The general lipid and lipid peroxidation byproduct content in the erythrocyte membrane among patients with gun shot pulmonary wound

In the injured persons with gun shot wounds of thorax the lowering of the common lipids lever, high contents of dienic ketones, dienic conjugats and malonic dialdehydes in the blood serum and the erythrocytes membranes before the operation and in postoperative period witness the lipid metabolism and the antioxidant defense system of organism changes.     

Catechol-O-methyltransferase activity in erythrocytes of persons with severe thermal injury

In the present investigation, we found that the catechol-O-methyltransferase activity (COMT) in erythrocytes of persons with severe thermal injury was strikingly increased when compared with that in erythrocytes of noninjured individuals. The specific activity of COMT in erythrocytes of burned patients was not correlated with extent of burn. Thus the echinocytes of burned persons are another example of abnormal red cells in which COMT activity is increased. This appears to be the first example of increased COMT activity in abnormal erythrocytes that is not associated with large numbers of reticulocytes.     

Analysis of lethality in the injured persons, suffering cranioabdominal trauma

The now observed enhancement of a human traumatism due to a traffic accidents occurrence demands the measures application, aimed on the improvement of results of the injured persons treatment. With this objective a retrospective analysis of the patients cases charts and of a court-medical expertise protocols was made of 161 injured persons, 69 of whom have died. Cranioabdominal trauma occupies a leading place in a tanatogenesis structure. Delivering of a timely aid to the injured persons in conditionally preventive and preventive lethal outcome constitutes the essential reserve for the treatment results improvement.     

The surgical choice strategies in the treatment of femoral bone fractures in injured persons with combined trauma

In 1990-1999 years osteosynthesis of the hip bone was performed in 500 injured persons with combined trauma. In 63.1% patients the plates were used, in 19.6%--pivots, in 17.3%--apparatuses of external fixation. The choice of the method and optimal terms of performance of the surgical stabilization procedure of fracture were determined by the trauma severity in accordance with anatomo-functional model. In 12-18 months after the operation 198 patients were examined. Good result was noted in 79.6% of patients, satisfactory--in 17.3%, bad--in 3.1%.     

Causes of postoperative peritonitis occurrence in the injured persons with gun-shot abdominal wounds

In 43 (39.1%) injured persons with gun-shot abdominal wounding postoperative complications have occurred, demanding reoperations. The most frequent of them were postoperative peritonitis, purulent complications, recurrent hemorrhage, early adhesive ileus. Inadequate abdominal cavity sanation in gun-shot wounding, perforation of deserosated places of intestinal wall, an acute ulcers of hollow organs, lost and not revealed foreign bodies in abdominal cavity were the causes of the progressing postoperative peritonitis occurrence. Absence of some signs, characteristic for postoperative peritonitis, made the diagnosis difficult, that is why in majority of observations the relaparotomy conduction was very delayed. Relaparotomy was conducted on the first-second day, as a rule, for insufficiently sanated abdominal cavity and on the 5-7th day--for perforation of the compound places in hollow organs. Antibacterial therapy was conducted for progressing peritonitis, duration of which depended on dynamics of the peritonitis course. The complications rate reduction was promoted by conduction of an active postoperative sanation of abdominal cavity and potent antibacterial therapy. One patient died because of the wounding severity.     

Anesthesiological support of operative interventions in the injured persons, suffering a cold trauma

Basing on analysis of the treatment results in 74 injured persons with a cold trauma there was proved, that during operative interventions performance a total intravenous anesthesy and a spinal cord anesthesy are used most frequently. Inhalation anesthesy and conducting methods of anesthesy ought to be used more frequently, because a total intravenous anesthesy is a lesser guided one and a spinal cord anesthesy may cause a severe hypotension in the injured persons.     

