RESUMEN

INTRODUCTION: It is controversial whether obesity and periodontitis are related. A representative US population was examined for the relationship between obesity and periodontitis. METHODS: In the National Health and Nutrition Examination Survey (NHANES) 2011-2014, participants (n = 6,662) aged 30 years or older and who underwent periodontal examinations were chosen for analysis. An assessment of obesity was based on body mass index (BMI) and waist circumference (WC). Estimates of obesity and periodontal disease were made using univariate and multivariate logistic regression models. RESULTS: According to an adjusted odds ratio (OR) for periodontitis, BMI (OR = 1.01, 95% CI: 1.01∼1.02) and WC (OR = 1.01, 95% CI: 1∼1.01) were significantly associated with periodontitis, respectively. After adjusting for confounding factors, the OR for patients with high WC with periodontitis was 1.18 (1.04∼1.33) compared to normal WC. BMI and WC subgroups showed no significant interaction (p for interaction >0.05), except for the age interaction in BMI. Among young adults aged 30-44 years, obesity was significantly associated with periodontitis in subgroups; the adjusted OR for having periodontal disease was 1.02 (1∼1.03) and 1.01 (1∼1.02) for subjects with BMI and WC, respectively. When all covariates were adjusted, BMI ≥30 kg/m2 was statistically significantly associated with prevalence of periodontal disease among people aged 30-44 years (p < 0.001). CONCLUSIONS: BMI and WC are significantly associated with periodontitis, even after adjusting for many variables, and were equally significant in obese (BMI ≥30 kg/m2) young people (30-44 years).

Asunto(s)

Enfermedades Periodontales , Periodontitis , Adulto Joven , Humanos , Adolescente , Encuestas Nutricionales , Obesidad/complicaciones , Obesidad/epidemiología , Índice de Masa Corporal , Periodontitis/complicaciones , Periodontitis/epidemiología , Circunferencia de la Cintura , Factores de Riesgo

RESUMEN

BACKGROUND: Spinal cord injury (SCI) is one of the serious complications of thoracoabdominal aortic aneurysm (TAAA) repair. Cardiopulmonary bypass (CPB) and left heart bypass (LHB) are well-established extracorporeal circulatory assistance methods to increase distal aortic perfusion and prevent spinal cord ischaemia in TAAA repair. Aorto-iliac bypass, a new surgical adjunct offering distal aortic perfusion without the need of complex perfusion skills, was developed as a substitute for CPB and LHB. However, its spinal cord protective effect is unknown. METHODS: The perioperative data of 183 patients who had elective open Crawford extent II and III TAAA repair at our aortic centre from July 2011 to May 2019 were retrospectively analysed. Spinal cord protection was compared between the aorto-iliac bypass group (n=106) and the extracorporeal circulatory assistance group (n=77 [65 CPB, 12 LHB]), and the risk factors for SCI in these patients were explored. RESULTS: Eleven (11) patients had postoperative SCI: five (6.5%) in the extracorporeal circulatory assistance group (four with CPB and one with LHB), and six (5.7%) in the aorto-iliac bypass group. The incidence of SCI was 6.0% (11/183 cases). There was no difference between the aorto-iliac bypass group and the extracorporeal circulatory assistance group (p=1.0), while operation time, proximal aortic clamp time, intercostal artery clamp time, and length of intensive care unit stay were all increased in the latter group. Multivariate logistic regression analysis showed that cerebrospinal fluid pressure (odds ratio [OR] 1.270; 95% confidence interval [CI] 1.092-1.478 [p=0.002]) and lowest haemoglobin on the first postoperative day (OR 0.610; 95% CI 0.416-0.895 [p=0.011]) were the independent predictors of SCI in TAAA repair. CONCLUSIONS: Spinal cord protection of aorto-iliac bypass is comparable to that of CPB and LHB in open TAAA repair.

