Obesity is the most important risk factor of primary hypertension. Rapid increase of obesity-related hypertension has become a worldwide problem. But the specific mechanism of the condition remains to be fully understood. This paper reviews the latest literatures and tries to explain the mechanism of obesity-related hypertension from the following four aspects: hypoadiponectinemia, leptin and resistance of leptin, insulin and resistance of insulin and the activation of renin-angiotensin system(RAS).

Objective To investigate the effects of inhalation of different concentrations of isoflurane on the expression of cytochrome c ( Cyt c) in hippocampus in aged rats.Methods Sixty-three aged male SD rats (20 months) weighing 500-600 g were randomly divided into 3 groups(n=21each):control group inhaling 30%O2 for 2h (group C) and 2 isoflurane groups anesthetized with 0.75 % and 1.5 % isoflurane in 30 % O2 for 2 h respectively (group Ⅰ1 and Ⅰ2 ).Arterial blood samples were obtained from 5 rats at 30 min, 1 and 2 h of anesthesia for blood gas analysis. Eight animals were killed at 24 h after anesthesia in each group.Their hippocampi were immediately removed for determination of Gyt c expression by immuno-histochemistry and Western blot analysis.Cognitive function was assessed by Morris water maze test the day before experiment and once a day for 6 consecutive days starting from the 1st postoperative day.Results The Cyt c expression in hippocampus was significantly increased in Ⅰ1 and Ⅰ2 groups in a concentration-dependent manner as compared with group C.The escape latency was significantly prolonged and the frequency of crossing the original platform and the duration of staying at the original platform quadrant were decreased in group Ⅰ1 and Ⅰ2 compared with group C.Conclusion Inhalation of isoflurane anesthesia can decrease cognitive function through up-regulating the Gyt c expression in hippocampus in aged rats.

Objective To explore the effect of isofluranee on receptor for advanced glycation end products (RAGE) expression of hippocampus and learning and memory function in rats. Methods 24-month Sprague-Dawley male rats (n=45) and 4-month Sprague-Dawley male rats (n=45) were randomly divided into six groups with 15 rats each group. Group C1 (aged control group),group C2(adult control group) breath 30% oxygen and air mixed gas; Group S1(single inhalation of isoflurane aged group),Group S2(single inhalation of isoflurane adult group)were anesthetized with 1.5% isoflurane,breath 30% oxygen and air mixed gas for 2h;Group R1(Repeated inhalation of isoflurane aged group), group R2(Repeated inhalation of isoflurane adult group) were anesthetized with 1.5% isoflurane,breath 30% oxygen and air mixed gas 2h a day for three days. Eight rats randomly selected from each group were killed and their hippocampus were immediately isolated for detection of RAGE expression by immunohistochemistry and RT-PCR after accomplished treatment 24h. The remained rats' learning and memory function were assessed using Morris water-maze test. Results The results of Morris water-maze test showed that the times of acerossing the original platform and the time consumption of staying the original platform quadrant was shorter in group S1 and group R1,but the escape latency was longer than group C1(escape latency C1 (9.42± 2.63)s,S1(13.20±3.85)s,R1(17.20±3.44)s, F=12.773, P<0.05). In the group R2,the escape latency was longer but the times of accrossing the original platform and the time consumption of staying the original plat-form quadrant was shorter than group C2 (times of accrossing the original platform C1(7.30±2.40), S1(3.90± 2.42),R1(3.44±2.40), F=7.448, P<0.01).To contrast with the group C2,there were no significant differ-enees in spatial probe test in the group S2(P>0.05). The levels of mRNA and protein of RAGE in hippocampus was significantly higher in group S1 and group R1 than group C1(RAGE mRNA expression C1(0.11±0.02),S1 (0.56±0.09), R1(0.73±0.14), F=179.447, P<0.01). To contrast with the group C2, there were no differ-ences found in the levels of mRNA and protein of RAGE in group S1(P>0.05), but it was higher in the group R2 (RAGE mRNA express C2(0.22±0.04), R2 (0.41±0.08), F=40. 209, P < 0. 01). Conclusion Isoflurane can reduce learning and memory function in both aged and adult rats, but aged rats are particularly significant im-pacted. This effect may be induced by the increase of RAGE expression in hippocampas.

