AIM:To observe the effects of fasudil on inflammatory reaction in cerebral ischemia/reperfusion rats.METHODS:Focal cerebral ischemia/reperfusion model in rats was made by transient occlusion of middle cerebral artery for 1.5 h followed by 24 h reperfusion.Fasudil was injected intraperitoneally before operation and 12 h after operation.The neurological function was scored and the infarct volume was measured after operation.The water content of brain was measured with dry-wet weight;The myeloperoxidase(MPO)activity was determined by spectrophotometer;The permeability of the blood brain barrier was evaluated by measurement of the Evans Blue(EB)content in the brain with spectrophotometer;The brain content of IL-8 was evaluated with ELISA;The level of NF-?B p65 mRNA expression was determined by RT-PCR;The expressions of ICAM-1,VCAM-1 and NF-?B p65 protein were observed by immunohistochemistry;The MCP-1 and the expression of NF-?B p65 protein in the nuclear extracts were detected by western blotting.RESULTS:Fasudil improved the neurological function,decreased the infarct size,reduced the permeability of blood brain barrier and brain water content,inhibited the MPO activity,decreased the content of IL-8 and the protein expressions of ICAM-1,VCAM-1 and MCP-1 in brain tissue,inhibited the expressions of NF-?B p65 mRNA and protein and reduced the content of NF-?B p65 protein in the nuclear extracts significantly(P

Objective To explore the therapeutic effect of combined endoscopic embelization and variceal ligation (EVL) for management in cirrhotic patients with gastroesophageal variceal bleeding. Meth-otis One hundred and fifty-six cases of active gastric fundal variceal bleeding combined with esophageal var-ices of over degree Ⅱ, and with other causes leading to upper digestive tract bleeding excluded, were ran-domized into therapeutic group (n = 80) and control group (n = 76). For the therapeutic group, endoscopic cyanoacrylate injection for embelization of gastric fundal varices and EVL for esophageal varices were per-formed simultaneously. For the control group, EVL was performed 2 months after embolization. Results There was no complication in beth groups. The rate of hemostasis in therapy group was 96. 3% (77/80), and that in control group was 97. 4% (74/76, P >0.05). There was significant difference between two groups, regarding the rates of early re-bleeding [6. 4% (5/78) vs 21.3% (16/75), P < 0. 05] and re-bleeding at 6 months [13.0% (9/69) vs 25. 4% (17/67), P < 0. 05]. There was no significant difference between two groups, regarding the effective rate in disappearance of gastric fundus varices (61.6% vs 59. 1%), and in that of esophageal varices (74. 0% vs 67.9%). Conclusion Endescopic embelisation of gastric fundus vaxices, combined with EVL for esophageal varices, is a safe and effective procedure for the treatment of gastroesophageal variceal bleeding, and it can reduce the rate of re- bleeding.

Objective To evaluate the clinical features and treatment of pelvi-ureteric junction obstruction (PUJO) in a duplex kidney. Methods From 1993 to 2010, 752 patients were diagnosed as PUJO in our hospital and 18 patients (2.4%) with PUJO in duplex kidneys. Three patients had obstruction in the complete duplicated systems and 15 in the incomplete duplicated systems. Five patients had obstruction of the upper moiety and 13 of the lower moiety. All of the 18 patients underwent B-ultrasonography, with 15 enhanced CT scan, 11 intravenous urography and 10 retrograde pyelography.All patients had serum creatinine test after admission and during the follow-up. Results Sixteen patients underwent operations and 2 patients were treated conservatively. Nine patients underwent pyeloplasty and 7 patients underwent heminephroureterectomy. Pathology shows derangement of the lamina muscularis at pelvi-ureteric junction and infiltration of inflammatory cells in mesenchymal. They were followed up from 6 months to 3 years with a mean of 24 months. The clinical symptoms of patients who underwent surgery were cured in all cases. B-ultrasound and IVU showed that hydronephrosis was obviously relieved and the levels of serum creatinine remained the same or decreased. The hydronephrosis and serum creatinine of patients who underwent conservative treatment remained stabilized. Conclusions PUJO in duplicated system is a rare condition. Careful preoperative evaluation is needed to reach the final diagnosis and retrograde pyelography has high specificity. Treatment should be individualized according to split and partial renal function.

