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1.
Chinese Medical Ethics ; (6): 568-572, 2024.
Article in Chinese | WPRIM | ID: wpr-1012942

ABSTRACT

After COVID -19, patients, medical workers and the whole society in COVID -19 were faced with the challenge of how to quickly return to normal life. Patients cured in COVID -19 would face mental or psychological barriers, or be discriminated against, or face problems such as overweight of local epidemic prevention policies. The front-line medical personnel experienced job burnout and a variety of mental and psychological disorders, with some even developing physical symptoms. During the epidemic, ordinary people were in a state of psychological stress, education, production and economic activities were affected, and the incidence of mental or psychological disorders increases. It was necessary to provide COVID -19 patients with mental health monitoring and counseling. Give professional guidance to front-line medical staff, arrange rotation reasonably, and pay attention to their mental health status. Local governments should strictly implement the national epidemic prevention system, formulate epidemic prevention policies with humanistic care, actively publicize epidemic related knowledge and safeguard the rights and interests of the people.

2.
Chinese Journal of Emergency Medicine ; (12): 1210-1215, 2021.
Article in Chinese | WPRIM | ID: wpr-907760

ABSTRACT

Objective:To explore the mechanism of miR-494 negatively regulating ROCK1 and PTEN in inhibiting apoptosis of pancreatic cells and participating in the occurrence and development of acute pancreatitis.Methods:Pancreatic acinar cells AR42J from rats were treated by caerulein, and then the levels of amylase, tumor necrosis factor alpha (TNF-α), interleukin 1 (IL-1) and IL-6 in the supernatant of cell culture were detected by ELISA to verify the cell model of acute pancreatitis. RT-PCR was used to detect the expression of miR-494 in normal AR42J cells (control group) and acute pancreatitis cell model (model group). Flow cytometry was used to detect the apoptosis of the control group, negative control miRNA transfected acute pancreatitis cell model (negative control group) and miR-494 transfected acute pancreatitis cell model (miR-494 transfection group). Western blot was used to detect the expression of ROCK1 and PTEN in the control group, negative control group and miR-494 transfection group.Results:The levels of amylase, TNF-α, IL-1 and IL-6 in the supernatant of AR42J cells treated with caerulein for 8 h and 12 h were significantly higher than those at 0 h and the control group ( P<0.05), indicating that the model was successfully constructed. The expression levels of miR-494 at 8 h, 12 h and 24 h after the establishment of acute pancreatitis cell model were significantly higher than those at 4 h and the control group ( P < 0.05). The apoptosis rate of the model group was significantly higher than that of the control group ( P<0.05), and the apoptosis rate of the miR-494 transfection group was significantly lower than that of the model group ( P<0.05). The expression levels of ROCK1 and PTEN in the miR-494 transfection group were significantly lower than those in the model group and negative control group ( P<0.05). Conclusions:When acute pancreatitis occurs, overexpression of miR-494 can inhibit the expression of pro-apoptotic protein, thus inhibiting the apoptosis of pancreatic acinar cells and promoting the development of acute pancreatitis.

