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Objective:To investigate the effect of L-carnitine on myocardial ischemia-reperfusion injury in patients undergoing coronary artery bypass grafting (CABG) operation.Methods:The clinical data of 60 patients who had underwent CABG under extracorporeal circulation in Department of Cardiovascular Surgery, the First Affiliated Hospital of Medical College of Xi′an Jiaotong University from January 2015 to December 2017 was retrospectively analyzed. L-carnitine was infused into the patients in the observation group while the equal amount of normal saline was given to the patients in the control group during perioperative period. Venous blood was collected from each patient 1 hour before the surgery and at 2, 6, 24 and 72 hours after unclamping the aorta, then serum levels of aspartate aminotransferase (AST), lactic acid dehydrogenase (LDH), creatine kinase (CK), and creatine kinase-MB isozyme (CK-MB) were detected. Additionally, cardiac function indices including stroke volume (SV), left ventricular diastolic diameter (LVDD), cardiac output (CO), Left ventricular ejection fraction (lVEF) were compared between the two group patients before the surgery and 6 days after operation.Results:Compared with before the operation, the levels of serum enzymes were all significantly increased after unclamping the aorta. The levels of serum AST, LDH and CK reached their peak at 24 hours after unclamping the aorta. Notably, the levels of serum AST, LDH and CK in the experimental group were lower than that in the control group at each time point after unclamping the aorta ( P<0.05). For serum CK-MB, the level in the experimental group reached its peak at 6 hours after unclamping the aorta, while the peak value was observed at 24 hours after unclamping the aorta in the control group. The level of CK-MB in the experimental group was significantly decreased compared with the control group at each time point after unclamping the aorta ( P<0.05). Moreover, there were no significant differences in cardiac function indices between the 2 groups before the operation ( P>0.05). The levels of SV, CO and LVEF in the experimental group were significantly increased while the level of LVDD was obviously decreased compared to that in the control group after the operation ( P<0.05). Conclusions:L-carnitine has protective effects on myocardial ischemia-reperfusion injury in patients undergoing CABG operation under cardiopulmonary bypass, with reducing serum levels of myocardial enzyme in these patients.
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Objective To investigate the difference of curative effects and prognosis between coronary artery bypass grafting with and without cardiopulmonary bypass.Methods 152 patients who were operated using off-pump coronary artery bypass grafting (OPCABG) and 107 patients who were performed with on-pump coronary artery bypass grafting (CABG) in the authors'department during the period from October 2013 to October 2017 were included in the study.The differences of postoperative recovery and major complications between the two groups were analyzed.Results Compared with CABG group,patients in OPCABG group had shorter intensive care unit (ICU) monitoring time,electrocardio-monitoring time,duration of antibiotic treatment,time of drainage tube intubation,mechanical ventilation time,arterial piezometer tube monitoring time and length of hospital stay (P ＜ 0.05).And postoperative draining fluid volume in patients of OPCABG group was also less than that in CABG group (P ＜ 0.05).Additionally,there was no difference between the two groups in postoperative parameters including renal insufficiency,using intra-aortic balloon pump (IABP) machine,perioperative myocardial infarction,second operation for hemorrhage,the occurrence of postoperative arrhythmias and cerebrovascular accident (P ＞ 0.05).However,the incidence of postoperative pulmonary infection was significantly higher in patients of CABG group than that in OPCABG group (P ＜ 0.05).Conclusions The incidence of postoperative pulmonary infection was significantly decreased in OPCABG group compared with that in CABG group.And the postoperative recovery of patients undergoing off-pump coronary artery bypass grafting was superior to that of patients undergoing onpump coronary artery bypass grafting.
