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Objective To evaluate the effect of dexmedetomidine on oxidative stress and pulmonary function in children with congenital heart disease after cardiopulmonary bypass. Methods From June 2016 to June 2018, fifty-five children who underwent ventricular septal or atrial defect repair under cardiopulmonary bypass in the First Affiliated Hospital of Zunyi Medical University were recruited and randomly divided into two groups: control group (group C) and dexmedetomidine group (group D). After tracheal intubation, patients of group D were received dexmedetomidine 0.5 ug/kg/h by intravenous pump until the end of operation. Patients of group C were received 0.9% physiological saline with the same volume. Heart rate, mean arterial pressure, oxygen saturation, bypass time, and computation of respiratory index (RI) and oxygenation index (OI) based on blood gas analysis, measured SOD, MDA and GSH in plasma, recording the time from the end of operation to the extubation of tracheal tube, the duration of stay in extracardiac ICU after operation, and pulmonary complications were followed up before infusion of dexmedetomidine (T0), sternal sawing (T1), CPB stopping (T2), and 24 hours after operation (T3). Results The changes of heart rate and mean arterial pressure in the two groups were within the normal range. There was no significant difference in plasma SOD, MDA and GSH between the two groups (P>0.05）. There was no difference in OI and RI at T0 and T1 time points (P>0.05). Compared with group C, OI was increased and RI was decreased in group D at T2 and T3 time points (P< 0.05). Compared with group C, group D had shorter ICU support time and extubation time, and fewer pulmonary complications after operation (P<0.05). Conclusion The treatment of 0.5 μg/kg/h dexmedetomidine can improve the respiratory function, reduce the pulmonary complications, and is conducive to the rehabilitation of children after CPB. But, this concentration cannot alleviate the oxidative stress reaction of children with CPB.
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<p><b>OBJECTIVE</b>To analyze the clinical factors that contribute to lowered bone mineral density (BMD) of the lumbar vertebrae in type 2 diabetic patients.</p><p><b>METHODS</b>Forty type 2 diabetic patients with osteoporosis and 40 age- and gender-matched healthy individuals, selected using propensity score method, were examined for BMD of the L1 to L4 vertebrae and the left femur. Age, gender, course of the disease, body mass index (BMI), fasting blood glucose, serum calcium, serum phosphate, urinary calcium, and urinary phosphate were compared between the two groups.</p><p><b>RESULTS</b>BMD of the L1 to L4 vertebras was significantly lower in the diabetic group than in the healthy individuals (P<0.05). In the diabetic patients, BMD showed an obvious difference between male and female patients and was negatively correlated with the course of the disease but positively with BMI, fasting blood glucose, urinary calcium and urinary phosphate; BMD was not correlated with age, serum calcium or serum phosphate in these patients.</p><p><b>CONCLUSION</b>Osteoporosis in type 2 diabetic patients is closely related with gender, BMI, course of the disease and poorly controlled glucose level.</p>
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<p><b>OBJECTIVE</b>To investigate the changes of neutrophils in airway inflammation in children with severe asthma.</p><p><b>METHOD</b>Children with mild to moderate asthma (n=23), severe asthma (n=16) and healthy control subjects (n=16) underwent lung function tests and sputum induction. The sputum specimens were assayed for cellular differential count, the supernatant and peripheral blood were assayed for the concentrations of IL-8 by "sandwich" enzyme linked immunosorbent assay (ELISA). Sputum supernatant, IL-8 and mifepristone were assessed for their abilities to prolong the in vitro survival of blood-derived neutrophils.</p><p><b>RESULT</b>The percentage of sputum neutrophils was significantly higher in severe asthmatics [59.54 (41.99-74.65)%] than mild-moderate asthmatics [30.03 (15.94-47.71)%] and healthy control subjects [29.72(16.53-45.74)%] (P < 0. 01); the level of IL-8 in sputum was significantly higher in severe asthmatics [2907.78 (331.67 - 3457.93) ng/L] than mild-moderate asthmatics [287.58 (130.75-656.84) ng/L] and healthy control subjects [179.2 (58.55-346.59) ng/L] (P < 0.01); the percentages of neutrophilic apoptosis respectively cultured with LPS [(10.57 +/- 1.97)%], severe asthmatics supernatant [(11.82 +/- 2.96)%], IL-8 [(10.47 +/- 1.93)%], dexamethasone [(9.93 +/- 1.95)%], severe asthma supernatant + mifepristone [(12.15 +/- 2.86)%] in vitro were lower than that cultured with PBS [(17.98 +/- 2.27)%], healthy control supernatant [(17.37 +/- 2.50)%], mild-moderate asthmatics supernatant [(16.35 +/- 3.26)%], mifepristone [(17.89 +/- 2.38)%], and dexamethasone + mifepristone [(17.06 +/- 2.59)%] (P < 0.01).</p><p><b>CONCLUSION</b>Suppression of neutrophilic apoptosis seems to play a potential role in airway neutrophilic inflammation in severe asthmatics, and the level of IL-8 in sputum was significantly higher in patients with severe asthmatics.</p>
Subject(s)
Adolescent , Child , Female , Humans , Male , Apoptosis , Asthma , Metabolism , Pathology , Case-Control Studies , Inflammation , Interleukin-8 , Metabolism , Leukocyte Count , Neutrophils , Cell Biology , Respiratory System , Metabolism , Pathology , Sputum , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the polymorphism of Kell blood group system in Chinese and to find a suitable method for large scale screening.</p><p><b>METHODS</b>An analysis method of polymerase chain reaction-restriction fragment-single strand conformation polymorphism (PCR-RF-SSCP) combined with heteroduplex was established to detect abnormal sample in KEL exon 7-9 area, then sequencing was used to find out the mutation site.</p><p><b>RESULTS</b>Two mutations were found from 500 samples: 966G > A mutation in exon 9 and C > A mutation in 67th site of intron 7, both with no amino acid change. The mutation rate was 4/1000. No mutation was found as missed in using PCR-RF-SSCP combined with heteroduplex.</p><p><b>CONCLUSION</b>PCR-RF-SSCP combined with heteroduplex is confirmed as an effective, economical and simple method, it is quite suitable for large scale population screening study with unclear gene background and unavailable positive controls. Since there is special polymorphism for Kell blood group system in Chinese, further study is needed.</p>