目的:总结一例64岁II型糖尿病合并血栓性血小板减少性紫癜患者在院治疗调控血糖期间针对在血浆置换治疗过程中出现感染、内分泌代谢紊乱、出血、气体交换障碍等主要护理问题的护理要点,以期为相似案例提供借鉴。方法:就患者治疗全周期...目的:总结一例64岁II型糖尿病合并血栓性血小板减少性紫癜患者在院治疗调控血糖期间针对在血浆置换治疗过程中出现感染、内分泌代谢紊乱、出血、气体交换障碍等主要护理问题的护理要点,以期为相似案例提供借鉴。方法:就患者治疗全周期进行管理,以抢救生命、治疗疾病为重点,期间以控制管理基础疾病为基础,包括预防感染、血糖管理、症状护理、血浆置换护理、管道管理、心理护理等方面。结果:连续治疗10 d后患者生命体征暂时能够平稳,病情得到控制。结论:对患者生命治疗周期进行整体管控护理,针对基础慢性疾病合并疑难急症进行科学合理地护理,能迅速保障患者生命安全、提升治疗效率。Objective: To summarize the key points of nursing for a 64-year-old patient with type II diabetes mellitus complicated with thrombotic thrombocytopenic purpura during inpatient treatment for major nursing problems such as infection, endocrine and metabolic disorders, bleeding and gas exchange disorders during plasma exchange treatment, in order to provide reference for similar cases. Methods: The whole cycle of treatment was managed, focusing on life-saving and disease treatment, and the control and management of underlying diseases were the basis, including infection prevention, blood glucose management, symptom nursing, plasmapheresis nursing, pipeline management, and psychological nursing. Results: After 10 days of continuous treatment, the patient’s vital signs were temporarily stable and the condition was controlled. Conclusion: The overall control and nursing of the patient’s life cycle and the scientific and reasonable nursing for the underlying chronic diseases combined with intractable and urgent diseases can quickly ensure the life safety of patients and improve the treatment efficiency.展开更多
目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分...目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分为生存组及死亡组。收集患者的临床资料及确诊脓毒症后24 h内血小板体积(MPV)、淋巴细胞(LYM)计数的最差值,并计算平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分及SOFA评分。随后使用多因素Logistic回归分析,确定脓毒症患者预后的影响因素,再构建受试者工作特征曲线,评估各项指标对脓毒症患者预后的预测价值。结果:共纳入患者127例,生存组患者76例,死亡组患者51例。死亡组患者更易合并慢性阻塞性肺疾病,且平均血小板体积(MPV)、平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分、SOFA评分、及年龄均高于生存组,且差异具有统计学意义(P Objective: To investigate the prognostic value of the mean platelet volume (MPV)-to-lymphocyte ratio (MPVLR) combined with the APACHE II score in predicting the outcomes of patients with sepsis. Methods: This retrospective study screened patients with sepsis who were hospitalized in our hospital, from August 2020 to August 2023 were included and categorized into the survival group and the non-survival group based on 28-day outcomes of sepsis patients. Clinical date and the worst of mean platelet volume (MPV), lymphocyte (LYM) count values within 24 hours of sepsis diagnosis were collected, MPVLR and APACHE II scores were calculated. Multifactorial logistic regression analysis was used to identify risk factors affecting the prognosis of sepsis patients, and then a subject operating characteristic curve (ROC) was constructed to assess the predictive value of each indicator on the prognosis of sepsis patients. Results: A total of 127 patients were included, with 76 in the survival group and 51 in the non-survival group. Patients in the non-survival group were more likely to have chronic obstructive pulmonary disease, and had significantly higher MPV, MPVLR, APACHE II scores, SOFA scores and age compared to the survival group (P < 0.05). In contrast, peripheral blood lymphocyte counts in the survival group were significantly higher than that in the non-survival group (P < 0.05). Multivariate logistic regression analysis showed that MPVLR and APACHE II scores were independent risk factors for 28-day mortality in sepsis patients (P < 0.05). Receiver operating characteristic curve (ROC) curve analysis showed that the area under the curve (AUC) values for MPVLR, APACHE II scores, and their combination were 0.840, 0.800, and 0.885, respectively. Notably, the MPVLR combined with the APACHE II score showed the best predictive value, with an AUC of 0.824. It demonstrated excellent predictive performance, achieving a sensitivity of 94.6% and a specificity of 82.4%. Conclusion: APACHE II scores and MPVLR are independent risk factors for 28-day mortality in sepsis patients, and their combined use provides higher predictive value.展开更多
