Objective To investigate the changes in the dose requirements of rocuronium after right hemihepatectomy in donor of living donor liver transplantation. Methods Sixteen ASA Ⅰ patients of living donor liver transplantation, aged 21-49 yr, weighing 51-86 kg, scheduled for right hemihepatectomy, were enrolled in this study. Anesthesia was induced with iv midazolam and fentanyl, and TCI of propofol and rocuronium. Changes in adductor pollicis muscle were monitored by the train of four (TOF) stimulation. The patients were mechaincally ventilated after tracheal intubation when T1/Tc = 0. The target plasma concentration of rocuroniurn was reduced to 1.0 μg/ml after tracheal intubation and the concentration was regulated to maintain 0 < T1 ≤ 10%. Anesthesia was maintained with sevoflurane inhalation, TCI of propofol, intermittent iv injection of fentanyl. The infusion of rocuronium and inhalation of sevoflurane were stopped before the second time of cholangiography, the total time and amount of rocuronium administered and the recovery of muscle relaxation were recorded at this time (before hemihepatectomy). The infusion of rocuronium and inhalation of sevoflurune were rests-ted after right hemibepatectomy. After the peritoneum was closed, the infusion of rocuroniurn and inhalation of sevoflurane were stopped again, the total time and amount of rocuronium administered and the recovery of muscle relaxation were also recorded at this time (after hemihepatectomy). Results The amount of rocuronium administered was significantly reduced after hemihepatectomy compared with that before hernihepatectomy (P < 0.05). The amount of rocurunium administered after hemihepatectomy was (67 ± 13) % of that before hemihepatectomy. Conclusion Right hemihepatectomy can affect the metabolism of rocuronium in the donor of living donor liver transplantation.

Antibacterial Chinese drug Dingxiangliao has been studicd on botanical,pharmacognostical characters and microspectroscopic Properties.The results provide a scientific mean for the identification of the drug.

Objective To investigate the changes of alveolar epithelial permeability and the capacity of alveolar epithelium to remove alveolar fluid in the rat models of acute lung injury induced by oleic acid.Methods A total of 35 Wistar rats were randomly assigned to the control group(n=7),and the injured group(n=28) in which the lung injury was induced by intravenous injection of oleic acid at the dose of 0.25 ml/kg.The alveolar liquid clearance rate(ALCR),total lung water content(TLW),extravascular lung water content(EVLW) and alveolar epithelial permeability(AEP) were examined in 3,6,12,24 h after injury(n=7 at each time point).Results After lung injury,there was continuous increase of AEP,TLW and EVLW,as well as progressive reduction of ALCR.On 24 h after injury when all changes were most significant,AEP was increased by 68.7%,ALCR was reduced by 49.4%,TLW and EVLW increased by 44.6% and 92.0% respectively,as compared with control group.Conclusion The alveolar epithelial barrier might play a role in the pathogenesis of pulmonary edema in acute lung injury.

OBJECTIVETo explore the relationship between interleukin-6 (IL-6) production and central nervous injury in septic patients.

METHODSTwenty-two septic patients without central nervous system diseases were examined for serum IL-6 and neuron-specific enolase (NSE) levels, and the serum NSE levels and APACHEII scores were compared between patients with low, moderate, and high serum IL-6 levels. The correlations between NSE, APACHEII and serum IL-6 were analyzed.

RESULTSIn patients with low, moderate, and high serum IL-6 levels, the serum levels of NSE were 10.29∓4.05, 16.06∓5.84 and 23.97∓3.28 µg/L, respectively, showing a significant difference between the 3 groups (P<0.001). The APACHEII scores also differed significantly between the 3 groups (14.17∓4.67, 16.40∓4.84, and 24.00∓6.26, respectively, P=0.009). Correlation analysis showed significant positive correlations of IL-6 with NSE (r=0.788, P<0.001) and with APACHEII scores (r=0.733, P<0.001).

CONCLUSIONIn septic patients, serum IL-6 level is significantly correlated with the severity of sepsis and brain injury, and can be used as a marker to monitor brain injury in septic patients.

