Nai-jing Li, Xiu Gu, Wei Li, Yan Li, Sheng-qi Li, and Ping He
2013(1): 1-6.
Abstract:Objective To investigate the effect of phenylephrine (an α-adrenergic agonist) on alveolar fluid clearance (AFC) in ventilator-induced lung injury and the possible mechanism involved.
Methods A total of 170 male Wistar rats were randomly allocated into 17 groups (n=10) using random number tables. Short-term (40 minutes) mechanical ventilation with high tidal volume (HVT) was performed to induce lung injury, impair active Na+ transport and lung liquid clearance in the rats. Unventilated rats served as controls. To demonstrate the effect of phenylephrine on AFC, phenylephrine at different concentrations (1×10-5, 1×10-6, 1×10-7, 1×10-8, and 1×10-9 mol/L) was injected into the alveolar space of the HVT ventilated rats. To identify the influence of adrenergic antagonists, Na+ channel, and microtubular system on the effect of phenylephrine, phenylephrine at 1×10-5 mol/L combined with prazosin (an α1-adrenergic antagonist, 1×10-4 mol/L), yohimbine (an α2-adrenergic antagonist, 1×10-4 mol/L), atenolol (a β1- adrenergic antagonist, 1×10-5 mol/L), ICI-118551 (an β2-adrenergic antagonist, 1×10-5 mol/L), amiloride (a Na+ channel blocker, 5×10-4 mol/L), ouabain (a Na+/K+-ATPase blocker, 5×10-4 mol/L), colchicine (a microtubular disrupting agent, 0.25 mg/100 g body weight), or β-lumicolchicine (an isomer of colchicine, 0.25 mg/100 g body weight) were perfused into the alveolar space of the rats ventilated with HVT for 40 minutes. AFC and total lung water content were measured.
Results Basal AFC in control rats was (17.47±2.56)%/hour, which decreased to (9.64± 1.32)%/hour in HVT ventilated rats (P=0.003). The perfusion of phenylephrine at 1×10-8, 1×10-7, 1×10-6, and 1×10-5 mol/L significantly increased the AFC in HVT ventilated rats (all P<0.05). This effect of phenylephrine on AFC was suppressed by prazosin, atenolol, and ICI-118551 in HVT ventilated rats by 53%, 31%, and 37%, respectively (all P<0.05). The AFC-stimulating effect of phenylephrine was lowered by 33% and 42% with amiloride and ouabain, respectively (both P<0.05). Colchicine significantly inhibited the effect of phenylephrine (P=0.031).
Conclusion Phenylephrine could increase the AFC in HVT-ventilated rats and accelerate the absorption of pulmonary edema.
Kang-sheng Liu, Jia-hu Hao, Yu-qing Xu, Xiao-qi Gu, Juan Shi, Chun-fang Dai, Fei Xu, and Rong Shen
2013(1): 7-15.
Abstract:To evaluate levels of lead (Pb) and cadmium (Cd) in the breast milk in the second postpartum month, to investigate the relationship between Pb/Cd levels in breast milk and some sociodemographic pa-rameters, and to explore whether these levels affect the infants’ physical status or the mothers’ psychological status (postpartum depression).
Methods A cross-sectional study was conducted between November 2009 and December 2010. Altogether 170 healthy mothers were enrolled from Nanjing Maternity and Child Health Care Hospital. The inclusion criteria were: voluntary to participate in this study, healthy, with no chronic disease, breastfeeding in the second postpartum month, living in a suburban but not non-industrial area of Nanjing, and not occupationally exposed to toxic metals. All the mothers completed a questionnaire and were evaluated based on the Edinburgh Postpartum Depression Scale (EPDS) to identify the risk of postpartum depression. Pb and Cd levels in breast milk were determined by inductively coupled plasma mass spectroscopy. The infants of these mothers were examined for their z scores of weight for age, length for age, head circumference for age, and body mass index for age.