Epithelial-mesenchymal transition(EMT)plays an irreplaceable role in the development of silicosis.However,molecular mechanisms of EMT induced by silica exposure still remain to be addressed.Herein,metabolic profiles o...Epithelial-mesenchymal transition(EMT)plays an irreplaceable role in the development of silicosis.However,molecular mechanisms of EMT induced by silica exposure still remain to be addressed.Herein,metabolic profiles of human alveolar type II epithelial cells(A549 cells)exposed directly to silica were characterized using non-targeted metabolomic approaches.A total of 84 differential metabolites(DMs)were identified in silica-treated A549 cells undergoing EMT,which were mainly enriched in metabolisms of amino acids(e.g.,glutamate,alanine,aspartate),purine metabolism,glycolysis,etc.The number of DMs identified in the A549 cells obviously increased with the elevated exposure concentration of silica.Remarkably,glutamine catabolism was significantly promoted in the silica-treated A549 cells,and the levels of related metabolites(e.g.,succinate)and enzymes(e.g.,α-ketoglutarate(α-KG)dehydrogenase)were substantially up-regulated,with a preference toα-KG pathway.Supplementation of glutamine into the cell culture could substantially enhance the expression levels of both EMT-related markers and Snail(zinc finger transcription factor).Our results suggest that the EMT of human alveolar epithelial cells directly induced by silica can be essential to the development of silicosis.展开更多
BACKGROUND The National Comprehensive Cancer Network guidelines recommend adjuvant chemotherapy(ACT)for patients with stage II colon cancer who have undergone curative surgery when fewer than 12 lymph nodes(LNs)are re...BACKGROUND The National Comprehensive Cancer Network guidelines recommend adjuvant chemotherapy(ACT)for patients with stage II colon cancer who have undergone curative surgery when fewer than 12 lymph nodes(LNs)are retrieved.This study seeks to further examine the requirement for ACT in individuals who had 12 or more LNs harvested.AIM To investigate if stage II colon cancer patients with 12 or more LNs retrieved benefit from ACT.METHODS This retrospective cohort study included individuals diagnosed with stage II colon cancer who underwent surgery between 2008 and 2017 from the Surveillance,Epidemiology,and End Results(SEER)registry and a Chinese multicenter database.All patients had at least 12 LNs retrieved.The key endpoint was overall survival(OS).Cox regression analysis was performed to assess independent OS predictors.Propensity score matching controlled for confounders,and Kaplan-Meier analysis evaluated the impact of ACT on survival.RESULTS A total of 32742 patients with stage II colon cancer from the SEER cohort and 3153 patients from the Chinese cohort were included.The average number of LNs retrieved was 20.0(15.0,26.0)in the SEER cohort and 18.0(15.0,22.0)in the Chinese cohort.No-ACT remained an independent risk factor in both cohorts(hazard ratio=1.589,95%confidence interval:1.485-1.700 and hazard ratio=1.865,95%confidence interval:1.465-2.375,respectively).In the SEER cohort,patients in the ACT group consistently demonstrated better 5-year OS rates both before and after propensity score matching(79.4%vs 66.1%and 79.4%vs 69.4%,both P<0.0001).Similarly,these findings were further validated in the Chinese cohort(91.2%vs 82.1%and 90.0%vs 82.8%,both P<0.0001).ACT improved prognosis even in T3 and grade 1/2 patients.CONCLUSION This research,based on two large population-based cohorts,demonstrates that stage II colon cancer patients with 12 or more LNs retrieved can still benefit from ACT.展开更多
Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A tot...Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A total of 86 patients with severe pancreatitis treated in our hospital from March 2023 to March 2024 were selected. Using a random number table method, the patients were divided into a control group receiving conventional nursing care and a study group receiving nursing interventions based on APACHE II scores, with 43 patients in each group. The intervention effects of the two groups were compared. Results: The recovery time of gastrointestinal function in the study group was significantly shorter than that in the control group (P < 0.05). After the intervention, the quality of life scores in the study group was significantly higher than those in the control group (P < 0.05). The incidence of complications in the study group was significantly lower than in the control group (P < 0.05). Conclusion: Nursing interventions based on APACHE II scores can shorten gastrointestinal recovery time and reduce complications in patients with severe pancreatitis, contributing to improved quality of life.展开更多
