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Objective: To observe the changes of psychological state, cardiopulmonary function and quality of life in patients with stable chronic heart failure (CHF) after simple Tai Chi training combined with individualized heart exercise rehabilitation training. Methods: 102 patients with stable CHF who were treated in our hospital from July 2019 to April 2021 were selected. According to the random number table method, they were divided into control group (individualized heart exercise rehabilitation training based on routine treatment) and observation group (simple Tai Chi training was added to the control group), with 51 cases each. The cardiopulmonary function, quality of life and psychological state of the two groups were compared before and after intervention. Results: After intervention, the peak oxygen uptake(VO2peak) and peak heart rate increased, and the ventilatory carbon dioxide slope (VE/VCO2slope) decreased in the two groups(P<0.05). After intervention, VE/VCO2slope in the observation group was lower than that in the control group, peak heart rate and VO2peak were higher than those in the control group (P<0.05). After intervention, the scores of self rating Anxiety Scale (SAS) and self rating Depression Scale (SDS) decreased in the two groups (P<0.05). After intervention, SAS and SDS scores in the observation group were lower than those in the control group (P<0.05). After intervention, the scores of symptoms, psychological emotion, physical restriction, social restriction and total scores decreased in the two groups (P<0.05). After intervention, the scores of physical restriction, psychological emotion, social restriction, symptoms and total scores in the observation group were lower than those in the control group (P<0.05). Conclusion: Individualized heart exercise rehabilitation training combined with simple Tai Chi training can improve the cardiopulmonary function and psychological state of patients with stable CHF, and then improve the quality of life of patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of phentolamine combined with imipenem and cilastatin sodium on pulmonary function, inflammatory factors and serum levels of soluble myeloid cell trigger receptor-1 (sTREM-1) and soluble intercellular adhesion molecules-1 (sICAM-1) in children with severe pneumonia. Methods: 80 children with severe pneumonia treated in our hospital from September 2018 to October 2019 were randomly divided into control group(40 cases) and study group(40 cases). The control group was given intravenous infusion of imipenem and cilastatin sodium, the study group was given intravenous infusion of phentolamine injection on the basis of control group. The clinical effect of children in the two groups was compared. The disappearance time of fever, disappearance time of pulmonary rales and coughs as well as hospitalization time were compared. Before and after treatment, the changes of pulmonary function was compared, the changes of serum inflammatory factors levels and sTREM-1 and sICAM-1 levels were observed and compared. Results: The total effective rate in study group (92.5%) was significantly higher than that in control group(75%), the difference was statistically significant(P<0.05). Compared with the control group, the disappearance time of fever, disappearance time of pulmonary rales and coughs as well as hospitalization time in study group was significantly reduced (P<0.05). After treatment, the levels of arterial partial pressure of oxygen (PaO2) and arterial/alveolar oxygen pressure ratio (a/APO2) in the study group were significantly higher than those in the control group, but the level of partial pressure of carbon dioxide (PaO2) was significantly lower than that in the control group (P<0.05). The levels of serum interleukin(IL)-6, IL-8, C-reactive proteins(CRP), sTREM-1 and sICAM-1 in the study group were significantly decreased than those in the control group (P<0.05). Conclusion: Phenolramine combined with imipenem and cilastatin sodium in the treatment of children with severe pneumonia can significantly improve pulmonary function, reduce the levels of inflammatory factors and the serum levels of sTREM-1 and sICAM-1, promote the improvement of symptoms, improve the efficacy and shorten the hospitalization time. