BACKGROUND: Serious lesion to liver function may cause the pulmonary artery hypertension and fluctuation of haemodynamics directly induces changes of pulmonary artery pressure during neo-hepatic stage in liver transplantation. OBJECTIVE: To observe the change of pulmonary artery pressure during liver transplantation and to explore treatment for pulmonary artery hypertension. DESIGN, TIME AND SETTING: Controlled observation was carried out among the liver transplant recipients who were enrolled from the 181 Hospital of Chinese PLA from June 2004 to June 2006. PARTICIPANTS: Totally 13 patients, all males, were reviewed. Their ages ranged from 19 to 53 years. They were selective for the liver transplantation. METHODS: Undergoing general anesthesia, mean arterial blood pressure, central venous pressure, pulmonary arterial pressure and pulmonary arterial wedge pressure were continuously monitored by Swan-Ganz catheter method and reversible Fick’s law continuous monitoring. Available respiration administration, low dose of glyceryltrinitrate (0.1-5.0 ?g/kg/min) and Alprostadil (1.0-2.0 ?g) were administered to diminish elevated pulmonary arterial pressure and pulmonary arterial wedge pressure during the period after unclamping portal vein in liver transplantation. MAIN OUTCOME MEASURES: Changes of mean arterial blood pressure and pulmonary arterial pressure. RESULTS: The mean arterial blood pressure deceased at the time of unclamping portal vein in all 13 patients, pulmonary arterial pressure and pulmonary arterial wedge pressure both increased significantly at 5 and 15 minutes within neo-hepatic stage, which were more obvious than those during anhepatic stage in 13 patients (P

BACKGROUND: Serious lesion to liver function may cause the pulmonary artery hypertension and fluctuation of haemodynamics directly induces changes of pulmonary artery pressure during neo-hepatic stage in liver transplantation. OBJECTIVE: To observe the change of pulmonary artery pressure during liver transplantation and to explore treatment for pulmonary artery hypertension. DESIGN, TIME AND SETTNG: Controlled observation was carried out among the liver transplant recipients who were enrolled from the 181 Hospital of Chinese PLA from June 2004 to June 2006.PARTICIPANTS: Totally 13 patients, all males, were reviewed. Their ages ranged from 19 to 53 years. They were selective for the liver transplantation. METHODS: Undergoing general anesthesia, mean arterial blood pressure, central venous pressure, pulmonary arterial pressure and pulmonary arterial wedge pressure were continuously monitored by Swan-Ganz catheter method and reversible Fick's law continuous monitoring. Available respiration administration, low dose of glyceryltrinitrate (0.1-5.0 u g/kg/min) and Alprostadil (1.0-2.0 u g) were administered to diminish elevated pulmonary arterial pressure and pulmonary arterial wedge pressure during the period after unclamping portal vein in liver transplantation. MAIN OUTCOME MEASURES: Changes of mean arterial blood pressure and pulmonary arterial pressure. RESULTS: The mean arterial blood pressure deceased at the time of unclamping portal vein in all 13 patients, pulmonary arterial pressure and pulmonary arterial wedge pressure both increased significantly at 5 and 15 minutes within neo-hepatic stage, which were more obvious than those during anhepatic stage in 13 patients(P＜0.05).The pulmonary arterial pressure and pulmonary arterial wedge pressure revived to the level before unclamping inferior vein by treatment with glyceryltrinitrate and Alprostadil within 30 minutes. CONCLUSION: Reasonable application of glyceryltrinitrate and Alprostadil can obviously release pulmonary arterial pressure during neo-hepatic stage in liver transplantation.

OBJECTIVE To study the imprinting status of H19 gene in normal villi tissue during the first trimester,and its relation to the invasion of trophoblast. METHODS Using PCR-RFLP methods to examine the imprinting status of H19 gene in 93 cases of normal villi tissue during the first trimester. RESULTS Among 93 cases, heterozygous genotypes were found in 42 cases. And 11 cases of biallelic expression were found among these 42 cases of heterozygous genotypes from 5 to 9 weeks, however no biallelic expression existed from 10 to 12 weeks. CONCLUSIONS During the first trimester, H19 is expressed biallelically at the first 10 weeks. The H19 gene may dynamicly change in the trophoblast, and the dynamic change may have close relationship with the invasion of the trophoblast.

