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Objective To analyze the effects of dexmedetomidine(Dex) on levels of inflammatory cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods From April 2015 to April 2017,94 patients with acute exacerbations of COPD who received mechanical ventilation in Wenling Hospital Affiliated to Wenzhou Medical College were randomly divided into two groups according to the digital table,with 47 cases in each group. Group A was given Dex,and group B was given midazolam. The levels of TNF - α,IL - 1, hs - CRP between the two groups were compared. Results There were no statistically significant differences in TNF - α,IL - 1,hs - CRP between the two group before treatment (all P > 0. 05). One day after treatment,the levels of TNF - α,IL -1,hs - CRP in group A were (92. 99 ± 15. 25)ng/ L,(68. 63 ± 14. 53)ng/ L,(15. 44 ± 4. 92)mg/ L, respectively,which in group B were (150. 63 ± 20. 78)ng/ L,(91. 13 ± 12. 58)ng/ L,(19. 35 ± 5. 17)mg/ L,respec-tively,there were statistically significant differences between the two groups(t = 2. 736,2. 503,2. 421,P = 0. 008, 0. 012,0. 015). Three days after treatment,the levels of TNF - α,IL - 1,hs - CRP in group A were (73. 37 ± 11. 01)ng/ L,(51. 52 ± 9. 16) ng/ L, (14. 82 ± 3. 29) mg/ L, respectively, which in group B were (123. 80 ± 19. 62)ng/ L,(73. 46 ± 17. 36) ng/ L, (18. 77 ± 4. 02 ) mg/ L, respectively, there were statistically significant differences between the two groups(t = 2. 184,2. 354,2. 098,P = 0. 031,0. 022,0. 039). Five days after treatment, the levels of TNF - α,IL - 1,hs - CRP in group A were (63. 54 ± 13. 06)ng/ L,(34. 04 ± 8. 13) ng/ L,(13. 84 ± 4. 13)mg/ L,respectively,which in group B were (76. 63 ±17. 39)ng/ L,(50. 66 ± 9. 17)ng/ L,(14. 27 ± 3. 95)mg/ L, respectively,there were statistically significant differences between the two groups( t = 1. 906,2. 082,1. 834,P =0. 067,0. 041,0. 081). Compared with group B,the ICU time in group A was significantly decreased[(9. 27 ± 1. 63) d vs. (7. 16 ± 1. 21)d,t = 2. 215,P = 0. 031](t = 2. 215,P = 0. 031). There was no statistically significant difference in the incidence rate of multiple organ dysfunction syndrome between the two groups at 5 days after treatment (χ2 =2. 286,P = 0. 132). Conclusion Dex can effectively inhibit inflammation cytokines of the mechanical ventilation COPD patients in acute exacerbation,and can reduce the ICU time.
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Objective@#To investigate the expression of programmed death-1 (PD-1) in liver tissue and its association with liver pathology in patients with autoimmune hepatitis (AIH).@*Methods@#A total of 54 AIH patients (38 in the active stage and 16 in the remission stage) were enrolled, and 9 healthy volunteers were enrolled as control group. Immunohistochemistry combined with quantitative image analysis was used to measure the expression of PD-1 in liver tissue. The t-test, rank sum test, one-way analysis of variance, least significant difference t-test, Mann-Whitney U test, and Pearson relation analysis were used for statistical analysis of different types of data.@*Results@#The AIH group had a significantly higher positive rate of PD-1 in liver tissue than the control group (13.57%±6.84% vs 2.22%±0.66%, P < 0.01), and the patients in the active stage of AIH had a significantly higher positive rate of PD-1 in liver tissue than those in the remission stage (16.53%±7.72% vs 6.56%±3.16%, P < 0.01). The positive rate of PD-1 in liver tissue was 6.56%±3.16% in G0 group, 14.33%±5.08% in G1-2 group, and 19.23%±5.41% in G3-4 group (P < 0.01), but there was no significant difference in the positive rate of PD-1 between S0, S1-2, and S3-4 groups (P > 0.05). In AIH patients, the positive rate of PD-1 in liver tissue was positively correlated with the levels of total bilirubin, alanine aminotransferase, aspartate aminotransferase, and IgG (r = 0.665, 0.721, 0.711, and 0.813, all P < 0.01).@*Conclusion@#AIH patients have regulated PD-1 expression in liver tissue, which is closely associated with liver inflammation and is not associated with fibrosis degree, suggesting that PD-1 is involved in the development and progression of inflammation in AIH patients.
