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Xuan DD, Li YL, Zhang GN, Ding LW, Cao PP, Jia RJ, Zheng YA, Zhou XJ, Pan LY, Hu SK, Niu LN. [Analysis of intestinal microbial diversity in Leopoldamys edwardsi based on illumina sequencing technique]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:512-518. [PMID: 35488552 DOI: 10.3760/cma.j.cn112150-20210915-00892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
To explore the composition and diversity of the intestinal microflora of Leopoldamys edwardsi in Hainan Island. In November 2019, DNA was extracted from fecal samples of 25 adult Leopoldamys edwardsi (14 males and 11 females) in Hainan Island at the Joint Laboratory of tropical infectious diseases of Hainan Medical College and Hong Kong University. Based on the IonS5TMXL sequencing platform, single-end sequencing (Single-End) was used to construct a small fragment library for single-end sequencing. Based on Reads shear filtration and OTUs clustering. The species annotation and abundance analysis of OTUs were carried out by using mothur method and SSUrRNA database, and further conducted α diversity and β diversity analysis. A total of 1481842 high quality sequences, belonging to 14 Phyla, 85 families and 186 Genera, were obtained from 25 intestinal excrement samples of Leopoldamys edwardsi. At the level of phyla classification, the main core biota of the Leopoldamys edwardsi contained Firmicutes (46.04%),Bacteroidetes (25.34%), Proteobacteria (17.09%), Tenericutes (7.38%) and Actinobacteria (1.67%), these five phyla account for 97.52% of all phyla. The ratio of Helicobacter which occupied the largest proportion at the genus level was 12.44%, followed by Lactobacillus (11.39%), Clostridium (6.19%),Mycoplasma (4.23%) and Flavonifractor (3.52%). High throughput sequencing analysis showed that the intestinal flora of Leopoldamys edwardsi in Hainan Island was complex and diverse, which had the significance of further research.
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Affiliation(s)
- D D Xuan
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Department of Pathogen Biology, Hainan Medical University, Haikou 571101, China
| | - Y L Li
- Sanya People's Hospital, Sanya 572000, China
| | - G N Zhang
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Department of Pathogen Biology, Hainan Medical University, Haikou 571101, China
| | - L W Ding
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Department of Pathogen Biology, Hainan Medical University, Haikou 571101, China
| | - P P Cao
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Department of Pathogen Biology, Hainan Medical University, Haikou 571101, China
| | - R J Jia
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Department of Pathogen Biology, Hainan Medical University, Haikou 571101, China
| | - Y A Zheng
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Department of Pathogen Biology, Hainan Medical University, Haikou 571101, China
| | - X J Zhou
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Department of Pathogen Biology, Hainan Medical University, Haikou 571101, China
| | - L Y Pan
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Department of Pathogen Biology, Hainan Medical University, Haikou 571101, China
| | - S K Hu
- Department of Laboratory Medicine, Peking University Shougang Hospital, Beijing 100144, China
| | - L N Niu
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Department of Pathogen Biology, Hainan Medical University, Haikou 571101, China
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Xu J, Li C, Tang H, Tan D, Fu Y, Zong L, Jing D, Ding B, Cao Y, Lu Z, Tian Y, Chai Y, Meng Y, Wang Z, Zheng YA, Zhao X, Zhang X, Liang L, Zeng Z, Li Y, Walline JH, Song PP, Zheng L, Sun F, Shao S, Sun M, Huang M, Zeng R, Zhang S, Yang X, Yao D, Yu M, Liao H, Xiong Y, Zheng K, Qin Y, An Y, Liu Y, Chen K, Zhu H, Yu X, Du B. Pulse oximetry waveform: A non-invasive physiological predictor for the return of spontaneous circulation in cardiac arrest patients ---- A multicenter, prospective observational study. Resuscitation 2021; 169:189-197. [PMID: 34624410 DOI: 10.1016/j.resuscitation.2021.09.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aimed to investigate the predictive value of pulse oximetry plethysmography (POP) for the return of spontaneous circulation (ROSC) in cardiac arrest (CA) patients. METHODS This was a multicenter, observational, prospective cohort study of patients hospitalized with cardiac arrest at 14 teaching hospitals cross China from December 2013 through November 2014. The study endpoint was ROSC, defined as the restoration of a palpable pulse and an autonomous cardiac rhythm lasting for at least 20 minutes after the completion or cessation of CPR. RESULTS 150 out-of-hospital cardiac arrest (OHCA) patients and 291 in-hospital cardiac arrest (IHCA) patients were enrolled prospectively. ROSC was achieved in 20 (13.3%) and 64 (22.0%) patients in these cohorts, respectively. In patients with complete end-tidal carbon dioxide (ETCO2) and POP data, patients with ROSC had significantly higher levels of POP area under the curve (AUCp), wave amplitude (Amp) and ETCO2 level during CPR than those without ROSC (all p < 0.05). Pairwise comparison of receiver operating characteristic (ROC) curve analysis indicated no significant difference was observed between ETCO2 and Amp (p = 0.204) or AUCp (p = 0.588) during the first two minutes of resuscitation. CONCLUSION POP may be a novel and effective method for predicting ROSC during resuscitation, with a prognostic value similar to ETCO2 at early stage.
