Objective To determine the risk factors for development of early acute renal failure (ARF) after orthotopic liver transplantation (OLT) in patients with normal renal function.Methods Sixty ASA Ⅱ or Ⅲ patients aged 28-64 yr weighing 35-88 kg undergoing OLT were studied.Their preoperative serum Cr and BUN were within normal range.Early ARF was defined as serum Cr≥132 μmol/L and/or BUN≥18 mmol/L within 24 h after operation.The patients were divided into 2 groups: ARF group and non-ARF group.Arterial blood samples and urine specimens were collected before induction of anesthesia for determination of blood β2-micreglobulin(β2-MG) and urinary β2-MG and N-acetyl-β-D-glucurenidnse (NAG). Factors including preoperative liver function,preoperative blood and urinary β2-MG,the amount of urine output and bank blood infused during operation,MAP during anhepatic and neohepatic phase,the amount of vnsoactive drugs and diuretics used during operation,hypotension and arrbythmia during operation were recorded.The risk factors were identified by logistic regression analysis.Results Logistic analysis indicated that serum β2-MG higher than normal value before operation and persistent hypotensien during operation were closely correlated with development of early ARF after OLT.Conclusion Serum β2-MG higher than the normal value before operation.and persistent hypotension during operation are the risk factors for early ARF after OLT.

Objective To evaluate the effect of dexmedetomidine on the quality of recovery from anesthesia in the patients undergoing modified electroconvulsive therapy (MECT) with propofol anesthesia.Methods One hundred and ten patients of both sexes,aged 18-50 yr,weighing 45-80 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective MECT with general anesthesia,were randomly assigned into 2 groups (n =55 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine was infused intravenously in a dose of 0.5 μg/kg (in normal saline 10 ml) over 10 min in group D,while normal saline 10 ml was infused intravenously over 10 min in group C.Propofol 1.5 mg/kg and succinylcholine 0.5 mg/kg were injected intravenously,and MECT was performed in the two groups.The emergence time was recorded.The development of cardiovascular events,nausea and vomiting,respiratory depression,headache,somnolence and agitation during recovery from anesthesia was recorded.Results Compared with group C,the incidence of nausea and vomiting,headache and agitation during recovery from anesthesia was significantly decreased (P＜0.05),and no significant changes were found in the emergence time,and incidence of hypertension,tachycardia,respiratory depression and somnolence during recovery from anesthesia in group D (P＞ 0.05).Conclusion Dexmedetomidine (intravenously infused in a dose of 0.5 μg/kg over 10 min before anesthesia) can raise the quality of recovery from anesthesia in the patients undergoing MECT with propofol anesthesia.

Objective To investigate the relationship between heme oxygenase-1 (HO-1),glutathione S-transferase (GST) and cerebral atherosclerosis.Methods Cerebralvascular status was assessed with color flow Doppler sonography,transcranial Doppler (TCD),magnetic resonance angiography (MRA)or/and digital subtraction angiography (DSA) in patients with cerebral atherosclerosis (mild,moderate,and severity).Serum HO-1 and GST were measured with enzyme-linked immunosorbent assay (ELISA).Results In comparison between case and control groups,there was significant difference in age,hypertension,cerebral infarction,uric acid,and HO-1 (P =0.041,0.008,0.000,0.036,and 0.001).The level of serum HO-1 in the severe atherosclerosis was lower than that in the mild and moderate atherosclerosis (P =0.000 and 0.002).Logistic regression was used to find the association of HO-1 and the degree of cerebral atherosclerosis (P =0.000).Conclusions HO-1 might be related to cerebral atherosclerosis.

OBJECTIVEThis paper aimed to determine the mRNA expression of osteoclast-related factors interleukin-6 (IL-6), interleukin-12 (IL-12) p35, IL-12p40, matrix metalloproteinase-9 (MMP-9), nuclear factor of activated T-cells cytoplasmic 1 (NFATcl), receptor activator of nuclear factor-KB (RANK), and tumor necrosis factor-α (TNF-α) mRNA in murine macrophages infected by a periodontitis patient's own tissue nucleic acid. Another aim was to investigate the effects of a periodontitis patient's own tissue nucleic acid on the differentiation of macrophages into osteoclasts.

