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Objective To investigate the effect of BIS-guided closed-loop target-controlled infusion on perioperative Th1/Th2 balance in elderly patients undergoing laparoscopic radical gastrectomy under different anesthesia and sedation depths. Methods We applied random number table method to divide 73 elderly patients undergoing elective laparoscopic radical gastrectomy into BIS closed-loop target-controlled infusion group with BIS value of 55(group H, n=36) and BIS value of 45(group L, n=37).Intravenous blood samples were collected immediately before surgery (T1), 2h after surgery (T2), 24h after surgery (T3) and 72h after surgery (T4).IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ were determined by flow cytometry microsphere array.We compared operation duration, postoperative PACU stay time and postoperative hospitalization time between two groups. Results Compared with T1, IL-6 and IL-10 concentration in group H at T2, T3 and T4 significantly increased (P < 0.05), IL-4 and TNF-α in group H at T4 were significantly increased (P < 0.05), IL-2 and IFN-γ in group H at T2 and T4 were significantly increased (P < 0.05), the concentration of IL-6 and IL-10 in group L at T2, T3 and T4 were increased (P < 0.05), IL-2 in group L at T4 was decreased (P < 0.05), and IFN-γ/IL-6 in two groups were decreased at T2, T3 and T4(P < 0.05).Compared with group L, IL-6 and IL-10 in group H were significantly increased at T2(P < 0.05), IFN-γ/IL-6 in group H was significantly decreased (P < 0.05), IL-2 and IL-10 in group H were significantly increased at T4(P < 0.05).Operation duration, postoperative PACU stay time and postoperative hospitalization time had no statistical significance between two groups (P > 0.05). Conclusion The anesthesia and sedation depth of BIS-guided closed-loop target-controlled infusion set at 45 is better than 55 in maintaining Th1/Th2 balance in elderly patients undergoing laparoscopic radical gastrectomy, but it has no obvious effect on long-term prognosis.
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Objective To investigate the effects of ischemic postconditioning (IPOC) on myocardial perfusion and prognosis in patients with acute ST-segment elevation myocardial infarction (STEMI) who were treated with emergency percutaneous coronary intervention (PCI). Methods A total of 203 patients with STEMI who received emergency PCI were randomly divided into IPOC group (n=103) and control group (n=100). For the patients of IPOC group the angioplasty balloon was re-inflated within one minute after the beginning of reperfusion, the procedure was repeated three times, each time the inflation of balloon lasted for 1 minute using low-pressure (4-6 atm), and the interval between the inflation procedures was one minute. For the patients of the control group , no additional intervention was employed during the first 6 minutes of reperfusion. Cardiac troponin I(cTnI) peaks, creatine kinase-MB (CK-MB) peaks, left ventricular ejection fraction (LVEF), wall motion score index (WMSI), corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC), and major adverse cardiac events (MACE) occurred during hospitalization time in both groups were recorded and the results were compared between the two groups. Results No significant differences in age, sex, risk factors, infarction-related artery, ischemia time, etc. existed between the two groups (P>0.05). The CTFC values of IPOC group were significantly faster than those of the control group, that was (25.3±7.9) vs.(29.4±8.4),(P<0.05). The CK-MB peak and cTnI peak values of IPOC group were remarkably lower than those of the control group, those were (157.3 ±83.6) U/L vs. (201.5 ±77.3) U/L and (2.5 ±1.3) ng/mL vs. (3.1 ±1.0) ng/mL respectively (P<0.05). At the time of admission, there were no significantly differences in the LVEF and WMSI values between the two groups, and three months after PCI the LVEF and WMSI values of IPOC group were significantly better than those of the control group, those were (57.4 ±8.7)% vs. (53.6 ±9.3)% and (1.19 ±0.4) vs. (1.27 ±0.3) respectively, the differences were statistically significant (P<0.05). Three months after PCI, the occurrence of MACE in IPOC group was obviously lower than that in the control group (P<0.05). Conclusion Ischemic postconditioning can improve the infarction-related artery blood flow in patients with STEMI who receive emergency PCI treatment, it can also reduce ischemia-reperfusion injury and improve the cardiac function as well as patient’s prognosis after AMI.
