Objective To summarize the experience of emergency coronary artery bypass grafting(CABG) on serious myocardium ischemia in early post CABG. Methods Between 1998 and 2002, emergency redo CABG was performed in 13 patients with serious early post operative myocardium ischemia. The causes included vein graft embolize(4 cases),uncompleted revascularize(3 cases), graft spasm(1 case) and anastomose stenosis or occlusion (5 cases). The grafts was 1 3(1.8±0.9) during redo CABG. Results There were 6 deaths, the mortality was 46%. The mean follow up was 31 months. There was no recurrence of angina. NYHA function was Ⅰ Ⅱ. Conclusion Emergency CABG is an important method in saving the patients with severe myocardium ischemia in early post CABG. The perioperative prevention and early treatment should be emphasized.
【Abstract】Objective To investigate the protective effect of improving the pancreatic ischemia and calcium channel blockers on preventing the progression of acute pancreatitis. Methods Twenty-four patients with mild acute pancreatitis were randomly divided into two groups： control group and treated group. Within the first 72 hours from the onset of AP, routine conservative managements were performed in control group, improving the pancreatic ischemia and preventing Ca2+ overload were performed in treated group for two weeks. The hemorrheological parameters were measured at 1,4,7,14 days after adimission, simultanously, serum TNFα, IL-1β, C-reactive protein and plasma TXB2, 6-keto-PGF1α levels were determined with ELISA methods. Results The hemorrheological changes were improved in treated group, serum TNFα, IL-1β, C-reactive protein and plasma TXB2, 6-keto-PGF1α levels were significantly decreased each time point in treated group as compared with control group. Conclusion Improving the pancreatic ischemia and calcium channel blockers have protective effect through reducing the generation of cytokines and inflammatory mediators on preventing the progression of acute pancreatitis.
Objective Ginsenoside Rg1 could increase the tolerance of neural hypoxia and ischemia under stress, and play an anti-apoptotic effect in hypoxia ischemia brain damage (HIBD). To investigate the effects of ginsenoside Rg1 on neural apoptosis and recovery of neurological function in neonatal rats with HIBD, and to explore the possible mechanism. Methods Fifty-four 10-day-old SD rats (weighing 16-22 g) were randomly allocated into sham-operation group (Sham group, n=6), HIBD model group (HIBD group, n=24), and ginsenoside Rg1 treatment group (Rg1 group, n=24). SDrats in HIBD group and Rg1 group were made the models of HIBD by l igation of the right common carotid artery (CCA) and subsequently hypoxic ventilation (8%O2 plus 92%N2) for 2.5 hours; and in Sham group, the right CCA was only exposed without l igation of CCA and hypoxic ventilation. Intraperitoneal injection of 0.1 mL normal sal ine (NS) containing 40 mg/kg Rg1 was given immediately after operation in Rg1 group, intraperitoneal injection of 0.1 mL pure NS was given in both HIBD group and Sham group and was repeated every 24 hours. The general state of SD rats was monitored after operation, and Longa scores were recorded to evaluate the neurological function at 4, 8, 24, and 72 hours after HIBD. Western blot and immunohistochemistry staining were used to detect protein expressions of both hypoxia inducible factor 1α (HIF-1α) and cleaved caspase 3 (CC3). TUNEL staining was used to evaluate neural apoptosis in situ. Results All rats survived to the end of the experiment. Neurological dysfunction was observed in both HIBD group and Rg1 group, showing significant difference in Longa score when compared with that in Sham group (P lt; 0.05). There was significant difference in Longa score between Rg1 group and HIBD group at 72 hours after HIBD (P lt; 0.05). Western blot showed that the protein expressions of both HIF-1α and CC3 were observed at every time point in every group. The expressions of HIF-1α protein in HIBD group and Rg1 group were significantly higher than those in Sham group at 4, 8, 24, and 72 hours (P lt; 0.05), and the expressions in Rg1 group were significantly higher than those in HIBD group (P lt; 0.05). The expressions of CC3 protein in HIBD group were significantly higher than those in Sham group at 4, 8, 24, and 72 hours (P lt; 0.05), and significant difference was found between Rg1 group and Sham group only at 4 hours (P lt; 0.05). Immunohistochemistry staining demonstrated that HIF-1α and CC3 protein mainly distributed in nucleusand cytoplasma, the results of HIF-1α and CC3 protein expression were similar to the results by Western blot. TUNEL staining showed that the positive cells were characterized by yellow or brown particle confined within nucleus. The number of apoptotic cells at every time point in HIBD group was significantly higher when compared with that in Sham group (P lt; 0.05), and the number of apoptotic cells in Rg1 group was significantly lower when compared with that in HIBD group at 8, 24, and 72 hours (P lt; 0.05). Conclusion Rg1 could inhibit Caspase 3 activation by strengthening and stabil izing HIF-1α signal pathway, and plays a role of anti-apoptosis in neonatal rats with HIBD.
