2.Effect of tranexamic acid on inflammatory response in pafiens undergoing off-pump coronary artery bypass grafting
Guyan WANG ; Dong WANG ; Jing SHI ; Yu ZHANG ; Jia SHI ; Zhongrong FANG ; Fang CHEN ; Lihuan LI
Chinese Journal of Anesthesiology 2011;31(7):781-783
ObjectiveTo investigate the effect of tranexamic acid on inflammatory response in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods Sixty ASA Ⅰ -Ⅲ and NYHA Ⅰ -Ⅲ patients of both sexes,aged 45-64 yr,with body mass index 16-22 kg/m2,undergoing elective OPCABG,were randomly divided into 2 groups ( n =30 each):control group (group C) and tranexamic acid group (group T).Anesthesia was induced with iv injection of midazolam,fentanyl and pipecuronium.The patients were tracheal intubated and mechanically ventilated.PETCO2 was maintained at 35-45 mm Hg.Tranexamic acid 1 g was infused intravenously over 30 min after induction followed by continuous infusion at 400 mg/h until the end of operation in group T.While equal volume of normal saline was given in gtoup C.Anesthesia was maintained with inhalation of isoflurane and intermittent (i)v boluses of fentanyl and pipecuroninm.Venous blood samples were taken before induction,at the end of operation and 24 h after operation for determination of Hb,platelet count,prothrombin time,international normalized ratio and plasma D-dimer and IL-6 concentrations.The volume of chest tube drainage was collected and recorded at 6 and 24 h after operation.The requirement for transfusion of allogeneic red blood cells and fresh frozen plasma was recorded.The complications during hospital stay were also recorded.ResultsCompared with group C,the plasma concentrations of D-dimer and IL-6 were significantly decreased at the end of operation and 24 h after operation,and the volume of chest tube drainage and the requirement for transfusion of allogeneic red blood cells and fresh frozen plasma were significantly decreased after operation in group T ( P < 0.05 or 0.01).There was no significant difference in Hb,platelet count,prothrombin time and international normalized ratio between the two groups (P > 0.05).No complications occurred during hospital stay in the two groups.ConclusionTranexamic acid can reduce inflammatory response in patients undergoing OPCABG.
3.Involvement of Na~+ ,K~+ -ATPase in hypoxia-induced increase of cytosolic Ca~(2+) in rat cortical neurons
Shi LI ; Fang GUO ; Hui DONG ; Yongl WANG
Academic Journal of Second Military Medical University 1982;0(01):-
Objective:To investigate the effect of Na + , K + -ATPase on the increase of cytosolic Ca 2+ level induced by hypoxia in rat cortical neurons. Methods: Using confocal laser scanning microscope and video based motion edge detection system, we measured the intracellular Ca 2+ concentration (\ i ) and Na + concentration (\ i ) in cortical neurons exposed to hypoxia for different time periods and at presence of different concentrations of dihydroouabain (DHO, an inhibitor of Na + , K + -ATPase). We also observed the effect of Na + , K + -ATPase on the increase of cytosolic Ca 2+ level induced by hypoxia in rat cortical neurons. Results: DHO (10 -9 -10 -3 mol/L) dose-dependently and hypoxia(4-20 min) time-dependently increased the levels of \ i and \ i in cultured cortical neurons. \ i and \ i increased significantly 4 min after cortical neurons were exposed to hypoxia, and addition of DHO (10 -3 mol/L) further increased their concentrations. While 15 min after hypoxia exposure, different concentrations of DHO did not further increase \ i and \ i. We also found that hypoxia exposure did not enhance DHO pretreatment-induced \ i increase. Conclusion: Inhibition of Na + , K + -ATPase activity is one of the mechanisms responsible for hypoxia-induced elevation of \ i in cortical neurons.
4.Dynamic Change of Cerebral Blood Flow of Newborns with Hypoxic-Ischemic Encephalopathy
shi-qing, SHAO ; dong-mei, NING ; shu-fang, JIN
Journal of Applied Clinical Pediatrics 2004;0(12):-
Objective To observe the dynamic change of cerebral blood flow of newborns with hypoxic-ischemic encephalopathy(HIE).Methods Cerebral blood flow of middle cerebral artery and pulsatility index(PI) on 75 newborns with HIE and 50 normal infants were examined with transcranial doppler sonography at different time points,and the relations between cerebral blood flow and clinic indexes were analyzed.Results The blood velocity of normal infants increased gradually, and PI decreased from 2 to 5 days.The velocities were lower than that of normal infants,and PI was higher at 12th hour and 1st day, but during 2-5 days,the velocities got higher and PI got lower, in which the decrease of velocities correlated positively with Apgar scores and the increase of velocities were negatively correlative to Apgar scores.Compared with the neonates who had poor prognosis retrospectively with those had good prognosis, the velocity changes were found to be more significant.Conclusion The change of cerebral blood flow can show the pathophysiology of HIE and prognosticate the prognosis of neonates with HIE.
