Humans ; Hypertension, Pulmonary ; Sleep Apnea Syndromes

Cells, Cultured ; DNA Damage ; drug effects ; Dimethylformamide ; administration & dosage ; toxicity ; Dose-Response Relationship, Drug ; Hepatocytes ; drug effects ; pathology ; Humans

Chromosome Aberrations ; Combined Modality Therapy ; Humans ; Killer Cells, Natural ; pathology ; Lymphoma, T-Cell ; etiology ; genetics ; pathology ; therapy ; Nose Neoplasms ; etiology ; genetics ; pathology ; therapy ; Prognosis

Animals ; Female ; Gonads ; physiopathology ; Hypothermia ; chemically induced ; physiopathology ; Male ; Rats ; Rats, Wistar ; Sex Factors ; Soman ; adverse effects ; pharmacology

Objective To investigate the distribution and drug resistance of the gram positive bacteria isolates from hospital in Chongqing during 2006-2011 .Methods Non-repetitive gram positive bacterias were collected retrospectively from ten hospitals in Chongqing .Antimicrobial susceptibility testing of all clinical isolates were carried out using Kirby-Bauer(KB) .Results 14 473 strains were isolated .There were 4 840 strains of Staphylococcus aureus (33 .4% ) ,2 566 strains of Staphylococcus epidermidis (17 .7% ) ,1 822 strains of Staphylococcus haemolyticus (12 .6% ) ,1 325 strains of Enterococcus (E .faecalis/E .faecium )(9 .2% ) . Staphylococcus was highly sensitive to nitrofurantoin ,rifampicin ,piperacillin/tazobactam ,linezolid ,teicoplanin and vancomycin ,but their resistance rate to ampicillin/sulbactam ,oxacillin ,penicillin and clarithromycin was high .The resistance rate of E .faecium to the majority of antimicrobial agents was obviously higher than that of E .faecalis ,excluding imipenem ,chloramphenicol and tetracy-cline .Vancomycin and linezolid still remain the strongest antibacterial activity to Enterococcus .Conclusion The distribution and drug resistance of pathogenic bacteria in Chongqing present regional particularity ,and antibiotic resistance is severe .It is significant to strengthen the epidemiology study of pathogenic bacteria and to develop policies to intervene in the use of antimicrobial agents .

Objective To study the process of removing bacterial endotoxins by ultrafiltration technology in dextran 40 injection. Methods Dextran 40 solution was ultrafiltrated by 100,200,and 300 kDa aperture ultrafiltration membranes with composite, PES and PVDF materials. In order to optimize ultrafiltration process,the content of effective component and endotoxins were detected by HPLC and kinetic-turbidimetry,respectively,and the change of particle size distribution in dextran 40 solution was analyzed before and after ultrafiltration. Results The transmittance of dextran 40 was close to the same MWCO and different membrane material. When MWCO reached 300 kDa,the transmittance was above 91%,which met the requirement of filtration. The endotoxin removal rates by 100-300 kDa composite ultrafiltration membranes were more than 99%. But the endotoxin removal rates of both of PES and PVDF membranes were less than 40%,which were unable to guarantee the removal efficiency of the endotoxin in dextran 40 solution. The particle size declined after ultrafiltration by 300 kDa composite membrane, and level of the insoluble particles decreased. Conclusion The 300 kDa composite ultrafiltration membrane can effectively remove endotoxin in dextran 40 solution with less main components loss. The material can meet requirements for producing dextran 40 injection.

Objective To evaluate the effect of combination transfer pump and single blood pump to 32 cases of renal failure patient who need blood purification therapy.Methods The combination transfer pump and single blood pump were used.According to the clinical requirement,the parameters of transfer pump were set such as therapy time,replacement liquid flow rate,dialysate flow rate,temperature of warmer and filtrate flow rate,etc.Results 32 patients with varying degrees of illness have been alleviated.Patients' acute left heart failure,water and electrolyte turbulences,acid intoxication and azotemia caused by liquid retention were corrected,which ensured a role for further treatment.Conclusion It is the functions of adjustable time and transfusion volume that are used in the combination transfer pump,the task of which is accomplished by several transfer pumps together.This method is easy to implement and can meet the clinical requirement largely without special CBP instrument.

