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Objective@#To study the effect of mean arterial pressure (MAP) level on acute kidney injury (AKI) in patients with septic shock, and to determine the best resuscitation target MAP to prevent the occurrence or progression of sepsis- associated AKI.@*Methods@#The study subjects included 168 adult patients with septic shock (age≥65 years) who were admitted to the Department of Intensive Care Unit (ICU) of the First Hospital of Jilin University from January 2016 to January 2019. The clinical data of all enrolled patients were retrospectively analyzed. The baseline data were compared between the AKI group (n=111) and non-AKI group (n=57). Multivariate logistic regression analysis was used to determine the risk factors of AKI in patients with septic shock.@*Results@#① The first, second, third, and forth quartile of ΔMAP (pre-resuscitation MAP minus post-resuscitation MAP) were -24.3-3.9 mmHg, 4.0-12.3 mmHg, 12.4-19.8 mmHg, and 19.9-43.5 mmHg, respectively. The second to fourth quartile interval wasΔMAP ≥4 mmHg.② There were no significant differences in age, body mass index, sex, pre-resuscitation MAP, MAP at first hour, SOFA score, positive culture ratio, negative culture ratio, hypertension, peripheral vascular disease, cerebrovascular accident, chronic obstructive pulmonary disease, gastrointestinal ulcer, liver cirrhosis, and tumor between the two groups (P>0.05). There were significant differences in post-resuscitation MAP (P=0.01), APACHEⅡ score (P=0.02), diabetes mellitus (P=0.01), fluid balance (P=0.01), and ΔMAP from the second to fourth quartile (P=0.03) between the two groups.③ ΔMAP ≥4 mmHg (OR=0.26, 95%CI: 0.12-0.57, P=0.01), diabetes (OR=6.03, 95%CI: 1.35-44.16, P=0.04), and high APACHE Ⅱ score (OR=0.96, 95%CI: 0.84-0.97, P=0.02) were closely related to the increased incidence of AKI in patients with septic shock. Post-resuscitation MAP and fluid balance had no significant effect on the incidence of AKI in patients with septic shock.@*Conclusions@#ΔMAP ≥4 mmHg, APACHE Ⅱ score and diabetes were independent risk factors for the incidence of AKI in patients with septic shock. The incidence of AKI in septic shock patients with post-resuscitation MAP 4 mmHg or more lower than pre-resuscitation MAP is significantly increased.
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Objective To investigate the relationship between fluid overload(FO) and prognosis of critically ill patients with acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT), so as to provide a basis for the reasonable optimization of fluid management and improve the prognosis of critically ill patients with AKI. Methods We enrolled 261 adult AKI patients receiving CRRT who were admitted in ICU Department of the First Hospital of Jinlin University from January 2012 to June 2017. We retrospectively analyzed the clinical data of all enrolled patients and compared the clinical data between the survival group (n=149) and the death group (n=112). We screened and analyzed the risk factors of 30-day mortality after entering ICU of AKI critically ill patients receiving CRRT through multiple Logistic regression analysis. The Kaplan-Meier survival curve was used to compare the difference of 30-day mortality after entering ICU between the subgroups of fluid overload and non-fluid overload patients. Results ① The 30 day mortality was significantly higher in AKI patients receiving CRRT when the following situation existed: ％FO total ≥ 10％(OR=1.30, 95％CI:1.13-2.05, P=0.01), ventilator dependency(OR=1.65, 95％CI:1.01-2.55, P=0.03), oliguria(OR=1.55, 95％CI:1.13-2.15), SOFA ≥ 13(OR=1.15, 95％CI:1.01-1.20, P<0.01), the time from the diagnosis of AKI to the start of CRRT >3 days (OR=1.03, 95％CI:1.01-1.13, P=0.04) and mean arterial pressure<72 mmHg (OR=1.10, 