Effects of midazolam combined with propofol on recovery of patients with laparoscopic cholecystectomy / 药学实践杂志

Objective To explore the effect midazolam combination with propofol on postoperative recovery in patients undergoing laparoscopic cholecystectomy. Methods A total of 162 patients who were admitted to the hospital for laparoscopic cholecystectomy from April 2019 to January 2021 were selected. According to different anesthesia methods, they were divided into control group (midazolam anesthesia) and observation group (midazolam combined with propofol anesthesia), with 81 cases in each group. The stress index levels before and after operation, MoCA scores before operation (T0), 24 h after operation (T1) and 48 h after operation (T2), sleep quality at T0, the first day after operation (T3) and the second day after operation (T4), the perioperative recovery were compared between the two groups. Results The levels of Cor and NE, the recovery time of eyes opening, extubation, orientation, and the incidence of adverse reactions in the observation group were lower than those in the control group (P<0.05). Observation group MMSE score when T1, T2, T3, T4 sleep quality score were higher than control group (P<0.05). Conclusion Midazolam combined with propofol was safe and had good postoperative recovery in patients undergoing laparoscopic cholecystectomy.

Protective role of vasonatrin peptide in hepatic ischemia-reperfusion injury in rats through activation of extracellular signal-regulated kinase signaling pathway / 中华肝胆外科杂志

Objective:To investigate the protective role of extracellular signal-regulated kinase (ERK) signaling pathway in the process that vasonatrin peptide (VNP) reduces hepatic ischemia-reperfusion injury in rats.Methods:Twenty SD rats, weighting 200-250 g, were randomly divided into four groups and each group has five rats. The four groups were sham operation group (S group), ischemia-reperfusion group (I/R group), VNP group (V group) and PD98059+ VNP group (P+ V group). In the rat model of hepatic warm ischemia and reperfusion, the hepatic artery and portal vein of the left lobe and middle lobe of the liver were clamped with arterial clamp for 45 min followed by reperfusion for 120 min. In the V group, VNP (50 μg/kg) was injected 10 minutes before ischemia. In the P+ V group, PD98059 (2 mg/kg) was injected 20 min before VNP injection followed by VNP administration and I/R treatment. The serum levels of alanine amino transaminase (ALT), aspartate amino transferase (AST), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and the superoxide dismutase (SOD) in liver tissue homogenate and malondialdehyde (MDA) were measured. The histopathology of liver tissue was observed. The contents of p-ERK1/2 were detected by Western blot.Results:Compared with S group, in I/R group and P+ V group the serum levels of ALT [(489.65±11.22), (333.05±24.77) vs. (33.78±4.88) U/L], AST [(651.43±14.99), (503.18±21.48) vs. (154.84±12.32) U/L], TNF-α [(12.83±1.09), (9.64±0.57) vs. (2.11±0.11) ng/L], IL-1β [(7.19±0.62), (5.12±0.22) vs. (1.10±0.49) ng/L], MDA [(8.00±0.88), (5.60±1.01) vs. (2.76±1.29) μmol/mg] increased, while SOD [(54.89±10.60), (68.85±8.33) vs. (126.10±15.63) nmol/mg]decreased (all P<0.05). The histopathology of liver tissue revealed that liver structure damaged more seriously in I/R group and P+ V group. Western blot analysis showed that p-ERK1/2 decreased significantly in I/R group and P+ V group. Compared with I/R group, ALT, AST, MDA, TNF-α and IL-1β decreased significantly and SOD increased significantly in V group (all P<0.05). The histopathology of liver tissue revealed that liver structure was damaged slightly, and p-ERK1/2 increased significantly in V group compared with I/R group ( P<0.05). Conclusion:VNP can significantly reduce hepatic ischemia-reperfusion injury through activation of p-ERK1/2 signaling pathway and inhibition of hepatocyte inflammatory response.

Clinical value of individualized pharmaceutical services for patients receiving vancomycin for severe infections: a retrospective case-control study based on real-world data / 南方医科大学学报

OBJECTIVE@#To assess the clinical value of individualized pharmaceutical services for patients receiving vancomycin for severe infections and establish clinical monitoring procedures during vancomycin treatment.@*METHODS@#Data were collected from patients with severe infections who received vancomycin treatment with individualized pharmacy services (test group, 144 cases) or without such services (control group, 884 cases) between January, 2017 and December, 2018. Using propensity score matching, the patients in the two groups with comparable baseline data were selected for inclusion in the study (62 in each group), and the efficacy, safety and economic indicators were compared between the two groups.@*RESULTS@#The curative effects of the treatment did not differ significantly between the two groups, with the overall response rates of 95.16% in the test group and 91.94% in the control group (@*CONCLUSIONS@#The participation of clinical pharmacists during the treatment can improve the clinical benefits of vancomycin in patients with severe infections.

