scholarly journals Effects of norepinephrine on hemodynamics, vascular elasticity, cardiac pump function, and inflammatory factors in patients with septic shock

2019 ◽  
Vol 17 ◽  
pp. 205873921983839
Author(s):  
Fengzhi Wang ◽  
Mancui Zhang ◽  
Xiujuan Wang ◽  
Xiaopeng Zhong ◽  
Po Ding

The effects of norepinephrine on hemodynamics, vascular elasticity, cardiac pump function, and inflammatory factors in patients with septic shock remained unknown. In this study, we included 124 cases of severe septic shock patients in our hospital. The patients were randomly divided into control group (treated with dopamine) and experimental group (treated with dopamine plus norepinephrine), while the hemodynamic index (heart rate (HR)), blood vessel elasticity index, heart pump function, and inflammatory factor index were recorded. After 12 h of treatment, both groups showed decreased HR, increased levels of cardiac index (CI), mean arterial pressure (MAP), central venous pressure (CVP), peripheral vascular resistance index (PVRI), and vascular elasticity ( P < 0.05). To date, lower HR, higher levels of CI, MAP, CVP, and PVRI were observed in the experimental group ( P < 0.05). Furthermore, the vascular elastic coefficient, stiffness index, arterial compliance, and the precursors of plasma amino-terminal brain natriuretic peptide were also significantly higher in the experimental group than those in the control group ( P < 0.05). However, inflammatory cell tumor necrosis factor alpha factor test group (TNF alpha), interleukin-1 (IL-1), and interleukin-6 (IL-6) concentrations were significantly lower than the control group ( P < 0.05), compared to experimental group ( P < 0.05). This research indicates that phenylephrine could significantly improve hemodynamics in patients with severe septic shock, by maintaining blood vessel elasticity, improving heart pump function, and reducing the inflammatory factors’ activities, and this method could be used as a line of vascular tension of the medications used in patients with septic shock.

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Dan Zhang ◽  
Hongli Li ◽  
Xiang Tian ◽  
Sujuan Zhang

Objectives: To evaluate the effect of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure and its clinical significance. Methods: Eighty patients with moderate and severe heart failure admitted to the Cardiology Intensive Care Unit (CCU) of Baoding First Central Hospital from May 2019 to May 2020 were included in this study and randomly divided into two groups: the experimental group and the control group, with 40 patients in each group. The experimental group was given enteral nutrition support therapy on the basis of conventional therapy for one month, while the control group was given restricted salt and water intake on the basis of conventional therapy, and patients were given free diet according to their wishes. The changes in heart function before and after treatment, changes in inflammatory factors such as TNF-a, CRP, IL-6, changes in levels of immunoglobulins such as IgA, IgM, and IgG, and the improvement of the performance status of the two groups were compared and analyzed. Results: After treatment, indicators such as BNP, LVEDD, LVEF and 6min walking distance in the experimental group were significantly improved compared with the control group, with statistically significant differences (p<0.05), and the levels of inflammatory factors such as TNF-a, CRP and IL-6 in the experimental group were significantly reduced compared with those in the control group (p=0.00). The levels of IgG, IgA, IgM and other immunoglobulins in the experimental group improved more significantly after treatment than those in the control group, with statistically significant differences (IgG, IgA, p=0.00; IgM, p=0.01). Moreover, the experimental group was significantly superior to the control group in the improvement rate of performance status score (ECOG) after treatment (p=0.04); The incidence of gastrointestinal adverse reactions in the experimental group was 20%, and that in the control group was 15%. No statistically significant difference can be observed in the gastrointestinal tolerance of both groups (p=0.56). Conclusions: Reasonable enteral nutrition boasts a variety of benefits for the recovery of elderly patients with chronic heart failure. With reasonable enteral nutrition, the heart function of elderly patients with chronic heart failure can be significantly improved, inflammatory factors can be reduced, immunity and performance status can be enhanced, and gastrointestinal tolerance can be ameliorated without obvious gastrointestinal reactions. doi: https://doi.org/10.12669/pjms.38.1.4451 How to cite this:Zhang D, Li H, Tian X, Zhang S. Effects of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure. Pak J Med Sci. 2022;38(1):---------.  doi: https://doi.org/10.12669/pjms.38.1.4451 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Hao Zhang ◽  
Mei-ying Wang ◽  
Yong-nan Teng ◽  
Xiao-dan Wang ◽  
Hai-tao Cao

