To observe the influence of different concentrations of sevoflurane on blood brain barrier permeability in rats, thirty adult male SD rats were randomly divided into three groups: control group (without general anesthetics), 1 MAC sevoflurane and 1.5 MAC sevoflurane groups (maintaining end expiratory concentration to 2.2% and 3.3% respectively for 1 hour). Before the end of the experiment, 2% Evans′ blue dye (EB, 3ml/kg) was intravenously injected. The range and areas of EB staining on the surface and standardized serial coronal section of the brain were assessed. The brain was also observed under the light microscope and electron microscope. The results indicated that sevoflurane at both concentrations did not increase the permeability of BBB to EB and lanthanum, and there were no significant changes in morphological features of central nervous system after inhalation of sevoflurane.

Objective To measure the level of circulating endothelial progenitor cell (EPC) and serum vascular endothelial growth factor (VEGF), and to investigate its clinical significance in patients with different stages of renal cell carcinoma (RCC). Methods The level of circulating EPC was quantified by assaying CD45-CD34+VEGFR-R2 +cell phenotype in 45 patients with RCC (RCC group), 30 patients with benign renal tumors(benign renal tumors group) and 30 healthy controls (control group). Serum VEGF was quantified by enzyme- linked immunosorbent assay (ELISA). The results were compared. Results The level of EPC in RCC groups was (0.265 ± 0.042)%, in benign renal tumors group was(0.053 ± 0.008)% , and in control group was (0.048 ± 0.006)%. The level of EPC in RCC group was significantly higher than that in benign renal tumors group and control group (P<0.05). The level of EPC in Ⅲ- Ⅳ stage patients was significantly higher than that in Ⅰ-Ⅱ stage patients:(0.312 ± 0.038)%vs. (0.215 ± 0.021)%, P<0.05. Three months after operation, the level of EPC in 33 RCC patients without pretreatment was (0.078 ± 0.003)% and significantly lower that before treatment (P<0.05). The level of VEGF in RCC groups was (305.5 ± 29.1) ng/L, in benign renal tumors group was (29.8 ± 3.2) ng/L, and in control group was (25.1 ± 2.8) ng/L. The level of VEGF in RCC group was significantly higher than that in benign renal tumors group and control group (P<0.05). The level of VEGF inⅢ-Ⅳstage patients was significantly higher than that inⅠ-Ⅱstage patients:(365.6 ± 34.6) ng/L vs. (256.2 ± 23.2) ng/L, P<0.05. Pearson association analysis showed that the level of EPC had positive associations with VEGF (r=0.714, P<0.01). Multiple linear regression showed that the size of kidney neoplasms was a dependent factor for the level of EPC. Conclusions The level of EPC has a positive association with VEGF. EPC maybe a new biomarker for RCC.

Objective: To observe the clinical effect of pestle needle combined with Chinese herbal fumigation on cervical spondylosis and provide a safe effective therapy for this condition. Methods: A total of 54 cases were randomly allocated into two groups (27 cases in each group) according to their sequence of consultation. Patients in both groups were treated with the same Chinese herbal fumigation. Patients in the treatment group were additionally treated with pestle needle therapy on a unique set ofBa Zhen points around Dazhui (GV 14), Fengfu (GV 16) and the distance between Naohu (GV 17) and Dazhui (GV 14) along theHe Chepathway, whereas patients in the control group were additionally treated with routine acupuncture therapy. Then the short-term and long-term efficacies were observed and compared after treatment using the visual analog scale (VAS) and pain rating index (PRI). Results: At the end of treatment, VAS scores were significantly decreased in both groups, and the VAS score in the treatment group was lower than that in the control group (P<0.05). The intra-group differences were statistically significant in VAS scores 1 month, 3 and 6 months after treatment (allP<0.05). At the end of treatment, the sensory and total PRI scores in the treatment group were significantly lower than those in the control group, showing statistically significant differences (both P<0.01); and there was no significant between-group difference (P>0.05) in the affective PRI score. At the end of treatment, the total effective rate was 85.2% in the treatment group, versus 65.4% in the control group, showing a statistical significance (P<0.05). The follow-up six months later showed that the total effective rate was 92.6% in the treatment group, versus 76.9% in the control group, showing a statistical significance (P<0.05). Conclusion: Pestle needle therapy is a stable and positive therapy for cervical spondylosis.

