Objective To compare the outcome of patients with the strategy of conventional and steady cooling ＆ rewarming and cold reperfusion , who suffered from DeBakey type Ⅰ aortic dissection or aortic arch aneurysm and underwent the total aortic arch replacement. Methods Thirty-two patients who underwent total arch replacement were randomly allocated to one of two strategies of temperature management in cardiopulmonary bypass （CPB）, conventional group （group C, 16 cases） and steady cooling ＆. rewarming and cold reperfusion group （group S, 16 cases）. The jugular bulb venous oxygenation saturation （SjvO2）, jugular bulb venous oxygen tension （PivO2） and jugular bulb venous blood temperature （JVBT） were tested or monitored during the operation. Preoperative and postoperative neurological examinations and brain computerized tomography scan were performed. Results All patients survived the operations and were discharged from hospital. No new brain infarction occurred. Transient neurologic dysfunction occurred in 2 patients of the group S and 3 patients of the groupC. The “cooling ＆ rewarming blanket-impress puple” occurred in 4 cases of the group C. The SjvO2, PjvO2, lowest nasopharyngeal temperature and the post operative nasopharyngeal temperature of the patients in group S were significantly higher than those of the patients in group C （SjvO2 0.85±0. 11 vs. 0. 74±0.23, PjvO2 36. 9± 15.6mmHg vs. 24.5±7.7mmHg, P（ 0.01 ）. While the highest brain temperature, wake time and ICU stay in group S were remarkably lower than those in group C （P 〈0. 01,0. 05）. Conclusion With less postbypass afterdrop and satisfactory clinical outcome, the strategy of steady cooling ＆ rewarming and cold reperfusion can effectively avoid brain hyperthermia and mismatch of cerebral blood flow metabolism in the surgery of total aortic arch replacement.
Objective\ In order to assess and evaluate the clinical results of cold blood cardioplegia and intermittent cross clamping as myocardial preservation in coronary artery bypass grafting(CABG).\ Methods\ According to the management methods, 2 013 cases for elective, isolated CABG were divided into two groups at St.George’s Hospital, London.Cold blood cardioplegia group: 596 patients treated with cold blood cardioplegia, and hypothermic ventricular fibrillation group: 1 417 patients treated with intermitt...
【Abstract】Objective To investigate the injury of calcium on the liver. Methods By using collagenase-containing solution to perfuse the rat livers, the rat liver suspension with different viability was prepared, preserved hypothermically, and the cytosolic calcium comcentration was detected with Fura2/AM. Results ① The concentration of cytosolic calcium after 2-hour storage: Experiment group 1(viability 5%) (1055.0±30.79) nmol/L, experiment group 2(viability 10%) (853.0±20.42) nmol/L, experiment group 3(viability 30%) (616.0±13.20) nmol/L, experiment group 4(viability 50%) (562.0 ±26.06) nmol/L, experiment group 5(viability 70%-80%) (318.0±13.01) nmol/L, experiment group 6(viability 90%) (114.6±6.11) nmol/L. ②The concentration of cytosolic calcium after 24hour storage: Experiment group A(viability 10%) (1704.0±70.11) nmol/L, experiment group B(viability 50%) (1125.0±23.22) nmol/L. The results showed that the lower was the viability, the higher was the cytosolic calcium concentration.With the same viability the cytosolic calcium concentration elevated more than two times higher than the original concentration with the time lengthened. Conclusion Calcium overload is one of the main factors which attribute to the ischemiareperfusion injury of the hepatocytes.
