Chin Crit Care Med,Aug 2004,Vol.16,No8
PAGE:451-453
Application of fluid resuscitation and baso-active agents in the treatment of severe sepsis and septic shock
QIU Hai-bo, YANG Yi. LIU Song-qiao
PAGE:454-457
Analysis of etiological factors of pseudo—epitheliomatous granuloma after cutaneous wound healing: a report of 11 cases of patients with this lesion
JIANG Du—yin, FU Xiao—bing, SHENG Zhi—yong, CHEN Wei.
, 百拇医药
Taizhou Institute of Wound and Surgery Plastic, Taizhou Fourth People’s Hospital, Taizhou 225300, Jiangsu, China
Abstract: Objective: To explore the pathogenetic mechanism, clinical and pathological characteristics, and prevention and treatment of pseudo—epitheliomatous granuloma after skin wound healing. Methods: The clinical information and the treatment Results: of pseudo—epitheliomatous granuloma occurring in 11 patients (age 1—67 years) were reviewed and analyzed, their tissue specimens were used for microbial examination and histological observation. Results: Some bacteria such as Staphylococcus aureus, Pseudomonas pyocynea, Streptococcus hemolyticus B, and Streptococcus feacalis could be found in the culture of pseudo—epitheliomatous granuloma. The maJority of these bacteria was tolerant to celbenin but sensitive to vancomycin. The lesions were excised, and the wounds were covered with skin grafting or skin flap, supplemented by local of vancomycin to prevent recurrence of the lesion. Histological examination revealed in pseudo—epitheliomatous granuloma with long epithelial peduncle encapsulating granulation tissue like honeycomb, in which there were many capillaries, macrophages, lymphocytes and mast cells, with only a small amount of extracellular matrix. Conclusion: The main pathogenesis of pseudo—epitheliomatous granuloma formation might be improper treatment of wound in earlier period and infection of drug resistant bacteria. Surgical debridement followed by skin coverage and local inJection of vancomycin could be effective and curative.
, 百拇医药
Key words: skin trauma; pseudo—epitheliomatous granuloma; pseudoepitheliomatous hyperplasia; wound repair
PAGE:458-459
Effects of reconstructive human acidic fibroblast growth factor and wild type acidic fibroblast growth factor on skin cell proliferation
ZHAO Jing—yu, FU Xiao—bing, CHEN Wei, SUN Tong—zhu, ZHENG Shu—yun, WENG Li—xin, ZHANG Ying—min.
Key Research Laboratory of Wound Repair, Burns Institute, 304 th Hospital of PLA, BeiJing 100037, China
, 百拇医药
Abstract: Objective: To investigate the effects of reconstructive human acidic fibroblast growth factor (aFGF) and wild type aFGF on skin cell proliferation in rat.
Methods: Neonatal rat skin (area of 2 mm×2 mm) was cultured in Dulbecco's modification of Eagle's medium containing reconstructive human aFGF and wild type aFGF, respectively. The concentrations of aFGF were 1 μg/L, 10 μg/L, and 100 μg/L. After being cultured for 4 days, the area of skin was measured. Results: After treatment with two different growth factors in three different concentrations (1 μg/L, 10 μg/L and 100 μg/L) for 4 days, the areas of skin in three reconstructive human aFGF groups were 14, 15 and 13 fold of that of control, respectively and the areas of three wild type aFGF groups were 15, 32 and 16 fold of that of control, respectively, while the area of skin in the control group was (2.96±1.12) mm2. In comparison with those of other groups, the skin area of 10 μg/L wild type aFGF group was significantly increased (P<0.05). Conclusion: Reconstructive human aFGF confers less impact on cutaneous cell growth. The capability of wild type aFGF to induce cutaneous cell proliferation is much greater than that of reconstructive human aFGF. Key words: reconstructive human acidic fibroblast growth factor； wild type acidic fibroblast growth factor； skin； rat
, 百拇医药
PAGE:460-463
Effects of acidic fibroblast growth factor on intestinal mucosal damage due to ischemia/reperfusion
ZHENG Shu—yun, FU Xiao—bing, XU Jian—guo, SUN Tong—zhu.
Wound Healing and Cell Biology Laboratory, Burns Institute, 304 Hospital of PLA, BeiJing 100037, China
Abstract: Objective: To investigate the effect of exogenous acidic fibroblast growth factor(aFGF) on ischemia/reperfusion(I/R) inJury of the intestine in rat, and to explore the mechanism of its protective effect. Methods: The model of rat intestinal I/R inJury was replicated by clamping the superior mesenteric artery (SMA) for 45 minutes followed by reperfusion. Seventy—eight Wistar rats were divided randomly into sham—operation group, intestinal I/R control group and aFGF treated group. In sham—operation group, SMA were separated but not occluded. Animals were sacrificed, samples of blood and tissue from the intestine were obtained 45 minutes after ischemia in sham—operation group and 0.5, 1, 2, 6, 12， and 24 hours after reperfusion in the other groups. Plasma D—lactate level was measured and rat survival rate was noted. Histological changes in intestinal tissue
, 百拇医药
were observed under light microscope. Results: The Results showed that rat survival rate in aFGF treatment group was higher than that of intestinal I/R control group (P<0.05), and plasma D—lactate levels were markedly lower in aFGF group than that of intestinal I/R control group (P<0.05). Improvement in pathological changes was observed at 1, 2, 6, 12, and 24 hours after the reperfusion in aFGF treatment group compared with intestinal I/R control group. Conclusion: These data suggest that aFGF has a protective effect on intestinal I/R damage, and it may be related to the mitogenic effects and some hormone—like activities of aFGF.
