[Current status and considerations on clinical application of function-preserving pancreatic surgery].

For pancreatic neoplasms, the current clinical treatment strategy is mainly using standard surgical methods, including pancreaticoduodenectomy, distal pancreatectomy with splenectomy, and total pancreatectomy. Standard surgical methods require a larger resection, including resection of some surrounding organs and a large amount of pancreatic parenchyma. The endocrine and exocrine functions of the pancreas are easily damaged. Moreover, since the standard surgical procedure involves the reconstruction of the digestive tract at multiple anastomoses, there is a high risk of pancreatic, biliary, and intestinal fistulas occurring postoperatively. Therefore, function-preserving pancreatic surgery is recommended for some benign and low-grade pancreatic neoplasms. This type of surgery can treat pancreatic diseases while preserving more peripancreatic organs, pancreatic parenchyma and relatively complete digestive tract continuity, thereby improving the patient's short-term and long-term quality of life. In addition, with the development of laparoscopy and da Vinci robotic technology, minimally invasive technology-assisted pancreatic surgery has been carried out in clinical practice. They have been shown to be sufficiently safe and effective. This article reviews several common clinical pancreatic function-preserving surgical methods and their corresponding clinical applications and technical development status from the perspectives of preserving more peripancreatic organs, preserving more pancreatic parenchyma, and promoting pancreatic function recovery.

[Study on the value of fragmented red blood cell and fragmented red blood cells percentage for predicting the prognosis of sepsis patients].

To explore the predictive efficacy of fragmented red blood cells (FRC) and fragmented red blood cells percentage(FRC%) with regarding for the prognosis of septic patients, along with comparing with routine coagulation parameters. A prospective study was conducted. A total of 101 patients with sepsis who met the requirements admitted to the Intensive Care Department of the Third Xiangya Hospital of Central South University from June 1, 2022 to January 10, 2023 were selected as the research objects, they were divided into survival group and death group according to the 30-day prognosis. The clinical data and laboratory indexes such as FRCs, FRC% and Platelet (PLT) were compared between the survival group and the death group. Univariate logistic regression analysis was used first, then multivariate logistic regression analysis was used to analyze the factors affecting the prognosis. Receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of each parameter in the regression model for the prognosis of sepsis. The results showed that the levels of FRCs, FRC%, prothrombin time (PT), activated partial thromboplastin time (APTT) and D-dimer in death group were significantly higher than those in survival group, and PLT in death group were significantly lower than those in survival group (Z or t values were -3.712,-3.793,-2.119,-2.007,-2.209,all P<0.05). FRCs or FRC% and PLT could be independent predictors of 30-day mortality. The area under the ROC curve (AUC) of PLT for predicting 30-day death in sepsis patients was 0.727 (95%CI 0.629-0.811, P<0.01), when the optimal threshold was 137 ×109/L, the sensitivity was 83.87% and the specificity was 57.14%. The AUC of FRCs for predicting 30-day death in sepsis patients was was 0.732 (95%CI 0.635-0.815, P<0.01), when the optimal threshold was 10.1×109/L, the sensitivity was 77.42%, and the specificity was 67.14%. The AUC of FRC% for predicting 30-day death in sepsis patients was 0.737 (95%CI 0.640-0.820, P<0.01), When the optimal threshold was 0.34%, the sensitivity was 77.42%, and the specificity was 65.71%. In conclusion,PLT, FRCs and FRC% have great application value in the prognosis of sepsis. When the PLT, FRCs and FRC% of sepsis patients are more than 137 ×109/L, 10.1×109/L and 0.34% respectively, it is necessary to take necessary and reasonable clinical intervention measures as soon as possible.

[Assessment and influencing factors analysis of bromocresol green colorimetry for serum albumin].