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of continuous blood purification (CBP) with different doses of replacement fluid on respiratory system indexes, cytokines and adverse events in children with acute respiratory distress syndrome (ARDS). Methods: 117 cases of ARDS who were admitted to our hospital from March 2016 to March 2019 were selected. According to the random number table, the patients were divided into the conventional dose group (n=58, conventional dose replacement fluid) and the high dose group (n=59, high dose replacement fluid). The therapeutic effect, respiratory system index, cytokines, pediatric critical illness score (PCIs) and pediatric risk of mortality Ⅲ (PRISMⅢ ) scores and adverse events were compared between the two groups. Results: There was no significant difference between the two groups (P>0.05). At the end of treatment, arterial partial oxygen pressure, oxygenation index, interleukin-10 (IL-10) level and PCIS in the two groups were higher than before treatment, and those in the high dose group were higher than those in the conventional dose group (P<0.05). Artery partial pressure of carbon dioxide partial pressure, interleukin-1β (IL-1β ) levels, tumor necrosis factor-α (TNF-α ) levels, the PRISM Ⅲ score were lower than those before treatment (P<0.05), and the arterial partial pressure of carbon dioxide partial pressure, IL-1α, TNF-α levels in the high dose group were lower than those in the conventional dose group (P<0.05). But when two groups at the end of treatment the PRISM Ⅲ score was no difference (P>0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05). Conclusion: Conventional dose and high dose CBP displacement fluid can effectively improve ARDS in children with respiratory index, inflammatory cell factor, and high dose displacement fluid CBP better improve the effect of the above indicators, but in the recovery, PRISM Ⅲ score has no obvious advantage, etc. [ABSTRACT FROM AUTHOR]

To study on the significance of monitoring Noninvasive percutaneous oxygen partial pressure (tcpO2) and carbon dioxide partial pressure (tcpCO2) in sepsis patients and the evaluation of prognosis. 80 patients with sepsis treated in our hospital from January 2016 to December 2018 were selected for the study, the monitoring methods were divided into observation group (n=50) and control group (n=30). Patients in the control group were routinely monitored for arterial blood gas, while patients in the observation group were continuously monitored for percutaneous oxygen partial pressure/carbon dioxide partial pressure. Fluid resuscitation was guided according to relevant data to improve oxygen delivery, and the prognosis of patients was tracked. Analysis of tcpO2, tcpCO2, oxygen migration degree and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) change in sepsis and diagnostic value. Observation group of patients tcpO2, tcpCO2, oxygen migration degree and APACHE Ⅱ were significantly higher than that of control group (P<0.05); Two groups of patients death tcpO2, oxygen migration and APACHE Ⅱ group were significantly higher than survival, while tcpCO2 is lower than the survival group (P<0.05); Logistic regression analysis showed that tcpO2 and tcpCO2 with oxygen migration and APACHE Ⅱ has significant positive correlation (P<0.05); The AUC of tcpO2 in the diagnosis of sepsis was 0.806, and the 95%ci was 0.710~0.902. The AUC of tcpCO2 in the diagnosis of sepsis was 0.723, and the 95%CI was 0.608~0.839. The AUC and 95% ci in the diagnosis of sepsis were 0.970 and 0.938~1.000 respectively. APACHE Ⅱ diagnosis of sepsis in the AUC is 0.932, 95% CI 0.879 to 0.985; The AUC and 95% of combined detection in the diagnosis of sepsis were 0.997 and 0.989~1.000, respectively. The specificity and accuracy of combined detection were 93.74% and 95.68%, respectively, which were significantly higher than the individual detection of each indicator(P<0.05). Early detection of percutaneous oxygen/carbon dioxide partial pressure monitoring device is helpful for early assessment of sepsis severity and prognosis, which is worthy of popularization and application. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical value of change rate of central venous-arterial carbon dioxide tension difference to arterial-central venous oxygen content difference ratio (Pcv-aCO2/Ca-cvO2) for evaluating the progression and the prognosis of septic patients with high level of lactate in the emergency intensive care unit (EICU). Methods: Forty-eight septic patients with high level of lactate (lactic acid >4 minol/h) admitted to EICU from January 2017 to September 2018 were enrolled. All the patients were given an initial resuscitation therapy according to the 2016 sepsis guidelines. The arterial and central venous blood gases and lactate level were measured simultaneously at baseline (TOh). 6 hours after resuscitation (T6h) and 24 hours after resuscitation (T24h). The lactate level. lactate clearance rate (LC'R). Pcv-aCO2,. Pcv-aC'O2/Ca-cvO2 and Pcv-aCO2, Pcv-aCO2/Ca-cvO2 change rate were calculated. The patients were classified into two groups according to the improvement of 24-hour sequential organ failure assessment (SOFA) score. The basic clinical data and laboratory parameters of each group were analyzed and compared, and the relationship among Pcv-aCO2, Pcv-aCO2/Ca-cvO2. the change rate of Pcv-aCO2/Ca-cvO2 and lactate was analyzed. The relationship between the severity and prognosis of sepsis with hyperlactatemia and the above parameters was also analyzed. Results: Forty-five patients were included in the final analysis, and three patients were removed due to death or discharge within 24 hours. Twenty patients died and 25 survived eventually: 24-hour SOFA improved in 17 cases, and did not in 28 cases. There were no significant differences in the general clinical data between the two groups before resuscitation. The difference of Pcv-aCO2/Ca-cvO2 at 24 hours after resuscitation and its change rate at 0-24h were statistically significant between the SOFA improved group and the unimproved group (both P<0.01). There was a good correlation between the 24-hour LC'R and the change rate of Pcv-aC'O2/Ca-cvO2 in 45 patients (r=0.906, P=0.034). For the prediction of SOFA improvement, the area under ROC curve (AUC) of the change rate of Pcv-aCO2/Ca-cvO2 dining the 24 hours after the onset of resuscitation was 0.851. At the cut-off value of 0.307(30.7%). the change rate of Pcv-aCO2/Ca-cvO2 (0-24h) had a sensitivity of 76.5%. a specificity of 92.9% in the prediction of SOFA improvement. ROC analysis of death prediction showed that the area under the Pcv-aCO2/Ca-cvO2 (0-24h) was 0.696. which had no significant statistical difference with the lactate level at 24h. At the cut-off value of 0.181 (18.1%). the change rate of Pcv-aCO2/Ca-cvO2 (0-24h) had a sensitivity of 65%. a specificity of 68% in the prediction of the in-hospital death in septic patients. Conclusion: The change rate of Pcv-aCO2/Ca-cvO2 during the 24 hours after the onset of resuscitation can well predict the improvement of organ function in septic patients with hyperlactatemia and the death of septic patients with? hyperlactatemia. [ABSTRACT FROM AUTHOR]

Objective: Ex vivo lung perfusion (EVLP) is significant for lung transplantation but is costly. In this research, the EYLP system of pig model was established by using domestic economic materials to maintain the efficacy of the system while reducing the cost. Methods: We first configured the lung perfusate and assemble chambers via reasonably priced materials to established the EVLP system. Then we surgically obtained the lungs of three domestic pigs, perfused the lung perfusate, and stored them for 6 horns at low temperature. Finally, the lungs were connected to the EVLP system, and blood gas analysis and lung functional examination were used to assess the physiological function of the lungs over time. Results: By using this relatively low-priced EVLP system, we successfully obtained pig lungs and stored them for 6 hours at low temperature. Within 2 hours, the modified lung perfusion system maintained good oxygenation function and lung physiological indexes. Pulmonary arterial pressure, peak inflation pressure, platform pressure, pulmonary oxygen partial pressure and carbon dioxide partial pressure, and left atrial oxygen partial pressure and carbon dioxide partial pressure were all stable, while the lungs had normal color and elasticity without significant edema and functional damage. Conclusions: The EVLP system we established can effectively acquire and store the physiological functions of the donor pig lungs. Besides such systems could reduce costs greatly. Together, what we done provided research basis for optimizing the ex vivo lung perfusion techniques for the application of lung transplantation. