AIM： TO examine the effects of ethanol-induced proteasome inhibition, and the effects of proteasome inhibition in the regulation of epigenetic mechanisms.METHODS： Rats were fed ethanol for 1 mo using the Tsukamoto-F...AIM： TO examine the effects of ethanol-induced proteasome inhibition, and the effects of proteasome inhibition in the regulation of epigenetic mechanisms.METHODS： Rats were fed ethanol for 1 mo using the Tsukamoto-French model and were compared to rats given the proteasome inhibitor PS-341 （Bortezomib, Velcade^TM） by intraperitoneal injection. Microarray analysis and real time PCR were performed and proteasome activity assays and Western blot analysis were performed using isolated nuclei.RESULTS： Chronic ethanol feeding caused a significant inhibition of the ubiquitin proteasome pathway in the nucleus, which led to changes in the turnover of transcriptional factors, histone-modifying enzymes, and, therefore, affected epigenetic mechanisms. Chronic ethanol feeding was related to an increase in histone acetylation, and it is hypothesized that the proteasome proteolytic activity regulated histone modifications by controlling the stability of histone modifying enzymes, and, therefore, regulated the chromatin structure, allowing easy access to chromatin by RNA polymerase, and, thus, proper gene expression. Proteasome inhibition by PS-341 increased histone acetylation similar to chronic ethanol feeding. In addition, proteasome inhibition caused dramatic changes in hepatic remethylation reactions as there was a significant decrease in the enzymes responsible for the regeneration of S-adenosylmethionine, and, in particular, a significant decrease in the betaine-homocysteine methyltransferase enzyme. This suggested that hypomethylation was associated with proteasome inhibition, as indicated by the decrease in histone methylation.CONCLUSION： The role of proteasome inhibition in regulating epigenetic mechanisms, and its link to liver injury in alcoholic liver disease, is thus a promising approach to study liver injury due to chronic ethanol consumption.展开更多
TO evaluate the effects of abdominal trauma on hemorrhagic shock-induced acute lung injury in rats. METHODS： Five groups were allocated （n = 8） in the study. Group Ⅰ was taken as the control group, group Ⅱ as the...TO evaluate the effects of abdominal trauma on hemorrhagic shock-induced acute lung injury in rats. METHODS： Five groups were allocated （n = 8） in the study. Group Ⅰ was taken as the control group, group Ⅱ as the hemorrhagic shock group, group Ⅲ as hemorrhagic shock ＋ laparotomy, group Ⅳ as hemorrhagic shock ＋ splenectomy and group V as splenectomy ＋ omentectomy ＋ hemorrhagic shock group. Hemorrhagic shock was induced by drawing blood and reducing mean arterial pressure （MAP） to 40 mmHg within 10 min. After a hypotensive period of 1 h, animals were resuscitated. Bronchoalveolar lavage （BAL） was performed to recover cells from the alveolar space with 40 mL of BAL fluid after resuscitation malondialdehyde （MDA） and L-γ-glutamyl-L-cysteinylglycine （GSH） levels were measured in serum, erythrocytes and lung tissue. RESULTS： Serum, erythrocyte, lung tissue MDA and GSH levels were significantly increased in hemorrhagic shock groups Ⅱ-Ⅴ （P 〈 0.05）. Lymphocyte, neutrophil and alveolar macrophage counts in BAL fluid indicated a significant difference between control and shock groups （P 〈 0.05）. CONCLUSION： The degree of trauma increases hemorrhagic shock-induced acute lung injury.展开更多
The purpose of this study was focused on the imaging features of the chest trauma and its relation to clinical characteristics. All the injured patients were from the Yushu Earthquake areas on days April 14 - 23,2010....The purpose of this study was focused on the imaging features of the chest trauma and its relation to clinical characteristics. All the injured patients were from the Yushu Earthquake areas on days April 14 - 23,2010. After an initial treatment,the injurers were rapidly transported from Yushu at an altitude of 4 000 m via air to Xining at 2 260 m within 6~8 h,and promptly admitted to Qinghai Provincial People’s Hospital. A total of 130 wounded injurers who had high suspicion of chest injuries all had examinations of Chest X-ray and computed tomography(CT)images. Of them 63 injurers presented at least one of the features of the chest trauma in imaging with a positive rate of 48.5 %. Of these,37 cases (28.5 %) were multi-system with multiple injuries ,33 cases (25.4 %) were chest trauma with multi-injury types,which included thoracic fractures in 54 cases (85.7 %),pleural injury in 56 cases (88.9 %),lung injury in 54 cases (85.7 %),lungs complications in 37 cases (58.7 %),and extrapulmonary complications of 35 cases (55.6 %). The radiological data were analyzed retrospectively. The features of chest trauma in Yushu Earthquake,the complications of chest injuries,and the relation between imaging findings and clinical manifestations,as well as the differences of chest trauma between Yushu Earthquake and Wenchuan Earthquake were discussed in detail.展开更多