To investigate the application of bromocresol green Colorimetry (BCG) method in measuring serum albumin (ALB) and to evaluate its influencing factors in different diseases. This study was a cross-sectional study that included 128 people admitted to the department of nephrology, department of general surgery, department of infectious diseases and other departments of the Third Xiangya Hospital of Central South University in July 2021. They were divided into groups according to disease types, including chronic kidney disease group (47 cases), liver disease group (40 cases), other diseases group (41 cases), serum ALB was detected by BCG method and immunoturbidimetry at the same time, and the results were expressed as ALBBCG and ALBI respectively, each group was subdivided into three subgroups according to ALBI results: relatively high-value subgroup, relatively intermediate-value subgroup and relatively low-value subgroup of albumin. ALBI and ALBBCG were compared in all groups and subgroups. Passing-Bablok regression and Bland-Altman diagram analysis were used to evaluate the application of ALBBCG in each group. Immunoturbidimetry was used as a reference method to evaluate the bias of ALBBCG, and the differences between ALBI and ALBBCG were shown as follows:ΔALB= ALBBCG-ALBI. Pearson correlation analysis and multiple linear regression analysis were used to assess the correlation between ΔALB and ALB autoconcentration (ALBI), α1-globulin, α2-globulin, ß1-globulin, ß2-globulin, γ-globulin, creatinine (Cr), urea (UN), uric acid (UA), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), direct bilirubin (DBil), and C-reactive protein (CRP) levels.The results showed that ALBBCG were higher than ALBI in the relative low subgroups of total patients group, chronic kidney disease group, liver disease group and other disease groups, and the differences were statistically significant (t value was 8.025, 6.878, 2.628, 4.915, respectively, P<0.05). In the relatively high value subgroup, ALBBCG was lower than ALBI, and the differences were statistically significant in the relative high value subgroup of total patients group, liver disease group and other disease groups (t value was -4.388, -2.927, -3.979, P<0.05). Passing-Bablok regression and Bland-Altman analysis showed that the BCG method had proportional bias. In the chronic kidney disease group, the concentrations of ALBI and Cr had the greatest influence on BCG bias, and the regression model equation was ΔALB=5.437-0.146× AlbI-0.001 ×Cr, R²=0.505. In the liver disease group, the concentrations of ALBI, α1-globulin, ß1-globulin had the greatest influence on BCG bias, and the regression model equation was ΔALB=3.652-0.230×ALBI+0.398×α1-globulin+1.171×ß1-globulin, R²=0.658. In the other disease group, the concentration of ALBI and α2-globulin had the greatest influence on BCG bias, and the regression equation was ΔALB=5.558-0.225×AlbI-0.281×α2-globulin, R²=0.646. The BCG method has a proportion error, and its bias may lead to unacceptable differences. BCG method is mainly affected by the concentration of ALB itself, and may also be affected by α1-globulin, α 2-globulin, ß1-globulin, Cr.

[The operation techniques of distal pancreatectomy: laparotomy, laparoscopy or robotic surgery].

Due to the operational complexity, the application of minimally invasive surgery in pancreatic procedure has been delayed than other departments.But with the gradual development of minimally invasive surgery, especially since the introduction of robotic surgery system, pancreatic surgery in this field has seen a great number of achievement.Laparoscopic and robotic technology is being widely adopted, while the technique of laparotomy is also developing.These three operation techniques have their advantages and disadvantages.Which method to option for became a new problem for pancreatic surgeons.The safety and feasibility of minimally invasive surgery especially robotic procedure for distal pancreatectomy have been confirmed by many agencies.But even with these advantages, laparoscopic and robotic surgery can not completely replace laparotomy.Pancreatic surgeons need to master these three operation methods to be able to handle complicated clinical situations.

Treating congenital megacolon by transplanting GDNF and GFRα-1 double genetically modified rat bone marrow mesenchymal stem cells.

We studied the survival and gene expression of glial cell line-derived neurotrophic factor (GDNF) and GDNF receptor α-1 (GFRα-1) double-genetically modified rat bone marrow mesenchymal stem cells (BMSCs) transplanted into the intestinal walls of the rat models with congenital megacolon and determine the feasibility of treatment by transplantation of double-genetically modified rat BMSCs. The rat colorectal intestinal wall nerve plexus was treated with the cationic surface active agent benzalkonium chloride to establish an experimental megacolon model. The rat target genes GDNF and GFRα-1 were extracted and ligated into pEGFP-N1. Eukaryotic fluorescent expression vectors carrying the GDNF and GFRα-1 genes were transfected into BMSCs by in vitro culture. We treated congenital megacolon by transplanting double-genetically modified rat bone marrow mesenchymal stem cells. The pEGFP-EGFP-GDNF-GFRα-1 double-gene co-expressing the eukaryotic expression plasmid vector was successfully established. Protein gene protein 9.5 and vasoactive intestinal peptide-positive ganglion cells showed no positive expression in the phosphate-buffered saline transplantation group based on an immunofluorescence test at 1, 2, and 4 weeks after transplantation of BMSCs. Additionally, compared with the phosphate-buffered saline transplantation group, the expression of rearranged during transfection, GDNF, and GFRα-1 mRNA in the stem cell transplantation group increased gradually. The double-genetically modified BMSCs colonized and survived in the intestinal wall of the experimental megacolon rat model and expressed related genes, partially recovering the colonic neuromuscular regulatory functions and thus providing an experimental basis for treating congenital megacolon by cellular transplantation.