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Objective To investigate the clinical efficacy of Chinese herbal medicine and liquid wax in treating oral apatinib-induced hand-foot syndrome. Method Thirty patients with gastric or gastroesophageal junction adenocarcinoma, who had developed hand-foot syndrome after oral administration of apatinib for four weeks, with grade 0 in 3 cases, grade Ⅰ in 16 cases, grade Ⅱ in 9 cases and grade Ⅲ in 2 cases, were enrolled and treated by external application of Chinese herbal medicine and liquid wax on both hands and feet for three weeks. Result The 30 patients with hand-foot syndrome had grade 0 in 14 cases, grade Ⅰ in 14 cases, grade Ⅱ in 2 cases and grade Ⅲ in 0 case after treatment with Chinese herbal medicine and liquid wax. There was a definite therapeutic effect and a statistically significant difference (P<0.05). Conclusion External application of Chinese herbal medicine and liquid wax on both hands and feet for hand-foot syndrome not only has a definite therapeutic effect but is also an ideal means of prevention and treatment because of its noninvasive procedure and the high compliance of the patients.
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Objective To investigate the effects of Yindan Xinnaotong Soft Capsule on oxidative stress and vascular endothe‐lial function in the patients with type 2 diabetes mellitus(T2DM ) .Methods A total of 86 patients with T2DM were randomly di‐vided into the routine glucose‐reducing group(routine group ,40 cases) and the Yindan Xinnaotong Soft Capsule group(Yindan Xin‐naotong group ,46 cases) .On the basis of diet control and exercise ,the routine group was given the glucose‐reducing therapy for blood glucose reaching the standard for 12 successive weeks ,while on the basis of blood glucose reaching the standard by the rou‐tine therapy ,the Yindan Xinnaotong group was added with Yindan Xinnaotong Soft Capsule ,1 .2 g per time ,3 times daily for 12 successive weeks .The changes of blood lipids ,MDA ,SOD ,NO and ET were determined before treatment and after 12‐week treat‐ment .The flow mediated endothelium‐dependent diastolic function (FMD) and non‐flow mediated endothelium‐dependent diastolic function (NMD) in brachial artery were simultaneously detected using ultrasonography .Results After 12 weeks of treatment ,the levels of TC ,TG ,LDL‐C ,MDA and ET in the two group were obviously decreased compared with before treatment ,the levels of HDL‐C ,SOD ,NO and FMD in both groups were increased (P<0 .05);moreover the above indexes after treatment in the Yindan Xinnaotong group had significant changes compared with the routine group (P<0 .05) .Conclusion Yindan Xinnaotong Soft Cap‐sule can down‐regulate oxidative stress and regulate the lipid metabolic abnormality and obviously improve the injured vascular en‐dothelial function in T2DM .
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Objective To investigate the effects of early continuous renal replacement thempy(CRRT)on acute lung injury and prognosis in severe acute pancreatitis (SAP)patients.Methods 46 SAP patients were divided into the two groups randomly:the control group and CRRT treatment group.The levels of IL-1β,IL-6,TNF-α,the APACHEⅡscore,oxygenation index,the incidence of acute lung injury(ALI)/acute respiratory distress syndrome (ARDS),ICU stay were compared between the two groups.Results The level of interleukin-6(IL-6)in the con-trol group was significantly higher than that in CRRT group in day 1(t=2.265,P0.05).Conclusion Early CRRT therapy can eliminate the IL-1β,IL-6 and TNF-αin SAP patients,which can improve the oxygenation index and reduce the incidences of ALI/ARDS,may provide more clinical benefits in the early phase of SAP.