SD mice were selected for Collin’s solution (4℃) infusion into the portal vein with different pressure to preserve the liver transplants. The following parameters were determined ①liver tissue aderine ribonucleotide including adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP), ②cytoplasmic free Ca２＋ in single liver cell (［Ca２＋］i) and ③tissue pathologic ultrastructure change by highperformance liquid chromatography into quantimeter and pathologic examination respectively. The result suggested that with the infusion pressure becoming higher, the liver free Ca２＋(［Ca２＋］i), tissue aderine ribonucleotide, EC and tissue pathologic ultrastructure changed obviously. This result shows ［Ca２＋］i, EC and tissue aderine ribonucleotide might indicate the viability of liver transplant, and using low pressure infusion has benefit effect on liver preservation.Key wordsCold infusion pressureViability of liver transplantEnergy metabolismLiver cell free Ca２＋
ObjectiveTo investigate the recognition of cold in pharmacy college students. MethodsInvestigation on the recognition of cold, treatment and anti-cold drugs were carried out by questionnaires among 158 pharmacy college students from March to July, 2013. ResultsThe annual cold frequency was mainly between once and twice in these students. The cold therapy cost in a year was between 10 and 50 Yuan, and the treatment cycle of cold was mainly between 3 and 7 days. The students were familiar with the inducement and symptoms of cold, but they didn't get adequate message of non-chemoprophylaxis methods on cold. The students knew anti-cold drugs mainly by pharmacist in drugstores, doctors and advertisements. Traditional Chinese Medicine decoction and Chinese and Western medicine mixture were their favorite drug types, and capsule, tablet and oral solution were their favorite dosage forms. ConclusionIt is necessary to strengthen college students' ability to recognize and treat cold correctly by comprehensive measures.
ObjectiveTo summarize the research progress of difficulty in removing of locking plate and screw. MethodsThe domestic and foreign related literature about difficulty in removing of locking plate and screw was reviewed. The incidence, the reason, preventive measure, removing method, and its advantages and disadvantages were summarized and analyzed. ResultsWith the popularization of locking plate application, cases with difficulty in removing locking screw have significantly increased compared with non-locking plate, so it has become a new clinical problem. The main reasons are stripping, cross-threading, and cold-welding. In recent years, for the difficulty in removing of locking plate and screw, some special extraction tools and new extraction methods have developed, but each has its defects and indications. ConclusionSufficient preoperative preparation, being familiar with its advantage and disadvantage as well as its indications are necessary. The specific situations of patient, including the reason, the screw, the plate, the incision, the bone quantity, and existing equipment, should be comprehensively considered to select appropriate methods.
ObjectiveTo investigate the synergistic effect of cold stress plus particulate matter 2.5 (PM2.5) co-exposure on the occurrence of respiratory inflammation and the possible post-transcriptional regulation mechanism of cold inducible RNA-binding protein (CIRP).MethodsIn vivo and in vitro experiments were carried out, and the lung tissue specimens from human surgical resection were observed. The rat model and cultured airway epithelial cells 16HBE were respectively divided into four groups (n=8), namely blank control group, 5 °C/18 °C group, PM2.5 group and 5 °C/18 °C+PM2.5 group. The expression of mRNA and protein of representative inflammatory cytokines and CIRP of cultured airway epithelial cells and rat bronchial/pulmonary tissues were respectively detected by ELISA, qPCR, and Western blot. Furthermore, the temporal dynamics of CIRP distribution were observed by cellular immunofluorescence. Finally, immunohistochemical method was used to observe the localization and expression of CIRP in rat and human bronchial/pulmonary tissues at the same time.ResultsIn vivo experiments, the mRNA and protein expression levels of CIRP, interleukin-6, and tumor necrosis factor-α in 5 °C group and PM2.5 group were significantly higher than those in the control group (all P<0.05), while the expression level of mRNA and protein in 5 °C+PM2.5 group were increased most obviously (all P<0.01). The same rule also appeared in the experimental results of each group in the vitro experiment. In addition, CIRP was mainly located in the cell nucleus; compared with the control group, the intracellular shift of CIRP appeared in 18 °C group and PM2.5 group, while the migration phenomenon was most obvious in the 18 °C+PM2.5 group. In the immunohistochemistry of rat bronchus/pulmonary tissue, the expressions of CIRP in the 5 °C group and in the PM2.5 group were significantly higher than those in the control group, and the CIRP expression in 5 °C+PM2.5 group was increased most evidently. Moreover, CIRP was expressed in the bronchial epithelial mucosa of normal people and patients with chronic obstructive respiratory disease (COPD), and it is mainly located in the nucleus of airway mucosal epithelial cells. The CIRP expression of COPD patients was significantly higher than that in the normal population.ConclusionCold stress has a sensitizing effect on airway epithelial inflammatory response induced by PM2.5, and post-transcriptional regulation of CIRP translocation from nucleus to cytoplasm may be an important mechanism.
