Objective To investigate therapeutic effects of various resuscitation fluids and the changes of plasma TNFαand IL - 6 during traumatic shock.Methods 120 patients with traumatic shock were divided into three groups(Ringer's lactated solution, 25%human albumin injection,and voluven) randomly,40 each.The volumes of resuscitation fluids were recorded in the three groups after resuscitation to a controlled mean blood pressure.After resuscitation for 2 h,plasma TNFαand IL - 6 were measured.Results The volumes of fluids required were significantly smaller in ALB and voluven groups than the RLS group(P0.05).Plasma concentrations of TNFαand IL - 6,were significantly lower in ALB and voluven groups,compared with the RLS group(P0.05 ).Conclusions Resuscitation effects are better with crystalline and colloidal fluids than that only with crystalline fluid.Expressions of plasma TNFαand IL - 6 are decreased more markedly in ALB and voluven groups than those in the RLS group in traumatic shock.Resuscitation with 25%albumin and voluven is instrumental in reducing lung injury after traumatic shock.

Objective To investigate therapeutic effects of various resuscitation fluids and the changes of plasma TNFαand IL - 6 during traumatic shock.Methods 120 patients with traumatic shock were divided into three groups(Ringer's lactated solution, 25%human albumin injection,and voluven) randomly,40 each.The volumes of resuscitation fluids were recorded in the three groups after resuscitation to a controlled mean blood pressure.After resuscitation for 2 h,plasma TNFαand IL - 6 were measured.Results The volumes of fluids required were significantly smaller in ALB and voluven groups than the RLS group(P<0.05).Plasma concentrations of TNFαand IL - 6,were significantly lower in ALB and voluven groups,compared with the RLS group(P<0.05 ).Conclusions Resuscitation effects are better with crystalline and colloidal fluids than that only with crystalline fluid.Expressions of plasma TNFαand IL - 6 are decreased more markedly in ALB and voluven groups than those in the RLS group in traumatic shock.Resuscitation with 25%albumin and voluven is instrumental in reducing lung injury after traumatic shock.

Objective To investigate the efficacy of fluid resuscitation in treatment of severe traumatic shock.Methods Between July 2002 and February 2005,165 patients with severe traumatic shock treated in our department were analyzed retrospectively,and the volume-effect relationship between fluid volume during the first hour and traumatic shock was summarized. Results The success rate of resuscitation was 67.9%(112 cases),and traumatic mortality was 32.1%(53 cases),11 of whom died of multiple organ dysfunction syndrome(MODS) after resuscitation.Conclusion In earlier period(first 1 h) of severe traumatic shock,the survival rates in the two groups with infused amount >1.5 L were markedly higher than that in the group with infused amount <1.0 L.So the aim of fluid resuscitation in traumatic shock is to maintain the hemodynamics,prevent MODS and correct oxygen metabolic disturbance.

和熙的阳光洒满了院子的每个角落.中风后的王师傅,今天精神特别好.午睡刚起床,便慢慢地把躺椅挪到了门口外,独身沐浴着温暖的阳光.

In order to know whether Naloxone can prevent mice from heat stroke,the survival rate and ave\|rage survival time of mice administrated with different doses of Naloxone at 180,240 and 330 min after exposed to 42 ℃in an environment cabinet were observed.The results were as follows:(1)Survival rates of all dosage group at all different exposure periods were lower than those of the control.(2)Accompanied with the increase of injec\|ted dosage of Naloxone,the survival rate increased within 240 min,whereas beyond 240 min this trend diminished.(3)The average survival times of low,medium and high dose groups were 239.35±83.99，275.00±71.40 and 299.65±46.46 min respectively.They all were lower than that of the control(317.90±45.51 min).These results suggest that no significance of Naloxone was found in prevention of heat stroke in mice and in increase of survival rate when exposed to 42℃.Q

[Objective] To analyze the effect of the inner causes and multi - climatic elements on 1000 soldiers heatstroke in their armed cross- county training. [Method] Draw a conclusion on 41 cases of heatstroke - endured soldiers in 4 days combining with climatic condition of that time. And analyzed them according to 《Diagnosis Standard And Dealing Principles Of Occupational Heatstroke》. [Result] Heatstroke usually takes place in June and July when it's hot and damp. All the 41 patients experienced a change in serum enzyme at some extent. Among the 15 seriously heatstroke - endured patients, one of them died from serious acute renal failure. [Conclusion] soldiers' childhood diseases, psychological elements and individual heat adapting ability are main internal causes, while climatic elements are external causes shouldn't be ignored. To strengthen the function of emergency treatment system is an important measure to release, reduce and prevent heatstroke.

