Objective: To observe the changes of hemeoxygenase-1 (HO-1) activity in cerebral tissue, carboxyhemoglobin (COHb) level in blood of rats during global cerebral ischemia/reperfusion (I/R) and the influence of L-tetrahydropalmatine (L-THP) on them. Methods: Seventy-seven Sprague-Dawley (SD) rats were randomly divided into sham-operated group (S group, n=7), I/R group (I group, n=35) and L-2THP treatment group (T group, n=35). Cerebral I/R model was reproduced in SD rats of I group and T group. HO-1 activity, cyclic GMP (cGMP) in the brain and COHb in blood were evaluated respectively at 1, 3, 12, 24, and 48 hours after global cerebral I/R and compared to those of the S group. Results: ① HOCD*21 activity, COHb content and cGMP level in I group increased as compared with those in S group after global cerebral I/R (all P

OBJECTIVETo investigate the decrease of bone mineral density in female patients, effects on acetabular displacement.

METHODSFrom October 2013 to November 2015, a total of 34 patients underwent total hip replacement in the Department of orthopedics, the Third Affiliated Hospital of Zunyi Medical College. The two groups of patients were female and the patients were treated with hip osteoarthritis. Based on the lowest value of preoperative dual energy X-ray bone mineral density (DXA), the patients were divided into normal group and low bone mineral density(-3.5<=T<=-1). There were 10 patients in the normal group, ranging in age from 55 to 64 years old, with an average of (58.00±4.22) years old. There were 24 patients in the low bone density group, ranging in age from 58 to 72 years old, with an average age of (65.71±8.19) years old. All the patients received a THA implant with ceramic-on-ceramic bearings(Depuy America). The lining system was Pinnacle cup. During the operation, the acetabular cup was maintained at abduction 45 degree and anteversion 15 degree. Analysis (RSA) of acetabular components in 3, 6, 12, and 24 months after surgery.

RESULTSThere was a statistically significant difference in cup migration between patients with normal BMD and those with low BMD. At 3 months, compare to the normal group, the low bone mineral density (BMD) occurred in the X axis (95% confidence interval, 0.01 to 0.31;=0.006) and Y (95% confidence interval 0.20 to 0.39;=0.003). The initial rotation occurs in a separate Z axis(95% confidence interval -0.26 to 0.81;=0.006).

CONCLUSIONSIt has produced that increaseed migration of uncemented cups in female patients with low systemic BMD in 3 months after surgery.

Objective: To evaluate the effect of compound electrolyte injection on phosphatidylserine (PS) exposure in erythrocytes after blood salvage-retransfusion in dogs. Methods: Twenty healthy mongrel dogs, weighing 10-15 kg, aged 3-5 weeks, were divided into 2 groups (n=10 each) using a random number table method: normal saline group (group NS) and compound electrolyte injection group (group MEI). The process of intraoperative blood salvage-retransfusion was simulated in both groups: femoral vein was cannulated for blood withdrawal until the volume of blood lost was 400 ml, and the shed blood was salvaged by a blood recovery machine.The washing solution was normal saline in group NS and compound electrolyte injection in group MEI.The erythrocytes were retransfused after being labeled with fluorescein isothiocyanate.Blood samples were obtained before and after blood salvage for determination of erythrocyte ATP content by enzyme-linked immunosorbent assay.Blood samples were obtained at 24, 48 and 72 h after blood retransfusion, and the PS exposure rate of the salvaged erythrocytes was determined by flow cytometry.The spleen was taken at 72 h after retransfusion to detect the phagocytosis rate of salvaged erythrocytes by monocytes. Results: There was no significant difference in ATP content before and after blood salvage between the two groups (P>0.05). Compared with NS group, the PS exposure rate of the salvaged erythrocytes at each time point after retransfusion and phagocytosis rate of salvaged erythrocytes by monocytes were significantly decreased in MEI group (P<0.05). Conclusion Compound electrolyte injection as a washing solution for intraoperative blood salvage can reduce the PS exposure in salvaged erythrocytes and is helpful in prolonging the lifespan of erythrocytes after retransfusion in dogs.

