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Objective We investigated whether cirrhotic patients with upper gastrointestinal hemorrhage should be stratified for antibiotic prophylaxis based on Child-Pugh scores and etiology,to estimate risks of nosocomial infection,six-week re-bleeding,and mortality,and whether antibiotics prophylaxis have equal effects on patients of all Child-Pugh classes and etiologies.Methods A total of 316 hospitalized patients of cirrhosis patients with upper gastrointestinal hemorrhage were analyzed.The patients were classified as antibiotic group and control group,according to the patients whether received antibiotic prophylaxis or not.The two groups were monitored nosocomial infection rates,six-week re-bleeding rates and mortality rates.Results (1) Antibiotic prophylaxis reduces rates of nosocomial infection,six-week re-bleeding.(2)According to the etiology,cirrhosis can be divided into viral cirrhosis (VC) group and alcoholic cirrhosis (AC) group.The nosocomial infection rates and six-week re-bleeding rates of the VC group were lower in the antibiotic group.The nosocomial infection rates and the six-week re-bleeding rates of the AC group were lower in the antibiotic group.(3) According to Child-Pugh classification,patients were divided into Child-Pugh class A,B,C three groups.Child-Pugh class A group:the nosocomial infection rates,six-week re-bleeding rates and mortality rates had no significant difference between the antibiotic group and control group.Child-Pugh class B group:the nosocomial infection rates and six-week re-bleeding rates were lower in the antibiotic group.Child-Pugh class C group:the nosocomial infection rates and six-week re-bleeding rates were lower in the antibiotic group.Conclusion Antibiotic prophylaxis reduces rates of nosocomial infection,six-week re-bleeding in cirrhosis patients with upper gastrointestinal hemorrhage,so the writer suggests short-term antibiotic prophylaxis.Antibiotics prophylaxis have equal effects on cirrhosis patients of different etiologies.While antibiotics prophylaxis have no equal effects on cirrhosis patients of all Child-Pugh classes.The nosocomial infection rates,six-week-rebleeding rates and mortality rates of Child-Pugh class A are low.The recommendation for routine antibiotic prophylaxis for this subgroup requires further evaluation.
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Objective We investigated whether cirrhotic patients with upper gastrointestinal hemorrhage should be stratified for antibiotic prophylaxis based on Child-Pugh scores and etiology,to estimate risks of nosocomial infection,six-week re-bleeding,and mortality,and whether antibiotics prophylaxis have equal effects on patients of all Child-Pugh classes and etiologies.Methods A total of 316 hospitalized patients of cirrhosis patients with upper gastrointestinal hemorrhage were analyzed.The patients were classified as antibiotic group and control group,according to the patients whether received antibiotic prophylaxis or not.The two groups were monitored nosocomial infection rates,six-week re-bleeding rates and mortality rates.Results (1) Antibiotic prophylaxis reduces rates of nosocomial infection,six-week re-bleeding.(2)According to the etiology,cirrhosis can be divided into viral cirrhosis (VC) group and alcoholic cirrhosis (AC) group.The nosocomial infection rates and six-week re-bleeding rates of the VC group were lower in the antibiotic group.The nosocomial infection rates and the six-week re-bleeding rates of the AC group were lower in the antibiotic group.(3) According to Child-Pugh classification,patients were divided into Child-Pugh class A,B,C three groups.Child-Pugh class A group:the nosocomial infection rates,six-week re-bleeding rates and mortality rates had no significant difference between the antibiotic group and control group.Child-Pugh class B group:the nosocomial infection rates and six-week re-bleeding rates were lower in the antibiotic group.Child-Pugh class C group:the nosocomial infection rates and six-week re-bleeding rates were lower in the antibiotic group.Conclusion Antibiotic prophylaxis reduces rates of nosocomial infection,six-week re-bleeding in cirrhosis patients with upper gastrointestinal hemorrhage,so the writer suggests short-term antibiotic prophylaxis.Antibiotics prophylaxis have equal effects on cirrhosis patients of different etiologies.While antibiotics prophylaxis have no equal effects on cirrhosis patients of all Child-Pugh classes.The nosocomial infection rates,six-week-rebleeding rates and mortality rates of Child-Pugh class A are low.The recommendation for routine antibiotic prophylaxis for this subgroup requires further evaluation.