A case-control study indicates that the TRIB1 gene is associated with pancreatic cancer.

Pancreatic cancer is a malignant neoplasm originating from transformed cells arising in tissues that form the pancreas. To investigate whether the tribbles homolog 1 (Drosophila) gene (TRIB1) is associated with pancreatic cancer in the Chinese Han population, we conducted this case-control study and genotyped 3 single nucleotide polymorphisms (rs2980879, rs2980874, and rs2235108) of the TRIB1 gene in 182 patients and 359 normal controls of Chinese Han origin and analyzed their association. The results showed that the rs2980879 polymorphism was associated with pancreatic cancer [allele: P = 0.023434, genotype: P = 0.03005; odds ratio (OR) and 95% confidence interval (CI) = 0.727788 (0.552664-0.958404)], whereas the rs2980874 polymorphism had no association with pancreatic cancer [allele: P = 0.749885, genotype: P = 0.699533; OR and 95%CI = 1.041981 (0.809196-1.341734)], and the rs2235108 polymorphism was not associated with the disease [allele: P = 0.629475, genotype: P = 0.547534, OR and 95%CI = 1.128290 (0.690829-1.842770)]. Haplotype analyses and linkage disequilibrium tests were also conducted, and the results showed that these 3 loci are not in the same block. In conclusion, our study indicated that the TRIB1 gene is associated with pancreatic cancer. More studies with larger samples are needed in order to support this finding.

High frequency of ETFDH c.250G>A mutation in Taiwanese patients with late-onset lipid storage myopathy.

Lipid storage myopathies (LSMs) are characterized pathologically by the accumulation of lipid droplets in muscle fibers due to impaired cellular lipid metabolism. The purpose of this study was to determine etiologies and genetic mutations associated with LSMs in ethnic Han Taiwanese. The usefulness of the blood acylcarnitine (AC) profile for diagnosing LSMs in adult patients was also investigated. Nine patients were diagnosed with late-onset LSMs following a review of muscle biopsies and medical records and were recruited retrospectively. Genetic studies were performed to detect mutations in the SLC22A5 for primary carnitine deficiency, PNPLA2 for neutral lipid storage disease with myopathy, ABHD5 for neutral lipid storage disease with ichthyosis, ETFDH for multiple acyl-CoA dehydrogenation deficiency (MADD), and CPT2 for carnitine palmitoyltransferase II deficiency. Blood AC levels were measured by tandem mass spectrometry. The mutation c.250G>A in ETFDH was detected in seven (78%) patients, six of whom were homozygous for the variant. Patients with ETFDH mutations had elevated blood levels of ACs ranging from C8 to C16 species, a pattern consistent with MADD. ETFDH c.250G>A mutation is common in Taiwanese patients with late-onset LSMs. The blood AC profile is a sensitive biochemical marker for diagnosing MADD arising from ETFDH mutations in adults.

Chemokine IP-10: an adjunct marker for latent tuberculosis infection in children.

