Objective:To analyze the value of emergency rescue nursing intervention in the care of patients with traumatic hemorrhagic shock and its impact on the success rate of rescue efforts.Methods:A total of 80 patients with...Objective:To analyze the value of emergency rescue nursing intervention in the care of patients with traumatic hemorrhagic shock and its impact on the success rate of rescue efforts.Methods:A total of 80 patients with traumatic hemorrhagic shock were selected as samples,with the timeframe from July 2022 to July 2023.The patients were randomly divided into two groups using a random number table method.Group A received emergency rescue nursing,while Group B received routine nursing care.The success rate of rescue,rescue indicators,complication rates,and family satisfaction with nursing care were compared between the two groups.Results:The rescue success rate in Group A was higher than in Group B(P<0.05);the total blood loss in Group A was less,and the rescue time,full transportation time,and hospitalization time were shorter than in Group B(P<0.05);the complication rate of patients with traumatic hemorrhagic shock in Group A was lower than in Group B(P<0.05);the family satisfaction with emergency nursing care in Group A was higher than in Group B(P<0.05).Conclusion:Emergency rescue interventions for patients with traumatic hemorrhagic shock can reduce blood loss,shorten rescue times,and improve the success rate of shock rescue,providing a safe and effective approach.展开更多
Objective: To determine the effects of albumin administration on lung injury and apoptosis in traumatic/hemorrhagic shock (T/HS) rats. Methods: Studies were performed on an in vivo model of spontaneously breathing rat...Objective: To determine the effects of albumin administration on lung injury and apoptosis in traumatic/hemorrhagic shock (T/HS) rats. Methods: Studies were performed on an in vivo model of spontaneously breathing rats with induced T/HS; the rats were subjected to femur fracture, ischemia for 30 min, and reperfusion for 20 min with Ringer's lactate solution (RS) or 5% (w/v) albumin (ALB), and the left lower lobes of the lungs were resected. Results: Albumin administered during reperfusion markedly attenuated injury of the lung and decreased the concentration of lactic acid and the number of in situ TdT-mediated dUTP nick-end labelling (TUNEL)-positive cells. Moreover, immunohistochemistry performed 24 h after reperfusion revealed increases in the level of nuclear factor κB (NF-κB), and phosphorylated p38 mitogen-activated protein kinase (MAPK) in the albumin-untreated group was down-regulated by albumin treatment when compared with the sham rats. Conclusion: Resuscitation with albumin attenuates tissue injury and inhibits T/HS-induced apoptosis in the lung via the p38 MAPK signal transduction pathway that functions to stimulate the activation of NF-κB.展开更多
Objective: To elucidate which one of μ, δ and κ opioid receptors is involved in the cardiovascular depression following traumatic hemorrhagic shock. Methods: With traumatic hemorrhagic shock rat models, the cha...Objective: To elucidate which one of μ, δ and κ opioid receptors is involved in the cardiovascular depression following traumatic hemorrhagic shock. Methods: With traumatic hemorrhagic shock rat models, the changes of myocardial and brain μ, δ and κ opioid receptors and cardiovascular functions and their relationship with hemodynamic parameters were observed. The effects of δ and κ opioid receptor antagonists on hemodynamic parameters of traumatic hemorrhagic shock rats were observed. Results: Following traumatic hemorrhagic shock, the number of myocardial and brain δ and κ opioid receptors significantly increased, their affinity did not alter, and the increased number of δ and κ opioid receptors was significantly associated with the decreased hemodynamic parameters. However, μ opioid receptor in heart and brain did not obviously change. δ opioid receptor antagonist ICI174,864 and κ opioid receptor antagonist Nor binaltorphimine (50 μg, Icv) could significantly reverse those decreased hemodynamic parameters. Conclusions: It suggests that opioid receptors, especially δ and κ opioid receptors are closely related to the pathogenesis of traumatic hemorrhagic shock, and they play important roles in the depression of cardiovascular function following traumatic hemorrhagic shock.展开更多