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Affiliation(s)
- Jun Xu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Chen Li
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China; Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Hanqi Tang
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Dingyu Tan
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China; Department of Emergency Medicine, Northern Jiangsu People's Hospital, Yangzhou 225001, China
| | - Yangyang Fu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Liang Zong
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Daoyuan Jing
- Department of Emergency Medicine, Jinhua Municipal Central Hospital, Jinhua 321000, China
| | - Banghan Ding
- Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou 510120, China
| | - Yu Cao
- Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhongqiu Lu
- Department of Emergency Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yingping Tian
- Department of Emergency Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Yanfen Chai
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yanli Meng
- Department of Emergency Medicine, HuaBei Petroleum General Hospital, Renqiu 062552, China
| | - Zhen Wang
- Department of Emergency Medicine, Beijing Shijitan Hospital Capital Medical University, Beijing 100038, China
| | - Ya-An Zheng
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Xiaodong Zhao
- Department of Emergency Medicine, First Affiliated Hospital of PLA Hospital, Beijing 100048, China
| | - Xinyan Zhang
- Department of Emergency Medicine, Beijing Haidian Hospital, Beijing 100080, China
| | - Lu Liang
- Department of Emergency Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China
| | - Zhongyi Zeng
- Department of Emergency Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China
| | - Yan Li
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Joseph H Walline
- Centre for the Humanities and Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Priscilla P Song
- Centre for the Humanities and Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Liangliang Zheng
- Beijing Hospital, National Center of Gerontology, China, Beijing 100730, China
| | - Feng Sun
- Department of Emergency Medicine, Jiangsu Province Hospital, Yangzhou 210029, China
| | - Shihuan Shao
- Department of Emergency Medicine, Peking University People's Hospital, Beijing 100044, China; Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Ming Sun
- Department of Emergency Medicine, Affiliated Suqian Hospital of Xuzhou Medical University, Xuzhou 221004, China
| | - Mingwei Huang
- Department of Emergency Medicine, Jinhua Municipal Central Hospital, Jinhua 321000, China
| | - Ruifeng Zeng
- Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou 510120, China
| | - Shu Zhang
- Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiaoya Yang
- Department of Emergency Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Dongqi Yao
- Department of Emergency Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Muming Yu
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Hua Liao
- Department of Emergency Medicine, HuaBei Petroleum General Hospital, Renqiu 062552, China
| | - Yingxia Xiong
- Department of Emergency Medicine, Beijing Shijitan Hospital Capital Medical University, Beijing 100038, China
| | - Kang Zheng
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Yuhong Qin
- Department of Emergency Medicine, First Affiliated Hospital of PLA Hospital, Beijing 100048, China
| | - Yingbo An
- Department of Emergency Medicine, Beijing Haidian Hospital, Beijing 100080, China
| | - Yuxiang Liu
- Department of Emergency Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China
| | - Kun Chen
- Department of Emergency Medicine, Jinhua Municipal Central Hospital, Jinhua 321000, China
