Résumé
Objective To evaluate the treatment effect of sustained low-efficiency diafiltration( SLEDF) on patients with severe acute pancreatitis( SAP). Methods Forty-two patients with SAP were randomly divided into continuous veno-venous hemofiltration( CVVH)group with 22 patients and SLEDF group with 20 patients. In addition to routine treatment,patients in CVVH and SLEDF were administrated to patients respectively in two groups. Mortality,incidence of complication,clinical symptoms,sign and laboratory examination and recovery time were recorded and measured. The scores of acute physiology and chronic health evaluation( APACHE)II and multiple organ dysfunction syndrome( MODS ) were performed. The level of C-reactive protein( CRP ),tumor necrosis factor-α( TNF-α),interleukin( IL )-6 and IL-8 were measured. Results There were no significant differences in terms of the mortality(90. 91% vs. 90. 00%;χ2 =0. 010,P=0. 920),incidence of complication (18. 18% vs. 20. 00%;χ2 =0. 023,P =0. 881)and recovery time of clinical symptoms,sign and laboratory examination in CVVH group and SLEDF( P﹥0. 05 ). There were also no significant differences between CVVH and SLEDF group in terms of scores of APACHE II((12. 1 ± 6. 1)vs.(11. 9 ± 7. 2);t=0. 097,P=0. 920), MODS((4. 3 ± 1. 7)vs.(4. 4 ± 1. 8);t=0. 185,P=0. 850),CRP((161. 7 ± 22. 9)mg/L vs.(157. 6 ± 21. 8) mg/L;t=0. 594,P=0. 550),TNF-α((5. 8 ± 1. 9)ng/L vs.(5. 7 ± 1. 8)ng/L;t=0. 175,P=0. 860),IL-6 ((4. 1 ±1. 2)pg/L vs.(4. 2 ± 1. 1)pg/L;t =0. 282,P =0. 780)and IL-8((3. 3 ± 1. 4)pg/L vs.(3. 2 ± 1. 0)pg/L;t=0. 268,P=0. 790)at 72 h post-treatment. However,the above test indices were decreased at 72 h post-treatment than those at admission(P﹥0. 05). Conclusion SLEDF and CVVH are proved with same treatment effect based on the levels of inflammatory cytokine,alleviating pathogenetic condition and improving prognosis in patients with severe acute pancreatitis.
Résumé
Objective To investigate the effects of ulinastatin on renal expression of endothelin ̄1 and nitric oxide (NO) in rats with toxic acute kidney injury(AKI). Methods Twenty ̄four male SD rats were randomly divided into the normal control group,model control group and treatment groups, with 8 rats in each group. Except normal control group, rats were subcutaneously injected with gentamicin (300 mg.kg-1 .d-1 ) for 3 days to establish a model of toxic AKI.Rats in the treatment group were intraperitoneally injected with a 7 ̄day course of ulinastatin (30 000 U.kg-1 .d-1 ) from the fourth day.While the other two groups were injected with 0.9% sodium chloride injection (3 mL.kg-1 .d-1 ). The serum level of creatinine and cystatin ̄C,urinary concentration of kidney injury molecule ̄1(Kim ̄1) and neutrophil gelatinase ̄associated lipocalin (NGAL), level of endothelin ̄1 and NO,expression of endothelin ̄1 mRNA,endothelial nitric oxide synthase (eNOS),induced nitric oxide synthase (iNOS),eNOS mRNA and iNOS mRNA in homogenate of renal tissues in each group were detected on the eleventh day. Results Compared with the normal control group,serum level of creatinine and Cystatin ̄C,urinary concentration of Kim ̄1 and NGAL,level of endothelin ̄1 and NO,expression of endothelin ̄1 mRNA,iNOS and iNOS mRNA in homogenate of renal tissues were higher in model control group (P<0.01, respectively), while which were lower in treatment group than those in model control group ( P < 0. 01, respectively). And no statistical significant difference of eNOS and eNOS mRNA expression in homogenate of renal tissues existed among the three groups. Conclusion Ulinastatin possesses curative role against rat with toxic AKI via down ̄regulating renal expression of endothelin ̄1,NO and iNOS.
Résumé
Objective:To compare the efficacy and safety of ropivacaine and bupivacaine in combined spinal epidural anesthesia in abdominal operation. Methods:Totally 86 abdominal operation patients with combined spinal epidural anesthesia were randomly divid-ed into group A and group B with 43 ones in each. Group A was with ropivacaine anesthesia, while group B was with levobupivacaine anesthesia. The anesthesia effect, hemodynamic changes at different time points and adverse drug reactions were compared between the two groups. Results:The duration of sensory block in the two groups was not statistically different (P>0. 05), while the patients in group A had shorter motor nerve recovery time than those in group B (P0. 05). During the operation, the parameters at different time points in group A had no significant difference from those in group B (P>0. 05). The incidence of adverse drug reaction was not statistically significant between the two groups as well (P>0. 05). Conclusion:Ropivacaine and levobupivacaine show similar blocking effect on the sensory nerve with the same effects on hemodynamics and adverse reactions, however, the blocking effect of ropivacaine on motor nerve is weaker, which is more beneficial to the early exercise of the patients after operation.
