Effects of ulinastatin on cognitive function in patients with coronary artery bypass grafting / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effects of ulinastatin(UTI) on postoperative cognitive function in patients undergoing coronary artery bypass grafting.</p><p><b>METHODS</b>One hundred and twenty-seven patients undergoing elective coronary artery bypass surgery were randomly divided into three groups:high-dose UTI group(16000 U/kg i.v.), low-dose UTI group(8000 U/kg i.v.) and control group(normal saline). The levels of plasma cortisol were measured before and one day after surgery. The level of IL-6, IL-10, TNF-α and S100β were measured before operation(T0), at open chest(T1), end of operation(T2), 6 h(T3)and 24 h(T4) after operation. A neuropsychological test scale was to evaluate the cognitive function 1 day before operation, 1 week and 3 months after operation.</p><p><b>RESULTS</b>Ninety-three patients completed the study. There was no significant difference in general information of patients among three groups(P>0.05). The level of plasma cortisol one day after operation was significantly higher than that before operation in control group(P<0.01). The levels of plasma cortisol in high-dose UTI group and low-dose UTI group were lower than that of control group(P<0.01). In all groups, the level of plasma IL-6, IL-10, TNF-α and S100B increased remarkably at T2, T3, T4 compared to those at T0(all P<0.05). The level of plasma IL-6, TNF-α(at T2, T3, T4)and S100β(at T3)in high-dose UTI group and low-dose UTI group were all lower than those of control group(P<0.05),while there were no significant differences between high-dose UTI group and low-dose UTI group(P>0.05). The incidence of postoperative cognitive dysfunction in POCD 1 week after operation in high-dose UTI and low-dose UTI groups(25.8% and 23.3%)was lower than that in control group(50.0%), while there were no significant difference 1 month after operation between high-dose UTI group(12.9%) or low-dose UTI group(16.7%)and control group(28.1%). The level of plasma S100β at T2 of POCD patients(n=31)was higher than that of non-POCD group(n=62)(P<0.05).</p><p><b>CONCLUSION</b>Ulinastatin can reduce the incidence of postoperative cognitive dusfunction 1 week after coronary artery bypass surgery, which might be associated with inhibition of inflammation and S100β expression.</p>

Qualitative analysis of platelet rich plasma prepared by acute plateletpheresis in patients undergoing heart surgery / 中国实验血液学杂志

This study was aimed to evaluate the efficiency and effectiveness of platelet-rich plasma(PRP) prepared by acute plateletpheresis in patients undergoing open heart surgery, and to analyze the quality of prepared platelet-rich plasma. Whole blood from 20 patients with ASAII-III was collected and PRP was harvested by machine after induction of anesthesia. Platelet count (Plt), mean platelet volume (MPV), platelet distribution width (PDW), plasma pH, plasma lactic acid (LA) concentration, and lactic dehydrogenase (LDH) concentration, germiculture result, CD62p and PAC-1 positive rate of inactivated and activated platelets by ADP in the whole blood before plateletpheresis (T1) , in the PRP after plateletpheresis (T2) and PRP before back-transfusion (T3) were determinated. The results showed that as compared with whole blood the platelet count in the PRP at T2 was (783 ± 184) ×10(9)/L, MPV, PDW and pH significantly decreased (P < 0.01) , while the plasma LDH, LA concentration, CD62p and PAC-1 positive rate of inactivated platelets were not significantly different from the whole blood at T1. In the PRP at T3, the platelet count, MPV, PDW and pH significantly decreased (P < 0.01) , while plasma LDH concentration, CD62p and PAC-1 positive rate of inactivated platelet significantly increased (P < 0.05 or P < 0.01) compared with the whole blood at T1. There were no significant difference among the CD62p and PAC-1 positive rate of activated platelets in the whole blood and PRP. It is concluded that PRP can be efficiently obtained from the patients undergoing open heart surgery by acute plateletpheresis, and the platelets in PRP are not activated during the preparing process. Some platelets in PRP are activated during the preserving process, but the whole activating function of platelets keeps normal.

Effects of propofol on metabolism of neurotransmitters in different regions of CNS in healthy volunteers / 中华麻醉学杂志

Objective To investigate the changes in the metabolism of neurotransmitters in different regions of the brain induced by propofol in healthy volunteers using the proton magnetic resonance spectroscopy (MRS) technology.Methods IH-MRS was performed in ten 20-40 year old healthy volunteers. Each volunteer underwent MRS scan twice. The first MRS scan was performed when they were conscious as baseline control value. The second scan was performed during target-controlled infusion (TCI) of propofol. The target effect-site concentration was set at 3.0 ?g?ml-1. Volume of interest (VOI) included sensory cortex, motor cortex, thalamus, hippocampus and basal ganglia. The metabolites in the spectra included N-acetyl-aspartic acid (NAA), glutamic acid (Glu), GABA, choline compounds (Cho) and creatine (Cr) .Results During TCI of propofol MAP and RR were significantly decreased ( P 0.05) as compared to the baseline value when the volunteers were conscious. During TCI of propofol the NAA content in thalamus and hippocampus, Glu content in thalamus, hippocampus and basal ganglia and Cho content in all the 5 regions of the brain were significantly decreased ( P