Asunto(s)

Aneurisma de la Aorta Torácica , Isquemia de la Médula Espinal , Aneurisma de la Aorta Torácica/cirugía , Humanos , Estudios Retrospectivos , Factores de Riesgo , Isquemia de la Médula Espinal/etiología , Isquemia de la Médula Espinal/prevención & control , Resultado del Tratamiento

RESUMEN

BACKGROUND: Many surgical methods of thoracoabdominal aortic aneurysm repair (TAAAR) have been introduced over the past several decades, with varying degrees of success. We developed an aorta-iliac bypass technique to treat thoracoabdominal aortic aneurysm (TAAA) in young Chinese patients. The aim of this study is to evaluate the results of this technique intraoperatively and postoperatively. METHODS: From June 2014 to March 2015, 28 patients underwent TAAAR using aorta-iliac bypass technique. A four-branched tetrafurcate graft was used. Two branches of the graft are sutured to bilateral common iliac arteries in an end-to-side fashion. The trunk of the graft was sutured to the proximal descending aorta in an end-to-end fashion. Then aorta-iliac bypass was established, and the lower extremities, viscera organ and spinal cord (SC) obtained perfusion from proximal descending aorta via the bypass graft. The thoracic and abdominal aorta were clamped in a staged fashion. The patent segmental arteries (SAs), and visceral arteries (coeliac trunk, superior mesenteric arteries, and renal arteries) were reattached sequentially. Evoked potential (EP) monitoring was adopted to assess the SC ischaemia throughout the procedure. The postoperative outcomes and follow-up results of this technique were evaluated. RESULTS: There was no in-hospital mortality. Complications included acute kidney dysfunction and pulmonary haemorrhage in one case (3.6%) each. The SAs were reattached in all cases. The EP wave disappeared after proximal descending aorta was clamped, and gradually recovered after the patent SAs reattached. The median follow-up after operation was eight months (range, 1-10 months). There was no delayed neurologic deficit or late death. CONCLUSIONS: Thoracoabdominal aortic aneurysm repair using aorta-iliac bypass may be a simple and safe choice for young Chinese patients with thoracoabdominal aortic aneurysms.

Asunto(s)

Aneurisma de la Aorta Abdominal , Aneurisma de la Aorta Torácica , Procedimientos Endovasculares/métodos , Potenciales Evocados , Monitoreo Fisiológico , Adulto , Aneurisma de la Aorta Abdominal/fisiopatología , Aneurisma de la Aorta Abdominal/cirugía , Aneurisma de la Aorta Torácica/fisiopatología , Aneurisma de la Aorta Torácica/cirugía , Pueblo Asiatico , China , Procedimientos Endovasculares/efectos adversos , Femenino , Humanos , Masculino , Estudios Retrospectivos

RESUMEN

The signaling mechanisms underlying ischemia-induced nerve cell apoptosis are poorly understood. We investigated the effects of apoptosis-related signal transduction pathways following ischemic spinal cord injury, including extracellular signal-regulated kinase (ERK), serine-threonine protein kinase (Akt) and c-Jun N-terminal kinase (JNK) signaling pathways. We established a rat model of acute spinal cord injury by inserting a catheter balloon in the left subclavian artery for 25 minutes. Rat models exhibited notable hindlimb dysfunction. Apoptotic cells were abundant in the anterior horn and central canal of the spinal cord. The number of apoptotic neurons was highest 48 hours post injury. The expression of phosphorylated Akt (p-Akt) and phosphorylated ERK (p-ERK) increased immediately after reperfusion, peaked at 4 hours (p-Akt) or 2 hours (p-ERK), decreased at 12 hours, and then increased at 24 hours. Phosphorylated JNK expression reduced after reperfusion, increased at 12 hours to near normal levels, and then showed a downward trend at 24 hours. Pearson linear correlation analysis also demonstrated that the number of apoptotic cells negatively correlated with p-Akt expression. These findings suggest that activation of Akt may be a key contributing factor in the delay of neuronal apoptosis after spinal cord ischemia, particularly at the stage of reperfusion, and thus may be a target for neuronal protection and reduction of neuronal apoptosis after spinal cord injury.

