Objective To assess the incidence of contrast-induced nephropathy(CIN)in patients with chronic thromboembolic pulmonary hypertension(CTEPH)after receiving balloon pulmonary angioplasty(BPA),and to evaluate the effect of the contrast agents on renal function.Methods A total of 143 CTEPH patients,who received BPA at the China-Japan Friendship Hospital of China from December 2018 to May 2022,were enrolled in this study.The clinical data,hemodynamic indicators,and serum creatinine(SC)concentrations within one week before and 48-72 h after BPA were collected.The estimated glomerular filtration rate(eGFR)was calculated according to the Modification of Diet in Renal Disease(MDRD)formula.The SC concentration and eGFR changes before and after each BPA procedure were compared.The incidence of CIN and its risk factors were evaluated,and the changes in hemodynamics,SC and eGFR after the initial and last time of BPA treatment were analyzed.Results A total of 192 BPA procedures were performed in 115 CTEPH patients,including 88 BPA procedures in males and 103 BPA procedures in females.The mean amount of contrast agent used for each BPA was(145.58±47.26)mL.After BPA,12 patients developed 13 times of CIN,with an incidence of 6.8％.There was no significant differences(P＞0.05)in the baseline characteristics and SC concentration before BPA between CIN patients and non-CIN patients.In terms of the hemodynamic indexes,the mixed venous oxygen saturation(SvO2)in CIN patients was significantly lower than that in non-CIN patients(58.58％±10.38％vs.66.15％±8.02％,P=0.002),and no statistically significant differences(P＞0.05)in the other hemodynamic indexes existed between CIN group and non-CIN group.No statistically significant differences in SC concentration and eGFR existed before and after each BPA procedure.In patients who had received several BPA procedures,significant improvements in the SC[(78.09±18.760)μmol/L vs.(82.26±21.37)μmol/L,P＜0.001]and eGFR[(86.08±21.22)mL/(min·1.73 m2)vs.(82.07±22.05)mL/(min·1.73 m2),P=0.007]was achieved when compared with their baseline values.Conclusion CTEPH patients may develop CIN after receiving BPA treatment.After receiving several BPA treatments the patient's clinical symptoms and hemodynamics can be improved,and the patient's renal function is also significantly improved.

Objective To evaluate the effects of extremity ischemic preconditioning on liver injury after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Sixty ASA physical status Ⅱ or Ⅲ patients (NYHA Ⅱ or Ⅲ), weighing 44-72 kg, with ejection fraction≥40％, schedule for elective cardiac valve replacement with CPB, were randomly divided into 2 groups (n =30 each) using a random number table: control group (group C) and extremity ischemic preconditioning group (group E).Immediately after anesthesia induction, an auto-inflatable cuff was placed under the right lower extremity, and was inflated to 300 mmHg to induce ischemia (oxygen saturation at the finger tip undetected or foot pulse untouched on the operated side) which was preceded by 3 cycles of 5 min ischemia-5 min reperfusion in group E.Before anesthesia induction (T0) , and at 2, 12, 24, and 72 h, and 7 days after operation (T1-5) , blood samples were taken from the right internal jugular vein for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities.The expression of serum miR-122 was detected at T0-4 by real-time reverse transcriptase polymerase chain reaction.Results Compared with the value at T0, the serum ALT and AST activities were significantly increased at T2-4, and the expression of miR-122 was up-regulated at T1-3 in the two groups (P＜0.05).Compared with group C, the serum ALT and AST activities were significantly decreased at T2-4, and the expression of miR-122 was down-regulated at T1-3in group E (P＜0.05).Conclusion Extremity ischemic preconditioning can mitigate liver injury after cardiac valve replacement with CPB.

ABSTRACT:Objective To investigate the nursing methods of artificial lens implantation by three points suspension in the treatment of aphakic eye.Methods 12 cases with aphakic eyes were included in this study.XLSTABI -SKY foldable artificial lens was implanted by suspension of three points in the second phase,and all the patients was followed-up by more than six months. Preparation before operations,human-based nursing during operations and individualized nursing after operations were done and complications were observed.Results Through the operation and special nursing,each patient got a better corrected visual acuity than that before operation,en-dothelial decompensation and endophthalmitis of artificial artificial lens were not observed.Conclu-sion Special nursing and education for patients with implantation of foldable artificial lens sus-pended by three points could improve visual acuity and satisfactory consequences.

ABSTRACT:Objective To investigate the nursing methods of artificial lens implantation by three points suspension in the treatment of aphakic eye.Methods 12 cases with aphakic eyes were included in this study.XLSTABI -SKY foldable artificial lens was implanted by suspension of three points in the second phase,and all the patients was followed-up by more than six months. Preparation before operations,human-based nursing during operations and individualized nursing after operations were done and complications were observed.Results Through the operation and special nursing,each patient got a better corrected visual acuity than that before operation,en-dothelial decompensation and endophthalmitis of artificial artificial lens were not observed.Conclu-sion Special nursing and education for patients with implantation of foldable artificial lens sus-pended by three points could improve visual acuity and satisfactory consequences.