Imaging features of 99Tc m-dextran lymphoscitigraphy in thoracic duct exports obstruction / 中华核医学与分子影像杂志

Objective:To compare the 99Tc m-dextran(DX) lymphoscitigraphy and direct lymphography (DLG), in order to investigate the imaging features and clinical significance of 99Tc m-DX lymphoscitigraphy in patients with thoracic duct exports (TDE)obstruction. Methods:A total of 304 patients (140 males, 164 females, median age: 32 years) with TDE obstruction confirmed by thoracic duct exploration between 2017-01-01 and 2019-01-01 in Beijing Shijitan Hospital were retrospectively analyzed. Based on the different imaging characteristics of TDE, the reluts of 99Tc m-DX lymphoscitigraphy were divided into five groups (Ⅰ: no TDE presenting; Ⅱ: TDE presenting temporarily; Ⅲ: TDE presenting constantly or extensively; Ⅳ: abnormal reflux of imaging agents; Ⅴ: bilateral venous angle presenting). Ⅰ/Ⅱ groups were regarded as negative and Ⅲ-Ⅴ groups as positive. The consistency of 99Tc m-DX lymphoscitigraphy with DLG was evaluated with Kappa test, and the positive rates of the two methods were compared by McNemar test. Results:In the detection of TDE, the positive rate of 99Tc m-DX lymphoscintigraphy was 70.1% (213/304), which was significantly lower than that of DLG (97.4%, 296/304; χ2=4.16, P<0.001). The group Ⅲ has the largest number of cases (54.9%, 167/304), and there was a low consistency with DLG ( Kappa=0.08, P=0.005). However, there was a higher consistency between 99Tc m-DX lymphoscintigraphy results and the corresponding DLG results in the groups Ⅳ/Ⅴ ( Kappa values: 0.48, 0.86, both P<0.001). Furthermore, the diagnostic accordance rates of lower extremity lymphedema and chylous effusion were 96.1%(98/102) and 83.6%(127/152), respectively, compared with the clinical diagnosis. Conclusions:TDE obstruction of 99Tc m-DX lymphoscitigraphy presents in the majority with Ⅲ type. 99Tc m-DX lymphoscitigraphy results in patients with type Ⅳ and Ⅴ have a better consistency with those of DLG. 99Tc m-DX lymphoscitigraphy can be used as a screening tool of TDE obstruction, and play a role in the diagnosis of lower limb lymphedema and chylous effusion caused by TDE obstruction.

Analysis of the cause and prevention of vascular crisis in finger replantation / 中国基层医药

Objective@#To explore the causes of vascular crisis caused by replantation of severed finger, and summarize the experience of prevention and treatment.@*Methods@#From April 2015 to February 2017, 108 patients with wounded finger treated in the First People's Hospital of Yongkang were divided into two groups according to the occurrence of postoperative vascular crisis situation: the control group (56 cases, vascular risk), the observation group (52 cases, vascular crisis happened). The clinical data of all patients were collected, the various data were compared, and the causes of vascular crisis were analyzed.The observation group was given low molecular dextran treatment, the changes of blood coagulation function indicators before and after treatment were observed.@*Results@#The age, disconnection plane, ischemia time had statistically significant differences between the two groups(all P<0.05). After treatment, the four coagulation function index in the observation group [fiber protease: (3.32±0.29)g/L, activated partial thrombin time: (27.56±2.08)s, thrombin time: (12.13±1.62)s, prothrombin time: (11.47±1.29)s] were improved obviously (t=4.86, 8.63, 6.04, 4.70, all P<0.05).@*Conclusion@#The age, disconnection plane and ischemic time are the factors that cause vascular crisis.In addition, postoperative pain, patients' mood, postoperative posture and other factors may also lead to vascular crisis.Preoperative assessment of the condition should be done well, postoperative monitoring should be strengthened, and prophylactic medication can be used to prevent vascular crisis.