RESUMEN

OBJECTIVE: The present study assessed the effectiveness of preoperative transcatheter occlusion of the bronchopulmonary collateral artery (PTOBPCA) in reducing reperfusion pulmonary edema after pulmonary thromboendarterectomy (PEA). METHODS: The data from 155 patients with chronic thromboembolic pulmonary hypertension at Anzhen Hospital, treated from January 2007 to August 2013, with PEA were retrospectively reviewed. The patients were classified into a control (group A, n = 87) and treated (group B, underwent PTOBPCA, n = 68) group. The reperfusion pulmonary edema incidence, mechanical ventilation and intensive care unit hospitalization duration, and hemodynamic function were compared between the 2 groups. RESULTS: Of the 87 patients in group A, 5 died in-hospital (5.7% mortality); no patient in group B died (0% mortality; P = .035). In group A, 9 patients (10.3%) required extracorporeal membrane oxygenation (ECMO) after PEA; 1 patient (1.5%) in group B required ECMO (chi-square test, P = .026, χ(2) = 4.980). Group B had shorter intubation and intensive care unit hospitalization times, lower mean pulmonary artery pressures and pulmonary vascular resistance, higher partial pressures of oxygen in arterial blood and oxygen saturation, and decreased medical expenditure compared with group A. During a mean 37.1 ± 21.4 months of follow-up, 3 patients in group A and 2 in group B died; however, the difference in the actuarial survival at 3 years postoperatively between the 2 groups was not statistically significant. CONCLUSIONS: PTOBPCA can reduce the incidence of reperfusion pulmonary edema, shorten intensive care unit hospitalization and intubation duration, improve early hemodynamic function, and reduce ECMO usage after PEA.

Asunto(s)

Oclusión con Balón , Circulación Colateral , Endarterectomía , Hemodinámica , Hipertensión Pulmonar/terapia , Pulmón/irrigación sanguínea , Circulación Pulmonar , Edema Pulmonar/prevención & control , Embolia Pulmonar/terapia , Adulto , Extubación Traqueal , Oclusión con Balón/efectos adversos , Oclusión con Balón/mortalidad , Distribución de Chi-Cuadrado , China/epidemiología , Enfermedad Crónica , Terapia Combinada , Endarterectomía/efectos adversos , Endarterectomía/mortalidad , Femenino , Mortalidad Hospitalaria , Humanos , Hipertensión Pulmonar/diagnóstico , Hipertensión Pulmonar/mortalidad , Hipertensión Pulmonar/fisiopatología , Incidencia , Unidades de Cuidados Intensivos , Estimación de Kaplan-Meier , Tiempo de Internación , Masculino , Persona de Mediana Edad , Edema Pulmonar/diagnóstico , Edema Pulmonar/etiología , Edema Pulmonar/mortalidad , Edema Pulmonar/fisiopatología , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/mortalidad , Embolia Pulmonar/fisiopatología , Respiración Artificial , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento

RESUMEN

BACKGROUND: Pulmonary thromboendarterectomy (PTE) has evolved as a treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to characterize if pulmonary oligemia maneuver (POM) can alleviate pulmonary artery injury during PTE procedure. METHODS: A total of 112 cases of CTEPH admitted to Beijing Anzhen Hospital from March 2002 to August 2011 received PTE procedure. They were retrospectively classified as non-POM group (group A, n = 55) or POM group (group B, n = 57). Members from group B received POM during rewarming period, whereas members from group A did not. RESULTS: There were three (5.45%) early deaths in group A, no death in group B (0) (Fisher's exact test, P = 0.118). Six patients in group A needed extracorporeal membrane oxygenation (ECMO) as life support after the PTE procedure, no patients in group B needed ECMO (Fisher's exact test, P = 0.013). The patients in group B had a shorter intubation and ICU stay, lower mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR), higher partial pressure of oxygen in artery (PaO2) and arterial oxygen saturation (SaO2) and less medical expenditure than patients in group A. With a mean follow-up time of (58.3 ± 30.6) months, two patients in group A and one patient in group B died. The difference of the actuarial survival after the procedure between the two groups did not reach statistical significance. Three months post the PTE procedure, the difference of residual occluded pulmonary segment between the two groups did not reach statistical significance (P = 0.393). CONCLUSION: POM can alleviate pulmonary artery injury, shorten ICU stay and intubation time, and lower down the rate of ECMO after PTE procedure.

