Objective To investigate the effects of cardioplegic solution containing different concentrations of emulsified isoflurane on myocardial ischemia-reperfusion injury in isolated rat hearts. Methods Fifty-six male SD rats, weighing 180-250 g, were anesthetized with intraperitoneal 20% urethane 1 g/kg and heparin 1 000 U/kg. Their hearts were excised and perfused in a Langendorff apparatus. Fifty-six isolated hearts were randomly divided into 7 groups ( n = 8 each) : St. Thomas cardioplegic solution group (group C) and St. Thomas cardioplegic solution containing 6 different concentrations of emulsified isoflurane groups (group E1-6 ). After 20 min equilibration, cardiac arrest was induced with St. Thomas cardioplegic solution 20 ml and St. Thomas cardioplegic solution containing 0.28, 0.56, 1.12, 1.68, 2.24 and 2.80 mmol/L emulsified isoflurane 20 ml at 4℃for 45 min followed by 60 min reperfusion in group C and E1-6 respectively. HR, left ventricular developed pressure (LVDP), left ventricular end-diastolic pressure (LVEDP) and + dp/dtmax were recorded at the end of 20 min equilibration, 20, 40 and 60 min of reperfusion. Coronary effluent 1.5 ml was collected for determination of LDH and SOD activity and the concentration of cTnI. At the end of 60 min reperfusion, the area of myocardial infarction was calculated. Results Compared with group C, HR, LVDP, + dp/dtmax and SOD activity were significantly higher, LVEDP, LDH activity and cTnI concentration lower, and the area of myocardial infarction lower in group E4, and HR, LVDP, + dp/dtmax and SOD activity were significantly lower, LVEDP, LDH activity and cTnI concentration higher, and the area of myocardial infarction higher in group E6 and E6 ( P < 0.05) , but there was no significant difference in the above indices between group E1-3 and group C ( P > 0.05) . HR, LVDP, + dp/dtmax and SOD activity were significantly lower, LVEDP, LDH activity and cTnI concentration higher, and the area of myocardial infarction higher in group E1-3-5-6 than in group E4 (P < 0.05 ). Conclusion St. Thomas cardioplegic solution containing 1.68 mmol/L emulsified isoflurane can attenuate myocardial ischemia-reperfusion injury in isolatede rat hearts.

Objective [WT5”BZ] To evaluate the surgical treatment of insulinomas in the head and neck of the pancreas. [WT5”HZ]Methods [WT5”BZ] Data of 43 patients with insulinomas located in the head and neck of the pancreas during the past 16 years in PUMC Hospital were analyzed retrospectively.[WT5”HZ] Results [WT5”BZ] The average age of patients was 37 years old with an average preoperative history of 2 7 years. The preoperative accuracy of PTPC, DSA, B ultrasound, CT and MRI were 89 5%,72 5%,22 4%,25 3% and 66 7% respectively. The accuracy of intraoperative palpation was 97 8%. Enucleation of tumors was usually applied, and distal pancreatectomy or Roux en Y pancreaticojejunostomy were performed in 7 cases. The incidence of postoperative pancreatic leakage was 32 6%.[WT5”HZ] Conclusions [WT5”BZ] Selection of operation methods depends on the relationship of tumor with pancreatic duct and bile duct. Intraoperative monitoring of blood glucose is an essential mean to verify the complete resection of tumors. [WT5”HZ]

Objective To analyze the clinical characterist ic s and treatment of chronic idiopathic intestinal pseudo-obstruction(CIIP). Methods We retrospectively reviewed 8 C IIP patients admitted to our hospital from 1980 to 1999. There were 4 males and 4 females, with an average age of 29 years. Results The earliest onset of symptom was at an age of 2 years old. Re current abdominal distention is the most common symptom. Gastrointestinal imagin g and colonoscopy showed dilated loops of bowels with no evidence of mechanical obstruction. Delayed gastric emptying was presented by radionucleotide(~99m Tc-Sc) gastric emptying test. Gastrointestinal manometry showed low pressure in esophagus and colon. Biopsy taken in 2 patients showed chronic inflammation. On e patient underwent total colectomy for the treatment of lesions confined within the colon. Prokinetic agents have limited efficacy. Conclusions CIIP is a rare disease. Operation is not a prima ry method for treatment. The patients usually have poor prognosis.

According to the unique geographical conditions,climatic factors,human constitution,dietary custom,social environment and so on,the main etiology of exogenous cough in Lingnan areas is pathogenic dampness;and the main pathogenesis is phlegm-dampness internal retention and impaired and descending of lung.The syndrome of phlegm-dampness and syndrome of phlegm-heat are more common clinical types.We propose eliminating dampness and resolving phlegm,dispersing and descending lung qi as its main therapeutic methods.For chronic cough,it often have to take the therapeutic methods of strengthening spleen and nourishing lung.

