ABSTRACT
The report described one case of vascular paralysis syndrome during kidney transplantation to provide references for clinical practice.After intraoperative opening of kidney artery and vein, the recipient developed vascular paralysis syndrome.However, the efficacy is not obvious after dosing of norepinephrine.After an intravenous infusion of methylene blue, the recipient has a successful removal of tracheal intubation and recovered well.
ABSTRACT
Objective:To evaluate the effect of stroke volume variation(SVV) goal-directed fluid therapy on postoperative pulmonary complications(PPCs) after pediatric living donor liver transplantation.Methods:One hundred and twenty pediatric patients undergoing pediatric living-donor liver transplantation(all diagnosed with congenital biliary atresia) were divided into 2 groups( n=60 each) using the random number table method: control group and SVV group. Intraoperative fluid management was guided by central venous pressure and mean arterial pressure in control group, while by SVV combined with cardiac output in SVV group. Intraoperative circulation, fluid intake and usage of vasoactive drug were recorded. Central venous blood samples were collected to determine the concentrations of serum Clara cell 16 kDa protein, interleukin-6, and tumor necrosis factor-alpha before anesthesia(T 0), at the end of anhepatic phase(T 1), at 3 h of neohepatic phase(T 2), at the end of surgery(T 3) and at 24 h after operation(T 4). Pulmonary ultrasonography was performed before surgery, at the end of surgery and at 1, 3 and 7 days after surgery. The pediatric patients were followed up for 1 week after surgery to record the PPCs, including acute lung injury, pulmonary infection, pulmonary atelectasis, pleural effusion and acute respiratory distress syndrome. Results:Compared with control group, the incidence of PPCs, acute lung injury and pulmonary infection was significantly decreased, the pulmonary ultrasound score was decreased at the end of surgery and at 1, 3 and 7 days after surgery, the usage of intraoperative dobutamine was increased, the duration of postreperfusion syndrome was shortened, the fluid intake and epinephrine usage were reduced, and the serum Clara cell 16 kDa protein, tumor necrosis factor-alpha and interleukin-6 concentrations were decreased at T 1-T 4 in SVV group( P<0.05). Conclusions:SVV goal-directed fluid management can reduce the development of PPCs in pediatric living donor liver transplantation.
ABSTRACT
Objective:To identify the risk factors for acute lung injury (ALI) after pediatric living donor liver transplantation (LDLT) and evaluate the predictive value.Methods:The pediatric patients (all diagnosed with congenital biliary atresia) who underwent parental liver transplantation in our center from January to December 2021 were selected. Perioperative data were obtained through the electronic medical record system, and the pediatric patients were divided into non-ALI group and ALI group according to whether ALI occurred or not at 1 week after surgery. The factors of which P values were less than 0.05 between groups would enter the multivariate logistic regression analysis to stratify the risk factors for ALI after pediatric LDLT, and the value of the risk factors in predicting intraoperative ALI was evaluated using the receiver operating characteristic curve. Results:A total of 140 pediatric patients were enrolled in the analysis, and the incidence of ALI was 30.7%. The results of the multivariate logistic regression analysis showed that preoperative pediatric end-stage liver disease score, preoperative serum NT-pro-BNP concentrations, intraoperative volume of fluid transfused, and duration of postreperfusion syndrome were independent risk factors for ALI after LDLT in pediatric patients ( P<0.05). The area under the receiver operating characteristic curve of the preoperative N-terminal pro-brain natriuretic peptide(NT-pro-BNP) concentration in predicting postoperative ALI was 0.737 ( P<0.001), with a cutoff value of 222.1 ng/L, sensitivity of 0.628, and specificity of 0.732. Conclusions:Preoperative pediatric end-stage liver disease score, serum NT-pro-BNP concentrations, intraoperative volume of fluid transfused, and duration of postreperfusion syndrome are independent risk factors for ALI after LDLT in pediatric patients; preoperative serum NT-pro-BNP concentrations can effectively predict the development of ALI after pediatric LDLT surgery.
