Objective:To construct a risk prediction model for in-hospital cardiac arrest(IHCA)in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:The clinical data of 550 pati...Objective:To construct a risk prediction model for in-hospital cardiac arrest(IHCA)in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:The clinical data of 550 patients with COPD complicated with respiratory failure in our hospital from January 2016 to June 2022 were retrospectively analyzed.According to the occurrence of IHCA,they were divided into the IHCA group and non-IHCA group.The general data and clinical indicators of the two groups were compared,and logistic regression analysis was performed,R software was used to establish the risk prediction model(nomogram model)for predicting the occurrence of IHCA in patients with COPD complicated with respiratory failure.The risk prediction model(line graph model)for patients with IHCA was validated by the Bootstrap method,and the predictive value was analyzed by applying the receiver operating characteristic(ROC)curve.Results:Among 550 COPD patients complicated with respiratory failure,95 cases(17.27%)had IHCA.There were significant differences in age,old myocardial infarction,heart failure,moderate and severe chronic kidney disease,assisted breathing mode,state of consciousness,body temperature,heart rate,respiratory rate,systolic blood pressure,lactic acid,Sa O,Pa CO,serum creatinine,albumin,and prealbumin between the non-IHCA group and IHCA group(P<0.05).Logistic regression analysis showed that age,heart failure,heart rate,respiratory rate,systolic blood pressure,unclear state of consciousness,serum creatinine and prealbumin were independent influencing factors of IHCA in COPD patients complicated with respiratory failure(P<0.05).According to the results of binary logistic regression analysis,a nomogram model for predicting the incidence of IHCA in COPD patients complicated with respiratory failure was constructed.The fitting degree of the model was determined by the H-L test.The calibration curve showed that the incidence of IHCA in COPD patients complicated with respiratory failure predicted by nomogram was in good agreement with the actual incidence of IHCA in patients with COPD complicated with respiratory failure(χ~2=2.017,P=0.334).The ROC curve showed an AUC of 0.627(95%CI:0.593-0.689,P<0.005),and the optimal cut point value for diagnosis was 0.69,at which the sensitivity and specificity were 42.57%and 96.03%,respectively.Conclusion:According to the independent influencing factors of IHCA in COPD patients complicated with respiratory failure,the establishment of a risk prediction nomogram model has high predictive value,which is worthy of clinical promotion.展开更多
Objective:To explore the effect of atorvastatin on the expression of inflammatory cytokines in rats with Klebsiella pneumonia.Methods:90 healthy SPF-grade SD rats were randomly divided into three groups:atorvastatin g...Objective:To explore the effect of atorvastatin on the expression of inflammatory cytokines in rats with Klebsiella pneumonia.Methods:90 healthy SPF-grade SD rats were randomly divided into three groups:atorvastatin group,model group and blank group(with 10 rats in each group),30 rats in each treatment period(3,6,9 d).A rat model of Klebsiella pneumonia was constructed,in which the blank group and the model group were given the same volume of saline,while the atorvastatin group was given 10 ml/kg of atorvastatin by intraperitoneal instillation.The rats were killed on the 10th day after administration,and the lung tissue was extracted to detect the pathological results and the expression of inflammatory cytokines was detected in serum.Results:Lung histopathology showed that lung histopathology and fibrosis were improved in atorvastatin group,and alveolar structure integrity≥50%and collagen fiber precipitation≤10%in atorvastatin group indicated that the model was successful.The expression of inflammatory cytokines showed that the levels of IL-6,TNF-αand TGF-βin the atorvastatin group and the model group were significantly increased compared with the blank group,with statistically significant differences(P<0.05).The levels of IL-6,TNF-αand TGF-βin atorvastatin group were lower than those in model group,and the levels of IL-10 in atorvastatin group were higher than those in model group,with statistically significant differences(P<0.05).After 9 days,the levels of IL-6,TNF-α,TGF-βand IL-10 in the atorvastatin group and the model group were higher than those in the blank group,with statistically significant differences(P<0.05).The results of immunological function study showed that WBC,RBC and PLT in orvastatin group and model group were significantly reduced at 3 d compared with the blank group,with statistically significant differences(P<0.05).After 6 and 9 d,WBC,RBC and PLT in atorvastatin group and model group were lower than those in blank group,and WBC,RBC and PLT in atorvastatin group were lower than those in model group,with statistically significant differences(P<0.05).Conclusion:Atorvastatin can significantly improve the immune dysfunction and the expression of inflammatory cytokines in rats with Klebsiella pneumonia.展开更多