The authors describe a rare case in which blunt abdominal trauma resulted in mesenteric injury with delayed double ischemic ileal stenosis. Abdominal computed tomography demonstrated stenotic ileal loop with mural thi...The authors describe a rare case in which blunt abdominal trauma resulted in mesenteric injury with delayed double ischemic ileal stenosis. Abdominal computed tomography demonstrated stenotic ileal loop with mural thickening. At surgery, a double stenotic bowel loop was found adjacent to a healed defect in the mesentery. Histological examination of the two resected segments showed fibrotic and ischemic lesions within the mesentery. Ischemic intestinal stenosis from mesenteric injury should be considered in the differential diagnosis in patients suffering from intestinal occlusion with a history of blunt abdominal trauma.展开更多
To probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury. Methods: A retrospective study involving 113 patients with seve re hepatic trauma (AAST grade I...To probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury. Methods: A retrospective study involving 113 patients with seve re hepatic trauma (AAST grade IV and V) during the past 12 years was carried out . Ninety eight patients underwent surgical treatment. Surgical interventions in cluding hepatectomy or direct control of bleeding vessels by finger fracture tec hnique with Pringle maneuver, selective ligation of hepatic artery, retrohepatic caval repair with total hepatic vascular occlusion, and perihepatic packing wer e mainly used. Results: In the 98 patients treated operatively, the survival r ate was 69.4 % (68/98). Among 40 patients with juxtahepatic venous injury (JH VI), 15 were cured with the maximum blood transfusion of 12 000 ml. Eight ca ses of Grade IV injury treated nonoperatively were cured. The percentage of fail ure of nonoperative management was 42.9 % (6/14). The overall mortality rate was 32.7 % (37/113), and 57% of the deaths were due to exsanguination. Conclusions: Reasonable surgical procedures based on classifica tion of hepatic injuries can increase the survival rate of severe liver trauma. Accurate perihepatic packing is effective in dealing with JHVI.展开更多
Objective:: To prospectively compare the clinical outcome of intensive care therapy (ICT) with that of conventional care therapy (CCT) in severe head injured patients. Methods: Patients with severe head injury were as...Objective:: To prospectively compare the clinical outcome of intensive care therapy (ICT) with that of conventional care therapy (CCT) in severe head injured patients. Methods: Patients with severe head injury were assigned randomly into Group ICT and Group CCT, 100 patients in each group. Patients in Group ICT accepted intensive care therapy in neurosurgical intensive care (NIC) unit for the first 2 weeks after admission, while patients in Group CCT accepted conventional care therapy in ordinary ward. The outcomes were evaluated 3 months after injury. Results: There was a significant increase in good recovery (54%) (χ 2= 4.43 , P< 0.05 ) and significant decrease of death (25%) (χ 2= 4.50 , P< 0.05 ) in Group ICT compared to 39% and 39% in Group CCT respectively. The differences were also confirmed statistically in the following aspects: the patients under 50 years with good recovery pronounced a number increase (χ 2= 7.54 , P< 0.01 ), while the mortality in the same range of age was decreased in Group ICT (χ 2= 5.28 , P< 0.05 ). The mortality was reduced significantly in patients with GCS for 6-8 on admission (χ 2= 8.47 , P< 0.01 ) and in patients with the level of brain stem injured bellow mesencephalon (χ 2= 4.15 , P< 0.05 ). ICT would improve the outcome in patients undergoing conservative therapy only (χ 2= 13.13 , P< 0.01 ). Conclusions: NIC plays an important role in assessing the neurological state, guiding management, evaluating curative effect and estimating the outcome.展开更多
