1.Prognostic value of difference of fluid intake and excretion in elderly patients with septic shock during hospitalization
Xiaozhou LI ; Qianqian YIN ; Guangkuo ZHAO
Chinese Journal of Emergency Medicine 2025;34(5):656-661
Objective:To evaluate the effect of difference of fluid intake and excretion on the prognosis of elderly patients with septic shock during hospitalization in ICU, and to provide evidence for clinical assessment of the condition, prognosis prediction, and optimization of fluid resuscitation strategies during hospitalization.Methods:A retrospective cohort study was conducted, involving elderly septic shock patients admitted to the ICU of Zhoupu Hospital affiliated to Shanghai Health College from January 2018 to June 2024. Data on general characteristics, clinical parameters at 6 h and 24 h after ICU admission, and cumulative difference of fluid intake and excretion during ICU stay were collected. Patients were divided into survival group and death group based on whether they survived during hospitalization. Differences in study variables between groups were analyzed. Logistic regression analysis was performed on the independent risk factors of the mortality rate during hospitalization. Receiver operating characteristic (ROC) was plotted to evaluate the prognostic value of difference of fluid intake and excretion in elderly patients with septic shock during hospitalization in ICU.Results:A total of 159 elderly septic shock patients were included (108 males, 51 females), with an in-hospital mortality rate of 66.66% (106 deaths vs. 53 survivors). Compared with the survival group, the difference of total fluid intake and excretion during hospitalization in ICU in the death group was significantly lower [2 441.00 (228.50, 5 101.50) mL vs. 6 215.50 (3 755.00, 9 874.75) mL, P<0.001]. Multivariate logistic regression analysis showed that SOFA score ( OR=1.359, 95% CI: 1.135-1.626, P=0.001) and the difference of total fluid intake and excretion during hospitalization in ICU ( OR=1.174, 95% CI: 1.067-1.291, P=0.001) were independent risk factors for predicting prognosis during hospitalization. ROC analysis revealed that the cumulative difference of fluid intake and excretion achieved an AUC of 0.756 (95% CI: 0.674-0.838, P<0.001), with a sensitivity of 61.8% and specificity of 82.4% at a cutoff value of ≥5 396.5 mL. In addition, AUC of the total fluid intake and excretion difference and SOFA score during hospitalization in ICU was 0.885 (95% CI: 0.825-0.944, P<0.001). Conclusions:A higher cumulative difference of fluid intake and excretion during ICU hospitalization is associated with increased mortality in elderly septic shock patients. A positive difference of fluid intake and excretion may serve as a clinical indicator for predicting prognosis of elderly patients with septic shock.
2.Clinical characteristics and genetic analysis of four patients with Disorders of sex development.
Xiuyan WANG ; Fanrong MENG ; Yunfang SHI ; Duan JU ; Xinghong ZHOU ; Haiwei DONG ; Xiaozhou LI
Chinese Journal of Medical Genetics 2025;42(9):1089-1095
OBJECTIVE:
To explore the clinical characteristics and genetic factors in four patients with Disorder of sex development (DSD).
METHODS:
Four patients who visited Tianjin Medical University General Hospital between January 2023 and January 2024, presenting with short stature, abnormal external genitalia, or infertility as their chief complaints, were selected as the study subjects. Clinical data were collected, and peripheral or umbilical cord blood samples were obtained for karyotyping analysis and low-depth whole-genome sequencing (CNV-seq). Quantitative fluorescence PCR (QF-PCR) was used to detect the sex-determining region Y (SRY) gene and azoospermia factor (AZF) on the Y chromosome, while fluorescence in situ hybridization (FISH) was employed to determine the location of the SRY gene. Whole exome sequencing (WES) was performed for genetic testing, and Sanger sequencing was used for familial validation of the candidate variants. The study procedure and protocol were approved by the Medical Ethics Committee of Tianjin Medical University General Hospital (Ethics No.: IRB2024-WZ-006).
