Objective:To investigate the effect of septic shock rapid response team (SSRRT) on the compliance and prognosis of hour-1 bundle therapy strategy in emergency department patients with septic shock.Methods:This study was conducted on emergency patients with septic shock who were admitted to Huai’an First Hospital Affiliated to Nanjing Medical University from January 2020 to December 2021. The inclusion criteria were emergency patients with septic shock who met the international guideline for surviving sepsis campaigns (Sepsis 3.0). Exclusion criteria: age<18 years, pregnant patients, patients transferred from another hospital who had received fluid resuscitation and/or vasoactive drugs, patients requiring emergency surgery, patients with emergency detention time<1 h, patients who refused to place central venous catheterization or had contraindications for catheterization, and patients who refused to give informed consent. SSRRT was established in January 2021. According to the establishment of SSRRT, patients were divided into the pre-SSRRT intervention group and the post-SSRRT intervention group. The general clinical data of the enrolled patients were collected, including vital signs, lactate, fluid resuscitation volume, maximum vasoactive drug pumping rate at the diagnosis of septic shock, implementation of hour-1 bundle therapy strategies, and ICU and 28-day mortality. Statistical software SPSS 25.0 was used. Pearson chi-squared test was used to compare categorical variables between groups, and Mann-Whitney U test was used to compare continuous variables between groups.Results:A total of 289 emergency patients met the inclusion criteria, 115 patients were excluded, and 174 patients were eventually included, including 83 patients in the pre-SSRRT group and 91 patients in the post-SSRRT group. Compared with the pre-SSRRT group, the proportion of lactate monitoring (54.2% vs. 100.0%, P<0.001), blood culture (27.7% vs. 93.4%, P<0.001), antibiotics (57.8% vs. 97.8%, P<0.001), fluid resuscitation volume ≥ 30 mL/kg (4.8% vs. 34.1%, P<0.001), and mean arterial pressure ≥ 65 mmHg (49.4% vs. 68.1%, P<0.001) were significantly increased. There was no significant difference in ICU mortality (50.6% vs. 37.4%, P=0.079) or 28-day mortality (53.0% vs. 38.5%, P=0.054) between the two groups. Conclusions:SSRRT can significantly improve the compliance of hour-1 bundle therapy strategy implementation in patients with emergency septic shock, and has a trend of decreasing mortality.

Objective To analyze the epidemiological characteristics of adverse drug reaction (ADR) induced by Brucea Jananica Oil Injection,through literature review and to provide theoretical support for rational use in clinic.Methods With retrospective case study,analyzed ADR induced by Brucea Jananica Oil Injection,which were searched from revelent domestic pharmaceutical database from January 1990 to September 2016.Results Totaliy 76 cases were collected,and most were middle-aged and aged patients.Males patients were more than female patients (61.84％).ADR appeared in every period.The main ADRs of Brucea Jananica Oil Injection were allergic reactions (27.71％),digestive system damage (26.51％),and skin and accessories damage (19.28％).Conclusion Brucea Jananica Oil Injection can induced various ADRs and the occurrence of ADRs was associated with a variety of factors.Clinical monitoring should be enhanced,so as to ensure safety and efficacy of medication.

OBJECTIVETo study the prevalence of IgG4-positive plasma cells in Rosai-Dorfman disease and to assess the association between Rosai-Dorfman disease and IgG4-related sclerosing disease (IgG4-SD).

METHODSThe clinicopathologic features of 12 tissue samples of Rosai-Dorfman disease (11 extranodal and one nodal) from nine patients were reviewed. The degree of fibrosis and occlusive phlebitis was studied by HE staining. The expression of IgG4 and IgG in plasma cells were studied by immunohistochemistry (EnVision) and quantitatively analyzed by medical image analysis system.

RESULTSNine tissue samples showed different degree of fibrosis (four tissue samples were mild, one tissue sample was moderate and four tissue samples were severe) and two tissue samples showed occlusive phlebitis in the lesional tissue. Immunohistochemical study showed marked infiltration by IgG4-positive plasma cells (> 50 per high-power field) in four tissue samples, moderate infiltration (30 to 50 per high-power field) in two tissue samples, mild (10 to 29 per high-power field) in three cases and negative infiltration (< 10 per high-power field) in three tissue samples (P < 0.01). Three tissue samples fulfilled the diagnostic criteria of IgG4-SD (> 50 IgG4-positive plasma cells per high-power field and IgG4-to-IgG ratio > 40%), including one tissue sample each of Rosai-Dorfman disease in the left facial skin, above the left eye socket, and in the right parotid.

