Diuresis Research Articles

Clinical value of delayed 18F-FDG PET/CT imaging after diuresis in male patients with locally recurrent rectal cancer

Objective To explore the diagnostic value of delayed 18F-FDG PET/CT pelvic imaging after forced diuresis in detecting male patients with locally recurrent rectal cancer. Methods Thirty-two male patients (32-79 years) with clinically suspicious recurrences of rectal cancer were retrospectively analyzed. All patients underwent a standard 18F-FDG PET/CT followed by a delayed pelvic imaging after 2.5 h of administration of 20 mg furosemide intravenously and extra water intake of 500 ml at least. Final diagnosis was made by pathology or clinical follow-up (>10 months). Diagnostic efficiency of 18F-FDG PET/CT standard and delayed pelvic images were calculated and compared. χ2 test was used for data analysis. Results A total of 25 patients were diagnosed with recurrent rectal cancer, including 10 cases with invasion of surrounding tissue, and 5 cases with metastases. Among the 7 patients without local recurrences, 2 had distant metastases. The sensitivity, specificity, and accuracy of standard FDG PET/CT were 92.0%(23/25), 3/7, 81.2%(26/32), respectively. The corresponding values of the delayed imaging were 96.0%(24/25), 6/7, and 93.8%(30/32), respectively. The specificity of delayed imaging was higher than that of standard FDG PET/CT (χ2=14.333, P 0.05). The urinary bladder activity reached or approached the background during the delayed imaging. Twenty-two malignant lesions of surrounding invasion were confirmed. The positive rate of delayed imaging was higher than that of standard FDG PET/CT: 95.5%(21/22) vs 63.6%(14/22); χ2=6.400, P<0.05. Conclusions 18F-FDG PET/CT delayed pelvic imaging after diuresis and hydration is useful for eliminating the artifacts from urinary bladder activity, and for detecting the invasion to the rectal surrounding tissue more effectively. It could be a supplement to standard FDG PET/CT. Key words: Rectal Neoplasms; Neoplasm recurrence, local; Diuresis; Tomography, emission-computed; Tomography, X-ray computed; Deoxyglucose

Curative efficacy of sodium phosphocreatine combined with aminophylline in the treatment of postpartum hypertensive heart failure

Objective To investigate the curative efficacy of sodium phosphocreatine combined with aminophylline in the treatment of postpartum hypertensive heart failure. Methods 80 patients with postpartum hypertensive heart failure were randomly divided into the control group and the observation group equally by random number table method, 40 cases in each group.The control group was given conventional treatment, such as oxygen inhalation, diuresis by furosemide, strengthening heart by cedilanid, vascular dilation by nitroglycerin, keeping water-electrolyte balance and so on.Besides that, the observation group was given sodium phosphocreatine in combination with aminophylline.Then, the curative efficacy, changes of blood pressure, indices of cardiac function and adverse reactions were compared. Results The total effective rate of the observation group was 95.0%, which was higher than 80.0% of the control group(χ2=4.11, P<0.05).After treatment, SBP, DBP, LVEDD, LVESD, LVEF in the control group and the observation group were (125.7±6.5)mmHg vs (120.1±7.2)mmHg(t=3.651), (88.4±8.9)mmHg vs (81.4±9.0)mmHg(t=3.498), (64.0±6.8)mm vs (61.3±6.2)mm(t=2.268), (53.7±6.3)mm vs (51.0±5.6)mm(t=2.461), (38.6±9.0)% vs (42.5±8.7)%(t=2.476), respectively.In comparison with the control group, SBP[(125.7±6.5)mmHg vs.(120.1±7.2)mmHg], DBP[(88.4±8.9)mmHg vs.(81.4±9.0)mmHg], LVEDD[(64.0±6.8)mm vs.(60.7±6.2)mm], LVESD[(53.2±5.3)mm vs.(50.2±5.6)mm]were significantly reduced and LVEF[(38.6±9.0)% vs.(42.5±8.7)%]was significantly increased in the observation group(t=3.651, 3.498, 2.268, 2.461, 2.476, all P<0.05).During the treatment, there was no severe adverse reaction. Conclusion Sodium phosphocreatine combined with aminophylline is effective for postpartum hypertensive heart failure, which can significantly increase curative efficacy, decrease blood pressure and improve cardiac function with less adverse reactions. Key words: Heart failure; Hypertension, pregnancy-induced; Postpartum period; Sodium phosphocreatine; Aminophylline

Questionnaire design to evaluate water balance.

