Clinical treatment guideline for pulmonary blast injury (version 2023) / 中华创伤杂志

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Progress in surgical treatment of pectus excavatum / 中国胸心血管外科临床杂志

@#The surgical treatment of pectus excavatum has a history of more than 100 years, which has gone through from traditional open surgery to the current popular minimally invasive surgery. Nuss procedure, as the most classic minimally invasive operation, has been improved in accordance with the clinical needs since its inception to achieve fewer complications and better results, but there are still limitations that are difficult to break through, attracting a large number of scholars to make continuous innovation and develop updated devices and operation methods. This article reviews the history of funnel chest surgery, application and improvement of Nuss operation, double compression and complete fixation bar system and Wang procedure.

The effects of pretreatment with alanyl-glutamine dipeptide on intestinal barrier function in rats after cardiopulmonary bypass / 中华胸心血管外科杂志

Objective To explore the protective effects of pretreatment with alanyl-glutamine dipeptide on intestinal barrier function in rats after cardiopulmonary bypass.Methods CPB model in rats was established.60 SD rats were randomly divided into group G(pretreatment with alanyl-glutamine before CPB for 3 days and primed with it during CPB,n =20),group CPB(n =20) and sham-operation(SH) group(n =20).The diamine oxidase(DAO) activity of plasma and tissue homogenate of intestinal mucosa were measured by spectrophotometry,and the concentration of plasma D-lactate was also detected by spectrophotometry.The levels of plasma lipopolysaccharide(LPS) was measured by tachypleus amebocyte lysate development process.And software SPSS 16.0 was used for statistics analysis.Results The plasma DAO activity in group G was significantly lower than that in group CPB(P ＜0.05),even though compared with group SH,the DAO activity in group G and CPB were significantly increased (P ＜ 0.05).The activity of DAO in tissue homogenate in group G and CPB were decreased more significantly than that in group SH(P ＜ 0.05),but there was no difference between group G and CPB (P =0.065).The plasma concentrations of D-lactate and LPS in group G were significantly lower than that in group CPB (P ＜ 0.05),and the plasma concentration of D-lactate and LPS in both group G and CPB were markedly enhanced compared with group SH(P ＜ 0.05).Conclusion Precondition with alanyl-gluamine dipeptide can decrease the permeability of gut mucosa,and might be a new way to protect the intestinal barrier function during cardiopulmonary bypass.

Study on intestinal mucosal barrier dysfunction induced by postthoracotomyand and protection of alanyl-glutamine dipeptide in aged patients / 中国综合临床

Objective To investigate the changes of intestinal mucosal barrier function and protection of alanyl-glutamine(Alm-Gln) dipeptide during early stage of postthoracotomy in aged patients.Methods A prospective,randomized and controlled trial was conducted and 20 aged patients who underwent non-digestive thoracotomy were randomized into two groups,experimental group (intravenous administration of Aln-Gln dipeptide,0.5 g/(kg · d),for 4 days,n =10) and control group(equal amount saline as placebo,for 4 days,n =10).The indices of boby temperatures,heart rates,respiration and white blood cell count of all patients were daily recorded during administration.Serum concentrations of glutamine (Gln),D-lactate,diamine oxidase (DAO) and tumor necrosis factor-α(TNF-α) were measured before and after operation.Results There were no statistically significant differences in the patients' general information between experimental group and control group including age,gender and body weight.Plasma Gln concentration in postoperative 5 days was higher than that of pre-operation of experiment group ((478.32 ± 47.42) μmol/L vs.(372.67 ± 29.14) μmol/L,P =0.021).The plasma Gln level of control group at 5th day after operation was higher than that in pre-operation ((431.12 ± 42.27) μmol/L vs.(386.29 ± 19.73) μmol/L,P =0.017).The plasma level of Gln in experimental group was significantly higher than that in control group after operation((478.32±47.42) μmol/L vs.(386.29 ± 19.73) μmol/L,P =0.012).There were no significantly differences between the two groups in terms of the plasma level of DAO and D-lactate before operation (P ＞ 0.05).Meanwhile the levels of DAO and D-lactate in both group at 5th day after operation were significantly higher than that at before operation(DAO:(2.53 ±0.47) U/ml vs.(1.66±0.32) U/ml,P =0.003;D-lactate:(6.82 ±1.91) mg/L vs.(4.92 ±1.57) mg/L,P =0.024),and the levels of them in experimental group were significantly lower than that in control group(DAO:(1.10 ± 0.23) U/ml vs.(2.53 ± 0.47) U/ml,P =0.013 ; D-lactate:(4.87 ± 1.33) mg/L vs.(6.82 ± 1.91) mg/L,P =0.019).The concentration of TNF-α was significant increase in both two groups at first day after operation,but decreased at the third day.The concentration of TNF-α in experimental group at 5th day after operation was lower than that in control group ((6.89 ± 5.21) pg/L vs.(13.04 ± 4.46) pg,/L,P =0.003).The morbidity of systemic inflammatory response syndrome (SIRS) was significantly decreased in experimental group and the rate of SIRS was also lower than that in the control group(P ＜ 0.01).Conclusion Intestinal mucosal barrier function was damaged after thoracotomy in aged patients.Administration of Aln-Gln dipeptide could increase the level of serum Gln,protect the intestinal barrier and attenuate the systemic inflammatory response.Aln-Gln dipeptide can be used to help aged patients recover rapidly.

