Objective To investigate the volume kinetics of 6% hydroxyethyl starch 130/0.4 in healthy volunteers.Methods Seven healthy volunteers aged 18-32 yr weighing 46-84 kg were selected in this study. 6% hydroxyethyl starch 130/0.4 30 ml/kg was infused over 60 min. Volume kinetics analysis of 6% hydroxyethyl starch 130/0.4 was performed with Matlab 6.0 software, compartment model was determined by F test.Results One-compartment model parameters: basic clearance, clearance and distribution volume of one-compartment model were (3.5 ± 1.3) ml/min,(19± 11) ml/min and (5746 ± 1371) ml respectively. Two-compartment model parameters: clearance, K1, the volume of central compartment, the volume of peripheral compartment, distribution volume of two-compartment model were (63 ±29) ml/min,(11 ±4) ml/min, (1551 ± 995) ml, (908 ±398) ml,(2460 ± 1332) ml respectively. There was no difference between the distribution volume of one-compartment model and blood volume of healthy volunteers ( P ＞ 0.05) .The distribution of infused 6% hydroxyethyl starch 130/0.4 was accordant with one-compartment model (F value was 3.81, P ＞ 0.05)and 4 h clearance was (75 ± 10)% .Conclusion The distribution of infused 6% hydroxyethyl starch 130/0.4 for volume expansion is accordant with one-compartment model, and the effective duration of plasma volume expansion is 4 h.

Objective To evaluate the effect of ropivacaine and bupivacaine on L-type calcium current (ICa-L) in ventricular myocytes of guinea pigs and to identify the probable mechanism of their negative inotropic effect on myocardium. Methods Single ventricular myocytes were enzymatically isolated from adult male guinea pigs weighing 300-350 g using the enzymatic dissociation method as described by Liu et al. The whole-cell patch clamp technique was used to record ICa-L Results 100 ?mol?L-1 ropivacaine and bupivacaine decreased the peak current of ICa-L by 37% ? 3% and 42% ? 5% respectively ( P

Objective To identify the risk factors for early postoperative elevation in body temperature in patients undergoing coronary artery bypass grafting (CABG).Methods Nine hundred and forty-one patients of both sexes,aged 14-70 yr,were assigned into hyperthermia (≥ 38 ℃) group or non-hyperthermia (＜ 38 ℃) group according to the bladder temperature at 8h after operation.Factors including age,sex,height,weight,complications (hypertension,hyperlipemia,diabetes),history of smoking and drinking,preoperative blood pressure,heart rate,ejection fraction,routine blood examination,routine urine examination,and respiratory function examination,intraoperative cardiopulmonary bypass (CPB) and hormone,operation time,extubation time,duration of stay in the intensive care unit,and blood pressure,heart rate,ejection fraction,routine blood examination,and routine urine examination at the end of operation,and postoperative analgesia were recorded.The risk factors of which P values were less than 0.05 would enter the multi-factor logistic regression analysis to stratify the risk factors for early postoperative elevation in body temperature after CABG.Results Six hundred and ninety patients developed early postoperative elevation in body temperature (73.3％).Logistic regression analysis showed that preoperative respiratory dysfunction,preoperative ejection fraction ≤ 50％ and CPB were independent risk factors for early postoperative hyperthermia after CABG (P ＜ 0.05).Conclusion Preoperative respiratory dysfunction,preoperative ejection fraction≤ 50％ and CPB are independent risk factors for early postoperative elevation in body temperature in patients undergoing CABG.

Objective To determine the risk factom for the development of systemic inflammatory response syndrome(SIRS)in patmnts after off-pump coronary artery bypass grafting(OPCABG).Methods Sixty NYHA Ⅰ or Ⅱ patients,aged 46-73 yr,weighing 54-110 kg,undergoing OPCABG,were studied.Blood samples from intemal iugular vein were taken for determination of the plasma concentrations of IL-6 and IL-10 at 4 h after the surgery by ELISA.SIRS 8COre W88 performed during 24 h after the surgery.The patients were divided into 2 groups:SIRS group(S,SIRS 8core≥2)and non-SIRS group(U,SIRS score<2).Factors including age,sex,weight,percentage of mononuclear cells,concentration of hemoglobin,time of operation,left ventricular ejection firction,whether using proteinase inhibitor or not during surgery and plasma concentrations of IL-6 and IL-10 at 4 h after surgery were reccorded.The risk factors were identified by logistic regression analysis.Results Logistic analysis indicated that percentage of mononuclear cells,concentration of hemoglobin,the plasma concentrations of IL-6 and IL-10 were closely related with the development of SIRS in patients after 0PCABG(P<0.05),Y=0.155+0.52 X1+0.39 X2+0.76X1-0.79X,Conclusion The percentage of mononuclear cells,concentration of hemoglobin,and plasma concentrations of IL-6 and IL-10 after surgery Call be the risk factors for the development of SIRS in patients after OPCABG.