Introduction: Body water balance is determined by the difference between the sum of water intake and endogenous water production and the sum of losses. Several questionnaires have been developed to evaluate water intake through food and drinks. However, assessing water losses through different routes of elimination is more complicated. Thus, few questionnaires evaluate intake and loss of water at the same time. Objective: This study aims to develop a hydration questionnaire which can accurately determine the hydration status in the university population. Method: The questionnaire development process included 3 steps: (1) identifying all foods and beverages from Spanish food composition tables which have water content higher than 80% (w/w); (2) recognizing the drugs and pathologies that may compromise hydration status as well as important hydration habits such as daily fluid consumption; (3) compiling all items and developing the hydration questionnaire. Results: The final version of the hydration questionnaire comprises 24 items about hydration habits, relevant pathologies and questions related to regular fluid elimination (urination/defecation). In addition, it includes a brief food frequency questionnaire of the main water diet contributors. Conclusions: We have designed a comprehensive, short and simple screening tool to assess the population’s hydration status.

Pulmonary ultrasound guidance of congenital heart disease postoperative ventilator applications

To investigate the pulmonary ultrasound in children with congenital heart disease postoperative invasive ventilator time, non-invasive ventilator use the guide. Using prospective clinical observation research methods, Randomly divide 100 cases ranged from 6 months to 3 years old in cardiopulmonary bypass after congenital heart disease surgery patients into ultrasound group and control group, 50 cases in each group. All postoperative give positive cardiac function maintenance, diuresis, etc. Ultrasound group adopted the pulmonary ultrasound in children with pulmonary interstitial pulmonary edema monitoring and guide to extubation, enable the timing of the noninvasive ventilator support; Control group based on the bedside chest X-ray lung condition. Compare two groups of children with mechanical ventilation time (including the invasive and noninvasive ventilator support), noninvasive ventilator utilization rate and its accuracy, start the noninvasive ventilator time, the incidence of ventilator associated pneumonia (VAP), secondary tracheal intubation cases and ICU stay time, etc. The ultrasound group compared with the control group in Invasive ventilator time [(15.0 ± 11.0) vs (20.0 ± 13.5, P=0.043)], noninvasive ventilation time [(38.5 ± 11.8) vs (48.6 ± 21.9, P=0.032)], the number of cases of the use of noninvasive ventilation (10 cases vs 22 cases, P=0.041), the correct use of the number of cases (10 vs 14, P=0.034) and VAP cases (3 vs 8, P=0.044), there was statistical significance, P< 0.05. The ultrasound group of children with ICU stay time was significantly lower than the control group [(66.0 ± 38.9) vs (82.0 ± 42.4, P=0.038)]; Control group had 2 cases with secondary tracheal intubation, ultrasound group one, comparing the two groups has no statistical significance (P> 0.05). Postoperative children with congenital heart disease using pulmonary ultrasound evaluation of pulmonary interstitial edema,guide the ventilator, it can effectively shorten (invasive and noninvasive mechanical ventilation time and ICU length of hospital stay, lung ultrasound has instant, noninvasive, No radiation, repeatable,pulmonary ultrasound will be important after cardiopulmonary bypass interstitial lung edema diagnosis, evaluation of treatment means and helps to treat critically ill children.