Objective: To investigate the effects of neurokinin-1 receptor antagonist WIN 62, 577 on airway inflammation and airway hyperresponsiveness in asthmatic mice. Methods: Thirty-two BALB/c mice(Specific-pathogen-free grade) were randomly divided into 4 groups: control group, asthmatic group, WIN 62, 577 intervention group and dexamethasone group.The asthmatic group, the WIN 62, 577 intervention group, and the dexamethasone group were given intraperitoneal injection of 0.2 ml of OVA sensitization solution at 0 d, 7 d, and 14 d, respectively.Then the asthmatic group, WIN 62, 577 group and dexamethasone group were given OVA challenge solution(4% OVA solution) by inhalation once a day for 30 min from 21 d to 28 d for 7 consecutive days.The WIN 62, 577 intervention group was given WIN 62, 577 300 μg intraperitoneal injection 1 h before each challenge; the dexamethasone group was given intraperitoneal injection of dexamethasone 2 mg/kg 1 h before each challenge.The airway responsiveness of each group of mice was detected by non-invasive pulmonary function test.The bronchoalveolar lavage fluid(BALF) was obtained for inflammatory count.The HE staining of lung tissue was used to observe airway inflammation in mice. Results: Compared with the asthmatic group, the mice in the WIN 62, 577 intervention group showed less restlessness, standing upright, crouching back, scratching the ears and scratching the cheeks, shortness of breath and cyanosis of the lips.After inhaling different concentrations of acetylcholine, the Penh value of mice in the WIN 62, 577 intervention group and the dexamethasone group was significantly lower than that in the asthmatic group(P<0.05). Compared with the asthmatic group, the number of WBC and EOS in BALF decreased significantly in the WIN 62, 577 intervention group and the dexamethasone group(P<0.01). HE staining showed that the inflammatory changes in the lung tissue of mice in the WIN 62, 577 intervention group were significantly reduced, the bronchial epithelium did not fall off significantly, the mucosal edema was not obvious, the smooth muscle proliferation was reduced, and the inflammatory cell infiltration was reduced, similar to the airway changes in the dexamethasone group. Conclusion Neurokinin-1 receptor antagonist WIN 62, 577 can reduce airway inflammation and airway hyperresponsiveness in asthmatic mice.

