ABSTRACT
Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.
ABSTRACT
Abstract Background: Vein graft restenosis has an adverse impact on bridge vessel circulation and patient prognosis after coronary artery bypass grafting. Objectives: We used the extravascular supporter α-cyanoacrylate (α-CA), the local application rapamycin/sirolimus (RPM), and a combination of the two (α-CA-RPM) in rat models of autogenous vein graft to stimulate vein graft change. The aim of our study was to observe the effect of α-CA, RPM, and α-CA-RPM on vein hyperplasia. Methods: Fifty healthy Sprague Dawley (SD) rats were randomized into the following 5 groups: sham, control, α-CA, RPM, and α-CA-RPM. Operating procedure as subsequently described was used to build models of grafted rat jugular vein on carotid artery on one side. The level of endothelin-1 (ET-1) was determined by enzyme-linked immunosorbent assay (ELISA). Grafted veins were observed via naked eye 4 weeks later; fresh veins were observed via microscope and image-processing software in hematoxylin-eosin (HE) staining and immunohistochemistry after having been fixed and stored" (i.e. First they were fixed and stored, and second they were observed); α-Smooth Muscle Actin (αSMA) and von Willebrand factor (vWF) were measured with reverse transcription-polymerase chain reaction (RT-PCR). Comparisons were made with single-factor analysis of variance and Fisher's least significant difference test, with p < 0.05 considered significant. Results: We found that intimal thickness of the α-CA, RPM, and α-CA-RPM groups was lower than that of the control group (p < 0.01), and the thickness of the α-CA-RPM group was notably lower than that of the α-CA and RPM groups (p < 0.05). Conclusion: RPM combined with α-CA contributes to inhibiting intimal hyperplasia in rat models and is more effective for vascular patency than individual use of either α-CA or RPM.
Resumo Fundamento: Reestenose de enxertos venosos tem um impacto adverso na circulação de pontagens e no prognóstico de pacientes após a cirurgia de revascularização miocárdica. Objetivos: Nós utilizamos α-cianoacrilato (α-CA) como suporte extravascular, rapamicina/sirolimus (RPM) como aplicação local e a combinação dos dois (α-CA-RPM) em modelos de enxerto venoso autógeno em ratos para estimular mudança no enxerto venoso. O objetivo do nosso estudo foi observar o efeito de α-CA, RPM e α-CA-RPM na hiperplasia venosa. Métodos: Cinquenta ratos Sprague Dawley (SD) saudáveis foram randomizados nos 5 grupos seguintes: sham, controle, α-CA, RPM e α-CA-RPM. O procedimento operacional descrito subsequentemente foi utilizado para construir modelos de enxertos da veia jugular na artéria carótida em ratos, em um lado. O nível de endotelina-1 (ET-1) foi determinado por ensaio de imunoabsorção enzimática (ELISA). As veias enxertadas foram observadas a olho nu 4 semanas após; as veias frescas foram observadas via microscópio e software de processamento de imagem com coloração hematoxilina-eosina (HE) e imuno-histoquímica depois de serem fixadas e armazenadas; α-actina do músculo liso (αSMA) e o fator de von Willebrand (vWF) foram medidos com reação em cadeia da polimerase-transcriptase reversa (RT-PCR). Realizaram-se as comparações com análise de variância de fator único (ANOVA) e o teste de diferença mínima significativa (LSD) de Fisher, com p < 0,05 sendo considerado estatisticamente significante. Resultados: Nós achamos que a espessura intimal nos grupos α-CA, RPM e α-CA-RPM era menor que no grupo controle (p < 0,01) e a espessura no grupo α-CA-RPM era notavelmente menor que nos grupos α-CA e RPM (p < 0,05). Conclusão: A combinação de RPM e α-CA contribui à inibição de hiperplasia em modelos em ratos e é mais efetivo para patência vascular que uso individual de α-CA ou RPM.
