A novel polysaccharide obtained from Craterellus cornucopioides enhances immunomodulatory activity in immunosuppressive mice models via regulation of the TLR4-NF-κB pathway.

The immunoregulatory effect of a novel Craterellus cornucopioides polysaccharide (CCP) with a triple-helix structure on immunosuppressive BALB/c mice models was investigated; moreover, the immune response of BALB/c mice models in the preventive and therapeutic treatment groups treated with CCP was explored, and its molecular mechanism was elucidated. It was found that the BALB/c mice models in the preventive groups treated with CCP (120 and 240 mg kg-1 d-1) had better immunoregulatory activity. The spleen and thymus weight indices of the BALB/c mice models were significantly increased, and the histopathological analysis indicated a protective function of CCP against the immunosuppression induced by cyclophosphamide (CTX). Moreover, CCP displayed definite and clear synergistic effects on the T- or B-lymphocyte proliferation induced by ConA or LPS, respectively, promoted the natural killer (NK) cell activity and significantly increased phagocytic activity to activate peritoneal macrophages in immunosuppressive mice. The western blot and quantitative real-time polymerase chain reaction (qRT-PCR) results provided comprehensive evidence that CCP could upregulate the protein expression of the G-protein-coupled cell membrane receptor TLR4 and the production of its downstream protein kinases (TRAF6, TK1, p-IKKα/ß and NF-κB p50); this, in turn, enhanced the production of cytokines (IL-2, IL-6, TNF-α and IFN-α) through both preventive and therapeutic treatments via regulation of the TLR4-NFκB pathway in the peritoneal macrophage of immunosuppressive mice.

Surface Characteristics and Hydrophobicity of Ni-Ti Alloy through Magnetic Mixed Electrical Discharge Machining.

Nickel⁻titanium (Ni-Ti) alloy has been selected as stent material given its good biocompatibility. In this study, experimental research on this material was conducted using magnetic field-assisted electrical discharge machining (EDM). The surface topography of the machined workpiece was analyzed with a scanning electron microscope (SEM). Hydrophobicity was measured by using an optical contact angle measuring instrument. The roughness values of different positions on the surface were measured using a TR200 roughness instrument. Results showed that the composite structure of solidification bulge⁻crater⁻pore⁻particle can be prepared on the surface of the Ni-Ti alloy through magnetic mixed EDM using suitable processing parameters. Moreover, the contact angle of the surface reaches 138.2°.

Effects of diets with different energy and bile acids levels on growth performance and lipid metabolism in broilers.

This experiment was conducted to evaluate the effects of bile acids (BAs) on the growth performance and lipid metabolism of broilers fed with different energy level diets. 480 one-day-old Arbor Acres broilers (45.01 ± 0.26 g) were allotted to a 2 × 2 factorial design with 2 levels of energy (basal or high-energy level) and 2 levels of BAs (with or without BAs supplementation), resulting in 4 groups of 8 replicates; the experiment lasted 42 d. High-energy diets decreased the feed/gain ratio (F/G) from 1 to 21 d (P < 0.05), and increased the liver index and abdominal fat percentage at 42 d (P < 0.05). The serum total triglyceride (TG) and high-density lipoprotein cholesterol at 42 d were increased by high-energy diets (P < 0.05), while the hepatic lipoprotein lipase (LPL) activity at 21 and 42 d was decreased (P < 0.05). BAs supplementation increased the body weight at 21 d and decreased the F/G during entire period (P < 0.05), as well as improved the carcass quality reflected by decreased abdominal fat percentage at 42 d and increased breast muscle percentage at 21 and 42 d (P < 0.05). The serum TG at 21 and 42 d were decreased by BAs (P < 0.05), and the hepatic LPL activity at 42 d was increased (P < 0.05). In addition, high-energy diets increased the expression of sterol regulatory element binding transcription factor 1, acetyl-CoA carboxylase, and fatty acid synthase (P < 0.05), while BAs diets decreased these genes expression (P < 0.05). Moreover, BAs supplementation also increased the expression of carnitine palmitoyltransferase 1 (P < 0.05), which was increased in high-energy groups (P < 0.05). In conclusion, BAs supplementation could increase growth performance, elevate carcass quality, and improve lipid metabolism in broilers.

