RESUMO
Objective: To analyze effects of pulse contour cardiac output (PiCCO) monitoring technology in amelioration of myocardial damage in fluid resuscitation of patients with large area burn in the early stage. Methods: From November 2015 to November 2017, medical data of 52 patients with large area burn hospitalized in our unit, meeting the inclusion criteria, were analyzed retrospectively. Twenty-seven patients (18 males and 9 females) with age of (43±10)years in tradition group hospitalized from November 2015 to November 2016 were monitored by traditional monitoring methods for fluid resuscitation, and 25 patients (18 males and 7 females) with age of (44±10)years in PiCCO group hospitalized from December 2016 to November 2017 were monitored by traditional monitoring methods and PiCCO monitoring equipment for fluid resuscitation. Fluid infusion coefficients and total fluid replacement volume of patients in both groups at the first and second post burn hour (PBH) 24, as well as the levels of N terminal pro B type natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), and creatine kinase MB (CK-MB) immediately on admission and post burn day (PBD) 1, 2, 3, 4, 5, 6, and 7 were recorded. Data were processed with analysis of variance for repeated measurement, chi-square test, t test and Bonferroni correction, and Mann-Whitney U test and Bonferroni correction. Results: (1) The fluid infusion coefficients of patients in tradition group at the first and second PBH 24 were respectively (1.42±0.10) and (0.94±0.14)mL·kg(-1)·% total body surface area (TBSA)(-1), and those in PiCCO group were respectively (1.76±0.14) and (0.85±0.08) mL·kg(-1)·%TBSA(-1). Fluid infusion coefficient and total fluid replacement volume at the first PBH 24 of patients in PiCCO group were significantly higher than those in tradition group (t=-9.775, -4.769, P<0.01). Fluid infusion coefficient at the second PBH 24 of patients in PiCCO group was significantly lower than that in tradition group (t=2.682, P<0.05). There was no statistically significant difference in total fluid replacement volume at the second PBH 24 in patients between the two groups (t=1.167, P>0.05). (2) Immediately on admission and PBD 1, 2, 3, 4, 5, 6, and 7, the levels of NT-proBNP of patients in tradition group were respectively 518 (320, 763), 236 (98, 250), 139 (62, 231), 172 (104, 185), 296 (225, 341), 727 (642, 921), 1 840 (1 357, 2 081), 1 005 (671, 1 297) pg/mL, and those in PiCCO group were respectively 444 (206, 601), 66 (29, 73), 54(28, 75), 139(101, 175), 199 (106, 279), 576 (333, 837), 833 (466, 1 080), 485 (225, 710) pg/mL. The levels of NT-proBNP of patients in PiCCO group on PBD 1, 2, 6, and 7 were significantly lower than those in tradition group (Z=-5.004, -3.967, -5.285, -4.626, P<0.01). The levels of NT-proBNP immediately on admission and PBD 3, 4, and 5 in patients between the two groups were close (Z=-0.834, -0.806, -2.665, -2.153, P>0.05). (3) Immediately on admission and PBD 1, 2, 3, 4, 5, 6, and 7, the levels of cTnT of patients in tradition group were respectively (42±15), (21±12), (17±7), (11±4), (12±4), (94±32), (88±23), (42±23) pg/L, and those in PiCCO group were respectively (37±15), (9±3), (10±3), (13±3), (12±5), (85±30), (60±26), (22±14) pg/L. The levels of cTnT of patients in PiCCO group on PBD 1, 2, 6, and 7 were significantly lower than those in tradition group (t=5.227, 4.751, 4.239, 3.845, P<0.01). The levels of cTnT immediately on admission and PBD 3, 4, and 5 of patients between the two groups were close (t=1.098, -1.562, -0.117, 1.107, P>0.05). (4) The levels of CK-MB of patients in PiCCO group on PBD 3, 6, and 7 were significantly lower than those in tradition group (t=3.123, 4.103, 3.178, P<0.05 or P<0.01). The levels of CK-MB immediately on admission and PBD 1, 2, 4, and 5 in patients between the two groups were close (t=0.351, 1.868, 1.100, 0.798, 2.094, P>0.05). Conclusions: PiCCO monitoring technology can monitor and guide fluid resuscitation of patients with large area burn in the early stage more scientifically and reasonably, and the effect of reducing myocardial damage is better than traditional monitoring methods.
Assuntos
Queimaduras/terapia , Débito Cardíaco , Hidratação , Miocárdio/patologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
L-Tryptophan (Trp) and some of its metabolites regulate the circadian rhythm in mammals. We aimed to investigate the effects of short-term supplementation of Trp in isocaloric meals on growth performance using the parameters of multiple blood biomarkers and free amino acids in growing pigs. A total of 32 Landrace × Yorkshire barrows with a mean body weight of 8.64 (±1.13) kg were randomly assigned to four groups and then fed with various concentrations of Trp diets daily. Our results showed that sequential supplementation of different concentrations of Trp in isocaloric meals decreased the feed:gain (F:G) ratio (P = 0.079) and plasma urea and albumin (P = 0.019), whereas the level of total protein did not. Among the essential and conditionally essential amino acids, the concentrations of histidine, isoleucine, proline, threonine, arginine, and valine in the plasma decreased (P < 0.05), whereas the concentrations of Trp, glycine, serine, and methionine increased (P < 0.01). In addition, concentrations of branched chain amino acids also significantly decreased (P = 0.004), while the rate of conversion of Trp to branched chain amino acids increased (P < 0.001). Taken together, we show that administration of a high concentration of Trp in breakfast with decreasing concentrations of Trp in lunch and dinner positively affected feed utilization and improved feed efficiency, at least in part, through the optimization of amino acid interconversions and nitrogen utilization.
Assuntos
Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal/efeitos dos fármacos , Sus scrofa/crescimento & desenvolvimento , Triptofano/farmacologia , Aumento de Peso/efeitos dos fármacos , Aminoácidos/metabolismo , Aminoácidos de Cadeia Ramificada/sangue , Aminoácidos Essenciais/sangue , Ração Animal/estatística & dados numéricos , Animais , Glicemia , Nitrogênio da Ureia Sanguínea , Suplementos Nutricionais , Nitrogênio/metabolismo , Sus scrofa/metabolismo , Triptofano/metabolismoRESUMO
Fallopia multiflora, locally known as Heshouwu, is one of the most important and widely used Chinese medicinal herbs. However, there is still considerable confusion concerning its different provenances. DNA barcoding is a recent aid to taxonomic identification and uses a short standardized DNA region to discriminate plant species. We assessed the applicability of 4 candidate DNA barcodes (matK, rbcL, psbA-trnH, and ITS2) to identify populations of F. multiflora. To our knowledge, this is the first attempt involving the plant kingdom to apply DNA barcoding at a level lower than species. Four DNA loci (matK, rbcL, psbA-trnH, and ITS2) of 105 samples, including the wild F. multiflora distributed in 17 provinces of China and 4 cultivated F. multiflora lines, were amplified by PCR and sequenced. The 4 loci were evaluated by PCR amplification for sequence quality, extent of genetic divergence, DNA barcoding gap, and the ability to discriminate between populations by BLAST1 and Nearest Distance. We found that psbA-trnH was the best barcode, with significant inter-population variability and best potential for identifying F. multiflora. The combination of loci gave better performance for distinguishing populations than a single locus. We recommend using matK + rbcL + psbA-trnH + ITS2 or psbA-trnH alone for this species. This research demonstrates the utility of DNA barcoding for geoherbalism identifications.