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Objective To investigate the role of IL-17 in immune inflammatory reaction after spinal cord injury, and provide more evidence for clinical treatment of spinal cord injury on cytokine levels. Methods Male C57BL/6 mice were randomly divided into 4 groups: in the spinal cord injury group, mice were made into spinal cord clamp model. In the sham surgery group, the dura was cut without injuring the spinal cord. The IL-17 neutralizing antibody group received IL-17 neutralizing antibody injection through the cadual vein at 1 h after the spinal cord clamp. The solvent control group received the sterile PBS (0.01 μmol/L) through the cadual vein at 1 h after the spinal cord clamp. Mouse scale for locomotion(BMS) was applied to evaluate the mice's behavior change of hindlimb in 1-7 d. The real time fluorescent quantitative PCR was used to detect the expression changes of IL-1β、IL-6 and TNF-αmRNA, and the immunohistochemistry technique was conducted to observe the morphological changes of neurons of NeuN on the 7th day after spinal cord injury respectivly. Results The behavior score of mice after spinal cord injury indicates: the BMS scores were all 9 on the 1st to the 7th day in the sham surgery group, but were 0 on the 1st day in the model group, the IL-17 neutralizing antibody group and the solvent control group. With time extension, the motor function of hindlimbs of mice in each group were improved, but improved even better in the IL-17 neutralizing antibody group than in the model group and the solvent control group. Immunohistochemistry staining showed that after spinal cord injury, there were much complete structure of NeuN positive staining cells in the gray matter in the sham surgery group, which were obviously shrinking and protrusions disappearing in the model group and the solvent control group, while large number of NeuN neurons vacuolated and reduced significantly. It could be seen that part of neurons morphology was normal and with complete NeuN neuronal cell bodies and branches of the synapse, and the amount of NeuN neuron staining positive cells rebounded in the IL-17 neutralizing antibody group. The results of RT-qPCR on the 7th day after spinal cord injury indicated that compared with sham surgery group, IL-1β mRNA increased significantly in the model group and the solvent control group(P<0.01); compared with the model group and the solvent control group, IL-1β mRMA decreased significantly in the IL-17 neutralizing antibody group(P<0.05); compared with sham surgery group , TNF-α mRNA increased significantly in the model group (P<0.01); compared with the sham surgery group, TNF-α mRNA increased significantly in the solvent control group (P<0.05); compared with the model group , TNF-α mRNA decreased significantly in the IL-17 neutralizing antibody group (P< 0.05). IL-6 mRNA expression was on the decline in the IL-17 neutralizing antibody group, but without statistically significant difference with other groups. Conclusion Combined action of IL-17, IL-1β, IL-6 and TNF-α deteriorates the immune inflammatory of spinal cord injury, and it might relieve spinal cord injury in mice by inhibition of IL-17.
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Objective To research the influences of massive hemorrhage on spatial learning and memory ability in elderly SD rats .Methods Fifty six aged SD rats were randomly divided into 3 groups:blank group (B group ,n=8) ,control group (C group , n=24) ,and hemorrhage group (H group ,n=24) .B group was not given any intervention .C group received femoral artery ligation and was sutured under general anesthesia .H group underwent femoral artery puncture phlebotomy ,and then the rats were sutured . Morris water maze was used to test the spatial working ability .Results The escape latency of H group on postoperative day 1 ,3 and 7 were(29 .93 ± 7 .93)s ,(34 .56 ± 6 .74)s and (15 .47 ± 6 .42)s respectively .Compared with B group(12 .56 ± 3 .08)s ,these re‐sults indicated the spatial learning and memory of H group was destroyed after surgery 1 d and 3 d (P0 .05) .The escape latent periods to platform observed in C group rats on day1 ,3 and 7 after operation were(15 .74 ± 5 .86)s ,(15 .61 ± 2 .56)s and (13 .56 ± 4 .61)s .Compared with B group [(12 .56 ± 3 .08)s] ,these results indicated that there was no significant difference 7 (P>0 .05) .Conclusion The findings of this study indicate that massive hemorrhage of old rats may destroy the spatial learning and memory .
