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Objective:To explore the protective effect of emodin on D-galactosamine (D-GalN)/lipopolysaccharide (LPS)-induced acute liver injury and its mechanism.Methods:A total of 40 male BALB/c mice were randomly (random number) divided into 5 groups ( n=8 in each group): the control group, the emodin group, the D-GalN/LPS group, the emodin+D-GalN/LPS group and the 3-MA+emodin+D-GalN/LPS group. D-GalN (700 mg/kg) and LPS (10 μg/kg) were intraperitoneally injected to induce acute liver injury in mice. Autophagy inhibitor 3-MA (15 mg/kg) and/or emodin (20 mg/kg) were intraperitoneally injected 30 min before the liver injury model. The animals were sacrificed under anaesthesia 6 h after D-GalN/LPS challenge, blood samples and liver tissues were collected. The levels of alanineaminotransferase (ALT) and aspartateaminotransferase (AST) in serum, and myeloperoxidase (MPO) activity of liver tissues were determined by colorimetric quantitative method; the levels of tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured by ELISA; the expression of LC3-II and Beclin 1 in the liver tissues were evaluated by Western blot; the pathological changes of liver was evaluated by HE staining. Animal survival rate was also analyzed. The one-way ANOVA was use to compare quantitative data, SNK- q test was used for pairwise comparison between two groups, and Games-Howell test was used when homogeneity of variance were not met. Results:Compared with the control group, the levels of ALT, AST, TNF-α, IL-6 and MPO activity [(2 476.80 ± 263.14) U/L, (271.71 ± 47.15) U/L, (537.92 ± 89.35) pg/mL, (169.74 ± 25.52) pg/mL, and (1.37 ± 0.22) U/mg] were obviously increased in the D-GalN/LPS group ( P<0.05). Compared with the D-GalN/LPS group, the levels of ALT, AST, TNF-α, IL-6 and MPO activity [(1 248.01 ± 380.70) U/L, (142.59 ± 34.63) U/L, (288.91 ± 67.21) pg/mL, (61.83 ± 13.64) pg/mL, and (0.80 ± 0.21) U/mg] were obviously decreased in the emodin+ D-GalN/LPS group ( P<0.05). Compared with the D-GalN/LPS group, the histopathological abnormalities in liver tissue were significantly alleviated and the survival rate of mice was improved in the emodin+ D-GalN/LPS group. Compared with the control group, the expression of LC3-II and Beclin1 was decreased in the liver tissue in the D-GalN/LPS group, while compared with the D-GalN/LPS group, the expression of LC3-II and Beclin1 was increased in the emodin+ D-GalN/LPS group. With co-administration of 3-MA, the protective effects of emodin in acute liver injury were reversed, the levels of AST, ALT, TNF-α, IL-6, and MPO [(2 398.78 ± 233.57) U/L, (242.79 ± 43.46) U/L, (505.07 ± 67.89) pg/mL, (151.46 ± 14.11) pg/mL, and (1.27 ± 0.15) U/mg] were increased, and the pathological damage of liver tissue was aggravated. Conclusions:Emodin alleviates D-GalN/LPS-induced acute liver injury in mice, which may be related to the activation of protein LC3-II, Beclin1 and restored autophagy.
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The pathophysiological process of immune inflammatory response after severe trauma is extremely complex, especially manifested in the dynamic changes. In the physiological response state, the inflammatory and anti-inflammatory conditions are in a dynamic balance. The immune inflammatory response is relatively stable, avoiding excessive inflammatory reactions or immunosuppression and reducing further damage to the body. In the pathological response state, the dynamic balance between inflammatory and anti-inflammatory is broken, and it can also lead to persistent inflammatory-immunosuppression-catabolism syndrome (PICS). As a result, it increases serious complications such as uncontrolled inflammatory reactions, sepsis, multiple organ dysfunction syndrome (MODS), and multiple organ failure (MOF). Current researches on post-traumatic immune inflammatory response have also expanded to the genetic level, indicating that the over-expression of genes and the generation and increase of immune response media are likely to be the key reasons for the disorder of immune inflammatory response. The author reviews the research progress of immune inflammatory response mechanism and related clinical intervention after severe trauma, in order to summarize the previous research results and explore the future research direction.
