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@#Objective To explore the effects of perioperative autologous platelet transfusion on postoperative complications and prognosis of adult cardiac surgery patient. Methods Using the method of systematic review of Cochrane Collaboration, we searched PubMed, Web of Science, EMbase, The Cochrane Library, CNKI and Wangfang databases, retrieving the literature from January 1970 to June 2020 to collect clinical randomized controlled trials on the effects of autologous platelet transfusion on complications and prognosis of adult cardiac surgery patients. The extracted valid data was analyzed by RevMan5.3 software. Results Ten studies were included, with a total of 1 083 patients. The results of meta-analysis showed that there were statistical differences in the perioperative blood loss (MD=−195.15, 95%CI − 320.48-−69.83, P=0.002) and perioperative blood transfusion (MD=−0.88, 95%CI −1.23-−0.52, P<0.001). There was no statistical difference in the death rate 30 days after the operation (RR=0.90, 95%CI 0.48-1.70, P=0.75), reoperations (OR=0.48, 95%CI 0.23-1.02, P=0.06), postoperative myocardial infarction (OR=1.29, 95%CI 0.48-3.51, P=0.61), postoperative infection (OR=1.71, 95%CI 0.89-3.29, P=0.11) or postoperative ICU retention time (MD=−0.31, 95%CI − 0.67-0.05, P=0.09). Conclusion Perioperative autologous platelet transfusion can reduce perioperative blood loss and blood transfusion in adult cardiac surgery patients, but has no significant impact onprognosis and postoperativecomplications, which indicates that perioperative autologous platelet transfusion is a safe and beneficial blood protection measure for patients undergoing cardiac surgery.
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Objective:To evaluate lung protection of remote limb ischemic preconditioning after pulmonary resection.Methods:Methods sixty adult patients scheduled for elective pulmonary resection, were randomly divided into control group(group C, 30 cases) and remote limb ischemic preconditioning(group RLIP, 30 cases) using a random number table. Before one-lung-ventilation(T0), at 30 minites, 1 hour and 2 hours of OLV(T1, 2, 3), 15minites after re-expansion of the collapsed lung(T4), blood samples were drawn from the radial artery and vein for blood gas analysis, alveolar-arterial oxygen gradient(A-aDO 2)、pulmonary shunt ratio(Qs/Qt)were calculated. Extraction time of closed thoracic drainage tube, length of hospital stay, the incidence of in-hospital complications after operation were recorded. Results:Compared to T0 , each group at T1-T4, A-aDO 2 were obviously increased. We found that at T3, A-aDO 2 of group C increased much more higher and statistically significant( P<0.05). Compared to group RLIP, Qs /Qt of group C were significantly increased at T2( P<0.05). Compared with C group, the expression of microtubule-associated protein 1 light chain 3B in lung tissues was significantly"up-regulated in RLIP group( P<0.05). Followed the extraction time of closed thoracic drainage tube, length of hospital stay, the incidence of in-hospital complications after operation there were no statistically different( P>0.05). Conclusion:Remote limb ischemic preconditioning had some protective effect after pulmonary resection, which mechanism may be related to enhancing autophagy in the operated 1ung tissues of the patients.
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Objective@#To investigate indoor air quality monitoring and management in primary and secondary schools, so as to provide scientific basis for health protection of students and healthy school environment.@*Methods@#Stratified sampling method was adopted to select schools for investigation. Data of daily ventilation and ventilation was collected from relevant principals of schools through questionnaire survey. Chi-square test was used to analyze the difference of ventilation and ventilation among different types of schools.@*Results@#Daily indoor air quality testing indicators: 317 schools (13.2%) have tested the concentration of CO2 in the air environment. Daily detection of CO2 in urban schools was significantly better than that in township schools, and the difference is statistically significant(χ2=72.06, P<0.01); Non-boarding schools were superior than boarding schools(χ2=21.89, P<0.01). The proportion of schools that routinely tested for carbon monoxide, particulate matter and volatile pollutants was 6.5%, 7.5% and 9.3%, respectively. Of the schools that participated in the survey, 80.8% had a daily ventilation system. Among them, 925 schools (38.5%) had a cumulative daily ventilation time of more than 90 minutes in cold season, and 331 schools (13.8%) had a daily ventilation time of less than 30 minutes.@*Conclusion@#Regulations and standards for school air quality monitoring needs to be improved. The Center for Disease Control and Prevention or other qualified institutions are suggested to lead air quality monitoring in schools testing, creating a healthy learning and living environment for primary and secondary school students.