95％CI:1.00-1.30, P=0.04). ② There was significant difference in the 30 day survival rate between the fluid overload group (n=92) and the non-fluid overload group (n=169) (P<0.01). ③ Sub group analysis:group1(n=130): ％FO pre-CRRT <10％ and ％FO total<10％; group 2 (n=39): ％FO pre-CRRT ≥ 10％and ％FO total<10％; group 3 (n=64): ％FO pre CRRT <10％ and ％FO total ≥ 10％; group 4 (n=28):％FO pre-CRRT ≥ 10％ and ％FO total ≥ 10％. There was a significant difference in the survival rate between the four groups, that was group 1 >group 2> group 3> group > 4 (P<0.01). ④ The 30 day survival rate was significantly different between fluid overload patients(n=62) and non-fluid overload patients (n=92) in the septic group (P<0.01), while in the non-septic group the 30-day survival rate had no significant difference between fluid overload patients (n=31) and non-fluid overload patients (n=76) (P=0.291). The 30-day survival rate was significant different between fluid overload patients (n=57) and non-fluid overload patients (n=78) in the SOFA ≥ 13 group (P=0.026), while in the SOFA<13 group the 30-day survival rate had no significant difference between fluid overload patients (n=35) and non-fluid overload patients (n=91) (P=0.074). Conclusions Fluid overload is closely associated with poor prognosis of critical ill patients with AKI. The removal of too much fluid through CRRT appears to reduce the mortality of severe AKI patients. The adverse effect of fluid overload on survival is more evident in AKI patients with sepsis or with more severe illness (SOFA ≥ 13).
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Objective To study the effect of mean arterial pressure (MAP) level on acute kidney injury (AKI) in patients with septic shock, and to determine the best resuscitation target MAP to prevent the occurrence or progression of sepsis- associated AKI.Methods The study subjects included 168 adult patients with septic shock (age≥65 years) who were admitted to the Department of Intensive Care Unit (ICU) of the First Hospital of Jilin University from January 2016 to January 2019. The clinical data of all enrolled patients were retrospectively analyzed. The baseline data were compared between the AKI group (n=111) and non-AKI group (n=57). Multivariate logistic regression analysis was used to determine the risk factors of AKI in patients with septic shock.Results ① The first, second, third, and forth quartile ofΔMAP (pre-resuscitation MAP minus post-resuscitation MAP) were -24.3-3.9 mmHg, 4.0-12.3 mmHg, 12.4-19.8 mmHg, and 19.9-43.5 mmHg, respectively. The second to fourth quartile interval wasΔMAP≥4 mmHg.② There were no significant differences in age, body mass index, sex, pre-resuscitation MAP, MAP at first hour, SOFA score, positive culture ratio, negative culture ratio, hypertension, peripheral vascular disease, cerebrovascular accident, chronic obstructive pulmonary disease, gastrointestinal ulcer, liver cirrhosis, and tumor between the two groups (P>0.05). There were significant differences in post-resuscitation MAP (P=0.01), APACHEⅡ score (P=0.02), diabetes mellitus (P=0.01), fluid balance (P=0.01), andΔMAP from the second to fourth quartile (P=0.03) between the two groups.③ΔMAP≥4 mmHg (OR=0.26, 95％CI: 0.12-0.57,P=0.01), diabetes (OR=6.03, 95％CI: 1.35-44.16,P=0.04), and high APACHEⅡ score (OR=0.96, 95％CI: 0.84-0.97,P=0.02) were closely related to the increased incidence of AKI in patients with septic shock. Post-resuscitation MAP and fluid balance had no significant effect on the incidence of AKI in patients with septic shock.Conclusions ΔMAP≥4 mmHg, APACHEⅡ score and diabetes were independent risk factors for the incidence of AKI in patients with septic shock. The incidence of AKI in septic shock patients with post-resuscitation MAP 4 mmHg or more lower than pre-resuscitation MAP is significantly increased.
