Laparoscopic reduction of intussusception in children by a single surgeon in comparison with open surgery.

The surgical approach for managing intussusception is controversial. In this study, a retrospective analysis of patients undergoing surgical reduction for intussusception over a period of five years was conducted. All patients received either open surgery or laparoscopic approach after failing enema reduction of intussusception. The clinical and operative data were collected and analyzed. Eight patients received open surgery (OPEN group), and 37 patients received laparoscopic surgery, while two (5.4%) of them converted to open surgery. The remaining 35 patients were included in the LAP group. There was no difference in age, gender, clinical symptoms and signs, duration of symptoms, level of intussusception, and complications between the OPEN and LAP groups. In contrast, the operation time and length of hospital stay in the LAP group were significantly shorter than those in the OPEN group (P = 0.013 and P = 0.001 respectively). No recurrence was disclosed in the OPEN group but three patients in the LAP group had recurrent intussusception (8.6%); however, the difference of the recurrence rate between these two groups was not statistically significant (P = 0.40). In conclusion, reducing intussusception with the laparoscopic approach is highly successful and can be performed first for stable patients requiring surgical intervention.

Tetrandrine attenuates dendritic cell-mediated alloimmune responses and prolongs graft survival in mice.

Tetrandrine, a bisbenzylisoquinoline alkaloid, has significant immunosuppressive effects; however, the effects of tetrandrine on dendritic cells (DCs) and the associated immune reactions are unclear. In this study, we investigated the effects of tetrandrine on DCs and the effects of the tetrandrine-treated DCs on alloimmune reactions in vitro and graft survival in vivo. Tetrandrine significantly downregulated the expression of CD80 and CD86 of DCs and increased their secretion of IL-10 (p = 0.0001). Mixed leukocyte reaction showed that tetrandrine inhibited dendritic-cell allo-stimulatory activity, which was reversed by the anti-IL-10 treatment. An in vivo study demonstrated that tetrandrine-treated DCs prolonged the survival time of skin grafts in mice compared to control (p = 0.005) and decreased cellular infiltration of the graft in the histopathological study. The data suggest that tetrandrine-treated DCs cause immunosuppression and protect skin grafts from rejection. The tetrandrine-induced immunosuppression seems to be partially due to increased IL-10 secretion.

Tetrandrine ameliorated reperfusion injury of small bowel transplantation.

PURPOSE: In small bowel transplantation, the bowel graft is susceptible to reperfusion injury. This study investigated the effects of tetrandrine, a bisbenzylisoquinoline alkaloid, on the development of intestinal reperfusion injury in small bowel transplantation in pigs. MATERIALS AND METHODS: Pigs underwent small bowel transplantation and were treated with tetrandrine or a vehicle. Blood and small bowel specimens were harvested at 1, 3, and 24 hours after reperfusion. Histopathologic analysis of the small bowel was assessed for tissue damage. Serum levels of tumor necrosis factor-alpha, interleukin-1beta (IL-1beta), and IL-6 were measured by enzyme-linked immunosorbent assay. Reverse-transcriptase polymerase chain reaction analysis was performed to analyze the expression of proinflammatory cytokines, and immunohistochemical analysis was used to study the expression of intercellular adhesion molecule-1 (ICAM-1) in the small bowel. Myeloperoxidase staining detected neutrophil infiltration in the small bowel and the number of myeloperoxidase positively stained cells was counted. RESULTS: Pigs receiving small bowel transplantation had elevated serum proinflammatory cytokine levels. The transplanted small bowel showed mucosal damage, increased expression of proinflammatory cytokines and ICAM-1, and prominent neutrophil infiltration. Tetrandrine administration reduced mucosal damage, serum and tissue proinflammatory cytokine levels, ICAM-1 expression, and neutrophil accumulation in the transplanted small bowel. CONCLUSIONS: Tetrandrine reduced the reperfusion injury in porcine intestinal transplantation during the first 24 hours after the procedure.

Effects of tetrandrine plus radiation on neuroblastoma cells.

BACKGROUND: Tetrandrine, a bisbenzylisoquinoline alkaloid, has cancer cell cytotoxicity. The effects of combined tetrandrine and radiation, alone or combined, on human SH-SY5Y neuroblastoma cells were examined. MATERIALS AND METHODS: A combination treatment, using either concomitant irradiation at the beginning or end of the tetrandrine treatment (designated as the RT-Tet and Tet-RT protocols, respectively), was used to investigate radiosensitization by tetrandrine. The level of radiosensitization was evaluated by the dose-enhancement ratio and isobologram analysis. The cell cycle distribution of the neuroblastoma cells was examined using flow-activated cell sorter (FACS) analysis. RESULTS: Tetrandrine had a time- and concentration-dependent cytotoxic effect (p<0.05). The dose-enhancement ratio for RT-Tet and Tet-RT was increased, and higher for RT-Tet. Isobologram analysis revealed mainly synergistic cytotoxicity for RT-Tet, but only subadditive cytotoxicity for Tet-RT. FACS analysis revealed that radiation caused accumulation in the G(2)/M-phase of the cell cycle, while tetrandrine caused G(0)/G(1) accumulation. Compared to RT alone, RT-Tet increased the G(0)/G(1) fraction and decreased the G(2)/M accumulation (p<0.001), whereas Tet-RT led to no reduction in radiation-induced G(2)/M accumulation. CONCLUSION: Tetrandrine radiosensitization is sequence dependent, with stronger cytotoxic effects noted when radiation is delivered at the beginning of tetrandrine treatment. The effect is, at least partly, related to the partial abrogation of radiation-induced G(2)/M accumulation.

Review. Pro- and anti-angiogenesis effects of resveratrol.

Resveratrol, a natural polyphenol, has a variety of effects including protection against ischemia-reperfusion injury, and antitumor and chemopreventive action against malignant tumors. In recent years, resveratrol has been found to exert pro-and anti-angiogenic effects, depending on the situation. For example, pro-angiogenic effects are noted in the peri-infarct myocardium, whereas resveratrol inhibits angiogenesis in tumors. In this article, a review of the literature concerning both pro-angiogenic and anti-angiogenic effects of resveratrol and the underlying mechanisms of its effects on angiogenesis is presented.