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编号:10416469
Chin Crit Care Med,February 2004,Vol.16,No.2
http://www.100md.com 2004年2月19日 急救快车
     65-66

    Neural factors and their effects on wound healing

    Fu Xiao-bing

    304th Hospital of PLA, Beijing 100037, China

    67-69

    A novel strategy of immno-modulation in sepsis

    Lin Hong-yuan, Sheng Zhi-rong

    304th Hospital of PLA, Beijing 100037, China
, 百拇医药
    70-72

    Dynamic change in interleukin-18 and its relationships with multiple organ dysfunction syndrome

    Liu Jing-qu, He Zhong-jie, Lin Hong-yuan, Yao Yong-ming, Sheng Zhi-yong

    Trauma Center, 304th Hospital of PLA, Beijing 100037, China

    OBJECTIVE: To determine interleukin-18 (IL-18) in plasma after trauma, and evaluate its relationship with multiple organ dysfunction syndromes. METHODS:A total of 54 patients were enrolled and divided into low injury seriousness score (L-ISS) and high injury seriousness score (H-ISS) groups. Blood IL-18 levels were determined on admission, day 4, day 7 and day 14 after trauma using enzyme-linked immunoadsorbent assay (ELISA), and the relationship between its level and organ dysfunction was analyzed. RESULTS: Plasma IL-18 concentration was significantly increased on posttrauma day 4 and day 7. Also, plasma IL-18 concentration was significantly higher in patients with organ dysfunction. CONCLUSION:This study suggests that major trauma can lead to a marked elevation of IL-18, which might be associated with organ dysfunction.
, 百拇医药
    73-76

    Gene expression of Toll-like receptors in the liver, lungs and spleen in mice after endotoxin challenge

    Wan Xing, Wang Pei-xun, Zhou Lian, Xiang Qun

    Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China

    OBJECTIVE: To investigate the gene expression of some lipopolysaccharide (LPS) receptors after LPS stimulation. METHODS:The total RNA from normal and LPS-challenged mice was extracted by Trizol reagent and the gene expression of Toll-like receptor 2 (TLR2), TLR4, CD14, LPS-binding protein (LBP) and tumor necrosis factor-α(TNF-α) were measured by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR).RESULTS:The gene of TLR2 was expressed in normal lungs and spleen tissues, and TLR2, CD14, LBP in liver. After challenged by LPS, the expressions of TLR2, TLR4, and TNF-α in lungs, TLR2, CD14, LBP and TNF-α in liver, TLR2, TLR4, CD14, and TNF-α in spleen were increased at 1, 3, and 5 hours. CONCLUSION: LPS might alert the ability against pathogen-associated molecules by inducing or enhancing the expression of genes that involved in the LPS signal transduction.
, 百拇医药
    77-80

    Experimental study on composite transplantation of acellular porcine dermal matrix and micro-autograft to repair deep burn wound

    Liu Qiang, Chai Jia-ke, Yang Hong-ming, Yin Hui-nan

    Institute of Burns, 304 th Hospital of PLA, Beijing 100037, China

    OBJECTIVE: To observe the effect of composite skin graft consisting of heterogeneous (swine) acellular dermal matrix and combined micro-autograft and allograft with the aim at overcoming shortcomings of repairing materials for burn wound. METHODS:Forty-eight Sprague-Dawley rats with full-thickness skin defect on the back were grafted with the composite skin (compound skin grafting group, G) and autologous particulate skin (control group, C), respectively. The area of wound healing and the rates of wound contraction were measured. Tissue specimens were harvested for histological examination. RESULTS:The composite skin graft resulted in less contracture and better elasticity. Compared with group C, the wound contraction rate was lower significantly. Histological examination revealed that there was full differentiation of epithelium, orderly collagen arrangement and intact basement membrane. CONCLUSION: Coverage of wound with composite skin composing heterogeneous (swine) acellular dermal matrix and autologous particulate skin could promote wound healing and improve wound healing quality.
, 百拇医药
    81-84

    Effects of high-volume hemofiltration on serum levels of tumor necrosis factor and its receptors in patients with multiple organ dysfunction syndromes

