Objective To investigate the effect of continuous blood purification(CBP) in the patients with severe acute pancreatitis(SAP). Methods Twenty-six patients with severe acute pancreatitis were divided into the control group and the observation group randomly. Fourteen cases in the control group were given conventional treatment only, 12 cases in CBP group were given continuous blood purification as well as the conventional treatment. The APACHE Ⅱ score and CRP of pre- and intra-treatment at the 2nd and 5th day were observed in the two groups. The duration of mechanical ventilation, the duration of ICU stay, the mortality of hospital were observed as well. Results The APACHE Ⅱ score and CRP of the second day and the fifth day of intra-treatment in the control group were 1.61±3.00,10.76±4.30, (149.71±60.06) mg/L and (101.21±33.98) mg/L, respectively, which were significantly different to those of (8.20±1.87) mg/L, (6.19±1.49) mg/L, (109.17±23.91) mg/L,(70.83±25.45)mg/L in the CBP group(P＜0.05). The duration of mechanical ventilation,the duration of ICU stay and the mortality of hospital were (13.29 ± 6.23) d, (16.00 ± 6.86) d, 21.43% in the control group, which were significantly lower than those of (8.00 ±5.27)d,(10.33 ±4.81)d,8.33% in the other group (P ＜0.05).Conclusions CBP is an effective method for the patients with severe acute pancreatitis to shorten the duration of mechanical ventilation and the ICU stay,and decrease the mortality of hospital.

ObjectiveTo evaluate the effect of early fluid resuscitation in treatment of septic shock.Methods56 patients with septic shock in ICU were divided into two groups by the method of the treatment. Early goal-directed therapy were given in the early fluid resuscitation group except anti-infective treatment, and the traditional therapy were given in the traditional group. The CVP,MAP,ScvO2 ,SaO2 of 6h and 12h of intra-treatment were observed in the two groups, and the incidence of MODS and the mortality rate were observed also. ResultsThe CVP,MAP, ScvO2, SaO2 of the early fluid resuscitation group were improved better than that in the traditional group. The incidence of MODS and the mortality rate in the early fluid resuscitation group were lower than that in the traditional group. ConclusionThe prognosis of septic shock was better for the early fluid resuscitation, and it could lower the incidence of MODS and the mortality rate.

Objective To compare the clinical efficacy and safety of pegylated interferon α-2a (Peg IFN α-2a) or adefovir dipivoxil(ADV) monotherapy and their combination therapy in HBeAg positive chronic hepatitis B (CHB) patients. Methods An open randomized controlled multicenter clinical trial was performed. One hundred and twenty cases with CHB were divided into 3 groups: Peg IFN α-2a monotherapy (group A), ADV monotherapy (group B) and Peg IFN α-2a plus ADV combination therapy (group C). The virological response (VR), serological response (HBeAg, HBsAg clearance and seroconversion), biochemical response (BR) and sustained response (SR) were tested at week 24 and 48 of therapy and week 48 of follow-up after end of treatment (EOT) for'evaluation of therapeutic effects, safety and drug resistance. The efficacy was compared using X2 test. Results At week 48 of treatment, the VR (HBV DNA ≤500 copy/mL) rates were 36. 8%(14/38), 37. 5%(15/40) and 62. 9% (22/35), respectively in groups A, B and C; that in group C was higher than those in groups A and B (X2 = 4. 933, 4. 801, respectively; both P < 0. 05); HBeAg seroconversion rates in three groups were 44. 7% (17/38), 17. 5% (7/40) and 51. 4% (18/35), respectively. At week 48 of follow-up,SR rates in three groups were 34. 2%(13/38), 15. 0%(6/40) and 48. 6% (17/35), respectively; those in groups C and A were higher than that in group B (X2 = 9. 894,P<0. 01;X2 =3. 903, P<0. 05, respectively). Conclusions VRs at week 24 and 48 of Peg IFN α-2a plus ADV combination therapy are better than Peg IFN α-2a or ADV monotherapy. SRs at week 48 of follow-up after Peg IFN α-2a monotherapy and combination therapy are both better than ADV monotherapy.