Objective To investigate the changes in cerebral oxygen metabolism during liver transplantation in patients with liver cirrhoses.Methods Sixteen ASAⅢorⅣpatients with liver cirrhoses(14 male,2 female)aged 25-67 yrs,weighing 45-80 kg undergoing liver transplantation were studied.Radial artery was cannulated for direct BP monitoring and blood sampling.Swan-Ganz catheter was placed in pulmonary artery (PA)via right internal jugular vein(IJV)for cardiac output(CO)monitoring and sampling mixed venous blood. Left IJV was cannulated and the catheter was advanced cephalad until jugular bulb for blood sampling.Anesthesia was induced with midazolam,fentanyl,propefol and vecuronium and maintained with isoflurane inhalation and intermittentⅣboluses of fentanyl and vecuronium.The patients were mechanically ventilated after tracheal intubation.PaCO_2 was maintained between 30-45 mm Hg.Blood samples were taken from radial artery,pulmonary artery and jugular bulb simultaneously for blood gas analysis before operation(T_0,baseline),10 min before anhepatic phase(T_1)20 min after onset of anhepatic phase(T_2),30 min after graft reperfusion(T_3)and at the end of operation(T_4).Oxygen delivery(DO_2),oxygen consumption(VO_2),oxygen content of jugular bulb blood (CjvO_2),cerebral arterial-venous oxygen content differences(Ca-jvO_2)cerebral oxygen extraction ratio(CERO_2) and CBF/CMRO_2 were calculated.Results The mean duration of operation was(364?51)min and the mean intraoperative blood loss was(1340?430)ml.CO was significantly increased before anhepatic phase(T_1), during neohepatic phase(T_3)and at the end of operation(T_4)but decreased during anhepatc phase(T_2)as compared with the baseline value at T_0.Hb,CaO_2,Ca-jvO_2 and CERO_2 were all decreased while SjvO_2 and CBF/ CMRO_2 were increased during operation;DO_2,VO_2 and CjvO_2 were decreased during anhepatic phase;DO_2 was increased during other phases;VO_2 was increased at the end of operation as compared with the baseline(T_0)(P＜0.05 or 0.01).Conclusion There is no cerebral oxygen deficiency during liver transplantation in patients with liver cirrhoses.

160 s and core temperature was 36-37℃.Blood ga- ses,platelets,plasma free hemoglobin and coagulation factors were measured during ECMO support. The blood supply was monitored in the limbs cannulated with the femoral artery cannula.Results Two patients were successfully treated with ECMO without major complications.The circulatory and respiratory function of the patients was stable.The chest X-ray showed a no clouding of lungs and he- patic function was greatly improved in case 2 who underwent a successful heart transplantation follo- wing mechanical cardiocirculatory support as a bridge,Two patients received ECMO support for 5 and 3 days respectively.Both patients recovered well.No any severe acute rejection occurred and heart func- tion was NYHAⅠ.Conclusion When candidates suffered acute cardiogenic shock,ECMO can provide safe and effective mechanical circulatory support as a bridge to heart transplantation.

OBJECTIVETo study the effect of exogenous Ca2+ on photosynthetic parameters of Pinellia ternate and accumulations of active components under high temperature stress.

METHODThe pigment contents of P. ternata leaves, photosynthesis parameters and chlorophyll fluorescence parameters of P. ternata leaves, the contents of guanosine, adenosine and polysaccharide in P. ternata tubers were measured based on different concentrations of exogenous Ca2+ in heat stress when the plant height of P. ternata was around 10 cm.

RESULTThe contents of total chlorophyll and ratio of chlorophyll a/b were relatively higher by spaying Ca2+. Compared with the control, spaying 6 mmol x L(-1) Ca2+ significantly enhanced the net photosynthetic rate (Pn), transpiration (Tr) and stomatal limitation (L8), but reduced intercellular CO2 concentration (C) in P. ternata leaves. With the increase of Ca2+ concentration, maximal PS II efficiency (Fv/Fm), actual photosynthetic efficiency (Yield) and photochemical quenching coefficient (qP) initially increased and then decreased, however, minimal fluorescence (Fo) and non-photochemical quenching coefficient (NPQ) went down first and then went up. The contents of guanosine and polysaccharide and dry weight of P. ternata tubers showed a tendency of increase after decrease, and the content of adenosine increased with the increase of Ca2+ concentration. The content of guanosine and polysaccharide in P. ternata tubers and its dry weight reached maximum when spaying 6 mmol x L(-1) Ca2+.