| | - Huadong Zhu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xuezhong Yu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Bin Du
- Department of Medical Intensive Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
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Ye SD, Wang SJ, Wang GG, Li L, Huang ZW, Qin J, Li CS, Yu XZ, Shen H, Yang LP, Fu Y, Zheng YA, Zhao B, Yu DM, Qin FJ, Zhou DG, Li Y, Liu FJ. Association between anemia and outcome in patients hospitalized for acute heart failure syndromes: findings from Beijing Acute Heart Failure Registry (Beijing AHF Registry). Intern Emerg Med 2021; 16:183-192. [PMID: 32356137 DOI: 10.1007/s11739-020-02343-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/11/2020] [Indexed: 10/24/2022]
Abstract
Whether the anemia increases the risk of mortality in patients with acute heart failure (AHF) remains unclear. This study aims to explore the relationship between anemia and outcomes in patients with AHF including subgroup analysis. This study included 3279 patients with hemoglobin available from the Beijing Acute Heart Failure Registry (Beijing AHF Registry) study. The primary endpoint was all-cause mortality in 1 year, and the secondary endpoint was 1-year all-cause events including all-cause death and readmission. Logistic regression models were applied to describe related variables of anemia in patients with AHF. Multivariate Cox proportional hazards models described associations of anemia with clinical outcomes in the overall cohort and subgroups. 45.4% of the patients were found anemic. They were older and had more comorbidities than non-anemic patients. Variables including older age, female, chronic kidney dysfunction (CKD), lower hematocrit, lower albumin, with loop diuretics applied, without beta-blockers, angiotensin-converting enzyme inhibitors /angiotensin receptor blockers (ACEIs/ARBs) and spironolactone applied in the emergency department (ED) were associated with anemia in AHF patients. Anemic patients had higher 1-year mortality (38.4% vs. 27.2%, p < 0.0001) and 1-year events rates (63.2% vs. 56.7%, p < 0.0001). After adjusted for covariates, anemia was associated with the increase of 1-year mortality (hazard ratio [HR] 1.278; 95% confidence interval [CI] 1.114-1.465; p = 0.0005) and 1-year events (HR 1.136; 95% CI 1.025-1.259; p = 0.0154). The severer anemia patients had higher risks both of 1-year mortality and events. In the subgroup analysis, the independent associations of anemia with 1-year mortality were shown in the subgroups including age < 75 years, male, body mass index < 25 kg/m2 and BMI ≥ 25 kg/m2, New York Heart Association (NYHA) functional class I-II and NYHA functional class III-IV, with and without cardiovascular ischemia, heart rate (HR) < 100 bpm and HR ≥ 100 bpm, systolic blood pressure (SBP) < 120 mmHg and SBP ≥ 120 mmHg, left ventricular ejection fraction (LVEF) < 40% and LVEF ≥ 40%, serum creatinine (Scr) < 133 umol/l, and with diuretics use, with and without beta-blockers use, without ACEIs/ARBs use in the ED. Anemia is associated with older age, female, CKD, volume overload, malnutrition, with loop diuretics, without beta-blockers, ACEIs/ARBs and spironolactone administration, and higher mortality and readmission in AHF. The risk associations are particular significantly obvious in younger, male, overweight, preserved LVEF, lower Scr, with diuretics and beta-blockers, without ACEIs/ARBs administration subgroups.Clinical trial No. ChiCTR-RIC-17014222.
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Affiliation(s)
- Shao-Dong Ye
- National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China.
| | - Si-Jia Wang
- National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Guo-Gan Wang
- National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China.
