Design and application of heating device and temperature control system for dialysis fluid bag in continuous renal replacement therapy / 中华危重病急救医学

In the process of continuous renal replacement therapy (CRRT), various factors such as the temperature of replacement fluid, the flow of fluid and the circulation of blood in cardiopulmonary bypass, lead to the temperature of the blood injected back into the body is often lower than normal. It leads to the decrease of body temperature and the occurrence of hypothermia, which can be life-threatening in severe cases. In clinical practice, medical staff mostly reduces the occurrence of hypothermia in patients with CRRT by means of the heating device of the machine, the heating of the liquid temperature box for cardiopulmonary bypass, and the application of heating blankets, but the effect is not ideal. Therefore, medical staff of the department of critical care medicine of the Second Affiliated Hospital of Anhui Medical University designed a heating device and temperature control system for CRRT dialysis fluid bag, and obtained the National Invention Patent of China (ZL 2021 1 0334906.7). The device includes a heating and thermal insulation device and a temperature control system, wherein the heating and thermal insulation device is composed of the body of the heating dialysis fluid bag and the temperature control structure, which solves the problems of safe and efficient liquid heating and thermal insulation during the CRRT process. The temperature control system can display the dynamic state of the patient's body temperature, adjust the temperature of the dialysis fluid bag in time, and monitor the temperature of the blood transfusion in real time through the cooperation of the five modules of data collection, data handle, data analysis, regulation and display. This design is applied to CRRT, which can achieve precise control of body temperature of critically ill patients, and has certain clinical significance.

Effect of early tracheoscopic treatment on patients with aspiration pneumoni / 中华急诊医学杂志

Objective:To investigate the clinical effect of early bronchoalveolar lavage on patients with aspiration pneumonia.Methods:A retrospective study was conducted on 55 patients with aspiration pneumonia who met inclusion criteria but not exclusion criteria in the Intensive Care Department of our hospital from January 2020 to April 2021. The patients were divided into the control group (32 cases) and the bronchoscopic lavage group (23 cases) according to whether they received bronchoscopic lavage within 24 h after aspiration. Basic information (sex, age, body mass index, chest X-ray score, oxidation index, temperature, heart rate, respiratory rate, white blood cells, PCT, IL-6, CPR and APACHE Ⅱ score), etiology changes at the early stage (≤ 3 d) and later stage (4-7 d after admission), and changes in prognostic indexes (mechanical ventilation time, length of ICU stay, length of stay and mortality) were compared between the two groups. The clinical efficacy of early endoscopy lavage for aspiration pneumonia was evaluated.Results:The positive rate of early etiological culture was 85.2%, the bacterial positive rate was 72.9% and the fungal positive rate was 14.6%. Pseudomonas aeruginosa accounted for 20.8%, Klebsiella pneumoniae accounted for 14.6%, Staphylococcus aureus and Streptococcus accounted for 12.5%, and there was no significant difference in the distribution between the bronchoscopic lavage group and the control group (all P>0.05). The positive rate of late etiological culture was 88.6%, the bacterial positive rate was 85.7% and the fungal positive rate was 2.9%. The positive rate of late bacterial culture was significantly decreased in the bronchoscopic lavage group ( P < 0.05), and the other results were not significantly different from the control group (all P>0.05). After early bronchoscopic lavage, the duration of mechanical ventilation, length of ICU stay and length of stay were significantly shortened, and the fifth day CPIS score was significantly decreased (all P< 0.05). Conclusions:Early endotracheal lavage can reduce mechanical ventilation time, length of ICU stay and length of stay of aspiration pneumonia, and reduce the positive rate of bacterial culture in the lung at the later stage, which needs to be further verified by a large randomized controlled study.