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Objective To investigate the incidence and risk factors of septic cardiomyopathy,and to provide evidence for the diagnosis,treatment and prevention of septic cardiomyopathy.Methods Totally 208 patients with septic or septic shock (≥ 18 years old) were admitted to ICU Department of The First Hospital of Jilin University from January 2015 to August 2017.The clinical data of all patients were retrospectively analyzed,and the baseline data and clinical outcomes were compared between the septic cardiomyopathy group (39 cases) and non-septic cardiomyopathy group (169 cases).Multiple Logistic regression analysis was used to analyze the risk factors of septic cardiomyopathy.Results (1) The incidence of septic cardiomyopathy in patients with septic or septic shock was about 18.8％.(2) There was no significant difference in baseline body weight,atrial fibrillation,hypertension,diabetes,malignant tumor,maximum body temperature,blood leukocyte,C-reactive protein(CRP),procalcitonin(PCT),positive blood culture,in-hospital mortality and 30-day mortality between the two groups (all P＞0.05).Age (P=0.01),sex (P=0.02),history of heart failure (P=0.03),history of coronary heart disease (P=0.01),platelet at ICU admission (P=0.01),lactic acid at ICU admission (P=0.02),vasoactive drugs (P=0.03),APACHE Ⅱ score (P=0.03),SOFA score (P=0.01),and ICU length of hospital stay (P=0.03) were significantly different between the two groups.(3) Patients with a history of heart failure (OR=1.55,95％CI:0.73-1.66;P=0.01),a history of coronary heart disease (OR=1.18,95％CI:1.03-1.66;P=0.03),and lactic acid at ICU admission ＞ 4.0 mmol/L (OR=1.10,95％CI:1.00-1.30;P=0.04) were independent risk factors for the incidence of septic cardiomyopathy.Conclusion Septic cardiomyopathy has a relatively high incidence in patients with septic or septic shock.Patients with a history of heart failure,a history of coronary heart disease and lactic acid at ICU admission ＞ 4.0 mmol/L are independent risk factors for the incidence of septic cardiomyopathy.
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Objective To investigate the risk factors and prognosis of fl uid overload in patients with septic shock in order to provide guidelines for the reasonable optimization of fluid resuscitation to improve the prognosis of patients with septic shock. Methods A total of 203 septic shock patients admitted in ICU of the fi rst Hospital of Jinlin University from July 2013 to December 2016 were enrolled for retrospective study. The clinical data of all patients were collected to analyzed the differences in clinical settings and outcomes between fluid overload group (n=51) and non-fluid overload group (n=152). The risk factors of fluid overload were achieved using multiple logistic regression analysis. Results Compared with non-fl uid overload group, there were statistically higher levels of APACHE II score(27.5± 9.8 vs.22.7± 9.2,P=0.03),rate of congestive heart failure(17.6% vs.9.2%,P=0.02),rate of acute kidney injury(47.1% vs.29.6%, P=0.04), rate of liver cirrhosis(17.6% vs.9.2%,P=0.02), percentage of albumin≤20 g/L(39.2% vs.36.2%,P=0.03),percentage of blood transfusion(43.1% vs.15.1%,P=0.04), percentage of mechanical ventilation employed(64.7% vs.39.5%,P=0.02),volume of fluid infusion in 24 h(8.3 L vs.5.8 L,P=0.01),rate of renal replacement therapy(15.7% vs.7.9%,P=0.02),and mean duration of mechanical ventilation(4.5 d vs.2.6 d,P<0.01)found in fluid overload group.The hospital mortality of fluid overload group was higher than that of non-fluid overload group(45.1% vs.34.9%,P=0.01).The length of ICU stay in fluid overload group was longer than that of non-fluid overload group(6.8 d vs.3.8 d, P=0.02). The ICU re-admission rate within 48 h in fl uid overload group was higher than that in non-fluid overload group(7.8% vs.3.9%,P=0.03).with free fluid infusion without meticulous calculation of fluid volume(OR=2.65,95%CI:1.33-5.28,P=0.01)and serum albumin≤20 g/L(OR=2.35,95%CI:1.24-4.21,P=0.04)were more likely to develop fluid overload. Conclusion Fluid overload in septic shock patents is associated with poor prognosis. Free fl uid infusion without careful calculation of fl uid volume and severe hypo-albuminemia are the independent risk factors of fl uid overload in septic shock patients.
