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Objective:To study the antioxidant protective effects of different low-dose of insulin glargine on organs of burned rats with delayed resuscitation.Methods:Forty male Sprague-Dawley (SD) rats were randomly divided into sham group, delayed resuscitation control group, and insulin glargine 0.5, 1.0, and 2.0 U groups, with 8 rats in each group. The rats were immersed in hot water (95.0±0.5) ℃ for 15 s to establish the third-degree scald model with 30% total body surface area. The rats in the sham group were immersed in a 37 ℃ water bath for 15 s. Insulin glargine (0.5, 1.0, 2.0 U·kg -1·d -1) was injected subcutaneously in corresponding insulin glargine group 2 hours after injury, and the same amount of normal saline was injected intraperitoneally in the delayed resuscitation control group. Intraperitoneal injection of normal saline 40 mL/kg simulated delayed resuscitation 6 hours after injury in all groups. Abdominal aortic blood samples, heart and kidney tissue were collected immediately after simulating burn in the sham group, and 24 hours after burn in other four groups. The blood glucose, myocardial enzymes [lactate dehydrogenase (LDH), creatine kinase (CK), α-hydroxybutyrate dehydrogenase (α-HBDH), and aspartate aminotransferase (AST)] and renal function indexes [blood urea nitrogen (BUN) and serum creatinine (SCr)] were measured by spectrophotometry, and the isoenzyme MB of creatine kinase (CK-MB) level was determined by immunosuppression method to evaluate the effects of different low-dose insulin glargine intervention on blood glucose, cardiac and renal functions in scalded rats with delayed resuscitation. The oxidative and antioxidant indices [xanthine oxidase (XOD), myeloperoxidase (MPO), copper-zinc superoxide dismutase (CuZn-SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and total antioxidant capacity (T-AOC)] from the heart and kidney tissues of rats were detected by spectrophotometry to analyze the antioxidant effects of different low-dose insulin glargine interventions. Results:Compared with the sham group, the blood glucose of the rats in the delayed resuscitation control group was significantly increased, the heart and kidney functions were significantly reduced, the oxidation capacity was enhanced, and the antioxidant indicators were significantly reduced. After the intervention of insulin glargine, with the increase of insulin glargine dose, the blood glucose, myocardial enzyme and renal function indicators of rats showed a gradual downward trend, the oxidation indicators continued to decrease, and the antioxidant indicators showed a gradual upward trend. When the dose was 2.0 U·kg -1·d -1, the blood glucose, LDH, CK, CK-MB, α-HBDH, AST, BUN, SCr, XOD and MPO were significantly lower than those in the delayed resuscitation control group [blood glucose (mmol/L): 5.91±0.25 vs. 11.76±0.36, LDH (U/L): 3 332.12±51.61 vs. 5 008.94±490.12, CK (kU/L): 0.49±0.03 vs. 0.85±0.04, CK-MB (U/L): 125.40±12.19 vs. 267.52±11.63, α-HBDH (U/L): 122.99±5.37 vs. 240.85±13.99, AST (U/L): 11.95±1.81 vs. 17.87±1.57, BUN (mmol/L): 4.72±0.15 vs. 7.16±0.34, SCr (μmol/L): 87.11±6.51 vs. 137.50±11.36, XOD (U/g): 166.29±3.27 vs. 204.90±4.82 in heart tissue, 63.51±1.46 vs. 79.69±1.75 in kidney tissue, MPO (U/g): 1.05±0.02 vs. 1.55±0.06 in heart tissue, 1.04±0.04 vs. 1.87±0.01 in kidney tissue, all P < 0.05], and CuZn-SOD, CAT, GSH-Px and T-AOC were significantly higher than those in the delayed resuscitation control group [CuZn-SOD (kU/g): 82.95±2.69 vs. 56.52±2.26 in heart tissue, 94.50±2.73 vs. 62.02±1.66 in kidney tissue, CAT (U/g): 36.07±2.01 vs. 15.15±2.22 in heart tissue, 184.49±4.53 vs. 156.02±3.96 in kidney tissue, GSH-Px (kU/g): 231.93±8.03 vs. 179.48±3.15 in heart tissue, 239.63±7.30 vs. 172.20±2.09 in kidney tissue, T-AOC (kU/g): 4.85±0.23 vs. 2.71±0.11 in heart tissue, 5.51±0.08 vs. 3.50±0.07 in kidney tissue, all P < 0.05]. Conclusion:Different low-dose of insulin glargine (≤2.0 U·kg -1·d -1) could exert antioxidant protection on the heart and kidney of rats with delayed resuscitation after burns, with a dose-dependent manner.