Objective:: To summarize the peri-operative experience from 53 patients with traumatic head injuries with GCS score 3-5. Methods: Fifty-three most severely head-injured patients with GCS score 3-5 were admitted to our...Objective:: To summarize the peri-operative experience from 53 patients with traumatic head injuries with GCS score 3-5. Methods: Fifty-three most severely head-injured patients with GCS score 3-5 were admitted to our department and treated operatively from Oct. 1994 to Jun. 1998 and the data were analyzed retrospectively. Results: Thirty-seven cases ( 69.8 %) survived, among them 28 ( 52.8 %) had a good recovery or moderate disability, and 9 (17%) had severe deficits. The other 16 ( 30.2 %) died after therapy. Conclusions: The prognosis of most severely head-injured patients could be improved by peri-operative treatment including premedical care, early evacuation of intracranial hematoma with large decompressive craniectomies, intracranial hypertension monitoring, moderate hypothermia therapy, effective prevention and treatment of cerebral vasospasm and complications.展开更多
Objective: To summarize the experience of the treatment of traumatic hepatorrhexis. Methods: The clinical data of 209 cases of liver trauma treated in the three affiliated hospitals of the Third Military Medical Unive...Objective: To summarize the experience of the treatment of traumatic hepatorrhexis. Methods: The clinical data of 209 cases of liver trauma treated in the three affiliated hospitals of the Third Military Medical University from 1989 to 1999 were retrospectively analyzed. Among the 209 patients, 108 ( 51.7 %) had Grade III or more severe liver injury. Operative treatment was performed in 186 cases and preservative treatment in 23. Results: In the operated group, 169 patients were cured. The complications occurred in 18 patients and 17 of them died. In the non operated group, the complications occurred in 22 patients and only 1 of them died. Conclusions: Severe injury and delayed treatment are two major factors leading to death from liver injuries. Surgical intervention is still the principal measure to treat traumatic hepatorrhexis. The indications for non operative treatment should be carefully selected.展开更多
基金Supported by The NIH/NIAAA grant 8116 and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Centerseed grant 513217-00-00
文摘AIM： TO examine the effects of ethanol-induced proteasome inhibition, and the effects of proteasome inhibition in the regulation of epigenetic mechanisms.METHODS： Rats were fed ethanol for 1 mo using the Tsukamoto-French model and were compared to rats given the proteasome inhibitor PS-341 （Bortezomib, Velcade^TM） by intraperitoneal injection. Microarray analysis and real time PCR were performed and proteasome activity assays and Western blot analysis were performed using isolated nuclei.RESULTS： Chronic ethanol feeding caused a significant inhibition of the ubiquitin proteasome pathway in the nucleus, which led to changes in the turnover of transcriptional factors, histone-modifying enzymes, and, therefore, affected epigenetic mechanisms. Chronic ethanol feeding was related to an increase in histone acetylation, and it is hypothesized that the proteasome proteolytic activity regulated histone modifications by controlling the stability of histone modifying enzymes, and, therefore, regulated the chromatin structure, allowing easy access to chromatin by RNA polymerase, and, thus, proper gene expression. Proteasome inhibition by PS-341 increased histone acetylation similar to chronic ethanol feeding. In addition, proteasome inhibition caused dramatic changes in hepatic remethylation reactions as there was a significant decrease in the enzymes responsible for the regeneration of S-adenosylmethionine, and, in particular, a significant decrease in the betaine-homocysteine methyltransferase enzyme. This suggested that hypomethylation was associated with proteasome inhibition, as indicated by the decrease in histone methylation.CONCLUSION： The role of proteasome inhibition in regulating epigenetic mechanisms, and its link to liver injury in alcoholic liver disease, is thus a promising approach to study liver injury due to chronic ethanol consumption.
