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[PMID]: 23648346 [Au] Autor: Luo MY; Wang SY; Song YH; Yin CH; Sun HT; Sun X; Xu N; Xu JP; Wang W; Hu SS [Ad] Address: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China. [Ti] Title: [Surgical treatment for hypertrophic obstructive cardiomyopathy: a report of 118 cases]. [So] Source: Zhonghua Yi Xue Za Zhi;93(2):110-3, 2013 Jan 8. [Is] ISSN: 0376-2491 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To assess the clinical outcomes of transaortic extended septal myectomy on early and midterm survival of patients with hypertrophic obstructive cardiomyopathy (HOCM). METHODS: From October 2009 to April 2012, 118 consecutive patients underwent extended Morrow's procedure for HOCM. There were 69 males and 49 females with an average age of (46 ± 13) years. Their clinical data were analyzed retrospectively. Preoperative transthoracic, intraoperative transoesophageal and postoperative transthoracic echocardiography was performed to assess septal thickness, left ventricular outflow tract (LVOT) gradient, mitral valve function and systolic anterior motion (SAM) of anterior mitral valve leaflet, etc. Concomitant surgical procedures were performed if other cardiac diseases required surgical interventions. Follow-up study was carried out during subsequent clinic visits at outpatient department and through telephone interviews with patients and their relatives. RESULTS: The septal thickness was (25 ± 7) mm. SAM was detected in all. The in-hospital mortality was 0.8% (1/118) since one patient died of multiple organs failure one week later. Postoperative echocardiography demonstrated marked reduction in LVOT gradient (92 ± 22 vs 13 ± 10 mm Hg (1 mm Hg = 0.133 kPa), P = 0.000), New York Heart Association (NYHA) class (2.9 ± 0.6 vs 1.2 ± 0.4, P = 0.000) and significant improvement in mitral regurgitation. Concomitant surgical procedures were performed in 45 cases (38.1%, all for preexisting conditions). Complications included complete atrioventricular block (n = 3), first degree atrioventricular block (n = 6), complete left bundle branch block (n = 51), intraventricular conduction delay or left anterior division block (n = 26), transient renal dysfunction (n = 2) and intra-aortic-balloon-pumping (n = 2). No other severe complication was observed. During a follow-up period of 1 - 27 (7 ± 6) months, there was no readmission or death. All patients reported significant increase in physical ability and obvious decrease in limiting symptoms. At the latest follow-up, the NYHA functional class maintained grade I-II in all. And mitral regurgitation remained absent or mild. CONCLUSION: Surgical procedure for HOCM patients is both safe and efficacious. It provides an excellent relief of LVOT obstruction. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review

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[PMID]: 23648345 [Au] Autor: Yang F; Chen RP; Song QQ; Chen LS; Lin SD; Liang GX; Hu BC; Zhu ZZ; Wang YL; Yan L; Lin JC; Li YB; Cai DH [Ad] Address: Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China. [Ti] Title: [A cross-sectional survey on current status of type 2 diabetes mellitus with overweight or obesity in Guangdong province]. [So] Source: Zhonghua Yi Xue Za Zhi;93(2):104-9, 2013 Jan 8. [Is] ISSN: 0376-2491 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To explore the glycemic control status and related risk factors of overweight or obesity patients with type 2 diabetes mellitus (T2DM) in Guangdong province. METHODS: The medical records of overweight or obesity patients with T2DM from 60 tertiary and secondary hospitals in Guangdong Province were collected by questionnaire and physical examination. And the clinical data were analyzed to explore the influencing factors of glycemic control. The HbA1c level was used to assess glycemic control. HbA1c < 7.0% indicated that glycemic control was up to standard. RESULTS: From August 2011 to March 2012, 5241 T2DM patients were recruited. The scope of current analysis was restricted to 4768 subjects with true data and deficiency no more than 5%. There were 2252 males and 2516 