Objective To evaluate the safety of surgical procedures for patients after heart valve prosthesis implantation.Methods Clinical data of 12 cases with heart valve prosthesis implantation undergone other surgical treatment from November 1996 to December 2005 were retrospectively analyzed.All the cases had routine oral warfarin with prothrombin time (PT) of 20.0—28.3 s averaged 23.5 s, international normalized ratio (INR) for prothrombin of 1.79—2.23 averaged 1.95 and heart functional class Ⅰ—Ⅲ.Among them,appendectomy was performed in three cases with acute appendicitis,reposition and repair in one with inguinal hernia,radical gastrectomy in two with gastric carcinoma,left hemicolectomy in one,cholecystectomy in three,left femoral head replacement in one,and bilateral high ligation and ablation of great saphenous vein in one.Elective surgical operation was performed in seven cases,and emergency operation in five.In those with elective surgery,warfarin was stopped 2—3 days before operation,while 5—10 mg vitamin K_1 was injected intramuscularly 6—8 hours before emergency surgery with preoperative median PT of 15.1 and 15.3 s and median INR of 1.24 and 1.30,respectively.In operation,5—10 mg vitamin K_1 were injected intravenously into the patients by drip depending on their bleeding on the surface of wound.ECG,blood pressure,hemoglobin and oxygen saturation were routinely monitored for all the cases intraoperatively and postoperatively.For the cases with heart function above class Ⅱ,fluid infusion was adjusted based on intubated central venous pressure,and for those with general anesthesia,analyses of blood gases and electrolyte were monitored routinely in operation.Results OPeration time averaged 20—160 rain in all the 12 patients,with blood loss 5—280 ml in average and without complications of massive hemorrhage,thrombosis and heart failure.Conclusions Surgical operation was safe for patients with heart valve prosthesis implantation,if preoperative PT and INR were adjusted to about 15 s and 1.30,respectively by cessation of warfarin or application of vitamin K_1,combined with careful manipulation and strengthened perioperative management.

AIMTo explore the effect of ligustrazine injection on the expression of heme oxygenase-1 (HO-1) in rabbits with pulmonary ischemia/reperfusion injury after.

METHODSSingle lung ischemia/reperfusion injury animal model was used in vivo. Twenty rabbits were randomly divided into two groups( n = 10, in each), pulmonary ischemia/reperfusion injury (I/R) group and I/R + ligustrazine injection (LGT) group. The tissue slides were stained by immunohistochemistry (IHC) and in situ hybridization (ISH) for HO-1 to detect the expression of HO-1 in lung and to analyze the absorbance, wet to dry ratio of lung tissue weight (W/D) and the injured alveoli rate (IAR) were measured at 180 minutes after lung reperfusion. Meanwhile the lung tissue slide was prepared for electron microscopic observation at 180 minutes after reperfusion.

RESULTSHO-1 expression was upregulated in two groups in the pulmonary endothelial cells, part of pulmonary vascular smooth muscle cells, extima of vessels and epithelial cells of airway, the absorbance was 0.168 +/- 0.016 (0.148 +/- 0.013), 0.186 +/- 0.014 (0.158 +/- 0.012) respectively.The LGTI group showed higher absorbance than those of the I/R group (P < 0.01), lower W/D and IAR values than those of the I/R group (P < 0.01) significantly and lighter abnormal changes of the lung tissue in morphology than those of the I/R group.

CONCLUSIONLigustrazine injection possesses notable protective effects on I/R in rabbits by increasing the expression of HO-1 in lung.

Animals ; Disease Models, Animal ; Heme Oxygenase-1 ; metabolism ; Lung ; blood supply ; metabolism ; Pyrazines ; pharmacology ; Rabbits ; Reperfusion Injury ; metabolism

AIMTo explore the role of ligustrazin on dynamic changes of lipid peroxidation in hepatic ischemia/reperfusion injury (HIRI) and its mechanism.

METHODSThe HIRI model was used. Twenty rabbits were randomly divided into control group (n = 10) and ligustrazin group (n = 10). The xanthine oxidase (XO) activity, superoxide dismutase (SOD) activity,malondialdehyde (MDA) content and glutamic pyruvic transaminase (GPT) activity in plasma were observed before ischemia and at ischemia 25 min, reperfusion 25 min, reperfusion 60 min and reperfusion 120 min.

