Role of peripheral blood lymphocyte subsets in echinococcosis-induced sensitization in mice / 中华微生物学和免疫学杂志

Objective:To establish a BALB/c mouse model of Echinococcus granulosus allergy and investigate the role of lymphocyte subsets in Echinococcus granulosus-induced sensitization. Methods:Echinococcus granulosus was isolated from the liver of sheep naturally infected with Echinococcus granulosus and cultured for 40 d. BALB/c mice were intraperitoneally injected with 50 microcapsules and sensitized by intraperitoneal injection of 0.1 ml/10 g of larval Echinococcus granulosus capsule six months after infection. According to the symptom scores 1 h after sensitization, these mice were divided into two groups: non-sensitized group ( n=6) and sensitized group ( n=6). The mice ( n=6) in control group were injected with sterile saline. Blood sample was collected from the angular vein of each mouse. Flow cytometry was used to detect B cells, NK cells and CD3 +/CD4 +/CD8 + T cells. Cytometric bead array was used to measure IL-4, IL-6 and IL-13. Results:The percentage of B cells was significantly higher in the non-sensitized group than in the control group ( P<0.001), but no significant difference was observed between the sensitized group and the control group. Compared with the non-sensitized group, the percentage of B cells in the sensitized group decreased significantly ( P<0.01). Compared with the control group, the percentages of NK cells in the non-sensitized group and the sensitized group decreased significantly ( P<0.001 and P<0.01). Compared with the non-sensitized group, the percentage of NK cells in the sensitized group increased significantly ( P<0.05). Compared with the control group, the percentage of CD3 + and CD4 + T cells in the non-sensitized group decreased significantly ( P<0.05), while the percentage of CD8 + T cells increased significantly ( P<0.01). Compared with the control group, the percentage of CD3 + and CD4 + T cells in the sensitized group increased significantly ( P<0.05 and P<0.001), while no significant change in the percentage of CD8 + T cells was detected. Compared with the non-sensitized group, the percentage of CD3 + and CD4 + T cells in the sensitized group increased significantly ( P<0.05), while the percentage of CD8 + T cells decreased significantly ( P<0.01). The levels of IL-4, IL-6 and IL-13 were significantly higher in the non-sensitized group than in the control group ( P<0.001). Compared with the control group, the sensitized group showed increased IL-4 ( P>0.05), significantly increased IL-6 ( P<0.01) and decreased IL-13 ( P>0.05). The levels of IL-4, IL-6 and IL-13 in the sensitized group were significantly lower than those in the non-sensitized group ( P<0.001). Conclusions:The BALB/c mouse model of allergy induced by larval Echinococcus granulosus was successfully established. This study proved that the humoral immune response induced by Th2 cells played an important role in Echinococcus granulosus-induced sensitization, which provides an important scientific basis for establishing a prevention and treatment strategy for patients with anaphylactic shock caused by extravasation of Echinococcus granulosus fluid.

Role of HIF-1α/BNIP3 signaling pathway in sevoflurane-induced attenuation of myocardial ischemia-reperfusion injury in rats: relationship with autophagy / 中华麻醉学杂志