Structure characterization, physicochemical property and immunomodulatory activity on RAW264.7 cells of a novel triple-helix polysaccharide from Craterellus cornucopioides.

In the study, a new triple-helix polysaccharide with favorable stability was purified from C. cornucopioides. Its structural characterization, stability and solution behavior were investigated by the GC-MS, periodate oxidation-smith degradation, FT-IR, 1D and 2D NMR spectroscopy, methylation analysis, Scanning electron microscope, Congo-red, CD, TGA and DSC analysis. The results showed that Craterellus cornucopioide polysaccharide (CCP) possessed the molecular weight of 1.97 × 103 kDa, is mainly composed of mannose (48.73%), galactose (17.37%), glucose (15.97%) and xylose (17.93%), respectively. It was a heteroglycan with (1 → 3)­linked­ß­d­Manp­(1 → 6)­linked α­d­Galp backbone distributed by (1 → 4)­linked­α­d­Xylp­t­α­d­Manp and t­ß­d­Glup units at O-6. The result of TGA and DSC assay indicated that CCP has a favorable thermal stability. MTT and Scanning electro microscopy (SEM) assay showed that CCP could significantly improve the proliferation activity and induce cells activation of RAW264.7 in a certain range of concentrations and period.

C-terminus of Hsc70-interacting protein (CHIP) enhances stemness properties of human Wharton's jelly mesenchymal stem cell.

Mesenchymal stem cells are an attractive source of multipotent cells in part because they are easy to obtain. Several E3 ligases regulate the stability and functions of various factors in different adult stem cells through the ubiquitylation pathway. We investigated the C-terminus of Hsc70-interacting protein (CHIP) E3 ligase that regulates pluripotency of human Wharton's jelly mesenchymal stem cells (hWJMSC). We found that CHIP increases protein kinase B (Akt) phosphorylation by decreased expression of phosphatase and tensin homolog (PTEN), which suggests improvement of the survival pathway by CHIP over-expression. We also found that increased CHIP expression induced Sox2 and NANOG, which can promote stem cell self-renewal and prevent oxidative stress-induced senescence of hWJMSC by decreased p21. We found that CHIP could be used to enhance the multiple functions of hWJMSC.

A study of predictors for hyponatraemia in patients with cervical spinal cord injury.

STUDY DESIGN: A retrospective study. OBJECTIVES: The objectives of the study were to investigate the predictors for hyponatraemia in patients with cervical spinal cord injuries (CSCIs) and to define the relationship between magnetic resonance imaging (MRI) scans and hyponatraemia. SETTING: The study was carried out at The First Affiliated Hospital of Anhui Medical University. METHODS: A total of 292 patients with CSCIs were retrospectively reviewed to determine the predictors of hyponatraemia. Fourteen variables were extracted from the medical records: age, sex, blood pressure (BP), tracheostomy, serum potassium, serum chloride, serum bicarbonate, serum albumin, intravenous fluid intake and urine volume for 24 h, haematocrit, haemoglobin, neurological assessment and four MRI signal patterns. Univariate and multivariate analyses were used to determine the effect of each variable on hyponatraemia. RESULTS: Eighty-two of the 270 patients (30%) developed hyponatraemia. Univariate analyses indicated that the following variables were significant predictors of hyponatraemia: tracheostomy; the initial American Spinal Injury Association (ASIA) Impairment Scale (AIS) A assessment; and haemorrhage changes on T2-weighted MRI scans, and low BP. Multivariate regression analyses revealed two variables were significant predictors of hyponatraemia: haemorrhage changes on T2-weighted MRI scans and low BP. CONCLUSIONS: Haemorrhage changes on MRI scans were closely associated with the onset of hyponatremia and could provide objective data for forecasting hyponatraemia in CSCI patients. Low BP was also a reasonable predictor of hyponatremia.

Integrative analyses of transcriptome sequencing identify novel functional lncRNAs in esophageal squamous cell carcinoma.

