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Objective To observe the damage of various organs of rats with exertional heatstroke (EHS), and to investigate the protective effect of oral rehydration salts Ⅲ (ORSⅢ) on multi-organ function in rats with EHS. Methods Fifty-one male Sprague-Dawley (SD) rats were randomly divided into four groups by random digit table: normal control group (n = 13), EHS group (n = 13), EHS+water group (n = 12), and EHS+ORSⅢ group (n = 13). All rats in the EHS groups received adaptive training for 7 days before the experiment. On the 8th day, the rats of EHS+water and EHS+ORSⅢ groups were orally given 20 mL/kg water or ORSⅢ 30 minutes before the experiment. No pretreatment was performed in the EHS group. EHS model was reproduced by forcing rats to run under hot environment. The rats which refused to exercise and which core temperature > 40.5 ℃ were considered as the onset of EHS. The rats in the normal control group were exposed to room temperature (25±2) ℃ and humidity (50±5)% without any treatment. Six hours later, blood of inferior vena cava was collected, and the levels of serum MB isoenzyme of creatine kinase (CK-MB), lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate transaminase (AST), serum creatinine (SCr), blood urea nitrogen (BUN), serum potassium, serum sodium and serum chloride were determined by automatic chemical analyzer. Serum intestinal fatty acid-binding protein (I-FABP) was determined by enzyme linked immunosorbent assay (ELISA). Results The levels of LDH, ALT, AST, BUN, serum sodium and serum chloride in the EHS group were significantly higher than those in the normal control group [LDH (U/L): 1 220±427 vs. 837±485, ALT (U/L): 138 (97, 164) vs. 37 (33, 42), AST (U/L): 409 (380, 566) vs. 86 (78, 104), BUN (mmol/L): 11.7 (9.6, 13.2) vs. 5.9 (5.5, 6.1), serum sodium (mmol/L): 148.0 (143.5, 154.5) vs. 139.0 (138.0, 140.5), serum chloride (mmol/L): 100.9±2.3 vs. 97.3±1.4, all P < 0.05], but no significant difference in CK-MB, SCr or serum potassium could be found [CK-MB (U/L): 1 280±373 vs. 1 379±480, SCr (μmol/L): 38.2±7.5 vs. 35.5±6.3, serum potassium (mmol/L): 5.5 (4.4, 6.2) vs. 4.7 (4.4, 4.9), all P > 0.05]. In the EHS+ORSⅢ group, only serum potassium level was significantly lower than that in the EHS group [mmol/L: 4.0 (3.7, 4.4) vs. 5.5 (4.4, 6.2), P < 0.01], while no significant difference in other parameters was found between the EHS+ORSⅢ group and the EHS group as well as the EHS+water group. Serum I-FABP level in the EHS group was significantly higher than that in the normal control group [μg/L: 36.90 (29.10, 45.00) vs. 11.39 (0.31, 20.80), P < 0.01]. Serum I-FABP level in the EHS+water and EHS+ORSⅢ groups were notably lower than that in the EHS group [μg/L:24.19 (20.00, 28.36), 0.31 (0.31, 5.58) vs. 36.90 (29.10, 45.00), both P < 0.01], additionally, I-FABP level was much lower in the EHS+ORSⅢ group (P < 0.01). Conclusions EHS could lead to liver, intestinal barrier dysfunction and electrolyte disturbance. Pre-treatment of ORSⅢ could alleviate the intestinal dysfunction and electrolyte disorder caused by EHS in rats. It can lower the serum potassium to some extent. However, ORSⅢ failed to protect liver from EHS.
