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Objective To explore the effects of continuous renal replacement therapy (CRRT) on the changes of the respiration and blood circulation as well as peripheral blood cytokines levels in patients with severe acute pancreatitis(SAP) complicated with acute respiratory distress syndrome.Methods 48 SAP patients complicated with acute respiratory distress syndrome were divided into control group and CRRT treatment group according to the parallel control design principle.The control group was treated with routine way,and the CRRT treatment group was treated with CRRT on the basis of routine way.The clinical data and the levels of IL-6,IL-1β,TNF-α were compared between the two groups.Results The levels of IL-6,TNF-α were significantly lower in the CRRT treatment group than those in the control group in 12h [(147.72 ± 22.06) ng/L vs.(132.27 ± 18.03) ng/L,t =2.315,P＜0.05;(236.08 ±41.29) ng/L vs.(208.79±39.25)ng/L,t =2.406,P ＜0.05].The levels of IL-6,IL-1β,TNF-α were significantly lower in the CRRT treatment group than those in the control group in 24h [(136.57 ± 30.74) ng/L vs.(109.98 ± 35.83) ng/L,t =2.184,P ＜ 0.05;(35.76 ± 8.57) ng/L vs.(28.96 ±3,95) ng/L,t =2.237,P ＜0.05;(219.81 ±36.06) ng/L vs.(173.48 ±48.19) ng/L,t =2.206,P ＜0.05].The level of PaO2/FiO2 was significantly higher in the CRRT treatment group than that in the control group in 24h[(139.89 ±35,61) vs.(173.12 ±21.84),t =2.913,P ＜0.01].The levels of Ppeak,IL-1β were significantly lower in the CRRT treatment group than those in the control group in 48h [(28.96 ± 4.14) cmH2 O vs.(24.73 ± 8.52) cmH2 O,t =2.518,P ＜0.05;(29.87 ±5.12) ng/L vs.(23.57 ±3.91) ng/L,t =2.427,P ＜0.05].The levels of IL-6,TNF-αwere significantly lower in the CRRT treatment group than those in the control group in 48h [(117.60 ± 23.46) ng/L vs.(88.56 ± 13.02) ng/L,t =3.062,P ＜ 0.01;(205.25 ± 46.14) ng/L vs.(141.63 ± 33.80) ng/L,t =3.174,P ＜0.01].The level of PaO2/FiO2 was significantly higher in the CRRT treatment group than that in the control group in 48h [(148.07 ± 25.64) vs.(193.23 ± 29.60),t =2.983,P ＜ 0.01].There were no significant differences between the control group and CRRT treatment group in PaO2/FiO2,Ppeak,IL-6,IL-1β,TNF-α before treatment [(103.68±29.65) vs.(107.07 ±25.13),t =0.359,P ＞0.05;(34.62 ±7.36)cmH2O vs.(35.18 ±4.04)cmH2O,t =0.416,P ＞0.05;(152.61 ±31.53)ng/L vs (150.74 ±30.26) ng/L,t =0.668,P ＞0.05;(40.06 ±5.15) ng/L vs.(38.09 ±10.13) ng/L,t =0.819,P ＞0.05;(226.85 ±37.62) ng/L vs.(225.47 ±39.02) ng/L,t =0,702,P＞0.05].Conclusion CRRT can effectively reduce the plasma levels of IL-6,IL-1β,TNF-α in SAP patients complicated with acute respiratory distress syndrome,it has therapeutic effect on the respiration through changing the cytokines of SAP patients complicated with acute respiratory distress syndrome.
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Objective To investigate the serum concentration and expressions of S100β protein in hippocampus CA1 region and the changes of water content in rats with asphyxia following ulinastatin injection after cardiopul-monary resuscitation (CPR). Method One hundred twenty male adult SD rots were randomly divided into 3 groups:sham-operation group, CPR group and ulinastafin group. And each group was further divided into 5 sub-groups (n=8) based on various intervals, 0.5 h,3 h,6 h,12 h and 24 h after tracheotomy in sham-operation group or after ROSC in CPR group and ulinastatin group. Asphyxial cardiac arrest and CPR model of rat was used in CPR group and ulinastatin group in which bolus dose of 100 000 U/kg ulinastatin was injection into arteria carotis. Anaesthesia, tracheotomy and vascular canratlafion without asphyxia and CPR in sham-operation group. Samples from subgroups were taken at different intervals. Brain water content was measured by using wet-dry weight method. Serum S100β protein was measured with enzyme-linked immunosorbent assay ( ELISA). The expres-sion of S100β protein in hippocampus CA1 region was measured by using immunohistochemistry. Data were ana-lyzed by SPSS version 10.0 software. Results Compared with sham-operation group, the brain water content of rats elevated significantly in all CPR subgroups after ROSC (P<0.05 or P<0.01). The brain water content of rats decreased significantly 12 h and 24 h after ROSC in ulinastatin group in comparison with CPR group (P<0.05). The serum S100β protein started to elevated significantly 0.5 h after ROSC in CPR group, and reached the peak 12 h after ROSC (P<0.01).serum S100β decreased 6 h,12 h and 24 h after ROSC in ulinastatin group compared with CPR group (P<0.01).The expression of S100β protein in hippocampus CA1 region remained at a low level in sham-operation group. The expression of S100β protein elevated significantly in all CPR subgroups after ROSC compared with sham-operation group (P<0.05 or P<0.01). Compared with CPR group, the ex-pression of S100β protein decreased after ROSC in ulinastatin group(P<0.05) .However,the expression of S100β protein in hippocampus CA1 region was significantly correlative with brain edema in all subgroups of CPR (r=0.862, P<0.05). Conclusions Ulinastatin can decrease serum S100β protein and the expression of S100β pro-tein in hippocampus CA1 region and lessen the severity of cerebral edema, alleviate the brain isehemic injury in rats after cardiopulmonary resuscitation.