The efficacy of Saccharomyces boulardii sachets in adjuvant therapy of liver cirrhosis patients with spontaneous bacterial peritonitis

Objective To observe the adjuvant therapy efficacy of Saccharomyces boulardii sachets in liver cirrhosis patients with spontaneous bacterial peritonitis(SBP). Methods 72 liver cirrhosis patients with SBP were randomly divided into the observation group and control group.The patients in the control group(30 cases) were given routine medical treatment such as anti-infection,correction of hypoproteinemia,liver protection,and diuresis,etc.At the base of the control group,the patients in the observation group(32 cases) were orally given Saccharomyces boulardii(Baili Pharmaceutical Factory,French)0.5g for one time,two times daily for 10 days.The changes of serum interleukin-6(IL-6),pmcalcitonin(PCT) and hypersensitive c-reactive protein(hs-CRP)levels in the two groups were observed and compared before and after treatment,and curative effect and safety were also observed. Results Before treatment,the serum IL-6,PCT and hs-CRP levels in the two groups had no obviously statistical difference(all P> 0.05),but after treatment,the serum IL-6, PCT and hs-CRP levels of the observation group were much lower than those of the control group[(60.50± 19.10)pg/m L vs(98.32±17.20)pg/m L,(1.80±0.34)μg/L vs(6.38±3.56)μg/L,(6.20±4.15)mg/L vs(20.28±8.30)mg/L,t= 8.147,7.246,8.529,all P 0.05). Conclusion Saccharomyces boulardii can significantly reduce serum IL-6,PCT and hs-CRP levels of liver cirrhosis patients with SBP,and reduce inflammation reaction to control development of SBP. Key words: Peritonitis; Yeasts; Interleukin-6; C-Reactive Protein

The use of brain natriuretic peptide in pediatric diseases

Brain natriuretic peptide (BNP) is one member of natriuretic peptide family and mainly secreted by ventricular myocardium. BNP has many functions such as natriuresis, diuresis, dilation of blood vessels, inhibition of renin-angiotensin-aldosterone system and sympathetic nervous system activity. In recent years, BNP analysis widely used in fields of adult diseases, especially in cardiovascular disease. But research and application of BNP in pediatrics diseases is still relatively small. This article reviewed biology character and the progress of BNP in pediatric diseases. Key words: Brain natriuretic peptide; Children; Diseases

Curative effects of Levocarnitine on chronic congestive heart failure

Objective To discuss influence and curative effects of Levocarnitine on serum B-type natriuretic peptide （BNP） and β-endorphin levels of old patients with chronic congestive heart failure （CHF）.Methods 86 patients with CHF were divided into the observation group and control group by random number table.The patients in the two groups were given routine anti-heart failure treatment,such as bed rest,oxygen uptake,low sodium diet,strong heart diuresis,dilation of blood vessels and etc.The patients in the observation group were additionally given 2.0g Levocarnitine by intravenous infusion once a day for 14 days.The changes of serum BNP and β-endorphin levels of patients in the two groups before and 14 days after medical treatment were observed,and clinical curative effect and untoward effect were compared as well.Results After 14 days medical treatment,the serum BNP and β-endorphin levels of patients in the two groups[（345.85 ±58.25）pg/mL,（120.84 ±25.13）pg/mL,（237.04 ±60.54）pg/mL, （92.08 ±26.17） pg/mL] obviously declined than before （405.28 ±83.07） pg/mL,（146.42 ±30.72） pg/mL, （410.23 ±75.12）pg/mL,（150.56 ±32.51）pg/mL]（t=2.24,2.31,3.18,2.96,P〈0.05 or P〈0.01）,and the declining rate in the observation group was much higher than that in the control group （t=2.41,2.28,all P〈0.05）. Meanwhile,total efficiency in the observation group （95.35%） was much higher than that in the control group （81.40%）（χ^2 =4.07,P〈0.05）.6 cases of untoward effect appeared on patients in the two groups during the medi-cal treatment,including 4 cases in the observation group and 2 cases in the control group with light symptom.After comparing the occurrence rates of untoward effect,no obvious statistical difference appeared （χ^2 =0.18,P〉0.05）. Conclusion Levocarnitine is a kind of adjunctive therapy （AT） drug to treat CHF,whose mechanism of action has close effect on reducing serum BNP andβ-endorphin levels and adjusting neuroendocrine hormone levels. Key words: Heart failure,congestive; Levocarnitine; β-Endorphin