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Objective:To compare the curative effect and the changes of serum electrolytes between oral rehydration salts (ORS) Ⅰ and ORS Ⅲ treatment in neurally mediated syncope children.Methods:The children with the symptom of unexplained syncope and pre-syncope were collected in Second Xiangya Hospital from May 2014 to May 2017.After head-up tilt test (HUTT),their serum electrolytes levels were examined.Children who were positive in the HUTT received ORS (ORS Ⅰ or ORS Ⅲ) and health education.Subjects were randomly divided into an ORS Ⅰ group (n=27) and an ORS Ⅲ group (n=49).Results:There was no statistical significance in sex,age,height,body mass,initial diagnosis and re-diagnosis interval between the 2 groups (P＞0.05);the total efficiency after ORS Ⅲ and ORS Ⅰ treatment were 79.59％ and 62.96％,respectively,with no statistical significance (x2=2.483,P＞0.05);the HUTT negative conversion rate after ORS Ⅲ and ORS Ⅰ treatment were 51.02％ and 48.16％,respectively,with no statistical significance (x2=0.058,P＞0.05);before treatment,the serum sodium [(140.20±2.26) mmol/L vs (138.39±2.72) mmol/L;t=2.856,P＜0.05] in the ORS Ⅲ group was higher than that in the ORS Ⅰ group,the serum phosphorus [(1.46±0.19) mmol/L vs (1.65±0.29) mmol/L;t=3.146,P＜0.05] in the ORS Ⅲ group was lower than that in the ORS Ⅰ group;after treatment,the serum sodium [(140.31±2.01) mmol/L vs (138.88±2.08) mmol/L;t=2.692,P＜0.05] and serum calcium [(2.31±0.09) mmol/L vs (2.24±0.11) mmol/L;t=2.696,P＜0.05] in the ORS Ⅲ group were higher than those in the ORS Ⅰ group,the serum phosphorus [(1.45±0.16) mmol/L vs (1.61±0.25) mmol/L;t=3.128,P＜0.05] in the ORS Ⅲ group was lower than that in the ORS Ⅰ group;after ORS Ⅲ treatment,there was no statistical significance in serum electrolytes between HUTT positive group and HUTT negative group (P＞0.05);after ORS Ⅰ treatment,the serum calcium [(2.29±0.10) mmol/L vs (2.19±0.10) mmol/L;t=2.501,P＜0.05]and serum phosphorus [(1.71±0.24) mmol/L vs (1.50±0.21) mmol/L;t=2.392,P＜0.05] in HUTT positive group were higher than those in HUTT negative group.There was no statistical significance in serum sodium,potassium,magnesium,and chloride (P＞0.05);there was no statistical significance in serum electrolytes between pre-treatment and post-treatment in the ORS Ⅰ group and the ORS Ⅲ group (P＞0.05);there was no statistical significance in serum electrolytes between vasovagal syncope and postural orthostatic tachycardia syndrome in the ORS Ⅰ group and the ORS Ⅲ group before ORS treatment (P＞0.05).Conclusion:The ORS Ⅲ and ORS Ⅰ have the similar efficacy in the treatment of children with neurally mediated syncope.ORS Ⅲ is easier to be accepted by children than ORS Ⅰ,with better compliance.
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Objective To explore the effects of oral rehydration salts [Ⅰ] (ORS Ⅰ) for autonomic nerve mediated syncope(NMS) in children with different hemodynamic patterns.Methods A total of 105 patients with unexplained syncope and prodromal symptoms of syncope who were confirmed as NMS by head-up tilt table test(HUTY) and treated in the Department of Pediatric Cardiovasology,Children's Medical Center,the Second Xiangya Hospital,Central South University,from March 2012 to February 2015.Their ages were from 4 to 18 years old,the average age was (11.96 ± 2.86) years old.Totally 73 cases were diagnosed as vasovagal syncope (VVS) (46 cases were vasodepressor type,27 cases were VVS mixed type or cardioinhibitory type),while 32 cases were diagnosed as postural orthostatic tachycardia syndrome(POTS).Simple random method was used to divide them into conventional therapy (health education and tilt training) plus ORS Ⅰ group (55 cases),and conventional therapy group (50 cases).Patients were followed up for 6-25 (14.82 ± 6.13) months.The recurrence of syncope and review of HUTT outcome assessment in 6 months,treatment was studied to evaluate short-term efficacy of 2 different therapies for NMS in children with different hemodynamic patterns.Taking recurrence of syncope as outcome events,Kaplan-Meier curves were drawn to compare long-term efficacy of different therapies in treating NMS children.Results There was no statistical difference in the short-term efficacy among the different hemodynamic patterns when treated with conventional therapy plus ORS I,or conventional therapy(all P ＞ 0.05).The cumulative efficiency of the conventional therapy plus ORS Ⅰ was superior to that of the conventional therapy for NMS children through the long-term follow-up study (74.5％ vs.52.0％,x2 =14.424,P ＜ 0.01).Patients with vasodepressor patterns had a better response than those with mixed or cardioinhibitory patterns to conventional therapy plus ORS I (90.0％ vs.61.1％,x2 =4.435,P ＜ 0.05).Conclusions Compared with VVS mixed type or cardioinhibitory type,children with VVS vasodepressor patterns are more appropriate to take ORS I as initial treatment.
