The amount of superoxide anions released by polymorphonuclear leukocytes (PMNs)and malonyldialdehyde (MDA) level in plasma,lung homoge-nate and bronchoalveolar lavage fluid (BALF) were determined in pigs after they were inflicted with gunshot wounds of steel-ball pellets.It was found that the amount of superoxide anions released spontaneously and after the stimulation of zymosa was increased and reached the peak in the 4th and 8th hour after injury respectively,and then returned to the preinjury level gradually.The changes of plasma MDA level was similar to those of superoxide anions released by PMNs.MDA level of lung homogenate and BALF was also significantly increased in the 24th hour postinjury.In addition,the relationship between PMNs function and lipid peroxidation in the plasma and the lungs was discussed.

Respiratory distress syndrome was produced in dogs with the combination of oleic acid injection and gunshot wounding,and the therapeutic effects of naloxone(NAD and positive end expiratory pressure ventilation(PEEP)were assessed with the examinations of macropatholo-gy of the lungs,lung water ratio.respiratory rate(RR)and blood gas analysis.It was found that RR was rapidly and significantly increased tPaO2 decreased and Qs/Qt increased and there was severe pulmonary hemorrhage,edema and atelectasis in the controls after injury.NAL treatment could slightly alleviate the increase of RR and prevent the early of PaCO2,but it had no effects on the changes of PaO2,Qs/Qt and increase pulmonary hemorrhage,edema and atelectasis.PEEP could improve the decrease of PaO2 and the increase of Qs/Qt and prevent pulmonary atelectasis and alveolar edema from occurring,but it could not significantly stop the increase of lung water ratio.

Objective To investigate the predisposing factors of urinary tract infection(UTI) with extendedspectrum beta-lactaraase(ESBLs) producing Escherichia Coli(E. coli) and its resistance to antimicrobial agents.Methods 26 cases of UTI patients with ESBLs producing E. coli from 2003 to 2005 in our hospital were analyzed retrospectively and compared with the ESBLs non-producing strains. Results 88.5 % of the patients with UTI in ESBLs producing E. coli had received broad-spectrum antimierobial therapy before the diagnosis, 69.2 % of the patients were complicate UTIS, 42.3 % of the patients experienced invasive operations in urinary tract; the incidence of drug resistance of ESBLs producing bacteria to the second, third-generation cephalosporins and quinolone was significantly higher than that of ESBLs non-producing bacteria, but it was highly sensitive to imipenem. Conclusion The drug resistance of ESBLs producing E. coli is severe gradually. So much attention should be paid to the ESBLs producing bacteria detection in UTIs. Antimicrobial therapy should be initiated under the guidance of drug sensitivity test,it is necessary to rid the predisposing factors of UITs as much as possible in order to decrease ESBLs-producing bacteria infection.

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.

