tbuckley/cabot-search huggingface dataset:
Exploring the service mode and operation mechanism of family doctor studio
Authors: Feng Xiao, Aihua Yu, Minjie Zhu, Lei Xu, Qi Zhao
Journal: BMJ (2017)

The first family doctor studio was established at 2011 in Shanghai, afterwards a wide variety of family doctor studios were set up over the country. Family doctor studio has been become a significant form and carrier to promote the family doctor service. However, there are still lacks of unified standards and perfect mechanisms for its operation and evaluation. To adapt the reform of community health service, it is urgent to standardize the family doctor studio, to promote the development of the community health service and the reform of the family doctor system. Based on Zhoujiaqiao mode, Changning District has kept exploring the operation mechanism, standardizing the management and service mode, and promoting brand building of the family doctor studio since 2012. The service mode and operation mechanism of family doctor studio with Changning characteristics has gradually formed. This article summarizes the construction, development and improvement of the family doctor studio.


Key words: 
Family doctor studio; Service mode; Operating mechanism
Smoking status among people with disabilities in Shanghai Jing′an District
Authors: Shijie Fu, Limin Lao, Wei Dai, Yao Liu
Journal: BMJ (2018)

Objective
To survey on the smoking status among people with disabilities in Shanghai Jing′an District.


Methods
A cross-sectional questionnaire survey on smoking status among people with disabilities was conducted from July to December 2015 in 5 communities of Shanghai Jing′an District.


Results
Total 1 815 valid questionnaires were collected. Among all participants, 278 were smokers with an overall smoking rate of 15.3% (278/1 815); the smoking rate in males was 28.1% (265/944) and in females was 1.5% (13/871). The disables people aged 45-60 years had the highest smoking rate (23.4%, 141/602). The nicotine dependence rate in regular smokers accounted for 74.6% (182/244). The nicotine dependence was mainly mild to moderate, and the average of Fagerstrom Test of Nicotine Dependence(FTND)score was 3.75±1.97. Most participants (90.8%, 238/262) were aware of the harm of smoking to health, but the awareness rate of health hazards of second-hand smoke was only 59.5% (156/262). The awareness rates of tobacco-related diseases were all lower than 70%. The rate of quitting was 33.5% (93/278), but only 17.2% (16/93) succeeded; 66.0% (173/262) of the smokers did not intend to quit, only 15.3% (40/262) started to quit or to reduce the smoking; and 83.6% (219/262) of current smokers thought that it was impossible to quit smoking.


Conclusion
The smoking rate in people with disabilities is lower than that in the general population, the awareness of the harm of second-hand smoke is low and there is lack of knowledge of tobacco related diseases; the intend of quitting is low but the success rate of smoking cessation is high among people with disabilities in Shanghai Jing′an District.


Key words: 
Smoking; Tobacco; Disabled persons; Shanghai
Zanubrutinib monotherapy for patients with relapsed or refractory non-germinal center diffuse large B-cell lymphoma: Results from a phase II, single-arm, multicenter, study.
Authors: Haiyan Yang, Bing Xiang, Yuqin Song, Huilai Zhang, Weili Zhao, Dehui Zou, Fangfang Lv, Ou Bai, Aichun Liu, Caixia Li, Ziwen Tan, Weige Wang, Haiyi Guo, William Novotny, Jane E. Huang, Yufu Li
Journal: Journal of Clinical Oncology (2020)

