BACKGROUND Sepsis often causes severe liver injury and leads to poor patient outcomes.Early detection of sepsis-induced liver injury(SILI)and early treatment are key to improving outcomes.AIM To investigate the clinic...BACKGROUND Sepsis often causes severe liver injury and leads to poor patient outcomes.Early detection of sepsis-induced liver injury(SILI)and early treatment are key to improving outcomes.AIM To investigate the clinical characteristics of SILI patients and analyze the associated risk factors,to identify potential sensitive biomarkers.METHODS Retrospective analysis of clinical data from 546 patients with sepsis treated in the intensive care unit of the 908th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force between May 2018 and December 2022.The patients were divided into the sepsis group(n=373)and SILI group(n=173)based on the presence of acute liver injury within 2 hours of admission.We used the random forest algorithm to analyze risk factors and assessed potential diagnostic markers of SILI using the area under the receiver operating characteristic curve,Kaplan-Meier survival curves,subgroup analysis and correlation analysis.RESULTS Compared with the sepsis group,tissue plasminogen activator-inhibitor complex(t-PAIC)levels in serum were significantly higher in the SILI group(P<0.05).Random forest results showed that t-PAIC was an independent risk factor for SILI,with an area under the receiver operating characteristic curve of 0.862(95%confidence interval:0.832-0.892).Based on the optimal cut-off value of 11.9 ng/mL,patients at or above this threshold had significantly higher levels of lactate and Acute Physiology and Chronic Health Evaluation II score.The survival rate of these patients was also significantly worse(hazard ratio=2.2,95%confidence interval:1.584-3.119,P<0.001).Spearman’s correlation coefficients were 0.42 between t-PAIC and lactate,and 0.41 between t-PAIC and aspartate transaminase.Subgroup analysis showed significant differences in t-PAIC levels between patients with different severity of liver dysfunction.CONCLUSION T-PAIC can serve as a diagnostic indicator for SILI,with its elevation correlated with the severity of SILI.展开更多
Objective:To study the application effect of standardized nutritional care combined with exercise intervention in patients with gestational diabetes mellitus and the effect on fasting blood glucose(FPG),2-hour postpra...Objective:To study the application effect of standardized nutritional care combined with exercise intervention in patients with gestational diabetes mellitus and the effect on fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),and glycated hemoglobin(HbA1c)levels.Methods:Ninety cases of gestational diabetes mellitus diagnosed between June 2022 and June 2023 were selected and randomly divided into two groups of 45 cases each.The control group received conventional intervention,while the observation group received combined standardized nutritional care and exercise intervention.Blood glucose levels,adverse pregnancy outcomes,and adverse neonatal outcomes were compared.Results:On the day before delivery,the FPG,2hPG,and HbA1c levels of patients in the observation group were lower than those of patients in the control group(P<0.05).The incidence of adverse pregnancy outcomes(4.44%)and adverse neonatal outcomes(2.22%)in the observation group was lower than in the control group(P<0.05).Conclusion:The blood glucose levels of gestational diabetes mellitus patients can be controlled through standardized nutritional care and exercise interventions,leading to improved pregnancy and neonatal outcomes.展开更多
This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with p...This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.展开更多
