Objective To compare the effects of dexmedetomidine on the respiration and circulation with midazolam in mechanically ventilated patients.Methods A total of 62 patients supported with mechanical ventilation in medical intensive care unit were randomly (random number) divided into two groups:midazolam group ( group A,n =38 ) and dexmedetomidine group ( B group,n =24).The patients in group A were intravenously administered with midazolam in bolus dose of 0.05 mg/kg given over 30 - 60 s,and then maintained with 0.05 -0.15 mg/(kg ·h) by venous pump.The patients in group B were intravenously administered dexmedetomidine in bolus dose of 1.0 μg/kg given in more than 10 min,and then maintained with 0.2 - 0.7 μg/( kg · h) by venous pump.When the patients' sedation degree were required to reach Ⅲ - Ⅳ Ramsay Grade,the heart rate,mean arterial pressure,respiratory rate and SpO2 before sedation were compared with those 10 min,30 min and 2 hours after sedation between two groups.Results Respiratory rate or heart rate after sedation significantly decreased compared with those of presedation ( P ＜ 0.05 ).Blood pressure after sedation did not decrease significantly compared with that of presedation in Dexmedetomidine group.In midazolam group,blood pressure was (83.11 ± 12.95 ) mm Hg before sedation,and there was a significant decrease to (74.13 + 12.50) mm Hg in 10 min after sedation (P ＜ 0.05 ),while there were no significant difference between ( 80.53 + 12.93 ) mm Hg 30 min after sedaton and (82.47 ± 12. 15 ) mm Hg 2 hours after sedation.Conclusions There is no difference in effects on respiration of mechanically ventilated patients between dexmedetomidine and midazolam,and the effect of dexmedetomidine on circulation was less than that of midazolam.

Objective To investigate the effects of ulinastatin on serum concentrations of advanced oxidation protein products and C-reactive protein in patients with multiple organ dysfunction syndrome(MODS).Methods Seventy-two patients with MODS were randomly divided into ulinastatin group(n=36) and control group(n=36).The serum concentrations of advanced oxidation protein products and C-reactive protein in two groups were determined before therapy and after 3d,5d and 7d of therapy.Acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ)for patients were recorded before therapy and after 3d,5d,7d of therapy.Mortality within 28d was also compared between the two groups.The serum concentrations of advanced oxidation protein products and C-reactive protein in 36 healthy volunteers were detected as normal control.Results The concentrations of AOPP and CRP in patients with MODS before therapy were significantly higher than those obtained from healthy volunteers(P<0.05), whereas no obvions difference was found between the two groups.However,the levels of AOPP and CRP in patients with MODS were significantly decreased after 3d,5d,7d of therapy.Compared with control group,AOPP concentrations and CRP levels were markedly attenuated and APACHE Ⅲ scores decreased significantly in ulinastatin group(P<0.05).The mortality in ulinastatin group was also improved more significantly than that in control group(P<0.05).Conclusion Ulinastatin can decrease the concentrations of serum AOPP and CRP in patients with MODS,so as to alleviate the damage resulting from oxidative stress and inflammation,contributing to improve the outcome in patients with MODS.

[Objectives]To investigate the protective effects of recombinant Trichinella spiralis excretory-secretory 53ku pro-tein(rTsP53)on acute lung injuries in mice.[Methods]Thirty Balb/c mice were randomly divided into normal group. ALI group and rTsP53 group(n=10,respectively). Macrophages were harvested by bronchoalveolar lavage. Mortality in 72 hours was counted and compared. Pathological damage of lung tissues was observed by HE staining and graded by Smith score. Wet/dry ratio was measured. The bronchoalveolar lavage fluid concertration of IL-6 and IL-4 was measured by ELISA. The mRNA expression of TNF-α,iNOS, IL-10 and Arg-1 in alveolar lavage macrophages was detected by RT-PCR.[Results]72 h mortality of ALI mice was 70%,which was reduced to 30% in mice received rTsP53 treatment. Compared with ALI mice,the pathological damage of in rTsP53 treated-mice was improved and Smith score was declined ,combined with descending W/D ratio. IL-6 level of alveolar lavage fluid was elevated in ALI mice compared with normal group. And alveolar lavage macrophage was polarized to M2 sub-type,appeared as higher mRNA expression of TNF-α and iNOS and lower level of IL-10 and Arg-1. Bronchoalveolar lavage fluid concentration of IL-6 was declined and IL-4 was elevated in rTsP53-treated mice compared with ALI group. The macrophages of alveolar wash had higher mRNA expression of IL-10 and Arg-1,while lower level of TNF-α and iNOS,manifesting M2 polarization characteristics.[Conclusion]Recombinant T.spiralis P53 protein could protect mice from acute lung injuries induced by LPS via modulating M2 macrophage polarization,which play a role in depression of inflammatory reaction and tissue repairment.