ObjectiveTo summarize the perioperative management experience and the treatment strategy of hyperkalemia after simultaneous pancreas and kidney transplantation (SPK).MethodThe clinical data of patients with diabetes combined with end-stage renal disease who accepted SPK in the Organ Transplantation Center of West China Hospital of Sichuan University from November 2017 to November 2019 were retrospectively analyzed.ResultsA total of 6 patients accepted SPK totally. The cold ischemia time of all allografts was less than 8 h. The levels of fasting blood glucose and serum creatinine were normal in the 5 surviving patients, and the diabetic complications were relieved or improved, except for 1 patient who died of cardiac arrest due to acute left heart failure. There were 1 case of delayed primary renal function recovery, 2 cases of bleeding in the surgical area of pancreas transplantation, 1 case of gastrointestinal bleeding, 3 cases of microthrombosis in the blood vessels of pancreas transplantation, 2 cases of perirenal effusion infection, 2 cases of pulmonary infection, and 1 case of ureterobladder anastomotic leakage, all of which were cured after symptomatic treatment. Only 2 patients occurred hyperkalemia after SPK (the highest level was 6.49 mmol/L and 6.67 mmol/L respectively), and transfusion of 10% glucose injection contain insulin, emergency dialysis and oral fludrocortisone were successively performed on them to restore the potassium density in 1 month and 2 months after surgery. There were no complications of perioperative surgical technical hemorrhage, intestinal leakage, large arteriovenous thrombosis, necrotizing pancreatitis, etc.ConclusionsSPK is the most effective treatment for patients with diabetes combined with end-stage renal disease. Transfusion of 10% glucose injection contain insulin, emergency dialysis, and oral fludrocortisone are effective strategies in treating hyperkalemia after SPK.
目的 探讨持续性非卧床腹膜透析（CAPD）患者低钾血症的发生及临床特点。 方法 选取2002年12月－2011年12月采取持续非卧床腹膜透析治疗的47例尿毒症患者，就其透析过程中低钾血症发生情况进行总结分析。 结果 低钾血症31例（66%）；低钾血症组与非低钾血症组比较，低钾血症组血尿素氮、肌酐、血钠、血氯、血钙及白蛋白明显降低（P＜0.05）；两组年龄、性别、糖尿病肾病所占的比例及透析龄差异均无统计学意义（P＞0.05）。血钾水平随白蛋白浓度、血氯及血钙的提高而下降（OR=0.756， 0.772，0.022，P＜0.05）。 结论 密切联系、定期随诊观察CAPD患者，提高患者就诊依从性，及时发现与纠正低钾血症，有助于提高CAPD患者的生活质量与长期存活率。
Objective To investigate the role of mitochondrial adenosine triphosphatesensitive potassium channel(mitoKATP) in immature myocardial ischemic preconditioning, and to provide evidence for immature myocardial protection. Methods Langendorff isolated heart infused model was used in the experiment. Twentyfour rabbits (aged from 14 to 21 days) were randomly divided into 4 groups：ischemiareperfusion group（I/R group）, myocardial ischemic preconditioning group(E1 group), 5hydroxydecanoate(5-HD) group (E2 group) and Diazoxide (Diaz) group(E3 group). Hemodynamics recovery rate, myocardial water content(MWC), the leakage rates of serum creatine kinase and lactate dehydrogenase, adenosine triphosphate content, superoxide dismutase activity, malondialdehyde content, myocardial cell Ca2+ content and myocardial mitochondrial Ca2+ content, myocardial mitochondrial Ca2+-ATPase activity, the adenosine triphosphate(ATP) synthesizing ability of myocardial mitochondria were tested, and myocardial ultrastructure was observed via electron microscopy. Results The hemodynamics recovery rate, myocardial water content(P＜0.05), adenosine triphosphate content, superoxide dismutase activity, myocardial mitochondrial Ca2+-adenosine triphosphyatase(ATPase) activity and the ATP synthesizing ability of myocardial mitochondria of the rabbits in E1 and E3 group were significantly better than that in I/R group and E2 group(P＜0.05). Malondialdehyde content, the leakage rates of serum creatine kinase and lactate dehydrogenase, myocardial cell Ca2+ content and myocardial mitochondrial Ca2+ content of the rabbits in E1 group and E3 group were significantly lower than that in I/R group and E2 group (P＜0.05). The myocardial ultrastructure injury in E1 and E3 group were significantly reduced compared with that in I/R and E2 group. Conclusion Myocardial ischemic preconditioning has significant protective effects on immature myocardium. Its mechanism may be related to the activation of mitoKATP.
ObjectiveTo detect the expression and function of Kv1.3 channel in peripheral blood T lymphocytes of chronic obstructive pulmonary disease (COPD) patients, and to explore the possibility of Kv1.3 channel blockers in treating chronic airway inflammation in patients with COPD.MethodsT lymphocytes were isolated from peripheral blood of COPD patients and healthy controls. Then the mRNA and protein levels of Kv1.3 were detected in T cells. The effects of Kv1.3 channel inhibitors ShK on T cell proliferation and the production of interleukin 2 were detected.ResultsThe Kv1.3 level of peripheral blood T lymphocytes in patients with COPD was significantly higher than that of healthy controls. ShK significantly inhibited the proliferation and interleukin 2 production ability of T lymphocytes.ConclusionsKv1.3 may play important roles in inflammation in COPD. Selective blocking of Kv1.3 channels may be one of the future treatment for COPD.
Weightlessness in the space environment affects astronauts’ learning memory and cognitive function. Repetitive transcranial magnetic stimulation has been shown to be effective in improving cognitive dysfunction. In this study, we investigated the effects of repetitive transcranial magnetic stimulation on neural excitability and ion channels in simulated weightlessness mice from a neurophysiological perspective. Young C57 mice were divided into control, hindlimb unloading and magnetic stimulation groups. The mice in the hindlimb unloading and magnetic stimulation groups were treated with hindlimb unloading for 14 days to establish a simulated weightlessness model, while the mice in the magnetic stimulation group were subjected to 14 days of repetitive transcranial magnetic stimulation. Using isolated brain slice patch clamp experiments, the relevant indexes of action potential and the kinetic property changes of voltage-gated sodium and potassium channels were detected to analyze the excitability of neurons and their ion channel mechanisms. The results showed that the behavioral cognitive ability and neuronal excitability of the mice decreased significantly with hindlimb unloading. Repetitive transcranial magnetic stimulation could significantly improve the cognitive impairment and neuroelectrophysiological indexes of the hindlimb unloading mice. Repetitive transcranial magnetic stimulation may change the activation, inactivation and reactivation process of sodium and potassium ion channels by promoting sodium ion outflow and inhibiting potassium ion, and affect the dynamic characteristics of ion channels, so as to enhance the excitability of single neurons and improve the cognitive damage and spatial memory ability of hindlimb unloading mice.
The effects on rat’s liver preservation using HX solation with high potassium and low sodium or HXm solution with high sodium and low potassium were studied with isolated perfusion of rat livers (IPRL). Sixty inbred Wistar rats were randomly divided into group HX (preserved with HX solution, n=30) and group HXm (preserved with HXm solution,n=30). The preservation effects of the storage solutions were assessed by measuring the sinunoidal lining cell mortality (SLCM), the Krebs-hense-leit perfusate ketone bidy ratio (PKBR), the hepatic sugar release (SL), and the hepatic tissue water content (HTWC). The results showed that there no significant differences between the two storage solutions after 6 hours preservation. If the preserved time was prolonged to 12 hours or more, the effect of rat’s liver preservation using HX solution were much superior to those using HXmsolutin.