Journal Detail Information

1

Cite

Share

Clinical study of peritoneal dialysis treatment on severe acute pancreatitis

Huanrong YANG ; Gaoling SUN ; Shufang CAI ; Aixia HAO ; Chanmei YU ; Yuxie QIN

Chinese Journal of Emergency Medicine.2009;18(12):1316-1320. doi:10.3760/cma.j.issn.1671-0282.2009.12.024

Objective To ivevstigate the feasibility, the effects and the therapy of peritoneal dialysis(PD) on severe acute pancreatitis (SAP). Method From January,2001 to Jaly 2006,48 patients of SAP were divided randomly into PD group and non-PD group in Qingzhou hospital. Both groups were treated by the conventional mode of therapy. In PD group , using the concept of PD,24 patients of SAP were treated with PD and NPD group were treated only with common therapy. The release time of abdominal pain and distention, CT scores, APACHE II scores, the time of hospital stay, cost of treatment in hospital, operative rate and rate of complications and recovered rate of the two groups were compared. Simutaneously. the concentration of serum and fluid filtrated inflammatory cytokines TNFα,IL-6,IL-8,IL-10 and CRP were also determined pro and post the therapy. Results In the PD and NPD group, the duration for disappear-ance of abdominal pain and tenderness,and amelioration for abdominal distension was (19.70 ±7.32) hvs. (81.46±36.68) h and (23.16±6.95) h vs.(78.19± 29.26) h;So that the PD group was precede to that in NPD group ( P < 0.05). The concentration of serum and fluid filtrated pro-inflammatory cytokines TNFα, IL-6, IL-8 and CRP at each observation points after PD was decreased significantly (P <0.05) in the PD group. But the concentration of the serum and fluid filtrated anti-inflammatory cytokines IL-10 was increased significantly (P < 0.05) as compared with that of the NPD group. Conclusions Through PD, the imbalance of pro-inflammatory and anti-inflammatory cytokines has been corrected at early stage of SAP. But the PD is method that is easy, quick, small wou-ndell,few complicated and effective in patients with early-phase SAP, and will be of great value in wide application and further study.

2

Cite

Share

Roles of CCR2b and CCR1 antagonist RS504393 in LPS-induced acute lung injury

Dong YANG ; Chunxue BAI ; Xiangdong WANG ; Lin TONG ; Yaoli WANG

Chinese Journal of Emergency Medicine.2009;18(12):1278-1282. doi:10.3760/cma.j.issn.1671-0282.2009.12.013

Objective To evaluate the potential effects of RS504393, CC chemokine receptor (CCR) 2b and CCR1 antagonist, on LPS-induced acute lung injury (ALI) and to investigate the underlying mechanisms. Method A549 cell line was stimulated with LPS (10 μg/mL) and then treated with RS504393 (10 μg/mL) for 6 hours. ALI model was established with intranasal administration of LPS (5 mg/kg) in C57BL/6J mice. RS504393 (5 mg/kg) was administered 30 min before LPS dripped nasally. IL-8, IL-1β, plasminogen activator inhibitor (PAI)-l,monocyte chemoattractant protein (MCP)-2,and the expressions of CCR1 and CCR2b were studied by using Realtime-RT-PCR, ELISA and cyto-flowmetry. Results In A549 cell line treated with RS504393,the expressions of CCR1, CCR2b and IL-8 were significantly inhibited after LPS stimulation. In rats with LPS-induced ALI, treatment with RS504393 significantly protected mice against lung injury by attenuating influx of leukocytes and protein into bronchoalveolar space and by lessening pathological changes of lung. Treatment with RS504393 down-regulated IL-1β and PAI-1 expressions in bronchoal veolar lavage fluid (BALF) and lungs at mRNA and protein levels along with up-regulation MCP-2 expression compared to rats of vehicle-treated groups. Conclusions CCR2b and CCR1 play pivotal roles in the development of ALl,and RS504393 as a antagonist can halt the development of ALI.

