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AbstractBackground: This study aims to compare the effectiveness of inhaled prostacyclin or its analoguesversus nitric oxide (NO) in treating pulmonary hypertension (PH) after cardiac or pulmonary surgery remains unclear.Methods: PubMed, Cochrane, and Embase databases were searched for literature published prior to December 2019 using the following keywords: inhaled, nitric oxide, prostacyclin, iloprost, treprostinil, epoprostenol, Tyvaso, flolan, and pulmonary hypertension. Randomized controlled trials and multiple-armed prospective studies that evaluated inhaled NO versus prostacyclin (or analogues) in patients for perioperative and/or postoperative PH after either cardiac or pulmonary surgery were included. Retrospective studies, reviews, letters, comments, editorials, and case reports were excluded.Results: Seven studies with a total of 195 patients were included. No difference in the improvement of mean pulmonary arterial pressure (pooled difference in mean change= ?0.10, 95% CI: ?3.98 to 3.78, p?=?.959) or pulmonary vascular resistance (pooled standardized difference in mean change= ?0.27, 95% CI: ?0.60 to 0.05, p?=?.099) were found between the two treatments. Similarly, no difference was found in other outcomes between the two treatments or subgroup analysis.Conclusions: Inhaled prostacyclin (or analogues) was comparable to inhaled NO in treating PH after cardiac or pulmonary surgery.
- Key messages
This study compared the efficacy of inhaled prostacyclin or its analogues versus inhaled NO to treat PH after surgery. The two types of agent exhibited similar efficacy in managing MPAP, PVR, heart rate, and cardiac output was observed.
Inhaled prostacyclin may serve as an alternative treatment option for PH after cardiac or pulmonary surgery.
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柴松岩主任是全国名老中医师承导师之一,从事中医妇科临床工作50余年。临证主张辨证与辨病相结合,重视女性的生理病理特点,强调参考基础体温、结合月经周期组方遣药,注重“治未病”理念在妇科临床的应用,在继承祖国医学的基础上不断创新,并已形成自己独到的理论特色。现就在跟师期间的些许体会加以总结,以飨同道。 相似文献
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Cardiotoxin, isolated from the venom of Naja naja atra, was found to cause rat hind-paw edema in a dose-dependent manner. This edematous response was significantly suppressed by pretreatment with diphenhydramine, methysergide or compound 48/80, which reduced the tissue histamine content. Polymorphonuclear (PMN) leukocyte infiltration appeared within 1 h and had accumulated markedly in the rat paw 3-6 h after subplantar injection of cardiotoxin. Methotrexate pretreatment significantly reduced not only the peripheral leukocyte count but also cardiotoxin-induced paw edema. Captopril, a kininase inhibitor, potentiated the edematous response caused by a low dose of cardiotoxin. The initial phase, occurring within 3 h, of paw edema induced by cardiotoxin was suppressed by trasylol, [Thi5,8,D-Phe7]bradykinin, or by cellulose sulfate pretreatment which greatly reduced plasma kininogen levels. Both mast cells and PMN leukocytes possess kinin-forming activities, but with different properties. The kinin-forming activity of mast cells but not of PMN leukocytes was inhibited by trasylol. In isolated mast cells, cardiotoxin caused a dose-dependent release of histamine, beta-glucuronidase, lactate dehydrogenase and kinin-forming activity. These observations suggest that mast cells and PMN leukocytes are involved in cardiotoxin-induced paw edema, and that inflammatory mediators such as histamine, serotonin and kinins were supplied directly or indirectly by mast cells, at least in the initial phase. 相似文献
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赛赓啶对 KBV200细胞多药抗性的逆转作用 总被引:3,自引:0,他引:3
研究赛赓啶对KBV200细胞多药抗性的逆转作用及逆转机制。在KBV200细胞,采用MTT法,测出赛赓啶对长春新碱、阿霉素和鬼臼乙叉甙耐药的逆转系数分别为5.5,2.0和1.9,而对5-氟尿嘧啶、美法仑的细胞毒性作用无明显影响,表明赛赓啶为多药抗性逆转剂。荧光分光光度法测定表明,赛赓啶可使KBV200细胞内阿霉素蓄积量增加。流式细胞荧光测定显示赛赓啶可增加罗丹明123的蓄积并减慢其外排。免疫细胞化学及狭缝杂交表明赛赓啶不影响KBV200细胞的P-糖蛋白染色深度和 mdr1 RNA 表达水平。以上结果提示赛赓啶的多药抗性逆转机制是抑制P-糖蛋白泵的功能。 相似文献
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逆行交锁髓内钉治疗股骨髁上骨折及关节僵硬 总被引:2,自引:0,他引:2
目的:探讨应用逆行交锁强内钉治疗陈旧性股骨碟上骨折钢板断裂不愈合并膝关节僵硬的临床意义。方法:对5例患采用断裂钢板拆除,手术松解粘连,矫正畸形,股骨碟逆行交锁铝内钉固定,术后早期应用CPM机锻炼。结果:5例随访8—12个月,肢体无畸形,骨折愈合时间6—9个月,平均7.5个月,膝关节功能按Kolmert评定标准,优4例,良1例。结论:应用逆行交锁铝内钉治疗股骨碟上陈旧性骨折钢板断裂骨不愈合并膝关节僵硬,操作简便,固定牢靠,可早期功能锻炼,效果良好。 相似文献
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