Protective effects of valproic acid on cardiac and cerebral injury in rats subjected to severe scalding combined with seawater immersion injury with delayed fluid replacement / 中国药房

OBJECTIVE To study the protective effects o f valproic acid on cardiac and cerebral injury in rats subjected to severe scalding combined with seawater immersion injury with delayed fluid replacement. METHODS The rats were divided into scalding+delayed fluid replacement group （group S ），scalding+seawater immersion+delayed fluid replacement group （group SS ）， scalding+seawater immersion+valproic acid+delayed fluid replacement group （group SSV ）according to random number table ，with 60 rats in each group. All groups were subjected to 35％total body surface area third-degree full-thickness scalding with boiled water. Group SS and group SSV were immersed in artificial ；seawater（30 min）immediately after scalding ，and group SSV was subcutaneously injected with valproic acid 300 mg/kg immediately after out of water. Sodium lactate Ringer ’s 0314-2279277。E-mail：125467374@qq.com injection was injected intravenously within 30 minutes according to 1/2 Parkland formula at 2 h after scalding in each group for delayed fluid replacement. The death time of rats was recorded ，and the average survival time and 24 h survival rate of rats in each group were calculat ed. Mean arterial pressure （MAP），heart rate （HR），respiration rate （RR），rectal temperature （RT），arterial blood pH ，arterial partial pressure of oxygen （PaO2），arterial blood partial pressure of carbon dioxide （PaCO2），HCO3－，creatine kinase MB isoenzyme （CK-MB）and neuron specific enolase （NSE）were detected before scalding ，at 0，2，5 h after scalding. The pathological changes of cardiac and cerebral tissue were observed. RESULTS The 24 h survival rate of group SS （55％）was significantly lower than that of group S （90％）， while that of group SSV （75％）was increased significantly ，compared with group SS （P＜0.05）. Compared with group S ，the levels of MAP ，RT，HR，pH，PaO2 and HCO 3－ in group SS were significantly lowered ，while the levels of CK-MB and NSE were increased significantly at 0，2，5 h after scalding ；the levels of PaCO 2 were increased significantly at 2，5 h after scalding ， while the levels of RR were decreased significantly at 0，2 h after scalding （P＜0.05）. Compared with group SS ，the levels of MAP，RT，HR，pH，PaO2 and HCO 3－ in group SSV were significantly increased ，while the levels of PaCO 2，CK-MB and NSE were decreased significantly at 2，5 h after scalding ；the level of RR was increased significantly at 2 h after scalding （P＜0.05）. At 2，5 h after scalding ，cardiac and cerebral injury of rats in group SS were aggravated significantly than that in group S ；cardiac and cerebral injury of rats in group SSV were relieved significantly than that in group SS. CONCLUSIONS After severe scalding combined seawater immersion injury ，hypodermic injection of sodium valproate could protect cardiac and cerebral function of rats ， improve vital signs and blood gas index ，prolong survival time and improve survival rate in rats.

Knowledge and Attitudes Towards Fluid Hydration of Athletes by Jamaican Track and Field High-school Coaches

ABSTRACT Objective: To determine whether or not Jamaican coaches' knowledge and practices of fluid replacement are on par with that of the National Athletic Association's and the American College of Sports Medicine Standards. Methods: A descriptive survey of 90 high-school track and field coaches in Jamaica was conducted. Coaches were given a 29-item survey questionnaire which adapted the content from previous surveys and also based on the National Athletic Trainers' Association guidelines for fluid replacement and information sources of fluid replacement. A pass score of 80% was employed. Results: Approximately 26.6% of participants passed the knowledge-based assessment with the minimum requirement of 80% and 73.4% of participants had an unacceptable level of knowledge about fluid replacement and hydration. Only 26 (28.9%) coaches received training in fluid replacement therapy. Most of them therefore relied on reading materials ranging from magazines to journals, or learnt it on the job from other coaches. Conclusion: Findings suggest that the level of knowledge in Jamaican track and field high-school coaches about fluid replacement and hydration is very poor. However, their attitudes towards fluid replacement and hydration are very good, and this will facilitate their acceptance and adoption of correct fluid replacement guidelines. Tapping into this positive attitude and implementing workshops, seminars and onsite promotion should improve the coaches' knowledge significantly.

