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find Keyword "脓毒症" 127 results
  • Pathogenesis of Immune Dysfunction in Surgical Infection

    Release date:2016-09-08 10:50 Export PDF Favorites Scan
  • Effect of Intensive Insulin Therapy on Inflammatory Level of Biliary Pyemia

    Objective To explore the possible anti-inflammatory mechanism of intensive insulin therapy (IIT) by studying the effect of IIT on the levels of TNF-α, IL-6, C-reactive protein (CRP) and APACHE Ⅱ score in biliary pyemia. Methods Twenty eight patients with biliary pyemia who were admitted by our department and given an operation within 24 h form Jan. 2005 to Dec. 2008 were randomly divided into two groups by using random number table numbers: one group treated with IIT (IIT group, n=14) and another group treated with routine insulin therapy (RIT group, n=14). The inflammatory factors, such as TNF-α, IL-6 and CRP were detected dynamically and the APACHEⅡ score was calculated. ResultsThe level of CRP and APACHEⅡ score on day 5 and 7 and the levels of TNF-α and IL-6 on day 3, 5 and 7 after operation in IIT group were significantly lower than those in RIT group (P<0.05, P<0.01). Compared with preoperative levels, the IL-6 and APACHEⅡ score in IIT group commenced to decrease on day 3 after operation (P<0.05), that was earlier than control group. Conclusion The treatment with IIT can suppress the composition of TNF-α, IL-6 and CRP, protect impaired hepatic cells, and reduce APACHEⅡ score, the degree of systemic inflammation and incidence of MODS.

    Release date:2016-08-28 03:48 Export PDF Favorites Scan
  • 脓毒症中性粒细胞移行障碍研究进展

    中性粒细胞通过复杂机制向感染部位移行, 对减轻全身炎症反应、有效清除病原有重要意义。研究表明中性粒细胞移行障碍甚至衰竭是脓毒症的重要特点, 也是脓毒症严重性的标志, 对脓毒症死亡有预测作用。然而脓毒症时中性粒细胞移行受损的机制尚不清楚, 本文就其机制研究取得的一些进展综述如下。......

    Release date:2016-09-13 04:00 Export PDF Favorites Scan
  • 早期乳酸清除率对重症感染患者预后的评估研究

    目的 分析早期乳酸清除率对重症感染患者预后的临床评估价值。方法 选取2009 年1 月至2011 年12 月收治的248 例重症感染患者为研究对象进行回顾性分析。根据患者转归分为生存组和死亡组, 比较两组一般资料、APACHEⅡ 评分、脓毒症休克发生率、初始血乳酸浓度和治疗 6 h的乳酸清除率差异。根据乳酸清除率水平分为高乳酸清除率组和低乳酸清除率组, 比较两组一般资料、APACHEⅡ评分、脓毒症休克发生率、初始血乳酸浓度和病死率的差异。结果 生存组和死亡组患者的一般资料、APACHEⅡ评分、初始血乳酸浓度间的差异均无统计学意义( P gt;0. 05) 。生存组乳酸清除率明显高于死亡组[ ( 32. 6 ±11. 3) % 比( 15. 2 ±10. 1) % , P = 0. 024] , 而脓毒症休克发生率明显低于死亡组( 30. 9% 比87. 5% , P = 0. 019) 。高乳酸清除率组的脓毒症休克发生率( 34. 6% 比 53. 7%) 及死亡率( 25. 5% 比61. 1% ) 明显低于低乳酸清除率组( P 均lt;0. 05) 。结论 早期乳酸清除率可用于早期评估重度感染患者的预后转归。

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  • Current Status and Prospects in Treatment of Sepsis and Endotoxemia

    Release date:2016-08-28 04:44 Export PDF Favorites Scan
  • Protective Effects of Ulinastatin on Human Pulmonary Vascular Endothelial Cells Attacked by Serum from Patients with Septic Shock

    Objective To investigate the protective mechanism of ulinastatin(UTI) in pulmonary microvascular endothelial cells (PMVECs) attacked by serum from the patients with severe sepsis. Methods PMVECs were cultured in vitro and randomly divided into 4 groups,ie. a normal group (culture medium with 10% fetal bovine serum,group N),a health group (culture medium with 10% healthy human serum,group H),a patient group (culture medium with 10% human septic shock serum,group S),and a ulinastatin group (culture medium with 1000 U/mL UTI and 10% human septic shock serum,group U). The proliferation activity of PMVECs was measured by MTT expressed by optical density (OD). The concentration of TNF-α in supernatant of culture medium was examined by ELISA at 0,1,2,4,6 hours. The expression of NF-κB was examined by immunohistochemistry at 1 hour. Results Compared with group N,the cell proliferation activity of group S decreased significantly,and the cell proliferation activity of group U decreased slightly at each time poi nt. Compared with group N,the cell proliferation activity of group S and group U at 1,4,6 hours were significant different (Plt;0.05 ). Compared with group S,the cell proliferation activity of group U at 1,2,6 hours increased significantly (Plt;0.05). Obviously positive expression of NF-κB in PMVECs could be seen in group S,a little positive expression in group S,and no expression in group N and group H. Compared with group N,the TNF-α levels of group S and group U increased significantly at each time point with significant differences (Plt;0.01). Compared with group S,the TNF-α levels were significantly reduced at each time point in group U (Plt;0.01). Conclusions UTI can reduce the release of TNF-α by inhibiting NF-κB activation,thus reduce PMVECs injury attacked by serum from severe sepsis patients.