CONCLUSIONWith the treatment of calcium ion, the inhibition of photosynthesis and the damage of PS II system were relieved in heat stress, which increased the production of P. ternata tubers.

Breeding ; Calcium ; pharmacology ; Chlorophyll ; metabolism ; Dose-Response Relationship, Drug ; Heat-Shock Response ; drug effects ; Organ Size ; drug effects ; Photosynthesis ; drug effects ; Pinellia ; drug effects ; growth & development ; metabolism ; physiology ; Plant Leaves ; drug effects ; growth & development ; metabolism

Objective To investigate the changes in systemic and pulmonary hemodynamics in patients with liver cirrhosis and portopulmonary hypertension(PPH)during liver transplantation.Methods Eight patients with liver cirrhosis and PPH(5 male,3 female)aged 50-63 yr weighing 45-80 kg were included in PPH group. Another 8 liver-cirrhotic patients without PPH served as control group.The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg.Anesthesia was induced with midazolam 3-5 mg,fentanyl 0.15-0.2 mg,propefol 1 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with 0.5%-3% isoflurane inhalation and intermittent Ⅳ boluses of fentanyl and vecuronium.The patients were mechanically ventilated after tracheal intubation.P_(ET)CO_2 was maintained at 30-45 mm Hg.Right subclavian vein was cannulated for fluid and drug administration and blood transfusion.Radial artery was cannulated for BP monitoring.Swan-Ganz catheter was placed via right internal jugular vein.BP,CVP,MPAP,PAWP,CI,PVRI and SVRI were monitored and recorded before operation(baseline),during preanhepatic phase,at 3 and 30 min of anhepatic phase and 3,7, 15,60 min of neohepatic phase and at the end of operation.Results(1)The two groups were comparable with respect to fluid balance,the amount of vasoactive drugs used during anhepatic and neohepatic phase,duration of anhepatic phase and operation.(2)MPAP and PVRI were significantly higher before operation in PPH group than in control group.(3)CI,MPAP, PAWP and CVP were siguificanfly decreased during anhepatic phase as compared to the baseline values(before operation)in both groups and then gradually returned to and even exceeded the baseline values during neohepatic phase.(4)During neohepatic phase PVRI in PPH group was significantly increased as compared to the baseline value and was significantly higher than that in control group.Conclusion MPAP and PVRI are significantly increased during neohepatic phase in patients with PPH and need to be treated.

OBJECTIVETo summarize the experiences of cardiopulmonary bypass (CPB) techniques in 15 patients of orthotopic heart transplantation.

METHODSAll patients received mild hypothermia and high flow rate perfusion. Effective strategies were taken to protect myocardium, lung, kidney, and blood conservation. The donor hearts were arrested with aorto perfusion using 1 000 ml St. Thomas solution at 4 degrees C, perfused with 1 000 ml University of Wiscosin (UW) solution or Histidin-Tryptophan-Ketoglutarat (HTK) solution at 4 degrees C, and then preserved in ice saline. Ice mud was covered on the donor heart during anastomosis. Low potassium cardioplegia solution was perfused before the unclamping of aorta.

RESULTSThe CPB time was (165.2 +/- 22. 8) min, the warm ischemia time was ( 7. 7 +/- 1. 7) min, and the cold ischemia time was ( 142. 4 +/- 11. 5) min. Heart beats was automatically recovered in 10 patients, and was recovered upon defibrillation in 5 patients. Left ventricular ejection fractions were (64. 1 +/- 4. 6) % after one month. All patients survived.

CONCLUSIONProper CPB management and effective donor heart protection are essential to guarantee the success of heart transplantation.

Cardiopulmonary Bypass ; Heart Transplantation ; methods ; Humans

OBJECTIVETo observe the effects of astragalus membranacaus injection on the activity of the intestinal mucosal mast cells (IMMC) and inflammatory response after hemorrahagic shock-reperfusion in rats.

METHODThirty-two Wistar rats were randomly divided into four groups: normal group, model group, low dosage group, (treated with astragalus membranacaus 10 g kg(-1)) and high dosage group (treated with astragalus membranacaus 20 g kg(-1)). Models of hemorrhage shock for 60 minutes and reperfusion for 90 minutes were created. The animals were administrated 3 mL therapeutic solution before reperfusion. At the end of study, intestinal pathology, ultrastructure of IMMC, and expression of tryptase were observed. The levels of MDA, TNF-a, histamine, and SOD activity of intestinal were detected, and the number of IMMC was counted.

