Objective To investigate the effect of diabetes on hyperlipidemic acute panereatitis. Methods The clinical data of 96 patients with hyperlipidemic acute pancreatitis from Jun 1996 to Jun 2006 were retrospectively reviewed. Results Of all 96 patients, 21.9% (21/96) suffered from severe acute pancreatitis ( SAP ), 78. 1% ( 75/96 ) suffered from mild acute pancreatitis ( MAP ), respectively. Twenty-four patients (25%) were diabetics. Triglyceride level, obesity rate, SAP cases and APACHE Ⅱ scores in patients with diabetes were significantly higher than those of no-diabetes patients( P < 0. 05 ). The glucose level, diabetes of history length, triglyceride level and fat were the independent factors for prognosis of acute pancreatitis with hyperlipidemia by the Cox model analysis. With the increasing of APACHE Ⅱ score, the blood glucose level of patients increased. Blood glucose level in a short period of time does not correlate with lipid levels. Conclusions The level of blood glucose is related with hyperlipidemic acute pancreatitis, the history of the diabetes to a certain extent influences the development of hyperlipidemic acute pancreatitis.

No abstract available.
Colonic Neoplasms* ; Humans ; Hydromorphone* ; Intercellular Adhesion Molecule-1*

Objective To study the application effects of timely regional vascular occlusion in primary liver cancer(PLC) surgery. Methods Eighty-eight patients with PLC who underwent surgery in the Department of General Surgery of Yan'an University Affiliated Hospital from January 2014 to December 2016 were selected for prospective study, and they were divided into the experimental group and the control group by the random number table method, 44 cases of each group. In the experimental group, the blood supply was blocked with timely regional vascular occlusion while in the control group, the blood supply was blocked with half hepatic vascular occlusion. The occurrence of postoperative complications, and surgical indexes(surgical time, intraoperative blood loss, the time of hepatic portal occlusion, blood transfusion volume, abdominal drainage volume and hospital stay), levels of alanine aminotransferase, albumin and total bilirubin, levels of CD3+, CD4+, CD8+ and CD4 + /CD8 +, effective rate, control rate, and clinical efficacy were compared between the two groups. Measurement data with normal distribution were represented as (x) ± s and analyzed using the independent-sample t test between the two groups; within the groups, paired t-tests were used. Comparison of count data were represented as n(％ ), and analyzed using the chi-square test. Results The intraoperative blood loss, time of hepatic portal occlusion, blood transfusion volume and hospital stay of the experimental group were(331. 48 ±30.65) ml, (14.78土2.27) min, (132.61 ±13.87) ml, (9.29土1.19) d, and the control group were (500.61 ±50.62) ml, (23.96±2.89) min, (305.76 ± 30.64) ml, (12.10 ± 1.22) d, with statistically significant differences in above indexes between the two groups(all P< 0.05). The operation time and abdominal drainage volume in the experimental group were(146.86 ± 15.87) min and(321.77 ±33.65) ml respectively, while those in the control group were (143.07土15.35) min and(335.18 ±33.82) ml respectively, there was no significant difference between the two groups(P> 0.05 ). After surgery, the levels of alanine aminotransferase, total bilirubin and albumin of the experimental group were(54.86 ±5.61) U/L, (20.65 ± 2.32) U/L, (41.95土4.32) ng/ml, and the control group were(120.75 ± 13.03) U/L, (35.42+3.21) U/L, (70.25 ±7.45) ng/ml, with statistically significant differences in above indexes between the two groups(all P <0.05). After surg;ery, the levels of CD3 +, CD4+, CD8 + and CD4 + /CD8 + of the experimental group were 0.63 ±0.16, 0.52 ± 0.11, 0.20 ±0.04, 1.70 ±0.17 and the control group were 0.56 ±0.14, 0.45±0.12, 0.26 ± 0.05, 1.46土0.22, with statistically significant differences in above indexes between the two groups (all P< 0.05 ). There were no differences between the experimental group and the controlg roup in the response rate and the control rate(75.00％ vs.79.55％; 88. 64％ vs.90.91％ ) (P>0.05). Conclusions The application of timely regional vascular occlusion in PLC surgery can reduce the intraoperative blood loss, the time of hepatic portal occlusion, blood transfusion volume and hospital stay, improve the immune level and liver function. And there is no difference in response rate and control rate compared with half hepatic vascular occlusion, therefore it is worthy of clinical application.