ABSTRACT
Objective:To systematically summarize the real experience of nursing students and clinical nurses after needle stick injury exposure, so as to provide the basis for the subsequent development of intervention strategies.Methods:Databases including PubMed, The Cochrane Library, Web of science, Science direct and EBSCO host, PsychINFO, Scopus, CNKI, Wanfang, VIP and CBM were searched about the qualitative research on the real experience of needle stick injury exposure of nursing students and clinical nurses from the establishment of the database to September 2020. The qualitative research quality evaluation standard of Australia JBI evidence-based health care center was used for evaluation, and the result integration method was used for integration.Results:A total of 19 literatures were included, 16 literatures related to interns and junior nurses were included, and 79 research results were extracted. 11 literatures related to senior nurses were included, and 57 research results were extracted. The similar research results were summarized into six new categories, which were summarized into three integrated results, namely, the psychological experience of nurses with needle stick injuries; the impact of needle stick injuries on family life and personal value; and the need for support.Conclusions:We should pay attention to the emotional and emotional experience of interns and clinical nurses after needle stick injury, provide professional psychological counseling, improve the occupational exposure monitoring and security system, and give full social support.
ABSTRACT
Early detection and intervention is an important strategy for the prevention and treatment of Alzheimer's disease(AD). Blood screening for AD has advantages such as low cost and convenient sample collection.However, there are also problems such as low levels of markers in peripheral blood and insufficient sensitivity of detection methods.At present, as a highly sensitive detection technology for protein molecules, single-molecule array(Simoa)technology can accurately analyze low-concentration biomarkers that cannot be detected by traditional methods.This article reviews research progress on blood neuronal markers for early AD diagnosis based on the new Simoa technology.
ABSTRACT
Objective:To evaluate the myocardial protective effect of goal-directed circulation management guided by cardiac index (CI) monitored by pressure recording analytical method (PRAM) in infants undergoing pediatric liver transplantation.Methods:A total of 120 pediatric patients, aged 5-15 months, weighing 5.5-10.0 kg, scheduled for elective living donor liver transplantation (all diagnosed with congenital biliary atresia) were selected and divided into 2 groups ( n=60 each) using a random number table method: routine group (group R) and goal-directed management guided by CI group (group CI-G). Patients in group R received routine hemodynamic monitoring according to central venous pressure (CVP), continuous invasive arterial pressure, blood gas analysis and other monitoring methods to guide intraoperative circulation management.Patients in CI-G group received intraoperative hemodynamic monitoring through radial artery using PRAM/Mostcare, and related treatments were guided by PRAM hemodynamic monitoring indicators.The intraoperative volume of fluid intake, highest and lowest values of parameters of hemodynamics such as heart rate (HR), mean arterial pressure (MAP) and CVP, the maximum fluctuations (△ RHR, △ RMAP and △ RCVP) and the development of reperfusion syndrome within 5 min of reperfusion were recorded.At the beginning of anesthesia (T 0), at 5 min before reperfusion (T 1), at 30 min of neohepatic phase (T 2), at 3 h of neohepatic phase (T 3) and at 12 h after operation (T 4), concentrations of serum cardiac troponin I (cTnI), N-terminal plasma brain natriuretic peptide precursor (NT-pro-BNP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high mobility group protein B1 (HMGB1) were determined.Mechanical ventilation time, duration of intensive care unit (ICU) stay, the development of heart failure and pulmonary infection, length of hospital stay were recorded. Results:Compared with group R, the intraoperative volume of fluid intake, highest value of CVP, △ RHR, △ RMAP and the incidence of reperfusion syndrome were significantly decreased, lowest value of MAP was increased, concentrations of serum cTnI, NT-pro-BNP, IL-6, TNF-α and HMGB1 was decreased, mechanical ventilation time and duration of ICU were shortened, and the incidence of heart failure during ICU stay were decreased in group CI-G( P<0.05). Conclusion:The goal-directed circulation management guided by CI monitored by PRAM can accurately guide the use of volume and vasoactive drugs, stabilize circulation, which can produce myocardial protective effect to some extent in infants undergoing pediatric liver transplantation.
