Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.01.014
Meng Pan, Wei Song, Mingyu Liao, M. Han, Mianmian Wu
Sepsis is one of the leading causes of hospitalization and death in adult intensive care units.Clinical observations have found that when the patient′s condition progresses to sepsis, the cost of medical resources is also increased and the mortality rate is also significantly increased.Therefore, early diagnosis, disease assessment, and prognosis of sepsis patients are crucial.At present, there are many biomarkers or scoring standards in clinical practice because of their different defects, which limits the clinical application.In recent years, many researchers at home and abroad have found that neutrophil/lymphocyte ratio as a simple and effective index is related to the progression of patients with sepsis.This review summarizes the research progress of neutrophil/lymphocyte ratio in sepsis, aiming to guide clinicians to have a better understanding of the condition of patients with sepsis, to help clinicians improve the diagnosis and treatment plan in time, thereby reducing the mortality rate of patients with sepsis.to improve its prognosis. Key words: Sepsis; Mortality; Neutrophil-lymphocyte ratio
{"title":"Progress in the study of neutrophil-lymphocyte ratio in sepsis","authors":"Meng Pan, Wei Song, Mingyu Liao, M. Han, Mianmian Wu","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.01.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.01.014","url":null,"abstract":"Sepsis is one of the leading causes of hospitalization and death in adult intensive care units.Clinical observations have found that when the patient′s condition progresses to sepsis, the cost of medical resources is also increased and the mortality rate is also significantly increased.Therefore, early diagnosis, disease assessment, and prognosis of sepsis patients are crucial.At present, there are many biomarkers or scoring standards in clinical practice because of their different defects, which limits the clinical application.In recent years, many researchers at home and abroad have found that neutrophil/lymphocyte ratio as a simple and effective index is related to the progression of patients with sepsis.This review summarizes the research progress of neutrophil/lymphocyte ratio in sepsis, aiming to guide clinicians to have a better understanding of the condition of patients with sepsis, to help clinicians improve the diagnosis and treatment plan in time, thereby reducing the mortality rate of patients with sepsis.to improve its prognosis. \u0000 \u0000 \u0000Key words: \u0000Sepsis; Mortality; Neutrophil-lymphocyte ratio","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77066782","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}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.01.001
Lei Liu
As a common and frequently-occurring disease, pulmonary thromboembolism (PTE) has attracted increasing attention.However, the application of anticoagulant drugs and treatment course of acute PTE of different etiologies are different, and some patients with acute PTE may relapse or develop chronic thromboembolic disease or even chronic thromboembolic pulmonary hypertention even after adequate treatment, therefore, outpatient follow-up of such patients is particularly important.This paper aims to summarize the purpose and focus of follow-up of PTE patients at different stages, so as to help clinicians standardize outpatient follow-up management. Key words: Pulmonary embolism; Follow-up studies; Case management
{"title":"Outpatient follow-up management of patients with pulmonary thromboembolism","authors":"Lei Liu","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.01.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.01.001","url":null,"abstract":"As a common and frequently-occurring disease, pulmonary thromboembolism (PTE) has attracted increasing attention.However, the application of anticoagulant drugs and treatment course of acute PTE of different etiologies are different, and some patients with acute PTE may relapse or develop chronic thromboembolic disease or even chronic thromboembolic pulmonary hypertention even after adequate treatment, therefore, outpatient follow-up of such patients is particularly important.This paper aims to summarize the purpose and focus of follow-up of PTE patients at different stages, so as to help clinicians standardize outpatient follow-up management. \u0000 \u0000 \u0000Key words: \u0000Pulmonary embolism; Follow-up studies; Case management","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77998847","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}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.01.004
Haixia Zhou
