As an initial factor,sepsis and multiple organ dysfunction syndrome(MODS)caused by sepsis are the principal causes of death in burned patients. In this report, we measured the levels of tumor necrosis factor (TNF)-α,...As an initial factor,sepsis and multiple organ dysfunction syndrome(MODS)caused by sepsis are the principal causes of death in burned patients. In this report, we measured the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8 in severely burned patients with sepsis after the initiation of continuous vein-vein hemodiafiltration (CVVHDF) to evaluate the clinical usefulness of CVVHDF on the removal of key mediators. The vital sign indices, such as the heart rate (HR), respiration (R) and central venous pressure (CVP), were recorded at 0 and 42 h in each group. Further, the laboratory examinations indexes, such as the white blood cel count, blood sugar, se-rum sodium, blood urea nitrogen and serum creatinine, were detected in venous blood samples. Twenty-two severely burned patients suffering from sepsis were randomized into the control group (A, n = 11) and the experimental group (B, n = 11). The patients in group A underwent conventional treatment, and those in group B received conventional+CVVHDF treatment. The vital signs, such as the HR, R, and CVP, and laboratory examination indices, such as the blood cel count, blood sugar, serum sodium, blood urea nitrogen, and serum creatinine, dropped significantly in group B compared with those in group A at 42 h (P < 0.05). The plasma levels of TNF-α, IL-6 and IL-8 were measured at 0, 12, 18, 24, 36 and 42 h after the start of CVVHDF and at the same time points after the patients were diagnosed with sepsis in group A. The plasma levels of TNF-α in group B decreased by 32% at 18 h after the start of CVVHDF and decreased by 43%at 42 h after the start of CVVHDF;however, these levels were increased compared with the normal values (P < 0.01). The plasma levels of IL-6 decreased at 18 h after the start of CVVHDF (0.274 ± 0.137 ng/ml). Fol owing a brief increase at 24 h, the plasma levels of IL-6 again decreased continuously until the end of the investigation (0.192 ± 0.119 ng/ml). The plasma levels of IL-8 in group B decreased by 56% at 18 h after the start of CVVHDF, but they were increased compared with the normal values (P < 0.01). The plasma levels of IL-8 in group B decreased by 70% at 42 h after the start of CVVHDF, but they were increased compared with the normal values (P < 0.01). The MODS incident was 4 of 11 in group A compared with 1 of 11 in group B (P < 0.01). In conclusion, CVVHDF can effectively reduce the levels of TNF-α, IL-6 and IL-8 as wel as the MODS incidence in patients with serious burns.展开更多
BACKGROUND： The study aimed to investigate the clinical characteristics of acute renal failure（ARF） caused by oral acyclovir.METHODS： A 45-year-old Chinese male patient with acyclovir-induced ARF suffered fromabdo...BACKGROUND： The study aimed to investigate the clinical characteristics of acute renal failure（ARF） caused by oral acyclovir.METHODS： A 45-year-old Chinese male patient with acyclovir-induced ARF suffered fromabdominal pain for one day. The pain was extended to the epigastric area from the right lowerquadrant. Transient oliguria was seen in addition to microscopic hematuria and proteinuria. Theserum creatinine concentration was 304 !mol/L. Eight days before the occurrence of ARF, the patienttook oral acyclovir for facial neuritis.RESULTS： His renal function was restored completely following the discontinuation of acyclovir,with continuous renal replacement therapy for 54 hours and some symptomatic treatment.CONCLUSION： The presentation of acute renal failure caused by acyclovir can be diverse, butthe prognosis is good after active treatment.展开更多
文摘As an initial factor,sepsis and multiple organ dysfunction syndrome(MODS)caused by sepsis are the principal causes of death in burned patients. In this report, we measured the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8 in severely burned patients with sepsis after the initiation of continuous vein-vein hemodiafiltration (CVVHDF) to evaluate the clinical usefulness of CVVHDF on the removal of key mediators. The vital sign indices, such as the heart rate (HR), respiration (R) and central venous pressure (CVP), were recorded at 0 and 42 h in each group. Further, the laboratory examinations indexes, such as the white blood cel count, blood sugar, se-rum sodium, blood urea nitrogen and serum creatinine, were detected in venous blood samples. Twenty-two severely burned patients suffering from sepsis were randomized into the control group (A, n = 11) and the experimental group (B, n = 11). The patients in group A underwent conventional treatment, and those in group B received conventional+CVVHDF treatment. The vital signs, such as the HR, R, and CVP, and laboratory examination indices, such as the blood cel count, blood sugar, serum sodium, blood urea nitrogen, and serum creatinine, dropped significantly in group B compared with those in group A at 42 h (P < 0.05). The plasma levels of TNF-α, IL-6 and IL-8 were measured at 0, 12, 18, 24, 36 and 42 h after the start of CVVHDF and at the same time points after the patients were diagnosed with sepsis in group A. The plasma levels of TNF-α in group B decreased by 32% at 18 h after the start of CVVHDF and decreased by 43%at 42 h after the start of CVVHDF;however, these levels were increased compared with the normal values (P < 0.01). The plasma levels of IL-6 decreased at 18 h after the start of CVVHDF (0.274 ± 0.137 ng/ml). Fol owing a brief increase at 24 h, the plasma levels of IL-6 again decreased continuously until the end of the investigation (0.192 ± 0.119 ng/ml). The plasma levels of IL-8 in group B decreased by 56% at 18 h after the start of CVVHDF, but they were increased compared with the normal values (P < 0.01). The plasma levels of IL-8 in group B decreased by 70% at 42 h after the start of CVVHDF, but they were increased compared with the normal values (P < 0.01). The MODS incident was 4 of 11 in group A compared with 1 of 11 in group B (P < 0.01). In conclusion, CVVHDF can effectively reduce the levels of TNF-α, IL-6 and IL-8 as wel as the MODS incidence in patients with serious burns.
文摘BACKGROUND： The study aimed to investigate the clinical characteristics of acute renal failure（ARF） caused by oral acyclovir.METHODS： A 45-year-old Chinese male patient with acyclovir-induced ARF suffered fromabdominal pain for one day. The pain was extended to the epigastric area from the right lowerquadrant. Transient oliguria was seen in addition to microscopic hematuria and proteinuria. Theserum creatinine concentration was 304 !mol/L. Eight days before the occurrence of ARF, the patienttook oral acyclovir for facial neuritis.RESULTS： His renal function was restored completely following the discontinuation of acyclovir,with continuous renal replacement therapy for 54 hours and some symptomatic treatment.CONCLUSION： The presentation of acute renal failure caused by acyclovir can be diverse, butthe prognosis is good after active treatment.
