Objective To investigate the blood-saving effect of controlled low central venous pressure (CLCVP) in different types of hepatectomy.Methods Ninety ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 37-76 yr,weighing 40-75 kg,undergoing elective hepatectomy,were divided into 6 groups according to the surgical approach and whether CLCVP was used during surgery (n =15 each):CLCVP1-3 groups and nonCLCVP1-3 groups (NCLCVP1-3 groups).The standard hepatectomy,half liver resection and irregular hepatectomy were performed in CLCVP1-3 groups,respectively,with CLCVP.The standard hepatectomy,half liver resection and irregular hepatectomy were performed in NCLCVP1-3 groups,respectively,without CLCVP.In CLCVP1-3 groups,from skin incision to the end of liver resection,CVP was maintained ≤ 5 cm H2 O through adjustment of the position,fluid restriction and iv infusion of nitroglycerin,and norepinephrine was infused simultaneously to maintain mean arterial pressure ≥ 60 mm Hg.In NCLCVP1-3 groups CVP was maintained at 6-12 cm H2O.Intraoperative blood loss and blood transfusion were recorded.Results Compared with NCLCVP1-3 groups,intraoperative blood loss was significantly decreased in CLCVP1-3 groups (P ＜ 0.05).Compared with NCLCVP3 group,the amount of blood transfusion was significantly decreased,the constituent ratio of intraoperative blood loss ＜ 200 ml was increased,and the constituent ratio of intraoperative blood loss ＞ 1000 ml was decreased in group CLCVP3 (P ＜ 0.05).Conclusion CLCVP can decrease the intraoperative blood loss and blood transfusion in patients undergoing irregular hepatectomy.

Objective To compare the therapy effectiveness and life quality of different surgery strategy on hypertensive cerebral hemorrhage .Methods 106 patients of hypertensive cerebral hemorrhage during 2010 to 2012 were randomly divided into therapy group and control group .The therapy group was treated with surgery according to location and volume of hematoma while the con-trol group was treated with little bone window hematoma remove surgery .The outcomes of both groups were observed .Results The therapy group had shorter hospital time ,lower hematoma residual volume and higher GCS score than control group(P<0 .05) . The therapy group had significantly higher cured rate and effective rate and significantly lower complication rate than control group (P<0 .05) .After 3 months ,ADL score showed patients who recovered self-care ability in therapy group were more than control group(P<0 .05) .Conclusion Individual surgical methods in treatment of hypertensive cerebral hemorrhage can improve therapy effectiveness and cerebral function recovery ,and elevate the life quality .

Objective To explore the impact of dexamethasone on inflammatory response of thyrocytes.Methods Primary thyrocytes were extracted from thyroid tissue of patients with Graves' disease.The cells were stimulated with interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α),and cultured in dexamethasone.Thyrocytes were divided into 4 groups:control group,dexamethasone group,TNF-α + IFN-γ group,and dexamethasone+TNF-α+IFN-γ group.Interferon-γ-induced protein 10 (CXCL10) and CCL2 in supernatant of cell cultured in 4 groups were detected by enzyme-linked immunosorbent assay.Cell protein in 4 groups was extracted and GSK-3β,P50,and P100 protein were detected by Western blotting.Results MTT assay demonstrated that 10-5 mmol/L concentration of dexamethasone was optimal for cell culture.The CXCL10 level in TNF-α+IFN-γ group was higher than that in the control group and dexamethasone group (P＜0.01),but no difference was found between dexamethasone+TNF-α+IFN-γgroup and TNF-α+IFN-γgroup(P＞0.05).The CCL2 level in TNF-α+IFN-γ group was higher than that in control group and dexamethasone group(P＜0.01).There was a significant lowering of CCL2 level in dexamethasone + TNF-α + IFN-γgroup compared with TNF-α + IFN-γ group (P ＜ 0.05).The expression of GSK-3β and P100 protein was increased in TNF-α + IFN-γgroup compared with control group.The expression of GSK-3β and P100 protein was lower in dexamethasone+TNF-α + IFN-γ group than that in TNF-α + IFN-γ group.Conclusion TNF-α + IFN-γ could stimulate the secretion of CXCL10 and CCL2 in thyrocytes and thus activate the inflammatory response.Dexamethasone could reduce CCL2 secretion.Dexamethasone had little effect on CXCL10.Dexamethasone could reduce GSK-3β and P100 expressions,and inhibit the activation of NF-κB signaling pathway and thus the inflammatory response.