BACKGROUND: The activation of hypothalamus-pituitary-adrenal cortex axis may play key role in the increasing expression of hypothalamic corticotropin-re-leasing hormone (CRH) during stress reaction. However by what way to induce the CRH expression in hypothalamic neuron, and whether CRH can activate hypothalamic neurons are still not very clear.OBJECTIVE: To observe the changes of intracellular cyclic adenosine monophosphate (cAMP) and cytoplasmic Ca2+ concentration in the hypothalamic neurons cultured in vitro due to exogenous CRH stimulation.DESIGN: Comparative observation experiment.SETTING: Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA; Department of Neurosurgery , Tiantan Hospital, Capital University of Medical Sciences MATERIALS: This experiment was carried out in the Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA between December 1999 and March 2002. Hypothalamus was obtained from fetus rat at pregnancy of 17 days for the in vitro culture of hypothalamic neurons.METHODS: Hypothalamic neurons were co-cultured with exogenous CRH,with or without pretreatment with specific CRH 1 receptor antagonist -CP-154526. hypothalamic neurons were randomized into: ① CRH (10-12,10-10, 10-8, 10-6 mol/L) stimulation group. ② CP-154526(500 μmol/L)pretreatment aud CRH ( 10-12, 10-10, 10-8,10-6 mol/L) stimulation group. ③Hypothalamic neurons in corresponding normal control group were exposed to the isotonic saline stimulation. PTI fluorescence image system was used to determine and analyze the change of cytoplasmic free Ca2+ concentration in hypothalamic neurons due to exogenous CRH stimulation and RIA was used to detect the neuronal cAMP content.MAIN OUTCOME MEASURES: ①Cytoplasmic free Ca2+ concentration in hypothalamic neurons. ②cAMP content in hypothalamic neurons.RESULTS: The cytoplasmic free Ca2+ concentration and cAMP content were relatively lower in the hypothalamic neurons in normal control group,which obviously increased due to CRH stimulation [(240±22),(153±11)nmol/L; (3.26±0.19),(0.44±0.02) pmol/dish,P ＜ 0.01];CP-154526 could remarkably suppress the CRH (10-6 mol/L)induced increase in cytoplasmic free Ca2+ concentration and cAMP content in hypothalamic neurons [Ca2+ concentration: (240±22),(171±16)nmol/L; cAMP content:(3.26±0.19), (2.33±0.21) pmol/dish, P ＜ 0.01].CONCLUSION: CRH can directly act on hypothalamic neurons via type 1-receptor,thereby increase the cytoplasmic free Ca2+ concentration and cAMP content in hypothalamic neurons,playing the key role in the modulation of the synthesis and secretion of CRH during the activation of hypothalamic neurons.

BACKGROUND: Through what signal pathway does corticotropin release hormone (CRH) regulate hypothalamic neuronal neuroendocrine activity during acute stress?OBJECTIVE: To probe into the regulatory effects of CRH on CREB secretion in hypothalamic neurons.DESIGN: Repetitive measurement design.SETTING: At Field Surgery Research Institute of Daping Hospital, Third Military Medical University of Chinese PLA; Neurosurgery Department,Tiantan Hospital Affiliated to the Capital University of Medical Sciences.MATERIALS: This experiment was carried out in Daping Hospital of Third Military Medical University of Chinese PLA between December 1999and March 2002. Rat fetuses were selected from Wister rats of 17-day gestation.METHODS: In vitro cultured cells were divided into the following groups:① CRH (10-12, 10-10, 10-8 and 10-6 mol/L) stimulation groups. ② Pretreated with nimodipine (5 μmol/L) or CP-154526 (500 μmol/L) followed by CRH (10-12, 10-10, 10-8 and 10-6 mol/L ) stimulation groups. ③ Corresponding control groups stimulated with isotonic physiological saline. PTI fluorescence imaging system was used to detect the changes of neuronal cytoplasmic free calcium concentration; meanwhile, Western blot technique was used to determine the changes of neuronal P-CREB content.MAIN OUTCOME MEASURES: ① Changes of neuronal cytoplasmic free calcium concentration. ② Changes of neuronal P-CREB content.RESULTS: The content of cytoplasmic free calcium in hypothalamic neurons was lower in normal control group, and it increased immediately after exogenous CRH stimulation. However, such increase could be suppressed by pretreatment with nimodipine or CP-154526 before CRH stimulation,and the increase of neuronal P-CREB content was also obviously suppressed.CONCLUSION: During acute stress, the combination of CRH with hypothalamic neuronal CRH 1 receptor leads to the opening of membrane Ltype calcium ions channels, thus enhancing the influx of calcium ions and increasing cytoplasmic free calcium ions content, which would further activate P-CREB signal transduction pathway in neurons. It suggests that CRH may play a vital role in hypothalamic neuronal activation.

AIM:To investigate the protective effect of bactericidal/permeability-increasing protein (BPI) on sepsis induced by intra-abdominal infection in rats and its mechanism.METHODS:Intra-abdominal infection induced sepsis was reproduced by cecal ligation and puncture (CLP). BPI or equal volume of physiological saline was intra-abdominally given immediately after CLP and 12 hours after CLP respectively (2.5 mg/kg of BPI each time). Plasma endotoxin levels were determined with limulus amebocyte chromogenic assay.RESULTS:(1)The survival time in BPI group was significantly higher than in physiological saline (PS) group. (2)The values of MAP, LVSP, IP, d p /d t max and -d p /d t max in BPI group, although decreasing ,were markedly higher than those in PS group. (3) Plasma glutamate-pyruvate transaminase and urea nitrogen levels in BPI group, though increasing, were significantly lower than those in PS group.(4) There was no significant change of plasma endotoxin levels in BPI group, while plasma endotoxin levels were markedly increased in PS group. There was significantly different between two groups. CONCLUSIONS:BPI has an obvious protective effect on intra-abdominal infection induced sepsis, which might be related to its antagonism against endotoxin.