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Objective:To observe the effects of medium and long-term insulin pretreatment on the activity of main oxidase and antioxidant enzyme in the myocardium of burned rats with delayed fluid resuscitation.Methods:According to random number table method, forty male Sprague-Dawley (SD) rats were divided into pseudo-burn group, burn delayed resuscitation group, insulin glargine pretreatment group and neutral protamine hagedorn (NPH) insulin pretreatment group, with 10 rats in each group. 30% total body surface area (TBSA) as Ⅲ degree scald model was prepared by bathing the back of rats in 95 ℃ hot water for 15 s; the rats in the pseudo-burn group were immersed in 37 ℃ warm water for 15 s as control. Insulin glargine pretreatment group, NPH insulin pretreatment group and burn delayed resuscitation group were injected subcutaneously with insulin glargine, NPH insulin, and normal saline 1.0 U·kg -1·d -1 2 hours after injury, and intraperitoneal injection of normal saline 40 mL/kg simulated delay resuscitation 6 hours after injury. The pseudo-burn group didn't receive medicine and delayed resuscitation. Abdominal aortic blood samples and heart tissue were collected immediately after simulating scald in the pseudo-burn group, and 24 hours after scald in three burn groups. Blood glucose, xanthine oxidase (XOD), myeloperoxidase (MPO), CuZn-superoxide dismutase (CuZn-SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) of the heart tissue were determined by spectrophotometry. Results:Compared with the pseudo-burn group, the burn delayed resuscitation group have significantly higher blood glucose level and the XOD and MPO in the heart tissue, while significantly lower CuZn-SOD, CAT, and GSH-Px in the heart tissue. Compared with the burn delayed resuscitation group, insulin glargine pretreatment group and NPH insulin pretreatment group have lower blood glucose level and heart tissue XOD [blood glucose (mmol/L): 6.37±1.22, 6.66±1.45 vs. 9.47±0.80; XOD (U/g): 271.93 (261.59, 275.91), 285.32 (251.96, 297.29) vs. 363.37 (354.12, 377.76), all P < 0.05], while significantly higher heart tissue CuZn-SOD, CAT, and GSH-Px [CuZn-SOD (U/g): 0.13±0.01, 0.14±0.01 vs. 0.10±0.01; CAT (U/g): 29.17±7.28, 27.16±7.37 vs. 18.36±4.53; GSH-Px (U/g): 0.33 (0.16, 0.41), 0.30 (0.17, 0.41) vs. 0.07 (0.04, 0.11), all P < 0.05]. MPO activity in insulin glargine pretreatment group was significantly lower than that in burn delayed resuscitation group (U/g: 0.016±0.002 vs. 0.020±0.002, P < 0.05), but there was no significant difference between insulin pretreatment group and NPH insulin pretreatment group (U/g: 0.019±0.003 vs. 0.020±0.002, P > 0.05). There was no significant difference in the blood glucose, and activities of XOD, MPO, CAT, GSH-Px between insulin glargine pretreatment group and NPH insulin pretreatment group, but the activity of CuZn-SOD in NPH insulin pretreatment group was further higher than that in insulin glargine pretreatment group (U/g: 0.14±0.01 vs. 0.13±0.01, P < 0.05). Conclusions:Medium and long-term insulin pretreatment can improve the antioxidant capacity of myocardium in delayed resuscitation rats after burns, inhibit the production of reactive oxygen species and improve the scavenging capacity of reactive oxygen species. However, only CuZn-SOD activity is different between the two groups, and further study needs to be carried out to determine whether it is related to the type if insulin.