ABSTRACT
Objective:To systematically evaluate the effects of different umbilical cord time on maternal and fetal outcomes.Methods:Meta analysis was used, CNKI, Wanfang, VIP, PubMed, The Cochrane Library, EBSCO, Web of Science database, etc. were searched. The literatures were screened according to the inclusion and exclusion criteria, and the literature quality was evaluated. Revman 5.2 software was used for data processing and analysis.Results:A total of 9 randomized controlled trials were included. Meta-analysis showed that delayed umbilical cord did not increase postpartum 2,24 h hemorrhage[mean difference ( MD)=-40.69, 95%confidence interval (CI) (-83.05-1.67), P>0.05 and MD=-10.33, 95% CI (-22.47-1.81), P>0.05] and did not prolong the third stage of labor [ MD= 0.32, 95% CI (-0.71-1.35), P>0.05] compared with conventional umbilical cord (early umbilical cord) method. 1,5 min Apgar scores for different neonatal umbilical cord time was not statistically significant[ MD=0.05, 95% CI (-0.02-0.12), P>0.05 and MD=-0.01, 95% CI (-0.04-0.03), P>0.05]. There was no significant difference in neonatal weight [ MD=72.91, 95% CI (-53.98-199.80), P>0.05]. Delayed umbilical cord could improve the newborn's 24 h capillary hemoglobin [ MD=17.69, 95% CI (13.55-21.83), P<0.01] and bilirubin peak [ MD=17.50, 95% CI (11.88-23.12), P<0.01]. Conclusions:Delayed umbilical cord and early umbilical cord did not increase postpartum hemorrhage and prolong the third stage of labor, and had no adverse effects on maternal. The peak levels of capillary hemoglobin and bilirubin in newborns were increased 24 h, but there was no significant difference in neonatal 1 min and 5 min Apgar scores and neonatal weight.
ABSTRACT
Objective:To understand the current situation of effective teaching behavior of clinical nursing teachers and analyze it.Methods:A convenient sampling method was used to conduct a questionnaire survey on nursing students and teaching teachers in Tai′an City central hospital and the Second Affiliated Hospital of Shandong First Medical University, using Cui Shasha Chinese version of Nursing Clinical Teacher Effectiveness Inventory as the research tool.Results:The score of the teachers in the "interpersonal relationship" dimension was the highest (6.32±0.89), while the score in the "nursing ability" dimension was the lowest (5.95±0.99). There was no statistically significant difference between college students and undergraduate students in the evaluation of effective teaching behaviors of teachers, while there was statistically significant difference between nursing students (including college students and undergraduate students) and teachers in all dimensions and total scores of the scale ( t values were -4.616--2.250, P<0.05 or 0.01). Teachers and students were more consistent with the 10 items with low scores than the 10 items with high scores (the total number of items was 2 and 5, respectively). Conclusions:The teaching teacher should be able to correctly identify and judge the learning needs of the internship nursing students, so that the teaching effect meets the expectations of the internship nursing students, and should be targeted when teaching internship nursing students of different educational levels as well as focusing on nursing research.
ABSTRACT
Objective:To discuss the oncologic safety, aesthetic outcome, and upper extremity function of single-port insufflation endoscopic nipple-sparing mastectomy (SIE-NSM) in the treatment of early breast cancer.Methods:From January 2014 to August 2019, a total of 80 patients with stage Ⅰ and Ⅱ breast cancer underwent SIE-NSM, at Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed and followed up. Estimated the oncologic safety, aesthetic outcome, and upper extremity function.Results:SIE-NSM was performed successfully on all 80 patients.There was no serious complication after surgery.The follow-up time was 16-82 months and the median follow-up time was 42 months. Local recurrence occurred in two patients, and there was no distant metastases. Four (5%) patients developed grade 1-3 nipple-areola complex ischemia. There were no cases of subcutaneous effusion.The satisfaction with breasts, chest well-being, psychosocial well-being, and sexual well-being scores were confirmed to be highly rated by Breast-Q scale. Upper extremity function score confirmed that good upper limb function was preserved after surgery. The mean length of incision was (3.6±0.8) cm, and the blood loss was (24.7±19.3) mL.Conclusions:SIE-NSM can achieve a higher cosmetic score and a better recovery of upper limb function on the premise of ensuring the safety of the tumor.This novel method is an appropriate surgical option for patients with early breast cancer.