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Objective@#To understand the current situation of infrastructure construction and sanitation practice of school canteens in China and to provide a reference for improving food safety in school canteen and sanitation management level.@*Methods@#Stratified sampling method was adopted to select the surveyed schools. Information regarding school canteen infrastructure and sanitation practice was collected through questionnaires. Chi-square test was used to compare the difference in passing rate on the survey indices among different school types.@*Results@#In environmental sanitation, 91.0% of the school canteen was rated as good and in personal hygiene, 92.8% of the employees were rated as good. The overall health level of urban schools was better than that of township schools, and non-boarding schools was better than that of boarding schools, with statistically significant differences(P<0.01). 67.1% of school canteens provided with independent food outlets while 98.7% of school canteens without independent food stores. The qualified rate of washing facilities in the dining area was 94.7%, and the qualified rate of distance between the canteen and the pollution source was 92.5%. Nearly all the employees held canteen catering service license (99.0%) and the health qualification certificate (99.5%). Most of the school canteens (98.7%) established the safety rules and regulations, including the food retention sample system. Nearly 61.5% schools initiated the principal meal program.@*Conclusion@#Sanitation management in the canteens of primary and secondary schools in China is generally satisfactory, with some canteens still fail to meet the standard requirements. More supervision from schools and relevant government departments (market supervision, health and education departments) is needed to provide students with a clean and heathy campus canteen.
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Objective To compare the effect of heparin protamine double titration with traditional meth-ods on postoperative bleeding in patients underwent cardiopulmonary bypass(CPB). Methods Ninety adult patients scheduled to elective CPB by open heart surgery were randomly divided into three groups. In the Conven-tional Group(group A,n=30),375 U/kg heparin was administered.The amount of protamine was in proportion to 125 U:1.2 mg base on the initial heparin dose.In the Heparin Titration Group(group B,n=30),heparin was given according to the effect of heparin titration. In the Heparin and Protamine Double Titration Group(group C, n = 30),heparin titration combined with protamine titration were administered. The general data of the patients were recorded. The blood transfusion volume during and after operation,volume of thoracic drainage within 24 hours after operation,operative complications were compared among the 3 groups. Results Group B and group C heparin dosage were less than the group A(P<0.05).The protamine dosage in group C was less than that in group A and group B(P < 0.05). The thoracic drainage volume within 24 hours after operation was higher in the group A than group B and group C(P < 0.05). Conclusion Compared the traditional anticoagulation with heparin and protamine double titration,the latter individualized anticoagulation can reduce the amount of bleeding after CPB.
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Objective To explore the relationship between individual difference in heparin sensitivity and postoperative bleeding,and lay the foundation for individualized heparin anticoagulant strategy. Methods A total of 120 patients undergoing cardiopulmonary bypass were enrolled in this study. Activated clotting time(ACT)of whole blood was established,and 2.5 mg/kg first heparin was given to the sternum.The value of ACT was measured after five minutes.The patients were divided into 3 groups according to the results of the first measured heparin.If the ACT value did not meet the transfer requirements,heparin 0.5 mg/kg was added,and the amount of bleeding was recorded. The general information of patients,blood transfusion and drainage and other information 24 hours postoperatively were recorded. Results Drainage volume 24 hours after the operation in 3 groups was statistically significant(P < 0.05). Drainage volume 24 hours after the operation in group with ACT>750 s and group with ACT<480 s was significantly higher than that in group with ACT ranging from 480 s to 750 s but the difference be-tween the group with ACT < 480 s and the group with ACT > 750 s was not statistically significant(P > 0.05). Conclusions Heparin sensitivity is associated with postoperative bleeding in patients with cardiopulmonary by-pass surgery,and patients with ACT ranging from 480 s to750 s have the lowest amount of bleeding.
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Objective Using meta-analysis method to compare the effect of liberal and restrictive transfusion strategies on the prognosis of adult patients undergoing cardiac surgery,and to provide evidence for evidence-based medicine.Methods By using the Cochrane system evaluation method,the database of Chinese and foreign countries,Chinese biomedical literature database,Chinese journal full-text database and so on were searched by computer.To search the literature from 1970 to 2018,and to collect clinical randomized controlled trials on blood transfusion strategy and prognosis in adult patients undergoing cardiac surgery.According to the evaluation method of Cochrane system,the effective data extracted is analyzed by meta with RevMan5.3 software.Results A total of 2 863 patients were included in 9 studies.Meta-analysis results showed that the death toll on 30 days after operation (RR value:1.02,95 ％ CI:0.79-1.32,I2 =2％,P =0.86),acute renal damage,infection,acute renal injury,pulmonary complications and hospital stay time were no statistical difference,but ICU retention time(RR value:-33.35,95％ CI:-61.7-1.01,I2 =38％,P =0.04) in the restrictive transfusion policy group was significantly lower than that of liberal blood transfusion strategy group.Conclusion The use of liberal or restrictive blood transfusion strategy in adult cardiac surgery has no significant impact on the prognosis and complications,but it can reduce the retention time of ICU after operation and significantly reduce the use of blood products and medical costs.
