ObjectiveTo investigate the effect of ulinastatin on perioperative renal function in patients undergoing orthotopic liver transplantation.MethodsSixty ASA Ⅱ or Ⅲ patients of both sexes aged 35-64 yr weighing 50-75 kg with normal blood urea nitrogen (BUN) and creatinine (Cr) before operation undergoing orthotopic liver transplantation were randomly divided into 2 groups ( n ＝ 30 each):control group (group C) and ulinastatin group ( group U).Anesthesia was induced with midazolam,fentanyl,etomidate and vecuronium and maintained with isoflurane inhalation,propofol TCI,continuous remifentanil infusion and intermittent iv boluses of fentanyl and vecuronium.The patients were tracheally intubated and mechanically ventilated.PET CO2 was maintained at 30-35 mm Hg.Ulinastatin 400 000 IU in normal saline 20 ml was infused iv after induction of anesthesia.Ulinastatin 200 000 IU was then infused every 4 h until 48 h after operation.Urine volume and the amount of furosemide administered were recorded before anhepatic phase,and during anhepatic and neohepatic phase.Venous blood samples and urine were collected before induction of anesthesia (T1),at 15 min of anhepatic phase ( T2 ),at 15min of neohepatic phase (T3),at the end of operation (T4) and 48 h after operation (T5) for determination of serum concentrations of BUN,Cr and creatinine clearance rate and urinary N-acetyl-beta-D-glucosaminidase (NAG)activity and microalbumin concentration.ResultsCompared with group C,ulinastatin significantly decreased the amount of furosemide administered and increased urine volume during anhepatic and neohepatic phase,decreased serum Cr concentration,increased creatinine clearance rate at T2.5,decreased urinary NAG activity and microalbumin concentration at T4.5 and serum BUN concentration at T3-s.ConclusionUlinastatin has protective effect on rehal function during perioperative period in patients undergoing orthotopic liver transplantation.

An α-amylase inhibitor (α-AI) was isolated from white kidney beans (Phaseolus vulgaris. L) by ethanol fractional precipitation, ion exchange chromatography and gel filtration column chromatography. It was a homogeneity glycoprotein demonstrated by SDS-PAGE and gel filtration on CL-6B. The glycoprotein contained 88.2% protein and was rich in aspartic acid, glutamic acid, leucine, threonine and serine. The carbohydrate moiety was consisted of Man, Glc, Gal and Xyl in a mole ratio of 2.42∶1.50∶1.52∶1.00. The glycan and the core protein backbone was connected by O-linkage as determined by β-elimination reaction. The continuous oral administration of the α-AI (150 mg·kg-1·d-1 ) for 7 days can lower fasting blood glucose and 300 mg·kg-1 ·d-1 α-AI for 7 days can improve the sugar tolerance on alloxan-dependent diabetic model rats. The result showed the α-AI obtained from white kidney beans had good hypoglycemic effect on alloxan induced diabetic rats and may have high potential pharmaceutical value as a regulative digestive-starch degradation in patients suffering from diabetes.

Objective To asses the value of fluorescence in situ hybridization (FISH) in diagnosis of transitional cell carcinoma of bladder in the urine using directly labeled DNA probes to the pericentromeric regions of chromosomes 3 , 7 and 17 and to the region of P16 tumor suppressor gene. Methods Chromosomal and gene abnormalities were detected using directly labeled DNA probes to the pericentromeric regions of chromosomes 3 , 7, and 17 and to the region of P16 tumor suppressor gene. The sensitivity of FISH and Cytology in diagnosing transitional cell carcinoma of bladder was also compared. Results The sensitivity of FISH and Cytology in diagnosing the disease was 85.5% and 34.2%, respectively. The sensitivity of FISH was prior to that of Cytology( P ＜0.05 ) and increased with increasing tumor pathologic grade but not clinical staging. Conclusions High sensitivity of FISH in diagnosing transitional cell carcinoma of bladder was obtained and it might be a potent method to diagnose bladder cancer in Chinese people in the future.