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The CD4+ T cells have an important effect on the regulation of the adaptive immune response. Unlike Th1 cells and Th2 cells,this newly-found Th17 cell plays an important role in autoimmune diseases,inflammation response,transplant rejection and central nervous system disease by the cytokine IL-17. This paper gives a brief review on the relationship among the Th17 cell,the cytokine IL-17 and the disease of central nervous system.
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Objective To investigate the mechanism of expression of interlenkin (IL)-17 in C57 mice′s spinal cord clamp area,and to provide new targets for clinical treatment of spinal cord injury (SCI). Methods Male C57BL/6 mice were randomly divided into three groups. In the spinal cord injury group,mice were made into spinal cord clamp model. In the sham surgery group, the dura was cut without injuring the spinal cord. The IL-17 neutralizing antibody group received IL-17 neutralizing antibody injection through the cadual vein at 1 hour after the spinal cord clamp . Mouse scale for locomotion (BMS)was applied to evaluate the mice's behavior change of hindlimb in 1-7 days,the real time fluorescent quantitative PCR was used to detect the change in the expression of spinal cord injury district TNF-αmRNA each time,HE staining was conducted to detect the morphological changes of spinal cord injury of the sham surgery group,the spinal cord injury group and the IL-17 neutralizing antibody group at the 7th days. Results After spinal cord injury,the mice's BMS score were 9 in the sham surgery group;in the model of spinal cord injury group,the mice's BMS score were 0 on the 1st day,and 2.9 on the 7th day. In the IL-17 neutralizing antibody group,the mice's BMS score were 0 on the 1st day,and 3.5 on the 7th day. The expression of IL-17 mRNA in the injury area peaked at the 3rd hour,which showed statistical difference when compared with sham surgery group (P0.05),and the expression of IL-17 mRNA reduced the lowest levels on the 7th day. The 7th day following spinal cord injury,mice's spinal cord tissue was complete normal in the sham surgery group. In the spinal cord injury group,a large number of mice's nerve cells were necrotic, a lot of cells formed vacuolated. In the IL-17 neutralizing antibody group, part of mice's nuclear neurons were shrinking, cells formed vacuolated, but part of cells remained morphologically complete. Conclusion IL-17 is involved in secondary immune inflammatory process of spinal cord injury, it may be targets for intervention in the treatment of spinal cord injury.
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BACKGROUND:Intervention using known inflammatory transmitters has limitations on relieving secondary spinal cord injury. Interleukin-17 is an important proinflammatory cytokine, and is gradual y paid attention in the pathogenesis of central nervous system diseases. OBJECTIVE:To investigate the altered rule of interleukin-17 mRNA and protein in a rat model of acute spinal cord injury. METHODS:Healthy male Sprague-Dawley rats were randomly assigned to two groups. In the model group, rats were made into complete spinal cord transaction models. In the sham surgery group, only spinal dura mater was opened, but parenchyma was not injured. Basso, Beattie, Bresnahan locomotor rating scale was used to observe the effects of acute spinal cord injury on limb motor function of rats. Hematoxylin-eosin staining was used to observe histopathological changes at various time points after spinal cord injury. Real-time fluorescence quantitative PCR and western blotting were used to detect interleukin-17 mRNA and protein levels in each group at various time points after spinal cord injury. RESULTS AND CONCLUSION:Basso, Beattie, Bresnahan locomotor rating scale:Basso, Beattie, Bresnahan scores were 20 to 21 in the sham surgery group. Basso, Beattie, Bresnahan scores were 0 at 1 and 2 days after spinal cord injury. At 7 days, Basso, Beattie, Bresnahan scores were 0 to 3 (P<0.05). Hematoxylin-eosin staining results revealed that compared with the sham surgery group, inflammatory cel infiltration, neuronal and glial cel swel ing, and a reduced number of neuronal processes were observed at 6 hours after spinal cord injury. Gray matter and white matter were loose and vacuolated at 12 hours. Gliocyte proliferation and tissue fibrosis were apparent at 7 days. Real-time PCR results demonstrated that interleukin-17 mRNA appeared at 3 hours, and peaked at 6 hours (P<0.01), and then decreased. Interleukin-17 mRNA levels were similar to the sham surgery group at 7 days. Western blotting results revealed that interleukin-17 expression began to increase at 6 hours and peaked at 12 hours (P<0.05), and then reduced, and reached the levels in the sham surgery group at 7 days. Results indicated that tissue injury was most severe at 12 hours, and showed a time consistency with interleukin-17 expression. It is inferred that interleukin-17 is possibly involved in the process of secondary inflammatory reaction of spinal cord.
