Objective To discuss the monitor and treatment of patients' abnormal condition of circulation system after liver transplantation.Methods Dynamic monitor of 23 patients' circulation system after liver transplantation.Variables include haemodynamics index,plasma albumin,coagulation function,temperature,urinary volume,electrolyte,et al.Results The patients with liver transplantion are in high haemodynamics.Some of them undergo pulmonary hypertension,hypoproteinemia,hypothermia,hypourocrinia,kaliopenia.Conclusion Pay attention to the abnormal condition of circulation system after liver transplantation,take protective the restoration of graft function actively.

The clinical teaching of ICU is a new challenge.According to the problem encountered in the practice we should improve and better the teaching methods such as asking students to pay more attention to the combination of substructural subjects and critical medicine and having a clinical macrocosm thinking,good responsibility,and the "intensive" concept during their work so that student can learn more initiatively and get more as well.

Objective To evaluate the dynamic change of the antithrombase and fibrinolytic function in the critical patients.Methods Eighty-seven patients hospitalized in ICU were studied. According to the clinical manifestation, all patients were divided into systemic inflammatory response syndrome (SIRS) group ( n = 68) and non-SIRS group ( n = 19), or multiple organ dysfunction syndrome (MODS) group ( n = 37) and non-MODS group (n = 50) respectively. Thirty-one healthy volunteers were selected for control in the same period. The intravenous blood samples were taken 1,3 and 5 days after ICU admission to measure platelet,count (PLT) , and the plasma levels of antithrombase activity (AT: A), plasminogen activity (PLG: A), fibrinogen (FIB) and D-dimer (D-D) concentrations.Results AT: A, PLG: A and PLT were lower and FIB and D-D levels higher in all patients than control levels (P

AIM: To observe the changes of inflammatory factors and blood coagulatory factors and effects of antithrombin Ⅲ (ATⅢ) on activated inflammatory factors and blood coagulatory factors in rats with hemorrhagic shock. METHODS: The rat model of hemorrhagic shock was set up. 40 SD rats were randomized into four groups: sham operation, shock, routine dose ATⅢ and high dose ATⅢ groups, each group was composed of 10 SD rats. Shock group was administered common resuscitation fluid, routine dose ATⅢ group was administered ATⅢ 20 U/kg, high dose ATⅢ group was administered ATⅢ 100 U/kg everyday for successive three days. Plasma NF-?B, 6-Keto-prostaglandinF1?, E-selectin, sICAM-1, thrombin-ATⅢ complexes, thrombinogen fragment F1+2 (PF F1+2), D-dimer and TMD levels were detected. RESULTS: Plasma NF-?B, sICAM-1, E -selectin levels were significantly lower in high dose ATⅢ group than those in shock group and routine dose ATⅢ group (P

Objective To investigate the effect of rh-BNP combined with sodium nitroprusside in acute decompensated heart failure patients with loss of blood flow dynamics, the effects on heart function and circulating factor levels.MethodsSelect Wenzhou Institute of Physiology from February 2014 to January 2016 admitted during the period of 120 cases of acute decompensated heart failure patients, according to random number table method to all of the patients were randomly divided into two groups, control group and test group with the control group patients were given conventional treatment of heart failure treatment, while the experimental group patients give tome sodium nitrate joint treatment with recombinant human brain natriuretic peptide, compare two groups of patients 12 h level of circulating factors, cardiac function and hemodynamics.ResultsTwo groups of patients after the hemodynamics after 24 h treatment was significantly lower than that after the treatment of 12h(P<0.05), the control group of patients after treatment of 12h and 24h after pulmonary capillary wedge pressure and right atrial pressure and central venous pressure index were significantly higher than those in the test group (P<0.05) for the treatment of 24h.After the control group of patients with left ventricular GSRa, GSRe, GSRs, ROTR, ROT, GCS, GLS levels were significantly lower than those in the test group (P<0.05).After treatment of 12h patients in the control group were hsCRP, ST2, IL-6 and blood The levels of cTn I and NT-proBNP were significantly higher than those in the experimental group (P<0.05).ConclusionRh-BNP combined with sodium nitroprusside in patients with acute decompensated heart failure treatment can effectively optimize the circulation of patients with factor level and heart function and hemodynamics, it is worth to be popularized in clinical use.

Objective: To observe the changes of blood coagulation factors and inflammatory factors and the regulatin effect of Omegaven.Methods: Thirty ICU patients were randomly allocated into two groups: Omegaven group and control group.Serum concentrations of NF-κB、PGF1α、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 were measured before and after parenteral nutrition.Results: Patients in control group had significantly higher NF-κB、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 concentration,lower PGF1α concentration.Patients treated with Omegaven had significantly lower NF-κB、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 concentration,higher PGF1α concentration.Conclusion: Omegaven can suppress inflammatory reaction and improve coagulopathy.

Objective To investigate the coagulant function of Thrombomodulin-Protein C-EPCR System in rats with hemorrhagic shock in virto study.Methods In this study,30 rats were divided into three groups,with each group 10 rats:control group,the sham shock group,hemorrhagic shock group.Hemorrhagic shock model was subjected to computer-controlled arterial hemorrhage to 40 mm Hg for 60 min The rat blood serum samples were obtained from rats in sham shock group and shock group after maintaining 3 hours,and fetal bovine serum (FBS) was used as control group.Then medium contained fore-mentioned serums cultured with SV40-transformed aortic rat endothelial cells for 6 hours,12 hours and 18hours.The messenger RNA (mRNA) expression of thrombmodulin (TM),Endothelial cell protein C receptor in the SV40-transformed aortic rat endothelial cells which were treated with serums were detected by reverse-transcription polymerase chain reaction.Results Compared to control group,SVARECs were incubated for 6hrs with shock serum,the mRNA expression of TF,TM and t-PA was significantly higher,and continued elevating at the time of 18 hours (P ＜ 0.01).Conclusions Serums from hemorrhagic shock rats upregulate TMmRNA EPCRmRNA expression on the endothelial cells surface.It is suggested that Thrombomodulin-Protein C-EPCR System pay a key role of anticoagulation,the protection of endothelial function.

