1.Characteristics of hemodynamics during closed chest cardiopulmonary resuscitation
Xiangyang ZOU ; Xiaoyun HAO ; Huarong CUI
Chinese Journal of Emergency Medicine 2011;20(1):26-29
Objective To study the hemodynamics during closed chest cardiopulmonary resuscitation (CCCPR) in dogs in order to unravel the mechanism. Method Twelve healthy mongrel dogs were selected to make animal model of ventricular fibrillation induced by electric shock on the chest wall. Closed-chest cardiopulmonary resuscitation (CCCPR) was initiated four minutes after ventricular fibrillation appeared according to American Heart Guidelines in 2005 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Rescue. After CPR for 2 minutes, 1mg epinephrine was injected intravenously. The central venous pressure (CVP), the aortic pressure (AOP)and the invasive electrocardiogram (ECG) were used to monitor continuously before ventricular fibrillation and the entire course of CPR. The coronary perfusion pressure (CPP) was calculated. The changes in aortic diastolic pressure (ADP) and CPP produced by chest compression or the injection of epinephrine were analyzed. The aortic pressure and the central venous pressure were recorded simultaneously during CPR. A chart was made and the CPP was calculated with the software Chart5Ch. The hemodynamic changes produced by the administration of epinephrine were studied. Data were analyzed with paired Student t test. P < 0.05 was considered as a significant difference. Results Two kinds of hemodynamic effects of CPR were observed. In 8 dogs (8/12) , the aortic pressure changed synchronously with the CVP, and the CPP was almost zero, and in other 4 dogs (4/12), the aortic pressure increased and the CVP remained unchanged with presence of the CPP. After the administration of epinephrine, the AOP and the CPP increased significantly. The Aortic systolic pressure(ASP) increased from (66± 14) mmHg to(107 ± 28) mmHg, (P = 0. 001). The Aortic diastolic pressure (ADP) increased from (25 ±2.2) mmHg to(45 ± 13) mmHg (P =0.001). And the coronary perfusion pressure (CPP) increased from (2.8± 3.8) mmHg to (29 ± 13) mmHg (P < 0.001). The 95 % confidential interval of the added value of the ASP,ADP and CPPwere (21.1-59.1), (10.2-28.3) and (16.7-35.7), respectively. Conclusions The thoracic pump mechanism is the primary role in the closed chest Cardiopulmonary resuscitation. Epinephrine can increase ADP and CPP and has the capability to break the balance between aortic pressure and central venous pressure, increasing the rate of successful cardiopulmonary resuscitation.
2.Biomechanical properties of a novel automatic anti-rotation posterior atlantoaxial internal fixation system: a finite element analysis
Min YANG ; Xiangyang MA ; Jincheng YANG ; Shujin CHEN ; Xiaobao ZOU
Chinese Journal of Tissue Engineering Research 2017;21(19):3031-3037
BACKGROUND: Atlantoaxial posterior approach is currently the main surgical treatment for atlantoaxial instability and/or dislocation, but the shape of rod in normal screw-rod device system is cylindrical. To obtain satisfactory reduction of atlantoaxis, the rod will be pre-bent obviously before fixation; however, the cylindrical rod will be rotated when tighten the nuts. Extra devices will be required to adjust and maintain the direction of the rod, thereafter, the surgical field will be blocked by the device, and spinal injury will occur once the devices are not held tightly. While the novel automatic anti-rotation rod has the function of anti-rotation during nut-tightening process, and also holds all the advantages of normal rod. Further research should be performed for the differences in biomechanical characteristics between two methods.OBJECTIVE: To investigate the biomechanical properties of the novel automatic anti-rotation rod for internal fixation system of atlantoaxial posterior approach based on three-dimensional finite-analysis model of upper cervical spine.METHODS: The three-dimensional finite element model of upper cervical spine with internal rod fixation system was developed. The biomechanical characteristics of the internal fixation system were analyzed. RESULTS AND CONCLUSION: The traditional and novel three-dimensional finite element model with realistic and geometric similarity contained 198330 elements, 964747 nodes and 246788 elements, 996069 nodes,correspondingly. There was no obvious stress concentration in both two systems, stress was concentrated mainly in the screw-bone and screw-rod interfaces. The stress values of the novel system were higher than those of the traditional system, but the maximum Von Misses Stress of two systems was lower than the yield (795-827 MPa ) and ultimate (860-896 MPa) strength of titanium alloys. These results show that the design of the novel automatic anti-rotation rod-screw fixation system has matched the biomechanical requirements for new internal fixation instruments, and is one safe, effective and practical device for atlantoaxial posterior procedure showing promising application prospect.
