Adult ; Carcinoma, Hepatocellular ; surgery ; Cryosurgery ; Female ; Humans ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Pneumothorax, Artificial

BACKGROUNDReal-time perfusion imaging (RTPI) using ultrasound contrast agents has shown good "accuracy" in detecting myocardial infarction, however its accuracy in the assessment of peri-infarct ischemia and stress echocardiography are not known. The aim of this study was to determine the accuracy of RTPI in assessment of peri-infarct ischemia during dobutamine and adenosine stress.

METHODSWe employed the RTPI modality (Agilent and ATL Philips) in a canine model (18 dogs) of distal coronary occlusion and proximal coronary stenosis. Using coronary flow probe recordings, the physiologic significance of proximal coronary stenosis was established by confirming abolition of the coronary reserve. The contrast agent Optison was given as a slow bolus injection at baseline, during prolonged distal coronary occlusion, during adenosine bolus stress and during dobutamine stress. Triphenyltetrazolium chloride (TTC) staining was used to verify a distal infarction. RTPI recordings at baseline, the distal coronary occlusion and stress protocols were randomly mixed and reviewed blindly.

RESULTSIn all but one dog, RTPI detected a distal infarct as small as 9% of the left ventricle. The sensitivity, specificity and overall diagnostic accuracy of RTPI in the detection of distal infarcts were: 94%, 89% and 92%, respectively. The sensitivity, specificity, and overall diagnostic accuracy of RTPI in the assessment of peri-infarction ischemia were 83%, 92% and 88% for adenosine stress and 95%, 86% and 91% for dobutamine stress, respectively.

CONCLUSIONSEven small distal infarcts can be detected by RTPI; peri-infarct ischemia can be accurately recognized by RTPI during stress; adenosine and dobutamine stress appear equally reliable in the RTPI evaluation of peri-infarct ischemia.

Adenosine ; toxicity ; Animals ; Coronary Circulation ; drug effects ; Dobutamine ; toxicity ; Dogs ; Echocardiography ; methods ; Female ; Hemodynamics ; drug effects ; Male ; Myocardial Infarction ; diagnostic imaging

Objective To improve the service quality and work efficiency of inpatient pharmacy and promote the development of information construction in hospital pharmacy.Methods To transform the traditional management model in pharmacy with three ways:orally administered drugs were dispensed by automated drug dispensing machine,the irrational prescriptions were analyzed by prescription automatic screening system and all drugs were distributed to every nurse station by transfer center.Results The pharmacy management was further standardized,the work efficiency of pharmacy was improved,the pharmaceutical research level was enhanced,and the supervision on the prescription was strengthened.Conclusion The work pattern of inpatient pharmacy carried out in our hospital embodies the concept of patients-oriented and rational drug use,and informationization of pharmacy management has been achieved basically.

OBJECTIVETo study the effect of vitamin B on treatment of hyperhomocysteinemia and endothelial dysfunction in renal-transplant recipients.

METHODSThirty-six stable hyperhomocysteinemic renal-transplant recipients were randomly assigned to vitamin treatment (group A, n = 18, folic acid 5 mg/d, vitamin B(6) 50 mg/d, B(12) 1000 microg/d) or controlled group (group B, n = 18) for 6 months. All subjects underwent assessment of levels for creatinine, creatinine clearance, average pressure, total cholesterol, triglyceride and fasting homocysteine. Endothelial function was evaluated using high-resolution vascular ultrasound.

RESULTSThe levels of homocysteine markedly decreased in group A [(13 +/- 4) micromol/L vs (20 +/- 5) micromol/L, t = 5.3, P < 0.01] after treatment, whereas no significant changes were observed in group B. In group A, endothelium dependent [(12 +/- 5)% vs (9 +/- 5)%, t = 2.9, P < 0.01] and independent [(18 +/- 4)% vs (12 +/- 5)%, t = 3.4, P < 0.01] vasodilatation responses significantly increased after treatment, no significant changes were observed in group B. Endothelium dependent [(9 +/- 6)%, t = 2.8, P < 0.01] and independent [(12 +/- 5)%, t = 3.5, P < 0.01] vasodilatation responses of group A were significantly lower than that of group B after treatment.

CONCLUSIONSVitamin B supplementation can reduce the levels of homocysteine and improve the endothelial function in hyperhomocysteinemic renal-transplant recipients.

