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The effects of hydroxyethyl starch on renal function and blood coagulation of patients with acute pancreatitis

Bangyi LI ; Mei ZHANG ; Hongming ZHU ; Dandan ZHAO ; Yan YANG

The Journal of Practical Medicine.2014;(10):1626-1628,1629. doi:10.3969/j.issn.1006-5725.2014.10.037

Objective To evaluate the effects of hydroxyethyl starch (HES) on the renal function and blood coagulation of patients with acute pancreatitis (AP). Methods 151 patients with acute pancreatits were divided into treatment group (treated with HES, n=62) and control group (treated with crystalloid solutions, n =89). The two groups were compared by retrospective analysis of the indices such as serum creatinine (Scr), blood urea nitrogen (Bun), platelet count(Plt), prothrombin time activity (PTA), international normalized ratio (INR), activated partial thromboplastin time (APTT) and fibrinogen (FIB) before and after treatment. Results Before hospitalization, there were insignificant differences in respect of Scr and Bun in the two groups respectively. But at discharge, Scr and Bun in the treatment group were significantly increased (P<0.05), while Bun was significantly decreased 24 h right after infusion of crystalloid solutions in the control group (P<0.05). There were no differences between the two groups in terms of Scr and Bun. As for indices of coagulation, APTT in the treatment group was significantly increased after infusion of HES (P<0.05). The hospital stay in the treatment group was longer than the control group (P < 0.05). Conclusions HES may adversely affect renal function and intrinsic pathway of blood coagulation of patients with AP. Renal function and blood coagulation should be monitored when using HES.

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Effects of low T3 level on the severity of coronary artery lesions and prognosis

Minfu BAI ; Chuanyu GAO ; Chaokuan YANG ; Xianpei WANG

The Journal of Practical Medicine.2014;(7):1158-1160,1161. doi:10.3969/j.issn.1006-5725.2014.07.047

Objective To analyze the severity of coronary artery lesions and the prognosis in patients with low levels of free triiodothyronine (fT3)undergoing coronary angiography (CAG). Methods From August 2011 to August 2012, 600 consecutive suspected patients with coronary heart disease (CHD) who undergone CAG were selected. The patients were divided into two groups based on thyroid function prior to CAG:euthyroidism group (450 patients) and low T3 group (150 patients). All the patients underwent elective coronary angiography, then the severity of coronary artery lesions was assessed by the Gensini scores , and the patients were followed up for cardiovascular events. Results The incidence rate of CHD in low T3 group was significantly higher than that in euthyroidism group (P=0.01). Multiple variables logistic regression analysis showed that fT3 was a protective factor for CHD (OR = 0.351,P < 0.001); The severity of coronary artery lesions was greater in low T3 group than in euthyroidism group (P < 0.001). The mean duration of follow-up was (15.4 ± 3.6) months; the incidence of the composite end-point (death, non-fatal myocardial infarction and target vessel revascularization ) was significantly higher in low T3 group than in euthyroidism group (P=0.023). Conclusions Patients with a decreased T3 level has a higher incidence rate of CHD , an increase in the severity of coronary artery lesions , and a poorer prognosis.

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Pharmacodynamics of paclitaxel long-circulating thermo sensitive liposomes in Lewis tumor-bearing mice

Meibo LI ; Shengjiu GU ; Wenpeng ZHAO ; Kaimei ZHU

The Journal of Practical Medicine.2014;(14):2193-2195,2196. doi:10.3969/j.issn.1006-5725.2014.14.003

Objective To investigate the tumor inhibition effect of paclitaxel long-circulating thermo sensitive liposomes (PLTL) in mice bearing Lewis lung carcinoma cells. Methods A tumor-bearing mouse model was established, and the mice were randomly divided into five groups: control, heating, paclitaxel (PTX), paclitaxel thermo sensitive liposomes (PTL), and PLTL groups. The living status was observed in the mice. The volume and weight of the tumor were measured. The morphological changes in the tumor cells were observed f by HE staining and apoptosis of the tumor cells was determined by flow cytometry. Results The inhibition rate of tumor in PTX, PTL and PLTL groups was 48.87%, 57.22%and 78.87%, respectively. The apoptotic rate of tumor cell in PTX, PTL and PLTL groups was (42.7 ± 3 .8)%, (54.6 ± 2.9)%and (69.7 ± 5.0)%, respectively. Conclusions PLTL, as compared with PTX and PTL, has an evident thermo sensitive feature and increases the anticancer effect of paclitaxel remarkably in combination with local hyperthermia.