OBJECTIVES: Utilisation of high-frequency drills is known to increase noise induced hearing loss due to increasing the damages of inner ear cells. This study aimed to investigate whether preconditioning by using dexmedetomidine (DEX) decreased the occurrence of ischemia in inner cells of the ear. METHODS: We utilised a transgenic zebrafish line Brn3C, and the embryos were collected from breeding adult zebrafish. Five-day-old larvae were cultured at the density of 50 embryos, and the larvae were classified into 4 groups: control, cisplatin group, DEX group, and DEX+yohimbine; adrenoreceptor blocker group. The DEX group was categorised into 3 subgroups by dosage; 0.1, 1, and 10 microM. Preconditioning was performed for 150 minutes and then exposed to cisplatin for 6 hours. The experiment was performed in 7 replicates for each group and the number of hair cells in 3 parts of the neuromasts of each fish was determined. RESULTS: Hair cell apoptosis by cisplatin was attenuated more significantly in the DEX preconditioning group than in the control group. However, the preconditioning effects were not blocked by yohimbine. CONCLUSION: The results of this study suggest that hearing loss caused by vibration-induced noise could be reduced by using DEX and may occur through other mechanisms rather than adreno-receptors.
Adult ; Apoptosis ; Breeding ; Cisplatin ; Dexmedetomidine* ; Ear ; Ear, Inner ; Embryonic Structures ; Hair ; Hearing Loss ; Humans ; Ischemia ; Larva ; Noise ; Yohimbine ; Zebrafish*

The daily insertion of endotracheal tubes, laryngeal mask airways, oral/nasal airways, gastric tubes, transesophageal echocardiogram probes, esophageal dilators and emergency airways all involve the risk of airway structure damage. In the closed claims analysis of the American Society of Anesthesiologists, 6% of all claims concerned airway injury. Among the airway injury clams, the most common cause was difficult intubation. Among many other causes, esophageal stethoscope is a relatively noninvasive monitor that provides extremely useful information. Relatively not many side effects that hardly is ratable. Some of that was from tracheal insertion, bronchial insertion resulting in hypoxia, hoarseness due to post cricoids inflammation, misguided surgical dissection of esophagus. Also oropharyngeal bleeding and subsequent anemia probably are possible and rarely pharyngeal/esophageal perforations are also possible because of this device. Careful and gentle procedure is necessary when inserting esophageal stethoscope and observations for injury and bleeding are needed after insertion.
Anemia ; Anoxia ; Bivalvia ; Bronchoscopes ; Emergencies ; Esophagus ; Foreign Bodies* ; Hemorrhage ; Hoarseness ; Inflammation ; Insurance Claim Review ; Intubation ; Laryngeal Masks ; Stethoscopes

A large reservoir of bacterial lipopolysaccharide (LPS) is available in the colon and this could promote colon cancer metastasis by enhancing tumor cell adhesion, intravasation, and extravasation. Furthermore, adhesion molecules like ICAM-1, VCAM-1, and E-selectin play important roles in the adhesion of tumor cells to endothelium. This study was designed to determine whether morphine can attenuate the expressions of adhesion molecules up-regulated by the supernatant of LPS-stimulated HCT 116 colon cancer cells (LPS-Sup). In this study, we divided to three groups by cell-growth medium of human umbilical vascular endothelial cells (HUVECs): the control group was incubated in growth factor-free endothelial medium, the Sup group was incubated in the supernatant of HCT 116 cells (Sup), and the LPS-Sup group was incubated in LPS-Sup. To observe effect of morphine to the adhesion molecules expressions in the LPS-Sup group, we co-treated morphine with LPS or added it to LPS-Sup. Adhesion molecule expressions on HUVECs in all three groups were measured during incubation period. Consquentially, ICAM-1, VCAM-1, and E-selectin expressions on HUVECs were significantly lower when morphine was co-treated with LPS than not co-treated. Thus, we suggest that morphine affects the expressions of adhesion molecules primarily by attenuating LPS stimuli on tumor cells.
Cell Adhesion Molecules/*metabolism ; Cell Line, Tumor ; Cell Survival/drug effects ; Colonic Neoplasms/*metabolism ; E-Selectin/metabolism ; Endothelial Cells/drug effects/metabolism ; Endothelium, Vascular/cytology ; Humans ; Intercellular Adhesion Molecule-1/metabolism ; Lipopolysaccharides/toxicity ; Morphine/*pharmacology ; Vascular Cell Adhesion Molecule-1/metabolism

BACKGROUND: Sugammadex is a new neuromuscular blockade reversal agent. Recently, it has been used in patients under general anesthesia. However, sugammadex could be toxic to fetuses and pediatric patients under 3 years of age. In this study, we demonstrated the safety of sugammadex in fetuses, using zebrafish larvae. Furthermore, its neurotoxicity was evaluated using neuronal cell lines.METHODS: We used SH-SY5Y cells to determine the viability of neuronal cells treated with sugammadex. Zebrafish larvae were used to determine the teratogenic effects of sugammadex.RESULTS: Sugammadex showed no adverse effects on neuronal cells and zebrafish larvae. The survival rates of neuronal cells were not different in all concentrations. In addition, the heart formation of zebrafish embryos, which were exposed to various concentrations of sugammadex, were not different.CONCLUSION: This study demonstrated the feasibility of using sugammadex during pregnancy. However, further clinical studies will be required to extrapolate these results to humans.
Anesthesia, General ; Cell Line ; Embryonic Structures ; Fetus ; Heart ; Humans ; Larva ; Neuromuscular Blockade ; Neurons ; Pregnancy ; Survival Rate ; Zebrafish