Analysis of the cause and prevention of vascular crisis in finger replantation / 中国基层医药

To explore the causes of vascular crisis caused by replantation of severed finger ,and summarize the experience of prevention and treatment.Methods From April 2015 to February 2017,108 patients with wounded finger treated in the First People＇s Hospital of Yongkang were divided into two groups according to the occurrence of postoperative vascular crisis situation :the control group (56 cases,vascular risk),the observation group (52 cases,vascular crisis happened ).The clinical data of all patients were collected ,the various data were compared , and the causes of vascular crisis were analyzed.The observation group was given low molecular dextran treatment ,the changes of blood coagulation function indicators before and after treatment were observed .Results The age, disconnection plane,ischemia time had statistically significant differences between the two groups ( all P ＜0.05). After treatment,the four coagulation function index in the observation group [ fiber protease:(3.32 ±0.29) g／L, activated partial thrombin time:(27.56 ±2.08) s,thrombin time:(12.13 ±1.62) s,prothrombin time:(11.47 ± 1.29)s] were improved obviously (t＝4.86,8.63,6.04,4.70,all P＜0.05).Conclusion The age,disconnection plane and ischemic time are the factors that cause vascular crisis.In addition,postoperative pain, patients＇mood, postoperative posture and other factors may also lead to vascular crisis.Preoperative assessment of the condition should be done well,postoperative monitoring should be strengthened ,and prophylactic medication can be used to prevent vascular crisis.

Six-month outcomes of corneal crosslinking with dextran-free isotonic riboflavin solution / Resultados após seis meses de crosslinking de córnea com solução isotônica de riboflavina sem dextrano

ABSTRACT Purpose: To analyze the short-term clinical and topographic outcomes in patients with keratoconus after corneal collagen cross-linking treatment (CXL) with dextran-free isotonic riboflavin solution. Methods: In this retrospective case series, 26 eyes from 26 patients with keratoconus were studied. The best corrected visual acuity (BCVA) and refractive and topographic findings were analyzed at a 6-month follow-up. Results: The mean BCVA (Snellen lines) values before and 1, 3, and 6 months after CXL were 0.51 ± 0.2, 0.48 ± 0.2, 0.57 ± 0.2, and 0.64 ± 0.2, respectively, and the difference between the preoperative and 6-month values was statistically significant (p=0.006). The mean spherical equivalent refraction decreased from -5.6 ± 2.4 diopters (D) preoperatively to -5.0 ± 2.1 D, and mean simulated keratometry decreased from 48.5 ± 2.5 D to 47.8 ± 2.6 D at 6 months. (p=0.145 and p=0.001, respectively). In addition, the maximum keratometry decreased progressively and significantly from the preoperative value during follow-up (p=0.003). The central and minimal corneal thicknesses, including those of the epithelium, also decreased from 442.8 ± 25.6 µm and 430.5 ± 23.9 µm preoperatively to 420.7 ± 31.8 µm and 409.3 ± 28.7 µm at the most recent follow-up (p<0.001), respectively. No intraoperative or postoperative complications were observed. Conclusions: CXL with dextran-free isotonic riboflavin solution appears to be a safe treatment alternative for keratoconus and yields sustained short-term improvements in visual acuity, keratometric readings, and corneal thickness. However, long-term results are needed to confirm these outcomes.