Long non-coding RNAs (lncRNAs) have a critical role in cancer initiation and progression, and thus may mediate oncogenic or tumor suppressing effects, as well as be a new class of cancer therapeutic targets. We performed high-throughput sequencing of RNA (RNA-seq) to investigate the expression level of lncRNAs and protein-coding genes in 30 esophageal samples, comprised of 15 esophageal squamous cell carcinoma (ESCC) samples and their 15 paired non-tumor tissues. We further developed an integrative bioinformatics method, denoted URW-LPE, to identify key functional lncRNAs that regulate expression of downstream protein-coding genes in ESCC. A number of known onco-lncRNA and many putative novel ones were effectively identified by URW-LPE. Importantly, we identified lncRNA625 as a novel regulator of ESCC cell proliferation, invasion and migration. ESCC patients with high lncRNA625 expression had significantly shorter survival time than those with low expression. LncRNA625 also showed specific prognostic value for patients with metastatic ESCC. Finally, we identified E1A-binding protein p300 (EP300) as a downstream executor of lncRNA625-induced transcriptional responses. These findings establish a catalog of novel cancer-associated functional lncRNAs, which will promote our understanding of lncRNA-mediated regulation in this malignancy.

Ho:YAG Laser Endopyelotomy is effective for primary and secondary UPJOs.

PURPOSE: To assess efficacy of laser endopyelotomy in both primary and secondary ureteropelvic junction obstructions (UPJOs) PATIENTS AND METHODS: Primary category consisted of 10 patients of congenital UPJOs. Secondary category was comprised of UPJOs in 12 status post pyeloplasty, 10 status post lithotomy, 5 status post shock wave lithotripsy, and 10 status post ureteroscopic lithotripsy. Ho:YAG laser endopyelotomy was performed in all subjects. Exclusion criteria included obstructions longer than 2 cm, ipsilateral upper urinary calculi and crossing vasculature. RESULTS: Mean operation time was 44 min. Average inpatient duration was 1.87 days. No major complication occurred. Follow-ups were at least 12 months. Success rate for single endopyelotomy was 82.5%, leaving 7 patients for a secondary endopyelotomy. Secondary UPJO due to failed pyeloplasty had a predilection of restenosis after endopyelotomy (P = 0.0005) compared to other aetiologies. CONCLUSIONS: Ho:YAG laser endopyelotomy is a safe and effective approach effective in both primary and secondary UPJO treatments.

Vagal afferent-dependent cholecystokinin modulation of visceral pain requires central amygdala NMDA-NR2B receptors in rats.

BACKGROUND: Cholecystokinin (CCK), a gut hormone that is released during feeding, exerts gastrointestinal effects in part through vagal pathway. It is reported to be a potential trigger for increased postprandial visceral sensitivity in healthy subjects and, especially in patients with irritable bowel syndrome. NR2B-containing N-methyl-d-aspartate (NMDA) receptors in the central amygdala (CeA) participate in pain modulation. Systemically administered CCK activates the CeA-innervating neurons. Here, we investigated whether CCK modulation of visceral sensitivity is mediated through CeA NMDA-NR2B receptors and whether this modulation involves vagal pathway. METHODS: We first examined the visceromotor response (VMR) to colorectal distention (CRD) following i.p. injection of CCK octapeptide (CCK-8) in a rat model. Next, the NR2B antagonist ifenprodil and the NR2A antagonist NVP-AAM077 were microinjected into the CeA before systemic CCK injection. NR2B phosphorylation was detected by Western blot. To down-regulate NR2B gene expression, NR2B-specific small interfering RNA (siRNA) was delivered into CeA neurons by electroporation. In addition, the effects of functional deafferentation by perivagal application of capsaicin and pretreatment with the CCK1 receptor antagonist devazepide were investigated. KEY RESULTS: CCK-8 increased VMR to CRD in a dose-dependent manner. This effect was blunted by intra-CeA administration of ifenprodil (but not NVP-AAM077) and was accompanied by phosphorylation of NR2B subunits in the CeA. CCK failed to increase VMR to CRD in NR2B siRNA-treated rats. Perivagal capsaicin application and pretreatment with devazepide prevented CCK-induced pronociception and CeA NR2B phosphorylation. CONCLUSIONS & INFERENCES: The pronociception induced by systemic CCK, which is vagal afferent-dependent, requires activation of CeA NMDA-NR2B receptors.

Residual effect of reductions in red blood cell count and haematocrit and haemoglobin levels after 10-month withdrawal of pioglitazone in patients with Type 2 diabetes.

