Objective To evaluate the effects of teriipressin on perioperative renal function in patients undergoing liver transplantation. Methods Forty ASA Ⅲ or Ⅳ patients (31 males and 9 females) aged 35-55 yr and weighing 46-81 kg were randomly divided into2 groups (n=20 each): terlipressin group and control group. The patients were premedicated with intramuscular midazolam 2- 3 mg and atropine 0.5 mg. Swan-ganz catheter was placed via the right internal jugular vein and the radial artery was cannulated. Electrocardiography (ECG), blood pressure (BP), heart rate (HR), central venous pressure (CVP) and pulmonary arterypressure (PAP) were monitored during general anesthesia. General anesthesia was induced with midazolam (0.1-0.2 mg/kg), fentanyl (5-10 μg/kg), propofol(1-2 mg/kg) and vecuronium (0.1 mg/kg) and maintained with 0.5%-1.5% isoflurane, propofol infusion at 2-5 mg·kg-1·h-1 and intermittent i.v. boluses of fentanyl and vecuronium. The patients were mechanically ventilated after tracheal intubation. In the terlipressin group, 2 mg of terlipressin was added to 50 ml of normal saline (NS) and was continuously infused at 10 ml/L from beginning of operation until the end of anhepatic phase, while in the control group, NS was infused only. Blood and urine samples were taken before operation(T0), at the end of anhepatic phase (T1), at the end of operation (T2), and on the 1st and 2nd day after operation (T3, T4)for determination of plasma angiotensin Ⅱ (AT- Ⅱ ), serumβ2-microglobulin (MG), blood urea nitrogen (BUN) and creatinine (Cr) concentrations and N-acetyl-βd-glucosaminidase (NAG) concentrations in the urine. Urine output was measured during pre-anhepatic, anhepatic and neo-hepatic phase and on the 1 st and2nd day after operation. Results The urinary NAG and serum β2-MG concentrations were significantly increased at T1 as compared with the baseline at T0in both groups. The urinary NAG, plasma AT-Ⅱ, serum β2-MG, BUN and Cr concentrations were significantly lower and theurinary output was significantly higher during T2-4 in the terlipressin group than in the control group. Conclusion Terlipressin has protective effects on renal function in patients undergoing orthotopic liver transplantation.

AIMTo investigate the effects of c-myb on progesterone-induced mouse germinal vesicle(GV) stage denuded oocyte (DO) maturation in vitro.

METHODSWe used mouse GV stage oocyte cultured with special concentration progesterone, or/and antisense c-myb ODN, or/and db-cAMP, or/and heparin for 24 h, and observed oocyte maturation and analysed the relationship among them.

RESULTSWe cultured DO in the medium 199 for 24 h, and found 10 micromol/L progesterone had more significant effect than 5 micromol/L progesterone (2 h GVBD% P < 0.05, 8 h PB 1% P < 0.05), but had not more significant effect than 20 micromol/L progesterone. We found that 16 micromol/L antisense c-myb ODN significantly inhibited progesterone (10 micromol/L)-induced mouse germinal vesicle stage oocyte maturation in vitro (2 h GVBD% P < 0.05, 8 h PBI% P < 0.01). 1 x 10(-4) micromol/L dbcAMP, 100 microg/ml heparin could single significantly inhibited progesterone-induced mouse GV stage oocyte maturation in vitro (2 h PBI% all P < 0.01, 8 h PBI% all P < 0.01), and could enhanced the inhibition of 16 micromol/L antisense c-myb ODN (2 h GVBD% all P < 0.01, 8h PBI% all P < 0.01).

CONCLUSIONProgesterone, protooncogene c-myb,cAMP and calcium all pay important role in regulating oocyte maturation and the mechanism of progesterone, cAMP and calcium in regulating oocyte maturation may be through the expression of protooncogene c-myb.

