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1.

The coronavirus disease 2019 (COVID-19) pandemic is a major public health event caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has spread widely all over the world. A high proportion of patients become severely or critically ill, and suffer high mortality due to respiratory failure and multiple organ dysfunction. Therefore, providing timely and effective treatment for critically ill patients is essential to reduce overall mortality. Convalescent plasma therapy and pharmacological treatments, such as aerosol inhalation of interferon-α (IFN-α), corticosteroids, and tocilizumab, have all been applied in clinical practice; however, their effects remain controversial. Recent studies have shown that extracorporeal therapies might have a potential role in treating critically ill COVID-19 patients. In this review, we examine the application of continuous renal replacement therapy (CRRT), therapeutic plasma exchange (TPE), hemoadsorption (HA), extracorporeal membrane oxygenation (ECMO), and extracorporeal carbon dioxide removal (ECCO2R) in critically ill COVID-19 patients to provide support for the further diagnosis and treatment of COVID-19.

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2.
目的:探讨川芎嗪、当归注射液对失血性休克大鼠血液动力学的影响。方法:颈动脉放血复制大鼠失血性休克模型,通过微循环观察、器官血流和血液流变学测定方法,观察川芎嗪、当归注射液对失血性休克大鼠血液动力学的影响。结果:失血性休克时,微循环明显障碍,主要表现为微血流变慢和血细胞聚集;经川芎嗪、当归注射液治疗后,微循环改善,血粘度、血小板粘附率和聚集率降低,器官微区血流量增加,与NS组比较有显著性差异(P<0.05)。结论:川芎嗪、当归注射液能明显改善失血性休克大鼠微循环障碍,降低血小板聚集率,增加器官血液灌流量。  相似文献   

3.
Objective:To investigate the relationship between renal function and clinical outcomes among patients with acute ST-segment elevation myocardial infarction (ASTEMI), who were treated with emergency percutaneous coronary intervention (PCI). Methods: 420 patients hospitalized in Peking University First Hospital, diagnosed with ASTEMI treated with emergency (PCI) from January 2001 to June 2011 were enrolled in this study. Estimated glomerular filtration rate (eGFR) was used as a measure of renal function. We compared the clinical parameters and outcomes between ASTEMI patients combined renal insufficiency and the patients with normal renal function. Results:There was a significant increase in the concentrations of fibrinogen and D-Dimer (P<0.05) and a much higher morbidity of diabetes mellitus in the group of patients with chronic kidney disease (CKD; eGFR<60 ml/(min·1.73 m2)) (P<0.01). CKD (eGFR<60 ml/(min·1.73 m2)) was an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI receiving PCI therapy rapidly (P=0.032, odds ratio (OR) 4.159, 95% confidence interval (CI) 1.127-15.346). Conclusions:Renal insufficiency is an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI treated with primary PCI.  相似文献   

4.

Objective

To evaluate the clinical efficacy of levosimendan versus dobutamine in critically ill patients requiring inotropic support.

Methods

Clinical trials were searched in PubMed, EMBASE, and the Cochrane Central Registry of Clinical Trials, as well as Web of Science. Studies were included if they compared levosimendan with dobutamine in critically ill patients requiring inotropic support, and provided at least one outcome of interest. Outcomes of interest included mortality, incidence of hypotension, supraventricular arrhythmias, and ventricular arrhythmias.

Results

Data from a total of 3 052 patients from 22 randomized controlled trials (RCTs) were included in the analysis. Overall analysis showed that the use of levosimendan was associated with a significant reduction in mortality (269 of 1 373 [19.6%] in the levosimendan group, versus 328 of 1 278 [25.7%] in the dobutamine group, risk ratio (RR)=0.81, 95% confidence interval (CI) 0.70-0.92, P for effect=0.002). Subgroup analysis indicated that the benefit from levosimendan could be found in the subpopulations of cardiac surgery, ischemic heart failure, and concomitant β-blocker therapy in comparison with dobutamine. There was no significant difference in the incidence of hypotension, supraventricular arrhythmias, or ventricular arrhythmias between the two drugs.

