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Objective To investigate the effect of volume resuscitation with normal saline (NS) at 37 ℃ on the coagulation function and microcirculation of neonates with septic shock. Methods Children with septic shock admitted to neonatal intensive care unit (NICU) of the First Affiliated Hospital of Gannan Medical University were enrolled. Twenty-four newborns with septic shock were divided into two groups by random number table method (12 in each group), and were resuscitated with 10 mL/kg at 25 ℃ NS and 37 ℃ NS respectively on the basis of routine treatment. FactorⅡ,Ⅴ,Ⅶ,Ⅷ,Ⅸ,Ⅹ, and prothrombin time (PT), thrombin Time (TT), fibrinogen (FIB), activated partial thromboplastin time (APTT), D-Dimer (DD), lactic acid (Lac) were detected before treatment and 6 hours and 12 hours after treatment. Results The levels of coagulation factors Ⅱ,Ⅴ,Ⅶ,Ⅷ,Ⅸ,Ⅹ were not significantly changed before and after treatment in the two groups, and there was no significant difference between the two groups. After treatment, PT and APTT in both groups were gradually shortened, DD and Lac were gradually decreased, FIB were gradually increased, while TT had no significant change. Among them, PT, APTT, DD and Lac at 6 hours after treatment in 37 ℃NS group were significantly lower than those before treatment [PT (s): 14.07±1.02 vs. 17.08±1.54, APTT (s):54.83±12.39 vs. 69.17±16.36, DD (mg/L): 2.40±0.63 vs. 4.18±0.88, Lac (mmol/L): 2.84±0.82 vs. 5.98±1.17, all P < 0.05]; DD and Lac at 6 hours after treatment in 25 ℃ NS group were significantly lower than those before treatment [DD (mg/L): 3.13±0.84 vs. 4.16±1.04, Lac (mmol/L): 4.83±0.64 vs. 5.69±0.74, both P < 0.05], and PT at 12 hours after treatment was significantly shorter than that before treatment (s: 14.63±1.14 vs. 16.48±1.61, P < 0.01); FIB in both 25 ℃ NS group and 37 ℃ NS group at 12 hours after treatment were significantly higher than those before treatment (g/L: 2.83±0.83 vs. 1.58±0.43, 2.87±0.87 vs. 1.47±0.41, both P < 0.01), but TT had no significant change. The comparison between groups showed that PT, DD and Lac in the 37 ℃ NS group were significantly lower than those in the 25 ℃ NS group at 6 hours after treatment [PT (s): 14.07±1.02 vs. 15.69±1.21, DD (mg/L): 2.40±0.63 vs. 3.13±0.84, Lac (mmol/L): 2.84±0.82 vs. 4.83±0.64, all P < 0.05]; at 12 hours after treatment, PT, APTT and DD in the 37 ℃NS group were significantly lower than those in the 25 ℃ NS group [PT (s): 13.26±0.91 vs. 14.63±1.14, APTT (s):37.08±10.43 vs. 54.75±14.96, DD (mg/L): 1.20±0.59 vs. 2.06±0.69, all P < 0.01], and FIB was significantly higher than that in the 25 ℃ NS group (g/L: 2.87±0.87 vs. 2.83±0.83, P < 0.05). Conclusion Volume resuscitation at 37 ℃ can improve the coagulation function and microcirculation of newborns with septic shock.
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Objective To explore the clinical effect of corticosteroids combined with Chinese medicine sequential therapy of Guishao Dihuang pill and Yupingfeng granules on children nephrotic syndrome (NS) with yin deficiency of liver and kidney.Methods Fifty patients (the loss of children during the course of treatment were not included in the statistical analysis) with definitely diagnosed NS accompanied by yin deficiency of the liver and kidney admitted to the First Affiliated Hospital of Gannan Medical University from January 2012 to June 2016 were enrolled,and they were divided into control group and observation group by random number table,25 cases in each group.Conventional treatment of western medicine and long-term treatment of corticosteroids were given to the two groups.In addition,sequential therapy of Guishao Dihuang pills and Yupingfeng granules was given to the observation group on the bases of conventional treatment.The changes of platelet aggregation rate (PAT),cholesterol,cortisol,T cell subsets CD3,CD4,CD4/CD8 were observed before and after treatment for 8 weeks and 6 months,then the clinical efficacy and infection,etc.complications were compared between the two groups.Results There were no statistical significant differences in cholesterol,cortisol and curative effect compared between the two groups before treatment and after treatment for 8 weeks and 6 months (all P ＞ 0.05).Mter treatment for 8 weeks and 6 months,the PAT,cholesterol,cortisol of two groups were significantly decreased compared with those before treatment,while CD3,CD4 were obviously higher than those before treatment,and the degrees of changes of PAT,CD3,CD4 in the observation group were more remarkable than those of the control group [PAT:treatment after 8 weeks was (63.01 ± 6.99)％ vs.(66.62 ± 4.65)％,treatment after 6 months was (51.42 ± 7.74)％ vs.(57.01 ± 6.77)％,CD3:treatment after 8 weeks was 0.56 ± 0.06 vs.0.52± 0.06,treatment after 6 months was 0.61 ± 0.05 vs.0.58 ± 0.03,CD4:treatment after 8 weeks was 0.33 ± 0.06 vs.0.30 ± 0.05,treatment after 6 months was 0.39 ± 0.05 vs.0.33 ± 0.06,all P ＜ 0.05].CD4/CD8 ratio was significantly higher in observation group after treatment for 8 weeks and 6 months than those before therapy (1.68 ± 0.76,1.82 ± 0.95 vs.1.16 ± 0.67,both P ＜ 0.05);the number of patients with infection in observation group was obviously lower than that of the control group (86 cases vs.175 cases,P ＜ 0.05).Conclusions The therapeutic effect of corticosteroids combined with Chinese medicine sequential therapy of Guishao Dihuang pills and Yupingfeng granules for treatment of children NS with yin deficiency of the liver and kidney is better than that of using western medicine therapy alone,as the combined sequential therapy has good effects on reduction of infection,anti-thrombosis and elevation of immunity.
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Objective To analyze the expression of synaptophysin (SY) in hippocampal dentate gyrus of rats with hypoxic-ischemic brain damage(HIBD) after the injection of bone marrow stromal cells(BMSCs) and its supernatant into the lateral ventricle and to explore the mechanism of potential effects. Methods Eighty 7-day-old sprague-dawley(SD) rats were randomly divided into sham group, control group, cell group and supernatant group, with 20 rats in each group. The HIBD model was established via the ligation of left carotid arteries followed by 2-hour hypoxia. One week later, control group was injected with 0.01 mol/L PBS via the left ventricle. Meanwhile, cell and supernatant group were injected with BMSCs and supernatant harvested from BMSC culture, respectively, via the same route. For spam group, the left carotid arteries were separated but not ligated, and no hypoxia treatment was imposed on this group. They also received 0.01mol/L PBS injection one week post surgery. After 8 weeks, the expression of SY in the dentate gyrus of rats was measured. Results Compared with sham group, model group showed significantly lower IOD (integral optical density) of SY positive material in the dentate gyrus(P 0.05). Conclusions BMSCs and supernatant injected via the lateral cerebral ventricle can increase SY expression in the hippocampal dentate gyrus of HIBD rats and promote synapse formation. The mechanism of this effect may be related to cytokine secretion by BMSCs which promotes synapse formation.