Animals ; Cells, Cultured ; Genes, myb ; Meiosis ; Mice ; Mice, Inbred Strains ; Oocytes ; cytology ; drug effects ; Oogenesis ; Progesterone ; pharmacology

Objective To investigate the effect of batroxobin combined with tranexamic acid on the perioperative bleeding and blood coagulation in the patients undergoing adolescent idiopathic scoliosis.Methods Eighty ASA Ⅰ or Ⅱ patients,aged 15-26 yr,weighing 41-56 kg,scheduled for elective adolescent idiopathic scoliosis,were randomly divided into 4 groups (n =20 each):normal saline group (group A),batroxobin group (group B),tranexamic acid group (group C) and batroxobin combined with tranexamic acid group (group D).0.9 ％ normal saline was infused after admission to the operating room in group A.Batroxobin 0.02 U/kg was infused at 20 min before skin incision,an increment of 0.02 U/kg was given every 2 h until the end of operation and the maximal dose was less than 1 U in group B.Tranexamic acid 20 mg/kg was injected immediately before skin incision,followed by infusion at 10 mg· kg-1 · h-1 until the end of operation in group C.In group D,batroxobin and tranexamic acid were given as the method described in B and C groups.The intraoperative blood loss,volume of autologous and allogeneic blood transfused,transfusion of fresh frozen plasma (FFP),and volume of drainage within 24 h after operation were recorded.Blood routine,prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fbi),thrombin time (TT),activated clotting time (ACT),clot rate (CR) and platelet function (PF) were measured.Deep vein thrombosis was detected at 1 week after operation.Results Compared with group A,the intraoperative blood loss,volume of allogeneic blood transfused,transfusion of FFP,volume of autologous blood transfused and volume of postoperative drainage were significantly reduced,and Plt and Fib were significantly increased at T2,3 in groups B,C and D,and PF was increased at T2 in group C,Hct,Plt,Fib and PF were increased and PT was prolonged at T2,3 in group D (P ＜ 0.05).Compared with group B,the intraoperative blood loss,volume of allogeneic blood transfused,transfusion of FFP,volume of autologous blood transfused and volume of postoperative drainage were significantly decreased and Hct,Plt,Fib and PF were increased at T2,3 in group D,and the volume of postoperative drainage was increased and Plt increased at T2,3 was in group C (P ＜ 0.05).Compared with group C,the intraoperative blood loss,volume of allogeneic blood transfused,volume of autologous blood transfused,volume of postoperative drainage and transfusion of FFP were significantly decreased and Hct,Plt,Fib and PF were significantly increased at T2,3 in group D (P ＜ 0.05).No patients developed blood coagulation disorder and deep vein thrombosis.Conclusion Batroxobin combined with tranexamic acid can significantly reduce the intraoperative blood loss and volume of allogeneic blood transfused and improve the blood coagulation,and the efficacy is superior to that of either alone for the patients undergoing adolescent idiopathic scoliosis.

Objective To study the clinical features and therapeutic method of severe cerebral injured patients with hyponatremia.Methods The electrolyte and central venous pressure were examined on 45 cases of severe cerebral injured patients with hyponatremia every day.According to plasma sodium value and central venous pressure,we regulated treatment perscription daily.Results 45 patients occured hyponatremia in total 288 of severe cerebral injured patients.Hyponatremia was detected 5～13 days after operation or after injure.The morbility is usually the highest in the seventh day.Plasma sodium recovered to normal value in 14 days after operation.Conclusion Severe cerebral injured patients with hyponatremia should be diagnosed and treated as early as possible,then it will receive better prognosis.

Aim To investigate the effect of nicotinyl salicylic acid(NSA) on rabbit platelet aggregation induced by Collagen,ADP and AA.Methods Platelet aggregation induced by collagen,adenosine diphosphate(ADP) or arachidonic acid(AA) was studied with turbidimetry in rabbtis blood,in vitro and vivo.Results NSA significantly inhibited the platelet aggregation induced by Collagen and ADP,in vitro and vivo.The inhibition by NSA was dose-dependent.NSA had no effect on the platelet aggregation induced by AA.Conclusion NSA can inhibit rabbit platelet aggregation induced by Collagen and ADP.

Objective To investigate the clinical value of transesophageal echocardiography during the lung transplanta tion. Methods From August 2005 to August 2009, 19 patients with advanced lung diseases received lung transplantation.The average age was(48.35±13.04) years. The echocardiographic probe was placed in patient's esophagus before surgery.The left and right pulmonary venous openings, artery blood flow velocity, right ventricular wall motion, left and right ventricular volume, right ventricular ejection fraction were recorded at different time intervals during lung transplantation, especially at the break and after completion of bronchus, pulmonary veins, and pulmonary artery anastomosis. Results The procedure included sequential-type lung transplantation in 6 cases and single lung transplantation in 13. The blood flow disappeared when blocking pulmonary artery and vein and right ventricular volume increased slightly. The right ventricular volume restored after completion of trachea, pulmonary veins, pulmonary artery anastomosis. TEE detected that the blood flow velocity of pulmonary veins, pulmonay artery anastomosis increased slightly. In 1 case the opening of the right pulmonsry artery blood flow velocity increased significantly and blood flow velocity decresed and blood oxygen partial pressure resumed after re-anastomosis of pulmonary artery. Conclusion TEE play an important role in monitoring pulmonary artery and vein anastomosis diameter and blood flow velocity and right ventricular function and predicting complications during lung transplantation.