females. The age range was from 16 to 90 years, a median age 59.0 (50.0 - 69.0) years, onset age of diabetes 52.0 (44.0 - 60.0) years; a range of disease duration from 1 day to 42 years and a median of 5.0 (2.0 - 11.0) years. The median body mass index was 26.33(24.88 - 28.34) kg/m(2) and median waist circumference 93.0 (88.0 - 100.0) cm. Median HbA1c was 8.1% (6.9% - 10.1%) and only 26.2% patients reached the target level of HbA1c < 7.0%. Influencing factors of poor glycemic control were central obesity, high levels of resting heart rate, concurrent fatty liver and high intensity of treatment. And influencing factors of good glycemic control were regular exercises, smoking cessation, regular glycemic monitoring and good control of total chloestrol/triglyceride. CONCLUSION: A majority of Guangdong type 2 diabetics fail to achieve target values for glycemic control. There is an urgent need for comprehensive management for improving glycemic control. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review

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[PMID]: 23648165 [Au] Autor: Jiang W [Ad] Address: Department of Intensive Care Unit, the Central Hospital, Wuhan 430014, Hubei, China. Corresponding author: Jiang Wei, Email: thicu5853@yahoo.cn. [Ti] Title: [The tendency of changes in blood oxygen saturation and arrhythmia: a clinical report of 500 cases]. [So] Source: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue;25(2):112-4, 2013 Feb. [Is] ISSN: 2095-4352 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To observe the correlation of duration of hypoxia and degree of arrhythmia in patients with and without past history of cardiac disease, in order to provide a warning value supplied by pulse oxygen saturation (SpO2) monitoring for clinical surveillance. METHODS: A prospective study was conducted. Patients with arrhythmia induced solely by hypoxia were included, and they were grouped into cardiac diseases group (n=487) and non-cardiac diseases group (n=13) according to whether or not they had cardiac diseases. Both groups were undergoing mechanical ventilation, and the real time monitoring of electrocardiogram (ECG) and the SpO2 were monitored. The types of arrhythmia and duration and severity of hypoxia were observed. The method of logistic regression was conducted to find the affecting factors of arrhythmia. RESULTS: There were significant differences in SpO2 (0.82±0.12 vs. 0.50±0.10) and duration of arrhythmia (2.55±1.02 minutes vs. 17.13±1.45 minutes) between the cardiac disease group and the non-cardiac disease group (both P<0.01). The multifactor logistic regression analysis on the affecting factors in patients with cardiac arrhythmia indicated that cough during sputum suction [odds ratio (OR)=3.078, 95% confidence interval (95%CI) 1.756 - 6.235], long duration of tracheal intubation (OR=0.267, 95%CI 0.122 - 0.573), over anesthesia (OR=2.541, 95%CI 1.039 - 6.615), inadequate tidal volume (OR=4.360, 95%CI 2.187 - 9.443), low respiratory frequency (OR=0.297, 95%CI 0.069 - 1.113) were all risk factors of arrhythmia (P<0.05 or P<0.01). CONCLUSIONS: The hypoxemia (lowering of SpO2) is the independent risk factor leading to arrhythmia. Healthy heart can tolerate hypoxia better, and the SpO2 warning value is ≤0.60. Compared with the non-cardiac disease group, patients in cardiac disease group has significantly lower toleration ability against hypoxia, and its SpO2 warning value is lower than 0.95. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.2095-4352.2013.02.016

