Cardiopulmonary Resuscitation ; China ; Humans ; Time Factors

Objective:To evaluate iron metabolism disorders in sepsis patients and explore the effect of iron deficiency on mortality.Methods:Patients ( n=130) who were admitted to the emergency intensive care unit (ICU) of the First Affiliated Hospital of Dalian Medical University from September 2016 to July 2018 and met the diagnostic criteria of Sepsis 3.0 were selected, and sex- and age-matched healthy volunteers ( n=20) were enrolled as a control group. Peripheral venous blood samples were collected in sepsis patients on day 1, 3 and 7 after admission, or in the healthy volunteers upon enrollment, to detect iron metabolism-related indicators and interleukin-6 (IL-6); the Sequential Organ Failure Assessment (SOFA) score was calculated upon hospital admission. Iron metabolism-related indicators were compared between the groups; the correlation of plasma iron with hemoglobin, hepcidin, ferritin, IL-6, sTFR/log ferritin and the ability of plasma iron to predict 28-day death of sepsis patients were analyzed. Results:Sepsis patients developed significant anemia on day 3 after admission; plasma iron, transferrin, iron saturation, total iron binding capacity and unsaturated iron binding capacity in the first week of admission were significantly lower than those in the control group; distribution width of red blood cells, ferritin, IL-6, hepcidin and soluble transferrin receptor were significantly higher than those in the control group. Distribution width of red blood cells, ferritin and hepcidin on day 3 and 7 after admission, and plasma iron and iron saturation on day 7 after admission were significantly higher than those on day 1. However, total iron binding capacity and unsaturated iron binding power on day 7, and sTFR/log ferritin on day 3 were significantly lower than those on day 1. Patients in the survival and non-survivor groups in the first week of admission had significant anemia on day 3 and 7, but the anemia was worse in the non-survivor group. Transferrin, total iron binding capacity, and unsaturated iron binding capacity in the non-survivor group in the first week of admission, and plasma iron in the non-survivor group on day 3 and 7, were significantly lower than those in the survival group. Ferritin, IL-6 and hepcidin in the non-survivor group in the first week of admission, and iron saturation on day 7 were significantly higher than those in the survival group. Spearman correlation analysis showed that plasma iron was negatively correlated with IL-6 ( r=-0.391, P<0.01), ferritin ( r=-0.293, P=0.001) and hepcidin ( r=-0.209, P=0.017), but not with hemoglobin ( r=0.005, P=0.958). The area under the operation curve (AUC) for plasma iron for predicting 28-day mortality in sepsis patients was 0.524 (95% CI: 0.416-0.631, P=0.656). Conclusions:Sepsis patients have significant anemia and iron metabolism disorders in the early stage, while non-survival patients are more severe. Reduced plasma iron level has no capacity to predict 28-day mortality of sepsis patients. In addition, decreased plasma iron level is not related to decreased hemoglobin, and thus iron supplementation should be cautious in sepsis patients.

Objective: To investigate the effect of glutamine (Gln) on the content of reduced glutathione hormone (GSH) and aminoglutaminic acid (Glu) of spinal cord following ischemia-reperfusion injury. Methods: Totally 40 healthy adult male rabbits were randomly divided into five groups: sham-operation group (S group), ischemia-reperfusion injury group (I/R group), low-dose glutamine group (L Gln group), median-dose glutamine group (M Gln group) and high-dose glutamine group (H Gln group). After glutamine preconditioning, the model of spinal cord ischemia-reperfusion injury was established according to Zivin's method. The general status of animals was observed and the changes of Jacobs scoring were recorded in each group. Malondialdehydes (MDA), GSH, Glu and superoxide dismutase (SOD) activity in lumbar spinal cord tissues were determined using chemical colorimetry. The neuron number and deviation rate in spinal cord anterior horn were observed histopathologically. Results: There was no significant difference between L Gln group and I/R group in behavior scoring, SOD activity, content of MDA and Glu, neuron number and deviation rate of spinal cord (P>0.05); however, there was a significant difference in GSH content of spinal cord (P<0.05). M Gln group and I/R group differed significantly (P<0.05) in behavior scoring, SOD activity, content of MDA, Glu, GSH, neuron number and deviation rate of spinal cord. Between H Gln group and M Gln group, there was no significant difference in behavior scoring, content of MDA and Glu, SOD activity, neuron number and aberration rate in spinal cord (P>0.05), whereas there was a significant difference in SOD activity and Glu content (P<0.05). Conclusion: Pretreatment with medium-dose glutamine has a protective effect on spinal cord ischemia-reperfusion injury in rabbits, which may be related to the maintenance of GSH content, increase of SOD activity and reduction of MDA.

