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BACKGROUND Our previous studies confirmed that abdominal paracentesis drainage (APD) attenuates intestinal mucosal injury in rats with severe acute pancreatitis (SAP), and improves administration of enteral nutrition in patients with acute pancreatitis (AP). However, the underlying mechanisms of the beneficial effects of APD remain poorly understood. AIM To evaluate the effect of APD on intestinal inflammation and accompanying apoptosis induced by SAP in rats, and its potential mechanisms. METHODS SAP was induced in male adult Sprague-Dawley rats by 5% sodium taurocholate. Mild AP was induced by intraperitoneal injections of cerulein (20 μg/kg body weight, six consecutive injections). Following SAP induction, a drainage tube connected to a vacuum ball was placed into the lower right abdomen of the rats to build APD. Morphological changes, serum inflammatory mediators, serum and ascites high mobility group box protein 1 (HMGB1), intestinal barrier function indices, apoptosis and associated proteins, and toll-like receptor 4 (TLR4) signaling molecules in intestinal tissue were assessed. RESULTS APD significantly alleviated intestinal mucosal injury induced by SAP, as demonstrated by decreased pathological scores, serum levels of D-lactate, diamine oxidase and endotoxin. APD reduced intestinal inflammation and accompanying apoptosis of mucosal cells, and normalized the expression of apoptosis-associated proteins in intestinal tissues. APD significantly suppressed activation of the intestinal TLR4 signaling pathway mediated by HMGB1, thus exerting protective effects against SAP-associated intestinal injury. CONCLUSION APD improved intestinal barrier function, intestinal inflammatory response and accompanying mucosal cell apoptosis in SAP rats. The beneficial effects are potentially due to inhibition of HMGB1-mediated TLR4 signaling.

AIM To investigate the role of peritoneal macrophage (PM) polarization in the therapeutic effect of abdominal paracentesis drainage (APD) on severe acute pancreatitis (SAP). METHODS SAP was induced by 5% Na-taurocholate retrograde injection in Sprague-Dawley rats. APD was performed by inserting a drainage tube with a vacuum ball into the lower right abdomen of the rats immediately after the induction of SAP. To verify the effect of APD on macrophages, PMs were isolated and cultured in an environment, with the peritoneal inflammatory environment simulated by the addition of peritoneal lavage in complete RPMI 1640 medium. Hematoxylin and eosin staining was performed. The levels of pancreatitis biomarkers amylase and lipase as well as the levels of inflammatory mediators in the blood and peritoneal lavage were determined. The polarization phenotypes of the PMs were identified by detecting the marker expression of M1/M2 macrophages via flow cytometry, qPCR and immunohistochemical staining. The protein expression in macrophages that had infiltrated the pancreas was determined by Western blot. RESULTS APD treatment significantly reduced the histopathological scores and levels of amylase, lipase, tumor necrosis factor-α and interleukin (IL)-1β, indicating that APD ameliorates the severity of SAP. Importantly, we found that APD treatment polarized PMs towards the M2 phenotype, as evidenced by the reduced number of M1 macrophages and the reduced levels of pro-inflammatory mediators, such as IL-1β and L-selectin, as well as the increased number of M2 macrophages and increased levels of anti-inflammatory mediators, such as IL-4 and IL-10. Furthermore, in an in vitro study wherein peritoneal lavage from the APD group was added to the cultured PMs to simulate the peritoneal inflammatory environment, PMs also exhibited a dominant M2 phenotype, resulting in a significantly lower level of inflammation. Finally, APD treatment increased the proportion of M2 macrophages and upregulated the expression of the anti-inflammatory protein Arg-1 in the pancreas of SAP model rats. CONCLUSION These findings suggest that APD treatment exerts anti-inflammatory effects by regulating the M2 polarization of PMs, providing novel insights into the mechanism underlying its therapeutic effect.

As the firs-line treatment for acute pancreatitis (AP) related infectious walled-off necrosis (WON), percutaneous catheter drainage (PCD) are usually accomplished under CT or US guidance, either of which has certain disadvantages. It is necessary to verify the clinical effects of using US and CT images fusion as guidance of PCD.The total 94 consecutive AP patients with infected WON from January of 2013 to January of 2017 were included. Among these patients with infected WON, 48 received PCD under simple US guidance (US-PCD) and 46 under US/CT images fusion guidance (US/CT-PCD). The clinical data consisting of puncture data, drainage effectiveness indicators, intervention complications were collected.The demographic characteristics and disease related characteristics of two groups were comparable. After 48 h of PCD treatment, the US/CT-PCD group achieved a significantly higher imaging effective rate, and significantly lower inflammatory response indexes and severity score, than the US-PCD group (P 0.05). The US/CT-PCD group required fewer puncture times and drainage tubes and lower rate of advanced treatment, showing higher operational success rate than the US-PCD group (P 0.05). Moreover, the US/CT-PCD group exhibited significantly fewer puncture related complications, lower hospital stay, intubation time, and hospitalization expenses than the US-PCD group (P 0.05).PCD treatment under the US/CT images fusion guidance is a reliable intervention with definite clinical effects for AP complicated with infected WON.

NADPH oxidase (Nox) is considered a major source of reactive oxygen species (ROS) in the heart in normal and pathological conditions. However, the role of Nox in severe acute pancreatitis- (SAP-) associated cardiac injury remains unclear. Therefore, we aim to investigate the contribution of Nox to SAP-associated cardiac injury and to explore the underlying molecular mechanisms. Apocynin, a Nox inhibitor, was given at 20 mg/kg for 30 min before SAP induction by a retrograde pancreatic duct injection of 5% sodium taurocholate. Histopathological staining, Nox activity and protein expression, oxidative stress markers, apoptosis and associated proteins, cardiac-related enzyme indexes, and cardiac function were assessed in the myocardium in SAP rats. The redox-sensitive MAPK signaling molecules were also examined by western blotting. SAP rats exhibited significant cardiac impairment along with increased Nox activity and protein expression, ROS production, cell apoptosis, and proapoptotic Bax and cleaved caspase-3 protein levels. Notably, Nox inhibition with apocynin prevented SAP-associated cardiac injury evidenced by a decreased histopathologic score, cardiac-related enzymes, and cardiac function through the reduction of ROS production and cell apoptosis. This protective role was further confirmed by a simulation experiment in vitro. Moreover, we found that SAP-induced activation in MAPK signaling molecules in cardiomyocytes was significantly attenuated by Nox inhibition. Our data provide the first evidence that Nox hyperactivation acts as the main source of ROS production in the myocardium, increases oxidative stress, and promotes cell apoptosis via activating the MAPK pathway, which ultimately results in cardiac injury in SAP.

Our previous study showed that abdominal paracentesis drainage (APD) benefits patients with severe acute pancreatitis (SAP) by delaying or avoiding multiple organ failure. However, the role of APD treatment in SAP-associated lung injury (PALI) remains unclear. Therefore, we investigated the impact of APD on PALI in rats to explore the mechanisms underlying its potential treatment benefits. A drainage tube was inserted into the right lower quadrant of rats immediately after SAP induction via the retrograde infusion of 5% sodium taurocholate into the biliopancreatic duct. Mortality rates, histological scores, wet-to-dry weight (W/D) ratios, inflammatory infiltration and oxidative stress in lung tissues were then examined. Xanthine dehydrogenase (XDH) and xanthine oxidase (XOD) activities in the sera, intestines and lungs were assessed, as was P-selectin expression. APD treatment significantly decreased pathological damage scores, oxidative stress and neutrophil infiltration in lung tissues, indicating that APD has protective effects against PALI in rats. Moreover, APD decreased the levels of serum α-amylase and trypsin and resulted in a significant decrease in XDH mobilization from the intestines, which suppressed P-selectin expression in lung tissues following SAP induction. APD treatment exerts a significant protective effect against lung injury secondary to SAP by reducing the mobilization of intestinal XDH or XOD (XDH/XOD) and the expression of P-selectin in the lungs. These findings provide novel insights into the mechanisms underlying the effectiveness of APD in patients with SAP.

