Effect of different fluid resuscitation strategies on respiratory mechanics and oxygenation in patients with septic shock / 重庆医学

Objective To observe the effect of different fluid resuscitation strategies on respiratory mechanics and oxygena-tion in the patients with septic shock .Methods The treatment data in 125 patients with septic shock in ICU of this hospital were retrospectively investigated and analyzed .The patients were divided into the restriction fluid resuscitation group (n=58) and open fluid resuscitation (n=67) according to fluid resuscitation results .The changes of respiratory mechanics (static lung compliance ,in-spiratory resistance) and oxygenation before and after resuscitation were compared between the two groups .Meanwhile the hemo-dynamics and vasoactive drugs application were recorded in the two groups .Results The hemodynamic indicators had no statistical difference between the two groups .The use amounts and use time of vasoactive drugs in the open fluid resuscitation group were less than those in the restriction fluid resuscitation group (P<0 .01);the airway resistance in the two groups had no obvious change be-tween before and after resuscitation ,the lung compliance and oxygenation in the restriction fluid resuscitation group were superior to those in the open fluid resuscitation group (P<0 .01) .With the fluid resuscitation amount increase ,the lung compliance in the re-striction fluid resuscitation group and open fluid resuscitation group were progressively poorer ,which was especially obvious in the open fluid resuscitation group(P<0 .01);the amount of fluid resuscitation was negatively correlated with the lung compliance and oxygenation (R= -0 .783、-0 .860 ,P<0 .01) .Conclusion In treating septic shock ,although the open resuscitation strategy has smaller dose and use time of vasoactive drugs ,but the lung compliance and oxygenation are affected ,while the restriction fluid re-suscitation strategy is in contrast .

Effects of Medicinal Serum of Shenqi Yiliu Formula on Proliferation of Gastric Cancer MGC-803 Cells / 中国中医药信息杂志

Objective To investigate the inhibitory effects of medicinal serum of Shenqi Yiliu Formula on cell proliferation of gastric cancer MGC-803 cells;To discuss relevant mechanism. Methods After treated with different concentrations of medicinal serum of Shenqi Yiliu Formula, gastric cancer MGC-803 cells were tested by the following methods: MTT was employed to test the proliferation of gastric cancer MGC-803 cells; Flow cytometry was used to detect cell cycle; qRT-PCR was used to detect the genetic expressions of CDKN1B and CDKN1C;Western blot was employed to test the protein expressions of p27 and p57. Results When 3%, 5%and 10%medicinal serum of Shenqi Yiliu Formula was treated to MGC-803 cells for 24 h, 48 h and 72 h, proliferation of cells decreased significantly (P<0.01), with time- and dosage-dependent relationship. When 3%, 5% and 10% medicinal serum of Shenqi Yiliu Formula was treated to MGC-803 cells for 24 h, cells in G0/G1 increased, decreased in S. qRT-PCR results showed that compared with the blank control group and the negative control group, mRNA expressions of CDKN1B and CDKN1C of MGC-803 cells in medicinal serum all dose group increased significantly (P<0.01). Western blot results showed that compared with the blank control group, protein expressions of p27 and p57 of MGC-803 cells in medicinal serum all dose group increased significantly (P<0.01). Conclusion Medicinal serum of Shenqi Yiliu Formula can inhibit MGC-803 cells proliferation and the mechanism may be through adjusting CDKN1B, CDKN1C mRNA and proteins expression to intervene in the cell cycle.