, 百拇医药
PAGE:463
Effects of acidic fibroblast growth factor on intestinal mucosal damage due to ischemia/reperfusion
GUO Kai-tong, WANG Fa-zhi
Wound Healing and Cell Biology Laboratory, Burns Institute, 304 Hospital of PLA, BeiJing 100037, China
PAGE:464-467
Analysis of diagnosis and misdiagnosis of pulmonary thromboembolism in emergency
, 百拇医药
LIU Shuang, ZHU Xiao—ling, ZHOU Yi, ZHANG Jing—lan, XU Xiao—feng, LI Zhi—zhong. Anzhen Hospital, Capital University of Medical Science, BeiJing 100029, China
Abstract: Objective: To investigate the differential diagnosis of pulmonary thromboembolism in emergency in order to increase the correct diagnosis rate of pulmonary thromboembolism. Methods: The data of patients who were diagnosed pulmonary thromboembolism in Emergency Intensive Care Center of Anzhen Hospital from January 2000 to the end of August 2003 were analyzed. Patients were divided into two groups. One group of patients with pulmonary thromboembolism were diagnosed pneumonia, heart disease and cerebrovascular disease. The other group of patients were not pulmonary thromboembolism and were misdiagnosed. Results: Five patients with pulmonary thromboembolism were diagnosed pneumonia, 7 and 3 patients were diagnosed heart disease and cerebrovascular disease, respectively. In the other group, 4 patients with lung or mediastinal tumors, 2 with pneumonia and 1 with bronchiectasis were diagnosed pulmonary thromboembolism. Conclusion: It is essential to correctly diagnose pulmonary thromboembolism, especially emergency physicians should master diagnosis method of pulmonary thromboembolism and reduce the rate missed of diagnosis.
, http://www.100md.com
PAGE:468-472
Roles of hydroxyethyl starch solution in resuscitation for shock induced by ischemia/reperfusion inJury of the intestine
TU Zi—zhi, SUN Qing—hua, George Dimopoulos, Suzana M Lobo, Daniel de Backer, XIAO Xian—zhong, Jean—Louis Vincent.
Department of Pathophysiology, Xiangya Medical College, Central South University, Changsha 410078, Hunan, China; Department of Intensive Care Medicine, Erasme Hospital, Free University of Brussels, Belgium
, 百拇医药
Abstract: Objective: To compare the effects of high and low doses of 6% hydroxyethyl starch solution (HES) on resuscitation for shock induced by ischemia/reperfusion inJury of the intestine in rabbits. Methods: Thirty—two anesthetized rabbits were randomized into four groups of eight animals each. The animals in the control group received no fluid resuscitation, animals in group 2 received lactated Ringer's solution (LRS, 20 ml·kg-1·h-1), those in group 3 received LRS+HES (LRS 18 ml·kg-1·h-1+HES 2 ml·kg-1·h-1, low dosage of HES), and those in group 4 received HES only in high dosage of HES (20 ml·kg-1·h-1). All these rabbits underwent intestinal ischemia/reperfusion inJury developed by occluding superior mesenteric artery (SMA) with a noncrushing vascular clamp for 60 minutes and then the clamp was loosened for 240 minutes. The fluid resuscitation began at the same time of reperfusion. Hemodynamic parameters including mean artery pressure, heart rate, aortic velocity (as cardiac output), and SMA blood flow were measured. Tissue oxygenation was assessed indirectly by measuring the tonometric parameters of the gut, including difference between partial pressure of carbon dioxide in intestinal intramucosal and partial pressure of carbon dioxide in arterial blood (Pt—aCO2 gap), intestinal intramucosal pH (pHi), arterial blood lactate acid concentration and oxygen delivery. Mortality of the rabbits was counted at the end of the experiment. Results: Hemodynamic parameters as measured in low and high doses of HES groups were significantly higher in values than LRS group (LRS) and control (all P<0.05). Low dose of HES was better in restoring hemodynamic parameters than high dose of HES (all P<0.05). Low dose of HES could greatly decrease lactate and Pt—aCO2 gap, significantly improve pHi compared with other three groups (all P<0.05), but high dose of HES did not do so, and oral and nasal bleeding even death of some animals were seen. Low dose and high dose of HES significantly improved oxygen delivery while LRS did not (all P<0.05). Conclusion: Low dose of HES together with LRS is more effective than only high dose of HES or LRS in the resuscitation for shock induced by ischemia/reperfusion inJury of the intestine in rabbits, resulting in better hemodynamic parameters and tissue oxygenation.
, http://www.100md.com
PAGE:473-476
Mechanism of better result of limited resuscitation in a model of uncontrolled hemorrhagic shock
WANG Qin—cun, XIAO Nan, DIAO You—fang, TIAN Kun—lun, FAN Xiao—qing, CHEN Hui—sun.
