Objective To evaluate the effects of limited fluid resuscitation on septic shock caused by myocardial injury . Methods 60 severe traumatic sepsis and septic shock patients were randomly divided into study group and control group ,with 30 cases in each group ,the control group was given active fluid resuscitation ,maintain the mean arterial pressure (MAP) in 70 mm Hg ;the study group were treated with limited fluid resuscitation ,namely when MAP rose to a slow infusion rate 50-60 mm Hg ,we restrict the amount of fluid ,maintain MAP at about 50 mm Hg ,observe and record the two groups of patients hemodynam-ics index ,APACHE Ⅱ score and heart function index ,and compared serum cTnI ,NT proBNP and CRP in the two groups .Results (1)In study group the infusion volume before admission was (258 ± 105)mL ,preoperative was (558 ± 226)mL ;in the control group that of before admission was (816 ± 422)mL ,preoperative was (1 668 ± 780) mL (P<0 .05) .The mortality rate in study group was 13 .3% ,the mortality in control group rate was 26 .7% (P<0 .05) .(2) the HR and blood lactic acid levels in two groups decreased significantly after treatment ,MAP and CVP increased significantly (P<0 .05);there were no significant differences in hemodynamic parameters (P>0 .05) .(3)After the treatment APACHEⅡscore of the two groups was significantly decreased ,car-diac output ,stroke volume and left ventricular ejection fraction significantly increased in control group ,the study group were better than control group (P<0 .05) .(4) The plasma cTnI ,NT proBNP ,CRP levels of the two groups significantly decreased after treat-ment (P<0 .05) ,plasma cTnI ,NT proBNP and CRP levels of research group were significantly lower than that of control group (P<0 .05) .Conclusion Limited fluid resuscitation can maintain hemodynamic ,reduce the interference on the internal environment ,re-duce myocardial injury ,and improve the success rate of treatment .

Autophagy is a ubiquitous physiological process that occurs in all eukaryotic cells.It can be induced by starvation,ischemia/reperfusion injury and heart failure.Rational autophagy in cardiac cells during ischemia/reperfusion helps to keep cellular homeostasis,and inhibit the cell loss.However,inappropriate activation of autophagy leads to cell death.

Objective To explore the curative effect and safety of of Entecavir ( ETV) combined Liuweiwul-ing Pian in the treatment of chronic hepatitis B patients with HBeAg +.Methods 124 patients according to the ran-dom number table were divided into the two groups ,which respectively used ETV combined Liuweiwuling Pian treat-ment and ETV.The liver function and index of viral replication of the two groups were compared .Results The effec-tiveness of the observation group was 91.94%,which of the control group was 82.26%,the difference between the two groups had statistical significance(Ridit=32.251,P=0.000);Since 24 week treatment,HBV DNA of the observa-tion group was lower than the control group,the difference was statistically significant (t =2.365,4.595,all P<0.05);After treatment,ALT,AST of the observation group decreasing degree was higher than the control group ,the difference was statistically significant (t=78.512,62.145,all P<0.05);after treatment,the ALT rate,effective rate and bounce rate in the two groups was statistically significant differences (χ2 =25.621,46.241,11.512, all P<0.05);After treatment,the HBV DNA and HBeAg positive in two groups was below cut-off test cases,differences was statistically significant(χ2 =17.265,21.264,all P<0.05).Conclusion Entecavir combined Liuweiwuling Pian in the treatment of chronic hepatitis B patients with HBeAg +can reduce liver fibrosis , and has obvious detoxification and anti-viral.

Objective To evaluate the therapeutic efficacy and safety of micro-invasive craniopuncture scavenging technique (MPST) for treatment of intracranial hematoma in patients with hypertensive cerebral hemorrhage (HICH).Methods All the clinical randomized controlled trial (RCT) studies published on MPST and internal medicine conservative treatment of HICH were searched via computer screening of databases including Cochrane clinical trials database, the Chinese biomedical literature database (CBM), Chinese periodical network full-text special topic database, Chinese science and technology periodical database and electronic periodicals database of Wanfang from January 2006 to January 2017. The study group was given the MPST plus basic treatment, and the control group was given conservative treatment. The studies collected meeting the eligible criteria were sorted and analyzed by the software RevMan 5.0, the differences in therapeutic effect and mortality were compared between the two groups, and a funnel chart was plotted to analyze the potential publication bias.Results A total of 13 RCTs published studies consistent with the eligible criteria were found, including1556 patients. The Meta-analysis showed that the effective rate in the study group was significantly higher than that in the control group [odds ratio (OR) = 4.29, 95% confidence interval (95%CI) 3.33 - 5.53,P < 0.01]; the fatality rate was markedly lower than that of the control group (OR = 0.25, 95%CI 0.19 - 0.35,P < 0.01). The funnel graph showed that each study had asymmetrical scatter plot of the variable quantity of research results, indicating a publication bias being present, which might be related to the subjectivity of the researchers in publishing their results.Conclusions Using MPST to treat HICH can significantly improve the therapeutic efficiency and reduce deterioration rate. However, due to the low quality of clinical research, it is necessary to carry out rigorous andmulti-center randomized controlled studies to further confirm the results.