Effects of Ferulic Acid on Gastric Cancer Cell Line MGC-803 Proliferation / 中国中医药信息杂志

Objective To explore the effects of ferulic acid on gastric cancer cell line MGC-803 proliferation;To discuss the mechanism of apoptosis induced by ferulic acid. Methods Ferulic acid with a variety of concentrations was used to treat gastric cancer cell line MGC-803 for 24, 48, 72 h;MTT experiment was used to detect the growth of gastric cancer cells. After gastric cancer cell line MGC-803 were treated with ferulic acid with a variety of concentrations (0, 5, 7.5, 10 mg/mL) for 48 h, all gastric cancer cells were collected and stained by Annexin V-FITC/PI for the detection of apoptosis by flow cytometry. RT-qPCR and Western-blot methods were used to detect mRNA and protein levels of Caspase-3, Caspase-9, Bax, Bcl-2 and Xiap. Results Compared with the control group, the OD value of cell line MGC-803 treated by ferulic acid with a variety of concentrations (5, 7.5, 10, 12.5 mg/mL) decreased significantly;the anti-tumor effect of ferulic acid was obvious;IC50 of 24, 48, and 72 hours after treated by ferulic acid was 12.93, 9.73 and 5.52 mg/mL respectively. Cell lineMGC-803 treated by ferulic acid with a variety of concentrations (5, 7.5, 10 mg/mL) after 48 h could induce the apoptosis of MGC-803 cells, up-regulate mRNA and protein levels of Caspase-3, Caspase-9, and Bax, down-regulate mRNA and protein levels of Bcl-2 and Xiap. Conclusion Ferulic acid can inhibit the proliferation of MGC-803 cells effectively and induce the apoptosis of MGC-803 cells, which mechanism is related to mitochondria apoptosis pathway and the down-regulation of Xiap expression.

Effects ofShenqi YiliuDecoction Medicated Serum on Blocking Cell Cycle and Inhibiting Invasion and Metastasis of Gastric Cancer Cell Lines MKN-45 / 中国中医药信息杂志

Objective To investigate the relevant mechanism of different concentrations of Shenqi YiliuDecoction medicated serum on blocking cell cycle and inhibiting invasion and metastasis of gastric cancer cell lines MKN-45. Methods Sixty SPF Wistar rats were randomized intoShenqi Yiliu Decoction low-, medium-, and high-dose groups and control group, with 15 rats in each group. Low-, medium- and high-dose groups were fed with different concentrations of TCM liquid from which containing crude medicine (0.25, 0.50, 1.00 g/mL) separately for gavage. Rats in the blank group were given the same amount of drinking water for gavage, twice a day, for 7 days.2 h after the last gavage, rat blood was taken and serum was separated. After MKN-45 cells were dealt with different concentrations of medicinal serum, FCM was used to detect cell cycle and immunohistochemistry technology was used to detect the expressions of COX-2 and PTEM proteins.Results FCM analysis showed that medicated serum could increase G0-G1 phase and shorten S phase of cells; medicated serum could reduce the positive expression rate of COX-2 of the MKN-45 cells and increase positive expression rate of PTEN proteins (P<0.05).ConclusionShenqi YiliuDecoction medicated serum can block the cell cycle and inhibit invasion and metastasis of MKN-45 cell lines, which may be related to the intervention in the expression levels of COX-2 and PTEN proteins.

Effect of high positive end-expiratory pressure for mechanical ventilation in the treatment of neurological pulmonary edema / 中华危重病急救医学