Conclusions

In contrast with dobutamine, levosimendan is associated with a significant improvement in mortality in critically ill patients requiring inotropic support. Patients having cardiac surgery, with ischemic heart failure, and receiving concomitant β-blocker therapy may benefit from levosimendan. More RCTs are required to address the questions about no positive outcomes in the subpopulation in a cardiology setting, and to confirm the advantages in long-term prognosis.  相似文献   

5.
目的:研究复方金银花和茵陈五苓两种注射液对内毒素所致家兔肾衰中肾脏组织结构的保护作用。方法:将重量2.5±0.25kg的健康雄性家兔32只,随机分为对照组、模型组、复方金银花组和茵陈五苓组,每组8只。模型组、复方金银花组、茵陈五苓组家兔一次性静脉注射大肠杆菌O111B4内毒素生理盐水,剂量为100ug/kg。两保护组家兔注射内毒素24h后静脉注射剂量为100ug/kg的中药注射液。模型组家兔静脉注射同容积的生理盐水。对照组家兔静脉注射与内毒素溶液和中药注射剂等体积的生理盐水。静脉注射内毒素及生理盐水后第7h处死。取肾组织标本,Bouns液固定,石蜡切片,HE染色,显微观察并摄影。结果:模型组肾脏肾小体血管球肿胀,有血栓形成,肾小囊壁层内皮细胞脱落,肾小囊腔变小,肾小管内皮细胞脱落。复方金银花组、茵陈五苓组肾脏的肾小体血管球略有肿胀,肾小囊的内皮细胞较完整,肾小囊腔较对照组稍变小。结论:复方金银花与茵陈五苓对家兔因内毒素所致肾衰中肾脏组织结构有确实的保护作用。  相似文献   

6.
This study was carried out to elucidate the nephroprotective effects from a mixture of 8 L-amino acids and the possible mechanism of protection by this amino acid mixture. Acute renal failure model was induced by an intravenous administration of 10 mg/kg cisplatin to male Sprague-Dawley rats. A mixture of 8 L-amino acids or 0.9% saline was infused at a rate of 2 ml/h for 3 h, starting with a 2 ml bolus injection before cisplatin administration. Amino acids showed no acute effect on renal morphology. The infusion of a mixture of 8 L-amino acids increased GFR by 85% in control rats. The abnormalities of urine sodium and potassium excretion caused by cisplatin were markedly attenuated by the administration of the amino acid mixture. With the infusion of this amino acid mixture, cisplatin-induced abnormal state 4 respiration returned to control levels and the depressed state 3 respiration, respiratory control ratio and carbonyl cyanide p-trifluoromethoxyphenyl hydrazone-uncoupled respiration were ameliorated remarkably. A mixture of 8 L-amino acids showed marked nephroprotection against cisplatin-induced acute renal failure in rats and might function through augmentation of the cisplatin-injured renal mitochondrial electron transport-oxidative phosphorylation sequence, probably via stabilizing the membrane (including inner mitochondrial membrane) protein tertiary structure. In addition, this amino acid mixture remarkably increased GFR and decreased urine sodium excretion in rats.  相似文献   