Adult ; Drug Therapy, Combination ; Endothelium, Vascular ; drug effects ; physiopathology ; Female ; Folic Acid ; administration & dosage ; Humans ; Hyperhomocysteinemia ; drug therapy ; physiopathology ; Kidney Transplantation ; Male ; Middle Aged ; Treatment Outcome ; Vitamin B 12 ; administration & dosage ; Vitamin B 6 ; administration & dosage

Animals ; Apoptosis ; drug effects ; Cell Line, Tumor ; DNA Damage ; Doxorubicin ; pharmacology ; Fas Ligand Protein ; Gene Expression Regulation ; drug effects ; Humans ; Liver Neoplasms, Experimental ; drug therapy ; metabolism ; pathology ; ultrastructure ; Membrane Glycoproteins ; genetics ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Necrosis ; Sulfinic Acids ; pharmacology ; Tumor Necrosis Factors ; genetics ; Up-Regulation ; bcl-2-Associated X Protein ; genetics

BACKGROUNDMuch research has been focused on ischemia/reperfusion injury (IRI) to the transplanted organs. As a free radical, nitric oxide (NO) plays an important role in IRI. In this study, the production of NO and its functions during IRI were monitored in rat models after allotransplantation of kidney grafts.

METHODSOf 75 male LEW rats, 30 served as donors, and the remaining 45 rats were divided into three groups (15 rats in each group): controls (group 1), kidney allotransplantation followed by bilateral nephrectomy during reperfusion (group 2), 2 hours before operation, donors and recipients were treated with N(G)-nitro L-arginine methyl ester (L-NAME), a NO synthase inhibitor, at a dose of 30 mg/kg (group 3). Bilateral nephrectomies were performed while kidney grafts were reperfused. The kidney grafts were hypothemically stored for 24 hours. The production of NO before and after reperfusion was measured by electron paramagnetic resonance (EPR). The creatinine level, the glomerular filtration rate (GFR) and the protein carbonyl content in tissue samples were recorded on the first and the fifth day after operation. The data were evaluated by one-way analysis of variance. Differences were considered to be statistically significant when a P value was less than 0.05.

RESULTSAfter reperfusion for 15 minutes, the production of NO increased remarkably and kept increasing till 120 minutes, after which the level returned to normal. In group 3, which was pretreated with L-NAME, creatinine levels were higher than those in group 2 at the 24th hour (4.10 +/- 0.50 mg/dl vs. 3.77 +/- 0.42 mg/dl, P < 0.05) and the 120th hour (3.19 +/- 0.79 mg/dl vs. 2.22 +/- 0.53 mg/dl, P < 0.05). GFR levels in group 3 were lower than those in group 2 at the 24th hour (0.50 +/- 0.12 ml/min vs. 0.71 +/- 0.19 ml/min, P < 0.05) and the 120th hour (0.59 +/- 0.38 ml/min vs. 1.27 +/- 0.23 ml/min, P < 0.01). The content of protein carbonyl in tissue samples of group 3 was lower than that in group 2 at the 24th hour (29.01 +/- 7.02 nmol/mg protein vs. 49.39 +/- 13.13 nmol/mg protein, P < 0.05), but was higher than that at the 120th hour (75.71 +/- 16.74 nmol/mg protein vs. 57.93 +/- 15.32 nmol/mg protein, P < 0.05).

CONCLUSIONSAfter transplantation of hypothemically stored kidney grafts, the increased NO production in the early stage has protective effects on the transplanted kidney. Application of L-NAME to inhibit NO production is harmful to the recovery of the renal functions of kidney grafts.

Animals ; Creatinine ; blood ; Electron Spin Resonance Spectroscopy ; Glomerular Filtration Rate ; Kidney Transplantation ; Male ; Nitric Oxide ; biosynthesis ; Oxidation-Reduction ; Proteins ; metabolism ; Rats ; Rats, Inbred Lew ; Reperfusion Injury ; metabolism

OBJECTIVETo investigate the role of multidrug resistant protein 2 (MRP2) and glutathione (GSH) cotransport system in hepatic arsenic metabolism in rats.

METHODSThirty healthy Wistar rats were divided randomizedly into five groups. The first group was the control group and the rats in this group were administered with normal saline. In the second, third and fourth group the rats were administered with 4, 10 and 20 mg As(+)3/kg BW of sodium arsenite respectively every other day for two weeks. The fifth group was the benzene-soluble organics (BSO) intervention group and in this group the rats were administered with 2 mmol/kg BW BSO intraperitoneally every day three days before the end of the experiment. The other treatment was the same as in other groups. All rats were sacrificed two weeks after the treatments. Arsenic contents in bile, liver and blood were detected by atomic absorption spectroscopy (AAS), and the expression of MRP2 in the membrane of hepatocyte was determined by Western-blot analysis.

RESULTSThe level of total arsenic (including organic arsenic and inorganic arsenic) in bile, liver and blood in all three different dose groups was higher than those in the control groups (P < 0.05). Arsenic levels of bile and liver were increased with intragastric arsenic dose. Blood arsenic levels were not significantly different in three different dose groups. Expression of hepatic MRP2 was increased with intragastric arsenic concentration. A positive correlation between biliary arsenic concentration and MRP2 levels was found in liver (r = 0.986, P < 0.05). For the rats pretreated with BSO, the biliary arsenic was significantly higher than that in the control group but lower than that in the high dose group; the liver and blood arsenic was higher than that in the control group and in the high dose group. Expression of MRP2 pretreated with BSO was decreased.