Venous thromboembolism(VTE) is a commoncomplication and the most important cause of unexpected death among hospitalized patients.In order to reduce the morbidity and mortality of VTE, reduce medical risks and improve quality of medical care, it is quite necessary to establish a standardized VTE management system within the hospitals through comprehensive education, establishment of management framework and regulations, application of the " multidisciplinaryteam, integration of nursing and medical care" model, utilization of the information-based means, in-depth studies of the VTE prevention and treatment. Key words: Venous thromboembolism; Hospital administration; Prevention
{"title":"Standardization of the prevention, treatment and management of venous thromboembolism within the hospitals: experience from West China Hospital of Sichuan University","authors":"Haixia Zhou","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.01.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.01.004","url":null,"abstract":"Venous thromboembolism(VTE) is a commoncomplication and the most important cause of unexpected death among hospitalized patients.In order to reduce the morbidity and mortality of VTE, reduce medical risks and improve quality of medical care, it is quite necessary to establish a standardized VTE management system within the hospitals through comprehensive education, establishment of management framework and regulations, application of the \" multidisciplinaryteam, integration of nursing and medical care\" model, utilization of the information-based means, in-depth studies of the VTE prevention and treatment. \u0000 \u0000 \u0000Key words: \u0000Venous thromboembolism; Hospital administration; Prevention","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90378431","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}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.01.003
Yuanhua Yang
Clinical trials of direct oral anticoagulants (DOACs) in both treatment and prevention of venous thromboembolism (VTE) is increasing in recent years.More and more evidence had proved DOACs to be a significant part in anticoagulation therapy, along with higher rating of recommendation grade in guidelines and wider use in different conditions.However, there are still some problems in clinical practice that need to be discussed.This paper provides a summarization of latest progress in the field of DOACs in tumor-related VTE, the prevention of VTE and anticoagulation therapy of VTE in children, and put forward some issues that need our attention during the process of application. Key words: Anticoagulants; Venous thromboembolism; Treatment; Prevention
{"title":"Progress of diract oral anticoagulants in venous thromboembolism treatment and prevention","authors":"Yuanhua Yang","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.01.003","url":null,"abstract":"Clinical trials of direct oral anticoagulants (DOACs) in both treatment and prevention of venous thromboembolism (VTE) is increasing in recent years.More and more evidence had proved DOACs to be a significant part in anticoagulation therapy, along with higher rating of recommendation grade in guidelines and wider use in different conditions.However, there are still some problems in clinical practice that need to be discussed.This paper provides a summarization of latest progress in the field of DOACs in tumor-related VTE, the prevention of VTE and anticoagulation therapy of VTE in children, and put forward some issues that need our attention during the process of application. \u0000 \u0000 \u0000Key words: \u0000Anticoagulants; Venous thromboembolism; Treatment; Prevention","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91462896","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}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.01.007
Haiyan Sheng, Xiaofang Liu, Jian-min Jin, Jie Xu
Objective To explore the diagnostic values of the Wells score, the revised Geneva score, the Padua score and the D-dimer level for venous thrombus embolism (VTE) in hospitalized patients with chronic pulmonary diseases. Methods The clinical data of inpatients with chronic pulmonary diseases (n=135) at department of respiratory medicine in Beijing Tongren Hospital from January 2012 to December 2018 were analyzed retrospectively.The Wells score, revised Geneva score and Padua score were calculated to evaluate the diagnosis and risk stratification of VTE, and the patients were divided into VTE group (n=50) and non-VTE group (n=85) according to the imaging results, and the clinical data between the two groups were compared.The diagnostic value of the three scoring systems and D-dimer level were compared by the area under the receiver operating characteristic (ROC) curve, and the Youden Index was calculated for the cut-off point. Results The incidence of VTE in patients with chronic pulmonary diseases was 37.04%.The D-Dimer level in VTE group was higher than that in non-VTE group [M(QR): 2 335(6 670) μg/L vs 