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ABSTRACT: The objective of this study is to investigate the effect of oral feeding of an electrolyte glucose mosapride solution for resuscitation in dogs with shock after a 35% TBSA full-thickness burn and the effect of mosapride on gastric emptying time. Eighteen male Beagle dogs were randomly divided into intravenous isotonic solution group, intragastric hypertonic solution group, and mosapride group after they were subjected to a 35% TBSA full-thickness flame injury. In intravenous isotonic solution group (I group), isotonic electrolyte glucose solution was given through vein with adoption of the Parkland formula. The resuscitation fluid in intragastric hypertonic solution group (H group) and mosapride group (M group) consisted of 1.8% NaCl and 5% glucose, the total fluid volume was one half of that for I group, and it was given in divided amount every 2 hours. Mosapride was added to the resuscitation fluid in mosapride group. Fluid replacement was begun 30 minutes after the injury in all the groups. Mean arterial pressure (MAP), cardiac output index (CI), intrathoracic blood volume index (ITBI), blood volume (BV), serum sodium concentration, intestinal mucosal blood flow (IMBF), gastric emptying, and serum motilin levels were determined at different time points. The urinary output of all animals was measured immediately after burn upto 360 minutes postburn. CI, ITBI, BV, and IMBF were all decreased obviously after burn. In I group and M group, CI, ITBI, BV, and IMBF were increased gradually after resuscitation, and they were significantly higher than that of H group (P < .05). MAP in all three groups was lowered significantly and then gradually recovered, showing no significant difference among groups. The urinary output in M group was similar to that in I group (P > .05), and it was higher than that in H group (P < .05). Serum sodium level in H group and M group increased in varying degrees and were markedly higher compared with the I group (P < .05). Postburn gastric emptying in H group was much more delayed (P < .05), but in M group it was much faster. Motilin level in the latter group also increased gradually postburn and was markedly higher than that of the other two groups (P < .05). At the early stage of 35% TBSA third-degree burns, gavage of 1.8% hypertonic electrolytes glucose ends in slow gastric emptying, resulting in delayed recovery from shock. When a prokinetic drug mosapride was added to the solution, gastric emptying could be accelerated and a resuscitation effect similar to that of intravenous isotonic fluid resuscitation can be achieved, while total fluid volume can be decreased by half.
Journal of burn care & research: official publication of the American Burn Association 12/2011; 33(2):e63-9. · 1.37 Impact Factor
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ABSTRACT: To study the change in intestinal barrier and organ functions of burned dog after enteral administration of hypertonic electrolyte glucose solution (HEGS) in shock stage.
Twenty-four Beagle dogs inflicted with 35% TBSA full-thickness burn were divided into no-fluid group (NF), intravenous infusion with isotonic electrolyte glucose solution (IEGS) group (II group), enteral infusion with IEGS group (EI), and enteral infusion with HEGS group (EH) according to the random number table, with 6 dogs in each group. Saline, containing 50 g/L glucose, was intravenously or enterally infused into dogs in II group and EI group respectively 0.5 hour post injury (PIH) for resuscitation. Total infusion volume within PIH 24 was 4 mL x kg(-1) x %TBSA(-1) (half of the total volume was infused in the first 8 hours in a constant speed, the other half volume was infused in the rest 16 hours in a constant speed). HEGS, containing 18 g/L NaCl and 50 g/L glucose, was enterally infused into dogs in EH group. Total infusion volume within PIH 24 was 2 mL x kg(-1) x %TBSA(-1), with the same infusion speed as that in II and EI groups. Liver and kidney function indexes [activity of ALT and CK-MB, expression levels of creatinine and blood urea nitrogen (BUN) in serum], activity of diamine oxidase (DAO), and activity of Na(+)-K(+)-ATPase in intestinal mucosa at PIH 24 were determined.
