Study the cardiac dysfunctions and its diagnoses after chest impact trauma / 中华胸心血管外科杂志

Objective To explore the changed rules and the diagnositic methods of the cardisc functions after chest impact trauma(CIT).Methods The medals of moderate to severity CIT were established using BIM-Ⅱ Bio-impactor in 20 rabbits.The cardiac functions were examined with cardiac catheterization,single photon-emission computed tomography(SPECT)and the Doppler echocardiography at pre end post 1h,4h,8h and 24h after CIT.Results The cardiac functions were changed significantly after CIT.The expressions of the right ventricular dysfunctions mainly were systolic dysfuction while the left ventricular dysfunctions mainly were diastolic dysfunction after CIT.Conclustion All the cardiac catheterization、SPECT and the Doppler echocardiography are beneficial to the diagnosis of cardiac dysfunction afte CIT.The SPEGT is more exactitude and the Doppler echocardiography is more cheaper compared with non-invasive approaches.

Epidemiological analysis and thinking on infections in the 533 trauma patients following Chinese Wenchuan earthquake / 中华创伤杂志

Objective To provide better emergency and patient services in well-equipped comprehensive hospitals, the organization and wisdom therapeutic strategy are of great importance for the recovery of injured patients from the earthquake zone. Method From 12 May 2008, following the 8.0 Magnitude earthquake in Wenchuan county of Sichuan Province, six Chongqing hospitals with third class in grade A were involved in the rescue of the injured patients with great effort. A total of 533 patients were retreated and followed up from quake zone. All the patients were scored with ISS and AIS system. The profiles of the patients examined, operated and clinical infection investigation were documented. Results Of 533 patients, the number of the patients whose ISS is below 16 is 456 (83.6%), the number between 16 and 25 is 65 (12.2%), and the humor above 25 is 12 (2.3%). The patients were classfled based on their fracture parts as follows: head and neck (n = 42), face (n = 7), chest (n = 114), abdominal and cavitas pelvis (n =81), limb and pelvis (n =314), body surface (n =205), with 180 single fracture site, 139 of them being two combined fracture sites, and 114 of them being above three combined fracture sites. Thirty-two of the patients were suffered from amputation. The number of patients suffered from crushing syndrome reached 21, with 281 surgical operations in hospitals. Seventy-nine patients were suffered from infections including 87.3% of pre-hespital infections. The results from bacteria culture and antibiotic susceptibility showed that the infected bacteria mainly involved in Escherichia coli, Staphylococcus anreus, Staphylococcus haemolyticns, Klebsiella pneumoniae, Baumanii, Aerobacter cloacae, Pseudomonas aeruginosa, C type chain coccus, Bacillus aerogenes capsulatus. The antibiotic susceptibility to diverse bacteria has no obvious changes and exists partial overlapping, and infected patients should be given the treatment of cephalosporin, macrolide antibiotic and so on. Conclusions For the emergency conditions after the catastrophe, the comprehensive hospitals must be prepared to meet large quantities of severe trauma and infection therapy. The scientific selection of antibiotics in the combinative therapy is of great importance to the enhancement of early specific treatment, prevention of severe trauma complications and rehabilitation of patients.

Preparation of vector of zinc finger protein A20 gene silence and its preliminary application / 中华创伤杂志

Objective To design and prepare an RNA interfering vector for effectively inhibiting the cellular expression of zinc finger protein A20 and observe the effect of A20 gene silence on cellular inflammatory response. Methods Specific RNA interfering oligonucleotide fragments (ASRF) were designed and synthesized artificially and the A20 RNA interfering vector pSUPER-EGFP-A20 siRNA constructed. Human monocyte cell line THP1 was used to infect the pSUPER-EGFP-A20 siRNA by means of genetic transfection technique; then, silence rate of cellular A20 was analyzed by real-time polymerase chain reaction (PCR). In the meantime, the activity of nuclear transcription factor nuclear factor-κB (NF-κB) and the level of tumor necrosis factor-α (TNF-α) in culture supernatant were measured by ELISA. Results Of two specific inhibitory oligonueleotide fragments of A20, the fragment M59465-385R/F had a higher inhibition to A20 expression, with rate of A20 gene silence of 83.86%. Preliminary application showed that after A20 gene silence, the activity of NF-κB was increased by 78.13% and the level of TNF-α in cell culture supernatant was increased by 49.30%. Conclusions Vector of A20gene silence with a high efficiency is obtained successfully. Preliminary application indicates that the expression of A20 can down-regulate the degree of cellular inflammatory responses.

