BACKGROUND AND OBJECTIVES: Osmolarity is known to affect ciliary beat frequency (CBF) ; however, little is known about the effects of saline spray or irrigation on ciliary activity in human nasal epithelium. The aim of this study was to assess whether CBF is affected by hypertonic, isotonic or hypotonic saline solution in vitro and whether histologic changes are associated with the alteration of ciliary movement. MATERIALS AND METHODS: Normal turbinate mucosa was exposed to five different concentrations including 0.06%, 0.12%, 0.9%, 3.0%, and 7.0% of phosphate-buffered saline solutions. CBF was measured up to 60 minutes after exposure to each concentration of saline solution and histologic changes were examined by transmission electron microscopy. RESULTS: Isotonic and hypotonic saline solutions produced no ciliary slowing ; however, ciliostasis was observed within a few minutes in 3.0% or 7.0% saline solution. Immediately after complete ciliostasis in the hypertonic solutions, the solutions were replaced with 0.12% or 0.9% saline solution in order to observe the reversibility of CBF. Only 0.12% hypotonic saline induced the recovery of ciliary movement. The ultrastructural changes demonstrated that the ciliary slowing might be attributed to epithelial damage by fluid transport toward the surrounding medium. CONCLUSION: Our results suggest that isotonic and hypotonic saline solutions may be more appropriate for nasal irrigation than hypertonic saline solutions.
Humans* ; Hypertonic Solutions ; Microscopy, Electron, Transmission ; Mucous Membrane ; Nasal Lavage ; Nasal Mucosa* ; Osmolar Concentration ; Saline Solution, Hypertonic ; Sodium Chloride* ; Turbinates

Local inflammatory reaction and microcirculation disturbance are the early manifestations of acute pancreatitis (AP). Studies have shown that early and reasonable fluid resuscitation of patients with AP can reduce related complications and prevent the deterioration to severe acute pancreatitis (SAP). Traditional isotonic crystalloid (such as Ringer solution) is considered to be a safe and reliable resuscitation solution, but too much and too fast infusion in the early stage of shock will increase the risk of complications such as tissue edema and abdominal compartment syndrome (ACS). Many scholars have found that hypertonic saline resuscitation solution has the advantages of reducing tissue and organ edema, rapidly restoring hemodynamics, inhibiting oxidative stress and inflammatory signal transduction, thereby improving the prognosis of AP patients and reducing the incidence of SAP and mortality. This article summarizes the mechanisms of hypertonic saline in the resuscitation treatment of AP patients in recent years, in order to provide reference for the clinical application and research of AP patients.
Humans ; Pancreatitis ; Acute Disease ; Resuscitation ; Inflammation ; Crystalloid Solutions ; Saline Solution, Hypertonic

In order to determine the tolerance ability of platelet to change of osmotic pressure in solution, the isotonic fresh platelets were exposed to a series of crystal salt solutions with osmotic pressure range from 47 to 611 mOsm for 15 minutes. Then the platelets were returned to isotonic condition and kept for 15 minutes. The expressions of phosphatidylserine and CD62p were assayed in platelets. The results showed that the phosphatidylserine and CD62p expressions were increased when the osmotic pressure of solution was below 238 mOsm, but no significant rise was detected when the platelets were exposed to 611 mOsm solution. No increases of positive rate of CD62p and phosphatidylserine were detected in platelets returned to isotonic condition. It is concluded that platelets are sensitive to hypoosmotic solution and tolerated to hyperosmotic solution. Exceeding the platelet safe volume limitation may lead to injure of platelet osmosis in crystal salt solution.
Blood Platelets ; drug effects ; metabolism ; Humans ; Hypotonic Solutions ; pharmacology ; Isotonic Solutions ; pharmacology ; Osmotic Pressure ; P-Selectin ; biosynthesis ; Phosphatidylserines ; biosynthesis ; Saline Solution, Hypertonic ; pharmacology ; Sodium Chloride ; pharmacology

SOLUTIONS ISOTONIC SOLUTIONS HYPERTONIC SOLUTIONS SODIUM CHLORIDE

OBJECTIVETo investigate the potential and early effect of hypertonic saline resuscitation on T-lymphocyte subpopulations in rats with hemorrhagic shock.

METHODSA model of rat with severe hemorrhagic shock was established in 18 Sprague-Dawley (SD) rats. The rats were randomly divided into Sham group, HTS group (hypertonic saline resuscitation group) and NS group (normal saline resuscitation group). Each group contained 6 rats. The CD4(+) and CD8(+) subpopulations of T-lymphocytes in peripheral blood were detected respectively before shock and after resuscitation by double antibody labelling and flow cytometry.

RESULTSIn the early stage after hemorrhagic shock, fluid resuscitation and emergency treatment, the CD4(+) lymphocytes of peripheral blood in HTS and NS groups markedly increased. Small volume resuscitation with HTS also induced peripheral CD8(+) lymphocytes to a certain extent, whereas NS resuscitation showed no effect in this respect. Consequently, compared with Sham and HTS groups, CD4(+)/CD8(+) ratio of peripheral blood in NS group was obviously increased, and showed statistically differences.