ALT activity in each group was close to one another. Serum levels of creatinine and BUN in II, EI, and EH groups were significantly lower than those in NF group. CK-MB activity obviously increased at PIH 2 in every group. CK-MB activity in EH group at PIH 2 to 8 was respectively lower than that in NF and II groups. DAO activity in serum in II, EI, and EH groups decreased since PIH 4 or PIH 6, respectively from (3.9 + or - 0.6) U/L to (3.6 + or - 0.5) U/L, (4.8 + or - 0.4) U/L to (2.8 + or - 0.8) U/L, (6.4 + or - 1.8) U/L to (3.5 + or - 0.8) U/L, all were significantly lower than those in NF group [from (12.5 + or - 0.4) U/L to (9.7 + or - 1.1) U/L, comparison between EH group and NF group, t value at PIH 4, 6, 8, 24 was respectively 10.25, 12.44, 17.99, 16.21, P values all below 0.05]. The order of Na(+)-k(+)-ATPase activity in intestinal mucosa at PIH 24 in each group from high to low was II group, EH group, EI group, and NF group (comparison between former 3 groups and NF group, t value was respectively 10.09, 4.96, 8.32, F value was 26.79, P values all below 0.05).
HEGS does not cause significant harm to the barrier function of intestinal mucosa of shock dog after burn. Compared with NF, HEGS can significantly improve functions of heart, liver, and kidney, and it can achieve the same resuscitation effect as enteral or intravenous infusion of IEGS with only half of the solution volume.
Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns 02/2010; 26(1):41-4.
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ABSTRACT: To study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) in enteral resuscitation of burn shock.
Eighteen Beagle dogs with 35% TBSA full-thickness flame injury were used in this study. They were randomized to a control group (no-fluid resuscitation, N group), a HEGS resuscitation group (H group) or an isotonic electrolyte glucose solution (IEGS) resuscitation group (I group). The solution enterally was given for resuscitation from half an hour after burn. The volumes and rates of fluid infusion in the H group were basically in accordance with 2 ml/(kg x 1%TBSA), those in the I group were basically in accordance with parkland formula [4 ml/(kg x 1%TBSA)]. The haemodynamic parameters, global end-diastolic volume index, plasma volume, osmotic pressure of plasma, intestinal absorptive rates of water and Na(+), and intestine mucosa blood flow were continuously assessed.
The cardiac output index, global end-diastolic volume index, plasma volume and intestine blood mucosa flow reduced markedly after burn in the three groups, and then gradually returned from 2 h after burn in two resuscitation groups, which were higher than that in the N group (P < 0.05). The activities of diamine oxidase in plasma in the two resuscitation groups were higher than that in N group (P < 0.05). The intestinal absorption rates of water and Na(+) reduced markedly after burn in two resuscitation groups with the lowest levels, and then returned from 6 h after burn. The rates of water in H group were lower than that in I group (P < 0.05); the rates of Na(+) in H group were higher than in I group (P < 0.05).
The results indicated that 35%TBSA III degrees burn-injury dogs be resuscitated effectively with 1.8% hypertonic electrolyte-glucose solution by enteral, which 1/2 volume of an isotonic electrolyte glucose solution.
Zhonghua wai ke za zhi [Chinese journal of surgery] 10/2009; 47(20):1581-4.
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Jinzhou Tian,
Jing Shi,
Leiming Zhang,
Junxiang Yin, Quan Hu,
Yi Xu,
Shuli Sheng,
Pengwen Wang,
Ying Ren,
Rong Wang,
Yongyan Wang
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ABSTRACT: Accumulation of beta-amyloid peptide (Abeta) in the brain is a primary influence driving Alzheimer's disease (AD) pathogenesis. The disease process, including formation of neurofibrillary tangles containing tau protein, is proposed to result from an imbalance between production and clearance of Abeta. A major therapeutic strategy for AD should be to decrease deposition of Abeta by the inhibition of its production and the facilitation of its degradation. Hence, the primary aim of this study was to investigate effects of GEPT, a combination of herbal extracts, on Abeta levels, beta- and gamma-secretases substrate (BACE1 and PS1, respectively) associated with production of Abeta, and insulin-degrading enzyme (IDE) and neprilysin (NEP) related to degradation of Abeta in the brain.
