Pretreatment of Nicorandil Protects the Heart from Exhaustive Exercise-Induced Myocardial Injury in Rats.

OBJECTIVE: Nicorandil has been widely used for the treatment of angina pectoris and myocardial infarction. The purpose of this study was to investigate whether nicorandil plays a protective role in exhaustive exercise (EE)-induced myocardial injury. METHODS: Here, we applied the rat EE model and treated them with exercise preconditioning (EP, reported to protect the heart) or different doses of nicorandil gavage, respectively, to explore whether there are protective effects of single EP or nicorandil or a combination of both and the potential mechanism. Forty-nine male Sprague Dawley rats were randomly divided into control, EE, EP + EE, nicorandil (with low, middle, and high dose) + EE, and EP + nicorandil (middle dose) + EE. Blood samples and myocardial tissues were collected to analyze the myocardial injury-related index. RESULTS: EE induced myocardial structural damage and altered the myocardial injury markers, which were partially reversed by pretreatment of nicorandil. In addition, oxidative stress and inflammation lead to the accumulation of reactive oxygen species (ROS) products and further damage to the myocardium, while pretreatment of nicorandil reduces the oxidative stress response and inflammation. Moreover, nicorandil suppressed the myocardial apoptosis induced by EE, as indicated by a decrease of Bax and caspase-3 expression and an increase of Bcl-2 expression. Finally, the pathway in which nicorandil plays a role may be involved in the endothelial nitric oxide synthase (eNOS)/nitric oxide (NO) pathway. Pretreatment of nicorandil increased the protein level of myocardial eNOS and NO production. CONCLUSION: Our result demonstrated that nicorandil has protective effects in EE-induced myocardial injury with dose-dependent effects. A combination of nicorandil and EP can further improve the protective effects. Taken together, nicorandil can be potentially used as an intervention method in EE-induced myocardial injury.

The effect of accelerated rehabilitation nursing on postoperative recovery, nutritional status, and psychological status in patients with gastric cancer.

OBJECTIVE: To explore the effect of accelerated rehabilitation nursing in patients after gastric cancer surgery. METHODS: This prospective study included 88 gastric cancer patients who scheduled to receive surgery. According to the random number table, these patients were assigned to the control group and the experimental group. Patients in the control group received routine nursing, while those in the experimental group received accelerated rehabilitation nursing. Clinical-related parameters, nutritional index, physiological state, the quality of life (QOL), and complications were compared between the two groups. RESULTS: Compared with the control group, postoperative time to get out of bed, anal exhaust time, recovery time of bowel sound, and the length of hospitalization were shortened (all P<0.05). Hemoglobin (Hb), serum total protein (TP), and albumin (Alb) level in both groups after intervention were significantly lower than those before intervention (all P<0.05). Meanwhile, Hb, serum TP, and Alb level in the experimental group after intervention were significantly higher than those in the control group (all P<0.05). Visual analogue scale (VAS) scores at different time points (12 h-5 d after surgery) in the experimental group were significantly reduced when compared with the control group (all P<0.05). Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) score in the two groups after intervention were markedly lower those before intervention (both P<0.05). At the same time, HAMA and HAMD score in the experimental group after intervention were lower than those in the control group (both P<0.05). Generic quality of life inventory-74 (GQOLI-74) scores in all aspects after intervention were higher than those before intervention (all P<0.05). Meanwhile, GQOLI-74 scores in all aspects in the experimental group after intervention were higher than those in the control group (all P<0.05). The total incidence of complications in the experimental group was significantly decreased when compared with the control group (P<0.05). CONCLUSION: For gastric cancer patients undergoing surgical treatment, accelerated rehabilitation nursing care can effectively promote their postoperative recovery of intestinal function, significantly improve their nutritional status, relieve their negative emotions, improve their quality of life, and reduce the incidence of complications. It is worth of clinical application.

Effects of Spine Motion on Foot Slip in Quadruped Bounding.

