Objective To compare the procotol of EGDT +Pt (cv-a ) CO2 with EGDT in fluid resuscitation and management after evaluate fluid responsiveness in shock patients by Vigileo and passive leg raising test.Metheds Prospectively collect patients who meet the criteria between 2013.5.1-2013.1 1.30 in our ICU.Randomly (random number)divided into Vigileo group (first evaluate the fluid responsiveness then give EGDT +Pt (cv-a) CO2 ) and CVP group (give EGDT).Compare the hospital mortality and morbility of MODS,the volume given in the first 6 hours and the first 7 days,consume of blood products , the ICU and hospital stay.Results Collected 46 patients,Vigileo group (21 )and CVP group (25 ). There’s no significant difference between groups at baseline.In the first 6 hours the CVP group had received more fluids (3656.281678.57 vs. 2639.141326.59 ) mL, P =0.03;and more blood products (573.00172.57 vs. 190.4770.82)mL,P=0.04,respictivily.Vigileo group significantly short the ICU stay ,(6.384.34 vs. 12.165.77)d,P=0.04.But there’s no significant difference in hospital motality and the morbility of MODS.The ROC of Age ,the accumulative volume of balance in 7 days,APACHEⅡscore in the first day to predict death is 0.84 (0.68-0.99)、0.82 (0.69-0.95)、0.80 (0.66-0.94),all P>0.05,respectively.By 7 days the accumulative volume of balance 3454.51mL as cutoff to predict death with the sensitivity of 0.67,specificity of 0.84.Conclusions 1.Given EGDT +Pt (cv-a) CO2 after evaluate the fluid responsiveness can reduce fluid and blood products given in the first 6 hours,significantly short the ICU stay,without worsen the tissue flow or increase the morbility of MODS;2.Consecutive positive fluid balance is a risk factor about poor prognosis,and also a sensitive indicator to predict death.

Small molecule drug screening technology is continuously evolving and expanding along with drug discovery,and the innovation in drug screening technology can improve the research and development efficiency and success rate,shorten the cycle time,and reduce the cost.From traditional screening technologies based on known active compounds and high-throughput screening(HTS)to new technologies such as structure-based drug discovery(SBDD),fragment-based drug discovery(FBDD),DNA encoded compound library(DEL)and proteolysis targeting chimeras(PROTAC),small molecule drug screening technologies are continuously broadening the market potential for small molecule drugs.This article will provide an overview of the current status of small molecule drug screening technology,systematically review each technique along with their advantages and disadvantages,and offer essential insights for the development of new small molecule drug screening technologies.

ObjectiveTo investigate the impacts of portal vein arterializations (PVA) on the liver regeneration in rats with liver cirrhosis.MethodsFifty rats with liver cirrhosis model were randomly divided into PVA group (n=40) and control group (n=10) according to the random number table method. Rats in PVA group underwent PVA+portocaval shunt. Rats in control group received no treatments. The ratio of hepatic wet weight to body weight, the hepatocyte percentage of positive proliferating cell nuclear antigen (PCNA) and hepatocyte percentage in DNA synthesis phase (S phase) in each group were measured at the time of 1 week (T1), 2 weeks (T2), 4 weeks (T3) and 8 weeks (T4) after operation or enrolling in the group. Parameters of every time points inside the group were compared by one-way analysis of variance and pairwise comparison was conducted by LSD-t test. Comparison between groups was conducted byt test.Results The ratio of hepatic wet weight to body weight at T1,T2,T3,T4 in PVA group [(3.72±0.26)%, (3.81±0.27)%, (3.83±0.31)%, (3.78±0.31)%] were signiifcantly increased compared with that in control group [(2.84±0.37)%] (t=6.11,6.64,6.49,6.17;P<0.05). The hepatocyte percentage of positive PCNA at T1, T2, T3, T4 in PVA group [(76±6)%, (69±8)%, (20±5)%, (15±4)% ] were signiifcantly increased compared with that in control group [(11±2)%] (t=34.48, 22.87,5.69,2.93;P<0.05). The hepatocyte percentage of positive PCNA at different time points inside the PVA group decreased gradually as time extended, where signiifcant difference was observed (F=316.20,P<0.05). The hepatocyte percentage in S phase at T1, T2, T3, T4 in PVA group [(27.0±1.2)%, (20.5±1.4)%, (16.2±1.3)%, (13.5±1.3)%] were signiifcantly increased compared with that in control group [(11.6±1.9)%] (t=21.97, 12.15, 6.30, 2.68;P<0.05). The hepatocyte percentage in S phase at different time points inside the PVA group decreased gradually as time extended, where signiifcant difference was observed (F=208.00,P<0.05).ConclusionsPVA can effectively promote liver regeneration in rats with liver cirrhosis and the effect declines as time extends.