Research Institute of Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, China
Abstract: Objective: To investigate the mechanism of better result of limited resuscitation in a model of uncontrolled hemorrhagic shock. Methods: Uncontrolled hemorrhagic shock was produced in 54 rats by a standardized massive splenic inJury with transection of the middle branch of splenic artery (MSIA). The rats were randomly assigned to six groups (n=6) by maintenance of the level of mean arterial pressure (MAP): sham—operated group(SS), 40 (RS40), 50 (RS50), 60 (RS60), 80 (RS80) and 100 mm Hg (RS100, 1 mm Hg=0.133 kPa). When the MAP reached 40 mm Hg, resuscitation was begun. Ringer's solution was continued as needed to maintain the following desired endpoints for 45 minutes (T45 point):MAP of 40, 50, 60, 80 and 100 mm Hg. After the bleeding was controlled, resuscitation was continued with Ringer's solution and whole blood (2∶1) to raise the MAP to 100 mm Hg for 120 minutes (T165 point), followed by a 240 minutes observation period (T405 point).All animals were observed for 240 minutes or till death. The blood samples were withdrawn from artery for hematocrit (Hct), blood lactate (BL), base excess(BE) at T0, T45, T165, T405 points. At the end of the experiment, a small amount of hepatic tissue was collected for measuring tissue blood perfusion, total antioxidative capacity (T—AOC), Na+—K+—ATPase, and malondialdehyde(MDA). Results: At T45, T405 points, Hct in SS, RS50 and RS60 were significantly higher than in RS80 and RS100(P<0.05). At T405 point, BL and BE levels in RS80 and RS100 were significantly higher than that of the other groups(P<0.05). The contents of MDA in SS, RS40, and RS50 were significantly lower than in RS80 and RS100(P<0.05). T—AOC level,Na+—K+—ATPase were significantly lower in RS80 and RS100 than that in the other groups. Blood perfusion was significantly lower in RS80 and RS100 than that in SS, RS40, and RS50. Conclusion: In the setting of uncontrolled hemorrhagic shock, limited resuscitation could balance well the needs of organ perfusion and decrease lactate level. It might also exert a protective effect against ischemia/reperfusion inJury to liver tissue.
, 百拇医药
Key words: uncontrolled hemorrhage shock; limited resuscitation; ischemia/reperfusion inJury
PAGE:476
Mechanism of better result of limited resuscitation in a model of uncontrolled hemorrhagic shock
SU Qing-ju
Research Institute of Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, China
PAGE:477-480
, http://www.100md.com
Study on morphological change in intestinal mucosa from inJury to repair after hemorrhagic shock
CHANG Jian—xing， CHEN Shuang, FU Yu—ru, CHANG Rui—ming, CHEN Jian—wen, HUANG Zi—tong.
The Second Affiliated Hospital, Sun Yat—sen University, Guangzhou 510120, Guangdong, China
Abstract: Objective: To study on morphological changes in mucosa of the small and large intestine mucosa after resuscitation of hemorrhagic shock. Methods: The morphological changes in intestinal mucosa were observed under light and electron microscope, including the histology of intestinal mucosa, determination of height of villi and evaluation of mucosa damage index in the different phases after traumatic—hemorrhagic shock. Results: Mucosa epithelial inJury was obvious in small intestine were even at 0 hour, becoming more serious in 1 hour up to 3 hours. The tissue repair began after 3 hours, though the inJury was still serious. Most of the inJured mucosa began to repair after 6 hours, and completed in 24 hours. The condition of the large intestine was similar to that of the small intestine, but the inJury was less severe. The mucosal thickness and the height of villi were diminished after 1 hour of shock, but there was no obvious change in the colon. Conclusion: In the early phase after hemorrhagic shock, intestinal mucosal barrier are subJected to damage, but it could repair and recover in a short time. Compare with small intestine, large intestinehave stronger potentiality against inJury
, 百拇医药
PAGE:480
Study on morphological change in intestinal mucosa from inJury to repair after hemorrhagic shock
HU Yan-sheng, HU Jin-nian
The Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong, China
PAGE:481-483
Level of tissue plasminogen activator protein in pulmonary artery in acute pulmonary thromboembolism in rabbit
, 百拇医药
ZHANG Jing—xia, SUN Gen—yi, CHEN Yong—li, WANG Pei—xian, YUAN Zhi—ming, ZHOU Yu—ling.
TianJin Thoracic Hospital, TianJin 300051, China
Abstract: Objective: To study the changes in tissue plasminogen activator(t—PA) protein in pulmonary artery and itsclinical significance after acute pulmonary thromboembolism (PTE). Methods: Thirty rabbits were randomly divided into four groups after replicating a model of acute PTE in rabbit by thrombi occlusion method. Specimens were obtained from both normal and morbid pulmonary artery 3, 8 and 24 hours after APE, and protein contents of t—PA were determined using immunohistochemical method. Results: A few endothelial cells and smooth muscle cells of the normal pulmonary artery were positive for t—PA. After 3 hours of PTE, there was no significant changes in t—PA positive stain among embolismic, non—embolismic and normal pulmonary artery. After 8 and 24 hours of PTE, strong positive staining was found in the residual endothelial cells and a part of smooth muscle cells (all P<0.01). Conclusion: There is significantly strong positive staining for t—PA in the pulmonary artery wall after pulmonary embolism, implying that the local fibrinolysis activity was enhanced, and it might be helpful for lysis of the embolus. Key words: pulmonary thromboembolism; tissue plasminogen activator; pulmonary artery; immunohistochemical method
, 百拇医药
PAGE:483
Clinical application of hemoperfusion: report of 11 cases
WANG Yu-gang, ZHANG Bin, ZHENG Shan-hai ,SU Zhen, GAN Wei-hong, JIANG Xiu-mei, MA Ya-xin
Coal General Hospital, Beijing 100028, China
PAGE:484-486
Analysis of the status of diagnosis of acute pulmonary embolism and a study of further strategy to improve the diagnostic level
, 百拇医药
LI Xin, LIAO Xiao—xing， GUAN Kai—pan, JING Xiao—li, MA Zhong—fu, TANG Hao, ZHAN Hong.
