Objective To explore the effect of mild hypothermia on tumor necrosis factor alpha (TNF-?),interleukin-1?(IL-1?),interleukin-6 (IL-6) and interleukin-8 (IL-8) in serum of patients with severe traumatic brain injury and its clinical significance. Methods Mild hypothermia was used within 24 hours after injury to keep the rectal temperature at 33℃-35℃ for five days in 23 patients, who suffered from severe brain injury with GCS score of 3-8 (mild hypothermia group). And 21 patients who suffered from severe brain injury with GCS score of 3-8 were taken as control group. The dynamic changes of serum TNF-?, IL-1?, IL-6 and IL-8 at days 1, 2, 3 and 4 respectively after trauma were monitored using ELISA. Results Levels of serum TNF-?, IL-1?, IL-6 and IL-8 were decreased more significantly in the mild hypothermia group than those in the control group(P

ObjectiveTo investigate the effect of adaptive support ventilation (ASV) plus lung recruitment maneuvers (LRM) and intermittent positive pressure ventilation (IPPV) on respiratory mechanics, hemodynamics and oxygen delivery in trauma patients combined with acute respiratory distress syndrome (ARDS).MethodsTwenty-eight trauma patients combined with ARDS including 18 males and 10 females at age range of 19-48 years were mechanically ventilated by two modes, ie, IPPV and ASV + LPS.The patient was initially ventilated with IPPV for eight hours, with tidal volume (VT) of 10 ml/kg, PEEP = 0, oxygen delivery speed for 32 L/min and oxygen inhalation concentration of 60％.Then, one of ASV + LRM and IPPV was randomly selected for continual ventilation.There were three levels of positive end-expiratory pressure (PEEP,0,5 and 10 cmH2O).Each level of PEEP was maintained for 60 minutes.During the use of ASV + LRM, continuous positive airway pressure (CPAP) was at 45cmH2O and breath holding continued for 30 seconds.Then, the mode was turned to ASV and respiratory mechanics, hemodynamics and oxygen delivery were measured by using Swan-Ganz catheter, electrocardioscanner and ventilator when each level of PEEP was ventilated for 50 minutes.Results Compared with IPPV mode in the same level of PEEP, ASV + LRM mode had lower peak inflating pressure (PIP),airway plate pressure (Pplat) and intrapulmonary shunt (Qs/Qt) (P ＜ 0.05) but higher oxygenation index (PaO2/FiO2) and oxygen delivery (DO2) (P ＜ 0.05).There was no statistical difference in aspects of MAP, CI and SVRI during ventilation with IPPV and ASV (P ＞ 0.05).ConclusionASV + LPS model is better than IPPV in ventilation for trauma patients combined with ARDS.

Objective To explore the diagnostic value of miR-1 in acute myocardial infarction(AMI).Meth-ods 148 patients with chest pain in the emergency department of this hospital from February 2013 to Decem-ber 2016 were selected and divided into the AMI group(82 cases)and non-AMI group(66 cases)according to the diagnostic criteria of acute AMI.Contemporaneous 74 healthy persons undergoing physical examination were selected as the healthy control group.The levels of serum miR-1,cardiac troponin I(cTnI)and creatine kinase isoenzyme(CK-MB)were measured in 3 groups.The correlation between miR-1 level with cTnI and CK-MB levels in the AMI group.The sensitivity and specificity of miR-1,cTnI,and CK-MB in the diagnosis of acute AMI were analyzed.Results The serum miR-1,cTnI and CK-MB levels in the AMI group were signifi-cantly higher than those in the non-AMI group,while the serum miR-1,cTnI and CK-MB levels in the non-AMI group were higher than those in the healthy control group,the difference among 3 groups was statistical-ly significant(P<0.05);the miR-1 level was positively correlated with cTnI and CK-MB levels in the AMI group(r=0.733,0.779,P<0.05);the receiver operating characteristic curve analysis showed that the sensi-tivity and specificity of miR-1 in the early diagnosis of acute AMI was 90.57% and 97.53% respectively.Con-clusion miR-1 can be used as a new index for early diagnosing acute AMI and assessing severity degree,more-over its sensitivity is higher than cTnI and CK-MB.