Objective To investigate the protective effects of ulinastatin (UTI) on ischemiareperfusion injury of donor lungs,and the possible mechanism.Method Forty male SD rats were randomly divided into two groups:group C as control group and group U as UTI group.In group C donor lungs were antegradely flushed with 20 ml of cold (4 C) low potassium dextron (LPD) solution and 5 ml retrogradely.Meanwhile,in group U,UTI (500 000 U/L) was added in LPD solution and the same doses were used.According to the time after initiation of reperfusion,each group was divided into two subgroups:30 min (subgroup A) and 1 h (subgroup B).Arterial blood samples were collected for blood gas analysis.Lung samples were obtained at the end of reperfusion (30 min or 1 h).Microscopic examination of the donor lungs was conducted.Besides,the pulmonary water index (W/D),tissue malondialdehyde (MDA) and superoxide dismutase (SOD) content,and mRNA expression of tumor necrosis factor (TNF-a),intercellular adhesion molecule 1 (ICAM-1) and interleukin 10 (IL-10) were also measured.Results (1) One h after reperfusion,oxygenation index in group U was higher than that in group C (P =0.025) ; (2) The levels of W/D in subgroup A and subgroup B of group U were decreased as compared with group C (P =0.005 and P =0.006) ; (3)The microscopic changes of donor lung tissues in group U were lessen than in group C; (4) In subgroup A of group U,MDA content was decreased (P=0.039),and SOD content was increased (P=0.035),and similar results could be observed in subgroup B of group U (P =0.006 and P =0.030 respectively); (5) As compared with group C,the mRNA expression of TNF-α in group U was decreased at the time of 30 min after reperfusion (P =0.000),but no significant change was found at the time of 1 h (P =0.139).The mRNA expression of ICAM-1 was not decreased evidently at the time of 30 min (P=0.062),but significantly decreased at the time of 1 h (P=0.001).The mRNA expression of IL-10 was increased in subgroups A and B (P =0.004 and P =0.000 respectively).Conclusion This study demonstrated that UTI had protective effects of reducing ischemia-reperfusion injury on the donor lungs after lung transplantation in rat non-heart beating donor models.

Objective To observe the effect of curcumin combined with cisplatin on the proliferation of human tongue squamous cell carcinoma Tca?8113 cells,and explore the possible mechanism of their anti?tumor effect in vitro. Methods In this study,the samples were divided into four groups:curcumin,cisplatin,curcumin combined with cisplatin,and control. Detection of rate of inhibition of Tca?8113 cell proliferation was carried out by MTT assay. This was followed by observation of the morphological changes of the nuclei by Hoechst 33258 fluorescence staining. Subse?quently,cellular apoptosis was assayed by flow cytometry,and expression of Notch1 and epidermal growth factor receptor(EGFR)was examined by Western blotting. Results Results of MTT assay showed that curcumin combined with cisplatin inhibited the proliferation of tongue squamous cell carcinoma to a greater extent than either curcumin or cisplatin alone(P<0.05). Flow cytometry analysis indicated that,unlike curcumin or cisplatin alone,curcumin combined with cisplatin noticeably induced apoptosis(P<0.05). Results of Western blotting revealed that the expres?sion of Notch1 was upregulated,whereas the expression of EGFR was downregulated to a greater extent in the control group than in cells treated with curcumin or cisplatin alone. Unlike curcumin and cisplatin groups,the combined group revealed statistically significant expressions of Notch1 and EGFR(P<0.05). Conclusion Curcumin and cisplatin have a combined effect on inhibition of proliferation of human tongue squamous cell carcinoma Tca?8113 cells. The mechanism may be related to upregulation of the Notch1 signaling pathway and downregulation of the EGFR signal?ing pathway.

Objective To discuss the effectiveness of anterolateral thigh propeller flaps for treatment of inguinal skin and soft tissue defects.Methods From June,2009 to October,2014,12 patients with inguinal skin and soft tissue defects were treated with anterolateral thigh propeller flaps pedicled with perforator of descending branch of lateral circumflex femoral artery.Of them there were 8 males and 4 females,aged from 22 to 51 years.The left side was involved in 3 cases and right side 9 cases.Defects were caused by traffic accident injury in 5 cases,crash injury of heavy object in 7 cases.There were mere skin and soft tissue in 2 cases,combined with bone fractures,nerves,vessels and muscles injury in 10 cases.The area of defects ranged from 9.0 cm×5.0 cm to 22.0 cm×9.0 cm.During operation,anterolateral thigh propeller flaps ranging from 11.0 cm×7.0 cm to 24.0 cm×1 1.0 cm were used to repair the wounds.Results All flaps and skingrafts survived after operation and the wounds obtained primary healing.After 8-24 months follow-up,all flaps were characterized by soft texture,good color,and satisfactory appearance.According to the Britain's Medical Research Council at 8 months after operation,the sensation of the flaps were recovered to S2 ～ S3+,No obvious scar contracture and chromatosis were observed at donor site.Conclusion Anterolateral thigh propeller flaps pedicled with artery descending branch of lateral circumflex femoral perforator is an ideal choice for the reconstruction for inguinal skin and soft tissue defects.

