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Objective:To investigate the effects of early intervention with low-dose dobutamine on pneumonia complicated with sepsis.Methods:We retrospectively analyzed the clinical data of 200 patients with pneumonia complicated by sepsis who received treatment in the First People's Hospital of Taizhou from January 2015 to January 2018. We divided these patients into control and observation groups with 100 patients/group according to different treatment methods. The control group was treated with immunoglobulin and methylprednisolone and given ventilator-assisted ventilation. The observation group was given low-dose dobutamine based on the treatments given in the control group. Clinical efficacy, pulmonary function, the incidence of adverse reactions, length of hospital stay, time to dyspnea disappearance, organ failure rate, and mortality were compared between the two groups.Results:Total response rate was significantly higher in the observation group than in the control group [96.0% (96/100) vs. 77.0% (77/100), χ2 = 15.45, P < 0.05]. After treatment, improvements in the pulmonary function indexes [forced vital capacity, forced expiratory volume in one second, and forced expiratory volume in one second/forced vital capacity] in the observation group were superior compared with those in the control group ( t = -15.25, -34.56, -3.77, all P < 0.001). Length of hospital stay and time to dyspnea disappearance in the observation group were (4.23 ± 0.89) days and (3.21 ± 0.58) days, respectively, which were significantly shorter than those in the control group [(8.96 ± 1.58) days, (7.26 ± 0.24) days, t = -26.08, -64.52, both P < 0.001]. The incidence of adverse reactions, incidence of organ failure, and mortality in the observation group were 2.0% (2/100), 1.0% (1/100) and 2.0% (2/100) respectively, which were significantly lower than those in the control group [18.0% (18/100), 20.0% (20/100), 10.0% (10/100), χ2 = 16.80, 19.20, 5.67, all P < 0.05). Conclusion:Early intervention with low-dose dobutamine for the treatment of pneumonia complicated by sepsis can greatly improve clinical efficacy, reduce adverse reactions, decrease the incidence of organ failure and mortality, improve pulmonary function, and shorten the length of hospital stay and time to dyspnea disappearance.
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Objective To investigate the therapeutic effect of ipratropium bromide on bronchial spasm of patients with asthma and chronic obstructive pulmonary disease (COPD).Methods 174 patients with asthma and COPD were selected and divided into two groups, 87 cases in the control group treated with budesonide and formoterol fumarate powder for inhalation , 87 cases in the experimental group received ipratropium bromide on the basis of the control group, pulmonary ventilation function, airway resistance and cytokine levels in induced sputum, the clinical effect and incidence of adverse reactions were compared after the treatment.Results The effective rate in the control group(81.61%)was lower than the experimental group (93.11%), with significant difference (P<0.05); compared with the control group, levels of peak expiratory flow (PEF), maximum midexpiratory flow (MMEF), forced expiratory volume in one second to forced vital capacity ratio (FEV1%), forced vital capacity (FVC) were higher in the experimental group after treatment, levels of airway resistance (Raw), Raw% were lower, level of specific airway conductance (Gsp) was higher after treatment, induced sputum levels of vascular endothelial growth factor (VEGF), intercellular adhesion molecular-1 (ICAM-1), interleukin-13 (IL-13), IL-17 were lower after treatment, with significant difference (P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The clinical effect of ipratropium bromide in the treatment of asthma and COPD was exactly , ipratropium bromide can significantly improve the pulmonary ventilation function in patients, relieve bronchial spasm, reduce airway resistance, inhibit airway inflammation, and the safety is higher.
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Extracellular recordings of field excitatory postsynaptic potential (fEPSP) is one of the most common ways for studies of synaptic plasticity, such as long-term potentiation (LTP) and paired-pulse plasticity (PPP). The measurement of the changes in the different components of fEPSP waveform, such as the initial slope, initial area, peak amplitude and whole area, were commonly used as criteria for the judgement of potentiation or depression of synaptic plasticity. However, the differences in the conclusions drawn from measuring different components of fEPSP waveform at the same recording have still been largely ignored. Here we compared high-frequency stimulation (HFS)-evoked synaptic plasticity, both LTP and PPP, by measuring different components of fEPSP waveform, including the initial slope, initial area, peak amplitude, whole area and time course. The results not only indicated the acceleration of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor kinetics underlies LTP in hippocampal CA1 region of mice, but also showed that different measurements of fEPSP waveform at the same recording result in different magnitudes of LTP and different forms of PPP in hippocampal CA1 region of mice. After HFS, the paired-pulse ratio was slightly decreased by measurement of the initial area, but obviously increased by measurement of the initial slope of the pair fEPSPs. These results might draw apparently contradictory conclusions. Therefore, careful and complete analysis of the data from different parts of fEPSP waveforms is important for reflection of the faithful changes in synaptic plasticity.