Objective To explore the efficacy of different modes of fluid resuscitation (early or delayed use of norepinephrine) on lung injury of septic shock rat induced by LPS.Methods A total of 60 male Wistar rats were randomly (random number) divided into 4 groups:the normal control group (group A,n =15),septic shock control group (group B,n =15),conventional fluid resuscitation group (group C,n =15),fluid resuscitation with early using of norepinephrine group (group D,n =15).All rats were mechanically ventilated with the same parameters.In the group C,norepinephrine was used 30 min after fluid resuscitation.In the group D,norepinephrine was used at the beginning of fluid resuscitation.Vital signs,volume of fluid infused and dosage of norepinephrine were recorded.Rats were sacrificed 2 h later and blood samples were collected for blood gas analysis.The lung tissues and BALF were collected.Pathological changes of the lung tissues were observed under light microscope.The levels of MPO,SOD and MDA were detected.The levels of IL-6,IL-8 and TNF-α in BALF and in serum were detected by using ELISA.Results Compared with group C,the mean volume of fluid infusion to achieve target blood pressure was decreased,oxygenation index was improved and the level of blood lactic acid were decreased in group D (P ＜ 0.05).HE staining indicated that inflammatory cells were decreased,pulmonary edema and alveolar walls hyperemia were alleviated in group D in comparison with group C.Inflammatory cytokines (IL-6,IL-8 and TNF-α) in BALF and in serum were significantly decreased in group D compared with group C (P ＜0.05).Levels of MPO were decreased in group D compared with group B and group C.However,early using of norepinephrine had limited effect on the levels of SOD and MDA.Conclusions The current study demonstrated that fluid resuscitation with early use of norepinephrine exhibited a protective effect on lung injuries induced by LPS.

Objective To explore the risk factors of acute organophosphorus pesticide poisoning(AOPP). Method The patients with acute organophosphorus pesticide poisoning,admitted from September 2004 to August 2005,were retrospectively analyzed.The 87 patients were divided into groups according to the presence or absence of combined conditions including hypotension,hypoxemia or metabolic acidosis.Acute physiology and chronic health evaluationⅡ(APACHEⅡ)score was calculated.The chi-square test was used to examine the mortality between those groups.Results The total in-hospital mortality of 87 acute organophosphorus pesticide poisoning patients was 21.8%.The mean APACHEⅡscore was(7.58?5.32)in the 68 survivors and(21.17～9.46)in the 19 dead,there were significant differences between the survivors and the dead(t=9.25,P20 was 65.2%(15/23),andit was 6.3% (4/64)in patients with APACHEII score

Diabetic microangiopathy is one of the most common chronic diabetic complications,which is associated with the genetic predispositions and environmental factors.Well-controlled blood glucose alone can not reduce the morbility or prevent the process of diabetic microangiopathy.The therapy aiming at the pathogenesis is an urgent request.The various proteins related to the development and progression of diabetic microangiopathiy were reviewed,aiming at providing the potential target for early diagnosis and efficient therapy.

Objective To explore the clinical value of respiratory index(RI) and oxygenation index(OI)dynamic monitoring in neonatal respiratory distress syndrome(NRDS) during mchanical ventilation.Methods According to prognosis,24 newborns with NRDS who had not be treated with pulmonary surfactant in NICU of Chengdu maternal and child health hospital from Dec.2006 to Nov.2007 were divided into 2 groups.There were 16 newborns in survival group and 8 newborns in death group.The changes of RI,OI,p(A-a)(O2) and pa(O2) were stu-died at 2,24,48 h after using of synchronized intermittent mandatory ventilation and before ventilation weaning.Results In the early periods,there were significant differences in RI,OI and p(A-a)(O2) between the survival group and the death group(t=2.47,2.62,3.01 Pa

Objective To analyze the relation between the CT changes of ventricular volume and prognosis in newborn of perinatal hypoxic-ischemic brain damage.Methods From Jan. 2002 to Dec. 2006, 105 newborns with perinatal hypoxic-ischemic brain damage (moderate to severe) were divided into 2 groups (group A with nervous system sequel and group B without nervous system sequal). Brain CT was performed in 24 hours after admission in all cases and at 1 and 3-month time point in some cases according to their convalescence condition. Huckman index,the third ventricular width on CT images of various time points were measured and calculated by radiologist. The relations between the values and prognosis were analyzed statistically.Results The huckman index increased gradually with rehabil (P

