Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fifth Edition)updated for the Omicron variant / 中华实用儿科临床杂志

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fourth Edition) / 中华实用儿科临床杂志

Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.

Expert consensus on the diagnosis, treatment and prevention of monkeypox in children / 中华实用儿科临床杂志

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.

Twenty key issues on severe acute respiratory syndrome coronavirus-2 vaccination in children / 中华实用儿科临床杂志

Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.

Experts′ consensus on severe acute respiratory syndrome coronavirus-2 vaccination of children / 中华实用儿科临床杂志

At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.

Diagnosis, treatment and prevention of 2019 novel coronavirus infection in children: experts′ consensus statement (Third Edition) / 中华实用儿科临床杂志

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.

Treatment of thoracoabdominal aortic aneurysm by prosthetic vessel replacement under left heart bypass / 中南大学学报(医学版)

OBJECTIVES@#Thoracoabdominal aortic aneurysm (TAAA) prosthetic vessel replacement is one of the most complex operations in the field of cardiovascular surgery. The key to success of this operation is to prevent and avoid ischemia of important organs while repairing TAAA. This study aims to summarize and analyze the effect of prosthetic vessel replacement under left heart bypass in the treatment of TAAA.@*METHODS@#Data of 15 patients with TAAA who underwent prosthetic vessel replacement under left heart bypass in Xiangya Hospital of Central South University were retrospectively analyzed. According to Crawford classification, there were 2 cases of type I, 8 cases of type II, 3 cases of type III, and 2 cases of type V. There were 14 cases of selective operation and 1 case of emergency operation. All operations were performed under left heart bypass, and cerebrospinal fluid drainage was performed before operation. Left heart bypass was established by intubation of left inferior pulmonary vein and distal abdominal aorta or left femoral artery. The thoracoabdominal aorta was replaced segment by segment. After aortic dissection, the kidneys were perfused with cold crystalloid renal protective solution, and the celiac trunk and superior mesenteric artery were perfused with warm blood.@*RESULTS@#One patient with TAAA after aortic dissection of type A died. During the operation, straight blood vessels were used to repair TAAA, and the celiac artery branches were trimmed into island shape and anastomosed with prosthetic vessels. After the operation, massive bleeding occurred at the anastomotic stoma, then anaphylactic reaction occurred during massive blood transfusion, resulting in death. One patient suffered from paraplegia due to ischemic injury of spinal cord. The other patients recovered well and were discharged. The postoperative ventilation time was (16.5±13.8) h and the postoperative hospital stay was (10±4) d. The amount of red blood cell transfusion was (13±9) U. The patients were followed up for 2 months to 2 years, and the recovery was satisfactory.@*CONCLUSIONS@#The effect of prosthetic vessel replacement under left heart bypass in the treatment of TAAA is good, which is worthy of clinical promotion.

Treatment strategies for congenital heart disease in infants with severe pneumonia / 中南大学学报(医学版)

To observe the results of different treatment of congenital heart disease (CHD) complicated with severe pneumonia in infants.
 Methods: A total of 27 infants with CHD and severe pneumonia were admitted to the Department of Pediatrics, Xiangya Hospital from January 2014 to December 2014, of whom 18 were male and 9 were female. The average age was 2.0-19.0(5.9±4.3) months, with an average body weight of 3.3-10.0 (5.8±1.8) kg. Infants were treated with a strategy of complete control of the lung infection before surgery (internal medicine group). From January 2015 to December 2015, 29 infants with same condition were admitted, of whom 15 were males and 14 females. The average age was 2.0-27.0 (6.1±3.9) months, with an average body weight of 3.1-8.0 (4.8±1.0) kg. Infants were treated with a strategy of combined treatment (combined treatment group), in which early surgical treatment were performed after a short time antibiotics and supportive treatment.
 Results: One nosocomial death in internal medicine group, with an average hospital stay for 3-26 (11±6) d. Further surgeries were performed in 5 patients after discharge with no surgical death. The mean preoperative hospital stay in combined treatment group was 1-21 (10±6) d. The mean total hospital stay for combined treatment group was 14-48 (24±9) d and the mean postoperative hospital stay was 6-35 (14±7) d. One patient died soon after surgery in combined treatment group. Thirty-day follow-up found that no other patient died in combined treatment group, and 6 patients died in internal medicine group. The 30-day mortality was 3.4% in combined treatment group and 22.2% in internal medicine group (P<0.01).
 Conclusion: Infant congenital heart disease complicated with severe pneumonia requires early surgical treatment, which contributed to the control of pulmonary infection and reduce mortality.

