Analysis of Fever Following Bronchoscopy and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration.

Objective: Bronchoscopy and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are two essential methods for obtaining the pathological diagnosis of central lung masses or hilar and mediastinal lymphadenopathy. We can observe that many patients have a fever after examinations, but the pathogenesis is not yet fully clear. We tried to comprehensively assess the occurrence of postoperative fever and bacterial infections in patients undergoing bronchoscopy and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) procedures. Methods: We retrospectively analyzed 512 patients undergoing bronchoscopy or EBUS-TBNA examination. According to examination methods, all patients were classified into three groups: Only perform bronchoscopy examination (BO) group (122 cases)，both perform bronchoscopy and biopsy (BB) group (262 cases), and EBUS-TBNA after bronchoscopy (EBUS) group (128 cases). Peripheral blood leucocyte, neutrophil count, and serum IL-6 test results were obtained before and after the examination. A blood culture was performed when the body temperature was higher than 38.5°C. Results: Among the three groups, the onset time (5.5h), average duration (6h), and peak temperature (37.7°C) of fever in the BO group were lower than those in the BB and EBUS groups. Still, there was no significant difference in onset time (11.66h, 11.83h), average duration (12.86h, 13.56h), and peak temperature (39.1°C, 39.1°C) between the BB group and EBUS group. There was no significant difference in the peripheral blood leukocyte count, neutrophil count or IL-6 level before the operation (P > .05). Compared with the preoperative, the leukocyte count, neutrophil count and IL-6 level in the three groups were increased after the operation (P < .05). Positive blood cultures were diagnosed as normal oropharyngeal flora. Conclusions: Postoperative fever after bronchoscopy is a relatively common complication, most of which do not require special treatment. Individuals with concomitant diseases such as diabetes may have postoperative infections after EBUS-TBNA, and they should be emphatically observed. The findings could potentially extend to similar diagnostic procedures or situations in pulmonary medicine. Understanding the risk factors associated with postoperative fever can help healthcare providers manage patient expectations and monitor certain groups more closely.

The Urban-Rural Disparities and Associated Factors of Health Care Utilization Among Cancer Patients in China.

Objective: This study aimed to examine the urban-rural disparities and associated factors of health care utilization among cancer patients in China. Methods: This study used the data collected from a cross-sectional survey conducted in China. A total of 1,570 cancer survivors from three urban districts and five rural counties were selected by using a multistage stratified random sampling method. We measured health care utilization with the way of cancer diagnosis, the number of hospitals visited, and receiving alternative therapies. Chi-square test was used to examine the differences between urban and rural cancer patients. Binary logistic regression analysis was performed to explore the determinants of health care utilization. Results: Among 1,570 participants, 84.1% were diagnosed with cancer after developing symptoms, 55.6% had visited two and above hospitals, and 5.7% had received alternative therapies. Compared with urban cancer patients, rural ones were more likely to be diagnosed with cancer after developing symptoms (χ2 = 40.04, p < 0.001), while they were less likely to visit more than one hospital (χ2 = 27.14, p < 0.001). Residence area (urban/rural), health insurance type, household income, age at diagnosis, tumor site, stage of tumor, and survival years were significantly associated with health care utilization of cancer patients (p < 0.01). Conclusions: Health care utilization was suboptimal among cancers patients in China. Rural cancer patients had less health care utilization including screenings and treatments than urban ones. Policymakers should implement specific strategies to ensure equitable utilization of cancer care. More attention should be paid to the disadvantaged groups and rural cancer patients. Prioritizing health resources allocation is needed to prevent, screen, and treat cancers in rural areas.

Effects of gut microbiome-targeted therapies on cardiometabolic outcomes in children and adolescents: A protocol for systematic review and meta-analysis.

