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OBJECTIVE@#To investigate the effect of acetylcorynoline (Ace) for promoting functional recovery of injured spinal cord in rats and explore the underlying mechanism.@*METHODS@#Rat models of spinal cord injury (SCI) were treated with intraperitoneal injection of different concentrations of Ace, with the sham-operated rats as the control group. After the treatment, the changes in motor function of the rats and the area of spinal cord injury were assessed with BBB score and HE staining, and the changes in pro-inflammatory cytokine levels and microglial activation were determined using PCR, ELISA and immunofluorescence staining. In a lipopolysaccharide (LPS)-treated BV2 cell model, the effects of different concentrations of Ace or DMSO on microglial activation and inflammatory cytokine production were observed. Network pharmacology analysis was performed to predict the target protein and signaling mechanism that mediated the inhibitory effect of Ace on microglia activation, and AutoDock software was used for molecular docking between Ace and the target protein. A signaling pathway blocker (Osimertinib) was used to verify the signaling mechanism in rat models of SCI and LPS-treated BV2 cell model.@*RESULTS@#In rat models of SCI, Ace treatment significantly increased the BBB score, reduced the area of spinal cord injury, and lowered the number of activated microglia cells and the levels of pro-inflammatory cytokines (P < 0.05). The cell experiments showed that Ace treatment significantly lower the level of cell activation and the production of inflammatory cytokines in LPS-treated BV2 cells (P < 0.05). Network pharmacology analysis suggested that EGFR was the main target of Ace, and they bound to each other via hydrogen bonds as shown by molecular docking. Western blotting confirmed that Ace inhibited the activation of the EGFR/MAPK signaling pathway in injured mouse spinal cord tissue and in LPS-treated BV2 cells, and its inhibitory effect was comparable to that of Osimertinib.@*CONCLUSION@#In rat models of SCI, treatment with Ace can inhibit microglia-mediated inflammatory response by regulating the EGFR/MAPK pathway, thus promoting tissue repair and motor function recovery.
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Mice , Animals , Rats , Recovery of Function , Lipopolysaccharides , Microglia , Molecular Docking Simulation , Spinal Cord Injuries , Signal Transduction , Cytokines , ErbB ReceptorsABSTRACT
Objective@#To investigate the clinical and laboratory features of Aeromonas bacteremia in patients with hematological diseases, and provide evidence for the prevention and treatment of Aeromonas infection.@*Methods@#A retrospective study of patients with bloodstream infection of Aeromonas in our hospital from January 2014 to December 2018 was carried out. The clinical characteristics, antimicrobial susceptibility, infection seasons, antimicrobial therapy and evolution were analyzed.@*Results@#A total of 42 patients with hematological diseases had Aeromonas bloodstream infection within 5 years. Among them, 39 cases (92.9%) of bloodstream infection occurred in the stage of neutropenia. The median time of fever was 4 (1-27) d, 22 (52.4%) patients only had fever, 6 (14.3%) with gastrointestinal symptoms (abdominal pain, diarrhea, nausea, upper gastrointestinal bleeding) , 8 (19.0%) with pulmonary infection, 13 (31.0%) with skin and soft tissue infections. Seven patients (16.7%) died with skin and soft tissue infection. The resistance of Aeromonas to carbapenems was 68.3%-70.7%, while the resistance rate to cephalosporins, quinolones and aminoglycosides were less than 10%.@*Conclusions@#Aeromonas bacteremia in patients with hematological diseases mainly occur in the neutropenia stage, usually with symptom like fever. The mortality is increased when accompanied by skin and soft tissue infection. Antibiotic use should be based on susceptibility results, and avoid the use of carbapenems.
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This paper summarized the current ethical dilemmas of living will in our country including life ethical dilemmas, medical ethical dilemmas and family ethical dilemmas, and then proposed several suggestions for the promotion of living will in China:strengthening the theoretical research on related contents of living will, increasing the intensity of death education, carrying out related activities in the communities, strengthening the policy support and establishing hospital or regional pilots, to provide the feasible problems for the advancement of our country's living will.
