Evidence suggests that translocation of gut bacteria or their toxins is a major contributor to gut-derived sepsis and multisystem organ failure in critically ill patients.This review reevaluates the data from studies in animal models and humans on bacterial translocation.The new insights in mechanisms of bacterial translocation pathogenesis and its clinical relevance will help clinicians to make correct strategies to enhance gut function.

Objective: To explore the protections of GLP-Ⅱ pretreatment on mouse intestinal mucosal immunity after ischemia/reperfusion insult. Methods: Thirty ICR mice were randomly divided into three groups: namely normal control (N), control (C) and GLP-Ⅱ pretreatment (P). Group C and group P were inflicted with ligation of superior mesenteric artery for twenty minutes. The morphology of distal ileum mucosa, the rate of intestinal bacteria translocation, the level of plasma endotoxin and intestinal IgA were determined. Results: After ischemia/reperfusion insult, there were obvious damage at distal ileum mucosa in group C and obvious proliferation in group P.The rate of intestinal bacteria translocation and the level of plasma endotoxin were significantly increased (P

Objective To evaluate the effect of sternocleidomastoid island myocutaneous flap applicating in reconstructing defect of head and neck neoplasms after operation. Methods We used sternocleidomastoid island myocutaneous flap to restore defect postoperation of head and neck neoplasms for 9 patients. Five patients used flap to reconstruct defect of oral mucosal, one case pucker myocutaneous flap, part of it restore oral mucosal defect, part restore skin defect of cheek, the others reconstruct defect of cheek or parotid gland. Seven cases used polyhole titanium to reconstruct mandible bone at the same time. Results Eight cases used sternocleidomastoid island myocutaneous flap survival postoperation, one case's flap appeared necrosis of distant part and recover after one half month. Conclusion Pedical sternocleidomastoid island myocutaneous flap can provide huge flap supply, survival rate higher, easy to execute and not complex, it is suitable for clinical doctors to reconstruct defect after operation for head and neck tumors.

Objective To study the effect of glucagon-like peptide 2 (GLP-2) on the absorption- related genes [ sodium dependent glucose transporter 1 (SGLT1) and dipeptide transporter 1 (PEPT1)] mRNA expressions of residual small bowel in a rat model of short bowel syndrome. Methods Rats undertaken 75% small bowel resection were randomly assigned into 3 groups: short bowel control (SBC) group, growth hormone (GH) group and GLP-2 group. Another weight-matched normal rats with normal diet was used as normal (NC) group. All rats were given normal chow on the 1st postoperative day (POD). On the 6th POD, partial segment of terminal ileum was harvested to evaluate the mRNA expressions of SGLT1 and PEPT1 by semiquantified reverse transcription polymerase chain reaction. Results The mRNA expressions of both SGLT1 and PEPT1 in SBC group were significantly higher than that of NC group(P0.05). Conclusions A short term GLP-2 adiministration in early postoperative days may has no significant effect on mRNA expressions of SGLT1 and PEPT1 in residual ileum in rats with short bowel syndrome.

OBJECTIVE To assess the outcomesof three different therapeutic approaches for the treatment of T3N0M0(stage Ⅲ) glottic squamous cell carcinoma. METHODS Sixty-five cases of T3N0M0 glottic squamous cell carcinoma treated with curative intent by three different modalities include vertical hemilaryngectomy(VHL,n=21),total laryngectomy(TL,n=31)and radiotherapy(RT,n=13) were reviewed retrospectively. The survival rate,recurrence rate at the primary lesion site and jugular lymph node, and laryngeal preservation was compared among three methods. RESULTS There was no significant difference in the overall survival rates(Cox proportion hazard model) and recurrence rates at the primary lesion site or jugular lymph node among the three methods. Laryngeal function was preserved in 100% of the cases in the VHL and RT groups after initial treatment. CONCLUSION The three treatment modalities had statistically similar survival and recurrence rates. Patients treated with VHL and RT had a higher rate of laryngeal preservation compared to that of TL, hence VHL or RT is a valid alternative to TL in treating selected patients with T3N0M0 glottic squamous cell carcinoma.