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The pathophysiological process of immune inflammatory response after severe trauma is extremely complex,especially manifested in the dynamic changes.In the physiological response state,the inflammatory and anti-inflammatory conditions are in a dynamic balance.The immune inflammatory response is relatively stable,avoiding excessive inflammatory reactions or immunosuppression and reducing further damage to the body.In the pathological response state,the dynamic balance between inflammatory and anti-inflammatory is broken,and it can also lead to persistent inflammatory-immunosuppression-catabolism syndrome (PICS).As a result,it increases serious complications such as uncontrolled inflammatory reactions,sepsis,multiple organ dysfunction syndrome (MODS),and multiple organ failure (MOF).Current researches on post-traumatic immune inflammatory response have also expanded to the genetic level,indicating that the over-expression of genes and the generation and increase of immune response media are likely to be the key reasons for the disorder of immune inflammatory response.The author reviews the research progress of immune inflammatory response mechanism and related clinical intervention after severe trauma,in order to summarize the previous research results and explore the future research direction.
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Objective:To bring to doctors' attention to the first time attack of epilepsy in the patients with Parkinson' s disease, enhance the rational drug use and reduce the occurrence of adverse reactions in clinics. Methods: A Parkinson patient with the first time attack of epilepsy was synthetically analyzed on the mechanism of disease, therapy regimen and pharmaceutical care. Results:It was difficult to distinguish the symptom of epilepsy during the treatment of Parkinson' s disease from that of L-dopa induced dyskinesia, therefore, the suitable treatment was difficult to perform. Moreover, antiepileptic drug valproic acid could aggravate Parkinson syn-drome imperceptibly, which was easy to be ignored in clinics. Conclusion:L-dopa induced dyskinesia should try to avoid during the treatment of Parkinson, and should distinguish from the first time attack of epilepsy in order to choose proper antiepileptic drugs.
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OBJECTIVE:To study the protective effect of butylphthalide on the apoptosis of human umbilical vein endothelial cells (HUVECs) induced by Aβ1-42 and its mechanism. METHODS:HUVECs were divided into normal control group,Aβ1-42 group,TAK242 group(10 nmol/L),DMSO group(1‰DMSO)and butylphthalide low-concentration,medium-concentration and high-concentration groups (40,80,160 μg/L). Except for normal control group and DMSO group,other groups were given 50 μmol/L Aβ1-42 to culture HUVECs for 24 h. TAK242 group,DMSO group and butylphthalide low-concentration,medium-concentra-tion and high-concentration groups were given relevant concentration of drugs for 30 min,with 3 holes for each concentration. The cell viability was determined by CCK-8 assay;cell apoptosis was observed by Hochest 33342/PI double staining;the cell apoptotic rate was detected by AnnexinⅤ-fluorescein isothiocyanate (FITC) flow cytometry;the protein expression of TLR-4 and COX-2 were determined by Western blot assay;the contents of IL-1 and TNF-α were detected by ELISA. RESULTS:Compared with nor-mal control group,cell viability of HUVECs were decreased in Aβ1-42 group;while apoptotic rate,protein expression of TLR4 and COX-2,the contents of IL-1 and TNF-α were increased. Compared with Aβ1-42 group,cell viability of HUVECs were increased in TAK242 group and butylphthalide low-concentration,medium-concentration and high-concentration groups;while apoptotic rate, protein expression of TLR4 and COX-2,the contents of IL-1 and TNF-α were decreased,with statistical significance(P<0.05 or P<0.01). CONCLUSIONS:Butylphthalide can reduce HUVECs apoptosis induced by Aβ1-42,which may be related with inhibiting the expression of TLR4,COX-2 and inflammatory factors.