Objective. To determine the effect of albumin administration on lung injury in traumatic/hemorrhagic shock （T/HS） rats. Methods： Forty-eight adult Sprague-Dawley rats were divided into three groups randomly （ n =...Objective. To determine the effect of albumin administration on lung injury in traumatic/hemorrhagic shock （T/HS） rats. Methods： Forty-eight adult Sprague-Dawley rats were divided into three groups randomly （ n = 16 in each group） ： Group A, Group B, Group C. In Group A, rats underwent laparotomy without shock. In Group B, rats undergoing T/HS were resuscitated with their blood plus lactated Ringer＇s （twice the volume of shed blood ）. In Group C, rats undergoing T/HS were resuscitated with their shed blood plus additional 3 ml of 5% human albumin. The expression of polymorphonuclear neutrophils CD18/CD11b in jugular vein blood was evaluated. The main lung injury indexes （the activity of myeloperoxidase and lung injury score） were measured. Results： Significant differences of the expression of CD18/11b and the severity degree of lung injury were found between the three groups. （P〈0.05）. The expression of CD18/CD11b and the main lung injury indexes in Group B and Goup C incresed significantly compared with those in Group A （P 〈0.05）. At the same time, the expression of CD18/CD11b and the main lung injury indexes in Group C decreased dramatically, compared with those in Group B （ P 〈0.05 ）. Conclusions ： The infusion of albumin during resuscitation period can protect lungs from injury and decrease the expression of CD18/CD11b in T/HS rats.展开更多
Background： The increasing frequency of explosive injuries has increased interest in blast-induced traumatic brain injury （bTBI）. Various shock tube models have been used to study bTBI. Mild-to-moderate explosions ...Background： The increasing frequency of explosive injuries has increased interest in blast-induced traumatic brain injury （bTBI）. Various shock tube models have been used to study bTBI. Mild-to-moderate explosions are often overlooked because of the slow onset or mildness of the symptoms. However, heavy gas cylinders and large volume chambers in the model may increase the complexity and danger. This study sought to design a modified model to explore the effect of moderate explosion on brain injury in mice. Methods： Pathology scoring system （PSS） was used to distinguish the graded intensity by the modified model. A total of 160 mice were randomly divided into control, sham, and bTBI groups with different time points. The clinical features, imaging features, neurobehavior, and neuropathology were detected after moderate explosion. One-way analysis of variance followed by Fisher＇s least significant difference posttest or Dunnett＇s t 3-test was performed for data analyses. Results： PSS of mild, moderate, and severe explosion was 13.4 ± 2.2, 32.6 ± 2.7 （t = 13.92, P 〈 0.001; vs. mild group）, and 56.6 ± 2.8 （t = 31.37, P 〈 0.001; vs. mild group）, respectively. After moderate explosion, mice showed varied symptoms of malaise, anorexia, incontinence, apnea, or seizure. After bTBI, brain edema reached the highest peak at day 3 （82.5% ± 2.1% vs. 73.8% ± 0.6%. t - 7.76, P 〈 0.001）, while the most serious neurological outcomes occurred at day 1 （Y-maze： 8.25 ±2.36 vs. 20.00 ± 4.55, t = -4.59, P=0.048; 29.58% ± 2.84% vs. 49.09% ±11.63%, t = -3.08, P = 0.008; neurologic severity score： 2.50 ± 0.58 vs. 0.00±0.00, t = 8.65, P = 0.016）. We also found that apoptotic neurons （52.76% ± 1.99% vs. 1.30% ± 0.11%, t =57.20, P 〈 0.001 ） and gliosis （2.98 ± 0.24 vs. 1.00 ± 0.00, t = 14.42, P = 0.021） in the frontal were significantly higher at day 3 post-bTBI than sham bTB1. Conclusions： We provide a reliable, reproducible bTBI model in mice that can produce a graded explosive waveform similar to the free-field shock wave in a controlled laboratory environment. Moderate explosion can trigger mild-to-moderate blast damage of the brain.展开更多
