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Polymyxin B hemoperfusion as a feasible therapy after source control in abdominal septic shock

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World Journal of Gastrointestinal Surgery 2019年第12期11卷 422-432页

作者： Jin Joo Kim Young Jun Park Ki Yoon Moon Jin Hyeong Park Yong Ki Jeong Eun Young Kim Division of Trauma and Surgical Critical Care Department of Surgery Seoul St. Mary’s Hospital College of Medicine The Catholic University of Korea

BACKGROUND Polymyxin B hemoperfusion(PMX-HP)has been used as a treatment for intraabdominal septic shock by absorbing and removing endotoxins of gram-negative *** To investigate the clinical efficacy of PMX-HP in patients with gram-negative septic shock who underwent abdominal *** From January 2012 to December 2018,patients who had septic shock secondary to peritonitis were *** were classified into PMX-HP treated and control groups based on postopreative intervention using *** clinical outcomes were compared using 1:1 propensity score matching methods to balance the overall distribution between the two *** After propensity score matching,40 patients were analyzed(20 patients in the PMX group and 20 patients in the control group).The scores of total Sequential Organ Failure Assessment(SOFA)score,renal SOFA and coagulation SOFA were significantly improved in the PMX group but not in the control group.(from 11.2±5.8 to 4.7±3.5 in PMX group vs 10.0±4.0 to 8.7±7.3 in control group,P=0.047 from 2.6±1.0 to 0.7±1.0 in PMX group vs 2.6±1.5 to 2.8±1.6 in control group,P=0.000,from 1.6±1.5 to 1.3±1.3 in PMX group vs 1.2±1.2 to 2.8±1.8 in control group,P=0.014,respectively).Further,the length of intensive care unit(ICU)stay was significantly shorter in PMX ***,no statistically significant difference was found in ICU mortality(50%in PMX group vs 50%in control group).CONCLUSION PMX-HP is a feasible adjunct treatment for peritonitis in ICU patients with peritonitis for improved organ impairment and to stabilize *** would be helpful to enhance clinical outcomes especially in patients with complete elimination of the source of gram-negative bacilli infection by surgical procedure accompanied with conventional treatment of sepsis.

关键词： Intraabdominal septic shock Panperitonitis Polymyxin B hemoperfusion Sepsis Toraymyxin

Therapeutic efficacy of charcoal hemoperfusion in patients with acute severe dichlorvos poisoning

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Acta Pharmacologica Sinica 2004年第1期 17-23页

作者： Ai PENG, Fan-qing MENG, Lan-fang SUN, Zhan-sheng JI, Yu-hui LIDepartment of Medicine, Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing 210008 Department of Emergency, Coal Mining Central Hospital of North China Coal-mining Medical College, Zibo 255120, China

AIM: To assess the efficacy of hemoperfusion (HP) in the treatment of the patients with acute severe dichlorvos (DDVP) poisoning. METHODS: One hundred and eight patients with acute severe DDVP poisoning in the two teaching hospitals were enrolled. Sixty-seven patients were treated with HP (HP group) and forty-one patients accepted traditional treatment only as the control. Serum concentration of DDVP was determined by gas chromatography. RESULTS: The duration of coma, impaired consciousness, ICU stay, and mechanical ventilation

关键词： dichlorvos poisoning hemoperfusion therapeutics adsorption

Evaluation of efficacy of resin hemoperfusion in patients with acute 2,4-dinitrophenol poisoning by dynamic monitoring of plasma toxin concentration

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2015年第8期16卷 720-726页

作者： Xue-hong ZHAO Jiu-kun JIANG Yuan-qiang LU Department of Emergency Medicine the First Affiliated Hospital School of Medicine Zhejiang University

