Expert consensus on gastrointestinal dysfunction secondary to sepsis with integrating Traditional Chinese Medicine and Western medicine / 中华危重病急救医学

Acute gastrointestinal dysfunction is a common and important complication of sepsis. As no exiting formal definition and classification of gastrointestinal dysfunction, most of the treatment strategies for gastrointestinal dysfunction are not based on clinical evidence, but on their own clinical experience. Experts of traditional Chinese medicine, integrated traditional Chinese and Western medicine and Western medicine from various disciplines in Shanghai are organized by the Shanghai Society of Integrated Traditional Chinese and Western Medicine and the Emergency Department Branch of Shanghai Physicians Association. After repeated discussion, literature search and formulation of the outline, we developed consensus on gastrointestinal dysfunction secondary to sepsis with integrating Traditional Chinese Medicine and Western medicine by consulting extensively on clinical experts in the fields of emergency medicine, gastroenterology, general surgery, infectious medicine and traditional Chinese medicine, and holding several expert forums and consultation meetings. This clinical expert consensus focused on acute gastrointestinal injury (AGI) classification and inducer of sepsis. In this consensus, the common symptoms, diagnosis, classifications, treatment strategies and suggestions of acute gastrointestinal injury or dysfunction secondary to sepsis were explored from the aspect of both Traditional Chinese Medicine and Western medicine.

Severe heatstroke treated by combination of Chinese and western medicine: a case report and literature review / 中国中西医结合急救杂志

Objective Via the analysis of clinical effect of combined traditional Chinese and western medicine in treating severe heatstroke (HS), to explore the rescue therapeutic measures of combined Chinese and western medicine for HS. Methods A case of HS patient admitted to the Department of Emergency Intensive Care Unit (EICU) of Shuguang Hosipital Affiliated to Shanghai University of Traditional Chinese medicine (TCM) was treated with the combination of traditional Chinese and western medicine. The physical hypothermia with ice-blanket and ice-cap and supportive therapy were immediately given to the patient after admission; then the TCM prescription Siwei Xiangru decoction plus or minus was additionally given; the ingredients of the decoction were as follows: elsholtziae 9 g, white lentil coat 15 g, poria cocos 20 g, rhizome atractylodis 15 g, tangerine peel 6 g, processed pinellia ternate 9 g, codonopsis 10 g, licorice 3 g, 1 dose, 2 times per day. The changes of HS patient's laboratory indexes, symptoms and signs were observed. Results After the combined treatment with traditional Chinese and western medicine, the respiratory rate of the patient was improved significantly, and the oxygenation was maintained at 0.99-1.00, no symptoms of fever, cough, sputum were seen. On the fourth day after treatment, the patient was transferred to local hospital, on the day of discharge, the patient had no fever or shortness of breath, urine volume and color were normal, and vital signs stable. Conclusions Effective continuous and controlled cooling is not only the main treatment measure in modern western medicine but also in TCM. Meanwhile, because 'heat must carry moisture, and heat often damage body fluid', it is necessary to observe the patient's dynamic changes of heat and damp evil. When clearing summer heat and damp evil, simultaneously, the measures of strengthening spleen and stomach, enhancing qi and nourishing fluid to prevent further consumption of the body fluid should be paid attention to.

Clinical analysis of 34 cases of candidemia / 中国实用内科杂志

Objective To search for clinical appearance and fungal resistance of candidemia in ICU.Methods Thirty-four cases of candidemia in ICU during 2003and 2006 were analyzed retrospectively.Results Twelve of 34 cases of candidemia were C.albicans,and 22 of 34 cases were non-C.albicans,which were 64.71% in candida monilia.Fever and chill of candidemia were 100% and 70.59% differently.Conclusion If there is high risk factor of fungous infection in clinic,at the same time fever and chill appear,and antibiotics treat is inefficacy not effective,it is possible to consider candidemia.

Efficacy of purging the lung and removing phlegm and blood stasis method(泻肺化痰祛瘀法) on rats with pulmonary hypertension / 中国中西医结合急救杂志

Objective: To study the efficacy of purging the lung and removing phlegm and blood stasis method(泻肺化痰祛瘀法) on animal model of pulmonary hypertension induced by monocrotaline and explore its mechanism.Methods: The model of pulmonary hypertension induced by monocrotaline was established in rats.Sixty healthy and clean male Wistar rats were randomly divided into normal control group,model group,low and high dosage of traditional Chinese medicine(TCM) drugs for purging the lung and removing phlegm and blood stasis groups.From the 15 th day after model establishment,two dosage groups were treated with the drugs in the prescription containing the main ingredients as follows: 9 g prepared rhubarb(制大黄),(2 g)(prepared)(euphorbia) kansui(炙甘遂),15 g lepidium apetalum(葶苈子),9 g ligusticum(川芎) and 15 g(scutellaria)(黄芩) infused into the stomach once a day for 7 days.Normal control group and model group were given normal saline infused into the stomach.Mean right ventricular pressure(MRVP) and the mean(pulmonary) artery pressure(MPAP) of rats were measured by right cardiac catheterization,and the(pathological)(changes) of lung tissues were detected by hematoxylin and eosin(HE) stained sections.(Results:) The MRVP and the MPAP in high dosage group((13.37?4.22)mm Hg and(12.26?2.79) mm Hg,(1 mm Hg)=(0.133 kPa)) were lower than that in the model group((16.27?2.27) mm Hg and(14.77?(2.39) mm Hg),P

Studies on the actions of Xiefei Dingchuan injection(泻肺定喘注射液) on Ca2＋Mg2＋ATPase and Na＋K＋ATPase of red blood cell membrane in rats with pulmonary hypertension induced by monocrotaline / 中国中西医结合急救杂志

To investigate the mechanism of Xiefei Dingchuan injection (XFDCI,泻肺定喘注射液) in treating pulmonary hypertension by means of measuring the activity of Ca2＋Mg2＋ ATPase and Na＋K＋ATPase of red blood cell(RBC) membrane.Methods:The pulmonary hypertension models induced by monocrotaline in 18 rats were established then treated with XFDCI.Using cardiac catheter and chromatometry respectively the pulmonary artery pressure (PAP) and the activities of Ca2＋Mg2＋ATPase and Na＋K＋ATPase of RBC membrane were measured.Results:The activities of Ca2＋Mg2＋ATPase and Na＋K＋ATPase of RBC membrane in XFDCI group were obviously higher than those in pulmonary hypertension group.Conclusions:XFDCI is able to reduce the pulmonary hypertension and its mechanisms may be related to increasing the activities of Ca2＋Mg2＋ATPase and Na＋K＋ATPase of RBC membrane.

Nutritional support in non-operative management of severe acute pancreatitis / 肠外与肠内营养

Objectives:To study the impact of nutritional support in non operative management of severe acute pancreatitis. Methods:Sixteen patients with severe acute pancreatitis were provided with stage nutritional support. Results:Fourteen cases fully recovered and 2 cases died. Stage of maintenance equilibration was (57.0?12.5)hours,TPN was (12.1?4.2)days and PN+EN was (12.2?3.5)days. Conclusions:Stage nutritional support might be favourable in improving prognosis and survival rate of severe acute pancreatitis.