BACKGROUND: Emerging evidence indicates the role of gut microbiota in the development of cardiovascular diseases. Thus, gut microbiota is increasingly recognized as a potential therapeutic target of cardiovascular disease. However, the effects of gut microbiome-targeted therapies on cardiometabolic outcomes in children and adolescents remain unclear. METHODS: We plan to perform a systematic search from PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science. Two authors will independently select the relevant studies and extract data according to a previously defined data extraction sheet. We will use the Stata 14.0 statistical software and RevMan V.5.3 software to conduct data analyses. RESULTS AND CONCLUSION: The results of this study will be published in a peer-reviewed journal and provide more evidence for the application of gut microbiome-targeted therapies in children and adolescents for the intervention of cardiovascular risk factors in clinical practice. PROTOCOL REGISTRATION NUMBER: INPLASY202060050.

Protective activity of mogroside V against ovalbumin-induced experimental allergic asthma in Kunming mice.

We investigated the antiasthmatic effect of mogroside V (Mog V) in mice with ovalbumin (OVA)-induced asthma. Administration of Mog V effectively attenuated OVA-induced airway hyperresponsiveness and reduced the number of inflammatory cells in bronchoalveolar lavage fluid (BALF). Histological examination showed that Mog V reduced the inflammatory infiltration of the lungs in the asthmatic mice. ELISAs suggested that Mog V effectively decreased the levels of IL-4, IL-5, and IL-13 in BALF and serum levels of OVA-specific IgE and IgG1 in the asthmatic mice. A quantitative reverse-transcription PCR assay also indicated that Mog V decreased the mRNA levels of IL-17A, IL-23, and RORγt in the lungs of the asthmatic mice (the opposite effect on Foxp3 mRNA). Furthermore, Mog V significantly reduced the OVA-induced activation of NF-κB in the lungs. This study indicates that Mog V alleviates OVA-induced inflammation in airways, and this effect is associated with a reduction in NF-κB activation. PRACTICAL APPLICATIONS: A traditional Chinese medicine herb has been reported to have a strong curative effect on asthma in clinical practice. Siraitia grosvenorii is known in China as a functional food product with the ability to improve lung function. Mogroside V is a triterpene glycoside isolated from S. grosvenorii. Nonetheless, the antiasthmatic effect of mogroside V has not been evaluated yet. The aim of this study was to investigate the antiasthmatic activity of mogroside V in mice with chemically induced asthma. The data from this study will provide some scientific evidence supporting wider use of S. grosvenorii in functional foods.

Job satisfaction of the primary healthcare providers with expanded roles in the context of health service integration in rural China: a cross-sectional mixed methods study.

OBJECTIVE: Against the backdrop of integrating public health services and clinical services at primary healthcare (PHC) institutions, primary healthcare providers (PCPs) have taken on expanded roles. This posed a potential challenge to China as it may directly impact PCPs' workload, income, and perceived work autonomy, thus affecting their job satisfaction. This study aimed to explore the association between the expanded roles and job satisfaction of the PCPs in township healthcare centers (THCs), the rural PHC institutions in China. METHODS: A cross-sectional study using mixed methods was conducted in 47 THCs in China's Shandong province. Based on a sample of 1146 PCPs, the association between the proportion of PCPs' working time spent on public health services and PCPs' self-reported job satisfaction was estimated using the logistic regression. Qualitative data were also collected and analyzed to explore the mechanism of how the expanded roles impacted PCPs' job satisfaction. RESULTS: One hundred eighty-four physicians and 146 nurses undertook increased work responsibilities, accounting for 15.91% and 12.61% of the total sample. For those spending 40-60%, 60-80%, and more than 80% of the working time providing public health services, the time spent on public health was negatively associated with job satisfaction, with the odds ratio being 0.199 [0.067-0.587], 0.083 [0.025-0.276], and 0.030 [0.007-0.130], respectively. Qualitative analysis illustrated that a majority of the PCPs with expanded roles were dissatisfied with their jobs due to the heavy workload, the mismatch between the income and the workload, and the low level of work autonomy. PCPs' heavier work burden was mainly caused by the current public health service delivery policy and the separation of public health service delivery and regular clinical services delivery, a significant challenge undermining the efforts to better integrate public health services and clinical services at PHC institutions. CONCLUSION: The current policies of adding public health service delivery to the PHC system have negative impacts on PCPs' job satisfaction through increased work responsibilities for PCPs, which have led to low work autonomy and the mismatch between the income and the workload. The fundamental reason lies in the fragmented incentives and external supervision for public health service delivery and clinical service delivery. Policy-makers should balance the development of clinic and public health departments at the institutional level and integrate their financing and supervision at the system level so as to strengthen the synergy of public health service provision and routine clinical service provision.

