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检索条件"任意字段=中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会"

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Introspection of Chinese status of treatment:Comparison of the curative effect of endocrinology inpatient in a certain grade-three general hospital between 1996 and the first half of 2014

Introspection of Chinese status of treatment:Comparison of t...

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中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会

作者： Jinjian Chen Shichao Quan Qingsong Wu Yueyue Huang Wangzhou Chen Binbin He Lijun Song Jingye Pan Department of General Medicine The First Affiliated Hospital of Wenzhou Medical College Record Room The First Affiliated Hospital of Wenzhou Medical College Department of Intensive Care Unit The First Affiliated Hospital of Wenzhou Medical College

Rationale,aims and objectives:Despite the rapid development of medical technology,the real curative effect is unable to find *** study aims to compare the efficacy of endocrinology inpatient in a certain grade-three general hospital between 1996 with the first half of 2014and analyze the underlying ***:We used the score of Barthel Index to evaluate the activities *** subjects are inpatients of endocrinology department in1996(n=205)and in the first half of 2014(n=1495).Result:The improving score of 1996 was 5.05 and in the first half of 2014was ***,the daily average growth of 1996 was XXX while the score of 2014 was only XXX Conclusion:Significant decrease of the curative effect in the first half of 2014 when we compared with the 1996.

关键词： Barthel Index ADL endocrinology department curative effects status of treatment

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The time titration treatment of five cases of human infection with highly pathogenic avian influenza(H7N9 and H1N1)

The time titration treatment of five cases of human infectio...

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中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会

作者： Xiaomin Zhang Haina Zhang Jingye Pan Department of the First Clinical Medical The First Affiliated Hospital of Wenzhou Medical Univ ersity Department of Pharmacy The First Affiliated Hospital of Wenzhou Medical University Department of Intensive Care Unit The First A ffiliated Hospital of Wenzhou Medical University

Avian influenza is one of the most severe infectious diseases caused by the influenza A virus,and it is characterised by a rapid progression to severe *** and poultry have a role in the spread of this *** diagnosis of avian influenza is by clinical evidence and reverse transcription-polymerase chain reaction *** recently treated five patients,including four infected with H7N9 and one with H1N1;four of the patients were cured..The patients'clinical manifestations were similar and included hyperpyrexia,cough,anoxia and rapid progression to severe *** leukocyte and blood platelet levels were shown in the laboratory *** case report describes the"time titration"treatment of four Chinese patients infected with H7N9 and one with H1N1.

关键词： avian influenza H7N9 H1N1 Time titration treatment

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Elucidating the function and tolerance mechanism of gamma delta(γδ) T cells in a Helicobacter pylori infection model

Elucidating the function and tolerance mechanism of gamma de...

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中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会

作者：陈童恩许兆军

In this study,the functions and mechanisms ofγδT cells were analysed in patients infected with Helicobacter *** blood was collected from gastritis patients in the Gastroenterology Department of Ningbo No.2 *** analyses revealed 24 ***-positive and 17 ***-negative *** wild-type andγδT knockout mice were infected with cultured *** cells（obtained from the ***-positive patients）.*** in mice was quantified by polymerase chain reaction（PCR）;gastritis was confirmed by hematoxylin and Eosin *** TCR-δmice were treated with vein adoptive immunotherapy 24 h prior to *** inoculation;the same method was used to detect the extent of gastritis and bacterial ***γδT knockout mice showed high levels of *** infection than the wild-type mice;in addition,the knockout mice showed severedisease pathology,γδT knockout mice also displayed increased matrix metalloproteinase-9（MMP-9）and decreased MMP-7 expression in the gastric mucosa.γδT cells play a protective role in patients infected with ***,γδT cell(responsible for the production of interleukin-17（IL-17）and IL-22)expression was increased in ***/on-positive patients,indicating a statistically ***,there was no significant difference in the interferon-gamma（IFN-y）+γδT expression between the positive and negative *** study demonstrated the probable involvement ofγδT cells in the immune response of an organism,via the secretion of IL-17 and IL-22.

关键词： γ δ T cell receptor H.pylori infection Immune response

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Non-invasive neurally adjusted ventilatory assist for critically ill adults and children

Non-invasive neurally adjusted ventilatory assist for critic...

