The Significant Roles of Gut-lung Microbiota in Shaping and Regulating Immunity / 中山大学学报(医学科学版)

The interaction between microbes and the human immune system has long been a focus in biomedical research. Next-generation sequencing has revealed that in addition to gut microbiota， the respiratory tract also harbors microbial communities， forming an interconnected network with the gut microbiota through immune cells and active factors. This review aims to explore how the gut and lung microbiota regulate immune responses， including their roles in local and systemic immune modulation. It also delineates the immunological connections along the gut-lung axis. Further elucidating the influence of microbes on the immune system holds important clinical significance for understanding diseases and exploring novel diagnostic and therapeutic strategies.

Evaluation of brain injury after cardiopulmonary resuscitation onby T2W images texture analysis: A preliminary study / 中华急诊医学杂志

Objective:To evaluate the feasibility of brain injury after cardiopulmonary resuscitation (CPR) in rats based on T2WI image texture analysis.Methods:Eighteen SD rats were randomly divided into the sham group ( n=8) and model group ( n=10). The rats in the model group underwent MRI scanning at 6 h after return of spontaneous circulation (ROSC), and the rats in the sham group received MRI scanning at 6 h after the operation. The differences in the texture features of T2WI images and the expressions of AQP4 and NSE between the two groups were analyzed. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of statistically different texture features between the two groups for brain injury. The associations between texture features and AQP4 and NSE expressions in the sham group and model group were analyzed using Spearman correlation coefficients. Results:The minimum intensity, standard deviation, and inverse difference moment of the whole brain T2WI texture features of the model group were significantly lower than those of the sham group ( P<0.05), while the difference entropy and characteristics of high gray in homogeneity were significantly higher than those of the sham group ( P<0.05). The difference entropy was the best with an area under curve (AUC) of 0.922, a sensitivity of 100% and a specificity of 75%. The AQP4 and NSE expressions in the model group were significantly higher than those in the sham group ( P<0.05). The minimum intensity value was positively correlated with AQP4 and NSE expressions ( r=0.501, 0.568, P=0.048, 0.022). The standard deviation was positively correlated with AQP4 and NSE expressions ( r=0.620, 0.530, P=0.010, 0.035). The difference entropy was negatively correlated with AQP4 expression ( r=-0.535, P=0.033). Conclusions:Texture analysis on T2WI images can evaluate the degree of brain edema and neuronal damage. The minimum intensity, standard deviation, and difference entropy are sensitive indicators to evaluate brain injury after CPR, and difference entropy has the highest sensitivity and specificity.

The effect of thrombolytic therapy and TOAST and OCSP classification on the short-term prognosis of patients with acute ischemic stroke / 中华急诊医学杂志

Objective:To investigate the short-term prognosis of patients with acute ischemic stroke after thrombolysis with alteplase and the relationship between TOAST and OCSP classification and prognosis of patients with acute ischemic stroke.Methods:A retrospective analysis was conducted in 193 patients with acute ischemic stroke in the Emergency Department of our hospital from January 2019 to June 2020, including 158 males and 85 females, aged 69.46±13.02 years. Among them, 66 patients were treated with alteplase thrombolysis and 127 patients were not treated with thrombolysis. The short-term prognosis of thrombolytic patients and non-thrombolytic patients were compared; the influence of TOAST classification and OCSP classification on the prognosis of acute ischemic stroke was analyzed.Results:There was no significant difference in the length of hospital stay between the thrombolytic group and the non-thrombolytic group ( P>0.05), while the improvement rate of NIHSS score, GCS score, and mRS score were significantly different at admission and discharge ( P<0.05). According to TOAST classification, 78 cases (40.41%) were LAA, 100 cases (51.81%) were SAO, 9 cases (4.66%) were CE, 3 cases (1.55%) were SOE, and 3 cases (1.55%) were SUE; SAO type accounted for the highest proportion (51.81%), the improvement rate of NIHSS score at admission and discharge was significantly different from that of the LAA patients ( P<0.05), and the short-term prognosis was the best. According to OCSP classification, 39 cases (20.21%) were LACI, 64 cases (33.16%) were PACI, 55 cases (28.50%) were POCI, 35 cases (18.13%) were TACI, among which the PACI patients had the highest proportion, while the improvement rate of NIHSS score in the LACI patients was significantly different at admission and discharge compared with other types of patietns ( P<0.05), and the short-term prognosis was good. Conclusions:The short-term prognosis and symptom improvement of patients with acute ischemic stroke after alteplase thrombolytic therapy are obvious. TOAST classification and OCSP classification have certain prediction effects and play clinical reference roles on the short-term prognosis of patients with acute ischemic stroke.

