Objective To investigate the effects of small volume resuscitation on hemodynamics and visceral perfusion in dog model of hemorrhagic shock. Methods Twenty-four dogs were hemorrhaged to hold mean arterial blood pressure at 45-55 nun Hg for 45 minutes, and then eight dogs were resuscitated with 6 ml/kg of hypertonic saline (HS group) solution and the other eight resuscitated with 6 ml/kg of hypertonic saline-hydroxyethyl starch (HSS group) solution. The rest eight dogs were set as control and resuscitated with normal saline (NS). Hemodynamics and gastrointestinal intramucosal pH (pHi) were detected after fluid resuscitation. Results (1) All three kinds of solutions could improve early hemodynamics and visceral perfusion. But 30 minutes after fluid resuscitation, the hemodynamics of dogs in HS group, HSS group and NS group began to decrease, with more obvious decrease HS group and NS group compared with HSS group. (2) pHi of three groups began to decrease 120 minutes after fluid resuscitation, but the level of arterial lactate remained unchanged. Conclusions (1) HS has the similar effect as NS in aspect of resuscitation, and HSS is better than HS and NS.(2) pHi is an ideal marker in monitoring the visceral perfusion and has higher sensitivity than arterial lactate.

Objective To study the clinical significance of the change of plasma BNP levels in patients with grades sepsis and its correlation with the left ventricular ejection fraction.Methods One hundred patients of sepsis who were admitted in intensive care unit of Taizhou hospital were selected.It was divided into four groups:30 patients with septic shock,40 patients with severe sepsis,30 patients with sepsis and 20 persons without disease as control group.The concentration of plasma BNP was determined using sandwich immunoflurescence,and ultrasonic cardiogram was used to evaluate heart function and clinical features in all groups.To compare with the differences of the concentration of plasma BNP and the correlation between the concentration of Plasma BNP and LVEF in all groups,the data of clinical features,28-day mortality,prognostic values of BNP and the length of stay (ROG) in ICU were collected and compared.Result Plasma BNP levels in patients with septic shock[ (976.3 ± 160.7) pg/ml] were obvious higher than severe sepsis[ (648.4 ± 267.3) pg/ml ],sepsis [ (217.2 ± 89.7) pg/ml ] and control group [ (50.3 ± 25.4)pg/ml] (P ＜0.01).LVEF in patients with septic shock [ (48.2 ±9.6)% ] was obvious lower than severe sepsis[ (52.8 ±9.4)% ],sepsis[ (61.3 ± 8.9)% ] and control group[ (66.4 ±9.3)% ] (P ＜0.05 or P ＜0.01).It appeared to be inverse relationship between LVEF and the plasma BNP levels (r =-0.876,-0.724,P ＜0.01).BNP levels were significantly higher in non-survivors compared with survivors[ (1367.6±506.4)pg/ml vs (420.3 ±82.6)pg/ml,P ＜0.01 ].The receiver operating characteristic (ROG) curves indicated that values of areas under the curve of plasma BNP levels for 28-days mortality were 0.918(P ＜0.01).Conclusion The concentration of plasma BNP in patients was different in different grades of sepsis.It appeared to be negative correlation between the concentration of plasma BNP and LVEF.Plasma BNP levels had predictive value to the patients with sepsis.

OBJECTIVETo investigate the effect of general glycosides from Cynanchun auriculatum of Jiangsu on liver fibrosis of rats.

METHODSeventy-two Wistar rats were randomly divided into normal group, model group, BSW three doses treated group and hydrocortisone treated group. CCl4 (50%, 2 mL x kg(-1)) was orally administraeated twice a week for 8 weeks. The liver and spleen indices were observed. The level of serum GPT, GOT, and HA, PCIII and the level of SOD, HyP, MDA in liver homogenates was also measured. The histopathologic change in hepatic of rats was examined.

RESULTThe elevation of serum GPT, GOT, HA, PCIll, MDA and HyP and the content of liver homogenates were attanuated remarkably by BSW treatment. BSW groups also increased the level of SOD of liver homogenates, and make the fibrotic liver better.

CONCLUSIONThe general glycosides in C. auriculatum of jiangsu province have an anti-hepatic fibrosis ettect on CCl4-induced fibrosis rats, the mechanisms might be associated with its anti-oxidative action.

Animals ; China ; Cynanchum ; chemistry ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; administration & dosage ; Glycosides ; administration & dosage ; Liver ; drug effects ; pathology ; Liver Cirrhosis ; drug therapy ; pathology ; Male ; Random Allocation ; Rats ; Rats, Wistar

