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Objective:To investigate the clinical effects of Jiakang Pingxiao prescription combined with methiimidazole on hyperthyroidism. Methods:A total of 100 patients with hyperthyroidism admitted to Shanxian Central Hospital from February 2018 to January 2021 were included in this study. They were randomly divided into a study group and a control group, with 50 patients in each group. The control group was treated with methiimidazole, and the study group was treated with Jiakang Pingxiao prescription combined with methiimidazole. Thyroid function, serum levels of osteocalcin (OCN), β-CTx, hypersensitive C-reactive protein, and interleukin-6 (IL-6) were compared between the two groups. Results:After treatment, serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4) in the study group were (3.10 ± 1.36) mU/L, (5.76 ± 1.25) pmol/L, (15.22 ± 1.95) pmol/L, respectively, which were significantly lower than (4.88 ± 1.47) mU/L, (7.13 ± 1.32) pmol/L, (19.07 ± 2.02) pmol/L in the control group ( t = 5.27, 4.71, 6.29, all P < 0.05). Serum OCN, β-CTx, hS-CRP, and IL-6 in the study group were (17.36 ± 2.62) μg/L, (0.32 ± 0.04) μg/L, (4.07 ± 0.86) mg/L, and (1.38 ± 0.21) pg/L, respectively, which were significantly lower than (26.05 ± 2.88) μg/L, (0.51 ± 0.09) μg/L, (6.23 ± 0.91) mg/L, (1.89 ± 0.28) pg/L in the control group ( t = 12.37, 10.40, 7.39, 8.57, all P < 0.05). The incidence of adverse reactions in the study group was significantly lower than that in the control group [6.00% (3/50) vs. 12.00% (3/50), χ2 = 14.78, P < 0.05). Conclusion:Jikang Pingxiao prescription combined with methiimidazole can effectively reduce the inflammatory responses in patients with hyperthyroidism, inhibit the expression of OCN and β-CTX in the serum, and improve thyroid function. The combined method is scientific and reasonable, and is suitable for clinical application. It has good therapeutic effects on hyperthyroidism and is worthy of clinical promotion.
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Resumen: Introducción: El método simplificado de Fencl-Stewart puede ser empleado a la cabecera del paciente y es más exacto para la evaluación del balance ácido-base. Omron desarrolló un modelo fisicoquímico del cambio en el exceso de base posterior a la infusión de cristaloides con diferencia de iones fuertes (DIF) diferente; sin embargo, fue un trabajo experimental bajo condiciones controladas. Objetivo: Describir el cambio en el estado ácido-base inicial y a las 24 horas en personas críticamente enfermas tras la infusión de siete diferentes tipos de soluciones balanceadas. Material y métodos: Se realizó un estudio retrospectivo, observacional y descriptivo en una terapia intensiva de tercer nivel. Se incluyeron individuos mayores de 18 años de enero de 2015 a julio de 2016. Se evaluaron los efectos en el estado ácido-base a través del modelo fisicoquímico de Fencl-Stewart modificado al inicio y a las 24 horas de la infusión de cristaloides balanceados con DIF de 27 a 154 mEq/L. Se analizaron los gases arteriales a través del gasómetro ABL800 Flex y GEM Premier 3500. El análisis de electrolitos séricos se realizó a través de Architec plus c16,000. El análisis estadístico fue descriptivo a través del programa SPSS v21.0. Resultados: Se incluyeron 198 sujetos. Las soluciones utilizadas con mayor frecuencia fueron Hartmann y H25, en 27.8 y 26.3%, respectivamente. En general, al analizar la totalidad de la población estudiada, todos los parámetros relacionados con acidosis metabólica tuvieron mejoría a las 24 horas. Conclusiones: El uso de soluciones con DIF > 24 mEq/L mejora el estado ácido-base, sin mayor incidencia de hipercloremia a las 24 horas.
