Objective To study endotoxin release induced by differential antibiotics in gram negative bacterial infection. Methods Thirty critical patients accompanied with gram negative bacterial infection were divided into group A (imipenem group, n=15) and group B (ceftazidine group, n=15). Imipenem (0.5 g iv q8h) and ceftazidine (1.0 g iv q8h) were given respectively. White blood cell (WBC), systolic blood pressure (SBP), lipopoly sacchride (LPS), tumor necrosis factor alpha (TNFα) and high density lipoprotein (HDL) were determined in 0, 1, 2, 3, 5 and 7 day. Results There was no difference in the change of WBC between two groups. Group A had a more stable SBP than group B. There was lower endotoxin release in group A than in group B and so were the cytokines release. HDL level was lower in group B than in group A. Conclusion Imipenem has lower endotoxinliberating potential than ceftazidine and mediate lower cytokines release. HDL may protect the patients from LPS damage.
Ｗｅ ｄｅｔｅｒｍｉｎｅｄ ｔｈｅ ｗｈｏｌｅ ｐｒｏｃｅｓｓ ｏｆ ｌｉｐｏｐｒｏｔｅｉｎ ｍｅｔａｂｏｌｉｓｍ ｄｕｒｉｎｇ ｔｈｅ ｆｏｒｍａｔｉｏｎ ｏｆ ｇａｌｌｓｔｏｎｅ ｉｎ ｒａｂｂｉｔ ｍｏｄｅｌ ｏｆ ｃａｌｃｉｕｍ ｂｉｌｉｒｕｂｉｎａｔｅ ｃｈｏｌａｎｇｉｏｌｉｔｈｉａｓｉｓ．Ｔｈｅ ｍａｉｎ ｒｅｓｕｌｔｓ ｉｎｃｌｕｄｅｄ：ｔｈｅ ｃｏｎｃｅｎｔｒａｔｉｏｎｓ ｏｆ ｆｒｅｅ ｃｈｏｌｅｓｔｅｒｏｌ ａｎｄ ＨＤＬ３ｃｈｏｌｅｓｔｅｒｏｌ ｏｂｖｉｏｕｓｌｙ ｉｎｃｒｅａｓｅｄ ｉｎ ａｌｌ ｅｘｐｅｒｉｍｅｎｔａｌ ｇｒｏｕｐｓ ｗｈｉｌｅ ＨＤＬｃｈｏｌｅｓｔｅｒｏｌ，ＨＤＬ２ｃｈｏｌｅｓｔｅｒｏｌ ｄｅｃｒｅａｓｅｄ，ｔｈｅ ａｃｔｉｖｉｔｉｅｓ ｏｆ ｌｅｃｉｔｈｉｎｃｈｏｌｅｓｔｅｒｏｌ ａｃｙｔｒａｎｓｆｅｒａｓｅ（ＬＣＡＴ） ａｎｄ ｔｈｅ Ｂｍａｘ ｏｆ ＨＤＬｒｅｃｅｐｔｏｒ ｉｎ ｈｅｐａｔｉｃ ｃｅｌｌ ｃｅｎｔｒａｔｉｏｎｓ ｏｆ ｇｌｙｃｏｃｈｏｌｉｃ ａｃｉｄ，ｇｌｙｃｏｄｅｏｘｙｃｈｄｉｃ ａｃｉｄ ａｎｄ ｔｏｔａｌ ｂｉｌｅ ａｃｉｄ ｉｎ ｔｈｅ ｂｉｌｅ ｄｅｃｒｅａｓｅｄ ｏｂｖｉｏｕｓｌｙ ｉｎ ｅｘｐｅｒｉｍｅｎｔａｌ ｇｒｏｕｐｓ，ｔｈｅ ｌｅｖｅｌｓ ｏｆ ＬＤＬｃｈｏｌｅｓｔｅｒｏｌ，ｖＬＤＬｃｈｏｌｅｓｔｅｒｏｌ ｉｎ ｔｈｅ ｓｅｒｕｍ ａｎｄ ｔｏｔａｌ ｃｈｏｌｅｓｔｅｒｏｌ，ｔｒｉｇｌｙｃｅｒｉｄｅ ｉｎ ｔｈｅ ｈｅｐａｔｉｃ ｔｉｓｓｕｅ ｗｅｒｅ ｎｏｔ ｓｉｇｎｉｆｉｃａｎｔ ｄｉｆｆｅｒｅｎｃｅｓ ｉｎ ａｌｌ ｇｒｏｕｐｓ．Ａｃｃｏｒｄｉｎｇ ｔｏ ｔｈｅ ａｂｏｖｅ ｒｅｓｕｌｔｓ，ｉｔ ｍａｙ ｂｅ ｃｏｎｃｌｕｄｅｄ ｔｈａｔ：ｔｈｅｒｅ ｗｅｒｅ ｄｉｓｏｒｄｅｒｓ ｏｆ ｒｅｄｕｃｅｄ ＨＤＬ ｂｉｏｓｙｎｔｈｅｓｉｓ ａｎｄ ｉｔｓ ｍａｔｕｒｅ ｐｒｏｃｅｓｓ ｃａｕｓｅｄ ｂｙ ｄｅｃｒｅａｓｉｎｇ ｏｆ ＬＣＡＴ ａｃｔｉｖｉｔｙ ｄｕｒｉｎｇ ｔｈｅ ｆｏｒｍａｔｉｏｎ ｏｆ ｔｈｅ ｇａｌｌｓｔｏｎｅｓ ｃａｕｓｅｄ ｂｙ ｔｈｅ ｂｉｌｅ ｄｕｃｔ ｏｂｓｔｒｕｃｔｉｏｎ ａｎｄ ｉｎｆｅｃｔｉｏｎ．Ｍｅａｎｗｈｉｌｅ，ｔｈｅ Ｂｍａｘ ｏｆ ｔｈｅ ＨＤＬｒｅｃｅｐｔｏｒ ｏｆ ｔｈｅ ｈｅｐａｔｉｃ ｃｅｌｌ ｍｅｍｂｒａｎｅ ｄｅｃｒｅａｓｅｄ．Ｔｈｅｒｅｆｏｒｅ，ｔｈｅｒｅ ｗｅｒｅ ｄｉｓｏｒｄｅｒｓ ｏｆ ｒｅｖｅｒｓｅ ｃｈｏｌｅｓｔｅｒｏｌ ｔｒａｎｓｐｏｒｔ ｉｎ ｍａｎｙ ａｓｐｅｃｔｓ．Ｔｈｅｓｅ ｆａｃｔｏｒｓ ｔｏｇｅｔｈｅｒ ｗｉｔｈ ｏｔｈｅｒ ｌｉｔｈｏｇｅｎｉｃ ｅｌｅｍｅｎｔｓ ｐｒｏｂａｂｌｙ ｐｒｏｍｏｔｅ ｔｈｅ ｆｏｒｍａｔｉｏｎ ｏｆ ｔｈｅ ｃａｌｃｉｕｍ ｂｉｌｉｒｕｂｉｎａｔｅ ｇａｌｌｓｔｏｎｅｓ．
