Influence of oxidative stress on apoptosis and expression of bax and bcl-2 of enterocytes in burn rats with delayed resuscitation on the plateau / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore influence of oxidative stress reaction on apoptosis rate and expression of apoptosis-related genes bax and bcl-2 of enterocytes in severely burned rats with delayed resuscitation on the plateau.</p><p><b>METHODS</b>One hundred and twenty rats subjected to 30% TBSA full-thickness scald on the back were devided into plateau experimental group (PE, altitude 3840 m) and Lanzhou experimental group (LE, altitude 1517 m). Then LE and PE groups were subdivided into Lanzhou immediate fluid resuscitation group (LIFR, with immediate intraperitoneal injection of isotonic saline after scald, 40 mL/kg), Lanzhou delayed fluid resuscitation group [LDFR, with intraperitoneal injection of isotonic saline at 6 post scald hour (PSH), 40 mL/kg], and plateau immediate fluid resuscitation group (PIFR, with immediate intraperitoneal injection of isotonic saline after scald, 40 mL/kg), plateau delayed fluid resuscitation group (PDFR, with intraperitoneal injection of isotonic saline at 6 PSH, 40 mL/kg). Another 12 rats were divided into Lanzhou sham scald group (LS) and plateau sham scald group (PS), with 6 rats in each group. Rats in LS and PS groups were sham scalded in a water bath for 15 s without fluid infusion. Rats were sacrificed at 6, 12, 24, 48, 72 PSH for collection of small intestine samples to determine the contents of malonaldehyde (MDA) and total hydrosulfide (TSH). The apoptosis of enterocytes was determined by TUNEL, and the expression of bax and bcl-2 in epithelial cells were observed by immunohistochemical method. Intestinal sample of LS and PS groups were collected to determine the contents of MDA and TSH.</p><p><b>RESULTS</b>After being scalded, content of MDA in intestinal tissue of rats in LDFR group and PDFR group was respectively greater than that in LIFR group and PIFR group (P < 0.05 or P < 0.01). Intestinal tissue content of MDA of rats in LDFR group (9.8 +/- 4.0 nmol/mg) and PDFR group (10.2 +/- 1.3 nmol/mg) was respectively greater than that in LIFR group (9.5 +/- 2.7 nmol/mg) and PIFR group (9.6 +/- 1.1 nmol/mg) (P < 0.05) at 24 PSH. After being scalded, intestinal content of TSH of rats in PE group and PDFR group was respectively smaller than that in LE group and LIFR group (P < 0.05). A multitude of brown positive apoptotic cells were observed in PDFR at 6 and 12 PSH. Absorbance values in LDFR group, PIFR group, and PDFR group were higher than that in LIFR group at each time point (P < 0.05 or P < 0.01). A multitude of bax positive cells were observed in intestinal mucous membrane in PDFR at 6 and 12 PSH. Expression of bal-2 was negative in PE group, and LIFR and LDFR groups at 6, 12 PSH, and it was weakly positive in LIFR and LDFR groups at 24, 48, 72 PSH.</p><p><b>CONCLUSIONS</b>Enhancement of bax expression and weakening of bcl-2 expression in enterocytes are induced by the severe oxidative stress reaction in intestinal mucous membrane after burn with delayed resuscitation on the plateau, which may be one of the important reasons in inducing an increase in apoptosis of enterocytes.</p>

Acute high altitude reaction syndrome and systemic inflammatory response syndrome / 中国医学科学院学报

Critical care medicine (CCM) is one of the challenging issue in clinical practice. The key issues of CCM include acute lung injury, acute respiratory distress syndrome, and multiple organ dysfunction syndrome (MODS), generally termed as systemic inflammatory response syndrome (SIRS). When SIRS occurs at high altitude areas (H-SIRS), it will need be distinguished with an idiopathic acute high altitude sickness (generally termed as acute high altitude reaction syndrome), that make the differential diagnosis and treatment of H-SIRS even more difficult. It has became a high priority to properly address the relevant issues in this field: construction of disciplines; identification of speciality scopes; standardization of the diagnosis and treatment of CCM; and decreasing of the mortality of MODS at high altitude.

Preventive and treatment effect of composite Rhodiolae on acute lung injury in patients with severe pulmonary hypertension during extracorporeal circulation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the possibility of early prevention and treatment of acute lung injury by using composite Rhodiolae (CR) in patients with severe pulmonary hypertension during extracorporeal circulation.</p><p><b>METHODS</b>Seventy-six patients with severe pulmonary hypertension screened out by color 2D-Doppler ultrasonography were randomly divided into the treated group (n = 40) and the control group (n = 36). The general treatment for the two groups, including preoperational preparation, operational procedure and conventional drug therapy, was the same. To the treated group, CR was administered 4 g every day (half the dose in children) at 7-10 day before and 5-7 day after the operation. The life signs, pulmonary ventilation parameters, arterial blood gas analysis were monitored and blood levels of TXB2, 6-keto-PGF1 alpha in both groups were determined in the fixed time points.</p><p><b>RESULTS</b>The various parameters in the treated group were all better than those in the control group (P < 0.05 or P < 0.01), the occurrence rate of acute lung injury and its mortality in the treated group were 7.5% (3/40) and 0% (0/3) respectively, while in the control group were 19.4% (7/36) and 43% (3/7) respectively.</p><p><b>CONCLUSION</b>CR has good preventive and treatment effect in treating complicated acute lung injury during extracorporeal circulation (cardiopulmonary bypass) in patients with pulmonary hypertension.</p>