Prognostic significance ofneutrophil-to-lymphocyte ratioin ovarian cancer:A systematic review and meta-analysis of observational studies / 实用医学杂志

Objective To obtain a more accurate assessment of prognostic significance of NLR in ovarian cancer. Methods A systematic literature search was conducted using the electronic databases PubMed ,Web of Science,and Embase up to May 2016. Hazard ratio(HR)and odds ratio(OR)with 95% confidence interval (95%CI)were calculated. Statistical analysis was performed using Stata 12.0. Results 12 studies,consisting of 3 ,854 patients ,were selected in this meta-analysis. High NLR level was significantly associated with poorer overall survival(OS)(HR:1.69)and shorter progression free survival(PFS)(HR 1.63). Additionally,increased NLR was significantly correlated with advanced FIGO stage(OR 2.32),higher level of CA-125(OR 3.33),more extensive ascites(OR 3.54)as well as less chemotheraputic response(OR 0.53). Conclusions Elevated pretreat-ment NLR can serve as a predicative factor of poor prognosis for ovarian cancer.

Protective effect of right coronary artery ischemic preconditioning on myocardial ischemia reperfusion injury in rabbit heart / 中南大学学报(医学版)

To explore the protective effects of right coronary artery ischemic preconditioning and post-conditioning on myocardial ischemia reperfusion injury in rabbit heart.
 Methods: A total of 30 rabbits were randomly divided into 4 groups: a control group (n=7), an ischemia reperfusion group (IR group, n=8), an ischemic preconditioning group (IPC group, n=8) and an ischemic post-conditioning group (IPO group, n=7). Venous blood samples were taken at pre-operation, 1 and 6 h post-operation, and the concentration of serum creatine kinase isoenzyme (CK-MB) and cardiac troponin-T (cTn-T) were measured. The infarct area of cardiac muscle was calculated.
 Results: Compared with the IR group, the levels of CK-MB and cTn-T at 1 and 6 h post-operation in the IPC group and the IPO group were reduced (all P<0.05). Compared with the IR group, the infarct size in the IPC group and the IPO group was significantly decreased, with significant difference (both P<0.05) .
 Conclusion: Right coronary artery ischemic preconditioning and post-conditioning exert significant protective effects on the myocardial ischemia reperfusion injury in New Zealand rabbits.

Heparin-induced thrombocytopenia in patients undergoing cardiac surgery / 中南大学学报(医学版)

OBJECTIVE@#To investigate the incidence for heparin-induced thrombocytopenia (HIT) in patients undergoing cardiac surgery and to evaluate the risk factors for the generation of HIT-antibody.
@*METHODS@#A total of 315 patients undergoing cardiac surgery in the Department of Cardiothoracic Surgery, Xiangya Hospital between December, 2013 and July, 2014 were enrolled for this study. Among them, 120, 154 and 41 were for surgery of congenital heart defect, valve and coronary artery bypass graft, respectively. There were 170 male patients and 69 patients were under 18 years old. Platelet counts, HIT-antibody and concentration of platelet factor 4 (PF4) were tested before and after the surgery. Diagnosis of HIT was based on "4Ts" (Pretest Clinical Scoring System). 
@*RESULTS@#HIT was diagnosed in 11 patients (3.5%, 11/315). And thromboembolic events occurred in 2 of 11 patients with HIT. The positive ratio for HIT-antibody was 36.5% (115/315). The coronary artery disease patients had a higher incidence of HIT than that of either the valve disease or the congenital heart defect (17.1%, 7/41 versus 1.9%, 3/154 or 0.8%, 1/120; P<0.05). The congenital heart defect patients had a higher positive ratio for HIT-antibody than that of both the valve disease and the coronary artery disease. The valve disease patients had a higher positive ratio for HIT-antibody than that of the coronary artery disease (51.7%, 62/120 versus 30.5%, 47/154 versus 14.6%, 6/41; P<0.05). Major postoperative complications occurred more frequently in HIT patients (36.4%, 4/11 versus 10.5%, 32/304; P<0.05). Age was a risk factor for HIT (P=0.030, OR=1.083, 95% CI 1.008-1.163). Cardiopulmonary bypass (CPB) (P=0.037, OR=3.113, 95% CI 1.071-9.050) and age (P<0.001, OR=0.970, 95% CI 0.959-0.982) were risk factors for HIT-antibody.
@*CONCLUSION@#The incidence of HIT is low during cardiac surgery, but HIT is a highly risk factor for the major postoperative complications. More attentions should be paid to these severe complications and the risk factors for HIT.