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Objective To investigate the effects of controlled low central venous pressure (CLCVP) on cerebral oxygen metabolism during orthotopic liver transplantation (OLT),and study the safety of CLCVP in OLT.Method Forty-six patients subject to OLT were randomly divided into CLCVP group (CL group) and CVP group (C group).Blood samples were taken from radial artery and jugular simultaneously for blood gas analysis before operation (T1,baseline),immediately blocking inferior vena and portal vein (T2),30 min after anhepatic phase (T3),30 min after graft reperfusion (T4),2 h after graft reperfusion (T5),and 24 h after graft reperfusion (T6).Cerebral arterial oxygen content (CaO2),jugular oxygen content (CjvO2),cerebral arterial-venous oxygen content difference (Ca-jvO2),cerebral oxygen extraction rate (CERO2),and cerebral blood flow/ cerebral metabolic rate of oxygen (CBF/CMRO2) were calculated by the Fick formulae.Meanwhile,blood samples were taken from jugular simultaneously for serum creatinine (Cr) and urea nitrogen (BUN) a different time points.We also recorded the whole operation time,anhepatic phase time,volume of blood loss and transfusion,and urine volume.Results As compared with C group,CaO2,CjvO2,Ca-jvO2,SjvO2,CERO2 and CBF/CMRO2 in CL group were nearly not changed at different time pioints (P＞0.05),but in the same group,as compared with T1 and T2,the CaO2,CjvO2,Ca-jvO2 and CERO2 in T3,T4 and T5 were decreased significantly (P＜0.05),and the SjvO2 in T3,T4 and T5 was increased remarkably.The operation time and anhepatic phase time had no significant difference in both groups.As compared with C group,the volume of blood loss and transfusion in CL group were decreased (P＜0.05),and the urine volume in CL group CL was increased significantly (P＜0.05).Cr and BUN showed no significant difference in both groups and at the same time points of C group and CL group.Conclusion CLCVP can decrease volume of blood loss and transfusion,increase urine volume during OLT,and it does not change the cerebral oxygen metabolism during OLT.
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ObjectiveTo observe the changes of the respiratory dynamics during expand thymectomy,and to explore the protection of ulinastatin on pulmonary function.MethodsSixty patients with myasthenia gravis( Ossermann Ⅰ,Ⅱ b)undergoing expand thymectomy were randomly divided into control group( group C,n =30)and ulinastatin group( group U,n =30).Patients in ulinastatin group received intravenous injection of ulinastatin 4000 U/kg in 20 ml physiological saline immediately after entering operating room and pumped ulinastatin 2000 