ObjectiveTo investigate the effects of norepinephrine on oxygen metabolism and postoperative outcomes in the elderly patients undergoing fluid-restored abdominal surgery.MethodsAfter hospital ethics committee approval,and written informed consent was obtained from all patients,40 elderly patients,aged ＞ 64 yr,with a body mass index of 18-24 kg/m2,undergoing elective colorectal surgery,were randomly divided into 2 groups (n =20 each):routine fluid administration group (group A) and restricted fluid administration group (group B).In group A,lactated Ringer's solution was given routinely.Lactated Ringer's solution was given at a rate of 5 ml· kg- 1 · h- 1 and small dose of norepinephrine was infused intravenously at 0.01-0.03 μg· kg- 1 · h - 1 simultaneously during the surgery,and MAP was maintained ≥65 mm Hg in group B.Intraoperative blood loss was replaced with the equal volume of 6％ hydroxyethyl starch 130/0.4.Before the surgery ( baseline),1 and 2 h after beginning of the surgery,and while leaving postanesthesia care unit,mean arterial pressure (MAP),heart rate (HR),cardiac index (CI) and central venous pressure (CVP) were recorded,and arterial and central venous blood samples were drawn for blood gas analysis.Oxygen delivery index (DO2 I ),oxygen consumption index (YO2I) and oxygen extraction ratio (ERO2) were calculated.The gastric mucosal pH was determined before the surgery and 1 h after beginning of the surgery.Blood samples were taken form the peripheral vein to determine the concentration of Hb,serum albumin,blood urea nitrogen (BUN) and creatinine (Cr) concentrations before the surgery and 1 day after the surgery.The extubation time,duration of stay in hospital,the time when the patients passed the flatus,pulmonary complications,gastrointestinal complications,and wound infections were recorded.ResultsCompared with group A,CI,Hb,ScvO2 and DO2I were significantly increased,CVP and ERO2 were decreased during the surgery,the concentrations of Hb and serum albumin were significantly increased,1 day after the surgery,and the incidence of pulmonary complications and wound infections was significantly decreased after the surgery in group B (P ＜ 0.05 ).There were no significant differences in gastric muscosal pH,the indexes of renal function,extubatiotn time,the time when the patients passed the flatus,duration of stay in hospital and the incidence of gastrointestinal complications between the two groups ( P ＞ 0.05).ConclusionWhen small dose of norepinephrine is used to treat perioperative hypotension induced by fluid restriction,it can increase oxygen delivery,and reduce the incidence of postoperative complications,and has no adverse effects on gastrointestinal microcirculation and oxygen consumption in the elderly patients undergoing colorectal surgery.

Objective To study the effects of traditional Chinese medicine Zuojin Pill on gastrointestinal system.Methods Through ig giving 0.1％ methyl orange solution,the gastric residual rate was calculated,and the effect of Zuojin Pill on gastric emptying in mice was observed.By ig administration of 5％ carbon powder,the advance rate of carbon powder was calculated,and the effect of Zuojin Pill on intestinal motility in normal mice and the antagonistic effect on intestinal motility hyperfunction induced by neostigmine were observed.Effect of Zuojin Pill on contraction of isolated guinea pig ileum induced by histamine was observed.After D-xylose solution was ig given to rats,the serum xylose level was determined 1 h later,and the effect of Zuojin Pill on rat intestinal absorption was observed.The anti-diarrhea effect of Zuojin Pill was observed by giving castor oil to mice.At the same time,we have made a comparison between Zuojin Pill and Wuji Pill-berberine,to evaluate the rationalization of Zuojin Pill.Results It was obvious in experimental results that Zuojin Pill had a regulating effect on gastrointestinal system.Zuojin Pill dose-dependently inhibited the gastric emptying.Zuojin Pill demonstrated more effective suppression on the accelerated movement induced by neostigmine,but did not inhibit normal intestinal transit in mice.Zuojin Pill markedly inhibited sperm motility in mice.Zuojin Pill concentration-dependently inhibited the contraction intensity of isolated ileum muscles in guinea pigs induced by histamine.Zuojin Pill markedly inhibited diarrhea induced by castor oil.Compared with Wuji Pill-berberine,the effect of Zuojin Pill on gastrointestinal system was more visible in the same dose.Conclusion Zuojin Pill has obvious regulation effect on the gastrointestinal tract,there are indications that the application of Zuojin Pill to clinic is scientific and reasonable.

AIM: To study the pharmacological effect of Weichangshu (WCS) (Rhizoma coptidis, Fructus Evodiae., etc.) on rodent gastrointestinal function and gastric mucosa, and to analyze its analgesic and antidiarrheal mechanism. METHOD: Mouse's hypermobility induced by neostigmine and its gastric emptying were treated by WCS in comparison with normal subjects, rat's gastric ulcer induced by absolute ethanol, diarrhea induced by castor oil, pain induced by acetic acid and rat's gastric secretion and absorption were observed. RESULTS: The experimental results showed that WCS did not affect normal mouse's intestinal propulsion but significantly antagonized neostigmine induced intestinal propulsion and inhibited the gastric mucosa injure and decreased the frequency of the writhe and limited diarrhea. CONCLUSION: WCS has power to recover gastrointestinal function and lessen gastric mucosa injury and has analgesic and antidiarrheal effect.