OBJECTIVE: To investigate the effects of different doses of Yinzhihuang oral liquid and different concentrations of Lonicera japonica extract on hemolysis and hyperbilirubinemia in rats with glucose-6-phosphate dehydrogenase (G6PD) deficiency. METHODS: Male Wistar rats were randomly divided into 10 groups (n=10 each):normal control group (untreated), negative control group (saline-treated), positive control group (primaquine-treated), low-, medium-and high-dose Yinzhihuang oral liquid groups (13.4, 26.8, and 53.6 mL/kg, respectively), and low-, medium-, high-, and very-high-concentration Lonicera japonica groups (6.7 mL/kg administered, containing 8, 40, 80, and 160 mg/mL Lonicera japonica extract, respectively). A rat model of acetylphenylhydrazine-induced G6PD deficiency was established in all groups except the normal control group, as confirmed by the morphological changes in erythrocytes observed using Wright's stain. After treatment, routine blood and biochemical tests were conducted to measure hemolytic indices, as well as changes in total and indirect bilirubin levels. RESULTS: Rats with G6PD deficiency demonstrated irregular erythrocytes with a lighter-staining center. In the positive control group, the red blood cell count decreased, while the free hemoglobin count and the reticulocyte percentage increased, as compared with before treatment (P < 0.05); in all the Yinzhihuang oral liquid groups and Lonicera japonica extract groups, all the above indices except reticulocyte percentage returned to the levels before treatment (P < 0.05). Compared with the positive control group, all the Yinzhihuang oral liquid groups had significantly reduced total and indirect bilirubin levels (P < 0.05), and all the Lonicera japonica group had significantly reduced indirect bilirubin levels (P < 0.05). However, the total bilirubin level was significantly higher in the Lonicera japonica groups than in the Yinzhihuang oral liquid groups (P < 0.05). The low-dose Yinzhihuang oral liquid group demonstrated a significantly greater decrease in total bilirubin level than the medium-and high-dose Yinzhihuang oral liquid group (P < 0.05). CONCLUSIONS: Administration of high-dose Yinzhihuang oral liquid and different concentrations of Lonicera Japonica extract do not cause hemolysis in rats with G6PD deficiency. Yinzhihuang oral liquid is more effective in treating hyperbilirubinemia than Lonicera Japonica extract. However, the efficacy of Yinzhihuang oral liquid may not be dose-dependent.

OBJECTIVE: To investigate the accuracy and clinical utility of neonatal critical illness score (NCIS) and score for neonatal acute physiology, perinatal extension, version Ⅱ (SNAPPE-Ⅱ) in predicting the "dead and abandoned" risk in critically ill neonates. METHODS: A total of 269 critically ill neonates were divided into two groups according to their prognosis:dead/abandoned and improved/cured. The accuracy of these two scoring systems, NCIS and SNAPPE-Ⅱ, in predicting the "dead and abandoned" risk was compared. RESULTS: The dead/abandoned group had a significantly higher SNAPPE-Ⅱ score than the improved/cured group (P < 0.001), while there was no significant difference in the NCIS score between the two groups (P=0.091). The children who were in line with the individual indicator in the NCIS results had a significantly higher "dead and abandoned" risk than those who were not (P=0.005). CONCLUSIONS: SNAPPE-Ⅱ is more accurate in early prediction of the "dead and abandoned" risk in critically ill neonates compared with NCIS. NCIS has the ability to predict the "dead and abandoned" risk in children in line with the individual indicator.

Cholecystolithiasis is the most common disease treated by general surgery, with an incidence of about 0.15–0.22 %. The most common therapies are open cholecystectomy (OC) or laparoscopic cholecystectomy (LC). However, with a greater understanding of the function of the cholecyst, more and more patients and surgeons are aware that preserving the functional cholecyst is important for young patients, as well as patients who would not tolerate anesthesia associated with either OC or LC. Based on these considerations, we have introduced a notable, minimally invasive treatment for cholecystolithotomy. We performed a retrospective review of patients with cholecystolithiasis who were unable to tolerate surgery or who insisted on preserving the functional cholecyst. Our particular approach can be simply described as ultrasound-guided percutaneous cholecystostomy combined with a choledochoscope for performing a cholecystolithotomy under local anesthesia. Ten patients with cholecystolithiasis were treated via this approach. All except one patient had their gallbladder stones totally removed under local anesthesia, without the aggressive procedures associated with OC or LC. The maximum number of gallbladder stones removed was 16, and the maximum diameter was 13 mm without lithotripsy. After the minimally invasive surgery, the cholecyst contractile functions of all patients were normal, confirmed via ultrasound after a high-fat diet. Complications such as bile duct injury, biliary fistula, and bleeding occurred significantly less often than with OC and LC. The recurrence rates for each of 2 post-operative years were about 11.11 % (1/9, excluding a failure case) with uncertainty surrounding recurrence or residue, and 22.22 % (2/9, including one non-recurrence patient with follow-up time of 22 months), respectively. Ultrasound-guided percutaneous cholecystostomy combined with choledochoscope is a safe, efficient, and minimally invasive cholecystolithotomy method. We recommend this technique for the management of small stones (less than 15 mm) in high-risk surgical patients.

Objective: To investigate the metabolic effects of open Roux-en Y gastric bypass (RYGB) on pancreatic endocrine reserve in overweight/obese Chinese patients with type 2 diabetes during postoperative year 1. Methods: Retrospective analysis comparing pre- and postoperative results of oral glucose tolerance tests (OGTT) with determinations of insulin and C-peptide, glycated hemoglobin (HbA1c), insulin resistance (HOMA-IR), and BMI at 1, 3, 6, and 12 months in 99 overweight patients (BMI 26.3 ± 4.0 kg/m2; 59 men) with type 2 diabetes at the General Hospital of Chengdu Military Region. Results: 79 patients (80%) achieved complete remission (maintaining random blood glucose levels < 11.1 mmol/l, fasting blood glucose levels < 7.0 mmol/l, 2-hour OGTT blood glucose levels < 11.1 mmol/l, and glycated hemoglobin < 6.5%). Nine cases (9%) were ‘improved' (reduced medication or diet controlled blood sugar), and 11 cases did not meet either criterion (‘unchanged'). Patients in complete remission were younger and heavier, more often men, had significantly shorter history of diabetes (4.3 ± 3.8 years vs. 7.6 ± 3.8 years, p < 0.05), and exhibited significantly higher fasting and OGTT levels of C-peptide and insulin, and HOMA-IR than the other 2 groups (p < 0.05-0.01). Conclusion: Open gastric bypass achieved complete remission of type 2 diabetes in Chinese overweight/obese, heavier, younger, predominantly male patients with shorter duration of disease exhibiting greater pancreatic endocrine reserve.

Li-Tao Cheng1, Li-Jun Tang1,2, Hui-Min Chen1,3, Wen Tang1, Tao Wang11Division of Nephrology, Peking University Third Hospital, Beijing, China; 2Division of Nephrology, Qilu Hospital of Shandong University, Ji’nan, China; 3Division of Cardiology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, ChinaBackground: Hypoalbuminemia is a risk factor for cardiovascular events and mortality in dialysis patients, but the underlying mechanism remains unclear. Meanwhile, increased pulse wave velocity (PWV), the marker of arterial stiffness, has been proved to be an independent predictor of cardiovascular disease. The relationship between serum albumin and PWV in continuous ambulatory peritoneal dialysis patients (CAPD) was studied.Methods: Sixty-two CAPD patients were studied. The average age was 63 ± 12 years and dialysis duration was 23 ± 22 months. Serum albumin, C-reactive protein (CRP), and carotid-femoral PWV were measured.Results: Among these patients, 43.5% were men. The mean serum albumin concentration was 37 ± 4 g/L and PWV was 11.9 ± 2.3 m/s. PWV positively correlated with age (r = 0.35, P < 0.01), diabetes (yes = 1, no = 0; r = 0.292, P < 0.05), systolic blood pressure (SBP; r = 0.493, P < 0.001) and CRP (r = 0.295, P < 0.05), but negatively correlated with serum albumin (r = −0.357, P < 0.01). In multiple regression analysis, SBP (β = 0.615, P < 0.001), age (β = 0.414, P < 0.01), albumin (β = −0.315, P < 0.05) and total cholesterol (β = 0.275, P < 0.05) were independent determinants of PWV. In a non-inflamed subgroup (CRP < 3 mg/L, n = 30), albumin still negatively correlated with PWV (r = −0.66, P < 0.001).Conclusion: Serum albumin inversely correlated with increased PWV in CAPD patients, suggesting that increased arterial stiffness might be the link between hypoalbuminemia and increased cardiovascular mortality in dialysis patients.Keywords: hypoalbuminemia, cardiovascular events, pulse wave velocity, arterial stiffness, peritoneal dialysis

