Objective To investigate the relationship between preoperative albumin level and postoperative acute kidney injury(AKI)following off-pump coronary artery bypass(OPCAB)surgery;to confirm albumin cut-off value associated with AKI. Method This was a retrospective cohort study. data from patients who accepted OPCAB surgery in last two years in our hospital and AKI was diagnosed according to KIDGO-AKI criteria. Results Generalized additive model and multivariable logistic regression analysis have shown that the higher preoperative albumin level is related with the lower the incidence of AKI after OPCAB surgery. By generalized additive model,multivariable logistic regression analysis and ROC curve,we confirmed the albumin cut-off value associated with AKI between 39~40 g/L. Conclusion For patients undergoing OPCAB surgery,the higher preoperative albumin level ,the lower the incidence of AKI. In order to reduce the incidence of AKI in OPCAB surgery patients,preoperative albumin level higher than 40 g/L should be maintained.

10.3969/j.issn.1008-9691.2013.03.003

Objective To evaluate the effect of fast track surgery on immunologic functions and clinical outcome in patients with gastric cancer during perioperative period. Methods Thirty-six gastric cancer patients receving radical operation were randomly divided into two groups: fast track group (18, fast track surgery) and conventional management group (18, non-fast track surgery). Serum levels of IgA、IgM、 IgG and C reaction protein (CRP) in 36 patients were assayed preoperatively and postoperatively on 1st, 3rd, 7th day. The postoperative hospital stay, duration of fever, inhospital expense, postoperative time of flatus and postoperative complications were recorded respectively. Results On the postoperative 3rd day, serum levels of IgA [(1.57 ± 0. 40) g/L vs. (1.27±0.49) g/L, P <0. 05],IgG[(9.99 ± 2. 12) g/L vs.(8.53±2. 15)g/L, P<0.05]and IgM [(0.92 ± 0.18) g/Lvs. (0.78 ± 0.20) g/L, P<0.05]in patients of fast track group were significantly higher than those in patients in non-fast track group. On the postoperative 1 st, 3rd , 7th day, serum levels of CRP [d1 (56 ± 10) g/L vs. (79 ± 9) g/L,P < 0. 05];d3[(140±15) g/L vs. (170±15) g/L, P<0.05)];d7 [(52±11) g/L vs. (78±12) g/L,P<0.05]in patients of fast track group were significantly lower than those in patients in non-fast track group. The duration of fever [(2. 4 ± 0.9) d vs. (3.8 ± 0. 8) d, P < 0.05], passage of gas by anus [(3. 1 ± 0. 8) d vs. (4.4±0.7) d,P<0.05], time of hospitai stay [(6.3 ± 1.2) d vs. (8.2 ± 0.9) d,P<0.05]and treatment expense in patients of fast track group[(25 260 ± 2910) $ vs. (30 651 ± 3578) $ ,P <0. 05]were also significantly lower than those in non-fast track group (P < 0. 05). Patients in fast track group had no more complications than those in non-fast track group (P > 0. 05). While discharged from hospital, the quality of life score [(14. 8 ± 1.9) vs. (16. 1 ± 1.6), P < 0. 05]in patients of fast track group was significantly higher than that in patients in non-fast track group (P < 0. 05). Conclusions Fast track surgery mitigates the immunologic impairment of gastric cancer patients during perioperative period, and accelerates postoperative rehabilitation.

Adenoma ; Adult ; Ear Neoplasms ; Ear, Middle ; pathology ; Humans ; Male

AIM: To investigate relationship between activity of matrix metalloproteinases - 2 ( MMP - 2, 72 kD) and invasion, metastasis of breast cancer. METHODS: Useing zymography and computer software assisted analysis, the activitive levels of MMP- 2 (72 kD) in tissues from breast cancer were measeured. RESULTS: Mean activitive levels of MMP- 272 kD (13.93 + 3.60) in breast cancer were lower than those in benign disease (21.43 + 8.31), P < 0.05. There was no difference (P > 0.05) in MMP - 2 62 kD + 72 kD of benign and malignant dis ease, but MMP - 262 kD ( 13.83 + 4.53) and MMP - 262 kD/62 kD + 72 kD (0.48) respectively were significantly higher in malignant disease (P < 0.01). It was also found that MMP- 262 kD/62 kD + 72 kD were apparently higher in invasive carcinomas (0.48) and lymph node metastases (0.61), P < 0.01, respectively. CONCLUSION: These results demonstrated that a clear relationship between MMP - 2 activity and the invasion and metastasis of breast carcinoma.

AIM: The purpose of this study was to investigate the effects of rhBMP-2/collagen composite on bone regeneration during expansion of the interparietal suture in the rats. METHODS: 32 10-week old SD rats were divided into groups consisting of 8 rats each. They were comprised of normal control group, expansion control group and the treatment group, the two treatment groups were covered with atelo-typeⅠcollagen and rhBMP-2/collagen composite on the suture before subjected to the expansion force. The bone regeneration in the interparietal suture was estimated by histological method, the osteocalcin content was measured by radioimmonoassay and the calcium content was determined by atomic absorption spectrophotometer. RESULTS: The bone regeneration was more active in the suture after giving an expanding force than in the suture without any intervention. Even bone bridge was formed in the rhBMP-2/collagen composite group. Both the osteocalcin content and calcium content were much higher in the rhBMP-2/collagen composite group than in other three groups (P

Objective To investigate the role of nerve growth factor (NGF) in the pathogenesis of diabetic neuropathy (DNP) and the correlation of NGF level with,sensory nerve conduction velocity (SNCV) and duration of DNP.MethodsThe 41 patients with DNP,35 diabetics without DNP and 33 healthy controls were enrolled.And the serum level of NGF was measured with ELISA,the SNCV of left medial nerve,ulnar nerve,peroneal nerve and tibial nerve were measured too. Then the correlation analysis was completed. ResultsThe serum level of NGF was significantly lower in DNP patients [(665.18±188.32) ng/L] than in healthy controls [(976.44±159.07)ng/L] and in diabetics without DNP [(943.32±167.33) ng/L,F=9.316,P<0.001].The NGF level of DNP patients was positively correlated with SNCV of left medial nerve (r=0.810,P<0.001 ),left peroneal nerve (r=0.760,P<0.001) and duration of DNP (r=0.542,P<0.001).Conclusions The serum level of NGF is lower in DNP patients than in healthy controls.The decrease of the production of NGF may play a role in the pathogenesis of DNP.

