OBJECTIVETo study the influence of alcohol on the liver sinusoids endothelial cell (LSEC) fenestrae of rats.

METHODSSetting up the rat model of alcoholic liver disease by orogastric administration of alcohol, then kill the experimental and control groups of rats at the end of 4 weeks, 8 weeks and 12 weeks after alcohol feeding, and also at the end of another 12 weeks after balance foods feeding succeeding with alcohol feeding for 12 weeks. Staining the liver tissue by means of HE method and observing the successive change of LSEC fenestrae by transmission electron microscope.

RESULTSThe normal LSEC was flat with nucleus and organelle arranged regularly. The distal cytoplasm displayed as lamina with many fenestrae, not accompanied by basement membrane (BM) formation under the endothelial cell. At the end of 4 weeks of alcohol feeding, fenestrae decreased at the partial distal LSEC cytoplasm, but no BM developed. At the end of 8 weeks, fenestrae decreased significantly, even disappeared, with the BM developed incompletely under the endothelial cell. Concomitantly, fibroblast with active function developed. At the end of 12 weeks, the changes became more obvious; the complete BM could even be seen. However, this kind of changes was mostly limited in the single or adjoining sinusoids, as well as with little widespread formation of fibrosis. At the end of 12 weeks of stopping alcohol feeding, defenestrae and development of BM attenuated obviously.

CONCLUSIONThe defenestrae and BM of LSEC develop gradually with the chronic alcohol stimulation. Sinusoid capillarization and liver fibrosis even form when significant changes happen. The early change of the limited defenestrae and capillarization may be the basis of alcohol periportal fibrosis formation. This kind of liver fibrosis can be reversible after stopping alcohol feeding.

Animals ; Basement Membrane ; pathology ; Endothelium ; drug effects ; pathology ; Ethanol ; Liver ; blood supply ; pathology ; Liver Cirrhosis, Experimental ; pathology ; Liver Diseases, Alcoholic ; pathology ; Male ; Rats ; Rats, Wistar

AIMTo study the vasodilation effect of atropine and its mechanism.

METHODSIsometric tension was recorded in isolated rat super mesenteric arteries precontracted by noradrenaline (NE) to study the vasodilation effect of atropine, and to investigate the role of endothelial cell and vascular smooth muscle cell on vasodilation.

RESULTSAtropine was shown to significantly dilate the endothelium-intact and endothelium-denuded arteries precontracted by NE. Nomega-Nitro-L-arginine methyl ester (L-NAME, nitric oxide synthase inhabitor), indomethacin (cyclooxygenase inhibitor), propranolol (general beta adrenoceptor antagonist) and glibenclamide (ATP sensitive potassium channel inhibitor) showed no effect on vasodilation of atropine. Atropine did not affect the concentration-contraction curve of K+. However, atropine suppressed the contraction induced by NE and CaCl2, but not that by caffeine in the Ca+ -free Krebs solution.

CONCLUSIONAtropine showed significant vasodilation effect which may derive, in part, from endothelium. Besides, atropine could inhibit the receptor-mediated Ca2+ -influx and Ca2+ -release, which was inferred to the mechanism of atropine on vasodilation.

Animals ; Atropine ; pharmacology ; Calcium ; metabolism ; Calcium Chloride ; antagonists & inhibitors ; Cyclooxygenase Inhibitors ; pharmacology ; Endothelial Cells ; physiology ; Female ; In Vitro Techniques ; Indomethacin ; antagonists & inhibitors ; Male ; Mesenteric Artery, Superior ; drug effects ; NG-Nitroarginine Methyl Ester ; antagonists & inhibitors ; Nitric Oxide Synthase ; antagonists & inhibitors ; Norepinephrine ; antagonists & inhibitors ; Potassium Chloride ; antagonists & inhibitors ; Rats ; Rats, Sprague-Dawley ; Vasodilation ; drug effects ; Vasodilator Agents ; pharmacology

OBJECTIVETo determine the clinical characteristics and outcomes of redo CABG.

METHODSThe outcomes of 42 consecutive patients who underwent redo CABG from January 2002 to December 2010 was analyzed. There were 29 males and 13 females, aging from 46 to 78 years old with a mean of (61.2 ± 2.1) years. Off-pump CABG was applied for 31 patients and on-pump CABG for 11 patients. There were 1 patient underwent concomitant aortic valve replacement and 1 patient underwent aortic root and right aortic arch replacement respectively.