7.
ＩＮＴＲＯＤＵＣＴＩＯＮＡｃｕｔｅｒｅｎａｌｆａｉｌｕｒｅ(ＡＲＦ),ｕｓｕａｌｌｙｒｅｆｅｒｒｅｄｔｏａｓａｃｕｔｅｔｕｂｕｌａｒｎｅｃｒｏｓｉｓ,ｉｓａｃｏｍｍｏｎｓｙｎｄｒｏｍｅｃｈａｒａｃｔｅｒｉｚｅｄｂｙａｎａｂｒｕｐｔａｎｄｓｕｓｔａｉｎｅｄｄｅｃｌｉｎｅｉｎｇｌｏｍｅｒｕｌａｒｆｉｌｔｒａｔｉｏｎｗｉｔｈｒｅｓｕｌｔａｎｔａｚｏｔｅｍｉａ,ｃａｕｓｅｄｂｙａｃｕｔｅｉｓｃｈｅｍｉｃａｎｄ/ｏｒｔｏｘｉｃｉｎｊｕｒｉｅｓ.Ｉｔｉｓｎｏｔｉｍｍｅｄｉａｔｅｌｙｒｅｖｅｒｓｉｂｌｅｗｈｅｎｃａ…  相似文献   

8.
Saline soil stabilization is being increasingly applied in foundation treatment engineering. Chloride saline soil obtained from sites and laboratory-made chloride soil (ZS) with various NaCl concentrations prepared artificially were stabilized using alkali-activated slag (AS). A series of unconfined compressive strength (UCS) tests, X-ray diffraction (XRD), energy-dispersive X-ray analysis (EDXA), thermal gravity-differential thermal gravity (TG-DTG), and ion concentration tests were conducted to investigate the strength variation and mechanism of the AS-stabilized chloride saline soils. The results showed that NaCl has a significant influence on the strength of AS-stabilized chloride saline soil and the strength of AS-stabilized ZS (GZS) increases with increase of chloride content in soil samples. Friedel’s salt (Fs) and NaOH are generated by the reaction of NaCl and CaO·Al2O3 (CA) in the slag in the GZS. Fs can fill the pores in stabilized soil, and NaOH can promote calcium silicate hydrate (CSH) generation. These two effects combine to enhance the strength of GZS. The relationship between the rate of increase of 28-d UCS of AS-stabilized chloride saline soil and the chloride content in soil was obtained through regression analysis of the increase of UCS of GZS.  相似文献   

9.
烧伤早期肾内皮素的变化的探讨   总被引：1，自引：0，他引：1  
多器官功能衰竭(MOF)是严重烧伤的重要死亡原因,其中急性肾功能衰竭(ARF)发生率占58%～64%,死亡率极高。既往的研究认为,严重烧伤早期肾功能损害是由于严重休克,肾脏缺血缺氧所致,但发病机理甚为复杂,迄今远未阐明。内皮素-1(Endothelin-1,ET-1)是目前已知的作用最强,时间最持久的内源性缩血管活性肽。基于它对肾血流、肾功能的强大调节作用,提示烧伤后肾功能损害与其可能存在密切关系。  相似文献   

10.
目的 分析门诊输液病人发生低血糖反应的原因,寻求预防方法.方法 对襄阳职业技术学院附属医院2012年1至12月门诊输液出现低血糖反应的病人进行原因分析.结果 出现低血糖反应者多为幼儿、老年人和老年糖尿病人,输液溶媒为盐水.结论 门诊输液病人出现低血糖的原因多样,尤以幼儿、老年及老年糖尿病人多见,早预防可防止其发生.  相似文献   

11.
盐湖矿产资源是我国十分紧缺和急需的资源。国家历来重视对盐湖矿产资源的开发，尤其是现阶段对柴达木地区盐湖矿产资源综合开发的力度会越来越大。盐湖矿产资源综合开发需要在战略上进行总体部署，在理论上进行深入细致的研究，在思想上做出统一的认识，这对全面推行柴达木地区经济发展将起到重要作用。  相似文献   

