1.Effect of creatine phosphate on perioperative myocardial injury caused by living donor fiver transplantation in adult patients
Wenli YU ; Hongyin DU ; Yiqi WENG
Chinese Journal of Anesthesiology 2010;30(12):1424-1427
Objective To investigate the effect of creatine phosphate on perioperative myocardial injury caused by living donor liver transplantation(LDLT)in adult patients.Methods Forty ASA Ⅱ -Ⅳ patients(liver function Child-Pugh grade B or C)aged 45-62 yr weighing 47-91 kg undergoing LDLT were randomly divided into 2 groups(n = 20 each): control group(group C)and creatine phosphate group(group CP).In group CP,creatine phosphate 30 mg/kg was injected intravenously at skin incision followed by creatine phosphate infusion at 4 mg· kg- 1 · h- 1 until the end of surgery.In group C,equal volume of normal saline was infused instead of creatine phosphate.HR,MAP,CVP,PCWP,CO and SvO2 were recorded immediately before skin incision,at 5 and 30 min of anhepatic phase,at 5 and 30 min of neohepatic phase and at the end of operation.Blood samples were taken from central vein immediately before skin incision(baseline,T0),at 30 min of anhepatic phase(T1),at 30min of neohepatic phase(T2),at the end of operation(T3)and at 4 and 24 h after operation(T4,5)for determination of serum cardiac troponin I(cTnI)and creatine kinase MB(CK-MB)concentrations and lactate dehydrogenase(LDH)activity.Postoperative adverse events were recorded.Results The serum cTnI and CK-MB concentrations and LDH activity were significantly increased at T2-5 as compared with the baseline value at T0 in both groups(P <0.05 or 0.01).MAP and CO were significantly higher from 5 min of neohepatic phase to the end of operation,the serum cTnI and CK-MB concentrations and LDH activity were significantly lower at T2-5,and the incidence of ventricular arrhythmia was significantly lower in group CP than in group C(P < 0.05 or 0.01).Conclusion Creatine phosphate can attenuate perioperative myocardial injury caused by LDLT in adult patients.
2.Blood-conservation techniques during orthotopic liver transplantation
Jiangang XU ; Hongyin DU ; Hong JIA
Chinese Journal of Organ Transplantation 2003;0(01):-
Objective To investigate the blood conservation techniques during orthotopic liver transplantation(OLT). Methods Thirty-eight patients undergoing OLT without veno-venous bypass under general anesthesia were studied. During operation, the blood conservation measures such as controlled blood loss and blood coagulation, etc. were implemented. The input and output of liquid, blood component transfusion in preanhepatic, anhepatic and reperfusion phases was analyzed. The blood samples from central vein were collected, plasma creatinine, hemoglobin and albumin were determined after anesthesia, 1 h after preanhepatic phase, 20 min after anhepatic phase and 1 h after reperfusion phase, and the central venous pressure and Sonoclot data were measured.Results The total volume of whole blood transfusion was about ( 816? 86.3) ml and that of red blood cells ( 962? 55.3) ml during operation. Two patients had no blood transfusion. The normal urinary output was maintained during preanhepatic, anhepatic and reperfusion phases. The central venous pressure at three phases was significantly decreased compared to that after anesthesia (P 0.05). The plasma creatinine was significantly increased at reperfusion phase (P
3.Efficacy of plasma radiofrequency ablation at low temperature in disc combined with collagenase injection out of disc in patients with cervical intervertebral disc herniation
Yongjin HE ; Wenxue JIANG ; Hongyin DU
Chinese Journal of Anesthesiology 2011;31(9):1042-1044
Objective To evaluate the efficacy of plasma radiofrequency ablation at low temperature in disc combined with collagenase injection out of disc in patients with cervical intervertebral disc herniation.Methods Fifty-six patients suffering from cervical intervertebral disc herniation with headache,dizziness,and pain in the neck and in the shoulder were randomly divided into 2 groups ( n =28 each):collagenase injection out of disc group (group C) and plasma radiofrequency ablation at low temperature in disc combined with collagenase injection out of disc group (group R).All operations were carried out under CT guidance.Results At the sixth month of follow up after treatment,the remission rates of headache,dizziness and pain in the neck and in the shoulder were 86%,79%,and 93% in group C and 96%,93%,and 100% in group R,.respectively,with significant difference between the two groups ( P < 0.05 ) Conclusion The efficacy of plasma radiofrequency ablation at low temperature in disc combined with collagenase injection out of disc is much better than collagenase single in patients with cervical intervertebral disc herniation.