Objective:To evaluate the role of hypoxia-inducible factor-1α (HIF-1α)/Bcl-2/E1B-19kDa interacting protein 3 (BNIP3) signaling pathway in sevoflurane-induced attenuation of myocardial ischemia-reperfusion (I/R) injury in rats and the relationship with autophagy.Methods:Ninety healthy adult male Sprague-Dawley rats, weighing 300-350 g, were randomly divided into 5 groups ( n=18 each): sham operation group (Sham group), I/R group, sevoflurane group (SEV group), HIF-1a inhibitor 2ME2 group (2ME2 group), and 2ME2+ sevoflurane group (MSP group). Myocardial I/R injury model was established by ligating the left anterior descending branch of coronary artery for 40 min followed by 120-min reperfusion in anesthetized rats.In SEV group, 2.4% sevoflurane was inhaled for 15 min starting from the beginning of reperfusion.In 2ME2 group and MSP group, 2ME2 (15 mg/kg) was intraperitoneally injected at 1 h before ligation of the left anterior descending branch of coronary artery, and the other treatments were similar to those previously described in group I/R or in group SEV.Animals were sacrificed at 120 min of reperfusion, and the left ventricular myocardium was taken for determination of the expression of HIF-1α and BNIP3 (by Western blot), activity of ROS (by DHE), and myocardial infarct size (by TTC)and for observation of autophagosome (with an electron microscope). Results:Compared with Sham group, the activity of ROS, the number of autophagosome and myocardial infarct size were significantly increased in the other four groups, the expression of HIF-1α and BNIP3 was up-regulated in I/R group and SEV group ( P<0.05). Compared with I/R group, the activity of ROS, the number of autophagosome and myocardial infarct size were significantly decreased in the other four groups, the expression of HIF-1α and BNIP3 was up-regulated in SEV group, and no significant difference was found in the activity of ROS, the number of autophagosome or myocardial infarct size ( P>0.05), and the expression of HIF-1α and BNIP3 was down-regulated in 2ME2 and MSP groups ( P<0.05). Compared with SEV group, the activity of ROS, the number of autophagosome and myocardial infarct size were significantly increased, and the expression of HIF-1α and BNIP3 was down-regulated in 2ME2 and MSP groups ( P<0.05). Conclusion:HIF-1α/BNIP3 signaling pathway is involved in sevoflurane-induced attenuation of myocardial I/R injury, which is related to inhibiting autophagy in rats.

Cardioprotection induced by sevoflurane postconditioning in patients undergoing cardiac surgery with cardiopulmonary bypass: a meta-analysis / 中华麻醉学杂志

Objective To systematically review the cardioprotection induced by sevoflurane postconditioning in the patients undergoing cardiac surgery with cardiopulmonary bypass.Methods Databases including Pubmed,EMBase,Web of Science,Cochrane Library,CBM,WangFang Data,CNKI and VIP were searched by a computer from the date of database establishment up to February 2019 and there was no limitation for language.The randomized control trials involving the cardioprotection induced by sevoflurane postconditioning in the patients undergoing cardiac surgery with cardiopulmonary bypass were collected.Evaluation indexes included:incidence of perioperative cardiac events,duration of intensive care unit stay,plasma concentrations of cardiac troponin I and creatine kinase-MB at 6 and 24 h after aortic opening,plasma concentrations of interleukin-6 at 2,12 and 24 h after aortic opening and percentage of spontaneous recovery of heart beat.Meta-analysis was conducted using the RevMan 5.3 and Stata 12.0 softwares.Results Seventeen randomized controlled trials involving 763 patients were included in our meta-analysis.Compared with control group,the incidence of reperfusion arrhythmia was decreased,the plasma concentrations of cardiac troponin I and creatine kinase-MB at 6 and 24 h after aortic opening and interleukin-6 at 2,12,and 24 h after aortic opening were decreased,the percentage of spontaneous recovery of heart beat was increased (P＜0.05 or 0.01),and no significant change was found in duration of intensive care unit stay in sevoflurane postconditioning group (P ＞ 0.05).Conclusion Sevoflurane postconditioning can produce cardioprotection in the patients undergoing cardiac surgery with cardiopulmonary bypass.

Comparison of intraoperative wake-up test performed under different methods of anesthesia in pa-tients undergoing scoliosis correction / 中华麻醉学杂志

Objective To compare the intraoperative wake-up test performed under different meth-ods of anesthesia in the patients undergoing scoliosis correction. Methods Sixty American Society of An-esthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 14-35 yr, undergoing elective scoliosis correction, were divided into dexmedetomidine-based anesthesia group (D group) and sevoflurane-based anesthesia group (S group), with 30 cases in each group. Patients were tracheally intubated after induc-tion of anesthesia. Maintenance of anesthesia was as follows: remifentanil 0. 3 μg·kg-1 ·min-1 was intra-venously infused, dexmedetomidine 0. 2 μg·kg-1 ·h-1 was intravenously infused in group D, and group S inhaled low flow sevoflurane 1 L∕min with the end-tidal concentration of 0. 8％ - 1. 5％. Narcotrend index value was maintained at 30-45. The wake-up time, adverse events, requirement for vasoactive agents and blood loss during wake-up test were recorded. The wake-up quality was evaluated. Results All the pa-tients successfully completed wake-up tests. Compared with group S, the wake-up quality was significantly increased, the incidence of agitation and bucking was decreased during wake-up test, the blood loss was reduced during wake-up test (P<0. 05), and no significant change was found in wake-up time or require-ment for vasoactive agents in group D (P>0. 05). Conclusion Dexmedetomidine-based anesthesia pro-duces better efficacy for intraoperative wake-up test than sevoflurane-based anesthesia in the patients under-going scoliosis correction.