BACKGROUND: Recently emerged immunosuppressive scheme combined with basiliximab following liver transplantation, such as the early steroid withdrawal or half amount of steroid. Many studies demonstrated that it would not increase the rejection rate in reducing the use of steroid. However, there were rare reports addressing whether it was safe and effective to replace the steroid by basiliximab. OBJECTIVE: Through the application of non-steroid and early steroid withdrawal immunosuppressive scheme in patients of hepatocellular carcinoma following liver transplantation, to evaluate the therapeutic effect and safety of two treatments. METHODS: A total of 80 patients of hepatocellular carcinoma receiving liver transplantation were divided into the experimental and control group. In the experimental group, 33 patients were applied with non-steroid treatment (Tacrolimus+mycophenolate mofetil+basiliximab); additionally 47 patients were applied with early steroid withdrawal treatment (Tacrolimus+mycophenolate mofetil+ steroid). Steroid was reduced gradually from the first day after transplantation to discontinuation after 1 month. The rates of rejection, infection, cancer recurrence and 1 -year survival were measured. RESULTS AND CONCLUSION: Compared to the control group, the rates of infection and cancer recurrence were significantly smaller in the experimental group (P < 0.05). However, there was no significantly difference between 2 groups in the rates of rejection and 1 -year survival (P > 0.05). It revealed that the non-steroid treatment can be safely and effectively applied in the patients with hepatocellular carcinoma following liver transplantation. The non-steroid treatment can significantly cut down the infection rate and cancer recurrence rate, which has no effect on the rejection and 1 -year survival rate.

Objective To investigate the effects of isoflurane on receptor for advanced glycation endproducts (R(A)GE) expression in the hippocampus in rats. Methods Forty-five male 4-month-old and 45 male 24-month-old rats were used in this study. The animals were divided into 2 age groups ( n = 45 each): the aged group (group O) and the adult group (group A). Each group was further divided into 3 subgroups ( n = 15 each):Ⅰ control subgroup (group OC,AC) inhaled 30% O2 in air; 1 single isoflurane inhalation subgroup (group OS,AS) inhaled 1.5 % isoflurane for 2 h and Ⅲ repeated isoflurane inhalation subgroup (group OR, AR) inhaled 1.5 % isoflurane 2 h per day for 3 days. One day after isoflurane inhalation, learning and memory function was assessed using Morris water maze test in 8 animals in each subgroup. The rest of each subgroup were killed and their hippocampi were immediately isolataed for detection of RAGE mRNA and protein expression by RT-PCR and immuno-histochemistry. Results The cognitive function was impaired after signle or repeataed isoflurane anesthesia as compared with control animals in both aged and adult groups. The expression of RACE mRNA and protein in hippocampus was significantly increased after either single or repeated isoflurane anesthesia in aged group but only after repeated isoflurane anesthesia in adult gpoup. There was no significant difference in RAGE mRNA and protein expression in the hippocampus between control and single isoflurane inhalation animals in adult group. Conclusion Isoflurane can reduce learning and memory function in both aged and adult rats by increasing RAGE expression in hippocampus especially in aged rats.

Objective To observe the change in memory of aged rats and the expression of alpha 4 acetylcholine receptor in hippocampus 5 h after inhalation of 1.2% isoflurane.Methods Fifty healthy adult and 50 aged SD rats were randomly divided into aged normal control group(A0),aged water labyrinth normal control group(WA0),1 day isoflurane aged water labyrinth group(WA1),3-day isoflurane aged water labyrinth group(WA3),7-day isoflurane aged water labyrinth group(WA7),adult normal control group(B0), adult water labyrinth normal control group(WB0),adult 1 day isoflurane water labyrinth group(WB1),3-day isoflurane water labyrinth group(WB3),and 7-day isoflurane water labyrinth group(WB7),10 rats in each group.Memory of rats in WA1,WA3,WA7 groups was detected 5 h after inhalation of 1.2% isoflurane while memory in rats of WB1,WB3 and WB7 groups was detected during the Morris water maze testing.The rats in A0,WA0,WA7,B0,WB0 and WB7 groups were killed on day 7 to detect the expression of ?4 acetylcholine receptor by Westernblotting for observation of changes in distribution of positive immune reaction cells in hippocampus.Results Water maze test showed that there was no significant difference in expression of alpha 4 acetylcholine receptor between WA0 and WB0 groups.However,the expression level of alpha 4 acetylcholine receptor was significantly lower in latent period of WA1 than in latent period of WA0,WB0 and WB7 groups(P