Department of Emergency, The First Affiliated Hospital of Zhongshan University, Guangzhou 510080, Guangdong, China
Abstract: Objective: To analyze the present status of diagnosis of pulmonary embolism (PE) by analyzing the clinical data of patients admitted during last 10 years to our hospital, in order to look for a significant diagnostic strategy to improve the diagnostic level. Methods: The data of patients diagnosed to have PE in last 10 years were analyzed. In the last 5 months, the patients suspected to have PE were diagnosed by a comprehensive approach including clinical manifestations, lung scan and/or spirals computer tomography(SCT) in our emergency department. Results The diagnostic rate, the final diagnostic rate within 3 days and the diagnostic rate by lung scan or/and SCT were all higher in the last 3 months than ever. The proportions of angiograms and the overall 3—month PE risk were 2.8% and 0 Conclusion: The comprehensive approach which includes clinical manifestations, lung scan and/or SCT can obviously improve the diagnostic level of PE.
, http://www.100md.com
PAGE:487-490
Therapeutic application of molecular adsorbent recirculation system in the treatment of multiple organ dysfunction syndrome patients
LUO Hong—tao, GUO Li—min, LIU Quan—mei, WU Min, BAI Hong—lian, LUO Yue—hua, ZHANG Pei—hua, LUO Zuan—di, WANG Min—min.
Department of Infectious Diseases, the First People's Hospital of Foshan, Foshan 528000, Guangdong, China
, 百拇医药
Abstract: Objective: To assess the effectiveness of molecular adsorbent recirculation system (MARS) to remove nitric oxide(NO) and cytokines in multiple organ dysfunction syndrome(MODS) in patients with severe liver failure. Methods:
Single MARS treatment were performed for 198 times with duration ranging from 6 to 24 hours on 61 MODS patients (42M/19F). The efficacy was evaluated by sequential organ failure assessment, biochemical parameters and the levels of pro—inflammatory cytokines. Results: The MARS therapy resulted in a significant removal of NO and certain cytokines such as tumor necrosis factor—α(TNF—α), interleukin—2(IL—2), IL—6, IL—8, and lipopolysaccharide—binding protein(LBP), together with marked reduction of other non—water soluble albumin bound toxins and water soluble toxins. These were associated with an improvement of the patients' clinical conditions, including deranged hemodynamics, respiratory function, cardiovascular and renal functions, hepatic encephalopathy, thus resulting in a marked decrease of sequential organ failure assessment(SOFA) score and improved outcome. Twenty—five patients were able to be discharged from the hospital, and successful liver transplantation could be performed in 6 patients. The overall survival rate of 61 patients was 41.0%. Conclusion: MARS could be used for the treatment of MODS patients associated with elevated levels of NO and cytokines with satisfactory Results.
, 百拇医药
PAGE:490
Clinical application of fluid infusion accelerator in emergency treatment of patients with traumatic shock
WEI Yi-ting
Pingyi Peole's Hospital, Shandong 273300, China
PAGE:491-492
23 cases analysis of pulmonary embolism
CHENG Fang-zhou, HUANG Jun, YU Xi-qiu, TANG Guo-hua
, 百拇医药
Department of Cardiology, Affiliated Hospital of Xiangning Medical College, Xianying 437100, Hubei, China
PAGE;493
The dynamic changes in cytokines and oxygen metabolism in critically ill patients
QIAO Wan-hai, LI Xiao-zhen, PEI Hong-hong
Department of Emergency, he Second Hospital, Xi`an Traffic University, Xi`an 710004, Shanxi, China
, http://www.100md.com
PAGE:494
Dynamic changes in coagulation parameters and platelet counts in perioperative patients with in-situ liver transplantation
ZHANG Xiu-sheng, FENG Yi-qi, LI Jin-yuan
The First Contral Hospital, Tianjin 300192, China
PAGE:495
Plasma infusion during shock stage and the complications of severe burns: a retrospective study in 39 severe cases
, 百拇医药
BAI Xiao-dong, WANG Fa qiang, TONG Qing-ying
Armed force Police General Hospital, Beijing 100039, China
PAGE:496
Effect of hydrocortisone succinate injection on the treatment of acute dyspnea
CHEN Wei, SHEN Hong
Department of Emergency, General Hospital of PLA, Beijing 100853, China
PAGE:497-498
, http://www.100md.com
Analysis on clinical manifestation and reatment in paients of acute auidental poisoning by 2,4-dinitrophenol
WANG Yue, WANG Li-hua, CHEN Yu, LI Lu
Zhejiang University, Medical College, Hangzhou 310031, Zhenjing, China
PAGE:499-501
Advances in research on messenchymal stem cells from bone marrow
DU Yi-ri, FU Xiao-bing, LI Cun-bao
, http://www.100md.com
304th Hospital of PLA, Beijing 100037, China
PAGE:502-505
Non-mitogenic activities of acidic fibroblast growth factor
CAO Ding-guo, LI Xiao-kun, FU Xiao-bing
Jinan University Pharmacology College, Guangzhou 510632, Guangdong, China
PAGE:506-509
Current status and advances in chronic thromboembolic pulmonary hypertension
, 百拇医药
ZHANG Yun-jian, LU Wei-xuan
Chinese Insititute of Medical Science, Beijing 100005, China
PAGE:510-512
New advances in the treatment of endotoxin-induced systemic inflammatory response syndrome by antithrombin III
JIA Hong-yan, REN Xin-sheng
Tianjin Tianhe Hospital, Tianjin 300050, China, http://www.100md.com
Application of fluid resuscitation and baso-active agents in the treatment of severe sepsis and septic shock
QIU Hai-bo, YANG Yi. LIU Song-qiao
PAGE:454-457
Analysis of etiological factors of pseudo—epitheliomatous granuloma after cutaneous wound healing: a report of 11 cases of patients with this lesion
JIANG Du—yin, FU Xiao—bing, SHENG Zhi—yong, CHEN Wei.
