检索结果-南通市图书馆

Establishment of a Rat Model of Capillary Leakage Syndrome Induced by Cardiopulmonary resuscitation After Cardiac Arrest

在线全文

学校读者我要写书评

暂无评论

当代医学科学(英文) 2023年第4期43卷 708-715页

作者： Xiao-lei ZHANG Ye CHENG Chun-lin XING Jia-yun YING Xue YANG Xiao-di CAI Guo-ping LU Department of Pediatric Emergency Medicine and Critical Care Medicine Children's Hospital of Fudan UniversityShanghai 201102China Department of Pediatric Critical Care Medicine Children's Hospital of Chongqing Medical UniversityChongqing 400014China

Objective:Cardiopulmonary resuscitation(CPR)after cardiac arrest(CA)is one of the main causes of capillary leakage syndrome(CLS).This study aimed to establish a stable CLS model following the CA and Cardiopulmonary resuscitation(CA-CPR)model in Sprague-Dawley(SD)rats.Methods:We conducted a prospective,randomized,animal model study.All adult male SD rats were randomly divided into a normal group(group N),a sham operation group(group S),and a Cardiopulmonary resuscitation group(group T).The SD rats of the three groups were all inserted with 24-G needles through their left femoral arteries and right femoral veins.In group S and group T,the endotracheal tube was intubated.In group T,CA induced by asphyxia(AACA)was caused by vecuronium bromide with the endotracheal tube obstructed for 8 min,and the rats were resuscitated with manual chest compression and mechanical ventilation.Preresuscitation and postresuscitation measurements,including basic vital signs(BVS),blood gas analysis(BG),routine complete blood count(CBC),wet-to-dry ratio of tissues(W/D),and the HE staining results after 6 h were evaluated.Results:In group T,the success rate of the CA-CPR model was 60%(18/30),and CLS occurred in 26.6%(8/30)of the rats.There were no significant differences in the baseline characteristics,including BVS,BG,and CBC,among the three groups(P>0.05).Compared with pre-asphyxia,there were significant differences in BVS,CBC,and BG,including temperature,oxygen saturation(SpO_(2)),mean arterial pressure(MAP),central venous pressure(CVP),white blood cell count(WBC),hemoglobin,hematocrit,pH,pCO_(2),pO_(2),SO_(2),lactate(Lac),base excess(BE),and Na+(P<0.05)after the return of spontaneous circulation(ROSC)in group T.At 6 h after ROSC in group T and at 6 h after surgery in groups N and S,there were significant differences in temperature,heart rate(HR),respiratory rate(RR),SpO_(2),MAP,CVP,WBC,pH,pCO_(2),Na+,and K+among the three groups(P<0.05).Compared with the other two groups,the rats in group T showed a significantly increased W/D weight r

关键词： cardiac arrest Cardiopulmonary resuscitation capillary leakage model

Cardiac arrest, stony heart, and Cardiopulmonary resuscitation: An updated revisit

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Cardiology 2024年第3期16卷 126-136页

作者： Ayman El-Menyar Bianca M Wahlen Department of Trauma and Vascular Surgery Clinical ResearchHamad Medical CorporationDoha 3050Qatar Department of Clinical Medicine Weill Cornell Medical CollegeDoha 24144Qatar Department of Anesthesiology Hamad Medical CorporationDoha 3050Qatar

The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Major manifestations may include but are not limited to,persistent precipitating pathology,systemic ischemia/reperfusion response,post-cardiac arrest brain injury,and finally,post-cardiac arrest myocardial dysfunction(PAMD)after successful resuscitation.Why do some patients initially survive successful resuscitation,and others do not?Also,why does the myocardium response vary after resuscitation?These ques-tions have kept scientists busy for several decades since the first successful resuscitation was described.By modifying the conventional modalities of resu-scitation together with new promising agents,rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal,stony heart.Community awareness and staff education are crucial for shortening the resuscitation time and improving short-and long-term outcomes.Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes.This review extensively addresses the underlying pathophysiology,management,and outcomes of post-resuscitation syndrome.The pattern,management,and outcome of PAMD and post-cardiac arrest shock are different based on many factors,including in-hospital cardiac arrest vs out-of-hospital cardiac arrest(OHCA),witnessed vs unwitnessed cardiac arrest,the underlying cause of arrest,the duration,and protocol used for CPR.Although restoring spontaneous circulation is a vital sign,it should not be the end of the game or lone primary outcome;it calls for better understanding and aggressive multi-disciplinary interventions and care.The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.

