Zhonghua nei ke za zhi
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Zhonghua nei ke za zhi · Feb 2021
[The correlation of plasma thrombomodulin plasminogen activator inhibitor-1 and endothelial cell injury in septic patients].
To study the correlation of plasma thrombomodulin (TM), plasminogen activator inhibitor-1 (PAI-1) and endothelial cell injury in septic patients. A total of 100 septic patients were enrolled from February 2017 to February 2019 in Intensive Care Unit (ICU), Union Jiangbei Hospital, Huazhong University of Science and Technology. Subjects were divided into two groups including 50 patients with septic shock and 50 patients with only sepsis. ⋯ Correlation analysis suggested that cEPCs, ESM-1 and vWF were positively correlated with TM and PAI-1 (r=0.561, 0.576, P<0.05;r=0.558, 0.603, P<0.05;r=0.677, 0.692, P<0.05). In conclusion, plasma TM and PAI-1 are closely related to the severity of endothelial cell injury in patients with sepsis. The more serious the damage of endothelial cells is, the higher the TM, PAI-1,cEPCs,ESM-1 and vWF levels are, which could be criterion for treatment evaluation.
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Zhonghua nei ke za zhi · Oct 2020
Multicenter Study[The prognostic role of the programmed death-1 expression on T lymphocytes in septic patients].
Objective: To investigate the value of programmed death-1（PD-1） expression on the T lymphocytes for the prognosis of septic patients. Methods: From September 2017 to May 2019, septic patients were included in Department of Intensive Care Unit at 6 hospitals. The PD-1 expression on T cells were measured by flow cytometry. ⋯ The percentage of PD-1+/CD8+T cell was 3.91%, with AUC 0.771, sensitivity 64.29%, specificity 81.25%，(P=0.000 3). Conclusions: The T cell PD-1 expression is an independent risk factor to predict the 28-day mortality in septic patients. Combining the proportions of PD-1+/CD3+, PD-1+/CD4+and PD-1+/CD8+T cells may further enhance the predictive value for death.
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Zhonghua nei ke za zhi · Sep 2020
[A preliminary study on the evaluation of diaphragm function by ultrasound in patients with invasive mechanical ventilation].
Objectives: To study the feasibility of using ultrasound to evaluate diaphragm function in patients with invasive mechanical ventilation. Methods: From March to December 2017, 40 adult patients with acute respiratory distress syndrome who were admitted to the Department of Critical Care Medicine, Xiangya Hospital, Central South University for more than 48 hours were included. Diaphragmatic excursion and thickness of bilateral anterior, middle and posterior parts were measured by ultrasound for 5 consecutive days. ⋯ Bilateral anterior, middle and posterior diaphragmatic excursion recovered on day 5, and was higher than the baseline levels on day 1, with the left middle and posterior diaphragmatic excursion changing most significantly. (2) Compared with day 1, 2, 3, the thickening fraction of bilateral anterior, middle and posterior diaphragm were significantly decreased on day 4, with the left middle part [day 1: (33.87±14.34)%; day 2: (37.26±13.91)%; day 3: (30.56±14.27)%; day 4: (15.53±5.68)%] and the left posterior part [day 1: (35.50±15.69)%; day 2: (39.84±15.32)%; day 3: (29.06±14.96)%; day 4: (13.30±5.79)%] changing most significantly (P<0.05). The thickening fractions of left anterior, middle and posterior diaphragm recovered on day 5 compared with that on day 4, but still lower than those on day 1 (P<0.05). Conclusions: It is feasible to evaluate the diaphragm function in patients with invasive mechanical ventilation by ultrasound, which can provide guidance for preventing diaphragmatic atrophy and withdrawing from mechanical ventilation.