OBJECTIVETo observe the effect of purgation and detoxification therapy on gastrointestinal dysfunction of critically ill patients undergoing abdominal surgery.

METHODSTotally 56 inpatients with severe gastrointestinal dysfunction after abdominal surgery at ICU of Guangdong Provincial Hospital of Traditional Chinese Medicine were assigned to the treatment group and the control group, 28 in each group. All patients received routine Western medical treatment. Patients in the treatment group additionally took Modified Huanglian Jiedu Decoction (MHJD) and received electroacupuncture (EA) for 7 days. The first exhaust time, defecation time, scores for gastrointestinal dysfunction, mechanical ventilation time, ICU hospitalization time, and 28-day fatality rate were observed. Furthermore, serum levels of diamine oxidase (DAO) and D-lactic acid were detected at day 1, 3, and 7 after treatment.

RESULTSThe first exhaust time and the first defecation time in the treatment group were ahead of schedule, when compared with those of the control group (P <0. 05). Scores for gastrointestinal dysfunction, mechanical ventilation time, serum levels of DAO obviously decreased in the treatment group (P <0. 05). There was no statistical difference in serum levels of D-lactic acid, ICU stay time, the incidence of pulmonary infection, and 28-day mortality between the two groups (P >0. 05). Results of Logistic analysis showed that scores for gastrointestinal dysfunction were related with the incidence of pulmonary infection (P <0. 05).

CONCLUSIONMHJD combined EA could promote the recovery of gastrointestinal function in critically ill patients after abdominal surgery via improving intestinal barrier function, which was benefit for shortening mechanical ventilation time.

Critical Illness ; Defecation ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Electroacupuncture ; Gastrointestinal Diseases ; drug therapy ; Humans ; Lactic Acid ; Medicine, Chinese Traditional

Objective To explore the shielding effect that Tween has made on the erythrocyte’ s surface antigen( ABO and D antigen mainly) and the stability of the RBC. Methods Various types red blood cells’ surface antigens were incubated with different concentrations of Tween,then the titers of RBC’ s surface antigen before and after incubation were compared. The erythrocyte’ s function alterations and sta-bility through the morphological obersavation,the osmotic fragility,RBC’ s own hemolysis rate,oxygen saturation( SO2 ) ,routine test of blood as well as the supernatant of free hemoglobin determination were confirmed. Results The masking effect of the Tween-20 on D antigen with the weaken titer keeping above“ +” was better and more stable than that on A,B antigen. The impact on B antigen was a little worse,and A was the worst. The advantaged concentration is about 0. 004%. Besides,the influence of Tween-80’s on B and D antigen was not apparent e-nough. Among all of the concentration,0. 74% and 0. 80% did a relatively better job,which also could keep the weaken titer above “ +”. Conclulsion The shielding effect that Tween has made on the erythrocyte’ s surface antigen( ABO and D antigen mainly) is stable,which keeps above “ +”. The morphology and function of the RBC does not change.

To study the anti-coagulant effect and influence of danggui Sini decoction (DSD) on rat's plasma endogenous metabolites by animal experiment and ¹H-NMR based metabolomics method. After intragastric administration of Danggui Sini Decoction for 7 days, Plasma thrombin time (TT) was measured. Rat plasma metabolic fingerprint in two groups was analyzed using ¹H-NMR, based on which the principal component analysis( PCA) and orthogonal partial least-squares discriminant analysis(OPLS-DA) models for metabonomic analysis. Potential biomarkers were screened by using variable importance in the projection (VIP) and T test. DSD could prolong TT of the rat significantly (P < 0.05). Compared with control group, six kinds of endogenous metabolites in DSD group change significantly (P < 0.05), among which isobutyrate, carnitine and phenylalanine content had an upward trend (P < 0.01) and lysine, Histidine and cholesterol content had a downward trend (P < 0.05). It is likely that carnitine, phenylalanine, Histidine and cholesterol are the potential metabolic markers in the anti-coagulant process and DSD affects the platelet aggregation and the expression of tissue factor and fiber protease by regulating the energy, amino acid and lipid metabolism.
Animals ; Anticoagulants ; chemistry ; Blood Coagulation ; drug effects ; Drugs, Chinese Herbal ; chemistry ; Female ; Male ; Metabolomics ; methods ; Proton Magnetic Resonance Spectroscopy ; methods ; Rats