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Objective To evaluate the feasibility and efficacy of posterior enlargement of spinal canal for the treatment of multi-segmental cervical diseases without cervical lordosis.Methods From January 2013 to June 2017,a retrospective study was conducted with 21 patients of multi-segmental cervical diseases accompanied cervical lordosis loss,and the complete followup data was obtained.There were 14 males and 7 females,with an average age of 53.9±7.3 years (range,42-65 years).There were 14 multi-segmental cervical spondylotic myelopathy,5 ossification of posterior longitudinal ligament,and 2 congenital cervical stenosis included in this study.The cervical lordotic angle and cervical curvature index were measured preoperatively and 1 year postoperatively.To access the enlargement of spinal canal and spinal cord,the anteroposterior diameter and cross section area of spinal canal or spinal cord were measured on MRI preoperatively and 1 year postoperatively.The Japanese Orthopaedic Association Scores (JOA) was applied to evaluate the neurological function at preoperation and postoperation.Visual Analogue Scales (VAS) was applied to evaluate the pain degree at preoperation and postoperation.Frankel classification was used to assess the severity of spinal cord injury at preoperation and postoperation.Results The follow-up time was 12-26 months,with an average of 16.4 months.The cervical lordosis angle was 3.1°±2.3° preoperatively,and 4.2°±1.6° 1 year postoperatively with a significant difference.The cervical curvature index was 4.4％ ± 1.7 ％ preoperatively and 5.0％ ± 1.5 ％ 1 year postoperatively with no statistically difference.Except for C7T1 level,the preoperative anteroposterior diameter and cross section area of spinal canal at C2.3,C3.4,C4.5,C5.6,and C6.7 level were lower than that at 1 year after operation with a significant difference.Except for C2,3 and C7T1 and level,the preoperative anteroposterior diameter and cross section area of spinal cord at C3,4,C4,5,C5,6,and C6,7 level were significantly lower than that at 1 year after operation.The average JOA score preoperatively was 8.9±1.7.The average JOA score at 3 months postoperatively was 13.1±2.0,which was significantly higher than that preoperatively.At 3 months postoperatively,the average improvement rate was 52.0％,and the superior rate was 52.3 ％.At 1 year postoperatively,the average JOA score was 13.3±2.1,which improved significantly from that preoperatively.The average improvement rate was 54.3 ％,and the superior rate was 61.9％.The VAS score at preoperatively was 3.0±2.4,and which was 2.7± 1.7 at 1 year postoperatively with no significant differences.At pre-operation,the level of Frankel classification was C level in one (4.8％) case,D level in 8 (38.1％) cases and E level in 12 (57.1％) cases.At 1 year postoperatively,the level of Frankel classification was C level in one (4.8％) case,D level in 6 (28.6％) cases and E level in 14 (66.7％) cases,compared with that at preoperatively,there was no statistically significant difference.One patients suffered from neurologic deterioration at 1 year after surgery and recovered after anterior cervical surgery.No other serious complications were occurred.Conclusion For the patients with multi-segmental cervical diseases accompanied cervical lordosis loss,effective spinal decompression by cervical posterior laminoplasty was feasible,and a good clinical efficacy was achieved.
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Objective To evaluate the mid-term and long-term effects of early endovascular emboli-zation in treating ruptured posterior communicating artery aneurysm. Methods Early endovascular embolization therapy was carried out in 36 patients with ruptured posterior communicating artery aneurysm (36 aneurysms in total), and the effects of embolization therapy were evaluated by using Raymond grading method. The unified imaging review program was formulated, and the mid-term and long-term effects were evaluated at half, 1, 2, 3 and 5 years after the treatment. Results The technical success rate was 100% in 36 patients (36 aneurysms in total). Raymond grading evaluation showed that gradeⅠwas seen in 32 patients, gradeⅡ in 2 patients, and grade Ⅲ in 2 patients. Recurrence of aneurysm was found in 5 patients (13.89%) at half (n=1), 2 (n=1), 3 (n=1) and 5 years (n=2) after the treatment. Re-rupture of the recurrent aneurysm was seen in one patient (2.78%). No death occurred during the following-up period. Conclusion Early endovascular embolization for ruptured posterior communicating artery aneurysm can effectively improve the prognosis of subarachnoid hemorrhage, and regular imaging examination can promptly detect the recurrence of aneurysm. Effective interventions are helpful for preventing deterioration and rupture of aneurysm.