The consistency of changes in macrocirculation and microcirculation in rats with severe hemorrhagic shock and septic shock / 实用医学杂志

Objective To investigate the dynamic changes and coordination of macrocirculation and microcirculation in rats with severe hemorrhagic shock and septic shock. Methods A total of 20 male Sprague-Dawley rats (450～550 g) were randomly divided into two groups (n = 10) : hemorrhagic shock group (H-Shock) and septic shock group (S-Shock). 40％ of the systemic blood volume was withdrawn in 1 hour in H-Shock group.While in the S-Shock group, cereal ligation and puncture (CLP) was performed and then the abdomen was closed.Mean arterial pressure (MAP) and the end-tidal carbon dioxide (ETCO2) were recorded continuously. Cardiac ultrasonography and sublingual microcirculation were performed per hour till 12 hours or the rat die (End). A total of 12 hours were observed or the rat die. Arterial blood gas was measured at baseline (BL) , MAP ≤ 65 mmHg (Shock) and at the termination of observation respectively. Results The values reflect macrocirculation or microcirculation in the H-Shock group were all decreased than BL respectively at each time. In the S-Shock group, the values that reflect macrocirculation such as MAP, ETC02 and cardiac output (CO) showed no significant changes within 3 hours (P> 0.05) , while the values of microcirculation were decreased compared with BL respectively at each time (P < 0.05). With the progress of shock, the pH was decreased compared with BL in both groups, while the level of Lac were increased (P < 0.05). Conclusions The changes of macrocirculation and microcirculation in severe hemorrhagic shock are basically the same; while they are inconsistent in septic shock, the changes of microcirculation occurred earlier than that of macrocirculation.

The effect of mild hypothermia on the myocardial and microcirculatory dysfunction induced by epinephrine during early post-resuscitation / 中华急诊医学杂志

Objective To investigate the effect of mild hypothermia on the myocardial and microcirculation dysfunction induced by epinephrine during early post-resuscitation in a rat model of cardiac arrest and cardiopulmonary resuscitation (CPR).Methods Transesophageal cardiac pacing was performed in order to elicit cardiac arrest for 5 min in SD male rats.Totally 40 rats were randomly (random number) divided into 4 groups (n=10):normothermic control group (N),normothermic epinephrine group (N+E),hypothermic control group (H),and hypothermic epinephrine group (H+E).Chest compression was then initiated.Epinephrine (0.02 mg/kg) or saline was administrated at 1 min during CPR.Restoration of spontaneous circulation (ROSC) was recorded,and the rates of ROSC were observed.Myocardial and microcirculatory function were observed at 1,2,3,and 4 h during early post-resuscitation.Serum lactate level was assessed at baseline and ROSC 4 h.Results The ROSC rates were 10/10 in the H+E group,9/10 in the N+E group,4/10 in the H group,and 1/10 in the N group,respectively.Ejection fraction (EF)and cardiac output (CO) in the H+E group were significantly higher than that of other groups (P＜0.05).Total vessel density,perfused vessel density,proportion of perfused vessels,and microvascular flow index in the H+E group were also significantly higher than those of other groups during early post-resuscitation.The serum lactate level in the H+E group was significantly lower than that in the N+E and H groups..Conclusions Both epinephrine and mild hypothermia can improve the success rate of resuscitation.However,mild hypothermia can improve the epinephrine induced myocardial and microcirculatory dysfunction during postresuscitation in the rat cardiac arrest.

