ABSTRACT
Objective To explore the roles and clinical significance of glutamine(GLN) in carbon tetrachloride(CCl_(4)) induced acute hepatic injury.Methods The SD rats were divided into model group,GLN pretreated group and control group.The animal model was established by CCl_(4) intraperitoneal injection.GLN at dose of 1 g/kg was intragastrically administrated for 7 d before intraperitoneal injection of CCl_(4) in the rats of GLN pretreated group.The rats were executed 4,8,12,16,24 h after injure.To evaluate the hepatic injury,the serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were detected by automatic biochemistry analysator.The liver tissue was observed by light microscope and transmission electron microscope(TEM).The expression of nuclear factor-?B(NF-?B) was detected by immunohistochemistry and the tumor necrosis factor?(TNF-?) was detected by reverse transcription polymerase chain reaction(RT-PCR).The apoptosis of hepatocyte was detected by TUNEL.The oncosis index was detected by TEM.Results The levels of ALT,AST,NF-?B,TNF-? mRNA in model group were apparently elevated as compared to control group(P
ABSTRACT
Objective To investigate the correlation of oncosis and TNF-? in D-galactosamine (D-GalN) induced acute hepatic injury. Methods Acute hepatic injury model was induced by D-GalN in 24 SD rats, and 12 rats served as control. At 4, 8, 12, 16, 20, 24 h after intraperitoneal injection of D-GalN, the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum, and the tumor necrosis factor-? (TNF-?) in liver tissue were measured. The pathological changes of liver and the oncosis of hepatocytes were observed by TEM. Results In acute hepatic injury, the levels of ALT, AST, TNF-? mRNA, OI were higher than that of control group (P
ABSTRACT
Objective To explore the significance of dynamic determination of arterial blood gas for early diagnosis, treatment and prognosis of patients with acute respiratory stress syndrome(ARDS). Methods The results of 655 times arterial blood gas assayed in 113 patients with ARDS were analysed retrospectively.Results (1)Types of acid-basic disturbance:The simple acid-base disturbances were 44 cases,in which respiratory alkalosis were 20 cases, respiratory acidosis 11 cases, metabolic acidosis 10 cases, metabolic alkalosis 3 cases. Complex acid-base disturbances were 53 cases,in which respiratory alkalosis with metabolic acidosis were12 cases, respiratory alkalosis with metabolic alkalosis 14 cases, respiratory acidosis with metabolic acidosis 21 cases, respiratory alkalosis with metabolic alkalosis 6 cases. Triple acid-base disturbances (TABD) were 16 cases, in which the type of respiratory alkalosis were 11 cases, the type of respiratory acidosis 5 cases. the types of acid-base disturbances in cured patients mainly were respiratory alkalosis (17 cases) and respiratory alkalosis with metabolic alkalosis (12 cases). The types of acid-base disturbances in dead patients were mainly respiratory acidosis with metabolic acidosis (19 cases),TABD (14 cases) and respiratory acidosis (9 cases).(2)The oxygenation indexes(PaO2/FiO2) of all 113 patients were less than 26.7kPa.(3)The cured rate in 113cases was 53/113(46.0%)and the mortality was 61/113(54.0%).Conclusion Dynamic determination of arterial blood gas and calculation of index of oxygenation were of important clinical value in diagnosis and treatment of ARDS.
ABSTRACT
OBJECTIVE: To investigate the classification and incidence of acid-base disturbance (ABD) in the patients with post-traumatic multiple organ dysfunction syndrome (MODS). METHODS: A total of 119 patients with MODS were examined with arterial blood gas analysis and serum electrolytes detection for 675 times in this study. RESULTS: Different types of ABD existed in 647 times out of 675 times (95.9%) of blood-gas analyses. There were 270 times (41.7%) of simple ABD, 271 times (41.9%) of double ABD and 106 times (16.4%) of triple ABD. Among which, 404 times (62.4%) were in respiratory alkalosis (RAL), 332 times (51.3%) in metabolic acidosis (MA), 227 times (35.1%) in metabolic alkalosis (MAL) and 167 times (25.8%) in respiratory acidosis (RA). In this study, 79 cases (66.4%) out of 119 cases with MODS died from these kinds of ABD. CONCLUSIONS: It suggests that in the early stage of MODS, RAL with or without hypoxemia may exist, and later on, MA or even triple ABD may occur. In order to detect and correct the primary disorders as early as possible, it is important to keep the balance of hydrolyte. The treatment of primary diseases is also important. Disorders of acid-base balance were corrected according to pH standard values, anion gap (AG) and the potential [HCO(3)(-)] were also calculated simultaneously. When pH was more than 7.50 or lower than 7.20, it is necessary to give drugs of acidity or alkalinity to the patients with ABD to maintain pH value within a normal range.
ABSTRACT
The serum level of cholygylycine acid was determined in 118 patients with liver cirrhosis and the patients were followed up for 1 year.37 patients out of the 118 died in the fol-lowup period.It was found that the serum level of cholygylycine acid was more closely correlated with the mortality rate of the patients with liver cirrhosis than other commonly used indices such as hepatic encephalopathy,ascites.nutritional status,hihrubin,albumin and gamma-globulin.The serum level of cholygylycine acid was compared with Child's grading concerning the prediction of the mortality rate.After Logistic regression analysis.it was confirmed that the serum level of cholygylycine acid was the most ideal index for the prognosis of the patients with liver cirrhosis.