5.Closure of large full thickness stomach wall defect with a newly designed hemostatic clip
Dong WANG ; Xingang SHI ; Jun FANG ; Jing XIE ; Zhaoshen LI
Chinese Journal of Digestive Endoscopy 2015;32(11):754-757
Objective To design a hemostatic clip and evaluate its efficacy and success rate of closure of stomach wall defect after full thickness resection (FTR).Methods A full thickness circular or linear resection (3 to 5 cm) was made on each model's antrum with needle knife and insulated-tip knife.The specimens were divided into 2 groups, using either an interrupted or continuous suturing method.Then the closure condition, suturing time, number of clips required and success rate of closure were compared.Results All 12 defects were successfully closed.The average closing time of interrupted and continuous suturing group were 13.33 ± 1.09 and 10.17 ±2.11 minutes, and the mean number of clips used were 4.67 ± 0.82 and 2.67 ± 0.82.The success rate was 100%.Conclusion This newly designed clip is a fast, reliable and convenient tool for stomach wall defect closure after FTR.
7.A Scratch-wound Model in Cultured Rat Astrocytes
Zhongfang SHI ; Ming HAN ; Lixin XU ; Liping DONG ; Fang YUAN
Chinese Journal of Rehabilitation Theory and Practice 2007;13(12):1132-1133
Objective To reproduce a scratch-wound model in cultured rat astrocytes (AST).Methods The secondary cultured AST prepared from newborn Wistar rat cerebral cortex were scratched with plastic pipette tips. The morphologic change of AST was observed through microscope at 10 min before and 1, 3, 6, 12, and 24 h after injury, meanwhile the lactate dehydrogenase (LDH) leakages in the cultured medium were determined.Results Immediately after injury the edge of the scratch was lined with irregularly shaped cell. 6 h after injury the AST processes began extending to cell-free area, and elongated further at 12 and 24 h after injury, with presented of new generated cells in the denuded area. At different times after injury, the LDH leakages of the experiment group were higher than that before injury ( P<0.05), and were higher than that of the control group ( P<0.05).Conclusion According to observed AST morphologic changes and determined LDH leakages in culture medium, the scratch-wound model in cultured rat AST is successfully reproduced.
8.Antimicrobiai bioceramic combined with chitosan and ceftriaxone sodium:Preparation and its in vitro and in vivo study
Rui XIA ; Shi-yuan FANG ; Wei XU ; Hang DONG ; Yue'e FANG
Chinese Journal of Microsurgery 2009;32(6):474-476
Objective To synthesize antimicrobial bioceramic using chitosan and calcium phosphate cements mixed with ceftriaxone sodium. Methods The bioceramic was synthesized through the hardening of chitosan liquid combined with calcium phosphate cements and cefiriaxone sodium.The released ceftriaxone sodium was studied according to the linear equation between UV-VIS absorbance to concentration.The in vitro bactefiostatic effect of the chosen bioceramic was investigated via the microbiological method.The model of rats'contaminated bone defect were deployed to study the antimicrobial performance of the bioceramic. Results The best synthesis condition was chosen at:0.1g calcium phosphate cements and 10.4 mg ceftriaxone sodium combined with 2.4 ml hardening liquid C.then keeping the mixture at 60℃ and 100%humidity for 24 h.In vitro release of the resulting antimicrobial bioceramic remained stable,while that of ceftriaxone sodium lasted for a week,higher than the minimal inhibitory concentration(MIC) of Staphylococcus aureus.As proved by the WBC number and tissue sectioning,a lighter inflammatory response of treatment group was observed as compared with the control group. Conclusion The antimicrobial bioceramic combined with chitosan and ceftriaxone sodium shows promising antimicrobial performance.