AIM: To investigate the effect of repeated intravitreal injection of anti-vascular endothelial growth factor(VEGF)on the vitreomacular interface(VMI)and its related risk factors in patients with diabetic macular edema(DME).METHODS: The clinical data of 31 patients(55 eyes)with DME who received intravitreal injections of Conbercept(3+PRN)in the ophthalmology department of the First People's Hospital of Zunyi from January 2018 to December 2021 were analyzed retrospectively. There were 9 cases(13 eyes)in the group that has changes in VMI and 22 cases(42 eyes)in the other group that has no changes in VMI. The best corrected visual acuity(BCVA), central retinal thickness(CRT), and central choroidal thickness(CCT)of the two groups were compared, and the risk factors of VMI change were analyzed.RESULTS: The patients were followed up for an average of 9.58±8.32mo, received an average of 4.07±2.17 times of anti-VEGF therapy, and the number of intravitreal injections in VMI changed group was more than that in VMI unchanged group(5.77±2.09 times vs. 3.55±1.93 times, P=0.001). At the last follow-up, compared with before treatment, the BCVA of both patients improved significantly after treatment(both P<0.05), while CCT had no significant change(both P>0.05). CRT of patients in the VMI unchanged group decreased significantly(P=0.039), but there was no significant change in patients of VMI changed group(P=0.627). Logistic regression analysis showed that BCVA was a risk factor for VMI change before treatment(P=0.049, OR=6.210, 95%CI 1.006～38.346).CONCLUSIONS: The VMI of DME patients may change during repeated intravitreal injections of anti-VEGF drugs. The worse the BCVA before treatment, the higher the risk of change in VMI, and the patients with VMI change have a poor response to anti-VEGF treatment.

Objective　To evaluate the effect of dexmedetomidine on oxidative stress and pulmonary function in children with congenital heart disease after cardiopulmonary bypass.　Methods　From June 2016 to June 2018, fifty-five children who underwent ventricular septal or atrial defect repair under cardiopulmonary bypass in the First Affiliated Hospital of Zunyi Medical University were recruited and randomly divided into two groups: control group (group C) and dexmedetomidine group (group D). After tracheal intubation, patients of group D were received dexmedetomidine 0.5 ug/kg/h by intravenous pump until the end of operation. Patients of group C were received 0.9% physiological saline with the same volume. Heart rate, mean arterial pressure, oxygen saturation, bypass time, and computation of respiratory index (RI) and oxygenation index (OI) based on blood gas analysis, measured SOD, MDA and GSH in plasma, recording the time from the end of operation to the extubation of tracheal tube, the duration of stay in extracardiac ICU after operation, and pulmonary complications were followed up before infusion of dexmedetomidine (T0), sternal sawing (T1), CPB stopping (T2), and 24 hours after operation (T3).　Results　The changes of heart rate and mean arterial pressure in the two groups were within the normal range. There was no significant difference in plasma SOD, MDA and GSH between the two groups (P>0.05）. There was no difference in OI and RI at T0 and T1 time points (P>0.05). Compared with group C, OI was increased and RI was decreased in group D at T2 and T3 time points (P< 0.05). Compared with group C, group D had shorter ICU support time and extubation time, and fewer pulmonary complications after operation (P<0.05).　Conclusion　The treatment of 0.5 μg/kg/h dexmedetomidine can improve the respiratory function, reduce the pulmonary complications, and is conducive to the rehabilitation of children after CPB. But, this concentration cannot alleviate the oxidative stress reaction of children with CPB.

The risk of early acute rejection after kidney transplantation is relatively high, which severely affects the quality of life of the recipients. In 2009, Kidney Disease: Improving Global Outcomes (KDIGO) recommended that immune inducers should be included in the immune-inducing regime before kidney transplantation, aiming to provide certain strength of immunosuppression during this critical phase and effectively reduce the incidence of acute rejection following kidney transplantation. At present, the selection, efficacy and safety of immune inducers remain controversial among transplantation centers around the world. In this article, clinical efficacy of monoclonal antibodies including interleukin-2 receptor antagonist, alemtuzumab, rituximab and polyclonal antibody antithymocyte globulin in immune induction therapy before kidney transplantation were compared and literature review was performed at home and abroad, aiming to provide reference for promoting the individualized selection of immune inducers for kidney transplantation and improving the quality of life of recipients.

