ABSTRACT
Multiple rib fracture is a common chest injury that can cause severe pain and seriously affect life quality of the patients. The traditional pulmonary function test can only assess changes in total lung volume and ventilation of the multiple rib fracture, but fails to reveal regional ventilation status in rib fracture area and ventilation differences within the whole lung. Instead, pulmonary electrical impedance tomography (EIT), as a novel bedside technique for ventilation monitoring, has advantages of non-invasiveness, non-use of radiative rays and dynamic visualization of regional ventilation, enabling to quantify ventilation defects and heterogeneity in space and time. Starting with the assessment of ventilation changes and research status of ventilation function in multiple rib fracture and the characteristics of EIT, the authors review the research progress in the evaluation of ventilation function following multiple rib fracture based on EIT, with the aim to provide new insight into the research on ventilation changes after multiple rib fracture.
ABSTRACT
Objective To investigate the expression of macrophage migration inhibitory factor (MIF) in serum and renal tissue of septic rats with actue kidney injury (AKI), and to explore the effect of Chinese traditional medicine-Xuebijing injection on MIF expression as well as on acute kidney injury in rats with sepsis. Methods Sepsis model was reproduced in rats with cecal ligation and puncture (CLP).Eighty healthy SD rats were randomly divided into three groups:sham operation group(n=16), CLP model group (n=32), and xuebijing group(n=32). All rats were sacrificed at either 2, or 8, or 24 and or 48 hours after operations.MIF mRNA levels in renal tissues of septic rats were semi-quantified by Real-time PCR.The content of MIF in serum was determined by enzyme linked immunosorbent assay (ELISA). Serum creatinine (Cr) contents were measured by automatic biochemistry analyze. Results Compared with sham operation group, transcription of MIF mRNA in renal tissues of model group were significantly enhanced at 8, 24 and 48 hours after operations (P<0.01). Both contents of MIF and creatinine level in serum of model group rose obviously at 24 and 48 hours after operation (P<0.01);Compared with model group, the transcription of MIF mRNA in renal tissues of xuebijing group decrease obviously at 2, 8, 24 and 48 hours (P<0.01) and both contents of MIF and creatinine in serum of xuebijing group drop remarkably at 24 and 48 hours (P<0.01). Conclusion MIF is a kind of late cytokine which might participate in the pathogenesis of AKI in rats with sepsis.Xuebijing injection can inhibit MIF expression, and possess the protective effects on the kidney in rats with sep-sis.
ABSTRACT
Objective To observe the protection of carbachol on intestinal barrier function in patients with trauma. Methods A prospective randomized controlled trial was conducted. Seventy patients after trauma with a definite diagnosis of multiple organ dysfunction syndrome(MODS)from Department of Critical Care Medicine in Hebei United University Affiliated Hospital were included. According to random number table,the patients were divided into a carbachol treatment group(37 cases)and a mosapride citrate treatment group(33 cases),and all the patients in the two groups were treated by antibacterial drugs,supportive agents for organ function,surgery, etc symptomatic treatment. Based on the conventional treatment,in the carbachol treatment group,carbachol was administered through a stomach tube at the dose of 0.2 mg/kg,twice a day,and the dose was doubled if no exhaust or defecation persisted for 3 days after treatment,while in the mosapride group,mosapride citrate was given at the dose of 5 mg once and thrice a day,the therapeutic course of both groups being 7 days. On the 1st,3rd,5th, 7th day after admission,peripheral venous fasting blood in early morning was collected,the activity of diamine oxidase(DAO),expression rates of CD11b+and CD18+in polymorphonuclear neutrophil(PMN),contents of tumour necrosis factor-α(TNF-α)and interleukin-10(IL-10) were detected,and the clinical curative effects were observed. Results Compared to the mosapride citrate treatment group,the total effective rate was significantly higher in the carbachol treatment group on the 7th day after treatment〔70.3%(26/37)vs. 45.5%(15/33),P<0.05〕. The activity of DAO,expression rates of CD11b+and CD18+in PMN,contents of TNF-αand IL-10 in the carbachol treatment group were decreased with the extension of time,and reached valley values on the 7th day,the differences were statistically significant in the comparisons with those in mosapride citrate treatment group at the same time point〔DAO(mg/L):3.21±0.52 vs. 3.93±0.51,CD11b+:(14.89±2.16)% vs.(28.92±1.59)%,CD18+:(53.67±2.44)% vs. (72.46±4.08)%, TNF-α(ng/L):111.44±16.42 vs. 129.73±18.74, IL-10(ng/L):67.71±38.83 vs. 121.45±40.23,all P<0.05〕. At the various time points,the above indexes had no obvious changes in mosapride citrate treatment group. Conclusion Carbachol can ameliorate the ischemic/reperfusion(I/R)injury in patients with intestinal barrier dysfunction after trauma,decrease the release of inflammatory cytokines in vivo,and promote peristalsis of intestinal tract,therefore carbachol has clinical value of protecting intestinal barrier function.