Effect of Hypertonic Versus Isotonic Saline Resuscitation on Heme Oxygenase-1 Expression in Visceral Organs Following Hemorrhagic Shock in Rats

To compare the early effects of hypertonic and isotonic saline resuscitation on heme oxygenase-1 （HO-1） expression in organs of rats with hemorrhagic shock. Rats were randomly divided into hypertonic saline resuscitation （HTS）, normal saline resuscitation （NS） and sham groups. HO-1 mRNA, protein expression and apoptosis were evaluated in organs. In the HTS group, significant difference was noted in HO-1 protein in small intestinal mucosa and liver compared with the NS and sham groups, and in HO-1 mRNA in liver and kidney compared with the sham group. The apoptosis of small intestinal mucosa, liver, heart, and lung was significantly lower in the HTS group than that in the NS group. In this study, small volume resuscitation with HTS can efficiently up-regulate the expression level of HO-1 in small intestinal mucosa and liver, which may be one of the mechanisms alleviating organ damage.

An Accuracy Improvement for the Clinical Test Result by United ISO-GUM and QE

This research developed the technology which united ISO-GUM （International Organization of Standard-Guide to Express of Uncertainty in Measurement） and QE （Quality Engineer） strategically and employed both feature efficiently. Although to tow technology of purpose use is same, each has future. The purpose is scheduled to improve the accuracy as a result of the clinical examinations. The result of research was used for diagnosis by equivalent Quality Control （eqQC） of the same level when and where, that are needed for broader-based medical system of the time of IT-era. Since National Institute of Standard and Technology （NIST） is recommend use of complicated operation by ISO-GUM for uniting, realization required the newest high quality computer technology. The algorithm of the complexity system of operation is that Fast Fourier Transform （FFT）, Inverse Fast Fourier Transform （IFFT） and Multi-variance Analysis （MA） are needed in Fig. 4. The main new improving points are changed of ambiguous expression method of data, and the pursuit which the cause of worsens accuracy put into data. All data with an assurance reported the final result for patient or donor. Medical laboratory quality system service is offered essential in the laboratory to be correct result for health care by Good Laboratory Practices （GLP） useful ISO 15189. Quality Assurance （QA） is achieved though system reliability.

lnterleukin-6 and interleukin-10 plasma levels and mRNA expression in polytrauma patients

Purpose： Host response to polytrauma occasionally has unpredictable outcomes. Immune response is a major factor influencing patient＇s outcome. This study evaluated the interaction of two main cytokines in immune response after major trauma, specifically interleukin-6 （IL-6） and interleukin-10 （IL-10）. Plasma level of these cytokines is determined by mRNA expression of these cytokines genes which may decide the outcome of polytrauma patients. Methods： This prospective multicenter trial held at four trauma centers enrolled 54 polytrauma patients [Injury Severity Score （ISS） ≥ 16]. Plasma levels and mRNA expression of IL-6 and IL-10 were measured for 5 days after trauma. Clinical evaluation was conducted to observe whether patients endured multiple organ dysfunction syndrome （MODS） and death. MODS evaluation was performed using sequential organ failure assessment （SOFA）. Trauma load which in this study is represented with ISS, plasma level, expression of cytokine genes and patient＇s outcome were examined with correlation test and statistical analysis. Results： The elevated IL-6/IL-10 ratio indicated increased activity of systemic inflammation response, especially pro-inflammation response which bears higher probability of progressing to MODS and death. The decline of IL-6/IL-IO ratio with heavy trauma load （1SS 〉 30） showed that compensatory anti- inflammation response syndrome （CARS） state was more dominant than systemic inflammatory response syndrome （SIRS）, indicating that malfunction and failure of immune system eventually lead to MODS and deaths. The statistical significance in plasma level of cytokines was found in the outcome group which was defined as bearing a low trauma load but mortality. Conclusion： The pattern of cytokine levels in inflammation response has great impact on the outcome of polytrauma patients. Further study at the genetic level is needed to investigate inflammation process which may influence patient＇s outcome.