Discussion on the treatment of heat stroke complicated with multiple organ dysfunction syndrome using circulating fluid replacement / 中国实用护理杂志

Objective@#To investigate the nursing strategy and curative effect for two kinds of circulating fluid replacement in the treatment of heat stroke (HS) with multiple organ dysfunction (MODS).@*Methods@#The nursing data for 32 patients with HS were analyzed retrospectively. 17 patients of group A were treated with "spend-and-tax" of circulating fluid replacement. 15 patients of group B were treated with conventional fluid replacement. The rehydration fluid was 5% glucose (500ml) and Ringer′s solution (500ml). If necessary, the potassium should be supplemented. The last, to observe the effect of "spend-and-tax" on the outcome of comprehensive treatment of HS combined with MODS.@*Results@#17 patients (group A) were all cured. During treatment, water, electrolyte and acid-base balance disorders did not occur. Comparing with the 15 cases (group B) treated for conventional fluid replacement at same time, the temperature (T), heart rate (HR) were significantly improved (t=-7.453-7.632, all P<0.05), the arterial blood pressures (ABP) were significantly increase (t=-7.896--3.326, all P<0.05).@*Conclusions@#Using the model of "spend-and-tax" fluid replacement can obviously improve the function of liver and kidney, reduce the injury of myocardium and skeletal muscle, improve prognosis, and decrease the mortality rate on patient suffered HS complicated MODS. It was an important content of nursing work that observing and nursing water、electrolytes for patients with HS and MODS.

Hidratação em atividades físicas de longa duração: uma revisão / Hydration in physical activities long term: a review

Introdução: a prática atividade física prolongada aumenta a dissipação de calor acarretando o processo fisiológico da desidratação. Por outro lado, a hidratação é de suma importância para evitar os efeitos negativos da perda hídrica. Objetivo: revisar os métodos de avaliação do processo de desidratação e estratégias de hidratação em atividades físicas de longa duração. Metodologia: foi realizado revisão de literatura integrativa. Foram consultados livros em biblioteca e artigos em diversas bases de dados (Google Acadêmico, Lilacs, Medline, Scielo e Bireme), utilizando os seguintes unitermos: hidratação; desidratação; reposição hídrica; atividade física; longa duração. A primeira parte da revisão foi realizada de forma narrativa e levantadas informações acerca de líquidos corporais, conceitos de desidratação, bem como, estratégias de hidratação. Na revisão sistemática foram totalizados 15 artigos, sendo 12 manuscritos com modelo humano, 02 revisões de literatura e 01 trabalho contendo diretrizes gerais sobre reposição hídrica, após o levantamento os artigos Recebido em: 03/11/2017 foram discutidos em seus métodos de avaliação de desidratação e estratégias de intervenção para hidratação em diversas modalidades prolongadas de atividade física. Conclusão: o método de avaliação da massa corporal é amplamente utilizado como indicador de desidratação e como estratégica de intervenção de hidratação. Verifica- -se também que o consumo de água isolada não reduz os efeitos da desidratação. A maioria dos estudos encontrados foi realizada com atletas, sugerindo assim que investigações com indivíduos praticantes de atividade física para a saúde sejam encorajadas para criação de estratégias de reposição hídrica para tal população.

