Objective To observe changes of plasma thrombinogen segment 1+2(FI+2)and D-dimer(D-D)in multiple trauma patients and exphlore their relations with traumatic disseminated intra-vascular coagulation(DIC). Methods A total of 66 multiple trauma patients were divided into minor injury group(ISS＜16 points,21 patients)and severe multiple trauma group(ISS≥16 points,45 pa-tients).Then.severe multiple trauma group were divided into DIC group(12 patients)and non-DIC group(33 patients).Another 10 healthy pemons were served as control group.Venous blood was collect-ed once in the control group and that collected from other groups at days 1,3 and 7 after injury.The F1 +2 concentrarion was detetrained with ELISA.and the D-D concentration was measured by automated la-tex enhanced immunoassay. Results The F1+2 and D-D levels in the minor injury group and sever multiple trauma group were both higher than that of the control group.In the meantime.the F1+2 and D-D levels in severe injury group were remarkably higher than that in the minor injury group.The plasma F1 +2 and D-D levels were elevated continuously in traumatic DIC group and remarkably higher than that in the non.DIC group.in which the plasma F1+2 and D-D levels gradually declined.Plasma F1+2 and D-D levels had significantly positive correlations at days 1,3 and 7 after injury. Conclusions Hiigher levels of F1+2 and D.D at acute stage is not only relevant to the injury severity,but also closely to the occurrence of traumatic DIC after injury.Detection of plasma F1+2 and D-D levels may play an impor-taut role in early prediction of DIC.

Objective To explore the relation between traumatic disseminated intravascular coagulation (DIC) and the level of plasma thrombomodulin (TM) in severe multiple-injury patients. Methods Sixty-six multiple-injury patients were divided into minor-injury group (ISS

Objective To investigate the effect of fibroblast growth factor receptor 3(FGFR3) in development phase of murine small intestine.Methods Wild type mice and their littermate FGFR3+ mice were used to observe their morphology and proliferation characteristics of epithelia of small intestinine in development phase and changes of FGFR3 expression.Results Mutant mice had lower density and their villa were lower than those of the controls.But to the depth of crypt,the results were conversely.Cells in proliferation mainly located in intestine crypt.Mutant mice had more proliferation than the controls at every time point.Expression of FGFR3 was detected at birth(day 1),and the expression was maximal from day7 to day 21,decreasing rapidly thereafter to reach the relatively low at day35.And the expression of FGFR3 also located in intestine crypt,overlapping with that of Brdu.Conclusion FGFR3 improves formation of murine intestine crypt in development phase.

Objective To evaluate the antiinflammatory effect of ulinastain( UTI) with ghrelin( GHL) on amelioration of small intestine dysfunction and its possible mechanisms in endotoxemia rats. Methods Animals were received intraperitoneal injection with lipopolysaccha-ride(LPS,15 mg/kg)as a endotoxemia model. 60 male SD rats were randomly divided into control group(CON group),LPS group,UTI group,GHL group,and UTI+GHL group. Microstructure of small intestinal submucosa was observed with HE staining. Dextran blue-2000 (BD-2000)was drenched for calculation of propulsion rate of the small intestine. The level of tumor necrosis factorα(TNF-α),IL-6 and HMGB1 in serum and small Intestinal mucosal tissue were determined by enzyme linked immunosorbent assay( ELISA) . RealTime-PCR was administrated for detection of rat defensin-5 mRNA(RD-5)and trefoil factor family-3(TFF-3)mRNA. All above measurement were taken re-spectively at 12 hours and 24 hours after LPS injection. Results HE staining shows that UTI+GHL group significantly alleviate the damage of intestinal microtructure caused by LPS when compared with UTI group and GHL group. The UTI+GHL group markedly increased expres-sion of RD-5 and TFF3 mRNA than those of UTI and GHL group in small Intestinal mucosal tissue (P<0. 05). Both the GHL group and the UTI+GHL group significantly enhanced the function of intestine motility,but the propulsion rate of UTI+GHL group was significant higher than that of GHL group(P<0. 05). In LPS group,the level of TNF-α、IL-6 and HMGB1 both in serum and intestinal mucosa tissue were markedly increased(P<0. 05),but those of UTI group,GHL group and UTI+GHL group were significantly decreased when compare to LPS group after the drugs administration at 12 and 24 hours. Conclusion UTI combined with GHL can significantly improve the intestinal func-tion of mucosal barrier and the motor through the inhibition of both systemic and intestinal mucosal inflammatory reaction in the process of en-dotoxemia.

Objective To explore the etiopathology of slow transit constipation(STC). Methods The model of rat with cathartic colon was established and the changes of colonic electromyography and reaction to acetylcholine(Ach) were examined. Result The frequency, amplitude of slow wave and colon reaction to Ach of rats with cathartic colon decreased markedly. Conclusion Long term abuse of stimulant laxatives could damage enteric nervous system(ENS) and accelerate the pathological changes of STC.

