1.Cerebrospinal fluid interferon-gamma in the diagnosis of tuberculous meningitis
Chinese Journal of Infection and Chemotherapy 2014;(5):429-431
Objective To evaluate the clinical utility of interferon-gamma (IFN-γ) in serum and cerebrospinal fluid in the diagnosis of tuberculous meningitis .Methods IFN-γlevels in serum and cerebrospinal fluid were analyzed by ELISA method in 25 patients with tuberculous meningitis ,31 patients with viral meningitis and 12 patients with suppurative meningitis .Results The IFN-γlevels in cerebrospinal fluid were significantly higher in the patients with tuberculous meningitis (386 .3 ± 83 .5) ng/L than in the patients with viral meningitis (63 .4 ± 16 .2) ng/L or the patients with suppurative meningitis (116 .8 ± 22 .6) ng/L (P<0 .01) .The overlap was very small .In contrast ,the serum IFN-γ levels were very similar among the three groups (P>0 .05) .The sensitivity ,specificity and accuracy of IFN-γ level in cerebrospinal fluid for diagnosis of tuberculous meningitis were 92 .0% ,95 .3% and 94 .1% ,respectively .Conclusions Measurement of IFN-γlevel in cerebrospinal fluid may be helpful for the diagnosis of tuberculous meningitis .
2.Clinical value of systemic vascular resistance index combined with procalcitonin in the early diagnosis of sepsis
Tingqiu WEI ; Shuwang WEI ; Hongkun HUANG ; Yuxiu WEI ; Lingling XIE ; Zhanhong TANG ; Jieyan LAN ; Zhangxu WEI
Chinese Critical Care Medicine 2016;28(10):921-926
Objective To assess the clinical value of systemic vascular resistance index (SVRI) combined with serum procalcitonin (PCT) and sequential organ failure assessment (SOFA) score in the early diagnosis of sepsis. Methods A retrospective study was conducted. The data of critical patients admitted to Department of Critical Care Medicine of the Third People's Hospital of Hechi from November 2013 to April 2016 were enrolled. The clinical data were recorded as follows: gender, age, infection site, SOFA score, serum PCT level (enzyme linked fluorescence analysis) within 1 hour after intensive care unit (ICU) admission, hemodynamics parameters, including mean arterial pressure (MAP), central venous pressure (CVP), cardiac index (CI), SVRI, global end diastolic volume index (GEDVI), extravascular lung water index (EVLWI), which were monitored by pulse indicator continuous cardiac output (PiCCO) after ICU admission. The patients were divided into sepsis and non-sepsis groups according to the diagnostic criteria of sepsis. Septic patients were divided into low SVRI group, normal SVRI group, and high SVRI group according to SVRI normal value (170-240 kPa·s·L-1·m-2), and the differences in parameters among the three groups were compared. The correlations between SVRI and various parameters were analyzed by using Pearson correlation analysis. The receiver operating characteristic curve (ROC) was plotted to evaluate the diagnostic efficiency of each parameter. Results Totally 103 critical patients were enrolled, 55 in sepsis group, and 48 in non-sepsis group. Compared with non-sepsis group, SVRI in septic group was significantly lowered (kPa·s·L-1·m-2: 146.56±45.17 vs. 188.04±56.27), and serum PCT was significantly increased (μg/L: 10.43±6.17比0.32±0.11) with statistically significant differences (both P < 0.05). In 55 sepsis patients, there were 21 in low SVRI group, 19 in normal SVRI group, and 15 in high SVRI group. There were no statistically significant differences in gender, age and infection site among the three groups, indicating that the baseline data among all groups was balanced with comparability. SOFA score, PCT, and CI in the low SVRI group were significantly higher than those of normal SVRI and high SVRI groups [SOFA: 10.57±2.89 vs. 5.73±2.28, 5.73±2.15, PCT (μg/L): 24.15±12.43 vs. 7.18±5.05, 7.39±4.38, CI (mL·s-1·m-2): 71.01±9.67 vs. 62.01±8.34, 62.51±8.67, all P < 0.05], but no significant difference was found between the normal SVRI group and high SVRI group. There was no statistically significant difference in MAP, CVP, EVLWI, and GEDVI among the three groups. It was shown by Pearson correlation analysis that SVRI was negatively correlated with PCT, SOFA score, and CI (r value was -0.622, -0.598, -0.398, all P = 0.000). It was shown by ROC curve that area under ROC curve (AUC) of PCT combined with SVRI for diagnosis of sepsis was higher than that of PCT or SVRI alone (0.943 vs. 0.911, 0.884). When the cut-off value of PCT was 3.79 μg/L, and cut-off value of SVRI was 156.81 kPa·s·L-1·m-2, the sensitivity and specificity were 94.6% and 92.3% respectively. Conclusions For sepsis patients, SVRI is related to PCT and SOFA score. Combined monitoring of PCT, SVRI, SOFA score can accurately reflect the severity of sepsis patients, guide diagnosis and treatment, and estimate prognosis. The efficacy of PCT combined with SVRI in the early diagnosis of sepsis is better than that of the two alone.
