中华急诊医学杂志最新文献

{"title":"The clinical study on the relationship between serum albumin concentration and lymphocyte levels in patients with 2019-novel coronavirus pneumonia/ 中华急诊医学杂志","authors":"Ruoqing Li, J. Tian, Fang Yang, Jie Yu, L. Lv, G. Sun, Hongqun Wang, Yinghong Liu, Xi Chen, Qingyong Fang, Xiaojuan Yang","doi":"10.3760/CMA.J.ISSN.1671-0282.2020022.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020022.004","url":null,"abstract":"Objective \u0000To explore the relationship between different serum albumin and lymphocyte levels in patients with 2019-novel coronavirus (2019-nCoV) pneumonia (COVID-19). \u0000 \u0000 \u0000Methods \u0000A retrospective study was performed to identify the characteristics of the clinical data of 205 COVID-19 patients who were hospitalized in the Happy Street of Hanchuan People's Hospital, Xiaogan, Hubei Province from January 24 to February 12, 2020, including their general information, serum albumin (ALB) levels, lymphocyte counts (LYM), percentage of lymphocytes (LYM%) and other laboratory parameter levels. Low ALB group and normal ALB group were demarcated by the concentration of 35g/L, further to identify the differences of LYM and LYM% levels and the incidence of LYM and LYM% decline at different ALB levels between groups,as well as the correlation between ALB and LYM, LYM% levels in hypoalbuminemia conditions . \u0000 \u0000 \u0000Results \u000017.5% of COVID-19 patients were associated with hypoalbuminemia. The levels of LYM and LYM% in the low ALB group were significantly lower than those in the normal ALB group (P <0.001). The incidence of LYM and LYM% decline in the low ALB group was significantly higher than those in the normal ALB group (P <0.001). The levels of LYM and LYM% in the low ALB group were significantly positively correlated with serum ALB concentrations (P <0.05). \u0000 \u0000 \u0000Conclusions \u0000The decrease of lymphocyte levels in COVID-19 patients may be correlated to hypoalbuminemia. COVID-19 patients complicated by hypoalbuminemia should be actively intervened to maintain serum albumin in the normal range. \u0000 \u0000 \u0000Key words: \u0000Novel coronavirus; COVID-19; Albumins; Hypoalbuminemia; Infectious diseases; Lymphocyte count; Inflammatory factor; Treatment, integration","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46641437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Consensus on Medical Applications of Respirator","authors":"R. China","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.0010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.0010","url":null,"abstract":"","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45389668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of 2019 novel coronavirus infection patients and a feasible screening procedure/ 中华急诊医学杂志","authors":"Yan Li, Sheng-yong Xu, Tie-kuan Du, Xu Jun, Yi Li, Xuezhong Yu, Huadong Zhu","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.0007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.0007","url":null,"abstract":"Objective \u0000To study the clinical characteristics of 2019 coronavirus (2019-nCoV) pneumonia patients and make a feasible screening process in fever clinic. \u0000 \u0000 \u0000Methods \u0000Epidemiologic features, clinical presentation, laboratory findings and image features of the screened patients were retrospectively collected and analyzed. \u0000 \u0000 \u0000Results \u0000Totally, 46 patients were screened, 9 of them were laboratory-confirmed 2019-nCoV infection, and others were defined as laboratory-excluded patients. Laboratory-confirmed patients had higher frequency of travelling or residence in Wuhan within two weeks of onset (P 0.05). The most common feature of the laboratory-confirmed patients was fever (100%), but the symptoms showed no differences between the two groups (P>0.05). Laboratory-confirmed patients had lower white blood cell count than the laboratory-excluded patients (P<0.05), and all of them had pneumonia in chest CT scan. None of the patients with normal chest CT had positive 2019-nCoV nucleic acid test. \u0000 \u0000 \u0000Conclusions \u0000No specific symptom was helpful in the diagnosis of 2019-nCoV infection. However, patients without chest CT scan changes had a very low risk of 2019-nCoV infection despite of the epidemiologic history and fever. We recommended a screening procedure that might be helpful to reduce the rate of miss diagnosis and improve screening efficiency. \u0000 \u0000 \u0000Key words: \u00002019-nCoV; pneumonia; fever; chest CT","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43165018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A combination regimen by lopinave/litonawe (LPV/r), emtricitabine and tenofovir alafenamide fumarate (FTC/TAF) for treatment of novel coronavirus pneumonia (TARCoV)/ 中华急诊医学杂志","authors":"Hua Jiang, Yu Wang, Kai Wang, Xingxiang Yang, Jian-cheng Zhang, Hongfei Deng, Lu Wang, J. Zeng","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.03.