Showing papers in "Chinese Journal of Critical Care Medicine in 2008"

Effects of Xuebijing injection combined with hemoperfusion on the acute paraquat poisoning at the early stage

Abstract: Objective To evaluate the effects of Xuebijing injection combined with hemoperfusion on the treatment of acute paraquat poisoning.Methods 30 patients with acute paraquat poisoning,who were admitted to ICU of our hospital from January 2002 to January 2008 and were divided into treatment group and control group.Patients in control group were treated with routine therapy and hemoperfusion.Treatment group accepted Xuebijing injection on the basis of control group.Results Zymologic indexes and blood creatinine were decreased significantly after the treatment in two groups,and were significantly lower in treatment group than in control group.One week later,the oxygen pressure in treatment group was significantly higher than that in control group.Conclusion At the early stage,Xuebijing injection combined with hemoperfusion can protect major organs from paraquat jnjury,and reduce the mortality of paraquat poisoning.

Development of acute lung injury

Abstract: Acute lung injury and acute respiratory distress syndrome are severely acute respiratory diseases and are common in clinic,and their pathogenesis is complicated and the mortality is high.All kinds of direct or indirect factors can induce the release of inflammatory medium,which leads to excessive and uncontrolled inflammation.In this article,we will expatiate the scientific research of acute lung injury.

Effects of ulinastatin on inflammatory response and curative effect in severe sepsis patients

Abstract: Objective To study the effects of ulinastatin(UTI)on inflammatory response in the patients with severe sepsis and to evaluate the curative effect of UTI.Methods 63 patients of severe sepsis were randomly divided into three groups.Control group(groupⅠ,n=21),UTI 10 000 U·kg-1·d-1 group(groupⅡ,n=21),UTI 20 000U·kg-1·d-1 group(groupⅢ,n=21).Before treatment and on 120th hour after the treatment,blood samples were taken from peripheral veins for the determination of TNF-α,IL-1β,IL-10,MDA and SOD activities,simultaneously APACHEⅡ scores were recorded.Mortality rate was compared on 28th day.Results The indexes of three groups were similar before treatment.On 120th hour after the treatment,the venous blood levels of TNF-α,MDA and APACHEⅡ score,the 28-day mortality rate in groupⅡ and Ⅲ were significantly lower than those in groupⅠ(P〈0.05),the venous blood levels of IL-10,SOD in groupⅡ andⅢ were significantly higher than those in group I(P〈0.05),the venous blood levels of TNF-a,MDA in groupⅢ were significantly lower than those in groupⅡ(P〈0.05),the venous blood levels of IL-10 in groupⅢ were significantly higher than those in groupⅡ(P〈0.05).Conclusions UTI can inhibit inflammatory response in patients with severe sepsis and reduce 28-day mortality.UTI 20 000 U·kg-1·d-1 group is superior to UTI 10 000 U·kg-1·d-1 group in inhibiting inflammatory response.

Relationship between 469K/E polymorphism of the ICAM-1 gene and myocardial infarction (MI) in the patients with coronary heart disease

Abstract: Objective To investigate the relationship between 469K/E variant of intercellular adhesion molecule-1(ICAM-1) gene polymorphisms and myocardial infarction(MI) in the patients with coronary heart disease.Methods 231 patients with coronary heart disease,who were diagnosed by coronary angiography and were enrolled in this study.The genotypes of ICAM-1 were determined by polymerase chain reaction.The patients were divided into two groups according to the genotypes:KK+ KE genotype(n=86) and EE genotypes(n=145).The differences in the incidences of MI and risk factors of cardiovascular disease between the two groups were compared,and the risk factors of MI were assessed.Results The incidences of MI and diabetes mellitus was significantly higher in the KK+KE genotypes group than in the EE genotype group(P0.01),but other clinical data were similar between the two groups.After the adjustment for age,sex,smoking,family history of cardiovascular disease,total cholesterol and diabetes mellitus by using a multivariate Logistic regression,the odds ratio of the risk of MI between the KK+KE genotypes and the EE genotype was 3.42(P0.01).However,inclusion of hypertension as one of the independent variables downplayed the importance of the KK+KE genotype(OR=3.03,P=0.03),and inclusion of hypertension and HDL-cholesterol downplayed the importance of the ICAM-1 genotype further(P=0.23).Conclusion The KK+KE genotypes of the ICAM-1 gene could be an independent risk factor for MI,which have an effect on MI by changing blood pressure and HDL-cholesterol.

