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Objective To explore the impact of ischemic stroke on intestinal barrier changes in dogs.Methods Totally 20 mongrel dogs were divided into 2 groups by random number table with 10 in each.Double silicone cylinders measuring 1.1 mm in diameter and 8 mm in length were placed into their internal carotid arteries in all dogs of group A.Group B served as a control group and received sham operation.Light microscopy was performed for morphological measurement of intestinal epithelial cell.Immunohistochemistry was used to analysis the changes of protein zonula occludens-1(ZO-1)localizing at tight junction of intestinal epithelial cells.Results Ischemic stroke was confirmed by cranial CT scanning in all dogs of group A.Compared with the test results in group B,the occludin and Zo-1 protein levels in group A were significantly lower than those in group B(occludin:0.20 ±0.01 vs 0.22 ±0.01,P =0.007; ZO-1:0.20 ±0.01 vs 0.22 ±0.02,P =0.008).The apoptotic index in group A was significantly higher than in group B(29.04 ± 3.79 vs 6.44 ± 1.24,P =0.002).There was a positive correlation between occludin and ZO-1(R =0.71,P =0.02),and the apoptotic index was negatively correlated with levels of occludin,ZO-1(R =-0.91,P =0.00; R =-0.77,P =0.01).Light microscopy showed that the dogs in group A had intestinal mucousal injuries while no obvious change was detected in group B.Conclusions Dogs with ischemic stroke tend to develop intestinal barrier dysfunction,during which the destruction of tight junction plays a key role.The up-regulated apoptosis of intestinal epithelial cell constitutes one of the cellular bases of intestine injury.
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Objective To investigate clinical service delivered at the Polyclinic of Beijing 2008 Olympic and Paralympic Village and outcomes of the medical patients visited there.to provide experiences in medical care service for other mass-gatherings in the future.Methads Clinical data of all the medical patients evaluated at the Polyclinic during July 27 to August 27 and during August 29 to September 19,2008 were reviewed retrospectively.with univariate and multivariate analyses.Results In total.1537 and 1206 medical patients visited the Polyclinic at the Olympic and Paralympic Village,respectively.Proportion of athletes visited was hisher during the Paralympic Games than that during the Olympic Games(14.2% vs.9.8%,P<0.01).We reeeived 775 patients(50.4%)with acute respiratory tract disorders,including 16 cases(1.0%)with asthma,during the Olympic Games,and 686(56.9%),including eight cases (0.7%)with asthma,during the Paralympic Games,and antibiotics were prescribed for 149(9.7%)and162(13.4%)of them,respectively.Twelve(0.8%)patients were hospitalized during the Olympic Games and four(0.3%)during the Paralyrnpie Games,and age equal to or nlore than 55 years and digestive disease were independent risk factors for hospitalization,with odds ratios(ORs) of 5.3 and 9.5 and their 95% confidence intervals(Cls)of 1.4-19.6 and 2.5-36.4,respectively.Conclusions Acute respiratory disorder was the most connnon cause for medical visits in the Polyclinic.Asthma did not play a significant role to iniluence athletes'performance in the Beijing 2008 Olympic and Paralympic Games.Antibiotic prescription in the Polyclinic had been controled to an acceptable level.Conditions in elder patients and those with digestive disorder tended to be severe.deserving more attention infuture's mass gathering.
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Objective To investigate the effects of small volume resuscitation on hemodynamics and visceral perfusion in dog model of hemorrhagic shock. Methods Twenty-four dogs were hemorrhaged to hold mean arterial blood pressure at 45-55 nun Hg for 45 minutes, and then eight dogs were resuscitated with 6 ml/kg of hypertonic saline (HS group) solution and the other eight resuscitated with 6 ml/kg of hypertonic saline-hydroxyethyl starch (HSS group) solution. The rest eight dogs were set as control and resuscitated with normal saline (NS). Hemodynamics and gastrointestinal intramucosal pH (pHi) were detected after fluid resuscitation. Results (1) All three kinds of solutions could improve early hemodynamics and visceral perfusion. But 30 minutes after fluid resuscitation, the hemodynamics of dogs in HS group, HSS group and NS group began to decrease, with more obvious decrease HS group and NS group compared with HSS group. (2) pHi of three groups began to decrease 120 minutes after fluid resuscitation, but the level of arterial lactate remained unchanged. Conclusions (1) HS has the similar effect as NS in aspect of resuscitation, and HSS is better than HS and NS.(2) pHi is an ideal marker in monitoring the visceral perfusion and has higher sensitivity than arterial lactate.