CONCLUSIONIn this model of rat with severe hemorrhagic shock, small volume resuscitation with HTS is more effective than NS in reducing immunologic disorders and promoting a more balanced profile of T-lymphocyte subpopulations regulating network.

Animals ; Blood Pressure ; CD4-CD8 Ratio ; Disease Models, Animal ; Isotonic Solutions ; administration & dosage ; Male ; Rats ; Rats, Sprague-Dawley ; Resuscitation ; methods ; Saline Solution, Hypertonic ; administration & dosage ; Shock, Hemorrhagic ; immunology ; physiopathology ; therapy ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) in enteral resuscitation of burn shock.

METHODSEighteen Beagle dogs with 35% TBSA full-thickness flame injury were used in this study. They were randomized to a control group (no-fluid resuscitation, N group), a HEGS resuscitation group (H group) or an isotonic electrolyte glucose solution (IEGS) resuscitation group (I group). The solution enterally was given for resuscitation from half an hour after burn. The volumes and rates of fluid infusion in the H group were basically in accordance with 2 ml/(kg x 1%TBSA), those in the I group were basically in accordance with parkland formula [4 ml/(kg x 1%TBSA)]. The haemodynamic parameters, global end-diastolic volume index, plasma volume, osmotic pressure of plasma, intestinal absorptive rates of water and Na(+), and intestine mucosa blood flow were continuously assessed.

RESULTSThe cardiac output index, global end-diastolic volume index, plasma volume and intestine blood mucosa flow reduced markedly after burn in the three groups, and then gradually returned from 2 h after burn in two resuscitation groups, which were higher than that in the N group (P < 0.05). The activities of diamine oxidase in plasma in the two resuscitation groups were higher than that in N group (P < 0.05). The intestinal absorption rates of water and Na(+) reduced markedly after burn in two resuscitation groups with the lowest levels, and then returned from 6 h after burn. The rates of water in H group were lower than that in I group (P < 0.05); the rates of Na(+) in H group were higher than in I group (P < 0.05).

CONCLUSIONThe results indicated that 35%TBSA III degrees burn-injury dogs be resuscitated effectively with 1.8% hypertonic electrolyte-glucose solution by enteral, which 1/2 volume of an isotonic electrolyte glucose solution.

Animals ; Burns ; therapy ; Disease Models, Animal ; Dogs ; Enteral Nutrition ; Fluid Therapy ; methods ; Glucose Solution, Hypertonic ; administration & dosage ; therapeutic use ; Random Allocation ; Resuscitation ; methods ; Saline Solution, Hypertonic ; administration & dosage ; therapeutic use

OBJECTIVE: We wanted to compare the efficacies of 95% ethanol and 20% hypertonic saline (HS) sclerotherapies that were performed in a single session under CT guidance for the management of simple renal cysts. MATERIALS AND METHODS: A prospective series of 74 consecutive patients (average age: 57.6 +/- 8.1 years) with simple renal cysts were enrolled in this study. They were randomized into two groups and 95% ethanol or 20% HS, respectively, corresponding to 25% of the aspiration volume, was injected. Treatment success was determined six months later with follow-up clinical evaluation and performing ultrasonography. RESULTS: The sclerotherapy was accepted as technically successful without major complications in all except two patients who were excluded because of a communication between the simple renal cyst and the pelvicalyceal collecting system. Thirty-six patients in the ethanol group received sclerotherapy with 95% ethanol and 36 patients in the HS group underwent sclerotherapy with 20% HS. The complete regression ratio of the ethanol group was significantly higher (94% versus 72%, respectively) than that of the HS group. There was one patient with partial regression in each group. The failure ratio of the ethanol group was significantly lower (3% versus 25%, respectively) than that of the HS group. CONCLUSION: Ethanol sclerotherapy under CT guidance is a successful and safe procedure and it can be used for the treatment of simple renal cysts. Sclerotherapy with 95% ethanol is more effective than 20% HS sclerotherapy. Sclerotherapy with HS may be an option for patients preferring to undergo a less painful treatment procedure.
Adult ; Aged ; Ethanol/administration & dosage/*therapeutic use ; Female ; Follow-Up Studies ; Humans ; Kidney/drug effects/radiography/ultrasonography ; Kidney Diseases, Cystic/*drug therapy ; Male ; Middle Aged ; Prospective Studies ; Saline Solution, Hypertonic/administration & dosage ; Sclerosing Solutions/administration & dosage/*therapeutic use ; Sclerotherapy/adverse effects/*methods ; Tomography, X-Ray Computed/*methods ; Treatment Outcome

OBJECTIVETo investigate the dynamic variation and action mechanism of sICAM-1 and p38 mitogen-activated protein kinases (MAPK) signal transduction in human severe trauma and resuscitation, as well as the effect of lactated Ringer's solution(LR), 7.5% sodium chloride solution(HS) and 20% albumin injection(ALB) on the incidence and mortality of multiple organ dysfunction syndrome (MODS).

METHODSSeventy-two severe trauma patients (ISS score 16-43) were divided into ISS < or = 25 and ISS > 25 groups (each group was subdivided into LR, HS and ALB groups). ELISA was used to measure the concentration of sICAM-1. Western blot was used to measure the expression of p38 MAPK.

