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

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

OBJECTIVESTo explore the effects of aminoguanidine (AG) in different dosages on renal function in endotoxin induced rabbits shock model in the early stage and to approve the effects of dose-depended and time-depended of AG.

METHODSFourty New Zealand rabbits under anaesthesia were randomly divided into 5 groups: sham group, LPS group, the first group of AG, the second group of AG, the third group of AG. Each rabbits from the four groups received Escherichia Coli O55B5 LPS 400 micro g/kg to induce endotoxic shock except sham group. Edotoxic shock was diagnosed when the mean arterial pressure (MAP) decreased to 30%. Each rabbits in sham group and LPS group received 5ml NS, in the other three groups were infused with AG 30 mg/kg (the first group of AG), 50 mg/kg (the second group of AG), 100 mg/kg (the third group of AG) in 5ml NS, respectively. Urine output was recorded at the following time points, before injecting IPS (T(0)), shock (T), 1 h (T(1)), 2 h (T(2)), 3 h (T(3)), 4 h (T(4)), 5 h (T(5)) and 6 h (T(6)) after shock. Plasma nitrate and nitrite (NO(3)(-)/NO(2)(-), stable products of NO), BUN, Scr, RBP were determined at the time points of T, T(2), T(4) and T(6).

RESULTSLPS increased NO(3)(-)/NO(2)(-), BUN, Scr, RBP [from (47 +/- 5) micro mol/L, (5.8 +/- 1.5) mmol/L, (41 +/- 10) micro mol/L, (240 +/- 61) ng/L (T(0)) to (160 +/- 18) micro mol/L, (15.5 +/- 1.8) mmol/L, (166 +/- 23) micro mol/L, (1580 +/- 180) ng/L (T(6)), respectively, P < 0.01]; Urine output decreased significantly [from (17.6 +/- 2.8) ml (T(0)) to (1.3 +/- 0.6) ml (T(6)), P < 0.01]. AG attenuates the increasing of NO(3)(-)/NO(2)(-), BUN, Scr and RBP, and decreasing of urine output. NO(3)(-)/NO(2)(-) of the first, second and third group of AG at T(6) were (58 +/- 8), (50 +/- 14) and (46 +/- 9) micro mol/L, respectively. Compared to LPS group, there was a significant difference (P < 0.01). BUN was (8.2 +/- 2.9), (7.5 +/- 1.9) and (5.5 +/- 1.8) mmol/L, respectively at T(6). Compared to LPS group, there was a significant deference (P < 0.01). RBP was (350 +/- 60), (272 +/- 72) and (248 +/- 103) ng/L, respectively at T(6) (compared to LPS group, there was a significant deference. P < 0.05, < 0.05, < 0.01). Urine output was (11. 1 +/- 2.4), (12. 1 +/- 1. 3) and (17.1 +/- 2. 4) ml, respectively on T(6) (compared to LPS group, there was a significant deference, P < 0.01). AG of 100 mg/kg showed the best effect among three AG groups.

CONCLUSIONAG inhibited NO formation in dose-depended and time depended way. AG attenuated the changes of renal function induced by NO.

Animals ; Dose-Response Relationship, Drug ; Enzyme Inhibitors ; administration & dosage ; therapeutic use ; Female ; Guanidines ; administration & dosage ; therapeutic use ; Kidney Function Tests ; Male ; Nitric Oxide Synthase ; antagonists & inhibitors ; metabolism ; Rabbits ; Random Allocation ; Shock, Septic ; drug therapy ; Treatment Outcome

OBJECTIVETo investigate the effect of three kinds of drug with different mechanism, dexamethasone (Dex), aminoguanidin (AG) and amrinone (Amr) on oxygen utilization in endotoxic shock rabbits.

METHODSThirty-five rabbits were randomly allocated into five groups: operation, lipopolysaccharide (LPS), Dex, Amr and AG. The endotoxin shock was induced by intravenously injecting LPS (400 micro g/kg). The arterial blood gas, mixed venous blood gas and cardiac output were recorded at 30 min after the operation (T(0)), shock status (T), 1 - 6 h after the treatment (T(1)-T(6)). The oxygen delivery (DO(2)), oxygen consumption (VO(2)) and extraction ratio of oxygen (ERO(2)) were calculated.

RESULTSAll the parameters in five groups showed no significant differences (P > 0.05) at T(0). Six hours after treatment, rabbits in Dex group presented with significantly improved DO(2) (12.4 +/- 3.1) ml/(kg.min), P < 0.01 and VO(2) (5.1 +/- 1.6) ml/(kg.min), P < 0.05 compared with DO(2) (8.1 +/- 2.4) ml/(kg.min) and VO(2) (2.7 +/- 1.0) ml/(kg.min) in LPS group. Rabbits in AG group showed significantly increased DO(2) (17.0 +/- 2.8) ml/(kg.min) (P < 0.01), (17.2 +/- 2.5) ml/(kg.min) (P < 0.05), compared with (12.2 +/- 2.6), (14.1 +/- 3.8) ml/(kg.min) in LPS group at T(1) and T(2), respectively, but there was no significant difference (11.2 +/- 1.7) ml/(kg.min) (P > 0.05) at T(6). The VO(2) increased significantly, (5.0 +/- 1.0) ml/(kg.min) (P < 0.01) compared with LPS group at T(6). The VO(2) of Amr group was significantly higher than LPS group at T(3) and T(4). At T(6), the DO(2) and VO(2) were (9.5 +/- 1.3) and (4.1 +/- 1.5) ml/(kg.min), respectively, but there was no significant difference compared with LPS group. There was no significant difference in ERO(2) among groups (P > 0.05).