Translation and bend of the spine in the sagittal plane during high-speed quadruped running were investigated. The effect of the two spine motions on slip between the foot and the ground was also explored. First, three simplified sagittal plane models of quadruped mammals were studied in symmetric bounding. The first model's trunk allowed no relative motion, the second model allowed only trunk bend, and the third model allowed both bend and translation. Next, torque was introduced to equivalently replace spine motion and the possibility of foot slip of the three models was analyzed theoretically. The results indicate that the third model has the least possibility of slip. This conclusion was further confirmed by simulation experiments. Finally, the conclusion was verified by the reductive model crawling robot.

Comparison of Two Different Red Blood Cell Transfusion Thresholds on Short-Term Clinical Outcomes of Patients Undergoing Aortic Surgery With Deep Hypothermic Circulatory Arrest.

OBJECTIVE: Patients undergoing aortic surgery with deep hypothermic circulatory arrest (DHCA) usually are associated with a high rate of allogeneic blood transfusion, and their red blood cell (RBC) transfusion threshold is unclear and controversial. The purpose of this study was to explore whether a restrictive transfusion threshold was as effective as a liberal transfusion threshold for patients undergoing aortic surgery with DHCA. DESIGN: Retrospective, controlled study. SETTING: National Center for Cardiovascular Diseases and a university hospital, Beijing, China. PARTICIPANTS: The study comprised 74 patients undergoing aortic surgery with DHCA from January 1 to December 31, 2014. INTERVENTIONS: Patients were divided retrospectively into the following 2 groups according to the RBC transfusion thresholds-the restrictive group received allogeneic RBC transfusion if the hemoglobin (Hb) level of the patient fell below 8 g/dL during the surgery, and in the liberal group the hemoglobin threshold for allogeneic transfusion was 10 g/dL. MEASUREMENTS AND MAIN RESULTS: Data on patient demographics, procedure characteristics, allogeneic blood use, and postoperational morbidity and mortality were collected and analyzed. In total, the restrictive group required fewer perioperative transfusions of RBCs (3.9±4.8 v 8.5±6.9 units, p = 0.001) and platelets (1.9±0.8 v 2.6±1.0 units, p = 0.003) compared with the liberal group. Postoperative mortality and complications, including 30-day mortality and bleeding requiring re-exploration, did not differ significantly between the 2 groups. CONCLUSIONS: For patients undergoing aortic surgery with DHCA, a restrictive RBC transfusion threshold (Hb<8 g per deciliter) may be as effective as a liberal RBC transfusion threshold (Hb<10 g per deciliter) during the surgery, with similar short-term clinical outcomes and less allogeneic transfusion.

A pilot study on combination compartmentalisation and sclerotherapy for the treatment of massive venous malformations of the face and neck.

SUMMARY: Venous malformations of the face and neck involve multiple anatomical spaces and encase critical neuromuscular structures, making surgical treatment difficult; high recurrence rates and high morbidity are well documented. The purpose of this study was to evaluate the clinical curative effect of combination compartmentalisation and sclerotherapy for the treatment of massive venous malformations of the face and neck. Sixteen patients with massive venous malformations of the face and neck region (12 males and four females; mean age: 14.9 years, range: 6-22 years) were treated with compartmentalisation using silk sutures followed by injections of 0.1 mg OK-432 and 8 mg pingyangmycin into each small compartment. The injections were performed every two weeks. All lesions received three to six treatments. All the patients had significant swelling and mild pain postoperatively for a period of one to two weeks with no major complications. One patient had transient facial paresis, which resolved spontaneously within two weeks. The follow-up period ranged from three to 14 months (median: 7.1 months). The treatments resulted in the following: four of the lesions were completely involuted, six were mostly involuted, five were partially involuted, and one experienced a small involution. All of the patients had normal liver and kidney functions and normal lung fields on chest X-ray. Compartmentalisation followed by injection of OK-432 and pingyangmycin into each compartment provided a simple, safe, and reliable alternative treatment for massive venous malformations of the face and neck.