Objective To investigate and compare the clinical values of serum procalcitonin (PCT)and high sensitivity C-reac-tive protein (hs-CRP)levels for predicting the blood culture positivity in the patients with sepsis.Methods 132 adult patients with sepsis were enrolled in this study.Blood cultures were performed before the antibacterial therapy.The white blood cell (WBC) count,absolute neutrophil count(ANC),levels of PCT and hs-CRP were determined.The application value of PCT and hs-CRP for predicting the positive blood culture results were evaluated.Results The median serum PCT levels in the blood culture positive group and the blood culture negative group were 7.92 ng/mL and 0.95 ng/mL respectively,the difference had statistical signifi-cance(P <0.01).The receiver operating characteristic (ROC)curves showed that PCT had a higher predictive accuracy for blood culture positivity compared with hs-CRP,the area under the curve (AUC)was 0.810(P =0.001)and 0.690(P =0.274),respec-tively.The combined detection of PCT and hs-CRP for predicting the blood culture positive results was similar to the performance of PCT alone,AUC as 0.885 (P =0.001 ).The median cut point of PCT was 0.91 ng/mL,the sensitivity of PCT for predicting blood culture positivity was 90%.This sensitivity remained unchanged when PCT cut point was1.14ng/mL.Using the PCT cut points of 0.91 and 1.14 enabled reducing the submitted blood cultures by 51% and 56% respectively.Conclusion Compared with hs-CRP,serum PCT level could better predict the blood culture positivity in the patients with sepsis.

BACKGROUND:It is particularly important to establish an ideal animal model of pulmonary fibrosis to investigate the underlying pathogenesis and screen effective drugs to prevent and control pulmonary fibrosis. OBJECTIVE: To establish a modified scheme of establishing mouse models that can reflect pulmonary fibrosis formation in humans. METHODS: Fifty-six male C57BL/6 mice were randomly divided into two groups: A (a single large-dose injection) and B (multiple smal-dose injections). Mice in group A were subjected to a single intravenous injection of bleomycin 200 mg/kgviathe tail vein; and mice in group B received intravenous injections of bleomycin 50 mg/kg via the tail vein per week, totaly for 6 weeks. 

OBJECTIVETo investigate the mechanism underlying sodium butyrate (NaB)-induced apoptosis of a human colon cancer cell line HCT-116.

METHODSThe apoptosis of HCT-116 cells induced by NaB was confirmed by hoechst33342 staining and AnnexinV+ PI assay. The changes in the intracellular localization of stromal interaction molecule (STIM1) and Orai1 following NaB treatment were detected by immunofluorescence technique. Western blotting was used to investigate the protein expression levels of STIM1 and Orai1.

RESULTSNaB induced apoptosis and caused translocation and colocalization of STIM1 and Orai1 in HCT-116 cells.

CONCLUSIONThe apoptosis of human colon cancer cells induced by NaB is correlated to the redistribution of STIM1 and Orai1.

Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Butyrates ; pharmacology ; Calcium Channels ; metabolism ; HCT116 Cells ; Histone Deacetylase Inhibitors ; pharmacology ; Humans ; Membrane Proteins ; metabolism ; Neoplasm Proteins ; metabolism ; ORAI1 Protein ; Stromal Interaction Molecule 1

Objective: This study aimed to investigate the risk factors of post-contrast acute kidney injury (PAKI) and the usefulness of the Mehran score for predicting PAKI in patients who underwent contrast-enhanced abdominopelvic computed tomography (CE-APCT) in the emergency department (ED). Methods: This was a retrospective observational study. Patients who underwent CE-APCT and had a follow-up creatinine test within 72 hours in the period January to June, 2017, were enrolled for the study. PAKI is defined as a 25% or higher increase in the level of serum creatinine (sCr) within 72 hours after receiving contrast, or an increase in the level of sCr by 0.5 mg/dL. The odds ratio (OR) of risk factors and incidence of PAKI after CE-APCT were analyzed according to the Mehran risk group, and compared to expected incidence. Univariate and multivariate logistic regression analyses were performed for each risk factor. Results: A total of 1,718 patients were enrolled in the study. Of these, 203 patients (11.8%) developed PAKI, and 2 patients (0.1%) required dialysis. Hypotension (systolic blood pressure <80 mmHg) was determined to be statistically significant (P=0.029; OR, 3.181) among the considered risk factors of PAKI. In the group having abnormal estimatedglomerular filtration rate (<90 mL/min/1.73 m2), the age and rate of the underlying disease (congestive heart failure, hypertension) was found to be higher in the PAKI group. The receiver operating curve of Mehran score (area under the curve: 0.521 in model A, 0.520 in model B) was statistically not significant in the univariate analysis. A higher Mehran score was associated with a higher proportion of patients who underwent prophylactic treatment. Conclusion There are no definite useful risk factors, including the Mehran score, for predicting PAKI in patients who underwent contrast-enhanced computed tomography in the ED.