U/( kg · h)to the end of the operation continuously.Patients in control group received the same volume of normal saline.Heart rate ( HR ),mean arterial pressure ( MAP ),lung compliance,airway peak pressure,plateau airway pressure,inspiratory and expiratory resistance were monitored before induction of anesthesia( T1 ),during skin incision ( T2),at 30 min after operation ( T3 ) and at 60 min after operation (T4),at the end of operation before extubation(T5).ResultsCompared with T1,HR and MAP at T2 in two groups were increased obviously [ group U HR:( 90.2 ± 13.5 ) bpm vs ( 78.6 ± 10.4 ) bpm,MAP:( 15.5 ± 2.3 ) kPa vs ( 12.1 ± 1.5)kPa;group C HR:(94.3 ± 15.4)bpm vs(81.6 ± 12.2)bpm,MAP:( 16.8 ± 2.6) kPa vs( 12.6 ±1.8)kPa,P ＜ 0.05 )].There was no significant difference on HR,MAP at each time between the two groups (P ＞0.05).At T3,T4,T5,the lung compliance was significantly decreased when compared with T1 [ group U:T3,T4,TS(51.23 ± 12.33) ml/cm H2O,(50.35 ± 13.29) ml/cm H2O and(50.65 ± 13.16) ml/cm H2O vs T1 (53.69 ± 14.34) ml/cm H2O;group C:T3,T4,T5(41.56 ± 11.20)ml/cm H2O,(42.02 ± 10.12) ml/cm H2O and(39.85 ± 10.31 ) ml/cm H2O vs T1 ( 53.45 ± 15.21 ) ml/cm H2O; P ＜ 0.05 ) ].Airway peak pressure,plateau airway pressure,inspiratory and expiratory resistance at T3,T4,T5 were obviously increased compared with T1 in two groups [ airway peak pressure:group U:( 13.04 ± 2.14 ) cm H2O,( 13.12 ± 2.42 ) cm H2O,(13.22±2.48)cm H2O,vs(12.04 ±2.12)cm H2O;group C:(16.25 ±3.27)cm H2O,(15.56 ±4.34)cm H2 O,( 16.64 ± 3.45 ) cm H2O,vs ( 13.12 ± 2.32 ) cm H2O; plateau airway pressure:group U:( 10.54 ±2.46) cm H2O,( 11.76 ± 3.11 ) cm H2O,( 12.02 ± 3.25 ) cm H2 O,vs ( 9.48 ± 2.13 ) cm H2O; group C:(15.02 ±3.87)cm H2O,( 15.51 ± 3.13) cm H2O,( 15.67 ± 3.02) cm H2O,vs (9.25 ± 1.26) cm H2O;inspiratory resistance:group U:( 8.56 ± 2.52 ) cm H2O,( 9.31 ± 3.06 ) cm H2O,( 8.44 ± 2.45 ) cm H2O,vs (8.25 ±2.20)cm H2O;group C:(11.52 ±3.06)cm H2O,(12.16 ±3.02)cm H2O,(12.83 ±3.14)vs ( 8.31 ± 2.24 ) cm H2O ; expiratory resistance:group U:( 10.22 ± 2.24 ) cm H2O,( 10.34 ± 2.66 ) cm H2O,(10.27 ± 2.22) cm H2O,vs(8.46 ± 2.37) cm H2O; group C:(14.43 ±3.18)cm H2O,(14.56 ±3.32)cm H2O,( 14.46 ± 3.52 ) cm H2O,vs ( 8.55 ± 2.18 ) cm H2O; P ＜ 0.05 ) ].The increased degree of lung compliance and the decreased degree of airway peak pressure,plateau airway pressure,inspiratory and expiratory resistance at the time of T3,T4,T5 and T1 in ulinastatin group were all significantly higher than those in control group(F=6.167,3.138,4.137,5.217,4.361,respectively,P ＜0.05).ConclusionUlinastatin can improve respiratory dynamics,reduce lung injury,and play a protective role in patients with myasthenia gravis.