RESUMO Objetivo: Analisar os resultados clínicos e topográficos curto prazo após crosslinking (CXL) de córnea com solução isotônica de riboflavina sem dextrano, em pacientes com ceratocone. Método: Estudamos 26 olhos de 26 pacientes com ceratocone, nesta série retrospectiva de casos. Melhor acuidade visual corrigida (BCVA), refração e achados topográficos foram analisados aos 6 meses de acompanhamento. Resultados: BCVA pré-operatória (linhas de Snellen) foi de 0,51 ± 0,2. BCVA após CXL foram de 0,48 ± 0,2, 0,57 ± 0,2 e 0,64 ± 0,2 no 1º, 3º e 6º meses, respectivamente. A diferença entre a BCVA pré-operatória e mais recente foi estatisticamente significativa (p=0,006). O equivalente esférico médio diminuiu de -5,6 ± 2,4 dioptrias (D) no pré-operatório para -5.0 ± 2.1 D e a média da ceratometria simulada diminuiu de 48,5 ± 2,5 D para 47, 8± 2,6 D aos 6 meses. (p=0,145 e p=0,001, respectivamente). A ceratometria máxima diminuiu progressivamente durante o acompanhamento com as mudanças sendo significativamente diferentes do valor pré-operatório (p=0,003). As espessuras corneanas central e mínima, diminuiram de 442,8 ± 25,6 µm e 430,5 ± 23,9 µm para 420,7 ± 31,8 µm e 409,3 ± 28,7 µm, respectivamente, na visita mais recente (p<0,001). Não foram observadas complicações intraoperatórias e pós-operatórias. Conclusões: CXL com solução de riboflavina isotônica sem dextrano parece ser uma opção segura de tratamento para o ceratocone com melhora mantida na acuidade visual, ceratometria e espessura corneana, no curto prazo. Resultados a longo prazo são necessários para confirmar estes resultados.

Optimal preparation procedure and quality evaluation of the superparamagnetic iron oxide coated by dextran / 中华核医学与分子影像杂志

Objective To determine the optimal procedure for preparation of the SPIO nanoparticles modified by dextran polylysine,and to evaluate the quality of this product.Methods The optimal preparation procedure of four factors (solution pH value,dextran concentration,reaction temperature and stirring rate) affecting SPIO hydrodynamic size were obtained through orthogonal experiments (3 levels).SPIO nanoparticles were synthesized under an optimum procedure.The shape and hydrodynamic size were detected by transmission electron microscope (TEM) and Malvern Zetasizer respectively.The content of Fe was detected by atomic absorption spectrophotometer,while chemical structures of SPIO nanoparticles were characterized and analyzed by infrared spectroscopy (IR) method.X-ray powder diffraction method was used to identify the ingredients,and the magnetic parameters were measured by vibrating sample magnetometer.Furthermore,experiments with ovarian cancer cells were performed to primarily validate the magnetic property of SPIO nanoparticles.Results The results of the orthogonal experiments showed that the optimum preparation procedure was as follows:dextran concentration of 10 mg/ml,pH 10,reaction temperature of 80 ℃ and stirring rate of 600 r/min.The TEM results showed the SPIO nanoparticles were in spherical shape,homogeneously distributed and uniform in size,and the mean diameter was 7.0 nm.The content of Fe was (12.36±0.08) g/L.The IR results clearly showed that the Fe3O4 was coated by dextran successfully.The Xray powder diffraction method showed that the sample contained Fe3O4 and the magnetism parameters indicated that the sample had superparamagnetism.The experiments with ovarian cancer cells demonstrated that SPIO nanoparticles could enter into the cells and then the cells had certain magnetic properties.Conclusions The SPIO nanoparticles synthesized under the optimal procedure are stable,small in size,with good dispersion and are feasible to enter into cells for rendering certain magnetic properties.This study has provided a good foundation and potential for further research.

Harmine has no lung-protective effects in a canine model of lung ischemia-reperfusion injury / 中国组织工程研究

