Showing papers in "Chinese Journal of Critical Care Medicine in 2006"

Study on the expression of nuclear factor-kappa B and inducible nitric oxide synthase in lung tissue of acute paraquat poisoned rats

Abstract: Objective This study aimed at investigating the activity of NFκB and the expression of inducible nitric oxide synthase(iNOS) in lung tissue of acute paraquat poisoned rats.Methods 80 Sprague-Dawley (SD) rats weighing 180 g to 200 g were randomly divided into two experimental groups: Poisoned group and Control group.At 1,3,7,14,21,28 and 35 days after exposure,lung pathological changes of ten rats were observed,NF-κB activity in the lung tissues was assessed by electrophoresis mobility shift assay(EMSA),and expression of iNOS mRNA were evaluated by RT-PCR.Results Compared with that in control group,NF-κB activity in lung tissue of Poisoned group was elevated at the first day,reached the peak at the third day,return to normal level at the 21th day;and expression of iNOS mRNA in lung tissue of Poisoned group markedly increased at the first day,reached the peak at the 7th day,decreased slowly afterwards,return to normal level at the 28th day.Conclusions NF-κB and iNOS could play an important role in lung injury of poisoned rats.

Protective effect of Shenfu injection on endotoxin induced acute lung injury

Abstract: Objective To study the mechanism of protective effect of Shenfu injection on endotoxin induced acute lung injury.Methods 30 clean grade SD rats were randomly divided into three groups: ET group(n=10) and ET+SF group(n=10) were injected iv.with endotoxin(ET)(5 mg/kg),and NS group(n=10) with 0.9%NS(2 mL/kg).At the same time,ET+SF group were injected ip.with Shenfu injection(SF)(10 mL/kg),and NS group and ET group with 0.9%NS(10 mL/kg).5 hours after,the partial pressure of oxygen in artery(Pa0_2),the expression of nuclear factor-κB(NF-κB)in lung,the tumor necrosis factor-α(TNF-α) content in plasma was assayed respectively,the extent of lung injury was further assessed by measuring the ratio of wet weight to dry weight(W/D) and evaluating histologic change of tissue slice under a light microscope.Results The W/D,the TNF-α content in plasma and the NF-κB expression in lung tissue of ET group significantly increased compared with NS group,and ET+SF group significantly decreased compared with ET group.The Pa0_2 of group ET significantly decreased compared with NS group,while ET+SF group increased compared with ET group.The extent of lung injury of ET group was more serious than NS group(P0.05),while ET+SF group was milder than ET group((P0.05).)Conclusion Shenfu injection can lighten endotoxin induced acute lung injury.One mechanism of action may be that it decreases the activation of NF-κB and then reduce the production of TNF-α.

Risk factors of nosocomial acquired pneumonia in the patients with apoplexy

Abstract: Objective To explore the risk factors and preventive measures for nosocomial acquired pneumonia in the patients with apoplexyMethod A prospective and retrospective study was carried out to investigate the clinical data of 1832 patients with apoplexy during January 1st,2003 to December 31st,2004Results The nosocomial acquired pneumonia rate was 557%The nosocomial acquired pneumonia rate in the patients with cerebral hemorrhage and cerebral infarction was 772%(24/311)and 513%(78/1521) respectivelyThe risk factors were the application of antibiotics,tracheal intubation,tracheotomy,confusion,H_2-receptor blocking agents,duration of diabetes mellitus,the days of hospitalization,dysphagia,chronic obstructive pulmonary disease(COPD) and enteral nutrition infusionConclusions Nosocomial acquired pneumonia is closely related to ten factors: the days of hospitalization,tracheal intubation,tracheotomy,confusion,enteral nutrition infusion,duration of diabetes mellitus,dysphagia,COPD and the application of antibiotics and H_2-receptor blocking agentsThe results suggest that we should pay attention to clinical treatment and nursing in order to lower the occurrence of the nosocomial acquired pneumonia

Effects of propofol on the expression of aquaporin-1 in lipopolysaccharide-activated rat lung microvessel endothelial cells

