Objective To explore the clinical value of intra-arterial thrombolytic therapy for hepatic artery thrombosis after liver transplantation. Methods Routine color doppler imaging (CDI) was used to detect hepatic artery thrombosis (HAT) after liver transplantation in 160 cases. Suspected patients were further confirmed by immediate angiography. Four cases of HAT were diagnosed and treated by intra-arterial thrombolysis. Two cases received repeatable transcatheter hepatic arterial thrombolysis with a low dose of urokinase. Results Hepatic artery recanalization was achieved in 3 cases. Among the 3 cases, multiple HAT occurred in 1 case, intra-arterial thrombolysis was successfully completed in the end. Two cases had intra-abdominal hemorrhage, which was cured by conservative treatment. One case received retransplantation because of interventional thrombolysis failure and intra-abdominal hemorrhage. Conclusion Intra-arterial thrombolytic therapy may be a promising method in the treatment of HAT. Transcatheter hepatic arterial thrombolysis shows a significant result.

Objective To investigate the effect of Emodin on intracellular calcium concentration ([Ca~(2+)]i) and apoptosis of hepatic cells after simulated cold ischemia-reperfusion. Methods Glucose-oxygen deprivation, low temperature, subsequent reoxygenation and rewarming were used to induce ischemia-reperfusion injury model in cultured hepatic cells which were divided into 4 groups: control group and Emodin-treated group(100, 10 and apoptosis rate were determined by flow cytometry (FCM) respectively; the content of lactate dehydrogenase (LDH) in supernatant was tested. Results Intracellular calcium fluorescence intensity in Emodin-treated groups of high, medium and low density was 24.12±0.51, 26.35±1.34 and 39.12±1.94, respectively, which were significantly lower than 105.29±1.01 in control group(P<0.01). Apoptosis rate in Emodin-treated groups of high, (179.67±18.57)u/L in Emodin-treated groups of medium and high density respectively, which were significantly lower than (351.33±34.16)u/L in control group(P<0.01). Conclusion Emodin could reduce [Ca~(2+)]i and inhibit apoptosis of hepatic cells after simulated cold ischemia-reperfusion, thus protecting hepatic cells effectively.

AIM: To observe the effects of porous polyethylene ( Medpor) as a spacer graft in the reconstruction of large areas eyelid defect after the operation of malignant tumors of lower eyelids.
METHODS: Nineteen cases ( 19 eyes ) of malignant tumors of lower eyelid underwent the eyelid reconstruction were selected. Medpor lower eyelid inserts implantation were used to replace tarsal joint sliding conjunctival flap and pedicle flap, and repaired full -thickness lower eyelid defects then underwent eyelid reconstruction.
RESULTS: Appearance of eyelids and functional improvements were satisfactory with no stimulation on the eyeball and no effect on the visual function. Implants is with no absorption, shift, exclusion or infection and no tumor recurrence in all cases during the follow up for 6-36mo.
CONCLUSION: Medpor lower eyelid inserts implantation can instead tarsal plate for the reconstruction of medium to large areas lower eyelid defect, which is easy performing with rare complications. It is an ideal alternatives of tarsal plate.

Objective To report the combined Aspergillus and Mucor infections in surgical site after orthotopic liver transplantation. Methods We retrospectively analyzed clinical data of two liver transplantation recipients suffering from postoperative combined Aspergillus and Mucor infections and evaluate the symptoms, diagnosis and treatment. Results In the first patient the graft arteries suddenly ruptured on the 8th day postop caused by Aspergillus and Mucor infection failing an emergency surgical rescue. The patient eventually died of multiple organ failure. In the second recipient deep surgical site infection was diagnosed on the 10th day postop. Combination infection of Aspergillus and Mucor was identified by pathology. Despite of aggressive anti-fungal treatment and support, the general condition continued to deteriorate and the patient eventually died of systemic severe infection and respiratory failure. Conclusion Combined Aspergillus and Mucor infections in operative location is a rare complication of liver transplantation, which was usually occult in onset, and the prognosis is poor.

Hypoxia-induced 15-hydroxyeicosatetraenoic acid (15-HETE) is an essential mediator to constrict pulmonary arteries (PA). The signaling pathway involved in 15-HETE-induced PA vasoconstriction remains obscure. The aim of the present study was to test the hypothesis that hypoxic PA constriction induced by 15-HETE was possibly regulated by the extracellular signal-regulated kinase-1/2 (ERK1/2) pathway. PA ring tension measurement, Western blot and immunocytochemistry were used in the study to determine the possible role of ERK1/2 in 15-HETE-induced PA vasoconstriction. The organ bath for PA rings tension study was employed. Adult male Wistar rats were raised in hypoxic environment with fractional inspired oxygen (FIO2, 0.12) for 9 d. PA 1~1.5 mm in diameter were dissected and cut into 3 mm long rings for tension study. ERK1/2 up-stream kinase (MEK) inhibitor PD98059, which blocks the activation of ERK1/2, was used. The results showed that pretreatment of PD98059 significantly blunted 15-HETE-induced PA vasoconstrictions in the rings from hypoxic rat. Moreover, in endothelium-denuded rings, PD98059 also significantly attenuated 15-HETE-induced vasoconstriction. Phosphorylation of ERK1/2 in pulmonary arterial smooth muscle cells (PASMCs) of rat was enhanced evidently when stimulated by 15-HETE. Thus, the data suggest that ERK1/2 signaling pathway is involved in 15-HETE-induced hypoxic pulmonary vasoconstriction.
Animals ; Flavonoids ; pharmacology ; Hydroxyeicosatetraenoic Acids ; antagonists & inhibitors ; pharmacology ; Hypoxia ; physiopathology ; MAP Kinase Signaling System ; physiology ; Male ; Muscle, Smooth, Vascular ; cytology ; Myocytes, Smooth Muscle ; drug effects ; Pulmonary Artery ; cytology ; drug effects ; physiopathology ; Rats ; Rats, Wistar ; Vasoconstriction ; drug effects

