Chlorfenapyr poisoning is associated with high mortality due to the absence of evidence-based treatment strategies or specific antidotes.[1,2]Chlorfenapyr is a novel N-substituted halogenated pyrrole pro-insecticide.T...Chlorfenapyr poisoning is associated with high mortality due to the absence of evidence-based treatment strategies or specific antidotes.[1,2]Chlorfenapyr is a novel N-substituted halogenated pyrrole pro-insecticide.The active metabolite of tralopyril(a metabolite of chlorfenapyr)can uncouple oxidative phosphorylation and impair adenosine triphosphate(ATP)production.[3]Blood purification techniques,including hemoperfusion(HP),may facilitate tralopyril clearance.[4,5]Here,we present a case of severe chlorfenapyr poisoning that was treated with intensive HP.H owever,during follow-up,we unexpectedly found a ventricular aneurysm in the left ventricle that was not fully explained by coronary artery lesions.展开更多
BACKGROUND Data on adsorptive extracorporeal membrane oxygenation(ECMO)(combined with HA380 hemoperfusion column)on the inflammatory factors in patients with cardiogenic shock(CS)remains limited.AIM To investigate the...BACKGROUND Data on adsorptive extracorporeal membrane oxygenation(ECMO)(combined with HA380 hemoperfusion column)on the inflammatory factors in patients with cardiogenic shock(CS)remains limited.AIM To investigate the effects of adsorptive ECMO on the inflammatory factors in patients with CS.METHODS A retrospective analysis was performed on 81 patients with CS caused by acute myocardial infarction,fulminant myocarditis,or cardiac surgery who required venoarterial ECMO support at TEDA International Cardiovascular Hospital from December 2020 to December 2024.Patients were divided into the conventional ECMO group(42 cases)and the adsorptive ECMO group(ECMO combined with hemoperfusion,39 cases).The adsorptive ECMO group received 2 columns of HA380 initiation on the first day(the first column connected within 2 hours of ECMO and the second after 12 hours of ECMO),followed by 1 column each day,with each column used for 4–6 hours,totaling 24–30 hours of treatment.Baseline data were compared between the two groups:Inflammatory factor levels(at 0,6,12,24,48,and 72 hours after ECMO or hemoperfusion initiation);ECMO support duration;successful weaning rate;continuous renal replacement therapy(CRRT)utilization;Sequential Organ Failure Assessment(SOFA)score;Vasoactive-Inotropic Score(VIS);systemic inflammatory response syndrome(SIRS)incidence;and in-hospital survival and 30-/90-day survival after discharge.RESULTS The adsorptive ECMO group showed significantly lower levels of C-reactive protein,interleukin(IL)-6,tumor necrosis factor(TNF)-α,and lactate from 6 to 72 hours compared with the conventional ECMO group(all P<0.05),with IL-6 decreasing by 94.4%and tumour necrosis factor alpha by 70.1%from baseline at 72 hours.The adsorptive ECMO group had a significantly shorter ECMO duration[114.0(75.0–139.0)hours vs 135.0(73.0–199.3)hours,P=0.032];higher successful weaning rate(66.7%vs 42.9%,P=0.032);a trend toward lower CRRT utilization(54.8%vs 38.5%,P=0.070);lower post-weaning SOFA score[7(6–8)vs 9(8–10),P<0.001];significantly reduced VIS(8.4±1.3 vs 9.8±1.6,P<0.001);and a trend toward lower SIRS incidence(10.3%vs 26.2%,P=0.065).There were no significant differences in complications,in-hospital survival(64.1%vs 52.4%,P=0.285);or 30-/90-day survival between the two groups(all P>0.05).CONCLUSION Adsorptive ECMO efficiently clears IL-6 and TNF-α,significantly improving ECMO weaning success rate and hemodynamics.However,it has no significant impact on survival,and its efficacy requires validation through prospective studies.展开更多
Objective: To analyze the emergency treatment effect of ultra-early hemoperfusion (HP) in patients with severe organophosphate pesticide poisoning (SOPP). Methods: Sixty SOPP patients treated in the emergency departme...Objective: To analyze the emergency treatment effect of ultra-early hemoperfusion (HP) in patients with severe organophosphate pesticide poisoning (SOPP). Methods: Sixty SOPP patients treated in the emergency department between January 2022 and January 2024 were randomly divided into two groups using a random number table. The observation group (30 cases) received ultra-early HP treatment, while the reference group (30 cases) received conventional HP treatment initiated 6 hours post-poisoning. The groups were compared in terms of overall emergency efficacy, clinical indicators, serological markers, inflammatory factors, and complication rates. Results: The observation group had a higher total efficacy rate than the reference group, superior clinical indicators, and a lower complication rate (P < 0.05). After 24 hours of emergency treatment, serological markers and inflammatory factor levels in the observation group were lower than those in the reference group (P < 0.05). Conclusion: Ultra-early HP treatment provides better emergency outcomes for SOPP patients by shortening treatment time, improving serological markers and inflammatory factor levels, and offering higher safety. It demonstrates significant advantages in emergency care.展开更多
BACKGROUND Hemoperfusion(HP)is an extracorporeal blood purification modality utilized to remove small-to medium-sized molecules,such as toxins and cytokines,that are difficult to remove by conventional hemodialysis.In...BACKGROUND Hemoperfusion(HP)is an extracorporeal blood purification modality utilized to remove small-to medium-sized molecules,such as toxins and cytokines,that are difficult to remove by conventional hemodialysis.In clinical practice,HP has been successfully used as a salvage therapy for drug overdose and occasionally in patients with liver failure and sepsis.AIM To summarize the clinical outcomes of a series of patients with severe coronavirus disease 2019(COVID-19)who received HP.METHODS Here,we summarize the clinical outcomes of a series of 18 patients with severe COVID-19 who received HP in our institution during the COVID-19 pandemic.A review of the literature was also performed.RESULTS HP was well-tolerated,and after an average of three sessions,respiratory and cardiovascular parameters as well as blood inflammatory markers improved in most patients.Ten patients were discharged alive.Our literature search identified a total of 20 studies(873 patients)in which HP was used for COVID-19.Nine studies reported improvements in respiratory parameters,and 13 studies(438 patients in total)reported better survival rates in patients undergoing HP.CONCLUSION HP was well-tolerated in patients with severe COVID-19,and most studies reported improved clinical parameters,including better survival rates,when HP was used in patients with severe COVID-19.Further research,especially prospective studies,is needed to evaluate the utility of HP as an early and supportive therapy for critically ill patients due to infectious diseases,such as those with COVID-19 or severe sepsis.展开更多
Objective： The intoxications caused by 2,4-dinitrophenol （2,4-DNP）, even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and ex...Objective： The intoxications caused by 2,4-dinitrophenol （2,4-DNP）, even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and explore the clinical value of resin hemoperfusion （HP） in the treatment of patients with acute 2,4-DNP poisoning. Methods We reported 16 cases of acute 2,4-DNP poisoning through occupational exposure due to ignoring the risk of poisoning. The blood samples were collected from the 14 survivors. According to the different treatments of resin HP, the survivors were divided into routine HP （n=5） and intensive HP （n=9） groups. Ultra high performance liquid chromatography/ tandem mass spectroscopy （UPLC-MS/MS） was used to detect the 2,4-DNP concentration in plasma in this study. Results： The 14 survivors recovered very well after treatment. The initial plasma 2,4-DNP concentrations （C1） of survivors ranged from 0.25 to 41.88 pg/ml （mean （12.56＋13.93） pg/ml）. A positive correlation existed between initial plasma 2,4-DNP concentration （C1） and temperature. The elimination of 2,4-DNP was slow and persistent, and the total clearance rates of plasma toxin from the 1st to 3rd day （R3）, the 3rd to 7th day （R3-7）, and the 1st to 7th day （RT）, were only （53.03±14.04）%, （55.25±10.50）%, and （78.29±10.22）%, respectively. The plasma toxin was cleared up to 25 d after poisoning in most of the patients. The R3, R3-7, and R7 in the intensive HP group were all apparently higher than those in the routine HP group, with statistical significance （P〈0.05）. Simultaneously, the elimination half-life （tl/2） of 2,4-DNP in the intensive HP group was apparently shorter than that in the routine HP group, with statistical significance （P〈0.05）. Conclusions： The clinicians should be aware of this slow and persistent process in the elimination of plasma 2,4-DNP. Higher initial plasma toxin concentration resulted in a more severe fever for the patient. According to the limited data, longer and more frequent resin HP may accelerate to eliminate the poison.展开更多