RESULTSThree patients died of right ventricle rupture, heart failure and multiple system organ failure respectively and the perioperative mortality rate was 4.8%. The post-operatively mechanical ventilation time varied from 9 to 27 h with a mean of (17 ± 7) h. There was no residual angina and perioperative myocardial infarction in the remaining patients who were all discharged uneventfully. Intraoperative 6 patients had accepted intraaortic balloon counterpulsation. During the follow-up from 6 months to 4.5 years for 38 patients, which showed no evidence of recurrent angina and postoperative coronary CT angiography in 12 patients showed the patency of grafts is good.

CONCLUSIONSatisfactory outcome of redo coronary artery bypass grafting can be achieved if proper indication were choose and reasonable management were performed.

Aged ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Restenosis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reoperation ; Treatment Outcome

Objective The use of tourniquets in total knee arthroplasty has been controversial. Many studies have focused only on the different time courses and neglected the effects of pressures. Currently,there is no study explaining the mechanism of tourniquet-induced injury. The aim of this study was to explore the effects of different tourniquet pressures on pain and swelling after total knee arthroplasty and to explore the mechanism of injury. Methods Ninety-six patients who underwent total knee arthroplasty at Nanjing General Hospital from June 2017 to December 2017 were randomly as-signed to 240 mmHg group (low pressure),270 mmHg group (medi- um pressure),and 300 mmHg group (high pressure). The patient's pain and thigh circumference were measured before and 1-2 days after surgery. Blood samples were taken before and 3,8,and 24 hours after surgery. Superoxide dismutase 1 (SOD1),prostaglandin E2 (PGE2) and myoglobin were detected,analysed and compared. Results In the perspective of the pain and swelling of affected limb after surgery,the 300 mmHg group (73.24±10.51) was significantly different from the 240 mmHg group (58.18±9.66) and the 270mmHg group (63.06±10.06). In the perspective of the SOD1 level in serum,the 300mmHg group (97.77±13.82) was significant-ly different from the 240mmHg group (63.72±15.02) and the 270 mmHg group (70.58±5.85) at 3h after surgery,and then the diver-gence was gradually decreased. In the perspective of the PGE2 level in serum,the 300 mmHg group (478.05±35.80) was significantly different from the 240mmHg group (334.42±33.12) and the 270mmHg group (391.85±19.41) at 3h after surgery,and the divergence was started to decrease after 8 h. In the perspective of the myoglobin level in serum,the 300 mmHg group (30.43±9.79) was also sig-nificantly different from the 240 mmHg group (17.58±1.93) and the 270 mmHg group (22.28±4.21) at 8 h after operation,the diver-gence was started to decrease after 24 h. which began to decrease after 24 h. Correlation analysis showed that there was a significant cor-relation between pain (correlation coefficient 0.518,P<0.001),swelling (correlation coefficient 0.345,P<0.05) and stress after sur-gery. Conclusion The pain and swelling of the affected limb is positively correlated with the pressure of the tourniquet during the operation. Muscle necrosis is the main mechanism of the injury. Oxidative stress occurs in the ischemic phase and inflammation occurs in the reperfusion phase.

BACKGROUNDPre-operative chemotherapy has gained widespread interest while treating advanced gastric cancer in eastern countries. However, there is currently no established standard regimen for gastric cancer. The aim of this research was to explore the value of preoperative chemotherapy with a combination of intravenous and intra-arterial intensified chemotherapy in advanced gastric cancer.

METHODSA total of 56 histologically proven gastric cancer patients, who were considered to be stage II or higher with metastatic lymph nodes and with or without distant metastasis (T2-4, N1-3, and M0-1), were treated with a neoadjuvant chemotherapy. Patients received a combination of intravenous 5-Fu (370 mg/m2) and leucovorin (200 mg/m2) on days 1-5, and intra-arterial etoposide (80 mg/m2) and cisplatin (80 mg/m2) on days 6 and 20. After two cycles of preoperative chemotherapy, patients with resectable tumors underwent laparotomy.