Bone marrow mesenchymal stem cells and cardiovascular diseases

Abstract: Bone marrow mesenchymal stem cells(MSCs) have the capability of replacing dead cardiomyocytes,inducing revascularization of the injured region,repairing the extracellular matrix,releasing soluble factors and therefore preventing deleterious pathological remodeling in cardiovascular diseases.MSCs will become the most promising "seed" stem cells in treating cardiovascular diseases.

Study on curative effect and mechanism of Xuebijing combined with ulinastatin in severe sepsis patients

Abstract: Objective To evaluate the curative effect and safety of Xuebijing combined with ulinastatin in the patients with severe sepsis and to investigate it's mechanisms. Methods 228 severe sepsis patients were randomly divided into ulinastatin treatment group(group A),Xuebijing treatment group(group B),Xuebijing combined with ulinastatin treatment group(group C) and control group(group D). The patients in the control group were treated according to the therapy guideline of severe sepsis. Besides the treatment in the control group,patients in group A received ulinastatin 200 000 Units intravenously twice a day for 7 days; the patients in group B received Xuebijing injection 100 mL intravenous drip twice a day for 7 days; the patients in group C received both Xuebijing injection and ulinastatin used in group B and group A. Before the treatment and on 4 th,8 th day after the treatment,blood concentrations of LPS,TNF-α,IL-6,PCT were determined,and the time of mechanical ventilation,the days in ICU,the 28-day survival rate were compared among the four groups. Results LPS,IL-6,TNF-α,PCT in all the groups decreased after the treatment,and the descending degree in group C on 4th and 8th day was more obvious than that in group A,group B and group D. There were significant differences among the four groups(all P0.01).The time of mechanical ventilation and the days in ICU were shorter in group C than those in group A,group B and group D,but the 28-day survival rate showed opposite tendency. There were significant differences among the four groups (all P0.05). Conclusions The treatment of Xuebijing combined with ulinastatin significantly improves patient's condition,reduces the time of mechanical ventilation,the days in ICU,and improves survival rate. The mechanisms are antagonizing endotoxin,intercepting Toll-like receptors,inhibiting proinflammatory cytokines and lowering the level of serum PCT.

Correlation between the expression of endothelial lipase in CECs and the improved jeopardy score in CAD patients

Abstract: Objective To detect the expression of endothelial lipase in the endothelial cells and its correlations with the patients of stable angina pectoris(SAP)or acute coronary system(ACS).Methods The 107 patients with ACS,69 patients with SAP and 82 patients without coronary artery disease(control)were studied.Blood samples were collected from ulnar wein and circulating endothelial cells(CECs)were separated,the number of CEC was calculated and the expression of endothelial lipase(EL)in CECs were detected by immmunohistochemistry and Western blot,the percentage of positive endothelial lipase/CECs(EL+/CECs)were calculated.The improved jeopardy score for coronary artery lesion was evaluated according to the method introduced by Califf.Results In coronary artery diseases patients,especially in ACS patients,the EL+/CECs,improved jeopardy score,hsCRP and the number of CECs were higher than those in control group(P0.05).There was significant difference in EL+/CECs,hsCRP and CEC count between SAP and ACS groups(P0.05).The EL+/CECs,hsCRP and the CEC count were positively correlated with the improved jeopardy scores(P0.001).Conclusion The expression of EL in endothelial cell may play a key role in the progression of coronary artery disease,high EL+/CECs show that there is lesion in the coronary artery.

Clinical trial of Xuebijing's kidney protection effect for severe sepsis by improving the coagulation function

Abstract: Objective To observe the kidney protection effect of Xuebijing injection by improving the coagulation function and 28-day survival rate in severe sepsis patients.Methods Randomized,blind and controlled trial was applied.128 severe sepsis patients were assigned randomly to the Xuebijing group or control group.28-day survival rate was observed and blood Cr,BUN,PLT,APTT,PT and Fib before and after the test were detected.Results According to coagulation function,the patients were divided into normal coagulation subgroup and abnormal coagulation subgroup.Kidney protection was improved significantly in treatment group compared with control group and in abnormal coagulation treatment subgroup compared with normal coagulation treatment subgroup.28-day survival rate was improved significantly in treatment group compared with control group.There was no significant difference in 28-day survival rate between abnormal coagulation treatment subgroup and normal coagulation treatment subgroup.Conclusions Xuebijing injection can protect renal function by improving coagulation function and increase 28-day survival rate in severe sepsis patients.

