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脓毒症患者血清I-FABP、D-Lac、hs-CRP水平的变化及其临床意义 被引量:9
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作者 杨火保 刘进生 郑彩罚 《海南医学》 CAS 2021年第18期2331-2333,共3页
目的探讨脓毒症患者血清肠型脂肪酸结合蛋白(I-FABP)、D-乳酸(D-Lac)、高敏C反应蛋白(hs-CRP)水平的变化及其临床意义。方法回顾性分析2019年4月至2021年4月福建省立医院收治的83例脓毒症患者的临床资料,将合并脓毒症休克的45例患者纳... 目的探讨脓毒症患者血清肠型脂肪酸结合蛋白(I-FABP)、D-乳酸(D-Lac)、高敏C反应蛋白(hs-CRP)水平的变化及其临床意义。方法回顾性分析2019年4月至2021年4月福建省立医院收治的83例脓毒症患者的临床资料,将合并脓毒症休克的45例患者纳入休克组,未合并脓毒症休克的38例患者纳入无休克组,另选择同期在我院行健康体检的50例健康者作为对照组。比较三组受检者的I-FABP、D-Lac和Hs-CRP水平。将脓毒症患者按照感染部位分为腹腔感染组(n=57)和非腹腔感染组(n=26),比较两组患者的血清I-FABP、D-Lac、hs-CRP水平。结果脓毒症无休克组与休克组患者的I-FABP、D-Lac、hs-CRP水平分别为(28.64±5.36)ng/mL、(15.83±7.36)mg/L、(52.41±9.47)mg/L与(37.94±5.91)ng/mL、(28.41±8.86)mg/L、(66.53±14.39)mg/L,明显高于对照组的(18.15±2.39)ng/mL、(9.26±3.18)mg/L、(8.36±2.11)mg/L,且无休克组患者的I-FABP、D-Lac、hs-CRP水平明显低于休克组,差异均有统计学意义(P<0.05);腹腔感染组患者的血清I-FABP、hs-CRP水平分别为(35.93±5.92)ng/mL、(65.14±15.27)mg/L,明显高于非腹腔感染组的(24.72±7.25)ng/mL、(49.72±8.26)mg/L,差异均有统计学意义(P<0.05);但腹腔感染组患者的血清D-Lac水平为(25.43±11.62)mg/L,与非腹腔感染组的(30.67±13.81)mg/L比较差异无统计学意义(P>0.05)。结论脓毒症患者血清I-FABP、D-Lac、hs-CRP水平均明显升高,且合并脓毒症休克的患者升高更加明显,可以作为反应脓毒症疾病严重程度的重要指标,而血清I-FABP、hs-CRP水平在脓毒症腹腔感染患者中明显升高。 展开更多
关键词 脓毒症 脓毒性休克 肠型脂肪酸结合蛋白 D-乳酸 高敏C反应蛋白 肠道损伤
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Value of combining the serum D-lactate, diamine oxidase, and endotoxin levels to predict gut-derived infections in cancer patients
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作者 Shou-Mei Yang Xiao-Dan Zhang +7 位作者 Huai-XingMa DanWu XingLiu Hao-Bin Yu Shi-Wei Li Wen-Jun Gao Wei-Wei Liu Su-Yi Li 《Journal of Nutritional Oncology》 2023年第2期101-106,共6页
Objective:This is a retrospective observational cohort study.The objective of this retrospective observational cohort study was to evaluate the value of the combined serum D-lactic acid,diamine oxidase(DAO),and endoto... Objective:This is a retrospective observational cohort study.The objective of this retrospective observational cohort study was to evaluate the value of the combined serum D-lactic acid,diamine oxidase(DAO),and endotoxin levels to predict intestinal barrier impairment and gut-derived infection(GDI)in cancer patients.Methods:Cancer patients receiving chemotherapy or palliative care treatment at our hospital were enrolled in the study.The serum concentrations of DAO,D-lactic acid,and endotoxin were determined using the intestinal barrier function biochemical index analysis system.The patients'infection information came from the hospital's Medicom Prescription Automatic Screening System and themedical records.Three hundred fifty-three cancer patients were included in the study(53.8%female,73.7%cancer stage IV,27.8%had bowel obstruction).Results:The total incidence of GDI was 33.4%(118/353).The median length of hospital stay was 16 days for patients with GDI,compared with 7 days for patients without GDI(P<0.001).The media hospitalization costs were¥27,362.35 for patients with GDI compared with¥11,614.08 for patients without GDI(P<0.001).The serum concentrations of DAO,D-lactic acid,and endotoxin were significantly higher in patients with GDI.As malignant bowel obstruction(MBO)worsened,the concentrations of DAO,D-lactic acid,and endotoxin increased.Multivariate logistic regression models revealed that the DAO,endotoxin,IL-6,and C-reactive protein levels were significantly associated with an increased risk of GDI.In addition,we also found a fivefold increased risk of infection in patients withMBO compared with those without bowel obstruction(OR=6.210,P<0.001).All of the areas under the receiver operating characteristic curve(AUCs)for DAO,D-lactate,and endotoxin to predict GDI were<0.7(AUC=0.648,P<0.001;AUC=0.624,P<0.01;AUC=0.620,P<0.01,respectively).However,when the parameters were combined(DAO+D-lactate+endotoxin),the predictive power increased significantly(AUC=0.797,P<0.001).Moreover,combining these intestinal barrier indicators and the presence of MBO had better power to predict GDI than either alone(AUC=0.837,P<0.001).Conclusions:Combining the serum DAO,D-lactic acid,and endotoxin levels was a better predictor of GDI than any of the indicators alone,and combining these with the diagnosis of MBO could further improve the efficacy for predicting GDI. 展开更多