关键词： Cardiac arrest Out-of-hospital cardiac arrest In-hospital cardiac arrest Post-resuscitation Myocardial dysfunction Cardiopulmonary resuscitation Stony heart

Carbon monoxide-releasing molecule-2 protects intestinal mucosal barrier function by reducing epithelial tight-junction damage in rats undergoing Cardiopulmonary resuscitation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Intensive Medicine 2022年第2期2卷 118-126页

作者： Qingsheng Niu Fang Liu Jun Zhang Xiaojun Yang Xiaohong Wang Department of Critical Care Medicine General Hospital of Ningxia Medical UniversityYinchuanNingxia Hui Autonomous Region 750004China Ningxia Medical University YinchuanNingxia Hui Autonomous Region 750004China Department of Critical Care Medicine Heze Second People’s HospitalHezeShandong 274000China

Background:Ischemia-reperfusion injury(IRI)to the small intestine is associated with the development of systemic inflammation and multiple organ failure after Cardiopulmonary resuscitation(CPR).It has been reported that exogenous carbon monoxide(CO)reduces IRI.This study aimed to assess the effects of carbon monoxide-releasing molecule-2(CORM-2)on intestinal mucosal barrier function in rats undergoing CPR.Methods:We established a rat model of asphyxiation-induced cardiac arrest(CA)and resuscitation to study intestinal IRI,and measured the serum levels of intestinal fatty acid-binding protein.Morphological changes were investigated using light and electron microscopes.The expression levels of claudin 3(CLDN3),occludin(OCLN),zonula occludens 1(ZO-1),tumor necrosis factor-alpha(TNF-α),interleukin-10(IL-10),and nuclear factor kappa B(NF-κB)p65 were detected by western blotting.Results:Compared with the sham-operated group,histological changes and transmission electron microscopy revealed severe intestinal mucosal injury in the CPR and inactive CORM-2(iCORM-2)groups.In contrast,CORM-2 alleviated intestinal IRI.CORM-2,unlike iCORM-2,markedly decreased the Chiu’s scores(2.38±0.38 vs.4.59±0.34;P<0.05)and serum intestinal fatty acid-binding protein level(306.10±19.22 vs.585.64±119.84 pg/mL;P<0.05)compared with the CPR group.In addition,CORM-2 upregulated the expres-sion levels of tight junction proteins(CLDN3,OCLN,and ZO-1)(P<0.05)and downregulated those of IL-10,TNF-α,and NF-кB p65(P<0.05)in the ileum tissue of rats that received CPR.Conclusions:CORM-2 prevented intestinal mucosal damage as a result of IRI during CPR.The underlying protective mechanism was associated with inhibition of ischemia-reperfusion-induced changes in intestinal epithelial permeability and inflammation in intestinal tissue.

关键词： Carbon monoxide-releasing molecule-2 Cardiopulmonary resuscitation Intestinal mucosal barrier Tight junction Inflammation

Mitochondrial Autophagy and NLRP3 Inflammasome in Pulmonary Tissues from Severe Combined Immunodeficient Mice after Cardiac Arrest and Cardiopulmonary resuscitation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Medical Journal 2018年第10期131卷 1174-1184页

作者： Jing-Jun Lyu Jawahar L Mehta Yi Li Lu Ye Sheng-Nan Sun Hong-Shuang Sun Jia-Chang Li Dong-Mei Zhang Jie Wei Department of Emergency Renmin Hospital o1 Wuhan University Wuhan Hubei 430060 China Department of Medicine Central Arkansas Veterans Healthcare System University of Arkansas for Medical Sciences Little Rock AR 72205 USA Department of Emergency Peking Union Medical College Hospital Beijing 100032 China