RESULTSCompared with LR group, the transfusion volume needed for maintaining systolic blood pressure > or = 90 mm Hg was significantly decreased in HS and ALB groups (P < 0.05). Compared with the control group, the concentration of blood sICAM-1 and the expression of p38 MAPK was elevated from 4 to 48 hours after trauma in all experimental groups (P < 0.05-0.01). At 4, 12, and 24 hours, there was significant correlation between the expression of p38 MAPK and sICAM-1 (P < 0.01). Compared with LR group, sICAM-1 and p38 MAPK in HS and ALB groups were decreased (P < 0.05). sICAM-1 and p38 MAPK were significantly higher in the group of ISS > 25 than that of ISS < or = 25 (P < 0.05). MODS incidence and mortality were significantly higher in the group of ISS > 25 than that of ISS < or = 25 (P < 0.05). MODS incidence and mortality were lower in HS and ALB groups than LR group (P < 0.05).

CONCLUSIONSThe up-regulation of polymorphonuclear neutrophil-endotheliocytes (PMN-EC) adhesion may be due to the increased sICAM-1 expression during severe trauma. The up-regulation of sICAM-1 expression is correlated with the activation of p38 MAPK. During severe trauma, the levels of sICAM-1 and p38 MAPK, as well as the incidence and mortality of MODS are lower when HS and ALB are used than single lactated LR solution is used.

Adult ; Albumins ; therapeutic use ; Cell Adhesion ; Female ; Fluid Therapy ; methods ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; physiology ; Isotonic Solutions ; therapeutic use ; Male ; Middle Aged ; Multiple Organ Failure ; epidemiology ; mortality ; Resuscitation ; Saline Solution, Hypertonic ; therapeutic use ; Systole ; Wounds and Injuries ; blood ; physiopathology ; therapy ; p38 Mitogen-Activated Protein Kinases ; blood ; physiology

The influences of osmolarity on the cardiac muscle contraction were investigated in cat papillary muscles. The muscle was immersed in the modified Krebs-Ringer-bicarbonate solutions containing various Ca ion concentrations and osmolarities and the resultant changes in maximum developed tension, rate of development of tension and time to maximum tension were analyzed. Following are the results. 1) Mean length of papillary muscle used was 9.3+/-0.60mm, end mean cross-sectional area was l. 73+/-0.07 mm2. Normal contraction amplitude at 5 mM Ca ion-K-R-B solution was 2. 46+/-0. 1 gram/mm. 2) Within the range of 2.5-10.0 mM Ca ion concentration, the contraction amplitude increased along with the increment of Ca concentration. 3) Osmolarity exerted dual effects on contraction; within the range of 300-400 mosm/I solution, the hypertonic solution exported a positive inotropic effect while 500 mOsm/1 solution exerted a negative inotropic effect upon papillary muscle. 4) Maximum rate of tension development increased in 350 mOsm/1 solution, but decreased in 400 mOsm/1 or more hypertonic solution. The time to maximum tension did not change within the range of 300 400 mOsm/1 osmolarity and in 500 mOsm/1 solution. 5) The difference in maxium developed tension between single and paired stimulation was 1. 99 gram/mm' at 300 mOsm/1 solution and was negligible in 450 mOsm/1 or more hypertonic solutions.
Animals ; Cats ; Hypertonic Solutions ; Myocardium ; Osmolar Concentration ; Papillary Muscles

BACKGROUND: If the skin is kept in continuous contact with water or other solutions after acute barrier perturbation, the pattern of barrier recovery will be different from that of the air exposure state at room temperature. Changes in the concentration of the solution also make a difference in the pattern of barrier recovery. However, there have been only a few studies on the difference of the barrier recovery or the changes in stratum corneum lipid between cases in the water immersion state and the air exposure state. OBJECTIVE: We studied the effect of immersion on the recovery of the epidermal barrier after acute perturbation so as to give aid to the basic research of the epidermal barrier and clinical application in prevention and treatment of contact dermatitis, hand eczema, and other occupational dermatoses. METHODS: After disruption of the epidermal barrier by tape stripping, hairless mice were immersed in temperature regulated hypotonic, isotonic, or hypertonic solutions, respectively. The pattern of barrier recovery with time was evaluated and compared with that of the air exposure group by means of TEWL measurement, and histochemical stain with Nile red. RESULTS: Immersion into water or solution without time to recovery after epidermal barrier disruption makes the recovery rate slower than that of the air exposure group except for the isotonic solution immersing group. CONCLUSION: For the normal recovery or prevention of the deterioration of the epidermal barrier, we should keep in mind to avoid the exposure to water or other solutions when acute or chronic barrier perturbation has developed. In addition, it would be better to use normal saline or other isotonic solutions, which do not disturb the normal barrier recovery process, to decrease damage to the epidermal barrier when it cannot help immersing into the solution.
Animals ; Dermatitis, Contact ; Eczema ; Hand ; Hypertonic Solutions ; Immersion* ; Isotonic Solutions ; Mice ; Mice, Hairless ; Skin ; Skin Diseases ; Water