Acute kidney injury in patients hospitalized with COVID-19 in Wuhan, China: a single-center retrospective observational study / 南方医科大学学报

OBJECTIVE@#To assess the predictors and outcomes of acute kidney injury (AKI) among patients with coronavirus disease 2019 (COVID-19).@*OBJECTIVE@#This retrospective observational study was conducted among patients with a confirmed diagnosis of COVID-19 admitted to Hankou Hospital between January, 5 and March 8, 2020. We evaluated the association of AKI with the demographic and biochemical parameters and clinical outcomes of the patients using univariate regression analysis.@*OBJECTIVE@#Atotal of 287 COVID-19 patients, including 55 with AKI and 232 without AKI, were included in the analysis. Compared with the patients without AKI, the patients with AKI were older, predominantly male, and were more likely to have hypoxia and pre-existing hypertension and cerebrovascular diseases. The patients with AKI also had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3% and that of stage 2 or 3 AKI was 4.9%. The patients with AKI had much higher mortality rate than those without AKI.@*OBJECTIVE@#AKI is an important complication of COVID-19. An older age, a male gender, multiple pre- existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions are all potential risk factors ofAKI. COVID- 19 patients with AKI that progresses into stages 2 or 3 AKI have a high mortality rate. Prevention of AKI and monitoring kidney function is critical in the care of COVID-19 patients.

Clinical features of severe or critical ill patients with COVID-19 / 南方医科大学学报

OBJECTIVE@#To analyze the clinical features of severe or critical ill adult patients with coronavirus disease (COVID-19).@*METHODS@#The clinical data of 75 patients with severe or critical COVID-19 in Honghu People's Hospital from January to March in 2020 were collected.@*RESULTS@#Of the 75 patients with COVID-19 pneumonia, 41 were male (54.67%) and 34 were female (45.33%) with a mean age of 67.53 ±12.37 years; 43 patients had severe and 32 had critical COVID-19, and 49.3% of the patients had underlying diseases. The main clinical manifestations included fever (78.67%) and coughing (70.67%). Compared with the severe patients, the critically ill patients had higher proportions of patients over 60 years old with elevated white blood cell count, increased prothrombin time, and higher levels of hsCRP, PCT, D-dimer, ALT, LDH, cTnI and NT-proBNP. Univariate logistic regression analysis showed that an age over 60 years, leukocytosis, hs-CRP elevation, prolonged prothrombin time, and increased levels of D-dimer, NT-proBNP and cTnI were associated with severe COVID-19. Multivariate logistic regression showed that an age over 60 years (OR=8.165, 95% : 1.483-45.576, =0.017), prolonged prothrombin time (OR=7.516, 95% : 2.568-21.998, =0.006) and elevated NT-proBNP (OR=6.194, 95% : 1.305-29.404, =0.022) were independent risk factors for critical type of COVID-19.@*CONCLUSIONS@#An age over 60 years, a prolonged prothrombin time and elevated NT-proBNP level are important clinical features of critically ill patients with COVID-19, and can be deemed as early warning signals for critical conditions of the disease.

Clinical characteristics and outcomes of adult critically ill patients with COVID-19 in Honghu, Hubei Province / 南方医科大学学报

OBJECTIVE@#To explore the clinical characteristics and outcomes of adult critically ill patients with COVID-19 and identify the risk factors correlated with in-hospital deaths.@*METHODS@#This study was conducted among 20 confirmed adult cases of COVID-19 in the Intensive Care Unit (ICU) of Honghu People's Hospital in Jingzhou City, Hubei Province. According to the final outcome, the patients were divided into survivor group and death group with 10 patients each. The demographic data, clinical manifestations and signs, laboratory findings, treatment measures and clinical outcomes were obtained from electronic medical records to compare the clinical characteristics and outcomes between the two groups. Univariate logistic analysis was used to analyze the risk factors associated with in-hospital death.@*RESULTS@#The mean age of patients with confirmed COVID-19 was 70 ± 12 years, and 40% of them were male. The patients were admitted to ICU 11 ± 9 days after symptom onset. The most common symptoms on admission were cough (19 cases), fatigue or myalgia (18 cases), fever (17 cases) and dyspnea (16 cases). Eleven (55%) of the patients had underlying diseases, among which hypertension was the most common (11 cases), followed by cardiovascular disease (4 cases) and diabetes (3 cases). Six (30%) of the patients received invasive mechanical ventilation and continued renal replacement therapy but eventually died. Acute cardiac injury was the most common complication (19 cases). Half of the patients died between the 2nd and 19th day after ICU admission. Compared with dead patients, the surviving patients had a lower average body weight (61.70±2.36 68.60±7.15 kg, =0.01) and a higher Glasgow Coma Index (14.69 ± 0.70 12.70 ± 2.45, =0.03), and were less likely to develop shock (2 10, =0.001) or acute respiratory distress syndrome (2 10, =0.001).@*CONCLUSIONS@#Critically ill patients with COVID-19 are generally older. A higher body weight and a lower lymphocyte count are potentially associated with a greater likeliness of fatality in ICU patients with COVID-19.

