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@#Objective To explore the effects of intravenous treprostinil in different doses on the hemodynamics and postoperative outcomes after high-risk total cavo-pulmonary connection (TCPC). Methods From 2018 to 2021, among 189 patients who underwent TCPC in the Department of Pediatric Cardiac Surgery of Fuwai Hospital, 26 high-risk patients who received the intravenous treprostinil therapy were retrospectively analyzed. There were 12 males and 14 females, with an age of 4 (3, 6) years and a weight of 17.6±6.2 kg. The patients were divided into two groups: a high-dose group [15 patients, maintaining dose>10 ng/(kg·min)] and a low-dose group [11 patients, maintaining dose≤ 10 ng/(kg·min)]. The hemodynamics before treprostinil using and during the first 24 hours after reaching the maintaining dose of treprostinil, and postoperative outcomes of the two groups were investigated. Results The incidence of heterotaxia was higher in the high-dose group (66.7% vs. 18.2%, P=0.021). During the observation period, the mean pulmonary artery pressure decreased from 11.9±3.6 mm Hg to 11.0±3.3 mm Hg in the low-dose group (P=0.013), and from 12.9±4.7 mm Hg to 10.2±3.4 mm Hg in the high-dose group (P=0.001). The decreasing effect in the high-dose group was better than that in the low-dose group (P=0.010). There was no statistical difference in the postoperative outcomes between the two groups (P>0.05). In terms of side effects, patients needed temporarily increased dosage of vasoactive drugs to maintain stable blood pressure during 6-12 h after treprostinil therapy in the high-dose group. Conclusion In patients after high-risk TCPC, intravenous high-dose treprostinil has a better therapeutic effect on reducing pulmonary artery pressure. However, it should be noted that increased dosage of vasoactive agents may be required to maintain blood pressure stability in patients with high-dose treprostinil.
ABSTRACT
N-acetyltransferase 2 is an important metabolic enzyme in the human body,participating mainly in the metabolism of medicine containing nitrogen.Presently a lot of researches have been undertaken in the respects like the determination of NAT2 genotype and drug metabolism and so on.In the recent years,more and more attention is paid to the simulation of three-dimension(solid)structure of protein,but the study is just at the outset on three-dimension structure of the NAT2 as well as its structure-function relationship when combined with drug.The research progress of construction of the three-dimension structure of NAT2 is summarized,emphasizing on its methods and tools.
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Objective:To simulate human N-acetyltransferase 2 protein 3D model by computer technology. Methods: 3D model of human N-acetyltransferase 2 protein was simulated with protein list and computer technology,the physical,chemical,biological characteristics and the functions were analyzed.Results: The possible structure of NAT2 was simulated using ANTHEPORT5.0,a software for determining the sequence of protein,forecasting the pHi and molecular weight of NAT2 were 5.495 and(33 544) respectively.The titration curve and physics-chemistry characteristic curve of NAT2 were also obtained.A Helical Wheel chart was plotted,aiming at the fragment of NAT2 around amino acid 282 nd.Conclusion:The possible structure of NAT2 was simulated using computer,analysis and forecast was also carried out,the method was feasible to genetic analysis of NAT2.
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Objective To evaluate the value of magnetic resonance imaging in rheumatoid arthritis(RA) of the knee and compare with radiography.Methods 34 cases of RA of the knee were performed MRI and radiography.Enhanced MRI scans were obtained in 13 knees.Results On MRI there were bone erosion in 34 knees,subchondral sclerosis in 21 knees,meniscus destruction in 22 knees,cartilage damage in 15 knees,tibia movement in 10 knees,posterior cruciate ligament dragged in 8 knees.Pannus adhesion,proliferation synovium and joint effusion were showed on enhanced MRI in all of the 13 knees.On radiography bone erosion was showed in 1 knee,subchondral sclerosis in 11 knees,joint space stricture in 16 knees,tibia movement in 8 knees.Conclusion MRI is much better than radiolgraphy for diagnosis of RA of the knee.