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Objective To investigate the differences in GD-EOB-DTPA multi-modality MR images be-tween well-differentiated hepatocellular carcinoma(WHCC)and non well-differentiated HCC.Methods The clin-ical and MR images of 57 patients with pathologically proved HCC were retrospectively collected. All patients un-derwent abdominal enhancement MRI,including T1 weighted and T2 weighted imaging(T1WI and T2WI),diffu-sion weighted imaging(DWI),the apparent diffusion coefficient(ADC)map,and gadoxetic acid-enhanced multi-phase sequences. The patients were classified into well-differentiated HCC(WHCC)group and non-WHCC group which combined moderate HCC and poor differentiated HCC according to their histopathological differentiation.Dif-ferences of T1WI,T2WI,DWI,ADC map,the types of HCC on hepatobiliary phase(HBP)images,and enhance-ment patterns on dynamic images were compared. The chi-square test or Fisher exact was used for comparing the imaging signal differences between WHCC and non-WHCC. Multiple logistic regression analysis was performed to identify the independent predictors of WHCC. Results T1WI signal intensities,HBP signal types,enhancement patterns and ADC maps showed statistical significance between WHCC and non-WHCC(P<0.05).But,multiple logistic regression analysis showed that signal intensities on T1WI were independent risk factors for WHCC(P =0.001). In addition,hyperintense on T1WI showed higher statistical significance compared with isointense or hy-pointense on T1WI(P = 0.002). Conclusions Multi-modality of GD-EOB-DTPA MRI is useful for assessing WHCC. The signal intensities on T1WI are independent risk factors for evaluating WHCC. Moreover,WHCC are more likely in hyperintense T1WI signal intensity.
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Objective To explore the effect of decoction of four-drug juice plus glutamine on nutritional support in the elderly critically ill patients. Methods One hundred and twenty-four elderly critical ill patients in The First Hospital of Jilin University from May 2010 to May 2012 were randomly divided into treatment group(n = 62)and control group(n = 62). Patients in both two groups were given enteral nutrition(EN)plus parenteral nutrition(PN)after the hemodynamics became stable. In addition,patients in control group were given routine EN + PN,while in treatment group was given decoction o four-drug juice + EN plus glutamine + PN. Prealbumin (PA),serum total protein( TP),transferrin( TF)and serum albumin( ALB)were detected before and after treatment of nutritional support. The informations including recovery of bowel sounds,the occurrence of complications,antibiotic use time and the duration of ICU stay were recorded. Results There were no significant differences between two groups in terms of nutrition indices before treatment(P > 0. 05). After treatment,the contents of pre albumin,transferrin,total serum protein,serum albumin in treatment group were( 145. 24 ± 6. 72)g/ L,(1. 93 ± 0. 98)g/ L,(79. 86 ± 10. 38)g/ L,(54. 91 ± 2. 91)g/ L respectively,better than those in control groups((139. 24 ± 38. 76),(1. 68 ± 0. 33),(74. 73 ± 7. 31),(49. 87 ± 2. 61)g/ L),and the differences were statistically significant( t = 3. 610,2. 929,4. 360,6. 767;P < 0. 05). The incidence of stress ulcer and double infection in treatment group were 42%(26 / 62),37%(23 / 62),significantly lower than the control group(59%(37 / 62),53%(33 / 62)),and the differences were statistically significant( χ2 = 5. 186, 5. 271,P < 0. 05). Antibiotic use time and the duration of ICU stay in treatment group were(8. 82 ± 0. 71)d and(16. 14 ± 3. 01)d,and reaching full eternal nutrition time was(6. 90 ± 1. 01)d,decreased less than that in control group((10. 21 ± 1. 30),(20. 67 ± 2. 29),(13. 91 ± 1. 51)d)and the differences were statistically significant(t = 8. 892,7. 786,3. 609,P < 0. 05). The average recovery time of bowel sounds and first anal exhaust time average in treatment group were(26. 8 ± 3. 6)h,(25. 4 ± 3. 2)h,lower than that in control group ((38. 4 ± 4. 8)h,(37. 6 ± 4. 9)h)and the differences were statistically significant( t = 3. 551,2. 516,P< 0. 05). Conclusion The application of decoction of four-drug juice plus glutamine on nutritional support of the elderly critically ill patients can reduce complications,shorten the duration of ICU,recover the intestinal function as soon as possible. Meanwhile,patients can transit to full eternal nutrition as soon as possible,then the cost of therapy is reduced and rehabilitation is quickly.
