Objective
To investigate the effect of Xuebijing injection on the level of serum procalcitonin(PCT) in patients with severe sepsis and septic shock, and its effect on prognosis.
Methods
64 patients with severe sepsis and septic shock were randomly divided into control group and treatment group by using a random number table, 32 cases in each group.All patients in the two groups were given cluster treatment, the patients in the treatment group received Xuebijing injection additionally.At the beginning of treatment and 3, 7 and 10-day after treatment, laboratory indicator of PCT was tested in venous blood, and Acute Physiology and Chronic Health Evaluation II(APACHE II) was recorded.Patients' stay time in ICU, total hospital time, mortality in 28 days and mortality in ICU were recorded.
Results
At 3, 7, 10-day after treatment, the levels of PCT of the two groups were (3.24±1.23)ng/mL vs.(3.96±1.35)ng/mL, (1.37±0.68)ng/mL vs.(1.84±0.71)ng/mL, (0.69±0.30)ng/mL vs.(0.91±0.42)ng/mL, and APACHE II scores were (16.21±7.03)points vs.(19.89±7.06)points, (14.02±5.71)points vs.(17.42±6.23)points, (11.06±4.02)points vs.(13.19±4.17)points, which of the treatment group were better than the control group, the differences were statistically significant(t=2.230, 2.704, 2.411, 2.089, 2.276, 2.080, all P<0.05). The stay time in ICU was (16.74±4.03)d vs.(19.25±4.26)d, and total hospital time was (25.39±4.58)d vs.(28.17±5.01)d, which in the treatment group were shorter than the control group, the differences were statistically significant(t=2.421, 2.327, all P<0.05).
Conclusion
Xuebijing injection can effectively reduce the levels of PCT in patients with severe sepsis and septic shock, and improve the condition in a certain degree.
Key words:
Sepsis; Xuebijing injection; Procalcitonin
Abstract Acute Radiation Pneumonitis (ARP) is one of the most common dose-limiting toxicities of thoracic radiotherapy. The accurate diagnosis of ARP remains a challenge because of the lack of a rapid biomarker capable of differentiating ARP from bacterial pneumo (BP). The aim of this study was to investigate the potential usefulness of procalcitonin (PCT) in the differential diagnosis of ARP and BP. Lung cancer patients who had undergone thoracic radiotherapy within 6 months and were admitted to hospital for ARP or BP were retrospectively analyzed. The serum levels of PCT, C-reactive protein (CRP) and white blood cells (WBC) were compared between the two groups. Receiver operating characteristic (ROC) curve was used to assess the diagnostic value of PCT, CRP and WBC in the differential diagnosis of ARP and BP and determine the best cut-off values. One hundred eighteen patients were included. Among them, seventy-seven patients were diagnosed with ARP, and 41 patients were diagnosed with BP. The PCT concentrations for patients diagnosed with ARP group were significantly lower than those in the BP group (P < 0.001). There were no differences in CRP and WBC between the two groups. The areas under the ROC curves (AUC) for PCT, CRP and WBC were 0.745, 0.589 and 0.578, respectively. The best cutoff values of PCT, CRP and WBC were 0.47 μg/L, 54.5 mg/L and 9.9 × 10 9 /L, respectively. Low serum PCT levels are associated with ARP. PCT is a useful biomarker to distinguish ARP from BP.
Abstract In a retrospective study design, we explored the relationship between serum thymidine kinase 1 (TK1) concentration before radiotherapy and clinical parameters and evaluated the prognostic value of serum TK1 concentration before radiotherapy in breast cancer patients with type 2 diabetes mellitus. The present study finally consisted of 428 breast cancer patients with a mean age of 53.0 years. Compared with low TK1 group, the high TK1 group tended to have larger tumor size (P=0.011) and had more lymph node number (P=0.021). Significant differences were also observed in clinical stages I, II and III (P=0.000). There was no significant difference between TK1 and other clinical parameters. For disease-free survival (DFS), the univariate analysis indicated that the high TK1 increased the risk of poor prognosis (HR = 2.38, 95% CI: 1.64–4.23, P=0.000). The Kaplan–Meier curve indicated the high TK1 group was poorer than that in the low TK1 group (P=0.002). For the overall survival (OS), similar results were found that the high TK1 was related to poor OS (HR = 1.89, 95% CI: 1.34–3.67, P=0.000). The multivariate Cox regression indicated that the TK1 was still associated with DFS (HR = 1.83, 95% CI: 1.22–3.17, P=0.001) and OS (HR = 1.63, 95% CI: 1.19–2.08, P=0.006). The high pretreatment serum TK1 levels in breast cancer patients were associated with poor OS and DFS. TK1 could be a potential predictive factor in differential diagnosis of poor prognosis from all patients.
