The effect and mechanism of tacrolimus pretreatment on cold ischemia reperfusion injury of transplanted liver in rats / 中华肝胆外科杂志

Objective:To investigate the roles of tacrolimus pretreatment on hepatic ischemia reperfusion injury (IRI) and its possible mechanism in a rat autologous orthotopic liver transplantation (AOLT) model.Methods:For 24 specific pathogen free 8-10 week male Sprague Dawley rats (220-250g) were randomly and equally divided into three groups. The abdomen of sham-operated group was only opened and closed; the treatment with tacrolimus was administered via dorsal penile vein before the experiment in tacrolimus-pretreated group; the AOLT group and tacrolimus-pretreated group were set to construct the AOLT IRI rat models. The levels of ALT, AST, tumor necrosis factor-α (TNF-α) and interleukin-1 β (IL-1β) in serum were tested after the reperfusion. The change of liver structure was evaluated by H&E staining. The quantitative real-time PCR (RT-qPCR) and Western blot assay were used to test the mRNA and protein level of hypoxia-inducible factor-1α (HIF-1α) and heme oxygenase-1 (HO-1).Results:The levels of serum ALT (1 332.0±52.8) U/L and AST (2 472.0±257.8) U/L in the AOLT group were higher than the levels in the sham-operated group (65.0±17.4)U/L, (222.3±45.2) U/L and tacrolimus-pretreated group (789.9±54.0) U/L, (533.4±31.6) U/L. The differences were significant ( P<0.05). And in the tacrolimus-pretreated group there were less lesions in the liver than in the AOLT group. The serum level of TNF-α and IL-1β of the AOLT group were increased than the sham-operated group and tacrolimus-pretreated group, and the differences were significant ( P<0.05). Compared with the AOLT group, the expressions of HIF-1α and HO-1 were increased significantly after the tacrolimus pretreatment ( P<0.05). Conclusion:Tacrolimus pretreatment could reduce rats hepatic cold IRI by inducing the expressions of HIF-1α and HO-1, and inhibiting the production of inflammatory cytokines.

Endoscope-assisted lauromacrogol inject ion for hemangioma of pharynx and larynx / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the efficacy and safety of local lauromacrogol injection in the treatment of laryngopharyngeal hemangioma. METHODS A total of 10 patients suffering from hemangioma of pharynx and larynx from Aug 2015 to Mar 2018 were collected. Endoscope assisted local lauromacrogol injection under topical was used. The therapeutic effects were observed and analyzed.RESULTS All patients were followed up for 3 months to 1 year. Among them, 9 cases were cured and 1 was obviously effective for totally 1 to 4 (mean 1.9) injections. All patients complained of postoperative pain or foreign body sensation, 3 patients were significantly affected by local swelling of the injection site. 2 patients underwent tracheostomy and 1 patient returned to ward with endotracheal intubation postoperatively. No complications such as mucosal ulceration, fever, allergies occurred. CONCLUSION Lauromacrogol injection is a safe and effective method to treat hemangioma of pharynx and larynx.

Effect of ulinastatin on lung function in pediatric patients undergoing cardiopulmonary bypass:a meta-a-nalysis / 临床麻醉学杂志

Objective To systemically review the effect of ulinastatin on lung function in pediatric patients undergoing cardiopulmonary bypass.Methods PubMed,Embase,Cochrane Controlled Trials Reg-istry,China National Knowledge infrastructure,China Biology Medicine disc,VIP and Wanfang databases were searched from their inception to October 2015.Articles regarding the use of ulinastatin on lung function in patients undergoing cardiopulmonary bypass were searched.Studies were screened by two independent re-viewers and then the data were extracted.The methodological quality was evaluated according to the inclusion and exclusion criteria.Meta-analysis was then performed using RevMan 5.1 software. Results Nineteen eligible studies (n = 657 patients)were identified.The results of meta analysis showed that ulinastatin could improve the oxygen partial pressure(SMD=0.90,95%CI 0.52-1.28,P <0.01)and oxygenation index (SMD=1.01,95%CI 0.45-1.56,P <0.01),decrease the PA-a O2 (SMD= -0.87, 95%CI -1.70--0.03,P =0.04),reduce the respiratory index (SMD=-0.81,95%CI -1.51--0.11, P =0.02),Lower the airway peak pressure (SMD=-0.83,95%CI -1.18--0.48,P <0.01),improve the dynamic compliance (Cd)(SMD=1.10,95%CI 0.57-1.62,P <0.01),and shorten the breathing ma-chine ventilation time (SMD=-0.98,95%CI -1.59--0.36,P <0.01).Conclusion This meta-analysis showed that ulinastatin treatment had a certain degree of protective effects on lung function in pediatric pa-tients undergoing cardiac surgery with CPB,but further research was needed for all these studies which were not multicenter,strictly controlled.