Objective: To investigate the effect of glutamine (Gln) on the content of reduced glutathione hormone (GSH) and aminoglutaminic acid (Glu) of spinal cord following ischemia-reperfusion injury. Methods: Totally 40 healthy adult male rabbits were randomly divided into five groups: sham-operation group (S group), ischemia-reperfusion injury group (I/R group), low-dose glutamine group (L Gln group), median-dose glutamine group (M Gln group) and high-dose glutamine group (H Gln group). After glutamine preconditioning, the model of spinal cord ischemia-reperfusion injury was established according to Zivin's method. The general status of animals was observed and the changes of Jacobs scoring were recorded in each group. Malondialdehydes (MDA), GSH, Glu and superoxide dismutase (SOD) activity in lumbar spinal cord tissues were determined using chemical colorimetry. The neuron number and deviation rate in spinal cord anterior horn were observed histopathologically. Results: There was no significant difference between L Gln group and I/R group in behavior scoring, SOD activity, content of MDA and Glu, neuron number and deviation rate of spinal cord (P>0.05); however, there was a significant difference in GSH content of spinal cord (P<0.05). M Gln group and I/R group differed significantly (P<0.05) in behavior scoring, SOD activity, content of MDA, Glu, GSH, neuron number and deviation rate of spinal cord. Between H Gln group and M Gln group, there was no significant difference in behavior scoring, content of MDA and Glu, SOD activity, neuron number and aberration rate in spinal cord (P>0.05), whereas there was a significant difference in SOD activity and Glu content (P<0.05). Conclusion: Pretreatment with medium-dose glutamine has a protective effect on spinal cord ischemia-reperfusion injury in rabbits, which may be related to the maintenance of GSH content, increase of SOD activity and reduction of MDA.

Objective To study the pathogenic bacteria species and drug resistance rate in the intensive care unit(ICU)in county hospital to guide clinical rational use of antibiotics. Methods 263 various specimens were chosen from January 2013 to December 2013 in the ICU of Zigui County People's Hospital in Hubei Province,these were applied to perform the bacterial culture and identification,and disc AGAR diffusion method was used to test the in vitro drug susceptibility and observe the specimens distribution,pathogenic distribution and the rate of drug resistance. Results In the 263 specimens,the top three isolated were 131 sputum(49.8%),49 blood(18.6%) and 38 ascites specimens(14.4%)respectively,and the pleural effusion was the least isolated with 5(1.9%). A total of 125 strains bacteria were isolated with positive detection rate of 47.5%(125/263). In the 125 strains,80(64.0%) were Gram-negative(G-)bacilli at the pioneer position,and the top four were:Klebsiella pneumonia 23(18.4%), Acinetobacter Baumanni 19(15.2%),Escherichia coli 18(14.4%)and Pseudomonas aeruginosa 12 strains(9.6%). There were 33 strains(26.4%)of Gram positive(G+)cocci including mainly Staphylococcus aureus 25 strains(20.0%);fungi strains were 12,the least(9.6%). The drug resistance rates of the top four G- bacillus were as follows:the rate of Klebsiella pneumoniae to ampicillin sodium was the highest(100%),while its rate to imipenem,meropenem and ciprofloxacin was 0;the rates of Acinetobacter baumannii to tobramycin and ceftriaxone were very high(100%, 92.3%),while to imipenem,meropennem were much lower respectively(26.3%,15.4%);the rates of Escherichia coli to ampicillin sodium and piperacillin were relatively high(88.9%,83.3%),while the rates to amikacin,imipenem, meropennem respectively were 0;the rates of Pseudomonas aeruginosa to ceftriaxone,cefotaxime sodium were very high(both 100%),while the resistant rate to levofloxacin was 0. The G+ cocci had no drug-resistance to linezolid, teicoplanin and vancomycin;the rates of Staphylococcus aureus to azithromycin,clindamycin,erythromycin and penicillin were higher than 80%,and those of Excrement enterococcus to erythromycin,gentamycin,levofloxacin were also higher than 80%. Conclusions The ICU infection of our hospital is primarily respiratory tract infection, the pathogenic bacteria are mainly G- bacilli and the antibacterial drug resistance is very serious. Therefore it is necessary to monitor the trend of bacterial resistance closely,and according to the results of bacteria identification and drug susceptibility,the antimicrobial agents are reasonably chosen to effectively reduce and control the ICU hospital infection.

