ABSTRACT
Mori Cortex is sweet and pungent in taste， cold in nature， and has the tropism to the lung meridian. It has the functions of purging the lung and relieving asthma and can treat oliguria and edema， being one of the commonly used herbal medicines in clinical practice. The prescriptions with Mori Cortex， such as Sangbaipi Tang， Qingjin Huatanfang， and Qingfei Huatantang， are widely used in clinical practice. The main active components in Mori Cortex are the material basis for its efficacy. Owing to the mature methods for the identification of pharmacodynamic substances in Chinese herbal medicines， the research on the chemical components of Mori Cortex has been in-depth and systematic. This article reviews the recent studies about the chemical components and pharmacological effects of Mori Cortex， as well as the treatment of respiratory diseases by the prescriptions with Mori Cortex. On this basis， the effect and mechanism of Mori Cortex and related prescriptions in the treatment of respiratory diseases are summarized. Furthermore， this article analyzes the formulation compatibility and commonly used dosages of Mori Cortex-related prescriptions in clinical practice. It provides reference for the clinical application of Mori Cortex and related prescriptions in the treatment of respiratory diseases.
ABSTRACT
Mori Cortex is sweet and pungent in taste， cold in nature， and has the tropism to the lung meridian. It has the functions of purging the lung and relieving asthma and can treat oliguria and edema， being one of the commonly used herbal medicines in clinical practice. The prescriptions with Mori Cortex， such as Sangbaipi Tang， Qingjin Huatanfang， and Qingfei Huatantang， are widely used in clinical practice. The main active components in Mori Cortex are the material basis for its efficacy. Owing to the mature methods for the identification of pharmacodynamic substances in Chinese herbal medicines， the research on the chemical components of Mori Cortex has been in-depth and systematic. This article reviews the recent studies about the chemical components and pharmacological effects of Mori Cortex， as well as the treatment of respiratory diseases by the prescriptions with Mori Cortex. On this basis， the effect and mechanism of Mori Cortex and related prescriptions in the treatment of respiratory diseases are summarized. Furthermore， this article analyzes the formulation compatibility and commonly used dosages of Mori Cortex-related prescriptions in clinical practice. It provides reference for the clinical application of Mori Cortex and related prescriptions in the treatment of respiratory diseases.
ABSTRACT
Objective:To explore the value of critical ultrasound in evaluating the fluid responsiveness of small dose volume challenge in patients with septic shock.Methods:Thirty-six patients with septic shock admitted to the Third People's Hospital of Datong from January 2021 to December 2021 were enrolled, and the patients were randomly divided into control group and observation group, with 18 patients in each group. The control group was treated with traditional fluid challenge (500 mL of crystalloid injected within 30 minutes); the observation group received a small dose fluid challenge (100 mL of crystalloid injected within 1 minute). The hemodynamic indexes [central venous pressure (CVP), invasive mean arterial pressure (MAP), velocity-time integra (VTI)] and bilateral lung ultrasound scores were measured by critical ultrasound in both groups. The outcome related indicators of patients in the two groups were observed. The correlation between the above indexes and the fluid challenge was evaluated.Results:Compared with the control group, the heart rate (HR) and CVP of patients in the observation group after the challenge were significantly lower than those in the control group [HR (times/min): 99.74±3.22 vs. 107.65±3.14, CVP (mmHg, 1 mmHg ≈ 0.133 kPa): 7.55±0.22 vs. 10.26±0.52, both P < 0.05], invasive MAP and VTI were significantly higher than those in the control group [invasive MAP (mmHg): 77.36±2.14 vs. 69.81±2.56, VTI (cm/s): 68.85±1.26 vs. 44.71±1.28, both P < 0.05]. The ultrasonic score of the observation group was significantly better than those of the control group (all P < 0.05). In terms of outcome, the length of intensive care unit (ICU) stay, mechanical ventilation time and the time for urine volume more than 0.5 mL·kg -1·h -1 of the observation group were significantly shorter than those in the control group [the length of ICU stay (hours): 138.26±1.25 vs. 205.73±1.26, mechanical ventilation time (hours): 36.80±0.25 vs. 47.65±0.36, time to reach urine volume more than 0.5 mL·kg -1·h -1 (hours): 27.38±1.25 vs. 38.61±1.30, all P < 0.05], The dosage of norepinephrine was significantly decreased in the observation group compared with the control group (mg: 45.26±1.85 vs. 53.73±1.92, P < 0.05), and the amount of resuscitation crystalloid was significantly reduced compared with the control group (mL: 1 532.62±12.38 vs. 1 755.52 ± 12.30, P < 0.05). Correlation analysis showed that the volume of crystalloid was highly consistent with M-BLUE pulmonary ultrasound (zone 2, 4 and 5), mechanical ventilation time, norepinephrine dose, time to reach the standard of urine volume and ΔVTI (all P < 0.05). Conclusions:Small dose fluid challenge evaluated by critical ultrasound in septic shock patients has a high value for fluid responsiveness, which can better reduce the risk of obvious tissue edema caused by fluid overload, organ damage and even life-threatening, make fluid challenge more reasonable and appropriate, thereby improving the success of treatment.