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Objective To explore the two different anesthesia methods on hemodynamics and inflammatory cytokines in elderly patients during peroperative period.MethodsFifty elderly patients with Knee Replacement( ASA Ⅰ,Ⅱ )were randomly divided into general anesthesia group( group A,n =25 ) and combined general and epidural anesthesia group( group B,n =25 ).The changes of mean arterial pressure(MAP) and heart rate ( HR ) were monitored before induction of anesthesia ( T1 ),at intubation ( T2 ),during skin incision ( T3 ) and at the time of extubation ( T4 ),at 30 min after extubation ( T5 ).Blood samples were taken from artery for determination of plasma TNF-α,IL-6,IL-10 concentrations before tourniquet inflation ( T5 ),10 min after tourniquet deflation(T6),30 min after tourniquet deflation (T7)and 30 min after operation (T8)by enzymelinked immunosorbent assay(ELISA).ResultsThe MAP and HR of patients in two groups at T2,T3,T4 were all increased when compared with T1 [ group A:HR:( 94.3 ± 10.4 ) bpm,( 96.4 ± 12.7 ) bpm,(93.3 ± 11.1 )bpm vs(62.6 ±7.3)bpm;MAP:( 18.8 ±3.4)kPa,( 19.6 ±3.4)kPa,( 17.8 ±2.0)kPa vs ( 14.5 ± 1.5)kPa,P＜0.05;group B:HR(76.2 ±6.5)bpm,(70.1 ± 9.7) bpm,(71.5 ± 8.3) bpm vs(64.6 ± 8.4) bpm;MAP:( 16.3 ± 2.5 ) kPa,( 15.3 ± 1.2) kPa,( 14.8 ± 1.4) kPa vs ( 14.1 ± 1.3 ) kPa,P ＜ 0.05 ].There was significant difference on MAP and H R between group A and group B( F =11.957,9.745;P ＜ 0.05 ).The level of plasma TNF-α,IL-6 and IL-10 were significantly increased at T6 to T8 compared with T5 in both groups[ groupA:TNF-α:(4.36 ±0.18) ng/L,(7.54 ± 1.23) ng/L,(10.35 ±2.21 )ng/L vs (2.26 ±0.16) ng/L; groupA:IL-6:(4.32 ±0.21 ) ng/L,( 8.35 ± 1.26 ) ng/L,( 10.23 ± 2.23 ) ng/L vs ( 1.36 ± 0.08 ) ng/L; groupA:IL-10:(5.32±1.10) ng/L,(7.56 ± 1.36) ng/L,(8.63 ± 2.21) ng/L vs (1.25 ± 0.03) ng/L; groupB:TNF-α:(3.43 ±0.06)ng/L,(5.24 ±2.10) ng/L,(7.68 ± 1.43) ng/L vs(2.22 ±0.15) ng/L;groupB:IL-6:(3.41 ±0.08 ) ng/L,(5.34 ± 1.34 ) ng/L,( 8.54 ± 2.03 ) ng/L vs ( 1.28 ± 0.04 ) ng/L; groupB:IL-10:( 7.28 ± 1.22 )ng/L,( 10.53 ± 2.14)ng/L,( 12.45 ± 2.03 )ng/L vs( 1.31 ± 0.04)ng/L,P ＜ 0.05 ].And there was significant difference on TNF-α,IL-6 and IL-10 between group A and group B( F =7.889,3.554,5.443,respectively,P ＜0.05).ConclusionCompared with general anesthesia group,combined general and epidural anesthesia group can ensure hemodynamic stability of elderly patients during peroperative period very well and can reduce the releasing of inflammatory cytokins,it is a viable and an ideal method.
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ObjectiveTo explore two different anesthesia methods on hemodynamics and the quality of palinesthesia in elderly patients during peroperative period.Methods Sixty elderly patients with Hip Replacement( ASA,Ⅰ,Ⅱ ) were randomly divided into general anesthesia group ( group A,n =30 ) and combined general and epidural anesthesia group( group B,n =30).The changes of mean arterial pressure(MAP)and heart rate( HR ) were monitored before induction of anesthesia( T1 ),at intubation( T2 ),during skin incision (T3) and at the time of extubation ( T4 ),at 30 min after extubation ( T5 ) and at the same time,the dosage of general anesthetics and each index's time after operation to awake were recorded of the patients in both groups.ResultsThe MAP and HR of patients in two groups at T2,T3,T4,T5 were all increased when compared with T1.And the increasing degree of MAP and HR in group A were higher than that in group B ( MAP:within group F =17.352,interaction F =4.326,between groups F =8.652; HR:within group F =11.561,interaction F =5.241 between groups F =7.248; P ＜ 0.05 ).The dosage of general anesthetics was significantly different between two groups[ sevoflurane:(1.40 ± 0.30)MAC vs (1.00 ± 0.12 )MAC,t =0.37,P＜0.05 ; fentanyl:(0.34 ±0.08)mg vs(0.18 ±0.03) mg,t =0.21,P ＜0.05 ; vecuronium:(6.20 ±0.32) mg vs(4.10 ±0.31 ) mg,t =1.24,P ＜0.05 ; propofol:(448 ±24) mg vs(393 ±26) mg,t =3.46,P ＜0.05].There was significant difference on gag reflex time [ ( 18.00 ± 1.27 ) min vs ( 12.31 ± 2.54 ) min,t =2.74,P ＜ 0.05 ],time to extubation [ ( 24.03 ± 2.42 ) min vs ( 16.05 ± 1.20 ) min,t =3.68,P ＜ 0.05 ],fully awake time [(29.54±5.24)min vs(19.25±2.64)min,t=1.35,P＜0.05] between these two groups.ConclusionThe two different anesthesia methods can ensure haemodynamic stability of elderly patients undergoing hip replacement during peroperative period.But compared with general anesthesia group,combined general and epidural anesthesia group can reduce the dosage of general anesthetics and shorten the time of extubation significantly,it is a viable and an ideal method.