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ObjectiveTo investigate the effect of therapeutic hypercapnia on hepatic ischemia-reperfusion (I/R) injury in rat liver transplantation.MethodsMale specific pathogen-free adult Wistar rats aged 6 weeks weighing 220-280 g were used in this study.Sixteen rats in which liver transplantation was successfully performed were randomly divided into 2 groups ( n =8 each): liver transplantation group (group LT) and therapeutic hypercapnia group (group TH).In group TH,PaCO2 was maintained at 80-100 mm Hg by inhalation of CO2 for 1 h at the begining of reperfusion.MAP,PaO2 and PaCO2 was recorded during reperfusion.Blood samples were obtained at 2 h of reperfusion for determination of serum ALT,AST,TNF-α,IL-1 and IL-6 levels,and then the rats were sacrificed and transplanted liver was immediately removed for determination of NF-κB activity and apoptosis and microscopic examination.The apoptotic index was calculated.ResultsMAP,PaO2 and PaCO2 were higher,and serum ALT,AST,TNF-α,IL-1 and IL-6 levels,NF-κB activity and apoptotic index lower in group TH than in group LT ( P ＜ 0.05).The histopathologic damage was ameliorated in group TH as compared with group LT.Conclusion Therapeutic hypercapnia can attenuate hepatic I/R injury in rat liver transplantation by inhibiting inflammatory response and apoptosis.
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Objective Curative effect of 2 drugs which present elinie used in atrium filament trembles,provides the elinieal experience.Methods Choice outpatient service atrial fibrillation trembles the patient 344 eases,plants stochastically according to sickness divides into two groups,takes the rope separately Sotalol and Amiedarone,the adjustment medication dosage treats and observes for 12 months,carries on the material summary.Results The rope Sotalol group and the Amiedarone group each is 172 people,the rope Sotalol group atrial fibrillation trembles transfers sinous rhythm 45 peoples,transfers rate 26.2%,recurs 5 patients,after transfers sinous rhythm maintenance rate 88.9% ; Amiodarone,group atrial fibrillation trembles transfers sinus rhythm 41 people,transfers rate 23.8%,recurs 2 patients,after transfers sinous rhythm maintenance rate 95.1% ; Conclusion Sotalol group treats atrial fibrillation trembles rate to be higher than the Amiedarone group,after transfers sinous rhythm maintenance rate Amiedarone group to be higher than Sotalol group.
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Objective To investigate the protective effects of morphine preconditioning on the lungs against ischemia-reperfusion (I/R) injury and the possible mechanisms.Methods Twenty-four Japanese long-ear white rabbits weighting 2.5-3.0 kg were used in this study. The animals were anesthetized with intramuscular atropine 0.5 mg and intravenous 3 % pentobarbital 30 mg ?kg-1, tracheostomized and mechanically ventilated ( VT 10 ml?kg-1, RR 30 bpm, FiO2 100% , PEEP 1 cm H2O) . Right carotid artery was cannulated for BP monitoring and blood sampling. An elastic band was placed around the hilum of left lung via thoracotomy to perform lung ischemia. Body temperature was maintained at 36-38℃( rectal) . The animals were randomly allocated to one of 3 groups (n = 8 each) : (1) Sham group; (2) I/R group was subjected to 2 h in situ left hilar occlusion followed by 2 h reperfusion and (3) morphine preconditioning group received morphine 4 mg?kg-1 via pulmonary artery 30 min before I/R. Mean pulmonary artery pressure (MPAP) and peak inspiratory pressure (PIP) were monitored and recorded. Arterial blood samples were taken before occlusion of lung hilum (baseline) and at 5, 30, 60, 90 and 120 min of reperfusion for blood gas analysis, and determination of plasma endothelin-1 concentration. The animals were killed at the end of 120 min reperfusion. The lungs were removed for determination of lung water content (W/ D ratio), percentage of neutrophils in the broncho-alveolar lavage fluid ( BALF) and microscopic examination.Results MPAP and PIP were significantly lower while PaO2 was significantly higher at 30, 60, 90 and 120 min of reperfusion in morphine preconditioning group than in I/R group. Plasma endothelin-1 concentration was significantly lower at 60 and 120 min of reperfusion in morphine preconditioning group than in I/R group ( P
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0.05). After the injection, PaO 2 in group A, B and C increased significantly, whereas PaO 2 in group D did not change and was kept at low level below 13.3kPa (P