AIM: To investigate the recovery of thiazolidinedione-induced body weight gain and haematopoietic changes after stopping pioglitazone treatment in patients with Type 2 diabetes. METHODS: This retrospective cohort study included 214 patients divided into three groups according to pioglitazone treatment status. The first study arm included patients who received pioglitazone for 38 months then interrupted this for 10 months (pioglitazone-interruption group). The second arm consisted of patients who received pioglitazone throughout the 48 months (pioglitazone-continuous group); the third arm included patients who had never received pioglitazone therapy (control group). RESULTS: Red blood cell count and haematocrit and haemoglobin levels decreased significantly, while body weight increased in the two pioglitazone-treated groups as compared with the control group at 38 months. Multivariate regression analysis showed that the reductions in red blood cell count/haemoglobin levels were associated with pioglitazone use. In the pioglitazone-interruption group, no recoveries of red blood cells, or haematocrit or haemoglobin levels were observed after stopping pioglitazone for 10 months compared with the pioglitazone-continuous group, but body weight gain decreased to a level that was significantly lower than that in the pioglitazone-continuous group and did not differ significantly from the control group. CONCLUSION: In this study, we observed a reversal of body weight gain but no recoveries in red blood cells or haematocrit or haemoglobin levels after stopping pioglitazone for 10 months in patients treated with pioglitazone for 38 months. This finding should prompt a reconsideration of the sustained effect of thiazolidinediones on the haematopoietic system in patients with Type 2 diabetes.

Sex-specific differences in the relationship between the single-nucleotide polymorphism rs2298804 of FCER1A and the susceptibility to systemic lupus erythematosus in a Chinese Han population.

BACKGROUND: IgE plays a important role in systemic lupus erythematosus (SLE). A recent study identified the high-affinity IgE receptor α-chain (FcεRIα) gene FCER1A as a susceptibility locus influencing total serum IgE levels. AIM: To investigate whether the single-nucleotide polymorphism (SNP) rs2298804 (251 A>G) of FCER1A is associated with SLE and its clinical characteristics in a Chinese Han population. METHODS: This case-control study enrolled 948 patients with SLE and 976 healthy controls. Precise phenotyping of patients was accomplished by means of a questionnaire and clinical examination. rs2298804 was genotyped using real-time fluorescence quantitative PCR. RESULTS: Compared with the healthy controls, patients with SLE had much lower frequencies of the AG genotype (OR = 0.26; 95% CI 0.194-0.374; P << 0.001) and G allele (OR = 0.45; 95% CI 0.36-0.55; P << 0.001). We also found a stronger association of the FCER1A exon SNP, rs2298804 (A/G), in females (OR = 0.42; 95%CI 0.34-0.53; P << 0.001) compared with males (OR = 0.52; 95% CI 0.28-0.97; P < 0.04). G-allele carriers are less likely to develop SLE than A-allele carriers. Although we did not find any significant correlation between the rs2298804 and the incidence of lupus nephritis, rs2298804 seemed to protect against proteinunia, fever and hypocomplementaemia in patients with SLE, but appeared to be a risk factor for photosensitivity and vasculitis. CONCLUSIONS: We found that rs2298804 seemed to have a protective effect against SLE in Chinese patients, especially women. It also protected against proteinunia, fever and hypocomplementaemia, but was a risk factor for photosensitivity and vasculitis.

Study on bladder cancer susceptibility and genetic polymorphisms of XPC, XPG, and CYP in smokers and non-smokers.

AIM: To investigate the gene susceptibility of bladder cancer and potential relation with smoking. METHODS: An analysis of SNPs were conducted among DNA repair genes of XPC, XPG, XRCC1, and six members of metabolic enzyme gene CYP 450 via TaqMan Probe-based polymerase chain reaction. A total of 130 patients with bladder cancer and 304 healthy controls were involved. RESULTS: Polymorphisms of XPC gene was related to bladder cancer. It was also related to smoking status in bladder cancer patients, as well as to tumour stage, male gender and older age. The XPG gene polymorphism was also related to bladder cancer yet it was prevalent in female non-smokers. No association was acquired for XRCC1 gene. The combination of more than 2 polymorphisms in DNA repair genes was associated with bladder cancer. No association was obtained in any of the metabolic enzyme gene of CYP450 with either bladder cancer or smoking status. CONCLUSION: DNA repair genes XPC and XPG could be related to carcinogenesis and tumour progression of bladder cancer. Confirmation within larger population was warranted.