Retrospective analysis of clinical characteristics of septic cases in general intensive care unit

Abstract: Objective To study the clinical characteristics of septic patients in general intensive care unit. Methods To retrospectively analyze clinical data of 912 cases with sepsis admitted to the ICU of our hospital during 2005-2006, and to compare clinical characteristics of patients with severe sepsis, septic shock and non-sepsis. In addition, the site of primary infections in the patients with sepsis were investigated. Results There were significant differences in average age, the length in ICU, APACHEⅡ scores, the usage frequency of ventilator and mortality between patients with severe sepsis or septic shock and non-sepsis (P0.01); There was positive correlation between age, APACHEⅡ score and mortality in the patients with severe sepsis; Compared with other causes, the mortality of sepsis as a result of infection from respiratory system showed a significant difference (P0.01). Conclusions Sepsis occurs generally in the ICU, especially clinical characteristics such as old age, severity of illness and higher mortality in patients with severe sepsis is evident; The proportion is high for patients with sepsis as a result of infection from respiratory system,which affects the prognosis of patients.

Comparison of three different administration methods of pralidoxime chloride in the treatment of acute organophosphorus pesticide poisoning

Abstract: Objective To compare different administration methods of pralidoxime chloride in the treatment of severely acute organophosphorus pesticide poisoning(AOPP) and to observe the curative effect.Methods The patients with severely AOPP were randomly divided into continuous intravenous infusion of pralidoxime chloride group(group A),repeated injection of pralidoxime chloride group(group B),the infusion of pralidoxime chloride 2~3 times /day group(group C).To compare atropine and pralidoxime chloride dosage in the different groups,adverse reactions and complications,CHE recovery time,the average length of stay in hospital etc.Results Compared with group C,the total volume of pralidoxime chloride was more(P0.01),but atropine dosage was less,incidence of intermediate syndrome,mortality,and the average time in hospital was lower in group A and B(P0.01).The differences of CHE were not significant in A,B,and C groups after 12-hour treatment(P0.05).At 24,48,72 h,CHE was better in group A and group B than in group C,the difference was significant(P0.05).In group A and group B,the above indicators were compared,the difference was not significant(P0.05).Drugs and other adverse reactions were significantly less in group A than in group B and group C,the difference was significant(P0.01).Conclusions Continuous intravenous injection and repeated injection of pralidoxime chloride in the treatment of AOPP is superior to fractional infusion of pralidoxime chloride,and the first two methods were not significantly different.

Observation of hypocaloric and low nitrogen parenteral nutrition support in severe abdominal trauma

Abstract: Objective To observe the role of hypocaloric and low nitrogen parenteral nutrition support in early severe abdominal trauma.Methods Eighty cases with severe abdominal trauma were randomly divided into control group(n=40)and study group(n=40).Control group was treated with traditional parenteral nutrition and study group with hypocaloric and low nitrogen parenteral nutrition.The blood glucose level,nitrogen balance,serum albumin,immunity indexes and complications were analyzed.Results The blood glucose level and occurrence of postoperative complications were significantly lower in study group than in control group(P0.05),but there was no significant difference in serum albumin and immunity indexes between the two groups(P0.05).Conclusions The hypocaloric and low nitrogen parenteral nutrition support is safe and useful in severe abdominal trauma.

Study on the changes of inflammatory factors in acute organophosphorus pesticide poisoning patients with intermediate syndrome

Abstract: Objective To observe the changes of inflammatory factors in acute organophosphorus pesticide poisoning(AOPP)patients with intermediate syndrome(IMS).Methods We detected serum tumor necrosis factor-α(TNF-α),soluble vascular cell adhesion molecule-1(sVCAM-1)and interleukin-1β(IL-1β)in 30 AOPP patients with IMS,and compared them with thirty healthy cases and 51 AOPP patients without complications.Results The serum levels of IL-1β,TNF-αand sVCAM-1in patients with IMS were higher than those in control group and AOPP group(P0.01 or P0.05).Conclusions The endothelial function damage in patients with IMS can activate macrophage,which cause the release of various cytokines.

Effect of anticoagulation and thrombolysis on hemodynamics during cardiopulmonary resuscitation in rabbits

