1.Cerebral oxygen metabolism during liver transplantation in patients with liver cirrhoses
Zi-Qing HEI ; Shang-Rong LI ; Gang-Jian LUO ;
Chinese Journal of Anesthesiology 1994;0(06):-
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.
2.Changes in systemic and pulmonary hemodynamics in patients with liver cirrhosis and portopulmonary hypertension during liver transplantation
Zi-Qing HEI ; Shang-Rong LI ; Gang-Jian LUO ; Chenfang LUO ; Wuhua MA ; Xinjin CHI
Chinese Journal of Anesthesiology 1994;0(01):-
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.
3.Etiological analysis of acute intestinal obstruction requiring surgical intervention elderly patients
Jing TIAN ; Xing KANG ; Hao WANG ; Wenxian GUAN ; Jian HEI ; Jun WANG
Chinese Journal of General Practitioners 2021;20(6):682-685
Clinical data of 289 patients aged 60 years old and above with acute intestinal obstruction operated in Drum Tower Hospital during June 2010 to December 2020 were analyzed retrospectively. Among 289 cases, 97 cases(33.6%)had tumor, 66(22.8%)had external hernias, 44(15.2%)had adhesions, 36(12.5%)had volvulus, 20(6.9%)had internal hernias, 8(2.8%)had intussusception and 18(6.2%)had other causes. Of 156 strangulated intestinal obstruction cases, 51 cases(32.7%)had external hernias,36(23.1%)had volvulus, 26(16.7%)had adhesions, 18(11.5%)had internal hernias, 14(9.0%)had tumor, 8(5.1%)had intussusception, and 3(1.9%)had other causes. There was a history of abdominal surgery in 88.6%(39/44)cases of adhesion, 85.0% (17/20) cases of internal hernia and 61.1%(22/36)cases of volvulus. For patients with acute intestinal obstruction caused by intestinal tumor, the cases of small bowel obstruction, strangulated intestinal obstruction and the strangulated large bowel were significantly less than those of large bowel obstruction, the non-strangulated intestinal obstruction and the non-strangulated large bowel obstruction (5 vs. 92, 14 vs. 80, 12 vs. 83, respectively; all P<0.05). For patients with strangulated intestinal obstruction caused by external hernias, volvulus, internal hernias and intussusception were significantly more than those with non-strangulated intestinal obstruction groups(51 vs.15, 36 vs. 0, 18 vs. 2, 8 vs. 0, respectively; P<0.05). The patients with strangulated large bowel obstruction caused by external hernias( n=4) and volvulus( n=9)were significantly more than those with non-strangulated large bowel obstruction( n=1 and 0, respectively; P<0.05). The patients with strangulated small bowel obstruction caused by adhesions( n=26)and volvulus( n=27)were significantly more than those with non-strangulated small bowel obstruction( n=18 and 0,respectively; P<0.05).The study showed that the principal causes of emergency operation for acute intestinal obstruction and strangulated intestinal obstruction are intestinal tumor and external hernias in elderly patients.
4.A genetic study of 15 STR loci in Chinese E Wen-ke population.
Yu-li HUANG ; Mming-bo GU ; Jian WANG
Journal of Forensic Medicine 2004;20(3):162-166
OBJECTIVE:
To investigate the genetic polymorphisms of 15 STRs loci in Chinese E Wen-ke population.
METHODS:
DNA samples from 99 unrelated individuals in Chinese E Wen-ke population were screened by Power Plex 16 System and ABI3100 Genetic Analyzer.
RESULTS:
The genotype frequencies of these 15 STR loci meet the Hardy-Weinberg expectation. The Matching probability of 15 STRs loci were between 0.0205-0.1733, discriminating power (DP) at 0.8267-0.9795, heterozygosity (Ho) at 0.6061-0.9091, power of exclusion (PE) at 0.4038-0.7690, polymorphism information content (PIC) at 0.5985-0.8734. The total DP of 15 STRs loci is 0.9999999999998.
CONCLUSION
Our results showed that the 15 STRs loci of Power Plex 16 System are valuable STR loci genetic marker system having high DP and are useful in forensic case work in Chinese E Wen-ke population.
Alleles
;
Asian People/genetics*
;
China/ethnology*
;
DNA/isolation & purification*
;
Forensic Medicine
;
Gene Frequency
;
Genotype
;
Humans
;
Polymerase Chain Reaction/methods*
;
Polymorphism, Genetic
;
Tandem Repeat Sequences
5.A genetic study of 15 STR loci in Chinese East Mongolian population.