Follow-up value of ultrasound in fetal tricuspid regurgitation

Objective To explore the follow-up value of ultrasound in fetal tricuspid regurgitation. Methods 44 fetuses who presented with moderate tricuspid regurgitation with differential pressure over 20 mmHg, dilation of right atria and ventricles were chosen as the observation group.Examinations,in terms of the degree,velocity and differential pressure of reflux,size of heart chamber and the presence perieardial or pleural effusion were carried out once every four weeks from 24 weeks of pregnancy to 9 weeks after birth. Results 40.9% （18/44） of eases had been getting better before birth.The degree of regurgitation of 56.8% （25/44） eases significantly decreased or even disappeared from 1 to 62 days after birth.Especially,3 eases whose regurgitation velocity reached to 4.2 m/s with the differential pressure over 70 mmHg as well as onset of heart failure symptoms had been recovered gradually after born in advance.1 ease （2.3%） with the persistence of both tricuspid regurgitation and heart failure symptoms after birth died in right heart failure, even though using different active treatments, such as oxygen, strong heart and diuresis. Conclusions High-speed tricuspid regurgitation in fetuses without pathological changes can be almost reversed, and the prognosis is good.Once the fetal tricuspid regurgitation pressure is over 70 mmHg or a fetus appears the onset of heart failure symptoms,pre-term delivery should be advised in a bid to prevent accidents in uterine cavity. Key words: Ultrasonography, prenatal; Fetus ; Tricuspid valve insufficiency; Follow-up studies

Oldenlandia corymbosa L. : A Phytopharmacological review

Oldenlandia corymbosa (L.) (Rubiaceae) is a weedy annual herb, found throughout India. It is commonly known as Parppatakapullu in traditional medicine of Kerala. The plant is known to clear heat and toxins, activate blood circulation, promote diuresis and relieve stranguria. It is also active against appendicitis, hepatitis, pneumonia, cholecystesis, urinary infection, cellulites and snake bite. Chinese folk medicine describes the plant to treat skin sores, ulcers, sore throat, bronchitis, gynecologic infections and pelvic inflammatory diseases. The plant contains flavonols, phenolic acids, anthocyanidins, irridoids and alkaloids. A scrutiny of literature revealed some notable pharmacological activities of the plant such as hepatoprotective, cytotoxic anti-oxidant, oxytocic and anti malerial activity. The present review is an attempt to highlight the various ethnobotanical and traditional uses as well as phytochemical and pharmacological reports on Oldenlandia corymbosa.

The changes of function and ultrastructure of detrusor cell following acute urinary bladder overdistension

Objective To evaluate the contractive function and ultrastructure changes of detrusor following acute bladder overdistension.Methods 14 New Zealand white male rabbits were divided into two group,7 rabbits in each.Overdistension group was induced for 3 hours by forced diuresis and ligation of urethra to volumes 130％ of maximum intravesical volume.control group was catheterized with an 8 F catheter but not instillation.The weight of each bladder and function and ultrastructure of detrusor were examined after3 d.Results The weight of bladder is (3.45±0.36) gin overdistension group and (4.02±0.47) g in control group.The contractive strength of per 100 mg detrusor of overdistension group increased significantly in adenosine-triphosphate (ATP) solution,atropine solution and Ca2+ free solution; The contractive velocity increased significantly.in atropine solution,Ca2+ free solution and high K + solusion; The average area of rough endoplactmic reticulum in overdistension group was (1.748 ± 0.772) μm2 in each unit cytoplasm area versus (0.203 ± 0.097) μm2 in control group (P ＜ 0.05).The relative density of mitochondrion was 1.142 ± 0.085 in overdistension group versus 1.681 ± 0.219 in control group (P ＜ 0.05).Conclusion Overdistension of bladder will increase the constructive function of detrusor.and there are structure foundations of the changes. Key words: Bladder; Overdistension ; Endoplactmic reticulum ; Mitochondrion

Analysis on Curative Effect of Hemopurification Treatment in Acute Severe Organophosphate Poisoning Patients