e20051 Background: The non-germinal center (non-GCB) subtype of diffuse large B-cell lymphoma (DLBCL) is associated with poor clinical outcomes. Inhibitors of Bruton’s tyrosine kinase (BTK) have established therapeutic activity in mantle cell lymphoma, chronic lymphocytic leukemia, and Waldenstrom macroglobulinemia and have shown modest activity in DLBCL. Zanubrutinib, a potent and selective BTK inhibitor, was evaluated in a phase 2 study in patients with relapsed or refractory (R/R) non-GCB DLBCL. Methods: The BGB-3111-207 study (NCT03145064) is a multicenter, single arm, phase 2 study in patients with R/R non-GCB DLBCL who were ineligible for intensive chemotherapy and bone marrow transplantation. Subjects received zanubrutinib 160 mg by mouth twice daily until disease progression or unacceptable toxicity. The primary endpoint was the overall response rate (ORR) using the Lugano criteria. Secondary endpoints included progression free survival (PFS) and duration of response (DOR). Overall survival (OS) was the exploratory endpoint. Results: Forty-one patients were enrolled at 11 sites in China between June 2017 and May 2018. Patients were 61% male, with a median age of 62 years. The median number of prior therapies was 2. International Prognostic Index risk was high-intermediate or high for 48.8% of patients, and 56.1% of patients had extranodal disease at study entry. As of the data cutoff date of May 24, 2019, four patients were continuing treatment and 37 patients had discontinued. With a median follow-up time of 6.8 months, the ORR was 29.3% and the complete response rate was 17.1%. The median DOR was 4.5 months, the median PFS was 2.8 months, and the median OS was 8.4 months. Adverse events (AEs) leading to treatment discontinuation were reported in four patients. Grade 3 or higher AEs were reported in 48.8% of patients. Major hemorrhage, atrial fibrillation and/or flutter, second primary malignancy, and tumor lysis syndrome were not observed. Conclusions: In this study zanubrutinib demonstrated modest antitumor activity in non-GCB DLBCL, similar to other BTK inhibitors. The safety profile was tolerable and consistent with previous reports of zanubrutinib treatment. Future studies of zanubrutinib in R/R non-GCB DLBCL will focus on the development of mechanism-based treatment combinations and biomarker-driven patient selection. Clinical trial information: NCT03145064 .
Myelodysplastic syndrome survival and secondary AML trends in the United States.
Authors: Wade T. Swenson, Abigail Paige Swenson
Journal: Journal of Clinical Oncology (2020)

7552 Background: Myelodysplastic syndrome (MDS) is a rare heterogeneous group of hematologic stem cell disorders. The most recent FDA therapies approved for the treatment of MDS were decitabine (May 2006), lenalidomide (June 2005), and azacitidine (November 2004). This analysis utilized a population-based cancer registry to identify changes in survival rates and secondary AML rates among patients with MDS. Methods: SEER 18 regions database (November 2017 submission) was accessed to obtain data on survival and secondary malignancies using SEER*Stat 8.3.6. ICD-O-3 codes were used to identify patients with refractory anemia (RA), refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, refractory cytopenia with multilineage dysplasia, MDS with 5q deletion, therapy-related MDS, and MDS, not otherwise specified. An observed survival analysis was conducted using a cohort diagnosed between 2001 and 2004 and another diagnosed between 2009 and 2012. Secondary AML risk was calculated using multiple primary - standardized incidence ratios (MP-SIR) to obtain observed/expected (O/E) ratio. Results: Three-year observed survival rates for patients diagnosed between 2001 and 2004 was 53.2% (50.4%, 55.9%) and was 61.2% (57.9%, 64.3%) for patients diagnosed between 2009 and 2012. There was no observed survival difference among other MDS subtypes. O/E ratio for development of AML among patients with RA was 2.77 (0.57, 8.11) for patients diagnosed between 2001 and 2004, and 49.49 (33.39, 70.65) for patients diagnosed between 2009 and 2012. Conclusions: Survival among patients diagnosed with RA has improved in recent years, whereas survival among other subtypes of MDS has not changed. Secondary AML rates have increased among RA patients identified in the population-based cancer registry.
Comparison of oncologic outcomes for robotic-assisted radical cystectomy (RARC) versus open radical cystectomy (ORC) among locally advanced and node-positive patients: An analysis of the National Cancer Database (NCDB).
Authors: Akshay G Reddy, Andrew D Sparks, Christina Darwish, Michael Joseph Whalen
Journal: Journal of Clinical Oncology (2020)

