检索结果-南通市图书馆

HAT therapy for sepsis:A review of the therapeutic rationale and current clinical evaluation status

在线全文

学校读者我要写书评

暂无评论

Journal of Intensive Medicine 2023年第4期3卷 320-325页

作者： Yali sun Yongfang Yang Zhuoyi Ye tongwen sun Department of General ICU The First Affiliated Hospital of Zhengzhou UniversityHenan Key Laboratory of Critical Care MedicineZhengzhou Key Laboratory of SepsisZhengzhou 450052HenanChina Henan Engineering Research Center for Critical Care Medicine Department of General ICUThe First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052HenanChina

Vitamin C-based cluster therapy,which involves the combined application of hydrocortisone,vitamin C,and thiamine(HAT),is a recently proposed new treatment option for sepsis on top of conventional *** therapy has a strong theoretical basis,but its clinical efficacy remains *** review summarizes the rationale for HAT therapy for sepsis and describes the evaluation of its efficacy in clinical observational studies and randomized controlled trials,with the aim of providing a reference for the future clinical practice application of HAT therapy in sepsis.

关键词： Sepsis HAT therapy Hydrocortisone Vitamin C Thiamine Metabolic resuscitation

二甲双胍对老年脓毒症急性肺损伤大鼠肠道代谢组学的影响

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

中华急诊医学杂志 2024年第9期33卷 1265-1272页

作者：梁火燕徐籽力邱思敏张开源胡智铂丁显飞张晓娟刘韶华孙同文郑州大学第一附属医院急诊医学部综合ICU 河南省重症医学工程研究中心河南省重症医学重点实验室郑州市脓毒症重点实验室河南省脓毒症诊疗中心郑州450052

目的探索二甲双胍对老年脓毒症大鼠肠道代谢物的影响及对肺脏损伤的保护作用。方法SD大鼠在郑州大学动物实验中心进行饲养,将14只老年SD大鼠随机分为三组:假手术组(age-Sham,AgS组,n=4)、盲肠结扎穿孔诱导脓毒症组(age-Cecal ligation a... 详细信息

目的探索二甲双胍对老年脓毒症大鼠肠道代谢物的影响及对肺脏损伤的保护作用。方法SD大鼠在郑州大学动物实验中心进行饲养,将14只老年SD大鼠随机分为三组:假手术组(age-Sham,AgS组,n=4)、盲肠结扎穿孔诱导脓毒症组(age-Cecal ligation and puncture,AgCLP组,n=5)、CLP处理1 h后灌胃二甲双胍(100 mg/kg)处理组(age-Metformin,AgMET组,n=5),并于造模后24 h收集各组大鼠粪便和肺组织。采用液相色谱-串联质谱非靶向代谢组学分析粪便中的代谢物组成及组间差异。两组间的代谢物和各组间代谢变化的可视化结果分别用正交偏最小二乘判别分析、热图和主成分分析图进行展示。代谢物的通路分析使用MetaboAnalyst 3.0软件基于KEGG数据库和人类代谢组数据库进行分析。结果大鼠肺组织中的CCL4(F=203.00,P<0.001)、CXCL1(F=65.69,P<0.001)、IL-6(F=38.94,P<0.002)、TNF-α(F=14.85,P=0.005)的表达水平在组间比较均差异有统计学意义(均P<0.05)。然而,CCL2在AgCLP组和AgMET组间差异无统计学意义。此外,与AgS组相比,AgCLP组的7-甲基黄嘌呤、N-花生四烯酰甘氨酸、Manoalide等17个代谢物相对强度显著升高;而安替比林、Gly-Phe、伏立诺他等9个代谢物则明显降低,二甲双胍治疗后可逆转上述代谢物的变化。相关性分析发现,炎性指标IL-6和TNF-α水平与7-甲基黄嘌呤、N-花生四烯酰甘氨酸等代谢物相对强度呈正相关,而与安替比林、Gly-Phe呈负相关;CCL4和CXCL1与Manoalide呈正相关,而与伏立诺他呈负相关。结论本研究结果表明,二甲双胍改善了脓毒症急性肺损伤并调节了宿主肠道菌群代谢物,这可能为老年脓毒症急性肺损伤提供潜在的有效治疗手段。

