Intestinal prolapse and exposure after peritoneal dialysis in low-birth-weight preterm infants with acute renal failure: a case report.

Background: The mortality rate of acute kidney injury (AKI) in low-birth-weight premature infants with acute renal failure is extremely high. Since small hemodialysis catheters do not exist, peritoneal dialysis (PD) is the most suitable dialysis method. At present, only a few studies have reported cases of PD in low-birth-weight newborns. Case Description: On September 8, 2021, a 10-day-old, low-birth-weight preterm infant, who presented with neonatal respiratory distress syndrome and acute renal failure, was admitted to the Second Affiliated Hospital of Kunming Medical University, China. The patient was the elder of twins and had experienced acute renal failure, hyperkalemia, and anuria following the onset of respiratory distress syndrome. During the initial PD catheterization operation, a double Tenckhoff adult PD catheter cut short by 2 cm was used, with the inner cuff placed in the skin. However, the surgical incision was relatively large, and PD fluid leakage occurred. Later, the incision tore, and the intestines prolapsed when the patient cried. The intestines were returned to the abdominal cavity in an emergency operation, and the PD catheter was placed again. This time, the inner Tenckhoff cuff was placed outside the skin, and PD fluid leakage did not reoccur. However, the patient also experienced a decrease in heart rate and blood pressure, as well as severe pneumonia and peritonitis. Following an active rescue, the patient recovered well. Conclusions: The PD method effectively treats low-birth-weight preterm neonates with AKI. An adult Tenckhoff catheter was shortened by 2 cm and successfully used in the PD treatment of a low-birth-weight preterm infant. However, the catheter placement should be outside the skin, and the incision should be as small as possible to avoid leakage and incision tears.

Exoskeleton-Assisted Walking for Pulmonary and Exercise Performances of SCI Individuals.

OBJECTIVE: To determine whether exoskeleton-assisted walking (EAW) improves pulmonary ventilation function, motor function and related body structure, and activities equivalently as the conventional exercise program for people with spinal cord injury (SCI). METHODS: Forty participants (7 females and 33 males; age 37.1±12.0 years) with thoracic SCI were randomized into two groups and undertook 16 sessions of 50-60 min training (4 days/week). Participants in the EAW group received EAW trainings, such as assisted standing, walking, and climbing the stairs. The control group received a conventional exercise program. Outcomes were measured at baseline and upon completion of treatment. RESULTS: After trainings, the EAW group improved more than the control group in the forced vital capacity (FVC, 0.53 L [0.01-1.06 L]), predicted FVC% (19.59 [6.63-32.54]) and forced expiratory volume in 1s (0.61 L [0.15-1.07 L]), basic activities of daily living (BADL) (19.75 [10.88-28.62]), and distal femoral cartilage. Participants in the EAW group completed 6-minute walk test with median 17.3 meters while wearing the exoskeleton. There was no difference in trunk and lower extremity motor function, bone mineral density, and adverse events ( P > 0.05). CONCLUSION: In people with lower thoracic neurological level of SCI, EAW training has potential benefits to facilitate pulmonary ventilation function, walking, BADL and thickness of cartilage comparing to a conventional excise program. SIGNIFICANCE: This study provided more evidence for using EAW in clinic, and partly proved EAW had equivalent effects as conventional exercise program, which may combine with conventional exercise program for reducing burden of therapists in the future.

A bioinformatics analysis of the contribution of m6A methylation to the occurrence of diabetes mellitus.

N6-methyladenosine (m6A) methylation has been reported to play a role in type 2 diabetes (T2D). However, the key component of m6A methylation has not been well explored in T2D. This study investigates the biological role and the underlying mechanism of m6A methylation genes in T2D. The Gene Expression Omnibus (GEO) database combined with the m6A methylation and transcriptome data of T2D patients were used to identify m6A methylation differentially expressed genes (mMDEGs). Ingenuity pathway analysis (IPA) was used to predict T2D-related differentially expressed genes (DEGs). Gene ontology (GO) term enrichment and the Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to determine the biological functions of mMDEGs. Gene set enrichment analysis (GSEA) was performed to further confirm the functional enrichment of mMDEGs and determine candidate hub genes. The least absolute shrinkage and selection operator (LASSO) regression analysis was carried out to screen for the best predictors of T2D, and RT-PCR and Western blot were used to verify the expression of the predictors. A total of 194 overlapping mMDEGs were detected. GO, KEGG, and GSEA analysis showed that mMDEGs were enriched in T2D and insulin signaling pathways, where the insulin gene (INS), the type 2 membranal glycoprotein gene (MAFA), and hexokinase 2 (HK2) gene were found. The LASSO regression analysis of candidate hub genes showed that the INS gene could be invoked as a predictive hub gene for T2D. INS, MAFA,and HK2 genes participate in the T2D disease process, but INS can better predict the occurrence of T2D.

