In order to study the characteristics of the early cardiovascular responses following the occlusion of the superior mesenteric artery, occlusion of the artery was perfomed on 7 dogs, and sham operation on 6 dogs to serve as control- It was found that after the release of the occlusion 2 hours later, the mean arterial pressure and the central venous pressure of the experimental group dropped significantly. Comparable changes could not be observed in the controls. Meanwhile, the parameters of left ventricular functions such as left ventricular systolic pressure, + dp/dt max, = dp/dt max, Q-dp/dt max interval, and the product of 3 items(cardiac rate, Q-dp/d max interval and the peak value of left ventricular pressuure) showed no difference between the 2 groups.The results suggest that the general functional derangement of the cardiovascular system can be ascribed to the pooling of blood and/or fluid in the splanchnic area, and the adnormal myocardial performance does not appear in the initial phase of superior mesentric artery occlusion.

In order to study the characteristics of the early cardiovascular responses after oleic acid induced lung damage, oleic acid (OA) 0.1ml/kg body weight was infused intravenously into 11 anesthetized and artificially ventilated dogs, and the effects were observed for 3 hours. After OA infusion, PaO2 decreased progressively to a fairly low level with a coincident increase of the alveolar-arterial PO2 gradient and decrease of the oxygen delivery. Cardiac index gradually decreased and reached only 49% of the baseline value at 180 minutes after OA injection. Mean systemic arterial pressure decreased transiently at 60 minutes after OA injection without concomitant increase of the pulmonary arterial pressure. The left ventricular stroke work, +dp/dtmax and - dp/dtmax, and the impedance contractility index were inhibited throughout the experiment. The postmortem lung-body ratio was significantly increased.These results suggest that the dogs following OA injection exhibit severe hypoxemia, reduced cardiae output, suboptimal cardiac performance and reduced oxygen delivery; the reduced cardiac outpur is associated with early and sustained inhibition of the myocardial contractility; and the pulmonary arterial pressure does not change significantly in the whole course of the experiment, so the edema formation does not result from the increase of the capillary hydrostatic pressure.

Hemorrhagic shock was induced in 13 dogs with modified Wigger's method to maintain the mean arterial pressure at 5.33kPa for 60 minutes. 6 dogs were treated with 10% calcium gluconate 0.15ml/kg intravenously at the 60th, 70th, and 80th minute of the oligemic period respectively, while 7 dogs received an equal volume of normal saline at the corresponding time. At the 90th minute of the oligemic period, the shed blood was transfused back to the animals.During the 90-minute oligemic shock period, the mean arterial pressure, the peak value of the left ventricle systolic pressure, + dp/dtmax and total peripheral resistance of the treated dogs were significantly higher than those of the controls, but the heart rate, cardiac index, - dt/dtmax and myocardial oxygen consumption showed no significant difference between the 2 groups. After the transfusion of the shed blood back to the animals, no apparent difference of any of the above-mentioned parameters between the 2 groups could be found. In both groups, the oxygen delivery, oxygen consumption, oxygen extract ration and pH value were similar during the oligemic period and after the back-transfusion of the shed blood.The results indicate that exogenous calcium infusion cannot bring about any beneficial effects on the cardiovascular functions, oxygen transport and acid-base balance during hemorrhagic shock.

On 8 dogs a moderate hypotension is produced by stcpwisc blood loss of 24ml/kg for 60 min At the end of this period the shed blood is rcinfuscd back in the animal.Results of observation after 60 min demonstrate a significant (p

The effect of intravenous infusion of glucose-insulin-potassium (G1K) on the cardiovascular functions during acute hypoxia was studied and was compared with that of normal saline(NS). 14 anesthetized dogs were forced to inhale a hypoxic gas mixture. After the first ten-minute inhalation, Pao2 and total peripheral vascular resistance decreased to 29~3l% and 66-67% of the pre-in-halation levels respectively while the pulmonary arterial pressure increased 43-49%. Then a bolus injection of GIK was given to 8 dogs, and an injection of NS to 6 dogs. Hypoxic gas inhalation was continued for 20 more minutes. 5 -10 minutes after GIK injection, the mean arterial pressure, cardiac output, stroke volume, stroke work , and left ventricular pressure all significantly increased, however, no apparent changes could be observed in any of the above mentioned parameters after NS injection. This result reveals that cardiovascular functions during acute hypoxia can be rapidly, markedly but temporarily improved when a small volume of GIK is administered intravenously.