12.
To describe the long-term clinical outcomes of patients with autosomal dominant polycystic kidney disease (ADPKD) who are on peritoneal dialysis (PD) therapy. We performed a retrospective matched-cohort analysis comparing the clinical outcomes of 30 ADPKD patients with those of 30 non-diabetic patients who had bilateral small kidneys between July 1 2007 and July 31 2014. The patient groups were matched by age, gender, and time of PD initiation. There were no significant differences in the demographic or biochemical parameters, comorbid conditions, residual glomerular filtration rate, or Charlson comorbidity score at the beginning of PD. The median renal volume was 1315 ml for the ADPKD group and 213 ml for the control group. Patients with ADPKD had similar 3-year patient survival (90.6% versus 86.3%, P=0.807) and technique survival (89.2% versus 74.3%, P=0.506) compared with non-ADPKD patients. Also, there was no significant difference in the peritonitis-free survival between the ADPKD and control groups (P=0.22), and rates of peritonitis were similar (0.19 versus 0.21 episodes per patient-year, P=0.26). No differences were observed in the incidence of PD-related complications, such as hernia and dialysate leak. ADPKD is not a contraindication for PD, and a subgroup of ADPKD patients with relatively small kidney volume can be treated using PD.  相似文献   

13.
盐酸丙帕他莫和哌替啶用于肾绞痛的比较研究   总被引：1，自引：0，他引：1  
目的观察并比较盐酸丙帕他莫和哌替啶治疗肾绞痛的疗效及安全性。方法140名肾绞痛患者随机分为观察组和对照组各70例,观察组采用盐酸丙帕他莫2g溶于100ml生理盐水于15min静脉滴注,同时肌肉注射生理盐水1ml;对照组采用哌替啶50mg肌肉注射,同时静脉滴注100ml生理盐水15min。观察比较给药后1小时内两组的镇痛效果及不良反应。结果两组的镇痛效果无明显差异（P〉0．05）但不良反应比较有显著性意义（P〈0．01）。结论盐酸丙帕他莫与哌替啶用于’肾绞痛疗效相似,但不良反应少,值得临床推广。  相似文献   

14.
Objective： To investigate the dynamics of vascular volume and the plasma dilution of lactated Ringer＇s solution in patients during the induction of general and epidural anesthesia. Methods： The hemodilution of i.v. infusion of 1000 ml of lactated Ringer＇s solution over 60 min was studied in patients undergoing general （n=31） and epidural （n= 22） anesthesia. Heart rate, arterial blood pressure and hemoglobin （Hb） concentration were measured every 5 rain during the study. Surgery was not started until the study period had been completed. Results： General anesthesia caused the greater decrease of mean arterial blood pressure （MAP） （mean 15% versus 9%; P〈0.01） and thereby followed by a more pronounced plasma dilution, blood volume expansion （VE） and blood volume expansion efficiency （VEE）. A strong linear correlation between hemodilution and the reduction in MAP （r=-0.50;P〈0.01） was found. At the end of infusion, patients undergoing general anesthesia retained 47% （SD 19%） of the infused fluid in the circulation, while epidural anesthesia retained 29% （SD 13%） （P〈0.001）. Correspondingly, a fewer urine output （mean 89 ml versus 156 ml; P〈0.05） and extravascular expansion （454 ml versus 551 ml; P〈0.05） were found during general anesthesia. Conclusion： We concluded that the induction of general anesthesia caused more hemodilution, volume expansion and volume expansion efficiency than epidural anesthesia, which was triggered only by the lower MAP.  相似文献   

15.
Objective: The aim of this paper is to compare the propofol concentration in plasma and cerebrospinal fluid (CSF) in patients scheduled for intracranial tumor removal and anaesthetized using propofol as part of a total intravenous anaesthesia technique. Methods: Twenty-seven patients (ASA I–II) scheduled for elective intracranial tumor removal were studied. Anesthesia was induced with 2 mg/kg propofol for 5 min and infused at 10 mg/(kg·h) for 5 min and then stopped. CSF and arterial blood were collected simultaneously before infusion of propofol and at different time points after infusion of propofol according to bispectral index (BIS) values. Concentrations of propofol in plasma and CSF were measured by HPLC with fluorescence detection. The correlation coefficient and regression equation between plasma and CSF concentration of propofol were worked out by linear simple regression. Results: The propofol CSF concentration that we measured was 1.46% of the plasma concentration. The coefficient of relation between plasma and CSF concentration was 76.7%. Conclusions: The propofol CSF concentration was positively correlated with and much lower than the plasma concentration. Discrepancies may result from high plasma protein binding of propofol, intracranial pathology and sampling volume. Project supported by Startup Foundation for Introducing Talent of Zhejiang University, China  相似文献   

