Objective To investigate imaging findings of lung injury after seawater drowning.Methods The imaging data in 12 cases with seawater drowning treated in our hospital in the past 8 years were analyzed retrospectively.Results After 2 to 12 hours of leaving the water,the initial chest X-ray examinations or CT scans were taken.The initial X-ray films displayed the lung markings increase,the small patch shadows or wide distribution patch shadows.CT showd large ground-glass density,diffuse patchy or flocculus shadows and different degress of emphysema in bilateral lung.Most of the foci were absorbed obviously in 1 to 3 days.In 1 case,the focus formed pulmonary abscess later.Conclusion X-ray and CT examinations can clearly show the severity and changes of lung damage in seawater submersion victims,and that can provide important informations for clinical diagnosis and treatment.

Objective To investigate the effect of Ghrelin on gastrointestinal motility after traumatic brain injury (TBI).Methods A total of 72 adult male SD rats were randomly divided into sham operation group (n =8),TBI group (n =32) and Ghrelin group (n =32),according to the random number table.In the sham operation group,the scalp was sutured after craniotomy and sterilization,without any strike.In the TBI group,after intraperitoneal anesthesia,the skull was opened and the electric cortical contusion impactor was used to strike the center of bone window at the depth of 3 mm and the rate of 5 m/s.The duration of hitting the lowest point was 200 ms.In the Ghrelin group,20 μg/kg of Ghrelin was injected into the rat via the tail vein 30 minutes after injury.The modified neurologicalseverity score (mNSS),percentage of water content in feces and percentage of gastric contents in body weight at 6,24,48 and 72 hours after operation in each group were measured.The stomach,the small intestine 15 cm from ileocecal junction,ileocecal junction (about 3 cm in the proximal ileal loops,about 3 cm in the distal ileal loops,and 3 cm colon loops) were taken out to prepare the electron microscopy section and observe the microscopic changes of the gastrointestinal mucosa.Results The mNSS in the TBI and Ghrelin groups was higher than that in the sham operation group after 24,48 and 72 hours (P ＜0.01).The mNSS in the TBI group was higher than that in the Ghrelin group after 24,48 and 72 hours (P ＜0.01).In the sham operation group,the intestinal wall was pink.In the TBI group,gastric dilatation and thinner wall with pale or dark red color were seen,and small intestine cavity expansion with dark color and even congestion were observed.There was much mucus in the intestinal wall.The Ghrelin group improved obviously than the TBI group after 6 hours.Compared with the Ghrelin group,the percentage of fecal water content in the TBI group decreased significantly after 24 hours (P ＜ 0.05),and the decrease rate dropped with time.Obvious delayed gastric emptying occurred (P ＜ 0.05),and the percentage of gastric contents in body weight demonstrated downtrend.The changes of gastric mucosa were as follows:the chief cells in the gastric glands were observed 72 hours after TBI in the TBI group,and scattered short microvilli were seen in the cell surface.The cytoplasm protruded into the glandular cavity,and a large number of rough endoplasmic reticulum could be seen in the cytoplasm,with irregular arrangement.Medullary bodies could be seen inside the mitochondria which swelled locally.Abundant endocrine granules were seen in the cytoplasm.Mitochondria were scattered and swollen,and mitochondria cristae became shorter and fewer,which contained medullary bodies.The Ghrelin group improved obviously than TBI group after 72 hours in terms of gastric mucosa changes.With respect to cecum mucosa,in the TBI group 72 hours after TBI,severe edema of the cecum absorption epithelium,obvious dilation of the rough endoplasmic reticulum,expansion of the free water gap inside the cell,and local decrease of the microvilli at the top of the cell were observed.Abundant microvilli were seen in the cecum absorption epithelium and cell top.The connection complex composed of tight connections,intermediate connections,and bridging particle connections could be seen between cells.The Ghrelin group improved obviously than TBI group after 72 hours in terms of cecum mucosa changes.Conclusions Ghrelin can improve gastrointestinal motility and protect gastrointestinal mucosa in rats after TBI.