文摘TO evaluate the effects of abdominal trauma on hemorrhagic shock-induced acute lung injury in rats. METHODS： Five groups were allocated （n = 8） in the study. Group Ⅰ was taken as the control group, group Ⅱ as the hemorrhagic shock group, group Ⅲ as hemorrhagic shock ＋ laparotomy, group Ⅳ as hemorrhagic shock ＋ splenectomy and group V as splenectomy ＋ omentectomy ＋ hemorrhagic shock group. Hemorrhagic shock was induced by drawing blood and reducing mean arterial pressure （MAP） to 40 mmHg within 10 min. After a hypotensive period of 1 h, animals were resuscitated. Bronchoalveolar lavage （BAL） was performed to recover cells from the alveolar space with 40 mL of BAL fluid after resuscitation malondialdehyde （MDA） and L-γ-glutamyl-L-cysteinylglycine （GSH） levels were measured in serum, erythrocytes and lung tissue. RESULTS： Serum, erythrocyte, lung tissue MDA and GSH levels were significantly increased in hemorrhagic shock groups Ⅱ-Ⅴ （P 〈 0.05）. Lymphocyte, neutrophil and alveolar macrophage counts in BAL fluid indicated a significant difference between control and shock groups （P 〈 0.05）. CONCLUSION： The degree of trauma increases hemorrhagic shock-induced acute lung injury.
基金Project of Qinghai Development of Science and Technology (No.2011-N-150)
文摘The purpose of this study was focused on the imaging features of the chest trauma and its relation to clinical characteristics. All the injured patients were from the Yushu Earthquake areas on days April 14 - 23,2010. After an initial treatment,the injurers were rapidly transported from Yushu at an altitude of 4 000 m via air to Xining at 2 260 m within 6~8 h,and promptly admitted to Qinghai Provincial People’s Hospital. A total of 130 wounded injurers who had high suspicion of chest injuries all had examinations of Chest X-ray and computed tomography(CT)images. Of them 63 injurers presented at least one of the features of the chest trauma in imaging with a positive rate of 48.5 %. Of these,37 cases (28.5 %) were multi-system with multiple injuries ,33 cases (25.4 %) were chest trauma with multi-injury types,which included thoracic fractures in 54 cases (85.7 %),pleural injury in 56 cases (88.9 %),lung injury in 54 cases (85.7 %),lungs complications in 37 cases (58.7 %),and extrapulmonary complications of 35 cases (55.6 %). The radiological data were analyzed retrospectively. The features of chest trauma in Yushu Earthquake,the complications of chest injuries,and the relation between imaging findings and clinical manifestations,as well as the differences of chest trauma between Yushu Earthquake and Wenchuan Earthquake were discussed in detail.
文摘The authors describe a rare case in which blunt abdominal trauma resulted in mesenteric injury with delayed double ischemic ileal stenosis. Abdominal computed tomography demonstrated stenotic ileal loop with mural thickening. At surgery, a double stenotic bowel loop was found adjacent to a healed defect in the mesentery. Histological examination of the two resected segments showed fibrotic and ischemic lesions within the mesentery. Ischemic intestinal stenosis from mesenteric injury should be considered in the differential diagnosis in patients suffering from intestinal occlusion with a history of blunt abdominal trauma.