Three-month-old-male APPV717I mice were randomly divided into five groups (n=6 per group): (i) APP mice alone were given distilled water, (ii) APP donepezil mice were treated with donepezil (0.92 mg/kg/d), and (iii-v) APP mice treated with GEPT low dose (0.75 g/kg/d), middle dose (1.5 g/kg/d), and large dose (3.0 g/kg/d) for 8 months. Three-month-old-male C57BL/6J mice (n=6) for vehicle were given distilled water for 8 months. Immunohistochemistry and Western blot analysis were used in determining amyloid precursor protein (APP), Abeta1-42, BACE1, PS1, IDE and NEP in hippocampal CA1 region and hippocampal tissue homogenates.
Expression level of Abeta1-42 in the large GEPT dose was significantly lower than those in APP alone or APP treated with donepezil, and decreased to the level of vehicle mice. Similarly, a ratio calculated from the densitometric measures of Abeta1-42 protein/beta-actin in the large dose also was significantly lower than those in APP mice alone or APP mice treated with donepezil, and even reduced to the level of vehicle mice. Expression of PS1 in the large GEPT dose was significantly lower than that of APP mice alone and decreased to those in vehicle mice as well. A decreased level of BACE1 appeared, respectively, in APP mice treated with the large GEPT dose or donepezil but was still much greater than the level of vehicle mice. In contrast, NEP and IDE showed a significantly higher expression in APP mice treated with either the large dose or the middle dose of GEPT compared to APP mice alone or donepezil, and were even increased in level compared to vehicle mice.
The combination of GEPT extracts can reduce levels of endogenous Abeta peptide in APPV717I transgenic mice through the inhibition of PS1 activity rather than BACE1 and the promotion of IDE and NEP activity. Lower-expression of PS1 and over-expression of IDE or NEP may be helpful in potentially lowering brain Abeta levels in subjects with AD, and hence GEPT appears to offer potential that should be explored in AD.
Current Alzheimer research 05/2009; 6(2):118-31. · 4.97 Impact Factor
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Jia-ke Chai,
Zhi-yong Sheng,
Hong-ming Yang,
Dai-feng Hao,
Chuan-an Shen,
Xiao-ming Jia,
Feng Li,
Sa Jing,
Li-gen Li,
Hui-feng Song,
Chi-yu Jia,
Xiao-ye Tuo,
Tian-jun Sun, Quan Hu
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ABSTRACT: Mass burn casualties are always a great challenge to a medical team because a large number of seriously injured patients were sent in within a short time. Usually a high mortality is impending. Experiences gained from successful treatment of the victims may be useful in guiding the care of mass casualties in an armed conflict.
Thirty-five burn victims in a single batch, being transferred nonstop by air and highway from a distant province, were admitted 48 hours post-injury. All patients were male with a mean age of (22.4 +/- 8.7) years. The burn extent ranged from 4% to 75% ((13.6 +/- 12.9)%) total body surface area. Among them, thirty-two patients were complicated by moderate and severe inhalation injury, and tracheostomy had been performed in 15 patients. Decompression incisions of burn eschar on extremities were done in 17 cases before transportation. All the thirty-five patients arrived at the destination smoothly via 4-hour airlift and road transportation. Among them, twenty-five patients were in critical condition.
These thirty-five patients were evacuated 6 hours from the scene of the injury, and they were transferred to a local hospital for primary emergency care. The patients were in very poor condition when admitted to our hospital because of the severe injury with delayed and inadequate treatment. Examination of these patients at admission showed that one patient was suffering from sepsis and multiple organ dysfunction syndrome. Dysfunction of the heart, lung, liver, kidney, and coagulation were all found in the patients. Forty-eight operations were performed in the 23 patients during one month together with comprehensive treatment, and the function of various organs was ameliorated after appropriate treatment. All the 35 patients survived.
