Showing papers in "Chinese Journal of Critical Care Medicine in 2007"

Prognosis of severe sepsis patients assessed by lactate clearance rate

Abstract: Objective To retrospectively analyze the correlation between the prognosis and the lactate clearance rate in severe sepsis patients.Methods The data of 247 severe sepsis patients were col- lected,including the score of APACHEⅡafter admission to ICU,the morbidity of septic shock,the lac- tate clearance rate after 12 hours in ICU and the patients' prognosis.A total of 247 cases were divided in- to survival group and dead group,low lactate clearance rate group and high lactate clearance rate group, and the differences between them were compared for statistical significance.Results There were no differences in age,sex,the score of APACHEⅡafter admission to ICU and the initial blood concentration of lactate(P＞0.05).In survival group,the morbidity of septic shock was significantly less(31.03% vs 83.33%,P＜0.01),but the lactate clearance rate was significantly higher than in dead group[(31.86±16.34)% vs(14.77±10.35)%,P＜0.01];In high lactate clearance rate group,the morbidity of sep- tic shock and the mortality were significantly lower than in the low lactate clearance rate group(29.45% vs 90.48%,P＜0.01;30.67% vs 85.71%,P＜0.01).Conclusion The lactate clearance rate can pre- dict the prognosis of severe sepsis even in early phase.

Changes of phospholipase A_2 in the patients with acute pancreatitis and therapeutic effect of verapamil

Abstract: Objective To observe the changes of phospholipase A2 (PLA2) in the patients with acute pancreatitis(AP), and to investigate the role of PLA2 in the injury of pancreas and organ function and the therapeutic effect of verapamil. Methods 48 patients diagnosed as AP were observed and were randomly divided into verapamil treatment group and routine treatment group,and healthly people were used as the control one. 4 mL blood was drawn from every patient's elbow vein and PLA2 activity in plasma, amylase activity in serum and calcium concentration in plasma were detected respectively at the time of admission before the treatment, on the 2nd and 4th day after the treatment. Results Amylase activity in serum was significantly higher in the patients with the AP than in the control group (P0.01), and it was obviously less in the patients of verapamil treatment group after treatment than in the patients of routine treatment group (P0.05, P0.01). PLA2 activity in plasma was significantly higher in the patients with the AP than in the control group (P0.01), and it was obviously less in the patients of verapamil treatment group after treatment than in the patients of routine treatment group(P0.05, P0.01). Calcium concentration in plasma was significantly less in the patients with the AP than in the control group ( P0.01), and it was obviously higher in the patients of verapamil treatment group after treatment than in the patients of routine treatment group(P0.05,P0.01).The number of the patients with organ malfunctions in verapamil treatment group decreased significantly in comparison with that in routine treatment group(P0.01). Conclusions PLA2 plays a major role in AP and the injury of organ function caused by it. The verapamil inhibited PLA2 activity by blocking calcium channel and had a therapeutic effect on relieving the damages of pancreas and its organ function.

Association between gene polymorphisms of tumor necrosis factor and the susceptibility and prognosis of severe sepsis

Abstract: Objective To determine the allele frequency and genotypic distribution of tumor necrosis factor (TNF)-α and TNF-β gene polymorphisms and serum TNF-α concentrations in the patients with severe sepsis. Methods Genotypes were determined in patients (n=56) and healthy controls (n=60) by means of restriction fragment length polymorphism analysis of polymerase chain reaction products. Serum concentrations of TNF-α were measured by ELISA. Results ①The TNF-α allele frequency and genotypic distribution in the patients with severe sepsis were comparable with those values found in normal individuals (0.25 vs 0.067, P0.05, RR=4.667). No significant differences were found in TNF-β gene polymorphism. ②TNF-α2 frequency was significantly higher in nonsurvivors with septic shock than in survivors (0.429 vs 0.19, P0.05, RR=4.163). No significant differences were found in TNF-β gene polymorphism between the two groups. ③There were significant differences in baseline concentrations of TNF-α between survivors and nonsurvivors [(65.24 ± 6. 55)pg/mL vs (76.54±7. 45)pg/mL,P0.05].④ TNF-α concentration correlated with TNF-α polymorphism, but not with TNF-β polymorphism. Conclusion Some associations between the susceptibility and prognosis of sepsis and the TNF-α polymorphisms were found, but no associations were found between TNF-β gene polymorphism and sepsis.