Intervention of NGAL and HO-1 in valve replacement surgery-induced acute kidney injury / 中南大学学报(医学版)

OBJECTIVE@#To determine the pathological mechanism and prevent heart-renal syndrome after heart valve replacement surgery.@*METHODS@#A total of 46 patients were admitted for selective valve replacement, and divide into 3 groups randomly: a control group (Con, n=16), a remote ischemic perconditioning (RIPerC) group (n=15) and a remote ischemic postconditioning (RIPostC) group (n=15). The serum creatinine (SCr), blood urea nitrogen (BUN), serum heme oxygennase-1 (HO-1), serum iron and urinary neutrophil gelatinase associated lipocalin (NGAL) level in the 3 groups were compared preoperatively and 6, 12, 24, 48 h after aortic cross-release.@*RESULTS@#Compared with the preoperative level, the SCr, BUN, urinary NGAL, serum iron (6 and 12 h) and serum HO-1 values were significantly increased after the heart valve replacement surgery in the control patients, RIPreC and RIPostC groups (P0.05).@*CONCLUSION@#Abnormal change in urinary NGAL, serum iron and HO-1 can be used as early warning indicators of acute kidney injury when cardio-renal syndrome occurrs among patients under heart valve replacement surgery. Remote ischemic conditioning plays a preventive role in the occurrence of cardio-renal syndrome and renal protection.

Effect of stress on myocardial apoptosis in ischemic preconditioning in rabbit hearts / 中南大学学报(医学版)

OBJECTIVE@#To determine the influence of stress on myocardial apoptosis in ischemic preconditioning group (IPC).@*METHODS@#Twenty-four Japanese white rabbits were randomly divided into 4 groups (n=6): an etomidate group (the Etom group) of depressed stress established by intravenous etomidate, an IPC group, an ischemic reperfusion group (the IR group) and a methylprednisolone group (the MP group). Myocardial apoptosis was examined by DNA-laddering, in situ nick-end labeling (TUNEL) and Hoechst dyeing.@*RESULTS@#The DNA ladder increased in the Etom group. The percentage of apoptosis by TUNEL method was 1.7%±0.2% in the IPC group, 2.3%±0.8% in the MP group, 3.8%±1.3% in the IR group and 3.0%±0.4% in the Etom group. Hoechst dying was 4.1%±0.9% in the IPC group, 3.5%±0.4% in the MP group, 6.2%±1.6% in the IR group and 7.6%±0.4% in the Etom group. There was significant difference between the IPC group and the Etom group or IR group, and also between the MP group and the IR group.@*CONCLUSION@#A depressed stress response impairs the inhibition on myocardial apoptosis in ischemic preconditioning. Methylprednisolone may inhibit myocardial apoptosis.

REV procedure for complex congenital heart diseases / 中南大学学报(医学版)

OBJECTIVE@#To introduce REV procedure in patients with transposition of the great arteries (TGA) with a ventricular septal defect (VSD) and pulmonary stenosis (PS).@*METHODS@#From May 2012 to June 2012, 4 patients with TGA were admitted for surgery. Two patients with VSD underwent SWITCH operation. REV procedure was used for the other two patients with PS. The Senning procedure was also used for the patient with atrioventricular discordance.@*RESULTS@#There was no in-hospital mortality. Shortest cardiopulmonary bypass time and aortic crossclamp time were found in simple REV procedure patient. Postoperative echocardiography demonstrated physiologic hemodynamics in the left ventricular outflow tract and normal heart function. All the patients were in excellent clinical condition during follow-up.@*CONCLUSION@#REV procedure is a good choice for transposition of great arteries associated with ventricular septal defect and obstruction of the pulmonary outflow tract.

Role of stress in myocardial protection of ischemic preconditioning / 中南大学学报(医学版)

Objective:To determine the role of stress in myocardial protection of ischemic preconditioning (IPC). Methods:hTirty rabbits were randomly divided into an IPC group, an etomidate (Etom) group, an ischemic/reperfusion (IR) group, a methylprednisolone (MP) group and a sham group. hTe ratio of infarction size versus risk area (infarct/risk) was calculated. hTe elevations of the serum creatine kinase (CK) activity and cardiac troponin I (cTnI) concentrations as well as the serum cortisol concentrations were measured. Results:hTe percentages of infarct/risk in the IPC group, the MP group, the IR group, and the Etom group were (5.86±2.81)%, (11.28±3.62)%, (26.79±4.53)%, and (18.19±3.72)%, respectively. The elevations of the serum CK activity in the IPC group, the MP group, the IR group, and the Etom group were (255±89), (314±160), (855±371), and (768±404) U/L, respectively. hTe elevations of serum cTnI concentrations in the IPC group, the MP group, the IR group, and the Etom group were (3.6±0.6),(6.1±2.2), (8.1±3.6), and (6.4±1.6)μg/L, respectively. Those indicators among the groups were signiifcantly different (P Conclusion: A blunted cortisol reaction can markedly reduce the benefit of IPC while methylprednisolone shows cardioprotective effects, suggesting that stress might be involved in the myocardial protection of IPC.