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Objective To observe the effect of Shengmai Injection (a Chinese herbal medicine preparation) on the serum levels of TNF-α used as indicators of organ function in post cardiopulmonary resuscitation rabbits.Methods Rabbit cardiac arrest model was made with asphyxia by clamping the trachea of rabbit.A total of 30 rabbits were randomly (random number) divided into two groups,namely the normal saline group (n =15) and the Shengmai injection group (n =15).Rabbits in Shengmai injection group were injected with 2 ml/kg Shengmai Injection immediately at the beginning of cardiopulmonary resuscitation (CPR),and the same dose of Shengmai injection given 10 min after CPR.Rabbits in saline group were injected with the same volume of physiological saline instead at the same intervals as previous group.The rate of restoration of spontaneous circulation (ROSC) and survival rates at 6,12,24 and 48 h after ROSC were observed.The serum levels of TNF-α were measured by enzyme-linked immunosorbent assay (ELISA).Biochemical methods were used to detect myocardial MB-isoenzyme of creatine kinase (CK-MB),alanine aminotransferase (ALT),creatinine (Cr),glucose (Glu) and arterial partial pressure of oxygen (PaO2) before resuscitation and 12,24 and 48 h after ROSC simultaneously in the two groups.Results There was no statistically significant difference in the ROSC rate and survival rate after resuscitation between the two groups (P ＞ 0.05).Before asphyxia,there was no significant difference in the level of TNF-α found between the two groups (P ＞ 0.05),but at 12,24 and 48 h after ROSC,the levels of TNF-α in Shengmai group were much lower than those in Saline group (P ＜ 0.05).At 24 h after ROSC,the levels of serum CK-MB,ALT,and Cr in Shengmai group were much lower than those in Saline group (P ＜0.05).Furthermore,at 48 h after ROSC,the levels of CK-MB and ALT in Shengmai group were still lower than those in Saline group (P ＜ 0.05),but there was no significant difference in the level of Cr between the two groups (P ＞ 0.05).There was also no significant difference in the blood glucose and arterial partial pressure of oxygen between the two groups (P ＞ 0.05).Conclusions Shengmai Injection has significant inhibiting effect on the serum level of TNF-α in post cardiopulmonary resuscitation rabbits,and it also has more or less some degrees of protective effect on organ function of heart,liver and kidney in rabbits after ROSC.