Comparison of lung injury degrees after one-lung ventilation for different time

Abstract: Objective To study the changes of oxygenation index,lung injury score and wet/dry lung weight ratio (W/D) after one lung ventilation for different duration on the rabbit models.Method 24 white Japanese rabbits were randomly divided into 4 groups (n=6). The control group performs two-lung ventilation for 2 h. The groups of O1,O2 and O3 performed one-lung ventilation for 1,2,3 h respectively, which were followed with two-lung ventilation for 1 h. Lung separation was achieved with a double-lumen tube made by myself. The arterial blood gas samples were drawn from femoral artery,the right pulmonary vein and the left one to get the oxygenation indexes. Light microscopic evaluations were performed to get the lung injury scores and W/D were determined. Result Lung injury scores were significant differences in left lung compared to right lung in the groups of O1,O2 and O3, though no significant differences were noted in the group C. Comparison of the right lungs of the four groups to all other documented significant increase of lung injury scores. The magnitudes of lung injury scores were related to OLV duration. The changes in the left lung were similar and more severe to the right ones. A similar changes of oxygenation index and W/D was found in all the groups.Conclusion Long time OLV could induced acute lung injury, which was inhomogeneous. The degrees of lung injury were related to OLV duration and were more severe in the non-ventilated lung.

The building of delayed neuropsychologic sequelae rat model by carbon monoxide peritoneum injection

Abstract: Objective To explore a reliable method for building the animal model of delayed neuropsychologic sequelae(DNS)after acute carbon monoxide(CO)poisoning.Methods Adult Wistar rats were selected and randomly divided into 4 treatment groups(n=10 each group)and 1 control group (n=4).In treatment groups,different doses of CO(50 mL/kg,100 mL/kg,150 mL/kg and 200 mL/ kg)were administrated by peritoneum injection,and in control group,CO was replaced by air(200 mL/ kg)to peritoneum inject.Carboxyhemoglobin(HbCO)levels in blood were detected after administration. Morris maze test was adopted to identify DNS occurring.In different time points after treatment,brain cor- tex and hippocampus were isolated,embedded into paraffin and sliced into 5μm sections.Apoptosis of brain cells was measured by TUNEL staining.Result The rats of each treatment group showed typical a- cute CO poisoning symptoms after CO infusion.There was positive correlation between HbCO and injected CO doses(r=0.77,P0.05).In 50 mL/kg group and control group,neither DNS nor dead was oc- curred.The apoptosis in 50 mL/kg group was not significantly different with those in control group.In 100 mL/kg group and 150 mL/kg,most rats were surviving(8 in 100 mL/kg group and 7 in 150 mL/kg)af- ter poisoning and more than half of survived rats(62.50% in 50 mL/kg group and 71.43% in 100 mL/ kg)developed into DNS identified by Morris maze testing.The apoptosis of brain cells in both 50 mL/kg group and 100 mL/kg group were significantly higher than those in control group.In 200 mL/kg group, the majority of 7 cases were dead within 30 min after poisoning,and in 4 survived rats,3 of them devel- oped DNS.However,neither apoptosis nor DNS rates in 200 mL/kg group were significantly different with those in 100 mL/kg group and in 150 mL/kg group.Conclusion CO peritoneum injection is a effective, convenient,and reliable way to build the animal model of DNS by acute CO poisoning.