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Objective To evaluate clinical the effects and significance of the occurence and development of varies intervention on control of acute lung injury(ALI)in clinical practice.Methods Sixty-nine ALI patients were randomly divided into three groups:traditional ventilation therapy group(n=17),low dose ulinastatin intervention with traditional ventilation therapy group(n=24)and high dose ulinastatin intervention in lung protective ventilation therapy group(n=28).We compared the changes of pneumodynamics,arterial blood gas and hemodynamics among these groups.Resident time in ICU,time course of mechanical ventilation and mortality of these groups were also compared.Results Large dose ulinastatin intervention in lung protective ventilation therapy group had further improved influence on pneumodynamics,arterial blood gas and puhnonary oxygenation than other groups(P＜0.05)and no mechanical ventilation induced lung injury was found in the group.There were no obvious differences in pneumodynamics,arterial blood gas and pulmonary oxygenation between the other two groups(P＞0.05).Lung injuries induced by mechanical ventilation were all observed in these two groups.There were no obvious differences in hemodynamics among the three groups(P＞0.05).Conclusions Large dose ulinastatin intervention in lung protective ventilation can improve pneumodynamics,arterial blood gas and pulmonary oxygenation of ALI patients.It could decrease the incidence of ventilator induced lung injury(VILI).The treatment should been applied prospectively in clinical practice.
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Objective To investigate the change in coagulation function in relation to different amounts of blood loss in selective non-cardiovascular surgery patients.Methods Twenty American Anesthesia Association (ASA) class I or Ⅱ patients,aged 23-57 yr,undergoing non-cardiovascular surgery with normal preoperative coagulation were chosen randomly.After general anesthesia,on the basis of adequate sedation and analgesia,patients were given Ringer's solution and Voluven (pre-warmed to 37℃,volume ratio of crystalloid/colloid was 1:2) to maintain the stability of heart rate,blood pressure and central venous pressure.Temperature and blood gas analysis were monitored to prevent potential interference induced by hypothermia and acidosis.When the ratio of blood loss/blood volume reached 10%,15%,20% and 25%,all the routine blood components analysis and coagubility parameters,and Sonoclot coagulation and platelet function parameters were observed.Results Preoperative average value of Hct was 38.1%,and when ratio of blood loss/blood volume were 10%,15%,20 % and 25%,Hct was decreased to 33.4%,31.5%,30.1% and 27.9% respectively.When the ratio reached 15% or larger,platelet count decreased significantly compared with preoperative value (P
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0.05),while in 75U/ml,100U/ml and 200U/ml groups,PF decreased significantly(P
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Objective To investigate the effects of dilution of whole blood in vitro with different amount of normal saline on blood coagulation.Methods Nineteen healthy adult volunteers were enrolled in the present study.Venous blood samples obtained from each volunteer were diluted with normal saline in saline/blood ratio(v/v) of 2∶8(20%),3∶7(30%),4∶6(40%),5∶5(50%) and 6∶4(60%).Undiluted blood was considered as control.Coagulability of each group was determined with Sonoclot coagulation and platelet function analyzer,including activated clotting time(ACT),clot rate(CR),time to peak(TP),maximal clot signal(MCS),and platelet function(PF).Results 1) ACT: Compared with control value,ACT was significantly shortened with 20% dilution(P
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Objective To investigate the changes in gastrointestinal circulation during the operation of orthotopic liver transplantation. Methods In 15 patients undergoing orthotopic liver transplantation, PgCO2 and PaCO2 were determined and the values of Pg-aCO_2 and pHi were calculated at the time points as follows: pre-operation (T0), 30min before anhepatic phase (T1), 30min of anhepatic phase (T2), and 5min (T3), 30min (T4) and 90min (T5) after reperfusion of the transplanted liver, and at the end of the operation(T6). Results Compared with that of pre-operation, PgCO2 and Pg-aCO2 increased significantly at the following time points: 30min before anhepatic phase, 30min of anhepatic phase, as well as 5min and 30min after reperfusion of the transplanted liver (P0.05). The values of pHi decreased significantly at 30min before anhepatic phase, 30min of anhepatic phase, and 5min and 30min in neohepatic phase (P
