1.Clinical value of serum endocan and procalcitonin in early diagnosis and prognosis evaluation of sepsis
Chinese Critical Care Medicine 2017;29(4):321-326
Objective To investigate the clinical value of serum endocan and procalcitonin (PCT) in early diagnosis and prognosis evaluation of sepsis.Methods The patients with systemic inflammatory response syndrome (SIRS,n = 26) and sepsis (n = 78) admitted to intensive care unit (ICU) of the Third Hospital of Hebei Medical University from December 2014 to December 2016 were enrolled. According to the severity of disease, the sepsis patients were divided into general sepsis group (n = 20), severe sepsis group (n = 24), and septic shock group (n = 34). The cases were divided into survival group (n = 55) and non-survival group (n = 23) according to 28-day mortality. The serum endocan, PCT, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and sequential organ failure assessment (SOFA) score were recorded when the patients were admitted into ICU. The differences in endocan, PCT, APACHE Ⅱ, SOFA score between SIRS and sepsis groups and within sepsis subgroups were compared. Spearman correlation analysis was used to analyze the correlation between the indexes of sepsis patients. Receiver operation characteristic curve (ROC) was used to evaluate the value of endocan and PCT for the diagnosis and prognosis of sepsis.Results ① Serum endocan, PCT, APACHE Ⅱ, SOFA score and 28-day mortality in the sepsis group were significantly higher than those in the SIRS group [endocan (μg/L): 4.28 (10.64) vs. 1.03 (0.69), PCT (μg/L): 3.94 (10.75) vs. 0.43 (0.39), APACHE Ⅱ:18.81±9.17 vs. 9.35±3.78, SOFA: 9.00 (7.20) vs. 4.50 (1.50), 28-day mortality: 29.49% vs. 11.54%, allP < 0.01]. The area under the ROC curve (AUC) of endocan, PCT, APACHE Ⅱ, SOFA score for sepsis diagnosis were 0.887, 0.842, 0.822, 0.835, respectively. When the cut-off value of endocan was 1.26μg/L, the sepsis diagnostic sensitivity was 87.2% and specificity was 81.8%. When the cut-off value of PCT was 0.75μg/L, the sepsis diagnostic sensitivity was 85.9% and specificity was 81.8%. ② With the severity of the disease increased, the index showed an increasing trend in patients with sepsis. Serum endocan, PCT, APACHE Ⅱ, SOFA score and 28-day mortality in septic shock group were significantly higher than those in severe sepsis group or general sepsis group [endocan (μg/L): 13.02 (6.70) vs. 3.33 (3.05), 1.60 (0.98); PCT (μg/L): 8.10 (17.68) vs. 5.47 (8.92), 1.57 (2.78); APACHE Ⅱ: 25.00 (9.50) vs. 18.00 (9.00), 9.50 (5.75); SOFA: 13.00 (4.50) vs. 8.00 (3.00), 5.00 (3.50); 28-day mortality: 52.94% vs. 20.83%, 0%; allP < 0.01]. There was a significantly positive correlation between endocan, PCT, APACHE Ⅱ, SOFA, indicating that the endocan and PCT can be used to assess the severity of sepsis. ③ Serum endocan, PCT, APACHE Ⅱ and SOFA score in non-survival group were significantly higher than those in the survival group [endocan (μg/L): 15.05 (9.23) vs. 2.32 (4.81), PCT (μg/L):18.40 (16.99) vs. 3.10 (6.67), APACHE Ⅱ: 28.13±7.56 vs. 14.91±6.64, SOFA: 14.70±3.65 vs. 7.38±3.26, allP < 0.01]. The AUC of endocan, PCT, APACHE Ⅱ, SOFA score for the prediction of non-survival sepsis were 0.915, 0.763, 0.899, 0.930. When the cut-off value of endocan was 4.37μg/L, the septic death prediction sensitivity was 95.7% and specificity was 70.9%. When the cut-off value of PCT was 7.68μg/L, the septic death prediction sensitivity was 65.2% and specificity was 78.2%.Conclusions Serum endocan is more clinically valuable than PCT in early diagnosis and prognosis assessment of sepsis.
