[Guide of emergency medicine on the basis of evidence based medicine].
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Biomedical subjects
Publications and source records attributed to Yin-ping Li.
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OBJECTIVE: To investigate the protective effects of the integrated traditional Chinese and western medicine Xuebijing injection on stress-induced organ damage in rabbits. METHODS: Forty rabbits were randomly divided into four groups: the control group, the model group, the western medicine group, and the Xuebijing group. The stress-induced organ damage model was replicated by soak the rabbits in water, the animals in the western medicine group and Xuebijing group received injection of lytic cocktail and Xuebijing, respectively. The changes in cortisol (Cor), thromboxane A(2) (TXA(2)), endothelin (ET), nitric oxide synthase (NOS) were determined at different time points in all the groups. The pathologic changes of the gastric mucosa, the adrenal gland and the cardiac muscle cell were observed. RESULTS: The content of Cor increased significantly in model group (P<0.01). The content of Cor decreased in the western medicine group and Xuebijing group, the changes showed no significant difference between two groups (P>0.05). The contents of ET, TXA(2) decreased and NOS increased in Xuebijing group compared with the western medicine group, the differences were significant (all P<0.05). The pathological changes of the gastric mucosa, the adrenal gland and the cardiac myocyte were less marked in Xuebijing group, compared with the western medicine group, the difference was significant (P<0.05). CONCLUSION: Xuebijing has better protective effects on stress-induced organ damage.
OBJECTIVE: To observe the effects of cyclooxygenase (COX)-2 inhibitor on apoptosis of hypoxic myocardial cells in vitro. METHODS: The myocardial cells were obtained from new-born Wistar rats, and were dispersed to single cell with trypsin. The cells in 4th-6th passages were randomly divided into 24 samples (every sample contained 1 x 10(5) cells): normal control group, hypoxic myocardial cells control group; hypoxic myocardial cells+NS-398 (20 micromol/L) and hypoxic myocardial cells+aspirin (100 microg/L). During culture, oxygen was replaced by N(2), and the cells were cultivated in 5% CO(2)+95% N(2) at 37 centigrade for 6 hours. Either interventional medicine or same amount of dimethyl sulphoxide was added to the cells 30 minutes before hypoxia. The expression of COX-1 and COX-2 in cultured myocardial cells in vitro was examined with Western blot. The apoptosis percentage of cells in each group was examined with flow cytometry. After centrifuging the culture medium under low temperature, 6-keto-prostaglandin F(1alpha) (6-keto-PGF(1alpha)) and thromboxane B(2) (TXB(2)) were determined with radioimmunoassay (RIA). RESULTS: There was no significant difference in the expression of COX-1 among the groups. The expression of COX-2 was higher in all acute hypoxic myocardial cells groups compared with the control group. Neither aspirin nor NS-392 inhibited the expression of COX-2. The positive percentage of apoptosis of cultured myocardial cells ranked as follow: hypoxic+NS-398 group, hypoxic +aspirin group, hypoxic control group and normal control group. The differences of apoptosis rate between hypoxic+NS-398 group and other groups were significant (all P<0.05). The levels of TXB(2) in each group of cell medium ranked in the following order: normal control group, hypoxic +NS-398 group, hypoxic+aspirin group and hypoxic control group. The difference of TXB(2) level between hypoxic+NS-398 group and hypoxic control group was significant(P<0.05). The levels of 6-keto-PGF(1alpha) in each culture medium ranked in the following order: normal control group, hypoxic+aspirin group, hypoxic+NS-398 group and hypoxic control group. The difference between hypoxic+NS-398 group and hypoxic control group was significant (P<0.05). The ratio of TXB(2)/6-keto-PGF(1alpha) showed no significant difference (P>0.05) among groups. CONCLUSION: The results suggest that acute hypoxia could directly induce cultured myocardial cells to express COX-2, but do not effect expression of COX-1. Hypoxia could elevate the level of 6-keto-PGF(1alpha) and TXB(2) in culture medium. COX-2 inhibitor (NS-398) could lessen the elevation, but it could not change the ratio between TXB(2) and 6-keto PGF(1alpha). NS-398 could increase apoptosis percentage of hypoxic myocardial cells in vitro, and the effect is independent of other inflammatory cells.
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OBJECTIVE: To investigate the effects of a combination of naloxone and methylprednisolone on nuclear factor-kappaB (NF-kappaB) p65 expression in the lung tissue in lipopolysaccharide (LPS)-induced acute lung injury (ALI) in rats. METHODS: ALI models were reproduced by intratracheal instillation of LPS (3 mg/kg). Four hours after LPS instillation, rats were randomly divided into five groups: normal saline group, LPS group, methylprednisolone group, naloxone group (LPS+naloxone) and combined drug group (LPS+naloxone+methylprednisolone). The level of interleukin-8 (IL-8) in serum was measured by immunoassay. Meanwhile, the expression of NF-kappaB p65 in the lung tissue was determined with immunohistochemical staining. RESULTS: Naloxone and methylprednisolone significantly reduced the LPS-induced increase in IL-8 concentrations in serum in vivo, and suppressed the activation of NF-kappaB p65 in the lung tissue. CONCLUSION: NF-kappaB activation is involved in the LPS-induced ALI in rats. Combination of naloxone and methylprednisolone could suppress the increase of IL-8 content and NF-kappaB activation in the lung tissue of rat in vivo in our experiment.
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OBJECTIVE: To summarize and analyze the clinical manifestations of pulmonary alveolar proteinosis (PAP) and its treatment. METHODS: Retrospective analysis of 2 cases with literature was reviewed. RESULTS: PAP presented a protracted chronic clinical course with overt symptoms but few physical signs, distinct chest radiography, and was a benign process. It was manifested as primary or secondary pathological changes. Typical chest CT scan showed "map" or "cobble stone" changes. Clinically, PAP was characterized by its incompatibility between symptoms and signs, and also radiographic picture and physical signs. The examination of bronchoalveolar lavage fluid could be used to confirm the diagnosis of PAP with periodic acid-schiff staining and electro microscopic examination. Whole lung lavage was an efficient therapy for PAP. CONCLUSION: It is very important for physicians to pay much more attention on the early diagnosis and treatment of pulmonary alveolar proteinosis.