目的探讨新型冠状病毒肺炎患者入院血糖水平对其预后评估的临床价值。方法选取2020年1月18日~2月26日序贯入住华中科技大学同济医学院附属同济医院明确诊断为新型冠状病毒肺炎(COVID-19)的420例患者为研究对象,记录是否并发糖尿病、入...目的探讨新型冠状病毒肺炎患者入院血糖水平对其预后评估的临床价值。方法选取2020年1月18日~2月26日序贯入住华中科技大学同济医学院附属同济医院明确诊断为新型冠状病毒肺炎(COVID-19)的420例患者为研究对象,记录是否并发糖尿病、入院首次血糖水平和入院时临床分型及院内死亡事件等资料,依据是否并发糖尿病分为糖尿病组与非糖尿病组,入组后根据院内死亡事件分为生存亚组与死亡亚组,根据临床分型分为普通型亚组、重型亚组与危重型亚组,分析比较组内各亚组间入院血糖水平的差异,另根据入院血糖水平(GLU)分为GLU 3.9~7.8mmol/L亚组、7.8~10.0mmol/L亚组和GLU>10.0mmol/L亚组,分析比较组内在不同血糖水平亚组下院内死亡率的差异,最后采用多变量logistic回归分析,研究入院血糖水平升高是否为糖尿病组与非糖尿病组患者在校正年龄、性别及基础疾病下院内死亡事件的独立危险因素。结果在非糖尿病组中,死亡亚组的入院血糖水平高于生存亚组[6.96(5.95,8.23)mmol/L vs 5.96(5.32,6.92)mmol/L],差异具有统计学意义(U=6047.0,P<0.001)。而在糖尿病组中,死亡亚组入院血糖水平虽高于生存亚组[12.42(8.41,18.17)mmol/L vs 9.88(7.79,14.02)mmol/L],但差异无统计学意义(U=1200.5,P=0.059)。以入院时临床分型分层,随入院时病情严重程度增加,非糖尿病组入院血糖水平亦随之升高,普通型亚组vs重型亚组vs危重型亚组血糖水平[5.87(5.24,6.69)mmol/L vs 6.94(5.95,7.90)mmol/L vs 9.73(6.22,11.64)mmol/L],两两比较差异均具有统计学意义(U=723.0~4978.0,均P<0.01)。而在糖尿病组中,随入院时病情严重程度增加,普通型亚组、重型亚组、危重型亚组入院血糖水平依次为9.88(7.81,11.93)mmol/L,12.42(8.43,16.94)mmol/L,11.43(7.89,18.76)mmol/L,两两比较差异均无统计学意义(U=262.0~946.5,均P>0.05)。以入院血糖水平分层,非糖尿病组在GLU>10.0mmol/L亚组院内死亡率最高达72.0%,高于GLU 3.9~7.8mmol/L亚组(24.8%)与7.8~10.0mmol/L亚组(30.0%),差异均有统计学意义(χ^(2)=24.607,9.625,均P<0.01),另GLU7.8~10.0mmol/L亚组较GLU 3.9~7.8mmol/L亚组相比院内死亡率差异无统计学意义(χ^(2)=0.383,P>0.05)。而在糖尿病组中,随入院血糖水平升高,GLU 3.9~7.8mmol/L亚组、GLU7.8~10.0mmol/L亚组、GLU<10.0 mmol/L亚组院内死亡率依次为34.8%,41.4%,49.2%,两两比较差异均无统计学意义(χ^(2)=0.236~1.380,均P>0.05)。多变量logistic回归分析显示,入院血糖水平GLU≥10.0mmol/L是非糖尿病COVID-19患者在校正年龄、性别及基础疾病后院内死亡事件的独立危险因素,其比值比(OR)为7.969,95%置信区间(95%CI)为3.022~21.013,而在糖尿病COVID-19患者中入院血糖水平升高并非院内死亡事件独立危险因素。结论入院血糖水平对未并发糖尿病COVID-19患者病情严重程度及院内死亡事件均具有良好的预测价值,对于既往无糖尿病史的COVID-19患者若存在入院高血糖往往提示预后不良。展开更多
To enhance the adhesion of seeding-cells to the biomaterial scaffolds, the PEG-hydrogels were modified. Porcine aortic valves were decellularized with Triton X-100 and trypsin. The cells were encapsulated into the PEG...To enhance the adhesion of seeding-cells to the biomaterial scaffolds, the PEG-hydrogels were modified. Porcine aortic valves were decellularized with Triton X-100 and trypsin. The cells were encapsulated into the PEG-hydrogels to complete the process of the cells attaching to the acellular porcine aortic valves. Herein, the autologous mesenchymal stem cells （MSCs） of goats were selected as the seeding-cells and the tendency of MSCs toward differentiation was observed when the single semilunar TEHV had been implanted into their abdominal aortas. Furthermore, VEGF, TGF-β1, and the cell adhesive peptide motif RGD were incorporated. Light and electron microscopy observations were performed. Analysis of modified PEG-hydrogels TEHV＇s （PEG-TEHV） tensile strength, and the ratio of reendothelial and mural thrombosis revealed much better improvement than the naked acellular porcine aortic valve （NAPAV）. The data illustrated the critical importance of MSC differentiation into endothelial and myofibroblast for remodeling into native tissue. Our results indicate that it is feasible to reconstruct TEHV efficiently by combining modified PEG-hydrogels with acellular biomaterial scaffold andautologous MSCs cells.展开更多
