After one hind leg of the pig was wounded by the high-speed steel spheres the status of the animals was continuously monitored by determination of hemody-namics, blood gas, chest X-ray, serum T3, T4, fibronectin, protein content of lung lavage, lung weight, light and electromicroscopic examination etc. When the animals died or were killed 72 hours after injury, the pathologic examinations were carried out as soon as possible. It showed that there were various changes in above mentioned parameters, especially in those of the dead animals. The relationship between the incidence of RDS and trauma index-injury severity score (ISS) was discussed. In addition, the subclinical type of RDS was emphasised.

Bacterial endotoxins (LPS) are not only the major constituents of the outer membrane of Gram-negative (G -) bacteria, but also the toxic determinants for G - infection, which is closely related to human health and the development of diseases. Pattern recognition receptors (PRR) have been considered to be the important initial steps for cellular recognition of LPS and consequent initiation of LPS responses. Scavenger receptor, CD14, toll-like receptors, ?2-integrins and L-selectin have been shown to be involved in the clearance of LPS or LPS activation. LPS receptor may be a complex of multiple components. Different individual response to LPS is related to gene background. The gene polymorphism of LPS receptors and LPS-induced cytokines have been shown to contribute to LPS sensitivity, susceptibility and prognosis of sepsis.

With the continuous improvement in weaponry, especially explosive weapons, blast injury has become one of the most common war injuries. Underwater blast injury is a common war injury during combat around islands or fighting for beach-head. The wounding effects of underwater blast wave and the characteristics of underblast injury are quite different from that produced in air due to special physical features of water and the underwater pressure. We have investigated the injurious effects of underwater blast wave and its dose-effect relationship. In addition, some protective measures have been tested to prevent or alleviate underwater blast injury. All of these primary results have provided both experimental and theoretical foundation evidence for further researches in respect to the diagnosis, emergency care and protection against underwater blast injury.

Objective To review the application of trauma and injury severity score (TRISS) and a severity characterization of trauma (ASCOT) in the outcome evaluation of trauma care and their research advances.Data sources Both Chinese- and English-language literature searched by using MEDLINE/CD-ROM (1985-1996) and Index of Chinese-Language Literature (1985-1996).Study selection Over fifty papers and reviews published over the past ten years were selected.Results and conclusion TRISS can be employed for different purposes, that is, preliminary outcome-based evaluation (PRE) and definitive outcome-based evaluation (DEF). TRISS is a method which is now the most extensively used for the outcome evaluation of trauma. Even so, it still has some shortcomings, e.g., trauma can not be given the weights that should be given, and the section of age is too simple. ASCOT is also a physiologic and anatomic combined method for the evaluation of injury severity and outcome. To some extent, this method obviates the shortcomings of TRISS in the calculation of probability of survival (Ps) with injury severity score (ISS). Therefore, ASCOT is considered to be superior to TRISS in the evaluation of Ps. However, TRISS is still now more extensively used than ASCOT just because ASCOT was recently developed.

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.

Calcium content and calcium-calmodulin complex were determined in endothelial cells before and after they were treated with endotoxin.It was found that endotoxin can promote the disintegration of calcium-calmodulin complex and greatly increase the cacium content in the endothelial cells.

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.

The effects of tumor necrosis factor (TNF) on the activity of plasmogen acitva-tor inhibitor (PAD and the morphology of the cells were observed in the original passage of cultured human umbilical vein endothelial cells (HUVEC). It was found that the TNF effect on the PAI was determined by the dosage of TNF, that is, 500U/ml of TNF could significantly activate PAT activity while 2500U/ml markedly inhibit it. Morphdogical observation canfirmed that 2500U/ml of TNF could injure HUVEC to form a kind of cells whose morphology was quite similar to that of circulating endothelial cells originating from peripheral blood.These findings suggest that TNF can stimulate HUVEC to increase the PAI acivity but too large a dosage of TNF could injure the metabolic function and structure of HUVEC.

To investigate the role of ICAM 1 in the aggregation of polymorphoneucleocytes (PMN) in the lungs at the early stage of burns. Myeloperoxidase (MPO) content in lung tissues and bronchoalveolar lavage fluid (BALF) was assayed. Intercellular adhesion molecule 1 (ICAM 1) and its mRNA expression in lung tissues were determined by immunohistochemical method and in situ hybridization. CD11b/CD18 expression on the circulating PMN were measured by flow cytometry. The results showed that levels of MPO in lung tissues and BALF were markedly higher than those of control after burn injury. Expression of ICAM 1 and its mRNA in the lung tissues and CD11b/CD18 on circulating PMN surface were significantly increased at 2, 6, 12, 24hr after burns. It suggests that PMN aggregation in the lungs might be related to increased ICAM 1 expression on pulmonary microvascular endothelial cells and CD11b/CD18 expression on PMN at the early stage of burn injury.

In order to explore the effect of anti vegf on fracture healing process,rabbits with left radius fracture were used as an animal model and divided randomly into control and experiment groups.VEGF polyclonal antibody was given to the animals of the experiment group films were thken at the fracture sites after 1,3,5 and 8 weeks of the fracture.the results showed that the cellular necrosis increased in the experiment group shortly after the fracture.Although there was fibroblast proliferation at 72 hours after the fracture,continuous focal necrosis was seen from 1 to 5 weeks in the fracture sites,and the vascularization reduced obviously 3 weeks after the injury.The organelle degeneration was observed in the fibroblasts and osteoblasts under microscope.The fracture sites were filled with fibrous tissue at the 8 th week and nonunion was ween in the fracture sites on X ray films.These results suggest that the lack of VEGF in the fracture sites might be one of the important reasons of fracture healing.