The relationship between left ventricular functions and calcium station alterations after blunt chest trauma / 中国医师杂志

Objective To explore the changes and the significance of left ventricular functions after blunt chest trauma(BCT)in rabbits.Methods 36 rabbit models of BCT with BIM-Ⅱ Bio-impactor in were used to observe the changes of left ventricular functions and free calcium,free calmodulin and total calmodulin were detected at pre-injury,the 2nd,4th,8th,12th and 24th hour after injury.Results The cardiac function were impaired.The systolic functions of left ventricle were impaired and recovered during 4-12 hour after BCT.The diastolic functions of left ventricle were impaired but not recovered 24h after BCT.The free calcium and total calmodulin in myocardial cells were increased from the 4th hour,reached,peak at the 8th hour post-BCT(P＜0.01),and then decreased,but were still higher at the 24th hour post-BCT than that of pre-BCT(P＜0.05).The free calmodulin in myocardial cells was low and reached peak at the 8th hour after BCT(P＜0.01).There is remarkable positive correlation between free calcium in myocardial cells and LVEDP and dp/dtmax with cardiac function(P＜0.05,P＜0.01).Conclusion The cardiac function is obviously changed after BCT,especially the diastolic functions of left ventricle.The hish concentration of free calcium in myocardial ceils may be one of the reasons of cardiac dysfunction after BCT.

Quantitative study of cochlear hair cells injuries in guinea pigs exposed to blast underpressure / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the characteristics of cochlear hair cell injuries in guinea pigs exposed to blast underpressure(BUP). METHODS The guinea pigs were killed 14 days after exposure to experimental BUP. Their basilar membranes were stained by silver nitrate and the hair cell injuries were quantitatively assessed using the light microscope. RESULTS The outer hair cells(OHCs) of the guinea pigs clearly appeared to be injured following exposure to the experimental BUP at a peak underpressure varying between -22.4kPa and -63.3kPa. The most obvious injury was in the second turn and OHC loss was smallest in the first row and more severe in the second and third rows. OHC loss was seen in all of three experimental groups of animals following exposure to BUP. Furthermore, the higher the peak of underpressure, the more obvious the injury of OHCs. Quantitative morphological analysis of cochlear hair cells showed that the total OHC loss rates in all the experimental groups of guinea pigs exposed to BUP were significantly higher than that of control group animals(P

Regulative effect of corticotropin-releasing hormone on the concentration of cytoplasmic cyclic adenosine monophosphate and Ca2+in hypothalamic neuron / 中国组织工程研究