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Objective To compare the effect of video‐assisted thoracoscopic(VAT) surgery and conventional thoracotomy in emergency treatment of multiple rib fracture complicating pulmonary laceration to provide the reference for clinical treatment .Meth‐ods Forty‐seven cases of multiple rib fracture complicating pulmonary laceration in our hospital from April 2013 to April 2014 were selected and divided into the VAT group(n=32) and thoracotomy group(n=15) according to the willingness of patients .The two groups performed the thoracoscopic and traditional thoracotomy titanium nickel alloy rib plate treatment respectively .The sur‐gery situation ,complications and changes of perioperative blood gas levels were compared between the two groups .Results The op‐eration time ,intraoperative bleeding volume ,ICU hospitalization time ,total hospitalization time and postoperative analgesic in the VAT group were lower than those in the thoracotomy group ,the differences were statistically significant (P0 .05) .The excellent rate in the VAT group was 90 .6% ,which was higher than 66 .7% in the thoracotomy group ,and the differ‐ence was statistically significant (P<0 .05) .Conclusion Thoracoscopic internal fixation for the treatment of multiple rib fractures complicating laceration has the advantages of minimal trauma ,convenient operation and high safety ,could effectively alleviate the patient′s sufferring ,improve the living quality ,and be a better way of treatment .
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Objective To analyze the related factors of foot blisters caused by long-distance weight-bearing march and to explore the pathogenesis of foot blisters to provide a useful way for the prevention and treatment.Methods After the 300 km march,counted the number who had accomplished the march,and then recorded the number of foot blisters,location of blisters,and abrasion of sole.Collected the data of gender,age,body mass index (BMI),hand dominance,and whether had bliters before the march through questionnaire.And the data were coded for analysis with SPSS 13.0 statistical package.Results The 7 cases who complete the whole march and 17 cases who already had foot blisters before the march were ruled out of the final statistics.Among the remaining 590 cases,there were 554 cases (93.9%)suffered from foot blisters.And there were 1 282 blisters in total,among which the plantar blisters occupied 98% (1 257 cases).The analysis showed that the incidence of foot blisters had no significant correlation with gender,left/right foot,hand dominance,BMI and age.The predilection sites of blisters were the second and third metatarsals (28.2%),the hallux (21.3%),the fifth metatarsal (18.1%),and the calcaneus (15.8%)of the left foot.The predilection sites of blisters were the second and third metatarsals (33.3%),the hallux (22.4%),the fifth metatarsal (18.6%),and the calcaneus (14.5%)of the right foot.In terms of the abrasion of sole,the lateral heel was worn out the most (34.6% on the left and 34.2% on the right).Conclusion The study confirmed that the incidence of foot blisters had no significant correla-tion with gender,left/right foot,hand dominance,BMI and age,which may be affected by the particularity of this march.Most of the foot blisters occurred in the planta,and the predilection sites of blisters were in accord with sites of of the abrasion of sole and the distribution of plantar shear force,which demonstrated the shear force is the most critical factor on the pathogenesis of foot blisters.
