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Objective To compare the blood-saving effect when acute hypervolemic hemodilution (AHH) was performed with hydroxyethyl starch (HES) 130/0.4 dissolved in electrolyte injection (HES-E) and HES 130/0.4 in sodium chloride injection (HES-NaCl).Methods Thirty patients of both sexes,aged 18-60 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with body mass index of 18-25 kg/m2,hemoglobin (Hb) ＞100 g/L,hematocrit (Hct) ＞ 35％,scheduled for elective abdominal operations under general anesthesia,were randomly divided into HES-E group and HES-NaCl group using a random number table,with 15 patients in each group.AHH was performed after induction of anesthesia.In HES-E and HES-NaCl groups,HES-E and HES-NaCl 15 ml/kg were intravenously infused over 30 min,respectively,and the infusion was conpleted before skin incision.Immediately after onset of AHH (T1),at 2 h after the end of AHH (T2),and at the end of operation (T3),arterial blood samples were collected for blood gas analysis and blood routine test,and pH value,base excess,HCO3-,K+,Na+,Cl-,Ca2+,Hb and Hct were recorded.Venous blood samples were collected at T1 and T2 for measurement of blood coagulation parameters including prothrombin time,activated partial thromboplastin time and fibrinogen and thrombelastography parameters.The volume of liquid intake and output and requirement for allogeneic blood transfusion were recorded,and the blood volume expansion rate was calculated.Results Compared with group HES-NaCl,no significant changes were found in the total volume of liquid infused,requirement for allogeneic blood transfusion,blood volume expansion rate,blood coagulation parameters at each time point,Hb and Hct (P＞0.05),pH value,base excess,HCO3 and K+ were significantly increased,and Na+ and Cl-were significantly decreased in group HES-E (P＜0.01).Conclusion There is no significant difference in the blood-saving effect between AHH with HES-E and HES-NaCl clinically,but HES-E can maintain homeostasis better.
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Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on lung injury induced by hepatic ischemia-reperfusion (I/R) in rats.Methods Sixty healthy male SpragueDawley rats, aged 6-8 weeks, weighing 220-280 g, were randomly divided into 3 groups (n=20 each) using a random number table: sham operation group (group S) , hepatic I/R group (group I/R), and rHuEPO group (group E).I/R and E groups underwent I/R of 70 percent of the liver.The rHuEPO 4 000 U/kg was injected intraperitoneally at 24 h before I/R in group E, while the equal volume of normal saline was given in S and I/R groups.The rats were sacrificed at 3 h of reperfusion, and lungs were removed and cut into sections which were stained with haematoxylin and eosin and examined under light microscope.Wet to dry lung weight ratio (W/D ratio) was calculated.The expression of heme oxygenase-1 (HO-1) and inducible nitric oxide synthase (iNOS) in lung tissues was determined by immunohistochemistry.The content of malondialdehyde (MDA), and activities of superoxide dismutase (SOD) and myeloperoxidase (MPO) in lung tissues were detected.Results Compared with group S, the W/D ratio, MDA content, and MPO activity were significantly increased, the SOD activity was decreased, the expression of HO-1 and iNOS was up-regulated (P＜0.05) , and the pathological changes of lung tissues were obvious in E and I/R groups.Compared with group I/R, the W/D ratio, MDA content, and MPO activity were significantly decreased, the SOD activity was increased, the expression of HO-1 was up-regulated, the expression of iNOS was down-regulated (P＜0.05) , and the pathological changes of lung tissues were reduced in group E.Conclusion The rHuEPO can alleviate hepatic I/R-induced lung injury in rats, and the mechanism may be related to up-regulated expression of HO-1 and down-regulated expression of iNOS.
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<p><b>OBJECTIVE</b>To investigate the effect of pretreatment with ulinastatin on liver regeneration and TNF-α/IL-6/STAT-3 signal pathway in rats after 70% hepatectomy combined with ischemia-reperfusion injury.</p><p><b>METHODS</b>A total of 120 normal male SD rats weighing 230-280 g were randomized into 3 groups (n=40), namely simple partial hepatectomy (PH) group, partial hepatectomy with ischemia-reperfusion (PHIR) group, and ulinastatin group. All the rats received resection of the left and middle liver lobes. In PHIR group, the remnant right lobes were subjected to blood flow occlusion for 30 min; in UTI group, the rats were given 50 000 U/kg UTI intravenously prior to the occlusion, and in PH group, the blood flow was not occluded. At 1, 6, 12, 24, and 48 after the reperfusion, the remnant liver tissues were examined for regenerated liver weight, PCNA staining, TNF-α and IL-6, STAT-3, cyclin D1, and Cdk4 expressions.</p><p><b>RESULTS</b>The regenerated liver weight and PCNA positivity rates were significantly higher in ulinastatin group than in PHIR group at 24 h and 48 h after the reperfusion (P<0.05). In ulinastatin group, the levels of TNF-α and IL-6 were significantly lower, and IL-6 level and the expressions of STAT-3, cyclin D1, and Cdk4 mRNA and cyclin D1 and Cdk4 proteins were significantly higher in ulinastatin group than in PHIR group at 24 h and 48 h (P<0.05).</p><p><b>CONCLUSION</b>Ulinastatin can promote liver regeneration after major hepatectomy and ischemia-reperfusion injury, and the effect is possibly related with activation of IL-6/STAT-3 signal pathway, which promotes the synthesis of cyclin Dl-Cdk4 complex and hepatocyte proliferation.</p>
Subject(s)