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Objective To assess the relationship between lactate clearance and prognosis of patients with multiple organ dysfunction syndrome following resuscitation.Methods Data of 42 eligible patients with multiple organ dysfunction syndrome after resuscitation admitted from January 2009 to December 2011 were collected for retrospective analysis.The patients included were adult patients who survived more 24 hours after CPR for cardiac arrest with subsequent multi-organ failure.Exclusion criteria were traumatic heart arrest and the end-stage diseases.All the patients were divided into survival group and death group on the 3rd day and the 7th day after restoration of spontaneous circulation.The differences in the age,gender,mean arterial pressure,oxygenation index (PaO2/FiO2),APACHE Ⅱ score,white blood cell count (WBC),initial lactate level and 6h lactate clearance rate between the two groups were compared by using the Mann-Whitney U-tests and logistic regression analysis.Results Of 42 patients,the mean age was (59.57±14.68) years and mean APACHE Ⅱ score was (26.79 ±7.77),and 23 (54.8％) patients survived until the 3rd day and 14 (33.3％) patients survived to the 7th day after restoration of spontaneous circulation (ROSC).Univariate analysis showed that APACHE Ⅱ score in death group was significantly higher and 6 h lactate clearance was significantly lower than those in survival group (P ＜ 0.05) on the 3rd day and the 7th day after ROSC,and other biomarkers were not significantly different between the two groups.The results from logistic regression analysis showed that there were statistically significant difference in APACHE Ⅱ score (RR =2.143,P =0.028) and 6-h lactate clearance (RR =0.887,P =0.040) between survival group and death group on the 7th day after ROSC,although no significant differences in APACHE Ⅱ score and 6 h lactate clearance were found between the two groups on the 3rd day after ROSC.Conlusions Post-cardiac arrest patients with low lactate clearance in the early stage after ROSC have a poor prognosis.Lactate clearance may be an independent predictor of mortality in post-cardiac arrest patients in the recovery phase.
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ObjectiveTo explore the influences of Penehyclidine Hydrochloride on [ Ca2 + ] i and the expression of cysteine-containing aspartate-specific proteases-3 (Caspase-3) in neural cells of neonatal rats after hypoxic-ischemic injury within 12 h.MethodsSeven-day-old Sprage-Dowley rats ( n =128) were randomly assigned into four groups:Sham group ( sham operation group,n =32),hypoxic-ischemic encephalopathy (HIE) group ( HIE models,n =32 ),N group ( HIE models treated with Nimodipine,n =32 ),and P group (HIE models treated with Penehyclidine Hydrocloride,n =32).Brain tissues were collected at different time points (2 h,4 h,6 h,and 12 h) after modeling.We utilized fluorescent microscope to detect the expression of Caspase-3 via making frozen slices of rat brain tissue,while [ Ca2+ ]iof neural cells in live brain slices of rats was measured by laser scanning confocal microscope.ResultsCompared with Sham group,both [ Ca2 + ] i and the expression of Caspase-3 of neural cells increased significantly ( P ＜ 0.01 ) in brain cortex in HIE group.[ Ca2 + ] i and Caspase-3 activity increased gradually with time since 2 h after making HIE models and reached a peak at the time points of 12 h ( P ＜0.05).In N group and P group,both of [ Ca2+ ]i and Caspase-3 decreased compared with HIE group (P ＜0.01 ),however,there was no significant difference between N group and P group ( P ＞ 0.05 ).In addition,[ Ca2 + ] i and Caspase-3 activity had no significant difference between 6 h and 12 h (P ＞ 0.05 ).ConclusionPenehyclidine Hydrocloride can protect the brain tissue from hypoxic-ischemic injury via relief of calcium overload and inhibition of Caspase-3 activity.
