Study of the radiotherapy sensitization of retroperitoneal lymph node metastasis in patients by sodium glycididazole

To observe the radiotherapy sensitization effect of retroperitoneal lymph node metastasis in patients by sodium glycididazole in recent clinical efficacy and toxicity. A total of 42 patients admitted with metastasis and recurrence of retroperitoneal lymph node from September 2006 to December 2009 were classified with the method of case-control. After three dimensional conformal radiation therapy with or without sodium glycididazole [800mg/m2] for sensitization, the results of recent clinical efficacy, relief of pain, and Karnofsky score were obtained. Tumor remission rate of patients in sensitization group [with sodium glycididazole] at post-radiotherapy 3 months was significant higher than that in control group [without sodium glycididazole] [52% vs. 24%; P<0.05]. Oral dose of morphine daily, and Karnofsky score in anterior-posterior radiotherapy of patients in the sensitization group were significant different with those in the control group [93 +/- 12 and 42 +/- 6mg vs. 94 +/- 12 and 20 +/- 5mg and [65 +/- 4] and [90 +/- 9] vs. [64 +/- 5] and [80 +/- 10], respectively; P<0.01]. Sodium glycididazole has positive radiotherapy sensitization to the metastasis or recurrence of retroperitoneal lymph node for digestive tract cancer, which could obviously improve the life quality or release the pain for patients

Extensive variability in vasoactive agent therapy: a nationwide survey in Chinese intensive care units / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Inconsistencies in the use of the vasoactive agent therapy to treat shock are found in previous studies. A descriptive study was proposed to investigate current use of vasoactive agents for patients with shock in Chinese intensive care settings.</p><p><b>METHODS</b>A nationwide survey of physicians was conducted from August 17 to December 30, 2012. Physicians were asked to complete a questionnaire which focused on the selection of vasoactive agents, management in the use of vasopressor/inotropic therapy, monitoring protocols when using these agents, and demographic characteristics.</p><p><b>RESULTS</b>The response rate was 65.1% with physicians returning 586 valid questionnaires. Norepinephrine was the first choice of a vasopressor used to treat septic shock by 70.8% of respondents; 73.4% of respondents favored dopamine for hypovolemic shock; and 68.3% of respondents preferred dopamine for cardiogenic shock. Dobutamine was selected by 84.1%, 64.5%, and 60.6% of respondents for septic, hypovolemic, and cardiogenic shock, respectively. Vasodilator agents were prescribed by physicians in the management of cardiogenic shock (67.1%) rather than for septic (32.3%) and hypovolemic shock (6.5%). A significant number of physicians working in teaching hospitals were using vasoactive agents in an appropriate manner when compared to physicians in nonteaching hospitals.</p><p><b>CONCLUSIONS</b>Vasoactive agent use for treatment of shock is inconsistent according to self-report by Chinese intensive care physicians; however, the variation in use depends upon the form of shock being treated and the type of hospital; thus, corresponding educational programs about vasoactive agent use for shock management should be considered.</p>

Assessment effect of central venous pressure in fluid resuscitation in the patients with shock: a multi-center retrospective research / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Central venous pressure (CVP) and intrathoracic blood volume index (ITBVI) were used to assess the fluid status. It has previously been shown that CVP is not as accurate as ITBVI for all the shock patients. We therefore hypothesized that the change of CVP has the ability to predict fluid responsiveness in some clinical cases of shock.</p><p><b>METHODS</b>From September 1st 2009 to September 1st 2011, sixty-three patients with shock from different Intensive Care Unit (ICU) were collected into this retrospective study. All the patients received fluid challenge strategy (infusing 300 ml hydroxyethyl starch in 20 minutes), were monitored with CVP and pulse-indicated continuous cardiac output (PICCO). The correlation between changes in cardiac index (ΔCI), CVP (ΔCVP) and ITBVI (ΔITBVI) were analyzed. Fluid responsiveness was defined as an increase in CI ≥ 10%. Receiver operating characteristic (ROC) curves were generated for ΔCVP and ΔITBVI.</p><p><b>RESULTS</b>For all the patients, there was no correlation between ΔCI and ΔCVP (P = 0.073), but in the subgroup analysis, the correlation between ΔCI and ΔCVP was significant in those younger than 60 years old (P = 0.018) and those with hypovolemic shock (P = 0.001). The difference of areas under the ROC curves of ΔCVP and ΔITBVI were not statistically significant in the group younger than 60 years old or hypovolemic shock group (P > 0.05, respectively). However, no similar results can be found in the group older than 60 years old and the other two shock type groups from ROC curves of ΔCVP and ΔITBVI.</p><p><b>CONCLUSIONS</b>ΔCVP is not suitable for evaluating the volume status of the shock patients with fluid resuscitation regardless of their condition. However, in some ways, ΔCVP have the ability to predict fluid responsiveness in the younger shock patients or in the hypovolemic shock patients.</p>

Protective effects of vagus nerve stimulation on the liver in a rat model of sepsis / 中华麻醉学杂志

Objective To determine if stimulation of cholinergic anti-inflammatory pathway mediated by vagus can protect liver against sepsis.Methods Male SD rats weighing 250-300 g were anesthetized with intraperitoneal methane 1g?kg~(-1).Left common carotid artery,was cannulated for MAP monitoring and blood sampling.Sepsis was produced by ligation of cecum which was punctured twice at an interspace of 3 mm with a 9G needle(CLP).Bilateral vagus nerves were isolated,ligated with 4-0 silk and cut(VGX).The distal end of the vagus nerve was stimulated with direct current(5V,2 ms,1 Hz)continuously for 20 min(STM).Forty animals were randomly divided into 4 groups(n=10 each):group Ⅰ sham operation;group Ⅱ CLP;group Ⅲ CLP + VGX and group Ⅳ CLP+VGX+STM.Arterial blood samples were obtained at 0,1,2 and 4 h after operation for determination of plasma TNF-? concentration and serum ALT and AST activities.The animals were then killed and the livers removed for ultrastructure examination with electron microscope.Results Electrical stimulation of the distal end of vagus nerve significantly attenuated the significant decrease in MAP and increase in plasma TNF-? concentration and serum AST and ALT activities and the damage to the organelle in the liver cell induced by sepsis.Conclusion Our results show that electrical stimulation of vagus nerve can protect liver from sepsis to some extent through cholinergic anti-inflammatory pathway.