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OBJECTIVE@#To determine the influence of stress on myocardial apoptosis in ischemic preconditioning group (IPC).@*METHODS@#Twenty-four Japanese white rabbits were randomly divided into 4 groups (n=6): an etomidate group (the Etom group) of depressed stress established by intravenous etomidate, an IPC group, an ischemic reperfusion group (the IR group) and a methylprednisolone group (the MP group). Myocardial apoptosis was examined by DNA-laddering, in situ nick-end labeling (TUNEL) and Hoechst dyeing.@*RESULTS@#The DNA ladder increased in the Etom group. The percentage of apoptosis by TUNEL method was 1.7%±0.2% in the IPC group, 2.3%±0.8% in the MP group, 3.8%±1.3% in the IR group and 3.0%±0.4% in the Etom group. Hoechst dying was 4.1%±0.9% in the IPC group, 3.5%±0.4% in the MP group, 6.2%±1.6% in the IR group and 7.6%±0.4% in the Etom group. There was significant difference between the IPC group and the Etom group or IR group, and also between the MP group and the IR group.@*CONCLUSION@#A depressed stress response impairs the inhibition on myocardial apoptosis in ischemic preconditioning. Methylprednisolone may inhibit myocardial apoptosis.
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Animaux , Lapins , Apoptose , Étomidate , Pharmacologie , Coeur , Préconditionnement ischémique , Préconditionnement ischémique myocardique , Méthylprednisolone , Pharmacologie , Myocarde , AnatomopathologieRÉSUMÉ
Objective:To determine the role of stress in myocardial protection of ischemic preconditioning (IPC). Methods:hTirty rabbits were randomly divided into an IPC group, an etomidate (Etom) group, an ischemic/reperfusion (IR) group, a methylprednisolone (MP) group and a sham group. hTe ratio of infarction size versus risk area (infarct/risk) was calculated. hTe elevations of the serum creatine kinase (CK) activity and cardiac troponin I (cTnI) concentrations as well as the serum cortisol concentrations were measured. Results:hTe percentages of infarct/risk in the IPC group, the MP group, the IR group, and the Etom group were (5.86±2.81)%, (11.28±3.62)%, (26.79±4.53)%, and (18.19±3.72)%, respectively. The elevations of the serum CK activity in the IPC group, the MP group, the IR group, and the Etom group were (255±89), (314±160), (855±371), and (768±404) U/L, respectively. hTe elevations of serum cTnI concentrations in the IPC group, the MP group, the IR group, and the Etom group were (3.6±0.6),(6.1±2.2), (8.1±3.6), and (6.4±1.6)μg/L, respectively. Those indicators among the groups were signiifcantly different (P Conclusion: A blunted cortisol reaction can markedly reduce the benefit of IPC while methylprednisolone shows cardioprotective effects, suggesting that stress might be involved in the myocardial protection of IPC.
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OBJECTIVE@#To explore the degree, mechanism and clinical significance of three-dimensional tumor microvascular architecture phenotype heterogeneity (3D-TMAPH) in non-small cell carcinoma (NSCLC).@*METHODS@#Twenty-one samples of solitary pulmonary nodules were collected integrally. To establish two-dimensional tumor microvascular architecture phenotype (2D-TMAP) and three-dimensional tumor microvascular architecture phenotype (3D-TMAP), five layers of each nodule were selected and embedded in paraffin. Test indices included the expressions of vascular endothelial growth factor (VEGF), proliferating cell nuclear antigen (PCNA), EphB4, ephfinB2 and microvascular density marked by anti-CD34 (CD34-MVD). The degrees of 3D-TMAPH were evaluated by the coefficient of variation and extend of heterogeneity. Spearman rank correlation analysis was used to investigate the relationships between 2D-TMAP, 3D-TMAP and clinicopathological features.@*RESULTS@#3D-TMAPH showed that 2D-TMAP heterogeneity was expressed in the tissues of NSCLC. The heterogeneities in the malignant nodules were significantly higher than those in the active inflammatory nodules and tubercular nodules. In addition, different degrees of heterogeneity of CD34-MVD and PCNA were found in NSCLC tissues. The coefficients of variation of CD34- MVD and PCNA were positively related to the degree of differentiation (all P0.05). The level of heterogeneity of various expression indexes (ephrinB2, EphB4, VEGF) in NSCLC tissues were inconsistent, but there were no significant differences in heterogeneity in NSCLC tissues with different histological types (P>0.05).@*CONCLUSION@#3D-TMAPH exists widely in the microenvironment during the genesis and development of NSCLC and has a significant impact on its biological complexity.