METHODSInflammatory periodontal tissue samples of chronic periodontitis patients were taken during periodontal flap surgery, and healthy gingival tissue samples were taken from orthodontic patients during tooth extractions. Total RNA from periodontal tissue was extracted and reversely transcribed into cDNA and then cryo-preserved until further use. First, specific sequence oligodeoxynucleotide MT0I at a concentration of 1 µg · mL⁻¹ was added in murine macrophage RAW264.7, and the cells were incubated for 3 hours. Cells with PBS (1 µg · mL⁻¹) were used as negative controls. The inflammatory periodontal tissue cDNA and healthy periodontal tissue cDNA (1 µg · mL⁻¹) was added subsequently. There were four experimental groups: healthy periodontal tissue cDNA+ RAW264.7, inflammatory periodontal tissue cDNA+RAW264.7, MT01+healthy periodontal tissue cDNA+RAW264.7, and MT01+inflammatory periodontal tissue cDNA+RAW264.7. Real-time quantitative polymerase chain reaction was used to detect the mRNA expression of osteoclast-related factors IL-6, IL-12p35, IL-12p4O, MMP-9, NFATcl, RANK, and TNF-α mRNA after 3, 6, 12, and 24-hours.

RESULTSThe mRNA levels of osteoclast-related factors NFATc1, MMP-9, TNF-a, IL-6, IL-12p40, IL-12p35, and RANK in RAW264.7 were markedly upregulated with the treatment of periodontitis patient's own tissue nucleic acid. However, the mRNA expression of osteoclast-related factors was inhibited by use of an immunosuppressant MT01.

CONCLUSIONThe periodontitis patient's own tissue nucleic acid could promote the differentiation of murine macrophage into osteoclasts.

Animals ; Cell Differentiation ; Cytokines ; metabolism ; Gene Expression ; Gingiva ; Humans ; Interleukin-12 Subunit p40 ; Interleukin-6 ; Macrophages ; Matrix Metalloproteinase 9 ; Mice ; Osteoclasts ; metabolism ; Periodontitis ; RNA, Messenger ; Tumor Necrosis Factor-alpha

Objective To investigate the effect of leptin (LEP) pretreatment on hypoxia-reoxygenation (H/R) induced apoptusis in human L02 liver cells. Methods Human L02 liver cells were obtained from pharmacology laboratory, Zhong-Shan University and cultured in DMEM liquid culture medium in an incubator filled with 5% CO_2 at 37℃. The cells were divided into 6 groups ( n = 6 each) : group control (group C) ; grouphypoxia-reoxygenation (group H/R); group Ⅰ-Ⅳ pretreatment with LEP 100, 200, 400 and 800 μg/L + H/R. In group H/R and group Ⅰ-Ⅳ L02 cells were exposed to 95% N_2-5% CO_2 for 12 h followed by 12 h reoxygenation. In group Ⅰ-Ⅳ the cells were pretreated with LEP 100, 200, 400, 800 μg/L respectively before H/R. At the end of 12 h of reoxygenation, the cells were centrifuged and the supematant was collected for determination of ALT and AST concentrations. Apoptosis in L02 cells was detected by Hoechst 33342/PI staining. Fluorescent quantitative PCR was used to detect Bax and Bcl-2 mRNA expression. Results (1) ALT and AST concentrations were significantly increased after H/R. The increase in ALT and AST concentrations was ameliorated by pretreatment with LEP. (2) The H/R-induced apoptotic changes of the cells were attenuated by pretreatment with LEP. (3) The Bax mRNA and Bcl-2 mRNA expression was significantly increased in group H/R as compared with group C. Leptin pretreatmcnt significantly reduced Bax mRNA expression and increased Bcl-2 mRNA expression as compared with group H/R. Conclusion LEP pretreatment can decrease H/R-indtwed apoptosis in the L02 liver cells by down-regulation of Bax mRNA expression and up-regulation of Bcl-2 mRNA expression.

Objective To study the effects of lucentis preventing vitreous hemorrhage after vitrectomy for diabetic retinopathy combined with iris neovascularization.Methods The clinical data of 70 patients (70 eyes) underwent vitrectomy for diabetic retinopathy combined with iris neovascularization during 2009 to 2015 in our hospital were retrospectively analyzed.The control group (30 eyes) accepted panretinal photocoagulation (PRP),re-vitrectomy,cyclocryotherapy,and the study group (40 eyes) had the 0.5mg lucentis in addition.The follow-up time was 3 months,and the visual acuity,IOP,vitreous hemorrhage,INV regression and complication were observed.Results At 1 month,2 months in the follow-up,the visual acuity of study group was better than the control group,but there was no significant difference along with the follow up.The average preoperative IOP was (26.312 ±4.566) mmHg (1 kPa =7.5 mmHg) in the study group and (24.586 ±5.783) mmHg in the control group,and at the end of the follow up,IOP was (18.576 ±4.762) mmHg in the study group and (28.587 ±7.786) mmHg in the control group,there was statistical difference between the two groups (P =0.041).The intraoperative and postoperative anterior chamber or vitreous hemorrhage occurred in 15 cases,5 cases of the control group,and 3 cases,1 case of the control group,there were significant differences (all P =0.000).At the end of the follow up,3 eyes (7.5％) developed to NVG in the study group and 10 eyes (33.3％) in the control group,there was statistical difference (P ＜ 0.05).Conclusion Lucentis can effectively eliminate the new vessels,reduce the incidence of neovascularization glaucoma and vitreous hemorrhage for patients after vitrectomy for diabetic retinopathy combined with iris neovascularization,and improve the visual acuity in a short time.

