Abstract: Objective To investigate the effect of liposomal prostaglandin E1 (LipoPGE1) on inflammatory reaction during cardiopulmonary bypass (CPB) coronary artery bypass grafting (CABG). Methods Between July 2006 and December 2008, a total of 32 patients undergoing CABG were randomly divided into two groups of 16 patients each using a random digits table. The experimental group had 9 male and 7female patients with a mean age of 54.4±18.1 years; each patient received 15.0ng/(kg·min) of LipoPGE1 by venous pump through the central vein throughouttheCPB procedure. The control group had 9 male and 7 female patients with a mean age of 54.8±20.4 years, who were treated identically to the experimental group except did not receive LipoPGE1. Arterial blood samples were taken before CPBand at the 1st, 2nd, 6th, and 24th hour after open aorta ascendens. The levels of interleukin6(IL6), tumor necrosis factorα (TNFα), and soluble intercellular adhesion molecule1 (sICAM1) were tested and compared. Results In both groups, levels of IL6, TNFα, and sICAM1 were all gradually increased after the ascending aorta was opened, and they reached their highest levels at the 6th hour after open aorta ascendens. In the experimental group, at every time point afterthe ascending aorta was open, levels of IL6 (24th hour after open aorta ascendens: 16.1±2.2 μg/L vs. 19.2±4.5 μg/L,Plt;0.05), TNFα (24th hour after open aorta ascendens: 1.8±04 μg/L vs. 2.2±0.5 μg/L,Plt;0.05), and sICAM1 (24th hour after open aorta ascendens: 233.6±36.6 μg/L vs. 294.2±55.7 μg/L,Plt;0.05) were significantly lower than those of the control group. 〖WTHZ〗Conclusion LipoPGE1 effectively reduces the aggregation of polymorphonuclear neutrophilic leukocytes, inhibits activation of vascular endothelialcells, and decreases systemic inflammatorome during CPB.
Gastrointestinal (GI) complications after heart surgery included slight bleeding through fulminant hepatic failure. Although overall rate of these complications is low, it can lead to high mortality after heart surgery. Diagnosis of GI complication is difficult. Risk factors for GI complications are clear. Mechanisms of complications are various. Therefore, we collected the recent prospective and retrospective literatures to sumarize mortality of GI complications, pathogenesis, risk factors, recent progress of prevention and management, to guide clinical practice.
The Rapid Advice Guidelines (RAGs), prepared in the form of evidence-based guidelines for responding to public health emergencies in a short period, are characterized by their capability to significantly reduce the time for the development of guidelines to the maximum extent while ensuring quality. Therefore, the RAGs are primarily used to guide and respond to public health emergencies. This article will introduce the definition, characteristics, current situation, applicable situation, development methods, advantages and limitations of the RAGs. Our study proposes several suggestions for RAGs developers and researchers to improve development of RAGs in China.