Abstract: Objective To observe the dynamic changing of hemodynamics during basic life support(BLS)of cardiopulmonary resuscitation(CPR)by establishing the rabbit model of ventricular fibrillation,then research the influence of anticoagulation and thrombolysis to above targets by comparisons.Methods Twenty-four healthy rabbits were divided into control or experiment group randomly.After cardiac arrest(CA),both groups were given BLS,but the experiment group was given heparin and urokinase by intravenous injection also.The dynamic changing of blood pressure and flow rate of internal carotid artery were recorded per 5 minutes,and microcirculatory blood flow of ear per 3 minutes before and after CA respectively.Results Systolic pressure(SP),diastolic pressure(DP),blood flow of internal carotid artery and microcirculation decreased sharply after CA(P0.05),then fell gradually in BLS phase along the extending of time(P0.05).The dynamic changes of SP,DP and blood flow of internal carotid artery had no statistic deference between the two groups(P=0.779,0.297 and 0.244),and their changing curves were similar.Difference between microcirculatory blood flows changing of the two groups had statistic significance(P0.001).The two curves dropped sharply after CA,then stepped down,and intersected at about the 9th minute,whereafter the curve of experiment group tended to smoothness while the curve of the control still falling.Conclusions With regard to aortic blood pressure and flow rate,anticoagulation and thrombolysis were neutral,but can postpone deteriorating of microcirculatory perfusion during BLS in the rabbit's CA model.

Prevention and curative effects of Xuebijing injection in the acute pancreatitis-associated kidney injury

Abstract: Objective To study the prevention and curative effects of Xuebijing in acute pancreatitis-associated kidney injury(APAKI)Methods 120 patients with severe acute pancreatitis were divided into two groups:control group and therapeutic group56 patients in control group were treated with the conventional treatment,while 64 patients in therapeutic group were treated with the conventional treatment and Xuebijing injection,100mL q8h,intravenous dripThe patients' clinical symptoms,signs and the levels of serum creatinine(Cr),blood urea nitrogen(BUN),interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α)in serum were analyzed to compare the differences in the incidence of injury and curative effect of kidney injury between both groupsResults The incidences of APAKI within 24 hours and 24~72 hours after the onset of severe acute pancreatitis were 22% and 33% in therapeutic group,but those in control group were 44% and 50%There was significant difference between both groups(P005)Compared with control group,the degree of kidney injury lessened significantly in therapeutic group(P005)Conclusion Xuebijing can reduce the occurrence of APAKI and accelerate the recovery of APAKI

Application of three fluid resuscitation methods to the treatment of hemorrhagic traumatic shock patients

Abstract: Objective To discuss the different methods of fluid resuscitation for the treatment of hemorrhagic traumatic shock (HTS). Methods 73 clinical records of hemorrhagic traumatic shock using different methods of fluid resuscitation in the emergency department of Tongren hospital from 2005-07 to 2007-11 were reviewed. These cases were randomly divided into three groups according to the methods of the resuscitation, which were the conventional resuscitation group (conventional group, 27cases), the limited fluid resuscitation group (limited group, 25cases) and the hypertonic saline solution resuscitation group(hypertonic saline group, 21 cases). The hemodynamic index, the input, the level of lactic acid and base excess before and after the resuscitation were analysed. Results The input in the conventional group was (3012±497)mL, and the limited group was (2156±541)mL. The difference of the input between two groups was significant (P0.05). The input of the hypertonic saline group was (2235±503)mL. The difference of the input between the conventional group and the hypertonic saline group was significant (P0.05), but there was no significant difference between the limited group and the hypertonic group (P0.05). There were no significant differences in the lactic acid and the base excess between the limited fluid resuscitation group, the hypertonic saline group and the conventional resuscitation group (P0.05). The value of lactic acid in 12 hrs' resuscitation and 24 hrs' resuscitation were significant, as well as the base excess. In this investigation, 61 patients (83.6%) were cured, and 12 patients (16.4%) died. 11 patients were ARDS. 15 patients were MODS. The differences of the cure rate, mortality, ARDS incidence and MODS incidence among these three groups were significant (P0.05). Conclusions Limited fluid resuscitation and the hypertonic saline solution resuscitation for the treatment of hemorrhagic traumatic shock can increase the effective circulating blood volume and improve the perfusion of tissue and organ, which not only raise the cure rate, but also decrease the mortality. The curative effect of two methods is better than the method of the conventional resuscitation.

Analysis of diseases spectrum of patients after Wenchuan earthquake

Abstract: Objective To investigate the data of the patients admitted to field hospital one week after the earthquake,and to analyze the regularity of diseases spectrum in Wenchuan earthquake Methods Sex, age and diagnosis result of the patients were collected and the percentage of diseases was respectively calculated The tendencies of time distribution of patients were also analyzed Results Sex differences of patients were not obvious in a total of 2331 cases 1535(659%)cases was 15~60 years old,which were significantly higher than other groups, 382 (164%) cases was 0~14 years old, 414(177%) cases was over 60 years old The top 4 diseases consisted of respiratory system 601 (258%), trauma ( fracture, wound or injury) 586 (249%), dermatology system 295 (127%) and others 243(104%) The amount of internal medicine patients exceeded that of surgery Conclusions The reasonable allocations of medical personnel and drugs after earthquake may improve the remedy results and to prevent the waste of medical resource during future disasters