| | - Lin Li
- National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Zhi-Wei Huang
- National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Jian Qin
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Chun-Sheng Li
- Department of Emergency, Beijing Chao Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xue-Zhong Yu
- Department of Emergency, Peking Union Medical College Hospital, Beijing, 100032, China
| | - Hong Shen
- Department of Emergency, Chinese People's Liberation Army General Hospital, Medical School of Chinese People's Liberation Army, Beijing, 100853, China
| | - Li-Pei Yang
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Yan Fu
- Department of Emergency, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Ya-An Zheng
- Department of Emergency, Peking University Third Hospital, Beijing, 100083, China
| | - Bin Zhao
- Department of Emergency, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Dong-Min Yu
- Department of Emergency, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
| | - Fu-Jun Qin
- Department of Emergency, Liangxiang Hospital of Fangshan District, Beijing, 102400, China
| | - De-Gui Zhou
- Department of Emergency, Shunyi District Hospital, Beijing, 101300, China
| | - Ying Li
- Department of Emergency, People's Hospital of Beijing Daxing District, Beijing, 102600, China
| | - Fu-Jun Liu
- Department of Emergency, Beijing Luhe Hospital, Capital Medical University, Beijing, 101100, China
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Liu YY, Wang YP, Zu LY, Zheng K, Ma QB, Zheng YA, Gao W. Comparison of intraosseous access and central venous catheterization in Chinese adult emergency patients: A prospective, multicenter, and randomized study. World J Emerg Med 2021; 12:105-110. [PMID: 33728002 DOI: 10.5847/wjem.j.1920-8642.2021.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the used devices, pain score, and complications between intraosseous (IO) access and central venous catheterization (CVC) in critically ill Chinese patients. METHODS In this prospective clustered randomized controlled trial, eight hospitals were randomly divided into either the IO group or the CVC group. Patients who needed emergency vascular access were included. From April 1, 2017 to December 31, 2018, each center included 12 patients. We recorded the data mentioned above. RESULTS A total of 96 patients were enrolled in the study. There were no statistically significant differences between the two groups regarding sex, age, body mass index, or operator satisfaction with the used devices. The success rates of the first attempt and the procedure time were statistically significant between the IO group and the CVC group (91.7% vs. 50.0%, P<0.001; 52.0 seconds vs. 900.0 seconds, P<0.001). During the study, 32 patients were conscious. There was no statistically significant difference between the two groups regarding the pain score associated with insertion. There were statistically significant differences between the two groups regarding the pain score associated with IO or CVC infusion (1.5 vs. 0.0, P=0.044). Complications were not observed in the two groups. CONCLUSIONS IO access is a safe, rapid, and effective technique for gaining vascular access in critically ill adults with inaccessible peripheral veins in the emergency departments.
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Affiliation(s)
- Yan-Yan Liu
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital; NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191, China
| | - Yu-Peng Wang
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital; NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191, China
| | - Ling-Yun Zu
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital; NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191, China
| | - Kang Zheng
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Qing-Bian Ma
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Ya-An Zheng
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Wei Gao
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital; NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191, China
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Ma QB, Fu YW, Feng L, Zhai QR, Liang Y, Wu M, Zheng YA. Performance of Simplified Acute Physiology Score 3 In Predicting Hospital Mortality In Emergency Intensive Care Unit. Chin Med J (Engl) 2018. [PMID: 28639569 PMCID: PMC5494917 DOI: 10.4103/0366-6999.208250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Since the 1980s, severity of illness scoring systems has gained increasing popularity in Intensive Care Units (ICUs). Physicians used them for predicting mortality and assessing illness severity in clinical trials. The objective of this study was to assess the performance of Simplified Acute Physiology Score 3 (SAPS 3) and its customized equation for Australasia (Australasia SAPS 3, SAPS 3 [AUS]) in predicting clinical prognosis and hospital mortality in emergency ICU (EICU). Methods: A retrospective analysis of the EICU including 463 patients was conducted between January 2013 and December 2015 in the EICU of Peking University Third Hospital. The worst physiological data of enrolled patients were collected within 24 h after admission to calculate SAPS 3 score and predicted mortality by regression equation. Discrimination between survivals and deaths was assessed by the area under the receiver operator characteristic curve (AUC). Calibration was evaluated by Hosmer-Lemeshow goodness-of-fit test through calculating the ratio of observed-to-expected numbers of deaths which is known as the standardized mortality ratio (SMR). Results: A total of 463 patients were enrolled in the study, and the observed hospital mortality was 26.1% (121/463). The patients enrolled were divided into survivors and nonsurvivors. Age, SAPS 3 score, Acute Physiology and Chronic Health Evaluation Score II (APACHE II), and predicted mortality were significantly higher in nonsurvivors than survivors (P < 0.05 or P < 0.01). The AUC (95% confidence intervals [CIs]) for SAPS 3 score was 0.836 (0.796–0.876). The maximum of Youden's index, cutoff, sensitivity, and specificity of SAPS 3 score were 0.526%, 70.5 points, 66.9%, and 85.7%, respectively. The Hosmer-Lemeshow goodness-of-fit test for SAPS 3 demonstrated a Chi-square test score of 10.25, P = 0.33, SMR (95% CI) = 0.63 (0.52–0.76). The Hosmer-Lemeshow goodness-of-fit test for SAPS 3 (AUS) demonstrated a Chi-square test score of 9.55, P = 0.38, SMR (95% CI) = 0.68 (0.57–0.81). Univariate and multivariate analyses were conducted for biochemical variables that were probably correlated to prognosis. Eventually, blood urea nitrogen (BUN), albumin, lactate and free triiodothyronine (FT3) were selected as independent risk factors for predicting prognosis. Conclusions: The SAPS 3 score system exhibited satisfactory performance even superior to APACHE II in discrimination. In predicting hospital mortality, SAPS 3 did not exhibit good calibration and overestimated hospital mortality, which demonstrated that SAPS 3 needs improvement in the future.
