Influence of N‐acetylcysteine combined ulinastatin on pulmonary function in patients undergoing coro‐nary artery bypass grafting／ / 心血管康复医学杂志

To explore influence of N‐acetylcysteine (NAC ) combined ulinastatin on pulmonary function in patients undergoing coronary artery bypass grafting (CABG ).Methods : A total of 94 patients needed CABG from our hospital were randomly and equally divided into ulinastatin group and combined treatment group (received NAC based on ulinastatin group ).Postoperative mechanical ventilation time ,in‐hospital time ,pulmonary function indexes and prognosis were compared between two groups .Results :Compared with ulinastatin group ,there was sig‐nificant rise in surgery time [ (172.35 ± 10. 70) min vs .(177. 98 ± 10.56) min] ,and significant reductions in post‐operative mechanical ventilation time [ (23. 41 ± 6. 27) h vs.(15. 98 ± 6.34) h] and in‐hospital time [ (24. 11 ± 3.33) d vs.(21. 39 ± 3. 45) d] , P＜0.05 or ＜0.01 ;significant rise in partial pressure of oxygen in artery [ (85. 47 ± 9.16) mmHg vs .(98.26 ± 8. 96) mmHg] ,oxygenation index [ (504. 41 ± 44.76) mmHg vs .(541.53 ± 42.92) mmHg] ,and significant reductionsin alveolar‐arterial oxygen difference [ (51.69 ± 7.42) mmHg vs.(42. 13 ± 8. 64) mmHg] , respiratory index [ (0.60 ± 0.26) vs.(0. 43 ± 0. 12)] in combined treatment group after treatment , P＝0.001 all.After treatment ,serum levels of interleukin (IL )‐6 ,IL‐8 and CD11b／CD18 were significantly higher than those of before treatment in two groups ( P＝0.001 all) ,but levels of above inflammatory factors in combined treatment group were significantly lower than those of ulinastatin group , P＝0. 001 all ;there were no severe infec‐tions ,pneumothorax and death in two groups after surgery .Conclusion : N‐acetylcysteine combined ulinastatincan significantly inhibit inflammatory reactions ,improve pulmonary function and relieve pulmonary injury in patients undergoing coronary surgery .

Clinical research of ulinastatin combined with ambroxol hydrochloride in the treatment of acute respiratory distress syndrome complicated with ventilator-associated pneumonia / 中国基层医药

Objective To study the clinical efficacy of ulinastatin combined with ambroxol hydrochloride in the treatment of acute respiratory distress syndrome (ARDS) complicated with ventilator-associated pneumonia (VAP).Methods One hundred and ten cases of ARDS complicated with VAP were randomly divided into the study group (55 cases) and the control group (55 cases) according to the different treatment method.The two groups accepted symptomatic anti-infective treatment,and the control group was treated with 300mg of ambroxol twice daily,the study group were intravenously infused 200 000U ulinastatin on the basis of the control group,two groups of patients were treated for 1 week.The ventilation indicators,pathogen clearance rate,off-time rate,mechanical ventilation time,respiratory rate,APACHE score,lung injury score and adverse reactions during the treatment were compared between the two groups.Results After treatment,PaO2,PaO2/FiO2,CL,RAW and PIP in the study group were (97.83 ± 12.01)mmHg,(364.25 ±35.77)mmHg,(88.93 ±9.44)mL/cmH2O,(31.45 ±4.87)cmHH2O · L-1 · s-1,(21.43 ± 5.75)cmH2O,respectively,which in the control groupwere (83.25 ± 10.13)mmHg,(238.55 ± 34.29) mmHg,(62.77 ± 8.54) mL/cmH2 O,(37.97 ± 6.54) cmH2 O · L-1 · s-1,(29.12 ± 5.43) cnH2 O,respectively.The P.aO2,PaO2/FiO2,CL in the study group were significantly higher than those in the control group,the RAW,PIP in the study group were significantly lower than those in the control group,the differences were statistically significant (t =6.88,18.81,5.93,7.21,15.42,all P ＜ 0.05).The clearance rate of both Gram-positive lacteria (90.00％)and Gram-negative bacteria (92.00％) in the study group were significantly higher than those in the control group (66.67％ and 70.21％) (x2 =4.81,8.84;P =0.03,0.00).The mean mechanical ventilation time in the study group [(7.15 ± 2.43) days] was significantly shorter than that in the control group [(12.85 ± 3.12) days] (t =10.69,P ＜ 0.05).The respiratory rate,APACHE score and lung injury scores of the two groups were significantly lower than those before treatment (P ＜ 0.05).The respiratory rate,APACHE scores and lung injury scores of the study group [(18.94 ± 6.99) times/min,(12.53 ± 3.14) points,(1.31 ± 0.15) points] were significantly lower than those of the control group [(25.87 ± 6.12) times/min,(16.53 ± 4.42) points,(1.65 ± 0.32) points],the differences were statistically significant (t =5.53,5.47,7.14;P =0.00,0.00,0.00).The off-line success rate and mortality between the two groups had no statistically significant differences (all P ＞ 0.05).Conclusion Ulinastatin combined with ambroxol hydrochloride can significantly improve the respiratory function of ARDS patients complicated with VAP,significantly shorten the duration of mechanical ventilation,improve respiratory function,reduce lung injury and improve pathogens clearance rate,but with no significant impact on mortality.