RESULTThe degranulation of IMMC was seen in model group and was attenuated by astragalus membranacaus treatment. Chiu's score of model group was higher than that of the other groups. Astragalus membranacaus could attenuate the up-regulation of the Chiu' s score, the levels of MDA and TNF-alpha, expression of tryptase, and the down-regulation of SOD activity and histamine concentration. The Chiu's score and MDA content were negatively, while SOD activity was positively correlated to the histamine concentration respectively in the four groups.

CONCLUSIONAstragalus membranacaus can reduce small intestine mucosal damage by inhibiting the activity of IMMC after hemorrhage shock reperfusion.

Animals ; Astragalus membranaceus ; chemistry ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Injections, Intravenous ; Intestinal Mucosa ; metabolism ; pathology ; Intestine, Small ; metabolism ; Male ; Malondialdehyde ; metabolism ; Mast Cells ; drug effects ; metabolism ; ultrastructure ; Random Allocation ; Rats ; Rats, Wistar ; Reperfusion Injury ; metabolism ; pathology ; Shock, Hemorrhagic ; metabolism ; pathology ; Tryptases ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Objective To examine the cognitive function of the childhood schizophrenia and healthy children,and to explore the characterized impairment of cognitive function in childhood schizophrenia.Methods Fifty untreated children with first-episode schizophrenia(schizophrenia group) and 50 healthy children(control group) were enrolled in the study.Chinese Wechsler intelligence scale for children (C-WISC),Wiscosin Cards Sorting Test (WCST),Stroop test and Trail making test A and B(TMT-A/B) were used to measure the cognitive function.The Clinical features were assessed with the scale for positive and negative syndrome(PANSS).Results Full intelligence quotient (FIQ),verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ) in schizophrenia group were significantly lower than those in the control group(P ＜ 0.05),but the change between VIQ and PIQ in schizophrenia group was higher than that in the control group(P =0.023).The complete categories in schizophrenia group were significantly lower than that in the control group(P ＜ 0.05).The total number of errors and the continuous errors in the schizophrenia group were significantly higher than those in the control group(P ＜0.05).No significant difference of the random errors was observed between the schizophrenia group and the control group.The times to complete word A,color B,double-word C and double-color D in the control group were significantly less than those in the schizophrenia group(P ＜ 0.05).The reaction time of Trail Making Test A/B and the error number of B in the schizophrenia group were significantly higher than those in the control group(P ＜ 0.05).No significant difference of the A error numbers were observed between the 2 groups (P ＞ 0.05).There were significant negative relationships between the negative syndrome and VIQ,PIQ(P ＜0.05) ;in contrast,there was significantly positive relationship between the negative syndrome and the A error numbers (P ＜ 0.05).There was significantly negative relationship between the total score of PANSS and completed categories (P ＜ 0.05).Multiple regression analysis showed that:there was a significant correlation between the damage of cognitive function in children and negative symptoms,PANSS total score,gender,age,years of education and place of residence (all P ＜ 0.05).Conclusions Children with first-episode schizophrenia have multiple cognitive deficits in speed of processing working memory,spatial memory,attention and executive function.Some of the cognitive impairments have certain relationships with negative syndrome.

OBJECTIVETo investigate cardiac function impairment and myocardial injury in rats with intestinal ischemia-reperfusion and the protective effect of cromolyn sodium.

METHODSThirty-two SD rats were randomized into 4 groups (n=8), namely the sham operation group, model group, 50 mg/kg cromolyn sodium group, and 25 mg/kg cromolyn sodium group. Intestinal damage was induced by clamping the superior mesenteric artery for 45 min followed by reperfusion for 60 min. Cromolyn Sodium was administrated intaperitoneally 15 min before reperfusion. The heart rate (HR), left ventricle pressure (LVSP), and the maximal/minimum rate of LVSP (+dp/dt(max), -dp/dt(max)) were sacrificed immediately before ischemia (baseline, T(0)), at 15 min (T(1)), 30 min (T(2)), 45 min (T(3)) of ischemia, and at 3 min (T(4)), 5 min (T(5)), 10 min (T(6)), 15 min (T(7)), 45 min (T(8)), 60 min (T(9)) of reperfusion. At the end of the experiment, the rats were executed and the hearts were immediately removed for observation of the pathological changes and determination of MDA contents and SOD activity.