[Objective] To investigate the effect of Lycium barbarum polysaccharide (LBP) on T-lymphocyte subsets levels, dendritic cells (DCs) counting and antigen CD80 expression in peripheral blood and tumor stroma of H22-bearing mice. [Methods] H22-bearing mice models were established. LBP in the dosages of 1.25 and 0.625 g?kg-1?d-1 was orally administered to the mice models for two weeks. The changes of T-lymphocyte subsets levels, DCs counting and antigen CDgo expression in peripheral blood and tumor stroma were detected by flow cytometry (FCM) . [ Results ] LBP increased the numbers of CD4+ and CD8+ T-cells, promoted the proliferation of CD4+ T-cells, and elevated the ratio of CD4+ /CD8+ in peripheral blood. LBP in large dosage also increased the numbers of CD4+ and CD8+ T-cells in the tumor-infiltrating lymphocytes (P

Gallbladder carcinoma (GC) is the most common malignant tumor in bile duct system.Xanthogranulomatous cholecystitis (XGC) is a benign inflammatory gallbladder disease.It is often misdiagnosed between them.This paper,through reviewing the literature and summarizing our own clinical experience,will give a better understanding on the two diseases,which was summarized as follows:inflammation is important both in the pathogenesis of GC and XGC,and we can make the correct diagnosis and choose an appropriate treatment by analy zing the feature of disease history,image data and rapid intraoperative pathological diagnosis.Radical resection remains the first choice in the treatment of GC,but the extent of resection is controversial.Normally,cholecystectomy is sufficient for curing XGC,but different surgeries are needed according to the specific disease conditions.

Objective To summarize the experiences of a single treatment group in surgical treatment of hilar cholangiocarcinoma during the past 10 years. Methods From January 2000 to December 2009, 1572 patients with hilar cholangiocarcinoma were admitted to the Eastern Hepatobiliary Surgery Hospital, and the clini-cal data of 462 patients in our treatment group were retrospectively analyzed. Among the patients, 314 received surgical treatment, and the remaining 148 received conservative interventions or refused any therapy. Factors that may have influenced the prognosis were analyzed by the Kaplan-Meier method, Log-rank test and Cox proportional hazards model. The correlation of different factors was analyzed by the chi-square test. Results A total of 314 patients underwent surgical treatment and tumor resection was performed in 237 patients, including 174 with R0 resection, 17 with R1 resection, and 46 with R2 resection. There were 91 patients with postoperative complications and 10 in-hospital deaths. A total of 260 patients had been followed up for 5-113 months, and the overall 1-, 3-, and 5-year survival rates were 71.7% , 32.6% and 10.9% , respectively; the 1-, 3-, and 5-year survival rates of patients with R0 resection were 76. 9% , 48. 6% and 32. 7% , respectively, with a median survival time of 35 months. R0 resection, TNM staging, regional lymph node involvement and tumor differentiation were the independent prognostic factors (RR = 2. 1, 1.9,2.2, 1.7, P<0.05). Conclusions Curative resection is the treatment of choice for hilar cholangiocarcinoma. Preoperative systematic evaluation and preparation can improve the radical resection rate and reduce postoperative morbidity.

Objective To summarize the clinical experience of surgical treatment for the congenital coronary artery anomaly.Methods 15 patients with coronary artery anomaly,congenital coronary artery fis-tulas were 11 patients,including 1 patient associated with Fallot,5 patients underwent ligation of isolated fistula and 1 patient's fistula was performed tangent suture though off-pump cardiopulmonary bypass,4 pa-tients'fistulas were repaired by endocardiac way and 1 patient was mended through dissection of fistula under Oil-pump cardiopulmonary bypass.Anomalous origin of the left coronary artery from pulmonary artery were 4 patients and 1 patient associated with rheumatoid valve disease.Operative methods included ligation of left circumflex (1 case),anastomosis of left subclavian artery-left artery-left main (1 case) and transplantation of left main(2 cases).Results There was 1 death becaused severe low cardiac output syndrome,and the there was good prognosis and no clinical symptoms found in 14 patients during follow-up.Conclusion The feasible operation for the coronary artery anomaly should be performed as early as possible once diagnosed correctly.