2.Using CT density-difference postprocessing in early diagnosis of acute middle cerebral artery occlusion
Chinese Journal of Neurology 2001;0(03):-
Objective To examine the feasibility by applying the CT density-difference postprocessing in early diagnosis of middle cerebral artery (MCA) occlusion. Methods The possible MCA occlusion patients were scanned with CT in early stage (within 3 hours) and divided into two groups randomly.Each group included 50 samples and one was processed technologically by CT density-difference and the other one was not.The two groups were scanned once more in 24 hours later and the data being processed by statistical method. Results The results showed that the accurate diagnosis rates were 14.3% within 60 minutes,93.3% from 60 to 119 minutes and 100% from 120 to 180 minutes .In comparing these two groups,there appeared no significant differences in the situation within 60 minutes and there was found significant difference in the other two situations. Conclusion Applying the technology of CT density-difference postprocessing,the middle cerebral artery (MCA) occlusion in early stage might be diagnosed.
3.Preventing Of Post-operrational Acute Pulmonary Embolism
Shimin ZHAO ; Xiaomin JIANG ; Xianguang WANG
Journal of Medical Research 2006;0(12):-
Objective To analysis and conclude the problem of preventing post-operational acute pulmonary embolism. Methods Data from 29 cases of post-operational acute pulmonary embolism,including primary disease ,high risk factors ,process of operation, the coming on of post-operational acute pulmonary embolism,and the problem of prevention . Results There is inadequate attention on the prevention of post-operational acute pulmonary embolism.Conclusions Failing of bring the prevention measures into effect is the reason of the high incidence rate and mortality rate of post-operational acute pulmonary embolism.
4.Study on the effect of mouse pregnancy immunological tolerance induced by oral antigen administration
Aimin ZHAO ; Qide LIN ; Shimin BAO
Chinese Journal of Obstetrics and Gynecology 2001;0(05):-
0 05) Conclusion The results suggested that pregnancy immunological tolerance can be induced efficiently and the ELR can be decreased significantly by oral administration of proper dosage antigens of OVA and TMA2
5.The clinical evaluation of gas exchange impairment in neonatal respiratory failure
Danhua WANG ; Weilin WAN ; Shimin ZHAO
Chinese Journal of Practical Pediatrics 2001;(3):159-161
Objective To study the clinical evaluation of gas exchange impairment in neonatal respiratory failure.Methods Blood gas, PaO2/PAO2, Qs/QT, PaO2/FiO2, A-aDO2 and RI of 53 newborn infants with respiratory failure in NICU of PUMCH from Jan. 1993 to Dec. 1997 were measured. Results These infants were divided into two groups according to PaO2/PAO2: moderate and severe respiratory failure. Qs/QT(11±3)%, PaO2/FiO2(183±113), A-aDO2(22.9±6.8)kPa, RI(2.5 ±0.8) in 21 neonates with moderate respiratory failure; Qs/QT(24±6)%, PaO2/FiO2 (82±30), A-aDO2 (49.3 ± 17.8)kPa,RI(7.6 ±3.4) in 32 neonates with severe respiratory failure(P<0.001). These results in respiratory failure caused by different pathogenesis were different. In meconium aspiration and pneumothorax group there were the highestQs/QT(32±3)% ,A-aDO2 (69.8 ± 12.2)kPa,RI(9.2 ±2.9)and the lowest PaO2/FiO2 (77±39). Mortality of infants with high pulmonary shunt was high. Qs/QT(17±8)% in 38 survives and (24±6)% in 10 died neonates( P<0.05). Conclusion The clinical evaluation using these indexes for newborn infants with respiratory failure is beneficial in recognizing pathogenesis,guiding therapy and evaluating prognosis.
6.Roles of regulator of G-protein signaling 5 in tumors
Chaofen ZHAO ; Lang HE ; Shimin WEN
Journal of International Oncology 2013;40(10):729-732
Regulator of G-protein signaling 5 (RGS5) belongs to RGS family,which can negatively regulate the conduction of this signaling pathway.RGS5 mainly expresses in vascular pericyte,and is closely related to the occurrence,development and maturation of the blood vessels.Loss of RGS5 results in pericyte maturation,tumor vascular normalization,and these changes can improve the curative effect combined with chemotherapy and immunotherapy,indicating that RGS5 may become a new target of anti-tumor treatment.In addition,RGS5 involves in tumor metastasis and apoptosis,which can improve antineoplastic effect by inducing tumor cells apoptosis.
