Objective To verify the association between admission serum phosphate level and short-term (<30 days) mortality of severe pneumonia patients admitted to intensive care unit (ICU) / respiratory intensive care unit (RICU). Methods Severe pneumonia patients admitted to the ICU/RICU of Quanzhou First Hospital Affiliated to Fujian Medical University from November 2019 to September 2021 were included in the study. Serum phosphate was demonstrated as an independent risk factor for short-term mortality of severe pneumonia patients admitted to ICU/RICU by logical analysis and receiver operator characteristic (ROC) curve. The patients were further categorized by serum phosphate concentration to explore the relationship between serum phosphate level and short-term mortality. Results Comparison of baseline indicators at admission between the survival group (n=54) and the non survival group (n=46) revealed that there was significant difference in serum phosphate level [0.9 (0.8, 1.2) mmol/L vs. 1.2 (0.9, 1.5) mmol/L, P<0.05]. Logical analysis showed serum phosphate was an independent risk factor for short-term mortality. ROC curve showed that the prediction ability of serum phosphate was close to pneumonia severity index (PSI). After combining serum phosphate with PSI score, CURB65 score, and sequential organ failure score, the predictive ability of these scores for short-term mortality was improved. Compared with the normophosphatemia group, hyperphosphatemia was found be with significantly higher short-term mortality (85.7% vs. 47.3%, P<0.05), which is absent in hypophosphatemia (25.8%). Conclusions Serum phosphate at admission has a good predictive value on short-term mortality in severe pneumonia patients admitted to the ICU/RICU. Hyperphosphatemia at admission is associated with a higher risk of short-term death.
Objective To investigate clinical significance of serum VEGF-C level and C-erbB-2 protein expression in patients with breast cancer. Methods Sixty-two female patients with breast invasive ductal cancer and breast benign lesion were respectively selected. Serum VEGF-C level was detected by enzyme-linked immunosorbent assay (ELISA) before operation and at one month after operation, and C-erbB-2 protein expression in tissues of breast cancer was detected by immunohistochemistry. Then, the relationship between serum VEGF-C level and clinicopathologic characteristics and C-erbB-2 protein expressions wereas analyzed. Results The serum VEGF-C level before operation in breast cancer patients〔(279.65±17.34) pg/ml〕 was significantly higher than that in breast benign lesions patients 〔(167.26±12.15) pg/ml〕, P＜0.01. In breast cancer patients, the serum VEGF-C level before operation was higher than that at one month after operation 〔(209.45±15.23) pg/ml〕, P＜0.01. The serum VEGF level was related to tumor stage (P＜0.05) but not to patient age, tumor size, menopause status , lymph node metastasis or not and ER and PR expression (Pgt;0.05). The positive expression rate of C-erbB-2 protein in breast cancer patients (54.84%, 34/62) was significantly higher than that in breast benign lesion patients (11.29%, 7/62), P＜0.01. Moreover, the positive expression rate of C-erbB-2 protein in breast cancer patients with axilla lymph node metastasis (69.44%) was significantly higher than that without axilla lymph node metastases (34.62%), P＜0.05. The serum VEGF level increased with increasing expression intensity of C-erbB-2 protein and there was positive correlation between them (r=0.813，P＜0.05). Conclusions The serum VEGF-C level in breast cancer may be conducted as an assisted marker to differential diagnosis of breast tumor. C-erbB-2 is related to lymph node metastasis of breast cancer patients. There is synergistic effect between VEGF-C and C-erbB-2 in the lymph node metastasis way of breast cancer.