关键词 Cancer Diamine oxidase d-lactic acid ENDOTOXIN Gut-derived infection
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Immunologically effective poly(D-lactic acid) nanoparticle enhances anticancer immune response 被引量:2
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作者 Weiguo Xu Yuanzhen Su +5 位作者 Yang Ma Qi Wei Jiazhen Yang Xiuli Zhuang Jianxun Ding Xuesi Chen 《Science China Chemistry》 SCIE EI CAS CSCD 2023年第4期1150-1160,共11页
Chiral materials with the same atomic compositions exhibit different chemical,physical,and biological properties because of their distinct spatial structures.Herein,a chiral strategy was proposed to develop poly(lacti... Chiral materials with the same atomic compositions exhibit different chemical,physical,and biological properties because of their distinct spatial structures.Herein,a chiral strategy was proposed to develop poly(lactic acid)(PLA)nanoparticle as an efficient nanoadjuvant to activate adaptive anticancer immunity.Two chiral nanovaccines were prepared by directly mixing amino-terminated PLA(PLLA-NH2 or PDLA-NH2)with the model protein antigen ovalbumin(OVA).After being injected into mice subcutaneously,both nanovaccines efficiently migrated to the lymph nodes to initiate the sequential anticancer immune responses.Compared with the PLLA nanovaccine(PLLA-OVA),the PDLA one(PDLA-OVA)contributed to more robust dendritic cell(DC)maturation,antigen presentation,and T lymphocyte activation.In addition to the activation of cellular immunity,PDLA-OVA also triggered a more vigorous activation of humoral immunity,which induced the production of more anti-OVA immunoglobulin G(IgG)than PLLA-OVA.When used as prophylactic or therapeutic nanovaccine toward murine melanoma models,PDLA-OVA triggered more potent adaptive anticancer immune responses that more effectively inhibited the cancer genesis and progression,indicating the significant potential of immunologically effective PDLA nanoadjuvant in cancer immunotherapy. 展开更多
关键词 poly(d-lactic acid) chiral nanomaterial immune nanoadjuvant NANOVACCINE cancer immunotherapy
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Yinlai Decoction Protects Microstructure of Colon and Regulates Serum Level of D-Lactic Acid in Pneumonia Mice Fed with High-Calorie and High-Protein Diet
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作者 WANG Yun-hui YU He +13 位作者 LIU Tie-gang Teck Chuan Kong ZHENG Zi-an WAN Yu-xiang BAI Chen HAO Yu MAO Ying-qiu WU Jun XU Jing-nan CUI Li-jun WANG Yu-han SHAN Yan-ran SHAO Ying-jun GU Xiao-hong 《Chinese Journal of Integrative Medicine》 SCIE CAS CSCD 2023年第8期714-720,共7页
Objective To investigate the effect of Yinlai Decoction(YD)on the microstructure of colon,and activity of D-lactic acid(DLA)and diamine oxidase(DAO)in serum of pneumonia mice model fed with high-calorie and high-prote... Objective To investigate the effect of Yinlai Decoction(YD)on the microstructure of colon,and activity of D-lactic acid(DLA)and diamine oxidase(DAO)in serum of pneumonia mice model fed with high-calorie and high-protein diet(HCD).Methods Sixty male Kunming mice were randomly divided into 6 groups by the random number table method:normal control,pneumonia,HCD,HCD with pneumonia(HCD-P),YD(229.2 