A well-organized team consisting of several cooperative groups with specified duties is very important. As a whole, the treatment protocol should be individualized, basing on the extent of the injury and the care that the patient had received at the spot. During airlift, the stretchers should be arranged perpendicular to the longitudinal axis of the cabin. The treatment protocol in our hospital consisted mainly of prompt effective relief of all life-threatening complications, followed by early closure of burn wounds, appropriate use of anti-infection therapy, emphasis on nutritional support, correction of metabolic disorders, alleviation of immunosuppression, correction of coagulopathy, and effective support and protection of organ function.
Chinese medical journal 04/2009; 122(5):525-9. · 0.86 Impact Factor
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Jinzhou Tian,
Jing Shi,
Leiming Zhang,
Junxiang Yin, Quan Hu,
Yi Xu,
Shuli Sheng,
Pengwen Wang,
Ying Ren,
Rong Wang,
Yongyan Wang
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ABSTRACT: Background: Accumulation of beta-amyloid peptide (Aβ) in the brain is a primary influence driving Alzheimer's disease (AD) pathogenesis. The disease process, including formation of neurofibrillary tangles containing tau protein, is proposed to result from an imbalance between production and clearance of Aβ. A major therapeutic strategy for AD should be to decrease deposition of Aβ by the inhibition of its production and the facilitation of its degradation. Hence, the primary aim of this study was to investigate effects of GEPT, a combination of herbal extracts, on Aβ levels, β- and γ-secretases substrate (BACE1 and PS1, respectively) associated with production of Aβ, and insulin-degrading enzyme (IDE) and neprilysin (NEP) related to degradation of Aβ in the brain. Methods: Three-month-old-male APPV717I mice were randomly divided into five groups (n=6 per group): (i) APP mice alone were given distilled water, (ii) APP donepezil mice were treated with donepezil (0.92mg/kg/d), and (iii-v) APP mice treated with GEPT low dose (0.75g/kg/d), middle dose (1.5g/kg/d), and large dose (3.0g/kg/d) for 8 months. Three-month-old-male C57BL/6J mice (n=6) for vehicle were given distilled water for 8 months. Immunohistochemistry and Western blot analysis were used in determining amyloid precursor protein (APP), Aβ1-42, BACE1, PS1, IDE and NEP in hippocampal CA1 region and hippocampal tissue homogenates. Results: Expression level of Aβ1-42 in the large GEPT dose was significantly lower than those in APP alone or APP treated with donepezil, and decreased to the level of vehicle mice. Similarly, a ratio calculated from the densitometric measures of Aβ1-42 protein/β-actin in the large dose also was significantly lower than those in APP mice alone or APP mice treated with donepezil, and even reduced to the level of vehicle mice. Expression of PS1 in the large GEPT dose was significantly lower than that of APP mice alone and decreased to those in vehicle mice as well. A decreased level of BACE1 appeared, respectively, in APP mice treated with the large GEPT dose or donepezil but was still much greater than the level of vehicle mice. In contrast, NEP and IDE showed a significantly higher expression in APP mice treated with either the large dose or the middle dose of GEPT compared to APP mice alone or donepezil, and were even increased in level compared to vehicle mice. Conclusion: The combination of GEPT extracts can reduce levels of endogenous Aβ peptide in APPV717I transgenic mice through the inhibition of PS1 activity rather than BACE1 and the promotion of IDE and NEP activity. Lower-expression of PS1 and over-expression of IDE or NEP may be helpful in potentially lowering brain Aβ levels in subjects with AD, and hence GEPT appears to offer potential that should be explored in AD.
Current Alzheimer Research 03/2009; 6(2):118-131. · 3.95 Impact Factor
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ABSTRACT: To investigate changes in apoptosis-related ligands in serum in rats with severe scald and the effect of intensive insulin therapy on the changes.