Objective To evaluate the diagnostic efficiency of serum soluble CD26 （sCD26） on the diagnosis of colorectal cancer. Methods The serum sCD26 concentration of 59 colorectal cancer patients, 51 colorectal benign disease patients, and 41 healthy volunteers were detected by ELISA. The diagnostic efficiency of sCD26 and carcinoma embryonic antigen （CEA） was assessed by receiver operating characteristics （ROC） analysis. The association between sCD26 and colorectal cancer was assessed by logistic regression which included CEA in the model. Results Increased serum sCD26 was observed in colorectal cancer patients （P＜0.01）, but the differences of sCD26 in different Dukes stages were not statistic significance （P=0.78）. The area under cure （AUC） of sCD26 confirmed by ROC analysis was 0.72 〔95% confidence interval （CI）：0.63-0.82, P＜0.01〕. The diagnostic sensitivity and specificity for sCD26 at 526 μg/L, the optimal diagnostic threshold, were 0.59 （95% CI： 0.48-0.72） and 0.80 （95% CI： 0.67-0.90）, respectively. Positive serum sCD26 was associated with colorectal cancer after adjusted for CEA with odds ration （OR） 5.17 （95% CI：1.72-15.53, P＜0.01）, as confirmed by logistic regression. Increased positive rate of serum sCD26 was observed in patients at Dukes A stage （P=0.03）, but not Dukes B, C, and D stage （P＜0.05）. Conclusions Serum sCD26 has high diagnostic performance for colorectal cancer. The association of sCD26 is independent of serum CEA. Compared to serum CEA, sCD26 has more potential to be an early biomarker for colorectal cancer diagnosis.
目的 测定多发性骨髓瘤（MM）患者血清胱抑素C （Cys-C） 的水平，探讨Cys-C与国际分期体系（ISS）、血β2-微球蛋白、溶骨性损害等指标的关系。 方法 收集2008年1月－2010年9月32例初治和8例复发的MM患者作为研究对象，同时收集40例健康体检者的检查资料作为对照组，测定血清Cys-C、血肌酐（Scr）、血β2-微球蛋白。采用核素全身骨显像（ECT）观察患者的溶骨性病变部位数。 结果 患者血清Cys-C水平（1.40 mg/L）明显高于健康对照组（0.90 mg/L）（P＜0.01）；在MM患者中Cys-C比Scr更敏感，能反映肾小球滤过率；血清Cys-C水平与ISS分期晚，血β2-微球蛋白升高以及溶骨性病变进展密切相关。 结论 MM患者的Cys-C水平高于健康者。Cys-C是骨髓瘤肾损害的早期敏感标志物，与肿瘤负荷及溶骨性损害密切相关，可作为评价肿瘤负荷的潜在指标。Objective To evaluate the serum levels of cystatin-C in patients with multiple myeloma (MM), and to explore its possible correlations with clinical data, including ISS stage, serum β2-microglobulin, and advanced lytic lesions. Methods From January 2008 to September 2010, serum cystatin-C, creatinine (Scr), and β2-microglobulin in 32 patients with MM, 8 patients with relapsed disease, and in 40 healthy controls were detected by automatic biochemistry analyzer detection. According to skeleton ECT, grading of osteolytic lesion was observed. Results The levels of serum cystatin-C of patients with MM were significantly higher than those of the controls. Serum cystatin-C could reflect the glomerular filtration rate , and was more sensitive than Scr in patients with renal lesion. Serum cystatin-C had ber correlations with advanced ISS stages, high levels of serum β2-microglobulin, and extensive bone diseases. Conclusion Serum cystatin-C is a sensitive marker of renal lesion in patients with MM, it could be a potential indicator to assess the tumor burden.