Qing-xin DU ; Jian WANG ; Yu-li HUANG
Journal of Forensic Medicine 2004;20(3):164-166
OBJECTIVE:
To investigate the genetic polymorphisms of 15 STRs loci in Chinese East Mongolian population.
METHODS:
DNA samples from 105 unrelated individuals in Chinese East Mongolian population were screened by Power Plex 16 System and ABI3100 Genetic Analyzer.
RESULTS:
The genotype frequencies of these 15 STR loci meet the Hardy-Weinberg expectation. The Matching probability of 15 STRs loci were between 0.0084-0.2169, discriminating power (DP) at 0.7831-0.9916, heterozygosity (H) at 0.5619-0.9231, power of exclusion (PE) at 0.4490-0.8444, polymorphism information content (PIC) at 0.5438-0.9178. The total DP of 15 STRs loci is 0.9999999999998.
CONCLUSION
Our results showed that the 15 STRs loci of Power Plex 16 System are valuable STR loci genetic marker system having high DP and are useful in forensic case work in Chinese East Mongolian population.
Alleles
;
Asian People/genetics*
;
DNA/isolation & purification*
;
Gene Frequency
;
Genotype
;
Humans
;
Mongolia
;
Polymerase Chain Reaction/methods*
;
Polymorphism, Genetic
;
Tandem Repeat Sequences
6.Changes of hemodynamics and concentrations of nitric oxide, endothelin, prostacyclin, and thromboxane A2 during portal cavity clamping and opening in portal hypertensive canines.
Xin-Jin CHI ; Jian-Qi WEI ; Zi-Qing HEI ; Mian GE ; De-Zhao LIU
Journal of Southern Medical University 2009;29(7):1337-1340
OBJECTIVETo observe the changes in systemic hemodynamics and their relations to the concentrations of nitric oxide, endothelin, prostacyclin, and thromboxane A2 after portal cavity clamping and opening in portal hypertensive canines.
METHODSTwelve canines were randomly divided into control group and model group, and partial ligation of the portal vein was performed in the model group. Portal cavity clamping and opening was performed 12 weeks later in the two groups. The hemodynamic parameters including cardiac output index (CI), heart rate (HR), mean artery blood pressure (MABP), central venous pressure (CVP), pulmonary arteriole wedge pressure (PAWP), and systemic vascular resistance index (SVRI) were measured during the operation. Samples were obtained from the central vein at 3 time points during the operation for measuring NO, ET, PGI2, and TXA2.
RESULTSPortal vein ligation and portal cavity clamping produced obvious changes in the systemic circulation of the dogs, and the alteration was milder in the control group. After obstruction of the portal vein, the NO levels in systemic circulation in portal hypertensive dogs declined obviously, but gradually recovered the normal level after reperfusion.
CONCLUSIONSystemic circulation undergoes significant alterations after portal vein obstruction, but its changes in portal hypertensive dogs are milder than those in the control group, the mechanism of which needs further investigation.
Animals ; Disease Models, Animal ; Dogs ; Endothelins ; blood ; Epoprostenol ; blood ; Hemodynamics ; Hypertension, Portal ; blood ; physiopathology ; Nitric Oxide ; blood ; Plasma ; metabolism ; Portal Vein ; physiopathology ; Thromboxane A2 ; blood ; Vena Cava, Inferior ; physiopathology
7.Effect of Astragalus membranacaus injection on activity of intestinal mucosal mast cells and inflammatory response after hemorrahagic shock-reperfusion in rats.
Gang-jian LUO ; Xiao-liang GAN ; Zi-qing HEI ; Li-xin CHEN ; Shang-rong LI
China Journal of Chinese Materia Medica 2007;32(14):1436-1440
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
8.Efficient derivation of functional hepatocytes from mouse induced pluripotent stem cells by a combination of cytokines and sodium butyrate.
Qi ZHANG ; Yang YANG ; Jian ZHANG ; Guo-Ying WANG ; Wei LIU ; Dong-Bo QIU ; Zi-Qing HEI ; Qi-Long YING ; Gui-Hua CHEN
Chinese Medical Journal 2011;124(22):3786-3793
BACKGROUNDHepatocyte transplantation has been proposed as an alternative to whole-organ transplantation to support many forms of hepatic insufficiency. Unfortunately, the lack of donor livers makes it difficult to obtain enough viable human hepatocytes for hepatocyte-based therapies. Therefore, it is urgent to find new ways to provide ample hepatocytes. Induced pluripotent stem (iPS) cells, a breakthrough in stem cell research, may terminate these hinders for cell transplantation. For the promise of iPS cells to be realized in liver diseases, it is necessary to determine if and how efficient they can be differentiated into functional hepatocytes.