Objective To evaluate the role of nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE) singling pathway in reduction of myocardial ischemia-reperfusion (I/R) injury by zinc sulfate preconditioning in rats.Methods SPF healthy male Sprague-Dawley rats,weighing 250-280 g,aged 16-20 weeks,were used in this study.After the animals were anesthetized,their hearts were immediately removed and retrogradely perfused with an oxygenated K-H solution at 37 ℃ in a Langendorff apparatus.Forty isolated rat hearts were randomly divided into 4 groups (n=10 each):control group (group C),I/R group,zinc sulfate preconditioning group (group Zn) and zinc sulfate preconditioning plus Nrf2/ARE singling pathway blocker luteolin group (group Zn+Lut).After 20 min of equilibration,the hearts were continuously perfused for 100 min in group C,the hearts were perfused with 4 ℃ St.Thomas′ cardioplegic solution before ischemia and then subjected to 40 min global ischemia followed by 60 min reperfusion to establish the model of I/R in group I/R,200 μmol/L zinc sulfate 1.5 ml/kg was injected intraperitoneally,and 24 h later the model of I/R was established in group Zn,and in group Zn+Lut,the hearts were perfused for 3 min with K-H solution containing luteolin 50 μmol/L starting from the time point immediately before ischemia,and the other treatments were similar to those previously described in group Zn.Heart rate (HR),left ventricular end diabetic pressure (LVEDP),left ventricular developed pressure (LVDP) and the maximum rate of increase of left ventricular pressure (+dp/dtmax) were recorded at the end of equilibration and reperfusion.Coronary effluent was collected at the end of reperfusion to measure the levels of lactate dehydrogenase (LDH) and malondialdehyde (MDA).The expression of heme oxygenase-1 (HO-1),quinone oxidoreductase (NQO1),superoxide dismutase 1 (SOD1) and Nrf2 in myocardial tissues was detected by Western blot.Results Compared with group C,HR,+dp/dtmax and LVDP were significantly decreased,LVEDP was increased,and the levels of LDH and MDA in coronary effluent were increased at the end of reperfusion in I/R and Zn+Lut groups,and the expression of NQO1,HO-1,Nrf2 and SOD1 was up-regulated in I/R,Zn and Zn+Lut groups (P<0.05).Compared with group I/R,the HR,+dp/dtmax and LVDP were significantly increased,LVEDP was decreased,and the levels of LDH and MDA in coronary effluent were decreased at the end of reperfusion,and the expression of NQO1,HO-1,Nrf2 and SOD1 was up-regulated in group Zn (P<0.05).Compared with group Zn,HR,+dp/dtmax and LVDP were significantly decreased,LVEDP was increased,and the levels of LDH and MDA in coronary effluent were increased at the end of reperfusion,and the expression of NQO1,HO-1 and SOD1 was down-regulated(P<0.05),and no significant change was found in Nrf2 expression in group Zn+Lut (P>0.05).Conclusion The mechanism by which zinc sulfate preconditioning reduces myocardial I/R injury is related to activation of Nrf2/ARE singling pathway in rats.

Objective To explore the protective effect and the mechanism of fastigial nucleus electric stimulation on brain of rats with hypoxic-ischemic brain damage(HIBD).Methods Ninety rats were randomly divided into 3 groups:sham operated group(n=30),model group(n=30)and electric stimulation group(n=30),every group was divided into group A(n=10),group B(n=10)and group C(n=10)again.The models of perinatal HIBD rats were prepared by ligation of left common carotid artery with a temporary systemic hypoxia(N2O2 was 928)for 2 hours.Electric stimulation group was used electric stimulation for 20 minutes,2 times everyday after surgery.The sham operated group and model group was not used electric stimulation but catched to fix in corresponding period.All of the group A would be injected bromodeoxyuridine(BrdU)to enterocoelia before 8 hours when the rats would be killed and the group B would be not injected it.The rats of the group A and B would be killed and got the brain tissue after cardiac perfusion 7 days later,then,consecutively coronal slice.The changes of BrdU and nestin levels in brain were observed by immunohistochemistry staining assay.And the study and memory ability of all the group C would be tested by maze test after 28 days.The brain tissue would be tested by hematoxylin and eosin stain at the same time.All of the data would be described and analyzed by SPSS 13.0.More than a few means would be compared by One-Way analysis of variance and the t-test between 2 groups would be used.Results The BrdU and nestin levels of the model group were lower than the sham operated group(Pa

Objective To reverse P-glycoprotein-mediated muhiple drug resistance using RNA interference(RNAi)in cultured rat astrocytes.Methods Astroeytes overexpressing P-glyeoprotein induced by coriaria lactone were transfected with the short-hairpin RNA expression vector-p-SIREN shuttle designed to target Mdrl mRNA.The mRNA level of Mdrl gene was evaluated by real-time PCR;the P-glycoprotein was examined by immunocytochemistry and image analysis,meanwhile the rhodamine efflux was assessed by flow cytometry.Results The astrocyte model overexpressing P-glycoprotein were established and successfully transfected with the short-hairpin RNA expression vector-p-SIREN shuttle.The mRNA level of Mdrl gene was knocked down by 67.70%(P