El nivel de BLCA-4 urinario es útil para la detección del carcinoma de células uroteliales de vía urinaria superior / Urinary BLCA-4 Level is Useful to Detect Upper Urinary Tract Urothelial Cell Carcinoma

Objetivo: Los carcinomas de células uroteliales de las vías urinarias superiores (CCU-VUS) son poco comunes, pero normalmente invasivos en el diagnóstico. Se garantiza por lo tanto el diagnóstico temprano de CCU-VUS. El CCU tiene el mismo origen embriológico que el de vejiga y el BLCA-4 es un marcador específico altamente sensible para el cáncer de vejiga. Tenemos la intención de investigar la viabilidad del BLCA-4 para detectar CCU-VUS. Material y métodos: Se incluyó la orina de 30 pacientes con CCU-VUS, 10 pacientes con pólipo ureteral, 20 pacientes infectados con piedras ureterales incarceradas y 30 controles normales. El anticuerpo BLCA-4 se produjo y aplicó en un ensayo indirecto ELISA. Resultados: El BLCA-4 urinario es significativamente mayor en el grupo de CCU-VUS que en el grupo «pólipo» (p=0,0017), grupo «infección» (p<0,0001) o grupo «normal» (p<0,0001). El grupo «pólipo» también es mayor que el de «infección» (p=0,015) o «normal» (p=0,0009). La curva ROC revelada en el punto de corte fue de 5,5×10−4 A, la sensibilidad fue del 93,3% y la especificidad del 100%. Cuando se agruparon como masa ureteral vs. normal el mismo valor del punto de corte dio un 93,3% de sensibilidad y un 83,3% de especificidad. A 2,4×10−4 A, la sensibilidad fue del 56, 7% y la especificidad del 97,2%. Conclusiones: El BLCA-4 urinario también es muy específico en la detección del CCU-VUS. Para la masa ureteral identificada incidentalmente el BLCA-4 se puede considerar un indicador auxiliar además de la biopsia (AU)

Objective: Upper urinary tract urothelial cell carcinomas (UUT-UCCs) are rare but usually invasive at diagnosis. Early diagnosis of UUT-UCCs is thus warranted. UUT has the same embryological origin with bladder and BLCA-4 is a highly sensitive and specific marker for bladder cancer. We intend to investigate the viability of BLCA-4 in detecting UUT-UCCs. Material and methods: Urines from 30 UUT-UCC patients, 10 ureteral polyp patients, 20 infected patients with incarcerated ureteral stones, and 30 normal controls were included. BLCA-4 antibody was produced and applied in an indirect ELISA assay. Results: Urinary BLCA-4 is significantly higher in UUT-UCC group than «Polyp» group (P=0.0017), «Infection» group (P<0.0001), or « Normal» group (P<0.0001). The «Polyp» group is also higher than «Infection» group (P=0.015), or «Normal» group (P=0.0009). ROC curve revealed at cut-off of 5.5×10−4 A, sensitivity was 93.3% and specificity was 100%. When grouped as ureteral mass vs normal, same cut-off value yielded 93.3% sensitivity and 83.3% specificity. At 2.4×10−4 A, sensitivity was 56.7% and specificity was 97.2%. Conclusions: Urinary BLCA-4 is also highly specific in UUT-UCCs detection. For incidentally identified ureteral mass, BLCA-4 can be considered an auxiliary indicator besides biopsy (AU)

[Urinary BLCA-4 level is useful to detect upper urinary tract urothelial cell carcinoma]. / El nivel de BLCA-4 urinario es útil para la detección del carcinoma de células uroteliales de vía urinaria superior.

