Objective To evaluate the effects of ulinastatin on proinflamatory cytokines and oxygen free radical during orthotopic liver transplantation (OLT). Methods Eighteen ASA Ⅲ-Ⅳ patients with end-stage liverⅣ diseases, undergoing OLT were randomly divided into two groups: (1) ulinastatin group received intravenous infusion of ulinastatin 2? 105 IU in 100 normal saline after skin incision and every 4 hours thereafter (group U n = 9); control group received same amount of normal saline instead of ulinastatin (group C n = 9). Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1 , fentanyl 5 ?g?kg-1 and pipecuronium 0.1 mg?kg-1 and maintained with isoflurane inhalation and intermittent iv boluses of fentanyl and pipecuronium combined with epidural anesthesia(T8.9). The patients were mechanically ventilated with 100% O2 and PETCO2 was maintained at 35-40 mm Hg during operation. Swan-ganz catheter was inserted via right internal jugular or subclavian vein after induction of anesthesia. Cardiac output, mixed venous oxygen saturation and central venous temperature were continuously monitored with continuous cardiac output monitor (Baxter, Vigilance). ECG,CVP,SpO2 and PETCO2 were also continuously monitored during operation. Radial artery was cannulated for continuous direct blood pressure monitoring. Blood samples were taken before skin incision (T0), 120 min after skin incision (T1), 30 min after liver was removed ( anhepatic phase) (T2) , 5 min and 60 min after reperfusion of the graft (T3 , T4) and at the end of operation (T5 ) for determination of plasma IL-6, IL-8, TNF-? and MDA concentration. Body temperature was maintained above 35.5℃ during operation. Venovenous bypass was performed during anhepatic phase. Results (1) In group C plasma IL-6 and Ⅱ-8 concentrations were significantly increased from T1-5 during operation as compared with the baseline values (T0), whereas plasma levels of TNF-? and MDA did not change significantly before and during anhepatic phase (T1 , 2) but were significantly increased during neohepatic phase and at the end of surgery (T3 ,45) as compared with the baseline values (T0).(2) In group U plasma IL-6, IL-8, TNF-? and MDA concentrations were not significantly increased during operation, except that plasma IL-6 and IL-8 concentrations were significantly higher at T3 (5 min after reperfusion of the graft) than the baseline values. Conclusion Ulinastatin inhibits release of proinflammatory cytokines and reduces production of oxygen free radicals during OLT.

Objective To evaluate the effects of prostaglandin E1 (PGE1) and low-dose dopamine on renal function during orthotopic liver transplantation (OLT) .Methods Eighteen ASA Ⅲ-Ⅳ patients with end-stage liver diseases undergoing OLT were randomly divided into two groups of 9 patients each : PGE1 group (group P) and low-dose dopamine group (group D). Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1 , fentanyl 5 ?g?kg-1 and pipecuronium 0.1 mg?kg1 and maintained with isoflurane inhalation and intermittent i.v. boluses of fentanyi and pipecuronium. The patients were mechanically ventilated after tracheal intubation. PGE1 was infused at 0.4-0.8?g? kg-1 ? h-1 in group P and dopamine at 1 -3 ?g ? kg-1? min in group D after induction until the end of operation. Swan-Ganz catheter was inserted via right internal jugular vein or subclavian vein and radial artery was cannulated. MAP, ECG, CVP, SvO2 , cardiac output ( CO), SpO2 , PET CO2 and core temperature were continuously monitored during operation. Venous blood samples were taken and urine was collected before induction of anesthesia (T1 .baseline), during preanhepatic (T2) anhepatic (T3) and neohepatic phases (T4) and at the end of operation (T5) for determination of serum creatinine (Cr) concentration and serum and urine concentration of ?2 -microglobulin (?2-MG). Creatinine clearance ratio (CCr) was calculated. Total urine output during operation and urine output and the amount of furosemide given during anhepatic phase were recorded. Core body temperature was maintained above 35.5℃ during operation. Veno-venous bypass (VVB) was performed during anhepatic phase.Results In group P, compared to baseline there were no significant changes in MAP, Cr and CCr duringoperation, while serum ?2-MG decreased significantly at T5 and urine ?2-MG increased significantly at T3-5 . In group D serum ?2-MG was significantly decreased while urine ?2 -MG significantly increased at T2.5 compared to baseline. There was significantly more urine output during anhepatic phase and the whole operation and less furosemide was given in group D than in group P. Conclusion Low dose dopamine is more effective in protecting renal function during OLT than PGE1 .

