BACKGROUND:Liver ischemia reperfusion(IR)injury triggers a systemic inflammatory response and is the main cause of organ dysfunction and adverse postoperative outcomes after liver surgery.Pentoxifylline(PTX)and hypert...BACKGROUND:Liver ischemia reperfusion(IR)injury triggers a systemic inflammatory response and is the main cause of organ dysfunction and adverse postoperative outcomes after liver surgery.Pentoxifylline(PTX)and hypertonic saline solution(HTS)have been identified to have beneficial effects against IR injury.This study aimed to investigate if the addition of PTX to HTS is superior to HTS alone for the prevention of liver IR injury.展开更多
Objective: To investigate the dynamic variation and action mechanism of sICAM-1 and p38 mitogen-activated protein kinases (MAPK) signal transduction in human severe trauma and resuscitation, as well as the effect of l...Objective: To investigate the dynamic variation and action mechanism of sICAM-1 and p38 mitogen-activated protein kinases (MAPK) signal transduction in human severe trauma and resuscitation, as well as the effect of lactated Ringer's solution ( LR), 7.5% sodium chloride solution ( HS ) and 20% albumin injection ( ALB ) on the incidence and mortality of multiple organ dysfunction syndrome (MODS).Methods: Seventy-two severe trauma patients (ISS score 16-43) were divided into ISS≤25 and ISS＞25 groups (each group was subdivided into LR, HS and ALB groups). ELISA was used to measure the concentration of sICAM-1. Western blot was used to measure the expression of p38 MAPK.Results: Compared with LR group, the transfusion volume needed for maintaining systolic blood pressure ≥ 90 mm Hg was significantly decreased in HS and ALB groups (P＜0.05). Compared with the control group, the concentration of blood sICAM-1 and the expression of p38 MAPK was elevated from 4 to 48 hours after trauma in all experimental groups (P ＜ 0.05 -0.01 ). At 4, 12, and 24 hours, there was significant correlation between the expression of p38 MAPK and sICAM-1 (P ＜ 0. 01).Compared with LR group, sICAM-1 and p38 MAPK in HS and ALB groups were decreased (P ＜ 0.05). sICAM-1 and p38 MAPK were significantly higher in the group of ISS ＞25 than that of ISS ≤ 25 (P ＜ 0.05 ). MODS incidence and mortality were significantly higher in the group of ISS ＞ 25 than that of ISS ≤ 25 ( P ＜ 0.05 ). MODS incidence and mortality were lower in HS and ALB groups than LR group (P＜0.05).Conclusions: The up-regulation of polymorphonuclear neutrophil-endotheliocytes (PMN-EC) adhesion may be due to the increased sICAM-1 expression during severe trauma. The up-regulation of sICAM-1 expression is correlated with the activation of p38 MAPK. During severe trauma, the levels of sICAM-1 and p38 MAPK, as well as the incidence and mortality of MODS are lower when HS and ALB are used than single lactated LR solution is used.展开更多
基金supported by a grant from Sao Paulo Foundation Research FAPESP 2011/05214-3
文摘BACKGROUND:Liver ischemia reperfusion(IR)injury triggers a systemic inflammatory response and is the main cause of organ dysfunction and adverse postoperative outcomes after liver surgery.Pentoxifylline(PTX)and hypertonic saline solution(HTS)have been identified to have beneficial effects against IR injury.This study aimed to investigate if the addition of PTX to HTS is superior to HTS alone for the prevention of liver IR injury.
文摘Objective: To investigate the dynamic variation and action mechanism of sICAM-1 and p38 mitogen-activated protein kinases (MAPK) signal transduction in human severe trauma and resuscitation, as well as the effect of lactated Ringer's solution ( LR), 7.5% sodium chloride solution ( HS ) and 20% albumin injection ( ALB ) on the incidence and mortality of multiple organ dysfunction syndrome (MODS).Methods: Seventy-two severe trauma patients (ISS score 16-43) were divided into ISS≤25 and ISS＞25 groups (each group was subdivided into LR, HS and ALB groups). ELISA was used to measure the concentration of sICAM-1. Western blot was used to measure the expression of p38 MAPK.Results: Compared with LR group, the transfusion volume needed for maintaining systolic blood pressure ≥ 90 mm Hg was significantly decreased in HS and ALB groups (P＜0.05). Compared with the control group, the concentration of blood sICAM-1 and the expression of p38 MAPK was elevated from 4 to 48 hours after trauma in all experimental groups (P ＜ 0.05 -0.01 ). At 4, 12, and 24 hours, there was significant correlation between the expression of p38 MAPK and sICAM-1 (P ＜ 0. 01).Compared with LR group, sICAM-1 and p38 MAPK in HS and ALB groups were decreased (P ＜ 0.05). sICAM-1 and p38 MAPK were significantly higher in the group of ISS ＞25 than that of ISS ≤ 25 (P ＜ 0.05 ). MODS incidence and mortality were significantly higher in the group of ISS ＞ 25 than that of ISS ≤ 25 ( P ＜ 0.05 ). MODS incidence and mortality were lower in HS and ALB groups than LR group (P＜0.05).Conclusions: The up-regulation of polymorphonuclear neutrophil-endotheliocytes (PMN-EC) adhesion may be due to the increased sICAM-1 expression during severe trauma. The up-regulation of sICAM-1 expression is correlated with the activation of p38 MAPK. During severe trauma, the levels of sICAM-1 and p38 MAPK, as well as the incidence and mortality of MODS are lower when HS and ALB are used than single lactated LR solution is used.
