[An analysis of the characteristics of perioperative cardiac troponin elevation in orthopaedic surgical patients].

Objective: Perioperative myocardial infarction remains a severe complication in non-cardiac surgery and is one of the major causes of death. Cardiac troponin (cTn) I elevation is associated with short-term and long-term mortality. The aim of the study was to assess the proportion rate of cTnI elevation and its clinical characteristics among patients admitted for orthopaedic surgery with or without cardiovascular events. Methods: This is a retrospective study including 27 744 patients aged 50 years or older who admitted for orthopaedic surgery from 2009-2015 in Beijing Jishuitan Hospital. Results: Two hundred and sixty-five patients [age (71.7±9.9) years] had cTnI level> 0.04 µg/L with 66% (175 patients) of them being female. Among them, 59 patients were isolated troponin rise (ITR) (n=59), 13 were preoperative acute myocardial infarction (AMI), and 193 were postoperative AMI. The proportion of postoperative AMI was 0.69%. Those patients were more likely to have a history of coronary artery disease or hypertension. Non-ST-segment elevation myocardial infarction (NSTEMI) was more common (93.3%) than ST-segment elevation myocardial infarction in these patients. Most of them did not experience ischemic symptoms. Totally 76.7% of the AMI occurred within 3 days of surgery; and the in-hospital mortality rate was 10.4%. Conclusions: Perioperative elevation of troponin is common in patients undergoing orthopaedic surgery. Most postoperative AMI were NSTEMI and with absent or atypical ischemia symptoms. Monitoring troponin levels and electrocardiograph in at-risk patients is needed to find most of the AMI.

The synergistic effect of recombinant human endostatin (YH-16) combined with oxaliplatin on human colorectal carcinoma.

This study was designed to investigate the effect of recombinant human endostatin (YH-16) combined with oxaliplatin (L-OHP) on the growth of orthotopically-implanted human colorectal carcinoma in nude mice. Tumour volumes and weights were measured after therapy. Tumour cell morphology was observed by light and electron microscopy. Apoptosis was detected using the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) assay, and vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) were determined by immunohistochemical staining. Tumour volumes in all treatment groups were significantly reduced compared with controls. YH-16 and L-OHP either alone or in combination caused tumour cell apoptosis, except in the YH-16 low-dose group. MVD was strongly inhibited in the treatment groups compared with the controls, although only YH-16 combined with L-OHP or L-OHP alone decreased VEGF expression. No obvious change in side-effects occurred. In conclusion, YH-16 combined with L-OHP inhibited growth and induced apoptosis in orthotopically-transplanted human colorectal carcinoma in nude mice without increasing side-effects.

Effects of Hydrogen Gas Inhalation on Endometriosis in Rats.

OBJECTIVE: Oxidative stress is generated during the pathophysiology of endometriosis (EMT). Hydrogen (H2) has been demonstrated as a gas antioxidant. The aim of the present study is to evaluate the protective effect of H2 on EMT in rats. STUDY DESIGN: Sprague Dawley rats with surgically induced EMT were randomly received the inhalation of 67% H2-33% oxygen (O2) mixture (1 h/d, 4 weeks) immediately after the EMT surgery or 4 weeks after the operation. The mixture of 67% N2-33% O2 was also used to exclude the possible influence of the increased O2. Eight weeks after the operation, the endometrial tissues were weighted and analyzed using histology, immunohistochemistry, and real-time polymerase chain reaction. Several antioxidant enzymes and malondialdehyde were also measured in serum and tissue. The estrous cycles were monitored for H2 safety. RESULTS: The results showed that both profiles of high-dose H2 breathing reduced the size of the endometrial explants, inhibited cell proliferation, improved superoxide dismutase, glutathione peroxidase, malondialdehyde, and catalase activities, and regulated the expression of matrix metalloproteinase 9 and cyclooxygenase 2. However, inhalation of the same dose of nitrogen failed to show the protection. High-dose H2 breathing did not change the normal estrous cyclicity. CONCLUSION: These results suggest that 67% H2-33% O2 breathing has a beneficial effect on EMT model rats, and inhalation of a high dose of H2 could be a potential method applied in clinical practice.