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Affiliation(s)
- Qing-Bian Ma
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100091, China
| | - Yuan-Wei Fu
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100091, China
| | - Lu Feng
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100091, China
| | - Qiang-Rong Zhai
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100091, China
| | - Yang Liang
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100091, China
| | - Meng Wu
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100091, China
| | - Ya-An Zheng
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100091, China
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Wang GG, Wang SJ, Qin J, Li CS, Yu XZ, Shen H, Yang LP, Fu Y, Zheng YA, Zhao B, Yu DM, Qin FJ, Zhou DG, Li Y, Liu FJ, Li W, Zhao W, Gao X, Wang Z, Jin M, Zeng H, Li Y, Wang GX, Zhou H, Sun XL, Wang PB, Woo KS. Characteristics, Management, and Outcomes of Acute Heart Failure in the Emergency Department: A Multicenter Registry Study with 1-year Follow-up in a Chinese Cohort in Beijing. Chin Med J (Engl) 2017; 130:1894-1901. [PMID: 28776539 PMCID: PMC5555121 DOI: 10.4103/0366-6999.211880] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The emergency department (ED) has a pivotal influence on the management of acute heart failure (AHF), but data concerning current ED management are scarce. This Beijing AHF Registry Study investigated the characteristics, ED management, and short- and long-term clinical outcomes of AHF. METHODS This prospective, multicenter, observational study consecutively enrolled 3335 AHF patients who visited 14 EDs in Beijing from January 1, 2011, to September 23, 2012. Baseline data on characteristics and management were collected in the EDs. Follow-up data on death and readmissions were collected until November 31, 2013, with a response rate of 92.80%. The data were reported as median (interquartile range) for the continuous variables, or as number (percentage) for the categorical variables. RESULTS The median age of the enrolled patients was 71 (58-79) years, and 46.84% were women. In patients with AHF, coronary heart disease (43.27%) was the most common etiology, and myocardium ischemia (30.22%) was the main precipitant. Most of the patients in the ED received intravenous treatments, including diuretics (79.28%) and vasodilators (74.90%). Fewer patients in the ED received neurohormonal antagonists, and 25.94%, 31.12%, and 33.73% of patients received angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, and spironolactone, respectively. The proportions of patients who were admitted, discharged, left against medical advice, and died were 55.53%, 33.58%, 7.08%, and 3.81%, respectively. All-cause mortalities at 30 days and 1 year were 15.30% and 32.27%, respectively. CONCLUSIONS Substantial details on characteristics and ED management of AHF were investigated. The clinical outcomes of AHF patients were dismal. Thus, further investigations of ED-based therapeutic approaches for AHF are needed.