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Objective To evaluate the effect of pre-emptive analgesia on pain and inflammation control in patients with severe multiple trauma.Methods Severe multiple trauma patients treated in the emergency department from September 2014 to December 2014 were prospectively included based on the inclusion criteria including injury severity score (ISS) of 16 to 25,Glasgow Coma Scale (GCS) ≥ 13 and visual analogue scale (VAS) ≥ 4.The patients were assigned to pre-emptive analgesia group,traditional analgesia group and non-analgesia group,according to the random number table.Pre-emptive analgesia group had patient-controlled intravenous analgesia (PCIA) with sufentanil and tramadol on admission.Traditional analgesia group were administered intramuscular pethidine or subcutaneous morphine for temporary analgesia when the pain could not be tolerated.Non-analgesia group received no analgesia.VAS,systemic inflammatory response syndrome (SIRS) score and serum interleukin (IL)-6 concentration were compared among the groups on admission day,24,48,72,120,168 and 240 h after admission.Results Fifty-seven patients (46 males and 11 females) were included,and age was (39.61 ± 12.05)years.There were 18 patients in pre-emptive analgesia group,20 patients in traditional analgesia group,and 19 patients in non-analgesia group.Comparison between pre-emptive analgesia,traditional analgesia and non-analgesia groups showed no significant differences on admission with respect toVAS [(6.5±1.5),(6.6±1.4),(6.4 ±1.4)points],SIRS [(3.3±0.7),(3.4±0.6),(3.4±0.8) points] and IL-6 concentration [(109.2 ± 47.9),(99.9 ± 44.3),(106.3 ± 50.0) ng/L] (P ＞0.05).Compared to traditional analgesia and non-analgesia groups,VAS and SIRS score in pre-emptive analgesia group differed significantly at 24,48,72,120,168 and 240 h after admission,and IL-6 in pre-emptive analgesia group differed significantly at 48,72,120,168 and 240 h after admission (all P ＜0.05).VAS,SIRS score and IL-6 concentration declined faster in pre-emptive analgesia group than other two groups (P ＜ 0.05),while there were no significant differences between traditional analgesia and nonanalgesia groups (P ＞ 0.05).Positive correlation was noted between VAS and SIRS score,and between VAS and t IL-6 concentration (P ＜ 0.05).Conclusion Pre-analgesia provides quick and effective pain relief and attenuate excessive systemic inflammation response that contributes to stabilization and recovery of the severe multiple trauma patients.
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Objective To investigate the effect of the extracts of Centella asiatica(L.) Urban (ECA) on the depressive-like behavior alteration in rats and mice. Method 60 Wistar rats were randomly divided into 6 groups (10 rats each), the normal group, model group, Fluoxetine group, ECA high dose group (component 10.08 mg+component 24.48 mg/kg), ECA middle dose group (component 1 0.04 mg+component 2 2.24 mg/kg) and ECA low dose group component 1 0.02 mg+component 2 1.12 mg/kg. Chronic unpredictable mild stress (CUMS) induced depression in rats and sugar consumption to detect the antidepressant effect of ECU. 60 Kunming mice were randomly divided into six groups as above. Locomotor activity, forced swim, tail suspension test were used to detect the effect of ECA on the behavioral alteration in mice. Results Compared with model group, sugar consumption in ECA groups was significant increased (P<0.01). ECA treatments also decreased duration of immobility in the tail suspension test and forced swim. Conclusion ECA could improve the depressive-like behavior in rats and mice.
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Objective To study the healing response of a tissue engineered bone of bMSCs combined rFN/CDH-BCP in a rabbit model. Methods The biomimetic surface was achieved by immobilizing rFN/CDH onto biphasic calcium phosphate ceramic ( BCP) covalently. The effect of rFN/CDH-BCP on adhesion,proliferation and differentiation were evaluated comprehensively by using cell centrifugal adhesive as-say,MTT method,SEM,Alkaline phosphatase ( ALP) activity and alizarin red staining respectively. A rabbit lumbar fusion model was estab-lished by implanting bMSCs combined rFN/CDH-BCP into intertransverse process space of L4 ~L5 ,the fusion site bone formation was ob-served by imaging means,histological techniques was used to observe the new bone formation and distribution of seed cells. Results Cell centrifugal adhesive assay indicated the adherent bMSCs on rFN/CDH-BCP associated with the ligand density,the biomimetic surface posses-ses excellent biocompatibility. The ALP activity on rFN/CDH-BCP surface was the highest among all samples on the 10th day after induction (P<0. 05). On the 21st day,alizarin red staining showed that the oval-shaped and orange-red nodules,either the number or the area,distrib-uted wider on rFN/CDH-BCP surface. The results from X plain after 3 months revealed a fuzzy gap between material and bone bed,and higher cover rate of intertransverse process space with new bone deposition on rFN/CDH-BCP surface. Conclusion Histologically,rFN/CDH-BCP exhibited as interlacing bone trabecula bridging biomaterial suface and cortical bone of transverse process continously. The bone mass was much more than the ture BCP class. The comprehensive data reveals that when loaded with MSCs,rFN/CDH-BCP demonstrates superior char-acteristics of osteoconduction and osteoinduction,and substantially enhances healing capacity in vivo.