Antiviral activity of sophoridine against enterovirus 71 in vitro.

ETHNOPHARMACOLOGICAL RELEVANCE: Enterovirus 71 (EV71) has a propensity to cause hand-foot-and-mouth disease (HFMD) epidemics associated with neurological sequelae. Unfortunately, no drugs are currently available for the clinical treatment of EV71 infections. Sophoridine (SRI) is one of the most abundant alkaloids in Sophora flavescens Aiton (Leguminosae), which has been used to treat fever, throat inflammation, cancer, and other diseases. MATERIALS AND METHODS: In this study, we found that SRI inhibits EV71 infection in Vero cells. To study the antiviral activity of SRI, Vero cells were divided into 3 treatment groups based on the timing of SRI dosing: prior to viral adsorption (Group A), during viral adsorption (Group B), and after viral adsorption (Group C). We further revealed the antiviral activity of SRI with the attachment assay and the penetration assay. For Group A, 50% viability of Vero cells was observed at a SRI concentration of 61.39 µg/mL, whereas for Groups B, 50% viability was observed at SRI concentrations of 196.86 µg/mL. Furthermore, 29.7% cell viability was observed even at a SRI concentration of 1000 µg/mL in Groups C. The results show that SRI was highly effective against EV71 when Vero cells were pretreated with SRI for 2 h (Group A). Further researches indicate SRI was highly effective at inhibiting EV71 attachment when the SRI concentrations over 250 µg/mL (P < 0.001). CONCLUSIONS: We have shown that Vero cell viability increases when SRI is administered prior to viral adsorption. This suggests that SRI has the considerable potential as an antiviral for EV71 disease prevention.

Electromyographic bridge for promoting the recovery of hand movements in subacute stroke patients: A randomized controlled trial.

OBJECTIVE: The electromyographic bridge (EMGB) detects surface electromyographic signals from a non-paretic limb. It then generates electric pulse trains according to the electromyographic time domain features, which can be used to stimulate a paralysed or paretic limb in real time. This strategy can be used for the contralateral control of neuromuscular electrical stimulation (NMES) to improve motor function after stroke. The aim of this study was to compare the treat-ment effects of EMGB vs cyclic NMES on wrist and finger impairments in subacute stroke patients. METHODS: A total of 42 hemiplegic patients within 6 months of their cerebrovascular accidents were randomly assigned to 4-week treatments with EMGB or cyclic NMES. Each group underwent a standard rehabilitation programme and 10 sessions per week of hand training with EMGB or cyclic NMES. Outcome measures were: Brunnstrom stage, upper extremity components of the Fugl-Meyer Assessment, Motor Status Scale, voluntary surface electromyographic ratio and active range of motion of the wrist and finger joints. RESULTS: The EMGB group showed significantly greater improvements than the cyclic NMES group on the following measures: Brunnstrom stages for the hand, upper extremity - Fugl-Meyer Assessment, Motor Status Scale, and the voluntary surface electromyographic ratio of wrist and finger extensors. Eleven and 4 participants of the EMGB group who had no active wrist and finger movements, respectively, at the start of the treatment could perform measurable wrist and finger extensions after EMGB training. The corresponding numbers in the cyclic NMES group were only 4 and 1. CONCLUSION: In the present group of subacute stroke patients, the results favour EMGB over cyclic NMES for augmenting the recovery of volitional wrist and finger motion.