OBJECTIVE: To investigate the expressions of Survivin protein and nm23 protein and the relationship among the expressions and axillary lymph node metastasis in breast cancer. METHODS: The expression of Survivin and nm23 in 80 cases of breast cancer tissues were detected by immunohistochemistry SP method, and their correlation with axillary lymph node metastasis and 5-year disease free survival (DFS) were analysed. RESULTS: Survivin protein positive expression rate was 68.75% (55/80) in breast cancer tissues, which had positive correlation with the axillary lymph nodes metastasis but negative correlation with 5 years FS (P < 0.05); nm23 protein expression had negative correlation with the axillary lymph nodes metastasis but positive to 5 years FS (P < 0.05). Survivin and nm23 proteins expression had no obvious correlation with the breast cancer pathology type, patient age and clinical stage (P > 0.05). CONCLUSION The anti-apoptosis effect of Survivin protein and the anti-metastasis effect of nm23 protein may be important in the occurrence and advancement of breast cancer, suggesting that it may be a new indicator of prognostic and judgement in breast cancer.
Adult ; Aged ; Axilla ; Biomarkers, Tumor ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Mastectomy ; Microtubule-Associated Proteins ; biosynthesis ; genetics ; Middle Aged ; NM23 Nucleoside Diphosphate Kinases ; Neoplasm Proteins ; biosynthesis ; genetics ; Nucleoside-Diphosphate Kinase ; biosynthesis ; genetics ; Prognosis ; Retrospective Studies ; Survivin

OBJECTIVETo explore the potential causes and the optimal treatments of recurrent venous ulceration of lower limbs after initial operation.

METHODSData of patients admitted between January 2000 and June 2010 for recurrent ulceration in lower limbs after previous operation were retrospectively analyzed. Altogether 81 limbs in 73 patients were recruited. There were 55 male patients (60 limbs) and 18 female patients (21 limbs). The average age was 52.6 years (ranging from 31 to 73 years). All the patients had received at least one surgery procedures before recurrence. The average time between ulceration recurrence and the last operation was 10.6 months (ranging from 5 to 37 months). Average diameter of ulcers was 3.7 cm (ranging from 1.3 to 6.5 cm). Color duplex sonography before re-treatment revealed incompetent calf perforators in 57 limbs (70.4%), primary deep vein insufficiency in 38 limbs (46.9%), post-DVT syndrome in 16 limbs (19.8%), reflux of accessory saphenous veins in 11 limbs (13.6%) and residual/re-opened great saphenous vein in 8 limbs (9.9%). Managements including stripping of great saphenous vein, ligation around the ulcer, percutanous ligation of varicose veins, valvoplasty, and adjuvant compressive therapy were adopted according to different venous abnormality.

RESULTSAll the patients were followed. All the ulcers healed and hemodynamic indexes were greatly improved 6 months after re-operation. Only 3 limbs (3.7%) suffered again from recurrence 1 year after re-operation.

CONCLUSIONSIncompetent perforators in calf, primary or secondary deep vein insufficiency and incorrectly treated saphenous veins are main causes for recurrent venous ulceration in our series. Management of residual vein abnormalities can still achieve satisfying clinical outcome.

Adult ; Aged ; Female ; Humans ; Leg ; blood supply ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Varicose Ulcer ; etiology ; surgery ; Varicose Veins ; etiology ; surgery

BACKGROUNDThe endovascular treatment of abdominal aortic aneurysm (AAA) has improved greatly in the last 15 years. The present study aimed to evaluate the endografting experience for the treatment of unfavorable abdominal aortic aneurysm (uAAA).

METHODSDuring December 2001 and December 2007, 41 patients with uAAA were treated with endografting using concomitant techniques. Patients were followed up for 1 to 48 months (mean 20.5 months).

RESULTSTechnical success rate was 97.6% (40/41) with 1 failure converted to open surgery for an unaccessed iliac stenosis. Nine (22.5%) type I endoleaks (5 proximal and 4 distal) were observed on the completion angiograms and successfully corrected with aortic cuffs and iliac extensions during the procedure. Twenty-two of the planed adjunctive procedures were concomitantly performed just before endograft-implantation. There were 2 (5.0%) type I endoleaks at 30 days; one type I patient was treated by open conversion, another type I patient died from a rupture before treatment in the ward, causing a 2.5% of initial mortality. The two type II endoleaks were observed without aneurismal expansion. No buttock or leg claudication or ischemic colitis occured. During late follow-up, one additional death occurred from stroke. One new type I endoleak was encountered from thrombocytopenia, which caused a 2.6% secondary endoleak that converted to an open surgery in the third month after a failed transabdominal banding of the aortic neck in the second month. All type II endoleaks had disappeared in the third and sixth month. The Endografts did not present signs of material fatigue and no other type of endoleak formed. One patient presented with left limb ischemia, which underwent percutaneous transluminal angioplasty. There was no additional aneurysm rupture or any endograft imgration.

CONCLUSIONThe endografting with concomitant procedures is a feasible and efficient alternative for managing unfavorable AAAs, achieving low morbidity and mortality rates and has a good clinical outcome.

Aged ; Angiography ; Aortic Aneurysm, Abdominal ; diagnosis ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Humans ; Male ; Middle Aged ; Stents ; Survival Analysis ; Treatment Outcome

OBJECTIVETo investigate the expression of RANTES in venous ulceration.

METHODSFrom patients with lower limb venous ulceration, patients with non-ulcerous venous insufficiency, and healthy individuals, peripheral blood was collected from the lower limb veins for measurement of RANTES mRNA using RT-PCR.