4.Effect of interleukin-1 on contractile function of rat thoracic aorta
Zhongping CAO ; Wenna LIU ; Hongyin DU
Chinese Journal of Anesthesiology 2015;35(2):214-217
Objective To investigate the effect of interleukin-1 (IL-1) on contractile function of rat thoracic aorta.Methods Forty male Sprague-Dawley rats,weighing 250-300 g,were sacrificed to obtain the thoracic aortic rings.The experiment was performed in 2 parts.Part Ⅰ The thoracic aortic rings were divided into 2 segments and randomly divided into 2 groups (n =20 each):control group and IL-1 group.In IL-1 group,the thoracic aortic rings were incubated with Kreb solution containing 20 ng/ml IL-1 for 2 h,and contracted with cumulative concentrations of phenylephrine,ranging from 10-9 to 10-5mol/L.In control group,the thoracic aortic rings were incubated with Kreb solution for 2 h,and contracted with cumulative concentrations of phenylephrine,ranging from 10 9 to 10-5mol/L.Part Ⅱ The thoracic aortic rings were divided into 3 segments and randomly divided into 3 groups (n=20 each):IL-1 group,IL-1+ L-NAME (the NOS inhibitor) group and IL-1 +cyclooxygenase inhibitor indomethacin group (IL-1 +Ⅰgroup).The thoracic aortic rings were incubated with Kreb solution containing 20 ng/ml IL-1 for 1.5 h in the three groups.In addition,in IL-1 +L-NAME and IL-1 +Ⅰ groups,the thoracic aortic rings were incubated for 30 min with Kreb solution containing 100 μmol/L L-NAME and 2.5 mmol/L indomethacin,respectively.Contraction of the thoracic aorta was then induced with cumulative concentrations of phenylephrine,ranging from 10 9 to 10-5 mol/L.In group IL-1,the thoracic aortic rings were incubated with Kreb solution.The maximum contractile tension of the thoracic aortic rings was recorded at each concentration of phenylephrine,and the percentage of the maximum contractile tension at the concentration of 10-6 mol/L in group C was obtained.Results Part Ⅰ The percentage of contractile tension at phenylephrine 10-s,10-7,l0 6 and 10-5mol/L was significantly decreased in IL-1 group as compared with C group.Part Ⅱ The percentage of contractile tension at phenylephrine 10-7,10-6 and 10-5mol/L was significantly increased in IL-1+L-NAME and IL-1+I groups as compared with IL-1 group.Conclusion IL-1 can inhibit the contraction of rat thoracic aorta,and promoted production of NO and prostacyclin may be involved in the mechanism.
5.Comparison of kidney injury following liver transplantation performed under propofol versus sevoflurane combined anesthesia
Weituan XU ; Wenli YU ; Hongyin DU
Chinese Journal of Anesthesiology 2012;(10):1246-1248
Objective To compare the severity of kidney injury following liver transplantation performed under sevoflurane versus propofol combined anesthesia in patients.Methods Fifty ASA Ⅱ or Ⅲ patients of both sexes,aged 40-64 yr,weighing 47-85 kg,scheduled for elective orthotopic liver transplantation,were randomly divided into 2 groups (n =25 each) ∶ propofol combined anesthesia group (group P) and sevoflurane combined anesthesia group (group Se).During maintenance of anesthesia,propofol was given by target-controlled infusion and the target plasma concentration was 2-4 μg/ml in group P,and sevoflurane was continuously inhaled and the endtidal concentration was maintained at 1.0%-3.0% in group Se.Venous blood samples and urine specimens were taken immediately before skin incision (T0),at 30 min after occlusion of the inferior vena cava (T1),at 30 min of neohepatic phase (T2),at the end of surgery (T3),and at 1,3 and 5 days after operation (T4-6) for determination of serum concentrations of creatinine (Cr),blood urea nitrogen (BUN),β2-microglobulin (β2-MG) and urinary β2-MG concentrations.Results Compared with group P,the serum concentrations of Cr,BUN and β2-MG and urinary β2-MG concentrations were significantly lower at T3,4 in group Se (P < 0.05 or 0.01).Conclusion The severity of kidney injury is reduced in patients undergoing liver transplantation performed under sevoflurane combined anesthesia compared with that under propofol combined anesthesia.
