BACKGROUND Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus(T2DM)is associated with the levels of serum tumor markers of the digestive tract,such as cancer antigen(CA)199.Therefore,tumor ...BACKGROUND Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus(T2DM)is associated with the levels of serum tumor markers of the digestive tract,such as cancer antigen(CA)199.Therefore,tumor markers in T2DM are important.AIM To evaluate the expression of serum tumor markers[CA199,CA242,and carcinoembryonic antigen(CEA)]and the clinical implications of the expression in T2DM.METHODS For this observational study conducted at Hefei BOE Hospital,China,we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020.Levels of fasting blood glucose(FBG),tumor markers(CA199,CEA,and CA242),glycosylated hemoglobin(HbA1c),etc.were measured and group index levels were compared.Moreover,FBG and HbA1c levels were correlated with tumor marker levels.Tumor markers were tested for diagnostic accuracy in patients with>9%HbA1c using the receiver operating curve(ROC)curve.RESULTS The T2DM group had high serum FBG,HbA1c,CA199,and CEA levels(P<0.05).A comparative analysis of the two groups based on HbA1c levels(Group A:HbA1c≤9%;Group B:HbA1c>9%)revealed significant differences in CEA and CA199 levels(P<0.05).The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809,respectively.CA199,CEA,and CA242 levels positively correlated with HbA1c(r=0.308,0.426,and 0.551,respectively)and FBG levels(r=0.236,0.231,and 0.298,respectively).CONCLUSION As compared to controls,serum CEA and CA199 levels were higher in patients with T2DM.HbA1c and FBG levels correlated with CA199,CEA,and CA242 levels.Patients with poorly controlled blood sugar must be screened for tumor markers.展开更多
The widespread use of gastrointestinal bleeding prophylaxis in critically ill patients was one of the most controversial issues. Since few studies reported the incidence of gastrointestinal bleeding in mechanically ve...The widespread use of gastrointestinal bleeding prophylaxis in critically ill patients was one of the most controversial issues. Since few studies reported the incidence of gastrointestinal bleeding in mechanically ventilated patients, this study aimed to identify the incidence and risk factors related to gastrointestinal bleeding in patients undergoing mechanical ventilation for more than 48 hours. A total of 283 IOU patients who had received mechanical ventilation for longer than 48 hours at a provincial hospital affiliated to Shandong University from January 1,2007 to December 31, 2009 were analyzed retrospectively. Those were excluded from the study if they had a history of gastrointestinal bleeding or ulceration, recent gastrointestinal surgery, brain death and active bleeding from the nose or throat. Demographic data of the patients included patient age, diagnosis on admission, duration of ICU stay, duration of ventilation, patterns and parameters of ventilation, ICU mortality, APACHE II score, multiple organ dysfunction, and indexes of biochemistry, kidney function, liver function and coagulation function. Risk factors of gastrointestinal bleeding were analyzed by univariate analysis and multiple logistic regression analysis. In the 242 patients who were given mechanical ventilation longer than 48 hours, the incidence of gastrointestinal bleeding was 46.7%. The bleeding in 3.3% of the patients was clinically significant. Significant risk factors were peak inspiratory pressure 〉30cmH2O, renal failure, liver failure, PLT count〈50xl09/L and prolonged APTT. Enteral nutrition had a beneficial effect on gastrointestinal bleeding. However, the multiple logistic regression analysis revealed that the independent risk factors of gastrointestinal bleeding were as follows： high pressure ventilator setting 〉 30cmH2O（RR=3.478, 95%CI=2.208-10.733）, renal failure（RR=1 .687, 95%CI=1.098-3.482）, PLT count〈50×10^9/L （RR=3.762, 95%CI=2.346-14.685）, and prolonged APTT（RR=5.368, 95%CI=2.487-11.266）. Enteral nutrition（RR=0.436, 95%CI= 0.346-0.764） was the independent protective factor. The incidence of gastrointestinal bleeding was high in the patients who received mechanical ventilation, and bleeding usually occurred within the first 48 hours. High pressure ventilator setting, renal failure, decreased PLT count and prolonged APTT were the significant risk factors of gastrointestinal bleeding. However, enteral nutrition was the independent protective factor.展开更多
