Objective To investigate the effect of ketamine on the expression of HSP 70 in myocardium in severely burned rats for its possible mechanism of myocardial protection. Methods Seventy-two male Wistar rats were randomly divided into 3 groups: normal control group (group C, n=8), burn injury group (group BI, n= 32) and ketamine group (group K,n=32). 30% Wtal body surface area of Ⅲ degree burn model was developed in group BI and group K. Ketamine 20 mg/kg was injected IM in group K 15 min after the burn model was made. Equal volume of normal saline was given instead of ketamine in group BI. Group C received no treatment. The rats were sacrificed at 3, 6, 12 and 24 h after administration in group BI and group K respectively(8 rats at each time point). Myocardial samples were obtained for determination of the expression of HSP 70 by Western blot analysis. The myocardial ultrastructure was observed at 3 h after administration with electron microscope. Results The myocardial damage was milder in group K than in group BI. The expression of HSP 70 was significantly higher at 3, 6, 12 and 24 h after administration in group K and group BI than in group C(P<0.05).The HSP 70 expression was significantly higher at 3 and 6 h after administration in group K than in group BI ( P<0.05). Conclusion Ketamine can reduce the myocardial injury induced by severe burn through up-regulating the expression of HSP 70 in cardiocytes.

Objective To evaluate the effect of controlled hypotension at the beginning of reperfusion on ischemia-reperfusion (I/R) injury of the liver in patients undergoing hepatectomy. Methods Forty ASA Ⅱ or Ⅲ patients aged 30-60 yr weighing 40-70 kg undergoing elective partial hepatectomy for liver cancer were randomly divided into 2 groups ( n = 20 each): group C normal BP and group H controlled hypotension. Hepatic portal was occluded during operation. In group C normal BP was maintained during reperfusion while in group H controlled hypotension (MAP was maintained at 60-70 mm Hg) was performed for 10 min since the beginning of reperfusion.Venous blood samples were taken before hepatic ischemia (T0 ,baseline) and at 15 min of ischemia (T1) and 25 min of reperfnsion (T2 ) for determination of plasma endothelin (ET), nitric oxide(NO), TNF-α and IL-1 concentrations. Results I/R of the liver led to significant increase in plasma ET, TNF-α and IL-1 concentrations and decrease in plasma NO concentration at T1,2 as compared with the baseline values at T0 in both groups. Plasma ET,TNF-α and IL- 1 concentrations were significantly lower while plasma NO concentration was significantly higher at T2 in group H than in group C. Conclusion Ten minutes controlled hypotension in the initial stage of reperfusion can attenuate I/R-induced injury to the liver in patients undergoing hepatectomy by balancing ET with NO and inhibiting inflammation response.

Objective To investigate the value in MR spectrum of diagnosis and grading of gliomas.Methods 36 cases of patient with gliomas who confirmed by histopathologic findings or clinical follow-up were collected. Using a GE Signa EXCITE HD 3.0T super conduct MR unit, all the cases of patients were performed conventional MR scan and multi-voxel with 2-D multi-voxel PRESS 144 ms. Functool software was used for post-processing of spectrum. The ratios of NAA/Cr, NAA/Cho, Cho/Cr were measured in the solid part of masses, circum of tumors and contralateral parenchyma respectively. The result was processed by the statistical method. Results The statistical analysis was exacted by SAS 8.2 software. In the solid part of masses, there were significant differences between low-grade gliomas and high-grade gliomas in the ratios of Cho/Cr, Cho/NAA、NAA/Cr and MI (P ＜0.05), but in peritumoral edema, there were significant differences in the ratios of Cho/Cr, NAA/Cr (P ＜0.05), and no significant differences in the ratios of MI (P ＜0.05).Conclusion 1H-MRS is very important and useful in the evaluation of gliomas. It has made it possible to exactly evaluate the grade of gliomas combined with other imagings.

Thirty six patients with hypertriglyceridemia and impaired glucose regulation or newly diagnosed type 2 diabetes, whose fasting plasma glucose was ≤8.0 mmol/L, were treated by fenofibrate for 3 months. Lipid profile, insulin during intravenous glucose tolerance test and oral glucose tolerance test ( including glucose) were measured before and after treatment After treatment, lipid profile was significantly improved. Insulinogenic index (△I30/△G30) and acute insulin response were significantly increased (98. 9vs. 129. 2, 3558.9 vs. 4783. 3 pmol · L - 1 · min - 1, respectively, P ＜ 0. 05 ). Fasting insulin and insulin resistant index in homeostasis model assessment ( HOMA IR) decreased ( 128. 6 vs. 84. 8 pmol/L, 4. 8 vs.3.0, respectively, P ＜0. 05 ). The improvement of insulin secretory function was more significant in patients with higher triglyceride (TG ＞ 3. 3 mmol/L). These results indicate that short-term lipid-lowering treatment with fenofibrate can improve β-cell function and insulin resistance. Patients with higher triglyceride are likely to achieve more benefit from lipid-lowering treatment.