Prognostic significance of BISAP combined with intra-abdominal pressure measurement in acute pancreatitis / 中华普通外科杂志

Objective:To investigate the predictive value of intra-abdominal pressure (IAP) combined with bedside index for severity in acute pancreatitis (BISAP) score on the severity and prognosis of acute pancreatitis (AP).Methods:In this retrospective study, 204 AP patients admitted to the Department of ICU, Second Hospital of Anhui University from Jan 2015 to Dec 2020 were divided based on the severity: into SAP group (145 cases) and Non-SAP group (59 cases) with end point survival (177 cases) and death (27 cases). The receiver operating characteristic (ROC) curves were drawn, and the predictive value of IAP, BISAP score and I-B (IAP and BISAP scores) in the severity and the prognosis of AP was studied. Medcalc software was used to compare the areas under ROC curve for different predictors.Results:IAP and BISAP scores increased with the severity of AP ( P<0.001), the area under the ROC curve (AUC) was 0.791, 0.749 and 0.907 respectively,comparison of area under ROC curve showed that I-B combined assessment was superior to IAP value and BISAP score alone in predicting severity ( P<0.05). IAP and BISAP scores were higher in the death group than in the survival group ( P<0.001). The ROC curve results of IAP, BISAP score and I-B combined on the prognosis of AP showed that the AUC was 0.773, 0.841 and 0.950, respectively,comparison of area under ROC curve showed that I-B combined assessment was superior to IAP and BISAP score alone in predicting prognostic value ( P<0.05). Conclusion:Both IAP and BISAP scores can better predict the severity of and the prognosis of AP, and the combination of IAP and BISAP score is more valuable for prediction of prognosis in AP.

Quantitative determination and optimun extraction technique of nine compounds of / 浙江大学学报·医学版

OBJECTIVE@#To establish the optimum extraction technique and high performance liquid chromatographic (HPLC) method to simultaneously quantify nine compounds of gallic acid, hydroxy-paeoniflorin, catechin, albiflorin, paeoniflorin, pentagalloylglucose, benzoic acid, benzoylpaeoniflorin and paeonol in .@*METHODS@#Linear gradient elution was applied using water containing 0.1%phosphoric acid and acetonitrile as the mobile phase with a flow rate of 0.8 mL/min, column temperature of 30℃ and wavelength of 230 nm. The method of ultrasound extraction was used. Methanol and ethanol were used as extraction solvents, and three factors and three levels of orthogonal experiments was designed using L (3 ) table to investigate the effects of solvent concentration, ratio of liquid to material and extraction time on the total content of nine components of .@*RESULTS@#HPLC method was verified to have high specificity, sensitivity and accuracy through methodological validation, and it could be used for simultaneous quantitative analysis of nine components of . The results showed that the optimum extraction technology of nine components of was using 70%ethanol as extraction solvent, ratio of liquid to material was 200 mL/g and ultrasound extraction time was 30 min.@*CONCLUSIONS@#HPLC method for the simultaneous determination of nine components of is established, and the optimum extraction technology is confirmed.

Comparative analysis of changes of volume and blood flow of spleen in men migrating to high-altitude area / 局解手术学杂志

Objective To analyze the changes of splenic volume and blood flow detected by ultrasonography in men having been migra-ted in high-altitude area for 10 years and to explore the relationship between the splenic blood flow and volume. Methods Men migrating to high-altitude area for 10 years,male indigenous Tibetan and healthy men from planitia with 55 cases in each were involved. Ultrasonography was performed to measure the length,width and thickness of spleen to calculate the volume,and color Doppler flow imaging was applied to measure the diameter of splenic artery and the mean flow velocity to calculate the blood flow volume. The differences among groups were com-pared and the relationship between the blood flow and the volume was analyzed. Results The blood flow and the volume of spleen in men migrating to high-altitude area were higher than those in male indigenous Tibetan and healthy men from planitia (P<0. 01),and the blood flow was positively correlated with the splenic volume (r=0. 828,P<0. 01). Conclusion The splenic volume and blood flow are increased in men when have been migrated in high-altitude area for 10 years and ultrasonography is of great importance in detecting the pathophysiologic changes in high-altitude area in our country.

EFFECT OF RUBUSOSIDE EXTRACTS ON HYPERGLYCEMIC RATS INDUCED BY STREPTOZOTOCIN / 营养学报

Objective: To study the anti hyperglycemic effect of rubusoside on diabetic rats induced by streptozotocin (STZ)and its mechanism . Methods: The STZ induced diabetic rats were dived into three groups and were given (ig.) saline, rubusoside and Phenformin respectively once a day. After three weeks, the levels of serum glucose, fructosamine, insulin,SOD were assayed. Results: Rubusoside could reduce the level of serum glucose significantly, enhance the ability of anti oxidation and stimulate the secretion of insulin in STZ induced diabetic rats. Conclusion: The action of rubusoside on secretion of insulin can be explained for the anti hyperglycemic effect.