3

Cite

Share

Changes of VE-cadherin and arginine vasopressin in patients with acute brain injuries

Li LI ; Youmin HUANG

Chinese Journal of Emergency Medicine.2009;18(12):1266-1269. doi:10.3760/cma.j.issn.1671-0282.2009.12.009

Objective To observe the changes of serum vascular endothelium-cadherin (VE-cadherin) and plasma arginine vasopressin (AVP) in patients with acute brain injury, and to investigate the VE-cadherin and plasma AVP related to brain edema and prognosis following acute brain injury. Method ELISA was used to measure the serum VE-cadherin level and radioimmunoassay was used to measure serial concentration of AVP in plasma of 110 patients with acute brain injury 12 hours and 3 and 5 days after brain injury. The outcome was estimated in combination of clinical manifestation, iconographic findings and Glasgow Outcome Scale (GOS). Results The levels of VE-cadherin and AVP increased significantly over 12 hours after brain injury with reduction of GCS. The severer brain injury resulted in higher levels of VE-cadherin and AVP, and prolongation of peak brain edema (P < 0.01). VE-cadherin levels showed positive correlation with severity of brain edema (r = 0.69, P < 0.01) and prolongation of brain edema (r = 0.70.P < 0.01). AVP levels had positive correlation with severity of brain edema (r = 0.65, P < 0.01) and prolongation of brain edema (r = 0.64, P < 0.01). Furthermore, there were significant increases in VE-cadherin and AVP levels in patients with low GOS groups (P < 0.01). The VE-cadherin and AVP leveb in poor outcome group persistently increased for 5 days after brain injury and were higher than those in good outcome group and normal control group. There were a correlation between VE-cadherin and AVP in patients with acute brain injury (r = 0.75, P < 0.01). Conclusions VE-cadherin and AVP leveb are closely associated with the prognosis of patients after acute brain injury. VE-cadherin and AVP may play pivotal roles in the pathogenesis of brain edema after acute brain injury.

4

Cite

Share

Primary resection and anastomosis without intraoperative colonic irrigation in left colonic cancer with complete obstruction

Xiaoan WANG ; Yajun WANG ; Fei LI ; Yu FANG ; Ang LI ; Dongbin LIU ; Jiabang SUN

Chinese Journal of Emergency Medicine.2009;18(7):744-746. doi:10.3760/cma.j.issn.1671-0282.2009.07.019

Objective To assess the value of primary resection and anastomosis without intraoperative irrigation in the patients with obstructive left colonic cancer. Method Between January 2000 and January 2008, 93patients underwent primary resection and anastomosis for colonic cancers were analyzed retrospectively. Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) was performed in 43 patients with obstructive left colonic caner and traditional left-sided colectomy in 50 cases without obstruction. Both groups of patients were comparable in terms of gender, nutritional status, underlaying disease, tumor location and stage, etc ( P = 0.83,0.13,0.29,0.51,0.38). The average age of the patients with colonic obstruction was significant older than that of the cases without obstruction (61.2 ± 8.6 vs. 58.1 ±7.8, P =0.010).The operative results were compared between patients with obstructive colonic cancer and cases without obstruction.Results The mean hospital stay of the primary anastomosis group and traditional left-sided colectomy group were (16.6±7.8) d and (12.4±5.4) d respectively, and the former was significant longer than the latter (P =0.002). The costs of hospitalization in the two groups were (50192.8 ± 39727.4) RMB and (46489.3 ±29543.1)RMB respectively (P = 0.04) . The morbidity and mortality in the two groups were 25.6% (11/43) vs. 18%(9/50) (P =0.375) and 2.3% (1/43) vs. 2.0% (1/50) (P =0.714) respectively, and there were no significant difference between the two groups. Conclusions Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) compares favorably with traditional left-sided colectomy in safety and efficiency for left colonic cancer with obstruction.

