Hemodynamics ; Humans ; Hypertension, Portal ; physiopathology ; surgery ; Portal Vein ; physiopathology ; Portasystemic Shunt, Surgical ; methods

Objective To determine the mechanism of nitric oxide synthase(NOS) and prostacyclin(PGI2) acting on splanchnic hyperdynamic circulation of portal hypertention(PHT). Methods Ninety-six Sprague-Dawley rats were divided into three groups, namely, intrahepatic portal hypertension(IHPH, n=31), prehepatic portal hypertension(PHPH, n=33) and sham-operated controls(SO, n=32). Animals of each group were received indomethacin(INDO) either on a short term or long term with saline as control. Portal venous pressure, together with the concentration of nitric oxide (NO) and PGI2 in serum was measured. The constitutive nitric oxide synthase(cNOS)and inducible nitric oxide synthase(iNOS)activity in the abdominal aorta and small intestine of these rats were detrmined by spectrophotometry method. RT-PCR was performed to measure the levels of iNOS and cNOS mRNA in the arteries and guts mentioned above. Results Although INDO decreased the concentration of PGI2 in serum, the long-term INDO-treated group restored splanchnic hyperdynamic circulation in both IHPH and PHPH rats, concomitant with enhanced expression of iNOS and concentration of NO(P0.05). Conclusion Overproduction of NO inducing hemodynamic abnormalities of PHT is synthesized principally by increase of iNOS. There may be a possible interaction between PGI2 and NO in hyperhemodynamics of PHT, while PGI2 may not be a mediator in the formation and development of hyperdynamic circulatory state.

AIM: To compare the effects of different surgeries in the treatment of angle closure glaucoma with cataract and the improvement of quality of life.METHODS: The clinical data of 60 cases (60 eyes) with angle closure glaucoma and cataract who were admitted to the hospital between January 2014 and October 2016 were collected.According to the surgical method, they were divided into the control group (simple trabeculectomy, n=28) and the observation group (trabeculectomy combined with phacoemulsification and intraocular lens implantation, n=32).The changes of visual acuity and intraocular pressure before and after surgery were compared between the two groups.The incidence of postoperative complications was statistically analyzed, and the quality of life was compared between the two groups.RESULTS: Before surgery, there was no significant difference in visual acuity, intraocular pressure and anterior chamber depth between the two groups (P>0.05).At 4wk after surgery, the visual acuity of two groups increased and intraocular pressure decreased.The anterior chamber depth of observation group increased while that of the control group decreased (P<0.05).At 4wk after surgery, the visual acuity and anterior chamber depth of observation group were higher than that of the control group but intraocular pressure was lower than that of control group (P<0.05).The success rate of surgery and the opening rate of chamber angle after surgery in the observation group were higher than those in the control group (P>0.05).The incidence of postoperative complications in the observation group was lower than that in the control group (P<0.05).Before surgery, there was no statistically significant difference in quality of life score between the two groups (P>0.05).At 4wk and 3mo after surgery, the scores of the two groups increased (P<0.05), and the quality of life scores of observation group were higher than those of the control group at different time (P< 0.05).CONCLUSION: The success rate of trabeculectomy combined with phacoemulsification and intraocular lens implantation is high in the treatment of angle closure glaucoma with cataract.The regimen can improve the visual function, reduce the incidence of postoperative complications, and improve the quality of life of patients.

Objective:To observe the clinical effects of acupuncture plus external medicine application for cervical radiculopathy.Methods:A total of 98 patients with cervical radiculopathy were randomly divided into an observation group and a control group based on the random digital table.The observation group (50 cases) was treated by acupuncture plus external medicine application and the control group (48 cases) was treated by acupuncture alone.The patients received the treatment every day.Ten sessions made a course.Cervical spondylosis symptom scale was used to assess the cases before and after the treatment.The clinical efficacy was compared between the two groups after the treatment.Results:The total effective rate was 98.1％ in the observation group versus 87.6％ in the control group with a statistically significant difference between the two groups (P＜0.05).The cure rate was 52.0％ in the observation group versus 18.8％ in the control group with a significant difference between the two groups (P＜0.05).There was no significant difference in the score of cervical spondylosis symptom scale between the two groups before the treatment (P＞0.05).It increased with a significant difference in both groups after the treatment (both P＜0.05),while a significant difference was found in the results between the two groups after the treatment (P＜0.05).Conclusion:Acupuncture plus external medicine application is more effective than acupuncture alone for treating cervical radiculopathy.The method also effectively improves the clinical symptoms.