CONCLUSIONSodium arsenite can induce expression of MRP2 and the up-regulation of MRP2 may play an important role in the bile secretion of arsenite and its metabolites. The function of MRP2 for transportation of arsenic and its metabolites is associated with the intracellular GSH level. BSO inhibits the synthesis of GSH, which weakens the function of the MRP2-GSH cotransport system and makes the liver arsenic increased.

Animals ; Arsenic ; pharmacokinetics ; Arsenic Poisoning ; metabolism ; Bile ; metabolism ; Female ; Glutathione ; biosynthesis ; Liver ; metabolism ; Male ; Membrane Transport Proteins ; biosynthesis ; Multidrug Resistance-Associated Proteins ; biosynthesis ; Random Allocation ; Rats ; Up-Regulation

OBJECTIVETo investigate the age-related change in biomechanical properties of the costal cartilage and its relevance to the timing of ear reconstruction with costal cartilage framework.

METHODSThe patients of 5 to 25 years old were divided into three groups according to their age. The biomechanical properties of costal cartilage harvested from these patients during ear reconstruction were tested, including stree-strain relationship, stress relaxation and creep, tensile strength. All the results were analyzed statistically.

RESULTSThe costal cartilage from children group had the best biomechanical properties, while the costal cartilage from the adolescent group had the worst. The difference had a statistically significance (P < 0.05).

CONCLUSIONSThe biomechanical properties of costal cartilage are age-related. So it is recommended that ear reconstruction with costal cartilage framework should be performed in childhood when the costal cartilage has the best biomechanical properties.

Adolescent ; Adult ; Age Factors ; Cartilage ; physiology ; transplantation ; Child ; Child, Preschool ; Ear Auricle ; surgery ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Ribs ; physiology ; transplantation ; Stress, Mechanical ; Young Adult

OBJECTIVETo analyse retrospectively the diagnosis and treatment of severe pneumonia in kidney transplantation recipients.

METHODSBetween January 1999 and December 2003, 172 adult patients underwent kidney transplantation at our department. In all severe pneumonia cases, empirical therapy was initiated with aztreonam, erythromycin and ganciclovir. And the therapy was switched to proper antibiotics according to the results of sensitivity testing. Responsible pathogen was detected by study of BAL (bronco-alveolar-lavage), sputum and blood specimen. Analyses included cell differential count, cytopathologic examination and cultures for bacteria, fungi and viruses. The immunosuppressive therapy was drastically reduced. Hypoxia was relieved by BiPAP (Bi-level Positive Airway Pressure) or mechanical ventilation if necessary.

RESULTSSeventeen cases (9.9%) of pneumonia were observed in the 172 recipients, only 11 (65%) patients experienced severe pneumonia, 1 (9%) of them died. Fever was the most common symptom on presentation (82%). On presentation 46% of the patients presented with classical clinical syndrome of fever accompanied by cough and dyspnea. Positive rate of BAL and blood culture were 100% and 46% respectively. BiPAP and mechanical ventilation were required in 6 and 2 cases respectively.

CONCLUSIONBAL is preferred for early detection of responsible pathogen. A combination of drastic reduction of the immunosuppressive regimen, implementation of appropriate empirical antibiotics, proper BiPAP or mechanical ventilation are important.

Adult ; Combined Modality Therapy ; Female ; Humans ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Pneumonia ; diagnosis ; etiology ; therapy ; Respiration, Artificial ; Retrospective Studies ; Transplantation, Homologous ; adverse effects

Objective To study the effect of arthroscopic internal fixation combined with arthrodesis on patients with advanced ankle arthritis and American Orthopedic Ankle Association Scoring System (AOFAS) and visual analogue scale (VAS). Methods 84 patients with advanced ankle arthritis from January 2012 to January 2015 were randomly divided into experimental group (42 cases) and control group (42 cases) by random number method. The patients in the control group were treated with traditional open ankle arthrodesis, the experimental group under the arthroscopic assisted internal fixation joint fusion. Then compare the time of surgery, intraoperative blood loss, postoperative hospitalization time and complication. The follow-up period was 12 to 36 months. Used the AOFAS score system to evaluate the curative effect. Use VAS to evaluate the degree of ankle pain. Results The operation time and intraoperative blood loss were significantly lower in the experimental group than that in the control group (P < 0.05). The postoperative hospital stay and the time of joint fusion were lower in the experimental group than that in the control group (P < 0.05). The incidence of complication (9.52%) in the experimental group was significantly lower than that in the control group (25.57%) (P < 0.05). The results of follow-up showed that the VAS and AOFAS scores of the experimental group were better than those in the control group (P < 0.05). Conclusion The procedure of arthroscopic endoscopic fusion is short, the bleeding rate is low, the incidence of complications is low, the healing rate is high, and the follow-up effect is accurate. It is suitable for clinical use.