9.Effect of Methylene Blue on Blood-brain Barrier after Focal Cerebral Ischemia-reperfusion in Rats
Min WU ; Qing FANG ; Zhongfang SHI ; Lixin XU ; Liping DONG ; Xu YAN ; Shaohua YANG ; Fang YUAN
Chinese Journal of Rehabilitation Theory and Practice 2016;22(2):125-131
Objective To investigate the protective effect of methylene blue (MB) on blood-brain barrier (BBB) injury after focal cere-bral ischemia-reperfusion in rats. Methods 18 male Sprague-Dawley rats were randomly divided into sham-operated group (n=6), model group (n=6) and MB treatment group (n=6). The left middle cerebral arteries were occluded for 1 hour and reperfused. MB was infused intra-venously immediately after reperfusion (3 mg/kg) and again 2 hours post-reperfusion (1.5 mg/kg), while normal saline was administered in the model group. The sham-operated group was treated as same as the model group without occlusion and infusion. HE staining was used to observe the histological injury in the cortex around the infarcted region 47 hours after reperfusion, while albumin immunohistochemistry was used to evaluate the permeability of the BBB, and immunohistochemistry and double immunofluorescence staining were used to exam-ine the expressions of glial fibrillary acidic protein (GFAP) and aquaporin-4 (AQP-4). Results HE staining showed that cells and blood ves-sels were not intact in the cortex around the infarcted region in the model group and they were better in the MB treatment group. The expres-sions of the albumin, GFAP and AQP-4 were higher in the model group than in the sham-operated group (P<0.01), and were lower in MB treatment group than in the model group (P<0.05). The double immunofluorescence staining showed the colocalization of GFAP and AQP-4 in the astrocytes. Conclusion MB may ameliorate the BBB disruption induced by focal cerebral ischemia-reperfusion through reducing glio-cyte proliferation and down-regulation of AQP-4 expression in rats.
10.Efficacy analysis on arterial catheter stents for pulmonary atresia with intact ventricular septum in newborns
Zhongjian CHEN ; Fang LI ; Bo ZHAI ; Zhenliang CHEN ; Penggao WANG ; Lei SHI ; Fang YANG ; Xiangyang DONG ; Wenbo YU
Chinese Journal of Applied Clinical Pediatrics 2016;31(23):1795-1798
Objective To compare the efficacy of arterial stenting with that of traditional B -T shunt for neo-natal pulmonary atresia with intact ventricular septum.Methods Twenty -six cases of neonatal pulmonary atresia with intact ventricular septum were treated at Children′s Hospital of Zhengzhou from December 2005 to December 201 5,aged 3 to 23 days[(8.20 ±4.80)days],and weighted 2.80 -3.88 (3.41 ±0.27)kg.Accompanied with pulmonary hypo-plasia,all these patients were combined with PDA and ASD or PFO.Before operation,the peripheral oxygen saturation was kept in 61 % -75%,averaged at 67%.Among them,1 2 cases underwent arterial catheter stenting,and 1 4 cases re-ceived B -T shunt (including modified B -T shunt and central shunt)ductus ligation.After operation,the oxygen satu-ration in these children was observed,and they were examined by echocardiography and true lateral chest X -ray,blood flow situations in stents and shunts were assessed,and follow -up examinations were conducted in 1 ,3,6 and 1 2 months postoperatively.Results Stents were successfully inserted into these 1 2 cases.After traditional pulmonary shunt,pa-tients′peripheral oxygen saturation was (82.73 ±5.59)%,compared with that of patients after arterial catheter sten-ting (86.1 8 ±3.1 9)%,there was significant difference(t =1 0.71 ,P <0.05).In pulmonary shunt group,2 cases died,1 case died of postoperative heart failure,and the other case was complicated with pulmonary infection and died of respiratory failure;in catheter stent group,1 case was complicated with postoperative supraventricular tachycardia and recovered after drug intervention.For the follow -up examinations 1 ,3,6 and 1 2 months after the operation,1 case of B -T shunt in pulmonary shunt group was improved by central shunt due to slow blood flow,less shunt volume,and ox-ygen saturation decreased to 69%.For the catheter stent group,1 case was improved by stent balloon dilatation due to declined peripheral oxygen saturation 2 months postoperatively,and after the operation,transcutaneous oxygen saturation was improved.No patients died in the catheter stent group.Conclusions In traditional B -T shunts,the operation is extensive,and complications are common,and the recovery turns slowly.Arterial catheter stenting can be used as the preferred method of treatment for one -stage surgical pulmonary atresia with intact ventricular septum to reduce the weakness feasibly and effectively.