Objective To explore the effect of high positive end-expiratory pressure (PEEP) for the treatment of neurological pulmonary edema (NPE) in patients undergoing mechanical ventilation,and to look for the best mechanical ventilation strategy to improve the prognosis.Methods A prospective study was conducted,and 120 patients with NEP admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Guangxi Traditional Chinese Medical University from January 2010 to August 2013 were enrolled and divided into two groups according to random number table (n=60 in each group).The patients in two groups were given empiric treatment for the disease,and they underwent mechanical ventilation.In the normal PEEP group PEEP was 3-10 cmH2O (1 cmH2O =0.098 kPa),and in the high PEEP group PEEP was 11-30 cmH2O,and all the rest parameters were the same.Clinical indices before and 7 days after treatment,and 28-day morality rate were compared between two groups.Results The 28-day morality rate in high PEEP group was obviously lower than that in the normal PEEP group [25.0％ (15/60) vs.65.0％ (39/60),x2=6.465,P=0.011].The clinical signs in both groups were improved after treatment.Compared with the normal PEEP group,the clinical indices in high PEEP group were more significantly improved.There were significant differences in body temperature (℃ 37.4 ± 0.5 vs.38.5 ± 0.6),respiratory rate (times/min 18.3 ± 3.1 vs.23.3 ±3.5),heart rate (beats/min 94.7 ±8.5 vs.113.5 ±8.0),white blood cell count [WBC (× 109/L) 12.5 ±2.1 vs.17.1 ± 1.7],acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (15.6 ± 3.2 vs.19.8 ± 3.7),Glasgow coma score (GCS 12.5 ± 2.1 vs.8.5 ± 2.9),gastrointestinal dysfunction score (3.9 ± 3.0 vs.3.6 ± 2.4),oxygenation index [PaO2/FiO2 (mmHg,1 mmHg=0.133 kPa) 196.5 ± 45.1 vs.134.1 ± 22.3],serum creatinine [SCr (μmol/L) 86.5 ± 35.6 vs.98.5 ± 37.7],total bilirubin [TBil (μmol/L) 39.7 ± 23.5 vs.41.5 ± 16.2],C-reacting protein [CRP (mmol/L) 53.7 ± 21.4 vs.108.4 ± 26.3],prothrombin time [PT (s) 15.0 ± 2.1 vs.20.4 ± 2.2],activated partial thromboplastin time [APTT (s):37.3 ±4.9 vs.56.7 ± 13.6],international normalized ratio (INR 2.52 ±0.64 vs.4.01 ±0.77),extra vascular lung water index [EVLWI (mL/kg) 7.53 ± 1.21 vs.15.85 ±3.41],pulmonary vascular permeability index (PVPI 6.07 ± 0.89 vs.9.47 ± 1.26),mean arterial pressure [MAP (mmHg) 87.3 ± 10.9 vs.98.7 ± 13.6],cardiac output [CO (L/min) 7.15 ± 1.42 vs.5.65 ± 1.82],systemic vascular resistance index [SVRI (KP) 112.4 ± 9.5 vs.136.5 ± 11.9],and blood lactate (mmol/L:2.53 ± 1.23 vs.5.81 ± 2.17) between high PEEP group and normal PEEP group (P＜0.05 or P＜0.01).Conclusion Prognosis can be improved in NPE patients with the use of high PEEP in mechanical ventilation.

The clinical research on Ditan Xingnao Chengqi soup for treatment of patients with sepsis brain dysfunction / 中国中西医结合急救杂志

Objective To study the clinical effects of Ditan Xingnao Chengqi soup for treatment of patients with sepsis brain dysfunction. Methods Sixty-two cases of sepsis brain dysfunction were divided into treatment group(32 cases)and control group(30 cases)according to random digits table. Both groups received general clinical treatment,while the treatment group additionally accepted Ditan Xingnao Chengqi soup through nasal feeding. The changes of C-reactive protein(CRP)of two groups before treatment and after treatment for 12,24,48,72 hours and 1 week were observed. Besides,the Glasgow Outcome Scale(GOS)was used to assess the curative effect of two groups, and its clinical significance was judged. Meanwhile,the hospitalization costs,the times staying in hospital and total effective rates of the two groups after treatment were observed. In addition,cost-effectiveness analysis was carried out. Results With the extension of therapeutic time,the levels of CRP(mg/L)in the two groups were reduced effectively in comparison with those before treatment,and the change was more obvious in the treatment group;after treatment for 24 hours,the difference in the level of CRP between the two groups began to be statistically significant(106.5±22.3 vs. 201.6±25.4,P0.05).The ratio of cose effectiveness analysis in treatment group was smaller than that of control group(497.42 vs. 855.80,P<0.05). Conclusions Ditan Xingnao Chengqi soup has a relatively good effect on antagonizing inflammatory factors,controlling excessive inflammatory response and improving disturbance of consciousness. The early intervention with this agent for a patient with sepsis cognitive impairment can control the disease situation,improve the patient's prognosis and reduce his or her hospitalization costs.