Objective To analyze the risk factors of acute kidney injury (AKI) in the patients undergoing gastrointestinal surgical procedures.Methods We retrospectively analyzed all gastrointestinal surgical patients nearly 2 years who were in the first affiliated hospital of Kunming Medical University and the first people's hospital of Yunnan province.Results The incidence of AKI was 2.1%.Univariate analysis and multivariate analysis indicated that: age>65 years, emergency operation and serious infection were significantly related with the incidence of AKI.Conclusion AKI is a common complication after gastrointestinal surgical procedures.This study showed that age>65 years, emergency operation, serious infection were risk factors most likely associated with postoperative AKI development.

Objective To observe the influence of hands-washing and non-hands-washing on clinical disinfection effect before surgical hands antisepsis.Methods Totally 40 surgcal staff wee divided into the handa-washing group and the non-hands-washing group.The sterilizing effect of handa at diggerent time points during operations and kinds of bacteria colony were compared between two groups.Results Bacteria colony of hands at different time points during operations showed no significant difference between two groups.Both groups were detected bacteris colony on their hands,mainly made up of coagulase negative staphylococcus,corynebacterium and eaterococcus and no difference was seen between two groups.Conchusions The non-hands-washing method can acquire the same disinfection effect as traditional hands-washing method.Its disinfection effect lasts three hours,easy to operate,little stimulation on the skin,and was worthy of clinical application.

Objective To observe the action of Rhodiola Crenulate(RC) oral liquid reproduction function for the male rats. Methods 100 SD rats were randomly divided into 5 groups with equal gender number respectively. The male rats were given RC oral liquid (0, 2.48 g/kg, 7.48 g/kg, 24.80 g/kg) and Nanbao (2.00 g/kg)by oral twice a day for 48 d, respectively. Then the male rat was put into the same box in which the female rat whit two-side ovarys were excised for 15 d, respectively. The intercoursing ability,testosterone levels, and the weight of immune organs of the male rats were examined. 40 four-week-old rats were divided into 5 groups. Except for blank control, all rats's testis were excised. The castrated rats were treated with RC oral liquid (2.48 g/kg, 24.8 g/kg)and Methyltestosterone (2.00 mg/kg). The blank control group and model control group were given the same dose NS by oral twice a day for 28 d, respectively. The weight of accessory sex organs in castrated rats was observed. Results The level of testosterone and the organ coefficients of thymus and spleen in RC oral liquid groups were higher than blank control (P<0.05 or P<0.01).The weight of accessory sex organs of castrated rats in RC oral liquid groups were heavier than model control (P<0.05). Conclusion RC oral liquid can improve the reproduction function in male rats.

Objective To improve understanding of infectious mononucleosis by reporting the clinical data of 21 adults diagnosed as infectious mononucleosis.Methods We investigated retrospectively the clinical and laboratory data of 21 patients diagnosed as infectious mononucleosis.Results Among those 21 cases,the manifestations were fever(19 cases,90%),angina(14 cases,67%),lymphadenopathy(15cases,71%),hepatosplenomegaly (9 cases, 43%).Laboratory results showed that increased leucocyte count (10 cases,48%),high percentage of abnormal lymphocytes between 10% to 29%(14 cases,67%),abnormal liver function(18 cases,86%),positive Epstein -Barr virus capsid antigen IgM(18 cases,86%).All 21 patients were get better.Conclusion It showed that the clinical manifestations of infectious mononucleosis in adults were complex and diverse.The diagnosis should be combined with clinical manifestations and relevant examination.The outcome of this disease is good.

Objective To explore the influencing factors of late diagnosis for newly diagnosed HIV/AIDS positive patients in Guangxi in 2015.Methods The CD4 + T lymphocytes count which was first detection for newly diagnosed HIV/AIDS positive patients in Guangxi during 2015 was collected.Data were statistically analyzed.Results We collected 8 586 newly diagnosed HIV/AIDS whose median CD4+ T lymphocytes counts was 237.5 cells/μl,and 43.12％ of them had less than 200 cells/μl.Gender,age,occupation,marriage,nation,education,route of transmission,types of testing and region had effects on late HIV diagnosis(all P ＜ 0.05).Logistic analysis found that risk factors associated with the late diagnosis of HIV were male(OR =1.851,95％ CI:1.673-2.048),migrant worker (OR =1.387,95％ CI:1.242-1.549),education below middle and secondary school(OR =1.619,95％ CI:1.400-1.873),currently married(OR =1.207,95％ CI:1.075-1.354),divorced or widowed(OR =1.508,95％ CI:1.309-1.738).Voluntary testing was a protective factor.Conclusions The prevalence the late diagnosis of HIV was high in Guangxi in 2015,it is crucial for related departments to enhance the testing and screening effort for HIV/AIDS.