Objective： The intoxications caused by 2,4-dinitrophenol （2,4-DNP）, even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and explore the clinical value of resin hemoperfusion （HP） in the treatment of patients with acute 2,4-DNP poisoning. Methods We reported 16 cases of acute 2,4-DNP poisoning through occupational exposure due to ignoring the risk of poisoning. The blood samples were collected from the 14 survivors. According to the different treatments of resin HP, the survivors were divided into routine HP （n=5） and intensive HP （n=9） groups. Ultra high performance liquid chromatography/ tandem mass spectroscopy （UPLC-MS/MS） was used to detect the 2,4-DNP concentration in plasma in this study. Results： The 14 survivors recovered very well after treatment. The initial plasma 2,4-DNP concentrations （C1） of survivors ranged from 0.25 to 41.88 pg/ml （mean （12.56＋13.93） pg/ml）. A positive correlation existed between initial plasma 2,4-DNP concentration （C1） and temperature. The elimination of 2,4-DNP was slow and persistent, and the total clearance rates of plasma toxin from the 1st to 3rd day （R3）, the 3rd to 7th day （R3-7）, and the 1st to 7th day （RT）, were only （53.03±14.04）%, （55.25±10.50）%, and （78.29±10.22）%, respectively. The plasma toxin was cleared up to 25 d after poisoning in most of the patients. The R3, R3-7, and R7 in the intensive HP group were all apparently higher than those in the routine HP group, with statistical significance （P〈0.05）. Simultaneously, the elimination half-life （tl/2） of 2,4-DNP in the intensive HP group was apparently shorter than that in the routine HP group, with statistical significance （P〈0.05）. Conclusions： The clinicians should be aware of this slow and persistent process in the elimination of plasma 2,4-DNP. Higher initial plasma toxin concentration resulted in a more severe fever for the patient. According to the limited data, longer and m

关键词： 2,4-Dinitrophenol Poisoning hemoperfusion Pharmacokinetics Therapeutics

STRUCTURAL AND ADSORPTION RELATIONSHIP OF MACROPOROUS R ESIN IN hemoperfusion

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Chinese Journal of Biomedical Engineering(English Edition) 1998年第1期7卷 1-6页

作者： Baoan Li Chunli Gao Changzhi Chen Yaoting Yu(Molecular Biology Institute,Bioactive MaterialsResearch Laboratory, Nankai University, Tianjin 300071,China)

In order to achieve high adsorption capacity of adsorbents in hemoperfusion,macroporous resins were tailor made with appropriate pore sizes and specific area. This allows the toxin molecules to diffuse freely within the channels ofthe porous resins and rinally reach the adsorption *** resin NK - 107 having small pore size and large Surface area(1086cm2) were synthesized which showed a high adsorption capacity of 82 - 94%for small molecules such as hypnotic and sedative drugs. For the adsorption of middle molecules i. e. Vit B12 or cytochrome C adsorbents having large pore sizes weretailor made. In the case of the adsorption of unconjugated bilirubin which is a verybig molecule, the pore size of the adsorbent should be at least>160A. NK - 110 istailor made with a very big pore size,which have a high adsorption capacity of 87%for bilirubin. DNA immobilized on carbonized resins,which have a porous structurewith a large surface area of 1000m2/g,can adsorb DNA antibody effectively. Resultsfrom animal and clinical trials indicated that the above tailor - made adsorbentshave a high efficacy in the removal of endogenous and exogenous toxins in hemoperfusion.

关键词： macroporous resin. hemoperfusion adsorbents structure toxins

Beyond conventional care:The therapeutic potential of hemoperfusion in severe COVID-19

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World Journal of Critical Care Medicine 2024年第4期13卷 88-98页

作者： John Vásquez-Torres Ramses Dávila-Collado Leyla Abdalah-Perez Oscar Jarquin-Duran JoséSantos Latino Jorge Luis Espinoza Kidney and Hemodialysis Unit Baptist Hospital of NicaraguaManagua 2300Nicaragua Emergency Medicine Baptist Hospital of NicaraguaManagua 2300Nicaragua Faculty of Health Sciences Kanazawa UniversityKanazawa 920942Japan