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Objective To evaluate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) with oxaliplatin (OXA), fluorouracil (5-Fu) and pirarubicin (THP) scheme in treating primary liver cancer. Methods A total of 65 patients with primary liver cancer were treated with TACE using infusion of OXA/5-Fu/THP scheme (TACE group). Other 21 patients with primary liver cancer, who were encountered at the Department of Interventional Radiology of authors’ hospital during the same period as the patients of TACE group, received simple transarterial embolization (TAE group). The therapeutic effect, the occurrence of adverse reactions, the progression-free survival time (PFS) and overall survival time (OS) of the two groups were comprehensively evaluated. The results were compared between the two groups. Results In the TACE group, the objective response rate (ORR) and disease control rate (DCR) were 55.4%and 81.5%respectively, and the median PFS and median OS were 11.5 months and 18.5 months respectively. Single factor analysis indicated that patients, who had liver function of Child-Pugh A and received more times or treatment, and who had small-sized tumor and no portal vein tumor thrombus or metastasis, usually had a better prognosis, and the differences were statistically significant (P<0.05). The prognosis of the patients with Barcelona staging (BCLC) B was better than that of the patients with Barcelona staging C, and the difference was statistically significant (P=0.000). Cox multivariate analysis revealed that the portal vein tumor thrombus and tumor metastasis were independent risk factors for the prognosis of the patients. Compared with the TAE group, TACE with OXA/5-Fu/THP scheme could effectively improve the mean progression-free survival time. Conclusion For the treatment of primary liver cancer, TACE with infusion of OXA/5-Fu/THP is clinically effective with fewer adverse reactions.
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Objective To investigate the effect of all-trans retinoic acid (at-RA) on fetal alveolar epithelial type Ⅱ cells (fAEC Ⅱ s) proliferation and the expression of pulmonary surfactant C (SPC) as well as aquaporin 5 (AQP5).Methods fAEC Ⅱ s were isolated and purified from fetal lung of pregnant SD rats (19 days).After being cultured for 1 day,and the fAEC Ⅱ s were interfered by at-RA for 1,2 and 3 days.Cell proliferation,viability as well as growth state,expressions of SPC mRNA as well as AQP5 mRNA and expressions of protein SPC as well as AQP5 were respectively detected by using 4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide (MTT),inverted microscope,real-time fluorescence quantitative PCR (RT-PCR) and Western blot.Results (1) When fAEC Ⅱ s were treated with at-RA for 1 day,and the cell proliferation and viability did not change (P ＞ 0.05),while the proliferation and viability were significantly improved in 2 days (P ＜ 0.05),and the difference was the most obvious (P ＜ 0.05) at 3 days.(2)Compared with the control group,the cell growth state was better,and the cell adherence was tighter and the refraction was higher in at-RA group.(3) Compared with the control group,at-RA up-regulated the expressions of AQP5 mRNA and AQP5 protein(t =-19.58,-10.44,-16.01,-46.25,-12.79,-27.96,all P ＜ 0.05),and the percentages of control group were 281.07％,766.67％,1 163.33％ and 792.65％,1 310.52％,1 561.56％ in 1,2 and 3 days respectively.(4) Compared with control group,the expressions of SP-C mRNA and SPC protein were up regulated when cells were exposed to at-RA for 1 and 3 d,but while they were down-regulated at 2 days(protein:the percentages of control group were 615.480％,369.450％ and 11.269％,respectively ; mRNA:728.33 ％,400.83 ％,66.57％,respectively)(t=-26.34,-25.26,13.80,-25.25,-31.71,9.12,all P＜0.05).Conclusions at-RA can promote the proliferation and differentiation of fAEC Ⅱs,enhance the fAEC Ⅱ s viability,and improve the expression of SPC and AQP5.
