Hua xi yi ke da xue xue bao = Journal of West China University of Medical Sciences = Huaxi yike daxue xuebao / [bian ji zhe, Hua xi yi ke da xue xue bao bian wei hui]
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Hua Xi Yi Ke Da Xue Xue Bao · Jun 1999
[Effects of warm blood and clot crystalloid cardioplegia on the heart rate variability of canine].
The objectives of this study were to explore the mechanisms of cardiac autonomic system (CAS) impairment and to assess whether warm blood cardioplegia can prevent the decrease of heart rate variability (HRV) after CPB. Twelve adult mongrel dogs were divided into two groups. One group received warm blood cardioplegia and maintained at a systemic temperature of 38 degrees C throughout the experiment (WB group). ⋯ The LF/HF did not change both between groups and between before- and after-CPB in each group (P > 0.05). The mean heart rate at 24 hours (MHR) increased in both groups, compared to control (P < 0.05), with CC group having a significantly higher MHR than WB group (P < 0.05). The data suggest that CPB, with warm blood or cold crystalloid cardioplegia does not disturb the balance of CAS, but it causes the decrease of HRV, and warm blood cardioplegia can not prevent the impairment of HRV.
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Hua Xi Yi Ke Da Xue Xue Bao · Mar 1999
[Leukocyte adhesion molecule expression and circulating ICAM-1, E-selectin levels during cardiopulmonary bypass in patients undergoing valve replacement].
The objectives of this study were to measure leukocyte adhesion molecule expression, assess the possibility of evaluating the serum levels of the soluble form of endothelium adhesion molecule as an alternative for endothelia cell activation, and analyze the correlation and regression between leukocyte adhesion molecule expression and soluble endothelium adhesion molecule levels during cardiopulmonary bypass (CPB) in patients undergoing valve replacement. Twelve adult patients were included in this study. The extracorporeal circuit was primed with Ringer's lactate. ⋯ Upregulation of the leukocyte adhesion molecule expression and increase of the circulation endothelium adhesion molecule levels lasted at least 2 days after surgery (P < 0.05) except CD11a. There were correlation and regression between leukocyte adhesion molecule expression and soluble endothelium adhesion molecule levels (r = 0.91-0.99, P = 0.0322-0.0005; Y = -1377.06-44.64 + 1.49-14.78a to Y = 44.64 + 1.49a). These results suggest that CPB causes obvious leukocyte-endothelia interactions, that the expression of these adhesion molecules are presented by means of receptor-ligand form, and that the measurement of sICAM-1 and sE-selectin may well be used as a marker of endothelial cell activation.
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Hua Xi Yi Ke Da Xue Xue Bao · Mar 1999
[On the problems of fitting linear regression models for hierarchically structured data in medical research].
There are a large number of the hierarchically structured data in the field of medical sciences, which have been analyzed usually by conventional linear regression models. The objective of this paper is to explore the problems and the relationship of parameter estimates of the three common linear regression models in fitting the hierarchically structured date, and the correction of the precision of parameter estimates. It is shown that the estimate of parameter and it's precision of linear regression models is related to the variation of independent variable between and within level 2 units, and the difference of residual estimates is associated with the difference of parameter estimates. The three common linear regression models are all inappropriate for the hierarchically structured data, but the standard error of the level 1 combined model can be corrected by variance inflation factor in conditions.
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Hua Xi Yi Ke Da Xue Xue Bao · Mar 1998
[Cytokines release related to cardiopulmonary bypass in patients with prosthetic valve replacement].
To examine cytokines release related to cardiopulmonary bypass(CPB), the anthers investigated the possible differences in cytokines responses between patients undergoing prosthetic valve replacement (study group, n = 10) and those receiving closure of patent ductus arteriosus or pericardiectomy(control group, n = 9). Venous levels of interleukin-2 (IL-2), soluble interleukin-2 receptor (sIL-2R), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and interleukin-10 (IL-10) were measured at multiple time points before, during and after operation. As compared with pre-operative values, IL-2 levels in both groups decreased significantly (P < 0.05), and the levels of sIL-2R, IL-6, TNF-alpha, and IL-10 in both groups increased significantly at multiple time points post-operative (P < 0.01). ⋯ The values were 34 pg/ml, 36 pg/ml, and 162 pg/ml respectively. This result suggests that besides surgical stress mediated cytokines production or suppression, CPB itself also results in obvious changes of cytokine metabolism. However further studies are needed to elucidate the underlying mechanisms and clinical value of post-operative cytokines production or suppression related to CPB in patients with prosthetic valve replacement.
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With the introduction and wide acceptance of the Glasgow coma scale, some progress was made in 1980s. Various types of coma scale were offered from different centers of the world for assessing coma and impaired consciousness. The existing coma scales may be divided into two main categories: (1) multi-dimensional scale, e.g., Glasgow coma scale (GCS), Glasgow-Liege coma scale (G-LCS), Maryland coma scale (MCS); and (2) uni-dimensional scale, e.g., Edinburgh-2 coma scale (E2CS). ⋯ On the basis of comparison between two main categories of coma scale and considering the shortcomings of E2CS, a modified uni-dimensional ordinal coma scale called "Chengdu-1 Coma scale" (C1CS) was proposed and applied for evaluating the depth of coma and for prognosticating the patients' outcome. This study was based on 98 acutely head-injured patients treated in the Neurosurgical department of 1st Affiliated Hospital of WCUMS, from October 1983 through May 1984. The follow-up results showed that a good correlation was observed between the score of C1CS and the outcome scale score (Glasgow outcome scale, GOS) of the patients.