CONCLUSIONSSome cases of Rosai-Dorfman disease fulfill the diagnostic criteria and show the histologic features of IgG4-SD. They may represent members of the IgG4-SD spectrum. The detection of IgG4-positive plasma cells in the lesional tissues of Rosai-Dorfman disease may have clinical pathological significance.

Fibrosis ; Histiocytosis, Sinus ; diagnosis ; immunology ; Humans ; Immunoglobulin G ; chemistry ; Immunohistochemistry ; Phlebitis ; pathology ; Plasma Cells ; chemistry

Objective To study the prevalence of IgG 4-positive plasma cells in Rosai-Dorfman disease and to assess the association between Rosai-Dorfman disease and IgG4-related sclerosing disease (IgG4-SD) .Methods The clinicopathologic features of 12 tissue samples of Rosai-Dorfman disease (11 extranodal and one nodal) from nine patients were reviewed.The degree of fibrosis and occlusive phlebitis was studied by HE staining .The expression of IgG4 and IgG in plasma cells were studied by immunohistochemistry ( EnVision ) and quantitatively analyzed by medical image analysis system .Results Nine tissue samples showed different degree of fibrosis ( four tissue samples were mild , one tissue sample was moderate and four tissue samples were severe ) and two tissue samples showed occlusive phlebitis in the lesional tissue.Immunohistochemical study showed marked infiltration by IgG 4-positive plasma cells (>50 per high-power field ) in four tissue samples , moderate infiltration ( 30 to 50 per high-power field ) in two tissue samples,mild (10 to 29 per high-power field) in three cases and negative infiltration (<10 per high-power field) in three tissue samples (P <0.01).Three tissue samples fulfilled the diagnostic criteria of IgG4-SD (>50 IgG4-positive plasma cells per high-power field and IgG4-to-IgG ratio >40%), including one tissue sample each of Rosai-Dorfman disease in the left facial skin , above the left eye socket , and in the right parotid.Conclusions Some cases of Rosai-Dorfman disease fulfill the diagnostic criteria and show the histologic features of IgG 4-SD.They may represent members of the IgG 4-SD spectrum.The detection of IgG4-positive plasma cells in the lesional tissues of Rosai-Dorfman disease may have clinical pathological significance.

Objective Through observing the clinical effect and the changes of gastrointestinal hormones caused by the treatment of different moxibustion time of the superficial gastritis patients due to the spleen and stomach weakness,to investigate the regulation of the dose-effect relation and the adjustment function on gastrointestinal hormone of serum of patients caused by the warming and nourish effect with moxibustion.Methods Eighty-four superficial gastritis Patients due to the spleen and stomach weakness were divided into group 1(treated by warming moxibustion for twenty minutes)(n=28),group 2(treated by warming moxibustion for forty minutes)(n=28),and drug(n=28)groups.The changes of the content of the Prostaglandin E2(PGE2)、Somatostatin(SS)and Epidermal growth factor(EGF)were observed before and after treatment between 3 groups and the clinical effect in different time.Results ①All 3 groups were compared after treatment,their clinical effect had no significant difference(P＞0.05):②Compared with pre-treatment,the superficial gastritis symptom score had a very significant difference after the treatment(3.07±1.54)、(3.11±1.40)、(3.79±2.25)and during the 1 month follow-up(2.25±1.32)、(2.57±1.10)、(4.11±2.48),(P＜0.01);③After treatment,the content of the PGE2 of the serum was increased obviously,compared with pre-treatment.There was a significant difference in each group(33.751±1.267)pg/ml、(33.774±8.583)pg/ml、(32.583±8.259)pg/ml,(P＜0.05);After warming moxibustion for forty minutes,the content of the EGF of the serum was increased obviously,compared with pre-treatment,showing a significant difference(1.331±0.823)pg/ml,(P＜0.05).Conclusion ①All of the three treatment methods had significant curative effect,and the curative effect had no significant difference among these 3 groups.But the moxibustion groups were markedly higher than the drug group in long-term result;②The moxibustion had established adjustment function on gastrointestinal hormone of the superficial gastritis patients due to the spleen and stomach weakness,which suggested that the gastrointestinal hormone may participate in its onset and the process of pathology and physiology.