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[PMID]: 23648162 [Au] Autor: Luo JY; Wang XY; Cai TB; Jiang WF [Ad] Address: Department of Intensive Care Unit, the People's Hospital of Liuzhou, Liuzhou 545006, Guangxi, China. Corresponding author: Wang Xiao-yuan, Email: ljy613@126.com. [Ti] Title: [Study of setting of ventilator volume tidal and airway pressure alarm threshold with continuous extra-sternum heart compression in cardiopulmonary resuscitation]. [So] Source: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue;25(2):102-5, 2013 Feb. [Is] ISSN: 2095-4352 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To investigate the setting of ventilator volume tidal (VT) and airway pressure alarm threshold during cardiopulmonary resuscitation (CPR) by continuous extra-sternum heart compression. METHODS: Forty cases with respiration and cardiac arrest in the department of critical care medicine were randomly divided into low VT ventilation group and conventional VT group. Both groups were given the volume control mode. In the low VT ventilation group, VT was set on 6 - 7 ml/kg, and high pressure alarm threshold was adjusted to 60 cm H2O by the conventional 40 cm H2O during CPR. In the conventional VT group, VT and high pressure alarm threshold were set at 8 - 12 ml/kg and 40 cm H2O, respectively. Real-time actual VT, peak inspiratory pressure (PIP), and arterial blood gas test, blood lactic acid at 10 minutes and 30 minutes after CPR were observed. RESULTS: At 10 minutes after CPR, in the low VT ventilation group, arterial blood pH, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3(-), arterial oxygen saturation (SaO2) and blood lactic acid were better as compared with those in the conventional VT ventilation group (pH: 7.21±0.09 vs. 7.13±0.07, PaO2: 45.35±5.92 mm Hg vs. 40.70±4.70 mm Hg, PaCO2: 57.10±7.59 mm Hg vs. 61.60±5.47 mm Hg, HCO3(-): 18.50±3.50 mmol/L vs. 14.75±2.65 mmol/L, SaO2: 0.796±0.069 vs. 0.699±0.066, blood lactic acid: 7.07±1.60 mmol/L vs. 8.13±1.56 mmol/L, all P<0.05). The success rate of resuscitation in the low VT ventilation group was higher than that of the conventional VT ventilation group (45% vs. 15%, P<0.05), and PIP (cm H2O) of low VT ventilation group was lower than that of the conventional VT group (37.25±7.99 cm H2O vs. 42.70±7.40 cm H2O, P<0.05). In all the patients in both groups barotrauma did not occur. CONCLUSION: The strategy of low ventilator VT (6 - 7 ml/kg) with appropriate elevation of airway pressure alarm threshold was better than that of conventional ventilation setting, with no increase in incidence of barotraumas during CPR. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.2095-4352.2013.02.013

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[PMID]: 23648161 [Au] Autor: Shi ZH; Gao CY; Liu LG; Zhang RR; Xu RH [Ad] Address: Department of Critical Care Medicine, the Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China. Corresponding author: Gao Chuan-yu, Email: gaocy2000@yahoo.com.cn. [Ti] Title: [The effect of ventricular fibrillation time and NYHA classification on defibrillation in intensive care unit patients]. [So] Source: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue;25(2):99-101, 2013 Feb. [Is] ISSN: 2095-4352 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To investigate whether the sequence of defibrillation (DF) and cardiopulmonary resuscitation (CPR), duration of ventricular fibrillation (VF), and New York Heart Association (NYHA) classification would affect DF result in intensive care unit. METHODS: Ninety-three cases needing instantaneous DF were divided into three groups according to VF lasting time: <4 minute group (n=53), 4 - 8 minute group (n=24), >8 minute group (n=16), and each group was randomly divided into two sub-groups according to time sequence: the prior DF group or the prior CPR for five cycles followed by DF group (prior CPR group). The effect of VF time, the sequence of DF and CPR, and NYHA classification on success rate of DF were observed. RESULTS: With prolonging VF time, success rate of DF obviously lowered [success rate of DF for VF<4 minute, 4 - 8 minute, and >8 minute groups were 83.0% (44/53), 62.5% (15/24), and 25.0% (4/16), respectively, all P<0.01]. When VF time lasted less than 4 minutes, success rate of DF in the prior DF group was obviously higher than that in the prior CPR group [88.9% (24/27) vs. 76.9% (20/26), P<0.05]. When VF time lasted for 4 - 8 minutes, the prior DF group had slightly higher success rate of DF compared with the prior CPR group [66.7% (8/12) vs. 58.3% (7/12), P=0.09]. When VF time lasted longer than 8 minutes, the success rate of DF in the prior CPR group was obviously higher than that in the prior DF group [37.5% (3/8) vs. 12.5% (1/8), P<0.01]. The success rate of DF was lowered in higher NYHA classification [success rate of DF for NYHA classification I-IV was 96.4% (27/28), 80.0% (20/25), 47.8% (11/23), 29.4% (5/17), respectively, P<0.05 or P<0.01]. CONCLUSIONS: VF lasting time and NYHA classification are key factors to success rate of DF, and the choice of sequence of DF and CPR depends on the lasting time of VF. For cases with the high NYHA classification, we should make some judgement beforehand and prepare some preventive measures. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.2095-4352.2013.02.012