Objective To establish the A549 cell line with stable expression of HIF1α by using lentiviral vector system.Methods Primers were designed and synthesized with human HIF1α gene coding sequence by the National Center of Biotechnogical Information(NCBI) as the template.HIF1α was amplified by PCR.The HIF1α fragment recycled by enzyme digestion was recombined with prepared lentiviral vector HBLV-RFP-Puro.The recombinant plasmid was identified by PCR and gene sequencing.The recombinant plasmid and the auxiliary plasmid were co-transfect into 293T cell.After filtration and concentration of packaged virus,the viral titer was detected by using the dilution counting method.The prepared lentivirus was infected A549 cells.The drug screening was adopted to stabilize the transfected cell line.The transfection effect was detected and observed by fluorescence microscope and Western blotting.Results The HIF1α fragment amplified by PCR was successfully verified and the recombinant plasmid was successfully constructed by PCR and gene sequencing identification.High-titer LV-HIF1α was obtained by successful package.After LV-HIF1α infecting A549 cells,the cells showed the red fluorescence by fluorescence microscope.The expression level of HIF1α in the LV-HIF1α group was significant higher than that in the control group by Western blot.Conclusion The 549 cell line with HIF1α stable expression mediated by lentivirus is constructed successfully.

Objective:To evaluate the effect of dexmedetomidine on the quality of recovery from anesthesia in elderly patients undergoing electroconvulsive therapy (ECT) with propofol anesthesia.Methods:Sixty patients of both sexes, aged>65 yr, weighing 45-80 kg, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, scheduled for elective ECT with propofol anesthesia, were assigned into 2 groups ( n=30 each) using a random number table method: control group (group C) and dexmedetomidine group (group D). Dexmedetomidine was intravenously infused in a dose of 0.2 μg/kg (in normal saline 10 ml) over 10 min starting from onset of anesthesia induction in group D, while normal saline 10 ml was given instead in group C. Propofol 1.0-1.5 mg/kg was intravenously injected slowly.Succinylcholine 0.7 mg/kg was intravenously injected after the eyelash reflex disappeared, and oxygen was delivered via a mask to assist artificial ventilation.The mask was removed when the muscle twitching disappeared during depolarization, treatment was performed with an ETC apparatus, and electroencephalogram was monitored.The electrical stimulus intensity was set according to the age of the patient during ECT treatment, and the initial intensity was set at 0.5 times the age of the patient. When the postictal suppression index was less than 80%, a higher level of stimulus intensity was used in the next ECT treatment (the difference between adjacent intensity levels was 25.2 mc, which was 5% of the total stimulus intensity). After the end of ECT procedure, participants were manually ventilated with a mask, and the patients were transferred to postanesthesia care unit when the spontaneous breathing was completely restored.The time to recovery of spontaneous breathing and emergence time were recorded.The development of adverse cardiovascular events, nausea and vomiting, respiratory depression, headache, drowsiness, agitation and delirium during recovery from anesthesia was also recorded. Results:Compared with group C, the incidence of agitation, delirium, hypertension and tachycardia during recovery from anesthesia was significantly decreased, and no significant change was found in the other variables in group D ( P<0.05). Conclusion:Dexmedetomidine can improve the quality of recovery from anesthesia in elderly patients undergoing ECT under propofol anesthesia.

BACKGROUND: Airway stents has been widely used in airway stenosis and fistula, yet clinical date of airway stents in reestablishment a complex airway is insufficient. The aim of this study is to evaluate the efficacy and safety to combine the silicon stent and the metal stent in reestablishment a complex malignant airway. METHODS: Patients with non-operable complex malignant airway stenosis and fistula were recruited in this study. Silicon Y stent combined with covered metal stent (Hybrid stent) were inserted to reestablishment the airway. Clinical outcomes and complications were observed over six months. RESULTS: A total of 23 silicon Y stents and 25 covered metal stents were inserted in 23 patients. Nineteen of 23 (19/23, 82.6%) patients felt a immediately relieving of current symptoms. The mean duration of stents placement in patients was (153.43±9.14) days. The modified British Medical Research Council, Karnofsky Performance Status and Performance Status scale were improved significantly after stenting. A total of 12 patients living with stent at 6 months. Others dead of tumor progression. There were no death or immediate complications related to hybrid stenting implication. CONCLUSIONS Hybrid stenting proved to be useful and was well-tolerated in the management of complex malignant airway stenosis and fistula.