Objective To explore the feasibility and success rate of hemopurification treatment in acute severe organophosphate poisoning patients.Methods From January 2011 to December 2012,a total of 54 patients with acute severe organophosphate poisoning in Jianghan Oilfield General Hospital were included in this study.According to the treatment number of these patients,they were divided into the study group (n=27) and the control group (n=27) randomly.Patients of the control group were treated with conventional treatment,including digestive tract cleaning,catharsis,diuresis and atropine.Patients of the study group were treated with hemopurification treatment on the basis of the control group.The situation of treatment,rescuing success rate,and incidence of complications of two groups were compared.Results The average amount of atropine was (50.18 ± 33.04) mg,the average time of recovery of consciousness was (8.15± 2.50) h in study group,which were significantly reduced compared with (57.23±32.01) mg and (22.54 ±3.27) h in control group.The complication rates in study group significantly reduced,including the complication rates of respiratory failure (7.41％),liver damage (22.22％),kidney damage (40.74％).Compared with control group (18.52％,37.04％ and 55.56％),the difference was statistically significant (P＜0.05).In 27 patients of the study group,25 cases were cured,2 cases died,and the success rate was 92.95％; in 27 patients of the control group,22 cases were cured,5 cases died,and the success rate was 81.48％.The difference of success rate in two groups had statistical significance (x2=13.6,P＜0.05).Conclusions Hemopurification technology could remove the residual poisons in the blood timely,reduce the damage of poison to target organs.It has high success rate and good security,and the clinical effect is satisfactory. Key words: Comparative effectiveness research; Hemopurification; Organophosphate poisoning

A brief history of recognition on urolithiasis before medieval period

Urinary stone was first found by human as early as 4900 BC when the Egyptian monks applied emesis, catharsis, diuresis, and diaphoresis for its treatment which, as they claimed, can expel the stones out of the body occasionally. In 2700 BC, definite records on urinary stone were seen in Egytian papyrus which attempted to cure this disorder by sucking method. In the 4(th) century BC, the Greek physician Alexandria mentioned that such stones can be expelled after being smashed. By then, the Greeks recognized the existence of renal stone by describing its manifestations. Sushruta, an ancient Indian royal physician mentioned in 6(th) century BC, the picking up of stones by splints through the urethra and the complications of such disorder in his Sushrutasamhita. He also recommended the removal of stones through the perineal part. Unfortunately, many patients died of such operation. Ancient Roman physicians described such operation circumstantially and the herbs for its treatment in the 1(st) century BC. During the 10(th) century, the Arabian physician Abukasis was the first to advocate the method of smashing stones in the urethra with an instrument he devised. In the period before medieval age, the removal of urinary stones through the perineal incision had been the main method which was so limited an approach due to the lack of anatomical knowledge and antiseptic conception.

Isosorbide mononitrate injection in the treatment of pulmonary heart disease

Objective To explore the efficacy and safety of isosorbide mononitrate injection in the treatment of pulmonary heart disease.Methods 138 patients with pulmonary heart disease were randomly divided into two groups,69 for each group.The patients in the control group received conventional treatments including anti-infection,improvement in heart function,diuresis,relief of dyspnea,and oxygen inhalation; while the patients in the study group received isosorbide mononitrate injection in addition to conventional therapies.The clinical efficacy and cardiac function were observed in both groups before and after treatment.Results The study group was markedly superior to the control group in the improvement of symptoms,hemorheology,and TCD indexes.The total effectiveness rate was 89.86％ in the study group and 75.36％ in the control group; the efficacy differed significantly between the two groups (P＜0.05).Conclusions The study group has a quicker onset,stronger action,and better efficacy and is more reliable and safer than the control group. Key words: Isosorbide mononitrate; Pulmonary heart disease; Efficacy

A Case of Severe Hypernatremic Myopathy by Primary Hypodipsia, Hyperglycemic Hypertonic State in a 17-Year-Old Patient With Mental Retardation

