Effects of two different hydroxyethyl starch solutions (HES200/0.5 vs. HES130/0.4) on the expression of platelet membrane glycoprotein

BACKGROUND: There are various hydroxyethyl starch (HES) solutions with different degrees of hydroxylation and different molecular weights. HES200/0.5 solution is most commonly used. HES130/0.4 is a new HES solution and is the 'state-of-the-art' in volume substitution. However, the mechanism of the observed anticoagulation action of HES has not been fully delineated. The objective of this study was to further investigate the effect of HES200/0.5 and HES130/0.4 on platelet coagulation. METHODS: Sixty ASA I-II patients undergoing elective minor surgery were randomly allocated to receive an intravenous infusion (20 ml/kg) of lactated Ringer's solution (group L), HES200/0.5 (group H) or HES130/0.4 (group V) after the induction of anesthesia. The expression of CD42b, CD41/61 and CD62p in vivo was assessed on non-stimulated platelets and adenosine diphosphate (ADP) agonist-activated platelets using flow cytometry. RESULTS: Resting glycoprotein expression of the non-stimulated platelets was observed. HES200/0.5 and HES130/0.4 reduced the CD42b, CD41/61 and CD62p expression of ADP-agonist-activated platelets at 15 min after intravenous infusion. At 6 h after intravenous infusion, the trend of decreasing expression of activated CD42b, CD41/61 and CD62p was maintained in group H. However, CD42b, CD41/61 and CD62p expression returned to the pre-operative level in group V. CONCLUSION: This study showed that both HES200/0.5 and HES130/0.4 can inhibit platelet coagulation. Platelet dysfunction experienced a faster recovery after the infusion of HES130/0.4 than after HES200/0.5. Liquid resuscitation with HES130/0.4 may decrease the risk of hemorrhage in the operative period.     

Banded versus nonbanded Roux-en-Y gastric bypass: a systematic review and meta-analysis of randomized controlled trials

BackgroundBariatric surgery is remarkably effective in achieving weight loss and improving obesity-related co-morbidities; however, efforts still continue to improve its long-term outcomes. Particularly, banded Roux-en-Y gastric bypass (RYGB) has been scrutinized in comparison to standard (nonbanded) RYGB in terms of benefits and postoperative complications.ObjectivesThis study aims to compare the safety and efficacy of banded versus nonbanded RYGB.SettingMeta-analysis of randomized controlled trials (RCTs).MethodsA meta-analysis of high-quality studies that compared banded and nonbanded RYGB was conducted through February 2019 by systematically searching multiple electronic databases. Published RCTs comparing these 2 procedures were included to pool the data on excess weight loss, food tolerability, and postoperative complications.ResultsThree RCTs were eligible to be included in this meta-analysis, comprising a total of 494 patients (247 in each group). Two of the RCTs provided 2-year postoperative data, and 1 study reported 5-year outcome. Age ranged from 21 to 50 years, and body mass index ranged from 42 to 65 kg/m². Percentage of excess weight loss was significantly greater with banded RYGB than with nonbanded RYGB (mean difference 5.63%; 95% CI 3.26–8.00; P < .05). Postoperative food intolerance, emesis, and dysphagia were more common after banded RYGB (odds ratio 3.76; 95% CI 2.27–6.24; P < .001). Nevertheless, major postoperative complications did not significantly differ between the 2 groups.ConclusionFindings of this meta-analysis of RCTs indicate that in a medium-term follow-up, excess weight loss with banded RYGB would be 5% greater than that with the nonbanded RYGB (about 1 point difference in body mass index) at the expense of more food intolerance and postoperative vomiting; however, the frequency of postoperative complications would not be significantly different.     

Posttransplant Lymphoproliferative Disorder in Kidney and Liver Transplant Recipients: A Single-Center Experience

Introduction

Posttransplant lymphoproliferative disorder (PTLD) is a heterogeneous group of lymphoid malignant neoplasms arising after solid organ transplantation or hematopoietic stem cell transplantation. The current World Health Organization classification identified 4 basic histologic types of PTLD: early, polymorphic variant, monomorphic variant, and classical Hodgkin lymphoma-type lesions.

注射腺病毒介导的Cyr61基因对鼠缺血心肌血管生成影响的实验研究

目的:探讨Cyr61基因的血管生成作用。方法:制备大鼠心肌梗死模型,随机分3组:Ad-Cyr61组;Ad-null组;单纯心肌梗死组;每组24只,根据处死大鼠不同时间点每组又分成3个亚组,每亚组8只。在缺血区心肌内注射Ad-Cyr61及Ad-null。于梗死后3、7、14d处死大鼠,通过RT-PCR检测Cyr61mRNA的表达,免疫组化检测CD31及α-SMA。结果:注射Ad-Cyr61组3d时Cyr61mRNA显著表达,与Ad-null组及单纯心肌梗死组比较,吸光光度值有显著性差异(0.394±0.119对0.158±0.017和0.149±0.014,P<0.01),7、14d时仍有表达,但无显著差异。注射Ad-Cyr61组毛细血管密度3d时与Ad-null组及单纯心肌梗死组比较没有明显变化,7、14d时毛细血管密度明显增加,与后二者比较有显著性差异(P<0.01)。Ad-null组α-SMA阳性的小动脉于14d时较Ad-null组增多。结论:心肌注射Ad-Cyr61后,缺血心肌表达Cyr61,并且促进了血管生成作用。     

Endotoxaemia in severe burns

In an attempt to detect endotoxaemia the authors carried out the Limulus test in burned patients' plasma. The test was positive mainly in lethal cases, yet it was negative in many other cases where endotoxaemia could be presumed.The authors therefore carried out a series of experiments in rabbits, in which they proved that endotoxin entering the circulation is being accumulated in leucocytes and can be detected in platelet-leucocyte lysate, using Limulus test, even at low concentrations, when Limulus test in plasma is negative.It appears that endotoxin detection by Limulus test in plasma does not offer decisive results and that it should be supplemented by endotoxin detection in platelet-leucocyte lysate.     

Protein and isoamylase content of rat-submaxillary gland under the influence of α- and β-sympathicolysis

Summary In order to study the function of adrenergic receptors in the submaxillary gland in vivo, rats were treated with the -sympathicolytic, phentolamine (Regitin^®) and with the -sympathicolytic, propranolol (Dociton^®) and the protein, amylase, and isoamylase content of their submaxillary glands were investigated. The protein concentration rises after 3 weeks of - as well as combined -and -sympathicolysis while the amylase concentrations remain, on the whole, unchanged. The pharmacologically induced secretory inhibitions are being discussed in connection with the generally accepted receptor functions.     

大鼠即刻早期基因产物Cyr61短发夹环 RNA质粒的构建与鉴定

目的构建Cyr61短发夹环RNA(shRNA),探讨即刻早期基因产物Cyr61RNAi对Cyr61功能的影响,以期为进行这方面研究提供基础。方法在Gene Bank中查到鼠Cyr61的mRNA基因序列并输入到相应设计软件中,以此设计引物序列。经PCR扩增、酶切后,克隆于Pgenesil-1载体并行酶切鉴定。结果构建的鼠即刻早期基因产物Cyr61shRNA质粒经测序鉴定验证与预期相符。结论该研究结果为研究Cyr61shRNA质粒的RNAi功能及其对Cyr61功能影响的研究奠定了基础。