Objective To investigate methods of weaning acute brain stem hemorrage patients with respiratory failure from mechanical ventilation.Methods This was a retrospective analysis of 45 acute brain stem hemorrage patients with respiratory failure requiring mechanical ventilaiton.Results 15(33.3%)patients were successfully weaned from mechanical ventilation for the first time;the other 30(66.7%)patients failed in the first place,then succeeded after 3~7 days of and occasional disconnection from ventilation.The time of mechanical ventilation varied from 6 to 35 days.Conclusion It is difficult to wean acute brain stem hemorrage patients with respiratory failure from mechanical ventilation.Occasional disconnction from ventilaiton,antiinfection and nutritional supplementation might contribute to successful weanning.

Objective To study the effects of naloxone on ?-endorphin (?-EP) in plasma and on myocardial ultrastructure during myocardial ischemia-reperfusion (I/R) injury in rabbits.Methods The myocardial ischemia models and myocardial ischemia -reperfusion injury models in rabbits,by ligating the left anterior descending branch of coronary artery,were used to investigate the changes of ?-EP and ET-1 in plasma during I/R injury, and after treatment with naloxone, an antagonist of opiate receptor. 20 New Zealand rabbits were randomly assigned to 2 groups (each 10 rabbits in naloxone treatment and ischemia-reperfusion group). The bloods were taken at different times in each group. The concentrations of ?-EP and ET-1 were detected with radioimmunology method.The changes of myocardial ultrastructure in samples of myocardial ischemia,were observed through electron microscope.Rseults The levels of ?-EP were significantly improved after I/R injury compared with those before ischemia (P0.05). For ischemia-reperfusion group, most of cardiac muscles were in the contracting state, the myofibril dissolved and broke locally. The edema was found on the circumference of nucleus. For naloxone treatment group, the structure of myofibril was clear and its arrangement was in good order, and no obvious breakage was found. The contracting of myofibril, the edema of mitochondria and kytoplasm were moderating. Conclusion Naloxone may effectively control the levels of ?-EP and the synthesis and secreting of ET-1 after myocardial ischemia and during I/R injury;and reduce the injury to the myocardial ultrastructure and decrease the injury to blood vessel and myocardium.

Objective Discussing the clinical features, early diagnosis and therapeutic methods of aortic dissection (AD). Methods We analyzed and concluded the clinical datum of 33 AD patients in our hospital. Results The rate of male to female was 5.6 to 1 among all patients, average age 60, hypertension accounted for 81.8 percent. There were 26 patients (78.8 percent) suffered an acute pain, of who 22 patients got a pain in anterior chest.There were 22 of 26 patients diagnosed AD through echocardiography, 20 and 11 patients confirmed AD by MRI or CT respectively among all 33 patients. 13 patients had abnormal ECG, 10 ST-T segment changed, 12 left ventricular hypertrophy or hyper-voltage. Hypertension patients were treated through a infusion of nitroglycerin or nitroprusside by intervenous drop or by vein pump firstly to decend systolic blood pressure to the level of 100~120 mmHg and heart rate to 60~70 bpm,combining with the use of beta blocker, calcium antagonist and rennin- angiotensin inhibitor. 27 patients’ pain alleviated gradually even disappeared after controling their blood pressure, whose state of illness became to stable. 2 persons did the operation of aortic replacement in emergency. 6 persons died for aortic dissection broken in one week or one month. Conclusions The clinical manifestations of AD are complex, and the rate of false or leak diagnosis is high. Radiology studies including echocardiography, MRI or CT may be very important to enhance the ability of diagnosing AD early and to guide the treatment. Taking medical treatment is primary in emergency. Operating the replacement of aorta is an effective measure to treat AD.

Objective To evaluate plasma BNP level change in acute pulmonary embolism and its clinical value.Methods 33 cases were diagnosed by CT pulmonary angiography or DSA.they were divided into two groups:the group with right ventricular(RV)dysfunction group and the group without right ventricular(RV)dysfunction.Plasma BNP was detected by Triage BNP test.otherwise,we observed severe clinical presentation、 death rate and mechanical ventilation in two groups.Results Plasma BNP level is higher in the group with RV dysfunction(288?102pg/ml)than that in the group without RV dysfunction(61?32pg/ml)(P