e17002 Background: Despite recent concerns of atypical recurrence following RARC, utilization of the modality is increasing. The presumed mechanisms are especially relevant in more aggressive disease, where the metastatic potential of tumor cells may be greater. This study aims to compare the oncologic efficacy of RARC to ORC among patients with stage pT3-4 or node-positive bladder cancer. Methods: A retrospective cohort analysis of pT3-4N0-3 and pT(any)-4N1-3 patients who underwent RARC or ORC from 2010-2016 was performed using the NCDB. Appropriate univariate and multivariable analysis were performed between treatment cohorts. Results: RARC was significantly associated with superior unadjusted survival compared to ORC (median survival relative to ORC; 23.6 mo. vs. 21.6 mo.; P= 0.001). Additionally, RARC was associated with lower proportions of unadjusted 30- and 90-day mortality, positive margin status, and shorter surgical inpatient stay (all respective P&lt; 0.05). However, after adjusting for confounding covariates, multivariable analysis revealed no difference in mortality hazard or odds of secondary outcomes with the exception of inpatient stay (Table). RARC was also significantly associated with higher lymph node yield (increased incidence of &gt; 14 lymph nodes examined relative to ORC; 55% vs. 40%; P&lt; 0.01). Conclusions: RARC is no less safe than ORC for patients with locally advanced or node-positive bladder cancer on the basis of overall, 30- and 90-day survival outcomes. Unadjusted mortality and surgical outcomes in this population demonstrate advantages to the robotic modality. Perioperative benefits may favor RARC, but further randomized control studies are necessary to better elucidate differences between surgical approaches. [Table: see text]
Limitations of Contemporary Guidelines for Managing Patients at High Genetic Risk of Coronary Artery Disease
Authors: Krishna G. Aragam, Amanda Dobbyn, Renae Judy, Mark Chaffin, Kumardeep Chaudhary, George Hindy, Andrew Cagan, Phoebe Finneran, Lu-Chen Weng, Ruth J.F. Loos, Girish Nadkarni, Judy H. Cho, Rachel L. Kember, Aris Baras, Jeffrey Reid, John Overton, Anthony Philippakis, Patrick T. Ellinor, Scott T. Weiss, Daniel J. Rader, Steven A. Lubitz, Jordan W. Smoller, Elizabeth W. Karlson, Amit V. Khera, Sekar Kathiresan, Ron Do, Scott M. Damrauer, Pradeep Natarajan
Journal: Journal of the American College of Cardiology (2020)
Progress in epidemiological study of female functional coustipation
Authors: 王静怡, 朱兰
Journal: BMJ (2009)

慢性便秘多指功能性便秘(functional constipation,FC),是一种常见的消化性疾病,在成年女性中有极高的发病率.目前,世界范围内普遍接受的便秘诊断标准是2006年Gastroenterology杂志上发表的针对功能性胃肠病分类的最新的罗马Ⅲ标准[1].FC的诊断标准:(1)必须满足以下2条或多条:①排便费力(至少每4次排便中有1次);②排便为块状或硬便(至少每4次排便中有1次);③有排便不尽感(至少每4次排便中有1次);④有肛门直肠梗阻和(或)阻塞感(至少每4次排便中有1次);⑤需要用手协助排便(如手指辅助排便、盆底支撑排便);⑥排便少于每周3次.(2)不用缓泻药几乎没有松软大便。
Diagnosis and management strategies of functional constipation in primary care
Authors: Xiaoqing Li
Journal: BMJ (2018)

功能性便秘是基层医院常见的功能性肠病，罗马基金会基层医疗委员会对基层医院医生处理功能性便秘提出了相应的诊疗策略，侧重于患者特征、病史采集和体格检查，报警症状和罹患器质性疾病患者的识别，启动有效的沟通、合理的药物治疗及适时转诊，便于基层医院医生更好地处理并管理功能性便秘患者。
Correlation of serum vitamin D and glycosylated hemoglobin levels with thyroid function in type 2 diabetes mellitus
Authors: Liyan Guo, Rongrong Zheng, Dandan Peng, Zhijun Zhao
Journal: BMJ (2018)

Two hundred and seventy two type 2 diabetes mellitus (T2DM) patients with negative anti-thyroid autoantibody were enrolled in Shanxi Provincial People′s Hospital from November 2016 to September 2017. According to serum vitamin D levels, patients were classified as serious deficiency of vitamin D group([25(OH)D]<25 nmol/L, n=119), vitamin D deficiency group (≥25~<50 nmol/L, n=124) and normal vitamin D group (≥ 50 nmol/L, n=29) . There were significant differences in total T4(P=0.04), TSH (P<0.01), parathyroid hormone (P=0.03) among these groups (P<0.05). After adjusting gender, age, BMI, glycosylated hemoglobin (HbA1c) and duration of diabetes, serum 25(OH)D level was negatively correlated with TSH (r=-0.24, P<0.05). After adjusting gender, age, BMI, duration of diabetes and serum 25(OH)D level, HbA1c level was negatively correlated with free T3 (r=-0.18, P<0.01) and TSH (r=-0.20, P<0.01). Multiple linear regression analysis revealed that TSH was correlated with 25(OH) D (β=-0.224, P<0.01) and HbA1c (β=-0.206, P<0.01). In conclusion, the serum vitamin D and HbA1c levels are independently correlated with thyroid function in patients with T2DM.