Effect of PA-MSHA vaccine on the prevention of pulmonary infection in severe traumatic patients

Abstract: Objective To explore the effect of pseudomonas aeruginosa-mannose sensitive haemagglutination(PA-MSHA)vaccine on the immune function and prevention of pulmonary infection in severe traumatic patients.Methods Fifty-five patients with severe trauma were studied and were at ran- dom divided into two groups after admission to our ICU:control group(n=27)and vaccine group(n= 28).Besides routine treatment for two groups,vaccine group accepted injection of 1.0mL of PA-MSHA strain vaccine by subcutaneous injection once a day for 14 days.In two groups,the immune function data were measured respectively at first day and 14th day after admission,and the rates of pulmonary infection were evaluated.Results At 14th day,the levels of serum IgG,complement C3 and C4,NK cell activi- ty,CD3,CD4,CD4/CD8 ratio in vaccine group were significantly higher(P＜0.01)than those at first day,respectively,while only the level of complement C3 was elevated(P＜0.05)significantly in the con- trol group.The rate of pulmonary infection in vaccine group(21.4%)was greatly lower than that in con- trol group(44.4%),P＜0.01.Conclusion PA-MSHA vaccine can improve the immune function of severe traumatic patients and may play an important role to reduce the incidence of pulmonary infection.

Changes of ventricular late potential in the children with vasovagal syncope

Abstract: Objective To explore the ventricular late potential(VLP) in the children with vasovagal syncope(VVS).Methods The VLP was analyzed in children(n=45) who had a positive head-up tilt table test(HUTT) result and the diagnosis of VVS.The VLP was recorded by the method of superposition on body surface.Healthy children were matched as controls(n=45).SPSS11.0 software was used for the statistical analysis of these data.Result LAS40 in study group was prolonged,compared with control group(P0.05).No statistical differences were found in HR,the total time of the QRS(TQRS) and root mean square value(RMS40) between two groups(P0.05).Conclusion There are abnormal electrical activities in myocardium and the cardiac accidents in the children with VVS.

Influence of thymosin α_1 on cellular immunity in the patients with severe sepsis

Abstract: Objective To observe the influence of thymosin α1 on CD14+ monocyte human leukocyte antigen DR(HLA-DR),T lymphocytes subpopulation and cytokine in the patients with severe sepsis. Methods A total of 42 patients with severe sepsis were randomly divided into two groups: the therapy group(n=21) and the control group(n=21). The control group accepted routine therapy and placebo, and the therapy group accepted 1.6 mg thymosin α1 by subcutaneous injection q 24 h for a week. To observe the effect of thymosin α1 on plasma concentrations of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-10(IL-10), endotoxin, HLA-DR and the percentage of CD4+, CD8+ and Th/Ts. Results TNF-α and IL-6 significantly decreased, and the concentration of plasma IL-10, the level of monocyte HLA-DR, CD4+ cell and Th/Ts ratio increased significantly after the treatment of thymosin α1 in the therapy group. Conclusions Thymosin α1 can improve the immunological function of the patients with severe sepsis and is helpful to regulate the conditions of inflammatory reaction.

Study of free radical scavenger for the treatment of acute intracerebral hemorrhage

Abstract: Objective To study the efficacy of free radical scavenger(edaravone)in the treatment of acute intracerebral hemorrhageMethods 212 patients with acute intracerebral hemorrhage were randomly assigned into two groups:102 patients in the treatment group were given edaravone besides routine treatment for 14 days,other 110 patients were treated routinely without edaravone as the control groupResults The improvement of the National Institute of Health Stroke Scale(NIHSS)and activities of daily living scale in the treatment group evaluated at 14th and 28th day were significantly higher than those in the control group(P005),but the levels of superoxide dismutase(SOD)and glutathione peroxidase(GSHPx)significantly rised at 3rd and 7th day after the treatment,the levels of NO and lipid peroxide(LPO)in the treatment group were obviously lower than those in the control group(P005)There was no the statistical difference in the adverse drug reaction in two groups(P005)Conclusion Free radical scavenger(edaravone)is efficacious and safe in the treatment of acute intracerebral hemorrhage due to the improvement of neurological impairment and activities of daily living in the patients

