west china medical publishers
Author
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Author "虞竹溪" 5 results
  • 危重患者持续静静脉血液滤过时血糖监测的影响因素研究

    目的 观察危重患者持续静静脉血液滤过( CVVH) 过程中血糖监测的影响因素。方法 选择CVVH治疗的危重患者30 例, 根据其入选时的循环状态将患者分为休克组和非休克组, 同时监测两组患者动脉血糖、末梢血糖及CVVH 导管动脉端血糖, 比较同一时点各部位血糖监测值。结果 所有患者动脉血糖值与末梢血糖值比较有显著差异( P lt; 0. 05) , 动脉血糖值与CVVH 导管动脉端血糖值差异无统计学意义( P gt; 0. 05) , 且二者存在明显相关性( r = 0. 989, P lt; 0. 001) , 末梢血糖值与CVVH导管动脉端血糖值差异有统计学意义( P lt;0. 05) ; 休克组末梢血糖值较动脉血糖值低, 差异有统计学意义( P lt; 0. 05) , 非休克组末梢血糖值与动脉血糖值差异无统计学意义( P gt;0. 05) 。结论 危重患者末梢血糖监测值偏低, 该差异在休克患者中更加明显; CVVH时可通过导管动脉端采血监测血糖。

    Release date:2016-08-30 11:52 Export PDF Favorites Scan
  • 可溶性髓样细胞触发性受体1 对感染性疾病的诊断价值

    感染性疾病的发病率高, 给社会经济带来沉重负担, 感染性疾病的早期诊断和治疗对提高临床疗效和降低死亡率有重要意义。髓样细胞触发性受体1 ( triggering receptor-1expressed on myeloid cells, TREM-1) 在炎症反应的发生发展过程中起着重要的作用。Bouchon 等[ 1] 在2000 年首先发现TREM-1 选择性表达于中性粒细胞、CD14 + 单核细胞膜表面。后来的研究发现TREM-1 也表达于上皮细胞、多核巨细胞、腹膜巨噬细胞、淋巴结巨噬细胞、肺泡巨噬细胞, 纤维肉瘤细胞膜表面[ 2-5] 。人的TREM-1 由胞外区、跨膜区、胞浆区共同组成, 跨膜区含有1 个带正电荷的赖氨酸残基, 它可与接头蛋白DAP12 跨膜区内的带负电荷的天冬氨酸相偶联, 并通过胞浆区中的免疫受体酪氨酸活化基序( ITAM) 来激活下游信号传导, 促进促炎因子的分泌[ 6] 。TREM-1 激发、放大炎症反应的同时促进抗炎因子的下调[ 1, 2, 7] 。‥‥‥

    Release date:2016-08-30 11:53 Export PDF Favorites Scan
  • The Signal Transduction Pathway of TREM-1 on Endotoxin-Induced Acute Lung Injury in Mice

    Objective To investigate the transduction pathway of TREM-1 during endotoxininduced acute lung injury ( ALI) in mice through the specific activating or blocking TREM-1.Methods 40 mice were randomly divided into a saline control group, an ALI group, an antibody group, and a LP17 group ( 3.5 mg/kg) . All mice except the control group were intraperitoneally injected with lipopolysaccharide ( LPS) to establish mouse model of ALI. Two hours after LPS injection, anti-TREM-1mAb ( 250 μg/kg) was intraperitoneally injected in the antibody group to activation TREM-1, and synthetic peptide LP17 was injected via tail vein in the LP17 group to blocking TREM-1. After 6,12,24, 48 hours, 3 mice in each group were sacrificed for sampling. The expression of NF-κB in lung tissue was determined by immunohistochemistry. The levels of TNF-α, IL-10, TREM-1, and soluble TREM-1 ( sTREM-1) in lung tissue and serumwere measured by ELISA. Pathology changes of lung were observed under light microscope, and Smith’s score of pathology was compared. Results Administration of anti-TREM-1mAb after ALI modeling significantly increased the NF-κB expression in lung tissue at 48h, resulting in a large number of pro-inflammatory cytokines releasing in the lung tissue and serumand lung pathology Smith score increasing. Administration of LP17 after modeling significantly down-regulated the expressions of NF-κB and pro-inflammatory cytokines, while led to a slight increase of anti-inflammatory cytokines and a decline of lung pathology Smith’s score.Conclusion TREM-1 may involve in inflammatory response by promoting the generation of inflammatory factors via NF-κB pathway, thus lead to lung pathological changes in ALI.