Key words: 
Diabetes mellitus, type 2; Vitamin D; Hemoglobin A, glycosylated; Thyroid function
Author Correction: Caring for patients with cancer in the COVID-19 era
Authors: Joris van de Haar, Louisa R. Hoes, Charlotte E. Coles, Kenneth Seamon, Stefan Fröhling, Dirk Jäger, Franco Valenza, Filippo de Braud, Luigi De Petris, Jonas Bergh, Ingemar Ernberg, Benjamin Besse, Fabrice Barlesi, Elena Garralda, Alejandro Piris-Giménez, Michael Baumann, Giovanni Apolone, Jean Charles Soria, Josep Tabernero, Carlos Caldas, Emile E. Voest
Journal: Nature Medicine (2020)

An amendment to this paper has been published and can be accessed via a link at the top of the paper.
SARS-CoV-2 antibody testing—questions to be asked
Authors: Mustafa K. Özçürümez, Andreas Ambrosch, Oliver Frey, Verena Haselmann, Stefan Holdenrieder, Michael Kiehntopf, Michael Neumaier, Michael Walter, Folker Wenzel, Roman Wölfel, Harald Renz
Journal: Journal of Allergy and Clinical Immunology (2020)
心房颤动的现代分类及其意义
Authors: 赵明中
Journal: BMJ (2006)

心房颤动(atrial fibrillation, AF)(简称房颤)是临床上较为常见的一种心律失常,可发生于有或无心脏疾患的个体,其临床表现及其危险性在不同的房颤类型及个体有很大的差异.不同类型的房颤,其治疗对策也迥然不同,因此正确认识房颤的类型及其危害,对房颤的有效防控具有重要价值。
Patterns of bruising in preschool children with inherited bleeding disorders: a longitudinal study
Authors: Collins Peter W, Hamilton Melinda, Dunstan Frank D, Maguire Sabine, Nuttall Diane E, Liesner Ri, Thomas Angela E, Hanley John, Chalmers Elizabeth, Blanchette Victor, Kemp Alison M, 王欣
Journal: BMJ (2018)

目的
明确遗传性出血性疾病患儿（年龄<6岁）的瘀斑数量、大小和分布特征。


研究设计
前瞻性、纵向、观察性研究。


研究地点
社区。


研究对象
试验组纳入105例遗传性出血性疾病患儿，对照组纳入328名无遗传性出血性疾病儿童，根据躯体活动能力分为走前状态（不能滚动/能翻身/可站立）、早期行走（缓慢爬行/缓慢步行）和正常行走3个等级，重度出血性疾病定义为凝血因子Ⅷ/Ⅸ/Ⅹ<1 IU/dl或确诊3型血管性血友病。


干预措施
每周记录全部对象的瘀斑数量、大小和分布，直至12周。


结局
比较重度与轻度/中度出血性疾病患儿与对照组儿童的干预情况。应用多级建模方法分析研究对象的多重集合。


结果
出血性疾病患儿的瘀斑更多、更大，以走前状态患儿最为严重。相比中度出血性疾病患儿，无出血性疾病的走前状态患儿瘀斑/数量的均值模型比为31.82（95%可信区间8.39~65.42），而重度、轻度/中度出血性疾病患儿的瘀斑大小的均值模型比分别为5.15（1.23~11.17）和1.81（1.13~2.23）。出血性疾病患儿在耳部、颈部、眼部或生殖器部位罕见瘀斑。


结论
在出血性疾病患儿，可见更多、更大的瘀斑，而且均处于晚期，这种差异尤以走前状态儿童最为突出。对于不明原因瘀斑的患儿，尽早行凝血功能检查至关重要，因为可以有效避免将重度出血性疾病误诊为躯体虐待。但是，血液检查无法为轻度/中度出血性疾病患儿明确瘀斑原因。
Early postoperative complications of renal cell cancer surgery with inferior vena cava tumor thrombus invasion
Authors: Zhuo Liu, Lulin Ma, Guoliang Wang, Xiaofei Hou, Lei Zhao, Shudong Zhang, Xiaojun Tian, Chunlei Xiao, Jian Lu, Yi Huang, Yuqing Liu, Hongxian Zhang
Journal: International Journal of Surgery (2016)
Clinical features of 21 pregnant women with scrub typhus
Authors: Cui-ping Wu, Xian-gang Cao, De-quan Xia
Journal: BMJ (2010)

Clinical data of 21 pregnant women with scrub typhus were analyzed retrospectively.They all had fever,13 of them with lymph nodes enlargement,12 with skin rashes,11 with eschar or ulcer,and 20 positive with Weil-Felix reaction.Oxytetracycline was given in 17 of them and other four were treated by azithromycin,with all cured.Seven of them gave natural childbirth at the 37th week of gestation,nine were aborted inductively,three aborted spontaneously and two delivered premature births.Scrub typhus was harmful to both pregnant women and their fetuses,early diagnosis and treatment are necessary for patients with it for avoiding exacerbation and reducing fatality.

