【Abstract】Objective To investigate the protective effect of improving the pancreatic ischemia and calcium channel blockers on preventing the progression of acute pancreatitis. Methods Twenty-four patients with mild acute pancreatitis were randomly divided into two groups： control group and treated group. Within the first 72 hours from the onset of AP, routine conservative managements were performed in control group, improving the pancreatic ischemia and preventing Ca2+ overload were performed in treated group for two weeks. The hemorrheological parameters were measured at 1,4,7,14 days after adimission, simultanously, serum TNFα, IL-1β, C-reactive protein and plasma TXB2, 6-keto-PGF1α levels were determined with ELISA methods. Results The hemorrheological changes were improved in treated group, serum TNFα, IL-1β, C-reactive protein and plasma TXB2, 6-keto-PGF1α levels were significantly decreased each time point in treated group as compared with control group. Conclusion Improving the pancreatic ischemia and calcium channel blockers have protective effect through reducing the generation of cytokines and inflammatory mediators on preventing the progression of acute pancreatitis.
The present paper is aimed to investigate the effect of basic fibroblast growth factor (bFGF) on proliferation, migration and differentiation of endogenous neural stem cell in rat cerebral cortex with global brain ischemia-reperfusion. A global brain ischemia-reperfusion model was established. Immunohistochemistry was used to observe the pathological changes and the expression of BrdU and Nestin in cerebral cortex. RT-PCR was used to measure the NSE mRNA in brain tissue. The results of measurements indicated that in sham operation group, there was no positive cell in cerebral cortex, and the content of NSE mRNA did not change. In the operation group, the expression of BrdU and Nestin increased significantly at the end of the 3rd day, and peaked on the 7th day. NSE mRNA expression did not significantly increase. In bFGF group, compared with sham operation group and model group, the number of BrdU-positive and Nestin-positive cells increased significantly at each time point (P<0.05), and peaked at the end of the 11th day, and the content of NSE mRNA increased significantly (P<0.05). This research demonstrated that the proliferation of endogenous neural stem cells in situ could be induced by global cerebral ischemia and reperfusion, and could be promoted and extended by bFGF. In additiion, bFGF might promote endogenous neural stem cells differentiated into neurons.
Local hypothermia as a preventive method to reperfusion injury of skeletal muscles was studied. Sixteen Japanese rabbits were divided into four groups at random. Before the tourniquet was inflated, a cold gel pack was applied to the right hind leg of each rabbit for 15 minutes to produce local hypothermic condition, without application of tourniquet the left hind limb was under local hypothermic condition as a control. The duration of tourniquet ischemia was 4 hours, and then reperfusion for one and two hours in the A and B groups respectively; in the C and D groups the duration of ischemia was 5 hours, and reperfusion for one and two hours, respectively. The muscle temperature averaged 16.6 degrees C with a needle thermocouple in the hind limb under local hypothermia. The serum K+, LA, SOD, LPO were determined from bilateral femoral veins, and electron and light microscopic studies of sural muscles were done in the post-reperfusion period. It was found that the K+, LA, LPO were lower than that of the control groups (P lt; 0.01), but SOD was higher than that of the control group (P lt; 0.01). Electron and light microscopic studies showed sight but reversible damage of muscular structure with the possibility of in the hypothermic groups cell regeneration. Basing on this experimental results, this method was applied in 45 cases reparative and reconstructive surgery of limbs. The duration of application of tourniquet averaged 2 hours and 57 minutes, the longest being 4 hours and 31 minutes, when the muscle temperature had reduced to 22.4 degrees C. There were no postoperative complications associated with this technique. Local hypothermia appeared to be a safe and effective method of decreasing the reperfusion damage after ischemia.