3.
Chinese Journal of Emergency Medicine ; (12): 960-965, 2021.
Article in Chinese | WPRIM | ID: wpr-907737

ABSTRACT

Objective:To explore the mechanism of pioglitazone in reducing lung injury induced by acute pancreatitis.Methods:Thirty healthy male SD rats were randomly(random number) divided into the sham operation group, model group and pioglitazone group, with 10 rats in each group. After anesthesia, the rats in the sham operation group were injected with normal saline retrogradely through the pancreaticobiliary duct. In the model group, after anesthesia, the rats were retrogradely injected with sodium taurocholate into the pancreaticobiliary duct to construct the lung injury model of severe acute pancreatitis. In the pioglitazone group, the model was established after intraperitoneal injection of pioglitazone. Six rats in each group were randomly selected and killed 12 h after operation, and then lung tissue and venous blood were collected. The levels of serum amylase and TNF-α and NO in lung tissue homogenate were detected and compared among the three groups; the expression of TLR2 mRNA and TLR4 mRNA in lung tissue was detected by RT-PCR and compared among the three groups; the lung tissue pathological injury score and lung leakage index were calculated and compared among the three groups. The correlation of TLR2 and TLR4’s mRNA expression with lung tissue pathological injury score and lung leakage index was analyzed.Results:The levels of serum amylase and the levels of TNF-α and NO in lung tissue homogenate in the model group were significantly higher than those in the sham operation group, and the above indexes in the pioglitazone group were significantly lower than those in the model group ( P<0.05). The expression levels of TLR2 mRNA and TLR4 mRNA in lung tissue, the lung tissue pathological injury score and lung leakage index in the model group were significantly higher than those in the sham operation group, and the above indexes in the pioglitazone group were significantly lower than those in the model group ( P<0.05). Spearman correlation analysis showed that the expression levels of TLR2 mRNA and TLR4 mRNA in lung tissue were significantly positively correlated with the lung tissue pathological injury score ( rs=0.959, P<0.001; rs=0.924, P<0.001). Pearson correlation analysis showed that the expression levels of TLR2 mRNA and TLR4 mRNA in lung tissue were significantly positively correlated with the lung leakage index ( r=0.957, P<0.001; r=0.958, P<0.001). Conclusions:Pioglitazone may reduce the severity of severe acute pancreatitis induced lung injury by inhibiting the expression of TLR2 mRNA and TLR4 mRNA in lung tissue.

4.
Chinese Journal of Emergency Medicine ; (12): 1251-1256, 2019.
Article in Chinese | WPRIM | ID: wpr-796624

ABSTRACT

Objective@#To explore the role of toll-like receptor 4 (TLR4)/NF-κB signaling pathway in acute necrotizing pancreatitis (ANP)-associated lung injury and the intervention of lipoxin A4 (LXA4) analogue.@*Methods@#Forty-five Sprague-Dawley rats were randomly(random number)divided into the sham operation group, experimental group, and intervention group, each group containing 15 rats. ANP animal models were prepared by injecting sodium taurocholate into biliopancreatic tube in the experimental group. No sodium taurocholate was injected into biliopancreatic duct in the sham operation group. After the preparation of ANP animal models in the intervention group, LXA4 was injected through the tail vein. Rats in each group were randomly divided into 3 subgroups (n=5 each subgroup). The serum amylase, TNF- α, IL-1β, IL-6 and endotoxin levels were detected 6, 12 and 24 h after the operation. The lung injury scores were assessed and the lung wet/dry weight ratio was calculated. The expressions of TLR4 and NF-κB p65 in lung tissues were detected by Western blot.@*Results@#Serum levels of amylase, TNF-α, IL-1β, IL-6 and endotoxin in the experimental and intervention groups were significantly higher than those in the sham operation group, while the levels of the above indicators in the intervention group was significantly lower than those in the experimental group, and the differences were statistically significant (P<0.05). Postoperative lung injury scores and lung wet/dry weight ratio in the experimental group were significantly higher than those in the sham operation group, and the differences were statistically significant (P<0.05). Lung injury scores in the intervention group 6 h after operation had no significant difference compared with those in the sham operation group (P>0.05), while lung wet/dry weight ratio in the intervention group 6 h after operation, and lung injury scores and lung wet/dry weight ratio in the intervention group 12 h or 24 h respectively after operation were significantly higher than those in the sham operation group, with statistically significant differences (P<0.05). Postoperative lung injury scores and lung wet/dry weight ratio in the intervention group were significantly lower than those in the experimental group, and the differences were statistically significant (P<0.05). The expressions of TLR4 and p65 in the lung tissues of the experimental and intervention groups were significantly higher than those of the sham operation group, and the expressions of TLR4 and p65 in the lung tissues of the intervention group were significantly lower than those of the experimental group, with statistically significant differences (P<0.05).@*Conclusions@#LXA4 can reduce the severity of acute necrotizing pancreatitis-associated lung injury, and its mechanism is related to reducing the stimulation of endotoxin, thus inhibiting TLR4 signaling pathway and the activation of p65 to down-regulate the level of pro-inflammatory cytokines.