Key words: 
Pregnancy; Scrub typhus
Association Between a National Insurer’s Pay-for-Performance Program for Oncology and Changes in Prescribing of Evidence-Based Cancer Drugs and Spending
Authors: Justin E. Bekelman, Atul Gupta, Ezra Fishman, David Debono, Michael J. Fisch, Ying Liu, Gosia Sylwestrzak, John Barron, Amol S. Navathe
Journal: Journal of Clinical Oncology (2020)

Cancer drug prescribing by medical oncologists accounts for the greatest variation in practice and the largest portion of spending on cancer care. We evaluated the association between a national commercial insurer's ongoing pay-for-performance (P4P) program for oncology and changes in the prescribing of evidence-based cancer drugs and spending.We conducted an observational difference-in-differences study using administrative claims data covering 6.7% of US adults. We leveraged the geographically staggered, time-varying rollout of the P4P program to simulate a stepped-wedge study design. We included patients age 18 years or older with breast, colon, or lung cancer who were prescribed cancer drug regimens by 1,867 participating oncologists between 2013 and 2017. The exposure was a time-varying dichotomous variable equal to 1 for patients who were prescribed a cancer drug regimen after the P4P program was offered. The primary outcome was whether a patient's drug regimen was a program-endorsed, evidence-based regimen. We also evaluated spending over a 6-month episode period.The P4P program was associated with an increase in evidence-based regimen prescribing from 57.1% of patients in the preintervention period to 62.2% in the intervention period, for a difference of +5.1 percentage point (95% CI, 3.0 percentage points to 7.2 percentage points; P < .001). The P4P program was also associated with a differential $3,339 (95% CI, $1,121 to $5,557; P = .003) increase in cancer drug spending and a differential $253 (95% CI, $100 to $406; P = .001) increase in patient out-of-pocket spending, but no significant changes in total health care spending ($2,772; 95% CI, -$181 to $5,725; P = .07) over the 6-month episode period.P4P programs may be effective in increasing evidence-based cancer drug prescribing, but may not yield cost savings.
Laparoscopic sacral colpopexy with prolene mesh in treatment of pelvic organ prolapse
Authors: Li Hong, Xue-xian Xu, Yan-bo Li, Xin Li
Journal: BMJ (2010)

The clinical data of 42 patients with pelvic organ prolapse, who underwent laparoscopic sacral colpopexy using prolene meshes were retrospectively reviewed. During the operation prolene meshes were placed in the rectovaginal septum and vesicovaginal septum ,and the uterus was preserved in all cases.The mean operation time was (92 ± 12)min and the mean blood loss during the operation was (98 ± 11 )ml.Postoperatively, both prolapse and symptoms were significantly improved ( P ＜0. 01 ) according to the pelvic organ prolapse quantification (POP-Q) system. The operation is an effective and minimally invasive new technique which offers a chance for patients with pelvic organ prolaps who desire to preserve uterus.

Key words: 
Uterine prolapse;  Laparoscopes
接诊社区老年患者需警惕甲状腺功能减退症的误诊
Authors: 陈瑒, 杜雪平
Journal: BMJ (2012)

2010年7月14日,笔者在本中心接诊了一位患病1年多未能正确诊断的老年甲状腺功能减退症(甲减)患者.患者为女性、70岁,主诉为反复跌倒1年多.详细询问病史了解到,患者在1年前就开始有无明显诱因的跌倒,曾就诊,以不除外缺血性脑血管病转入上级医院行头颅CT检查,诊断为腔隙性脑梗死(陈旧性),转回中心,予银杏叶注射液(商品名舒血宁)治疗.治疗期间无不适,治疗1周后出院.出院后按缺血性脑血管病治疗,仍有间断跌倒,发作逐渐频繁,休息后可缓解,发作时无意识障碍,无二便失禁,无眩晕、耳聋、耳鸣等.家属觉其语言动作迟缓,反应较前迟钝,有嗜睡、厌食.对患者做查体,血压140/64 mm Hg(1 mm Hg=0.133 kPa)。
Racial disparities in immune-related adverse events (irAE) of immune checkpoint inhibitors (ICPi) and association with survival based on clinical and biochemical responses.
Authors: Monica Peravali, Cristiane Gomes-Lima, Eshetu Tefera, Mairead Baker, Mamta Sherchan, Saira Farid, Kenneth D Burman, Florina Constantinescu, Irina Veytsman
Journal: Journal of Clinical Oncology (2020)