Objective To investigate the effect of mesenteric lymphatic duct liagtion and glutamine enteral nutrition on intestine and distant organs in intestinal ischemia/reperfusion injury. Methods Forty male SD rats undergoing gastrostomy were randomly assigned into 5 groups (n=8): sham operation group, normal enteral nutrition group, normal enteral nutrition+lymphatic duct ligation group, glutamine group and glutamine+lymphatic duct ligation group. Sham operation group only received laparotomy after 7 days of full diet, the other four groups were subjected to 60 min of intestinal ischemia after 7 days of enteral nutrition, and the two lymphatic duct ligation groups were plus mesenteric lymphatic duct ligation. The original nutrition continued 3 days after reperfusion. Intestinal permeability was detected on day 1 before reperfusion, day 1 and 3 after reperfusion. Intestinal morphology was observed, endotoxin, D-lactate and diamine oxidase levels in serum, and apoptotic index in lung tissue were detected on day 3 after reperfusion. Results The intestinal permeability in each group was significantly increased on day 1 after reperfusion (Plt;0.05), and which in normal enteral nutrition+lymphatic duct ligation group and glutamine+lymphatic duct ligation group were significantly decreased on day 3 after reperfusion (Plt;0.05). The mucosal thickness and villus height of ileum and mucosal thickness of jejunium in glutamine+lymphatic duct ligation group were significantly higher than those in other groups (Plt;0.05), and villus height of ileum in glutamine group was higher than that in normal enteral nutrition group (Plt;0.05); those morphology indexes in normal enteral nutrition+lymphatic duct ligation group were higher than those in normal enteral nutrition group, but there was no statistical signification (Pgt;0.05). Apoptosis index of lung tissue in lymphatic duct ligation groups was significant lower than that in no-ligation groups (Plt;0.05). Levels of endotoxin, D-lactate, and diamine oxidase in lymphatic duct ligation groups had downward trends compared with no-ligation groups, but there was no statistical signification (Pgt;0.05). Conclusions Intestinal ischemia/reperfusion injury of rats can cause intestinal permeability increase, bacterial endotoxin translocation and systemic inflammatory response. Mesenteric lymphatic duct ligation and glutamine enteral nutrition intervention can weak lung tissue damage, increase thickness of intestinal mucosa, maintain intestinal barrier function, reduce endotoxin translocation and attenuate systemic inflammatory response. Enteral nutrition with glutamine was better than normal enteral nutrition.
Diabetic macular ischemia (DMI) is one of the manifestation of diabetic retinopathy (DR). It could be associated with diabetic macular edema (DME), which may affect the vision of DR patients. FFA is the gold standard for the diagnosis of DMI, but with the advent of OCT angiography, a more convenient and diversified method for the evaluation of DMI has been developed, which makes more and more researchers start to study DMI. Intravitreal injection of anti-VEGF has become the preferred treatment for DME. When treating with DME patients, ophthalmologists usually avoid DMI patients. But if intravitreal anti-VEGF should be the contradiction of DME is still unclear. To provide references to the research, this article summarized the risk factors, assessment methods and influence of DMI. This article also analyzed the existing studies, aiming to offer evidences to a more reasonable and effective treatment decision for DME individual.
This study aims to investigate the effect of lung ischemia reperfusion injury (LIRI) on expression of transient receptor potential vanilloid 1 (TRPV1) in the lung and brainstem of rats. Sixteen adult male Sprague Dawley rats weighing 250-320 g were randomly divided into Sham group and ischemia reperfusion group (IR group). Before ischemia, 0.5 hour and 4 hours after the reperfusion, respectively, arterial partial pressure of oxygen (PaO2) and arterial-alveolar oxygen pressure gradient (A-aDO2) were recorded and calculated, respectively. Left lung tissues and the brainstems were obtained at the end of the experiment. Lung tissue malondialdehyde (MDA), myeloperoxidase (MPO) activities, calcitonin gene related peptide (CGRP) and substance P (SP) levels were assessed. The mRNA and protein expressions of TRPV1 in the lung and brainstem were measured by qRT-PCR and Western blot. Compared with in the Sham group, rats in the IR group had a poorer blood gas exchange (P<0.05) and the MPO activity and MDA level of lung tissues in the IR group were significantly higher than those in the Sham group (P<0.05). CGRP level in the IR group increased remarkably (P<0.05), while SP level did not differ statistically between the two groups (P>0.05). The mRNA and protein expressions of TRPV1 in the lung tissue were upregulated in the IR group (P<0.05), but there were no differences of those in the brainstem between the two groups (P>0.05). The results suggest that LIRI could upregulate the expressions of TRPV1 and evoke CGRP release in the lung.
Gastrointestinal complications after cardiac surgery are rare, but they are associated with significant morbidity and mortality. The mechanisms of gastrointestinal complications after cardiac surgery may be unique, as the abdominal cavity is not involved. This review summarizes the current evidence of the pathophysiology, clinical manifestations, risk factors, and management of gastrointestinal complications after cardiac surgery, aiming to improve the recognition of gastrointestinal complications after cardiac surgery.
