The Bmax and Kd of beta-adrenoceptors in splenie lymphocytes of rats were determined by direct binding of radioligand, ~3H-dihydroalpranolol. Bmax of beta-adrenoceptors was significantly increased on day+1, was peak on day+2 and gradually reduced to control values on day+ 6 after the intraperitoneal injection of 5?10~9SRBC. A positive correlation (r=0. 86) was found between the Bmax of beta-adrtenoceptors on day+1 to+3 and the amount of Ig M in s(?)rum after 72 hours. Both the Bmax of beta-adrenoceptors on day+2 and the amount of Ig M in serum on day+5 were reduced by the intraperitoneal injection of propranolol. In study on antibody response to SRBC.in vitro, Ig M Synthesis in mouse spleen cells was enhanced by norepinephrine (10?mol/L), and blocked by propranolol (1?mol/L). These results indicated that: (1) the immune response to SRBC in vivo up-regulates the density of beta-adrenoceptors in splenic lymphocytes; (2) the up-regulation of Bmax of beta-adrenceptors in splenic lymphocytes may increase its Ig M synthesis;(3) the enhancement of the Ig M antibody response to SRBC in vitro by norepinephrine was mediated by the beta-adrenoceptors.

~3H-Clonidine, a potent and selective alpha2-adrenergic agonist was used to label alpha2-a-drenoceptors in intact lymphocytes isolated from rat spleen. Binding of ~3H-Clo-nidine was rapid(t1/2: 2min)and readily reversed by 10umol?L~(-1) clonidine(t1/2: 3-4min). ~3H-Clonidine saturationexperiments indicated a single c1ass of site with a K_D of 6.57?1.63nM and Bmax of 72.4?13.4 fmol/10~7 lymphocytes. Adrenergic agonists competed for ~3H-clonidine binding site with anorder of potency:epinephrine)norepinephrine)isoproterenol. These results show the presence ofalpha2-adrenoceptors in splenic lymphocytes. Computer analysis of competition experiments withadrenergic agonists revealed three classes of sites: high affinity site, medium affinity site and lowaffinity site. The affinity of high affinity site is 2-3 orders of magnitude higher than the one ofmedium affinity site, whereas the latter is the same orders higher than low affinity site Using im-proved Mishell-Dutton method, 10umol?L~(-1) clonidine suppressed the Ig M synthesis and thesuppression was blocked by 10 umol?L~(-1) phentolamine. These results indicate the suppression ofIg M antibody response to SRBC in vitro by clonidine is mediated by the alpha-adrenoceptors.

Objective To study the brain protection of sequential double-sided antegrade cerebral perfusion to central nervous system in arotie arch surgery. Methods 24 patients received aortic arch replacement under deep hyperthermic circulatory arrest (DHCA) ,with fight-sided, and following double-sided, and left-sided,if necessary, antagrade cerebral perfnsion through right axillary arterial cannula or right femoral arterial eannula homeochronously. Post-operation recovery and the central nervous complications (CNC) were recorded and analyzed. Results 2 cases died, one of whom died of refractory low cardiac output syndrome and the other died of late massive gastrointestinal tract hemorrhage. No patient suffered severe CNC. Conclusion Sequential double-sided antegrade cerebral perfusion combined with DHCA can provide good brain protection in arotic arch replacement.