[Objective] The study was conducted to investigate the effect of micronized fenofibrate on acute insulin response in the subjects with impaired glucose metabolism and hypertriglyceridemia. [Methods] Fifty-three subjects were randomly (2:1 ratio) allocated to fenofibrate group (n=36, including IFG 3 cases, IGT 19 cases, IFG/IGT 6 cases, T2DM 8 cases) or control group (n = 17, including IFG 1 case, IGT 9 cases, IFG/IGT 4 cases, T2DM 3 cases) without any intervention for 3 months. Fasting blood samples were collected for measuring fasting plasma glucose (FPG), free fatty acids (FFA), and lipid profile. IVGTTs were carried out with measurement of plasma insulin before and after treatment. Acute insulin response (AIR), the maximum insulin concentrations (C_(INS,MAX)) to fasting insulin (FINS) ratio (C_(INS,MAX)/FINS) and values of the maximum insulin concentrations increment (△C_(INS)) during IVGTT were calculated as indexes of first-phase insulin secretion. HOMA insulin resistance index (HOMA IR) was used for assessing insulin resistance. [Results] After 3-month treatment, the lipid profile was evidently improved in fenofibrate group. Levels of trigiyceridemia (TG), low-density lipoprotein cholesterol and FFA were significantly reduced and high-density lipoprotein cholesterol increased significantly. Waist circumference was also significantly declined. No change of above indicators was found in control group. In fenofibrate group, C_(INS,MAX)/FINS and △C_(INS) were significantly increased (median 8.4 pmol/L vs. 5.3 pmol/L, 808±473 pmol/L vs. 660±472 pmol/L, both P<0.0001), along with great improvement of AIR (5 585±3 441 pmol·L~(-1)·min~(-1) vs. 4 444±3 642 pmol·L~(-1)·min~(-1), P<0.0001). The level of FINS and HOMA IR was also markedly reduced (108±65 pmol/L vs. 166±115 pmol/L, P = 0.002; 3.8±2.3 vs. 6.0±4.2, P = 0.001). In contrast, there were modest declining in acute insulin response (AIR: 4 313～1 943 pmol·L~(-1)·min~(-1) vs. 5 362±2 861 pmol·L~(-1).min~(-1); C_(INS,MAX)/FINS: median 4.6 vs. 7.0, P= 0.01; △C_(INS): 641±286 pmol/L, vs. 720±321 pmol/L, P= 0.003 9) and increasing HOMA IR (7.8±4.2 vs. 5.6±3.2, P<0.000 1) in control group after 3-month follow-up. The improvement of AIR was correlated with the decreasing of plasma FFA and TG (r=0.41, 0.36, P = 0.002, 0.014), but no correlation with the changing of FPG and HOMA IR. [Conclusions] These results indicated that sbort-term lipid-lowering treatment with fenofibrate evidently improved acute insulin response and alleviated insulin resistance in subjects with impaired glucose metabolism and hypertriglyceridemia. Moreover, the improvement of insulin secretion capacity may be mainly due to the relieving of iipotoxity resulting from finofibrate.

Objective To evaluate the effect of controlled hypotension at the beginning of reperfusion on ischemia-reperfusion (I/R) injury of the liver in patients undergoing hepatectomy.Methods Forty ASA Ⅱ or Ⅲ patients (aged 30-60 years and weighing 40-70 kg) undergoing elective partial hepatectomy for liver cancer were randomly divided into two groups (n =20 each):normal blood pressure group (control group,group C) and controlled hypotension group (group H).In group C,normal blood pressure was maintained during reperfusion,while in group H,controlled hypotension (the mean arterial blood pressure (MAP) was maintained at 60-70 mm Hg) was performed for 10 minutes since the beginning of reperfusion.Hepatic portal was occluded during operation.Venous blood samples were taken before hepatic ischemia (T0,baseline) and after 15 minutes of ischemia (T1) and after 25 minutes of reperfusion (T2) for determination of plasma levels of endothelin (ET),nitric oxide (NO),tumor necrosis factor-alpha (TNF-α) and interleukin-1 (IL-1).Results I/R of the liver led to significant increases in plasma levels of ET,TNF-α and IL-1 and a decrease in plasma level of NO at T1,2 as compared with the baseline values at T0 in both groups.Plasma levels of ET,TNF-α and IL-1 were significantly lower while plasma level of NO was significantly higher at T2 in group H than in group C.Conclusion Controlled hypotension for 10 minutes in the initial stage of reperfusion can attenuate I/R-induced injury to the liver in patients undergoing hepatectomy through balancing ET with NO and inhibiting inflammation responses.

Objective To investigate the effects of ulinastatin on the expression of Toll-like receptor 4 (TLR4) during myocardial ischemia/reperfusion (I/R) in rats and the possible mechanism.Methods Thirty adult Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 3 groups (n =10 each):sham operation group (group S),I/R group and ulinastatin group (group U).Myocardial ischemia was induced by 30 min occlusion of left anterior descending coronary artery followed by reperfusion.Ulinastatin 1 × 104 IU/kg was injected intravenously at 5 min before reperfusion in group U,while the equal volume of normal saline was given in groups S and I/R.The animals were sacrificed at 5 h of reperfusion and myocardial specimens were obtained for microscopic examination and determination of myocardial apoptosis (using TUNEL),TLR4 expression (by immuno-histochemistry) and TNF-α content (by ELIAS).The apoptotic index was calculated.Results Compared with S group,the apoptotic index,TLR4 expression and TNF-α content were significantly increased in groups I/R and U (P ＜0.05).Compared with I/R group,the apoptotic index,TLR4 expression and TNF-α content were significantly decreased (P ＜ 0.05),and the pathological changes were significantly reduced in group U.Conclusion The mechanism by which ulinastatin alleviates myocardial I/R injury is related to inhibition of TLR4 expression and reduction of inflammatory responses during early I/R in rats.

