Objective To investigate the effect of enhanced recovery after surgery (ERAS) on stress hyperglycemia in patients after pancreaticoduodenectomy (PD). Methods Patients matched inclusion and exclusion standards were divided into two groups. The patients after PD before the implementation of ERAS programme were named as the control group (40 cases). The patients after PD with the implementation of ERAS programme were named as the experimental group (52 cases). The fast blood glucose (FBG) in postoperative day (POD) 1, 3, 7 and the volatility of capillary blood glucose during postoperative 3 days were compared between the two groups. Results The FBG in POD1, POD3, POD7 were (8.27 ± 1.99), (6.78 ± 1.22), (5.97 ± 1.21) mmol/L in the experimental group respectively, and the FBG in POD1, POD3, POD7 were (10.46 ± 5.17), (7.88 ± 2.98), (7.29 ± 2.94) mmol/L in the control group respectively, there were significant differences between two groups (t=2.545, 2.219, 2.683, all P<0.05). The volatility of capillary blood glucose during postoperative 3 days in the experimental group were (3.47± 1.98), (3.16 ± 1.46), (2.74 ± 1.49) mmol/L respectively, and the volatility of capillary blood glucose during postoperative 3 days in the control group were (4.13±2.36), (3.26±1.59), (4.07±2.74) mmol/L respectively, no significant differences were found in the volatility of capillary blood glucose in POD1 and POD2 between the two groups (t=1.479, 0.308, all P > 0.05), while significant differences were found in the volatility of capillary blood glucose in POD3 between the two groups (t=2.739, P<0.05). Conclusions It can be concluded that ERAS may be useful to decrease stress hyperglycemia and the volatility of capillary blood glucosein patients after PD, and accelerate the recovery of patients after PD.

Castleman Disease ; complications ; Dendritic Cell Sarcoma, Follicular ; complications ; Humans

Objective To reconstruct the three-dimensional images of normal liver using 256-slice intelligent CT (iCT)and to measure the volume of liver and its segments.Methods 48 healthy adults underwent abdominal contrast enhancement iCT,and the images in portal venous phase were transmitted to a workstation (EBW4.5)to obtain the three-dimensional images of the liver.The total liver volume was measured,and a scatter plot was gotten between body surface area and liver volume.According to the Couinaud classification of hepatic segment ofⅠ-Ⅷ,the volume of each segment was also measured.Results The mean total liver volume in 48 adults was (1 343.2±238.3)mL,which was positively correlated with body surface area with a correlation coefficient of 0.87 and a regression equation of LV(mL)=763.0×BSA-28.6.The volume of SegmentⅠ-Ⅷ was(24.5±4.3)mL,(148.6±31.6)mL,(110.4±24.9)mL, (222.3±43.0)mL,(212.8±36.5)mL,(186.7±34.7)mL,(164.3±30.8)mL and (273.4±56.1)mL,and their percentage was (1.8±0.2)%,(11.0±1.1)%,(8.2±1.1)%,(16.6±1.4)%,(15.9±1.0)%,(13.0±1.0)%,(12.2±0.7)% and (20.3±1.5)% respec-tively.Conclusion The three-dimensional images of liver and hepatic segments can be well reconstructed by 256 slice iCT.

AIM: To investigate the effects of aging on sperm maturation and fertility in mice. METHODS: Sperm of caput epididymides and cauda epididymides were obtained from Kunming mice aged 6 months (n=15, as control) and 18 months ( n=15). Sperm parameters including sperm density, viability, motility and nor mal morphological rate were recorded. Sperm of cauda epididymides was observed b y transmission electron microscope. The fertility potential and embryo developme ntal competence were performed by in vitro fertilization and embryo culture. RESULTS: Sperm motility, density and normal morphological rate i n aged mice were lower than those in control (P

