1.Significance of combined application of biomarkers in the diagnosis and prognosis assessment of patients with acute respiratory distress syndrome
Chinese Critical Care Medicine 2021;33(1):69-73
Objective:To explore the clinical significance of the combined detection of Clara cell secretory protein 16 (CC16) and soluble receptor for advanced glycation end product (sRAGE) in the diagnosis and prognosis of acute respiratory distress syndrome (ARDS).Methods:100 ARDS patients admitted to the intensive care unit (ICU) of Chu Hsien-I Memorial Hospital of Tianjin Medical University from July 2019 to September 2020 were enrolled as the ARDS group, and 100 non-ARDS patients admitted to the ICU during the same period were enrolled as the control group. The general information, vital signs, blood gas analysis, serum CC16 and sRAGE levels, duration of mechanical ventilation, length of ICU stay and prognosis during hospitalization were collected. The receiver operating characteristic (ROC) curve was drawn and the area under ROC curve (AUC) was calculated to evaluate the clinical value of CC16 and sRAGE lonely or combination in the diagnosis and prognosis of ARDS.Results:The duration of mechanical ventilation in the ARDS group was significantly longer than that in the non-ARDS group (days: 15.44±3.04 vs. 12.61±3.73, P < 0.01), and the hospitalization mortality was higher (38.0% vs. 9.0%, P < 0.01), but there was no significant difference in gender, age, body mass index (BMI), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or the length of ICU stay between the two groups. There were 62 ARDS patients survived and 38 ARDS patients died during hospitalization. The APACHEⅡ score of the death group was significantly higher than that of the survival group (23.55±2.83 vs. 19.40±4.10, P < 0.01), but there was no significant difference in age, BMI, oxygenation index, mean arterial pressure, duration of mechanical ventilation or the length of ICU stay between the two groups. The serum levels of CC16 and sRAGE in the ARDS group were significantly higher than those in the non-ARDS group [CC16 (mg/L): 38.78±14.70 vs. 21.87±2.45, sRAGE (pg/L): 2 470.95±288.70 vs. 2 013.22±131.15, both P < 0.01]; and the serum levels of CC16 and sRAGE of ARDS patients in the death group were significantly higher than those in the survival group [CC16 (mg/L): 42.02±10.81 vs. 30.52±9.47, sRAGE (pg/L): 2 638.34±324.07 vs. 2 279.91±163.70, both P < 0.01]. ROC curve showed that the AUC of CC16 and sRAGE in the diagnosis of ARDS alone were 0.859 [95% confidence interval (95% CI) was 0.808-0.911] and 0.821 (95% CI was 0.762-0.879), and the best cut-off values were 25.76 mg/L and 2 203.00 pg/L, respectively; the AUC of combined detection of CC16 and sRAGE was 0.932 (95% CI was 0.900-0.965) with the sensitivity of 89.0% and the specificity of 87.6%. The AUC of CC16 and sRAGE in predicting the death of patients with ARDS during hospitalization were 0.747 (95% CI was 0.651-0.843) and 0.819 (95% CI was 0.737-0.902), and the best cut-off values were 32.95 mg/L and 2 554.50 pg/L, respectively; the AUC of combined detection of CC16 and sRAGE was 0.900 (95% CI was 0.828-0.972) with the sensitivity of 88.7% and the specificity of 84.5%. Conclusions:Serum CC16 and sRAGE have clinical value for the diagnosis and prognosis of ARDS. The combined detection of them is superior to individual detection for early prediction of ARDS and prognosis.
2.Study Progress of Diagnosis and Treatment of Systemic Lupus Erythematosus in Children
Journal of Applied Clinical Pediatrics 2004;0(09):-
Systemic lupus erythematosus(SLE) is an autoimmune connective-tissue disorder with a wide range of clinical features.Although the clinical symptoms and immunological findings of pediatric SLE are similar to those of adult SLE patients,the pediatric SLE has some special aspects.In the recent years,although there was no abrupt development in the diagnosis and treatment of SLE,there were some new findings,maybe not mature.On the basis of recent findings outsides,this study drew attention to the advances in the novel clinical manifestation,update treatment of pediatric SLE.
3.Role and mechanisms of HMGB1 in respiratory diseases
Liucheng LI ; Jian GAO ; Jun LI
Chinese Pharmacological Bulletin 2015;(1):15-18
High-mobility group box 1 ( HMGB1 ) is a conserva-tive nuclear protein and plays an essential role in maintaining nu-cleosome stability, DNA recombination, replication, repair and transcription. It can be passively released by necrotic cells or ac-tively secreted into extracellular under appropriate stimulus. Re-cent studies show that the activation of HMGB1 signaling is closely related to the progress of lung diseases including lung in-jury, pulmonary fibrosis and lung cancer, while blocking HMGB1 signaling inhibits the pathological process, indicating the therapeutic potential of HMGB1 inhibition in treating these diseases. This review summarizes the role and mechanisms of HMGB1 in such diseases, in order to provide novel evidence for the diagnosis and treatment.