3.PROLIFERATION INHIBITION AND APOPTOSIS INDUCTION ON HUMAN HEPATO-CARCINOMA HepG-2 CELLS BY UNDARIA PINNATIFIDA POLYSACCARIDES
Xiangyang ZOU ; Xue WANG ; Huaxin WANG ; Lianying GUO ; Rong XING ; Lin HOU
Acta Nutrimenta Sinica 2004;0(05):-
Objective: To investigate the inhibitory effect of Undaria pinnatifida polysaccharides (UPPS) on hepatocellular carcinoma HepG-2 cells and its possible mechanism. Method: The effect of inhibiting proliferation and inducting apoptosis of UPPS were determined by means of MTT and FCM. The expression of Bcl-2 and Bax proteins was immunohis to chemcally evaluated after treatment of UPPS. Results: UPPS inhibited HepG-2 cells growth in vitro , significantly higher than the negative control group (P
4.Impact of enhanced recovery after surgery program for hungry bone syndrome in patients on maintenance hemodialysis undergoing parathyroidectomy for secondary hyperparathyroidism
Ling WANG ; Xiaohong ZHANG ; Fengqi HU ; Hai YUAN ; Zhao GAO ; Li HE ; Shuang ZOU
Annals of Surgical Treatment and Research 2022;103(5):264-270
Purpose:
Hungry bone syndrome after parathyroidectomy is an important clinical problem in patients on maintenance hemodialysis. We examined the effect of an enhanced recovery after surgery (ERAS) program on the incidence of hungry bone syndrome after parathyroidectomy in this population.
Methods:
This single-institution, retrospective study analyzed 108 patients on hemodialysis who underwent parathyroidectomy for secondary hyperparathyroidism. Patients were classified into the pre-ERAS (n = 52) and post-ERAS (n = 56) groups. The ERAS program identified high-risk patients and enforced aggressive measures to normalize calcium levels following parathyroidectomy.
Results:
There was no significant difference in age, sex, body weight, presenting symptoms, preoperative calcium and alkaline phosphatase levels, postoperative intact parathyroid levels, postoperative calcium levels at 1 and 24 hours after parathyroidectomy, and 30-day readmission rates between the groups. The post-ERAS group had significantly higher levels of postoperative calcium at 48 and 72 hours after parathyroidectomy, but a lower incidence of hungry bone syndrome and shorter postoperative length of stay. Patients with hungry bone syndrome had higher preoperative levels of alkaline phosphatase and intact parathyroid, longer postoperative length of stay, and were less likely to have been part of the ERAS program. High preoperative alkaline phosphatase levels and absence of the ERAS program were independent risk factors for hungry bone syndrome after parathyroidectomy.
Conclusion
The ERAS program reduced the incidence of hungry bone syndrome and shortened the postoperative length of stay in patients on maintenance hemodialysis who underwent parathyroidectomy for secondary hyperparathyroidism.
5.Comparison of the effects of polymer ceramic onlay and all ceramic crown in short crown molar
GUAN Darong ; ZHANG Deying ; ZOU Kangyuan ; CHEN Jueqing
Journal of Prevention and Treatment for Stomatological Diseases 2017;25(8):533-536
Objective :
To compare the clinical effects of polymer ceramic onlay and all ceramic crown in short crown molars
Methods :
45 cases of polymer ceramic onlay and 45 cases of Zirconium dioxide all ceramic crowns which repaired the short crowm molars after root canal therapy were compared clinically from the aspects of beauty of restoration, fracture and dislodgement, marginal adaptation and the preservation of abutment teeth.