Results The median breast milk levels of Pb and Cd were 40.6 μg/L and 0.67 μg/L, respectively. In 164 (96.5%) of the 170 samples, Pb levels were higher than the limit reported by the World Health Organization (> 5 μg/L). Breast milk Cd level was > 1 μg/L in 54 (31.8%) mothers. The mothers with a history of anemia had a higher breast milk Pb level than those without a history of anemia (41.1 μg/L vs. 37.9 μg/L, P = 0.050). The median breast milk Cd level in those who were active and passive smokers during pregnancy was significantly higher than that in non-smokers (0.88 μg/L vs. 0.00 μg/L, P = 0.025). The breast milk Cd level in the mothers not taking iron and vitamin supplements for 2 months postpartum was higher than in those taking the supplements (iron supplement: 0.74 μg/L vs. 0.00 μg/L, P = 0.025; vitamin supplement: 0.78 μg/L vs. 0.00 μg/L, P = 0.005). Breast milk Cd level at the second postpartum month was negatively correlated with the z scores of head circumference (r = - 0.248, P = 0.042) and weight for age at birth (r =- 0.241, P = 0.024) in girls. No correlation was found between the breast milk Pb/Cd levels and the EPDS scores.
Conclusion Considering the high levels of Pb and Cd in breast milk in this study, breast milk monitoring programs are necessary.
Abstract:To investigate the association between plasminogen activator inhibitor (PAI)-2 expression and invasive potential in hepatocellular carcinoma (HCC) cells.
Methods The HCC cell lines with high, low, and non-metastatic potentials, namely MHCC97-H, MHCC97-L, and SMMC-7721 respectively, were cultured in vitro. Matrigel invasion assay and Western blot of PAI-2 protein expression were conducted.
Results The number of invaded cells in MHCC97-L was significantly higher than that in SMMC-7721 (P=0.005), whereas that in MHCC97-H was higher than in MHCC97-L (P=0.017) and SMMC-7721 (P=0.001). Contrarily, PAI-2 protein expression was gradually reducing from SMMC-7721, MHCC97-L, to MHCC97-H (MHCC97-H vs. MHCC97-L, P<0.001; MHCC97-H vs. SMMC-7721, P=0.001; MHCC97-L vs. SMMC-7721, P=0.001). The Pearson’s correlation analysis revealed a significant negative association between invaded cell number and PAI-2 expression (r=-0.892, P=0.001).
Conclusion PAI-2 expression may be negatively associated with the invasive potential of HCC.
Hui Gao, Bin Zhu, Jie Yi, Tie-hu Ye, and Yu-guang Huang
2013(1): 55-57.
Abstract:SEVERE tracheal stenosis can not only cause criti- cal medical problems such as severe shortness of breath, hypoxia, and even orthopnea, but also impose overwhelming challenges on the physicians, particularly the anesthesiologist. Life-threa- tening airway obstruction can make the patient’s gas exchange extremely difficult.Though several options could be offered regarding the treatment of tracheal stenosis, normally, tracheal resection and following reconstruction is the first choice for severe airway stenosis.1 Successful surgical intervention relies on the close communication and cooperation between surgeons and anesthesiologists. In these cases, airway management is the top issue for the anesthesiologist, and the level of difficulty varies with stenosis location, severity of stenosis, and surgical technique. Extracorporeal membrane oxygenation (ECMO), or cardiopulmonary bypass (CPB), is rarely utilized for the surgery, but for those impossible airways due to nearly complete tracheal obstruction, ECMO or CPB could be the final choice for anesthesiologists. 2-4 Here we report a case of successful urgent airway management for tracheal resection and reconstruction assisted by temporary CPB.
Abstract:APLASTIC anemia (AA) is a bone marrow failure disease caused by abnormal activation of T lymphocytes, resulting in the apoptosis of hematopoietic cells and bone marrow failure. 1 Currently, hematopoietic stem cell transplantation (HSCT), immunosuppressive - therapy (IST), and supportive care (e.g. transfusion adjuvant therapy, hematopoietic growth factors, and prevention of infection) are the main treatments of AA. Granulocyte transfusion has recently been accepted as an useful adjuvant therapy of HSCT and intensive IST. 2 This article reported a severe AA patient who failed to respond to IST, but achieved spontaneous remission three times after granulocyte transfusions from related donors. Such cases have rarely been reported. Existence of human leukocyte antigen (HLA) cross between the patient and his relatives may influence the T cell-mediated immunity, which might explain this patient’s recovery.