BACKGROUND: The activation of hypothalamus-pituitary-adrenal cortex axis may play key role in the increasing expression of hypothalamic corticotropin-re-leasing hormone (CRH) during stress reaction. However by what way to induce the CRH expression in hypothalamic neuron, and whether CRH can activate hypothalamic neurons are still not very clear.OBJECTIVE: To observe the changes of intracellular cyclic adenosine monophosphate (cAMP) and cytoplasmic Ca2+ concentration in the hypothalamic neurons cultured in vitro due to exogenous CRH stimulation.DESIGN: Comparative observation experiment.SETTING: Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA; Department of Neurosurgery , Tiantan Hospital, Capital University of Medical Sciences MATERIALS: This experiment was carried out in the Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA between December 1999 and March 2002. Hypothalamus was obtained from fetus rat at pregnancy of 17 days for the in vitro culture of hypothalamic neurons.METHODS: Hypothalamic neurons were co-cultured with exogenous CRH,with or without pretreatment with specific CRH 1 receptor antagonist -CP-154526. hypothalamic neurons were randomized into: ① CRH (10-12,10-10, 10-8, 10-6 mol/L) stimulation group. ② CP-154526(500 μmol/L)pretreatment aud CRH ( 10-12, 10-10, 10-8,10-6 mol/L) stimulation group. ③Hypothalamic neurons in corresponding normal control group were exposed to the isotonic saline stimulation. PTI fluorescence image system was used to determine and analyze the change of cytoplasmic free Ca2+ concentration in hypothalamic neurons due to exogenous CRH stimulation and RIA was used to detect the neuronal cAMP content.MAIN OUTCOME MEASURES: ①Cytoplasmic free Ca2+ concentration in hypothalamic neurons. ②cAMP content in hypothalamic neurons.RESULTS: The cytoplasmic free Ca2+ concentration and cAMP content were relatively lower in the hypothalamic neurons in normal control group,which obviously increased due to CRH stimulation [(240±22),(153±11)nmol/L; (3.26±0.19),(0.44±0.02) pmol/dish,P ＜ 0.01];CP-154526 could remarkably suppress the CRH (10-6 mol/L)induced increase in cytoplasmic free Ca2+ concentration and cAMP content in hypothalamic neurons [Ca2+ concentration: (240±22),(171±16)nmol/L; cAMP content:(3.26±0.19), (2.33±0.21) pmol/dish, P ＜ 0.01].CONCLUSION: CRH can directly act on hypothalamic neurons via type 1-receptor,thereby increase the cytoplasmic free Ca2+ concentration and cAMP content in hypothalamic neurons,playing the key role in the modulation of the synthesis and secretion of CRH during the activation of hypothalamic neurons.

Correlation of the expressions of scavenger receptor and CD14 in murine alveolar macrophages with lung injury / 中国组织工程研究

BACKGROUND: There exists a close relationship between the expression of scavenger receptor(SR) and CD14 and the endotoxic lung injury. To further detect the expression of these two receptors and their relationship is helpful to disclose the receptor mechanism of lung inflammatory disequilibrium so as to provide a possible theoretical foundation for sepsis therapy.OBJECTIVE: To investigate the expression of CD14 and SR in murine alveolar macrophages and their effect after trauma and traumatic endotoxin challenge.DESIGN: Randomized and controlled experimental study.SETTING: Fourth Laboratory(a state key laboratory), Trauma, Burns and Combined Injury, the Research Institute of Field Surgery, Daping Hospital,the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was completed in the Research Institute of Field Surgery of Daping Hospital of the Third Military Medical University of Chinese PLA from August 2001 to November 2001. Totally 63 Kunming mice with murine alveolar macrophages were used in the experiment.METHODS: The experimental animals were randomly divided into three groups including control group, trauma group and traumatic endotoxin challenge group. The model mice with both femur fracture and endotoxin challenge were used. Endotoxin at a dose of 5 mg/kg was injected one hour after fracture via tail vein and the dynamic expression of CD14 and SR in murine alveolar macrophages (AM) was detected.RESULTS: Six hours after trauma, the expression of CD14 and that of SR in AM showed the tendency of up-regulation and down-regulation respectively. Furthermore, the post-traumatic endotoxin challenge induced CD14up-regulation and SR down-regulation drastically. Correlation analysis indicated that CD14 and SR showed a significantly negative relationship.CONCLUSION: The study suggested that the dual modulation of CD14 and SR in AM is possibly related with the change of "self-control" to "out of control" of inflammatory reactions in the lungs after endotoxic challenge. The dual regulation of the effective antagonists CD14 and SR are helpful in further understanding lung injury and its repairing mechanism.

Regulatory effects of corticotropin release hormone on hypothalamic neuronal calcium signals and CREB / 中国组织工程研究