Objective To explore the outcomes of the transplanted kidney as donor for clinical renal transplantation and summarize experience in combination with related literature.Method This study retrospectively analyzed the clinical documents of one case of uremia receiving renal allograft transplantation with the transplanted kidney as the donor in one case of renal transplantation after brain death in February,2015.The donor was a 31-year-old man who received renal transplantation for uremia in November,2014 and obtained normal renal function.Two months later,the patient was brain dead because of neurologic disorder and donated his transplanted kidney.The serum creatinine of the donor was 167 μmol/L,and the glomerular filtration rate was about 35 mL/min befor donation.The recipient was 27 years old who needed transplantation because of chronic renal function failure and uremia.Preoperation tests showed that PRA was negative,and serum creatinine was 1 353 μmol/L.After separating and dissecting the donor kidney carefully,we perfused and compensated the kidney by Lifeport Organ Perfusion and Preservation Conveyor.The warm ischemia time was about 15 min.The renal vein of the donor was anastomized with right external iliac vein of the receptor,artery with right external iliac artery,and ureter with right centrifugal ureter.Result The operating time was more than 3 h.Postoperatively,the recipient was given the immunosuppressive regimen as tacrolimus,mycophenolate mofetil and methylprednisolone to prevent rejection.At 1 st day postoperation,the 24-h urine volume of the receptor was 5 000 mL,serum creatinine was declined gradually to a minimum of 180μmol/L,and there was trace urine protein.The renal function of patient recovered well by now.Meanwhile,the patient was still under the follow-up.Conclusion It is practical that using transplanted kidney as donor kidney for re-transplantation.There were certain clinical significance for shortening the waiting time of renal transplantation in uremia patients and relieving the shortage of transplant kidney.

Objective To evaluate the immune status of acute rejection recipients,and to improve the short-term and long-term survival rate of renal transplant recipients and grafts,and to investigate dynamically the changes in the immune repertoire of patients with acute rejection.Methods Combined multiplex PCR amplification technique and high throughput sequencing technique,the TCR β chain complementarity determining region 3(CDR3)diversity and repertoire characteristics at different time points during renal transplantation were analyzed,in order to reveal the immunological characteristics of T lymphocytes in patients with acute rejection.Results The diversity of TCR CDR3 in acute rejection patients was reduced to the lowest one day after surgery.The diversity of TCR CDR3 before acute rejection was higher than before.The acute rejection-related upregulated TCR CDR3 amino acid sequences were screened out.In addition,TCR beta chain V and J subfamily showed the phenomenon of advantage usage in pre-acute rejection,which may be due to T cell recognition of transplanted kidney antigens in vivo.Conclusions The immune diversity of patients with acute rejection is significantly lower.In addition,TCR beta chain V and J subfamily show the phenomenon of advantage usage.

OBJECTIVE: To determine the relationship between intravoxel incoherent motion (IVIM) imaging derived quantitative metrics and serum soluble CD40 ligand (sCD40L) level in an embolic canine stroke model. MATERIALS AND METHODS: A middle cerebral artery occlusion model was established in 24 beagle dogs. Experimental dogs were divided into low- and high-sCD40L group according to serum sCD40L level at 4.5 hours after establishing the model. IVIM imaging was scanned at 4.5 hours after model establishment using 10 b values ranging from 0 to 900 s/mm². Quantitative metrics diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) of ischemic lesions were calculated. Quantitative metrics of ischemic lesions were normalized by contralateral hemisphere using the following formula: normalized D = D(stroke) / D(contralateral). Differences in IVIM metrics between the low- and high-sCD40L groups were compared using t test. Pearson's correlation analyses were performed to determine the relationship between IVIM metrics and serum sCD40L level. RESULTS: The high-sCD40L group showed significantly lower f and normalized f values than the low-sCD40L group (f, p < 0.001; normalized f, p < 0.001). There was no significant difference in D*, normalized D*, D, or normalized D value between the two groups (All p > 0.05). Both f and normalized f values were negatively correlated with serum sCD40L level (f, r = −0.789, p < 0.001; normalized f, r = −0.823, p < 0.001). However, serum sCD40L level had no significant correlation with D*, normalized D*, D, or normalized D (All p > 0.05). CONCLUSION: The f value derived from IVIM imaging was negatively correlated with serum sCD40L level. f value might serve as a potential imaging biomarker to assess the formation of microvascular thrombosis in hyperacute period of ischemic stroke.
Animals ; CD40 Ligand* ; Diffusion ; Dogs ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging* ; Perfusion ; Stroke* ; Thrombosis

Human infection with avian influenza A (H7N9) is easy to induce severe acute respiratory distress syndrome (ARDS), and traditional mechanical ventilation cannot correct hypoxemia, so patients may die from multiple organ failure (MOF) caused by persistent hypoxia. Extracorporeal membrane oxygenation (ECMO) can provide effective respiratory support and win time for the treatment of severe H7N9. The first case of severe H7N9 in Guangdong Province in 2018 was admitted to Zhongshan Hospital Affiliated to Sun Yat-sen University. The case was insult with severe ARDS caused by H7N9, the traditional mechanical ventilation could not correct hypoxemia, and the lung condition gradually improved with ECMO assistance. After 13 days of ECMO support, the patient was successfully weaned from ECMO and was transferred to a general ward after 55 days. After 102 days of rehabilitation, the patient was discharged from hospital and followed up for 2 months, who was in good health and had a good quality of life. This article states the diagnosis and treatment of severe H7N9 in details, providing experience for the treatment of severe H7N9 in the future.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.