RESULTS:
Case 1 had a karyotype of 45,X[22]/46,XY[8], with CNV-seq indicating a mosaic deletion of 7.44 Mb (copy number = 0.2) at Yp11.31-p11.2, a mosaic deletion of 5.32 Mb (copy number = 0.3) at Yq11.1-q11.221, and a deletion of 10.26 Mb (copy number = 0) at Yq11.221-q11.23. Y chromosome microdeletion analysis showed SRY and AZFa (+), AZFb+c (-). Case 2 had a karyotype of 45,X[12]/46,X,del(X)(q26.3)[18], with CNV-seq indicating a mosaic deletion of 132.62 Mb (copy number = 1.4) at Xp22.33-q26.3 and a deletion of 19.62 Mb (copy number = 1) at Xq26.3-q28. Case 3 had a karyotype of 46,XX, with CNV-seq showing two copies of the X chromosome and no Y chromosome. Y chromosome microdeletion analysis showed SRY (+) and AZFa+b+c (-), and FISH confirmed a translocation of the SRY gene to the terminal end of the short arm of the X chromosome. Case 4 had a karyotype of 46,XY, with CNV-seq showing one copy each of the X and Y chromosomes. Y chromosome microdeletion analysis showed SRY(+) and AZFa+b+c (+), and WES revealed a c.1103del variant in the AR gene (maternal origin), which was classified as a pathogenic variant based on the guidelines from the American College of Medical Genetics and Genomics (ACMG) (PVS1+PP1+PM2_Supporting).
CONCLUSION
The combined application of multiple detection techniques such as chromosomal karyotyping analysis, CNV-seq, QF-PCR, and WES can identify the genetic etiology of DSD patients, providing a basis for clinical consultation and treatment plan formulation.
Humans
;
Male
;
Female
;
Chromosomes, Human, Y/genetics*
;
Disorders of Sex Development/genetics*
;
Sex-Determining Region Y Protein/genetics*
;
Karyotyping
;
In Situ Hybridization, Fluorescence
;
Exome Sequencing
;
Adult
;
Child
3.Clinical characteristics and genetic analysis of four cases with disorder of sex development
Xiuyan WANG ; Fanrong MENG ; Yunfang SHI ; Duan JU ; Xinghong ZHOU ; Haiwei DONG ; Xiaozhou LI
Chinese Journal of Medical Genetics 2025;42(9):1089-1095
Objective:To explore the clinical characteristics and genetic factors in four patients with Disorder of sex development (DSD).Methods:Four patients who visited Tianjin Medical University General Hospital between January 2023 and January 2024, presenting with short stature, abnormal external genitalia, or infertility as their chief complaints, were selected as the study subjects. Clinical data were collected, and peripheral or umbilical cord blood samples were obtained for karyotyping analysis and low-depth whole-genome sequencing (CNV-seq). Quantitative fluorescence PCR (QF-PCR) was used to detect the sex-determining region Y ( SRY) gene and azoospermia factor ( AZF) on the Y chromosome, while fluorescence in situ hybridization (FISH) was employed to determine the location of the SRY gene. Whole exome sequencing (WES) was performed for genetic testing, and Sanger sequencing was used for familial validation of the candidate variants. The study procedure and protocol were approved by the Medical Ethics Committee of Tianjin Medical University General Hospital (Ethics No.: IRB2024-WZ-006). Results:Case 1 had a karyotype of 45, X[22]/46, XY[8], with CNV-seq indicating a mosaic deletion of 7.44 Mb (copy number = 0.2) at Yp11.31-p11.2, a mosaic deletion of 5.32 Mb (copy number = 0.3) at Yq11.1-q11.221, and a deletion of 10.26 Mb (copy number = 0) at Yq11.221-q11.23. Y chromosome microdeletion analysis showed SRY and AZFa (+ ), AZFb+ c (-). Case 2 had a karyotype of 45, X[12]/46, X, del(X)(q26.3)[18], with CNV-seq indicating a mosaic deletion of 132.62 Mb (copy number = 1.4) at Xp22.33-q26.3 and a deletion of 19.62 Mb (copy number = 1) at Xq26.3-q28. Case 3 had a karyotype of 46, XX, with CNV-seq showing two copies of the X chromosome and no Y chromosome. Y chromosome microdeletion analysis showed SRY (+ ) and AZFa+ b+ c (-), and FISH confirmed a translocation of the SRY gene to the terminal end of the short arm of the X chromosome. Case 4 had a karyotype of 46, XY, with CNV-seq showing one copy each of the X and Y chromosomes. Y chromosome microdeletion analysis showed SRY(+ ) and AZFa+ b+ c (+ ), and WES revealed a c. 1103del variant in the AR gene (maternal origin), which was classified as a pathogenic variant based on the guidelines from the American College of Medical Genetics and Genomics (ACMG) (PVS1+ PP1+ PM2_Supporting). Conclusion:The combined application of multiple detection techniques such as chromosomal karyotyping analysis, CNV-seq, QF-PCR, and WES can identify the genetic etiology of DSD patients, providing a basis for clinical consultation and treatment plan formulation.
