ABSTRACT
<p><b>BACKGROUND</b>It is unclear that how to decide the calcium infusion rate during continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA). This study aimed to assess the determinants of calcium infusion rate during CVVH with RCA in critically ill patients with acute kidney injury (AKI).</p><p><b>METHODS</b>A total of 18 patients with AKI requiring CVVH were prospectively analyzed. Postdilution CVVH was performed with a fixed blood flow rate of 150 ml/min and a replacement fluid flow rate of 2000 ml/h for each new circuit. The infusion of 4% trisodium citrate was started at a rate of 29.9 mmol/h prefilter and adjusted according to postfilter ionized calcium. The infusion of 10% calcium gluconate was initiated at a rate of 5.5 mmol/h and adjusted according to systemic ionized calcium. The infusion rate of trisodium citrate and calcium gluconate as well as ultrafiltrate flow rate were recorded at 1, 2, 4, 6, 12, and 24 h after starting CVVH, respectively. The calcium loss rate by CVVH was also calculated.</p><p><b>RESULTS</b>Fifty-seven sessions of CVVH were performed in 18 AKI patients. The citrate infusion rate, calcium loss rate by CVVH, and calcium infusion rate were 31.30 (interquartile range: 2.70), 4.60 ± 0.48, and 5.50 ± 0.35 mmol/h, respectively. The calcium infusion rate was significantly higher than that of calcium loss rate by CVVH (P < 0.01). The correlation coefficient between the calcium and citrate infusion rates, and calcium infusion and calcium loss rates by CVVH was -0.031 (P > 0.05) and 0.932 (P < 0.01), respectively. In addition, calcium infusion rate (mmol/h) = 1.77 + 0.8 × (calcium loss rate by CVVH, mmol/h).</p><p><b>CONCLUSIONS</b>The calcium infusion rate correlates significantly with the calcium loss rate by CVVH but not with the citrate infusion rate in a fixed blood flow rate during CVVH with RCA.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Acute Kidney Injury , Drug Therapy , Therapeutics , Anticoagulants , Therapeutic Uses , Calcium , Therapeutic Uses , Citric Acid , Therapeutic Uses , Hemofiltration , Methods , Prospective StudiesABSTRACT
Background Nearly over 40 years have elapsed since the original findings of visual cortical plasticity,but none of drug has been found for curing amblyopia effectively. Objective The goal of this study was to investigate the effects of different dose of levodopa on flash visual evoked potential(F-VEP)and morphology of visual cortex cells in monocular deprivation rat and explore the possible mechanism of curing amblyopia.Methods Monocular deprivation model were established by suturing eyelids of 30 2-week-old Sprague Dawley(SD)rats for 4 weeks.The 30 SD rats were then divided into 3 groups randomly and 10 rats for each group.Normal saline.20 ms/kg levodopa,80 ms/kg levodopa were intragastrically administered once per day after modeling respectively for 4 weeks.F-VEP was recorded after establishment of model and administration of drug respectively.The rats were sacrificed and the visual cogex was obtained for histological examination,and TUNEL technique was used to assess the structural change of visual cortex.Results The latency of P1 wave was significantly longer in the deprived eye than the normal eyes(P<0.05).After administration of levodopa,the latent periods of Pl wave in the deprived eye were obviously shortened in comparison with before administration of levodopa in 20 ms/kg and 80 mg/kg levodopa group (P<0.05).The difference values of latent period of P1 wave between before and after administration of drug showed statistically significant change in three groups(P<0.05).No evidently alterations were found in the amplitude differences of N1 P1 and P1 N2 waves among three groups(P>0.05).The number and structure of neurons in contralateral visual cortex of non-deprived eye were normal.However,the numbers of neurons in deprived eye were significantly less and presented the signs of para-apoptosis in normal saline group.In 20 mg/kg levodopa groups,the alterations of number and morphology in neurons of rat visual eogex were slight.TUNEL assay revealed that the numbers of positive neurons in contralateral visual codex of non-deprived eye were 2.20±1.23.while those in deprived eye were 53.7±9.36,27.20 4±5.96 and 10.70±3.23 in normal saline group,20 mg/kg and 80 mg/kg levodopa group respectively,showing a significant difference among them(P>0.05).After usage of levodopa,the numbers of positive neurons was negatively correlated with the difference value of P,latent period of VEP(r=-0.815,P=0.000).Conclusion Levodopa has a therapeutic effect on rat deprived eye,and its possible mechanism is inhibiting the para-apoptosis of neurons and participating in the development and plasticity of visual system.
ABSTRACT
<p><b>OBJECTIVE</b>The combination of oxaliplatin (L-OHP), 5-fluorouracil (5-Fu) and folinic acid (FA), being one of the effective regimens for advanced gastric cancer, is used in form of chronomodulated chemotherapy for advanced gastric cancer to investigate its efficacy and safety.</p><p><b>METHODS</b>Twenty-six patients received a 4-day chronomodulated infusion of L-OHP, 5-Fu and FA. L-OHP (25 mg.m(-2).d(-1)) infused from 10:00 am to 22:00 pm, and followed by 5-Fu (600 mg.m(-2).d(-1)) and FA (300 mg.m(-2).d(-1)) from 22:00 pm to 10:00 am for 4 days using a multichannel programmable pump, every 2 weeks as an cycle for at least 2 cycles.</p><p><b>RESULTS</b>Twenty-six patients with previously untreated advanced gastric cancer were eligible. Two complete and 13 partial remissions were observed with an overall response rate of 57.7%. Stable disease was observed in 6 patients (23.1%) and progressive disease in five (19.2%). Four of these patients underwent surgery. The median remission time was 3.5 months and time to tumor progression (TTP) was 4.5 months. The median overall survival time was 8 months. A total of 80 cycles were given without any grade 4 toxicity observed, but grade 3 thrombocytopenia (1.3%) and mucositis (1.3%) in one patient, two grade 3 neutropenia (2.5%) and nausea/vomiting (2.5%) in 2.</p><p><b>CONCLUSION</b>Chronomodulated intravenous chemotherapy of oxaliplatin, 5-fluorouracil and folinic acid is effective and safe in the treatment of advanced gastric cancer.</p>