Objective To investigate the impact of diabetes on coronary artery bypass grafting (CABG)in peroperative patients. Methods Clinical data of 692 CABG patients were collected retrospectively from Sep. 2006 to Jul. 2010. The CABG patients were divided into diabetic group (n = 276) and nondiabetic group (n = 416) according to with the status of diabetes or not before operation. Blood glucose was dynamicaly monitored and treated with insulin to control blood glucose in perioperativeperiod. The postoperative effect,perioperative complication and inhospital case fatality and their relationship with diabetes were analyzed using univariate analysis. Results No significant differences were found regarding the incision complications (5. 8%vs. 4. 3 % , P > 0. 05). The volume of blood transfusion was (890. 7 ± 520. 6) ml in the diabetes group, which was not significantly different from that of (825. 2 ±518. 4)mlin the non-diabetes group (P>0. 05). No significant difference was found on cardiac arrhythmia (13.0% vs. 13. 5%),renal function insufficient (5. 1% vs. 2.4%)and case fatality (2. 9% and 1. 9%) between the diabetes and non-diabetes group (Ps >0. 05). In the diabetes group and non-diabetes group, the duration of IABP (3.7 ± 1. 6) d vs (3.5 ± 1.6)d, use of ventilator (2. 6 ± 1.9)d vs. (2. 4±1.5)d were not sigfnificantly different (Ps >0.05). The length of hospital stay and cost were (22. 0 ±8. 8)d and (8. 11 ±2. 40) thousand RMB in the diabetes group, which were significantly higher than that of (20. 6 ±7. 6)d and (7. 63 ±2. 20) thousand RMB in the non-diabeties group (t =2. 22 and 2. 71 ,Ps <0.05) . Conclusion There are no significant differences in the operative case fatality and complications between patients with diabetes and without nondiabetes. However,diabetes increases hospital stay and expense.

Objective To investigate the diagnosis and therapy of primary maligmant tumors of the heart. Methods Clinical data of 21 patients with malignant cardiac tumors admitted to our department from June 1980 to May 2008 was analyzed and the references were reviewed. Results All patients received operations. Pathological classification of the tumors was made by histological examinations. Radical resections for 10 eases and partial resections for 5 eases were performed. The other 6 patients received only thoracotomy and cardiac exploration. Three eases were lost during follow up. Three survivors received radical resections are still alive now 2-15 months after the surgery, while all the other patients died within 4 years after the operation due to malignant tumor recurrence and (or) metastasis. Conclusion Echocardiography, CT, 3D-CT, MRI, coronary CT and angiocardiography are helpful for the diagnosis of the malignant cardiac tumors and the selection of operations. Histological examination is necessary for the final diagnosis. Early diagnosis, radical resection and post-operative radiotherapy and chemo therapy may provide a better result.

OBJECTIVETo summarize the method and experience of cardiopulmonary bypass (CPB) with vacuum-assisted venous drainage technology (VAVD) in the minimally invasive cardiac surgery (MICS).

METHODS35 cases of patients undergoing MICS were achieved femoral arterial cannula and femoral venous cannula. During the course of the CPB, we used the VAVD technology. At the same time, we selected 35 cases as control group.The time of the CPB, mechanical ventilation and ICU, and the amount of the urine, blood products, and chest drainage were recorded.

RESULTSThe time of mechanical ventilation and ICU staying, the volume of the blood products and the volume drainage within 48 h postoperatively in the MICS group were significantly shorter and less than that in control group (P < 0.05).

CONCLUSIONThe use of VAVD in the MICS can increase the vena cava drainage effectively, and ensure the surgery safe and successful.

Adolescent ; Adult ; Aged ; Cardiac Surgical Procedures ; methods ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Vacuum ; Veins ; Young Adult

OBJECTIVE: To analyse the clinical audiological significance in the diagnosis of large vestibular aqueduct syndrome (LVAS) by the auditory brain stem response (ABR) testing. METHOD: Patients with sensorineural hearing loss were examined by temporal bone CT scanning from January, 2008 to September, 2009. The result of CT scanning of 70 cases inner ear malformation were analysed. Patients were divided into two groups, LVAS group including 38 cases (76 ears) and other inner ear malformation group including 32 cases (62 ears). All patient accepted clinical audiology analysis and auditory brainstem response (ABR) test. RESULT: Twenty-four cases (41 ears) of LVAS group were detected with ASNR in 2 3 cm by the ABR testing, the positive rate was 54%, while ASNR was not detected in patients of other inner ear malformations group. There was significant differences (P=0.01) of the ASNR between two groups. CONCLUSION There is high incidence of LVAS on the patients with non-syndromic deafness. ASNR by ABR testing could help diagnosing the LVAS.
Child ; Child, Preschool ; Ear, Inner ; abnormalities ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Loss, Sensorineural ; diagnosis ; physiopathology ; Humans ; Infant ; Infant, Newborn ; Male ; Syndrome ; Vestibular Aqueduct ; abnormalities

OBJECTIVETo investigate the cardioprotective effects of morphine on ischemic reperfused rat heart in vitro and its mechanism.