BACKGROUND:Blood hemoperfusion with resin adsorption can clean larger molecules that exceed the molecular weight cutoff of combined continuous veno-venous hemofiltration(CWH).Hence blood hemoperfusion with resin adsor...BACKGROUND:Blood hemoperfusion with resin adsorption can clean larger molecules that exceed the molecular weight cutoff of combined continuous veno-venous hemofiltration(CWH).Hence blood hemoperfusion with resin adsorption combined CWH(HP+CWH) has higher ability of mediator clearance,and can improve clinical outcomes in theory.This study aimed to investigate the effect of blood hemoperfusion with resin adsorption combined continuous veno-venous hemofiltration(HP+CWH) on plasm cytokines like TNF-α,IL-1β,IL-6,cellular immunity and prognosis in patients with multiple organ dysfunction syndrome(MODS).METHODS:This was a prospective,randomized clinical trial.A total of 30 patients who had been diagnosed with MODS were enrolled in this study.Patients were randomly allocated to routine treatment+HP+CWH group(treatment group) and routine treatment+only CWH group(control group).In the treatment group,patients received blood hemoperfusion with resin adsorption for 2hours,and then received CWH for 10 hours every day.In the control group,patients received CWH for 12 hours only every day.The patients in the two groups received blood purification therapy for three days.The plasma of patients in the treatment group was obtained at 0,2,12,24,26,36,48,50,60 hours,5th day,7th day and 10 th day,respectively.The plasma of patients in the control group was obtained at 0,12,24,36,48,60 hours,5th day,7th day and 10 th day,respectively.APACHE Ⅱscore,T-lymphocytes subpopulations,blood lactate acid concentration,heart rate,breathing rate,and oxygenation index were observed.RESULTS:Plasma cytokines like TNF-α,IL-1β,IL-6 decreased markedly after HP(P<0.01);T-lymphocytes subpopulations CD3+,CD4+,CD8+,CD4+/CD8+ increased after HP+CWH or only CWH.The plasma concentrations of TNF-α,IL-1β and IL-6 in the two groups were not markedly different at 12,36,and 50 hours.But on the 5th day,the plasma concentrations of TNF-α,IL-1β and IL-6 in the treatment group were lower than those in the control group(P<0.05).On the 28 th day,5patients died in the treatment group,and 6 patients in the control group.CONCLUSIONS:Both HP+CWH and CWH can clean plasma cytokines like TNF-α,IL-1β,and IL-6,and improve cellular immunity and clinical symptoms and signs of patients.Compared with only CWH,the plasma concentrations of TNF-α,IL-1β and IL-6 were lower on the 5th day,and patients have an increased survival rate on the 28 day in the HP+CWH group.展开更多
AIM： To investigate the effectiveness of direct hemoperfusion with polymyxin B-immobilized fibers （DHPPMX therapy） on warm ischemia-reperfusion （I/R） injury of the small intestine.METHODS： The proximal jejunum a...AIM： To investigate the effectiveness of direct hemoperfusion with polymyxin B-immobilized fibers （DHPPMX therapy） on warm ischemia-reperfusion （I/R） injury of the small intestine.METHODS： The proximal jejunum and distal ileum of mongrel dogs were resected. Warm ischemia was performed by clamping the superior mesenteric artery （SMA） and vein （SMV） for 2 h. Blood flow to the proximal small intestine was restored 1 h after reperfusion, and the distal small intestine was used as a stoma. The experiment was discontinued 6 h after reperfusion. The dogs were divided into two groups： the DHP-PMX group （n = 6, DHP-PMX was performed for 180 min; from 10 min prior to reperfusion to 170 rain after reperfusion） and the control group （n = 5）. The rate pressure product （RPP）, SMA blood flow, mucosal tissue blood flow, and intramucosal pH （pHi） were compared between the two groups. The serum interleukin （IL）-10 levels measured 170 min after reperfusion were also compared.RESULTS： The RPP at 6 h after reperfusion was significantly higher in the PMX group than in the control group （12174 ± 1832 mmHg/min vs 8929 ± 1797 mmHg/min, P 〈 0.05）. The recovery rates of the SMA blood flow at I and 6 h after reperfusion were significantly better in the PMX group than in the control group （61%±7% vs 44% ±4%, P 〈 0.05, and 59%±5% vs 35%±5%, P 〈 0.05, respectively）. The recovery rate of the mucosal tissue blood flow and the pHi levels at 6 h after reperfusion were significantly higher in the PMX group （61%±8% vs 31%±3%, P 〈 0.05 and 7.91±0.06 vs 7.69±0.08, P 〈 0.05, respectively）. In addition, the serum IL-IO levels just before DHP-PMX removal were significantly higher in the PMX group than in the control group （1 569 ± 253 pg/mL vs 211± 40 pg/mL, P 〈 0.05）.CONCLUSION： DHP-PMX therapy reduced warm I/R injury of the small intestine. IL-10 may play a role in inhibiting I/R injury during DHP-PMX therapy.展开更多
BACKGROUND Polymyxin B hemoperfusion(PMX-HP)has been used as a treatment for intraabdominal septic shock by absorbing and removing endotoxins of gram-negative bacilli.AIM To investigate the clinical efficacy of PMX-HP...BACKGROUND Polymyxin B hemoperfusion(PMX-HP)has been used as a treatment for intraabdominal septic shock by absorbing and removing endotoxins of gram-negative bacilli.AIM To investigate the clinical efficacy of PMX-HP in patients with gram-negative septic shock who underwent abdominal surgery.METHODS From January 2012 to December 2018,patients who had septic shock secondary to peritonitis were enrolled.They were classified into PMX-HP treated and control groups based on postopreative intervention using PMX-HP.The clinical outcomes were compared using 1:1 propensity score matching methods to balance the overall distribution between the two groups.RESULTS After propensity score matching,40 patients were analyzed(20 patients in the PMX group and 20 patients in the control group).The scores of total Sequential Organ Failure Assessment(SOFA)score,renal SOFA and coagulation SOFA were significantly improved in the PMX group but not in the control group.(from 11.2±5.8 to 4.7±3.5 in PMX group vs 10.0±4.0 to 8.7±7.3 in control group,P=0.047 from 2.6±1.0 to 0.7±1.0 in PMX group vs 2.6±1.5 to 2.8±1.6 in control group,P=0.000,from 1.6±1.5 to 1.3±1.3 in PMX group vs 1.2±1.2 to 2.8±1.8 in control group,P=0.014,respectively).Further,the length of intensive care unit(ICU)stay was significantly shorter in PMX group.However,no statistically significant difference was found in ICU mortality(50%in PMX group vs 50%in control group).CONCLUSION PMX-HP is a feasible adjunct treatment for peritonitis in ICU patients with peritonitis for improved organ impairment and to stabilize hemodynamics.It would be helpful to enhance clinical outcomes especially in patients with complete elimination of the source of gram-negative bacilli infection by surgical procedure accompanied with conventional treatment of sepsis.展开更多
BACKGROUND:This study aimed to observe the effect of hemoperfusion(HP) cartridge on different internal environment indicators at different time points in patients with acute blood poisoning and to find alternative ind...BACKGROUND:This study aimed to observe the effect of hemoperfusion(HP) cartridge on different internal environment indicators at different time points in patients with acute blood poisoning and to find alternative indicators for the detection of blood poisoning.METHODS:The levels of internal environment indicators(blood pH,P_vCO_2,P_vCO_2,blood lactate,potassium,free calcium,bicarbonate,and blood glucose) before and after HP treatment were recorded for patients with acute poisoning at time points of 30 minutes and 120 minutes.After calculating the difference value 5,the statistical software was used to analyze the statistical difference of the influence caused by HP cartridge at two time points.According to the formula,adsorption rate%=(a-v)/a×100,the adsorption rate of each indicator was calculated respectively.RESULTS:The difference of indicators at different time points in inlet and outlet such as blood glucose,free-calcium,and lactate was statistically significant(P<0.05),but the difference in indicators such as pH,P_vCO_2,P_vO_2,potassium,sodium,and bicarbonate was not statistically significant(P>0.05).CONCLUSION:During HP treatment,the indicators of blood glucose,free-calcium and lactate were significantly affected by HP cartridge,and the effect varies with time.展开更多
