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Objective To investigate the complications of therapeutic endoscopic retrograde cholangiopancreatography(ERCP) in patients with metabolic syndrome and their prevention. Methods Clinical data of 300 patients who underwent therapeutic ERCP in the First Affiliated Hospital of Soochow University from March 2013 to January 2016 were analyzed retrospectively. Among these patients, 100 of them(group A)had metabolic syndrome and 200 others(group B)did not. Age, sex and post-operative hyperamylasemia,acute pancreatitis,infection of biliary tract and upper gastrointestinal bleeding of two groups were compared. In addition,effects of BMI,TG,BP and FPG on the occurrence of complications in group A were analyzed. Results No difference was found in age and sex between group A and B(P>0.05),but group A had higher incidences of post-operative hyperamylasemia[16.0%(16/100)VS 6.0% (12/200)],acute pancreatitis[14.0%(14/100)VS 4.0%(8/200)], infection of biliary tract[12.0% (12/100)VS 4.0%(8/200)]and upper gastrointestinal bleeding[8.0%(8/100)VS 1.0%(2/200)] (P<0.05). Meanwhile, patients had higher incidences of complications(post-operative hyperamylasemia, acute pancreatitis,infection of biliary tract and upper gastrointestinal bleeding)when BMI[56.10%(46/82) VS 22.22%(4/18)],TG[56.41%(44/78)VS 27.27%(6/22)],BP[64.29%(27/42)VS 39.66% (23/58)]or FPG[54.44%(49/90)VS 10.00%(1/10)]increased in group A(P < 0.05).Conclusion Patients with metabolic syndrome have a higher incidence of complications after therapeutic ERCP than patients without. Therefore,careful preparation, post-operative observation and intervention are essential when patients with metabolic syndrome undergo therapeutic ERCP.
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BACKGROUND:More than 10 kinds of lipid metabolism-related genes have been found, and endocrine dysfunction mediated by these genes is an important pathological basis for the occurrence and development of insulin resistance. OBJECTIVE:To investigate the effects of metformin on serum lipid profiles and the expression levels of various genes associated with insulin resistance, as well as the histopathological changes of the liver and pancreas in rats with type 2 diabetes melitus. METHODS:A type 2 diabetes mellitus rat model was established by feeding a high-fat diet to the rats for 4 weeks, combined with the intraperitoneal injection of streptozotocin (35 mg/kg). In the meanwhile, metformin was administered orally (400 mg/kg?d) (model group) or nothing (control group). Semi-quantitative RT-PCR, histopathological and biochemical examinations were then performed. RESULTS AND CONCLUSION:Metformin improved the symptoms of insulin resistance by normalizing the serum lipid profiles in the diabetic rats. Furthermore, metformin upregulated the expression levels of insulin receptors and genes associated with lipid metabolism, including acyl-CoA oxidase, carnitine palmitoyl transferase-1 and peroxisome proliferator activated receptor-α. In addition, metformin downregulated the expression levels of fetuin-A and retinol binding protein-4, and improved the expression of perilipin that had been reduced in the type 2 diabetes mellitus rats. Metformin was shown to induce positive signaling for insulin and the regeneration of pancreaticβcells in the pancreas. These results suggest that metformin ameliorates the insulin resistance induced by type 2 diabetes mellitus via regulating the expression levels of fetuin-A, retinol binding protein-4, perilipin and various genes associated with lipid metabolism.