4.Risk Factors and Pathogens Distribution of Urinary Tract Infection in Patients with Spinal Cord Injury
Chinese Journal of Rehabilitation Theory and Practice 2017;23(4):420-423
Objective To analyze the risk factors and distribution of pathogenic bacteria of urinary tract infection (UTI) patients with spi-nal cord injury (SCI). Methods A total of 452 patients with SCI collected from December, 2015 to June, 2016 were retrospectively analyzed. Results 104 cases (23.1%) were diagnosed as UTI. 119 strains were identified, including 96 strains of Gram-negative bacteria (80.7%) and 22 strains of Gram-positive bacteria (19.3%). Female, invasive operation, depressed lower limb muscle strength, neurogenic bladder and pre-vention of antibacterial agents use were considered to be the main risk infection factors. The invasive operation included indwelling urethral catheterization, intermittent catheterization and other transurethral operation. The incidence rate of UTI in patients with SCI who also accept-ed indwelling catheter was 100.0%. Conclusion Gram-negative bacteria is the dominated pathogenic bacteria in SCI patients with UTI. It should be noticed the characteristics of pathogen, which both may have the high drug resistance rate and high separation rate, to select exact-ly antimicrobial agents to control the spread and drug resistance of pathogenic bacteria. In addition, patients with underlying diseases, inva-sive operation and lower strength should be monitored targeted.
6.Analysis and treatment of 13 histiocytic necrotizing lymphadenitis cases.
Hong-jun XU ; Ge GAO ; Li-feng AN
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2011;46(7):590-591
Adolescent
;
Adult
;
Female
;
Histiocytic Necrotizing Lymphadenitis
;
diagnosis
;
therapy
;
Humans
;
Lymph Nodes
;
Male
;
Middle Aged
;
Neck
;
Young Adult
9.Antiarrhythmic effect of TJ0711.
Xiao-Jing ZHANG ; Jun QIU ; Gao LI
Acta Pharmaceutica Sinica 2014;49(3):419-426
To study the antiarrhythmic effect of the newly developed alpha/beta-blocker TJ0711, a variety of animal models of arrhythmia were induced by CaCl2, ouabain and ischemia/reperfusion. Glass microelectrode technique was used to observe action potentials of right ventricular papillary muscle of guinea pig. The onset time of arrhythmia induced by CaCl2 was significantly prolonged by TJ0711 at 0.75, 1.5 and 3 mg x kg(-1) doses. TJ0711 (1.5 and 3 mg x kg(-1)) can significantly shorten the ventricular tachycardia (VT) and ventricular fibrillation (VF) duration, the incidence of VF and mortality were significantly reduced. On ischemia-reperfusion-induced arrhythmic model, TJ0711 (0.25, 0.5, 1 and 2 mg x kg(-1)) can significantly reduce the ventricular premature contraction (PVC), VT, VF incidence, mortality, arrhythmia score with a dose-dependent manner. At the same time, rats serum lactate dehydrogenase (LDH) and creatine kinase (CK) activities decreased significantly by TJ0711 (1 and 2 mg x kg(-1)). Ouabain could cause arrhythmia in guinea pigs, when TJ0711 (0.375, 0.75, 1.5 and 3 mg x kg(-1)) was given, the doses of ouabain inducing a variety of arrhythmia PVC, VT, VF, cardiac arrest (CA) were significantly increased with a dose-dependent manner. In the TJ0711 0.1-30 micromol x L(-1) concentration range, guinea pig right ventricular papillary muscle action potential RP (rest potential), APA (action potential amplitude) and V(max) (maximum velocity of depolarization) were not significantly affected. APD20, APD50 and APD90 had a shortening trend but no statistical difference with the increase of TJ0711 concentration. TJ0711 has antiarrhythmic effect on the sympathetic nerve excitement and myocardial cell high calcium animal arrhythmia model. Myocardial action potential zero phase conduction velocity and resting membrane potential were not inhibited by TJ0711. APD20, APD50 and APD90 were shortened by TJ0711 at high concentration. Its antiarrhythmic action mechanism may be besides the action of blocking beta1 receptor, may also have a strong selective blocking action on alpha1 receptor and reducing intracellular calcium concentration.
Action Potentials
;
drug effects
;
Adrenergic alpha-Antagonists
;
administration & dosage
;
pharmacology
;
Adrenergic beta-Antagonists
;
administration & dosage
;
pharmacology
;
Animals
;
Anti-Arrhythmia Agents
;
administration & dosage
;
pharmacology
;
Arrhythmias, Cardiac
;
blood
;
chemically induced
;
etiology
;
pathology
;
physiopathology
;
Calcium Chloride
;
Creatine Kinase
;
blood
;
Dose-Response Relationship, Drug
;
Female
;
Guinea Pigs
;
Heart Ventricles
;
cytology
;
Lactate Dehydrogenases
;
blood
;
Male
;
Myocardial Reperfusion Injury
;
complications
;
Myocytes, Cardiac
;
drug effects
;
physiology
;
Ouabain
;
Papillary Muscles
;
cytology
;
Phenoxypropanolamines
;
administration & dosage
;
pharmacology
;
Random Allocation
;
Rats
;
Rats, Sprague-Dawley