    Zhang Jun, Tao Li-jian, Ning Jian-ping, Xu Hui, Ai Yu-hang, Zhao Shuang-ping

    Department of Nephrology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China

    OBJECTIVE: To investigate whether serum tumor necrosis factor-α(TNF-α) and its receptors can be removed by high-volume hemofiltration (HVHF) or continuous veno-venous hemofiltration (CVVH). METHODS:The study was performed in 12 multiple organ dysfunstion syndrome (MODS) patients with acute renal failure (ARF). They were randomized to receive either CVVH (n=10) or HVHF (n=8). TNF-α and soluble tumor necrosis factor-receptor (sTNF-R1 and sTNF-R2) concentrations were measured in serum by enzyme-linked immunoadsorbent assay (ELISA). RESULTS:Compared with that before the therapy, the average concentrations of plasma creatinine and urea were decreased significantly 8 hours after HVHF or CVVH in MODS patients with ARF (P<0.001). In patients on HVHF, the serum TNF-α concentrations were significantly lower 8 hours after treatment (P<0.01) compared with that before treatment, 1 hour and 4 hours after treatment. There were not significant changes in the serum TNF-α concentrations in patients on CVVH and the serum sTNF-R1 and sTNF-R2 concentrations in patients on CVVH or HVHF. CONCLUSION:In MODS patients with ARF undergoing HVHF, the serum TNF-α concentrations dropped significantly, but the serum sTNF-R1 and sTNF-R2 concentrations do not change significantly. Our study suggests that HVHF may be the better option for the treatment of MODS patients.
, 百拇医药
    85-89

    Gene expression of angiogenesis-related factors in fetal skin at different developmental stages and childhood skin

    Chen Wei, Fu Xiao-bing, Ge Shi-li, Zhou Gang, Han Bing, Sun Tong-zhu, Sheng Zhi-yong

    Key Research Laboratory of Wound Repair, Burns Institute, 304 th Hospital of PLA, Beijing 100037, China

    OBJECTIVE: To explore the change in gene expression of angiogenesis-related factors vascular endothelial growth factor(VEGF), angiopoietin-1(Ang-1), acid fibroblast growth factor (aFGF) and basic fibroblast growth factor (bFGF), in fetal skin at different developmental stages and children skin and their potential biological significances. METHODS:Fetal skin samples of human embryo were obtained from spontaneous abortion at different gestational ages ranging from 13 to 32 weeks, and children skin specimens were collected from child patients (4-12 years) undergoing plastic surgery. After morphological characteristics of skin at different developmental stages were defined histologically gene expressions of VEGF, Ang-1, aFGF and bFGF were examined with reverse transcription-polymerase chain reaction analysis (RT-PCR). RESULTS:The trend of changes in gene expression of VEGF, Ang-1, aFGF and bFGF was not same for different skin specimens at various developmental stages. In early gestational fetal skin, genes of VEGF and Ang-1 were strongly expressed, while in late gestational and childhood skins, gene expressions of VEGF and Ang-1 were apparently decreased. In skin of middle gestational stage, the level of aFGF gene expression was highest, and then it was progressively reduced. In childhood skin, this gene was weakly expressed. In marked contrast, the contents of transcripts of bFGF showed no substantial change in fetal skin at different developmental stages, whilst the mRNA content of bFGF was significantly decreased in childhood skin. CONCLUSION:VEGF, Ang-1, aFGF and bFGF might be involved in regulating angiogenesis in skin from fetuses of different gestational stages and children. The relative increase in gene transcription of VEGF and Ang-1 in younger fetal skin might be one of the reasons why cutaneous cells proliferate rapidly and the wounds heal without scar.
, 百拇医药
    90-92

    Effects of carbachol injection in intestine on plasma levels of inflammatory medium in rats during gut ischemia/reperfusion