BACKGROUND:Inflammatory cellactivation and the generation of oxygen free radicals are important factors of lung ischemia-reperfusion injury. Adding the drugs with anti-inflammation and antioxidant effects into the lung preservation solution used, can improve the protection fluid, and play a crucial role in the study of lung ischemia-reperfusion injury and protection of the function of transplanted lung. OBJECTIVE:To discussion the effect of harmine in canine model of pulmonary ischemia-reperfusion injury. METHODS:Twelve healthy hybrid dogs were randomly divided into two groups, with six rats in each group. A canine model of lung ischemia-reperfusion injury was established, and the protecting liquid was perfused with the clockwise irrigation method. Control group:low potassium dextran protective fluid;experimental group:low potassium dextran+harmine protective fluid. After 2 hours of ischemia, the left lung circulation was recovered. The left lung tissue and blood samples were col ected from two groups of animal models after reperfusion, and their cytokines levels and the lung wet/dry weight ratio were detected and calculated. Bronchoalveolar lavage fluid was col ected to observe the pathological indicators. The main pulmonary artery pressure, left and right pulmonary artery pressure were recorded by continuous monitoring. RESULTS AND CONCLUSION:There were no statistical y significant differences in the interleukin-17, tumor necrosis factorαand endothelin 1 content in the left lung tissue and the blood between the two groups at 2 and 4 hours after reperfusion (P>0.05). After 4 hours of reperfusion in both groups, the neutrophil number, the number of lymphocytes, alveolar edema index, and vascular wal damage in bronchoalveolar lavage fluid showed no statistical y significant differences (P>0.05). Through the analysis of variance, the main pulmonary artery pressure, left pulmonary artery pressure and right pulmonary artery pressure also had no statistical significance between the two groups (P>0.05). By the analysis of cytokines, pathological indicators, lung wet/dry weight ratio, and pulmonary arterial pressure, harmine has no significant lung protection effect in canine model of lung ischemia-reperfusion injury.

Raffinose-low potassium dextran solution in clinical lung transplantation: a retrospective study / 中华器官移植杂志

ObjectiveTo evaluate the security and effectiveness of raffinose-low potassium dextran solution (RLPDs) for donor lung preservation.MethodsFrom Sep.2002 to Dec.2011,131patients underwent lung transplantation in our institution,including 81cases of single lung transplantation and 50 cases of bilateral lung transplantation.There were 95 males and 36 females.A total of 129 donors were used for organ harvest.Two donors denoted their lungs to four patients receiving single lung transplantation. All the donors were flushed, perfused antegradely and retrogradely,and preserved with hypothermal RLPDs.The repeated reperfusion was necessary when the cold ischemic time was fairly long and the function of donor was poor.During operation,the blood gas analysis,mean pulmonary artery pressure (mPAP) and breathing mechanics were monitored.Postoperatively,all the recipients received re-examination of cardiac ultrasonography,pulmonary function,blood gas analysis and chest imaging.ResultsAll lung transplantations were performed successfully,with a mean cold ischemic time of (193±21) min (range,65-630 min).There was a significant relationship between postoperative pneumonedema and donor lung cold ischernic time (P＜0.05),which was also observed between postoperative pneumonedema and primary graft dysfunction (P＜0.01). The blood gas analysis and oxygenation index were significantly improved postoperatively,with the mPAP and parameters of breathing mechanics being descended to a normal level.There were 24 early deaths in the first month post-transplant,with a mortality of 18.3％ (24/131),including 11cases of sepsis,7 cases of primary graft dysfunction,3 cases of heart failure,1case of bronchial stomal leak,1case of acute rejection,and 1case of pulmonary infarction.The pulmonary function was improved significantly 3 months postoperatively.Conclusion RLPDs is efficient in the preservation of donor lung,with the ability to alleviate ischemic reperfusion injury and improve pulmonary function.

Lymphoscintigraphy in patients with lymphedema after gynecological cancer treatment: assessment of injury of the lower limb lymphatic system / 中华核医学杂志