Effect of propofol pretreatment against hepatic ischemia-reperfusion injury on mitochondrial permeability transition pore in rats / 中华肝胆外科杂志

Objective To investigate the protective effect of propotol against hepatic ischemiareperfusion injury in rats on mitochondrial permeability transition pore (MPTP) and the mechanism of GSK-3β.Methods Thirty SD rats were randomly assigned into five groups (n =6):sham operation group (S group),ischemia reperfusion group (I/R group),CsA pretreatment group (C group),propofol pretreatment group (P group),and propofol plus atractyloside pretreatment group (A + P group).Nauta liver ischemia-reperfusion rat model was used.Liver lobes were subjected to warm ischemia for 60min and then reperfusion for 120 min.In P group,propofol [12 mg/(kg · h)] was administered in the femoral vein for 30 min before ischemia until the end of reperfusion.In C group,CsA (2 mg/kg) was administered in the femoral vein for 20min before ischemia.In A + P group,20 μmol/kg of atractyloside was given through the femoral vein 10min before the injection of propofol.Rats were sacrificed at the end of reperfusion,and venous blood and hepatic tissue specimens from the same part of ischemia were obtained from different groups.Results Compared with S group,the AST and ALT levels were increased significantly,mitochondrial swelling were increased and mitochondrial membrane potential were decreased significantly in I/R group and A + P group.Casepase-3 were increased significantly and p-GSK3β Ser9 were decreased significantly in I/R group and A + P group.Compared with I/R group,the content of AST and ALT were decreased significantly,mitochondrial swelling were decreased and mitochondrial membrane potential were increased significantly,casepase-3 release were decreased significantly and p-GSK3β Ser9 were increased significantly in P group and C group.GSK-3β in each group displayed no significant difference.Conclusions Propofol can significantly reduce hepatic ischemia-reperfusion injury.The protective effect of propofol may be achieved via the inhibition of GSK-3β activation,increased p-GSK-3β Ser9 level,suppressing MPTP opening and decreasing hepatocytes apoptosis.

Analgesic effect and safety evaluation of PECS block under ultrasound guidance in multimodal analgesia after modified radical mastectomy / 临床麻醉学杂志

Objective To evaluate the efficacy and safety of PECS block under ultrasound guidance in multimodal analgesia after modified radical mastectomy.Methods Sixty female patients aged 18-65 years, ASA grade Ⅰ or Ⅱ, undergoing elective unilateral modified radical mastectomy were enrolled.Patients were randomly divided into PECS group (group P, n=30) or control group (group C, n=30).Two groups of patients were given flurbiprofen axetil 1 mg/kg via intravenous injection before operation.After general anesthesia induction, patients in group P received ultrasound guided pectoral nerves block with 30 ml of 0.375% ropivacaine.Patients in group C didn`t receive nerve block.Anesthesia maintenance was performed by combined intravenous-inhalation Anesthesia.Postoperative VAS pain scores (at 0, 3, 6, 12, and 24 postoperative hours), does of intraoperative remifentanil, rescue analgesic requirements in the first 24 h after surgery, adverse reactions were recorded.Results VAS score in group P was lower than that in group C at 0, 3, 6 and 12 h after surgery (P<0.05), there was no difference at 24 h.The dose of remifentanil and the rescue analgesic requirements in group P were lower than those in group C (P<0.05).There was no significant difference in postoperative adverse reactions between the two groups.Conclusion As a supplementary mode of multimodal analgesia, PECS block is a safe and reliable technique that provide better analgesia effect for modified radical mastectomy.

Role of GSK-3β in the protective effect of propofol pretreatment against hepatic ischemia-reperfusion injury and oxidative stress in rats / 中华肝胆外科杂志