400(870) μg/L, P<0.001]. The area under curve(AUC)of the ROC in Wells score, revised Geneva score, Padua score and the D-dimer level was 0.681±0.049, 0.614±0.051, 0.795±0.042, 0.811±0.039, separately.The cut-off of Padua score was 3 points and Youden Index was 0.497.The cut-off of D-dimer level was 1 460 μg/L and Youden Index was 0.519.The AUC of Padua score combined with D-dimer (0.865±0.034) was higher than that of Padua (P=0.009) or D-dimer (P=0.087), separately. Conclusions The index of Padua score combined with plasma D-dimer has the highest value in the diagnosis of VTE in patients with chronic pulmonary diseases, which can provide reference for timely, reasonable and standardized selection of imaging diagnosis, and further to improve the diagnostic accuracy and optimize the allocation of medical resources. Key words: Venous thromboembolism; Diagnosis; Lung disease
{"title":"The diagnostic values of Padua score combined D-Dimer for venous thromboembolism in patients with chronic pulmonary diseases","authors":"Haiyan Sheng, Xiaofang Liu, Jian-min Jin, Jie Xu","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.01.007","url":null,"abstract":"Objective \u0000To explore the diagnostic values of the Wells score, the revised Geneva score, the Padua score and the D-dimer level for venous thrombus embolism (VTE) in hospitalized patients with chronic pulmonary diseases. \u0000 \u0000 \u0000Methods \u0000The clinical data of inpatients with chronic pulmonary diseases (n=135) at department of respiratory medicine in Beijing Tongren Hospital from January 2012 to December 2018 were analyzed retrospectively.The Wells score, revised Geneva score and Padua score were calculated to evaluate the diagnosis and risk stratification of VTE, and the patients were divided into VTE group (n=50) and non-VTE group (n=85) according to the imaging results, and the clinical data between the two groups were compared.The diagnostic value of the three scoring systems and D-dimer level were compared by the area under the receiver operating characteristic (ROC) curve, and the Youden Index was calculated for the cut-off point. \u0000 \u0000 \u0000Results \u0000The incidence of VTE in patients with chronic pulmonary diseases was 37.04%.The D-Dimer level in VTE group was higher than that in non-VTE group [M(QR): 2 335(6 670) μg/L vs 400(870) μg/L, P<0.001]. The area under curve(AUC)of the ROC in Wells score, revised Geneva score, Padua score and the D-dimer level was 0.681±0.049, 0.614±0.051, 0.795±0.042, 0.811±0.039, separately.The cut-off of Padua score was 3 points and Youden Index was 0.497.The cut-off of D-dimer level was 1 460 μg/L and Youden Index was 0.519.The AUC of Padua score combined with D-dimer (0.865±0.034) was higher than that of Padua (P=0.009) or D-dimer (P=0.087), separately. \u0000 \u0000 \u0000Conclusions \u0000The index of Padua score combined with plasma D-dimer has the highest value in the diagnosis of VTE in patients with chronic pulmonary diseases, which can provide reference for timely, reasonable and standardized selection of imaging diagnosis, and further to improve the diagnostic accuracy and optimize the allocation of medical resources. \u0000 \u0000 \u0000Key words: \u0000Venous thromboembolism; Diagnosis; Lung disease","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77513542","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}
Objective To investigate the relationships between white blood cell (WBC), neutrophils, lymphocytes, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and serum IL-6 levels with pulmonary artery obstruction index (PAOI) in pulmonary embolism (PE) patients before and after short term treatment. Methods A prospective study was conducted on the PE patients first-diagnosed by computed tomographic pulmonary angiography in 3 hospitals from June 2015 to February 2017.The WBC, neutrophils, platelets, lymphocytes, neutrophil to lymphocyte radio (NLR), platelet to lymphocyte radio and serum IL-6 levels were examined pre-treatment and post-treatment on the 14th day.The relationships of these biomarkers with PAOI were analyzed pre-treatment and post-treatment on the 14th day. Results A total of 47 PE patients were enrolled from 3 hospitals.The PAOI was positively correlated with WBC, neutrophils, NLR, IL-6 pre-treatment (all P<0.05). The PAOI was positively correlated with IL-6 post-treatment (r=0.498, P=0.000). The varied rate of PAOI pre-and post-treatment were negatively correlated with NLR pre-treatment (r=-0.352, P=0.015), positively correlated with lymphocytes pre-treatment (r=0.335, P=0.021). Conclusions The WBC, neutrophils, NLR and IL-6 levels have correlations with PAOI, especially the IL-6 has closer correlation with PAOI, which could predict the degree of pulmonary artery obstruction better.The lower NLR and higher lymphocytes, the more significant of the embolus dissolution effect, they all have a certain clinical significance in predicting the degree of pulmonary embolus dissolution. Key words: Pulmonary embolism; Pulmonary artery obstruction index; White blood cell; Neutrophil to lymphocyte radio; Lnterleukin-6