APACHE ; Adult ; Aged ; Brain Injuries ; blood ; pathology ; Female ; Humans ; Interleukin-6 ; blood ; Male ; Middle Aged ; Phosphopyruvate Hydratase ; blood ; Sepsis ; blood

Objective To establishing an immortal cell line of familial papillary thyroid carcinoma (FPTC), and explore a new approach for studying familial non-medullary thyroid carcinoma (FNMTC). Methods The specimen from a patient with FPTC was selected, separated, and the primary cells were cultured using DMEM/F12 medium (with TSH, T3, EGF and hydrocortisone). To inducing cell immortalization, the exogenous genes SV40T/TERT were transfected into cells by two ways. RT-PCR was used to detect the expressions of thyroid peroxidase (TPO), thyroid globulin (TG), thyroid stimulating hormone receptor (TSHR) and sodium/iodide co-transporter (NIS). Immunofluorescence method was used to detect the expressions of TPO and GPC3. In order to detect the genomic mutations, the peripheral blood DNA of the patient was extracted. The cell genome was detected. Results The FPTC cells adhered to the plate and showed an irregular polygon shape. The cells can stably grow for six months, FPTC-S (with SV40T transfected) passaged to p26, FPTC cells passaged to p23 and FPTC-ST (with SV40T/TERT transfected) passaged to p19. Both FPTC-S and FPTC-ST can stably express TPO, TG and TSHR in mRNA level. MLH1 R217C mutation existed in the peripheral blood of the patient, and BRAF V600E mutation existed in the primary cultured cells. Either the primary or the immortal cells showed MLH1 R217C mutation. Conclusion This study preliminarily established an immortal cell line of familial papillary thyroid carcinoma with MLH 1 R217C and BRAF V600E mutations. This cell line provides a research model for studying these mutations in FPTC.

A patient with skin rash, skin denudation, anuria, general dropsy and dyspnea for unknown etiology underwent continuous renal replacement therapy (CRRT) for 3 consecutive days. The biochemical indexes were monitored during the therapy and biopsy was performed on the right thigh. Pathological examination of the biopsy sample established the diagnosis of polymyositis(PM) and dermatomyositis(DM). After the start of CRRT, the patient's heart, liver, kidney and lung injuries showed obvious improvement, and the urine volume (UV) increased and serum creatinine (Cr), urea, total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) levels all decreased promptly. The patient showed progressive improvement of the physiological condition even after CRRT, and was discharged 10 days later. This case suggests the efficacy of CRRT in the management of severe PM/DM and its value as a good option for treatment of severe autoimmune disease, especially systemic inflammatory response syndrome.
Adult ; Dermatomyositis ; therapy ; Humans ; Male ; Polymyositis ; therapy ; Renal Replacement Therapy ; Treatment Outcome

Objective:To compare the efficacy of HES 130/0.4 and acetate Ringer′s solution (A-HES) and HES 130/0.4 and normal saline (NS-HES) for volume therapy in the patients undergoing non-cardiac surgery with general anesthesia.Methods:Two hundred and fifty American Society of Anesthesiologist physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18-32 kg/m 2, undergoing noncardiac surgery with general anesthesia, were divided into group A-HES and group NS-HES using the stratified block randomization technique.A-HES and NS-HES 15 ml/kg were intravenously infused over 1 h immediately after induction of anesthesia in A-HES and NS-HES groups, respectively.Mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP) were recorded before and after infusion, and the maximum changing rate of MAP and HR and the maximum change in CVP were calculated.The pH value, BE and HCO 3- were recorded before infusion and at 15 min after the end of infusion, and Hb, Hct, electrolytes, blood glucose, blood biochemical parameters and parameters of coagulation function were measured.The occurrence of abnormal blood biochemical parameters, blood glucose, and parameters of coagulation function, intraoperative requirement for vasoactive drugs, occurrence of HES-related adverse events, and intraoperative fluid intake and output were recorded. Results:A total of 251 cases were actually enrolled in this study, with 125 cases in group A-HES, and 126 cases in group NS-HES.Compared with group NS-HES, no significant change was found in the maximum changing rate of MAP and HR and the maximum change in CVP ( P>0.05) in group A-HES, and non-inferiority analysis showed that group A-HES was not inferior to group NS-HES.Compared with group NS-HES, the concentrations of BE and HCO 3-, K + , Ca 2+ and Mg 2+ were significantly increased, the concentrations of Na + and Cl - were decreased, the PT was shortened, the incidence of abnormal PT was decreased at 15 min after the end of infusion ( P< 0.05), and no significant change was found in the other parameters mentioned above in group A-HES ( P>0.05). Conclusion:The volume expanding effect of A-HES and its effect on liver and kidney function are not significantly different from those of NS-HES, however, A-HES has certain advantages in maintaining acid-base balance, electrolyte stability and coagulation function.

