Objective To determine the kinetic changes of plasma D-lactate and endotoxin levels in patients after intraperitoneal operations. Methods Blood samples of 63 patients undergoing selective laparotomy were collected 0, 2, 24 and 48h after surgery. According to various criteria, the patients were divided into two groups respectively, i.e. extensive operation or medium sized operation,involvement of gastrointestinal (GI) tract or non-involvement GI tract, and development of symptoms of SIRS or no SIRS after operation. Plasma levels of D-lactate and endotoxin in systemic circulation were determined. Results The analytical data showed that the plasma levels of D-lactate and endotoxin were elevated significantly at 2, 24 and 48h post laparotomy in SIRS patients and major surgery group, and there was also a significant correlation between the plasma levels of D-lactate and endotoxin(?=0.91,P

Objective To study the effect and mechanism of intensive insulin therapy on stress hyperglycemia in rabbits with sepsis. Methods Rabbits were subjected to cecal ligation plus puncture (CLP) to reproduce sepsis. Sixty rabbits were randomly divided into three groups, control group (n=12), CLP group, and intensive insulin therapy group (n=24). The following parameters were measured with the method indicated in parentheses: blood glucose (blood sugar meter), glucose transporter 4 (GluT4) mRNA expression (RT-PCR), GluT4 protein level (Western blot). Results Compare with the control group, the level of blood glucose was significantly increased at 2h after CLP and reached its peak 12h after CLP (P

Objective To investigate gut barrier dysfunction and bacterial translocation (BT) from gastrointestinal tract in postoperative patients using polymerase chain reaction (PCR) and plasma D-lactate measurement, and to study the relationship between BT and infections complications. Methods 34 patients undergoing selective gastrointestinal operations were observed. Blood samples were collected prior to and 2, 24, 48 h after surgery for bacterial culture, plasma D-lactate, and LPS measurement. PCR was used to detect microbial DNA. PCR was performed after DNA extraction, with target ?-lactosidase gene of E. coli and 16S rRNA gene of most pathogenic bacteria. All the patients were observed for 30 days for monitoring infectious complications. Results No bacterial DNA was detected before surgery, but it was positive in 7 patients (20.6%) after operation. Bacterial DNA was discovered in 38.9% (7/18) of SIRS (systemic inflammatory response syndrome) patients, no bacterial DNA was detected in the 16 non-SIRS patients (P

Objective To investigate the effects of tension free herniorrhaphy on endocrine functions of patients with inguinal hernia. Methods One hundred and twenty seven patients were randomly divided into tension free group( n =65) and conventional group ( n =62). The mean ages of tension free group and conventional group were(51.8?14) year and(48.4?12) year respectively. There were 52 indirect hernias and 13 direct hernias in tension free group. There were 51 indirect hernias and 11 direct hernias in conventional group. Bassini repair was used in conventional group. Peripheral blood samples were obtained preoperatively and 3 h, 24 h after operation for measuring the levels of cortisol, T3, TSH, insuline, C peptide and and glucose. The data were analysed through t test. Results The levels of cortisol, C peptide and glucose in conventional group were remarkably higher ( P

Objective To observe the changes in gut mucosal barrier and gut-origin bacteria-endotoxin translocation in acute necrotizing pancreatitis (ANP) rats. Methods Wistar rats were divided randomly into normal group (n=6), sham operation group (n=30) and ANP group (n=39). ANP was introduced by infusion of artificial bile into biliopancreatic duct. Morphology of pancreas and intestine were observed and tight junction on ileum epithelia were assessed by cryofracture replicas electroscopy. Plasma levels of D-lactic acid and endotoxin were examined at various time points. The rates of bacterial translocation to abdominal organs were also calculated. Results Mucosal and tight junction damages of the gut were found during early stage of ANP. Simultaneously, plasma D-lactate levels increased and endotoxemia occurred. The rate of bacterial translocation to organs was 59.5% 72h after ANP occurred. Conclusions Gut barrier function can be injured in the early stage of ANP, and resulting in gut origin bacteria-endotoxin translocation, which may be the originator of systemic inflammatory reaction and secondary infection of the pancreas.

ObjectiveTo investigate the hemodynamic changes after multiple firearm injuries in a swine model. Methods Twelve pigs were divided into 2 groups randomly, with control group ( n =6) subjected to catheterization only. Multiple trauma group ( n =6) was subjected to tangential fracture of parietal bone and comminuted fractures of bilateral femora (ISS≥16) using 5 8 mm bullets. The hemodynamic changes, including MAP, PAP, PAWP, CO, SVRI and portal vein blood flow, were observed at different time intervals up to 72 h after trauma or catheterization. At the same time, gastric pHi was measured as well. Results Compared with control group pigs in multiple trauma group suffered a hyperdynamic circulation developed at 48～72 hours. The cardiac output rose and vascular resistance declined obviously. The pulmonary artery pressure and pulmonary capillary wedge pressure elevated significantly. Mean artery pressure, portal vein blood flow and gastric pHi declined significantly. Conclusion Without severe blood loss and hemorrhagic shock, the decrease of portal vein blood flow and viscera underperfusion still took place after multiple firearm injuries.