RESULTSThe XO activity, SOD activity, MDA content and GPT activity of ligustrazin group, as compared with control group, showed significant differences (P < 0.05 or P < 0.01) at total time points of reperfusion.

CONCLUSIONLigustrazin has notable anti-lipid peroxidation effect on HIRI, which is due to its inhibiting the generation of oxygen free radicals and its strengthening scavenging of oxygen free radicals.

Alanine Transaminase ; metabolism ; Animals ; Female ; Lipid Peroxidation ; drug effects ; Liver ; drug effects ; metabolism ; Male ; Malondialdehyde ; blood ; Pyrazines ; pharmacology ; Rabbits ; Reperfusion Injury ; metabolism ; Superoxide Dismutase ; metabolism ; Xanthine Oxidase ; metabolism

OBJECTIVETo evaluate the therapeutic effects of mitral valve repair for the treatment of the anterior leaflet prolapse of mitral valve.

METHODSFrom November 1998 to October 2007, 210 patients with severe anterior leaflet prolapse of mitral valve underwent valve repair. The condition of valve was preoperative, intraoperative, and postoperative assessed with echocardiography.

RESULTSEdge-to-edge repair technique was used in 134 cases (63.8%). The cardiac function was NYHA class I in 168 cases and class II in 40 cases after operation. Patients were followup for 1 - 150 (25.7 +/- 29.0) months, two patients (0.95%) died of postoperative low cardiac output syndrome. Echocardiography examination indicated that the mean JP2 postoperative left atrial diameter was (37.7 +/- 9.2) mm against the preoperative value of (47.5 +/- 12.7) mm (P < 0.05), the mean postoperative left ventricular end-diastolic diameter was (51.7 +/- 7.9) mm against the preoperative value of (67.7 +/- 10.3) mm (P < 0.05), the mean postoperative left ventricular ejection fraction was (62.2 +/- 3.2)% against the preoperative value of (52.2 +/- 6.4)% (P < 0.05), and the mean preoperative regurgitation area was (10.4 +/- 4.1) cm(2) against the postoperative value of (4.1 +/- 1.7) cm(2) (P < 0.01).

CONCLUSIONSOptimal outcome was achieved by appropriate edge-to-edge technique or other mitral valve repair techniques for anterior leaflet prolapse of mitral valve. Edge-to-edge technique is a reliable and efficient surgical technique.

Adult ; Cardiac Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve Prolapse ; surgery ; Treatment Outcome ; Young Adult

AIMTo investigate protective effects of polydatin(PD) during lung ischemia/reperfusion in rabbits and its potential mechanisms.

METHODSRabbit lung model of ischemia/reperfusion (I/R) injury was constituted in vivo. Thirty rabbits were divided into groups randomly: Control (C), I/R, PD group, respectively. Endotoxin (ET) in plasma was analyzed by End-point Chromogenic Assay, the expression of Toll-like receptor 4 (TLR4) mRNA, nuclear factor (NF)-kappaBp65 mRNA, intracellular adhesion molecule-1 (ICAM-1) mRNA were measured by RT-PCR, the morphological changes of lung tissue were observed with hematoxylin-eosin (HE) staining.

RESULTSThere was no significant difference in ET concentration of plasma between groups (all of P > 0.05). The expression of TLR-4 mRNA, NF-kappaBp65 mRNA and ICAM-1mRNA in I/R group were significantly increased as compared to C group and PD group, while those expressions in PD group were evidently higher than those in C group (all of P < 0.01). Light microscope showed that the lung pathological injuries in PD group were obviously alleviated as compared to I/R group.

CONCLUSIONPD might have a protective effect on lung ischemia/reperfusion injury by down-regulating TLR4 and NF-kappaB expression, then inhibiting the release of mediators of inflammation as ICAM-1.

Animals ; Female ; Glucosides ; pharmacology ; Intercellular Adhesion Molecule-1 ; genetics ; metabolism ; Ischemia ; metabolism ; physiopathology ; Lung ; blood supply ; Male ; Protective Agents ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Rabbits ; Reperfusion Injury ; metabolism ; prevention & control ; Signal Transduction ; drug effects ; Stilbenes ; pharmacology ; Toll-Like Receptor 4 ; genetics ; metabolism ; Transcription Factor RelA ; genetics ; metabolism

BACKGROUNDThe aim of this research was to explore quality of life (QOL) and acceptance of disability and social support of colostomy patients as well as the relationship between these factors.