Novel cationic cotton fabrics were prepared by an efficient and simple one-step pad–dry–bake pretreatment process with betaine as cationic reagent. Ester bonds formed between cotton fibers and betaine hydrochloride ...Novel cationic cotton fabrics were prepared by an efficient and simple one-step pad–dry–bake pretreatment process with betaine as cationic reagent. Ester bonds formed between cotton fibers and betaine hydrochloride were proved by Fourier transformed infrared attenuated total reflection(FTIR-ATR) spectra. Moreover, the properties of the cationic fabrics, including X-ray Diffraction(XRD), tensile strength and whiteness and yellowness index,were investigated in comparison with that of the untreated ones. The cationic fabrics were applied in salt-free dyeing of C.I. Reactive Red 195, C.I. Reactive Yellow 145 and C.I. Reactive Blue 19. Different dye fixation processes were applied and compared for untreated and cationic cotton. Dye fixation and color fastness properties of the dyes were tested, and the results presented that dye fixation on the cationic fabrics in the absence of salt was improved with satisfactory light fastness property and applicable wash and rub fastnesses.展开更多
The research study proposes to examine a three-dimensional visualization program, emphasizing on improving genetic algorithms through the optimization of a layout design-based standard and discrete shipbuilding worksh...The research study proposes to examine a three-dimensional visualization program, emphasizing on improving genetic algorithms through the optimization of a layout design-based standard and discrete shipbuilding workshop. By utilizing a steel processing workshop as an example, the principle of minimum logistic costs will be implemented to obtain an ideological equipment layout, and a mathematical model. The objectiveness is to minimize the total necessary distance traveled between machines. An improved control operator is implemented to improve the iterative efficiency of the genetic algorithm, and yield relevant parameters. The Computer Aided Tri-Dimensional Interface Application （CATIA） software is applied to establish the manufacturing resource base and parametric model of the steel processing workshop. Based on the results of optimized planar logistics, a visual parametric model of the steel processing workshop is constructed, and qualitative and quantitative adjustments then are applied to the model. The method for evaluating the results of the layout is subsequently established through the utilization of AHP. In order to provide a mode of reference to the optimization and layout of the digitalized production workshop, the optimized discrete production workshop will possess a certain level of practical significance.展开更多
Introduction Human serum albumin(HSA)is a non-glycosylated,negatively charged,single-chain polypeptide composed of 585 amino acid residues with a relative molecular mass of 66.438 kD.It is synthesized by the liver at ...Introduction Human serum albumin(HSA)is a non-glycosylated,negatively charged,single-chain polypeptide composed of 585 amino acid residues with a relative molecular mass of 66.438 kD.It is synthesized by the liver at a rate of approximately 200 mg·kg^(-1)·day^(-1),with a half-life of 21 days,and subjected to catabolism in the muscles,liver,and kidneys at a rate of 4%per day.[1]Albumin,accounting for 60%of the total plasma protein,has various physiological functions,[2]such as maintaining 70%to 80%of effective plasma colloid osmotic pressure,coordinating vascular endothelial integrity,anti-oxidant and anti-inflammatory activities,maintaining the acidbase balance,and participating in the transport,distribution,and metabolism of a variety of endogenous and exogenous substances.展开更多
