目的研究分析感染可能性评分(infection probability score,IPS)对于行输尿管软镜术后患者发生尿源性脓毒血症的筛查预测效果。方法研究纳入医院2016年1月-2017年12月收治的行输尿管软镜术治疗的196例患者,以炎症反应作为诊断标准,遵照...目的研究分析感染可能性评分(infection probability score,IPS)对于行输尿管软镜术后患者发生尿源性脓毒血症的筛查预测效果。方法研究纳入医院2016年1月-2017年12月收治的行输尿管软镜术治疗的196例患者,以炎症反应作为诊断标准,遵照随机分配原则分为对照组108例与试验组88例,对试验组患者进行细菌培养分析,并检测对比两组患者血清降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactionprotein,CRP)以及白细胞(white blood cell,WBC)水平,对IPS评分在术后尿源性脓毒血症的预筛查中的价值进行分析。结果试验组中88例患者共培养病原菌102株,其中革兰阴性菌82株占80.39%、革兰阳性菌20株占19.61%,革兰阴性菌中以大肠埃希菌为主;血清指标检测结果显示,试验组患者PCT、CRP以及WBC水平均高于对照组患者(P<0.05);试验组患者IPS评分均高于对照组患者(P<0.05)。结论输尿管软镜术后尿源性脓毒血症患者主要感染病原菌为革兰阴性菌,患者CRP及WBC水平均有所升高,应用IPS评分可有效鉴别患者术后感染情况,对于尿源性脓毒血症的诊断准确性较高,在临床预测筛查中有一定的应用价值。展开更多
Objective: To test the hypothesis that acute phase reactants, such as alpha 1-antitrypsin and alpha 1-acid glycoprotein, could protect mammalian cells from further damage. Methods: Human dermal fibroblasts (5×10 ...Objective: To test the hypothesis that acute phase reactants, such as alpha 1-antitrypsin and alpha 1-acid glycoprotein, could protect mammalian cells from further damage. Methods: Human dermal fibroblasts (5×10 4) were cultured with DMEM plus 10% FBS at 37℃ in a 5% CO 2 incubator. Different doses of LPS (lipopolysaccharide) and/or acute phase reactants were added. After 24 hours, the cultured supernatant was aspirated, the cells were washed, fixed and stained by methylene blue. The unbound stain was washed off. The stained cells were solubilized in 0.1 ml of 1% Triton X-100. The absorbance of each well was measured using an ELISA spectrophotometer. The concentration of LPS which decreased the absorbance to 70% of the control (LPS-free) cultures was defined as LD 30. Results: In order to achieve LD 30 in the presence of acute phase proteins, it was necessary to alter the LPS concentrations. The LD 30 of LPS treated with 0, 0.5, 2, 10 mg/ml antitrypsin and 0, 0.5, 2, 10 mg/ml glycoprotein was 5.4, 6.5, 7.6, 14.2 mg/ml and 5.2, 5.9, 6.9, 10.5 mg/ml, respectively. Statistically, with the treatment of more than 2 mg/ml antitrypsin or glycoprotein, LD 30 increased significantly. Conclusions: Our data show that fibroblasts are susceptible to the direct toxicity of LPS. Alpha 1-antitrypsin and alpha 1-acid glycoprotein can reduce the toxicity and/or increase the tolerance of mammalian cells to LPS.展开更多
文摘目的研究分析感染可能性评分(infection probability score,IPS)对于行输尿管软镜术后患者发生尿源性脓毒血症的筛查预测效果。方法研究纳入医院2016年1月-2017年12月收治的行输尿管软镜术治疗的196例患者,以炎症反应作为诊断标准,遵照随机分配原则分为对照组108例与试验组88例,对试验组患者进行细菌培养分析,并检测对比两组患者血清降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactionprotein,CRP)以及白细胞(white blood cell,WBC)水平,对IPS评分在术后尿源性脓毒血症的预筛查中的价值进行分析。结果试验组中88例患者共培养病原菌102株,其中革兰阴性菌82株占80.39%、革兰阳性菌20株占19.61%,革兰阴性菌中以大肠埃希菌为主;血清指标检测结果显示,试验组患者PCT、CRP以及WBC水平均高于对照组患者(P<0.05);试验组患者IPS评分均高于对照组患者(P<0.05)。结论输尿管软镜术后尿源性脓毒血症患者主要感染病原菌为革兰阴性菌,患者CRP及WBC水平均有所升高,应用IPS评分可有效鉴别患者术后感染情况,对于尿源性脓毒血症的诊断准确性较高,在临床预测筛查中有一定的应用价值。
基金NationalNatureScienceFundGrant (No .395 0 0 15 0 ) OutstandingTalentFundGrantof NationalNatureScienceFundCommittee (No .3972 5 0 2 9)
文摘Objective: To test the hypothesis that acute phase reactants, such as alpha 1-antitrypsin and alpha 1-acid glycoprotein, could protect mammalian cells from further damage. Methods: Human dermal fibroblasts (5×10 4) were cultured with DMEM plus 10% FBS at 37℃ in a 5% CO 2 incubator. Different doses of LPS (lipopolysaccharide) and/or acute phase reactants were added. After 24 hours, the cultured supernatant was aspirated, the cells were washed, fixed and stained by methylene blue. The unbound stain was washed off. The stained cells were solubilized in 0.1 ml of 1% Triton X-100. The absorbance of each well was measured using an ELISA spectrophotometer. The concentration of LPS which decreased the absorbance to 70% of the control (LPS-free) cultures was defined as LD 30. Results: In order to achieve LD 30 in the presence of acute phase proteins, it was necessary to alter the LPS concentrations. The LD 30 of LPS treated with 0, 0.5, 2, 10 mg/ml antitrypsin and 0, 0.5, 2, 10 mg/ml glycoprotein was 5.4, 6.5, 7.6, 14.2 mg/ml and 5.2, 5.9, 6.9, 10.5 mg/ml, respectively. Statistically, with the treatment of more than 2 mg/ml antitrypsin or glycoprotein, LD 30 increased significantly. Conclusions: Our data show that fibroblasts are susceptible to the direct toxicity of LPS. Alpha 1-antitrypsin and alpha 1-acid glycoprotein can reduce the toxicity and/or increase the tolerance of mammalian cells to LPS.