Objective:To explore the correlation between early inflammation indicators and the severity of coronavirus disease 2019 (COVID-19).Methods:A retrospective study was conducted. Patients with COVID-19 admitted to Wenzhou Central Hospital from January 17 to February 14, 2020 were enrolled. The general information, chest CT before admission, the first laboratory parameters and chest CT within 24 hours after admission were collected. Patients were followed up for 30 days after the first onset of dyspnea or pulmonary imaging showed that the lesions progressed more than 50% within 24 to 48 hours (according to the criteria for severe cases) as the study endpoint. According to the endpoint, the patients were divided into two groups: mild type/common type group and severe/critical group, and the differences in general information and inflammation index of the two groups were compared. Logistic regression was used to analyze the inflammation index and the severity of COVID-19. Receiver operating characteristic (ROC) curve was draw to evaluate the predictive value of early inflammation indicators for severe/critical in patients with COVID-19.Results:A total of 140 patients with COVID-19 were included, 74 males and 66 females; the average age was (45±14) years old; 6 cases (4.3%) of mild type, 107 cases (76.4%) of common type, and 22 cases (15.7%) of severe type, 5 cases (3.6%) were critical. There were significantly differences in ages (years old: 43±13 vs. 57±13), the proportion of patients with one chronic disease (17.7% vs. 55.6%), C-reactive protein [CRP (mg/L): 7.3 (2.3, 21.0) vs. 40.1 (18.8, 62.6)], lymphocyte count [LYM (×10 9/L): 1.3 (1.0, 1.8) vs. 0.8 (0.7, 1.1)], the neutrophil/lymphocyte ratio [NLR: 2.1 (1.6, 3.0) vs. 3.1 (2.2, 8.8)] and multilobularinltration, hypo-lymphocytosis, bacterial coinfection, smoking history, hyper-tension and age [MuLBSTA score: 5.0 (3.0, 5.0) vs. 5.0 (5.0, 7.0)] between mild/common group and severe/critical group (all P < 0.05). Univariate Logistic regression analysis showed that CRP, NLR, MuLBSTA score, age, and whether chronic diseases were associated with the severity of COVID-19 [odds ratio ( OR) and 95% confidence interval (95% CI) were 1.037 (1.020-1.055), 1.374 (1.123-1.680), 1.574 (1.296-1.911), 1.082 (1.042-1.125), 6.393 (2.551-16.023), respectively, all P < 0.01]. Further multivariate Logistic regression analysis showed that CRP and MuLBSTA score were risk factors for the development of COVID-19 to severe/critical cases [OR and 95% CI were 1.024 (1.002-1.048) and 1.321 (1.027-1.699) respectively, both P < 0.05]. ROC curve analysis showed that the area under the curve for CRP and MuLBSTA score to predict severe/critical cases were both 0.818, and the best cut-off points were 27.4 mg/L and 6.0 points, respectively. Conclusion:CRP and MuLBSTA score are related to the severity of COVID-19, and may have good independent predictive ability for the development of severe/critical illness.

Objective To investigate the clinical effect of treatment of severe carbon monoxide poisoning with Naoxingjing injection combined with naloxone.Methods Emergency department of affiliated theorem clinical college, hospital 70 patients diagnosed with severe carbon monoxide poisoning from emergency department in June 2014 to December 2016, were randomly divided into observation group and control group 35 cases.In the control group were treated with naloxone treatment, observation group were treated based on the use Naoxingjing injection treatment.The two groups were observed and recorded recovery time, mortality, the incidence of delayed encephalopathy, Glasgow Coma Score(GCS)and serum levels of IL-1β.Results The patients in the observation group total effective rate of 97.14% was significantly higher than 77.14%, and the difference was statistically significant(P<0.05);the recovery time was observed in patients(2.25 ± 0.88)h, significantly shorter than the control group(3.46 ± 1.10)h, and the difference was statistically significant(P<0.05);and follow-up observation group mortality rates were delayed encephalopathy(1.43%, 8.57%)than the control group(17.14%, 25.71%), and the difference was statistically significant(P<0.05);④ observation group were GCS score was (12.77±1.89), significantly better than the control group, and the difference was statistically significant(P<0.05);⑤ observed in patients IL-1β is(65.41±9.93)ng / L was significantly lower than the control group(89.86±10.74)ng / L, and the difference was statistically significant(P<0.05).Conclusion Naoxingjing injection combined with naloxone treatment of severe carbon monoxide poisoning exact clinical effect, can effectively reduce patient recovery time, reduce mortality and morbidity.

Objective To study the clinical characteristics、risk factors and preventive measures in the patients of hospital-acquired septicemia in ICU.Methods Retrospective survey was carried out in 76 patients with hospital-acquired septicemia from 2002 to 2005.Results The hospital-acquired septicemia was related to the underlying disease、aggressive procedure and long duration of combined antibiotics.The most bacteria were Gram-negative bacilli.Fungemia must be given reconstruction.Conclusions It is important to reduce the aggressive procedures and reasonably use antibiotics in the prevention of the hospital-acquired septicemia for patients.