Diagnosis of pulmonary embolism

Abstract: Pulmonary embolism is comparatively common on clinic, but it is difficult to diagnose Diagnosis should begin with recognizing risk factors of pulmonary embolism and assessing the possibility of pulmonary embolism and symptoms and signs of patients with pulmonary embolism Routine examinations include D-dimer, electrocardiogram, chest X ray, and echocardiogram and so on Along with the development of imaging technology, many advanced methods are also gradually applied in the diagnosis of pulmonary embolism and shows the good prospects Pulmonary arteriography is a golden standard in the diagnosis of pulmonary embolism Multidetector CT might be another one, but diagnosis based on clinical findings is useful for pulmonary embolism

Time distribution and relative factors of prehospital delay in the patients with acute ST- segment elevation myocardial infarction

Abstract: Objective To investigate time distribution and relative factors of prehospital delay (PHD) in the patients with acute ST- segment elevation myocardial infarction (STEMI) Methods In this prospective, consecutive study, 412 patients with confirmed STEMI admitted to the study hospital(Luhe hospital and Xuan Wu hospital) were studied Patient delay (PD), transportation delay (TD) and PHD were recorded According to the median PHD of 6 hours, the patients were divided into 2 different groups: ≤6 h group and 6 h groupEffect of sociodemographic factor, clinical factors and psychological factors on PHD was analysed Results The following median times were recorded: PD 75 minutes, TD 50 minutes, PHD 170 minutes Factors associated with PHD in a univariate analysis were history of angina, typical symptoms, dizziness, syncope, severe chest pain, sudden onset, progressive symptoms, directly transferred to study hospital and suspect myocardial infarction, attributing symptoms to heart origin, death anxiety, attention to symptoms, waiting and seeing, worried about troubling others Logistic Regression Analysis showed the following factors were related to PHD: directly transferred to study hospital, sudden onset, progressive symptoms, attention to symptoms, worried about troubling others Conclusion Patient delay and diagnostic dilemmas at the community hospital are the main factors responsible for PHD Directly transferred to study hospital, sudden onset, progressive symptoms, attention to symptoms, worried about troubling others are the independent factors associated with PHD in the patients with STEMI

Protective effect of Shengmai injection on myocardium during the cardiopulmonary resuscitation

Abstract: Objective To explore the protective effect and its mechanism of Shengmai injection on myocardium during cardiopulmonary resuscitation.Methods A clinical study was performed in 42 pa- tients including 23 patients with Shengmai injection treatment and 19 cases with routine treatment.Blood samples were collected during the different courses of resuscitation to investigate the level of myocardial enzymes and SOD,NO,MDA at the same time,the incidences of the complications were also monitored. Results Compared with the routine treatment group,expression of SOD and NO was markedly increased while expression of MDA and myocardial enzymes were significantly decreased in the Shengmai treatment group during the different courses of cardiopulmonary resuscitation(P＜0.05 or P＜0.01).The inci- dence of complications in the Shengmai treatment group was less than that of the routine treatment group. Conclusion Shengmai injection can protect myocardium from the ischemia-reperfusion injury and im- prove successful rate by raising NO level and SOD activity,decreasing MDA level.

Study on Xuebijing ameliorating the immune paralysis of sepsis by modulating the expression of Fas and Bax in spleen

Abstract: Objective To observe the effect of Xuebijing on modulating the expression of pro-apoptosis associated proteins in spleen and the cellular immunity function of sepsis rats. Methods The sepsis models were produced by cecal ligation and puncture (CLP). 96 Wistar rats were randomly divided into four groups: control group (n=8), sham operation group (n=8), CLP group (n=40), and Xuebijing treatment group (n=40). The IL-2 and IL-10 in serum were detected by ELISA, the expression of Fas and Bax in spleen were detected by immunohistochemistry methods. Results The expression of Fas and Bax in spleen increased obviously in CLP group. Simultaneously the IL-2 in serum decreased at 36 , 48 h after the CLP operation and IL-10 in serum increased obviously. After the intervention of Xuebijing, the expression of Fas and Bax reduced, the IL-2 in serum enhanced and the IL-10 in serum lessened. The degree of injury of vital organs lightened. Conclusions The intervention of Xuebijing can ameliorate the immune paralysis of sepsis by depressing the expression of pro-apoptosis associated proteins.