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Objective To monitor and modulate the coagulation disorder during operation in patients undergiong allogeneic liver transplantation. Methods PT, TT, APTT, FIB, HB, PLT count, sonoclot coagulation and platelet function were measured dynamically in 10 patients during anesthesia and operation. Results After coagulants were used, the above parameters pertaining to coagulation function were improved obviously. All of above coagulation parameters were severely abnormal in the period from 30 minutes before anesthesia to 20 minutes after portal vein recirculation. The hypocoagulability was significantly improved at the end of operation by target supplementation of prothrombin complex, fibrinogen, fresh platelets, and other coagulants, complementing large amount of fresh blood plasma. Notably, severe hemorrhage and thrombosis leading to re-operation did not happen in all the recepients. Conclusion The relationship of the local hypercoagubility at the anastomosis and the systemic hypocoagulation should be concerned to prevent coagulation and thrombosis during operation of liver transplantation.
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Objective This study was to investigate the management of hemodynamics during operation in patients undergoing orthotopic liver transplantation. Method Hemodynamic parameters were monitored during operation. Norepinephrine, epinephrine or dopamine, as well as nitroglycerin or PGE 1 were used in 21 cases to maintain a stable hemodynamics. Results Our data demonstrated that rational use of norepinephrine and epinephrine was beneficial in maintaining vital organ perfusion and improving tissue oxygenation. Compared with PGE 1, nitroglycerin was shown to be more controllable in lowering pulmonary artery hypertension, and notably, it significantly increased renal blood flow. Conclusion The results of this sudy indicated that in addition to fluid resuscitation, different combinations of vasoactive agents were beneficial in maintaining hemodynamic stability
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0 05). CI, SvO 2 , DO 2 were decreased significantly in the early 5min of the anhepatic stage( P
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Objective Blood lactic acid(LA) and glucose(Glu) level are important parameters of anaerobic glycolysis and can be used to assess the severity of brain injury and cerebral metabolism. The purpose of this study was to evaluate effect of propofol on traumatic brain injury by measuring blood and CSF level of LA and Glu in addition to microscopic and NSE immunohistochemical examination of brain tissue. Methods Ninety New Zealand rabbits weighing 2.6-3.0 kg were used . Traumatic brain injury model was established according to Wang's method. Part Ⅰ . Twenty rabbits were divided into two groups of ten animal each. Blood and CSF samples were taken before and 4h, 24h, 48h, 72h and 1 week after trauma for determination of LA and Glu levels. Propofol group received propofol 30mg' kg-1?h-1 infusion for 30 min in addition to ketamine 1mg/kg before each collection of samples. PartⅡ . Seventy rabbits were divided into seven groups with ten animals in each group. Brain tissues were taken before and 24h, 72h, and 1 week after trauma for microscopic and NES immunohistochemical examination. Propofol group received infusion of 30 propofol mg kg-1 h-1 for 30 mm every day. In control group animals received same amount of normal saline. Results Blood and CSF levels of LA increased significantly after trauma in both groups but were significantly higher in control group than those in propofol group at corresponding intervals. Blood and CSF Glu levels decreased significantly in control group after trauma but in propofol group blood Glu level decreased only at 4h and 24h after trauma and CSF Glu level at 24h after trauma. There was significant difference in blood and CSF levels of Glu after trauma between the two groups. In both groups microscopic examination of brain tissue showed hemorrhage, degeneration, decrease in glial cells and vacuolization of some neuron in brain tissue of injured and surrounding areas at 24h after trauma, infiltration of neutrophils at 72h after trauma and cerebral interstitial edema and glial cell proliferation at 1 week after trauma. Neurons showed no NSE expression. In propofol group the above mentioned changes were relatively slight. Conclusions Propofol can significantly reduce blood and CSF LA levels after trauma and protect the animal from traumatic brain injury. Further studies are needed on the dosage and method of administration of propofol.