Factors Associated with Echinococcosis-Induced Perioperative Anaphylactic Shock

This retrospective case-control study explored the factors associated with anaphylactic shock during surgery for cystic echinococcosis (CE) at the First Affiliated Hospital of Xinjiang Medical University between October 2008 and September 2013. Patients who suffered from anaphylactic shock (n=16) were age-matched 3:1 to patients who did not (n=43). Multivariate analysis suggested that IL-4 levels (odds ratio=1.096; 95% confidence interval=1.015–1.185; P=0.02) and cyst size (odds ratio=3.028, 95% confidence interval=1.259–7.283, P=0.013) were independently associated with CE-induced perioperative anaphylactic shock. Using the receiver operating characteristic (ROC) curves and a cut-off value of 415.7 ng/ml, IL-4 showed an area under the ROC (AUC) of 0.926, sensitivity of 75.0%, and specificity of 97.7%. Using a cut-off value of 7.8 cm, cyst size showed an AUC of 0.828, sensitivity of 81.3%, and specificity of 76.7%. In conclusion, results suggest that levels of IL-4 and cyst size were independently associated with echinococcosis-induced perioperative anaphylactic shock. These results could help identifying patients with echinococcosis at risk of anaphylactic shock in whom appropriate prophylaxis could be undertaken.

Establishment of Myocardial Infarction Model in Rabbits with Dynamic Investigation of Cardiac Function and Pathological Changes / 中国医学影像学杂志

Purpose To establish myocardial infarction model in rabbits and to evaluate cardiac function and pathological changes.Materials and Methods In 35 New Zealand white rabbits, the left anterior descending branch (LAD) of the coronary artery was ligated. The cardiac function was evaluated using echocardiography, and the blood serum brain natriuretic peptide (BNP) level was examined preoperatively, on postoperative day 1, and in 1 week, 2 weeks, 4 weeks and 8 weeks for comparison. Pathological sections and HE staining were performed to observe pathological changes. Results The death rate was 28.6% (10/35). There was progressive increase in left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) at 1 week, 2 weeks and 4 weeks (P<0.05). There was progressive decrease in left ventricular ejection fraction (LVEF) and left ventricular fractional shortening fraction (LVFS) at 1 day, 1 week, 2 weeks and 4 weeks (P<0.05). The BNP level started increasing in 1 day, peaked in 1 week, then gradually decreased but remained higher than preoperative level in 8 weeks (P<0.01). Pathological section showed typical myocardial cell degeneration, necrosis, ifbrosis, calciifcation and scar formation. Conclusion This myocardial infarction model is satisfactory with signiifcant decrease of cardiac function and increase of BNP level.

Clinical study on optimized anesthesia method in elderly patients with coronary heart disease scheduled for undergoing lower extremity surgery / 中华老年医学杂志

Objective To evaluate the safety and efficacy of three types of anesthesia methods in elderly patients with coronary heart disease undergoing unilateral lower extremity surgery.Methods Totally 65 patients with coronary heart disease of cardiac function Ⅰ-Ⅱ (NYHA),scheduled for undergoing unilateral lower limb surgery were randomly divided into three groups:local nerve block anesthesia of lumbar plexus plus the sciatic nerve (21 cases),general anesthesia (19 cases),epidural anesthesia (25 cases).Systolic blood pressure (SBP),heart rate (HR),pulse rate and blood oxygen saturation (SPO2) at 0 min,10 min,20 min,30 min,40 min after surgery at the end of the surgery were observed and recorded.The change of troponin Ⅰ (cTnI) at 3 day after surgery was observed.Visual analoguc scales (VAS) scores.movement reaction,the infortnation of muscle relax and corresponding management were recorded in order to detect anesthesia efficacy.Results The excellent and satisfactory rate of anesthesia efficacy of three groups were 17 cases (81.0％) and 4 cases (19.0％),17 eases (89.5％) and 2 cases (10.5％),22 cases (88.0％) and 3 cases (12.0％) (all P＞0.05).In epiduralgroup compared with other groups,SBP were decreased (both P＜0.05).cTnI in nerve stimulator group was decreased (all P＜0.05) at 1 and 3 day after surgery compared with general anesthesia group,and at 3 day after surgery,cTnI level in nerve stimulator group was lower than other two groups(all P＜0.05).Conclusions The nerve stimulator guided nerve block is the most safe method among general anesthesia and epidural anesthesia in elderly patients with coronary heart disease scheduled for lower extremity surgery.