Familial hereditary features in the patients with vasovagal syncope

Abstract: Objective To investigate familial hereditary features in the patients with vasovagal syncope(VVS). Methods Undergoing head-up tilt table test(HUTT),383 patients with unexplained syncope(UPS)were carefully inquired familial syncope history and filed. Results 36 of the 383 patients (9.4%) with UPS had familial syncope history, and 23 patients of them were positive in HUTT, and accounted for 12 % (23/191). Females were more than males in all patients with UPS. Males with syncope history significantly increased the risk of syncope by 18.6% in male-offspring of first-degree relatives. Females were more likely to faint than males, whose female-predecessors of first-degree relatives fainted. Inducement existed in 83 of the 383 UPS patients (21.7%) and 9 of the 23 positive patients (39.1%) with familial syncope history. Mixed response was relatively higher in positive patients who had familial syncope history than all positive patients, which was 34.8% and 27.7%, respectively. Positive patients with or without familial syncope history didn't show significant differences between males and females or between different age groups(18 years and ≥18 years)(P0.05). Conclusions There is a hereditary tendency for VVS, especially first-degree relatives have syncope history whose offsprings are more likely to faint . Environmental stimulus may accelerate the occurrence of syncope.

Effect of rhubard on heat shock protein 70 expression in rats with aute lung injury

Abstract: Objective To investigate the expression of HSP70 in acute lung injury induced by endotoxin lipopolysaccharide(LPS) and the protective mechanisms of rhubard against ALI.Methods LPS was injected into rats via the internal jugular vein to induce ALI and rhubard extract was given by intraperitoneal injection. The rats were randomly divided into four groups: saline control group, LPS-induced ALI group,ALI treated with prophylactic rhubard group, and ALI treated with therapeutic rhubard group.The rats were sacrificed 2 hours after injection of LPS or saline. Physiological and pathological examinations were conduced,including arterial gas analysis,lung coefficient,hematoxylin-eosin staining ,and HSP70 expression(immunohistochemistry and Western blotting). Results In the LPS-induced ALI group,interstitial edema,neutrophil infiltration,plasma exudation in alveoli, and damaged vascular endotheliun were observed.HSP70 levels were slightly increased in LPS-treated rats,while HSP70 expression was enhanced significantly and overall lung function was improved in rhubarb-treated groups compared to ALI model rats.Conclusions Our study confirme that rhubard protects rats from LPS-induced ALI and upergulates HSP70 expression.Thus,the protective effect of rhubard may be mediated by the HSP70 signaling pathway.

Application of sequential airway opening (laryngeal mask airway-tracheal intubation) during cardiopulmonary cerebral resuscitation

Abstract: Objective To use sequential airway opening laryngeal mask airway(LMA)-tracheal intubation in order to improve the successful rate of cardiopulmonary cerebral resuscitation(CPCR).Methods 108 patients with cardiopulmonary sudden were randomly divided into 2 groups:LMA group and normal group.The chronergy,closed cardiac massage-LMA interaction,successful rate of spontaneous circulation recovery and prognosis were compared in two groups.Results Compared with the normal group,the time of the airway opening was shorter,the cerebral ischemia was improved more rapidly without interference with the closed cardiac massage and successful rate of spontaneous circulation recovery was higher in the LMA group.The differences were significant.Conclusion Sequential airway opening can open the airway in time,effectively and reliably.It can harmonize with closed cardiac massage,increase the survival rate,and reduce the mortality.

