Efficacy of electroacupuncture on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass: a systematic review and Meta-analysis.

OBJECTIVE: To evaluate the efficacy of electroacupuncture (EA) intervention on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). METHODS: Eight databases, including PubMed, Embase, the Cochrane Library, Web of Science, Chinese BioMedical Literature Database, China National Knowledge Infrastructure Database, Wanfang Data, China Science and Technology Journal Database, and two clinical trial registries, were searched. All randomized controlled trials (RCTs) related to EA intervention in cardiac surgery with CPB were collected. Based on the inclusion and exclusion criteria, two researchers independently screened articles and extracted data. After the quality evaluation, RevMan 5.3 software was used for analysis. RESULTS: Fourteen RCTs involving 836 patients were included. Compared with the control treatment, EA significantly increased the incidence of cardiac automatic rebeat after aortic unclamping [relative risk (RR) = 1.15, 95% confidence interval (CI) (1.01, 1.31), P < 0.05; moderate]. Twenty-four hours after aortic unclamping, EA significantly increased the superoxide dismutase [standardized mean difference (SMD) = 0.96, 95% CI(0.32, 1.61), P < 0.05; low], and interleukin (IL)-2 [SMD = 1.33, 95% CI(0.19, 2.47), P < 0.05; very low] expression levels and decreased the malondialdehyde [SMD =－1.62, 95% CI(－2.15, －1.09), P < 0.05; moderate], tumour necrosis factor-α [SMD = －1.28, 95% CI(－2.37, －0.19), P < 0.05; moderate], and cardiac troponin I [SMD = －1.09, 95% CI(－1.85, －0.32), P < 0.05; low] expression levels as well as the inotrope scores [SMD = －0.77, 95% CI(－1.22, －0.31), P < 0.05; high]. There was no difference in IL-6 and IL-10 expression levels. The amount of intraoperative sedative [SMD = -0.31, 95% CI(－0.54, －0.09), P < 0.05; moderate] and opioid analgesic [SMD = -0.96, 95% CI(－1.53, －0.38), P < 0.05; low] medication was significantly lower in the EA group than in the control group. Moreover, the postoperative tracheal intubation time [SMD = －0.92, 95% CI(－1.40, －0.45), P < 0.05; low] and intensive care unit stay [SMD = －1.71, 95% CI(－3.06, －0.36), P < 0.05; low] were significantly shorter in the EA group than in the control group. There were no differences in the time to get out of bed for the first time, total days of antibiotic use after surgery, or postoperative hospital stay. No adverse reactions related to EA were reported in any of the included studies. CONCLUSIONS: In cardiac surgery with CPB, EA may be a safe and effective strategy to reduce myocardial ischaemia-reperfusion injury and speed up the recovery of patients after surgery. These findings must be interpreted with caution, as most of the evidence was of low or moderate quality. More RCTs with larger sample sizes and higher quality are needed to provide more convincing evidence.

Renal depth measured by CT optimize the glomerular filtration rate using the Gates method in living donor kidney transplantation / 中华器官移植杂志

Objective To evaluate the significance of kidney depth obtained by computed tomography (CT) in measuring glomerular filtration rate (GFR) by Gates method in living kidney transplant donors.Methods Individual kidney depth was compared among the estimates of Tφnnesen,Taylor and Li Qian formulas and CT measurements in 167 living-related kidney transplant donors respectively.While maintaining the active region of interest of kidney and background unchanged in 137 99mTe-DTPA renal dynamic imaging cases,GFR was measured by Gates' method and individual kidney compared among the estimates of Tφnnesen,Taylor and Li Qian formulas and CT measurements.Results Left/right kidney depth obtained by CT,Tφnnesen,Taylor and Li Qian formula was 6.82 ± 0.96/7.02 ± 1.00,5.67 ± 0.58/5.71 ± 0.59,6.43 ± 0.77/6.81 ± 0.72 and 7.03 ± 0.76/7.06 ± 0.70 cm;GFR 45.44 ± 9.04/46.61 ± 9.06,37.54 ± 6.34/37.37 ± 6.02,43.39 ± 7.59/44.62 ± 6.94 and 46.99 ± 8.04/46.70 ± 7.30 ml/min respectively.Individual kidney depth and GFR calculated by Taylor and Li Qian were higher than those of Tφnnesen formula (P＜0.01).Individual kidney depth and GFR calculated by CT were higher than those of Tφnnesen and Taylor formulas (P＜0.01).Left kidney depth and GFR calculated by Li Qian formula were higher than those of CT measurements (P＜0.01).And no significant difference existed in right kidney(P＞0.05).Conclusions Kidney depth measured by CT improves the accuracy of kidney depth estimated by Gates method and optimizes GFR in living donors for renal transplant.

Research of relevant laboratory indexes of rheumatic heart disease / 国际检验医学杂志

Objective To investigate the relationship between the related indexes with rheumatic heart disease (RHD) and its clinical significance .Methods The medical records information in 236 patients with rheumatic fever caused cardiac were collected and divided into the RHD group ,simple rheumatic fever group and normal healthy control group .The levels of related indiexe such as Mb and cTnI were detected in the three groups .Results The Mb ,cTnI and CK‐MB and NT‐proBNP had statistical differences between the RHD group and simple rheumatic fever groups (P<0 .05);the levels of ESR ,RF ,CRP ,cTnI ,Mb ,CK‐MB ,CK and NT‐proBNP had statistically significant differences between the RHD group and healthy control group (P<0 .05);With the NT‐proB‐NP level of 136 .17 pg/mL as the critical value ,the sensitivity ,specificity ,positive predictive value and negative predictive value of NT‐proBNP for diagnosing RHD were 95 .48% ,90 .15% ,86 .7% and 97 .86% respectively .Conclusion The levels of blood cTnI , Mb and CK‐MB in the patients with RHD are significantly higher than those in the normal controls ,so detecting the serum NT‐proBNP concentration is a sensitive indicator for early diagnosis of RHD .

