ABSTRACT
Objective To investigate the protective effects of Ulinastatin on intestinal barrier damaged after cardiopulmonary resuscitation (CPR) in rats in order to illustrate the possible mechanism.Methods Twenty-one male SD rats were divided into three groups randomly (random number) including control group (sham group, n =7), cardiopulmonary resuscitation group (CPR group, n =7) and ulinastatin group (UTI group, n =7).The rats were anesthetized with pentobarbital sodium (45-60 mg/kg) by intraperitoneal injection.The rats of sham group were only treated with endotracheal intubation.Ulinastatin (100 000 U/kg) were injected via caudal vein 2 hours prior to CPR, and cardiac arrest was made in rats and cardiopulmonary resuscitation was carried out in the UTI group, while equivalent volume of sterile saline was used instead in the CPR group.Blood and ileum samples were obtained at 48 hour after restoration of spontaneous circulation (ROSC).The levels of tumor necrosis factor alpha (TNF-α) and interleukin-1β (IL-1β) were assayed by ELISA (enzyme-linked immunosorbent assay), the protein levels of caspase-3 were determined by western blot, the intestinal mucosa were stained by terminaldeoxynucleoitidyl transferase mediated nick end labeling (TUNEL) and ileac mucosa were observed under transmission electron microscope.Data were processed with SPSS 17.0 software.Results The plasma levels of TNF-α and IL-1β were dramatically higher in CPR group than those in other two groups (CPR vs.sham, P ＜ 0.01;CPR vs.UTI, P ＜ 0.05).Moreover, the tight junctions between cells obviously broadened and loosened in the CPR group were found under electron microscope, however, this phenomenon was not obvious in the UTI group.A large number of apoptotic cells were observed by TUNEL assay in the CPR group, but a small number of apoptotic cells were observed in the UTI group.The protein levels of caspase-3 in the UTI group were higher than those in sham group, but lower than those in CPR group (both P ＜ 0.05).Conclusions Ulinastatin has protective effects on the intestinal barrier damaged after cardiopulmonary resuscitation in rats by decreasing the proinflammatory mediators in the blood, reducing the expression of caspase-3and then reducing the numbers of apoptotic intestinal cells.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the outcomes of hand-assisted laparoscopic liver surgery (HALS) and pure laparoscopic liver surgery (PLS).</p><p><b>METHODS</b>The clinical data were analyzed for 64 patients undergoing major hepatectomy with HALH (23 cases) and PLS (41 cases) between January, 2010 and December, 2012.</p><p><b>RESULTS</b>The general data of the two groups were comparable. Compared with PLS, HALS was associated with a significantly shorter operative time (240 vs 191 min), less intraoperative blood loss (430 vs 220 ml, P<0.05), and a lower cost (P<0.05). There was no significant difference between the two groups in postoperative hospital stay, complication rates or recurrence rate of hepatocellular carcinoma.</p><p><b>CONCLUSION</b>HALS is safe for major liver resection with such advantages over PLS as causing less trauma and a lower cost.</p>
Subject(s)
Humans , Blood Loss, Surgical , Carcinoma, Hepatocellular , General Surgery , Hepatectomy , Methods , Laparoscopy , Methods , Length of Stay , Liver Neoplasms , General Surgery , Neoplasm Recurrence, LocalABSTRACT
Objective To study the establishment of rat model of asphyxia-cardiac arrest and efficacy of CPR in order to find the length of optimum time of asphyxia to cause injury.Methods One hundred and twenty-six male Sprague-Dawley rats were randomly (random number) divided into sham operation group and experimental groups.Cardiac arrest was induced by asphyxiation after intravenous injection of vecuronium bromide.The experimental groups were assigned into AP4 (four-minute asphyxia period),AP6 and AP8 subgroups in accordance with different lengths of time of asphyxia subjected to.In these groups,CPR,including pre-cordial compression and synchronized mechanical ventilation,was initiated 4,6 and 8 min after asphyxia-induced cardiac arrest,respectively.The successful ratio of resuscitation and hemodynamic variables were recorded.Brain water content,neural deficit scores (NDS),imaging changes on MR,pathological changes of brain tissue and neuronal apoptosis were evaluated at 1 d,3 d and 7 days after ROSC.All the data were analyzed by single-factor analysis of variance or Chi-square test.P ＜ 0.05 was considered statistically significant.Result The lowest NDS occurred at 1 d after ROSC,brain water content and imaging changes on MR were most obvious at 3 d after ROSC,while pathological changes of brain tissue and neuronal apoptosis increased and reached the peak at 7d after ROSC.The survival rates after 24 hours of AP4,AP6 and AP8 groups were 85％,75％ and 45％,respectively.The rate of ROSC and survival rate of AP8 group were significantly lower than those of other groups (P ＜0.01).The longer time of asphyxia the severer pathological changes of brain tissue,brain edema,neural deficit,and magnetic resonance imaging changes in all experimental groups.As compared to other groups,the brain damage index of AP8 group was most serious,while that of AP6 group was moderate.Conclusions The rat model following asphyxia-induced cardiac arrest and cardiopulmonary resuscitation was established successfully.From the evidence of survival rate and damage grade of brain tissue,asphyxia for 6 min may be the rational length of ischemic time in this model.
