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Objective@#To investigate the effect of global end-diastolic volume index (GEDI)-guided fluid resuscitation on the prognosis of patients with chronic heart failure and septic shock.@*Methods@#This study was a prospective randomized controlled study. Consecutive eligible patients were divided into 2 groups according to the random number table method: control group (n=21) and experimental group (n=20). On the basis of routine treatment, patients in the control group received early goal-directed therapy until the central venous pressure (CVP) reaching 8-12 mmHg (1 mmHg=0.133 kPa), mean arterial pressure reaching over 65 mmHg, urine volume reaching over 0.5 ml·kg-1·h-1, and central venous oxygen saturation reaching more than 70%. On the basis of routine treatment, patients in the experimental group were monitored continuously on cardiac output with pulse indication and fluid resuscitation guided by volume index GEDI. The GEDI should be maintained on the range of 680-800 ml/m2. The remaining resuscitation goals were the same as control group. General clinical data of the two groups were collected at admission. Negative fluid balance onset time, duration of mechanical ventilation, ICU mortality and 28-day mortality were compared between the two groups. The outcomes were recorded as listed: start time of negative fluid balance, duration of mechanical ventilation, mortality in ICU and 28-day mortality.@*Results@#There was no significant difference in age, sex, weight, APACHE Ⅱ score, SOFA score and NYHA functional class score between the two groups (all P>0.05). The negative liquid balance onset time in the control group was 3.5 (2.5, 4.0) days, which was significantly longer than that in the experimental group (2.6 (2.0, 3.0) days,U=115.0, P=0.012). The duration of mechanical ventilation was 355 (118, 552) hours in the control group, which was significantly longer than that in the experimental group (132 (36.75, 233.3) hours, U=130, P=0.038). The ICU mortality was 38.1% (8/21) in the control group, tended to be higher than that in the experimental group (20.0%(4/20), χ2=1.620, P=0.203). The 28-day mortality was 42.9% (9/21) in the control group, similar as in the experimental group (25.0%(5/20), χ2=1.482,P=0.477).@*Conclusion@#Fluid resuscitation guided by volume index (GEDI) may improve the prognosis of patients with chronic heart failure complicated with septic shock.
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BACKGROUND:Although several prosthetic methods, such as artificial denture and dental implants, are clinical therapies to tooth loss, they are thought to have safety and usage time issues. With the development of biological and biomaterial sciences, recently, tooth tissue engineering has attracted more and more attention. OBJECTIVE:To reflect advances and problems of tissue engineering technologies for promotion of tooth regeneration. METHODS:Using the keywords of“tissue engineering, tooth regeneration”in English and Chinese, PubMed and CNKI databases from 2007 to 2013 were retrieved. A total of 65 literatures addressing tooth regeneration and tissue engineering were col ected, including 25 Chinese articles and 40 English articles. Published early, repetitive, and similar researches were excluded. Final y, 48 articles were included. RESULTS AND CONCLUSION:The combination of stem cells and suitable scaffolds is widely used in tooth regeneration today, and growth factors or bone marrow which can produce promote tooth regeneration are added as wel , which has achieved partial or whole tooth regeneration. But there are apparent deficiencies in studies which focus on mechanisms behind tooth regeneration.