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Twenty-five pediatric patients (10 males,15 females) with inherited epidermolysis bullosa,aged 3-16 yr,weighing 11-29 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,underwent lysis and reconstructive surgery of both hands adhesions from July 2015 to April 2017 in our hospital.Ketamine 4-6 mg/kg and atropine 0.01 mg/kg were intramuscularly injected at 20 min before admission to the operating room.Oxygen 2 L/min was inhaled by mask after admission to the operating room.Anesthesia was induced by Ⅳ injection of midazolam 0.08 mg/kg and ketamine 2 mg/kg.Pediatric patients kept spontaneous breathing.Anesthesia was maintained by Ⅳ infusion of propofol 5 mg · kg-1 · min-1 and remifentanil 0.05-0.08 μg · kg 1 · min-1.Mepitel was used to protect skin during surgery,and sodium potassium magnesium calcium and glucose injection was intravenously infused to replace the physiological requirement,blood loss and continued loss.Anesthesia time was (130±43) min,surgery time (107±42) min,the amount of intraoperative fluid infused (352± 120) ml,blood loss (29± 10) ml and emergence time (15±6) min.Intraoperative respiratory depression was found in 5 cases (20％);postoperative new bullae occured in 3 eases,and among the 3 cases,one developed on the back and the other two on the buttocks.No cardiovascular events occurred during and after surgery in this study.
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BACKGROUND:Increasing autologous stem cellmobilization is conceived to achieve effectively repair of cardiac ischemic injury. Therefore, it is important to seek a specific and effective mobilization agent. OBJECTIVE:To observe the effects of hypoxia-inducible factor-1α(HIF-1α) on bone marrow mesenchymal stem cellmobilization in myocardial infarction. METHODS:Left anterior descending artery was ligated to establish a rat model of acute myocardial infarction in 90 outbreeding Sprague-Dawley rats, and then the models were randomly divided into three groups. In HIF-1α-antisense oligonucleotide (ASODN) group, HIF-1α-ASODN was infused into the tail vein to restrain the expression of HIF-1αin infarcted ischemic tissue. In HIF-1α-missense oligonucleotide (MSODN) group or control group, an equal volume of HIF-1α-MSODN or saline was injected. RESULTS AND CONCLUSION:After 30 hours and 7 days of modeling, the number of bone marrow mesenchymal stem cells and expression of vascular endothelial growth factor in the peripheral blood of the control group were similar to the HIF-1α-MSODN group, but significantly higher than the HIF-1α-ASODN group. After 7 days of modeling, the expressions of HIF-1αprotein, vascular endothelial growth factor protein and mRNA in the ischemic myocardial tissues of the control group were similar to the HIF-1α-MSODN group, but significantly higher than the HIF-1α-ASODN group. After 7, 14 and 28 days of modeling, the capil ary density in the ischemic myocardial tissues of the control group was similar to the HIF-1α-MSODN group, but significantly higher than the HIF-1α-ASODN group. These findings indicate that after acute myocardial infarction, high expression of HIF-1αexhibits a causal relationship with mobilization of bone marrow mesenchymal stem cells, initiating a series of self-healing process of myocardial tissues.
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BACKGROUND:Ischemia microenvironment contributes mostly to the low survival rate of rat bone marrow mesenchymal stem cells after transplantation. Hydrogen sulfide (H2S) can protect various cells and tissue models against apoptosis and injury. OBJECTIVE:To detect the cellapoptosis and viability, content of H2S in supernatant, and the expression of H2S synthetase after different time of hypoxia and serum deprivation cultivation of rat bone marrow mesenchymal stem cells. METHODS:The passage 3 rat bone marrow mesenchymal stem cells were divided into five different cultivation time groups:0-, 3-, 6-, 12-and 24-hour groups. After enough hypoxia and serum deprivation cultivated time, the cellapoptosis was detected by SubG1, the cellviability was determined by cellcounting kit-8, the content of H 2S in supernatant was measured by N,N-dimethyl-p-phenylenediamin and the expression of H2S synthetase by RT-PCR and western blot. RESULTS AND CONCLUSION:Compared to the normal cultivation group, after different hypoxia and serum deprivation cultivated time, the cellapoptosis increased and cellviability decreased significantly. The longer hypoxia and serum deprivation cultivated time caused the more cellapoptosis and the lower cellviability. The contents of H2S and its synthetase were also suppressed by hypoxia and serum deprivation cultivation. The difference was statistical y significant. These findings suggest that hypoxia and serum deprivation cultivation can inhibit the generation of H 2 expression of its synthetase.
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80 NSTE-ACS patients were randomly divided into 2 groups: the control group and the therapy group (40 cases in each group). The therapy group was treated with Tirofiban besides the conventional treatment which received by the control group. The level of HIF-1α and hs-CRP was detected immediately, 12, 24, 48 h,and 7 d after hospitalization. The HIF-1αlevel of both group increased in the first 12 hours and then decreased gradually to the baseline in 7 days. The hs-CRP level of both group increased gradually and reached its peak after 24 h after hospitalization, then decreased. Compared with the control group, the level of HIF-1α and hs-CRP decreased sig-nificantly at 12, 24, 48 h and 7 d after hospitalization in the therapy group.
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Objective To explore the X-ray radiation dose to patients from different cardiovascular interventional procedures and analyze the dose-affecting factors.Methods In accordance with the A,B,C operators,442 patients undergoing cardiovascular interventional procedures were collected,including single coronary angiography (CAG),percutaneous coronary intervention ( PCI ),radiofrequency catheter ablation (RFCA),congenital heart disease intervention (CHD) and permanent cardiac pacemaker implantation (PCPI),to observe dose area product (DAP),cumulative radiation dose (CD),fluoroscopy time.Results CD values of patients in groups of CAG,PCI,RFCA,CHD,PCPI were (0.34 ±0.23),(1.33 ±0.76),(0.71 ±0.43),(0.27 ±0.22) and (0.92±0.42) Gy and DAP values were (34.18 ±23.33),(135.92 ±81.14),(79.79 ±50.66),(27.93 ±23.66),and (94.60 ±48.11 ) Gy·cm2,respectively.Fluoroscopy time were (4.82 ±3.73),( 16.64 ±9.01 ),( 17.04 ± 15.29),(9.60 ±5.97)and (7.31 ±6.45) min.DAP values and fluoroscopy time were highly correlated (r =0.84,P ＜ 0.05 ).Conclusions There is significant difference in radiation dose for cardiovascular interventional procedures.Radiation dose and fluoroscopy time are directly related to surgeons' proficiency in operations.Improvement of operation proficiency should be carried out to reduce the patients' radiation dose.