Objective To investigate the effect of curcumin (Cur)on acute lung injury (ALI) induced by one-lung ventilation (OLV)in mice.Methods Sixty C57BL/6J mice were randomly alloca-ted into six groups (n =10):two-lung ventilation group (TLV group),OLV group,OLV+Cur pre-treated with 50 mg/kg group (Cur50 group),100 mg/kg group (Cur100 group),1 50 mg/kggroup (Cur1 50 group)and200 mg/kg group (Cur200 group).Peak and averaged airway pressure (Ppeak and Paw)of mice in each group were recorded.Mice were euthanized and the end of experiment,and left lung tissue was excised.Wet lung weight to dry lung weight (W/D)and total lung water content (TLW)were tested.Pathological changes of lung tissue were observed under light microscope,and changes of ultrastructure of lung tissue were observed by transmission electron microscope.Index of quantitative evaluation for alveolar damage (IQA)and lung injury scores were tested under light mi-croscope.The expression of c-Jun N-terminal kinase (JNK)mRNA and phosphorylated JNK (p-JNK)protein were detected respectively by reverse transcription-polymerase chain reaction (RT-PCR)and Western Blot.Apoptosis index (AI)of lung tissue was determined by terminal dexynucle-otidyl transferase(TdT)-mediated dUTP nick end labeling (TUNEL)method.Results There was no statistical significance at Ppeak and Paw of rats in each group.Compared to TLV group,the expres-sion of JNK mRNA and p-JNK protein were all significantly increased (P <0.05)in OLV group,and W/D,TLW,IQA,lung injury scores and AI were all notably higher (P <0.05);morphological and ultrastructural injuries in lung tissue were notably occured in OLV group.Compared to OLV group,the expression levels of JNK mRNA and p-JNK protein were decreasingly lower (P <0.05 )in the groups of Cur100,Cur1 50 and Cur200,W/D,TLW,IQA,lung injury scores and AI were also de-creased (P <0.05);morphological and ultrastructural injuries in lung tissue were gradually alleviated in the groups of Cur100,Cur1 50 and Cur200.However,there was no statistical significance in the in-dexes mentioned above between Cur50 group and OLV group.Conclusion Cur at doses of 100 to 200 mg/kg has protective effects on lung against OLV injury in mice,which may be related to inhibition of pneumocyte apoptosis induced by JNK.

BACKGROUND: The biliary stents commonly used in clinic are made of plastics and metal, both of which have some irresolvable defects. New type of material characterizing by great biocompatibility and degradation for the making of biliary stents needs to be found and studied.OBJECTIVE: To evaluate the biodegradation law and the change in radical force of five different mole-ratios of biliary stents made of poly (lactic-co-glycolic acid) (PLGA) in human bile in vitro.DESIGN, TIME AND SETTING: A Completely random design was performed at the Laboratory of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University between July and December 2006.MATERIALS: Five different mole-ratios of PLGA hiliary stents (90L/10G, 80L/20G, 70L/30G, 60L/40G, and 50L/50G) were provided by Dalgang Biological Science and Technology Co., Ltd., Jinan; Human fresh bile was obtained from the patients who underwent external drainage of bile in the Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University.METHODS: Thirty-two PLGA biliary stents of each proportion were respectively divided into eight groups, with four stents in each group. All of them were independently submerged into test tubes with 10 mL fresh human bile which were then placed in constant temperature oscillator. The temperature was set at 37 ℃. The bile was changed every day. After incubated for one week to eight weeks, the PLGA biliary stents were respectively taken out of test tubes from the first to the eighth group each week. They were washed with distilled water and dried in calorstat for 24 hours.MAIN OUTCOME MEASURES: ① Gross morphology, color and integrality of PLGA stents; ② Scanning electron microscope; ③ the mass and the radical force of PLGA stents.RESULTS: ① Five different mole-ratios of PLGA stents followed a similar changing law as to gross morphology: stents remained intact → stents became soft → the surface ofstents became coarse and cracked → stents collapsed → stents were degraded into pieces → stents were completely degraded. ② Before degradation: limpid stereo reticular structure of PLGA; One week after degradation: PLGA was corroded and the reticular structure was decreased; Three weeks after degradation: airspace was gradually disappeared and the reticular structure was further decreased; Five weeks after degradation: airspace and the reticular structure were completely damaged, which was in an indefinite form. ③ The mass loss of each proportion of PLGA stents gradually speeded up along with the time extension. Furthermore, with the content of PGA increasing, the mass loss of the stents became faster. The initial radical force was different among five different mole-ratios of hiliary stents. With the content of PLA increasing, the radical force of the stents became stronger.CONCLUSION: The material of PLGA possesses adjustable biodegradation and good mechanical feature, so it is suitable for preparation of biliary stents.