Objective: To evaluate the clinical effect of high-dose intravenous immunoglobulin (HDIVIG) single dose and pulse therapy combined with small-dose prednisone acetate in the treatment of patients with Kawasaki disease (KD). Methods: Eighty patients with KD from Baoding Children’s Hospital, China, were randomly divided into two groups: the experimental group and the control group, each with 40 cases. Patients in the experimental group were treated with HDIVIG single dose, pulse therapy combined with low-dose prednisone acetate, while patients in the control group were treated with conventional-dose immunoglobulin. Patients in both groups were treated with aspirin orally, and given symptomatic treatment including anti-inflammatory, nutritional support, correction of water and electrolyte disturbance and acid-base balance. Peripheral venous blood samples were drawn from all patients at the time of admission, Day-1, Day-7 and Day-14 after treatment, and in the basic state of getting up in the morning, and then the levels of tumor necrosis factor (TNF-a), C-reactive protein (CRP), interleukin-6 (IL-6) and other inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). The time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, mucosal hyperemia regression after treatment in the two groups was recorded, and the treatment effect of the two groups was comprehensively evaluated. Results: After treatment, the levels of inflammatory factors such as TNF-a, CRP, IL-6 in the experimental group were significantly lower than those in the control group, with a statistically significant difference (P<0.05). In addition, the time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, and mucosal hyperemia regression in the experimental group was significantly shorter than that in the control group (p=0.00). The effective rate of the experimental group was 95% and that of the control group was 80%, with a statistically significant difference (p=0.04). Conclusion: HDIVIG single dose, pulse therapy combined with small-dose prednisone acetate has a favourable therapeutic effect in the treatment of patients with KD, by which the inflammatory factors can be significantly improved, clinical symptoms and weight can be quickly ameliorated, and therapeutic effect can be enhanced. doi: https://doi.org/10.12669/pjms.37.4.4023 How to cite this:Zhang H, Wang MY, Teng YN, Wang XD, Cao HT. Observation on the clinical effect of high-dose Intravenous Immunoglobulin combined with low-dose prednisone acetate in the treatment of patients with Kawasaki Disease. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.4023 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xiaolu Wang ◽  
Wenpeng Wei ◽  
Yanyan Qi ◽  
Lihua Dong ◽  
Yun Zhang

Objective. This study is aimed to observe the clinical effects of integrated traditional Chinese and Western medicine in treating severe preeclampsia (SPE) and its effects on maternal and infant outcomes after cesarean section under combined lumbar and epidural anesthesia. Method. One hundred and sixty-six pregnant women with SPE were randomly divided into an experimental group and control group, with 83 cases in each group. The control group was given conventional treatments such as magnesium sulfate, and the experimental group received self-made traditional Chinese medicine decoction for oral administration. Results. The total clinical effective rate of treatment in the experimental group was significantly higher than that in the control group. After treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and 24 h proteinuria (24 h PRO) levels of the experimental group were significantly lower than those of the control group. After cesarean section (c-section) under combined lumbar and epidural anesthesia, there were statistically significant differences in placental abruption, uterine weakness, fetal intrauterine distress, and neonatal asphyxia in the experimental group, while there were no significant differences in oligohydramnios. After treatment, the contents of inflammatory factors in both groups decreased, and the decrease was more prominent in the experimental group. After treatment, the levels of blood urea nitrogen (BUN), serum creatinine (Scr), and albumin (Alb) and β2 microglobulin (β2-MG) of the two groups of patients decreased, and the levels of them in the experimental group decreased. After treatment, the levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the two groups increased. However, the levels of malondialdehyde (MDA), lipid peroxide (LPO), and advanced oxidation protein products (AOPP) all reduced, and the increase or decrease in the experimental group was more prominent. Conclusion. The combination of traditional Chinese and Western medicine can reduce the blood pressure of a patient with SPE. After the combined spinal-epidural anesthesia and cesarean section, it can significantly improve the maternal and infant outcomes and renal function, reduce inflammatory factors levels and body oxidative stress, and increase the activities of antioxidant enzymes.