Objective: To evaluate the effect of dexmedetomidine on cell apoptosis during lung ischemia-reperfusion (I/R) injury in a rat model of cardiopulmonary bypass (CPB). Methods: Ninety-six SPF healthy adult male Sprague-Dawley rats, weighing 350-500 g, were divided into 4 groups (n=24 each) using a random number table method: sham operation group(group S), CPB group(group C), CPB plus left lung I/R group (group IR), and CPB plus left lung I/R plus dexmedetomidine group (group D). The chest was only opened, and the rats underwent no CPB in group S. Only the CPB model was established in group C. The model of left lung I/R injury was established based on the CPB model in group IR.In group D, the model of CPB plus left pulmonary I/R injury was established, dexmedetomidine was intravenously infused in a dose of 3 μg/kg through the tail vein, followed by a continuous infusion of 1.5 μg·kg^-1·h^-1 until the end of surgery.Eight rats were selected in each group before operation (T₀), at 10 min after opening the left hilum (T₁), and at the end of operation (T₂), the left lung tissues were taken for examination of pathological changes (with a light microscope) which were scored and for determination of cell apoptosis, and immunohistochemistry score (IHS) was assessed.The apoptosis index was calculated. Results: Compared with group S, the pathological changes of lung tissues, IHS and apoptosis index were significantly increased at T_{1, 2} in the other three groups (P<0.05). Compared with group C, the pathological changes of lung tissues, IHS and apoptosis index were significantly increased at T_{1, 2} in IR and D groups (P<0.05). Compared with group IR, the pathological changes of lung tissues, IHS and apoptosis index were significantly decreased at T₂ in group D (P<0.05). Conclusion The mechanism by which dexmedetomidine reduces lung I/R injury during CPB is related to inhibiting cell apoptosis in rats.

PURPOSETo observe the therapeutic effect of interventional embolization and haemorrhage control in multiple trauma patients with a major abdominal or pelvic injury.

METHODSData of 160 multiple trauma patients with a major abdominal or pelvic injury were retrospectively analyzed. They were admitted into the Department of Emergency of the First Affiliated Hospital of Zunyi Medical College from October 2013 to April 2016. Eighty-seven patients who received emergent intervention for embolization and haemorrhage control were set as group A, including 72 males and 15 females, with an average age of (39.32 ± 14.0) years. Patients underwent emergent intervention for embolization and hemostasis. The other 73 patients who received traditional surgeries were set as group B, including 62 males and 11 females, with an average age of (38.48 ± 13.12) years. The time from admission to emergency intervention, the time of interventional embolization, transfusion during hospitalization, length of stay and prognosis were observed. The whole treatment and prognosis were compared between group A and group B.

RESULTSIn group A, the average time from admission to intervention exploration was (132.05 ± 86.80) min, the average operation time was (149 ± 49.69) min, the average hospitalization time was (18.37 ± 4.71) days, the average amount of RBC transfusion during hospitalization was (7.2 ± 4.33) units, and the mortality was 4.60% (4 patients died). The corresponding data in group B were respectively (138.95 ± 82.49) min, (183 ± 52.39) min, (22.72 ± 6.63) days, (12.23 ± 5.43) units, and 9.59% (7 cases died). There was no statistical difference in the time from admission to operation between the two groups (p > 0.05), but there was statistical difference in operation time, RBC transfusion, hospitalization time, prognosis, and mortality between the two groups (all p < 0.05).

CONCLUSIONThe emergent intervention for embolization and haemorrhage control of multiple trauma patients with a major abdominal or pelvic injury and visceral organ haemorrhage has the advantages of less trauma, shorter operation time, shorter hospital stay, less blood transfusion in comparison to the traditional emergency surgeries.

Hepatogenous diabetes (HD) is a common complication of end-stage liver disease, and many studies have confirmed its adverse effect on prognosis. In recent ten years, a great number of studies have been conducted on the pathogenesis of HD and some progress has been made. This article reviews the research advances in the pathogenesis of HD, in order to provide a reference for the diagnosis and treatment of HD by clinicians.

Both diabetes mellitus and liver cirrhosis have high incidence rate and mortality rate around the world, and in recent ten years, scholars in China and globally have conducted many studies on the association between diabetes mellitus and liver cirrhosis. This article systematically reviews the advances in the basic and clinical research on the influence of diabetes mellitus on liver cirrhosis and its complications and summarizes possible mechanisms. The results show that diabetes mellitus can accelerate the process of liver fibrosis, increase the risk of complications and progression to liver cancer in patients with liver cirrhosis, and reduce their survival rate.