Objective To investigate the effect of different PEEP levels on stroke volume variation (SVV) in patients with acute respiratory distress syndrome (ARDS) treated with mechanical ventilation for predicting cardiac pre-load and the changes of hemodynamics.Methods Thirty critical patients with ARDS met the new criteria in 2012 set at European Berlin were enrolled in this study with measured values (MV) in EICU from September 2012 to October 2013.The changes in SVV and cardiac output (CO) monitored with Vigileo system were determined at different selected PEEE levels of 5,7,9,11,13,15 mmHg.At the same time,MAP and CVP were measured.Results Variation of PEEP levels led to a significant changes in SVV,CO (P ＜ 0.01).However,there were no significant differences in MAP (P =0.933).Changes of SVV induced by high PEEP showed a S shape rise,but there were no differences between groups PEEP 5 and PEEP 7,and as well as between groups PEEP 13 and PEEP 15 (P ＜0.05).The changes of CO showed a downtrend decline with the increase in PEEP levels.When PEEP was set at 13 mmHg and higher,the value of SVV denoted pre-load insufficiency.When PEEP was set at 11 mmHg or higher,cardiac output decreased.CVP could not predict the changes of pre-load.Conclusion Increase in PEEP levels can significantly reduce the cardiac pre-load.SVV can be a useful indicator of the changes in cardiac pre-load induced by high PEEP,suggesting fluid replacement necessary in time.

Objective To compare the efficacy of patient-controlled epidural analgesia(PCEA) and routine analgesia on treatment of bleeding in patients prostate pit after prostatectomy.Methods 82 patients underwent prostatectomy were randomly divided into two groups:patient-controlled epidual analgesia(n=40) and routine postoperative analgesia (n=42).Results As compared with control group,the rate and duration of bladder spasm were reduced significantly in PCEA group(P

To investigate the role of Fas/FasL system in pathogenesis of hemodialysis(HD) and its correlation with clinical status, plasma levels of sFas/sFasL and the expression of Fas antigen on peripheral blood lymphocytes(PBL) membrane were assayed by ELISA and flow cytometry respectively. The CD3 + Fas + of PBL cells was singnificantly higher( P

The aim of this study was to explore the myocardial ultrastructure of experimental uremic rats and the effect of myocardiocyte succinate dehydrogenase(SDH) and free cytosolic calcium changes on membrane channel. By making a uremia model in rats, changes of SDH activation was observed by quantitative enzyme cytochemistry methods and membrane calcium channel was checked by laser scanning confocal microscopy. The results showed that with the uremia becoming heavier, myocardiocyte membrane was rolled and broken, myofibrils were swollen and broken. The quantity of mitochondria with SDH products significantly decreased, while activation of cell membrane calcium channel markedly increased and cytosolic calcium piled up. It is suggested that impaired myocardial membrane, decreased contents of mitochondrial function enzyme and cytosolic calcium overload are the pathophisiological basis leading to cardiac dysfunction in uremia.

To examine the effect of benapril on atherogenesis, circulating endothelial cells (CEC), and factor vWF. Twenty four healthy male New Zealand white rabbits were randomly divided into 3 groups. In group C (control group) the rabbits were fed normal rabbit diet for ten weeks, in group AS 1% cholesterol diet was fed, and in group B both 1% cholesterol diet and benapril 5mg/day were fed. Fasting blood samples were collected for the determination of serum total cholesterol (TC), high density lipoprotein cholesterol (HDL c), low density lipoprotein cholesterol (LDL c), and triglyceride (TG) on day 0, 5 and 10 weeks after feeding. The levels of plasma CEC were measured by morphometrical count and the levels of plasma vWF were determined by ELISA. After the animals were sacrificed, aortas were obtained, and they were stained with oil red O. The tissue was sectioned for histological examination. Planimetry was performed with a computer system. Endothelial cells were identified by the presence of factor VIII related antigen, which was the specific marker for endothelial cells. The results showed that the levels of serum Tc, TG, and LDL c were increased progressively in group B and group AS, but the levels of vWF in group AS were significantly higher than that in group B at the 5 th and 10 th weeks respectively ( P