Objective To determine the effect of cardiomyopeptidin on transient outward potassium current(I_(to) of rat ventricular myocytes and its action mechanism on the ion channels of myocardium.Methods Single ventricular myocytes of rats were obtained by enzymatic dissociation.The whole-cell patch-clamp recording technique was used to record the change of transient outward potassium current(I_(to) by different dosages of cardiomyopeptidin.Results Cardiomyopeptidin decreased I_(to) in a dose-dependent manner.Cardiomyopeptidin in dose of 10,50,100,250 and(500 mg/L) decreased I_(to %) by 4,13,22,32 and 38 respectively.Cardiomyopeptidin 50 mg/L moved the current density-voltage curve of I_(to) down,but the shape of the curve had no changes.Cardiomyopeptidin 50 mg/L did not change the steady state activation curve of I_(to).Conclusions Cardiomyopeptidin decreases the I_(to) of rat ventricular myocytes,which might be one of the mechanisms of its antiarrhythmic effect.

Objective To evaluate the role of reperfusion injury salvage kinase signaling pathway in reduction of myocardial ischemia-reperfusion (I/R) injury by sevoflurane postconditioning in rats.Methods Seventy SPF healthy adult male Sprague-Dawley rats,weighing 300-350 g,were divided into 7 groups (n =10 each) using a random number table:sham operation group (group S),group I/R,sevoflurane postconditioning group (group SP),phosphatidylinositol 3-kinase inhibitor LY294002 group (group LY),sevoflurane postconditioning plus LY294002 group (group SPLY),mitogen-activated protein kinase kinase 1/2 inhibitor U0126 group (group U) and sevoflurane postconditioning plus U0126 group (group SPU).Myocardial I/R was induced by occlusion of the left anterior descending branch of the coronary artery for 30 min followed by 120 min of reperfusion.In group SP,1.8％ sevoflurane was inhaled for 5 min starting from the beginning of reperfusion.In LY and U groups,LY294002 0.3 mg/kg and U0126 0.5 mg/kg were intravenously injected,respectively,at 10 min before reperfusion.In SPLY and SPU groups,LY294002 0.3 mg/kg and U0126 0.5 mg/kg were intravenously injected,respectively,at 10 min before reperfusion,and 1.8％ sevoflurane was inhaled for 5 min starting from the beginning of reperfusion.At 15 min of reperfusion,myocardial specimens were obtained from the left ventricular area at risk for determination of the phosphorylation of protein kinase B (Akt) and extra-cellular signal-regulated kinase 1/2 (ERK1/2) (by Western blot) and NAD+ content in myocardial tissues (by fluorescence spectrophotometry).At the end of reperfusion,blood samples were collected from the jugular vein for measurement of serum cardiac troponin Ⅰ (cTnI) concentrations (by photoelectric colorimetry),and myocardial specimens were obtained from the left ventricular area at risk for determination of myocardial infarct size (IS).Resuits Compared with group S,the IS and serum cTnI concentrations were significantly increased,the NAD+ content was decreased (P＜0.05),and no significant change was found in the phosphorylation of Akt or ERK1/2 in group I/R (P＞0.05).Compared with group I/R,the IS and serum cTnI concentrations were significantly decreased,and the NAD+ content and phosphorylation of Akt and ERK1/2 were increased in group SP (P＜0.05),and no significant change was found in the parameters mentioned above in LY,SPLY,U and SPU groups (P＞0.05).Compared with group SP,the IS and serum cTnI concentrations were significantly increased,and the NAD+ content was decreased in SPLY and SPU groups,the phosphorylation of Akt was significantly decreased in group SPLY,and the phosphorylation of ERK1/2 was significantly decreased in group SPU (P＜0.05).Conclusion The mechanism by which sevoflurane postconditioning reduces myocardial I/R injury may be related to activation of reperfusion injury salvage kinase signaling pathway in rats.

