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Objective To evaluate the clinical value of the level of plasma procalcitonin,blood lactic acid an1 endotoxin in patients of severe pneumonia complicated with sepsis.Methods The 40 cases of severe pneumonia complicated with sepsis(observation group)were analyzed retrospectively,they were divided into survival group included 20 cases and the death group included 20 cases.Meanwhile the 20 cases of healthy persons were selected as control group.The worst score of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) within 24 hours after admission were record.The level of plasma procalcitonin,blood lactic acid and endotoxin were compared between three groups.In addition do a correlation study between the above indexes and the score of APACHE Ⅱ.Results The level of plasma Procalcitonin,blood lactic acid and endotoxin of observation group increased significantly compared with the control group [(0.02±0.01 ng/ml,0.87 ± 0.27 mmol/L,4.15±1.63 pg/ml) vs (18.29±11.02 ng/ml,6.55 ± 3.02 mmol/L and 15.5±10.38 pg/ml),t=10.48,11.79,6.75,all P＜0.05].The level of plasma procalcitonin,blood lactic acid and endotoxin of the death group increased significantly compared with the survival group [(9.52±2.93 ng/ml,4.26±1.78 mmol/L,7.62±3.04 pg/ml) vs (27.06±8.88 ng/ml,8.84± 2.14 mmol/L and 23.39± 9.00 pg/ml),t=8.39,7.35,7.42,all P＜0.05].In the all patients of severe pneumonia complicated with sepsis,there was positive correlation among plasma procalcitonin,blood lactic acid,endotoxin and the score of APACHE Ⅱ (r=0.919,P=0.001;r=0.914,P=0.002;r=0.909,P=0.004).Conclusion The level of plasma procalcitonin,blood lactic acid and endotoxin are very important indexes in assessment of the severity and the prognosis of severe pneumonia complicated with sepsis,that has important value in clinical application.
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Objective To evaluate the effect of irbesartan and nifedipine controlled-release tablets on morning blood pressure surge in patients with essential hypertension. Methods Ninety patients with essential hypertension were randomly divided into irbesartan group ( group A, n = 45) and nifedipine group (group B, n =45). Irbesartan tablets 150 mg/d and nifedipine controlled-release tablets 30 mg/d were respectively given in group A and group B for 4 weeks. The levels of diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure ( MAP ) and morning blood pressure surge ( MBPS ) before and after treatment were measured by ambulatory blood pressure monitoring. Results The DBP, SBP, MAP and MBPS levels of two groups after treatment for 4 weeks were all decreased (P < 0.01). All the indexes of group B decreased more significant compared to group A (P < 0.05 ). Conclusion To control blood pressure and prevent morning blood pressure surge, nifedipine controlled-release tablets are better than irbesartan.
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Objective To investigate the changes of interleukin-18 (IL-18), tumor necrosis factor-α(TNF-α) and interferon-γ (IFN-γ) levels of liver cirrhosis induced by the composite factors of carbon tetrachloride (CCl_4) in SD rats and their significance. Methods Totally 80 male SD rats of clean class were randomly divided into normal control group (20 rats) and model groups, the latter of which were further divided into three groups according to the length of administration time, namely, 2-week group (2 wk group), 4-week group (4 wk group) and 6-week group (6 wk group), with 20 rats in each. Six rats were killed after 2 wk, 4 wk and 6 wk administration time, respectively. The rat serum levels of IL-18, TNF-α and IFN-γ and the hepatic homogenate supernatant of IL-18 were detected by ELISA; pathological changes of liver tissues were observed by HE staining. Results ① Pathological observation revealed that in the model groups hepatic cells degenerated and swelled at week 2 while large amounts of fibrosis and pseudolobules of some liver tissues occurred at week 6. ② The serum levels of IL-18, TNF-α and IFN-γ were gradually increased with the modeling time, and they were significantly higher in 6-week group than in normal control group (P<0.01). ③ The levels of hepatic homogenate supernatant of IL-18 in the model groups were elevated with liver damage, and they were significantly higher in 6-week group than in normal control group (P<0.01). Conclusion During the formation of liver cirrhosis induced by composite factors of CCl_4 in rats, IL-18, TNF-α and IFN-γ levels gradually increase, suggesting that the three cytokines play a certain role during the occurrence of liver cirrhosis in rats.