Serum cortisol and plasma ACTH were determined in 10 patients with severe sepsis and 12 with septic shock on day 1,3,5 after diagnosis were made,and the data were compared with 12 control patients. To evaluate the hypothalamic-pituitary-adrenal(HPA)axis function in patients with severe sepsis and septic shock,1?g ACTH stimulation test was applied after hormone concentrations were obtained on day 1.Compared with the control patients,ACTH level was significantly higher in patients with severe sepsis and lower in septic shock(P

Background:The platelet to lymphocyte ratio (PLR) has recently emerged as a potential inflammatory biomarker and has been shown to be significantly associated with atherosclerotic coronary artery disease (CAD).Therefore,we aimed to explore the association of PLR with in-hospital major adverse cardiovascular events (MACEs) and the severity of CAD assessed by the Gensini score (GS) in patients with acute myocardial infarction (AMI) undergoing coronary angiography.Methods:A total of 502 patients with AMI consecutively treated at the Affiliated Hospital of Qingdao University (Qingdao,China) and underwent coronary angiography from August 2017 to December 2018 were recruited in this study.The demographic,clinical,angiographic characteristics,and laboratory parameters were collected.According to the presence of in-hospital MACEs,the included patients were divided into the MACE group (n =81) and the non-MACE group (n =421).Further,according to tertiles of the GS,the patients were classified into three groups:the low GS group (GS ≤ 32 points,n =173),medium GS group (32 points ＜ GS ≤ 60 points,n =169),and high GS group (60 points ＜ GS ≤ 180 points,n =160).The main statistical methods included Chisquared test,non-parametric Mann-Whitney U test,Kruskal-Wallis H test,logistic regression,and receiver operating characteristic curves.Results:The PLR in the MACE group was significantly higher than that in the non-MACE group (179.43 [132.84,239.74] vs.116.11 [87.98,145.45],Z =-8.109,P ＜ 0.001).Further,there were significant differences in PLR among the tertiles of GS (110.05 [84.57,139.06] vs.119.78 [98.44,157.98] vs.140.00 [102.27,191.83],H=19.524,P ＜ 0.001).PLR was demonstrated to be an independent risk factor of in-hospital MACEs (odds ratio [OR]:1.012,95 ％ confidential interval [CI]:1.006-1.018,P ＜ 0.001) and severe CAD assessed by the GS (OR:1.004,95％ CI:1.002-1.009,P =0.042).The cutoff value of PLR for predicting the development of in-hospital MACEs was 151.28 with a sensitivity of 66.7％ and a specificity of 78.1％ (area under the curve [AUC]:0.786,95％ CI:0.730-0.842,P ＜ 0.001),and a PLR of 139.31 was also identified to be an effective cutoff point for detecting a high GS (＞60 points) with a sensitivity of 49.4％ and a specificity of 69.6％ (AUC:0.611,95％ CI:0.556-0.666,P ＜ 0.001).Conclusions:PLR as a novel inflammatory marker is significantly and independently associated with the occurrence of in-hospital MACEs and the severity of CAD assessed by the GS in patients with AMI.As an easily available and inexpensive inflammatory indicator,PLR could be widely used as an efficient inflammatory biomarker for identifying high-risk patients and for individualizing targeted therapy to improve the prognosis of AMI.

Adolescent ; Adult ; Ambulatory Surgical Procedures ; instrumentation ; methods ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Radio Waves ; Tonsillectomy ; instrumentation ; methods ; Young Adult

OBJECTIVETo explore the effect of Rhodiola on the expression of iNOS mRNA in severe acute pancreatitis (SAP) associated renal injury rats.

METHODSA total of 72 healthy rats were randomly divided into the sham-operated group (S), the SAP associated renal injury group (M), and the Rhodiola-treated group (RHO), 24 in each group. Rats in S and M groups were peritoneally injected with 10 mL/kg saline 3h before modeling, while rats in the RHO group were peritoneally injected with 10 mL/kg Rhodiola Injection 3 h before modeling. The peripheral ligament of pancreas was bluntly dissociated in rats of M and RHO groups. The head of pancreas was occlused by nontraumatic blood vessel forceps 3 h later to establish the model. Eight rats were randomly selected from each group at 12, 24, and 36 h after modeling to detect levels of serum amylase, creatinine, and blood urea nitrogen. Serum levels of interleukin 1β (IL-1β) and interleukin 10 (IL-10) were detected by enzyme-linked immunosorbent assay (ELISA). Pathological changes of the left kidney were observed under light microscope. The expression of inducible nitric oxide synthase (iNOS) mRNA in the right kidney was detected with real time polymerase chain reaction (RT-PCR).

RESULTSCompared with the S group, serum levels of amylase, creatinine (Cr), blood urea nitrogen (BUN), IL-1β, IL-10, and iNOS mRNA expression significantly increased in the M group (P < 0.01). The function of kidney and pancreas were obviously improved in the RHO group than in the M group. Levels of IL-1β and iNOS significantly decreased, but IL-10 levels significantly increased in the RHO group with statistical difference (P < 0.05).