Objective To explore the characteristic of transcranial color-coded sonography(TCCS)and contrast-enhanced transcranial color-coded sonography (CE-TCCS) in patients with intracerebral hemorrhage and thiers clinical value.Methods 66 patients were randomly selected,whose preliminary clinical diagnosis were intracerebral hemorrhage (ICH).The patients were followed up by TCCS in acute phase,subacute phase and chronic phase.The changes of the echo,boundary and the hematoma volume were recorded in different stages.In acute phase,patients' complications of intracerebral structure were observed.32 patients were selected randomly to underwent CE-TCCS examination in the subacute phase.The size,shape and the perfusion situation of hematoma were observed.The results of CE-TCCS were compared with the results of TCCS.Correlation analysis was made between the results of ultrasound and CT scan.Results (1) CT results:61 patients (61/66) were confirmed ICH through CT scan.(2) TCCS results:50 patients (50/61) with ICH could show the bleeding site.TCCS showed that 33 patients with ICH accompanied by intraventricular pressure,haematoma defeats ventricle and midline shift in acute phase.The echo became lower and the boundary became more clear with time.The long diameter,wide diameter,thickness diameter and volume of hematoma in different stages on TCCS had a good correlation with that on CT scan.(3)CE-TCCS results:30 cases of intracerebral hematoma could be clearly displayed the situation of hematoma through the ipsilateral temporal window.Compared with TCCS,CE TCCS had a better correlation with CT scan on the measurement of the hematoma length,width.The images of 2 cases observed through contralateral temporal window failded to be clearly shown.In 7 cases of ICH,visible low-enhanced edema area could be seen around the hematoma.The width of the edema area had a good correlation with the CTP result.Conclusions TCCS could clearly show the bleeding sites,hematoma volume and complications and the features of ICH in different stages of disease.TCCS could be used to monitor the condition of patients with ICH and recognized the disease progression initially.CE-TCCS had a much more clear display of intracerebral hematoma location,shape,boundary.At the same time,CE-TCCS could provide blood perfusion information of surrounding tissue in hematoma so that it could observe the change of peripheral edema more convenient.

Objectives To investigate the relationship between single nucleotide polymorphism (SNP)H558R in SCN5A gene and chronic Keshan disease (KSD) complicated with hypertension,and the relationship between H558R and occurrence of arrythmia in chronic KSD complicated with hypertension.MethodsThirty nine patients with chronic KSD complicated with hypertension and 63 geographical region matched hypertension control subjects were recruited in our study in Fuyu county,Qiqihaer city,Heilongjiang province between 2006 and 2010.H558R polymorphism in case and control groups was genotyped using the polymerase chain reaction single-strand conformation polymorphism(PCR-SSCP) and sequenced,and electrocardiography(ECG) characteristics were examined in the two groups.Case-control study analytical methods were applied to analyze the relationship between H558R and chronic KSD complicated with hypertension,and the relationship between H558R and occurrence of arrythmia in chronic KSD patients complicated with hypertension.Results Subjects of genotype 558 TC in the case group had a decreased risk of chronic KSD complicated with hypertension with odds ratio of 0.288[95％ confidence interval (CI):0.104 - 0.794],and subjects of genotype TC in chronic KSD complicated hypertension patients had a decreased risk of QRS prolongation with odds ratio of 0.061 (95％CI:0.006 - 0.612).Conclusions Polymorphism H558R in SCN5A gene may be a predisposition factor of chronic KSD complicated with hypertension and occurrence of arrythmia in chronic KSD complicated with hypertension.

