OBJECTIVETo study the effect of acupuncture on the immune function of sepsis patients.

METHODSNinety sepsis patients were assigned to the control group, the thymosin a1 group, and the acupuncture treatment group according to random digit table, 30 patients in each group. Patients in the control group were treated according to the guideline of Surviving Sepsis Campaign (SSC). Patients in the control group received routine treatment. Those in the thymosin alpha1 group additionally received subdermal injection of thymosin alpha1 (1.6 mg), once per day for 6 successive days. Needling at related points such as Zusanli (ST36), Yanglingquan (GB34), Neiguan (PC6), Guanyuan (RN4), and so on, was performed in patients of the acupuncture treatment group, once per day for 6 successive days. T cell subgroups (CD3+, CD4+, CD8+, CD4+ /CD8+) and immunoglobulin levels (IgG, IgA, IgM) were detected. The length of ICU hospital stay, hospital readmission rate, and 28-day mortality were compared among the three groups.

RESULTSAfter six days of treatment, CD3+, CD4+, CD8+, IgG, IgA, IgM, and CD4+ /CD8+ ratio of three groups were all significantly increased (P < 0.01). Of them, CD3+, CD4+, CD8+, IgG, IgA, and IgM increased more significantly in the thymosin alpha1 group and the acupuncture treatment group (P < 0.01). Compared with the control group, the ICU hospitalization length was significantly shortened, the hospital readmission rate and the 28-day mortality were lower in the thymosin alpha1 group and the acupuncture treatment group (P < 0.05, P < 0.01). There was no statistical difference in each index between the thymosin alpha1 group and the acupuncture treatment group (P > 0.05).

CONCLUSIONAcupuncture could adjust the immune function of sepsis patients, improve their immunological indicators and prognoses.

Acupuncture Therapy ; CD4-CD8 Ratio ; Humans ; Length of Stay ; Prognosis ; Sepsis ; diagnosis ; immunology ; therapy ; T-Lymphocyte Subsets ; Thymosin ; analogs & derivatives

OBJECTIVETo observe the clinical effect of acupuncture on acute heart failure (AHF) patients.

METHODSTotally 60 patients who were diagnosed as AHF were assigned to the acupuncture group and the control group, 30 in each group. Those in the control group received inotropic agents, preload and afterload reducing therapy, anti-infection and so on. Besides, those in the acupuncture group received needling at relative points, once daily for 5 consecutive days. The mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), stroke volume index (SI), left ventricle working index (LCWI) were monitored by thermodilution pulse-indicated continuous cardiac output (PiCCO) technique. Changes of the aforesaid data were compared between before and after treatment. The ICU length of stay, readmission rate,and the 28-day mortality were also compared between the two groups.

RESULTSAfter 5 days of the treatment, CI, SI, and LCWI increased more obviously (P < 0.01), HR and MAP decreased significantly (P < 0.05). Of them, CI, SI, and LCWI increased more obviously in the acupuncture group (P < 0.05).There was no obvious difference in HR or MAP between the two groups (P > 0.05). Compared with the first day of admission in the same group, CI, SI, and LCWI obviously increased in the acupuncture group from the second day (P < 0.05). HR started to decrease since the fourth day (P < 0.05), and MAP began to decrease until the fifth day (P < 0.05). CI, SI, and LCWI started to increase in the control group from the third day (P < 0.05); HR and MAP both began to decrease since the fifth day (P < 0.05). Compared with the control group, the ICU length of stay was obviously shortened in the acupuncture group (P < 0.05). The readmission rate and the 28-day mortality rate were lower than those of the control group (P < 0.05).

CONCLUSIONThe combination of acupuncture and Western medical therapy might strengthen acute heart failure patients' heart functions, elevate the therapeutic effect, and improve the prognosis.

Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Heart Failure ; physiopathology ; therapy ; Heart Rate ; Humans ; Male ; Middle Aged ; Stroke Volume

In order to explore the dormancy physiological and biochemical mechanism of Paris seeds, the seed embryo growth courses, and the dynamic change of 5 enzymes, include SOD, POD, CAT, MDH, G-6-PDH were measured during variable temperature stratification. The results indicated that Paris seeds embryo grew quickly after 40 d in warm-stratification (18 ± 1) °C, at the meantime the metabolic activity was significantly strengthened. These facts showed that Paris seeds turned into physiological after-ripening process. After 60-80 d, the morphological embryo after-ripping process basically completed, and the following cold-stratification (4 ± 1) °C furthered Paris seed to finish physiological after-ripening. After 40 d, the activity of MDH decreased while G-6-PDH increased significantly. This showed that the main respiratory pathway of seed changed from TCA to PPP, which benifited breaking seed dormancy. In the whole period of stratification process, the activity variation of SOD and CAT was insignificantly and the activity of POD was enhanced significantly after shifting the seed in cold stratification process. This showed that SOD, CAT had no direct effects on breaking Paris seed dormancy but keeping the seed vigor, while the POD might involve in the process of Paris seed dormancy breaking.
Germination ; Liliaceae ; chemistry ; embryology ; enzymology ; Plant Proteins ; metabolism ; Seeds ; chemistry ; enzymology ; growth & development ; Temperature

OBJECTIVETo investigate characteristics of treating dislocation and fracture of sacroiliac joint through anterior and posterior approaches.

