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Objective To discuss the effect of melatonin on sleep and agitation in patients who had undergone tracheotomy in ICU.Methods Sixty-six tracheotomisd patients of ASA Ⅱ or Ⅲ in ICU were included,age 18-60 years,weaning from mechanical ventilation not receiving continuous sedation.We conducted a double-blind, placebo-controlled randomized pilot study comparing melatonin with placebo in such patients.They were allocated into two groups by compute randomiza-tion-melatonin group(n =32)and control group(n = 34).We administered either oral melatonin (3 mg)or placebo at 20∶00 for 7 days.We collected pre-and post-dosage blood samples on days 1 and 3 to confirm drug delivery.The hours of sleep at day and night were assessed by the bedside nurse as the primary outcome.And the secondary outcome included comparison of the incidence of agitation, assessed by score on the Riker Sedation Agitation Scale,and requirement for sedatives or haloperidol to settle agitation.Results Pre-treatment melatonin levels in the two groups were similarly low.Post-treatment,melatonin levels increased significantly in the melatonin group compared with the placebo group (3 233±1 961 )pg/ml versus (3.8 ± 2.2 )pg/ml(P < 0.05 ).And subsequently the observed sleep time in the two groups was (1 1.9±2.0)hours for melatonin vs (7.8±1.6)hours for placebo, respectively (P < 0.01 ).The incidence of agitation was significantly lower in the melatonin group (0% vs 8.8%).Conclusion Melatonin is well absorbed,and a standard dose increases blood levels approximately 1000-fold.Furthermore it would help the tracheotomisd patients sleep and ease agitation in ICU.
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<p><b>OBJECTIVE</b>To analyze the drug resistance and drug resistance genes of imipenem-resistant Pseudomonas aeruginosa (IRPA) strains isolated from burn wards.</p><p><b>METHODS</b>From June 2011 to June 2012, 30 strains of IRPA were isolated from wound excretion, sputum, and venous catheter attachment from burn patients hospitalized in Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine. Drug resistance of the IRPA to 12 antibiotics commonly used in clinic, including ceftazidime, amikacin, ciprofloxacin, etc., was tested with K-B paper agar disk diffusion method. Metallo-β-lactamase (MBL)-producing IRPA was detected by synergism test with imipenem-2-mercaptoethanol. Plasmid of IRPA was extracted, and it was inserted into competent cells, producing transformation strains (TSs). Drug resistance of TSs to imipenem and the MBL-producing TSs were detected. The genes blaIMP, blaVIM, blaOXA-1, blaOXA-2 and blaOXA-10 of IRPA and the TSs were detected by polymerase chain reaction. The drug resistance of IRPA producing MBL or OXA enzyme was summed up.</p><p><b>RESULTS</b>The sensitive rates of the 30 strains of IRPA to the 12 antibiotics were equal to or above 60.0%. Six strains of MBL-producing IRPA were screened. Twenty-four TSs were resistant to imipenem, and 6 strains among them were MBL-producing positive. Among the 30 strains of IRPA, 6 strains and their corresponding TSs carried blaVIM; 20 strains and their corresponding TSs carried blaOXA-10; no strain was detected to carry blaIMP, blaOXA-1 or blaOXA-2. Two strains and their corresponding TSs were detected carrying both blaVIM and blaOXA-10. No significant difference of drug resistance was observed between strains producing only MBL or OXA enzyme, with the same high resistance to β-lactam antibiotics and some degree of sensitivity to aminoglycoside antibiotics. Strains producing enzymes MBL and OXA were all resistant to the 12 antibiotics.</p><p><b>CONCLUSIONS</b>IRPA strains isolated from burn wards of Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine are multidrug-resistant, and they mainly produce type B and D carbapenemases.</p>
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Humans , Burns , Microbiology , Cross Infection , Microbiology , Drug Resistance, Multiple, Bacterial , Genetics , Imipenem , Microbial Sensitivity Tests , Pseudomonas aeruginosa , GeneticsABSTRACT
Objective To evaluate the different cardioprotective function of transplantation of marrow mesenchymal stem cells(BMSCs) from coronary heart disease(CHD) patients with diabetes mellitus (DM) or not to myocardial infarction rats.Methods 45 adult male rats with acute myocardial infarction experimentally were randomized into three groups,15 rats in each group.BMSCs from CHD patients with DM or not were injected into the infarcted myocardium.In control group,culture medium was used.Echocardiography,Western-blot analysis,TUNEL were performed 4 weeks after transplantation.Results Proliferation of BMSCs in DM group was significantly lower than that in non-DM group.Transplantation of BMSCs in the infarcted border zone improved cardiac function,Bcl-2 protein level in DM and non-DM group compared with control group,moreover,BAX protein level and TUNEL positive cells were decreased.Furthermore,compared with non-DM group,cardiac function and Bcl-2 protein level were decreased,however,BAX protein and TUNEL positive cells were improved.Conclusion BMSCs from CHD patients have proliferative properties.Transplantation of BMSCs can improve cardiac function by inhibiting apoptosis.But DM may decrease apoptosis resistance,which might impair the cardioprotective function of cells transplantation.
