ObjectiveTo study the protective effects of ischemia preconditioning (IPC) on cryopreservation injury of rat liver.MethodsThe model of isolated nonrecirculated perfusion rat liver was established. The grafts were treated with IPC in different time (ischemia preconditioning time in IPC1 group was 5 min; the time in IPC2 group was 10 min; while the time in IPC3 group was 15 min). The cryopreservation injury of the grafts in each group was determined and compared. ResultsThe levels of aspartate transaminase (AST) and alanine transaminase (ALT) in the effluent solutions in IPC1 group were (40.1±6.3) U/L and （17.1±0.5） U/L respectively, and IPC2 group (53.6±3.7) U/L, （19.7±0.5） U/L, which were much lower than those of nonpreconditioning (NPC) group 〔(64.5±8.2) U/L, （23.8±3.9） U/L〕 (P＜0.05). Those in IPC1 group was much lower than those in IPC2 group and IPC3 group 〔(63.8±7.2) U/L,（22.8±2.5） U/L〕 (P＜0.05). The level of lactic acid dehydrogenase (LDH) in NPC group (104.3±20.6) U/L, IPC1 group (84.1±19.7) U/L, IPC2 group (90.5±21.1) U/L, and IPC3 group (103.1±18.5) U/L were of no significant difference (Pgt;0.05). The contents of bile product and the hepatocellular contents of ATP in IPC1 group were (53.5±10.2) μl and (6.15±0.65) μmol/g respectively, and IPC2 group (41.5±8.1) μl, (4.77±0.21) μmol/g, which were much higher than those NPC group 〔(22.8±9.7) μl, (2.62±0.34) μmol/g〕 (P＜0.05). Those in IPC1 group were much higher than those in IPC2 group and IPC3 group 〔(27.5±2.8) μl, (2.61±0.29) μmol/g〕 (P＜0.05). The contents of malondialdehyde (MDA) in liver tissue in IPC1 group was (4.36±0.26) nmol/gand IPC2 group (5.51±0.13)
ObjectiveTo discuss the impact of health education for the patients with decompensated cirrhosis and their family members on patients' family life quality, psychological conditions, medication compliance, and re-admission rates.
MethodsWe selected 100 decompensated cirrhosis patients between December 2012 and December 2013, and randomized them into two groups with 50 patients in each. One week prior to discharge, we conducted a comprehensive nursing assessment for the patients and developed hospital care regimen. Patients were followed up after discharge for six months. The control group underwent routine health education and extended care, while the experimental group had an addition of health education and extended care intervention on their family members.
ResultsAnxiety and depression were alleviated in both the two groups. The psychological conditions of patients in the experimental group were significantly better than the control group (P<0.01). The total scores of quality of life was significantly different compared with the scores before intervention (P<0.01). Medication compliance improved more significantly in the experimental group after intervention (P<0.05). Re-admission rates decreased more significantly in the experimental group than the control group (P<0.01).
ConclusionHealth education and extended care intervention for patients and their family members can improve patients' psychological conditions, promote medication compliance, reduce readmission rates, and improve patients' quality of family life.
Objective To explore the impact of ischemic postconditioning on ischemia-reperfusion injury in isolatedelderly rat hearts and their relation with P-Akt. Methods A total of 30 healthy elderly SD rats (21-23 months old， male or female) with their body weight of 450-500 g were divided into 3 groups: control group， ischemia-reperfusion group， and postconditioning group， with 10 rats in each group. Coronary artery blood flow，myocardial infarction size， phosphorylatedAkt （p-Akt） expression， and changes in myocardium and mitochondria were detected. Results Coronary artery blood flow of the postconditioning group was significantly higher than that of the ischemia-reperfusion group （6.4±1.2 ml/min vs.3.1±1.2 ml/min， P＜0. 01）， and myocardial infarction size of the postconditioning group was significantly smaller thanthat of the ischemia-reperfusion group （35.0%±2.0% vs. 55.7%±3.6%， Plt;0. 05）. The expression of P-Akt was significantlyhigher， and myocardial fibers and mitochondria were preserved better in the postconditioning group than the ischemia-reperfusion group. Conclusion Ischemic postconditioning can protect isolated elderly rat hearts against ischemia-reperfusion injury， which may be related to P-Akt activation.
