Objective:To investigate the relationship between oxygen consumption (VO 2), carbon dioxide production (VCO 2), and Oxygen Consumption/lactate (VO 2/Lac) with risk of death in patients with severe ARDS. Methods:A retrospective cohort study method was used, and the study subjects were hospitalized for >5 days adult patients with severe ARDS in the central intensive care unit of Henan Provincial People's Hospital from 1 March 2020 to 30 June 2023. The following patients were excluded: IC test was not completed on the 4th day of ICU admission, IC test results were unreliable, mechanical ventilation duration had exceeded 48 h at the time of ICU transfer or admission, palliative care patients and pregnant and parturient women. Using indirect calorimetry to determine VO 2 and VCO 2 values on the 4th day of admission, reviewing medical records to obtain general condition, disease information, blood gas analysis (including lactate value), diagnostic and therapeutic measures, and following up deaths by telephone and time of death. The primary outcome measure was death at 90 days, and the secondary outcome measure was death at 28 days, length of stay in ICU, total length of stay, and total hospitalization cost. Cox regression analysis and linear regression analysis were used to investigate the relationship between VO 2, VCO 2, VO 2/Lac and primary and secondary outcome indexes. Results:A total of 216 patients were enrolled, 78 patients (36.1%) died and 138 patients (63.9%) survived at 90 days. After correction for confounders, the results of multifactorial Cox regression analysis suggested that compared with the Q4 group, HR (95% CI) for 90-day risk of death in the VO 2 Q1 and Q2 groups was 3.21 (1.38, 7.49) and 3.24 (1.42, 7.38), and HR (95% CI) for 90-day risk of death in the VCO 2 Q1, Q2 and Q3 groups was 5.88 (2.33, 14.84), 4.26 (1. 60, 11.34) and 3.54 (1.34, 9.35), respectively, and the HR (95% CI) for 90-day risk of death in the VO 2/Lac Q1, Q2 and Q3 groups were 8.72 (3.01, 25.25), 8.43 (2.91, 24.47) and 4.04 (1.34, 12.17) respectively. P-trends were all <0.05, indicating that VO 2, VCO 2 and VO 2/Lac were linearly and negatively associated with the risk of 90-day mortality. In addition, VO 2, VCO 2, and VO 2/Lac were negatively associated with 28-day risk of death and higher VO 2/Lac was negatively associated with length of ICU stay. Conclusions:VO 2, VCO 2 and VO 2/Lac were negatively associated with 90-day mortality risk and 28-day mortality risk in patients with severe ARDS and may be independent risk factors predicting mortality risk of such patients.

Objective:To investigate the effect of predictive nursing intervention on immune function, psychological state and self-efficacy of patients with advanced gastric cancer (AGC) in tumor immunotherapy.Methods:Fifty patients with AGC who underwent tumor immunotherapy from February 2016 to November 2018 were enrolled in the study. They were divided into two groups according to the principle of numerical randomization. The control group (25 cases) was routinely used. In the nursing mode, the observation group (25 cases) used predictive nursing intervention. The venous blood was collected at the time of admission, 1 day and 2 days before discharge, and the T lymphocyte subsets were measured. The Self-rating Anxiety Scale (SAS), the Self-rating Depression Scale (SDS), Self-Efficacy Scale, and Quality of Life were used to assess the patient's mental state, subjective feelings, and quality of life.Results:There were no significant differences in CD 3+, CD 4+, CD 8+ and CD 4+/CD 8+ between the two groups before intervention ( P>0.05). CD 3+, CD 4+, CD 8+ and CD 4+/CD 8+ after intervention was 0.576 3±0.071 7, 0.496 3±0.067 7, 0.292 1±0.061 4, 1.75±0.48 in the observation group and 0.552 4±0.074 2, 0.489 2±0.070 4, 0.294 1±0.062 5, 1.63±0.51 in the control group. There were significant differences in CD 3+, CD 4+, and CD 4+/CD 8+ between the two groups after intervention ( t values were 3.158, 1.954, 2.347, all P<0.05). There was no significant difference in SAS and SDS scores between the two groups before intervention ( P>0.05). The SAS, SDS score after intervention in the observation group was (51.4±4.2), (50.8±3.5) points, and (55.7±3.6), (56.5±4.0) points in the control group, there was significant difference between the two groups ( t values were 3.887, 5.362, all P<0.01). There was no significant difference in self-efficacy between the two groups and the total score ( P>0.05). The total score of self-efficacy after intervention was (137.7±14.4) in the observation group, and (121.5±11.8) points in the control group, there was significant difference between the two groups( t value was 4.351, P<0.01). The quality of life score was (52.5±13.4) points in the observation group and (45.3±11.0) points in the control group, there was significant difference between the two groups ( t value was 2.077, P<0.05). The excellent and good rate of the quality of life score was 76.0%(19/25) in the observation group, and 56.0%(14/25) in the control group, there was no significant difference between the two groups ( χ2 value was 2.228, P>0.05). Conclusions:Tumor immunotherapy for the treatment of patients with AGC uses predictive care and significantly relieves their mental state and self-efficacy, promotes the recovery of their physical functions and improves the quality of life.