Objective: To investigate the neuroprotective effect of Ghrelin on traumatic brain injury (TBI) in mice. Methods: TBI model of C57BL / 6 mice was established by electronic cortical impact instrument (eCCI). According to the random figure table method, twenty-four mice were randomly divided into sham group(Sham group), TBI group and Ghrelin intervention group(Ghrelin group) with 8 mice in each group. The model of TBI was established in TBI group and Ghrelin group.The mice in Ghrelin group was injected intraperitoneally 0.5 g/kg before and 1 h after injury respectively. And the mice Sham group and TBI group were injected with the same amount of normal saline. The changes of cerebral blood perfusion (CBP) were monitored in real time by laser speckle contrast analysis(LSCI), the changes of neuroelectrophysiology were observed by monitoring motor evoked potential (MEP), and the status of neurological deficit was evaluated by modified neurological deficit score (mNSS). Results: Compared with Sham group, the mice in TBI group had significantly lower cerebral blood perfusion(CBP) (t=-12.36, P<0.01), longer latency and lower amplitude of motor evoked potential (MEP) (t=5.03, -11.55, all P<0.01), and significantly higher mNSS scores (t=9.34, P<0.01). However, compared with the TBI group, the cerebral blood perfusion(CBP) of Ghrelin group increased significantly at 12 h after TBI((196.87±17.36) PU/mm² vs (123.62±8.04)PU/mm², t=10.45, P<0.01), while the latency of MEP decreased((5.30±0.33)ms vs (6.80±0.97)ms, t=-5.01, P<0.01), the amplitude of MEP increased((2.21±0.16)mV vs (1.27±0.27)mV, t=9.65, P<0.01). And compared with the TBI group, the neurological deficit score of Ghrelin group decreased significantly at 24 h after TBI((4.9±1.2) vs (8.4±2.6), t=-3.87, P<0.01). Conclusion Ghrelin exhibits a significant neuroprotective role by increasing cerebral blood flow perfusion, reducing the degree of neurological deficit and promoting motor function recovery in TBI mice.

ObjectiveTo analyze the expression level of triggering receptor expressed on myeloid cells-1 （TREM-1） in serum and ascites of patients with cirrhotic ascites， and to investigate its correlation with clinical features and inflammatory markers and its role in the diagnosis of infection and prognostic evaluation. MethodsA total of 110 patients with cirrhotic ascites who were hospitalized in The Fifth Hospital of Shijiazhuang from January 2019 to December 2020 were enrolled， and according to the presence or absence of intra-abdominal infection， they were divided into infection group with 72 patients and non-infection group with 38 patients. The patients with infection were further divided into improvement group with 38 patients and non-improvement group with 34 patients. Clinical data and laboratory markers were collected from all patients. Serum and ascites samples were collected， and ELISA was used to measure the level of TREM-1. The independent-samples t test was used for comparison of normally distributed continuous data between two groups； the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups； the chi-square test was used for comparison of categorical data between two groups. A Spearman correlation analysis was used to investigate the correlation between indicators. A multivariate Logistic regression analysis was used to identify the influencing factors for the prognosis of patients with cirrhotic ascites and infection. The receiver operating characteristic （ROC） curve was used to evaluate the diagnostic and prognostic efficacy of each indicator， and the Delong test was used for comparison of the area under the ROC curve （AUC）. ResultsThe level of TREM-1 in ascites was significantly positively correlated with that in serum （r=0.50， P<0.001）. Compared with the improvement group， the non-improvement group had a significantly higher level of TREM-1 in ascites （Z=-2.391， P=0.017） and serum （Z=-2.544， P=0.011）， and compared with the non-infection group， the infection group had a significantly higher level of TREM-1 in ascites （Z=-3.420， P<0.001）， while there was no significant difference in the level of TREM-1 in serum between the two groups （P>0.05）. The level of TREM-1 in serum and ascites were significantly positively correlated with C-reactive protein （CRP）， procalcitonin （PCT）， white blood cell count， and neutrophil-lymphocyte ratio （r=0.288， 0.344， 0.530， 0.510， 0.534， 0.454， 0.330， and 0.404， all P<0.05）. The ROC curve analysis showed that when PCT， CRP， and serum or ascitic TREM-1 were used in combination for the diagnosis of cirrhotic ascites with infection， the AUCs were 0.715 and 0.740， respectively. The multivariate Logistic regression analysis showed that CRP （odds ratio ［OR］=1.019， 95% confidence interval ［CI］： 1.001‍ ‍—‍ ‍1.038， P=0.043） and serum TREM-1 （OR=1.002， 95%CI： 1.000‍ ‍—‍ ‍1.003， P=0.016） were independent risk factors for the prognosis of patients with cirrhotic ascites and infection， and the combination of these two indicators had an AUC of 0.728 in predicting poor prognosis. ConclusionThe level of TREM-1 is closely associated with the severity of infection and prognosis in patients with cirrhotic ascites， and combined measurement of TREM-1 and CRP/PCT can improve the diagnostic accuracy of infection and provide support for prognostic evaluation.