Protective Effect of Citrulline on the Hearts of Rats with Sepsis Induced by Cecal Ligation and Puncture.

PURPOSE: To investigate the protective effect of citrulline (Cit) on the hearts of rats with sepsis. METHODS: Wistar rats were divided into the normal, sham-operated, CLP, Cit, and CLP+Cit groups. Routine blood tests were performed, and the blood biochemical indexes were measured. Pathological changes in the cardiac tissues were observed. The levels of NO and iNOS in blood and SOD activity and MDA levels in the heart were measured. RESULTS: Less inflammatory cell infiltration of the myocardial fibers and significantly decreased white blood cell count, absolute neutrophil count, neutrophil percentage, CK, HBDH, and NO (all P<0.05) were detected in the CLP+Cit group compared with the CLP group. In addition, SOD activity and MDA levels in heart tissues were, respectively, higher and lower in the CLP+Cit group than in the CLP group (both P<0.05). CONCLUSIONS: Cit reduces pathological damage in the heart and enhances the heart's antioxidant capacity, thereby protecting cardiomyocytes.

Pooled analysis of the comparative efficacy between tacrolimus and infliximab for ulcerative colitis.

BACKGROUND: Acute moderate-to-severe steroid-refractory ulcerative colitis (UC) has a poor prognosis and requires optimal rescue therapy. A pooled analysis was conducted to assess tacrolimus and infliximab (IFX) as rescue agents in patients with moderate-to-severe and steroid-refractory UC. METHODS: A literature search identified studies that investigated tacrolimus and IFX in moderate-to-severe steroid-refractory patients with UC. The primary outcome was short-term clinical response to treatment, including the remission and response rates. Secondary outcomes included the rates of colectomy at 3 months and adverse events rate. RESULTS: A total of 6 studies comprising 438 cases were eligible for inclusion. The pooled analysis showed that the short-term clinical response rate, clinical remission rate, and 3-month colectomy rate were 72.1%, 52.4%, and 10.1%, respectively, for those receiving tacrolimus, and 76.9%, 48.8%, and 12.4%, respectively, for those receiving IFX. No significant difference was, however, seen for tacrolimus compared with IFX with regard to clinical remission rate (odds ratio [OR] =1.08, 95% confidence interval [CI] = 0.77-1.49, P = .67), clinical response rate (OR = 0.92, 95% CI = 0.63-1.34, P = .66), and 3-month colectomy rate (OR = 0.86, 95% CI = 0.39-1.93, P = .72). More adverse events were, however, observed in the Tac group (OR = 2.16, 95% CI = 1.25-3.76, P = .006). CONCLUSIONS: Our meta-analysis suggested that both tacrolimus and IFX appeared to be effective and safe for the rescue therapy of moderate-to-severe active UC and steroid-refractory UC. Therefore, tacrolimus is another choice for these patients.

[Comparison of three fixations for treatment of intertrochanteric femoral fractures in the elderly].

OBJECTIVE: To compare the clinical effects of three internal fixations as follows:dynamic hip screw (DHS), proximal femoral nail-A (PFNA) and InterTAN, for intertrochanteric femoral fractures in elderly patients. METHODS: From February 2007 to May 2012,136 elderly patients with intertrochanteric fractures (including 71 males and 65 females, ranging in age from 60 to 88 years old with an average of 69 years old) were treated with DHS (group A, 80 cases), PFNA (group B, 36 cases) and InterTAN (group C, 20 cases). Statistical analysis were applied to compare the 3 groups in operative time, blood loss, fracture healing time, intrraoperative complications and functional outcome (Harris hip score). RESULTS: The average follow-up was 4.1 months (from 2.5 to 14 months). Compared with group A,groups B and C showed significant advantages in operative time, blood loss, fracture healing time, and intrraoperative complications, functional outcome (Harris scores) (P < 0.05). Compared with group B, group C had significant fewer intrraoperative complications (P < 0.05). There were no significant differences in all the indexes except intrraoperative complications between groups B and C (P > 0.05). CONCLUSION: The PFNA and InterTAN appear to be more reliable than DHS for the treatment of intertrochanteric femoral fractures in the elderly, but InterTAN appear to be more reliable in comminuted and complex intertrochanteric femoral fractures in the elderly than PFNA.