ABSTRACT
Objective:To study the guiding value of renal artery ultrasound in cardiopulmonary resuscitation (CPR) for patients with cardiac arrest and its influence on the rescue effect.Methods:A total of 130 patients with cardiac arrest who were treated in Zhejiang Xin'an International Hospital from February 2017 to December 2019 were collected in the study.They were divided into observation group and control group according the random digital table method, with 65 cases in each group.The control group received routine CPR, while the observation group received CPR guided by bedside renal artery ultrasound.The rescue effect, blood gas index, myocardial injury index and survival rate of the two groups were compared.Results:The recovery time of spontaneous rhythm, respiration and consciousness in the observation group were (6.78±2.93)min, (12.09±3.93)min, (17.29±5.87)min, respectively, which were lower than those in the control group [(8.63±3.13)min, (14.12±4.17)min, (21.03±6.12)min], and there were statistically significant differences between the two groups( t=3.479, 2.856, 3.556, all P<0.05). The levels of PaO 2, SaO 2 and PaCO 2 in the observation group were (12.80±2.99)kPa, (92.33±5.81)% and (3.11±1.22)kPa, respectively, which in the control group were (10.45±2.86)kPa, (89.11±5.14)% and (3.98±1.35)kPa, respectively, and the differences between the two groups were statistically significant( t=4.579, 3.347 and 3.855, all P<0.05). ).The 24-hour survival rate and discharge survival rate of the observation group were 86.15% (55/65) and 78.46% (51/65), respectively, which were higher than those of the control group [70.77% (46/65) and 61.54% (40/65)], and there were statistically significant differences between the two groups(χ 2=4.552 and 4.432, all P<0.05). Conclusion:CPR guided by bedside renal artery ultrasound has good rescue effect in patients with cardiac arrest.It can shorten the time of spontaneous rhythm, respiration and consciousness recovery, improve the blood gas index of patients, reduce the myocardial injury of patients, and improve the survival rate of patients.It can be widely used in emergency department.
ABSTRACT
Objective:To investigate the levels of plasma high mobility group protein B1 (HMGB1), helper T cell 17 (Th17) and regulatory T cell (Treg) in patients with acute severe cholecystitis and its correlation.Methods:One hundred and twenty patients with acute severe cholecystitis were selected as the cholecystitis group, and 120 healthy subjects during the same period were selected as the control group from January 2017 to December 2018 in Zhejiang Xin′an International Hospital. Enzymelinked immunosorbent assay was used to determine the levels of HMGB1, interleukin (IL)-17 and transforming growth factor-β (TGF-β). Flow cytometry was used to determine Th17 and Treg cell levels. The patients in cholecystitis group received percutaneous transhepatic cholecystectomy combined with laparoscopic surgery, and the levels of above mentioned were detected and compared.Results:The levels of HMGB1 and Th17 cells in the cholecystitis group were higher than those in the control group, the level of Treg cells was lower than that in the control group [(9.84 ± 0.82) μg/L vs. (4.12 ± 0.75) μg/L, (4.02 ± 0.31)% vs. (1.53 ± 0.24)%, (3.16 ± 0.65)% vs. (6.17 ± 0.73)%], and the differences were statistically significant ( P<0.01). The level of IL-17 in the cholecystitis group was higher than that in the control group, the level of TGF-β was lower than that in the control group [(37.46 ± 4.73) ng/L vs. (18.52 ± 4.32) ng/L, (4.32 ± 0.64) μg/L vs. (6.84 ± 0.67) μg/L], and the differences were statistically significant ( P<0.01). The serum HMGB1 level in patients with acute severe cholecystitis was positively correlated with Th17( r=0.564) and IL-17( r=0.602), was negatively correlated with Treg ( r=- 0.518) and TGF-β( r=- 0.563), and the differences were statistically significant ( P<0.01). In the cholecystitis group, after treatment the levels of HMGB1, Th17, IL-17 were decreased [(4.76 ± 0.75) μg/L vs. (9.84 ± 0.82) μg/L, (1.82 ± 0.24)% vs. (4.02 ± 0.31)%,(16.27 ± 4.28) ng/L vs. (37.46 ± 4.73) ng/L], the levels of Treg, TGF-β were increased [(5.58 ± 0.73)% vs. (3.16 ± 0.65)%, (5.23 ± 0.55) μg/L vs. (4.32 ± 0.64) μg/L], and the differences were statistically significant ( P<0.01). Conclusions:Patients with acute severe cholecystitis have elevated levels of HMGB1 and Th17 in plasma and have decreased levels of Treg. The levels of HMGB1, Th17 and Treg cells can reflect the therapeutic effect. HMGB1 is closely related to the imbalance of Th17/Treg.