Objective To investigate the effects of low-dose hydrocortisone on brain dysfunction in LPS-induced sepsis rats and the role of nuclear factor kappa B (NF-?B) signal transcription pathway in the pathogenesis. Methods Fifty-four rats were randomly divided into 3 groups: control group (A group, n=6), model group (B group, n=24), low-dose HC treatment group(C group, n=24). The septic rat model was established by intra-peritoneal injection of LPS (1 mg/kg), the intervention was by caudal vein injection of low-dose HC (6 mg/kg), each of B and C group was subdivided into 2,8,16,24 hours after LPS injection (n=6).At serial time points,the animals in each group were sacrificed , brain tissue samples were harvested to determine NF-?B,I?B expression in hippocampus by immunohistochemistry. Also, the changes of behaviors were observed and the histopathological changes were investigated by Nissl stain.Results In model group (B group): lethargy, anorexia, tachypnea, piloerection, loss of body weight were all more obvious than control groups.Nissl stain showed significant histopathological changes; NF-?B expression was up regulated compared with control group(P

ObjectiveTo assess the effects of dopamine,dobutamine and norepinephrine on the P(g-a)CO2 and superior mesenteric blood flow in septic shock.MethodsRabbit septic shock model was established by challenging with intravenous injection of lipopolysaccharides from Escherichia coil(2 mg/kg).The rabbits with septic shock were randomly assigned to 3 groups-dopamine group(n = 8),dobutamine group(n = 8) and norepinephrine group(n = 8).Apart from volume resuscitation with normal saline solution [20 ml/(kg· h)]，dopamine[5μg/(kg·min)],dobutamine[(5μg/(kg·min)]and norepinephrine [(1μg/(kg·min)]were infused in dopamine group,dobutamine group and norepinephrine group respeclively.Cardiac index(CI) and superior mesenteric blood flow index(SMBFI) were continuously monitored by doppler flowrneter.Gastric mucosal PCO2 was evaluated by gas tonometry every 10 min.Arterial and venous blood gas analyses and lactate levels were measured every 1 h.ResultsMAP,CI,and SMBFI significandy decreased and P(g-a) CO2 increased after lipopolysaccharides infusion in three groups.After 2-hour treatment,MAP in norepinephrine group[(70 +3) mm Hg]was higher than that of dopamine group[(66±4) mm Hg]and dobutamine group[(65±4) mm Hg](P ＜0.05).SMBFI in norepinephrine group [(18.7±2.9) ml/(kg·min)]was higher than that of dopamine group[(16.2±1.6) ml/(kg·min)]and dobutamine group[(15.8±1.9) ml/(kg·min)](P＜0.05).P(g-a) CO2 in norepinephrine group [(30±6) mm Hg]was lower than that of dobutamine group[(23±5)mm Hg](P＜0.05).Condnsion As an adjuvant therapy of volume resuscitation,norepinephrine is more effective than low dose dopamine and dobutamine in improving splanchnic perfusion.

In the past 20 years, emergency medicine in China has witnessed rapid development and emergency care has contributed considerably to safeguarding people's life and health. The emergency departments in most hospitals have completed the transition from being dependent to being supportive and some hospitals have set up autonomous emergency departments. The functions and business scope of emergency care have gradually been clarified. However, some problems remain to be solved in such aspects of emergency care as training, management, scientific research, and professional promotion.

Objective To determine the prevalence of mortality and respiratory support therapy evolved for severe respiratory failure in pediatric intensive care units(PICU)in China. Method Two sessions of prospective, multicentric, and descriptively epidemiological survey of acute respiratory distress syndrome(ARDS)was carried out in year 2004 and 2006,and survey of alveolar hypoventilation respiratory failure(AHRF)in 2006 by 20 PICUs in China. Data about severity, outcome and respiratory therapy of critically ill patients, as well as PICU facilities were documented prospectively. PICU facilities, patients' mortality and respiratory therapy in different years were compared. Mortality risk factors were analyzed by multivariate logistic regression. Results Compared with those data in year 2004,the number of PICU bed and ventilator increased in year 2006.But,there was no increase in area per bed in year 2006.Proportion of critically ill patients in 2006 was significantly higher than that in 2004(69.0%vs.57.5%,x2=318,P<0.01).There were no significant difference in mortalities of critically ill patients between these two years. According to multivariate regression analysis, mortality was lowered in PICU with increase in heavy working load of physicians, evidenced by linear trend test P=0.013.Mortality of ARDS in year 2006 was significantly lower than that in 2004(39.7%vs 55.8%,x2=6.59,P<0.01).Whereas there was no significant difference in ventilation mode,tidal volume and airway pressure level for ventilated patients between two years.Conclusions With increasing the capacity of PICU there was a significant improvement of treatment as reflected by outcome of ARDS.Mortality of PICU patients was inversely correlated to the working load done by physicians.

Objective:To construct a computed tomography (CT)-based three-dimensional digital model of small bowel, and investigate its application value for predication of small bowel length before bariatric surgery.Methods:The retrospective and descriptive study was conducted. The clinical data of 3 patients with obesity who were admitted to the Daping Hospital of Army Medical University from December 2018 to January 2019 were collected. There were 2 males and 1 female, aged from from 24 to 44 years, with a median age of 25 years. Patients underwent abdominal enhanced CT examination before operation, and the three-dimensional digital models of small bowel for each patient were constructed respectively. Of the 3 patients, 2 underwent sleeve gastrectomy and 1 underwent Roux-en-Y gastric bypass. The 3 patients were numbered as No.1, No.2, and No.3 according to the operation time. Observation indicators: (1) construction of three-dimensional digital model of small bowel and preoperative prediction of small bowel length; (2) intraoperative measurement of small bowel length and the relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length. Count data were represented as absolute numbers or percentages.Results:(1) Construction of three-dimensional digital model of small bowel and preoperative prediction of small bowel length: the three-dimensional digital models of small bowel for each patient were constructed respectively before operation. The volume of small bowel, area of each cross-section for the 10 cross-sections of small bowel, average area of cross-section of small bowel, preoperative prediction of small bowel length in the three-dimensional digital model of small bowel of No.1 patient were 1 312 985 mm 3, 174 mm 2, 154 mm 2, 143 mm 2, 172 mm 2, 345 mm 2, 213 mm 2, 357 mm 2, 173 mm 2, 382 mm 2, 154 mm 2, 227 mm 2, 578 cm. The above indicators of No.2 patient were 1 817 224 mm 3, 274 mm 2, 196 mm 2, 487 mm 2, 413 mm 2, 520 mm 2, 254 mm 2, 231 mm 2, 170 mm 2, 212 mm 2, 168 mm 2, 293 mm 2, 620 cm. The above indicators of No.3 patient were 2 183 019 mm 3, 320 mm 2, 408 mm 2, 281 mm 2, 222 mm 2, 194 mm 2, 219 mm 2, 188 mm 2, 419 mm 2, 326 mm 2, 235 mm 2, 281 mm 2, 777 cm. (2) Intraoperative measurement of small bowel length and the relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length: the length of small bowel measured intraoperatively for No.1, No.2, and No.3 patients were 570 cm, 600 cm, and 780 cm, respectively. The relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length of No.1, No.2, and No.3 patients were 1.40%、3.33%、0.38%, respectively. Conclusion:Three-dimensional digital model of the small bowel can predict the small bowel length before bariatric surgery.