Objective To study on the significance of accompany relatives of children with access to pediatric transplantation ward on clinical treatment and nursing.Methods 37 children undergoing autologous peripheral blood stem cell transplantation (APBST) were collected from January 2007 to April 2010.All cases were divided into the no tending group(7 cases)and the tending group (30 cases).The accompany relatives of the tending group accepted standard training before entering the ward.The compliance with basic nursing,acute side-effect and hemopoiesis rebuild period of marrow during APBST in two groups were compared.Results The compliance with basic nursing of the no tending group was only 28.6％,but was 73.3％ in the tending group.According to Bearman standard,the acute side-effect of the no tending group:1 case of grade Ⅳ,1 case of grade Ⅲ,4 cases of grade Ⅱ,1case of grade Ⅰ; in the tending group:1 case of grade Ⅳ,1 case of grade Ⅲ,6 cases of grade Ⅱ,22 case of grade Ⅰ.The marrow-reconstitution took place in 36 children.The most long time was 41 days in the no tending group,the average time was (28.14+7.98)days.The time took for marrow-reconstitution was 22 days in the tending group,the average time was ( 14.61+2.33)days.Conclusions It is safe and feasible for accompany relatives of children to participate in nursing during transplantation.Relatives accompany is beneficial for psychology adaptability,nursing compliance and success of APBST.

Objective To evaluate the clinical application and safety of CT-guided transthoracic cutting needle lung biopsy in diagnosing diffuse lung diseases. Methods By using automatic biopsy gun (14 & 16 gauge), CT-guided transthoracic cutting needle lung biopsy was performed in 29 cases with diffuse lung diseases. The samples obtained were sent for pathological and immunohistochemical examination. The sampling successful rate, the diagnostic accuracy and the occurrence of complications were analyzed. Results Technical success rate was 100%, and large size of sample enough for pathological and immunohistochemical examination was obtained in all 29 cases. Definite pathological diagnosis could be made in 25 cases, with the positive diagnostic rate of 82.8%. The main complications included pneumothorax and pulmonary hemorrhage. The symptoms in most cases were not severe and disappeared within one week after the treatment. Conclusion For the diagnosis of diffuse lung diseases, CT-guided transthoracic cutting needle lung biopsy is a safe, easy, effective and reliable method with high successful rate, high diagnostic value and fewer complications, in these respects this technique is superior to transbronchial lung biopsy, open lung biopsy and video-assisted thoracoscopic lung biopsy. Therefore, this technique should be popularized in clinical practice.

Aim: To study the effects of astragaloside IV on experimental ventricular remodeling in mice and its mechanism from matrix metalloproteinase aspect.Method: Ventricular remodeling in mice was induced by con-secutively subcutaneous injection of isoproterenol for 14 days.Astragaloside IV(40,80 mg/kg)and propranolol(40 mg/kg,positive control)were administered by gavage to mice.Echocardiography was used to observe the left ventricular end diastolic diameter(LVIDd),left ventricular end systolic diameter(LVIDs),fractional shortening(FS)and ejection fraction(EF).The myocardial pathological pattern was detected by HE staining.Expressions of matrix metalloproteinases(MMP2,MMP9)and tissue inhibitor of metalloproteinases(TIMP1,TIMP2)mRNA in myocardium were detected by RT-PCR.Activities of MMP2 and MMP9 were assayed by zymography.Results:Compared with those of control mice,LVIDd and LVIDs were increased,FS and EF were decreased in the model group.Myocardial injury and fibrosis existed in histop at hological slices of the model group.In addition,the mRNA expressions and activities of MMP2 and MMP9 were increased in the model group.However,there were no markable changes to TIMP1 and TIMP2.Treatment with astragaloside IV reduced LVIDd and LVIDs,increased FS and EF,attenuated myocardial injury,and down-regulated mRNA expressions and activities of MMP2 and MMP9 compared with the model group.Conclusion: Astragaloside IV can greatly improve ventricular remodeling and dysfunction via decreasing MMP2 and MMP9 mRNA expression and activities in cardiac ventricles.

