Objective To probe the changes of plasma albumin concentration and its correlation with that of blood inflammatory factors at the postoperative early stage in patients undergoing intraabdominal surgery. Methods From August 2008 to March 2009, 45 patients undergoing abdominal surgery were divided into three groups according to different types of operation with 15 cases in each group, cholecystectomy group( A), chole cystectomy plus common bile duct exploration group(B) and radical resection of alimentary duct maliguance group (C). Before the surgery and 12,24,48,72 h after operation, plasma albumin contentserum IL-6 and TNF-α concentration were measured. Results Postoperatively the content of plasma albumin did not change significantly in group A ( P ＞ 0.05 ), while that decreased after operation in group B and group C(P ＜0.01 ). The postoperative concentration of serum IL-6 and TNF-α increased in group A at 12, 24 h and 48 h after operation(P ＜0.01 ). In group B and group C IL-6 and TNF-α increased at all tested time point after operation ( P ＜ 0.01 ). The postoperative alterations of IL-6 and TNF-α were statistically different between the three groups at all time points(P ＜0.01 ). The content of plasma albumin was in a negative correlation with the concentration of IL-6 and TNF-α; ( r = - 0.376, P = 0.000; r =-0.772,P = 0.000). Conclusions The content of plasma albumin decreased at the early stage after major and moderate abdominal surgery. The content of plasma albumin was in a negative correlation with the concentration of inflammatory factors at the early stage after abdominal surgery.
Key words:
Surgical procedures, operative; Albumins; Tumor necrosis factor-alpha; Interleukin-6
The aim of this prospective study was to screen and combine effective biomarkers to improve their diagnostic performance in detecting intestinal barrier dysfunction in patients after major abdominal surgery.Patients undergoing major abdominal surgery were enrolled after signing informed consent in this study. The serum concentrations of α-GST, DAO, D-lactate, citrulline and I-FABP were detected 24 hours before and after surgery. The diagnostic performance of five biomarkers on intestinal barrier dysfunction was assessed using logistic regression models and receiver operating characteristic (ROC) curve analyses.Thirty-nine patients with major abdominal surgery were enrolled in and successfully completed this study. ROC analysis revealed that the sensitivities of D-lactate, citrulline and I-FABP were very high (0.91, 0.91 and 1.00, respectively), but the specificities of these biomarkers were less than 0.70. The sensitivity of DAO was very low [0.25; 95% confidence interval (CI), 0.05-0.57], but its specificity was high (0.92; 95% CI, 0.75-0.99). The accuracies of D-lactate and I-FABP were very high, and the areas under the curves (AUCs) of the biomarkers were 0.84 (95% CI, 0.68-0.93) and 0.81 (95% CI, 0.65-0.92), respectively. Different combinations of five biomarkers were also analysed. The sensitivity, specificity and AUC values of the combination of I-FABP, citrulline and D-lactate were 1.00, 0.74 and 0.89, respectively. These results were similar to those derived from the combination of α-GST, DAO, D-lactate, citrulline and I-FABP (P=1.000).The combination of serum D-lactic acid, citrulline and I-FABP greatly improved the diagnostic performance for identifying intestinal barrier dysfunction in patients after major abdominal surgery.
Objective:To study the different effects between local anesthesia and epidural block anesthesia on early postoperative wound pain and aesthema after tension-free inguinal hernia repair.Methods:All of the 60 cases performed tension-free inguinal hernia repair were randomly divided into two groups,32 cases were treated with local anesthesia and the other 28 cases were treated with epidural block anesthesia.In the early postoperation,wound pain was investigated with a visual analog scale(VAS),and wound pain and hypoesthesia were assessed using von Frey monofilaments(Semmes-Weistein5.07/10g).To compare the using of pain-killer in two groups.Results:In the postoperative 1d,the VAS on resting(P=0.000),the VAS on walking(P=0.036),the VAS on coughing(P=0.015)and wound pain area(P=0.000) of local anesthesia group were lower than those of epidural block anesthesia group.In the postoperative 2d,the VAS on walking(P=0.000),the VAS on coughing(P=0.004)and wound pain area(P=0.004)of local anesthesia group were lower than those of epidural block anesthesia group,the VAS on resting were no significant differences(P=0.136).In the postoperative 3d,the VAS on coughing(P=0.003),the VAS on walking(P=0.026) and wound pain area(P=0.024) of local anesthesia group were lower than those of epidural block anesthesia group,the VAS on resting were no significant differences(P=0.055).In the postoperative 4-5d,the total pain indexs between both of groups had significant differences(P0.05).In the postoperation,wound hypoesthesia area had no difference(P 0.05).In the postoperative 12h,1,2,3,4d,the percentage of patients using pain-killer of local anesthesia group was lower than that of epidural block anesthesia group(P0.05),but that of postoperative 5d had no difference(P=1.000).Length of stay of local anesthesia group was lower than that of epidural block anesthesia group(P=0.000).Conclusion:Comparing to epidural block anesthesia,local anesthesia can relieve wound pain in the early postoperation(3d) after tension-free inguinal hernia repair,and shorten the length of stay;but the way of anesthesia has no effect on wound hypoesthesia area.