5

Cite

Share

Septic patients caused by Vibrio vulnificus: epidemiology, clinical findings, diagnosis and treatment

Zhongqiu LU ; Caijiao LU ; Guangliang HONG ; Junyan CHENG ; Qiaomeng QIU ; Huan LIANG ; Bing WU ; Jingrong LI

Chinese Journal of Emergency Medicine.2009;18(7):732-736. doi:10.3760/cma.j.issn.1671-0282.2009.07.017

Objective To study epidemiology, clinical findings, diagnosis and treatment of sepsis caused by Vibrio vulnificus. Method Patientss with Vibrio vulnificus sepsis were collected from 1995 to 2008. The medical records including epidemiological and clinical data were analyzed. Results The male-to-female ratio of 34cases was 4.7:1 and 76. 5% of these patients suffered from chronic liver disease. Most patients occurred from April to October with signs of abrupt fever, characteristic cutaneous lesions, hypotension and progressive multiple organ disfunction syndrome (MODS). The mortality was over 47.1% . The criteria proposed for early diagnosis of Vibrio vulnificus sepsis were abrupt onset with fever during the period from April to November, characteristic cutaneous lesions, such as the most commonly occurred haemorrhagic bullae on the extremities or even extensive necrosis of skin and muscular tissue, progressive hypotension or shock accompanied by MODS, pre-existing liver disease or chronic abuse of alcohol, and consumption of raw seafood or exposure to seawater within 12 week. Early administration of the third-generation cephalosporins with the quinolones in full dosage, aggressive wound debridement,appropriate dermoplasty and supportive care contribute to a better outcome. Conclusions Vibrio vulnificus sepsis progresses rapidly with high mortality. Early diagnosis, rapid treatment with prompt antibiotics and aggressive surgery treatment are very important to improve the outcome.

6

Cite

Share

Hepatic gene expression of rats subjected to hemorrhagic shock

Huibin XU ; Lingzhi HUANG ; Wei ZHENG ; Xiaofeng LI ; Ziling WANG ; Hong ZHOU

Chinese Journal of Emergency Medicine.2009;18(7):702-706. doi:10.3760/cma.j.issn.1671-0282.2009.07.009

Objective To analyze the differential gene expression profiling of liver in rats subjected to hemorrhagic shock(HS) and sham hemorrhage shock(SHAM) by gene chip technology, thus to evaluate the possible molecular pathogenesis of HS. Method 20 male Wistar rats were randomly divided into a SHAM group and a HS group, with 10 rats in each group. Hepatic gene expression profiles were detected by oligonucleotide microarrays of 5705 mouse genes in two groups for three times. Genes with ratio(R) > 2 were identified as up-regulated and R < 0.5 were identified as down-regulated. Biological function of differentially expressed genes was analyzed and 9 genes were selected to undergo semi-quantitative RT-PCR. Results Among the total 5705 probes detected,86 genes showed differential expression in HS group comparison with SHAM group. The expression levels of 72 genes were up-regulated while those of 14 genes were down-regulated significantly. Differentially expressed genes were classified according to their biological function: transport genes, transcription regulator genes, signaling genes, response to stress genes, metabolic genes, development genes and cell adhesion genes. Conclusions cDNA microarray is an efficient and high-throughout method to survey gene expression profiles in HS.The variation of those gene expressions might be a potential pathogenic mechanism for HS that may offer a novel target for further study of therapeutic strategies of HS.

7

Cite

Share

Effect of penehyclidine hydrochloride on the expression of Toll-like receptor 4 during acute lung injury

Baiqiang LI ; Haichen SUN ; Shinan NIE ; Danbing SHAO ; Hongmei LIU ; Xiaoming QIAN

Chinese Journal of Emergency Medicine.2009;18(7):737-743. doi:10.3760/cma.j.issn.1671-0282.2009.07.018

