Anastomosis, Surgical ; methods ; Humans ; Organ Transplantation ; adverse effects ; methods ; Postoperative Complications ; etiology ; surgery ; Vascular Surgical Procedures ; methods

Toll-like receptor 4 (TLR4), the natural receptor of lipopolysaccharide(LPS), plays an important role in the regulation of acute inflammation, intracellular signal transduction and cell apoptosis. TLR4 over expresses in both acute inflammation and fibrotic tissues, which suggests that TLR4 may be essential in acute inflammation and subsequent fibrosis. Nowadays, some progress has been made in the exploration of TLR4 in pathogenesis and treatment of liver cirrhosis and pulmonary fibrosis. TLR4 may become a new target in the treatment of human fibrotic diseases including liver cirrhosis and pulmonary fibrosis. The research status of TLR4 in human fibrotic diseases and its future development are reviewed in this paper.

Objective To assess the relationship between GABA_(B) receptor in medulla and trigeminal neuralgia on rats. Methods Twelve SD rats were randomly divided into 4 groups,3 for each group.Group A and B were surgical groups,while Group C and D were sham surgical ones.In the surgical group,right unilateral chronical constriction injury(CCI) of rats was produced by placing loose chromic gut ligature around the infraorbital nerve(ION).In the sham surgical group,the ION was only exposed using the same procedure but not ligated.Mechanical response threshold was observed before operation and 3,6,9,12 and 15 days after operation.Medullas of rats in group A and B were taken to measure the quantity of GABA_(B) receptor by real-time PCR 9 days after operation,and medullas of rats in group C and D were done 15 days after operation. Results Compared with the sham surgical group,an allodynia to mechanical stimulation on the territory of ligated ION was found from the ninth to fifteenth day after operation in surgical group(P

As a non-pungency inhaled agent with less respiratory irritation,sevoflurane has been widely used in various surgeries for induction and maintenance of general anesthesia.However,the incidence of pediatric emergence delirium has been significantly increased with sevoflurane general anesthesia which severely disturbs the surgical effect and increases the requirement of medical staff in post anesthesia care unit.This article systematically reviews the research advance in emergence delirium in children with sevoflurane general anesthesia and introduces the reasonable intervention for the improvement of anesthesia quality.

Humans ; Hemangioma, Cavernous/diagnostic imaging* ; Tomography, X-Ray Computed ; Magnetic Resonance Imaging

Objective To analyze the timing and frequency of spontaneous gasping during cardiopulmonary resuscitation in a rat model,and evaluate its value bearing some relation to duration of cardiac arrest (CA ) in predicting the severity of post-resuscitation myocardial dysfunction.Methods Twenty-seven healthy Sprague-Dawley rats were randomly (random number)divided into 3 groups according to different durations of CA:CA 4 min (n=9),CA 6 min (n=9)and CA 8 min (n=9).CA of rats was electrically induced and untreated for 4,6 or 8 min respectively in the corresponding groups,and then cardiopulmonary resuscitation (CPR)was initiated and continued for 8 min in all animals.The emergence timing and frequency of spontaneous gasping during cardiopulmonary resuscitation and resuscitation outcomes were documented.Myocardial function such as cardiac output,ejection fraction and Tei index was measured by echocardiography prior to CA and at 1 h,2 h and 4 h post-resuscitation.Results The earliest appearance of gasping with highest frequency was observed in the CA 4 min group during CPR.Gasping appeared later with decreased frequency observed following longer duration of CA.There were statistically significant differences in the timing and frequency of gasping among the 3 groups.In the CA 4 min group with frequent gasping,all animals were successfully resuscitated with 8-min CPR with the least number of defibrillation,which was significantly better than that in the CA 8 min group.During the evaluation of post-resuscitation myocardial function,cardiac output,ejection fraction and myocardial work index (Tei index) were better in the CA 4 min group with frequent gasping,worse in the CA 6 min group and worst in the CA 8 min group, showing statistically significant differences in cardiac function among the 3 groups. Conclusions The spontaneous gasping appeared sooner with higher frequency during cardiopulmonary resuscitation indicated shorter duration of CA,and predicted better success of resuscitation and post-resuscitation myocardial function.

