Objective To study the application value of myocardial markers combined with BNP in the early diagnosis of cardiac dysfunction in patients with sepsis. Methods diagnosed patients 66 cases as the research object of this paper,on the basis of 3~5 days in 66 patients with left ventricular ejection fraction after admission of LVEF > 50% and LVEF < 50% were divided into two groups ,two groups were monitored for 0 days ,3 days , 5 days,12 days LVEF,BNP and TNI. Results the left ventricular ejection fraction LVEF>50%and LVEF<50%two groups:3,5 days when the BNP value was significantly higher than that of non cardiac injury heart injury;cardiac injury group EF was negatively correlated with TNI value ,value and blood 3~5 days EF troponin levels in patients admitted to hospital after the show was negatively correlated;the concentration of EF and patients admitted to the hospital after twelfth days of blood troponin value is displayed as a negative correlation. TNI can directly reflect the cardiac function of patients. Research shows that the BNP value had a significant positive correlation in fifth days and APACHE Ⅱ score. Conclusion the data show that TNI and BNP can directly reflect the sepsis patients with heart dysfunction ,that BNP combined with TNI can effectively evaluate the clinical treatment of severe sepsis and septic shock patients ,prognosis has high significance.

Objective To investigate the relationship between the serum adiponectin levels and prognosis of septic patients, by detecting the serum levels of adiponectin in septic patients. Methods 110 septic patients and 100 healthy controls subjects were enrolled. The serum levels of adiponectin were measured and compared. Clinical data and outcomes of septic patients were analyzed multi-factor Logistic regression analysis were used. Results The serum levels of adiponectin in septic patients were lower than that in healthy controls (P < 0.05). Serum levels of adiponectin in death group was lower than that in sepsis survival group (P < 0.05). There were close correlations between age, MODS, adiponectin and sepsis death(P < 0.05), which were the independent risk factors of death in septic patients. Conclusion The lower the adiponectin level is, the higher mortality rate occurs.Adiponectin can be used as the indicators of patients′ prognosis.

Objective:To explore the protective effect of ulinastatin on sepsis-related acute lung injury (ALI) in mice and its related mechanism analysis.Methods:A total of 50 male mice aged 6-8 weeks were selected and randomly divided into 5 groups, with 10 mice in each group. Group A was the sham operation group, group B was the sham operation and ulinastatin (30 000 U/kg) intervention group, group C was the simple cecal ligation and perforation (CLP) group, group D was the CLP+low-dose ulinastatin (15 000 U/kg) treatment group, and group E was the CLP+high-dose ulinastatin (30 000 U/kg) treatment group. Ulinastatin in groups B, D and E was injected intraperitoneally at the corresponding dose 1 h before CLP operation. The hematological characteristics, lung edema and inflammatory changes of lung tissue in mice of each group were evaluated and the expression levels of interleukin(IL)-6, tumor necrosis factor(TNF)-ɑ, IL-1β and nuclear factor(NF)-κB p65 mRNA and protein expression in blood and lung tissue were compared among the five groups.Results:Compared with that in group A, the lung water content in group C was significantly increased: (78.68 ± 1.85)% vs. (51.98 ± 0.77)%, P<0.01. Compared with that in group C, pulmonary edema of the mice treated with ulinastatin was significantly reduced, with a certain dose-effect relationship. The wet weight/dry weight ratio of the lung tissue in group C was significantly higher than that of group A, B, D, E: 4.74 ± 0.28 vs. 2.23 ± 0.16, 2.25 ± 0.22, 2.89 ± 0.31, 2.09 ± 0.12, P<0.01, and group E had the lowest ratio. After ulinastatin intervention, the inflammatory manifestations of the lungs were reversed in a dose-dependent manner. The degree of structural destruction was improved, and edema and polymorphonuclear neutrophil infiltration were reduced. Ulinastatin could significantly reduce the neutrophil and lymphocyte counts of mice after CLP treatment, reduce the expression of IL-6, TNF-α, IL-1β inflammatory cytokines and MPO activity. The reverse transcription-polymerase chain reaction (RT-PCR) results and Western blot analysis showed that the mRNA and protein expressions of NF-κB p65 in group C of lung tissue was significantly increased. However, after treatment with ulinastatin, it was significantly reduced, and it had a certain dose-effect relationship. Conclusions:Ulinastatin pretreatment can significantly reduce the expression levels of IL-6, IL-1β and TNF-α in sepsis-related acute lung injury, and can alleviate the inflammatory response in the lung. The protective effect of ulinastatin may be related to the inhibition of NF-κB pathway activation.