BACKGROUND hemoperfusion(HP)is an extracorporeal blood purification modality utilized to remove small-to medium-sized molecules,such as toxins and cytokines,that are difficult to remove by conventional *** clinical practice,HP has been successfully used as a salvage therapy for drug overdose and occasionally in patients with liver failure and *** To summarize the clinical outcomes of a series of patients with severe coronavirus disease 2019(COVID-19)who received *** Here,we summarize the clinical outcomes of a series of 18 patients with severe COVID-19 who received HP in our institution during the COVID-19 pandemic.A review of the literature was also *** HP was well-tolerated,and after an average of three sessions,respiratory and cardiovascular parameters as well as blood inflammatory markers improved in most *** patients were discharged *** literature search identified a total of 20 studies(873 patients)in which HP was used for *** studies reported improvements in respiratory parameters,and 13 studies(438 patients in total)reported better survival rates in patients undergoing *** HP was well-tolerated in patients with severe COVID-19,and most studies reported improved clinical parameters,including better survival rates,when HP was used in patients with severe *** research,especially prospective studies,is needed to evaluate the utility of HP as an early and supportive therapy for critically ill patients due to infectious diseases,such as those with COVID-19 or severe sepsis.

关键词： hemoperfusion Cytokine storm Severe COVID-19 Blood Therapy Survival

Microencapsulated Hepatocytes hemoperfusion for the Treatment of Fulminant Hepatic Failure Rats

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Chinese Journal of Biomedical Engineering(English Edition) 1998年第4期7卷 192-195页

作者： Ji-Chang Song Jin-Juan Zhang Tao-Li Zhi-Du Ping-Yuan A.M. Sun(The Third Central Hospital Affiliated To Tianjin Medical University.Artificial Cell Engineering & Technology Research Center Of Public Health Ministry,China)(The Project Supported by Nati

Hepatocytes were isolated from suckling porcine using modified seglen’s collagenase perfusion technique, and were encapsulated with alginate-polylysine-alginate (APA) microcapsules. Fulminant hepatic failure(FHF) was induced in male SD rats by galactosamine. hemoperfusion performed 24hErs after galactosamine injection. In vitro culture, both encapsulated hepatocytes and free hepatocytes express the ability to synthesis Albumin, Urea .for 7 days, Encapsulated hepatocytesperfusied with Williams’ E medium was shown to provide albumin, urea synthesis functions in 24hrs. The survival time after treatment of microencapsulated hepatocytes hemoperfusion group was longer than othergroups, and Serum ALT, TBIL levels decreased.

关键词： Fulminant hepatic failure microencapsulated hepatocytes hemoperfusion

Successful treatment of patients with paraquat intoxication:three case reports and review of the literature

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第5期13卷 413-418页

作者： Qin ZHANG Wei-zhen WU Yuan-qiang LU Jie-zan WANG An-dong SHANG Feng YAO Yan CHEN Department of Emergency the First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003China Dep rtrnent of Geriatricsthe First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003China

Objective: To report on three patients with paraquat (PQ) intoxication surviving after combined therapy with hemoperfusion (HP), cyclophosphamide (CTX), and glucocorticoid. Methods: Three patients suffered acute renal failure in a few days after ingesting a lethal amount of PQ. Chest computed tomography (CT) scans revealed obvious pulmonary inflammation, pleural effusion, and fibrous lesions several days after ingestion. HP was performed immediately, followed by large doses of glucocorticoid (methylprednisolone, 500 g/d) and CTX (approximately 4 g). Results: After 50 d of treatments, all three patients were discharged in healthy condition, with chest CT showing small fibrous lesions, exuda- tion, and both lungs clear of auscultation. Conclusions: The protective effect of the lungs may have been due to timely treatment at adequate doses.