Posttraumatic retroperitoneal hematoma in injured persons with severe closed multiple and combined abdominal trauma

The experience of treatment of 69 injured persons with posttraumatic retroperitoneal hematoma suffering severe multiple combined abdominal trauma was analyzed. Application of the classification proposed permits to formulate diagnosis and to choose the tactic of treatment correctly. The intraoperative tactics algorithm was elaborated. It promotes the correct analysis of intraoperative findings and reduction of the diagnostic mistakes frequency as well. In the presence of vast defect, making impossible to suture over the parietal peritoneum, extraperitonization using cerebral dura mater was done. Operative intervention was concluded by drainage with subsequent laserotherapy.     

系膜细胞己糖激酶的表达及蛋白激酶C依赖的调控

目的 讨糖尿病相关因素－蛋白激酶Ｃ（ＰＫＣ）对己糖激酶的特异性调节以及与细胞对葡萄糖净利用的相关性，并探讨ＨＫｓ在糖尿病肾病中的作用。方法 ＳＶ４０转基因鼠肾小球系膜细胞株（ＳＶ４０ＭＥＳ１３）作为细胞模型，分别使用６－磷酸葡萄糖脱氢酶耦联比色法和醋酸纤维膜区带电泳、原位底物染色法检测ＨＫｓ总活性及同工酶活性，用Ｔｒａｎｄｅｒ氧化法检测细胞对葡萄糖的净利用。结果 ＳＶ４０ＭＥＳ１３细胞株和原代培养     

上腹部手术病人围术期红细胞内HK、PFK和G-6PD酶活性的变化

目的 探讨磷酸戊糖途径在上腹部术后糖酵解酶活性下降中的作用及其机制。方法 ２６例择期上腹部手术病人随机分成三组：硬膜外阻滞（ＥＢ）组（１０例）。异丙酚静脉麻醉（ＰＲＯ）组（１０例）和静脉普鲁卜因复合麻醉（ＩＰＢＡ）组（６例）。于麻醉前、手术６０ｍｉｎ、术后６０ｍｉｎ、术后第１ｄ和第２ｄ５个时点取静脉血,同步测定血糖和红细胞内己糖激酶（ＨＫ）、磷酸果激酶（ＰＦＫ）及６－磷酸葡萄糖脱氢酶（Ｇ－６ＰＤ）     

Myocardial high-energy phosphates, lactate and pyruvate during moderate or severe normothermic ischemia in rat hearts perfused with phosphoenolpyruvate and ATP in cardioplegic solution

Rat hearts were subjected to normothermic ischemia for 15 min (group I) or 30 min (group II). During the ischemic period the hearts were perfused twice with cardioplegic solution supplemented with 14.4 mM phosphoenolpyruvate (PEP) and/or 0.067 mM adenosine triphosphate (ATP), and at the end of ischemia they were freeze-clamped. The myocardial ATP content in group I fell to about 55% of normal values except in hearts supplemented with only PEP, which showed greater reduction. In group II the ATP fell to only about 5% of normal values, without significant differences between the subgroups Hearts supplemented with PEP alone or with combined PEP-ATP showed significantly higher levels of pyruvate than in hearts with only ATP supplementation or control hearts. The study thus demonstrated clear difference in ATP content between moderate and severe ischemic trauma. The high pyruvate levels after PEP supplementation indicate formation of pyruvate without concomitant lactate increase.     

创面脓毒症大鼠组织ATP含量及合成酶活性的变化

目的：探讨烧伤后创面脓毒症对组织能量合成的影响。方法：60只背部30%Ⅲ度烫伤大鼠随机分为单纯烫伤组和刨面脓毒症组,创面脓毒症组大鼠创面涂以1×10~9 cfu/ml的铜绿假单胞菌观察伤后96h内心、肝、骨骼肌的ATP的含量及合成酶活性变化,同时电镜观察组织超微结构的相应改变。结果：伤后早期心肌、肝脏、骨骼肌细胞内ATP含量及合成酶活性均明显下降,此后单纯烫伤组逐渐恢复,至伤后96h脓毒症组大鼠ATP含量及合成酶活性明显低于对照组,并有与此相对应的线粒体数量和形态结构的改变。结论：烧伤后发生创面脓毒症时机体重要器官的线粒体结构损伤严重,组织ATP含量及合成酶活性明显下降,ATP合成不足加重了能量代谢的紊乱状况,线粒体的早期损伤可能是导致代谢紊乱的病理基础。     