7025 Background: ICPi cause various irAE with thyroid dysfunction as a commonly reported abnormality. There is increasing evidence showing positive association with development of irAE and survival. However, prior trials with ICPi had underrepresentation of minorities with &lt;5% African Americans (AA). Methods: We retrospectively reviewed patients (pts) with stage IV solid malignancies treated with PD1/PDL1 blockers between 1/2013-12/2018 across MedStar Georgetown Cancer Institute facilities. Pts treated with CTLA-4 inhibitors were excluded. Progression free survival (PFS) and overall survival (OS) were primary endpoints and were calculated using Kaplan-Meier methods and Wilcoxon rank sum test for comparison. Results: 293 pts met eligibility criteria. 91 pts (31%) had any grade irAE; most common AE were endocrine (40.7%) specifically TSH elevation, dermatological (23.1%) and rheumatologic (18.7%). Proportion of irAE was significantly higher in Caucasians versus AA (60.4% vs 30.8%), in pts with low PDL1, lower LDH, older age, and those who had more treatment cycles with ICPi. Rate of progression was lower in pts with irAE (30.8% vs 46.0%, p-0.0140). Median PFS (5.8 vs 3.0 months (mo), p- 0.0204) and OS (17.1 vs 7.2 mo, p value- &lt;0.0001) were higher with irAE. Statistically significant difference in OS (17.1 vs 8.6 mo, p- 0.0002) but not in PFS (5.8 vs 3.3 mo, p: 0.0545) was noted with endocrine irAE. No differences in survival were observed among other commonly reported irAE. Differences in survival among subgroups of pts with irAE are detailed in table. Conclusions: Development of irAE positively correlated with improved PFS and OS as reported in previous studies. To our knowledge, this is the first study observing differences in OS favoring endocrine AE and Caucasian race. These factors may be potential surrogate markers of prognosis pending replication of these results in large-scale studies. [Table: see text]
Clinical study and use of procalcitonin in critically ill patients
Authors: 曹秋梅, 傅研
Journal: BMJ (2007)

目的 探讨血浆降钙素原水平对感染和非感染性病因所致的全身炎症反应综合征(SIRS)的鉴别作用,与病情严重程度的相关性.方法 采用前瞻性研究方法,选取2003年9月至2004年9月经我院急诊抢救室收治的危重SIRS患者共101例,其中52例感染性SIRS(感染组)和49例非感染性SIRS(非感染组),感染组按结局又分为存活组(41例)和死亡组(11例).常规测定体温、白细胞计数和分类、常规生化和血气分析,并进行急性生理与慢性健康评分(APACHE Ⅱ).采用双抗免疫荧光发光法测定各组血浆降钙素原水平.结果 感染组与非感染组比较,体温(38.2±0.9)℃与(37.3±1.1)℃(P＜0.01),血白细胞(15±8)×109/L与(10±5)×109/L(P＜0.01),分类中性粒细胞0.85±0.08与0.80±0.10(P＜0.01),APACHE Ⅱ26±7与22±9(P＜0.01),感染组均明显高于非感染组.血浆降钙素原水平感染组(3.5±4.0)μg/L,明显高于非感染组的(0.5±0.4)μg/L(P＜0.01).感染存活组与感染死亡组之间,血白细胞、中性粒细胞、淋巴细胞数值比较差异无统计学意义(P＞0.05),而APACHE Ⅱ(25±6与32±7)、血浆降钙素原(2.8±0.4与7.5±5.4)两组间差异有统计学意义(P＜0.01).在感染组中≥5μg/L组与＜5μg/L组相比,死亡率差异有统计学意义(P＜0.01).结论 由血浆降钙素原水平诊断感染具有较高的敏感性和特异性;血浆降钙素原与病情严重程度有一定的相关性。