16.
INTRODUCTION The specific morphologic properties of choroidal epithelium and the existence of a cerebrospinal fluid(CSF)pathway for drug distribution to the central nervous system(CNS)suggest that the choroid plexus-CSF route may be more significant than pre-viously thought for drug delivery to the brain(Ghersi-Egea and Strazielle,2001).There is limitedl d l d-n d information about the CSF pharmacokinetics of propofol in humans(Engdahl et al.,1998;Dawid-owicz et al.,2001a).Propofol…  相似文献   

17.
煤矿综采工作面乳化液泵站一般配置两泵以上,根据工作面液压支架用液量决定启动一台及以上乳化泵运行,当工作面液压支架用液量减少或不用液时,高压液则通过卸载阀回液箱,系统始终处于高压卸载状态,电机仍然处于负载状态运行,造成能源浪费;变频控制装置的使用可以根据工作面实时用液量变化情况,自动调整电机转速,从而改变乳化液泵的转速,供液量随着用液量实时变化,避免高压卸载,节省电能,延长设备使用寿命;该系统在淮南矿业集团张集矿1132(3)工作面投入试用,效果明显,平均节电率约为34%。  相似文献   

18.
为了探讨小剂量消炎痛治疗羊水过多的临床疗效,选择70例诊断羊水过多的病人,分为2组:消炎痛组,服用消炎痛25mg Q8h1次;对照组,不接受药物治疗,一般治疗.用药前后B超测量羊水平段,计算羊水指数,观察疗效及随访妊娠结果.结果表明:消炎痛组有效率100%,用药后2天症状减轻,羊水减少,1周至2周羊水恢复正常.对照组无效.两组间差异显著.妊娠结局消炎痛组优于对照组.可见,小剂量消炎痛治疗羊水过多,无任何副作用,疗效可靠.  相似文献   

19.
Objective: To observe the effects of three fluid resuscitation methods on apoptosis of visceral organs in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock and active bleeding was established in 32 SD (Sprague-Dawley) rats. The rats were randomly divided into control group, no fluid resuscitation group (NF group), controlled fluid resuscitation group (NS40 group) and rapid large scale fluid resuscitation group (NS80 group). Each group contained 8 rats. The curative effects were compared. At the same time, the apoptosis in liver, kidney, lung and small intestinal mucosa of survivors after hemorrhage and resuscitation was detected by light microscopy in HE (hematoxylin and eosin) stained tissue sections, flow cytometry and terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL). Results: The survival rate of early fluid resuscitation (14/16) was markedly higher than that of NF group (3/8). There was some apoptosis in liver, kidney, lung and small intestinal mucosa of all survivors. Compared with NF and NS40 groups, the apoptosis of liver, kidney and small intestinal mucosa of NS80 group was obviously increased. Conclusions: Among three fluid resuscitation methods, controlled fluid resuscitation can obviously improve the early survival rate and the apoptosis of liver, kidney and small intestinal mucosa in rats with severe and uncontrolled hemorrhagic shock, and may benefit improvement of prognosis.  相似文献   

20.
通过分析直接能量平衡在供热机组中的实际应用效果,指出了某300MW机组煤量波动大与协调控制系统调节品质低下的原因;提出了相应的优化策略,并应用于该300MW机组的协调控制系统中,有效根除了优化之前的不良现象,协调控制系统的调节控制品质显著提高,而且使得供热机组的AGC功能正常长期投运.  相似文献   

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