1.Significance of using procalcitonin combined with acute physiology and chronic health evaluation Ⅱ score to estimate prognosis of elderly patients with sepsis
Junying YANG ; Jianjun ZHAO ; Luochun LEI ; Wanchun YANG ; Wei ZHENG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2019;26(1):34-37
		                        		
		                        			
		                        			Objective To investigate the significance of using procalcitonin (PCT) combined with acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores to estimate the prognosis of elderly patients with sepsis. Methods One hundred and fourteen elderly patients with sepsis admitted into the Department of Intensive Care Unit (ICU) of 13th Division Xinjiang Production and Construction Corps Red Star Hospital from January 2011 to December 2017 were enrolled, general information of all patients [sex, age, body mass index (BMI), smoking, drinking alcohol, site of infection, underlying disease or complication, education level and marital status], vital signs (pulse, respiration frequency, pH value, body temperature, oxygenation index, diastolic blood pressure, systolic blood pressure), blood and biochemical indicators [blood sugar, high-density lipoprotein (HDL) and low-density lipoprotein (LDL)], D-dimer, PCT, C-reactive protein (CRP), APACHE Ⅱ, chronic health score (CHS) were recorded and survival situation of all patients after entering the study for 28 days. Univariate and multivariate analyses were used to analyze the prognostic factors of elderly patients with sepsis, and the receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic efficacy of the factors in sepsis. Results Within 28 days from admission to hospital, 64 patients (44.44%) died, 80 patients (55.56%) survived, and there were no significant differences in the sex, age, BMI, infected site, underlying disease or complication, education level, marital status, smoking, drinking alcohol, pulse, respiration frequency, pH, body temperature, oxygenation index, blood pressure, blood glucose, HDL, LDL and infection type in the comparisons between the survival and death groups (all P > 0.05). Compared with the survival group, the D-dimer, PCT, CRP, APACHE Ⅱ, mechanical ventilation ratio were higher in the death group [D-dimer (mg/L):3.6±1.1 vs. 3.2±1.2, PCT (mg/L): 15.4±3.5 vs. 4.1±1.4, CRP (ng/L): 637.0±8.9 vs. 596.0±9.6, APACHEⅡ:31.4±5.5 vs. 16.4±4.5, proportion of mechanical ventilation: 87.5% (56/64) vs. 56.2% (45/80), all P < 0.05];multivariate analyses showed that PCT, APACHEⅡ and proportion of mechanical ventilation were independent risk factors of the prognosis of sepsis [PCT: odds ratio (OR) = 4.126, 95% confidence interval (95%CI) = 2.045-6.115, P = 0.000; APACHEⅡ: OR = 2.935, 95%CI = 1.237-4.118, P = 0.001; mechanical ventilation: OR = 2.012, 95%CI =1.068-3.048, P = 0.034, all P < 0.05]. The PCT, APACHE Ⅱ and PCT combined with APACHEⅡ all can be used to diagnose the prognosis of senile sepsis, and the diagnostic value of PCT combined with APACHEⅡ was the largest [area under the ROC curve (AUC) = 0.946, 95%CI = 0.894-0.971, sensitivity = 86.7%, specificity = 90.8%, P = 0.000]. Conclusion PCT combined with APACHE Ⅱscore can be used to estimate the prognosis of elderly patients with sepsis.
		                        		
		                        		
		                        		
		                        	
2.Study on Increasing the Protein Expression of Cells by Specific Nutrient Compensation and Metabolism Control Strategy
Yang ZHAO ; Zheng WANG ; Fang WU ; Bei LU ; Wen-Lei SHI ; Jing-Wei TAN ; Wen-Jun MA ; Gang LI ; Min LU ; Jie WENG ; Jinsong WU ; Luochun WANG ; Yanjun LIU ;
China Biotechnology 2006;0(04):-
		                        		
		                        			
		                        			To increase the productivity and yield of recombinant protein in continual perfusion processing, Every amino acid consumption rate in continual perfusion culture of engineering CHO cell line which expressed recombinant TNFRp75: Fc fusion protein were analyzed. Then rational amino acids were accordingly added to improve its comprehensive utilizing. At the same time, glucose supply was controlled to make the concentration of glucose below 0.5 g/L for ameliorating the toxicity of lactate accumulation in order to decrease the perfusion rate. The result showed that the productivity of recombinant protein was 3.1 times (388mg/L) and the total yield was 4. 7 times (244. 4g) that of control cultures after nutrient compensation and metabolism control in 30 liter working volume, and the fermentation period was prolonged one week longer. The sialic acid content and bioactivity in vitro of recombinant TNFRp75: Fc were not changed after nutrient compensation and glucose control supply. Nutrient compensating and metabolic control in continual perfusion fermentation could significantly increase the productivity and yield of recombinant TNFRp75:Fc, and thus reduced relative industrialization costs.
		                        		
		                        		
		                        		
		                        	
            
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