The effect of high-power atrial fibrillation ablation on intraoperative acute pulmonary vein isolation and postoperative troponin levels / 中国医师杂志

Objective:To compare the effects of high-power and conventional power atrial fibrillation ablation on intraoperative acute pulmonary vein isolation, postoperative troponin levels, and atrial fibrillation recurrence.Methods:A retrospective selection was conducted on 105 patients with paroxysmal atrial fibrillation admitted to the Baoding NO.1 Central Hospital from January 2017 to December 2020. According to different treatment methods, they were divided into a high-power ablation group of 52 cases and a conventional power ablation group of 53 cases. The intraoperative rate of single circle acute pulmonary vein isolation, the recovery of electrical conduction after acute pulmonary vein isolation, and the location and number of points that need to be added were compared between the two groups; At the same time, two groups were compared in terms of surgical time, ablation time, surgical radiation exposure time and radiation dose, intraoperative complications postoperative cardiac troponin levels at 12 hours, and recurrence of atrial fibrillation within 1 year after ablation.Results:The intraoperative single loop pulmonary vein isolation rate and postoperative troponin levels in the high-power atrial fibrillation ablation group were higher than those in the conventional atrial fibrillation ablation group (all P<0.05). The surgical time, ablation time, and the number of sites and points that need to be added during surgery were less than those in the conventional atrial fibrillation ablation group (all P<0.05). There was no statistically significant difference in the incidence of intraoperative complications and postoperative atrial fibrillation recurrence between the two groups (all P>0.05). Conclusions:High power atrial fibrillation ablation has a higher single loop acute pulmonary vein isolation rate, fewer patch sites and points, shorter surgical time, and greater ablation damage compared to conventional ablation, and the clinical efficacy of the two groups is similar after surgery.

Half effective dose of propofol sedation inhibiting response to inserted gastroscope with Dixon sequential method in eldly patients / 国际外科学杂志

Objective:To study the half effective dose of propofol inhibiting pharyngeal response of elderly patients to inserted gastroscope under anesthesia by Dixon sequential method.Methods:In this prospective study, 31 elderly patients aged 75 to 84 years who planned to undergo painless gastroscopy at the Digestive Endoscopy Center of Beijing Friendship Hospital, Capital Medical University from March to June 2021 were enrolled, American Society of Anesthesiologists class Ⅰ-Ⅱ. The heart rate (HR), mean arterial pressure (MAP), peripheral pulse oxygen saturation (SpO 2) were monitored. The propofol dose started at 1.1 mg/kg (the first patient), and the gap dose was 0.1 mg/kg. The sequential dose given to the patient increased by 0.1 mg/kg if the pharyngeal response to inserted gastroscope of the previous patient was not considered inhibited or decreased by 0.1 mg/kg if the pharyngeal response was inhibited, the positive pharyngeal response-inhibited pharyngeal response was regarded as one crossover, and this study stopped after the seventh crossover. The change of MAP, HR and SpO 2 prior to anesthesia, insertion of gastroscope, 2 minutes after insertion, after gastroscopy was recorded. Nausea and vomiting, cough and swallowing, and body movement were also recorded. The measurement data were expressed as mean ± standard deviation ( ± s), and the changes at different time points were compared by repeated measurement data ANOVA. Results:The half effective dose of propofol inhibiting pharyngeal response to inserted gastroscope was (1.11±0.16) mg/kg. The MAP prior to anesthesia, insertion of gastroscope, 2 minutes after insertion, after gastroscopy were (105.05±13.39) mmHg, (90.48±10.98) mmHg, (90.48±11.11) mmHg, (82.68±9.98) mmHg, respectively, and the MAP at each observation point after administration was significantly lower than that before anesthesia, the differences were statistically significant ( P<0.05). The HR prior to anesthesia, insertion of gastroscope, 2 minutes after insertion, after gastroscopy were 77.26±12.67, 72.81±10.39, 72.90±11.63, 68.32±9.42, respectively, and the HR at each observation point after administration was significantly lower than that before sedation, the differences were statistically significant ( P<0.05). The SpO 2 prior to anesthesia, insertion of gastroscope, 2 minutes after insertion, after gastroscopy were (96.48±1.81)%, (98.65±1.31)%, (97.36±2.14)%, (96.48±1.81)%, respectively, and the SpO 2 prior to anesthesia was statistically significant compared with insertion of gastroscope ( P<0.001), the SpO 2 of 2 minutes after insertion, and after gastroscopy were significant differences compared with insertion of gastroscope ( P<0.05). Conclusion:Half effective dose of propofol for inhibiting pharyngeal response to inserted gastroscope under anesthesia by Dixon sequential method was determined as (1.11±0.16)mg/kg .

Research progress of low energy laser irradiation in hyperlipidemia treatment / 国际生物医学工程杂志

Hyperlipidemia is one of the most important risk factors of human atherosclerosis and cardiaccerebral vascular disease.The number of hyperlipidemia in China increased year by year and showed a younger trend.The current treatments for hyperlipidemia include drug therapy,physical exercise,diet prevention,liposuction surgery and low-energy laser therapy,etc.Many researches showed that low intensity laser irradiation has a certain curative effect on hyperlipidemia.The aim of this paper is to provide a new idea and method for the future treatment of dyslipidemia by reviewing the anti-hyperlipidemia methods and mechanism of low energy laser irradiation treatment.