    Release date:2016-08-30 11:58 Export PDF Favorites Scan
  • Efficacy of Fish Oil Containing Lipid Emulsion in Sepsis: A Meta-Analysis

    ObjectiveTo evaluate the clinical efficacy of fish oil containing lipid emulsion (FO) in sepsis. MethodsRandomized controlled trials about fish oil containing lipid emulsion in sepsis,which were published from 1980,were searched from the following electronic databases:PubMed,Embase,Foreign Medical Journal Service,Cochrane Library,CNKI,Wanfang Database,and VIP Database. The articles screening,quality assessment and data extraction were conducted by two reviewers independently. The methodological quality of trials was assessed by Jadad's scale. All data was analyzed by Review Manager 5.2 software. ResultsFifteen studies involving 794 participants met the inclusion criteria. The meta-analysis results were as follows:compared with the control group,①FO could shorten the length of ICU stay[WMD=-5.59,95%CI(-7.65,-3.53)] and the length of hospital stay[WMD=-10.48,95%CI(-14.67,-6.29)],and also decrease the 28-day mortality[RR=0.69,95%CI(0.52,0.93)]. ②FO could reduce the concentration of TNF-α[WMD=31.78,95%CI(5.63,57.92)] and improve oxygenation index[WMD=41.95,95%CI(30.80,53.11)] in septic patients. ③There was no statistical significance in the decrease of C-reactive protein (CRP) between two groups(P>0.05). ConclusionThe administration of FO in septic patients can significantly shorten the length of ICU stay and hospital stay,decrease the 28-day mortality,reduce the concentration of TNF-α and improve oxygenation index. However,it shows no significant difference in the decrease of CRP compared with the administration of traditional lipid emulsion. All of the above results show that the septic patients can benefit from the administration of fish oil containing lipid emulsion.

    Release date:2016-08-30 11:31 Export PDF Favorites Scan
  • Diagnostic Value of Presepsin for Sepsis: A Meta-analysis

    ObjectiveTo systematically review the diagnostic value of Presepsin for sepsis. MethodsWe searched databases including PubMed, EMbase, Web of Science, WanFang, VIP and CNKI from inception to June 2015 to collect diagnostic tests related to Presepsin for spesis. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by QUADAS-2 tool. Then, meta-analysis was performed by Stata 13.0 software. ResultsA total of 19 studies involving 4140 samples were included. The results of meta-analysis showed that:the pooled sensitivity (Sen) and specificity (Spe) were 0.85 (95%CI 0.79 to 0.90) and 0.83 (95%CI 0.76 to 0.87), respectively. The area under the summary receiver operating characteristic (SROC) curve was 0.91 (95%CI 0.88 to 0.93). ConclusionPresepsin shows high diagnostic value for sepsis as a novel biomarker. Due to the limited quality of the included studies, more high quality studies are needed to verify the above conclusion.

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  • 丙酮酸乙酯对脓毒症保护作用研究进展

    丙酮酸是糖酵解的终产物及三羧酸循环的起始物,是机体能量代谢的主要中间产物,当机体氧供应充足时丙酮酸在线粒体内氧化为乙酰辅酶A,维持三羧酸循环;当氧供应不足时在乳酸脱氢酶作用下直接转化成乳酸,迅速为机体供能。丙酮酸在细胞内可能作为内源性抗氧化物,无需酶就能降解过氧化氢,产生二氧化碳和水。丙酮酸消除过氧化氢的反应高效迅速。除了清除过氧化氢,丙酮酸也能清除羟基、一氧化氮等其他活性氧。丙酮酸乙酯(EP)是丙酮酸亲脂性的酯化物,在抗炎、抗凝及安全性方面明显优于丙酮酸[1]

    Release date:2016-09-14 11:57 Export PDF Favorites Scan
  • Interpretation of the hotspots of Surviving Sepsis Campaign 2016

    The publication of the 2016 version of the Surviving Sepsis Campaign guidelines is a further step to the treatment of sepsis worldwide. This version of guidelines approves new definition of Sepsis-3. Overall, the new guidelines do not change the previous principle of treatment significantly. Some detailed and specific modifications have been made. Understanding and rational use of the new guidelines based on clinical practice, are the key to managing sepsis and performing accurate and effective treatment.

    Release date:2018-07-27 09:54 Export PDF Favorites Scan
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