Different diagnostic efficacy of solitary pulmonary nodules in 99 Tcm-MIBI SPECT/CT varient background selected / 西安交通大学学报(医学版)

Objective To assess the diagnostic accuracy of solitary pulmonary nodules while selecting different backgrounds in 99 Tcm‐MIBI SPECT/CT examination .Methods Totally 38 suspected solitary pulmonary nodules (SPN) were analyzed retrospectively .The lesions were divided into malignant group and benign group according to the pathological findings . We selected two different backgrounds , contralateral lung field ( DL ) and the contralateral soft tissue (NST) .The maximum counts and the mean counts of lesion to non‐lesion ratio (L/N) were calculated to evaluate diagnostic efficacy using ROC curve . The relationship between lesion size , pathological grading and L/N ratio was analyzed by Spearman correlation analysis . Results With DL and NST as the backgrounds ,the maximum counts and the mean counts of L/N between benign and malignant groups both differed significantly (all P0 .05) .The size and pathological grading of SPN did not affect 99 Tcm‐MIBI accumulation in the SPN (all P>0 .05) .Conclusion DL and NST both can be used as the background in diagnosis of pulmonary nodules on 99 Tcm‐MIBI SPECT/CT examination .The mean counts of the contralateral tissue used as the background can provide a stable result and a high diagnostic accuracy to assess the SPN .

Pharmacokinetics of gene recombined angiogenesis inhibitor Kringle 5 in vivo using 131I specific markers and SPECT/CT$ / 药物分析学报

The previous pharmacokinetic methods can be only limited to drug analysis in vitro, which provide less information on the distribution and metabolismof drugs, and limit the interpretation and assessment of pharmacokinetics, the determination of metabolic principles, and evaluation of treatment effect. The objective of the study was to investigate the pharmacokinetic characteristics of gene recombination angiogenesis inhibitor Kringle 5 in vivo. The SPECT/CT and specific 131I-Kringle 5 marked by Iodogen method were both applied to explore the pharmacokinetic characteristics of 131I-Kringle 5 in vivo, and to investigate the dynamic distributions of 131I-Kringle 5 in target organs. Labeling recombinant angio-genesis inhibitor Kringle 5 using 131I with longer half-life and imaging in vivo using SPECT instead of PET, could overcome the limitations of previous methods. When the doses of 131I-Kringle 5 were 10.0, 7.5 and 5.0 g/kg, respectively, the two-compartment open models can be determined within all the metabolic process in vivo. There were no significant differences in t1/2α, t1/2β, apparent volume of distribution and CL between those three levels. The ratio of AUC(0 ? 1) among three different groups of 10.0, 7.5 and 5.0 g/kg was 2.56:1.44:1.0, which was close to the ratio (2:1.5:1.0). It could be clear that in the range of 5.0–10.0 g/kg, Kringle 5 was characterized by the first-order pharmacokinetics. Approximately 30 min after 131I-Kringle 5 was injected, 131I-Kringle 5 could be observed to concentrate in the heart, kidneys, liver and other organs by means of planar imaging and tomography. After 1 h of being injected, more radionuclide retained in the bladder, but not in intestinal. It could be concluded that 131I-Kringle 5 is mainly excreted through the kidneys. About 2 h after the injection of 131I-Kringle 5, the radionuclide in the heart, kidneys, liver and other organs was gradually reduced, while more radionuclide was concentrated in the bladder. The radionuclide was completely metabolized within 24 h, and the distribution of radioactivity in rats was similar to normal levels. In our study, the specific marker 131I-Kringle 5 and SPECT/CT were suc-cessfully used to explore pharmacokinetic characteristics of Kringle 5 in rats. The study could provide a new evaluation platform of the specific, in vivo and real-time functional imaging and pharmacokinetics for the clinical application of 131I-Kringle 5.

Effects of Tangshenkang on MMP-9 and TIMP-1 of Human Renal Tubular Epithelial Cell HK-2 Induced by High Glucose / 中国中医药信息杂志

Objective To explore the mechanism of Tangshenkang in the prevention and treatment of diabetic nephropathy. Methods HK-2 cells were cultured in vitro and divided into control group, high glucose group (30 mmol/L D-glucose), control group (30 mmol/L D-glucose+10% animal serum), and Tangshenkang drug-containing serum therapy groups (30 mmol/L D-glucose+5%low concentration Tangshenkang, 30 mmol/L D-glucose+10%middle concentration Tangshenkang, 30 mmol/L D-glucose+20% high concentration Tangshenkang). After 24 h and 48 h treatment, MMP-9 and TIMP-1 in cell cultural supernatant were observed by ELISA. Results MMP-9 of HK-2 cultured with high glucose was much decreased and TIMP-1 increased significantly than the control group, with statistical significance (P<0.05). TIMP-1 significantly decreased and MMP-9 increased in HK-2 cultured with high glucose plus Tangshenkang compared with those only induced by high glucose, with statistical significance (P<0.05). Conclusion Tangshenkang could regulate the secretion of fibrosis cell factor of HK-2 cell induced by high glucose, which may be one of the mechanisms in its treatment of diabetic nephropathy.