CONCLUSIONRhodiola had better protective effect on SAP associated renal injury, which might be achieved through inhibiting the expression of IL-1β, stimulating the expression of IL-10, down-regulating iNOS mRNA expression, reducing the generation of oxygen free radicals and NO damage to cells, and improving hypoxia tolerance capabilities of the kidney.

Amylases ; Animals ; Blood Urea Nitrogen ; Creatinine ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Interleukin-1beta ; Kidney ; Nitric Oxide Synthase Type II ; genetics ; metabolism ; Pancreas ; Pancreatitis ; drug therapy ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Rhodiola

Objective To explore the experience of diagnosis and surgical treatment of carotid body tumor.Methods A retrospective analysis between November 2008 and November 2015 was proceeded,the clinical data of surgical treatment for 81 patients with carotid body tumor was collected,to analyze data by SPSS19.0,and summarize the diagnosis of carotid body tumor,choice of operation methods and curative effect and complications prevention.Results Seventy-four cases underwent surgery treatment:tumors of 52 cases were simply stripped,tumors of 13 cases were resected combined with ligation of external carotid artery.Tumors of 7 cases were resected with internal and external carotid artery ligation,3 cases of whom underwent artificial blood vessel internal carotid artery end to end anastomosis.Postoperative death in 1 case of acute myocardial infarction,complicated with cerebral infarction in 2 cases,6 cases of injury of cranial nerve relieved after symptomatic treatment.No hemiplegia,aphasia and other serious complications.Tumor size and the surgery time correlation analysis:the correlation coefficient was 0.226,no significant correlation.Conclusions CTA is the most commonly used method of preoperative examination.Surgical resection is an effective method in treatment of carotid body tumor.Prevention injury of carotid artery cr internal carotid or common carotid artery and their reconstruction is the key to a successful operation.Sufficient preoperative assessment,select the appropriate operation method,intraoperative careful performance can ensure the cerebral perfusion,is the key to prevent and reduce the complications.

Objective To understand the mental authorization status and job burnout for domestic nursesandanalyze the correlation between them, and to explore new strategies to prevent and reduce nurse job burnout.Methods There were 203 clinical nursesinvolved, who were chosen from 5 first-class leveltop first class hospitals in Guangzhou, using mental authorized scale and job burnout scale questionnaires made by ourselves to investigate the basic information, psychological empowerment and job burnout.Results Perception of nurses’ mental authorizationachieved (4.75 ±0.67) (the medium level), while self-efficacy acquired the highest score (5.34 ±0.73) compared work effectiongained the lowest one (3.64 ±0.11).The nurses had suffered severe burnout, which performed asloss of personal accomplishment dimension (3.83 ±0.62), emotional exhaustion dimension (2.96 ±0.81) and depersonalization tendency dimensions (1.89 ±0.84);nurses perceived psychological empowerment and job burnout had negative correlation with emotional exhaustion, depersonalization tendencies, personal accomplishment dimension ( r = -0.436, -0.366, 0.514, respectively;P<0.01).Working influence had less correlation with job burnout dimensions, especially with the dimension of depersonalization work and job burnout dimensions affect the correlation was not obvious, especially with the tendency to personify no correlation dimension (r=-0.094,P>0.05).Conclusions The mental authorizationof clinical nurses just acquires middle level;hence, clinical nursing managers should enhance nurse's mental authorizationto release job burnout.

A growing number of neuroimaging studies have revealed abnormal brain structural and functional alterations in subjects with internet addiction (IA), however, with conflicting conclusions. We plan to conduct a systematic review and meta-analysis on the studies of voxelbased morphometry (VBM) and resting-state functional connectivity (rsFC), to reach a consolidated conclusion and point out the future direction in this field. A comprehensive search of rsFC and VBM studies of IA will be conducted in the PubMed, Cochrane Library, and Web of Science databases to retrieve studies published from the inception dates to August 2021. If the extracted data are feasible, activation likelihood estimation and seed-based d mapping methods will be used to meta-analyze the brain structural and functional changes in IA patients. This study will hopefully reach a consolidated conclusion on the impact of IA on human brain or point out the future direction in this field.

OBJECTIVETo clarify the effect of aluminum exposure on the cognitive function in electrolytic workers and the prevalence of mild cognitive impairment (MCI) among them by prevalence survey, and to investigate its influential factors.

METHODSSixty-six retired workers from the electrolysis workshop of an electrolytic aluminum plant were selected as an aluminum exposure group, while 70 retired workers from a flour mill in the same region were selected as a control group. MCI patients were screened out by Mini-Mental State Examination (MMSE); the blood aluminum level was measured by inductively coupled plasma-mass spectrometry; multivariate statistical analysis was used to investigate the influential factors for MMSE scores and the correlation between blood aluminum level and MCI prevalence.

