After one hind leg of the pig was wounded by the high-speed steel spheres the status of the animals was continuously monitored by determination of hemody-namics, blood gas, chest X-ray, serum T3, T4, fibronectin, protein content of lung lavage, lung weight, light and electromicroscopic examination etc. When the animals died or were killed 72 hours after injury, the pathologic examinations were carried out as soon as possible. It showed that there were various changes in above mentioned parameters, especially in those of the dead animals. The relationship between the incidence of RDS and trauma index-injury severity score (ISS) was discussed. In addition, the subclinical type of RDS was emphasised.

Bacterial endotoxins (LPS) are not only the major constituents of the outer membrane of Gram-negative (G -) bacteria, but also the toxic determinants for G - infection, which is closely related to human health and the development of diseases. Pattern recognition receptors (PRR) have been considered to be the important initial steps for cellular recognition of LPS and consequent initiation of LPS responses. Scavenger receptor, CD14, toll-like receptors, ?2-integrins and L-selectin have been shown to be involved in the clearance of LPS or LPS activation. LPS receptor may be a complex of multiple components. Different individual response to LPS is related to gene background. The gene polymorphism of LPS receptors and LPS-induced cytokines have been shown to contribute to LPS sensitivity, susceptibility and prognosis of sepsis.

With the continuous improvement in weaponry, especially explosive weapons, blast injury has become one of the most common war injuries. Underwater blast injury is a common war injury during combat around islands or fighting for beach-head. The wounding effects of underwater blast wave and the characteristics of underblast injury are quite different from that produced in air due to special physical features of water and the underwater pressure. We have investigated the injurious effects of underwater blast wave and its dose-effect relationship. In addition, some protective measures have been tested to prevent or alleviate underwater blast injury. All of these primary results have provided both experimental and theoretical foundation evidence for further researches in respect to the diagnosis, emergency care and protection against underwater blast injury.

Objective To review the application of trauma and injury severity score (TRISS) and a severity characterization of trauma (ASCOT) in the outcome evaluation of trauma care and their research advances.Data sources Both Chinese- and English-language literature searched by using MEDLINE/CD-ROM (1985-1996) and Index of Chinese-Language Literature (1985-1996).Study selection Over fifty papers and reviews published over the past ten years were selected.Results and conclusion TRISS can be employed for different purposes, that is, preliminary outcome-based evaluation (PRE) and definitive outcome-based evaluation (DEF). TRISS is a method which is now the most extensively used for the outcome evaluation of trauma. Even so, it still has some shortcomings, e.g., trauma can not be given the weights that should be given, and the section of age is too simple. ASCOT is also a physiologic and anatomic combined method for the evaluation of injury severity and outcome. To some extent, this method obviates the shortcomings of TRISS in the calculation of probability of survival (Ps) with injury severity score (ISS). Therefore, ASCOT is considered to be superior to TRISS in the evaluation of Ps. However, TRISS is still now more extensively used than ASCOT just because ASCOT was recently developed.

Objective　To make clear the effect of gastrointestinal tract ischemia on multiple organ dysfunction syndrome (MODS). Methods　The literature in the recent years was reviewed. Results　The low-flow states of gastrointestinal tract and decrease of gastrointestinal intramucosal pH, which occured following a variety of insults (sever trauma, hemorrhagic shock, et al), as well as overgrowth of enterobacteria, may result in a significant increase of permeability of bowel and lead to endotoxemia and bacterial translocation. Ischemia also resulted in release of TNF, IL-6 into the systemic circulation, dysfunction of gastrointestinal tract motility, and activation of neutrophile which was integral in local and distant organ damage. Conclusion　These data suggest that the management of correct ischemia of gastrointestinal tract, which include fluid infusion to replacement of blood volume, early enteral nutrition, improvement of gastrointestinal movement, could contribute to improve the intestinal barrier function, and prevent the development of MODS.

