ABSTRACT
Objective:To investigate the types, incidences, and clinical characteristics of shock in polytrauma patients at different stages after polytrauma.Methods:A retrospective study was conducted on polytrauma patients admitted to multiple trauma centers from June 2020 to December 2021. The inclusion criteria were patients >18 years old and treated due to polytrauma. Exclusion criteria included an admission time of more than 48 h after trauma, a history of malignancy, or metabolic, consumptive, and immunological diseases. The early stage was defined as the period of ≤48 h after polytrauma, and the middle stage was defined as the period between 48 h and 14 days. The patient’s medical history, clinical manifestations, laboratory tests, imaging examination, injury severity score (ISS), and Glasgow coma scale (GCS) were collected. The types, incidences, and clinical characteristics of shock in different stages after polytrauma were analyzed, according to the diagnostic criteria of each type of shock. The differences between the groups were compared by Student’s t test, χ2 test or Mann-Whitney U test. Results:The incidence of the early and middle stage shock after polytrauma were 73.1% and 36.4%, respectively, with statistically significant difference between stages ( P<0.01). There were significant differences in the incidence of hypovolemic shock (83.6% vs. 28.4%), distributed shock (13.7% vs. 80.9%) and cardiogenic shock (3.5% vs. 6.6%) between stages (all P<0.05). The incidence of obstructive shock (8.4% vs. 9.7%, P>0.05) was similar between stages. The incidence of undifferentiated shock was 1.6% and 1.2%, respectively. There were 9.5% patients with multifactorial shock in the early stage and 14.4% in the middle stage. Totally 7 combinations of multifactorial shock were found in different stages after polytrauma. In the early stage, the combination of HS and DS accounted the highest ratio (42.3%) and followed by HS and OS for 28.8%. In the middle stage, the combination of HS and DS was the most common (48.6%) and followed by DS and OS (24.3%). Conclusions:The incidence of shock in polytrauma patients is high. Different types of shock can occur simultaneously or sequentially. Therefore a comprehensive resuscitation strategy is significant to improve the success rate of treatment.
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Objective To observe the influence of Xin-ke-shu Capsule (XKSC) on NO and ET in patients with coronary artery disease(CAD) combined with type 2 diabetes mellitus(T2DM), and to investigate its mechanism of treatment. Methods 80 patients with CAD combined with T2DM were randomly recruited into two groups: 40 patients in the treatment group were treated by conventional therapy plus XKSC, and the 40 in the control group treated by conventional therapy exclusively. The plasma level of NO and ET was observed before and after the three-month therapeutic course. Results The plasma level of ET in the treatment group significantly decreased after the treatmaent and was lower than that in the control group(P<0.01), but NO in the treatment group elevated significantly and was higher than that in the control group (P<0.01). Conclusion Xin-ke-shu Capsule displays its effect on protecting vascular endothelia by elevating the level of NO and decreasing the plasma level of ET.
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levels are elevated in patients with NAFL and correlated with HOMA-IR, suggesting RBP4 may participate in the development of IR and NAFL.