Influence of esmolol infusion during operation on QT dispersity in elderly patients with coronary heart disease during perioperative period / 中华麻醉学杂志

Objective To investigate the influence of esmolol infusion on QT dispersity(QTd)in elderly patients with coronary heart disease during perioperafive period.Methods Fifty ASA Ⅱ or Ⅲ patients with coronary heart disease aged 65-80 yr undegoing non-cardiac surgery under general anesthesia were randomly divided into 2 groups(n=25 each):control group(group C)and esmolol group(group E).Anesthesia was induced with midazolam,fentanyl and vecuronium and maintained with continuous iv infusion of propofol andvecuronium and intermittent iv boluses of fentanyl.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 25-35 mm Hg.In group E a loading dose of esmolol 0.5 mg/kg was given iv over 1 min at 2 min before skin incision and was followed by esmolol infusion at 25 μg·kg-1·min-1 maintained until the end of operation.Radial artery was caunulated.MAP,HR,SpO2 and PETCO2 were continuously momtored.ECG composed of 12 leads was momtored before operation,at 30 min after skin incision,immediately after operation,and at postsurgery days 1 and 2.The longest and shortest QT intervals were measured and detected by a cardiologist not involved in the study.The QTd was calculated.The ventricular arrhythmia was also recorded.Results QTd,the incidences of QTd abnormality and ventricular arrbythmia were significantly lower in group E than in group C.Conclusion The use ofesmolol during operation may decrease QTd and prevent the occurrence ofventricular arrhythmia.

Efficacy and adverse events of sevoflurane versus propofol combined anesthesia for induction of general anesthesia: a Meta-analysis / 中华麻醉学杂志

Objective To systematically review the efficacy and adverse events of sevoflurane or propofol combined anesthesia for induction of general anesthesia. Methods We searched the PubMed, OVID, EMBASE,Cochrane Library and Chinese Biomedical Database (CBM) for studies on efficacy of sevoflurane versus propofol for anesthesia induction. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 4.2.8 software. Results Thirteen prospective randomized controlled trials involving 968 patients were included in our meta-analysis. The results showed that the time from onset of induction to loss of consciousness and the time for induction were significantly longer, the incidence of respiratory depression lower in S group than in P group. There were no significant differences in the incidence of adverse events during induction and success rate of inserting LMA at first attempt between the 2 groups. The incidence of adverse events with LMA insertion was significantly lower in S group than in P group. Conclusion Propofol combined anesthesia is suitable for rapid induction of anesthesia, and sevoflurane combined anesthesia is indicated for slow induction of anesthesia in patients with potential respiratory difficulty and for LMA insertion.

The experimental research of the evaluation on Pseudomonas aeruginosa infection with FQ-PCR / 中国医师杂志