RESULTSAll patients finished two cycles of chemotherapy. The overall response rate was 78.57% (44 cases), of which 7.14% (four cases) clinical complete response. Forty-six patients underwent resection, including 21 initially unresectable diseases. R0 resection rate for prechemotherapy resectable and unresectable diseases was 96.15% (25/26 cases) and 66.67% (20/30 cases), respectively. Pathological complete response was observed in 8.70% of patients. Toxicity was moderate and there were no chemotherapy-related deaths. With a median follow-up of 31 months (range 6-76 months), the 5-year survival rate for the whole group and patients with initially resectable tumors were 21.8% and 42.3%, respectively. The median survival for initially resectable and unresectable patients were 41 months (95%CI, 31.006-50.994) and 18 months (95%CI, 13.399-22.601; P<0.01), respectively.

CONCLUSIONPreliminary results proved that the combined intensive chemotherapy was a safe and promising regimen for pre-operative treatment of advanced gastric cancer.

Adult ; Aged ; Cisplatin ; administration & dosage ; therapeutic use ; Etoposide ; administration & dosage ; therapeutic use ; Female ; Fluorouracil ; administration & dosage ; therapeutic use ; Humans ; Infusions, Intra-Arterial ; Infusions, Intravenous ; Leucovorin ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Neoadjuvant Therapy ; methods ; Retrospective Studies ; Stomach Neoplasms ; drug therapy ; surgery

OBJECTIVETo seek the problems of position, measuring and locating methods of Baliao points (posterior sacral foramina) in modern researches.

METHODSUsing Baliao (eight sacral foramina), Shangliao(BL 31), Ciliao(BL 32), Zhongliao(BL 33), Xialiao(BL 34), Dihoukong (posterior sacral foramina), Dikong (sacral foramina) and Digu(sacrum) as the key words, literature in the database of the CNKI from 1957 to 2012 were re trieved and analyzed.

RESULTSProblems were found in the past researches including limited numbers of relative literature, disunity of the measurement targets, complicated terms of indices, disunity of the starting and ending point of measurement, unclear weight of indices, deviation of results, lacking of combination with clinical practice and variety of locating methods.

CONCLUSIONPosition of Baliao points (eight sacral foramina) are clear. However, the locating methods are blurred and vary a lot. Study on living body has more significance for measurement and researches. Factors of gender, body weight, height and childbearing should also be taken into consideration. Therefore, it is necessary to find a more accurate and easier way of locating.

Acupuncture Points ; Acupuncture Therapy ; Humans ; Sacrum ; anatomy & histology ; diagnostic imaging ; Tomography, X-Ray Computed

OBJECTIVETo detect and study the types of Borrelia burgdorferi sensu lato in ticks and rodents from Da Xing-An Mountains Forest areas of China.

METHODSNested PCR was performed to amplify 5S-23S rRNA intergenic spacer of B. burgdorferi. Positive products were analysed by restriction fragment length polymorphism (RFLP) and single strand conformation polymorphism (SSCP), specimens showing unique RFLP profile were sequenced and analysed.

RESULTS1336 Ixodes persulcatus, 144 Dermacento silvarum, 144 Haemaphysalis concinna and 145 rodents of 9 species were collected from 16 sections of Da Xing-An Mountains Forest areas of China. Specific fragments were amplified from 293 I. persulcatus and 6 D. silvarum and 5 rodents of 4 species. B. burgdorferi was not detected in H. concinna. Among the positively tested I. persulcatus, 209 contained B. garinii genospecies and 45 contained B.afzelii genospecies based on RFLP. Moreover, B.garinii genospecies consisted of B. garinii 20047 and B. garinii NT29. 17 adult I. persulcatus were simultaneously infected with B. garinii 20047 and B. garinii NT29. Nine adult I. persulcatus were simultaneously infected with B. garinii 20047 and B. afzelii. Four adult I. persulcatus were simultaneously infected with B. garinii 20047 and B. garinii NT29 and B. afzelii. Two D. silvarum were infected with B. garinii 20047, 1 D. silvarum with B. garinii 20047, 2 D. silvarum with B. afzelii. 3 rodents were infected with B. garinii 20047 while 2 rodents were infected with B. garinii NT29. Mixed infection was not found in D. silvarum and rodents. In addition, nine I. persulcatus and one D. silvarum specimens showed unique RFLP pattern. Data from sequential analysis showed that they all belonged to B. garinii. PCR-SSCP profiles of 5S-23S rRNA intergenic spacer of B. burgdorferi in the positive specimens exceeded 36 types; B. garinii 20047 showed 16 types while B. garinii NT29 showing 11 types, B. afzelii showing 9 types. SSCP profiles of the specimens coinfected with multiple B. burgdorferi was relatively complex.

