ObjectiveTo explore the clinical effects of exogenous glutamine on patients suffering from sepsis with hypoalbuminemia in emergency department. MethodsEighty-six patients with sepsis and hypoalbuminemia enrolled from January to November 2013 in the Emergency Department of our hospital were randomly divided into treatment group and control group. Forty-three patients in the control group were given conventional treatments, while the other 43 in the treatment group were treated with glutamine therapy based on the conventional treatments. The clinical efficacy of the two groups including inflammatory markers, albumin level, APACHEⅡ score and SAPSⅡ score, mortality, length of hospital stay were analyzed on day 7, 14, and 28 after being enrolled. A comprehensive analysis of the clinical effects in these two groups was performed. ResultsEighty-six cases were enrolled in this study. The mortality on day 14 and 28 in the treatment group was significantly lower than that in the control group (P<0.05). Inflammatory markers (WBC count, CRP concentration, and PCT concentration) in patients of the treatment group were gradually decreased, whereas serum albumin levels were gradually increased compared with the control group (P<0.05). The cure rate of patients in the treatment group was significantly higher than that in the control group, while the average length of stay was shorter than the control group (P<0.05) on day 28. ConclusionExogenous glutamine supplementation can improve patient cure rates and reduce hospital stays which has good clinical effects on patients with sepsis and hypoalbuminemia in emergency department.
Objectives To explore the relationship between diabetic macular edema (DME) classified by different optical coherence tomography (OCT) types and the risk of diabetic nephropathy (DN). MethodsA retrospective clinical study. A total of 304 patients with DME, involving 421 eyes, diagnosed through ophthalmic examinations at Xi'an Third Hospital between August 2019 and December 2024 were included in the study. All affected eyes underwent OCT examination along with laboratory tests including glycated hemoglobin (HbA1c), serum albumin, serum creatinine, glomerular filtration rate (GFR), urine albumin-to-creatinine ratio (UACR), serum β2-microglobulin, and 24-hour urine protein quantification. Based on OCT imaging characteristics, DME was classified into diffuse retinal thickening (DRT) type, cystoid macular edema (CME) type, and serous retinal detachment (SRD) type, with corresponding group sizes of 96 patients (138 eyes), 102 patients (132 eyes), and 106 patients (151 eyes), respectively. The risk of DN development was categorized as low, moderate, high, or very high risk according to KDIGO guidelines. Intergroup comparisons of renal function-related indicators were performed using nonparametric tests. ResultsThe number of affected eyes classified as low risk for DN in the DRT, CME, and SRD groups were 87, 72, and 63, respectively. The number classified as moderate risk were 23, 23, and 28, respectively. The number classified as high risk were 22, 27, and 35, respectively. The number classified as extremely high risk were 6, 10, and 25, respectively. These differences were statistically significant (χ2=20.359, P=0.002). Serum albumin levels were (44.66±4.89), (43.59±6.41), and (41.31±7.53) g/L, respectively. Serum β2-microglobulin levels were (2.15±1.55), (2.52±2.34), and (4.09±5.57) mg/L, respectively. The 24-hour urine protein quantification was (94.88±64.58), (106.20±75.49), and (151.38±121.88) mg/24 h, respectively. Low serum albumin levels were (32.58±1.84), (31.58±2.13), and (30.15±1.63) g/L, respectively. 24-hour high urine protein levels were (225.15±59.78), (246.96±67.38), and (317.71±96.52) mg/24 h, respectively. High serum β2-microglobulin levels were (5.51±3.03), (7.80±3.63), and (14.60±6.81) mg/L, respectively. The comparison of indicators related to renal function showed that there were statistically significant overall differences among the three groups in serum albumin, serum β2-microglobulin and 24-hour urine protein quantification (χ2=18.367, 18.674, 14.612; P＜0.001). The SRD group presented more significant characteristics of renal function impairment. Its low serum albumin level was lower than that of the DRT and CME groups, while the 24-hour high urine protein quantification and high serum β2-microglobulin level were significantly higher than those of the other two groups, and the differences were statistically significant (χ2=21.587, 21.344, 21.587; P＜0.001). ConclusionDN is an important risk factor for SRD-type DME, and patients with this type often have more severe abnormal markers of renal function impairment.