Objective:To investigate the complications of spastic cerebral palsy with selective posterior rhizotomy (SPR).Methods:In the study, 2 593 patients who had undergone SPR from January 2000 to September 2012 were followed-up for at least one year .The complications were classified .Results:Peri-operative complications:pulmonary system complications including bronchial spasm (5 cases, 0.19%) and aspiration pneumonia (4 cases, 0.15%);digestive system complications including abdominal bloa-ting (145 cases, 5.6%) and colic (80 cases, 3.1%);urinary system complications including tempora-ry bladder dysfunction (54 cases, 2.1%) and urinary tract infection (6 cases, 0.23%); peripheral nervous system complications including lower extremity weakness ( 327 cases, 12.6%) and lower extremity sensory disturbances ( 140 cases, 5.4%); central nervous system complications including headache (112 cases, 4.3%) and epileptic seizures (4 cases, 0.15%).None spinal or intracranial in-fection, intraspinal hematoma or intracranial hemorrhage were identified .General surgery complications including back pain (1 382 cases, 53.3%), delay wound healing caused by infection (5 cases, 0.19%) and cerebrospinal fluid leakage (8 cases, 0.31%).Long-term follow-up complications inclu-ding lower limb decreased exercise capacity ( incidence: 7.33%) and lower extremity sensory distur-bance (incidence:5.59%).Urination occurred in only one case and defecation function disturbance with no sexual dysfunction was identified .The incidences of scoliosis , thoracic kyphosis , spondylolisthe-sis and long-term back pain were 7.23%(31/429), 4.2%(18/429), 10.49%(45/429) and 9.72%respectively .Conclusion:SPR is one of the effective and safe surgical treatments for spastic cerebral pal-sy.Valid methods should be applied to reduce the incidence of postoperative complications , such as choosing the appropriate patients , meticulously operating in the surgery , assistance of electrophysiological guidance , reinforcing perioperative management and regular rehabilitation training after operation .

Objective To explore the effect of long-term depleted uranium (DU)ingestion on testosterone production in rats, and its involvement mechanism. Methods Male and female rats (F0 and F1 respectively) for 160 days, respectively. The contents of testosterone (T), luteinizing hormone (LH), and follicle stimulating hormone (FSH) in serum were detected in 20 months of F0 generations, and 15 months of F1 generations. RT-PCR was used to analyze the levels of StAR mRNA and P450scc mRNA. Results Compared with the normal control group, the testosterone contents in exposed F0 and F1 generations increased, the lowest was 51.73 U/L, but those of LH and FSH decreased. The expression of StAR mRNA in the low-doze group of F1 generation (StAR/β-actin = 1.35) was up-regulated, down-regulated for other groups.compared with the normal control group (P450scc/β-actin = 0. 313), the expression of P450scc mRNA in the low- and high-dose groups of F0 generation were decreased (P450scc/β-actin = 0.21), and those in the low- and high-dose groups of F1generation were increased (P450scc/β-actin = 0.623) (P ≤ 0.01). Conclusion Long-term DU exposure inhibit the male reproduction by intervening the sexual hormone production through down-regulated the expression of StAR mRNA and P450scc roRNA.

Objective To study the effects of rhubarb on the mitogen-activated protein kinase (MAPK) sig-naling transducfon pathway in rats with severe acute pancreatitis (SAP),and to investigate the treatment mecha-nism of rhubarb on SAP. Method One hundred SD rats were provided by from the Animal Center of Nanjing Uni-versity. All animals were randomly divided into sham operation (n=33), SAP (n=33) and rhubarb groups (n=34). SAP model was induced by retrograde injection of 5% sodittm taurocholate. Rhubarb was given with 10% rhubarb decoction (2 mi/100 g) at the time of pancreafitis induction in the rhubarb groups. At 1, 3, 6, and 12 h after the models were established,animals were killed. MAPK activity in pancreatic tissue was examined by West-em blotting and the mRNA levels of TNF-α and IL-6 in pancreatic tissues were detected by RT-PCR. All data were analyzed by SPSS statistical software and statistical differences between values from two sroups were determined by the Student's t -test. Results MAPK activity, TNF-α and IL-6 mRNA levels in pancreatic tissues were signifi-cantly enhanced in the SAP group compared with the sham operation group (all P<0.01). Rhubarb treatment markedlyinhibited MAPK activation,TNF-α,IL 6 mRNA (all p<0.01). Conclusions Rhubarb can alleviate the inflammatory response of SAP by down-regulating MAPK activity.