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Sepsis remains the leading cause of death in intensive care unit.The pathogenesis of sepsis is extremely complex.Immune dysfunction plays an important role in the occurrence and development of sepsis.Many mechanisms are responsible for sepsis induced immune-suppression,including apoptotic depletion of immune cells,increased T regulatory and myeloid-derived suppressor cells,and cellular exhaustion.The article provided a brief review on the advance of immunologic mechanisms underlying sepsis.
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Objective To explore the effect of decoction of four-drug juice plus glutamine on nutritional support in the elderly critically ill patients. Methods One hundred and twenty-four elderly critical ill patients in The First Hospital of Jilin University from May 2010 to May 2012 were randomly divided into treatment group(n = 62)and control group(n = 62). Patients in both two groups were given enteral nutrition(EN)plus parenteral nutrition(PN)after the hemodynamics became stable. In addition,patients in control group were given routine EN + PN,while in treatment group was given decoction o four-drug juice + EN plus glutamine + PN. Prealbumin (PA),serum total protein( TP),transferrin( TF)and serum albumin( ALB)were detected before and after treatment of nutritional support. The informations including recovery of bowel sounds,the occurrence of complications,antibiotic use time and the duration of ICU stay were recorded. Results There were no significant differences between two groups in terms of nutrition indices before treatment(P > 0. 05). After treatment,the contents of pre albumin,transferrin,total serum protein,serum albumin in treatment group were( 145. 24 ± 6. 72)g/ L,(1. 93 ± 0. 98)g/ L,(79. 86 ± 10. 38)g/ L,(54. 91 ± 2. 91)g/ L respectively,better than those in control groups((139. 24 ± 38. 76),(1. 68 ± 0. 33),(74. 73 ± 7. 31),(49. 87 ± 2. 61)g/ L),and the differences were statistically significant( t = 3. 610,2. 929,4. 360,6. 767;P < 0. 05). The incidence of stress ulcer and double infection in treatment group were 42%(26 / 62),37%(23 / 62),significantly lower than the control group(59%(37 / 62),53%(33 / 62)),and the differences were statistically significant( χ2 = 5. 186, 5. 271,P < 0. 05). Antibiotic use time and the duration of ICU stay in treatment group were(8. 82 ± 0. 71)d and(16. 14 ± 3. 01)d,and reaching full eternal nutrition time was(6. 90 ± 1. 01)d,decreased less than that in control group((10. 21 ± 1. 30),(20. 67 ± 2. 29),(13. 91 ± 1. 51)d)and the differences were statistically significant(t = 8. 892,7. 786,3. 609,P < 0. 05). The average recovery time of bowel sounds and first anal exhaust time average in treatment group were(26. 8 ± 3. 6)h,(25. 4 ± 3. 2)h,lower than that in control group ((38. 4 ± 4. 8)h,(37. 6 ± 4. 9)h)and the differences were statistically significant( t = 3. 551,2. 516,P< 0. 05). Conclusion The application of decoction of four-drug juice plus glutamine on nutritional support of the elderly critically ill patients can reduce complications,shorten the duration of ICU,recover the intestinal function as soon as possible. Meanwhile,patients can transit to full eternal nutrition as soon as possible,then the cost of therapy is reduced and rehabilitation is quickly.
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Objective:To study the dynamic changes and clinical singniticance of interleukin 6(IL 6) and interleukin 8(IL 8) in serum of patients with acute myocardial infarction(AMI).Methods:Asynchronous serum IL 6 and IL 8 concentrations measured with radioimmunological assay in 30 patients with AMI from symptoms onset to thromblytic therapy finished and the datas were compard with 20 members of a healthy controlgroup,to investigate the relationship between the changes and myocardial ischemia/reperfusion.Results:The serum concentrations of IL 6 and IL 8 were elevated in all patients with AMI when compared with the healthy control group ( P