OBJECTIVE: To investigate the implementation and application effect of 1-hour bundle in the treatment of patients with sepsis. METHODS: A convenient sampling method was conducted. 102 patients with sepsis admitted to central intensive care unit (ICU) of Henan Provincial People's Hospital from January 2018 to February 2019 were enrolled. Thirty-five patients with 3-hour and 6-hour bundle from January to September in 2018 were served as the control group, and 67 patients who received 1-hour bundle from October 2018 to February 2019 were served as the observation group. The patients in the control group was treated with 3-hour and 6-hour bundle according to 2012 international guidelines for the diagnosis and treatment of severe sepsis and septic shock; and those in the observation group were treated and nursed according to the 1-hour bundle published by Surviving Sepsis Campaign (SSC) update 2018, and the sepsis cluster treatment medical team was established. The team members were trained in relevant knowledge and discussed the possible obstacles within the team and propose feasible measures. The implementation of the 1-hour bundle in the observation group was recorded. The general data of the patients in both groups including gender, age, acute physiology and chronic health evaluation II (APACHE II), etc. were collected, and the outcome indicators (duration of mechanical ventilation, length of ICU stay, 28-day mortality) were observed. RESULTS: In the observation group, 37 of 67 patients receiving 1-hour bundle met the target, with the overall achievement rate of 55.2% (37/67). Of the 37 eligible patients, 5 patients receiving 1-hour bundle met the target before the training of 1-hour bundle, accounting for only 33.3% (5/15) of the 15 patients who received 1-hour bundle during the same period. With the extension of training time, the achievement rate of sepsis 1-hour bundle was gradually increased [the achievement rate at 1 week and 4 weeks of training was 40.0% (4/10) and 52.4% (11/21), respectively], and increased to 81.0% (17/21) at the end of 12 weeks training. Thirty-seven patients who received 1-hour bundle and met the criteria were enrolled and compared with the control group. There was no significant difference in gender, age, or APACHE II score between the two groups. Compared with the control group, the duration of mechanical ventilation and length of ICU stay of the observation group were significantly shortened (days: 6.15±0.49 vs. 7.24±0.53, days: 8.21±1.49 vs. 9.51±1.92), and the 28-day mortality was decreased significantly [10.8% (4/37) vs. 31.4% (11/35)], with statistically significant differences (all P < 0.05). CONCLUSIONS Through teamwork, discussion and improvement, the achievement rate of sepsis 1-hour bundle can be significantly improved. The use of sepsis 1-hour bundle can effectively decrease the duration of mechanical ventilation and length of ICU stay, and reduce the 28-day mortality.
APACHE ; Humans ; Intensive Care Units ; Prognosis ; Sepsis/therapy* ; Shock, Septic

Objective To observe the effect of mature rehmannia extract on platelet derived growth factor (PDGF) and b-cell lymphoma-2 (bcl-2) 2 in myocardial tissue of rats with myocardial infarction.Methods A total of 30 healthy SD rats were randomly divided into blank group,model group and rehmannia glutinosa group with 10 rats in each group.Myocardial infarction models were established in rats of model group and prepared Rehmannia glutinosa group.The rats in the prepared rehmannia glutinosa group were subcutaneously injected with the extract of the prepared Rehmannia glutinosa 4 g/kg.The rats in the blank group and the model group were subcutaneously injected with the same volume of saline.Once a day for 15 days.The cardiac function was measured by echocardiography in rats.The HE staining was used to observe the histopathological changes of myocardium.The levels of PDGF and Bcl-2 in myocardium were detected by ELISA.The levels of vascular endothelial growth factor (VEGF),basic fibroblast growth factor (BFGF) and CD34 protein were detected by immunoturbidimetry.Results Compared with the model group,the levels of LVDd,LVDs,LVEDs and LVESV in the Rehmannia glutinosa group were significantly decreased (P＜0.05) and LVEF was significantly increased (P＜0.05),while the levels of PDGF (0.53 ± 0.02 g/ml vs.0.35 ± 0.01 g/ml),Bcl-2 (1.04 ± 0.20 g/ml vs.0.84 ± 0.12 g/ml),VEGF (85.24 ± 12.45 pg/ml vs.65.26 ± 10.06 pg/ml),BFGF (86.27 ± 6.56 pg/ml vs.62.26 ± 4.37 pg/ml) and CD34 (102.36 ± 10.52 pg/ml vs.26.37 ± 3.94 pg/ml) in in the Rehmannia glutinosa group were significantly increased (P＜0.05).Conclusions The Rehmannia glutinosa extract can improve the cardiac function of rats with myocardial infarction,Promote the formation of new blood vessels and improve myocardial damage.

