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.

Objective To explore the changes and the significance of left ventricular functions after blunt chest trauma(BCT)in rabbits.Methods 36 rabbit models of BCT with BIM-Ⅱ Bio-impactor in were used to observe the changes of left ventricular functions and free calcium,free calmodulin and total calmodulin were detected at pre-injury,the 2nd,4th,8th,12th and 24th hour after injury.Results The cardiac function were impaired.The systolic functions of left ventricle were impaired and recovered during 4-12 hour after BCT.The diastolic functions of left ventricle were impaired but not recovered 24h after BCT.The free calcium and total calmodulin in myocardial cells were increased from the 4th hour,reached,peak at the 8th hour post-BCT(P＜0.01),and then decreased,but were still higher at the 24th hour post-BCT than that of pre-BCT(P＜0.05).The free calmodulin in myocardial cells was low and reached peak at the 8th hour after BCT(P＜0.01).There is remarkable positive correlation between free calcium in myocardial cells and LVEDP and dp/dtmax with cardiac function(P＜0.05,P＜0.01).Conclusion The cardiac function is obviously changed after BCT,especially the diastolic functions of left ventricle.The hish concentration of free calcium in myocardial ceils may be one of the reasons of cardiac dysfunction after BCT.

Objective To explore the changed rules and the diagnositic methods of the cardisc functions after chest impact trauma(CIT).Methods The medals of moderate to severity CIT were established using BIM-Ⅱ Bio-impactor in 20 rabbits.The cardiac functions were examined with cardiac catheterization,single photon-emission computed tomography(SPECT)and the Doppler echocardiography at pre end post 1h,4h,8h and 24h after CIT.Results The cardiac functions were changed significantly after CIT.The expressions of the right ventricular dysfunctions mainly were systolic dysfuction while the left ventricular dysfunctions mainly were diastolic dysfunction after CIT.Conclustion All the cardiac catheterization、SPECT and the Doppler echocardiography are beneficial to the diagnosis of cardiac dysfunction afte CIT.The SPEGT is more exactitude and the Doppler echocardiography is more cheaper compared with non-invasive approaches.

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 study the effect of application of vascular endoth el ial growth factor (VEGF) and anti-VEGF on the expression of fracture healing rel ated factors and observe the pathological changes at fractured site. Methods Fra cture models were established in 105 rabbits. All rabbits were randomly assigned into controlled group, VEGF treated group and anti-VEGF treated group. The fact ors related to fracture healing were detected, and pathological changes were obs erved at 8, 24, 72 h and 1, 3, 5, 8 weeks after fracture. Results After the appl ication of VGEF, BMP was expressed earlier and the express period was prolonged . On the contrary, anti-VEGF completely inhibited the expression of BMP in the f ractured ends. The fractured sites were filled with fibrous callus, cartilage ca llus and bony callus at the 3rd week and they were converted into woven bone at the 5th week. The fracture reached to normal healing at the 8th week in the VEGF treated group. Cellular necrosis increased in the earlier period in the VEGF po lyclonal antibody treated group, continuous focal necrosis was seen in the fract ured sites between 1st week to 5th week, vascularization reduced obviously at th e 3rd week. Conclusion Fracture healing is the result of mutual modulation and c oordination among many factors. VEGF may be an important factor which plays impo rtant role in the course of fracture healing.

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.