Objective:To study the effect of hemodialysis (HD) combined with hemoperfusion (HP) on dialysis efficiency, lipid metabolism and atherosclerosis in patients with uremia.Methods:A total of 70 patients with uremia who w...Objective:To study the effect of hemodialysis (HD) combined with hemoperfusion (HP) on dialysis efficiency, lipid metabolism and atherosclerosis in patients with uremia.Methods:A total of 70 patients with uremia who were treated in our hospital between March 2013 and October 2015 were collected and divided into observation group and control group (n=35) according to double-blind randomized control method. Observation group of patients received hemodialysis combined with hemoperfusion, control group of patients received hemodialysis alone, and the treatment lasted for 6 months. After 6 months of intervention, automatic biochemical analyzer was used to detect renal function indexes and lipid metabolism indexes, and the two-dimensional ultrasound was used to quantitatively determine the carotid atherosclerosis parameters.Results:Before intervention, differences in renal function, lipid metabolism and atherosclerosis levels were not statistically significant between two groups of patients;after 6 months of intervention, renal function indexes blood urea nitrogen (BUN), serum creatinine (Scr),β2-microglobulin (β2-MG) and blood uric acid (BUA) levels of observation group were lower than those of control group, lipid metabolism indexes total cholesterol (TC), triglyceride (TG), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) levels were lower than those of control group, and differences between groups were statistically significant;quantitative carotid ultrasound parameters gray-scale median (GSM) of observation group was higher than that of control group, enhanced intensity (EI) and enhanced density (ED) were lower than those of control group, and differences between groups were statistically significant.Conclusion:Hemodialysis combined with hemoperfusion can improve the dialysis efficiency, also reduce lipid metabolism disturbance and delay the formation of atherosclerosis in patients with uremia.展开更多
Objective: To observe the effects of hemoperfusion combined with sequential dialysis on soluble tumor necrosis factor receptor in patients with diabetic kidney disease. Methods:A total of 100 patients with diabetic ki...Objective: To observe the effects of hemoperfusion combined with sequential dialysis on soluble tumor necrosis factor receptor in patients with diabetic kidney disease. Methods:A total of 100 patients with diabetic kidney disease who had been seeking treatment in the hospital between May 2015 and July 2017 were selected, and then according to the random number table method, these patients were divided into a control group and an observation group, with 50 cases in each group. The control group was treated with hemodialysis only, whereas the observation group was given hemoperfusion combined with sequential dialysis for treatment. The changes of soluble tumor necrosis factor receptor, oxidant factor and metabolic indexes after 12 weeks of treatment were compared between the two groups. Results: After treatment, the metabolic indexes in the observation group were shown to be lower than the control group, the levels of soluble tumor necrosis factor receptor related indexes in the former group were lower than the control group, and the level of oxidative stress indicators in the former group was shown to be better than the control group, where the differences were statistically significant. Conclusion: For patients with diabetic kidney disease, hemoperfusion combined with sequential dialysis is with significant clinical curative effects, which can effectively relieve their oxidative stress, better control the blood glucose level, significantly improve their renal function and significantly reduce the level of soluble tumor necrosis factor receptor.展开更多
Objective: To investigate the effects of hemoperfusion combined with hemodialysis on target organ damage in patients with acute paraquat poisoning. Methods: A total of 42 patients with acute paraquat poisoning who wer...Objective: To investigate the effects of hemoperfusion combined with hemodialysis on target organ damage in patients with acute paraquat poisoning. Methods: A total of 42 patients with acute paraquat poisoning who were admitted and treated in our hospital between December 2013 and October 2017 were selected as the research subjects, and their therapies were reviewed and used to divide them into the control group (n=20) who received hemoperfusion alone and the combined treatment group (n=22) who received hemoperfusion combined with hemodialysis. The differences in the levels of liver and kidney function indexes in peripheral blood as well as lung function indexes in arterial blood were compared between the two groups of patients immediately after admission, after 1 d of treatment and after 3 d of treatment. Results: Immediately after admission, the differences in the levels of liver and kidney function indexes in peripheral blood as well as lung function indexes in arterial blood were not statistically significant between the two groups. After 1d of treatment and after 3 d of treatment, kidney function indexes Scr, BUN and β2-MG levels in peripheral blood of combined treatment group were lower than those of control group at corresponding time points respectively;liver function indexes ALT, AST, TB and ALP levels in peripheral blood were lower than those of control group at corresponding time points respectively;lung function indexes PaO2, BE and PCO3- levels in arterial blood were higher than those of control group at corresponding time points respectively whereas PaCO2 levels were lower than those of control group at corresponding time points respectively. Conclusion: Compared with hemoperfusion alone, hemoperfusion combined with hemodialysis is more advantageous in protecting the functions of liver, kidney, lungs and other target organs of patients with acute paraquat poisoning.展开更多
Objective: To study the effects of intensive hemoperfusion on the toxin clearance, target organ function and oxidative stress in patient with paraquat poisoning. Methods: A total of 56 patients with paraquat poisoning...Objective: To study the effects of intensive hemoperfusion on the toxin clearance, target organ function and oxidative stress in patient with paraquat poisoning. Methods: A total of 56 patients with paraquat poisoning who were treated in the People's Hospital of Hanchuan between November 2013 and January 2017 were reviewed and divided into the control group (n=30) and the intensive hemoperfusion group (n=26). Control group received conventional therapy, and intensive hemoperfusion group received conventional therapy combined with intensive hemoperfusion. The differences in paraquat clearance effect, target organ function and oxidative stress response were compared between the two groups. Results: Serum paraquat level in intensive hemoperfusion group was lower than that in control group, and the paraquat clearance rate was higher than that of control group. Serum pulmonary fibrosis indexes PⅠCP, CⅣ and HA levels in intensive hemoperfusion group were lower than those in control group;serum liver function indexes ALP, STB and ALT levels were lower than those in control group;serum oxidative stress index GSH-Px level was higher than that in control group whereas MDA level was lower than that in control group. Conclusion: Intensive hemoperfusion can significantly improve the paraquat clearance rate, protect the important organ function and suppress the systemic oxidative stress response in patient with paraquat poisoning.展开更多
Hepatocytes were isolated from suckling porcine using modified seglen’s collagenase perfusion technique, and were encapsulated with alginate-polylysine-alginate (APA) microcapsules. Fulminant hepatic failure(FHF) was...Hepatocytes were isolated from suckling porcine using modified seglen’s collagenase perfusion technique, and were encapsulated with alginate-polylysine-alginate (APA) microcapsules. Fulminant hepatic failure(FHF) was induced in male SD rats by galactosamine. Hemoperfusion performed 24hErs after galactosamine injection. In vitro culture, both encapsulated hepatocytes and free hepatocytes express the ability to synthesis Albumin, Urea .for 7 days, Encapsulated hepatocytesperfusied with Williams’ E medium was shown to provide albumin, urea synthesis functions in 24hrs. The survival time after treatment of microencapsulated hepatocytes hemoperfusion group was longer than othergroups, and Serum ALT, TBIL levels decreased.展开更多