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Expression of high-risk HPV and ATM in human laryngeal squamous cell carcinoma and its clinical significance

Xiaofeng WANG ; Qiyi HE ; Jiajun HUANG ; Xuejun ZHOU

The Journal of Practical Medicine.2016;32(18):2974-2978. doi:10.3969/j.issn.1006-5725.2016.18.010

Objective To study the expression of human papillomavirus ( HPV) and ATM protein in laryngeal squamous cell carcinoma (LSCC), and discuss the correlation among the expression and its prognosis Method The expression of HPV16/18 mRNA was detected by PCR , and the expression of ATM proteins by immunohistochemical method in 63 LSCC specimens and 30 specimens of normal tissue adjacent to cancer. Results The positive expression rates of HPV16 /18 and ATM protein in LSCC group were 39.7% (25 /63) and 41. 3% (26 /63) respectively and those of HPV16 /18 and ATM protein in normal group were 9.5% ( 6/63 ) and 83.3% (25 /30) respectively. There was no correlation between the expression of ATM and HPV16/18 in LSCC. The accumulative 5-year survival rates of HPV16/18 positive group and HPV16/18 negative group in 63 patients were 69.8% and 52.6% respectively ,and there was no significant difference (P> 0.05. The accumulative 5-year survival rates of ATM positive group and ATM negative group in 63 patients were 65.4%and 45.9% respectively and there was no significant difference (P>0.05. Conclusion Both HPV16/18 and ATM are abnormally expressed in LSCC , but there is no correlation between the expression of HPV16/18 and ATM and the expression and its prognosis.

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Analysis of Correlated Factors Affecting Tumor Volume Doubling Time of Breast Cancer

Yan DING ; Qiaoying ZHU ; Min XUAN ; Ji DONG ; Pengxi WU ; Chunyan WU ; Xinmei ZHAO

The Journal of Practical Medicine.2016;32(18):2955-2958. doi:10.3969/j.issn.1006-5725.2016.18.004

Objective To measure volume of breast cancer , calculate tumor volume doubling time (TVDT), and analyze the correlated factors affecting TVDT using three-dimensional ultrasound (3D-US). Methods We applied 3D-US to measure the volume of breast cancer of BI-RADS-US 4A classified by conventional ultrasound. The breast cancer case scanned by 3D-US at least twice (the interval is 3 months at least) without any medical intervention were included in the study. We calculated TVDT according to the formula, and analyzed the affecting factors of TVDT using multiple linear regression. Results Sixty-nine cases were enrolled in the study. The TVDT of breast cancer were from 66 to 521 days , in an average of 185 ± 126 days and the median time of 164 days. We found that: ① there were no statistics significances in TVDT between different breast cancer pattern , smoothing border lines , speculated sign , hyperechoic halo , microcalcification and different rear echo (P > 0.05). ② TVDT of different age groups, lymph node metastasis, pathological grade and NPI score were significantly different (P < 0.05), while menstrual cycle, family history of breast cancer and molecular typing showed no difference (P > 0.05). ③ TVDT of patients with different expression of ER, PR and Ki-67, molecular typing showed statistically difference (P < 0.05), but there was no significant difference between different level of HER2 (P >0.05). ④ multi-factor analysis showed that the NPI score, lymph node metastasis, Ki-67 and molecular typing of breast cancer were relative factors in TVDT (P < 0.05). Conclusions The NPI score , lymph node metastasis , Ki-67 and molecular typing significantly correlate with TVDT of breast cancer. Triple-negative breast cancer in molecular typing has the fastest growth rate.

