PTH基因多态性与骨质疏松性骨折的相关性研究

目的探讨甲状旁腺激素(parathyroid hormone,PTH)基因rs1459015位点多态性与北京地区汉族人群骨质疏松性骨折骨密度的关系。方法研究对象为北京地区无亲缘关系的汉族人群,其中骨质疏松性骨折患者(骨折组)127例,非骨质疏松性骨折患者(对照组)145例。采用SNaPshot法检验PTH基因多态性,双能X线吸收仪测定腰椎L2~4、股骨近端的neck、Ward’s三角、troch和total骨密度,计算两组等位基因频率、基因型频率,分析骨折组和对照组各部位骨密度差异以及骨折组PTH基因多态性与各部位骨密度的关系。结果骨折组A、G等位基因频率19.7%、80.3%,对照组A、G等位基因频率18.6%、81.4%,差异无统计学意义(P0.05)。两组AA、AG、GG基因型频率分别为3.9%、31.5%、64.6%和3.4%、30.3%、66.2%,差异无统计学意义(P0.05)。骨折组各部位骨密度均低于对照组,除neck骨密度差异外均有统计学意义(P0.05)。骨折组中GG基因型腰椎骨密度均高于AA、AG基因型(P0.05)。与AA、GG基因型相比,骨折组AG基因型髋部骨密度较高(P0.05)。结论PTH基因多态性rs1459015位点与北京地区汉族人群骨质疏松性骨折患者骨密度不相关。     

CYP11A1基因多态性与老年性骨质疏松性骨折相关性研究

目的探讨CYP11A1基因rs900798位点多态性与老年性骨质疏松性骨折骨转换标志物的关系。方法研究对象为121例老年性骨质疏松性骨折患者(骨折组),114例老年性骨质疏松症患者(对照组)。骨折组中胸椎骨折、腰椎骨折、胸腰椎骨折、股骨颈骨折、粗隆间骨折、肱骨近端骨折和桡骨远端例数分别为32例、40例、3例、19例、20例、4例和3例。采用SNa Pshot法进行SNP分型,化学发光法测定血清Ⅰ型前胶原氨基端前肽(PINP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)浓度。计算两组等位基因频率、基因型频率并分析骨折组CYP11A1基因多态性与PINP、β-CTX的关系。结果两组rs900798位点等位基因基因频率和基因型频率分布符合哈迪温伯格平衡。骨折组和对照组G、T等位基因频率分别为40.1%、59.9%和38.2%、61.8%,差异无统计学意义(P0.05);两组GG、GT、TT基因型频率分别为14.9%、50.4%、34.7%和13.2%、50.0%、36.8%,差异无统计学意义(P0.05)。骨折组和对照组血清PINP、β-CTX差异无统计学意义(P0.05)。骨折组中GG、GT、TT基因型的PINP、β-CTX差异无统计学意义(P0.05)。结论 CYP11A1基因rs900798位点多态性与老年性骨质疏松性骨折患者血清PINP、β-CTX无相关性。     

CD40基因rs1883832多态性与老年性骨质疏松性骨折相关性研究

目的探讨CD40基因rs1883832多态性与老年性骨质疏松性骨折患者骨代谢标志物和骨密度的关系。方法研究对象为183例老年骨质疏松性骨折患者(骨折组)和163例老年骨质疏松患者(对照组)。采用SNa Pshot法进行SNP分型,化学发光法测定骨代谢标志物PINP和β-CTX水平,双能X线吸收仪测定腰椎L2-4和髋部骨密度。分析两组等位基因频率和基因型频率有无差异,并分析两组rs1883832基因多态性与骨代谢标志物和各部位骨密度的关系。结果对照组基因型频率符合哈迪温伯格平衡(P0. 05)。骨折组和对照组A、G等位基因频率分别为30. 3%、69. 7%和32. 2%、67. 8%(P0. 05);两组AA、AG和GG基因型频率分别为11. 5%、37. 7%、50. 8%和10. 4%、43. 6%、46. 0%(P0. 05)。骨折组骨转换标志物水平高于对照组而各部位骨密度低于对照组;两组AA基因型各部位骨密度均低于AG、GG基因型(P0. 05)。结论未发现CD40基因rs1883832多态性与老年骨质疏松性骨折患者骨代谢标志物和骨密度存在相关性。     