Objective To investigate the effect of peroxisome proliferatoractivated receptor-γ coactivator-1α(PGC-1α) on early ischemic preconditioning (IPC) which may act as an important role in early IPC. Methods Building isolated working rat heart Langendorff model, thirty Wistar rats were divided randomly into three groups. Control group(CON group,n=10): a 120-min perfusion was performed without any intervension; ischemia and reperfusion group(I/R group,n=10): a 30-min equilibration period perfusion, a 30-min ischemia and a 60-min reperfusion were performed.; IPC group (n=10): a 10-min equilibration period perfusion was performed, then was elicited by two cycles of 5-min of ischemia interspersed with 5-min reperfusion prior to 30-min ischemia and a 60-min reperfusion. Frozen sections of myocardium at cardiac apex were made and immunohistochemical staining was used to detect expression and the intergrated optical density average (IODA) of PGC-1α. Ultrathin sections were made and the mitochondria under each specimen was evaluated according to Flameng score. Results PGC-1α expression in IPC group (IODA 10.94±5.23) was significantly higher than that in I/R group (IODA 3.88±1.72) and that in CON group (IODA 3.39±2.46; P=0.009, 0.007). The mitochondria changes in I/R group were significant edema and severe damage; but there were not so severe in CON group and IPC group.Flameng score of IPC group (0.44±0.13) and CON group (0.88±0.22) were lower than that in I/R group(1.78±0.14;P=0.003, 0.014) respectively. Conclusion IPC can protect myocytes mitochondria from ischemia and reperfusion.The cardioprotection may be related with the activation and the high expression of PGC-1α, which may act as one of the most important endogenous defence factors of the heart.
Objective To study the protective effects of ischemic preconditioning(IP) duration against ischemic reperfusion injury of skeletal muscle. Methods Thirty-six Wister rats were made amputation-like models, which underwent temporary amputation at the level of the femur, excluding the femoral vessels. They were divided into 6 groups(n=6) according to different treatments before ischemiareperfusion: group A(4 hours of ischemiareperfusion); groups B, C, D, E(5, 10,15, 20 minutes of ischemia and 5, 10, 15, 20 minutes of reperfusion respectively, for 3 cycles, 4 hours ischemiareperfusion ); group F (no ischemia-reperfusion). The malondialdehyde(MDA), the extent of edema and necrosis of skeletal muscle were measured to observe protective effects of different ischemic preconditioning duration. Results Five minutes of ischemic preconditioning（IP5）could protect skeletal muscle of ischaemia against necrosis and the survival area of the muscle was 82.47%.The effects of IP10 and IP 15 were significantly superior to that of IP5 and the survival areas of the muscle were 89.03% and 89.49%. The effect of IP20(78.27%) was significantly inferior to that IP5. IP5 could reduce edema of skeletal muscle, the effect of IP10 was significantly superior to that of IP5. IP5, IP 10,and IP 15 could decrease the level of MDA, but IP20 did not decrease it. Conclusion The trend of protective effect of IP on ischemia-reperfusion injury of themuscle in rats first rise to the peak and then go down,10minutes ofIPis optimal.
