OBJECTIVE:To study the mechianism of inhibitory effect of ulinastain on inflammatory factors of patients during cardiopulmonary bypass(CPB)cardiac surgery. METHODS:Totally 40 patients underwent selective CPB cardiac surgery collected from our hospital during Jul. 2012-Jul. 2016 were divided into control group and observation group according to random number ta-ble,with 20 cases in each group. Observation group was given 300000 U of ulinastatin at 2.5 mL/min by intravenous pump within 20 min after anesthesia induction, then given 700000 U of ulinastatin at 0.2 mL/min by continuous intravenous pump until opera-tion finish. Control group was given equal volume of normal saline. Blood samples of patients were collected before anesthesia in-duction (before surgery) and 6,12,24 h after CPB (after surgery),respectively. The expression of miR-155 and its target gene MyD88 in peripheral blood mononuclear cells of each group were detected by Real-time PCR and Western blot. The expression of TNF-α,IL-6 and IL-8 were measured by ELISA. The correlation of miR-155 with the expression of TNF-α,IL-6 and IL-8 in pa-tients of observation group 24 h after surgery were analyzed by using Pearson correlation analysis. RESULTS:Compared with con-trol group,the expression of miR-155 in observation group was significantly increased,while the expression of its target gene MyD88 was significantly decreased;the expression of TNF-α,IL-6 and IL-8 were reduced significantly,with statistical signifi-cance(P<0.01). The expression of miR-155 was significantly negative correlation with the expression of TNF-α,IL-6 and IL-8 in the patients of observation group 24 h after surgery(P<0.01). CONCLUSIONS:Ulinastatin can inhibit the release of inflammatory factors TNF-α,IL-6 and IL-8 by inducing the expression of miR-155,which may be a new mechanism for the anti-inflammatory ef-fect of the drug in CPB cardiac surgery.

Objective To investigate the feasibility and efficacy of endoscopic catheterization of ileus tube combined enterectomy for the treatment of elderly patients with acute sigmoid volvulus. Methods From August 2015 to August 2017,27 cases of elderly patients with acute sigmoid volvulus received treatment of endoscopic placement of ileus tube combined enterectomy in Pudong New Area Gongli Hospital.Retrospectively collected clin-ic parameters of pre-catheterization,post-catheterization,enterectomy and postoperative follow-up;the success rate of catheterization and enterectomy,compression efficiency,post-operative complications,and efficacy of the com-bined therapy were analyzed. Results Emergency catheterizations of anorectal ileus tube were succeeded in 27 (100%)patients;one patient who developed intestinal gangrene received emergency enterectomy,the hemogram and internal environmental disturbance of the 26 cases were significantly relieved,and the efficacy rate of decom-pression was 96.3%. The success rate of was enterectomy was 100%;the incidence of severe complications and mortality were 22.2% and 3.7%,respectively. During the follow-up,2(7.4%)patients developed ileus,and the efficacy rate of the combined therapy was 85.2%. Conclusions The catheterization of ileus tube could effectively depress intestinal pressure. The success rate of enterectomy was significantly improved and postoperative mortality was reduced. The therapy of endoscopic ileus tube catheterization combined enterectomy is a safe and effective method for the treatment of acute sigmoid volvulus in the elderly.