Animals , Male , Rats , Cell Proliferation , Cyclin D1 , Metabolism , Cyclin-Dependent Kinase 4 , Metabolism , Glycoproteins , Pharmacology , Hepatectomy , Hepatocytes , Cell Biology , Interleukin-6 , Metabolism , Liver , Liver Regeneration , Rats, Sprague-Dawley , Reperfusion Injury , Metabolism , STAT3 Transcription Factor , Metabolism , Signal Transduction , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
Objective To investigate the effects of ulinastatin pretreatment on oxidative stress response and hepatocyte growth factor (HGF) after hepatectomy in rats.Methods One hundred and twelve pathogen-free male Sprague-Dawley rats,aged 3 months,weighing 230-280 g,were randomly divided into 2 groups (n=56 each): group hepatectomy (group H) and group ulinastatin pretreatment (group U).Left and median lobe resection was performed and then liver ischemia was induced by blood flow occlusion of right and caudate lobes for 30 min,followed by perfusion in both groups.Ulinastatin 50 000 U/kg was injected intravenously at 5 min before occlusion in group U.Eight rats in each group were chosen and the blood samples were taken from the inferior vena cava for measurement of serum ALT and AST activities and HGF concentration before ischemia and at 1,6,12,24and 48 h of reperfusion.Then the right lobe were removed for determination of apoptosis,SOD and myeloperoxidase (MPO) activities,MDA content,expression of proliferating cell nuclear antigen (PCNA) and liver regeneration.Apoptotic index was calculated.Another 8 rats in each group were chosen and the 7 day survival rate was recorded.Results Compared with group H,the levels of ALT,AST,MPO aud MDA and apoptotic index were significantly decreased,and the levels of HGF and SOD,PCNA expression and liver regeneration were significantly increased at different time points in group U (P ＜ 0.05).There was no significant difference in 7 day survival rate between group H and group U (P＞ 0.05).Conclusion Ulinastatin pretreatment can strengthen liver regeneration after hepatectomy in rats,the underlying mechanism may be related to inhibition of oxidative stress response and increase in HGF production.
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Objective To study the effects and mechanism of Huangqi against myocardium injury induced by ischemia and reperfusion in rats. Methods Totally 30 male Sprague-Dauley rats were randomly divided into three groups: control group (C group), ischemia/reperfusion group (I/R group), ischemic pretreatment with Huangqi group (H+I/R group), with 10 rats in each. The left anterior descending (LAD) coronary artery was ligated to establish the ischemia/reperfusion heart model. Huangqi was administered before the model was established in the H+I/R group. The pathologic changes of myocardial tissues (under light and electron microscopy), content of creatine kinase (CK), lactate dehydrogenase (LDH), malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) in serum, as well as activities of Na~+K~+-ATPase and Ca~(2+)-ATPase in myocardial tissues were observed. Results Light and electron microscopic examination showed that the necrotic degeneration and pathologic changes of myocardiocytes in Huangqi group were significantly milder than those in the model group. The levels of CK, LDH, MDA were decreased significantly in Huangqi group (P<0.05), the activities of SOD, Na~+K~+-ATPase and Ca~(2+)-ATPase in myocardial tissues in Huangqi group significantly increased (P<0.05). Conclusion Huangqi shows a significantly protective effect on myocardial I/R injury in rats. The mechanism may be related to multiple factors, including improving microcirculation, forming anti-oxygen free radicals and decreasing calcium overload.
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Objective To study the effects and mechanism of Huangqi against myocardium injury induced by ischemia and reperfusion in rats.Methods Totally 30 male Sprague-Dauley rats were randomly divided into three groups: control group(C group),ischemia/reperfusion group(I/R group),ischemic pretreatment with Huangqi group(H+I/R group),with 10 rats in each.The left anterior descending(LAD) coronary artery was ligated to establish the ischemia/reperfusion heart model.Huangqi was administered before the model was established in the H+I/R group.The pathologic changes of myocardial tissues(under light and electron microscopy),content of creatine kinase(CK),lactate dehydrogenase(LDH),malondialdehyde(MDA) and the activity of superoxide dismutase(SOD) in serum,as well as activities of Na+K+-ATPase and Ca2+-ATPase in myocardial tissues were observed.Results Light and electron microscopic examination showed that the necrotic degeneration and pathologic changes of myocardiocytes in Huangqi group were significantly milder than those in the model group.The levels of CK,LDH,MDA were decreased significantly in Huangqi group(P
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Objective To investigate the effects of prostaglandin E 1 (PGE 1) on the chronic obstructive pulmonary diseases (COPD) with pulmonary artery hypertension in the elderly people. Methods 60 elderly patients of COPD with pulmonary artery hypertension were randomly divided into therapy group and control group. The patients in therapy group received routine therapy plus intravenous 10?g PGE 1 once a day for 15 days. The patients in control group only received routine therapy. Before and after therapy, the mean pulmonary artery pressure (MPAP), artery O 2 pressure (PaO 2) and artery CO 2 pressure (PaCO 2), whole blood viscosity ratio, plasma viscosity ratio, hematocrit, platelet adhesive ratio and erythrocyte sedimentation rate were measured. Results The MPAP and PaCO 2 of post-treatment were significantly lower than those of pre-treatment(P