Introduction The incidence of hyperglycemia is 40-60%in critically ill patients and is up to 60-80%in those who have undergone car-diac surgery.[1]The results of an epidemiological study in the United States showed th...Introduction The incidence of hyperglycemia is 40-60%in critically ill patients and is up to 60-80%in those who have undergone car-diac surgery.[1]The results of an epidemiological study in the United States showed that 28.6%of diabetic patients and 9.3%of non-diabetic patients had elevated mean daily glucose on the day of ICU admission.[2]In critically ill patients,elevated blood glucose is primarily the result of stress,and stress-induced hy-perglycemia is an independent risk factor associated with prog-nosis,regardless of a previous diagnosis of diabetes.Nutritional therapy has become an integral treatment option for patients in the ICU,[3,4]though nearly 30%of patients with enteral nu-trition and 44-50%with parenteral nutrition(PN)experience elevated glucose.[5,6]Intensive insulin therapy(IIT)is an impor-tant treatment for controlling hyperglycemia in critically ill pa-tients,but it also carries a corresponding risk of hypoglycemia.展开更多
Background:Vancomycin treatment failure against vancomycin-susceptible gram-positive cocci is not rare in the intensive care unit(ICU).One of the reasons for this is the substandard drug trough concentration.We aimed ...Background:Vancomycin treatment failure against vancomycin-susceptible gram-positive cocci is not rare in the intensive care unit(ICU).One of the reasons for this is the substandard drug trough concentration.We aimed to examine the hypothesis that the target serum concentration could be reached earlier with a loading dose of vancomycin.Methods:This retrospective cohort study was conducted at our ICU between June 2018 and June 2020 and involved patients who were suspected of having,or confirmed to have,gram-positive cocci infection and treated with vancomycin.One group of the patients was administered a loading dose of vancomycin(loading group)and compared with the group that did not receive a loading dose(control group).The baseline characteristics,vancomycin serum concentrations,and clinical outcomes were collected and analyzed.Results:Fifty-five patients were finally included,of which 29 received a loading dose of vancomycin.The serum concentration of vancomycin before the second dose was significantly higher for the loading group than for the control group(10.3±6.1 mg/Lvs.5.7±4.4 mg/L,P=0.002).The results for both groups were similar before the fifth dose(12.4±7.3 mg/Lvs.10.3±6.3 mg/L in the loading and the control groups,respectively;P=0.251).The 28-day mortality was lower for the loading group than for the control group(6.7%vs.34.6%in the loading and control groups,respectively;P=0.026).No significant differences were observed in serum creatinine(Cr)concentrations of the two groups.Conclusion:With the loading dose of vancomycin,the target serum concentration of vancomycin may be reached earlier without increasing the risk of acute kidney injury.展开更多
文摘BACKGROUND Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus(T2DM)is associated with the levels of serum tumor markers of the digestive tract,such as cancer antigen(CA)199.Therefore,tumor markers in T2DM are important.AIM To evaluate the expression of serum tumor markers[CA199,CA242,and carcinoembryonic antigen(CEA)]and the clinical implications of the expression in T2DM.METHODS For this observational study conducted at Hefei BOE Hospital,China,we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020.Levels of fasting blood glucose(FBG),tumor markers(CA199,CEA,and CA242),glycosylated hemoglobin(HbA1c),etc.were measured and group index levels were compared.Moreover,FBG and HbA1c levels were correlated with tumor marker levels.Tumor markers were tested for diagnostic accuracy in patients with>9%HbA1c using the receiver operating curve(ROC)curve.RESULTS The T2DM group had high serum FBG,HbA1c,CA199,and CEA levels(P<0.05).A comparative analysis of the two groups based on HbA1c levels(Group A:HbA1c≤9%;Group B:HbA1c>9%)revealed significant differences in CEA and CA199 levels(P<0.05).The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809,respectively.CA199,CEA,and CA242 levels positively correlated with HbA1c(r=0.308,0.426,and 0.551,respectively)and FBG levels(r=0.236,0.231,and 0.298,respectively).CONCLUSION As compared to controls,serum CEA and CA199 levels were higher in patients with T2DM.HbA1c and FBG levels correlated with CA199,CEA,and CA242 levels.Patients with poorly controlled blood sugar must be screened for tumor markers.
