休克

Shock comlicated by alkalosis has not been uncommon,especially during the early stage of shock.

休克合并碱中毒在临床并不少见，尤在休克早期较易发生，如未及时识别和纠正，将给休克的治疗增添困难。

objective to raise the level of regarding congnition,prevention,diagnosis and therapy on multiple organ dysfunction syndrome.methods report the process and correlative therapy on one case who occured with mods involving 6 organs after hemorrhagic shock lead to heartbeat and respiration stopping suddenly and resuscitated resulting in left nephrostome titanium nip falled off accidentally from left kidney lymphatic fastening.at the same time,the author reviewed correlative literature and introduce the investigative progress about mods.results one case who happened with mods following hemorrhagic shock,heartbeat and respiration stopped suddenly was diagnozed and resuscitaed.6 organ dysfuncted including brain,heart,lung,liver,kidney and the digestive system.after being given therapy integrated chinese and western medicines,allopathy and nutritional treatment,all circadian parameters of the case came back in gear and discharged at last.conclusion the mechanism about mods is very complicated.because of serious infection,hurt and oxygen-lack,excessive inflammatery reaction activates multifarious cell factors and inflammatery mediums,which improve the happen-rate of mods.wiping off pathogeny,providing life-sustain treatment and recognising sirs and mods in time and adopting corresponding therapy,such as treatment integrated chinese and western medicines,can improve the hit-rate of cure on mods.

作者：王静恩，蔡金芳，王志华，谢晓洪多器官功能障碍综合征；中西医结合；治疗；休克，出血性目的提高对多器官功能障碍综合征（multiple organ dysfunction syndrome，mods）的认识、预防、诊断、治疗水平。方法报告成功抢救1例经腹腔镜左肾淋巴管结扎手术后左肾静脉钛夹意外脱落失血性休克，导致心跳呼吸骤停复苏后再手术并发mods累及6个脏器功能衰竭过程及有关治疗，并复习相关文献，介绍目前关于mods的研究进展。结果确诊1例因失血性休克心跳呼吸骤停复苏后并发mods，累及脑、心、肺、肝、肾、血液、胃肠等6个脏器。经积极采取中西医结合对症、支持救治，各生理指标全部恢复正常，康复出院。结论 mods的发生机制非常复杂，在严重感染、创伤、缺氧等打击下，失控的过度炎症反应激活多种细胞因子和炎症介质的释放，使mods发生率升高。尽早去除病因，尽早给予各种生命支持治疗，尽早对可能发生全身炎症反应综合征、mods识别并给予干预治疗，包括中西医结合治疗能改善mods的救治成功率。

In the early treatment stage of severe traumatic brain injury complicated with shock,HTS could effectively reduce ICP,improve blood perfusion of organs as comparied with MTS,the effects of which is quicker,safer and lasting.HTS could improve dynamic index of circulation caused by hemorrhagic shock,and correct relative pathophysiologic changes caused by shock.

HTS在重型颅脑外伤合并休克早期治疗中能有效降低ICP，改善器官血流灌注，且与甘露醇相比，起效更快，更持久和更安全，同时能改善失血性休克发生时的血流动力学指标和纠正休克引起的相应病理生理改变。

Decreasing the gravidity and the times of curettage、avoiding delivery out of hospital and better supervision of antenatal care in the community studied are recommended to reduce obstetric hemorrhagic shock cases.

结果：产科失血性休克的发生率为0.65%，胎盘因素是失血性休克的主要原因；主要的危险因素是多次妊娠和流产、院外分娩及重度子痫前期。产科失血性休克导致的子宫切除率为17.6%。

The present research elaborates an appropriate condition for production of allotriploid zebrafish by using heat shock with the retention of the second polar body.

本研究分析了热休克处理的参数与三倍体出现率和胚胎相对存活率的关系，并得出诱导参数中起始休克时间为重要因素，其次为持续时间和休克温度。

Now the mechanism of action of heat shock protein is not quite sure to us.Understanding the biological function and its transplantation immunity of HSP will be helpful in investigating the relationship of HSP and graft ischemical reperfusion injury,graft rejection,HSP gene transfer,cardiac graft vascular disease.

目前，还不能确定热休克蛋白在上述反应过程中的直接作用的机制，了解热休克蛋白的生物学功能及其在移植免疫中的作用，有助于进行热休克蛋白与缺血/再灌注、移植排斥反应，以及热休克蛋白转基因治疗移植物血管病关系的研究。

The best proteotive effect asainst traumatic shock was observed in AG Ⅱ Stoup, In spite of obvious decrease of plasma NO level after resusoitation,L-NAME exhibited little efficacy In allevlating the tissue damages in the orsans and hence failed to improve the surviat rate of rats.

NO在创伤性休克的病理发展过程中起着重要作用，应用AG有助于创伤性休克的改善；L-NAME能降低NO的水平，但对休克的预后无明显改善。

Hydrocortisone is widely used in patients with septic shock even though a survival benefit has been reported only in patients who remained hypotensive after fluid and vasopressor resuscitation and whose plasma cortisol levels did not rise appropriately after the administration of corticotropin.

1月10日《新英格兰医学杂志》报道，Hadassah希伯来大学医学中心等地的研究人员证实，无论是对所有的脓毒性休克患者还是只针对那些对促肾上腺皮质激素无反应的患者，氢化可的松都不能改善生存率或逆转休克症状；但是，对于已经逆转了休克进程的患者来说，氢化可的松可以加快休克的恢复。

GA had no effect on SMA constriction induced by NE. The reactivity of SMA rings to myricetin was increased at 0, 0.5, 1 hour and 2 hours after shock, and it reached the peak at 2 hours, then it significantly decreased at 3 hours and 4 hours after shock.

结果 SMA血管环对NE的反应性表现为：休克0 h和0.5 h组明显高于正常对照组和其他休克时间点组，休克1 h和2 h组明显低于正常对照组和休克0 h和0.5 h组；18α-GA对NE诱导的SMA血管环收缩反应性无明显影响。

GA antagonized SMA constriction induced by myricetin. The antagonizing effect on myricetin in shock 1, 2 and 3 hours groups was more obvious than that in the other groups. CONCLUSION :At the early stage after hemorrhagic shock, the endothelium-dependent and independent vascular contractile response show a compensatory increase.

SMA血管环对杨梅黄酮的反应主要表现为：休克0、0.5、1和2 h组明显高于正常对照组，于休克2 h达最高点；休克3 h和4 h组明显低于正常对照组，运用18α-GA阻断MEGJ后，各组血管环的收缩反应性较18α-GA作用前明显下降，其中以休克1、2和3 h组下降幅度明显大于其他组。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。