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find Author "李多" 7 results
  • The value of fibrinogen/albumin ratio combined with PESI in the diagnosis and prognosis evaluation of acute pulmonary thromboembolism patients

    Objective To investigate the value of fibrinogen to albumin ratio (FAR) combined with pulmonary embolism severity index (PESI) in the assessment of severity and prognosis of patients with acute pulmonary thromboembolism (APTE). Methods A retrospective study of hospitalized patients with confirmed APTE admitted to the Affiliated Hospital of Southwest Medical University from September 2013 to August 2021, divided into low-risk, intermediate-risk, and high-risk groups according to the Guidelines for the Diagnosis, Treatment and Prevention of Pulmonary Thromboembolism, and divided into survival groups and death groups according to the 30-day prognosis. The general data of all patients and relevant blood laboratory tests within 2 hours after admission were collected to calculate PESI and FAR. FAR and PESI levels were compared in APTE patients with different severity of disease and different prognosis. Independent risk factors for 30-day mortality in APTE patients were analyzed using logistic regression. Subject working characteristic curves were drawn to assess the differences in sensitivity, specificity and area under the curve of FAR, PESI and FAR combined with PESI in predicting 30-day death. Results Total of 235 APTE patients were included, divided into 85 in the low-risk group, 110 in the intermediate-risk group, and 40 in the high-risk group; 192 in the survival group and 43 in the death group according to 30-day survival. The differences in age, albumin (ALB), high-sensitivity troponin, D-dimer, fibrinogen (FIB), FAR, and PESI of APTE patients with different disease severity were statistically significant (P<0.05). FAR increased progressively with increasing severity of disease (P<0.05), and correlation analysis showed a positive correlation between FAR and PESI (r=0.614, P<0.05). Elevated FIB, FAR, PESI and decreased ALB were independent risk factors for 30-day death in patients with APTE (P<0.05). FAR, PESI, and FAR combined with PESI all had predictive value for 30-day death in APTE patients, and FAR combined with PESI predicted the largest area under the 30-day death curve. Conclusions FAR correlated with the severity and prognosis of APTE patients. FAR combined with PESI was more valuable in assessing the 30-day prognosis of APTE patients than FAR alone or PESI alone.

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  • Arbutin alleviates LPS-induced acute lung injury in mice through PI3K/Akt/mTOR signaling pathway

    ObjectiveTo investigate the protective effect and mechanism of arbutin on LPS induced Acute lung injury in mice. Methods SPF BCLB/C mice were randomly divided into control group, model group,arbutin group, and arbutin+PI3K inhibitor group.arbutin group and arbutin+PI3K group were intervened with corresponding drugs respectively; Constructing an ALI model by intranasal instillation of LPS into mice; After modeling for 6 hours, the mice were killed. After staining the lung tissue slices, observe the pathological changes of the lung tissue and evaluate the lung injury score, and calculate the wet to dry weight ratio (W/D); ELISA method was used to determine the levels of TNF-a and IL-6 in serum and bronchoalveolar lavage fluid (BALF); Measure the ROS content, MDA level,and MPO activity in the lungs; Western blot method was used to detect the expression of PI3K/Akt/mTOR pathway related proteins and autophagy related proteins Beclin-1 and LC3II/I. ResultsCompared with the control group, the pathological changes in the lung tissue of model group mice worsened, and the W/D and lung injury scores increased, The levels of IL-6 and TNF-a in BALF and serum was increased, The ROS content, MDA expression and MPO activity in the lungs was increased,the expression of Beclin-1 and LC3II/I in the lungs was increased. The expression of PI3K/Akt/mTOR pathway related proteins in the lungs decreased (P<0.05). Compared with the model group, the pathological changes in the lung tissue of arbutin group mice were alleviated, with a decrease in W/D and lung injury score, The levels of IL-6 and TNF-a in BALF and serum decrease,ROS content, MDA expression and MPO activity in lung were decreased.The expression of PI3K/Akt/mTOR pathway related proteins in the lung was increased, The expression of Beclin-1 and LC3II/I decreased. However, the appeal performance was partially blocked in the arbutin+PI3K group after the administration of LY294002.ConclusionsArbutin regulates autophagy through PI3K/Akt/mTOR pathway to inhibit inflammatory response and oxidative stress in LPS-induced ALI mice, and plays a protective role in LPS-induced ALI.

