Cava-atrial shunt was performed in the Treatment of Budd-Chiari syndrome in two cases, in which one belonged to type Ⅲ， and the oother type Ⅱ,the recent results were satidgactory. A rare cause of Budd-Chiari syndrome in one case is that some drugs for occluding the spermiduct was inadveretntly injected into the spermatic vein and inferior vana cava.
【摘要】 目的 探讨NF-κB在重症急性胰腺炎小鼠肠黏膜屏障功能损伤中的调控机制。 方法 36只BALB/C小鼠随机分为对照组、模型组、NF-κB干预组，每组12只。18 h后处死小鼠，比较各组的腹腔内大体改变、肠黏膜病理改变，肠道通透性的变化及血清细胞因子水平，肠上皮紧密连接蛋白occludin的表达。 结果 模型组小鼠腹腔内呈明显炎症反应，肠管水肿，肠黏膜水肿，肠道通透性显著增高，NF-κB特异性阻断剂能降低肠道损伤，改善肠黏膜水肿，上调肠上皮紧密连接蛋白occludin的表达，显著降低肠道通透性，降低细胞因子水平。 结论 NF-κB阻断剂能够通过选择性的抑制NF-κB活性，改善受损的肠屏障功能。这一作用通过上调肠上皮紧密连接蛋白occludin的水平而实现。【Abstract】 Objective To investigate the roles of NF-κB in the intestinal mucosal barrier injury in mice with severe acute pancreatitis(SAP). Methods Thirty-six BALB/C mice were randomly assigned to normal control group, SAP model group and intervention group. Eighteen hours later, pathological intestinal villus changes, intestinal permeability, serum cytokines were evaluated in all three groups. Results In SAP model group, intestinal mucosa was found to be oedematous and intestinal permeability was markedly increased. NF-κB could ameliorate intestinal injury and mucosa edema, and improve intestinal permeability by upregulating occluding expression. Conclusion NF-κB could protect the function of intestinal mucosal barrier by inhibiting NF-κB activity, which suggests that NF-κB may play an intermediating role in SAP-induced intestinal failure through upregulating occluding expression.
ObjectiveTo explore the mechanism of liver capillary permeability in rats with severe acute pancreatitis (SAP). MethodsTotally 40 healthy Sprague-Dawley (SD) rats were randomly divided into two groups: sham operation (SO) group and SAP group, SAP group were divided into four subgroups according to sampling time (3 h， 6 h, 12 h， and 24 h). The model was established by injecting 5% sodium taurocholate retrogradely into pancreaticobiliary ducts. The changes of tumor necrosis factor-α (TNF-α), pathohistology, and tissue moisture content were compared among different groups. Liver occludin protein expression was analyzed by immunohistochemistry method, and occludin mRNA was measured by RT-PCR. ResultsThere was no significant pathological changes of liver tissue in the SO group. Typical pathological changes of SAP， such as interstitial edema, vasodilatation, infiltration of inflammatory cells, were found in the SAP group. TNF-α level and tissue moisture content of each phase increased gradually, and the highest level appeared at 24 h within the observing period. The two above indicators at different time point in subgroups were significantly different from each other and higher than those in the SO group (Plt;0.05)． In the SAP group, the expression of occludin and it’s mRNA began to decrease at 3 h to the bottom at 6 h and rebounced significantly at 12 h, 24 h compared with those at 6 h (Plt;0.05), but still lower than those in the SO group (Plt;0.05). ConclusionUpregulation in TNF-α and subsequent downregulation in occludin protein and mRNA maybe bly related to the severe liver capillary permeability in rats with SAP.
ObjectiveTo evaluate the clinical efficiency of balloon occlusion of the lower abdominal aorta in blood loss control during resections of pelvic or sacral tumor. MethodsFrom April 2006 to April 2010, 24 patients diagnosed as pelvic or sacral tumor in this hospital were collected. Balloon occlusion of the lower abdominal aorta to control blood loss was used in these cases. Balloon catheters were placed via femoral artery to occlude the abdominal aorta before operation. Resections of pelvic or sacral tumors were performed after occlusion of abdominal aorta, duration no longer than 60 min per occlusion, if repeated occlusions needed, 10－15 min release in between. Results Average operative time was 153 min (range 40－245 min) and average blood loss was 310 ml (range 200－650 ml) in this series, and the procedure helped in clearly identifying the surgical margin, neurovascular structures, and adjacent organs. The blood pressure were stable in all the cases. No postoperative renal function impairment was found in all the cases, no side injuries to adjacent organs was identified. One case complicated with thrombosis in iliac artery at same puncture side was successfully treated with catheter thrombectomy. ConclusionIntraoperative abdominal aorta balloon occluding in pelvic and sacral tumor surgical operation could reduce blood loss, and improve the safety of operation.