METHODSBetween January 2006 and September 2012, 39 patients with dislocations and fractures of sacroiliac joint were treated with operation. There were 28 males and 11 females, aged 12 to 64 (mean, 41.3) years old. Seventeen cases were chosen through anterior approach, 13 cases through posterior and 9 cases were combined with anterior and posterior approaches. The anterior approach were made with supine position, performed open reduction, and two plates with 4 holes were used as internal fixation for arthrodesis of sacroiliac joint after reduction; while posterior approach prone position, close or open reduction was performed, and one or two partial thread lag screws, which with 7.3 mm in diameter and 60 to 75 mm in length, were penetrated via sacroiliac joint for fixation under X-ray. Postoperative complications were observed, Matta and Majeed scoring were used to evaluated currative effects.

RESULTSAll patients were followed up from 6 to 36 months. The patient could sit on the bed 2 to 4 weeks after surgery and walk with a crane 6 weeks' later. No breakage or loosening of screw occurred during follow-up. In all but one case with old sacral iliac fractures reducted poor, others obtained good opposition. According to Matta's criteria, 30 cases got excellent results, 8 good and 1 fair. According to Majeed's funtional standard, 14 patients got excellent results, 20 good 4 fair and 1 poor.

CONCLUSIONTreating dislocation and fracture of sacroiliac joint through anterior and posterior approaches can obtain good effects. However, anatomic location, fracture types, degree of displacement, the rate of preoperational reduction, vulnerability assessment of operation and fixation strength should be considered.

Adolescent ; Adult ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Internal Fixators ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Sacroiliac Joint ; injuries ; surgery ; Young Adult

BACKGROUNDDecreased platelet (PLT) count is one of the independent risk factors for mortality in intensive care unit (ICU) patients. This study was to investigate the relationship between PLT indices and illness severity and their performances in predicting hospital mortality.

METHODSAdult patients who admitted to ICU of Changzheng Hospital from January 2011 to September 2012 and met inclusion criteria were included in this study. Univariate analysis was used to identify potential independent risk factors for mortality. Multiple logistic regression analysis was used to calculate adjusted odds ratio for mortality in patients with normal or abnormal PLT indices. The relationship between PLT indices and illness severity were assessed by the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores or sequential organ failure assessment (SOFA) scores in patients with normal and abnormal PLT indices. The performances of PLT indices in predicting mortality were assessed by receiver operating curves and diagnostic parameters. The survival curves between patients with normal and abnormal PLT indices were compared using Kaplan-Meier method.

RESULTSFrom January 2011 to September 2012, 261 of 361 patients (204 survivors and 57 nonsurvivors) met the inclusion criteria. After adjustment for clinical variables, PLT count <100 × 10 12 /L (P = 0.011), plateletcrit (PCT) <0.108 (P = 0.002), mean platelet volume (MPV) >11.3 fL (P = 0.023) and platelet distribution width (PDW) percentage >17% (P = 0.009) were identified as independent risk factors for mortality. The APACHE II and SOFA scores were 14.0 (9.0-20.0) and 7.0 (5.0-10.5) in the "low PLT" tertile, 13.0 (8.0-16.0) and 7.0 (4.0-11.0) in the "low PCT" tertile, 14.0 (9.3-19.0) and 7.0 (4.0-9.8) in the "high MPV" tertile, 14.0 (10.5-20.0) and 7.0 (5.0-11.0) in the "high PDW" tertile, all of which were higher than those in patients with normal indices. Patients with decreased PLT and PCT values (all P < 0.001), or increased MPV and PDW values (P = 0.007 and 0.003, respectively) had shortened length of survival than those with normal PLT indices.

CONCLUSIONSPatients with abnormally low PLT count, high MPV value, and high PDW value were associated with more severe illness and had higher risk of death as compared to patients with normal PLT indices.

Adolescent ; Adult ; Aged ; Blood Platelets ; physiology ; Critical Illness ; Female ; Humans ; Male ; Mean Platelet Volume ; Middle Aged ; Platelet Count ; Prognosis ; Retrospective Studies ; Young Adult