Aim To investigate the effects of fasudil on neuronal apoptosis after cerebral ischemia/reperfusion(I/R) injury in rats.Method Focal cerebral ischemia/reperfusion model in rats was made by transient occlusion of the middle cerebral artery for 90 minutes followed by 24 h reperfusion.The number of neural apoptotic cells was measured by the method of TUNEL staining;Bcl-2,Bax,Caspase-3 protein expressions were observed by immunohistochemical staining;the expression of phospho-MYPT and phospho-Akt protein was determined by Western blot.Result Compared with the MCAO group,fasudil could decrease the number of neural apoptotic cells,upregulate the expression of Bcl-2 and phospho-Akt protein and inhibit the expression of Bax,Caspase-3 and phospho-MYPT protein significantly(P

ObjectiveTo investigate the effects of morphine preconditioning on myocardial ischemiareperfusion (I/R) injury and the expression of phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2)in rats with chronic heart failure.MethodsForty-eight healthy male SD rats weighing 220-250 g were randomly divided into 6 groups ( n =8 each):control group (group C),sham operation group (group S),I/R group and preconditioning with low,median and high doses of morphine groups (groups MP1-3 ).Chronic heart failure was induced by iv edriamycin 2.0 mg/kg once a week for 6 weeks in groups S,I/R and MP1-3.Left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were measured using ultrasound,and left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were calculated at the end of 14th day after the end of adriamycin administration.Blood samples from the carotid artery were collected after ultrasonography for determination of the plasma brain natriuretic peptide (BNP) concentration.Myocardial I/R was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion at 2 day after ultrasonography in groups I/R and MP1-3.In groups MP1-3,iv morphine 0.015,0.030 and 0.050 mg/kg were repeated 3 times at 5 min interval at 30 min before ischemia respectively,while normal saline 5 ml/kg was given in group I/R.The animals were sacrificed at the end of reperfusion in groups S,I/R and MP1-3,and the hearts were removed to measure the area at risk (AAR),infarct size (IS),and IS/AAR ratio was calculated.The p-ERK1/2 expression in myocardium was assessed by Western blot.ResultsThe LVESD and plasma BNP concentration were significantly higher,while the LVEF and LVFS lower in the other 5 groups than in group C (P ＜0.01).No myocardial infarction was found in group S.The p-ERK1/2 expression was significantly lower in groups I/R and MP1 than in group S (P ＜ 0.05).IS and IS/AAR ratio were significantly lower,and p-ERK1/2expression was significantly higher in groups MP2.3 than in group I/R ( P ＜ 0.05).There were no significant differences in IS,IS/AAR ratio and p-ERK1/2 expression between groups MP1 and I/R (P ＞ 0.05).IS and IS/AAR ratio were decreased gradually,and the p-ERK1/2 expression was up-regulated gradually in groups MP1-3 ( P ＜0.05).ConclusionMorphine preconditioning can confer cardioprotection against myocardial I/R in a dose-dependent manner in rats with chronic heart failure.Up-regulation of p-ERK1/2 expression is involved in the underlying mechamism.

Objective To evaluate the effects of flurbiprofen axetil administered at different time points on oxygenation in the patients undergoing one-lung ventilation (OLV).Methods Ninety patients of both sexes,aged 45-64 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective thoracoscope-assisted pulmonary lobectomy,were assigned into 3 groups (n =30 each) using a random number table:control group (group C),preoperative administration group (group F1) and intraoperative administration group (group F2).Flurbiprofen axetil (10 mg/ml) and fat emulsion 10 ml were injected intravenously at 15 min before operation in F1 and C groups,respectively.Flurbiprofen axetil 10 ml was intravenously injected immediately after the beginning of OLV in group F2.At 15 min before operation (T1),15 and 30 min of OLV (T2,3),and 15 min after restoration of two-lung ventilation (T4),airway peak pressure (Ppeak) and dynamic lung compliance (Cdyn) were recorded,arterial blood samples were collected for blood gas analysis.The arterial oxygen partial pressure (PaO2) was recorded,and the oxygenation index (OI) and intrapulmonary shunt (Qs/Qt) were calculated.The concentrations of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1α (6-K-PGF1α) in serum were measured by enzyme-linked immunosorbent assay,and TXB2/6-K-PGF1α ratio was calculated.The development of interrupting OLV due to SpO2＜90％ and postoperative dyspnea,pulmonary infection,atelectasis and length of hospital stay were recorded.Results Compared with group C,PaO2 and OI were significantly increased,and Qs/Qt was decreased at T2,3,the serum concentrations of TXB2 and 6-K-PGF1α were decreased,and TXB2/6-K-PGF1α ratio was increased at T2-4,the incidence of interrupting OLV was decreased (P＜0.05),and no significant change was found in the parameters mentioned above in group F2 (P＞0.05).Compared with group F1,PaO2 and OI were significantly decreased at T2,3,Qs/Qt was increased at T2,and the serum concentrations of TXB2 and 6-K-PGF1α were increased,and TXB2/6-K-PGF1α ratio was decreased at T2-4 in group F2 (P＜0.05).There was no significant difference in the incidence of postoperative dyspnea,pulmonary infection and atelectasis and length of hospital stay between the three groups (P＞0.05).Conclusion Flurbiprofen axetil injected at 15 min before operation can significantly improve oxygenation and prevent the development of hyoxemia in the patients undergoing OLV,however,flurbiprofen axetil administered immediately after the beginning of OLV has no such effect.

