[Application of damage control concept in severe limbs fractures combining with multiple trauma].

OBJECTIVE: To discuss the application and clinical effect of damage control concept in the treatment of severe limbs fractures combining with multiple trauma. METHODS: From July 2009 to July 2012, 30 patients with severe limbs fractures combining with multiple trauma were treated with the damage control concept, included 20 males and 10 females with an average age of (34.03 ± 12.81) years old ranging from 20 to 60 years old; the ISS averaged (35.00 ± 12.81) points (ranged from 26 to 54 points). And the control group also contained 30 patients with severe limbs fractures combining with multiple trauma treated by the traditional operation from June 2006 to June 2009, there were 23 males and 7 females with an average age of (34.23 ± 11.04) years old ranging from 18 to 65 years old. The ISS averaged (35.56 ± 11.04) points (ranged from 26 to 51 points). The age, gender, ISS, Gustilo classification, operation time, intraoperative blood loss, blood transfusion,postoperative complications and mortality rate were observed and compared. RESULTS: In the damage control concept group,there were 28 cases surviving and 2 cases (6.7%) death; 6 cases of postoperative complication included 2 cases of adult respiratory distress syndrome, 1 case of multiple organ failure, 1 case of disseminated intravascular coagulation and 2 cases of wound infection. In the control group, there were 22 cases surviving and 8 cases death(26.7%); 13 cases of postoperative complication included 4 cases of adult respiratory distress syndrome,2 cases of multiple organ failure, 2 cases of disseminated intravascular coagulation and 3 cases of wound infection. There were no statistically significant differences between two groups in age, gender, ISS, Gustilo classfication and complication (P > 0.05), however there were statistically significant differences in mortality rate, operation time, blodd loss, blodd transfusion between two groups (P < 0.05). CONCLUSION: Damage control concept is used to treat severe limbs fractures combining with multiple trauma which has the rapid and effective therapy, can improve survival rate and reduce complication.

Involvement of taurine in penicillin-induced epilepsy and anti-convulsion of acupuncture: a preliminary report.

The potential role of taurine on epilepsy and acupuncture anti-convulsion was addressed in the present study. Epilepsy was induced by micro-injection of penicillin into hippocampus of Wistar rats. Taurine was applied by intraperitioneal (i.p.) injection. Electro-acupuncture (EA) was performed on acupoints of DU 20 "Bai Hui" and DU 16 "Feng Fu" along DU channel. Epileptic grades were evaluated by electro-encephalography (EEG) and behavior score. We featured the dose-response relationship between taurine-treated epilepsy and epilepsy-only subjects, detected the effect of exogenous taurine on epilepsy and acupuncture treatment, and investigated taurine transporter immuno-activity in hippocampus using immunohistochemistry. It was found that: 1), taurine had a significant antiepileptic effect as applied at i.p. 20 mg/kg, 40mg/kg, 80mg/kg, especially at 40mg/kg in the rat model of penicillin-induced seizure. Animals were improved by one to three Racine grades in behavior and in frequency and amplitude of EEG. 2), Exogenous taurine enhanced the anti-convulsive effect of EA. Both behavior and EEG were improved in taurine-treated rats. EA inhibited epilepsy. Exogenous taurine improved epilepsy in a synergistic manner to EA. 3), EA increased the concentration of taurine transporter in hippocampus by comparing EA-treated epilepsy with normal control and penicillin only, or EA-treated plus taurine-treated epilepsy with taurine-treated only epilepsy and penicillin only. The resulting data suggested that taurine may play an inhibitory role against epilepsy as an inhibitory amino acid in the central nervous system and EA may inhibit epilepsy via upregulating the concentration of taurine transporter to increase the release of taurine.

Electro-acupuncture improves epileptic seizures induced by kainic acid in taurine-depletion rats.

Electro-acupuncture (EA) partially inhibited epilepsy with great success. The biological basis underlying EA anti-convulsion remained uncertain, which resulted in limited application and slow improvement of acupuncture. Our previous study indicated that taurine may play an inhibitory role against epilepsy as an inhibitory amino acid in the central nervous system and EA may inhibit epilepsy via up-regulating the expression of taurine transporter to increase the release of taurine. Involvement of taurine in kainic acid (KA)-induced epilepsy and anti-convulsion of EA was further addressed on taurine deficiency animal in the present work. We instituted endogenous taurine-deficiency model by supplementation of beta-alanine (3%) in drinking water for continuous 10 days initially, injected KA into lateral cerebral ventricle to induce epileptic seizure, and performed EA treatment on DU26 "RenZhong" and K "YongQuan" acupoints by an EA apparatus (Model G6805-2) using successive waves with the frequency 64Hz and the current intensity 0.8-1.0 mA for 30 minutes in Sprague-Dawley (SD) rats. Taurine levels markedly decreased in cortex, hippocampus, striatum and cerebellum of rats after beta-alanine administration by fluore-HPLC measurement. EA alleviated epileptic activity in rats at 3.5 h time point after KA injection, whereas beta-alanine-induced taurine depletion rendered rats more susceptible to KA-induced epilepsy. Taurine transporter level increased after EA treatment. These results suggested that taurine participated in epileptogenesis and EA may be related to taurine in controlling epileptic seizure.