15-hydroxyeicosatetraenoic acid (15-HETE) plays an important role in hypoxia-induced pulmonary vasoconstriction. Release of nitric oxide (NO) is apparently decreased and activity of endothelial nitric oxide synthase (eNOS) is impaired in chronic hypoxia. However, little is known whether 15-HETE contributes to eNOS/NO pathway in the constriction induced by 15-HETE. We examined the response of rat pulmonary artery (PA) rings to 15-HETE, the production of NO, total eNOS expression and the phosphorylation of eNOS in bovine pulmonary artery endothelial cells (BPAECs) stimulated by 15-HETE. Rat PA rings were divided into three groups: endothelium intact group, endothelium denuded group, and nitro-L-arginine methyl ester (L-NAME, 0.1 mmol/L, an inhibitor of eNOS) group. Constrictions to 15-HETE were significantly enhanced in endothelium denuded group and L-NAME group (both P< 0.05 vs endothelium intact group, n= 9); BPAECs were incubated in different conditions to test nitrite production by Greiss method. Nitrite production was significantly reduced by 1 mumol/L 15-HETE (P<0.05), and increased by the lipoxygenase inhibitors, 10 mumol/L cinnamyl 3,4- dihydroxy-[alpha] -cyanocinnamate (CDC, P< 0.05) and 0.1 mmol/L nordihydroguiairetic acid (NDGA, P< 0.01 ); Western blot analysis of extracts from BPAECs incubated with 15-HETE in different time was carried out to test total eNOS expression, and the expression was changed unobviously. Immunoprecipitation (IP) and Western blot analysis of cell extracts from BPAECs treated with 2 mumol/L 15-HETE in different length of time were accomplished, using phospo-eNOS-threonine 495 (Thr495, an inhibitory site) antibody for IP, and eNOS or 15-lipoxygenase (15-LO) antibodies for Western blot. 15-HETE depressed eNOS activity by increasing the levels of phospho-eNOS-Thr 495. The data suggest that eNOS/NO pathway is involved in PA constrictions induced by 15-HETE and that 15-HETE depresses eNOS activity by phosphorylation in Thr495 site. The protein interaction between phospho-eNOS (Thr495) and 15-LO is discovered for the first time.
Animals ; Cattle ; Down-Regulation ; drug effects ; Endothelium, Vascular ; cytology ; drug effects ; enzymology ; Hydroxyeicosatetraenoic Acids ; pharmacology ; In Vitro Techniques ; Male ; Nitric Oxide Synthase Type III ; metabolism ; Pulmonary Artery ; cytology ; enzymology ; physiology ; Rats ; Rats, Wistar

OBJECTIVETo summarize the diagnostic and therapeutic experiences of acute mesenteric venous thrombosis (MVT).

METHODSThe clinical data of 27 cases of acute MVT treated between 1983 and July 2007 were analyzed retrospectively.

RESULTSThe courses of disease were from 1 to 14 days (mean, 6.1 days). Eighteen cases (66.7%) had the history of portal hypertension, deep vein thrombosis, acute MVT or other hypercoagulability. The diagnostic sensitivity of ultrasonography, CT, angiography and serum D-Dimer level were 70.6% (12/17), 75.0% (6/8), 100% (6/6), 100% (6/6), respectively. Bowel necrosis occurred in all the 16 cases with bloody ascites. The thrombolytic and anticoagulation therapy are effective in 36.4% of cases (4/11). Twenty-two cases received operation, and resection of necrotic bowel was performed in all and thrombectomy in 3 cases. The main postoperative complications included 3 cases of deep vein thrombosis, 1 acute cardiac infarction, 3 short bowel syndrome. MVT recurred in 4 cases within a week after operation. Eight patients died within a month after confirmed with acute MVT, in which 7 patients died after operation. Anticoagulation medication was implemented in all the 19 survived patients. Fifteen patients were followed-up for 1-120 months (mean, 39.2 months), 7 of them continued the anticoagulation therapy during this period.

