A retrospective study about the factors of early postoperative fluid balance of patients undergoing cardiopulmonary bypass / 中国实用护理杂志

Objective To explore the possible factors of early postoperative fluid balance and the influence of early postoperative fluid balance on the prognosis of patients undergoing cardiopulmonary bypass. Methods A retrospective study was conducted on the clinical data of 180 adult patients undergoing cardiopulmonary bypass from January 2012 to December 2015.All the patients were from Sun Yat-sen Memorial Hospital, Sun Yat-Sen University. The data were input and analyzed by SPSS 17.0 software. Results The early postoperative fluid balance of cardiovascular surgery with cardiopulmonary bypass was (540.94 ± 135.86) ml. The value of the early postoperative fluid balance (the difference of the total input amount and the total output amount/body quality) in predicting the major clinical outcome was analyzed by ROC curve. The area under the ROC curve from fluid balance was 0.850 (95%CI 0.736-0.965, P<0.01) and it had the sensitivity of 80.0%, and the specificity was 84.6%. The result showed that the cut off values had a good prediction ability for outcome. The cut off values determined by the biggest Youden index were 28.63 ml/kg, indicated that patients may had better outcome when they had the fluid balance of 28.63 ml/kg. The level of early postoperative fluid balance of patients undergoing cardiopulmonary bypass was correlated with mechanical ventilation time, ICU length of stay, higher risk of acute kidney injury, mixed venous oxygen saturation and clinical outcome (P<0.05). Multivariate analysis indicated that European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE Ⅱ), other types of surgery, body mass index, early postoperative urine output and early postoperative drainage flow were independently associated with postoperative fluid balance of patients undergoing cardiopulmonary bypass. Conclusions Early postoperative fluid balance has a good prediction ability for prognosis of patients undergoing cardiopulmonary bypass. Compared with patients having lower level of fluid balance, the patients with a higher level would be more likely to have longer mechanical ventilation time, longer ICU length of stay, higher risk of acute kidney injury and lower level of mixed venous oxygen saturation. By analysis of ROC curves, the cut-off value for early postoperative fluid balance is 28.63 ml/kg, worse prognosis may be predicted if fluid balance is above 28.63 ml/kg. EuroSCORE Ⅱ, other types of surgery, body mass index, early postoperative urine output and early postoperative drainage flow are independently associated with the postoperative fluid balance of patients undergoing cardiopulmonary bypass.

Effect of early postoperative enteral nutrition on Chinese domestic gastric cancer patients:A Meta-analysis / 中国实用护理杂志

Objective In order to evaluate the nutritional effect of early enteral nutrition in patients of Chinese domestic gastric cancer surgery,using evidence-based medicine methods,and supply evidence for clinical nutrition intervention.Methods CBM,Chinese academic Journals,Wanfang database and VIP Information Resource System were searched from January 2000 to March 2013 to collect the published clinical randomized controlled trials literatures of nutrition support in patients of Chinese domestic gastric cancer surgery according to inclusion and exclusion criteria of literature,using the Cochrane System Evaluation Handbook independent,double-blind principle of the literature methodology quality evaluation.Finally Meta analysis was conducted by using RevMan5.2 software.Results 14 articles were enrolled in the study,Meta analysis results showed that:early enteral nutrition comparing with parenteral nutrition in postoperative gastric cancer patients:the WMD of serum albumin was 1.55,95％ CI (0.81,2.29); the WMD of serum transferrin was 0.34,95％CI (0.30,0.38);the WMD of postoperative anal exhaust time was-20.66,95％CI (-23.91,-17.40).Conclusions Early enteral nutrition is better than the parenteral nutrition,which can restore adequate serum protein source for patients,and can recover the gastrointestinal digestion and absorption function of itself earlier,which is worthy of clinical promotion.

The status and perspective of the GP-73 in the diagnosis and treatment of hepatocellular carcinoma / 中华肝胆外科杂志

Hepatocellular carcinoma(HCC) is one of the most common malignant tumors with the highest cause of death and increasing incidence worldwide, and the annual incidence rate is rising. The early diagnosis of HCC is very essential to its prognosis. At present, AFP has been widely used in the survey of HCC diagnosis, therapeutic effect and predict recurrence. However, the sensitivity and specificity of AFP is not satisfactory. In recent years a variety of new serum tumor markers have emerged one after another. A new serum marker-Golgi glycoprotein-73(GP-73) in early diagnosis of HCC is expected to become the new target maker,its sensitivity and specificity are better than AFP.

Effect of Prostaglandin E1 Lipid Drug-loaded Microcapsules on Early Diabetic Nephropathy / 中国药房

OBJECTIVE: To explore the therapeutic effect of prostaglandin E1 lipid drug-loaded microcapsules(Lipo PGE1) on the earlier diabetic nephropathy (DN). METHODS: 72 cases with early DN were randomly divided into treatment group and control group. The control group were assigned to receive routine hypoglycemic agent,blood pressure controlling, and symptomatic treatment, while the treatment group were given another drip infusion of Lipo PGE1 20ug plus NS100ml q.d besides the routine therapy as in the control group. Both groups received 3 weeks’ course of treatment. The changes of urinary albumin excretion rate(UAER), urinary transferrin(TRF), urinary microglobulin(?1MG)and so on in the 24h urine of the 2 groups before and after treatment were observed.RESULTS: There was great decrease in UAER, TRF and ?1MG in the 24h urine in the treatment group after treatment(P

Combination of Low Molecule Heparin Calcium with Aspirin for Early Acute Cerebral Infarction / 中国药房

OBJECTIVE:To evaluate the clinical efficacy of combination of low molecule heparin calcium with Asipilin for early acute cerebral infarction.METHODS:A total of 320 patients with early acute cerebral infarction were randomly assigned to low molecule heparin calcium group,aspirin group,combination treatment group(low molecule heparin calcium group plus aspirin)or control group.The clinical efficacy in 4 groups was evaluated respectively.RESULTS:The nerve function showed a better recovery in all the treatment groups than in control group.As compared with low molecule heparin calcium group or aspirin group,the combination treatment group showed a significantly improved nerve function and higher clinical efficacy.There were significant differences in total effective rate among groups after treatment for different time(P0.05).CONCLUSION:The combination of low molecule heparin calcium with Asipilin for early acute cerebral infarction is safe and more effective than low molecule heparin calcium and Asipilin used alone.

Protective Effect of Alprostadil on Renal Graft Functions in Early Period / 中国药房

OBJECTIVE:To assess whether Alprostadil plays a role in improving renal function of renal recipi?ents.METHODS:A randomized control clinical trial was designed between January1,2001and February28,2004.Alprostadil was administered in85renal recipients who received60?g Alprostadil while transplanting kidney and each day after opera?tion.The effects of Alprostadil were compared with the control group which included276recipients to determine the influences of Alprostadil on urine,creatinine(Cr)and creatinine clearance(Ccr).Under Doppler Ultrasound the renal blood flow resis?tance_indexes(RI)were measured.The rates of acute renal graft rejection(AR)and delayed graft function(DGF)were also calculated in both groups.RESULTS:Urine and Ccr were significantly higher in Alprostadil_treated group than in control.On the contrary Cr and RI were significantly lower in Alprostadil_treated group than in control.Alprostadil_treated group also showed a significantly lower incidence of DGF,but the incidences of rejection in both groups were equal.CONCLUSION:The findings suggest that the addition of Alprostadil to renal recipients improves early graft function and reduce the incidence of DGF,but does not influence the incidence of rejection.