关键词： Paraquat poisoning hemoperfusion Glucocorticoid Cyclophosphamide

Investigations on the adsorbents for uremic middle molecular toxins (Ⅱ)——Influences of crosslinking agent chain length on the adsorption capacities of crosslinked chitosan adsorbents

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Science China Chemistry 2001年第5期44卷 457-464页

作者：王虹袁直刘晓航滕欣莲何炳林 State Key Laboratory of Functional Polymer Materials for Adsorption and Separation Institute of Polymer Chemistry Nankai University Tianjin China

Chitosan resins, which clinically served as adsorbents in hemoperfusion therapy, were prepared with reversed-phase suspension methodology using three differently structured crosslinking agents, methanal, glyoxal and glutaraldehyde. And the glyoxal and glutaraldehyde crosslinked chitosan resins were reduced with NaBH4 afterwards. By analyzing the results from FTIR and SEM, it was found that the reduction treatment to the adsorbents efficiently improved the chemical stability of these chitosan resins, and the shifts in crosslinking agents exerted influences over the morphologies of the adsorbents obviously. After being put to use in the adsorption tests upon some model uremic middle molecular toxins and BSA in vitro, all three adsorbents demonstrated a fairly realistic adsorption capability to the model toxins but little to BSA. And the adsorption process reached the equilibrium in a clinically qualified short time. But the adsorption capacities of these adsorbents to the model toxins were quite different. It had been found that with the growing of fatty chain length of crosslinking agent, these adsorbents showed a gradually increased adsorption capacity to the model toxins, and the glutaraldehyde crosslinked chitosan resin behaved best.

关键词： hemoperfusion uremia middle molecular toxins adsorbent crosslinked chitosan.

Incidence and clinical characteristics of hypertriglyceridemic acute pancreatitis:A retrospective single-center study

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World Journal of Gastroenterology 2022年第29期28卷 3946-3959页

作者： Xue-Yan Lin Yi Zeng Zheng-Chao Zhang Zhi-Hui Lin Lu-Chuan Chen Zai-Sheng Ye Department of Gastroenterology Fujian Provincial HospitalFujian Medical University Provincial of Clinical MedicineFuzhou 350001Fujian ProvinceChina Department of Gastrointestinal Surgical Oncology Fujian Cancer HospitalFujian Medical University Cancer HospitalFuzhou 350014Fujian ProvinceChina Department of Emergency Surgery Fujian Provincial HospitalFujian Medical University Provincial of Clinical MedicineFuzhou 350001Fujian ProvinceChina

BACKGROUND The incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased yearly,but updated population-based estimates on the incidence of HTG-AP are *** serum triglyceride(TG)levels quickly is crucial in the early treatment of *** serum TG levels are treated by non-invasive methods,which include anti-lipidemic agents,heparin,low-molecular weight heparin,and insulin,and invasive methods,such as blood purification including hemoperfusion(HP),plasmapheresis,and continuous renal replacement ***,authoritative guidelines have not been *** selection of appropriate treatment is important and beneficial in controlling the development of *** To evaluate the effect between patients treated with intravenous insulin(INS)and HP to guide clinical *** We retrospectively reviewed 371 patients with HTG-AP enrolled in the Department of Fujian Provincial Hospital form April 2012 to March *** inpatient medical and radiologic records were reviewed to determine clinical features,severity,complications,mortality,recurrence rate,and *** logistic regression analyses were used to analyze risk factors for severe *** score matching was used to compare the clinical outcomes of INS and *** A total of 371 patients met the HTG-AP *** incidence of HTG-AP was increased by approximately 2.6 times during the 10 years(8.4%in April 2012-March 2013 and 22.3%in April 2020-March 2021).The highest incidence rate of acute pancreatitis was observed for men in the age group of 30-39 *** amylase level was elevated in 80.1%of patients but was only three times the normal value in 46.9%of *** frequency of severe acute pancreatitis(26.9%),organ failure(31.5%),rate of recurrence(32.9%),and mortality(3.0%)of HTG-AP was *** Marshall score,modified computed tomography severity index score,baseline TG,baseline amylase,C-reactive protein(CRP),albumin,aspar

关键词： Hypertriglyceridemic acute pancreatitis Triglyceride Improved Marshall score Severity of acute pancreatitis Intravenous insulin hemoperfusion