The role of pulchinenoside (PULC) in the regulation of MeCP2 expression was investigated in RA model rats. Adjuvant arthritis rats were used as RA model rats, and fibroblast-like synoviocytes (FLS) from the RA model rats were cultured. The effect of 100 mg x kg(-1) PULC gavage treatment on the MeCP2 expression and the effect of MeCP2 siRNA on the expression of SFRP2 and β-catenin were detected by real time qPCR and Western blotting. The role of PULC in the FLS proliferation was detected by MTT. The results showed that the MeCP2 expression was down-regulated, the SFRP2 expression was up-regulated and the FLS proliferation was inhibited in FLS after therapy. MeCP2 siRNA significantly inhibited the MeCP2 expression, up-regulated the SFRP2 expression and inhibited the β-catenin expression in FLS from RA model rats. PULC may increase the SFRP2 expression, inhibit the Wnt signaling and inhibit the FLS proliferation in FLS from the RA model rats by inhibiting the MeCP2 expression.
Animals ; Arthritis, Rheumatoid ; drug therapy ; genetics ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Fibroblasts ; drug effects ; metabolism ; Gene Expression Regulation ; drug effects ; Humans ; Male ; Methyl-CpG-Binding Protein 2 ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Synovial Membrane ; cytology ; drug effects ; metabolism ; Wnt Signaling Pathway ; drug effects ; beta Catenin ; genetics ; metabolism

To study the effect of pulchinenoside (PULC) on the Frizzled (FZD) expression of adjuvant arthritis ( AA) rats. AA rats were prepared through the toe injection with complete Freund's adjuvant to culture fibroblast-like synoviocytes (FLS). The effect of the oral administration with PULC on the FZD8 expression was detected by the real time qPCR. The effect of FZD8 knockout on the expressions of IL-1, IL-6, IL-8 were detected by MTT and ELISA. The role of miR-375 in the abnomal expression of FZD8 was detected by the real time qPCR. The results showed signfiicant decrease in the FZD8 expression among AA rats, FLS proliferation ater FZD8 knockout and IL-1, IL-6, IL-8 expressions and notable increase in miR-375 expression after the oral administration with PULC. The up-regulated miR-375 expression can inhibit the FZD8 expression. PULC may inhibit the FZD8 expression by up-regulating the miR-375 expression.
Animals ; Arthritis, Experimental ; drug therapy ; genetics ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Cell Surface ; genetics ; metabolism ; Saponins ; administration & dosage

[ ABSTRACT] AIM:To investigate the role of ATP-sensitive potassium ( KATP ) channels in the inhibitory effect of hydrogen sulfide ( H2 S) on high glucose ( HG)-induced inflammation mediated by necroptosis in H 9c2 cardiac cells. METHODS:The expression levels of receptor-interacting protein 3 ( RIP3; an indicator of necroptosis ) and cyclooxyge-nase-2 (COX-2) were determined by Western blot.The levels of interleukin-1β(IL-1β) and tumor necrosis factor-α( TNF-α) were detected by ELISA .RESULTS:After H9c2 cardiac cells were treated with 35 mmol/L glucose ( HG) for 24 h, the expression of RIP3 was significantly increased .Pre-treatment of the cells with 100 μmol/L diazoxide ( DZ; a KATP channel opener) or 400 μmol/L NaHS (a donor of H2S) for 30 min considerably blocked the up-regulation of RIP3 induced by HG.Moreover, pre-treatment of the cells with 100 μmol/L 5-hydroxydecanoic acid (5-HD; a KATP channel
blocker) attenuated the inhibitory effect of NaHS on HG-induced up-regulation of RIP3.On the other hand, co-treatment of the cells with 100μmol/L necrostatin-1 ( a specific inhibitor of necroptosis ) or pre-treatment of the cells with 100 μmol/L DZ or 400 μmol/L NaHS attenuated HG-induced inflammatory responses , evidenced by decreases in the expression of COX-2 and secretion levels of IL-1βand TNF-α.However , pre-treatment of the cells with 100 μmol/L 5-HD significantly attenuated the above anti-inflammatory effects of NaHS.CONCLUSION:KATP channels play an important role in the inhib-itory effect of H2 S on HG-induced inflammation mediated by necroptosis in H 9c2 cardiac cells.