Objective To study the therapeutic effects and mechanism of Sodium Fendate(SF) on rats with severe acute pancreatitis(SAP) induced by L-arginine. Method A total of 60 adult SD rats were randomly and e-qually divided into control group, SAP group and SF group, with 20 rats in each group. The rat model of SAP wes established by injecting 2.5 g/kg L-arginine at a dose of intraperitoneally twice at an interval of 1 hour, and rats in SAP group and SF groups were administrated intraperitoneally with 20% L-arginine solution(2.5 g/kg×2) twice at an interval of 1 hour; rats in control group were injected intraperitoneally with the same volume of physiological saline twice alone.At 5 minutes after L-arginine administration,rats in SF group were injected with SF solution (100 mg/kg, qd×3 d) via the tail vein, and rats in the other two groups received a sham injection of the same volume of physiological saline alone. The characteristics of ascites, the pathological changes of pancreatic tissue and the serum levels of amylase(AMY), endothelin-l(ET-1), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and the contents of malonaldehyde (MDA), suede dismutase (SOD), reduced glutathioue (GSH) of pan-creatic tissue of rats and prognosis were compared at 72 hours after L-arginine administration. Measurement data were evaluated by oue-way ANOVA, and numeration data were assessed by Fisher' s exact test. P<0.05 was considered statistically significant. Results Compared with control group,at 72 hours after L-arginine administra-tion,rats in SAP group presented characteristically histopathological changes of SAP with significantly higher serum levels of AMY, ET-1, TNF-α, IL-6 and MDA of pancreatic tissue[(9715.5±301.3) IU/L vs. (729.2±134.2) IU/L;(25.32±3.67) ng/L vs. (14.32±2.69) ng/L;(102.95±11.24) ng/L vs. (38.62±3.87) ng/L; (538.63±9.53) ng/L vs. (186.35±1.19) ng/L;(34.8±3.9) mol/kg vs. (8.1±2.1) mol/kg, all P< 0.01], and lower GSH and SOD in the pancreatic tissue[(7.1±0.6) mg/kg vs. (16.9±1.9) mg/kg; (6423± 1978) kU/kg vs. (29905+2945) kU/kg,both P<0.01].Compared with SAPmodel group,at 72 hours after ad-ministration of L-arginiue, the pathological lesions of SAP in rats of SF group were significantly alleviated with lower pathological scores (P<0.05), lower serum levels of AMY, ET-1 ,TNF-α,IL-6 and MDA in the pancreatic tissue [(8104.6±149.9) IU/L vs. (9715.5±301.3) IU/L; (20.26±5.86) ng/L vs. (25.32±3.67) ng/L; (84.19±15.14) ng/L vs. (102.95±11.24) ng/L;(458±5.37) mol/kg vs. (538.63±9.53) rig/L;(28.3±2.5) moL/kg vs. (34.8±3.9) mol/kg,all P<0.05], and higher SOD and GSH in the pancreatic tissue[(8.5 ±1.4) mg/kg vs. (7.1±0.6) mg/kg;(10 316±2810) kU/kg vs. (6423±1978) kU/kg, both P<0.05].At 72 hours the death rate in SF group was lower than that in SAP group,but the difference had no significance (P= 0.2.5). Conclusions SF can scavenge oxygen-derived free radicals, upgrade the contents of SOD and GSH of pancreatic tissue,decrease the levels of serum proinflammatory cytokines and ET-1, ameliorate the pathological le-sions of pancreatic tissue in rats,and has the capability of decreasing death rate, so it possesses a distinct advantage for the treatment of SAP.

