ABSTRACT
Objective:To compare the safety of adrenal central vein treated at different times in laparoscopic adrenal pheochromocytoma resection through abdominal approach.Methods:A study was conducted on 43 patients with adrenal pheochromocytoma admitted to Xijing Hospital, Air Force Military Medical University from June 2012 to June 2019. The included patients were divided into two groups according to the surgical method: observation group ( n=22) and control group ( n=21). The patients of observation group were ligated the central advenal vein before the tumor was completely isolated, and the patients of control group were ligated the central advenal vein after the tumor was isolated. The changes of blood catecholamine levels before anesthesia, before central adrenal vein ligation, and after tumor resection were compared between the two groups, as well as the differences in operative time, intraoperative blood loss, hospital stay, number of cases with intraoperative blood pressure fluctuations and frequency. Measurement data were expressed as mean±standard deviation ( Mean± SD), comparison between groups was by t-test; comparison of count data between groups was by Chi-square. Results:There was no significant difference in the mean operation time, the mean hospital stay, intraoperative blood loss, number of cases with dramatic blood pressure fluctuations between two groups ( P>0.05). The frequency of severe fluctuation of intraoperative blood pressure in observation group and control group was 19 times and 47 times, respectively, the difference was statistically significant ( P<0.05). There was no significant difference in the blood epinephrine and norepinephrine levels between the two groups before anesthesia and after tumor resection ( P>0.05). However, before ligation of the central vein, the epinephrine concentrations in the observation group and the control group were (572.1±282.1) pg/mL and (935.6±417.5) pg/mL, respectively, the noradrenaline concentrations were (8 347.9±4 103.6) pg/mL and (13 695.7 ±3 205.3) pg/mL, respectively, the difference was statistically significant ( P<0.05). Conclusion:Early ligation of the adrenal central vein can improve the safety of the laparoscopic approach to adrenal pheochromocytoma.
ABSTRACT
Objective To investigate the effect of TAK-242,an antagonist for Toll-like receptor 4,against myocardial isch?emia/reperfusion injury(I/R)in C57BL/6 mice along with the underlying mechanism. Methods C57BL/6Mice(n=36)were random?ized into three groups:sham group,I(30 min)/R 24 h model group and I/R+TAK-242(3 mg/kg)treatment group. At 24 h after reper?fusion,cardiac function and myocardial infarct size were evaluated with echocardiography and triphenyltetrazolium chloride(TTC), myocardial pathological pattern in mice was detected by HE staining,the mRNA and protein levels of TLR4 were determined by real time PCR and Western blot respectively,and the serum levels of IL-6,TNF-α,IL-10 and HMGB1 were detected by ELISA. Re?sults Our results showed that left ventricular systolic diameters(LVID)were shortened(P<0.01),left ventricular ejection fraction (LVEF)and left ventricular short axis shortening fraction(LVFS)were both decreased significantly(P<0.01)in following I/R mice. Myocardial infarction size was large and myocardial inflammatory cell infiltration was severe in I/R mice. The mRNA and protein levels of TLR4 were elevated(P<0.01),the serum levels of IL-6,TNF-α,IL-10 and HMGB1 in I/R mice were significantly increased com?pared with the sham group(P<0.01). We found that TAK-242 significantly extended LVID(P<0.05),increased LVEF and LVFS (P<0.05),reduced myocardial infarction and improved myocardial inflammatory cell infiltration,inhibited the mRNA and protein levels of TLR4(P<0.05),down-regulated the expression of IL-6 and TNF-α(P<0.01),and up-regulated IL-10 and HMGB1 com?pared with I/R group(P<0. 01). Conclusion Treatment with TAK-242 can significantly reduce myocardial ischemia/reperfusion in?jury partly via regulating inflammation.