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.03.003","url":null,"abstract":"Objective \u0000To explore the efficacy of a combination regimen by Lopinave/Litonawe (LPV/r), emtricitabine and tenofovir alafenamide fumarate (FTC/TAF) for the treatment of novel coronavirus pneumonia (NCP). \u0000 \u0000 \u0000Methods \u0000We design the protocol as a real world study, which includes two groups: prospective intervention cohort (T1) and historical control group (T2). For T1 group, ninety patients will be enrolled who are diagnosed as NCP. All patients in T1 group will receive standard therapies following the recommendation in the guidelines of National Commission of Health, and they will be administered an anti-virus regimen includes LPV/r and FTC/TAF. The T2 group will enroll patients who have received single regimen includes LPV/r. The major outcome is the survival rate of patients. Secondary outcomes are the time of seroconversion of RNA, ARDS progression rate and length of hospital stay. \u0000 \u0000 \u0000Conclusions \u0000The results of this real world study might provide clinical practitioners a high efficiency and fast antivirus regimen for NCP. In addition, the conduction of this study will accelerate screening for other new effective therapeutic method. \u0000 \u0000 \u0000Key words: \u0000Novel coronavirus pneumonia; Lopinave/Litonawe; Emtricitabine and tenofovir alafenamide fumarate; Survival rate; Length of hospital stay","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48091279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early clinical manifestations and pulmonary imaging analysis of patients with Novel coronavirus pneumonia/ 中华急诊医学杂志","authors":"Tao Yang, Xiaona Yu, Xingxing He, Wei Zhou, Yifu Fu, Q. Feng","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.0005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.0005","url":null,"abstract":"Objective \u0000To investigate the early clinical characteristics and radiographic changes in confirmed Novel coronavirus pneumonia (NCP) and excluded NCP patients. \u0000 \u0000 \u0000Methods \u0000Twenty-four patients with suspected NCP admitted to Shanghai Jiao Tong University Affiliated Sixth People’s Hospital and Jinshan Branch Hospital between January and February, 2020 were chosen as our research subjects. Early clinical features and radiographic changes were analyzed in 10 patients of confirmed NCP and 14 patients of excluded NCP. \u0000 \u0000 \u0000Results \u0000In the early stage, all 24 suspected patients were mild, and had normal blood gas analysis. Of 10 diagnosed patients, 50% were male. All the 10 patients had fever and fatigue, with body temperature between 37.5℃ and 38.5℃. Only 1 patient had dry cough. 2 patients had no clear epidemiological exposure history, the other 8 had a clear epidemiological exposure, with a possible incubation period of 1-10 days. From CT imaging, lesions were characterized as ground glass shadow (n=9), which could be unilateral (n=1) or bilateral (n=9), and were mainly close to the pleura (n=9), with nodule shadow (n=1) and without focal necrosis, and could combined with pleural effusion (n=1. Among patients excluded NCP, all 14 patients had a clear history of epidemic exposure, with an onset time of 1 to 13 days. 12 patients had fever , including 4 with temperature > 38.5°C, 8 with temperature 37.3-38.5°C, and 2 without fever. All patients had fatigue , 7 patients had dry cough and 2 patients had chest pain. From CT imaging, ground glass shadow appeared in 4 patients , lesions were unilateral in 10 patients and bilateral in 4 patients , and the lesions were relatively sporadic, without necrosis or pleural effusion. \u0000 \u0000 \u0000Conclusion \u00001．Not all patients with NCP have a direct history of epidemiology exposure, some patients may be infected unknowingly. 2. According to CT imaging, NCP seems to have no special manifestations different from other viral pneumonia. 