Establishment of porcine model of prolonged cardiac arrest and cardiopulmonary resuscitation electrically induced by ventricular fibrillation / 中华危重病急救医学

Objective To investigate the optimal injury time point of cardiac arrest (CA) induced electrically, and establish a reproducible prolonged CA and cardiopulmonary resuscitation (CPR) model in pigs. Methods Forty healthy domestic male pigs were randomly divided into four groups, which were ventricular fibrillation (VF) 8, 10, 11, and 12 minutes groups, each group for 10 animals. In these groups, VF was induced by alternating current delivered to right ventricular endocardium and untreated for 8, 10, 11, and 12 minutes, respectively, followed by 6 minutes of CPR procedure. The resuscitation and survival outcomes were recorded. Hemodynamic parameters and arterial blood gases of animals after successful resuscitation were measured and recorded for 6 hours. Those successful resuscitation animals were regularly evaluated for the neurological deficit score (NDS) and survival outcomes every 24 hours till 96 hours after resuscitation. Results The shortest duration of CPR (minute: 6.9±1.3) and the highest successful ratio of the first defibrillation (7/10) were observed in group VF 8 minutes, and the ratio of successful resuscitation was 100%. The best coronary perfusion pressure (CPP) during the CPR, less neurological impairment, longer survival time, more stable hemodynamics, and shorter time for arterial pH and lactate level restoring to the original state after CPR were also observed in group VF 8 minutes, and no severe damage was found in those animals. The longest duration of CPR (minute:10.3±2.9) and the lowest successful ratio of the first defibrillation (1/10) were observed in group VF 12 minutes, and only 4 animals achieved restoration of spontaneous circulation (ROSC), and no animal survived to CPR 96 hours. The worst CPP during CPR and the highest NDS after resuscitation were also found in VF 12 minutes animals compared to those animals in the other groups. The injuries caused by ischemia and hypoxia in groups VF 10 minutes and VF 11 minutes were in between those of the groups VF 8 minutes and VF 12 minutes, and the duration of CPR were (7.0±2.1) minutes and (8.2±2.6) minutes. There were 9 and 7 animals achieved ROSC in groups VF 10 minutes and VF 11 minutes correspondingly, and 6 and 4 animals survived to 96 hours respectively. Obviously unstable hemodynamics was observed during the period of CPR 2 hours in the two groups. At CPR 1 hour, the heart rates (HR, beats/min) in groups VF 10 minutes and VF 11 minutes increased to 172 (155, 201) and 168 (136, 196) respectively, and the mean arterial pressures (MAP, mmHg, 1 mmHg = 0.133 kPa) declined to 97 (92, 100) and 81 (77, 100), the cardiac output (CO, L/min) decreased to 5.0 (4.0, 5.8), 3.7 (3.0, 5.4) correspondingly. Distinct injuries were found in the two groups [CPR 24-96 hours NDS in groups VF 10 minutes and VF 11 minutes: 180 (110, 255)-20 (0, 400) and 275 (223, 350)-240 (110, 400)], and the arterial pH of the two group decreased to 7.26±0.09 and 7.23±0.09 respectively, and the level of lactate (mmol/L) increased to 9.17±1.48 and 12.80±2.71 correspondingly at CPR 0.5 hour. Significantly lower pH was observed in group VF 11 minutes compared to group VF 8 minutes at CPR 0.5 hour (7.23±0.09 vs. 7.33±0.04, P < 0.05). The highest level of lactate (mmol/L) was also found at the same time point in group VF 11 minutes, which recovered to normal slowly, and was still significantly higher than groups VF 8, 10, 12 minutes (7.58±3.99 vs. 2.55±1.53, 2.13±2.00, 3.40±2.30, all P < 0.05) at CPR 4 hours. Conclusions The longer duration of CA was, the more severe damage would be, the longer CPR time would be required, and the harder of the animals to achieve ROSC. In this prolonged CA and CPR porcine model, 10-11 minutes for untreated VF, was an optimal time point with appropriate successful rate of resuscitation, survival outcomes, and post-resuscitation injuries. Therefore, we recommended 10-11 minutes might be the rational length of no-flow time in this model.

Short period of mild hypothermia improves resuscitation outcome in a porcine model of prolonged ventricular fibrillation / 中华急诊医学杂志