Abstract:ORAL contraceptives are widely used to prevent pregnancy. A number of studies have demonstrated the increased risk of venous throm- boembolism in women taking oral contraceptives. 1,2 Pulmonary embolism (PE) and deep vein thrombosis (DVT) are two clinical presentations of venous thromboembolism which share the same predisposing factors. 3 This article described a female patient who taked oral contraceptives and had an unhealthy life habit developed PE and DVT.
Ting Chu, Lin-nong Wang, Hao Yu, and Ru-yang Zhang
2013(1): 20-27.
Abstract:To evaluate the current cornea donation awareness of tissue donors in the city of Nanjing, China.
Methods Altogether 2000 registered tissue donors in the Red Cross Eye Bank of Nanjing by the end of 2010 and 2000 control residents of Nanjing in February to June 2011 were randomly selected to participate in our field questionnaire survey. The questionnaire consisted of questions regarding the understanding of cornea dona-tion, the attitude toward cornea donation, and attitude toward legislation and free donation. The awareness of cornea donation between the registered tissue donors and residents was compared. Related factors of the willing-ness to donate corneas and to become a tissue donor were evaluated with univariate and multiple logistic regression analysis.
Results A total of 1867 (response rate: 93.4%) tissue donors and 1796 (response rate: 89.8%; effective questionnaires: 1697) residents participated in this survey. For the questions about the knowledge of cornea donation, 90.3% tissue donors (residents: 78.9%) knew that donated corneas could be used for transplantations; 71.2% tissue donors (residents: 47.6%) knew that the appearance would not be destroyed after cornea donation; 70.7% tissue donors (residents: 20.0%) knew the formalities to become a cornea donor. For attitude toward cornea donation, 82.2% tissue donors (residents: 45.1%) were willing to donate corneas or eyeballs after death; 84.0% tissue donors (residents: 30.2%) had discussed with their families about donation; 85.1% tissue donors (res-idents: 24.8%) supported their families' or friends' cornea donation. For attitude toward legislation and free donation, 88.3% tissue donors (residents: 61.3%) approved of legislation to regular cornea donation; 72.2% tissue donors (residents: 38.8%) thought that cornea or organ donation should be gratis. The difference between two groups was significant (P<0.001). However, some tissue donors did not know cornea donation well, some even opposed the legislation of cornea donation and free donation protocol. For the factors influencing the willingness to donate corneas, population was the most relevant factor (P<0.001), since tissue donors were more willing to donate corneas than residents. Other significantly related factor were age, gender, occupation, and education level (P<0.001), while political status or religion were not significant. For the factors related to becoming a tissue donor, older age, male, white-collars (including white-collar, civil servant, teacher, soldier, lawyer, salesman, healthcare provider), higher education level, party members (including the Chinese Communist Party members, democratic party members, and the Communist Youth League members) (P<0.05). Conclusions The registered tissue donors have better understanding and more positive attitude towards cornea donation than control residents do. They approve of the legislation of cornea donation and free donation protocol. It may be more effective to target the population of over 58 years old, male, white-collars, well-educated people, and party members in the promotion of cornea donation.
Keywords:cornea donation;tissue donors;eye banks;cross-sectional study
Ping Zhao, Lei Dong, Jin-yan Luo, Hai-tao Guan, Hui Ma, and Xue-qin Wang
2013(1): 28-33.