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中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会

作者： Danqiong Wang Weiwen Zhang Jian Luo Xiaohua Xiong Lihua Zhu Honglong Fang Jianhua Hu Department of Critical Care Medicine Quzhou hospital of zhejiang university

Purpose:To assess the benefits of weaning from noninvasive ventilation for critically ill ventilated adults and children when managed with neurally adjusted ventilatory assist versus Conventional Noninvasive ***:We searched the Cochrane Central Register of Controlled Trials,MEDLINE,EMBASE,CINAHL,and reference lists of *** included studies comparing neurally adjusted ventilatory assist to conventional non-invasive ventilation including PSV,CPAP in patients receiving noninvasive ventilation in an intensive care unit and pediatric intensive care *** 8 trials that fulfilled inclusion criteria,we assessed the effect on trigger delay and asynchrony index during NAVA and conventional noninvasive ventilation.A meta-analysis was conducted on the included trials with the assistance of RevMan 5.2 ***:Totally 8 trials including 89 patients were ***-analysis indicated that,compared with control group,The trigger delay was shorter(IV-124.08[-150.89,-97.28],P<0.001),and the asynchrony index was lower during NAVA than during Conventional Noninvasive ventilation.(IV-21.14[-36.90,-5.39],P<0.001).We found that there is significant heterogeneity among studies and an insufficient number of studies to investigate the source of this ***:NAVA improved patient-ventilator synchrony in critically ill ventilated adults and children during non-invasive *** to the lack of,or limited,evidence on neurally adjusted ventilatory assist other than conventional noninvasive ventilation no conclusions can be drawn regarding their influence on diese outcomes.

关键词： Patient-ventilator interaction Patient-ventilator synchrony Noninvasive Ventilation Neurally adjusted ventilatory assist

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Effects of of early goal directed therapy in septic shock

Effects of of early goal directed therapy in septic shock

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中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会

作者： ZHANG Jinbo XU Zhongcheng LI Zhiqiang CHEN Zhijun The Wenling Hospital Affiliated to Wenzhou Medical College The department of emergency the first people' s hospital of jingmen

Objective:To explore the Effects of early goal directed therapy(EGDT)in septic ***:A total of 148 septic shock patients were divided into two groups randomly:the treatment group(apply early goal directed therapy)for 73 patients and the control group(apply Conventional treatment)for 75 *** mortality of 30d、60d were compared between the two ***:there is no significant differences between the treatment group than that the control group in the mortality of 30d.60d(P=0.623,P=0.812);The mean intravenous fluid volume was significantly lower in the control group than that in treatment group during the first 6 hours(P=0.013);there is no significant differences between the two groups in duration of intensive care unit(ICU)stay(P=0.675),,in hospital stay(P=0.729);there is no significant differences between the two groups in new organ failure of renaU respiratory,,cardiovascular(P=0.722,P=0.763,P=0.524);There was no significant difference between the two groups in the use of vasopressors(P=0.773),in the use of renal replacement therapy(P=0.722),in the use of mechanical ventilation(P=0.794)there is no significant differences between the two groups in gender、Age、APACHEⅡscoer,,Charlson comorbidity score、Positive blood culture(all P>0.05).Conclusions:early goal directed therapy(EGDT)in septic shock did not improve outcomes.

关键词： septic shock mortality early goal directed therapy

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Early interventional therapy for acute massive pulmonary embolism guided by minimally invasive hemodynamic monitoring

Early interventional therapy for acute massive pulmonary emb...

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中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会

作者： Jian Luo Yi Xu Weiwen Zhang Wei Lu Meiqin Chen Lihua Wang Department of Surgery Quzhou People's HospitalZhejiang University

Aim:The aim of this study was to investigate the clinical significance of minimally invasive hemodynamic monitoring in the early catheter-based intervention for acute massive pulmonary embolism(PE).Methods:A total of 40 cases with acute massive PE were analyzed *** patients were divided into experimental and control group with 20 cases in each *** the experimental group,the hemodynamics was monitored via Vigileo/FloTrac system,while echocardiography was used in the control *** hours after systemic thrombolysis,catheter-based clot fragmentation and local thrombolysis were employed in the experimental group if Vigileo/FloTrac system revealed hemodynamic *** the control group,the application of catheter was determined by the findings in echocardiography at 24 hours after systemic ***:A total of 12 cases in the experimental group underwent catheter therapy successfully while 4 cases in the control group received the same *** to the control group,12 hours after catheter intervention the experimental group had higher PaO2/FIO2 and right ventricular ejection fraction(RVEF)but lower pulmonary artery systolic pressure(PASP),indicating the effectiveness of Vigileo/FloTrac ***28-day survival rates were identical between the groups although one patent in the control group *** the RVEF and PASP were significantly improved in the experimental group in 6 months compared to the control ***:In massive PE,hemodynamic monitoring via Vigileo/FloTrac system might be useful in the decision making for catheter intervention after systemic thrombolysis and might improve the outcomes for patients.