, 百拇医药
Taizhou Institute of Wound and Surgery Plastic, Taizhou Fourth People’s Hospital, Taizhou 225300, Jiangsu, China
Abstract: Objective: To explore the pathogenetic mechanism, clinical and pathological characteristics, and prevention and treatment of pseudo—epitheliomatous granuloma after skin wound healing. Methods: The clinical information and the treatment Results: of pseudo—epitheliomatous granuloma occurring in 11 patients (age 1—67 years) were reviewed and analyzed, their tissue specimens were used for microbial examination and histological observation. Results: Some bacteria such as Staphylococcus aureus, Pseudomonas pyocynea, Streptococcus hemolyticus B, and Streptococcus feacalis could be found in the culture of pseudo—epitheliomatous granuloma. The maJority of these bacteria was tolerant to celbenin but sensitive to vancomycin. The lesions were excised, and the wounds were covered with skin grafting or skin flap, supplemented by local of vancomycin to prevent recurrence of the lesion. Histological examination revealed in pseudo—epitheliomatous granuloma with long epithelial peduncle encapsulating granulation tissue like honeycomb, in which there were many capillaries, macrophages, lymphocytes and mast cells, with only a small amount of extracellular matrix. Conclusion: The main pathogenesis of pseudo—epitheliomatous granuloma formation might be improper treatment of wound in earlier period and infection of drug resistant bacteria. Surgical debridement followed by skin coverage and local inJection of vancomycin could be effective and curative.
, 百拇医药
Key words: skin trauma; pseudo—epitheliomatous granuloma; pseudoepitheliomatous hyperplasia; wound repair
PAGE:458-459
Effects of reconstructive human acidic fibroblast growth factor and wild type acidic fibroblast growth factor on skin cell proliferation
ZHAO Jing—yu, FU Xiao—bing, CHEN Wei, SUN Tong—zhu, ZHENG Shu—yun, WENG Li—xin, ZHANG Ying—min.
Key Research Laboratory of Wound Repair, Burns Institute, 304 th Hospital of PLA, BeiJing 100037, China
, 百拇医药
Abstract: Objective: To investigate the effects of reconstructive human acidic fibroblast growth factor (aFGF) and wild type aFGF on skin cell proliferation in rat.
Methods: Neonatal rat skin (area of 2 mm×2 mm) was cultured in Dulbecco's modification of Eagle's medium containing reconstructive human aFGF and wild type aFGF, respectively. The concentrations of aFGF were 1 μg/L, 10 μg/L, and 100 μg/L. After being cultured for 4 days, the area of skin was measured. Results: After treatment with two different growth factors in three different concentrations (1 μg/L, 10 μg/L and 100 μg/L) for 4 days, the areas of skin in three reconstructive human aFGF groups were 14, 15 and 13 fold of that of control, respectively and the areas of three wild type aFGF groups were 15, 32 and 16 fold of that of control, respectively, while the area of skin in the control group was (2.96±1.12) mm2. In comparison with those of other groups, the skin area of 10 μg/L wild type aFGF group was significantly increased (P<0.05). Conclusion: Reconstructive human aFGF confers less impact on cutaneous cell growth. The capability of wild type aFGF to induce cutaneous cell proliferation is much greater than that of reconstructive human aFGF. Key words: reconstructive human acidic fibroblast growth factor； wild type acidic fibroblast growth factor； skin； rat
, 百拇医药
PAGE:460-463
Effects of acidic fibroblast growth factor on intestinal mucosal damage due to ischemia/reperfusion
ZHENG Shu—yun, FU Xiao—bing, XU Jian—guo, SUN Tong—zhu.
Wound Healing and Cell Biology Laboratory, Burns Institute, 304 Hospital of PLA, BeiJing 100037, China
Abstract: Objective: To investigate the effect of exogenous acidic fibroblast growth factor(aFGF) on ischemia/reperfusion(I/R) inJury of the intestine in rat, and to explore the mechanism of its protective effect. Methods: The model of rat intestinal I/R inJury was replicated by clamping the superior mesenteric artery (SMA) for 45 minutes followed by reperfusion. Seventy—eight Wistar rats were divided randomly into sham—operation group, intestinal I/R control group and aFGF treated group. In sham—operation group, SMA were separated but not occluded. Animals were sacrificed, samples of blood and tissue from the intestine were obtained 45 minutes after ischemia in sham—operation group and 0.5, 1, 2, 6, 12， and 24 hours after reperfusion in the other groups. Plasma D—lactate level was measured and rat survival rate was noted. Histological changes in intestinal tissue
, 百拇医药
were observed under light microscope. Results: The Results showed that rat survival rate in aFGF treatment group was higher than that of intestinal I/R control group (P<0.05), and plasma D—lactate levels were markedly lower in aFGF group than that of intestinal I/R control group (P<0.05). Improvement in pathological changes was observed at 1, 2, 6, 12, and 24 hours after the reperfusion in aFGF treatment group compared with intestinal I/R control group. Conclusion: These data suggest that aFGF has a protective effect on intestinal I/R damage, and it may be related to the mitogenic effects and some hormone—like activities of aFGF.
