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Objective To assess the efficacy and safety of sequential type artificial liver with regional citrate anticoagulation in patients with hepatic failure at high risk of bleeding.Methods Fifteen patients with hepatic failure at high risk of bleeding treated with plasma exchange(PE)plus continuous veno -venous hemofiltration (CVVH)for 4h anticoagulation selected anticoagulant citrate dextrose solution A (ACD -A),blood flow velocity was setted to 100 -120mL/min.In the former,ACD -A solution was delivered pre -filter,with the rate adjusted to maintain a postfilter ionized calcium (iCa2 +)level between 0.35 -0.45mmol/L.Before the extracorporeal blood returned to the patients, 10% calcium gluconate was infused to maintain a systemic iCa2 + level between 0.90 -1.20mmol/L.Hypoxemia and hypocalcemia were correctted before treatment.Acid -base changes,serum sodium,total calcium -ionized calcium ratio were recorded at 2h,4h and 6h during the treatment.Effective therapeutic time (the therapy was completed successfully)also was recorded.Results The total 38 sessions were performed,effective performance was 35 sessions. 3 sessions were stopped because of high transmembrane pressure.Acid -base change,serum sodium had no significant changes.Serum iCa2 + concentration was detected 110 times,16 times were below 0.9mmol/L,the lowest concentration was 0.62mmol/L.Convulsion of the limbs appeared two times because of hypocalcemia.The total calcium -ionized calcium ratio above 2.5 appeared totally 6 times.The events improved after augmented substitution fluid.All events presented in advanced hepatic failure.Conclusion Under closely monitoring and application of preventive measures, regional citrate anticoagulation sequential type artificial liver is safe and efective for patients with hepatic failure at high risk of bleeding.The application in patients with advanced hepatic failure still is cautious.
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Objective To investigate the incidence, clinical characteristics, diagnosis, treatment and prognosis of solid-pseudopapillary tumor of pancreas (SPTP) in China. Methods Data of 5 cases treated in Liaocheng Second Hospital and 649 cases reported in literature in the recent 10 years were retrospectively analyzed.Results The disease showed an increasing trend in recent 10 years. In total, 595 cases were reported in the recent 4 years. The disease was more common in young female, with a 1: 10 male female ratio. Their ages ranged from 8 to 67 years, 26.1 years on average. The chief symptoms were abdominal pain and discomfort. Diagnosis depended on postoperative pathological and immunohistochemical analysis. Tumors were mainly located in pancreas. All tumors were treated by surgical resection and prognosis was good. Conclusion SPTP is not rare. Definite diagnosis of SPTP depends on postoperative pathological and immunohistochemical study. Surgical resection is recommended due to its good prognosis.
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Objective To explore the more secure and available methods in replacing traeheostomy tube.Methods Sixty patients with incision of trachea were divided into group A(29 eases)and group B (31 cases)randomly.The new method was used in group A with putting a catheter into the old tracheostomy tube before taking it out,and placing the new tracheostomy tube under the guide of catheter.While the traditional method was used in group B.The heart rate,SpO2,manipulation time,perioperative haemorrhage, and the condition of entering the false passage were recorded.Results The heart rate,SpO2 were no significant difference before and after manipulation in group A,but the heart rate increased and SpO2 decreased in group B(P<0.01 or<0.05).The manipulation time was(50.5±4.2) s in group A,and (84.9±5.3) s in group B(P<0.05).The perioperative haemorrhage >3 ml and the condition of entering the false passage in group A(2 Cases,o cage)were less than those in group B(15 cases.5 cases)(P<0.01 or<0.05).Conclusion The new method in replacing tracheostomy tube which use an input catheter is more security and more availability.
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The effects of drugs on intracellular calcium concentration(［Ca2+］i) were investigated with fura-2 fluorescence technique to investigate ATP and thrombin-induced Ca2+ entry in bovine aortic endothelial cells(BAEC). It was found that application of ATP and thrombin gave rise to biphasic ［Ca2+］i elevation. ATP or thrombin only triggered a fraction of cyclopiazonic acid(CPA)-sensitive Ca2+ store, which was enough to activate Ca2+ entry. The Ca2+ release induced by thrombin resulted from the activation of phospholipase C(PLC), whereas the PLC-independent mechanism was involved in ATP-induced Ca2+ release. Nifedipine had no effect on ATP and thrombin- induced Ca2+ entry. SK&F 96365 and ginsenoside-2A inhibited both ATP and CPA-induced Ca2+ entry, however no effect of them on thrombin-induced Ca2+ entry was found. The inhibitory effects of SK&F 96365 and ginsenoside-2A on CPA-induced Ca2+ entry were less than that on ATP-induced Ca2+ entry. The Ca2+ influx sensitive to SK&F 96365 was not the same as that to ginsenoside-2A. These observations suggest that both ATP and thrombin evoke Ca2+ release and Ca2+ influx by activation of different receptor. However their mechanisms appear different.
