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 study the experience of diagnosi and reatment of gasrinoma.Mehod.A etropectie study of 1 patients with astrinoa seen from 1978 through 1998 in PUMC hospital.Results.Three of the 17 cases were associated with multiple endocrine neoplasia tye I(MEN-I)syndrome.Tumors dispersed extensively in pancreas(31%),duodenm(25%),lymphnode(19%)and other place(25%).Ultrasonography and computed tomography(CT)were sensitive in ocalizig tumor in panceas andliver,but were not so well for small tumor in duodenum and lymph node.The angiography,percutaneous transhepatic portal sampling(PTPS),scintigraphy and ndoscopc ultraonography(EUS)also can be used.Sixteen of 17 patients underwent 38 operatons and 56 percent of the 16 cases underwent several operations.Seven patients at last performed total gastrectomy that was still considered as a choice of treatment.Tumor resection was rre because the advancing of tumor in most cases.Conclusions.Diagnosing gastrinoma in its early stage and striving for the tumor resection and reducing the metastasis of liver were the cruxes for good prognosis.Gastrnoma,also called Zollinger-Ellison syndrome,is clinically charactarized by evee peptic ulcer and diarrhea,it takes th seond place in all islet cell tumors of the pancreas,accounts for 0.1% of peptic ulcer in abroad(1).But little information is available in China.From 1978 through 1998,17 cases of gastrinoma were treated in our hospital.This paper reports the experiences of diagnosis and treatment of gastrinoma.

Nowadays surgical technologies develop fast under the guidance of minimally invasive medicine,evidence-based medicine,multi-disciplinary team and other ideas.However,the long-term outcome of pancreatic cancer remains dismal.In addition to the improvement of surgical resection rate,more attention should be paid to improve the overall survival rate of the patients with pancreatic cancer after surgery.Clinical studies of neoadjuvant therapies for the treatment of borderline resectable pancreatic cancer are advocated.Various types of pancreaticojejunostmy should be applied individually to improve the anastomosis quality and to reduce the postoperative complications.In the system of precision medicine,standardized surgical treatment pattern remains important.

Nowadays surgical technologies develop fast under the guidance of minimally invasive medicine,evidence-based medicine,multi-disciplinary team and other ideas.However,the long-term outcome of pancreatic cancer remains dismal.In addition to the improvement of surgical resection rate,more attention should be paid to improve the overall survival rate of the patients with pancreatic cancer after surgery.Clinical studies of neoadjuvant therapies for the treatment of borderline resectable pancreatic cancer are advocated.Various types of pancreaticojejunostmy should be applied individually to improve the anastomosis quality and to reduce the postoperative complications.In the system of precision medicine,standardized surgical treatment pattern remains important.

Objective:To understand the current status of the compliance of immunosuppressive drugs in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) and to explore the influencing factors of their compliance.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 238 allo-HSCT patients who were followed up in the Transplant Center of Taizhou Hospital of Zhejiang Province, Zhejiang Provincial Hospital of Traditional Chinese Medicine and the First Affiliated Hospital of Wenzhou Medical University from March 2020 to February 2021 were selected as the research objects. The self-designed general information questionnaire, Basel Assessment Scale for Immunosuppressive Drug Compliance, Chinese version of Medication Belief-Specific Scale, General Self-Efficacy Scale, Perceived Social Support Scale and Family Care Index Scale were used for on-site investigation of patients. Pearson correlation analysis was used to analyze the correlation between medication compliance and medication belief, self-efficacy, social support and family care of allo-HSCT patients. Multiple linear regression analysis was used to investigate the influencing factors of immunosuppressive medication compliance in allo-HSCT patients.Results:A total of 238 questionnaires were distributed in this study, and 228 valid questionnaires were finally recovered. The medication compliance score of allo-HSCT patients was (4.80±1.18) points. And 111 patients (48.68%, 111/228) had poor medication compliance, among which the incidence of not taking medication on time was the highest, accounting for 44.30% (101/238) . Multiple linear regression analysis showed that average monthly family income, rejection, medication belief, social support and family care were the influencing factors of medication compliance ( P< 0.05) . Conclusions:The immunosuppressant medication compliance of allo-HSCT patients is at a medium and low level. Average monthly family income, rejection reaction, medication belief, social support and family care are the main factors affecting the immunosuppressant medication compliance of allo-HSCT patients. Medical staff should formulate targeted intervention measures according to the influencing factors of medication compliance to improve the immunosuppressive medication compliance of allo-HSCT patients.

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