BACKGROUND: Through what signal pathway does corticotropin release hormone (CRH) regulate hypothalamic neuronal neuroendocrine activity during acute stress?OBJECTIVE: To probe into the regulatory effects of CRH on CREB secretion in hypothalamic neurons.DESIGN: Repetitive measurement design.SETTING: At Field Surgery Research Institute of Daping Hospital, Third Military Medical University of Chinese PLA; Neurosurgery Department,Tiantan Hospital Affiliated to the Capital University of Medical Sciences.MATERIALS: This experiment was carried out in Daping Hospital of Third Military Medical University of Chinese PLA between December 1999and March 2002. Rat fetuses were selected from Wister rats of 17-day gestation.METHODS: In vitro cultured cells were divided into the following groups:① CRH (10-12, 10-10, 10-8 and 10-6 mol/L) stimulation groups. ② Pretreated with nimodipine (5 μmol/L) or CP-154526 (500 μmol/L) followed by CRH (10-12, 10-10, 10-8 and 10-6 mol/L ) stimulation groups. ③ Corresponding control groups stimulated with isotonic physiological saline. PTI fluorescence imaging system was used to detect the changes of neuronal cytoplasmic free calcium concentration; meanwhile, Western blot technique was used to determine the changes of neuronal P-CREB content.MAIN OUTCOME MEASURES: ① Changes of neuronal cytoplasmic free calcium concentration. ② Changes of neuronal P-CREB content.RESULTS: The content of cytoplasmic free calcium in hypothalamic neurons was lower in normal control group, and it increased immediately after exogenous CRH stimulation. However, such increase could be suppressed by pretreatment with nimodipine or CP-154526 before CRH stimulation,and the increase of neuronal P-CREB content was also obviously suppressed.CONCLUSION: During acute stress, the combination of CRH with hypothalamic neuronal CRH 1 receptor leads to the opening of membrane Ltype calcium ions channels, thus enhancing the influx of calcium ions and increasing cytoplasmic free calcium ions content, which would further activate P-CREB signal transduction pathway in neurons. It suggests that CRH may play a vital role in hypothalamic neuronal activation.

Effects of subconvulsive electrical stimulation to the hippocampus on emotionality and spatial learning and memory in rats / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To observe the effects of repeated subconvulsive electrical stimuli to the hippocampus on the emotional behavior and spatial learning and memory ability in rats.</p><p><b>METHODS</b>One hundred and eight male Wistar rats were randomized into 3 groups. Animals in group SE (n = 42) were given subconvulsive electrical stimulation to the hippocampus through a constant pulsating current of 100 mu A with an intratrain frequency of 25 Hz, pulse duration of 1 millisecond, train duration of 10 seconds and interstimulus interval of 7 minutes, 8 times a day, for 5 days. In the electrode control group or CE group (n = 33), animals were implanted with an electrode in the hippocampus, but were not stimulated. Group NC (n = 33) animals received no electrode or any stimulation. The emotional behavior of experimental rats was examined by activity in an unfamiliar open field and resistance to capture from the open field, while the spatial learning and memory ability was measured during training in a Morris water maze.</p><p><b>RESULTS</b>The stimulated rats tested 1 month after the last round of stimulation displayed substantial decreases in open field activity (scale: 10.4 +/- 2.3, P < 0.05) and increases in resistance to capture (scale: 2.85 +/- 0.56, P < 0.01). The amount of time for rats in group SE to find the platform (latency) as a measurement for spatial bias was prolonged (29 +/- 7) seconds after 15 trials in the water maze, P < 0.05). The experimental rats swam aimlessly in all four pool quadrants during the probe trial in the Morris water maze.</p><p><b>CONCLUSIONS</b>Following repeated subconvulsive electrical stimuli to the hippocampus, rats displayed long-lasting significant abnormalities in emotional behavior, increased anxiety and defensiveness, enhanced ease to and delayed habituation to startlement, transitory spatial learning and memory disorder, which parallels many of the symptoms in posttraumatic stress disorder patients.</p>

Effects of zinc finger protein A20 on lipopolysaccharide responses in human monocytes / 第三军医大学学报

Objective To investigate the effect of zinc finger protein A20 expression on lipopolysaccharide(LPS)response in human monocytes so as to discuss its regulation roles and mechanism to inflammation in vivo and its potential value of clinical application.Methods Cell transfection technique was respectively used to make zinc finger protein A20 transgenic cell model and gene silence cell model,both of which were then treated with LPS.Real-time reverse PCR was employed to analyze the expression of zinc finger protein A20 and ELISA to determine the activity of nuclear transcription factor NF-?B and the levels of dependent inflammatory cytokines including tumor necrosis factor(TNF)alpha.Results After LPS treatment,the NF-?B activity and the TNF-alpha level were significantly lower in the cells with overexpressed zinc finger protein A20 than LPS control cells(P

