BACKGROUND:Sepsis is commonly acute and critical illness with high morbidity and high mortality, and requires timely diagnosis and treatment. Septic patients had elevated serum H-FABP levels, which may correlate with disease severity and mortality. However, previous studies showed that the association between H-FABP and mortality during the sepsis remains unclear. Thus, we performed a study to analyze this relationship.METHODS:The electronic databases such as Cochrane Library, PubMed, Embase, Web of Science, Cochrane Clinical Trials Database, Wanfang Database, and China National knowledge Infrastructure (CNKI) were systematically searched to determine the qualified clinical trials. The study language is limited to English or Chinese. The 2 authors used Cochrane Risk of Bias Tool v.2.0 to independently check the quality of papers and extract relevant data. Comprehensive analysis of data extracted in the research using appropriate statistical methods.RESULTS:Evaluation of the relationship between the prognosis of patients with sepsis and serum H-FABP is the result of this study.CONCLUSION:The analysis results of this study can infer that H-FABP may be an independent risk factor for the prognosis of patients with sepsis. It is also helpful for clinical workers to make early evaluation and early treatment of patients with sepsis.ETHICS AND DISSEMINATION:The conclusions of this meta-analysis study are based on the published evidence. Therefore, moral recognition is unnecessary.OSF REGISTRATION NUMBER:DOI: 10.17605/ OSF.IO / 2V4HN.(https://osf.io/2v4hn/).

目的:研究心型脂肪酸结合蛋白在内毒素致大鼠心肌损伤中的动态变化及其规律,为临床脓毒症心肌损伤的诊断及心功能评估提供动物实验的依据.方法:将雄性Wistar大鼠随机分组:正常对照组、内毒素组.内毒素组:腹腔注射LPS(10mg/kg,用2mLnS溶解)后,正常对照组:腹腔注射同等剂量生理盐水.于3h、6h、12h、24h、48h眼球后静脉丛取血,测量血清中心型脂肪酸结合蛋白(H-FABP)、肌钙蛋白T(cTnT)、心型肌酸激酶(CK-MB)、脑钠肽(BnP)含量.结果:(1)H-FABP:与正常对照组相比,内毒素各组的H-FABP含量明显升高,其中H-FABP含量在3h升高,6h达到高峰,12h出现快速下降,48h下降幅度减少(P<0.01);(2)cTnT:与正常对照组相比,cTnT在6h明显升高,12h达到高峰,24h有所下降,48h仍保持较高浓度(P<0.01);(3)CK-MB:与正常对照组相比,CK-MB在6h明显升高,12h达到高峰,48h保持在较高浓度(P<0.01);(4)BnP:与正常对照组相比,内毒素各组BnP明显升高,并随时间推移,呈上升趋势(P<0.01).结论:血清H-FABP可作为诊断内毒素心肌损伤的早期生物标记物之一,并与cTnT和CK-MB相结合,能更好的发现内毒素的心肌损伤及严重程度.

日间手术指病人在一日(24h)内入、出院完成的手术或操作,是对病人有计划进行的手术和操作,不合门诊手术.可以减少住院时间、降低患者费用,是一种新型医疗模式,合理的管理模式和流程设置是日间手术推广和开展的必要条件,其中流程的合理化、精细化是日间手术成功开展的关键.流程化的管理模式、医护人员的紧密配合,临床医技科室的支持,切实保证了日间手术的运行和实施.

目的：探讨左西孟旦治疗重症监护病房（ICU）心力衰竭患者临床效果，以及对心功能和B型脑钠肽（BNP）、超敏C反应蛋白（hs‐CRP）等的影响。方法选择2013年2月至2016年2月于该院治疗的144例ICU心力衰竭患者作为研究对象，按照随机数字表法分为观察组（72例）和对照组（72例），两组患者均给予适当休息、吸氧、低盐饮食，并给予常规药物治疗。对照组在常规治疗基础上联合应用多巴酚丁胺静脉滴注，初始剂量2μg／（kg · min），1 h后增至4μg／（kg · min），持续用药24 h。观察组在常规治疗基础上联合应用左西孟旦，初始负荷量12．0μg／kg静脉注射10 min ，然后以0．1μg／（kg · min）持续静脉泵入50 min ，如耐受性好剂量增至0．2μg／（kg · min），持续静脉泵入24 h。两组患者分别于治疗前、后检测左心室射血分数（LVEF）、左室舒张末期内径、BNP、hs‐CRP 水平，观察临床疗效、用药3个月和6个月后病死率与再次入院率及不良反应发生情况。结果治疗后观察组总有效率（81．9％）显著高于对照组（66．7％），差异有统计学意义（P＜0．05）；观察组LVEF明显增高，BNP、hs‐CRP水平明显降低，差异均有统计学意义（P＜0．05）；观察组在用药3、6个月后病死率与再次入院率优于对照组，但差异无统计学意义（P＞0．05）；两组患者均发生恶心、呕吐、胸痛、心悸、低血压、头痛、低血钾等不良反应，两组各种不良反应发生情况比较差异无统计学意义（P＞0．05）。结论左西孟旦能有效提高ICU心力衰竭患者临床效果，改善心功能及BNP和hs‐CRP水平，安全性好，值得临床推广应用。

