Low-dose dopamine reduces inflammatory factors of acute pancreatitis in rats

BACKGROUND: Acute pancreatitis, especially acute necrotizing pancreatitis (ANP), is a serious disease with a high morbidity because of multiorgan dysfunction. Recent studies have indicated that during the pathogenesis of ANP, changes of the microcirculation play an important role in the worsening of the disease. This study based on a. model of acute pancreatitis in Wistar rats was to determine the effect of treatment with low-dose dopamine on acute pancreatitis by the dynamic measurement of serum levels of inflammatory factors IL-6 and TNF-alpha. METHODS: Fifty Wistar rats were randomly divided into two groups, and a model of ANP was set up by injecting sodium taurocholate into the pancreatic duct. Rats in the dopamine group (treatment group) were given dopamine by vein and those in the acute pancreatitis group (control group) were given normal saline. To assess the effect of low-dose doparnine (5 mu g . kg(-1) . min(-1)) on induced acute pancreatitis, the antibody sandwich ELISA method was used to measure the serum levels of IL-6 and TNF-alpha at different times before and after the induction of ANP. RESULTS: The serum levels of IL-6 and TNF-alpha in the treatment and control groups before and after ANP induction were significantly different. There was a markedly significant difference in the comparison of the two groups after ANP induction (P<0.01), but no significant difference in the comparison before the induction (P>0.05). Postoperative pancreatic histopathologic changes in the treatment group were more marked than those in the control group. CONCLUSIONS: Low-dose dopamine is effective in treating ANP by alleviating inflammatory reactions. This effect may be related to the fact that low-dose doparnine not only can increase the blood flow of the pancreatic microcirculation but also reduce its permeability.

Medical care service fee makes the value of doctor＇s work recognized

To the editor： Beijing has begun implementing its new public hospital reform programs since July 1, 2012.1 According to the new policies, patients are charged a medical care service fee which varies according to doctor＇s seniority while the 15 percent of drug markup is eliminated, aiming at reducing hospitals＇ dependency on profits from drug prescriptions and fine-tuning the structure of hospitals＇ incomes.

Effect of artesunate on reducing renal and intestinal injury after cardiopulmonary resuscitation in porcine

Objective To investigate the effect of artesunate(ART)on renal and intestinal injury aftercardiopulmonary resuscitation(CPR)in porcine,and to explore its mechanism.Methods A total of 24 healthy male white porcines were randomly divided into 3groups:Sham group(n=6),CPR group(n=10)and ART group(n=8).Sham group was only prepared for the experiment.

Safety and efficacy ofthe early administration of levosimendan in patients with acute non-ST-segment elevation myocardial infarction and elevated NT-proBNP levels: An Early Management Strategy of Acute Heart Failure (EMS-AHF)

Objective To investigate the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction(NSTEMI)and elevated levels of N-terminal pro-hormone B-type natriuretic peptide(NTproBNP)with levosimendan within 24 hours of first medical contact(FMC).

Comparison of Charlson＇s weighted index of comorbidities with the chronic health score for the prediction of mortality in septic patients