ObjectiveTo investigate the effect of sex on learning and memory ability of newborn mice with hypoxic-ischemic brain injury.MethodsFifty C57BL/6 mice aged 10 days were divided into hypoxia-ischemia group and sham group according to the random number table method, and there were 28 in the hypoxic-ischemic group and 22 in the sham group with half female and half male respectively. In the ischemia-hypoxia group, the left common carotid artery was ligated and then the mice were placed in 34℃ hypoxia chambers with 8% oxygen and 92% nitrogen mixture for 45 minutes. In the sham group, only the skin of the left neck was cut and sutured. After 2 months, Y maze test and Morris water maze test were used to evaluate the learning and memory ability of mice.ResultsThe success rate of the hypoxic-ischemic group was 71.4% (20/28), and that of the sham group was 100.0% (22/22), a total of 42 mice were enrolled in the experiment. In Y maze test, there were differences in entries and total distance of new arms between the two groups (entries: F=16.068, P<0.001; total distance: F=8.532, P=0.007); compared between different groups in the same gender, the entries and total distance of new arms in the hypoxic-ischemic group were lower than those in the sham group with statistically significant differences (entries in males: P=0.001, entries in females: P=0.012; total distance in males: P=0.010, total distance in females: P=0.046). Compared between males and females in the same group, the entries and total distance of new arms of females were higher than those of males in the hypoxic-ischemic group, with statistically significant differences (P=0.039, 0.043). In Morris water maze test, the escape latency of positioning navigation in the hypoxic-ischemic group was higher than that in the sham group, and males showed more obviously poor performance (P<0.001); in the experiment of space exploration, differences were found in the duration of stay and the target quadrant entries between the two groups (duration of stay: F=8.297, P<0.001; entries: F=4.042, P=0.014), and there were statistically significant differences in the same gender males and females in the hypoxic-ischemic group and the sham group (duration of stay in males: P=0.003, duration of stay in females: P=0.038; entries in males: P=0.006, entries in females: P=0.041). Compared between males and females in the same group, the duration of stay and the target quadrant entries of females were higher than those of males in the hypoxic-ischemic group, with statistically significant differences (duration of stay: P=0.018; entries: P=0.032).ConclusionsThe learning and memory ability of newborn mice may be slightly impaired after hypoxic ischemic brain injury. There is significant difference in the effect on learning and memory ability between different genders, and the effect on males is higher than that on females.
