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.

BACKGROUND: There exists a close relationship between the expression of scavenger receptor(SR) and CD14 and the endotoxic lung injury. To further detect the expression of these two receptors and their relationship is helpful to disclose the receptor mechanism of lung inflammatory disequilibrium so as to provide a possible theoretical foundation for sepsis therapy.OBJECTIVE: To investigate the expression of CD14 and SR in murine alveolar macrophages and their effect after trauma and traumatic endotoxin challenge.DESIGN: Randomized and controlled experimental study.SETTING: Fourth Laboratory(a state key laboratory), Trauma, Burns and Combined Injury, the Research Institute of Field Surgery, Daping Hospital,the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was completed in the Research Institute of Field Surgery of Daping Hospital of the Third Military Medical University of Chinese PLA from August 2001 to November 2001. Totally 63 Kunming mice with murine alveolar macrophages were used in the experiment.METHODS: The experimental animals were randomly divided into three groups including control group, trauma group and traumatic endotoxin challenge group. The model mice with both femur fracture and endotoxin challenge were used. Endotoxin at a dose of 5 mg/kg was injected one hour after fracture via tail vein and the dynamic expression of CD14 and SR in murine alveolar macrophages (AM) was detected.RESULTS: Six hours after trauma, the expression of CD14 and that of SR in AM showed the tendency of up-regulation and down-regulation respectively. Furthermore, the post-traumatic endotoxin challenge induced CD14up-regulation and SR down-regulation drastically. Correlation analysis indicated that CD14 and SR showed a significantly negative relationship.CONCLUSION: The study suggested that the dual modulation of CD14 and SR in AM is possibly related with the change of "self-control" to "out of control" of inflammatory reactions in the lungs after endotoxic challenge. The dual regulation of the effective antagonists CD14 and SR are helpful in further understanding lung injury and its repairing mechanism.

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.

Objective To evaluate the expressive varieties of Nogo-A mRNA in injured optic nerves of rats. Methods Reverse transcription polymerase chain reaction (RT-PCR) method was used to hemi-quantitatively analyze the levels of Nogo-A mRNA in the optic nerves 3, 7, 9, 15, 21, and 25 days respectively after injury. Results The level of the expression of Nogo-A mRNA was low in the normal optic nerves, while it was significantly high in the optic nerves 3 days after injury, and kept the high level still after 25 days. Conclusion The expression of Nogo-A mRNA in injured optic nerves is increased.

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 separation,purification and activity determination of basic fibroblast growth factor (bFGF) with nucleic acid molecular hybridization was described and the changes of bFGF in lung injury treated with prostacy-clin were observed.It was found that bioactive bFGF and bFGF-mRNA could only be found in the injured lung tissues but not in the normal lungs.Administration of prostacyclin could slightly elevate the activity of bFGF and signficantly increase the level of bFGF-mRNA.The findings of this study suggest that there is an increase of bFGF level after lung injury,prostacyclin can influence the expression of bFGF,and bFGF plays an important role in the repair of the injured lung tissues.