Ventilation improvement after pneumonia treatment evaluated with electrical impedance tomography: an observational study.

Objective.Due to radiation exposure, not all patients with pneumonia receive chest x-rays or CT measurements to confirm treatment effectiveness. The aim of this study was to examine the ability to use electrical impedance tomography (EIT) to evaluate the treatment effectiveness in such patient group.Approach.A total of 35 consecutive patients with non-severe pneumonia were included in this prospective study. The patients received standard treatment according to our internal protocol. EIT measurements were performed in supine position before the treatment started and on day 6 of the treatment period. The EIT-based global inhomogeneity (GI) index and center of ventilation (CoV) index were calculated. The clinical pulmonary infection score (CPIS) was obtained at both time points.Main results.Clinically significant improvements inGIandCoVwere found in the patient group (ΔGI: -34% ± 17% and ΔCoV: -10% ± 11%;p<0.001). Although the CPIS was also significantly improved (ΔCPIS-0.70 ± 0.17,p<0.001), no correlations were demonstrated when compared to ΔGIor ΔCoV. Significance.EIT demonstrated individual improvement of ventilation heterogeneity after standard treatment in non-severe pneumonia, and provided different information compared to CPIS. EIT has the potential to become a routine non-invasive, non-radiative tool to assess pneumonia treatment effectiveness.

The Role of the Diaphragm in Postural Stability and Visceral Function in Parkinson's Disease.

Background: In normal subjects, the diaphragm plays a key functional role in postural stability, articulation, respiration, defecation, and urination. Objectives: The aim of this study was to investigate the role of the diaphragm in postural stability and visceral function in patients with Parkinson's disease (PD) and to compare the diaphragm function by gender, Hoehn and Yahr (H&Y) staging, and motor subtypes. Methods: In total, 79 patients were enrolled in this cross-sectional study. The severity of the disease was assessed by the Movement Disorder Society-Unified Parkinson's Disease Rating Scale III and by H&Y staging. Postural stability was quantitatively recorded, and respiratory function was evaluated by spirometry. Several scales were used to evaluate visceral function in patients with PD. In addition, diaphragm ultrasound was used to measure the excursion, contraction velocity, and thickness of the diaphragm during quiet breathing, deep breathing, and the sniff test. Significant features were selected by the least absolute shrinkage and selection operator (LASSO) regression and fitted in the multivariate linear regression and Pearson's correlation analysis. Results: Diaphragm thickness and excursion during quiet breathing were significantly different between men and women and between H&Y stage 1-2 and stage 2.5-3, whereas the diaphragm function was not influenced by motor subtypes. It was shown that the diaphragmatic function was significantly correlated with postural stability, voice function, respiratory function, constipation, and urological function to varying degrees in patients with PD. Conclusion: The diaphragmatic function is associated with dysfunction in PD although it remains unclear as to whether the observed changes in the diaphragm are primary or secondary.

[Risk factors for cow's milk protein allergy in infants: a multicenter survey].

OBJECTIVE: To investigate the risk factors for cow's milk protein allergy (CMPA) among infants through a multicenter clinical study. METHODS: A total of 1 829 infants, aged 1-12 months, who attended the outpatient service of the pediatric department in six hospitals in Shenzhen, China from June 2016 to May 2017 were enrolled as subjects. A questionnaire survey was performed to screen out suspected cases of CMPA. Food avoidance and oral food challenge tests were used to make a confirmed diagnosis of CMPA CMPA. A multivariate logistic regression analysis was used to investigate the risk factors for CMPA. RESULTS: Among the 1 829 infants, 82 (4.48%) were diagnosed with CMPA. The multivariate logistic regression analysis showed that maternal food allergy (OR=4.91, 95%CI: 2.24-10.76, P<0.05), antibiotic exposure during pregnancy (OR=3.18, 95%CI: 1.32-7.65, P<0.05), and the introduction of complementary food at an age of <4 months (OR=3.55, 95%CI: 1.52-8.27, P<0.05) were risk factors for CMPA, while exclusive breastfeeding (OR=0.21, 95%CI: 0.08-0.58, P<0.05) and the introduction of complementary food at an age of >6 months (OR=0.38, 95%CI: 0.17-0.86, P<0.05) were protective factors. CONCLUSIONS: The introduction of complementary food at an age of <4 months, maternal food allergy, and antibiotic exposure during pregnancy are risk factors for CMPA in infants.