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Affiliation(s)
- Guo-Gan Wang
- Emergency and Critical Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Si-Jia Wang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Jian Qin
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Chun-Sheng Li
- Department of Emergency, Beijing Chao Yang Hospital, Beijing 100020, China
| | - Xue-Zhong Yu
- Department of Emergency, Peking Union Medical College Hospital, Beijing 100032, China
| | - Hong Shen
- Department of Emergency, The General Hospital of Chinese People's Liberation Army, Beijing 100853, China
| | - Li-Pei Yang
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Yan Fu
- Department of Emergency, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Ya-An Zheng
- Department of Emergency, Peking University Third Hospital, Beijing 100083, China
| | - Bin Zhao
- Department of Emergency, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Dong-Min Yu
- Department of Emergency, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Fu-Jun Qin
- Department of Emergency, Fangshan District Liangxiang Hospital, Beijing 102400, China
| | - De-Gui Zhou
- Department of Emergency, The Hospital of Shunyi District, Beijing 101300, China
| | - Ying Li
- Department of Emergency, People's Hospital of Beijing Daxing District, Beijing 102600, China
| | - Fu-Jun Liu
- Department of Emergency, The Luhe Teaching Hospital of the Capital Medical University, Beijing 101100, China
| | - Wei Li
- Medical Research and Biometrics Centre, National Centre for Cardiovascular Diseases, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Xishan Institute of Fuwai Hospital, Beijing 102300, China
| | - Wei Zhao
- Information Technology Centre, Fuwai Hospital, Beijing 100037, China
| | - Xin Gao
- Emergency and Critical Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Zheng Wang
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Ming Jin
- Department of Emergency, Beijing Chao Yang Hospital, Beijing 100020, China
| | - Hong Zeng
- Department of Emergency, Beijing Chao Yang Hospital, Beijing 100020, China
| | - Yi Li
- Department of Emergency, Peking Union Medical College Hospital, Beijing 100032, China
| | - Guo-Xing Wang
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Hong Zhou
- Department of Emergency, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Xiao-Lu Sun
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Peng-Bo Wang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
- Heart Center, First Hospital of Tsinghua University, Beijing 100016, China
| | - Kam-Sang Woo
- Department of Medicine and Therapeutics, School of Life Sciences, The Chinese University of Hong Kong, Hong Kong 999077, China
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Ge HX, Ma QB, Zheng K, Du LF, Han JL, Feng JL, Zheng YA. [A case report of cerebral resuscitation by surface cooling in a patient with cardiac arrest]. Beijing Da Xue Xue Bao Yi Xue Ban 2014; 46:983-985. [PMID: 25512297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Therapeutic hypothermia is an important treatment for cerebral resuscitation in patients after cardiac arrest. But it is rarely used for comatose survivor post-cardiac arrest in China. The patient was the first case who was in coma post cardiac arrest caused by acute myocardial infarction and given hypothermia therapy in our hospital. After coronary reperfusion and therapeutic hypothermia, the patient's sneurologic function was recovered to normal. The paper discussed the indications, contraindications, cooling methods and complications of therapeutic hypothermia.
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Affiliation(s)
- H X Ge
- Department of Emergency, Peking University Third Hospital, Beijing 100191, China
| | - Q B Ma
- Department of Emergency, Peking University Third Hospital, Beijing 100191, China
| | - K Zheng
- Department of Emergency, Peking University Third Hospital, Beijing 100191, China
| | - L F Du
- Department of Emergency, Peking University Third Hospital, Beijing 100191, China
| | - J L Han
- Department of Cardiology, Peking University Third Hospital, Beijing 100191, China
| | - J L Feng
- Department of Emergency, Peking University Third Hospital, Beijing 100191, China
| | - Y A Zheng
- Department of Emergency, Peking University Third Hospital, Beijing 100191, China
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Liu HL, Gao MJ, Zheng YA, Liu GH. Propylthiouracil induced antineutrophil cytoplasmic antibodies-associated vasculitis. Chin Med J (Engl) 2013; 126:4814. [PMID: 24342342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Affiliation(s)
- Hui-Lin Liu
- Department of Emergency, Peking University Third Hospital, Beijing 100191, China
| | - Mei-Juan Gao
- Departments of Endocrinology and Metabolism, Peking University Shougang Hospital, Beijing 100144, China
| | - Ya-An Zheng
- Department of Emergency, Peking University Third Hospital, Beijing 100191, China
| | - Gui-Hua Liu
- Department of Emergency, Peking University Third Hospital, Beijing 100191, China.