Objective To investigate the protective effect of propofol pretreatment against hepatic ischemia-reperfusion injury and oxidative stress in rats and the mechanism of the role of GSK-3 β.Methods Sixty SD rats were randomly divided into four groups:sham operation group (S group),ischemia-reperfusion group (I-R group),propofol pretreatment group (P group),TDZD-8 pretreatment group (T group).The hepatic ischemia-reperfusion rat models were established by the method of Nauta.Rats were subjected to 30-min,60-min and 90-min 70％ warm ischemia of liver followed by reperfusion for 120 min,respectively.Propofol (12 mg/kg · h) was injected via femoral vein 30 min before ischemia till the end of reperfusion in P group and TDZD-8 (1 mg/kg) were injected via femoral vein 20 min before ischemia in T group.The animals were killed at 120 min after reperfusion.Blood samples and the liver tissue were obtained.The levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),lactate dehydrogenase (LDH),malondialdehyde (MDA) and superoxide dismutase (SOD) were analyzed.Liver morphological changes were observed using optical microscopy.p-GSK-3β Ser9 and total GSK-3 β expression was determined by Western blot.Results Compared with S group,AST,ALT,LDH and MDA level was increased,SOD level was reduced,and p-GSK-3 β Ser9 expression was significantly reduced in I-R group.Compared with I-R group,the content of AST,ALT,LDH and MDA was reduced significantly,SOD increased significantly,and the content of p-GSK-3β Ser9 increased significantly in P group and T group.There were no significant differences between P group and T group.The hematoxylin-eosin staining of hepatic tissues revealed in I-R group had severe structural damage and periportal inflammatory cells infiltrated,hepatocyte necrosis and sinusoidal congestion.In P group and T group,liver tissues had normal structure,less cell death,edema and inflammatory cell infiltration.Conclusions Propofol can significantly reduce hepatic ischemia reperfusion injury by reducing oxidative stress and lipid hydroperoxides.This protective effect of Propofol may be associated with the inhibition of GSK-3 β by GSK-3 β Ser9 phosphorylation.

Effects of the Compatibility of Gushuling Granules on the Icariin Content / 中国药房

OBJECTIVE:To study the effects of the compatibility of medicinal materials on the content of icariin in Gushuling granules formula. METHODS:The effects of the compatibility of medicinal materials on the content of icariin was investigated by orthogonal design with the compatibility of Astragalus membranaceus,Achyranthes bidentata and Concha ostreae as factors,using the content of icariin in decoction as index. The pH of mixture of Epimedium brevicornu and A. membranaceus,and the content of icariin in precipitation were determined. RESULTS:The effects of the compatibility of A. membranaceus on the content of icariin had statistical significance (P0.05);the interactions between two medicinal materials had not been found;the pH of the mixtures had no significant difference;the com-patibility of E. brevicornu and A. membranaceus produced precipitation,and the content of icariin in precipitation increased. CON-CLUSIONS:The compatibility of E. brevicornu and A. membranaceus can produce precipitation,so as to decrease the content of icariin in decoction,which is not influenced by pH value of decoction.

Study on antibiotic resistance and staphylococcal chromosomal cassette mec molecular epidemiology of methicillin resistant coagulase negative staphylococci in children / 中华实用儿科临床杂志

Objective To learn about the antibiotic resistance status of methicillin resistant coagulase negative staphylococcus(MRCNS),and to investigate the distribution and resistant feature of different staphylococcal chromosomal cassette mec(SCCmec) genotypes of children in Anhui,so as to guide clinical medication.Methods Resistance phenotype screening was conducted in coagulase negative staphylococcus,which were isolated from clinical strains in children in Anhui from 2010 to 2014 each year in September.MecA gene was detected by using PCR method in order to collect MRCNS.Minimal inhibitory concentrations (MIC) of 16 antibiotics were determined by adopting agar dilution method.Vacomycin-resistant strains were identified with population analysis and the Brain Heart Infusion vancomycin screen agar dilution method recommended by Clinical and Laboratory Standards Institute in 2013.Van gene and SCCmec types were detected by using PCR method.Results A total of 148 MRCNS strains were detected through the resistance phenotype screening and the detection of mecA gene.There were methicillin resistant staphylococcus epidermidis,methicillin resistant staphylococcus haemolyticus,methicillin resistant staphylococcus hominis,and other kinds of MRCNS,and the proportions of them were 44.59％ (66/148 cases),25.68％ (38/148 cases),19.59％ (29/148 cases) and 10.14％ (15/148 cases),respectively.The analysis of antibiotic resistance showed the antimicrobial resistant rates of MRCNS to Penicillin,Cefoperazone,Cefotaxime,Ceftriaxone,lmipenem and Meropenem were all 100％,to Erythromycin and Azithromycin,Ciprofloxacin,Clindamycin,Gentamicin,Lewofloxacin,Rifampincin,Chloramphenicol,Teicoplanin and Vancomycin were 92.57％,97.98％,83.78％,79.05％,43.24％,35.81％,24.32％,8.78％,2.03％ and 0.68％,respectively.There was 1 heterogeneous Vancomycin-resistant strain,which was resistant to both Vancomycin and Teicoplanin (with MIC 32.00 mg/L and 64.00 mg/L).No vanA,vanB,vanC1 or vanC2/3 gene was detected from heterogeneous Vancomycin-resistant strain by PCR.Ⅰ to Ⅴ SCCmec genotypes were detected from 148 MRCNS strains,and the major SCCmec type was SCCmec type Ⅲ,which was followed by hybrid type.Three subtypes of SCCmec type Ⅳ were identified,including Ⅳa,Ⅳc and Ⅳd.There were 148 MRCNS strains that showed different resistant phenotypes to various antibiotics.Conclusions The MRCNS strains of children in Anhui province showed multiple resistance to antibiotics.It should be on alert when heterogeneous Vaneomycin-resistant strain appeared.There were several different SCCmec types among several kinds of MRCNS,and SCCmec Ⅲ genotype was the major epidemic isolate.There was no significant correlation between the different resistance rates of non-β-lactamase antibiotics and SCCmec genotypes in MRCNS.

