Animals ; Humans ; Hypertension, Pulmonary ; complications ; Hypothermia ; complications ; Hypoxia ; etiology ; therapy ; Respiratory Distress Syndrome, Adult ; complications ; Shock, Septic ; complications

Glucocorticoids ; adverse effects ; therapeutic use ; Humans ; Respiratory Distress Syndrome, Adult ; drug therapy ; immunology ; metabolism ; Systemic Inflammatory Response Syndrome ; drug therapy ; immunology ; metabolism

Humans ; Kidney Diseases ; etiology ; physiopathology ; Sepsis ; complications ; physiopathology ; Shock, Septic ; complications ; physiopathology

Adolescent ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; International Cooperation ; Pediatrics ; Practice Guidelines as Topic ; standards ; Sepsis ; diagnosis ; physiopathology

0.05),and all were improved after operations (P

Background Trans-arachidonic acids (TAAs) are specific lipid markers of nitrative stress and the major products of NO2·-mediated ismoerization of aracchidonic acid(AA),and they represent a possible new mechanism of NO2·-induced toxicity in ischemic retinopathy.Our previous study demonstrated that high glucose induce nitrative stress response. Objective This study aimed to evaluate the effect of nitrative stress on retinal capillary in diabetic rats by detecting the TAAs with gas chromatography and mass spectrometry(GC/MS).Methods One hundred 2-week-old clean male SD rats were randomly divided into control group and diabetic group.Diabetic rat models were induced by intraperitoneal injection of streptozoticin of 60 mg/kg,and the successful models were identified as the blood glucose level>16.7 mmol/L.The synthesis method was modified in this study andaraehidonic acid w8$utilized as starting material.14E-AA was obtained as a standard sample via expoxidation and deoxidation in a safe and practical pattern.Serum TAAs and AA in diabetic rats were detected by GC/MS in 2,4,8,12 and 16 weeks after injection of streptozoticin.The ratio of peak area of TAAs to AA with selected ion of 79 was estimated and compared with normal rats. Results Fifty rats had been in Diabetic models were established in 50 rats with the successful rate 100%,and the high blood glucose level in model rats retained throughout the experimental duration.GC/MS results showed that the 14E-AA was obtained with the purity of 97.3%,which provided a standard sample to nitrative stress-related research as a premise. No significant differences were found in serum TAAs/AA values at 2 weeks and 4 weeks between model group and control group (t =-0. 376, t =-0. 642,P>0. 05). However,serum TAAs/AA values in at 8,12 and 16 weeks after streptozoticin injection were considerably elevated in comparison with those of control group (0. 0832 vs 0. 1042,0. 0910 vs 0. 1568, 0. 1100 vs 0. 1895;t=-36.409,t=-166.714,t=-148.212,P<0. 05). Conclusion Elevation of serum TAAs/AA is associated with diabetic duration,implying that damage of nitrative stress to retinal capillary is a parallel procedure to diabetic course.Establishment of GC/MS detection system offers a new evaluating indicator in the research on microvascular ischemic disease and could be implemented in clinical testing.

Objective To understand awareness of basic knowledge on control and prevention for chronic obstructive pulmonary disease (COPD) among general practitioner in community health service centers. Methods Questionnaire survey was conducted among 593 general practitioners at 15 community health service centers in a district of Shanghai in the morning of February 26, 2008. Results Five hundred and forty-two of 593 ( 91.4% ) general practitioners surveyed knew that chronic obstructive pulmonary disease can be abbreviated as COPD, and 315 of them (53.1%) thought they knew the main contents of the "Guidelines for Prevention and Control of Chronic Obstructive Pulmonary Disease". No pulmonary function instrument was equipped at all 15 community health service centers surveyed, and 501 of 593 ( 84.5% ) general practitioners knew spirometry is gold standard for diagnosis of COPD. Only 115 ( 19.4% ) general practitioners knew that COPD can be categorized as acute exacerbation and stable stage. One hundred and sixty-three of them (27.5%) knew that drug therapy should be maintained in COPD patients for long term following effective treatment, 328 (55.3%) recognized that treatment for COPD patients was still needed in their stable stage, and 312 (52.6%) believed that antibiotics may not be necessary and 465 (78.4%) thought that inhalation therapy was the choice of treatment for acute exacerbation of COPD. Two hundred and thirty-five of them (39.6%) knew that oxygen inhalation should be more than 15 hours per day in regular family therapy. The investigation showed that 365 (61.6%) general practitioners had participated in training for COPD-related knowledge, only one or two times a year. Awareness of COPD knowledge was significantly poorer in rural practitioners than that in urban community ones. Conclusions Basic knowledge of prevention and treatment for COPD was seriously lack in general practitioners, so it is a necessity to strengthen training for them.

Objective To evaluate the clinical value of epicardial echocardiographic examination in cardiac valve surgery.Methods Epicardial echocardiography were performed in 46 patients undergoing valvular plasty or valvular replacement surgery to estimate the function of valve and left ventricle and residual shunt during cardiac surgery.Results Twelve cases of 46(26.1％)showed abnormality during cardiac surgery.Two cases of 15 patients performed valvuloplasty were changed to valvular replacement because of remarkable regurgitation of native valves.There was 1 case of periprosthetic leakage,3 cases of left atrial appendage thrombus,1 case of patent foramen ovale and 5 cases of low ejection of left ventricle in all 31 cases of valvular replacement.Conclusions Epicardial echocardiograpyc examination is an effective examination in cardiac valve surgery with clearly image,simplicity operation and promptness.

Objective To investigate the effect of low-dose hydrocortisone(HC)on hippocampus nuclear factor kappa B((NF-?B)),I?B expression in lipopolysaccharide(LPS)induced septic rats and the role of NF-?B signal transcription pathway in pathogenesis.Methods Fifty-four rats were randomly divided into 3 groups: control group(A group,n=6),model group(B group,n=24),low-dose HC treatment group(C group,n=24).The septic rat model was established by intraperitoneal injection LPS(1 mg/kg),as the intervention by caudal vein injection low-dose HC(6 mg/kg),each of B and C group was subdivied into 2,8,16,24 hours respectively after LPS injection(n=6).At serial time points,the animals in each group were sacrificed,brain tissue samples were harvested to determine NF-?B,I?B expression by immunhistochemistry in hippocampus.Results In B group: NF-?B expression was up regulated compared with A group(P

Objective To observe the change of gastric mucosal-arterial partial pressure of carbon dioxide gap [p(g-a)(CO2)] in septic shock rabbit.Methods Sixteen anesthetized and mechanically ventilated rabbit were randomly assigned to 2 groups:shock group(n=8) and control group(n=8).The rabbit in shock group were challenged with intravenous injection of 2 mg/kg Lipopolysaccharides from Escherichia coli.The rabbit in control group were intravenous injection of normal saline solution.Mean arterial pressure(MAP) and heart rate were continuously recorded by multichannel physiologic recorder.Cardiac index(CI) and superior mesenteric blood flow index(SMBFI) were continuously monitored by doppler flowmeter.Gastric mucosal partial pressure of carbon dioxide [pg(CO2)] was evaluated by gas tonometry every 10 min.Arterial and venous blood gas analysis,hemoglobin,and lactate levels were measured every 1 hour.Results The parameters remained stable in control group,but the parameters changed significantly in shock group.Compared with baseline levels,2 hours after Lipopolysaccharides infusion in shock group,MAP decreased from(78?5) mmHg to(50?2) mmHg(1 mmHg=0.133 kPa)(F=145.3 P