Objective To study the prognostic role of plasma neutrophil gelatinase-associated lipocalin (NGAL) early after renal transplantation.Methods A total of 37 kidney recipients were enrolled from Department of Organ Transplantation,Guangdong Second Provincial General Hospital within a 12-month period of time.Plasma NGAL was measured immediately before and at 6 and 12 h post-transplantation.Changes of serum creatinine were documented daily within the first week postoperation.Acute kidney injury (AKI)/graft rejection during the first week after transplantation was the outcome variable.Results The levels of serum NGAL in the 37 patients were (311.14 ± 102.69),(317.81 ± 107.28) and (312.16 ± 134.80) μg/L respectively immediately before and at 6 and 12 h post-transplantation.There was no significant difference in serum NGAL levels before and 6 h or 12 h after operation (P =0.70,and P =0.96).There were no significant differences in gender and age between the two groups (P =0.29,and P =0.20).There was significant difference in creatinine levels between the AKI group and the non-AKI group (P =0.002) and between pre-operation and 6 or 12 h postoperation.The preoperative levels of serum NGAL in AKI group and non-AKI group were (333.58 ± 116.30) and (300.36 ± 96.15) μg/L (P =0.36),and those were (383.3 ± 147.16) and (286.32 ± 65.97) μg/L (P＜0.01) at 6 h,and (437.33 ± 164.16) and (252.08 ± 57.53) μg/L (P＜ 0.001) at 12 h after operation.The sensitivity and specificity of serumNGAL (317μg/L at 12 h after operation as the cutoff value) predicting AKI was 100％ and 92％ respectively,which was much better than that of serum creatinine at the corresponding time point (sensitivity =66.7％,and specificity =61.9％).Conclusion Plasma NGAL,particularly at 12 h after transplantation,is a very sensitive and specific biomarker for predicting AKI.

Adult ; Alanine Transaminase ; blood ; Bilirubin ; blood ; Cholesterol ; blood ; Female ; Hepatic Encephalopathy ; blood ; physiopathology ; Humans ; Liver ; physiopathology ; Pregnancy ; Pregnancy Complications ; blood ; physiopathology ; Prognosis ; Prothrombin Time ; Serum Albumin ; analysis

Objective To develop a medical technical support module and box-type medical technical equipment so as to supply medical oxygen and water for the tent-form field medical system at field conditions.Methods The medical technical support module had its service orientation analyzed to determine its functional requirements and technical indexes, which involved in PSA oxygen generation technology with variable frequency,constant pressure and self-adaptability to altitudes as well as medical water preparation technology by integrated membrane separation. Box-type modules for medical oxygen generation and medial water preparation were trial-produced with the mode of integrated box and instruments as well as high-density polyethylene as the box material.Results The oxygen production was 1.3 Nm3/h,and the oxygen concentration was 92.7%.The flow volume of cleaning water and purified water was 433.7 and 37.2 L/h respectively at 25℃,and the water quality accorded with the relevant water quality indexes of GB 5749—2006 and the national pharmacopoeia(2010 edition). Conclusion This set of medical equipment can meet the design requirements and can effectively guarantee the medical oxygen and medical water needed for medical treatmentin field tent hospital under field conditions. [Chinese Medical Equipment Journal,2018,39(5):7-11]

Objective To explore the feasibility of serum Klotho level in the elderly donors to predict the renal graft function in the recipients. Methods Clinical data of 16 elderly donors and 27 recipients undergoing renal transplantation were collected. The general status of the recipients was observed. The levels of serum Klotho and serum creatinine (Scr) in the elderly donors were measured on the day of renal transplantation. The Scr levels in the recipients were measured at postoperative 1, 3 and 12 months respectively. The estimated glomerular filtration rate (eGFR) was calculated. The correlation between the serum Klotho level of the donors and postoperative graft function of the recipients was analyzed. Results The cold ischemia time during renal transplantation was (649±245) min. The incidence rate of delayed graft function (DGF) was 26%. The incidence rate of acute rejection was 7%. In the elderly donors, the serum Klotho level was 537 (245-793) pg/mL and the Scr level was (164±62) μmol/L. At postoperative 1, 3 and 12 months, the Scr levels in the recipients were (136±47), (132±43) and (133±46) μmol/L, respectively. The corresponding eGFR was (52±20), (52±19) and (53±21) mL/(min?1.73m²), respectively. The serum Klotho level in the elderly donors was negatively correlated with the renal graft function at postoperative 1 month in the recipients (P < 0.05). The sensitivity and specificity of serum Klotho level in predicting the renal graft insufficiency at postoperative 1 month were 0.909 and 0.769. Conclusions The preoperative serum Klotho level in the elderly donors have predictive value for renal graft function in the recipients at postoperative 1 month.

Objective To explore the role of infection control nurses in healthcare-associated infection(HAI)man-agement,and provide basis for HAI management.Methods Through setting up infection control nurses in clinical departments of the whole hospital,clarifying their responsibilities and duties,training,and supervising them,the effect of infection control nurses on HAI management was observed.Results A total of 67 infection control nurses were set up in the clinical departments of the whole hospital,HAI management knowledge among health care work-ers (HCWs)in 26 departments improved significantly,scores of HAI management knowledge among HCWs in April and December was compared,difference was statistically significant (Z = - 2.193,unilateral P = 0.014). Hand hygiene compliance rate of HCWs improved from 83.35%(1817/2180)in April to 89.53% (2002/2236)in December,difference was statistically significant(χ2 =36.13,P <0.01).A total of 56670 hospitalized patients were monitored from April to December 2015,the total length of hospital stay was 411164 days,utilization rate of three catheters was 27.18%,three catheter-related infection rate was 0.74‰.The median scores of supervision on HAI management in clinical departments improved from 95.30 in May to 97.70 in September(P <0.05).Conclusion Setting up infection control nurses is of great significance to strengthen the HAI management organization and pro-mote the quality of HAI management.