5.
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care ; (6): 611-614, 2019.
Article in Chinese | WPRIM | ID: wpr-824352

ABSTRACT

Objective To discuss the ethical necessity and feasibility of implementing multiple comprehensive psychological intervention measures in intensive care unit (ICU), and to investigate the effect of the measures on treatment compliance. Methods The conscious adult patients hospitalized in emergency ICU (EICU) of the Second Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2017 were enrolled, and divided into control group and intervention group according to random number table, with 40 patients in each group. Patients in control group were treated with routine care and routine diagnosis and treatment, and patients in intervention group were treated with the help of psychologists and with multiple comprehensive psychological intervention measures (including nursing care, medical treatment, family and management) based on routine care and routine diagnosis and treatment. After 5 days of intervention, the treatment compliance, the medical coping attitude and the mental health were assessed respectively using the Treatment Compliance Scale, the Medical Coping Modes Questionnaire (MCMQ) and the Symptom Checklist Scale (SCL-90), and then comparation were done between the two groups. Results After 5 days of intervention, 3 patients in the control group and 4 patients in the intervention group withdraw the study because of the change of illness, and at last 37 patients in the control group and 36 in the intervention group were enrolled. There was no significant difference in basic data such as gender, age, education level, disease, course of disease, the length of EICU stay, and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score between the two groups. The scores of treatment compliance in intervention group was significantly higher than that in control group (2.89±0.67 vs. 2.32±0.91, P < 0.01). Compared with the control group, the "confrontation" dimension score of the MCMQ questionnaire in intervention group was significantly increased (19.75±2.08 vs. 18.62±2.65, P < 0.05), while the "avoidance" and"surrender" dimensions scores were significantly decreased (14.22±1.91 vs. 15.14±1.92, 8.83±1.54 vs. 9.73±2.10, both P < 0.05). In the SCL-90 scale, the scores of the 5 factors such as "somatization", "interpersonal sensitivity","depression", "anxiety" and "photic anxiety" in intervention group were significantly less than those in control group (1.59±0.38 vs. 1.81±0.37, 1.72±0.40 vs. 1.93±0.42, 1.76±0.32 vs. 1.92±0.29, 1.82±0.40 vs. 2.14±0.40, 1.44±0.30 vs. 1.60±0.38, all P < 0.05), while there was no significantly difference in the scores of the other 4 factors as "obsessive-compulsive symptoms", "hostile", "bigotry" and "psychoticism" between the two groups (all P > 0.05). Conclusion The multiple comprehensive psychological intervention measures used for ICU conscious patients could improve the treatment compliance, make the patients' medical coping attitude more active and improve the mental health of the patients, so it has ethical necessity and certain feasibility.

6.
Chinese Journal of Emergency Medicine ; (12): 1251-1256, 2019.
Article in Chinese | WPRIM | ID: wpr-789206

ABSTRACT

Objective To explore the role of toll-like receptor 4 (TLR4)/NF-κB signaling pathway in acute necrotizing pancreatitis (ANP)-associated lung injury and the intervention of lipoxin A4 (LXA4) analogue.Methods Forty-five Sprague-Dawley rats were randomly(random number)divided into the sham operation group,experimental group,and intervention group,each group containing 15 rats.ANP animal models were prepared by injecting sodium taurocholate into biliopancreatic tube in the experimental group.No sodium taurocholate was injected into biliopancreatic duct in the sham operation group.After the preparation of ANP animal models in the intervention group,LXA4 was injected through the tail vein.Rats in each group were randomly divided into 3 subgroups (n=5 each subgroup).The serum amylase,TNF-α,IL-1β,IL-6 and endotoxin levels were detected 6,12 and 24 h after the operation.The lung injury scores were assessed and the lung wet/dry weight ratio was calculated.The expressions of TLR4 and NF-rκB p65 in lung tissues were detected by Western blot.Results Serum levels of amylase,TNF-α,IL-1β,IL-6 and endotoxin in the experimental and intervention groups were significantly higher than those in the sham operation group,while the levels of the above indicators in the intervention group was significantly lower than those in the experimental group,and the differences were statistically significant (P<0.05).Postoperative lung injury scores and lung wet/dry weight ratio in the experimental group were significantly higher than those in the sham operation group,and the differences were statistically significant (P<0.05).Lung injury scores in the intervention group 6 h after operation had no significant difference compared with those in the sham operation group (P > 0.05),while lung wet/dry weight ratio in the intervention group 6 h after operation,and lung injury scores and lung wet/dry weight ratio in the intervention group 12 h or 24 h respectively after operation were significantly higher than those in the sham operation group,with statistically significant differences (P<0.05).Postoperative lung injury scores and lung wet/dry weight ratio in the intervention group were significantly lower than those in the experimental group,and the differences were statistically significant (P<0.05).The expressions of TLR4 and p65 in the lung tissues of the experimental and intervention groups were significantly higher than those of the sham operation group,and the expressions of TLR4 and p65 in the lung tissues of the intervention group were significantly lower than those of the experimental group,with statistically significant differences (P<0.05).Conclusions LXA4 can reduce the severity of acute necrotizing pancreatitis-associated lung injury,and its mechanism is related to reducing the stimulation of endotoxin,thus inhibiting TLR4 signaling pathway and the activation of p65 to down-regulate the level of pro-inflammatory cytokines.

