To observe the changes in hemorheology, endotoxin and TNF ? in blood after hemoperfusion(HP) with adsorbent immobilized polymyxin B (PMB) on sepsis in rats. Wistar rats were randomly divided into three groups:LPS+HP+PMB,LPS+HP and LPS. All the rats received intravenously injection of lipopolysaccharide (LPS, Escherichia coil O111:B4,1mg/kg). Plasma of the rats in the group of LPS+HP+PMB was passed through a column containing sepharose coated activated charcoal immobilized polymyxin B at the 4th hour after LPS injection. The treated plasma was transfused bak after being mixed with blood cells. In LPS+HP group, the column did not contain immobilized polymyxin B. The animals of LPS group received LPS only. Quantitative endotoxin determination in blood was done with limulus amebocyte lysate test,TNF ? of the plasma assayed with ELISA, and hemorheology parameters were also observed after hemoperfusion. In LPS+HP+PMB group, the concentration of plasma was significantly decreased after hemoperfusion, but it was still significantly higher than the baseline value, and there was a decrease of blood cell ratio after hemoperfusion. The results suggest that specific adsorbent could remove endotoxin in the circulation and improve hemorheology.

Cytokine-Induced Killer Cells ; immunology ; Cytotoxicity, Immunologic ; Dendritic Cells ; immunology ; Fetal Blood ; immunology ; HL-60 Cells ; Humans ; K562 Cells ; Killer Cells, Natural ; immunology

ObjectiveTo investigate the effect of indomethacin on insulin resistance and metabolic response to surgical injury in patients with gastrointestinal tumor.MethodsFifty-eight cases with gastric cancer or colon cancer were divided into an indomethacin group (n =28) and a control group (n =30).All the operations were performed under general anesthesia.Patients in both groups were given parenteral nutrition 24 hours after operation for 5 ～ 7 days.The patients in the indomethacin group were treated with indomethacin suppository ( 100 mg/12 h).Fasting blood glucose (FBG),fasting serum insulin (FINS),creatinine (Cr),blood urine nitrogen (BUN),triglyceride (TG),free fatty acid (FFA) and C-reactive protein (CRP) of the two groups were detected on the day before operation,and 24,72,120 hours after operation.Insulin resistance index (HOMA-IR) was calculated by using the homeostasis model assessment (HOMA).The vital signs were observed in 72 hours after operation.ResultsThe vital signs in the indomethacin group were more steady.The levels of FBG,FINS,and InHOMA-IR of the control group 24 hours and 72 hours after operation were higher than before operation ( all P =0.000) and those of the indomethacin group ( all P ＜0.01 ).In both of the two groups,the levels of Cr,BUN,TG,and FFA were higher than those before operation,but declined over time.All the indexes in the indomethacin group 120 hours after operation decreased significantly compared with the levels 24 hours after operation ( all P =0.000 ),as well as with the levels in the control group 120 hours after operation ( all P ＜ 0.05 ).No significant difference was found in the level of CRP between the two groups and between before and after operation.ConclusionIndomethacin could reduce the postoperative stress hyperglycemia and insulin resistance in patients with gastrointestinal tumor.

Objective To evaluate the effect of the gastric signet ring cell cancer(SIG)on the T,N,M stages. Methods Three hundred and fifty-one patients undergoing D2 or greater gastrectomy for gastric cancer were ana lyzed retrospectively.The T,N,M stages of 59 patients with SIG and 161 patients with tubular adenocarcmonla (TUB)were compared using univariate and multivariate analysis.Results The chi-square test showed that there were not significant differences in T,N,M stages between TUB and SIG.Multivariate Logistic regression analysis indicated that SIG Was not a independent factor influencing the T,N.M stage.Conclusion Gastric cancer with SIG has not higher T,N,M stages than that with TUB.

Objective To estimate the uncertainty of measurement in detecting of hepatitis B virus DNA(HBV DNA)by method of fluorescence quantitative polymerase chain reaction(FQ-PCR),and discuss the application value.Methods The process of the detection of HBV DNA by FQ-PCR was analysed to confirm and simplify the sources of uncertainties of measurement,which were obtained by disposing the data of methodology validation,internal quality control(type A evaluation of uncertainty)and external quality assessment(type B evaluation of uncertainty);combined uncertainty and expanded uncertainty were obtained by statistical methods.Results The main sources of uncertainties of measurement were:precision within laboratory,precision between laboratory,method bias.The expanded uncertainty of HBV DNA by FQ-PCR was U=0.62(k=1.96,n=2).The uncertainty caused by method bias was found mostly.Conclusion Expanded uncertainty can be compared in different results of HBV DNA by FQ-PCR,and it provides guide significance for observing the cure effect of anti-HBV and choosing the concentration of quality control.