Objective To investigate the change and significance of electrocardiogram and myocardial damage index in patients with acute organophosphorus pesticide (AOPP).Methods 71 hospitalized patients in EICU with AOPP from January 2000 to June 2006 were recorded.The patients were divided into 3 groups: mild poisoning group (n=18),moderate poisoning group(n=22) and severe poisoning group (n=31).Electrocardiogram(ECG), serum creatine kinase(CK), serum creatine kinase isoenzyrne MB(CK-MB),lactate dehydrogenase(LDH) and TnI were detected,the relation between the above-mentioned indexes and the toxical degree were analyzed.Results Abnormal ECG had a rasied tendency along with increase of the poisoning degree.The incidence of Ⅱ~Ⅲ atrioventricular block, atrial premature beats, ventricular premature contraction, ventricular tachycardia and ventricular fibrillation in severe poisoning group significantly increased compared with that in mild poisoning group and moderate poisoning group(P

Objective To explore effects of hcmoperfusion on toxic ingredients in plasma of rabbiis with a-cute intoxication of Radix Aconiti Kusmezoffii Monkshood.Method Sixteen male Japanese Giant Ear Rabbits were randomly divided into acute poisoning(AP)group and acute poisoning + hemoperfusion(AH)group(8 an-hnals in each group).Acute poisoning models were established in rabbits of both groups with intragastric adminis-tration of Radix Aconiti Kusmezoffii Monkshood liquid in dose of 1 mL/kg in order to produce arrhythm which oc-curred within ode hour after intragastric administration was regarded as the criteria of successful animal model.and then hemoperfusion with active carbon was performed for 2 hours in AH group.The pathological chanses of brain,myocardium and hepatic tissues were observed.The plasma concentrations of toxicants including mesaconitine,a-conitine and hypaconitine were measured by using HPLC-MS at 1 h,2 h,3 h,and 6 h after poisoning.Student's T test was used to identify the significance.Results The brain.myocardium and hepatic tissues of the rabbits in AP group showed hyperemia and edema which were attenuated after hemoperfusion.The plasma concentrations of mesaconitine,aconitine and hypaconitine revealed no significant differences between AP group and AH group with-in one hour after poisoning(P＞0.05),while at 2 h and 3 h after poisoning,the plasma concentrations of mesaconitine were(2.11±1.08)ng/mL,(2.02±1.46)ng/mL,respectively,aconitine(39.70±9.31)ng/mL,(19.71±16.06)ng/mL,respectively,and hypaconitine(1.70±0.71)ng/mL,(2.12±1.33)ng/mL,respec-fively in AH group,and they were significantly lower than those in AP group(P＜0.05).Conclusions The the plasma concentrations of mesaconitine,aconitine and hypaconitine were lower and the histopathological changes were attenuated after hemoperfusion.Hemoperfusion is a good intervention for acute intoxication of Radix Aconiti Kusmezoffii Monkshood.

OBJECTIVE To study the changes in matrix metalloproteinase-9 (MMP-9) mRNA, tissue-inhibitor of metalloproteinase-1 (TIMP-1) mRNA and the ratio of MMP-9 mRNA/TIMP-1 mRNA in the lungs of paraquate poisoning rats, and to investigate the protective effects of sodium dimercaptopropane sulfonate (DMPS, Unithiol). METHODS One hundred and twenty male SD rats were divided into 12 groups (n=10) randomly: normal control, DMPS control, PQ poisoning 1, 3, 7, 14 and 28 d model groups, (DMPS+PQ) 1, 3, 7, 14 and 28 d groups. PQ poisoning model was established by intraperitoneal injecting paraquate. The expression of MMP-9 mRNA and TIMP-1 mRNA in lung tissues was detected by RT-PCR. RESULTS ①By observing the changes of action and observing the lung tissues sections, the rats' PQ poisoning models was successfully established. ②The histopathology of lung showed infiltration of inflammatory cell in acute phase(within 2 weeks), the inflammation decreased gradually after 2 weeks, hyperplasia of collagen and pulmonary fibrosis were instead. Howerer, the pathological changes were alleviated obviously in the (DMPS+PQ) groups. ③Compared with the PQ groups, the expression of MMP-9 mRNA and TIMP-1 mRNA in lungs diminished greatly in the DMPS+PQ groups after rats injected DMPS(P<0.05); the ratio of MMP-9/TIMP-1 mRNA was bigger at 7, 14 and 28 d in the DMPS+PQ groups after rats injected DMPS. CONCLUSION Down-regulation of the expression of MMP-9 mRNA and TIMP-1 mRNA and up-regulation ratio of MMP-9 mRNA/TIMP-1 mRNA by DMPS may be one of mechanisms by which pulmonary injury and pulmonary fibrosis are prevented in the acute paraquate poisoning.