Abstract： Objective To study the changes of the cyclic adenosine monophosphate (cAMP) and protein kinase A (PKA) expression of isolated rat hearts after diazoxide preconditioning (DPC), and to explore the possible mechanism of cAMP signaling pathway in myocardial protection by DPC. Methods Isolated working heart Langendorff perfusion models of 40 Wistar rats were set up and were divided randomly into four groups. For the ischemia reperfusion injury(I/R) group (n=10), 30 min of equilibrium perfusion was followed by a 60 min reperfusion of KrebsHenseleit (K-H) fluid. The DPC group (n=10) had a 10 min equilibrium perfusion and two cycles of 5 min of 100 μmol/L diazoxide perfusion followed by a 5 min diazoxidefree period before the 30 min ischemia and the 60 min reperfusion of K-H fluid. The blank control group (control group, n=10) and the Dimethyl Sulphoxide(DMSO) group (n=10) were perfused with the same treatment as in the DPC group except that diazoxide was replaced by natriichloridum and DMSO respectively. The activity of creatine kinase (CK) in coronary outflow, the activity of malonyldialdehyde (MDA) and superoxide dismutase (SOD) in myocardium were detected. And the scope of myocardial infarction and the concentrations of myocardial cAMP and PKA were also assessed. Results Compared with the I/R group, the level of MDA for the DPC group decreased significantly (8.28±2.04 nmol/mg vs. 15.52±2.18 nmol/mg, q=11.761,Plt;0.05), the level of SOD increased significantly (621.39±86.23 U/mg vs. 477.48±65.20 U/mg, q=5.598,Plt;0.05). After a 30 min reperfusion, compared with the I/R group, the content of CK decreased significantly (82.55±10.08 U/L vs. 101.64±19.24 U/L, q=5.598, Plt;0.05) and the infarct size reduced significantly (5.63%±9.23% vs.17.58%±5.76%, q=6.176,Plt;0.05) in the DPC group. The cAMP concentration in the DPC group was much higher than that in the I/R group (0.64±0.07 pmol/g vs. 0.34±0.05 pmol/g, q=14.738,Plt;0.05), and PKA concentration was also much higher than that in the I/R group ［17.13±1.57 pmol/(L·min·mg) vs. 12.85±2.01 pmol/(L·min·mg), Plt;0.05］. However, there were no significant differences between the I/R group, DMSO group and the control group in the above indexs (Pgt;0.05). Conclusion DPC significantly improves the releasing of cAMP and PKA, decreases oxygen free radicals, and relieves myocardial ischemia reperfusion injury. The cAMP signaling pathway may be involved in triggering the process of myocardial protection mechanisms of DPC.
Objective To investigate the protective effect of ischemic preconditioning (IP) on ischemicreperfusion injury of rat liver graft. MethodsMale Sprague Dawley rats were used as donors and recipients of orthotopic liver transplantation,the period of cold preservation and anhepatic phase were 100 min and 25 min respectively.Sixtyfour rats were randomly divided into 2 groups (n=32),control group: donor livers were flushed through the portal veins with physiological saline solution containing heparin only before harvested; IP group: before donor livers were harvested,the portal veins and hepatic arteries of them were interrupted for 10 min,and reflow was initiated for another 10 min,then did as control group.One half of each group were used to investigate 1 week survival rate of recipients,and another half of each group were used to take sample of blood and hepatic tissue after 2 hours of reperfusion of liver graft. ResultsOne week survival rate,amount of bile,serum NO and activity of antioxidase were higher in IP group than those in control group(P＜0.05),meanwhile,serum ALT,AST,LDH,TNF and superoxide in hepatic tissue were lower in IP group than those in control group (P＜0.05),and histological findings in IP group showed less injury than those in control group. Conclusion IP could increase production of serum NO,reduce the level of serum TNF and protect rat liver graft from ischemicreperfusion injury.
