICD-11 and DSM-5 for sexual dysfunction
Sichuan Mental Health 2022;35(1):70-76
The purpose of this paper is to compare the similarities and differences between the diagnostic criteria of sexual dysfunction in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and the International Classification of Diseases, eleventh edition (ICD-11). Sexual dysfunction is the inability of adults to experience various forms of satisfactory sexual performance. In this paper, the main diagnostic points of sexual dysfunction in both manuals are summarized and compared with a view to assisting psychiatric and psychological workers to acquire a better understanding of the corresponding sections.
5.Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for sleep-wake disorders
Sichuan Mental Health 2021;34(6):565-573
This paper aims to discuss the similarities and differences between the diagnostic criteria for sleep-wake disorders in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and International Classification of Diseases, eleventh edition (ICD-11). Sleep-wake disorders are characterized by the unsatisfactory quality, quantity and circadian rhythm of sleep, leading to daytime distress and impaired social functioning. Therefore, the main diagnostic points of sleep-wake disorders in both manuals are summarized and compared in this study, in order to assist psychiatric and psychological workers to acquire a better understanding of the corresponding sections.
6.Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for elimination disorders
Sichuan Mental Health 2021;34(5):480-483
The purpose of this paper is to discuss the similarities and differences between the diagnostic criteria of elimination disorders in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and International Classification of Diseases, eleventh edition (ICD-11). Elimination disorders are clinically characterized by inappropriate urination or defecation, resulting in pain or functional impairment. This paper discussed the main points of elimination disorders in the two diagnostic manuals, in order to improve psychiatric and psychological workers’ understanding of the corresponding sections.
7.Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for feeding and eating disorders
Sichuan Mental Health 2021;34(4):372-376
The purpose of this paper is to discuss the similarities and differences between the diagnostic criteria of feeding and eating disorders in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and International Classification of Diseases, eleventh edition (ICD-11). Feeding and eating disorders are clinically characterized by persistent disturbances in feeding or food-related behaviors that result in altered food consumption or absorption and significant impairment in physical health or social function. This paper discusses the similarities and differences of feeding and eating disorders in the two diagnostic manuals, in order to improve psychiatric and psychological workers’ understanding of the corresponding sections.
8.Similarities and differences between the diagnostic criteria of ICD-11 and DSM-5 for somatic symptoms and related disorders
Sichuan Mental Health 2021;34(1):83-86
The purpose of this paper is to compare the similarities and differences between the diagnostic criteria for somatic symptoms and related disorders in the International Classification of Diseases, eleventh edition (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). The clinical features of somatic symptoms and related disorders are prominent somatic symptoms that cause significant functional impairment and suffering. This paper discusses the similarities and differences between the two diagnostic systems in order to facilitate mastery of the corresponding content.
9.Interview and treatment of a case with body dysmorphic disorder
Gaofei LI ; Miao LI ; Daolong ZHANG
Sichuan Mental Health 2021;34(3):272-276
This paper reported a case of patient with body dysmorphic disorder in order to improve the clinical interview skills, diagnosis and treatment of clinicians in psychiatric department. The client was a 17-year-old unmarried male, came for psychological consultation because he was not satisfied with his appearance and had low self-esteem. After the changing of learning environment, the client showed excessive attention to his appearance along with low mood. The client was diagnosed with body dysmorphic disorder, and a biological-psychosocial comprehensive intervention was recommended. Sertraline combined with quetiapine was given as biotherapy to improve his mood and cognition. The psychotherapy included mindfulness-based stress reduction and cognitive behavioral therapy. These therapies helped the client learn to relax and correct cognitive biases. In terms of social resources, family members were encouraged to pay more attention to the client’s advantages, and schoolwork management on campus was strengthen. These methods promoted the development of client’s self-confidence.
10.Interview and treatment of idiopathic hypersomnia comorbidity tics disorder
Gaofei LI ; Miao LI ; Daolong ZHANG
Sichuan Mental Health 2021;34(2):172-176
The purpose of this paper is to present the diagnosis and treatment of idiopathic hypersomnia comorbidity tics disorder. The client is 15 years old, female, a senior student, with frequent blinking and a crooked mouth since childhood, diagnosed with tics disorder. She previously had consistently good academic performance. Since the COVID-19 epidemic in 2020, the client has been sleeping more, averaging 12 hours per day, accompanied by increased daytime sleep with fatigue after waking up, and a significant decline in her studies. She was diagnosed with idiopathic hypersomnia comorbidity persistent (chronic) movement or tic disorder. It was suggested that she adopt a method of comprehensive biopsychosocial intervention. Biotherapy with methylphenidate can improve her arousal, enhance attention and improve drowsiness, meanwhile, changes to tic symptoms must be monitored. Cognitive behavioral therapy was used to help the client correct cognitive biases, reshape cognitive structure, and establish confidence in rehabilitation. Mindfulness therapy was adopted to help the client adjust her emotions. In terms of social resources, the client was encouraged to explore resources actively, seek social support, and build therapeutic alliances. Through coordinating multiple resources, the client reduced symptoms of sleepiness and enhanced her adaptability to continue with her studies.