[Evaluation the application of intra-operative cell salvage in cesarean section based on multicenter data].

Objective: To investigate the safety, efficacy and application indication of intra-operative cell salvage (IOCS) in cesarean section. Methods: A total of 1 265 pregnant women who received IOCS blood transfusion during cesarean section in 11 tertiary A hospitals from August 2016 to January 2019 were collected and divided into <1 500 ml group (796 cases) and ≥1 500 ml group (469 cases) according to the amount of blood loss during cesarean section. The general clinical data, ultrasonic imaging data, perinatal and puerperium indicators were analyzed retrospectively. The risk factors of intraoperative blood loss ≥1 500 mL using IOCS transfusion were analyzed by logistic multivariate regression. Results: (1) A total of 848 001 ml of blood was recovered and a total of 418 649 ml of blood was transfused in 1 265 pregnant women who received IOCS transfusions, which was equivalent to 23 258 U red blood cell suspension, greatly saving medical resources. The intraoperative blood loss in <1 500 ml group and ≥1 500 ml group was 800 ml (300-1 453 ml) and 2 335 ml (1 500-20 000 ml), respectively. No amniotic fluid embolism, severe adverse reactions, shock and death occurred in the two groups. (3) Multivariate regression analysis showed that age ≥35 years (OR=1.5, 95%CI: 1.1-1.9), prenatal hemoglobin level <110 g/L (OR=1.7, 95%CI: 1.3-2.2), history of uterine surgery (OR=1.8, 95%CI: 1.3-2.6), placenta previa (OR=1.9, 95%CI: 1.1-3.1), placenta accreta (OR=2.6, 95%CI: 1.8-3.9), blood pool in the placenta (OR=1.6, 95%CI: 1.1-2.3), abnormal posterior placenta muscle wall (OR=1.8, 95%CI: 1.2-2.6), placenta projecting to the anterior uterine wall (OR=3.0, 95%CI: 1.3-7.0) were risk factors for blood loss ≥1 500 ml in obstetric transfusion using IOCS technique, with statistical significance (all P<0.05). Conclusion: IOCS is safe and effective in cesarean section, which could save the medical resources and reduces medical expenses, however, it is necessary to strictly master the application indication.

Impact of methylenetetrahydrofolate reductase polymorphisms and folate intake on the risk of gastric cancer and their association with Helicobacter pylori infection and tumor site.

Folic acid and methylenetetrahydrofolate reductase (MTHFR) may both affect the development of human cancer. We conducted a population-based case-control study in a Chinese population to investigate the potential role of folate intake and MTHFR gene polymorphisms in gastric cancer, and their interaction with infection by Helicobacter pylori and tumor location. A total of 767 patients with newly diagnosed gastric cancer and 775 controls were selected for this study. Genotyping of MTHFR C677T and A1298C was conducted by TaqMan assays using the ABI Prism 7911HT Sequence Detection System, and information on folate intake was collected by questionnaire. Compared with the CC genotype of MTHFR C677T, the TT genotype was significantly associated with a decreased risk of gastric cancer when the analysis was adjusted for other potential risk factors. We found a marginal significantly decreased risk of gastric cancer for individuals carrying the T allele [adjusted odds ratio (OR) = 0.83; 95% confidence interval (CI) = 0.65-1.01]. We detected an inverse relationship between folate intake and risk of gastric cancer, and the adjusted ORs (95%CI) for moderate and high folate intake were 0.97 (0.74-1.25) and 0.64 (0.49-0.87), respectively. Moreover, H. pylori infection, folate intake, and location of the tumor showed a significant interaction with the MTHFR C677T polymorphism. Our study suggests a protective role of MTHFR 677TT and high folate intake against gastric cancer, and the effect of the MTHFR C677T genotype may differ by H. pylori infection, folate consumption, and tumor site.

C-terminal peptide of anaphylatoxin C3a enhances hepatic function after steatotic liver transplantation: a study in a rat model.

