ObjectiveTo study the effect of recombinant human growth hormone (rhGH) on postoperative patients on mechanical ventilation.Methods Forty postoperative respiratory failure patients on mechanical ventilation were treated by rhGH 8?IU injection subcutaneously QD.ResultsThe time of mechanical ventilation of rhGH group was (30?12)?d, compared with that in 40 control patients (39?13)?d (t=2 538,P

Objective To study autologous peripheral blood stem cells (PBSCs) transplantation for cardiac myoid cells formation and angionesis after recombinant human granulocyte-colony stimulating factor (rhG-CSF) mobilizing. Methods The 60 white Japanese big-ear rabbits were divided into 3 groups, i.e. transplantation (T) mobiliztor (M) and control (C) groups, each group with 20 rabbits. Myocardial infarction (MI) model was developed by ligating the anterior descending coronary artery. G-CSFs were given continually for 7 d in T and M groups since 1 h after MI model development. Cell suspension which derived from the peripheral blood and labeled with BrdU which prepared 1 week ago were injected into infarction regions and borders, while in C groups only the same doses saline was injected. The survival and differentiation of the implanted cells were detected with histological analyses and capillary densities. Results BrdU positive cells which were taken on immature cardiac myoid cells were observed at infarcted areas in T group, which were detected as the Actin positively. HE stains showed that the structures of infarction regions were deranged in C group, but in T and M groups cell arrangements were arranged regularly. Meanwhile, there were a large amount of neogenesis capillaries. The capillaries densities were respectively (58.2 ± 11.5) and (52.3±6.0) per high-power field in T and M groups, while in C group was (21.6±4.9) (P＜0.01 ). In C group blue collagen fibers were much more than T and M group under Masson stains (P ＜0.01). In T and M groups the cardiac functions were much better than in the C group at the end of 4 weeks, especially ejection fraction were respectively (65.34±2.54)% and (63.40±2.84)% in M and T groups. In C group it was only (50.51 ±6.47)% (P＜0.01). Conclusion After G-CSF mobilizing the implanted PBSCs may survive and differentiate into cardiac myoid cells in infarcted areas and vicinities, at the same time promote neogenisis and improve cardiac function. It is significant that cell transplantation will treat the cardiac infarction in future.

Objective To study the effect of high volume hemofiltration(HVHF) in patients with multiple organ dysfunction syndrome (MODS). Methods Nineteen MODS patients were divided into two groups randomly, 10 patients receiving HVHF and 9 patients treated by routine continuous venovenous hemofiltration(CVVH).Artery blood was sampled before and 2、4、8 hours after HVHF and CVVH, concentrations of Scr, BUN, TNF?, IL 1?, IL 6 and blood gas were measured.Results In both HVHF group and CVVH group, the 4th hour Scr、BUN decreased significantly, renal function improved. In HVHF group compared with pre-treatment level the 4th hour concentrations of TNF?[(1 759?506)ng/L vs. (1 265?397)ng/L]、IL-1?[(964?185)ng/L vs. (511?124)ng/L]、IL-6[(1 332?415) ng/l vs. (726?243)ng/L] decreased singificantly. In CVVH group, the 4th hour concentrations of TNF?[(1 799?511) vs.(1 327?421) ng/L] decreased significantly (all P

A multicenter blinded randomized controlled trial (RCT) was conducted in accordance with international clinical trial standards to evaluate the efficacy and safety of Xuebijing injection in the treatment of severe community-acquired pneumonia (SCAP) under strict quality control condition. This article aims to illustrate key contents of the design ideas and implementation process of the RCT of Xuebijing injection in the treatment of SCAP, including the selection of research objects, design, implementation, and insights, etc., share experience with researchers of the respiratory and critical care, and provide reference for future studies in critical care.