OBJECTIVE To explore the characteristics of cochlear hair cell injuries in guinea pigs exposed to blast underpressure(BUP). METHODS The guinea pigs were killed 14 days after exposure to experimental BUP. Their basilar membranes were stained by silver nitrate and the hair cell injuries were quantitatively assessed using the light microscope. RESULTS The outer hair cells(OHCs) of the guinea pigs clearly appeared to be injured following exposure to the experimental BUP at a peak underpressure varying between -22.4kPa and -63.3kPa. The most obvious injury was in the second turn and OHC loss was smallest in the first row and more severe in the second and third rows. OHC loss was seen in all of three experimental groups of animals following exposure to BUP. Furthermore, the higher the peak of underpressure, the more obvious the injury of OHCs. Quantitative morphological analysis of cochlear hair cells showed that the total OHC loss rates in all the experimental groups of guinea pigs exposed to BUP were significantly higher than that of control group animals(P

Objective To observe the regulative effect of high dose of glucocorticoid (GC) on protein synthesis and mRNA transcription of corticotropin-releasing hormone (CRH) in paraventricular hypothalamic nucleus (PVN) so to ascertain whether there exists difference upon effect of GC either at high dose or at normal dose. Methods A total of 60 Wistar rats were divided into five groups, ie, blank control group, 10 -6 mol/L dexamethasone (DEX) group, 10 -9 mol/L DEX group, 9 g/L saline group and group that was treated with 10 -4 mol/L RU486 first and then with 10 -6 mol/L DEX. The drugs were given through femoral vein. CRH protein expression was measured by means of immunohistochemistry and laser confocal scanning microscophy (LCSM); CRH mRNA transcription level was investigated by in situ hybridization. Results There appeared positive CRH mRNA granules in cytoplasm of PVN after administration with 10 -6 mol/L DEX for 20 minutes but could be seen positive fluorescent granules of CRH protein 30 minutes later, which was reversed at an in advance blockage of GR, as was free in 10 -9 mol/L DEX group, 9 g/L saline group and blank control group. Conclusions High dose of GC can up regulate CRH gene expression in PVN and differs much from the traditional effect of GC at normal dose, as may be due to that high dose of GC exerts effects depending on membrane glucocorticoid receptor but normal dose of GC dose via iGR.

Objective To analyze the reason of drug shortages in medical institutions and take corresponding prevention measures to ensure drug supply .Methods The drug outbound orders in 2012 were retrospectively analyzed to trace the pro‐curement plan of badly‐needed drugs and the delivery time of supplier .Excel was used to carry out classification and statistics for the information of drug shortages combined with the explanations that the supplier failed to supply to summarize the exter‐nal cause and internal cause of drug shortages in medical institutions .Results In 2012 ,the dispensing department received a to‐tal of 46862 plans ,and 1423 items were badly‐needed drugs .The drug shortage rate was 3 .0% .643 times of drug shortages were caused by external causes which accountedfor 45 .2% of all the shortages ;780 times of the drug shortages were caused by internal causes which accounted for 54 .8% .Price inversion accounted for 40 .7% in the external causes that lead to the drug shortages ,and it was the top of the external causes for drug shortages .The low‐priced small varieties and generic drugs ac‐counted for 71 .2% of drug shortages caused by external causes;in the internal causes of drug shortages ,the inventory control accounted for 45 .0% ,ranked the first .Conclusion The scientific and reasonable drug price ,the improvement of bidding poli‐cy ,the joint effort of all parties of drug supply chain ,and the enhancement of the early warning and management of the badly‐needed drugs can reduce drug shortage .