2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Rong He

Objective: To study the clinical effect of the Huagai Pingchuan decoction combined with Seretide in the treatment of asthma. Methods: 138 cases of asthma patients in our hospital were separated into the control group and the experimental group. The control group was given Seretide alone, while the experimental group was treated with Huagai Pingchuan decoction combined with Seretide. Results: After treatment, the wheezing symptoms remission time of the experimental group was shorter than control group, the performance of serum inflammatory factors and lung function indexes were better than control group, P<0.05 with significant difference. Conclusion: Huagai Pingchuan decoction combined with Seretide is more effective in the treatment of asthma.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ting Wu ◽  
Meiling Gao ◽  
Jun Shi ◽  
Linfang Xu ◽  
Jing Wang ◽  
...  

Providing high-quality care to patients undergoing hemodialysis (HD) is a priority for nurses. The present study was conducted to explore the experiences of the quality of nursing care among patients, nurses, and caregivers in Yanghu Branch of Changzhou Second People’s Hospital, China. A total of 120 hemodialysis patients consecutively admitted to Yanghu Branch of Changzhou Second People’s Hospital were enrolled and divided into two groups according to the nursing method they received: control group (routine nursing) and experimental group (responsibility nursing). The two cohorts were observed and compared for alterations of adverse emotions and inflammatory factors, the incidence of complications, pre-and post-nursing sleep quality, life quality, and patients’ satisfaction with nursing. After nursing, the Self-Rating Anxiety/Depression Scale (SAS/DS) scores were lower in the experimental group (EG) than in the control group (CG) (both P < 0.05 ). Serum IL-6, hs-CRP, and TNF-α were decreased in both groups after nursing and were even lower in EG (both P < 0.05 ). EG had significantly improved sleep quality and life quality than CG, with a higher nursing satisfaction (all P < 0.05 ). This validates that the responsibility nursing for dialysis patients can validly mitigate patients’ negative emotions, improve their quality of life, and ensure high-quality dialysis effect, which is feasible for wide popularization and application in clinics.


2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Chen-li Zhang ◽  
De-qiong Xie ◽  
Li-na Ao ◽  
Lei Zhu

Objective: This study aims to compare the clinical application value of high-flux dialysis with low-flux dialysis in patients without significantly improved renal function after cervical cancer and obstructive renal failure catheterisation. Methods: This prospective randomised study was conducted from January 2018 to December 2019. Eighty cervical cancer patients with obstructive renal failure who showed no significant renal function improvement after catheterisation were randomised into two groups (n = 40 in each group) in the Second People’s Hospital of Yibin City. High-flux and low-flux dialysis were employed in the experimental group and the control group, respectively. Treatments in both groups were provided every other day, with the whole course lasting one week. Data were recorded before and after dialysis included inflammatory factors such as IL-6, CRP and TNF-a, large and moderate molecular toxins (e.g., β2 micro-globulin, parathyrin (PTH) and cysteine protease inhibitor). Renal function changes during the dialysis were also recorded. Afterwards, the two groups were compared regarding the overall efficacy. Results: Both the experimental group and the control group experienced a significant decrease in IL-6, CRP, TNF-a, β2 micro-globulin, PTH and cysteine protease inhibitor, with the decrease in the experimental group being more evident (p < 0.05). After dialysis was completed, the experimental group restored renal function indicators such as Cre, CysC and serum K+ levels more quickly than the control group (p < 0.05). The effective rate was 100% for the experimental group and 87.5% for the control group. The intragroup difference in the efficacy.was significant. Conclusions: High-flux dialysis appears to be more beneficial for cervical cancer patients with obstructive renal failure, showing no significant improvement in renal function after catheterisation. It restored renal function more quickly, had more radical draining of inflammatory factors and large and moderate molecular toxins, and had a higher overall effective rate. doi: https://doi.org/10.12669/pjms.37.4.3515 How to cite this:Zhang C, Xie DQ, Ao L, Zhu L. A comparative analysis of high-flux and low-flux dialysis in cervical cancer patients with obstructive renal failure showing no significantly improved renal function after catheterisation. Pak J Med Sci. 2021;37(4):---------.  doi: https://doi.org/10.12669/pjms.37.4.3515 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Fan-xing Qi ◽  
Ying Hu ◽  
Ya-wei Li ◽  
Juan Gao