Prognostic factors in patients undergoing early-start peritoneal dialysis within 24 h after catheter insertion.

This study aimed to investigate the clinical characteristics, prognosis, and factors for survival of patients who underwent early-start peritoneal dialysis (PD) within 24 h after catheter insertion three years after PD. This study was conducted from January 1, 2013 to December 31, 2017. All adult patients who were diagnosed with end-stage renal disease (ESRD) and underwent PD for the first time within 24 h after catheter insertion in our hospital were included. All patients with PD were followed-up until they withdrew from PD, switching to hemodialysis, were transferred to other medical centers, underwent renal transplantation, died or were lost to follow-up, or continued to undergo dialysis until the end of the study period. The follow-up observation lasted three years. The number of eligible patients was 110, and switching to hemodialysis and death were the main reasons for patients to withdraw from PD. The 1-, 2-, and 3-year technical survival rates of patients were 89.1, 79.1, and 79.1% respectively, while the 1-, 2- and 3-year survival rates were 90, 81.8, and 81.8%, respectively. The Charlson comorbidity index, age, hemoglobin, serum albumin, diabetic nephropathy, chronic glomerulonephritis, and hypertensive renal damage were independent risk factors that affected the prognosis of PD patients. Under the condition of ensuring the quality of the PD catheter insertion, early-start PD within 24 h after catheter insertion is a safe treatment approach for ESRD patients.

Prognostic factors in patients undergoing early-start peritoneal dialysis within 24 h after catheter insertion

This study aimed to investigate the clinical characteristics, prognosis, and factors for survival of patients who underwent early-start peritoneal dialysis (PD) within 24 h after catheter insertion three years after PD. This study was conducted from January 1, 2013 to December 31, 2017. All adult patients who were diagnosed with end-stage renal disease (ESRD) and underwent PD for the first time within 24 h after catheter insertion in our hospital were included. All patients with PD were followed-up until they withdrew from PD, switching to hemodialysis, were transferred to other medical centers, underwent renal transplantation, died or were lost to follow-up, or continued to undergo dialysis until the end of the study period. The follow-up observation lasted three years. The number of eligible patients was 110, and switching to hemodialysis and death were the main reasons for patients to withdraw from PD. The 1-, 2-, and 3-year technical survival rates of patients were 89.1, 79.1, and 79.1% respectively, while the 1-, 2- and 3-year survival rates were 90, 81.8, and 81.8%, respectively. The Charlson comorbidity index, age, hemoglobin, serum albumin, diabetic nephropathy, chronic glomerulonephritis, and hypertensive renal damage were independent risk factors that affected the prognosis of PD patients. Under the condition of ensuring the quality of the PD catheter insertion, early-start PD within 24 h after catheter insertion is a safe treatment approach for ESRD patients.

Clinical observation of umbilical cord mesenchymal stem cell transplantation for treating patients receiving peritoneal dialysis.

BACKGROUND: This study aims to observe the outcome and safety of umbilical cord-mesenchymal stem cell (UC-MSC) treatment for continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS: A total of 24 CAPD patients, who underwent UC-MSC treatment from June 2011 to December 2012, were selected for this study. These patients were followed up until June 2015. RESULTS: Results revealed a significant increase in hemoglobin, erythropoietin and albumin levels, a decrease in C-reactive protein levels, and marked improvement in cystatin C and urine volume within three months after UC-MSC transplantation; and the difference was statistically significant (P<0.05). However, the difference in residual glomerular filtration rate, serum creatinine, peritoneal KT/V and remnant kidney KT/V was not statistically significant (P>0.05). CONCLUSIONS: Clinical indicators of patients with CAPD can be partially improved through UC-MSC treatment.

Social Capital and Quality of Life Among People Living With HIV/AIDS in Southeast China.

A cross-sectional study was conducted with 261 people living with HIV (PLWH) in Southeast China. A social capital questionnaire was used to measure social capital dimensions (trust, social connection, and social participation). A Chinese version of the Medical Outcomes Study HIV Health Survey (MOS-HIV) was used to assess Quality of Life (QoL); Physical Health Summary Scores (PHS) and Mental Health Summary Scores (MHS) were calculated. Multiple regression assessed whether social capital and its dimensions were associated with PHS and MHS. After controlling for sociodemographics and HIV-related factors, lower PHS scores were found among participants with low overall social capital (P < .01) and low trust (P < .001). Lower MHS scores were found among participants with low overall social capital (P < .001), low trust (P < .001) and low social connection (P < .01). Our findings identify potential intervention targets to improve QoL among PLWH in Southeast China, including the promotion of social capital.