CONCLUSIONThe infection of B. burgdorferi was found in the ticks and rodents in Da Xing-An Mountains Forests areas. The infection rate of I. persulcatus was high. B. garinii was predominant genospecies, and the population of B. burgdorferi was heterogeneous in the area. Mixed infections of different B. burgdorferi genospecies in ticks were found. I. persulcatus and Clethrionomys rufocanus were possibly served as major vector and major host for B. burgdorferi, respectively, suggesting that further study is needed to confirm the coinfection in humans and animals in this region.

Animals ; Borrelia burgdorferi Group ; genetics ; isolation & purification ; China ; epidemiology ; Humans ; Lyme Disease ; epidemiology ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single-Stranded Conformational ; RNA, Bacterial ; analysis ; Rodentia ; microbiology ; Ticks ; microbiology ; Trees

BACKGROUND: Periprosthetic infection after total knee arthroplasty (TKA) has become the most serious complication. However, there is still a lack of clinical study on the distribution of pathogenic bacteria. Therefore, understanding the distribution characteristics of the main pathogenic bacteria is critical for preventing and treating OBJECTIVE: To analyze the bacteriological characteristics in the patients with periprosthetic joint infection following TKA, so as to provide reference for early prevention and treatment. METHODS: CNKI, VIP, WanFang and PubMed databases were retrieved for the literature concerning periprosthetic infection following TKA published before 2016. The incidence of periprosthetic joint infection after TKA was statistically analyzed. RESULTS AND CONCLUSION: (1) 103 articles were included, involving 1 399 patients. (2) The main pathogenic bacteria were Staphylococcus aureus,coagulase negative Staphylococcus aureus,Staphylococcus epidermidis,Escherichia coli, Streptococcus and Enterococcus.There is no significant difference in the distribution of bacteria at home and abroad. Treatment strategies are divided into conservative and surgical treatments. (3) The key for successfully preventing and treating periprosthetic infection after TKA lies in the multiple disciplinary team collaboration, understanding the distribution of bacteria, early diagnosis and active preventive measurements, as well as rational treatment strategies.

OBJECTIVETo investigate the influence of combined supplementation of glutamine (Gln) and recombinant human growth hormone (rhGH) on the protein metabolism in severely burned patients.

METHODSSixty severely burned patients were enrolled in the study and were randomly divided into control (C, n = 20) and Gln with rhGH (Gln + rhGH, n = 20) groups. The patients in C group received glycine as the placebo, while those in Gln group took Gln orally in dose of 0.5 g kg(-1) d(-1) during 1-14 postburn days (PBDs). For the patients in Gln + rhGH group rhGH was administered subcutaneously in dose of 0.2 U kg(-1) d(-1) in addition to glutamine in same dosage beginning on the 7 PBD for 7 days. The plasma Gln concentration in the 3 groups of patients was determined on the 1st, 7th and 14th PBD and the plasma albumin level was determined on 14th and 21st PBD. The wound healing rate of the patients within 30 PBSs and the total hospital stay days were recorded.

RESULTSThe plasma Gln concentration in Gln + rhGH group of patients was evidently higher than that in C group after 7 PBD[(452.28 +/- 21.72) micromol/L vs(325.12 +/- 25.34) micromol/L, P < 0.05]. The plasma albumin level in Gln + rhGH group was obviously higher than that in C and Gln groups on the 21st PBD (P < 0.05). The wound healing rate in Gln + rhGH group was evidently higher than that in Gln and C groups on the 30th PBD (P < 0.05). The total hospital stay days in Gln + rhGH group were obviously less than that in C and Gln groups (P < 0.05 or 0.01).

CONCLUSIONCombined administration of Gln and rhGH could be beneficial to the elevation of plasma Gln level in severely burned patients and the systemic protein synthesis was therefore enhanced and the wound healing rate was improved.

Adult ; Aged ; Burns ; metabolism ; therapy ; Female ; Glutamine ; administration & dosage ; blood ; therapeutic use ; Human Growth Hormone ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Treatment Outcome ; Wound Healing ; drug effects ; Young Adult