关键词： Acute massive pulmonary embolism hemodynamic Vigileo/FloTrac

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Cardioprotective role of mesenchymal stem cell-secreted Follistatin-like1 in a rat model of ischemia/reperfusion injury

Cardioprotective role of mesenchymal stem cell-secreted Foll...

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中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会

作者： Meiqi Zhang Xianghong Yang Ye Shen Renhua Sun Qiuran Xu Department of Emergency Zhejiang Provincial People's Hospital ICU Zhejiang Provincial People's Hospital

Introduction:Follistatin-like protein 1(FSTL1)is a secreted glycoprotein that has been implicated in multiple pathological *** aim of this study is to investigate the protective role of FSTL1secreted by mesenchymal stem cells(MSCs)during myocardial ischemia/reperfusion ***:siRNA against FSTL1(siFSTL1)and FSTL1 expression plasmid were employed to modulate expression of *** of FSTL1 expression on H9C2 cell viability were evaluated by CCK-8 assay and EdU proliferation detection *** of FSTL1 expression on myocardium injury under ischemia/reperfusion were also assessed in a rat model of ischemia/reperfusion *** this model,myocardium infarction area was *** changes were analyzed by Hematoxylin and eosin *** biomarkers were all determined by ELISA *** was also detected by TUNEL ***:knockdown of FSTL1 in MSCs promoted,while overexpression of FSTL1 inhibited H9C2cell viability without significantly affecting cell *** the ischemia/reperfusion injury(IRI)model,mice treated natural MSC supernatants(containing FSTL1)exhibited significantly smaller infarction areas and minimal histological *** injury biomarkers,including serum lactate dehydrogenase(LDH),creatine phosphorkinase(CK)and malondialdehyde(MDA)were accordingly decreased under MSC supernatants ***,MSC supernatants with FSTL1knockdown blunted the above *** addition,myocardium apoptosis was inhibited by MSC supernatant treatments,whereas it was promoted after knockdown of ***:Mesenchymal stem cell protects myocardium from ischemia/reperfusion injury through secreting FSTL1.

关键词： mesenchymal stem cell FSTL1 ischemia/reperfusion injury

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Elevated miR-155 expression induced immunosuppression via CD39+ Tregs in Sepsis patients

Elevated miR-155 expression induced immunosuppression via CD...

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中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会

作者： Jingquan Liu Kai Shi Liang Xu Minhua Chen Xianghong Yang Jun Hong Bangchuan Hu Renhua Sun Department of Intensive Care Unit Zhejiang Provincial People's Hospital Department of Respiratory Medicine The Affiliated Hospital of Hangzhou Normal University(The 2nd People's Hospital of Hangzhou)

Background:Altered microRNA profile exists in many infectious diseases such as *** a remarkable immunosuppressive effect,CD39 Tregs cells play an important role in the regulation of immune balance in *** the correlation between microRNA change and the ratio of CD39 Tregs in sepsis patients has yet not been *** this study,the altered microRNAs expression profile in sepsis patients was ***,the correlation between microRNAs and severity of disease and prognosis was ***,the correlation between microRNA and the percentage of peripheral blood CD39 Tregs was also investigated and further verified by animal ***:Sixty sepsis patients and 30 healthy controls were *** difference in microRNA expression was investigated by microRNA microarray and further confirmed by *** correlation between microRNAs changes and SOFA score,severity of sepsis and survival was *** percentage of CD39+Tregs in peripheral blood of sepsis patients was measured by flow *** correlation between microRNAs and percentage of CD39+Tregs was analyzed and further confirmed by mouse sepsis ***:Compared with the healthy controls,the sepsis patients exhibited a significant elevated microRNA-155(miR-155)level(p<0.05),which related positively to higher SOFA score(r=0.641,p<0.05)and more severity of *** area under ROC curve of miR-155 used for prediction of 28 d survival was 0.763 with a cut-off point of *** with miR-155 level>2.47 had a lower 28 d survival(p<0.05).The miR-155 level of patients was proportional to the percentage of CD39+Tregs(r=0.637,p<0.05).After transfected with miR-155 inhibitor,the ratio of CD39+Tregs in mice with sepsis was significantly reduced(p<0.05).Conclusions:A higher level of miR-155 indicated a more severe condition and poor prognosis in sepsis *** possible underlying mechanism could be that miR-155 induced the percentage of CD39+Tregs and thus immunos

关键词： Sepsis microRNA Regulatory T cell microRNA microarray outcome

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The clinical study of drug resistance transition of the main pathogenic bacteria in ICU during active screening

The clinical study of drug resistance transition of the main...