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[PMID]: 23648159 [Au] Autor: Su ZY; Li CS [Ad] Address: Department of Emergency, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China. Corresponding author: Li Chun-sheng, Email: lcscyyy@163.com. [Ti] Title: [The evaluation of cerebral function by diffusion weighted imaging after norepinephrine-induced hypertensive perfusion therapy in pig model of cardiac arrest]. [So] Source: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue;25(2):92-5, 2013 Feb. [Is] ISSN: 2095-4352 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To evaluate the changes in cerebral function of pigs with cardiac arrest (CA) after recovery of spontaneous circulation (ROSC) after hypertension perfusion therapy induced by norepinephrine (NE). METHODS: Ventricular fibrillation (VF) was induced by electrical stimulation, and standard cardiopulmonary resuscitation (CPR) was performed after VF for 4 minutes. The pigs with successful ROSC were randomly divided into two group, each n=5. The pigs in the hypertensive reperfusion group were given with NE immediately to maintain the mean arterial pressure (MAP) at 130% before VF for 4 hours; MAP of the pigs in normal reperfusion group was maintained for 4 hours as baseline. The changes in hemodynamics were observed for 4 hours in both groups. Cerebral cortex was scanned with diffusion weighted imaging (DWI) before VF and 1 hour and 3 hours after ROSC, and the dynamic changes in brain functional imaging were observed. Twenty-four hours after ROSC, brain biopsy were collected and examined after hematoxylin and eosin staining (HE). RESULTS: Compared with the normal reperfusion group, heart rate (HR), MAP, cardiac output (CO) and coronary perfusion pressure (CPP) in the hypertensive reperfusion group showed a tendency to increase (ROSC 30 minutes HR: 167±8 bpm vs. 140±15 bpm, ROSC 1 hour MAP: 131±9 mm Hg vs. 108±10 mm Hg, ROSC 1 hour CO: 4.9±0.1 L/min vs. 3.4±0.5 L/min, ROSC 2 hours CPP: 118±12 mm Hg vs. 88±1 mm Hg, P<0.05 or P<0.01). There was no obvious abnormality as shown by DWI before and after resuscitation, and the apparent diffusion coefficient (ADC) showed a tendency to decrease after resuscitation in both groups. The ADC in the normal reperfusion group was decreased more than that in the hypertensive reperfusion. Pathological study showed that the protective effect of the hypertensive reperfusion on brain tissue was better than that of the normal reperfusion group. CONCLUSION: Hypertensive reperfusion can produce hemodynamic changes, and an increase in cerebral blood flow, thus it produces a protective effect on brain to promote the recovery of neurological function in pigs with CA after resuscitation. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.2095-4352.2013.02.010

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[PMID]: 23648156 [Au] Autor: Huang Y; He Q; Zhan L [Ad] Address: Department of Emergency, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China. Corresponding author: He Qing, Email: kk555888@126.com. [Ti] Title: [The effects of CDP-Choline on the improvement of the successful rate of cardiopulmonary resuscitation and post-resuscitation cardiac function]. [So] Source: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue;25(2):80-3, 2013 Feb. [Is] ISSN: 2095-4352 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To investigate the effects of CDP-Choline on the improvement of recovery of spontaneous circulation (ROSC) and protection against myocardial injury in cardiopulmonary resuscitation (CPR). METHODS: Sprague-Dawley (SD) rats were randomized into four groups: control group (n=5, no asphyxia), model group (n=10), adrenaline group (n=10) and CDP-Choline group (n=10). Cardiac arrest (CA) was induced by asphyxia, and then CPR was initiated. Drugs were administered at 5 minutes before CPR and at the initiation of CPR. Equal amount of normal saline was given in the control group and the model group. The hemodynamic parameters were monitored during CPR and after ROSC. After 2 hours, the myocardial tissue of the rats was harvested to assess the degree of ischemia/reperfusion (I/R) injury by measuring ATPase activity, superoxide dismutase (SOD) activity and malondialdehyde (MDA) content. RESULTS: Compared with the model group, the rate of ROSC was significantly elevated (90%, 80% vs. 20%, both P<0.01) in the CDP-Choline group and the adrenaline group, the time of achieving ROSC was shorter (53±10 s, 55±9 s vs. 95±7 s, both P<0.01), and the heart rate (HR) and mean arterial pressure (MAP) at 2 hours after CPR were higher (HR: 222.78±41.55 bpm, 167.75±11.76 bpm vs. 131.50±0.70 bpm; MAP: 36.53±8.69 mm Hg, 39.30±6.45 mm Hg vs. 30.19±5.15 mm Hg, all P<0.01). The cardiac function [the maximal rate of left ventricular pressure increase/decline (±dp/dt max)] in the CDP-Choline group was gradually stabilized and significantly higher than that in the model and the adrenaline groups. The cardiac function in the adrenaline group was higher than that of the model group, but it was in a tendency of lowering. Compared with the model group and the adrenaline group, the reduction of Na(+)-K(+)-ATPase and SOD activity were significantly increased in the CDP-Choline group (Na(+)-K(+)-ATPase: 7.35±0.20 µmol×mg(-1)×h(-1) vs. 5.11±0.69 µmol×mg(-1)×h(-1), 4.70±0.41 µmol×mg(-1)×h(-1); SOD activity: 320.65±47.25 U/mg vs. 225.79±24.64 U/mg, 253.67±12.00 U/mg, all P<0.01), and myocardial MDA content in the CDP-Choline group was significantly lower than that in the model group and the adrenaline group (8.19±1.64 mmol/mg vs. 16.59±1.27 mmol/mg, 14.65±0.93 mmol/mg, both P<0.01) . There was no significant difference in the measured parameters between the CDP-Choline group and the control group, and also between the model group and the adrenaline group. CONCLUSION: CDP-Choline has the effect on improvement of the successful rate of CPR, and it shows an obvious myocardial protection against I/R compared with adrenaline. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.2095-4352.2013.02.007

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[PMID]: 23648155 [Au] Autor: Han Y; Li CS [Ad] Address: Department of Emergency, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China. Corresponding author: Li Chun-sheng, Email: lcscyyy@163.com. [Ti] Title: [Influence on kidney after resuscitation of heart arrest due to hypothermia induced by 4 centigrade normal saline in pig]. [So] Source: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue;25(2):76-9, 2013 Feb. [Is] ISSN: 2095-4352 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To assess the effects of hypothermia state induced by 4 centigrade normal saline (NS) on kidney after successful cardiopulmonary resuscitation (CPR) in pig. METHODS: After the induction of a 4-minute ventricular fibrillation (VF) in pigs, standard CPR was performed, and then the surviving pigs were divided into two groups: hypothermia group (n=5) with 4 centigrade NS continuous infusion at the speed of 1.33 ml×kg(-1)×min(-1) for 22 minutes, and then the speed was slowed down to 10 ml×kg(-1)×min(-1) and maintaining for 4 hours; the normal temperature group (n=5) with infusion of NS of normal temperature with the same speed as that of the hypothermia group. The hemodynamic parameters and oxygen metabolism were monitored before CA and also at different time points after recovery of spontaneous circulation (ROSC). Blood samples were collected to determine the serum urea nitrogen (BUN) and creatinine (Cr). The animals were sacrificed, and the kidneys were collected to determine the ATPase activity, as well as the histological changes with both light and electron microscopy at 24 hours after