Abstract: Introduction: Acid-base status in a body fluid is physically determined by several independent variables. These are: pCO2, the «strong ion difference¼ (SID), all the strong anions (among them is Cl-), and concentrations of nonvolatile weak acids (ATOT). Normal acid-base status is achieved when the independent variables have normal (empirically established) values. The simplified Fencl-Stewart's method can be used at the bedside of the patient and is more accurate in the assessment of acid-base balance. Omron developed a physicochemical model of the projected change in standard base excess (SBE) as a consequence of infused crystalloid solutions of common use (isotonic saline and balanced fluids); unfortunately this was a clinical simulation at standard physiological state. In addition, Kaplan evaluated acid-base balance after the administration of balanced fluids in trauma patients. Nevertheless, to our knowledge, there are no other clinical trials that evaluate the administration of other types of balanced fluids. Objective: To assess the acid-base status of critically ill patients after the infusion of seven different types of balanced solutions. Material and methods: This was a retrospective, observational and descriptive study conducted in an intensive care unit of a tertiary care hospital. We included all patients 18 years and older admitted to this department from January 2015 to July 2016. We evaluated the effects on acid-base balance after the infusion of seven different solutions: 1) Hartmann + 17.8 mEq/L sodium bicarbonate (NaHCO3) (SID 45.8), 2) Hartmann + 8.9 mEq/L NaHCO3 (SID 36.9), 3) Hartmann + 15 mEq/L NaHCO3 (SID 43), 4) Hartmann + 25 mEq/L NaHCO3 (SID 53), 5) Hartmann (SID 28), 6) normal saline 0.45% + 77 mEq/L NaHCO3 (SID 75), and 7) dextrose solution 5% + 154 mEq/L NaHCO3 (SID 154). Arterial blood gases, serum electrolytes, and proteins were measured in the same blood sample. Also SIDa, SEDe, SIG, ATOT, pCO2, change in standard base excess (SBE), pH, [HCO3], [Na]p and SOFA were calculated. pH, SBE and pCO2 were estimated with the ABL8000 FLEX blood gas analyzer. Data are mean ± SD or percents. We used the data analysis package SSPS. Results: One hundred ninety-eight patients were included. Of these, 54% were women and 45% men. The solutions most used were Hartmann (25%), Hartmann + 8.9 mEq/L NaHCO3 (21%), and Hartmann + 25 mEq/L NaHCO3 (18%). Before the infusion, SIDe was under 30 mEq/L in 30% of the patients and above in 23% of them. The effect on the SIDe was significant before the infusion of different solutions (p 0.01), SIDe > 30 ± 8 mEq/L. No metabolic alkalosis or greater decrease of SIDa/SIDe was observed. Conclusions: This study assesses additional varieties of fluids that have a different SID in the clinical setting. No major acid-base disturbances were observed.
Resumo: Introdução: O método simplificado de Fencl-Stewart pode ser usado no leito do paciente e é mais preciso para a avaliação do equilíbrio ácido-básico. Omron desenvolveu um modelo físico-químico da mudança do excesso de base após a infusão de cristalóide com DIF diferente; No entanto, foi um estudo experimental sob condições controladas. Objetivo: Descrever a mudança no estado ácido-básico inicial e às 24 horas em pacientes em estado crítico após a infusão de sete tipos diferentes de soluções equilibradas. Material e métodos: Realizou-se um estudo retrospectivo, observacional e descritivo em uma terapia intensiva. Incluiram-se pacientes maiores de 18 anos de janeiro de 2015 a julho de 2016. Avaliamos os efeitos no estado ácido-básico através do modelo físico-químico de Fencl-Stewart modificado no início e às 24 horas após a infusão de cristalóides equilibrados com DIF 27 a 154 mEq/L. Analizaram-se gases arteriais através do Gasômetro ABL800 Flex e GEM Premier 3500. A análise dos eletrólitos séricos foi feita através de Architec plus C16,000. A análise estatística foi descrita através do programa SPSS v21.0. Resultados: 198 pacientes. As soluções usadas com mais frecuência eram Hartmann e H25, com 27,8 e 26,3%, respectivamente. Em geral, ao analisar toda a população estudada, todos os parâmetros relacionados com acidose metabólica apresentou melhoria às 24 horas. Conclusão: O uso de soluções com DIF 24 mEq/L melhoraram o estado ácido-básico, sem maior incidência de hipercloremia em um intervalo de 24 horas.
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Objective To study the effect of TREK-1 potassium channel blocker on the behavior in rats with depression.Methods Forty-eight healthy adult male Sprague Dawley (SD) rats were divided into 6 groups as following:control + saline (CON group),control + fluoxetine (CON + FLU group),control + SID1900 (CON+SID group),CUMS + saline (CUMS group),CUMS + fluoxetine (CUMS+FLU group) and CUMS + SID1900 (CUMS+SID group) with 8 in each group.Isolated living conditions combining chronic unpredicted mild stress (CUMS) were used to establish depression model in rats.Four weeks after modeling,fluoxetine 10 mg· kg-1,SID1900 5.1 mg · kg-1 and 0.9％ sodium chloride were given by intraperitoneal injection respectively.Body weight and behavioral performance of rats in several experiment paradigms were measured after drug administration.The behavioral paradigms included sucrose preference test(SPT),open field test(OFT) and forced swimming test(FST).Results Drug administration had no significant effect on body weight and behavioral performance in non stress rats (P＞0.05),however,after chronic unpredicted mild stress the body weight,percentage of sucrose consumption,movement distances and rearing times in CUMS group were decreased dramatically contrast to CON group,but the immobility duration was increased significantly (all P＜0.001).After treatment with drug for 14 days,the sucrose consumption percentage(62.03± 6.99) ％) and rearing times (18.57 ± 6.37) in CUMS+SID group were increased contrast to C UMS group ((45.46± 15.54) ％,(5.83±3.06)),while the immobility time((123.57±26.73) s) was decreased compared with that in CUMS group((174.33±40.68) s).When drug administration for 28 days,the sucrose consumption percentage((79.64± 11.37) ％),the total distance as well as the rearing times ((13.18 ± 3.17) m,(19.33±3.33)) within OFT in CUMS+FLU group were increased in comparison with CUMS group((48.06± 17.10) ％,(4.45±3.69) m,(5.17± 2.99)),and the immobility duration ((97.83± 18.97) s) in CUMS+FLU group was shorter than that ((194.83±37.97) s) in CUMS group(P＜0.05).Notably,the immobility time in CUMS+SID group ((44.29± 14.30)s) was shortened obviously compared with that in CUMS+FLU group ((97.83± 18.97)s) (P＜0.01).Conclusion Blockade of TREK-1 potassium channel can ameliorate the depression-like behavior rapidly in rats.