Objective To investigate the relationship between ?3 adrenergic receptor(?3AR) gene Trp~(64)Arg mutation and insulin resistance(IR) in Chinese.Methods The 120 patients with type 2 diabetes mellitus(group DM) and 80 nondiabetic subjects as normal controls(group N)were involved in the study.Polymerase chain reaction(PCR) and the restriction fragment length polymorphism analysis(PCR-RFLP) were used to determine the ?3AR genotype.The indexes such as body weight,height,waist circumstance,hip circumstance,blood pressure,lipids,fast plasma glucose and insulin were detected in all subjects.The IR was estimated by homeostasis model assessment(HOMA-IR).The patients in the diabetes group were divided into relative insulin sensitive group and relative insulin resistant group by the 75th percentile HOMA-IR.Results The BMI of the patients with the ?3AR Trp~(64)Arg mutation was significantly higher than that of those without the mutation(P

Background and purpose: AMP-activated protein kinase (AMPK) plays an important role in the regulation of cell metabolism and energy balance and is associated with cell proliferation, survival and multiple signaling pathways. Recent reports found that AMPK is involved in tumor suppression and drug resistance. The aim of this study was to explore the effect of AMPK on the anti-tumor effect of adriamycin and underlying mechanism in breast cancer MCF-7/adr cells. Methods:The anti-proliferative effects of adriamycin was detected by methyl thiazolyl tetrazolium (MTT) assay in MCF-7/adr, MCF-7/adr-vector and MCF-7/adr-AMPKαcells. The cell morphology in each group was stained with the lfuorescent dye Hoechst 33528, and the effects on apoptosis induction were examined by lfow cytometry (FCM). The intracellular concentration of adriamycin was detected by lfuorescence assay. The resis-tance-and apoptosis-related proteins were analyzed by Western blot. Results:The growth of breast cancer MCF-7/adr cells was inhibited by adriamycin in a dose-and time-dependent manner. The IC50 values at 24 and 48 h were (36.8±2.1) and (28.8±1.3) μg/mL, respectively. AMPKαover-expression enhanced the cytotoxic effect of adriamycin in MCF-7/adr-AMPKαcells in a dose-and time-dependent manner. Its IC50 values at 24 and 48 h were (16.0±0.7) and (4.2±0.2) μg/mL, respectively. Fluorescent morphological assay showed that AMPKαoverexpression contributed to adriamycin induced apoptosis in MCF-7/adr-AMPKαcells. After treatment with 1.0 μg/mL adriamycin for 48 h, the apoptosis rates of MCF-7/adr, MCF-7/adr-vector and MCF-7/adr-AMPKα cells were (12.0±1.4)%, (12.7±1.6)% and (32.0±4.2)%, respectively, indicating that overexpression of AMPKα enhanced the adriamycin-induced apoptosis in MCF-7/adr cells. Fluorescence microplate assay showed that over expression of AMPKαsigniifcantly increased the intracellular accumulation of adriamycin, in a concentration dependent manner. Western blot analysis showed that, compared with MCF-7/adr and MCF-7/adr-vector cells, the expressions of Bax, caspase-3 and cleaved PARP proteins were increased. Meanwhile, Bcl-2 and P-gp protein expressions were decreased in MCF-7/adr-AMPKαcells. Furthermore, the release of cytochrome c from mitochondria into the cytosol was also observed in MCF-7/adr-AMPKαcells. Conclusion:AMP-Kαoverexpression can enhance the chemosensitivity of breast cancer MCF-7/adr cells to adriamycin through inhibiting the drug effux transporter and regulating the expression of apoptosis-related proteins.

Objective To discuss the value of tension-free hernia repair to recurrent inguinal hernia in elderly patients.Methods 38 eases with recurrent inguinal hernia in elderly patients were treated with shaped polyproplene tension-free hernioplasty.Results All eases were operated successfully.In the follow-up period ranged from 6 to 42 months.No Serious postoperation complications were found,no recurrent case recurred.This treatment is effective.Conclusion Tension-free hernia repair has many advantages,such as safety,easily manipulation,minimal invasion,rapid recovery,lower recurrence.It is a perfect and ideal surgical operation for the recurrent inguinal hernia in elderly patients.

Objective To obtain the expression pattern of imprint gene H19 in JEG-3 cell in order to explore the regulation mechanism of H19 on trophoblast cellular biological behavior .Methods After correct identification with sequencing for the recom-binant eukaryotic expression plasmid pRc/CMV which including the whole length of H19 cDNA ,the plasmid was transfected to the cell line JEG-3 .The expression of H19 mRNA was observed and the gene expression profile of three groups of JEG-3 cell were de-tected with Affymetri :U133 plus 2 .0 Array .Results After being transfected with target H 19 gene ,the expression of the mRNA level was significantly increased compared with control group .And the gene expression profile was changed significantly .19 genes were up-regulated ,77 genes were down-regulated .Expression levels of HES1 gene which being choosed as a different expression gene were detected by fluorescence quantitative PCR in severe preeclampsia placenta tissue and normal late pregnant placenta .The expression level of HES1 mRNA in severe preeclampsia placenta decreased significantly than normal late pregnant placenta tissues . Conclusion Many genes induced by H19 have been screened by high-throughput gene chip method .It provides the experimental ba-sis for advanced studying the regulation the cellular biological behavior with H 19 gene .