Résumé
Objective To investigate the protective effect and its mechanism of edaravone against rat renal tubular epithelial cell injury induced by cisplatin. Methods The rat renal tubular epithelial cells (NRK-52E) were divided into the control, model control (50μmol·mL-1 cisplatin), group A (50μmol·mL-1 cisplatin plus 10μmol·mL-1 edaravone), B (50μmol·mL-1 cisplatin plus 20 μmol·mL-1 edaravone), and C (50 μmol·mL-1 cisplatin plus 40 μmol·mL-1 edaravone). The cell proliferation ability, content of malondialdehyde, activity of superoxide dismutase(SOD), level of reactive oxygen species ( ROS) , rate of apoptosis, express of protein and mRNA of Bax, Bcl-2 and Caspase-3 activation of cell were detected. Results The proliferation and SOD activity in NRK-52E cells declined, malondialdehyde and ROS were elevated upon being co-cultured with cisplatin. Moreover, the rate of apoptosis, express of protein and mRNA of Bax and Bcl-2, and Caspase-3 activation of cells were upregulated compared to the control group. However, edaravone stimulated cell proliferation, SOD activity and protein and mRNA of Bcl-2 and lowered content of malondialdehyde, level of ROS, rate of apoptosis, express of Bax protein and mRNA and Caspase-3 activation of cell(P<0. 05). Conclusion Edaravone can alleviate rat renal tubular epithelial cell injury induced by cisplatin, via inhibiting oxidative stress and down-regulating cell apoptosis.
Résumé
Objective To explore the curative effect of ulinastatin against toxic acute kidney injury(AKI) in rats and its mecha-nism .Methods Twenty-four male SD(Sprague Dawley) rats were randomly divided into 3 groups ,control group ,model group and treatment group with 8 rats in each group .Rats were subcutaneously injected gentamicin(300 mg/kg of body weight per day) for 3 days to establish models of toxic AKI .Rats in treatment group were intraperitoneally injected with a 7-day course of ulinastatin(30 000 U/kg of body weight per day) from 4th day .Dectetion of serum level of creatinine and Cystatin-C(Cys C) ,urinary concentra-tion of kidney injury molecule-1 (Kim-1 ) and neutrophil gelatinase-associated lipocalin (NGAL ) ,activity of superoxide dismutase (SOD) and glutathione peroxidase(GSH-Px) ,content of malondialdehyde ,levels of tumour necrosis factor-alpha(TNF-α) and inter-leukin-1β(IL-1β) in homogenate of renal tissues as well as observation of renal pathological changes and semiquantitative score in each group were conducted on 11th day .Results In model group ,degeneration and necrosis of renal tubular epithelial cell ,dilatation of renal tubular cavity and inflammatory cell infiltration in renal interstitial were observed .Renal pathological changes were milder in treatment group ,when compared with the model group .Renal pathological semiquantitative score ,serum level of creatinine and Cys C ,urinary concentration of Kim-1 and NGAL ,content of malondialdehyde ,levels of TNF-α and IL-1β in homogenate of renal tissues were higher in model group than in control group ,while those in treatment group were lower than in model group(P<0 .01 , respectively) .And activity of SOD and GSH-Px in homogenate of renal tissues were lower in model group than in control group ,and those in treatment group were higher than in model group and control group(P<0 .01 ,respectively) .Conclusion Ulinastatin pos-sesses a curative role in toxic AKI in rat via inhibiting oxidative stress and down-regulating levels of proinflammatory factor in renal tissues .
Résumé
Objective To explore the value of combined measurement of urine N-acetyl-beta-D-glucosaminidase (NAG) activity and serum Cystatin C in diagnosing diabetic nephropathy (DN) in early phase. Methods Sixty-two cases with type 2 diabetes (diabetic group) were divided into three groups according to their 24 hours urinary albumin excretion (24hUAE) : group A (normal albuminuria, 20 cases), group B (microalbuminuria, 22 cases) and group C (macroalbuminuria, 20 cases). Furthermore, 30 healthy people were involved in control group. 24hUAE,NAG,serum creatinine (SCr) and serum Cystatin C were measured, and endogenous creatinine clearance rate (Ccr) was calculated by Cockcroft-Gault formula. All these indexes among three groups were compared. Results The levels of urinary NAG activity and serum Cystafin C in diabetic group was significantly higher and Ccr was significantly lower than those in control group(P < 0.01). The levels of urinary NAG activity and serum cystatin C gradually increased in group A, B and C(P< 0.05 or < 0.01). While no significant difference was observed between group A and group B in the level of SCr (P > 0.05). There were significant positive correlations among the levels of urinary NAG activity, serum Cystatin C,24hUAE and SCr (P< 0.01),and all above showed negative correlations with Ccr (P<0.01). Co-detection of urinary NAG activity and serum Cystatin C had significantly higher positive rate [80.6%(50/62)] than single one [58.1%(36/62),61.3%(38/62)](P<0.05). Conclusion Co-detection of urinary NAG activity and serum Cystatin C may indicate early renal damage in DN, and it is valuable in diagnosing DN in early phase.
Résumé
sing guidewire through temporary catheter is an alternative strategy, because of avoiding this avoids vein re-puncturation and doesn't increase catheter related complication.
Résumé
Objective To investigate the distribution and quantitative changes in each marshland of Changsha section of the Xiang River and evaluate the effectiveness of snail control in recent years.Methods A snail survey was carried out by using the systematic and environmental sampling method for 5 years.Results Twenty-four marshlands were investigated continuously from 2003 to 2007.The number of marshland with snails accounted for 77.8%,66.7%,70.8%,75.0% and 62.5% of the each investigated year,respectively.The total number of marshlands with snails were 20 that accounted for 83.3% of all marshlands investigated over the five years.The number of snails and the rate of living snails were different in each marshland,but the downward trend was significant(P