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Objective: To investigate the effects of andrographolide on extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway and tumor necrosis factor-α (TNF-α) expression in lipopolysaccharide (LPS)-activated macrophages. Methods: LPS-activated mouse peritoneal macrophages were cultured in media with different concentrations of andrographolide. Cytotoxicity of andrographolide was detected by cell counting kit-8. The macrophages were lysed, and then expressions of phosphorylated ERK1/2, JNK and p38 and nuclear factor-κB inhibitor (IκBα) protein were detected by Western blotting and TNF-α mRNA expression was detected by reverse transcription-polymerase chain reaction. Supernatants of the macrophages were used to detect content of TNF-α protein by enzyme-linked immunosorbent assay. Results: Andrographolide at 1-100 μg/mL showed no cytotoxicity on LPS-activated mouse peritoneal macrophages. Andrographolide inhibited ERK1/2 phosphorylation in LPS-activated murine peritoneal macrophages, which was concentration-dependent (P<0.01). Andrographolide at 1-25 μg/mL had no effects on phosphorylation levels of JNK and p38 and IκBα degradation in LPS-stimulated mouse peritoneal macrophages. In activated macrophages, TNF-α expression was inhibited by 12 μg/mL andrographolide and 20 μmol/L PD98059 (inhibitor of ERK1/2 signaling pathway) at both mRNA expression and protein secretion levels. Conclusion: In LPS-activated macrophages, andrographolide may inhibit the expression of TNF-α by inhibiting ERK1/2 signaling pathway.
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Objective To investigate the effects of anxiety and anti - anxiety therapy on vascular endothelium function and platelet activation in patients with acute coronary syndrome (ACS).Methods One hundred and thirty -nine ACS patients were enrolled in this prospective and controlled clinical study from January 2009 through December 2010.Patients with severe heart failure,liver and renal dysfunction,infection,allergy to benzodiazepines and taking antipsychotic drugs in recent 2 weeks as well as patients unable to complete the questionnaire were excluded.All these patients were divided into the anxiety group ( n =68 ) and the non - anxiety group ( n =71 ) according to Hamilton Anxiety Scale (HAMA).The plasma levels of NO,ET,CD62p,CD63 and flow- mediated diastolic functions (FMD) of humeral arteries were measured.The patients in anxiety group were randomly assigned to group A ( n =34 ) and group B ( n =34).Lorazepam in a dose of 0.5 mg twice a day and Vitamin B6 in dose of 10 mg twice a day as placebo were prescribed for patients of Group A and B respectively.After 2 weeks,all above variables of group A and group B were measured once again as well as the score of Hamilton Anxiety Scale.The chi - square test was used for constituent ratios,while t - test was applied to analysis of differences in above variables between two groups.Results The plasma level of NO and FMD of humeral artery in the anxiety group were significantly lower than those in the non -anxiety group (t =2.090 and 2.558,P =0.038 and 0.012,respectively),and the plasma levels of ET,CD62p and CD63 in the anxiety group were significantly higher than those in the non - anxiety group ( t =2.082,2.042 and 2.145,P =0.039,0.043 and 0.034,respectively).There were no statistical differences in all above variables as well as HAMA score between group A and group B before anti - anxiety treatment.Two weeks after treatment,the level of NO and FMD of humeral artery in group A were significantly higher than those in group B ( t =2.821 and 2.246,P =0,006 and 0.028,respectively) and the levels of ET,CD62p,CD63 and HAMA score in group A were significantly lower than those in group B ( t =2.107,3.242,2.079 and 7.779,P =0.039,0.002,0.041 and ＜0.01,respectively).Conclusions Anxiety mood markedly aggravates the disorder of vascular endothelial function and platelet activation,and both of them can be improved by anti - anxiety therapy.Consequently,the intervention in anxiety mood may improve the outcomes of ACS patients.