Results :
One polymer ceramic onlay had fall out form the teeth after half year, while the all ceramic crowns have been 8 cases after 6~12 months. There were significant differences in fracture and dislodgement between the two groups (χ2=4.44, P < 0.05).
Conclusion
Polymer ceramic onlay has good clinical effects in the restoration of short crown molars.
6.Effect of the microbial lipopeptide on tumor cell lines: apoptosis induced by disturbing the fatty acid composition of cell membrane.
Xiangyang LIU ; Xinyi TAO ; Aihua ZOU ; Shizhong YANG ; Lixin ZHANG ; Bozhong MU
Protein & Cell 2010;1(6):584-594
Microbial lipopeptides play an important role in apoptosis induction of tumor cells. However, there is little knowledge about the relationship between apoptosis induction and membrane fatty acids. The present study focused on the effects of lipopeptides produced by Bacillus subtilis HSO121 on Bcap-37 cell lines. 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl (MTT) colorimetric assay and surface tension measurements, showed that the critical micelle concentration (CMC) was a critical level for the inhibitory activity of lipopeptides on the growth of Bcap-37 cells. Under the CMC, the order of least to greatest cytotoxicity effect on cancer cell lines by lipopeptides is C(13)-lipopeptide < C(14)-lipopepitde < C(15)-lipopeptide. Above CMC, all lipopeptides directly exert cytolytic activity. The flow cytometric analysis and Hoechst33258 staining experiments confirmed the apoptosis of Bcap-37 cell lines induced by lipopeptides in a dose-dependent manner. This apoptosis was associated with a significant decrease of the unsaturated degree of the cellular fatty acids of Bcap-37 cell lines due to the changes in the cellular fatty acids composition induced by the lipopeptide treatment. These results indicated that disturbance of the cellular fatty acid composition of breast cancer cell lines were related to in the cell apoptosis. Furthermore, significant difference in IC(50) values of tumor cells and normal cell showed that the lipopeptide exerted selective cytotoxicity on the cancer cells. Thus HSO121 lipopeptides may have potential applications as an anticancer leads.
Antineoplastic Agents
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chemistry
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pharmacology
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Apoptosis
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Bacillus subtilis
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Cell Cycle
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Cell Membrane
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chemistry
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metabolism
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Cell Survival
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drug effects
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Fatty Acids
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chemistry
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metabolism
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HeLa Cells
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Humans
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Lipopeptides
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chemistry
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pharmacology
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Ploidies
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Tumor Cells, Cultured
7.Biomechanical analysis of new horizontal screw-screw crosslink in C1-C2 pedicle screw-rod fixation
Beiping OUYANG ; Xiangyang MA ; Chunshan LUO ; Xiaobao ZOU ; Tingsheng LU ; Qiling CHEN
Chinese Journal of Tissue Engineering Research 2024;28(12):1837-1841
BACKGROUND:Posterior atlantoaxial pedicle screw rod internal fixation is the main method for treating atlantoaxial dislocation,and the horizontal crosslink plays an important role in the antirotation ability of the internal fixation system.The new horizontal screw-screw crosslink can effectively overcome the disadvantages of traditional horizontal crosslink,such as inconvenient installation,impact on bone grafting bed,and potential spinal cord injury.However,the biomechanical properties of the new horizontal screw-screw crosslink with different installation modes are still unclear. OBJECTIVE:To investigate the biomechanical characteristics of new different installation modes