Role of deacetylase sirtuins in sepsis: beneficial or harmful? / 中华危重病急救医学

Sepsis,life-threatening organ dysfunction caused by a dysregulated host response to infection,is a major public health concern.To date,the mechanism of sepsis is not completely understood,which is still a huge task ahead of numerous clinical and laboratory researchers.Recently,increasing evidences show that deacetylase sirtuins play an important role in sepsis and the function of sirtuins are varied in different stages of sepsis.More importantly,the mechanism of sirutins is not fully understood.The sirtuins family is composed by sirtuin 1-7 members.Among them,sirtuin 1 is widely reported.In addition to sirtuin 1,other members of sirtuins are also involved in the regulation of inflammation or metabolism signaling following sepsis.Of note,the sirtuins may interact with each other and form a precious control mechanism.Herein,we tried to summarize the recent paper from PubMed,to explain the possible mechanism of distinct role of sirtuin 1/2,to generalize the downstream effects of sirtuin 3 action,and to describe the interactions among sirtuins members on sepsis,which might be helpful for our future research and potential clinical applications.

Effect of polydatin on inflammatory response and oxidative stress in rats with sepsis-induced acute kidney injury / 临床麻醉学杂志

Objective To determine if polydatin inhibited oxidative stress and inflammatory response in rats with sepsis-induced acute kidney injury (AKI).Methods Seventy-two rats (weighing 180-220 g) were randomly divided into the following groups: sham group, cecal ligation and puncture (CLP) CLP+normal saline group (group CN), group CLP+vehicle (group CV), and group CLP+polydatin (group CD) (n=18 each).Rats in groups CN, CV and CD underwent CLP to mimic sepsis-induced AKI.In sham group, the cecum was not ligated or punched, and the remaining procedures were the same as in group CLP.Normal saline, vehicle, and 30 mg/kg polydatin were administered at 6, 12, and 18 hours after CLP via the tail vein.At 24 hour post CLP, two clinically used markers of AKI, blood urea nitrogen (BUN), and creatinine (Cr) were tested, pathological changes of kidney tissue was observed under light microscopy in each group.Renal tubular damage assessment was carried out.Malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione (GSH) content of renal tissue, serum cytokines such as TNF-α, IL-1β and IL-6, were also measured in each group at 24 hours after CLP.Results Compared with sham group, multiple indexes such as BUN, Cr, tubular injury scores, MDA content of renal tissue, and serum cytokines incluing TNF-α, IL-1β and IL-6 increased significantly (P<0.01), while SOD and GSH levels of renal tissue significantly decreased in groups CN and CV (P<0.01).Compared with groups CN and CV, the indicators such as BUN, Cr, tubular injury scores, MDA content of renal tissue, and serum cytokines such as IL-1β and IL-6 significantly decreased (P<0.05);while SOD and GSH levels of renal tissue significantly increased (P<0.05).Conclusion Sepsis caused by sepsis cecal ligation and puncture can cause acute kidney injury.Polydatin could alleviate kidney damage by attenuating systemic inflammatory response and inhibiting oxidative stress of renal tissue.

A retrospective review of 46 cases of chronic invasive fungal rhinosinusitis / 中华传染病杂志

