Secondary pancreatic infection in severe a-cute pancreatitis (SAP) was associated with mortality and the length of stay in hospital.Intensive Care Unit (ICU) identificate shock on account of the oxygen metaboilic level in earlier period of SAP and perform adequate fluid resuscita-tion.it advocate to perform organ function support and/or substitution therapy in time and think highly of coordination and combination each other among various kinds therapeutic measure.These therapeutic concept and measure will con-duce to decrease the incidence rate of MODS and secondary pancreatic infection accordingly in SAP.

Objective To investigate the effects of angiotensinⅡ(AngⅡ) receptors antagonist on the LPS-induced acute lung injury (ALl).Method Wistar rats were randomly divided into three groups:control group;in LPS group,mrs were treated with LPS (10 mg/kg) at 3,6,12,and 24 hours;in LPS+ AngⅡreceptors antagonist group,pre-expasure to AngⅡreceptors antagonist [Sar~1,Ile~8] AngⅡfor 30 minutes before treated with LPS (10 mg/kg) for 6 hours.All the rats were killed,and the lung tissue was collected.Results Compared with control group pulmonary wet/dry weight ratio was significantly higher in the other two groups (P

Objective To evaluate the therapeutic effect of early fluid resuscitation under the guidance of pulse indicator continuous cardiac output (PiCCO) on patients with severe acute pancreatitis (SAP).Methods Clinical data of 18 SAP patients (research group),who had undergone fluid resuscitation under the guidance of PiCCO in the Department of Critical Care Medicine of the Second Affiliated Hospital of Anhui Medical University from October 2011 to October 2013,were analyzed prospectively.At the same time,clinical data of 25 cases (control group) that had undergone fluid resuscitation without the guidance of PiCCO from January 2009 to September 2011 were collected retrospectively.The volume of fluid and clinical data were compared between two groups.Results During the first 6 hours,0-24 hours,24-48 hours,and 0-72 hours after intensive care unit (ICU) admission,the research group received larger volume of fluid than that of the control group (mL:2 133 ± 1 593 vs.1 024 ± 421,t=3.337,P=0.002; 5 960 ±2 951 vs.3 767 ± 854,t=3.531,P=0.001; 4 709 ± 1 508 vs.3 863 ± 1 122,t=2.112,P=0.031 ; 14 601 ± 5 095 vs.11 409 ± 2 667,t=2.673,P=0.007).Compared with the control group,the incidence of application of blood purification was lowered [5.56％ (1/18) vs.44.00％ (11/25),x2=7.688,P=0.006],the duration of the systemic inflammatory response syndrome (SIRS) was shortened (days:3.54 ± 2.44 vs.5.62 ± 3.62,t=2.113,P=0.041),acute physiology and chronic health Ⅱ (APACHE Ⅱ) score was significantly declined at 24 hours after admission (11±4 vs.14 ± 5,t=2.104,P=0.042),the blood lactic acid was decreased more significantly after 72 hours (mmol/L:3.10 ±0.55 vs.2.40 ± 1.12,t=2.442,P=0.019),and the length of ICU stay was shortened (days:10 ±9 vs.20 ± 10,t=3.371,P=0.002) in research group.But there was no significant difference in the percentage of the use of vasoactive drugs [16.67％ (3/18) vs.24.00％ (6/25),x2 =0.340,P=0.560],the incidence of invasive mechanical ventilation [50.00％ (9/18) vs.52.00％ (13/25),x2 =0.017,P=0.897],72-hour urea nitrogen changes (mmol/L:-0.33 ± 4.71 vs.-0.09 ± 5.37,t=0.152,P=0.880),and the percentage of abdominal infection [16.67％ (3/18) vs.16.00％ (4/25),x2=0.003,P=0.953] between research group and control group.The mortality in research group was lower than that in control group [5.56％ (1/18) vs.20.00％ (5/25)] without statistical difference (x2=1.819,P=0.178).According to the 2012 Atlanta classification,patients were re-evaluated after 48 hours fluid resuscitation.Six patients in research group developed moderately severe acute pancreatitis,and the incidence was significantly higher than that in control group [33.33％ (6/18) vs.8.00％ (2/25),x2=4.435,P=0.034].The time of mean PiCCO installation was 4.5 days in 18 cases of the research group,and no related complications occurred.Conclusions The PiCCO device may be a useful adjunct for fluid resuscitation monitoring in patients with SAP within 72 hours.Early fluid resuscitation under the guidance of PiCCO may be helpful in improving tissue perfusion,reducing the application of blood purification,as well as shortening length of ICU stay.This program did not increase the risk of invasive mechanical ventilation,and no obvious change in mortality rate was observed.

