ObjectiveTo investigate the changes of platelet-leukocyte aggregates (PLA) level in patients with sepsis and its diagnostic value in sepsis complicated with acute respiratory distress syndrome (ARDS).MethodsA prospective study was carried in adult sepsis patients admitted to our hospital from January 2015 to November 2016. According to the 2012 " Berlin definition” diagnostic criteria, 58 cases of sepsis with ARDS were allocated to an experimental group and 139 cases of sepsis non-ARDS patients were allocated to a control group. Immediately after the diagnosis of sepsis, elbow vein blood samples were collected for flow cytometry assay of PLA. The acute physiology and chronic health assessment II (APACHE II score) of each group was performed and the receiver operating characteristic (ROC) curve was drawn.ResultsPlatelet-neutrophil aggregates (PNA) and platelet-lymphocyte aggregates (PLyA) in the experimental group were higher than those in the control group, but there were no significant differences (both P>0.05). The platelet-monocyte aggregates (PMA) of the experimental group was significantly higher than that of the control group (P<0.05). Peripheral blood PMA was positively correlated with APACHE II score (r=0.671, P<0.001). When PMA was used as the test variable, the area under the curve (AUC) was 0.945 with significant diagnostic value (P<0.001), and optimal cutoff value of PMA was 8.25%, with diagnostic sensitivity of 0.806 and diagnostic specificity of 0.951. When APACHE II was used as the test variable, AUC was 0.930, with significant diagnostic value (P<0.001), and optimal threshold of APACHE II was 16.500 with diagnostic sensitivity of 0.871 and diagnostic specificity of 0.852.ConclusionPMA is of great value in the diagnosis of sepsis with ARDS.
Objective To evaluate the effectiveness of topical fluoride on prevention of enamel demineralization during the orthodontic treatment in China. Methods The Cochrane Library（Issue 9, 2012), MEDLINE (1996 to 2012.10), EMbase (1974 to 2012.10), CNKI (1994 to 2012.10), VIP (1994 to 2012.10), WanFang data (1998 to 2012.10) and CBM (1978 to 2012.10) are searched for the randomized controlled trials (RCTs) and quasi-Randomized controlled trials (qRCTs) about topical fluoride preventing enamel demineralization during the orthodontic treatment. The bibliographies of the included studies were searched, too. Two reviewers evaluated the quality of the included studies and extracted data critically and independently, and then the extracted data were analyzed using RevMan 5.2 software. Results A total of 20 studies within 19 articles were included, which involved 26 323 teeth. The results of meta-analysis results show that, the rate of enamel demineralization of the fluoride varnish group (8.4%) was lower than that of the control group (16.0%) (OR=0.44, 95%CI 0.33 to 0.59, Plt;0.000 01); the rate of enamel demineralization of the fluoride coating group (8.3%) was lower than that of the control group (17.7%) (OR=0.46, 95%CI 0.35 to 0.60, Plt;0.000 01); the rate of enamel demineralization of the fluoride toothpaste group (9.0%) was lower than that of the control group (14.5%) (OR=0.59, 95%CI 0.49 to 0.71, Plt;0.000 01); the rate of enamel demineralization of the fluoride foam group (11.6%) was lower than that of the control group (18.2%) (OR=0.48, 95%CI 0.24 to 0.96, P=0.04); the rate of enamel demineralization of other groups (12.0%) was lower than that of the control group (21.8%) (OR=0.43, 95%CI 0.30 to 0.60, Plt;0.000 01). Two outcomes were low quality in the GRADE system and the other three are very low quality. Conclusion Current domestic evidence shows that topical fluoride is effective to prevent enamel demineralization during the orthodontic treatment. However, given the low methodological quality of most included studies, this conclusion still needs to be further proved by conducting more strictly-designed, high-quality and large-scale studies.
Objective To compare the differences of flow and volume responses in patients with mild to very severe chronic obstructive pulmonary disease（COPD） in bronchodilatation test. Methods The different changes of FEV1 and FVC in 217 patients with mild to very severe COPD（GOLD stage Ⅱ-Ⅳ） after inhaling salbutamol were analyzed retrospectively. Results FEV1 and FVC of the patients with COPD at stage Ⅱ-Ⅳ increased remarkably after inhaling β2 agonist，while there were significant differences between the changes of FEV1 and FVC. Increment of FEV1 and FVC (ΔFEV1 and ΔFVC)，representing flow and volume responses respectively，showed a normal distribution. The majority of patients fell in the range of ΔFEV1 from 0.00 to 0.04，0.05 to 0.09 and 0.10 to 0.14 liter，and ΔFVC from 0.00 to 0.09，0.10 to 0.19 and 0.20 to 0.29 liter. There was significant difference of ΔFEV1 among stage Ⅱ-Ⅳ patients with COPD （Plt;0.01），namely more severe the disease less ΔFEV1 got.In the other hand ΔFVC increased along with the progression of COPD，although no significant difference of ΔFVC among stage Ⅱ-Ⅳ patients with COPD was found. Though different changes of ΔFEV1 and ΔFVC were revealed，there was a positive correlation between ΔFEV1 and ΔFVC in patients at each GOLD stage and the correlation became more insignificant with the progression of COPD. Conclusions There are significant differences between post-bronchodilator flow and volume responses in patients with COPD.Flow response decreases remarkably along with the progression of COPD，whereas volume response increases along with the progression of COPD.