Objective To evaluate the lymphoscintigraphic imaging characteristics for the patients with lower limb lymphedema and to establish a novel grading system for the injury to lower limb lymphatic system. Methods One hundred and sixty six consecutive patients (332 lower limbs) with lower limb lymphedema after surgical and(or) radiotherapy treatment for gynecological cancer were recruited into this retrospective study. The lymphoscintigraphy studies were performed after subcutaneous injection of 111～185 MBq (0. 1～0. 15 ml) of 99Tcm-DX into the webbed space between the first and second toes of both feet. Based on the integrity of lymphatic vessel and the extension of dermal diffusion on lymphoscintigram,the lymphatic injury to the lower limb was graded as 0, 1,2 and 3 respectively. The lymphedema of the limb was staged as 0, Ⅰ , Ⅱ a, Ⅱ b, Ⅲ by the standard of Consensus Document of the International Society of Lymphology (ISL). Chi square test was carried out to validate the established grading system for the assessment of the injury to the lower limb lymphatic system. Results The lymphoscintigraphic imaging characteristics included lymphatic blockage, dermal backflow, no visualization of lymphatic or lymph node, lymphocele and lymph fistula in the lower limb, pelvis and abdomen. There were 65 (19.6%), 71 (21.4%),131 (39.5%), 62 (18.7%) and 3 (0.9%) limbs staged as 0, Ⅰ , Ⅱa, Ⅱb, and Ⅲ for lymphedema while 36(10.8%), 79(23.8%), 116(34.9%) and 101 (30.4%) limbs graded as 0, 1, 2, and 3 for lymphatic injury. There was a statistically significant correlation between the grading methods (χ2 =313.483, P <0.001). The patients who underwent radiotherapy had a higher incidence rate of grade 2 and 3 (70.5%, 158/224) than those who underwent surgery (53.6%, 59/108) (χ2 = 9.662, P = 0.022).The patients with erysipelas had a higher incidence rate of grade 3(73.1%, 38/52) than those without erysipelas (43.9%, 50/114) (χ2= 12.238, P<0.001). The incidence rate of grade 3 increased with the duration of lymphedema after treatment: 36.6% (34/93) for less than 1.5 years, 72.3% (34/47) for between 1.5 to 5 years, and 76.9% (20/26) for more than 5 years (χ2 = 23.123, P<0.001). The grade of lymphatic injury showed no significant difference among 3 types of gynecological cancers (χ2 = 4.000, P =0.676), or between the patients with and without chemotherapy (χ2 =0.411, P=0.938). Conclusions Lymphoscintigraphy is a reliable modality to diagnose lower limb lymphedema after treatment for gynecological cancer. The injury grading system could provide objective assessment of the lymphatic damage.

Injeção intraoperatória de dextran-500-99m_tecnécio para identificação do linfonodo sentinela em câncer de mama / Intraoperative injection of technetium-99m-dextran 500 for the identification of sentinel lymph node in breast cancer

OBJETIVO: avaliar a eficácia da injeção intraoperatória para identificação do LS em câncer de mama com o uso do Dextran 500-99m-tecnécio (Tc) e analisar o tempo para marcação do linfonodo sentinela (LS) axilar. MÉTODOS: estudo prospectivo realizado entre abril de 2008 e junho de 2009 que incluiu 74 biópsias de LS em pacientes com câncer de mama em estádios T1N0 e T2N0. Após a indução anestésica, injetou-se de 0,5 a 1,5 mCi (18 a 55 MBq) de Dextran 500-99m-Tc filtrado 0,22 µm num volume de 5 mL de acordo com a técnica de injeção subareolar para a biópsia do LS. Após a marcação com o radiofármaco injetou-se 2 mL de azul patente. O tempo entre a injeção e a marcação na região axilar, a contagem com o probe do LS in vivo, ex vivo, background e o número de LS identificados foram documentados. Os dados foram analisados por meio da estatística descritiva pelo programa SPSS, versão 18. RESULTADOS: identificamos o LS em 100 por cento dos casos. A taxa de identificação com o probe foi de 98 por cento (73/74 casos). Um caso (1,35 por cento) estava marcado apenas com o azul. A dose média do radiofármaco aplicada foi 0,97 mCi±0,22. O tempo para marcação na região axilar, após a injeção subareolar, foi de 10,7 minutos (±5,7 min. ). Foram identificados, em média, 1,66 linfonodos marcados com o radioisotopo. CONCLUSÃO: o procedimento para identificação do LS com injeção intraoperatória do radiofármaco é oncologicamente seguro, apresentando conforto ao paciente e agilidade à equipe cirúrgica.