AIM: To investigate the expression of B lymphocyte stimulator(BLyS) and CD38 molecules on peripheral blood lymphocytes of patients with systemic lupus erythematosus(SLE). METHODS: Twenty-two patients with SLE and fourteen healthy subjects entered the study. Isolated peripheral blood lymphocyte were stained for the lymphocyte surface markers BLyS, CD19, and CD38, and then was measured by flow cytometry(FACS). RESULTS: BLyS + lymphocytes, CD19 + lymphocytes, and CD19 +CD38 + lymphocytes were increased significantly in patients with SLE( P

Purpose: It is well known that congenital diaphragmatic hernia (CDH) in infants impacts pulmonary function rehabilitation after surgery. However, the risk factors of postoperative pulmonary function are still unclear. In this research, we analyzed the potential risk factors of postoperative pulmonary function in CDH patients in order to improve the clinical management of CDH patients. Methods: Thirty-three cases CDH infants followed were enrolled from November 2016 to September 2018. Clinical data were reviewed. Tidal breathing pulmonary function testing was performed after surgery. Correlation between pulmonary function and clinical characteristics was evaluated using multivariate analysis of variance. Results: Pulmonary dysfunction was detected in 87.9% patients (29 of 33). The defect size was found to be significantly larger in patients with obstructed and mixed ventilatory disorders (P = 0.001). Diagnosis of gestational age (GA) was also significantly earlier compared to restrictive ventilatory disorders (P = 0.001). Larger defect size, and earlier prenatal diagnosis of GA were detected in severe obstructive ventilatory disorders (P = 0.007, P = 0.001, retrospectively). Conclusion Most patients had various degrees of pulmonary dysfunction after surgery. Patients with larger defect size and earlier diagnosis time might be vulnerable to severe obstructive and mixed ventilatory disorders.

OBJECTIVETo Summarize the clinical experience in the treatment of late-stage emphysema by lung volume reduction (LVR) in 5 years.

METHODSWe retrospectively studied the indications, contraindications, operation procedures and complications of LVR in 22 patients.

RESULTSBefore operation, the average FEV(1) was 24.5%, RV 196.8%, and TLC 130.5%; after operation they were 27.8%, 148.8% and 112.5%, respectively. 16 patients needed inhaling oxygen before operation, and 5 after operation. 16 patients finished 6-minute walking test with an average of 198 m, all patients walked much longer with an average of 256 m after operation. 3-degree lung function was observed in 14 patients, and 4-degree before operation in 8 patients; but 2-degree lung function in 5 patients, 3-degree in 13, and 4-degree in 4 after operation.

CONCLUSIONSHeterogeneous type emphysema with clear target area, especially bullous emphysema is the best indication for LVR. Lung function and life quality could be much improved postoperatively. Homogeneous type could also be treated with LVR in highly selected cases. TLCO < 20% is not an absolute contraindication, others standards need further investigation. Video-assistant thoracoscopic surgery (VATS) with subaxillary small incision for LVR is safe, reliable and effective. Application of stapler buttressing with bovine pericardia could decrease air leakage postoperatively.

Aged ; Female ; Humans ; Male ; Middle Aged ; Pneumonectomy ; Pulmonary Emphysema ; surgery ; Retrospective Studies ; Thoracoscopy

The present case report was designed to summarize the clinical experience of operative technique. lung preservation, lung perfusion, and perioperative management. Of 7 cases who underwent allogenic single lung transplantation (LT), 3 were idiopathic pulmonary fibrosis, 2 were chronic obstructive pulmonary disease, 1 was silicosis, emphysema, and bulla, and I was tuberculosis in both sides and presented with destroyed lung in one side. All donors were already brain death. Donor lungs were well preserved utilizing Euro-Colins liquid or low-potassium dextran solution. Donors and recipients were matched in blood type. Of 7 cases selected,5 received single right lung transplantation, and 2 received single left LT. End-to-end anastomosis was performed for pulmonary branches and pulmonary arteries. while atrium-to-atrium anastomosis was performed for pulmonary vein. Antibiotics and immunosuppressants were routinely used prior to and subsequent to LT. Following LT, heart and lung function, usage of antibiotics, and adjustment of immunosuppressant were monitored. Stomal complications regarding bronchus and pulmonary artery and vein did not appear in any patient. Five cases survived for about 2 months, one for approximately 1 year, and one for nearly 2 years. Four cases died of multi-organ failure caused by pulmonary infection, and one of severe pulmonary hemorrhage caused by aspergillus sydowi infection. Rejection occurred in 6 cases. One case sufiered from rejection three times. Selection of indication, selection and preservafton of donor lung, LT operation and pre-and post-operative management of LT have acquired satisfactory achievements. High mortality occurred in patients with preoperative poor cardiac and pulmonary functions and postoperative severe infections accompany with application of immunosuppressant.

