Objective: To observe the effect of Xuebijing Injection on the expression of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in patients with severe pneumonia. Methods: Totally 100 patients with severe pneumonia were randomly assigned to the conventional treatment group (n = 50) and Xuebijing treatment group (n = 50). Each group was given conventional treatment, while in the Xuebijing treatment group, Xuebijing Injection was additionally given for consecutive 7 d. Ten healthy people were chosen as normal control group. The changes of patients' body temperature, white blood cell count, C-reactive protein, arterial oxygenation, and oxygenation index in two groups were compared. The expression levels of IL-6 and TNF-α were detected by ELISA method at different time points. Results: In conventional treatment group and Xuebijing treatment group, the patients' body temperature, white blood cell count, C-reactive protein, arterial oxygenation, and oxygenation index were significantly improved after treatment (P < 0.01). Compared with conventional treatment group, in Xuebijing treatment group, these indicators were significantly improved after treatment (P < 0.05 or 0.01). Compared with normal control group, in conventional treatment group and Xuebijing treatment group, the expression levels of IL-6 and TNF-α were significantly higher. Compared with the conventional treatment group, in Xuebijing treatment group, the expression levels of IL-6 and TNF-α had no significant difference before the treatment. On days 3 and 7 after Xuebijing administration, the expression levels of IL-6 and TNF-α decreased than those before the treatment. The expression levels of IL-6 and TNF-α in Xuebijing treatment group significantly decreased than those in the conventional treatment group. Conclusion: Xuebijing Injection can reduce the levels of IL-6 and TNF-α in patients with severe pneumonia, thus this agent has certain auxiliary therapeutic effect in the treatment of patients with severe pneumonia.

BACKGROUNDCommunity-acquired pneumonia (CAP) remains one of the leading causes of death from infectious diseases around the world. Most severe CAP patients are admitted to the intensive care unit (ICU), and receive intense treatment. The present study aimed to evaluate the role of the pneumonia severity index (PSI), CURB-65, and sepsis score in the management of hospitalized CAP patients and explore the effect of ICU treatment on prognosis of severe cases.

METHODSA total of 675 CAP patients hospitalized in the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively investigated. The ability of different pneumonia severity scores to predict mortality was compared for effectiveness, while the risk factors associated with 30-day mortality rates and hospital length of stay (LOS) were evaluated. The effect of ICU treatment on the outcomes of severe CAP patients was also investigated.

RESULTSAll three scoring systems revealed that the mortality associated with the low-risk or intermediate-risk group was significantly lower than with the high-risk group. As the risk level increased, the frequency of ICU admission rose in tandem and LOS in the hospital was prolonged. The areas under the receiver operating characteristic curve in the prediction of mortality were 0.94, 0.91 and 0.89 for the PSI, CURB-65 and sepsis score, respectively. Compared with the corresponding control groups, the mortality was markedly increased in patients with a history of smoking, prior admission to ICU, respiratory failure, or co-morbidity of heart disease. The differences were also identified in LOS between control groups and patients with ICU treatment, heart, or cerebrovascular disease. Logistic regression analysis showed that age over 65 years, a history of smoking, and respiratory failure were closely related to mortality in the overall CAP cohort, whereas age, ICU admission, respiratory failure, and LOS at home between disease attack and hospital admission were identified as independent risk factors for mortality in the high-risk CAP sub-group. The 30-day mortality of patients who underwent ICU treatment on admission was also higher than for non-ICU treatment, but much lower than for those patients who took ICU treatment subsequent to the failure of non-ICU treatment.

CONCLUSIONSEach severity score system, CURB-65, sepsis severity score and especially PSI, was capable of effectively predicting CAP mortality. Delayed ICU admission was related to higher mortality rates in severe CAP patients.

Adult ; Aged ; China ; Community-Acquired Infections ; mortality ; pathology ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pneumonia ; mortality ; pathology ; Sepsis ; mortality ; pathology ; Severity of Illness Index

Rational nutritional support shall be based on nutritional screening and nutritional assessment.This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area.It is helpful for the early detection of problems in nutritional supports,nutrition management and the implementation of intervention measures,which will contribute a lot to improving the patient's poor clinical outcome.A total of three tertiary medical institutions were enrolled in this study.From October 2015 to June 2016,1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002 (NRS2002) for nutritional risk screening,including 8 cases who refused to participate,5 cases of same-day surgery and 5 cases of coma.A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk.Logistic regression analysis was performed with univariate analysis (P＜0.05),to investigate the incidence of nutritional risk and influencing factors.The incidence of nutritional risk was 26.35％ in the inpatients,25.90％ in male and 26.84％ in female,respectively.The single-factor analysis showed that the age ≥60,sleeping disorder,fasting,intraoperative bleeding,the surgery in recent month,digestive diseases,metabolic diseases and endocrine system diseases had significant effects on nutritional risk (P＜0.05).Having considered the above-mentioned factors as independent variables and nutritional risk (Y=1,N=0)as dependent variable,logistic regression analysis revealed that the age ≥60,fasting,sleeping disorders,the surgery in recent month and digestive diseases are hazardous factors for nutritional risk.Nutritional risk exists in hospitalized patients in central urban areas.Nutritional risk screening should be conducted for inpatients.Nutritional intervention programs should be formulated in consideration of those influencing factors,which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.