Objective: To explore levels of anti-oxidative molecules and inflammatory factors in patients with vascular dementia (VD) and their clinical significance. Methods: Sixty VD patients admitted in our hospital from January 2016 to January 2019 were classified into an experimental group, while another 60 healthy patients seeking physical examinations in the corresponding period were selected as a control group. Various indexes related to serum inflammatory factors and anti-oxidative molecules were compared among patients in such two groups. For the purpose of comparing anti-oxidative molecular expression levels and inflammatory factor levels in patients with VD of different severities, 60 cases in the experimental group were divided, based on a Mini-mental State Examination (MMSE) scale, into patients with mild symptoms (n=20, score: 21~26), patients with moderate symptoms (n=22, score: 10~20) and patients with severe symptoms (n=18, score: 0~9). Results: By contrast to the control group, levels of inflammatory factors (e.g., TNF-a, CRP and IL-б) in VD patients are all significantly increased and their differences show statistical significance (p<0.05); and, expression levels of anti-oxidative factors, including superoxide dismutase (SOD), glutathion peroxidase (GSH-Px), total antioxidant capacity (TAC), catalase (CAT) and glutathione reductase (GR), in the experimental group are apparently below those of the control group (P<0.05). As dementia degree increases, expression levels of serum anti-oxidative molecules in such patients are inclined to drop in a significant way (P<0.05), while inflammatory factor levels tend to go up gradually (P<0.05). Conclusions: If compared with the normal population, inflammatory factor levels in serum of VD patients are higher; however, expression levels of anti-oxidative molecules become below those of the normal population. Additionally, levels of inflammatory factors and anti-oxidative molecules may change obviously as severity of illness increases. This suggests that inflammation and oxidation play a certain role of auxoaction in VD patients. doi: https://doi.org/10.12669/pjms.37.5.3854 How to cite this:Qi FX, Hu Y, Li YW, Gao J. Levels of anti-oxidative molecules and inflammatory factors in patients with vascular dementia and their clinical significance. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.3854 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 17 (9) ◽  
pp. 1850-1857
Author(s):  
Meiling Yan ◽  
Yali Zhang ◽  
Shanshan Chang

Chemically modified chitosan nanoparticles (NPs) are capable of releasing their own substances to target cells or tissues, improving microenvironment and promoting wound healing. This study aimed to explore the molecular mechanism underlying chitosan NPs loaded with TGF-β1 participating in cervical cancer (CC) progression. TGF-β1-loaded-chitosan NPs were prepared and particle size distribution, zeta potential and encapsulation efficiency of NPs were determined. MTT assay assessed the toxicity of NPs to macrophages. CC cells were co-cultured with TGF-β1-loaded chitosan NPs (experimental group) or pure chitosan NPs (control group) and cells were cultured alone to produce control group. After treatment, flow cytometry was conducted to detect apoptosis and cycle. Cancer cell migration was evaluated by Transwell assay, and miR-155 and Tim-3 expression was determined. At a ratio of 2:1 chitosan and TGF-β1, the particle size was102.65±11.98 nm, which was smallest, with high encapsulation rate of 81.26%, and low potential of 1.46±1.71. NP toxicity increased as concentration rose and relative cell proliferation rate was >80%, indicated as non-toxic. CC tissues had positive expression of CD163 and TGF-β1 (95%) (p < 0.05). Treatment with TGF-β1-loaded chitosan NPs induced increased apoptosis rate of 9.13±2.15%, reduced migration (67.65±9.91) and invaded cells (19.98±3.41), causing cell accumulation in the S phase when compared to the blank and control groups (p < 0.05). Besides, experimental group exhibited lower expression of miR-155 (0.39±0.59) and higher expression of Tim-3 (2.87± 0.51), which was higher than the blank group and control group. The optimal concentration ratio for producing TGF-β1-loaded chitosan NPs was 2:1, with less toxicity. The composite NPs suppressed malignant characteristics of CC cells through down-regulation of miR-155 and activation of Tim-3 signal pathway on the surface of macrophages, promoting secretion of macrophage inflammatory factors.