Objective To evaluate the effect of penehyclidine hydrochloride on cell apoptosis during acute lung injury (ALI) induced by two-hit in rats.Methods Thirty male SPF Sprague-Dawley rats, aged 8 weeks, weighing 240-270 g, were randomly assigned into 3 groups (n =10 each) using a random number table: sham operation group (group Sham), ALI induced by blunt chest trauma and hemorrhagic shock group (group ALI), and penehyclidine hydrochloric group (group PHC).In ALI and PHC groups, the rats were subjected to the combination of chest trauma and hemorrhage (mean arterial pressure 35-40 mmHg mm Hg, lasting for 60 min) to establish a model of ALI.In group PHC, penehyclidine hydrochloric 2 mg/kg was injected intraperitoneally at 1 h before blunt chest trauma.At 8 h after successful establishment of the model, the rats were sacrificed, and lungs were removed for examination of the pathologic changes and for determination of Bax, Bcl-2 and caspase-3 expression (using Western blot), tumor necrosis factor-alpha (TNF-α) content (by enzyme-linked immunosorbent assay) , and cell apoptosis (by TUNEL).Apoptotic index was calculated.Results Compared with group Sham, the levels of Bax, caspase-3 and TNF-α and apoptotic index were significantly increased, and Bcl-2 expression was down-regulated in ALI and PHC groups.Compared with group ALI, the levels of Bax, caspase-3 and TNF-α and apoptotic index were significantly decreased, and Bcl-2 expression was up-regulated in group PHC.The pathologic changes of lungs were significantly reduced in group PHC than in group ALI.Conclusion Penehyclidine hydrochloride mitigates ALI induced by two-hit through inhibiting cell apoptosis in rats.

Objective To investigate the effect of electro-acupuncture at zusanli on Severe thermal injury-induced acute lung injury in rats.Methods Forty male SD rats weighing 200-250 g were used in this study.Thirty percent of the total body surface (TBS) was shaved chemically with 20% sodium sulfate and then exposed to 99-100℃ water for 12 s.The animals with third degree thermal injury involving 30% TBS were randomly divided into 5 groups(n=8 each):group Ⅰ control(group C);groupⅡ thermal injury;group Ⅲ electro-acupuncture at zusanli;group Ⅳ electric stimulation of non-acupoint and group Ⅴ electro-acupuncture at zusanli+α-bungarotoxin α-BGT).In group Ⅲ,Ⅳ,and Ⅴ electro-stimulation(3 v,2 ms,3 Hz) of zusanli or non-acupoint was performed for 12 min immediately after thermal injury model was established and every 8 h.hung specimens were obtained at 48 h after thermal injury for microscopic examination.The pulmonary HMGB-l protein level was measured by ELISA.The expression of HMGB-1 mRNA and protein in the lung was determined by RT-PCR and immuno-histochemistry respectively.Results Thermal injury induced leucocytosis in the interstitial capillaries,interstitial edema,intra-alveolar fibrin deposit,blebbing of type Ⅱ alveolar lining cells and decrease in lamellar body.Both expression of HMGB-1 mRNA and protein in the lung was significantly enhanced at 48 h after thermal injury.Electrical stimulation of zusanli significantly down-regalated the expression of HMGB-1 mRNA and protein in the lung.However,α-BGT pretreatment reversed the effects of electrical stimulation of zusanli.Conclusion Electrical stimulation of zusanli could significantly ameliorate severe thermal injury-induced acute lung injury through inhibition of HMGB-1 mRNA and protein expression and activation of cholinergic anti-inflammatory pathway mediated by nicotinic acetylcholine receptor α7 subunit.