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Objective To explore the changes in serum and urine electrolytes of children with neurally media-ted syncope (NMS)after oral rehydration salts (ORS)[Ⅰ]treatment.Methods The study group included 135 patients [60 male and 75 female,aged 4 -16 years,average of (10.20 ±2.68)years old]with unexplained syncope and prodro-mal symptoms of syncope in our hospital between May 2014 and April 2015.The patients underwent head -up tilt test (HUTT),and completed serum electrolytes and 24 -hour urine electrolytes,and the serum electrolytes and 24 -hour u-rine electrolytes in different hemodynamic type of HUTT were compared.Positive HUTT patients were treated with health education and ORS[Ⅰ],while negative HUTT patients were received health education.Then 21 -154(42.63 ±27.71) days later,the patients returned to hospital,for the inquiry of symptom improvement,and review of HUTT,24 -hour urine and serum electrolytes.Results (1)The total effective rate of ORS[Ⅰ]treatment was 62.96% (17 /27 cases),while negative conversion rate of HUTT was 48.15% (13 /27 cases).(2)There was no significant difference in serum electro-lytes,24 -hour urine electrolytes or 24 -hour urine volume between HUTT positive group and negative group during the first visit (all P >0.05).(3)In return visit,serum calcium [(2.30 ±0.10)mmol/L vs (2.20 ±0.09)mmol/L,t =2.72,P 0.05).(4)24 -hour urine sodium [(159.06 ±72.76)mmol/24 h vs (118.97 ±52.75)mmol/24 h,t =2.712,P 0.05).(5)There was no significant difference in serum elec-trolytes,24 -hour urine electrolytes or 24 -hour urine volume between vasovagal syncope group and postural orthostatic tachycardia syndrome group during the first visit(all P >0.05).Conclusions ORS[Ⅰ]treatment can obviously increase the 24 -hour urine sodium,24 -hour urine chloride in children with NMS.ORS[Ⅰ]is an effective therapy for NMS.
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Objective To investigate the effect of oral rehydration salts for treating Ebola virus disease. Methods The treatment outcomes of 4 patients with confirmed Ebola virus disease in Liberia were analyzed. Oral or intravenous rehydration salts were chosen according to the severity of illness and the occurrence of severe vomiting. The fluid volume was determined according to the following conditions; urine, feces and sweat volume, and the daily fluid volume was 750-2 000 mL. Three patients received oral rehydration salts; one patient received oral rehydration salts on the first day and intravenous rehydration salts afterwards due to severe illness. The rehydration salt treatment was given until the complete remission of clinical symptoms. Results The three patients receiving oral rehydration treatment survived and the severe case who also received intravenous treatment died finally. Conclusion Oral rehydration should be used as the first-line choice for early, long-term treatment of patients with mild to moderate Ebola virus disease in West Africa, where the economic and health situation are backward.
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Objective Gastrointestinal rehydration is a simple and effective method in treatment of burn shock during war-time, fire disaster and other harsh conditions , and practice has proved the exact curative effect of HCO 3 salt sugar liquid .This article was to investigate the effect of pyruvate-enriched oral rehydration solution ( Pyr-ORS ) on intestinal mucosal blood flow ( IMBF ) , activity of Na +-K+-ATPase and intestinal absorption rate during en-teral resuscitation of a 35% TBSA third-degree scald in rats . Methods 90 male rats were randomly divided into 5 groups: scald without fluid resuscitation ( S group ); sham scald resuscitated with HCO3 salt sugar liquid ( SS HCO3 group ); sham scald resuscitated with Pyr-ORS ( SS Pyr-ORS group ); scald resuscitated with HCO 3 salt sugar liquid (S HCO3 group); scald resuscitated with Pyr-ORS (S Pyr-ORS group) (n=18).Each group was divided into 2 subgroups of 1.5 and 4.5 h after scald injury.Intestinal absorption rate of water and Na +, IMBF and activity of Na +-K+-ATPase were detected on each group . Results Compared with shame scald groups , the intestinal absorption rates of water and Na +decreased ob-viously in scald groups with fluid resuscitation (P<0.05);at 1 h after scald injury, the intestinal absorption rates of water and Na +in S Pyr-ORS groups were both higher than those in S HCO 3 groups(P<0.05).Compared with shame scald groups , IMBF and activity of Na+-K+-ATPase at 1.5 and 4.5 h after scald injury decreased obviously in scald groups with fluid resuscitation (P<0.05); at 1.5 and 4.5 h after scald injury, IMBF in S Pyr-ORS groups (95.250 ±5.096/112.765 ±7.215) were greater than those in S HCO3 group (80.764 ±7.852/94.671 ±8.469), which was of statistical significance (P<0.05). Conclusion Pyr-ORS is a simple and effec-tive method in treatment of burn shock during wartime , fire disaster and other harsh conditions .