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Clinical study of leflunomide combined with clopidogrel in the treatment of IgA nephropathy

Haijian LI ; Genyang CHENG ; Jing XIAO ; Dong LIU ; Yafei TAO ; Hui LIU ; Zhanzheng ZHAO

The Journal of Practical Medicine.2016;32(19):3260-3263. doi:10.3969/j.issn.1006-5725.2016.19.040

Objective To investigate the efficacy and feasibility of combination of leflunomide and clopi-dogrel in the treatment of IgA nephropathy. Methods 84 patients with primary IgA nephropathy were randomly divided into four groups: Control group (group 1) received valsartan; test group (group 2) received valsartan +clopidogrel; group 3 received valsartan + leflunomide; group 4 received valsartan + clopidogrel + leflunomide. The level of 24 h urinary protein,serum creatinine, glomerular filtration rate and therapeutic efficacy, adverse reactions were detected and recorded during the 48 weeks follow-up. Results The 24 h urinary protein of 84 patients showed a downward trend during the course of treatment , but there were statistical differences between groups since 8 weeks after treatment (P < 0.05). The level of urine protein in group 3 and group 4 decreased significantly to 61.48% and 67.23% respectively in 48 weeks after treatment. At the end of the follow up , the serum creatinine levels in group 1 and group 2 significantly increased while the glomerular filtration rate de-creased obviously (P < 0.05). Conclusion The combination of leflunomide with clopidogrel could reduce the level of urinary proteins and slow renal function deterioration in the treatment of IgA nephropathy with less ad-verse reactions. This study provides a new idea for treatment of IgA nephropathy.

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Clinical value of inflammatory factors in sepsis

Yunshan LUO ; Yilin LIU ; Xiamei DENG ; Jian ZHANG ; Li LI

The Journal of Practical Medicine.2016;32(17):2861-2863. doi:10.3969/j.issn.1006-5725.2016.17.023

Objective To study the clinical value of sTREM-1, PCT, CRP in sepsis. Methods A prospective study was conducted and clinical data of related patients from January to October 2015 were collected. Thirty-nine cases of sepsis patients , 15 patients with SIRS and 12 normal controls were detected by ELISA then the prognostic value of sTREM-1, PCT, CRP was determined in sepsis. Results In sepsis and SIRS group, sTREM-1 and PCT level were significantly higher than those in control group (P < 0.05); CRP only in sepsis group and control group was statistically significant (P < 0.05). In sepsis group, sTREM-1,PCT and CRP were significantly higher than those in SIRS group (P < 0.05). The ROC curve analysis indicated that sTREM-1,PCT and CRP for SIRS and non SIRS area under the curve was 0.914,0.887 and 0.831 respectively. Conclusion sTREM-1 is a good indicator for early diagnosis of sepsis, and it has high sensitivity and specificity.

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Changes and significance of heart-type fatty acid-binding protein and N terminal probrain natriuretic peptide in sepsis patients with myocardium injury

Hongna QI ; Jianjun ZHANG ; Jiaqi HE ; Weizhan WANG ; Yaqin LI

The Journal of Practical Medicine.2016;32(17):2857-2860. doi:10.3969/j.issn.1006-5725.2016.17.022