Subject(s)
Animals , Male , Female , Tunica Intima/drug effects , Tunica Intima/pathology , Sirolimus/pharmacology , Cyanoacrylates/pharmacology , Hyperplasia/prevention & control , Time Factors , Enzyme-Linked Immunosorbent Assay , Carotid Arteries/pathology , Carotid Arteries/transplantation , Random Allocation , Coronary Artery Bypass/adverse effects , Reproducibility of Results , Actins/analysis , Treatment Outcome , Rats, Sprague-Dawley , Endothelin-1/blood , Reverse Transcriptase Polymerase Chain Reaction , Cell Proliferation/drug effects , Disease Models, Animal , Drug Combinations , Graft Occlusion, Vascular/etiology , Graft Occlusion, Vascular/pathology , Graft Occlusion, Vascular/prevention & control , Jugular Veins/pathology , Jugular Veins/transplantationABSTRACT
Objective:To observe the relationship between diabetic retinopathy (DR) and ? 3 adrenergic receptor (? 3 AR) gene polymorphism in Chinese patients with type 2 diabetes mellitus. Methods: The mutation of genotype of Trp64Arg in ? 3 AR gene was measured wit h PCR RFLP in 50 normal control and 196 patients with type 2 diabetes, while other clinical parameters [body mass index (BMI), blood pressure, fasting blood glucose, serum lipid levels and HbA1c] were all measured. Results: (1)There were no significant differences in the freque ncies of ? 3 AR phenotypes and alleles between type 2 diabetic patients and n ormal controls or between female patients and male patients; (2) The plasma triglyceride, diastolic blood pressure and BMI in female patients with mutation of ? 3 AR gene were higher than those in without mutation. There was no difference in male diabetic patients; (3)There was no difference in genotype frequencies or allele frequencies between diabetic patients with or without retinopathy. Genotype and allele frequencies didnot differ in proliferative diabetic retinopathy and non proliferative diabetic retinopathy. Conclusion: The mutation of Trp64Arg in ? 3 AR gene is associated with obesity, hypertension and dyslipideamia in femal e diabetic patients. Trp64Arg polymorphism in ? 3 AR gene is not associated with diabetic retinopathy in type 2 diabetes mellitus patients in Shanghai.
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Objective: To investigate the role of cyclin kinase inhibitor P27 on the proliferation of mesangial cell(MC) in Thy1 glomerulonephritis(GN) rats. Methods: The Thy1 model of experimental mesangial proliferative glomerulonephritis was induced by intravenous injection of rabbit anti-thymocyte plasma. The P27 protein of glomerular lysate was detected with Western blotting analysis. The P27 mRNA was determined with RT-PCR. The extracellular matrix (ECM) protein (fibronectin and type Ⅳ collagen) of glomerular lysate was examined with ELISA. Results: Glomerular P27 protein of Thy1 model rat decreased compared with that of normal rat. The level of P27 was associated with the degree of MC proliferation:P27 began to decrease on day 1 in Thy1 model, then reached the lowest on day 3 when MC proliferation was maximal, then returned to 60% of the baseline level on day 5 when MC proliferation began to resolute. Glomeruar P27 mRNA remained constant in Thy1 GN(3 d) rats. Glomerular fibronectin(Fn) and type Ⅳ collagen increased in Thy1 model: They reached the highest on day 3(P
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Objective:To study the change of serum interleukin 6 levels in obese patients and effect of sibutramine on its levels.Methods:Totally 45 obese patients were assigned into sibutramine treated group( n =25) and placebo treated group( n =20), and 16 normal weight subjects were taken as control group.Before and after 24 week treatment,body mass,waist circumferences,serum levels of interleukin 6,glucose and insulin were determined,and the body mass index(BMI) and HOMA IR were calculated.Results:(1) Body mass,BMI and waist circumferences decreased after 24 week treatment in sibutramine and placebo group( P