Background Comorbidity is one of the most important determinants ot short-term and long-term outcomes in septic patients. Charlson＇s weighted index of comorbidities （WIC） and the chronic health score （CHS）, which is a component of the acute physiology and chronic health evaluation （APACHE） II, are two frequently-used measures of comorbidity. In this study, we assess the performance of WIC and CHS in predicting the hospital mortality of intensive care unit （ICU） patients with sepsis. Methods A total of 338 adult patients with sepsis were admitted to a multisystem ICU between October 2010 and August 2012. Clinical data were collected, including age, gender, underlying diseases, key predisposing causes, severity-of- sepsis, and hospital mortality. The APACHE II, CHS, acute physiology score （APS）, sequential organ failure assessment （SOFA） and WIC scores were assessed within the first 24 hours of admission. Univariate and multiple Logistic regression analyses were used to compare the performance of WlC and CHS. The area under the receiver operating characteristic curve （AUC） was used to predict hospital mortality over classes of risk. Results Of all the enrolled patients, 224 patients survived and 114 patients died. The surviving patients had significantly lower WlC, CHS, APACHE II, and SOFA scores than the non-surviving patients （P 〈0.05）. Combining WIC or CHS with other administrative data showed that the hospital mortality was significantly associated with age, severe sepsis, key predisposing causes such as pneumonia, a history of underlying diseases such as hypertension and congestive cardiac failure, and WlC, CHS and APS scores （P 〈0.05）. The AUC for the hospital mortality were 0.564 （95% confidence interval （CO 0.496-0.631） of CHS, 0.663 （95% CI 0.599-0.727） of WIC, 0.770 （95% CI 0.718-0.822） of APACHE II, 0.856 （95% Cl 0.815-0.897） of the CHS combined with other administrative data, and 0.857 （95% CI 0.817-0.897） of the WlC combined with other administrative data. The diagnostic value of WIC was better than that of CHS （P=0.0015）. Conclusions The WlC and CHS scores might be independent determinants for hospital mortality among ICU patients with sepsis. WlC might be an even better predictor of the mortality of septic patients with comorbidities than CHS. Chin Med J 2014;127 （14）： 2623-2627

Distinct properties and metabolic mechanisms of postresuscitation myocardial injuries in ventricular fibrillation cardiac arrest versus asphyxiation cardiac arrest in a porcine model

Background The two most prevalent causes of sudden cardiac death are ventricular fibrillation cardiac arrest （VFCA） and asphyxiation cardiac arrest （ACA）. Profound postresuscitation myocardial dysfunction has been demonstrated in both VFCA and ACA animal models. Our study aimed to characterize the two porcine models of cardiac arrest and postresuscitation myocardial metabolism dysfunction. Methods Thirty-two pigs were randomized into two groups. The VFCA group （n=16） were subject to programmed electrical stimulation and the ACA group （n=16） underwent endotracheal tube clamping to induce cardiac arrest （CA）. Once induced, CA remained untreated for a period of 8 minutes. Two minutes following initiation of cardiopulmonary resuscitation （CPR）, defibrillation was attempted until return of spontaneous circulation （ROSC） was achieved or animals died. To assess myocardial metabolism, 18F-FluoroDeoxyGlucose Positron Emission Tomography was performed at baseline and 4 hours after ROSC. Results ROSC was 100% successful in VFCA and 50% successful in ACA. VFCA had better mean arterial pressure and cardiac output after ROSC than ACA. Arterial blood gas analysis indicated more detrimental metabolic disturbances in ACA compared with VFCA after ROSC （ROSC 0.5 hours, pH： 7.01±0.06 vs. 7.21±0.03, P〈0.01; HCO3： （15.83±2.31 vs. 20.11±1.83） mmol/L, P〈0.01; lactate： （16.22±1.76 vs. 5.84±1.44） mmol/L, P〈0.01）. Myocardial metabolism imaging using Positron Emission Tomography demonstrated that myocardial injuries after ACA were more severe and widespread than after VFCA at 4 hours after ROSC （the maximum standardized uptake value of the whole left ventricular： 1.00±0.17 vs. 1.93±0.27, P〈0.01）. Lower contents of myocardial energy metabolism enzymes （Na＊-K＊-ATPase enzyme activity, Ca2＊- ATPase enzyme activity, superoxide dismutase and phosphodiesterase） were found in ACA relative to VFCA. Conclusions Compared with VFCA, ACA causes more severe myocardium injury and metabolism hindrance, therefore they should be treated as different pathological entities.