This study was aimed to observe the effect ofIllicium verum water extract on excess-cold syndrome in rats. The intragastric administration of the decoction of gypsum, gentian, phellodendron andrhizoma anemarrhenae (2:1.2:1:1.5) was used to establish the excess-cold rat model. Effects ofI. verum water extract on general body signs of excess-cold syndrome rats were observed. The detection was made on the contents of LD, PA, TG, TSH, T4 in the serum and LD, PA, glycogen in liver tissues. The vitality of the LDH, SDH and ATPas was also detected. The results showed thatI. verum water extract can improve the general body signs of excess-cold syndrome rats. It reduced the content of TG; increased the content of PA, T4, TSH; reduced the content of LD, glycogen, and the vitality of LDH;increased the vitality of LDH, Ca2+-Mg2+-ATPase in liver tissues. It was concluded thatI. verum water extract can improve some general body signs of excess-cold syndrome rats, improve the substance and energy metabolism, and regulate the thyroid axis function, in order to achieve the warmingyang for dispelling cold effect.

Objective To summarize the diagnostic and therapeutic experiences for multiple insulinoma. Methods Clinical data of 34 cKsefl of multiple insulinoma treated in Peking Union Medical College Hospital between 1984 and 2007 were analyzed retrospectively. Results Multiple insulinoma was identified in these 34 cases for 37 instances.Malignant insulinoma was found in 2 cases.Three cases suffered from postoperative recurrent multipie tumors.35.3% cases belonged to MEN1;13.5% cases were of insulinoma combined with islet hyperplasia;43.2% cases had 3 or more than 3 insulinomas;Fifteen cases (40.5%)had had a misdiagnosis.45.2%tumors were smaller than 1 cm in diameter:88.9%multiple insulinonla located at the body and tail of the pancreas.Enucleation of multiple tumors was performed for 48.7 percent of cases. Conclusions Most multiple insulinomas were small,it was difficult for preoperative examination to locate all the tumors therefore.Being on the alert against multiple insulinoma and such measures as careful exploration,intraoperative blood glucose determination.fine needle aspiration biopsy,frozen sections helps to avoid missing multiple imuhnoma.

To establish stable methods for detecting plasma endotoxin level and endotoxin inactivation capacity in a normal population and general surgical patients and evaluate their perioperative changes. 50 healthy people and 50 patients receiving gastrointestinal operation were enrolled, their plasma endotoxin levels and plasma endotoxin inactivation capacity were assayed. Our results showed that plasma endotoxin levels were 0.044 +/- 0.009 EU/ml in the normal population and 0.044 +/- 0.023 EU/ml in the preoperative patients. Endotoxin level peaked 3 h after the operation (0.223 +/- 0.041 EU/ml), and then decreased rapidly on the first day after the operation (0.134 +/- 0.164 EU/ml). Endotoxin inactivation capacity also had the same time course as endotoxin level. Systemic inflammatory response syndrome and infection induced another elevation in the time course. It is concluded that establishing the endotoxin standard curve by using pyrogenic free water is better than by using plasma. Plasma endotoxin inactivation capacity can be used as an indirect indicator of postoperative immune depression. Plasma endotoxin level and endotoxin inactivation capacity peaked shortly after operation, indicating surgical stress is closely related with the changes.
Adult ; Aged ; Colorectal Neoplasms ; blood ; surgery ; Endotoxins ; blood ; Female ; Humans ; Limulus Test ; methods ; Male ; Middle Aged ; Postoperative Period ; Reference Values ; Stomach Neoplasms ; blood ; surgery ; Stress, Physiological ; blood ; Systemic Inflammatory Response Syndrome ; blood