ROSC. RESULTS: Continuous infusion of 4 centigrade NS could lower the central temperature by no more than 1.5 centigrade, with a little lowering of cardiac output, without obvious changes in heart rate, mean arterial pressure and coronary perfusion pressure, but the oxygen extraction rate was decreased compared with that of the normal temperature group. Serum BUN and Cr at 2 hours and 4 hours of ROSC in the normal temperature group were higher than those before CA (BUN: 3.80±0.79 mmol/L, 4.12±0.85 mmol/L vs. 3.11±0.48 mmol/L; Cr: 94.43±18.25 µmol/L, 94.15±14.03 µmol/L vs. 79.70±16.03 µmol/L, all P<0.05), and the levels in hypothermia group showed no significant changes compared with those of normal temperature group. The activities of renal Na (+)-K(+)-ATPase and Ca(2+)-ATPase at 24 hours after ROSC in the hypothermia group were lower than those in the normal temperature group, but without significant difference (1.278±0.664 µmol×mg(-1)×h(-1) vs. 3.190±0.789 µmol×mg(-1)×h(-1), 1.727±0.772 µmol×mg(-1)×h(-1) vs. 2.630±0.816 µmol×mg(-1)×h(-1), both P>0.05). Compared with the normal temperature group, there were less cellular edema, necrosis and inflammatory cells infiltration in the hypothermia group, and the mitochondria appeared normal. CONCLUSION: 4 centigrade NS continuous infusion after CPR could quickly create a hypothermia state, and the hemodynamics and oxygen metabolism were maintained, thus protecting the kidney. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.2095-4352.2013.02.006

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[PMID]: 23648154 [Au] Autor: Zhang D; Li N; Chen Y; Wang YS [Ad] Address: Department of Intensive Care Unit, the First Hospital, Jilin University, Changchun 130021, Jilin, China. Corresponding author: Wang Yu-shan, Email: wang-yushan@tom.com. [Ti] Title: [Reproducing and evaluating a rabbit model of multiple organ dysfunction syndrome after cardiopulmonary resuscitation resulted from asphyxia]. [So] Source: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue;25(2):72-5, 2013 Feb. [Is] ISSN: 2095-4352 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To evaluate the reproduction of a model of post resuscitation multiple organ dysfunction syndrome (PR-MODS) after cardiac arrest (CA) in rabbit, in order to provide new methods for post-CA treatment. METHODS: Thirty-five rabbits were randomly divided into three groups, the sham group (n=5), the 7-minute asphyxia group (n=15), and the 8-minute asphyxia group (n=15). The asphyxia CA model was reproduced with tracheal occlusion. After cardiopulmonary resuscitation (CPR), the ratio of recovery of spontaneous circulation (ROSC), the mortality at different time points and the incidence of systemic inflammatory response syndrome (SIRS) were observed in two asphyxia groups. Creatine kinase isoenzyme (CK-MB), alanine aminotransferase (ALT), creatinine (Cr), glucose (Glu) and arterial partial pressure of oxygen (PaO2) levels in blood were measured in the two asphyxia groups before CPR and 12, 24 and 48 hours after ROSC. The survived rabbits were euthanized at 48 hours after ROSC, and heart, brain, lung, kidney, liver, and intestine were harvested for pathological examination using light microscope. PR-MODS after CA was defined based on the function of main organs and their pathological changes. RESULTS: (1) The incidence of ROSC was 100.0% in 7-minute asphyxia group and 86.7% in 8-minute asphyxia group respectively (P>0.05). The 6-hour mortality in 8-minute asphyxia group was significantly higher than that in 7-minute asphyxia group (46.7% vs. 6.7%, P<0.05), and the mortality of 8-minute asphyxia group at 12 - 48 hours was slightly higher compared with that of 7-minute asphyxia group (all P>0.05). (2) There was a variety of organ dysfunctions in survived rabbits after ROSC, including chemosis, respiratory distress, hypotension, abdominal distension, weakened or disappearance of bowel peristalsis and oliguria. (3) There was no SIRS or associated changes in major organ function in the sham group. SIRS was observed at 12 - 24 hours after ROSC in the two asphyxia groups. CK-MB was increased significantly at 12 