Objective:To investigate effects of hemoperfusion and hemofiltration combination on treating patients with acute organophosphours pesticide poisoning (AOPP) and influence of it on cholinesterase, dopamine and inflamma...Objective:To investigate effects of hemoperfusion and hemofiltration combination on treating patients with acute organophosphours pesticide poisoning (AOPP) and influence of it on cholinesterase, dopamine and inflammatory factors.Methods:A total of 82 cases of AOPP patients treated in our hospital from Sep 2012 to Jul 2016 were selected as subjects. They were randomly divided to be the observation group and the control group, 41 cases for each. For patients in observation group, combined therapy of hemoperfusion (HP) and hemofiltration (HF) were provided. For patients in control group, combined therapy of HP and hemodialysis (HD) were provided. Effects on the two groups of patients were compared. Meanwhile, cholinesterase, dopamine and inflammatory factors levels in different times before and after treatment were compared.Results:Consciousness improvement times and hospitalization times in observation group were significantly lower than in control group. No significant difference showed on fatality rates between the two groups. Before treatment, no significant difference showed on CHE and DE levels between two groups of patients;6 h and 12 h after treatment, CHE average levels in two groups were significantly higher than before treatment in the same group, and levels in observation group at the same phase were significantly higher than in control group;6 h and 12 h after treatment, DA levels in observation group were significantly lower than the same group before treatment, and significantly lower than control group, while 12 h after treatment, DA levels in control group were significantly lower than the same group before treatment. Before treatment, no significant difference showed on serum TGF-β1, TNF-α, IL-6, IL-8 between two groups of patients. After treatment, each index levels in two groups were significantly lower than the same group before treatment, and levels in observation group at the same phase were significantly lower than control group. Conclusion:Effects of blood purification therapy on treating AOPP were worth approving, but effects of HP and HF combined therapy were more significant. In addition, improvement of HP+HF on CHE, DA and inflammatory factors were better than HP+HD.展开更多
In order to achieve high adsorption capacity of adsorbents in hemoperfusion,macroporous resins were tailor made with appropriate pore sizes and specific area. This allows the toxin molecules to diffuse freely within t...In order to achieve high adsorption capacity of adsorbents in hemoperfusion,macroporous resins were tailor made with appropriate pore sizes and specific area. This allows the toxin molecules to diffuse freely within the channels ofthe porous resins and rinally reach the adsorption sites.Macroporous resin NK - 107 having small pore size and large Surface area(1086cm2) were synthesized which showed a high adsorption capacity of 82 - 94%for small molecules such as hypnotic and sedative drugs. For the adsorption of middle molecules i. e. Vit B12 or cytochrome C adsorbents having large pore sizes weretailor made. In the case of the adsorption of unconjugated bilirubin which is a verybig molecule, the pore size of the adsorbent should be at least>160A. NK - 110 istailor made with a very big pore size,which have a high adsorption capacity of 87%for bilirubin. DNA immobilized on carbonized resins,which have a porous structurewith a large surface area of 1000m2/g,can adsorb DNA antibody effectively. Resultsfrom animal and clinical trials indicated that the above tailor - made adsorbentshave a high efficacy in the removal of endogenous and exogenous toxins in hemoperfusion.展开更多
Objective: to study the clinical effect of seamless nursing in the treatment of acute pancreatitis complicated with hyperlipidemia by CRRT combined with hemoperfusion. Methods: from January 2021 to January 2022, 150 p...Objective: to study the clinical effect of seamless nursing in the treatment of acute pancreatitis complicated with hyperlipidemia by CRRT combined with hemoperfusion. Methods: from January 2021 to January 2022, 150 patients with acute pancreatitis complicated with hyperlipidemia were selected. The treatment scheme was CRRT combined with hemoperfusion, and they were randomly divided into two groups with equal numbers (n75). Routine nursing was applied to the control group, and seamless nursing was applied to the observation group. The clinical nursing effects of the two groups were compared and analyzed. Results: after nursing, compared with the control group, the indexes of hs-CRP, TG and AMY in the observation group were lower, and the difference was statistically significant (P<0.05). Compared with the control group, the scores of SAS and SDS in the observation group were lower, and the difference was statistically significant (P<0.05). Compared with the control group, the total compliance of the observation group was higher, and the difference was statistically significant (P<0.05). Compared with the control group, the total nursing satisfaction of the observation group was higher, and the difference was statistically significant (P<0.05). Compared with the control group, the quality of life scores of the observation group after nursing were higher, and the difference was statistically significant (P<0.05). Conclusion: acute pancreatitis complicated with hyperlipidemia is proved to have reliable curative effect by CRRT combined with hemoperfusion, while seamless nursing can improve patients compliance, improve patients mood, promote the improvement of patients condition, and then help patients get a better prognosis, which is more beneficial to the improvement of life quality.展开更多
Objective: to compare the clinical effect of different frequency hemoperfusion combined with hemodialysis in the treatment of end-stage renal insufficiency. Methods: selected hospital in January 2019 - January 2020 tr...Objective: to compare the clinical effect of different frequency hemoperfusion combined with hemodialysis in the treatment of end-stage renal insufficiency. Methods: selected hospital in January 2019 - January 2020 treatment of 94 patients with end-stage renal failure patients as the research object, randomly divided into 3 groups, all patients were given hemodialysis treatment, three times a week, at the same time give different frequencies of blood perfusion, I group of 32 cases of once every 2 weeks, II group of 31 cases, treatment for 1 times a week. In group III, 31 patients were treated twice a week. After 1 year of treatment, the changes of microinflammatory status indicators in all patients were observed and analyzed. Results: after treatment, the levels of TNF-α, hs-CRP and IL-6 in 3 groups were better than before treatment, and the levels of TNF-α, hs-CRP and IL-6 in group II and III were lower than group I, the differences were statistically significant (P < 0.05). There were no significant differences in TNF-α, hs-CRP and IL-6 levels between group II and group III (P > 0.05). Conclusion: medium and high frequency hemoperfusion combined with hemodialysis in the treatment of end-stage renal insufficiency can fully improve the microinflammatory status of patients, and medium frequency hemoperfusion is more cost-effective and more suitable for clinical treatment.展开更多
Objective: to apply comprehensive nursing to hemodialysis and observe its effect. Methods: the patients in our department were divided into basic group and comprehensive group, and basic nursing intervention and compr...Objective: to apply comprehensive nursing to hemodialysis and observe its effect. Methods: the patients in our department were divided into basic group and comprehensive group, and basic nursing intervention and comprehensive nursing intervention were adopted respectively. Results: in the comparison of treatment compliance and complication rate between the basic group and the comprehensive group, the basic group was 78.04% and 14.63% respectively, while the comprehensive group was 97.56% and 4.87% respectively (χ2 = 6.197, p=0.000). There was a difference between the two groups. Conclusion: the effect of hemodialysis combined with hemoperfusion and comprehensive nursing intervention in the treatment of uremia is significant and worthy of clinical recommendation.展开更多
Objective: to analyze the nursing methods in the treatment of uremia. Methods: from February 2020 to February 2021, patients with uremic skin pruritus in our department were selected. The method of retrospective data ...Objective: to analyze the nursing methods in the treatment of uremia. Methods: from February 2020 to February 2021, patients with uremic skin pruritus in our department were selected. The method of retrospective data analysis was used to obtain the nursing effect of patients. Results: after the follow-up analysis of 22 patients, the symptoms of 8 cases improved after one treatment, 10 cases improved after two treatments, and 4 cases alleviated 4-6 times after treatment. One of the 22 patients stopped, and the other 21 patients had no adverse reactions. Conclusion: nursing intervention in the treatment of uremic skin pruritus with hemoperfusion and hemodialysis is effective and worthy of clinical recommendation.展开更多
基金supported by the National Key Research and Development Program of China(2023YFC3603100 and 2023YFC3603105)"Leading Goose"R&D Program of Zhejiang(2022C03076-4).