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Objective To evaluate the protective effect of midazolam (MID) on PC 12 cells against injury induced by N-methyl-D-aspartate (NMDA) -Methods The differentiated PC12 cell strain was isolated and cultured in DMEM full nutrient liquid medium and incubated in CO2 incubator at 37℃ and 5 % CO2 for 3-4 days. The experiment consisted of 3 groups : (1) control group; (2) NMDA group and (3) MID treatment group. In NMDA group NMDA 300 ?mol?L-1 was added to DMEM liquid medium. MID group was further divided into five subgroups according to different concentrations of midazolam (MID) added to DMEM liquid medium in addition to NMDA 300 ?mol?L-1 :MID Ⅰ -Ⅴ subgroups (midazolam 0.33, 1, 3, 10, 30?mol?L-1 ). The PC 12 cells were then cultured for another few hours. Cellular viability was assessed by lactic dehydrogenase (LDH) assay and MTT assay. Meanwhile the [Ca2+ ] was measured by Fura-2/AM fluorescence and nitric oxide synthase (NOS) activity was measured with ultraviolet spectrophotometer. Results Exposure to NMDA 300 ?mol?L-1 for 4 h resulted in increase in release of LDH from PC 12 cells and decrease in optical density (OD570nm) absorbed by living cells, indicating that NMDA induced injury to PC12 cells. The presence of midazolam 0.33, 1, 3, 10 ?mol?L-1 ( MID subgroup I -IV ) decreased LDH release and increased OD570nm value. Exposure to NMDA 300 ?mol?L-1 for 4h also resulted in increase in intracellular Ca2+ concentration ([Ca2+ ];) and NOS activity in PC 12 cells. Midazolam 3 and 30?mol?L-1 significantly decreased [Ca2+ ]; and NOS activity as compared with NMDA group.Conclusion Midazolam can attenuate the NMDA-induced injury to PC12 cells, decrease the Ca2+ overloading and NOS activity in PC 12 cells. The inhibitory effects of midazolam on [Ca2+ ]; overloading and NOS activity may be involved in the mechanism of its protective action.
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Objective To observe the effects of propofol on the cytokine release from human monocytic cell line (THP1) induced by lipopolysaccharide (LPS). Methods THP1 cells cultured in vitro, and they were divided into 3 groups: 0 ?g/ml LPS group, 1 ?g/ml LPS group and 1?g/ml LPS+50?mol/L propofol group, respectively, and incubated for 12 hours. Then the supernatant was collected from each culture for the determination of the levels of granulocyte/macrophage colony stimulating factor (GM-CSF), interferon-? (IFN-?), tumor necrosis factor-? (TNF-?) and interleukin (IL)-1?, IL-2, IL-4, IL-6, IL-8, IL-10, and IL-12 by using LiquiChip system. Propol was added to the culture fluid of THP1 cells in the final concentrations of 0, 12.5, 25, 50 and 100?mol/L (for the groups B, C, D, E and F, respectively), with 1?g/ml LPS. 12 hours later the supernatants were collected to detect the levels of IL-6, IL-8, TNF-?. Culture fluid without LPS and propofol (group A) was used as control. Results The levels of IL-1?, IL-6, IL-8 and TNF-? were elevated obviously in group L than that in control group (P0.05). In group L+P, levels of IL-6, IL-8 and TNF-? were significantly lower than that in group L (P