文摘The widespread use of gastrointestinal bleeding prophylaxis in critically ill patients was one of the most controversial issues. Since few studies reported the incidence of gastrointestinal bleeding in mechanically ventilated patients, this study aimed to identify the incidence and risk factors related to gastrointestinal bleeding in patients undergoing mechanical ventilation for more than 48 hours. A total of 283 IOU patients who had received mechanical ventilation for longer than 48 hours at a provincial hospital affiliated to Shandong University from January 1,2007 to December 31, 2009 were analyzed retrospectively. Those were excluded from the study if they had a history of gastrointestinal bleeding or ulceration, recent gastrointestinal surgery, brain death and active bleeding from the nose or throat. Demographic data of the patients included patient age, diagnosis on admission, duration of ICU stay, duration of ventilation, patterns and parameters of ventilation, ICU mortality, APACHE II score, multiple organ dysfunction, and indexes of biochemistry, kidney function, liver function and coagulation function. Risk factors of gastrointestinal bleeding were analyzed by univariate analysis and multiple logistic regression analysis. In the 242 patients who were given mechanical ventilation longer than 48 hours, the incidence of gastrointestinal bleeding was 46.7%. The bleeding in 3.3% of the patients was clinically significant. Significant risk factors were peak inspiratory pressure 〉30cmH2O, renal failure, liver failure, PLT count〈50xl09/L and prolonged APTT. Enteral nutrition had a beneficial effect on gastrointestinal bleeding. However, the multiple logistic regression analysis revealed that the independent risk factors of gastrointestinal bleeding were as follows： high pressure ventilator setting 〉 30cmH2O（RR=3.478, 95%CI=2.208-10.733）, renal failure（RR=1 .687, 95%CI=1.098-3.482）, PLT count〈50×10^9/L （RR=3.762, 95%CI=2.346-14.685）, and prolonged APTT（RR=5.368, 95%CI=2.487-11.266）. Enteral nutrition（RR=0.436, 95%CI= 0.346-0.764） was the independent protective factor. The incidence of gastrointestinal bleeding was high in the patients who received mechanical ventilation, and bleeding usually occurred within the first 48 hours. High pressure ventilator setting, renal failure, decreased PLT count and prolonged APTT were the significant risk factors of gastrointestinal bleeding. However, enteral nutrition was the independent protective factor.
基金Supported by the National Natural Science Foundation of China(2137604221421005)+2 种基金the National Key Technology R&D Program(2013BAF08B06)Innovative Research Team of Ministry of Education of the People's Republic of China(IRT-13R06)Dalian University of Technology(DUT2013TB07)
文摘Novel cationic cotton fabrics were prepared by an efficient and simple one-step pad–dry–bake pretreatment process with betaine as cationic reagent. Ester bonds formed between cotton fibers and betaine hydrochloride were proved by Fourier transformed infrared attenuated total reflection(FTIR-ATR) spectra. Moreover, the properties of the cationic fabrics, including X-ray Diffraction(XRD), tensile strength and whiteness and yellowness index,were investigated in comparison with that of the untreated ones. The cationic fabrics were applied in salt-free dyeing of C.I. Reactive Red 195, C.I. Reactive Yellow 145 and C.I. Reactive Blue 19. Different dye fixation processes were applied and compared for untreated and cationic cotton. Dye fixation and color fastness properties of the dyes were tested, and the results presented that dye fixation on the cationic fabrics in the absence of salt was improved with satisfactory light fastness property and applicable wash and rub fastnesses.
文摘The research study proposes to examine a three-dimensional visualization program, emphasizing on improving genetic algorithms through the optimization of a layout design-based standard and discrete shipbuilding workshop. By utilizing a steel processing workshop as an example, the principle of minimum logistic costs will be implemented to obtain an ideological equipment layout, and a mathematical model. The objectiveness is to minimize the total necessary distance traveled between machines. An improved control operator is implemented to improve the iterative efficiency of the genetic algorithm, and yield relevant parameters. The Computer Aided Tri-Dimensional Interface Application （CATIA） software is applied to establish the manufacturing resource base and parametric model of the steel processing workshop. Based on the results of optimized planar logistics, a visual parametric model of the steel processing workshop is constructed, and qualitative and quantitative adjustments then are applied to the model. The method for evaluating the results of the layout is subsequently established through the utilization of AHP. In order to provide a mode of reference to the optimization and layout of the digitalized production workshop, the optimized discrete production workshop will possess a certain level of practical significance.