A study of of acute lung injury in different time phases after injection of flagellin via vena caudalis

Abstract: Objective To investigate the development of acute pneumochysis and lung inflammation of rats in different time phases after injection of flagellin via vena caudalis.Methods 210 sanitary rats were divided into 3 batches,every batch were randomized into 7 groups: control group and other 6 experimental groups,in order to perform detection in 6 different time phases after intravenous injection.Flagellin was injected intravenously to the experimental rats,by a dose of 50 μg/kg,same dose of physiological saline was given to the normal control group accordingly.Arterial partial pressure of oxygen(PaO2),pulmo-capillary permeability(Evans blue content),ratio of wet and dry lung tissue(W/D),cell counting in alveolar washing solution were determined at 2,4,6,12,24,48 h after injection.Tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-10(IL-10) in peripheral blood,lung tissue and alveolar washing solution were also determined at the same time by a ELISA method.Results After injection of flagellin,as time increases,PaO2 decreased,pulmo-capillary permeability increased,W/D of lung tissue increased,cell counting in alveolar washing solution increased.Further more,contents of TNF-α,IL-1β in peripheral blood,lung tissue and alveolar washing solution all increased,and amount of IL-10 decreased.There were significant differences between each experimental group and control group of all indexes above(P0.05).Conclusion Intravenous injection of flagellin may lead to acute lung injury in rats with a time variability.

Effect of Ulinastatin on expression of nuclear factor kappa B in the rabbits model of hemorrhagic shock with endotoxin

Abstract: Objectives To investigate the activation of nuclear factor kappa B (NF-κB) and release of tumor necrosis factor(TNF)-a in rabbits with acute lung injury(ALI)induced by hemorrhagic shock and endotoxin and the effect of ulinastatin Methods ALI rabbit model of hemorrhagic shock and endotoxin was used in this study:a total of 90 rabbits were randomly divided into three groups and each group has 30 rabbits which were sacrificed at 1,4,8,24 h and 48 h after hemorrhagic shock and LPS exposureArterial PaO2,lung dry/wet weight ratios(D/W)were recorded to assess lung injuryThe expression of NF-κB in the lung tissues and the concentration of tumor necrosis factor(TNF)-α were detectedAnd the pathological changes were examined with light microscope in lung tissuesResults Compared with group A,after hemorrhagic shock and LPS exposure,PaO2 decreased gradually in group B while the level of PaO2 in Group C was lowest at 4 h and went up graduallyThe level of TNF-a in serum and NF-κB expression in the lung tissues were increased at 1 h and peaked at 4 h(P001)in group B and while at 24 and 48 hours they were lowerer in group C (P005) The histological changes of lung injury in group C improved significantly compared with group B Conclusions Ulinastatin can attenuate lung injury through inhibiting the activation of NF-κB and release of TNF-α

Epidemiological study of 4349 emergency patients

Abstract: Objective To study the characteristics of epidemiology among the emergency patients in different age groups.Methods The data of 4349 patients treated in emergency room from Jan 1,2005 to Dec 31,2007,the diagnosis and mortality were analyzed retrospectively.Results ① 30.3% of all the patients was 70～79 years old,and 62% of the patients were over 60.② Ten emergency diseases in front were circulation system disease,nervous system disease,respiratory system disease,digestive system disease,trauma,cancer,intoxication,sudden death,shock,kidney disease.③ In all the stroke patients,the incidence of ischemia stroke was higher than hemorrhagic stroke(1.2:1),male patients were more than female patients(1.63:1).In the patients below 60 years old,the incidence of hemorrhagic stroke was higher than ischemia stroke;④ The main diseases of dead patients in order were nervous system disease(40.5%),sudden death(12.9%),respiratory system disease(12.2%),circulation system disease(11.6%),cancer(6.9%),shock(3.8%),trauma(2.5%).The rate of the dead patients below 40 years old accounted for 26.2% in nervous system,23.8% in trauma,14.3% in sudden death,11.9% in intoxication.About 80% of the dead patients in 40～59 years old group had circulation system disease and cerebrovascular disease.The incidence of circulation system disease and respiratory disease rose with the increase of age.In 80 years old group,more than 60% patients were circulation system disease or respiratory system disease.Conclusion The emergency critical illness are mainly cardiac or cerebrovascular disease as well as respiratory disease in the elderly,it is impotant pay attention to chronic diseases in the elderly and to establish "green-passage",which not only shorten the time of treatment,but also improve the survival rate.There is a tendency that cardiac or cerebrovascular disease events are more happened to young people,preventive education should start with young people.The society should be concerned about the physical and mental health of young people in order to reduce death and mutilation caused by spontaneous behavior.