ObjectiveTo investigate relationship between liver non-parenchymal cells and hepatic ischemia-reperfusion injury (HIRI).MethodThe relevant literatures on researches of the relationship between HIRI and liver non-parenchymal cells were analyzed and reviewed.ResultsDuring HIRI, hepatocytes could be severely damaged by aseptic inflammatory reaction and apoptosis. The liver non-parenchymal cells included Kupffer cells, sinusoidal endothelial cells, hepatic stellate cells, and dendritic cells, which could release a variety of cytokines and inflammatory mediators to promote the damage, and some liver non-parenchymal cells also had effect on reducing HIRI, for example: Kupffer cells could express heme oxygenase-1 to reduce HIRI, and hepatic stellate cells may participate in the repair process after HIRI. The role of liver non-parenchymal cells in HIRI was complex, but it also had potential therapeutic value.ConclusionLiver non-parenchymal cells can affect HIRI through a variety of mechanisms, which provide new goals and strategies for clinical reduction of HIRI.
Objective To investigate the etiology, diagnosis, revascularization of upper l imb ischemia and the compl ications. Methods From March 2003 to February 2008, 72 cases of upper l imb ischemia were treated. There were 44males and 28 females, aged 19-90 years old (median 63 years old). The duration of the disease was 1 hour to 2 years. All cases had symptoms of l imb ischemia such as paleness, coldness, paralysis. According to individual condition, 72 patients accepted revascularizations including thromboembolectomy, reconstruction after traumatic injuries, pseudoaneurysm excision and angioplasty, balloon dilatation and stent implant, arterial repair, patch, vascular prosthesis or vein bypass/transplantation, and l igation or coarctation of fistula. Results Sixty patients (83.3%) recovered well after operation. Re-occlusion following thromboemboletomy was found in 6 patients (8.3%). And there were 4 patients (5.6%) with l imbs disturbance and muscles contracture and 2 patients (2.8%) with compartment syndrome in this series. The affected l imb had to be amputated in 2 patients (2.8%). And 1 patient (1.4%) died of cerebral hemorrhage because of anticoagulation 3 days after operation. All patients were followed up 1-6 years (mean 52 months) after operation. Four patients recurred and got improved after retreatments. The others got a good result with normal skin color and temperature, restoration of the radial and ulnar pulses, normal saturation of blood oxygen of finger ti p (gt; 90%) and patent blood flow of affected arteries was shown by color Doppler ultrasound. Conclusion The study indicates that identifying the etiology of upper l imb ischemia before operation and active revascularizations consistent with different causes are the key to treat the upper l imb ischemia.
Objective To investigate the application of abdominal aorta and bilateral abdominal perineal artery ligation in a hindlimb ischemia model of rats for research. Methods According to the random digits table, 38 SD rats were divided into 3 groups randomly, sham operation group (SO group, n=12), abdominal aorta ligation group (AAL group, n=12) and abdominal aorta and bilateral abdominal perineal artery ligation group (AAL+BAPA group, n=14). Rats were anesthetized by 6 mg/100 g ketamine via intraperitoneal injection. Blood vessels were ligated via laparotomy according to different procedures. Movement and pale skin color of rat’s hindlimb were observed on 2 and 4 weeks after operation, meanwhile venous blood from unilateral iliac vein was obtained for blood gas analysis and hindlimb skeletal muscle for HE stain. Results Two rats were dead during 3 d after operation in AAL+BAPA group, other rats survived. Rats in SO group had no obviously abnormal appearance. AAL group and AAL+BAPA group immediately presented hindlimbs pale, lower skin temperature, hypofrontality of limb motion after procedure. Symptoms above mentioned had improved gradually after 2 weeks and completely recuperated 4 weeks after operation in AAL group. Ischemia symptoms were still remained obviously such as cold, dried and thin on the 4th weekend in AAL+BAPA group. Each group had no hindlimbs necrosis. Two weeks after operation, pale limbs and muscle strength in AAL+BAPA group were more severe than those of SO group (Plt;0.05); Pale limbs was still worse than that of AAL group on 4 weeks after operation (Plt;0.05). There were no significant differences on different time in each group (Pgt;0.05). Venous blood partial pressure of oxygen of AAL+PABA group was significantly lower than that of the other two groups on 2 and 4 weeks after operation (Plt;0.05). Normal