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Objective To analyze the methods and strategy of treatment for multiple injuries in the use of damage control operation, and improve the treatment level and cure rate for multiple injuries.Method From March 2005 to March 2009, 21 patients with multiple injuries were treated by damage control strategy and performed the determinacy operation after the resuscitation in ICU. Results In 21 patients, 16 cases (76.2%) were cured and 5 cases (23.8%) were dead. The injury severity score of 5 dead cases were exceeded 35 points. Conclusions In the strategy of damage control operation, the surgical operation is considered to be a part of the total resuscitative procedure, not the ending of treatment. To those multiple injuries patients, it is safe and effective to perform the damage control operation. It has practical value in clinical treatment.
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Objective To analyze the etiology of duodenal trauma and improve the result of its diagnosis and treatment. Methods The data of 28 cases with duodenal trauma during March 1968 to September 2007 was analyzed retrospectively. Results Twenty-two (78.6%) patients had blunt injuries. The rate of duodenal trauma and associated injuries was 21.4%(6/28)and 89.3% (25/28) respectively. The easiest injury part on the deseending part constituting was 46.4% (13/28) ,the secondary on the horizontal part constituting was 21.4% (6/28).The postoperative complication rate was 28.6% (8/28), the mortality rate was 3.6% (1/28), and the cure rate was 96.4% (27/28). Conclusions The incidence of blunt injuries is high compared with other kinds of duodenal trauma in China. It suggests that the early diagnosis, exploration proper surgical management,and intensive postoperative care are emphasized to reduce the mortality and complication rate.
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Objective To investigate the modulation of EPCs by interleukin 1β (IL-1β) and p38 mitogen activated protein kinase (p38MAPK) and the pathogenesis resulting from their dysdifferenfiation after trauma.Method Thirty pigs were divided into a control group (n = 15) and a multiple organ dysfimction syndrome (MODS) group (n = 15), the latter of which were subjected to a "two-hit" injury including hemon'hagic shock and endotoxemia. Phosphorylation of p38MAPK in peripheral blood mononuclear cells was monitored by western blotting. The concentration of IL-1β in peripheral blood plasma was determined by ELISA and the numbers of EPCs with FCM in peripheral blood plasma were monitored. The morbidity rates in the two groups were compared by chi square test. The levels of phosphorylation of p38MAPK in peripheral blood mononuclear cells, the concentmtions of IL-1β in peripheral blood plasma and the numbers of EPCs in the peripheral blood were compared between groups using with Student's t lest. Results The level of p38MAPK phosphorylation was more augmented and the concen-tration of IL-1β higher in peripheral blood mononuelear cells and plasma from MODS pigs compared with those from control pigs; nevertheless the mauler of EPC conspicuously decreased in the peripheral blood (P <0.01). The morbidity rate in the MODS group was much higher than that in the control group (P < 0.01). There were fewer EPCs in the peripheral blood of animals in group M than in the peripheral blood of animals in group C (P <0.01). Conclusions p38MAPK phosphorylation is important for the pathogenesis of MODS. p38MAPK phospho-rylation might cause the concentration of IL-1β in the peripheral blood plasma to rise and could cause a drop in the numbers of EPCs, thereby aggravating the inflanmmatory reaction in MODS.
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To observe changes in blood pressure of dogs with hemorrhagic shock during infusion of 7 5% NaCl, five mongrel dogs were bled to MAP 5 33～6 7kPa and then kept at this pressure for 1 hour. Each dog received 7 5% NaCl solution (4ml/kg) intravenously and the infusion time was 2 min. The results showed that during the 2 min infusion period the systolic pressure (SP) was obviously higher than that before the infusion ( P
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0.05).There was significant difference in lymph node metastatic rate between poorly-differentiated and undifferentiated adenocarcinoma(17.83%) compared with well-differentiated and middle-differentiated adenocarcinoma(1.58%)(P
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Two hour after LAK—like cells were co—cultured with gastric cancer cells,the mixed sus-pension was spread on slids and dyed with histochemical method.Through analysing the dyedcells,we directly confirmed what subset the LAK—like cells belonged to.The featrue of LAK—like cells adhering to cancer cell was observed under electron micrscope in our experiment.A-mong the lymphoctes which were adherent to cancer cells,the number of CD8~+ cells was in-creased.Most of adherent to cancer cells,the number of CD8~+ cells was increased.Most of ad-herent cells were TAC~+,suggesting that the expression of TAC antigen plays an important rolein cell mediated cytotoxity.
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The studies were undertaken on the trauma model of rats,whose right hind legs were amputated,in order to investigate the change in the immune adherence function of red cells,and the effect of treatment with Traditional Chinese Medicine,consisting of a mixture of Shen-er,to decrease immune adherence function of red cells after trauma.The results indicats that after trauma (1) the activity of C3b receptor of red cells decreased;(2) the amount of immune complexes on the surface of red cells increased;(3) the activity of the enhancing factors for the immune adherence of red cells dropped;(4) the activity of the inhibitors for the immune adherence of red cells elevated;(5) there is remarkable interrelation in the changes between the activity of the C3b receptors of red cells and the activity of the inhibitors for the immune adherence of red cells;(6) the mixture of Shen-er could effectively raise the inhibited activity of the C3b receptor of red cells;(7) the mixture could also effectively regulate the activity of the inhibitors of the immune adherence of red cells.