E-health is a new kind of health care model, which raises medical efficiency, brings happiness and hope to the therapy of severe disease, and stands for the future of health care. However, it is faced with many issues and challenges, such as the safety of information storing, privacy protection and the distribution of health resources.Therefore, research & development in e-health should observe some criterion. The author holds that the development of e-health should observe ethical principles such as inform-concent, safety, justice, risk-benefit and developing step by step, and puts forward regulating recommendations in many aspects.

AIM: To investigate the effects of Shuguan Capsule on myocardial blood flow (MBF) and myocardial oxygen consumption (MOC) in anesthetized dogs. METHODS: Coronary blood flow (CBF) of twenty-five thoracotomized dogs was detected by electromagnetic flow meter and the MBF was calculated. While the oxygen content in the artery (AO2 ) and in the coronary venous sinus (VO2) was determined with blood oxygen analysis.Moreover, the other cardiac hemodynamic parameters, such as heart rate (HR), femoral arterial blood pressure (BP), were observed by physiological polygraph. RESULTS: It was found that Shuguan Capsule (48.5 mg/kg and 194 mg/kg) could significantly increase the MBF, and then decease the coronary artery resistance. Furthermore, Shuguan Capsule could also lower the AO2, but increase the VO2, which led to the decreased MOC. CONCLUSION: Shuguan Capsule exhibits the effects to keep the balance between blood supply and oxygen consumption in the heart by modulating the coronary resistance and by reducing MOC in dogs.

AIM To explore whether plasma vasoactive substances and neutrophil infiltration make different contribution in cerebral ischemia-reperfusion injury and protective effect of triacetylshikimic acid(TSA). METHODSThe rat models of ischemia 90 min and reperfusion 3-48 h were prepared with middle cerebral artery occlusion. TSA 50-200 mg·kg-1 were given (ig) immediately and 60 min again after the onset of ische- mia. Serotonin and thromboxane B2 (TXB2) concentrations in plasma were detected by fluorescence spectrophotometry and radioimmunoassay respectively. Myeloperoxidase(MPO) activity in brain tissue was quantified by chemical analysis. RESULTS At 3-24 h after reperfusion, the concentrations of plasmic serotonin, TXB2, and brain MPO activity increased obviously in a time-dependent manner. At 48 h after reperfusion, the concentrations of serotonin and TXB2 decreased to the same level of sham. Nevertheless, brain MPO activity remained more elevated than the contralateral cortex. At 24 h after reperfusion, TSA (100 and 200 mg·kg-1) was shown to possess the ability to inhibit the increased plasmic serotonin, TXB2 concentrations, and brain MPO activity induced by focal cerebral ischemia-reperfusion. CONCLUSION Vasoactive substances in plasma and MPO activity in brain tissue show different time courses during focal cerebral ischemia-reperfusion and make different contribution to brain damage. TSA is effective to protect the ischemic brain tissue from ischemia-reperfusion injury.

OBJECTIVE：To explore the possible mechanism of astragalus in improving cardiac function.METHODS：To observe the effects of astragalus,added to basic anti-heart-failure therapy,on cardiac function and TNF in 45 cases of thronic heart failure.RESULTS：In comparison with basic therapy group,the improvement of cardiac function was more obvious and the level of serum TNF-α was lower in astragalus group.CONCLUSION：Astragalus probably has the action of decreasing TNF resulting in improvement of cardiac function.

Objective To investigate the effect of predictive nursing on the living donor liver transplantation.Methods Forty patients undergoing living donor liver transplantation were divided into the intervention group and the control group with 20 patients in each group randomly.We gave routine nursing cooperation to the control group while predictive nursing besides routine nursing cooperation to the intervention group.The operation time,cold ischemia time of donor liver,nursing complication,cost of surgery and satisfaction degree of surgery cooperation were recorded.Results Compared with the control group,the operation time,cold ischemia time of donor liver,nursing complication,cost of surgery were all decreased,and the satisfaction degree of surgery cooperation was improved.Conclusions Predictive nursing can improve nursing operation quality,raise the efficiency of nursing and surgery,reduce the incidence of complication,which is beneficial to smooth progress of operation and increase satisfaction degree of doctors and nurses to nursing cooperation.

Objective To investigate the serum levels of heat shock protein 70 (HSP70) in uremic patients with different dialysis ages.Methods Ninety-two maintenance haemodialysis patients were divided into short-term group(from three months to 2 years,n =32),median-term group(from 2 to 5 years,n =37) and longterm group(more than 5 years,n =23) according to different dialysis ages.Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of HSP70 before and after haemodialysis in each group.Results The semm levels of HSP70 had significant difference both in median-term group and long-term group before and after haemodialysis(median-term group:(54.94 + 39.21) μg/L vs (69.72 + 39.90) μg/L,t =-2.068,P =0.047 ;long-term group:(46.17 +34.63) μg/L vs (74.07 ±41.11) μg/L,t =-2.814,P =0.010).But there was no statistics difference on the serum levels of HSP70 before and after haemodialysis in the short-term group((70.42 ±38.30) μg/L vs (62.89 ±43.01) μg/L,t =0.870,P =0.390).Conclnsion Haemodialysis patients with more stress protection ability are likely to obtain long term survival.