Determination of D-glucaric acid and/or D-glucaro-1,4-lacton in different apple varieties through hydrophilic interaction chromatography.

d-Glucaric acid (GA) derivatives exhibit anti-cancerogenic properties in vivo in apples, but quantitative information about these derivatives is limited. Hydrophilic interaction-based HPLC with ultraviolet detection or mass spectrometry was developed to quantify GA and/or D-glucaro-1,4-lacton (1,4-GL) in apples. Although the formation of 1,4-GL from GA could be the prerequisite to exert biological effects in vivo, only a small portion of GA (<5%) was identified and converted to 1,4-GL in the rat stomach. The 1,4-GL content in apples ranged from 0.3 mg/g to 0.9 mg/g, and this amount can substantiate health claims associated with apples. The amount of 1,4-GL was 1.5 times higher in Gala and the ratio of 1,4-GL to GA was lower in Green Delicious apples than those in the other varieties. Our findings suggested that the variety and maturity of apples at harvest are factors that determine 1,4-GL content.

A frequency and pulse-width co-modulation strategy for transcutaneous neuromuscular electrical stimulation based on sEMG time-domain features.

OBJECTIVE: Surface electromyography (sEMG) is often used as a control signal in neuromuscular electrical stimulation (NMES) systems to enhance the voluntary control and proprioceptive sensory feedback of paralyzed patients. Most sEMG-controlled NMES systems use the envelope of the sEMG signal to modulate the stimulation intensity (current amplitude or pulse width) with a constant frequency. The aims of this study were to develop a strategy that co-modulates frequency and pulse width based on features of the sEMG signal and to investigate the torque-reproduction performance and the level of fatigue resistance achieved with our strategy. APPROACH: We examined the relationships between wrist torque and two stimulation parameters (frequency and pulse width) and between wrist torque and two sEMG time-domain features (mean absolute value (MAV) and number of slope sign changes (NSS)) in eight healthy volunteers. By using wrist torque as an intermediate variable, customized and generalized transfer functions were constructed to convert the two features of the sEMG signal into the two stimulation parameters, thereby establishing a MAV/NSS dual-coding (MNDC) algorithm. Wrist torque reproduction performance was assessed by comparing the torque generated by the algorithms with that originally recorded during voluntary contractions. Muscle fatigue was assessed by measuring the decline percentage of the peak torque and by comparing the torque time integral of the response to test stimulation trains before and after fatigue sessions. MAIN RESULTS: The MNDC approach could produce a wrist torque that closely matched the voluntary wrist torque. In addition, a smaller decay in the wrist torque was observed after the MNDC-coded fatigue stimulation was applied than after stimulation using pulse-width modulation alone. SIGNIFICANCE: Compared with pulse-width modulation stimulation strategies that are based on sEMG detection, the MNDC strategy is more effective for both voluntary muscle force reproduction and muscle fatigue reduction.

[C, N and P stoichiometric characteristics of different root orders for three dominant tree species in subalpine forests of western Sichuan, China].

Fine root order was classified according to Pregitzer's method. This study measured carbon (C), nitrogen (N) and phosphorus (P) concentrations of the 1-5 root orders (diameter < 2 mm) in three dominant subalpine tree species (Betula albosinensis, Abies faxoniana and Picea asperata) of western Sichuan. Their stoichiometric ratios of different root orders were also calculated. The results showed that C concentration, C/N and C/P increased, but N and P concentrations decreased from the first to fifth order of fine root for all tree species. No significant changes in N/P among root orders were detected in each species. There were significant differences in C, N, P concentrations and their stoichiometric ratios among the tree species. The species-associated differences were dependent on root order. There were significant correlations between C, N, P concentrations and their stoichiometric ratios in the three tree species.

Effect of conjugated linoleic acid on blood pressure: a meta-analysis of randomized, double-blind placebo-controlled trials.