{"title":"Relations between inflammation biomarkers and CT pulmonary artery obstruction index in patients with pulmonary embolism","authors":"Huaihai Zhou, Zhiqiang Qin, Shaojia Qin, Xueguan Liu, Gui-zhen Chen, Guanghong Feng, Zonglian Feng, Qiumei Liang","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.01.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.01.005","url":null,"abstract":"Objective \u0000To investigate the relationships between white blood cell (WBC), neutrophils, lymphocytes, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and serum IL-6 levels with pulmonary artery obstruction index (PAOI) in pulmonary embolism (PE) patients before and after short term treatment. \u0000 \u0000 \u0000Methods \u0000A prospective study was conducted on the PE patients first-diagnosed by computed tomographic pulmonary angiography in 3 hospitals from June 2015 to February 2017.The WBC, neutrophils, platelets, lymphocytes, neutrophil to lymphocyte radio (NLR), platelet to lymphocyte radio and serum IL-6 levels were examined pre-treatment and post-treatment on the 14th day.The relationships of these biomarkers with PAOI were analyzed pre-treatment and post-treatment on the 14th day. \u0000 \u0000 \u0000Results \u0000A total of 47 PE patients were enrolled from 3 hospitals.The PAOI was positively correlated with WBC, neutrophils, NLR, IL-6 pre-treatment (all P<0.05). The PAOI was positively correlated with IL-6 post-treatment (r=0.498, P=0.000). The varied rate of PAOI pre-and post-treatment were negatively correlated with NLR pre-treatment (r=-0.352, P=0.015), positively correlated with lymphocytes pre-treatment (r=0.335, P=0.021). \u0000 \u0000 \u0000Conclusions \u0000The WBC, neutrophils, NLR and IL-6 levels have correlations with PAOI, especially the IL-6 has closer correlation with PAOI, which could predict the degree of pulmonary artery obstruction better.The lower NLR and higher lymphocytes, the more significant of the embolus dissolution effect, they all have a certain clinical significance in predicting the degree of pulmonary embolus dissolution. \u0000 \u0000 \u0000Key words: \u0000Pulmonary embolism; Pulmonary artery obstruction index; White blood cell; Neutrophil to lymphocyte radio; Lnterleukin-6","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85444767","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}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.01.015
Zhengtu Li, Xidong Wang, Q. Deng, Xinguang Wei, Jinchuang Li, Zeqiang Lin, F. Ye
Chronic obstructive pulmonary disease (COPD) is a common and frequently-occurring disease that seriously endangers human health.It has become one of the major chronic diseases in China.Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an important factor in the death of patients with COPD.The most common cause of AECOPD is respiratory infection, and the mechanism of bacterial infection have been clarified.However, the correlation between respiratory virus infection and AECOPD is not clear.Thus, this review paper will be focused on the correlation with the occurrence and development of AECOPD and respiratory virus infection.It will emphasis on the occurrence of AECOPD caused by respiratory virus infection, the influence of lung function in patients with COPD, biomarkers knowledge exploration, and antiviral treatment.In summary, it expounds the role of respiratory virus infection in the occurrence and development of AECOPD, which provided a new perspective for the treatment of AECOPD in the future. Key words: Pulmonary disease, chronic obstructive; Respirovirus infections; Antiviral agents; Acute exacerbation of chronic obstructive pulmonary disease
{"title":"Research progress of acute exacerbation and respiratory virus infection in chronic obstructive pulmonary disease","authors":"Zhengtu Li, Xidong Wang, Q. Deng, Xinguang Wei, Jinchuang Li, Zeqiang Lin, F. Ye","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.01.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.01.015","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is a common and frequently-occurring disease that seriously endangers human health.It has become one of the major chronic diseases in China.Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an important factor in the death of patients with COPD.The most common cause of AECOPD is respiratory infection, and the mechanism of bacterial infection have been clarified.However, the correlation between respiratory virus infection and AECOPD is not clear.Thus, this review paper will be focused on the correlation with the occurrence and development of AECOPD and respiratory virus infection.It will emphasis on the occurrence of AECOPD caused by respiratory virus infection, the influence of lung function in patients with COPD, biomarkers knowledge exploration, and antiviral treatment.In summary, it expounds the role of respiratory virus infection in the occurrence and development of AECOPD, which provided a new perspective for the treatment of AECOPD in the future. \u0000 \u0000 \u0000Key words: \u0000Pulmonary disease, chronic obstructive; Respirovirus infections; Antiviral agents; Acute exacerbation of chronic obstructive pulmonary disease","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87186859","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}