目的:探讨血清钙与胰腺坏死的关系.方法:四川大学华西医院中西医结合科2003年9月~2005年3月收治的200例急性胰腺炎患者,根据CT结果分为坏死组和非坏死组,根据所有患者测得的血清钙相应的真阳性率和假阳性率做出ROC曲线以预测胰腺坏死。结果:ROC曲线下面积为0.436。结论:血清钙高低不能预测胰腺坏死。
ObjectiveTo explore the clinical significance of detecting serum intact parathyroid hormone (iPTH) and drainage fluid parathyroid hormone (dPTH) after thyroidectomy in forecasting parathyroid function.MethodsThe clinical data of 95 thyroidectomy patients in the same treatment group from March 2018 to September 2018 were retrospectively analyzed, which in the Department of Thyroid-Breast Surgery, the Second Affiliated Hospital of Kunming Medical University. According to the surgical method, the patients were divided into 3 groups: isthmus and unilateral thyroidectomy (partial resection group, n=33), total thyroidectomy (total resection group, n=33) and total thyroidectomy and central lymph node excision (radical resection group, n=29). The negative pressure drainage tube was placed in the operative area. The iPTH and serum calcium were detected before and the first day after operation. The dPTH was detected in the first day and the second day after operation. Serum calcium, iPTH and dPTH were statistically analyzed.ResultsThere were no significant differences in operative time, hospital stay and blood loss between the total resection group and the radical resection group (P>0.05), but the partial resection group were all less than the other two groups (P<0.01). On the first day after operation, the iPTH in the three groups were lower than that before operation, and the iPTH was significantly decreased in the total resection group and the radical resection group, with statistically significant difference (P<0.05). The dPTH in the three groups were significantly increased on the first and second day after operation (P<0.05), but there was no statistically significant difference between the three groups (P>0.05). There was no statistically significant difference in serum calcium between the three groups on the first day after operation (P>0.05).ConclusionsThe levels of iPTH, dPTH and serum calcium after thyroidectomy can comprehensively forecast the parathyroid function. Preventive calcium supplementation can reduce the occurrence of postoperative symptomatic hypocalcemia, which is conducive to the recovery of parathyroid function.
目的 探讨热性惊厥患儿血清电解质和血糖的变化及其临床意义。 方法 选取2009 年6月－2010 年12月儿科住院的呼吸道感染并发热性惊厥患儿38例和呼吸道感染无惊厥患儿42例，分别作为观察组和对照组，测定和比较两组患儿血清电解质和血糖值。 结果 观察组血清钠离子浓度为（133.05 ± 1.74）mmol/L、氯离子浓度为（100.37 ± 1.79）mmol/L；对照组血清钠离子浓度为（142.19 ± 1.85）mmol/L、氯离子浓度为（104.57 ± 1.55）mmol/L，差异均有统计学意义（P＜0.01）；观察组和对照组血糖浓度依次为（6.93 ± 0.87）、（5.12 ± 0.55）mmol/L，差异有统计学意义（P＜0.01）。观察组在治疗后的血清钠离子、氯离子浓度分别为（140.89 ± 2.68）、（103.29 ± 1.94）mmol/L，均高于发生惊厥时的浓度（P＜0.01）；观察组在治疗后的血糖浓度为（5.31 ± 0.68）mmol/L，明显低于发生惊厥时，差异有统计学意义（P＜0.01）。 结论 婴幼儿发生热性惊厥时存在血钠、血氯水平降低和血糖升高，在热性惊厥患儿的治疗中应纠正血钠水平和高血糖。Objective To explore the clinical significance of the changes in serum electrolytes and blood glucose in the children with febrile convulsion. Methods Thirty-eight children with respiratory infection combined with febrile convulsion and 42 children with single respiratory infection diagnosed between June 2009 and December 2010 were selected as the observation group and control group, respectively. Serum electrolytes and blood glucose concentration were assayed and compared between the two groups. Results The concentrations of serum sodium and chloride were (133.05 ± 1.74) mmol/L and (100.37 ± 1.79) mmol/L in the observation group, while (142.19 ± 1.85) and (104.57 ± 1.55) mmol/L in the control group; the differences between the two groups were significant (Plt;0.01). The concentrations of blood glucose were (6.93 ± 0.87) mmol/L in the observation group and (5.12 ± 0.55)mmol/L in the control group; the difference was significant (Plt;0.01). After the treatment, the serum concentrations of sodium and chloride were (140.89 ± 2.68) and (103.29 ± 1.94)mmol/L in the observation group, which were higher than those before treatment (Plt;0.01). After treatment, the blood glucose concentration was (5.31 ± 0.68）mmol/L in the observation group, which was lower than that before the treatment (Plt;0.01). Conclusion Hyponatremia, low serum chlorine and hyperglycemia occurre in the febrile convulsion in children, which should be corrected in the treatment of febrile convulsion.