关键词：二甲双胍脓毒症急性肺损伤代谢组学肠道代谢物老年大鼠

急性呼吸窘迫综合征患者保护性肺通气策略依从性现况调查

在线全文

学校读者我要写书评

暂无评论

中华结核和呼吸杂志 2024年第5期47卷 419-429页

作者：刘有芳詹庆元黄絮吴大玮卢海宁王导新邓旺孙同文邢丽华刘韶华王石磊北京中医药大学中日临床医学院呼吸与危重症医学科北京100029 中日友好医院呼吸中心呼吸与危重症医学科国家呼吸医学中心国家呼吸疾病临床医学中心北京100029 山东大学齐鲁医院(青岛)重症医学科青岛266035 重庆医科大学附属第二医院呼吸与危重症医学科重庆400010 郑州大学第一附属医院综合ICU 郑州450052 郑州大学第一附属医院呼吸与危重症医学科郑州450052

目的评估急性呼吸窘迫综合征(ARDS)患者保护性肺通气策略依从性情况及其与预后关系。方法选取前瞻多中心队列研究(CHARDS)中进行有创机械通气的ARDS患者,收集患者的基本信息、机械通气数据和预后数据。依从性定义为潮气量≤7 ml/kg PBW... 详细信息

目的评估急性呼吸窘迫综合征(ARDS)患者保护性肺通气策略依从性情况及其与预后关系。方法选取前瞻多中心队列研究(CHARDS)中进行有创机械通气的ARDS患者,收集患者的基本信息、机械通气数据和预后数据。依从性定义为潮气量≤7 ml/kg PBW或平台压≤30 cmH_(2)O或驱动压≤15 cmH_(2)O,潮气量纳入诊断ARDS后有创通气前7天数据,分为达标组(A组,100%达标)和非达标组(B组,50%~99%部分达标;C组,1%~49%部分达标;D组,完全不达标)。平台压、驱动压观察第一天数据。采用逐步回归方法,使用Logistics回归确定影响ICU存活的因素。结果共入组449例有创机械通气的ARDS患者,轻度、中度及重度患者分别为71例(15.8%)、198例(44.1%)和180例(40.1%)。前7天共监测到2880次潮气量数据,平均潮气量(6.89±1.93)ml/kg PBW,其中潮气量≤7 ml/kg PBW占53.2%。A、B、C、D组分别占29.8%(134/449)、24.5%(110/449)、23.6%(106/449)和22%(99/449)。轻度ARDS患者潮气量达标组18.3%(13/71)、非达标组81.7%(58/71);中度ARDS患者潮气量达标组25.8%(51/198)、非达标组74.2%(147/198);重度ARDS患者潮气量达标组38.9%(70/180)、非达标组61.1%(110/180),A组中重度ARDS患者达标率高于轻、中度ARDS患者(18.3%vs 25.8%vs 38.9%,χ^(2)=13.124,P=0.001)。221例患者记录平台压,95.9%(212/221)患者平台压≤30 cmH_(2)O;207例患者记录驱动压,77.8%(161/207)患者驱动压≤15 cmH_(2)O。前7天潮气量达标组ICU病死率低于非达标组(34.6%vs 51.3%,χ^(2)=10.464,P=0.001),达标组院内病死率低于非达标组(39.8%vs 57%,χ^(2)=11.016,P=0.001)。亚组分析显示中度和重度ARDS患者达标组ICU病死率和住院病死率均低于非达标组(均P0.05)。结论ARDS患者肺保护性机械通气策略整体依从性好,轻度ARDS患者依从性略低,平台压和驱动压依从性达标率高。潮气量完全依从性组较未依从组更能改善ARDS患者病死率,且中重度亚组ARDS患者呈现相似的趋势,轻度ARDS患者依从性与否与预后无显著相关性。

关键词：呼吸窘迫综合征,成人肺保护性通气策略潮气量平台压驱动压

在线全文

学校读者我要写书评

暂无评论

急性呼吸窘迫综合征早期进展与预后的关系

中国呼吸与危重监护杂志 2024年第1期23卷 37-42页

作者：翁兵兵黄絮吴大玮卢海宁王导新邓旺孙同文邢丽华刘韶华王石磊詹庆元北京中医药大学研究生学院北京100029 北京协和医学院研究生院北京100730 中日友好医院呼吸中心呼吸与危重症医学科国家呼吸疾病临床研究中心北京100029 山东大学齐鲁医院(青岛)重症医学科山东青岛100730 重庆医科大学附属第二医院呼吸与危重症医学科重庆400010 郑州大学第一附属医院综合ICU 河南郑州450052 郑州大学第一附属医院呼吸与危重症医学科河南郑州450052

