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Objective:To evaluate the role of hypoxia-inducible factor-1α (HIF-1α)/Bcl-2/E1B 19-kDa interacting protein 3 (BNIP3) signaling pathway in dexmedetomidine-induced reduction of myocardial ischemia-reperfusion (I/R)-induced brain injury in mice.Methods:Sixty clean-grade healthy male C57BL/6 mice, aged 8-10 weeks, weighting 20-30 g, were divided into 5 groups ( n=12 each) using a random number table method: sham operation group (S group), myocardial I/R group (IR group), myocardial I/R plus dexmedetomidine group (IRD group), myocardial I/R plus HIF-1α inhibitor 2ME2 group (IR-M group), and myocardial I/R plus dexmedetomidine plus HIF-1α inhibitor 2ME2 group (IRD-M group). The myocardial I/R-induced brain injury was produced by ligating the left anterior descending coronary artery for 30 min followed by 2 h of reperfusion in anesthetized mice.Dexmedetomidine 50 μg/kg was intraperitoneally injected at 5 min before ischemia in IRD group and IRD-M group.In IR-M and IRD-M groups, 2ME2 15 mg/kg was intraperitoneally injected at 5 min before ischemia.Blood samples were collected from the thoracic aorta at 2 h of reperfusion to measure the serum S-100β protein and neuron-specific enolase (NSE) concentrations.The animals were then sacrificed, brains were removed and hippocampi were obtained for determination of the apoptosis index (by TUNEL method) and expression of HIF-1α, BNIP3, Beclin-1, microtubule-associated protein 1 light chain 3 (LC3) and phosphorylated Tau protein (p-Tau) (by Western blot) and for microscopic examination of the pathological changes in hippocampal CA1 region.LC3Ⅱ/Ⅰ ratio was calculated. Results:Compared with group S, the concentrations of serum S-100β protein and NSE and apoptosis index of hippocampal neurons were significantly increased, the expression of HIF-1α, BNIP3, Beclin-1 and p-Tau was up-regulated, LC3Ⅱ/Ⅰ ratio was increased ( P<0.05), and the pathological changes in hippocampal CA1 region were aggravated in group IR.Compared with group IR, the concentrations of serum S-100β protein and NSE and apoptosis index of hippocampal neurons were significantly decreased, the expression of HIF-1α, BNIP3 and Beclin-1 was up-regulated, the expression of p-Tau was down-regulated, and LC3Ⅱ/Ⅰ ratio was increased ( P<0.05), and the pathological changes in hippocampal CA1 region were significantly attenuated in group IRD.Compared with group IRD, the concentrations of serum S-100β protein and NSE and apoptosis index of hippocampal neurons were significantly increased, the expression of p-Tau was up-regulated, the expression of HIF-1α, BNIP3 and Beclin-1 was down-regulated, LC3Ⅱ/Ⅰ ratio was decreased ( P<0.05), and the pathological changes in hippocampal CA1 region were aggravated in IR-M and IRD-M groups. Conclusions:HIF-1α/BNIP3 signaling pathway is involved in dexmedetomidine-induced reduction of myocardial I/R-induced brain injury in mice.
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Objective To investigate the incidence of insomnia and its influencing factors in the outpatients with cardiovascular diseases in a general hospital.Methods A total of 956 consecutive cases of the outpatients was collected from March 2016 to September in the department of cardiology patients in this general hospital.Insomnia was diagnosed with the 2012 Chinese adult insomnia diagnosis and treatment guidelines.All subjects underwent clinical examination,generalized anxiety scale (GAD-7),patient health questionnaire depression scale (PHQ-9),and self-made demographic sociology information questionnaire.Results A total of 925 patients with completed data was included in the analysis data.The insomnia incidence rate was 51.4％.The insomnia incidence rates were 57.8％ and 37.6％ in the patients with and without cardiovascular diseases.The difference was statistically significant (P ＜ 0.01) between both groups.The insomnia incidence rates in the patients with hypertension,coronary heart disease,arrhythmia,hypertension combined with coronary heart disease and other cardiovascular diseases were 50.8％,56.3％,53.2％,63.0％,and 54.3％,respectively.There were significant differences between the groups (P ＜ 0.05).The incidence of anxiety or depressive symptoms was 44.5％ in all investigators.Insomnia incidence rates were 75.6％ and 32.0％ in the subjects with and without anxiety or depressive symptoms.The difference was statistically significant (P ＜ 0.01) between both groups.Multivariate logistic regression analysis showed that gender,type A personality,family income satisfaction,cardiovascular diseases and anxiety/depression were independent factors to affect the occurrence of insomnia.Conclusions The insomnia incidence rates was high in the outpatients from the department of cardiology of general hospital.The main factors that affect the occurrence of insomnia include psychological,social aspects,and cardiovascular diseases.