目的:探究氨甲环酸联合碳酸氢钠注射液+林格氏液对创伤失血性休克合并创伤性凝血病患者的影响。方法:选取2022年5月—2023年2月昆明医科大学附属红河医院急诊科收治的67例创伤失血性休克合并创伤性凝血病患者作为研究对象,根据入院时间...目的:探究氨甲环酸联合碳酸氢钠注射液+林格氏液对创伤失血性休克合并创伤性凝血病患者的影响。方法:选取2022年5月—2023年2月昆明医科大学附属红河医院急诊科收治的67例创伤失血性休克合并创伤性凝血病患者作为研究对象,根据入院时间分为两组,2022年5—10月入院的33例纳入对照组,2022年11月—2023年2月入院的34例纳入观察组。两组均给予氨甲环酸和限制性液体复苏,对照组采用醋酸钠林格氏液复苏,观察组采用碳酸氢钠注射液+林格氏液复苏。比较两组氧代谢指标[静脉血氧饱和度(SvO_(2))、氧消耗(VO_(2))和氧输送(DO_(2))]、昏迷程度[格拉斯哥昏迷量表(GCS)]、休克指数、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、白细胞介素-6(IL-6)]、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)]及并发症。结果:两组复苏前氧代谢指标、昏迷程度、休克指数、炎症因子、凝血功能比较,差异无统计学意义(P>0.05);观察组复苏后2 h SvO_(2)、VO_(2)、DO_(2)水平、GCS评分较对照组更高,休克指数及TNF-α、IL-10、IL-6水平较对照组更低,APTT、TT、PT较对照组更短,差异有统计学意义(P<0.05)。观察组并发症总发生率较对照组更低,差异有统计学意义(P<0.05)。结论:氨甲环酸联合碳酸氢钠注射液+林格氏液可以减轻创伤失血性休克合并创伤性凝血病炎症状态,提高氧代谢,改变凝血功能指标,进而提升复苏效果,减轻昏迷程度,降低相关并发症发生率。展开更多
文摘Objective:To analyze the value of emergency rescue nursing intervention in the care of patients with traumatic hemorrhagic shock and its impact on the success rate of rescue efforts.Methods:A total of 80 patients with traumatic hemorrhagic shock were selected as samples,with the timeframe from July 2022 to July 2023.The patients were randomly divided into two groups using a random number table method.Group A received emergency rescue nursing,while Group B received routine nursing care.The success rate of rescue,rescue indicators,complication rates,and family satisfaction with nursing care were compared between the two groups.Results:The rescue success rate in Group A was higher than in Group B(P<0.05);the total blood loss in Group A was less,and the rescue time,full transportation time,and hospitalization time were shorter than in Group B(P<0.05);the complication rate of patients with traumatic hemorrhagic shock in Group A was lower than in Group B(P<0.05);the family satisfaction with emergency nursing care in Group A was higher than in Group B(P<0.05).Conclusion:Emergency rescue interventions for patients with traumatic hemorrhagic shock can reduce blood loss,shorten rescue times,and improve the success rate of shock rescue,providing a safe and effective approach.
基金Project supported by the National Natural Science Foundation of China (No. 30672071) the Traditional Chinese Medicine Foun- dation of Zhejiang Province, China (No. 2004C071)
文摘Objective: To determine the effects of albumin administration on lung injury and apoptosis in traumatic/hemorrhagic shock (T/HS) rats. Methods: Studies were performed on an in vivo model of spontaneously breathing rats with induced T/HS; the rats were subjected to femur fracture, ischemia for 30 min, and reperfusion for 20 min with Ringer's lactate solution (RS) or 5% (w/v) albumin (ALB), and the left lower lobes of the lungs were resected. Results: Albumin administered during reperfusion markedly attenuated injury of the lung and decreased the concentration of lactic acid and the number of in situ TdT-mediated dUTP nick-end labelling (TUNEL)-positive cells. Moreover, immunohistochemistry performed 24 h after reperfusion revealed increases in the level of nuclear factor κB (NF-κB), and phosphorylated p38 mitogen-activated protein kinase (MAPK) in the albumin-untreated group was down-regulated by albumin treatment when compared with the sham rats. Conclusion: Resuscitation with albumin attenuates tissue injury and inhibits T/HS-induced apoptosis in the lung via the p38 MAPK signal transduction pathway that functions to stimulate the activation of NF-κB.
文摘Objective: To elucidate which one of μ, δ and κ opioid receptors is involved in the cardiovascular depression following traumatic hemorrhagic shock. Methods: With traumatic hemorrhagic shock rat models, the changes of myocardial and brain μ, δ and κ opioid receptors and cardiovascular functions and their relationship with hemodynamic parameters were observed. The effects of δ and κ opioid receptor antagonists on hemodynamic parameters of traumatic hemorrhagic shock rats were observed. Results: Following traumatic hemorrhagic shock, the number of myocardial and brain δ and κ opioid receptors significantly increased, their affinity did not alter, and the increased number of δ and κ opioid receptors was significantly associated with the decreased hemodynamic parameters. However, μ opioid receptor in heart and brain did not obviously change. δ opioid receptor antagonist ICI174,864 and κ opioid receptor antagonist Nor binaltorphimine (50 μg, Icv) could significantly reverse those decreased hemodynamic parameters. Conclusions: It suggests that opioid receptors, especially δ and κ opioid receptors are closely related to the pathogenesis of traumatic hemorrhagic shock, and they play important roles in the depression of cardiovascular function following traumatic hemorrhagic shock.