Introduction: the prolonged practice of physical activity increases the heat dissipation causing the physiological process of dehydration. On the other hand, hydration is of paramount importance to avoid the negative effects of water loss. Objective: to review methods of evaluation of the dehydration process and hydration strategies in long-term physical activities. Methodology: an integrative literature review was carried out. Library books and articles were consulted in several databases (Google Scholar, Lilacs, Medline, Scielo and Bireme), using the following key words: hydration; dehydration; water replenishment; physical activity; Long term. The first part of the review was conducted in a narrative manner and raised information about body fluids, dehydration concepts, as well as, hydration strategies. In the systematic review, 15 articles were totalized, being 12 manuscripts with human model, 02 literature reviews and 01 work containing general guidelines on water replacement, after the survey the articles were discussed in their methods of evaluation of dehydration and intervention strategies for hydration in various prolonged modalities of physical activity. Conclusion: the method of assessing body mass is widely used as an indicator of dehydration and as a strategy of hydration intervention. It is also verified that the consumption of insulated water does not reduce the effects of dehydration. Most of the studies found were performed with athletes, thus suggesting that investigations with individuals practicing physical activity for health should be encouraged to create water replacement strategies for such population.

Effects of Different Plasmapheresis Supplement Timing on Therapeutic Efficacy of Toxic Liver Injury / 中国药房

OBJECTIVE:To explore the effect of different plasmapheresis supplement timing on therapeutic efficacy of toxic liver injury. METHODS:96 patients with toxic liver injury and divided into group A,B ,C and D with 32 cases in each group ac-cording to different plasmapheresis supplement timing. All patients received plasmapheresis supplement based on routine treatment. In group A,synchronized fluid replacement was 100% fresh plasma;in group B,synchronized fluid replacement was 40% normal saline firstly,and then 60%fresh plasma;in group C,substitute liquid was given till the in vitro blood reached 12%of circulation amount,supplement order as 40% normal saline for the first supplement,and then add 60% fresh plasma. The clinical symptoms and signs,liver function,prothrombin activity and blood biochemical indicators were observed in each group before and after treat-ment. RESULTS:Plasmapheresis supplement had good therapeutic efficacy on toxic liver injury;but the time of clinical symptoms and signs disappearance in group C was significantly shorter than that in group A and B,and the group B was significantly shorter the group A,with statistical significance (P0.05). CONCLUSIONS:Different plasmapheresis supplement timing have different effect on toxic liver injury. The supplement method that giving 40% normal saline for the first supplement,and then add 60% fresh plasma when in vitro blood reach 12%of circulation amount has more significant effect.

Clinical studies of cerebrospinal lfuid replacement combined with Vancomycin and dexamethasone intrathecal injection on intracranial infection / 中国生化药物杂志

Objective To investigate the effect of cerebrospinal lfuid replacement combined with vancomycin and dexamethasone intrathecal therapy on biochemical indicators of postoperative intracranial infection, in order to improve the clinical diagnosis and treatment. Methods 70 cases with intracranial infection collected in Third Hospital of Beijing Armed Police Corps from February 2010 to April 2013 were as subject, and randomly divided into two groups. Control group(n=35) were given cerebrospinal lfuid replacement and ceftriaxone intravenously, observation group(n=35) were given cerebrospinal lfuid replacement combined with vancomycin and dexamethasone intrathecal injection. The clinical effects and biochemical indicators were observed after treatment in two groups. Results In control group, the cure rate was 22.86%and total efifciency was 77.14%. In observation group, the cure rate was 37.14% and total efficiency was 91.43%. The differences between two groups were statistically significant (P<0.05). The differences of leukocytes, glucose, protein, intracranial pressure in two groups after treatment were also statistically signiifcant(P<0.05). Conclusion Cerebrospinal lfuid replacement combined with vancomycin and dexamethasone intrathecal injection therapy can increase intracranial infection.

