Objective To study the therapeutic effect of rheum(Chinese herbal medicine) preparation made by using ultrasonic technique on pro-inflammatory cytokines and sepsis in rats.In order to offer novel measure for the treatment of critically ill patients.Methods Firstly, rheum sterile solution was prepared through ultrasonic technique.Secondly, fifty healthy male SD rats were randomly(random number) divided to CLP group and rheum group.Moderate degree of sepsis model was established by using cecal ligation and puncture(CLP).Rats in group rheum received the liquid rheumpreparation via intragastric administration, while rats in group CLP received saline instead.The 7-day survival rate was recorded and was compared between two groups.In addition, another fifty-four rats were randomly(random number) divided to sham group, CLP group and rheum group(n=18 in each group).CLP was performed to induce sepsis in CLP group and rheum group.Then rats in rheum group received rheum sterile solution via intragastric administration, while rats in CLP group received saline instead.At 12 hours, 24 hours and 48 hours after modeling, six rats in each group were randomly sacrificed.Serum TNF-α and HMGB1 levels were detected by ELISA method.Levels of RAGE, HMGB1 and NF-κB P65 in small intestine were detected by Western Blot.Results Level of anthraquinones extracted from rheum by ultrasonic technique was higher than that by conwentional decoction method.The 7-day survival rate of rats in rheum group(76%) was higher than that in CLP group(48%)(P<0.05).Compared with sham group, serum TNF-αand HMGB1 levels in CLP group and rheum group were significantly increased(P<0.05).TNF-α was significantly lower in rheum group than that in CLP group at each interval(P<0.05).At 12 hours after modeling, there was no significant difference in serum HMGB1 level between CLP group and rheum group(P>0.05).At 24 hours and 48 hours after modeling, serum HMGB1 levels were significantly lower in rheum group than those in CLP group(P<0.05).Compared with sham group, protein levels of HMGB1, RAGE and NF-κB in small intestine were elevated in CLP group and rheum group at 48 hours after modeling(P<0.01), while protein levels of above biomarker were higher in CLP group than those in rheum group(P<0.05).Conclusions Rheum sterile solution could down-regulate the level of pro-inflammatory cytokines, modulate the inflammatory response, and improve the survival rate in rats with sepsis.

ObjectiveTo compare the predictive value of anatomic scoring system, physiological scoring system, and the combination of two systems in death prediction of patients with severe trauma in intensive care unit (ICU). Methods A retrospective analysis of patients with severe trauma admitted to department of critical care medicine of Daping Hospital, the Third Military Medical University, and Zunyi Medical University from January 2011 to December 2014 was conducted. The patients meeting the following criteria were enrolled: over 16 years old, admitted to hospital shorter than 24 hours after trauma, length of ICU stay≥48 hours, and injury severity score (ISS)≥16. Patients were divided into two groups: survivors and non-survivors. The data of anatomic scoring system, including ISS and new injury severity score (NISS), and physiological scoring system, including acute physiology and chronic health evaluationⅡ(APACHEⅡ) score were collected. The predictive power for death of the scoring system alone or combination in patients with severe trauma was evaluated.Results A total of 614 patients with severe trauma were enrolled, and there were 153 deaths with a mortality rate of 24.9%. ISS, NISS, APACHEⅡ, ISS+ APACHEⅡ, NISS+ APACHEⅡ of non-survivors were significantly higher than those of survivors (ISS: 29.15±7.75 vs. 24.31±6.50, NISS: 41.96±12.01 vs. 29.64±8.19, APACHEⅡ: 23.71±6.58 vs. 17.02±5.49, ISS+ APACHEⅡ: 52.86±10.00 vs. 41.33±8.70, NISS+ APACHEⅡ: 65.67±13.46 vs. 46.66±10.43, allP< 0.01). The area under receiver operating characteristic curve (AUC) of ISS, NISS, APACHEⅡ, ISS+ APACHEⅡ, NISS+ APACHEⅡ was 0.687, 0.792, 0.782, 0.809, and 0.860, respectively. Both of ISS+ APACHEⅡ and NISS+ APACHEⅡ had higher AUC than that of ISS, NISS or APACHEⅡ alone; and the AUC of NISS+ APACHEⅡ was significantly larger than that of ISS+ APACHEⅡ(allP< 0.05). NISS+ APACHEⅡ showed the largest AUC in death prediction of severe trauma patients. The cut-off value, sensitivity, specificity, positive predict value (+PV), negative predict value (-PV), positive likelihood ratio (+LR), negative likelihood ratio (-LR), and Youden index of NISS+ APACHEⅡ, which had the greatest AUC, were 56, 75.2%, 82.0%, 58.1%, 90.9%, 4.17, 0.30, and 0.572, respectively.Conclusion The combination of anatomic scoring system and physiological scoring system is better than single scoring system for death prediction in patients with severe trauma in ICU, and it may be considered to be a new method for early identification of death risk in patients with severe trauma.

