The relationship between lipid peroxidation and cell damage was studied in 8 dogs after they were inflicted with high-velocity missile trauma to the soft tissues of a leg and in another 8 to whom hemorrhagic shock was induced immediately after missile trauma. It was found that after trauma, the lipid peroxide(LPO) content of the muscle homogenate and mitochondria suspension of the wounded region and in plasma was markedly increased, and it had no tendency to restore to the normal until 12 hours after trauma. The increase of LPO occurred earlier in mitochondria suspension than in muscle homogenate. In addition, the activities of plasma creatine phosphokinase, acid phosphatase and cathepsin-D and of superoxide dismutase(SOD) were also increased, which was in significant correlation with LPO increase. The LPO content of the tissues of the remote regions remained un- changed. In the shock group, the LPO content of both the wounded region and the opposite leg was increased, which was in significant correlation with the increase of plasma enzyme activities, but SOD activity was markedly decreased,The results suggest that lipid peroxidation plays an important role in cell damage after high-velocity missile trauma and hemorrhagic shock. SOD may be activated as a compensatory response, but it is usually inhibited in severe trauma to result in irreversible damages.

In order to observe the pattern of energy expenditure in trauma patients,the REE, substrate oxygenization and nitrogen balance were measured in1 8severely injured patients. REE in posttrauma day1 was1 882? 2 45 kcal/d,1 .1 9of HBBEE,reduced gradually to normal range on posttrauma day 1 0 .REE in single trauma patients decreased more rapidly than that in multiple trauma patients.REE in patients with APACHE ≥ 1 2 was higher than that in patients with APACHE

Objective To reestablish cell polarity of hepatocytes cultured in vitro.Methods Sandwich configuration was used to culture hepatocytes. The morphology as well as specific plasma proteins were compared with a single collagen configuration.Results In sandwich configuration hepatocytes were arranged in single cell plate, and the gradual development of bile canaliculi like structures and an anastomotic network were observed over the course. Histochemical immunolocation revealed that membrane proteins were distributed specifically. Hepatocytes in single collagen configuration showed hardly any hepatic plate like structure,and the distribution of specific plasma protein was not formed. Conclusions Sandwich cultured hepatocytes reestablished cell polarity structurally and regained the characteristics of hepatocytes in situ.

Objective: To study depression of patients with Grave's disease and the therapeutic effect of Paroxetine (antidepressant). Method: 82 patients with first onset Grave's disease were collected and 52 of them had depression. The depressive patients were divided into Paroxetine and control group. All cases had the same anti-hyperthyroidism treatment. Result: 63.4% (52/82) patients with first onset Grave's disease had depression before Paroxetine treatment. After 4 weeks and 8 weeks treatment, Paroxetine group had greater decrease in FT3 and FT4, and lower scores of SDS and SAS than control group (p＜0.01). Conclusion: Paroxetine does enhance the therapeutic effect of anti-hyperthyroidism, as well as improving depression of patients with first-onset Grave's disease.

To summarize the experiences of optimization of emergency medical care in Nanjing General Hospital.The principles and methods of optimizing emergency medical care were analyzed and summarized.The following methods were used to improve the emergency medical care: Applying modern conceptions of emergency medicine and establishing professional physician teams;Reinforcing the duty of each position and improving the quality of medical care;Modifying the mode and improving the working efficiency;Establishing clinical pathways for disasters and other accidents.The roles of emergency medicine are changed and modernized. Optimization of emergency care and popularization of emergency care skills may improve the quality and efficiency of emergency medical care.

Objective To investigate the factors influencing the incidence of acute pancreatitis (AP) in patients with organophosphorus poisoning and explore the effectiveness of measures for its prevention and treatment. Methods Clinical data of 50 patients with organophosphorus poisoning were reviewed retrospectively in our center between January 2001 and December 2006. Results The incidence of AP in patients with organophosphorus poisoning was 30% (15/50), and 14 patients suffered from MAP, while one patient occurred SAP. 13 of 15 AP patients underwent gastric lavage with cold normal saline; gastric tube was placed in 14 patients; toxic doses over 50 ml were observed in 10 patients; atropine overdose were observed in 11 patients. There were 35 cases of organophosphorus poisoning alone, and 2 of them underwent gastric lavage with cold normal saline; gastric tube was not placed in 1 patient; toxic doses over 50 ml were not observed in all the patients. The toxic dose, water temperature for gastric lavage, gastric tube placement, duration from poisoning to treatment between the two groups were significantly different (P＜0.01). All the patients with organophosphorus poisoning alone survived, while in these 15 patients with AP, 14 patients were cured, 1 patient died. Conclusions Organophosphorus poisoning can induce AP and development of AP was possibly related to organophosphorus poisoning and improper treatment.