, 百拇医药
PAGE:463
Effects of acidic fibroblast growth factor on intestinal mucosal damage due to ischemia/reperfusion
GUO Kai-tong, WANG Fa-zhi
Wound Healing and Cell Biology Laboratory, Burns Institute, 304 Hospital of PLA, BeiJing 100037, China
PAGE:464-467
Analysis of diagnosis and misdiagnosis of pulmonary thromboembolism in emergency
, 百拇医药
LIU Shuang, ZHU Xiao—ling, ZHOU Yi, ZHANG Jing—lan, XU Xiao—feng, LI Zhi—zhong. Anzhen Hospital, Capital University of Medical Science, BeiJing 100029, China
Abstract: Objective: To investigate the differential diagnosis of pulmonary thromboembolism in emergency in order to increase the correct diagnosis rate of pulmonary thromboembolism. Methods: The data of patients who were diagnosed pulmonary thromboembolism in Emergency Intensive Care Center of Anzhen Hospital from January 2000 to the end of August 2003 were analyzed. Patients were divided into two groups. One group of patients with pulmonary thromboembolism were diagnosed pneumonia, heart disease and cerebrovascular disease. The other group of patients were not pulmonary thromboembolism and were misdiagnosed. Results: Five patients with pulmonary thromboembolism were diagnosed pneumonia, 7 and 3 patients were diagnosed heart disease and cerebrovascular disease, respectively. In the other group, 4 patients with lung or mediastinal tumors, 2 with pneumonia and 1 with bronchiectasis were diagnosed pulmonary thromboembolism. Conclusion: It is essential to correctly diagnose pulmonary thromboembolism, especially emergency physicians should master diagnosis method of pulmonary thromboembolism and reduce the rate missed of diagnosis.
, http://www.100md.com
PAGE:468-472
Roles of hydroxyethyl starch solution in resuscitation for shock induced by ischemia/reperfusion inJury of the intestine
TU Zi—zhi, SUN Qing—hua, George Dimopoulos, Suzana M Lobo, Daniel de Backer, XIAO Xian—zhong, Jean—Louis Vincent.
Department of Pathophysiology, Xiangya Medical College, Central South University, Changsha 410078, Hunan, China; Department of Intensive Care Medicine, Erasme Hospital, Free University of Brussels, Belgium
, 百拇医药
Abstract: Objective: To compare the effects of high and low doses of 6% hydroxyethyl starch solution (HES) on resuscitation for shock induced by ischemia/reperfusion inJury of the intestine in rabbits. Methods: Thirty—two anesthetized rabbits were randomized into four groups of eight animals each. The animals in the control group received no fluid resuscitation, animals in group 2 received lactated Ringer's solution (LRS, 20 ml·kg-1·h-1), those in group 3 received LRS+HES (LRS 18 ml·kg-1·h-1+HES 2 ml·kg-1·h-1, low dosage of HES), and those in group 4 received HES only in high dosage of HES (20 ml·kg-1·h-1). All these rabbits underwent intestinal ischemia/reperfusion inJury developed by occluding superior mesenteric artery (SMA) with a noncrushing vascular clamp for 60 minutes and then the clamp was loosened for 240 minutes. The fluid resuscitation began at the same time of reperfusion. Hemodynamic parameters including mean artery pressure, heart rate, aortic velocity (as cardiac output), and SMA blood flow were measured. Tissue oxygenation was assessed indirectly by measuring the tonometric parameters of the gut, including difference between partial pressure of carbon dioxide in intestinal intramucosal and partial pressure of carbon dioxide in arterial blood (Pt—aCO2 gap), intestinal intramucosal pH (pHi), arterial blood lactate acid concentration and oxygen delivery. Mortality of the rabbits was counted at the end of the experiment. Results: Hemodynamic parameters as measured in low and high doses of HES groups were significantly higher in values than LRS group (LRS) and control (all P<0.05). Low dose of HES was better in restoring hemodynamic parameters than high dose of HES (all P<0.05). Low dose of HES could greatly decrease lactate and Pt—aCO2 gap, significantly improve pHi compared with other three groups (all P<0.05), but high dose of HES did not do so, and oral and nasal bleeding even death of some animals were seen. Low dose and high dose of HES significantly improved oxygen delivery while LRS did not (all P<0.05). Conclusion: Low dose of HES together with LRS is more effective than only high dose of HES or LRS in the resuscitation for shock induced by ischemia/reperfusion inJury of the intestine in rabbits, resulting in better hemodynamic parameters and tissue oxygenation.
, http://www.100md.com
PAGE:473-476
Mechanism of better result of limited resuscitation in a model of uncontrolled hemorrhagic shock
WANG Qin—cun, XIAO Nan, DIAO You—fang, TIAN Kun—lun, FAN Xiao—qing, CHEN Hui—sun.