Objective: To investigate the implementation and application effect of 1-hour bundle in the treatment of patients with sepsis. Methods: A convenient sampling method was conducted. 102 patients with sepsis admitted to central intensive care unit (ICU) of Henan Provincial People's Hospital from January 2018 to February 2019 were enrolled. Thirty-five patients with 3-hour and 6-hour bundle from January to September in 2018 were served as the control group, and 67 patients who received 1-hour bundle from October 2018 to February 2019 were served as the observation group. The patients in the control group was treated with 3-hour and 6-hour bundle according to 2012 international guidelines for the diagnosis and treatment of severe sepsis and septic shock; and those in the observation group were treated and nursed according to the 1-hour bundle published by Surviving Sepsis Campaign (SSC) update 2018, and the sepsis cluster treatment medical team was established. The team members were trained in relevant knowledge and discussed the possible obstacles within the team and propose feasible measures. The implementation of the 1-hour bundle in the observation group was recorded. The general data of the patients in both groups including gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), etc. were collected, and the outcome indicators [duration of mechanical ventilation, length of ICU stay, 28-day mortality] were observed. Results: In the observation group, 37 of 67 patients receiving 1-hour bundle met the target, with the overall achievement rate of 55.2% (37/67). Of the 37 eligible patients, 5 patients receiving 1-hour bundle met the target before the training of 1-hour bundle, accounting for only 33.3% (5/15) of the 15 patients who received 1-hour bundle during the same period. With the extension of training time, the achievement rate of sepsis 1-hour bundle was gradually increased [the achievement rate at 1 week and 4 weeks of training was 40.0% (4/10) and 52.4% (11/21), respectively], and increased to 81.0% (17/21) at the end of 12 weeks training. Thirty-seven patients who received 1-hour bundle and met the criteria were enrolled and compared with the control group. There was no significant difference in gender, age, or APACHEⅡ score between the two groups. Compared with the control group, the duration of mechanical ventilation and length of ICU stay of the observation group were significantly shortened (days: 6.15±0.49 vs. 7.24±0.53, days: 8.21±1.49 vs. 9.51±1.92), and the 28-day mortality was decreased significantly [10.8% (4/37) vs. 31.4% (11/35)], with statistically significant differences (all P < 0.05). Conclusions Through teamwork, discussion and improvement, the achievement rate of sepsis 1-hour bundle can be significantly improved. The use of sepsis 1-hour bundle can effectively decrease the duration of mechanical ventilation and length of ICU stay, and reduce the 28-day mortality.

Objective To investigate serum total prostate special antigen(tPSA),complexed prostate special antigen(cPSA)and cPSA/tPSA ratio(C/T) in the differential diagnosis of benign prostate hyperplasia(BPH)and prostate cancer(PCa).Methods A total of 184 serum samples from hospital outpatient and inpatient were collected from May 2009 to December 2015,and which were divided into three groups including other diseases 68 patients,benign prostate hyperplasia(BPH group)80 patients,prostate cancer (PCa group)36 patients.Chemiluminescence immunoassay was used to detect the concentration of tPSA and cPSA,and the C/T ratio were calculated in the study.Results The tPSA,ePSA levels and C/T ratio were significant different from patients with PCa,BPH and other diseases group(P＜0.01).Compared with BPH group(r=0.661),the tPSA and cPSA levels have a higher relativity in PCa group(cPSA=0.708 × tPSA-0.219,r=0.956).While when tPSA level ranges 4.0-10.0 ng/mL),no significant difference of tPSA,cPSA levels and C/T ratio were found in these 3 groups(P＞0.05).Conclusion Combined detection of serum tPSA,cPSA and C/T,making importance in the differential diagnosis of BPH and PCa.