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Objective To investigate the effects of macrophage inflammatory protein-1α (MIP-1α) combined with molecule 4-1BB L on the tumorigenicity of hepatocellular carcinoma cells in vivo. Methods Mouse MIP-1α (mMIP-1α) expressed Hepa 1-6 cells were transfected with m4-1BBL recombinant retrovirus, the anti-histidinol cells clones were selected and amplified. The expression of m4-1BB L was confirmed by flow cytometry. The growth curve of Hepa 1-6 cells transfected with mMIP-1α and m4-1BBL alone or together was drawn and compared. C57B/L Mice were randomly divided into 7 groups, 9 mice in each group, injected with mMIP-1α+m4-1BB L Hepa 1-6 cells, m4-1BB L Hepa 1-6 cells, mMIP-1α Hepa 1-6 cells, Hepa 1-6 cells, pLXSHD Hepa 1-6 cells or PBS respectively. The tumorigenicity of hepatocellular carcinoma cells and the mice survival rate were compared between each groups. Results Hepa 1-6 mMIP-1α+m4-1BB L cells which expressed both mMIP-1α and m4-1BB L were successfully established. The expression of mMIP-1α and m4-1BB L alone or together did not affect the growth curve of Hepa 1-6 cells. Observed for 5 weeks, no tumor developed in Hepa 1-6 mMIP-1α+m4-1BB L injected mice. The tumorigenicity of Hepa 1-6 mMIP-1α+m4-1BB L was lower than that of Hepa 1-6 mMIP-1α or Hepa 1-6 m4-1BB L in vivo. The survival rate of Hepa 1-6 mMIP-1α+m4-1BBL injected mice(9/9) was higher than that of Hepa 1-6 m4-1BB L injected mice (6/9)or Hepa 1-6 mMIP-1α injected mice (1/9). Conclusion Chemokine MIP-1α combined with costimulatory 4-1BB L lowered the tumorigenicity of hepatocellular carcinoma cells in vivo, and prolonged the mice survival period.
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Objective To investigate hypolipemic treatment of hyperlipidemic panereatiti(HLP)with integrated traditional Chinese and western medicine.Methods Cinical data of 20 patients of HLP were analyzed retrospectively.Eight patients in the control group were treated with conventional therapies,while 12 patients in the treatment group were treated as follows:①Enema with 180ml solution(50% magnesium sulfate 30 ml.Glycerin 60ml,water 90ml).②Rhubarb gastrogavage with 9 g tid.③Intravenous drip with 24 g salvia miltiorrhiza qd.Results The treatment group had significant difference comparing with the control group in terms of the serum TG in 48 hours(P<0.01),time of autonomous bowel movement recover(P<0.01),days of abdominal pain disappear(P<0.05),days of hospitalization(P<0.01).Conclusion The treatment of Enema with 180 ml solution.Rhubarb gastrogavage with 9g tid,and Intravenous drip with 24 g salvia miltiorrhiza qd can relieve the symptoms of HLP and decrease blood-fat greatly.
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Objective To evaluate the plasma levels of adrenomedullin (ADM) and urotensin Ⅱ ( U-Ⅱ ) in children with capillary bronchiolitis, and their clinical significance. Methods One hundred and fifty three children with capillary bronchiolitis and 36 healthy children were recruited. Plasma levels of ADM and U- Ⅱ were measured at acute stage ( <7days) and convalescent stage (>14days) of airway inflammation. The relationship of plasma ADM and U-Ⅱ levels with symptom scores was evaluated. Results Plasma levels of ADM and U-Ⅱ in acute stage of capillary bronchiolitis were significantly higher than those in convalescent stage and healthy controls ( ADM: t = 20. 57 and 26. 26, P < 0. 01; U-Ⅱ: t = 14. 27 and 7. 61, P < 0. 01 ) , and there were significant differences among mild, moderate and severe capillary bronohiolitis (F = 245. 94 and 304. 79, P <0. 01). Plasma level of U-Ⅱ in convalescent stage of capillary bronchiolitis was lower than that of healthy controls (t = 6. 99, P <0. 01 ) , but ADM was still in a higher level ( t = 8. 98, P < 0. 01 ). In the convalescent stage, there was significant difference on U-Ⅱ levels among mild, moderate and severe capillary bronchiolitis ( F = 25.69, P < 0. 01 ) , but no significant difference was observed for ADM levels (F = 2. 25 , P > 0. 05 ) . Plasma levels of ADM and U- Ⅱ in acute stage showed positive correlation with symptom scores, and the regression coefficients were 0.884 (P =0. 000) for ADM and 0. 943 (P = 0. 000) for U-Ⅱ . Conclusion Plasma ADM and U-Ⅱ levels in children with capillary bronchiolitis are increased in acute stage and correlated with the symptom scores, which may serve as laboratory indicators for assessing the severity of the disease.
