Objective To explore the correlation of NT‐proBNP concentration and the fluid infusion volume in the patients with severe burn ,and to evaluate the significance of monitoring NT‐proBNP in severe burn patients .Methods Fifty cases of severe burn in 100 Hospital of PLA form September 2012 to September 2015 were selected ,without major disease history and genetic history before admission ,among them ,25 cases(group A) had the burned area 35% -50% TBSA or Ⅲ degree 10% -20% TBSA ,18 cases (group B) had the total burn area of >50% TBSA or Ⅲ degree >20% TBSA for group B and 10 cases(group C) had the total burn area>90% and were composite explosive injury .The NT‐proBNP concentrations were monitored on 1-30 d after admission for guiding blood transfusion and fluid infusion;contemporaneous age‐matched 53 patients with plastic surgery were selected as the control group .Compared with the calculation formula of the fluid volume ,the guiding advantage of NT‐proBNP was analyzed .Re‐sults The practical fluid volume in these burn patients were higher than that calculated by the common fluid replacement formula . The more severe burn ,the higher the NT‐proBNP concentration and the more blood products were demanded;the NT‐proBNP con‐centration ,fluid infusion volume ,MAP infusion volume and PLT transfusion volume had statistical difference between the group C and B and between the group B and A (P<0 .05) .Conclusion The NT‐proBNP concentration change may have a higher guidance and early warning significance for middle and long term rational control of blood transfusion and fluid infusion volume in the pa‐tients with severe burns .

Objective To explore the effect of salvianolate combined with Qumei trimetazidine on cardiac function in patients with chronic heart failure.Methods Seventy-four patients with chronic heart failure were randomly divided into treatment group and control group (37 cases per group).Patients in control group were treated with the regular treatment scheme including digitalis,diuretics,vasodilators,angiotensin converting enzyme inhibitor(ACEI),angiotensin receptor blockers (ARB) or β blocker therapy for 24 weeks treatment.Patients in treatment group were given the regular treatment scheme plus salvianolic acid and Qumei trimetazidine treatment,of which,the dose of salvianolic was 0.2 g into 5％ glucose injection 250 ml or 0.9％ sodium chloride injection 250 ml by intravenous injection,1 times/day,and Qumei trimetazidine for 20 mg,3 times/day,for 24 weeks.Cardiac function was observed in patients of two groups before and after treatment.The level of brain natriuretic peptide (BNP) was measured.Results Heart function were improved,the total effective rate in treatment group was 91.9％ (34/37),higher than that of control group (70.3％ (26/37),x2 =5.638,P ＜ 0.05).In treatment group,left ventricular ejection fraction (LVEF),stroke volume (SV),cardiac output (CO) of patients after treatment were (52 ± 7) ％,(65.10 ± 12.87) ml,(5.65 ± 1.18) L/min respectively,significant different from that before treatment ((39 ±5)％,(46.53 ± 12.14) ml,(4.79 ± 1.02) L/min,and the differences were statistic significant (t =9.192,6.384,3.352,P ＜ 0.05).Meanwhile,in treatment group,systolic pressure,diastolic pressure,heart rate,left ventricular end diastolic diameter (Dd),left ventricular diastolic posterior wall thickness(PWT),interventricular septal thickness (IVST),left ventricular mass (LVMW),plasma brain natriuretic peptide of patients after treatment were (105 ± 8) mmHg,(75 ± 9) mmHg,(76±8) time/min,(48.7 ±3.7) mm,(9.1 ±1.4) mm,(8.7 ±1.2) mm,(170±59) g,(104.1 ±19.5) ng/L respectively,significant different from that of before treatment((134 ± 12) mmHg,(84 ±8) mmHg,(118 ±11) time/min,(55.2 ±7.8) mm,(11.7 ±2.3) mm,(10.5 ±2.4) mm,(228 ± 111) g,(568.7±179.5) ng/L t=-12.231,-4.546,-18.782,-4.579,-5.874,-4.080,-2.806,15.652,P ＜ 0.01).The same trend was seen in control group in terms of LVEF,SV,systolic blood pressure,heart rate,PWT,plasma BNP before and after treatment(LVEF:(38 ±6)％ vs.(43 ± 8)％ ;:(46.76 ± 11.80) ml vs.(58.69 ± 11.58) ml; systolic blood pressure:(132 ± 10) mmHg vs.(116 ± 11) mmHg; heart rate:(116 ± 10) time/min vs.(77 ±9) time/min;PWT:(11.5 ±2.6) mm vs.(10.4 ±2.0) mm;plasma BNP:(570.2 ± 177.3) ng/L vs.(211.6 ± 21.2) ng/L;t =3.041,4.389;-6.546,-17.632,-2.039,12.21 ;P ＜ 0.05 or P ＜ 0.01).Moreover,after treatment,systolic pressure,diastolic pressure,LVEF,SV,CO,Dd,PWT,IVST,LVMW,plasma brain natriureticpeptide in treatment group were significantly better than that of control grouo (t =-4.919,-2.867,5.510,2.252,2.581,-2.319,-3.238,-3.628,-2.231,-22.701,P ＜0.01 or P ＜ 0.05).Conclusion The effect of salvianolate combined Qumei trimetazidine on treating chronic heart failure is significant,and there is a reverse effect on the left ventricle.