VDR基因SNPs多态性与新疆维、汉民族育龄女性腰 椎峰值骨密度的关系

目的探讨新疆地区维吾尔族、汉族两民族育龄女性维生素D受体(VDR)基因多态性与腰椎峰值骨密度的关系。方法分别对新疆地区无亲缘关系、年龄20~40岁的305例汉族健康妇女和216例维吾尔族健康妇女进行CDX2(rs11568820),TaqI(rs731236),Tru9 I(rs757343)位点多态性检测,用定量CT(QCT)骨密度仪测定腰椎骨密度(BMD)。结果维、汉族育龄女性腰椎骨峰值出现的年龄段略有不同,但都在35岁达到。两民族女性CDX2(rs11568820),TaqI(rs731236),Tru9 I(rs757343)位点基因型及等位基因频率分布均符合Hardy-Weinberg平衡定律;CDX2(rs11568820)基因型频率在维、汉两民族妇女中比较,差异有显著性(P0.05)。TaqI位点T和t等位基因分布频率在维族和汉族育龄女性中差异有有统计学意义(P0.05)。各基因型与BMD的关系显示:CDX2(rs11568820),TaqI(rs731236),Tru9 I(rs757343)位点多态性与维族、汉族腰椎峰值骨密度均无明显相关(P0.05)。但VDR基因TaqI携带Tt基因型的骨密度值在汉族与维族妇女比较时存在显著性差异,同样携带Tt基因型的维族女性骨密度比汉族女性高。Tru9I在汉族女性组中携带Tt基因型,其骨密度比携带tt型和TT型高,结论 VDR SNPs的基因型与腰椎峰值骨密度具有种族差异性,CDX2(rs11568820),TaqI(rs731236),Tru9 I(rs757343)位点多态性对新疆地区维、汉族育龄女性腰椎峰值骨量无明显影响。     

老年男性髋部骨折患者ERα基因多态性的病例对照研究

目的研究呼和浩特地区汉族老年男性髋部骨折患者雌激素受体基因多态性与骨质疏松症的关系。方法收集老年男性髋部骨质疏松性骨折128例,按年龄配比选取汉族男性健康体检者128名,进行病例对照研究。所有受试者均行骨密度检查,并进行雌激素受体基因多态性检测。结果骨质疏松组雌激素受体PvuⅡ基因型PP、Pp及pp频率分别为7.8%,42.2%和50.0%;对照组雌激素受体PvuⅡ基因型PP、Pp及pp频率分别为13.3%,53.9%和32.8%,卡方检验提示,骨质疏松组和对照组之间Pp,pp,PP三种基因型的频率分布差异有显著性意义(P<0.05)。骨质疏松组雌激素受体XbaI基因型XX、Xx及xx频率分别为4.7%,44.5%和50.8%;对照组雌激素受体PvuⅡ基因型XX、Xx及xx频率分别为3.1%,39.1%和57.8%,卡方检验提示,骨质疏松组和对照组之间XX、Xx及xx三种基因型的频率分布差异无显著性意义(P>0.05)。结论雌激素受体基因型分布频率均符合Hardy-Weinberg定律,呼和浩特地区老年男性ERα基因基因PvuⅡ酶切位点与原发性骨质疏松症存在相关性。老年髋部骨折与雌激素受体基因多态性可能存在相关性。     

老年男性髋部骨折患者ERa基因多态性的病例对照研究

目的研究呼和浩特地区汉族老年男性髋部骨折患者雌激素受体基因多态性与骨质疏松症的 关系。方法收集老年男性髋部骨质疏松性骨折128例,按年龄配比选取汉族男性健康体检者128 名,进行病例对照研究。所有受试者均行骨密度检査,并进行雌激素受体基因多态性检测。结果骨 质疏松组雌激素受体Pvu E基因型PP、Pp及pp频率分别为7. 8% , 42. 2%和50. 0% ;对照组雌激素 受体Pvu E基因型PP、Pp及pp频率分别为13. 3% , 53. 9%和32. 8%,卡方检验提示,骨质疏松组和 对照组之间Pp,pp, PP三种基_的频率分布差异有显著性意义（P<0.05)。骨质疏松组雌激素受 体Xbal基因型XX、Xx及xx频率分别为4. 7% ’ 44. 5%和50. 8% ;对照组雌激素受体Pvu II基因型 XX、Xx及xx频率分别为3. 1%,39. 1%和57.8%,卡方检验提示,骨质疏松组和对照组之间XX、Xx 及xx三种基因型的频率分布差异无显著性意义（P>0.05)。结论雌激素受体基因型分布频率均 符合Hardy-Weinbag定律,呼和浩特地区老年男性ERa基因基因Pvu II酶切位点与原发性骨质疏松 症存在相关性。老年髋部骨折与雌激素受体基因多态性可能存在相关性。     

hTERT基因多态性与结肠癌易感性关系的研究

目的:探讨人端粒酶逆转录酶(hTERT)基因rs2736098、rs2075786和rs2736100位点单核苷酸多态性(SNP)与结肠癌遗传易感性的关系。方法:采用聚合酶链反应-限制性片段长度多态性(PCRRFLP)方法对186例结肠癌患者和194例结肠腺瘤患者(病例组)以及随机匹配的406例健康体检行结肠镜检查未见明显异常者(对照组)进行基因多态性分析。结果:rs2736098、rs2075786位点各基因型在病例组和对照组中的频率分布差异无统计学意义(P0.05),结肠癌组rs2736100位点GG基因型频率显著高于健康对照组及结肠腺瘤组(29.03%vs 16.50%、18.04%,P0.05),携带GG基因型者罹患结肠癌风险增加2.216倍(95%CI:1.393-3.527)。结论:h TERT基因rs2736100位点基因多态性与结肠癌遗传易感性相关。     