Objective To prospectively study the main risk factors of variceal bleeding in cirrhotic patients. Methods Fifty-seven patients with liver cirrhosis and esophageal varices who had never experienced variceal bleeding were followed up for 12 months. The patients underwent measurements of esophageal variceal pressure by non-invasive endoscopic balloon technique. The endpoint of the study was the presence of a variceal hemorrhage. The relationship between variceal hemorrhage and endoscopic findings including varices, variceal pressure, Child-Pugh status, ascites, and etiology of cirrhosis was studied. Results Thirty-four patients (59.6% ) developed a variceal hemorrhage. In univariate analysis, the level of variceal pressure (P= 0. 001), the size of varices (P=0. 006), and the endoscopic red color sign on the variceal wall (P=0. 012) predicted higher risks of variceal hemorrhage. The multiple logistic regression revealed that variceal pressure was a major predictor of the risk for a first variceal bleeding (OR=2. 817, P=0. 003). The area under the receiver operating characteristic (ROC) of variceal pressure for predicting variceal bleeding was 0. 98, and the variceal pressure cutoff value was 25.3 mm Hg (1 mm Hg=0. 133 kPa) with both specificity and sensitivity of 91 %. Conclusion The level of variceal pressure is a major predictor for variceal bleeding in cirrhotic patients.

Objective: To investigate the effects of electro-acupuncture on obestatin in rat with simple obesity. Methods: Obesity was induced in male SD rats with high-fat and -glucose diet for 10 weeks. Twenty-four rats with obesity were randomly divided into untreated group and electro-acupuncture group, with 12 rats in each group. Another 12 normal SD rats serving as controls were fed standard rat chow. Rats in the electro-acupuncture group were treated with electro-acupuncture on bilateral Zusanli (ST36), Tianshu (ST25) and Pishu (BL20) acupoints for fifteen days consecutively. Rats in the blank control group and untreated group were not interfered. Body weight was measured every 3 days during treatment. After treatment, obestatin in serum and hypothalamus was detected by radioimmunoassay or immunohistochemiscal method respectively. Visceral fat weight was also detected. Results: Body weight and visceral fat weight of rats in the untreated group were significantly higher than those in the blank control group (P<0.01). Body weight and increase of body weight in the electro-acupuncture group were significantly lower than those in the untreated group (P<0.01). Visceral fat weight in the electro-acupuncture group was significantly lower than that in the untreated group (P<0.01), but there was no significant difference as compared with the blank control group. The obestatin expression in hypothalamus was higher in the untreated group than in the blank control group (P<0.05), while it was lower in the untreated group than in the electro-acupuncture group (P<0.01). Conclusion: Electro-acupuncture has an effect against obesity in rats, which may be related to up-regulating obestatin expression in hypothalamus.

OBJECTIVE:To establish a method of determining the plasma concentration of capecitabine/polyethylene glycol 1000/montmorillonite (CAP/PEG1000/MMT) in rats’plasma for the study on pharmacokinetics of CAP compound in rats in vivo. METHODS:HPLC was adopted. The determination was performed on Kromasil C18 with mobile phase consisted of 0.1% glacial acetic acid-acetonitrile(73∶27),at the flow rate of 1.0 ml/min. The detection wavelength was 250 nm and column temperature was 40 ℃. The sample size was 10 μl. 18 Wistar rats were randomly divided into CAP group,CAP/MMT group(MMT as carrier)and CAP/PEG1000/MMT group(PEG1000/MMT as carrier)and ig given corresponding drugs,that equal to 200 mg/kg of CAP. Blood sample was respectively taken 15,30,60,90,120,180,240,300 and 360 min after the administration of drugs,and plasma was isolated and added with internal standard ferulic acid. The concentration of the drug in the plasma was determined by HPLC fol-lowing protein precipitation with methanol,based on which the pharmacokinetic parameters were calculated by 3p97 software. RE-SULTS:The linear range of CAP was 0.054 9-4.390 0 μg/ml (r=0.998 2) with the method recovery of 98.2%-102.1%(RSD=1.50%-3.29%, n=5) and absolute recovery of 76.2%-78.9%(RSD=2.29%-2.99%, n=5). In the above-mentioned three groups,t1/2 were(1.11±0.32),(1.57±0.32)and(1.62±0.10)h;cmax were(2.91±0.36),(0.91±0.23)and(0.91±0.14)μg/ml;AUC0-6 h were (8.70 ± 1.79),(3.76 ± 0.27) and (3.73 ± 0.25)μg·h/ml;and tmax were (0.97 ± 0.20),(1.55 ± 0.47) and (1.50 ± 0.07) h,respectively. There was no significant difference in the pharmacokinetic parameters between the CAP/MMT group and CAP/PEG1000/MMT group(P>0.05). CONCLUSIONS:The method is reliable and simple,and can be used for pharmacokinetic study of CAP/PEG1000/MMT in rats. MMT and PEG1000/MMT compound can prolong CAP acting time in the body.