RESUMO
Objective:To observe the effect of Wendantang on tumor necrosis factor-α (TNF-α),interleukin(IL)-6,IL-17,IL-22 and other related inflammatory factors in peripheral blood and the expression of STAT3[the key molecule of Janus kinase 2/signal transducer and activator of transcription 3(JAK2/STAT3) signal pathway in hypothalamus] mRNA and protein of obese rats with syndrome of phlegm-dampness,so as to explore the internal mechanism of Wendantang in interfering obesity with syndrome of phlegm-dampness. Method:A total of 100 rats were randomly divided into blank group(30 rats) and modeling group(70 rats),rats in the blank group was fed with basic feed and the modeling group was fed with high-fat feed for 6 weeks.Animal model of obesity with syndrome of phlegm-dampness was established by the method in literature.After successful modeling,16 obese rats were selected and randomly divided into the model group and Wendantang intervention group with 8 rats in each group,and another 8 rats in the blank group were randomly selected as the normal group.Rats in Wendantang intervention group were given 15 g·kg-1 of crude drug by gavage,while the model group and the normal group were given the same amount of distilled water for gavage once a day for 6 weeks.No eating but no prohibiting drinking before dealing with 12 h and then taking samples after anesthesia.The body weight,Lee's index and obesity rate of rats were measured,the levels of blood lipids[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C)] of rats were detected with a full-automatic biochemical analyzer according to the requirements of the kit,the expression of TNF-α,IL-17,IL-22 and IL-6 in peripheral blood of rats was detected with enzyme-linked immunosorbent assay(ELISA),STAT3 mRNA expression in hypothalamus of rats was detected with real-time fluorescence quantitative polymerase chain reaction(Real-time PCR) and the expression of STAT3 protein in hypothalamus of rats was detected with Western blot. Result:The high-fat feed feeding could successfully replicate the obese rat model,and the obesity rate of rats in the modeling group was greater than 20%,and compared with the blank group,the body weight and Lee's index of rats in the modeling group were significantly increased(PPPPPPPPPPPConclusion:Wendantang has a good effect on improving phlegm-dampness in obese rats,and the mechanism may be related to regulating JAK2/STAT3 signal pathway then to improve the chronic inflammatory state of the body,and all of which provides a scientific basis for Wendantang in intervening obesity with syndrome of phlegm-dampness.
RESUMO
Introducción: Reconocer oportunamente las variables de riesgo perioperatorio permite predecir la frecuencia de morbimortalidad, así como tomar medidas a fin de reducir complicaciones. Para ello se han creado varias escalas de riesgo en pacientes portadores de enfermedad cardiovascular. Objetivo: Determinar la sensibilidad, la especificidad y los valores predictivos de los índices de riesgo cardíaco de Goldman, Detsky y Lee para cirugía no cardíaca. Método: Se realizó un estudio observacional, analítico, longitudinal y prospectivo del total de pacientes portadores de enfermedad cardiovascular con enfermedad quirúrgica no cardíaca en el período comprendido entre enero de 2011 y enero de 2013 en el Hospital Universitario Manuel Ascunce Domenech de la ciudad de Camagüey. La muestra estuvo constituida por 88 pacientes comprendidos en el universo que cumplieron con los criterios de inclusión. Las variables estudiadas fueron: edad, sexo, tipo de cirugía, tipo de complicación, y la presencia o no de estas en relación con el riesgo catalogado según los índices de Goldman, Detsky y Lee. Se aplicó prueba de sensibilidad, especificidad y valores predictivos. Resultados: Predominaron los pacientes mayores de 70 años, el sexo masculino, la cirugía ortopédica; la arritmia cardíaca fue la principal complicación. Fue frecuente encontrar pacientes de alto riesgo, en los cuales la mayoría sufrieron complicaciones. Conclusiones: Los índices de Goldman y Detsky mostraron alta sensibilidad y especificidad, y el índice de Lee, mayor valor predictivo positivo. No obstante, deben aplicarse los 3 índices predictivos para lograr una óptima estratificación del riesgo cardíaco en cirugía no cardíaca.
Introduction: Timely recognition of perioperative risk variables helps predict morbidity and mortality frequency, as well as adopt measures to reduce complications. Several risk scores have been developed for this purpose in patients with cardiovascular disease. Objective: To determine the sensitivity, specificity and predictive values of the Goldman, Detsky and Lee cardiac risk indices for non-cardiac surgery. Methods: Observational, analytical, longitudinal prospective study of the total number of patients with cardiovascular disease undergoing non-cardiac surgery between January 2011 and January 2013 at Hospital Universitario Manuel Ascunce Domenech in Camagüey. The sample consisted of 88 patients included in the universe of patients who met the inclusion criteria. The variables studied were: age, gender, type of surgery, type of complication, and the presence or absence of complications in relation to the risk assessed on the basis of the Goldman, Detsky and Lee indices. The sensitivity, specificity and predictive value test was applied. Results: There was a predominance of males in patients over 70 years of age coming for orthopaedic surgery; cardiac arrhythmiawas the main complication. High-risk patients were a frequent finding and the majority suffered complications. Conclusions: The Goldman and Detsky indices showed high sensitivity and specificity, while the Lee index showed higher positive predictive value. However, the three predictive indices must be applied in order to optimize cardiac risk stratification in non-cardiac surgery.