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@#Gastrointestinal complications after cardiac surgery are rare, but they are associated with significant morbidity and mortality. The mechanisms of gastrointestinal complications after cardiac surgery may be unique, as the abdominal cavity is not involved. This review summarizes the current evidence of the pathophysiology, clinical manifestations, risk factors, and management of gastrointestinal complications after cardiac surgery, aiming to improve the recognition of gastrointestinal complications after cardiac surgery.
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@#Left ventricular outflow tract obstruction (LVOTO) in Ebstein's anomaly is a rare complication, and LVOTO related to surgery is rarer. We present a 46 years old female patient who was dignosed with Ebstein's anomaly, then suffered from cardiac arrest because of LVOTO secondary to cone reconstruction in ICU.
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Objective To explore the effect of bilateral vagal nerves transection on the inflammatory reaction of rats induced by lung ischemia and reperfusion.Methods Twenty-four adult male SD rats weighed 250-320g were randomly divided into 3 groups (8 each): Sham group (S group), ischemia reperfusion group (IR group) and bilateral vagal nerves transaction and ischemia-reperfusion group (NIR group). Blood gas analysis with arterial blood was performed to detect the arterial partial pressure of oxygen (PaO2) and arterial-alveolar oxygen pressure gradient (A-aDO2) before ischemia and 0.5 and 4 hours after reperfusion. At the end of the experiment, the left lung tissues were collected to measure wet/dry ratio, the pathological changes were observed by light microscopy, and inflammatory indicators, including tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) levels and myeloperoxidase (MPO) activity were detected.Results Compared with S group, ischemia and reperfusion injury sharply decreased PaO2 and increased A-aDO2; the MPO activity, the contents of TNF-α and IL-10 and the wet/dry ratio obviously increased in IR group; more infiltration of inflammatory cells, hemorrhage, thickening and swelling of alveolar walls were observed. Compared with IR group, PaO2 further decreased while A-aDO2 had no obvious change in NIR group, the inflammatory reaction and pathologic lesions in lung tissues were getting worse.ConclusionBilateral vagal nerves transaction may aggravate lung ischemia and reperfusion injury, suggesting that the integrity of vagal nerves play a significant role in regulating inflammatory reaction of lung ischemia and reperfusion injury in rats.
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Objective To compare the changes in postoperative pain, complications and clinical effect between gastrodin and remifentanil for controlled hypotension in endoscopic sinus surgery.Methods Eighty patients undergoing endoscopic sinus surgery were enrolled in the study.Patients were randomized into two groups of 40 to receive gastrodin (Group G) or remifentanil (Group R) infusion.Two groups were administered with propofol of 2 mg/kg to induce anaesthesia, which was maintained using sevoflurane.Group R received a continuous infusion of remifentanil titrated between 3 and 4 ng/mL using target-controlled infusion, whereas Group G received an i.v.gastrodin bolus of 2 mg/kg followed by a 20 mg/kg continuous infusion to maintain a mean arterial pressure ( MAP) between 60 and 70 mmHg.Haemodynamic variables, surgical conditions, postoperative pain, and adverse effects, such as postoperative nausea and vomiting ( PONV) and shivering were recorded.Results Controlled hypotension was well maintained in both groups.MAP and heart rate were higher in Group R than Group G after operation(P<0.05).Surgical conditions scores were not different between two groups.Postoperative pain scores were significantly lower in Group G than Group R (P<0.05).Shivering and the use of antiemetic and analgesic drugs were also less frequent in Group G than Group R (P<0.05).Conclusions Both gastrodin and remifentanil when combined with sevoflurane provides adequate controlled hypotension and proper surgical conditions for endoscopic sinus surgery.However, patient administered gastrodin has a more favourable postoperative course with better analgesia and less shivering and PONV.
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Objecitve:To study the effects of ketamine on the large conductance Ca~(2+)-activated potassium (BK)channels in cultured newborn rat hippocampal neurons. Method:All experiments were carried out on 3-7 days old neurons. Single channel current signals were recorded in symmetrical high K~+ solution(140mM) under cell-attached patch and inside-out patch. Result:(1)In inside-out patch, with the unitary conductance being 176.5?16.5pS,the BK channel activity was markedly activated by internal Ca~(2+) but was blocked by potassium channel blocker (TEA). (2) In cellattached patch,when the concentration of ketamine was 0.01,0.05,0.20mmol/L and membrane potential kept at?60mV,the open probability (Po) decreased from 0.042?0.011 at baseline to 0.027?0.008,0.030?0.015,0.032?0.021 respectively(P0.05). Conclusion:Ketamine has dual effects on the BK channels,the inhibition may be related to its side effects,and the activation to the mechanism in anesthesia.