BACKGROUND: C3a, a complement component stimulates hepatocyte proliferation. In this study, we investigated whether a functional peptide from its C terminal, YAAALGLAR (C3aP), enhanced liver function after steatotic liver transplantation in a rat model. METHODS: Livers of Sprague-Dawley (SD) rats fed a high-fat diet for 2 months were used as donors. Their liver parenchyma displayed over 60% macrovesicular steatosis upon histopathologic examination. Weight and age-matched isogeneic SD rats were used as recipients of orthotopic liver transplantations (OLTs). Before OLT, the donor livers were perfused with University of Wisconsin solution supplemented with 10 mg/L C3aP. Postoperatively, 0.1 mL of 100 microg/mL C3aP was administered daily intraperitoneally to the experimental group. Recipients without C3aP intraperitoneal administration were the control group. We examined the survival rates, histopathologic changes, and hepatic functions of recipients. RESULTS: Six of the 10 control recipients died within 3 days posttransplantation; however, among the experimental group, 8 of 10 recipients survived beyond 7 days. Histopathologic examination showed that at day 3 posttransplantation, hepatocyte steatosis was notably reversed in the experimental group with cells undergoing active mitosis. In contrast, massive parenchymal necrosis was observed among the control group without notable hepatocyte proliferation. Furthermore, serum enzyme levels among the experimental group were significantly lower than those of the control group at day 3 postoperatively. CONCLUSION: C3aP stimulated hepatocyte proliferation and reversed fatty degradation of hepatocytes, thus enhancing hepatic function and prolonging the survival of recipients of steatotic liver transplantations.

Probiotics modulate inflammatory cytokine secretion from inflamed mucosa in active ulcerative colitis.

Enteric microflora of ulcerative colitis patients becomes aberrant. The abnormal interaction between microflora and intestinal mucosal immune system leads the mucosal inflammation. Probiotic administration may recover the commensal microflora and normalise the host-microbial interaction. In this experiment, we cocultured colonic biopsies from active ulcerative colitis patients with bifidobacterium to investigate the modulation effect of probiotics on inflamed colonic tissues and its possible mechanism. Colonic biopsies from active ulcerative colitis were cocultured for 24 h with Bifidobacterium longum. Tumour necrosis factor (TNF)-alpha and interleukin (IL)-8 in supernatants were measured using enzyme-linked immunosorbent assays, the biopsies were fixed using paraffin and the expression of NF-kappaB P65 of tissues was studied using immunohistochemical staining. The concentrations of TNF-alpha and IL-8 in supernatants of tissues cocultured with probiotics were lower than those cultured alone. The number of lamina propria mononuclear cells (LPMC) with nuclear factor-kappa B (NF-kappaB) P65 positive in cocultured tissues was also decreased. When cocultured with inflamed tissues of active ulcerative colitis, probiotics could inhibit NF-kappaB activation in LPMC and down-regulate inflammatory cytokine secretion from inflamed tissues of active ulcerative colitis.

Dual effects of tetrandrine on calcium-activated potassium channels in pulmonary artery smooth muscle cells.

AIM: To study the effects of tetrandrine (Tet) on calcium-activated potassium channels. METHODS: Inside-out configuration of patch-clamp single channel recording techniques. RESULTS: Tet 7.5 and 15 mumol.L-1 increased the open probability from control value 0.251 +/- 0.012 to 0.340 +/- 0.013 and 0.415 +/- 0.011, respectively (P < 0.01), decreased the close time from (61 +/- 15) ms to (33 +/- 10) and (28 +/- 11) ms, respectively (P < 0.01). But Tet 30 mumol.L-1 decreased the open probability and open time to (0.114 +/- 0.008) and (1.47 +/- 0.09) ms, respectively [P < 0.01 vs control (0.251 +/- 0.012) and (20 +/- 8) ms]. CONCLUSION: Tet has concentration-dependent dual effects on KCa channels in isolated rat pulmonary smooth muscle cells.

Diagnosis and treatment of adrenal tumours: a review of 35 years' experience.

