Objective To assess the clinical value of systemic vascular resistance index (SVRI) combined with serum procalcitonin (PCT) and sequential organ failure assessment (SOFA) score in the early diagnosis of sepsis. Methods A retrospective study was conducted. The data of critical patients admitted to Department of Critical Care Medicine of the Third People's Hospital of Hechi from November 2013 to April 2016 were enrolled. The clinical data were recorded as follows: gender, age, infection site, SOFA score, serum PCT level (enzyme linked fluorescence analysis) within 1 hour after intensive care unit (ICU) admission, hemodynamics parameters, including mean arterial pressure (MAP), central venous pressure (CVP), cardiac index (CI), SVRI, global end diastolic volume index (GEDVI), extravascular lung water index (EVLWI), which were monitored by pulse indicator continuous cardiac output (PiCCO) after ICU admission. The patients were divided into sepsis and non-sepsis groups according to the diagnostic criteria of sepsis. Septic patients were divided into low SVRI group, normal SVRI group, and high SVRI group according to SVRI normal value (170-240 kPa·s·L-1·m-2), and the differences in parameters among the three groups were compared. The correlations between SVRI and various parameters were analyzed by using Pearson correlation analysis. The receiver operating characteristic curve (ROC) was plotted to evaluate the diagnostic efficiency of each parameter. Results Totally 103 critical patients were enrolled, 55 in sepsis group, and 48 in non-sepsis group. Compared with non-sepsis group, SVRI in septic group was significantly lowered (kPa·s·L-1·m-2: 146.56±45.17 vs. 188.04±56.27), and serum PCT was significantly increased (μg/L: 10.43±6.17比0.32±0.11) with statistically significant differences (both P < 0.05). In 55 sepsis patients, there were 21 in low SVRI group, 19 in normal SVRI group, and 15 in high SVRI group. There were no statistically significant differences in gender, age and infection site among the three groups, indicating that the baseline data among all groups was balanced with comparability. SOFA score, PCT, and CI in the low SVRI group were significantly higher than those of normal SVRI and high SVRI groups [SOFA: 10.57±2.89 vs. 5.73±2.28, 5.73±2.15, PCT (μg/L): 24.15±12.43 vs. 7.18±5.05, 7.39±4.38, CI (mL·s-1·m-2): 71.01±9.67 vs. 62.01±8.34, 62.51±8.67, all P < 0.05], but no significant difference was found between the normal SVRI group and high SVRI group. There was no statistically significant difference in MAP, CVP, EVLWI, and GEDVI among the three groups. It was shown by Pearson correlation analysis that SVRI was negatively correlated with PCT, SOFA score, and CI (r value was -0.622, -0.598, -0.398, all P = 0.000). It was shown by ROC curve that area under ROC curve (AUC) of PCT combined with SVRI for diagnosis of sepsis was higher than that of PCT or SVRI alone (0.943 vs. 0.911, 0.884). When the cut-off value of PCT was 3.79 μg/L, and cut-off value of SVRI was 156.81 kPa·s·L-1·m-2, the sensitivity and specificity were 94.6% and 92.3% respectively. Conclusions For sepsis patients, SVRI is related to PCT and SOFA score. Combined monitoring of PCT, SVRI, SOFA score can accurately reflect the severity of sepsis patients, guide diagnosis and treatment, and estimate prognosis. The efficacy of PCT combined with SVRI in the early diagnosis of sepsis is better than that of the two alone.

ObjectiveTo observe the effect of warm needle moxibustion and exercise therapy on scapulohumeral periarthrits.Methods90 scapulohumeral periarthrits cases were randomly divided into the synthetic treatment group and exercise therapy group with 45 cases in each group. Patients of the synthetic treatment group were treated with warm needle moxibustion and exercise therapy, but that of the exercise therapy group only with exercise therapy. Some local acupoints, for example Point LI15 (Jian Yu), Piont SJ14 (Jian Liao), Piont SI9 (Jian Zhen) and so on, were selected when warm needle moxibustion performed. Eexercise therapy includes joint mobilization and initiative function training. One course was 15 days. The effect was evaluated after two courses.ResultsApparent efficiency of synthetic treatment groups was 71% and 42% for exercise therapy groups. There was a significant difference between two groups (χ2=22.815,P<0.01). There was also a obvious difference between two groups in improving range of shoulder joint movement and alleviating extent of shoulder pain (P<0.05).ConclusionWarm needle moxibustion cooperated with exercise therapy can increase cure rate and reduce recrudescence of scapulohumeral periarthrits.

Chronic high-salt diet-associated renal injury is a key risk factor for the development of hypertension. However, the mechanism by which salt triggers kidney damage is poorly understood. Our study investigated how high salt (HS) intake triggers early renal injury by considering the ‘gut-kidney axis’. We fed mice 2% NaCl in drinking water continuously for 8 weeks to induce early renal injury. We found that the ‘quantitative’ and ‘qualitative’ levels of the intestinal microflora were significantly altered after chronic HS feeding, which indicated the occurrence of enteric dysbiosis. In addition, intestinal immunological gene expression was impaired in mice with HS intake. Gut permeability elevation and enteric bacterial translocation into the kidney were detected after chronic HS feeding. Gut bacteria depletion by non-absorbable antibiotic administration restored HS loading-induced gut leakiness, renal injury and systolic blood pressure elevation. The fecal microbiota from mice fed chronic HS could independently cause gut leakiness and renal injury. Our current work provides a novel insight into the mechanism of HS-induced renal injury by investigating the role of the intestine with enteric bacteria and gut permeability and clearly illustrates that chronic HS loading elicited renal injury and dysfunction that was dependent on the intestine.
Animals ; Bacteria ; Bacterial Translocation ; Blood Pressure ; Drinking Water ; Dysbiosis ; Enterobacteriaceae ; Gastrointestinal Microbiome ; Gene Expression ; Hypertension ; Intestines ; Kidney ; Mice* ; Microbiota ; Permeability ; Risk Factors

Objective: To observe the effects of general anesthesia and intravertebral anesthesia on the patients' temperature, perfusion index(PI) and coagulation function. Methods: From January 2016 to December 2017, 60 patients in the First Hospital of Jiaxing undergoing elective line of great saphenous varicose veins surgery were selected.According to the random number table, the patients were divided into the general anesthesia group(group G, n=30) and intraspinal anesthesia group(group I, n=30). The general condition, operation time, the core temperature(tympanic membrane temperature) before anesthesia(T0), 10 min after anesthesia(T1), 20 min later(T2), 30 min later(T3), and the PI with no-infusion upper limb were recorded.The changes of coagulation function before anesthesia(T0) and after surgery(T4) were observed by extraction of the thrombus(TEG). Results: The core body temperature of T1, T2 and T3 was significantly decreased in both two groups(F_G=58.789, P=0.000, F_I=2.965, P=0.035), and the hypothermia of group G was greater than that of group I(t₁=-2.998, t₂=-5.985, t₃=-7.705; P<0.05). The PI of T1, T2 and T3 was significantly higher than T0 in both two groups(F_G=5.439, P=0.002, F_I=3.404 P=0.020), and the increase of group G was greater than that of group I(t₁=2.065, t₂=2.041, t₃=2.649; P<0.05). In group G, TEG examination was significantly prolonged(F=5.482, P=0.023), and no significant changes were observed in group I. Conclusion The hypothermia of the patients and the increase of PI increased significantly, and the R time index of TEG is prolonged, and the anesthesia in the spinal canal has no obvious effect on the coagulation function.