文摘Chlorfenapyr poisoning is associated with high mortality due to the absence of evidence-based treatment strategies or specific antidotes.[1,2]Chlorfenapyr is a novel N-substituted halogenated pyrrole pro-insecticide.The active metabolite of tralopyril(a metabolite of chlorfenapyr)can uncouple oxidative phosphorylation and impair adenosine triphosphate(ATP)production.[3]Blood purification techniques,including hemoperfusion(HP),may facilitate tralopyril clearance.[4,5]Here,we present a case of severe chlorfenapyr poisoning that was treated with intensive HP.H owever,during follow-up,we unexpectedly found a ventricular aneurysm in the left ventricle that was not fully explained by coronary artery lesions.
基金Supported by the Priority Project of the Multi-Source Investment Fund Program,China,No.S21DYZD3172the Tianjin Key Medical Discipline(Specialty)Construction Project,China,No.TJYXZDXK-020A.
文摘BACKGROUND Data on adsorptive extracorporeal membrane oxygenation(ECMO)(combined with HA380 hemoperfusion column)on the inflammatory factors in patients with cardiogenic shock(CS)remains limited.AIM To investigate the effects of adsorptive ECMO on the inflammatory factors in patients with CS.METHODS A retrospective analysis was performed on 81 patients with CS caused by acute myocardial infarction,fulminant myocarditis,or cardiac surgery who required venoarterial ECMO support at TEDA International Cardiovascular Hospital from December 2020 to December 2024.Patients were divided into the conventional ECMO group(42 cases)and the adsorptive ECMO group(ECMO combined with hemoperfusion,39 cases).The adsorptive ECMO group received 2 columns of HA380 initiation on the first day(the first column connected within 2 hours of ECMO and the second after 12 hours of ECMO),followed by 1 column each day,with each column used for 4–6 hours,totaling 24–30 hours of treatment.Baseline data were compared between the two groups:Inflammatory factor levels(at 0,6,12,24,48,and 72 hours after ECMO or hemoperfusion initiation);ECMO support duration;successful weaning rate;continuous renal replacement therapy(CRRT)utilization;Sequential Organ Failure Assessment(SOFA)score;Vasoactive-Inotropic Score(VIS);systemic inflammatory response syndrome(SIRS)incidence;and in-hospital survival and 30-/90-day survival after discharge.RESULTS The adsorptive ECMO group showed significantly lower levels of C-reactive protein,interleukin(IL)-6,tumor necrosis factor(TNF)-α,and lactate from 6 to 72 hours compared with the conventional ECMO group(all P<0.05),with IL-6 decreasing by 94.4%and tumour necrosis factor alpha by 70.1%from baseline at 72 hours.The adsorptive ECMO group had a significantly shorter ECMO duration[114.0(75.0–139.0)hours vs 135.0(73.0–199.3)hours,P=0.032];higher successful weaning rate(66.7%vs 42.9%,P=0.032);a trend toward lower CRRT utilization(54.8%vs 38.5%,P=0.070);lower post-weaning SOFA score[7(6–8)vs 9(8–10),P<0.001];significantly reduced VIS(8.4±1.3 vs 9.8±1.6,P<0.001);and a trend toward lower SIRS incidence(10.3%vs 26.2%,P=0.065).There were no significant differences in complications,in-hospital survival(64.1%vs 52.4%,P=0.285);or 30-/90-day survival between the two groups(all P>0.05).CONCLUSION Adsorptive ECMO efficiently clears IL-6 and TNF-α,significantly improving ECMO weaning success rate and hemodynamics.However,it has no significant impact on survival,and its efficacy requires validation through prospective studies.
文摘Objective: To analyze the emergency treatment effect of ultra-early hemoperfusion (HP) in patients with severe organophosphate pesticide poisoning (SOPP). Methods: Sixty SOPP patients treated in the emergency department between January 2022 and January 2024 were randomly divided into two groups using a random number table. The observation group (30 cases) received ultra-early HP treatment, while the reference group (30 cases) received conventional HP treatment initiated 6 hours post-poisoning. The groups were compared in terms of overall emergency efficacy, clinical indicators, serological markers, inflammatory factors, and complication rates. Results: The observation group had a higher total efficacy rate than the reference group, superior clinical indicators, and a lower complication rate (P < 0.05). After 24 hours of emergency treatment, serological markers and inflammatory factor levels in the observation group were lower than those in the reference group (P < 0.05). Conclusion: Ultra-early HP treatment provides better emergency outcomes for SOPP patients by shortening treatment time, improving serological markers and inflammatory factor levels, and offering higher safety. It demonstrates significant advantages in emergency care.
文摘BACKGROUND Hemoperfusion(HP)is an extracorporeal blood purification modality utilized to remove small-to medium-sized molecules,such as toxins and cytokines,that are difficult to remove by conventional hemodialysis.In clinical practice,HP has been successfully used as a salvage therapy for drug overdose and occasionally in patients with liver failure and sepsis.AIM To summarize the clinical outcomes of a series of patients with severe coronavirus disease 2019(COVID-19)who received HP.METHODS Here,we summarize the clinical outcomes of a series of 18 patients with severe COVID-19 who received HP in our institution during the COVID-19 pandemic.A review of the literature was also performed.RESULTS HP was well-tolerated,and after an average of three sessions,respiratory and cardiovascular parameters as well as blood inflammatory markers improved in most patients.Ten patients were discharged alive.Our literature search identified a total of 20 studies(873 patients)in which HP was used for COVID-19.Nine studies reported improvements in respiratory parameters,and 13 studies(438 patients in total)reported better survival rates in patients undergoing HP.CONCLUSION HP was well-tolerated in patients with severe COVID-19,and most studies reported improved clinical parameters,including better survival rates,when HP was used in patients with severe COVID-19.Further research,especially prospective studies,is needed to evaluate the utility of HP as an early and supportive therapy for critically ill patients due to infectious diseases,such as those with COVID-19 or severe sepsis.