Background: and Purpose Intracranial vertebrobasilar atherosclerotic stenosis (IVBAS) is a major cause of posterior circulation stroke. Some patients suffer from stroke recurrence despite receiving medical treatment. This study aimed to determine the prognostic value of a new score for the posterior communicating artery and the P1 segment of the posterior cerebral artery (PCoA-P1) for predicting stroke recurrence in IVBAS. Methods: We retrospectively enrolled patients with severe IVBAS (70%–99%). According to the number of stroke recurrences, patients were divided into no-recurrence, single-recurrence, and multiple-recurrences groups. We developed a new 5-point grading scale, with the PCoA-P1 score ranging from 0 to 4 based on magnetic resonance angiography, in which primary collaterals were dichotomized into good (2–4 points) and poor (0 or 1 point). Stroke recurrences after the index stroke were recorded. Patients who did not experience stroke recurrence were compared with those who experienced single or multiple stroke recurrences. Results: From January 2012 to December 2019, 176 patients were enrolled, of which 116 (65.9%) had no stroke recurrence, 35 (19.9%) had a single stroke recurrence, and 25 (14.2%) had multiple stroke recurrences. Patients with single stroke recurrence (odds ratio [OR]= 4.134, 95% confidence interval [CI]=1.822–9.380, p=0.001) and multiple stroke recurrences (OR=6.894, 95% CI=2.489–19.092, p<0.001) were more likely to have poor primary collaterals than those with no stroke recurrence. Conclusions The new PCoA-P1 score appears to provide improve predictions of stroke recurrence in patients with IVBAS.

Objective To investigate the effect of the mitochondria-targeted antioxidant SS-31 on acute liver injury in a mouse model of sepsis. Methods A total of 24 adult male C57BL/6J mice were randomly divided into control group, control+SS-31 group, lipopolysaccharide (LPS) group, and LPS+SS-31 group, with 6 mice in each group. The mice were given intraperitoneal injection of LPS (10 mg/kg) to establish a model of sepsis and acute liver injury, followed by intraperitoneal injection of SS-31 (10 mg/kg) for treatment, and the mice in the control group were given intraperitoneal injection of an equal volume of PBS solution, followed by intraperitoneal injection of an equal volume of normal saline. After 12 hours, ELISA was used to measure the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), reactive oxygen species (ROS), superoxide dismutase (SOD), tumor necrosis factor-α (TNFα), interleukin-1β(IL-1β), and interleukin-6 (IL-6), and HE staining was used to observe liver histopathological changes. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results Compared with the LPS group, the LPS+SS-31 group had significant reductions in the serum levels of ALT (140.05±12.22 U/L vs 102.64±8.75 U/L, P < 0.05) and AST (80.22±4.71 U/L vs 69.26±5.37 U/L, P < 0.05) and the levels of ROS (1 030.21±115.87 pg/mL vs 847.84±63.65 pg/mL, P < 0.05), TNFα (767.18±60.60 ng/mL vs 698.89±16.99 ng/mL, P < 0.05), IL-1β (29.97±1.37 ng/mL vs 26.70±3.09 ng/mL, P < 0.05), and IL-6 (59.13±7.09 pg/mL vs 49.29±3.41 pg/mL, P < 0.05) in liver tissue. Compared with the control group based on HE staining, the LPS group showed destruction of hepatic lobular structure, inflammatory cell infiltration, ambiguous intercellular space, and hepatocyte swelling, while the LPS+SS-31 group showed alleviation of inflammatory cell infiltration and hepatocyte swelling. Conclusion The mitochondria-targeted antioxidant SS-31 can reduce the production of ROS, downregulate the highly expressed inflammatory factors in sepsis, and alleviate sepsis-related acute liver injury in mice.

Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound,the examiner and interpreter of the image are critical care medicine physicians.The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes.With the idea of critical care medicine as the soul,it can integrate the above information and clinical information,bedside real-time diagnosis and titration treatment,and evaluate the therapeutic effect so as to improve the outcome.CUS is a traditional technique which is applied as a new application method.The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept,implementation and application of CUS.It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure.At the same time,the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications,and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS.Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group,based on the rich experience of clinical practice in critical care and research,combined with the essence of CUS,to learn the traditional ultrasonic essence,established the clinical application technical specifications of CUS,including in five parts:basic view and relevant indicators to obtain in CUS;basic norms for viscera organ assessment and special assessment;standardized processes and systematic inspection programs;examples of CUS applications;CUS training and the application of qualification certification.The establishment of applied technology standard is helpful for standardized training and clinical correct implementation.It is helpful for clinical evaluation and correct guidance treatment,and is also helpful for quality control and continuous improvement of CUS application.

Humans ; COVID-19 ; Consensus ; SARS-CoV-2 ; China