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Objective To compare the clinical effect of hepatic artery perfusion of antibiotics with that of intravenous administration of antibiotics in treating pyogenic liver abscess which is unsuitable for puncture drainage management. Methods Between October 2010 and October 2013, a total of 32 cases with bacterial liver abscesses which were unsuitable for puncture drainage management were encountered at the Third Affiliated Hospital of Wenzhou Medical University. The patients were divided into group A (n = 15) and group B (n = 17). Hepatic arterial perfusion of antibiotics was carried out in the patients of group A, while intravenous administration of antibiotics was employed in the patients of group B. Percutaneous puncture drainage was adopted in the patients when their imaging examination showed liquefaction within the lesion. Results The hospitalization time, recovery time of body temperature, hemogram recovery time and liquefaction extent of the lesion in group A were much better than those in group B , and the differences were statistically significant (P < 0.05). Conclusion Hepatic arterial perfusion of antibiotics is an important and effective treatment for bacterial liver abscesses.
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Objective To study the effects of the Notch ligands Dlk1 and recombinant human nucleu factorκB (Jagged1) on the proliferation and transdifferentiation of the type Ⅱ alveolar epithelial cells when the Notch signaling pathway activated.Methods The primary type Ⅱ alveolar epithelial cells (AEC Ⅱ) cultured with recombinant protein Dlk1 and recombinant human nucleu factor-κB (rhNF-κB) (activator of Jagged1),respectively,and then cultured with DMEM (containing 120 mL/L FBS) as controls.Proliferation and differentiation conditions of the AEC Ⅱ were observed at 48 h,72 h,96 h time point by the light microscope and electron microscopes separately.Cell number was counted with hemacytometer; the proliferation rate was measured by methyl thiazolyl tetrazolium (MTT) ; Immunofluorescence double standard method was used to detect the AEC Ⅱ specific surfactant protein C (SP-C) and AEC Ⅰ specific protein aquaporin5 (AQPS) ;the expression of SP-C,AQPS,Dlk1,Jagged1,Notch1 and Hes1 mRNA were detected by real time-PCR.Results The cell population and proliferation:compared with control group,AEC Ⅱ proliferation was promoted in the Dlk1 group [cell numbers (× 109/L) 9.05 ± 0.45 vs 7.95 ± 0.65,11.68 ± 0.43 vs 8.68 ± 0.52,11.55 ± 0.17 vs 8.73 ± 0.48,all P ＜ 0.05 ; MTT results (value A) 0.699 ± 0.050 vs 0.462 ± 0.080,0.912 ± 0.080 vs 0.535 ±0.040,0.726 ±0.050 vs 0.540 ±0.020,all P ＜0.05] and decelerated AEC Ⅱ transdifferentiation into AEC Ⅰ ; while AEC Ⅱ proliferation was inhibited in rhNF-κB group [cell numbers (× 109/L) 4.95 ± 0.33 vs 7.95 ± 0.65,4.73 ±0.71 vs 8.68 ± 0.52,4.04 ± 0.11 vs 8.73 ± 0.48,all P ＜ 0.05; MTT results (value A) 0.398 ± 0.030 vs 0.462 ± 0.080,0.402 ± 0.070 vs 0.535 ± 0.040,0.380 ± 0.110 vs 0.540 ± 0.020,all P ＜ 0.05] and accelerated AEC Ⅱ transdifferentiation into AEC Ⅰ.One-Way ANOVA showed that the difference among the 3 groups had statistical significance (cell numbers:F =486.73,P =0.02; cell proliferation:F =37.16,P =0.02).The mRNA expression:compared with control group,the expression of SP-C mRNA of Dlk1 group was significantly higher (P ＜ 0.05) while the expression of AQP5 mRNA was remarkably lower and delayed (P ＜ 0.05),the expression of Jagged1 mRNA was weak or little,Dlk1 and Notch1 mRNA were up-regulated (P ＜ 0.05),and the Hes1 mRNA was reduced (P ＜ 0.05) ; the expression of SP-C mRNA of rhNF-κB group was significantly reduced (P ＜ 0.05),while the AQP5 mRNA expressed ahead of time and increased (P ＜ 0.05),Jagged1,Hes1 and Notch1 mRNA were higher (P ＜ 0.05),and the Dlk1 mRNA was weak.One-Way ANOVA showed that the difference in the expressions of SP-C,AQP5,D1k1,Jagged1,Hes1 and Notch1 mRNA among the 3 groups had staistical significance (F =96.80,P =0.01 ; F =82.55,P =0.01 ; F =269.80,P=0.00;F =312.34,P =0.00;F =169.17,P =0.01;F =19.85,P =0.02).Conclusions There are varied effects on proliferation and differentiation of the AEC Ⅱ when the Notch signaling is activated by different ligands:Dlk1 promoted proliferation and inhibited differentiation,while Jagged1 inhibited proliferation and promoted transdifferentiation.