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  • Construction of Tumor Specific Tubercle Bacillus Antigen Ag85A Gene Lentiviral Vector

    ObjectiveTo construct tumor specific tubercle bacillus antigen Ag85A gene lentiviral vector driven by murine telomerase catalytic subunit promoter (PmTERT), paving the way for further research in tumor targeting immuno-gene therapy. MethodsPmTERT was amplified by PCR method, with murine genomic DNA as template. Then, transcriptional activities of PmTERT in various murine and human cell strains were studied by luciferase assay. Ag85A expression lentiviral vectors driven by cytomegalo virus (CMV) promoter and PmTERT respectively (pLVX-Ag85ACMV and pLVX-Ag85A-PmTERT) were constructed with nucleic acid cloning approach. And above recombinants were verified with DNA sequencing and Western blot. ResultsLucifease assay revealed that 331 bp PmTERT cloned in present research had transcriptional activity in murine Lewis lung cancer cells, human lung adenocarcinoma cells A549, and human esophageal cancer cells EC-109, while no transcriptional activity in murine fibroblasts NIH3T3 and human embryo fibroblasts MRC-5. Western blot revealed expression of Ag85A in pLVX-Ag85A-CMV transfected Lewis and NIH3T3 cells, pLVX-Ag85A-PmTERT transfected Lewis cells, no expression in pLVX-Ag85A-PmTERT transfected NIH3T3 cells. ConclusionPmTERT has tumor specific transcriptional activity. Ag85A gene can express selectively in tumor cells, driven by PmTERT.

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  • 血管介入联合气道介入治疗晚期中央型肺癌中心气道重度狭窄

    目的 探讨血管介入联合气道介入治疗在晚期中央型肺癌中心气道重度狭窄的临床应用价值。 方法 32 例晚期中央型肺癌中心气道重度狭窄患者于局麻下接受血管介入支气管动脉灌注化疗(BAC)和支气管动脉栓塞(BAE)肺癌供血血管介入治疗,然后在全麻下经电子支气管镜行冷冻切除、高频电、氩气刀(APC)、支架置入等气道介入治疗。测定患者治疗前及治疗后 2 周的气促指数、气道管径、FEV1%pred、Karnofsky 评分(KPS)、6 分钟步行距离(6MWD),以及血清鳞状细胞癌相关抗原(SCCA)、非小细胞肺癌相关抗原细胞角蛋白 19 片段抗原 21-1(CYFRA21-1)、神经元烯醇化酶(NSE)及癌胚抗原(CEA)水平。比较各指标治疗前后的变化,观察疗效及并发症。 结果 32 例患者均顺利完成 BAC+BAE 血管介入治疗联合气道介入治疗,临床有效率为 96.9%。气道介入麻醉方式:喉罩全麻 3 例,气管插管全麻 29 例。气道介入治疗方法:高频电烧灼治疗 28 例,电圈套 8 例,APC 治疗 16 例,冷冻切除治疗 26 例,气道支架置入 5 例。所有患者治疗后气促指数、气道管径、FEV1%pred、KPS 及 6MWD 各指标与治疗前比较均有显著改善(P 均<0.05),血清 SCCA、CYFRA21-1、NSE、CEA 水平较治疗前显著下降(P 均<0.05)。治疗过程中出现恶心呕吐 2 例,无气道大出血病例,无严重及致死性并发症。 结论 血管介入联合气道介入治疗晚期中央型肺癌中心气道重度狭窄具有微创、气道出血少、近期疗效确切的优势,具有很好的临床应用价值。

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  • Insights on diagnosis and treatment of coronavirus disease 2019

    The diagnosis of coronavirus disease 2019 should not only depend on nucleic acid test, but also be based on clinical information such as medical history and radiographic findings. It’s critical to identify patients with high risk of rapid progression. Treatment of coronavirus disease 2019 should be individualized according to the underlying diseases and progression manner. For severely ill patients, oxygen and nutrition supplementation need to be strengthened, and for some highly selected cases, administration of glucocorticoids might be beneficial.

    Release date:2020-04-23 06:56 Export PDF Favorites Scan
  • 关于呼吸道新型冠状病毒感染几个问题的思考

    Release date:2020-05-26 09:32 Export PDF Favorites Scan
  • Clinical study on the application of glucocorticoids in patients with coronavirus disease 2019

    ObjectiveTo investigate the clinical efficacy, side effects, influence on viral nucleic acid conversion and prognosis of glucocorticoid used in patients with coronavirus disease 2019.MethodsEighty-seven patients with severe and critical coronavirus disease 2019 were included to observe respiratory symptoms, blood oxygen saturation, pulmonary imaging absorption, weaning status, complicated bacterial infection and double infection, and prognosis after glucocorticoid use. Whether glucocorticoid use affects the patient's viral nucleic acid was analyzed.ResultsOf the 87 patients included, 55 were severe, 32 were critical, and 38 died, which included 30 critical patients. Seventy-seven patients accepted short-term glucocorticoid, and 10 patients accepted long-term glucocorticoid due to diffuse lung lesions and poor absorption. Eleven patients had bacterial infection and 4 cases had double infection. In 10 patients with long-term use of glucocorticoids, the lung lesions relieved, no double infection was found, but 1 patient maintained nucleic acid positive even after 5 weeks’ treatment.ConclusionsThe use of appropriate glucocorticoids is beneficial to the improvement of disease status and disease absorption in patients with coronavirus disease 2019. Long-term oral administration of glucocorticoids in patients with diffuse lung lesions may be beneficial to disease absorption.

    Release date:2021-05-25 01:52 Export PDF Favorites Scan
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