Objective:To explore the efficacy and mechanism of continuous veno-venous hemofiltration in treatment of severe acute pancreatitis(SAP).Methods:21 consecutive patients with SAP were included in this study.They were administrated with central venous catheteration.AV600 hemofilter(1.4m~2) was applied for CVVH.CVVH was started 2.8?1.4 days after onset of disease and sustained for 44.6?30.7 hours.We monitored the changes of symptorm,physical sign,laboratory examination and cytokines during CVVH.Results:The hemodynamic state in all patients was stable during CVVH.The overall surviral rate in ICU reached to 76.2%.After implement of the CVVH treatment,abdominal pain and abdominal distension were considerably improved.Temperature,heart rate,breath rate decreased significantly,as well as serum concentrations of BUN,Cr,ALT,ALP,AMY,LPS declined.There was a considerable reduction in cytokines including TNF-?,IL-6,?-INF at the end of CVVH treatment.Conclusion:CVVH is an effective therapeutic option in treatment of SAP.The early clearance of inflammatory mediators including TNF-?,IL-6,and ?-INF is thought to be an important mechanism for improving outcome.

Objective:To investigate the clinical value of rapid supraclavicular subclavian catheterization during cardiopulmonary resuscitation. Methods:218 patients with cardiac arrest were randomly divided into central and peripheral intravenous groups for drug administration. We compared the effect of two pathways for drug administration during CPR. Results:There were no significant differi-ence in time of catheterization and success rate of catheterizaiton between the two groups. The RSC time in group C was shorter and early success rate was significantly higher than that of group P. Conclusion : Supraclavicular approach to subclavian catheterization for drug administration increased the success rate of CPR at an early stage and proves beneficial to cerebral resuscitation. It will provide the best pathway for drug administration during CPR.

Objective: To investigate the changes of serum myocardium enzyme profile and cardiac troponin I(cTnI) in resuscitated patients,and explore the diagnostic value of cTnI on myocardial injury in patients after cardiopulmonary resuscitation.Methods: Standard cardiopulmonary resuscitation was performed in 82 patients with cardia arrest in emergency ICU.Serum myocardium enzymes and cTnI were determined at the point of cardia arrest and after the return of spontaneous circulation(ROSC).Results: The patients′ plasma cTnI levels was elevated significantly 1 hour after ROSC,and CK?CK-MB?LDH and AST level were increased 2 hours after CPR.The level of the elevated cTnI was responsive to the degree of myocardial injury and the fatality ratio of resuscitated patients.Conclusion: Acute myocardial injuries were present in all resuscitated patients.The level of plasma cTnI could reflect the degree of myocardial injury.

Objective: To explore the effect and methed of long-distance transportation in critical patients.Methods:The clinical datas of 62 critical patients with long-distance transportation were retrospectively analyzed.Results:Among 62 patients,one suffered ventricular fibrillation,the others arrived safely.After transportation,the increase of HR and decrease of MAP were observed.There were no significant differences in the PaO2,SaO2 and PaO2/FiO2 in the patients before transportation and after transportation.Conclusion:During the long-distance prehospital transportation,advanced equipments,unblocked communication,proficient medical care,the integration of out-hospital and in-hospital Emergency Medical Service System(EMSS) are of great importance..

0.05).Regression analysis revealed an R value of 0.89 and the regression equation was as follows:CORB=0.78COTD+0.25;After manipulating inotropic drugs there was also a good agreement between RBco and Tdco,the correlation coefficient was 0.81,while the regression equation was CORB=0.91COTD+0.61.Conclusion:There is a high correlation between RBco and TDco measurement.Partial CO2 rebreathing measurement provids a new noninvasive circulation monitoring method for critical patients.

Objective:To investigate the changes of myocardial energy production in septic mice after a cecal ligation and puncture,and to observe the intervention effects of Shenfu injection.Methods:Mice models of abdominal infection were established by a cecal ligation and puncture(CLP).Eighty-three mice were randomly divided into three groups:CLP group(infection group),CLP and treated with Shenfu injection group(treatment group)and pseudooperation control group.The morphology and membrane phospholipid of myocardial mitochondria were studied by using transmission electronmicroscope morphometry method.The activities of cytochrome oxidase(CCO)and succinate dehydrogenase(SDH)of myocardial mitochondria were also detected by enzyme cytochemical method.Reversed phase high-performance liquid chromatography(RP-HPLC)was used to analyze contents of myocardial ATP,ADP and AMP.Results:As compared to control group,a large number of mitochondria were damaged in infection group,the apparent mitochondrial membrane phospholipid deletion and localization change were observed,the activities of CCO and SDH in mitochondria declined obviously,and the contents of ATP,ADP as well as AMP declined notably.All of these were obviously improved in treatment group.Conclusion:The myocardial mitochondrial structure destroyed and its functions declined apparently in septic mice.Shenfu injection could protect the myocardial mitochondrial structure and function effectively,improve the myocardial energy metabolism in septic mice also.