Objective To probe the oprⅠ gene in rat model with Pseudomonas aeruginosa septicemia by FQ-PCR,and compare the sensitivity and specificity between FQ-PCR and traditional germiculture,and check the change of oprI gene before and after the antibiotic therapy as to rapidly judge its sensitivity.Methods The standard Pseudomonas aeruginosa with five different concentration were prepared,the drug-sensitive test wbre used to find lhe sensitive antibiotics.120 SD rats were random divided into five groups,five different concentrations of Pseudomonas aeruginosa were injecked into the rats with the same volume.Six rats of each group were picked up for taking blood for culture at the time points of Oh,12h,24h,and 48h after narcotization.Finally,the oprⅠ gene of each blood samples were checked with FQ- PCR.72 rats were random divided into three groups,therapeutic group,treated group and control group.Pseudomonas aeruginosa with the concentration of 1×109 CFU/ml were injected into those rats.Sensitive antibiotics,insensitive antibiotics and 0.9% NaCl were given to the therapeutic,treated and control group rats respectively.Six rats of each group were picked up for taking blood for culture at the time point of Oh,12h,24h,and 48h after narcotized.Finally,the oprⅠ gent of each blood sample were checked with FQ-PCR.Results The blood culture were positive in each period of the concentrations 1×109 CFU/ml and 1×108 CFU/ml.Results of FQ-PCR showed that the copy number decreased with time going,all of which were positive.The blood culture were positive at the time points of Oh and 12h with the concentrations of 1×107 CFU/ml and 1×106 CFU/ml,were positive with concentration of 107 CFU/ml at the time point of 24h,but negative with concentration of 107 CFU/m at the time point of 48h,and negative with the concentration of 1×106 CFU/ml at the time points of 24h and 48h.The blood culture were negative in each period of the concentration of 1×105 CFU/ml,and the results of FQ-PCR were negative.The blood culture were positive in each period of both treated and control group,but negative in each period of therhpeutic group,all the results of FQ-PCR were positive.Conclusion The coincidence rate between the method of FQ-PCR and trgditional germicuhure were 100%.Though the sensitivity of FQ-PCR was not increased,the time needed by diagnosis was shorter After treated with effective antibiotic,fhe sensitivity of FQ-PER to diagnosis Pseudomonas aeruginosa septicemia was higher than that of traditional germicuhure,and the experiment time was shorter.Detected the changes of the oprⅠ gene copies number may be helpful to estimate the sensitivity of antibiotic.

Comparation of the Diagnostic Value of Anti-Cyclic Citrullinated Peptide Antibody and Rheumatoid Factor in Patients with Rheumatoid Arthritis / 医学研究杂志

Objective To evaluate the role of anti-cyclic citrullinated peptide antibody(ACCP) and rheumatoid factor(RF) in patients with rheumatoid arthritis.Methods ACCP antibody and RF were detected in serum samples of 90 RA patients,30 other diseases patients and 35 healthy blood donors.The sensitivity,specificity,positive predictive value,negative predictive value,agreement rate and Youden`s index of these parsmeters for the diangnosis of RA were analyzed.We maped the receiver operative characteristic curve(ROC) and calculated area under the ROC curve.Results The positive rates of ACCP and RF were higher than those of patients with other diseases or healthy controls(P0.5).Conclusion ACCP is a valuable index for RA diagnosis.It is useful in improving the diagnostic accuracy of RA.

Early and late outcomes in patients with severe extracranial internal carotid stenosis undergoing carotid endarterectomy / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To determine the perioperative and late outcomes for carotid endarterectomy (CEA) in treatment of patients with high-grade stenotic lesions of the extracranial internal carotid artery.</p><p><b>METHODS</b>Twenty patients underwent 21 CEAs at the Zhongshan Hospital between May 1993 and June 2000. They were 19 men and 1 woman, with a mean age of 64 +/- 9 years. Seven patients were performed for stroke, 11 for transient ischaemic attacks (TIAs) and 2 for asymptomatic disease. Duplex scan was the primary tool of evaluation prior to surgery. Perioperative digital subtraction angiography and magnetic resonance angiography were done for 19 and 18 patients, respectively. The percentage of stenosis was calculated using NASCET criteria. Of the 21 lesions operated, 19 had a stenosis of 70% or greater, 2 had ulcerative lesions with a stenosis ranging from 60% to 69%. All CEAs were performed under cervical block anaesthesia with selective intraoperative shunting and patch angioplasty. The patients were followed up regularly with duplex scan surveillance.</p><p><b>RESULTS</b>There was no mortality or stroke during 30 days postoperatively. A TIA occurred in one patient and cranial nerve injury in 2 patients perioperatively. All patients were followed up for a mean interval of 31 +/- 20 months (range: 1 - 63 months). The 2-year survival rate and risk of stroke were 92.3% and 0%, respectively, and the 5-year survival rate and risk of stroke were 79.1% and 12.5%, respectively. Two asymptomatic recurrent stenoses ranging from 50% to 60% were detected on follow-up duplex scan.</p><p><b>CONCLUSIONS</b>For the patients in this study, CEA is associated with an acceptable perioperative outcome as well as a satisfactory long-term beneficial effect in stroke prevention.</p>