文摘目的探讨新型冠状病毒肺炎患者入院血糖水平对其预后评估的临床价值。方法选取2020年1月18日~2月26日序贯入住华中科技大学同济医学院附属同济医院明确诊断为新型冠状病毒肺炎(COVID-19)的420例患者为研究对象,记录是否并发糖尿病、入院首次血糖水平和入院时临床分型及院内死亡事件等资料,依据是否并发糖尿病分为糖尿病组与非糖尿病组,入组后根据院内死亡事件分为生存亚组与死亡亚组,根据临床分型分为普通型亚组、重型亚组与危重型亚组,分析比较组内各亚组间入院血糖水平的差异,另根据入院血糖水平(GLU)分为GLU 3.9~7.8mmol/L亚组、7.8~10.0mmol/L亚组和GLU>10.0mmol/L亚组,分析比较组内在不同血糖水平亚组下院内死亡率的差异,最后采用多变量logistic回归分析,研究入院血糖水平升高是否为糖尿病组与非糖尿病组患者在校正年龄、性别及基础疾病下院内死亡事件的独立危险因素。结果在非糖尿病组中,死亡亚组的入院血糖水平高于生存亚组[6.96(5.95,8.23)mmol/L vs 5.96(5.32,6.92)mmol/L],差异具有统计学意义(U=6047.0,P<0.001)。而在糖尿病组中,死亡亚组入院血糖水平虽高于生存亚组[12.42(8.41,18.17)mmol/L vs 9.88(7.79,14.02)mmol/L],但差异无统计学意义(U=1200.5,P=0.059)。以入院时临床分型分层,随入院时病情严重程度增加,非糖尿病组入院血糖水平亦随之升高,普通型亚组vs重型亚组vs危重型亚组血糖水平[5.87(5.24,6.69)mmol/L vs 6.94(5.95,7.90)mmol/L vs 9.73(6.22,11.64)mmol/L],两两比较差异均具有统计学意义(U=723.0~4978.0,均P<0.01)。而在糖尿病组中,随入院时病情严重程度增加,普通型亚组、重型亚组、危重型亚组入院血糖水平依次为9.88(7.81,11.93)mmol/L,12.42(8.43,16.94)mmol/L,11.43(7.89,18.76)mmol/L,两两比较差异均无统计学意义(U=262.0~946.5,均P>0.05)。以入院血糖水平分层,非糖尿病组在GLU>10.0mmol/L亚组院内死亡率最高达72.0%,高于GLU 3.9~7.8mmol/L亚组(24.8%)与7.8~10.0mmol/L亚组(30.0%),差异均有统计学意义(χ^(2)=24.607,9.625,均P<0.01),另GLU7.8~10.0mmol/L亚组较GLU 3.9~7.8mmol/L亚组相比院内死亡率差异无统计学意义(χ^(2)=0.383,P>0.05)。而在糖尿病组中,随入院血糖水平升高,GLU 3.9~7.8mmol/L亚组、GLU7.8~10.0mmol/L亚组、GLU<10.0 mmol/L亚组院内死亡率依次为34.8%,41.4%,49.2%,两两比较差异均无统计学意义(χ^(2)=0.236~1.380,均P>0.05)。多变量logistic回归分析显示,入院血糖水平GLU≥10.0mmol/L是非糖尿病COVID-19患者在校正年龄、性别及基础疾病后院内死亡事件的独立危险因素,其比值比(OR)为7.969,95%置信区间(95%CI)为3.022~21.013,而在糖尿病COVID-19患者中入院血糖水平升高并非院内死亡事件独立危险因素。结论入院血糖水平对未并发糖尿病COVID-19患者病情严重程度及院内死亡事件均具有良好的预测价值,对于既往无糖尿病史的COVID-19患者若存在入院高血糖往往提示预后不良。
文摘To enhance the adhesion of seeding-cells to the biomaterial scaffolds, the PEG-hydrogels were modified. Porcine aortic valves were decellularized with Triton X-100 and trypsin. The cells were encapsulated into the PEG-hydrogels to complete the process of the cells attaching to the acellular porcine aortic valves. Herein, the autologous mesenchymal stem cells （MSCs） of goats were selected as the seeding-cells and the tendency of MSCs toward differentiation was observed when the single semilunar TEHV had been implanted into their abdominal aortas. Furthermore, VEGF, TGF-β1, and the cell adhesive peptide motif RGD were incorporated. Light and electron microscopy observations were performed. Analysis of modified PEG-hydrogels TEHV＇s （PEG-TEHV） tensile strength, and the ratio of reendothelial and mural thrombosis revealed much better improvement than the naked acellular porcine aortic valve （NAPAV）. The data illustrated the critical importance of MSC differentiation into endothelial and myofibroblast for remodeling into native tissue. Our results indicate that it is feasible to reconstruct TEHV efficiently by combining modified PEG-hydrogels with acellular biomaterial scaffold andautologous MSCs cells.