基金the Wisdom Medical Research Project of Shanghai Municipal Health Commission(No.2018ZHYL0227)the Shanghai Science and Technology Commission(No.20DZ2200500).
文摘Introduction Human serum albumin(HSA)is a non-glycosylated,negatively charged,single-chain polypeptide composed of 585 amino acid residues with a relative molecular mass of 66.438 kD.It is synthesized by the liver at a rate of approximately 200 mg·kg^(-1)·day^(-1),with a half-life of 21 days,and subjected to catabolism in the muscles,liver,and kidneys at a rate of 4%per day.[1]Albumin,accounting for 60%of the total plasma protein,has various physiological functions,[2]such as maintaining 70%to 80%of effective plasma colloid osmotic pressure,coordinating vascular endothelial integrity,anti-oxidant and anti-inflammatory activities,maintaining the acidbase balance,and participating in the transport,distribution,and metabolism of a variety of endogenous and exogenous substances.
文摘Introduction The incidence of hyperglycemia is 40-60%in critically ill patients and is up to 60-80%in those who have undergone car-diac surgery.[1]The results of an epidemiological study in the United States showed that 28.6%of diabetic patients and 9.3%of non-diabetic patients had elevated mean daily glucose on the day of ICU admission.[2]In critically ill patients,elevated blood glucose is primarily the result of stress,and stress-induced hy-perglycemia is an independent risk factor associated with prog-nosis,regardless of a previous diagnosis of diabetes.Nutritional therapy has become an integral treatment option for patients in the ICU,[3,4]though nearly 30%of patients with enteral nu-trition and 44-50%with parenteral nutrition(PN)experience elevated glucose.[5,6]Intensive insulin therapy(IIT)is an impor-tant treatment for controlling hyperglycemia in critically ill pa-tients,but it also carries a corresponding risk of hypoglycemia.
基金This work was supported by grants from Ruijin Hospital,Affiliated to Shanghai Jiao Tong University School of Medicine(No.2018ZY04 and No.2019ZY22)the Shanghai Jiading District Health Commission(No.2019-QN-04)。
文摘Background:Vancomycin treatment failure against vancomycin-susceptible gram-positive cocci is not rare in the intensive care unit(ICU).One of the reasons for this is the substandard drug trough concentration.We aimed to examine the hypothesis that the target serum concentration could be reached earlier with a loading dose of vancomycin.Methods:This retrospective cohort study was conducted at our ICU between June 2018 and June 2020 and involved patients who were suspected of having,or confirmed to have,gram-positive cocci infection and treated with vancomycin.One group of the patients was administered a loading dose of vancomycin(loading group)and compared with the group that did not receive a loading dose(control group).The baseline characteristics,vancomycin serum concentrations,and clinical outcomes were collected and analyzed.Results:Fifty-five patients were finally included,of which 29 received a loading dose of vancomycin.The serum concentration of vancomycin before the second dose was significantly higher for the loading group than for the control group(10.3±6.1 mg/Lvs.5.7±4.4 mg/L,P=0.002).The results for both groups were similar before the fifth dose(12.4±7.3 mg/Lvs.10.3±6.3 mg/L in the loading and the control groups,respectively;P=0.251).The 28-day mortality was lower for the loading group than for the control group(6.7%vs.34.6%in the loading and control groups,respectively;P=0.026).No significant differences were observed in serum creatinine(Cr)concentrations of the two groups.Conclusion:With the loading dose of vancomycin,the target serum concentration of vancomycin may be reached earlier without increasing the risk of acute kidney injury.
基金the financial support of the National Natural Science Foundation of China(Nos.20806013, 20923006)the National Key Technology R&D Program(No. 2011BAE07B08)
文摘Received 26 September 2012 Received in revised form 18 December 20 Accepted 1 January 2013 Available online 4 February 2013