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of applying different concentrations of dexmedetomidine（Dex） to low hemoglobin patients on cerebral oxygen saturation（rSO2） under general anesthesia. Methods: Select sixty female patients with hemoglobin concentration between 8 to 9 g/dl. They are all scheduled for elective intraabdomenally gynecologic operation, and were randomly divided into four groups according to the different concentrations of dexmedetomidine: D1(0.1 μg·kg-1·h-1), D2(0.3 μg-1·kg-1·h-1), D3(0.5 μg·kg-1·h-1)and group C（given the equivalent amount of 0.9 % saline）, each group is composed of 15 patients. Before anesthesia induction, D1～D3 groups were all given 0.5 μg/kg loading dose of Dex, which was required to be pumped within 15 min for each patient. After anesthesia induction, four groups all underwent sevoflurane and remifentanil intravenous-inhalation combined anesthesia, D1～D3 group were given the corresponding concentration of dexmedetomidine, whereas group C given equivalent amount of saline. All the injection was stopped40 min before the end of surgery. Record the patients’ following baseline variables before induction: mean arterial pressure（MAP）, heart rate（HR）, oxygen saturation（SpO2）, cerebral oxygen saturation（rSO2）, bispectral index（BIS）, and axillary temperature（T）. Select a relatively stable period during surgery and record the variables mentioned above as well as end-tidal pressure of carbon dioxide(PETCO2) at every 3 min for 30 min. Results: There was no significant difference in the cerebral oxygen saturation, mean arterial pressure, heart rate,pulse oxygen saturation, and axillary temperature between the four groups（P>0.05）. Compared with group D1, cerebral oxygen saturation was higher in group D2. Compared with group D2, cerebral oxygen saturation was higher in group D3（P<0.05）. When increasing the application of dexmedetomidine within a certain dose range in patients of low hemoglobin can increase the cerebral oxygen saturation, and this relationship has a linear correlation（P<0.05）, with a correlation coefficient of r=0.9999, and a linear regression equation of y=12.45 x+56.005. Conclusion: Applying dexmedetomidine at a certain dose range, can increase low hemoglobin patients cerebral oxygen saturation as the dexmedetomidine dose increases. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of Yiqi Huoxue Huatan therapy on the treatment of patients with Qi deficiency and phlegm and blood stasis type hospital acquired pneumonia (HAP) and its effect on inflammatory factors, arterial blood gas and immune function. Methods: 84 cases of HAP patients who were treated in our hospital from January 2017 to January 2018 were selected.The patients were divided into the control group and the observation group according to the random digital table method, and all the two groups were 42 cases. The control group using conventional western medicine treatment, the observation group on the basis of treatment with Yiqi Huoxue Huatan therapy. The scores of TCM symptom scores, acute physiology and chronic health evaluation II (APACHE II), arterial partial pressure of oxygen (Pa02), arterial partial pressure of carbon dioxide (PaC02), hypersensitive C reactive protein (hs-CRP), tumor necrosis factor -a (TNF-a), interleukin 6 (IL-6), procalcitonin (PCT), immunoglobulin (Ig G, Ig M, I g A)were compared before and after treatment of the two groups, the adverse reactions of the two groups were compared. Results: After treatment, the level of Pa02 in the two groups was significantly higher, and the TCM symptom scores, APACHE П scores, PaC02, hs-CRP, TNP-a, IL-6 and PCT were significantly reduced (P<0.05). After treatment, the level of Pa02 in the observation group was higher than that of the control group, the TCM symptom scores, the APACHE II score, PaC02, hs-CRP, TNF-a, IL-6 and PCT were lower than those of the control group (P< 0.05). After treatment, the levels of Ig G and Ig M in the observation group increased significantly, which was higher than that in the control group (P<0.05). No obvious adverse reactions were observed in the two groups during the treatment. Conclusion: Yiqi Huoxue Huatan therapy can effectively treat HAP patients due to deficiency of vital energy, blood stasis and phlegm type, which can significantly improve arterial blood gas, immune function and inflammatory factors, and has no obvious adverse reactions. [ABSTRACT FROM AUTHOR]