Objective To observe the influences of dexmedetomidine (DEX) on efficacy,inflammatory factors,liver and kidney functions in severe sepsis patients with acute lung and kidney injury.Methods A total of 60 severe sepsis patients with acute lung and kidney injury were randomly divided into treatment group and control group,30 cases in each group.Patients in two groups were maintained with regular treatment.Patients in treatment group were received DEX injection 1 μg · kg-1 · h-1 for early sedative treatment.While,patients in control group were received propofol injection for early sedative treatment.They were treated for 48 h.Time of mechanical ventilation,intensive care unit (ICU) stay time,and duration of continuous renal replacement therapy (CRRT) were recorded.Liver and kidney functions indexes and the levels of inflammatory factors in two groups before and after treatment were detected.Results ICU stay time and duration of CRRT in control group were (96.32 ± 13.51),(61.30 ±9.85)h,had significant difference with those in treatment group,which were (76.18 ± 11.32),(52.93 ± 9.21) h (P ＜ 0.01).After operation,the levels of procalcitonin,C reactive protein,interleukin-6 and tumor necrosis factor in treatment group were(2.05 ±0.39),(56.36 ±9.94),(78.72 ± 11.33),(17.56 ±4.07)ng · L-1,had significant differences with those in eontrol group,which were (2.43 ±0.24),(79.91 ± 12.55),(92.07 ± 12.55),(24.41 ±4.25) ng · L-1 (all P ＜ 0.01).After operation,the levels of alanine aminotransferase,aspartate transaminase,alkaline phosphatase,total bilirubin,blood urea nitrogen and serum creatinine in treatment group were (21.37 ± 4.73) U·L-1,(29.61 ±6.97)g · L-1,(67.27 ±7.26)U · L-1,(11.36 ±2.91)μmol · L-1,(7.03 ±2.03) mmol· L-1,(87.98 ±10.56)μmol · L-1,had significant difference with those in control group,which were (30.46±6.44)U· L-1,(38.60 ±7.53)g · L-1,(71.75 ±8.41)U · L-1,(14.72 ±2.29)μmol · L-1,(10.07 ± 3.12) mmol · L-1,(123.73 ± 11.74) μmol · L-1 (all P ＜ 0.05).There was no significant adverse drug reaction in two groups.Conclusion Compared with propofol,dexmedetomidine has better clinical effect for severe sepsis patients with acute lung injury by improving the inflammatory factors and protecting organ.

OBJECTIVE: To observe the effect of electroacupuncture (EA) combined with lifestyle control on hepatic fat status, hepatic enzymology, glycolipid metabolism and anthropological parameters in patients with obese nonalcoholic fatty liver disease(NAFLD). METHODS: A total of 90 patients with obese NAFLD were randomized into an observation group (45 cases, 4 cases dropped off) and a control group (45 cases, 1 case dropped off). Lifestyle control was implemented in the control group. On the basis of the treatment in the control group, acupuncture was applied at Zhongwan (CV 12), Quchi (LI 11), Shuifen (CV 9), Huaroumen (ST 24), Daheng (SP 15), Guanyuan (CV 4), Qihai (CV 6), etc. EA was provided at Huaroumen (ST 24) and Daheng (SP 15) with dilatational wave, 2 Hz/100 Hz in frequency, 30 min each time, once every other day, 3 times a week. The treatment for 12 weeks was required in both of the two groups. Hepatic fat status [controlled attenuation parameter (CAP) and liver stiffness measurement (LSM)], hepatic enzymology [alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT)], glycolipid metabolism and insulin sensitivity [fasting plasma glucose (FPG), fasting serum lisulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C)] and anthropological parameters [body weight (BW), body mass index (BMI), fat percentage (FP), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR)] in the two groups were observed before and after treatment. RESULTS: ①Compared before treatment, hepatic CAP, LSM, serum ALT, AST and GGT after treatment were obviously reduced in the two groups (<0.05, <0.01). After treatment, CAP and ALT in the observation group were lower than the control group (<0.05). ②Compared before treatment, FINS, HOMA-IR, LDL-C, TC and TG after treatment were obviously reduced in the two groups (<0.05, <0.01),while the levels of HDL-C were increased (<0.05). Compared before treatment, FPG after treatment in the observation group was reduced (<0.05). Compared with the control group, FINS, HOMA-IR, TC and TG in the observation group were lower than those in the control group after treatment (<0.05). ③Compared before treatment, BW BMI, FP, WC, HC, WHR after treatment were obviously reduced in the two groups (<0.01). After treatment, WC and WHR in the observation group were lower than the control group (<0.05). CONCLUSION Electroacupuncture combined with lifestyle control can effectively treat obese nonalcoholic fatty liver disease, and present better therapeutic effect on hepatic fat status, glycolipid metabolism, insulin resistance, WC and WHR.