Objective: This study aimed to investigate the risk factors of post-contrast acute kidney injury (PAKI) and the usefulness of the Mehran score for predicting PAKI in patients who underwent contrast-enhanced abdominopelvic computed tomography (CE-APCT) in the emergency department (ED). Methods: This was a retrospective observational study. Patients who underwent CE-APCT and had a follow-up creatinine test within 72 hours in the period January to June, 2017, were enrolled for the study. PAKI is defined as a 25% or higher increase in the level of serum creatinine (sCr) within 72 hours after receiving contrast, or an increase in the level of sCr by 0.5 mg/dL. The odds ratio (OR) of risk factors and incidence of PAKI after CE-APCT were analyzed according to the Mehran risk group, and compared to expected incidence. Univariate and multivariate logistic regression analyses were performed for each risk factor. Results: A total of 1,718 patients were enrolled in the study. Of these, 203 patients (11.8%) developed PAKI, and 2 patients (0.1%) required dialysis. Hypotension (systolic blood pressure <80 mmHg) was determined to be statistically significant (P=0.029; OR, 3.181) among the considered risk factors of PAKI. In the group having abnormal estimatedglomerular filtration rate (<90 mL/min/1.73 m2), the age and rate of the underlying disease (congestive heart failure, hypertension) was found to be higher in the PAKI group. The receiver operating curve of Mehran score (area under the curve: 0.521 in model A, 0.520 in model B) was statistically not significant in the univariate analysis. A higher Mehran score was associated with a higher proportion of patients who underwent prophylactic treatment. Conclusion There are no definite useful risk factors, including the Mehran score, for predicting PAKI in patients who underwent contrast-enhanced computed tomography in the ED.

Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a costeffective model.

Purpose: This study investigated the characteristics and treatment outcomes of patients who visited the emergency department due to intoxication and analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on their visits. Methods: A retrospective study was conducted using data from the National Emergency Department Information System (NEDIS) on patients who visited the emergency department due to intoxication between January 2014 and December 2020. In total, 277,791 patients were included in the study, and their demographic and clinical data were analyzed. A model was created from 2014 to 2019 and applied to 2020 (i.e., during the COVID-19 pandemic) to conduct a time series analysis distinguishing between unexpected accidents and suicide/self-harm among patients who visited the emergency department. Results: The most common reason for visiting the emergency department was unintentional accidents (48.5%), followed by self-harm/suicide attempts (43.8%). Unexpected accident patients and self-harm/suicide patients showed statistically significant differences in terms of sex, age group, hospitalization rate, and mortality rate. The time series analysis showed a decrease in patients with unexpected accidents during the COVID-19 pandemic, but no change in patients with suicide/self-harm. Conclusion Depending on the intentionality of the intoxication, significant differences were found in the age group, the substance of intoxication, and the mortality rate. Therefore, future analyses of patients with intoxication should be stratified according to intentionality. In addition, the time series analysis of intentional self-harm/suicide did not show a decrease in 2010 in the number of patients, whereas a decrease was found for unintentional accidents.