Objective To investigate the expressions of nitric oxide synthase (NOS) protein and mRNA in the lung of rats with hepatopulmonary syndrome. Methods Male Sprague-Dawley rats were divided into four groups: sham operation (SO), intrahepatic portal hypertension (IHPH), prehepatic portal hypertension (PHPH) and portasymstimic shunt (PCS). Two weeks after preparation of rat models, the following measurements were performed: arterial blood gas analysis; the concentrations of NO in lungs; in situ hybridization of ecNOS and iNOS mRNA expressions in lung tissue sections with digoxin-labeled ecNOS and iNOS oligonucleotide probes; expressions of ecNOS and iNOS proteins by immunohistochemisty; image and semiquantitative analysis of the expressions of ecNOS, iNOS and their mRNA. Results PaO_ 2 was (73.85?6.51) mmHg in IHPH rats, significantly lower than that in PHPH, PCS and SO rats97.39? 1.33, 95.23?2.22 and (99.05?0.75)mmHg, respectively.The level of lung NO of IHPH was(19.78?5.33)?mol per gram of protein,much higher than that of PHPH, PCS and SO 13.21?3.99,13.89?3.16 and (8.71?1.68)?mol per gram of protein,respectively. In capillary endothelia, positive expressions of ecNOS mRNA and ecNOS protein in IHPH(4.96?0.82,4.11?0.28) were significantly higher than those of PHPH (1.81? 0.39, 1.63?0.18), PCS (1.88?0.53,1.83?0.16)and SO(1.19?0.32,0.98?0.20). Conclusion The expressions of NOS protein and mRNA in the lung of rats with hepatopulmonary syndrome were increased, and the level of lung NO was elevated, which seems to play an important role in the pathogenesis of hepatopulmonary syndrome.

Objective To summarize and discuss the diagnostic and treating experiences of chronic pancreatitis with mass in the head. Methods Eight patients of chronic pancreatitis with mass in the head who were misdiagnosised as carcinoma of head of pancreas were analyzed retrospectively in the past 10 years. Results All the patients exhibited abdominal pain,5 of whom were with jaundice and 3 with anorexia. All the patients were misdiagnosised as carcinoma of head of pancreas before the operation,but the pathology after operation indicated chronic pancreatitis. The pancreaticoduodenectomy was performed in 5 patients,the choledochojejunostomy in 2 patients,while the exploratory laparotomy in 1 patient. After the operations,the abdominal pain was relieved in 7 patients, while 2 patients who accepted pancreatoduodenectomy suffered from pancreatic fistula,1 of whom died in the end. Conclusion It’s hard to differentiate the chronic pancreatitis with mass in the head from the carcinoma of head of pancreas before operation. If the carcinoma of head of pancreas can’t be excluded during the operation,the pancreatoduodenectomy should be performed,while the duodenum-preserving total resection of the head of the pancreas or any intra-drainage operations should be done if chronic inflammation is found in the whole pancreas with a negative result of the biopsy of the pancreas through the needle aspiration.