文摘目的:总结一例64岁II型糖尿病合并血栓性血小板减少性紫癜患者在院治疗调控血糖期间针对在血浆置换治疗过程中出现感染、内分泌代谢紊乱、出血、气体交换障碍等主要护理问题的护理要点,以期为相似案例提供借鉴。方法:就患者治疗全周期进行管理,以抢救生命、治疗疾病为重点,期间以控制管理基础疾病为基础,包括预防感染、血糖管理、症状护理、血浆置换护理、管道管理、心理护理等方面。结果:连续治疗10 d后患者生命体征暂时能够平稳,病情得到控制。结论:对患者生命治疗周期进行整体管控护理,针对基础慢性疾病合并疑难急症进行科学合理地护理,能迅速保障患者生命安全、提升治疗效率。Objective: To summarize the key points of nursing for a 64-year-old patient with type II diabetes mellitus complicated with thrombotic thrombocytopenic purpura during inpatient treatment for major nursing problems such as infection, endocrine and metabolic disorders, bleeding and gas exchange disorders during plasma exchange treatment, in order to provide reference for similar cases. Methods: The whole cycle of treatment was managed, focusing on life-saving and disease treatment, and the control and management of underlying diseases were the basis, including infection prevention, blood glucose management, symptom nursing, plasmapheresis nursing, pipeline management, and psychological nursing. Results: After 10 days of continuous treatment, the patient’s vital signs were temporarily stable and the condition was controlled. Conclusion: The overall control and nursing of the patient’s life cycle and the scientific and reasonable nursing for the underlying chronic diseases combined with intractable and urgent diseases can quickly ensure the life safety of patients and improve the treatment efficiency.
文摘目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分为生存组及死亡组。收集患者的临床资料及确诊脓毒症后24 h内血小板体积(MPV)、淋巴细胞(LYM)计数的最差值,并计算平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分及SOFA评分。随后使用多因素Logistic回归分析,确定脓毒症患者预后的影响因素,再构建受试者工作特征曲线,评估各项指标对脓毒症患者预后的预测价值。结果:共纳入患者127例,生存组患者76例,死亡组患者51例。死亡组患者更易合并慢性阻塞性肺疾病,且平均血小板体积(MPV)、平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分、SOFA评分、及年龄均高于生存组,且差异具有统计学意义(P Objective: To investigate the prognostic value of the mean platelet volume (MPV)-to-lymphocyte ratio (MPVLR) combined with the APACHE II score in predicting the outcomes of patients with sepsis. Methods: This retrospective study screened patients with sepsis who were hospitalized in our hospital, from August 2020 to August 2023 were included and categorized into the survival group and the non-survival group based on 28-day outcomes of sepsis patients. Clinical date and the worst of mean platelet volume (MPV), lymphocyte (LYM) count values within 24 hours of sepsis diagnosis were collected, MPVLR and APACHE II scores were calculated. Multifactorial logistic regression analysis was used to identify risk factors affecting the prognosis of sepsis patients, and then a subject operating characteristic curve (ROC) was constructed to assess the predictive value of each indicator on the prognosis of sepsis patients. Results: A total of 127 patients were included, with 76 in the survival group and 51 in the non-survival group. Patients in the non-survival group were more likely to have chronic obstructive pulmonary disease, and had significantly higher MPV, MPVLR, APACHE II scores, SOFA scores and age compared to the survival group (P < 0.05). In contrast, peripheral blood lymphocyte counts in the survival group were significantly higher than that in the non-survival group (P < 0.05). Multivariate logistic regression analysis showed that MPVLR and APACHE II scores were independent risk factors for 28-day mortality in sepsis patients (P < 0.05). Receiver operating characteristic curve (ROC) curve analysis showed that the area under the curve (AUC) values for MPVLR, APACHE II scores, and their combination were 0.840, 0.800, and 0.885, respectively. Notably, the MPVLR combined with the APACHE II score showed the best predictive value, with an AUC of 0.824. It demonstrated excellent predictive performance, achieving a sensitivity of 94.6% and a specificity of 82.4%. Conclusion: APACHE II scores and MPVLR are independent risk factors for 28-day mortality in sepsis patients, and their combined use provides higher predictive value.
