ABSTRACT
Objective To analyze the effect of Shuxuetong injection on microcirculation in patients with septic shock and its therapeutic effect. Methods A prospective study was conducted. Eighty patients with septic shock treated in Department of Critical Care Medicine of Hebei Provincial Traditional Chinese Medical Hospital were randomly divided into a Shuxuetong group and a conventional therapy group according to random number table, 40 cases in each group. The conventional treatment in the two groups was energetically carried out in accord to the sepsis shock guidelines, such as positive fluid resuscitation, anti-infection, etc. In the Shuxuetong group, additionally Shuxuetong injection 6 mL in 5% glucose injection 250 mL intravenous drip was given once a day for 7 days. The levels of urine output, lactic acid (Lac), blood urea nitrogen (BUN), creatinine (Cr), aspartate aminotransferase (AST), alanine aminotransferase (ALT), left ventricular ejection fraction (LVEF), and cardiac index (CI) in the two groups were observed before and after treatment; the total dosages of dopamine, dobutamine, noradrenaline, etc. vascoactive agent used for the patients and 28-day mortality in the two groups were also recorded. Results The comparisons of levels of urine output, Lac, BUN, Cr, AST, ALT, LVEF, and CI before treatment between the two groups were of no statistical significant differences (all P>0.05). After treatment in the two groups, the urine output, LVEF, and CI were increased compared with those before treatment, whereas the Lac, BUN, Cr, AST, and ALT were significantly decreased, and the changes were more obvious in Shuxuetong group [urine output (mL/h):112.1±39.8 vs. 73.3±28.5, LVEF:0.49±0.15 vs. 0.44±0.14, CI (mL·s-1·m-2):66.2±5.7 vs. 54.2±6.2, Lac (mmol/L):3.83±1.65 vs. 4.72±2.25, BUN (mmol/L):7.1±2.7 vs. 9.3±3.5, Cr (μmol/L): 73.9±16.2 vs. 95.7±15.8, AST (U/L): 39.8±9.5 vs. 45.8±12.7, ALT (U/L):34.3±9.7 vs. 41.7±11.3, all P<0.05]. The total dosages of all kinds of vascoactive agent of Shuxuetong group were remarkably less than those in the conventional therapy group [dopamine (mg): 993.1±261.7 vs. 1 340.9±356.4, dobutamine (mg):776.2±281.0 vs. 1 049.2±364.3, noradrenaline (mg):56.4±34.6 vs. 107.6±51.3, all P<0.05]. The 28-day mortality of Shuxuetong group was obviously lower than that of conventional therapy group [40.0%(16/40) vs. 60.0%(24/40), P<0.05]. Conclusion Shuxuetong injection can improve the microcirculation perfusion in patients with septic shock and reduce their mortality.
ABSTRACT
Objective To Analyze the immunity to secondary infection in the elderly with severe acute pancreatitis.Methods Totally 105 old patients were included in the present study.The ratio of CD4+ to CD8+,and serum levels of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),interleukin-10 (IL-10),and interleukin-4 (IL-4) were determined by flow cytometer analysis or ELISA within 3 days after diagnosis of secondary infection.Results Among 105 old patients,58 cases experienced secondary infection.At 3th day after severe acute pancreatitis,the levels of TNF-α,IL-6,IL-4,IL-10,CD4+,CD8+ and CD4+/ CD8+ were (81.3±5.5)ng/L,(141.2±13.7)ng/L,(61.1±7.4) ng/L,(153.8 ±15.2) ng/L,(43.5±5.5)％,(20.7±2.9)％ and (2.4±0.3) in infection group,as compared with those of (50.8±4.7)ng/1,(81.4±11.7)ng/L,(30.8±7.8)ng/L,(100.3± 13.8)ng/L,(31.6±4.6)ng/L,(29.7±3.5)and (1.1±0.4)in control group,respectively,with statistically significant differences betwveen the two groups (t=7.30,6.51,4.87,4.52,2.88,3.41,4.26,all P＜0.05).At 28th day after SAP,the levels of TNF-α,IL-6,IL-4,IL-10,CD4+,CD8 ± and CD4+ /CD8+ were (29.3±5.8)ng/L,(51.7±7.9)ng/L,(33.8±5.1)ng/L,(82.6±9.5)ng/L,(22.1±3.3)％,(47.1±4.3)％ and (0.6±0.3) in infection group,as compared with those of (44.4±5.5)ng/L,(82.2±7.1)ng/L,(65.3±5.5)ng/L,(109.1±9.5)ng/L,(40.5±2.7)ng/L,(33.4±4.5)ng/L and (1.8±0.4) in control group,respectively,showing statistically significant differences between the two groups(t=3.26,4.93,7.32,3.43,7.41,3.81,4.33,all P＜0.05).Conclusions An early excessive immune response and subsequent immune injury is closely related to secondary severe acute pancreatitis.
ABSTRACT
Unfavorable psychic reactions or psychological crisis always occur in patients preliminarily diagnosed with cancer.By analyzing the psychological activities and affecting factors,we try to discuss the measures of psychological crisis intervention for patients preliminarily diagnosed with cancer.