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Objective To explore the effect of shengmai injection (a Chinese herb preparation made from radix astragali and radix rehmanniae) on restoration of spontaneous circulation (ROSC) and hemodynamics in the early stage of resuscitation (CPR) in animal models of cardiac arrest, providing adjuvant support to stabilize the circulation for the facilitation of follow-up study in the resuscitated animal. Method A total of 30 rabbits were randomly(random number) divided into two groups, shengmai group and saline group, ( n = 15 in each group).Asphyxia method was used to establish animal models of cardiac arrest. In the shengmai group, 2 mL/kg shengmai injection was given immediately just after initiation of CPR and the same dose of shengmai injectio was given once again 10 minutes after ROSC. In the saline group, saline was administered in the same volume and at the same given time instead of shengmai injectio. The duration of cardiac arrest of rabbits, and the lengths of time consumed for ROSC and for resume of spontaneous respiration after CPR as well as the rate of ROSC obtained and 6-hours survival rate after CPR were documented. The changes of hemodynamics including LVSP, + dp/dtmax,- dp/dtmax, LVEDP were recorded before asphyxia,just after the emergence of ROSC and 30 min,60 min, and 120 min after ROSC. Results There were no significant differences in duration of cardiac arrest, length of time consumed for the resume of spontaneous respiration, rate of ROSC obtained and 6-hours survival rate between two groups (P ＞ 0.05), but the ROSC emerged sooner in shengmai group. The LVSP, + dp/dtmax and- dp/dtmaxsignificantly lower 30 min, 60 min and 120 min after ROSC then those before asphyxia in both groups, but LVEDP increased after ROSC (P ＜0.05). At the corresponding intervals after ROSC, the values of LVSP, + dp/dtmaxand - dp/dtmax in the shengmai group were higher than those in the saline group, and the values of LVEDP in the shengmai group were lower than those in the saline group ( P ＜ 0. 05). Conclusions Shengmai injectio used in rabbits with cardiac arrest can shorten the time consumed for ROSC after CPR, improve cardiac diastolic and systolic function after R OSC, stabilizing the hemodynamics after resuscitation.
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BACKGROUND: The combination of electric acupuncture and clomipramine is the behavior attempt in the integration of Chinese and western medicine in the treatment of obsession.OBJECTIVE: To probe into the long-term therapeutic effects of the combination of acupuncture and medication on obsession and its influence on social functional recovery.DESIGN: Controlled study with observation in which the patients were taken as the objects.SETTING: Wards of a municipal mental hygiene center PARTICIPANTS: The research was performed in the Fifth People's Hospital of Zibo. Totally 30 inpatients were selected from January 1997 to October 2003 in the hospital, aged varied from 18 to 57 years, at the average of (33 ± 12) years. Thirty patients were divided randomly into two groups,named as experimental group, 15 cases with 8 males and 7 females; and the control group, 15 cases with 7 males and 8 females.METHODS: In the experimental group, electric acupuncture was applied on neiguan, renzhong and chengjiang, together with clomipramine orally. In the control group, only clomipramine was applied. The therapeutic effects and side effects were evaluated with Y-Bocs, TESS and clinical evaluation standards successively before the treatment, at the 4th, 6th and 8th weekends after treatment and by 6 months following visits. SDSS evaluation was carried on at the 8th week of the treatment.MAIN OUTCOME MEASURES: Comparisons of evaluating results with Y-Bocs, TESS and SDSS.RESULTS: At the 4th, 6th and 8th weekends of the treatment, the score-reducing rates of Y-Bocs in the experimental group were higher than those in the control group, but the difference was not significant ( P ＞ 0.05). The scores of TESSin the control group were remarkably higher than those in the experimental group( P ＜ 0. 01 ) . Factor scores of "profession and work" in SDSS in the experimental group were lower than that in the control group ( P ＜ 0.05 ).CONCLUSION: Electric acupuncture on neiguan, renzhong and chengjiang reduces the side effect of clomipramine in the treatment of obsession and improve the living quality of the patients with obsession.
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To study the effect of urokinase on platelet activation and aggregation in the patients with glomerulonephritis. Platelet counts(PC),mean platelet volume (MPV), and platelet distribution width (PDW) were determined with automatic blood cell analytic apparatus, the expressive levels of platelet granular membrane protein (GMP 140) and fibrinogen receptor(GPⅡb Ⅲa) on the surfaces of platelets were assayed with flow cytometry, and the levels of fibinogen and fibrin degradation products (FDP) in blood were measured with ELISA in 102 children with glomerulonephritis. The results showed that urokinase led to PC decreas,MPV increase and PDW exceeding normal value in 102 children with glomerulonephritis, including micro change (MC),glomerulosclerosis (GS),membranous nephropathy (MN), and proliferative glomerulonephritis (PGN).The expressive levels of GMP 140 after the treatment with urokinase were significantly higher than that before the treatment and controls( P 0 01). The results suggested that urokinase used in the patients with glomerulonephritis increased platelet activation function and decreased platelet aggregation function.
