Effect of ulinastatin combined rivaroxaban on deep vein thrombosis in major orthopedic surgery

Objective:To explore the effect of ulinastatin(UTI) continuous infusion combined Rivaroxaban on the deep vein thrombosis in patients undergoing major orthopedic surgery.Methods:Forty-five patients undergoing major orthopedic surgery were randomly divided into three groups:ulinastatin continuous infusion(Uc) group,ulinastatin single injection(Us) group and control(C) group.All patients received patient-controlled intravenous analgesia(PCIA) after operation,and took Rivaroxaban 10 mg orally 12 hours after operation.Ulinastatin(5 000 U/kg)was given intravenously to both Uc and Us groups preoperatively.Group C was given isometric normal saline,group Uc was pumped UTI continuous intravenously at the end of surgery(10 000U/kg) to 48 hours through PCIA pump.The values of hematocrit(HCT),thrombomodulin(TM),Interleukin(IL-6),thrombin-antithrombin complex(TAT),D-Dimer(D-D) were normally tested before surgery(T1),at the end of the surgery(T2),12 hours(T3).24 hours(T4) and 48 hours(T5)after surgery.Results:Compared with T1,there was an upward tendency in TM,IL-6,TAT,and D-D after operation in group C group(P <0.05).The values of them were significandy increased from nearly 24-hour after surgery in Us group(P<0.05).In group Uc.there were no significant changes in these indices after operation(P>0.05).Conclusions:During the perioperative period,ulinastatin continuous infusion combined Rivaroxaban can correct blood hypercoagulability through different approaches in patients undergoing major orthopedic surgery.

Low-dose Simvastatin Increases Skeletal Muscle Sensitivity to Caffeine and Halothane

Objective To determine whether the myotoxic side effects of statin simvastatin affect skeletal muscle's sensitivity to caffeine and halothane. Methods Primary cultured neonate rat skeletal myotubes were treated with 0.01-5.0 μmol/L simvastatin for 48 hours. MTT was used to evaluate cellular viability. The gross morphology and microstructure of the myotubes were observed with a light and electron microscope, respectively. The intracellular calcium concentrations([Ca^(2+)]i) at rest and in response to caffeine and halothane were investigated by fluorescence calcium imaging. Data were analyzed by analysis of variance(ANOVA) test. Results Simvastatin(0.01-5.0 μmol/L) decreased myotube viability, changed their morphological features and microstructure, and increased the resting [Ca^(2+)]i in a dose-dependent manner. Simvastatin did not change myotube's sensitivity to low doses of caffeine(0.625-2.5 mmol/L) or halothane(1.0-5.0 mmol/L). In response to high-dose caffeine(10.0 mmol/L, 20.0 mmol/L) and halothane(20.0 mmol/L, 40.0 mmol/L), myotubes treated with 0.01 μmol/L simvastatin showed a significant increase in sensitivity, but those treated with 1.0 μmol/L and 5.0 μmol/L simvastatin showed a significant decrease. The sarcoplasmic reticulum Ca^(2+) storage peaked in the myotubes treated with 0.01 μmol/L simvastatin, but it decreased when cells were treated with higher doses of simvastatin(0.1-5.0 μmol/L).Conclusions The myotoxic side effect of simvastatin was found to change the sensitivity of myotubes in response to high-dose caffeine and halothane. When dose was low, sensitivity increased mainly because of increased Ca^(2+) content in the sarcoplasmic reticulum, which might explain why some individuals with statin-induced myotoxic symptoms may show positive caffeine-halothane contracture test results. However, when the dose was high and the damage to the myotubes was severer, sensitivity was lower. It is here supposed that the damage itself might put individuals with statin-induced myotoxic symptoms at greater risks of presenting with rhabdomyolysis during surgery or while under anesthesia.

Effect of high-dose ulinastatin on the cardiopulmonary bypass-induced inflammatory response in patients undergoing open-heart surgery

Ulinastatin(UTI),a broad-spectrum elastase inhibitor,can stabilize lysosomal membranes and inhibit the activation and release of various inflammatory cytokines caused by cardiopulmonary bypass(CPB).[1,2]UTI has recently been considered to be an effective anti-inflammatory agent and has been widely used in clinical settings,[3-5]but the optimal dose has not been defined.Therefore,we conducted a prospective,randomized,controlled trial involving 60 patients undergoing cardiac surgeries with CPB and investigated the serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-8(IL-8),at different time points in order to evaluate the antiinflammatory efficacy of high-dose UTI and explore the optimum dose.

Measurement of wireless pressure sensors fabricated in high temperature co-fired ceramic MEMS technology

High temperature co-fired ceramics(HTCCs) have wide applications with stable mechanical properties,but they have not yet been used to fabricate sensors.By introducing the wireless telemetric sensor system and ceramic structure embedding a pressure-deformable cavity,the designed sensors made from HTCC materials(zirconia and 96% alumina) are fabricated,and their capacities for the pressure measurement are tested using a wireless interrogation method.Using the fabricated sensor,a study is conducted to measure the atmospheric pressure in a sealed vessel.The experimental sensitivity of the device is 2 Hz/Pa of zirconia and 1.08 Hz/Pa of alumina below 0.5 MPa with a readout distance of 2.5 cm.The described sensor technology can be applied for monitoring of atmospheric pressure to evaluate important component parameters in harsh environments.