4.Clinical characteristics and genetic analysis of four cases with disorder of sex development
Xiuyan WANG ; Fanrong MENG ; Yunfang SHI ; Duan JU ; Xinghong ZHOU ; Haiwei DONG ; Xiaozhou LI
Chinese Journal of Medical Genetics 2025;42(9):1089-1095
Objective:To explore the clinical characteristics and genetic factors in four patients with Disorder of sex development (DSD).Methods:Four patients who visited Tianjin Medical University General Hospital between January 2023 and January 2024, presenting with short stature, abnormal external genitalia, or infertility as their chief complaints, were selected as the study subjects. Clinical data were collected, and peripheral or umbilical cord blood samples were obtained for karyotyping analysis and low-depth whole-genome sequencing (CNV-seq). Quantitative fluorescence PCR (QF-PCR) was used to detect the sex-determining region Y ( SRY) gene and azoospermia factor ( AZF) on the Y chromosome, while fluorescence in situ hybridization (FISH) was employed to determine the location of the SRY gene. Whole exome sequencing (WES) was performed for genetic testing, and Sanger sequencing was used for familial validation of the candidate variants. The study procedure and protocol were approved by the Medical Ethics Committee of Tianjin Medical University General Hospital (Ethics No.: IRB2024-WZ-006). Results:Case 1 had a karyotype of 45, X[22]/46, XY[8], with CNV-seq indicating a mosaic deletion of 7.44 Mb (copy number = 0.2) at Yp11.31-p11.2, a mosaic deletion of 5.32 Mb (copy number = 0.3) at Yq11.1-q11.221, and a deletion of 10.26 Mb (copy number = 0) at Yq11.221-q11.23. Y chromosome microdeletion analysis showed SRY and AZFa (+ ), AZFb+ c (-). Case 2 had a karyotype of 45, X[12]/46, X, del(X)(q26.3)[18], with CNV-seq indicating a mosaic deletion of 132.62 Mb (copy number = 1.4) at Xp22.33-q26.3 and a deletion of 19.62 Mb (copy number = 1) at Xq26.3-q28. Case 3 had a karyotype of 46, XX, with CNV-seq showing two copies of the X chromosome and no Y chromosome. Y chromosome microdeletion analysis showed SRY (+ ) and AZFa+ b+ c (-), and FISH confirmed a translocation of the SRY gene to the terminal end of the short arm of the X chromosome. Case 4 had a karyotype of 46, XY, with CNV-seq showing one copy each of the X and Y chromosomes. Y chromosome microdeletion analysis showed SRY(+ ) and AZFa+ b+ c (+ ), and WES revealed a c. 1103del variant in the AR gene (maternal origin), which was classified as a pathogenic variant based on the guidelines from the American College of Medical Genetics and Genomics (ACMG) (PVS1+ PP1+ PM2_Supporting). Conclusion:The combined application of multiple detection techniques such as chromosomal karyotyping analysis, CNV-seq, QF-PCR, and WES can identify the genetic etiology of DSD patients, providing a basis for clinical consultation and treatment plan formulation.
