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Objective:To explore the relationship between hematocrit, early fluid therapy, and clinical outcomes in patients with septic shock, and to provide evidence for fluid resuscitation therapy and prognosis assessment in these patients.Methods:The clinical information of patients with septic shock who were diagnosed and treated in the Emergency Intensive Care Unit (EICU) of the First Affiliated Hospital of Wenzhou Medical University from January 1, 2018 to December 31, 2020 were collected. Taking the survival or death of patients 28 days after admission as the end point of clinical research, the patients were divided into the survival and death groups. After analyzing the basic data of the two groups, the univariate and multivariate COX regression analyses were used to analyze the evaluation value of Δ Hematocrit (HCT) d2-d1 and ΔHCT d3-d1 on the prognosis of patients with septic shock. At the same time, the Kaplan-Meier survival curve was used to analyze the overall survival rate of patients with septic shock, and the smooth curve fitting graph was used to verify its relationship with net fluid intake and death. Results:There were 241 cases in the survival group and 67 cases in the death group. Univariate COX analysis showed statistically significant differences between the survival and death groups in acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) ( P=0.0006), red cell volume distribution width (RDW) ( P=0.0043), age ( P=0.0184), ΔHCT d2-d1 ( P=0.0136), ΔHCT d3-d1 ( P=0.0204), and white blood cell (WBC) ( P=0.0444). Multivariate COX analysis showed that ΔHCT d2-d1 ( P=0.0115) and ΔHCT d3-d1 ( P=0.0029) were independent risk factors for death in EICU patients with septic shock. ΔHCT d2-d1 and ΔHCT d3-d1 were divided into three groups according to the three-digit method. The Kaplan-Meier survival curve showed no significant difference among the three groups in the overall survival rate related to ΔHCT d2-d1 ( P=0.16), but there was a statistically significant difference in the overall survival rate among the three groups related to ΔHCT d3-d1 ( P=0.025). The smooth fitting curve of ΔHCT d3-d1, net fluid intake, and prognosis showed that ΔHCT d3-d1 was negatively correlated with net fluid intake, and the middle ΔHCT d3-d1 group had the best prognosis. Conclusions:The value of ΔHCT d3-d1 is related to the net fluid intake of patients with septic shock. An appropriate decrease in HCT on the third day can improve the prognosis of patients with septic shock. The dynamic changes of hematocrit can provide a certain basis for fluid resuscitation and prognosis evaluation in patients with septic shock.
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Objective To investigate the effect of azelastin nasal spray combined with desloratadine in the treatment of allergic rhinitis .Methods Two hundred patients with allergic rhinitis were selected .According to the digital meter method ,the patients were randomly divided into observation group and control group ,with 100 cases in each group .The control group was treated by azelastin nasal spray , the observation group was given azelastin nasal spray combined with desloratadine .The clinical effects of the two groups were compared .Results The effective rate of the observation group(96.00%) was higher than that of the control group (80.00%),the difference was statistically significant(χ2 =6.235,P<0.05).After treatment,the scores of runny nose,nasal itching,nasal congestion,sneezing and the inferior turbinate swelling in the observation group were (1.1 ±0.2) points,(1.2 ±0.7) points,(1.1 ± 0.3)points,(0.8 ±0.3) points,(0.9 ±0.2) points,respectively,which were significantly lower than those in the control group [(1.4 ±0.9)points,(1.9 ±0.6)points,(1.8 ±0.8)points,(1.7 ±0.7)points,(1.9 ±0.9)points] (t=5.154,5.226,5.154,5.226,5.011,all P<0.05).Conclusion Azelastin nasal spray combined with deslorata-dine tablets in the treatment of allergic rhinitis can quickly relieve the patients 'clinical symptoms,improve the effec-tive rate,and it is safe and worthy of clinical popularization and application .
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Objective To evaluate the effect of Shenfuhuang injection (SFH) on tissue and plasma TNF-? level and multiple organ dysfunction in septic rats. Method Wistar rats were subjected to sepsis by ceral ligation and puncture, then they were randomly divided into four groups, normal control, sham operation grop, septic group, SFH group. Animals were sacrificed at 2, 8, 24, 48 h. TNF-? level of lung, liver and plasma were measured. DAO activity was determined. Result TNF-? level of liver, lung and plasma were markedly increased at 2～8 h post-CLP compared with sham operation group. In SFH group, TNF-? level decreased in different degrees. DAO activity was much lower in SFH group than in CLP group at 2, 8 h. Conclusion Early applying of SFH could markedly inhibit TNF-? level of vital organs and injury of intestine, thereby preventing the development of excessive inflammation response and subsequent multiple organ dysfunction syndrome associated with CLP-induced sepsis.
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Objective To investigate the effect of Shenfuhuang injection (SFH Injection) on function of organs and mortality of septic rats, using a sepsis mode by cecal ligation puncture(CLP). Methods 140 male Wistar rats were randomly divided into four groups: normal control group, sham operation group, CLP group (being further divided into 2, 8, 24, 48 h subgroups), SFH injection treatment group (being further divided into 2, 8, 24, 48 h subgroups, drug were inraveous injected just after operation and per 12 h). The mortality of animals and altering organ’s function were observed within 7 days. Results Compared to CLP model, mortality of Septic rats in SFH injection group was significant lower, and the treatment prolonged survival duration. SFH Injection group owned lower numerical values of ALT, AST, BUN and Cr in serum. Conclusion SFH Injection can obviously decline the mortality of septic rats and play an important role in protecting organ function.