SETTING: Recent reports indicate a role of chemokine inducible protein 10 (IP-10) in Mycobacterium tuberculosis infection substantiated by the detection of elevated levels in plasma and at infection foci in individuals infected with M. tuberculosis. OBJECTIVE: To evaluate IP-10 as a potential marker for the diagnosis of M. tuberculosis infection in children living in a region of low tuberculosis (TB) prevalence. DESIGN: IP-10 levels were obtained after whole blood stimulation with M. tuberculosis-specific antigens in 127 children. IP-10 results were evaluated upon gradations of exposure risk to M. tuberculosis and correlation with tuberculin skin test and an interferon-gamma release assay (IGRA). RESULTS: IP-10 reactivity correlated well to risk of exposure to M. tuberculosis in children. There was a strong correlation between IP-10 and IGRA results. IP-10 responses, unlike interferon-gamma (IFN-gamma), were not age-dependent and detected more positive results in children aged <5 years. In the children with active disease, the IGRA was more sensitive than IP-10 at detecting M. tuberculosis infection. CONCLUSION: Our findings suggest that IP-10 in combination with IFN-gamma may enhance the diagnostic performance of IGRAs in detecting M. tuberculosis infection, especially in young children.

Orthotopic abdominal multivisceral transplantation without venovenous bypass in pigs.

BACKGROUND: Because venovenous bypass (VVB) can cause specific complications, a simplified orthotopic abdominal multivisceral transplantation (MVTX) technique without VVB in pigs has been evaluated in terms of morbidity and mortality. MATERIALS AND METHODS: Outbred large-white pigs weighing 25 to 40 kg of random sex underwent MVTX operation. After in situ cold perfusion through the aorta and superior mesenteric vein, the multivisceral allograft was procured from the donor and tailored at the back table. The multivisceral allograft, including liver, pancreas, stomach, duodenum, and proximal 2 m of jejunum, was en bloc transplanted into recipient after resection of entire foregut and midgut; VVB was not used. We analyzed the hemodynamic change, arterial blood gas data, and fluid requirements intraoperatively. RESULTS: Among 25 MVTXs, 19 (76%) animals survived after the operation. Without using an immunosuppressant, postoperative survival time was 2 to 146 hours. Ten recipient pigs died within 24 hours. Seven animals were lost between postoperative days 2 and 5. Two pigs survived for more than 5 days. The recipient pigs were mostly in a state of hypovolemic shock and metabolic acidosis during the reperfusion phase. CONCLUSIONS: Despite a high morbidity and mortality, the simplified technique without VVB is feasible to successfully achieve MVTX in the pig.

Primary small-bowel non-Hodgkin's lymphoma: a study of clinical features, pathology, management and prognosis.

The records of 34 patients diagnosed with primary small bowel non-Hodgkin's lymphoma during a 10-year period between January 1996 and December 2005, including 27 cases for which complete follow-up records were available, were studied. Abdominal pain (70.6% of patients) was the main presenting symptom, followed by intestinal obstruction (38.2%). The most common primary site was the ileum (58.8%), followed by the jejunum (26.5%) and duodenum (17.6%); one case had tumours at two sites in the small bowel. Twenty-seven patients had small bowel B-cell lymphoma (24 diffuse large B-cell lymphoma; three mucosa-associated lymphoid tissue B-cell lymphoma) and seven patients had small bowel T-cell lymphoma. Cumulative survival in patients with small bowel B-cell lymphoma was higher than that in patients with small bowel T-cell lymphoma. Data on 16 male and eight female patients with diffuse large B-cell lymphoma showed that 62.5% of these patients presented with disease stages I or II and 37.5% with stages III or IV. Cumulative survival in patients at stages IE or IIE was significantly higher than that of patients at stages IIIE or IVE. Four of five patients who died from diffuse large B-cell lymphoma had abnormal levels of lactate dehydrogenase and serum albumin.

The incidence and risk factors for the development of vitreomacular interface abnormality in diabetic macular edema treated with intravitreal injection of anti-VEGF.

PurposeTo report the incidence and associated factors for the development of vitreomacular interface abnormality (VMIA) in patients with diabetic macular edema (DME) who received intravitreal injection (IVI) of anti-VEGF (Bevacizumab and Ranibizumab) treatment.MethodsA retrospective observational study. Patients with DME followed at least 6 months were reviewed. Baseline best-corrected visual acuity (BCVA), central retinal thickness (CRT) and final BCVA, CRT in eyes with and without VMIA were compared. Multiple logistic regression was also used to investigate the risk factors of VMIA formation in patients with DME treated by anti-VEGF.ResultsA total of 201 eyes in 142 patients met the inclusion criteria of the study. VMIA developed in 44 eyes (21.89%) of patients during a mean follow-up period of 40.84 months. The estimated mean incidence of VMIA formation was 6.43% per year. Poor baseline BCVA was found to be a risk factor for VMIA development (P=0.001, odds ratio=5.299, 95% confidence interval: 1.972 to 14.238). There was no difference between eyes with and without VMIA formation in improving BCVA (P=0.557) and lowering the macular edema (eyes without VMIA formation: -107.72±171.91 µm; eyes with VMIA formation: -155.02±212.27 µm, P=0.133).ConclusionsThis study revealed the incidence of VMIA formation in IVI anti-VEGF treated DME eyes was 6.43%. Poor baseline BCVA was found to be a risk factor for VMIA formation. Both eyes with and without VMIA development had favorable response to anti-VEGF treatment.