Clinical analysis for transcatheter aneurysm embolization and cerebrospinal fluid replacement therapy for subarachnoid hemorrhage in 85 cases / 重庆医学

Objective To explore clinical effects of transcatheter aneurysm embolization and cerebrospinal fluid replacement therapy for the treatment of subarachnoid hemorrhage .Methods Clinical path data of 85 cases of subarachnoid hemorrhage patients from January 2010 to August 2012 were analyzed ,and all were used transcatheter aneurysm embolization and cerebrospinal fluid re-placement therapy to observe the clinical effects .Results A total of 85 patients with 84 cases were cured or improved(98 .82% ) , died in 1 case(1 .18% ) and occur complications in 10 cases(11 .76% ) .68 cases of those were followed up for 0 .5-2 .0 years and no case occurred rebleeding .85 patients were hospitalized for 10 to 40 days ,and the average hospital stay was(17 .5 ± 13 .0)d .Conclu-sion Transcatheter aneurysm embolization is a safe ,effective method treating subarachnoid hemorrhage ,combined with cerebrospi-nal fluid replacement therapy to shorten the course ,reduce complications and improve the cure rate .

Discussion on circulating fluid replacement in the polyuria stage after simultaneous islet cell-renal transplantation / 中国实用护理杂志

Objective To discuss and improve the scheme of circulating fluid replacement in the polyuria stage after simultaneous islet cell-renal transplantation.Methods Nursing data of 26 patients after simultaneous islet cell-renal transplantation during the polyuria stage were analyzed retrospectively,the impact on spend-and-tax circulating fluid replacement on the outcome after surgery was observed.Results In 26 patients,3 case suffered graft function recovery delay,23 patients' renal function recovered smoothly without water-electrolyte and acid base disorders in period of diuresis,compared with the 16 cases with traditional fluid replacement in the same time,serum creatinine (SCr),blood urea nitrogen (BUN) and blood glucose (BG) decreased significantly in 72 h.Conclusions Using spend-and-tax fluid replacement can reduce postoperative complications such as water-electrolyte and acid-base disorders in simultaneous islet cell-renal transplantation patients,and promote the functional recovery of transplanted islet cells and kidney.

Time motion analysis of football (soccer) referees during official matches in relation to the type of fluid consumed

The aim of the present study was to determine the effect of volume and composition of fluid replacement on the physical performance of male football referees. Ten referees were evaluated during three official matches. In one match the participants were asked to consume mineral water ad libitum, and in the others they consumed a pre-determined volume of mineral water or a carbohydrate electrolyte solution (6.4 percent carbohydrate and 22 mM Na+) equivalent to 1 percent of their baseline body mass (half before the match and half during the interval). Total water loss, sweat rate and match physiological performance were measured. When rehydrated ad libitum (pre-match and at half time) participants lost 1.97 ± 0.18 percent of their pre-match body mass (2.14 ± 0.19 L). This parameter was significantly reduced when they consumed a pre-determined volume of fluid. Sweat rate was significantly reduced when the referees ingested a pre-determined volume of a carbohydrate electrolyte solution, 0.72 ± 0.12 vs 1.16 ± 0.11 L/h ad libitum. The high percentage (74.1 percent) of movements at low speed (walking, jogging) observed when they ingested fluid ad libitum was significantly reduced to 71 percent with mineral water and to 69.9 percent with carbohydrate solution. An increase in percent movement expended in backward running was observed when they consumed a pre-determined volume of carbohydrate solution, 7.7 ± 0.5 vs 5.5 ± 0.5 percent ad libitum. The improved hydration status achieved with the carbohydrate electrolyte solution reduced the length of time spent in activities at low-speed movements and increased the time spent in activities demanding high-energy expenditure.

Application of low lateral drainage of bilateral alternating and turokinaseinstillation in treatment of spontaneous intraventricular hemorrhage / 中国基层医药

Objective To evaluate the clinical value of combined treatment for spontaneous intraventricular hemorrhage. Methods 26 patients with spontaneous intraventricular hemorrhage were conducted on the whole turn of low lateral drainage of bilateral urokinase infusion therapy, supplemented by lumbar puncture cerebrospinal fluid replacement. Results The total effective rate was 84.62% ,mortality rate was 15. 38%. Conclusion Bilateral lateral drainage of alternating low urokinase infusion,supplemented by lumbar puncture cerebrospinal fluid replacement was effective in treatment of spontaneous intraventricular hemorrhage. It could reduce mortality in patients with intraventricular hemorrhage and increase the patients' prognosis.

