Early Postoperative Ondansetron Exposure is Associated with Reduced 90-Day Mortality in Patients Undergoing Cardiac Surgery.

Background: Ondansetron is a widely used anti-emetic for the prevention and treatment of nausea and vomiting for patients in critical care. Recent retrospective cohort studies suggest the potential beneficial effects of ondansetron in critically ill patients. In this study, we investigate the impact of ondansetron use on patient outcomes after cardiac surgery. Material and Methods: The MIMIC-III database was used to identify two types of cardiac surgical patients: those who were administered early ondansetron and those who were not given this early medication in the first 48 h in the postoperative period. Multivariable logistic regression was used to investigate the effect of ondansetron exposure on 90-day mortality, acute kidney injury, and malignant ventricular arrhythmias. Sensitivity analyses utilizing the inverse probability of treatment weighting and covariate balancing propensity score models were conducted to test the robustness of our findings. Results: A total of 12.4% of patients received ondansetron. Ondansetron use was associated with a lower risk of 90-day mortality in the multivariable logistic regression model (OR: 0.31, 95% CI: 0.13 to 0.72; P = 0.006) and sensitivity analyses. Additionally, ondansetron exposure was associated with less postoperative acute kidney injury (OR: 0.82, 95%CI: 0.69 to 0.96; P = 0.017) but did not increase the risk of postoperative malignant ventricular arrhythmias (OR: 0.38, 95%CI: 0.09 to 1.16; P = 0.191). Conclusions: In a population of cardiac surgical patients, early postoperative use of ondansetron appears to be associated with decreased 90-day mortality and acute kidney injury.

[Development of a freezing drier for lyophilization of biomaterials].

To observe and assess the performance and effect of our self-made FD-1 freezing drier on biomaterials. R502 compressor and R502 refrigerating agent were adopted. In the experiment, FD-1 lyophilized collagen sponge, strain and defibrinogenase. The evaporating-condenser temperature reached -45 degrees C and the small icebox temperature reached -30 degrees C under the loading or free-loading circumstances in the lyophilizing box. The lyophilized collagen sponge had many pores in the structure, and the strain and the defibrinogenase were lyophilized and maintained satisfactorily. This freezing drier is suitable for lyophilizing some biomaterial samples in small or medium batches.

[Intestinal permeability of patients with advanced digestive tract malignant tumors].

OBJECTIVE: To assess the intestinal barrier function of patients with advanced digestive tract malignant tumors by measuring the changes in intestinal permeability. METHODS: Sixteen patients with digestive tract tumors and 16 healthy volunteers were enrolled. After oral administration of mannitol and lactulose in deionized water, the 6-hour urine samples were collected for analyzing mannitol and lactulose concentrations using gas-liquid chromatography. RESULTS: Urine lactulose concentration and lactulose/mannitol (L/M) ratio of the tumor patients were increased in comparison with those of the healthy subjects (P<0.05). CONCLUSION: he intestinal permeability increased in these tumor patients, indicating intestinal barrier dysfunction.

Relationship between enteric microecologic dysbiosis and bacterial translocation in acute necrotizing pancreatitis.

AIM:To investigate the potential role of intestinal microflora barrier in the pathogenesis of pancreatic infection.METHODS:Fifteen dogs were colonized with a strain of E.coli JM109 bearing ampicillin resistance plasmid PUC18.The animals were divided into two groups. In experimental group (n = 8), acute necrotizing pancreatitis (ANP) was induced by injection of 0.5ml/kg of sodium tarocholate with 3000U/kg trypsin into the pancreatic duct. The control group (n = 7) underwent laparotomy only. All animals were sacrificed 7 days later. Mucosal and luminal microflora of intestine were analyzed quantitatively, and various organs were harvested for culturing, blood samples were obtained for determination of serum amylase activities and plasma lipopolysaccharide (LPS) concentrations.RESULTS:In the experimental group, the number of E. coli in the intestine was much higher than those of the controls, while bifidobacterium and lactobacillus were decreased significantly (Jejunum, 1.75 ± 0.95 vs 2.35 ± 0.79,P <0.05; 1.13 ± 0.8 vs 1.83 ± 0.64,P <0.05; ileum, 2.89 ± 0.86 vs 3.87 ± 1.05,P <0.05; 1.78 ± 0.79 vs 3.79 ± 1.11,P <0.01;cecum, 2.70 ± 0.88 vs 4.89 ± 0.87,P <001; 2.81 ± 0.73 vs 3.24 ± 0.84,P <0.05. Content of Cecum, 3.06 ± 0.87 vs 5.15 ± 1.44,P <0.01; 2.67 ± 0.61 vs 4.25 ± 0.81,P <0.01), resulting in reversal of bifido-bacterium/E. coli ratio as compared with the control group (jejunum,0.51 ± 0.76 vs 1.23 ± 0.53, P <0.05; ileum, 0.62 ± 0.68 vs 1.16 ± 0.32,P <0.05; cecum,0.46 ± 0.44 vs 1.03 ± 0.64, P < 0.05). In addition, intestinal bacteria were isolated from organs of all animals in the experimental group, and JM109 was also detected in most cases. Positive blood culture was 75.0% and 62.5% on day 1 and 2 after induction of ANP, respectively, but no bacterium was found in the controls. As compared with the control group, blood LPS levels and serum amylase activities increased 1-3 times and 3-8 times respectively.CONCLUSION: Microecological disturbance could occur in ANP, and overgrowth of intestinal gram-negative bacteria may lead to translocation to the pancreas and other organs, becoming the source of pancreatic and peripancreatic infection.

Traditional Chinese medicine Qing Yi Tang alleviates oxygen free radical injury in acute necrotizing pancreatits.

AIM:To observe the changes in oxygen free radical (OFR) and the curative effect of traditional Chinese medicine Qing Yi Tang in acute necrotizing pancreatitis (ANP).METHODS:After induction of ANP by injection of sodium taurocholate into pancreatic duct, 16 dogs were randomly divided into control group and Chinese medicine group.Serum amylase, SOD and MDA were determined on postoperative day 1, 2, 4 and 7. The animals were sacrificed on day 7. SOD and MDA in organs were determined, and pathological changes in pancreas were observed.RESULTS: As compared with control group, the serum level of amylase (734U/L vs 2783U/L) and MDA (7.8nmol/ml vs 14.8nmol/ml) in Chinese medicine group were decreased on day 7 (P < 0.05), while SOD increased significantly (281nU/ml vs 55nU/ml, P < 0.01), and similar changes occurred in MDA and SOD in organs, especially in the pancreas; the pathological changes in the pancreas were alleviated as well.CONCLUSION: Qing Yi Tang is effective in clearing OFRs and alleviating pathological changes in ANP.