ABSTRACT
Objective:To explore the effect of cardiac output-guided hemodynamic management on acute kidney injury(AKI)during pediatric liver transplantation.Methods:A total of 120 pediatric living-donor liver transplantation recipients were randomly divided into two groups of control and experiment(60 cases each group). Control group received routine hemodynamic management of central venous pressure(CVP), continuous invasive arterial pressure and blood gas analysis.Experiment group was subjected to cardiac output-guided hemodynamic management guided by cardiac index, stroke volume index, stroke volume variation and left ventricular contractility index (DP/DTmax). Intraoperative hemodynamics and incidence of AKI were recorded.And the serum changes of neutrophil gelatinase-associated lipocalin(NGAL), cystatin C(CysC)and inflammatory factors were analyzed.Results:The incidence of AKI was lower in experiment group than that in control group(26.7% vs 45%). The incidence of postreperfusion syndrome(PRS), intraoperative fluid infusion and maximal value of CVP were lower while minimal value of mean arterial pressure(MAP)higher in experiment group than those in control group( P<0.05). The serum levels of NGAL, CysC, interleukin-6(IL-6), interleukin-18(IL-18)and tumor necrosis level-alpha(TNF-α)were lower in experiment group than those in control group at each timepoint from 3 h post-reperfusion to 48 h post-operation( P<0.05). Conclusions:During pediatric living-donor liver transplantation, cardiac output-guided hemodynamic management is conducive to more accurate fluid management.It can stabilize circulation, minimize PRS and reduce the occurrence of AKI during perioperative period.
ABSTRACT
Objective:To discuss the necessity and feasibility of constructing the baccalaureate midwifery education standard in China by the comparative study of WHO and ICM education standards, combined with China's medical nursing education standards.Methods:We searched the scientific literature using the databases of CNKI, Wanfang, VIP and the official websites of WHO and ICM. Comparative study was conducted combined with the literature study, analyze the specific fields and indicators required for baccalaureate midwifery education standards in China.Results:ICM standard is more accord with the actual needs of the construction of baccalaureate midwifery education standard in China.Conclusion:It is feasible and necessary to construct the baccalaureate midwifery education standard according to ICM standards, this study further provides reference and basis for constructing the baccalaureate midwifery education standard in China.
ABSTRACT
Objective:Assessing the prognosis of patients with bladder urothelial carcinoma by using multiple molecular markers [epithelial-cadherin (E-cadherin), fibroblast growth factor receptor 3 (FGFR3), Jagged2, Survivin and stromal antigen 2 (STAG2)] in combination method, and compared it with the traditional method of evaluating prognosis by clinical pathological parameters.Methods:Retrospective analysis of 128 cases of bladder urothelial carcinoma patients admitted to Beijing Friendship Hospital, Capital Medical University from January 2010 to December 2016, including 102 males and 26 females; the median age was 70.5 years, ranged from 41 to 93 years. E-cadherin, FGFR3, Jagged2, Survivin and STAG2 alterations by immunohistochemistry during the first surgical treatment. The Kaplan-Meier survival curve was used to evaluate the relationship between the above markers and overall survival (OS), recurrence-free survival (RFS), progression-free survival (PFS), and clinicopathological indicators of tumors. Use Cox regression model to find the most suitable molecular markers for judging the prognosis of bladder urothelial carcinoma, and compare it with the traditional clinical staging + pathological grading method to evaluate OS to detect its sensitivity and specificity.Results:After 36.4 months of follow-up, it was found that the expressions of E-cadherin, FGFR3, Jagged2 and Survivin were all related to the OS, RFS and PFS of bladder urothelial carcinoma (all P<0.05). The expression of STAG2 was related to the TMN stage of bladder urothelial carcinoma ( P=0.047) and pathological grade ( P=0.015). Cox regression analysis showed that Survivin ( P=0.001) and Jagged2 ( P=0.037) were independent risk factors for evaluating the OS of bladder urothelial carcinoma, and Survivin ( P<0.001) and Jagged2 ( P=0.006) were independent risk factors for RFS, Survivin ( P=0.001) was also an independent risk factor for PFS. Multivariate analysis of the above molecular markers showed that the prognosis of patients with more than 3 molecular markers was better than that of independent application or the use of two of them to evaluate the prognosis ( P<0.001). The combined application of Survivin and Jagged2 to evaluate the 5-year survival rate was not less sensitive and specific than the clinical and pathological indicators (93.5% vs 77.2%, 84.7% vs 81.3%). Conclusions:Five molecular markers of E-cadherin, FGFR3, Jagged2, Survivin and STAG2 have an evaluation effect on the prognosis of bladder urothelial carcinoma, and some can independently predict the OS and RFS of patients with bladder urothelial carcinoma, however, the combined application is better than the single molecular marker to evaluate the prognosis. Compared with the traditional method of evaluating the prognosis by clinical pathological parameters, the combined application of Jagged2 and Survivin may be a better choice for evaluating the prognosis of patients with bladder urothelial carcinoma.
