Acute Disease ; Female ; Humans ; Hypertension ; chemically induced ; Middle Aged ; Organophosphate Poisoning ; Pesticides ; poisoning ; Skin Absorption

Animals ; Endotoxemia ; metabolism ; pathology ; Female ; Liver ; metabolism ; pathology ; Male ; Mitochondria, Liver ; metabolism ; Rats ; Reactive Oxygen Species ; metabolism

The disease incidence of aortic dissecting aneurysm showed an increasing tendency.Recently,the clinical application of endovascular stent-graft implantation received good results in treating aortic dissecting aneurysm,which is characterized by minimally invasive,safe,with high success rates.However,the chosen of anesthesia is still in dispute.Local anesthesia,intraspinal anesthesia and general anesthesia can be used in this operation.The investigation demonstrated that intubation general anesthesia is more security in this operation with less complication,which is conductive to controlling blood pressure and braking conditions.

bjective To clarify the heart rate variability (HRV) changes in patients subjected to deliberate hypotension with alprostadil.Methods Eighty-six elderly patients scheduled for nasal endoscopic surgery in general anesthesia were divided into alprostadil group (group A) and nitroglycerin group (group N) with 43 cases each by random digits table.Hypotension was induced with alprostadil and nitroglycerin through continuous infusion respectively,and the mean arterial pressure (MAP) was reduced to about 25％-30％ of baseline MAP.The MAP,heart rate (HR),total power ( TP ),low frequency (LF),high frequency (HF),and LF/HF were continuously monitored and blood was taken for analysis of lactate (LAC) before deliberate hypotension (T0),at the time of dropping to target blood pressure (T1),at 5 and 30 min after deliberate hypotension (T2 and T3),stopping deliberate hypotersion (T4) and 30 min after recovery from hypotension (T5).Results HR at T1-T4 was faster than that at T0in group N(P ＜ 0.05),and faster than that in group A( P ＜ 0.05 ),HR at T5 was faster than that at T0 in group N( P ＜ 0.05 ),but HR was stable at T1-T5 in group A (P ＞ 0.05 ).There was no significant difference in LAC of group A and group N whether in interior group or between two groups (P＞ 0.05).TP,LF and HF at T1-T4 were lower than those at T0 in two groups ( P ＜ 0.05 ),HF at T1-T4 was higher in group A than that in group N(P ＜ 0.05 ) ; LF/HF was no change at T1-T4 compared with that at T0 in group A (P ＞ 0.05),but increased in group N (P ＜ 0.05 ) which was higher than that in group A at the same time ( P ＜ 0.05 ) ;TP,LF and HF was recovered at Ts in two groups,and HF at T5 in group A was higher than that in group N( P ＜ 0.05 ) ; LF/HF at T5 in group A maintained the level at T0,but decreased in group N and lower than that at T5 in group N(P ＜ 0.05).Conclusion Alprostadil for deliberate hypotension is more likely to maintain cardiac autonomic nerve balance that is helpful for perioperative security of elderly patients.

OBJECTIVETo isolate antifungal compound from Paeonia suffruticosa, and to find the antifungal mechanisms by observing the ultrastructural modifications of yeasts in growth phase produced by 1,2,3,4,6-penta-O-galloyl-beta-D-glucose (PGG).

METHODSPeony (Paeonia suffruticosa) root bark (PRB) was separated by solvent extraction and purified by high performance liquid chromatography (HPLC) method using analytical and preparative reversed phase C18 column on the basis of bio-assay method. In order to investigate the antifungal mechanism of PGG, Yeasts were submitted to different concentrations [3 × minimum inhibition concentration (MIC), 0.3 × MIC] for 1 h under constant stirring at 30 °C, and transmission electron microscopy was performed.

RESULTSBased on the antifungal activity of PRB on Candida glabrata CBS138, the antifungal compound were isolated in ethyl acetate layer of PRB and identified as PGG by mass spectrometry, 1H nuclear magnetic resonance (NMR) analyses, with molecular weight of 940 and molecular formular as C41H32O26. Transmission electron microscopy showed that PGG degraded the cell wall envelope.

CONCLUSIONThe results suggest that PGG may be responsible for the antifungal activity of PRB by disrupting the structure of cell wall directly.

Antifungal Agents ; chemistry ; isolation & purification ; pharmacology ; Candida ; drug effects ; ultrastructure ; Chromatography, High Pressure Liquid ; Hydrolyzable Tannins ; chemistry ; isolation & purification ; pharmacology ; Mass Spectrometry ; Microbial Sensitivity Tests ; Paeonia ; chemistry ; Plant Bark ; chemistry ; Plant Extracts ; isolation & purification ; pharmacology ; Plant Roots ; chemistry ; Proton Magnetic Resonance Spectroscopy

OBJECTIVETo evaluate the effect of integrative Chinese and western medicine (ICWM) in treating severe a cute respiratory syndrome (SARS).

METHODSSixty SARS patients were diagnosed and observed according to the universal standard, and divided into the ICWM group (n = 31, treated with ICWM) and the control group (n = 29, treated by conventional western medicine alone).

RESULTSICWM showed better effect than that of western medicine alone in improving clinical symptoms, promoting the absorption of inflammation in lung, increased oxygen saturation (P < 0.01) and decreased the dosage of corticoid used (P < 0.05).

CONCLUSIONThe effect of ICWM is better than that of simple western medicine in treating SARS.

Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Methylprednisolone ; therapeutic use ; Middle Aged ; Phytotherapy ; Ribavirin ; therapeutic use ; Severe Acute Respiratory Syndrome ; drug therapy ; immunology ; Single-Blind Method

Antimicrobial peptides, a cluster of small peptides secreted by the majority of creatures, have been demonstrated with activity against a wide range of microorganisms including bacteria, protozoa, yeast, fungi, viruses and even tumor cells. These peptides have some features such as broad spectrum , high effi-cacy and stability, little drug resistance. A lack of new antibiotics combined with emerging multi-drug resis-tance issues demands that new antimicrobial strategies be explored for treating these infections. It has been proposed that the antimicrobial peptides might form the foundation for a new class of clinically useful an-timicrobials. We review the advantages of these molecules in construction features and bioactivity, with the focus on the mechanism and clinical applications.

OBJECTIVETo develop a scoring system to measure the severity of the multiple organ dysfunction syndrome (MODS).

METHODSThe clinical data of patients with MODS were collected and analyzed prospectively. Seven indicators were screened out to assess the functions of seven organs. Each indicator was scored from 0 to 4 points, with the 0 point representing the normal organ function, and 1 point to 4 points representing the dysfuntion to failure of the organ. Acording to the index and points a severity scoring system were developed.

RESULTSSeven indicators including the systolic pressure, oxygenation index, conscious state, peripheral blood platelet count, blood total bilirubin, and serum creatinine were used to represent the functions of seven organs. The seven organs included cardiovascular system, lung, brain, coagulative system, liver, kidney, and gastrointestinal tract. The severity scoring system were composed of seven indicators and their points. The total score was 24 points. The mortality increased along with the increase of the points (P<0.001).

CONCLUSIONThis scoring system can be used to assess the severity of the MODS.

Humans ; Multiple Organ Failure ; diagnosis ; mortality ; physiopathology ; Severity of Illness Index

OBJECTIVETo develop diagnostic criteria of multiple organ dysfunction syndrome (MODS) by a prospective and multi-center clinical investigation.

METHODSThe data of 1087 MODS cases obtained from ICU of 37 hospitals from March 2002 to January 2005 in 11 provinces in China were analyzed in order to derive the diagnostic criteria of MODS.

RESULTSThis MODS diagnostic criteria involved 7 organs. To diagnose MODS, the original cause of MODS should be identified, then there should be two or more organs showing signs of dysfunction. The criteria for organ dysfunction were as follows. (1) Cardiovascular system: SBP < 90 mm Hg (1 mm Hg = 0.133 kPa), MAP < 70 mm Hg, signs of shock, ventricular tachycardia, ventricular fibrillation, or myocardial infarction; (2) Respiratory system: oxygenation index < 300 mm Hg; (3) Nervous system: indifference, restlessness, lethargy, light coma, or deep coma, Glasgow score < or = 14; (4) Blood system: PLT < 100 x 10(9)/L; CT, APTT, and PT prolonged or shortened; positive plasma protamine paracoagulation; (5) Liver: TBIL > 20. 5 micromol/L, ALB < 28 g/L; (6) Kidney: Cr > 123.8 micromol/L, urinary volume < 500 ml/24 h; (7) Gastro-intestine: bowel sounds decreased or disappeared; retention in the stomach, or positive occult blood feces with dark stools or haematemesis; intraabdominal pressure (intravesical pressure) > or = 11 cm H2O (1 cm H2O = 0.098 kPa). Any organ function met with one of the above conditions was considered to have dysfunction.

CONCLUSIONSThis diagnostic criterion of multiple organ dysfunction syndrome has been developed by this research, but it needs to accumulate experience by clinical practice and to revise the diagnosis criteria.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; diagnosis ; Prospective Studies ; Young Adult

BACKGROUNDThe infection rate of methicillin-resistant Staphylococcus aureus (MRSA) is increasing yearly due to the overprescription of antibiotics. Traditional Chinese compound medicines are less inclined to induce bacterial resistance in the clinical setting because of their multi-acting mechanisms. However, most current research is limited to bacteriostasis in vitro using single extracts or formulations. Plasma pharmacology is an in vitro method, using what is called "medicine serum". The aim of this study was to investigate whether the medicine serum of compound Qingre granules (QRKL) alone or in combination with antibiotics may treat MRSA infection in the clinic.

METHODSAn animal model of MRSA resistance was created by injecting rabbits with the standard strain of MRSA ATCC43300. Infected rabbits were treated with QRKL by intragastric administration. Sixty minutes after the last intragastric administration, serum was obtained from the rabbits by heart puncture to obtain what is termed "medicine serum". The minimum inhibitory concentration (MIC) of QRKL, medicine serum alone, or serum combined with antibiotics was assessed by agar dilution.

RESULTSwere compared with the growth of sixteen isolates of MRSA.

RESULTSThe MIC of QRKL to the standard strain ATCC43300 was 10.00 mg/ml. The MIC(90) of vancomycin was 1.00 microg/ml, which, when combined with QRKL, dropped to 0.50 microg/ml. The MIC(90) of cefuroxime alone was 512.00 microg/ml. This level also decreased to 256.00 microg/ml when combined with QRKL. The addition of QRKL thus significantly reduced the MIC of both cefuroxime and vancomycin compared with antibiotics alone (P < 0.01). The MIC(90) of vancomycin with medicine serum decreased to 0.50 microg/ml, and the MIC of vancomycin with medicine serum also descended compared with using vancomycin alone (P < 0.01).

CONCLUSIONSThe growth of MRSA can be inhibited by QRKL or medicine serum of QRKL in vitro. The addition of QRKL results in increased sensitivity of MRSA to vancomycin and this may provide a novel treatment for patients with MRSA infection.

Drugs, Chinese Herbal ; pharmacology ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; Microbial Sensitivity Tests ; Vancomycin ; pharmacology