由于温室效应的存在和人体热耐力下降，中暑仍是夏季急诊中的主要疾病之一。特别是每年6～7月份正是长江中下游地区高温、湿热季节，35 ℃以上气温常持续数周，士兵武装越野跑训练及考核常在此期间进行，中暑常有发生。我们分析了1996～1999年4年期间急诊的41位不同程度中暑患者的发病情况，并提出防范措施。 一、对象与方法 1.调查对象：41名患者均为男性，年龄18～21岁，入伍6～24个月，大多数士兵经过有计划、长期的训练。41位中来自基层中队35名，卫生员2名，文秘4名。根据入伍前健康资料均为无心、脑、肾、肝、肺等疾病的健康者。 2.调查方法：考核前1周内无发热、腹泻、心律不齐等急性疾病。考前1个月经常进行5 km武装越野训练。考核时组织医护人员赴现场，一旦发现中暑立即现场施救，并尽快送医院确诊。对41名中暑患者的诊断，均符合我国《职业性中暑诊断标准及处理原则》(GB 11508-89)［1］，并进一步分为：(1)轻症中暑26名；(2)重症中暑15名(包括热射病、热痉挛和热衰竭3型)。

时钟已指向9点,窗外艳阳高照.老黄平时都要去公园溜达溜达,现在无论如何也该到起床的时间了.女儿一边敲门一边生气地说:"不是叫您把早晨饮酒的毛病戒掉吗?医生再三叮嘱空腹饮酒伤胃伤脾."话音刚落,只听见房间内扑嗵一声,像是有人跌倒在地.推门一看,老黄已神志不清,直挺挺地躺在地上,两眼紧闭,脸色灰白,全身颤抖,烦躁不安.左邻右舍闻讯赶来,很快把老黄送到附近医院的急诊室.经过医生的抢救治疗,老黄的病情得到有效控制,人也清醒了.但是,一大堆病名却出现在病历上,什么严重贫血、脑萎缩、肝硬化早期、糜烂性胃炎,等等.尤其让女儿揪心的是,父亲还伴有严重精神障碍.

Objective To explore the titer of antibodies against main heat stress or heat shock proteins (HSPs) in young heat-stroke population and the possibility of these antibodies as a biomarker of susceptibility to heat-stroke. Methods Western blot-ELISA was applied to detect the titer of antibodies against HSP60,HSP70,HSP90α and HSP90β in young heat-stroke population and control groups. Results The positive rates of antibodies against HSP60, HSP70, HSP90α and HSP90β in young heat-stroke population were 28.6 %, 64.3 %, 54.7 % and 28.6% respectively, while in the control groups they were 13.3% ,33.3% ,23.3% and 13.3% respectively. Compared with control, the positive rates of antibodies to HSP60 and HSP901β had an increasing tendency ( P > 0.05), and the rates of antibodies to HSP70 and HSP90a increased significantly ( P < 0.05 ). High titer of antibody against HSP70( 1: 80) appeared only in heat-stroke groups. Conclusion Amibodies to HSP70 and HSP90α playedsome certain role in the course of heat stoke happening and antibody against HSP70 may bo used as a biomarker ofsusceptibility to heat stroke.

Objective To explore the level of HSP70 and HSP70 antibody in heat stroke patients and their possible roles in heat stroke. Methods HSP70 level was determined by Western dot blotting,and HSP70 Ab dilution was measured by enzyme immunosorbent assay. Results The level of HSP70 was 4 211.2± 1 286.2(AS) in the heat illness group,4 137.8±1 207.5(AS) in the severe heat illness group,and 6 043.5±1 354.8(AS) in the control group.Compared with the control,the level of HSP70 decreased significantly in heat illness group and severe heat illness group( P 0.05).The HSP70 Ab positive rates in 1∶10,1∶20,1∶40 were 54.1%,48.9% and 21.6% respectively in heat illness group,but in the control group,they were 26.7%,13.8% and 0%.There were significant difference between these two groups ( P 0.05). Conclusion The decrease of the HSP70 level and the appearance of HSP70 antibody might play important role in the process of heat illness.