Objective To analyze the status of multiple organ failure in patients with acute poisoning and to investigate the relationship between sequential organ failure assessment (SOFA) and prognosis. Method A retrospective review of 76 patients admitted to emergency intensive care unit in the First Affiliated Hospital of China Medical University for acute poisoning was carried out. Data about heart rate, blood pressure, blood oxygen saturation, blood gas analysis, rutine blood examination (WBC,platelet,albumin, ALT,total bilirubin, BUN,creatinine, CK, CK-MB, blood glucose), dosage of vascular active agents and mental status were documented at admission and 48 h after admission. SOFAs were counted at admission (SOFA ) and 48 h after admission (SOFA ) and then a comparison was made between survivors and victims. Results There was no significant difference in SOFA between survivors and victims ( P = 0.26) , but significant difference in SOFA48 as well as SOFA was shown between survivors and victims (P < 0.01). Multivariate logistic regression analysis indicated that the SOFA48 of renal and nervous systems were the independent predictors with acute poisoning (P = 0.003 and 0.012 respectively). Spearman correlation analysis implicated that ALT,CK-MB, WBC,base excess (BE) and blood glucose (BG) had correlation with SOFAs48. Conclusions SOFA shows its score eorrellated with the prognosis of poisoning with a-cute poisoning and it is a practical method in eveluating the outcome of patients with acute poisoning.

Adolescent ; Adult ; Dermatitis, Occupational ; etiology ; immunology ; Female ; Humans ; Male ; Middle Aged ; T-Lymphocyte Subsets ; drug effects ; immunology ; Trichloroethylene ; adverse effects ; Young Adult

Objective To study the changes of transforming growth factor-β1(TGF-β1) in pulmonary fibrosis induced by paraquat (PQ) with immunohistochemistry method. MethodsA total of 58 C57BL/6J male mice were randomly (random number) divided into the experimental group and control group. Pulmonary fibrosis was induced by intra-peritoneal injection of PQ in dose of 10 mg/kg into the mice of experimental group (n = 48), while physiological saline was used instead in mice of control group (n = 10). The mice of experimental group were sacrificed 2, 5, 7 and 14 days after PQ poisoning and the mice of control group were sacrificed on the 7th day after saline administration. Lungs of mice were taken and histological changes in lungs were evaluated by haematoxylin-eosin stain, and TGF-β1 was determined with immunohistochemistry method. The integrated optical density (iOD) value of TGF-β1 was measured and analyzed. ResultsThe TGF-β1 was markedly increased in macrophages during the genesis of pulmonary fibrosis induced by PQ. As the course of fibrosis progressed, the positive staining of TGF-B1 was mainly seen in macrophages and neutrophil's cytoplasm. On the 14th day after PQ poisoning, TGF-β1-positive cells were also detected in the fibroblast and myo-fibroblast inside the fibroblastic foci. Compared with the control group, the iOD value of TGF-β1 increased in experimental group (P ＜ 0. 01 ) and it gradually upgraded during the course of fibrosis. Conclusions The TGF-β1 significantly increased during the course of pulmonary fibrosis induced by PQ and played an important role in the pathogenesis of the disease.

Objective To explore the diagnostic value of gram-stained sputum smears in elderly patients with ventilator-associated lower respiratory infection (VALRI).Methods 368 elderly patients undergoing mechanical ventilation over 48 hours in ICU were retrospectiely analyzed from Jun 2009 to Jun 2011.42 patients fulfilled the inclusion criteria (with good-quality sputa and presence of the same microorganism in sputum and blood cultures).58 gram-stained smears and sputum cultures were obtained and analyzed.Results The diagnostic sensitivity and specificity of Gram-positive bacteria and Gram-negative bacteria by gram-stained smears were 82.35％ and 78.05％,80.49％ and 82.35％,respectively.The positive and negative predictive value of Gram-positive bacteria and Gramnegative bacteria were 63.64％ and 91.43％,91.67％ and 60.87％,respectively.The coincidence rates in diagnosing Gram-positive bacteria and Gram-negative bacteria were 81.03％ and 79.31％,respectively.Conclusions Gram-stained sputum smear is reliable in diagnosing ventilator-associated lower respiratory infection in elderly patients,and has a certain clinical significance in guiding to the selection of antibiotics.

Objective To evaluate the value of endometrial volume measurement and 3-dimensional power Doppler imaging(3D-PDI) in the differentiation between endometrial polyps and endometrial hyperplasia.Methods One hundred and fifty-six women who diagnosed as thick and inhomogeneous endometrium or hyperechogenic focal intrauterine structures by 2D ultrasound were enrolled,including 50 patients with endometrial polyps in the proliferative phase,51 cases with hyperplasia and 55 cases with normal histology or others.All were scheduled for hysteroscopy,dilatation and curettage,and the ultrasound was performed within 24 hours before the procedure. Endometrial volume, vascularity index (VI), flow index (FI) and vascularity flow index (VFI) were measured. These parameters were compared between endometrial polyps group and endometrial hyperplasia group.Results These parameters (endometrial volume,VI,FI and VFI) were all considered statistically significant between two groups.Conclusions Endometrial volume and 3D-PDI are good diagnostic tools in the differentiation between endometrial polyps and endometrial hyperplasia.