ALDH2基因多态性与老年男性骨质疏松的相关性

目的探讨ALDH2基因多态性与老年男性骨质疏松的相关性。方法选取我院老年病科住院的204例老年男性患者,测定炎症因子C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)水平及骨密度,同时采用DNA微阵列芯片法检测ALDH2基因多态性,分析骨ALDH2基因多态性与老年男性骨质疏松的相关性。结果 117例骨质疏松组患者AA/GA基因型频率为61.6%;A等位基因频率为35.0%,均显著高于87例无骨质疏松组(分别为37.9%,21.3%)(均P0.05);骨质疏松组炎症因子水平明显高于非骨质疏松组,P0.05。结论 ALDH2基因多态性与老年男性骨质疏松有一定的相关性,ALDH2基因突变可能增加老年男性罹患骨质疏松的风险。     

PTCH1基因rs28377268多态性与骨质疏松性椎体压缩骨折骨代谢标志物的相关性研究

目的探讨PTCH1基因rs28 377 268位点多态性与骨质疏松性椎体压缩骨折患者骨代谢标志物的关系。方法选取2016年1月至2016年6月我科脊柱组收治的骨质疏松性椎体压缩骨折患者(骨折组)和脊柱退行性病变骨质疏松患者(对照组)各80例。采用SNa Pshot法进行SNP分型,化学发光法测定骨代谢标志物:骨钙素(osteocalcin,OC)、Ⅰ型胶原羧基端肽β特殊序列(beta-crosslaps of type I collagen cross-linked C-telopeptide,β-CTX)、Ⅰ型前胶原氨基端前肽(procollagen I N-terminal propeptide,P1NP)、25-羟维生素D(25-hydroxyvitamin D,25(OH)D)、甲状旁腺激素(parathyroid hormone,PTH)浓度。比较两组等位基因频率、基因型频率分布及两组骨代谢标志物浓度差异,并分析PTCH1基因rs28 377 268位点多态性与骨代谢标志物浓度的关系。结果骨折组和对照组G、T等位基因频率均为80%、20%,两组GG、GT、TT基因型频率分别为66.25%、27.50%、6.25%和62.50%、35.00%、2.50%,无统计学意义(P0.05)。骨折组中血清OC、PINP、β-CTX及25(OH)D浓度较对照组均无统计学意义,而PTH浓度明显高于对照组(P0.05)。血清OC、PINP、β-CTX及25(OH)D浓度在GG、GT、TT3种基因型之间亦无统计学意义(P0.05),血清PTH浓度在GT、TT基因型中均高于GG基因型,其中TT基因型显著高于GG、GT基因型(P0.05)。结论 PTCH1基因rs28 377 268位点在骨质疏松患者中G、T等位基因的表达频率分别为80%、20%,rs28377268-T等位基因高表达可能间接升高血清PTH浓度,促进骨质疏松发生,增加椎体脆性骨折风险。     

应用FRAX评价2型糖尿病对老年男性骨质疏松性骨折风险的影响

目的探讨2型糖尿病对老年男性骨质疏松性骨折风险的影响。方法收集138例老年男性2型糖尿病患者作为糖尿病组,140名血糖正常老年男性作为对照组,比较两组间的一般资料、血糖、骨质疏松患病率、骨密度以及骨折风险的差异,从而分析2型糖尿病对老年男性骨质疏松性骨折风险的影响。结果糖尿病组骨质疏松的患病率显著高于对照组(P0.05),糖尿病组患有骨量减少的比例与对照组比较差异无统计学意义(P0.05),糖尿病组的腰椎骨密度、股骨颈骨密度显著低于对照组(P0.05),糖尿病组的10年发生主要部位骨质疏松骨折的概率和10年发生髋部骨折概率显著高于对照组(P0.05)。结论 2型糖尿病可增加老年男性患者骨质疏松的患病率,会降低患者骨密度,增加患者骨折的风险,应采取措施积极加强预防和干预。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Immunomodulation in Transplantation with Photopheresis

Abstract: Photopheresis is a technique in which peripheral blood mononuclear cells, in the presence of a photoacti-vatable compound, are exposed extracorporeally to ultraviolet A light and reinfused, inducing a host autoregula-tory immune response. Experimental work and ongoing clinical studies are helping to define the role of this novel, safe, and non-toxic immunomodulating technology in the field of transplantation.