Asunto(s)

Endarterectomía/efectos adversos , Endarterectomía/métodos , Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/prevención & control , Arteria Pulmonar/lesiones , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos

RESUMEN

OBJECTIVE: To investigate the risk factors of postoperative hemodialysis in patients undergoing off-pump coronary artery bypass grafting (OPCAB). METHODS: The perioperative data of 2379 consecutive patients undergoing OPCAB from November 2007 to February 2009 were analyzed retrospectively. Patients were divided into dialysis group and non-dialysis group according to their use of hemodialysis therapy or not. RESULTS: Fifty-four patients experienced hemodialysis postoperatively. The incidence of hemodialysis was 2.3%, the mortality rate of dialysis group and non-dialysis group was 18.5% and 0.9% respectively. Univariate analysis showed that these factors significantly related with the postoperative dialysis:intraoperative ventricular fibrillation, emergent cardiopulmonary bypass, preoperative atrial fibrillation, intraoperative atrial fibrillation, preoperative renal dysfunction, intraoperative high-dose adrenaline usage, ventricular aneurysm, combined valvular disease, hypertension, age and numbers of grafting vessels. Multivariate logistic regression showed that intraoperative ventricular fibrillation, intraoperative high-dose adrenaline usage, hypertension, age and the numbers of grafting vessel were the risk factors of postoperative hemodialysis for patients undergoing OPCAB surgery. CONCLUSION: Intraoperative ventricular fibrillation, intraoperative high-dose adrenaline usage, hypertension, age and the numbers of grafting vessels were the independent predictors of postoperative hemodialysis in patients undergoing OPCAB surgery.

Asunto(s)

Puente de Arteria Coronaria Off-Pump/efectos adversos , Diálisis Renal , Factores de Edad , Anciano , Epinefrina/administración & dosificación , Epinefrina/efectos adversos , Femenino , Humanos , Hipertensión/epidemiología , Complicaciones Intraoperatorias/epidemiología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Periodo Posoperatorio , Estudios Retrospectivos , Factores de Riesgo , Fibrilación Ventricular/epidemiología

RESUMEN

OBJECTIVE: To study the alkaloids from Corydalis impatiens. METHODS: The alkaloids were isolated and purified by chromatography and their structures were identified by spectral data and others methods. RESULTS: Seven alkaloids were isolated and identified as bicuculline(1), ochotensine(2), ochotensimine(3), ochrobirine(4), tetrahydrothalifendine(5), norochotensimine(6), N-methylactinodaphnine(7). CONCLUSION: All these compounds are isolated from this plant for the first time.

Asunto(s)

Alcaloides/aislamiento & purificación , Corydalis/química , Dioxolanos/aislamiento & purificación , Plantas Medicinales/química , Alcaloides/química , Bicuculina/química , Bicuculina/aislamiento & purificación , Cromatografía en Capa Delgada , Dioxolanos/química , Estructura Molecular , Extractos Vegetales/química , Extractos Vegetales/aislamiento & purificación , Raíces de Plantas/química

RESUMEN

OBJECTIVE: To study the chemical constituents of Swertia mussotii. METHODS: The constituents were isolated by various column chromatography methods, and their structures were identified by physico-chemical properties and spectral analysis. RESULTS: Eleven compounds were isolated and identified as 1,3, 8-trihydroxy-7-methoxyxanthone (I), 2,8-dihydroxy-1,6-dimethyoxyxanthone (II), 1,8-dihydroxy-2,6-dimethoxyxanthone (III), 1,2,8-trimethoxyxanthone (IV), 1,3,5,6-tetrohyroxyxanthone (V), 1,8-dihydroxy-3,7-dimethoxyxanthone (VI), beta-daucosterol (VII), clerosterol 3beta-O-[6'-o-hydro-benzene-beta-D-glucoside] (VIII), ursolicacid (IX), 3beta,28-dihydroxylup-20 (29) -ene (X), erythrocentaurin (XI). CONCLUSION: Compounds VIII, IX and X are isolated from Swertia mussotii for the first time.

Asunto(s)

Plantas Medicinales/química , Swertia/química , Triterpenos/aislamiento & purificación , Xantonas/aislamiento & purificación , Estructura Molecular , Control de Calidad , Sitoesteroles/química , Sitoesteroles/aislamiento & purificación , Triterpenos/química , Xantonas/química