One hundred and fifty Wistar rats were randomly divided into 3 groups: sham burn (SB), scald (S) and treatment (T) groups. Rats in S and T groups were inflicted with 40% TBSA full-thickness burn, followed by intraperitoneal injection with 40 mL/kg of isotonic saline for resuscitation. Rats in T group were subcutaneously injected insulin in a dose of 0.25 U/100 g 24 hours after burn injury, and every 12 hours for 5 days (0.25, 0.50, 0.75, 1.00, 1.25 U/100 g each day, respectively) to control the level of blood glucose between 3 and 6 mmol/L. Rats in SB group were sham scalded at 37 degrees C without resuscitation. Blood was drawn from abdominal aorta on 1, 4, 7, 10, 14 post burn day (PBD) for determination of serum levels of TNF-alpha, soluble Fas ligand (sFasL) and soluble Fas receptor (sFas) by enzyme-linked immunosorbent assay (ELISA), and insulin by radioimmunity assay (RIA).
The serum level of TNF-alpha in S group peaked on 1 PBD (30.9 +/- 8.7) ng/L, which showed statistically significant difference when compared with that of SB and T groups (12.7 +/- 2.8) ng/L, (16.8 +/- 4.7) ng/L, respectively, P < 0.01), then lowered gradually to become similar to that of SB group on 7 PBD. The level of TNF-alpha in T group increased gradually, but was obviously lower than that of S group on 1, 4, 7 PBD (P < 0.01). The level of sFasL in S (on 7-14 PBD) and T (4-10 PBD) groups was significantly higher than that in SB group (P < 0.05), then lowered to normal level. The levels of sFas on 4-10 PBD in T group were obviously higher than that in S and SB group (P < 0.05). Ratio of sFasL to sFas in serum of S group was higher than that in SB group on 7, 10 PBD, which was higher than that in T group on 7 PBD (P < 0.05). There was significant decrease in serum level of insulin in S group compared with that of SB group on 4-10 PBD (P < 0.05). The level of insulin in T group increased on 1 PBD, peaked on 4 PBD (327 +/- 15 microU/mL), which was significantly higher than that in SB and S groups (42 +/- 15, 28 +/- 10 microU/mL, respectively, P < 0.01), then decreased gradually to normal level.
Insulin may inhibit apoptosis after burn by down-regulating secretion of apoptotic ligands.
Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns 03/2009; 25(1):42-5.
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ABSTRACT: To investigate the effect of GEPT extracts on spatial learning ability of the APPV717I transgenic mice at the early stage of dementia and its possible mechanism.
Thirty APPV717I transgenic mice were randomly divided into three GEPT groups by intragastric administration at doses of 0.075, 0.15, 0.3 g x kg(-1) x d(-1), and a donepezil group by intragastric administration of 0.92 mg x kg(-1) x d(-1), a APPV717I transgenic model group and a normal group by intragastric administration of distilled water. A four-month treatment regimen with GEPT extracts was administered to APPV717I transgenic mice. Results showed that Spatial memory ability was measured in Morris water maze. The total area covered by shank1 and integral optical density in CA1 subfield within the hippocampus were determined using immunohistochemical stains and Image-Pro plus analysis. The ultrastructure of synapses in the hippocampal CA1 region was observed by electronic microscope.
After a four-month of GEPT treatment regimen, the mean escape latency period were significantly shortened (P < 0.05), and the target quadrant search time were significantly increased (P < 0.05) compared to the APPV717I transgenic model mice. There was a significant higher level in the expression of shank1 detected in the hippocampal CA1 area of APPV717I transgenic mice associated with an increase in the number of synapses treated with GEPT than the levels in the APPV717I transgenic model mice alone. The total area of positive cells covered by shank1 and their integral optical density in the hippocampal CA1 area of the APPV717I transgenic mice treated with GEPT were significantly increased more than those of the APPV717I transgenic model mice.
GEPT extracts can obviously improve the spatial memory ability of APPV717I transgenic mice at the early stage of dementia through enhancing the number of synapses and the expression of shank1, and this might lead to development of novel treatment therapies for the memory loss associated with AD.
Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica 03/2009; 34(4):428-32.