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Objective To investigate the Cardioprotective effects of sevoflurane postconditioning on surgery patients undergoing cardiopulmonary bypass with diabetes mellitus ,in order to provide theoretic basic for clinical practic. Methods 180 patients of undergoing cardiopulmonary bypass sugery were divided into 3 groups:A group:64 patients undergoing heart valve replacement with Type II diabetes. B group:64 patients Pa-tients undergoing heart valve replacement without diabetes ,the group A and B were treated by sevoflurane post-conditionging for 10 minutes before the end of cardiopulmonary bypass. C group:60 patients undergoing heart valve replacement without diabetes,no sevoflurane postconditionging;Three groups of patients detect perioperative tro-ponin T and Creatine Kinase Isoenzyme-MB ,observed and following up the occurrence of postoperative com-plications. Results CK-MB and cTnT were compared at 8 and 24 hours after operation:two biochemical indi-cators of group A and C at different time points after operation were significantly higher than those in group B (P < 0.05),With significant statistical difference , The number of patients with heart failure and malignant arrhythmia in group A and C was higher than group B(P < 0.05),Differences in 30 day mortality and other clinical data between the three groups were not statistically significant. Conclusion Sevoflurane postconditionging has significant myocardial protection effect for patients undergoing valve replacement surgery without diabetes , however ,the myocardial protective effect of patients who undergoing valve replacement surgery with diabetes was weakened.
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Objective To evaluate the cardioprotection induced by ischemic preconditioning ( IPC) and hypoxic preconditioning ( HPC) which were carried out by using the double cardiopulmonary bypass ( CPB) circuits in in vivo hearts of dogs. Methods Eighteen healthy male dogs, weighing 17?5-24?5 kg, aged 13-24 months, were divided into 3 groups ( n=6 each) using a random number table: my?ocardial ischemia?reperfusion group (group I∕R), IPC group and HPC group. The double CPB circuits were established as follows: systemic and coronary circulation, and independent systemic and coronary cir?culation was carried out. In group IPC, the aorta was clamped, and the coronary circulation pump was sus?pended for 5 min followed by 5 min opening, repeating for 3 cycles. In group HPC, the aorta was clamped, the coronary circulation was started, and pure nitrogen was insufflated for 5 min followed by 5 min of oxygen insufflation, repeating for 3 cycles. CPB was performed for 1 h starting from the time point immediately after IPC or HPC. Before splitting of sternum ( T1 ) , after establishment of double CPB circuits ( T2 ) , at the end of preconditioning ( T3 ) , and at 60 and 120 min after restoration of spontaneous heart beat ( T4,5 ) , heat rate, mean arterial pressure, central venous pressure, left ventricular end?systolic pres?sure, left ventricular end?diastolic pressure and the maximum rate of increase∕decrease of left ventricular pressure were recorded. Blood samples were collected from the right internal jugular vein at T1 and T4,5 for determination of serum cardiac troponin I concentrations. The animals were sacrificed after determination of the parameter or after blood sampling at T5 , myocardial specimens were obtained for examination of the ul?trastructure and for detection of apoptosis in cardiomyocytes, and apoptosis index was calculated. Before aortic clamping, immediately after aortic unclamping and at 30 min after aortic unclamping, myocardial specimens were obtained for determination of ATP contents in cardiomyocytes. Results Compared with I∕R group, left ventricular end?systolic pressure was significantly increased, and the serum cardiac troponin I concentrations were significantly decreased at T4,5 , the myocardial ATP contents were significantly in?creased immediately after aortic unclamping and at 30 min after aortic unclamping, apoptosis index was sig?nificantly decreased ( P<0?05 or 0?01) , and the pathological changes were significantly attenuated in IPC and HPC groups. Compared with group IPC, the myocardial ATP contents were significantly increased (P<0?05), and the pathological changes were attenuated in group HPC. Conclusion Both HPC and IPC can exert cardioprotection when carried out by using the double CPB circuits, and HPC provides better cardioprotection than IPC in in vivo hearts of dogs.
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Objective To discuss the features of nosocomial infection in patients with multiple trauma in intensive care unit and the preventive measures. Method The nosocomial infections occurred in 137 patients with multiple trauma were analyzed including site of infection, pathogenic organisms and bacterial strains. Results The rate of nosocomial infection was 62.8%, mainly the lower respiratory tract infection and wound infection, the G-negative bacteria infection accounted for 67.8%, mostly Escherichia Coli, Pseudomonas aeruginosa and A cinctobacter baumanni I. The G-positive bacteria infection accounted for 32.2%, mainly Staphylococcus aureus and Coagulase negative staphylococcus. The positive detection rates of Klebsiella and pseudomonas aeruginosa were increasing year afer year. Conclusions The incidence of nosocomial infection in patients with multiple trauma is high, suggesting some appropriate preventive measures should be taken to reduce the rate of infection.
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OBJECTIVE: To survey the habits of public drug use in China and its reasons and to put forward countermeasures so as to provide reference for government and decision-making department. METHODS: From Nov. 2008 to Feb. 2009, questionnaire survey was adopted in 31 provincial administrative regions except for Hong Kong, Macao and Taiwan. 26 000 questionnaires were collected and 1 100 physicians were interviewed. SPSS17.0 software was used to analyze 11 796 valid questionnaires statistically. The frequency of words used by physicians was counted. RESULTS: The residents don’t have enough knowledge to support them to use medicine rationally. And they are not compliant with prescription but take medicine by arbitrariness. 44.88% of residents don’t buy medicines according to prescriptions and 74.39% don’t take medicine following treatment course, stop taking medicine once symptom relieve or change the category of drugs frequently. CONCLUSION: The improvement of pharmaceutical market environment, enhancement of medication guide and popularization of medication knowledge can promote rational use of drug.