目的 探讨脓毒症患者的病情预后与高密度脂蛋白（HDL）之间的关联性。 方法 2008年3月1日－2010年2月28日选择50例严重脓毒症患者（脓毒症组）和30例非脓毒症的健康人（对照组），比较两组急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）和HDL水平。 结果 脓毒症组的HDL水平为（1.10 ± 0.39）mmol/L，对照组HDL水平为（1.61 ± 0.42） mmol/L，两组差异有统计学意义（t=6.786，P=0.000）。多因素非条件logistic回归分析显示，HDL水平（OR=0.877，P=0.025）和APACHEⅡ评分（OR=15.556，P=0.009）是影响脓毒症患者患病程度的两个有效独立因素。 结论 脓毒症能够导致患者的脂代谢出现紊乱，HDL水平是评估脓毒症患病程度的较好指标。
目的:对无明显心血管病(CVD)临床症状者的高甘油三酯(TG)≥1.60 mmol/L低高密度脂蛋白胆固醇(HDL-C)≤1.18 mmol/L伴有活动平板运动试验(TET)心电图(ECG)阳性和TET ECG阴性的缺血性心脏病(IHD)的危险因素进行了对比观察。〖HTH〗方法:〖HT5”SS〗对无明显CVD临床症状的2900例受试者检测TG/HDL-C、其中伴有TET ECG阳性(缺血型ST-T改变)者500例和TET ECG阴性(不伴有缺血型ST-T改变)者2500例进行了5年对比观察, 预测其预后。〖HTH〗结果〖HTSS〗:在 5年随访的观察中高TG(≥1.60 mmol/L)/低HDL-C(≤1.18 mmmol/L)伴有TET ECG阳性者500例的IHD的发生(30例)率为6.00%;IHD死亡(14例)率为2.80%。而高TG/低HDL-C TET ECG 阴性者2500例的IHD发生(25例)率为2.80%, 死亡(8例)率为0.32%, Plt;0.001。表明高TG/低HDL-C伴有TET ECG阳性者是IHD的较大危险因素。结论:高TG/低H DL-C, 伴有TET ECG阳性对IHD者的死亡率的预测有重要意义, 提示二者指标共同作用对IHD者极为不利。
Objective In order to study the mechanism of cholesterol gallstone formation through rabbit model which was induced by high cholesterol diet (HCD)Methods the activities of the high density lipoprotein receptor (HDLR) and low density lipoprotein receptor (LDLR) of hepatocytes were investigated. Results The results were as follows: The HDLR activity increased significantly after taking HCD for one week, at the same time, the LDLR activity only increased slightly. Thereafter, the activities of HDLR and LDLR all decreased markedly. As the time of animals taking HCD went on, serum total cholesterol, LDL cholesterol and hepatic cholesterol increased, but bile acids of biliary tract decreased gradually. Conclusion The results suggest that the changes of HDLR and LDLR activities of hepatocytes had no significant effect on bile cholesterol and the decreased HDLR and LDLR activities may cause the reduction some of substrate for bile acids synthesise and play an important role in the formation of gallstone.