Influence of mesenchymal stem cells on expression of AQP1 and AQP2 in rats with nephropathy induced by adriamycin.

This study aims to explore the therapeutic effect of bone marrow mesenchymal stem cells on adriamycin nephrosis, and the potential mechanism. The rat experimental nephropathy model was established by unilateral nephrectomy combined repeated injecting adriamycin (ADR). Thirty adriamycin nephrosis rats were randomly divided into three groups, including ADR (n=10), MSCs transplantation through peripheral veins groups (M-V, n=10), and MSCs transplantation through right renal artery groups (M-A, n=10), and there was another normal control group (N, n=10). This study lasted 8 weeks, 24 hours urine was collected through simple metabolic cage to measure urinary volume and urine protein quantitation in 24 hours. The levels of plasma albumin (ALB), sodium were measured by biochemical analysis. The expressions of AQP1-2 were measured by immuno-histochemistry assay. Kidney medulla ultramicroscopic structure was observed by TEM. The results indicated that the ALB and 24 h urinary volume have significant increased in M-V and M-A group compared to the ADR group (P<0.05). Furthermore, the serum sodium and urine protein quantitation in 24 hours were decreased in M-V and M-A group compared to ADR group (P<0.05). Protein expression of AQP1-2 had been remarkably decreased (P<0.05). It showed degenerative changes of kidney ultra microscopic structures of the ADR rats, while MSCs transplantation could significantly improve the damage. In conclusion, in adriamycin nephropathy rats, MSCs transplantation exerts its therapeutic effects by decrease urinary albumin excretion, increase ALB, decrease sodium and the expression of AQP1-2 in renal tubules.

[Serum adiponectin levels in children with Kawasaki disease].

OBJECTIVE: To explore the change in serum adiponectin levels and its significance in children with Kawasaki disease (KD). METHODS: Forty-five KD patients were enrolled in this study, including 18 with coronary artery lesions (CAL group) and 27 without coronary artery lesions (NCAL group). Twenty healthy children were recruited to the control group. Enzyme-linked immunosorbent assay was used to measure serum adiponectin levels, and an automatic biochemical analyzer was used to measure the levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). RESULTS: The serum adiponectin levels in the CAL and NCAL groups were significantly lower than in the control group during the acute phase, subacute phase, and recovery phase (P<0.01), with lower levels observed during the acute phase and subacute phase (P<0.01). Compared with the NCAL group, the CAL group had significantly higher serum levels of adiponectin during the acute phase and recovery phase (P<0.05). The levels of TC, HDL, and LDL in the NCAL and CAL groups were significantly lower than in the control group (P<0.05). The levels of serum adiponectin in KD patients were positively correlated with the levels of TC, TG, and C-reactive protein and the occurrence of CAL (r=0.31, 0.30, 0.34, and 0.35, respectively; P<0.05). CONCLUSIONS: Children with KD have metabolic disorders of blood lipids and reduced serum adiponectin levels. Reduced serum adiponectin levels may be the result of systemic inflammation, while increased adiponectin levels may be closely associated with the occurrence of CAL.

SiRNA-HMGA2 weakened AGEs-induced epithelial-to-mesenchymal transition in tubular epithelial cells.

Diabetic nephropathy as the most common cause of end-stage renal disease accounts for a significant increase in morbidity and mortality in patients. Epithelial to mesenchymal transition (EMT) of tubular cells is associated with diabetic nephropathy. Advanced glycation end products (AGEs) are thought to be involved in the pathogenesis of diabetic nephropathy via multifactorial mechanisms. However, whether AGEs could induce EMT in Tubular epithelial cells is still unknown. In this study, we found that AGEs induced EMT and accompanied by reduced expression of the epithelial markers E-cadherin and enhanced expression of the mesenchymal markers vimentin and alpha-smooth muscle actin. Furthermore, the expression of HMGA2 was upregulated by AGEs. Far more interesting, its knockdown by short interfering RNA (siRNA) effectively reversed AGEs-induced EMT. Meanwhile, we also found that knockdown of HMGA2 inhibited high AGEs-induced generation of reactive oxygen species (ROS) and the activation of p38 MAPK. Collectively, these studies suggest that HMGA2 plays a important role in EMT during Diabetic nephropathy and more study toward HMGA2 should be played in renal pathogenesis.