Background Thrombocytopenia has been proved to be associated with hospital mortality in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. However, the detailed association of thrombocytopenia with subsequent progression of organ functions and long-term prognosis in critically ill COVID-19 patients remains to be explored. Methods Medical records of 167 confirmed cases of critically ill COVID-19 from February 16 to March 21, 2020 were collected in this two-center retrospective study. 180-day’s outcome and clinical organ development in patients with thrombocytopenia and non-thrombocytopenia were analyzed. Findings Among all 167 patients, the median age was 66 years and 67.07% were male. Significant differences were noticed in laboratory findings including white blood cells, blood urea, total bilirubin, lactate dehydrogenase and SOFA score between groups of thrombocytopenia and non-thrombocytopenia. Older age, lower platelet count and longer activated partial thromboplastin time at admission were determined to be risk factors of 28-day mortality, and all three, together with higher white blood cells were risk factors of 180-day mortality. Subsequent changes of six-point ordinal scale score, oxygenation index, and SOFA score in patients with thrombocytopenia showed marked worsening trends compared with patients without thrombocytopenia. Patients with thrombocytopenia had significantly higher mortality not only in 28 days, but also in 90 days and 180 days. The time-course curves in non-survival group showed a downtrend of platelet count and oxygenation index, while the curve of six-point ordinal scale kept an uptrend. Kaplan-Meier analysis indicated that patients with thrombocytopenia had much lower probability of survival (p<0.01). Interpretation The thrombocytopenia was associated with the deterioration of respiratory function. Baseline platelet count was associated with subsequent and long-term mortality in critically ill COVID-19 patients.
Abstract This study sought to find more exon mutation sites and lncRNA candidates associated with type 2 diabetes mellitus (T2DM) patients with obesity (O‐T2DM). We used O‐T2DM patients and healthy individuals to detect mutations in their peripheral blood by whole‐exon sequencing. And changes in lncRNA expression caused by mutation sites were studied at the RNA level. Then, we performed GO analysis and KEGG pathway analysis. We found a total of 277 377 mutation sites between O‐T2DM and healthy individuals. Then, we performed a DNA‐RNA joint analysis. Based on the screening of harmful sites, 30 mutant genes shared in O‐T2DM patients were screened. At the RNA level, mutations of 106 differentially expressed genes were displayed. Finally, a consensus mutation site and differential expression consensus gene screening were performed. In the current study, the results revealed significant differences in exon sites in peripheral blood between O‐T2DM and healthy individuals, which may play an important role in the pathogenesis of O‐T2DM by affecting the expression of the corresponding lncRNA. This study provides clues to the molecular mechanisms of metabolic disorders in O‐T2DM patients at the DNA and RNA levels, as well as biomarkers of the risk of these disorders.
Objective To investigate the relationship between high sensitivity C reactive protein(hs-CRP)level and peripheral artery disease in patients with type 2 diabetes mellitus(T2DM).Methods 120 patients with T2DM were enrolled in this study,58 paitiens of them were with peripheral artery diseases(observed group),as well as 62 patients of them without peripheral artery diseases(control group).The levels of hs-CRP in two groups were measured.Results The level of hs-CRP in the observed group were significantly higher than that in the control group.The level of hs-CRP was independently associated with the development of peripheral artery disease in patients with T2DM.Conclusions The development of T2DM is associated with hs-CRP.Increase of hs-CRP level is an independent risk factor for peripheral artery disease in patients with T2DM.
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