0.05). Compared with the altitude of 1 507 m group, the activity of SOD and GSH-Px significantly decreased in the altitude of 3 850 m and 2 500 m groups, it was contrary in the content of MDA (P

Objective To identify risk factors for anastomotic leakage after low anterior resection (LAR) in rectal cancer patients and study its impact on patients'long-term prognosis.Methods Chnical data were analyzed from 720 patients who underwent low anterior resection(LAR) for rectal cancer between 1996 and 2006.Results Anastomotic leakage after anterior resection occurred in 44 cases(6.1%).The median time of anastomotic leakage after operation was 5.6 days.Muhivariate analysis showed male patients.history of preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were independent risk factors predisposing anastomosis leakage (P<0.05).Tumor local recurrence rate was 13.6% in patients suffering from leakage and 5.9% for those without leakage (χ2= 4.116,P<0.05).The distant metastasis rates were 25.0 and 14.1 percent for the leakage and noaleakage groups,respectively(χ2=3.943,P<0.05).The survival rates were 56.8 and 72.5 percent in the leakage and nonleakage groups,respectively(χ2=4.979,P<0.05).Conclusion Sex,preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were found to be independent risk factors for anastomotic leakage after rectal cancer surgery.Anastomotic leakage was associated with poor prognosis.

Objective: To investigate whether antipsychotic agent-induced type 2 diabetes was associated with leptin gene -2548G/A functional polymorphism in schizophrenia patients who had treated by antipsychotics chronically. Methods: Fasting plasma glucose, 2-hour post meal plasma glucose, fasting plasma leptin and fasting plasma insulin were measured in 110 patients with chronic schizophrenia whose natural courses of the disorder were more than 5 years. According to the level of plasma glucose, these patients were divided into three groups, diabetes mellitus group, abnormal regulating glucose group and normal glucose group. The polymorphisms in the leptin promoter region (-2548 G/A) were determined with PCR-RFLP in the patients. Results: The patients in DM group were more likely to be homozygous for the -2548AA genotype. As compared with the patients with -2548AG/GG combined genotype, the patients with -2548AA genotype had significant increase in the level of plasma leptin(P=0.019). Conclusion: The -2548G/A polymorphism in promoter region of leptin gene may be associated with type 2 diabetes in schizophrenic patients treated by antipsychotics chronically. -2548A allele of leptin gene may be a genetic risk factor for the development of type 2 diabetes during antipsychotic treatment.

Objective To investigate the predictive value of sphingosine‐1‐phosphate (S1P) and adiponectin after coronary stent implantation .Methods Fifty patients confirmed by coronary angiography with in‐stent restenosis were selected as in‐stent resteno‐sis group while 50 patients without in‐stent restenosis were chose as control group .All cases were detected with the density of their serum S1P ,HDL‐S1P ,adiponectin and IL‐18 and analyzed relevance to in‐stent restenosis .Results Compared with the control group ,serum S1P in in‐stent restenosis group were lower [ (96 .10 ± 26 .33)ng/mL vs .(113 .40 ± 32 .72)ng/mL ,P<0 .01] ,and the levels of HDL‐S1P and adiponectin were also significant lower [(32 .81 ± 10 .02)ng/mL vs .(42 .72 ± 11 .75)ng/mL ,P< 0 .01 ;(7 .38 ± 2 .11)mg/L vs .(9 .25 ± 3 .29)mg/L ,P< 0 .01] .IL‐18 levels between the two groups had no significantly difference [(258 .15 ± 82 .19)ng/L vs .(224 .98 ± 84 .15)ng/L ,P>0 .05] .Adiponectin showed a positive correlation between S1P (r=0 .712 , P<0 .05) and HDL‐S1P (r=0 .821 ,P<0 .01) .Conclusion S1P and adiponectin could be independent predictive factor of coronary stent restenosis ,and high concentrations of S1P and adiponectin may reduce risk of in‐stent restenosis in patients with stenting per‐cutaneous coronary intervention (PCI) .

0.05].Conclusion To the middle-and old-aged GI cancer patients without organ dysfunction,lowering blood transfusion trigger from Hb 100 g/L to Hb 80 g/L during operation can meet the requirement of oxygen,reduce blood transfusion,and do not increase the rates of wound infection or delay wound healing.

The uptake of oral administered drugs primarily occurs in the small intestine,which also has the capability to metabolize drugs.Both phase Ⅰ and phase Ⅱ metabolic enzymes were expressed in the intestinal mucosa,and cytochromes P450(CYP450s) are the principle enzymes attributed to the biotransformation of drugs.CYP3A and CYP2C are the most abundant subfamilies,accounting for approximately 80% and 16% of total CYP450s in the intestine.Compared to the liver,the expression and activity of CYP450 enzymes in the intestine was susceptible to inducers or inhibitors,leading to drug-drug interaction.This article reviews the expression of CYP enzymes in small intestine and the role of the gut wall in CYP-mediated xenobiotic metabolism.Possible drug-drug interactions due to induction or inhibition of CYP enzymes in the small intestine are also addressed.