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Objective Diabetic infrapopliteal artery occlusive disease Deep balloon angioplasty ( percutaneoustransluminal an-gioplasty, PTA) near the middle of the treatment effect and the Department of internal medicine ,conservative treatment .Methods Sixty patients with type II diabetes mellitus complicated with severe infrapopliteal arterial occlusive patients , divided into treatment group (41 cases) and Department of internal medicine treatment group (19 cases),all patients had CTA or MRA or DSA imaging;in-terventional treatment group using Deep balloonPTA ,3 days before operation and postoperative long-term Plavix and culture as anti platelet , blood glucose controltherapy;Department of internal medicine treatment group with control of blood glucose ,precedent in im-proving microcirculation ,debridement dressing and anti infection;observed in 2 week,1 month,3 months,6 months ,1 year,2 years,3 years, two groups were compared after treatment of clinical symptoms and changes signs ,ankle brachial index (ABI),the dorsal artery of foot diameter and blood flow velocity ,evaluation and the total efficiency of 6 months,1 year,2 years,3 years and cut rate .Results Interventional arterial blood flow improved significantly after operation in treatment group ,the clinical symptoms,signs were improved obviously, ankle brachial index improved significantly ,compared with the Department of internal medicine treatment group statistical significance ( P <0.05 ) ,and the total efficiency of 3 years the rate of limb salvage and Department of internal medicine therapy group with significant difference ( P <0.05).Conclusions Deep balloon PTA treating diabetic infrapopliteal artery occlusive disease cura-tive effect,can significantly improve the rate of limb salvage;Department of internal medicine treatment forelderly ,important organ dys-function patients .
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Objective To evaluate the effect of evidence- based nursing for patients receiving percutaneous coronary intervention and stent implantation. Methods A total of 136 patients with coronary heart disease were randomly divided into the intervention group (n = 68) and the control group (n = 68). Traditional nursing measures were employed for the patients of the control group , while evidence-based nursing intervention was adopted for the patients of the intervention group. The patient’s comfortableness, satisfaction and the occurrence of complications were determined at 24, 48 and 72 hours after the operation, and the results were compared between the two groups. Results At 24, 48 and 72 h after percutaneous coronary intervention, the each dimension score of GCQ and the total score of the intervention group were significantly higher than those of the control group (P<0.05). The occurrence of back pain, urinary retention and hypotension in the intervention group was significantly lower than those of the control group (P < 0.05). Patient’s satisfaction extent of the intervention group was significantly better than that of the control group (P < 0.05). Conclusion Evidence-based nursing intervention can effectively enhance the nursing skill and orientation, and reduce the occurrence of back pain, urinary retention and hypotension, thus improve patient’s comfortableness and satisfaction. Therefore, evidence - based nursing intervention should be recommended in clinical practice.
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Objective To explore the surgical techniques and clinical outcome of standard large trauma craniotomy in the treatment of acute subdural hematoma.Methods The clinical data of 51 cases with acute subdural hematoma,who underwent standard large trauma craniotomy in recent 5 years in our department,were retrospectively analyzed.Results All the patients were followed up for 3 ～ 6 months.10 cases were dead,4 persistent vegetative status,severe disability in 6 cases,midrange disability occurred in 11 cases and 20 cases were good.Postoperative complications included tardive haematoma in 4 cases,traumatic cerebral infarction in 2 cases,subdural collection of fluid in 4 cases,cerebromalacia in depressor area in 2 cases,hydrocephalus in 2 cases,and traumatic epilepsy in 3 cases.Conclusion Standard large trauma craniotomy is an effective approach in the treatment of acute subdural hematoma,due to its advantages such as satisfactory exposure for haemostasis,rapid removal of haematoma and relief of acute intracranial hypertension.