RESULTSCompared with the baseline T(0), the HR, +dp/dt(max), -dp/dt(max) and the LVSP were decreased significantly at T(8) and T(9) in the model group and the two cromolyn sodium groups (P<0.05). Compared with the sham operation group, these indices were also significantly decreased at T(8) and T(9) in the model group and the two cromolyn sodium groups, but the model group had significantly lower levels for these indices at T(8) and T(9) than the two cromolyn sodium groups (P<0.05). The score of myocardial injury in the model group and the two cromolyn sodium groups were significantly higher than that of group A, and 50 mg/kg cromolyn sodium group had lower score than the model group (P<0.05). The rats in the model group had significantly higher MDA levels than those in the sham operation group and the 50 mg/kg cromolyn sodium group. SOD activities in the model group and 25 mg/kg cromolyn sodium group was lower than that in the sham operation group (P<0.05), but 50 mg/kg cromolyn sodium group had significantly higher SOD activities than the model group (P<0.05).

CONCLUSIONCromolyn sodium can protect the myocardium against intestal ischemia-reperfusion injury and improve the cardiac function.

Animals ; Cardiotonic Agents ; pharmacology ; Cromolyn Sodium ; pharmacology ; Female ; Heart ; drug effects ; physiopathology ; Heart Rate ; drug effects ; Intestines ; blood supply ; Male ; Malondialdehyde ; blood ; metabolism ; Myocardium ; metabolism ; pathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; blood ; prevention & control ; Superoxide Dismutase ; blood ; metabolism ; Time Factors

BACKGROUNDThe aim of this study was to investigate the potential relationship between the dynamic expression of Toll-like receptor 2 and 4 (TLR2/4) in peripheral blood mononuclear cells as well as changes in serum concentration of inflammatory factors and acute lung injury (ALI) in patients after orthotopic liver transplantation (OLT).

METHODSThe peripheral blood samples of 27 patients (23 men and 4 women with ASA III to IV) who received OLT were collected for measurement of TLR2/4 at T1 (after induction of anesthesia), T2 (25 minutes after anhepatic phase), T3 (3 hours after graft reperfusion) and T4 (24 hours after graft reperfusion). The expression of TLR2/4 in mononuclear cells was measured by flow cytometry. The serum concentrations of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta and IL-8 were measured by enzyme-linked immunosorbent assay (ELISA). Twenty-seven patients were assigned to ALI group (n = 9) and non-ALI group (n = 18) according to the diagnostic criteria of ALI. The expression of TLR2/4 in the ALI group or non-ALI group was analyzed.

RESULTSCompared to the non-ALI group, the volumes of blood loss, ascites, total output and transfused red blood cells were higher in the ALI group, and the anhepatic phase lasted longer (P < 0.05, P < 0.01). The expression of TLR2/4 in mononuclear cells increased significantly at T3 and T4, and serum concentrations of TNF-alpha, IL-1beta and IL-8 increased significantly too. There was no significant difference in Child-Turcotte-Pugh (CTP) scores between the ALI group and non-ALI group (P > 0.05). The expression of TLR2/4 in mononuclear cells increased significantly at T3 and T4 in the ALI group (P < 0.05, P < 0.01). A positive correlation was noted between the expression of TLR4 in mononuclear cells and the serum concentrations of TNF-alpha, IL-1beta (P = 0.041, P = 0.046) in the ALI group. In the non-ALI group, statistical results showed that the expression level of TLR2/4 in mononuclear cells was not significantly different during the peri-operative period of OLT (besides TLR4 expression at T4). Compared to the non-ALI group, the increasing amplitude of TLR2/4 expression in mononuclear cells was more significant in the ALI group. The patients whose TLR2/4 expression in mononuclear cells exceeded that at T1 by one time were more likely to suffer from ALI (P = 0.013), with a relative risk of 16.

CONCLUSIONThe expression level of TLR2/4 in mononuclear cells increases significantly in the peri-operative period of OLT, and it may be a high risk factor for occurrence of postoperative ALI.

Acute Lung Injury ; etiology ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Flow Cytometry ; Humans ; Interleukin-1beta ; metabolism ; Interleukin-8 ; metabolism ; Leukocytes, Mononuclear ; metabolism ; Liver Transplantation ; adverse effects ; Male ; Postoperative Period ; Toll-Like Receptor 2 ; metabolism ; Toll-Like Receptor 4 ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Blood Pressure ; Cardiac Output ; Creatine Kinase ; blood ; Creatine Kinase, MB Form ; blood ; Female ; Heart Rate ; Humans ; Liver Transplantation ; adverse effects ; Male ; Troponin I ; blood ; Ventricular Function