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Endothelium-derived hyperpolarizing factor (EDHF) is the third factor released by en-dothelial cell other than NO and PGI2. It relaxes smooth muscle accompanied by a hyperpolarization in the membrane potential. EDHF may be epoxye-icosatrienoic acids (EETs) formed from arachidon-ic acid by the action of cytochrome P450. It is synthesized and/or released by endothelial cell as a result of an cytosolic Ca2+ increase, which is stimulated by the action of acetylcholine or bradykinin on endothelial cell. EDHF is shown to activate Ca2+-activated K+ channels and induce a hyperpolarization in the membrane potential in vascular smooth muscle. The hyperpolarization of the membrane inhibits the opening of voltage-dependentcalcium channels, allows calcium sequestration and removal mechanisms to lower intracellular calcium, and leads smooth muscle to relaxation. In large conducing arteries, EDHF may provide a secondary system to NO, which assumes primary importance in endothelium-dependent relaxation and inhibits the release of EDHF. However, in small resistance arteries, EDHF appears to be a major determinant of vascular calibre, and may be of primary importance in the regulation of vascular resistance.
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Aluminum is a common metal element,and its nervous toxicity probably has an effect on the learning and memory mechanism. Long-term potentiation (LTP) is an available electrophysiology-model,cAMP/protein kinase A (PKA) approach is an important signal transduction pathway of nerve cells,and plays an important role in the process of learning and memory mechanism. Aluminum has some adverse effects on learning and memory through influencing some links,such as neurotransmitter,Ca2 + concentration,protein kinase and so on. According to the recent studies in this field,in electrophysiology and biochemistry,the present paper reviewed the effects of aluminum on the learning and memory mechanism,as well as the role of cAMP/PKA approach.
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The effects of Panax notoginseng saponins (PNS) and verapamil(Ver)on hemo-dynamics of internal carotid artery and superior mesenteric artery were determined and compared in anesthetized Sprague ~ Dawley strain rats. PNS 30-150 mg ? kg-1 iv was shown to reduce the mean blood pressure, internal carotid arterial resistance and superior mesenteric arterial resistance by 11 % ~19%, 14%~27%,23%~ 39%respectively. Meanwhile, the mesenteric ar-terial blood flow increased.by 16%~51%. Ver showed similar reflects as PNS. The results indicated that the vasodilation effects of PNS and Ver are vascular selective, that is PNS and Ver are more potent in dilating the mesenteric artery than the internal carotid artery.
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By means of DEAE-sephadex A - 50 column chromatography, the venom of Agkistrodon acutus was separated into fifteen fractions. The fraction Ⅱ was rechro-matographed, on sephadex G - 50 column and a single peak was obtained. The polyacrylamide disc gel electrophoresis also showed a single band. The fraction Ⅱ had strong fibrinolytic activity on dog plasma fibrin plate and showed direct fibrinolytic effect on heated fibrin plate. In addition to fibrinolytic activity, the fraction Ⅱ had fibrinogenolytic activity, In vitro and at aconcentration less than 17. 8 mg?L-1,the potency of fibrinolysis was higher than that of fib-rinogenolysis. Local hemorrhage activity which is characteristic for crude venom of Agkistrodon a-cutus was not found when the fraction 1 was injected hyperdermically in rabbit. The ip LD50 value of the purified fraction Ⅱ was determined to be 11. 1 mg ? kg-1 in mice and there was no gross hemorrhage found in the dead animals.
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Usually experiments done on isolated working heart preparation must be completed within 1 h, because of declining of cardiac functions after going beyond that limit reported by many authors. Our experiments on guinea pig showed that the viability time lasted at least 2 h. All measured indices of cardiac performance, namely LVP, dP/dtmax, MASP, HR, CF, AF, CO, LVPW, MVO2 and. working efficiency, remained stable within that period of time, .when PcO2 and PO2 of perfusing solution were adjusted at 4.7~7.3 kPa and over 67 kPa respectively, resulting in stability of pH value in 7.4 or so. Modification of the Krebs solution by devoid of phosphate and addition of pyruvate and EDTA may also be responsible for prolongation of the viability time. After such improvement, the preparation will give sufficient time to study the effect of drugs. Its use will be greatly widened.1 -10 mg/L cobra cardiotoxin increased CO, AF, LVEDP, MASP, LVP, dP/dtmax, decreased CF, and unchanged HR.MVO2 and working efficiency were insignificantly increased. These results obtained from this preparation were in accordance with that from other isolated cardiac preparations.
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AIM To establish the model of exudative pleurisy induced by alternatively activating complement and to study protection of anti inflammatory drugs on it. METHODS Purified cobra venom factor (CVF) was injected into the pleura, and then exudate volumn, total leukocyte count, protein content and histamine concentration were determined. RESULTS CVF, injected into rat pleura at dose of 0 08～2 mg?kg -1 , induced exudative inflammation in dose dependent and time dependent manner. Both diphehydramine and isoprenaline reduced significantly exudate volume, total leukocyte count, protein content and histamine concentration, while indomethacin, dexamethasone and cyclophosphamide also reduced exudate volume, total leukocyte count and protein content, although they did change the release of histamine. DLF, one of the toxic components in cobra venom, potentiated CVF induced inflammation. CONCLUSION CVF can induce significantly exudative pleurisy sensitive to anti inflammatory agents. DLF has augmentation on CVF induced inflammation.