Cell Adhesion ; drug effects ; Cell Movement ; drug effects ; Focal Adhesion Kinase 1 ; genetics ; metabolism ; Focal Adhesion Protein-Tyrosine Kinases ; Neoplasms ; Phosphorylation

Objective To investigate the clinical effectiveness of coronary artery bypass grafting through descending thoracic aorta in elderly patients with coronary heast disease and to decrease the post-operative complication.Methods Thirteen elderly patients underwent coronary bypass surgery with minimally invasive direct coronary artery bypass (MIDCAB).Age range from 70 to 82 years with a mean of(72.1?6.0)years.Patients suffered from multi vessel disease.Many minimally invasive techniques of“Y”blood vessel graft anastomosis,anastomosis of blood vessel graft to descending aorta,minimally invasive direct,thoracoscope assist were used.Results All patients were survived.The mean duration of intubation was (6.9?0.9) hours.The average ICU stay was (2.5?0.5)days.No patients received blood transfusion.During the short-term follow-up(3 to 14 months) patients had no complaint of angina,Conclusions The technique of“Y”blood vessel graft anastomosis,descending aorta blood vessel graft,minimally invasive direct and thoracoscope assist in combination with coronary artery bypass grafting is a safe and cost-effective new procedure for elderly patients with multi-coronary artery disease.

Objective To investigate the diagnosis and treatment of mucinous cystadenoma and cystadenocarcinoma of the pancreas. Methods The clinical data of 23 patients with pancreatic mucinous cystadenoma or cystadenocarcinoma confirmed by pathology from May 1993 to October 2005 was retrospectively studied. Results Fifteen cases of mucinous cystadenoma, 4 cases of mucinous cystadenocarcinoma, and 4 cases of mucinous cystadenoma with malignancy were included in this data. Ultrasonography, CT, and MRI/MRCP displayed a cystic tumor in 73.7%, 68.8%, and 83.3% of all patients, respectively. The mean diameter of the tumors was 9.4 cm, and the maximum diameter of the tumors was 20 cm. Pancreaticoduodenectomy, distal pancreatectomy and splenectomy, local excision of cystadenoma and other procedures were performed according to the site of tumors. The resectable rate was 82.6%. Twenty-one patients (91.3%) were followed up. All of the 14 patients with mucinous cystadenoma were alive with the follow-up from 4 months to 11 years after operation. Two of the 4 cases of mucinous cystadenoma with malignancy were alive with the follow-up of 5 months and 4 years after operations, while the other 2 died with the survival time of 15 months and 18 months. One patient with mucinous cystadenocacinoma was alive 5 months after operation, while the other 2 died with the survival time of 7 months and 13 months. Conclusion Mucinous cystadenoma has a malignant tendency. As the mucinous cystadenocacinoma is a low malignant potential tumor, the resectable rate is high and prognosis is satisfactory. The excision of total tumor including the surrounding pancreatic tissue is the first choice of the treatment. Pancreaticoduodenectomy, distal pancreatectomy and splenectomy, and other procedures according to the site tumors is feasible.

OBJECTIVETo analyze the factors which influence the safety and prognosis of aorta replacement combined with coronary artery bypass grafting (CABG) for thoracic aortic aneurysm associated with coronary artery disease.

METHODSFrom May 1982 to October 2002, 67 patients with thoracic aortic aneurysm were admitted, and 24 of them combined with CABG. Of the 24 patients, 9 received descending aorta replacement combined with CABG, and the other 15 received the ascending aorta replacement combined with CABG. The treatment results were compared with the other 43 patients only undergoing the thoracic aortic replacement.

RESULTSThe mortality rate of the patients with aorta replacement combined with CABG was 13% (3/24). Though the descending aorta replacement combined with CABG could make the cardiopulmonary bypass time and selective cerebral perfusion time longer, (278 +/- 54) min and (188 +/- 59) min respectively, no significant difference was observed in postoperative complications, 3-year survival rate, 3-year-cardiac-event-free rate compared with the patients only undergoing the thoracic aortic replacement (P > 0.05).

CONCLUSIONSThe aorta replacement combined with CABG can be performed safely, and the revascularization for coronary artery disease is useful for preventing occurrence of cardiac events.

Aorta, Thoracic ; surgery ; Aortic Aneurysm, Thoracic ; complications ; surgery ; Blood Vessel Prosthesis Implantation ; Coronary Artery Bypass ; Coronary Artery Disease ; complications ; surgery ; Female ; Humans ; Male ; Retrospective Studies ; Time Factors