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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 effect of sevoflurane postconditioning on microtubule struc-ture during myocardial ischemia-reperfusion(I∕R)in mice. Methods Thirty-two healthy male C57 mice, aged 7-8 weeks, wighing 20-30 g, were divided into 4 groups(n=8 each)using a random number table:sham operation group(Sham group), group I∕R, sevoflurane postconditioning group(group SP), and mi-crotubule depolymerizer colchicine plus sevoflurane postconditioning group(group CSP). Myocardial I∕R was produced by occlusion of the left anterior descending branch of coronary artery for 30 min followed by 120 min reperfusion in I∕R, SP and CSP groups. Colchicine 004 μmol∕kg was intraperitoneally injected at 30 min before ischemia in group CSP. In SP and CSP groups, 24% sevoflurane was inhaled for 15 min starting from onset of reperfusion. Mice were sacrificed at 120 min of reperfusion, and myocardial speci-mens were obtained for determination of myocardial infarct size and expression of α-tubulin(by Western blot). Results Compared with group Sham, the myocardial infarct size was significantly increased, and the expression of α-tubulin was down-regulated in the other three groups(P<005). Compared with group I∕R, the myocardial infarct size was significantly decreased, and the expression of α-tubulin was up-regula-ted in group SP, and no significant change was found in the parameters mentioned above in group CSP(P>005). Compared with group SP, the myocardial infarct size was significantly increased, and the expres-sion of α-tubulin was down-regulated in group CSP(P<005). Conclusion The mechanism by which sevoflurane postconditionning reduces myocardial I∕R injury is related to stabilizing microtubule structure of mice.
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Objective This study explored two methods of predicting the initial dose of heparin by heparin dose response curve(HDR)and in vitro heparin concentration progressive(HCP),and evaluated the predictive value of HCP for precise heparin dosage in patients undergoing cardiac surgery. Method Include 18-65 years old undergoing elective cardiac surgery patients,Before the start of the surgery internal jugular vein blood was taken in-to the HCP(2.5 mg/kg,3.0 mg/kg)test;The first injection of heparin 2 mg/kg via the internal jugular vein, then every 5 minutes each additional heparin 0.5 mg/kg to amount to 2.5 mg/kg,3.0 mg/kg,and measurement ACT and until ACT value≥480 s;According to HDR calculated per patient 2.5,3.0 mg/kg of ACT value;Respective-ly according to the HCP and HDR ACT values obtained by two methods with the actual measured by the correspond-ing value in the body. Results Comparing the ACT values measured by HDR and HCP with the corresponding ACT values in vivo:There are good similarity for heparinization ACT value between HCP and the actual body corresponding concentrations(r was 0.62 and 0.74,respectively),P<0.05;HDR results also have better similar-ity(r was 0.66 and 0.54,respectively),P < 0.05;However,HDR and HCP compared with the actual results in vivo found that in vitro HCP prediction results especially 3.0 mg/kg is more similar with the actual values.Conclu-sions HCP for predicting heparin dosage to meet extracorporeal circulation is more accurate.
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Objective To evaluate the relationship between antithrombin Ⅲ(ATⅢ)genetic pol-ymorphism and individual variation in anticoagulant effect of heparin in the patients of different nationalities. Methods Sixty patients of Uighur nationality and 60 patients of Han nationality, aged 18-64 yr, with body mass index of 21-25 kg∕m2, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, undergo-ing elective cardiac surgery under cardiopulmonary bypass, were divided into Uighur group and Han group, respectively. ATⅢ gene polymorphism was detected by polymerase chain reaction(A∕G was heterozygous, A∕A and G∕G were homozygous). Heparin sodium was intravenously injected at 5 min before the start of cardiopulmonary bypass with an amount of ACT≥480 s. The amount of heparin and protamine, intraoper-ative blood transfusion and postoperative 24 h drainage(pericardium, mediastinum∕thoracic cavity)were recorded. Activated partial thromboplastin time and prothrombin time were measured at 10 min before opera-tion and 24 h after operation. Results Compared with Han group, the amount of heparin, ratio of prota-mine to heparin for heparin neutralization and requirement for intraoperative blood transfusion were signifi-cantly decreased, the postoperative drainage volume was decreased, activated partial thromboplastin time was shortened at 24 h after operation, the frequency of A∕A genotype was increased and the frequency of G∕G genotype was decreased at ATⅢ gene single-nucleotide polymorphism sites rs5877 and rs5878, and the minimum allele(A>G)frequency was increased in Uighur group(P<0.05). Conclusion ATⅢ gene polymorphism may be one of the mechanisms underlying individual variation in anticoagulant effect of hepa-rin between the patients of Uighur nationality and Han nationality.