Abstract: Objective To investigate the effects of propofol on the expression of aquaporin-1(AQP-l) of rat lung(microvessel) endothelial cells(RLMECs) induced by lipopolysaccharide(LPS)Methods Rat lung microvessel endothelial cells were randomly assigned to one of the following seven groups: no additives(negative control),LPS alone(01 μg/mL,1 μg/mL and 10 μg/mL),LPS(10 μg/mL) combination with either propofol(4 μg/mL or 40 μg/mL) or introlipid(40 μg/mL)Changes of osmotic reflection coefficients(σ) were measured,and expression of aquaporin-1(AQP-l) measured by immunocytochemistry and western blotting were also observed in cultured RLMECsResults AQP-l protein expression and osmotic reflection coefficients(σ) values in LPS alone group,(specially) in high dose LPS alone group,were significantly lower than those in the normal control group(P001)The co-treatment of propofol and lipopolysaccharide significantly increased the protein expression of AQP-l and the osmotic reflection coefficients(σ) values(P001),while introlipid had no such benefical effectsConclusions LPS stimulation can significantly decrease AQP-l expressionPropofol rather than intralipid,may take part in regulating AQP-l expression of RLMECs and attenuate LPS-induced abnormal fluid transportation in acute lung injury

Use of peripheral venous blood for the monitoring of intestinal mucosal barrier function in the patients with hemorrhagic shock

Abstract: Objective To investigate the clinical significance of the use of peripheral venous blood as a means of monitoring intestinal mucosal barrier function in the patients with hemorrhagic shock.Methods 46 patients with hemorrhagic shock were recrui- ted.Healthy individuals were used as controls.4 mL blood was withdrawn before fluid resuscitation and at 1,3 and 8 hours after fluid resuscitation from the elbow vein of each subject for the determination of diamine oxidase(DAO),motilin(MTL)and lipopolysaccha- ride(LPS)in plasma.Results Plasma levels of DAO and MTL were increased at the various time points and were found to be signifi- cantly higher in the patients with hemorrhagic shock than in the control group(P＜0.01).Plasma LPS level could be detected at the various time points and the level was the highest at 8 hours after fluid resuscitation.Plasma LPS level was significantly higher in the pa- tients with hemorrhagic shock than in the control group(P＜0.01).Plasma DAO,MTL and LPS levels were significantly higher in the group with organ malfunction than in the group with normal organ(P＜0.01,P＜0.05).Conclusion Plasma DAO and MTL levels of peripheral venous blood could better reflect the intestinal mucosal barrier function in the patients with hemorrhagic shock.

Function and clinical significances of interleukin(IL)-6,interleukin(IL)-10 and tumor necrosis factor(TNF)-αin multiple organ dysfunction syndrome induced by acute organophosphorus pesticide poisoning(AOPP)

Abstract: Objective To investigate the dynamic changes of IL -6,IL - 10 and TNF -αin serum of the patients with AOPP and MODS and to discuss the mechanism of MODS induced by AOPP.Methods 42 patients with AOPP and MODS were enrolled in this study.The contents of these cytokines in the serum were detected with double antibody sandwich - enzyme linked immunosorbent assay(DAS-ELISA) and compared with control group.Results The contents of IL -6,IL - 10 and TNF -αincreased obviously in the serum of patients with AOPP,and there was significant difference between patients with AOPP and normal control (P＜0.01). Conclusion AOPP may conduce to the maladjustment of the cytokines,and the eytokines play an important role in the development - from systemic inflammatory response syndrome (SIRS)to MODS in AOPP patients.

Clinical trial in elderly patients with acute myocardial infraction by percutaneous coronary intervention after transport