Background Lead exposure induces microglial cell death, of which the mechanism is unclear. Ferroptosis is a new death form and its role in microglia death has not been reported. Objective To investigate the role of ferroptosis in microglia following lead exposure in order to provide a theoretical basis for the mechanism of lead neurotoxicity. Methods Microglial cell line BV-2 cells were co-cultured with 0, 10, 20 and 40 μmol·L⁻¹ lead acetate for 24 h. The 40 μmol·L⁻¹ lead acetate group with iron chelator (DFO) was named the 40+DFO group. Changes in BV-2 cell morphology after lead exposure were observed under an inverted microscope; tissue iron kit and glutathione kit were used to detect intracellular iron and glutathione (GSH) respectively; flow cytometry was applied to detect lipid reactive oxygen species (lipid ROS) immunofluorescence intensity. Western blotting and qPCR were adopted to detect the expressions of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), transferrin receptor 1 (TFR-1), divalent metal transporter 1 (DMT1), ferroportin 1 (FPN1) protein and mRNA. Results Compared with the control group, the number of BV-2 cells decreased with increasing doses of lead and the cells showed a large, round amoeboid shape. The intracellular levels of iron of BV-2 cells were (1.08±0.04), (1.29±0.03), and (1.72±0.10) mg·g⁻¹ (calculated by protein, thereafter) in the 10, 20, and 40 μmol·L⁻¹ lead acetate groups, respectively, significantly higher than that in the control group (P<0.05), and the intracellular level of iron in the 40+DFO group, (1.34±0.10) mg·g⁻¹, was lower than that in the 40 μmol·L⁻¹ lead acetate group, (1.72±0.03) mg·g⁻¹ (P<0.05). Compared with the control group, the TFR-1 and DMT1 protein and mRNA expressions were increased in BV-2 cells in the 10, 20, 40 μmol·L⁻¹ lead acetate groups (P<0.05), especially in the 40 μmol·L⁻¹ lead acetate group; the FPN1 protein expression did not change significantly, but the FPN1 mRNA expressions in BV-2 cells in the 10, 20, 40 μmol·L⁻¹ lead acetate groups were significantly decreased (P<0.05). Compared with the control group, the intracellular GSH level decreased and the lipid ROS content increased in all three lead acetate groups; compared with the 40 μmol·L⁻¹ lead acetate group, the GSH level increased by 12.30% and the lipid ROS content decreased by 13.00% in the 40+DFO group (P<0.05). The expressions of GPX4 protein were reduced to 50.00%, 35.00%, and 17.00% of that of the control group in the 10, 20, and 40 μmol·L⁻¹ lead acetate groups respectively, while the expressions of GPX4 mRNA were also significantly reduced; the expressions of SLC7A11 protein and mRNA in the 20 and 40 μmol·L⁻¹ lead acetate groups were lower than that in the control group, with the most significant decrease in the 40 μmol·L⁻¹ lead acetate group (P<0.05). Conclusion Lead exposure could induce ferroptosis in BV-2 cells, in which iron transport imbalance and oxidative damage might be involved.

Objective To summarize the clinical experience in liver retransplantation. Methods The clinical data of 24 patients receiving liver retransplantation 28 times in this hospital were retrospectively analyzed and discussed with relevant literature. Results Among the 880 consecutive liver transplantations, 28(3.18%) had liver retransplantation. The causes of liver retransplantation were biliary complications ( 16 cases, 57. 1%), carcinoma recurrece (6 cases, 21. 4%), hepatic artery thrombosis (4 cases, 14. 3%), chronic rejection (1 case, 3. 6%), primary nonfunction (1 case, 3.6%). Thirteen patients among the 24 were discharged healthy and were followed up for 51days to 67months. Eleven patients died. Three of them died of hemorrhagic shock, 2 of septic shock, 2 of hepatocellular carcinoma recurrence, 2 of cardiovascular system complication, 1of nervous system complication, and 1 of hepatic artery thrombosis. Conclusion Liver retransplantation can effectively save patients with graft failure. Proper indication, optimal operating time, improvement of operative skills,and appropriate treatment during the perioperative period are very important for promoting the rate of successful liver retransplantation.