目的探讨急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者早期进展的高危因素,为早期发现ARDS进展的高危患者并进行早期干预提供参考。方法对来自多中心临床研究项目中接受机械通气的轻中度ARDS患者数据进行回顾分析... 详细信息

目的探讨急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者早期进展的高危因素,为早期发现ARDS进展的高危患者并进行早期干预提供参考。方法对来自多中心临床研究项目中接受机械通气的轻中度ARDS患者数据进行回顾分析,根据机械通气72 h内ARDS严重程度分级是否进展为下一级分为早期进展组和非进展组,采用χ^(2)检验进行组间比较,采用Logistic回归分析ARDS患者进展的高危因素并比较两组患者的预后情况。结果共纳入有创机械通气的轻中度ARDS患者355例,其中72 h进展的患者97例(27.3%);进展组男性占78.4%,非进展组男性占64.0%;进展组ARDS患者较非进展组ARDS的28天无机械通气时间更短、重症监护病房(intensive care unit,ICU)病死率更高、30天及60天患者存活率更低(P0.05)。单因素及多因素回归分析显示进展组ARDS患者基线氧合指数较低[比值比(odds ratio,OR)=0.979,95%置信区间(confidential interval,CI)0.961~0.986,P<0.01]、气道峰压较高(OR=1.068,95%CI 1.017~1.121,P<0.01)、乳酸水平较高(OR=1.224,95%CI 1.057~1.417,P<0.01)、潮气量较高(OR=1.159,95%CI 1.002~1.341,P<0.05)、年龄较大(OR=1.373,95%CI 1.051~1.082,P<0.01),男性患者更多(OR=2.583,95%CI 1.336~4.995,P<0.05)。结论接受机械通气的轻中度ARDS患者早期进展常见,进展组较非进展组28天无机械通气时间更短、ICU病死率更高、30天及60天存活率更低。男性、较低的基线氧合指数水平、高气道峰压、潮气量、乳酸水平和年龄较大是轻中度ARDS患者早期进展的危险因素。

关键词：急性呼吸窘迫综合征分级高危因素

纳布啡用于重症加强治疗病房非机械通气患者的镇痛效果:多中心随机对照试验

在线全文

学校读者我要写书评

暂无评论

中华急诊医学杂志 2024年第1期33卷 59-64页

作者：周一刘韶华覃松张国秀芦乙滨段晓光王海旭张瑞芳张曙光罗永刚方宇傅小云陈涛任乐宁孙同文郑州大学第一附属医院急诊医学部郑州450052 遵义医科大学附属医院重症医学科遵义563003 河南科技大学第一附属医院急诊医学部洛阳471003 信阳市中心医院重症医学科信阳464000

目的探讨纳布啡应用于重症加强治疗病房(intensive care unit,ICU)非机械通气患者镇痛的有效性和安全性。方法本研究为多中心随机对照临床试验,选择2018年12月至2021年8月河南省和贵州省共4家医院ICU收治的、有镇痛需求的非机械通气患... 详细信息

