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Objective@#To explore the relationship between polymorphisms of interleukin 17(IL-17) gene (rs4711998, rs763780) and the susceptibility of pneumoconiosis, and to provide a basis for prevention of high-risk groups of pneumoconiosis.@*Methods@#A total of 219 pneumoconiosis patients and 242 workers without pneumoconiosis were enrolled in the study. All subjects were photographed with high undulating X-rays anterior chest radiographs, diagnosed according to diagnostic criteria for pneumoconiosis. We collected 3 ml of peripheral venous blood of the study subjects. Polymorphism in IL-17A rs4711998 and IL-17F rs763780 locus were evaluated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).@*Results@#The IL-17A rs4711998 locus has AA, AG and GG genotypes, there was no the significant difference between case and control groups (P>0.05). IL-17F rs763780 had AA, AG and GG genotypes, there was a significant difference between case and control groups (P<0.05). Allele A and allele G were statistically significant difference between the case group and the control group (P<0.05).@*Conclusion@#No relationship was found between IL-17A gene polymorphisms at rs4711998 and silicosis. IL-17F rs763780 locus gene polymorphism is associated with susceptibility to pneumoconiosis. AG genotype and G allele may have a protective effect.
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Objective@#To explore the effect of comprehensive rehabilitation treatment of individualized exercise program on lung function, exercise ability, quality of life and biochemical indexes of coal workers’ pneumoconiosis patients, and to provide scientific and effective methods for rehabilitation treatment of coal workers' pneumoconiosis.@*Methods@#In Huaibei Coal Mine Occupational Disease Prevention and Control Hospital, the data of pneumoconiosis patients treated by pneumoconiosis department in the hospital were collected and sorted out. 80 patients were selected according to the inclusion and exclusion criteria. Using a random number table, they were randomly divided into two groups with 40 cases in each group. The data investigated in this study include the results before and after treatment. Pulmonary function index, BMI index, six-minute walking distance (6MWD) , quality of life questionnaire (SF-36) , hospital anxiety and depression scale (HADS) , st George's breathing questionnaire (sgrq) , c-reactive protein (CRP) and blood oxygen saturation (SpO2) were used to evaluate and compare the efficacy of the two groups.@*Results@#The lung function indexes of the test group were significantly higher than those of the control group after treatment (P<0.05) , including forced vital capacity, forced vital capacity in the first second, maximum expiratory flow, expiratory flow when vital capacity was 75% and expiratory flow when vital capacity was 25%. The forced vital capacity, the first-second forced vital capacity and the maximum expiratory flow of the patients in the test group were higher after treatment than before (P<0.05) . The six-minute walking distance of the test group was greater than that of the control group after treatment (P<0.05) . After treatment, the scores of st George’s breathing questionnaire in the test group were lower than those in the control group (P<0.05) . The scores of quality of life questionnaire in the test group were higher than those in the control group after treatment (P<0.05) .@*Conclusion@#The comprehensive rehabilitation treatment of individualized exercise program improved the endurance and exercise ability of pneumoconiosis patients, improved the respiratory status and quality of life of pneumoconiosis patients in Huaibei Coal Mine, improved the lung function of pneumoconiosis patients, and improved the forced vital capacity of patients, but the small airway function has not been significantly improved.
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Objective Analysis of hybrid cardiac and non-cardiac operations.Methods 11 patients received hybrid operations during 2000 ～2016 in our hospital were summarized, meanwhile another 11 patients undergoing only cardiac sur-gery served as controls.The level of CK-MB, TNI and visual analogue pain scores were recorded.The hospitalization expenses and postoperative hospital time were compared between the two groups .Results There was no death during hospitalization . There were no serious complications such as wound infection, delayed wound healing, postoperative bleeding requiring re-thora-cotomy and hemostasis, malignant arrhythmia, cerebral infarction and so on.Longer operation time[(358 ±79)min vs.(224 ±56)min, P<0.01], more allogeneic red blood cells transfusion[(3.2 ±1.6)U/case vs.(1.1 ±0.8)U/case, P<0.05] and more plasma transfusion[(515 ±234)ml/case vs.(284 ±92)ml/case, P<0.01]in hybrid operation group than those in the control group.There was no significant difference about CK-MB and TNI between two groups perioperatively(P>0.05). The wound pain was mild after cardiac surgery , and the wound pain was moderate after hybrid operation , which had little effect on rehabilitation exercises such as cough.4 days longer of postoperative hospital stay and 23 thousand yuan of hospitalization cost in hybrid operation group than those in the control group.One patient diagnosed of unstable angina pectoris and sigmoid colon cancer with intestinal obstruction was failed to resection of the tumor after received pericardial stripping and coronary ar-tery bypass surgery.The patient died three weeks after surgery due to intestinal obstruction and cachexia .The remaining 10 pa-tients were underwent successful surgery, cured and left hospital.No serious cardiovascular events, tumor recurrence and me-tastasis were found as followed up for 6-20 months.Conclusion Our practices show that hybrid cardiac and non-cardiac op-erations can be done safely and effectively.