Background：The incidence of cancer,diabetes,and autoimmune diseases has been increasing.Furthermore,there are more and more patients with solid organ transplants.The survival rate of these immunocompromised individuals is extremely low when they are severely hit-on.In this study,we established cardiac arrest Cardiopulmonary resuscitation （CPR） model in severe combined immunodeficient （SCID） mice,analyzed the expression and activation of mitochondrial autophagy and NLRP3 inflammasome/caspase-1,and explored mitochondrial repair and inflammatory injury in immunodeficiency individual during systemic ischemia-reperfusion injury.Methods：A potassium chloride-induced cardiac arrest model was established in C57BL/6 and nonobese diabetic/SCID （NOD/SCID） mice.One hundred male C57BL/6 mice and 100 male NOD/SCID mice were randomly divided into five groups （control,2 h post-CPR,12 h post-CPR,24 h post-CPR,and 48 h post-CPR）.A temporal dynamic view of alveolar epithelial cells,macrophages,and neutrophils from bronchoalveolar lavage fluid （BALF） was obtained using Giemsa staining.Spatial characterization ofphenotypic analysis of macrophages in the lung interstitial tissue was analyzed by flow cytometry.The morphological changes ofmitochondria 48 h after CPR were studied by transmission electron microscopy and quantified according to the Flameng grading system.Western blotting analysis was used to detect the expression and activation of the markers of mitochondrial autophagy,NLRP3 inflammasome,and caspase-1.Results：（1） In NOD/SCID mice,macrophages were disintegrated in BALF,and many alveolar epithelial cells were shed at 48 h after resuscitation.Compared with C57BL/6 mice,the ratio of macrophages/total cells peaked at 12 h and was significantly higher in NOD/SCID mice （31.17 ± 4.13 vs.49.69 ± 2.43,t =14.46,P =0.001）.After 24 h,the results showed a downward trend.Furthermore,a large number of macrophages were disintegrated in the BALF.（2） Mitochondrial autophagy was present in both C57BL/6 and NOD/SCID mice after CPR,but it began

关键词： Autophagy Cardiopulmonary resuscitation Immunodeficiency Macrophage Mitochondria NLRP3 Inftammasome

Functional changes in the hypothalamic-pituitary-adrenal axis after successful Cardiopulmonary resuscitation

在线全文

学校读者我要写书评

暂无评论

Emergency and Critical Care Medicine 2023年第2期3卷 46-50页

作者： Le An Zhijiang Qi Huan Shao Chunsheng Li Emergency Department of Beijing Chao-Yang Hospital Capital Medical UniversityBeijingChina

Background:Cardiac arrest(CA)is a terminal event that results in a range of pathophysiological changes in the body,most notably,systemic ischemia-reperfusion injury.The hypothalamic-pituitary-adrenal(HPA)axis is an important neuroendocrine system that modulates adrenocortical hormone release.This study was designed to investigate the changes in HPA-related hormone levels after successful Cardiopulmonary resuscitation(CPR)and to explore possible etiologies to provide a basis for relevant clinical research.Methods:We collected the clinical data of 96 patients with CA admitted to the Emergency Department of Beijing Chaoyang Hospital,Capital Medical University,between January 2016 and May 2017.Serum samples were collected 6,24,and 72 hours after restoring spontaneous circulation(ROSC).The data were compared with those of the healthy control group(n=50).An enzyme-linked immunosorbent assay(ELISA)was performed to measure copeptin,adrenocorticotropic hormone(ACTH),corticotropin-releasing hormone(CRH),and total cortisol.Demographic data were collected for both groups.For the CPR group,clinical data and the end-of-study cerebral performance category(CPC)were analyzed.Patients were followed up through day 28.Death or survival after day 28 was used as the study endpoint.Simple values were expressed as medians and quartiles or ratios(%)for statistical analysis.Continuous variables are expressed as mean±standard deviation.Categorical variables were expressed as frequencies and percentages.The mean values of normally distributed measurement data were analyzed using 1-way analysis of variance(ANOVA)for among-group comparisons and the least significant difference(LSD)test for between-group comparisons.SPSS v17(SPSS,Chicago,IL,USA)was used for statistical analysis,and P<0.05 was considered statistically significant.Results:No significant between-group differences were observed in terms of age or sex.The 28-day mortality rate in the CPR group was 71%.ACTH and CRH levels were significantly lower in the CPR group than in the healthy

关键词： Cardiac arrest Cardiopulmonary resuscitation Cerebral performance category Hypothalamic-pituitary-adrenal axis PostCardiopulmonary resuscitation syndrome

Improved Survival and Neurological Outcomes after Cardiopulmonary resuscitation in Toll-like Receptor 4-mutant Mice