Research in effect of cerebrospinal fluid replacement in treatment of subarachnoid hemorrhage and its nursing countermeasures / 中国实用护理杂志

Objectives To investigate the effect of cerebrespinal fluid replacement using three- way pipe on subarachnoid hemorrhage and the nursing points were summarized. Methods 80 subarachnoid hemorrthage patients were divided into the treatment group and the control group with 40 patients in each group. The control group received traditional medical treatment and routine nursing. The treatment group received cerebrospinal fluid replacement.The incidence of complication,death and clinical effect were com-pared between the two groups and the data under χ2 test and t test. Results Each index in the treatment group was better than that of the control group. Conclusions Intensified nursing after cerebrospinal fluid replacement can improve treatment effect, alleviate prognosis and supply reference for future nursing work for this disease.

Study on therapeutic effect of cerebrospinal fluid replacement combined with intrathecal injection on tuberculous meningitis / 中国基层医药

Objective To explore the therapeutic effect of cerebrospinal fluid (CSF) replacement combined with intrathecal injection on tuberculous meningitis. Methods Fifty-five patients with tuberculous meningitis were randomly divided into treatment group and control group. The patients in the treatment group were treated with CSF replacement combined with intrathecal injection on the basis of routine anti-tuberculosis therapy. The curative effects between these two groups were analyzed after 8 weeks. Results The total effective rate was 95.7% in the treatment group,compared with that 61.9% in the control group (P < 0.01); the healing rate in the treatment group was 56.2% vs 28.6% in the control group. In addition,the decay rate for WBC and CSF pressure in the treatment group are more rapid than those in the control group(P < 0.05). Conclusion CSF replacement combined with intrathecal injection has better curative effect in patients with tuberculous meningitis.

Influence on early blood glucose of patients by 3L fluid replacement after kidney transplantation / 中国实用护理杂志

Objective To observe the influence on early blood glucose by 3 L fluid replacementafter kidney transplantation. Methods Patients(60 cases) after kidney transplantation were randomly di-vidod into two groups.Group A used circular fluid replacement and Group B used 3L fluid replacement. Thelevel of blood glucose was detected before operation,after operation ,once every 8 hours at the first day,thenonce a day for the following six days. Results The level of blood glucose with 3 L fluid replacement waslower than that with circular fluid replacement,especially from the fast day to the fourth day after operation(P < 0.05). Conclusions The method with 3 L fluid replacement surpasses obviously circular fluid re-placement in blood glucose control after kidney transplantation.

Research on the curative effect of cerebrospinal fluid replacement combining intravenous drips and intrathecal injection of amphotericin B in the treatment of cryptococcal neoformans meningitis / 中国基层医药

Objective To study the curative effect of cerebrospinal fluid replacement combining intravenous drips and intrathecal injection of amphotericin B in the treatment of cryptococcal neoformans meningitis(CNM for short).Methods 28 CNM patients were randomly divided into two groups.Group A was the treatment group,and the treatment method was cerebrospinal fluid replacement combining intravenous drips and intrathecal injection of amphotericin B.Group B was the control group,and the treatment method was only intravenous drips and intrathecal injection of arnphotericin B.The period of treatment was 16 weeks.The curative effect was assessed in terms of symptoms,physical features,CSF routine examination,CSF cultivation and smear examination.Results The cura- tive effect of treatment group was better than that of the control group.There were remarkable differences between these two groups(P

Relation of inflammatory inhibition and headache after subarachnoid hemorrhage / 中国康复理论与实践