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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 observe the effect of wound specialist group on preventing and managing pressure ulcer in operation. Methods The knowledge about pressure ulcer and ability of risk assessment for pressure ulcer of operating room nurses were tested and the incidenc-es of pressure ulcer were compared before and after the intervention of the wound specialist group. Results After the intervention of the wound specialist group, the passing rate of nurses in operating room increased from 58.23%to 94.11%in pressure ulcer theory (χ2=29.63, P<0.001) and from 56.96%to 95.29%in new type of dressings paste (χ2=33.80, P<0.001), and the rate of pressure ulcer risk factor assessment increased from 56.38%to 93.35%(χ2=5828.07, P<0.001), accuracy of assessment increased from 56.23%to 96.78%(χ2=4674.89, P<0.001). The incidence of intraoperative acute pressure ulcer decreased from 1.5‰to 0.22‰(χ2=17.59, P<0.001). Conclusion The intervention of wound specialist group may improve the awareness of assessing risk factors of pressure ulcer in the operation room and standardize the oper-ation to prevent pressure ulcer, and reduce the incidence of pressure ulcer in operation.
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Objective To investigate the value of prothrombotic state (PTS) in prediction of perioperative cardiac events in elderly patients with coronary heart disease undergoing noncardiac surgery.Methods One-hundred and twenty-eight ASA physical status Ⅰ or Ⅱ elderly patients (NYHA class Ⅰ or Ⅱ) of both sexes,aged 6575 yr,undergoing elective abdominal surgery,were enrolled in the study.Total intravenous anesthesia was performed during surgery.Venous blood samples were collected for detection of the levels of D-dimer,thrombus precursor protein and P-selectin (molecular markers of PTS).Detection of PTS was based on the three indexes mentioned above.The patients were divided into 2 groups according to the cardiac events occurred during surgery and within 3 days after surgery:non-cardiac event group and cardiac event group.The general data of patients and each index during surgery were recorded.Logistic regression analysis was used to pick out the potential risk factors for cardiac events.Results Twenty-nine patients developed cardiac events.There was no significant difference in age,obesity,ratio of diabetes,duration of operation,and ratio of PTS between non-cardiac event and cardiac event groups (P ＜ 0.05 or 0.01).Logistic regression analysis showed that old age,diabetes,prolonged duration of operation,and PTS were independent risk factors for cardiac events (P ＜ 0.01).Conclusion PTS produces some value in prediction of perioperative cardiac events in elderly patients with coronary heart disease undergoing noncardiac surgery.
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Objective To investigate the level of care burden and self efficacy of caregivers of patients with spinal cord injury,and analyze their correlation.Methods By convenience sampling method,150 cases of spinal cord injury patients and their caregivers were investigated with Zarit Caregiver Burden Scale and general self-efficacy scale.Results The score of care burden of caregivers with spinal cord injury was (52.91 ± 11.56) points,self-efficacy score of caregivers was (19.63 ± 4.85) points.The score of care burden of caregivers and self-efficacy was highly negatively correlated.Conclusions We should pay more attention to improve the self-efficacy of caregivers of patients with spinal cord injury (SCI),in order to mitigate the care burden,improve care ability and health level of the patients' families.
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Objective To investigate the real situation of the burden of the caregivers who take care of patients with spinal cord injury.Methods Using phenomenological research methods of qualitative study,information of 15 family caregivers of patients with spinal cord injury were collected through semi-structured interviews in Jiangxi province,and data were analyzed with Colaizzi 7-step analysis method.Results Four themes were summarized:weak social support system,heavy economic burden,insufficient care ability,mental and physical exhaustion; mental and physical exhaustion concluded three sub-themes:burnout,lifestyle changes,sad/helplessness.Conclusions Care burden of caregivers of patients with spinal cord injury includes four aspects:social,physical,psychological,and less caring capacity.Care workers should be concerned about the health status of the caregivers,give targeted care intervention,so that caregivers can be adapted to the caregivers' role,maintain and promote a high level of health of the patients and their families.