BACKGROUND: Numerous studies on animals evidenced that conjugated linoleic acid (CLA) could decrease blood pressure (BP) in several rat models. However, such beneficial effect is not completely supported by studies on humans. METHODS: We searched the Pubmed, Cochrane Library, and the ClinicalTrials.gov databases for relevant randomized, double-blind placebo-controlled trials up to August 2014 to perform a meta-analysis. A random-effects model was used to calculate the combined treatment effects. RESULTS: Eight studies with nine trials, which involved 638 participants with CLA supplementation ranging from 2.0 g/day to 6.8 g/day, were included in this meta-analysis. Compared with placebo, the pooled estimate of change was -0.03 mm Hg (95% CI: -2.29, 2.24, P=0.98) and 0.69 mm Hg (95% CI: -1.41, 2.80, P=0.52) in systolic and diastolic BPs, respectively. No significant heterogeneity across studies for systolic BP; however, substantial heterogeneity for diastolic BP was identified. Publication bias was not found for both systolic and diastolic BPs. CONCLUSION: The findings of this meta-analysis did not support the overall favorable effect of CLA supplementation on BP regulation.

Effect of garlic on blood pressure: a meta-analysis.

Garlic supplements are thought to reduce blood pressure (BP). The authors performed a meta-analysis to investigate garlic's effect on BP. Ovid Medline, Cochrane Library, and PubMed (1946 to November 2013) were used to search for randomized controlled trials. Seventeen trials were included. Pooled analysis showed that garlic intake caused a 3.75-mm Hg reduction (95% confidence interval [CI], -5.04 to -2.45, I(2) =30.7%; P<.001) in systolic BP and a 3.39-mm Hg reduction (95% CI, -4.14 to -2.65, I(2) =67%; P<.001) in diastolic BP compared with controls. Meta-analysis of subgroups showed a significant reduction in systolic BP in hypertensive (-4.4 mm Hg; 95% CI, -7.37 to -1.42, I(2) =0.0%; P=.004) but not normotensive patients. No significant reduction in diastolic BP was seen. After sensitivity analysis, heterogeneity disappeared and significant diastolic BP reduction (-2.68 mm Hg, 95% CI, -4.93 to -0.42, I(2) =0.0%; P=.020) was shown in hypertensive patients. This meta-analysis suggests that garlic supplements are superior to controls (placebo in most trails) in reducing BP, especially in hypertensive patients.

[Decomposition and nutrient release of root with different diameters of three subalpine dominant trees in western area of Sichuan Province, China].

In this study, a buried bag experiment was used to investigate mass loss and C, N and P release patterns of fine (≤2 mm), medium (2-5 mm) and coarse (≥ 5 mm) roots of 3 subalpine dominant trees, i. e., Betula albosinensis, Abies faxoniana and Picea asperata in the growing and non-growing seasons. In general, the remaining mass of B. albosinensis was lower than that of A. faxoniana and P. asperata. In addition, root remaining mass increased with the increase of root diameter for the same species. The mass losing rate in the non-growing season was 52.1%-64.4% of a year. The C release of B. albosinensis was the highest, but that of A. faxoniana was the lowest. Also, C release decreased with the increase of root diameter. N of A. faxoniana and P. asperata were enriched in the non-growing season but released in the growing season. However, the opposite pattern was found for B. albosinensis. During the non-growing season, the amount of N enrichment increased with the increase of root diameter. The P release of 3 species was characterized as the enrichment-release pattern. P enrichment of A. faxoniana was significantly greater than that of P. asperata and B. albosinensis. Nevertheless, no significant difference was observed between diameter sizes. In conclusion, diameter size had significant effect on root decomposition in the subalpine forests of western Sichuan, and the diameter effect was dependent on tree species and season.

Design of a pulse-triggered four-channel functional electrical stimulator using complementary current source and time division multiplexing output method.

In this paper, a four-channel pulse-triggered functional electrical stimulator using complementary current source and time division output method is proposed for the research and application of functional electrical stimulation (FES). The high-voltage compliance and output impedance is increased by adopting the complementary current source, which can also realize the linear voltage-to-current conversion and high channel isolation. A high-voltage analog switch chip MAX14803, combined with a FIFO queue algorithm in the microprocessor, is used to setup the H-bridge and multiplexers for the four-channel time division multiplexing output. With this method, the size and cost of the key components are reduced greatly. The stimulating core circuit area is 30 × 50 mm(2). According to the experiments, the stimulator can achieve the four-channel charge-balanced biphasic stimulation with a current range between 0 and 60 mA and a single-phase pulse amplitude up to 60 V.