7.
Chinese Critical Care Medicine ; (12): 377-380, 2018.
Article in Chinese | WPRIM | ID: wpr-703659

ABSTRACT

Exosomes are of great importance in cell communication and information transmission, which have become a hotspot in recent years. Most studies have focused on the transport of microRNA (miRNA) and proteins, that mediated by exosomes, as well as exosomes as a drug delivery carrier of the feasibility. Therefore, exosomes can be an important method of treatment for systemic inflammatory diseases. This article reviews the relevant literature, mainly on the related characteristics of exosomes, its association with clinical disease, and its application in sepsis.

8.
Chinese Journal of Emergency Medicine ; (12): 694-698, 2018.
Article in Chinese | WPRIM | ID: wpr-694424

ABSTRACT

Objective To investigate the feasibility and effect of scene simulation combined with multiple-station mini-CEX evaluation used for the teaching of standardized training of emergency medicine. Methods Sixty standard-trained doctors were randomly(random number) divided into two groups. Thirty standard-trained doctors in team A were taught using the traditional teaching modality of emergency medicine, and the rest in team B were trained using the method of scene simulation combined with multiple-station mini-CEX evaluation. At the end of standardized training, comparisons of the examination results of mini-CEX evaluation and the satisfaction of standard-trained doctors with the teaching mode were done between two groups. Results The scores of team B on medical interviewing skills, clinical judgment, counseling skills, proper presentation/efficiency and overall clinical competence were significantly higher than those of team A[(7.26±0.36),(7.63±0.39),(7.22±0.34),(7.26±0.45), (7.75±0.24) vs. (6.81±0.42),(7.24±0.39),(6.90±0.44),(6.97±0.50),(7.21±0.32)],while there were no significant differences in scores on physical examination skills and humanistic qualities/professionalism between two teams [(7.60±0.36),(7.92±0.35) vs. (7.42±0.30),(7.98±0.32)]. The satisfaction with the mini-CEX evaluation of both teachers and standard-trained doctors in team B were significantly higher than those in team A [(7.40±0.30), (7.46±0.28) vs. (7.06±0.38), (6.91±0.38)]. The satisfaction of standard-trained doctors in team B with the teaching mode and teaching effect were significantly higher than those in team A[(8.17±0.78),(8.59±0.66) (6.67±0.73), (6.80±0.72)]. Conclusions The scene simulation combined with multiple-station mini-CEX evaluation used for the teaching of standardized training of emergency medicine may improve some of the clinical skills of standard-trained doctors, and thus this teaching reform was feasible.

9.
Chinese Journal of Emergency Medicine ; (12): 442-445, 2018.
Article in Chinese | WPRIM | ID: wpr-694398

ABSTRACT

Objective To investigate the feasibility and effect of visualization teaching method using HC visual laryngoscope for the standardized training of endotracheal intubation in emergency department.Methods Forty standard-trainee doctors were divided into two groups randomly.20 standard-trainee doctors in team N were taught using the conventional teaching method of emergency medicine for the standardized training of endotracheal intubation,and the other 20 standard-trainee doctors in team HC were taught by visualization teaching method using HC visual laryngoscope.After 1 month training,comparisons of the success rate of tracheal intubation in airway management simulator,the time consumed for intubation and the number of attempt on successful intubation cases,and the satisfaction score with the teaching mode scored by standard-trainee doctors between the two groups were done.Results The one-attempt success rate and the success rate of tracheal intubation in airway management simulator by the standard-trainee doctors in group HC were significantly higher than those in group N (40% vs.10%,85% vs.55%),while the number of attempt and the time consumed for successful intubation were significantly less than those in group N[(1.65±0.61) vs.(2.27±0.66),(79.00±8.35) s vs.(89.36±12.03) s).The satisfaction score with this teaching mode and teaching effect of standard-trainee doctors in group HC were significantly higher than those in group N (8.10±0.74 vs.6.55±1.05,8.15±0.80 vs.6.85±0.91).Conclusions The visualization teaching method with application of HC visual laryngoscope for standardized training of endotracheal intubation in emergency department could improve the success rate and efficiency of tracheal intubation in airway management simulator for standard-trainee doctors,and this teaching method may be better than the conventional teaching method on teaching mode presenting some feasibility.