of horizontal screw-screw crosslink in the C1-C2 pedicle screw-rod fixation and to provide a theoretical basis for optimal installation mode. METHODS:Six fresh human occipitocervical specimens were divided into the intact state group(group A),and the atlantoaxial instability model of type Ⅱ odontoid fracture was established based on the intact state group as the instability group(group B).The C1-C2 pedicle screw-rod fixation was performed on each specimen based on the instability group(group C).In group C,different installation modes of horizontal screw-screw crosslink were successively installed in each specimen,including upper transverse connection(two atlas screw tails)as group D,lower transverse connection(two axis screw tails)as group E,diagonal transverse connection(upper left and lower right for group F,lower left and upper right for group G),and cross transverse connection as group H.The specimen models were tested in order of flexion,extension,lateral flexion and lateral rotation on a three-dimensional motion machine,and the atlantoaxial range of motion of each group of specimens was obtained.Repeated measure analysis of variance was used to evaluate the biomechanical properties of each group. RESULTS AND CONCLUSION:(1)Under six states,the range of motion of groups A,C,D,E,F,G and H was smaller than that of group B,and there were statistically significant differences(P<0.05).(2)In the flexion and extension states,there was no significant difference among the five types of horizontal screw-screw crosslink groups(P>0.05).(3)In the left and right rotation directions,there were significant differences in D and E groups compared with F,G and H groups(P<0.05);there were no significant differences between D and E groups,and F and G groups(P>0.05),and there were no significant differences in F and G groups compared with H group(P>0.05).(4)In conclusion,under flexion-extension states,the biomechanical stability of five types of horizontal screw-screw crosslink groups was similar,but under the rotation state,the stability of diagonal horizontal screw-screw crosslink group and cross horizontal screw-screw crosslink group was obviously better than that of transverse horizontal screw-screw crosslink group;however,the stability of diagonal horizontal screw-screw crosslink group is similar to the cross horizontal screw-screw crosslink group,so the former is more worthy of clinical recommendation.
8.Comparison of Transoral Anterior Jefferson-Fracture Reduction Plate and Posterior Screw-Rod Fixation in C1-Ring Osteosynthesis for Unstable Atlas Fractures
Mandi CAI ; Yifeng WU ; Rencai MA ; Junlin CHEN ; Zexing CHEN ; Chenfu DENG ; Xinzhao HUANG ; Xiangyang MA ; Xiaobao ZOU
Neurospine 2024;21(2):544-554
Objective:
To compare the clinical outcomes of transoral anterior Jefferson-fracture reduction plate (JeRP) and posterior screw rod (PSR) surgery for unstable atlas fractures via C1-ring osteosynthesis.
Methods:
From June 2009 to June 2022, 49 consecutive patients with unstable atlas fractures were treated by transoral anterior JeRP fixation (JeRP group) or PSR fixation (PSR group) and followed up at General Hospital of Southern Theatre Command of PLA; 30 males and 19 females were included. The visual analogue scale (VAS) score, Neck Disability Index (NDI), distance to anterior arch fracture (DAAF), distance to posterior arch fracture (DPAF), lateral mass displacement (LMD), Redlund-Johnell value, postoperative complications, and fracture healing rate were retrospectively collected and statistically analyzed.
Results:
Compared with that in the PSR group, the bleeding volume in the JeRP group was lower, and the length of hospital stay was longer. The VAS scores and NDIs of both groups were significantly improved after surgery. The postoperative DAAF and DPAF were significantly smaller after surgery in both groups. Compared with the significantly shorter DPAF in the PSR group, the JeRP group had a smaller DAAF, shorter LMDs and larger Redlund-Johnell value postoperatively and at the final follow-up. The fracture healing rate at 3 months after surgery was significantly greater in the JeRP group (p < 0.05).
Conclusion
Both C1-ring osteosynthesis procedures for treating unstable atlas fractures yield satisfactory clinical outcomes. Transoral anterior JeRP fixation is more effective than PSR fixation for holistic fracture reduction and short-term fracture healing, but the hospital stay is longer.