Objective To investigate the clinical characteristics of chronic invasive fungal rhinosinusitis.Methods Clinical features and outcomes of 46 proven cases of chronic invasive fungal rhinosinusitis admitted in Huashan Hospital,Fudan University from January 2009 to December 2016 were retrospectively reviewed.Results Of the 46 patients enrolled,left sphenoid sinus,ethmoid sinus and maxillary sinus were affected in 24,23 and 20 cases,respectively,while right maxillary sinus,ethmoid sinus and sphenoid sinus were affected in 18,16 and 15 eases,respectively.Left and right frontal sinus were affected in 9 and 6 cases,respectively.The central nervous system and orbit were the most commonly affected sites in external nasal involvements,noted in 22 cases respectively.Left sphenoid (17 cases) and ethmoid sinus (15 cases) involvements were most common in central nervous system affected patients.Left sphenoid (14 cases) and ethmoid sinus (13 cases) involvements were most common in orbit affected patients.Aspergillus species were the primary pathogens observed in 42 eases.Zygomycete,candida and dark filamentous fungus were observed in two,one and one case,respectively.Pathologically,37 of the cases were chronic nongranulomatous type and the left 9 were chronic granulomatous type who were all immunocompetent hosts.The initial symptoms usually included headache,dizziness and nasal discomforts including nasal obstruction and purulent secretion.The chief complaints usually included headache,dizziness,and visual disturbances including blurred vision,vision loss or even blindness.Antifungal treatment combined with surgical interventions for removal or drainage focus lesions achieved significant effect,and 42 patients were cured.Conclusions Chronic invasive fungal rhinosinusitis should be taken into consideration in the presence of nasal discomforts or nonspecific symptoms such as headache and dizziness.The possibility of chronic invasive fungal rhinosinusitis should be cautious after the emergence of vision abnormalities.

Short-term intensive atorvastatin therapy improves endothelial function partly via attenuating perivascular adipose tissue inflammation through 5-lipoxygenase pathway in hyperlipidemic rabbits / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Atherosclerosis is a kind of disease with multiple risk factors, of which hyperlipidemia is a major classical risk factor resulting in its pathogenesis and development. The aim of this study was to determine the effects of short-term intensive atorvastatin (IA) therapy on vascular endothelial function and explore the possible mechanisms that may help to explain the clinical benefits from short-term intensive statin therapy.</p><p><b>METHODS</b>After exposure to high-fat diet (HFD) for 8 weeks, the animals were, respectively, treated with IA or low-dose atorvastatin (LA) for 5 days. Blood lipids, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), endothelin-1 (ET-1), and endothelium-dependent vasorelaxation function were, respectively, measured. mRNA and protein expression of CRP, TNF-α, IL-6, macrophage chemoattractant protein-1 (MCP-1), and 5-lipoxygenase (5-LO) were also evaluated in pericarotid adipose tissue (PCAT) and cultured adipocytes.</p><p><b>RESULTS</b>HFD increased serum inflammatory factor levels; induced significant hyperlipidemia and endothelial dysfunction, including imbalance between NO and ET-1; enhanced inflammatory factors and 5-LO expression; and promoted macrophage infiltration into adipose tissue. Five-day IA therapy could significantly decrease serum inflammatory factor levels and their expression in PCAT; restore the balance between NO and ET-1; and improve endothelial function and macrophage infiltration without significant changes in blood lipids. However, all of the above were not observed in LA therapy. In vitro experiment found that lipopolysaccharide (LPS) enhanced the expression of inflammatory factors and 5-LO in cultured adipocytes, which could be attenuated by short-time (6 hours) treatment of high-dose (5 µmol/L) but not low-dose (0.5 µmol/L) atorvastatin. In addition, inhibiting 5-LO by Cinnamyl-3,4-dihydroxy-α-cyanocinnamate (CDC, a potent and direct 5-LO inhibitor) could significantly downregulate the above-mentioned gene expression in LPS-treated adipocytes.</p><p><b>CONCLUSION</b>Short-term IA therapy could significantly ameliorate endothelial dysfunction induced by HFD, which may be partly due to attenuating inflammation of PCAT through inhibiting 5-LO pathway.</p>

Effects of Drag-reducing polymer derived from Aloe vera on microcirculation in burn rats / 实用医学杂志

Objective To investigate the effects of drag-reducing polymers on microcirculation in 40%total body surface area burn-injured rats. Methods SD rats were randomized into control group, drag-reducing polymer (DRPs) group and normal saline (NS) group (5 minutes after scald, drag-reducing polymer or saline was injected for fluid resuscitation). Wet dry weigh ratio of lung, histopathologic changes and arterial blood gas at 24 hour were respectively measured by wet dry weigh ratio method, hematoxylin-eosin (HE) staining and arterial blood gas analysis. The velocity of flow of red cell in oblique ridge and the survival time of burn-injured rats were observed. Results Compared with control group, rats in NS group exhibit significant lung injury characterized by a high W/D (P < 0.01), accumulation of a large number of neutrophils in HE stain, low partial pressure of oxygen (PO2) and high lactate (Lac) (P<0.05 or P<0.01) in arterial blood. Compared with the NS group, DRPs treatment rats exhibit significantly reduced lung injury characterized by W/D reducing (P < 0.05), the reduction of neutrophil infiltration, increased PO2, decreased Lac (P<0.05, P<0.01). In addition, DRPs treatment obviously increases the burn-induced low velocity of flow of red cell in oblique ridge (P<0.01). Moreover, the survival time of burned rats can be improved by DRPs treatment (P < 0.05). Conclusion DRPs ameliorates burn-induced acute lung injury, the mechanism may be through improving the burn-induced microcirculation disorders.