METHODSThe isolated rat heart was perfused in a Langendorff apparatus. Infarct myocardium was determined by TTC. Coronary flow (CF), heart rate (HR), left ventricular pressure (LVP), the first derivative of ventricular pressure (LVP/dtmax) and infarct size after ischemia and reperfusion in rat heart given 0.3 micro mol/L morphine were observed. The effects of naloxone and glibenclamide on the cardioprotection of morphine were also measured.

RESULTSAfter ischemia and reperfusion, CF, HR, LVP and LVP/dtmax of isolated rat hearts decreased significantly (P < 0.01). After morphine preconditioning, HR, LVP and LVP/dtmax increased (P < 0.01) and infarct size was reduced significantly (P < 0.01), while no significant change in CF (P > 0.05). The cardioprotective effects of morphine were abolished by naloxone or glibenclamide completely.

CONCLUSIONSMorphine can reduce ischemia-reperfusion injuries in isolated rat heart. The cardioprotective effects of morphine are mediated by a local opioid receptor-K(ATP) channel linked mechanism in rat hearts.

Animals ; Cardiotonic Agents ; pharmacology ; Glyburide ; pharmacology ; Heart ; drug effects ; In Vitro Techniques ; Ischemic Preconditioning, Myocardial ; Male ; Morphine ; pharmacology ; Myocardial Reperfusion Injury ; prevention & control ; Naloxone ; pharmacology ; Rats ; Rats, Wistar

Objective    To investigate the incidence of acute kidney injury (AKI) after deep hypothermic circulatory arrest (DHCA), to explore the risk factors and prognosis of postoperative AKI, and to establish a relatively accurate preoperative risk assessment strategy and prevention measures. Methods    The clinical data of 252 patients who underwent deep hypothermic circulatory surgery in our hospital from January 2014 to October 2018 were retrospectively analyzed. There were 179 males and 73 females with an average age of 53.6±11.6 years. The patients were divided into an AKI group and a non-AKI group according to the AKI diagnostic criteria developed by kidney disease improving global outcomes (KDIGO). The data of the two groups were compared, and the risk factors related to AKI after DHCA were analyzed by single factor and multivariate logistic regression. Results    Among the 252 patients enrolled, the incidence of AKI was 69.0%. The postoperative hospital mortality rate was 7.9% (20/252). The univariate analysis showed that the patient's age and body mass index (BMI)≥28 kg/m2, left ventricular ejection fraction<55%, preoperative serum creatinine (Scr)≥110 μmol/L, preoperative estimated glomerular filtration rate (eGFR), Cleveland score and intraoperative cardiopulmonary bypass time, intraoperative infusion of red blood cells, intraoperative infusion of plasma, postoperative  mechanical ventilation time≥40 h and other indicators were significantly different between the two groups (P<0.05); multivariate logistic regression analysis showed that there was significant difference between the two groups in age (OR=1.040, 95% CI 1.017–1.064, P=0.001), BMI≥28 kg/m2 (OR=2.335, 95%CI 1.093–4.990, P=0.029), eGFR<90 mL/(min·1.73 m2) (OR=2.044, 95%CI 1.082–3.863, P=0.028), preoperative Cleveland score (OR=1.300, 95%CI 1.054–1.604, P=0.014) and intraoperative cardiopulmonary bypass time (OR=1.009, 95%CI 1.002–1.017, P=0.014). Conclusion    The incidence of AKI is higher after DHCA. Patients with postoperative AKI have longer hospital stay and higher risk of hospitalization death. The age of patients, BMI≥28 kg/m2, eGFR<90 mL/(min·1.73) m2, Cleveland score, intraoperative extracorporeal circulation time are independent risk factors for AKI after DHCA.

AIM: To study the toxicity of genipin-a kind of geniposide metabolites induced human tubular epithelial cells HK-2 and its effect on NLRP3 pathway. METHODS: The dose of GP on HK-2 cells were preliminarily determined by CCK8 method, the apoptosis or necrosis rate of HK-2 cells was detected by Hoechst 33342 / PI, the level of LDH release and reactive oxygen species was detected by Kits, and mitochondrial membrane potential and intracellular calcium ion concentration were detected by high content imaging. Real-time PCR detected mRNA levels of kindey injury factor-1, osteopontin, NLRP3, Caspase-1, interleukin 1β, and interleukin 18. RESULTS: Compared with the 0 μg / mL group, GP>50 μg/mL significantly reduced cell viability (P< 0.05, P<0.01), and the IC50 value was 110.50 μg/mL. Set the control group, the low, medium and high dose groups of GP (50, 100, 200 μg/mL); Compared with the control group, the cell density decreased in the medium and high dose groups of GP, and the PI positivity, LDH release, ROS, Ca