基金supported by the National Natural Science Foundation of China(Nos.22206207,22127810,and 22276224)the Natural Science Foundation of Guangdong Province(Nos.2021A1515011546 and 2023A1515010085)the Science and Technology Planning Project of Guangzhou(No.202102080005)。
文摘Epithelial-mesenchymal transition(EMT)plays an irreplaceable role in the development of silicosis.However,molecular mechanisms of EMT induced by silica exposure still remain to be addressed.Herein,metabolic profiles of human alveolar type II epithelial cells(A549 cells)exposed directly to silica were characterized using non-targeted metabolomic approaches.A total of 84 differential metabolites(DMs)were identified in silica-treated A549 cells undergoing EMT,which were mainly enriched in metabolisms of amino acids(e.g.,glutamate,alanine,aspartate),purine metabolism,glycolysis,etc.The number of DMs identified in the A549 cells obviously increased with the elevated exposure concentration of silica.Remarkably,glutamine catabolism was significantly promoted in the silica-treated A549 cells,and the levels of related metabolites(e.g.,succinate)and enzymes(e.g.,α-ketoglutarate(α-KG)dehydrogenase)were substantially up-regulated,with a preference toα-KG pathway.Supplementation of glutamine into the cell culture could substantially enhance the expression levels of both EMT-related markers and Snail(zinc finger transcription factor).Our results suggest that the EMT of human alveolar epithelial cells directly induced by silica can be essential to the development of silicosis.
基金Supported by Shanxi Special Projects of the Central Government Guiding Local Science and Technology Development of China,No.YDZJSX2021B016Shanxi Cancer Hospital Doctoral Master’s Guide and Companion Flying Fund,No.SD2023010.
文摘BACKGROUND The National Comprehensive Cancer Network guidelines recommend adjuvant chemotherapy(ACT)for patients with stage II colon cancer who have undergone curative surgery when fewer than 12 lymph nodes(LNs)are retrieved.This study seeks to further examine the requirement for ACT in individuals who had 12 or more LNs harvested.AIM To investigate if stage II colon cancer patients with 12 or more LNs retrieved benefit from ACT.METHODS This retrospective cohort study included individuals diagnosed with stage II colon cancer who underwent surgery between 2008 and 2017 from the Surveillance,Epidemiology,and End Results(SEER)registry and a Chinese multicenter database.All patients had at least 12 LNs retrieved.The key endpoint was overall survival(OS).Cox regression analysis was performed to assess independent OS predictors.Propensity score matching controlled for confounders,and Kaplan-Meier analysis evaluated the impact of ACT on survival.RESULTS A total of 32742 patients with stage II colon cancer from the SEER cohort and 3153 patients from the Chinese cohort were included.The average number of LNs retrieved was 20.0(15.0,26.0)in the SEER cohort and 18.0(15.0,22.0)in the Chinese cohort.No-ACT remained an independent risk factor in both cohorts(hazard ratio=1.589,95%confidence interval:1.485-1.700 and hazard ratio=1.865,95%confidence interval:1.465-2.375,respectively).In the SEER cohort,patients in the ACT group consistently demonstrated better 5-year OS rates both before and after propensity score matching(79.4%vs 66.1%and 79.4%vs 69.4%,both P<0.0001).Similarly,these findings were further validated in the Chinese cohort(91.2%vs 82.1%and 90.0%vs 82.8%,both P<0.0001).ACT improved prognosis even in T3 and grade 1/2 patients.CONCLUSION This research,based on two large population-based cohorts,demonstrates that stage II colon cancer patients with 12 or more LNs retrieved can still benefit from ACT.
文摘Objective: To explore the application effect of nursing interventions based on APACHE II scores in patients with severe pancreatitis and its impact on the recovery time of the gastrointestinal function. Methods: A total of 86 patients with severe pancreatitis treated in our hospital from March 2023 to March 2024 were selected. Using a random number table method, the patients were divided into a control group receiving conventional nursing care and a study group receiving nursing interventions based on APACHE II scores, with 43 patients in each group. The intervention effects of the two groups were compared. Results: The recovery time of gastrointestinal function in the study group was significantly shorter than that in the control group (P < 0.05). After the intervention, the quality of life scores in the study group was significantly higher than those in the control group (P < 0.05). The incidence of complications in the study group was significantly lower than in the control group (P < 0.05). Conclusion: Nursing interventions based on APACHE II scores can shorten gastrointestinal recovery time and reduce complications in patients with severe pancreatitis, contributing to improved quality of life.