@#ObjectiveTo explore pathogenesis of headache after subarachnoid hemorrhage (SAH) whether related with immune inflammatory reaction in subarachnoid and observe the effect of immunosuppressive action of dexamethasone on headache.Methods80 patients who was consciousness and complained headache after SAH were randomly divided into four groups, treated only with mannitol, mannitol plus cerebrospinal fluid (CSF) replacement, intrathecal and vein injection with dexamethasone. Effects of four groups were observed.ResultsEfficiencies of four groups were respectively the mannitol group 27.27%, the permutation group 66.67%, the intrathecal group 92.36% and the vein group 30.00%. There was a significantly difference between the intrathecal group and other three groups, and the time of headache remission for intrathecal group was also longer than that of other three groups (P<0.01).ConclusionThe wide immune inflammatory responses in subarachnoid induced by degenerative and hemic CSF is likely main cause of headache after SAH and intrathecal injection with dexamethasone has an obviously effect.

A Clinical Study on the Delayed Rapid Fluid Resuscitation in Burn Patients with Shock / 中国医师杂志

Objective To explore a suitable plan for the delayed rapid fluid resuscitation in burn patients with shock. Methods 20 patients with total body surface area (TBSA) burned over 40% admitted 4～8h after postburn were enrolled in this study. The patients were randomly divided into plasma and gelofusin groups. Rapid fluid replacement was given immediately after admission under close hemodynamic monitoring. Hemodynamic (PAP, PAWP, CO, PVR, SVR) and hemorrheological parameters, tissue oxygenation (DO 2, VO 2, O 2ext , lactic acid, base deficit) as well as indices reflecting the main visceral functions and damage were investigated. Results The amount of rapid fluid infusion within 2h after admission accounted for 38 8?6 1% of the amount calculated with the formula for the first 24h. When the infusion amount of pre-hospitalization was added, the amount would be (48 3?5 0)% of the amount for the first 24h. The real amount of the infusion for the first 24h was (31 4?14 3)% more than that of the amount calculated with the Evans formula. The real infused fluid amount for the second 24h was almost equal to the amount calculated with the formula. After fast fluid replacement therapy, all the parameters determined were markedly improved. Conclusions It is proposed that the formula for the delayed rapid fluid resuscitation in burn patients with shock should be: the amount infused for the first 24h (ml) =TBSA (%)?body weight (kg)?2 6,the ratio of colloid to electrolytes is 1:1, water=2000ml. Half of the total amount should be infused in the first 2h after admission under close hemodynamic monitoring. The amount infused for the second 24h (ml)=TBSA (%)?body weight (kg)?1,the ratio of colloid to electrolytes is 1:1, water=2000m1.

Heat stress and fluid replacement in golfers / 体力科学

The purpose of this study was to detemine the effect of water intake on themoregulatory response during a round of golf (18 holes) in the heat (30-33°C, 55-70% RH) . Ten middle-aged male subjects participated in two separate golf rounds. During the first round the subjects played without fluid replacement (D), while in the second they received water replacement equal to weight loss in D (R) . With D, body weight loss of 3.8% was accompanied by a 13.3% reduction in calculated plasma volume (PV), while a small loss of body weight (0.5%) with an increase in PV of 4.6% was observed in R. A third round of golf by 5 of the subjects in cooler weather (20.4°C) without fluid replacement two months later resulted in heart rate and rectal temperature changes only slightly lower than during R. Golfing with D significantly elevated rectal temperatures and heart rates as compared to R. The rectal temperatures and heart rates at end of the 4.5-hr rounds were 39.4°C and 145 bpm, and 38.6°C and 116 bpm, in D and R, respectively. The serum enzymes, aspaartate aminotransferase, alamine aminotransferase, lactate dehydrogenase, and creatine kinase were measured at rest and after golfing. All enzyme levels increased signijicantly after golfing in D and to a lesser extent in R. The advantages of frequent fluid replacement during golf in high environmental temperatures was clearly demonstrated.