【摘要】 目的 探討膿毒血癥患者膽堿酯酶水平與患者病情及預后的關系。 方法 2007年6月-2009年6月，將89例膿毒血癥患者設定為膿毒血癥組，進行血清膽堿酯酶測定及APACHEⅡ評分；另擇82例健康人為正常組，測定血清膽堿酯酶值，比較兩者之間差異；89例膿毒癥患者按病況再分為存活組及死亡組，比較兩者之間血清膽堿酯酶及APACHEⅡ評分差異。 結果 治療前膿毒血癥組膽堿酯酶水平明顯低于正常組，有統計學意義（Plt;0.01）；膿毒血癥組APACHEⅡ評分與血清膽堿酯酶呈負相關；死亡組APACHEⅡ評分明顯高于存活組，而血清膽堿酶低于存活組（Plt;0.01）。 結論 膽堿酯酶同APACHEⅡ評分呈負相關，能明顯反映膿毒癥患者病情嚴重程度及預后。【Abstract】 Objective To explore the relationship between the level of cholinesterase and the patients condition and the prognosis in the patients with sepsis. Methods From June 2007 to June 2009, 89 patients with sepsis were selected as the sepsis group, whose cholinesterase level was assayed and evaluated by APACHE Ⅱ score. Another 82 healthy people were as the control whose cholinesterase level was assayed and compared with that in the sepsis group. The patients in the sepsis group were subdivided into survival and death group; the level of cholinesterase and the result of APACHE Ⅱ score were compared between the two groups. Results The level of cholinesterase in sepsis group was significantly lower than that in the control group before treatment, and the difference was significant (Plt;0.01); the APACHE Ⅱ score negatively correlated with the serum cholinesterase in sepsis group. The APACHE Ⅱ score in the death group was significantly higher than that in the survival group, but the level of cholinesterase was obviously lower in the death group than that in the survival group (Plt;0.01). Conclusion The serumal cholinesterase negatively correlates with the APACHE Ⅱ score, which could obviously reflect the patients condition and the prognosis of sepsis.
Tyrosine kinase inhibitors (TKIs) are the standard of care for non-small cell lung cancer patients with epidermal growth factor receptor (EGFR) mutation. The efficacy of TKIs and prognosis of EGFR-mutated patients with compound EGFR mutation, oncogene mutation, suppresser gene mutation or other diver gene mutation are worse than those of patients with a single EGFR mutation. This article makes a review of related clinical researches aiming to provide references for clinical scenarios. To sum up, molecular alterations and clinical features should be correlated as accurately and dynamically as possible in the diagnostic and therapeutic process, and combined therapeutic strategies should be chosen flexibly and reasonably to improve patients’ survival and prognosis.
ObjectiveThis study applied Mendelian randomization to explore the potential causal relationship between inflammatory factors and diabetic nephropathy. MethodsSummary-level data from genome-wide association studies of inflammatory factors and diabetic nephropathy were used, and inverse variance weighted analysis was used as the primary analytical method, complemented by results from weighted median, MR-Egger regression, simple model, and median model approaches. Sensitivity analysis was used to test the reliability of the MR analysis results. ResultsIn the inverse variance weighted method, stem cell factor (OR=1.28, 95%CI 1.04 to 1.58, P=0.020) and interferon-γ (OR=1.36, 95%CI 1.10 to 1.70, P=0.005) were positively correlated with diabetic nephropathy, and diabetic nephropathy was positively correlated with interferon-inducible protein 10 (OR=0.90, 95%CI 0.83 to 0.98, P=0.012) were negatively correlated with diabetic nephropathy. Sensitivity analysis showed that MR analysis was reliable. ConclusionStem cell factors and interferon-γ are associated with an increased risk of developing diabetic nephropathy, and diabetic nephropathy decreases the expression of interferon-inducible protein 10 in vivo. Our results demonstrate a potential causal relationship between inflammatory factors and the development of diabetic nephropathy. This finding is of clinical significance for the pre-diagnosis and treatment of diabetic nephropathy.