Background/Aim: Volume overload is believed to play a pivotal role in the pathogenesis of hypertension in dialysis patients. Although the extracellular water (ECW) content in hypertensive dialysis patients was significantly higher than in normotensive dialysis patients on the whole, there was considerable overlap in ECW between the two groups. Little is known about the hemodynamic characteristics in subgroups of patients with normotension but a high volume (HV) status or with hypertension but a normal volume (NV) status. We investigate the overlap in ECW between controlled and uncontrolled hypertension in dialysis patients. Methods: Fifty-two patients (mean age 62 years, 26 males and 26 females) on peritoneal dialysis were enrolled into this study. The ECW was assessed by bioimpedance analysis and normalized by individual height in meters (NECW). The mean value of NECW in both sexes was arbitrarily set to define NV status (lower than mean value) or HV status (higher than mean value). All patients were thus divided into four subgroups: controlled hypertension with NV (CHT-NV), controlled hypertension with HV (CHT-HV), uncontrolled hypertension with NV (UHT-NV) and uncontrolled hypertension with HV (UHT-HV). The stroke volume, cardiac output and total peripheral resistance were echocardiographically measured and their respective indices were calculated. Results: There were 12 (23%), 8 (15%), 14 (27%) and 18 (35%) patients in the CHT-NV, CHT-HV, UHT-NV and UHT-HV subgroups, respectively. The four subgroups were matched for sex, diabetes and age. The NECW in the CHT-HV group was higher than that in CHT-NV and UHT-NV groups (p < 0.01), but was comparable with that in the UHT-HV group. The stroke volume and cardiac output indices in the CHT-HV group were not significantly different from those in the CHT-NV and UHT-NV groups. The total peripheral resistance index in the CHT-HV group was lower than that in UHT-NV and CHT-NV groups (p < 0.05), but was comparable to that in the UHT-HV group. There was no difference in heart rate among the four groups. Conclusions: The overlap in ECW between controlled hypertension and uncontrolled hypertension in dialysis patients was related to a significant difference in total peripheral resistance index, but not to significant differences in stroke volume and cardiac output indices. The CHT-HV patients were characterized by lower total peripheral resistance indices.

Background: While a high blood pressure (BP) in patients receiving maintenance ambulatory peritoneal dialysis (CAPD) is associated with congestive heart failure and an increased mortality, the relevance of diurnal variations in BP is unknown. Methods:In a prospective study, we enrolled 76 prevalent patients receiving stable CAPD (age 60.4 ± 13.8 years; 37 males). BP was measured over 24 h using an automated device. We also performed routine clinical and biochemical measurements, as well as the Karnofsky index to evaluate physical activity. Volume status was assessed using bioimpedance analysis. Results: 69 patients (with an average time on dialysis of 24.4 ± 22.5 months) completed the study. Of these, 16 patients experienced a drop in BP >10% at night (dippers), while 53 patients did not (non-dippers). Comparing these two groups, dippers had significantly lower extracellular water (ECW) (13.8 ± 2.1 vs. 15.9 ± 3.3 l; p < 0.05), normalized extracellular water (nECW) (0.22 ± 0.05 vs. 0.26 ± 0.04 l/m; p < 0.05), and serum albumin (38.2 ± 2.9 vs. 35.9 ± 3.7 g/l; p < 0.05). Age, Karnofsky index, vintage, residual renal Kt/V and peritoneal Kt/V, total Kt/V, dose of antihypertensive drugs, mean systolic and diastolic BP did not significantly differ between these groups. Correlation analysis showed the coefficient of variation (CV) of BP positively correlated with E/T (r2 = 0.292; p < 0.05), diabetic (r2 = 0.267; p < 0.05), male (r2 = 0.257; p < 0.05), nECW (r2 = 0.278; p < 0.05) and ECW (r2 = 0.249; p < 0.05) negatively correlated with albumin (r2 = –0.280; p < 0.05). Furthermore, in a multivariate linear regression model, E/T, albumin and sex were independently associated with CV for BP. Conclusions: We show that reduced BP variation is common in CAPD patients and associated with volume overload and hypoalbuminemia. Furthermore, the relationship between nutritional, inflammatory status and dipping needs further studies.

Background: A high peritoneal transport status in continuous ambulatory peritoneal dialysis (CAPD) patients is associated with a markedly increased morbidity and mortality. While the causes are as yet unknown, overall the proportion of deaths due to cardiovascular disease is estimated at 40–50% among dialysis patients. Arterial stiffness has been established as a cardiovascular risk factor, while the links between peritoneal transport status and aortic stiffness have not yet been investigated. Methods: We included 65 prevalent CAPD patients (24 males/41 females) from our center in a cross-sectional study. Arterial stiffness was assessed by brachial pulse pressure (PP) and carotid-femoral pulse wave velocity (C-F PWV). The patients’ peritoneal fluid transport was assessed by kinetic modeling. The patients’ peritoneal small solute transport rate was assessed by D/Pcr at 4 h. Extracellular water to total body water (E/T) ratio was assessed by means of bioimpedance analysis. C-reactive protein was also measured. Results: C-F PWV was positively correlated with patients’ age (r = 0.489, p < 0.01), diabetic status (r = 0.327, p < 0.01), peritoneal fluid absorption rate (Ke; r = 0.251, p < 0.05), PP (r = 0.483, p < 0.01), and E/T (r = 0.517, p < 0.01). Multivariate regression analysis showed that C-F PWV was independently related to E/T (p < 0.01), PP (p < 0.01), age (p < 0.05), and Ke (p < 0.05). Conclusion: Peritoneal fluid transport (Ke), as well as E/T, age and PP were found to be independent predictors of elevated C-F PWV in CAPD patients, suggesting that there might be a link between high aortic stiffness and increased Ke rate, hypothetically through generalized vasculopathy.

Background In our previous study,we found that DAZAP2 was the most significantly down regulated gene when differential screening of complementary DNA(cDNA)chips were used to analyze mRNA isolated from bone marrow mononuclear cells from newly diagnosed multiple myeloma(MM)patients without anticancer treatment.In this study,we observed DAZAP2 mRNA and protein expression in the mononuclear cells from MM bone marrow and investigated its role in the pathogenesis of MM. Methods The full-length cDNA of DAZAP2 was cloned and sequenced from mononuclear cells from human bone marrow.The nucleotide and amino acid sequences of DAZAP2 were analyzed using the ClustalW program.A dendrogram was constructed by multiple sequence alignment using ClustalW and amino acid sequence identity/similarity was derived based on comparisons attained using the MegAlign software.The recombinant pEGFP expression vector was constructed and the confocal microscopy was used for the localization of the DAZAP2 protein in transfected COS7 cells.The expression of DAZAP2 mRNA was detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and the expression level of DAZAP2 protein was detected by Western blotting analysis in MM samples. Results DAZAP2 proteins of vertebrates is highly conserved in evolution.It contains a proline-rich region,several potential SH2 and SH3 domain-binding motifs and a possible protein kinase C (PKC) phosphorylation site.We showed by confocal microscopy that the DAZAP2 protein predominantly resides in the cytoplasm with a discrete pattern of punctuated distribution.The expression of DAZAP2 was not detected in 24 of 36 MM samples by semi-quantitative RT-PCR.In contrast,DAZAP2 expression was detected in all 30 normal controls.The expression level of DAZAP2 protein was assayed by Western blotting analysis,showing a robust down-regulation in MM patients (P0.001) that matched with the results of the RT-PCR. Conclusions DAZAP2 is downregulated in MM samples and it may be a signal molecule in MM cells.DAZAP2 is involved in the pathogenesis of MM and could be used as a genetic marker for MM. Chin Med J 2007;120(19):1659-1665

To observe the toxicity of fangyouling after one month' s transdermal administration in rabbits and evaluate its security.Forty rabbits were randomly divided into 4 groups including a control group and low, middle and high dose groups of fangyouling. The rabbits in the control group were administered with sunflower oil, and the other rabbits were administrated dermally with fangyouling of 50,300 and 2,000 mg/kg respectively once a day for 4 weeks. The general condition, the skin irritation reaction, body weight, food consumption, hematology, blood biochemistry, organ coefficients and histopathological changes of all the rabbits were observed.There was no obvious effect on the general condition in all the rabbits. However, the mild skin irritation was observed in 2 rabbits of the middle dose group and 4 rabbits of the high-dose group. The decreases of body weight and food consumption were noted in the high dose group. No changes were detected of hematology, blood biochemistry or viscera pathological at all dose levels.The dose of non-toxic response of fangyouling is 50 mg/kg at this study condition.

