ABSTRACT
Objective To compare the accuracy of stroke volume variation (SVV),central venous pressure (CVP) and puhnonary arterial wedge pressure (PAWP) in monitoring the changes in blood volume in the patients undergoing renal transplantation.Methods Sixteen patients with chronic renal failure,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,aged 18-55 yr,scheduled for elective allograft renal transplantation under general anesthesia,were enrolled in the study.SVV was continuously monitored with the FloTrac/Vigileo monitor,and CVP,PAWP and stroke volume index (SVI) were continuously monitored with the volumetric pulmonary artery catheter during surgery.The parameters of hemodynamics were recorded at 30 min after induction of anesthesia,5 min before renal artery opening,5 and 30 min after renal artery opening,and at the end of surgery.Hydroxyethyl starch 130/0.4 electrolyte solution 6 ml/kg was infused over 15 min via the central venous catheter to perform fluid responsiveness starting from 30 min after induction of anesthesia.Positive fluid responsiveness was defined as the change in SVI ≥ 15％.The relationship between SVV and CVP and between SVV and PAWP was analyzed using the Pearson correlation analysis.The receiver operating characteristic curve for CVP,SVV and PAWP in monitoring the changes in blood volume was drawn,and the area under the curve was calculated.Results Compared with the value at 5 min before renal artery opening,SVV was significantly increased after renal artery opening (P＜0.05),and no significant change was found in CVP and PAWP after renal artery opening (P＞0.05).SVV was negatively correlated with CVP,and r=-0.82 (P＜0.01);SVV was negatively correlated with PAWP,and r=-0.77 (P＜0.01).The area under the curve of SVV in monitoring the changes in blood volume was 0.87,and of CVP and PAWP was 0.69 and 0.66,respectively.Conclusion SVV provides better accuracy than CVP and PAWP in monitoring the changes in blood volume in the patients undergoing renal transplantation.
ABSTRACT
Objective To explore the role of Cyclin B1 and Cyclin D1 on Barrett esophagus,Barrett's esophagus mixed with atypical dysplasia and esophageal adenocarcinoma.Methods Cyclin B1 and Cyclin D1 were examined with immunohistochemistry.76 esophageal tissues of patients werB collected,including severe reflux esophagitis(RE,25 cases),Barrett esophagus(BE,35 cases),Barrett esophagus mixed with atypical dysplasia(DY,8 cases),esophageal carcinoma(CA,8 cases).Ten cases with normal esophageal mucosa were examined as the control. Results Cyclin B1 and Cyclin D1 were high expression in the specimens of the BE,DY and CA groups and very low expression in the control and RE group.Statistieal difference Was showed(P<0.01).Expression of Cyclin D1 was increasing gradually from the tissues of intestinal metaplasia,atypical dysplasia to adenocarcinoma(50.04 vs 67.94 vs 74.31).There Was significant difference among these three groups(P<0.01).Conclusion Cyclin B1 and Cyclin D1 as markers of tumour development could evaluate the risk from Barrett esophagus to adenocarcinoma.Perhaps it is the earlv event in the development of esophageal carcinoma.