Objective To investigate the resuscitation outcome after a short period of mild hypothermia in porcine model of prolonged ventricular fibrillation (VF).Methods Fourteen male healthy domestic swine weighting 34 to 36 kg were used.VF was induced electrically and maintained untreated for 11 mins,followed by manual cardiopulmonary resuscitation (CPR) procedure.Two investigators initiated chest compression and bag-valve mask ventilation in pattern of 2 min rotation.A biphasic wave of 120 J electric defibrillation (ED) was attempted 6 mins after CPR.If there was no return of spontaneous circulation (ROSC),CPR was restored and ED was delivered when necessarily.Resuscitation was considered unsuccessful if absence of ROSC for 12 mins.However,if ROSC occurred,animals were randomly (random number) diveded into normothermia (NT) group and hypothermia treatment (CH) group.Animals in CH group were immediately cooled by using intravenous infusion of ice-cold saline and surface cooling.Core temperature was reduced to 32-34 degrees centigrade within 120 mins and maintained at this level for 2 h.Active rewarming was completed within 2 h until baseline body temperature was reached.Data of hemodynamic variables,blood-gas analysis and blood lactate before VF of two groups were recorded.Meawhile,cardiac output (CO),heart rate and Tc after ROSC were recorded.Neurological defect scores (NDS) were evaluated every 24 h until 96 h after ROSC.Variables were compared using either Fisher test or repeated measures analysis of variance,followed by Bonferroni for multiple comparisons.A two-sided P value ＜0.05 was regarded statistically significant.Results There was no significant difference in body weight,mean arterial pressure,CO,pH,pressure of end-tidal carbon dioxide (ETCO2) and lactate between groups before VF.In the period of CPR,there were also no significant difference in total resuscitation time,first shock success rate,ROSC rate,shock ROSC rate,total number of shock and doses of epinephrine.However,animals in CH group survived longer time than that in NT groups [(96.00 ± 0.00) hvs.(49.71 ±43.65) h,P=0.031].Meanwhile,the survival rate of 96 h was significantly higher in CH than that in NT (P ＜ 0.05).For neurological function,there was a obviously better NDS in CH group than that in NT group within ROSC 96 h (P ＜ 0.05).Conclusion Even a short duration of 2 hour mild hypothermia could improve resuscitation outcome in porcine model of 11 minute VF.

Study of the effects of mild hypothermia on improvement of cardiomyocyte contractility after ischemia-reperfusion in rats / 中华急诊医学杂志

Objective To study the effects of mild hypothermia on cardiomyocyte contractility improvement after ischemia-repeffusion injury and on the preservation of well-functioning mitochondrial respiratory capability.Methods A total of 50 newborn SD rats 1 ～ 2 days after delivery were sacrificed and their hearts taken to preserved in 4 ℃ cold D-hanks buffer solution with 0.12％ pancreatic proteinase and collagenase and then processed with 37 ℃ water bath to collect the cardiomyocytes cultured in DMEM medium with 10％ FBS for 5 days.The cardiomyocytes of rats were subjected to ischemia/reperfusion,in vitro,by oxygen and glucose deprivation(OGD)/oxygen and glucose restoration(OGR).The cardiomyocytes of rats after ischemia/reperfusion were divided into three groups:control group,hypothemia group and normothermia group.Contractile frequency and velosity were determined before OGD and 0 h,0.5h,1 h,1.5 h and 2 h after OGR.Ultrastructure changes of cardiomyocytes and mitochondrion were observed under transmission electron microscope(TEM)0 h and 2 h after OGR as well as assessment ot respiratory rate and respiratory control rate(RCR)with Clark oxygen electrode in each group.All data were analyzed with statistical software of SPSS 13.0.Results Contractile function of cardiomyocytes in hypothermia group and normothermia group declined to nadir at 0 h after OGR(P =0.000)and the contractile function of cardiomyocytes in hypothermia group was improved one hour later,compared with the normothermia group(P =0.000).Obvious swelling of mitochondrion was observed under TEM in normothermia group with little alteration after OGR.The RCR assessments indicated respiratory function in normothermia group was impaired after OGR(P =0.000)and this may be responsible for contractility dysfunction.Conclusions Mild hypothemia used after ischaemia can optimize the contractility of cardiomyocytes after a normothermia OGR,and the well-functioning respiratory capability of mitochondrion may be preserved in this process.