PURPOSE: to determine the efficacy of intraoperative injection of Dextran-500-99m-technetium (Tc) for the identification of the sentinel lymph node (SLN) in breast cancer and analyze time to label the SLN in the axillary region. METHODS: a prospective study between April 2008 and June 2009, which included 74 sentinel lymph node biopsies (SLNB) in patients with breast cancer in stages T1N0 and T2N0. After induction of anesthesia, 0.5 to 1.5 mCi of Dextran-500-99m-Tc filtered 0.22 µm in a volume of 5 mL was injected intraoperative using the subareolar technique for SLNB. After labeling with the radioisotope, 2 mL of patent blue was injected. The time elapsed between injection and the axillary hot spot, the in vivo and ex vivo counts of the hottest nodes, the background count, and the number of SLN identified were documented. Data were analyzed using descriptive statistics with SPSS program, version 18. RESULTS: we identified the SLN in 100 percent of cases. The rate of SLN identification with the probe was 98 percent (73/74 cases). In one case (1.35 percent) the SLN was labeled only with the blue dye. The mean dose of radioisotope injected was 0.97±0.22 mCi. The average time to label the SLN was 10.7 minutes (±5.7 min). We identified on average of 1.66 SLN labeled with the radioisotope. CONCLUSION: the procedure for SLN identification with an intraoperative injection of the radioisotope is oncologically safe and comfortable for the patient, providing agility to the surgical team.

99Tcm-dextran lymphoscintigraphy in evaluation of breast cancer-related lymphedema / 中华核医学杂志

Objective To investigate the imaging characteristics of lymphoscintigraphy in postoperative breast cancer patients and evaluate its diagnostic value in breast cancer-related lymphedema (BCRL).Methods Seventy-nine breast cancer patients who underwent mastectomy and axillary lymph node dissection were studied. Patients ( n = 158 ) were divided into the study ( affected arms, n = 79 ) and control groups ( contralateral arms, n = 79). After subcutaneous injection of 99Tcm-dextran via the first interphalangeal space, lymphoscintigraphy was performed at 10 min, 1,3, 6 h respectively. Sensitivity and specificity of lymphoscintigraphy for detection of BCRL were calculated. Results There were significant differences in the amount of visualized lymph nodes, lymphatic integrity and backflow pattern between the two groups.Lymphatic drainage was preserved in 96.2% (76/79) of the contralateral arms and only 5.1% (4/79) of affected arms. 87.3% (69/79) and 74.7% (59/79) of control arms had ≥2 lymph nodes in axilla and supraclavicular regions, respectively; while none ( 0/79 ) and 5.1% (4/79) of the affected arms had ≥ 2lymph nodes in both regions, respectively. Four backflow patterns of radiotracer in subcutis were observed in the affected arms: normal (2.5% , 2/79), dilatated (55.7%, 44/79), diffused (36.7%, 29/79) and without backflow (5.1%, 4/79 ). The sensitivity and specificity of "lymphatic integrity" and "backflow pattern" on lymphoscintigraphy for detecting BCRL were 97.5% (77/79) and 96.2% (76/79), 94.8%(73/77) and 100.0% (81/81), respectively. Conclusion Lymphoscintigraphy is a noninvasive, accurate and effective imaging modality for the evaluation of BCRL.

Analysis of multiple factors in the resuscitation of hemorrhagic shock in rabbits / 中华麻醉学杂志