Objective:To explore the effects of micro-classroom on pulmonary function, compliance with inhaled glucocorticoids, self-management ability and quality of life in children with bronchial asthma at school age.Methods:A total of 116 children with school-age bronchial asthma who were treated in our hospital from January 2018 to January 2019 were selected. Children were divided into control group ( n = 58) and observation group ( n = 58) according to the method of random numbers. The children in the control group were given routine health education, and the children in the observation group used micro-class health education strategies based on the control group. Intervention time was 3 months. The lung function indexes, inhaled glucocorticoid compliance, self-management ability, and quality of life were compared between the two groups before and after the intervention. Results:After the intervention, the forced vital capacity (FVC), forced expiratory volume percentage (FEV1%), peak expiratory flow rate (PEF), and forced expiratory 25% vital capacity instantaneous flow rate (FEF25%) were increased in both groups. The observation group was (6.29 ± 0.75) L, (75.61 ± 10.59)%, (91.55 ± 12.82) L / s, and (83.45 ± 10.85) L / s. All were higher than (5.98 ± 0.66) L, (71.25 ± 7.84)%, (78.92 ± 11.8) L / s, and (59.91 ± 8.39) L / s in the control group, and the differences were statistically significant ( t value was from -13.071 to -2.363, P <0.05 or 0.01). The Morisky-Green score of the control group decreased after the intervention ( t value was 7.937, P <0.05). The Morisky-Green score of the observation group showed no significant change compared with that before the intervention ( t value was 0.883, P> 0.05). The scores of self-care ability, nursing skills, sense of responsibility, self-concept, and health knowledge on the self-care ability scale of the observation group after the intervention were (21.05 ± 2.53), (17.53 ± 2.63), (17.65 ± 1.94), (27.35 ± 4.10), (27.36 ± 4.10) minutes. All were higher than the (15.68 ± 2.20), (13.58 ± 1.49), (14.56 ± 1.75), (20.45 ± 2.86), (22.35 ± 2.68) points of the control group, and the difference was statistically significant ( t value was from -12.198 to -7.790, P <0.01). In the observation group after intervention, the quality of life scale, asthma symptoms, mental state, response to stimulus, and health care scores were (75.68 ± 9.08), (58.91 ± 8.25), and (46.98 ± 7.05), (38.51 ± 5.39), (28.95 ± 4.05) minutes. All were higher than (68.35 ± 8.89), (51.23 ± 7.68), (41.05 ± 6.16), (31.58 ± 3.79), (22.36 ± 2.68) points in the control group, and the difference was statistically significant ( t value was from -10.334 to -4.393, P <0.01). Conclusion:The micro-classroom intervention mode for school-age children with bronchial asthma can effectively maintain treatment compliance, help improve children's lung function indicators, and improve children's self-management ability and quality of life.

β-Thalassemia is a single-gene disease caused by mutations in β-globin and has a distinct geographical characteristics. Current treatment for patients with moderate to severe thalassemia has mainly relied on long-term blood transfusion and/or hematopoietic stem cell transplantation. B cell lymphoma/leukemia 11A (BCL11A) as a transcriptional repressor plays a vital role in monitoring γ/β hemoglobin switching, maintaining the normal function of hematopoietic stem cells, and regulating erythrocyte differentiation and lymphocyte development. With the rapid progress in gene editing technology, the BCL11A as a therapeutic target for β-thalassemia has shown promising results. This article has systematically summarized the regulatory mechanism and therapeutic potential of the BCL11A, with an aim to provide new ideas for the treatment of β-thalassemia.

ObjectiveTo evaluate the dynamic disinfection effect of the upper-room 222 nm ultraviolet radiation on the air in different areas of the emergency department, and to provide references for a new solution of air disinfection that man-machine coexisted in the medical and healthcare institutions. MethodsThe upper-room 222 nm ultraviolet radiation air sterilizers were installed at a height of 2.3‒2.6 m from the ground in the observation room, computed tomography (CT) scanning room, rescue room and consulting room of the emergency department in Beijing Tiantan Hospital, Capital Medical University . The test area was divided into a 222 nm ultraviolet group and a control group according to whether the 222 nm ultraviolet germicidal air disinfection was conducted or not. The experimental group started air disinfection at8:00 a.m., and the air sampling was conducted from 9:00 a.m. to 16:00 p.m., with a 10 min sampling interval of every 1 hour. While the control group only collected air sample with the same air sampling method used in the experimental group, without air disinfection. The air microbial sampler with six-level sieve impingement was used for the air sampling, and the differences in the total number of airborne bacterial colonies were compared between the two groups. ResultsA total of 128 air samples were collected in the trial, of which 64 were from the experimental group and 64 from the control group. The total number of airborne bacterial colonies in the experimental group was lower than that in the control group (all P<0.001), and was maintained at a lower level throughout the entire period. The killing rate of 222 nm ultraviolet radiation to airborne microorganisms was approximately 55.76% to 76.33% in different sampling areas. The qualified rates of the total number of dynamic airborne bacterial colonies in the observation room, rescue room and consulting room were improved from 12.50%, 37.50% and 25.00% to 81.25%, 100.00% and 100.00%, respectively (all P<0.001). Over 62.50% of the time, the air quality in the consulting room and CT room in the 222 nm ultraviolet group met the environment standards for airborne bacterial colony criteria of class Ⅰ or class Ⅱ. ConclusionThe upper-room222 nm ultraviolet radiation germicidal disinfection can effectively reduce the total number of airborne bacterial colonies and improve the environment for emergency department, and the continuous using of it is helpful for keeping the air safe and clean.