Alteration of immunological barrier of intestine mucosa in rats with sepsis / 中华急诊医学杂志

Objective To investigate immunological dysfunction of intestine mucosa barrier in a rat model of sepsis. Method Sixty Sprague-Dawley rats were assigned randomly(random number) into sepsis group (n = 45)and control group (n = 15). The animals in sepsis group were subjected to cecal ligation and puncture (CLP), whereas rats of control group underwent a sham surgery. The ileac mucosa and segments were harvested 3 h, 6 h and 12 hours after CLP, and the blood samples were collected. Pathological changes, protein levels of defensin-5 (RD-5) and trefoil factor-3(TFF_3) mRNA, lymphocytes apoptosis in the intestinal mucosa were determined. In an additional experiment, the gut-origin bacterial DNA in blood was detected. Results In the septic animals, in-testinal mucosa showed marked injury with loss of ileal villi, desquamation of epithelium, detachment of the lamina propria, hemorrhage and ulceration. Compared with control, the expression of TFF_3 mRNA and level of RD-5 pro-tein were decreased and the mucosal lymphocyte apoptosis increased (P < 0.05) in sepsis group. Compared with control group, the significant differences in RD-5 and TFF_3 mRNA appeared 3 hours after CLP and those differ-ences were progressively increased in 6 hours and 12 hours after CLP in sepsis group (P < 0.05, F of RD-5 = 11. 76, F of TFF_3 = 16.86 and F of apoptosis = 122.52). In addition, the gut-origin bacterial DNA in plasma de-tected was positive in all sepsis animals. Conclusions It suggests that immunological function of intestinal mucosa is impaired in septic rats and further worsened following the course of sepsis.

The epidemiological analysis of patients in pre-hospital medical care in large and medium-sized cities in China / 中华急诊医学杂志

Objective To investigate the epidemiological information of patients in pre-hospital medical care for our large and medium-sized cities and probe the patients' characteristic. Method The data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country.The thorough records of data were conducted to statistical analysis. Results ( 1 ) The scheduling time, running time, rescue time, returning time, total time and service radius in the pre-hospital medical care group were 2.16± 1.10(min), 14.01 ±6.82(min), 12.12±5.96(min), 14.08± 6.85(min), 42.34± 20.21(min)and 8.50±4.18(km), and the above parameter in the non-death group were 2.19 ± 1.13(min), 14.15 ± 7.14(min),11.60±6.72(min), 14.92 ±6.89(min), 41.86± 19.53(minutes) and 8.63±4.31(Km), and the above parameter in the death group were 2.10± 1.08(min), 13.68 ± 7.14(min), 25.25 ± 12.34(min), 13.75±6.48(min), 54.74 ± 25.47(min) and 7.86± 3.91(Km), and the above parameter in the non-sudden cardiac death group were2.09± 1.03(min), 13.58±6.78(min), 25.53± 12.34(min), 13.60± 6.54(min), 53.79±23.77(min) and 7.67 ± 3.86(Km), and the above parameter in the sudden cardiac death group were 2.12 ±1.02(min), 14.10±7.05(min), 24.79± 12.08(min), 13.79±6.61(min), 54. 80 ± 25. 36( min) and 7.90±3.92(Km) respectively. The scheduling time, running time, returning time and service radius in the death group were less than those of the non-death group, but the rescue time and total time of the former were more than those of the latter respectively ( P ＜ 0.05 or P ＜ 0. 001 ). The scheduling time and returning time didn' t have significant difference between the sudden cardiac death group and the non-sudden cardiac death group respectively ( P ＞ 0.05), but the running time, total time and service radius of the sudden cardiac death group were more than those of the non-sudden cardiac death group, and the rescue time of the former was less than that of the latter respectively ( P ＜ 0.05 or P ＜ 0.001 ). (2)The patients' amount in pre-hospital medical care group, the non-death group, the death group, the non-sudden cardiac death group and the sudden cardiac death group were at most in first quarter, and the least time slice of patients' amount were 4:00～ 6:00, 4:00～6:00, 4:00～ 6:00, 22:00～ 24:00, 2:00～4:00 respectively, and the most time slice of patients' amount were 20:00～ 22:00, 20:00～22:00, 8:00～ 10:00, 2:00 ～ 4:00, 8:00 ～ 10:00 respectively. (3)In 241 876 cases of pre-hospital medical care group, the patients' amount of trauma was at most, whose age grades was by far among21 ～50, and the others in sequence were nervous system, circulatory system, other group, digestive system, respiratory system and poisoning group respectively, whose age grades in nervous system, circulatory system and respiratory system was by far above 51, especially above 70. The patients' age grades in other group and digestive system had two climax age groups, which the one was 21 ～ 30, and the other was above 70. The patients' age grades in poisoning group was by far among 21 ～ 50, which the patients' amount of acute alcoholism was at the most. (4) In 12 568 cases of death group, the death amount of circulatory system, other group, respiratory system, nervous system and digestive system ranked at the lst,2nd,4th,5th 8th respectively, whose age grades was by far above 51, especially above 70,and the patients' amount of sudden cardiac death was at the most in the death amount of circulatory system. The death amount of trauma and poisoning group ranked at the 3rd, 6th respectively, whose age grades was by far among 21 ～ 50. (5)The total amount, the death amount and the sudden cardiac death amount of male patients were more than those of female patients. (6)The percentage of the death group to the pre-hospital medical care group was 5.20%, and the percentage of the sudden cardiac death group to the pre-hospital medical care group was 1.29%,and the percentage of the sudden cardiac death group to the death group was 24.87 %, and the percentage of the sudden cardiac death group to the circulatory system group was 67.33 %. Conclusions ( 1 )The trauma and the sudden cardiac death are the overriding reason of disease and the overriding reason of death in our large and medium-sized cities respectively. (2) It is very important to cut the death rate of the middle-old age patients by strengthening prevention and cure of cardiovascular and cerebrovascular diseases, discerning the critical illness early and improving the level of pre-hospital medical care. (3)It is a strong method to decrease the total amount and the death amount of the trauma, especially in traffic accident, by strengthening safety in production, observing traffic regulation and enhancing the legal awareness.