OBJECTIVE: To review and analyse clinical data on the diagnosis and management of patients with adrenal masses. PATIENTS AND METHODS: Patients admitted with adrenal masses between 1960 and 1995 were reviewed. The series comprised 116 males (mean age 41.4 years, SD 10.5, range 3-77) and 95 females (mean 36.9 years, SD 11.6, range 1-62); eight patients were < 14 years old and the overall mean (SD) age was 39.4 (12.8) years. The diagnosis was based on symptoms, signs, hormone levels and imaging studies. All tumours were confirmed by surgery, and pathology and results of analysis assessed statistically. RESULTS: Over the last 35 years, the incidence of adrenal tumours was 1.7% of all patients admitted with genitourological diseases or 9.7% of patients with genitourinary tumours at our institution. The prevalence of adrenal tumours in males and females was similar but Cushing's syndrome was 3.1 times more frequent in females than in males and phaeochromocytoma 1.9 times more frequent in males than females. Most patients with adrenal tumour were aged 30-50 years. Of 211 adrenal tumours, 151 (72%) were functional, with a prevalence of benign tumour, and 60 (28%) were nonfunctional, with 35% malignant. There were 78 'incidentalomas' which included 18 functional tumours. Overall, 210 tumours were removed and one was explored. Correlation analysis between tumour size and character or hormone levels showed that size was significantly positively correlated with tumour character (r = 0.4010, P < 0.001), but there was no relationship between tumour size and hormonal levels. The postoperative complication rate was 3.3% and the mortality 0.5%. CONCLUSIONS: Based on this analysis we recommend that computed tomography is the first method used to define and localize the adrenal masses, that hormone levels should be determined in symptomatic or asymptomatic patients with adrenal masses, and that functional adrenal tumours and solid incidentalomas of any size should be removed surgically.

[Clinical study on the use of multiglycosides of Tripterygium wilfordii after cadaveric kidney transplantation].

Based on the animal experiments, we first used the multiglycosides of Tripterygium wilfordii (GTW) as a main immunosuppressive agent to treat the patients with cadaveric kidney transplantation instead of Azathioprine (Aza) from 1990. By clinical observation and 3-year follow-up, the result showed the GTW having a satisfactory immunosuppressive effect. In this study, there were 85 cases in control group (Aza+CSA+Pred) and 87 cases in therapeutic group (GTW+CSA+Pred). The normalizing times of graft function after transplantation taked 18.17 +/- 1.61 days in control group and 10.9 +/- 0.18 days in therapeutic group respectively. The 1-, and 2-year graft survival rates were 89.3 +/- 0.3% and 87.0 +/- 0.3% in control group, 96.1 +/- 0.2% and 90.4 +/- 0.6% in therapeutic group respectively. The difference of the normalization times of graft function and graft survival rates between the two groups had statistically significant (P < 0.01). The incidence of complication such as infection, liver function damaging, etc, in therapeutic group was lower than in control group.

[Diagnosis and treatment of pheochromocytoma. Report of 48 cases].

A total of 48 patients with pheochromocytoma were treated during 1965-1989. The incidence of pheochromocytoma was about 2% in hypertensive patients at same period. In this series, 31 (64.6%) had adrenal pheochromocytoma and 17 (35.4%) extra-adrenal pheochromocytoma. More than 50% of the patients showed such symptoms as hypertension, headache, sweating and palpitation. Urinary catecholamine level was significantly elevated in 97.6% of the patients. In tumor localization, CT showed an accurate diagnostic rate of 95.5% and ultrasonography 85.7%. The fluctuation of blood pressure and the amount of fluid requirement during operation in phenoxybenzamine-treated patients were lower than those in non-phenoxybenzamine-treated patients, but there was no statistically significant difference between < 14 days of treatment group and > 14 days of treatment group in phenoxybenzamine-treated patients. 47 patients underwent complete excision of tumor, except 1 patient with a gigantic tumor from the organs of Zuckerkandl. One patient died after operation.

Bacteriological study of juvenile periodontitis in China.

The predominant cultivable bacteria associated with juvenile periodontitis (JP) in China were studied for the first time. Subgingival plaque samples were taken on paper points from 23 diseased sites in 15 JP patients and from 7 healthy sites in 7 control subjects. Serially diluted plaque samples were plated on nonselective blood agar and on MGB agar, a selective medium for the isolation of Actinobacillus actinomycetemcomitans. Fifteen or more isolated colonies from each sample (in sequence without selection) were purified for identification. The results indicated that the microflora in healthy sulci of the 7 control subjects was significantly different from that in diseased sites of JP patients. The predominant species in healthy sulci were Streptococcus spp. and Capnocytophaga gingivalis. In JP patients, Eubacterium sp. was found in significantly higher frequency and proportion. Actinobacillus actinomycetemcomitans was not detected in any samples. It appears that this species is not associated with juvenile periodontitis in China.