Effect of methylprednisolone on reperfusion injury in severe uncontrolled hemorrhagic shock / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the effect of methylprednisolone (MP) on reperfusion injury in severe uncontrolled hemorrhagic shock and explore the possible mechanism involved.</p><p><b>METHODS</b>Twelve dogs were randomly divided into two groups, control group (Group I, n=6) and MP group (Group II, n=6). The animals were bled continuously from a femoral artery catheter to produce uncontrolled hemorrhagic shock models. Resuscitation with lactated Ringer's (LR) solution was initiated when mean arterial pressure (MAP) decreased to 20 mm Hg, and MAP was maintained at 30-40 mm Hg. MP (4 mg/kg) was injected intravenously in Group II when resuscitation began. While in Group I, normal saline (NS) was injected instead. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were measured before exsanguination (T(1)), when MAP decreased to 20 mm Hg (T(2)), 60 min (T(3)) and 120 min (T(4)) after resuscitation. Heart rate, MAP and cardiac output (CO) levels were recorded concomitantly.</p><p><b>RESULTS</b>Infusion volume and hemorrhage volume shed from the superior mesenteric artery in Group I were higher than those in Group II (P<0.01 and P<0.05). After reperfusion, blood SOD levels decreased progressively and MDA levels increased rapidly in Group I. In Group II, blood SOD levels at T(3) and T(4) decreased as compared with that at T(1) but a stepwise increase was present. At T(4), blood SOD level was significantly higher in Group II than in Group I (Plt;0.01). At T(3) and T(4), MDA levels were markedly lower in Group II than in Group I. During reperfusion, MAP was more steady in Group II than in Group I and survival rate after 120 min (at T(4)) was higher in Group II than in Group I (P<0.05).</p><p><b>CONCLUSIONS</b>MP has a protective effect on severe uncontrolled hemorrhagic shock and subsequent reperfusion injury. The mechanism mainly involves the anti-lipid peroxidation activity of MP.</p>

The therapeutic effects of radiofrequency thermocoagulation denervation mediated by digital subtraction angiography in lumbar facet joint syndrome / 中华物理医学与康复杂志

Objective To observe the therapeutic effects and assess the feasibility of radiofrequency thermo- coagulation denervation(TRD)mediated by digital subtraction angiography(DSA)for patients with lumbar facet joint syndrome(LFJS).Methods Eighty LFJS patients were randomly divided into two groups:a denervated group(groupⅠ)and a control group (groupⅡ).The lumbar facet joints of the patients in groupⅠwere treated with TRD,while those in groupⅡhad their lumbar facet joint cavities injected with the mixture of 1 mg betamethasone and 1 ml lidocaine.All patients were assessed using the Visual Analog Scale(VAS)before treatment and 30 rain,1 d, 1 w,1 m and 6 m after.Schober values were measured at 1 w,1 m and 6 m after treatment.The therapeutic effects and side effects were assessed at 6 m after treatment.Results VAS scores in groupsⅠandⅡat 30 min,1 d,1 w and 1 m after treatment were remarkably lower than before treatment.In addition,those in groupⅠ6m after treatment were also significantly lower(P＜0.01).Compared with those in the groupⅡ,VAS scores in groupⅠwere signifi- cantly decreased at 1 m and 6 m after treatment(P＜0.05 and P＜0.01,respectively).The schober values in groupⅠat 1 m and 6m were obviously increased in comparison with those in groupⅡ,while the therapeutic effects in groupⅠat 6m after treatment were better than those in groupⅡ(P＜0.01).There were no side effects,such as injuries to the nerve roots or dysfunctional dermal sensation,in either group.Conclusion TRD,mediated by DSA,has ther- apeutic effects on LFJS.Such treatment is safe,convenient,and gives long-term pain relief.