BACKGROUND: Bone cement coated by different materials has various characteristics and causes varying therapeutic effects. OBJECTIVE: By comparing characteristics of CPC, CPC/D, and CPC/M/D3 to investigate the preparation of doxorubicin microspheres-coated bone cement. METHODS: Doxorubicin microspheres were prepared with multiple emulsion solvent volatilixation method. Doxorubicin microspheres were mixed with CPC as the ratio of 3:7 to prepare doxorubicin microspheres-coated bone cement. The samples were randomly divided into three groups: CPC group, containing bone cement alone; CPC/D group, containing doxorubicin;CPC/M/D group, containing doxorubicin microspheres. Scanning electron microscope at varying magnification was used to observe structural characteristics and measure the diameter of microspheres. X-ray diffraction was used to estimate the extent of CPC and CPC/M/D samples. The initial and final setting time of cement samples in the three different groups was measured at 25 ℃ and 37℃ respectively. The injectability and interval porosity of different samples were tested. The compressive strength of the specimens was measured using a universal material testing machine to record the maximal compressive strength and breaking strength. RESULTS AND CONCLUSION: PLGA microspheres (100-150 μm) were globular and the surface was slick and sly. Micrestructure of bone cement was not obviously changed following mixing with drugs, thus the location and characteristics of drugs in bone cement were not determined. Micrespheres-coated bone cement (100-150 μm) was distributed among CPC powder. All the X-ray diffraction pattern of three different samples was in coincidence with standard X-ray diffraction pattern of hydroxyapatite, i.e., the major peak was located near 32°. Additional drugs and microspheres did not cause new phases. Obvious collapsing was not observed in the three samples following immediately adding in saline, but the collapsing appeared in both CPC/D and CPC/M/D samples after 24 hours. The setting-up time of CPC/M/D was the longest, but that of CPC was the shortest. On the other hand, the setting-up time was the longest at 37℃. The final setting-up time of CPC/M/D group was 45 minutes. The doxorubicin microspheres-coated bone cement showed the best property of injectability among the three kinds of cement. The interval porosity was the highest in the CPC/M/D group but the lowest in the CPC group. Interval porosity of doxorubicin microspheres-coated bone cement was up to 61.67%. The yield stress was the strongest in the CPC group but the weakest in the CPC/M/D group. Additionally, the yield stress of calcium phosphate cement dramatically decreased while doxrorubicin microspheres were coated. However, there was no significant difference between them. The preparation of doxorubicin microspheres-coated bone cement was reliable and the product had good structures and properties.

Objective To establish a swine model of 10 min prolonged cardiac arrest (CA) induced by electrically triggered ventricular fibrillation,and then evaluate the quality of the model and the value in the establishment of post-cardiac arrest syndrome.Methods Fourteen domestic healthy swine weighing 38 ±3 kg were selected for study.Ventricular fibrillation was induced for 10 min,and then cardiopulmonary resuscitation (CPR) was initiated and continued for 5 min.The resuscitated animals were observed for 72 h after resuscitation.The resuscitation outcomes and survival rate were recorded.The functions of heart,lung and brain,and systemic inflammatory response and tissue perfusion were regularly evaluated for 72 h post-resuscitation.Results Eleven of the fourteen swine obtained restoration of spontaneous circulation (ROSC),and the rate of successful resuscitation and 72 h survival were both 78.6％.Significantly worse post-resuscitation myocardial function was found in all animals compared to the value prior to CA and the myocardial function was evaluated by decreased stroke volume and global ejection fraction,and increased levels of serum cardiac troponin-Ⅰ and n-terminal pro brain natriuretic peptide.Postresuscitation extra-vascular lung water index and pulmonary vascular permeability index were significantly increased accompanied with significantly decreased oxygenation index compared with the values before CA,indicating the occurrence of acute lung injury.In addition,post-resuscitation systemic inflammatory response and tissue low perfusion evidenced by significantly higher levels of serum tumor necrosis factor-α and interleukin-6 and arterial blood lactate were observed.Consequently,severe neurological deficit with significantly higher levels of serum neuron-specific enolase and S-100B was observed following 72 h postresuscitation.Conclusions This swine model of prolonged cardiac arrest induced by electrically triggered ventricular fibrillation was a well established model with high success rate of resuscitation,significant vital organ injury and relatively long duration of survival;it is an excellent model for the study of post-cardiac arrest syndrome.