6.Changes of MAC and electrophsiology during preferentinal delivery of isoflurane to the situ goat spinal cord
Linong YAO ; Yun YUE ; Hongyin DU ; Wei CAI ; Yonghui YANG ;
Chinese Journal of Anesthesiology 1996;0(08):-
Objective:To evaluate the role of spinal cord in anesthesia of isoflurane. Method:The animal models of head bypass were established,which were used to preferentially anesthetized spinal cord, after 9 goats were anesthetized with isoflurane.MAC was determined using tail clamp at prebypass,druing bypass and postbypass. Electroen-cephalogram(EEG),brain stem auditory evoked Potential (BAEP) and visal evoked potential(VEP)were monitored constantly. Result:MAC of isoflurane,the relative power(RP)of ? wave and the latencies of BAEP and VEP were decreased when spinal cord was preferentinally anesthetized (P
7.Research progress of matrix metalloproteinase-9 in kidney disease
Xiangyang YU ; Lili JIA ; Wenli YU ; Yiqi WENG ; Hongyin DU
Journal of Chinese Physician 2017;19(8):1278-1280,封3
Kidney plays an important role in maintaining the homeostasis as an important excretory and endocrine organ.The occurrence and development of kidney disease is closely associated with glomerular filtration barrier dysfunction and renal interstitial remodeling.Matrix metalloproteinase-9 (MMP-9),a major enzyme in the extracellular matrix (ECM),plays an important role in the process of kidney disease by regulating the ECM components and its interaction with cytokines.The paper reviews the pathophysiology of MMP-9 in glomerular filtration barrier dysfunction and renal fibrosis to provide a theoretical basis for clinical treatment of kidney disease.
8.Effect of dexmedetomidine on myocardial injury in pediatric patients undergoing living-related liver transplantation
Mingwei SHENG ; Hongyin DU ; Wenli YU ; Yiqi WENG ; Ying SUN
Chinese Journal of Anesthesiology 2017;37(3):263-266
Objective To evaluate the effect of dexmedetomidine on myocardial injury in pediatric patients undergoing living-related liver transplantation. Methods Fifty-eight pediatric patients of both sexes,aged 5-20 months,weighing 4.5-15.0kg,of American Society of Anesthesiologists physical status Ⅲ or Ⅳ,scheduled for elective living-related liver transplantation,were divided into 2 groups(n=29 each)using a random number table:control group(group C)and dexmedetomidine group(group D).In group D,dexmedetomidine was intravenously infused at a dose of 0.5 μg/kg over 10min starting from the time point immediately before skin incision,followed by an infusion of 0.8 μg·kg-1·h-1 until the end of surgery. The equal volume of normal saline was given instead in group C. Immediately before skin incision(baseline,T0),at 10min of anhepatic phase(T1),at 30min of neohepatic phase(T2)and at the end of surgery(T3),blood samples were obtained from the central vein for determination of serum cardiac troponin I(cTnI),lactate dehydrogenase(LDH),alpha-hydroxybutyrate dehydrogenase(α-HBDH),interleukin-6(IL-6)and IL-10 concentrations. The changing rate of serum cTnI concentrations were calculated at T2. The occurrence of myocardial ischemia and ventricular premature beat and requirement for dopamine were recorded during surgery. Results Compared with the baseline at T0,the serum concentrations of cTnI,LDH and α-HBDH were significantly increased at T2,3,and the serum concentrations of IL-6 and IL-10 were increased at T1-3 in both groups(P<0.05).Compared with group C,the serum concentrations of cTnI,LDH,α-HBDH and IL-6 were significantly decreased at T2,3,the serum concentration of IL-10 was increased at T1-3,the changing rate of serum cTnI concentrations was decreased(P<0.05),and no significant change was found in the incidence of myocardial ischemia and ventricular premature beat and requirement for dopamine in group D(P>0.05).Conclusion Dexmedetomidine can attenuate the myocardial injury to some extent in pediatric patients undergoing living-related liver transplantation.