目的探讨纳布啡应用于重症加强治疗病房(intensive care unit,ICU)非机械通气患者镇痛的有效性和安全性。方法本研究为多中心随机对照临床试验,选择2018年12月至2021年8月河南省和贵州省共4家医院ICU收治的、有镇痛需求的非机械通气患者为研究对象,按随机数字表法将患者分为纳布啡组与芬太尼组。纳布啡组给予持续静脉泵入纳布啡[0.05~0.20 mg/(kg·h)],芬太尼组给予持续静脉泵入芬太尼[0.5~2.0μg/(kg·h)],镇痛目标为重症监护疼痛观察量表(critical-care pain observation tool,CPOT)评分0.05)。纳布啡组与芬太尼组用药后各时间点CPOT评分比较差异无统计学意义(P>0.05),两组用药后各时间点CPOT评分均较用药前明显降低,且用药后2 h均可达到镇痛目标并维持。两组用药后各时间点RASS评分比较差异无统计学意义(P>0.05),均较用药前明显降低,用药后2 h达到目标镇静效果。纳布啡组与芬太尼组患者ICU住院时间差异无统计学意义[5.0(4.0,7.5)d vs.5.0(4.0,8.0)d,P=0.504]。纳布啡组患者谵妄、恶心呕吐、腹胀、瘙痒、眩晕等不良事件发生率低于芬太尼组(均P0.05)。纳布啡组患者呼吸抑制发生率与芬太尼组差异无统计学意义(P>0.05),但需要机械通气比例明显低于芬太尼组[1.9%(2/105)vs.8.6%(9/105),P=0.030]。结论纳布啡可用于ICU非机械通气患者的镇痛,2 h可达到目标镇痛效果,且具有一定镇静作用,不良反应发生率低。

关键词：纳布啡芬太尼镇痛镇静不良事件

七载热血磨一剑砥砺奋进正当时——快速发展的郑州大学第一附属医院综合ICU

在线全文

学校读者我要写书评

暂无评论

中华危重病急救医学 2019年第2期31卷 146-149页

作者：孙同文郑州大学第一附属医院重症医学科GICU 河南郑州450052

2011年11月11日,在医院"做大做强"的发展理念下,郑州大学第一附属医院综合重症加强治疗病房(GICU)成立并收治了第一例重症患者。在国家政策支持下,在医院"做细做优,高质量可持续发展"的战略目标指引下,GICU发展势头良好,到2018年为止,... 详细信息

2011年11月11日,在医院"做大做强"的发展理念下,郑州大学第一附属医院综合重症加强治疗病房(GICU)成立并收治了第一例重症患者。在国家政策支持下,在医院"做细做优,高质量可持续发展"的战略目标指引下,GICU发展势头良好,到2018年为止,郑州大学第一附属医院GICU拥有河医院区和郑东院区2个病区共73张床位,年收治危重患者5?000余例。科室成立7年,发表学术论文70篇,获国家自然科学基金2项,河南省科技进步二等奖2项。

关键词：郑州大学第一附属医院综合重症监护发展

Effects of Imidapril on Venous Blood Gas Values in Broiler Chickens Exposed to Low Ambient Temperature

在线全文

学校读者我要写书评

暂无评论

Agricultural Science & Technology 2013年第7期14卷 1002-1004页

作者： Xueqin HAO Meng LI Shouyan ZHANG Yongshu WANG tongwen sun Department of Pharmacy College of Animal Science and Technology Henan University of Science and Technology Luoyang Entry-exit Inspection and Quarantine Bureau Department of Cardiology Luoyang Central Hospital Affiliated to Zhengzhou University Department of Ophthalmology Luoyang Central Hospital Affiliated to Zhengzhou University Department of Integrated ICU the First Affiliated Hospital of Zhengzhou University

ObjectiveThis study was designed to evaluate the effects of imidapril on blood gas parameters in broiler chickens. MethodTwenty-four chickens were randomly divided into three groups (n=8), control group, low temperature group and imidapril group. Chickens in low temperature group and imidapril group were exposed to low ambient temperature (12-18 ℃) from age at 14 d to 45 d, whereas the control group was exposed to 24-30 ℃; chickens in imidapril group were gavaged with imidapril (3 mg/kg) once daily for 30 d. At age of 45 d, blood was taken from wing vein and blood gas parameters were evaluated by blood gas analyzer in Luoyang Central Hospital Affiliated to Zhengzhou University. ResultImidapril significantly increased hematocrit (HCT) and total hemoglobin content (T HBC ) and blood Na concentration in broiler chickens exposed to low ambient temperature. No significant differences were observed in pH, P CO 2 , P O 2 , K + , Ca 2+ , HCO 3-, HCO 3std , T CO 2 , BE and SO 2c . ConclusionImidapril increases hematocrit, total hemoglobin content and blood Na + concentration in chickens exposed to low ambient temperature.