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Objective To investigate effects of acute normovolemic hemodilution(ANH) used in on-pump coronary artery bypass graft(CABG) surgery.Methods 60 patients had received CABG surgery under cardiopulmonary bypass,of which 30 patients using ANH techniques and 30 patients using no ANH techniques.A series of index were observed and compared between the two groups after operation.Results All patients had been revascularized completely with stable surgical procedure,no serious complications,no operative mortality.Oxygen supplying was balanced with demanding,without tissue hypoxia.Indicators of myocardial protective effect,coagulation,kidney function,degree of systemic inflammatory reaction and postoperative drainage volume were not significantly different between the two groups(P ＞ 0.05).Allogeneic blood transfusion volume of the study group was significantly lower than that of the control group [(1.1 ± 0.8) U vs.(2.3 ± 1.1) U,P ＜ 0.05].Condusion The ANH technique used in CABG operation on appropriate patient is feasible and safe,with satisfactory clinical result.
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Objective To study the pre-existing intimal hyperplasia and the expression of nuclear factor-κB (NF-κB) and vascular cell adhesion molecule 1 (VCAM-1) in great saphenous vein(GSV) among the patients with diabetes mellitus undergoing coronary artery bypass grafting(CABG).Methods Segments of GSV were collected from 20 patients with diabetes mellitus and 22 patients without diabetes mellitus undergoing CABG.Morphometric analysis was performed after hematoxylin-eosin (HE) staining and Masson staining by microscopic computer analysis.Immunohistochemistry staining was used to examine the expression of NF-κB and VCAM-1 in intima.Results Pre-existing intimal hyperplasia was more common and server in GSV of the patients with diabetes mellitus.The expression of NF-κB and VCAM-1 were significantly higher in intima of GSV in patients with diabetes mellitus than patients without diabetes mellitus.The expression of VCAM-1 was positively related to NFκB in intima of GSV.Conclusion The pre-existing intimal hyperplasia and the expression of NF-κB and VCAM-1 were more common and server in GSV of the patients with diabetes mellitus than patients without diabetes mellitus.This can partially explain the poor prognosis of patients with diabetes mellitus after CABG.
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Objective To investigate effects of acute normovolemic hemodilution (ANH) used in coronary artery bypass graft (CABG) surgery in elderly patients.Methods 60 elderly patients (aged ≥65 years) received CABG surgery under cardiopulmonary bypass,of which 30 patients using ANH techniques and 30 patients without ANH techniques.Results All patients were revascularized completely with stable surgical procedure,no serious complications and no operative mortality were found.Oxygen supplying was balanced with demanding,without tissue hypoxia.Indicators of the myocardial protective effect,coagulation,liver function,kidney function,glucose metabolism,negative nitrogen balance,and postoperative drainage volume were not significantly different between the two groups (P＞0.05).Allogeneic blood transfusion volume was significantly lower in study group than in control group[(0.9±0.9)U vs.(2.5±1.2)U,t=2.704,P＜0.01].Conclusions The ANH technique used in CABG operation in appropriate elderly patient is feasible and safe,with satisfactory clinical results.
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Objective To investigate the changes of hemodynamics,cardiac troponin T(cTNT) and CK-MB zymogram perioperatively in elderly patients receiving off-pump versus on-pump coronary artery bypass grafting (CABG).Methods Totally 40 elderly patients (age＞65 years) undergoing surgical revascularization in our hospital were reviewed.20 patients were received off-pump coronary artery bypass grafting (group A),20 patients received on-pump surgery (group B).The cardiac output index (CI) and systemic vascular resistance index (SVRI) of each patient were recorded at the time of preoperative (T1),surgery completion (T2) and first day after surgery (T3).cTNT and CKMB of all patients were detected perioperatively.Results The level of CI was increased after operation,whereas CI of group A in T2 was significantly higher than that of group B [(3.92±0.43) L· min-1 · m-2 & (3.81±0.52)L · min 1 · m-2,t=2.036,P＜0.05).SVRI was decreased after operation,there was no difference between the two groups during the same time (P＞0.05).The levels of cTNT and CK-MB were within normal range before operation,whereas enhanced immediately after operation and returned to normal within the 7th day.The level of CK-MB in group B after operation was higher than that in group A [(11.8±4.4)tμg/L vs.(8.4±4.3)μg/L,t=2.214,P＜0.05) ；The level of cTNT in group B at 1st day after operation was increaesd compared with that in group A [(0.23±0.12)μg/L vs.(0.l1±0.09)μg/L],t=2.189,P＜0.05).Conclusions Both off-pump and on-pump CABG could improve the cardiac output and get approving myocardial protection effects in elderly patients,the effect of off-pump CABG might be superior to that of onpump CABG comparatively.
