Objective To evaluate the effectiveness of volume therapy guided by the response of CVP and global end-diastolic volume index (GEDVI) in septic shock patients.Methods Twenty-three patients of both sexes aged 18-64 yr who had been in septic shock for ＜ 6 h were randomly divided into 2 groups:control group (group Ⅰ,n =12) and study group (group Ⅱ,n =11 ).Tracheal intubation was performed and the patients were mechanically ventilated in both groups.Right internal jugular vein or subclavian vein was cannulated for CVP monitoring and fluid administration.PiCCO catheter was inserted into femoral artery.Normal saline,6％ hydroxyethyl starch 200/0.5,albumin and plasma were infused via CVP line.CVP was maintained ≥8 mm Hg in both groups while in Ⅱ group GEDVI was maintained at 600-750 ml/m2 during resuscitation.Blood samples were taken from artery and CVP line before (baseline) and at 6 h of volume therapy (T2) for determination of blood lactate concentration and central venous oxygen saturation ( ScVO2 ).The changing rate of lactate ( (baseline lactate concentration-lactate concentration at 6 h of volume therapy) ÷ baseline value × 100％ ) and ScvO2 ( ( ScvO2 at 6 h of volume therapy - baseline ScvO2 ) ÷ baseline value × 100％ ) ) was calculated.Results The changing rate of lactate was significantly higher in Ⅱ group than in Ⅰ group.There was no significant difference in the changing rate of ScvO2 between the 2 groups.Conclusion Volume therapy guided by CVP and GEDVI can provide better tissue perfusion than by CVP alone in septic shock patients.

Objective To investigate the mechanism of icariin regulating the NLRP3 inflammasome in the treatment of cerebral ischemia-reperfusion injury in rats.Methods A rat model of focal cerebral ischemia-reperfusion was induced using the thread embolism method.At 24 hours post-operation,the rats were randomly allocated into a sham operation group,model group,butylphthalide group(70 mg/kg),ICA-low dose(20 mg/kg),ICA-middle dose(40 mg/kg),and ICA-high dose(80 mg/kg)groups.The corresponding drugs were administered by gavage at 10 mL/kg once a day for 13 consecutive days.One hour after the last administration,neurological function was scored.The cerebral cortex was observed by hematoxylin-eosin(HE)staining.Expression of interleukin(IL)-1β and IL-18 in the cerebral cortex was determined by immunohistochemistry.Expression of NLRP3,ASC,and Caspase-1 in the cerebral cortex was determined by Western Blot.Results In contrast to the sham operation group,there was a notable increase in neural function scores within the model group.The ischemic area around the visible cerebral cortex showed neuron necrosis at various level or glial cell proliferation,and the number of intact neurons was significantly reduced.IL-1β and IL-18 positive cells were significantly increased.Expression of NLRP3,ASC,and Caspase-1 was significantly increased(P＜0.01,P＜0.05).After treatment with icariin,the neural function score was decreased significantly.The degree of neuronal necrosis in the peri-ischemic area was significantly reduced,and the number of intact neurons was significantly increased.IL-1 β and IL-18-positive cells were decreased significantly.Expressions of NLRP3,ASC,and Caspase-1 were significantly decreased(P＜0.01,P＜0.05).Conclusions Treatment of cerebral ischemia-reperfusion injury by icariin may be related to regulation of the NLRP3 inflammasome.