Variations of p38 MAPK and sICAM-1 with therapeutic effect of different resuscitation fluids on severe traumatic patients / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the dynamic variation and action mechanism of sICAM-1 and p38 mitogen-activated protein kinases (MAPK) signal transduction in human severe trauma and resuscitation, as well as the effect of lactated Ringer's solution(LR), 7.5% sodium chloride solution(HS) and 20% albumin injection(ALB) on the incidence and mortality of multiple organ dysfunction syndrome (MODS).</p><p><b>METHODS</b>Seventy-two severe trauma patients (ISS score 16-43) were divided into ISS < or = 25 and ISS > 25 groups (each group was subdivided into LR, HS and ALB groups). ELISA was used to measure the concentration of sICAM-1. Western blot was used to measure the expression of p38 MAPK.</p><p><b>RESULTS</b>Compared with LR group, the transfusion volume needed for maintaining systolic blood pressure > or = 90 mm Hg was significantly decreased in HS and ALB groups (P < 0.05). Compared with the control group, the concentration of blood sICAM-1 and the expression of p38 MAPK was elevated from 4 to 48 hours after trauma in all experimental groups (P < 0.05-0.01). At 4, 12, and 24 hours, there was significant correlation between the expression of p38 MAPK and sICAM-1 (P < 0.01). Compared with LR group, sICAM-1 and p38 MAPK in HS and ALB groups were decreased (P < 0.05). sICAM-1 and p38 MAPK were significantly higher in the group of ISS > 25 than that of ISS < or = 25 (P < 0.05). MODS incidence and mortality were significantly higher in the group of ISS > 25 than that of ISS < or = 25 (P < 0.05). MODS incidence and mortality were lower in HS and ALB groups than LR group (P < 0.05).</p><p><b>CONCLUSIONS</b>The up-regulation of polymorphonuclear neutrophil-endotheliocytes (PMN-EC) adhesion may be due to the increased sICAM-1 expression during severe trauma. The up-regulation of sICAM-1 expression is correlated with the activation of p38 MAPK. During severe trauma, the levels of sICAM-1 and p38 MAPK, as well as the incidence and mortality of MODS are lower when HS and ALB are used than single lactated LR solution is used.</p>

Application and estimation of subjective criterion for judging immune status of recurrent aphthous ulceration patients / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To adopt a criterion summarized in long-term practice to judge the immune status of recurrent aphthous ulceration (RAU) patients, and to analyze its rationality and feasibility.</p><p><b>METHODS</b>60 cases were included, whose clinical information, such as age, sex, constitution status, history of system diseases and severity of ulceration were collected. The subjective judgement results of the immune status were obtained according to the criterion summarized in clinical practice. At the same time, peripheral blood parameters about immune function were examined in order to obtain the objective examination results of the immune status. With the examination result as the gold standard, the rationality of the criterion was estimated through its sensitivity and specificity.</p><p><b>RESULTS</b>According to subjective judgment, there were 86.67% cases with abnormal immune status (28.33% cases with elevated immune status, and 58.33% cases with reduced immune status). According to objective examination, there were 93.33% cases with abnormal immune status (23.33% cases with elevated immune status, and 70.00% cases with reduced immune status. Sensitivity and specificity were 89.29% and 50.00% when the criterion was used to judge immune abnormality, 42.86% and 76.09% when the criterion was used to judge immune elevation, and 64.29% and 55.56% when the criterion was used to judge immune reduction.</p><p><b>CONCLUSION</b>It is of some rationality and feasibility to judge the immune status according to the criterion based on clinical information, and the criterion can be used in small clinics.</p>