ABSTRACT
Objective To explore the application effect of fine needle aspiration cytology and sentinel lymph nodes stain assisted by contrast-enhanced ultrasound in early breast cancer.Methods A patient with early breast cancer enrolled in Beijing Friendship Hospital,Capital Medical University received fine needle aspiration cytology assisted by contrast-enhanced ultrasonography and the sentinel lymph nodes were stained with blue dye before a standard sentinel lymph nodes biopsy traced with indocyanine green.The axillary status accessed by these two methods were compared.Results Three sentinel lymph nodes were found and aspirated assisted by contrast-enhanced ultrasonography.Seven sentinel lymph nodes were obtained in sentinel lymph nodes biopsy surgery.All of these sentinel lymph nodes were negative.The stained sentinel lymph nodes could be recognized and dissected in open lymph nodes biopsy surgery.Conclusions Fine needle aspiration cytology assisted by contrast-enhanced ultrasonography could be a substitute for open sentinel lymph nodes biopsy.More related researches should be carry out to further compare these two methods.
ABSTRACT
Objective@#To explore the application effect of fine needle aspiration cytology and sentinel lymph nodes stain assisted by contrast-enhanced ultrasound in early breast cancer.@*Methods@#A patient with early breast cancer enrolled in Beijing Friendship Hospital, Capital Medical University received fine needle aspiration cytology assisted by contrast-enhanced ultrasonography and the sentinel lymph nodes were stained with blue dye before a standard sentinel lymph nodes biopsy traced with indocyanine green. The axillary status accessed by these two methods were compared.@*Results@#Three sentinel lymph nodes were found and aspirated assisted by contrast-enhanced ultrasonography. Seven sentinel lymph nodes were obtained in sentinel lymph nodes biopsy surgery. All of these sentinel lymph nodes were negative. The stained sentinel lymph nodes could be recognized and dissected in open lymph nodes biopsy surgery.@*Conclusions@#Fine needle aspiration cytology assisted by contrast-enhanced ultrasonography could be a substitute for open sentinel lymph nodes biopsy. More related researches should be carry out to further compare these two methods.
ABSTRACT
Objective@#To evaluate the role of 2B-containing NMDA receptors (NR2B) in sevoflurane anesthesia-induced cognitive dysfunction in aged rats.@*Methods@#Thirty-two healthy male Sprague-Dawley rats, aged 18 months, weighing 570-630 g, were divided into 4 groups (n=8 each) using a random number table method: control group (group C), sevoflurane anesthesia group (group S), sevoflurane anesthesia plus NR2B specific inhibitor Ro 25-6981 group (group S+ RO) and Ro 25-6981 group (group RO). S and S+ RO groups inhaled 3% sevoflurane for 4 h. Ro 25-6981 1 mg/kg was intraperitoneally injected at 15 min before inhaling sevoflurane in group S+ RO.Morris water maze test was performed at 2 days after the end of anesthesia to assess cognitive function.The rats were then sacrificed, and hippocampal tissues were obtained for determination of the expression and phosphorylation of ERK1/2 by Western blot.@*Results@#Compared with group C, the escape latency was significantly prolonged, the frequency of crossing the original platform was reduced, the time of staying at the original platform quadrant was shortened, and the phosphorylation of ERK1/2 was decreased in group S (P<0.05), and no significant change was found in the escape latency in S+ RO and RO groups (P>0.05). Compared with group S, the escape latency was significantly shortened, the frequency of crossing the original platform was increased, the time of staying at the original platform quadrant was prolonged, and the phosphorylation of ERK1/2 was increased in group S+ RO(P<0.05). There was no significant difference in ERK1/2 expression among the four groups (P>0.05).@*Conclusion@#The mechanism by which sevoflurane anesthesia induces cognitive dysfunction is related to up-regulating the expression of NR2B and inhibiting the activity of ERK1/2 in aged rats.