Objective To explore the role of H19 imprinting in etiology of pre-eclampsia. Methods Placentas of 24 women with pre-eclampsia (3 with mild pre-eclampsia and 21 with severe pre-eclampsia) and 50 healthy pregnant women at full term (control) were collected during selected cesarean delivery between August 2007 and March 2008. The statuses of H19 imprinting with placental tissues from normal pregnancy and patients with pre-eclampsia were identified upon polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The systolic and diastolic pressure were analyzed in H19 heterozygotic women. Results (1) There were 20 (40%) heterozygotes in 50 cases placenta tissues of the third trimesters, 11 (45%) heterozygotes in 24 cases placenta tissues of pre-eclampsia, There were no significant difference between two groups ( P > 0.05 ). (2) All 20 heterozygotes in placenta tissues of the third trimesters are exclusively monoallelically expressed, while 5 cases (45%) in 11 heterozygotes of pre-eclampsia are biallelically expressed (loss of imprinting, LOI). There were significant difference between two groups (P < 0. 01 ). (3) The values of systolic and diastolic pressure of patients with monoallelic expression of H19 were (171 ±9) mm Hg (1 nun Hg =0.133 kPa) and ( 104±8) mm Hg, the values of systolic and diastolic pressure with biallelic expression were ( 194±21 ) mm Hg and ( 124±18) mm Hg. There were significant difference between two groups (P<0.05 ). Conclusion LOI of H19 can be identified in pre-eclamptic placentas and is associated with maternal blood pressures, which implies the involvement of H19 gene LOI in the pathogenesis of pre-eclampsia and its potential relationship with the severity of the disease.

Objective To investigate the effect of the multimodal analgesia on postoperative pain after renal transplantation and the cytokines .Methods 40 cases of allogaft renal transplantation due to chronic renal failure were randomly divided into two groups (n=20) .The group D received the multimodal analgesia :preemptive analgesia plus patient controlled epidural analgesia(PCEA) and the group C(control) received analgesic drugs by intermittent intramuscular injection .The visual analogue scale(VAS) scores , the Ramsay sedation scores ,HR ,MAP and SPO2 at postoperative 2 ,6 ,12 ,24 ,48 h were recorded .Blood interleukin-2(IL-2) ,in-terleukin-6(IL-6) and interleukin-10(IL-10) levels were measured before anesthesia ,at the end of operation and postoperative 6 , 24 ,48 h .Results Postoperative MAP and SPO2 had no obvious change in the two groups ,no statistical differences in the various time points existed between the two groups (P>0 .05) .HR was significantly increased at 6 ,24 h after operation in the group C , which had statistical difference compared with that at the same time points in the group D (P<0 .05) .The VAS scores at postoper-ative 6 ,12 ,24 h in the group D were significantly lower than those in the group C ,the difference showed statistical significance (P<0 .05) .The sedation scores at various time points had no statistical difference between the two groups (P>0 .05) .The levels of IL-2 and IL-10 at postoperative 6 ,24 ,48 h in the two groups were significantly higher than those before anesthesia and at the end of operation (P<0 .05) .The levels of IL-2 and IL-6 at postoperative 6 ,24 ,48 h in the group D were significantly lower than those in the group C(P<0 .05) .Conclusion Multimodal analgesia can reach the effective analgesic effect ,down-regulate the pro-inflam-matory cytokines and up-regulate anti-inflammatory cytokines for maintaining postaperative serum cytokines balance .

Objective To investigate the expression of Aire,Foxp3,AchR and other immune factors in human thymoma tissue and plasma and explore their role in myasthenia gravis with thymoma.Methods T lymphocyte subsets,immunoglobulin and other immune factors in plasma were compared,and the Expression of Aire,Foxp3 and AchR were examined in thymoma by reverse transcriptional polymerase chain reaction and immunohistochemical staining,and the results were analyzed by SPSS statistics software.Results The ratio of CD4 + to CD8 + T lymphocyte was much higher in plasma,while the expressions of Aire,Foxp3 and AchR at mRNA and protein level were much lower in thymoma patients with myasthenia gravis,and related to Ossermann subtype,WHO subgroup and Masaoka stage.The differences were statistically significant (P ＜ 0.05).Conclusion The ratio of CD4 + to CD8 + T lymphocyte and the abnormal expressions of Aire and Foxp3could used as an indicator of immune state in thymoma patient with myasthenia gravis and play an important role in the development of thymoma with myasthenia gravis,but the mechanism is indefinite.