Present article discusses the physiological mechanisms of the state employees adaptation during active training in temporary groups. It is suggested that adaptive mechanisms to adverse effects may be studied basing on...Present article discusses the physiological mechanisms of the state employees adaptation during active training in temporary groups. It is suggested that adaptive mechanisms to adverse effects may be studied basing on the concept of functional isomorphism of the psychic and immune systems. Adaptive mechanisms were studied through the monitoring of the stress factors’ impact upon the law enforcement officers when training outside the places of permanent deployment. The specific purpose of present study was to evaluate the physiological indicators of the psychic, immune and endocrine systems dynamics at different stages of adaptation of the live organism to a stressful situation, hoping to get better insight into possible relations between psychic and immune domains. Through monitoring of the dynamics of the endocrine and immune responses to the psychic stimuli, it was possible to correlate the stages of the stress onset to the phases of specific immune reactions. Strong correlations between the parameters characterizing activation of the psychic and immune responses support the hypothesis of the presence of “strong cooperation” between psychic and immune domains. It supports earlier hypothesis that we are monitoring different manifestations of the functioning of a complex inseparable psycho-immune meta-system.展开更多
Background Fluid therapy for severe acute pancreatitis （SAP） should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for...Background Fluid therapy for severe acute pancreatitis （SAP） should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for fluid therapy dedicated to SAP. So, this study was aimed to investigate the effects of fluid therapy treatment on prognosis of SAP. Methods Seventy-six patients were admitted prospectively according to the criteria within 72 hours of SAP onset. They were randomly assigned to a rapid fluid expansion group （Group I, n=36） and a controlled fluid expansion group （Group II n=-40）. Hemodynamic disorders were either quickly （fluid infusion rate was 10-15 ml.kg-1-h-1, Group I） or gradually improved （fluid infusion rate was 5-10 ml-kg1.h-1, Group II） through controlling the rate of fluid infusion. Parameters of fluid expansion, blood lactate concentration were obtained when meeting the criteria for fluid expansion. And APACHE II scores were obtained serially for 72 hours. Rate of mechanical ventilation, incidence of abdominal compartment syndrome （ACS）, sepsis, and survival rate were obtained. Results The two groups had statistically different （P 〈0.05） time intervals to meet fluid expansion criteria （Group I, 13.5±6.6 hours; Group II, （24.0±5.4） hours）. Blood lactate concentrations were both remarkably lower as compared to the level upon admission （P 〈0.05） and reached the normal level in both groups upon treatment. It was only at day 1 that hematocrit was significantly lower in Group I （35.6%±6.8%） than in Group II （38.5%±5.4%） （P〈0.01）. Amount of crystalloid and colloid in group I （（4028±1980）ml and （1336±816）ml） on admission day was more than those of group II （（2472±1871）ml and （970±633）ml）. No significant difference was found in the total amount of fluids within four days of admission between the two groups （P〉0.05）. Total amount of fluid sequestration within 4 days was higher in Group I （（5378±2751）ml） than in Group II （（4215±1998）ml, P 〈0.05）. APACHE II scores were higher in Group I on days 1, 2, and 3 （P〈0.05）. Rate of mechanical ventilation was higher in group I （94.4%） than in group II （65%, P〈0.05）. The incidences of abdominal compartment syndrome （ACS） and sepsis were significantly lower in Group II （P 〈0.05）. Survival rate was remarkably lower in Group I （69.4%） than in Group II （90%, P〈0.05）. Conclusions Controlled fluid resuscitation offers better prognosis in patients with severe volume deficit within 72 hours of SAP onset. Chin Med J 2009; 122（2）： 169-173展开更多
文摘Present article discusses the physiological mechanisms of the state employees adaptation during active training in temporary groups. It is suggested that adaptive mechanisms to adverse effects may be studied basing on the concept of functional isomorphism of the psychic and immune systems. Adaptive mechanisms were studied through the monitoring of the stress factors’ impact upon the law enforcement officers when training outside the places of permanent deployment. The specific purpose of present study was to evaluate the physiological indicators of the psychic, immune and endocrine systems dynamics at different stages of adaptation of the live organism to a stressful situation, hoping to get better insight into possible relations between psychic and immune domains. Through monitoring of the dynamics of the endocrine and immune responses to the psychic stimuli, it was possible to correlate the stages of the stress onset to the phases of specific immune reactions. Strong correlations between the parameters characterizing activation of the psychic and immune responses support the hypothesis of the presence of “strong cooperation” between psychic and immune domains. It supports earlier hypothesis that we are monitoring different manifestations of the functioning of a complex inseparable psycho-immune meta-system.
文摘Background Fluid therapy for severe acute pancreatitis （SAP） should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for fluid therapy dedicated to SAP. So, this study was aimed to investigate the effects of fluid therapy treatment on prognosis of SAP. Methods Seventy-six patients were admitted prospectively according to the criteria within 72 hours of SAP onset. They were randomly assigned to a rapid fluid expansion group （Group I, n=36） and a controlled fluid expansion group （Group II n=-40）. Hemodynamic disorders were either quickly （fluid infusion rate was 10-15 ml.kg-1-h-1, Group I） or gradually improved （fluid infusion rate was 5-10 ml-kg1.h-1, Group II） through controlling the rate of fluid infusion. Parameters of fluid expansion, blood lactate concentration were obtained when meeting the criteria for fluid expansion. And APACHE II scores were obtained serially for 72 hours. Rate of mechanical ventilation, incidence of abdominal compartment syndrome （ACS）, sepsis, and survival rate were obtained. Results The two groups had statistically different （P 〈0.05） time intervals to meet fluid expansion criteria （Group I, 13.5±6.6 hours; Group II, （24.0±5.4） hours）. Blood lactate concentrations were both remarkably lower as compared to the level upon admission （P 〈0.05） and reached the normal level in both groups upon treatment. It was only at day 1 that hematocrit was significantly lower in Group I （35.6%±6.8%） than in Group II （38.5%±5.4%） （P〈0.01）. Amount of crystalloid and colloid in group I （（4028±1980）ml and （1336±816）ml） on admission day was more than those of group II （（2472±1871）ml and （970±633）ml）. No significant difference was found in the total amount of fluids within four days of admission between the two groups （P〉0.05）. Total amount of fluid sequestration within 4 days was higher in Group I （（5378±2751）ml） than in Group II （（4215±1998）ml, P 〈0.05）. APACHE II scores were higher in Group I on days 1, 2, and 3 （P〈0.05）. Rate of mechanical ventilation was higher in group I （94.4%） than in group II （65%, P〈0.05）. The incidences of abdominal compartment syndrome （ACS） and sepsis were significantly lower in Group II （P 〈0.05）. Survival rate was remarkably lower in Group I （69.4%） than in Group II （90%, P〈0.05）. Conclusions Controlled fluid resuscitation offers better prognosis in patients with severe volume deficit within 72 hours of SAP onset. Chin Med J 2009; 122（2）： 169-173