Efficacy and safety of vitamin D3 in patients with diabetic nephropathy: a meta-analysis of randomized controlled trials.

BACKGROUND: Several studies found that vitamin D3 might alter glucose metabolism, protect kidney from injury and even proposed the mechanisms. But results from previous studies have been conflicting. The aim of this study was to evaluate the efficacy and safety of vitamin D3 in patients with diabetic nephropathy. The underlying mechanism of vitamin D3 decreasing proteinuria is also discussed. METHODS: We conducted a search of English and Chinese articles using database of Pubmed, Embase, Sinomed, CNKI, Wanfang and clinical trial register centers, for randomized controlled trials of vitamin D3 in diabetic nephropathy patients. Two reviewers performed independently. Meta-analysis was used when studies were homogeneous enough. RESULTS: Twenty studies, including 1 497 patients with diabetic nephropathy, were involved in this systemic review. Vitamin D3-treated patients with diabetic nephropathy had a statistically significant reduction in 24-hour proteinuria (weighted mean difference -0.44, 95% CI -0.54 to -0.34, Z = 8.80, P < 0.000 01) and urine albumin/creatine ratio (standardized mean difference -0.29, 95% CI -0.48 to -0.10, Z = 2.96, P = 0.003). But vitamin D3 supplementation did not significantly reduce blood pressure and hemoglobin A1c compared with control group. The potential mechanisms about the renal protection of vitamin D3, including the inhibition of rennin-angiotensin system, the protection of kidney from inflammation, fibrosis and the structure change of kidney are discussed. In addition, vitamin D3 did not significantly increase the incidence of adverse effects, including total adverse effects, gastrointestinal adverse effects and fluctuation of blood pressure. CONCLUSIONS: Vitamin D3 can ameliorate proteinuria and protect kidney from injury in patients with diabetic nephropathy. This renoprotective effect is independent of blood pressure and glucose reduction. And it does not increase any adverse effects than control, even in combination therapy with angiotensin converting enzyme inhibitors/angiotensin receptor blockers. But due to the limited randomized controlled trials of high quality, more clinical researches should be taken in the future.

Effect of dietary fiber on constipation: a meta analysis.

AIM: To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials (RCTs). METHODS: We searched Ovid MEDLINE (from 1946 to October 2011), Cochrane Library (2011), PubMed for articles on dietary fiber intake and constipation using the terms: constipation, fiber, cellulose, plant extracts, cereals, bran, psyllium, or plantago. References of important articles were searched manually for relevant studies. Articles were eligible for the meta-analysis if they were high-quality RCTs and reported data on stool frequency, stool consistency, treatment success, laxative use and gastrointestinal symptoms. The data were extracted independently by two researchers (Yang J and Wang HP) according to the described selection criteria. Review manager version 5 software was used for analysis and test. Weighted mean difference with 95%CI was used for quantitative data, odds ratio (OR) with 95%CI was used for dichotomous data. Both I(2) statistic with a cut-off of ≥ 50% and the χ(2) test with a P value < 0.10 were used to define a significant degree of heterogeneity. RESULTS: We searched 1322 potential relevant articles, 19 of which were retrieved for further assessment, 14 studies were excluded for various reasons, five studies were included in the analysis. Dietary fiber showed significant advantage over placebo in stool frequency (OR = 1.19; 95%CI: 0.58-1.80, P < 0.05). There was no significant difference in stool consistency, treatment success, laxative use and painful defecation between the two groups. Stool frequency were reported by five RCTs, all results showed either a trend or a significant difference in favor of the treatment group, number of stools per week increased in treatment group than in placebo group (OR = 1.19; 95%CI: 0.58-1.80, P < 0.05), with no significant heterogeneity among studies (I(2)= 0, P = 0.77). Four studies evaluated stool consistency, one of them presented outcome in terms of percentage of hard stool, which was different from others, so we included the other three studies for analysis. Two studies reported treatment success. There was significant heterogeneity between the studies (P < 0.1, I(2) > 50%). Three studies reported laxative use, quantitative data was shown in one study, and the pooled analysis of the other two studies showed no significant difference between treatment and placebo groups in laxative use (OR = 1.07; 95%CI 0.51-2.25), and no heterogeneity was found (P = 0.84, I(2)= 0). Three studies evaluated painful defecation: one study presented both quantitative and dichotomous data, the other two studies reported quantitative and dichotomous data separately. We used dichotomous data for analysis. CONCLUSION: Dietary fiber intake can obviously increase stool frequency in patients with constipation. It does not obviously improve stool consistency, treatment success, laxative use and painful defecation.