Does sildenafil enhance the effect of tamsulosin in relieving acute urinary retention?

Objective To compare the safety and efficacy of combined therapy using sildenafil and tamsulosin for management of acute urinary retention (AUR) with tamsulosin alone in patients with benign prostate hyperplasia (BPH). Materials and Methods 101 patients were enrolled in a randomized placebo-controlled study from June 2009 to April 2012. Patients presenting with an initial episode of spontaneous AUR underwent urethral catheterization and then prospectively randomized to receive tamsulosin 0.4mg plus sildenafil 50mg in group A and tamsulosin 0.4mg plus placebo in group B for three days. Urethral catheter was removed three days after medical treatment and patient’s ability to void assessed at the day after catheter removal and seven days later. Patients who voided successfully were followed at least for three months. Results Mean age of patients was 59.64 ± 3.84 years in group A and 60.56 ± 4.12 years in group B (p value = 0.92). Mean prostate volume and mean residual urine were comparable between both groups (p value = 0.74 and 0.42, respectively). Fifteen patients in group A (success rate: 70%) and nineteen patients in group B (success rate: 62.7%) had failed trial without catheter (TWOC) at 7th day following AUR (p value = 0.3). No significant difference was noted between both groups regarding the rate of repeated AUR at one month and three month follow-up period (p = 0.07 and p = 0.45, respectively). Conclusion It seems that combination therapy by using 5-phosphodiesterase inhibitor and tamsulosin has no significant advantages to improve urinary retention versus tamsulosin alone. .

Effect of Urinastatin on Microcirculation of Extrapancreatic Organs in Rats with Acute Necrotizing Pancreatitis / 中国普外基础与临床杂志

Objective To explore the effects of urinastatin(UTI) on microcirculation of extra pancreatic organs in rats with acute necrotizing pancreatitis(ANP). Methods A total of 48 rats were randomized into control group, ANP group and UTI group. The model of ANP was established by uniform injection of 5% sodium taurocholate solution under pancreatic capsule, only injection of normal saline in control group. Then the rats of UTI group were injected with UTI through the femoral vein, the rats of ANP group and control group were injected with normal saline. The blood flow of lung, kidney and distal small intestine was measured by radioactive biomicrosphere technique at 2 h and 6 h after ANP.Results Compared with the control group, the blood flow of lung, kidney and intestine was decreased significantly in the ANP group at the 2 h and 6 h after ANP ( P

Effects of urinastatin on the expressions of NF-?B and TNF-?, liver transplantation in patients / 中国现代普通外科进展

Objective: To investigate the effect of urinastatin on the expression levels of NF-?B and TNF-? liver transplantation in patients. Methods: Thirty-six patients of late stage hepatic cirrhosis were randomly divided into two eaquel groups: the experiment group was administrated by urinastatin 300 000 U and saline 10 mL via venous injection during liver transplantation, the control group was administrated 10 mL saline by venous injection at the same time. The blood samples were harvestd at 1, 2, 4 and 6 h after the blood recovery of donated liver. The nuclear factor-?B (NF-?B) P65 relative level of blood was detected by Western blot analysis and the TNF-? level of blood was detected by double antibody Sandwich enzyme linked immunosorbent assay. Serum ALT and AST were also measured. Results: The expression level of serum NF-?B p65, TNF-? in the experiment group were lower than those in the control group, and the difference was significant(P

Partly purification of urinastatin by using affinity chromatography

A human urinary trypsin inhibitor (UTI) was purified by 80% amonium sulfat precipitation, affnity chromatography using trypsin cellulofine gel. Specificity inhibitory activity of solution after affinity chromatography was increase from 0.8 to 29.1 and its recovery was 20.8%. The reslt indicated that binding of trypsin to formyl- cellulofine and the affinity chromatography with trypsin cellulofine gel was successful. Capalary electrophoresis of urine, solutions before and after affinity chromatography also supported the above result.