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Objective To investigate the effect of intravenous drip of levocarnitine during perioperative period on serum cytokines and cardiac troponin (cTn) I in patients undergoing coronary artery bypass grafting (CABG) under extracorporeal circulation. Methods The clinical data of 70 patients who had underwent CABG under extracorporeal circulation in Department of Cardiovascular Surgery, the First Affiliated Hospital of Medical College of Xi′an Jiaotong University from January 2015 to December 2017 were retrospectively analyzed. Among them, 35 cases were treated with intravenous infusion of levocarnitine (experiment group), and 35 cases were not treated with intravenous infusion of levocarnitine (control group). The serum levels of cTnI, tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8 and IL-10 1 h before operation and 2, 6, 24, 72 h after aorta open were detected; the postoperative recovery and complication were recorded. Results There were no statistical differences in TNF-α, IL-6, IL-8, IL-10 and cTnI before operation between 2 groups (P＞0.05); the indexes 2, 6, 24 and 72 h after aorta open were significantly higher than those before operation, and there were statistical differences (P＜0.05). The TNF-α, IL-6 and cTnI 2, 6, 24 and 72 h after aorta open in experiment group were significantly lower than those in control group, and the IL-10 was significantly higher than that in control group; the IL-8 2, 6 and 24 h after aorta open in experiment group were significantly lower than that in control group, and there were statistical differences (P＜0.05). The ICU monitoring time, electrocardio-monitoring time, duration of antibiotic treatment, duration of drainage tube, mechanical ventilation time and length of hospital stay in experiment group were significantly shorter than those in control group: (2.9 ± 0.5) d vs. (3.5 ± 0.8) d, (5.7 ± 1.8) d vs. (7.6 ± 3.2) d, (6.7 ± 1.5) d vs. (9.8 ± 2.2) d, (3.1 ± 0.8) d vs. (3.9 ± 1.4) d, (3.3 ± 2.1) d vs. (5.1 ± 2.3) d and (8.1 ± 2.2) d vs. (12.8 ± 2.6) d, and there were statistical differences (P＜0.01). Moreover, there were no severe perioperative complications such as myocardial infarction and pulmonary infection in 2 groups. Conclusions Intravenous drip of levocarnitine during perioperative period could effectively control postoperative inflammatory response and myocardial injury in patients undergoing CABG under extracorporeal circulation. The effect of levocarnitine may be related to its ability to balance the levels between proinflammatory cytokines and anti-inflammatory cytokines.
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Objective@#To investigate the effect of Calcium dibutyryladenosine cyclophosphate on myocardial ischemia-reperfusion injury in patients undergoing coronary artery bypass grafting (CABG) operation.@*Methods@#The clinical data of 62cases were retrospectively analyzed. These patients were performed coronary artery bypass graft (CABG) operation under cardiopulmonary bypass (CPB) in the First Affiliated Hospital of Medical College of Xi′an Jiaotong University from January 2013 to January 2016. According to the use calcium dibutyryladenosine cyclophosphate, 62 patients were divided into the control group and the experimental group. Thirty-one cases in the experimental group were given an intravenous drip of calcium dibutyryladenosine cyclophosphate, while other 31 cases in the control group were not given to calcium dibutyryladenosine cyclophosphate during perioperative period. Venous blood was collected from each patient 1 h before the surgery and 2, 6, 24 and 72 h after unclamping the aorta, then serum levels of aspartate aminotransferase (AST), lactic acid dehydrogenase (LDH), creatine kinase (CK), and creatine kinase-MB isozyme (CK-MB) were detected. Additionally, cardiac function indices including SV, LVDD, CO, LVEF in these patients were recorded before the operation and 6 days after operation.@*Results@#Compared with those before the operation, the levels of serum enzymes were all significantly increased after unclamping the aorta. The levels of serum AST, LDH and CK reached their peak 24 h after unclamping the aorta. Notably, the levels of serum AST, LDH and CK in the experimental group were lower than those in the control group at each time point after unclamping the aorta (P < 0.05). For serum CK-MB, the level in both the two groups reached its peak 6 h after unclamping the aorta. The level of CK-MB in the experimental group was significantly decreased compared with that in the control group 6, 24 and 72 h after unclamping the aorta (P < 0.05). Moreover, there were no significant differences in cardiac function indices between the 2 groups before the operation (P > 0.05). The levels of SV, CO and LVEF in the experimental group were significantly increased while the level of LVDD was obviously decreased compared to that in the control group after the operation, SV: (70.93 ± 9.72) ml vs. (65.07 ± 6.81) ml, CO: (5.32 ± 0.98) L vs. (4.29 ± 0.91) L, LVEF: (57.87 ± 8.92)% vs. (52.68 ± 7.31)% and LVDD: (55.67 ± 4.12) mm vs. (62.85 ± 5.71) mm, and there were statistical differences (P < 0.05).@*Conclusions@#Calcium dibutyryladenosine cyclophosphate has protective effects on myocardial ischemia-reperfusion injury and cardiac function in patients undergoing CABG operation under CPB, by reducing serum levels of myocardial enzymes in these patients.