3. NCP is more common among middle-aged people. \u0000 \u0000 \u0000Key words: \u0000Novel coronavirus pneumonia; Clinical manifestations; Radiographic changes","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46668008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The possibility of using Lopinave/Litonawe (LPV/r) as treatment for novel coronavirus 2019-nCov pneumonia: a quick systematic review based on earlier coronavirus clinical studies/ 中华急诊医学杂志","authors":"Hua Jiang, Hongfei Deng, Yu Wang, Zhan Liu, M. Sun, Ping Zhou, Qingan Xia, C. Lu, J. Zeng","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.0001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.0001","url":null,"abstract":"Objective \u0000To explore the possibility of using Lopinave/Litonawe (LPV/r) as treatment for novel coronavirus 2019-nCov pneumonia by systematically review earlier coronavirus studies. \u0000 \u0000 \u0000Methods \u0000Systematically retrieve relevant clinical studies from Chinese and English databases such as CNKI,VIP, Wangfang Data,CBM,PubMed, Web of Science,EMBASE. In addition, information from Chinese bio-medical journals, WHO, US CDC, Chinese CDC websites and the references from published relevant articles were retrieved. The inclusion period is from January 2003 to January 24, 2020. The criteria for inclusion are: (1) studies that aim to compare LPV/r and placebo/standard for SARS, MERS; (2) studies that include at least one clinical outcome; (3) studies with diagnosis criteria meeting WHO requirement on SARS or MERS; (4) data from multiple reports but originated from one study, where we extract information from all reports; (5) guidelines, includes: national or academic guidelines/experts 'consensus. The exclude criteria are: 1) only have abstracts but no full information; 2) in vitro studies. Two reviewers independently review articles and extract data on study design, patients, diagnosis criteria, regimen, and clinical outcomes (mortality, morbidity, quality of life, steroids dosage, chest image and adverse responses). \u0000 \u0000 \u0000Results \u0000Two hundred and thirty potential article were found by screening, and narrow down to forty-four articles for evaluation and finally four studies were included. The results of included studies indicate the early use of LPV/r regimen can reduce the mortality of SARS and MERS, and reduce steroids dosing. \u0000 \u0000 \u0000Conclusions \u0000ILPV/r can be used as a component of experimental regimen for treat 2019-nCoV pneumonia. It strongly suggests that initiating real world studies to explore the true clinical effects of LPV/r on 2019-nCoV patients. \u0000 \u0000 \u0000Key words: \u00002019-nCoV; Lopinave/Litonawe (LPV/r); S`Anti-virus regimen; Systematical review; Real world study","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49441138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caffeine combined with heated humidified high-flow nasal cannula in the treatment of respiratory distress syndrome in preterm infants","authors":"Bao Jin, Xiang-yu Gao, Huiying Wang, Bo Yang, Yi Ren","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.016","url":null,"abstract":"Objective \u0000To observe the clinical efficacy and safety of caffeine citrate combined with heated humidified high-flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) in preterm infants. \u0000 \u0000 \u0000Methods \u0000From June 2017 to December 2018, a total of 82 preterm infants with RDS (28 weeks≤ gestational age<32 weeks) who were hospitalized in Neonatal Intensive Care Unit of the Affiliated Xuzhou Hospital of Southeast University were chosen as research subjects. They were randomly (random number table method) divided into two groups: the combined treatment group (n=42) and the control group (n=40). Infants in the combined treatment group were given caffeine citrate combined with HHHFNC, while infants in the control group were given nasal continuous positive airway pressure (NCPAP) without caffeine citrate. The general clinical data, results of blood gas analysis at 6 h and 24 h after breath support therapy, clinical efficacy, related complications and adverse drug reactions between the two groups were compared statistically by LSD-t test, Chi-square test and Kruskal-Wallis H rank sum test. \u0000 \u0000 \u0000Results \u0000① No significant differences were found between the two groups in the general clinical data (all P>0.05).