ObjectiveTo investigate the effect of simvastatin and mechanical pretreatment on intimal hyperplasia of venous graft and its mechanism.MethodsTwelve New Zealand rabbits were selected and randomly divided into 4 groups: a blank control group, a simvastatin topical treatment group, a mechanical precondition group and a combined group (n=3 in each group). Ultrasound was used to evaluate the changes of graft wall and blood flow velocity in the graft, and pathological section was used to evaluate the intimal hyperplasia. Human umbilical cord endodermal cells were cultured in vitro. A simvastatin group and a solvent control group were set to detect YAP phosphorylation, downstream target gene expression and cell proliferation.ResultsVascular ultrasound showed that except the simvastatin topical treatment group, the flow velocity in vein grafts in the other three groups significantly increased 21 days after surgery compared with 7 days after surgery (P<0.01). Pathological sections showed that the thickness of new intima in the simvastatin topical treatment group, mechanical precondition group, combined group and blank control group were 45.56±4.11 μm, 201.28±16.71 μm, 143.57±7.82 μm, 249.45±13.33 μm, respectively, and there were statistical differences compared with the blank control group (P<0.05). In vitro results showed that compared with the solvent control group, cell death was observed in high concentration simvastatin (5 mmol/L) group, cell proliferation was inhibited in low concentration simvastatin (2.5 mmol/L) group (P<0.05), the expression of YAP protein in the simvastatin group was unchanged, but the expression of phosphorylated YAP protein significantly increased (P<0.05), and the expression of downstream target gene ccn1 was down-regulated (P<0.001).ConclusionIntravascular local application of simvastatin and mechanical preconditioning alone or in combination can inhibit intimal hyperplasia of venous graft. High concentration of simvastatin has cytotoxicity, while low concentration of simvastatin has inhibitory effect on cell proliferation. Simvastatin can inhibit the formation of new intima by inhibiting the entry of YAP into the nucleus and reducing the transcription of cell proliferation-related target gene ccn1.
Objective To study the clinical significance of total gastrectomy in treatment for gastric cardia cancer.Methods The clinical data of 118 patients with gastric cardia cancer underwent operation from May 1997 to October 2012 in the Department of General Surgery of Baiyin Hospital， Affiliated to Lanzhou University were analyzed retrospe-ctively. Among these 118 patients， there were 65 patients treated by total gastrectomy （total gastrectomy group） and 53patients treated by proximal gastrectomy （proximal gastrectomy group）. The postoperative complications， survival rate，quality of life， and nutrition indexes were compared after operation between the total gastrectomy group and the prox-imal gastrectomy group. Results ① The incidence of postoperative complications was 7.7% （5/65） and 13.2% （7/53） in the total gastrectomy group and the proximal gastrectomy group， respectively， the difference was not statistically signi-ficant （χ2=0.972， P=0.248）. ② 1-， 3-， and 5-year survival rate after operation were 63.1%， 46.2%， and 30.8% in thetotal gastrectomy group；which were 66.0%， 36.9%， and 18.5% in the proximal gastrectomy group. The difference of 1-year survival rate after operation was not statistically significant in two groups （χ2=0.193， P=0.402）， the 3- and the 5-year survival rates of the total gastrectong group were significantly higher than those of the proximal gastrectony group （χ2=4.508， P=0.022；χ2=30.271， P=0.000）. ③ The Spitzer quality of life score had no difference at the different timeafter operation in two groups （P＞0.05）. Compared with the proximal gastrectomy group， the points of heartburn， swallo-wing problem， appetite， and food intake on 12 months after operation in the total gastrectomy group were higher （P＜0.05）， the points of the other indexes had no significant differences （P＞0.05）. ④ The nutrition indexes after operationhad no differences at the different time after operation in two groups （P＞0.05）. Conclusions Total gastrectomy in treatment for gastric cardia cancer would not increase complications， also can improve 5-year survival for patients withⅠ-Ⅲ stage， and survival condition after operation is also much better than that of proximal gastrectomy.
ObjectiveTo compare the effects of povidone iodine handwashing with brush and brush-free handwashing on the hand skin condition of nurses in operation room.
MethodA random sampling method was used to choose 150 nurses from the operation room of a grade-3 class-A hospital as our study subjects from June 2013 to December 2014. They were randomly divided into control group and study group according to the random number table with 75 in each. The control group used the traditional povidone iodine handwashing with brush, while the study group applied brush-free handwashing method. Then, we compared the hand skin condition and disinfection effect of these two kinds of handwashing methods.
ResultsThe control group had dry skin in 34 nurses (45.3%), dry desquamation in 9 (12.0%), tight feeling in 51 (68.0%), and allergy in 5 (6.7%). The study group had dry skin in 19 nurses (25.3%), dry desquamation in 0 (0.0%), tension in 21 (28.0%), and allergy in 0 (0.0%). The differences between the two groups were statistically significant (P<0.05).
ConclusionsThe brush-free handwashing method is able to achieve the requirements of surgical hand disinfection, and can protect the skin of nurses in operation room.