Objective To observe the effects of penehydidine hydrochloride (PHC) on t acute lung injury ( ALI) . To investigate into the expression of TLR4 on peripheral monocytes, kinetics of inflammatory and anti- inflammatory mediators. To explore the mechanism of TLR4 in ALI. Method A total of 45 patients with ALI were randomly divided into PHC treatment group(experimental group, n =21) and routine treatment group (control group, n = 24) . Patients of both groups were given with the routine treatment,and patients in experimental group were given with PHC in addition (1 mg,im,ql2h) . Therapeutic effects, average length of hospital stay, ICU stay,PaO_2 and PaO_2/FiO_2 > as well as the expression of TLR4 and some cytokines were observed for 48 hours. Results Patients of both groups got better gradually after treatment. The PaO_2 and PaO_2/FiO_2 of patients of both groups progressively increased. At 6 hours, 12 hours, 24 hours and 48 hours after treatment, the PaO_2 and PaO_2/FiO_2significantly increased than 0 hour ( P < 0.05). The improvement in experimental group was obviously better than that in control group at 6 hours, 24 hours and 48 hours after treatment (P < 0.05). There were no differences in average length of hospital stay between the two groups. The ICU stay was significantly shorter in the experimental group ( P < 0.01) . The expressions of TLR4 were higher in patients of both groups than in healthy ones (P <0.01) . TLR4 decreased significantly at 24 hours and 48 hours, while it was lower in experimental group than that in the control group (P < 0.05). The higher level of TLR4in the early stage implied worse prognosis. Most of them deteriorated to ARDS stage. At 24 hours, the incidence of ARDS in experimental group was 23.8 % , and 29.17% in control group. Two patients in control group didn' t become ARDS till 48 hours. Serum IL-1, IL-8 and TNF-α level reduced atr 24 hours in both groups. The reduction of IL-8 and TNF-α in experimental group was more obvious than in control group ( P < 0.05). IL-13 increased gradually from 0 hour to 24 hours, then descended a little at 48 hours. There was no difference in IL-13 some difference between the two groups ( P > 0.05) . Conclusions PHC can improve the arterial oxygen pressure, down-regulate TLR4, restrain inflammatory factors in its signal transduction downstream. This inhibitory action is not accomplished by increase in anti-inflammatory factors,but by down-regulating TLR4. PHC can prevent the development of ALI, and can be considered to act as an effective medicine for the treatment of ALI. TLR4 plays an important role in ALT process, and it is suggested that TLR4 can be used as a prognostic factor.

8

Cite

Share

Association between genetic polymorphism in the promoter region of heme oxygenase-1 and myocardial infarction in patients from Uighur ethnics of Xinjiang Autonomous Region

Yinghong WANG ; Yitong MA ; Zhenyan FU ; Yining YANG ; Xiang XIE ; Fen LIU ; Bangdang CHEN

Chinese Journal of Emergency Medicine.2009;18(7):719-722. doi:10.3760/cma.j.issn.1671-0282.2009.07.014

Objective To investigate the association between acute myocardial infarction (AMI) and the (GT)n repeat sequence polymorphism in promoter region of heme oxygenase-1 (HO-1) , and to study the influence of serum bilirubin on AMI as well for HO-1 as a rate-limiting enzyme of bilirubin production in patients from Uighur national minority. Method Totally 287 patients with AMI evidenced by coronary arteriography admitted from January 2006 to June 2008 were eligible for being studied, and another 190 healthy subjects without anomaly in coronary arteriography, and with normal findings in physical examination and in variety of biochemical assays were enrolled as controls. Serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDL-C), serum bilirubin were detected. Polymerase chain reaction-nondenaturing polyacrylamide gel electrophoresis was used to detect HO-1 promoter (GT)n repeat polymorphism, and at the same time the serum bilirubin was determined. The group representation of samples was tested with HardyWeinberg balance test. Differences in distributions of genotypes and alleles between AMI patients and control subjects were analyzed using Chi-square test. Comprehensive evaluation of the factors associated with myocardial infarction using multi-factor Logistic regression analysis. P < 0.05 was considered as significantly different. Results Body mass index, triglyceride, high density lipoprotein cholesterol and the proportion with hypertension in myocardial infarction group was significantly higher than those in control group ( P < 0.01) . The X~2 values of HO-1genotype distribution in the myocardial infarction group and the control group were 2.09 and 0.05, respectively (P > 0.05), consist with the results of Hardy-Weinberg balance test. The HO-1 genotype was classified into three groups, L/L, L/S and S/S. The L/L genotype frequency (35.5%) and L-allele frequency (57.8%) in AMI group and in control group showed statistically significant differences, respectively (X~2 = 11.65, P = 0.001; X~2= 11.32, P = 0.003). The bilirubin level of L/L genotype significantly decreased compared with that of S/S, L/S genotype ( P all < 0. 001) . Logistic regression analysis showed that body mass index, high blood pressure,triglycerides, blood bilirubin and HO-1 gene polymorphism are risk factors of myocardial infarction. Conclusions To the Xinjiang Uighur ethics, HO-1 promoter ( GT) n repeat polymorphism and the occurrence of myocardial infarction are relevant. People with L allele genotype have lower serum bilirubin and higher risk of myocardial infarction.