OBJECTIVE: To establish an artificial neural network (ANN) for predicting mycophenolic acid (MPA) pharmacokinetics in renal transplantation recipients by limited sampling strategy. METHODS: Sixty-four Chinese renal transplantation recipients receiving mycophenolate mofetil (MMF) were investigated. Eleven serum samples were drawn on different days after transplantation. MPA plasma concentration was determined by HPLC and ANN was established after the network parameters were optimized by using momentum method combined with genetic algorithm. RESULTS: When using MPA plasma concentrations at 0, 0.5 and 2 h after MMF administration to predict MPA concentration, the mean prediction error and mean absolute prediction error were (0.39±1.24) and (0.90±0.94) μg·mL-1, respectively. There was no significant difference between the pharmacokinetic parameters obtained from the predicted MPA concentrations vs those obtained from the measured MPA concentrations. CONCLUSON: ANN can be used to predict MPA pharmacokinetics by limited sampling strategy.

Background Retinal hypoxia is one of primary causes of retinal neovascularization,and its mechanism is research hot topic.Studies showed that hypoxia stimulates the activation of many trancripation factors and vascular endothelial cells,which leads to angiogenesis.Besides to the vascular endothelial growth factor,the effect of adenosine on angiogenesis is increasingly concerned.Objective This study was to invastigate the relationship of biological behaviour of human microvascular endothelial cells (HMEC-1) under the hypoxia and adenosine,and to explore the effect of adenosine on angiogenesis under hypoxia.Methods HMEC-1 cell line was cultured in vitro,and the cells were divided into normoxia group and hypoxia group.The cells in the normoxia group were cultured under the 5％ CO2 environment,and those in the hypoxia group were cultured under the 1％ O2,94％ N2 and 5％ CO2 environment.The proliferation ability and percentage of the cells were assayed by cell counting kit-8 (CCK8) and EDU.The migration number and invasive number of the cells were detected by transwell chamber.The expressions of CD39 and CD73 proteins in the cells were tested by Western blot and immunofluorescence technique,and the level of adenosine was measured by high performance liquid chromatography (HPLC).Results The proliferation values (absobancy) were 0.715-±0.067 and 0.821 ±0.056 in the normoxia group and the hypoxia group in 12 hours after culture,and those in 24 hours were 0.946±0.028 and 0.998±0.028,showing significant increase in the hypoxia group compared with the normoxia group (t12h =3.805,t24h =3.222,all at P ＜ 0.01).The precentage of the proliferation in the hypoxia group was evidently higher than that in the normoxia group (t =-6.868,P＜0.01).The number of the cell migration and invasion in 24 hours after culture was 185.3 ± 10.594 and 74.2± 10.741 respectively in the normoxia group,and that in the hypoxia group was 300.7±22.853 and 107.5±7.007,with significant differences between the two groups (t=-12.124,-6.367,both at P＜0.01).The expression levels of CD39 and CD73 proteins in the hypoxia group were significantly higher than those in the normoxia group in bothl2 hours and 24 hours after culture(all at P＜0.05),and the adenosine content in the cells is gradually increased in 2,6,12,24 and 36 hours after culture,with the highest content in 36 hours.The adenosine content was significantly higher in the hypoxia group than in the normoxia group at various time points (t2h =2.469,P =0.017;t6h =5.442,P＜0.001;t12h =3.841,P＜0.001;t24h =4.458,P＜0.001;t36h =2.757,P =0.008;t48h =3.319,P =0.002).Conclusions Compared with the normoxia group,the proliferation,migration and invasion abilities of HMEC-1 are stronger,meanwhile,the expression of CD39 and CD73 as well as the adenosine level in the cells are all increased under the hypoxic condition.It is suggested that the activation of human microvascular endothelial cells might be significantly related to the level of adenosine and its key enzymes.