Research Institute of Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, China
Abstract: Objective: To investigate the mechanism of better result of limited resuscitation in a model of uncontrolled hemorrhagic shock. Methods: Uncontrolled hemorrhagic shock was produced in 54 rats by a standardized massive splenic inJury with transection of the middle branch of splenic artery (MSIA). The rats were randomly assigned to six groups (n=6) by maintenance of the level of mean arterial pressure (MAP): sham—operated group(SS), 40 (RS40), 50 (RS50), 60 (RS60), 80 (RS80) and 100 mm Hg (RS100, 1 mm Hg=0.133 kPa). When the MAP reached 40 mm Hg, resuscitation was begun. Ringer's solution was continued as needed to maintain the following desired endpoints for 45 minutes (T45 point):MAP of 40, 50, 60, 80 and 100 mm Hg. After the bleeding was controlled, resuscitation was continued with Ringer's solution and whole blood (2∶1) to raise the MAP to 100 mm Hg for 120 minutes (T165 point), followed by a 240 minutes observation period (T405 point).All animals were observed for 240 minutes or till death. The blood samples were withdrawn from artery for hematocrit (Hct), blood lactate (BL), base excess(BE) at T0, T45, T165, T405 points. At the end of the experiment, a small amount of hepatic tissue was collected for measuring tissue blood perfusion, total antioxidative capacity (T—AOC), Na+—K+—ATPase, and malondialdehyde(MDA). Results: At T45, T405 points, Hct in SS, RS50 and RS60 were significantly higher than in RS80 and RS100(P<0.05). At T405 point, BL and BE levels in RS80 and RS100 were significantly higher than that of the other groups(P<0.05). The contents of MDA in SS, RS40, and RS50 were significantly lower than in RS80 and RS100(P<0.05). T—AOC level,Na+—K+—ATPase were significantly lower in RS80 and RS100 than that in the other groups. Blood perfusion was significantly lower in RS80 and RS100 than that in SS, RS40, and RS50. Conclusion: In the setting of uncontrolled hemorrhagic shock, limited resuscitation could balance well the needs of organ perfusion and decrease lactate level. It might also exert a protective effect against ischemia/reperfusion inJury to liver tissue.
, 百拇医药
Key words: uncontrolled hemorrhage shock; limited resuscitation; ischemia/reperfusion inJury
PAGE:476
Mechanism of better result of limited resuscitation in a model of uncontrolled hemorrhagic shock
SU Qing-ju
Research Institute of Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, China
PAGE:477-480
, http://www.100md.com
Study on morphological change in intestinal mucosa from inJury to repair after hemorrhagic shock
CHANG Jian—xing， CHEN Shuang, FU Yu—ru, CHANG Rui—ming, CHEN Jian—wen, HUANG Zi—tong.
The Second Affiliated Hospital, Sun Yat—sen University, Guangzhou 510120, Guangdong, China
Abstract: Objective: To study on morphological changes in mucosa of the small and large intestine mucosa after resuscitation of hemorrhagic shock. Methods: The morphological changes in intestinal mucosa were observed under light and electron microscope, including the histology of intestinal mucosa, determination of height of villi and evaluation of mucosa damage index in the different phases after traumatic—hemorrhagic shock. Results: Mucosa epithelial inJury was obvious in small intestine were even at 0 hour, becoming more serious in 1 hour up to 3 hours. The tissue repair began after 3 hours, though the inJury was still serious. Most of the inJured mucosa began to repair after 6 hours, and completed in 24 hours. The condition of the large intestine was similar to that of the small intestine, but the inJury was less severe. The mucosal thickness and the height of villi were diminished after 1 hour of shock, but there was no obvious change in the colon. Conclusion: In the early phase after hemorrhagic shock, intestinal mucosal barrier are subJected to damage, but it could repair and recover in a short time. Compare with small intestine, large intestinehave stronger potentiality against inJury
, 百拇医药
PAGE:480
Study on morphological change in intestinal mucosa from inJury to repair after hemorrhagic shock
HU Yan-sheng, HU Jin-nian
The Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong, China
PAGE:481-483
Level of tissue plasminogen activator protein in pulmonary artery in acute pulmonary thromboembolism in rabbit
, 百拇医药
ZHANG Jing—xia, SUN Gen—yi, CHEN Yong—li, WANG Pei—xian, YUAN Zhi—ming, ZHOU Yu—ling.
TianJin Thoracic Hospital, TianJin 300051, China
Abstract: Objective: To study the changes in tissue plasminogen activator(t—PA) protein in pulmonary artery and itsclinical significance after acute pulmonary thromboembolism (PTE). Methods: Thirty rabbits were randomly divided into four groups after replicating a model of acute PTE in rabbit by thrombi occlusion method. Specimens were obtained from both normal and morbid pulmonary artery 3, 8 and 24 hours after APE, and protein contents of t—PA were determined using immunohistochemical method. Results: A few endothelial cells and smooth muscle cells of the normal pulmonary artery were positive for t—PA. After 3 hours of PTE, there was no significant changes in t—PA positive stain among embolismic, non—embolismic and normal pulmonary artery. After 8 and 24 hours of PTE, strong positive staining was found in the residual endothelial cells and a part of smooth muscle cells (all P<0.01). Conclusion: There is significantly strong positive staining for t—PA in the pulmonary artery wall after pulmonary embolism, implying that the local fibrinolysis activity was enhanced, and it might be helpful for lysis of the embolus. Key words: pulmonary thromboembolism; tissue plasminogen activator; pulmonary artery; immunohistochemical method
, 百拇医药
PAGE:483
Clinical application of hemoperfusion: report of 11 cases
WANG Yu-gang, ZHANG Bin, ZHENG Shan-hai ,SU Zhen, GAN Wei-hong, JIANG Xiu-mei, MA Ya-xin
Coal General Hospital, Beijing 100028, China
PAGE:484-486
Analysis of the status of diagnosis of acute pulmonary embolism and a study of further strategy to improve the diagnostic level
, 百拇医药
LI Xin, LIAO Xiao—xing， GUAN Kai—pan, JING Xiao—li, MA Zhong—fu, TANG Hao, ZHAN Hong.