ABSTRACT
Objective To explore the management of spontaneous intraspinal hematoma.Methods From January 2011 to July 2018,29 cases with spontaneous intraspinal hematoma were admitted to our department.Date on etiology,clinical presentation,radiological features,treatment strategy and prognosis were analyzed retrospectively.The prognosis was assessed by American Spinal Injury Association impairment scale (ASIA) before and after the treatment.Results Total of 29 cases,only 10 cases (34.5％) revealed specific etiology,including 7 cases of spinal vascular malformation,2 of tumor apoplexy,1 of cavernous hemangioma.After 2 weeks of conservative treatment,3 patients with grade D and 3 patients with grade E were assessed for spinal function.The average interval from onset to surgery was(9.4±7.5) days,the ASIA after two weeks of the operation was as follows:5 patients were assessed at grade A,5 patients at grade C,8 patients at grade D and 4 patients at grade E.28 patients were followed up for (48.7±23.1) months on average,6 patients without surgery were E,22 cases with surgery were as follows:4 cases A,18 cases D/E.Conclusions The etiology of spontaneous intraspinal hematoma is hard to define even after complete preoperative examination and exploratory operation.The preoperative neurologic functions are important predicting factors for the prognosis of spontaneous intraspinal hematoma.For patients who had neurologic function deficit,surgical treatment should be performed urgently to remove the hematoma and release the decompression of spinal cord.The majority of these patients can achieve a positive prognosis after surgery.
ABSTRACT
Objective To construct a quantitative evaluation model for the suitability evaluation of scientific research innovation team members.Methods Firstly to identify and clarify the key indicators of the evaluation of scientific research team members,including:the evaluation of professional relevance of members,academic contribution expectation of members,evaluation indicators of cooperation convenience,and analysis of common evaluation indicators of objectives.Secondly,to conduct qualitative analysis of relevant indicators to determine the weighting levels of each sub-item of different indicators.Finally,design the mathematical model of calculation according to the weights and scores granted to the importance,grade,etc.of the indicators.Results After the simulation calculation,the designed formula can better reflect the weighting level of different indicators,which makes the evaluation of the suitability of the research team members feasible.Conclusions Quantitative evaluation of the suitability evaluation index of innovation team members makes the evaluation of innovation team members have evidence to follow,the evaluation results are fair and equitable,and easy to be accepted by all parties.It also helps to guide the team to clearly establish the direction.
ABSTRACT
Objective To evaluate the role of 2B-containing NMDA receptors(NR2B)in sevoflu-rane anesthesia-induced cognitive dysfunction in aged rats.Methods Thirty-two healthy male Sprague-Dawley rats,aged 18 months,weighing 570-630 g,were divided into 4 groups(n＝8 each)using a ran-dom number table method: control group(group C),sevoflurane anesthesia group(group S),sevoflurane anesthesia plus NR2B specific inhibitor Ro 25-6981 group(group S+RO)and Ro 25-6981 group(group RO).S and S+RO groups inhaled 3％sevoflurane for 4 h.Ro 25-6981 1 mg/kg was intraperitoneally injec-ted at 15 min before inhaling sevoflurane in group S+RO.Morris water maze test was performed at 2 days af-ter the end of anesthesia to assess cognitive function.The rats were then sacrificed,and hippocampal tis-sues were obtained for determination of the expression and phosphorylation of ERK1/2 by Western blot.Results Compared with group C,the escape latency was significantly prolonged,the frequency of crossing the original platform was reduced,the time of staying at the original platform quadrant was shortened,and the phosphorylation of ERK1/2 was decreased in group S(P＜0.05),and no significant change was found in the escape latency in S+RO and RO groups(P>0.05).Compared with group S,the escape latency was significantly shortened,the frequency of crossing the original platform was increased,the time of staying at the original platform quadrant was prolonged,and the phosphorylation of ERK1/2 was increased in group S+RO(P＜0.05).There was no significant difference in ERK1/2 expression among the four groups(P>0.05).Conclusion The mechanism by which sevoflurane anesthesia induces cognitive dysfunction is re-lated to up-regulating the expression of NR2B and inhibiting the activity of ERK1/2 in aged rats.