Background Pancreatitis induced by hypertriglyceridemia (HTG) has gained much attention. However, very limited numbers of studies have focused on the clinical significance of TG elevation in non-HTG induced pancreatitis, such as acute biliary pancreatitis (ABP). This study aimed to study the clinical significances of triglyceride (TG) elevation in patients with ABP. Methods We retrospectively analyzed a total of 426 ABP cases in our research center. According to the highest TG level within 72 h of disease onset, the patients were divided into a normal TG group and an elevated TG group. We analyzed the differences between the two groups of patients in aspects such as general information, disease severity, APACHE II (acute physiology and chronic health evaluation II) and Ranson scores, inflammatory cytokines, complications and prognosis. Results Compared with the normal TG group, patients in the elevated TG group showed a significantly higher body mass index and were significantly younger. TG elevation at the early stage of ABP was associated with higher risk of severe pancreatitis and organ failures, especially respiratory failure. For patients with severe pancreatitis, those with elevated TG levels were more likely to have a larger area of necrosis, and higher incidence of pancreatic abscess as well as higher mortality (17.78% versus 9.80%, P

Background: A seasonal variation in blood pressure (BP) has been observed in hemodialysis and renal transplant patients. However, this phenomenon in continuous ambulatory peritoneal dialysis (CAPD) patients, whose hemodynamics are different from hemodialysis patients, has not been reported before. In addition, the contribution of extracellular water (ECW) in the seasonal variation in BP is not clear. Methods: All stable CAPD patients (n = 122) dialyzed in a single center from January 1, 2003 to December 12, 2004 were studied. Systolic blood pressure (SBP), diastolic blood pressure (DBP), weight and ECW (by bioimpedance analysis) were measured in every patient. Climatic data were obtained from the Beijing Weather Bureau. These data were pooled together and grouped according to the calendar month. Results: In general, an apparent seasonal variation in BP was observed in CAPD patients. BP began to decrease from spring and reached the lowest level in summer, then increased from autumn and reached its peak in winter. The seasonal variation in BP in male patients was similar to that in female patients, but in comparison to non-diabetic patients there was no apparent seasonal variation in the BP of diabetic patients. SBP and DBP negatively correlated with the average atmospheric temperature (r = –0.768, p < 0.001 and r = –0.764, p < 0.001, respectively). BP also negatively correlated with rainfall and humidity, but this correlation disappeared when temperature was controlled in partial correlation analysis. Weight and ECW fluctuated throughout the year but showed no seasonal variation. Conclusion: On the whole there was an apparent seasonal variation in blood pressure in CAPD patients. As opposed to non-diabetic patients, there was no apparent seasonal variation in BP in diabetic patients. The seasonal variation in BP was influenced more by temperature than rainfall and humidity, and the change in ECW was not seasonal, suggesting that other mechanisms such as total peripheral resistance might play a more important role in this phenomenon.

Due to unsatisfying prognosis of AFP for hepatocellular carcinoma (HCC), we aim to evaluate the prognostic value of combination of exosomes and miRNAs in detecting HCC. HCC was induced with diethylnitrosamine in rats and using a scoring system based on histological examination six different stages (normal liver, degeneration, fibrosis, cirrhosis, early HCC and late HCC) were identified in the development of HCC. The expression levels of AFP, exosomes and miRNAs (miRNA-10b, miRNA-21, miRNA-122 and miRNA-200a) were detected in both tissue and blood samples from those six stages. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the power of each parameter and their different combinations in diagnosing HCC or cirrhosis. A change in the expression of both exosomes and miRNAs was observed during cirrhosis, which in contrast with AFP starts showing up until the early HCC stage. Interestingly, the expressions of exosomes and the selected four miRNAs at early HCC stage obtained more remarkably alterations than the level of AFP (P

The efficacy and safety of ultrasound-guided abdominal paracentesis drainage ahead of percutaneous catheter drainage as the new second step of a step-up approach are evaluated.The observed parameters were compared between groups including mortality, infection, organ failure, inflammatory factor levels, indexes of further interventions, and drainage-related complications.This retrospective study included 102 consecutive patients with acute pancreatitis from June 2009 to June 2011.In this step-up approach, all patients subsequently received medical management, percutaneous catheter drainage (with or without previous abdominal paracentesis drainage), and necrosectomy if necessary according to indications. The patients were divided into two groups: 53 cases underwent abdominal paracentesis drainage followed by percutaneous catheter drainage (abdominal paracentesis drainage + percutaneous catheter drainage group) and 49 cases were managed only with percutaneous catheter drainage (percutaneous catheter drainage-alone group).The demographic data and severity scores of the two groups were comparable. The mortality rate was lower in the abdominal paracentesis drainage + percutaneous catheter drainage group (0%) than the percutaneous catheter drainage-alone group (8.2%) (p = 0.050). Compared with the percutaneous catheter drainage-alone group, the laboratory variables of the abdominal paracentesis drainage + percutaneous catheter drainage group decreased more rapidly, the mean number of failed organs was lower, and the interval from the onset of disease to further interventions was much longer. However, there was no significant difference in the prevalence and duration of infections between the two groups.Application of abdominal paracentesis drainage ahead of percutaneous catheter drainage is safe and beneficial to patients by reducing inflammatory factors, postponing further interventions, and delaying or avoiding multiple organ failure.

Objective: This study was initiated to evaluate the effects of Roux-en-Y gastric bypass surgery on renal gluconeogenesis in type 2 diabetic rats and its relationship with hormonal parameters. Methods: Diabetic rats were induced by intraperitoneal injection of streptozotocin (STZ; 35 mg/kg) combined with a high-fat diet. They were then randomly divided into three groups: diabetes model group (DM group, n = 8), sham Roux-en-Y gastric bypass group (SRYGB group, n = 8), and Roux-en-Y gastric bypass group (RYGB group, n = 14). Another 8 normal rats comprised the normal control group (NC group, n = 8). Body weight, glucose, serum lipid, insulin, glucagon-like peptide-1 (GLP-1), leptin, and adiponectin were measured pre- and postoperatively. Glucose-6-phosphatase (G6Pase), phosphoenolpyruvate carboxykinase (PEPCK), insulin receptor-α (IR-α), insulin receptor-β (IR-β), and glycogen synthase kinase 3 beta (Gsk3b) were measured in renal cortex by using RT-PCR and Western immune-blot analyses on the 4th week after operation. Results: Following RYGB surgery, surgery-treated rats showed significantly improved oral glucose tolerance, dyslipidemia and insulin resistance as well as increased post-gavage insulin levels and serum circulating levels of GLP-1 and adiponectin. RT-PCR and Western immune-blot analyses showed PEPCK and G6Pase protein and mRNA to be significantly decreased in the renal cortex in the RYGB group (p < 0.05 vs. DM or SRYGB group); in addition, IR-α and Gsk3b phosphorylation levels increased in the RYGB group (p < 0.05 vs. DM or SRYGB group). Conclusion: Down-regulation of renal gluconeogenic enzymes might be a potential mechanism in hypoglycemia. An improved insulin signal pathway in the renal cortex and increased circulating adiponectin concentrations may contribute to the decline of renal gluconeogenesis following RYGB surgery.

To evaluate the effect of Jatropha seed oils extracted by different methods on killing cercaria of Schistosomajaponicum so as to screen the optimum process and formulations.The cercaria directly contacting tests with Jatropha seed oils extracted by 6 different extraction processes were carried out, and the mouse immediate contacting cercaria infection trials with different formulations of Jatropha seed oil and various additives were performed.With 95% ethanol, the ratio of material to liquid being 1:8, and 2 h extraction, the oil extraction rate was 30.7%. The cercaria directly contacting tests showed that 6 kinds of Jatropha seed oil killed all cercaria within 30 min. In the mouse immediate contacting cercaria infection trials, the worm declined rate of Jatropha seed oil liquid was 70.97%, and the worm declined rate of the sample added with benzyl benzoate was 58.87%, and the worm declined rate of the sample added with laurocapram was 77.42%. The worm declined rate of the samples added with benzyl benzoate, dibutyl phthalate and laurocapram was 100%.The process with 95% ethanol, the ratio of material to liquid being 1:8, and 2 h extraction is the optimum, and the Jatropha seed oil has a good killing schistosome cercaria effect.