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Objective To study the expression of adhesion molecule glycoprotein(CD_(44)) in children with primary nephrotic syndrome(NS) and its clinical significance.Methods The expression of CD_(44) in peripheral blood was detected in 28 children with NS by flow cytometry,controlled by 20 cases of healthy children.Results The CD_(44) expression level of NS in active stage was significantly higher than that of the control(P
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Objective:To investigate the expression of membrane cofactor protein (MCP)?decay accelerating factor (DAF) and homologous restriction factor 20 (HRF 20) on the surface of CD16 +monocyte/macrophage (Mo/M?) in the urine of patients with glomerulonephritis(GN) Methods:The expression of MCP?DAF and HRF 20 on the surface of urinary CD16 +Mo/M? were tested by Flow Cytometry and the levels of urinary sC5b 9 by ELISA in 134 patients with GN that were divided into mini change (MC)?glomerulosclerosis (GS)?membranous nephropathy (MN) and proliferative glomerulonephritis (PGN) Results:The expressions of MCP?DAF and HRF 20 on the surface of urinary CD16 +Mo/M? and the levels of urinary sC5b 9 in the patients with GS ?MN or PGN were significantly higher than those in controls (P
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The multifunctional hitch and suck injector is a new medical instrument that has hitch,injec- tion and incision functions.It can treat all kinds of piles and polyps.Patients have no pains and need not to be in hospital for the treatment.Clinical practice of 2100 cases achieves 97% cure rate.
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Objective:To investigate the expression of CD14 +/CD16 + by monocytes in neonate septicemia and its significance.Methods:The expression of CD14 +/CD16 + by monocytes in 124 neonates was analyzed by Flow cytometry,the levels of IL 6、IL 10 and TNF ? in blood was measured by radioimmunoassay and bacteria culture and drug sensitive were tested by Bactec 9120 bacteria culture system.Results:The expression levles of CD14 +/CD16 + by monocytes and the levels of IL 6 and TNF ? in the septicemia group were significantly higher than those in the normal group and non septicemia group (P
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Objective:To investigate the expression of membrane cofacto protein(MCP)?decay accelerating factor(DAF) and homologous restricition factor 20(HRF 20) on the surface of CD16 + monocyte/macrophage(Mo/M?) in patients with glomerulonephritis(GN).Methods:Tested the expression levels of MCP?DAF and HRF 20 on the surface of CD16 +Mo/M? by Flow Cytometry and the levels of serum C3d and C3d immunologic complex(C3d IC) by ELISA in 136 patients with GN,divided into mini change(MC)?glomerulosclerosis(GS)?membranous nephropathy(MN) and proliferative glomerulonephritis(PGN).Results:The expressions of MCP?DAF and HRF 20 on the surface of CD16 +Mo/M? and the serum levels of C3d in the patients with GS?MN or PGN were significantly higher than those in controls(P
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In order to improve the diagnosis and treatment of severe hemolytic uremic syndrome (SHUS),we summarized the rescuing experiences in 3 children with SHUS.Therefore,close observation of gastro intestinal symptoms,collaborated with repeated examinations of the blood,renal function,urinary output,blood pressure,and manifestations of the central nervous system could help predict to certain extent the occurrence of further hemolysis and renal failure in these patients.Energetic treatment of malignant hypertension and relieving the symptoms of center nervous system could successfully improve renal functions.If urinary output decreased quickly,creatinine (Cr) and blood urea nitrogen (BUN) increased,or severe infection occurred in SHUS patients,hemodialysis should be undertaken as early as possible to prevent caute renal failure and multiple organ failure syndrome (MOFS).Therefore,the treatment of SHUS in children has its peculiarity and complexity.