2018 ◽  
Vol 16 ◽  
pp. 205873921879406
Author(s):  
Lvlin Chen ◽  
Ying Lan ◽  
Jun-Cheng Zhu ◽  
Yan He

This study was to observe the effects of dexmedetomidine against acute kidney injury in patients with septic shock. A prospective randomized controlled trial (RCT) was conducted in which 80 patients with septic shock admitted in Department of Critical Care Medicine of the Affiliated Hospital of Chengdu University from June 2015 to January 2017 were divided into experimental group and control group. The patients in both groups received basic treatment for septic shock, and the patients in the experimental group were given intravenous injection of dexmedetomidine, maintained with 0.1–0.2 µg kg−1 h−1 for 5 days. In both groups, the changes in the levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, serum creatinine (SCr), cystatin C (Cys C), and β2-microglobulin (β2-MG) were determined before treatment and 1, 3, and 5 days after treatment. At 5 days after treatment, Cys C, β2-MG, and SCr were significantly decreased in both groups ( P < 0.05), and the degree of decrease in the experimental group was more obvious ( P < 0.05). At 1, 3, and 5 days after treatment, IL-6 and TNF-α were significantly decreased in both groups ( P < 0.05) and the degree of decrease in the experimental group was more obvious ( P < 0.05). Dexmedetomidine has certain renal protective effect in patients with septic shock, and its mechanism is possibly related to the regulation and improvement of uncontrolled inflammatory response.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuying Li ◽  
Yan Yin ◽  
Dan Xiao ◽  
Yong Zou

Abstract Background Ulcerative colitis is a common non-specific chronic disease. Supplementing probiotics has become an important method for the treatment of ulcerative colitis. This study aimed to explore the effect of supplementing bifid triple viable capsules on background mesalazine plus somatostatin on plasma inflammatory factors and T cell frequency in ulcerative colitis patients. Methods A total of 130 ulcerative colitis patients admitted to our hospital from August 2018 to March 2020 were included and divided into the experimental group (65 patients with mesalazine plus somatostatin and bifid triple viable capsules for treatment) and the control group (65 patients treated with mesalazine plus somatostatin) using the random number table method. Bifid triple viable bacteria capsules were given orally, 420 mg each time, with 3 times a day for 2 months. Results Before treatment, the plasma levels of IL-6, IL-8, hs-CRP, TNF-α, D-lactic acid, and endotoxin (ET), CD4+, CD8+, CD4/CD8 ratio, diamine oxidase (DA0), emotional ability, social ability, intestinal and systemic symptoms were not significantly different between the two groups (all P > 0.05). After treatment, the plasma levels of IL-6, IL-8, hs-CRP, and TNF-α decreased in both groups, and were lower in the experimental group than those in the control group (all P < 0.05). The levels of CD4+ and CD4/CD8 ratio increased, and were higher in the experimental group than those in the control group (P < 0.05); the CD8+ levels were reduced, and were lower in the experimental group than those in the control group (P < 0.05). The plasma D-lactic acid, ET, and DA0 levels were decreased, and were lower in the experimental group than those in the control group; emotional ability, social ability, intestinal and systemic symptoms were improved, and were higher in the experimental group than those in the control group (all P < 0.05). During the course of treatment, 2 cases of abdominal discomfort and 1 case of rash occurred in the experimental group, with an adverse event rate of 4.62% (3/65); 3 cases of abdominal discomfort and 2 cases of rash occurred in the control group, with an adverse event rate of 7.69% (5/65). Conclusion The supplementary treatment of bifid triple viable capsules can effectively enhance the curative effect in ulcerative colitis patients, reduce plasma inflammatory factors, and regulate T cell frequency, which is worthy of clinical application.


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