A new anastomat for digestive tract operations, based on the magnetic compressive technique and mechanical transmission mechanism, is composed of a removable head and a reusable body. The head includes two parts: the proximal end can be fixed to the body, and the distal end could be used for performing a purse string suture. The procedure of anastomosis is similar to that of the stapler, and the anastomoses is established using a pair of magnetic rings. The instrument makes magnamosis more simple and feasible, and it would facilitate the clinical application. The body of the anastomat is reusable and the head could be replaced according to the clinical scenarios, these could reduce the medical cost. The magnetic rings would be excreted with the feces, and there is no foreign body response at last.
Anastomosis, Surgical ; instrumentation ; methods ; Gastrointestinal Tract ; surgery ; Humans ; Magnetics

Objective To establish a rat model of sepsis induced by muramyl dipeptide (MDP) after scald burn.Methods Fifty SPF male Sprague-Dawley rats,aged 2-3 months,weighing 200-250 g,were randomly divided into 3 groups:control group (group C,n =10),scald group (group S,n =10) and MDP group (n =30).The rats were subjected to a third-degree scald burn covering 20% of total body surface area in groups S and MDP.The rats were only exposed to 20 ℃ water in group C.MDP 5 mg/kg was injected via the femoral vein at 24 h after scald bum in group MDP.Arterial blood samples were collected at 1,6 and 24 h after MDP injection in group MDP,at 24 h after scald burn in group S,or at 24 h after exposure to 20 ℃ water in group C for blood gas analysis and for measurement of white blood cell (WBC) and platelet (Plt) counts,serum aminotransferase (ALT),aspartate transferase (AST),total bilirubin (TB),creatinine (Cr) and blood urea nitrogen (BUN) levels,creatine kinase isoenzyme-MB (CK-MB) activity,and plasma tumor necrosis factor-α (TNF-α),interferon-γ(IFN-γ),interleukin-6 (IL-6),IL-10 and high mobility group box 1 protein (HMGB-1) levels.The rats were sacrificed after collecting blood samples,and heart,liver,lung,and kidney specimens were obtained for microscopic examination of pathologic changes.The activity of myeloperoxidase (MPO) in lung tissues was measured.Another 90 male Sprague-Dawley rats were randomly divided into 3 groups and treated as the method previously described for record of the survival rate within 72 h.Results Compared with C group,the plasma IL-6,IL-10,IFN-γ and HMGB1 levels,WBC count,serum ALT,AST,and BUN levels and MPO activity were significantly increased,and the survival rate within 72 h was decreased in S group,and the plasma TNF-α,IL-6,IL-10,IFN-γand HMGB-1 levels,serum ALT,AST,TB,BUN,Cr and CK-MB levels,MPO activity,PaCO2 and BE value were significantly increased,and WBC and PLT counts,pH value,PaO2 and survival rate within 72 h were decreased in MDP group (P ＜ 0.05).Compared with S group,the plasma TNF-α,IL-6,IFN-γ and HMGB-1 levels,serum ALT,AST,TB,BUN,Cr and CK-MB levels,MPO activity,PaCO2 and BE value were significantly increased,and WBC and Plt counts,pH value,PaO2 and survival rate within 72 h were decreased in MDP group (P ＜ 0.05).The pathologic changes of heart,liver,lung and kidney were obvious in S and MDP groups and severer in MDP group.Conclusion After a third-degree 20% total body surface area scald burn,MDP induces excessive production of inflammatory cytokines accompanying with multiple organ damage ; thus the model of sepsis is successfully established after scald burn in rats.

Objective To explore the clinical value of intra-arterial thrombolytic therapy for hepatic artery thrombosis after liver transplantation. Methods Routine color doppler imaging (CDI) was used to detect hepatic artery thrombosis (HAT) after liver transplantation in 160 cases. Suspected patients were further confirmed by immediate angiography. Four cases of HAT were diagnosed and treated by intra-arterial thrombolysis. Two cases received repeatable transcatheter hepatic arterial thrombolysis with a low dose of urokinase. Results Hepatic artery recanalization was achieved in 3 cases. Among the 3 cases, multiple HAT occurred in 1 case, intra-arterial thrombolysis was successfully completed in the end. Two cases had intra-abdominal hemorrhage, which was cured by conservative treatment. One case received retransplantation because of interventional thrombolysis failure and intra-abdominal hemorrhage. Conclusion Intra-arterial thrombolytic therapy may be a promising method in the treatment of HAT. Transcatheter hepatic arterial thrombolysis shows a significant result.

