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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.
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Distortion will occur when testing medical microwave products, due to its high power, high frequency, in the existing radiated emission testing process which will cause saturation non-linear of the pre-amplifier. It will lead to test distorted, the test results are not accurate. This article will improve the original test method by adding some suppressing-frequency devices to suppress the main frequency energy and avoid pre-amplifier saturation, eliminate distortion. All of this will ensure the test results are effective and relia ble.
Subject(s)
Amplifiers, Electronic , Equipment Design , Equipment and Supplies , Materials Testing , MicrowavesABSTRACT
With the enforcement of YY 0505-2012, the testing items and evaluation points of radio frequency ablation catheter in electromagnetic compatibility field should be studied and discussed. Based on the requirements of relevant standards, this paper discusses on the testing items that should be applied and the evaluation points that should be focused on by analyzing the intended use and the structure of radio frequency ablation catheter, when it intends to apply registration individually with the basic knowledge of electromagnetic compatibility field.
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Catheter Ablation , Electromagnetic Fields , Electromagnetic Phenomena , Evaluation Studies as TopicABSTRACT
Objective To analyze the characteristic colligation force vector curves in hemiplegic patients. Methods Eleven hemiplegic patients were recruited, and 11 healthy elderly served as control. The characteristic changes of the patients with regard to colligation force vector demonstrated on a feedback apparatus of the "X.O.S"system during the dynamic training exercise program were analyzed and compared with that of the control group. Results The value of the colligation force vector passing most of the regions were significantly decreased ( P
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Objective To explore the effect of fuzhengyangyingtang (FZYYT) on bone marrow proliferation in aplastic anemia (AA) mice. Methods AA mice models were set up according to Yaojun descriptive method, and then were randomly divided into FZYYT group, CsA group, FZYYT+CsA group, and AA group, each group containing 10 animals. 10 healthy mice served as control. The former three groups were fed with FZYYT, CsA and FZYYT+CsA, respectively, and the last two groups were fed with normal saline. After fed 10 days the changes in hemoglobin(Hb), platelet, BMNC and bone marrow hematopoiesis tissue volume were determined. Resutls Hb, platelet, BMNC and bone marrow hematopoiesis tissue volume obviously increased in groups FZYYT and CsA compared with AA group, and were the highest in group FZYYT+CsA. Conclusion The results indicated that FZYYT was effective in the treatment of AA.
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0.05);the therapeutic effect on slight syncope-collapse syndrome and septic shock is superior to the control group(P
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Objective To observe the long-term toxicity of Jiuxin Fumai Injection and to investigate the safety of clinical medication.Methods The rats were given intramuscular injection with Jiuxin Fumai Injection in large,medium,small dosage(respectively 20,10,5g? kg-1)every day for two weeks,and normal saline group served as the normal control.Two weeks after drug withdrawal,the toxic reaction in rats was observed.Results After two-week continuous administration,all the animals were alive.Some animals were vomiting and getting excited when administered the large dosage and medium dosage injection.The blood sugar elevated,the thoracic gland coefficient lowered,the hepatic cells were cloudily swollen in the animals of large dosage group.Two weeks after drug withdrawal,the above phenomenon vanished.There was no obvious toxic reaction in the small-dosage injection group.Conclusion Long-term administration of Jiuxin Fumai Injection in large dosage shows certain toxic reaction in rats.The safe dosage for intramuscular administration is less than 5 g? kg-1? d-1.
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Objective To investigate the changes of uveoscleral pathway by an I1 receptor agonist,moxonidine,and with pretreatment of antagonists topical administration,and to study the mechanism that moxonidine improves uveoscleral outflow.Methods Moxonidine was administered unilaterally and topically to rabbits and with pretreatment of the antagonists,namely,prazosin,yohimbine and efaroxan.FITC-BSA,a tracer agent,was injected into the anterior chamber after moxonidine treatment or with pretreatment of the antagonists.Frozen sections were undertaken at different time points between 2 to 10 h.Fluorescence intensity was observed in the sites of uveoscleral pathway in the sections by fluorescence microscopy.Results Bilateral fluorescence intensity treated with moxonidine was more intense than that with placebo,and the most intense regions of fluorescence were ciliary body and superchoroidal space.Fluorescence intensity by prazosin pretreatment was not significantly different compared to that by moxonidine,while yohimbine and efaroxan pretreatment decreased the intensity compared with moxonidine(P