②The results of intra-groups comparison within the combined treatment group or control group showed that the pH value, partial pressure of arterial carbon dioxide (PaCO2), partial pressure of arterial oxygen (PaO2) of blood gas analysis and PaO2/fraction of inspired oxygen (P/F) at 6 h and 24 h after breath support therapy were all significantly improved compared to those of before treatment (all P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Caffeine citrate combined with HHHFNC treatment strategy for premature infants with RDS can effectively improve oxygenation, shorten the duration of noninvasive mechanical ventilation, increase the success rate of machine withdrawal, and reduce the incidence of nasal trauma and abdominal distention. \u0000 \u0000 \u0000Key words: \u0000Caffeine; Heated humidified high-flow nasal cannula; Continuous positive airway pressure; Respiratory distress syndrome; Infant, preterm","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"99-105"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42572219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive value of extra pulmonary multiple factors including creatine kinase-isoenzyme MB in prognosis of patients with acute paraquat poisoning","authors":"C. Lan, Nengyuan Xu, Xing Meng, Xinya Jia, Zhongshi Li, Qingquan Lyu, Jinran Yang","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.018","url":null,"abstract":"Objective \u0000To investigate the predictive value of extra pulmonary multiple factors including creatine kinase-isoenzyme MB (CK-MB) for the prognosis of patients with acute paraquat poisoning. \u0000 \u0000 \u0000Methods \u0000A retrospectively analysis were conducted on 641 patients who were treated at the First Affiliated Hospital of Zhengzhou University due to oral paraquat poisoning from October 2002 to April 2017. The observation end point was that the patients died from paraquat poisoning within 3 months after admission or were still alive within 3 months after paraquat poisoning. The patients’ data were retrieved, including general information, the dose of poison, urinary paraquat concentration, arterial blood gas analysis, alanine transaminase (ALT), total bilirubin (TBIL), uric acid (UA), aspartate transaminase (AST), creatine kinase (CK), CK-MB, B type natriuretic peptide (BNP), lactic dehydrogenase (LDH), high sensitivity troponin T (hsTnT), C-reaction protein (CRP) and procalcitonin (PCT). According to the patient's prognosis within 3 months, the patients were divided into a survival group and a non-survival group. The above indicators were compared between the two groups and the diagnostic value of CK-MB for acute paraquat poisoning was analyzed according to the receiver operating characteristics (ROC) curve. Collect the last arterial blood gas analysis, and laboratory test results were analyzed by binary logistic regression analysis to determine the risk factors for death in patients with acute paraquat poisoning. \u0000 \u0000 \u0000Results \u0000Among the 641 patients with acute paraquat poisoning, 315 (49.1%) patients survived and 326 (50.9%) died. Compared with the survival group, patients in the non-survival groupthere were older, had a shorter hospital stay, and had a higher oral paraquat dose and urinary paraquat concentration; Lac, TBIL, UA, AST, CK, CK-MB, BNP, LDH, CRP and PCT were higher, while blood gas analysis index were lower in the non-survival group (P 18.05 U/L often indicated poor prognosis (AUC=0.808, sensitivity 79.7%, specificity 65.8%, Yoden index 0.455, P<0.01). \u0000 \u0000 \u0000Conclusions \u0000In the treatment of patients with acute paraquat poisoning, there are significant differences in extra pulmonary factors such as heart, liver, kidney, electrolytes and inflammatory markers in patients with different prognosis, so the monitoring and follow-up should be improved, in addition to focusing on the presence and treatment of pulmonary fibrosis. In particular, CK-MB is an independent risk factor for the prognosis of acute paraquat poisoning. In the late stage of poisoning, CK-MB, SCr, and blood Na+ have a strong predictive value for the prognosis of the patients, and we should pay attention to the regular follow-up of the above mentioned laboratory items. \u0000 \u0000 \u0000Key words: \u0000Paraquat; Poisoning; Myocardium; Prognosis; Creatine kinase-isoenzyme MB; Multiple organ failure; Multiple factors; Retrospective study; Late stage","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"112-120"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46915154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships between serum osteocalcin levels and C-peptide in post-traumatic male patients","authors":"Yanping Yang, Guandong Huang, Kaichao Yang, Weixi Zhong, Jianyin Huang, Yongxia Li","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.013","url":null,"abstract":"Objective \u0000To investigate the relationships between serum osteocalcin (OC) levels and glycometabolism markers in nondiabetic post-traumatic male patients. \u0000 \u0000 \u0000Methods \u0000Populaitons were selected at the Department of Emergency Medicine of Shanghai Jiao Tong University Affiliated Sixth People’s Hospital from October 2017 to February 2019. The age, injury severity score (ISS), and characteristic indicators were