Objective To investigate the renal protective effect of antivenom therapy assisted with hyperbaric oxygen(HBO) in agkistrodon acutus poisoning rat.Methods Ninety-six healthy adult male SpragueDawley rats were randomized into the control group(group A),snake venom poisoning group(group B),antivenom treatment group(group C) and antivenom+ HBO treatment group(group D),24 cases in each group.The group B,C and D were injected with agkistrodon acutus toxin 0.8 × LD50 (LD50 =1.594 mg/kg) by tail vein for establishing the poisoning model.The renal tissue pathological changes after agkistrodon acutus poisoning were observed.In the antivenom treatment group,antivenom(0.8 ×＜ 78 U/kg) was injected by tail vein after successfully constructing model,the group D was given once HBO treatment at 0,4,11 23 h after antivenom injection,while the group A was not given any treatment.Results The rats appeared obvious poisoning symptoms after snake venom intravenous injection.Compared with the group B,therat renal function and coagulation functions in the group C and D were significant improved,more over the group D was better than the group C(P＜0.05).The rats of the group B appeared glomerular hemorrhage,renal capsule expansion,different degrees of congestion in peripheral blood capillaries,renal tubular cavity dilation,cellular fatness,falling of brush border,vacuolation of renal tubular epithelial cells and inflammary cells infiltration in renal interstitial tissue.Along with time lapse,the renal hemorrhage was decreased and inflammatory cells infiltration was increased.The abovelesions in the group C and D were significantly improved.Conclusion The Agkistrodon acutus poisoning can lead to renal damage in rats;the antivenom treatment assisted with HBO has the protective effect on renal injury in agkistrodon acutus poisoning rat,moreover early adopting has better protective effect.

BACKGROUNDDecorin is a member of the small proteglycans in extracellular matrix of tumor microenvironment, which is known to relate to the initiation, progression and growth of the tumor. The aim of this study is to investigate the effects and mechanism of decorin on the proliferation of A549 lung adenocarcinoma cell line in vitro.

METHODSLung adenocarcinoma cell line A549 was cultured with decorin in a wide range of concentration for different time. Cell activities were studied by MTT. The changes of cell cycle and apoptosis were analyzed by FCM. Decorin mRNA expression was detected by RT-PCR. P21 expression was determined by Western blot. TGF-β concentration in the culture supernatants was determined by ELISA.

RESULTSThe proliferation of A549 cell could be inhibited by decorin in vitro and the inhibition effect was the time- and dose-dependent relationship. Apoptosis of adenocarcinoma cell could be efficiently induced by decorin in a time/dose-dependent manner. Decorin could upregulate the intrinsic decorin mRNA and P21 protein expression, downregulate the TGF-β, and block cell cycle at G1 phase.

CONCLUSIONSDecorin can inhibit adenocarcinoma cell proliferation and induce apoptosis of adenocarcinoma cells in vitro. The proliferation of A549 cell could be inhibited in vitro by decorin through the mechanism of increasing decorin mRNA, decreasing TGF-β, increasing P21 protein expression, inhibiting cell cycle and inducing cell apoptosis.