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Objective To investigate the efficacy of peritoneal dialysis(PD) in the children with complex congenital heart disease after surgery.Methods 65 children with complex congenital heart disease were divided into group A(33 cases) and group B(32 cases).Group A was given PD when diuretics or urine output was less than 0.5ml per hour,while group B was given PD when urine output was less than 0.5ml per hour after 6h.The survival effect and indicators of PD before and after treatment were observed.Results The effective rate of group A (84.85％ ) was significantly better than group B ( 53.12％ ) ( x2 =5.18,P ＜ 0.05 ).The fatality rate of group A (9.09％ ) was significantly lower than group B ( 18.75％ ) ( x2 =5.32,P ＜ 0.05 ).The renal function was significantly improved.Urine output increased to the normal level,serum potassium,blood urea nitrogen,serum creatinine concentration were effectively controlled,the changes of indicators had significant differences before and after PD (t =5.22,3.46,46,4.89,4.77,all P ＜ 0.05).Conclusion PD was an effective support method for heart,renal insufficiency after the surgery of complex congenital heart disease,and it had good clinical effect for early application.
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Objective To investigate the effect on electrical restitution of β1-adrenergic receptor antagonist esmolol administered during cardiopulmonary resuscitation in the porcine ventricular fibrillation model. Method Ventricular fibrillation untreated for four minutes was induced by dynamic steady state pacing protocol in 40 healthy male pigs, in which local unipolar electrograms were recorded using one 10-electrode catheter that was sutured to the left ventrieular epicarditan. During CPR, animals were randomized into two groups to receive saline as placebo or esmolol after two standards doses of epinephrine. At postresuscitation 2-hour, six pigs were randomly selected from each group and the second VF induction was performed. Local activation-recovery intervals (ARI) restitutions and the VF inducibility between control group and esmolol group were compared. Western blotting was performed to determine cardiac ryanodine receptor (RyR2) protein expression, and their phosphorylation status. Results No sig-nificant differences were observed at the restoration of spontaneous circulation between two groups. Higher postre-suseitation 2-hour survival rate was observed in the esmolol group. Esmolol significantly flattened ARI restitution slope, lessened regional difference of ARI restitution, decreased the VF inducibility, and alleviated RyR2 hyper-phosphorylation. Conclusions Esmolol given during CPR significantly improved postresuscitation 2-hour survival rate. Its effects on modulating electrical restitution property and intracellular calcium handling make up the most important reasons why β1-blockade significantly reduced the onset and maintenance of VF.
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Objective To investigate the protective effects of mild hypothenmia on myocardium of porcine with septic shock. Method A total of 24 Guishou miniature pigs were randomly(random number) divided into the pre-shock mild hypothermia group, shock mild hypothermia group and shock normothermia control group with 8 in each group. After the anesthesia of pigs, E. coli endotoxin was injected into femoral vein to establish the sepsis model of swine. After modeling, normal saline was continuously administered into femoral vein of pigs in three groups with in-fusion pump at steady speed. In the pre-shock mild hypothermia group,4 ℃ normal saline was used for intravenous injection to produce mild hypothermia before E. eoli endotoxin injection. In the shock mild hypothermia group, 38 ℃ saline was used at first and the 4 ℃ saline was employed after the systolic pressure of mice dropped to 60% of the o-riginal pressure for one hour. In shock normothermia group,38 ℃ saline was used from the beginning to the end of the experiment. The hemodynamics, blood lactate, CtnI, coronary angiography for detecting TIMI flow and the ultra-structural changes under electron microscopy were observed 6 h and 12 h after temperature intervention. Results (1) In pre-shock mild hypothermia group, the findings in all of observation were better than those in shock mild hy-pothermia group and shock normothennia group 6 h and 12 h after temperature intervention (P < 0.01). (2) In shock mild hypothermia group, the CtnI was lower and the ultra-structural changes were less severe than those in shock normothermia group (P < 0.05), but there were no significant differences in blood lactate, TIMI and hemody-namies between shock mild hypotherrnia group and shock normothermia group (P > 0.05). (3) There were no sig-nificant differences in all measurements between shock mild hypothermia group and shock normothennia group after 12 hours later (P > 0.05). Conclusions Mild hypothermia has some protective effects on myocardium of swine with sepsis. If the mild hypothermia is employed before the emergence of shock, the protective effects would be more ef-fective and the cardiac function would maintain at higher efficiency. If the hypothermia is used after the occmTence of shock, it could blunt the cardiac damage and preserve the cardiac function in some extent.
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Objective To investigate the effects of mesenchymul stem cells(MSCs) transfected with human home oxygenase- 1 gene on the inflammatory cytokines and the ventricular remodeling after myocardial infarction in rats.Method MSCs were acquired from the hone marrow of adults rats.They were isolated,purified cultured,and transfected with Adv-HO-1,or Adv-GFP in vitro before transplantation.At 1 hours after left coronary artery ligation,Adv-HO-1-MSCs or Adv-GFP-MSCs marked with DAPI were directly injected into the horder of cardiac infarction in rats.At 4 days after transplantation,western blot analysis was used to measure HO-1 protein expression in the the horder of cardiac infarction.The levels of VEGF,bFGF,HGF protein expression were measured by ELISA,and the levels of TNF-α,IL-1β,IL-6,IL-10 mRNA expression were measured by RT-PCR.The rat heart function was measured by echocardiography.At 4 weeks after transplantation,ventricular remodeling and pathological changes were measured by HE and Masson staining.Results The Adv-HO-1-MSCa treated group showed marked increase of HO-1 rotein (P<0.05),and displayed significant increase of montioned cytokines above,P <0.05,compared with other groups.The Adv-HO-1-MSCs treated group displayed significant reduction of mRNAs expreesion of TNF-α,IL-1β,IL-6,and significant increase in IL-10 mRNA expression,with P<0.05,compared with others.Conclusions HO-1-MSCs could secrete multiple cytokines in infarction hearts,and had beneficial effects on inflammatory cytokines,remodeling processes and cardiac function.
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Objective To study the differentiation of embryonic stem cells(ESCs) induced by transforming growth factor-?_1(TGF-?_1) and co_cultured with visceral endoderm like END_2 cells,and explore cardiomyocytes induction effects of the combined techniques Methods Day 2-3 embryoid bodies(EBs) were derived from ESCs,and then TGF-?_1 was added or/and co_cultured with END_2 cells or END_2 cells conditioned medium.Spontaneous differentiation was as a control.The expression of cardiac specific ?-sarcmeric actin(?-actin) and cardiac troponin_T(TnT) was detected by immunofluoresence staining.The ultrastructural analysis for ESCs_derived cardiomyocytes was scanned by transmission electron micrograph. Results The total percentage of beating EBs treated with TGF-?_1,co_cultured with END_2 cells,or END_2 cell conditioned medium was(43?2.08)%,(69?3.61)%,(65?3.06)%,respectively.All the beating cardiomyocytes derived from ESCs expressed cardiac_specific proteins for ?-actin and TnT,and could be observed the cardiac_specific ultrastructure.Interestingly,the total percentage of beating EBs treated with the combined method was(91?1.52)%.(P