Research on Glucocorticoids in the treatment of acute lung injury induced by paraquat

Abstract: Paraquat poisoning can cause the injury of many organs.The lung is one of the primary target organs of paraquat.Adrenocortical hormones has antiinflammatory and antifibrotic actions and can also attenuate the injury of oxygen free radicals.Its use in the treatment of paraquat-induced acute lung injury are recommended and most important therapy.However,the most appropriate regimen such as dosage,how long and treatment course remains controversial.Recent studies on the pathogenesis of paraquat-induced acute lung injury are reviewed in this paper.

Difference of CRP and ICAM-1 before and after the treatment in the patients with severe acute pancreatitis

Abstract: Objective To investigate the effect of Ulinastatin (UTI) on the treatment of severe acute pancreatitis (SAP) and the difference of C-reactive protein (CRP) and intercellular adhesion molecule-1 (ICAM-1) before and after the treatment. Methods 41 cases of SAP were divided into two groups: the trial group (n=21) with UTI (1,200,000 U/d×10 d) and Octreotide (0.6 mg/d×10 d), the control group(n=20)with Octreotide (0.6 mg/d×10 d). The symptom, sign and laboratory examination were detected on 5th and 10th day before and after the treatment. Results Compared with the control group, the cure rate and the total effective rat in trial group were significantly improved, CRP and ICAM-1 were remarkably improved on 5th and 10th day after the treatment, and there was statistical significance(P0.05). Conclusion UTI and Octreotide can significantly improve curative effect of SAP, which may be associated with the downregulation of ICAM-1 expression.

Rescue characteristics of medical transportation over ten thousand wounded cases of the disaster areas "into and out of Chengdu" during Wenchuan earthquake

Abstract: Objective To sum up the professional characteristics of medical transportation of the wounded in the disaster areas after Wenchuan earthquake. Method To consult on-duty statistics including the transportation of the wounded and the records of the vehicle in 120 center. To collect and analyze the official information of the rescue of earthquake disaster in the city's network of 120 hospitals, and combined with the specific actions of 120 center emergency reaction. Result By 120 center centralized dispatch and direction, within 4 weeks after the earthquake, 8264 wounded people of the disaster areas were transported into Chengdu, 2431 people were transported to other provinces for the further treatment. The first 3 days post-earthquake was the peak of rescue, the wounded accounted for 86.30% (7132/8264); severely injured cases was about 13% of the total; 90.54% (134/148) of the wounded died in hospital occurred at the first stage after the earthquake; the mortality of various stages in hospital showed a downwards with the rescue process(2.07%~0.77%). The quantity of the wounded around Chengdu area transported by land route was the biggest (81.53%, 6738/8264), the days of transportation were 13 days. The quantity of the wounded in the out-of-the-way mountainous area were transported by the air road accounted for 16.50% (1363/8264), but time-consuming was the longest about 24 days. The water-way was the shortest transit cycle (4 days).In the wounded going out of the town, the peak of transportation (53.56%) was at the third stage. The quantity of largest single-day wounded cases going out of town by train was bigger than those by the charter airplane. Conclusion The characteristics of medical transportation of the wounded in Wenchuan earthquake was long transit cycle, short transit peak, more severely injured cases, the centralized death time section, and so on, will have the enlightenment for the rescue of future earthquake disaster.

Epidemiological analysis of 2658 intoxicated patients

Abstract: Objective To master the acute intoxicated patients' clinical features and the rule of morbidity in order to improve effectively the success rate of rescue and to propagate the prevention knowledge of poisoning. Methods 2658 intoxicated patients were collected from the 2nd Affiliated Hospital of Kunming Medical College from Jan. 2005 to Dec. 2006. All the patients were statistically analyzed according to different factors such as sex, age, occupation, cause and pathway of intoxication, intoxicant and so on. Result The common intoxicants were alcohol, hypnagogue, antipyretic analgesic, beans, wild mushroom, pesticide, carbon monoxide, aconitine, multi-drugs, raticide and antipsychotic respectively. Patients aged 18~40 years old were the most (84.39%) and in all intoxicated causes, alcohol was the most common in the male but suicide was the most common in the female. The intoxication from alimentary tract was the most common (96.7%) in all intoxicated pathway. The distribution of occupation from high to low were worker, official, student, farmer and the unemployed respectively. The first cause of intoxication was eating by mistake(76.4%) and the second was suicide. The most visit time was from 18:00 to 4:00 of next day(79.5%). The mortality was 0.26%(7/2658). Conclusion The key to improve the curative effect of emergency treatment is adequate first aid items, staff and highly diathesis of medical staff. To propagate the prevention knowledge of poisoning will improve public diathesis and maximally decrease the happening of intoxication.