Clinical Pharmacist Participating in Medication Reconciliation for an Elderly Patient / 中国药房

OBJECTIVE:To investigate the role of medication reconciliation in pharmaceutical care provided by clinical phar-macists. METHODS:Clinical pharmacists participated in pharmaceutical care for a elderly patient,and reconciled drugs as anti-in-fective drugs,cardiovascular drugs,electrolyte:stop taking unnecessary drugs:Xuebijing injection,Kang'erxin capsule,Shedan chuanbei soft capsule,Mosapride citrate tablet;adjust the dose of Dihydrochlorothiazide tabet and Potassium chloride tablet;stop taking Non first-line drug Reserpine tablet in order to decrease the risk of drug use;stop taking Furosemide tablet,Lactulose oral solution and using Suppositories glycerol timely according to the disease outcome. RESULTS&CONCLUSIONS:The medication reconciliation can avoid repeated drug use,optimize medication plan,reduce drug variety and cost and decrease the potential ADR risk of drug use so as to guarantee safe and effective drug use.

Effects of Huaier Granule combined with TAC chemotherapy on immunologic function and prognosis in triple negative breast cancer patients after operation / 国际外科学杂志

Objective To investigate the effects of Huaier Granule combined with TAC chemotherapy on immunologic function and prognosis in triple negative breast cancer patients after operation.Methods Ninty-two cases of Ⅰ-ⅢA stage triple negative breast cancer patients entered the study.They were randomly divided into control group and research group.Only TAC chemotherapy was affected in control group of 42 cases, while Huaier Granule combined with TAC chemotherapy was applied in research group of 50 cases.And we gave Huaier Granule to patients in the first day of chemotherapy.The changes of T cell subset, NK cell were detected in the patients respectively in the first day before therapy and after therapy.The five-year disease-free survival rate and overall survival rate were also observed in two groups.Results Compared with control group, the changes of T cell subset, NK cell had no significant differences in research group in the first day before therapy(P ＞0.05).In the first day after therapy, the level of CD4 + (38.16 ± 5.71) ％ in control group was significantly lower than that (44.67 ± 6.47) ％ in research group(P ＜ 0.05).However, the percentage of CD8 + T cells (28.68 ± 4.06) ％ in control group was markedly higher than that (22.85 ± 3.22) ％ in research group (P ＜ 0.05).The level of NK cell (15.75 ± 3.47) ％ in control group was obviously lower than that (19.46 ± 4.22) ％ in research group(P ＜ 0.05).The five-year disease-free survival rate is 28.6％ in control group, however the five-year disease-free survival rate is 42.0％ in research group, there were significant differences between two groups(P ＜ 0.05).Furthermore, the five-year overall survival rate in research group was obviously higher than that in control group(P ＜ 0.01).Conclusions Huaier Granule combined with TAC chemotherapy not only enhances immune function but also improves prognosis and quality of life in triple negative breast cancer patients after operation.It provides a positive exploration for anti-cancer research by integration of traditional and western medicine.

Effect of recombinant human erythropoietin on lung injury induced by hepatic ischemia-reperfusion in rats / 中华麻醉学杂志

Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on lung injury induced by hepatic ischemia-reperfusion (I/R) in rats.Methods Sixty healthy male SpragueDawley rats, aged 6-8 weeks, weighing 220-280 g, were randomly divided into 3 groups (n=20 each) using a random number table: sham operation group (group S) , hepatic I/R group (group I/R), and rHuEPO group (group E).I/R and E groups underwent I/R of 70 percent of the liver.The rHuEPO 4 000 U/kg was injected intraperitoneally at 24 h before I/R in group E, while the equal volume of normal saline was given in S and I/R groups.The rats were sacrificed at 3 h of reperfusion, and lungs were removed and cut into sections which were stained with haematoxylin and eosin and examined under light microscope.Wet to dry lung weight ratio (W/D ratio) was calculated.The expression of heme oxygenase-1 (HO-1) and inducible nitric oxide synthase (iNOS) in lung tissues was determined by immunohistochemistry.The content of malondialdehyde (MDA), and activities of superoxide dismutase (SOD) and myeloperoxidase (MPO) in lung tissues were detected.Results Compared with group S, the W/D ratio, MDA content, and MPO activity were significantly increased, the SOD activity was decreased, the expression of HO-1 and iNOS was up-regulated (P＜0.05) , and the pathological changes of lung tissues were obvious in E and I/R groups.Compared with group I/R, the W/D ratio, MDA content, and MPO activity were significantly decreased, the SOD activity was increased, the expression of HO-1 was up-regulated, the expression of iNOS was down-regulated (P＜0.05) , and the pathological changes of lung tissues were reduced in group E.Conclusion The rHuEPO can alleviate hepatic I/R-induced lung injury in rats, and the mechanism may be related to up-regulated expression of HO-1 and down-regulated expression of iNOS.

Surveillance of Antimicrobial Susceptibility Patterns among Shigella Species Isolated in China during the 7-Year Period of 2005-2011

BACKGROUND: Shigella is a frequent cause of bacterial dysentery in the developing world. Treatment with antibiotics is recommended for shigellosis, but the options are limited due to globally emerging resistance. This study was conducted to determine the frequency and pattern of antimicrobial susceptibility of Shigella in China. METHODS: We studied the antimicrobial resistance profiles of 308 Shigella spp. strains (260 S. flexneri, 40 S. sonnei, 5 S. boydii, and 3 S. dysenteriae) isolated from fecal samples of patients (age, from 3 months to 92 yr) presenting with diarrhea in different districts of Anhui, China. The antimicrobial resistance of strains was determined by the agar dilution method according to the CSLI guidelines. RESULTS: The most common serogroup in the Shigella isolates was S. flexneri (n=260, 84.4%), followed by S. sonnei (n=40, 13.0%). The highest resistance rate was found for nalidixic acid (96.4%), followed by ampicillin (93.2%), tetracycline (90.9%), and trimethoprim/sulfamethoxazole (80.8%). Among the isolates tested, 280 (91.0%) were multidrug resistant (resistant to > or =2 agents). The most common resistance pattern was the combination of ampicillin, tetracycline, and trimethoprim/sulfamethoxazole (70.8%). Resistance to ampicillin and tetracycline were more common among S. flexneri than among S. sonnei isolates. CONCLUSIONS: S. flexneri is predominant in Anhui, China, and its higher antimicrobial resistance rate compared with that of S. sonnei is a cause for concern. Continuous monitoring of resistance patterns is necessary to control the spread of resistance in Shigella. The recommendations for antimicrobial treatment must be updated regularly based on surveillance results.

Effect of propofol on liver injury in mice with acute liver failure / 中华麻醉学杂志

Objective To evaluate the effect of propofol on liver injury in mice with acute liver failure (ALF).Methods Eighty adult male ICR mice,aged 1 months,weighing 20-25 g,were randomly divided into 3 groups (n =20 each) using a random number table:control group (group Ⅰ),ALF group (group Ⅱ),and ALF + propofol group (group Ⅲ).ALF model was established with intra-peritoneal D-galactosamine (D-GaIN) and lipopolysaccharide (LPS).Propofol 5 mg/kg was injected via the tail vein every 1 h within 6 h after injection of DGaIN and LPS in group Ⅲ,while the equal volume of normal saline was given instead in the other groups.Venous blood samples were taken from the tail vein at 1,3 and 6 h after injection of D-GaIN and LPS (T1-3) to detect the activities of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and serum tumor necrosis factor-alpha (TNF-α),interleukin-1β (IL-1β) and IL-10 concentrations (by ILISA).The survival within 12 h after injection of D-GaIN and LPS was observed and the survival rates were calculated.The mice were sacrificed and livers were removed for microscopic examination of pathologic changes.Results Compared with group Ⅰ,the activities of AST and ALT were significantly increased at each time point in Ⅱ and Ⅲ groups and the serum TNF-α concentrations at T1,2 and IL-1β and IL-10 concentrations at each time point were significantly increased in group Ⅱ,and the serum TNF-α concentrations at T1,and IL-1β and IL-10 concentrations at T2,3 were significantly increased in group Ⅲ (P ＜ 0.05).Compared with group Ⅱ,the activities of AST and ALT at each time point,serum TNF-α concentrations at T1,2 and IL-1β and IL-10 concentrations at T2,3 were significantly decreased and the survival rate within 12 h after injection of D-GaIN and LPS was increased in group Ⅲll (P ＜ 0.05).The pathologic changes of liver tissues were gradually attenuated in Ⅱ and Ⅲ groups.Conclusion Propofol can reduce the liver injury in mice with ALF through inhibiting inflammatory responses.