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<p><b>OBJECTIVE</b>To evaluate the role of gastric mucosa apoptosis in the stress of ischemic stroke, and to discuss the relationship between gastric mucosa apoptosis and gastric barrier.</p><p><b>METHODS</b>Ten dogs were artificially made ischemic stroke by operation (IS group), and another 10 shamly-operated dogs were served as control group. Sucrose permeability were measured after the operation. All dogs were sacrificed 24 hours after operation to measure the gastric mucosal apoptosis index, gastric gross classification, and histological score.</p><p><b>RESULTS</b>The gastric mucosal apoptosis index in the IS group were significantly higher than in the control group (14.83 +/- 4.41 vs. 5.60 +/- 2.61, P < 0.05). The gastric mucosal apoptosis index were correlated with the sucrose permeability (r = 0. 89, P < 0.05) , gastric gross classification (r = 0. 87, P < 0.05), and histological score (r = 0.92, P < 0.05).</p><p><b>CONCLUSIONS</b>Although ischemic stroke will not cause the obvious damage in the respiratory and circulatory system, it is responsible for the apoptosis of epithelial cell in the gastric mucosa and gastric barrier dysfunction. The apoptosis index is closely correlated with the damage of the function and morphology of the gastric barrier, indicating that the epithelial cell apoptosis acceleration in the gastric mucosa may result in the damage of gastric barrier function.</p>
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Animais , Cães , Apoptose , Fisiologia , Células Epiteliais , Patologia , Mucosa Gástrica , Patologia , Marcação In Situ das Extremidades Cortadas , Distribuição Aleatória , Acidente Vascular Cerebral , PatologiaRESUMO
<p><b>OBJECTIVE</b>To observe the effect of small volume resuscitation by hypertonic-hyperoncotic solution on the hemodynamics and extravascular lung water of septic shock dogs.</p><p><b>METHODS</b>Lipopolysaccharide of E. coli was injected to 24 healthy dogs via femoral vein to induce septic shock. These septic shock dogs were resuscitated with hypertonic salt solutions (HS, 6 ml/kg, n = 6), 6% hydroxyethyl starch in combination with HS (HSS, 6 ml/kg, n=6), normal saline (NS, 100 ml/kg, n=6), and 6% hydroxyethyl starch solutions (HES, 33 ml/kg, n=6), respectively. The changes of hemodynamics and extravascular lung water were observed.</p><p><b>RESULTS</b>After resuscitation, all the solutions improved the hemodynamics of septic shock dogs with significant differences (P<0.05). The effects were superior in HS group and HSS group when compared with in NS group. The extravascular lung water increased in NS group, while no obvious changes were found in the other three groups.</p><p><b>CONCLUSIONS</b>All these four solutions can improve the hemodynamics of septic shock dogs. Small volume hypertonic-hyperoncotic solution has a similar effect in hemodynamics as NS, HS, and HES. Meanwhile, it does not increase the extravascular lung water.</p>
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Animais , Cães , Feminino , Masculino , Modelos Animais de Doenças , Água Extravascular Pulmonar , Hemodinâmica , Soluções Hipertônicas , Usos Terapêuticos , Lipopolissacarídeos , Toxicidade , Distribuição Aleatória , Ressuscitação , Métodos , Choque Séptico , TerapêuticaRESUMO
Objective To evaluate the reliability of transpulmonary thermodilution technique,for the quantification of extravascular lung water.Method Eighteen dogs were randomly divided into 3 groups:normal group(n=6),ALIp(acute lung injury caused by pulmonary monary origin causes)group(n=6)and a ALIexp(acute lung injury caused by extra-pulmonary origin causes)(n=6).ALI_(exp)model was prepared by intravenous injection of injection of oleie acid.ALI_p model was made by inhalation of detergent.Extravascular lung water(EVLW)was measured by PiCCO monitor(PULSION,Germany)before and immediately after the intratracheal introduction of normal saline into the alveoh of lungs of normal and ALI dogs.Results The EVLW of the normal group was(254.5?13.0)mL.The volume of the normal between pre-and postinstillation(?EVLW) was approximate to the volume of normal saline instilled with a good correlation(r=0.986,P
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Objective To evaluate the feacibility of microalbumin(MA),alpha-1 -raicroglobulin (?1-MG) ,N-acetyl-beta-D-glucosaminidase (NAG), retinol-binding protein (RBP)as predictors of outcome in critically ill patients. Methods A prospective study was underwent in 30 critically ill patients.Urinary samples were collected at ICU admission and on the third,seventh ICU day for MA,?1-MG,NAG,RBP measurement.The severity of illness was assessed by APACHE II score calculated on the first ICU day,and the degree of organ dysfunction was assessed using SOFA score calculated on the first,third,seventh ICU day. Results MA,?1-MG,the durations of ICU stay and mechanical ventilation,APACHE II score, SOFA score were relative factors of MODS and death in ICU. There was significant association of APACHE II with MA (r=0.397),?1-MG (r=0.448), and RBP (r= 0.465), respectively. The area under ROC curve of APACHE II score,SOFA score,MA,?1-MG, RBP,NAG to predicate the death in ICU were 0.875 ( P
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Objective:To evaluate the physiologic work of breathing (WOBphy)as parameter of respiratory weaning and extubation. Method: Patient work of breathing (WOBt) and imposed work of breathing (WOBimp) were measured. WOBphy was obtained with WOBt minuting WOBimp. In the patients who did not meet conventional respiratory weaning parameters ,if WOBphy