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Objective:To evaluate the value of autologous platelet-rich plasma (aPRP) separation-retransfusion for blood conservation in the patients undergoing thoracolumbar laminectomy.Methods:Sixty American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 18-60 yr, with body mass index of 19-30 kg/m 2, scheduled for elective thoracolumbar laminectomy, were divided into 2 groups ( n=30 each) using a random number table method: conventional blood conservation group (group C) and aPRP blood conservation group (group aPRP). Group C received tranexamic acid and autologous blood salvage-retransfusion. Group aPRP received aPRP separation-retransfusion, tranexamic acid and autologous blood salvage-retransfusion. The volume of allogeneic blood transfused, percentage of patients who did not need the allogeneic blood transfusion and adverse reactions were recorded. Venous blood samples were collected for blood routine examination and for determination of the plasma concentrations of interleukin-6 (IL-6) and IL-10 at 1 day before operation (T 0), when the volume of blood loss reached 500 ml (T 1), immediately after surgery (T 2), and at 24 and 48 h after surgery (T 3, 4). The incidence of hypoxemia and amount of 24-h wound drainage were recorded. Results:Compared with group C, the amount of allogeneic red blood cells, plasma transfused and 24-h wound drainage were significantly decreased ( P<0.05), the percentage of patients who did not need the allogeneic red blood cell and plasma transfusion was increased (30% vs 47%, 10% vs 60%, P<0.05), the plasma concentrations of IL-6 and IL-10 at T 2-4 were significantly decreased ( P<0.05), and the incidence of hypoxemia in PACU was decreased in group aPRP (27% vs 10%, P<0.05). Conclusions:aPRP separation-retransfusion can provide marked improvement in conventional blood conservation in the patients undergoing thoracolumbar laminectomy.
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BACKGROUND@#Insufficient cerebral perfusion is suggested to play a role in the development of Alzheimer disease (AD). However, there is a lack of direct evidence indicating whether hypoperfusion causes or aggravates AD pathology. We investigated the effect of chronic cerebral hypoperfusion on AD-related pathology in humans.@*METHODS@#We enrolled a group of cognitively normal patients (median age: 64 years) with unilateral chronic cerebral hypoperfusion. Regions of interest with the most pronounced hypoperfusion changes were chosen in the hypoperfused region and were then mirrored in the contralateral hemisphere to create a control region with normal perfusion. 11C-Pittsburgh compound-positron emission tomography standard uptake ratios and brain atrophy indices were calculated from the computed tomography images of each patient.@*RESULTS@#The median age of the 10 participants, consisting of 4 males and 6 females, was 64 years (47-76 years). We found that there were no differences in standard uptake ratios of the cortex (volume of interest [VOI]: P = 0.721, region of interest [ROI]: P = 0.241) and grey/white ratio (VOI: P = 0.333, ROI: P = 0.445) and brain atrophy indices (Bicaudate, Bifrontal, Evans, Cella, Cella media, and Ventricular index, P > 0.05) between the hypoperfused regions and contralateral normally perfused regions in patients with unilateral chronic cerebral hypoperfusion.@*CONCLUSION@#Our findings suggest that chronic hypoperfusion due to large vessel stenosis may not directly induce cerebral β-amyloid deposition and neurodegeneration in humans.
الموضوعات
Aged , Female , Humans , Male , Middle Aged , Alzheimer Disease/pathology , Amyloid beta-Peptides/metabolism , Arteries , Atrophy , Brain/metabolism , Cerebral Cortex/metabolism , Cerebrovascular Circulation , Constriction, Pathologic/pathology , Magnetic Resonance Imaging/methods , Positron-Emission Tomography/methodsالملخص
Objective To improve the recognition of Pancreatitis, Panniculitis, and Polyarthritis syndrome (PPP syndrome). Methods We described the diagnosis and treatment of a patient with PPP syndrome, including the clinical, radiological, and pathological features. Results Here we report a 67-year-old man with chronic calcified pancreatitis with multiple subcutaneous nodules and polyarthritis, but without any abdominal pain or other abdominal symptoms. His serum pancreatic amylase and lipase were markedly elevated. Abdomen CT scan showed features of chronic calcified pancreatitis. MR imaging of ankle revealed intramedullary fat necrosis. Biopsy from subcutaneous swellings revealed fat necrosis without vasculitis and typical "ghost-like cells". He failed to response to corticosteroids therapy. When the diagnosis of pancreatitis was confirmed, he was managed conservatively with supportive measures, and recovered. Conclusion The diagnosis of PPP syndrome is often difficult when abdominal symptoms are absent, be aware the association between panniculitis and polyarthritis with pancreatic disease may lead to a prompt diagnosis and management.