3.Quantitative model for patchouli alcohol in Pogostemon cablin by near-infrared spectroscopy.
Jialiang CAI ; Nianxin GUO ; Jieyan HUANG ; Leilei LI ; Shengguo JI
China Journal of Chinese Materia Medica 2012;37(14):2113-2116
OBJECTIVETo establish a near-infrared spectroscopy quantitative model for rapid determination of the patchouli alcohol content in Pogostemon cablin.
METHODThe gas chromatography was adopted for determining the content of patchouli alcohol content in 102 batches of P. cablin samples. Their near-infrared spectrograms were collected and preprocessed by standard normal variate and the first derivative of Savitsky-Golay. The quantitative model of patchouli alcohol content was established by the partial least squares regression analysis.
RESULTAccording to the correction model established in this study, the root-mean-square error of calibration, the root-mean-square error of prediction and the root-mean-square error of cross-validation of the calibration model for Patchouli alcohol were 0.991 10, 0.012 9, 0.012 8 and 0.033 15, respectively.
CONCLUSIONThe near-infrared spectroscopy quantitative model established in this study is stable, accurate and reliable for the rapid determination of the content of patchouli alcohol in P. cablin.
Chromatography, Gas ; methods ; Lamiaceae ; chemistry ; Sesquiterpenes ; analysis ; Spectroscopy, Near-Infrared ; methods
4.Prevalence, risk factors, and survival associated with pulmonary hypertension and heart failure among patients with underlying coronary artery disease: a national prospective, multicenter registry study in China.
Li HUANG ; Lingpin PANG ; Qing GU ; Tao YANG ; Wen LI ; Ruilin QUAN ; Weiqing SU ; Weifeng WU ; Fangming TANG ; Xiulong ZHU ; Jieyan SHEN ; Jingzhi SUN ; Guangliang SHAN ; Changming XIONG ; Shian HUANG ; Jianguo HE
Chinese Medical Journal 2022;135(15):1837-1845
BACKGROUND:
Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the prevalence, risk factors, and survival in CAD-associated HF (CAD-HF) complicated with PH.
METHODS:
Symptomatic CAD-HF patients were continuously enrolled in this prospective, multicenter registry study. Echocardiography, coronary arteriography, left and right heart catheterization (RHC), and other baseline clinical data were recorded. Patients were followed up and their survival was recorded.
RESULTS:
One hundred and eighty-two CAD-HF patients were enrolled, including 142 with HF with a preserved ejection fraction (heart failure with preserved ejection fraction [HFpEF]; left ventricular ejection fraction [LVEF] ≥50%) and 40 with a reduced ejection fraction (heart failure with reduced ejection fraction [HFrEF]; LVEF < 50%). PH was diagnosed with RHC in 77.5% of patients. Patients with PH showed worse hemodynamic parameters and higher mortality. HFrEF-PH patients had worse survival than HFpEF-PH patients. CAD-HF patients with an enlarged left ventricular end-diastolic diameter and reduced hemoglobin were at higher risk of PH. Nitrate treatment reduced the risk of PH. Elevated creatinine and mean pulmonary arterial pressure (mPAP), diastolic pressure gradient (DPG) ≥7 mmHg, and previous myocardial infarction (MI) entailed a higher risk of mortality in CAD-HF patients with PH.
CONCLUSIONS:
PH is common in CAD-HF and worsens the hemodynamics and survival in these patients. Left ventricle enlargement and anemia increase the risk of PH in CAD-HF. Patients may benefit from nitrate medications. Renal impairment, elevated mPAP, DPG ≥7 mmHg, and previous MI are strong predictors of mortality in CAD-HF-PH patients.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT02164526.
Coronary Artery Disease/epidemiology*
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Creatinine
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Heart Failure/complications*
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Humans
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Hypertension, Pulmonary/complications*
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Nitrates
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Prevalence
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Prognosis
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Prospective Studies
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Registries
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Risk Factors
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Stroke Volume
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Ventricular Function, Left