Analysis of drug application in Wenchuan earthquake and its significance

Abstract: Objective To investigate the drug demand by analyzing drug application in Wenchuan earthquake.Methods The category and total quantity of drugs in our hospital within one week after earthquake were collected and sorted.Results The foremost 30 agents consisted of analgesics,Phenobarbital,antibacterials,antishock agent,stancher and the agents regulating water-electrolyte and the acid-base balances.Quinolones were the most frequently used in the category of antibacterials,followed by cephalosporins,metronidazole and Penicillins.Conclusion The emergency rescue of injuries/wound is the characteristic of the drug application within one week after earthquake.The analysis of drug application in earthquake may help to predict the needs of patients in disasters and prevent the waste of medical resources.

Significance of the distribution of disease in medical aids after the earthquake disaster

Abstract: Objective To investigate the significance of the distribution of diseases after earthquake disaster.Method According to the classification of diseases set by World Health Organization,there were five diseases including injuries/wounds,acute upper respiratory tract infection,acute hemorrhagic enteritis,acute enteritis and other diseases of internal medicine.We analyzed the distribution of disease and its regularity by the data in the hospital 1～14 days after the earthquake.Results Injuries/wounds mainly occurred within 7 days after earthquake.The incidences were 74.1% to 98.6%.Other diseases usually appeared one week later with the incidence of 44.3% to 75%.The incidence of acute upper respiratory tract infection reached considerably high rate one week after disaster.Whereas 13 patients with acute enteritis was found,the rate of acute hemorrhagic enteritis was 0.The rate of the fracture of lower extremity was highest in all fractures with the incidence of 31.1%.29 patients were diagnosed as simple and compound skull fracture in 38 died patients.Conclusion ① Injuries/wound are the main disease and major lethal factor on 7th day after disaster,so it is the most important to save lives.② The incidences of various kinds of diseases increase and more medical aids are needed in order to treat the upper respiratory tract infection and to lower the disable rate,and to prevent the prevalence of epidemic diseases during 7～14 days.③In view of high mortality of skull fracture,early selection and more intensive care treatment are important.

Apoptosis and related gene expression of Caspase-3,Cleaved caspase-3 protein in rat With experimental myocardial ischemia/reperfusion injury

Abstract: Objective To study effect of growth hormone on myocardial apoptosis and related gene expression of Caspase-3,Cleaved caspase-3 protein in rat with experimental myocardial ischemia/reperfusion injury.Methods Twenty-four rats were divided randomly into three groups,sham operated group(n=8,only operated for 24 h),I/R group(n=8)and GH group(n=8),30 min ischemia and followed by 24 h of reperfusion were performed in I/R group and GH group.The rats in GH group were treated with subcutaneous injection of rhGH 0.1 U/kg body weight per day for 7 d before models were performed,and the rats in other two groups were treated with normal saline correspondingly volume,Terminal deoxynucleotidyl transferase mediated dUTP fluoreseein nick and tabeling(TUNEL)and DAB immunohistochemical staining were used to detect the changes of apoptosis and protein expression of Caspase-3 and Cleaved caspase-3 individully,Histopathological changes in myocardium was observe by HE dyed.Results Apoptotis index(AI)and protein expression index(PEI,%)of Caspase-3 and Cleaved caspase-3 protein increased obviously in I/R group than that of sham operated group(P0.05).Local myocyte necrosis and inflammatory cell infiltration in I/R group were also observed.On the contray,AI and PEI of Caspase-3 and Cleaved caspase-3 protein in GH group were batter than that of I/R group(P0.05),Local myocyte necrosis and inflammatory cell infiltration diminished in the GH group than that of I/R group.Conclusion The AI and PEI of Caspase-3 and Cleaved caspase-3 protein in myocardial cell nuclear lessened obviously due to usage of GH and indicated GH can protect myocardial after I/R.