Objective To investigate the serum levels of advanced oxidation protein products (AOPP) in patients with chronic obstructive pulmonary disease (COPD) as well as explore the relevance of its clinical significance AOPP and COPD.Methods Fifty-four patients with mild/moderate COPD (COPD group) were enrolled in this study,who were treated in the No.100th Hospital of the Chinese People's Liberation Army from Apr.2011 to Nov.2013.Thirty healthy volunteers (control group) at same period were selected as control group and the general condition of two groups were matched.AOPP,superoxide dismutase(SOD) and malondialdehyde (MDA) levels were measured.Results The serum AOPP,MDA and SOD in control group were (45.78 ± 12.54) μmol/L,(2.96 ± 0.55) μmol/L and (78.40 ± 8.37) kU/L respectively.And its were (68.93 ± 10.62) μmol/L,(6.07 ± 2.44) μmol/L and (53.66 ± 5.99) kU/L respectively in COPD group.The differences were statistically significant (t =-8.57,-9.14,14.38 ; All P values were less than 0.01).The serum AOPP,MDA and SOD in mild COPD group were (65.56 ±9.65) μmol/L,(4.21 ± 1.83) μmol/L and (62.97 ± 6.28) kU/L respectively,and (71.79 ± 11.37) μmol/L,(7.43 ± 3.12) μmol/L and (41.25 ± 5.89) kU/L respectively in moderate CODP group.The differences were statistically significant (t =-2.17,-4.80,13.00; P ＜ 0.05 or P ＜ 0.01).Conclusion The increased levels of serum AOPP is important pathological changes in patients with COPD,which may be involved in the occurrence and development of COPD,and is the reaction of oxidative stress injury in patients with COPD early sensitive indicator.

Objective:To explore the effect of 1-methyltryptophan (1-MT) on lipopolysaccharide (LPS)-induced permeability and apoptosis of human umbilical vein endothelial cells (HUVECs).Methods:HUVECs were treated with phosphate buffer saline (PBS, control group), 1 μg/mL LPS (LPS group), and LPS combined with 1 mmol/L 1-MT (1-MT group). The expression levels of the p120 concatemer (p120ctn), vascular endothelial (VE) cadherin, caspase-3, and DNA repair enzyme polyadenylate ribose polymerase-1 (PARP) after incubation at 8 h were detected using Western blot. The concentrations of kynurenine (Kyn) after incubation at 2, 4, 6, and 8 h were measured by high-performance liquid chromatography, and indoleamine2, 3-dioxygenase (IDO) activity was calculated. Comparisons among groups were performed using the LSD- t test. Results:Compared with the control group, the expression of caspase-3 [(74.01±7.91)% vs (157.14±7.63)%, P<0.01] and the concentration of Kyn were significantly up-regulated, while the expression of p120ctn [(49.12±2.15)% vs (37.61±1.80)%, P<0.01], VE-cadherin [(107.70±7.01)% vs (90.66±2.58)%, P=0.027], and PARP-1 [(67.95± 3.08)% vs (57.93±5.26)%, P=0.038] were significantly down-regulated, and IDO activity was significantly increased in the LPS group ( P<0.05). Compared with the LPS group, the expression of caspase-3 [(157.14±7.63)% vs (110.74±7.89)%, P<0.01] was significantly down-regulated, while the expression of p120ctn [(37.61±1.80)% vs (47.19±0.82)%, P<0.01], VE-cadherin [(90.66±2.58)% vs (107.27±9.89)%, P=0.029], and PARP-1 [(57.93±5.26)% vs (74.12±4.90)%, P=0.005] were significantly up-regulated, and the activity of IDO was significantly decreased over time in the 1-MT group ( P<0.05). No significant differences were observed between the PBS and 1-MT groups in the protein levels of p120ctn, VE-cadherin, and PARP-1 protein as well as Kyn concentration and IDO activity ( P>0.05), while the expression of caspase-3 was increased in 1-MT group ( P=0.001). Conclusions:LPS aggravates the permeability of HUVECs, which can be reversed by 1-MT via inhibiting IDO activity and reducing Kyn concentrations. Moreover, 1-MT can also reduce apoptosis, which may be via increasing the expression of PARP-1 and reducing the expression of caspase-3, thus protecting endothelial cells.

Objective To investigate the application of the cross-sectional area ratio of internal jugular vein and common carotid artery (IJV/CCA) in the evaluating the volume responsiveness of critically ill patients. Methods The capacity of critically ill patients were prospectively assessed. The diameter and sectional area of the IJV and CCA were measured by bedside ultrasonography. The cross-sectional area ratio of IJV/CCA was calculated and compared with the variety of cardiac output (ΔCO) after passive leg raising (PLR). Then the correlation index between the cross-sectional area ratio of IJV/CCA and ΔCO was evaluated, and the sensitivity and specificity parameters of capacity status were assessed by the cross-sectional area ratio of IJV/CCA. Results Of 55 critically ill patients in this study, 34 cases had positive volume responsiveness, and 21 case negative volume responsiveness.The general clinical data of the two groups had no statistically significant difference. The cross-sectional area ratio of IJV/CCA in the positive group was significantly less than that of the negative group (1.38±0.55 vs. 2.16±0.68, P<0.01). There was a significant correlation between the IJV/CCA cross-sectional area ratio and the ΔCO value of PLR (r=-0.67, P<0.01). When the ratio of the cross-sectional area of IJV/CCA was 1.65, the sensitivity of the assessment capacity was 86.4％ and the specificity was 78.8％. Conclusions The use of portable bedside ultrasonography is a noninvasive, convenient and reliable method to evaluate the capacity state of the critically ill patients.