7.Clinical and Laboratory Study on Low Birth Weight Infant Supplemented with Human Milk Protein
Wei ZHANG ; Shimin ZHAO ; Xinghua HUANG
Chinese Journal of Perinatal Medicine 1998;0(03):-
Objective To evaluate the effect of supplementation with human milk fortifier (HMF) produced by human milk protein in low birth weight infants.Methods Eighty seven low birth weight infants undergoing neonatal intensive care were divided into 4 groups randomly,human milk +HMF 9307(enriched protein 6 g/L)and human milk;formula +HMF 9308(enriched SIgA 500 mg/L)and formula.Results The weight gain was faster in human milk+HMF 9307 group than that of human milk group(13.8 g?kg~(-1)?d~(-1).vs.9.4 g?kg~(-1)?d~(-1),P
8.Study on Cerebral Oxygen Metabolism and Cerebral Blood Flow in Hypoxic Ischemic Encepholopathy Monitored by NIRS
Saying CHEN ; Shimin ZHAO ; Kaoru SAKATANI
Chinese Journal of Perinatal Medicine 2000;0(04):-
0.05 ) and Hb were elevated significantly( P
9.Treatment of Severe Meconium Aspiration Syndrome of Newborn Piglet by High Frequency Oscillatory Ventilation and Magnesium Sulphate
Fang LIU ; Shimin ZHAO ; Danhua WANG
Chinese Journal of Perinatal Medicine 1998;0(03):-
Objective To evaluate the effect of high frequency oscillation ventilation (HFOV) and HFOV+ MgSO 4 on oxygenation, pulmonary and systemic arterial pressure, histologic alterations, and serum magnesium concentration in severe meconium aspiration syndrome(MAS) piglets with persistent pulmonary hypertension(PPH). Methods Newborn piglets were randomized to HFOV group( n =6), HFOV+MgSO 4 group( n =7) and control group( n =5). Piglets of HFOV group and HFOV+MgSO 4 group received an intratracheal a 20% suspension of human meconium. All piglets were given HFOV, Piglet of HFOV+MgSO 4 group was given MgSO 4 intravenously simultaneously. Cardiopulmonary functions, blood gases were monitored and serum magnesium concentration of piglets in HFOV+MgSO 4 group were measured by atomic absorption spectrophotometric assay. Results (1) HFOV and HFOV+ MgSO 4 treatment showed improved oxygenation in MAS model, PaO 2,a/APO 2 increased significantly and A-aDO 2?,Qs/Qt decreased significantly in HFOV group at 30 minute ( P
10.Effects of Total Rhizoma Panacis Japonica Saponins on Injury and Antioxidase Activities in Rats Brain with Focal Cerebral Ischemia
Hui ZHAO ; Jia LI ; Nancen LIU ; Shimin NI
Traditional Chinese Drug Research & Clinical Pharmacology 2000;0(06):-
Objective To investigate the protective effects of total rhizoma panacis japonica saponins (tRPJS)on rat brains after focal cerebral ischemia injury, and to explore its protective mechanisms of tRPJS. Methods Focal cerebral ischemia in rats was produced by 24 h occlusion the right part of the middle cerebral artery(MCAO).The activities of glutathione peroxidase (GSH-PX), superoxide dismutase (SOD), catalase (CAT) and malondialdehyde (MDA)in ischemic tissue of brain as well as the brain pathological changes were analyzed. Results The activities of GSH-PX, SOD and CAT were lowered and the content of MDA was elevated in the model rats. Treatment with tRPJS 200, 100, 50 mg? kg-1 could significantly improve the activities of all the enzymes mentioned above and reduce the content of MDA in ischemic tissue of brain. Conclusion The tRPJS has protective effect against focal cerebral ischemic injury and this may be related to the increase of activities the GSH-PX, SOD and CAT and to the reduction of the lipid peroxidation.