Objective To explore the value of neutiophil gelatinase-associated lipocalin ( NGAL) taken from blood and urine samples in early diagnosis of acute kidney injury ( AKI) after heart valves replacement surgeries. Meth-ods A total of 56 patients received heart valves replacement surgeries were selected prospectively in this study. NGAL from blood and urine samples and serum creatinine ( Scr) were tested among them at different moments. AKI and non-AKI groups were divided based on Scr levels and the value of NGAL taken from blood and urine sam-ples was estimated in early diagnosis of AKI with receiver operating characteristic curve ( ROC) . Results 16 AKIs were observed among all of them. The peak value of Scr in AKI group was shown between 12 and 24 hours after surgeries, while blood-NGAL was seen high significantly (P<0.05) since 2 hours after surgeries, peak value at 4 hours, for urine-NGAL, peak value was seen at 2 hours. The area of ROC of blood-NGAL 4 hours and urine-NGAL 2 hours after surgeries for AKI diagnosis were 0.891 and 0.934, respectively. The better sensitivity and specificity were shown in both threshold set as 50 μg/L and 110 μg/L. Conclusion Blood-NGAL and urine-NGAL can be used as early diagnostic markers of AKI after heart valves replacement surgeries, whose change is significantly earli-er than that of Scr.

Objective To explore the effects of penehyclidine hydrochloride (PHC) on lung epithelial type Ⅱcells against oxidative stress damage. Methods A549 cells treated with H2O2 were used as oxidative stress damage cell model. A549 cells were divided into 3 groups: control group (C group), H2O2 treated group (H group) and PHC treated group (P group). The viability of A549 cells was measured by MTT assay. The apoptotic rate was measured by TUNEL assay. The lev?els of malonicdialed (MDA), reactive oxygen species (SOD), reduced glutathione hormone (GSH) and nicotinamide adenine dinucleotide phosphate (NADPH) of cells were detected by biochemistry colorimetry. Results Compared with group C, the viability of A549 and the contents of SOD, GSH and NADPH were significantly decreased in group H, while MDA content and apoptotic rate were increased (P<0.05). Compared with group H, the viability of A549, the contents of SOD, GSH and NADPH were significantly increased in group P, while MDA content and apoptotic rate were reduced (P<0.05). Conclu?sion Penehyclidine hydrochloride shows protective effects on A549 cells through reducing the oxidative damage induced by H2O2.

Objective To compare the advantages and disadvantages of uniportal video-assisted thoracic surgery(uniportal-VATS)and three portal VATS in treatment of benign pulmonary diseases. Methods The clinical data of 66 patients with benign pulmonary disease treated by VAST from June 2015 to October 2016 were retrospec-tively analyzed. The patients were divided into two groups according to the specific operation. There were 32 patients (18 males and 14 females)in uniportal-VATS group. There were 34 patients(18 males and 16 females)in three portal VATS group. The operative time ,intraoperative blood loss ,thoracic drainage volume at 24 h after opera-tion,incision length,and the time of postoperative drainage of thoracic cavity,postoperative third day pain score and complication rate were compared between the two groups. Results The patients in the experimental and the control groups were successfully operated according to the scheduled protocol. No thoracotomy was performed. There was no statistical difference in the volume of blood loss,the volume of pleural drainage after 24 hours,the time of postoperative drainage of thoracic cavity ,the length of hospital stays and postoperative complications in uni-portal-VATS group and three portal VATS group(P>0.05). The pain score and postoperative third day pain score of the uniportal-VATS group was better than that of the three portal VATS group(P<0.05),but the operation time of the uniportal-VATS group was longer than that of the three portal VATS group(P<0.05). Conclusion Uniportal-VATS is safe and feasible for the treatment of benign lung diseases. It is more minimally invasive and beautiful than traditional three-hole thoracoscopic surgery. It is worthy of promotion and has broad prospects.

AIM: To evaluate the reliability of making a research model of coronary artery stenosis and local myocardial infarction reproduced in dog by ligating canine LAD. METHODS: We disparted 30 aged healthy cross-breed dogs [(18.5?6.7) kg] into three groups. The near part of the LAD through left minimal thoracic incision was ligated to interdict 25% (group A), 50% (group B), 75% (group C) of the flux, respectively. The changes of plasma endothelium-derived factors NO, ET-1, sP-selectin and CTnT were measured before ligation and at different time points after ligation. The expression of P-selectin gene in cardiac muscle was detected by Western blotting. The segments of distal parts of the ligated LAD were cut and pathological changes of the patches of topical cardiac muscle were observed by electronic microscope. RESULTS: After ligation, NO/ET-1, P-selectin and CTnT had significant changes in group B (P

