Objectives:To determine risk factors associated with postoperative hypoxemia after surgery for acute type A aortic dissection.Methods:We retrospectively analyzed the clinical data of 192 patients with acute type A aortic dissection who underwent surgery in Qingdao Municipal Hospital, Medical College of Qingdao University, Qingdao, China between January 2007 and December 2013. Patients were divided into hypoxemia group (n=55) [arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) ≤200 mm Hg] and non-hypoxemia group (n=137) [PaO2/FiO2 >200 mm Hg]. Perioperative clinical data were analyzed and compared between the 2 groups.Results:The incidence of postoperative hypoxemia after surgery for acute aortic dissection was 28.6% (55/192). Perioperative death occurred in 13 patients (6.8%). Multivariate regression identified body mass index (BMI) >25 kg/m2 (OR=21.929, p=0.000), deep hypothermic circulatory arrest (DHCA) (OR=11.551, p=0.000), preoperative PaO2/FiO2 ≤300 mm Hg (OR=7.830, p=0.000) and blood transfusion >6U in 24 hours postoperatively (OR=12.037, p=0.000) as independent predictors of postoperative hypoxemia for patients undergoing Stanford A aortic dissection surgery.Conclusion:Our study demonstrated that BMI >25 kg/m2, DHCA, preoperative PaO2/FiO2 ≤300 mm Hg, and blood transfusion in 24 hours postoperatively >6U were independent risk factors of the hypoxemia after acute type A aortic dissection aneurysm surgery.

RAGE signaling may contribute to the pain hypersensitivity observed in the rat SNL model of NP. Although the precise mechanism remains to be established, NF-κB, TNF-α, and IL-1β likely play a role, together with the activation of SGCs.

Background: This study aimed to investigate the anti-apoptosis effects of heme oxygenase-1 (HO-1) on lung injury (LI) after cardiopulmonary bypass (CPB) and its probable mechanisms. Methods: One hundred and forty-four male Wistar rats were divided into 3 groups randomly: group A (control group), group B (cobalt protoporphyrin, CoPP), and group C [CoPP plus zinc protoporphyrin (ZnPP)]. Lung tissues were harvested at different time: before CPB (T0), 0 min after CPB (T1), 2 h after CPB (T2), 6 h (T3), 12 h (T4), and 24 h (T5). Results: The HO-1 protein expressions in lung tissue in group B were higher than those in group A and group C in any given time, and the same as HO-1 activity (P<0.05). The expressions of Bcl-2 protein in group B at all time point after bypass were higher than those in group A and group C, and the difference was statistically significant (P<0.05). Apoptosis index (AI) in group B at any time point after bypass were lower than those in group A and group C (P<0.05). Conclusions: CoPP can significantly increase the expression of HO-1 protein in lung tissue. HO-1 is still highly expressed after CPB, so as to play an important part in anti-apoptosis, and reduce LI.

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Background Spinal tumor surgery usually involved long operation time, large area of soft tissue resection and long wound, and was prone to hypothermia during the operation. Therefore, actively promoting insulation and optimizing the intraoperative insulation program have great potential in reducing the incidence of hypothermia and reducing the incidence of postoperative complications. In this study, we compared patients who did not implement multi-mode nursing insulation program (MNIP) with those who implemented MNIP, observing and comparing clinical outcomes, and complications in both groups, with the aim of developing an optimal management plan for the preoperative, intraoperative, and postoperative periods, respectively. Methods We selected 2 periods of 1 year, before (n = 120 patients) and after MINP implementation (n = 120 patients). Data were collected on patient demographics, operative, perioperative details, temperature changes, anesthesia recovery effect, incidence of postoperative wound infection, length of hospital stay and complications. PS analyses were used for dealing with confounding bias in this retrospective observational study. Results After PS matching, the outcomes of 120 well-balanced pairs of patients were compared (No-MNIP vs MNIP). There was no significant difference concerning the satisfaction survey. The results indicated that the MNIP had better insulation effect at 90 min, 120 min, 150 min after anesthesia induction and after surgery. There were 16 cases of complications in the No-MNIP group and 5 cases in the MNIP group postoperative, which have significant statistical difference. Conclusion In this study, the incidence of intraoperative hypothermia was effectively reduced by adopting the multi-mode insulation scheme, thus reducing the incidence of incision infection and shortening the length of hospital stay of patients.