rough the ultramicroscopic observation on muscle and microcirculation, Group A,where a largeamount of DXM combined with heporin was given svstematically and locally into the femoral artery of the severed limb before replantation, and in Group B only heporin was given, and Group C and D ascontrol.The results showed that if the hormone and heparin were administred in large dosage, it wasadvantageous to reduce the tissues from reperfusion injury during delayed replantation.
【Abstract】ObjectiveTo investigate the effect of ischemia-reperfusion (I/R) injury on apoptosis of pancreatic cells in rats with acute pancreatitis(AP). MethodsFifty-four SD rats were randomized into 3 groups: pancreatitis group (n=24), I/R-injury group (n=24) and control group (n=6). The animal model of AP was induced by retrograde injection of 3% sodium taurocholate into biliopancreatic duct in rats. Pancreatic I/R was caused by blocking the inferior splenic artery and removing the clamp after AP induction. At 1 h, 3 h, 6 h and 12 h, groups of rats were sacrificed. A terminal deoxynucleotidyl transferase-mediated dUTP-biotion nick end labeling (TUNEL) was used to detect pancreatic apoptosis, and histological changes of the pancreas were observed. ResultsPancreatic hemorrhage, necrosis were respectively observed in the pancreatitis rats at 6 h and the I/R-injury rats at 1 h. Histological changes of the pancreatitis rats at 1 h and 3 h were only congestion and edema. Apoptoic acinar cells increased after AP induction, the peak respectively appeared at 6 h in the pancreatitis rats and at 3 h in the I/R-injury rats. Compared with the pancreatitis rats, apoptosis index (AI) of the I/Rinjury rats was significantly higher at 1 h and 3 h (P<0.01, P<0.05, respectively), but lower at 6 h and 12 h (P<0.05, P<0.01, respectively). ConclusionI/R injury can induce conversion of edematous pancreatitis to hemorrhagic necrotizing pancreatitis and apoptosis of acinar cells. Apoptosis may be a beneficial response to pancreatic injury in AP.
This study aims to overcome the shortcomings such as low efficiency, high cost and difficult to carry out multi-parameter research, which limited the optimization of infusion bag configuration and manufacture technique by experiment method. We put forward a fluid cavity based finite element method, and it could be used to simulate the stress distribution and deformation process of infusion bag under external load. In this paper, numerical models of infusion bag with different sizes was built, and the fluid-solid coupling deformation process was calculated using the fluid cavity method in software ABAQUS subject to the same boundary conditions with the burst test. The peeling strength which was obtained from the peeling adhesion test was used as failure criterion. The calculated resultant force which makes the computed peeling stress reach the peeling strength was compared with experiment data, and the stress distribution was analyzed compared with the rupture process of burst test. The results showed that considering the errors caused by the difference of weak welding and eccentric load, the flow cavity based finite element method can accurately model the stress distribution and deformation process of infusion bag. It could be useful for the optimization of multi chamber infusion bag configuration and manufacture technique, leading to cost reduction and study efficiency improvement.
Objective To explore the feasibilities, methods, outcomes and indications of atlas pedicle screw system fixation and fusion for the treatment of upper cervical diseases. Methods From October 2004 to January 2006, 17 patients with upper cervical diseases were treated with atlas pedicle screw system fixation and fusion. There were 13 males and 4 females, ageing 19 to 52 years. Of 17 cases, there were 14 cases of atlantoaxial dislocation(including 3 cases of congenital odontoid disconnection,4 cases of old odontoid fracture,2 cases of new odontoid fracture(typeⅡC), 3 cases of rupture of the transverse ligament, and 2 cases of atlas fracture; 2 cases of tumor of C2; 1case of giant neurilemoma of C2,3 with instability after the resection oftumors. JOA score before operation was 8.3±3.0. Results The mean operative time and bleeding amount were 2.7 hours (2.1-3.4 hours) and 490 ml (300-750 ml) respectively. No injuries to the vertebral artery and spinal cord were observed. The medial-superior cortex of lateral mass was penetrated by 1 C1 screw approximately 3 mmwithout affecting occipito-atlantal motions. All patients were followed up 3-18 months. The clinical symptoms were improved in some extents and the screws were verified to be in a proper position, no breakage or loosening of screw and rob occurred. All patients achieved a solid bone fusion after 3-6 months. JOA score 3 months after operation was14.6±2.2. JOA improvement rates were 73%-91%(mean 82%). Conclusion The atlas pedicle screw system fixation and fusion is feasible for the treatment of upper cervical diseases and has betteroutcomes, wider indications if conducted properly.
Objective To decrease the operative difficulty, with the purpose of looking for an orthotopic liver autotransplantation model which not only materializes the liver transplantation but also possesses higher survival rate. Methods This model was established via portal vein perfusion in thirty rats, and from which the result of the liver after perfusion, the operative time and the survival rate were observed. Liver tissues were researched at 24 h after operation under the light microscope. Results This model was easy to be perfused, the operative time was (48±3.0) min and the survival rate was 96.7% (29/30). The structure of hepatic tissue was basically normal with a little hydropic degeneration under the light microscope. Few erythrocytes residual occurred in the interlobular arteries under the light microscope. Conclusion The orthotopic liver autotransplantation model via portal vein perfusion has an exclusively blockage pattern which possesses a higher survival rate. It prevents the injury of immunological rejection and purely reflects the hepatic ischemia-reperfusion. But it is better to be applied in the non-hepatic artery anastomosis or the research nothing to do with the hepatic artery because the hepatic artery does not have sufficient perfusion.