关键词： Imidapril Blood gas value Broiler chicken Low ambient temperature

Adjunctive sepsis therapy with aminophylline(STAP):a randomized controlled trial

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2022年第23期135卷 2843-2850页

作者： Ruifang Zhang Huan Liu Dongmei Dai Xianfei Ding Dong Wang Yan Wang Xuexiu Shi Shuguang Zhang Xiaoguang Duan Haixu Wang Yonggang Luo Shaohua Liu Bing Han Xiaojuan Zhang Yu Fang Jing Yang Wangbin Xu tongwen sun General ICU The First Affiliated Hospital of Zhengzhou UniversityHenan Key Laboratory of Critical Care MedicineZhengzhou Key Laboratory of SepsisHenan Engineering Research Center for Critical Care MedicineZhengzhouHenan 450052China Department of Intensive Care Unit the First Affiliated Hospital of Kunming Medical UniversityKunmingYunnan 650032China Precision Medicine Monitoring Center The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China

Background:Sepsis is a serious disease caused by *** has anti-asthma and anti-inflammatory *** aimed to explore the safety and effect of aminophylline in ***:We conducted a clinical randomized controlled trial involving 100 patients diagnosed with sepsis within 48 h after intensive care unit(ICU)admission in two *** patients were randomized in a 1:1 ratio to receive standard therapy with or without *** primary clinical outcome was all-cause mortality at 28 ***:From September 27,2018 to February 12,2020,we screened 277 septic patients and eventually enrolled 100 patients,with 50 assigned to the aminophylline group and 50 to the usual-care *** 28 days,7 of 50 patients(14.0%)in the aminophylline group had died,compared with 16 of 50(32.0%)in the usual-care group(P=0.032).Cox regression showed that the aminophylline group had a lower hazard of death(hazard ratio=0.312,95%confidence interval:0.129–0.753).Compared with the usual-care group,patients in the aminophylline group had a longer survival time(P=0.039 by the log-rank test).The effects of aminophylline on vasopressor dose,oxygenation index,and sequential organ failure assessment score were timedependent with *** were no significant differences in total hospitalization days,ICU hospitalization days,and rates of serious adverse events(all P>0.05).No adverse events were observed in the ***:Aminophylline as an adjunct therapy could significantly reduce the risk of death and prolong the survival time of patients with *** registration:***,ChiCTR1800019173.

关键词： Aminophylline Mortality Randomized controlled trial Sepsis

Expert Consensus on Polymyxin Antimicrobial Susceptibility Testing and Clinical Interpretation

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Sciences Journal 2021年第1期36卷 1-16页

作者： Qiwen Yang Xiaoling Ma Fupin Hu Jing Zhang tongwen sun Baiyi Chen Yingchun Xu Youning Liu Chinese Committee on Antimicrobial Susceptibility Testing(ChiCAST) Expert Committee on Infectious Diseases,China Medical Education Association Department of Clinical Laboratory State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Laboratory Medicine the First Affiliated HospitalUniversity of Science and Technology of ChinaHefei 230001China lnstitute of Antibiotics Huashan HospitalFudan UniversityShanghai 200040China General ICU the First Affiliated HospitalZhengzhou UniversityZhengzhou 450052China Department of Infectious Diseases the First Affiliated HospitalChina Medical UniversityShenyang 110001China Department of Respiratory Medicine the First Medical Center of PLA General HospitalBeijing 100853China 不详

The polymyxins are important antimicrobial agents against antibiotic-resistant gram-negative *** 2020,the Clinical and Laboratory Standards Institute modified the clinical breakpoints for polymyxin susceptibility test by eliminating the"susceptible"interpretive category,only reporting intermediate(≤2 mg/L)and resistant(≥4 mg/L).However,the European Committee on Antimicrobial Susceptibility Testing recommended the use of clinical breakpoints of W2 mg/L as susceptible and>2 mg/L as *** first-line laboratorians and clinicians in China have been perplexed by the inconsistence of international polymyxin clinical breakpoints and discouraged by the difficulty of conducting polymyxin susceptibility ***,it is urgently needed to make it clear for the laboratorians in China to know how to accurately carry out polymyxin susceptibility testing and standardize the interpretation of susceptibility testing *** this end,the experts from relevant fields were convened to formulate this consensus statement on the testing and clinical interpretation of polymyxin *** recommendations are proposed accordingly for laboratorians and clinicians to streamline their daily work.

关键词： polymyxin antimicrobial susceptibility testing clinical interpretation expert consensus