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Sixty patients underwent surgery for malignant thoracic tumor were evenly randomized into control group (group A) and treatment group (group B).0.3 ml low-molecular-weight heparin was injected per 12 h for 3 d in group B from 24 h after surgery.Bilateral venous sonography of lower extremities were performed before and d1,d3 after operation.Blood coagulation marks PLT,PT,APTT,Fibrinogen (FIB)and D-dimer were determined at the same time.Diagnosis of calf vein thrombosis after surgery was confirmed by color Doppler sonography in 7 patients:1 in group B (3％) and 6 in group A (20％) (P ＜ 0.05 ).Thrombosis at calf intermuscular vein was found in 6 patients and thrombosis at posterior tibial vein in 1 patient.FIB and D-dimer had no significant difference on the dl ( P ＞ 0.05 ) between two groups,but significantly lower on the d3 after surgery in group B than that in group A ( P ＜ 0.05 ).Low-molecularweight heparin reduced blood hypercoagulation state and thrombosis.Color Doppler sonography can be a valuable method for detecting asymptomatic deep vein thrombosis in the early stage after surgery and monitoring the efficacy of thrombosis prevention.
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ObjectiveTo observe the effects of lung resection surgery on left heart hemodynamics in elderly patients, and explore its correlation with postoperative arrhythmia.Methods The 16 elderly patients (age≥75 years) receiving lung resection surgery were selected. At the same time, 21 patients (age＜60 years) were selected as controls. The hemodynamic parameters of each patient were recorded at the time of preoperative (T1), surgery completion (T2) and first day after surgery (T3). For patients with arrhythmia during three days after operation, the parameters would be recorded before and after arrhythmia. Results There were no significant changes in heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), cardiac stroke volume ( SV),acceleration index (ACI), systemic vascular resistance (SVR) at T2 and T3 compared with T1 for both the two groups (P＞0. 05). Only the central venous pressure (CVP) increased at T2 compared with that at T1 [elderly group: (7.58±0.45) cm H2O vs. (5.92±0. 51) cm H2O, t=2.641, P＜0.01; control group: (7.49±0.34) cm H2O vs. (6.23±0.47) cm H2O, t=1.982, P＜0.05], while the CVP recovered to the preoperative level at T3. The incidence of arrhythmia was significantly higher in elderly group than in control group (31.3% vs. 14.3%, x2 = 4.26, P＜0.05), but there were no significant changes in the parameters before and after arrhythmia compared with those before surgery (P ＞ 0. 05 ).Conclusions The effects of pulmonary resection surgery on left heart hemodynamics in elderly patients can be avoided through full assessment preoperatively, heart-lung protection intraoperatively, as well as the correctly and timely clinical treatment and intensive care postoperatively. Pulmonary resection surgery has no effect on left heart hemodynamics even for patients with postoperative arrhythmia.
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Objective: To investigate the protective effects of different storage solutions on the ultrastructure and integrity of rabbit endothelial cells, and their effects on endothelin 1 secretion. Methods: Femoral artery segments were harvested from 16 adult rabbits, which were then stored separately in four different storage solutions. The solutions was: (1) verapamil nitroglycerin solution (VG); (2) heparinized papaverine autologous blood (PB); (3) papaverine solution (PS); (4) Ringer's solution (Ringer). The ultrastructure of the endothelial cells,the covering percentage of endothelium monolayer and the level of endothelin 1 secretion were evaluated. Results: The covering percentage of endothelium monolayer was significantly higher in VG [(69?10)%] and PB[(71?9)%] compared with that in Ringer [(55?11)%] (P0.05). The endothelial ultrastructure was more seriously damaged in PS than that in VG and in PB through TEM. The level of endothelin 1 secreting was similar significantly increased only in PB [(116.781?22.387) pg/ml] compared with that in Ringer (P
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0. 05). Creatinine clearance improved significantly in group C from a mean value of (90?23)ml/min preoperatively to (139?46)ml/min during operation (P