9.Comparison of Transoral Anterior Jefferson-Fracture Reduction Plate and Posterior Screw-Rod Fixation in C1-Ring Osteosynthesis for Unstable Atlas Fractures
Mandi CAI ; Yifeng WU ; Rencai MA ; Junlin CHEN ; Zexing CHEN ; Chenfu DENG ; Xinzhao HUANG ; Xiangyang MA ; Xiaobao ZOU
Neurospine 2024;21(2):544-554
Objective:
To compare the clinical outcomes of transoral anterior Jefferson-fracture reduction plate (JeRP) and posterior screw rod (PSR) surgery for unstable atlas fractures via C1-ring osteosynthesis.
Methods:
From June 2009 to June 2022, 49 consecutive patients with unstable atlas fractures were treated by transoral anterior JeRP fixation (JeRP group) or PSR fixation (PSR group) and followed up at General Hospital of Southern Theatre Command of PLA; 30 males and 19 females were included. The visual analogue scale (VAS) score, Neck Disability Index (NDI), distance to anterior arch fracture (DAAF), distance to posterior arch fracture (DPAF), lateral mass displacement (LMD), Redlund-Johnell value, postoperative complications, and fracture healing rate were retrospectively collected and statistically analyzed.
Results:
Compared with that in the PSR group, the bleeding volume in the JeRP group was lower, and the length of hospital stay was longer. The VAS scores and NDIs of both groups were significantly improved after surgery. The postoperative DAAF and DPAF were significantly smaller after surgery in both groups. Compared with the significantly shorter DPAF in the PSR group, the JeRP group had a smaller DAAF, shorter LMDs and larger Redlund-Johnell value postoperatively and at the final follow-up. The fracture healing rate at 3 months after surgery was significantly greater in the JeRP group (p < 0.05).
Conclusion
Both C1-ring osteosynthesis procedures for treating unstable atlas fractures yield satisfactory clinical outcomes. Transoral anterior JeRP fixation is more effective than PSR fixation for holistic fracture reduction and short-term fracture healing, but the hospital stay is longer.
10.Comparison of Transoral Anterior Jefferson-Fracture Reduction Plate and Posterior Screw-Rod Fixation in C1-Ring Osteosynthesis for Unstable Atlas Fractures
Mandi CAI ; Yifeng WU ; Rencai MA ; Junlin CHEN ; Zexing CHEN ; Chenfu DENG ; Xinzhao HUANG ; Xiangyang MA ; Xiaobao ZOU
Neurospine 2024;21(2):544-554
Objective:
To compare the clinical outcomes of transoral anterior Jefferson-fracture reduction plate (JeRP) and posterior screw rod (PSR) surgery for unstable atlas fractures via C1-ring osteosynthesis.
Methods:
From June 2009 to June 2022, 49 consecutive patients with unstable atlas fractures were treated by transoral anterior JeRP fixation (JeRP group) or PSR fixation (PSR group) and followed up at General Hospital of Southern Theatre Command of PLA; 30 males and 19 females were included. The visual analogue scale (VAS) score, Neck Disability Index (NDI), distance to anterior arch fracture (DAAF), distance to posterior arch fracture (DPAF), lateral mass displacement (LMD), Redlund-Johnell value, postoperative complications, and fracture healing rate were retrospectively collected and statistically analyzed.
Results:
Compared with that in the PSR group, the bleeding volume in the JeRP group was lower, and the length of hospital stay was longer. The VAS scores and NDIs of both groups were significantly improved after surgery. The postoperative DAAF and DPAF were significantly smaller after surgery in both groups. Compared with the significantly shorter DPAF in the PSR group, the JeRP group had a smaller DAAF, shorter LMDs and larger Redlund-Johnell value postoperatively and at the final follow-up. The fracture healing rate at 3 months after surgery was significantly greater in the JeRP group (p < 0.05).
Conclusion
Both C1-ring osteosynthesis procedures for treating unstable atlas fractures yield satisfactory clinical outcomes. Transoral anterior JeRP fixation is more effective than PSR fixation for holistic fracture reduction and short-term fracture healing, but the hospital stay is longer.