Telephone follow-up of 1635 post-surgery lung cancer patients and retrospective study of lung cancer prognosis / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the telephone follow-up of surgery patients with lung cancer and to analyze the prognosis factors.@*METHODS@#From October 2011 to January 2012, 1635 post-surgery lung cancer patients from January 2002 to August 2011 were followed up by telephone interview. The data from follow-up and clinical characteristics were collected and analyzed. Among these patients, 116 patients with complete and reliable clinical data were further analyzed to determine the effective factors of lung cancer metastasis and long-term survival.@*RESULTS@#The average response rate in the follow-up was 36.1%, and the response rate was related to the interval time after the operations. The shorter the interval, the higher the response rate. The response rate in female patients was higher than that in male patients (P<0.001).The response rate was higher in patients younger than 40 (56 %) than that in the patients aged between 50-59 and over 60 (39% and 24% respectively, P<0.001). There was no statistical difference between patients from urban and rural areas (P=0.844). In the 116 patients with complete and reliable clinical data, statistical analysis confirmed that the metastasis and high lymph node staging were factors to increase patients' risk of death (with odd ratio 0.212 and 1.818 respectively, P<0.001). The adenocarcinoma grade, high lymph node staging and advanced age were related to the metastasis risk (odds ratio 2.353, 2.181 and 2.908, respectively).@*CONCLUSION@#Time, gender and age are the influencing factors in the telephone follow-up. Metastasis, lymph node metastasis, pathologic type and age are related to the lung cancer prognosis in the small-scale sample.

The effects of recombinant human brain natriuretic peptide on the plasma endotoxin and systemic inflammatory response in patients with cardiac valve replacement during cardiopulmonary bypass / 中华胸心血管外科杂志

Objective To observe the effects of recombinant human brain natriuretic peptide on the plasma endotoxin and systemic inflammatory response in patients undergoing cardiac valve replacement surgery during cardiopulmonary bypass (CPB) and to explore its mechanism.Methods 32 patients with elective heart valve replacement surgery during cardiopulmonary bypass were divided into a control group and a treatment group randomly.The patients of treatment group were recievel rhBN (1.5 μg · kg-1 · min-1 bolus intravenous injection before aortic cross-clamping followed by 0.0075 μg · kg-1 · min-1 for 24 hours),while the patients of control group received the same volume of 0.9％ sodium chloride.The plasma levels of endothelin -1 ( ET-1 ),diamine oxidase(DAO),lipopolysaccharide ( LPS),tumor necrosis factor-α (TNF-α) before skin incision ( T1 ),the end of CPB ( T2 ),4 h after the end of CPB ( T3 ),8 h after the end of CPB (T4),24h after the end of CPB (T5) respectively.Results Before skin incision ( T1 ),plasma ET-1,DAO,LPS,TNF-α of two group patients showed no significant difference ( P ＞ 0.05 ) ; At each time point after the end of CPB ( T2,T3,T4,T5 ) Plasma DAO,LPS,TNF-α levels of two groups patients were significantly higher than before skin incision ( T1 ) levels ( P ＜ 0.01 ).There was no significant difference of the plasma levels of ET-1 between T5 and T1 in treatment group patients ( P =0.24).At each time point after the end of CPB ( T2,T3,T4,T5 ),treatment group patients'plasma ET-1,DAO,LPS,TNF-α levels were significantly lower than the control group respectively (P ＜0.01 ).The increase in blood ET-1 was highly positive correlated with the increase in blood DAO (r=0.51,P ＜0.01 ).The increase in blood DAO was highly positive correlated with the increase in blood LPS (r =0.77,P ＜ 0.01 ).The increase in blood LPS was significantly positive correlated with the increase in blood TNF-α ( r =0.48,P ＜0.01 ).Conclusion Recombinant human brain natriuretic peptide can reduce gastrointestinal vasoconstriction,improve gastrointestinal mucosal perfusion and oxygenation,protect the gastrointestinal mucosal barrier function,preventing intestinal endotoxemia Shift,reduce plasma endotoxin levels and reduce systemic inflammatory response by inhibiting the release of ET-1 during CPB.