Autoimmune hemolytic anemia after orthotopic liver transplantation: analysis of 3 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the diagnosis and treatment of autoimmune hemolytic anemia (AIHA) in liver transplant recipients.</p><p><b>METHODS</b>A retrospective analysis was conducted of 3 patients who developed AIHA following orthotopic liver transplantation. The results of hemolysis tests and examinations of hemoglobin, white blood cells, platelets, total bilirubin, and alanine aminotransferase before and after treatments were reviewed.</p><p><b>RESULTS</b>These 3 patients developed AIHA following the transplantation possibly in association with the use of immunosuppressive agents, and the condition was effectively controlled after corresponding treatments.</p><p><b>CONCLUSION</b>AIHA is a uncommon complication after liver transplantation and can be cured after a definitive diagnosis with corresponding treatments.</p>

Histological and MR quantitative analysis of repaired tissue following microfracture treatment for knee joint osteochondritis dissecans in rabbit models / 中华放射学杂志

Objective To quantitatively analyze the histological and MR images of repaired tissue (RT) following microfracture for knee joint osteochondritis dissecans (OCD) in rabbit models at different time points,make comparisons with the RT performances of joint debribement,explore the efficiency of the microfracture treatment for OCD.Methods Twenty-seven New Zealand rabbits were randomly assigned into 3 groups (sacrificed at the end of 3,5 and 7 weeks post-operation respectively),with 9 in each group.For each rabbit,one knee joint was made into an OCD model.In each group,6 were for microfracture treatment,and the other 3 were for joint debridement as control.MR scan,which mainly included sequences of 3D double echo steady state sequence (3D-DESS) and T2-mapping,was taken at 3,5 and 7 weeks postoperation.The thickness index and T2 value index of RT were calculated and T2-mapping of repaired region was drafted.Then the operation sites were removed to make histological sections of HE and Masson staining.The modified O' Driscoll score system was employed to make semi-quantitative evaluation for the histological performance of RT.Comparisons were made with respect to MR and histological findings between two treatments at each time point using unpaired Student t test.Effects of two treatments were evaluated longitudinally by comparing the results of three time points using one-way ANOVA.Results The post-operation thickness indexes of two groups increased gradually (F =33.940,28.841,P ＜ 0.05),T2 value indexes decreased (F =80.183,206.206,P ＜ 0.05),and O'driscoll scores increased gradually (F =29.867,17.167,P ＜ 0.05).At each time point,the thickness index of microfracture was higher than that of debridement group(3-week:0.743 ±0.048 vs 0.624 ±0.013,t =4.077 ;5-week:0.813 ±0.031 vs 0.734 ±0.015,t =4.107 ; 7-week: 0.972 ± 0.064 vs 0.777 ± 0.039,t =4.782 ; P ＜ 0.05),and the defects of microfracture in 7-week group were almost fully recovered while the defects of the debridement in 7-week group were not.The T2 value index of microfracture group was lower than that of debridement group at 3-week point(1.338 ±0.043 vs 1.510 ± 0.009,t =6.583,P ＜ 0.05),but it was higher than that of debridement group at 5-week and 7-week points (5-week: 1.284 ± 0.097 vs 1.116 ± 0.068,t =2.663 ; 7-week: 0.916 ± 0.036 vs 0.843 ± 0.016,t =3.283 ; P ＜ 0.05).The O'Driscoll score of microfracture group was higher than that of joint debridement at every time point(3-week:7.167 ±0.753 vs 4.667 ±0.577,t =5.000;5-week: 9.833 ± 1.169 vs 7.667 ± 0.577,t =2.960 ; 7-week: 11.167 ± 0.753 vs 8.333 ± 1.155,t =4.520 ; P ＜ 0.05).For microfracture group,the RT was mainly repaired by fibrocartilage and got matured gradually with more production of well-distributed collagen fibrils ; while for joint debridement group,the RT was mainly repaired by fibrous and scar tissue.Conclusions The post-operation repairing thickness and tissue composition of microfracture for OCD are superior to that of joint debridement.MR 3D-DESS and T2-mapping can show the thickness and tissue composition of the RT after OCD treatments,provide effective evaluation of repairing conditions,and they are of great importance on the OCD post-op follow-up.