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Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Vaisseaux capillaires , Carcinome pulmonaire non à petites cellules , Éphrine B2 , Métabolisme , Tumeurs du poumon , Néovascularisation pathologique , Anatomopathologie , Phénotype , Antigène nucléaire de prolifération cellulaire , Métabolisme , Facteur de croissance endothéliale vasculaire de type A , MétabolismeRÉSUMÉ
OBJECTIVE@#To explore the protective effects of ischemic postconditioning on non-heart-beating donor (NHBD) in rat NHBD lung transplantation model.@*METHODS@#Forty Sprague-Dawley rats were randomized into the ischemic postconditioning group (IPO group) and the control group (C group), 10 pairs in each group in which left lung orthotopic transplantations from NHBDs were done with " two-cuff-one-stent technique". In the C group, perfusion was resumed by declamping pulmonary artery immediately after transplantation, whereas in the IPO group, 5 cycles of 1-min reperfusion and 1-min reocclusion of pulmonary artery were applied as postcontioning before full recovery of perfusion.@*RESULTS@#Compared with the C group, water content of donor lungs was lower and pathological changes were milder in the IPO group, meanwhile compliance, structure and function of donor lungs were better preserved. Furthermore, the expression of cell apoptosis and MDA content in donor lungs were lower in the IPO group, while SOD content was higher.@*CONCLUSION@#Ischemic postconditioning can reduce ischemic reperfusion injury of NHBD lung transplantation and preserve the structure and function of donor lungs. It can inhibit lipid peroxidation and cell apoptosis in NHBD lungs after transplantation.
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Animaux , Mâle , Rats , Arrêt cardiaque , Postconditionnement ischémique , Poumon , Métabolisme , Anatomopathologie , Chirurgie générale , Transplantation pulmonaire , Modèles animaux , Rat Sprague-Dawley , Lésion d'ischémie-reperfusion , Métabolisme , Anatomopathologie , Superoxide dismutase , MétabolismeRÉSUMÉ
OBJECTIVE@#To evaluate the telephone follow-up of surgery patients with lung cancer and to analyze the prognosis factors.@*METHODS@#From October 2011 to January 2012, 1635 post-surgery lung cancer patients from January 2002 to August 2011 were followed up by telephone interview. The data from follow-up and clinical characteristics were collected and analyzed. Among these patients, 116 patients with complete and reliable clinical data were further analyzed to determine the effective factors of lung cancer metastasis and long-term survival.@*RESULTS@#The average response rate in the follow-up was 36.1%, and the response rate was related to the interval time after the operations. The shorter the interval, the higher the response rate. The response rate in female patients was higher than that in male patients (P<0.001).The response rate was higher in patients younger than 40 (56 %) than that in the patients aged between 50-59 and over 60 (39% and 24% respectively, P<0.001). There was no statistical difference between patients from urban and rural areas (P=0.844). In the 116 patients with complete and reliable clinical data, statistical analysis confirmed that the metastasis and high lymph node staging were factors to increase patients' risk of death (with odd ratio 0.212 and 1.818 respectively, P<0.001). The adenocarcinoma grade, high lymph node staging and advanced age were related to the metastasis risk (odds ratio 2.353, 2.181 and 2.908, respectively).@*CONCLUSION@#Time, gender and age are the influencing factors in the telephone follow-up. Metastasis, lymph node metastasis, pathologic type and age are related to the lung cancer prognosis in the small-scale sample.