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Suo BJ, Zhou LY, Ding SG, Guo CJ, Gu F, Zheng YA. [Analysis of etiological and related factors responsible for acute gastrointestinal hemorrhage]. Zhonghua Yi Xue Za Zhi 2011; 91:1757-1761. [PMID: 22093734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To investigate the etiology, related factors and endoscopic characteristics of acute gastrointestinal hemorrhage. METHODS The data including age, gender, medical and medication history, and endoscopic characteristics of patients receiving emergency treatment for acute gastrointestinal hemorrhage between February 2006 and February 2010 were collected to analyze the etiological profiles of this disorder. RESULTS (1) A total of 1415 patients with a 2: 1 male-to-female ratio visited our hospital for acute gastrointestinal hemorrhage in the past 4 years. There was a higher mean age of disease onset in men than in women [(51 +/- 20) years old vs (61 +/- 17) years old, P = 0.000]. The numbers of patients were 399, 361, 242 and 413 for 4 respective quarters in order of sequence. (2) And 1030 patients received endoscopy. Among them, there were 897 (87.1%) with upper gastrointestinal hemorrhage and 133 (12.9%) with lower gastrointestinal hemorrhage. Significant differences existed in the mean age of two groups [(51 +/- 20) years old vs (57 +/- 18) years old, P = 0.000]. The male-to-female ratio was 656: 241 and 65:68 for these 2 groups respectively (P = 0.000). The percentage of patient with a history of NSAID (non-steroidal anti-inflammatory drug) treatment was 22.1% (n = 198) and 12.0% (n = 16) for these 2 groups respectively (P < 0.01). (3) The most common causative diseases of upper gastrointestinal hemorrhage were peptic ulcer (n = 546, 60.8%), esophageal & gastric varices hemorrhage (n = 130, 14.5%) and gastric cancer (n = 40, 4.6%). When the patients were divided into 5 groups of < 12 h, 12-24 h, 24-48 h, 48-72 h and > or = 72 h per time window of gastroscopy, their percentages with endoscopically active hemorrhage were 24.1% (20/83), 14.9% (24/161), 9.6% (16/166), 7.5% (8/106) and 7.6% (29/381) for these groups respectively with statistically significant differences. When peptic ulcer was examined by the Forrest classification, the ratio of grade I a- II c decreased gradually while the ratio of grade III increased gradually among 5 groups (chi2 = 80.414, P = 0.040). (4) The most common causative diseases of lower gastrointestinal hemorrhage were ischemic colitis (n = 44, 33.1%), small intestinal hemorrhage (n = 26, 19.5%) and colonic polyps (n = 18, 13.5%). (5) When the patients were divided into > 65 years old group (n = 277) and < or = 65 years old group (n = 620), the ratio of gastric ulcer and cancer in upper gastrointestinal hemorrhage was higher in the former than in the latter [23.5% (n = 65) vs 8.9% (n = 55) & 9.7% (n = 27) vs 2.1% (n = 13), P < 0.01)]. While the ratio of duodenal ulcer was lower in the former than in the latter [22.4% (n = 62) vs 49.7% (n = 308), P < 0.01]. The ratio of small intestinal hemorrhage in lower gastrointestinal hemorrhage was higher in the former than in the latter (all P < 0.01). CONCLUSION At the lowest in the third quarter, the incidence rate of acute gastrointestinal hemorrhage is higher in males than that in females at a lower age of onset. More common than lower gastrointestinal hemorrhage, upper gastrointestinal hemorrhage has a lower mean age of onset. Peptic ulcer is the most common disorder in upper gastrointestinal hemorrhage. Ischemic colitis is the most common disorder in lower gastrointestinal hemorrhage. The rate of gastric ulcer and gastric cancer in the old age group is higher than that in the young group. Emergency gastroscopy is recommended.