文摘Objective： The intoxications caused by 2,4-dinitrophenol （2,4-DNP）, even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and explore the clinical value of resin hemoperfusion （HP） in the treatment of patients with acute 2,4-DNP poisoning. Methods We reported 16 cases of acute 2,4-DNP poisoning through occupational exposure due to ignoring the risk of poisoning. The blood samples were collected from the 14 survivors. According to the different treatments of resin HP, the survivors were divided into routine HP （n=5） and intensive HP （n=9） groups. Ultra high performance liquid chromatography/ tandem mass spectroscopy （UPLC-MS/MS） was used to detect the 2,4-DNP concentration in plasma in this study. Results： The 14 survivors recovered very well after treatment. The initial plasma 2,4-DNP concentrations （C1） of survivors ranged from 0.25 to 41.88 pg/ml （mean （12.56＋13.93） pg/ml）. A positive correlation existed between initial plasma 2,4-DNP concentration （C1） and temperature. The elimination of 2,4-DNP was slow and persistent, and the total clearance rates of plasma toxin from the 1st to 3rd day （R3）, the 3rd to 7th day （R3-7）, and the 1st to 7th day （RT）, were only （53.03±14.04）%, （55.25±10.50）%, and （78.29±10.22）%, respectively. The plasma toxin was cleared up to 25 d after poisoning in most of the patients. The R3, R3-7, and R7 in the intensive HP group were all apparently higher than those in the routine HP group, with statistical significance （P〈0.05）. Simultaneously, the elimination half-life （tl/2） of 2,4-DNP in the intensive HP group was apparently shorter than that in the routine HP group, with statistical significance （P〈0.05）. Conclusions： The clinicians should be aware of this slow and persistent process in the elimination of plasma 2,4-DNP. Higher initial plasma toxin concentration resulted in a more severe fever for the patient. According to the limited data, longer and more frequent resin HP may accelerate to eliminate the poison.
文摘BACKGROUND:Blood hemoperfusion with resin adsorption can clean larger molecules that exceed the molecular weight cutoff of combined continuous veno-venous hemofiltration(CWH).Hence blood hemoperfusion with resin adsorption combined CWH(HP+CWH) has higher ability of mediator clearance,and can improve clinical outcomes in theory.This study aimed to investigate the effect of blood hemoperfusion with resin adsorption combined continuous veno-venous hemofiltration(HP+CWH) on plasm cytokines like TNF-α,IL-1β,IL-6,cellular immunity and prognosis in patients with multiple organ dysfunction syndrome(MODS).METHODS:This was a prospective,randomized clinical trial.A total of 30 patients who had been diagnosed with MODS were enrolled in this study.Patients were randomly allocated to routine treatment+HP+CWH group(treatment group) and routine treatment+only CWH group(control group).In the treatment group,patients received blood hemoperfusion with resin adsorption for 2hours,and then received CWH for 10 hours every day.In the control group,patients received CWH for 12 hours only every day.The patients in the two groups received blood purification therapy for three days.The plasma of patients in the treatment group was obtained at 0,2,12,24,26,36,48,50,60 hours,5th day,7th day and 10 th day,respectively.The plasma of patients in the control group was obtained at 0,12,24,36,48,60 hours,5th day,7th day and 10 th day,respectively.APACHE Ⅱscore,T-lymphocytes subpopulations,blood lactate acid concentration,heart rate,breathing rate,and oxygenation index were observed.RESULTS:Plasma cytokines like TNF-α,IL-1β,IL-6 decreased markedly after HP(P<0.01);T-lymphocytes subpopulations CD3+,CD4+,CD8+,CD4+/CD8+ increased after HP+CWH or only CWH.The plasma concentrations of TNF-α,IL-1β and IL-6 in the two groups were not markedly different at 12,36,and 50 hours.But on the 5th day,the plasma concentrations of TNF-α,IL-1β and IL-6 in the treatment group were lower than those in the control group(P<0.05).On the 28 th day,5patients died in the treatment group,and 6 patients in the control group.CONCLUSIONS:Both HP+CWH and CWH can clean plasma cytokines like TNF-α,IL-1β,and IL-6,and improve cellular immunity and clinical symptoms and signs of patients.Compared with only CWH,the plasma concentrations of TNF-α,IL-1β and IL-6 were lower on the 5th day,and patients have an increased survival rate on the 28 day in the HP+CWH group.
文摘AIM： To investigate the effectiveness of direct hemoperfusion with polymyxin B-immobilized fibers （DHPPMX therapy） on warm ischemia-reperfusion （I/R） injury of the small intestine.METHODS： The proximal jejunum and distal ileum of mongrel dogs were resected. Warm ischemia was performed by clamping the superior mesenteric artery （SMA） and vein （SMV） for 2 h. Blood flow to the proximal small intestine was restored 1 h after reperfusion, and the distal small intestine was used as a stoma. The experiment was discontinued 6 h after reperfusion. The dogs were divided into two groups： the DHP-PMX group （n = 6, DHP-PMX was performed for 180 min; from 10 min prior to reperfusion to 170 rain after reperfusion） and the control group （n = 5）. The rate pressure product （RPP）, SMA blood flow, mucosal tissue blood flow, and intramucosal pH （pHi） were compared between the two groups. The serum interleukin （IL）-10 levels measured 170 min after reperfusion were also compared.RESULTS： The RPP at 6 h after reperfusion was significantly higher in the PMX group than in the control group （12174 ± 1832 mmHg/min vs 8929 ± 1797 mmHg/min, P 〈 0.05）. The recovery rates of the SMA blood flow at I and 6 h after reperfusion were significantly better in the PMX group than in the control group （61%±7% vs 44% ±4%, P 〈 0.05, and 59%±5% vs 35%±5%, P 〈 0.05, respectively）. The recovery rate of the mucosal tissue blood flow and the pHi levels at 6 h after reperfusion were significantly higher in the PMX group （61%±8% vs 31%±3%, P 〈 0.05 and 7.91±0.06 vs 7.69±0.08, P 〈 0.05, respectively）. In addition, the serum IL-IO levels just before DHP-PMX removal were significantly higher in the PMX group than in the control group （1 569 ± 253 pg/mL vs 211± 40 pg/mL, P 〈 0.05）.CONCLUSION： DHP-PMX therapy reduced warm I/R injury of the small intestine. IL-10 may play a role in inhibiting I/R injury during DHP-PMX therapy.