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Medical Journal 2015年第19期128卷 2646-2651页

作者： Li Xu Qing Zhang Qing-Song Zhang Qian Li Ji-Yuan Han Peng Sun Department of Emergency Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China Department of Anesthesia Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China Department of Urology Liyuan HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China Department of Emergency Wuhan First HospitalWuhanHubei 430022China

Background：Toll-like receptor 4 （TLR4） is a crucial receptor in the innate immune system and noninfectious immune responses.It has been reported that TLR4 participates in the pathological course of ischemia/reperfusion （I/R） injury.However,the role of TLR4 in the process of I/R injury after cardiac arrest （CA） and Cardiopulmonary resuscitation （CPR） is still unknown.In this study,we investigated the effects of TLR4 mutation on survival and neurological outcome in a mouse model of CA/CPR.Methods：A model of potassium-induced CA was performed on TLR4-mutant mice （C3H/HeJ） and wild-type mice （C3H/HeN）.After 3 min of untreated CA,resuscitation was attempted with chest compression,ventilation,and intravenous epinephrine.Behavioral tests were performed on mice on day 3 after CPR.The morphological changes in hippocampal neurons were assessed by light and electron microscopy.Expressions of TLR4 and intercellular adhesion molecule-1 （ICAM-l） were detected by Western blot.Levels of tumor necrosis factor-α （TNF-α） and myeloperoxidase （MPO） were measured with enzyme-linked immunosorbent assay （ELISA）.Results：On day 3 after resuscitation the overall mortality was 33.33％ in C3H/HeJ group compared with 53.33％ in C3H/HeN group （P ＜ 0.05）.And there was much higher central tendency in C3H/HeJ group than C3H/HeN group during open field test （P ＜ 0.05）.Meanwhile,the percentage of nonviable neurons was 2 1.16％ in C3 H/HeJ group compared with 53.11％ in C3H/HeN group （P ＜ 0.05）.And there were significantly lower levels ofhippocampal TNF-α and MPO in C3H/HeJ mice （TNF-α：6.85±1.19 ng/mL,MPO：0.33±0.11 U/g） than C3 H/HeN mice （TNF-α：11.36±2.12 ng/mL,MPO：0.54±0.17 U/g）（all P ＜ 0.01）.CPR also significantly increased the expressions of TLR4 and ICAM-1 in C3H/HeN group.However,the expression ofICAM-l was much lower in C3H/HeJ group than in C3H/HeN group after CPR （P ＜ 0.01）.Conclusion：TLR4 signaling is involved in brain damage and in inflammation triggered by CA/CPR.

关键词： Cardiac Arrest Cardiopulmonary resuscitation Cerebral Injury Toll-like Receptor 4

A Review of Compression, Ventilation, Defibrillation, Drug Treatment, and Targeted Temperature Management in Cardiopulmonary resuscitation

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2015年第4期128卷 550-554页

作者： Jian Pan Jian-Yong Zhu Ho Sen Kee Qing Zhang Yuan-Qiang Lu Department of Emergency Medicine First Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang 310003 China School of Medicine Zhejiang University Hangzhou Zhejiang 310003 China

Objective：Important studies of Cardiopulmonary resuscitation （CPR） techniques influence the development of new guidelines.We systematically reviewed the efficacy of some important studies of CPR.Data Sources：The data analyzed in this review are mainly from articles included in PubMed and EMBAS E,published from 1964 to 2014.Study Selection：Original articles and critical reviews about CPR techniques were selected for review.Results：The survival rate after out-of-hospital cardiac arrest （OHCA） is improving.This improvement is associated with the performance of uninterrupted chest compressions and simple airway management procedures during bystander CPR.Real-time feedback devices can be used to improve the quality of CPR.The recommended dose,timing,and indications for adrenaline （epinephrine） use may change.The appropriate target temperature for targeted temperature management is still unclear.Conclusions：New studies over the past 5 years have evaluated various aspects of CPR in OHCA.Some of these studies were high-quality randomized controlled trials,which may help to improve the scientific understanding of resuscitation techniques and result in changes to CPR guidelines.