Purpose.This study aimed to investigate the therapeutic potential of hydrogen-rich saline on pancreatic ischemia/reperfusion (I/R) injury in rats.Methods.Eighty heterotopic pancreas transplantations (HPT) were performed in syngenic rats. The receptors were randomized blindly into the following three groups: the HPT group and two groups that underwent transplantation and administration of hydrogen-rich saline (HS, >0.6 mM, 6 mL/kg) or normal saline (NS, 6 mL/kg) via the tail vein at the beginning of reperfusion (HPT + HS group, HPT + NS group). Samples from the pancreas and blood were taken at 12 hours after reperfusion. The protective effects of hydrogen-rich saline against I/R injury were evaluated by determining the changes in histopathology and measuring serological parameters, oxidative stress-associated molecules, and proinflammatory cytokines.Results.Administration of hydrogen-rich saline produced notable protection against pancreatic I/R injury in rats. Histopathological improvements and recovery of impaired pancreatic function were observed. In addition, TNF-α, IL-1β, and IL-6 were reduced markedly in the HPT + HS group. Additionally, there were noticeable inhibitory effects on the pancreatic malondialdehyde level and considerable recruitment of SOD and GPx, which are antioxidants.Conclusion.Hydrogen-rich saline treatment significantly attenuated the severity of pancreatic I/R injury in rats, possibly by reducing oxidative stress and inflammation.

Objective This study investigated the effect of percutaneous catheter drainage (PCD) on pancreatic injury in severe acute pancreatitis (SAP) rats. Methods Sixty Wistar rats were equally randomized into three groups: a sham operated control group, an SAP control group, and a PCD group. The levels of inflammatory cytokines, the activity of group II phospholipase A2 (PLA2) in blood and ascitic fluid, and the pancreas level of group II PLA2 and trypsin activity were measured 24 h after the operation. The apoptosis of the pancreatic cells, the expression of cycloxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), active caspase-3, Bcl-2 and Bax in the pancreas was detected. Pancreatic pathological changes were observed. Results The levels of proinflammatory cytokines, the activity of group II PLA2 and trypsin activity in pancreas in the SAP group were higher than those in the PCD group. The histopathological results revealed that the pancreatic injury was alleviated in the PCD group. The expression of COX-2 and iNOS in the pancreatic tissue in the SAP control rats was higher than that in the PCD rats. The expression of Bcl-2 was decreased and the expression of active caspase-3 and Bax was increased in the pancreas of PCD rats. The apoptosis index of the pancreatic cells in the PCD rats was higher than that in the SAP control rats. Conclusion PCD can relieve SAP-induced pancreatic injury by inhibiting inflammatory reactions, and promoting apoptosis of pancreatic cells.

Oxidative stress and inflammation play important roles in the progression from simple fatty liver to non-alcoholic steatohepatitis (NASH). The aim of this work was to investigate whether treatment with hydrogen sulfide (H2 S) prevented NASH in rats through abating oxidative stress and suppressing inflammation.A methionine-choline-deficient (MCD) diet rat model was prepared. Rats were divided into three experimental groups and fed for 8 weeks as follows: (i) control rats; (ii) MCD-diet-fed rats; (iii) MCD-diet-fed rats treated with NaHS (intraperitoneal injection of 0.1 mL/kg/day of 0.28 mol/L NaHS, a donor of H2 S).MCD diet impaired hepatic H2 S biosynthesis in rats. Treatment with H2 S prevented MCD-diet-induced NASH, as evidenced by hematoxylin and eosin staining, reduced apoptosis and activities of alanine aminotransferase and aspartate aminotransferase, and attenuated hepatic fat accumulation in rats. Treatment with H2 S abated MCD-diet-induced oxidative stress through reducing cytochrome p4502E1 expression, enhancing heme oxygenase-1 expression, and suppressing mitochondrial reactive oxygen species formation, and suppressed MCD-diet-induced inflammation through suppressing activated nuclear factor κB signaling and reducing interleukin-6 and tumor necrosis factor α expressions. In addition, treatment of MCD-diet fed rats with H2 S had a beneficial modulation on expression profiles of fatty acid metabolism genes in livers.Treatment with H2 S prevented NASH induced by MCD diet in rats possibly through abating oxidative stress and suppressing inflammation.

Liver regeneration is the basic physiological process after partial hepatectomy (PH), and is important for the functional rehabilitation of the liver after acute hepatic injury. This study was designed to explore the effects of neurolytic celiac plexus block (NCPB) on liver regeneration after PH. We established a model of PH in rats, assessing hepatic blood flow, liver function, and serum CRP, TNF-α, IL-1β and IL-6 concentrations of the residuary liver after PH. Additionally, histopathological studies, immunohistochemistry, and western blotting were also performed. Our results indicated that NCPB treatment after PH improved liver regeneration and survival rates, increased hepatic blood flow, reduced hepatocyte damage, decreased the secretion and release of inflammatory cytokines, increased the expression of B cell lymphoma/leukemia-2 (Bcl-2), and decreased the expression of Bcl-2 associated X protein (Bax). Additionally, Western blotting revealed that the expression of NF-κB p65 and c-Jun were decreased in liver after NCPB. In conclusion, the results of our present study indicate that NCPB treatment has a favorable effect on liver regeneration after PH. We suggest that NCPB can be utilized as an effective therapeutic method to help the functional rehabilitation of the liver after acute hepatic injury or liver cancer surgery.

Objectives Urinary function can be protected following open lateral node dissection (LND) with pelvic autonomic nerve preservation (PANP) for advanced rectal cancer. However data regarding urinary function after laparoscopic LND with PANP have not been reported. The goal of this study was to determine the effects of laparoscopic LND with PANP on urinary function in male patients with rectal cancer. Methods Urine flowmetry was performed using an Urodyn flowmeter. Patients were also asked to complete the standardized International Prostate Symptom Score (IPSS) questionnaire before surgery and 6 months after. In total, this study consisted of 60 males with advanced rectal cancer. Results No significant differences were seen in maximal urinary flow rate, voided volume or residual volume before and after surgery. The total IPSS score increased significantly after surgery and at least 41 patients (68.3%) reported there was no change in one of the seven IPSS questions. Conclusions Laparoscopic LND with PANP was relatively safe in preserving urinary function.

To investigate the influence and significance of gastric bypass surgery on hepatic gluconeogenesis in type 2 diabetic Goto Kakizaki(GK) rats.Forty GK rats were randomly divided into Roux-en-Y gastric bypass group(group A) and sham operation group(group B). Differences in glucose tolerance experiment(OGTT) at preoperative and postoperative 1, 2 and 4 weeks were compared and weight was recorded. Glycated hemoglobin levels were measured preoperatively and 4 weeks postoperatively. The animals were sacrificed 4 weeks after surgery and liver tissues were harvested to detect the relative expression of mRNA and protein of glucose 6 phosphatase(G-6-P) and phosphoenol pyruvate kinase(PEPCK) with RT-PCR and Western blot.Fasting blood glucose levels were 6.5, 4.9, and 4.7 mmol/L in group A, and were 10.3, 10.4, and 12.5 mmol/L in group B, and the differences between two groups were statistically significant(P0.05). The blood glucose level at 2 h after stomach lavage were 8.3, 6.4 and 5.5 mmol/L in group A, and were 21.4, 23.8 and 24.7 mmol/L in group B at postoperative 1, 2, 4 weeks, and the differences between two groups were statistically significant(P0.05). The glycosylated hemoglobin at postoperative 4 weeks was(6.8±1.0)%, significantly lower than that in group B[(7.9±0.8)%, P0.05]. Hepatic G-6-P and PEPCK mRNA relative expression at postoperative 4 weeks was reduced by 21.0% and 25.9% respectively as compared to group B, and the protein expression reduced as well. Immunohistochemistry showed that hepatic glycogen sedimentary in group A increased significantly.The relative mRNA and protein level of key enzymes of hepatic gluconeogenesis are significantly decreased after Roux-en-Y gastric bypass surgery and hepatic gluconeogenesis is reduced, which may be a potential mechanism of the decrease of blood glucose.

This study explored the dose-dependent effect of oat cereal β-glucan on improving metabolic indexes of obesity mice. C57-Bl mice were randomized to chow diet (N) group and high fat diet group and other three doses of oat β-glucan groups (low β-glucan, medium β-glucan, and high β-glucan). Energy intake, glucose, lipids, and appetite related hormones were tested. Dose-dependent relation was observed on oat β-glucan doses and body weight change, average energy intake, total cholesterol, HDL cholesterol, plasma neural peptide Y, arcuate neural peptide Y mRNA, and arcuate neural peptide Y receptor 2 mRNA level. Oat β-glucan helped to increase plasma peptide Y-Y and intestine peptide Y-Y expression in obesity mice.