Abstract:To clarify the role of mast cells and neuropeptides substance P (SP), somatostatin (SS), and vasoactive intestinal peptide (VIP) in dextran sulfate sodium (DSS)-induced colitis in rats. Methods Experimental colitis was induced in Sprague-Dawley rats (180-200 g, n=20) by oral ingestion of 4% (w/v) DSS in drinking water for 7 days. Control rats (n=5) drank water and were sacrificed on day 0. Mast cell number, histamine levels in whole blood and tissue, tissue levels of SP, SS and, VIP in the distal colon of the rats were measured on day 8, day 13, and day 18 of experimentation. Results Oral administration of 4% DSS solution for 7 days resulted in surface epithelial loss and crypt loss in the distal colon. Mast cell count increased on day 8 (1.75±1.09/mm vs. 0.38±0.24/mm, P<0.05) and day 13 (1.55±1.01/mm vs. 0.38±0.24/mm, P<0.05) after DSS treatment. Whole blood histamine levels were increased on day 8 (266.93±35.62 ng/mL vs. 76.87±32.28 ng/mL, P<0.01) and gradually decreased by day 13 and day 18 after DSS treatment. Histamine levels in the distal colon were decreased on day 8 (1.77±0.65 ng/mg vs. 3.06±0.87 ng/mg, P<0.05) and recovered to control levels by day 13 after DSS treatment. SP level in the distal colon gradually increased and were raised significantly by day 13 (8777.14±3056.14 pg/mL vs. 4739.66±3299.81 pg/mL, P<0.05) after DSS treatment. SS and VIP levels in the distal colon were not changed. Conclusions Mast cell degranulation followed by histamine release may play an important role in the pathogenesis of colitis induced by DSS. SP may be a significant substance in the progression of inflammation and the recovery process of DSS-induced colitis.
Keywords:dextran sulfate sodium;colitis;mast cell;substance P
Abstract:To study the influence of Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis (SPDJCS) on the incidence of pancreatic fistula after pancreaticoduodenectomy, and to analyze its applicability, safety, and efficacies.
Methods A prospective controlled trial was conducted with 165 cases receiving pancreaticoduodenectomy in the Department of Hepatopancreatobiliary Surgery from January 2010 to May 2012. The patients were divided into Group A (end-to-end/end-to-side invaginated anastomosis, n=52), Group B (end-to-side mucosal anastomosis, n=48), and Group C (SPDJCS, n=65). The preoperative data, intraoperative data, and operative outcomes (incidence of pancreatic fistula, operation time, intraoperative blood loss, peritoneal drainage, peritoneal hemorrhage, peritoneal abscess, delayed gastric emptying, pulmonary infection, postoperative infection, blood transfusion, and perioperative mortality) were compared among the 3 groups. Results The total incidence of pancreatic fistula was 13.9% (23/165) in all the 165 patients. The incidence in Group A and Group B was 23.1% (12/52) and 18.8% (9/48), both higher than that in Group C [3.1% (2/65), both P<0.05]. Group C showed significantly better outcomes than group A and B in terms of the operation time (5.5±1.2 hours vs. 6.1±1.1 hours, 5.5±1.2 hours vs. 6.3±1.5 hours), volume of blood loss (412.0±205.0 mL vs. 525.0±217.0 mL, 412.0±205.0 mL vs. 514.0±217.0 mL), and postoperative drainage amount of plasma tubes (175.0±65.0 mL vs. 275.0±80.0 mL, 175.0±65.0 mL vs. 255.0±75.0 mL) (all P<0.05), while Group A and Group B displayed no difference in these aspects (P>0.05). As complications other than pancreatic fistula were concerned, the three groups were not different from each other (P>0.05). Conclusions SPDJCS may have the effect of reducing the incidence of pancreatic fistula after pancreaticoduodenectomy. It could be safe, practical and convenient technique of anastomosis for pancreaticojejunostomy.
Keywords:pancreaticoduodenectomy;pancreatic fistula;pancreaticojejunostomy;continuous suture;suspension of pancreatic duct
Mi Zhou, Zhong-li Li, Yan Wang, Yu-jie Liu, Shu-ming Zhang, Jie Fu, Zhi-gang Wang, Xu Cai, and Min Wei
2013(1): 39-43.