RESULTSThe aluminum exposure group showed a significantly higher blood aluminum level than the control group (25.18 ± 2.65 µg/L vs 9.97 ± 2.83 µg/L, P < 0.01). The total MMSE score of the aluminum exposure group (26.13 ± 2.57) was significantly lower than that of the control group (27.89 ± 1.91) (P < 0.05), particularly the scores on time and place orientation, short-term memory, calculation ability, and language skill (P < 0.05). The detection rate of MCI was significantly higher in the aluminum exposure group (18.2%) than in the control group (5.7%) (P < 0.01). The main influential factors for MMSE scores were gender, age, education level, and blood aluminum level. The logistic regression analysis indicated that the MCI prevalence was significantly correlated with blood aluminum level in the study population (OR = 1.168, P < 0.01).

CONCLUSIONLong-term exposure to aluminum can cause cognitive disorders in electrolytic workers and may be one of the risk factors for MCI. Advanced age, male, low education level, and high blood aluminum level may be high-risk factors for cognitive impairment.

Aged ; Aluminum ; adverse effects ; Case-Control Studies ; Cognition ; drug effects ; Cognition Disorders ; chemically induced ; epidemiology ; Electrolysis ; Female ; Humans ; Male ; Middle Aged ; Neuropsychological Tests ; Occupational Exposure

Objective To compare the clinical effect of nasal intubation with domestic video intubationscope and Macintosh direct laryngoscope. Methods One hundred patients scheduled for oro-maxillo-facial operation, American Society of Anesthesiologists (ASA) grade I or II, aged 19 ~ 67 years, were randomly divided into the domestic video intubationscope group (group V) and the Macintosh direct laryngoscope group (group M), with 50 cases in each group. Nasal intubation was respectively performed with domestic video intubationscope (Group V) and Macintosh direct laryngoscope (group M). Cormark-Lehane grade (C-L classification), tracheal intubation time, first-time intubation success rate and tracheal intubation complications were recorded.Mean arterial pressure (MAP) and heart rate (HR) of before induction of anesthesia (T0), after induction of anesthesia (T1), at glottic exposure (T2), at intubation (T3), 1 min after intubation (T4) and 3 min after intubation (T5) were recorded. Results C-L classification in group V was significantly lower than that in group M (P < 0.05), intubation time in group V was significantly shorter than that in group M (P < 0.05), first-time intubation success rate in group V was significantly higher than that in group M (P < 0.05). Compared with T1, MAP was significantly higher at T3~ T4and HR was significantly faster at T3in group V, MAP was significantly higher at T2~ T4and HR was significantly faster at T2~ T3in group M (P < 0.05). Compared with group M, MAP and HR in group V were significantly lower at T2~ T4 (P < 0.05). The incidence of tracheal intubation complications in group V was significantly lower than that in group M (P < 0.05). Conclusions Compared with Macintosh direct laryngoscope,domestic video intubationscope in nasal intubation is better in glottic exposure,it could shorten tracheal intubation time ,increase first-time intubation success rate, maintain stable hemodynamics, has fewer tracheal intubation complications and is worthy of clinical application.

Objective?To compare the clinical effects of domestic video intubationscope (VIS) versus fiberoptic bronchoscope (FOB) for difficult nasotracheal intubation.?Methods?60 ASA Ⅰ or Ⅱ elective patients with difficult airway, Mallampati class Ⅲ or Ⅳ, aged 22 ～ 68 years, weight 53 ～ 82 kg, were randomly divided into domestic video intubationscope group (group V) and fiber bronchoscope group (group F), 30 cases in each group. The nasotracheal intubation was respectively guided by VIS in group V and FOB in group F. Tracheal intubation time, success rate of tracheal intubation and complications of tracheal intubation were recorded. MAP, HR and SpO2 were recorded at before anesthesia induction (T0), after anesthesia induction (T1), at glottic exposure (T2), at intubation (T3).?Results?Compared with T0, MAP and HR were significantly decreased in both groups at T1(P < 0.05). MAP and HR were significantly increased in both groups at T3 than those at T1(P < 0.05), and there were no significant differences between the two groups (P > 0.05). SpO2 during tracheal intubation was no significantly reduced in both groups. The tracheal intubation time were respectively (76.0 ± 18.0) s and (80.0 ± 20.0) s in group V and group F, and the one-time success rate of intubation in group V and group F were respectively 96.7% and 93.3%, but there were no significant differences between the two groups (P > 0.05). There was no significant difference in the incidence of tracheal intubation complications between the two groups (P > 0.05).?Conclusions?Compared with FOB, difficult nasotracheal intubation guided by domestic VIS also is a safe and reliable, fast and effective method with high intubation success rate and less complications of tracheal intubation.