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Neurally mediated syncope (NMS) is the most common children unexplained syncope.Oral rehydration salts is the basis for the treatment of NMS.Oral rehydration salts can increase the extracellular fluid and blood volume,change the redistribution of blood,avoid the emptying effect caused by inadequate left ventricular filling volume when position changes suddenly,prevent increased vagus nerve activity induced syncope,can obviously increase the NMS children's ability of orthostatic intolerance.Increase water salt intake can be incorporated into the behavior training of the NMS children's daily life,and it can reduce the occurrence rate of NMS children,and improve the quality of life.
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Objective To compare the efficacy of oral rehydration salts(ORS),health education and autonomic nervous activity training with health education and autonomic nervous activity training on children with postural orthostatic tachycardia syndrome (POTS).Methods Fifty-two children with POTS based on head-up test or head-up tilt test were divided into ORS treatment group and conventional treatment group.ORS treatment group included 33 children,and they received ORS and health education and autonomic nervous activity training therapy.Conventional treatment group included 19 children who received health education and autonomic nervous activity training therapy only.Telephone follow-ups were made after the therapy for 1-3 months.The contents of follow-up were the compliance of ORS treatment,the implementation of health education and POTS related symptom frequency.Results 1.The compliance of doctor's advice in ORS treatment group was better than that in the conventional treatment group.2.There was no significant difference in the symptom scores before therapy between ORS treatment group and conventional treatment group [(6 ± 3) scores in ORS treatment group vs (5 ± 3) scores in conventional treatment group,t =0.799,P ＞ 0.05].After 1 to 3 months therapy,the symptom scores were significantly lowered in both groups.The symptom scores in ORS treatment group was lower than those of the conventional treatment group[(2 ± 1) scores in ORS treatment group vs(3 ± 1)scores in conventional treatment,t =-2.189,P ＜ 0.05].3.If the therapy was determined to be effective when the symptom scores decreased by at least 2 scores,the effective rate in ORS treatment group was significantly higher than that of the conventional treatment group(78.8％ in ORS treatment group vs 42.1％ in conventional treatment group,x2 =7.169,P ＜ 0.01).Conclusions The efficacy of ORS,health education and autonomic nervous activity training therapy is better than that of the health education and autonomic nervous activity training therapy only in POTS children.
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Objective To explore the curative effect of oral rehydration salts treating orthostatic hypotension in children. Methods 80 children with orthostatic hypotension collected in our hospital from January 2011 to December 2013 were given oral rehydration salts, the heart rate, blood pressure, and record dizziness were observed after two weeks treatment. Results 36 children in 80 were markedly improved after treatment, accounted for 45.0%, 37 children were valid, accounted for 46.2%, 7 children were invalid, accounted for 8.8%. The total effective rate was 91.2%. The number of dizziness, dizziness, nausea vomiting, blurred vision, palpitate discomfort after treatment were less than before treatment. Tilt table test began in 3 minutes, 7 minutes,heart rates, systolic blood pressures were decreased signiifcantly before and after treatment(P<0.05). Tilt table test began in 3 minutes, 7 minutes,diastolic blood pressure were decreased signiifcantly before treatment(P<0.05), not after treatment. Conclusion Oral rehydration salts can obviously increase diastolic blood pressure and improve the upright intolerance symptoms in orthostatic hypotension children.
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Objective: To develop and prepare oral rehydration salt powder II (ORS II) effervescent tablets. Methods: Taking the mass/tablet, rigidity, disintegration time, and pressing status as the main indicators, we optimized the formulation and preparation process of the effervescent tablet by single factor test. The character, identification, disintegration time, acidity, and content determination of the tablets were also investigated. Results: It was found that the optimized preparation process of the effervescent tablets was to mix the acid part, which was granulated with ethanol, with the base part, and then compressed the mixture. The optimal formula was composed of: NaCl (11.5%), KCl (4.93%), C6H8O7 (6.21%), NaHCO3 (8.15%), C6 H12 O6 (65.7%), and PEG-6000 (3%). The rigidity of the prepared effervescent tablet was 4.5 kg and the disintegration time was 175 s. Conclusion: The formulation of the present product is consistent with the corresponding Chinese Pharmacopoeia monograph, requiting no additional effervescent; the preparation process is simple and the products are stable, and the product my be developed into a new oral rehydration salt formulation.
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Since the oral rehydration salts solution(ORS) has been used to treat acute diarrhea of children, there are different kinds of ORS in order to satisfy the need of clinical work. They are the initial WHO-ORS, other substances-supplemented ORS and the reduced osmolarity ORS, each of which has their own efficiency and advantage.