The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease-a retrospective study.

BACKGROUND: Hand, foot, and mouth disease (HFMD) is an acute infectious disease caused by human enterovirus 71 (EV71), coxsackievirus, or echovirus, which is particularly common in preschool children. Severe HFMD is prone to cause pulmonary edema before progressing to respiratory and circulatory failure; thus hemodynamic monitoring and fluid management are important to the treatment process. METHODS: We did a review of young patients who had been successfully treated in our department for severe HFMD, which had been caused by EV71. A total of 20 patients met the inclusion criteria. Eight cases were monitored by the pulse indicator continuous cardiac output (PiCCO) technique, and fluid management was administered according to its parameters. With regard to the treatment with PiCCO monitoring, patients were divided into two groups: the PiCCO group (8 patients) and the control group (12 patients). The groups were then compared comprehensively to evaluate whether PiCCO monitoring could improve patients' clinical outcomes. RESULTS: After analysis, the findings informed that although PiCCO failed to shorten the length of ICU stay, reduce the days of vasoactive drug usage, or lower the number of cases which required mechanical ventilation, PiCCO did reduce the incidence of fluid overload (p = 0.085) and shorten the days of mechanical ventilation (p = 0.028). After effective treatment, PiCCO monitoring indicated that the cardiac index (CI) increased gradually(p < 0.0001), in contrast to their pulse (P, p < 0.0001), the extra vascular lung water index (EVLWI, p < 0.0001), the global end diastolic volume index (GEDVI, p = 0.0043), and the systemic vascular resistance index (SVRI, p < 0.0001), all of which decreased gradually. CONCLUSION: Our study discovered that PiCCO hemodynamic monitoring in young children with severe HFMD has some potential benefits, such as reducing fluid overload and the duration of mechanical ventilation. However, whether it can ameliorate the severity of the disease, reduce mortality, or prevent multiple organ dysfunction remain to be further investigated.

The efficacy of mesenchymal stromal cell-derived therapies for acute respiratory distress syndrome-a meta-analysis of preclinical trials.

BACKGROUND: The investigation of mesenchymal stromal cell (MSC)-conditioned medium or extracellular vesicles (exosomes or microvesicles) as a remedy for acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) has become a fast-growing field in recent years. Our purpose was to conduct a meta-analysis to investigate the efficacy of MSC-derived therapies (MDTs) for ALI/ARDS in animal models. METHODS: A meta-analysis of MDTs for ALI/ARDS in animal trials was performed. PubMed and EMBASE were searched to screen relevant preclinical trials with a predetermined search strategy. RESULTS: A total of 17 studies that compared MDT with the ALI control group were included in our study. The pooled result derived from the comparison of the two groups suggested that MDT could significantly reduce the lung injury score (standardized mean difference (SMD) = - 4.02, 95% CI [- 5.28, - 2.23], P < 0.0001) and improve animal survival (OR = - 6.45, 95% CI [2.78, 14.97], P < 0.0001). MDT mitigated the infiltration of neutrophils in alveoli (SMD = - 3.38, 95% CI [- 4.58, - 2.18], P < 0.00001). MDT also reduced the wet-dry weight ratio of the lung (SMD = - 2.34, 95% CI [- 3.42, - 1.26], P < 0.0001) and the total protein in BALF (SMD = - 2.23, 95% CI [- 3.07, - 1.40], P < 0.00001). Furthermore, MDT was found to downregulate proinflammatory mediators such as IL-1, IL-6 and TNF-a and to upregulate anti-inflammatory mediators such as IL-10. CONCLUSION: MDT reduces lung injury and improves survival in animal ARDS models since it can ameliorate lung permeability, decrease inflammatory cell infiltration, downregulate proinflammatory mediators, and upregulate anti-inflammatory mediators. However, more animal studies and human trials are needed for further investigation.

[The characteristics of Parkinson's disease with dementia and Alzheimer's disease with impaired cognitive function].

OBJECTIVE: To analyze the characterization of cognitive function in Parkinson's disease with dementia and Alzheimer's disease. METHODS: Cognitive function was examined in Parkinson's disease with dementia (PDD) patients (n = 30), Alzheimer's disease (AD) patients (n = 30) and healthy elderly control subjects (n = 60). Neuropsychological evaluation contained semantic fluency test, phonemic fluency test, action fluency test, objective and action naming tests. RESULTS: In PDD group, the score of semantic fluency test is 9.33 ± 2.78, 6.17 ± 1.67 of phonemic fluency test and 7.03 ± 2.34 of action fluency test, it is 6.90 ± 2.47, 7.87 ± 2.01, 8.30 ± 3.17 of AD group. The score of objective and action naming tests is 36.33 ± 3.39, 17.63 ± 2.17 in PDD group, while AD patients is 33.23 ± 3.56 and 22.33 ± 2.37. The verbal fluency tests and naming tests were impaired in PDD and AD patients compared with the healthy elderly control group (P < 0.01), phonemic fluency, action fluency and action naming were more impaired in PDD patients compared with the AD group, while semantic fluency and objective naming were more impaired in AD patients (P < 0.01). CONCLUSIONS: Executive function deficit and naming impairment are found in PDD and AD patients, it shows that PDD is characterized by the addition of cortical dysfunction upon a predominant and progressive fronto-subcortical impairment. There is subcortical dysfunction in AD patients.

Removal of metals by sorghum plants from contaminated land.

The growth of high biomass crops facilitated by optimal of agronomic practices has been considered as an alternative to phytoremediation of soils contaminated by heavy metals. A field trial was carried out to evaluate the phytoextraction efficiency of heavy metals by three varieties of sweet sorghum (Sorghum biocolor L.), a high biomass energy plant. Ethylene diamine tetraacetate (EDTA), ammonium nitrate (NH4NO3) and ammonium sulphate ((NH4)2SO4) were tested for their abilities to enhance the removal of heavy metals Pb, Cd, Zn, and Cu by sweet sorghum from a contaminated agricultural soil. Sorghum plants always achieved the greatest removal of Pb by leaves and the greatest removal of Cd, Zn and Cu by stems. There was no significant difference among the Keller, Rio and Mray varieties of sweet sorghums in accumulating heavy metals. EDTA treatment was more efficient than ammonium nitrate and ammonium sulphate in promoting Pb accumulation in sweet sorghum from the contaminated agricultural soil. The application of ammonium nitrate and ammonium sulphate increased the accumulation of both Zn and Cd in roots of sorghum plants. Results from this study suggest that cropping of sorghum plants facilitated by agronomic practices may be a sustainable technique for partial decontamination of heavy metal contaminated soils.