Effect of ischemic postconditioning on phosphatidylinositol-3-OH kinase and extracellular signal-regulated protein kinase in rats with hepatic ischemia-reperfusion injury / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of ischemic postconditioning on phosphatidylinositol-3-OH kinase (PI3K) and extracellular signal-regulated protein kinase 1/2(ERK1/2) in rats after hepatic ischemia reperfusion in rats and investigate the mechanism of ischemic postcoditioning of the liver.</p><p><b>METHODS</b>Three cycles of 1 min-off-1 min-on ischemic postconditioning regime were used in a rat model of 70% hepatic ischemia-reperfusion injury. The changes in the liver function, hepatocyte apoptosis, phosphorylation of Akt and ERK1/2 were assessed in rats treated with sham operation, LY294002+sham operation (LY+S), PD98059+sham operation (PD+S), ischemia reperfusion (IR), ischemic postconditioning (IPO), LY294002+ ischemic postconditioning (LY+IPO), or PD98059+ischemic postconditioning (PD+IPO).</p><p><b>RESULTS</b>Ischemic postconditioning significantly alleviated hepatic ischemia-reperfusion-induced liver function injury and hepatocyte apoptosis and increased phosphorylation of Akt and ERK1/2. LY294002 and PD98059 antagonized the effects of ischemic postconditioning in the liver.</p><p><b>CONCLUSION</b>Activation of PI3K and ERK1/2 may mediate the protective effect of ischemic postconditioning against hepatic ischemia- reperfusion injury in rats.</p>

Effect of ulinastatin pretreatment on liver regeneration and TNF-α/IL-6/STAT-3 signal pathway in rats with major hepatectomy and ischemia-reperfusion injury / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of pretreatment with ulinastatin on liver regeneration and TNF-α/IL-6/STAT-3 signal pathway in rats after 70% hepatectomy combined with ischemia-reperfusion injury.</p><p><b>METHODS</b>A total of 120 normal male SD rats weighing 230-280 g were randomized into 3 groups (n=40), namely simple partial hepatectomy (PH) group, partial hepatectomy with ischemia-reperfusion (PHIR) group, and ulinastatin group. All the rats received resection of the left and middle liver lobes. In PHIR group, the remnant right lobes were subjected to blood flow occlusion for 30 min; in UTI group, the rats were given 50 000 U/kg UTI intravenously prior to the occlusion, and in PH group, the blood flow was not occluded. At 1, 6, 12, 24, and 48 after the reperfusion, the remnant liver tissues were examined for regenerated liver weight, PCNA staining, TNF-α and IL-6, STAT-3, cyclin D1, and Cdk4 expressions.</p><p><b>RESULTS</b>The regenerated liver weight and PCNA positivity rates were significantly higher in ulinastatin group than in PHIR group at 24 h and 48 h after the reperfusion (P<0.05). In ulinastatin group, the levels of TNF-α and IL-6 were significantly lower, and IL-6 level and the expressions of STAT-3, cyclin D1, and Cdk4 mRNA and cyclin D1 and Cdk4 proteins were significantly higher in ulinastatin group than in PHIR group at 24 h and 48 h (P<0.05).</p><p><b>CONCLUSION</b>Ulinastatin can promote liver regeneration after major hepatectomy and ischemia-reperfusion injury, and the effect is possibly related with activation of IL-6/STAT-3 signal pathway, which promotes the synthesis of cyclin Dl-Cdk4 complex and hepatocyte proliferation.</p>

Effects of ulinastatin pretreatment on oxidative stress response and hepatocyte growth factor after hepatectomy in rats / 中华麻醉学杂志