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10.3969/j.issn.1007-3969.2013.04.003
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This article analyzes and summaries the problems and difficulties existing in the first-aid medicine's clinical teaching.Combined with his own teaching experience,the author has made some exploration on the teaching time,the way of teaching and inspection form,which has got a good teaching effect.It provids the reference and development for the clinical teaching of first-aid medicine.
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Objective To investigate early changes of angiopoietin-2(Ang-2)in multiple trauma patients and assess its clinical significance.Methods Forty-five multiple trauma patients aged 2060 years admitted to the hospital within one hour after injury were randomly divided into three groups according to injury severity score(ISS).Blood specimens were obtained immediately upon arrival in the emergency department and plasma samples were assayed for comparing changes of Ang-2,TNF-a and IL-6.Meanwhile,plasma level of Ang-2 was measured and analyzed under different oxygenation index,shock index and base deficit.Results Plasma level of Ang-2 was positively correlated with ISS(P ＜ 0.01)and was concordant with the plasma levels of TNF-a and IL-6(P＜0.01).Furthermore,plasma level of Ang-2 was elevated upon increase of shock index or decrease of oxygenation index(P ＜ 0.01).Plasma level of Ang-2 was elevated with the increase of base deficit(P ＜ 0.01).Conclusions High level of Ang-2 is a marker of endothelial activation and dysfunction early after trauma.Ang-2 is related tightly with the injury severity,inflammation factors,systemic oxygenation and tissue hypoperfusion and may have a tight relation with pathophysiological development and clinical outcome after trauma.
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Objective To address medical relief algorithm in earthquake center by analyzing triage and transfer of casualties in the quake-hit center Yingxiu town in the wake of the 5·12 Wenchuan earthquake.Method According to the actual hard working conditions and rule of CBASHPLAN,the locale was derided into triage area,minor wounds area,severe wounds area and transfer area.Medical team coming from Soulhwest Hospital,the Third Military Medical University was derided into several groups. Triage, treatment and transfer of casualties well arranged. Results A total of 415 victims was treated by our medical team in early three days.Of these victims,251 were severe injuned,153 were debrided,12 were decompression with cutting open the wound because of their oseofascial canpartment syndrome,and 317 casualties were transferred by helicopters.No victim died during treatment and transfer at quake-stricken region.The whole work was proceeded in good order and efficiently.Conclusions Triage and transfer of casualties scientifically allowing for the capability of medical relief and the sufficiency of medical resources are very important to deal with batches of casualties in quake-stricken region.
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30 ml) undergoing minimally invasive evacuation of intracranial hematoma from January 1999 to October 2002 in our department were analyzed retrospectively. The changes of IL 1, IL 6, and IL 8 in hematoma fluid were observed continuously. The content of IL 1 was determined by radioimmunassay and IL 6, IL 8 by ELISA methed. Results IL 1, IL 6, and IL 8 were observed at 6 12 h after hypertensive cerebral hemorrhage, and showed different changes in acute stage. Conclusion Inflammatory cytokines are involved in the pathological process of cerebral hemorrhage.
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Objective To type Acinetobacter baumannii using infrequent restriction site PCR (IRS PCR). Methods Strain specific electrophoretic patterns from PCR products by amplifying DNA sequences flanking infrequent restriction sites of 15 strains of Acinetobacter baumannii were compared with the results of biotyping and antimicrobial susceptibility. Results The 15 bacteria were divided into 5 gene types with IRS PCR, but 3 with biotyping, and 4 with antimicrobial susceptibility. Conclusion IRS PCR method for typing Acinetobacter baumannii is of strong sensitivity, high recognition, good repeatability, convenient operation, and wide range of application.