Objective To evaluate the safety and efficacy of FW-Ⅱ axial blood pump short term assistance for treating acute heart failure.Methods We selected 5 patients who were difficult to remove cardiopulmonary bypass,and implanted FW-Ⅱ axial blood pump by left atrium-pump-femoral artery.Perioperative hemodynamics,circulating markers of myocardial injury,vW factor levels in plasma and white blood cell-platelet aggregates in different rotational speed were observed and analyzed.Results All patients were assisted for(24.0 ± 2.6) h by FW-Ⅱ axial blood pump with speed of 7 000-9 000 r/min,flow of 1.9-3.0 L/min,and no mechanical dysfunction.Compared with mean artery pressure(MAP),cardiac index(CI) and systemic vascular resistance index (SVRI) before implantation of FW-Ⅱ axial pump was (50.29 ± 6.98) mmHg (1 mmHg=0.133kPa),(1.70±0.23)L· min-1 · m-2 and (2 009.86 ±129.46) dyn· s · cm-5,MAP and CI significantly increased,while SVRI significantly reduced at 8 000 r/min after pump assistance [(65.43 ± 6.90) mmHg,(2.53 ± 0.27) L · min-1 · m-2,(1 578.14 ± 356.70) dyn · s · cm-5,P ＜ 0.01).CK-MB and cTnI levels reached significant decrease after 12 hours of pump assistance and maintained low level [(66 ± 11) IU/L and (8.4 ± 3.8) μg/L,P ＜ 0.01].Compared with 7 000 r/min,vW factor levels significantly increased at 8 500 r/min [(2.59 ± 0.57) U/L vs (1.26 ± 0.43) U/L,P ＜0.01].Platelet activation and white blood cell-platelet aggregation was the lowest at 8 000 r/min,and reached the most high level at 7 000 and 9 000 r/min [(15 ± 3) ％,(33 ± 3) ％ and (31 ± 5) ％)].Conclusion FW-Ⅱ axial flow pump can be effectively used for short-term treatment of acute ischemic left ventricular failure,8 000 r/min is optimum speed to balance hemodynamics and biocompatility.

AIM: To study and evaluate the changes of two main kinds of voltage-gated K+ currents in human atrial fibrillation (AF) and to discuss the role of these changes in the atrial electrical remodeling (AER) caused by AF. METHODS: Specimens of human atrial appendage were obtained from 36 RHD patients (18 with chronic AF and 18 without AF). Single atrial myocytes were acutely dissociated by tissue chunk enzymatic digestion. I_~to1 and I_~Kur in the two groups were measured respectively with the patch-clamp technique in a whole-cell configuration and the I-V curves were compared. RESULTS: I_~to1 and I_~Kur amplitudes in AF groups were significantly reduced and the current densities of both I_~to1 and I_~Kur in AF patients were lower than those in NAF patients. CONCLUSION: The reduction of I_~to1 and I_~Kur may be related to changes in atrial conduction, refractory period and may constitute two main parts of the major mechanisms in the AER of chronic AF. Whether exists a relation between changes of the above K+ currents and that of other ionic currents and the AF initiation and perpetuation deserves further investigation. [

Hospital cases were collected from 18 hospitals regarding their clinic facility layout optimization when they implement the National Healthcare Improvement Initiative.These data were used to learn the implementation at such hospitals,and summarize problems and experiences of the Initiative,for reference of sustained improvements.

Objective: To study subclinical hypothyroidism (SCH) with its treatment in patients after coronary artery bypass grafting (CABG). Methods: A total of 1500 patients received CABG by the same surgical team in our hospital from 2010-06 to 2014-03 were retrospectively studied. According to thyroid function, the patients were divided into 2 groups: SCH group,n=107 and Normal group, n=1393. With 1:4 propensity score matching, there were 104 patients in SCH group and 416 patients in Normal group enrolled in our research. The rates of intra-aortic balloom pumping (IABP) implantation and peri-operational blood transfusion, mechanical ventilation time, new onsets of stroke, myocardial infarction and atrial ifbrillation, malignant arrhythmia, acute kidney injury and in-hospital mortality were observed. The outcome of treatment was assessed by single- and multi-factor analysis. Results: Compared with Normal group, SCH group showed increased mechanical ventilation time (23.3±47.9) h vs (15.0±5.5) h, P<0.05; more patients had mechanical ventilation time>12 h (89.4% vs 78.8%),P<0.05 and more patients had IABP implantation (3.8% vs 0.72%),P<0.05. SCH was related to mechanical ventilation time>12 h (OR=2.363, 95% CI 1.183-4.516) and IABP implantation (OR=6.126, 95% CI 1.190-31.537). The in-hospital death and other events were similar between 2 groups,P>0.05. Conclusion: Our research indicated that SCH was related to mechanical ventilation time and IABP implantation in patients after CABG.