The analysis of correlation between serum procalcitonin concentration and microbial infectionsin patients with sepsis

Objective To investigate the diagnostic and predict value of procalcitonin (PCT) in ICU patients with sepsis and the correlation between PCT concentration and positive results of bacterial culture.Methods A total of 278patients with sepsis were admitted into emergency ICU,general ICU and respiratory ICU from October 2011 to September 2012.Of them,193 patients had definite microbial infection evidence.Serum PCT levels among groups of different pathogens were compared.The analysis of correlation between the PCT concentration of

Activation of autophagy improves neuron injury after the restoration of spontaneous circulation from ventricular fibrillation in wistar rats

Objective To investigate the effects of activation of autophagy on cerebral injury after cardiopulmonary resuscitation(CPR)in Wistar rats.Methods At first 36healthy adult male Wistar rats were induced to suffer ventricular fibrillation(VF)by an external transthoracic alternating electricity current shock for 7 minutes and then received CPR.Before VF(0)and at 1 h,2 h,4 h,8 h and 12 hours after the restoration of spontaneous circulation(ROSC)from VF,cerebral cortex were harvested

The analysis of bacteria strains and sensitivity of bacteria to antibiotics in acute obstructive cholangitis with suppuration

Objective To analyze the changes of bacteria stains in acute obstructive cholangitis with suppuration(AOSC) and sensitivity of different bacteria strains to antibiotics in recent decade. Methods The data of

Establishment and evaluation of acute diquat poisoning model in Wistar rats

Objective To establish the Wistar rat model of acute diquat poisoning and observe the pathological damage of main target organs.Methods Thirty-six Wistar rats were randomly divided into six groups(n=6),including one normal saline control group and five treatment groups which were separately given single-dose of intragastric administration at the doses of 46.2 mg/kg,77.0 mg/kg,115.5 mg/kg,231.0 mg/kg and 346.5 mg/kg.The pathological changes of lung,liver and kidney were observed by hematoxylin and eosin(HE)and Masson staining.The optimal dose was determined according to the general situation and pathological changes.Thirty-six Wistar rats were randomly divided into five treatment groups and one normal saline control group.Treatment groups were given single-dose of intragastric administration according to the optimal dose.The rats were sacrificed on the 1st,3rd,7th,11th and 14th day of exposure,respectively.The activity of serum glutamic-pyruvic transaminase(ALT)and glutamic-oxalacetic transaminase(AST)were measured by chemical colorimetry.The pathological changes of lung,liver and kidney were observed by HE and Masson staining.Results According to 14 d survival rate,the toxic symptoms and pathological changes,115.50 mg/kg was determined the best dose.Given single-dose of intragastric administration at the doses of 115.50 mg/kg,it was found that the serum AST and ALT activity of rats on the first and third day of exposure was significant higher than those in control group.The results of pathological examination exhibited that in 115.50 mg/kg group,the pathological changes of lung,liver and kidney began to appear on the first day of exposure,the pathological changes were the most serious on the third day,and then gradually alleviated.On the 14th day,the alveolar septum was slightly widened,with inflammatory cell infiltration,local alveolar cavity became narrow,atrophy,peripheral alveolar compensation,bronchi and alveolar septum collagen fiber proliferation;The local renal tubular epithelial cells were enlarged and necrotic;the central vein surrounding hepatic cells showed vacuolar degeneration with punctate necrosis.Conclusion The rat model of acute diquat poisoning can be successfully induced by single-dose of intragastric administration.The condition of wistar rats and the pathological damage of the main target organs can be observed during the whole course of 115.50 mg/kg administration.

The predictive value of low T3 syndrome for delayed encephalopathy caused by severe acute carbon monoxide poisoning

Objective To explore the predictive value of low T3 syndrome(LT3S)for patients with delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Methods In May 2020,137 severe acute carbon monoxide poisoning(SACMP)patients were selected from Harrison International Peace Hospital Affiliated to Hebei Medical University from January 2019 to January 2020 as subjects.Blood samples were taken after admission to test thyroid function.

The value of sST2 combined with NLR for prediction of the occurrence of nosocomial cardiovascular adverse events in patients with myocardial injury from acute moderate to severe carbon monoxide poisoning

Objective To investigate the clinical significance of soluble growth stimulating expression gene 2 protein(sST2) combined with neutrophil/lymphocyte ratio(NLR) in the prediction of nosocomial cardiovascular adverse events in patients with acute carbon monoxide poisoning (ACOP) myocardial injury.