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Objective To observe the effect of acetated Ringer's solution or lactated Ringer's solution on intra-operative vital signs and blood gas analysis indexes in children (aged 1-6 years) undergoing tibia pseudoarthrosis orthopaedic operation. Methods Sixty-four children who underwent tibial pseudoarthrosis orthopaedic operation admitted to the Department of Anesthesiology of Hunan Children's Hospital from October 2016 to October 2018 were enrolled and anesthesia was performed by general anesthesia combined with epidural anesthesia, children were randomly divided into a sodium lactated Ringer's solution injection group (LR group) and a acetated Ringer's solution injection group (AR group), and different groups of children were treated with the corresponding crystal solution for intra-operative maintenance. The vital signs and results of blood gas analysis, etc of the two groups were compared at T1 (before the operation), T2 (2 hours after the beginning of operation) and T3 (at the end of operation). Results Finally, 22 patients in LR group and 28 patients in AR group had completed the study. The arterial partial pressure of carbondioxide (PaCO2), blood Na+, K+, Ca2+, glucose, hematocrit (HCT), bicarbonate (HCO3-), total hemoglobin (THb), etc laboratory indicators as well as vital signs of heart rate, systolic blood pressure, diastolic blood pressure, body temperature, etc. showed no statistically significant differences between the two groups at T1 (all P > 0.05). The lactate (Lac) levels at T2 and T3 in AR group were obviously lower than those in LR group (mmol/L: T2 was 1.01±0.21 vs. 1.42±0.47, T3 was 1.38±0.53 vs.2.07±0.48, both P < 0.05) , while pH, base excess (BE) and HCO3- were obviously higher in AR group [pH: T2 was 7.35±0.08 vs. 7.32±0.07, T3 was 7.33±0.06 vs. 7.28±0.03; BE (mmol/L): T2 was 1.02±0.18 vs. 0.67±0.45, T3 was 0.03±0.28 vs. -0.01±0.57; HCO3- (mmol/L): T2 was 21.28±1.20 vs. 20.10±0.17, T3 was 21.09±0.28 vs. 19.96±6.67, all P < 0.05]. Conclusion In the orthopaedic surgery of children's tibia pseudoarthrosis orthopaedic operation, acetated Ringer's solution not only can maintain water, electrolyte, acid-base balance and blood circulatory stabilities but also can reduce the increase of lactate level, which is conducive to maintaining the stability of the internal environment in the organism.
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Objective To study the effects of acetated ringer's solution resuscitation in hemorrhagic shock rats on inflammatory mediators on lung tissue and their JNK (c-Jun N-terminal kinase) signaling pathways. Methods Thirty-two SD rats were randomly(random number) divided into four groups: shock without resuscitation group (CR, n=8), saline group (NR, n=8), lactated ringer's solution group (LR, n=8) and acetated ringer's solution group (AR,n=8). The rats of NR group, LR group and AR group were prepared into shock models (mean arterial blood pressure maintained at 40-45 mmHg),The rats of NR group, LR group and AR group were in the shock for 60 min and then the corresponding kinds of liquid were administered for 30 min and observation was carried out for 4 hours. The rats of CR group without liquid resuscitation were observed for 4 hours after shock. After that, the lung tissues of rats were taken from NR group, LR group and AR group as well as from CR group 4 hours after shock (if the rats died, the lung tissues were immediately taken). The levels of TNF-α, IL-4 and IL-10 mRNA in lung were measured by real-time polymerase chain reaction (RT-PCR),and Western blot was used to measure the levels of JNK phosphorylation and MKP-1 acetylation. The one-way ANOVA was used for comparison among groups. Between the two groups, the comparison was analyzed by using LSD-t test. Results The IL-4 mRNA expression of lung tissue in AR group was higher than that in CR group, NR group and LR group (CR group:0.42±0.34; NR group:2.60±0.66; LR group:6.24±2.95; AR group: 11.08±4.24; P＜0.05).The IL-10 mRNA expression of lung tissue in AR group was significantly higher than that in CR group, NR group and LR group (CR group:0.25±0.25; NR group:2.79±1.62; LR group:3.51±1.66; AR group:9.35±2.86;P＜0.01).The TNF-a mRNA expression in AR group was significantly lower than that in CR group, NR group and LR group (CR group:4.98±1.26; NR group:2.50±0.76; LR group:3.87±3.00; AR group:0.19±0.09; P＜0.01). The level of JNK phosphorylation in lung tissue of rats in AR group was significantly lower than that in CR group, NR group and LR group (CR group:0.52±0.12; NR group:0.42±0.08; LR group:0.30±0.08; AR group:0.17±0.06;P＜0.01). The level of MKP-1 acetylation in lung tissue of rats in AR group was significantly higher than that in CR group, NR group and LR group (CR group:0.14±0.07; NR group:0.30±0.07; LR group:0.37±0.02; AR group:0.48±0.06;P＜0.01). Compared with normal saline and lactated ringer's solution, acetated ringer's solution used in hemorrhagic shock rats could promote MKP-1 acetylation, inhibit the phosphorylation of JNK, significantly inhibit the lung tissue TNF-a released, promote the release of anti-inflammatory factors, IL-4 and IL-10. Conclusions The acetated ringer's solution for resuscitation of hemorrhagic shock in rats could reduce inflammation of lung tissue in a certain extent, probably by enhanced the acetylation of MKP-1 to inhibited JNK signaling pathway and reduced lung tissue inflammation.
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Objective To research the clinical significance of acetated Ringer solution and succinylated gelatin in the fluid resuscitation of sepsis patients.Method Fifty-nine sepsis patients were divided into two groups:lactic acid Ringer solution and hetastarch (group A,27 cases)and acetated Ringer solution and suecinylated gelatin (group B,32 cases),compared the fluid resuscitation and other parameter.Results There were no significant difference in the central venous pressure,mean arterial pressure and the dose of noradrenaline (P ＞ 0.05).The activated partial thrombeplastin time in group A was longer than that in group B[(58±10),(74±13)s vs(48±7),(54 ±11) s in 6,24 hours],fibrinogen concentration was lower than that in group B [(3.3 ±0.8),(1.6±0.3)g/L vs (4.2±1.1),(2.1±0.2)g/L in 6,24 hours] (P＜0.05).Serum lactic acid,creatinine,calcium concentration in group A [(6.9±0.8)retool/L,(289 ~ 27)μ mol/L,(2.1 ±0.3)mmol/L]were higher than those in group B [(3.2 ±1.1)mmol/L, (193 ±42)μmol/L, (1.7±0.2)mmol/L](P＜0.05),there was no difference in APACHE Ⅲ scores on the third day between two groups (P＞0.05).Conclusions Acetated Ringer solution and succinylated gelatin in the fluid resuscitation of sepsis patients has the same effect,but fewer impacts on serum coagulation,serum lactic acid and renal function than lactic acid Ringer solution and hetastareh.They may be more suitable for fluid resuscitation of sepsis patients,but hypecalcemia is easy to happen,and there is no significant evidences proving the prognosis.