Objective To investigate the effect of propofol anesthesia on the expression of β-secretase 1 (BACE1) and content of anyloid beta protein 1-42 (Aβ1-42) in the neonatal rat hippocampus.Methods Ninety Sprague-Dawley rats,aged 7 days,weighing 12-16 g,were randomly divided into 3 groups ( n =30 each):control group (group C),single dose of propofol anesthesia group (group SP),and repeated doses of propofol anesthesia group (group RP).Group C received intraperitoneal normal saline 7.5 ml/kg once a day for 7 consecutive days.Group SP received normal saline 7.5 ml/kg once a day for 6 consecutive days and propofol 75 mg/kg on 7th day.Group RP received propofol 75 mg/kg once a day for 7 consecutive days.Six rats in each group were chosen at 15 min after the end of injection on 7th day and blood samples were taken from the left ventricle for determination of the blood glucose level and for blood gas analysis.Eight animals in each group were sacrificed on 1st,3rd and 7th day after the end of injection on 7th day to determine the expression of BACE1 (using Western blot) and content of Aβ1-42 in the hippocampus (by ELISA).Results Compared with groups C and SP,the expression of BACE1 was up-regulated and the content of Aβ1-42 was significantly increased at each time point in group RP ( P ＜ 0.01 ).There was no significant difference in the expression of BACE1 and content of Aβ1-42 at each time point between groups C and SP ( P ＞ 0.05).Conclusion Repeated doses of propofol up-regulate the expression of BACE1 and increase the content of Aβ1-42 in neonatal rat hippocampus,which may be one of the mechanisms by which propofol leads to long-term cognitive dysfunction.Single dose of propofol does not have the effect.

Objective To evaluate the role of prostaglandin E2 (EP) receptors in H9c2 cardiomyocyte hypertrophy induced by prostaglandin E2 (PGE2).Methods Primary cultured H9c2 cardiomyocytes were seeded in culture flasks (3 ml/flask) or in 24-well plate (1 ml/hole) or 6-well plate (2 ml/hole) with density of 4 × 104/ml.The cells were randomly divided into 4 groups (n=24 each): control group (group C),PGE2 group,AH6809 (EP1 and EP2 receptor antagonist) group (group A) and GW627368X (EP4 receptor antagonist) group (group G).The cells were continuously cultured for 48 h.PGE2 (final concentration 1 μmol/L) was added to the culture medium in PGE2 group.PGE2 (final concentration 1 μmol/L) and A H6809 (final concentration 10 μmol/L) were added to the culture medium in group A.PGE2 (final concentration 1 μmol/L) and GW627368X (final concentration 10 μmol/L) were added to the culture medium.The cells were then cultured for 48 h in groups PGE2,A and G.Then the cell morphology was observed by using fluorescent microscope.The cell diameter was measured by using the Image J medical image analysis system.Total protein content in the cells was measured with BCA method.The expression of atrial natriuretic peptide (ANP) mRNA and brain natriuretic peptide (BNP) mRNA in the cytoplasm was determined using RT-PCR.Results Compared with group C,the total protein in the cells and cell diameter were significantly increased,and the expression of ANP mRNA and BNP mRNA in the cytoplasm was up-regulated in groups PGE2,A and G (P ＜ 0.05).Compared with group PGE2,the total protein in the cells and cell diameter were significantly decreased,and the expression of ANP mRNA and BNP mRNA in the cytoplasm was downregulated in group G (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group A (P ＞ 0.05).Conclusion EP4 receptor mediates H9c2 cardiomyocyte hypertrophy induced by PGE2 and the effect is not related to EP1 and EP2.

Objective To investigate the skin reactions induced by to pical 0.1% tretinoin and its vehicle in mice.Methods 0.1% tretinoin and its v ehicle were applied separately on mice backs,once a day for 30 days.The skin r eactions,including erythema and scaling,were observed macroscopically and meas ured by biological instruments.Results Macroscopically the skin reactions of erythema and scaling induced by topical tretinoin occurred on day 3 after applic ation,reached its peak on day 6 and disappeared on day 12,and neither erythema nor abnormal scaling appeared in spite of continuing application until day 30.The erythema value measured was enhanced significantly on day 1 after applicatio n,reached its peak on day 6,maintained until day 9 and became normal on day 11.From then to day 30,it maintained at the normal level.The scaling value measu red enhanced significantly on day 3 after application,reached its peak on day 9 and became normal on day 27.Topical application of the vehicle induced neither skin reaction nor any change of erythema and scaling value.Conclusions Topic al application of 0.1% tretinoin induces skin reaction characterized by erythema and scaling.The reaction,transient but not related to the vehicle,experience s a process of "occurrence-peak-disappearance".