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 explore the changed rules and the diagnositic methods of the cardisc functions after chest impact trauma(CIT).Methods The medals of moderate to severity CIT were established using BIM-Ⅱ Bio-impactor in 20 rabbits.The cardiac functions were examined with cardiac catheterization,single photon-emission computed tomography(SPECT)and the Doppler echocardiography at pre end post 1h,4h,8h and 24h after CIT.Results The cardiac functions were changed significantly after CIT.The expressions of the right ventricular dysfunctions mainly were systolic dysfuction while the left ventricular dysfunctions mainly were diastolic dysfunction after CIT.Conclustion All the cardiac catheterization、SPECT and the Doppler echocardiography are beneficial to the diagnosis of cardiac dysfunction afte CIT.The SPEGT is more exactitude and the Doppler echocardiography is more cheaper compared with non-invasive approaches.

BACKGROUND: There exists a close relationship between the expression of scavenger receptor(SR) and CD14 and the endotoxic lung injury. To further detect the expression of these two receptors and their relationship is helpful to disclose the receptor mechanism of lung inflammatory disequilibrium so as to provide a possible theoretical foundation for sepsis therapy.OBJECTIVE: To investigate the expression of CD14 and SR in murine alveolar macrophages and their effect after trauma and traumatic endotoxin challenge.DESIGN: Randomized and controlled experimental study.SETTING: Fourth Laboratory(a state key laboratory), Trauma, Burns and Combined Injury, the Research Institute of Field Surgery, Daping Hospital,the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was completed in the Research Institute of Field Surgery of Daping Hospital of the Third Military Medical University of Chinese PLA from August 2001 to November 2001. Totally 63 Kunming mice with murine alveolar macrophages were used in the experiment.METHODS: The experimental animals were randomly divided into three groups including control group, trauma group and traumatic endotoxin challenge group. The model mice with both femur fracture and endotoxin challenge were used. Endotoxin at a dose of 5 mg/kg was injected one hour after fracture via tail vein and the dynamic expression of CD14 and SR in murine alveolar macrophages (AM) was detected.RESULTS: Six hours after trauma, the expression of CD14 and that of SR in AM showed the tendency of up-regulation and down-regulation respectively. Furthermore, the post-traumatic endotoxin challenge induced CD14up-regulation and SR down-regulation drastically. Correlation analysis indicated that CD14 and SR showed a significantly negative relationship.CONCLUSION: The study suggested that the dual modulation of CD14 and SR in AM is possibly related with the change of "self-control" to "out of control" of inflammatory reactions in the lungs after endotoxic challenge. The dual regulation of the effective antagonists CD14 and SR are helpful in further understanding lung injury and its repairing mechanism.

Objective To explore the changes and the significance of left ventricular functions after blunt chest trauma(BCT)in rabbits.Methods 36 rabbit models of BCT with BIM-Ⅱ Bio-impactor in were used to observe the changes of left ventricular functions and free calcium,free calmodulin and total calmodulin were detected at pre-injury,the 2nd,4th,8th,12th and 24th hour after injury.Results The cardiac function were impaired.The systolic functions of left ventricle were impaired and recovered during 4-12 hour after BCT.The diastolic functions of left ventricle were impaired but not recovered 24h after BCT.The free calcium and total calmodulin in myocardial cells were increased from the 4th hour,reached,peak at the 8th hour post-BCT(P＜0.01),and then decreased,but were still higher at the 24th hour post-BCT than that of pre-BCT(P＜0.05).The free calmodulin in myocardial cells was low and reached peak at the 8th hour after BCT(P＜0.01).There is remarkable positive correlation between free calcium in myocardial cells and LVEDP and dp/dtmax with cardiac function(P＜0.05,P＜0.01).Conclusion The cardiac function is obviously changed after BCT,especially the diastolic functions of left ventricle.The hish concentration of free calcium in myocardial ceils may be one of the reasons of cardiac dysfunction after BCT.

Objective To investigate the adjustment of immunosuppression and prevention of infections in lung after renal transplantation.Methods 253 cases of pulmonary infections after renal transplantation between January 1999 to March 2004 were analyzed. After 2003, postinduction period, the blood concentrations of CsA and FK506 were maintained at 0.125~0.166 ?mol/L and 5 ?g/L respectively. The oral dose of MMF was 1 g every day. Results The creatinine levels were stable 253 patients after treatment. Among 253 cases, 229 cases were cured (90.51 %) and 24 died (9.49 %). After adjustment of immunosuppressants, common pulmonary infections and severe pulmonary infections were decreased.Conclusions Infection in lung was a severe complication after renal transplantation. Timely treatment, nursing care and adequate adjustment of immunosuppression may achieve satisfactory effects in preventing lung infection.

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.

The separation,purification and activity determination of basic fibroblast growth factor (bFGF) with nucleic acid molecular hybridization was described and the changes of bFGF in lung injury treated with prostacy-clin were observed.It was found that bioactive bFGF and bFGF-mRNA could only be found in the injured lung tissues but not in the normal lungs.Administration of prostacyclin could slightly elevate the activity of bFGF and signficantly increase the level of bFGF-mRNA.The findings of this study suggest that there is an increase of bFGF level after lung injury,prostacyclin can influence the expression of bFGF,and bFGF plays an important role in the repair of the injured lung tissues.