9.Effect of JAK2/STAT1 on acute kidney injury induced by liver cold ischemia reperfusion in rats
Fei WANG ; Lili JIA ; Ying SUN ; Hongyin DU ; Wenli YU
Chinese Journal of Organ Transplantation 2017;38(5):297-301
Objective To investigate the effect of Janus kinase2/signal transducer and activator of transcription 1 (JAK2/STAT1) signaling pathway on acute kidney injury induced by liver cold ischemia reperfusion (IR) in rats.Methods Thirty healthy male Sprague-Dawley rats,weighing 220-250 g,were assigned randomly to 3 groups (n =10/group):sham operation group (Sham group);liver cold ischemia reperfusion model group (I/R group);JAK2 kinase inhibitor AG490 group (AG490 group) (AG490 at dose of 10 mg/kg was intraperitoneally injected 30 min before establishment of the model).Other groups were given the equal volume of normal saline at the same time points.Then the rats were sacrificed at 6 h after reperfusion (at 6 h after the end of operation in Sham group).The renal function and oxidative stress level were observed.The pathological changes of the renal tissues and nephritic cell apoptosis were analyzed,and the expression of p-JAK2,pSTAT1,Bcl-2 and Bax was detected by Western blotting.Results As compared with Sham operation group,renal histological lesion and renal dysfunction were aggravated,level of oxidative stress and apoptosis rate were increased in I/R group,the Bcl-2/Bax ratio was decreased and the expression of pJAK2 and p-STAT1 was up-regulated.As compared with I/R group,AG490 dramatically attenuated histological lesions and oxidative stress,restored the renal function,and reduced the number of apoptotic tubular epithelial cells.AG490 significantly increased the Bcl-2/Bax ratio,and inhibited the expression of p-JAK2 and p-STAT1.Conclusion Blockage of JAK2/STAT1 signaling pathway can alleviate acute kidney injury after liver cold ischemia reperfusion probable through inhibiting the oxidative stress and apoptosis.
10.Effect of dexmedetomidine pretreatment on activation of JAK/STAT signaling pathway during intestinal injury in rats undergoing liver transplantation
Lili JIA ; Fei WANG ; Wenli YU ; Yiqi WENG ; Hongyin DU
Chinese Journal of Anesthesiology 2016;36(10):1206-1210
Objective To evaluate the effect of dexmedetomidine pretreatment on activation of Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway during intestinal injury in rats undergoing liver transplantation.Methods Thirty-two pathogen-free healthy adult male Sprague-Dawley rats,weighing 220-250 g,aged 8-10 weeks,were divided into 4 groups (n =8 each) using a random number table:sham operation group (S group),liver transplantation group (LT group),dexmedetomidine pretreatment group (D group) and dexmedetomidine plus atipamezole (specific α2-adrenergic receptor antagonist) group (D+A group).The model of liver transplantation was established in LT,D and D+A groups except group S.In group D,dexmedetomidine 50 μg/kg was injected intraperitoneally at 30 min before skin incision.In group D+A,atipamzole 250 μg/kg was injected intraperitoneally at 5 min before administration of dexmedetomidine.At 6 h of reperfusion,blood samples were collected from the inferior vena cava for determination of serum concentrations of intestinal fatty acid binding protein (iFABP),lipopolysaccharide (LPS),tumor necrosis factor-alpha (TNF-ct) and high-mobility group box 1 protein (HMGB1).Intestinal specimens were then obtained for examination of the pathological changes of intestinal tissues (under light microscope) and for determination of the expression of activated caspase-3,phosphorylated JAK2 (p-JAK2),phosphorylated STAT1 (p-STAT1) and phosphorylated STAT3 (p-STAT3).Intestinal damage was assessed and scored.Wet/dry weight ratio (W/D ratio) was calculated.Results Compared with group S,the concentrations of iFABP,LPS,TNF-α and HMGB1 in serum,intestinal damage scores and W/D ratio were significantly increased,and the expression of activated caspase-3,p-JAK2,pSTATI and p-STAT3 in intestinal tissues was up-regulated in LT and D groups (P<0.05).Compared with group LT,the concentrations of iFABP,LPS,TNF-cα and HMGB1 in serum,intestinal damage scores and W/D ratio were significantly decreased,and the expression of activated caspase-3,p-JAK2,p-STAT1 and p-STAT3 in intestinal tissues was down-regulated in group D (P<0.05).Compared with group D,the concentrations of iFABP,LPS,TNF-cα and HMGB1 in serum,intestinal damage scores and W/D ratio were significantly increased,and the expression of activated caspase-3,p-JAK2,p-STAT1 and p-STAT3 in intestinal tissues was up-regulated in group D+A (P<0.05).The pathological changes of intestinal tissues were significantly attenuated in group D as compared with group LT.Conclusion The mechanism by which dexmedetomidine pretreatment reduces intestinal injury may be related to inhibition of JAK/STAT signaling pathway activation in rats undergoing liver transplantation.