Objective To investigate the risk factors of early allograft dysfunction (EAD) following C-Ⅱ donation after cardiac death (DCD) liver transplantation. Methods The data of 46 donors and recipients of C-ⅡDCD liver transplantation between March 2012 and August 2015 were retrospectively analyzed. The baseline data such as democracy, death cause, donor warm ischemic time (DWIT) and cold ischemic time (CIT) in EAD group and the non-EAD group (control group) was compared, and whether these factors were risk factors of EAD was investigated by univariate and multivariate analyses. Statistical cut-off values for significant factors of the unfavorable analysis were defined by receiver operating characteristics (ROC) analysis. The 6-month and 1-year graft survival rate were compared. Results The EAD group had a longer DWIT compared with the group [(17.6±4.7) and (12.7±6.2) minutes, P=0.009]; meanwhile, the EAD group had a longer CIT compared with the control group [(13.7±4.7) and (11.0±3.5) hours, P=0.020]. The other factors in both groups showed no statistical significance (P>0.05). The ROC curve revealed the cut-off values of DWIT and CIT were 17.50 minutes [area under the curve (AUC)=0.713, P=0.020] and 9.85 hours (AUC=0.723, P=0.015), respectively. The multivariate logistic regression analysis showed the DWIT [odds ratios (OR)=1.340, 95% confidence interval (CI)(1.042, 1.654), P=0.008] and CIT [OR=1.396, 95% CI (1.075, 1.698), P=0.015] were all independent risk factors of EAD. The 6-month and 1-year graft survival rate of the EAD group and the control group was 85.7% vs. 92.3% (P=0.607) and 71.4% vs. 84.6% (P=0.587), respectively. Conclusions EAD may occured in C-Ⅱ donors with DWIT≥17.50 minutes or CIT≥9.85 hours in DCD liver transplantation. The livers can be used as a resource for clinical use and also have a good outcome.
ObjectiveTo evaluate the efficacy of the glucosamine hydrochloride combined with risedronate in the treatment of knee osteoarthritis (KOA) associated with cold pain of knee. MethodsThe clinical data of 50 KOA patients including 25 with cold pain and 25 without cold pain, treated in the Department of Rheumatology between January and December 2015 were collected. The clinical symptoms, Western Ontario and McMater Universities (WOMAC) index of osteoarthritis score, knee cold pain score, knee joint therml texture maps (TTM) score, serum osteoprotegerin (OPG), Dickkopf-1 (DKK-1) , and sclerostin levels (SO) were recorded for comparison between patients with and without cold pain in order to investigate the correlation between these indicators and cold pain degree. Patients in the cold pain group were treated with glucosamine hydrochloride combined with risedronate. Follow-up lasted for six months, and the improvement of above indexes and the treatment safety were analyzed. ResultsThere were significant differences between the two groups in the disease course, TTM score of knee front and popliteal fossa, ΔTTM, DKK-1 and SO (P ＜ 0.05) . After 6 months of treatment, patients in the cold pain group improved significantly in WOMAC score, knee cold pain score, TTM score of knee front and popliteal fossa, ΔTTM, OPG, DKK-1 and SO (P ＜ 0.05) . ConclusionsAs one of the main complaints of patients with advanced OA, knee cold pain is associated with the metabolic activity of osteoclasts. It can be alleviated by the treatment with risedronate combined with glucosamine.
Objective To evaluate the effects of cold provoca tion on optic dise blood flow and retinal light sensitivity of primary open-angle glaucoma (POAG) patients,and explore the relationship between the changes of optic disc blood flow and retin al light sensitivity. Methods A total 33 POAG patients (33 eyes)and 13 normal controls (13 eyes) were tested by usin g th e Heidelberg retinal flowmetry (HRF) and Topcon automatic perimeter,and the optic disc blood flow and retinal light sensitivity of POAG patients and normal cont rols were measured at normal conditions and after cold provocation. Results The mean optic disc blood flow,volume and the mean retinal light sensitivity of POAG patients decreased significantly (Plt;0.05) after cold provocation.There was a linear and significant relationsh ip between the decrease of mean optic disc blood flow and mean retinal light sen sitivity of POAG patients (r=0.615,P＜0.001). The optic disc blood flow of POAG patients with a history of migraine were more likely to r educe in response to cold provocation and reduced much more than those without such history (Plt;0.05). Conclusion Cold provocation can significantly reduce both the optic disc blood flow and retinal light sensitivity in POAG patients.A close correlation was fo und between the amount of mean optic disc blood flow decrease and the volume of mean retinal light sensitivity decline. (Chin J Ocul Fundus Dis, 2001,17:37-40)