Objective To investigate the effect of continuous blood purification (CBP) on pro-or anti-inflammatory immune function and prognosis in patients with sepsis. Methods One hundred and two patients with sepsis were randomized into the CBP group (60 cases) and the control group (42 cases). The patients in the control group were treated with conventional therapy, and the patients in the CBP group received at least 72 h CBP treatment additionally. The APACHEⅡ score, SOFA score, the 28 day survival rate and ICU length of stay were recorded and levels of spleen Th1, Th2 were assessed by FACS flow cytometry. Enzyme linked immunoadsordent assay (ELISA) was used to determine the levels of serum IL-1, IL-10 and TNF-α before and at 24, 48, 72 h after the treatment. Results The APACHEⅡscore and SOFA score decreased markedly in the CBP group after the treatment (Р <0.05). The period of staying in ICU of patients in the CBP group was shorter than that of patients in the control group (Р < 0.05). There was no significant difference of the 28 day survival rate between the two groups (91.6% vs 71.2%, Р > 0.05). Compared with the control group, levels of IL-1, IL-10 and TNF-α were decreased markedly, and the ratio of Th1 / Th2 was increased significantly at 72 h after the treatment in the CBP group (Р < 0.05). Conclusion CBP can eliminate inflammatory mediators, and help to enhance the immune function, and restore the balance of Th1 / Th2 in patients with severe sepsis.

Objective To explore the influnce on the endothelin-1 (ET-1) and clinical application value of continuous blood purification (CBP) on the treatment of severe craniocerebral injury with the neurogenic pulmonary edema (NPE).Methods All data about sixty patients with NPE were prospectively studied.These 60 patients were randomly (random number) divided into control group (n =30) and treatment group (n =30).In control group,patients were rapidly given with lowering intracranial pressure,mechanical ventilation,calming,antibiotic therapy and so on.In the treatment group,patients received CBP integrated with routine treatment.On admission and 72 h posttreatment,ET-1,static lung compliance and oxygenation index were observed.Time of mechanical ventilation support,incidence rates of multipal organ dysfunction syndrome (MODS) were compared between two groups.The paired t-test was used for the amount data within the group.Chi-square was used for the constitute ratio and incidence ratio of the each relevant information.P ＜ 0.05 was considered statistically significant.Results Compared to the control group,the level of ET-1 was decreased significantly in the treatment group [(48 ± 10) ng/L vs.(85 ± 14) ng/L] after 72 h post-treatment,while static lung compliance [(60.9 ± 2.3) mL/cmH2O vs.(31.4 ±4.8) mL/cmH2O] and oxygenation index [(317 ± 11) mmHg vs.(192 ± 14) mmHg] increased significantly (P ＜ 0.05).In treatment group and control group,the time of respirator intervention were [(6.0 ± 2.1) d vs.(11 ± 3.2) d],and the statistical significance was shown (P ＜ 0.05).Compared to the control group [56.7％ (17/30)],incidence rate of MODS [20.0％ (6/30)] was lower in treatment group (P ＜ 0.05).Conclusions CBP combined with routine treatment,which can remove ET-1 effectively,improve oxygenation,reduce the time of mechanical ventilation support and incidence rate of MODS.

Exosomes are nanoscale extracellular vesicle structures that communicate and exchange information between cells. They carry a variety of biologically active molecules whose compositions and contents vary according to the origin and recipient cells. Therefore, exosomes can be used as biomarkers. Neurodegenerative diseases are diseases with hidden onset, so early screening and accurate diagnosis is undoubtedly a reliable guarantee to reduce their mortality and increase the cure rate. Exosomes, as a research hotspot in recent years, have great potential for the diagnosis and treatment of diseases given their transport capacity and contents, and have significant advantages in abundance, stability, diversity and accessibility. The purpose of this paper is to discuss exosomes as potential candidates for early diagnosis of neurodegenerative diseases, and thus to elaborate new fields of their application, with a view to providing a richer perspective for clinical prediction and treatment.