BACKGROUND Cardiopulmonary bypass(CPB)is an essential procedure for maintaining the blood supply to vital organs in patients undergoing cardiac surgery.However,perioperative cardiac injury related to CPB remains a sev...BACKGROUND Cardiopulmonary bypass(CPB)is an essential procedure for maintaining the blood supply to vital organs in patients undergoing cardiac surgery.However,perioperative cardiac injury related to CPB remains a severe complication in these patients.Cardiac protection is important for patients undergoing CPB.AIM To evaluate the potential cardioprotective efficacy of the Chinese medicine preparation Xuebijing injection(XBJ)in patients undergoing CPB.METHODS Sixty patients undergoing cardiac surgery with CPB were randomly allocated to the XBJ and control groups(saline).XBJ was administered intravenously three times:12 h prior to surgery,at the beginning of the surgery,and 12 h after the second injection.Cardiac function was evaluated by echocardiography 48 h after surgery.Circulating inflammation-and oxidative-stress-related markers were measured.Clinical outcomes related to intensive care unit(ICU)stay were recorded.RESULTS Compared to control treatment,XBJ was associated with improved PaO2/FiO2 and cardiac systolic function,but reduced troponin I and creatine kinase fraction after surgery(all P<0.05).The circulating concentrations of tumor necrosis factor-α,interleukin(IL)-1βand IL-8 in the XBJ group were significantly lower than those in the control group(all P<0.05),whereas the circulating concentration of IL-10 was significantly higher in the XBJ group(P<0.05).In addition,the lengths of ICU stay and hospitalization after surgery tended to be shorter in the XBJ group than in the control group,although the differences were not significant.CONCLUSION Perioperative administration of XBJ was associated with attenuated cardiac injury during CPB,likely via anti-inflammatory and antioxidative mechanisms.展开更多
Objective:To study the protective effect of levothyroxine on myocardial and cerebral ischemia reperfusion injury during surgery under cardiopulmonary bypass.Methods: Patients who underwent valve replacement under card...Objective:To study the protective effect of levothyroxine on myocardial and cerebral ischemia reperfusion injury during surgery under cardiopulmonary bypass.Methods: Patients who underwent valve replacement under cardiopulmonary bypass in Mianyang Central Hospital between March 2015 and December 2017 were selected and randomly divided into the Euthyrox group who received preoperative levothyroxine therapy and the control group who received routine preoperative intervention. The myocardial and cerebral injury indexes, pro-inflammatory and adhesion molecules as well as antioxidant indexes were measured before operation and 12 h after operation.Results: Twelve hours after operation, serum cTnI, LDH, CK-MB, H-FABP, NSE, S100B, CD11b/CD18, sP-selectin, IL-1 and IL-10 contents as well as SjvO2 levels of both groups were higher than those before operation whereas Cu-Zn SOD, CAT and GSH-Px contents were lower than those before operation, and serum cTnI, LDH, CK-MB, H-FABP, NSE, S100B, CD11b/CD18, sP-selectin, IL-1 and IL-10 contents as well as SjvO2 level of Euthyrox group were lower than those of control group whereas Cu-Zn SOD, CAT and GSH-Px contents were higher than those of control group.Conclusions:Levothyroxine has protective effect on the myocardial and cerebral ischemia reperfusion injury induced by inflammation and oxidative stress during surgery under cardiopulmonary bypass.展开更多
Objective: To study the effect of ulinastatin on the pathological links related to myocardial injury and ischemia reperfusion after cardiac surgery under cardiopulmonary bypass. Methods: The patients undergoing valve ...Objective: To study the effect of ulinastatin on the pathological links related to myocardial injury and ischemia reperfusion after cardiac surgery under cardiopulmonary bypass. Methods: The patients undergoing valve replacement under cardiopulmonary bypass between February 2015 and December 2017 in Mianyang Central Hospital of Sichuan Province were chosen as the research subjects and randomly divided into the experimental group who accepted ulinastatin + creatine phosphate sodium intervention and the control group who accepted creatine phosphate