BACKGROUNDGenome-wide association studies for type 2 diabetes mellitus (T2DM) identified FTO gene as a locus conferring increased risk for common obesity in many populations with European ancestry. However, the involvement of FTO gene in obesity or T2DM related metabolic traits has not been consistently established in Chinese populations. The objective of this study was to investigate the association of FTO genetic polymorphisms with metabolic syndrome (MetS) in Han Chinese.

METHODSWe tested 41 FTO single nucleotide polymorphisms (SNPs) for association between FTO and MetS-related traits. There were a total of 236 unrelated subjects (108 cases and 128 controls), grouped according to the International Diabetes Federation (IDF) criteria.

RESULTSOf the 41 SNPs examined, only SNP rs8047395 exhibited statistical significance (P = 0.026) under a recessive model, after Bonferroni adjustment for multiple testing (OR 1.64, 95%CI 1.11-2.42; P = 0.014). The common distributions of this polymorphism among Chinese--with a minor allele frequency (MAF) of 36% in the control group versus 48% in the MetS group--greatly improved our test power in a relatively small sample size for an association study. Previously identified obesity- (or T2DM-) associated FTO SNPs were less common in Han Chinese and were not associated with MetS in this study. No significant associations were found between our FTO SNPs and any endophenotypes of MetS.

CONCLUSIONSA more common risk-conferring variant of FTO for MetS was identified in Han Chinese. Our study substantiated that genetic variations in FTO locus are involved in the pathogenesis of MetS.

Alpha-Ketoglutarate-Dependent Dioxygenase FTO ; Asian Continental Ancestry Group ; Female ; Genetic Predisposition to Disease ; genetics ; Genetic Variation ; genetics ; Genotype ; Haplotypes ; genetics ; Humans ; Male ; Metabolic Syndrome ; genetics ; Middle Aged ; Polymorphism, Single Nucleotide ; genetics ; Proteins ; genetics

[Objective] The aim of our study is to examine nodule prevalence in a population over 40 years old in order to explore the relation between prevalence of thyroid nodules and metabolic parameters.[Methods] A total of 1875 individuals who were over 40 years of age were received the questionnaire and underwent thyroid ultrasonography examinations.Height,weight,waist circumference,blood pressure were measured.Levels of fasting blood glucose,fasting serum insulin,glycated hemoglobin,blood lipids,thyroid stimulating hormone and free T4 were detected.Body mass index (BMI) and homeostasis model assessment-insulin resistance (HOMA-IR) were calculated.[Result] The study included a total of 1875 subjects (513 men and 1362 women).The age of subjects were between 41 and 113 years old,and the mean age was 57.4±7.1 years old.The prevalence of thyroid nodules was 51.2％,and the prevalence of thyroid nodules in women was significantly higher than that in men (53.4％ vs.45.2％,P=0.002).The prevalence of thyroid nodules was significantly higher in subjects with hypertriglyceridemia (59.2％ vs.49.5％,P=0.009) and hypertension (56.5％ vs.47.8％,P＜ 0.001).Result of multivariate binary logistic regression revealed that hypertension (OR=1.405,P=0.002),female sex (OR=1.490,P=0.001),older age (OR=1.028,P＜0.001),and hypertriglyceridemia (OR=1.589,P=0.005) were independent risk factors for thyroid nodules.The prevalence of thyroid nodules increased along with age,systolic blood pressure and serum triglyceride level.[Conclusion] The prevalence of thyroid nodules and metabolism-related diseases were high in population over 40 years old.After adjusted for age and sex,hypertriglyceridemia and hypertension were possible independent risk factors for thyroid nodules especially in women.In general,hypertriglyceridemia and hypertension might play an important role in the pathological process of thyroid nodules.

【Objective】Serum gamma-glutamyltransferase（GGT）has recently been implicated in the pathogenesis of atherosclerosis and coronary heart disease（CHD）. We aimed to evaluate the association between the serum GGT level and the 10-year risk score for CHD（Framingham Risk Score，FRS）in a Chinese population.【Methods】We conducted a population-based cross-sectional study in 9，544 Guangzhou residents aged 40 years and older. Participants were divided into four quartiles according to their GGT levels：Quartile 1 <15 U/L（n=2 407），Quartile 2 15~19.9 U/L（n=2 302）， Quartile 3 20~28.9 U/L（n=2 442），and Quartile 4 ≥29 U/L（n=2 393）. The multivariate logistic regression analysis was used to assess the incidence of intermediate and high risk of developing CHD at 10 years（FRS≥10%）in relation to each quartile increase of serum GGT level.【Results】The incidence of FRS≥10% increased with elevating serum GGT levels（P for trend<0.001）. Compared with the lowest quartile of serum GGT level ，the adjusted odds ratio in the highest quartile was 1.72（95% confidence interval 1.28 to 2.29）.【Conclusion】Serum GGT level is associated with the FRS for CHD ，and might be used as an adjuvant marker for identifying patients at increased risk of cardiovascular events and early intervention.