Subconvulsive electrical stimuli facilitate increased NO level and neuronal NOS expression in hippocampi of rats / 第三军医大学学报

Objective To observe the alterations of nitric oxide (NO) level and the neuronal NOS (nNOS) expression in rats with posttraumatic stress disorder (PTSD) like behavior following subconvulsive electrical stimuli. Methods After the establishment of the PTSD animal model following subconvulsive stimuli to hippocampus, the nitric oxide (NO) and NO synthase (NOS) levels and the neuronal NOS (nNOS) expression in hippocampus and frontal cortex of experimental rats were investigated by neurochemistry and Western blotting, respectively. Results The NO level in hippocampus of experimental rats with PTSD like behavior following subconvulsive stimulation increased significantly at 12 h after the last stimulation (4.65?1.22 ?mol/g protein, P

Expression of zinc finger protein A20 mRNA of mouse liver tissues after trauma with lipopolysaccharide infection / 中华创伤杂志

Objective To study the expression law of zinc finger protein A20 mRNA of mouse liver tissues in the process of trauma with lipopolysaccharide (LPS) infection. Methods A total of 95 healthy mice (either sex, from Kunming, Yunnan province) with a mean body weight of 21 g (18-24 g) were randomized into 4 groups: control, trauma only (Group A), LPS only (Group B) and trauma plus LPS (Group C). The models with closed fracture of bilateral spines as well as endotoximia were made. The expression characteristics of zinc finger protein A20 mRNA of liver tissues were measured by reverse transcription-polymerase chain reaction (RT-PCR) and all result data expressed as total gray ratio of A20 mRNA to GAPDH mRNA (?s). Results In the control group, the A20 mRNA expressed at a low level. There was low expression of zinc finger protein A20 in the Group A at various time points, with no significant difference compared with the control group. After LPS infection, the expression of A20 mRNA in the Group B was elevated more obviously than that in the control group at 0.5 hour, reached peak during 0.5-2 hours and decreased after 2 hours. But expression of A20 mRNA at each time point was higher in the Group B than that in the Group A. In the Group C, after LPS infection, the expression of A20 mRNA was elevated more significantly than that in other two groups 0.5 hour, reached the highest level during 0.5-2 hours, much higher than that in the Group B (P

Regulative effects of high dose of glucocorticoid on protein expression and mRNA transcription of corticotropin-releasing hormone in paraventricular hypothalamic nucleus / 中华创伤杂志

Objective To observe the regulative effect of high dose of glucocorticoid (GC) on protein synthesis and mRNA transcription of corticotropin-releasing hormone (CRH) in paraventricular hypothalamic nucleus (PVN) so to ascertain whether there exists difference upon effect of GC either at high dose or at normal dose. Methods A total of 60 Wistar rats were divided into five groups, ie, blank control group, 10 -6 mol/L dexamethasone (DEX) group, 10 -9 mol/L DEX group, 9 g/L saline group and group that was treated with 10 -4 mol/L RU486 first and then with 10 -6 mol/L DEX. The drugs were given through femoral vein. CRH protein expression was measured by means of immunohistochemistry and laser confocal scanning microscophy (LCSM); CRH mRNA transcription level was investigated by in situ hybridization. Results There appeared positive CRH mRNA granules in cytoplasm of PVN after administration with 10 -6 mol/L DEX for 20 minutes but could be seen positive fluorescent granules of CRH protein 30 minutes later, which was reversed at an in advance blockage of GR, as was free in 10 -9 mol/L DEX group, 9 g/L saline group and blank control group. Conclusions High dose of GC can up regulate CRH gene expression in PVN and differs much from the traditional effect of GC at normal dose, as may be due to that high dose of GC exerts effects depending on membrane glucocorticoid receptor but normal dose of GC dose via iGR.