Objective To investigate the potential role and changes of CD14, TNF-ct and IL-10 in liver in Vibrio vulnificus septic rats, and detect the intervention effects of eefoperazone sodium combined with levofloxacin. Methods To make Vibrio vulnificus sepsis model (VV group) and drug intervention model (AA group) in rats, the expression of CD14, TNF-α, IL-10 in liver were detected by RT-PCR. Results Compared with normal control (NC) group,CD14 mRNA and TNF-α mRNA expression increased markedly at 2, 6, 9, 12, 16 h in VV group (P<0.05), IL-10 mRNA raised greatly at 9, 12, 16 in VV group (P<0.05). CD14 mRNA expression was also rised in AA group at 9 h(P<0.05). TNF-α mRNA at 9, 12 h and IL-10 mRNA at 9, 12, 16 h in the AA group increased (P<0.05). Compared with VV groups, CD14 mRNA expression diminished greatly at 9, 12, 16 h in AA group (P <0.05), TNF-α mRNA and IL-10 mRNA diminished in the AA group at 16 h(P<0.05). Conclusion The treatment with cefoperazone sodium and levofloxacin may reduce expression of CD14, TNF-α and IL-10 in liver of rats with VV sepsis, it may inhibit the level of pro-inflammatory/anti-inflammatory cytokines, thereby regulating the balance of the inflammatory response in VV sepsis.

Objective To investigate the expressions of TF mRNA and TFPI mRNA of liver in rats with Vibrio vulnificus sepsis and to assess the interventional effects of cefoperazone sodium along with levofloxacin lac-tate. Method One hundred and ten male SD rats were divided (random number) into normal control group (NC group, n = 10), Vibrio vulnificus sepsis group (VV group, five subgroups n = 10 in each), drug intervention model (AA group, five subgroups n = 10 in each). The Vibrio vulnificus sepsis models and drug intervention models of rat were made. The reverse transcription polymerase chain reaction (RT-PCR) assay was employed for the measurement of TF mRNA and TFPI mRNA. ANOVA and t-test performed with SPSS version 12.0 software. Results Compared with NC, the expressions of TF mRNA in liver increased markedly 2 h,6 h, 12 h and 16 h af-termodeling in VV groups (P<0.05), and reached peak 6 hours after modeling. The expressions of TF mRNA in liver of rats in AA groups were much higher than those in NC group 9 h and 12 h after modeling (P<0.05). The expressions of TFPI mRNA in liver of rats in VV groups and AA groups were not significantly different to those in NC group (P>0.05). Compared with VV groups, the expressions of TF mRNA in liver of rats in AA groups were greatly lowered 9 hours after administration of bactericide (P<0.05), and the expressions of TFPI mRNA in liver of rats in AA groups were significantly higher 12h and 16 h after intervention (P<0.05). Conclusions There is a obvious imbalance between coagulation and anticoagulation functions of circulation system during Vibrio vulnificus sepsis, and the imbalance can be corrected gradually after treatment with antibacterial agents.

AIM:To investigate the effect of capsaicin on lipopolysaccharide ( LPS)-induced activation of cul-tured endothelial cells of mouse aorta in vitro.METHODS:The endothelial cells were isolated from mouse aorta and cul-tured in vitro, and the specific cell markers of the cells were identified by immunofluorescence staining.The cells were stimulated with LPS (100μg/L) combined with or without capsaicin, and the cells and supernatant were collected at 12 h, 24 h and 48 h.The levels of soluble intercellular adhesion molecule 1 ( sICAM-1) , soluble vascular cell adhesion molecule 1 (sVCAM-1) and soluble P-selectin (sP-selectin) in the supernatant were measured by ELISA.The levels of nuclear NF-κB p65 and cytopasmic p-IκBαand IκBαwere detected by Western blotting.RESULTS: Compared with control group, the levels of sP-selectin, sICAM-1 and sVCAM-1 in LPS group were significantly increased (P<0.05), and LPS promoted the expression of sICAM-1 and sVCAM-1 in a time-dependent manner.Compared with LPS group at the same time point, capsaicin inhibited the expression of sP-selectin, sICAM-1 and sVCAM-1 in a dose-dependent manner.Compared with con-trol group, the protein levels of NF-κB p65 and p-IκBαin LPS group at 24 h were significantly increased (P<0.05), while the protein level of IκBαin LPS group at 24 h were significantly decreased (P<0.05).Compared with LPS group, capsaicin decreased the protein levels of NF-κB p65 and p-IκBαand increased the protein level of IκBαin a dose-depend-ent manner.CONCLUSION:Capsaicin has a protective effect on LPS-induced vascular endothelial cell activation, which potentially contributes to the suppression of IκBαdegradation and NF-κB p65 nuclear translocation.