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Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Adénocarcinome , Chirurgie générale , Carcinome épidermoïde , Chirurgie générale , Études de suivi , Tumeurs du poumon , Chirurgie générale , Période postopératoire , Pronostic , Qualité de vie , Études rétrospectives , TéléphoneRÉSUMÉ
Objective Stress effect plays an important role in the development of some myocardial diseases. We hypothesized it was important nosogenesis to myocardial damage and cardiac allograft vasculopathy. Methods The transplanted hearts from Lewis to Wister rats served as allografts and from Lewis to Lewis rats as isografts based Ono's model. The differential proteins in the transplanted hearts were separated by comparative proteome, and then identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) and searched by Matrix Science software system.Results All transplanted hearts were characterized by lumen loss [(total vessel area-luminal area)/total vessel area] in the coronary artery 2 weeks after the operation [(2.07%±0.93%) vs. (27.58%±11.14%), P<0.01], but more predominant after 8 weeks [(2.34%±1.06%) vs. (72.29%±20.57%), P<0.01]. All samples of the left ventricle were analyzed by proteomic techniques and 37 distinct proteins involving their respective isoforms and subunits were identified. Nine proteins were correlated to endoplasmic reticulum stress effect and myocardial damage, and 2 proteins were verified by Western blot.Conclusion Stress plays an important role in cardiac allograft damage and the development of rat cardiac allograft vasculopathy.
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OBJECTIVE@#To explore the protective effect of noninvasive limb ischemic preconditioning (N-LIP) on acute lung injury (ALT) induced by lipopolysaccharide (LPS) in rats.@*METHODS@#Fifteen female SD rats were randomly divided into a control group, an acute lung injury group (ALI group), an acute lung injury and noninvasive limb ischemic preconditioning group (ALI+N-LIP group). After ALI rats were treated with N-LIP, the changes of airway resistance (AR) and dynamic compliance (Cdyn) were tested by invasive pulmonary function system and recorded. Blood samples and bronchoalveolar lavage fluid (BALF) were collected, the amounts of white blood cell (WBC) in BALF were counted by cytometry, and the level of lactate dehydrogenase (LDH) in BALF was also examined by automatic biochemistry analyzer. The level of serum superoxide dismutase (SOD) and malondialdehyd (MDA) was examined by chromatometry. The lung tissues were acquired to observe the expression of pulmonary surfactant-associated protein-A (SP-A) and pathological changes.@*RESULTS@#After being stimulated by methacholine (Mch), the increasing rate of AR and decreasing rate of Cdyn in the ALI+N-LIP group were less than those in the ALI group (P<0.01). The levels of WBC and LDH in BALF in the ALI+N-LIP group were much lower than those in the ALI group (P<0.05). Meanwhile, the activity of serum SOD in the ALI+N-LIP group was higher, and the level of serum MDA was lower than that in the ALI group (P<0.05). The expression of SP-A in the lung tissue in the ALI+N-LIP group was the highest in the 3 groups, while that in the ALI group was the weakest (P<0.01). Injury of the lung tissue in the ALI+N-LIP group was less than that in the ALI group, but more severe than that in the control group.@*CONCLUSION@#N-LIP has protective effect on acute lung injury induced by LPS in rats. The possible mechanism is related to improving the secretion of SP-A and antioxidation.
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Animaux , Femelle , Rats , Lésion pulmonaire aigüe , Ischémie , Préconditionnement ischémique , Méthodes , Lipopolysaccharides , Membre inférieur , Répartition aléatoire , Rat Sprague-DawleyRÉSUMÉ
OBJECTIVE@#To determine the cardioprotection of adenosine treatment in cadaver donor rats with warm ischemia.@*METHODS@#Rats were randomly divided into 7 groups. Group C was a control group. Group I(5), I(15), and I(30): The donor hearts from the cadaver rats that died of acute hemorrhagic shock and within warm ischemic durations of 5, 15, and 30 min, respectively, and the donor hearts were perfused with STH-1 for 30 min before cervical heterotopic heart transplantation. Group A(5), A(15), and A(30) were adenosine treatment groups and the donor hearts were obtained as mentioned above and perfused with STH-1 plus adenosine (adenosine concentration 1.2 mmol/L) before cervical heterotopic heart transplantation. We detected the change of the grafts including ultrastructure, the level of ATP, SOD, and MDA, NF-kappaB mRNA, TNF-alpha, and IL-6 24 h after the transplantation.@*RESULTS@#At the same time point, compared with Group I(5), I(15), and I(30), Group A(5), A(15), and A(30) showed increased ATP and SOD in the myocardial tissues, and decreased MDA, NF-kappaB mRNA, TNF-alpha, and IL-6 (P<0.05).@*CONCLUSION@#Adenosine treatment can protect the graft in cadaver donor rats with warm ischemia. The mechanism may improve the myocardial energy metabolism, attenuate lipid peroxidation injury, suppress the expression of NF-kappaB mRNA, and decrease the inflammatory damage of TNF-alpha and IL-6.