ObjectiveTo discuss the relationship between microalbuminuria (MAU) and antioxidant activity of plasma hyper density lipoprotein (HDL) in hypertensive patients, and investigate whether MAU could be a predictor of HDL antioxidant activity. MethodFrom December 2007 to March 2009, sixty consecutive primary hypertensive patients from the inpatient and outpatient departments of West China Hospital and Sichuan Electric Power Central Hospital were included in the study, and 30 healthy volunteers served as controls. MAU, plasma HDL and paraoxonase (PON1) activity were tested. ResultsPON1 activity was lower in hypertensive patients than the controls (P<0.05), and this degree of decline was positively related to MAU (P<0.05). ConclusionMAU reflects PON1 activity in hypertensive patients and can be a predictor to judge plasma HDL function in patients with hypertension.
ObjectiveTo evaluate the relationship between low density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C) of preoperation (L/H value for short) and the pathological staging of colorectal cancer. MethodsThe clinical data of 187 patients with colorectal cancer who treated in PLA General Hospital from July 2009 to June 2014 were analyzed retrospectively. ResultsThere were statistical significance in L/H value among different TNM stagings, N stagings, and M stagings (P<0.05):L/H value of TNM Ⅳ staging was higher than those of TNM Ⅰ, Ⅱ, and Ⅲ staging, L/H values of N1 staging and N0 staging were lower than that of N2 staging, L/H value of M1 staging was higher than that of M0 staging. However, there was no statistical significance in L/H value among different T stagings of colorectal cancer (P>0.05). Logistic regression results showed that L/H value were positively associated with TNM staging (OR=4.34, 95% CI:2.837-6.644, P<0.000 1), T staging (OR=1.72, 95% CI:1.175-2.512, P=0.005 3), N staging (OR=2.15, 95% CI:1.422-3.254, P=0.000 3), and M staging (OR=3.04, 95% CI:1.733-5.332, P=0.000 1) of colorectal cancer, and patient with higher L/H value took more risk of progression of tumor, lymph node metastases, and distant metastasis. ConclusionsRaise of preoperative L/H value is an independent risk factor for the progression of TNM staging, T staging, N staging, and M staging in colorectal cancer.
