ObjectiveTo investigate the perioperative change of parathyroid hormone (PTH) and its effect on cardiac function in patients with rheumatic heart disease.MethodsFrom January 2018 to June 2019, 76 patients were randomly divided into calcium supplement group (n=39) and control group (n=37). Mitral valve replacement was performed in both groups with cardiopulmonary bypass (CPB). Blood gas was measured immediately and every 6 h within 24 h after CPB. The patients in the calcium supplement group were given 1 g of calcium gluconate when hypocalcemia occurred, while the control group received no calcium supplementation. Values of radial arterial blood PTH and calcium ion (Ca2+) were measured in the two groups before operation (T1), at 30 min after starting CPB (T2), immediately after stopping CPB (T3), at 24 h after operation (T4), and at 48 h after operation (T5), respectively.ResultsThere were 71 patients enrolled in this study finally, including 38 in the calcium supplement group and 33 in the control group. The PTH values of patients in the two groups gradually increased, reached the peak at T3 time-point, then began to recover gradually. There was no significant difference between the two groups at T1, T2 or T3 time-point (P>0.05), while there were significant differences at T4 and T5 time-points (P<0.05). The Ca2+ values of the two groups gradually decreased after CPB, and gradually increased after blood ultrafiltration. There was no significant difference between the two groups at T1 or T3 time-point (P>0.05), while there were significant differences at T2, T4 and T5 time-points (P<0.05). The postoperative 24-hour values of ejection fraction (EF) and cardiac troponin T (cTnT) and the 72-hour total amount of epinephrine used in the calcium supplement group were (42.66±4.18)%, (1 881.17±745.71) ng/L, and (3.04±0.86) mg, respectively, and those in the control group were (40.76±3.39)%, (2 725.30±1 062.50) ng/L, and (4.69±1.37) mg, respectively. There were statistically significant differences in EF, cTnT and the 72-hour total amount of epinephrine used between the two groups (P<0.05). Values of PTH at T4 and T5 time-points were respectively negatively correlated with postoperative 24-hour value of EF (r=-0.324, P=0.006; r=-0.359, P=0.002), positively correlated with postoperative 24-hour value of cTnT (r=0.238, P=0.046; r=0.248, P=0.037) and the 72-hour total amount of epinephrine used (r=0.324, P=0.006; r=0.383, P=0.001).ConclusionsHyperparathyroidism occures after CPB, and calcium supplementation could relieve the hyperparathyroidism. Hyperparathyroidism may be related to postoperative cardiac insufficiency.
ObjectiveTo investigate the effects of human placental mesenchymal stem cells (hPMSCs) transplantation on pulmonary vascular endothelial permeability and lung injury repair in mice with lipopolysaccharide (LPS)-induced acute lung injury (ALI).MethodsThe hPMSCs were isolated from the human placental tissue by enzyme digestion and passaged. The cell phenotype of the 3rd generation hPMSCs was detected by flow cytometry. Twenty-four 6-week-old healthy male C57BL/6 mice were randomly divided into 3 groups (n=8). The mice were instilled with LPS in the airway to prepare an ALI model in the ALI model group and the hPMSCs treatment group, and with saline in the control group. At 12 hours after LPS infusion, the mice were injected with 3rd generation hPMSCs via the tail vein in hPMSCs treatment group and with saline in the ALI model group and the control group. At 24 hours after injection, the lung tissues of all mice were taken. The pathological changes were observed by HE staining. The wet/dry mass ratio (W/D) of lung tissue was measured. The Evans blue leak test was used to detect the pulmonary vascular endothelial permea bility in mice. The expression of lung tissue permeability-related protein (VE-cadherin) was detected by Western blot.ResultsFlow cytometry examination showed that the isolated cells had typical MSCs phenotypic characteristics. Mice in each group survived. The alveolar structure of the ALI model group significantly collapsed, a large number of inflammatory cells infiltrated, and local alveolar hemorrhage occurred; while the alveolar structure collapse of the hPMSCs treatment group significantly improved, inflammatory cells infiltration significantly reduced, and a few red blood cells were in the interstitial lung. W/D and exudation volume of Evans blue stain were significantly higher in the ALI model group than in the control group and the hPMSCs treatment group (P<0.05), in the hPMSCs treatment group than in the control group (P<0.05). The relative protein expression of VE-cadherin was significantly lower in the ALI model group than in the control group and the hPMSCs treatment group (P<0.05), and in the hPMSCs treatment group than in the control group (P<0.05).ConclusionIntravenous injection of hPMSCs can effectively reduce the increased pulmonary vascular endothelial permeability mediated by LPS, relieve the degree of lung tissue damage, and play a therapeutic role in ALI mice.