目的:探讨加味逍遥散对不同性别抑郁样大鼠的行为、肝脏组织转录组、下丘脑-垂体-肾上腺(HPA)轴相关基因的表达及性激素水平的调控作用。方法:以利血平腹腔注射构建不同性别抑郁大鼠模型,对照组和模型组、氟西汀组、加味逍遥散组分别予...目的:探讨加味逍遥散对不同性别抑郁样大鼠的行为、肝脏组织转录组、下丘脑-垂体-肾上腺(HPA)轴相关基因的表达及性激素水平的调控作用。方法:以利血平腹腔注射构建不同性别抑郁大鼠模型,对照组和模型组、氟西汀组、加味逍遥散组分别予蒸馏水、氟西汀、加味逍遥散灌胃给药,连续21 d。采用旷场试验检测大鼠抑郁样行为,RNA-seq进行肝脏组织转录组分析,real time RT-PCR检测海马组织的5-羟色胺转运体(5-HTT)、γ-氨基丁酸A型受体(GABA_(A)R)、γ-氨基丁酸B型受体(GABA_(B)R2)、乙酰胆碱脂酶(AChE)、谷氨酸受体(GluR2)mRNA表达水平,酶联免疫吸附试验检测大鼠血清卵泡刺激素(FSH)、雌二醇(E2)、睾酮(T)激素水平。结果:加味逍遥散有效改善雌性、雄性大鼠抑郁样行为(P<0.05);主要调控肝脏组织细胞色素P450(CYP)家族基因转录;显著降低雌性抑郁大鼠GABA_BR2、AChE基因和雄性抑郁大鼠5-HTT、GABA_AR、GABA_BR2、GluR2基因表达水平(P<0.05);显著升高雌性抑郁大鼠FSH、E2和雄性抑郁大鼠T激素水平(P<0.05)。结论:加味逍遥散调控肝脏组织转录组,通过HPA-HPG轴发挥疏肝解郁、养血调经作用,有效改善不同性别大鼠抑郁样行为。展开更多
目的探讨血栓抽吸联合冠状动脉内注射重组人TNK组织型纤溶酶原激活剂对老年ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗术中冠状动脉微循环及心功能的影响。方法回顾性选取2021年1月至2023年10月于天津市第三中心医院就诊的并行急...目的探讨血栓抽吸联合冠状动脉内注射重组人TNK组织型纤溶酶原激活剂对老年ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗术中冠状动脉微循环及心功能的影响。方法回顾性选取2021年1月至2023年10月于天津市第三中心医院就诊的并行急诊经皮冠状动脉介入治疗的老年ST段抬高型心肌梗死患者90例,根据经皮冠状动脉介入治疗术中介入策略不同分为单纯血栓抽吸组(抽吸组)46例和血栓抽吸联合冠状动脉内注射重组人TNK组织型纤溶酶原激活剂组(联合组)44例。比较2组一般临床资料,术后90 min ST段回落指数≥70%比例,术后即刻心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI)血流分级,术后TIMI心肌灌注分级,校正的TIMI血流帧数,心脏超声指标以及住院期间主要不良心血管事件及出血事件。结果联合组术后ST段回落≥70%、术后即刻TIMI血流分级3级、术后TIMI心肌灌注分级3级比例显著高于抽吸组,校正的TIMI血流帧数显著低于抽吸组(P<0.05);抽吸组术后1周的左心室射血分数显著低于联合组[(52.5±6.2)%vs(58.3±6.4)%,P<0.05],联合组术后1周左心室舒张末期内径显著低于抽吸组[(44.1±3.9)mm vs(51.9±2.5)mm,P<0.05];联合组住院期间主要不良心血管事件发生率显著低于抽吸组(20.5%vs 37.0%,P<0.05)。结论在应用抽吸导管的基础上配合冠状动脉内注射重组人TNK组织型纤溶酶原激活剂可有效降低老年ST段抬高型心肌梗死患者冠状动脉内血栓负荷,改善心肌微循环灌注,降低住院期间主要不良心血管事件发生率且不增加出血风险。展开更多
基金Supported by National Key R&D Program of China,No.2022YFC2304600.
文摘BACKGROUND Sepsis often causes severe liver injury and leads to poor patient outcomes.Early detection of sepsis-induced liver injury(SILI)and early treatment are key to improving outcomes.AIM To investigate the clinical characteristics of SILI patients and analyze the associated risk factors,to identify potential sensitive biomarkers.METHODS Retrospective analysis of clinical data from 546 patients with sepsis treated in the intensive care unit of the 908th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force between May 2018 and December 2022.The patients were divided into the sepsis group(n=373)and SILI group(n=173)based on the presence of acute liver injury within 2 hours of admission.We used the random forest algorithm to analyze risk factors and assessed potential diagnostic markers of SILI using the area under the receiver operating characteristic curve,Kaplan-Meier survival curves,subgroup analysis and correlation analysis.RESULTS Compared with the sepsis group,tissue plasminogen activator-inhibitor complex(t-PAIC)levels in serum were significantly higher in the SILI group(P<0.05).Random forest results showed that t-PAIC was an independent risk factor for SILI,with an area under the receiver operating characteristic curve of 0.862(95%confidence interval:0.832-0.892).Based on the optimal cut-off value of 11.9 ng/mL,patients at or above this threshold had significantly higher levels of lactate and Acute Physiology and Chronic Health Evaluation II score.The survival rate of these patients was also significantly worse(hazard ratio=2.2,95%confidence interval:1.584-3.119,P<0.001).Spearman’s correlation coefficients were 0.42 between t-PAIC and lactate,and 0.41 between t-PAIC and aspartate transaminase.Subgroup analysis showed significant differences in t-PAIC levels between patients with different severity of liver dysfunction.CONCLUSION T-PAIC can serve as a diagnostic indicator for SILI,with its elevation correlated with the severity of SILI.