ObjectiveTo explore the effect of peridural injection on acute herniation of intervertebral disc.Methods60 cases of acute herniation of intervertebral disc were divided into two groups,including 30 cases of the peridural injection treatment group and 30 cases of the traditional treatment group. The clinical symptoms and signs were assessed before and after treatment.ResultsThe peridural injection restrained pain rapidly and shorten the period of treatment. The eminent rate was 83.4%. The index and rate in improvement and efficiency of peridural injection group were higher than that of traditional group. The course of treatment in hospital in peridural injection group was shorter than that in traditional group.ConclusionsThe peridural injection has preferable clinical curative effect in herniation of intervertebral disc.

Objective: To examine the effect of Benapril on atherogenesis and the plaque rupture in rabbits.Methods: Thirty four healthy male New Zealand white rabbits were randomly divided into 4 groups.Group C (control group) was fed normal diet for 10 weeks,group HL fed 1% cholesterol diet,group B fed 1% cholesterol diet and Benapril 5 mg/d.Ten rabbits of plaque rupture group were fed 1% cholesterol diet for 10 weeks with atherosclerosis induced by left carotid iliac damage.Ten weeks after the initiation of the diet,an angioplasty was performed.After angioplasty,the surviving rabbits( n =10) were randomized to receive benapril(5 mg/d,each) supplementation in drinking(B group, n =4) or no treatment(untreated group, n =4). The levels of CEC were measured by morphometrical counts at different periods(the 5th week,the 10th week).Before and 5,10 weeks after experiment,fasting blood samples were collected for serum total cholesterol(TC),high density lipoprotein cholesterol(HDL C),low density lipoprotein cholesterol(LDL C),and triglyceride(TG) assay.The levels of plasma circulating endothelial cells(CEC) were measured by morphometrical counts and the levels of plasma von Willebrand factor(vWF) were determined by ELISA.After sacrificing the separated, entire aortas were stained with oil red O and then processed for histological examination;planimetry was done with a computer system.Endothelial cells were confined by the presence of Factor Ⅷ related antigen as the specific cell marker.Results: The serum TC,TG,LDL C increased progressively in group B and group HL,but the levels of vWF in group HL were significantly higher than that in group B on the 5th and 10th respetively( P

Objective To study the predictive value of heart-type fatty acid-binding protein (H-FABP) in the improvement of survival rate in patients with severe sepsis.Methods There was a prospective case-control study in 50 patients with severe sepsis from October 2014 to October 2015.According to the international guidelines for severe sepsis and septic shock set in 2012,all patients were divided into sepsis group (n =16),severe sepsis group (n =14) and septic shock group (n =20),and these patients were further divided into to survival group (n =22) and non-survival group (n =28) as per patients surviving within 28 days.Gender,age,ethnic,and Acute Physiology and Chronic Health Evaluation score (APACHE Ⅱ) were recorded.H-FABP,B-type natriuretic peptide (BNP),creatine kinase (CK),creatine kinase isoenzyme (CK-MB),and troponin-T (cTn-T) were determined within 6 hours after admission.The statistical software SPSS21.0 was used to do t test,test,and the receiver operating characteristic curve for comparison between groups.Results H-FABP in septic shock group was higher than severe sepsis group and sepsis group (P ＜ 0.01).The 28-day mortality of septic group (80％) and severe sepsis group (71.4％) were higher than sepsis group (12.5％) (P ＜ 0.01).Non-survival' s H-FABP,BNP,cTn-T,CK,CKMB was higher than survivals (P ＜ 0.05).Through the ROC of H-FABP (AUC=0.748,P=0.003,95％ C I:0.605-0.890) and BNP (AUC =0.714,P=0.010,95％ CI:0.573-0.856),it shows that H-FABP is better than BNP.when H-FABP take 9.902 ng/mL,the sensitivity of 82.1％,specificity of 63.6％.H-FABP,BNP has a certain value in 28-day mortality prediction.Conclusions Sepsis shock has significantly higher 28-day mortality than sepsis and severe sepsis.Compared with BNP,H-FABP has greater predictive value in sepsis patients,it will increase along with the aggravation of the disease;it can also predict 28-day mortality.