Objective To investigate the effects of ulinastatin pretreatment on oxidative stress response and hepatocyte growth factor (HGF) after hepatectomy in rats.Methods One hundred and twelve pathogen-free male Sprague-Dawley rats,aged 3 months,weighing 230-280 g,were randomly divided into 2 groups (n=56 each): group hepatectomy (group H) and group ulinastatin pretreatment (group U).Left and median lobe resection was performed and then liver ischemia was induced by blood flow occlusion of right and caudate lobes for 30 min,followed by perfusion in both groups.Ulinastatin 50 000 U/kg was injected intravenously at 5 min before occlusion in group U.Eight rats in each group were chosen and the blood samples were taken from the inferior vena cava for measurement of serum ALT and AST activities and HGF concentration before ischemia and at 1,6,12,24and 48 h of reperfusion.Then the right lobe were removed for determination of apoptosis,SOD and myeloperoxidase (MPO) activities,MDA content,expression of proliferating cell nuclear antigen (PCNA) and liver regeneration.Apoptotic index was calculated.Another 8 rats in each group were chosen and the 7 day survival rate was recorded.Results Compared with group H,the levels of ALT,AST,MPO aud MDA and apoptotic index were significantly decreased,and the levels of HGF and SOD,PCNA expression and liver regeneration were significantly increased at different time points in group U (P ＜ 0.05).There was no significant difference in 7 day survival rate between group H and group U (P＞ 0.05).Conclusion Ulinastatin pretreatment can strengthen liver regeneration after hepatectomy in rats,the underlying mechanism may be related to inhibition of oxidative stress response and increase in HGF production.

Distribution and resistance surveillance of 104 clinical strains of Serratia marcescens in Anhui Province / 中华传染病杂志

ObjectiveTo analyze the clinical distribution and antimicrobial resistance profile of Serratia marcescens(S. marcescens), and to provide the scientific evidence supporting clinical diagnosis and treatment.MethodsThe antimicrobial susceptibility test was performed in 104 strains of S. marcescens by agar dilution method. The results were judged according to the criteria recommended by Clinical and Laboratory Standards Institute (CLSI) 2010.The data were analyzed by chi square test. Results The majority of S. marcescens were isolated from sputum specimens,accounting for 59.6％ (62/104). The bacteria were most frequently isolated from department of respiratory (33.7％,35/104),followed by intensive care unit (23.1％,24/104),department of gerontology (16.3％, 17/104). The results of antimicrobial susceptibility test showed that the resistance rates of S.marcescens against ampicillin,gentamicin and cephazolin were high,which were 90.4％,86.5％ and 79.8％,respectively; those against the 3rd generation of cephalosporins were 24.0％-43.3％. No imipenem and meropenem resistant strains were identified. Compared with cefoxitin-resistant strains,the resistance rates of non-cefoxitin resistant strains against piperacillin (82.9％ vs 28.6％),ceftazidime (63.4％ vs 9.5％),aztreonam (68.3％ vs 9.5％),amikacin (68.3％ vs 20.6％),ciprofloxacin (48.8％ vs 19.1％) and chloramphenicol (90.3％ vs 58.7％) were all lower (all P ＜ 0.05 ). Conclusions S. marcescens is one of the most common conditional pathogenic bacteria leading to nosocomial infections,which is resistant to many kinds of antimicrobial agents.The surveillance of antimicrobial resistance in S. marcescens should be strengthened for purpose of preventing the transmission of multidrug resistant strains.

Chromosome and plasmid-mediated quinolone resistance mechanism in clinical isolates of Serratia marcescens / 中华检验医学杂志

Objective To investigate the prevalence of plasmid-mediated quinolone resistance ( PMQR ) determinants [ qnr,aac ( 6' ) -Ib-cr and qepA ]and mutations in quinolone resistance-determining regions (QRDRs) of gyrA and parC and their association with fluoroquinolone susceptibility in clinical isolates of Serratia marcescens in Anhui.Methods The minimum inhibition concentration ( MIC ) of 104 strains of S.rnarcescens collected from various clinical specimens from 34 hospitals during 2005 to 2010 were determined by agar dilution method.The qnr,aac (6')-Ib,qepA,gyrA and parC genes were screened by polymerase chain reaction (PCR) in 31 strains resistant to ciprofloxacin,and positive results were subsequently confirmed by sequencing.The conjugation experiments were performed for qnr and aac(6')-Ib-cr positive strains.The MIC of S.marcescens isolates,recipient strains and conjugants were tested by agar dilution method for quinolones and other antimicrobial agents.Results Six strains of the 31 S.marcescens isolates harboured qnr and/or aac(6')-Ib-cr genes.Among those 6 strains,2 strains harboured a qnrB6 gene,1 harboured a qnrS2 gene,and 4 harboured aac( 6' ) -Ib-cr,whereas no qnrA-,qnrC- or qnrD-positive isolate was detected.None of the 31 isolates carried the qepA gene.Mutations in the QRDR of gyrA and parC genes were detected in 9 and 7 isolates,respectively.The conjugation experiments were successfully carried out in 5 isolates of 6 PMQR determinants-postive strains.The MIC of conjugants for quinolones were increased evidently compared to recipient strains.Conclusions Chromosome and plasmid-mediated resistance determinants play an important role in quinolone resistance in clinical isolates of S.marcescens.And more important is that the PMQR determinants can be horizontal transmitted.It is necessary to continuously survey and watch for the spread of PMQR in S.marcescens in public health control program.