OBJECTIVE: Upper urinary tract urothelial cell carcinomas (UUT-UCCs) are rare but usually invasive at diagnosis. Early diagnosis of UUT-UCCs is thus warranted. UUT has the same embryological origin with bladder and BLCA-4 is a highly sensitive and specific marker for bladder cancer. We intend to investigate the viability of BLCA-4 in detecting UUT-UCCs. MATERIAL AND METHODS: Urines from 30 UUT-UCC patients, 10 ureteral polyp patients, 20 infected patients with incarcerated ureteral stones, and 30 normal controls were included. BLCA-4 antibody was produced and applied in an indirect ELISA assay. RESULTS: Urinary BLCA-4 is significantly higher in UUT-UCC group than «Polyp¼ group (P=0.0017), «Infection¼ group (P<0.0001), or « Normal¼ group (P<0.0001). The «Polyp¼ group is also higher than «Infection¼ group (P=0.015), or «Normal¼ group (P=0.0009). ROC curve revealed at cut-off of 5.5×10(-4)A, sensitivity was 93.3% and specificity was 100%. When grouped as ureteral mass vs normal, same cut-off value yielded 93.3% sensitivity and 83.3% specificity. At 2.4×10(-4)A, sensitivity was 56.7% and specificity was 97.2%. CONCLUSIONS: Urinary BLCA-4 is also highly specific in UUT-UCCs detection. For incidentally identified ureteral mass, BLCA-4 can be considered an auxiliary indicator besides biopsy.

Slug regulates Cyclin D1 expression by ubiquitin-proteasome pathway in prostate cancer cells.

AIM: Cyclin D1 is an important cell cycle regulatory proteins, which is a functional target of Slug in the regulation of cell growth of prostate cancer cells. But the pathway of these two factors interacting with each other is unclear. METHODS: The infectde PCa Cells were treated with proteasome inhibitor MG-132. Expression level of Slug, HA-cyclin D1 and other protein was examined by Western blot. RESULTS: Increasing doses of adenovirus expressing human Slug were added to DU-145 cells separately, but there were no significantly difference on expressions of Slug and cyclin D1. We found that the protein expressions of HA-Cyclin D1 (wide-type) were all reduced through high expression of Slug, which is dose-dependent. However, there is no change for HA-Cyclin D1 (mutant) expression in PC-3 with pMIGW-Cyclin D1-HA T286A. The protein expression of HA-Cyclin D1 were all reduced three days after infection by adding adenovirus expressing human Slug to PC-3 carrying pMIGW-Cyclin D1-HA vector compared to negative control, which is dose-dependent. However, there is no change for HA-Cyclin D1 expression in PC-3 with pMIGW-Cyclin D1-HA treated by MG-132. CONCLUSION: We found that forced expression of Slug inhibited proliferation of prostate cancer cells through downregulation of cyclin D1 expression. And Slug regulates cyclin D1 expression by ubiquitin-proteasome pathway in PCa cells.

Urinary BLCA-4 is highly specific for detection of bladder cancer in Chinese Han population and is related to tumour invasiveness.

BLCA-4 is currently the most sensitive and specific urinary marker for bladder cancer. As the incidence of bladder cancer varies by ethnic and territory, we tended to evaluate the feasibility of bladder cancer detection using urinary BLCA-4 in Chinese Han nationality. Urines from 79 bladder cancer patients, 31 urinary tract infection patients and 29 normal controls were included. Tissue specimens of 53 bladder cancers, 24 pathologically normal tumour- adjacent urothelium and 15 healthy controls were involved. BLCA-4 antibody was produced and applied in an indirect ELISA assay for urine samples and immunohistochemistry study in tissue samples. Urinary BLCA-4 was significantly higher in the bladder cancer group (P=0.0001). The level was in no relation to age, gender, growth pattern, grade or stage. Discrepant to reported data, a cut-off value of 1.7×10⁻4 A was acquired here, which yields a sensitivity of 97.37% and specificity of 100%. Muscle invasiveness was related to a higher BLCA-4 level (P=0.0175). Tumour tissues were also scored higher in staining (P=0.0001), yet this was not related to invasiveness. In 41.67% of adjacent normal tissue we found positive BLCA-4 expression. Urinary BLCA-4 was also highly specific in bladder cancer detection in the Chinese, with additional indicative value in muscle invasiveness detection. A cut-off value of 1.7×10⁻4 A may be more adaptive to Chinese Han population.

The learning curve for hand-assisted laparoscopic colectomy: a single surgeon's experience.