Success rates and prognosis of heart valvuloplasty and valve replacement performed for elderly patients

To analyze the success rates and prognosis of heart valvuloplasty and valve replacement for elderly patients, and to provide clinical evidence. A total of 1240 patients who received heart valve surgeries in our hospital from June 2004 to October 2014 were selected and retrospectively analyzed. They were divided into two groups based on age [60], and those older than 60 [Group B] suffered from rheumatic valvular heart disease and nonrheumatic valvular heart disease including degenerative valve disease. Mitral valve replacement [MVR], tricuspid valve replacement [TVR], aortic valve replacement [AYR], double valve replacement [DVR], mitral valvuloplasty [MVP] and tricuspid valvuloplasty [TVP] were performed by using bioprosthetic and mechanical valves. Before surgery, coronary angiography, coronary artery bypass grafting [CABG], left atrial thrombectomy, left atrial wall folding and radiofrequency ablation were conducted. For the patients younger than 60 [Group A] who had congenital heart disease, rheumatic valvular heart disease and valvular heart disease, MVR, AYR, DVR, MVP, TVP and closed cuspid commissurotomy were performed with bioprosthetic and mechanical valves. The two groups were then monitored. The mortality rates of Group A and Group B were 2.7% [16 cases] and 3.1% [20 cases] respectively. They died mainly of malignant ventricular arrhythmias, multiple organ failure, left ventricular rupture, low cardiac output syndrome, acute renal failure, respiratory failure, upper gastrointestinal bleeding, mechanical valve failure and cerebrovascular accident. The two groups had significantly different application rates of bioprosthetic valve, times of auxiliary ventilation and hospitalization stay lengths [P<0.05], but left ventricular ejection fractions, left ventricular end-diastolic diameters [LVEDDs], mortality rates as well as times of aortic cross-clamping and cardiopulmonary bypass were similar [P>0.05]. LVEDD, complicated coronary artery disease, CABG and grade of the New York Heart Association Functional Classification were independent risk factors for postoperative death. When heart valvuloplasty and valve replacement were performed for elderly patients, the success rate and prognosis could only be improved by optimizing preoperative preparation, shortening the times of cardiopulmonary bypass and aortic cross-clamping, and paying particular attention to myocardial protection and postoperative treatment

Culture conditions optimization and high cell density fermentation of recombinant bacteria producing heparinase II from Flavobacterium heparinum / 生物工程学报

Heparinase II (Hep II) from Flavobacterium heparinum is an enzyme that could specifically cleave certain sequence of heparin and heparan sulfate. In this work, fermentation conditions of recombinant heparinase II (His-Hep II) producing bacteria were optimized, including initial induction time, inducer (IPTG) concentration, induction temperature and induction time. The optimum conditions were as follows: cultivating recombinant bacteria to exponential prophase under 37 degrees C, then adding IPTG to a final concentration of 0.3 g/L, finally cultivating recombinant bacteria under 20 degrees C for 10 h. The total crude enzyme activity reached 570 U/L. Based on these results, high cell density fermentation of recombinant bacteria was studied. The final OD600 could reach 98 and the total crude enzyme activity of His-Hep II increased to 9 436 U/L.

Effects of different operations on respiratory function after colon replacement in esophageal cancer / 中国综合临床

Objective To explore the effects of different operations on respiratory function after colon replacement for esophageal cancer.Methods Fourty patients with esophageal cancer underwent esophagectomy from May 2004 to June 2008,were retrospectively analyzed.The site of esophageal anastomosis was at neck after sternum in 20 cages.at neck through esophageal bed in other 20 cages.Blood gas analysis and pulmonary fuction were monitored in these patients before operation and in 14 days after operation.Results VC% were (42.17±10.15)%、(49.52±9.56)%、(55.67±10.73)%、(60.27±10.52)%in patients after sternum and(37.65±9.52)%、(40.72±10.12)%、(47.02±10.65)%、(52.89±10.82)%in patients through esophageal bed in 5th、7th、10th、14th postoperative day with sigllificant statistical difference;FEV_1% were(60.55±16.71)%、(67.12±16.90)%in patients after sternum and(45.23±16.26)%、(50.52±16.72)%in patients through esophageal bed in 10th、14th postoperative day with significant statistical difference;PaO_2 were(17.56±7.32)mm Hg、(19.67±6.08)mm Hg、(17.17±4.85)mm Hg、(15.43±5.02)mm Hg、(11.32±3.79)mm Hg、(9.67±2.87)mm Hg、(6.98±3.26)mm Hg in patients after sternum and(20.17±7.04)mm Hg、(22.83±6.75)mm Hg、(20.67±4.31)mm Hg、(18.32±4.85)mm Hg、(16.02±3.71)mm Hg、(13.44±2.56)mm Hg、(9.01±3.17)mm Hg in patients through esophageal bed in 1st,2nd,3rd,5th,7th,10th,14th postoperative day with significant statistical difference. Conclusions After esophagectomy,esophageal anastomosis through esophageal bed has significant negative effect on respiratory function.