Department of Emergency, The First Affiliated Hospital of Zhongshan University, Guangzhou 510080, Guangdong, China
Abstract: Objective: To analyze the present status of diagnosis of pulmonary embolism (PE) by analyzing the clinical data of patients admitted during last 10 years to our hospital, in order to look for a significant diagnostic strategy to improve the diagnostic level. Methods: The data of patients diagnosed to have PE in last 10 years were analyzed. In the last 5 months, the patients suspected to have PE were diagnosed by a comprehensive approach including clinical manifestations, lung scan and/or spirals computer tomography(SCT) in our emergency department. Results The diagnostic rate, the final diagnostic rate within 3 days and the diagnostic rate by lung scan or/and SCT were all higher in the last 3 months than ever. The proportions of angiograms and the overall 3—month PE risk were 2.8% and 0 Conclusion: The comprehensive approach which includes clinical manifestations, lung scan and/or SCT can obviously improve the diagnostic level of PE.
, http://www.100md.com
PAGE:487-490
Therapeutic application of molecular adsorbent recirculation system in the treatment of multiple organ dysfunction syndrome patients
LUO Hong—tao, GUO Li—min, LIU Quan—mei, WU Min, BAI Hong—lian, LUO Yue—hua, ZHANG Pei—hua, LUO Zuan—di, WANG Min—min.
Department of Infectious Diseases, the First People's Hospital of Foshan, Foshan 528000, Guangdong, China
, 百拇医药
Abstract: Objective: To assess the effectiveness of molecular adsorbent recirculation system (MARS) to remove nitric oxide(NO) and cytokines in multiple organ dysfunction syndrome(MODS) in patients with severe liver failure. Methods:
Single MARS treatment were performed for 198 times with duration ranging from 6 to 24 hours on 61 MODS patients (42M/19F). The efficacy was evaluated by sequential organ failure assessment, biochemical parameters and the levels of pro—inflammatory cytokines. Results: The MARS therapy resulted in a significant removal of NO and certain cytokines such as tumor necrosis factor—α(TNF—α), interleukin—2(IL—2), IL—6, IL—8, and lipopolysaccharide—binding protein(LBP), together with marked reduction of other non—water soluble albumin bound toxins and water soluble toxins. These were associated with an improvement of the patients' clinical conditions, including deranged hemodynamics, respiratory function, cardiovascular and renal functions, hepatic encephalopathy, thus resulting in a marked decrease of sequential organ failure assessment(SOFA) score and improved outcome. Twenty—five patients were able to be discharged from the hospital, and successful liver transplantation could be performed in 6 patients. The overall survival rate of 61 patients was 41.0%. Conclusion: MARS could be used for the treatment of MODS patients associated with elevated levels of NO and cytokines with satisfactory Results.
, 百拇医药
PAGE:490
Clinical application of fluid infusion accelerator in emergency treatment of patients with traumatic shock
WEI Yi-ting
Pingyi Peole's Hospital, Shandong 273300, China
PAGE:491-492
23 cases analysis of pulmonary embolism
CHENG Fang-zhou, HUANG Jun, YU Xi-qiu, TANG Guo-hua
, 百拇医药
Department of Cardiology, Affiliated Hospital of Xiangning Medical College, Xianying 437100, Hubei, China
PAGE;493
The dynamic changes in cytokines and oxygen metabolism in critically ill patients
QIAO Wan-hai, LI Xiao-zhen, PEI Hong-hong
Department of Emergency, he Second Hospital, Xi`an Traffic University, Xi`an 710004, Shanxi, China
, http://www.100md.com
PAGE:494
Dynamic changes in coagulation parameters and platelet counts in perioperative patients with in-situ liver transplantation
ZHANG Xiu-sheng, FENG Yi-qi, LI Jin-yuan
The First Contral Hospital, Tianjin 300192, China
PAGE:495
Plasma infusion during shock stage and the complications of severe burns: a retrospective study in 39 severe cases
, 百拇医药
BAI Xiao-dong, WANG Fa qiang, TONG Qing-ying
Armed force Police General Hospital, Beijing 100039, China
PAGE:496
Effect of hydrocortisone succinate injection on the treatment of acute dyspnea
CHEN Wei, SHEN Hong
Department of Emergency, General Hospital of PLA, Beijing 100853, China
PAGE:497-498
, http://www.100md.com
Analysis on clinical manifestation and reatment in paients of acute auidental poisoning by 2,4-dinitrophenol
WANG Yue, WANG Li-hua, CHEN Yu, LI Lu
Zhejiang University, Medical College, Hangzhou 310031, Zhenjing, China
PAGE:499-501
Advances in research on messenchymal stem cells from bone marrow
DU Yi-ri, FU Xiao-bing, LI Cun-bao
, http://www.100md.com
304th Hospital of PLA, Beijing 100037, China
PAGE:502-505
Non-mitogenic activities of acidic fibroblast growth factor
CAO Ding-guo, LI Xiao-kun, FU Xiao-bing
Jinan University Pharmacology College, Guangzhou 510632, Guangdong, China
PAGE:506-509
Current status and advances in chronic thromboembolic pulmonary hypertension
, 百拇医药
ZHANG Yun-jian, LU Wei-xuan
Chinese Insititute of Medical Science, Beijing 100005, China
PAGE:510-512
New advances in the treatment of endotoxin-induced systemic inflammatory response syndrome by antithrombin III
JIA Hong-yan, REN Xin-sheng
Tianjin Tianhe Hospital, Tianjin 300050, China, http://www.100md.com