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Objective To study the frequency and characteristics of secondary monoclonal gammopathy of undetermined significance(sMGUS) in multiple myeloma (MM),and analyze the impact on survival.Methods The data of 515 patients with MM admitted were analyzed retrospectively.73 cases of patients underwent stem cell transplantation and 442 patients received thalidomide or bortezomib based chemotherapy.Immunofixation electrophoresis(IFE) and clinical characteristics were respectively analyzed,and the comparison of survival between sMGUS group and non-sMGUS group was performed.Results Thirty-five cases (6.8 ％) of myeloma patients with sMGUS were found in all patients.The incidence of sMGUS after hematopoietic stem cell transplantation treatment is significantly higher than that of receiving chemotherapy (19.2 ％ versus 4.8 ％,x2 =20.587,P =0.002).The CR rates of sMGUS group and non-sMGUS group were 45.7 ％ (16/35) and 14.3 ％ (59/480) (x2 =22.961,P ＜ 0.001).The median survival time of patients with sMGUS was much prolonged compared with the control cohort (42.0 versus 14.0 months,P ＜ 0.001).However,when the analysis was restricted on patients underwent stem cell transplant,patients with sMGUS had a negative impact on outcome,and the median overall survival was 30.8 and 39.3 months (P =0.002).Conclusion The sMGUS may be attributed to either immune reconstitution or immune system dysregulation after highly immunosuppressive therapy.The incidenceof sMGUS after auto-SCT treatment is higher than chemotherapy.The sMGUS group has the higher response rate and longer survival.But for auto-SCT treatment patients,sMGUS may be not a good prognostic factor.
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It is important in clinical practice to identify the types of serum free light chain (FLC),especially to measure the concentration of serum FLC.The serum FLC assay in combination with other serum protein analysis are very valuable in the diagnosis,monitor,and response evaluation of patients with plasma cell disorders(PCD).The methods progress of the measurement of serum FLC and clinical application in diagnosis and evaluation of treatment are reviewed.
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Objective To explore the difficulty and strategy of percutaneous transheptic stenting for the junction of malignant hepatic duct obstruction. Method Twenty-three patients with highly malignant biliary obstruction received percutaneous transheptic biliary drainage (PTBD) by placement of stent and/or internal-external drainage tube. All the 23 patientws were followed up to determine the successful rate of surgery, the incidence of complications, decreased serum level of bilirubin, patency time of biliary stent and survival time. Results The initial operation was sucessful in 22 cases, accounting for 95.65%. Twenty-one patients had significant decline in total bilirubin (60%) and 2 had not (10%). The levels of alanine aminotransferase (GPT) and aspartate aminotransferase (GOT) decreased markedly and returned to nomral in an average of 18 d. After operation, 2 patients had fever,1 biliary tract bleeding, 6 pain in the right upper abodminal region, 1 localized peritonitis around the puncture point, 3 GPT increase and 1 drainage tube slip. There were no serious complications such as hemorrhea and biliary fistula etc. The symptoms of all these complications disappeared in 2 to 5 days through haemostasis, anti-inflammatory therapy and liver function protection. The median survival time was 8.5 months. Conclusion Although the merging of malignant hepatic duct obstruction stenting is difficult, try to pass through the obstruction by guide wire and master the right methods of operation can significantly improve the successful rate of surgery.
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This article was to study the micro-leakage of 3 different root canal sealers (Endomethasone, AH-Plus and GuttaFlow) by fluid filtration test, and to observe the micro-structure between walls of root canal and the sealers by SEM. The results indicated that the micro-leakage of GuttaFlow was the least and Endomethasone was the most. Statistics difference were found between all the groups. Different root canal sealer got different micro-structure between walls of root canal and sealers. So we consider that the canal sealing ability of GuttaFlow is the best among these sealers.
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Seminar is an exploratory learning model with problem-based and project-or-ganized characteristics.The application practice of Seminar learning model in the process of teaching and training postgraduates of health management shows that the model has an important influence on improving the quality of postgraduates in our country.
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Small knife needle plus manual reduction method was used to treat the transverse process syndrome of the third lumbar vertebra. The small knife needle was adopted to loosen the third vertebra with little invasion and manual reduction method to remove adhesion by pulling back and forth. Among 859 cases treated, 652 cases were cured and 196 cases improved, with the total effective rate of 98.8%. It is indicated that small knife needle plus manual reduction method has positive effects on the transverse process syndrome of the third lumbar vertebra as well as other soft tissues injury.