Resistance to atracurium in thermally injured rats. The roles of time, activity, and pharmacodynamics

Thermal injury induces resistance to nondepolarizing muscle relaxants in patients. Because the mechanism of the resistance is unknown, the authors have sought to establish thermally injured rats as a suitable model for subsequent detailed studies of mechanisms. Two hundred twenty-five- to 250-g rats sustained a 30% total body surface area thermal injury while anesthetized with pentobarbital. Another group had sham injury. Animal activity was monitored both by periods of direct observation and by use of activity cages. At 10, 20, 30, 40, 60, and 90 days after injury, rats were anesthetized and ventilated and the strength of contraction of their gastrocnemius produced by supramaximal stimulation of the sciatic nerve was measured before and after a bolus of atracurium (2.0 mg/kg) was administered. The plasma concentration required to diminish contraction to 50% of the preceding value (Cp50) was determined by atracurium infusion. Animals displayed the greatest resistance to atracurium at 40 days. The Cp50 value was also greatest at this time. The protein binding of atracurium was identical for both sham and injured groups. Activity for thermally injured resistant rats and for sham animals was not different. It appears that pharmacodynamic mechanisms are involved, and inactivity and disuse atrophy are not necessary in rats for development of resistance to nondepolarizing muscle relaxants after thermal injury.     

Optimization of surgical and reanimation tactic in injured persons with dominating damage of the abdominal cavity organs in polytrauma

Results of surgical treatment of 148 injured persons with polytrauma in dominating damage of the abdominal cavity organs and concurrent damage of various anatomic-functional regions were analyzed. Taking into account the delineated reanimation-operative period there were presented surgical and reanimation tactic, intensive infusion-transfusion therapy in an acute massive blood loss, which was conducted in conditions of artificial pulmonary ventilation and general multicomponent anesthesy performed. Introduction of the tactic elaborated into the clinical practice had promoted significant improvement of the treatment results in injured persons with polytrauma.     

Diagnosis and treatment of injured persons with closed injury of hollow abdominal organs in combination with craniocerebral trauma

Treatment of closed injury of hollow abdominal organs in combination with craniocerebral trauma constitutes one of actual problems of modern surgery of injuries, proper mortality in it is reaching 61.5%. Instrumental methods of investigation play an important role in diagnosis of the injury regarded. Structure of injury, peculiarities of diagnosis and surgical tactics were considered.     

Prognostication of occurrence of the organ dysfunction and course of traumatic disease in injured persons with severe combined trauma

The course of traumatic disease (TD) was studied up in 415 injured persons with severe combined trauma. There were analyzed 82 parameters, reflecting peculiarities of anatomic traumatization, age of injured person, proceeding diseases, functional state of main systems of the life support. The data obtained were processed using multilevel statistical analysis. There were determined parameters, defining severity of the TD course and probability of syndrome of the polyorgan dysfunction (SPOD) occurrence, original scale of the SPOD prognostication was elaborated, permitting to prognosticate the TD course, to change the tactics and to improve the results of treatment of injured persons.     

自体回收血与库血红细胞酶活性及ATP含量的比较

目的比较术中自体回收处理血和库存两周红细胞的酶活性以及红细胞ATP含量的差异。方法选择估计术中出血量在600ml以上的择期全麻手术患者50例,术中采用血液回收机进行洗涤式自体血液回收,取患者自体回收处理血及库存两周以枸橼酸钠枸橼酸无水葡萄糖磷酸二氢钠腺嘌呤(CPDA)为保养液的异体浓缩红细胞各50份,每份6ml,分别检测红细胞ATP酶(Na K ATP酶、Ca2 ATP酶、Mg2 ATP酶)、葡萄糖6磷酸脱氢酶(G6PD)活性及红细胞ATP含量。结果红细胞酶活性和ATP含量回收血与库血间差异均无显著意义。结论洗涤式自体血液回收处理的红细胞ATP酶、G6PD活性及ATP含量与库存两周异体红细胞接近。