recorded. The inclusion criteria were age ≥18 years and blood collection time 7.8 mmol/L) and nonstress hyperglycemia (NO-SH) (FPG≤7.8 mmol/L) groups. The fasting venous blood samples were collected and examined. The characteristics and biochemical indicators in the two groups were compared statistically by LSD-t test, rank sum test and ANOVA, and the relationships between serum OC levels and glycometabolism markers were analyzed by partial correlation analysis. \u0000 \u0000 \u0000Results \u0000A total of 395 traumatic patients were enrolled and divided into the SH group (n=182) and NO-SH group (n=213). There were no differences in ISS, fasting insulin (FINS), and C-peptide (C-P) levels between groups. Age, HbA1c and FPG were higher (P=0.041, P=0.037, P<0.01), while the OC level was lower (P=0.023), in the SH group than those in the NO-SH group. The serum OC level did not correlate with HbA1c, FPG, and FINS, but negatively correlated with C-P by partial correlation analysis (r=-0.262, P=0.008). The multivariate linear regression analysis showed that C-P was an independent factor affecting serum OC levels after trauma (β= -0.655, P=0.043). \u0000 \u0000 \u0000Conclusion \u0000A correlation existed between the serum OC level and glycometabolism markers in nondiabetic post-traumatic male patients. \u0000 \u0000 \u0000Key words: \u0000C-peptide; Osteocalcin; Stress hyperglycemia; Trauma","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"82-86"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46550585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The early diagnosis and therapy of septic shock caused by soft tissue infection","authors":"Taotao Liu, Ya-lin Liu, Qing He, Jue Wang, B. Du","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.012","url":null,"abstract":"Objective \u0000To assess the prognostic accuracy of the quick Sequential Organ Failure Assessment (qSOFA) score for septic shock of adults with soft tissue infections. The clinical characteristics of these patients were analyzed to provide reference for their multidisciplinary treatment. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted. The patients with soft tissue infections admitted to the General Surgery Department of Beijing Hospital and the Burn and Plastic Surgery Department of Fourth Medical Center of PLA General Hospital from January 2012 to December 2018 were enrolled and patients combined with other infections were excluded. Patients were divided into the septic shock group and the non-septic group according to whether septic shock occurred during hospitalization. The baseline data, non-operative management and prognosis were compared between the two groups with Fisher's exact test. The sensitivity, specificity, positive predictive value, negative predictive value and the area under the receiver operating characteristic curve (AUC) of the qSOFA for diagnosis of sepsis and septic shock were calculated. Patients were also divided into four groups according to the etiology of soft tissue infection. The pathogens, surgical treatment and morbidity of septic shock among the four groups were also compared. \u0000 \u0000 \u0000Results \u0000A total of 192 patients were enrolled, including 28 (14.6%) patients with septic shock. Compared with the non-septic shock group, there were more proportion of patients with qSOFA≥2 (60.7% vs 18.3%, P=0.001) within 24 h of diagnosis of infection, and higher morbidity of sepsis (82.1% vs 32.9%, P<0.01) within 48 h of diagnosis of infection in the septic shock group. At the cut-off value of qSOFA≥2, the sensitivity, specificity, positive predictive value, negative predictive value and the AUC were 60.7%, 81.7%, 36.2%, 92.4% and 0.767 (95%CI: 0.665-0.869, P<0.01) respectively for diagnosis of septic shock. The morbidity of septic shock (36.4%) and 28-day mortality (13.6%) in patients with necrotizing fasciitis were higher than those in patients with other causes (both P<0.05). The most common pathogens were methicillin-sensitive Staphylococcus (6.8%), methicillin-resistant Staphylococcus (6.2%), Enterobacter (5.7%) and Enterococcus (5.2%). \u0000 \u0000 \u0000Conclusions \u0000qSOFA≥2 can be used as a rapid septic shock screening tool for adults with soft tissue infection. Early diagnosis of sepsis, thorough debridement and effective antibiotic treatment are essential for these patients. \u0000 \u0000 \u0000Key words: \u0000Skin soft-tissue infection; Sepsis; Septic shock; Quick Sequential Organ Failure Assessment","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"76-81"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41845448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}