Vaginitis in pregnancy is related to adverse perinatal outcome

Objective: To determine whether education level and occupation are risk factors of vaginitis in pregnant women and to investigate relationship between vaginitis occurrence during pregnancy and perinatal mortality rates. Methods: A total of 319 women of early pregnancy or mid-pregnancy were enrolled. Six specimens were collected from posterior fornix of each pregnant woman and then cultured for identification of Neisseria gonorrhoeae, intestinal bacteria, general bacteria, fungi, mycoplasma, and chlamydia, respectively. Results: The pregnant women in the "elementary school or below" group and the "middle school" group had significantly higher incidences of vaginitis compared with the pregnant women in the groups of "high school", "skill education", and "college or above". The pregnant women in the groups of "Worker", "Government employee", "Company employee", and "Professionals" had significantly lower vaginitis incidences. The women with infections of Neisseria gonorrhoeae, intestinal bacteria, and general bacteria had higher perinatal mortalities [0.063 +/- 0.011, 0.052 +/- 0.012, and 0.017 +/- 0.008, respectively] than women with infections of fungi, mycoplasma, and Chlamydia [0.002 +/- 0.007, 0.003 +/- 0.004, and 0.001 +/- 0.001, respectively]. Conclusions: Education level and occupation are risk factors related to incidences of vaginitis in pregnant women. The bacteria-related vaginitis is a major reason of perinatal mortality

Observation on the effect of the dust mite sublingual immunotherapy for allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical effect of sublingual immunotherapy with dust mite for allergic rhinitis.@*METHOD@#The symptom score of 188 patients with dust mite allergic rhinitis were recorded before and after treatment for six months, a year, and compare the treatment effects.@*RESULT@#Symptom scores of 188 patients were decreased after treatment than before, the symptoms of treatment were improved significantly after six months, symptoms were improved more significantly after one year, the difference was significant (P<0.01).@*CONCLUSION@#Sublingual immunotherapy with dust mite is a safe and effective treatment for allergic rhinitis, and it is worthy of promotion.

The change of α-melanocyte-stimulating hormone(α-MSH)in the serum of patients multipleinjuries / 中华急诊医学杂志

Objective To detect the variations of the serum α-MSH and TNF-α in multiple-trauma patients and discuss their role in severity of casualties.Methods Fifty casualties were divided into two groups for study.There were 30 casualties with moderate severe trauma(ISS 16 ～ 25 point)and 20 patients with extreme severe trauma(ISS ＞ 25 point),and another 15 healthy subjects were enrolled as controls.The blood samples were obtained within 24 hours,and 3 days,5 days,7 days after admission.The serum levels of α-MSH and TNF-α in casualties with multiple injuries were determined by using enzyme-linked immunosorbent double antibody sandwich method(ELISA).The data were expressed in((x)± s),and analyzed with chi-square test and repetitive measures of ANOVA by using SPSS 13.0 package.P value less than 0.05 indicated statistical significance Results The serum α-MSH levels of casualties within 24 hours,and 3 days,5 days,7 days after injury in the two groups were much lower than those in the control group (P ＜ 0.01),while the serum TNF-α levels of casualties were much higher than those in the control group (P ＜0.01).The serum α-MSH levels of casualties with extreme severe traumawere lower,and the TNF-αlevels of casualties with extreme severe trauma were higher than those in patients with moderate severe trauma(P ＜0.01,respectively).There were negative correlations between two biomarkers 24 hours,5d and 7d after injury.Conclusions In casualties,the serum levels of α-MSH decreased and the serum levelsof TNF-α increased,and the degrees of changes were closely depended on the severity of trauma,the more severe the more significant changes.There was a negative correlation between two biomarkers.

Relationship between fibrinogen level and pathogenesis of sudden sensorineural hearing loss / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the relationship between fibrinogen level and pathogenesis of sudden sensorineural hearing loss(SSHI.).@*METHOD@#Fifty patients (55 ears) with SSHL within 7 days of the onset were studied: a control group was consist of 50 normal-hearing people who were individually matched on a pairwise basis according to the same gender and age. Both the patients and the normal people were tested for the parameters of hemorheology, blood biochemistry, whole blood cell count and clotting function.@*RESULT@#Fibrinogen level and plasma viscosity in patients with SSHL were significantly higher than that in control subjects. Prothrombin time and activated partial thromboplastic time were significantly less in the patients group than that in the control group (P 0.05).@*CONCLUSION@#Elevated plasma fibrinogen may be a major pathogenesis of SSHL. An increase in plasma fibrinogen level may lead to elevated plasma viscosity. All these may promote a prothrombin or hypercoagulable state and impair blood perfusion of cochlea.