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Objective To investigate the effects of local application of NGF combined with Insulin on wound healing with Ⅱ degree deep scald and the expression of HIF-1α and VEGF in diabetic rats. Methods 60 male Wistar rats were used in the study by intraperitoneal injection of streptozotocin (STZ). Deep partial thickness scalding was engendered on the back of the rats after one month. Then these rats were random divided into group B (scalding of the rats with diabetes, n = 15), C (insulin control, n = 15), D ( NGF control, n = 15) and E ( NGF and insulin supplementation, n = 15). And group A ( nomal control,n = 15) was created by normal rats of partial thickness scalding. The wound area, wound healing rate, and grey of HIF-1α and VEGF immunohistochemistry staining were determined on the 3rd, 7th, 15th, and 21st day post scalding days (PSDs). Results Compared to those in groups A, B, C and D, the wound healing rate in group E increased significantly since the 7th PSD [(25.33 ± 2. 32 ) %, P ＜ 0.05]. The wound healing rate in group C and D increased significantly compared with group B [( 16. 68 ± 1.95 ) %, ( 18.29±1. 70)%, P ＜0.05]. Compared to group A, the group D increased significantly since the 15th PSD [(54. 84 ±3.60)%, P ＜0. 05]. The expression of HIF-1α and VEGF in group E began to increase slower than other groups after the 7th day ( P ＜0. 05 ). Conclusion Local application of NGF combined with Insulin could be beneficial to the regeneration of capillary vessel in the burn wounds of the rats with diabetes,as well as to accelerate wound healing by redress anoxia and decrease the expression of HIF-1α and VEGF.
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Objective Our aim was to observe the effects of prenatal nicotine exposure on development of cerebral cortex and hippocampus in the offsprings of pregnant mice and expressions of NCAM proteins. Methods We established prenatally nicotine exposed(PNE) animal models.We investigated the offspring's structural changes of cerebral cortex and hippocampus with HE staining.Using immunohistochemistry and Western blotting we observed the changes of expressions of NCAM proteins in the neonatal mice. Results Cerebral cortex and hippocampus as well as hippocampal cell layers of the PNE offsprings were thinner than that of the control group.The expressions of PSA-NCAM in cerebral cortex and hippocampus of the PNE offsprings were higher than the control group while the expressions of NCAM-180,140 and 120 weaker.Conclusion Prenatally nicotine exposure can prevent normal morphogenesis of cerebral cortex and hippocampus of mice and can change the expressions of NCAM proteins in cerebral cortex and hippocampus of neonatal mice.
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Objective:To investigate the changes of plasma moderate molecule substance (MMS)level in pediatric patients with congenital heart disease during open heart surgery. Method: Siteen cases were studied. Blood samples were taken before anesthesia, after tracheal intubtion, after sternotomy. and rewarming during cardiopulmonary bypass, to measure the plasma MMS levels with ultraviolet absorption spectrophotometry. Result: As compared with that before anesthesia, the MMS levels after tracheal intubtion,sternotomy,and rewarming during cardiopulmonary bypass were significantly elevated(P
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0.05). CO decreased at T2, T3, T4 and T5 compared with that at T0 in both groups (P