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Objective To investigate the influence of tiotropium bromide on lung function index,quality of life and re-hospitalization risk of patients with bronchial dilation and pulmonary infection.Methods 100 patients with bronchiectasis and lung infection were chosen,and they were randomly divided into control group (50 patients) with BAL used alone and observation group(50 patients) with tiotropium bromide on the basis of control group.The short-term clinical effects,the levels of FVC,FEV1 and FEV1 ％,BODE index scores and QLI scores before and after treatment,and re-hospitalization rate of the two groups were compared.Results The short-term effective rate of the observation group was significantly higher than that of the control group(94.00％ vs.76.00％,x2 =7.81,P ＜ 0.05).The levels of FVC,FEV1 and FEV1％ after treatment of both two groups were significantly higherthan before treatment[(2.78 ±0.57)L vs.(2.15 ± 0.33) L,(3.60 ± 0.71) L vs.(2.20 ± 0.36) L;(2.15 ± 0.42)L vs.(1.23 ±0.32)L,(2.77±0.59)L vs.(1.17 ±0.29)L;(65.25 ±11.45)％ vs.(51.79 ±9.23)％,(77.46 ±15.80) ％ vs.(52.02 ± 9.36) ％,t =2.34,2.97;2.52,3.07;2.47,3.12,all P ＜ 0.05].After treatment,the levels of FVC,FEV1 and FEV1 ％ of the observation group were significantly higher than control group [(3.60 ± 0.71) L vs.(2.78 ±0.57)L;(2.77 ±0.59)L vs.(2.15 ±0.42)L;(77.46±15.80)％ vs.(65.25 ± 11.45)％,t =2.26,2.44,2.30,all P ＜0.05].The QLI score and BODE index scores after treatment of both two groups were significantly better than before treatment[(3.37 ± 0.54) points vs.(3.95 ± 0.65) points,(2.11 ± 0.40) points vs.(3.87 ±0.61)points,(7.28 ±1.18)points vs.(5.04 ± 0.95) points,(8.69 ± 1.54) points vs.(5.13 ±0.98) points,t =2.29,2.81;2.50,2.96,all P ＜ 0.05].After treatment,the QLI score and BODE index scores of the observation group were significantly better than the control group[(2.11 ±0.40) points vs.(3.37 ±0.54) points,(8.69 ± 1.54) points vs.(7.28 ± 1.18)points,t =2.21,2.44,all P ＜ 0.05].The re-hospitalization rate of the observation group was significantly lower than that of the control group (16.00％ vs.2.00％;28.00％ vs.6.00％;x2 =8.02,9.74,all P ＜ 0.05).Conclusion Selective cholinergic receptor blocker combined with BAL in the treatment of patients with bronchial dilation and pulmonary infection can efficiently relieve the respiratory symptoms,improve lung function,improve the quality of life and is helpful to avoid re-hospitalization occurrence.
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Objective@#To explore the differences among three methods of nucleic acid extraction and three kinds of real-time fluorescence quantitative PCR instrument.@*Methods@#Twenty-five respiratory virus nucleic acid and 25 enterovirus nucleic acid positive samples were with selected at random and nucleic acids were extracted by using three methods (method A, B, and C). The results among different methods were analyzed by randomized block design. 25 respiratory viral nucleic acid positive specimens and enterovirus nucleic acid positive samples were detected by using three kinds of real-time fluorescence quantitative PCR instrument (instrument A, B, and C). The results among different instruments were analyzed by randomized block design.@*Results@#There was a significant difference among three methods of nucleic acid extraction in results(χ2=42.9162, P<0.001), in which method A and C had not significant difference(Z=0.837, P=0.3816>0.05), while method A vs. B, B vs. C were significantly different(Z=7.025, P<0.001; Z=7.9, P<0.001). There was also a significant difference among three kinds of real-time fluorescence quantitative PCR instrument in results(χ2=23.773, P<0.001), in which instrument B and C had no significant difference(Z=0.75, P=0.4533>0.05), while instrument A vs. B, A vs. C were significantly different(Z=5.70, P<0.001; Z=6.45, P<0.001).@*Conclusions@#There is difference among different methods and instruments in the test results under the same condition, which call for options in practical work according to need.
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Many long non -coding RNA ( lncRNA ) has been found in recent years .The abnormal ln-cRNA expression is closely related to the occurrence and development of tumor .LncRNA can be divided into the tumor promoting and tumor inhibiting according to the function .lncRNA generally overexpresses in solid tumor tis-sue,acts as an important factor involved in tumor invasion ,proliferation and metastasis ,and has been associated with prognosis of neoplasm .This paper describes the current situation of lncRNA research .We mainly introduce several functions of lncRNA which thoroughly researched at present (such as HOTAIR,H19,MALAT-1,Lin-cRNA-p21,GAS5,etc) and their expression in colorectal tumor tissue ,indicating that regulating the expression level of lncRNA may provide a new basis for the diagnosis and treatment of colorectal cancer .