ABSTRACT
ObjectiveTo investigate the unfavorable factors of intestinal mucosa repair after the intestinal epithelial injury in vivo in a mouse model of sepsis. MethodsThe method of cecal ligature and puncture (CLP) was used to induce sepsis and then the intestinal mucosa damage, epithelial cell apoptosis and the number of transformed goblet cells were observed, and the concentrations of serum TNF-αt, IL-1 and TGF-β1 and TFF3 ( trefoil factor 3) in small intestinal mucosa were determined. All above various laboratory examinations were made by different assays including H-E staining, western blot, ELISA and immunohistochemistry respectively. The experimental mice were divided into sepsis group and sham operation control group. The mice with sepsis were separately sacrificed 6 hours ( n = 7 ), 24 hours ( n = 7) and 48 hours ( n = 7) after CLP. Results In septic mice group, the injured intestinal mucosa was found 6 hours after CLP. The damage scores in mice 24 h and 48 h after CLP were higher than those 6 h after CLP, but there was no significant difference between those 24 h and 48 h after CLP. Moreover, a few goblet cells or other epithelial cells adjacent to the injured surface migrated onto the wound to cover the denuded area. The number of goblet cells was substantially decreased in mice of sepsis group 6 hours after CLP compared with sham operation control group. Compared with sham operation control group, levels of IL-1 and TNF-α significantly increased 3-4 times in mice of sepsis group at all intervals, and the phosphorylated caspase-3 increased 4 times. Although TFF3 assayed by using Western blot showed modest increase 6 h after CLP and it declined 24 h and 48 h later. A similar change was found in TGF-β1, it modestly increased 6h after CLP, but it didn't elevate 24 h and 48 h later. ConclusionsSevere sepsis keeps on the inflammatory reaction and epithelial cell apoptosis, preventing the repair of intestinal mucosa from injury.
ABSTRACT
Objective To observe the effect of injecting Xuebijing via different routes, as either treatment or pretreatment, on changes in intestinal mucosal morphology in a rat model of sepsis. Method Ninety-one healthy Sprague-Dawley rats were randomly divided into five groups: 1) control group ( n = 7) , 2) sepsis group ( n = 21) , 3) intragastric pretreatment group ( n = 21) , 4) intravenous pretreatment group (n = 21) , and 5) intravenous treatment group (n = 21) . Except for the control group, the other groups were further divided into three sub-groups for assessment at 3, 6 and 12 h post-operation ( n = 7 per group) . Sepsis was induced by cecal ligation and puncture (CLP) . For the intragastric pretreatment group, Xuebijing injection (5 mL/kg) was administered via intragastric injection 2 hours before CLP. For the intravenous pretreatment group, Xuebijing injection (5 mL/kg)was administered via the caudal vein 2 hours before CLP. For the intravenous treatment group, Xuebijing injection (5 mL/kg) was intravenously infused 2 hours after CLP. The control group received no treatment. The ileum was removed from all rats for measurement. The rats were sacrificed at 3, 6 or 12 h after operation to obtain the ileum.Intestinal mucosal damage index and morphological changes in the intestinal mucosa were detected by light microscopy and electron microscopy. Analysis of variance was used to compare the groups. P -values < 0.05 were considered to indicate statistically significant differences. Results Intestinal mucosal damage was significantly reduced in and the three treatment groups compared with the untreated sepsis group (3h, F =53.35; 6h, F =74.93; 12 h, F - 171.27; P =0.000). Intestinal damage was significantly reduced in the intravenous pretreatment group compared with the intragastric pretreatment group (3 h, F = 53.35,P =0.036; 6 h, F = 74.93,P =0.039; 12 h, F = 171.27, P =0.042). Conclusions Irrespective of the route, the administration of Xuebijing protected against intestinal mucosal damage and intravenous pretreatment exerted the most effective protection against intestinal mucosal damage in this rat model of sepsis.