sodium intervention. The levels of myocardial injury markers, apoptosis molecules, inflammation molecules and oxidative stress molecules in serum as well as the expression intensity of inflammation molecules and oxidative stress molecules in peripheral blood were determined before surgery and 24 h after surgery. Results: Serum cTnI, CK-MB, H-FABP, sFasL, sTWEAK, Caspase-3, Caspase-8, IL-1β, TNF-α, ICAM1, MDA and NO levels as well as peripheral blood TLR4, NLRP3, NOX2 and iNOS expression intensity of both groups of patients after surgery were significantly higher than those before surgery, and serum cTnI, CK-MB, H-FABP, sFasL, sTWEAK, Caspase-3, Caspase-8, IL-1β, TNF- , ICAM1, MDA and NO levels as well as peripheral blood TLR4, NLRP3, NOX2 and iNOS expression intensity of experimental group after surgery were significantly lower than those of control group. Conclusion: Ulinastatin can improve the apoptosis, inflammation and oxidative stress related to myocardial injury and ischemia reperfusion after cardiac surgery under cardiopulmonary bypass.展开更多
Objective To study the hormonal and metabolic responses of fetal lamb during cardiopulmonary bypass.Methods Six pregnant ewes underwent fetal cardiopulmonary bypasses with artificial oxygenators and roller pumps for...Objective To study the hormonal and metabolic responses of fetal lamb during cardiopulmonary bypass.Methods Six pregnant ewes underwent fetal cardiopulmonary bypasses with artificial oxygenators and roller pumps for 30 minutes,which maintained the blood gas value at the fetal physiological level. The fetal blood pressure,heart rate,pH value and blood lactate levels were monitored. The levels of catecholamine,cortisol and insulin were measured pre-bypass and then again 30 minutes later. The blood glucose and free fatty acid levels were monitored continuously during the bypass. Fetal hepatic PAS staining was also carried out.Results There were no changes before and during the bypass in fetal blood pressure,heart rate and blood gas. However,pH values decreased and blood lactate levels increased ( P <0.05). The fetal catecholamine and cortisol levels increased significantly ( P <0.01),while the levels of insulin did not change. The blood glucose and free fatty acid levels increased at the beginning of the bypass ( P <0.01),and then gradually slowed down during the bypass. The fetal hepatic PAS staining showed that hepatic glycogen was consumed in large amounts. After 30 minutes of bypass,the fetal lamb would not survive more than 1 hour.Conclusion The fetal lamb has a strong negative reaction to cardiopulmonary bypass.展开更多
文摘BACKGROUND Cardiopulmonary bypass(CPB)is an essential procedure for maintaining the blood supply to vital organs in patients undergoing cardiac surgery.However,perioperative cardiac injury related to CPB remains a severe complication in these patients.Cardiac protection is important for patients undergoing CPB.AIM To evaluate the potential cardioprotective efficacy of the Chinese medicine preparation Xuebijing injection(XBJ)in patients undergoing CPB.METHODS Sixty patients undergoing cardiac surgery with CPB were randomly allocated to the XBJ and control groups(saline).XBJ was administered intravenously three times:12 h prior to surgery,at the beginning of the surgery,and 12 h after the second injection.Cardiac function was evaluated by echocardiography 48 h after surgery.Circulating inflammation-and oxidative-stress-related markers were measured.Clinical outcomes related to intensive care unit(ICU)stay were recorded.RESULTS Compared to control treatment,XBJ was associated with improved PaO2/FiO2 and cardiac systolic function,but reduced troponin I and creatine kinase fraction after surgery(all P<0.05).The circulating concentrations of tumor necrosis factor-α,interleukin(IL)-1βand IL-8 in the XBJ group were significantly lower than those in the control group(all P<0.05),whereas the circulating concentration of IL-10 was significantly higher in the XBJ group(P<0.05).In addition,the lengths of ICU stay and hospitalization after surgery tended to be shorter in the XBJ group than in the control group,although the differences were not significant.CONCLUSION Perioperative administration of XBJ was associated with attenuated cardiac injury during CPB,likely via anti-inflammatory and antioxidative mechanisms.