Objective To investigate the diagnostic value of Wells score combined with age-adjusted D-dimer (AADD) standard in acute pulmonary embolism (APE) in inpatients. Methods A total of 555 inpatients (over 50 years old) with suspected APE from Shantou Central Hospital during October 2010 and November 2018 were divided into low risk groups (Wells score 6) according to Wells criteria, with spiral CT pulmonary angiography (CTPA) as the diagnostic mehtod of APE.Meanwhile, the plasma concentration of D-dimer was detected and analyzed by immunoturbidimetry in all patients.The AADD cut-off value was (a patint′s age×10) μg/L.Then the sensitivity, specificity, positive predictive value (PPV) and negative predictive value(NPV) of Wells criteria, AADD and their combination for APE diagnosis were calculated and compared respectively. Results Out of 555 cases, 213 cases were diagnosed as APE by the CTPA.There were 290, 224 and 41 suspected cases which had low, medium and high Wells score respectively.The sensitivity, specificity, PPV and NPV of APE diagnosis for low, medium and high Wells score were 24.41%, 57.28% and 18.31%, 30.41%, 70.18% and 99.42%, 17.93%, 54.46% and 95.12%, 82.07%, 45.54% and 4.88%, respectively.The sensitivity, specificity, PPV and NPV of AADD were 89.20%, 40.06%, 48.10% and 85.63% respectively.Combinning a low risk Wells score with a negative AADD improved the NPV to 93.04%. Conclusions Patients with low Wells score and negative AADD may have higher clinical value in eliminating suspected APE. Key words: Pulmonary embolisms; D-dimer; Age-adjusted; Wells score
{"title":"The diagnostic value of wells score combined with age-adjusted D-dimer standard in acute pulmonary embolism patients","authors":"Sheng-bin Zhang, Zhang Qi-chuan, Maohuan Lin, J. Cai, Zhaohui Liu, Ziwen Zhao","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.01.006","url":null,"abstract":"Objective \u0000To investigate the diagnostic value of Wells score combined with age-adjusted D-dimer (AADD) standard in acute pulmonary embolism (APE) in inpatients. \u0000 \u0000 \u0000Methods \u0000A total of 555 inpatients (over 50 years old) with suspected APE from Shantou Central Hospital during October 2010 and November 2018 were divided into low risk groups (Wells score 6) according to Wells criteria, with spiral CT pulmonary angiography (CTPA) as the diagnostic mehtod of APE.Meanwhile, the plasma concentration of D-dimer was detected and analyzed by immunoturbidimetry in all patients.The AADD cut-off value was (a patint′s age×10) μg/L.Then the sensitivity, specificity, positive predictive value (PPV) and negative predictive value(NPV) of Wells criteria, AADD and their combination for APE diagnosis were calculated and compared respectively. \u0000 \u0000 \u0000Results \u0000Out of 555 cases, 213 cases were diagnosed as APE by the CTPA.There were 290, 224 and 41 suspected cases which had low, medium and high Wells score respectively.The sensitivity, specificity, PPV and NPV of APE diagnosis for low, medium and high Wells score were 24.41%, 57.28% and 18.31%, 30.41%, 70.18% and 99.42%, 17.93%, 54.46% and 95.12%, 82.07%, 45.54% and 4.88%, respectively.The sensitivity, specificity, PPV and NPV of AADD were 89.20%, 40.06%, 48.10% and 85.63% respectively.Combinning a low risk Wells score with a negative AADD improved the NPV to 93.04%. \u0000 \u0000 \u0000Conclusions \u0000Patients with low Wells score and negative AADD may have higher clinical value in eliminating suspected APE. \u0000 \u0000 \u0000Key words: \u0000Pulmonary embolisms; D-dimer; Age-adjusted; Wells score","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83550984","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}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.1673-436X.2020.01.002
Yang Bai
