A retrospective analysis of the relationship between dermatomyositis-associated interstitial lung disease and disease duration,age,arterial blood gas pH,and serum Cl^(-)levels

Background:Dermatomyositis-associated interstitial lung disease(DM-ILD)represents a severe and insidious complication of dermatomyositis(DM).The study aimed to investigate the association between DM-ILD and arterial blood gas indices,serum ion levels,and the timing of interstitial lung disease onset,with the goal of identifying potential predictors for DM-ILD.Methods:The investigation involved the collection of basic data from 89 patients with DM hospitalized at the Chinese PLA General Hospital between January 2019 and April 2022,and 43 normal control patients hospitalized for physical examinations during the same period.Analyses were conducted to explore the relationship between DM-ILD,arterial blood gas indices,disease duration,and serum ions.A regression model to predict DM-ILD was developed using these indices,and a receiver operating characteristic curve was generated.Results:Significant differences were observed in pH and PaO2 between the control group and the disease group(p<0.05).The DM group exhibited higher levels of pH,actual bicarbonate,and base excess(BE)compared with the control group.In contrast,pH and BE levels were lower in the DM-ILD group than in the DM group,with these differences being statistically significant(p<0.05).Interstitial lung disease was correlated with the duration of the disease and pH levels(p<0.05).The cutoff values for age,disease duration,pH,and Cl^(-)were 55.5 years,5.5 years,7.432,and 101.5 mmol/L,respectively.The model demonstrated a prediction sensitivity and specificity for DM-ILD of 0.809 and 0.722,respectively,with an area under the curve of 0.809.Conclusion:Arterial blood gas analysis and serum Cl^(-)levels may assist in predicting DM-ILD.A combined monitoring approach involving arterial blood gas pH,disease duration,age,and serum Cl^(-)levels could enhance the accuracy of DM-ILD predictions and hold significant clinical evaluation potential.

Correlation between GEM Premier 3000 and Vitros5.1+5600, SYSMEX XN-9000 in Detecting Electrolytes and Red Blood Cell Volume

Objective: To explore the consistency and relevance of the results of the bedside rapid blood gas analyzer GEM premier 3000, the Vitros5.1+5600 biochemical immunoassay analyzer and the SYSMEX XN-9000 automatic blood cell analyzer in the central laboratory detecting serum potassium (K+), serumsodium (Na+), blood glucose (Glu), hemoglobin (Hb) and red blood cell volume (Hct). And to provide a reference for the accurate interpretation of the bedside blood gas analysis report. Method: Usually, ICU patients will be taken arterial blood gas, biochemical and blood samples through the arterial indwelling needle;at the same time patients’ potassium, serum sodium, blood glucose, hemoglobin and red blood cell volume will be detected. This study implemented paired t-test and correlation regression analysis on each group of data, and used the analysis quality requirements (allowable total error) of CLIA’88 proficiency testing program as the criteria for clinical acceptance. Results: The paired t-test showed that the serum potassium, serum sodium and blood glucose detected by GEM premier 3000 and Vitros5.1+5600 were significantly different;and the hemoglobin and red blood cell volume detected by GEM premier 3000 and SYSMEX XN-9000 were significantly different (P < 0.05). The Pearson correlation coefficients (r) of hemoglobin, red blood cell volume and red blood cell volume were 0.860, 0.886, 0.924, 0.841 and 0.856, respectively, and the above test items all had good correlations (P < 0.05). The average (SE) of the paired differences of K+, Na+, Glu, Hb and Hct detected by the two sets of instruments is less than the allowable error of CLIA’88, and the SE of blood Na+ and Hb is less than half of the allowable error of CLIA’88. Conclusion: The test results of GEM premier 3000, the central laboratory Vitros5.1+5600 and SYSMEX XN-9000 have good correlation, but the consistency is not good. The test results of GEM premier 3000 cannot replace the central laboratory.

糖皮质激素用于COPD急性加重期的疗效观察

目的比较全身使用激素及雾化吸入激素治疗COPD急性加重期(AECOPD)对血气分析分压及血糖影响的差异。方法将178例AECOPD患者随机分为观察组和对照组各89例。观察组给予布地奈德雾化吸入治疗,对照组给予甲泼尼龙静脉注射治疗。比较2组治疗前后的动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)、p H值及空腹血糖水平。结果治疗后观察组Pa O2高于治疗前,Pa CO2低于治疗前,差异均有统计学意义(P<0.01)。观察组治疗前后p H值及空腹血糖比较差异无统计学意义(P>0.05)。治疗后对照组Pa O2高于治疗前,空腹血糖高于治疗前,差异均有统计学意义(P<0.05)。对照组治疗前后Pa CO2及p H值比较差异无统计学意义(P>0.05)。结论对于AECOPD患者局部吸入激素疗效优于全身用药,不良反应少。

The Clinical Value of Artery Umbilical Cord Blood Gas in Predicting Neonate Condition:A Prospective Cohort Study

Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan,China,and 360 aUCBG samples were collected.The average age of pregnant women was(29.50±4.42)years,range from 19 to 48 years old.The gestational age range from 28+4 weeks to 41+3 weeks at admission.Logistic regression and area under the curve(AUC)from Receiver operating characteristic curves were used to identify risk factors,such as,premature rupture of membranes(PROM),high blood pressure,premature delivery(PD),low 1-minute Apgar scores(Apgar 1),low 5-minute Apgar scores(Apgar 5),pH,base excess,bicarbonate,neonatal blood sugar(NBS),and so on,to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters.Results:In all cases,PROM,PD,Apgar 1,Apgar 5,pH,base excess,bicarbonate,total carbon dioxide,and neonatal blood sugar were risk factors and were associated with poor condition of neonate.Apgar 1 were an independent risk factor.Combined traditional and aUCBG parameters had higher AUC of 0.895(95%confidence interval(C/):0.830-0.960,P<0.001).In cesarean section subgroup,high blood pressure,PD,and Apgar 1 were risk factors and were associated with poor condition of neonate.Apgar 1 and low pH were the independent risk factors.Combined traditional and aUCBG parameters had highest AUC of 0.940(95%C/:0.886-0.993,P<0.001).In vaginal delivery subgroup,maternal age above 35 years,PROM,PD,Apgar 1,Apgar 5,and male newborn were risk factors and were associated with poor condition of neonate.Maternal age above 35 years was an independent risk factor.Combined traditional and aUCBG parameters had highest AUC of 0.897(95%Cl:0.828-0.965,P<0.001).For pregnant women without comorbidities and complications of pregnancy,aUCBG may not be necessat7.Conclusion:In high-risk pregnancies,especially lower Apgar scores,PD,and maternal age above 35-year old,aUCBG is recommended.Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.

国产冲洗液与IL1300系列血气酸碱分析仪冲洗液的对比研究

在IL1300系列血气酸碱分析仪上,对国产冲洗液和IL公司冲洗液,从两点标定、pH标准液测定、血气标准物ABC测量,以及临床应用等方面,进行了性能对比研究。其结果证明国产冲洗液,已达到IL公司冲洗液的标准,完全可以替代IL公司冲洗液,用于IL1300系列血气酸碱分析仪。