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BACKGROUND: Bone morphogenetic protein in combination with hol ow porous titanium al oy can improve the affinity with surrounding bone tissues. OBJECTIVE: To observe the effects of bone morphogenetic protein 2 on growth and osteogenic differentiation of bone marrow mesenchymal stem cel s cuftured on a hol ow porous metal prosthesis scaffold. METHODS: Passage 3 Sprague-Dawley rat bone marrow mesenchymal stem cel s were directly inoculated onto a hol ow porous metal prosthesis, and then the scaffold was cultured in DMEM medium containing 0, 0.001, 0.01, 0.06 and 0.1 g/L bone morphogenetic protein 2, respectively. At 6, 12, 24 and 48 hours after inoculation, cel adhesion was detected by MTT assay. Cel osteogenic differentiation was detected by alizarin red staining at 18 days. Besides, Transwel culture was put on the scaffold, and 5x108/L bone marrow mesenchymal stem cel s were added into the upper chamber, and DMEM medium containing 0, 0.001, 0.01, 0.06 and 0.1 g/L bone morphogenetic protein 2 were added into the lower chamber to observe cel migration capability after 0, 6, 12, 24 and 48 hours culture. RESULTS AND CONCLUSION: After 6-48 hours of inoculation, different mass concentrations of bone morphogenetic protein 2 promoted adhesion of bone marrow mesenchymal stem cells in a time-dependent manner. After 18 days of inoculation, bone marrow mesenchymal stem cells induced by different mass concentrations of bone morphogenetic protein 2 changed from fusiform to polygon, and arranged in a multilayer and overlapped form. Numerous calcified nodules could be found, which were stained red by alizarin red. Additionally, within 6-48 hours of culture, bone morphogenetic protein 2 could promote the migration of bone marrow mesenchymal stem cells in a concentration-and time-dependent manner. In conclusion, bone morphogenetic protein 2 can enhance the adhesion, osteogenic differentiation and migration of bone marrow mesenchymal stem cells cultured on the hollow porous metal prosthesis.
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BACKGROUND:Some scholars have prepared zein/chitosan composite membrane based on blending methods, and preliminary evaluation ofitsphysical and chemical properties showsthat chitosan partly improvesthe mechanical properties and hydrophilic properties of zein. Therefore, zein/chitosan composite membrane presumably has good cytocompati bility, which is beneficial to osteogenic differentiation of bone marrow mesenchymal stem cels. OBJECTIVE:To explore the effect of zein/chitosan composite membrane on the differentiation of bone marrow mesenchymal stem cels into osteoblasts and its feasibility asabone tissue-engineered material. METHODS:With 60% acetic acid as solvent, zein/chitosan composite membrane was prepared by blending and casting method. The structure and physicochemical properties of the composite membrane were investigated by Fourier transform infrared spectroscopy, tensile testing, water absorption testing and scanning electron microscopy. And the cytocompatibility of the membrane was evaluated byin vitrocel cufture. Besides,bone marrow mesenchymal stem celsfrom Sprague-Dawley ratwere isolatedvia adherence screening method, andthe effects of thecompositemembrane on theosteogenic differentiation ofthese celswere observedby scanning electron microscopy, fluorescent labeling and alkaline phosphatase assay. RESULTS AND CONCLUSION:The tensile strength, water absorption and hydrophilicity of the films were improved with the chitosan increased; chitosan could promote cel proliferation indicating the good cytocompatibility of the composite films. Moreover, osteogenic induction occurredin bone marrow mesenchymal stem cels cultured on the compositem embrane, and with an increase of chitosan, the induction was promoted. In conclusion, zein/chitosan composite membrane can be applied widely in the field of bone tissue engineering.
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Objective To investigate the clinic application significance of hand control high frequency continuous positive airway pressure treatment with self-inflating bags(SIB) fitted with positive end expiratory pressure (PEEP) valves on the neonatal transport of severe neonatal congenital diaphragmatic hemia (CDH).Methods Clinical data of a total of 28 infants with severe CDH transported by the pre-hospital emergency care team of our department were analyzed.The 28 patients were divided into treatment group (n =16) and control group (n =12).Hand control high frequency continuous positive airway pressure of SIB and PEEP valve were administered in the treatment group,while only hand control SIB positive airway pressure were given in the control group during the transportation.The exacerbation,complication and blood gas indicators at different time before and after treatment in two groups were monitored and compared.Results In the treatment group,no case aggravated,no case complicated with gas leakage,pulmonary hemorrhage,persistent pulmonary hypertension,intracranial hemorrhage; 2 cases died for multiple organ failure before operation (12.5％),5 cases died after operation (31.3％).In the control group,8 cases aggravated (66.7％),cases complicated with gas leakage,pulmonary hemorrhage,persistent pulmonary hypertension,intracranial hemorrhage were 5 (41.7 ％),3 (25.0％),1 (8.3 ％),respectively; 4 cases died for multiple organ failure before operation (41.7％),5 cases died after operation (33.3％).The indexes of pH,PaO2,PaCO2 and PaO2/FiO2 at different time before and after treatment between the treatment group and the control group or in each separate group all showed statistical significance (P ＜ 0.05).Conclusion Early accurate diagnosis during transportation with hand control high frequency continuous positive airway pressure of SIB fitted with PEEP valves for CDH is a safe and effective ventilation method which can reduce complications and increase successful transfer and survival rate.