Although severe hypernatremia, defined as a sodium concentration > 180 mEq / L, is associated with a high mortality rate, particularly in adults, little is known about severe hypernatremia in patients with diabetic ketoacidosis (DKA). Hypernatremic myopathy has been reported in patients with severe dehydration, acute kidney injury, and rhabdomyolysis. Dehydration in a diabetic patient with mental retardation may be caused by osmotic diuresis and exacerbated by hypodipsia, which requires the patient to be educated about regular oral hydration. Here, we describe a 17-year-old patient with reversible severe hypernatremia (serum corrected sodium, 180 mEq / L) and primary hypodipsia, but without DKA. The patient visited the emergency room due to agitation and weakness in both lower extremities. Initial laboratory tests showed hyperglycemia, acute kidney injury, acute hepatitis, and myopathy. Following rehydration with one-quarter isotonic saline and intensive insulin therapy, the patient ’ s symptoms (including leg weaknesses) and laboratory findings improved. doi: http://dx.doi.org/10.4021/jmc1136w

Dry Lungs Are Happy Lungs

In 2006, ARDSNet investigators demonstrated that aggressive diuresis of patients with acute respiratory distress syndrome (ARDS) resulted in earlier

Study of the method used to induce the model of type 2 diabetic mellitus rat and the characteristic of the nephropathy

Objective To discuss the feasibility of the method that can be used to induce the model of type 2 diabetic mellitus rat and explore the characteristic of the nephropathy.The rats were fed with the high sucrose,high fat and high energy feed for a long time and then it was injected with the low dose STZ.Methods 30 SD rats were selected and then it was randomly divided them into 2 groups,the control group (10 rats) and the model group (20 rats).The model group was fed with the high calorie feed forl0 weeks to induce insulin resistance and then the rats were induced to type 2 diabetes mellitus by injection of streptozocin (30 mg/kg).The rats of the model group were continually fed with the high calorie feed for 2 months.Before the end of this study,the 24-hours microalbuminuria,serum creatinine and blood urea nitrogen were detected and the periodic acid Schiff staining on the kidney were also measured.Results After the rats of the model group were established,the levels of the bodyweight,the cholesterol,the triglyceride and the insulin were [ (468.7 ± 8.8 ) g,( 1.92 ± 0.27 ) mmol/L,( 1.32 ± 0.34) mmol/L,(38.81 ± 5.39 ) mU/L ] respectively,all of them were higher than the levels in the normal group,which were [ (436.9 ± 7.4) g,(1.16 ±0.17)mmol/L,(0.8 ±0.18)mmo1/L,(21.43 ±4.19)mU/L],respectively( t =9.755,8.077,4.437,8.902,P ＜ 0.01 ).After injection of STZ for 2 weeks,the levels of the blood glucose,the insulin and the insulin resistance of the diabetes mellitus rats were [ ( 19.31 ± 1.55 ) mmol/L,( 31.31 ± 8.60) mU/L,(26.55 ± 6.33) ] respectively,it was higher than levels inf the normal group,which was[ (5.45 ±0.69) mmol/L,( 19.97 ± 3.26) mU/L,(4.82 ± 0.84) ] ( t =26.383,3.951,10.719,P ＜ 0.01 ).Before the end of this study,the levels of the blood glucose,insulin resistance,24-hours microalbuminuria,serum creatinine,blood urea nitrogen of the diabetes mellitus rats were [ ( 19.27 ± 1.97 ) mmol/L,( 16.70 ±7.51 ),(72.49 ± 8.53 ) mg/24 h,( 74.76 ± 8.38 ) μmol/L,( 19.09 ± 4.21 ) mmol/L],it was higher than the levels in the normal group,which were [ (5.62 ±0.65) mmol/L,(5.45 ± 1、33),( 15.26 ±2.20) mg/24 h,(40.81 ± 1.97) μmol/L,(9.87 ±2.13) mmol/L,t =20.961,4.657,20.623,12.495,6.352,P ＜0.01 ].And the pathological changes of the diabetes mellitus rats kidney tissues were the most serious through themethod of periodic acid-Schiff's staining (PAS).Conclusions The model of type 2 diabetic mellitus rat was constructed through the way of feeding the SD rats with high sucrose,high fat and high energy feed for a long time and low dose STZ.The diabetic mellitus rats had the symptom of drinking more,eating more and diuresis,and the character of this model had high levels of albuminuria,serum creatinine,blood urea nitrogen.The incrassated glomerular mesangium,the crescent-shaped focus and the glomerulosclerosis were also observed through the PAS. Key words: Diabetic nephropathies ; Models, animal ; Streptozocin/AD