Objective To study postoperative delirium in elderly patients.Methods We investigate the morbidity of postoperative delirium in 142 elderly patients (≥ 60 years)after gastrointestinal surgery by using Confusion Assessment Method (CAM) and Delirium Rating Scale Revised-98 (DRS-R98) scores.Data were analyzed using Student's t test and Chi-squaretest respectively with SPSS 19.0.Results Of 142 patients,delirium was diagnosed in 36 patients(25.4％),delirium developed in 4,7,17,7,1 patients in posto perative 1,2,3,4-7,7 + days respectively.There were significant difference in hospital stay:17.7 ± 2.6 days (postoperative delirium) and 13.4 ± 2.3 days (no postoperative delirium),t =4.608,P =0.000 1.The postoperative complications (52.8％ / 23.6％,x2 =10.710,P =0.001) and ICU admission (22.2％/6.6％,x2 =6.939,P =0.008) significantly increased.Conclusions Postoperative delirium is recognized as one of the most common surgical complications in elderly patients with gastrointestinal surgery leading to other major postoperative complications,and prolonged hospitalization.

Objective To explore an effective treatment for inflammatory hilar bile duct stricture. Methods The clinical data with patients of intra hepatic cholelithiasis complicated with hilar bile duct stricture that received plastic repair of hilar bile duct stricture(PHBDS) with pedicled cholecystic graft or Roux en Y cholangio jejunostomy (RYCJ) in our hospital during recent 10 years were retrospectively analyzed. The peri operative conditions, postoperative morbidity of cholangitis and recurrence of hepaticolithiasis were observed . Results The peri operative morbidity of biliary fistula and inflammatory ileus were not significantly different between the two groups. The postoperative morbidity rate of cholangitis was 5.66% and 21.88%,(P=0.010) and recurrence rate of hepaticolithiasis was 3.77% and 16.67%,(P=0.021) in PHBDS group and RYCJ group respectively . Conclusions PHBDS is an easy and safe operation. RHBDS can preserve the physiologic function of Oddi′s spincter, so the reflux of intestinal contents to bile duct is avoided , and the results are better than the RVCJ.

Objective To investigate the effect of matrix metalloproteinases(MMPs) in ventilator-induced lung injury inflammatory reaction of newborn rabbits.Methods Seventy-five newborn rabbits aged 1-5 days were randomly arranged to 3 groups:control group(n=3),other 72 rabbits designed by 2?2?3 factorial were divided into high concentration oxygen(100%)and low concentration oxygen(45%) groups,and each group was subdivided into 2 groups:High peak inspiratory pressure(PIP)group and low PIP group.All rabbits were done by mechanical ventilation and killed to obtain lung tissue at 1,3,6 hours after trailing respectively.The concentration of MMP-9 and MMP-2 in lung tissue bomogenate were detected by ELISA,at the same time the ratio of wet to dry was detected and pathological section was analyzed.Results 1.The concentration of MMP-2 in high concentration oxygen group,high PIP group and low PIP group increased compared with that in normal group,and there were significant differences.2.The mean concentration of MMP-9 was lower in high concentration oxygen group than that in normal control group,and there was significant difference between 2 groups.The mean concentration of MMP-9 in low concentration oxygen group was higher than that in normal group,and there was no significant difference between 2 groups.There was no significant difference in effect to mean concentration of MMP-9 by different PIP.3.There were positive correlation between MMP-2 and MMP-9,MMP-2 and the ratio of wet to dry in lung.Conclusions Within 6 hours in newborn rabbits by mechanical ventilation,ventilation with high concentration oxygen up-regulate MMP-2,but down-regulated MMP-9.The lungs stretch by mechanical ventilation increase MMP-9,but decrease MMP-2.Mechanical ventilation can affect the synthesis of MMPs,and MMPs plays an important role in ventilator-induced lung injury of newborn rabbits.

OBJECTIVE:To optimize the extraction technology for organic acids in Crataegi fructus. METHODS:Based on sin-gle factor test,using liquid-solid ratio,extraction time and ethanol volume fraction as independent variables,extraction yield of or-ganic acids as dependent variable,central composite design-response surface method was used to optimize the extraction technology of organic acids in Crataegi fructus. RESULTS:The optimal extraction technology was as follow as liquid-solid ratio of 18.5:1, adding 75% ethanol,reflux extraction twice,2.0 h each time. Average extraction yield of organic acids in verification test was 5.22%(RSD=2.70%,n=3),with 1.75% relative error of the predicted value(5.13%). CONCLUSIONS:Optimized extraction technology for organic acids in Crataegi fructus is simple,with good reproducibility and predictability.

Objective To identify the association strength of the prevalence of HBeAg, cccDNA with the occurrence of HBV related hepatocellular carcinoma (HCC) in high risk male cohort in Qidong area in China. Methods A cohort of 377 middle aged HBV infected men in Qidong was followed from 1989 for 13. 25 years. HCC cases were registered. A matched case-controlled study was conducted on 32 pairs of inherent HCC cases with non-HCC controls. Serum HBeAg was measured by ELISA. cccDNA was detected by semi-nested PCR and verified by DNA sequencing. Standard statistical comparison between the prevalence of each HBV marker in HCC versus control group provided the odds ratio and P-value was used to evaluate its association strength with HCC occurrence. Results Serum HBeAg prevalence was 53. 1% (17/32) in HCC group versus 15. 6% (5/32) in controls, odds ratio (OR) =6. 12, P