Objective To compared analgesic effect of sufentanil and fentanyl in surgery patients during mechanical ventilation, and to explore the rational dosage of analgesic and sedative drugs. Methods A prospective randomized controlled trial was conducted. 600 postoperative critically ill patients underwent mechanical ventilation for 12-72 hours admitted to Department of Critical Care Medicine of the Second Affiliated Hospital of Kunming Medical University from April 2013 to March 2015 were enrolled. They were randomly divided into two groups, sufentanil and fentanyl was used for analgesia respectively, and 300 patients in each group. The initiate dosage of sufentanil and fentanil was 5 μg/h and 50 μg/h, and the dosage was adjusted. A postoperative pain score (Prince-Henry score) of 0-1, and Richmond agitation-sedation scale (RASS) score -1-0 were targeted. 1 mg/kg of propofol was used if patient could not fall in sleep or felt anxious after loading dose of sufentanil (5 μg) or fentanil (50 μg) for 5 minutes. The use of analgesic drugs, the proportion and dosage of propofol was observed in the two groups, and adverse reactions were recorded. Results The mean dose of sufentanil for analgesia was (0.07±0.02) μg·kg-1·h-1, and the mean dose of fentanyl was (0.67±0.12) μg·kg-1·h-1. The patients in the two groups received propofol 40 to 60 mg/h in night, and the use proportion of propofol in sufentanil group was slightly less than that in fentanyl group (25.7% vs. 28.3%), but the difference was not statistically significant (P > 0.05). It was found by subgroup age analysis that, the mean analgesic dose of sufentanil or fentanyl in patients over 80 years old was lower than that in 70-79 years, 60-69 years and < 60 years groups but without statistical significance. There were 11 cases (3.7%) and 21 cases (7.0%) patients suffered from respiratory depression in sufentanil group and fentanyl group, respectively, without statistical significance (P = 0.069). The hemodynamics of patients in two groups was stable during analgesia, and no accidental extubation due to restlessness was found. Conclusions A smaller dose of sufentanil for postoperative patients underwent mechanical ventilation with satisfactory analgesia was (0.07±0.02) μg·kg-1·h-1, but need to be added with 40-60 mg/h and a small dose of propofol to improve anxiety and sleep. The proportion of patients needing propofol addition was slightly lower than that of fentanyl.

Objective To investigate Monilia infection and adverse pregnancy outcomes of pregnant women in labor.Methods Before informed consent,542 cases of pregnant women in labor were collected in Obstetrics Department of Maternity and Child Healthcare of Maoming City from January 2013 to April 2014,and all of these cases were examined by Monilia inspec-tion of vaginal secretions.All of these cases were 20 to 30 years old,without vaginal pathogenic infection symptoms,but in-cluded in a few of formulation of clinical features of vaginal Candida infection.With the two methods of 10% potassium hy-droxide solution wet sheet and Gram staining,if blastospore or pseudohypha of Candida mycoderma were found out in the two methods under microscope,this case was diagnosed as positive result,otherwise as negative result.Respectively choosing positive cases as observation group,and negative cases as control group,the indexes of premature rupture of membranes,per-ineum wound infection,neonatal thrush and neonatal diaper rash of the two groups were recorded.The statistical method:e-numeration data by chi-square test,measurement data using analysis of varianc.Results The positive rate of Monilia was 23.1% (125/542),higher than 19.3% reported in domestic.The incidence rates of neonatal diaper rash,premature rupture of membranes,neonatal thrush and perineum wound infection of the observation group were respectively 19.2%,8.0%, 16.8% and 12.8%,all much higher than the control group respectively was 8.4%,1.2%,3.8% and 1.7%,(χ2 =12.578~29.273,all P <0.01).Conclusion Monilia infection of pregnant women in labor could increase the chance of adverse preg-nancy outcomes.Healthy or clinical doctors should suggest that pregnant women early carry out routine examination and ear-ly treatment,in order to prevent adverse pregnancy outcomes.