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Objective To explore the applicative effect of the clinical cluster management during perioperative period on esophageal cancer in elderly patients aged 75 years and over.Methods A total of 36 cases with esophageal cancer aged 75 years and over admitted into Thoracic Surgery Department in our hospital from January 2010 to February 2015 were divided into experimental and control group.Patients in experimental group received clinical cluster management including preoperative therapy for improvement of heart and lung function, selective protection during operation, strengthening support after operation and early nasal tube nutrition.Patients in control group received routine treatment for esophageal carcinoma during perioperative period.The postoperative complications, intensive care unit (ICU) stay, the incidence of anastomotic leakage,postoperative feeding time, postoperative hospitalization time and other indicators were observed.Results Among 20 patients in the experimental group, postoperative cardiopulmonary complications were found in 6 cases, postoperative cardiovascular complications in 3 cases and anastomotic leakage in 2 cases.Among 16 patients in the control group, postoperative cardiopulmonary complications were found in 12 cases, postoperative cardiovascular complications in 10 cases and anastomotic leakage in 5 cases.The incidences of postoperative cardiopulmonary and cardiovascular complications were lower in experimental group than in control group (x2 =7.200 and 8.693, P =0.007 and 0.003).The incidence of anastomotic leakage showed no significant difference between the two groups (x2 =2.562,P=0.109).The mean duration of ICU stay and postoperative hospitalization time were shorter in experimental group than in control group[(5.6±2.7) d vs.(9.8±4.9) d, (15.4±4.5) d vs.(20.6±5.5) d, t=3.208 and 3.125, P=0.003 and 0.004].There was no significant difference in postoperative feeding time between the two groups [(8.4±1.5)d vs.(9.1±1.1)d, t=1.569, P=0.126].Conclusions A tightly clustered clinical managements during perioperative period can minimize the incidences of postoperative complications and mortality rate in elderly patients with esophageal carcinoma.
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This paper is to report the exploration of the activation of Rho/ROCK signal pathway in 5-HT-induced proliferation of rat pulmonary artery smooth muscle cells (PASMCs) and the inhibitory effect of m-Nis on this pathway. PASMCs were cultured with the explant technique. MTT assay was used to explore the proliferation of PASMCs after 5-HT treated for different time and the intervening effect of m-Nis. RT-PCR and Western blot were used respectively to explore the mRNA expression of RhoA, ROCK1 and the protein expression of p-MYPT1 in 5-HT-treated PASMCs and intervening effect of m-Nis. The results of MTT assay suggested that 5-HT (1 µmol · L(-1)) treatment for 12-72 h significantly induced the proliferation of rat PASMCs (P<0.05 or P < 0.01), which were inhibited by m-Nis (1 x 10(-5), 1 x 10(-6), l x 10(-7), 1 x10(-8) mol · L(-1)) in dose-dependent manners (P < 0.05 or P < 0.01). Similarly, the mRNA expression of RhoA, ROCK1 and the protein expression of p-MYPT1 were also inhibited by m-Nis in different degrees (P < 0.05 or P < 0.01). Thus, the results of this study suggested that Rho/ROCK pathway played an important role in 5-HT-induced proliferation of rat PASMCs, m-Nis inhibited 5-HT-induced proliferation obviously, which may be related to the blockage of Rho/ROCK signal pathway.
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Objective To explore the correlation between postoperative cognitive dysfunction (POCD)and serum level of S100βand NSE in patients undergoing on-pump heart valve replacement. Methods Ninety-eight patients underwent elective heart valve replacement were enrolled and divided into two groups:POCD group (group P)and none POCD group(group NP)by the result of neurocog-nitive testing with MMSE performed preoperatively and on the first postoperative day.Serum S-100βprotein and NSE were measured before operation(T0 ),at the end of operation(T1 ),24 h(T2 )and 48 h(T3 ) postoperatively.Results The incidence of POCD on the first postoperative day was 45 (45.9%).Compared with T0 ,the S100βincreased at T1 in both groups (P <0.05),NSE increased at T1 and T2 in both groups,and NSE increased in group NP at T3 (P <0.05).There was no signifi-cant difference of NSE between groups P and NP.The prolonged recovery time(OR = 1.222,P =0.004)and increased concentration of S100βat the end of operation(OR=1.85,P =0.009)were pre-dictors of POCD on the first postoperative day.Conclusion There was a higher incidence of POCD af-ter on-pump heart valve replacement surgery.The prolonged recovery time and increased concentra-tion of S100βat the end of operation might be predictors of POCD.