BACKGROUND: The expression and significance of transforming growth factor-alpha (TGF-α) and epidermal growth factor receptor (EGF-R) in different diseases are different.OBJ ECTTVE: To investigate the expression of TGF-α and EGF-R in human liver cirrhosis tissues.DESIGN : Non-randomized controlled trial.SETTING: Department of General Surgery, Tangdu Hospital, Fourth Military Medical University of Chinese PLA.MATERIALS: This trial was carried out in the Department of Pathology, Xijing Hospital, Fourth Military Medical University of Chinese PLA during March 2003 to May 2004. Sixty-three samples of human liver cirrhosis tissue were obtained from Department of General Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA (Informed consents were obtained). Five human normal liver tissues were obtained form autopsy in Department of Pathology, Fourth Military Medical University of Chinese PLA (patients with liver diseases were excluded).METHODS: Sixty-three samples of human liver cirrhosis specimens and five human normal liver tissues were studied with immunohistochemical method and in situ hybridization technique. The positive rates of TGF-α and EGF-R were calculated and managed statistically.MAIN OUTCOME MEASURE: Detection of the expressions of TGF-α and EGF-R in liver cirrhosis tissues were detected with immunohistochemical method and in situ hybridization technique.RESULTS: The expression rate of TGF-α and EGF-R in 63 samples of human liver cirrhosis tissues was 84% (53/63)and 52% (33/63) respectively. These positive granules were brown and most of them were in cytoplasm of hepatocytes.There was significantly positive correlation between TGF-α and EGF-R (r =0.32,P ＜ 0.05). In five normal liver tissues,TGF-α and EGF-R were not detectable in hepatocytes and bile ducts. In situ hybridization showed the levels of TGF-αmRNA and EGF-R mRNA were higher (86%, 54%) than those of immunohistochemistry. There was no significant difference between two detective methods (P＞0.05).CONCLUSrON: Liver cirrhosis might be under the autocrine regulation of TGF-α/EGF-R. Increasing expression of TGF-αand EGF-R might be one of important factors in liver cirrhosis pathogenesis.

Humans ; Monitoring, Intraoperative ; methods ; Perioperative Care ; Sleep Apnea, Obstructive ; nursing ; therapy

Objective: To construct eukaryotic expression vector pSecTag2/HygroB-DAF of human decay accelerating factor (DAF) and transfect NIH/3T3 cells after encapsulated by chitosan. Methods:The human DAF fragments were obtained by PCR form DAF-pGEM-T Easy Vector, cloned into the eukaryotic expression vector pSecTag2/HygroB, and identified by restriction endonuclease’s digestion and DNA sequencing. After the particles of pSecTag2/HygroB-DAF were encapsulated by chitosan, the NIH/3T3 cells were transfected by chitosan-DAF nanoparticles and detected DAF expression by immunohistochemistry stain. Results:The DAF fragment was 1049 bp. Its sequence was as same as DAF cDNA in Genebank. After having been transfected by chitosan-DAF nanoparticles 24 hours, the NIH/3T3 cells showed diffusely positive in cytoplasms by anti-DAF immunohistochemistry. Conclusion:Eukaryotic expression vector of human DAF were constructed successfully and transfected it to NIH/3T3 cells after encapsulated by chitosan.