Objective To. investigate the effect of electroacupuncture at acupoint Zusanli (ST36) on the liver injury during the early stage after bum in rats. Methods Forty adult male SD rats weighing 220-250 g were randomly divided into 5 groups ( n = 8 each) : group sham operation (group Ⅰ ) ; group burn (group Ⅱ ) ; group acupoint at Zusanli (ST36) (group Ⅲ ); group non-acupoint stimulation (group Ⅳ ) and group ST36 + alphabungarotoxin (alpha7 nicotinic acetylcholine receptor antagonist) (group Ⅴ ). Rats were subjected to 3rd degree burn covering 30% of the total body surface area. Rats were resuscitated with lactataed Ringer's solution according to Parkland formula (4 ml/kg per 1% body surface area) immediately after burn. Bilateral acupoints Zusanli were stimulated with constant voltage (3 V, 3 Hz,2ms) for 20 min 3 times a day for 2 days starting immediately after resuscitation in H and V groups. In group V alpha-bungarotoxin 1.0 μg/kg was administered iv immediately after fluid resuscitation before acupuncture. In group Ⅳ same electric stimulation was performed at a point 0.5 cm lateral to Zusanli. The animals were sacrificed at 48 h after burn. The content and expression of high mobility group box 1 (HMGB1) protein in liver were measured. Liver specimens were obtained for microscopic examination (with light and electronic microscope). Results Compared with group Ⅰ , hepatic HMGB1 protein level significantly increased in Ⅱ and Ⅳ groups. There were significant ultrastructural changes in the liver in burn rats in group Ⅱ and group Ⅳ. Electric stimulation of ST36 significantly attenuated the histologic changes in the liver and decreased the hepatic HMGB1 protein level in group Ⅲ . Pretreatment with specific alpha.7 nicotinie acetylcholine receptor antagonist alpha-bungarotoxin reversed the beneficial effect of electroacupuncture at Zusanli. Conclusion Electric stimulation of acupoint ST36 can ameliorate liver injury during the early stage of burn by activating alpha7 nicotinic acetylcholine receptor-mediated pathways for anti-inflammation.

Objective To investigate the risk factors associated with early mortality (within 30 days) of patients with spontaneously ruptured hepatocellular carcinoma (SRHCC) and assess the efficacies of different treatment regimens. Methods The clinical data of 28 patients with SRHCC who had been admitted to our hospital from January 1999 to January 2006 were retrospectively analyzed. Multiple factors that might cause early mortality were determined, and the efficacies of different treatment regimens were assessed. Results Eleven patients died within 30 days. with the mortality rate of 39%. Univariate analysis showed that shock, Child C status, hemoglobin. ALT, and volume of blood transfusion were associated with early mortality (X2=3.020, 13.741, Z=-2.059, -2.210, -4.153, P<0.05). Child C status and volume of blood transfusion were the independent risk factors. All the patients were divided into hepatectomy group (8 cases), surgical hemostasis group (7 cases), transarterial embolization group (7 cases) and conservative group (6 cases). Patients in hepatectomy group had a better 30-day and median time survival rate compared with those in the other 3 groups (X2=8.098, 8.098, 15.025, Z=-3.127, -2.840, -3.004, P<0.05). Conclusions Poor hepatic functional reserve and severe hemorrhage are closely associated with early mortality of patients with SRHCC. Hepatectomy is a better choice for SRHCC.

Objective To study the characteristics of hepatic artery anatomy and master the method of arterial repair,especially the method and technology of repair of anomalous donor arteries.Methods Sixty-four(human) liver arteries were dissected and repaired,and 31 of these were used in liver transplantation.Results Twelve of 64 cases had anatomical anomaly of hepatic artery(12/64,18.75%).Five of 24 fetal(liver) donors(20.83%) had anatomical anomaly of hepatic artery,one arose from the superior mesentery(artery) as a replaced right hepatic artery,3 from accessory right hepatic artery,and in 1 case the hepatic(artery) arose from superior mesentery artery directly.Seven adults had hepatic artery anomalies:2 cases of right hepatic artery being replaced by artery derived from SMA,2 cases of left hepatic artery deriving from left gastric artery and 3 cases of accessory right hepatic artery derived from SMA.In 31 hepatic(transplantations),4 grafts with anatomical anomaly of right hepatic artery were used.Conclusions (Reconstruction) of hepatic artery plays an important role in hepatic transplantation.Avoidance of injury to(aberrant) hepatic avteries during removal of donor liver is a key to ensure successful arterial repair.During(repair) of very small accessory hepatic arteries,ligation or repair of the artery may be determined after(observation) of backflow from collateral vessels.