The 26S proteasome is a proteolytic complex responsible for the degradation of the vast majority of eukaryotic proteins. Regulated proteolysis by the proteasome is thought to influence cell cycle progression, transcriptional control, and other critical cellular processes. A novel Schistosoma japonicum gene (GenBank Accession No. AY813725) proteasome alpha2 subunit (SjPSMA2) was cloned. Sequence analysis revealed that the ORF of SjPSMA2 gene contains 708 nucleotides encoding 235 amino acids, and the molecular weight was estimated to be 25.84 kDa. Real-time PCR analysis showed that this gene expressed in 7 d, 13 d, 18 d, 23 d, 32 d and 42 d schistosoma. The mRNA level of SjPSMA2 was lower in 7 d and 23 d schistosomulum than that in other stages. The SjPSMA2 cDNA fragment was subcloned into an expression vector pET28a(+) and transformed into E. coli BL21 (DE3) cells. After induction with IPTCQ the 30 kDa fusion protein was produced as included bodies. Western-blotting revealed that the fusion protein could be recognized by the rabbit serum anti-Schistosoma japonicum adult worm antigen preparation, and the protein in native could be detected. After immunization of BALB/c mice with the fusion protein, the reduction rates of worm counts and liver egg counts were 12.33% and 35.23%. ELISA results revealed that the vaccinated group showed a significant increase in the level of IgG antibody. This study provided an important basis for investigating the regulation mechanism of the proteasome during the development of Schistosoma japonicum.
Animals ; Antibodies, Helminth ; blood ; Base Sequence ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Genes, Helminth ; Helminth Proteins ; genetics ; metabolism ; Immunization ; Liver ; parasitology ; Male ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; Parasite Egg Count ; Proteasome Endopeptidase Complex ; biosynthesis ; genetics ; immunology ; Rabbits ; Recombinant Proteins ; biosynthesis ; genetics ; immunology ; Schistosoma japonicum ; genetics ; metabolism ; Vaccines, Synthetic ; immunology

Objective To investigate the effect of sub-anesthesia dose of isoflurane in 60％ oxygen on acute lung injury in aged rats with sepsis.Methods Ninety male Sprague-Dawley rats,aged 12-14 months,weighing 500-800 g,were divided into 3 groups (n=30 each) using a random number table:sham operation group (Sham group),sepsis group (S group),and sepsis plus isoflurane plus oxygen treatment group (S+I+O group).Sepsis was induced by cecal ligation and puncture in S and S+I+O groups.In group S+I+O,0.7％ isoflurane in 60％ oxygen was inhaled for 1 h starting from 1 and 6 h after operation.Eighteen rats were selected in each group and observed for 7 days after operation,and the survival rate was recorded.Six rats were selected in each group at 24 h after operation,and bronchoalveolar lavage fluid (BALF) was collected to determine the protein concentrations (by BCA protein assay),blood samples were collected from the femoral artery for blood gas analysis,PaO2 was recorded,and the oxygenation index was calculated.Six rats in each group were sacrificed at 24 h after operation,the left lung specimens were obtained and stained with hematoxylin and eosin for examination of pathological changes,the right lung specimens were obtained for determination of wet to dry weight ratio (W/D ratio),and blood samples were collected from the right atrium for measurement of the concentrations of interleukin-1β (IL-1β),IL-6,tumor necrosis factor-α (TNF-α),high-mobility group box 1 protein (HMGB1) and IL-10 in serum (by enzyme-linked immunosorbent assay).Results Compared with group Sham,the survival rate was significantly decreased,and the concentrations of IL-1β,IL-6,TNF-α,HMGB1 and IL-10 in serum were increased in S and S+I+O groups,and W/D ratio and protein concentrations in BALF were significantly increased,and the oxygenation index was decreased in group S (P＜0.05).Compared with group S,the survival rate was significantly increased,W/D ratio and protein concentrations in BALF were decreased,the oxygenation index was increased,the concentrations of IL-1β,IL-6,TNF-α and HMGB1 in serum were decreased,and the concentration of serum IL-10 was increased (P＜0.05),and the pathological changes were significantly attenuated in group S+I+O.Conclusion Sub-anesthesia dose of isoflurane in 60％ oxygen can reduce acute lung injury in aged rats with sepsis,and the mechanism may be ralated to inhibiting systemic inflammatory responses.