Objective To observe the influence of resveratrol on superoxide dismutase (SOD), malondialdehyde (MDA), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) of intestinal mucosal ischemia-reperfusion injury protection in rats with severe acute pancreatitis (SAP). Methods Fifty-four rats were divided into three groups randomly: sham operation group (SO group), SAP model group (SAP group) and resveratrol-treated group (Res group). SAP model was made by injecting sodium taurocholate 50 mg/kg to pancreatic bile duct and resveratrol was given intravenously at 5 min after inducing SAP model. The rats were sacrificed at 3 h, 6 h and 12 h after inducing SAP model respectively by equal number. The levels of MDA, SOD, ICAM-1 and VCAM-1 and histological changes of small intestine were measured. Results The level of MDA in small intestine tissue in SAP group was significantly higher than that in SO group (P＜0.05), while the activity of SOD was significantly lower in the relevant tissues (P＜0.05). The expressions of ICAM-1 and VCAM-1 in SAP group were higher than those of SO group (P＜0.05). The activity of SOD in small intestine tissue in Res group was significantly higher than that in SAP group (P＜0.05); while the level of MDA was significantly lower in the relevant tissues (P＜0.05). The expressions of ICAM-1 and VCAM-1 in Res group were lower than those of SAP group (P＜0.05). Conclusions Oxygen free radicals are concerned with the process of pathological changes in intestinal mucosal ischemia-reperfusion in rats with SAP. Resveratrol might increase SOD activity and decrease MDA level to attenuate lipid peroxidation in small intestine of SAP, and reduce the expressions of ICAM-1 and VCAM-1 in intestine, thus diminish the damage of the intestine in SAP. And it acts as a protective effect to small intestinal ischemia-reperfusion injury.
Objective To investigate the etiology, diagnosis, revascularization of upper l imb ischemia and the compl ications. Methods From March 2003 to February 2008, 72 cases of upper l imb ischemia were treated. There were 44males and 28 females, aged 19-90 years old (median 63 years old). The duration of the disease was 1 hour to 2 years. All cases had symptoms of l imb ischemia such as paleness, coldness, paralysis. According to individual condition, 72 patients accepted revascularizations including thromboembolectomy, reconstruction after traumatic injuries, pseudoaneurysm excision and angioplasty, balloon dilatation and stent implant, arterial repair, patch, vascular prosthesis or vein bypass/transplantation, and l igation or coarctation of fistula. Results Sixty patients (83.3%) recovered well after operation. Re-occlusion following thromboemboletomy was found in 6 patients (8.3%). And there were 4 patients (5.6%) with l imbs disturbance and muscles contracture and 2 patients (2.8%) with compartment syndrome in this series. The affected l imb had to be amputated in 2 patients (2.8%). And 1 patient (1.4%) died of cerebral hemorrhage because of anticoagulation 3 days after operation. All patients were followed up 1-6 years (mean 52 months) after operation. Four patients recurred and got improved after retreatments. The others got a good result with normal skin color and temperature, restoration of the radial and ulnar pulses, normal saturation of blood oxygen of finger ti p (gt; 90%) and patent blood flow of affected arteries was shown by color Doppler ultrasound. Conclusion The study indicates that identifying the etiology of upper l imb ischemia before operation and active revascularizations consistent with different causes are the key to treat the upper l imb ischemia.
Objective To evaluate the effects of Shengji Yuhong collagen on promoting angiogenesis of the ischemia tissues and probe the possible mechanisms. Methods Forty-eight Wistar rats were divided by random method of paired into blank group， control group （collagen），and experimental group （Shengjiyuhong collagen）. After made the rats hind limb ischemia model， collagens with or without the extracts of Shengji Yuhong Gao were randomly paired implanted locally in hind limb ischemia tissues of rats in experimental group or control group. The samples of collagens and tissues about 0.5 cm large surrounding the collagen were explanted respectively on day 3，7， 14， and 28 for detected the hemog-lobin contents in colagen， microvascular counting by using CD34 immunohistochemical markers， and the expressions of HIF-1α mRNA and VEGF mRNA by using real-time fluorescent quantitative RT-PCR. The blood perfusion of the ischemic tissues at each time were determined by using laser speckle imaging system of Moor-FLPI. Results The results of Moor-FLPI showed that the obvious ischemia condition after model made， the blood perfusion was significantly lower than that before operation （P＜0.01）. On day 3 after operation it showed obvious congestion in the ischemic tissues， and from day 7 to day 14， it showed the ischemia state locally till day 28 after operation which showed improved situation of ischemic. Except for the day 3， the blood perfusion of experimental group were higher than those of blank group （P＜0.05）. There was no statistical significance between the blank group and control group （P＞0.05）. The blood perfusion on day 7 and day 14 after operation of experimental group were higher than those of control group （P＜0.05）. The hemoglobin contentsof each time point in the experimental group were higher than those in the control group （P＜0.01）. The microvascular counting on day 7 and day 14 in experimental group were higher than those of control group （P＜0.05）. The expressions of HIF-1α mRNA and VEGF mRNA at each time point of experimental group were higher than those of control group and blank group （P＜0.05）， and there was no significant differences between the control group and blank group （P＞0.05）. Conclusion The effects on promoting angiogenesis of rat hind limb ischemia tissues with Shengji Yuhong collagen may though inducing the expressions of HIF-1 α mRNA and VEGF mRNA locally.