5.Propensity matching study of robot-assisted intracorporeal versus extracorporeal orthotopic neobladder reconstruction
Bing YAN ; Yuan LIU ; Xiaozhou ZHOU ; Yang LIU ; Yuwei LI ; Xuemei LI ; Zhiwen CHEN
Chinese Journal of Urology 2024;45(12):893-898
Objective:To compare the surgical efficacy and perioperative complications of total intracorporeal neobladder (ICNB) and extracorporeal neobladder (ECNB) reconstruction during robot-assisted radical cystectomy.Methods:We retrospectively reviewed our single-institutional, prospectively collected database for consecutive patients who underwent RARC with an ileum neobladder from January 2017 to June 2022. A total of 265 patients were collected, 158 in ICNB group and 107 in ECNB group. The two groups were matched 1∶1 according to gender, age, BMI, ASA score, NAC, history of abdominal surgery and tumor characteristics using propensity score matching (PSM) method. After PSM, operating time, estimated blood loss and perioperative complications were compared between ICNB and ECNB group. A total of 186 patients were paired (93 patients in each group). There were 91 males and 2 females in ICNB group. The median age of ICNB group was 64(55, 68) years; median BMI was 23.54(22.39, 25.39) kg/m 2; There were 91 cases with Clinical stage ≤T 2 stage and 15 cases with ASA score ≥3; 25 cases received neoadjuvant chemotherapy. There were 91 males and 2 females in ECNB group. The median age of ECNB group was 63(52, 67) years; median BMI was 23.31(20.76, 24.80) kg/m 2; There were 90 cases with Clinical stage ≤T 2 stage and 8 cases with ASA score ≥3; 12 cases received neoadjuvant chemotherapy. In the ECNB group, after completing the radical cystectomy and pelvic lymph node dissection with robot assistance, the traditional lower abdominal incision was used to pull the intestinal tube outside the body to complete the preparation of the new bladder and then restore it to the pelvic cavity for anastomosing, while in the ICNB group, the reconstruction of the new bladder in situ was always completed in the body cavity with robot assistance. The operative time, intraoperative blood loss and perioperative complications were compared between the two groups. Results:The median operative time in ICNB and ECNB groups was 302(261, 350) min and 337(285, 397) min, respectively ( P=0.003); median intraoperative blood loss was 300(225, 500) ml and 500(300, 650) ml, respectively ( P<0.01); perioperative blood transfusion rates were 4.3%(4/93) and 14.0%(13/93), respectively ( P=0.022); all the differences between the 2 groups were statistically significant. 90-d overall complications rate was significant lower in ICNB group (38.7% vs. 61.3%, P=0.002). There was no difference in 90-d major complications (8.6% vs. 16.1%, P=0.119). On multivariate logistic regression analysis, operating time( OR=1.004, 95% CI 1.000-1.007, P=0.040), surgical approach (ICNB/ECNB)( OR=2.248, 95% CI 1.220-4.141, P=0.009) and age( OR=1.036, 95% CI 1.002-1.072, P=0.037) were associated with 90-day overall complications. Operating time( OR=1.036, 95% CI 1.002-1.072, P=0.037), neoadjuvant chemotherapy( OR=0.198, 95% CI 0.059-0.663, P=0.009) and ASA score( OR=0.167, 95% CI 0.044-0.634, P=0.009) were associated with 90-day high-grade complications. Conclusion:Intracorporeal neobladder during robot-assisted radical cystectomy is safe and feasible. Compared with ECNB, ICNB significantly improved perioperative outcomes such as shorter operating time, fewer estimated blood loss and perioperative complications.