[Seasonal variations of fine root production and mortality in Larix gmelinii plantation in 2004-2008].

Minirhizotron approach was employed to investigate the seasonal variations of fine root production and mortality in Larix gmelinii plantation in 2004-2008. At the same time, air temperature, precipitation, and soil temperature and moisture at 10 cm depth were recorded. The overall aim of this study was to determine the seasonal patterns of fine root production and mortality in the plantation, and their relationships with the four environmental factors. On an annual basis, the fine root length production ranged from 0.20 to 0.78 mm x cm(-2), while the mortality varied from 0.26 to 0.72 mm x cm(-2). The mean fine root production and mortality in 2004-2006 were 0.67 mm x cm(-2) and 0.59 mm x cm(-2), respectively, being greater than the corresponding values (0.37 mm x cm(-2) and 0.39 mm x cm(-2)) in 2007-2008. During growth season (from May to October), the fine root production in late spring and early summer (June and July) occupied 51% -68% of total, while that in late autumn (October) only occupied 1% -4%. The root mortality in late summer (August) and autumn (September and October) ranged from 59% to 70%, but that in early spring (May) only ranged from 1% to 5%. Correlation analysis indicated that 66% of the variation in fine root production could be explained by air temperature, and only 24% and 27% could be explained by the soil temperature at 10 cm depth and precipitation, respectively. Fine root mortality only showed an exponential positive correlation with the soil temperature at 10 cm depth.

[A case-control study on the risk factors of female infertility].

OBJECTIVE: Understanding the risk factors of female infertility among child-bearing aged women, in Nanchang area. METHODS: A hospital-based matched case-control study was carried out in Nanchang. Matched by age (+/- 2 years old), 383 pairs of cases and controls were recruited and studied. Database was established with EpiData 3.0 software. Both cases and controls were interviewed face to face, with a uniformed questionnaire. Conditional logistic regression model was used for univariate and multivariate analysis on SPSS 11.5 to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Data from multiple conditional logistic regression analysis showed that the risk factors of infertility would include pelvic inflammatory diseases (OR = 7.078, 95% CI: 3.462-14.467), post-abortion complications' history (OR = 3.674, 95% CI: 1.690-7.986), drug treatment history (OR= 23.576,95% CI: 12.324-45.102), dysmenorrhea (OR = 1.622, 95% CI: 1.161-2.266), pain from sexual intercourse (OR = 2.447, 95% CI: 1.201-4.986), monthly frequency of sexual intercourse (OR = 1.416, 95% CI: 1.048-1.913) and mental stress (OR = 2.146, 95% CI: 1.662-2.771). The protective factor of infertility, however, was level of education (OR = 0.522, 95% CI: 0.391-0.696). CONCLUSION: Prevention and treatment of pelvic infection, application of strictly controlled drugs, popularization of awareness on sexual and reproductive health and relief of mental stress would be important measures in decreasing the incidence of infertility.

[A survey on AIDS discrimination among medical college students].

OBJECTIVE: To understand the related knowledge, discrimination attitudes toward HIV/AIDS among medical college students, and to provide scientific evidence for further HIV/AIDS anti-discrimination intervention. METHODS: By means of stratified cluster sampling to classes, 2844 undergraduate students were randomly selected from medical colleges. A self-designed and self-administered questionnaire survey was conducted, and SPSS 13.0 software was used for data analysis. RESULTS: 2501 valid questionnaires had been collected. The overall HIV/AIDS knowledge coverage rate of the respondents was 73.1% (1828/2501); The HIV/AIDS discrimination rates in different questions were varying, the discrimination rate of infected with AIDS by bad sex and sharing needles was 83.1% (2078/2501) and 77.7% (1943/2501) respectively, the discrimination rates in term of contacting with HIV patients and their daily necessities, sharing desks, personal social were all exceeding 40%. CONCLUSION: The medical students held serious discrimination attitudes to HIV infected persons and patients; it is necessary to strengthen anti-discrimination education about HIV/AIDS among medical students.

Seasonal variation in blood pressure of patients on continuous ambulatory peritoneal dialysis.