Abstract: Objective To evaluate clinical effect and safeties of elderly patients with acute myocardial infraction (AMI) by percutaneous coronary intervention(PCI) after transport. Methods Among 13 cases with AMI,5 were carried on emergency PCI within 6 hours from the onset of the symptoms,8 cases being carried on delay PCI in time that exceed 7days from the onset of the symptoms; we immediately carry on arteriogram after surgery in order to evaluate clinical effects,observe the circumstance of the hospitalization and the circumstance of follow-up period. Results 13 cases with AMI by reconstructed infract related artery (IRA) gained the result of TIMI,which is thrombolysis in myocardial infarction,myocardial perfusion grade three flow,and restenosis which were less than 20 percent. During the period of hospitalization,it had not ocurred the events such as sudden cardiac death,acute coronary artery restenosis,emergency call coronary artery bypass transplantation and serious hemorrhage. Further follow up period (from 8 months to 12 months),it have not occurred cardiac events (cardiac death,angina pectoris of related aim artery,AMI and reconstruction). Conclusions Under emergency transport the patients with AMI by operated PCI treatment have obtain not only the good hospitalizational effect and future clinical curative effect,but safety and credibility. It is also the benefits to the cardiac intervention system,which allow the hospital operate the surgery of PCI,Furthermore,to investigate how the hospital that is not allow operate PCI protect the patients effectively.

Influence of intensive insulin therapy on rate of CD14~+ and expression of CD14~+ monocyte human leukocyte antigen DR in severe trauma patients

Abstract: Objective To study the influence of intensive insulin therapy on rate of CD14~+ monocyt and expression of CD14~+ monocyt human leukocyte antigen DR(HLA-DR) in severe trauma patients,and to investigate the role of protection to serious illness.Methods Insulin therapy directed at establishing euglycemia was investigated in 32 sICU injured patients ISS 20,tailored to control blood glucose levels in the range 6-8 mmol/L,where as the conventional treatment group only received insulin when glucose levels exceeded 11.1 mmol/L.Blood samples were obtained at 0,2,4,6 and 8 days after admission.Two-color flow cytometric(FCM) analysis was used for the detection of the human leukocyte antigen HLA-DR expression on CD14~+ monocytes.Results Monocyte HLA-DR expressions were comparatively lower after using of insulin protocols,compared with the conventional approach.Conclusions Intensive insulin therapy improves blood glucose control and protects organ functions in injured patients.Attenuating the systemic inflammatory response to trauma,as well as its glycemia controlling effects,may contribute to the improved outcomes of sever trauma patients.

The expression of secretory leukocyte protease inhibitor in dermal pluripotent stem cells

Abstract: ObjectiveTo investigate the expression of secretory leukocyte protease inhibitor(SLPI) in dermal pluripotent stem cells and their change after the cells being stimulated by wound fluid.Methods Dermal pluripotent stem cells were routinely isolated, purified and explanded by the technique established in the prophase. We detected SLPI to know how they changed in dermal pluripotent stem cells and in the rat skin before and after the injure by using RT-PCR method. Extracted total protein from cultured cells by M-PER.We used Western to determine the exression of SLPI in dermal pluripotent stem cells before and after stimulated by wound fluid.ResultsThe isolated and purified dermal plufipotent stem cells had similar phase, and their abilities of proliferation were very strong.It was shown in the results of RT-PCR and western that SLPI expressed in dermal pluripotent stem cells and increased after the cells being stimulated by wound fluid. SLPI also high expressed in the rat skin 1day after injury.ConclusionsSLPI can be detected in dermal pluripotent stem cells .It increased after the cells were stimulated by wound fluid.In view of the multiple functions of SLPI, we supposed that it acted as an important role when dermal pluripotent stem cells participated in the reparing of cutaneous injury.

Protective effects of anisodamine on the myocardial experienced ischemia-reperfusion in minipigs

Abstract: Objective To investigate the protective effects of anisodamine on the myocardial experienced ischemia-reperfusion in minipigs.Methods Twelve minipigs were randomized into two groups: group normal saline(n=6) and anisodamine(n=6).The ischemic-reperfusion model were made by occluding LAD with balloon and withdrawing the balloon.At the same time,medicine was injected into the coronary artery,and blood samples were taken and NO,ET-1,and PagT were measured.During the time,blood pressure,incoronary pressure,and heart rate were monitered.Finally,the heart was taken out to measure myocardial ischemic and infarction area.Results ①In group saline group,NO was decreased while ET-I and PagT were increased at the time when reperfusion compared with those before occlusion.But these changing amplitudes were relatively small in group anisodamine compared with those in saline group.②There were no significant change of blood pressure,incoronary pressure and heart rate in group saline,while blood pressure,incoronary pressure and heart rate were raised in group anisodamine,and the most obvious change was at 30min after anisodamine was infused to coronary.And incoronary pressure was more raised in group anisodamine than that in group saline.③The ischemic and infarcted area was less in group anisodamine than that in group saline.Conclusion Intracoronary anisodamine injection could protect vascular endothelial function,inhibit platelet congregation,increase incoronary pressure,and decrease ischemic and infracted myocardial area.