Objective Role of melanocortin receptor 4 (MCAR) in excitatory amino acid release from rat astrocytes in spinal cord. Methods Astrocytes were isolated from the spinal cord of newborn pathogen-free Wistar rats ( 1-3 days after birth) and cultured in serum-free Neurobasal/B27 liquid culture medium. After 4 passages the primary cultured astrocytes were randomly divided into 3 groups (6 wells each): group Ⅰ control (group C); group Ⅱ the astrocytes were exposed to TNF-α 10 μg/L (group T) and group Ⅲ the astrocytes were exposed to TNF-α 10 μg/L and HS014 (selective MC4R antagonist) 1 μmol/L (group TH). The astrocytes were incubated at 37 ℃ for 3 h. The supernatant was collected for determination of glutamic acid (Glu) and aspartic acid (Asp)concentrations by HPLC-MS/MS. Results TNF-α significantly increased Glu and Asp release from astrocytes in group T as compared with group C. The Glu and Asp concentrations were significantly lower in group TH than in group T. Conclusion MG4R is involved in the excitatory amino acid release from astrocytes in the spinal cord.

Objective To observe the expression of connective tissue growth factor (CTGF) in pancreas, and discuss its significance. Methods The pancreatic fibrosis model was induced by high fat diets. The rats were sacrificed 16 weeks later, and the pancreatic tissue was harvested for routine pathologic examinations. Pancreatic collagen fibrosis I was determined by HE and Sirius red staining;α-SMA and CTGF expression were detected by immunohistochemistry. Results After pancreatic fibrosis, pancreatic lobules and acinar atrophy was observed, lobules gap was widened, interstitial fibrous tissue was significantly proliferated, the synthesis of pancreatic collagen fibrosis I was significantly increased when compared with normal pancreas ( 1500.2 + 255.8 vs. 57.4 ± 23.2, P ＜ 0. 01 ), the expression of α-SMA was significantly increased when compared with normal pancreas( 1500.2 + 255.8 vs. 57.4 + 23.2, P ＜ 0. 01 ), and the expression of CTGF was significantly increased when compared with normal pancreas (2950.5 ± 431.9 vs. 382.2 + 190.8, P ＜0.01 ), and there were abundant activated PSCs. Conclusions CTGF participated in the regulation of pancreatic fibrosis development; the function of CTGF was closely related to PSCs activation.

ObjectiveTo explore the sensitivity of cancer stem cells to chemotherapy in human pancreatic carcinoma.MethodsPANC-1 ceils were cultured in an incubator filled with 5％ CO2 at a temperature of 37℃,and were labeled with Hoechst 33342.The SP analysis and sorting were performed using a FACSVantage SE.RT-PCR was performed to detect the expression of human CD133 ABCG2 and Notch1.SP and non-SP cells from the PANC-1 cell line were treated with 5-fluorouracil (5-FU; 1,10,or 100 μg/ml) or gemcitabine (10,100,or 1000μg/ml),and the cell viability was determined using the MTT assay.The sensitivity of sorted tumor cells to chemotherapeutics was determined in NOD/SCID mice model.ResultsSP cells were found to have higher drug-resistance both in vivo and in vitro and higher levels of mRNA expression for CD133,ABCG2 and Notch1,when compared to non-SP ceils.The xenografted tumors derived from injected SP cells and treated with gemcitabine had more CD133± cells than the untreated group.ConclusionsThe SP of PANC-1 pancreatic carcinoma cells are enriched with highly gemcitabine-resistant CSCs and determine the carcinogenesis of the PANC-1 pancreatic carcinoma cells.

Objective: To explore the emergency treatment of acute respiratory tract injury caused by inhalation of phosphorus trichloride.Methods: The clinical data of 16 patients with acute respiratory tract injury caused by inhalation of phosphorus trichloride were analyzed.Intratracheal inhalation of salbutamol sulfate solution and pulmicort repules atomized liquid by aerosol rebreathing method was performed immediately after the diagnosis was made.Anti-inflammatory,fluid replacement,and other symptomatic treatment were given at the same time.Treatment lasted for 3-5 days.Results: The symptoms and signs improved significantly after 3-5 times of inhalation.Among the 16 patients,15 were cured and one improved;the cure rate was 93.75%.The shortest observation period was 2 days and the longest 7 days with an average period of 2.38 days.All cases were followed up for 3 months.No complications were found except one with pleural thickening.Conclusion: Early treatment of acute respiratory tract injury with intratracheal corticosteroid and?2 receptor activator is satisfactory for patients with inhalation of phosphorus trichloride.The method is fast-acting,efficient,with less side-effects,convenient,and easily accepted by patients.