Objective:To elucidate the spatial distribution patterns of the right hepatic vein by analyzing the image information obtained after CT three-dimension reconstruction of liver to provide guidance in surgical planning of anatomical hepatectomy.Methods:A retrospective analysis was performed on the clinical data of 77 subjects who underwent CT examination of the liver at the Second Affiliated Hospital of Harbin Medical University from September 2018 to October 2021. There were 42 males and 35 females, aged (50.2±12.8) years old. CT DICOM data of the patients were collected, and the two-dimensional image data were reconstructed into a three-dimensional model by using the 3D reconstruction software. The characteristics and typing were studied by analyzing the number of branches of the right hepatic vein and the spatial location of the main trunk.Results:Of 77 subjects, 645 branches of the right hepatic vein were observed in the liver CT 3D reconstruction model, including 268 (41.6%) right-sided branches, 240 (37.2%) dorsal branches, 70 (10.9%) left-sided branches, and 67 (10.3%) ventral branches. Each right hepatic vein possessed 3 (3, 4) right-sided branches, 3 (3, 4) dorsal branches, 1 (0, 1) left-sided branch, and 1 (0, 1) ventral branch. The numbers of branches in the four directions were significantly different ( H=175.89, P<0.001). Comparison showed that the number of right-sided branches was significantly more than that of the left-sided (χ 2=136.86) and ventral (χ 2=140.07), respectively. The number of dorsal branches was more than that of left-sided (χ 2=-123.36) and ventral (χ 2=126.57) branches, respectively. The differences were significant ( P<0.001). There were no significant differences between the number of ventral and left-sided branches, and between the dorsal and right-sided branches (all P>0.05). Conclusion:The right hepatic vein had fewer ventral and left-sided branches. It is relatively safe to dissect the right hepatic vein from the ventral or the left side during surgery. For resection of the central liver segments or segment VIII of the liver, it is reasonable to transect the liver along the left border of the right hepatic vein.

Objective To analyze the independent risk factors and complications for perioperative hyperbilirubinemia in Stanford type A aortic dissection undergoing operation and investigate the management strategy of perioperative hyperbilirubi-nemia. Methods Between January 2013 and January 2018 from the department of great vessel surgery of heart centre of,290 cases of patients with Stanford type A aortic dissection undergoing operation were collected consecutively,male 210 cases,fe-male 80 cases. The related data and perioperative peak hyperbilirubinemia were recorded. According to the perioperative peak hyperbilirubinemia,patients were divided into 2 groups:&ge;51. 3 μmol/ L group and < 51. 3 μmol/ L group. Univariate and lo-gistic regression analysis were used to identify the independent risk factors. The perioperative complications were also recorded. Results Preoperative total bilirubin &ge; 17. 1 μmol/ L(OR = 2. 105,95％ CI: 1. 153 - 3. 125,P = 0. 016),cardiopulmonary bypass time > 3. 5 h(OR = 1. 103,95％ CI: 1. 316 - 6. 151,P = 0. 031),a large number of hemolysis(OR = 1. 503,95％CI: 1. 506 - 6. 651,P = 0. 029),the input amount of 24 h allogeneic red blood cell > 2000 ml(OR = 1. 381,95％ CI:0. 956 - 2. 552,P = 0. 036)were the independent risk factors for perioperative hyperbilirubinemia. The incidence rate of post-operative acute hepatic failure(2. 5％ vs. 0,P = 0. 021)and artificial liver therapy(2. 5％ vs. 0,P = 0. 021)in&ge;51. 3μmol/ L group were significantly increased. The incidence rate of postoperative acute lung injury(37. 5％ vs. 25. 2％,P =0. 039)and acute kidney injury(38. 7％ vs. 19. 5％,P = 0. 035)in 51. 3 μmol/ L group were also significantly increased. The duration of mechanical ventilation[(4. 1 ± 1. 6)days vs. (2. 8 ± 1. 3)days,P < 0. 05]and ICU stay time[(5. 1 ± 2. 3)days vs. (3. 9 ± 1. 8)days,P = 0. 035]and hospitalization time[( 19. 3 ± 3. 1)days vs. ( 17. 3 ± 2. 5)days,P = 0. 035]were sig-nificantly prolonged. Temporary nerve dysfunction(52. 5％ vs. 32. 6％,P = 0. 002)and in-hospital mortality( 17. 5％ vs. 8. 1％,P = 0. 037)were significantly increased. Conclusion Preoperative total bilirubin &ge; 17. 1 μmol/ L,cardiopulmonary bypass time > 3. 5 h,a large number of hemolysis,the input amount of 24 h allogeneic red blood cell > 2000 ml were the in-dependent risk factors for perioperative hyperbilirubinemia in Stanford type A aortic dissection. The perioperative complications in&ge;51. 3 μmol/ L group were significantly increased. Therefore,more attention should be paid to the independent risk factors for perioperative hyperbilirubinemia in Stanford type A aortic dissection,hyperbilirubinemia and its clearance should be moni-tored more actively and dynamically,the cause should be found more precisely,the treatment be more comprehensive to achieve to control the level of bilirubinemia and improve the prognosis.