文摘Objective:To construct a risk prediction model for in-hospital cardiac arrest(IHCA)in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:The clinical data of 550 patients with COPD complicated with respiratory failure in our hospital from January 2016 to June 2022 were retrospectively analyzed.According to the occurrence of IHCA,they were divided into the IHCA group and non-IHCA group.The general data and clinical indicators of the two groups were compared,and logistic regression analysis was performed,R software was used to establish the risk prediction model(nomogram model)for predicting the occurrence of IHCA in patients with COPD complicated with respiratory failure.The risk prediction model(line graph model)for patients with IHCA was validated by the Bootstrap method,and the predictive value was analyzed by applying the receiver operating characteristic(ROC)curve.Results:Among 550 COPD patients complicated with respiratory failure,95 cases(17.27%)had IHCA.There were significant differences in age,old myocardial infarction,heart failure,moderate and severe chronic kidney disease,assisted breathing mode,state of consciousness,body temperature,heart rate,respiratory rate,systolic blood pressure,lactic acid,Sa O,Pa CO,serum creatinine,albumin,and prealbumin between the non-IHCA group and IHCA group(P<0.05).Logistic regression analysis showed that age,heart failure,heart rate,respiratory rate,systolic blood pressure,unclear state of consciousness,serum creatinine and prealbumin were independent influencing factors of IHCA in COPD patients complicated with respiratory failure(P<0.05).According to the results of binary logistic regression analysis,a nomogram model for predicting the incidence of IHCA in COPD patients complicated with respiratory failure was constructed.The fitting degree of the model was determined by the H-L test.The calibration curve showed that the incidence of IHCA in COPD patients complicated with respiratory failure predicted by nomogram was in good agreement with the actual incidence of IHCA in patients with COPD complicated with respiratory failure(χ~2=2.017,P=0.334).The ROC curve showed an AUC of 0.627(95%CI:0.593-0.689,P<0.005),and the optimal cut point value for diagnosis was 0.69,at which the sensitivity and specificity were 42.57%and 96.03%,respectively.Conclusion:According to the independent influencing factors of IHCA in COPD patients complicated with respiratory failure,the establishment of a risk prediction nomogram model has high predictive value,which is worthy of clinical promotion.
文摘Objective:To explore the effect of atorvastatin on the expression of inflammatory cytokines in rats with Klebsiella pneumonia.Methods:90 healthy SPF-grade SD rats were randomly divided into three groups:atorvastatin group,model group and blank group(with 10 rats in each group),30 rats in each treatment period(3,6,9 d).A rat model of Klebsiella pneumonia was constructed,in which the blank group and the model group were given the same volume of saline,while the atorvastatin group was given 10 ml/kg of atorvastatin by intraperitoneal instillation.The rats were killed on the 10th day after administration,and the lung tissue was extracted to detect the pathological results and the expression of inflammatory cytokines was detected in serum.Results:Lung histopathology showed that lung histopathology and fibrosis were improved in atorvastatin group,and alveolar structure integrity≥50%and collagen fiber precipitation≤10%in atorvastatin group indicated that the model was successful.The expression of inflammatory cytokines showed that the levels of IL-6,TNF-αand TGF-βin the atorvastatin group and the model group were significantly increased compared with the blank group,with statistically significant differences(P<0.05).The levels of IL-6,TNF-αand TGF-βin atorvastatin group were lower than those in model group,and the levels of IL-10 in atorvastatin group were higher than those in model group,with statistically significant differences(P<0.05).After 9 days,the levels of IL-6,TNF-α,TGF-βand IL-10 in the atorvastatin group and the model group were higher than those in the blank group,with statistically significant differences(P<0.05).The results of immunological function study showed that WBC,RBC and PLT in orvastatin group and model group were significantly reduced at 3 d compared with the blank group,with statistically significant differences(P<0.05).After 6 and 9 d,WBC,RBC and PLT in atorvastatin group and model group were lower than those in blank group,and WBC,RBC and PLT in atorvastatin group were lower than those in model group,with statistically significant differences(P<0.05).Conclusion:Atorvastatin can significantly improve the immune dysfunction and the expression of inflammatory cytokines in rats with Klebsiella pneumonia.