10.
Progress in Modern Biomedicine ; (24): 4369-4371,4390, 2017.
Article in Chinese | WPRIM | ID: wpr-606810

ABSTRACT

Objective:To investigate the efficacy and safety of continuous blood purification in the treatment of severe acute pancreatitis.Methods:60 cases of severe acute pancreatitis were selected and divided into two groups.The control group (29 cases) was given routine treatment and the observation group (31 cases) was given continuous blood purification.The efficacy of continuous blood purification in the treatment of severe acute pancreatitis was evaluated by CRP,ALT,PaO2/FiO2,HCO3-,Scr,APACHE Ⅱ and MODS scores before and after treatment,complications and survival situation during treatment.Results:Before treatment,there was no statistical significance in the CRP,ALT,PaO2/FiO2,HCO3-,Scr levels between two groups (P>0.05).After treatment,the CRP,ALT,HCO3-,Scr levels of two groups were decreased.These indexes of observation group were lower than those of the control group (P<0.05).The PaO2/FiO2 of both groups were increased.The PaO2/FiO2 of observation group was high than that of the control group (P<0.05).Before treatment,there was no statistical significance in the APACHE Ⅱ and MODS scores between two groups (P>0.05).After treatment,the APACHE Ⅱ and MODS scores were lower than those before treatment.The APACHE Ⅱ and MODS scores in the observation group were lower than those of the control group (P<0.05).During treatment,there was no statistical significance in the complications and survival rate between two groups (P>0.05).Conclusion:Continuous blood purification had a good therapeutic effect on the severe acute pancreatitis.It could improve the organ function,reduce inflammation and regulate the balance of water and electrolyte with high safety.

11.
Chinese Journal of Emergency Medicine ; (12): 1268-1273, 2017.
Article in Chinese | WPRIM | ID: wpr-669059

ABSTRACT

Objective To investigate the therapeutical effect of triptolide (TP) on subarachnoid hemorrhage (SAH) in rats and its underlying mechanisms.Methods Endovascular perforation technique was used to establish SAH models.TP was used to treat SAH rats by intraperitoneal injection.Rats were randomly divided into control group,SAH 3 d group,SAH 3 d + DMSO group and SAH 3 d + TP group.Pathologic change was observed in rat cortex by HE staining.Cell apoptosis was evaluated by TUNEL assay.Iba-1 considered as microglia marker was assessed by immunohistochemistry.The levels of inflammatory factors including IL-6,IL-1 β and TNF-o were detected by ELISA.Results Compared with control group,pathologic changes,such as cell edema,nuclear pyknosis were more obviously;the number of apoptosis cell,the expression of Iba-1 and the level of inflammatory factors including IL-6,IL-1β and TNF-α were all increased in the cortex of SAH 3 d group,SAH 3 d + DMSO group and SAH 3 d + TP group (P < 0.05).There were no significant differences in pathologic changes,the number of apoptosis cells,the expression of Iba-1 and the levels of inflammatory cytokines in the brain cortex between SAH 3 d group and SAH 3 d + DMSO group (P > 0.05).Compared with SAH 3 d group and SAH 3 d + DMSO group,pathologic changes were alleviated,and the number of apoptosis cells,the expression of Iba-1 and the levels of inflammatory cytokines including IL-6,IL-1β and TNF-α were all decreased in the brain cortex in SAH 3 d + TP group.Conclusion TP could alleviate the pathologic changes,reduce the cell apoptosis and inhibit the microglia activation in rat brain cortex after SAH,and the neuroprotective effect of TP might be associated with the decreased levels of inflammatory cytokines.