Cancer and its treatment are well-recognized risk factors for venous thromboembolism (VTE). Cancer-associated venous thromboembolism (CAT) is associated with significant mortality and healthcare utilization.Pooled analysis demonstrated a decrease of VTE events in cancer patients receiving heparin-based primary prophylaxis, but an increase of bleeding events.This article reviews the latest literature on risk assessment for CAT, risk assessment for anticoagulant related bleeding, and prevention and treatment of CAT.Through a comprehensive analysis of literature, it has been found that these VTE risk assessment models have limited predictive value on CAT and need to be further investigated.And no anticoagulantrelated bleeding risk model has been validated in cancer patients.The primary preventions of CAT include mechanical prevention and drug therapy.Patients with high risk for CAT should receive appropriate primary prevention based on the patient′s clinical condition and preferences.The currently available anticoagulants for CAT include unfractionated heparin, low molecular weight heparin, fondaparin sodium, direct oral anticoagulant, vitamin K receptor antagonist.Patients with CAT should be aware of the advantages and disadvantages of each anticoagulant, and be appropriately treated according to the patient′s clinical condition and preferences. Key words: Venous thromboemlism; Neoplasms; Therapeutics
{"title":"Prevention and treatment of cancer-associated venous thromboembolism","authors":"Yang Bai","doi":"10.3760/CMA.J.ISSN.1673-436X.2020.01.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-436X.2020.01.002","url":null,"abstract":"Cancer and its treatment are well-recognized risk factors for venous thromboembolism (VTE). Cancer-associated venous thromboembolism (CAT) is associated with significant mortality and healthcare utilization.Pooled analysis demonstrated a decrease of VTE events in cancer patients receiving heparin-based primary prophylaxis, but an increase of bleeding events.This article reviews the latest literature on risk assessment for CAT, risk assessment for anticoagulant related bleeding, and prevention and treatment of CAT.Through a comprehensive analysis of literature, it has been found that these VTE risk assessment models have limited predictive value on CAT and need to be further investigated.And no anticoagulantrelated bleeding risk model has been validated in cancer patients.The primary preventions of CAT include mechanical prevention and drug therapy.Patients with high risk for CAT should receive appropriate primary prevention based on the patient′s clinical condition and preferences.The currently available anticoagulants for CAT include unfractionated heparin, low molecular weight heparin, fondaparin sodium, direct oral anticoagulant, vitamin K receptor antagonist.Patients with CAT should be aware of the advantages and disadvantages of each anticoagulant, and be appropriately treated according to the patient′s clinical condition and preferences. \u0000 \u0000 \u0000Key words: \u0000Venous thromboemlism; Neoplasms; Therapeutics","PeriodicalId":10004,"journal":{"name":"Chinese Journal of Asthma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90705446","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}
Pub Date : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-436X.2019.24.005
Shen Xia, T. Ren, Kailing Wang
Objective To study whether the different concentrations of hydrogen combined with natural killer (NK) cells can contribute to the inhibition of lung cancer cell growth. Methods NK cells were isolated and cultured from peripheral blood of patients with non-small cell lung cancer.NK cells were treated with 20%, 40%, 60% hydrogen at different concentrations.NK cell growth curve was measured by methyl thiazolyl tetrazolium assay, NK cell cycle was analyzed by flow cytometry, the secretion of inflammatory factors in NK cells was analyzed by enzyme linked immunosorbent assay, in order to assess the impact of hydrogen on the proliferation of NK cells.NK cells and A549 cells (lung cancer cells) were added to co-culture system with a ratio of 1∶1 treated with different concentrations of hydrogen at the level of 20%, 40%, and 60%.The clone-forming, migration, and invasion ability of A549 cells were analyzed to evaluate the killing ability of hydrogen combined with NK cells. Results All the concentrations of hydrogen at the level of 20%, 40%, and 60% had little impact on the proliferation of NK cells.In the clone-forming and migration ability of A549 cells, 60% of the hydrogen combined with NK cells exhibited a little effect on inhibition, whereas, 20% or 40% of the hydrogen had no such effect.Nevertheless, all concentrations of the hydrogen combined with NK cells exhibited no effect on the invasion ability of A549 cells. Conclusions The combination of 60% of the hydrogen and NK cells could inhibit clone-forming and migration ability, as well as tumor growth, which provides a framework for future studies involving combined treatment of 60% of the hydrogen and NK cells for lung cancer. Key words: Carcinoma, non-small-cell lung; Hydrogen; Natural killer cell; Cell proliferation; Anti-tumor ability
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