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Objective To study the effects of isotonic and resistance exercises on renal hormones in plasma. Methods Eight healthy men were instructed to performed isotonic and resistance exercises, respectively, with the same target heart rate and the same exercise duration, in which both exercises-induced changes of plasma renin activity (PRA), aldosterone (ALDO) and antidiuretic hormone (ADH) were observed. Results Plasma levels of PRA, ALDO and ADH increased significantly after both isotonic exercise and resistance exercises. Plasma levels of ADH and PRA were higher after resistance exercise than those after isotonic exercise. Conclusion The increases of PRA, ALDO and ADH in plasma caused by exercise might be an adaptive response to maintain balances of water and electrolyte in the status of physical stresses. The tendency of increase of ADH and PRA after resistance exercise suggested that the exercise intensity rather than type of exercise correlated with on the changes of renal hormones.
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@#回顾结肠、直肠动力和排便的基本生理学特征 ,阐述脊髓损伤对排便的影响 ,讨论目前临床上的治疗措施 ,并提出新的治疗和研究方向。
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Exercise is effective in preventing and treating diseases of heart ,brain and lung . It plays a define role in treating the risk factors of these diseases such as hypctronsion , hyperlipemia , diabetes and obesity . This study discussed the development of domestic reha-bilition medicine and the diffence with developed countries . We also considered how to improve exercise therapy.
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pulmonary diseases, evaluation of respiratory function and exercise therapy were discussed in this study.
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@#Isometric exercise(IE) is an essential component of daily living activities.Lack of IE may result in deconditioning of IE capacity.IE has not been used in cardiac rehabilitation because of poor understanding in cardiovascular response to IE and the Valsalva Maneuver associated with IE.Eingteen healthy young subjects aged 23.7 yrs on average was studied by administration of beta blocker and antagonist of opioids during IE.The result demonstrated that the regulation of cardiovasular response during IE is attributed to both sympathetic system and opioids activity.Twenty patients with coronary artery disease (CAD) were also studied during brief maximal IE,sustained maximal IE and dynamic exercise(DE).The patients included 13 cases with more than one vessel lesions and 7 post myocardial infarction and/or angina.Ten age matched apparent healthy subjects were examined as the control group.The result showed that IE without the Valsalva Maneuver in patients with CAD might increase coronary artery perfusion by enhancing diastolic pressure and prolonging diastolic period,which had no harmful effect on CAD.Hemodynamic responses and cardiac function were weaker during IE than DE.The intensity of the responses to IE was correlated to the central command but not to the absolute work load.It is concluded that significant release of endogenous opioids due to strong central command during IE,especially perceived maximal sustained IE,may help to attenuate activity of sympathetic system,thus reducing risk of exercise in patients with CAD.
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A study on 48 middle-aged and elderly joggers through exercise echocardio-graphy and measurements during systolic time intervals (STI) showed that whencompared with a control group of 26 sedentary persons, their stroke volume was44.2% and cardiac output 25.1% greater at rest, 34.3% and 15.8% greater duringequivalent load exercise, and 35.1% and 33.1% grater during equivalent heart rateexercise. In addition, their left ventricular end-diastolic diameter (LVEDd) andleft auricule diameter were also longer and the closing velocity of the mitral valveduring the early diastolic stage was greater, although their ejection fraction, AD%and STI showed no significant difference. This proves that jogging can improvecardiac pumping function by enlarging LVEDd and increasing pre-load of heart.
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To resolve the problem of methodology of exercise echocardiography andthe criterion and value for evaluating left ventricular (LV) pumping func-tion, 68 healthy persons (age 54.8?8.9 years) and 48 patients with coronary artery disease (age 57.6?5.7 years) were studied by echocardiography bothat rest and during bicycle ergometer exercise in the supine position. Mostsubjects (76.8%) having clear echocardiograms at rest also acquired cleartracing during exercise. Fifty percent of patients had abnormal responsesto exercise. There were no increase in ejection fraction (EF%), percentchanges of diameter (△D%) and stroke volume index (SVI). All these weresensitive indices for determining LV pumping function reserve. Six indicesincluding △D%, PEP/LVET, mVcf at rest, exercise, increment of EF%, △D%and SVI were used as comprehensive assessing criterion of LV pumpingfunction. Compared with the indices of the rest state, the abnormal ratioof LV pumping dysfunction found in patients were raised from 21% to 37%by the indices of the exercise increment and further to 56% by the compre-hensive assessing criterion. This was not in the case of healthy persons.It showed that exercise echocardiography and comprehensive assessing cri-terion might enhance the sensitivity of evaluating LV pumping functionwithout affecting its specificity. It is suggested that they might be adaptedin the research works in rehabilitation medicine and sports medicine.