Objective To explore the status quo of nursing practice of hemophilia-specialized nurses, to find out the shortcomings of current work and to provide the basis for promoting the development of hemophilia-specialized nursing in China. Methods The nursing staff attending the National Nursing Conference on Hemophilia in Shenzhen on November 7, 2015 were investigated with questionnaires. This investigation involved more than 40 hemophilia treatment centers nationwide. The nursing staff were required to fill out the Questionnaire for Hemophilia-Specialized Nurses developed by the Nursing Council, World Hemophilia Federation on the site, which were taken back once completed. Totally 54 questionnaires were handed out, and 43 valid questionnaires were taken back. Results Totally 55.8% of the nurses engaged in hemophilia nursing for less than 5 years, and 58.1% of them spent less than 10 hours on hemophilia nursing per week. And the number of hemophilia centers whose requirement for specialized nurses was a college degree accounted for 55.8%. The major nursing practice of China's hemophilia-specialized nurses included preliminary diagnosis-related content and self-injection training (>50%), and involved less specialized nursing practice, including consultancy, education, liaison, triage, physical examination, medication management, extended care, nursing research and clinical trial (20%-50%). The functions of management and medical advice accounted for<20%, and the least nursing practice was "school visit", accounting for only 4.7%. Merely 5 hemophilia centers carried out nursing practice items that accounted for over 50%. Nurses with different working years and education backgrounds were moderately correlated with the number of carried out nursing practice items. Conclusions The hemophilia-specialized nurses in China has an uneven level, and they need to expand the nursing work, do better in information registration and health education for hemophilia patients, improve the training proportion of family treatment, and meanwhile strengthen the publicity of hemophilia in elementary and middle schools.

PURPOSE: Among the survivors of a ST elevation myocardial infarction (STEMI), higher platelet volume indices (mean platelet volume, MPV; platelet distribution width, PDW) are associated with impaired reperfusion and ventricular dysfunction. This study examined the relationship between the platelet volume indices and 30-day mortality with STEMI patients who underwent primary percutaneous coronary intervention (PCI). METHODS: This retrospective cohort study included patients presenting to the emergency department with STEMI between January 2011 and May 2016. The platelet volume indices were measured serially, using an automatic hematology analyzer, from admission to 24 hours after admission. The prognostic value of MPV, PDW for the 30-day mortality was determined by Cox proportional hazards model analysis. RESULTS: A total of 608 STEMI patients, who underwent reperfusion, were enrolled in this study. According to the multivariable Cox proportional hazard model, higher MPV (hazard ratio [HR], 1.414; 95% confidence interval [CI], 1.024-1.953; p=0.035) and PDW (HR, 1.043; 95% CI, 1.006-1.083; p=0.024) values at time-24 (24 hours after admission) were significant risk factors for the 30-day mortality. A MPV value >8.6 fL (HR, 5.953; 95% CI, 2.973-11.918; p<0.001) and PDW value >56.1% (HR, 5.117; 95% CI, 2.640-9.918; p<0.001) at time-24 were associated with an increased risk of 30-day mortality. CONCLUSION: The platelet volume indices without an additional burden of cost or time, can be measured rapidly and simply. Higher MPV and PDW levels predict independently the 30-day mortality in patients with STEMI after PCI.
Blood Platelets* ; Cohort Studies ; Emergency Service, Hospital ; Hematology ; Humans ; Mean Platelet Volume ; Mortality* ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Platelet Activation ; Prognosis ; Proportional Hazards Models ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survivors ; Ventricular Dysfunction

Objective:To investigate dyslipidemia and relevant factors of AIDS patients in general hospital.Methods:From April 2017 to January 2018, 306 AIDS patients seen in Peking Union Medical College Hospital (PUMCH) were included, their general information such as demographic characteristics, underlying diseases, regimens for treatment and duration of antiretroviral therapy were recorded and dietary conditions were evaluated. General Self-Efficacy Scale (GSES), Social Support Rating Scale (SSRS), Internal Physical Activity Questionnaire (IPAQ) were adopted for the investigation.Results:Of the 306 patients, 179 had dyslipidemia. Univariate analysis suggested that singlehood, higher age and body mass index (BMI), proteinase inhibitor (PI) and non-nucleotide reverse transcriptase inhibitor (NNRTI) contained antiretroviral therapy (ART) (especially the former) were relevant risk factors. After multivariable analysis, higher age and BMI, high fat diet, high baseline CD4 counting and longer course of disease were related with dyslipidemia, whereas female and higher activity level may be associated with little benefit.Conclusions:Dyslipidemia was more common in AIDS patients than in general population, which were mainly due to the disease itself and ART regimens. Those patients were middle-aged or older, with high baseline CD4 counting, treated with PI and whose course of disease was more than two years should reserve more attention.