ABSTRACT
Objective To evaluate the role of sirtuin 3 ( SIRT3)∕forkhead box O3α ( FOXO3α) signaling pathway in dexmedetomidine-induced reduction of hepatic ischemia-reperfusion ( I∕R) injury in mice. Methods Forty clean-grade C57BL∕6 mice of both sexes, aged 2 weeks, weighing 6-8 g, were di-vided into 4 groups (n＝10 each) using a random number table method: sham operation group (group S), hepatic I∕R group ( group I∕R), dexmedetomidine group ( group D) and SIRT3 inhibitor 3-TYP plus dexmedetomidine group (group T+D). Portal vein and hepatic artery supplying left and middle lobes of the liver and biliary tract were clamped resulting in ischemia of 70% of the liver in anesthetized rats. Normal sa-line 0. 25 ml was intraperitoneally injected at 1 h before establishing model, and 30 min later dexmedetomi-dine 50 μg∕kg (diluted to 0. 25 ml in normal saline) was intraperitoneally injected in group D. In group T+D, 3-TYP 5 mg∕kg (diluted to 0. 25 ml in normal saline) was intraperitoneally injected at 1 h before estab-lishing model, and 30 min later dexmedetomidine 50 μg∕kg (diluted to 0. 25 ml in normal saline) was in-traperitoneally injected. Mice were selected at 6 h after reperfusion, blood samples were obtained through eyeball, and the mice were then sacrificed and kidneys were removed for determination of the serum concen-trations of creatinine (Cr) and blood urea nitrogen (BUN), cell apoptosis (by TUNEL), malondialdehyde (MDA) content (using thiobarbituric acid method), superoxide dismutase (SOD) activity (by xanthine oxidase method), and acetylation of FOXO3α in renal tissues (by using immunoprecipitation) and for ex-amination of the pathologic changes. The damage to renal tubules was scored. Apoptosis index ( AI) was calculated. Results Compared with group S, the renal tubular damage score and AI were significantly in-creased, serum concentrations of Cr and BUN were increased, the content of MDA was increased, the ac-tivity of SOD was decreased, and the acetylation of FOXO3α was decreased in I∕R, D and T+D groups ( P＜0. 05). Compared with group I∕R, the renal tubular damage score and AI were significantly decreased, serum concentrations of Cr and BUN were decreased, the content of MDA was decreased, the activity of SOD was increased, and the acetylation of FOXO3α was decreased in group D (P＜0. 05), and no signifi-cant change was found in the parameters mentioned above in group T+D (P＞0. 05). Compared with group D, the renal tubular damage score and AI were significantly increased, serum concentrations of Cr and BUN were increased, the content of MDA was increased, the activity of SOD was decreased, and the acetylation of FOXO3α was decreased in group T+D ( P＜0. 05). Conclusion Activation of SIRT3∕FOXO3α signaling pathway is involved in dexmedetomidine-induced reduction of hepatic I∕R injury in mice.
ABSTRACT
Objective To investigate the effect of laparoscopic varicocele high ligation on the semen parameters of patients with unilateral varicocele associated infertility.Methods A total of 56 cases of unilateral varicocele with infertility treated in our hospital from March 2014 to March 2016 were recruited into this study,who were all recepted laparoscopic high ligation.The content of lactic dehydrogenase isoenzyme X(LDH-X),semen fragmentation rate(DFI) and other seminal plasma were observed and compared before surgery and 3 months after surgery.Results The ratio of LDH-X in seminal plasma and whole sperm,DFI and LDH-X of seminal plasma before laparoscopic varicocele high ligation were significant higher than those after surgery,LDH-X of whole sperm was lower than that after surgery,the differences were significant(P<0.05).Sperm concentration,sperm motility,survivability of sperm,and sperm forward progression percentage before laparoscopic varicocele high ligation were significant lower than those after surgery.Conclusion The quality of semen,the content of LDH-X and sperm DNA integrity of unilateral varicocele with infertility could be improved by laparoscopic high ligation of the internal cord vein.