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BACKGROUND: Nitric oxide in the central nervous system is involved in controlling the sympathetic outflow. The authors' recent data show that the reduction of nitric oxide in the rostral ventrolateral medulla (RVLM)enhanced the cardiac sympathetic afferent reflex (CSAR) evoked by stimulating the cardiac sympathetic afferent nerves in rats with chronic heart failure (CHF).OBJECTIVE: To further investigate the effect of nitric oxide in the RVLM on modulating the CSAR evoked by epicardial chemical stimulation in rats with CHF.DESIGN: Randomized controlled experiment.SETTING: Department of Physiology, Nanjing Medical University, and Department of Cellular and Integrative Physiology, University of Nebraska College of Medicine.MATERIALS: This study was carried out in the Department of Physiology, Nanjing Medical University from July 2003 to May 2004. A total of 52male Sprague-Dawley rats weighing 360-420 g were used, and were randomly divided into chronic heart failure group and control group with 23 in each group.METHODS: The rats were carried out either sham surgery or the left coronary artery ligation. Six to eight weeks later, all rats were anesthetized with α-chloralose and urethane and baroreceptor denervated and vagotomized. The CSAR was evoked by epicardial application of bradykinin (BK, 0.04 μg and 0.4 μg in 2.0 μL) to mimic the effect of chemical stimulation on the heart in the CHF state. The renal sympathetic nerve activity (RSNA), mean arterial pressure (MAP) and heart rate (HR) were recorded at baseline and during elicitation of the CSAR. Cannulae were inserted into the RVLM for microinjections.croinjection of MeTC, a nitric oxide synthase inhibitor, into the RVLM on Effects of epicardial pretreatment with lidocaine on the CSAR in CHF rats.infarction of (30.6±2.0) % of the left ventricular (LV) surface. The systolic arterial pressure, pulse pressure, left ventricle peak systolic pressure and maximum of the first differentiation of left ventricular pressure were decreased and the left ventricular end-diastolic pressure was significantly ininto the RVLM had no significant effects on the CSAR in rats with CHF,of SNAP (50 nmol) into the RVLM inhibited the CSAR in both sham rats ventricle abolished the CSAR evoked by epicardial application ofBK on the same area.CONCLUSION: Nitric oxide in the RVLM inhibits the CSAR evoked by epicardial application of BK in normal rats and CHF rats, and the reduction of nitric oxide in the RVLM led to the augmentation of the CSAR in CHF rats.
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Objectives To investigate and evaluate the preventive and therapeutic effects of celecox ib,a selective cyclooxygenase-2(COX-2)inhibitor,on multiple colorectal adenorna and compare it with aspirin.Methods Ninty-six patients with colorectal multiple adenoma were randomly divided into A,B and C groups.Adenomas in all patients were removed with high-frequency eleetrocoagulation,electroexci- sion or argon plasma coagulation(APC)under colonoscopy.Then,group A were administered celecoxib 200 mg twice daily,group B aspirin 50 mg twice daily,group C served as control.Colonoscopy was per formed every 6 months in the first year,and every year in order to observe and evaluate the recurrence rate of adenoma and the side effects after the treatment.Results Twenty-seven patients in group A,26 pa- tients in group B and 27 patients in group C had completed the treatment.At the end of the treatment, on PP/ITT analysis,the cure rate of the eolorectal adenoma were 84.4%/100% ,78.1%/96.2% and 75.0%/88.9% in group A,B and C,respectively.During the first year of follow-up,there were 1 ,1 and 6 cases which were found recurrences of the adenomas in group A,B and C,respectively.The recurrence rates of coloreetal adenomas in group A(3.7%)and group B(4.0%)were significantly low er than that in group C(24.0%) (P＜0.05 and＜0.05,respectively).At the end of follow-up,the total recurrence rate of colorectal adenomas in group A(14.80%)and group B(19.2%)were significant- ly lower than that in group C(46.2%)(P＜0.05 and＜0.05).While the side-effective rate regroup A (3.3%)was significantly lower than that in group B(22.5%)(P＜0.05).Conclusions After re- section of the multiple colorectal adenomas,both the selective inhibitor of COX-2,celeeoxib and the non- selective inhibitor of COX-2,aspirin,may reduce its recurrence rate,but the former has a good tolerance and lower side-effects.