Objective To investigate the effects and underlying mechanism of the scavenger receptor CD36 in high glucose-induced rat glomerular mesangial cells apoptosis.Methods The mesangial cells of rats were divided into 4 groups:control group (5.6 mmol/L glucose),mannitol group (24.2 mmol/L mannitol+5.6 mmo]/L glucose),high glucose group (30 mmol/L glucose),CD36 monoantibody group (30 mmol/L glucose+CD36 mono-antibody).The intracellular ROS level was detected by confocal microscopy with fluorescent probe CM-H2DCFDA.MDA,GSH-PX,8-OHDGA in cell supernatant were detected.Apoptosis was determined by flow cytometry followed by Annexin V-FITC/PI double stains.The expression of CD36,Bax and Bcl-2 were detected by RT-PCR and Western blotting.Results The expression of CD36 was detected in glomerular mesangial cells.The highest level was found in high glucose group in 24 hours.There was no significant difference found between control group and mannitol group with respect to intracellular ROS generation,MDA,8-OHDG,GSH-PX level,apoptosis rate,expression of CD36,Bax and Bcl-2 (all P ＞ 0.05).There was no significant difference in the expression of CD36 between CD36 mono-antibody group and high glucose group (P ＞ 0.05).Compared to control group,the intracellular ROS generation,MDA and 8-OHDG levels,apoptosis rate,the expression of CD36 and Bax were significantly increased,the GSH-PX level and the expression of Bcl-2 were significantly lower in high glucose group (all P ＜ 0.05).Compared to the high glucose group,the intracellular ROS generation,MDA and 8-OHDG levels,apoptosis rate,the expression of Bax were suppressed but the GSH-PX level and the expression of Bcl-2 increased in CD36 mono-antibody group (all P ＜ 0.05).The intracellular ROS level was positively correlated with apoptosis rate,protein expression of CD36 and Bax gene,was negatively correlated with Bcl-2 protein expression.Conclusions CD36 was involved in the high glucose induced apoptosis of mesangial cells which was potentially mediated by an increased level of oxidative stress.

Objective To explore preliminary clinical results of a new anatomical shape allogeneic bone posterior lumbar fusion cage. Methods Follow-up patients used the allogeneic bone posterior lumbar fusion cage and use imaging methods and clinical score (VAS, ODI) to evaluate the patients′ clinical efficacy. Results 14 patients were followed up for 6 months or more , with an average follow-up time of 9.7 months , mean preoperative VAS 6.8 ± 1.1, ODI 32.7 ± 4.5. The mean preoperative disc height was (9.7 ± 2.0) mm and the average intervertebral height of 3 days post operation was (13.2 ± 1.7) mm. All patients got bony fusion in 6 months post operation, pain and function scores improved significantly compared with the pre-operation: VAS 2.4 ± 0.8 (P =0.000), ODI 9.8 ± 2.5 (P = 0.000), the average intervertebral height was (13.1 ± 1.7) mm (P = 0.000). The average was VAS 2.1 ± 0.1 (P = 0.000), average ODI was 8.9 ± 0.9 (P = 0.000) at last follow up. Average of intervertebral height was (13.0 ± 1.8) mm, no significant difference compared to three days after surgery (P=0.831). No serious complications and deep surgical site infection was observed. All implants were found no fragmentation, shift, cutting boards, and obviously sinking. Conclusion The anatomical shape allogeneic bone posterior lumbar fusion device is suitable for posterior lumbar interbody fusion , advantages of high fusion rate , satisfactory clinical results in the initial clinical trials , but its long-term efficacy requires further observation.