Objective To evaluate the value and limitation of primary MSCT examination for rib fractures in a short interval. Methods Seventy-two cases with rib fractures were analyzed retrospectively.All of them underwent primary MSCT examination within the three days after trauma,and MSCT examination of chest,epigastria,rib or X-ray examination of rib for 1-6 times in the following 8 weeks.41 cases underwent X-ray examination firstly before MSCT examination.The total number of rib fractures was determined according to the compositive results of every examination.Diagnosis rate of the primary MSCT and X-ray examination were compared with each other.Results Among 72 cases,404 fractures in 325 ribs were diagnosed.Primary MSCT diagnosed 305 confirmed fractures and 28 doubtful fractures,and 84 fractures were not detected with diagnosis rate of 75.5%.13 of 28 suspected fractures were ruled out by the following re-examinations.The MSCT and X-ray diagnostic rates were 72.1%、50.3%,respectively for 41 cases who underwent X-ray examination firstly.Four fractures showed by X-ray plain film were not shown by primary MSCT.Conclusion There is a certain proportion of cases diagnosed as obscure or doubtful rib fracture by the primary MSCT. Therefore,diagnosis should be closely combined with the re-examination results of MSCT and X-ray plain film,especially MSCT ex-amination between the fourth and eighth weeks after trauma.

Objective To explore lung protection effect of levosimendan(LS) during cardiopulmonary bypass in canine model by ratio between dry and wet (W/D) lung tissue,concentrations of malonaldehyde (MDA) and superoxide dismutase (SOD) and alterations of histology.Methods A total of 32 canines were divided into 4 groups at random with the procedure of myocardial blocking for 1 hour and then recovering for 2 hours.Animals in 4 groups were handled as following:No any special treatment after myocardial blocking in control group(group C).Lung perfusion was performaned with cold oxygenated blood after myocardial blocking in experiment 1 group(group P).LS(65 μg/kg) was injected intravenously before thoracotomy in experiment 2 group(group LSIV) and remaining procedure was same to the control one.Combined with LS (65 μg/kg),lungperfusion was performaned with cold oxygenated blood after myocardial blocking in experiment 3 group(group LSP).Right lung tissue of canines was taken immediately after the study for observing pathological alterations and measuring the concentrations of MDA and SOD through corresponding procedure.Results Compared with group C,the ratios of W/D and the concentrations of MDA were lower significantly,while those of SOD were higher significantly(P ＜ 0.05).Compared with group P and LSIV,the concentration of MDA was lower significantly,while that of SOD was higher significantly(P ＜ 0.05).There was no significant difference between group P and LSIV(P ＞0.05).Less impairment of lung tissue was found after LS intervention by light and electric microscope.Conclusion LS plays an important role in protecting lung tissue,based on founding in canine model,with decreasing ration of W/D and concentration of MDA and increasing that of SOD by both intravenous injection and lung perfusion.

Objective To investigate the effect of flow rate on pH,urine volume and cerebral oxygen saturation during cardiopulmonary bypass (CPB) in patients with valvular heart disease.Methods 40 with valvular heart disease were divided into the high flow group (n =20) and the low flow group (n =20).The cerebral oxygen saturation value,lactic acid,BE value and the amount of urine between the two groups after induction of anesthesia (T1),at the beginning of CPB (T2),5 min after declamping shock (T3),5 min after recovery temperature (T4),5 min after aortic opening (T5),5 min after the end of aortic bypass (T6) were compared.Results (1) The cerebral oxygen saturation at the beginning of T2 was slightly lower than that of T1 after anesthesia induction.(2) The cerebral oxygen saturation was slightly higher and the absolute value of lactic acid and BE was slightly lower at T4 than that of T3.(3) The cerebral oxygen saturation was higher and the absolute value of BE was lower at T5 than that of T4.(4) The cerebral oxygen saturation of high flow group at T3,T4 and T5 was higher than that of the low flow group,while the absolute value of lactic acid and BE was lower than that of the low flow group.Conclusion High flow rate can increase cerebral oxygen saturation,reduce blood lactic acid,maintain the balance of pH,and increase renal blood perfusion.