    Jiang Xiao-guo, Hu Sen, Shi De-guang, Lu Yi, Li Jun-you, Sun Dan, Sheng Zhi-yong

    Burns Institute, 304 th Hospital of PLA, Beijing 100037, China

    OBJECTIVE: To investigate the effects of carbachol injection in intestine on plasma levels of tumor necrosis factor-α(TNF-α), interleukin-10 (IL-10) and cortisol in rats during gut ischemia/reperfusion. METHODS:Wistar rats were anaesthetized with soluble pentobarbitone, and subjected to superior mesenteric artery occlusion (SMAO) for 60 minutes, followed by reperfusion for 60 minutes. Animals were divided into three groups, pretreated group (carbachol injection in intestine at 30 minutes after SMAO; 0.1 mg/kg), treated group (carbachol injection at 30 minutes from onset of reperfusion), and controls (saline injection). Plasma TNF-α, IL-10 and cortisol levels were determined at 1.0, 2.5 and 6.0 hours after SMAO. RESULTS:The plasma levels of TNF-α significantly decreased in pretreated and treated groups than those in controls after carbachol injection (both P<0.01). However, the levels of IL-10 and cortisol didn't show significant differences among three groups. CONCLUSION:The RESULTS suggest that carbachol can reduce the proinflammatory cytokine release and have a less inhibitory effect on the anti-inflammatory cytokine. It is indicated that carbachol play a potential role in alleviating systemic inflammatory response during splanchnic ischemia/reperfusion injury.
, 百拇医药
    93-96

    Effects of enteral supplementation with glutamine on mitochondria respiratory function of intestinal epithelium in burned rats

    Peng Xi, Chen Rong-chun, Wang Pei, You Zhong-yi, Wang Shi-liang

    Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing 400038, China

    OBJECTIVE: To investigate the effects of enteral supplementation with glutamine on mitochondria respiratory function of intestinal epithelium in burned rats. METHODS: Wistar rats inflicted with 30% total body surface area(TBSA) full thickness thermal injury were randomly divided into three groups, i.e. burn with enteral nutrition(EN), burn with glutamine treatment (GLN), and normal control(C) groups. Burned rats were infused 732.2 kJ·kg-1·d-1 solution for intravenous nutrition and oral adminis tration , in which the supply energy ratio of glucose, fat and protein was 55∶30∶15 respectively, glucose was 15.3% and the proportion of calorie to nitrogen was 183∶1. The following indices including respiratory control rate (RCR), oxygen extraction (Oext), P/O ratio and intestine mucosal blood flow(IMBF) were measured on postburn days 1, 3, 5, 7, 10.RESULTS: After burn injury, the RCR, Oext, P/O ratio, and IMBF were significant decreased in both EN and GLN groups, but all above indices were markedly increased in GLN group compared to those in EN group. CONCLUSION: After burn injury, the IMBF and Oext were declined, resulting in mitochondria respiratory oxidative dysfunction and phosphorylation discoupling in intestinal epithelium. GLN supplementation appears to be beneficial to improving IMBF, increasing Oext, abating the extent of mitochondria respiration dysfunction, and promoting oxidative phosphorylation.
, 百拇医药
    96

    Clinical application of insertion of catheter by superior internal jugular vein puncture in critical illness

    Ren Wan-lu, Zhou Li-yuan

    Tianjin Tianhe Hospital, Tianjin 300050, China

    97-99

    Study on apoptosis of lung tissue cells in patients with severe brain injury complicated with aspiration-induced lung injury
, 百拇医药
    Li Tan-shi, Yin Di-cheng,Wu Xu-hui, Song Yang-li, Yin Ming, Shen Hong, He Quan-ying

    Department of Emergency, General Hospital of PLA, Beijing 100853, China

    OBJECTIVE: To investigate the role of apoptosis of pulmonary cells in aspiration induced lung injury in patients with severe brain injury with or without aspiration-induced lung injury. METHODS:The Glasgow scale (GCS) of 11 dead patients with severe closed brain injury was 3-8. There 11 cases were divided into aspiration-induced lung injury (AILI) and non-aspiration-induced lung injury (NAILI) groups. The plasma levels of tumor necrosis factor-α(TNF-α) and interleukin-8 (IL-8) were measured, and the ratio of apoptosis in lung tissue cells was also determined. RESULTS:The plasma levels of TNF-α and IL-8 in NAILI and AILI groups were (2.17±0.41)μg/L vs. (3.14±0.28)μg/L and (0.42±0.05)μg/L vs. (0.91±0.08) μg/L(P<0.05) respectively. Lung tissue cell apoptosis ratio was significantly higher in AILI group than NAILI group (P<0.01).CONCLUSION:TNF-α and IL-8 may induce apoptosis in lung tissues through different signaling pathway. During the early phase of aspiration-induced lung injury complicating severe closed brain injury, apoptosis in cells of lung tissue may play a role in the pathogenesis.
, http://www.100md.com
    100-102

