Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Objective To evaluate the association between plasma levels of visfatin and adiponectin with carotid arterial intima-media thickness in patients with type 2 diabetes.Methods A total of 100 elderly patients with type 2 diabetes and 30 healthy elderly controls were recruited from August 2015 to August 2016 at our hospital.Based on carotid arterial intima-media thickness(IMT) assessed via color Doppler ultrasonography,patients with diabetes were further divided into a thickened IMT group (40 cases)and a non-thickened IMT group (60 cases).Plasma levels of visfatin and adiponectin were analyzed and compared,and their associations with carotid arterial IMT were evaluated.Results Compared with the control group,patients in both the thickened IMT group and the non-thickened IMT group had significantly higher serum levels of visfatin(19.1 ± 2.8)μg/L vs.(40.6±3.9)μg/L,(28.9±3.6)μg/L,which was markedly higher in the thickened IMT group than in the non-thickened IMT group(P＜0.05).In addition,compared with the control group,patients in the thickened IMT group and the non-thickened IMT group had significantly lower serum levels of adiponectin(1 590±330)mg/L,(610±170)mg/L,(930±210)mg/L,which was markedly lower in the thickened IMT group than in the non-thickened IMT group (P ＜ 0.05).Furthermore,Pearson's analysis showed that the plasma level of visfatin was positively correlated with carotid arterial IMT(r =0.721,P＜0.05),and the plasma level of adiponectin was negatively correlated with carotid arterial IMT(r=-0.688,P＜0.05).Conclusions Plasma levels of visfatin and adiponectin are closely related to carotid arterial IMT in patients with type 2 diabetes,andmay be used as plasma markers for the prediction of early atherosclerosis.

Objective To study the acute toxicity of ginkgolic acids from Ginkgo biloba sarcotestas against fish.Methods The ginkgolic acid mixture was obtained from Ginkgo biloba sarcotestas.The acute toxicities of the ginkgolic acid mixture against the fry of Cyprinus carpio var.and fry of Carassius auratus were detected.Results LC50 and LC90 of the ginkgolic acid mixture against the fry of Cyprinus carpio var.were 1.805 mg/L and 2.191 mg/L,respectively.LC50 and LC90 of the ginkgolic acid mixture against the fry of Carassius auratus were 1.930 mg/L and 2.217 mg/L,respectively.Conclusions The toxicity of ginkgolic acids against the fry of Cyprinus carpio var.and fry of Carassius auratus is medium.