Objective To evaluate the phenomena of apoptosis and its relevant mechanism during ischemia-reperfusion period. Methods The published papers to explore the apoptotic phenomena and its mechanism in organs or tissues which experienced ischemia-reperfusion injury were reviewed. Results Apoptosis was common in ischemia-reperfusioned organ or tissue. The severity of apoptosis was influenced by many factors such as ischemia, hypoxia, oxygen free radials, intracellular free calcium ion overloading, various cytokines, et al; and also was regulated by bcl-2 family, caspase family and NF-κB,et al. Conclusion Apoptosis is a common phenomenum in ischemiareperfusioned organ or tissue which is affected and regulated by various factors.
OBJECTIVE: To observe the clinical results in the anterior stabile operation of spinal fracture using red blood salvage. METHODS: Nineteen cases with spinal fracture were performed the anterior decompress operation. Blood cell salvage were used during operation. Other 20 cases were also reviewed as control group, who were received the same operation without blood cell salvage. RESULTS: In the 19 cases, average volume of autologous transfusion was 536 ml. Only two cases had homologous transfusion requirements. In the control group, all cases needed homologous transfusion (averaged 947 ml). CONCLUSION: In the anterior decompress operation, the intraoperative blood salvage is highly effective in reducing transfusion and also improves the security of operation
Objective To elucidate the clinical features and treatment of parapneumonic effusions ( PPE) . Methods Ninety-seven patients were analyzed retrospectively in Guangzhou First Municipal People’s Hospital fromJanuary 2004 to July 2008. The data of 54 patients with complicated parapneumonic effusion ( CPPE) and 9 cases with empyema were compared with 49 patients with tuberculosis pleural effusions. Results Of 97 cases, 34 patients with uncomplicated parapneumonic effusion ( UPPE) were treated with antibiotics only, whose hospitalization time was ( 14. 8 ±7. 6) days, and 27 cases were cured ( 79. 4% ) . Of 54 CPPE patients, 42 were treated with antibiotics and pleural space drainage with central venous catheter, whose hospitalization time was ( 21. 7 ±13. 0) days, and 32 were cured ( 76. 2% ) . Another12 CPPE patients were treated with interapleural urokinase and drainage from the chest tube, whose hospitalization time was ( 22. 5 ±9. 3) days, and 8 were cured ( 66. 7% ) . Nine cases with empyema were rinsed the pleural with metronidazole solution, whose hospitalization time was ( 25. 7 ±17. 4) days, and 8 were cured( 89. 0% ) . Compared with the tuberculous pleurisy patients, most CPPE and empyema occurred in middle and old aged patients with an average age of ( 63. 3 ±19. 3) years. Polykaryocyte and lactate dehydrogenase increased significantly. Adenosine deaminase ( ADA) was lt; 45 U/L in most UPPE and empyema patients, but was gt; 45 U/L in 7 cases ( 11% ) . Conclusions UPPE is simple and preferably treated with antibiotics alone. While CPPE and empyema should be drainaged as early as possible, and the low-dose urokinase may be helpful. The level of ADA can not absolutely distinguish parapneumonic effusion from tuberculous pleural effusion.
Objective To explore changes in the height and width of the cervical intervertebral foramina of C6,7 before and after the C5,6 discetomy, the replacement or the anterior intervertebral fusion so as to provide the theoretical basis for the clinical practice. Methods Eleven fresh cervical spinal specimenswere obtained from young adult cadavers. The specimens of C5,6 were divided into the integrity group, the discectomy group, the artificial disc replacement group, and the intervertebral fusion group. The range of variety (ROV) of the C6,7 intervertebral foramen dimensions (height, width) before and after the loading tests (0.75, 1.50 Nm) were measured in the 4 groups. Results The C6,7 intervetebral foramen height and width increased significantly during flexion (Plt;0.01) but decreased significantly during extension (Plt;0.01). There was a significantdifference between the two test conditions in each of the 4 groups (Plt;0.01). However, in the two test conditions there was no significant difference in ROV of the C6,7 intervetebral foramen height and width during flexion and extension betweenthe integrity group, the discectomy, and the artificial disc replacement group(Pgt;0.05), but a significant difference in the above changes existed in the intervertebral fusion group when compared with the other 3 groups (Plt;0.05). In the same group and under the same conditions, the ROV of the C6,7 intervetebral foramen height and width was significantly different in the two test conditions (Plt;0.01). Conclusion The results have indicated thatartificial disc replacement can meet the requirements of the normal cervical vitodynamics. The adjacent inferior cervical intervetebral foramen increases during flexion but decreases during extension. The intervertebral fusion is probably one of the causes for the cervical degeneration or the accelerated degeneration and for the cervical spondylotic radiculopathy and the brachial plexus compression.
To investigate the role of platelet-activating factor (PAF), neutrophils in ischemia-reperfusion-induced liver injury and their possible mechanism, PAF and the degree of neutrophil infiltration in liver tissue and the preventive effects of PAF antagonist kadsurenone were evaluated in this study by means of a partial liver ischemia model, in which it was induced by clamping only left and median lobes of the liver without causing intestinal congestion. The present study was undertaken to find out the mechanism of liver ischemia-reperfusion injury and preventive effect of kadsurenone. The results indicate that in early stage of reperfusion liver injury possibly caused by the generation of free radicals, declined of autioxidant defence and increased Ca2+ influx, and in the later stage of reperfusion injury was mainly mediated by accumulation of PAF in the liver, which elicits the release of polymorphonuclear leukocytes induced toxical free radical, endothelial damage, microcirculatory collapse. The authors conclude that the effectiveness of antagonist kadsurenone in protecting against ischemiareperfusioninduced liver injury is due not only to their action in preventing the direct effects of PAF, but also to their ability to inhibit both PAF priming and PAF dependent feedback processes, thus preventing escalation of auto generated inflammatory damage.