Effects of ischemic postconditioning on mitochondrial permeability transition and mitochondrial transmembrane potential following hepatic ischemia-reperfusion in rats / 中华麻醉学杂志

Objective To investigate the effects of ischemic postconditioning on mitochondrial permeability transition and mitochondrial transmembrane potential(△Ψm)following hepatic ischemia-reperfusion(I/R)in rats.Methods Forty male SD rats weighing 220-260 g were randomly divided into 5 groups with 8 animals in each group:sham operation group(group S);atractyloside+sham operation group(group A+S);I/R group;ischemic postconditioning group(group IPO)and atractyloside+ischemic postconditioning group(group A+IPO).The animals were anesthetized with intramuscular injection of atropine 0.05 mg/kg.Hepatic I/R was produced by occlusion of hepatic blood flow for 60 min followed by 6 h reperfusion.In group A+S,atractyloside 5 mg/kg was injected intravenously before abdomen Was closed.In group IPO,the animals were subjected to 3 cycles of 1 min reperfusion interspersed with 1 min hepatic isehemia at the end of 60 min hepatic ischemia.In group A+IPO,atractyloside 5 mg/kg was injected intravenously before reperfusion. Venous blood samples were collected for determination of serum ALT and AST activities immediately before ischemia and at 6 h of reperfusion. The animals were then sacrificed.Their livers were removed for microscopic examination, detection of apoptosis and determination of cytochrome c (Cyt c) expression, △Ψm and mitochonerial permeability transition pore (MPTP)activity. Apoptosis index (AI) was calculated. Results There was no significant difference in serum ALT and AST activities, AI, Cyt c expression, △Ψm and MPTP activity between S and A + S groups (P＞0.05). Compared with group S, serum ALT and AST activities and AI were significantly increased, Cyt c expression was up-regulated, △Ψm was decreased and MPTP activity was increased in groups I/R, IPO and A+IPO(P＜0.05).Compared with group I/R, serum ALT and AST activities and AI were significantly decreased,Cyt c expression was down-regulated, △Ψm was increased and MPTP activity was decreased in group IPO(P＜0.05), while no significant change was found in group A+IPO(P＞0.05).Compared with group IPO,serum ALT and AST activities and AI were significantly increased, Cyt c expression was up-regulated, △Ψm was decreased and MPTP activity was increased in group A + IPO(P＜ 0.05).Microscopic examination showed that hepatic injury was reduced in group IPO compared with group I/R, while aggravated in group A+ IPO compared with group IPO. Conclusion Ischemic postconditioning can protect liver from I/R injury by attenuating the I/R-induced increase in MPTP opening and decrease in △Ψm in rats.

Detection of genotypes of plasmid-mediated quinolone resistance in clinical isolates of Shigella / 中华传染病杂志

ObjectiveTo investigate the variations and distributions of the plasmid-mediated quinolone resistance genes in clinical isolates of Shigella and their resistance to antimicrobial agents. Methodsqnr, aac(6')-Ib-cr and qepA genes were identified by polymerase chain reaction (PCR) in 137 clinical isolates of Shigella.DNA sequencing of gene-positive strains were analyzed and the conjugation experiment was performed. The minimal inhibitory concentrations (MIC) of Shigella isolates, recipient strains and transconjugants were tested by agar dilution method for quinolones and other antimicrobial agents. The genotype of transconjugants were determined by PCR and sequencing. ResultsFour (2.9％) strains of the 137 Shigella isolates were qnr gene positive, including 3 qnrS2 positive and 1 qnrB4 positive (GenBank accession numbers of the complete sequence were JF261185 and HQ917003, respectively).Furthermore,five (3.6％) aac ( 6')-Ib-cr gene-positive strains (GenBank accession number JF261186 ) and one (0.7％) qepA gene-positive strain were identified in all isolates. The conjugation experiments were successfully carried out in six out of ten PCR-positive isolates. The MIC of transconjugants against quinolones and other antimicrobial agents increased differently compared to recipient strains. Conclusions The plasmid-mediated quinolone resistance genes are lowly prevalent in clinical isolates of Shigella. However, these resistance genes have the characteristic of horizontal transfer, which indicates that more attention should be paid to this phenomenon.