Objective:To investigate the expression of PTEN(phosphatase and tensin hmmlogy deleted on ten) in the breast cancer and the relationship with the tumor angiogenesis.Methods:The expression of PTEN and MVD were detected by immunohistochemical SP method in paraffin section from 53 women with primary breast cancer and 10 subjects of hyperplasia of mammary glands.Results:The higher lever PTEN expression in 53 case with the rate 49.1 %(26/53),which was reduced compared with the expression in benign hyperplasia of mammary glands(P0.01).The lower lever expression of PTEN rate was higher in the group of axillary lymph node metastasis case than that of the case without lymph node metastasis(P0.05).The lower lever PTEN expression rate was higher in the group of estrogen receptor negative status than that of the estrogen receptor positive status(P0.01).The lower lever PTEN expression was related with higher MVD(P0.05).Conclusion:The expression reduce or loss of PTEN may related with tumor angiogenesis and axillary lymph node metastasis in breast cancer.
Numerous studies have investigated the utility of serum intestinal fatty-acid binding protein (I-FABP) in differentiating acute intestinal ischemia from acute abdomen. However, the results remain controversial. The aim of this meta-analysis is to determine the overall accuracy of serum I-FABP in the diagnosis of acute intestinal ischemia. Publications addressing the accuracy of serum I-FABP in the diagnosis of ischemic bowel diseases were selected from databases. The values of true-positive (TP), true-negative (TN), false-positive (FP), and false-negative (FN) were extracted or calculated for each study. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated. The overall diagnostic performance was assessed using a summary receiver operating characteristic curve (SROC) and area under curve (AUC). Nine studies that collectively included 1246 patients met the eligible criteria. The pooled sensitivity, specificity, DOR, PLR, and NLR were 0.80 (95% CI: 0.72-0.86), 0.85 (95% CI: 0.73-0.93), 24 (95% CI: 9-65), 5.5 (95% CI: 2.8-10.8) and 0.23 (95% CI: 0.15-0.35), respectively. The AUC was 0.86 (95% CI: 0.83-0.89). The meta-analysis carried out in this report suggests that the I-FABP may be a useful diagnostic tool to confirm acute intestinal ischemia in acute abdomen, but better-designed trials are still required to confirm our findings.
Activation of Aryl hydrocarbon receptor (AhR) is involved in the control of intestinal mucosal homeostasis. Intestinal barrier dysfunction contributes to the development of many intestinal diseases, such as inflammatory bowel disease (IBD). In this study, we investigated the mechanisms of AhR activation in the maintenance of intestinal barrier function. Adult C57BL/6 mice were treated with dextran sulphate sodium (DSS) for 7 days, with or without 6-Formylindolo(3,2-b)carbazole (FICZ), a ligand of AhR. We found that AhR activation by FICZ attenuated the decreased TJ protein expression in the colonic mucosa of the DSS-induced mice. Further, the increase of both MLC phosphorylation and MLCK expression in the mice with DSS-induced colitis was also significantly inhibited by FICZ induced AhR activation. For in vitro experiments, Caco-2 cells were treated with tumour necrosis factor alpha (TNF-α)/interferon gamma (IFN-γ) for 48 h, with or without FICZ. AhR activation prevented TNF-α/IFN-γ-induced decrease in TER and morphological disruption of the TJs in Caco-2 monolayers. It also inhibited TNF-α/IFN-γ-induced increase in MLCK expression and MLC phosphorylation by suppression of NF-κB p65 signaling pathway. Thus, AhR-activating factors might have potential as therapeutic agents for the treatment of patients with IBD.
The aim of this study was to label Bovine Serum Albumin (BSA) by Rhodamine B Isothiocyanate (RBITC) and test its stability in vivo. RBITC-BSA was labelled by the improved Marshall’s method, scanned at full wavelength, and the RBITC:BSA ratio was calculated. Blood and urine samples were obtained from rabbits injected with the RBITC-BSA complex and SDS-PAGE analysis was performed. Full wavelength scanning showed that the labelled RBITC-BSA complex possessed features of both RBITC and BSA, and the RBITC:BSA ratio was 1:80. Furthermore, the RBITC-BSA complex was stable in vivo. Thus, we developed a stable RBITC-BSA complex with high specificity and sensitivity, which could be used as a tracer molecule to study protein transportation and vascular permeability.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)