Effects of trace element supplementation on the inflammatory response in a rabbit model of major trauma.

Patients with a severe trauma exhibit a strong oxidative stress, an intense inflammatory response, and long-lasting hypermetabolism, all of which are proportional to the severity of injury. In this study, we investigated the impact of trace element (TE) supplementation on the inflammatory response in an animal model of major trauma. New Zealand White rabbits were randomly assigned as a control group (n=5) and an experimental group (n=70) that, after receiving a major trauma, was subdivided into Trauma-Control (n=35) and Trauma-TE (n=35) groups. Systemic inflammatory response syndrome (SIRS) was observed in 40 out of 70 rabbits with a trauma, with a higher incidence in the Trauma-Control group (88.6%; 31/35) than the Trauma-TE group (28.6%; 10/35) (p<0.01). The mortality rate was significantly different between the Trauma-Control and the Trauma-TE groups; (34% vs. 8%; p<0.01). There were significant post-trauma alterations in the levels of (1) serum and spleen zinc (Zn), copper (Cu), selenium (Se), and manganese (Mn), (2) serum AST and ALT, (3) serum interleukin-6/10, and (4) nuclear factor kappa binding (NF-kappaB) activity and the expression. TE supplementation: (1) improved blood urea nitrogen (BUN), and creatinine (Cr) levels, (2) stabilized IL-6/10 production, (3) decreased NF-kappaB p(65) production. Appropriate TE supplementation can improve the TE status, mitigate SIRS, and reduce the mortality due to multiple organ dysfunction syndromes (MODS)/multiple organ failure (MOF) after major trauma.

Alterations of trace elements (Zn, Se, Cu, Fe) and related metalloenzymes in rabbit blood after severe trauma.

To investigate the status of the trace elements (TEs) and related metalloenzymes activities in the injury and repair process after severe trauma, we established a rabbit model of severe trauma whose Injury Severity Score (ISS) was 22. Concentrations of blood selenium (Se) and serum copper (Cu), zinc (Zn), iron (Fe), and ferritin were measured on D0 (before injury), and day (D) 1, D2, D3, D6, D9, D14, D21, D28 after trauma, respectively. The activities of glutathione peroxidase (GPx), Cu/Zn superoxide dismutase (Cu/Zn-SOD), myeloperoxidase (MPO), the contents of lipid peroxidation product malondialdehyde (MDA) and serum biochemical profile were detected synchronously. In addition, the morphologic changes of major organs were observed at different time intervals. Results showed that blood Se and serum Zn, Fe contents decreased significantly within 2 weeks after injury. Serum Cu concentration was significantly reduced on D1 but normalized quickly. Serum ferritin level increased during the first week while following an obvious decrease thereafter. The blood GPx activity dropped markedly from D1 to D6, the serum Cu/Zn-SOD activity decreased on D1 and then increased significantly within 2 weeks, and the blood MPO-positive stained cells increased within a week after trauma and followed by a decrease from D14 to D21. The serum MDA increased significantly on D6. Seven of 34 rabbits died in 4-6 days after injury. Biochemistry values and pathological features revealed these rabbits died of multiple organ dysfunction syndrome (MODS). Our experiment suggested that the circulating TEs status is dramatically modified in response to trauma, which might be a factor in MODS.