Objective To investigate the effects of two different resuscitation fluids of two different temperatures and two different target MAP on the outcome of hemorrhagic shock in rabbits. Methods Forty adult male rabbits weighing 2.3-3.2 kg were anesthetized with iv pentobarbital sodium 30-35 mg/kg and tracheostomized. Spontaneous breathing was maintained. Hemorrhagic shock was induced according to modified Wiggers method. used. The temperature of the fluids was 23 ℃ (B_1) and 45 ℃ (B_2) respectively. The target MAP was 60 mm Hg (C_1) and 80 mm Hg (C_2). Forty animals were randomly divided into 8 groups (n=5 each) : group A_1B_1C_1; group A_1B_1C_2; group A_1B_2C_1; group A_1B_2C_2; group A_2B_1C_1; group A_2B_1C_2 ; group A_2 B_2 C_1 and group A_2B_2C_2 .Arterial blood samples were obtained from femoral artery at 5 min before blood-withdrawal, immediately after shock was induced and at 1, 2, and 3 h of resuscitation for blood gas analysis and determination of blood lactate concentration and serum concentrations of TNF-α and IL-6. Hemodynamies and changes in mesenteric capillaries were continuously monitored. Results PaO_2 was significantly higher in animals resuscitated with HSD (A_2) than in animals resuscitated with HS (A_1). Blood lactate concentration was significantly higher in group A_1B_1 (HS-23℃) than in group A_2B_1 (HSD-23℃). There was no significant difference in blood lactate concentration between group A_1B_2 (HS-45℃) and group A_2B_2 (HSD-45℃). The 3 factors did not have different effects on mesenteric capillaries. The serum TNF-α and IL-6 concentrations were significantly higher in animals resuscitated with HS (A_1) than in animals resuscitated with HSD (A_2) .Conclusion The effect of resuscitation of hemorrhagic shock is better with HSD than with HS. The resuscitation fluid of 23 ℃ is superior to fluid of higher temperature. The target BP during resuscitation does not influence the outcome of resuscitation.

Effect of combination with flurosemide on nephritic syndrome / 中国基层医药

Objective To observe the diuretic effect of Dextrans on primary nephritic syndrome. Methods In adoutble-blind placebo-controlled study,60 cases of primary nephritic syndrome patients were randomly devided into three groups and received by intravenous administration for 60 minutes for three days: (1)FU(1mg/kg) combination with as ham infusion;(2)FU(1mg/kg) combination with 50ml of 20% solution of albumin; (3)FU(1mg/ kg) combination with 250ml dextran. Urinary volume, sodium and plasma atrial nartiuretic peptide concentration were assessed. Results The results showed that administration of FU alone could increase mean cumulative urinary sodium and volume excretion(P

Prophylaxis of hepatic veno-occlusive disease after HSC transplantation with lipo-prostaglandin E1 plus dextran 40 / 解放军医学杂志

Objective To explore the effect of lipo-prostaglandin E1 plus dextran 40 in the prophylaxis of hepatic veno-occlusive disease(HVOD) after hematopoietic stem cell(HSC) transplantation.Methods Two hundred and thirty-four patients,162 males and 72 females,mean age 30.6(ranged from 3 to 64),were admitted during May 1999 to April 2007 and undergone HSC transplantation.Lipo-prostaglandin E1 associated with dextran 40 were administered to all patients for the prophylaxis of hepatic veno-occlusive disease.Lipo-prostaglandin E1,10?g dissolved in 100ml saline,20?g per day iv,were administered from day 7 before transplantation(-7 day) to day 30 after transplantation(+30 day).Dextran 40,500ml per day iv,were administered from-1 day to +5 day.In order to identify the risk factors inducing HVOD,patients were allocated to 2 groups according to following factors:age(

Administering a second rinse solution of low-potassium-dextran before reperfusion ameliorates the donor lung / 中国医师杂志

Objective To studied the effects of administering a second rinse solution of low-potassium-dextran(LPD) before reperfusion on the donor lung of rat after long time,cold ischemic preservation.Methods Twenty-four rats were randomly divided into control group(n=12) and trial group(n=12).Donor lungs of control group were flushed with LPD solution.The levels of malonaldehyde(MDA),myeloperoxidase(MPO) and interleukin-8(IL-8) were tested in the tissue of right lung and the left lungs were reperfused with venous blood for 30 minutes.The partial pressure of oxygen(PaO_2),PaP and PawP were measured at every 10 minutes intervals during reperfusion.After reperfusion,the MDA,MPO activity and interlukin-8(IL-8) were determined in the lung tissue.Results The levels of MDA,MPO and IL-8 decreased significantly in right lung of trial group than those in control group(P