Effect of polyethylene oxide on renal hemodynamics in rabbits with endotoxin shock / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of polyethylene oxide (PEO) on renal blood flow and its renoprotective effect in rabbits with endotoxin sepsis.</p><p><b>METHODS</b>Twenty normal New Zealand white rabbits were randomly divided into normal saline (NS) group and PEO group (n=10), and endotoxin shock was induced by an intravenous injection of 0.6 mg/kg lipopolysaccharide. Resuscitation was performed when the blood pressure of the rabbits showed a 30% decline, using NS (in NS group) or the mixture of equal volumes of NS and 20 ng/g PEO (in PEO group) perfused at the rate of 5 ml/kg per hour. Before and during shock and at 1 h after resuscitation, the renal hemodynamics was monitored by ultrasound and the venous blood was extracted to examine the renal functions. The heart rate and arterial blood pressure were monitored throughout the experiment.</p><p><b>RESULTS</b>The rabbits in both groups showed a significantly lower renal artery blood flow velocity during the shock (P<0.05) with significantly increased pulsatility index (PI) and resistance index (RI) compared with those before the shock. One hour after resuscitation, the blood flow velocity in the renal arteries at all levels and the tertiary veins were reduced in NS group without obvious reduction of the PI and RI; in PEO group, the blood flow velocities in the renal arteries increased significantly compared to those before shock (P<0.05), and the PI and RI of the tertiary arteries were significantly lower than those in NS group (P<0.05). In both groups, BUN and Cr increased during endotoxin shock stage, and 1 h after resuscitation, PEO group showed significantly lower BUN and Cr levels than NS group (P<0.05).</p><p><b>CONCLUSION</b>A small dose of PEO can significantly promote renal perfusion in rabbits with septic shock, thus offering renoprotective effect against early damage in septicopyemia and septic shock.</p>

Role of Med19 in the proliferation and tumorigenicity of human bladder cancer cells / 中华泌尿外科杂志

Objective To study the role of Med19 in bladder cancer by analyzing the effects of lentivirus-mediated suppression of Med19 expression on T24 bladder cancer cells in vitro.Methods The lentivirus vectors containing a small hairpin RNA (shRNA) to target Med19 were constructed.After T24 bladder cancer cells were infected,real-time PCR and Western-blotting were used to study the Med19 expressions in the CON group (non-infected cells),the NC group (Lv-NC-infected cells) and the KD group (Lv-shMed19-infected cells).The influence of Med19 on the proliferation of bladder cancer cells were assessed using MTT,BrdU,colony formation assay and tumorigenicity experiment in mice.Cell cycle was analyzed with flow cytometry assay.Results Med19 relative mRNA level (0.35 ± 0.03) and Med19 protein expressing in the KD group were significantly inhibited (P ＜ 0.05).The KD group displayed an increased proportion of cells (77.50 ± 0.29)％ in the G0/G1 phase compared with the CON group (69.81 ± 0.81)％and NC group (67.53 ± 0.67) ％ (P ＜ 0.05).Compared with the CON group and the NC group,the KD group displayed a significant cell proliferation defect by MTT and BrdU assay and the number of colonies (91.33 ± 6.11) was significant decreased (P ＜ 0.05).On the day 24,the tumor volume (596.64 ± 485.36) mm3 and weight (0.57 ± 0.44) g of the KD group mice were decreased after inoculation into nude mice (P ＜ 0.05).Specific lentivirus-mediated knockdown of Med19 significantly impacted the cell cycle and proliferation of bladder cancer cells.Infected T24 cells nearly lost their tumorigenicity when being inoculated into nude mice.Conclusion Our results provide new evidence of an important role for Med19 in the development of bladder cancer,suggesting that lentiviruses delivering shRNA against Med19 may be a promising tool for bladder cancer therapy.