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Objective To study effects of fluid resuscitation on thoracoabdominal injury combined with hemorrhagic traumatic shock.Method A total of 98 patients,who were treated in Affiliated Zhongshan Hospital of Dalian University from November 2004 to December 2006,were retrospectively analyzed.The patients were diagnozed according to Surgery(fifth edition).Patients were divided into delayed fluid resuscitation group(n= 51)and immediate fluid resuscitation group(n=47).Patients in delayed fluid resuscitation group were given with balanced salt solution for the body to maintain basic requirements.Patients in immediate fluid resuscitation group were rapidly administered with a lot of isotonic crystaUoid and(or)colloid solution after admission. Hemoglobin,platelet count,hematocrit,blood lactic acid,basedeficit,preoperative resuscitation time and mortality were compared between the two groups.Paired t test and variance analysis or x~2 test were used.Results The transfusion fluid volume of delayed group and immediate group was(1586?346)ml,(3520?575)ml, respectively,with P value
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Objective To investigate whether intestinal bacterial translocation in scalded rat with delayed fluid resuscitation (DFR) was partly due to the reduction of the expression of rat defensin (RD), which was the most important defensin in rat intestinal defensin family excreted by Paneth cells. Methods Fifty-six SPF rats were randomized to 3 groups: sham injury group (n=8); early resuscitation (ER) group (n=24), receiving fluid resuscitation immediately after scald (30% TBSA, third degree); delayed resuscitation group (n=24), receiving fluid resuscitation 6 hours after scald. The animals (n=6, at each time point) were sacrificed at 8, 24, 72 hours after injury. The expression of RD-5 in the terminal ileum was determined with PCR technic. Morphological changes in ileal Paneth cells were observed. Quantitative bacterial cultures of mesenteric lymph nodes (MLN), liver, spleen and lung were also done. Results In both ER group and DR group, ileal RD-5 mRNA expression level was significantly increased at 8 hours after injury, and it began to decrease at 24 hours until the end of the experiment, when the level was much lower than that of the sham group. When two experimental groups were compared, RD-5 mRNA expression level was significantly higher at 8 hours and significantly lower at 72 hours in DR group than in ER group. There were no obvious morphological changes in ileal Paneth cells in all 3 groups. Although high incidence of bacterial translocation was observed in both experimental groups, it was significantly higher in DR group than in ER group. Conclusions DFR did not cause Panth cell damage, and RD-5 changes did not contribute to bacterial translocation in 24 hours after DFR, as the increase in RD-5 mRNA might be an innate protective reaction. However, the decrease in RD-5 production at 72 hours may play a role in bacterial transloca- tion.
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Objectives:To investigate nutritional support in severely burned patients with delayed fluid resuscitation. Methods:From January 1990 through December 2000,62 cases with delayed fluid resuscitation were admitted to our burn department and were divided by different periods into two groups:group N(1990-1994,n=26) and group A(1995-2000,n=36).Group A was treated with recombinant human growth hormone(rhGH),early enteral feeding(EEF) and glutamine(Gln). Plasma albumin,pre-albumin,insulin,blood glucose and urine glucose levels were measured and lymphocyte was counted immediately after hospitalization and postburn day(PBD) 1,3,7,14,21,28. Results:①The survival rate in group A was very significantly higher than in group N.The complication in group A was significantly lower than in group N.②The time of wound healing in group A was shorter than in group N.③Plasma albumin,pre-albumin levels and lymphocyte count were decreased in two groups and was more serious in the group N(P