BACKGROUND: Surgical experience and outcomes for hand-assisted laparoscopic colectomy were evaluated to define a learning curve. METHODS: This study included 60 patients who underwent hand-assisted laparoscopic colectomies performed by a single surgeon. They were analyzed as three consecutive equal groups: A, B, and C. Pearson's chi-square test and one-way analysis of variance (ANOVA) were used to compare differences in demographics and perioperative parameters. Operative times were analyzed to document the learning curve for the procedure. RESULTS: There were no significant differences between the three groups in terms of age, sex, operative procedure, or comorbidity. Groups B and C showed significantly shorter operative times, significantly earlier recoveries of gastrointestinal function, less blood loss, and shorter hospital stays than group A. The incidence of operative complications was not significantly different among the three groups (35% vs 5% vs 15%; p = 0.07). CONCLUSIONS: Approximately 21 to 25 cases were needed to achieve proficiency in this series.

[Abdominal bipedicled subepidermal vascular-network flap in repair of degloving injury of hand].

OBJECTIVE: To evaluate the clinical result of repairing degloving injury of hand with abdominal bipedicled subdermal vascular-network flap in emergence. METHODS: From 1994 to 1997, 19 cases with degloving injury of hand were treated with two flaps, one flaps with the inferior epigastric artery as pedicle, another with superficial epigastric artery. The two skin flaps were designed oppositely to cover the injured hands. RESULTS: All the flaps survived. Followed up for 1 to 3 years, the contour of hands were fine. Extension of fingers was normal and opponers of thumbs was good. Range of flexion of metacarpo-phalangeal joints was from 45 to 60 degrees, and the proximal interphalangeal joints was from 10 to 25 degrees. CONCLUSION: For the subdermal vascular network, the bipedicled flaps of abdomen in repair of degloving injury of hand have sufficient blood supply, strong resistance to infection, high survival rate, and good contour.

Effects of Ilexonin A on circulatory neuroregulation.

Ilexonin A (IA), a pentacyclic triterpene, has been semisynthesized in china for the first time. It is extracted from the root of Ilicis pubescentis, a commonly used herbal medicine in Guangdong for the treatment of cardiovascular, cerebrovascular and peripheral vascular diseases and heart failure with satisfactory effects. The pharmacokinetic studies indicated that the elimination half-life after oral and i.v. dosing were 17.7 +/- 2.4 h and 22.5 +/- 2.9 h respectively. The total clearance was 4.6 +/- 0.51/h. The bioavailability of IA capsules was 0.39 +/- 0.14 and LD50 was 234 mg/Kg. We have adopted modern techniques, including cellular electrophysiology, isotope tracing methods, molecular biology, electromicroscopy, etc., to probe into the pharmacologic mechanisms of the effects of IA on cardiovascular system. The results indicated that IA can increase the contractility of isolated guinea pig auricular myocardium, attenuate vascular smooth muscle tension induced by noradrenaline in the rabbit aorta. IA can exert a biphasic regulatory effect on arterial blood pressure. IA also can prolong A-V duration of Hiss bundle electrograph (HBE) in rabbits and prolong the action potential duration and the effective refractory period (ERP) of myocardial cells in guinea pigs. The results showed that IA can increase the cAMP content in the smooth muscle of aorta and exert a calcium-blockade effect. Therefore, the peripheral resistance vessels are relaxed and the cardiac afterload is lowered. IA-blocked calcium channels are correlated with both the potential-dependent channel and the receptor operated channel in vascular smooth muscles. IA also increases the cAMP content of myocardium and accelerates the cellular calcium influx and efflux, and this may be responsible for the direct mechanism of the positive inotropic action of IA. Under electron microscopy, it is observed that IA can alleviate the defect of succinate dehydrogenase in the myocardial mitochrondria of rabbit chronic congestive heart failure (CF) model and reduce the microstructural damage of the failed myodardium, therefore the anoxic tolerance of myocardium is increased, the effect of IA on the platelet stretching activity and microstructure in the patients with CF is also studied. It is found that IA can reduce the hypercoagulability of blood, decrease the severity of blood stagnation and improve the status of microcirculation. Effects of IA introventricular and cardiovascular central microinjection (nucleus tractus solitarius, paraventricular nucleus) on arterial blood pressure and heart rate were studied. It demonstrated that IA possess circulatory neuroregular effects by the medium of alpha-receptor and beta-receptor of cardiovascular motoneurons.