Curative effect of Xuebijing in the acute renal failure

Abstract: Objective To observe the curative effect and mechanisms of Xuebijing in the acute renal failure(ARF). Methods 64 patients with ARF were randomly divided into two groups:Ⅰgroup,34 patients treated with routine treatment and intravenous drip of Xuebijing, andⅡ group, 30 patients treated with routine treatment. Results The total effective rate was 91.18% in I group and was 73.33% in Ⅱ group, the differences were significant between two groups (P0.05).There were significant differences in the recovery time of serum creatinine(Scr) and blood urine nitrogen(BUN) to normal level between the two groups(P0.01).There were also significant differences in the total time of oliguria, the duration of oliguria after treatment, the recovery time of the proteinuria to normal level and the average time of blood dialysis between two groups(P0.05).Conclusion The curative effect of Xuebijing is good for the acute renal failure patients.

Preliminary study of the procedures of emergency medical aid in the overseas earthquake disaster

Abstract: Objective To explore the procedures of the emergency medical aid in the five overseas earthquake disaster performed by Chinese International Search and Rescue Team(CISAR)in order to perfect the systems of medical aid and improve the level of medical aid.Method The essential data was based on the materials of the emergency medical aid actions in the five overseas earthquake disaster by CISAR including Algeria,Bam of Iran,Aceh of Indonesia,Pakistan and Yogyakarta of Indonesia.The projects of emergency medical aid actions would be analyzed and summarized.Results To summarize the characteristics and regulation of the emergency medical aid in the overseas earthquake disaster performed by CISAR,and to make a flow chart.Conclusion There are special procedures of the emergency medical aid in the overseas earthquake disaster performed by CISAR.

Effects of intensive insulin therapy at the early stage on IFN-γand IL-18 in serum for severe trauma patients

Abstract: Objective To explore the expression of interferon-γ(IFN-γ)and intedeukin-18 (IL-18)in serum and their effect on the prognosis after intensive insulin therapy in severe trauma pa- tients.Methods 40 severe trauma patients with stress hyperglycemia within 24 hours after trauma were randomly divided into intensive insulin therapy group and control group.Radioimmunoassay and ELISA methods were used to determine the IFN-γand IL-18 levels 12,24,48,72 h after the treatment.Re- sults Levels of IFN-γand IL-18 in severe trauma patients were significantly lower in intensive insulin therapy group than in control group.Conclusion Intensive insulin therapy after severe trauma can obvi- ously lower main inflammatory meditors IFN-γlevel,inhibit the SIRS and decrease the incidence of com- plications and mortality.

Dynamic changes of blood coagulation factors in rat model of alcoholic liver disease with Vibrio vulnificus sepsis

Abstract: Objective To investigate the dynamic changes of blood coagulation factors in rat medol of alcoholic liver disease with vibrio vulnificus sepsis and try to find out its significance.Methods Based on vibrio vulnificus sepsis model in SD rats with alcoholic liver desease,the signs of sepsis,the levels of blood coagulation factors(including FIG,AT:A,tPA,PAI-1)were tested at the different time of 2 h,6 h,12 h and 24 h after innoculation with vibrio vulnificus.Results The apparente toxemic symptoms of sepsis began 6 h after innoculation,then the symptoms aggravated gradually and get the top at 24 h.Compared with the control groups(N and A6),the levels of FIG increased markedly at 6 h(P0.01),and got the top at 12 h.However,it droped back slightly at 24 h(P0.05,compared with group 12 h).The levels of AT:A decreased gradually and significantly in groups of 6 h,12 h,24 h.tPA in- creased markedly(P0.05)in groups of 2 h and 24 h and PAI-1 increased markedly(P0.01)at 2 h,whereas the ratio(tPA/PAI-1)decreased significantly(P0.05)at 2 h,but increased markly(P0.05)at 24 h compared with control groups.Conclusion Coagulopathy appears in early stage of vibrio vulnificus sepsis in rat model of alcoholic liver disease and the levels of FIG,AT:A,tPA,PAI-1 can in- dicate the severity of disease.