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Animaux , Mâle , Rats , Adénosine , Pharmacologie , Cardiotoniques , Pharmacologie , Coeur , Transplantation cardiaque , Lésion de reperfusion myocardique , Conservation d'organe , Méthodes , Répartition aléatoire , Rat Sprague-Dawley , Ischémie chaude , MéthodesRÉSUMÉ
Objective To investigate the perioperative management and video-assisted thoraco-scopic (VATS) extended thymectomy for myasthenia gravis ( MG ). Methods A total of 102 patients who received extended thymectomy for MG from June 2000 to August 2007 were divided into 2 groups by operative approach: 51 in the VATS group and 51 in the full median sternotomy group. The clinical features, including operation time, operation blood loss, post-operative drainage, inci-dence of crisis, hospital stay, and the 1-year total effective rate after the operation were compared. Complications were treated exactly and cholinesterase inhibitors were applied to control the symptom of MG before the operation. The whole thoracic gland and fat in the anterior mediastinum were removed. Steroid, cholinesterase inhibitors and plasmapheresis were used to prevent and cure masthemic crisis after the operation. Results No patients died in the operation and hospitalization. There was no sig-nificant difference in the operation time [(128.14±34.82) min vs. (130.46±28.71) min] and the 1-year total effective rate after the operation (85.8% vs. 87.2% )in the 2 groups(P>0.05).The operation blood loss, postoperative drainage, incidence of crisis, and postoperative hospital stay in the median sternotomy group were higher or longer than those in the VATS group [(93.77±21.64) mL vs. (45.42±10.96)mL,P<0.05; (174.65±21.64)mL vs. (101.33±28.76) mL,P <0.01;7.84% vs. 1.96%, P<0.05;(14.23±3.17)d vs. (8.37±1.18)d, P<0.05)]. Conclusion VATS extended thymectomy for myasthenia gravis is safe, less invasive and effective. Preoperative preparation and the perioperative managemant can decrease the incidence of crisis. The plasmapheresis is the key of curing masthemic crisis.
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OBJECTIVE@#To summarise the experience of peri-operative management of infants undergoing open heart surgery.@*METHODS@#Clinical data of 206 infants undergoing open heart surgery were analyzed retrospectively. The patients aged from 20 days to 3 years.The weight was 3~18(9.60+/-2.75)kg.Altogether 149 patients were found non-cyanotic and 57 with cyanotic heart diseases.Radical operation was performed on 204 patients with the exception of two by palliative operation.@*RESULTS@#The mortality was 4.85%(10/206) and the incidence of early complications was 13.6%(28/206).@*CONCLUSION@#Early surgical treatment was crucial to infants with congenital heart disease at an appropriate time.To improve the operative and CPB techniques, to strengthen the management of postoperative respiratory and circulatory system, attention to the protection of vital organs, and nutrition support for infants are all keys to the success of heart surgery.
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Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Nouveau-né , Mâle , Procédures de chirurgie cardiaque , Méthodes , Pontage cardiopulmonaire , Méthodes , Cardiopathies congénitales , Chirurgie générale , Communications interventriculaires , Chirurgie générale , Complications peropératoires , Soins périopératoires , Méthodes , Études rétrospectives , Tétralogie de Fallot , Chirurgie généraleRÉSUMÉ
objective To detect CK19 mRNA and CEA mRNA in blood of the peripheral vein and to investigate the effect of ligating pulmonary vein firstly or ligating pulmonary artery firstly during surgical operation on haematogenous dissemination of malignant cells.Methods Fifty six non-small cell lung cancer patients were collected and random assigned to two groups before operation (ligating pulmonary vein firstly or ligating pulmonary artery firstly).The patients were accepted radical operation and their operations were put in practice by doctors of one team.Vein blood was collected one day before operation and one week after operation.CK19 mRNA and CEA mRNA in blood were detected by nested reverse transcriptase-polymerase chain reaction. Result The positive rate of expression of CK19 mRNA and CEA mRNA after operation is lower than that before operation.The positive rate of expression of CK19 mRNA and CEA mRNA in ligating pulmonary vein firstly after operation is lower than that in the other group. Conclusions Surgical operation have effects on the dissemination of malignant cell and ligating palmonary vein firstly during operation can reduce the dissemination of malignant cell.