Pathomorphological changes after liver impact injury in rabbits / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the histopathological changes in the liver and other organs after impact injury.</p><p><b>METHODS</b>The rabbits were impacted with a BIM-IV biological impacting machine at the xiphoid process. The severity of liver injury was graded and scored through gross anatomy. At the same time, the pathological changes in the liver, heart, and lung were observed by light and electron microscopes.</p><p><b>RESULTS</b>Light microscopy showed that the pathological changes in the liver were: 1) loss of normal structure, hemorrhage and distortion of hepatic lobules; 2) cloudy swelling, degeneration, vacuolation and necrosis of liver cells; 3) infiltration of neutrophils. The lungs were injured and there were liver cell emboli in the small pulmonary arteries. Electron microscopy showed that the ultrastructure of the liver cells was severely damaged and the cells had significant features of necrosis.</p><p><b>CONCLUSIONS</b>The major pathomorphological changes in the liver after impact injury are hemorrhage and necrosis. They may be complicated by exfoliation of liver cells to hepatic sinusoids. These cells circulate with the blood to form emboli in the pulmonary blood vessels.</p>

Early changes and rules of cardiac function and hemodynamics in rabbits with experimental myocardial contusion / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study changes and rules of the left ventricular functions in rabbits with myocardial contusion through parallel functional analysis by using echocardiography combined with cardiac catheter intervention.</p><p><b>METHODS</b>Thirty healthy rabbits were selected and impacted to make moderate or severe myocardial contusion by BIM-II biomedical impact machine. The changes of hemodynamics and cardiac systolic and diastolic functions were respectively observed before injury and 1, 4, 8 and 24 hours after injury.</p><p><b>RESULTS</b>After myocardial contusion, the heart rate, systolic pressure, diastolic pressure and mean arterial pressure of rabbits decreased remarkably at 1-4 hours. The left ventricular end systolic pressure (LVESP), the maximum increasing rate of the left intraventricular pressure (+dp/dtmax), isovolumic pressure (IP) and the maximum systolic velocity of the left ventricle (Vmax) also decreased markedly. And then these parameters recovered to the level of preinjury at 8-24 hours. The left ventricular end-diastolic pressure (LVEDP), the rate of the left intraventricular pressure (-dp/dtmax) and the decreasing time constant of the left intraventricular pressure (T) increased remarkably 1 hour after myocardial contusion, and did not decrease until 8 hours after myocardial contusion. Detection by echocardiography showed that ejection fraction of the left ventricle markedly decreased at 24 hours after myocardial contusion, while the systolic volume decreased obviously as early as 1 hour after myocardial contusion, at 4-8 hours it recovered a little and again decreased at 24 hours. The end systolic volume and end diastolic volume increased after myocardial contusion, but statistical significance was only seen at 8 hours after myocardial contusion.</p><p><b>CONCLUSIONS</b>Cardiac functions of the left and right ventricles are markedly injured after myocardial contusion with disorders of the left ventricle diastolic function and of the right ventricle systolic function as the dominant injury. While the systolic function of the left ventricle can recover. Echocardiography shows clinical importance in detection of early injuries of cardiac functions.</p>

Effect of hypertonic saline solution on the left ventricular functions of isolated hearts from burned rats / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the effect of hypertonic saline solution on the left ventricular functions of isolated hearts from burned rats.</p><p><b>METHODS</b>Thirty-six Wistar rats were used and divided into 4 groups: (1) normal hearts perfused with isotonic Krebs-Henseleit solution; (2) normal hearts perfused with Krebs-Henseleit solution which contained 215 mmol/L Na+; (3) hearts of rats suffered from 25% TBSA third degree burn and perfused with isotonic Krebs-Henseleit solution; (4) hearts of the burned rats perfused with Krebs-Henseleit solution which contained 215 mmol/L Na+. The systolic and diastolic functions of the left ventricle were observed.</p><p><b>RESULTS</b>During perfusion, there were very short periods of decrease in heart systolic and diastolic functions at first, but they recovered very soon and even became stronger than normal both in the normal and burned rats. The systolic and diastolic functions of the hearts increased very significantly when the perfusion solution was changed to isotonic solution from the hypertonic solutions. The effect of the hypertonic saline solution on the ventricular systolic and diastolic improvements was stronger in the hearts of the burned rats than that in the normal hearts.</p><p><b>CONCLUSIONS</b>Hypertonic saline solution can directly affect myocardium and significantly improve the ventricular systolic and diastolic functions, especially in the hearts of the burned rats.</p>

