ABSTRACT
BACKGROUND: Superior mesenteric artery (SMA) injuries rarely occur during blunt abdominal injuries, with an incidence of < 1%. The clinical manifestations mainly include abdominal hemorrhage and peritoneal irritation, which progress rapidly and are easily misdiagnosed. Quick and accurate diagnosis and timely effective treatment are greatly significant in managing emergent cases. This report describes emergency rescue by a multidisciplinary team of a patient with hemorrhagic shock caused by SMA rupture. CASE SUMMARY: A 55-year-old man with hemorrhagic shock presented with SMA rupture. On admission, he showed extremely unstable vital signs and was unconscious with a laceration on his head, heart rate of 143 beats/min, shallow and fast breathing (frequency > 35 beats/min), and blood pressure as low as 20/10 mmHg (1 mmHg = 0.133 kPa). Computed tomography revealed abdominal and pelvic hematocele effusion, suggesting active bleeding. The patient was suspected of partial rupture of the distal SMA branch. The patient underwent emergency mesenteric artery ligation, scalp suture, and liver laceration closure. In view of conditions with acute onset, rapid progression, and high bleeding volume, key points of nursing were conducted, including activating emergency protocol, opening of the green channel, and arranging relevant examinations with various medical staff for quick diagnosis. The seamless collaboration of the multidisciplinary team helped shorten the preoperative preparation time. Emergency laparotomy exploration and mesenteric artery ligation were performed to mitigate hemorrhagic shock while establishing efficient venous accesses and closely monitoring the patient's condition to ensure hemodynamic stability. Strict measures were taken to avoid intraoperative hypothermia and infection. CONCLUSION: After 3.5 h of emergency rescue and medical care, bleeding was successfully controlled, and the patient's condition was stabilized. Subsequently, the patient was transferred to the intensive care unit for continuous monitoring and treatment. On the sixth day, the patient was weaned off the ventilator, extubated, and relocated to a specialized ward. Through diligent medical intervention and attentive nursing, the patient made a full recovery and was discharged on day 22. The follow-up visit confirmed the patient's successful recovery.
ABSTRACT
AIM: To investigate the effect of IL-10 on proliferation of rat primary cultured hepatocytes. METHODS: Rat hepatocytes were isolated from rat liver by in situ digestion of collagenase IV and cryopreserved, resuscitated, cultured in vitro. Reverse-transcription polymerase chain reaction (RT-PCR) was used to characterize the purity of hepatocytes and analyze IL-10/IL10Ralpha mRNA from freshly isolated cells. The primary cultured hepatocytes were divided into 3 groups and treated with nothing (group N), Insulin (group C), and IL-10 in combination with Insulin (group I), respectively. Nuclear cell cycle analysis, MTT, and Trypan Blue cell count was assayed. RESULTS: RT-PCR showed expression of characterization genes in primary hepatocytes group and liver tissue are different. RT-PCR showed an expression of IL-10/IL10Ralpha mRNA in rat primary hepatocytes. Trypan Blue cell count showed an depression of cell quantity in group I at 48h (71.96% contrast to group C, P<0.05). MTT analyse also showed absorbance of group I was declined contrast to group C at 24 h and 48 h (88.41% and 90.24%, P<0.05). Cell cycle analysis via FCM showed a decline at 24h in group I than group C and group N (59.06% and 70.18%, P<0.01). CONCLUSION: The primary hepatocytes we isolated is quite purity. Rat primary hepatocytes express IL-10/IL10Ralpha mRNA. IL-10 has an suppression effect on proliferation of primary cultured hepatocytes.