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Objective To investigate the protective effect of endotoxin pretreatment on hippocampal neurons in rat forebrain following ischemia reperfusion and its possible mechanism. Methods Rat forebrain ischemia reperfusion model was used. The effects of endotoxin pretreatment on the changes of superoxide dismutase (SOD), glutathione peroxidase (GSH PX) and malondialdehyde (MDA) activities and the neuron count in CA1 region were observed. Results Pretreament with endotoxin before cerebral ischemia enhanced the activities of SOD and GSH PX but decreased MDA level and the number of ischemic neurons in CA1 region. Conclusion Endotoxin pretreatment can protect the neurons in rat forebrain against ischemia reperfusion injury. The mechanism may be associated with the enhancement of endogenous antioxidant activity in central nervous system.
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Objective To investigate the effects of sustained inflation (SI) combined with small tidal volume ventilation on lung recruitment and hemodynamics in patients with acute lung injury (ALI). Methods Patients with severe trauma followed by ALI were selected for this study. Patients underwent small tidal volume ventilation (baseline) for 1 h and then SI with 20 cm H 2O?30 s(SI 1), 30 cm H 2O?30 s(SI 2), 40 cm H 2O?30 s(SI 3) and 50 cm H 2O?30 s(SI 4) for 1 h, respectively. Parameters of pulmonary mechanics and hemodynamics were measured at 1 h after baseline, SI and returning baseline, respectively. Results Compared with those of the baseline, no changes of parameters were found after SI 1 and SI 2, but EELV and Cst increased significantly after SI 3 and SI 4. Paw, PAP and PVRI decreased significantly after SI 3 and SI 4. After SI interruption, all the physiological variables returned to baseline. SI had no significant effect on HR, AP and CI. Conclusion Treatment with SI combined with small tidal volume ventilation in patients with ALI can provide lung recruitment and improve lung compliance, but it has no significant side effect on hemodynamics.
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Objective To compare treatment outcomes and antibiotic related costs of A. baumannii infection treated with imipenem cilastatin and ampicillin sulbactam and to provide evidence for clinical treatment of A. baumannii infection. Methods A prospective investigation was performed on 71 ICU A. baumannii infection patients treated with imipenem cilastatin and ampicillin sulbactam. The treatment outcomes and antibiotic related costs were also analyzed. Results There was no significant difference between the therapeutic efficacy of these two drugs within the same time limit. The antibiotic related costs of the patients treated with ampicillin sulbactam were significantly lower than those with imipenem cilastatin (2 113 Yuan vs 5 789 Yuan , P
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Objective To determine the effects and significance of endotoxin preconditioning on iNOS activity,nNOS activity in rat cerebral cortex,hippocampus and cerebella region after global brain ischemia/reperfusion.Methods Global ischemia for 20 min was made by four-vessel occlusion model(4-vo) in 60 Wistar rats,among which 30 were injected of 20 ?g/kg MPL through caudal vein 24 h before model establishment.Another 8 rats undergoing sham operation served as controls.The dynamic change of iNOS activity,nNOS activity and neuron density of the cerebral cortex,hippocampus and cerebella region were observed at 1,4,8 h after reperfusion. Results The activity of iNOS and nNOS decreased significantly after endotoxin preconditioning in the regions mentioned above,as compared with that of rats only undergoing the ischemia/reperfusion.The neuron number in rat hippocampus decreased after ischemia/reperfusion,but no significant difference was found between control and endotoxin preconditioning groups.Conclusion The activity of iNOS and nNOS changed significantly after global brain ischemia/reperfusion.That endotoxin preconditioning decreased iNOS and nNOS activities may be the protective mechanism.