12.
Chinese Journal of Emergency Medicine ; (12): 910-914, 2016.
Article in Chinese | WPRIM | ID: wpr-495513

ABSTRACT

Objective To investigate the usefulness of HC visual laryngoscope designed for unskilled junior emergency resident doctors in respect of increasing the efficiency and success rate of emergency tracheal intubation.Methods A total of 80 patients needed the emergency tracheal intubation were at first divided into two groups randomly (random number).Patients in group A were operated by junior emergency resident doctors and patients in group B were operated by well experienced attending doctors.Then,the two groups of patients above were divided into two groups randomly (random number).Patients in group N were operated with conventional laryngoscope and patients in group HC were managed with HC visual laryngoscope.Then comparisons of the success rate of glottis exposure,the one-time success rate of tracheal intubation,the success rate of tracheal intubation,the complications,the number of attempt in successful intubation cases and the operative time consumed for successful intubation cases among the groups were done.Results (1)The success rate of glottis exposure,the one-time success rate and the success rate of tracheal intubation in group A-HC were 90%,70% and 90%,respectively which were significantly higher than those (50%,20% and 45%)in group A-N (P 0.05 ). Conclusions HC visual laryngoscope used by unskilled junior emergency resident doctors for emergency tracheal intubation,could increase success rate of glottis exposure,decrease the number of attempt of intubation,decrease rate of complication,shorten operative time required for intubation thus improving efficiency and success rate of emergency tracheal intubation,and maybe narrow the skill gap between unskilled junior resident doctors and well experienced attending doctors in respect of emergency tracheal intubation.

13.
Chinese Medical Ethics ; (6): 703-705, 2015.
Article in Chinese | WPRIM | ID: wpr-478604

ABSTRACT

In this paper , the causes of patients in emergency ICU were analyzed .The authors used classical theory of ethics to illuminate and put forward the ethical principles that both doctors and patients should follow and the conception of patients′moderate right , as well as the relevant suggestions and strategies , with the aim to make the application of emergency ICU medical resources more reasonable and make the treatment and cure of the emer -gency and critical patients more conform to the requirement of the ethics .

14.
Chinese Medical Ethics ; (6): 722-724, 2015.
Article in Chinese | WPRIM | ID: wpr-479078

ABSTRACT

Through stating the current situation of the doctor -patient relationship , and combining with its characteristics in emergency ICU (EICU), to analyze the application basements and skills of progressive doctor -patient communication in EICU , in order to explore the present stage to build a harmonious doctor -patient rela-tionship , a feasible way to safeguard the rights and interests of both doctors to provide the reference .

15.
Chinese Journal of Emergency Medicine ; (12): 760-764, 2013.
Article in Chinese | WPRIM | ID: wpr-437922

ABSTRACT

Objective To explore the clinical efficacy of Qingyi decoction (a preparation of Chinese herbal medicine) combined with DAR (combined use of dexamethasone,anisodamine and rhubarb) for the treatment of acute pancreatitis.Methods A total of 387 eligible patients met the criteria of acute pancreatitis were enrolled from January 2005 to April 2012 for prospective study.All patients,mild acute pancreatitis (MAP) or severe acute pancreatitis (SAP),were divided (random niumber) into four groups,namely conventional therapy (T),DAR therapy (DAR),Qingyi decoction therapy (Q) and Qingyi decoction combined with DAR therapy (Q + DAR).Outcome,fasting time,serum amylase,abdominal pain relief time,pancreatic or peri-pancreatic complications and average hospital-stay were analvzed with SPSS 13.0 statistic software.P < 0.05 was considered statistically significant.Results None of MAP patients died.Of SAP patients,there was no difference in mortality among different groups (P > 0.05).length of fasting time,tine elapsed for abdominal pain relief,time required for normalized serum amylase level and length of hospital stay in MAP patients were significantly shorter than those in SAP patients regardless of different therapies (P < 0.05).Either patients of SAP or MAP treated with Q + DAR or DAR suffered shorter length of time than those treated with T or Q in respect of fasting,abdominal paiu relief,serum amylase level normalization and hospital stay (P < 0.05).For SAP or MAP patients,there was no difference in abdominal pain relief time between receiving DAR and Q + DAR treatment (P > 0.05),but the fasting time in Q + DAR was shorter than that in DAR (P < 0.05).Patients with SAP were more likely to suffer pancreatic or per-pancreatic complications than those with MAP,but there was no difference for SAP or MAP with different treatments.Conclusions DAR or Q + DAR was an alternative to conventional treatment for MAP or SAP,and they were both superior to conventional treatment.And Q + DAR was more advantageous than DAR when fasting time,hospital-stay time and cost were considered.