BACKGROUND: Cardiopulmonary bypass (CPB) can cause systemic hypoperfusion, which remains undetected by routine monitoring of physiological parameters. Noninvasive tissue perfusion monitoring offers a clinical benefit by detecting low systemic perfusion. In this study, we tried to evaluate whether regional tissue perfusion saturation reflects systemic hypoperfusion during CPB. METHODS: This retrospective study included 29 patients with American Society of Anesthesiologists physical status II–III, who required cardiac surgery with CPB. We evaluated the correlations of serum lactate and delivery oxygen with organ perfusion values of peripheral tissue oxygen saturation and cerebral oxygen saturation. Data were recorded at different stages of CPB: T1 (pre-CPB), T2 (cooling), T3 (hypothermia), T4 (rewarming), and T5 (post-CPB). RESULTS: Lactate levels were elevated after CPB and up to weaning (P < 0.05). The levels of peripheral and tissue oxygen saturation decreased after the start of CPB (P < 0.05). Lactate levels were negatively correlated with peripheral tissue oxygen saturation levels at T4 (R = −0.384) and T5 (R = −0.370) and positively correlated with cerebral oxygen saturation at T3 (R = 0.445). Additionally, delivery oxygen was positively correlated with peripheral tissue oxygen saturation at T4 (R = 0.466). CONCLUSIONS: In this study, we demonstrated that peripheral tissue oxygen saturation can be a reliable tool for monitoring systemic hypoperfusion during CPB period. We also believe that peripheral tissue oxygen saturation is a valuable marker for detecting early stages of hypoperfusion during cardiac surgery.
Cardiopulmonary Bypass* ; Humans ; Lactic Acid* ; Oxygen ; Perfusion* ; Retrospective Studies ; Thoracic Surgery ; Weaning

BACKGROUND: Static parameters such as central venous pressure and pulmonary artery occlusion pressure, have limitation in evaluation of patients' volume status. Dynamic parameters such as stroke volume variation (SVV), have been used to evaluate intraoperative hemodynamic volume status, in various operations. We examined if SVV is also effective for patients undergoing operation with prone position for fluid management. METHODS: Eighteen patients that received spinal surgery under prone position November 2015 to May 2016, were enrolled. Patients were kept at an SVV value less than 14% during surgery. Changes of pre-, post-operative volume status were evaluated, using transthoracic echocardiography. RESULTS: Mean fluid administered was 1,731.97 ± 792.38 ml. Left ventricular end-diastolic volume was 72.85 ± 13.50 ml before surgery, and 70.84 ± 15.00 ml after surgery (P value = 0.594). Right ventricular end-diastolic area was 15.56 ± 1.71 cm² before surgery, and 13.52 ± 2.65 cm² after surgery (P value = 0.110). Inferior vena cava diameter was 14.99 ± 1.74 mm before surgery, and 13.57 ± 2.83 mm after surgery (P value = 0.080). CONCLUSIONS: We can confirm that fluid management based on SVV is effective, even in prone position surgery. So, SVV, that can be measured by continuous arterial pressure, can be considered a guideline for effective fluid management in spinal surgery.
Arterial Pressure ; Central Venous Pressure ; Echocardiography ; Fluid Therapy ; Hemodynamics ; Humans ; Prone Position ; Pulmonary Artery ; Stroke Volume ; Stroke ; Vena Cava, Inferior

BACKGROUND: Sugammadex is a new neuromuscular blockade reversal agent. Recently, it has been used in patients under general anesthesia. However, sugammadex could be toxic to fetuses and pediatric patients under 3 years of age. In this study, we demonstrated the safety of sugammadex in fetuses, using zebrafish larvae. Furthermore, its neurotoxicity was evaluated using neuronal cell lines. METHODS: We used SH-SY5Y cells to determine the viability of neuronal cells treated with sugammadex. Zebrafish larvae were used to determine the teratogenic effects of sugammadex. RESULTS: Sugammadex showed no adverse effects on neuronal cells and zebrafish larvae. The survival rates of neuronal cells were not different in all concentrations. In addition, the heart formation of zebrafish embryos, which were exposed to various concentrations of sugammadex, were not different. CONCLUSION This study demonstrated the feasibility of using sugammadex during pregnancy. However, further clinical studies will be required to extrapolate these results to humans.