AIM: To observe the inhibitory effects of vinpocetine injection on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in the rats and to explore the underlying mechanisms.METHODS: Male Wistar rats (n=50) were randomly divided into 5 groups: control group, ALI model group, and low, medium and high doses of vinpocetine treatment groups.The rats in control group were injected with 0.9% NaCl at 5 mL/kg through femoral vein.The rats in ALI model group received LPS at 10 mg/kg through femoral vein.After injected with LPS, the rats in vinpocetine treatment groups received vinpocetine at 0.2 mg/kg, 0.7 mg/kg or 1.2 mg/kg via intraperitoneal injection.The pathological changes of the lung tissues were observed under microscope with HE staining.The cell apoptosis in the lung tissues was detected by TUNEL staining.Myeloperoxidase (MPO) activity was measured by the method of spectrophotometry.The protein expression of NF-κB, ICAM-1, VCAM-1, Bax and Bcl-2 was determined by Western blot.RESULTS: Compared with ALI group, administration of vinpocetine significantly attenuated the structural injury of the lung and the infiltration of inflammatory cells.Moreover, vinpocetine decreased cell apoptosis and MPO activity in the lung tissues of ALI rats.In addition, the protein expression of NF-κB, ICAM-1, VCAM-1 and Bax was inhibited after vinpocetin treatment, whereas Bcl-2 expression was increased.CONCLUSION: Vinpocetine attenuates LPS-lung injury by reducing MPO activity and regulating NF-κB, ICAM-1, VCAM-1, Bax and Bcl-2 protein expression.

OBJECTIVETo retrospectively evaluate the results of deep sternal wound infection (DSWI) after cardiac surgery.

METHODSBetween January 2010 and September 2013, 139 patients suffering from DSWI after median sternotomy. The incidence of DSWI was 0.47% (139/29 574). There were 111 (79.9%) male and 28 (20.1%) female patients. The mean age was (61 ± 11) years, the mean body weight was (74 ± 14) kg. The incidence of postoperative DSWI was 0.88% (91/10 341) after isolated coronary artery bypass grafting (CABG), 0.70% (15/2 143) after valve surgery or other cardiac surgery plus CABG, 0.21% (24/11 429) after valve surgery, 0.15% (3/2 002) after thoracic aortic surgery, and 0.19% (6/3 158) after congenital heart disease. The sternotomy was re-opened and extensive debridement of the wound was performed in all patients. When the wound was clean and there was a bed of fresh granulation tissue, the sternum was rewired. The surgical procedure performed included debridement, drainage, sternal wire reclosure and pectoralis major muscular transpositions depended on the clinical condition of the patient.

RESULTSThe in-hospital mortality was 9.3%. Failure of secondary sternal refixation appeared in 15 (10.8%) patients, the reoperation procedure of these 15 patients was pectoralis major muscular transpositions. Other complications included sepsis in 13 patients, perivalvular leakage in 3 patients, and cardiac rupture during the surgical procedure in 3 patients. The mean hospitalization was (39 ± 30) days.

CONCLUSIONDeep sternal wound infection is a life-threatening complication after cardiac surgery associated with high morbidity and mortality.

Adult ; Aged ; Aged, 80 and over ; Cardiac Surgical Procedures ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Sternum ; surgery ; Surgical Wound Infection ; surgery ; Young Adult