9

Cite

Share

The expression of resistin-like molecules-a in atherosclerotic plaque

Hongming ZHANG ; Xiiaoyan LI ; Zuoyun HE ; Hong TAN ; Kewei LIU ; Zhigang HUANG

Chinese Journal of Emergency Medicine.2009;18(7):711-714. doi:10.3760/cma.j.issn.1671-0282.2009.07.012

Objective To explore the expression of resistin-like molecules-a (RELMa) in atherosclerotic plaque of ApoE-/- mouse, and to study the effects of RELMa on the proliferation and migration of vascular smooth musclee cells (VSMCs) . Method Nine ApoE-/- mice and nine C57BL/6J mice were fed with high fat diet. All mice were sacrificed 24 weeks after force feeding. Vessels were dissected from to abdominal aorta. Sections of aortic tissue were stained with HE dyeing and RELMa in aortic tissue was assayed by immunohistochemistry. The expression of RELMa mRNA in vessels was detected by RT-PCR. The effects of different concentration RELMa in different concentrations on the proliferation and migration of VSMCs were detected. Data was expressed as mean ± standard deviation. ANOVA were used for comparison in SPSS 11.0, and changes were considered as statistically significant if P value was less than 0.05. Results Atherosclerosis plaque formed in aortic root of ApoE-/- mice after they were fed with high fat diet for 24 weeks. RELMa protein and RELMa mRNA were found by immunohistochemistry and RT-PCR in atherosclerotic plaque of ApoE-/- mouse. RELMa protein didn't be found in vessels of control mouse. RELMa promoted the proliferation of VSMCs (RELMa groups: 2811. 21 ± 216. 89,4056. 87 ±220.65,5061.45 ± 335.86, vs. control 1609.58 ± 203.53, P < 0.01). RELMa promoted the migration of VSMCs (RELMa groups: 130.54±12.98,158.39±11.58,203.50± 17.37 vs. control:70.54± 11.92, P<0.01).Conclusions RELMa expresses in atherosclerotic plaque of ApoE-/- mouse. RELMa enhances the proliferation and migration of VSMCs of aorta.

10

Cite

Share

The expression of macrophage migration inhibitory factor in the heart and renal tissue in rats with

Zhenhui ZHANG ; Peiyi LIN ; Xiaohui CHEN ; Huilin JIANG ; Yanling LI ; Huajun WANG

Chinese Journal of Emergency Medicine.2009;18(11):1159-1162. doi:10.3760/cma.j.issn.1671-0282.2009.11.011

Objective To investigate the expression profile of macrophage inhibitory factor (MIF) in heart and renal tissues of sepsis mice. Method The sepsis model was established by Cecal ligation and puncture (CLP) in mice. Thirty male BALB/c mice were randomly divided into five groups: sham operation group, the twelfth hour, twenty-forth hour, thirty-sixth and forty-eighth hour group after CLP. MIF mRNA were semiquantitat-ed by the reverse transcription polyraerase chain reaction(RT-PCR), Western Blotting was used for MIF protein. The measured data were analyzed with one-way ANOVA. Results MIF mRNA and protein expressions in heart tissue signifiantly increased at the twelfth hour, peaking at the thirty-sixth hour, and a high level was maintained till the forty-eighth hour after CLP. But in the kidney tissue of models, the content of MIF reached peak at the twenty-forth hour and started to decrease at the forty-eighth hour after CLP. Conclusions The content of MIF in heart and kidney tissues of sepsis models was higher than that in the sham group, especially from the twelfth hour to forty-eighth hour after CLP. It indicates that MIF as a kind of late cytokine might participate in dysfunction of organs in mice with sepsis.

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share