    Impact factors and clinical significance of the lung injury complicating acute pancreatitis

    Yu Wen-kui, Li Wei-qin, Li Ning, Li Jie-shou

    Research Institute of General Surgery, Jinling Hospital, Nanjing 210002, Jiangsu, China

    OBJECTIVE: To study the impact factors and clinical significance of the acute lung injury (ALI) complicating acute pancreatitis. METHODS:Two hundred and fifty patients with acute pancreatitis were retrospectively analyzed to study the impact of the clinical types, different stages of the disease, systemic inflammatory response syndrome (SIRS) and its duration on the incidence of ALI. Also, the relationship between ALI and severity of the disease, as shown by acute physiology and chronic health evaluation II (APACHE II) score, the incidence of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndromes (MODS), and prognosis was analyzed in patients with acute pancreatitis. RESULTS:Our data showed that the clinical types and different stages of acute pancreatitis were significantly related to the incidence of ALI(P<0.01).The incidence of ALI was significantly higher in patients with SIRS compared with those no SIRS(P<0.01), and the longer the duration of SIRS, the higher was the incidence of ALI. In patients with ALI, APACHE II score and incidence of ARDS and MODS (P<0.01) were significantly higher, and the prognosis was poor (P<0.05). CONCLUSION:SIRS is an important factor that has strong influence on incidence of ALI, and the ALI is an important determinant of prognosis and severity of patients with acute pancreatitis.
, http://www.100md.com
    102

    Experiences in treatment of 31 patients with severe bronchial asthma in the basal hospital

    Wei Ze-yu, Mo Jian-yi, Huang Zu-kang

    The Third Hospital, Hechi 547000, Guangxi, China

    103-105

    Effect of peritoneal lavage with povine-iodine on prevention of postoperative sepsis after exposure of peritoneal cavity to sea water in rat
, 百拇医药
    Wang Zhi-wei, Jin Hao-sheng, Luo Zhen-dong, Xie Shang-kui, Hu Shi-xiong, Liu Xian-tang, Wu Yin-ai

    Department of General Surgery, the 157th Hospital of PLA, Guangzhou 510510, Guangdong, China

    OBJECTIVE: To observe the effects of peritoneal lavage with povine-iodine on prevention of sepsis after exposure of peritoneal cavity to sea water in rat. METHODS:Eighty-four SD rats were randomly divided into two groups, and the peritoneal cavity was exposed to sea water. Rats in group A were not treated (group A, n=42), and the peritoneal cavity was lavage with povine-iodine in group B (n=42). Plasma levels of endotoxin and tumor necrosis factor (TNF) were measured preimmersion, and 0, 12, 24 hours after seawater immersion (n=6), and positive incidence of blood bacterial culture was performed (n=18 in each group) in groups A and B.RESULTS:① Plasma levels of endotoxin and TNF in group A and B were increased significantly after exposure of peritoneal cavity to sea water (compared with baseline values, all P<0.05). Plasma levels of endotoxin and TNF in group B became lower than those in group A from 12 hours after seawater immersion (P<0.05 or P<0.01). ② Positive incidence of bacterial culture in group B was 16.7 % (3/18) and it was lower than that in group A 〔77.8 % (14/18), P<0.01〕. CONCLUSION:Povine-iodine lavage in the peritoneal cavity can reduce levels of plasma endotoxin and TNF, and lower positive incidence of bacterial culture in rats after exposure of peritoneal cavity to sea water, thereby preventing the development of postoperative sepremia.
, 百拇医药
    105

    Invasive fungal infection caused patients undergoing superior tracheotomy

    Yang Zi-li, Gu Bao-chun, Wu Heng-yi, Zhou Hong-feng

    General Hospital of Guangzhou military area, Guangzhou 510010, Guangdong, China

    106-108

    Effect of continuous renal replacement treatment on stress reaction in patients with severe trauma
, 百拇医药
    Lan Guang-ming, Fu Qing-hua, Lin Ai-ling