Objective To observe the effect of dexmedetomidine combined with goal-directed fluid therapy(GDFT)on hemodynamics and cerebral oxygen supply of patients undergoing cerebral aneurysm clipping.Methods A total of 78 patients undergoing cerebral aneurysm clipping surgery in Jinhua Municipal Central Hospital from January 2021 to December 2022 were selected and divided into control group and observation group according to random number table method,with 39 cases in each group.The patients in control group received conventional fluid therapy,and the patients in observation group received dexmedetomidine pump +GDFT.Mean arterial pressure(MAP),heart rate(HR),cardiac index(CI),brain metabolic markers,neuron specific enolase(NSE),S100β levels and mini mental status examination(MMSE)scores at different time points[before anesthesia induction(T0),immediately after tracheal intubation(T1),beginning of surgery(T2),opening meninges(T3),immediately after aneurysm clipping(T4),end of surgery(T5),24h after surgery(T6),72h after surgery(T7)],and fluid intake and outflow of two groups were compared.Results MAP at T1-T4 and CI at T1-T3 in observation group were significantly higher than those in control group(P<0.05).The colloid volume,total infusion volume and urine volume in observation group were significantly higher than those in control group(P<0.05).The serum levels of NSE and S100β at T5-T7 were significantly higher than those at T0 in both groups(P<0.05).The levels of serum NSE and S100β at T5 and T6 in observation group were significantly lower than those in control group(P<0.05).The oxygen content in jugular venous blood(CjvO2)at T1-T4 was significantly lower than that at T0 in control group(P<0.05).Cerebral oxygen extraction ratio at T1 was significantly higher than that at T0 in both groups(P<0.05).CjvO2 at T3-T4 in observation group were significantly higher than those in control group(P<0.05).At T6 and T7,MMSE scores in two groups were significantly lower than at T0 in this group(P<0.05).MMSE score at T6 of observation group was significantly higher than that of control group(P<0.05).Conclusion Dexmedetomidine combined with GDFT can effectively improve preload and brain function,stabilize intraoperative circulatory function,and improve early postoperative cognitive function in patients undergoing cerebral aneurysm clipping.

Objective To explore the effects of remote ischemic preconditioning combined with permissive hypercapnia on brain oxygen saturation and postoperative cognition in patients which undergoing thoracoscopic lung cancer surgery.Methods A collection of 64 patients elective requiring thoracoscopic lung cancer surgery who were divided into control group and combined group according to the randomized grouping method,with 32 cases in each group.The PaCO2 in the control group of patient was maintained at normal,and patients in the combination group were given permissive hypercapnia ventilation strategies and performed remote ischemic preconditioning,PaCO2 is maintained at 45-50mmHg(1mmHg=0.133kPa).Record the cerebral oxygen saturation(rSO2)at the five time points before operation(T0),10min after one lung ventilation(T1),30min after one lung ventilation(T2),10 min after lung recruitment(T3)and the end of surgery(T4),measured the internal jugular venous blood oxygen saturation(SjvO2)and calculated cerebral arteriovenous blood oxygen content difference(CaO2-CjvO2),brain oxygen uptake rate(CERO2).Monitored the average arterial pressure(MAP)and heart rate(HR)of the hemodynamic indicators at the above five time points.The scores of cognitive function were recorded 1 day before operation and 1 day and 3 days after operation;detected the levels of serum neuron-specific enolase(NSE),amyloid β(Aβ)and S100β protein(S100β)in 1 day before surgery,24hours after surgery and 48hours after surgery;Comparison of postoperative related indicators and adverse reactions between the patients of two groups.Results The rSO2 and SjvO2 of combined group were higher than control group in the T1-T4,but CaO2-CjvO2 and CERO2 were lower than those of control group.There was no significant difference in HR and MAP between two groups from T0-T4.The mini-mental state examination(MMSE)score of the combined group was significantly higher than that of the control group on the 1 day after operation.The level of serum NSE,Aβ and S100β in the combined group was lower than those of control group at 24hours and 48hours after operation.There was no significant difference in incidence of postoperative adverse reactions and postoperative related indexes between the two groups.Conclusion Permissive hypercapnia combined with remote ischemic preconditioning can increase cerebral oxygen saturation in patients undergoing thoracoscopic lung cancer surgery,improve cerebral oxygen metabolism and reduce the levels of serum neuron-specific enolase,β-amyloid protein and S100β protein,decrease the postoperative cognitive dysfunction.