Abstract:To evaluate the efficacy of arthroscopic surgery in inflammatory hip arthritis. Methods A retrospective clinical study was conducted inspecting 40 hips in 36 patients of inflammatory arthritis. There were 17 cases of ankylosing spondylitis, 11 cases of rheumatoid arthritis, and 8 cases of psoriatic arthritis. The joints were irrigated and the inflamed tissues were debrided with anthroscopy. The patients were followed up with Harris hip score, Oxford hip score, Visual Analog Scale (VAS), and magnetic resonance imaging (MRI). Statistical analysis was performed using Student t test.Results All of the 36 cases were followed up for 46-103 months, averaging 67.2±8.4 months. Harris and Oxford scores increased from 66.9±12.1 and 69.4±16.4 before operation to 78.4±19.3 and 80.2±18.8 after operation, respectively (P<0.05). VAS score decreased from pre-operative 8.5±2.5 to post-operative 7.2±2.5 (P<0.05). All the patients showed improved joint range of motion. MRI revealed alleviation of hip synovitis. The results were classified as excellent in 8 patients, good in 17 patients, fair in 8 patient, and poor in 3 according to Harris hip score. Twenty-seven patients were satisfied with the operative outcomes as they regained normal daily activities. Conclusions Arthroscopy-assisted joint debridement and synovium resection is an effective procedure for hip lesion in inflammatory arthritis. The inflammatory lesion might be thereby controlled and the symptoms be relieved.
Guo-gui Sun, Wan-ning Hu, Jun Zhang, Cheng-lin Li, and Cong-rong Yang
2013(1): 44-49.
Abstract:To investigate the radiosensitizing effect of nitric oxide (NO) combined with radiation on esophageal cancer cell line TE-1.
Methods Methyl thiazolyl tetrazolium (MTT) assay was used to assess the effects of NO and radiation on TE-1 cells regarding inhibition of cell proliferation. Flow cytometry was used to examine the effect of NO and radiation on cell apoptosis and cycle. Reverse transcription polymerase chine reaction and Western blot were used to evaluete the effect of NO on mRNA and protein expression of manganese superoxide dismutase (MnSOD). Results NO inhibited the proliferation of TE-1 cells while significantly enhancing their radiosensitivity. The application of NO combined with radiation significantly increased the apoptosis rate and G2/M phase propor-tion of TE-1 cells, with substantial decreases in the MnSOD mRNA and protein expression levels. Conclusions NO reduces the MnSOD mRNA and protein expression levels by affecting TE-1 cell cycle, further inhibiting the apoptosis of esophageal cancer cells and enhancing the killing effect of radiation on esopha-geal cancer cells.
Tao Wang, Hua-shan Zhao, Qiu-ling Zhang, Chang-lin Xu, and Chang-bai Liu
2013(1): 50-54.
Abstract:Induced pluripotent stem (iPS) cells were originally generated from mouse fibroblasts by enforced expression of Yamanaka factors (Oct3/4, Sox2, Klf4, and c-Myc). The technique was quickly reproduced with human fibroblasts or mesenchymal stem cells. Although having been showed therapeutic potential in animal models of sickle cell anemia and Parkinson’s disease, iPS cells generated by viral methods do not suit all the clinical applications. Various non-viral methods have appeared in recent years for application of iPS cells in cell transplantation therapy. These methods mainly include DNA vector-based approaches, transfection of mRNA, and transduction of reprogramming proteins. This review summarized these non-viral methods and compare the ad-vantages, disadvantages, efficiency, and safety of these methods.
Keywords:induced pluripotent stem cells;non-viral methods;transcription factor;regenerative medicine
Li-mei Pei, Gao-feng Shi, Run-ze Wu, Ru-xun Li, and Yu Du
2013(1): 64-65.
Abstract:GASTRIC cancer is one of the most frequently diagnosed cancers and leading causes of cancer-related deaths. Computed tomography (CT) is routinely used to observe the tumor location, size, invasion, and metastasis, which are necessary for tumor staging and therefore treatment planning. With the recently introduced dual-source dual-energy CT (DECT), different kevS images could be obtained, the feature of which depending on the attenuation coefficient of the scanned tissue. We investigated spectrum characteristics of the curve of normal gastric tissue and those with gastric cancer, normal fat and invased fat, metastatic lymph nodes in DECT.