The present study is to elucidate the mechanisms underlying Gleevec-induced apoptosis of chronic myeloid leukemia (CML) K562 cells in vitro. The apoptotic cell death and cell cycle distribution after Gleevec treatment and the effect of PDCD4 siRNA on Gleevec-induced apoptosis of K562 cells were analyzed by flow cytometry. The effect of Gleevec on p-Crkl, caspase-3, PARP and PDCD4 protein levels, and the knockdown efficacy of PDCD4 siRNA were detected by Western blotting. The results showed that Gleevec dramatically suppressed the phosphorylation level of Crkl in a dose-dependent manner and induced significant apoptosis and G0/G1 cell cycle arrest of K562 cells in time- and dose-dependent manners. In addition, Gleevec activated caspase-3 and its downstream substrates PARP, and the caspase pan inhibitor Z-VAD-FMK (50 micromol x L(-1)) markedly reduced Gleevec-induced apoptosis from 47.97% +/- 10.56% to 31.05% +/- 9.206% (P < 0.05). Moreover, Gleevec significantly increased the protein expression of programmed cell death 4 (PDCD4). PDCD4 knockdown by siRNA reduced Gleevec-induced apoptosis from 46.97% +/- 14.32% to 42.8% +/- 11.43%. In summary, Gleevec induced apoptosis in K562 cells via caspase-3 activation.
Amino Acid Chloromethyl Ketones ; Apoptosis ; drug effects ; Benzamides ; pharmacology ; Caspase 3 ; metabolism ; Cell Cycle ; drug effects ; Humans ; Imatinib Mesylate ; K562 Cells ; Phosphorylation ; Piperazines ; pharmacology ; Pyrimidines ; pharmacology

Objective To explore the epidemiological character of elderly burn patients and to provide the experience of prevention and treatment.Methods The retrospective study method was used,and totals of 531 elderly patients with burn from January 2002 to December 2010 in two hospitals were selected.Cases information such as demographics,clinical diagnosis,treatments,causes of injury,mortality rate and causes of death since admission and so on was recorded and analysed,then,the epidemiological character was summarized and the prevention and treatment were proposed.Results Among 531 patients with burn,the average age was 72.86,the rate of burn in home was 72.5％ and in accident was 16.70％.The clinical cure rate was 82.11％and the mortality rate was 2.33％.The proportion of the elderly burn patients account for the total admitted patients in the same period was 5.13％ in 2002 and 5.64％ in 2010,and the average age of elderly burn patients was higher from 72.53 years old in 2002 to 73.58 years old in 2010.Conclusions The proportion of the elderly burn patients account for total admitted patients in the same period was higher as well as the average age of patients from 2002 to 2010.We should pay more attention to the prevention and education for the burn in home as the main cause of elderly burn patients is the home burn.

Adult ; Enzyme-Linked Immunosorbent Assay ; Female ; HSP70 Heat-Shock Proteins ; blood ; Humans ; Lead ; toxicity ; Male ; Occupational Exposure

Objective To determine the accuracy of femoral components sizing predicted by standardized digital templating in total knee arthroplasty (TKA).Methods Fifty consecutive patients (50 knees),who underwent primary TKAs for endstage osteoarthritis,were prospectively studied.The intra-operative and radiographic data were collected.All operations were performed by the same surgical techniques with PS type,open box Vanguard Complete Knee System.All patients underwent lateral and AP radiography of the involved knee under fluoroscopy before and after surgery.The distal femoral anteroposterior dimension (DFAP) were measured and the femoral components size were predicted on preoperative radiographs by two different methods:measurement of DFAP did not include (group A) the cartilage thickness of the medial posterior condyle or included that (group B).Cutting errors were corrected gradually,and DFAP was measured consequently.The most appropriate size was chose after each step respectively based on postoperative radiographs.The accuracy of femoral size predicted under different conditions was compared within two groups.Results During correction of cutting errors,the correct rate ranged from 18％ to 44％ in group A and from 26％ to 34％ in group B,the accuracy within one size ranged from 54％ to 84％ in group A and from 58％ to 84％ in group B.The cartilage thickness of medial posterior condylar,external rotation of femoral component,under-resected of anterior condylar,flexion of femoral component,and over-resected of posterior condylar can change the DFAP by 1.97±0.85 mm,1.56±2.06 mm,1.15±1.31 mm,-2.86±1.52 mm,and-0.87±0.77 mm,respectively.Conclusion Variation of intraoperative cutting errors and the cartilage thickness of medial posterior condyles can influence the accuracy of templating to some extent.Standardized digital radiography templating cannot predict femoral sizes accurately.

There is no specific treatment for post-polio syndrome. The common applied therapies include mediciation, exercise, cogni-tive behavioural therapy, physiotherapy, occupational therapy, Traditional Chinese Medicine, assistive technology, psychological and social factors adjustment, interdisciplinary comprehensive rehabilitation, and so on.