Shen-fu injection alleviates acute renal injury by reducing cytokine levels and modulating apoptosis in a porcine hemorrhagic shock model

ABSTRACT Purpose Shen-fu injection (SFI) was used to intervene in the resuscitation of porcine hemorrhagic shock (HS) model to study its protective effects on acute kidney injury. Methods After 60 min of HS, 28 animals were randomly assigned into four groups. The groups were as follows: hemorrhagic shock group (HS); HS resuscitation with shed-blood group (HSR); HS resuscitation with shed-blood and SFI (1 mL·kg-1) group (HSR-SFI); and the sham operation group (Sham). The bloods were analyzed for serum creatinine (sCr), cystatin C (CysC) and neutrophil gelatinase-associated lipocalin (NGAL). BAX, Bcl-2, and caspase-3 protein expressions by Western blot analysis and immunohistochemical staining. The renal tissues were removed and pathologic changes were observed. Results Mean aortic pressure (MAP) in HSR-SFI groups were higher than that in HSR groups after shock. At the 6th hour after shock, the urine volume per hour in the HSR-SFI groups was more than that in the HSR groups. The sCr, NGAL, CysC and cytokine levels of HSR-SFI groups were lower. The Bcl-2 expression was increased in the HSR-SFI groups. The BAX and caspase-3 expressions were reduced. The histopathologic score in the HSR-SFI was lower. Conclusions SFI may reduce the risk of acute kidney injury (AKI) following hemorrhagic shock by attenuating systemic inflammatory responses, and regulating the expression of apoptosis-related proteins.

Transoperative refusion: a simple and safe method in emergency surgery / Reinfusão transoperatória: um método simples e seguro na cirurgia de emergência

The objective is to reinforce the importance of blood reinfusion as a cheap, safe and simple method, which can be used in small hospitals, especially those in which there is no blood bank. Moreover, even with the use of devices that perform the collection and filtration of blood, more recent studies show that the cost-benefit ratio is much better when autologous transfusion is compared with blood transfusions, even when there is injury to hollow viscera and blood contamination. It is known that the allogeneic blood transfusion carries a number of risks to patients, among them are the coagulation disorders mediated by excess enzymes in the conserved blood, and deficiency in clotting factors, mainly the Factor V, the proacelerin. Another factor would be the risk of contamination with still unknown pathogens or that are not investigated during screening for selection of donors, such as the West Nile Fever and Creutzfeldt-Jacob, better known as "Mad Cow" disease. Comparing both methods, we conclude that blood autotransfusion has numerous advantages over heterologous transfusion, even in large hospitals. We are not against blood transfusions, just do not agree that the patient's own blood is discarded without making sure there will be enough blood in stock to get him out of the hemorrhagic shock.

O objetivo deste trabalho é reforçar a importância da reinfusão sanguínea como um método barato, seguro e simples, e que pode ser utilizado em hospitais de pequeno porte, destacando aqueles que não dispõem de banco de sangue. Além disso, mesmo com a utilização de aparelhos que realizam a coleta e filtração do sangue, trabalhos mais recentes mostram que a relação custo-benefício é bem melhor, comparando a transfusão autóloga com a transfusão de hemoderivados, mesmo quando há lesão de vísceras ocas e contaminação do sangue. Sabe-se que, atualmente, a transfusão de sangue alogênico acarreta uma série de riscos aos pacientes, dentre eles, estão os distúrbios de coagulação mediados pelo excesso de enzimas no sangue, conservada e deficiência nos fatores de coagulação; destacando o Fator V, a proacelerina. Outro fator seria o risco de contaminação com patógenos ainda desconhecidos ou que não são investigados durante a triagem para seleção de doadores, como por exemplo, a Febre do Nilo Ocidental e a Doença de Creutzfeldt-Jacob, mais conhecida como Doença da "Vaca Louca". Comparando ambos os métodos, concluímos que a autotransfusão sanguínea possui inúmeras vantagens em relação à transfusão heteróloga, mesmo em hospitais de grande porte. Não somos contra a transfusão de hemoderivados, só não concordamos que seja desprezado o sangue do próprio paciente, sem termos certeza de que vai chegar sangue em quantidade suficiente para tirá-lo do choque hemorrágico.

Protective effect of Ligustrazini on gut barrier function / 中国病理生理杂志

AIM: To study the protective effect of Ligustrazini(LGT) on gut barrier function after hemorrhagic shock-reperfusion. METHODS: Thirty white rabbits were divided randomly into 3 groups: control group (A),shock group (B) and LGT group (C). Malondialdehyde(MDA), tumor necrosis factor-?(TNF ?), interleukin-1?(IL-1?) and nitric oxide products(NO - 2/NO - 3) contents were measured in intestinal mucosa at 3 hours following reperfusion,culture of bacteria in blood from rabbits of 3 groups was carried out,the intestinal mucosa was examined under optical and electron microscope. RESULTS: MDA, TNF ?, IL-1? and NO - 2/NO - 3 contents of intestinal mucosa remained unchanged in group C,but increased significantly in group B, compared with group A. Incidence of bacterial translocation in group B was markedly higher than that in group A at 30 min following reperfusion,there was not any difference between group A and group C. Under light and electronic microscope,in comparison with A and C groups,intestinal mucosa damage in B group became more severe. CONCLUSION: LGT can protect gut barrier from intestinal ischemia-reperfusion injury induced by hemorrhagic shock through reducing oxygen free radicals,raising nitric oxide and preventing inflammation.

Liver protection by Sini decoction in hemorrhagic shock and its mechanism relating to oxygen free radical and nitric oxide / 中国病理生理杂志

AIM: The work was designed to explore protective effects of a traditional Chinese medicine-sini decoction (SD) on liver in hemorrhagic shock and its mechanism relating to oxygen free radical and nitric oxide. METHODS: Anesthetized Wistar rats were subjected to a hemorrhagic shock protocol for 60 min followed by intravenous injection with normal sodium chloride solution or SD solution. Superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide (NO) in liver were examined. The inducible nitric oxide synthase (iNOS) was determined immunohistochemically. RT-polymerase chain reaction (RT-PCR)was used to assay the mRNA, which were corresponding to eNOS (endothelial nitric oxide synthase) and iNOS. RESULTS: The activity of SOD decreased, while the concentration of MDA increased in liver during hemorrhagic shock. SD enhanced SOD activity and inhibited a increase in MDA level in liver ( P

Preliminary observations on ultrastructural changes of atrial myocardial cells during hemorrhagic shock and after autotrans-fusion in rats / 第三军医大学学报

The ultrastructural changes of atrial myocardial cells during hemorrhagic shock and after autotransfusion with the shedded blood were observed in rats,which were divided into control,hemorrhagic shock and auspeto-transfusion groups.It was found that there was a marked increase of atrial specific granules in the atrial myocardial cells during hemorrhagic shock.Striking ultrastructural changes of atrial myocardial cells were noted after transfusion of the shedded blood.Reduction in the number of atrial specific granules,in addition to mitochondrial swelling,reduction of the cristae,focal emptying of mitochondria,myelin-like figure in mitochondrial matrix,expansion of sar-coplasmic reticulum,dilatation of Golgi complexes and perinuclear space,and dissociation of myocardial disk,were remarkable.The findings suggest that atrial myocardila cells participate in the patho-physiological changes of hemorrhagic shock and autotransfusion.