    Release date:2016-09-13 03:46 Export PDF Favorites Scan
  • 单核细胞 HLA-DR 和 T 淋巴细胞亚群预测严重创伤继发感染的临床研究

    目的 探讨连续监测单核细胞人类白细胞抗原 DR(HLA-DR)表达率变化及外周血 T 淋巴细胞亚群比例变化对严重创伤继发感染的预测价值。 方法 纳入 2014 年 6 月至 2016 年 6 月南京大学医学院附属鼓楼医院重症医学科收治的 26 例严重创伤患者,用流式细胞学方法检测其入院当天及第 3、5、7 d 外周血 HLA-DR 表达率及 T 淋巴细胞亚群比例,根据患者 28 d 内感染情况分为非感染组、局部感染组和全身感染组,分析 HLA-DR 表达率变化规律和 T 淋巴细胞亚群比例变化规律与感染的关系。 结果 26 例严重创伤患者中发生局部感染 10 例,全身感染12 例,感染率达 84.6%。与非感染组及局部感染组比较,全身感染组第 7 d 的 HLA-DR 表达率显著降低。与非感染组比较,局部感染组和全身感染组第 7 d 的 CD4+/CD8+ 比例显著降低。 结论 外周血单核细胞表面 HLA-DR 表达率及外周血 T 淋巴细胞亚群比例的连续监测在预测严重创伤患者继发感染、判断预后和预防治疗感染中具重要价值。

    Release date:2017-07-24 01:54 Export PDF Favorites Scan
  • Application of metagenomic next-generation sequencing in diagnosis of Psittacosis: a report of eight cases

    ObjectiveTo improve the understanding of psittacosis, the clinical data of 8 cases are reviewed. The application of pathogen metagenomics next-generation sequencing (mNGS) in the diagnosis of nocardiosis is also investigated.MethodsThe clinical data of eight patients with psittacosis diagnosed by mNGS in Nanjing Drum Tower Hospital from January 2018 to May 2020 were reviewed. The clinical characteristics, laboratory examination characteristics and imaging changes were analyzed, and the treatment outcome was followed-up.ResultsAmong the eight cases, there were six males and two females, aged 43~83 years old, with an average age of 64±12 years old. Six of them had a clear history of poultry exposure. The major clinical manifestations were fever, cough, dyspnea, etc. Chest high-resolution computed tomography (HRCT) may have solid shadow, ground glass like shadow. Chlamydia psittaci was detected by mNGS in eight patients’ bronchoalveolar lavage fluid. Minocycline or moxifloxacin were administrated, six patients were discharged after their condition improved, and two patients died.ConclusionsThe incidence of psittacosis is low, and its clinical manifestations lack specificity. In the course of the disease, there may be different degrees of fever, cough, sputum, dyspnea and other symptoms. The lungs can be heard with wet rales, chest HRCT can be seen ground glass shadow, consolidation shadow, accompanied by air bronchogram. Chlamydia psittaci can be detected in alveolar lavage fluid by mNGS. The patients need to be treated for a long time, lasting at least 10 to 14 days. Tetracycline drugs should be the first choice, and can be combined with other antibiotics with activity against gram-positive and gram-negative bacteria in critical patients.

    Release date: Export PDF Favorites Scan
1 pages Previous 1 Next

Format

Content