OBJECTIVE: To explore the effects of Shenfu injection on myocardial ATPase activities and sodium/calcium metabolism in viral myocarditis model mice.METHODS: The experimental mice were randomly divided into 4 groups: control group,infected group,high dose Shenfu injection group and low dose Shenfu injection group.The myocardial ATPase activities and concentrations of sodium/calcium were determined at different time poins,and the pathologic changes were investigated as well.RESULTS: As compared to control group,the activities of Na+,K+-ATPase and Ca2+-ATPase of the infected group decreasd significantly(P

Objective To clone, express, purify and evaluate the immunoreactivity of the recombinant protein Tp0844 of Treponema pallidum (Tp), and to screen major Tp proteins with high host reactivity. Methods The Tp0844 gene sequence was obtained through bioinformatics analysis. A prokaryotic expression vector of the Tp0844 gene was constructed and transformed into E. coli BL21 followed by isopropyl-1-thio-β-D-galactopyranoside (IPTG)induction for the expression of the recombinant protein Tp0844. Nickel-NTA affinity chromatography columns were utilized to purify the recombinant protein, and Western blotting was performed to evaluate the reactivity of the recombinant protein with sera positive or negative for anti-Tp IgG antibodies. Results The recombinant prokaryotic expression vector PET-30a (+)-Tp0844 was successfully constructed. After IPTG induction, a soluble recombinant protein with a relative molecular mass of about 43 000 was highly expressed, and purified by affinity chromatography. Western blotting showed that the Tp0844 recombinant protein specifically reacted with anti-Tp IgG antibody-positive sera, but not with anti-Tp IgG antibody-negative sera. Conclusions The soluble recombinant protein Tp0844 has good immunoreactivity, and can serve as a candidate antigen for investigation into the pathogenesis of syphilis.

Objective To discuss the feasibility of application of laryngeal mask airway(LMA)in pediatric corrective surgery of lingual frenum. Methods Retrospective study was conducted of 42 chil-dren using laryngeal mask airway in selective surgical correction of lingual frenum under general anesthe-sia in our hospital. The childrenˊs vital signs were recorded at five different time points:baseline before an-esthesia(T0),consciousness and eyelid reflex disappear just after anesthesia induction(T1),time right af-ter the LMA insertion(T2),3 ~ 5 min after beginning of operation(T3),and time at the extubation(T4). The success rate of first LMA insertion and the number of changing to other ventilation way were recorded. The shift of LMA and postoperative sore throat within 24h were recorded. Results The success rate of the first LMA insertion was 85. 71% . Intraoperative laryngeal mask airway leak and shift did not occur and the ventilation was also good. Vital signs of the children were stable during operation. The incidence of postop-erative sore throat was 15% within 24h. As to the heart rate,the vital signs of baseline T0 were significant-ly different from other time points(T1,T2,T3,T4). After the anesthesia,there were no significant differ-ences in heart rate among different time points(T1,T2,T3,T4). Compare with T2 and T3,the values of partial end expiratory pressure of CO2 at T0,T1,and T4 were significantly different. Compare with T0,the values of mean arterial pressure at T1,T2 and T3 were significantly different,but there was a significant difference in mean arterial pressure between T1 and T4. As to the pulse oxygen saturation,all the values were above 95% . Conclusion Laryngeal mask airway is a supraglottic airway management method. The advantages of fewer haemodynamic changes and postoperative complication are confirmed. It is feasible and safe for securing the airway in surgical correction of lingual frenum.

Objective To prepare the recombination protein and polyclonal antibodies against human apolipoprotein A5(ApoA5)and detect the expression of ApoA5 in human tissues with the antibody,then further study the fuction and serum level of ApoA5.Methods With PCR and gene recombinated techniques,the prokaryotic ApoA5 expression vector was constructed.The His-ApoA5 fusion protein was expressed in E.ColiM15,and the fusion protein was injected into New Zealand rabbits to prepare polyclonal antibody.The antibody was tested for their specificity with ELISA and Western-blot,then it was used to detect the tissue distribution of ApoA5.Results It was found that there was a specific brand at 40 ku of the recombination ApoA5(rApoA5);the polyclonal antibody had high immunoreactivity and specificity.ApoA5 was expressed in human sera and hepatic tissue,not in other tissues(heart,vessel,spleen,intestine and lung),regardless of the lipid level.Conclusion The pQE30-ApoA5 is constructed successfully,the rApoA5 can be expressed in E.Coli M15;ApoA5 antibody has highly specifity.It can be used in clinical test.There is ApoA5 in human serum,and ApoA5 is expressed in liver which may be significant in lipid metabolism.