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<p><b>BACKGROUND</b>Lung cancer is easy to occur in patients older than 70 years, whose special health condition makes their treatment more difficult. The aim of this study is to investigate the best surgical treatment and perioperative management for high risk elderly patients with lung cancer.</p><p><b>METHODS</b>After 5 years' follow-up, 120 high risk elderly patients with lung cancer were analyzed retrospectively.</p><p><b>RESULTS</b>Of 120 patients, there was no operative death. Four patients died of respiration failure and 2 died of myocardial infarction. Perioperational death rate was 5.0%. The overall 1-, 3-and 5-year survival rate was 67.7%, 41.7% and 28.1%, respectively.</p><p><b>CONCLUSIONS</b>Appropriate management of complications is the key point to decrease perioperative death rate, and it may influence the quality of life of patients. To resect tumor maximally may be not the best choice for elderly patients. Lobectomy or segmental resection combined with positive lymph node dissection may be the considerable patterns.</p>
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0 05), but there were significant difference,as compared with control group (all P
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Objective To investigate the protective effects and mechanism of nitric oxide(NO) inhalation on rabbit lung ischemia/reperfusion injury. Methods Total 32 Japanese white rabbits were randomly divided into four groups, each group containing 8 rabbits. In group A, animals received only thoracotomy. In group B, after animals left chest were opened, their left main pulmonary arteries were occluded for 2h, then reperfused for another 2h. In group C, animal inhaled 20 ppm NO for 30min since the eleventh minute after reperfusion. In group D, animal inhaled 60ppm NO for 30min since the eleventh minutes after reperfusion. The levels of blood PaO 2, cGMP, slCAM-1, XOD and MDA were measured before operation and after reperfusion. The pathologic changes of left lung was observed. The wet/dry (W/D) weight ratio of left lung tissue was measured. Results Both PaO 2 and cGMP levels after reperfusion in group B were much lower than that in groups A, C and D(P
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Objective To explore the diagnosis, surgical treatment and prognosis of thymoma complicated with myasthenia gravis(MG). Methods A retrospective analysis was performed in 33 thymoma patients with MG, who underwent surgical treatment. Results The total effective rate of operation was 75.8%, and the 5 and 10 years survival rates of the patients after operation were 85% and 78.7%, respectively. According to the Masaoka staging system, the 5 and 10 years survival rates of stages I and II were obviously higher than those of stages III and IV (P
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Objective To establish the model of myocardial infarction by ligation of the left anterior descending branch in rats.Method Adult inbred strain Wistar rats were randomly divided into sham group(n=6) and model groups(n=79).Model of myocardial infarction were established by ligation of the left anterior descending branch.The electrocardiogram(ECG),HE staining tissue sections,and heart function of the rats were compared in the two groups.Results Rats in the model group had showed special changes of ST-T and Q wave in ECG,show serious necrosis of myocytes and proliferation of fibrous tissue compared with rats in the sham group.The left ventricular systolic pressure(LVSP),left ventricular develop pressure(LVDP),?dp/dt_(max),heart rate(HR) were significantly decreased in the rats of model group than those of the sham group(P
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Using isolated rat hearts perfused on a langendorff apparatus,ischemic preconditioning (IP) was investigated with 5 min normothermic (at 37℃) or hypothermic (at 30 ℃) ischemia, followed by 10 min of reperfusion before the arrest period, as an adjunct to St. Thomas crystalloid cardioplegia during 180 min ischemia. After basline functional data were obtained, IP was induced 1 control hearts underwent no IP. Results showed that IP improved functional recovery from ischemia during 45 min reperfusion in normothermic ischemic preconditioning group (NP) comparing with normothermic control (NC),P