Diagnosis and surgical treatment of 98 cases with adult primary retroperitoneal malignant tumor / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis and surgical treatment of adult primary retroperitoneal malignant tumor (APRMT).</p><p><b>METHODS</b>The clinical data of 98 cases with APRMT underwent resection from January 1990 to April 2003 were analyzed retrospectively.</p><p><b>RESULTS</b>Among the 98 cases, complete excision were performed in 79 cases (80.6%), palliative excision in 16 cases (16.3%), tumor biopsy only in 3 cases (3.1%). Resection of involved adjacent organs were carried out in 25 cases (25.5%) and the re-operation rate for recurrence was 28.6% (28 cases). The 1, 3, 5 year survival rates for 79 cases with complete resection were 93.7%, 73.4% and 34.2%, respectively. The 1, 3, 5 year survival rate for 16 cases with palliative resection were 75.0%, 6.3% and 6.3%, respectively.</p><p><b>CONCLUSIONS</b>Certain imaging examinations are crucial to the diagnosis and preoperative evaluation of APRMT. Resection of the involved organs could improve resection rate and prognosis. For the recurrent cases, earlier reoperation is strongly recommended.</p>

Effects of nitric oxide on reperfusion injury following pancreaticoduodenal transplantation in rats / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of nitric oxide (NO) on reperfusion injury following pancreaticoduodenal transplantation in rats.</p><p><b>METHODS</b>The homologous male Wistar rat model of heterotopic total pancreaticoduodenal transplantation was used. The L-arginine (L-Arg) group received intravenous injection of L-Arg 5 minutes before and after reperfusion at a dose of 200 mg/kg while the N-Nitro-L-Arginine methyl ester (L-NAME) group received intravenous injection of L-NAME at a dose of 10 mg/kg, and control group received saline. The amount of NO in the pancreas graft was measured. Serum concentration of cytokine-induced neutrophil chemoattractant (CINC) determined by enzyme-linked immunosorbant assay, expression of CINC mRNA detected by Northern blot assay, and myeloperoxidase (MPO) activity in the pancreas graft were measured. Histological observation was performed.</p><p><b>RESULTS</b>The amount of NO in the L-Arg group was higher than in the control group, while in the L-NAME group was lower than in the control group (P < 0.05). The peak of serum CINC concentration occurred 3 hours after reperfusion with significant difference among groups. Expression peak of CINC mRNA in the pancreas graft occurred 3 hours after reperfusion. The expression level in the L-Arg group was lower than in the control group, the L-NAME group was higher than control group (P < 0.05). MPO activity in the L-Arg group obviously decreasd compared with other groups. The pancreas inflammation was ameliorated in L-Arg group, and pancreas damage was aggravated in L-NAME group.</p><p><b>CONCLUSIONS</b>L-Arg can increase the amount of NO and inhibit the elevation of CINC, CINC mRNA expression, and early neutrophil accumulation in the transplanted pancreas. NO has protective effects on the ischemia/reperfusion injury of pancreaticoduodenal transplantation.</p>

The protective role of gadolinium chloride in lung injury associated with acute necrotizing pancreatitis / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the role of gadolinium chloride (GdCl(3)) in lung injury associated with acute necrotizing pancreatitis (ANP).</p><p><b>METHODS</b>Experimental animals were randomized into five groups (n = 18 for each group): normal control group, ANP group, GdCl(3) pretreatment group, ANP GdCl(3) pretreatment group, ANP GdCl(3) treatment group. Rat ANP model was induced by intraductal administration of 3% sodium taurocholate. Alveolar macrophages (AM) were obtained by bronchoalveolar lavage. The blood gas assay, the ratio of wet/dry tissue, protein content of bronchoalveolar lavage fluids (BALF), the myeloperoxidase (MPO) of lung tissue and generation of TNFalpha and NO by AM were evaluated. The apoptosis of AM was checked by agarose gel electrophoresis analysis, transmission electric microscopy observation and cytometry propidium iodide single stained method. The lung tissue was examined by histology.</p><p><b>RESULTS</b>The parameter of GdCl(3) pretreatment group compared with normal control group had no statistical significance (P > 0.05). The indicators of ANP GdCl(3) pretreatment group and ANP GdCl(3) treatment group were elevated compared with the normal control group and had statistical significance (P < 0.05). But compared to the ANP group, they were all decreased and also had the statistical significance (P < 0.05). The 180 - 200 bp ladder pattern unique to apoptosis in agarose gel electrophoresis and the apoptotic typical morphologic feature in AM by transmission electric microscopy and typical subdiploid peak in DNA content figure could be observed in ANP GdCl(3) pretreatment group and ANP GdCl(3) treatment group, while the other three groups could not.</p><p><b>CONCLUSIONS</b>Lung injury associated with ANP could be ameliorated by application of GdCl(3) through inducing apoptosis of AM of ANP.</p>

The role of nitric oxide in lung injury associated with acute necrotizing pancreatitis / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the role of nitric oxide (NO) in lung injury associated with acute necrotizing pancreatitis (ANP).</p><p><b>METHODS</b>One hundred and twenty SD rats were randomized into five groups: control group, ANP group, L-arginine (L-arg) pretreatment group, L-NAME pretreatment group, and mixed pretreatment group (n = 24 for each group). Rat ANP model was induced by intraductal administration of 3% sodium taurocholate. Alveolar macrophages (AMs) were obtained by bronchoalveolar lavage. The protein content of bronchoalveolar lavage fluids (BALF), the myeloperoxidase (MPO) of lung tissue and generation of tumor necrosis factor alpha (TNFalpha)and NO by alveolar macrophages were evaluated. The expression of TNFalpha mRNA and iNOS mRNA was also measured.</p><p><b>RESULTS</b>Lung injury was aggravated gradually with progression of the disease. The level of MPO of lung tissue and the protein content of BALF showed a steady increase with time and peaked at the 12(th) hour (10.8 +/- 0.6 U/g for MPO and 2,011.0 +/- 105.5 micro g/ml for protein, respectively). TNFalpha and NO secreted by AMs were elevated gradually and peaked at the 6(th) hour (1,624.2 +/- 149.2 pg/ml and 88.8 +/- 6.5 micro mol/L respectively) but decreased at the 12(th) hour. The expression of TNFalpha mRNA and iNOS mRNA was similar with the change of TNFalpha and NO. The parameters of the groups of L-arg, L-NAME and the mixed pretreatment were similar to those of ANP group. The parameters compared with those of the control group showed a significant difference (P < 0.05). The parameters of groups of L-Arg and L-NAME pretreatment in comparison with those of the ANP group showed significant difference (P < 0.05).</p><p><b>CONCLUSIONS</b>Over production of NO mediated by iNOS aggravates lung injury caused by acute necrotizing pancreatitis. Administration of exogenous NOS substrate would worsen lung injury, whereas administration NOS inhibitor would alleviate lung injury.</p>