Study on distribution and precise quantification of pleural effusion in mechanically ventilated patients

Abstract: Objective To explore the distribution characters of pleural effusion in mechanically ventilated patients and to find a new alternative to precisely quantify effusions by ultrasonography. Methods Thoracic spiral computer tomography were performed in 37 mechanically ventilated patients with pleural effusion. CT images were analyzed with special software to acquire total volume of effusion (V), height of effusion (H), thickness (T) and area (A) of effusion on the middle slice. Linear and multiple linear regression analysis between V and H, T, S were done. Different formulas were compared by their precision to estimate effusion volume. Results Distribution of effusion volume was approximately linear both in left and right thoraces of mechanically ventilated patients. The best formula to estimate effusion volume consisted of S and H, with the best correlation (r=0.958, P0.001) and precision [difference between estimated and actual volume had a 95% range of (-3±137) mL]. Conclusion Volume of pleural effusion can be well estimated by H and S in mechanically ventilated patients, and thus provide a new alternative to precisely quantify pleural effusion by ultrasonography.[

Protective effect of penehyclidine hydrochloride pretreatment on lipopolysaccharide-induced acute lung injury in rats

Abstract: Objective To explore the potential protective effect of PHC pretreatment on in vivo lipopolysaccharide-induced model of acute lung injury in rats. Methods Thirty healthy Wistar rats were randomly assigned into three groups:①control group: LPS was administered by caudal vein injection (LPS 5 mg/kg);② PHC group: LPS (5 mg/kg) plus PHC (0.02 mg/kg);③anisodamine group: LPS (5 mg/kg) plus anisodamine (2 mg/kg). Each group rats brochoalveolar lavage fluid (BALF) were collected and wet to dry weight ratio (W/D) were determined after the injections were performed 6 hours. The tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) and interleukin 1β (IL-1β) which contained in BALF supernatant were determined by ELISA method. Result The level of BALF supernatant cytokine content in PHC group were significantly lower than in anisodamine group(P0.05). Comparision of anisodamine group with PHC group that W/D ratio of PHC group significantly lower than anisodamine group (P0.05). Conclusion By blocking the excess release of cytokine and relieving the damage of PMVEC, PHC could exert more protective effect on ALI induced by LPS.

Effect of DAR therapy on endotoxin and activation of NF-κB in rat model of ANP

Abstract: Objective To study the mechanism of action of DAR therapy on acute necrotizing pancreatits(ANP).Methods 40 SD rats were randomly divided into DAR group and control group.Each group had 20 SD rats.5% taurocholate was employed to develop ANP model.In DAR group dexamethasone(0.2 mg/kg)and anisodamine(0.2 mg/kg)were injected into peritoneal cavity,rhubarb(200 mg/kg)were lavaged.In control group,equal amont of normal saline were used the same way as used in DAR group.In 6 hs the animals were sacrificed and we harvested pancreatic tissue from 20 SD rats to assay activation of nuclear factor kappa-B(NF-κB)in each group.Portal vein blood samples were randomly collected with pyrogen free tubes from 10 SD rats for endotoxin measurement in each group.Results The content of portalvein venous plasma endotoxin in DAR group was significantly lower than that in control group(P=0.027).Strong activation of NF-κB in pancreas tissue in DAR group was significantly lower than that in control group(P=0.045).While the positive cells of NF-κB in two groups did not show significant difference(P=0.862).Conclusion DAR therapy might via decrease portal blood endotoxin,might through inhibit the activation of NF-κB to inhibit cascade inflammation in ANP,but not overwhelm inflammatory response in ANP.Thus DAR therapy might protect ANP from multiple organ dysfunction syndrome,and then decrease the mortality.These might be part of the treatment mechanisms of DAR therapy on ANP.