文摘BACKGROUND Polymyxin B hemoperfusion(PMX-HP)has been used as a treatment for intraabdominal septic shock by absorbing and removing endotoxins of gram-negative bacilli.AIM To investigate the clinical efficacy of PMX-HP in patients with gram-negative septic shock who underwent abdominal surgery.METHODS From January 2012 to December 2018,patients who had septic shock secondary to peritonitis were enrolled.They were classified into PMX-HP treated and control groups based on postopreative intervention using PMX-HP.The clinical outcomes were compared using 1:1 propensity score matching methods to balance the overall distribution between the two groups.RESULTS After propensity score matching,40 patients were analyzed(20 patients in the PMX group and 20 patients in the control group).The scores of total Sequential Organ Failure Assessment(SOFA)score,renal SOFA and coagulation SOFA were significantly improved in the PMX group but not in the control group.(from 11.2±5.8 to 4.7±3.5 in PMX group vs 10.0±4.0 to 8.7±7.3 in control group,P=0.047 from 2.6±1.0 to 0.7±1.0 in PMX group vs 2.6±1.5 to 2.8±1.6 in control group,P=0.000,from 1.6±1.5 to 1.3±1.3 in PMX group vs 1.2±1.2 to 2.8±1.8 in control group,P=0.014,respectively).Further,the length of intensive care unit(ICU)stay was significantly shorter in PMX group.However,no statistically significant difference was found in ICU mortality(50%in PMX group vs 50%in control group).CONCLUSION PMX-HP is a feasible adjunct treatment for peritonitis in ICU patients with peritonitis for improved organ impairment and to stabilize hemodynamics.It would be helpful to enhance clinical outcomes especially in patients with complete elimination of the source of gram-negative bacilli infection by surgical procedure accompanied with conventional treatment of sepsis.
文摘BACKGROUND:This study aimed to observe the effect of hemoperfusion(HP) cartridge on different internal environment indicators at different time points in patients with acute blood poisoning and to find alternative indicators for the detection of blood poisoning.METHODS:The levels of internal environment indicators(blood pH,P_vCO_2,P_vCO_2,blood lactate,potassium,free calcium,bicarbonate,and blood glucose) before and after HP treatment were recorded for patients with acute poisoning at time points of 30 minutes and 120 minutes.After calculating the difference value 5,the statistical software was used to analyze the statistical difference of the influence caused by HP cartridge at two time points.According to the formula,adsorption rate%=(a-v)/a×100,the adsorption rate of each indicator was calculated respectively.RESULTS:The difference of indicators at different time points in inlet and outlet such as blood glucose,free-calcium,and lactate was statistically significant(P<0.05),but the difference in indicators such as pH,P_vCO_2,P_vO_2,potassium,sodium,and bicarbonate was not statistically significant(P>0.05).CONCLUSION:During HP treatment,the indicators of blood glucose,free-calcium and lactate were significantly affected by HP cartridge,and the effect varies with time.
文摘Objective:To study the effect of hemodialysis (HD) combined with hemoperfusion (HP) on dialysis efficiency, lipid metabolism and atherosclerosis in patients with uremia.Methods:A total of 70 patients with uremia who were treated in our hospital between March 2013 and October 2015 were collected and divided into observation group and control group (n=35) according to double-blind randomized control method. Observation group of patients received hemodialysis combined with hemoperfusion, control group of patients received hemodialysis alone, and the treatment lasted for 6 months. After 6 months of intervention, automatic biochemical analyzer was used to detect renal function indexes and lipid metabolism indexes, and the two-dimensional ultrasound was used to quantitatively determine the carotid atherosclerosis parameters.Results:Before intervention, differences in renal function, lipid metabolism and atherosclerosis levels were not statistically significant between two groups of patients;after 6 months of intervention, renal function indexes blood urea nitrogen (BUN), serum creatinine (Scr),β2-microglobulin (β2-MG) and blood uric acid (BUA) levels of observation group were lower than those of control group, lipid metabolism indexes total cholesterol (TC), triglyceride (TG), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) levels were lower than those of control group, and differences between groups were statistically significant;quantitative carotid ultrasound parameters gray-scale median (GSM) of observation group was higher than that of control group, enhanced intensity (EI) and enhanced density (ED) were lower than those of control group, and differences between groups were statistically significant.Conclusion:Hemodialysis combined with hemoperfusion can improve the dialysis efficiency, also reduce lipid metabolism disturbance and delay the formation of atherosclerosis in patients with uremia.
文摘Objective: To observe the effects of hemoperfusion combined with sequential dialysis on soluble tumor necrosis factor receptor in patients with diabetic kidney disease. Methods:A total of 100 patients with diabetic kidney disease who had been seeking treatment in the hospital between May 2015 and July 2017 were selected, and then according to the random number table method, these patients were divided into a control group and an observation group, with 50 cases in each group. The control group was treated with hemodialysis only, whereas the observation group was given hemoperfusion combined with sequential dialysis for treatment. The changes of soluble tumor necrosis factor receptor, oxidant factor and metabolic indexes after 12 weeks of treatment were compared between the two groups. Results: After treatment, the metabolic indexes in the observation group were shown to be lower than the control group, the levels of soluble tumor necrosis factor receptor related indexes in the former group were lower than the control group, and the level of oxidative stress indicators in the former group was shown to be better than the control group, where the differences were statistically significant. Conclusion: For patients with diabetic kidney disease, hemoperfusion combined with sequential dialysis is with significant clinical curative effects, which can effectively relieve their oxidative stress, better control the blood glucose level, significantly improve their renal function and significantly reduce the level of soluble tumor necrosis factor receptor.
文摘Objective: To investigate the effects of hemoperfusion combined with hemodialysis on target organ damage in patients with acute paraquat poisoning. Methods: A total of 42 patients with acute paraquat poisoning who were admitted and treated in our hospital between December 2013 and October 2017 were selected as the research subjects, and their therapies were reviewed and used to divide them into the control group (n=20) who received hemoperfusion alone and the combined treatment group (n=22) who received hemoperfusion combined with hemodialysis. The differences in the levels of liver and kidney function indexes in peripheral blood as well as lung function indexes in arterial blood were compared between the two groups of patients immediately after admission, after 1 d of treatment and after 3 d of treatment. Results: Immediately after admission, the differences in the levels of liver and kidney function indexes in peripheral blood as well as lung function indexes in arterial blood were not statistically significant between the two groups. After 1d of treatment and after 3 d of treatment, kidney function indexes Scr, BUN and β2-MG levels in peripheral blood of combined treatment group were lower than those of control group at corresponding time points respectively;liver function indexes ALT, AST, TB and ALP levels in peripheral blood were lower than those of control group at corresponding time points respectively;lung function indexes PaO2, BE and PCO3- levels in arterial blood were higher than those of control group at corresponding time points respectively whereas PaCO2 levels were lower than those of control group at corresponding time points respectively. Conclusion: Compared with hemoperfusion alone, hemoperfusion combined with hemodialysis is more advantageous in protecting the functions of liver, kidney, lungs and other target organs of patients with acute paraquat poisoning.
文摘Objective: To study the effects of intensive hemoperfusion on the toxin clearance, target organ function and oxidative stress in patient with paraquat poisoning. Methods: A total of 56 patients with paraquat poisoning who were treated in the People's Hospital of Hanchuan between November 2013 and January 2017 were reviewed and divided into the control group (n=30) and the intensive hemoperfusion group (n=26). Control group received conventional therapy, and intensive hemoperfusion group received conventional therapy combined with intensive hemoperfusion. The differences in paraquat clearance effect, target organ function and oxidative stress response were compared between the two groups. Results: Serum paraquat level in intensive hemoperfusion group was lower than that in control group, and the paraquat clearance rate was higher than that of control group. Serum pulmonary fibrosis indexes PⅠCP, CⅣ and HA levels in intensive hemoperfusion group were lower than those in control group;serum liver function indexes ALP, STB and ALT levels were lower than those in control group;serum oxidative stress index GSH-Px level was higher than that in control group whereas MDA level was lower than that in control group. Conclusion: Intensive hemoperfusion can significantly improve the paraquat clearance rate, protect the important organ function and suppress the systemic oxidative stress response in patient with paraquat poisoning.