The anti-tumor effect and mechanisms of action of penta-acetyl geniposide.

Gardenia, the fruit of Gardenia jasminoides Ellis, has been widely used to treat liver and gall bladder disorders in Chinese medicine. It has been shown recently that geniposide, the main ingredient of Gardenia Fructus, exhibits the anti-tumor effect. In this review, we discuss the anti-tumor effect and possible mechanisms of a derivative from Gardenia Fructus, penta-acetyl geniposide ((Ac)5GP). It has been demonstrated that (Ac)5GP plays more potent roles than geniposide in chemoprevention. (Ac)5GP decreased DNA damage and hepatocarcinogenesis induced by aflatoxin B1 (AFB1) by activating the phase II enzymes glutathione S-transferase (GST) and GSH peroxidase (GSH-Px). It reduced the growth and development of inoculated C6 glioma cells especially in pre-treated rats. In addition to the preventive effect, (Ac)5GP exerts its actions on apoptosis and growth arrest. Treatment of (Ac)5GP caused DNA fragmentation of glioma cells. (Ac)5GP induced sub- G1 peak through the activation of apoptotic cascades PKCdelta/JNK/Fas/caspase8 and caspase 3. Besides, p53/Bax signaling was suggested to be involved in (Ac)5GP-induced apoptosis, though its downstream cascades needs further clarified. (Ac)5GP has also been shown to inhibit DNA synthesis of tumor cells. It arrested cell cycle at G0/ G1 by inducing the expression of p21, thus suppressing the cyclin D1/cdk4 complex formation and the phosphorylation of E2F. The phosphorylation status of p53 on serine 392 correlated with the process of growth arrest. Evidences from the in vivo experiments showed that (Ac)5GP is not harmful to liver, heart and kidney. In conclusion, (Ac)5GP is highly suggested to be an anti-tumor agent for development in the future.

The mutagenicities of alkaloids and N-nitrosoguvacoline from betel quid.

In Taiwan, betel quid is a natural masticatory, which is composed of fresh green areca fruit, Piper betle and slaked lime paste. Areca fruit contains some alkaloids, of which arecoline is the major one. N-Nitrosoguvacoline (NG), one of the N-nitrosation products of arecoline, is the only one N-nitrosamine found in Taiwanese betel quid chewing saliva. The mutagenic studies in Ames Salmonella microsome test showed that crude alkaloid extracts of areca fruit and arecoline were active in Salmonella typhimurium TA100, and NG was weakly active in TA98 and TA100. The activities in both arecoline and NG decreased further in the presence of rat liver S9 mix. Nitrite was significantly consumed during the N-nitrosation of arecoline and sodium nitrite at acidic condition (pH 3), whereas the formation of NG was favored at neutral condition (pH 7). Crude phenolic extracts of leaf and inflorescence of Piper betle inhibited the formation of NG by blocking the nitrite. However, a high amount of crude phenolic extracts of areca fruit enhanced the formation of NG.

Safe upper limit of intermittent hepatic inflow occlusion for liver resection in cirrhotic rats.