OBJECTIVE: To explore the expression, localization and regulatory effect on mitochondrial calcium signaling of Rictor in embryonic stem cell-derived cardiomyocytes (ESC-CMs). METHODS: Classical embryonic stem cell cardiomyogenesis model was used for differentiation of mouse embryonic stem cells into cardiomyocytes. The location of Rictor in ESC-CMs was investigated by immunofluorescence and Western blot. The expression of Rictor in mouse embryonic stem cells was interfered with lentiviral technology, then the superposition of mitochondria and endoplasmic reticulum (ER) in ESC-CMs was detected with immunofluorescence method; the cellular ultrastructure of ESC-CMs was observed by transmission electron microscope; the mitochondrial calcium transients of ESC-CMs was detected by living cell workstation;immunoprecipitation was used to detect the interaction between 1,5,5-trisphosphate receptor (IP3 receptor, IP3R), glucose-regulated protein 75 (Grp75) and voltage-dependent anion channel 1 (VDAC1) in mitochondrial outer membrane; the expression of mitochondrial fusion protein (mitonusin-2, Mfn2) was detected by Western blot. RESULTS: Rictor was mainly localized in the endoplasmic reticulum and mitochondrial-endoplasmic reticulum membrane (MAM) in ESC-CMs. Immunofluorescence results showed that Rictor was highly overlapped with ER and mitochondria in ESC-CMs. After mitochondrial and ER were labeled with Mito-Tracker Red and ER-Tracker Green, it was demonstrated that the mitochondria of the myocardial cells in the Rictor group were scattered, and the superimposition rate of mitochondria and ER was lower than that of the negative control group (<0.01). The MAM structures were decreased in ESC-CMs after knockdown of Rictor. The results of the living cell workstation showed that the amplitude of mitochondrial calcium transients by ATP stimulation in ESC-CMs was decreased after knockdown of Rictor (<0.01). The results of co-immunoprecipitation showed that the interaction between IP3R, Grp75 and VDAC1 in the MAM structure of the cardiomyocytes in the Rictor group was significantly attenuated (<0.01); the results of Western blot showed that the expression of Mfn2 protein was significantly decreased (<0.01). CONCLUSIONS Using lentiviral technology to interfere Rictor expression in mouse embryonic stem cells, the release of calcium from the endoplasmic reticulum to mitochondria in ESC-CMs decreases, which may be affected by reducing the interaction of IP3R, Grp75, VDAC1 and decreasing the expression of Mfn2, leading to the damage of MAM structure.
Animals ; Calcium Signaling ; genetics ; Gene Expression Regulation ; genetics ; Gene Knockdown Techniques ; Mice ; Mitochondria ; physiology ; Mouse Embryonic Stem Cells ; Myocytes, Cardiac ; physiology ; Protein Transport ; Rapamycin-Insensitive Companion of mTOR Protein ; genetics ; metabolism

Objective To evaluate the relationship between perioperative myocardial injury(PMI)and serum N/OFQ levels in elderly patients with coronary heart disease.Methods Totally 120 elderly patients who underwent hip fracture surgery under general anesthesia from January 2022 to May 2023 were included,including 60 patients with coronary heart disease(CHD group)and 60 patients without coronary heart disease(control group).The venous blood of patients was collected 10 minutes before anesthesia induction(T0),12 hours after surgery(T1)and 24 hours after surgery(T2)to detect the content of N/OFQ and high-sensitivity myocardial troponin I(hs-cTnI)in serum.Record perioperative adverse cardiovascular events(PACE)and the use of vasoactive drugs during surgery.Results Compared with the control group,the N/OFQ and hs cTnI levels at T0 and T1 in the CHD group were significantly increased(P<0.05).There was a positive correlation between N/OFQ and hs-cTnI levels at T1 and T2 in CHD and control group(P<0.05).The use of PACE and intraoperative vasoactive drugs in the CHD group was higher than that in the control group(P<0.05).Conclusion There is a correlation between the increased N/OFQ content and PMI in elderly patients with coronary heart disease after surgery,which may become an early predictive indicator of PMI.