文摘Objective:To study the application effect of standardized nutritional care combined with exercise intervention in patients with gestational diabetes mellitus and the effect on fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),and glycated hemoglobin(HbA1c)levels.Methods:Ninety cases of gestational diabetes mellitus diagnosed between June 2022 and June 2023 were selected and randomly divided into two groups of 45 cases each.The control group received conventional intervention,while the observation group received combined standardized nutritional care and exercise intervention.Blood glucose levels,adverse pregnancy outcomes,and adverse neonatal outcomes were compared.Results:On the day before delivery,the FPG,2hPG,and HbA1c levels of patients in the observation group were lower than those of patients in the control group(P<0.05).The incidence of adverse pregnancy outcomes(4.44%)and adverse neonatal outcomes(2.22%)in the observation group was lower than in the control group(P<0.05).Conclusion:The blood glucose levels of gestational diabetes mellitus patients can be controlled through standardized nutritional care and exercise interventions,leading to improved pregnancy and neonatal outcomes.
基金Sichuan Province Medical Research Project Plan(Project No.S21113)。
文摘This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.
文摘目的:探讨加味逍遥散对不同性别抑郁样大鼠的行为、肝脏组织转录组、下丘脑-垂体-肾上腺(HPA)轴相关基因的表达及性激素水平的调控作用。方法:以利血平腹腔注射构建不同性别抑郁大鼠模型,对照组和模型组、氟西汀组、加味逍遥散组分别予蒸馏水、氟西汀、加味逍遥散灌胃给药,连续21 d。采用旷场试验检测大鼠抑郁样行为,RNA-seq进行肝脏组织转录组分析,real time RT-PCR检测海马组织的5-羟色胺转运体(5-HTT)、γ-氨基丁酸A型受体(GABA_(A)R)、γ-氨基丁酸B型受体(GABA_(B)R2)、乙酰胆碱脂酶(AChE)、谷氨酸受体(GluR2)mRNA表达水平,酶联免疫吸附试验检测大鼠血清卵泡刺激素(FSH)、雌二醇(E2)、睾酮(T)激素水平。结果:加味逍遥散有效改善雌性、雄性大鼠抑郁样行为(P<0.05);主要调控肝脏组织细胞色素P450(CYP)家族基因转录;显著降低雌性抑郁大鼠GABA_BR2、AChE基因和雄性抑郁大鼠5-HTT、GABA_AR、GABA_BR2、GluR2基因表达水平(P<0.05);显著升高雌性抑郁大鼠FSH、E2和雄性抑郁大鼠T激素水平(P<0.05)。结论:加味逍遥散调控肝脏组织转录组,通过HPA-HPG轴发挥疏肝解郁、养血调经作用,有效改善不同性别大鼠抑郁样行为。
文摘目的探讨血栓抽吸联合冠状动脉内注射重组人TNK组织型纤溶酶原激活剂对老年ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗术中冠状动脉微循环及心功能的影响。方法回顾性选取2021年1月至2023年10月于天津市第三中心医院就诊的并行急诊经皮冠状动脉介入治疗的老年ST段抬高型心肌梗死患者90例,根据经皮冠状动脉介入治疗术中介入策略不同分为单纯血栓抽吸组(抽吸组)46例和血栓抽吸联合冠状动脉内注射重组人TNK组织型纤溶酶原激活剂组(联合组)44例。比较2组一般临床资料,术后90 min ST段回落指数≥70%比例,术后即刻心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI)血流分级,术后TIMI心肌灌注分级,校正的TIMI血流帧数,心脏超声指标以及住院期间主要不良心血管事件及出血事件。结果联合组术后ST段回落≥70%、术后即刻TIMI血流分级3级、术后TIMI心肌灌注分级3级比例显著高于抽吸组,校正的TIMI血流帧数显著低于抽吸组(P<0.05);抽吸组术后1周的左心室射血分数显著低于联合组[(52.5±6.2)%vs(58.3±6.4)%,P<0.05],联合组术后1周左心室舒张末期内径显著低于抽吸组[(44.1±3.9)mm vs(51.9±2.5)mm,P<0.05];联合组住院期间主要不良心血管事件发生率显著低于抽吸组(20.5%vs 37.0%,P<0.05)。结论在应用抽吸导管的基础上配合冠状动脉内注射重组人TNK组织型纤溶酶原激活剂可有效降低老年ST段抬高型心肌梗死患者冠状动脉内血栓负荷,改善心肌微循环灌注,降低住院期间主要不良心血管事件发生率且不增加出血风险。