mg/mL),and dexamethasone(15.63 mg/mL)groups,with 10 in each group.HCD mice were fed with 52%milk solution by gavage.Pneumonia mice was modeled with lipopolysaccharide inhalation and was fed by gavage with either the corresponding therapeutic drugs or saline water,twice daily,for 3 days.After hematoxylin-eosin staining,the changes in the colon structure were observed under light microscopy and transmission electron microscope,respectively.Enzyme-linked immunosorbent assay was used to detect the protein levels of DLA and DAO in the serum of mice.Results The colonic mucosal structure and ultrastructure of mice in the normal control group were clear and intact.The colonic mucosal goblet cells in the pneumonia group tended to increase,and the size of the microvilli varied.In the HCD-P group,the mucosal goblet cells showed a marked increase in size with increased secretory activity.Loose mucosal epithelial connections were also observed,as shown by widened intercellular gaps with short sparse microvilli.These pathological changes of intestinal mucosa were significantly reduced in mouse models with YD treatment,while there was no significant improvement after dexamethasone treatment.The serum DLA level was significantly higher in the pneumonia,HCD,and HCD-P groups as compared with the normal control group(P<0.05).Serum DLA was significantly lower in the YD group than HCD-P group(P<0.05).Moreover,serum DLA level significantly increased in the dexamethasone group as compared with the YD group(P<0.01).There was no statistical significance in the serum level of DAO among groups(P>0.05).Conclusions YD can protect function of intestinal mucosa by improving the tissue morphology of intestinal mucosa and maintaining integrity of cell connections and microvilli structure,thereby reducing permeability of intestinal mucosa to regulate the serum levels of DLA in mice. 展开更多
关键词 Yinlai Decoction Chinese medicine PNEUMONIA MICROSTRUCTURE d-lactic acid diamine oxidase
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D-二聚体联合乳酸对急诊科疑似脓毒症患者预后的预测价值 被引量:20
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作者 李心笛 寿松涛 《中国急救医学》 CAS CSCD 北大核心 2018年第4期323-327,共5页
目的 观察不同严重程度脓毒症患者D-二聚体(D-Dimer, D-D)、乳酸(Lactic Acid, Lac)和C反应蛋白(C-reactive protein, CRP)水平变化,探讨D-D、Lac对脓毒症患者预后评估的临床价值。方法 回顾性分析急诊科209例临床诊断疑似脓毒... 目的 观察不同严重程度脓毒症患者D-二聚体(D-Dimer, D-D)、乳酸(Lactic Acid, Lac)和C反应蛋白(C-reactive protein, CRP)水平变化,探讨D-D、Lac对脓毒症患者预后评估的临床价值。方法 回顾性分析急诊科209例临床诊断疑似脓毒症患者的临床资料。根据sepsis-3诊断标准分为感染性休克组(76例)、脓毒症组(75例)和单纯感染组(58例),分别比较三组患者CRP、D-D、Lac的表达和临床转归,应用Logistic回归分析,筛选出影响脓毒症患者预后的独立危险因素,应用ROC曲线评价D-D和Lac对脓毒症患者预后的评估价值。结果 ①单纯感染组、脓毒症组、感染性休克组的患者住院病死率分别为0.00%、37.30%、81.60%,差异有统计学意义(P<0.05);与单纯感染组比较,感染性休克组D-D、CRP和Lac明显升高(P<0.05),脓毒症组Lac明显升高(P<0.05);感染性休克组D-D和Lac水平高于脓毒症组(P<0.05)。②Logistic回归分析显示,D-D和Lac是脓毒症患者死亡的独立危险因素。③以D-D和Lac拟合生成联合预测因子曲线下面积(AUC=0.892)大于D-D单独检测(AUC=0.798,Z=3.287,P<0.05);单独检测D-D与Lac判断脓毒症患者预后的AUC比较,差异无统计学意义(Z=1.609,P>0.05)。结论 CRP、D-D和Lac的变化程度与脓毒症患者的病情严重程度密切相关,D-D和Lac是脓毒症患者预后的独立危险因素。联合检测D-D和Lac对脓毒症患者预后评估具有更高的临床价值。 展开更多
关键词 脓毒症 C反应蛋白(CRP) D-二聚体(D—D) 乳酸(Lac)
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急性重症脑出血患者肠黏膜屏障变化研究 被引量:1
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作者 史福平 王惠凌 +2 位作者 王德超 邸卫英 苏立凯 《临床医学》 CAS 2014年第7期5-6,共2页
目的探讨急性重症脑出血患者肠黏膜屏障变化。方法选取发病24 h内住院的中、重度脑出血患者40例及健康体检者30例,脑出血组分别于住院后24 h内、3 d、7 d、14 d抽取血清,利用酶联免疫法检测二胺氧化酶(DAO)、D-乳酸(D-LAC)的动态变化进... 目的探讨急性重症脑出血患者肠黏膜屏障变化。方法选取发病24 h内住院的中、重度脑出血患者40例及健康体检者30例,脑出血组分别于住院后24 h内、3 d、7 d、14 d抽取血清,利用酶联免疫法检测二胺氧化酶(DAO)、D-乳酸(D-LAC)的动态变化进行肠黏膜屏障变化的研究。结果脑出血组DAO、D-LAC在发病24 h内迅速升高,并达高峰,持续约2周后呈下降趋势,脑出血组各时间段DAO、D-LAC与对照组比较明显升高,差异有统计学意义(P<0.05)。结论急性重症脑出血患者血清中DAO、D-LAC均增高,提示发病后可出现肠黏膜屏障功能损伤。 展开更多
关键词 急性重症脑出血 二胺氧化酶 D-乳酸 肠黏膜屏障
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