Cardioprotection of adenosine treatment in cadaver donor rats with warm ischemia / 中南大学学报(医学版)

OBJECTIVE@#To determine the cardioprotection of adenosine treatment in cadaver donor rats with warm ischemia.@*METHODS@#Rats were randomly divided into 7 groups. Group C was a control group. Group I(5), I(15), and I(30): The donor hearts from the cadaver rats that died of acute hemorrhagic shock and within warm ischemic durations of 5, 15, and 30 min, respectively, and the donor hearts were perfused with STH-1 for 30 min before cervical heterotopic heart transplantation. Group A(5), A(15), and A(30) were adenosine treatment groups and the donor hearts were obtained as mentioned above and perfused with STH-1 plus adenosine (adenosine concentration 1.2 mmol/L) before cervical heterotopic heart transplantation. We detected the change of the grafts including ultrastructure, the level of ATP, SOD, and MDA, NF-kappaB mRNA, TNF-alpha, and IL-6 24 h after the transplantation.@*RESULTS@#At the same time point, compared with Group I(5), I(15), and I(30), Group A(5), A(15), and A(30) showed increased ATP and SOD in the myocardial tissues, and decreased MDA, NF-kappaB mRNA, TNF-alpha, and IL-6 (P<0.05).@*CONCLUSION@#Adenosine treatment can protect the graft in cadaver donor rats with warm ischemia. The mechanism may improve the myocardial energy metabolism, attenuate lipid peroxidation injury, suppress the expression of NF-kappaB mRNA, and decrease the inflammatory damage of TNF-alpha and IL-6.

Protective effect of limb ischemic preconditioning on acute lung injury induced by lipopolysaccharide in rats / 中南大学学报(医学版)

OBJECTIVE@#To explore the protective effect of noninvasive limb ischemic preconditioning (N-LIP) on acute lung injury (ALT) induced by lipopolysaccharide (LPS) in rats.@*METHODS@#Fifteen female SD rats were randomly divided into a control group, an acute lung injury group (ALI group), an acute lung injury and noninvasive limb ischemic preconditioning group (ALI+N-LIP group). After ALI rats were treated with N-LIP, the changes of airway resistance (AR) and dynamic compliance (Cdyn) were tested by invasive pulmonary function system and recorded. Blood samples and bronchoalveolar lavage fluid (BALF) were collected, the amounts of white blood cell (WBC) in BALF were counted by cytometry, and the level of lactate dehydrogenase (LDH) in BALF was also examined by automatic biochemistry analyzer. The level of serum superoxide dismutase (SOD) and malondialdehyd (MDA) was examined by chromatometry. The lung tissues were acquired to observe the expression of pulmonary surfactant-associated protein-A (SP-A) and pathological changes.@*RESULTS@#After being stimulated by methacholine (Mch), the increasing rate of AR and decreasing rate of Cdyn in the ALI+N-LIP group were less than those in the ALI group (P<0.01). The levels of WBC and LDH in BALF in the ALI+N-LIP group were much lower than those in the ALI group (P<0.05). Meanwhile, the activity of serum SOD in the ALI+N-LIP group was higher, and the level of serum MDA was lower than that in the ALI group (P<0.05). The expression of SP-A in the lung tissue in the ALI+N-LIP group was the highest in the 3 groups, while that in the ALI group was the weakest (P<0.01). Injury of the lung tissue in the ALI+N-LIP group was less than that in the ALI group, but more severe than that in the control group.@*CONCLUSION@#N-LIP has protective effect on acute lung injury induced by LPS in rats. The possible mechanism is related to improving the secretion of SP-A and antioxidation.

Peri-operative management of infants undergoing open heart surgery / 中南大学学报(医学版)

OBJECTIVE@#To summarise the experience of peri-operative management of infants undergoing open heart surgery.@*METHODS@#Clinical data of 206 infants undergoing open heart surgery were analyzed retrospectively. The patients aged from 20 days to 3 years.The weight was 3~18(9.60+/-2.75)kg.Altogether 149 patients were found non-cyanotic and 57 with cyanotic heart diseases.Radical operation was performed on 204 patients with the exception of two by palliative operation.@*RESULTS@#The mortality was 4.85%(10/206) and the incidence of early complications was 13.6%(28/206).@*CONCLUSION@#Early surgical treatment was crucial to infants with congenital heart disease at an appropriate time.To improve the operative and CPB techniques, to strengthen the management of postoperative respiratory and circulatory system, attention to the protection of vital organs, and nutrition support for infants are all keys to the success of heart surgery.