OBJECTIVE:To a evaluation method for the measurement uncertainty for the content of Bisacodyl enteric-coated tablet. METHODS:HPLC external standard method was conducted for content determination of Bisacodyl enteric-coated tablet, and mathematical model for uncertainty evaluation was established to systematically analyze and evaluate the influential factors in processes of solution preparation and instrument measurement. RESULTS:HPLC external standard method showed the content was 97.8%,confidence probability was 95%,expanded uncertainty was 2.8%,and determination result was (97.8 ± 2.8)%,k=2. CONCLUSIONS:The established method is suitable for the evaluation of measurement uncertainty for the content of Bisacodyl en-teric-coated tablet. Regularly calibrated verification for HPLC equipment and strict control of the weighing process will help to im-prove the accuracy measured by HPLC.

Adolescent ; Adult ; Audiometry, Pure-Tone ; methods ; Auditory Cortex ; physiopathology ; Case-Control Studies ; Female ; Hearing Loss, Sensorineural ; diagnosis ; physiopathology ; Humans ; Magnetoencephalography ; Male ; Young Adult

OBJECTIVE:To establish a method for the determination of related substances in Lovastatin tablet. METHODS:HPLC was performed on the column of Waters XTerra? MS C18 with mobile phase A of 0.01%Phosphoric acid solution and B of acetonitrile(gradient elution)at a flow rate 1.0 ml/min,column temperature was 40 ℃,the detection wavelength was 238 nm,and the injection volume was 10 μl. RESULTS:The impurity components were well separated in principal components;the linear range of lovastatin was 17.5-700 μg/ml(r=0.9999);RSDs of precision,stability and reproducibility tests were lower than 1%;recov-ery was 99.30%-100.67%(RSD=0.4%,n=9). CONCLUSIONS:The method is reproducible with good durability and high preci-sion,and can be used for the quality control of Lovastatin tablet.

Objective To evaluate the safety and effectiveness of bedside nasointestinal nutritional tube insertion with specific guiding techniques in critically ill patients.Methods Critically ill patients who could not take oral or gastric feeding were collected from September 1st, 2013 to September 10th, 2015 in Intensive Care Unit of The Second Hospital of Anhui Medical University.In these patients, bedside nasointestinal tube insertion was performed according to the relevant standard operating procedure in our department, and guiding technique was chosen based on patients' clinical characteristics.Operation time, position of tube tip and complications associated with the bedside operations were recorded for retrospective analysis.Results A total of 21 patients were collected in this study, in whom 23 bedside insertions were preformed.In 21 insertions (91.3％), the tip of the tube was successfully inserted across the transpyloric plane;and in 20 insertions (87.0％), 10 cm distal to the ligament of Treitz.The average operation time was (14.10 ± 1.80) min.The average cost was (297.01 ± 35.26) yuan.No severe complications were occurred.Conclusions The bedside nasointestinal feeding tube insertion without visual guiding is simple, safe, low-cost, and of high success rate.It may be a good choice for establishing enteral nutrition channel in order to implement early enteral nutrition in patients unable to take oral or gastric feeding.

OBJECTIVETo study the characteristics of the effect of different temperatures on mortality of different cities through analyzing the relationship between mortality and meteorology of five Chinese cities.

METHODSWe get the demography and climate data of Beijing, Tianjin, Shanghai, Nanjing and Changsha cities from National Center of Disease Control and Prevention and Climate net respectively. Then we applied the R software and Distributed Lag Non-linear Models (DLNM) package to analyze our data and find the nonlinear and lag effects on mortality using DLNM.

RESULTSThe city of Beijing and Tianjin are located in the temperate zone. And the climate of Shanghai, Nanjing, Changsha belong to subtropical monsoon climate. When the daily mean temperature arrived 30°C and on lag 0 day, the values of relative risk of effect of high mean temperature on mortality in Nanjing (1.31, 95%CI: 1.21 - 1.41) and Changsha (1.25, 95%CI: 1.13 - 1.39) are larger than that in Beijing (1.18, 95%CI: 1.12 - 1.25), Tianjin (1.18, 95%CI: 1.10 - 1.26) and Shanghai(1.15, 95%CI: 1.06 - 1.24). While the relative risk of effect of low mean temperature on mortality is lower and lasts for a longer lag time. During the whole lag time, the relative risk of effect of the lowest daily mean temperature of each city on mortality in Tianjin, Changsha, Beijing, Nanjing, and Shanghai is 3.41, 95%CI: 1.60 - 7.27, 2.15, 95%CI: 1.11 - 4.15, 2.24, 95%CI: 1.12 - 4.48, 2.80, 95%CI: 1.75 - 4.48, 1.53, 95%CI: 1.12 - 2.03, respectively. The cumulative effect of mean temperature on mortality appears like a U-shape. When on lag 0-1 day, the value of relative risk of effect of extremely high temperature and the highest mean temperature on mortality is larger than 1. While the effect of low temperature on mortality becomes obvious after lag 2 days.