METHODSA descriptive, correlational study was conducted using four scales: the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and European Organization for Research and Treatment of Cancer Colorectal Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-CR38) scales, the Acceptance of Disability Scale (ADS), and the Social Relational Quality Scale (SRQS). A convenience sample of 111 colostomy patients from four hospitals in Guangzhou who underwent colostomy operation at least one month prior to the study and who visited the stoma clinic or association from August 2011 to February 2012 was evaluated for inclusion in the study. All statistical analyses were performed using SPSS 17.0 software (SPSS Inc., Chicago, IL, USA).

RESULTSThe patients' general health status was better than the reference level recommended by European Organization for Research and Treatment of Cancer, and the overall ADS score was average. The SRQS score was similar to that found in a Hong Kong study. The general health status and dimensions of QOL were significantly correlated with ADS and all of its dimensions (P < 0.05). The general health status and dimensions of QOL were also significantly correlated with SRQS and all of its dimensions (P < 0.05).

CONCLUSIONSQOL, acceptance of disability, and social relational quality of colostomy patients were closely related. Our results emphasize that patients should work to form rational values and close bonds with families and friends to achieve a better QOL.

Aged ; Colostomy ; adverse effects ; psychology ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Social Support ; Surveys and Questionnaires

OBJECTIVETo introduce the methods of dacron flap application and its indications in treating fracture of multiple ribs, in order to reduce the incidence of the complications of fracture displacement.

METHODSFrom September 2006 to March 2008, 12 patients with fracture of multiple ribs were treated with absorbable rib fixed nail and dacron flap. Included 8 males and 4 females,the age was from 22 to 51 years with an average of 38.2 years,the operative time was 2 hours to 3 days after injured. All the patients were closed injury and simultaneously accompanied with significant chest pain and chest tightness. 4 cases with dyspnea, blood in sputum and blood oxygen saturation decreased. The X-ray showed 3 cases of unilateral fracture and 9 cases of bilateral rib fractures and all cases accompanied with hemopneumothorax.

RESULTSAll patients were followed up from 2 to 26 months with an average of 8 months. All the fractures healed. According to clinical criteria, pain, breathing, ribs alignment etc. to observe the effect, 10 cases got excellent result, 1 case good, 1 case poor.

CONCLUSIONIt is safe and effective to use absorbable rib fixed nails and dacron flap for treating fracture of multiple ribs and especially for the patients of osteoporosis, comminuted fracture or oblique fracture.

Adult ; Bone Nails ; Female ; Fracture Fixation, Intramedullary ; Humans ; Male ; Middle Aged ; Rib Fractures ; surgery ; Surgical Flaps ; Treatment Outcome ; Young Adult

AIMTo observe protective effects of safflower injection (SI) on lung ischemia/reperfusion injury (LIRI) and investigate its potential mechanism.

METHODSRabbit lung model of ischemia/reperfusion injury was constituted in vivo. The rabbits were randomly divided into three groups: sham-operation group (S group), ischemia/reperfusion group (I/R group) and ischemia/reperfusion plus safflower injection group (SI group). Malondialdehyde (MDA) content, superoxide dismutase (SOD) and xanthine oxidase (XO) activities in serum were measured. The lung tissue sampled at the end of the experiment was assayed for wet/dry weight ratio (W/D), injured alveoli rate (IAR) and ultrastructural changes were observed under electron microscope. The expression of COX-1 and COX-2 were measured by immunohistochemistry (IHC). The expressions of COX-1mRNA and COX-2mRNA were observed by in situ hybridization (ISH).

RESULTSIn I/R group, XO and MDA increased and SOD decreased in serum, while the same changes happened in SI group but less severely(P<0.01). The value of W/D and IAR was much higher in I/R group than S group, but decreased in SI group. Electron microscope showed obvious ultrastructural injury brought by LIRI in I/R group, which was greatly attenuated in SI group. The IHC and ISH demonstrated that COX-2 and COX-2mRNA in pulmonary tissue of I/R group were significantly higher than those of SI group (P < 0.01). The difference of COX-1 and COX-1mRNA in pulmonary tissue among the three groups was not significant.