6.Propensity matching study of robot-assisted intracorporeal versus extracorporeal orthotopic neobladder reconstruction
Bing YAN ; Yuan LIU ; Xiaozhou ZHOU ; Yang LIU ; Yuwei LI ; Xuemei LI ; Zhiwen CHEN
Chinese Journal of Urology 2024;45(12):893-898
Objective:To compare the surgical efficacy and perioperative complications of total intracorporeal neobladder (ICNB) and extracorporeal neobladder (ECNB) reconstruction during robot-assisted radical cystectomy.Methods:We retrospectively reviewed our single-institutional, prospectively collected database for consecutive patients who underwent RARC with an ileum neobladder from January 2017 to June 2022. A total of 265 patients were collected, 158 in ICNB group and 107 in ECNB group. The two groups were matched 1∶1 according to gender, age, BMI, ASA score, NAC, history of abdominal surgery and tumor characteristics using propensity score matching (PSM) method. After PSM, operating time, estimated blood loss and perioperative complications were compared between ICNB and ECNB group. A total of 186 patients were paired (93 patients in each group). There were 91 males and 2 females in ICNB group. The median age of ICNB group was 64(55, 68) years; median BMI was 23.54(22.39, 25.39) kg/m 2; There were 91 cases with Clinical stage ≤T 2 stage and 15 cases with ASA score ≥3; 25 cases received neoadjuvant chemotherapy. There were 91 males and 2 females in ECNB group. The median age of ECNB group was 63(52, 67) years; median BMI was 23.31(20.76, 24.80) kg/m 2; There were 90 cases with Clinical stage ≤T 2 stage and 8 cases with ASA score ≥3; 12 cases received neoadjuvant chemotherapy. In the ECNB group, after completing the radical cystectomy and pelvic lymph node dissection with robot assistance, the traditional lower abdominal incision was used to pull the intestinal tube outside the body to complete the preparation of the new bladder and then restore it to the pelvic cavity for anastomosing, while in the ICNB group, the reconstruction of the new bladder in situ was always completed in the body cavity with robot assistance. The operative time, intraoperative blood loss and perioperative complications were compared between the two groups. Results:The median operative time in ICNB and ECNB groups was 302(261, 350) min and 337(285, 397) min, respectively ( P=0.003); median intraoperative blood loss was 300(225, 500) ml and 500(300, 650) ml, respectively ( P<0.01); perioperative blood transfusion rates were 4.3%(4/93) and 14.0%(13/93), respectively ( P=0.022); all the differences between the 2 groups were statistically significant. 90-d overall complications rate was significant lower in ICNB group (38.7% vs. 61.3%, P=0.002). There was no difference in 90-d major complications (8.6% vs. 16.1%, P=0.119). On multivariate logistic regression analysis, operating time( OR=1.004, 95% CI 1.000-1.007, P=0.040), surgical approach (ICNB/ECNB)( OR=2.248, 95% CI 1.220-4.141, P=0.009) and age( OR=1.036, 95% CI 1.002-1.072, P=0.037) were associated with 90-day overall complications. Operating time( OR=1.036, 95% CI 1.002-1.072, P=0.037), neoadjuvant chemotherapy( OR=0.198, 95% CI 0.059-0.663, P=0.009) and ASA score( OR=0.167, 95% CI 0.044-0.634, P=0.009) were associated with 90-day high-grade complications. Conclusion:Intracorporeal neobladder during robot-assisted radical cystectomy is safe and feasible. Compared with ECNB, ICNB significantly improved perioperative outcomes such as shorter operating time, fewer estimated blood loss and perioperative complications.
7.Effect of Wenyang Huazhuo recipe on pregnancy outcomes in patients with unexplained recurrent spontaneous abortion
Yunhuan QIU ; Saihua MA ; Tiantian MA ; Yiran CHEN ; Baojuan WANG ; Rong DONG ; Xiaozhou LI ; Duan JU ; Tian XIA
Chinese Journal of Reproduction and Contraception 2024;44(4):347-352
Objective:To observe the effect of Wenyang Huazhuo recipe (WYHZ) on pregnancy outcomes in patients with unexplained recurrent spontaneous abortion (URSA).Methods:A retrospective cohort study was used and 240 cases of pregnancy URSA patients with spleen kidney yang deficiency syndrome at the Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and Department of Gynaecology and Obstetrics, General Hospital of Tianjin Medial University from November 2018 to March 2022 were recruited. The patients were assigned to WYHZ group (120 cases) and control group (120 cases) based on whether accepting oral WYHZ from 3 months before pregnancy to 8-12 weeks after pregnancy regularly. Pregnancy outcomes, perinatal period outcomes and obstetric complications were compared between the two groups. Multivariate logistic regression were used to analyze the effect of WYHZ on pregnancy outcome.Results:The live birth rate and the clinical pregnancy rate in WYHZ group [86.67% (104/120), 90.00% (108/120)] were higher than those in control group [71.67% (86/120), P=0.004; 75.00% (90/120), P=0.002]. The early abortion rate in WYHZ group [10.08% (12/119)] was lower than that in control group [25.86% (30/116), P=0.002], the differences were statistically significant. There were no significant differences in perinatal outcome and incidence rate of obstetric complications between the two groups (all P>0.05). Multivariate logistic regression analysis showed that the application of WYHZ significantly improved the live birth rate ( OR=8.818, 95% CI: 3.556-21.871, P<0.001) and sustained pregnancy rate ( OR=11.261, 95% CI: 4.262-29.751, P<0.001) in URSA patients. Conclusion:WYHZ using before and during pregnancy can significantly improve the live birth rate and the clinical pregnancy rate of URSA patients with syndrome of yang deficiency of spleen and kidney, and improve their pregnancy outcomes.