Objective To investigate the effect of controlled low central venous pressure(CLCVP) on blood loss and prognosis in different types of hepatectomy .Methods Two hundred and fifty seven patients underwent standard hepatectomy ,half liver resec‐tion or irregular partial hepatectomy from January 2011 to December 2012 in the First Affiliated Hospital of Chongqing Medical U‐niversity were retrospectively studied .Patients treated with CLCVP during hepatectomy were attributed to the CLCVP group .CVP of these patients were lowed to below 5 cm H2 O by minimizing fluid infusion and one or both of the following maneuvers :posture adjustment ,nitroglycerin administration .Alpha agonists were used when necessary to maintain the mean arterial pressure MAP at ≥60 mm Hg .Other patients been maintained with normal level of CVP by adjusting fluid administration were included in normal CVP group (NCVP) .Blood loss and transfusion volume ,length of hospital stay of the two groups were compared ,and the effects of different surgery type on CLCVP blood protection were evaluated .Results In the patients underwent standard hepatectomy or half liver resection ,intraoperative blood loss and transfusion were not statistically different between the two groups .While in the pa‐tients underwent irregular partial hepatectomy ,the CLCVP group suffered less blood loss and transfusion(P<0 .05) .Percentage of the patients with less than 200 mL blood loss and no transfusion of concentrated red cell in CLCVP group was higher than that of in NCVP group(P<0 .05) .Differences between the two groups in postoperative hospital stay were with no significance in all the operation types(P>0 .05) .Conclusion The efficiency of CLCVP on blood protection during hepatectomy is influenced by the sur‐gery type ,the blood protection is found to be significant only in irregular partial hepatectomy .No relationship was found between CLCVP and postoperative hospital stay in all types of hepatectomy .

Objective To evaluate the application value of inhibitor enhanced modified carbapenemase inactivation method (imCIM) in the detection of class B carbapenemase.The differences between imCIM and EDTA disc potentiation test (EDPT) were comparatively analyzed.Methods A total of 181 strains of carbapenem insensitive strains were collected,among which there were 44 strains of Klebsiella pneumoniae,44 strains of Escherichia coli,43 strains of Acinetobacter baumannii and 50 strains of Pseudomonas aeruginosa.The 83 strains of carbapenem-sensitive strains were composed of 25 strains of Klebsiella pneumoniae,16 strains of Escherichia coli,25 strains of Acinetobacter baumannii and 17 strains of Pseudomonas aeruginosa.The class B carbapenemase in the 264 strains of pathogenic bacteria was screened by imCIM and EDPT,and PCR results were used as gold standard.The statistical analysis wasperformed with consistency check,related-sample Wilcoxon signed rank sum test,independent samples Kruskal-Wallis H test and ROC curve.Results Among the 181 strains of carbapenem insensitive strains,PCR results of 144 strains were positive for drug resistance gene.The samples of class A,B and D of carbapenemase were 39,77 and 28 strains respectively.The results of imCIM showed that 70 strains were positive,and the other 111 strains were negative.The imCIM results of 166 strains were consistent with those of PCR.The results of EDPT showed that 72 strains were positive,and the other 109 strains were negative.The EDPT results of 134 strains were consistent with those of PCR.The results of PCR,EDPT and imCIM of 83 carbapenem sensitive strains were negative.The sensitivity and specificity of imCIM were 85.71％ (66/77) and 97.86％ (183/187),and the value of Kappa was 0.859.The sensitivity and specificity of EDPT were 66.23 ％ (51/77) and 88.77 ％ (166/187),and the value of Kappa was 0.561.The difference of inhibition zone of imCIM (AdimCIM) was different from EDPT(AdEDPr) and the difference was statistically significant (Z =-6.941,P ＜ 0.05).In the imCIM detection,the AdimciM level of class B carbapenemase showed different population distribution position from class A and D carbapenemase with the statistically significant difference (x2 =108.887,P ＜ 0.05).The areas under the ROC curve of imCIM and EDPTwere 0.988 (95％CI:0.977 to0.999) and0.936 (95％CI:0.909 to0.963),respectively.Conclusion imCIM should be accurate,efficient and convenient for screening of carbapenem phenotype for its high sensitivity and specificity,and suitable for epidemiological monitoring.