Objective To explore the methods for early diagnosis and treatment on severe thoracic and abdominal vascular injuries.Methods Eighty one patients were diagnosed as severe thoracic and abdominal vascular injuries and treated from January 2000 to October 2007.Twenty two cases suffered from hemorrhagic shock when admitted to the Emergency Department,from whom amount of inagglutinable blood were drawn out by thoracentesis or peritoneocentesis,and underwent operation immediately;38 cases were diagnosed by spiral CT and angiography(CTA);21 cases were diagnosed by digital substraction angiography.Forty-five patients accepted operation,and 36 cases underwent blood vessel suture and repair.Angiography was performed and blood vessels were blocked by sacculus in 12 cases before operation.Nine cases underwent artificial blood vessel anastomosis,among them 3 cases had to receive damage control for heavy injury,i.e.temporary shunting was made by intubating in the severe damaged blood vessel,the patients were then resuscitated in ICU to improve system condition,and operations were performed in 48 hours.Thirty six patients,including 31 cases of retroperitoneal blood vessel injuries in pelvic cavity,were treated by arterial embolization.Results Of the 81 patients,73 cases were cured(90.1%).Thirty-five cases developed severe complications,including 6 cases of sepsis,8 ARDS and 23 MODS.Eight cases died,of them 6 cases died of multiple organs damaged and hemorrhagic shock within 12 hours after injury,and 2 cases died of sepsis and MODS respectively at 8 and 16 days after injury.Conclusions Examination and diagnosis must be done immediately when the thoracic and abdominal vascular injured,and then the urgent operation of blood vessel repair or anastomosis should be performed.Some abdominal and retroperitoneal vascular injuries may be treated with artery embolization.

Objective To investigate the dynamic changes in endothelial cell specific molecule-1(ESM-1) in rat with sepsis and the relationship between ESM-1 level and renal injury.Methods Thirty-six SD rats were randomly divided into six groups: normal control group(n=6),sham operation group(n=6);CLP group(n=24),and in the latter group rats were divided into four subgroups according to time after CLP: CLP3h,CLP6h,CLP12h and CLP24h group(6 each).In rats of CLP group cecal ligation and puncture(CLP) was done to produce sepsis,and rats in sham operation group underwent the same surgical procedure as CLP group except the cesum was not ligated and punctured.The changes in ESM-1,blood urea nitrogen(BUN) and creatinine(Cr) level in peripheral blood were determined.Paraffin section and HE staining were used to examine pathological changes in kidney tissue,and immunohistochemisty was used to determine the ESM-1 expression in kidney tissue.Results Compared with normal control group,the serum level of ESM-1 increased significantly in CLP6h,CLP12h and CLP24h group(P

Objective To explore methods of easy treatment of bulk trauma patients caused by Wenchuan earthquake.Methods Early treatment was done on 1123 patients including extremity injuries in 925,spinal injuries in 65,brain injuries in 46,thoracic injuries in 53 and abdominal injuries in 72.There were 809 patients with single part injury and 314 with multiple injury.Emergent operation was performed in 67 patients including 13 with liver repair,14 with spleenectomy,three with mesentery blood vessel repair,six with repair of multiple abdominal organ injuries,four with repair of raptured diaphragm and injured organs,12 with evacuation of intracranial hematoma,four with lung repair,five with partial resection of lung and bronchus,one with pericardium discission and five with internal fixation of ribs.Early operation was carried out in 166 patients including 105 with only debridement,36 with debridement plus external fixation and 25 with amputation.Results Of all,406 patients were cured,673 were transferred to higher level hospitals after fundamental treatment and three died.Conclusion Staged treatment is suitable for early management for bulk trauma patients.Damage control technique should be applied early for critically severe patients and those with severe disease of heart and lung.Repeated examination is efficient to avoid delayed diagnosis and treament.

Objective To explore the role of fibrobronchoscopy in diagnosis and treatment of se- vere chest trauma. Methods A retrospective analysis was done on 114 patients with severe chest trau- ma who were diagnosed and treated by fibrobronchoscope from January 1999 to July 2007. We finished 289 times of fihrohronchoscopies including 181 times through nasal cavity, 32 through tracheal, 52 through oral cavity and 56 through traeheostomy tube. SaO2 and arterial blood gas were monitored continu- ously before and after operation, and respirator support or oxygen was administered simultaneously. Re- suits Definite diagnosis was achieved in all patients, of whom were 102 patients treated with lavement. SaO2 was significantly increased in all patients after bronchial lavement (P <0.01) and Pao2 was signifi- candy ameliorated two hours after bronchial lavement (P < 0.05). Conclusions Fibrobronchoscopy can identify diagnosis of bronchial injury and remove foreign body, secretion, blood and phlegm for pa- tients with severe chest trauma. Meanwhile, fibrohronchoscopy can relieve obstructive atelectasis and ob- structive pneumonia, improve respiratory function and hence increase survival rate.

Objective To observe expression of human beta-defensin-3 (HBD-3) in tissues around the infected artificial prostheses and investigate its value in treatment and diagnosis of periprosthetic joint infection (PJI).Methods According to clinical diagnosis,periprosthetic tissues and normal synovial membrane excised in operation were collected and divided into the following four groups:PJI group (n =13),aseptic loosening group (loosening group,n =9),spacer treatment group (treatment group,n =12),and normal group (n =15).HE staining was used to observe infiltration of inflammatory cells.Immunofluorescence staining was used to detect positive cells number and fluorescence intensity.Image-pro plus (IPP) 7.0C software was used to measure the average value of absorbance.Preoperative peripheral white blood cell count,erythrocyte sedimentation rate (ESR),and C-reactive protein (CRP) results were documented.Then,differences of those parameters were analyzed and compared among groups.Results HE staining revealed that all groups had different degree of inflammatory cell infiltration except for normal group.Immunofluorescence staining revealed that the most number of positive cells and highest fluorescence intensity existed in PJI group.Value of absorbance in PJI group was 0.430 ± 0.013,followed by 0.308 ±0.005 in loosening group,0.234 ± 0.009 in treatment group,and 0.089 ± 0.019 in normal group.Preoperative peripheral white blood cell count,ESR and CRP were the highest in PFI group,but were not significantly different among the remaining three groups.Conclusion HBD-3 is highly expressed in tissues around the prostheses which had infection or aseptic loosening,but its expression in response to infection and loosening has difference.