Background and purpose:The incidence of hepatoma is high. The outcome of treatment on hepatoma is poor.So we investigated the effect and mechanism of a selective cyclooxygenase-2 inhibitor celecoxib on the proliferation and apoptosis of SMMC-7721 hepatoma cell line. Methods:MTT assay was used to study the inhibitive effect of celecoxib on the growth of SMMC-7721 hepatoma cell. The effect of celecoxib on cell cycle and apoptosis on cells was studied by flow cytometry(FCM).Transmission electron microscopy (TEM) was used to display the morphological change of the SMMC-7721 hepatoma cell . The biochemical character of apoptosis was viewed on the agarose gel electrophoresis.The expression of bax gene and bcl-2 gene were measured by immunohistochemistry.Results:The SMMC-7721 cells were cultured in media that contained 25,50,75,100 ?mol/L celecoxib,by means of MTT, the inhibition rate was(15?3)%,(34.6?2.4)%,56.8?1.0)%,(86.2?0.4)% respectively after 24 hours; but the inhibition rate was (33.4?0.7)%,(66.7?1.8)%,(76.1?2.4)%,(97.3?0.8)% respectively after 48 hours(P

Objective: To study the effect of GLP-Ⅱ on residual bowel absorption of glucose in a rat model of short bowel syndrome. Methods: Rats undertaken 75% small bowel resection were randomly assigned to SB group and SB/GLP-Ⅱ group. Another group of weight-matched normal rats(Normal) received normal diet ad libitum was used as control group for SB group. All rats were allowed normal chow on the 1st postoperative day(POD). On the POD6,the intestinal glucose absorption data per unit length as well as per unit weight of ileum were measured by in vivo circulatory perfusion experiment. Results: Length of perfused ileum in 3 groups of rats were not significantly different. Wet weight to length ratio of perfused ileum in SB group was significantly higher than that of normal group,but significantly lower than that of SB/GLP-Ⅱ group. 45min glucose absorption of per cm ileum in SB/GLP-Ⅱ group was significantly higher than that of SB group(P0.05). Conclusions: In a rat model of SBS, GLP-Ⅱ can enhance the intestinal glucose absorption measured as per unit length of resudial ileum and GLP-Ⅱ manifests a trend to increase the glucose absorption measured as per unit wet weight of resudial ileum.

Objective To investigate the correlation between gene polymorphism within human β defensin 1 (DEFB1) and fungal susceptibility to severe sepsis through case-control association study.Methods A total of211 patients with severe sepsis in ICU were enrolled in the present case control study. Sepsis in this study was diagnosed according to the definition of American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference in 1992 and 2002. Based on the development of fungal infection during ICU stay, all 211 patients were divided into fungal infection group (Group Ⅰ) and control group (Group C). Alleles and genotypes of-1816A/G, -390A/T, -52A/G, -44C/G and-20A/G within DEFB1 gene were assayed in all 211 patients by means of DNA direct sequencing, Allele-specific PCR amplifications or high-throughput site-specific TaqMan assay. Genetic analysis was employed to calculate the distribution frequency of haplotypes. The correlation between the genomic variations (allele,genotype and haplotype) and fungal infection was analyzed by Chi-square test or Fisher's exact test.Odds ratio (OR) was employed to reflect the correlation degree of genetic factor with fungal susceptibility to severe sepsis. Results Group Ⅰ enrolled 80 patients, of whom 43 pstients were male, at age of (60.81 ± 18.30) years. Group C enrolled 131 patients, of whom 80 patients were male, at mean age of (60.42 ± 17.03) years. No significant difference was found between two groups in aspect of gender and age (P＞0.05). The genetic locus of -1816A/G, -390A/T, -52A/G, -44C/G and -20A/G of both groups were in agreement with Hardy Weinberg equilibrium. No significant difference was found between two groups in the distribution of allelic frequencies and genotype frequencies (P ＞0.05). No significant difference was found in the distribution frequency of four common haplotypes of the above five genetic locus such as AAACG, ATGCA, GTGGG and ATACG (all P ＞ 0.05). Conclusions Genetic locus of -1816A/G, -390A/T, -52A/G, -44C/G and-20A/G within DEFB1 gene have no correction with fungal infections in severe sepsis, suggesting that DEFB1 gene polymorphism may not serve as a key genetic marker for the predisposition to fungal infection in severe sepsis.

Bile Ducts, Intrahepatic ; Dilatation, Pathologic ; Humans ; Synchrotrons

Carcinoma, Hepatocellular ; blood supply ; diagnostic imaging ; Humans ; Liver Neoplasms ; blood supply ; diagnostic imaging ; Microvessels ; diagnostic imaging ; Neovascularization, Pathologic ; diagnostic imaging ; Tomography, X-Ray Computed ; methods