Objective To evaluate the role of transient receptor potential vanillic acid subtype 1 (TRPV1)/calcitonin gene-related peptide (CGRP) signaling pathway in lidocaine postconditioning-induced reduction of myocardial ischemia-reperfusion (I/R) injury in rats.Methods Forty healthy male SpragueDawley rats,aged 3 months,weighing 250-300 g,were divided into 5 groups (n=8 each) using a random number table method:sham operation group (group Sham),group I/R,lidocaine postconditioning group (group LP),lidocaine postconditioning plus CGRP8-37 group (group LP+CGRP8-37),and lidocaine postconditioning plus capsazepine group (group LP+Capz).Myocardial ischemia was induced by ligating the anterior descending branch of left coronary artery for 30 min,followed by 120-min repeRFusion in anesthetized rats.Lidocaine 2 mg/kg was injected via the tail vein at 5 min before reperfusion in group LP.In group LP + CGRP8-37,lidocaine was intravenously injected,and CGRP receptor selective antagonist CGRP8-37 2 mg/kg was intravenously injected at the same time.In group LP+Capz,lidocaine was injected intravenously,and TRPV1 blocker capsazepine 3 mg/kg was injected intravenously at the same time.A catheter was retrogradely implanted to the left ventricle,and heart rate (HR),left ventricular systolic pressure (LVSP),left ventricular end-diastolic pressure (LVEDP),and the maximum rate of increase or decrease in left ventricular pressure (±dp/dtmax) were continuously monitored and recorded.Blood samples were collected from the carotid artery at 120 min of reperfusion for determination of cardiac troponin I (cTnI),myoglobin (Myo) and creatine kinase-MB (CK-MB) concentrations in serum.Rats were then sacrificed for determination of myocardial infarct size.Results Compared with Sham group,the serum concentrations of cTnI,Myo and CK-MB were significantly increased,LVSP,+dP/dtmax and HR were decreased,and LVEDP and-dP/dtmax were increased in I/R group and LP group (P＜0.05).Compared with group I/R,the serum concentrations of cTnI,Myo and CK-MB and myocardial infarct size were significantly decreased,LVSP and +dP/dtmax were increased,and LVEDP,-dP/dtmax and HR were decreased in group LP (P＜0.05),and no significant change was found in the parameters mentioned above in group LP+ CGRP8-37 and group LP+Capz (P＞0.05).Compared with group LP,the serum concentrations of cTnI and Myo,myocardial infarct size and LVEDP were significantly increased,and + dP/dtmax was decreased in group LP+CGRP8-37,and the serum concentrations of cTnI and Myo and myocardial infarct size were significantly increased,LVSP and +dP/dtmax were decreased,and LVEDP was increased in group I/R+Lido+Capz (P＜0.05).Conclusion The mechanism by which lidocaine postconditioning mitigates myocardial I/R injury is related to activating TRPV1/CGRP signaling pathway in rats.

Objective To investigate the surgical options for the management of portal vein thrombosis (PVT) during liver transplantation and its impact on the outcome of patients. Methods 773 cases of liver transplantation were analyzed retrospectively. PVT occurred in 107 patients, inclu-ding 59 of grade Ⅰ ,33 of grade Ⅱ, 12 of grade Ⅲ and 3 of grade Ⅳ. Simple thrombectomy or thrombus-extraction was performed in grade Ⅰ and Ⅱ. 12 patients with grade Ⅲ received thrombus-extraction or using the donor iliac vein to act as a bridge between the donor portal vein and host superior mesenteric vein. Two cases of grade Ⅳ received a modified cavo-portal hemitransposition and one case received portal-vena coronaria varication anastomosis. Results Liver function had a good recover and the perio-perative mortality is 4. 3% in grade Ⅰ and Ⅱ. In grade Ⅲ , 5 cases received thrombus-extraction had a normal liver function after transplantation and had no died. 2 cases among the other 7 cases using por-tal vein reconstruction had bad liver function and died. The liver function recovered well after trans-plantation and there was no died in grade Ⅳ. Conclusions PVT is not a contraindication for liver transplantation. Good results can be obtained by applying reasonable operative procedures individually.

Objective To evaluate the therapeutic effects of liver transplantation (LT) for cholangiocarcinoma(CC)and analyze the prognostic factors.Methods From December 2001 to December 2006,234 patients receiving LT for hepatic carcinoma in our institute were enrolled as a basis of comparative study for 6 CC patients undergoing LT during the same period.Results These 6 patients were followed-up from 1 to 56 months.Five patients died and one recurred.The 0.5-,1-and 2-year patient cumulative survival rates were 4/6,3/6 and 1/6,respectively.The 0.5-,1-and 2-year tumor-free survival rates were 3/6,2/6 and 1/6,respectively.The average patient or tumor-free survival time were both(14±4) months.Conclusion The prognosis of cholangioearcinoma patients after LT iS poor.