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Objective To analyze the relationship between the change of serum vascular epidermis growth factor(VEGF) level and curative effect of pancreatic cancer treated by gamma rays, and evaluate it clinical significance. Methods The serum VEGF level of thirty patients with pancreatic cancer treated by gamma rays were determined before and one month after treatment. The relationship between curative effect,survival, life quality and the serum VEGF level was analyzed. Results The serum VEGF level of 30 cases before treatment was (624.1 ± 144.3) pg/ml, whereas one month after treatment it was (279.3 ± 83.4) pg/ml(P ＜0.01 ). In the 19 patient whose serum VEGF level decreased by more than 50%, CR + PR was gained in 18 patients, improved quality of life in 7 patients, and in the 11 patient whose serum VEGF level decreased by less than 50%, CR + PR in 7 patients, improved quality of life in 1 patient( P = 0.012, P = 0. 028). In 24patients who completed 2 years follow-up, 11 of 15 patients whose serum VEGF level decreased by more than 50% survived more than 1 year, which was higher than that of the patients whose serum VEGF level decreased by less than 50%. Conclusions The serum VEGF level decreased significantly after gamma rays treatment and the extent of decrease could be used as a surrogate to evaluate the therapeutic efficacy.
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The study was to analyze the correlation between pancreatic cancer and appendectomy, partial gastrectomy, cholecystectomy and tonsillectomy in Chinese population. Case control study was made comprising 493 pancreatic cancer patients confirmed by histology and 1031 hospitalized non neoplastic controls matched with age, sex, residing district, and economical income. The value of odds ratio (OR) and its 95% confidence interval (CI) were calaclated to estimate the relative risk of appendectomy, partial gastrectomy, cholecystectomy and tonsillectomy to the occurrence of pancreatic cancer, and logistic regression was conducted. The results showed that the risk of pancreatic cancer increased in patients who had had appendectomy, partial gastrectomy and cholecystectomy, and all the p values of trend test were
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Smoking is presently the only generally accepted risk factor for pancreatic cancer. In recent studies, reproductive history has been associated with pancreatic cancer, but with contradictory results. In order to evaluate a possible association between age of first parturition and the number of births and pancreatic cancer, we conducted a case control study with a hospital background. Association between age of first parturition and the number of births and pancreatic cancer was found, and it remained after adjustment for cigarettes smoking, alcohol consumption, body mass index, cholelithiasis, cholecystectomy, diabetes mellitus, chronic pancreatitis and partial gastrectomy. Young age of first parturition and high reproductive history, such as 3 or more births were risk factors for pancreatic cancer.
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To study the relationship between the occurrence of pancreatic cancer with diabetes mellitus, other medical conditions and familial history in Chinese population. A case control study comprising 493 histologically confirmed pancreatic cancer patients and 1031 hospital non neoplastic controls matched with age, sex and economical income was conducted. The value of odds ratio (OR) and its 95% confidence interval (CI) to estimate the relative risk of diabetes mellitus, other medical conditions and familial history were calculated. The results showed that ORs and 95%CIs of diabeties diagnosed 2 years prior to the diagnosis of pancreatic cancer, cholelithiasis, chronic pancreatitis, cancer history, pulmonary tuberculosis, Helicobacter pylori infection, family history of cancer and family history of diabetes mellitus were 4 64(2 05～10 49),4 12(2 81～6 04),18 38(6 33～53 35),9 47(4 97～18 06),4 21(2 30～7 72),1 14(0 45～2 89),2 01(1 29～3 14), 0 83(0 15～4 56) respectively. The p values of diabeties and cholelithiasis in logistic regression analysis were less than 0 05. The analysis suggested that diabetes mellitus, cholelithiasis, chronic pancreatitis, cancer history, pulmonary tuberculosis, and family history of cancer were risk factors of pancreatic cancer, whereas diabetes mellitus and cholelithiasis were the independent factors.