Establish the three-dimensional finite element model of the human thorax and stress analysis

Abstract: Objective To establish a three-dimensional finite element computer model of the human thorax and simulate chest pressing ,in order to validate theavailability of the model, and provide biomechanics investigative new thinking for approach the mechanisms and clinic effect of CPR. Methods Taking the image datum from CT of one male corpse, to establish a integrity three-dimensional-finite element analysis model of the human thorax. The stresses of the model were analyzed during the perpendicularity loading. Result Establish the three-dimensional finite element model of the human thorax, it consisted of clavicle, Costa, Spine and so on. The mesh division and the elements of the model were 356 562 nodes and 215 808 elements, the model were discriminated into six kind of material. The effect of the perpendicularity loading indicated that the maximum downward displacement was breast bone, and the maximum force was on theposterior part of costa. Conclusions The finite element model constructed has the advantages of intact structure and precise elements which can provide the biomechanics basis for human chest pressing.

Clinical research on the treatment of acute trauma hemorrhage with quick-acting styptic powder

Abstract: Objective To observe clinical curative effect and safety of quick-acting styptic powder on the treatment of acute trauma hemorrhageMethods Quick-acting styptic powder was cast on the bleeding part of human bodyHemostasis effect,total time and the onset time were observedResults Quick-acting styptic powder was suited for various kinds of trauma hemorrhage,especially for middle and large artery hemorrhage,and promoted coagulationQuick-acting styptic powder was superior to the routine therapyConclusion Quick-acting styptic powder is a safe and effective drug for the treatment of all kinds of acute trauma hemorrhage

Relationship between hypocholesterolemia and the prognosis of severe multiple injury

Abstract: Objective To evaluate the relationship between the dynamic changes of serum total cholesterol and prognosis of the patients with severe multiple injuryMethods Our study comprised 89 patients with severe multiple injuries admitted to the traumatic ward and the traumatic intensive care unit(SICU),and serum total cholesterol concentration was measuredBlood samples were taken immediately on admission and on 2nd,3rd,4th,6th and 10th day after traumaAccording to the clinical outcome,the 89 patients were divided into survival group(61 cases)and death group(28 cases)Results In death group,a continuous decrease of cholesterol was noted,while survival group increased prior to discharge from hospital,there were statistical significance between the two groups(P005 or P001)Hypocholesterolemia was the independent risk factor of the death in patients with severe multiple injury according to Cox proportional hazards regression model(HR=2067,95%CI 1212~4759,P=0018)Conclusion The hypocholesterolemia in patients with severe multiple trauma correlated closely with high mortalityThe dynamic measurements of total cholesterol could provide useful information for the clinical treatment of patients with severe multiple injury

Neuroprotective effects of citicoline against oxygen-glucose deprivation and reperfusion injury in cultured hippocampal cells

Abstract: Objective To demonstrate the protective effects of citicoline against neuronal oxygen-glucose deprivation and reperfusion injury and to investigate the underlying mechanisms. Methods The rat neurons cultivated as the object of study and then build the model of oxygen-glucose deprivation and reperfusion. They were randomly divided into 3 groups: control group, oxygen-glucose deprivation group, citicoline treatment groups(1,10,100 μmol/L), Metabolic rate of MTT at reperfusion 24 h,the content of reduced glutathione and the active of glutathion peroxidase were measured by assay kits at reperfusion 6 h and 24 h. Cells were dyed Annexin V-PI and the rate of apoptosis was detected by flow cytometry. Results Compared with OGD/reperfusion group, citicoline treatment after OGD obviously increased GSH level and activity GPx at reperfusion 6 h (P0.05); citicoline increased cell survival rate, activity GPx and decreased cell apoptotic rate. Conclusion Citicoline has protective effect on hippocampal neurons against oxygen-glucose deprivation and reperfusion injury by increasing the metabolic rate of MTT, raising antioxidation, and decreasing apoptosis.