8.Effect of Wenyang Huazhuo recipe on pregnancy outcomes in patients with unexplained recurrent spontaneous abortion
Yunhuan QIU ; Saihua MA ; Tiantian MA ; Yiran CHEN ; Baojuan WANG ; Rong DONG ; Xiaozhou LI ; Duan JU ; Tian XIA
Chinese Journal of Reproduction and Contraception 2024;44(4):347-352
Objective:To observe the effect of Wenyang Huazhuo recipe (WYHZ) on pregnancy outcomes in patients with unexplained recurrent spontaneous abortion (URSA).Methods:A retrospective cohort study was used and 240 cases of pregnancy URSA patients with spleen kidney yang deficiency syndrome at the Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and Department of Gynaecology and Obstetrics, General Hospital of Tianjin Medial University from November 2018 to March 2022 were recruited. The patients were assigned to WYHZ group (120 cases) and control group (120 cases) based on whether accepting oral WYHZ from 3 months before pregnancy to 8-12 weeks after pregnancy regularly. Pregnancy outcomes, perinatal period outcomes and obstetric complications were compared between the two groups. Multivariate logistic regression were used to analyze the effect of WYHZ on pregnancy outcome.Results:The live birth rate and the clinical pregnancy rate in WYHZ group [86.67% (104/120), 90.00% (108/120)] were higher than those in control group [71.67% (86/120), P=0.004; 75.00% (90/120), P=0.002]. The early abortion rate in WYHZ group [10.08% (12/119)] was lower than that in control group [25.86% (30/116), P=0.002], the differences were statistically significant. There were no significant differences in perinatal outcome and incidence rate of obstetric complications between the two groups (all P>0.05). Multivariate logistic regression analysis showed that the application of WYHZ significantly improved the live birth rate ( OR=8.818, 95% CI: 3.556-21.871, P<0.001) and sustained pregnancy rate ( OR=11.261, 95% CI: 4.262-29.751, P<0.001) in URSA patients. Conclusion:WYHZ using before and during pregnancy can significantly improve the live birth rate and the clinical pregnancy rate of URSA patients with syndrome of yang deficiency of spleen and kidney, and improve their pregnancy outcomes.
9.Prognostic value of albumin and aspartate aminotransferase/alanine aminotransferase ratio in patients with acute liver failure in hyperacute phase of sepsis: a multicenter retrospective cohort study
Xiaozhou LI ; Qianqian YIN ; Guangkuo ZHAO ; Yanan HAI ; Zhiping SUN ; Yunli CHANG
Chinese Critical Care Medicine 2024;36(11):1121-1126
Objective:To investigate the prognostic value of albumin (ALB), aspartate aminotransferase/alanine aminotransferase ratio (AST/ALT) in patients with acute liver failure (ALF) in hyperacute phase of sepsis which provided the basis for clinical evaluation and prognostic judgment and corresponding treatment options.Methods:A multicenter retrospective cohort study was conducted. Patients with ALF in hyperacute phase of sepsis admitted to Zhoupu Hospital Affiliated to Shanghai Health College, Shanghai Pudong New Area People's Hospital, and Shanghai Oriental Hospital from January 2019 to February 2024 were enrolled. General data such as gender and age of the patients were collected. Lactate dehydrogenase (LDH), liver function indexes [total bilirubin (TBIL), direct bilirubin (DBIL), AST, ALT, AST/ALT, ALB, total protein (TP), globulin (GLB), ALB/GLB ratio (A/G), blood amine, γ-glutamyl transpeptidase (γ-GT)], platelet count (PLT), creatinine, activated partial thromboplastin time (APTT), severity of illness scores [acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), sequential organ failure assessment (SOFA)], serum procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NT-proBNP), arterial blood lactic acid (Lac) within 24 hours after admission, and whether to use mechanical ventilation, whether to use vasoactive drugs, whether to use artificial liver treatment and prognosis during hospitalization also were collected. The differences of clinical data between patients with different prognosis were compared. The variables with statistically significant differences in univariate analysis were included in multivariate Logistic regression analysis to determine the independent risk factors for death of patients with ALF in hyperacute phase of sepsis during hospitalization. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of ALB and AST/ALT for death of patients with ALF in hyperacute phase of sepsis during hospitalization.Results:A total of 73 patients with ALF in hyperacute phase of sepsis were included, with 22 survived and 51 died during hospitalization and the mortality of 69.86%. Compared with the survival group, the patients in the death group had lower ALB, γ-GT within 24 hours after admission and proportion of artificial liver treatment, and higher AST/ALT, SOFA score, LDH and proportion of use of vasoactive drugs. The differences were statistically significant. Multivariate Logistic regression analysis showed that ALB and AST/ALT were the independent risk factors for death in patients with ALF in hyperacute phase of sepsis during hospitalization [ALB: odds ratio ( OR) = 0.856, 95% confidence interval (95% CI) was 0.736-0.996, P = 0.044; AST/ALT: OR = 2.018, 95% CI was 1.137-3.580, P = 0.016]. ROC curve analysis showed that the area under the curve (AUC) of ALB for predicting in-hospital death in patients with ALF in hyperacute phase of sepsis was 0.760 (95% CI was 0.637-0.884, P < 0.001). When ALB ≤ 29.05 g/L, the sensitivity was 68.2%, and the specificity was 76.5%. The AUC of AST/ALT for predicting in-hospital death in patients with ALF in hyperacute phase of sepsis was 0.764 (95% CI was 0.639-0.888, P < 0.001). When AST/ALT ≥ 1.26, the sensitivity was 59.1%, and the specificity was 90.2%. Conclusions:The lower the ALB level, and the higher the AST/ALT within 24 hours after admission, the worse the prognosis of patients with ALF in hyperacute phase of sepsis. ALB and AST/ALT can be used as clinical indicators to evaluate the severity and prognosis of patients with ALF in hyperacute phase of sepsis.
10.Study on quality evaluation of Buddleja officinalis from different habitats based on HPLC fingerprint and content determination
Cuijie WEI ; Xiaoxia LIU ; Zhiwen DUAN ; Yongwei FENG ; Xiaozhou JIA ; Yueyi LIANG ; Xiangdong CHEN ; Dongmei SUN ; Zhenyu LI
International Journal of Traditional Chinese Medicine 2024;46(2):215-221
Objective:To establish UPLC fingerprint method and 2 contents determination methods of Buddleja officinalis; To provide a reference for improving the quality control standard and evaluation of Buddleja officinalis from different habitats.Methods:UPLC method was used to establish the fingerprints of 17 batches of Buddleja officinalis. The similarity evaluation, clustering analysis, principal component analysis and orthogonal partial least squares discriminant analysis were used to compare the quality differences of Buddleja officinalis from different habitats. The contents of acteoside and linarin in Buddleja officinalis were determined.Results:There were 12 common peaks in UPLC fingerprints of Buddleja officinalis, six of which were identified as echinacoside, acteoside, cynaroside, isoacteoside, linarin, and apigenin. The fingerprint similarity of 17 batches of Buddleja officinalis was more than 0.9; Buddleja officinalis from different habitats were classified into 2 groups. Five differential markers were determined by OPLS-DA analysis. The order of significance was acteoside > peak 3 > echinacoside > isoacteoside > linarin. Edgeworthia chrysantha was identified by the method of fingerprint as counterfeit. The results of content determination showed that the content of Buddleja officinalis in Hubei and Sichuan was the high and stable.Conclusion:The method can effectively analyze the differences of Buddleja officinalis from different habitats, and provide reference for the quality control of Buddleja officinalis.

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