文摘Hepatocytes were isolated from suckling porcine using modified seglen’s collagenase perfusion technique, and were encapsulated with alginate-polylysine-alginate (APA) microcapsules. Fulminant hepatic failure(FHF) was induced in male SD rats by galactosamine. Hemoperfusion performed 24hErs after galactosamine injection. In vitro culture, both encapsulated hepatocytes and free hepatocytes express the ability to synthesis Albumin, Urea .for 7 days, Encapsulated hepatocytesperfusied with Williams’ E medium was shown to provide albumin, urea synthesis functions in 24hrs. The survival time after treatment of microencapsulated hepatocytes hemoperfusion group was longer than othergroups, and Serum ALT, TBIL levels decreased.
文摘Objective:To investigate effects of hemoperfusion and hemofiltration combination on treating patients with acute organophosphours pesticide poisoning (AOPP) and influence of it on cholinesterase, dopamine and inflammatory factors.Methods:A total of 82 cases of AOPP patients treated in our hospital from Sep 2012 to Jul 2016 were selected as subjects. They were randomly divided to be the observation group and the control group, 41 cases for each. For patients in observation group, combined therapy of hemoperfusion (HP) and hemofiltration (HF) were provided. For patients in control group, combined therapy of HP and hemodialysis (HD) were provided. Effects on the two groups of patients were compared. Meanwhile, cholinesterase, dopamine and inflammatory factors levels in different times before and after treatment were compared.Results:Consciousness improvement times and hospitalization times in observation group were significantly lower than in control group. No significant difference showed on fatality rates between the two groups. Before treatment, no significant difference showed on CHE and DE levels between two groups of patients;6 h and 12 h after treatment, CHE average levels in two groups were significantly higher than before treatment in the same group, and levels in observation group at the same phase were significantly higher than in control group;6 h and 12 h after treatment, DA levels in observation group were significantly lower than the same group before treatment, and significantly lower than control group, while 12 h after treatment, DA levels in control group were significantly lower than the same group before treatment. Before treatment, no significant difference showed on serum TGF-β1, TNF-α, IL-6, IL-8 between two groups of patients. After treatment, each index levels in two groups were significantly lower than the same group before treatment, and levels in observation group at the same phase were significantly lower than control group. Conclusion:Effects of blood purification therapy on treating AOPP were worth approving, but effects of HP and HF combined therapy were more significant. In addition, improvement of HP+HF on CHE, DA and inflammatory factors were better than HP+HD.
文摘In order to achieve high adsorption capacity of adsorbents in hemoperfusion,macroporous resins were tailor made with appropriate pore sizes and specific area. This allows the toxin molecules to diffuse freely within the channels ofthe porous resins and rinally reach the adsorption sites.Macroporous resin NK - 107 having small pore size and large Surface area(1086cm2) were synthesized which showed a high adsorption capacity of 82 - 94%for small molecules such as hypnotic and sedative drugs. For the adsorption of middle molecules i. e. Vit B12 or cytochrome C adsorbents having large pore sizes weretailor made. In the case of the adsorption of unconjugated bilirubin which is a verybig molecule, the pore size of the adsorbent should be at least>160A. NK - 110 istailor made with a very big pore size,which have a high adsorption capacity of 87%for bilirubin. DNA immobilized on carbonized resins,which have a porous structurewith a large surface area of 1000m2/g,can adsorb DNA antibody effectively. Resultsfrom animal and clinical trials indicated that the above tailor - made adsorbentshave a high efficacy in the removal of endogenous and exogenous toxins in hemoperfusion.
文摘Objective: to study the clinical effect of seamless nursing in the treatment of acute pancreatitis complicated with hyperlipidemia by CRRT combined with hemoperfusion. Methods: from January 2021 to January 2022, 150 patients with acute pancreatitis complicated with hyperlipidemia were selected. The treatment scheme was CRRT combined with hemoperfusion, and they were randomly divided into two groups with equal numbers (n75). Routine nursing was applied to the control group, and seamless nursing was applied to the observation group. The clinical nursing effects of the two groups were compared and analyzed. Results: after nursing, compared with the control group, the indexes of hs-CRP, TG and AMY in the observation group were lower, and the difference was statistically significant (P<0.05). Compared with the control group, the scores of SAS and SDS in the observation group were lower, and the difference was statistically significant (P<0.05). Compared with the control group, the total compliance of the observation group was higher, and the difference was statistically significant (P<0.05). Compared with the control group, the total nursing satisfaction of the observation group was higher, and the difference was statistically significant (P<0.05). Compared with the control group, the quality of life scores of the observation group after nursing were higher, and the difference was statistically significant (P<0.05). Conclusion: acute pancreatitis complicated with hyperlipidemia is proved to have reliable curative effect by CRRT combined with hemoperfusion, while seamless nursing can improve patients compliance, improve patients mood, promote the improvement of patients condition, and then help patients get a better prognosis, which is more beneficial to the improvement of life quality.
文摘Objective: to compare the clinical effect of different frequency hemoperfusion combined with hemodialysis in the treatment of end-stage renal insufficiency. Methods: selected hospital in January 2019 - January 2020 treatment of 94 patients with end-stage renal failure patients as the research object, randomly divided into 3 groups, all patients were given hemodialysis treatment, three times a week, at the same time give different frequencies of blood perfusion, I group of 32 cases of once every 2 weeks, II group of 31 cases, treatment for 1 times a week. In group III, 31 patients were treated twice a week. After 1 year of treatment, the changes of microinflammatory status indicators in all patients were observed and analyzed. Results: after treatment, the levels of TNF-α, hs-CRP and IL-6 in 3 groups were better than before treatment, and the levels of TNF-α, hs-CRP and IL-6 in group II and III were lower than group I, the differences were statistically significant (P < 0.05). There were no significant differences in TNF-α, hs-CRP and IL-6 levels between group II and group III (P > 0.05). Conclusion: medium and high frequency hemoperfusion combined with hemodialysis in the treatment of end-stage renal insufficiency can fully improve the microinflammatory status of patients, and medium frequency hemoperfusion is more cost-effective and more suitable for clinical treatment.
文摘Objective: to apply comprehensive nursing to hemodialysis and observe its effect. Methods: the patients in our department were divided into basic group and comprehensive group, and basic nursing intervention and comprehensive nursing intervention were adopted respectively. Results: in the comparison of treatment compliance and complication rate between the basic group and the comprehensive group, the basic group was 78.04% and 14.63% respectively, while the comprehensive group was 97.56% and 4.87% respectively (χ2 = 6.197, p=0.000). There was a difference between the two groups. Conclusion: the effect of hemodialysis combined with hemoperfusion and comprehensive nursing intervention in the treatment of uremia is significant and worthy of clinical recommendation.
文摘Objective: to analyze the nursing methods in the treatment of uremia. Methods: from February 2020 to February 2021, patients with uremic skin pruritus in our department were selected. The method of retrospective data analysis was used to obtain the nursing effect of patients. Results: after the follow-up analysis of 22 patients, the symptoms of 8 cases improved after one treatment, 10 cases improved after two treatments, and 4 cases alleviated 4-6 times after treatment. One of the 22 patients stopped, and the other 21 patients had no adverse reactions. Conclusion: nursing intervention in the treatment of uremic skin pruritus with hemoperfusion and hemodialysis is effective and worthy of clinical recommendation.