Expression of IL-4 and IFN-γmRNA in T lymphocyte during the operation with cardiopulmonary bypass

Abstract: Objective Study the expression of IL-4 and IFN-γmRNA in T lymphocyte during the operation with cardiopulmonary bypass(CPB).Methods 30 children with congenital heart disease aged from 3 to 12 years were selected randomly,the blood was sampled on the time of 24 hours before operation,20 minutes after CPB,the end of CPB,6 hours after operation,24 hours after operation.After seperated T lymphocyte and distilled RNA,we measured the expression of IL-4 and IFN-γ mRNA by RT-PCR.Results The expression of IL-4 mRNA in T lymphocyte up-regulated obviously on the time of 20 minutes after CPB,peaked on the end of CPB,and returned to the level of preoperation 24 hours after operation.The expression of IFN-γ mRNA down-regulated obviously on the time of 20 minutes after CPB till the end of CPB,and returned to the level of preoperation 24 hours after operation.Conclusion CPB makes the upregulation of IL-4 mRNA and downregulation of IFN-γ mRNA,and the disbalance of Th1/Th2,which plays an important role in the inflammatory response happened in CPB.

Influence of hypertonic saline on blood coagulation and fibrinolysis in craniotomy following pre-operative acute hemodilution

Abstract: Objective To evaluate the influences of hypertonic saline on blood coagulation and fibrinolysis in craniotomy following pre-operative acute hemodilution.Methods Thirty adult patients,ASA grade Ⅰ～Ⅱ,scheduled for selective craniotomy,were randomly allocated to receive intravenous infusion of hypertonic saline(HS group),succinyl gelatin(GEL group),or Lactate Ringer's(LR group),with 10 cases in each group.Every patient was bled before operation slowly and hematocrit(Hct) was not below 25% in principle.At the beginning of bleeding,HS,GEL and LR were infused intravenously in three groups respectively to keep blood pressure normal.The venous blood samples were taken at 5 min before bleeding and 1 h after infusion to determine platelet count(PC),platelet aggregation test(PAgT),activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(Fg),tissue plasminogen activator(t-PA) and plasminogen activator inhibitor(PAI∶A).Results In HS group PC and PAgT(1)decreased greatly,PT and APTT prolonged significantly after bleeding.There were significant differences in APTT between HS and LR groups(P0.05).In GEL group only Fg reduced obviously after bleeding,and it was remarkably lower than that in LR group(P0.05).Conclusions Following intravenous infusion with HS during pre-operative acute hemodilution,there are no influences on fibrinolysis,while HS-induced depression of intrinsic factor of blood coagulation may results from not only hemodilution but also their pharmacological properties.

Comparison of two kinds of direct current cardioversion on the treatment of atrial fibrillation

Abstract: Objective To investigate the comparison of two kinds of direct current cardioversion on the treatment of atrial fibrillation.Methods 71 patients with persistent atrial fibrillation were divided into two groups.Group A received anterior-anterior electrode position while Group B received anterior-posterior electrode position.Observed the success rate,the discharging numbers and total electric energies that needed to restore sinus rhythm,the levels of LDH,CK,CK-MB after cardioversion.Results Both groups had similar success rate and levels of serum LDH,CK,CK-MB.Group B needed fewer discharging numbers(1.8±0.8 times vs 2.2±0.7 times,P0.05) and lower total electric energies(291.9±197.7 J vs 388.2±193.5 J,P10.05).In both groups,the level of CK increased while CK-MB did not change.Conclusions Both kinds had similar success rates on the cardioversion of atrial fibrillation.But anterior-posterior electrode position was better than anterior-anterior electrode position on the discharging numbers and total electric energies.Both were safe and have no damage on the myocardium.