BACKGROUND AND OBJECTIVES: To explore the lung-protective effect of levosimendan (LS) during cardiopulmonary bypass in a canine model by determining the wet/dry weight (W/D) ratio of lung tissue, malonaldehyde (MDA) and superoxide dismutase (SOD) concentrations, and performing a histological evaluation. MATERIALS AND METHODS: Thirty-two canines were divided randomly into four groups and underwent a routine aortic cross-clamping cardiopulmonary bypass procedure for 1 h, followed by recovery for 2 h. Animals were handled as follows: group C (means control group), no special treatment after aortic cross clamping; group P (means pulmonary artery perfusion group), pulmonary artery perfusion with cold oxygenated blood after aortic cross clamping; group LSIV (means intravenous injection of LS group), intravenous injection of LS (65 µg/kg) before thoracotomy, and the rest of the procedure was identical to the control group; group LPS (means pulmonary perfusion with LS group), pulmonary perfusion with cold oxygenated blood combined with LS (65 µg/kg) after aortic cross clamping. Lung tissues were removed and subjected to evaluation of pathological alterations, W/D ratio and MDA and SOD concentrations. RESULTS: In group C, the W/D ratio and MDA concentration were higher, while the SOD concentrations were lower (p<0.05). Compared with groups P and LSIV, the MDA concentration was lower in group LPS, while that of SOD was higher (p<0.05); Light and electron microscopy indicated that LS intervention reduced impairment of lung tissues. CONCLUSION: Our findings suggest that LS plays an important role in protecting lung tissues.
Animals ; Cardiopulmonary Bypass* ; Constriction ; Injections, Intravenous ; Lung Injury* ; Lung* ; Malondialdehyde ; Microscopy, Electron ; Oxygen ; Perfusion ; Pulmonary Artery ; Superoxide Dismutase ; Thoracotomy

Objective To investigate the expression of glucogen branching enzyme 1 (GBE1) in hypoxic lung cancer tissues and cells, to evaluate its significance for hypoxia tolerance in lung cancer and to explore its mechanism of apoptosis of lung cancer. Methods Data of 20 patients with hypoxic lung cancer and normoxia lung cancer tissue microarray were downloaded through the GEO database, GCBI was used to screen the differential genes for GO and KEGG pathway analysis. In vitro culture of A549 cells was cultured and transfected with siGEBl for knock down or GBE1 for overexpression. After hypoxia treatment, cell viability was analyzed using MTT assay. Western blot and real-time PCR were used to detect the expression of apoptosis-related genes. Results The data from 20 cases of lung cancer specimens showed that 206 genes displayed differences, and the GBE1 was the most significant, GO and KEGG pathway analysis found that the differential gene involved in cell cycle, cell metabolism and other multiple access. The expression of GBE1 in A549 cells after hypoxia treatment was significantly increased, and GBE1 could significantly enhance the expression of apoptosis-related genes in A549 cells after hypoxia treatment. Over-expression of GBE1 could inhibit the expression of apoptosis-related genes. Conclusion GBE1 may be a potential marker of hypoxia tolerance in lung cancer, this study provide a reference for further study of hypoxia tolerance mechanism of lung cancer.

Objective    To compare the short-term outcomes of surgical repair for atrial septal defect (ASD) with a robotic (da Vinci Si) approach versus a conventional open procedure. Methods    Clinical data of 140 patients undergoing ASD closure in the First Affiliated Hospital of Anhui Medical University from January 2016 to May 2020 were retrospectively analyzed. The patients were divided into a robotic group and a sternotomy group according to different surgical methods. In the robotic group, there were 67 patients including 20 males and 47 females at a median age of 40.0 (25.0) years, and in the sternotomy group there were 73 patients including 23 males and 50 females at a median age of 41.0 (29.0) years. Multivariate linear regressions were used to produce risk-adjusted analysis of pertinent clinical characteristics. Kaplan-Meier analysis was performed to compare the speed of sternotomy versus robotic group returning to exercise or daily life. Results    Robotic-assisted surgery was associated with significantly shorter 24 h postoperative drainage volume [220.0 (210.0) mL vs. 345.0 (265.0) mL, P<0.001], mechanical ventilation [6.0 (11.0) h vs. 8.0 (11.0) h, P=0.024], intensive care unit length of stay (LOS) [19.0 (19.0) h vs. 22.0 (25.0) h, P=0.005], postoperative hospital LOS [9.0 (5.0) d vs. 10.0(6.0) d, P=0.003], and a lower rate of perioperative blood transfusion (28.36% vs. 84.93%, P<0.001). After controlling for patient comorbidity in the multiple regression model, there remained a trend toward decreased 24 h postoperative drainage volume (β=–115.30, 95%CI–170.78 to –59.82, P<0.001), mechanical ventilation (β=–4.96, 95%CI –8.33 to –1.59, P=0.004) and postoperative hospital LOS (β=–2.31, 95%CI –3.98 to –0.63, P=0.007) in the robotic group. Kaplan-Meier analysis revealed that patients returned to exercise or daily life earlier in the robotic group [35.0 (32.0) d vs. 90.0 (75.0) d, P<0.001]. Conclusion    Closure of ASD can be performed safely and effectively via robotic approach. And the minimally invasive technique is beneficial to postoperative recovery.