CONCLUSIONThe ischemia/reperfusion lung injury insults induced the regulation of COX-2 in lung. Safflower injection may attenuate lung ischemia/reperfusion injury through inhibiting cyclooxygenase-2 expression.

Animals ; Carthamus tinctorius ; Cyclooxygenase 1 ; metabolism ; Cyclooxygenase 2 ; metabolism ; Lung ; drug effects ; enzymology ; physiopathology ; Malondialdehyde ; blood ; Rabbits ; Reactive Oxygen Species ; metabolism ; Reperfusion Injury ; metabolism ; Superoxide Dismutase ; blood ; Xanthine Oxidase ; blood

AIMTo observe protective effects of polydatin (PD) during lung ischemia/reperfusion injury (LI/RI) and investigate its potential mechanism .

METHODSRabbit lung model of ischemia/reperfusion injury was constituted in vivo. The 40 rabbits were randomly divided into four groups (n = 10): control group (C group), ischemia/reperfusion group (I/R), PD + I/R group (PD) and PD+ polymyxin B (PMB) + I/R group (PMB). The blood specimen gathered at different time points were tested for the content of melondialdehyde (MDA) and the enzyme activity of superoxide dismutase (SOD). The lung tissue sampled at the end of the experiment were assayed for wet/dry weight ratio (W/D), injured alveoli rate (IAR) and observing ultrastructure changes under electron micro scope.

RESULTS(1) The activity of SOD showed a similar time-dependent decline in I/R group and PMB group during I/R, while in PD group this tendency was milder (P < 0.01 vs I/R group). (2) In contrast to the results above, the level of MDA markedly increased in I/R and PMB group, but was slowed down in PD group (P < 0.01 vs I/R group). (3) The value of W/D) and IAR was much higher in I/R and PMB group (P < 0.05 or P < 0.01 vs C group). In PD group, it was decreased (P < 0.01 vs I/R group or PMB group). (4) Electron microscope showed obvious ultrastructure injury brought by LI/RI in I/R group and PMB group, which was greatly attenuated in PD group.

CONCLUSIONPD can protect lung from LI/RI, and PKC may participate in its mechanisms.

Animals ; Female ; Glucosides ; pharmacology ; Lung ; blood supply ; Male ; Protective Agents ; pharmacology ; Protein Kinase C ; metabolism ; Rabbits ; Random Allocation ; Reperfusion Injury ; metabolism ; physiopathology ; prevention & control ; Stilbenes ; pharmacology

BACKGROUND: The present study aimed to explore the relationship between surgical methods, hemorrhage position, hemorrhage volume, surgical timing and treatment outcome of hypertensive intracerebral hemorrhage (HICH). METHODS: A total of 1310 patients, who had been admitted to six hospitals from January 2004 to January 2008, were divided into six groups according to different surgical methods: craniotomy through bone flap (group A), craniotomy through a small bone window (group B), stereotactic drilling drainage (group C1 and group C2), neuron-endoscopy operation (group D) and external ventricular drainage (group E) in consideration of hemorrhage position, hemorrhage volume and clinical practice. A retrospective analysis was made of surgical timing and curative effect of the surgical methods. RESULTS: The effectiveness rate of the methods was 74.12％ for 1310 patients after one-month follow-up. In this series, the disability rate was 44.82％ 3–6 months after the operation. Among the 1310 patients, 241 (18.40％) patients died after the operation. If hematoma volume was >80 mL and the operation was performed within 3 hours, the mortality rate of group A was significantly lower than that of groups B, C, D, and E (P<0.05). If hematoma volume was 50–80 mL and the operation was performed within 6–12 hours, the mortality rate of groups B and D was lower than that of groups A, C and E (P<0.05). If hematoma volume was 20–50 mL and the operation was performed within 6–24 hours, the mortality rate of group C was lower than that of groups A, B and D (P<0.05). CONCLUSIONS: Craniotomy through a bone flap is suitable for patients with a large hematoma and hernia of the brain. Stereotactic drilling drainage is suggested for patients with hematoma volume less than 80 mL. The curative effect of HICH individualized treatment would be improved via the suitable selection of operation time and surgical method according to the position and volume of hemorrhage.