    Intensive Care Unit, Dongguan People's Hospital, Dongguan 523018, Guangdong, China

    OBJECTIVE: To investigate the effect of continuous renal replacement treatment (CRRT) stresses reaction in patients with severe trauma and its clinical significance. METHODS:Twenty-nine patients with severe trauma were randomly divided into two groups: treatment group 〔15 cases, treated with continuous veno-venous hemofiltration (CVVH) within 12 hours after trauma〕 and control group (14 cases, not treated with CVVH). The levels of cortical, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in plasma were determined at 12 hours, 24 hours, 48 hours, 72 hours after trauma, and the temperature, heart beat, respiratory rate, blood pressure were observed. RESULTS: The levels of cortical, IL-6 in both groups increased to some degree in 12 hours. In control group, the level of cortical increased gradually, peaking at 48 hours, and it was still higher than normal at 72 hours. The level of cortical decreased in the treatment group gradually after 24 hours, approaching normal level at 72 hours. When compared with the control group, the levels of cortical in plasma were lower obviously in the treatment group at 24 hours, 48 hours, 72 hours (all P<0.001). The level of IL-6 decreased obviously after 12 hours and was lower evidently at 24 hours,48 hours, 72 hours (all P<0.05). The clinic symptoms were improved obviously. The level of TNF-α was increased at each time point in both groups, but there was no significant difference between two groups. CONCLUSION:CRRT can eliminate effectively the stress hormone, and reduce stress reaction obviously. The change in IL-6 is more marked than that of cortical.
, 百拇医药
    109-110

    Changes in myocardium enzyme in rabbits with acute renal failure

    Zhao Zi-gang, Niu Chun-yu, Hou Ya-li, Zhang Jing, Fan Gui

    Pathology Staff Room, Beifang University, Zhangjiakou 075000, Heibei, China

    111

    Establishment of a rat model with pulmonary embolism-reperfusion

    Geng Yu-shan, Cui Hua-lei, Wang Jia-tai
, 百拇医药
    Tianjin Dagang Central Hospital, Tianjin 300270, China

    113-116

    High mobility group box-1 protein and sepsis

    Tang Dao-lin, Xiao Xian-zhong

    Xiangya Medical University, Central-South University, Changsha 410078, Hunan, China

    116

    Influence of adjustable sodium dialysis therapy on incidence of hypotension in the elderly
, 百拇医药
    You Xi-lei, Zhang Hong-yan, Zhang Yi-juan, Wang Xin, Xia Xin-hua, Ren Xin-sheng

    Tianjin Tianhe Hospital, Tianjin 300050, China

    117-119

    Advances in study on predicative factors for multiple organ dysfunction syndrome after trauma

    Fei Jun, Huang Xian-kai, Liang Hua-ping, Jiang Yao-guang

    Daping Hospital, the Third Military Medical University, Chongqing 400042, China
, 百拇医药
    120-123

    Advances in cytokines and signal transductions after lung ischemia-reperfusion injury

    Lv Tang-feng, Song Rong

    General Hospital of Nanjing military area, Nanjing 210002, China

    123

    Analysis of 270 critically ill patients undergoing superior tracheotomy

    Zhang Ji-li, Pang Hai-tao, Wu Zhong, Zhao Yong-qian, Diao Shang-zhi
, 百拇医药
    People's Hospital of Dunhuang, Dunhuang 736200, Gansu, China

    124-126

    Procalcitonin and critical illness

    Kong Yi-chun, Ren Xin-sheng

    Tianjin Tianhe Hospital, Tianjin 300050, China

    127-128

    Guidelines of European Heart Association: Principles of Emergency treatment
, 百拇医药
    Zhu Hai-yan, Shen Hong

    Department of Emergency, General Hospital of People's Liberation Army, Beijing 100853, China

    128

    Prevention and treatment of mechanical complications in patients with intubations feeding

    Yang Jin-mei

    Tianjin Tianhe Hospital, Tianjin 300050, China, 百拇医药