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Objective To investigate the effects of source to image receptor distance (SID) on the image quality and entrance surface dose (ESD) in the chest digital radiography (DR) for infants.Methods Anthropomorphic chest phantoms were exposed to 60 kVp and different values of SID ( 150 -80 cm with the interval of 10 cm,totally 8 groups) so as to record the values of mAs and ESD.The SID values of 110 cm and 90 cm with the moderate and low ESD values were selected for clinical test.Forty-two hospitalized infants,aged 12 months (8 months to 2 years) underwent chest DR with the SID of 110 cm before admission and 90 cm before discharge respectively.The values of ESD were recorded and compared.Three experienced experts assessed the quality of 84 pieces of images.Results The values of mAs and ESD decreased gradually along with the decrease of the SID from 150 cm to 80 cm.All the 84 images from the 42 infants met the demands for diagnosis.There was no significant difference in the score of image quality of the group with the SID of 110 cm (4.4±0.3) and 90 cm(4.2±0.4) (t=0.453,P＞0.05).The value of ESD of the group with the SID of 90 cm was significantly lower than that of the group of SID of 110 cm by 0.003 4 mGy ( t =12.001,P ＜ 0.05 ).Conclusions The image quality of chest DR could meet the demands for diagnosis in spite of the value of SID,however,the SID value in chest DR significantly might influence the ESD.The SID value of 90 cm shoud be recommended in chest DR for infants.
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INTRODUCCIÓN. La atención a los pacientes con de sepsis intraabdominal diseminada continúa presentado variantes de conducta. A pesar de los adelantos terapéuticos, los índices de mortalidad continúan siendo elevados y oscilan entre el 30 y el 60 por ciento. Dicha oscilación está influenciada, en ocasiones, por la selección de la muestra. El objetivo principal del presente estudio fue conocer el comportamiento de la sepsis intraabdominal diseminada entre los años l995 y 2005, en nuestra institución. MÉTODOS. Se realizó un estudio retrospectivo y prospectivo de los pacientes con sepsis intraabdominal diseminada, operados entre l995 y 2005 en el Servicio de Cirugía General del Hospital Docente Clinicoquirúrgico Joaquín Albarrán. Fueron revisados 119 expedientes clínicos y 49 protocolos de necropsia. Se estudiaron grupos etarios, patologías más frecuentes, síntomas y signos, efectividad en el diagnóstico, métodos de tratamientos, complicaciones, gérmenes causales y mortalidad. RESULTADOS. Hubo 49 fallecidos (41,1 por ciento) y se constató un incremento del 3 por ciento de la mortalidad en comparación con el año anterior, debido fundamentalmente al aumento del número de dehiscencias de suturas intestinales, ocurridas en el 22,5 por ciento de los fallecidos por falta de una decisión quirúrgica precoz. La mayoría de estos pacientes tenían enfermedades oncoproliferativas. El método de tratamiento local más empleado fue el cerrado (72 pacientes; 60,5 por ciento). En general hubo un cumplimento adecuado del algoritmo de trabajo utilizado en el Servicio(AU)
INTRODUCTION: Care of patients presenting with spreading intra-abdominal sepsis continues presenting behavior variations. Despite therapeutical advances, mortality rates are still high, and fluctuate between 30 percent and 60 percent. Sometimes, such fluctuation is influenced by sample selection. The main objective of present paper was to know the behavior of spreading intra-abdominal sepsis between 1995 and 2005 in our institution. METHODS: Authors made a retrospective and prospective study of patients presenting with spreading intra-abdominal sepsis, operated on between 1995 and 2005 in General Surgery Service of Joaquín Abarrán Clinical Surgical Teaching Hospital. A total of 119 clinical records and 49 necropsy protocols were reviewed. Age groups, more frequent pathologies, symptoms and sings, diagnosis effectiveness, treatment methods, complications, causal germs, and mortality were studied. RESULTS: There were 49 deceased (41, 1 percent) and a mortality increment of 3 percent was confirmed, compared with past year, basically due to raise in number of intestinal suture dehiscences, occurred in 22,5 percent of deceased by a lack of early surgical decision. Most of these patients presented with onco-proliferative diseases. The more used local treatment was the closed one (72 patients; 60, 5 percent). In general, there was an appropriate fulfillment of work algorithm used in the service(AU)