使休克

One hand mechanical obstruct led to the increase of veinous resistance and the obstacle of microcirculation, the other hand the adhesive PMN was activated in excess, the white blood cells released a lot of enzymes, in which PMN-elastase can decompose the components of cell and many albumens, inclusive of immunoglobulin、alexin and fibrication. These components induced the injury of the pancreatic capillary vessels and cell and lysosome enzy made the tissue protein hydrolyze and produced unsaturated fatty acids, which destroyed the structure and function of cellar membrane. The inflammatory cellar factors activate other immunocytes to produce the injury and necrosis of tissue, which aggravated the pathological injury and led to shock、pyaemia and MODS. So ICAM-1 and LFA-1 played an important role in SAP. Frossard found that the expression of ICAM-1 in the rat model, especially in serum、pancreas and lung. All these showed ICAM-1 is an important factor in AP and concomitant lung injury.

胰腺小叶组织局部血管EC首先被激活，ICAM-1表达升高，与被激活的PMN表面表达的LFA-1相结合，"PMN-EC"相互作用加剧，一方面机械性阻塞毛细血管导致静脉阻力增加、微循环障碍；另一方面粘附的PMN过度吞噬或激活，当白细胞吞噬的颗粒不能被封闭隔离，连同细胞内的酶被释放出来，其中的PMN-elastase能够降解细胞基质中各种成分，水解多种蛋白，加重胰腺的毛细血管内皮细胞和腺泡的损伤；释放的溶酶体酶使组织蛋白水解，产生的不饱和脂肪酸引发脂质过氧化方应，破坏细胞膜的结构和功能；释放的炎性细胞因子，激发其他的免疫细胞的功能，导致进一步的组织损伤和坏死，加重SAP的病理损伤，最终导致休克、脓毒血症及多器官功能障碍等严重后果。

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。

It should improve both our comprehension of coagulation abnormalities in sepsis and how those abnormalities link up to inflammation, but it may also add to the therapeutic armamentarium with which sepsis, severe sepsis, and septic shock can be more successfully treated.

它将使我们能够更加深入的理解脓毒症时的凝集异常以及这些异常同炎症反应的关系，同时，此观点融入也将使脓毒症、严重脓毒症和脓毒性休克的治疗获得更大成功。

Sanchez ET ,Botella LM ,Velasco B ,et al. Synergistic cooperation between hypoxia and transforming growth factor2beta pathways on humanvascular endothelial growth factor gene expression. J Biol Chem ,2001,19,276:38527238535.[3] Blancher C,Moore JW,Talks kl,et al.Relationship of hyposia-inducible factor HIF-1alpha expression to vascular endothelial growth factor I nduction and hypoxia survival in human breast cancer cell lines.

肝细胞癌中缺氧诱导因子-1α、热休克蛋白70的表达】；综上所述，肝细胞癌发生后，由于血供不足诱导HIF-1α过度表达，应激状态下产生的HSP70通过减轻缺血性损伤，增加毛细血管的生成及减轻细胞凋亡等途径使肿瘤细胞的增殖、移行加快，促进恶性肿瘤的生长、浸润和转移，使肿瘤细胞在适应缺氧、能量代谢、细胞凋亡及转移中起重要作用。

In addition, excessive collarband oppression of the neck carotid sinus in pressure sensors, neural reflex, causing blood pressure and heart slows down, the brain occurs vbi, headache and dizziness, nausea, eye emit a beautiful wait for a phenomenon, especially with hypertension, atherosclerosis, coronary heart disease, diabetes, very easy occurrence faints and shock.

另外，过紧的领口压迫了颈部的颈动脉窦中压力感受器，通过神经反射，引起血压下降和心跳减慢，使脑部发生供血不足，出现头痛、头晕、恶心、眼冒金花等现象，尤其是患有高血压、动脉硬化、冠心病、糖尿病的人，很容易发生晕倒和休克。

An early event in a cellular heat shock response is the transmittance of stress signal from cell surface into the interior and the...

在细胞应答热休克过程中最早期的事件是将胁迫信号从细胞表面传至细胞内，从而诱导热休克蛋白的合成使细胞产生对热的耐受性。

The dose-response curve of histamine was shifted parallely to the right. pA2 was 9.34±0.61. The guinea-pigs were effectively reduced the rate of histamine induced death, decreased reaction extent of shock (P＜0.01) and prolonged latency period of shock (P＜0.05) by orally administered cetirizine ranged from 0.1, 0.2 and 0.4 mg.kg-1. The capillary permeability to intracutaneous injection of histamine was potently inhibited by orally administered cetirizine ranged from 0.0625 to 0.25 mg.kg-1 in mice, blue area obviously decreased (P＜0.01), and dose-response curve existed obviously. In which the effect of these dosage groups were superior to the group of chlorphenamine.

结果：西替利嗪3×10-8～3×10-7mol.L-1可剂量依赖性地对抗组胺引起的肠肌收缩，使组胺的量效曲线平行右移，pA2为9.34 ± s 0.61，西替利嗪0.1，0.2及0.4 mg.kg-1口服给药时，能明显减轻豚鼠静脉注射组胺所致休克反应的严重程度(P＜0.01)，并可延长豚鼠惊厥反应的潜伏期及降低死亡率(P＜0.05)，西替利嗪0.0625～0.25 mg.kg-1口服给药可显著对抗组胺引起的小鼠皮肤血管通透性的增高，使蓝染面积显著缩小(P＜0.01)，且存在明显的量效关系，3个剂量组的作用均优于氯苯那敏组。

Only a properly matched antenna system will allow maximum power transfer from the 50 transmission line to the radiating element.

只有一个匹配合适的天线系统才能在发射时使能量充分辐射出去。感染性休克的真正治疗在于预防。

Arrhythmias are detected by electrocardiography and treated by electric shock (often with an implanted pacemaker) or by drugs such as quinidine and digitalis.

用心电描记法可侦测到心律失常现象，可使用电休克或服用奎尼丁或洋地黄等药物来治疗。

Arrhythmias are detected by electrocardiography and treated by electric shock (often with an implant ed pacemaker) or by drugs such as quinidine and digitalis.

用心电描记法可侦测到心律失常现象，可使用电休克或服用奎尼丁或洋地黄等药物来治疗。

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。