文摘Objective:To study the protective effect of levothyroxine on myocardial and cerebral ischemia reperfusion injury during surgery under cardiopulmonary bypass.Methods: Patients who underwent valve replacement under cardiopulmonary bypass in Mianyang Central Hospital between March 2015 and December 2017 were selected and randomly divided into the Euthyrox group who received preoperative levothyroxine therapy and the control group who received routine preoperative intervention. The myocardial and cerebral injury indexes, pro-inflammatory and adhesion molecules as well as antioxidant indexes were measured before operation and 12 h after operation.Results: Twelve hours after operation, serum cTnI, LDH, CK-MB, H-FABP, NSE, S100B, CD11b/CD18, sP-selectin, IL-1 and IL-10 contents as well as SjvO2 levels of both groups were higher than those before operation whereas Cu-Zn SOD, CAT and GSH-Px contents were lower than those before operation, and serum cTnI, LDH, CK-MB, H-FABP, NSE, S100B, CD11b/CD18, sP-selectin, IL-1 and IL-10 contents as well as SjvO2 level of Euthyrox group were lower than those of control group whereas Cu-Zn SOD, CAT and GSH-Px contents were higher than those of control group.Conclusions:Levothyroxine has protective effect on the myocardial and cerebral ischemia reperfusion injury induced by inflammation and oxidative stress during surgery under cardiopulmonary bypass.
文摘Objective: To study the effect of ulinastatin on the pathological links related to myocardial injury and ischemia reperfusion after cardiac surgery under cardiopulmonary bypass. Methods: The patients undergoing valve replacement under cardiopulmonary bypass between February 2015 and December 2017 in Mianyang Central Hospital of Sichuan Province were chosen as the research subjects and randomly divided into the experimental group who accepted ulinastatin + creatine phosphate sodium intervention and the control group who accepted creatine phosphate sodium intervention. The levels of myocardial injury markers, apoptosis molecules, inflammation molecules and oxidative stress molecules in serum as well as the expression intensity of inflammation molecules and oxidative stress molecules in peripheral blood were determined before surgery and 24 h after surgery. Results: Serum cTnI, CK-MB, H-FABP, sFasL, sTWEAK, Caspase-3, Caspase-8, IL-1β, TNF-α, ICAM1, MDA and NO levels as well as peripheral blood TLR4, NLRP3, NOX2 and iNOS expression intensity of both groups of patients after surgery were significantly higher than those before surgery, and serum cTnI, CK-MB, H-FABP, sFasL, sTWEAK, Caspase-3, Caspase-8, IL-1β, TNF- , ICAM1, MDA and NO levels as well as peripheral blood TLR4, NLRP3, NOX2 and iNOS expression intensity of experimental group after surgery were significantly lower than those of control group. Conclusion: Ulinastatin can improve the apoptosis, inflammation and oxidative stress related to myocardial injury and ischemia reperfusion after cardiac surgery under cardiopulmonary bypass.
基金ThisstudywassupportedbytheNationalNaturalScienceFoundationofChina (No 3 9770 73 4)
文摘Objective To study the hormonal and metabolic responses of fetal lamb during cardiopulmonary bypass.Methods Six pregnant ewes underwent fetal cardiopulmonary bypasses with artificial oxygenators and roller pumps for 30 minutes,which maintained the blood gas value at the fetal physiological level. The fetal blood pressure,heart rate,pH value and blood lactate levels were monitored. The levels of catecholamine,cortisol and insulin were measured pre-bypass and then again 30 minutes later. The blood glucose and free fatty acid levels were monitored continuously during the bypass. Fetal hepatic PAS staining was also carried out.Results There were no changes before and during the bypass in fetal blood pressure,heart rate and blood gas. However,pH values decreased and blood lactate levels increased ( P <0.05). The fetal catecholamine and cortisol levels increased significantly ( P <0.01),while the levels of insulin did not change. The blood glucose and free fatty acid levels increased at the beginning of the bypass ( P <0.01),and then gradually slowed down during the bypass. The fetal hepatic PAS staining showed that hepatic glycogen was consumed in large amounts. After 30 minutes of bypass,the fetal lamb would not survive more than 1 hour.Conclusion The fetal lamb has a strong negative reaction to cardiopulmonary bypass.