Objective To explore influences of the fistula's location on the procedure and outcome of a transvaginal vesicovaginal (VVF) repair.Methods The medical data of patients undertaken transvaginal VVF repairs in Peking University First Hospital between Janurary 2009 and Auguest 2016 were retrospectively collected,including age,past history,causes of the fistula,disease course,past treatment,outcomes of the cystoscopy and imaging test and surgical information.The follow-ups were performed.Patients who had incomplete clinical data and lost to follow-up were not included.The present study included 68 VVF subjects with the median age of 46 years (range:24-64 years).The univariate analysis was performed to figure out potential risk factors for the VVF repair outcome.The duration and blood loss of VVF repairs were compared among the subjects with the fistulae located at bladder neck,trigone and supra-trigone region.Results There were 5,23 and 40 cases having VVFs located at bladder neck,trigone and supratrigone region respectively.The overall repair success rate was 88.2％ (60/68).According to results of the univariate analysis,subjects with more past repair times had significantly lower success rates.There were no significant differences in success rates of surgical repairs for VVFs located at bladder neck (80.0％,4/5),trigone (91.3％,21/23) and supra-trigone region (87.5％,35/40).And the location of VVFs had no significant association with the duration and blood loss during the VVF repair.Conclusions The location of VVFs had no influences on the procedure and outcomes of the transvaginal repairs.The VVF repair approach may not be determined based on the fistula's location alone.

Objective To investigate the effects of remifentanil postconditioning on apoptosis in hippocampal neruons in a rat model of cerebral ischemia-reperfusion(I/R)and the mechanism involved.Methods Twentyfour male SD rats weighing 250-300 g were randomly divided into 4 groups(n = 6 each): sham operation group (group S);global cerebral I/R group(group I/R);remifentanil 0.6μg·kg- 1·min-1+global cerebral I/R group (group R1)and remifentanil 1.8μg·kg-1·min-1 + global cerebral I/R group(group R2).Global cerebral ischemia was induced by 10 min occlusion of bilateral common carotid combined with hypotension.In group R1 and R2,remifentanil at 0.6 and 1.8μg·kg-1·min-1 were infused for 5 min before ischemia respectively.The cognitive function was tested with Morris water maze and step-down tests from the day 3 to day 8 after reperfusion.When Morris water maze test was finished,rat brains were removed for HE staining and determination of the expression of caspase-3 in hippocampal CA1 region by immuno-histochemistry.Apoptosis in neurons in hippocampal CA1 region was detected by TUNEL assay.Results Compared with group S,the cognitive function was significantly decreased and the number of apopotic neurons in hippocampus CA1 region increased in group I/R,R1 and R2,and the expression of caspase-3 was up-regulated in group I/R(P＜0.05).Compared with group I/R,the cognitive function was significantly increased,the expression of caspase-3 was down-regulated,and the number of apopotic neurons in hippocampus CA1 region was significantly decreased in group R1 and R2(P＜0.05).Conclusion Remifentanil postconditioning can improve the cognitive function through down-regulating caspase-3 expression and inhibiting the apoptosis in hippocampal neruons in a rat model of cerebral I/R.

Objective To evaluate gastric varices embolization by endoscopic ultrasonography (EUS). Methods One hundred and eighty-five hepatic cirrhosis patients complicated with gastric varices were divided into two groups, the EUS group, 109 patients and the control group, 76 patients. Ninty-nine patients with confirmed gastric varices by EUS in the EUS group were treated by Histoacryl. All of the patients were examined by EUS soon after the embolization and at three months later. While 76 cases confirmed by endoscopy in the control group were treated by Histoacryl who only examined by EUS three months later. Results The rate of hemostasic both were 100% and rebleeding never occurred within three weeks in EUS group while the rate of the early rebleeding in the control group was 11. 8% (9/76). There was significant difference between the two groups (P

AIM:To investigate effects of propolis-ethanol extract on platelet activity in flowing blood.METHODS: Intima-injury model was made by in vitro perfusion.Coverslips was coated by using fibrinogen and human Ⅲ type collagen to detect platelet adhesive rate when blood went through fibrinogen and collagen surface in 1 000/s shear rate.Three experimental groups were set up: negative control group(24% ethanol),experimental group(0.1 g/L,24% propolis-ethanol extract) and positive control group(0.1 g/L,ferulic acid).RESULTS: Intima-injury model was made.On fibrinogen and collagen,platelet adhesion on area of experimental group was lower than that in negative control group(P0.05).Propolis-ethanol extract decreased more obviously the platelet adhesion area on fibrinogen surface than that in collagen surface(P