CONCLUSIONDepending on this research, extremely low temperature and the lowest mean temperature has a more obvious impact on mortality in the northern area than in the south. Extremely high temperature and the highest daily mean temperature is on the contrary. Meanwhile, different temperatures have different impacts on mortality in the same city: high temperature has an acute impact while there is a longer lag time in low temperature.

China ; Climate ; Humans ; Mortality ; Nonlinear Dynamics ; Temperature ; Urban Population

Objective To investigate the relationship between multiple blood indexes and frequent exacerbation of chronic obstructive pulmonary disease (COPD). Methods 102 patients with COPD were selected and divided into frequent exacerbation group (≥ 2 times/year, 55 patients) and infrequent exacerbation group (< 2 times/year, 47patients), according to the frequency of acute exacerbation in one year. The relationship between multiple indicators in blood routine and blood gas analysis and frequent exacerbation of COPD was explored by independent sample t test, 2 test, and multiple Logistic regression analysis. A retrospective study was conducted. Results Neutrophils count (NEU), neutrophils ratio (Neut%), and neutrophil-to-lymphocyte ratio (NLR) of frequent exacerbation group were significantly higher than those of infrequent exacerbation group, while lymphocytes (LY), lymphocytes ratio (LY%) were lower (All P<0.05). OR(95% CI) of NLR was 3.483(1.170-10.373)，and OR(95% CI) of partial pressure of carbon dioxide in artery (PaCO2) was 1.124(1.053-1.201).NLR and PaCO2 were risk factors for frequent exacerbation of COPD. Increase of NLR and PaCO2 led to an increasing risk of frequent exacerbation of COPD ( All P<0.05). Conclusions The levels of NLR and PaCO2 in COPD patients with frequent exacerbation are higher than those in patients with infrequent exacerbation. As a consequent, NLR and PaCO2 could be considered risk factors for frequent exacerbation of COPD.

OBJECTIVETo explore the characteristics of bacteria isolated from patients with chronic sinusitis (CR) and antibiotic-resistance.

METHODSThe purulent discharges taken from the maxillary sinus and posterior ethmoid sinus of 76 patients during endoscopic sinus surgery were cultured for both bacteria and fungi, then the antimicrobial susceptibility test and beta-lactamase-producing bacteria (beta-LPB) were detected. In the control group, the discharges from the nasal cavity from 10 healthy adults were also cultured for bacteria.

RESULTSTwenty species, including Staphylococcus epidermidis, Escherichia coli, Staphylococcus aureus, alpha-Hemolytic streptococcus and Streptococcus pneumoniae, were cultured from the testing group. The total positive rate of bacteria was 81.8%. The detectable rates of aerobe, anaerobe, gram-positive bacteria and gram-negative bacteria were 83.4%, 16.6%, 56.3% and 43.7%, respectively. The fungi was only detected in 1.4% patients. The antimicrobial susceptibility test demonstrated that Imipenem, Cefotaxime and Amoxicillin-clavulanate were good in vitro activity to aerobic pathogens and Metronidazole, Imipenem and Chloramphenicol was good to anaerobic pathogens. The beta-LPB was detected in 37.7% strains in which Staphylococcus epidermidis, Staphylococcus aureus, alpha-Hemolytic streptococcus and Branhamella catarrhalis were more frequent. Five species including Staphylococcus epidermidis and Escherichia coli etc were cultured from the control group. There was no significant difference of distribution of the same bacteria between the control group and the testing group (P > 0.05).

CONCLUSIONSThe pathogenic bacteria of CR mostly involve aerobes. The antibiotics-resistance of these pathogen is serious. The bacterial infection plays no leading role in CR, so the need of antibiotics should not be excessively emphasized. Before treatment by antibiotics, the antimicrobial susceptibility test should be performed. The broad-spectrum antibiotics containing beta-lactamase inhibitor such as Cefotaxime and Amoxicillin-clavulanate is recommended in condition that the test can not be finished.

Adolescent ; Adult ; Bacteria ; isolation & purification ; Bacterial Infections ; microbiology ; Chronic Disease ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Sinusitis ; microbiology ; Young Adult