AIM: To evaluate the effects of varying ischemic durations on cirrhotic liver and to determine the safe upper limit of repeated intermittent hepatic inflow occlusion. METHODS: Hepatic ischemia in cirrhotic rats was induced by clamping the common pedicle of left and median lobes after non-ischemic lobes resection. The cirrhotic rats were divided into six groups according to the duration and form of vascular clamping: sham occlusion (SO), intermittent occlusion for 10 (IO-10), 15(IO-15), 20(IO-20) and 30(IO-30) minutes with 5 minutes of reflow and continuous occlusion for 60 minutes (CO-60). All animals received a total duration of 60 minutes of hepatic inflow occlusion. Liver viability was investigated in relation of hepatic adenylate energy charge (EC). Triphenyltetrazollum chloride (TTC) reduction activities were assayed to qualitatively evaluate the degree of irreversible hepatocellular injury. The biochemical and morphological changes were also assessed and a 7-day mortality was observed. RESULTS: At 60 minutes after reperfusion following a total of 60 minutes of hepatic inflow occlusion, EC values in IO-10 (0.749 +/- 0.012) and IO-15 (0.699 +/- 0.002) groups were rapidly restored to that in SO group (0.748 +/- 0.016), TTC reduction activities remained in high levels (0.144 +/- 0.002 mg/mg protein, 0.139 +/- 0.003 mg/mg protein and 0.121 +/- 0.003 mg/mg protein in SO, IO-10 and IO-15 groups, respectively). But in IO-20 and IO-30 groups, EC levels were partly restored (0.457 +/- 0.023 and 0.534 +/- 0.027) accompanying with a significantly decreased TTC reduction activities (0.070 +/- 0.005 mg/mg protein and 0.061 +/- 0.003 mg/mg protein). No recovery in EC values (0.228 +/- 0.004) and a progressive decrease in TTC reduction activities (0.033 +/- 0.002 mg/mg protein) were shown in CO-60 group. Although not significantly different, the activities of the serum aspartate aminotransferase (AST) on the third postoperative day (POD(3)) and POD(7) and of the serum alanine aminotransferase (ALT) on POD(3) in CO-60 group remained higher than that in intermittent occlusion groups. Moreover, a 60% animal mortality rate and more severe morphological alterations were also shown in CO-60 group. CONCLUSION: Hepatic inflow occlusion during 60 minutes for liver resection in cirrhotic rats resulted in less hepatocellular injury when occlusion was intermittent rather than continuous. Each period of 15 minutes was the safe upper limit of repeated intermittent vascular occlusion that the cirrhotic liver could tolerate without undergoing irreversible hepatocellular injury.

Diagnosis and treatment of congenital choledochal cyst: 20 years' experience in China.

AIM: To summarize the experience of diagnosis and treatment of congenital choledochal cyst in the past 20 years (1980-2000). METHODS: The clinical data of 108 patients admitted from 1980 to 2000 were analyzed retrospectively. RESULTS: Abdominal pain,jaundice and abdominal mass were presented in most child cases. Clinical symptoms in adult cases were non-specific, resulting in delayed diagnosis frequently. Fifty-seven patients (52.7%) had coexistent pancreatiobiliary disease. Carcinoma of the biliary duct occurred in 18 patients (16.6%). Ultrasonic examination was undertaken in 94 cases, ERCP performed in 46 cases and CT in 71 cases. All of the cases were correctly diagnosed before operation. Abnormal pancreatobiliary duct junction was found in 39 patients. Before 1985 the diagnosis and classification of congenital choledochal cyst were established by ultrasonography preoperatively and confirmed during operation, the main procedures were internal drainage by cyst enterostomy. After 1985, the diagnosis was established by ERCP and CT, and cystectomy with Roux-en-Y hepaticojejunostomy was the conventional procedures.In 1994, we reported a new and simplified operative procedure in order to reduce the risk of choledochal cyst malignancy. Postoperative complication was mainly retrograde infection of biliary tract, which could be controlled by the administration of antibiotics, there was no perioperative mortality. CONCLUSION: The concept in diagnosis and treatment of congenital choledochal cyst has obviously been changed greatly.CT and ERCP were of great help in the classification of the disease.Currently, cystectomy with Roux-en-Y hepaticojejunostomy is strongly recommended as the choice for patients with type I and type IV cysts. Piggyback orthotopic liver transplantation is indicated in type V cysts (Caroli's disease) with frequently recurrent cholangitis.

Oxidative stress before and after operation in patients with chronic cholecystitis containing gallstone.