RESULTSIn the ulceration group, the expression of RANTES mRNA was significantly increased as compared with the other two groups (P<0.01). RANTES mRNA expression was also significant higher in the non-ulcerous group than the control group (P<0.01).

CONCLUSIONHigh expression of RANTES mRNA may be one of the important mechanisms of venous ulceration.

Adult ; Aged ; Chemokine CCL5 ; biosynthesis ; blood ; genetics ; Female ; Humans ; Male ; Middle Aged ; RNA, Messenger ; biosynthesis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Varicose Ulcer ; blood ; etiology ; Venous Insufficiency ; blood ; complications ; Young Adult

OBJECTIVETo develop a small-caliber vascular grafts and study its morphologies, mechanical properties and biocompatibility.

METHODSThe effects of electrospinning conditions on the microstructure and porosity of the resulting scaffolds were investigated for preparation of a small-caliber (4 mm) polyurethane vascular grafts with optimum microstructures and mechanical properties. The mechanical properties and biocompatibility of the prepared grafts were evaluated.

RESULTSThe polyurethane vascular grafts showed a three-dimensional reticular structure consisting of nanofibers, with an average porosity of (51.48∓4.47)% and tensile strength of 5.85 ∓ 0.62 MPa. The grafts provided a better long-term support than e-PTFE graft for endothelial cell growth and endothelialization.

CONCLUSIONThe polyurethane vascular prosthesis possessed favorable microstructures, excellent mechanical properties and good biocompatibility for potential clinical application.

Biocompatible Materials ; chemistry ; Blood Vessel Prosthesis ; Cell Adhesion ; Humans ; Materials Testing ; Mechanical Phenomena ; Polyurethanes ; chemistry ; Porosity ; Prosthesis Design ; Tensile Strength

OBJECTIVETo study the expression of a novel marker, kidney-specific-protein (Ksp)-cadherin, in renal epithelial neoplasms and its clinicopathologic significance.

METHODSImmunohistochemical study (using EnVision method) for Ksp-cadherin, CD10, vimentin, epithelial membrane antigen and CK7 was carried out in normal human kidney samples, as well as in 166 cases of primary renal neoplasms (including 120 cases of clear cell renal cell carcinoma (RCC), 20 cases of papillary RCC (type I papillary RCC 15 cases and type II papillary RCC 5 cases), 18 cases of chromophobe RCC and 8 cases of oncocytoma).

RESULTSKsp-cadherin was expressed in distal convoluted tubules of normal kidney in a membranous pattern. It was also detected in 23% (27/120) of clear cell RCC, 20% (4/20) of papillary RCC, 100% (18/18) of chromophobe RCC and 75% (6/8) of oncocytoma. High expression of CD10 and vimentin was noted in clear cell RCC and papillary RCC. CD10 was also expressed in chromophobe RCC in cytoplasmic pattern, compared with membranous staining in the other tumors. CK7 expression was mainly seen in chromophobe RCC and papillary RCC, while epithelial membrane antigen was expressed in all variants of RCC. On the other hand, the expression of Ksp-cadherin in clear cell RCC correlated with tumor stage and grade.

CONCLUSIONSKsp-cadherin is expressed in normal distal convoluted tubules and the related neoplasms. It carries relatively high specificity and sensitivity in diagnosis of chromophobe RCC and oncocytoma. The expression of Ksp-cadherin also correlates with biologic behavior of clear cell RCC.

Adenoma, Oxyphilic ; metabolism ; pathology ; Cadherins ; metabolism ; Carcinoma, Renal Cell ; metabolism ; pathology ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Kidney Neoplasms ; metabolism ; pathology ; Kidney Tubules ; metabolism ; pathology ; Neoplasm Staging ; Neprilysin ; metabolism ; Vimentin ; metabolism

OBJECTIVETo study the expression of the ID3 protein in prostate cancer and its clinicopathological significance.

METHODSWe detected the expression of the ID3 protein in PC-3M cells by indirect immunofluorescence, and that in 29 prostate cancer and 15 prostate hyperplasia specimens by immunohistochemistry. Then we analyzed the correlation between the expression level of ID3 and the clinicopathological parameters.

RESULTSThe ID3 protein was expressed predominantly in the nucleus of PC-3M cells. Its expression rate was 82.7% (24/29) in the prostate cancer specimens, significantly higher than 6.6% (1/15) in prostate hyperplasia (P < 0.05), and was positively correlated with the Gleason score of prostate cancer (P < 0.05).

CONCLUSIONThe ID3 protein is expressed in prostate cancer, and is elevated with the increase of Gleason score.

Aged ; Aged, 80 and over ; Fluoroimmunoassay ; Humans ; Immunohistochemistry ; Inhibitor of Differentiation Proteins ; metabolism ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Prostatic Neoplasms ; metabolism ; pathology