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Objective To evaluate the blood-saving effect of prophylactic tranexamic acid (TXA) use in the patients undergoing cervical spine surgery.Methods A total of 100 patients of both sexes,aged 55-75 yr,with body mass index of 19.0-25.0 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective cervical laminectomy and instrumentation,were divided into TXA group and normal saline group (group NS) using a random number table,with 50 patients in each group.TXA 15 mg/kg was intravenously injected at 30 min before skin incision in group TXA,and the equal volume of normal saline was given instead in group NS.Hemoglobin was measured before operation and on postoperative days 1,3 and 5.The intraoperative,postoperative,total blood loss,hidden blood loss and requirement for blood (allogeneic and autologous blood) transfusion were recorded.The development of complications such as epidural hematoma,deep vein thrombosis and pulmonary embolism was also recorded.Results Compared with group NS,the postoperative blood loss,total blood loss and blood transfusion rate were significantly decreased,the postoperative hemoglobin was increased (P<0.05),and no significant change was found in the intraoperative blood loos or hidden blood loss in group TXA (P>0.05).No patients developed complications such as epidural hematoma,deep vein thrombosis or pulmonary embolism in the two groups.Conclusion Prophylactic TXA use produces blood-saving effect to some extent in the patients undergoing cervical spine surgery.
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Objective To improve the recognition of Pancreatitis, Panniculitis, and Polyarthritis syndrome (PPP syndrome). Methods We described the diagnosis and treatment of a patient with PPP syndrome, including the clinical, radiological, and pathological features. Results Here we report a 67-year-old man with chronic calcified pancreatitis with multiple subcutaneous nodules and polyarthritis, but without any abdominal pain or other abdominal symptoms. His serum pancreatic amylase and lipase were markedly elevated. Abdomen CT scan showed features of chronic calcified pancreatitis. MR imaging of ankle revealed intramedullary fat necrosis. Biopsy from subcutaneous swellings revealed fat necrosis without vasculitis and typical "ghost-like cells". He failed to response to corticosteroids therapy. When the diagnosis of pancreatitis was confirmed, he was managed conservatively with supportive measures, and recovered. Conclusion The diagnosis of PPP syndrome is often difficult when abdominal symptoms are absent, be aware the association between panniculitis and polyarthritis with pancreatic disease may lead to a prompt diagnosis and management.
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Objective To investigate the effect of dexmedetomidine pretreatment on the expression of caspase-12 in lung tissues undergoing one-lung ventilation (OLV) in rats.Methods Thirty male Sprague-Dawley rats, aged 6-8 weeks, weighing 180-220 g, were randomly allocated into 3 groups (n=10 each) using a random number table: two-lung ventilation (TLV) group, OLV group and dexmedetomidine group (Dex group).Bilateral lungs were ventilated for 2 h in group TLV.In OLV and Dex groups, unilateral lung was ventilated for 1.5 h followed by 0.5 h TLV.In group Dex, dexmedetomidine was infused intravenously at a rate of 3.0 μ g · kg-1 · h-1 over 60 min starting from 60 min prior to OLV.The equal volume of normal saline was given instead of dexmedetomidine in OLV and TLV groups.Peak airway pressure (Ppeak) and mean airway pressure (Paw) were recorded at 45 min of OLV and 15 min of TLV in OLV and Dex groups, and at 15 min of TLV in group TLV.The rats were then sacrificed, and left lungs were removed for microscopic examination of the pathologic changes (using HE staining) and the ultrastructure of lung tissues (with transmission electron microscope) and for determination of wet to dry lung weight ratio (W/D ratio), cell apoptosis in lung tissues (by TUNEL), caspase-12 mRNA expression (using real-time reverse transcriptase-polymerase chain reaction), and caspase-12 expression (by Western blot).Results Ppeak and Paw were significantly lower at 15 min of TLV than at 45 min of OLV in OLV and Dex groups (P<0.05).Compared to group TLV, W/D ratio and AI were significantly increased, and the expression of caspase-12 protein and mRNA was up-regulated in OLV and Dex groups (P<0.01).Compared to group OLV, W/D ratio and AI were significantly decreased, and the expression of caspase-12 protein and mRNA was down-regulated in group Dex (P < 0.01).The pathologic changes of lung tissues were significantly alleviated in group Dex as compared with group OLV.Conclusion The mechanism by which dexmedetomidine pretreatment alleviates acute lung injury caused by OLV is associated with down-regulated expression of caspase-12 and inhibited cell apoptosis in rats.