Objective To study the effect of black granule capsules(BGCs) on growth of transplanted mouse hepatocarcinoma cells, cell proliferation cycle and apoptosis.Methods KM mouse were subcutaneously inoculated with Hepatocarcinoma cells (H22) and randomly divided into the model control group, the positive control group, the low, medium and high does of BGC group after 24h. The positive control group received intraperitoneal injection with 30 mg/kg cyclophosphamide. Mice of BGC groups were intragastricaly with different dosage of BGC (400, 800, 1 600 mg/kg). The model control group received intragastricaly with normal saline. The drugs were administrated once a day for seven days. The tumor inhibition rate was calculated at 24 h after the last administration. Flow cytometry was used to detect changes of cell cycle and apoptosis in harvested H22 tumor cells.Results The group of high does showed significant inhibitory effect on the growth of transplanted H22 tumor cells withthe inhibitory rate 38.78% (male) and 43.57% (female). Compared with model control group, groups of different dosages decreased time of G0-G1 phase (58.06% ± 9.65%, 55.10% ± 5.89%, 61.36% ± 15.95%vs. 74.47% ± 2.63%), increased tiem of Sphase (33.96% ± 11.90%, 32.67% ± 4.04%, 33.89% ± 9.82%vs. 14.37% ± 4.92%), and increased the apoptosis rate (31.12% ± 1.85%, 31.89% ± 2.16%, 40.64% ± 0.55%vs.21.75% ± 2.64%).Conclusion BGC has antitumor effect on mouse hepatocarcinoma H22 tumor cells, and its mechanism was to regulate cell proliferation cycle and induce the apoptosis.

Carrier Proteins ; Humans ; Nutrition Surveys ; Nutritional Status ; Population Surveillance ; Xenopus Proteins

ObjectiveTo investigate the effects of Saposhnikovia divaricata extract combined with arsenic trioxide (ATO) on the proliferation and apoptosis in chronic myelogenous leukemia K562 cells. MethodsSaposhnikovia divaricata extract was prepared.Cultured K562 cells were treated with different concentration of Saposhnikovia divaricataextract or/and ATO for 48h. Cell proliferation was determined using the MTT assay. Apoptosis and cell cycle were detected using flow cytometry.ResultsThe MTT assay showed that Saposhnikovia divaricata extract of 750,1 000,1 250,1 500 μg/ml had a significantly proliferation inhibitory effect compared with control group, the inhibitory rates were 23.29% ± 3.31%, 48.30% ± 2.50%, 79.62% ± 3.41% and 88.94% ± 0.06%, respectively (allP<0.05); Saposhnikovia divaricata extract of 500 μg/ml combined with ATO of 1.0, 0.5 μg/ml significantly increased inhibitor rates compared with ATO of 1.0, 0.5 μg/ml (64.99% ± 5.18%vs. 44.48% ± 3.31%,38.59% ± 3.88%vs.26.30% ± 5.03%; allP<0.05). FCM showed that Saposhnikovia divaricata extract of 500 μg/ml combined with ATO of 2.0, 1.0, 0.5 μg/ml significantly increased apoptotic rate compared with ATO group of 2.0, 1.0, 0.5 μg/ml (33.97% ± 0.59%vs.20.97% ± 2.17%, 13.53% ± 0.47%vs.9.77%±0.64%、6.63%±&0.40%vs.4.00%±0.46%; allP<0.05 ). Cell cycle results showed that Saposhnikovia divaricata extract of 500μg/ml combined with ATO of 2.0,1.0, 0.5μg/ml significantly increased the rate of S phase compared with ATO group of 2.0, 1.0, 0.5 μg/ml (60.25 ± 2.59%vs.55.61 ± 1.28%, 60.89 ± 1.53%vs.37.96 ± 1.02%, 47.76 ± 0.87%vs.39.90 ± 0.92%; allP<0.05).ConclusionsSaposhnikovia divaricataextract could obviously inhibit the proliferation of K562 cells and enhance the apoptotic effect of ATO. ATO could induce a G2/M phase arrest, while Saposhnikovia divaricata extract combined with ATO could induce a S phase arrest in K562 cells.

Objective:To examine the expression of TRAF6 in esophageal organization from protein level and analyze the correlations between TRAF6 expression and clinical features.Methods: Seventy-eight patients with esophageal adenocarcinoma who were admitted to the Department of Oncology , Henan Province Hospital of TCM from January 2005 and January 2010 were finally eligible for present study and the corresponding esophageal normal tissues and clinical data were collected .All the specimens were confirmed by pathology for esophageal squamous cell carcinoma or esophageal normal tissues .The expression of TRAF6 in the tissue samples was detected by immunohistochemistry .The correlation between the TRAF6 expression and clinical characteristics of patients was analyzed.Results:The positive expression rate of TRAF 6 in esophageal cancer organizations and normal esophageal mucosal tissues were 71.79%and 10.26%,respectively.The positive expression rate of TRAF6 in esophageal cancer were significantly higher than those in normal esophageal mucosal tissue ( P<0.05 ) .The positive expression rate of TRAF 6 in esophageal cancer organizations has nothing to do with the age,sex,tumor differentiation degree and size(P>0.05),but with lymph node metastasis and clinical stage (P<0.05).Patients with positive TRAF6 expression had significantly lower five-year survival rate than those with tumors having positive TAK1 expression.Conclusion:TRAF6 may play an important role in the pathology and development of squamous cell carcinoma ,and could be an important therapeutic target in the treatment of esophageal cancer .