16.
Chinese Journal of Emergency Medicine ; (12): 163-167, 2011.
Article in Chinese | WPRIM | ID: wpr-384209

ABSTRACT

Objective To explore the effective molecular mechanism of PPAR-γligands rosiglitazone to biliary ischemia-reperfusion injury in autologous liver transplantation. Method A total of 40 SD rats were randomly (random number) divided into sham operation group (SO), ischemia - reperfusion group (Ⅰ/R), rosiglitazone (ROS) and GW9662 group, with 10 ones in each. The models, rat biliary ischemiareperfusion injury of autologous liver transplantation, were made by modified two-cuff technique. Tissues of the liver and bile ducts and blood of those models were evaluated by pathological and biochemical methods to make sure the models were made successfully or not. SO group suffered autologous orthotopic liver transplantation, and L/R group suffered both that and ischemia-reperfusion. ROS group were injected rosiglitazone (0.3mg/kg) via portal vein after having been done all as I/R. GW9662 group suffered all as ROS, and 10min later ,they were injected GW9662(0.3mg/kg) via portal vein. 4h after the experiment, tissues of livers and bilary ducts were taken to be tested by immunohistochemistry method, and the blood punctured from the right ventricular were taken to be determined by ELISA. ANOVA was used for statistical analysis.Results IL-1β, TNF-α and IL-6 were mainly expressed in the cytoplasm of hepatocytes and bile duct cells,while NF-κB was expressed both in the cytoplasm and nuclei. Expression of those proteins in L/R and GW9662 group was increased, significantly higher when compared to the SO and ROS (P < 0.05). IL-1β,TNF-α and IL-6 in rat serum were simultaneously increased, and significantly higher than SO(P <0.05).Compared with the SO, expressions of the IL-1 β,TNF-α and IL-6 were not significantly changed in ROS (P> 0.05 )but significantly increased in GW9662. Conclusions PPAR-γ ligand rosiglitazone took protective role in biliary ischemia-reperfusion injury in autologous liver transplantation. The mechanism correlates with the release of the IL-lα, IL-1β and TNF-α and other inflammatory mediators, which decreased as the expression of NF-κB inhibited by its antagonist.

17.
Chinese Journal of Emergency Medicine ; (12): 277-280, 2009.
Article in Chinese | WPRIM | ID: wpr-396086

ABSTRACT

Objective To explore the effects and mechanism of peroxisome proliferators activated receptor-gamma(PPAR-γ)and its ligand rosiglitazone on ischemia-reperfusion injury of the donor bile ducts.Method Forty-two SD rats were randomly divided into three groups with fourteen rats in each:the sham operation group (SO),ischemia-reperfusion(I/R)group and I/R+rosiglitazone group(I/R+Ros).The animal model of is-chemia-reperfusion occurred in the orthotopically transplanted liver was used.Tne signal pathway of iuflanunatory response of bile duets of the transplanted hver and the variations of associated cytokines were detected by the signal transduction pathway-finder gene array and cytokine antibody chips.The pathological changes and the biochemical markers of the donor liver were assessed by histopathological score and the estimation of the functional changes of some other organs.Data were analyzed by using SPSS version 10.0 software package.Statistical analysis was car-ried out by using one-way anova and Bonferroni test.Results Compared with the SO group and I/R+Ros group.the expression of NF-кB gene of I/R group to more than two times,and the levels of IL-1α,IL-1β and TNF-α pro-tein expressions in I/R group went up over double too.Compared with I/R group,the histopathological score and the biochemical markers of I/R+Ros group were significantly lower (P<0.05,P<0.01,respectively).Con-clusions PPAR-γ and its ligand rosiglitazone have protective effects on ischemia-reperfusion injury to donor bile ducts.The mechanism may be attributed to decrease in the release of inflammatory mediators(IL-1α,IL-1β,TNF-α and so on)resulted from the down-expression of decreased due to NF-кB.

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