Background There is not any stable, repeatable, and clinically simulated animal model of isolated pancreatic trauma been established as yet. The aim of our study is to establish a small animal model that mimics the pathophysiology of isolated pancreatic blast trauma and to study the features of traumatic condition in the model. Methods Rats were divided into three groups: calibrate group, impact group, and control group. The pancreas in the impact group was injured by BIM-III model of the biotical impact machine with the impact pressures of 800 kPa, 600 kPa, 400 kPa, 200 kPa, and 100 kPa. The mortality, intra-abdominal structural changes, amylase (AMS) and lipase (LPS) activities of serum, and pathologic alterations of the pancreas were examined at 24 hours after trauma. We especially observed these changes and the variation of proliferation index in the rats impacted with 400 kPa pressures after 6 hours, 24 hours, 72 hours, and 7 days. Results Pancreatic edema, hemorrhage, cell necrosis, and vacuolization were found accompanied with marked increase in serum AMS and LPS. Severity of pancreatic histologic injury was associated with the impact pressure level and varied over time in the 400-kPa group. Applying 400 kPa impact pressure could be able to provide ideal research samples. Pancreatic trauma also induced compensatory proliferation of pancreatic cells. Conclusion A practical animal model of isolated pancreatic blunt trauma could be established under 400 kPa pressures. It is ideal for further pathologic and therapeutic study. The combined determination of serum AMS and LPS, particularly the dynamic variation of these enzymes, might assist the diagnosis and prognosis of pancreatic trauma. Further research should focus on the promotion of the cellular regenerative response.

Objective to investigate the protective effects of Ligustrazine preconditioning against hepatic ischemia/reperfusion injury (IRI) in rats.Fifty male Wistar rats were randomly allocated into 3 groups: sham operation group, in which animals underwent laparotomy, experimental group and control group in which were treated with 70% IRI of the liver, especially, the animals in experimental group was given intraperitoneal injection of 2 mL Ligustrazine per day for 3 days before operation. After the operation, liver tissues were harvested at 1 h, 6 h, 24 h and 72 h for the study of histomorphological change, the respiratory control ratio (RCR) and phosphorus: oxygen ratio (P/O) of hepatocytes mitochondria, and the contents of adenosine triphosphate (ATP) of liver tissue.(1) The damage hepatic tissue in experimental group was slighter than that in control group at each corresponding time-point after operation. (2) The RCR and P/O ratio at each corresponding time-point were higher in experimental group than those in control group (P0.05), and all of the two groups recovered after 72 h. (3) The ATP concentration in experimental group also was higher than that in control group at each corresponding time-point, and recovered faster than control group.The current results show that Ligustrazine preconditioning may improve energy metabolism of rat liver in ischemia reperfusion injury.

To study the effect of pre-storing glycogen on warm ischemia reperfusion injury in rat liver.Lewis rats were divided into sham operation group (S group), low-glycogen group (L group, fasted 24 h), normal-glycogen group (N group, standard laboratory diet), high-glycogen group (H group, standard laboratory diet plus intravenous injection of 50% glucose solution 1 mL every 6 h x 4 times). Seventy percent portal ligation was performed on all of the rats for 30 min except for those in the S group. Ten rats from each group were sacrificed for harvest of serum and tissue samples 1 h, 4 h, 12 h and 24 h after reperfusion, respectively. The hepatic function was measured and the morphological changes of the livers were examined. Bcl-2, a well known antiapoptotic factor, was also detected using quantitative polymerase chain reaction.The rats with higher glucose presented higher glycogen in hepatocytes, better hepatic function, lower levels of ALT, AST and apoptosis index (AI), and higher 1 week survival rate. These rats also showed slighter histological damage and lower apoptotic index than the rats in the other groups. Furthermore, the morphological changes of the liver tissues of the rats with higher glucose were mild. The Bcl-2 mRNA expression was the strongest.Pre-storing glycogen might protect liver impairment caused by ischemia reperfusion injury, perhaps through enhancing the Bcl-2 expression and preventing the hepatic cells from apoptosis.

AIM: To propose a new classification system for sphincter of Oddi dysfunction (SOD) based on clinical data of patients. METHODS: The clinical data of 305 SOD patients documented over the past decade at our center were analyzed retrospectively, and typical cases were reported. RESULTS: The new classification with two more types (double-duct, biliary-pancreatic reflux) were set up on the basis of the Milwaukee criteria. There were 229 cases of biliary-type SOD, including 192 (83.8%) cases cured endoscopically, and 29 (12.7%) cured by open abdominal surgery, and the remaining 8 (3.5%) cases observed with unstable outcomes. Eight (50%) patients with pancreatic-type SOD were cured by endoscopic treatment, and the remaining 8 patients were cured after open abdominal surgery. There were 19 cases of double-duct-type SOD, which consisted of 7 (36.8%) patients who were cured endoscopically and 12 (63.2%) who were cured surgically. A total of 41 cases were diagnosed as biliary-pancreatic reflux-type SOD. Twenty (48.8%) of them were treated endoscopically, 16 (39.0%) were treated by open abdominal surgery, and 5 (12.2%) were under observation. CONCLUSION: The newly proposed SOD classification system introduced in this study better explains the clinical symptoms of SOD from the anatomical perspective and can guide clinical treatment of this disease. (C) 2011 Baishideng. All rights reserved.

To explore the clinical significance of toll-like receptor 4 expression on the surface of peripheral blood mononuclear cells (PBMC) in uremic patients and observe the effect of ultrapure dialysate on the PBMC expression of TLR4 in these patients.Eighty patients on maintenance dialysis were randomly divided into two groups: conventional dialysate group (CD, n=40), ultrapure dialysate group (UPD, n=40) and 40 uremic patients without dialysis in NHD group. The blood cells from all patients and 40 healthy controls were stained with FITC labeling anti-TLR4 monoclonal antibodies. Samples were collected and analyzed by flow cytometry.The expression of TLR4 was significantly lower in CD group (18.1±3.7) than in NHD group (24.5±4.6, P0.05) and healthy control group (31.6±5.8, P0.01). And marked difference existed between CD group (18.1±3.7) and UPD group (23.1±3.2, P0.05) at Month 6 post-dialysis. In CD group the expression of TLR4 became significantly smaller as the duration of dialysis increased (P0.05) while in UPD group although the expression of TLR4 became smaller as the duration of dialysis became longer. But the difference was not statistically significant (P0.05).The PBMC expression of TLR4 becomes down-regulated in uremic patients with or without dialysis and its expression is smaller in conventional dialysate group than in ultrapure dialysate group. The conventional dialysate may suppress the expression of TLR4 while the phenomenon is absent in ultrapure dialysate group.

This study examined the levels of interleukin (IL)-1β, IL-6, IL-8 and tumor necrosis factor alpha (TNF-α) in peripheral blood of premature infants with chronic lung disease (CLD) in order to investigate the possible role of immunologic factors in CLD.Twenty-six premature infants who had been admitted to the neonatal intensive care unit for 28 days were classified into CLD (n=14) and non-CLD (control, n=12) groups. IL-1β, IL-6, IL-8 and TNF-α concentrations in peripheral blood were measured by multiplex technique (Bio-plex).There were no significant differences in peripheral blood levels of IL-1β, IL-6, IL-8 and TNF-α between the two groups.There are no significant changes in peripheral blood levels of IL-1β, IL-6, IL-8 and TNF-α in premature infants with CLD on the non-acute phase. Immunologic factors might not play a key role in CLD on the phase.

To establish nude mice models with the liver metastases of colonic adenocarcinoma and study the effects of Geranium sibirum extracts on them.Nude mice liver metastases model of colonic cancer was established with human colonic cancer cells line( Ls 174t) inoculated into mice spleen. 36 nude mice were randomly divided into 3 groups, containing control group, Geranium sibirum extracts group and hydroxycamptothecine group. The weight and size of the mice and growth of the carcinoma were recorded. All specimens were examined histologically. pS2 in blood in nude mice with liver metastasis of colonic carcinoma was detected with nested RT-PCR.The incidence of liver metastasis was 100% in this intrasplenic injection model. The pathological results showed that tumour cells of liver metastases were poorly differentiated human colonic adenocarcinoma. In Geranium sibirum extracts group, the tumor number and the weight of liver metastases were significantly lower than those in hydroxycamptothecine group (P0.05). Using semiquantitative examination,in Geranium sibirum extracts group,the relative value of pS2 expression in blood was significantly higher than that in hydroxycamptothecine group (P0.05).Geranium sibirum extracts can effectively inhibit the occurrence of liver metastases carcinoma and decrease the positive expression of pS2, it also has better effect than hydroxycamptothecine so that Geranium sibirum extracts may become the potential therapeutic strategy for liver metatstases of colonic cancer.