Changes in endothelial glycocalyx in ischemia-reperfusion injury and their relationship with microvascular permeability / 中国病理生理杂志

AIM: To determine the role of the glycocalyx in microvascular permeability. METHODS: Dextran was intravenously injected and quatitatively examined in the rat transient cerebral ischemic model. At the same time, endothelial glycocalyx (anionic sites) was labelled with the probe cationic gold colloid (CGC) using post-embedding technique and examined with electron microscope. RESULTS: The labeling of CGC decreased significantly following ischemia, meanwhile, microvascular permeability to dextran increased. CONCLUSION:Endothelial glycocalyx is very sensitive to ischemia or anoxia. Its disruption may be the initiator of the dysfunction of endothelium and the determinant of increased permeability.

Influence of fluid resuscitation on pancreatic microthrombosis in severe acute pancreatitis / 中国病理生理杂志

AIM: To make evaluation on fluid resuscitation with either hypertonic saline(HS) or dextran 40(Dx) on pancreatic microthrombi and dysfunction of microcirculation in rats with severe acute pancreatitis(SAP).METHODS: SD rats were allocated into 4 groups randomly,ie.SAP group,HS group,Dx group,which respectively received normal saline(NS,4 mL/kg),HS(4 mL/kg),Dx(4 mL/kg) for 2 h by the tail intravenous injection consecutively after being made as SAP animal models,and operate sham group(OS).12 h after the operation,all animals were blooded to assess the serum amylase levels,plasma D-dimer,von Willebrand factor and GMP-140 levels.The amount of ascites was measured and the samples of the pancreas were collected for pathologic examination under light microscopy as well as transmission electron microscope.The numbers of pancreatic microthrombi were also counted with microscopy.RESULTS:(1) 12 h later when the rats were sacrificed,the survival rate in SAP group was the lowest,significantly lower than that in the 2 fluid resuscitation groups(P

The protective effect of hemodilution on the lung against ischemia-reperfusion injury / 中华麻醉学杂志

C. Conclusion Adequate hemodilution can attenuate the lung injury induced by I/R. The protective effect is better if hemodilution is performed before I/R.

AN EXPERIMENTAL STUDY ON DEXTRAN 40 TREATMENT IN LOW VELOCITY MISSILE CRANIOCEREBRAL WOUND / 解放军医学杂志

A LMCWanimal model in cat was reproduced according to Carey′s method. Twelve cats were divided into two groups with 6 in each. In one group low velocity missile craniocerebral wound (LMCW) was produced (C group), and in another dextran 40 was given after the injury(Dex40 group). Pial microcirculation was observed in vivo under transluminal microscope, and pial microvessel caliber was also measured. Microregional cerebral blood flow (CBF) was measured with laser doppler flowmetry. Blood samples were collected at 5 time points for surveying and calculating blood rheological parameters. Brain tissues and brain microvascular corrosion casts were obtained for light and electronic microscope observation. There was vasoconstriction of the pial arterioles and venules immediately after the injury,lasting for about 30min. In C group, they dilated 1h later, and returned to normal at 2h,again vasoconstriction appeared in the arterioles from 5h to 8h, while there was vasodilatation of the venules. All blood rheological parameters rose significantly, and did not recover to normal after 8 hours. Petechial hemmorhage, swelling and damage of the nerve cells were found in the parietal lobe contralateral to the trauma. Microthrombosis and occlusion were observed in some microvessels. When the injured mice were treated with dextran 40 micro regional CBF and blood rheological changes were improved. We conclude that Dextran 40 ameliorates the cerebral microcirculation disturbance through improving the blood rheological changes following low velocity missile craniocerebral wounds, and Dextran 40 may be useful in clinical practice.