CONCLUSIONThe dexamethasone, aminoguanidin, amrinone can improve oxygen utilization in endotoxic shock rabbits, especially for dexamethasone and aminoguanidin.

Amrinone ; therapeutic use ; Animals ; Anti-Inflammatory Agents ; therapeutic use ; Dexamethasone ; therapeutic use ; Enzyme Inhibitors ; therapeutic use ; Female ; Guanidines ; therapeutic use ; Male ; Nitric Oxide Synthase ; antagonists & inhibitors ; Oxygen Consumption ; drug effects ; Phosphodiesterase Inhibitors ; therapeutic use ; Rabbits ; Shock, Septic ; drug therapy ; Treatment Outcome ; Vasodilator Agents ; therapeutic use

OBJECTIVETo simplify the Pediatric Critical Illness Scoring (PCIS), to evaluate the simplified PCIS and to make the simplified scoring system applicable in the grassroots hospitals.

METHODSTotally 1,036 patients were scored by PCIS on 1, 3, 7 and the last (discharged or dead) hospital days. The PCIS has 10 items. The full score is 100. The scores of approximately 100, approximately 80, and approximately 70 represent non-serious, serious, and extremely serious patients' condition. The PaO(2) and pH (2 items), BUN or creatinine (3 items), plasma sodium and potassium (5 items) were deleted from PCIS's 10 items in turn. The remaining 8, 7, and 5 items were applied as new scoring system after the original scores were multiplied by 0.8, 0.7, and 0.5. The simplified PCIS was evaluated by comparing the patients' condition that was assessed by PCIS. The consistency rate of patients' condition that was obtained by using PCIS and simplified PCIS should be over 80%. The mortality of non-serious, serious, and extremely serious groups that were defined by using PCIS and simplified PCIS was observed and compared.

RESULTSWhen 2, 3 and 5 items were deleted from the PCIS on d1 scoring the consistency rates of the patients' condition were 82.6%, 80.7%, and 69.9%. While 5 items remained on d1 scoring the consistency rate was lower than 80%. When the same 2, 3 and 5 items were deleted from PCIS on d3, d7 and last scoring, the consistency rates of the patients' condition were 81.5% approximately 97.1%. The PCIS and simplified PCIS had a close correlation (r = 0.629-0.948, P < 0.001). In PCIS the mortality rates of non-serious, serious and extremely serious patients were significantly different. When simplified PCIS was used, the mortality rates of the three groups also had significant differences (chi(2) = 86.13-740.33, P < 0.001). Within a group of patients with the same condition, the mortality rates were not significantly different for PCIS and simplified PCIS. For instance, on d1 and last scoring, the mortality rates of extremely serious patients were 29.8%, 67.3% for PCIS and 30.0%-27.9%, 66.3%-64.4% for simplified PCIS.

CONCLUSIONWhen 2 items (PaO(2) and pH) were deleted from d1 PCIS scoring and 5 items (PaO(2) and pH, BUN or creatinine, plasma sodium and potassium) were deleted from d3, d7, and last PCIS scoring, the results of assessment of patients' condition were basically the same as those of PCIS. The consistency rates of PCIS and simplified PCIS were > 80%. When simplified PCIS was applied, mortality rates of non-serious, serious, and extremely serious patients were significantly different that were the same as those of PCIS. In patients with the same condition, the mortality rates were not significantly different between the simplified PCIS and PCIS.

Adolescent ; Child ; Child, Preschool ; Critical Illness ; classification ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Severity of Illness Index

Objective To evaluate therapeutic effects of wedge resection on male paraurethral duct dilatation following gonococcal paraurethral duct infection. Methods With the aid of high-frequency ultrasound images, 11 male patients with paraurethral duct dilatation following gonococcal paraurethral duct infection were treated with wedge resection. The data were collected, including the surgical duration, amount of bleeding during the surgery, period of wound healing and complications. If the ostium beside the external urethral orifice disappeared within 4 weeks after the surgery, there was no discharge from the ostium with pressure, and no tubular echoic area was observed by high-frequency ultrasound imaging, the patient was considered to be recovered. If none of the above three conditions could be met, the surgical treatment was considered to be ineffective. Results The average surgical duration was 19.19 ± 2.71 minutes(range, 14-23 minutes), the average amount of bleeding during the surgery was 11.09 ± 2.07 ml (range, 8-14 ml), and the average period of wound healing was 14.91 ± 1.45 days(range, 13-17 days). Of the 11 patients, 10 were cured, and 1 showed no response. No complications were observed in any of the 11 patients, and no defects formed in the glans penis. Conclusion Wedge resection is a kind of effective therapy for paraurethral duct dilatation following gonococcal paraurethral duct infection in males.