Objective To investigate the clinical value of heart-type fatty acid-binding protein ( H-FABP) and N terminal probrain natriuretic peptide (NT-proBNP) in sepsis patients with myocardium injury. Methods 118 sepsis patients were included as survivor group (68 cases) and death group (50 cases) according to their prognosis outcome. 50 healthy people were selected as control group. Creatase, H-FABP, NT-proBNP, APACHEⅡscore and 28 day morbidity of control group and sepsis patients were assessed at 1 h, 6 h after admission by physical examination . Results At 1 h after admission , APACHEⅡscore , H-FABP and NT-proBNP level in sepsis patients were significantly higher than control group (P < 0.05); APACHEⅡscore, H-FABP, NT-proBNP and cTnI level at 6 h after admission were higher than that at 1 h (P < 0.05); APACHEⅡscore, H-FABP and NT-proBNP level in death group were higher than survivor group at 1, 6 h after admission (P < 0.05), cTnI level at 6 h after admission was higher in death group (P < 0.05). Futhermore, H-FABP, NT-proBNP and cTnI at 6 h after admission were positively correlated with each other (both P < 0.05). At 6 h after admission , H-FABP showed a better predictive value of 28-day mortality than NT-proBNP and APACHEⅡscore (P < 0.05). Conclusion H-FABP and NT-proBNP may suggest important significance in early diagnosis and prognosis prediction of sepsis patients with myocardium injury.

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The early diagnosis value of arterial blood gas analysis, neuron specific enolase and glial fibrillary acidic protein levels in brain injury of premature infant

Yanmei QIU ; Hongtao HOU ; Wei WANG ; Xiuchun YE ; Yuemei LI ; Suling MA

The Journal of Practical Medicine.2016;32(17):2847-2850. doi:10.3969/j.issn.1006-5725.2016.17.019

Objective To investigate the early diagnosis value of arterial blood gas analysis , neuron specific enolase and serum glial fibrillary acidic protein in brain injury of premature infant. Methods In the study, 95 premature infants admitted in our hospital were enrolled. 45 premature infants with brain injury were selected as experimental group. 50 premature infants without brain injury were selected as control group. All patients received arterial blood gas analysis , NSE and GFAP on the 1st day and 7th day after birth. Results There is statistically significant difference between the experimental group and the control group on the 1st day after birth in terms of pCO2, pH, BE and lactic acid (P<0.05). In experimental group, there is statistically significant difference between the 1st day and 7th day after birth in terms of pCO2, pH, BE and lactic acid (P < 0.05). The NSE and GFAP levels had statistically significant difference between the experimental group and the control group on the 1st day and 7th day after birth(P < 0.01); the NSE levels of experimental group had statistically significant difference between the 1st day and 7th day after birth (P < 0.05); The GFAP levels of experimental group had statistically significant difference between the 1st day and 7th day after birth (P < 0.01). Conclusion pCO2, NSE and GFAP levels are correlated with brain damage in premature infants in early stage. This could provide evidence of early diagnosis for brain injury in preterm infants.

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Relationship between polymorphism site rs5744168 of TLR5 and AAV

Linlin HE ; Chao XUE ; Yunhua LIAO ; Suzhen WEI ; Aimei GONG ; Yangfei LAI

The Journal of Practical Medicine.2016;32(17):2821-2825. doi:10.3969/j.issn.1006-5725.2016.17.012

Objective To investigate the relationship between putative rs5744168 of Toll-like receptors 5 (TLR5)and ANCA associated small vasculitis (AAV) in Guangxi Han nationality. Methods Polymorphism was analyzed by polymerase chain restricted fragments length polymorphism in 120 cases with AAV and 212 controls. Results (1)There were two genotypes of CC and CT in AAV group and control group. The frequencies distribution of CC and CT in 120 AAV patients were 82.50% and 17.50% respectively and the frequencies of allele C and T 91.25% and 8.75%,respectively. In controls,the genotypefrequencies of CC and CT were 88.68% and 11.3%, and frequencies of allele C and T 94.34% and 5.66%, respectively. No significant difference was found in either genotype distribution or allele frequencies between the patients and the controls ( P > 0 . 05 ) . ( 2 ) Significant reductions in the incidence of BUN, uric acid, quantitative test of 24 h urinary protein and erythrocyte sedimentation rate(ESR) were found in CC genotype (P < 0.05). (3) Binary regression model with a logit link function found total cholesterol was related with AAV. Conclusion The susceptibility of AAV in Guangxi Han population has nothing to do with the polymorphism of rs5744168.In AAV patients, polymorphism of rs5744168 may be associated with ESR, BUN, uric acid and quantitative test of 24 h urinary protein levels.

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