Objective To investigate the effect of bezafibrate on serum pro-inflammatory cytokine levels and blood pressure change in patients with hypertriglyceridemia and hypertension after antihypertensive therapy with extended release nifedipine. Methods Fifty-eight patients with both hypertriglyceridemia and hypertension, which was treated with extended release nifedipine, were randomized into 2 groups: bezafibrate group (n=30) and placebo group (n=28). Changes in levels of blood lipids, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor?(TNF-?) and interleukin-6 (IL-6) were observed following the treatment. A correlation between these changes and blood pressure was analyzed in both groups. Results The levels of triglyceride, total and low density lipoprotein cholesterol were significantly reduced (P

Objective:To improve the method for isolating platelet-rich plasma (PRP). Methods:Whole blood was collected from 8 healthy donors and then PRP was separated by both the tube method and the syringe method respectively. Samples were activated to get serum rich-in growth factors (SRGF).Platelets in the SRGF were counted and the level of TGF-?1 was assayed by enzyme-linked immunosorbent assay (ELISA).Results:The end product of syringe method has both a higher platelet count in PRP (P=0.003) and a higher level of TGF-?1 in SRGF(P=0.041) than that of tube method.Conclusion:The syringe method is an effective method in preparation of PRP.

Objective To study the changes of detrusor microvessel density and apoptosis related factor PCNA and Bax in different phase of partial bladder outlet obstruction. Methods Forty Wistar rats were divided into control(n =10), sham-operation(n =10) , two-week obstruction( n = 10) and five-week obstruction group(n = 10). The expression of detrusor microvessel density and apoptosis related factors PCNA and Bax were evaluated with immunohistochemistry method. Results The average weight of bladder was (125.5?10. 1) ,(128.5?8.9) ,(380.0?12.4) ,(400.0?12.5) mg in control, sham-operation, two-week obstruction and five-week obstruction group, respectively. The difference between control, sham-operation group and obstruction group was significant (P 0. 05 ) . The expression of microvessel density was 2. 1?1.3,13.3?2.3,36.4?4. 1 and 37.3?5.6 in control, sham-operation, two-week obstruction and five-week obstruction group, respectively. The difference between control, sham-operation group and obstruction group was significant ( P 0. 05 ). The expression of PCNA was (38. 2?17. 2)% , (39. 4?11.4)% , (64. 1?11. 5)% and (46. 2?9. 6)% in control, sham-operation, two-week obstruction and five-week obstruction group, respectively. The difference between control, sham-operation group and obstruction group was significant (P

Objective To assess the effects of propofol on left and right ventricular function of isolated rat heart against ischemia reperfusion injury Methods Sixteen male SD rats were randomly divided into control and experiment groups The isolated rat hearts was connected to Langendorff preparation and perfused as in our previous experiment After being perfused for 25 min, the isolated heart was subjected to 30 min no flow global ischemia followed by 40 min reperfusion The temperature of the isolated heart was maintained at 36℃ 37℃ during global ischemia In experiment group the isolated heart was perfused with propofol 6?g/ml in perfusate for 10 min before global ischemia The heart rate was paced at 348 beats/min The isovolumetric force velocity indexes and coronary flow were monitored continuously with MacLab instruments Results As compared with the isolated hearts in control group, propofol (6?g/ml) perfusion before ischemia significantly improved left and right ventricular diastolic function by decreasing ventricular end diastolic pressure, dp/dt min and T value At the same time, propofol protected left and right ventricular systolic function by elevating developed pressure, dP/dtmax and Vpm during reperfusion At the end of reperfusion, ventricular tissue superoxide dismutase (SOD) activity was significantly well preserved in the hearts pretreated with propofol Conclusions Propofol 6?g/ml perfusion before ischemia protects the isolated rat heart against ischemia reperfusion injury by improving diastolic and contracting function of right and left ventricles and intrinsic contractivity of myocardium Propofol increases coronary blood flow during reperfusion and increases SOD activity of myocardial tissue