The shortage of donor heart and the lack of satisfactory donor heart are embarrassing heart transplantation. With the development of the study of the effects of thyroid hormone（TH） on cardiovascular system, amazing achievement has been obtained. TH could improve the quality of donor heart, increase successful rate and reduce mortality of heart transplantation. In the mean time ,some donor hearts that could not be used originally had been used after TH application, thus expanded donor pool. TH has been a routine treatment measure in heart transplantation in many heart centers. The application of TH in heart transplantation has been reviewed in this article.
Adenosine triphophate (ATP), substantially liberated from the injured cells, activates the inflammatory cells to secrete various inflammatory factors, thus triggering uncontrolled systemic inflammatory response and thrombosis with aggravating the degree of damage. Metabolic pathway of adenosine consists of adenosine (Ado) synthase CD39-CD73, nucleoside transporters (NTs) and termination system of adenosine deaminase (ADA) and adenosine kinase (ADK). As a " switch” of the inflammatory response, the metabolic pathway converts ATP (the pro-inflammatory cytokines) to Ado (the anti-inflammatory mediators), maintaining the homeostasis between pro-inflammatory and anti-inflammatory as well as affecting the outcome of the injury. This review focused on the recent progress of adenosine metabolic pathway in cell injury.
ObjectiveTo evaluate the effect of perioperative nebulization of ipratropium bromide on preoperative pulmonary function and incidence of postoperative pulmonary complications as well as safety in chronic obstructive pulmonary disease (COPD) patients who underwent lung resection in thoracic surgery. MethodsDuring November 18, 2013 to August 12, 2015, 192 COPD patients with a necessity of selective surgical procedures of lobectomy or right bilobectomy or segmentectomy under general anaesthesia in 10 centers were 1 : 1 randomized to an ipratropium bromide group (96 patients) and a placebo group (96 patients), to compare the effect on preoperative pulmonary function and incidence of postoperative pulmonary complications. The average age of treated patients was 62.90±6.50 years, with 168 male patients and 22 female patients. Results The demographic and baseline characteristics were well-balanced between the two groups. The adjusted mean increase of forced expiratory volume in one second (FEV1) in the ipratropium bromide group was significantly higher than that in the placebo group (169.90±29.07 mL vs. 15.00±29.35 mL, P<0.05). The perioperative use of ipratropium bromide significantly decreased incidence of postoperative pneumonia (2.6% vs. 14.1%, P<0.05). There was no ipratropium bromide related adverse event (AE) observed in this trial. ConclusionThis trial indicates that perioperative nebulization of ipratropium bromide significantly improves preoperative lung function and reduces postoperative pneumonia in COPD patients undergoing lung resection in thoracic surgery, and has good safety profile.