[ ABSTRACT] AIM:To investigate the effects of Chaihu Shugan powder ( CSP) on lipid metabolism and the pro-teins involved in adenosine 5’-monophosphate-activated protein kinase (AMPK)/sirtuin 1 (SIRT1) pathway in the liver tissues of the rats with non-alcoholic fatty liver disease (NAFLD).METHODS: Sprague-Dawley rats were randomly di-vided into normal control ( NC) group, with HFD ( HFD) group and CSP group.The NAFLD models were established by feeding with HFD for 16 weeks in the rats.The rats in CSP group were intragastrically administered with CSP extracts (9.6 g· kg-1 · d-1 ) , and blood and liver samples were collected 16 weeks later.Serum and liver levels of total cholesterol ( TC) and triglyceride ( TG) , and serum levels of alanine aminotransferase ( ALT) and aspartate aminotransferase ( AST) were measured using an automatic biochemical analyzer.The histological changes of liver tissues were observed with HE staining, while the lipid deposition was observed with Oil Red O staining.The ultrastructural changes of the liver tissues were observed under transmission electron microscope.Moreover, the protein levels of AMPK, phosphorylated AMPK (pAMPK), SIRT1 and uncoupling protein 2 (UCP2) in the liver were detected by Western blot.RESULTS:The results of HE staining, Oil Red O staining and electron microscopy demonstrated that NAFLD rat model was successfully estab-lished.Compared with NC group, the serum and liver levels of TC and TG, and serum level of AST in model group were markedly elevated ( P<0.01) .Moreover, the protein levels of pAMPK and SIRT1 in HFD group were markedly reduced (P<0.01), whereas UCP2 level was elevated (P<0.01).Furthermore, liver levels of TC and TG, and serum level of AST in GSP group were markedly reduced as compared with HFD group ( P<0.05 ) .The protein levels of pAMPK and SIRT1 were elevated ( P<0.05 ) , whereas the UCP2 level was reduced as compared with HFD group ( P<0.01 ) .The protein level of AMPK between the 3 groups had no significant difference.CONCLUSION: CSP attenuates hepatic lipid disorder and hepatic lipid deposition in NAFLD rats induced by feeding with HFD for 16 weeks, which is associated with the activation of AMPK/SIRT1 pathway.

Objective To explore the clinical application and value of percutaneous treatment of pancreatic pseudocysts guided by CT.Methods The percutaneous external draining of pancreatic pseudocyst caused by various causes was performed under CT guidance in 29 cases, including 21 males and 8 females, age from 22 to 71 years, average (48.2?13.6) years. After the point, the angle,and the depth of puncture were measured on CT images, pseudocyst puncture and catheterization of external draining were made and followed up. Results 30 procedures of puncture in 29 lesions were done, the successful rate was 100%. Puncture path included frontal in 17 cases(18 times of puncture), lateral in 8 cases ; back in 4 cases, and 30 drainage catheters were placed. All cases were followed up except one case, follow up time ranged from 1 to 20 months [average (8 07?4 04) months]. Following disappearance of pseudocyst, catheters were extracted in 19 cases except 2 cases with pseudocyst recurrance. Follow up time from 4 to 14 months[average (8.29?4.03) months]. 5 cases had surgerical operations again after draining 1-4 months, 4 cases were still being followed up. The effective rate of therapy was 65.52%(19/29). Conclusion The technique of percutaneous catheter external draining of pancreatic pseudocyst guided by CT is mildly invasive and simple, and has high successful rate.

Objective To study the influence of miR-191 expression on the proliferation of human malignant meningioma cell line IOMM-Lee in vitro and to explore its mechanism.Methods The expression of miR-191 in malignant meningioma tissue,the adjacent normal tissues and human Malignant meningioma cell lines IOMM-Lee and CH157-MN was tested by Realtime PCR.miR-191 inhibitor was transfected in IOMM-Lee cells and MTT assay was employed to detect the cell viability.Bioinformatics prediction software was used in miR-191 target gene predictive analysis and verified by luciferase reporter system.The effect of EGR1 siRNA on the proliferation of IOMM-Lee cells was observed.Prorein interaction database was used to analyze which proteins could interact with EGR1.The effect of inhibition of EGR1 expression on TP53 protein expression was detected.The influence of inhibition of miR-191 expression on EGR1and TP53 expression was observed.Result The expression of miR-191 in malignant meningioma tissue (0.933±0.144) was higher than that in the adjacent normal tissue (0.459±0.104,P＜0.05).The expressiong of miR-191 in humam malignant meningioma cell line IOMM-Lee (1.25±0.07) was higher than that in CH157-MN cell line (0.50±0.14,P＜0.05).The cell proliferation capability was significantly decreased in miR-191 inhibitor group [(0.53±0.02) vs (0.74±0.01),P＜0.05].EGR1 was identified and validated to be a target gene of miR-191.Inhibition of EGR1 gene can promote OMM-Lee cell proliferation (0.83±0.02,0.71 ±0.01,P＜0.05).EGR 1 could positively regulate TP53 protein expression [(13 758.17±57.22) vs (10 239.00±71.30),P＜0.001.miR-191 Inhibition could increase EGR1 [(14 663.00±80.08) vs (11 184.33±153.90),P＜0.001] and TP53 expression [(15 206.17±102.08) vs(11 400.17±97.00),P＜0.001].Conclusion Downregulation of miR-191 can inhibit the proliferation of IOMM-Lee cell,which may be related to the upregulation of EGR1/TP53 signaling pathway.