Research on acute physiology and chronic health evaluationII and establishment of a regression model in paraquat poisoning

Abstract: Objective Use acute physiology and chronic health evaluationⅡ(APACHEⅡ) to assess the degree of the illness and the prognosis of the paraquat poisoning patients.Methods 66 patients with paraquat poisoning in EICU were enrolled.After APACHEⅡscore was calculated,the prognostic value of this system was assessed,then analysis the relationship between mortality and APACHEⅡ,and establish the regression model.Results APACHEⅡ scores of these patients were in the range of 2 to 35,average(11.6±9.24),with average score of(5.58±3.02) for 38 survivors and(19.79±8.52) for nonsurvivors.The difference between these two groups of patients was significant(P0.01).There was a significant correlation between APACHEⅡ score and mortality,regression model was established.Conclusion APACHEⅡscore system can be used to predict the prognosis of paraquat poisoning patients.

Effect of L-arginine on expression of Fas/FasL mRNA in pulmonary injury induced by ischemia-reperfusion in rabbits

Abstract: Objective To investigate the effect of L-arginine (L-Arg) on expression of Fas/FasL mRNA during pulmonary ischemia and reperfusion injury (PIRI) in the rabbits.Methods Single lung ischemia and reperfusion animal model was used in vi- vo.The rabbits were randomly into three groups ,control group (C,n=10),ischemia/reperfusion group (I/R,n=10) and I/R+L -arginine group(L-Arg,n=10).Changes of several parameters which included apoptotic index (AI),wet to dry ratio of lung tissue weight(W/D) and index of quantitative assessment of histologic lung injury(IQA) were measured at 180 minutes after reperfusion in lung tissue.Meanwhile the location and expression of Fas/FasL mRNA were observed,lung tissue was prepared for light microscopic and electron microscopic observation at 60,180,300 minutes after reperfusion.Results As compared with group I/R,Fas/FasL mR- NA slightly expressed in intima and extima of small pulmonary artery,alveoli,and bronchiole epithelia in L-Arg group.The values of AI,W/D and IQA showed significantly lower than that in I/R group at 180 minutes after reperfusion in lung tissue (P＜0.01 and P＜0.05).Meanwhile,abnormal changes of the lung tissue in morphologically were lessen markedly in L-Arg group.Conclusion L- arginine produces notable protective effects on PIRI in rabbits by inhibiting Fas/FasL mRNA express in lung tissue,decreasing apopto- sis.

Effects of low dose of cyclophosphamide on acute lung injury in sepsis sats

Abstract: Objective To explore the effects of low dose of cyclophosphamide(CY) on acute lung injury(ALI) in sepsis rats.Methods ALI rat models were given the intraperitoneal injection of lipopolysaccharide(LPS).40 SD rats were randomly divided into four groups: experiment group(CY group,ALI+CY,n=10),positive control group(DXM group,ALI+DXM,n=10),negative control group(ALI group,ALI+NS,n=10) and uncontrolled group(NS group,n=10).All the rats were killed and the specimens of lung tissues were reserved at 6 hours after establishment of the models.The relative content of NF-κB P65,IκB-α were detected by image analyse system and immunohistochemistry.The pathological changes of the lung tissues were examined with light microscope. Results By light microscopy,the evidence of lung injury-neutrophil infiltration and hemorrhage in the cavity of alveolus,bronchiole epithelial desquamation,edema and so on were found in the sections of ALI group stained with hematoxylin-eosin.Compared with ALI group,neutrophil infiltration,alveolar atelectasis in CY group and DXM group,were alleviated(P0.05);CY group and DXM group were compared with ALI group,the expression of NF-κB P65 was down-regulated(P0.01)and IκB-α was up-regulated(P0.05).CY group was compared with DXM group,the difference wasn't found(P0.05).Conclusions Low dose of CY alleviated neutrophil in filtration in lung,and down-regulated the expression of NF-κB P65.The result indicated that low dose of CY,same as DXM had prominently anti-inflammatory effect and can relieve the lung injury in ALI rats induced by LPS.