CONCLUSIONSThe determination of serum D-Dimer level and such adjuvant examinations as ultrasonography, CT and angiography are important diagnostic means for acute MVT. Anticoagulation and thrombolysis should be considered firstly if there is no active bleeding and bowel necrosis. We recommend laparotomy when bowel necrosis is suspected.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Mesenteric Veins ; Middle Aged ; Retrospective Studies ; Venous Thrombosis ; diagnosis ; therapy

BACKGROUNDTanis was reported as a putative receptor for serum amyloid A (SAA) involving glucose regulated protein in insulin regulated resistance. It was found to be dysregulated in diabetic rats (Psammomys obesus, Israeli sand rat) and its homologue for humans is SelS/AD-015. The present study analyzed mRNA expression of SelS in omental adipose tissue biopsies from patients with type 2 diabetes mellitus (T2DM), and age- and weight-matched nondiabetic patients, the relationship of SelS mRNA with Homa-IR and serum SAA level.

METHODSHuman omental adipose tissues from ten cases of type 2 diabetic patients and twelve cases of nondiabetic individuals were analyzed for the expression level of SelS mRNA by semiquantitative polymerase chain reaction (PCR), Homa-IR estimated by standard formula and SAA level by enzyme-linked immunosorbent assay (ELISA).

RESULTSSelS mRNA expression, Homa-IR and serum SAA were higher in T2DM sufferers than in nondiabetic control group. SelS mRNA level was positively correlated with Homa-IR and SAA level in each group.

CONCLUSIONSSelS protein may be involved in insulin resistance in Chinese with T2DM by acting as the SAA receptor, thus playing an important role in the development of T2DM and atherosclerosis.

Adipose Tissue ; metabolism ; Adult ; Aged ; Base Sequence ; Diabetes Mellitus, Type 2 ; metabolism ; Female ; Humans ; Insulin Resistance ; Male ; Membrane Proteins ; genetics ; Molecular Sequence Data ; Omentum ; metabolism ; RNA, Messenger ; analysis ; Selenoproteins ; genetics ; Serum Amyloid A Protein ; analysis

BACKGROUNDThe aim of the current study was to investigate the role of interleukin (IL)-2, interferon (IFN)-gamma, IL-4 and IL-10 in a concordant hamster-to-rat cardiac xenotransplantation model.

METHODSA hamster-to-rat cardiac transplantation was performed using SD rats as recipients of Golden Syrian hamster hearts. A total of 60 SD rats were divided into four groups and treated as follows: control group (n = 15); splenectomy group (n = 15); CsA group (n = 15); CsA + splenectomy group (n = 15). Levels of IL-2, IFN-gamma, IL-4 and IL-10 were measured by enzyme linked immunosorbent assay (ELISA). Sera were harvested at different time points in each group: day 1, and 3 as well as the day the xenograft stopped beating in the control group and CsA group; day 1, 3, 7, 14 and 30 in the splenectomy group and CsA + splenectomy group. The expression of P-selectin and intercellular adhesion molecule-1 (ICAM-1) was examined by immunohistochemical analysis of the xenograft after cardiac xenotransplantation.

RESULTSSerum levels of IL-2 and IFN-gamma were upregulated in untreated (day 3) and splenectomy-treated animals (day 7) compared to CsA + splenectomy treated animals (day 7). IL-10 was upregulated in long-term survival recipients following splenectomy + CsA. Neither P-selectin nor ICAM-1 expression was detected in long-term survival xenografts.

CONCLUSIONSSerum IL-2 and IFN-gamma were elevated following acute vascular rejection. Serum IL-10 was correlated to immunosuppression and protective effects in long-term survival rats following concordant cardiac xenotransplantation.

Acute Disease ; Animals ; Cricetinae ; Cytokines ; biosynthesis ; Graft Rejection ; prevention & control ; Graft Survival ; Heart Transplantation ; immunology ; Immunohistochemistry ; Mesocricetus ; Rats ; Transplantation, Heterologous ; immunology

OBJECTIVETo investigate the feasibility of endoscopic transnasal reconstruction of skull base defect with titanium mesh.

METHODSEight cases were selected to reconstruct their anterior skull base defects by endoscopic transnasal approach with titanium mesh between April, 2006 and January, 2007.

RESULTSPathologies of these cases included two esthesioneuroblastomas, one squamous cell carcinoma, one chondrosarcoma, one malignant fibroma, two meningiomas, and one chordoma. The defects involved anterior-medial skull base in 2 cases, anterior skull base-sellar turcica in 2 cases, and anterior skull base sellar turcica-clivus in 4 cases. All patients were followed up for 2 to 10 months after operation and were monitored with endoscopic examinations and imaging. Replacement of titanium mesh was found in one case and other seven cases were successfully reconstructed without replacement of titanium mesh.

CONCLUSIONSEndoscopic transnasal reconstruction with titanium mesh is a feasible technique for defects of the anterior skull base. This procedure is simple and safe. Result of this protocol is desirable.

Adolescent ; Adult ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Skull Base ; surgery ; Surgical Mesh ; Titanium ; Young Adult