Preparation and in Vitro Release of Poly(lactide-co-glycolide) Microspheres Loaded with Ropivacaine / 中国药房

OBJECTIVE: To optimize the preparation technology of poly(lactide-co-glycolide) (PLGA) microspheres loaded with ropivacaine (ROP-PLGA-MS) and study their powder particle characteristics and in vitro release characteristics. METHODS: ROP-PLGA-MS was prepared with PLGA as carriers using the water-in-oil-in-water(W/O/W) emulsion solvent evaporation method. The micromeritic characteristics of ROP-PLGA-MS,such as the particle size,loading and entrapment efficiency were taken as indexes for evaluation,and the preparation technology was optimized by orthogonal design. Its dissolution characteristics in vitro were studied. RESULTS: The prepared microspheres were spherical with smooth surfaces,with an average particle size of (2.525?0.047) ?m and over 80% falling in the range of 1.8～5.0 ?m. The encapsulation efficiency was (58.05?1.169)% and the drug loading efficiency was (6.067 ?0.312)%. The in vitro release curves of ropivacaine microspheres could be fitted with Higuchi equation. The accumulated release percentage of which was 82 % in 192 h,and t1/2=60.16 h. CONCLUSION: ROP-PLGA-MS has obvious sustained release.

Expression of MT1-MMP, EMMPRIN, P-gp in gastric carcinoma and their correlation / 中国癌症杂志

Purpose:To study the expression of MT1-MMP ,EMMPRIN and P-gp in gastric carcinoma and the relation of invasion, metastasis with drug resistance in gastric carcinoma. Methods:Detected membrane-type-1 matrix metalloproteinase (MT1-MMP), extra-cellular matrix metalloproteinase inducer (EMMPRIN), P-glycoprotein (P-gp) in gastric carcinoma by immunohistochemical method. Results:Among 40 cases of gastric carcinoma, there were 15 cases (37.5%) MT1-MMP-positive, 26 cases (65%) EMMPRIN-positive, 23 cases (57.5%) P-gp-positive respectively. The over-expression of MT1-MMP, EMMPRIN, P-gp was associated with invasive depth and lymph node matasteses of tumor cells(P

Perioperative changes in serum levels of TNF-?,IL-6 and IL-10 in peri-operative period of liver orthotopic transplantation / 解放军医学杂志

Objective To study perioperative changes in serum levels of TNF-?, IL-6 and IL-10 in orthotopic liver transplantation without veno-venous bypass. Methods Sixteen patients with terminal liver disease underwent orthotopic liver transplantation under general anesthesia. Samples from arterial blood were obtained at beginning of surgery, before the anhepatic phase, 5min before recirculation, 15min and 60min after recirculation, 4h and 24h after operation, respectively. Serum levels of TNF-?, IL-6 and IL-10 were measured by ELISA. Results TNF-? and IL-6 concentrations were kept at a low level before operation, while IL-10 was not detected. The concentrations of IL-6 and IL-10 rose during the anhepatic phase (P

Care and treatment of the open cardiac traumas / 解放军医学杂志

Objective To explore the clinical features and urgent treatment strategies of open stabbing and penetrating wound of the heart. Methods In recent five years, 22 cases of cardiac trauma patients were sent to our emergency department, among them 19 sustained penetrating wounds produced by sharp instruments, 3 with perforating wounds, produced by firearm in 2 and sharp instrument in one. Emergent thoracotomy was performed in all the patients. The injury involved right auricle in 4, left auricle in 1, right ventricle in 11, left ventricle in 3, and perforating wounds of both right and left ventricles in 3 patients. Results Among them 19 survived, and their cardiac and pulmonary recovered 2 weeks after the operation. Three patients with injury of the great vessel died, one of them died 8 hour after the operation. Conclusion When the patients who presented open wounds on the anterior or posterior chests, showing a low or undetectable blood pressure, which could not raised even with fluid resuscitation with two venous lines or in some of them displaying signs of Beck's triad, open cardiac injury should be seriously suspected, and emergent thoracotomy should be taken in order to rescue the patients.

Spontaneous rupture of right cardiac atrium: report of two cases and review of literature / 解放军医学杂志

Objective To study the clinical features of spontaneous rupture of the right cardiac atrium. Methods Two cases of spontaneous rupture of right cardiac atrium were reported, and related literature was reviewed. Results Spontaneous rupture of the right cardiac atrium which was a rare disease, presented symptoms including stifling sensation in the chest, chest pain and symptoms of cardiac tamponade. The diagnosis should be differentiated with by ultrasonic examination and CT from cardiac infarction, cardiac rupture caused by external injury and dissecting aneurysm of aorta. Conclusion Spontaneous rupture of right cardiac atrium is rare disease, and an early diagnosis and prompt operation are necessary.