文摘To probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury. Methods: A retrospective study involving 113 patients with seve re hepatic trauma (AAST grade IV and V) during the past 12 years was carried out . Ninety eight patients underwent surgical treatment. Surgical interventions in cluding hepatectomy or direct control of bleeding vessels by finger fracture tec hnique with Pringle maneuver, selective ligation of hepatic artery, retrohepatic caval repair with total hepatic vascular occlusion, and perihepatic packing wer e mainly used. Results: In the 98 patients treated operatively, the survival r ate was 69.4 % (68/98). Among 40 patients with juxtahepatic venous injury (JH VI), 15 were cured with the maximum blood transfusion of 12 000 ml. Eight ca ses of Grade IV injury treated nonoperatively were cured. The percentage of fail ure of nonoperative management was 42.9 % (6/14). The overall mortality rate was 32.7 % (37/113), and 57% of the deaths were due to exsanguination. Conclusions: Reasonable surgical procedures based on classifica tion of hepatic injuries can increase the survival rate of severe liver trauma. Accurate perihepatic packing is effective in dealing with JHVI.
文摘Objective:: To prospectively compare the clinical outcome of intensive care therapy (ICT) with that of conventional care therapy (CCT) in severe head injured patients. Methods: Patients with severe head injury were assigned randomly into Group ICT and Group CCT, 100 patients in each group. Patients in Group ICT accepted intensive care therapy in neurosurgical intensive care (NIC) unit for the first 2 weeks after admission, while patients in Group CCT accepted conventional care therapy in ordinary ward. The outcomes were evaluated 3 months after injury. Results: There was a significant increase in good recovery (54%) (χ 2= 4.43 , P< 0.05 ) and significant decrease of death (25%) (χ 2= 4.50 , P< 0.05 ) in Group ICT compared to 39% and 39% in Group CCT respectively. The differences were also confirmed statistically in the following aspects: the patients under 50 years with good recovery pronounced a number increase (χ 2= 7.54 , P< 0.01 ), while the mortality in the same range of age was decreased in Group ICT (χ 2= 5.28 , P< 0.05 ). The mortality was reduced significantly in patients with GCS for 6-8 on admission (χ 2= 8.47 , P< 0.01 ) and in patients with the level of brain stem injured bellow mesencephalon (χ 2= 4.15 , P< 0.05 ). ICT would improve the outcome in patients undergoing conservative therapy only (χ 2= 13.13 , P< 0.01 ). Conclusions: NIC plays an important role in assessing the neurological state, guiding management, evaluating curative effect and estimating the outcome.
文摘Objective:: To summarize the peri-operative experience from 53 patients with traumatic head injuries with GCS score 3-5. Methods: Fifty-three most severely head-injured patients with GCS score 3-5 were admitted to our department and treated operatively from Oct. 1994 to Jun. 1998 and the data were analyzed retrospectively. Results: Thirty-seven cases ( 69.8 %) survived, among them 28 ( 52.8 %) had a good recovery or moderate disability, and 9 (17%) had severe deficits. The other 16 ( 30.2 %) died after therapy. Conclusions: The prognosis of most severely head-injured patients could be improved by peri-operative treatment including premedical care, early evacuation of intracranial hematoma with large decompressive craniectomies, intracranial hypertension monitoring, moderate hypothermia therapy, effective prevention and treatment of cerebral vasospasm and complications.
文摘Objective: To summarize the experience of the treatment of traumatic hepatorrhexis. Methods: The clinical data of 209 cases of liver trauma treated in the three affiliated hospitals of the Third Military Medical University from 1989 to 1999 were retrospectively analyzed. Among the 209 patients, 108 ( 51.7 %) had Grade III or more severe liver injury. Operative treatment was performed in 186 cases and preservative treatment in 23. Results: In the operated group, 169 patients were cured. The complications occurred in 18 patients and 17 of them died. In the non operated group, the complications occurred in 22 patients and only 1 of them died. Conclusions: Severe injury and delayed treatment are two major factors leading to death from liver injuries. Surgical intervention is still the principal measure to treat traumatic hepatorrhexis. The indications for non operative treatment should be carefully selected.