Effect of cardiopulmonary bypass on the gut mucosal barrier function in rat model / 中华胸心血管外科杂志

Objective To investigate the change of intestine mucosal permeability during cardiopulmonary bypass (CPB) and its effect on gut barrier in rats model. Methods The rats model of CPB was established and samples of tissue and plasma were collected at different intervals. Plasma D-lactate and LPS concentrations were determined and gut tissue was examined microscopically. Results The plasma concentration of D-lactate and LPS increased gradually at 1h CPB, and increased markedly 1h after CPB. They recovered to normal 8h after CPB, respectively. In addition, it was noted that there was a significant positive correlation between the plasma concentrations of LPS and D-lactate (r = 0.8312, P

THE EFFECT OF MSG ON THE EXPRESSION OF 5-HT IN GASTROENTERIC MUCOSA OF RAT / 解剖学报

Objective To explore the effect of monosodium glutamate (MSG) on the expression of 5\|HT in gastroenteric mucosa of rat. Methods Immunohistochemical technique was used to detect the expression of 5\|HT. The immuno\|activity and the density of positive cells were measured by image analysis. Results The immuno\|activity and the density of 5\|HT positive cells(EC cell) in the experimental group are higher than that in control group. The effect by 120d is the most significant, followed by that of 52d. Statistical analysis showed a significant difference ( P

RELATIONSHIP BETWEEN 5-LIPOXYGENASE AND LUNG INFECTION OF MICE / 解剖学报

Objective To investigate the relationship between the 5-lipoxygenase(5-LO) in mouse lung and during infection in the respiratory system.Methods Investigate the expression of 5-LO in the lung of a mouse by immunocytochemistry.Results The intensity of the immune staining against 5-LO antibody was stronger in infected mice than that in non-infected rats.A weaker immuneoreation was observed in the treated group of animals.Conclusion Changes in the expression of 5-LO in pulmonary tisssues could be designed to detect the treatment efficacy during the lung infection.

Role of Apoptosis in the Gut Mucosal Barrier Dysfunction in Rats with Cardiopulmonary Bypass / 中国医师杂志

Objective To investigate the role of cell apoptosis in the gut mucosal barrier dysfunction in rats undergoing cardiopulmonary bypass(CPB) . Methods The rat model of CPB was set up. The rats were divided into CPB group, sham operation(SO) group and normal control group. The morphological changes of ileum mucosal tissues were observed by microscope and electron microscope at 3h, 6h, 12h and 24h after operation, respectively. The apoptotic index of gut mucosal epithelial cells was measured with TUNEL method. Results Gut mucosal morphology was normal in CPB group at 3h, 6h and 12h after operation, but gut mucosal epithelial desquamation occurred at 24h after operation. Typical apoptotic cells could be seen with electron microscope in CPB group at every time point. Apoptotic index of gut mucosal epithelial cells significantly increased in CPB group at every time point compared with SO group, and peaked at 6h after operation. Apoptotic cells were mostly located in the gut crypt. Conclusion The data suggested that the apoptosis of intestinal epithelial cells significantly increased at early stage of post-CPB in rats, which might contribute to gut mucosal barrier dysfunction.