Objective To observe the changes of serum procalcitonin(PCT),C-reactive protein(CRP) and serum cholinesterase(ChE) in multiple trauma patients,and to explore the relationship between the syndrome and multiple organ dysfunction(MODS).Methods Sixty-two multiple injuries patients,according to the presence or absence of MODS,they were divided into MODS group(31 cases) and non-MODS group(31 cases).Determined PCT and CRP levels at after injury's 1,2,3,5,7,14 days and within 24 h' s serum levels of ChE,assessed injury severity score(ISS) value,observed the condition of MODS patients.At the same period,31 cases of healthy people were enrolled as healthy control group,PCT,CRP and serum ChE levels of them also were determined.Results Multiple trauma patients,in different periods after injury,the PCT and CRP levels were higher than the healthy control group,MODS group and non-MODS group' s PCT and CRP levels in second days after injury were reached the peak value,and then decreased gradually with the change of time.The level of PCT in MODS group was higher than the non-MODS group,while the CRP level at seventh,14 th days were higher than in the non-MODS group,the difference was statistically significant(P 0.01).The content of ChE in healthy control group was higher than that in MODS group and non-MODS group,non-MODS group was higher than in MODS group,with statistically significant difference(P 0.01).The ISS was positively correlated with the value of PCT(r =0.625,P =0.000),while no correlation with CRP value(r =0.047,P =0.718),and negatively correlated with serum ChE level(r =0.935,P =0.000).Conclusion Multiple trauma patients' PCT,CRP and cholinesterase level can effectively assess the injury condition,has prediction value for secondary MODS.

Objective:To study the effective mechanism of the Mongolian nutmeg on stress-induced myocardial injury. Methods Wistar rats were randomly divided into three groups: control group, braking and ice swimming group and nutmeg treatment group. Pathological changes of myocardium were observed with the HE staining under the light microscopy. Troponin I ( cTnI) , tumor necrosis factor a ( TNF-a ) and interleukin-6 ( IL-6 ) levels were detected by ELISA in serum. Cardiac myocyte apoptosis was detected by TUNEL assay. Results Compared with normal control group, myocardial injury and cardiomyocyte apoptosis are both increased significantly in braking and ice swimming group, and the contents of cTnI, TNF-a, IL-6 are also increased in Serum(P<0. 01). However, Compared with braking and ice swimming group, myocardial injury and cardiomyocyte apoptosis are less in nutmeg treatment group, and the contents of cTnI, TNF-a, IL-6 are also decreased in Serum ( P<0 . 01 ) . Conclusion stress-induced myocardial injury may be related with myocardial apoptosis mediated by the inflammatory mediators tumor necrosis factor-a, IL-6. Moreover, Mongolian nutmeg had protective effects on stress-induced myocardial injury by reducing tumor necrosis factor-a, IL-6,and inhibiting cardiomyocyte apoptosis.

Objective:To observe the myocardial injury in rats with endotoxemia, and the intervention effect of GSH and its mechanisms of protection on septic myocardial injury. Methods : Twenty-four Wistar rats were randomly divided into three groups, and eight in each: LPS group:intraperitoneal injection of LPS; LPS + GSH group : intraperitoneal injection of LPS and; normal control group(NS group): intraperitoneal injection of the same dose of NS. Take part of heart HE dyeing to observe the change of myocardial use microscope. Detect the serum cTnI and ET-1 by ELISA; Results: ①LPS group has severe myocardial injury observed under light microscope, LPS + GSH group myocardial tissue injury more severe than Normal control group, but lighter than LPS group. ② Compared with normal control group, serum levels of cTnI and ET-1in the LPS group were significantly higher(P0.01), serum of cTnI and ET-1 in LPS + GSH group were higher than the normal control group,but lower than the LPS group(P0.05). Conclusion: Endothelin myocardial vasoconstriction involved in the pathogenesis of myocardial injury in endotoxemia. GSH can relieve the myocardial injury in rats with endotoxemia, probably through reducing the ET-1 on the expression.

The main function of Mongolian medicine myristica fragranr houtt-5 is to cure heart disease.Its compositions are nutmeg,woods,Choerospondiatis,Piper longum,civil incense.Piper longum volatile oil can enhance the capability of fighting animals hypoxia tolerance,to expanse the coronary,and antagonistic pituitary vasopressin-induced myocardial ischemia;and Choerospondiatis can accelerate blood circulation,nourishing the heart,soothe the nerves,anti-ischemic and protection of cardiac function and so on;woody can diuretic and promote the Dissolving of fibrinolysis,etc.nutmeg make the role of warm,Exhaust,digestion,Antidiarrheal,and it can cure the pain of heart and belly,and offer the help of Digestion.In this paper,the main idea is about the composition,pharmacological effects and clinical applications of Mongolian medicine myristica fragranr houtt-5.