关键词： Cardiopulmonary resuscitation Defibrillation Epinephrine Ventilation

The Chinese Expert Consensus on Evaluation of Coma after Cardiopulmonary resuscitation

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2016年第17期129卷 2123-2127页

作者： Su, Ying-Ying Huang, Xu-Sheng Pan, Su-Yue Peng, Bin Jiang, Wen Capital Med Univ Xuanwu Hosp Dept Neurointens Care Unit Beijing 100053 Peoples R China Chinese Peoples Liberat Army Gen Hosp Dept Neurol Beijing 100853 Peoples R China Southern Med Univ Nanfang Hosp Dept Neurol Guangzhou Guangdong Peoples R China Chinese Acad Med Sci Peking Union Med Coll Hosp Dept Neurol Beijing Peoples R China Peking Union Med Coll Beijing Peoples R China Fourth Mil Med Univ Xijing Hosp Dept Neurol Xian Peoples R China

INTRODUCTIONThe prognosis of patients who suffer from coma after Cardiopulmonary resuscitation （CPR） may be poor （defined as cerebral performance categories scores from 3 to 5） Thus, an accurate prediction of their neurological outcomes is an essential component of post-cardiac arrest evaluation, especially for decisions to limit or withdraw life-sustaining care. Since the 1960s, a series of domestic and foreign studies began to focus on the evaluation of coma patients after CPR, and considerable progress has been achieved in this field.

关键词： Cardiopulmonary resuscitation Coma Consensus Electrophysiological Examination Neuroimaging Neurological Biomarkers Clinical Examination

Vagus nerve stimulation protects against cerebral injury after Cardiopulmonary resuscitation by inhibiting inflammation through the TLR4/NF-κB and α7nAChR/JAK2 signaling pathways

在线全文

学校读者我要写书评

暂无评论

World Journal of Emergency Medicine 2023年第6期14卷 462-470页

作者： Shuang Xu Lang Guo Weijing Shao Licai Liang Tingting Shu Yuhan Zhang He Huang Guangqi Guo Qing Zhang Peng Sun Department of Emergency Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Department of Urology the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 51000China Department of Emergency Medicine the Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China Department of Intensive Care Unit Wuhan Hospital of Traditional Chinese MedicineWuhan 430000China Department of Intensive Care Unit Xiangyang Central HospitalAffiliated Hospital of Hubei University of Arts and ScienceXiangyang 441021China Department of Emergency General Hospital of Central Theatre Command of the Chinese People's Liberation ArmyWuhan 430070China Department of Anesthesiology Union HospitalTongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022China

BACKGROUND: Our previous research proved that vagus nerve stimulation(VNS) improved the neurological outcome after Cardiopulmonary resuscitation(CPR) by activating α7 nicotinic acetylcholine receptor(α7nAChR) in a rat model, but the underlying mechanism of VNS in neuroprotection after CPR remains unclear.METHODS: In vivo, we established a mouse model of cardiac arrest(CA)/CPR to observe the survival rate, and the changes in inflammatory factors and brain tissue after VNS treatment. In vitro, we examined the effects of α7nAChR agonist on ischemia/reperfusion(I/R)-induced inflammation in BV2 cells under oxygen-glucose deprivation/reoxygenation(OGD/R) conditions. We observed the changes in cell survival rate, the levels of inflammatory factors, and the expressions of α7nAChR/Janus kinase 2(JAK2) and toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB).RESULTS: In vivo, VNS preconditioning enhanced functional recovery, improved the survival rate, and reduced hippocampal CA1 cell damage, and the levels of inflammatory mediators after CA/CPR. The application of α7nAChR agonists provided similar effects against cerebral injury after the return of spontaneous circulation(ROSC), while α7nAChR antagonists reversed these neuroprotective impacts. The in vitro results mostly matched the findings in vivo. OGD/R increased the expression of tumor necrosis factor-alpha(TNF-α), TLR4 and NF-κB p65. When nicotine was added to the OGD/R model, the expression of TLR4, NF-κB p65, and TNF-α decreased, while the phosphorylation of JAK2 increased, which was prevented by preconditioning with α7nAChR or JAK2 antagonists.CONCLUSION: The neuroprotective effect of VNS correlated with the activation of α7nAChR. VNS may alleviate cerebral IR injury by inhibiting TLR4/NF-κB and activating the α7nAChR/JAK2 signaling pathway.

关键词： Cardiopulmonary resuscitation Vagus nerve stimulation Inflammation Toll-like receptor 4 α7 nicotinic acetylcholine receptor