Lipopolysaccharide upregulates the expression of Toll-like receptor 4 in human vascular endothelial cells / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the expression of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) and the effect of lipopolysaccharide (LPS) on their expression in cultured endothelial cells.</p><p><b>METHODS</b>Total RNA was extracted from ECV304 cells and isolated human umbilical vein endothelial cells (HUVECs) exposed to LPS, respectively. The quantification of TLR2 and TLR4 mRNA in HUVECs and EVC304 cells was carried out by reverse transcriptase-polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>ECV304 cells and HUVECs were able to express TLR2 and TLR4 mRNA, but the expression levels of TLR4 appeared to be stronger than those of TLR2. LPS could upregulate the expression levels of TLR4 obviously, whereas it had no effect on the expression level of TLR2.</p><p><b>CONCLUSIONS</b>Our data indicate that TLR4 may be the LPS signal transducer in endothelial cells and plays important roles in the cell activation of LPS. The ECV304 cell line is a better experimental model than isolated HUVECs in the research of endothelial cells.</p>

Pathological observation of the dog lungs after underwater blast injury / 第三军医大学学报

Objective To explore pathological changes of the dog lungs after underwater blast injury. Methods Lungs from 37 adult dogs were taken after different underwater blast explosions, and observed with gross examination, light microscopy (LM) and electron microscopy (EM). Results Pulmonary hemorrhage and edema were the main morphological changes. Under LM the alveolus space was seen to be filled with edematous fluid and bloody components. Part of alveolus walls were ruptured and fused into bigger cavities while under EM the mitochondria of alveolar epithelium were vacuolated and some of the capillary predominant endothelium were broken. Hemorrhage was the pathological feature of intestinal tract. Conclusion Severe pulmonary hemorrhage and edema may be the main cause of early death of dogs with underwater blast injury.

Changes of lung microvascular permeability in blunt chest trauma, endotoxemia and their combined injury in rats / 第三军医大学学报

Objective　To observe the changes of the microvascular permeability after blunt chest trauma (BCT), endotoxemia and their combined injury in rats. Methods　After the establishment of the rat models of BCT, endotoxemia and their combined injury in the right lungs, the fluorescein sodium (FINa) content was measured with flurospectrophotometer in lungs 0.5, 1, 4 and 8 h after injury. Results　There was an early obvious increase of the microvascular permeability in the impact lateral (peak at half an hour after injury), and a delayed increase in the contralateral lung (peak at the 8th h) in the BCT group. The FINa content was higher in endotoxemia group than in the BCT group(P<0.05), and lower than that in the combined injury group(P<0.05) in the contralateral lung. Conclusion　Results indicate that there were different pathophysiologic processes among the 3 kinds of injury and the FINa content is a useful index to manifest the changes of microvascular permeability in tissues.

THE EFFECT OF GASTROINTESTINAL TRACT ISCHEMIA ON THE DEVELOPMENT OF MULTIPLE ORGAN DYSFUNCTION SYNDROME / 中国普外基础与临床杂志

Objective　To make clear the effect of gastrointestinal tract ischemia on multiple organ dysfunction syndrome (MODS). Methods　The literature in the recent years was reviewed. Results　The low-flow states of gastrointestinal tract and decrease of gastrointestinal intramucosal pH, which occured following a variety of insults (sever trauma, hemorrhagic shock, et al), as well as overgrowth of enterobacteria, may result in a significant increase of permeability of bowel and lead to endotoxemia and bacterial translocation. Ischemia also resulted in release of TNF, IL-6 into the systemic circulation, dysfunction of gastrointestinal tract motility, and activation of neutrophile which was integral in local and distant organ damage. Conclusion　These data suggest that the management of correct ischemia of gastrointestinal tract, which include fluid infusion to replacement of blood volume, early enteral nutrition, improvement of gastrointestinal movement, could contribute to improve the intestinal barrier function, and prevent the development of MODS.