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中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会

作者： Liu Peng Fang Jun Chen Yu Xu Xiao-min Zhang Yu-chu Xu Zhao-jun Intensive Care Unit Ningbo NO.2 Hospital Microbiology laboratory Ningbo NO.2 Hospital

Objective:Our objective is to explore the drug resistance transition of the main pathogenic bacteria in intensive care unit(ICU)during active ***:1865 strains of pathogenic bacteria separated in our hospital between January,2012-July,2013 and their drug resistance data were selected as the data before active screening,2210 strains of pathogenic bacteria separated in our hospital between August,2013-October,2014 and their drug resistance data were selected as the data after active *** distribution of pathogenic bacteria and the transition of drug resistance before and after active screening were ***:1865strains of pathogenic bacteria were detected before active screening,including 1367 strains of gram-negative bacteria which was 73.3%,396 strains of gram-positive bacteria which was 21.2%,and 102 strains of fungus which was 5.5%;2210 strains of pathogenic bacteria were detected after active screening,including 1549 strains of gram-negative bacteria which was 70.1%,510 strains of gram-positive bacteria which was 23.1%,and 151 strains of fungus which was 6.8%;compared with before active screening,the drug resistance rates of escherichia coli,pseudomonas aeruginosa staphylococcus aureus and streptococcus pneumoniae to most antibiotics after active screening were deceased,however,the drug resistance rate of pseudomonas aeruginosa to cefoperazone/sulbactam was increased,the differences were statistically significant(P<0.05);compared with before active screening,the detection rates of eschenchia coll producing extended-spectrumβ-lactamases(ESBLs)and multi-drug resistant pseudomonas aeruginosa and klebsiella pneumoniae producing ESBLs were significantly higher after active screening,which were statistically significant(P<0.05).Conclusion:Active screening in ICU patients can effectively decrease the drug resistance rates of the main pathogenic bacteria and it is helpful for the detection of multi-drug resistant *** indicates that t

关键词： Intensive Care Unit pathogenic bacteria transition

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急性心肌梗死合并心源性休克的救治体会

急性心肌梗死合并心源性休克的救治体会

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中华医学会第二届重症心脏全国学术大会暨第三届西湖重症医学论坛、2015年浙江省重症医学学术年会

目的探析急诊经皮冠状动脉介入术（PCI）联合主动脉内球囊反搏（IABP）治疗急性心肌梗死合并心源性休克的治疗效果、安全性及预后情况,旨在为今后临床治疗方案选择提供参考和借鉴,以期制定科学合理的治疗方案,改善患者的预后。方法前瞻... 详细信息

目的探析急诊经皮冠状动脉介入术（PCI）联合主动脉内球囊反搏（IABP）治疗急性心肌梗死合并心源性休克的治疗效果、安全性及预后情况,旨在为今后临床治疗方案选择提供参考和借鉴,以期制定科学合理的治疗方案,改善患者的预后。方法前瞻性选取本院2011年2月014年2月期间心内科收治的90例急性心肌梗死合并心源性休克患者为研究对象,根据入院单双号分为对照组和观察组,对照组在常规抗休克治疗基础上行急诊PCI治疗,观察组在对照组治疗基础上给予IABP治疗,对比分析两组患者血流动力学各项指标、并发症、预后情况。结果两组患者心率水平、血压水平、心功能水平较治疗前均明显改善（P<0.05）,观察组改善情况明显优于对照组（P<0.05）;观察组并发症发生率、再次心肌梗死发生率、死亡率分别为26.67%、0.00%、4.44%明显低于对照组的82.22%、13.33%、28.89%,各项比较差异均有显著统计学意义（P<0.05）。结论主动脉内球囊反搏术辅助治疗下急诊行冠状动脉介入治疗已经成为目前治疗急性心肌梗死并发心源性休克患者最安全有效的治疗方案,在临床实践中药早期发现急性心肌梗死并发心源性休克并给予全方位治疗,重建冠脉血运,完成缺血心肌再灌注,改善预后,降低死亡率。

关键词：急性心肌梗死心源性休克经皮冠状动脉介入术主动脉内球囊反搏术疗效

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