目的 探讨血清降钙素原（PCT）、C反应蛋白（CRP）与急性生理及慢性健康评分标准Ⅱ（APACHE Ⅱ）评分在转诊肺炎合并脓毒症患者诊断中的相关性，以寻找更为简洁、快速判断其病情严重程度的指标。 方法 2009年1月－2010年12月，选取178例转诊肺炎合并脓毒症患者并进行脓毒症分级，对其进行血清PCT和CRP测定，并与APACHE Ⅱ评分及预后进行相关性分析。 结果 严重脓毒症组及脓毒性休克组患者血清PCT、CRP水平与APACHE Ⅱ评分较全身炎症反应综合征组及脓毒症组高（P＜0.05）；30 d内死亡的患者其血清PCT、CRP水平及APACHEⅡ评分较存活组明显增高（P＜0.05）；转诊肺炎合并脓毒症患者血清PCT与APACHE Ⅱ评分呈正相关（r=0.683，P=0.023），与血清CRP水平呈较弱的正相关（r=0.272，P=0.037）。 结论 对转院肺炎合并脓毒症患者进行血清PCT和CRP测定，对病情评估具有一定临床价值，特别是PCT可作为对转诊肺炎合并脓毒症患者病情程度判断的重要指标，为早期干预及治疗提供依据，值得临床推广应用。
目的 了解成人大骨节病（KBD）患者血清中硒和氟的含量及其与大骨节病分度的相关性。 方法 2008年8月－2009年10月，采集四川阿坝壤塘县大骨节病区成人KBD患者血清标本37例，四川非大骨节病区健康成人血清39例作为对照组。血清硒的含量采用石墨炉原子吸收分光光度法进行检测，氟采用氟离子选择电极法进行检测。统计学分析组间差异有无统计学意义，同时分析硒和氟的表达水平与大骨节病分度的相关性。 结果 大骨节病组患者血清硒的表达水平明显低于健康对照组（P＜0.05）；血清氟的表达水平虽略低于健康对照组，但无统计学意义（P＞0.05）。大骨节病组患者Ⅰ度和Ⅱ、Ⅲ度间硒和氟的表达水平无统计学差异（P＞0.05）。 结论 成人大骨节病患者血清中硒水平偏低，血清氟水平与健康人无统计学差异；血清硒和氟含量与大骨节病的分度并无明显相关性。
Objective To evaluate the efficacy of Yangxue Qingnao Grain for migraine. Methods We searched The Cochrane Library (Issue 3, 2007), EMBASE (1974 to June 2007), PubMed (1966 to June 2007), VIP (1989 to June 2007), CNKI (1979 to June 2007) and CBM (1978 to June 2007) to identify randomized controlled trials or quasirandomized controlled trials comparing Yangxue Qingnao Grain versus sibeline for migraine. The quality of included studies was critically assessed and data analyses were performed with The Cochrane Collaboration’s RevMan 4.2.7. Results Eight studies were included, involving 5 randomized trials and 3 quasi-randomized trials. Meta-analyses showed that the total response rate (RR=1.07, 95%CI 1.00 to 1.15, P=0.06), the duration of headache (WMD 1.33, 95%CI – 0.87 to 3.52, P=0.24), and the frequency of headache episodes (WMD 0.93, 95%CI –1.00 to 2.86, P=0.35) were similar between Yangxue Qingnao Grain and sibeline. One study reported that the changes of ACA (WMD 3.70, 95%CI –3.46 to 10.86), MCA (WMD 0.60, 95%CI –10.37 to 11.57), ICA (WMD 3.40, 95%CI –4.35 to 11.15) and DCA (WMD – 2.30, 95%CI –9.52 to 4.92) revealed by transcranial doppler sonography were also comparable between the two groups. Conclusion Yangxue Qingnao Grain is effective in the treatment of migraine, but its superiority over sibeline is not demonstrated. Due to the poor quality and small sample of the included trials, more large-scale multi-center randomized trials are needed.