Manejo não farmacológico de pacientes com insuficiência cardíaca descompensada: estudo multicêntrico - EMBRACE

OBJETIVO: Identificar a prescrição e execução dos cuidados não farmacológicos nas prescrições médicas ou de enfermagem em três centros de referência no atendimento de pacientes com insuficiência cardíaca. MÉTODOS: Estudo de abordagem quantitativa, transversal de uma coorte multicêntrica. Incluíram-se pacientes admitidos por IC descompensada, classe funcional III/IV; de qualquer etiologia; idade ≥ 18 anos; de ambos os gêneros. RESULTADOS: Foram incluídos 562 pacientes, dentre os cuidados não farmacológicos, a restrição de sal foi o mais prescrito (95,4%), seguido pelo controle de diurese (48%). A proporção de cuidados prescritos e realizados foi maior no terceiro, e nos outros dois a diferença entre o prescrito e o realizado foi superior a 20%. CONCLUSÕES: Os cuidados não farmacológicos não estão totalmente incorporados à prática clínica. Estratégias que possam mobilizar a equipe multiprofissional com vistas às prescrições e realizações desses cuidados merecem ser estudadas.

Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: acute renal failure.

Nutritional support in acute renal failure must take into account the patient's catabolism and the treatment of the renal failure. Hypermetabolic failure is common in these patients, requiring continuous renal replacement therapy or daily hemodialysis. In patients with normal catabolism (urea nitrogen below 10 g/day) and preserved diuresis, conservative treatment can be attempted. In these patients, relatively hypoproteic nutritional support is essential, using proteins with high biological value and limiting fluid and electrolyte intake according to the patient's individual requirements. Micronutrient intake should be adjusted, the only buffering agent used being bicarbonate. Limitations on fluid, electrolyte and nitrogen intake no longer apply when extrarenal clearance techniques are used but intake of these substances should be modified according to the type of clearance. Depending on their hemofiltration flow, continuous renal replacement systems require high daily nitrogen intake, which can sometimes reach 2.5 g protein/kg. The amount of volume replacement can induce energy overload and therefore the use of glucose-free replacement fluids and glucose-free dialysis or a glucose concentration of 1 g/L, with bicarbonate as a buffer, is recommended. Monitoring of electrolyte levels (especially those of phosphorus, potassium and magnesium) and of micronutrients is essential and administration of these substances should be individually-tailored.

Diuretics and diuresis.

Diuretics and diuresis.

Analysis on the treatment of 42 cases of glaucoma with compound trabeculectomy combined with activating blood circulation and promoting diuresis Chinese medicine

Objective To observe clinical effect of treating glaucoma with compound trabeeuleetomy combined with activating blood circulation and promoting diuresis Chinese medicine. Methods 42 cases with glaucoma were randomly divided into two groups by means of random number table. The control group was treated with compound trabeculeetomy, and the treatment group was treated with Chinese medicine after compound trabeeuleetomy. The regular reexamination was performed, and follow-up visit was executed for an average of 12 months. Results Compared with the control group, the postoperative vision in the treatment group increased significantly (λ2=4.511, P<0.05) , and intraocular pressure decreased significantly (λ2=3.638,P< 0.05); The rate of anterior chamber in the treatment group was lower than that of the control group(λ2=4.256 P< 0.05) . Both groups had filtering bleb, and the rate of non-functional filter blebs in the treatment group was lower than that of the control group (λ2=3.054, P< 0.05 ) . Conclusion The therapy of compound trabeculectomy combined with Chinese medicine on glaucoma was better than compound trabeculeetomy only. Key words: Glaucoma; Chinese medicine; Compound trabeculectomy