Purpose To detect the expressions of stress induced phosphoprotein 1 (STIP1) and estrogen receptor-α(ER-α) in papil-lary thyroid carcinoma and to analyse the relationship between STIP1 and ER-α. Methods 54 cases of paraffin-embedded tissues of papillary thyroid carcinoma, 18 cases of papillary thyroid carcinoma with lymph node metastasis, 15 cases of Hashimoto’ s thyroiditis, 10 cases of adjacent normal thyroid tissue were collected. The expressions of STIP1 and ER-αwere detected by immunohistochemistry, and the relationship between the expressions and clinicopathological features of papillary thyroid carcinoma was analyzed. Results The expression of STIP1 and ER-α in papillary thyroid cancer group ( 55. 6% and 44. 4%) were higher than that of normal thyroid group (10% and 0) and Hashimoto’s thyroiditis group (8. 3% and 0, all P<0. 05). STIP1 expressions was related to lymph node metastasis ( P<0. 05 ) , while ER-α expression was related to gender, TG-Ab and the merger of nodular goiter, but not related to lymph node metastasis (P>0. 05). The expressions of STIP1 and ER-α in papillary thyroid carcinoma were not related to patients’ age , tumor location, number of tumors, tumer size, invasion of capsule, the concomitant Hashimoto’ s thyroiditis and TPO-Ab ( all P>0. 05). And the expressions of STIP1 was not related to gender, TG-Ab and the merger of nodular goiter (all P>0. 05). A positive correlation was found between the expressions of STIP1 and ER-αin thyroid papillary carcinoma (P<0. 05). Conclusion STIP1 and ER-α in papillary thyroid carcinoma may be related with lymph node metastasis.

AIMTo investigate the distribution of c-myb, an oncoprotein, in mouse oocytes-cumulus cell complex and sperm immunohistochemically.

METHODSTo study the effect of c-myb on mouse fertilization in vitro, various concentration of c-myb antisense-oligodeoxynucleotides (c-myb ASODNs) were incubated with sperms and oocytes during fertilization. To explore the possible mechanism involved in fertilization, the relationship between c-myb ASODNs and GABA or dbcAMP or Verapamil or Progesterone in fertilization was also observed by immunohistochemical methods.

RESULTSc-myb oncoprotein was observed on the nucleus of cumulus cell and head of sperm. c-myb ASODNs inhibited the rate of fertilization in vitro in a dose-dependent way. The fertilization rates of the control group, low (5 micromol/L), medium (10 micromol/L), high (20 micromol/L) concentration c-myb ASODNs groups and nonsense tat oligodeoxynucleotides (20 micromol/L) group were 34.97%, 30.89%, 20.14%, 16.68%, 34.47%, respectively. All of GABA, Progesterone and dbcAMP inversed the c-myb ASODNs inhibition effects on fertilization rate, but neither of them showed significant effect on the percentages of immunohistochemical stain of Myb on sperm and cumulus cells. By contrast, Verapamil inhibited the fertilization rate. Co-treated with c-myb ASODNs, Verapamil showed synergic inhibiting effects on the fertilization with c-myb ASODNs. Verapamil also inhibited the expression of Myb on head of sperm. The fertilization rates of the control group, medium (10 micromol/L) concentration c-myb ASODNs group, GABA group, P4 group, Verapamil group, dbcAMP group were 34.81%, 22.96%, 40.83%, 39.12%, 7.46%, 40.61%, respectively.

CONCLUSIONc-myb ASODNs is closely correlated with fertilization. Verapamil can inhibit fertilization in vitro through regulating Myb expression of sperm, while GABA, dbcAMP and Verapamil may affect the process of fertilization through the way other than Myb expression.

Animals ; Bucladesine ; pharmacology ; Female ; Fertilization ; physiology ; Fertilization in Vitro ; Male ; Mice ; Mice, Inbred Strains ; Oligodeoxyribonucleotides, Antisense ; pharmacology ; Oocytes ; physiology ; Proto-Oncogene Proteins c-myb ; metabolism ; Spermatozoa ; physiology ; Verapamil ; pharmacology ; gamma-Aminobutyric Acid ; pharmacology