hours after ROSC compared with that before asphyxia (7-minute asphyxia group: 786.88±211.84 U/L vs. 468.20±149.45 U/L, 8-minute asphyxia group: 894.88±248.80 U/L vs. 462.11±115.15 U/L, both P<0.05), ALT, Cr and Glu were elevated obviously at 24 hours after ROSC (7-minute asphyxia group ALT: 174.25±36.28 U/L vs. 50.27±9.37 U/L, Cr: 144.25±41.64 µmol/L vs. 67.71±16.47 µmol/L, Glu: 11.21±1.14 mmol/L vs. 5.59±1.10 mmol/L; 8-minute asphyxia group ALT: 205.50±10.61 U/L vs. 51.13±10.37 U/L, Cr: 230.50±88.39 µmol/L vs. 65.93±13.81 µmol/L, Glu: 11.55±0.35 mmol/L vs. 6.41±1.23 mmol/L, all P<0.05), and PaO2 was lowered significantly at 48 hours after ROSC (7-minute asphyxia group: 5.03±0.73 kPa vs. 9.07±1.03 kPa, P<0.05). (4) There were pathological changes in major organ in the survived rabbits at 48 hours after ROSC (only 4 rabbits survived in 7-minute asphyxia group), including infiltration of inflammatory cells, partial cellular degeneration, edema, necrosis and tissue bleeding in major organs. CONCLUSION: If the SIRS and dysfunction of two or more organ were defined in animals after ROSC, the signs, biochemical markers and nonspecific pathological changes could be accepted to evaluate the PR-MODS. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3760/cma.j.issn.2095-4352.2013.02.005

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[PMID]: 23648254 [Au] Autor: Xia WF; Tang QZ; Yu SB; Cui HY; Qin M; Liu T; Kong B; Zhao QY; Huang H; Huang CX [Ad] Address: Department of Cardiology; Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China. [Ti] Title: [Effect of temperature on hospital admission among patients with chronic systolic heart failure]. [So] Source: Zhonghua Liu Xing Bing Xue Za Zhi;34(1):67-70, 2013 Jan. [Is] ISSN: 0254-6450 [Cp] Country of publication: China [La] Language: chi [Ab] Abstract: OBJECTIVE: To investigate the effect of temperature on hospital admission among patients with chronic systolic heart failure (CSHF). METHODS: Data regarding in-hospital patients with CSHF were gathered from 12 hospitals in Hubei province, between 2000 and 2010. Patients with a history of congenital heart disease and the history of cancer from this series, were excluded. Chi-square (χ(2)) tests and t tests were used for descriptive analysis. Univariate and multivariate logistic regression methods were performed to determinate the risk of hospital admission of every month to compare with the previous one. We used 2-tailed 95% confidence interval (CI), and tests with P < 0.01 to consider the significant levels, statistically. We also used the SPSS 13.0 for Windows, release 15, 2006 (SPSS Inc, Chicago, Ill) for data analyses. RESULTS: (1) 48 964 patients were enrolled in the present study. The numbers of admission increased 18.71%, 13.84%, -21.90%, -34.62%, -21.97%, -3.81%, -2.04%, 10.13%, -17.13%, -0.85%, 21.54% and 42.70% from January to December when compared to the average number of admission. (2) The odds ratios (ORs) (95% CI, P values) of hospital admission in January, February and December were 1.09 (0.96 - 1.23, 0.54), 0.98 (0.84 - 1.10, 0.46) and 0.96 (0.84 - 1.08, 0.59), respectively in females which did not show any significant differences when compared to the number in August. However the ratios were 0.61 (0.54 - 0.69, < 0.01), 0.80 (0.68 - 0.92, < 0.01) and 0.73 (0.64 - 0.83, < 0.01), respectively, in males that showed significant differences when, compared to the figures in August. (3) The OR of admission increased more when temperature got lower for patients with coronary artery disease, hypertension heart disease or rheumatic heart disease, but not with dilated cardiomyopathy. (4) The OR of admission showed a different impact on patients with different occupation, along with the change of temperature. Low or high temperature did not seem to have different effects on the OR of admission in patients who were free-lanced or unemployed. CONCLUSION: Temperature seemed to have significant effects on the risk of admission, which related to gender, etiology or occupation. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review

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