To study the relationship of oxidative, antioxidative constituents and antioxidases in blood with chronic cholecystitis containing gallstone, levels of lipoperoxides (LPO), nitric oxide (NO), vitamin C(VC), vitamin E (VE) and beta-carotene (beta-CAR) in plasma as well as level of LPO, activities of superoxide dismulase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) in erythrocytes were investigated by spectrophotometric assay in 107 patients with this condition (PCg) and 100 healthy volunteers (HVs). Compared with HVs group, the average value of LPO and NO in plasma and that of LPO in erythrocytes of PCg group were significantly increased (P < 0.0001), while that of VC, VE and beta-CAR in plasma and the average activities of SOD, CAT and GSH-Px in erythrocytes were significantly decreased (P < 0.0001). Linear regression and correlation analysis for 107 preoperative PCg showed that the value of LPO and NO in plasma and that of LPO in erythrocytes of PCg gradually increased (P < 0.0001), representing a significant linear positive correlation. The value of VC, VE and beta-CAR in plasma and that of SOD, CAT and GSH-Px in erythrocytes of PCg gradually decreased (P < 0.0001), representing a significant linear negative correlation. Stepwise regression and correlation analysis for 107 preoperative PCg suggested that the closest correlation was observed between the course of disease and the value of NO and VC in plasma and that of SOD, GSH-Px and LPO in erythrocytes, r = 0.7306, F = 32.1408, P < 0.0001. Compared with the preoperative PCg group, the average value of LPO and NO in plasma and that of LPO in erythrocytes of the postoperative PCg group were significantly decreased (P < 0.0001). Furthermore, the average value of VC in plasma and that of SOD, CAT and GSH-Px in erythrocytes of the postoperative PCg group were significantly increased (P < 0.0001), whereas no significant difference was found between their average value of VE and beta-CAR in plasma. These findings suggested that oxidative stress was an aggravating pathological condition in PCg group. Therefore, we recommend that in treating PCg, antioxidants such as VC, VE, beta-CAR should be given in order to alleviate their potential oxidative damages.

In vitro evaluation of the effects of transportation and storage on platelet concentrates.

Platelets may be activated and become acidic during transportation and storage, resulting in poor post-transfusion platelet survival and recovery. In this study, we evaluated the current local shipment protocol for platelet concentrates and the storage technique used at the National Taiwan University Hospital. Platelet concentrates were transported routinely in cardboard boxes at ambient temperature. They were then stored in an agitator at 20 degrees C to 24 degrees C in the blood bank. We measured changes in beta-thromboglobulin, pH, platelet distribution width (PDW) and platelet counts before and after shipment and storage. The level of beta-thromboglobulin reflects platelet activation and was determined by enzyme immunoassay. The beta-thromboglobulin levels and platelet counts were not significantly different after transportation and during the storage period but there were significant changes in pH and PDW after storage (p < 0.001). Regression study showed that the prestorage platelet counts and pH were strongly associated with the pH at the end of storage (r = -0.71, r = 0.75 respectively). We concluded that the current shipment technique has no adverse effect on the in vitro characteristics of platelets, and the prestorage pH and platelet count could be used as predictors for the pH at end of storage. The data indicate that it is important to measure the prestorage pH and platelet count to set up an optimal storage strategy.

The morphologic structure of the openbite in adult Taiwanese.

Anterior openbite (AOB) is an intricate occlusal problem. Treatment of AOB is one of the most challenging tasks in orthodontics. An ethnic-specific norm for craniofacial skeletal patterns would be valuable in diagnosing and treating patients with AOB. To establish this norm for the people of Taiwan, a cephalometric study was conducted using the quadrilateral analysis developed by DiPaolo. The sample consisted of 15 males and 25 females in their 20s and 30s. The patients were randomly selected and were diagnosed with AOB. Various craniofacial skeletal patterns were measured, and these measurements were compared with values taken from a group of normal Taiwanese as well as with published values from a hyperdivergent group of westerners. The results support the following generalizations: (1) The growth pattern of subjects in the AOB group is hyperdivergent. (2) Both the maxillary and mandibular corpora of subjects with AOB are shorter than those of normal subjects. (3) The sagittal angle, average lower facial height, and the maxillary and mandibular sagittal ratio of subjects with AOB are larger than those of normal subjects. Abnormalities in the maxillomandibular complex causing changes in the vertical dimension of facial patterns are involved in AOB.