Objective To study the effect of application of vascular endoth el ial growth factor (VEGF) and anti-VEGF on the expression of fracture healing rel ated factors and observe the pathological changes at fractured site. Methods Fra cture models were established in 105 rabbits. All rabbits were randomly assigned into controlled group, VEGF treated group and anti-VEGF treated group. The fact ors related to fracture healing were detected, and pathological changes were obs erved at 8, 24, 72 h and 1, 3, 5, 8 weeks after fracture. Results After the appl ication of VGEF, BMP was expressed earlier and the express period was prolonged . On the contrary, anti-VEGF completely inhibited the expression of BMP in the f ractured ends. The fractured sites were filled with fibrous callus, cartilage ca llus and bony callus at the 3rd week and they were converted into woven bone at the 5th week. The fracture reached to normal healing at the 8th week in the VEGF treated group. Cellular necrosis increased in the earlier period in the VEGF po lyclonal antibody treated group, continuous focal necrosis was seen in the fract ured sites between 1st week to 5th week, vascularization reduced obviously at th e 3rd week. Conclusion Fracture healing is the result of mutual modulation and c oordination among many factors. VEGF may be an important factor which plays impo rtant role in the course of fracture healing.

Objective To study the expression law of zinc finger protein A20 mRNA of mouse liver tissues in the process of trauma with lipopolysaccharide (LPS) infection. Methods A total of 95 healthy mice (either sex, from Kunming, Yunnan province) with a mean body weight of 21 g (18-24 g) were randomized into 4 groups: control, trauma only (Group A), LPS only (Group B) and trauma plus LPS (Group C). The models with closed fracture of bilateral spines as well as endotoximia were made. The expression characteristics of zinc finger protein A20 mRNA of liver tissues were measured by reverse transcription-polymerase chain reaction (RT-PCR) and all result data expressed as total gray ratio of A20 mRNA to GAPDH mRNA (?s). Results In the control group, the A20 mRNA expressed at a low level. There was low expression of zinc finger protein A20 in the Group A at various time points, with no significant difference compared with the control group. After LPS infection, the expression of A20 mRNA in the Group B was elevated more obviously than that in the control group at 0.5 hour, reached peak during 0.5-2 hours and decreased after 2 hours. But expression of A20 mRNA at each time point was higher in the Group B than that in the Group A. In the Group C, after LPS infection, the expression of A20 mRNA was elevated more significantly than that in other two groups 0.5 hour, reached the highest level during 0.5-2 hours, much higher than that in the Group B (P

The effects of tumor necrosis factor (TNF) on the activity of plasmogen acitva-tor inhibitor (PAD and the morphology of the cells were observed in the original passage of cultured human umbilical vein endothelial cells (HUVEC). It was found that the TNF effect on the PAI was determined by the dosage of TNF, that is, 500U/ml of TNF could significantly activate PAT activity while 2500U/ml markedly inhibit it. Morphdogical observation canfirmed that 2500U/ml of TNF could injure HUVEC to form a kind of cells whose morphology was quite similar to that of circulating endothelial cells originating from peripheral blood.These findings suggest that TNF can stimulate HUVEC to increase the PAI acivity but too large a dosage of TNF could injure the metabolic function and structure of HUVEC.

To investigate the role of ICAM 1 in the aggregation of polymorphoneucleocytes (PMN) in the lungs at the early stage of burns. Myeloperoxidase (MPO) content in lung tissues and bronchoalveolar lavage fluid (BALF) was assayed. Intercellular adhesion molecule 1 (ICAM 1) and its mRNA expression in lung tissues were determined by immunohistochemical method and in situ hybridization. CD11b/CD18 expression on the circulating PMN were measured by flow cytometry. The results showed that levels of MPO in lung tissues and BALF were markedly higher than those of control after burn injury. Expression of ICAM 1 and its mRNA in the lung tissues and CD11b/CD18 on circulating PMN surface were significantly increased at 2, 6, 12, 24hr after burns. It suggests that PMN aggregation in the lungs might be related to increased ICAM 1 expression on pulmonary microvascular endothelial cells and CD11b/CD18 expression on PMN at the early stage of burn injury.

In order to explore the effect of anti vegf on fracture healing process,rabbits with left radius fracture were used as an animal model and divided randomly into control and experiment groups.VEGF polyclonal antibody was given to the animals of the experiment group films were thken at the fracture sites after 1,3,5 and 8 weeks of the fracture.the results showed that the cellular necrosis increased in the experiment group shortly after the fracture.Although there was fibroblast proliferation at 72 hours after the fracture,continuous focal necrosis was seen from 1 to 5 weeks in the fracture sites,and the vascularization reduced obviously 3 weeks after the injury.The organelle degeneration was observed in the fibroblasts and osteoblasts under microscope.The fracture sites were filled with fibrous tissue at the 8 th week and nonunion was ween in the fracture sites on X ray films.These results suggest that the lack of VEGF in the fracture sites might be one of the important reasons of fracture healing.