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Objective To explore the correlation between major inflammatory factors and septic shock in intensive care unit (ICU) patients, and to provide a basis for the diagnosis and treatment of septic shock. Methods The patients admitted to ICU of the Third People's Hospital of Datong from March 2017 to August 2018 were selected as the research objects. According to the diagnostic criteria of septic shock, the patients were divided into septic shock group and non-septic group. The basic information and inflammatory factors levels of the two groups, including age, gender, body mass index (BMI), course of disease, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), infection site and pathogenic; and C-reactive protein (CRP), procalcitonin (PCT), neutrophil lymphocyte ratio (NLR), N-terminal pro-B-type natriuretic peptide (NT-proBNP), tumor necrosis factor-α (TNF-α), γ-interferon (IFN-γ), interleukins (IL-1β, IL-2, IL-6, IL-8) at 8 hours after diagnosis, were compared. Logistic regression was used to analyze the influencing factors of septic shock in ICU patients. Results A total of 154 ICU patients were selected, of whom 74 had septic shock. The APACHEⅡ score of septic shock group was significantly higher than that of non-sepsis group (23.42±3.64 vs. 15.67±2.26, P < 0.05). There was no significant difference in other baseline data between the two groups. The levels of CRP, NT-proBNP, TNF-α, IFN-γ, PCT, IL-6, IL-8 in the septic shock group were significantly higher than those in the non-septic group [CRP (mg/L): 164.3±22.6 vs. 52.3±16.2, NT-proBNP (ng/L): 426.3±288.9 vs. 167.3±80.6, TNF-α (ng/L): 193.4±39.3 vs. 88.1±20.3, IFN-γ (ng/L): 133.3±52.0 vs. 97.0±56.1, PCT (ng/L):27.6±10.2 vs. 7.3±4.1, IL-6 (ng/L): 83.0±17.6 vs. 20.9±6.4, IL-8 (ng/L): 445.8±34.0 vs. 84.0±25.7, all P < 0.05]. It was shown by Logistic regression analysis that CRP, NT-proBNP, TNF-α, PCT, IL-6 were independent risk factors for septic shock [CRP: odds ratio (OR) = 1.662, 95% confidence interval (95%CI) = 1.132-2.567; NT-proBNP: OR = 14.688, 95%CI = 3.580-20.238; TNF-α: OR = 1.093, 95%CI = 1.043-1.343; PCT: OR = 6.378, 95%CI = 4.556-12.243; IL-6: OR = 9.641, 95%CI = 2.242-13.786; all P < 0.05]. Conclusion The levels of inflammatory factors CRP, NT-proBNP, TNF-α, PCT and IL-6 were significantly increased, which were important factors for early diagnosis of septic shock.
ABSTRACT
Objective To discuss the method and efficiency of less invasive stabilization system (LISS) in treatment of comminuted tibia[ fractures. Methods A total of 14 patients with comminuted tibial fractures were treated with LISS between January 2005 and July 2006. There were 10 males and four females, at age range of 19-61 years (mean 34 years). Of all, 11 patients were with proximal fractures of tibia and three with distal ones, including six with open fractures and eight with closed ones. The period from injury to operation was 2-13 days. An observation was done on postoperative soft tissue recovery and fracture healing. Results The average period of follow-up was 9.4 months (4-16 mouths). All frac-tures were healed up after average 7.8 months (4-12 months). All incisions were healed up at one stage, with no complications on nerves, blood vessels or soft tissues. The axes of tibia were good, with sound function of knee and ankle joints. Conclusion LISS is characterized by easy operation, minor trauma, high healing rate and low complications in treatment of comminuted tibial fractures.