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Objective To systematically review the myocardial protective effect of ischemic preconditioning in patients undergoing open heart surgery.Methods PubMed,EMBASE,Highwire,CENTREN and its affiliated clinical trial registration data center,CBM and CNKI were searched to identify all randomized controlled trials involving the myocardial protective effect of ischemic preconditioning in patients undergoing open heart surgery under general anesthesia.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included the incidences of postoperative cardiac death,myocardial infarction and ventricular arrhythmias and postoperative inotropic drug requirement.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software.Results Twelve randomized controlled trials (8 high-quality trials and 4 medium-quality trials) involving 626 patients were included in our Meta-analysis.Meta-analysis indicated that ischemic proconditioning significantly reduced the incidence of postoperative ventricular arrhythmias and postoperative inotropic drug requirement (P ＜ 0.05) and had no effect on the incidences of postoperative cardiac death and myocardial infarction (P ＞ 0.05).Conclusion Ischemic preconditioning can reduce the postoperative ventricular arrhythmias and have no effect on postoperative cardiac death and myocardial infarction in patients undergoing open heart surgery.
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Objective To evaluate the efficacy of different doses of glucocorticoid for prevention of postoperative complications in patients undergoing coronary artery bypass grafting (CABG).Methods We searched PubMed,EMBASE,Highwire,CENTREN and its affiliated clinical trial registration data center,Chinese Biomedical Database,and CNKI from 2000 to 2010 for randomized controlled trials involving the efficacy of different doses of glucocorticoid for prevention of postoperative complications in patients undergoing CABG.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included development of fibrillation,requirement for insulin treatment because of hyperglycosemia,infection,and death (during stay in hospital or within 30 days after discharge from hospital) after operation and mechanical ventilation time.Meta-analysis was conducted using the RevMan 5.1 software.Results Twenty-one randomized controlled trials involving 1737 patients were included in our meta-analysis.Different doses of glucocorticoid decreased the risk of fibrillation,and did not increase the risk of various causes-induced infection and death.Moderate and large doses of glucocorticoid increased the risk of requirement for insulin treatment because of hyperglucosemia.Large dose of glucocorticoid resulted in prolongation of ventilation time.Conclusion Different doses of glucocorticoid can decrease the development of postoperative fibrillation without increasing the risk of infection and death,moderate and large doses of glucocorticoid increase the risk of requirement for insulin treatment because of hyperglucosemia and large dose of glucocorticoid increases the risk of prolonged ventilation time in patients undergoing CABG.
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Objective To evaluate the efficacy of α2 adrenergic agonists for the prevention of postoperative adverse cardiac events in patients with coronary disease.Methods MEDLINE,EMBASE,CINHAL,Web of Science,CBM and CNKI were searched to identify all randomized controlled trials on the efficacy of α2 adrenergic agonists for the prevention of postoperative cardiac complications following operation performed under general anesthesia in patients with coronary artery disease.The incidence of myocardial ischemia,myocardial infarction,bradycardia and hypotension were evaluated.Meta-analysis was conducted using the RevMan 5.1 software.Results Fifteen trials included 9 high-quality trials,4 medium-quality trials and 2 low-quality trials.A total of 3422 patients were included in this meta-analysis.1790 patients received α2 adrenergic agonists (clonidine and dexmedetomidine) and 1632 patients received placebo; 724 patients underwent non-cardiac surgery and 2698 patients underwent cardiac surgery.Meta-analysis indicated that α2 adrenergic agonists reduced incidence of myocardial infarction following non-cardiac surgery and myocardial ischemia following non-cardiac surgery and cardiac surgery.Alpha-2 adrenergic agonists significantly increased the incidence of postoperative bradycardia.Conclusion Alpha-2 adrenergic agonists can decrease postoperative cardiac adverse events in patients with coronary disease,but can induce bradycardia,and the efficacy of clonidine is consistent with that of dexmedetomidine.
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A method for the rapid enantioseparation of five β-blocker drugs, including alprenolol, propranolol), mexiletine, metoprolol and pindolol was developed by a 5-cm short column packed with perphenylcarbamoylated β-cyclodextrin(CD) chiral stationary phase by HPLC. The results showed that except for alprenolol), the other 4 β-blocker drugs were completely separated using ACN-0.1% thriethylammonium acetate(TEAA), 40∶ 60, V/V, pH=4.0) as mobile phase. The 5-cm short CD-based column exhibited rapid separation ability to the above β-blocker drugs within 5 min, which indicated that the separation has high efficiency. According to the chemical structures of the β-blockers and their chromatographic behavior, related separation mechanisms were also discussed. The proposed method was rapid, effective and repeated.