Effects of ulinastatin on expression of intestinal defensin-5 mRNA in the rat model of sepsis / 中华急诊医学杂志

Objective To investigate the effeets of ulimstatin on expression of intestinal defemin-5 mRNAin the rat model of sepsis.Method The experiment was performed in pharmaco-laboratory of medical college,Sun Yat-Sen University.sixty Sprague-Dawley rals were randomly divided into control,sepsis,pretreated andtreated groups(n=15).Semis was induced in the mts of latter three groups by cecal lifo.and puncture(CLP).The rats of pretreated group received 25 000 U/kg ulinastatin 2 hours before operation and the rats of uli-nastatin treated groups received 50 000 U/kg ulinastatin 2 hours after operation.Some pieces of ileum mucosa weretaken 12 h after CLP.Tge pathological changes were observed and the expression of RD-5 mRNA was detectedwith RT-PCR.All data were managed by SPSS 13.0 software and arIaIyzed by using One-way ANOVA and LSD-ttest.Results The expression of RD-5 mRNA in the rats of sepsis group significantly decreased compared to col-trol(P<0.05).The expression of RD-5 mRNA of pretreated and treated groups sigificantly inereased comparedto sepsis group(P<0.05);pretreated groups had more increased expression of,RD-5 mRNA compared to treatedgroups(P<0.05).Conclusions The expression of intestinal RD-5 mRNA significantly decreases in sepsis,which could be improved by the treatment of ulinadtatin leading to intestinal mucosal protection of the siqnifleant.The pretreatment may be more effective than the theTapeatic treatment in the rat model of sepsis.

Effect of somatostatin combined with compound salvia miltiorrhiza injection(复方丹参注射液) on patients with acute pancreatitis / 中国中西医结合急救杂志

Objective:To observe the therapeutic efficacy of somatostatin combined with compound salvia miltiorrhiza injection(复方丹参注射液)on patients with acute pancreatitis(AP).Methods:By using randomized controlled trail,62 patients with AP were divided into control group(31 cases) and observation group(31 cases) in a period from June,2002 to December,2006.In the control group,routine measures,such as forbidding food,decompressing stomach and intestines,were taken,and in addition,intravenous injection of somatostatin 250 ?g with subsequent intravenous drip 3 000 ?g in normal saline 500 ml at a rate of 250 ?g/h once everyday was used for 7-14 days.On the above treatment of the control group,compound salvia miltiorrhiza injection 20 ml in normal saline 250 ml,intravenous drip every day for 7-14 days,was added in the observation group.The disappearance of symptoms and abdominal signs,amylase of urine and blood,the time of recovery of hepatic function,change of calcium concentration,incidences of multiple organ dysfunction syndrome(MODS) and case fatality were observed and compared.Results:Amylase of blood after treatment in observation group was lower than that in the control group,while serum calcium concentration was higher,especially on 3 and 5 days after treatment(all P