METHODSIn this study, we directly compared the hepatic-differentiation capacity of mouse iPS cells and embryonic stem (ES) cells with three different induction approaches: conditions via embryonic body (EB) formation plus cytokines, conditions by combination of dimethyl sulfoxide and sodium butyrate and chemically defined, serum free monolayer conditions. Among these three induction conditions, more homogenous populations can be promoted under chemically defined, serum free conditions. The cells generated under these conditions exhibited hepatic functions in vitro, including glycogen storage, indocynine green (ICG) uptake and release as well as urea secretion. Although efficient hepatocytes differentiation from mouse iPS cells were observed, mouse iPS cells showed relatively lower hepatic induction efficiency compared with mouse ES cells.
RESULTSMouse iPS cells would be efficiently differentiated into functional hepatocytes in vitro, which may be helpful in facilitating the development of hepatocytes for transplantation and for research on drug discovery.
CONCLUSIONWe demonstrate that mouse iPS cells retain full potential for fetal liver development and describe procedures that facilitates the efficient generation of highly differentiated human hepatocyte-like cells from iPS cells in vitro.
Animals ; Butyrates ; pharmacology ; Cell Differentiation ; drug effects ; Cells, Cultured ; Cytokines ; pharmacology ; Embryonic Stem Cells ; cytology ; drug effects ; Hepatocytes ; cytology ; drug effects ; metabolism ; Induced Pluripotent Stem Cells ; cytology ; drug effects ; Mice ; Reverse Transcriptase Polymerase Chain Reaction
9.Cromolyn sodium ameliorates rat left cardiac function during intestinal ischemia-reperfusion.
Gang-jian LUO ; Xiao-liang GAN ; Ning SHEN ; Zi-qing HEI ; Shang-rong LI ; Li-xin CHEN
Journal of Southern Medical University 2007;27(5):650-653
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
10.The level of peripheral circular DNA in patients with hand foot and mouth disease.
Zhao-Xia ZHAO ; Jian-Hua LU ; Zhi-Qin MEI ; Shi-Yang PAN ; Dan CHEN ; Yu-Zhen LIU ; Wen-Ying XIA ; Er-Hei DAI
Chinese Journal of Experimental and Clinical Virology 2011;25(6):483-485
OBJECTIVETo determine the circular DNA level of patients with hand foot and mouth disease (HFMD) and evaluate its potential clinical value.
METHODSVenous blood in 30 healthy children and 78 patients with HFMD within 3 days of onset of illness and convalescent period was collected. The level of plasma circular DNA was detected by duplex real-time polymerase chain reaction assay. Blood sugar, high-sensitive CRP(hs-CRP) and leucocyte were also detected.
RESULTSThe level of circular DNA in control group was (6.57 +/- 4.67) ng/ml. The level of circular DNA in ordinary and severe HFMD patients was (11.51 +/- 7.75) ng/ml and (20.59 +/- 10.67) ng/ml before treatment, respectively. The levels of circular DNA in ordinary and severe HFMD patients were significantly higher than that in control group (P = 0.021; 0.000); the level of circular DNA in severe HFMD patients was significantly higher than that in ordinary HFMD patients (P = 0.011). The level of circular DNA in severe HFMD patients after treatment were significantly lower than that before treatment (P = 0.033). The level of circular DNA before treatment and after treatment in ordinary HFMD patients had no significant difference. The levels of blood sugar and hs-CRP in severe HFMD patients were higher than those in ordinary before treatment (P = 0.045; 0.011). The levels of blood sugar and hs-CRP before treatment and after treatment in ordinary HFMD patients had no significant change. There was significantly positive correlation between the level of circular DNA and that of hs-CRP in HFMD patient (P = 0.021), but there was no correlation between the level of circular DNA and that of blood sugar and leucocyte.
CONCLUSIONSThe level of circular DNA not only become an early identification marker of severe HFMD patients, but also become monitoring marker of effect of treatment.
Biomarkers ; Blood Glucose ; analysis ; C-Reactive Protein ; analysis ; Child, Preschool ; DNA, Circular ; blood ; Female ; Hand, Foot and Mouth Disease ; blood ; genetics ; Humans ; Infant ; Male