Objective To explore the characteristics and the related factors of the lipid profiles in patients with ankylosing spondylitis (AS). Methods Sixty AS patients and 60 healthy controls were included retrospectively from January 2005 to January 2015. Information including general data, physical examination, and blood sample were collected; triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), high-density lipoprotein cholesterol (HDL-C), and C-reactive protein (CRP) were assessed. Results TG increased in 46.7% (28/60) patients, and HDL-C decreased in 50.0% (30/60). Compared with the control group, AS patients had lower levels of HDL-C, TC and LDL-C, and higher levels of TG, VLDL-C, VLDL-C/LDL-C ratio, LDL-C/HDL-C ratio, and TC/HDL-C ratio; the differences above were all statistically significant (P<0.01). Spearman correlation test demonstrated that HDL-C level was correlated negatively with serum CRP (rs=–0.359, P=0.005). Multiple linear regression model demonstrated that CRP was associated with HDL-C in AS patients (P=0.019). Conclusions Dyslipoproteinemia is a common feature in AS patients. The main characteristic is the increase of TG and decrease of HDL-C, related with inflammation. It suggests a high risk of atherosclerosis.
ObjectiveTo explore the independent factors related to clinical severe events in community acquired pneumonia patients and to find out a simple, effective and more accurate prediction method.MethodsConsecutive patients admitted to our hospital from August 2018 to July 2019 were enrolled in this retrospective study. The endpoint was the occurrence of severe events defined as a condition as follows intensive care unit admission, the need for mechanical ventilation or vasoactive drugs, or 30-day mortality during hospitalization. The patients were divided into severe event group and non-severe event group, and general clinical data were compared between two groups. Multivariate logistic regression analysis was performed to identify the independent predictors of adverse outcomes. Receiver operating characteristic (ROC) curve was constructed to calculate and compare the area under curve (AUC) of different prediction methods.ResultsA total of 410 patients were enrolled, 96 (23.4%) of whom experienced clinical severe events. Age (OR: 1.035, 95%CI: 1.012 - 1.059, P=0.003), high-density lipoprotein (OR: 0.266, 95%CI: 0.088 - 0.802, P=0.019) and lactate dehydrogenase (OR: 1.006, 95%CI: 1.004 - 1.059, P<0.001) levels on admission were independent factors associated with clinical severe events in CAP patients. The AUCs in the prediction of clinical severe events were 0.744 (95%CI: 0.699 - 0.785, P=0.028) and 0.814 (95%CI: 0.772 - 0.850, P=0.025) for CURB65 and PSI respectively. CURB65-LH, combining CURB65, HDL and LDH simultaneously, had the largest AUC of 0.843 (95%CI: 0.804 - 0.876, P=0.022) among these prediction methods and its sensitivity (69.8%) and specificity (81.5%) were higher than that of CURB65 (61.5% and 76.1%) respectively.ConclusionCURB65-LH is a simple, effective and more accurate prediction method of clinical severe events in CAP patients, which not only has higher sensitivity and specificity, but also significantly improves the predictive value when compared with CURB65.
Objective To investigate the effect of monocyte count to high density lipoprotein ratio (MHR) on early complications after off-pump coronary artery bypass grafting and to explore the predictive factors for early complications in patients after off-pump coronary artery bypass grafting. Methods The clinical data of patients who underwent simple off-pump coronary artery bypass grafting from October 2021 to September 2023 in our hospital were retrospectively analyzed. The patients were divided into a low value group and a high value group according to the median MHR value. The clinical data of the two groups were compared, and binary logistic regression analysis was used to explore the and predictors of atrial fibrillation (AF) and acute kidney injury (AKI) after coronary artery bypass grafting. Results A total of 220 patients were included, with a median MHR of 0.48. There were 108 patients in the low value group (MHR<0.48), including 71 males and 37 females, with an average age of 65.28±7.85 years. There were 112 patients in the high-value group (MHR≥0.48), including 84 males and 28 females, with an average age of 64.57±8.75 years. There was no statistical difference between the two groups in terms of general basic data such as gender or age (P>0.05). The incidence of postoperative AF and AKI in the high-value group was significantly higher than that in the low-value group (P<0.05), and no statistical difference in terms of other postoperative complications was observed. Binary logistic regression analysis showed that MHR was a risk factor for postoperative AKI and postoperative AF (P<0.05). Conclusion The study shows that MHR is a risk factor for new-onset AF and AKI after coronary artery bypass grafting.