To investigate if higher hepatocellular glycogen contents can alleviate hepatic ischemia reperfusion injury and its relationship to ICAM-1 gene expression in hepatic sinusoidal cells (HSCs).Twenty-one rabbits fed with a standard diet were randomly divided into three groups (n=7 in each). All the animals were subjected to hepatic ischemia reperfusion injury then sacrificed. Before the injury, group A rabbits fasted for 24 hours; group C rabbits had 6 intravenous glucose solution (25%, 20 ml) injections, 4 hours between two injections. Hepatic enzymological changes, hepatic ICAM-1 mRNA expressions and leukocytic counts in the sinusoids were observed.The liver glycogen contents of the three groups were significantly different. Livers of group A had higher contents of glycogen (9.85+/-0.91 mg/g. wet tissue); in group B they were 38.93+/-5.72; and in group C they were 48.31+/-6.58. Group C animals had the slightest liver function damage. There were no differences in the pre- and post-ischemic ICAM-1 mRNA contents in the three groups. However, livers with a higher content of glycogen showed less expression of ICAM-1 mRNA (group A: 1.398+/-0.365 ng/mg wet tissue; group B: 0.852+/-0.297; group C: 0.366+/-0.183) and lower leukocytic counts. The relationship analysis showed a negative relationship between hepatocellular glycogen and hepatic ICAM-1 mRNA contents (r= -0.965, P less than 0.01).Hepatocellular glycogen is important in protecting liver ischemic reperfusion injury. Also hepatocellular glycogen decreases the expression of ICAM-1 mRNA of HSCs.

Background: In this study, we focused on whether volume overload plays a role in the development of arterial stiffness. Methods: Seventy-three prevalent hemodialysis patients were enrolled in a cross-sectional study. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (PWV), and volume overload was assessed by bioimpedance analysis. Results: Patients were divided into a high PWV group and a low PWV group based on the median of PWV. Age, systolic blood pressure, pulse pressure (PP), extracellular water/total body water ratio (ECW/TBW), diabetic status (all p < 0.01), and history of cardiac events (p < 0.05) were significantly higher in the high PWV group (n = 37) than in the low PWV group. In the correlation analysis, PWV was positively associated with PP, systolic blood pressure, ECW/TBW, age, history of cardiac events, and diabetes (all p < 0.01). Multiple regression analysis showed that PWV was independently related to PP and ECW/TBW (p < 0.01). Conclusion: Volume overload plays an important role in the development of arterial stiffness in hemodialysis patients.

The aim of this study was to validate whether differences in aortic stiffness are responsible for the differences in cardiovascular mortality among hypertension subtypes. Twenty hundred and fifty continuous ambulatory peritoneal dialysis patients were included in the present study. They were classified into four groups: normotensives (n=92) with systolic blood pressure (SBP)

While cardiovascular disease accounts for 40-50% of the mortality in dialysis patients, and while a high peritoneal transport in continuous ambulatory peritoneal dialysis (CAPD) is an independent predictor of outcome, it is unclear if there are any links. Aortic stiffness has become established as a cardiovascular risk factor. We thus studied pulse wave velocity (PWV) in CAPD patients to explore the possible link between peritoneal small solute transport and aortic stiffness. CAPD patients (n = 76, 27 M/49 F) in our center were included in the present study. Aortic stiffness was assessed by brachial pulse pressure (PP) and carotid-femoral PWV. Patients' peritoneal small solute transport rate was assessed by D/P(cr) at 4 h. Extracellular water over total body water (E/T ratio) was assessed by means of bioimpedance analysis. C-reactive protein was also measured. Carotid-femoral PWV was positively associated with patients' age (r = 0.555; P < 0.01), time on peritoneal dialysis (r = 0.332; P < 0.01), diabetic status (r = 0.319; P < 0.01), D/P(cr) (r = 0.241; P < 0.05), PP (r = 0.475; P < 0.01), and E/T (r = 0.606; P < 0.01). In a multivariate regression analysis, carotid-femoral PWV was independently determined by E/T (P < 0.01), PP (P < 0.01), age (P < 0.01), and D/P(cr) (P < 0.05). D/P(cr), in addition to E/T, age, and PP, was an independent predictor of elevated carotid-femoral PWV in CAPD patients, suggesting that there might be a link between high aortic stiffness and increased peritoneal small solute transport rate.

To observe the influences of Jianwei Yuyang (JWYY) granules on expressions of PS2 and platelet activating factor (PAF), and analyze its potential mechanism.76 gastric ulcer patients were final diagnosed by gastroscope. They were randomly devided into 3 groups, including JWYY group (36 cases), Ranitidine group (36 cases) and Normal group (12 cases). Detection on Biospy Specimens of gastric mucosa to obseve the change of PAF, PS2 and the contents of aninohexose and phosphatide in ulcerated gastric mucosa for Immunohischemical and Western blotting.The contents of aninohexose, phosphatide of PU patients increased in JWYY group. There was significant difference between JWYY group and Ranitidine group (P0.01). The Immunohischemical and Western blotting methods showed that there was a linear correlation between the the contents of phosphatide, anino-hexose and the expression of PAF, PS2 in PU patients (P0.01).JWYY granule can prevent the occurrence and relaps of ulcer and affect the hydrophobicity of gastic mucosa and strengthen the stability of myxo-gellayer by reducing the expression of PAF, elevating the expression of PS2 and effecting the contents of phosphatide and aninohexose, that may be one of the mechanisms of JWYY to heal ulcer quickly.

Although the augmentation index (AIx) is widely used to evaluate arterial stiffness in clinics and research, some conflicting data exist in regard to its validity. We therefore performed a series of studies to test the validity of AIx. The first study in 196 peritoneal dialysis patients showed that AIx in diabetics was lower than that in non-diabetic patients (p0.05), which was in contradiction with the previous studies. Further analysis showed that AIx was just weakly correlated with pulse pressure (PP)-a known index of arterial stiffness. We also found that the increase of augmentation pressure (AP) was usually accompanied with increased central PP (C-PP). As AP and C-PP are used as the numerator and denominator in the AIx formula, an increase in the numerator (AP) would not necessarily result in an increase of the quotient (AIx) unless the denominator (C-PP) was stable. We then conducted a second study trying to test the validity of AIx through mathematical ratiocination. The increases in the central second peak (P2) and AP were assumed to represent increased arterial stiffness. Different values of AIx were obtained by varying the central initial systolic peak (P1) and diastolic pressure (DP). Mathematical ratiocination showed that AIx was dependent on multiple factors, F=(DeltaSP-DeltaDP)x(P1-P2)+(DeltaP2-DeltaP1)x(SP-DP), which suggested that a change of AIx would not always be attributable to changes in P2 and AP. This speculation was further proved by clinical data in our third study. In conclusion, through a series of studies and ratiocination, we showed that the augmentation index (AIx or AIx@75bpm) might not be a sensitive surrogate for a change in central pressure waveforms, which is a manifestation of change in large artery function. The limitation of AIx as an index of arterial stiffness is rooted in its formula, which has a clear mathematical flaw.

Background: Malnutrition is a predictor of cardiovascular disease in dialysis patients, but the mechanisms remain unknown. We investigated links between nutritional markers and arterial stiffness in continuous ambulatory peritoneal dialysis patients. Methods: We evaluated the relationship between arterial stiffness evaluated by pulse-wave velocity (PWV) and four estimates of nutritional status (serum albumin, handgrip strength [HGS], subjective global assessment [SGA], and bioelectrical impedance analysis phase angle [PA]) in 124 PD patients. Results: Malnourished patients exhibited a significantly higher PWV than those classified as well-nourished by SGA (p < 0.05). Furthermore, PWV correlated negatively with albumin, HGS and PA (p < 0.001, respectively). PWV was also correlated with age, systolic blood pressure, and C-reactive protein. In multivariate regression analysis, albumin, HGS, SGA and PA were each independently associated with PWV after adjustment. Conclusions: The significant association between each nutritional marker and PWV in PD patients was independent of inflammation and diabetic state, suggesting that malnutrition may contribute to vascular dysfunction.