BACKGROUND: A seasonal variation in blood pressure (BP) has been observed in hemodialysis and renal transplant patients. However, this phenomenon in continuous ambulatory peritoneal dialysis (CAPD) patients, whose hemodynamics are different from hemodialysis patients, has not been reported before. In addition, the contribution of extracellular water (ECW) in the seasonal variation in BP is not clear. METHODS: All stable CAPD patients (n = 122) dialyzed in a single center from January 1, 2003 to December 12, 2004 were studied. Systolic blood pressure (SBP), diastolic blood pressure (DBP), weight and ECW (by bioimpedance analysis) were measured in every patient. Climatic data were obtained from the Beijing Weather Bureau. These data were pooled together and grouped according to the calendar month. RESULTS: In general, an apparent seasonal variation in BP was observed in CAPD patients. BP began to decrease from spring and reached the lowest level in summer, then increased from autumn and reached its peak in winter. The seasonal variation in BP in male patients was similar to that in female patients, but in comparison to non-diabetic patients there was no apparent seasonal variation in the BP of diabetic patients. SBP and DBP negatively correlated with the average atmospheric temperature (r = -0.768, p < 0.001 and r = -0.764, p < 0.001, respectively). BP also negatively correlated with rainfall and humidity, but this correlation disappeared when temperature was controlled in partial correlation analysis. Weight and ECW fluctuated throughout the year but showed no seasonal variation. CONCLUSION: On the whole there was an apparent seasonal variation in blood pressure in CAPD patients. As opposed to non-diabetic patients, there was no apparent seasonal variation in BP in diabetic patients. The seasonal variation in BP was influenced more by temperature than rainfall and humidity, and the change in ECW was not seasonal, suggesting that other mechanisms such as total peripheral resistance might play a more important role in this phenomenon.

[Role of neutrophil activation in ventilator induced lung injury].

OBJECTIVE: To probe further the role of neutrophil activation in the lung injury induced by mechanical ventilation. METHODS: Thirty-two normal Wistar rats were randomly divided into four groups: control group, low tidal volume group, conventional tidal volume group, and high tidal volume group. The counts of white blood cell (WBC) and neutrophil in bronchoalveolar lavage fluid (BALF) were carried out. The levels of protein and myeloperoxidase (MPO) activity in plasma and BALF were determined by biochemical methods respectively. RESULTS: The numbers of WBC and neutrophils, and the levels of protein and MPO activity in BALF were significantly increased in normal and high tidal volume groups than those in control and low tidal volume groups (P<0.05 or P<0.01, respectively). The levels of protein and MPO activity in BALF in high tidal volume group were markedly higher compared with normal tidal volume group (both P<0.01), but no statistical differences existed between the low tidal volume group and the control group (both P>0.05). There were no significant differences in the levels of protein and MPO activity in plasma among the four groups (P>0.05). CONCLUSION: The recruitment and activation of neutrophils might play an important role in pathogenesis of the biotrauma induced by mechanical ventilation. MPO activity in BALF is a credible index in reflecting the activation of neutrophils. Measuring the level of protein in BALF is valuable to evaluate the extent of lung injury induced by mechanical ventilation.

[Change in plasma free 15 - F2t - isoprostane concentrations in smoking patients undergoing coronary artery bypass grafting and its clinical significance].

OBJECTIVE: To investigate the change in plasma free 15-F2t-isoprostane fn(15-F(2t)-IsoP) concentration and its relationship with postoperative cardiac function of smoking patients who underwent coronary artery bypass grafting (CABG). METHODS: Sixty patients with coronary artery heart disease were divided into smoking group [n=30, age 54-69 years old, American Heart Association (AHA)II-III] and non-smoking group(n=30, age 58-70 years old, ASA II-III). All the patients were scheduled for CABG under combination anesthesia with isoflurane and fentanyl and conventional cardiopulmonary bypass. Blood samples were drawn from the central vein to measure 15-F(2t)-IsoP at the following time points: before operation (T0); 30 minutes after aortic clamping for cardiopulmonary bypass(T1); 10 and 30 minutes after aortic declamping(T2,T3). RESULTS: There was no statistical difference in 15-F(2t)-IsoP between two groups at T0, but contents of 15-F(2t)-IsoP in the two groups was increased markedly at T1, compared to those at T0 (P<0.05 and P<0.01 for smoking and non-smoking groups, respectively), and the degree of increase of 15-F(2t)-IsoP in smoking group was significantly higher than that in non-smoking group(P<0.05). During reperfusion period (at T2,T3), the rate of lowering of 15-F(2t)-IsoP in smoking group was slower than that in non-smoking group(P<0.05), and moreover, these patients needed more inotropic support than those in non-smoking group. CONCLUSION: Smoking patients have weaker anti-oxidation capability during CABG, therefore they have higher incidence of low cardiac function.