Objective To explore the treatment of sepsis in patients with severe sepsis, the use of CBP (continuous blood purification) effect on lactic acid and hemodynamics in patients with blood.MethodsIn 40 cases of patients with severe sepsis treated by conventional methods, and classified as the control group, the other 40 patients using CBP (continuous blood purification treatment;blood lactic acid) after evaluation and hemodynamics of two groups of patients before and after treatment, and compared between groups, the patients were treated in our hospital from January 2015 to October 2016.ResultsThere was no significant difference in blood lactate level of the two groups of patients before treatment, after grouping After treatment, the patients in the observation group decreased more significantly, while the monitoring of patients in different time period, showed its obvious difference;hemodynamics of two groups were observed and compared, found before treatment all indexes had no significant difference after the treatment group were improved more obviously in patients in the observation group, group are P<0.05 shows obvious differences.ConclusionAnalysis of the influence of the dynamics of CBP in severe sepsis patients blood lactic acid and blood flow, which can significantly improve the patient's level of lactic acid, which decreased gradually, while helping the hemodynamic situation of the patient to recover, it is worthy of reference.

Objective To prepare dual-targeted microbubbles carrying both anti-CD34 monoclonal antibody and anti-ICAM-1 monoclonal antibody,to identify its basic characteristics,and to investigate its targeting performance in vitro.Methods ICAM-1-targeted microbubbles (MgIcAM-1),CD34-targeted microbubbles(MBcD34) and dual-targeted (with both monoclonal antibodies) microbubbles (MBD) were prepared by biotin-avidin bridging chemistry method.The targeted microbubbles were observed under light microscrope and characterized by a Mastersizer 3000,DFY software,laser confocal microscopy,and flow cytometry.The targeting specificity and attachment capability of dual-targeted microbubbles to endothelial progenitor cells (EPCs) and damaged human umbilical vein endothelial cells (HUVECs) were assessed in vitro.Results The morphous,diameter,surface potential,concentration,and the antibody-binding rates of microbubbles were not statistically significant in MBIcAM-1,MBCD34,and MBD (P ＞0.05).Echo intensity in MBD significantly increased compared with MBICAM1,MBCD34,and MBiotin (P ＜ 0.01).The targeting experiment in vitro showed that the attachment rate of MBD to EPCs and damaged HUVECs significantly increased compared with MBiotin (P ＜0.01),while no remarkable difference in attachment rate was found between MBD and MBcD34 in EPCs,and between MBD and MBIcAM-1 in damaged HUVECs (P ＞0.05).Conclusions Dual-targeted microbubbles carrying both anti-CD34 monoclonal antibody and anti-ICAM-1 monoclonal antibody are prepared successfully.The study in vitro has proved that the dual-targeted microbubbles can specifically bind to both EPCs and damaged HUVECs.

Objective To explore the clinical results of total knee arthroplasty (TKA) in the treatment of knees with bony ankylosis in extension.Methods From June 2000 to June 2007,10 patients had knees with bony ankylosis in extension were treated with TKA,including 4 males and 6 females,with an average age of 49 years (range,29 to 63 years).The primary diseases were as follows:ankylosing spondylitis in 3 cases,rheumatoid arthritis in 2 cases,hemophilic arthritis in 1 care,traumatic arthritis in 3 cases and pyogenic arthritis in 1 case.The range of motion (ROM) was 0° in all knees,and the average HSS (the Hospital for Special Surgery) score before operation was 32.5±10.26.Two patients underwent bilateral TKA,and 8 underwent unilateral TKA.Results All patients were followed up for 3 to 10 years (average,5.3 years).The average HSS score was improved to 87.75±6.45 at the last follow-up,and there was significant difference compared with that before operation (t=18.668,P=0.000).The average ROM was improved to 97.08°±11.57°at the last follow-up,and there was remarkable difference compared with that before operation (t=29.063,P=0.000).The postoperative complications included cutaneous necrosis in 2 cases,deep venous thrombosis of lower limb in 1 case,periprosthetic fracture in 1 case,and deep prosthetic infection in 1 case who underwent revised TKA later.The postopertative X-ray showed no looseness of the prostheses.Conclusion TKA through medial parapatellar approach,with dissection of the rectus femoris,secondary osteotomy and soft tissue balance intraoperatively is effective in the treatment of knees with bony ankylosis in extension,which can correct the ankylosed knee deformitis successfully.Combining with the correct rehabilitation exercise,it is possible to improve significantly the function of knee and life quality in these patients.

Objective:To analyze the value of low dose enteral nutrition (EN) in treatment of septic shock combined with acute gastrointestinal injury Ⅲ (AGI Ⅲ).Methods:Clinical data of septic shock patients combined with AGI Ⅲ admitted at our hospital were analyzed.Patients were divided into two groups according to the nutrition therapy they received:treatment group (EN,n =41) and control group (no EN,n =46).The mortality and ICU hospital stays were collected.The intestinal barrier,inflammatory cytokines,and oxidative stress were evaluated before and after EN treatment.Results:For patients in the treatment group,the dosages of EN ranged from 200 to 410 kcal/d,with the median dose of 350 kcal/d.No significant differences were found on death rates between the two groups (24.4％vs 32.6％,P =0.398).Patients in the treatment group had shorter ICU hospital stays than those of the control group (11.8 ± 3.7 vs 16.2 ± 5.3,P ＜0.01).After one week EN treatment,patients in the treatment group had lower levels of CRP,IL-6,TNF-α,diamine oxidase,endotoxin and D-lactate than those of the control group (P ＜ 0.05).Conclusion:For septic shock patients combined with AGI Ⅲ,low dose EN can improve the intestinal barrier function and systemic inflammatory responses.