To explore the necessity, advantages and disadvantages of reducing the Icterus Index before operation in carcinoma of the head of pancreas.A total of 183 patients with serum total bilirubin (TB) level higher than 220 micromol/L were randomized into 2 groups: jaundice-reducing group (92 patients) and non-reducing group (91 patients). In jaundice-reducing group, all the patients were performed ultrasound-guided percutaneous transhepatic bile duct drainage (UPTBD) and endoscopic nasobiliary drainage (ENBD). The jaundice-reducing group was operated on 3 weeks after tube placement. In non-reducing group, all the patients underwent operations only after general pre-operation routine preparation within 5 days after admission. The operation and post-operation recovery in the two groups was investigated and compared.In jaundice-reducing group, the level of TB decreased to 120 micromol/L from 279 micromol/L in 89 patients after biliary drainage. Of the 89 patients, pancreatoduodenectomy was successfully performed in 39 (43.8%), 47 (52.8%) underwent simple internal drainage and the other 3 were just explored. The average blood loss was 250 ml (110 - 980 ml), complications were found in 8 patients (9.0%) and one died. In non-reducing group, pancreatoduodenectomy was successfully performed in 24 (26.4%), simple internal drainage in 58 patients (63.7%) and exploration in 9 (9.9%). The average blood loss was 480 ml (320 - 1750 ml), complications were found in 19 patients (20.9%) and 4 died. In the non-reducing group, the patients with complications were older than those without complications, and the TB level was higher. The excision rate of carcinoma, incidence rate of complications and hospital time in patients whose TB decreased over 30% weekly after reducing the Icterus Index were all better than those of the rest.It is necessary to reduce the Icterus Index before operation in the patients with carcinoma of head of pancreas complicated with serious jaundice, especially for the elder, which can not only reduce the blood loss but also make operations safer and increase cure rate, in addition. And whether the Icterus Index decreases smoothly with biliary drainage can be used to predict the operational risk, effect and prognosis.

Aims Although we previously demonstrated abdominal paracentesis drainage (APD) preceding percutaneous catheter drainage (PCD) as the central step for treating patients with moderately severe (MSAP) or severe acute pancreatitis (SAP), the predictors leading to PCD after APD have not been studied. Methods Consecutive patients with MSAP or SAP were recruited between June 2011 and June 2013. As a step-up approach, all patients initially received medical management, later underwent ultrasound-guided APD before PCD, if necessary, followed by endoscopic necrosectomy through the path formed by PCD. APD primarily targeted fluid in the abdominal or pelvic cavities, whereas PCD aimed at (peri)pancreatic fluid. Results Of the 92 enrolled patients, 40 were managed with APD alone and 52 received PCD after APD (14 required necrosectomy after initial PCD). The overall mortality was 6.5%. Univariate analysis showed that among the 20 selected parameters, 13 factors significantly affected PCD intervention after APD. Multivariate analysis revealed that infected (peri)pancreatic collections (P = -0.001), maximum extent of necrosis of more than 30% of the pancreas (P = -0.024), size of the largest necrotic peri(pancreatic) collection (P = -0.007), and reduction of (peri)pancreatic fluid collections by

To establish a genetic diagnosis method for a novel MSH2 mutation.A specific primer on the mutated site of MSH2 was synthesized and PCR was conducted using the specific primer and another downstream primer. PCR products were electrophoresed and then the carriers with the novel gene mutation of the carriers or non-carriers were identified.MSH2 in a hereditary nonpolyposis colorectal cancer family were successfully found.The method is effective and simple for genetic diagnosis of the novel mutation in MSH2.

To investigate the significance of protein kinase C(PKC), P44/42 mitogen-activated protein kinase (MAPKs) and heat shock protein (HSP)70 signal transduction during hepatocyte ischemic preconditioning.In this study we used an in vitro ischemic preconditioning (IP) model for hepatocytes and an in vivo model for rat liver to investigate the significance of protein kinase C (PKC), P44/42 mitogen-activated protein kinase (P44/42 MAPKs) and heat shock protein 70 (HSP70) signal transduction in IP. Through a normal liver cell hypoxic preconditioning (HP) model in which cultured normal liver cells were subjected to 3 cycles of 5 min of incubation under hypoxic conditions followed by 5 min of reoxygenation and subsequently exposed to hypoxia and reoxygenation for 6 h and 9 h respectively. PKC inhibitor, activator and MEK inhibitor were utilized to analyze the phosphorylation of PKC, the expression of P44/42 MAPKs and HSP70. Viability and cellular ultrastructure were also observed. By using rat liver as an in vivo model of liver preconditioning (3 cycles of 10-min occlusion and 10-min reperfusion), in vivo phosphorylation of PKC and P44/42MAPKs, HSP70 expression were further analyzed. AST/ALT concentration, cellular structure and ultrastructure were also observed. All the data were statistically analyzed.Similar results were obtained in both in vivo and in vitro IP models. Compared with the control without IP (or HP), the phosphorylation of PKC and P44/42 MAPKs and the expression of HSP70 were obviously increased in IP (or HP) treated model in which cytoprotection could be found. The effects of preconditioning were mimicked by stimulating PKC with 4beta phorobol-12-myristate13-acetate (PMA). Conversely, inhibiting PKC with chelerythrine abolished the protection given by preconditioning. PD98059, inhibitor of MEK (the upstream kinase of P44/42MAPKs), also reverted the cytoprotection exerted by preconditioning.The results demonstrate that preconditioning induces a rapid activation of P44/42MAPKs and PKC activation plays a pivotal role in the activation of P44/42 MAPKs pathway that participates in the preservation of liver cells. HSP expression is regulated by signals in PKC dependent P44/42 MAPKs pathway.

To determine the difference in gene expression between human multiple myeloma (MM) and normal bone marrow.cDNA chip was used to detect the mRNA of mononuclear cell from 10 untreated MM patients and 10 cases of normal bone marrow.Of the 2,048 genes, we found 566 different expression genes, of which the expression of 237 genes was higher and 329 lower in MM than in the normal bone marrow.Many genes may be involved in the pathogenesis of MM. cDNA chip technology is an effective tool in the study of tumor related genes.

To investigate the bacteriostasis of iodoform in vivo and in vitro.Bacteriostasis of iodoform and economycin against different species of bacteria was observed in vitro and the curves of bacteriostasis were obtained for each agent. In rabbit models traumatic liver injury complicated by infection of the wounds with Staphylococcus aureus, Escherichia coli and Pseudomonas aerudomonas, common bandage supplemented respectively with 6% iodoform, 10% iodoform, economycin ointment, and saline were applied for wound addressing and the changes in the number of bacterium in the wounds was measured 1, 3, and 7 days later, respectively.Iodoform showed better bacteriostatic effect than economycin in inhibiting the growth of the majority of the aerobic bacteria in vitro, and its action on anaerobic bacteria appeared similar to the effect of economycin. In rabbit models, iodoform at the concentration of 10% showed significantly better bacteriostatic effect against the 3 species of bacteria than economycin (P0.01).Iodoform possesses more potent bacteriostatic effect than economycin against most bacteria.

To study the mechanism of hepatocellular glycogen in alleviation of liver ischemia-reperfusion injury during hepatic vascular occlusion for partial hepatectomy.Seventeen patients were randomly divided into experimental group (n=9) and control group (n=8). In the experimental group, patients were given high concentration glucose intravenously during 24 hours before operation. The hepatic lesion was resected after portal triad clamping in the two groups. Non-cancer liver tissue was biopsied to measure hepatic tissue ATP content and change of malondialdehyde (MDA) and superoxide dismutase (SOD). Liver function of all patients was assessed before operation and the first and fifth day after operation.Hepatic tissue ATP content of the experimental group was significantly higher than that of the control group both at the end of hepatic vascular occlusion and the point of one-hour reperfusion. Besides, liver function of the experimental group was significantly better than that of the control group the first and fifth day after operation. There was significant difference in SOD activity or MDA content between the two groups at the end of hepatic vascular occlusion and at the point of one-hour reperfusion.Abundant intracellular glycogen may reduce liver ischemia-reperfusion injury caused by hepatic vascular occlusion. It is beneficial to give a large amount of glucose before a complex liver operation, in which temporary occlusion of hepatic blood flow is necessary.