Relationship of vasovagal syncope with height,weight and body mass index

Abstract: Objective To explore the relationship of the height,weight and body mass index(BMI) with vasovagal syncope(VVS).Methods 418 out-patient and in-patient cases in the Second Xiangya Hospital,Central South University from January 2001 to August 2007 with unexplained syncope or prodromata 223 children,4～17 years old,mean(11.37±2.99)years old195 adults,18～70 years old,mean(36.82±13.64)years old were enrolled in this study.Head-up tilt table test(HUTT) was performed in all the subjects,if the result was positive,the patient was diagnosed as vasovagal syncope.To measure their height and weight and to calculate the body mass index.Results ①In HUTT positive or negative adults patients,BMI was higher in the patients with dizziness symptom than in those with syncope symptom(P0.05).The HUTT negative group of adults subjects got a higher BMI and weight than HUTT positive group(P0.01),but there were no significant differences in height(P0.05).②In children group,BMI at every age stage had no differences between the HUTT negative group and the HUTT positive group(P0.05).There was a marked linear correlation between BMI and age in both the HUTT negative and positive groups,the two groups linear regression showed that HUTT negative group got a higher BMI than the positive group when the age of the subjects were under 16 years old,but lower when the age above 16years old.Conclusions Adults who have lower body weight and lower BMI level get a higher susceptibility to syncope,and the BMI level of children may have some effect on syncope.

Protective effect of Xuebijing injection on paraquat-induced injury in rat pulmonary microvascular endothelial cells

Abstract: Objective To investigate the protective effect of Xuebijing injection on paraquat-induced injury in rat pulmonary microvascular endothelial cells(rPMVECs). Methods The primary passage cells of rPMVECs cultured were divided into three groups: blank control group, Paraquat (PQ) group(only treated with Paraquat) and low, middle, high concentrations Xuebijing groups(pretreated with PQ for 30 minutes, and then Xuebijing whose concentrations in culture-medium were 10,20,50 mg/mL respectively were added). The total activity of Superoxide dismutase (SOD), the content of Malondialdehyde (MDA) in supernatant were measured by spectrophotometry at an interval of 3, 12, 24, 48 hours, and Von willebrand factor (vWF), Endothelin (ET) by ELISA. Results There were significant difference in the total activity of SOD and the contents of MDA, vWF and ET in PQ group compared with blank control group(P0.01). Xuebijing could concentration-dependently inhibit decreasing of the total activity of SOD, increasing of the contents of MDA, vWF and ET accordingly. And high concentrations were most significant(P0.01 or 0.05). Meanwhile, the total activity of SOD time-dependently presented reduction to a certain extented in Xuebijing of different concentrations, while the contents of MDA, vWF and ET present increasing trend. But the speeds of their changes were relatively slow compared with PQ group. Conclusion Xuebijing injection can protect rPMVECs from PQ-induced injury by raising the total activity of SOD and reducing the contents of MDA, vWF and ET.

Analysis of the fever of unknown origin in 126 patients

Abstract: Objective To analyse the characteristics and diagnostic method in the patients with fever of unknown origin(FUO).Methods The clinical data of 126 cases of FUO admitted to the Xinqiao Hospital from February 2000 to October 2007 were analyzed.Results The classic FUO induced by mainly the infective diseases(50.79%,64/126) including tuberculosis infection(31.25%,20/64) in it;malignant tumor(24.6%,31/126);connective tissue diseases(15.87%,20/126),the other diseases(3.17%,4/126) and unknown diseases(5.56%,7/126).Conclusion The main diseases in the infective,connective tissue and malignant tumor diseases were tuberculosis infection,adult Still's disease and lymphoma,respectively.The diagnostic method of FUO should be systemic and sequential and the bacterial culture,ultrasound and CT examination were done in time.The repeated puncture,biopsy and traumatic examination are helpful to clinical diagnosis.

Risk factor in the patients with intermediate syndrome after acute organophosphorous pesticides poisoning

Abstract: Objective To analyze risk factor in the patients with intermediate syndrome(IMS)after acute organophosphorous pesticides poisoning(AOPP)Methods The general condition,time of gastric lavage,tracheotomy or tracheal cannula,hemoperfusion,the time of mechanical ventilation,in ICU or not,the time of IMS accident happened,heart rates,acetylcholinesterase(AchE),WBC count,platelet count were collected in 48 patients with IMS after AOPPThe patients were divided into two groups:death group(19cases)and survival group(29cases)Result There were no statistical differences in heart rates,AchE,WBC count,platelet count,in ICU or not,the time of IMS incident happened between two groupsTime of gastric lavage,tracheotomy,hemoperfusion and the time of mechanical ventilation were different between two groups,there were statistical significanceConclusion Time of gastric lavage,tracheotomy,hemoperfusion,the time of mechanical ventilation were key factors to improve the survival rate of patients with IMS