Objective To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock.Methods A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled. The patients satisfied ARDS Berlin diagnostic criteria, over 15 years old, needing vasopressor after fluid resuscitation were enrolled. The patients were divided into norepinephrine group (NE group) and terlipressin group (TP group) by randomise number table derived by computer. Patients in TP group were given terlipressin (0.01-0.04 U/min) with an intravenous pump, while those of NE group were given norepinephrine (> 1μg/min) with an intravenous pump, and the target mean arterial pressure (MAP) was maintained at 65-75 mmHg (1 mmHg = 0.133 kPa). Hemodynamics and extravascular lung water index (EVLWI) were monitored by pulse indicator continuous cardiac output (PiCCO). The volume responsiveness of patient was evaluated by passive leg raising (PLR) test, and cardiac index (CI) change (ΔCI ≥ 10%) served as positive volume responsiveness. The differences in hemodynamics, EVLWI, oxygenation index (OI), lactate clearance rate (LCR), rate of positive volume responsiveness, urinary output, fluid volume balance, renal function, and prognostic indicators were compared between the two groups.Results Fifty-seven patients with ARDS complicated with septic shock were enrolled, with 26 patients in NE group, and 31 patients in TP group, thebaseline data in both groups was balanced with comparability. Compare with NE group, 48-hour and 72-hour heart rate (HR) in TP group was significantly slowed (bpm: 82.1±6.8 vs. 87.6±7.4, 81.3±6.1 vs. 85.6±8.3, bothP < 0.05), 72-hour central venous pressure (CVP) was significantly decreased (mmHg: 9.4±2.6 vs. 10.9±3.0,P < 0.05), but no significant difference was found in HR, MAP, CVP, CI, EVLWI, OI and LCR at other time points between the two groups. 48-hour and 72-hour positive volume responsiveness rate in TP group were significantly increased as compared with those of NE group (74.2% vs. 46.2%, 64.5% vs. 38.5%, both P < 0.05), urinary output on the 2nd day (mL/24 h: 2342.8±704.1 vs. 1944.6±684.3) and fluid volume balance (mL: -319.7±54.8 vs. -169.6±27.2) were significantly decreased (bothP < 0.05). There was no significant difference in positive volume responsiveness rate, urine output, fluid volume balance, and the level of serum creatinine at other time points between the two groups. There was no statistically significant difference in the following features between TP group and NE group: duration of mechanical ventilation (days: 8.41±2.97 vs. 9.67±3.56), length of intensive care unit (ICU) stay (days: 12.84±4.47 vs. 14.77±5.01), total length of hospital stay (days: 19.34±7.37 vs. 21.07±8.41), and 28-day mortality (29.0% vs. 30.8%, allP > 0.05).Conclusions Compared with norepinephrine, terlipressin for ARDS patients with septic shock is more conducive to restrict fluid load, improve the renal perfusion and increase urine output. However, in both groups therewas no significant difference in the efficiency of stabilizing hemodynamics, shortening the duration of mechanical ventilation, reducing ICU or hospital days and decreasing 28-day mortality.

Objective To explore the influence of different positive end-expiratory pressure (PEEP) levels on cerebral blood flow (CBF) and cerebrovascular autoregulation in patients with acute respiratory distress syndrome (ARDS).Methods A prospective study was conducted.Moderate or severe ARDS patients admitted to Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st,2013 to October 1st,2013 were enrolled.The changes in hemodynamics,respiratory mechanics and gas exchange under different levels of PEEP were observed.CBF velocity of middle cerebral artery (MCA) was measured using transcranial Doppler (TCD),and breath-holding index (BHI) was also calculated.Results 35 patients with ARDS were included.The oxygenation index (OI),peak inspiratory pressure (PIP),plat pressure (Pplat) and central venous pressure (CVP) were markedly elevated [OI (mmHg,1 mmHg=0.133 kPa):324.7± 117.2 vs.173.4± 95.8,t=5.913,P=0.000; PIP (cmH2O):34.7 ± 9.1 vs.26.1 ± 7.9,t=4.222,P=0.000; Pplat (cmH2O):30.5 ± 8.4 vs.22.2 ± 7.1,t=4.465,P=0.000; CVP (mmHg):12.1 ± 3.5 vs.8.8 ± 2.2,t=4.723,P=0.000] when PEEP was increased from (6.4 ± 1.0) cmH2O to (14.5-± 2.0) cmH2O (1 cmH2O=0.098 kPa).But no significant difference in the heart rate (beats/min:85.5 ± 19.1 vs.82.7 ± 17.3,t=0.643,P=0.523),mean arterial pressure (mmHg:73.5 ± 12.4 vs.76.4 ± 15.1,t=0.878,P=0.383) and CBF velocity of MCA [peak systohc flow velocity (Vmax,cm/s):91.26 ± 17.57 vs.96.64 ± 18.71,t=1.240,P=0.219; diastolic flow velocity (Vmin,cm/s) 31.54 ±7.71 vs.33.87 ±8.53,t=1.199,P=0.235; mean velocity (Vmean,cm/s) 51.19 ± 12.05 vs.54.27 ± 13.36,t=1.013,P=0.315] was found.18 patients with BHI＜0.1 at baseline demonstrated that cerebral vasomotor reactivity was poor.BHI was slightly decreased with increase in PEEP (0.78 ± 0.16 vs.0.86 ± 0.19,t=1.905,P=0.061).Conclusions Some of moderate or severe ARDS patients without central nervous system disease have independent of preexisting cerebral autoregulation impairment.However,independent of preexisting cerebral autoregulation may not further be impaired when a high PEEP was chosen.

Objective:To detect the expression of IL-17A、IL-10 and IFN-? in patients wth different forms of inflammatory bowel disease(IBD) during clinical remission phase and investigate their role in the onset and treatment of IBD.Methods:Tissue samples were obtained from patients with ulcerative colitis(UC,n=46),Crohn's disease(CD,n=12),and normal colorectal tissues(n=20).IL-17A expression was evaluated by a standard immunohistochemical procedure.Serum IL-17A、 IL-10 and IFN-? levels were determined by ELISA.Results:IL-17A expression was not detected in samples from normal colonic mucosa but was present in the mucosa of IBD.The level of IL-17A significantly increased in IBD patients while it was not detected in the sera of normal individuals.The level of IL-10 in patients with Crohn's disease was significantly higher than that in patients with ulcerative colitis and control group(P