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Affiliation(s)
- Bao-Jun Suo
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
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Guo YM, Wang JJ, Li GX, Zheng YA, He W, Pan XC. [Association between ambient temperature and hospital emergency room visits for cardiovascular diseases: a case-crossover study]. Zhonghua Liu Xing Bing Xue Za Zhi 2009; 30:810-815. [PMID: 20193204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To explore the association between ambient average temperature and hospital emergency room visits for cardiovascular diseases (International Classification of Diseases, Tenth Vision ICD-10: I00 - I99) in Beijing, China. METHODS Data was collected on daily hospital emergency room visits for cardiovascular diseases from Peking University Third Hospital, including meteorological data (daily average temperature, relative humidity, wind speed, and atmospheric pressure) from the China Meteorological Data Sharing Service System, and on air pollution from the Beijing Municipal Environmental Monitoring Center. Time-stratified case-crossover design was used to analyze data on 4 seasons. RESULTS After adjusting data on air pollution, 1 degree ( degrees C) increase of ambient average temperature would associate with the emergency room visits of odds ratio (ORs) as 1.282 (95%CI: 1.250 - 1.315), 1.027 (95%CI: 1.001 - 1.055), 0.661 (95%CI: 0.637 - 0.687), and 0.960 (95%CI: 0.937 - 0.984) in spring, summer, autumn, and winter respectively. After controlling the influence of relative humidity, wind speed, and atmospheric pressure, 1 degrees C increase in the ambient average temperature would be associated with the emergency room visits on ORs value as 1.423 (95%CI: 1.377 - 1.471), 1.082 (95%CI: 1.041 - 1.124), 0.633 (95%CI: 0.607 - 0.660) and 0.971 (95%CI: 0.944 - 1.000) in spring, summer, autumn, and winter respectively. CONCLUSION These data on outcomes suggested that the elevated level of ambient temperature would increase the hospital emergency room visits for cardiovascular diseases in spring and summer while the elevated level of ambient temperature would decrease the hospital emergency room visits for the cardiovascular diseases in autumn and winter, suggesting that patients with cardiovascular diseases should pay attention to the climate change.
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Affiliation(s)
- Yu-Ming Guo
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China
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Zhang HC, Guo JH, Fang Q, Zheng YA, Sun YM, Zhu WQ, Wan Z, Guo JX, Ge JB, Han SM. [Immediate cardioversion of atrial fibrillation and atrial flutter lasting less than 90 days by ibutilide versus propafenone: a multicenter study]. Zhonghua Yi Xue Za Zhi 2005; 85:798-801. [PMID: 15949393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE To compare the efficacy and safety of ibutilide versus propafenone in immediate cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) lasted less than 90 days. METHODS 212 consecutive patients suffering from AF or AFL all lasting less than 90 days that were diagnosed and treated in 5 medical centers were randomly assigned into two groups: ibutilide group (n = 107, including 75 AF cases and 32 AFL cases, receiving intravenous injection of ibutilide 1mg over 10 minutes) and propafenone group as control group (n = 105, including 76 AF cases and 29 AFL cases, receiving intravenous injection of propafenone 70 mg over 10 minutes). If AF/AFL still persisted 10 minutes after treatment, the above dose was repeated. The conversion rate within 1.5 hours and adverse effects within 4 hours were observed. RESULTS (1) The conversion rate on AFL of the ibutilide group was 78.1%, significantly higher than that of the propafenone group (48.3%, P < 0.01), while no significant difference was observed in the conversion rate on AF (54.7% vs. 39.5%, P > 0.05) and the mean conversion time (P > 0.05). However the overall conversion rate on AFL and AF of the ibutilide group was 61.7%, significantly higher than that of the propafenone group (41.9%, P < 0.05). (2) The conversion rate on AF/AFL lasting less than 48 h was 65.9% in the ibutilide group, not significantly different from that of the propafenone group (55.7%), the conversion rate on AF/AFL lasting 3 approximately 30 d in the ibutilide group was 66.7%, significantly higher than that of the propafenone group (26.3%, P < 0.05), and the conversion rate on AF/AFL lasting 31 - 88 d was 50%, significantly higher than that of the propafenone group (0, P < 0.01). (3) There was no difference in the times needed for conversion between these 2 groups. (4) The most severe adverse effect in the ibutilide group was short run of ventricular tachycardia occurring in 5 cases among which 4 cases recovered simultaneously and one case recovered after accepting a bolus dose of 100 mg lidocaine. The most severe adverse effects in propafenone group were RR interval longer than 1.5 s (4 cases) and transient hypotension. An acute coronary event was also seen in propafenone group, however, unrelated to the experimental drug. CONCLUSION Intravenous administration of ibutilide in cardioversion of AF and AFL is safe and effective.
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Affiliation(s)
- Hai-Cheng Zhang
- Department of Cardiology, People's Hospital, Peking University, Beijing 100044, China
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