striated muscle structure was presented in SO group pathologically. AAL group revealed coloretur unevenness, swelling and distension, muscle cellular transverse striation elimination, skeletal muscle cell nucleolus deeply stained on the 2nd weekend and no difference with the SO group on the 4th weekend. AAL+BAPA group presented skeletal muscles decoration unevenness, cells swelling and distension, muscle cellular transverse striation elimination, skeletal muscle cell nucleolus stained deeply and intensively, intercellular space widening until the 4th weekend， but no obviously necrocytosis. Conclusion The method of ligating abdominal aorta and bilateral abdominal perineal artery can make a stable SD rat model of hindlimb ischemia
The present paper is aimed to investigate the effect of basic fibroblast growth factor (bFGF) on proliferation, migration and differentiation of endogenous neural stem cell in rat cerebral cortex with global brain ischemia-reperfusion. A global brain ischemia-reperfusion model was established. Immunohistochemistry was used to observe the pathological changes and the expression of BrdU and Nestin in cerebral cortex. RT-PCR was used to measure the NSE mRNA in brain tissue. The results of measurements indicated that in sham operation group, there was no positive cell in cerebral cortex, and the content of NSE mRNA did not change. In the operation group, the expression of BrdU and Nestin increased significantly at the end of the 3rd day, and peaked on the 7th day. NSE mRNA expression did not significantly increase. In bFGF group, compared with sham operation group and model group, the number of BrdU-positive and Nestin-positive cells increased significantly at each time point (P<0.05), and peaked at the end of the 11th day, and the content of NSE mRNA increased significantly (P<0.05). This research demonstrated that the proliferation of endogenous neural stem cells in situ could be induced by global cerebral ischemia and reperfusion, and could be promoted and extended by bFGF. In additiion, bFGF might promote endogenous neural stem cells differentiated into neurons.
Purpose To examine the change of optic disc blood flow in primary open angle glaucoma(POAG) patients after cold provocation test and nifedipine administration． Methods Using Heidelberg retinal flowmetry (HRF),the blood flow of optic disc of glaucoma patients and normal control subjects were measured under basal condition, after cold provocation test,and after nifedipine administration. Results The mean optic disc blood volume and flow of POAG patients reduced from 27.1 and 545.4 to 22.3 and 452.4 after cold provocation test (Plt;0.05),and increased to 29.0 and 579.5 after nifedipine adminstration(Plt;0.05).The changes of mean optic disc blood flow of patients with a history of cold extremities show statistic significance compared with whom without such history (Plt;0.05)). Conclusion The changes of blood flow of optic disc in POAG patients may be influenced by cold stimuli and administration of nifedipine,and the history of cold extremities might be connected with the change of optic disc blood flow in POAG patients. (Chin J Ocul Fundus Dis,2000,16:85-87)
Cardiac arrest (CA) represents a significant global public health challenge, severely endangering both individual lives and public safety. Over the past years, cardiopulmonary resuscitation (CPR) techniques have advanced significantly. In 2013, the American Heart Association proposed high-quality CPR (HQ-CPR) as a key component for enhancing survival and neurological prognosis in patients with CA. HQ-CPR extends beyond the fundamental skills of compression and ventilation by prioritizing key metrics such as compression rate and depth, full chest recoil, minimal interruptions, and early defibrillation, representing a pivotal shift of CPR toward evidence-based, standardized, and precision-oriented practices. Despite the widespread recognition and adoption of HQ-CPR in Western nations, China continues to encounter multiple barriers in CPR dissemination and quality assurance, including low public training rates, variable instructional quality, delayed emergency responses, and disparities in healthcare resource allocation. Accordingly, this article provides a comprehensive review of the essential components of HQ-CPR. By analyzing the key challenges in China’s current clinical implementation, this paper focuses on exploring the latest research on enhancing resuscitation efficacy in recent years, especially focusing on new strategies to minimizing myocardial ischemia and improving reperfusion efficiency, in order to provide information for clinical optimization and improving patient outcomes following CA.