文摘Objective. To determine the effect of albumin administration on lung injury in traumatic/hemorrhagic shock （T/HS） rats. Methods： Forty-eight adult Sprague-Dawley rats were divided into three groups randomly （ n = 16 in each group） ： Group A, Group B, Group C. In Group A, rats underwent laparotomy without shock. In Group B, rats undergoing T/HS were resuscitated with their blood plus lactated Ringer＇s （twice the volume of shed blood ）. In Group C, rats undergoing T/HS were resuscitated with their shed blood plus additional 3 ml of 5% human albumin. The expression of polymorphonuclear neutrophils CD18/CD11b in jugular vein blood was evaluated. The main lung injury indexes （the activity of myeloperoxidase and lung injury score） were measured. Results： Significant differences of the expression of CD18/11b and the severity degree of lung injury were found between the three groups. （P〈0.05）. The expression of CD18/CD11b and the main lung injury indexes in Group B and Goup C incresed significantly compared with those in Group A （P 〈0.05）. At the same time, the expression of CD18/CD11b and the main lung injury indexes in Group C decreased dramatically, compared with those in Group B （ P 〈0.05 ）. Conclusions ： The infusion of albumin during resuscitation period can protect lungs from injury and decrease the expression of CD18/CD11b in T/HS rats.
文摘Background： The increasing frequency of explosive injuries has increased interest in blast-induced traumatic brain injury （bTBI）. Various shock tube models have been used to study bTBI. Mild-to-moderate explosions are often overlooked because of the slow onset or mildness of the symptoms. However, heavy gas cylinders and large volume chambers in the model may increase the complexity and danger. This study sought to design a modified model to explore the effect of moderate explosion on brain injury in mice. Methods： Pathology scoring system （PSS） was used to distinguish the graded intensity by the modified model. A total of 160 mice were randomly divided into control, sham, and bTBI groups with different time points. The clinical features, imaging features, neurobehavior, and neuropathology were detected after moderate explosion. One-way analysis of variance followed by Fisher＇s least significant difference posttest or Dunnett＇s t 3-test was performed for data analyses. Results： PSS of mild, moderate, and severe explosion was 13.4 ± 2.2, 32.6 ± 2.7 （t = 13.92, P 〈 0.001; vs. mild group）, and 56.6 ± 2.8 （t = 31.37, P 〈 0.001; vs. mild group）, respectively. After moderate explosion, mice showed varied symptoms of malaise, anorexia, incontinence, apnea, or seizure. After bTBI, brain edema reached the highest peak at day 3 （82.5% ± 2.1% vs. 73.8% ± 0.6%. t - 7.76, P 〈 0.001）, while the most serious neurological outcomes occurred at day 1 （Y-maze： 8.25 ±2.36 vs. 20.00 ± 4.55, t = -4.59, P=0.048; 29.58% ± 2.84% vs. 49.09% ±11.63%, t = -3.08, P = 0.008; neurologic severity score： 2.50 ± 0.58 vs. 0.00±0.00, t = 8.65, P = 0.016）. We also found that apoptotic neurons （52.76% ± 1.99% vs. 1.30% ± 0.11%, t =57.20, P 〈 0.001 ） and gliosis （2.98 ± 0.24 vs. 1.00 ± 0.00, t = 14.42, P = 0.021） in the frontal were significantly higher at day 3 post-bTBI than sham bTB1. Conclusions： We provide a reliable, reproducible bTBI model in mice that can produce a graded explosive waveform similar to the free-field shock wave in a controlled laboratory environment. Moderate explosion can trigger mild-to-moderate blast damage of the brain.
文摘目的:探究氨甲环酸联合碳酸氢钠注射液+林格氏液对创伤失血性休克合并创伤性凝血病患者的影响。方法:选取2022年5月—2023年2月昆明医科大学附属红河医院急诊科收治的67例创伤失血性休克合并创伤性凝血病患者作为研究对象,根据入院时间分为两组,2022年5—10月入院的33例纳入对照组,2022年11月—2023年2月入院的34例纳入观察组。两组均给予氨甲环酸和限制性液体复苏,对照组采用醋酸钠林格氏液复苏,观察组采用碳酸氢钠注射液+林格氏液复苏。比较两组氧代谢指标[静脉血氧饱和度(SvO_(2))、氧消耗(VO_(2))和氧输送(DO_(2))]、昏迷程度[格拉斯哥昏迷量表(GCS)]、休克指数、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、白细胞介素-6(IL-6)]、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)]及并发症。结果:两组复苏前氧代谢指标、昏迷程度、休克指数、炎症因子、凝血功能比较,差异无统计学意义(P>0.05);观察组复苏后2 h SvO_(2)、VO_(2)、DO_(2)水平、GCS评分较对照组更高,休克指数及TNF-α、IL-10、IL-6水平较对照组更低,APTT、TT、PT较对照组更短,差异有统计学意义(P<0.05)。观察组并发症总发生率较对照组更低,差异有统计学意义(P<0.05)。结论:氨甲环酸联合碳酸氢钠注射液+林格氏液可以减轻创伤失血性休克合并创伤性凝血病炎症状态,提高氧代谢,改变凝血功能指标,进而提升复苏效果,减轻昏迷程度,降低相关并发症发生率。