Objective To explore the value of the spectral CT iodine-based material decomposition technique in differential diagnosis of central pulmonary carcinoma from obstructive pneumonia and atelectasis.Methods 25 cases with central pulmonary carcinoma complicating with obstructive pneumonia and atelectasis underwent CT plain scan and spectral contrast scan including pulmonary-arterial-phase (PAP) and bronchial-arterial-phase(BAP).Conventional CT images and iodine base images were generated in each phase by GSI viewer.The 4 groups of images differences between the tumor and the obstructive pneumonia and atelectasis were analyzed.Results The margin of the tumor was ill-defined in plain scan.The cases that showed difference between the tumor and the obstructive pneumonia and atelectasis in 4 groups of images were respectively as follows,10 in conventional CT images of PAP,1 6 in conventional CT images of BAP,1 9 in iodine base images of PAP,and 23 in iodine base images of BAP.The difference of the 4 groups was significant (χ2 =16.54,P<0.05).There was the highest accuracy in iodine base images of BAP in defining the tumor margin (χ2 = 12.83,χ2 = 4.20,χ2 =1.34,P <0.05). The accuracy between conventional CT images of BAP and iodine base images of PAP had no significant differences (χ2 =0.86,P >0.05),but were better than that of the conventional CT images of PAP(χ2 =6.65,P <0.05).Conclusion Spectral CT iodine-based material decomposition technique is helpful to improve subjective diagnosis of central pulmonary carcinoma complicating with obstructive pneumonia and atelectasis,especially in iodine base images of BAP,it can provide accurate information for clinical stage and treatment.

Objective To investigate the effect of gender differences in distal femoral geometry on the clinical outcomes of total knee arthroplasty (TKA). Methods From March 2003 to October 2006, 213 cases with 294 osteoarthritic knees who had underwent primary TKA were involved in the study. The study included 87 men (118 knees) and 126 women (176 knees) who had a mean age of 64.4 years. All the cases were assessed with the knee-rating system of Knee Society, the knee range of flexion (ROF), corrected posterior offset (PCO) and anterior condylar offset (ACO) based on sex. Results Each patient had a Minimum of 2 years follow-up. The preoperative Knee Society scores and ROF, the two-year postoperative changes of stability scores and walking ability had no differences between the two groups. While greater improvements of postoperative pain scores and stair-climbing ability were seen in male. Men had better intraoperative ROF than women had ones, but there were no gender differences with regard to the two-year postoperative improvement of ROF. Corrected PCO decreased more markedly in female than in male. Corrected ACO decreased equally in female and male. The difference in the posterior condylar offset after TKA was statistically correlated with the change in pain scores, stair climbing ability and intraoperative ROF, respectively. Conclusion Male had a better outcome than female did after TKA. Femoral components which designed in the light of Caucasian anatomic characteristics couldn't match the native anatomy of distal femurs of Chinese female. Sexual dimorphism in humans and anatomic variations in various ethnic groups should be seriously considered in total knee prosthesis design.

OBJECTIVETo compare the difference in the efficacy on thoracic facet joint disorder between the combined therapy of electroacupuncture and manual reduction and the simple manual reduction.

METHODSOne hundred and sixty patients were randomized into an electroacupuncture and manual manipulation group (group A) and a simple manual manipulation group (group B), 80 cases in each one. In the group A, Ashi points and three pairs of Jiaji (EX-B 2) bilateral to the painful sites were selected. The perpendicular puncture was used at Ashi points, the oblique puncture was used at Jiaji (EX-B 2) and connected with electric stimulation for 20 min, additionally, the corresponding manual reduction was adopted at the sites of facet joint disorder. In the group B, the simple manual reduction was applied to the affected sites. Acupuncture was given once every day, the manual reduction was applied once every 10 days. The treatment of 10 days made one session. The efficacy was analyzed statistically at the end of two sessions of treatment. Before and after treatment, McGill pain scale was adopted for the value statistical analysis. PRI score, VAS score and PPI score of patients were calculated before and after treatment and compared in the two groups. The efficacy was compared between the two groups.

RESULTSThe curative rate was 56.3% (45/80) in the group A, which was better than 18.8% (15/80) in the group B (P< 0.01). The total effective rate was 95.0% (76/80) in the group A, which was better than 76.3% (61/80) in the group B (P<0.01). The scores of PRI, VAS and PPI after treatment were all improved significantly in the two groups (all P<0.05), in which, the results in the group A were better than those in the group B (PRI: 4.00 +/- 0.97 vs 5.44 +/- 1.16, VAS: 3.29 +/- 0.72 vs 3.87 +/- 0.81, PPI: 1.07 +/- 0.74 vs 1.64 +/- 0.90, all P<0.05).

CONCLUSIONThe combined therapy of electroacupuncture and manual manipulation achieves the superior efficacy on thoracic facet joint disorder as compared with the simple manual manipulation. The combined therapy relieves the symptoms of thoracic facet joint disorder and reduces the severity of disorder.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Thoracic Diseases ; therapy