BACKGROUND: Lung transplantation can improve quality of life of patients who get terminal pulmonary disease and also it can help to get better survival.Now it has become one of the best therapeutic methods for terminal pulmonary disease.However,limited donors leave the development of lung transplantation in dilemma.The emergence of living lobar transplantation and cadeveric lobar transplantation let this procedure much easier.OBJECTIVE: To evaluate the clinical probability of bilateral lobar transplantation.METHODS: Sequential bilateral lobar transplantation was performed for one 26 years old cystic fibrosis female.Cardiac pulmonary bypass was used during operation.Anti-rejection(Tacrolimus,mycophenolate,etc)and anti-infection was used postoperatively.RESULTS AND CONCLUSION: The recovery course postoperatively was smooth,and the recipient got out of hospital 7weeks later.Bilateral lobar transplantation could offer satisfied short-term pulmonary function.The long term results should be further evaluated.

Objective To investigate the treatment and surgical results of acute volar plate avulsion fracture of proximal interphalangeal joint.Methods From August 2013 to June 2016,data of 15 cases of acute volar plate avulsion fracture of proximal interphalangeal joint were retrospectively analyzed.There were 8 males and 7 females aged 18-43 years old with an average of 28.6 years old.There were 4 cases of index finger,6 cases of middle finger,2 cases of ring finger and 3 cases of little finger.Eight injuries resulted from falls,four from finger breaking and three from crushing.The time from injury to operation was 5-9 days,with an average of 6.7 days.The acute volar plate avulsion fracture of proximal interphalangeal joint were treated by double thread compression suture fixation,and Kirschner wires were used to obliquely fix the interphalangeal joint.After the operation,the fore arm was fixed by plaster for 3-4 weeks.After the removal of the plaster,the flexion and extension function of the distal interphalangeal joint and the metacarpophalangeal joint was performed under the guidance of the rehabilitation instructor in a state of no weight.The finger was evaluated by X-ray every 2 weeks until the fracture healing.After 5-8 weeks,the Kirschner wire was removed when the fracture line disappeared,and the active flexion and extension of the proximal interphalangeal joint was guided by the rehabilitation instructor.Resuts In this group of 15 patients,all the incisions healed at the first stage.There was no surgical complications such as skin necrosis,and needle path infection and no abnormal finger feeling or blood circulation disorder.All patients were followed up for 8-32 months (mean,21.7 months).8 months after operation,the DASH score was 1.5 to 7.0 points with an average of 4.6 points.At the latest follow-up,there was no pain,swelling and joint contracture in the proximal interphalangeal joints.The dorsal extension of joints were stable,and the degree of active joint activity was:90°±7° of the metacarpophalangeal joint,80°±6° of the proximal interphalangeal joint,78°±7° of the distal interphalangeal joint,and 248°±22° of total active activity.According to TAM system assessment criteria:there was excellent in 12 cases,good in 2 cases,fair in 1 case,and excellent rate was 93.3％(14/15).Conclusion Double thread compression suture fixation for the treatment of acute volar plate avulsion fracture of proximal interphalangeal joints could reduce the damage to the accessory structure of the joint,and reach adequate exposure in the operationfor fixing the bone block firmly.After operation,good fracture healing and good finger function could be achieved,so the double thread compression suture fixation is an effective surgical method.

BACKGROUND/AIMS: Interstitial cells of Cajal (ICC) and their special calcium-activated chloride channel, anoctamin-1 (ANO1) play pivotal roles in regulating colonic transit. This study is designed to investigate the role of ICC and the ANO1 channel in colonic transit disorder in dextran sodium sulfate (DSS)-treated colitis mice. METHODS: Colonic transit experiment, colonic migrating motor complexes (CMMCs), smooth muscle spontaneous contractile experiments, intracellular electrical recordings, western blotting analysis, and quantitative polymerase chain reaction were applied in this study. RESULTS: The mRNA and protein expressions of c-KIT and ANO1 channels were significantly decreased in the colons of DSS-colitis mice. The colonic artificial fecal-pellet transit experiment in vitro was significantly delayed in DSS-colitis mice. The CMMCs and smooth muscle spontaneous contractions were significantly decreased by 5-nitro-2-(3-phenylpropylamino)benzoic acid (NPPB), an ANO1 channel blocker, and NG-Nitro-L-arginine methyl ester hydrochloride (L-NAME), an inhibitor of nitric oxide synthase activity, in DSS-colitis mice compared with that of control mice. Intracellular electrical recordings showed that the amplitude of NPPB-induced hyperpolarization was more positive in DSS-colitis mice. The electric field stimulation-elicited nitric-dependent slow inhibitory junctional potentials were also more positive in DSS-colitis mice than those of control mice. CONCLUSION: The results suggest that colonic transit disorder is mediated via downregulation of the nitric oxide/ICC/ANO1 signalling pathway in DSS-colitis mice.
Animals ; Blotting, Western ; Chloride Channels ; Colitis ; Colon ; Dextrans ; Down-Regulation ; In Vitro Techniques ; Interstitial Cells of Cajal ; Mice ; Muscle, Smooth ; Myoelectric Complex, Migrating ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Polymerase Chain Reaction ; RNA, Messenger ; Sodium