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<p><b>OBJECTIVE</b>To study the transdermal absorbability of gentiopicroside, naringin and protosappanin B contained in Xuanbi gel plaster.</p><p><b>METHOD</b>The Franz diffusing cells method was adopted for the in vitro model of rat belly skins. Three indexes, gentiopicroside, naringin and protosappanin B, residued in the accept liquid, skins and plaster were determined by HPLC.</p><p><b>RESULT</b>The penetration rates of gentiopicroside, naringin and protosappanin B were respectively 3.47, 1.59, 2.13 microg x cm(-2) x h(-1). After 24 h, their penetration rates were 25.42%, 11.73%, 17.78%, respectively. The residual quantities of gentiopieroside, naringin and protosappanin B in skin were 0.231, 0.593, 0.568 microg x cm(-2), ith the retention rates of 0.027%, 0.227%, 0.475%, respectively. The amount of residue of gentiopicroside, naringin and protosappanin B in plaster were 2179, 674, 278 microg, with the retention rates of 81.36%, 81.92%, 73.83%, respectively.</p><p><b>CONCLUSION</b>The in vitro transdermal behavior of Xuanbi gel plaster is close to a zero-order process. The residual quantity the retention rate in skins is much lower than the penetration rate and the residual rate in plaster.</p>
الموضوعات
Animals , Male , Rats , Administration, Cutaneous , Flavanones , Metabolism , Gels , Chemistry , Iridoid Glucosides , Metabolism , Phenols , Metabolism , Rats, Sprague-Dawley , Skin Absorptionالملخص
Objective To investigate the expression of apoptosis-related neuclosome assembly protein-1(NAP-1) gene in related brain region of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP) treated mice and beta-amyloid treated rats. Methods The animal models with central nervous system degeneration were established by consecutive administration of MPTP to C57BL mice and injection of beta-amyloid to brain ventricular of SD rats. The RNA in striatum and substantia nigra of mice and the RNA in cortex and hippocampus of rats were extracted. The levels of NAP-1 mRNA in these samples were estimated by RT-PCR. Results For mice, the expression of NAP-1 were decreased after MPTP treatment in substantia nigra, while its expression showed no significant change in striatum. In contrast, no effect on NAP-1 gene expression by beta-amyloid injection can be detected in cortex and hippocampus of rats. Conclusions The apoptosis of dopaminergic neurons in nigrostriatal pathway after MPTP treatment may be related to the expression of NAP-1 gene. But the mechanism of neurodegeneration after beta-amyloid injection in rats may be different.
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Objective To study the expressions of matrix metalloproteinase (MMP) gene family in papillary thyroid carcinoma (PTC) and its relationship to the pathogenesis of PTC. Methods The thyroid tissues of patients were collected in surgical operation, including 8 cases with papillary thyroid carcinoma, 7 cases with Hashimoto′s thyroiditis, 8 cases with adenoma and 8 normal tissues. The total RNA of these samples were extracted and purified by the method of acidic phenol. The gene expressions of MMP-2, MMP-9, MMP-14, MMP-25 and MMP-26 were assayed by RT-PCR and 1% agarose gel electrophoresis. The fluorescent degree of electrophoretic bands was detected by automatic gel scanner and analyzed statistically in order to compare the levels of gene expressions among 4 groups. Results The positive rates and the levels of MMP-2, MMP-9 and MMP-14 gene expressions in PTC group were significantly higher than those in other 3 groups (all P