ObjectiveTo study the effect of endothelin receptor antagonist on recent outcome of patients undergoing Fontan surgery. MethodsThirty nine patients who received Fontan procedure from January 2009 to December 2010 in Wuhan Asia Heart Hospital were recruited in the study. There were 25 males and 14 females with mean age of 8.02±4.98 years (ranged from 2.5 to 18.0 years). According to the admission number, the patients were randomly divided into an endothelin receptor antagonists group (bosentan group, n=16) and a control group (n=23). The bosentan group received bosentan treatment by gastric fill or oral according to the recommended dose in three days after surgery for over 7 days. The control group did not receive any pulmonary hypertension targeted therapy. On the 10th day after surgery, indexes including mortality etc in the two groups were compared. ResultsNo death occurred in the bosentan group. One patient died on the 5th day after operation in the control group. There was no significant difference in the postoperative mortality. The patients in the bosentan group got significantly better results than the control group in cardiac function, incidence of pleural effusion, vasoactive drugs score, and serum B-type natriuretic peptide, albumin, alanine aminotransferase on the 10th day (P < 0.05); while the 6-minute walk distance, transcutaneous oxygen saturation, white blood cell count, C-reactive protein, cardiac troponin I, and creatinine of the two groups showed no statistical difference (P > 0.05). ConclusionEndothelin receptor antagonists can improve the short-term outcome of patients after Fontan surgery.
【Abstract】 Objective To investigate the effects of respiratory syncytial virus ( RSV) infection on the dynamic changes of airway hyperresponsiveness ( AHR) in ovalbumin ( OVA) -induced asthma in mice.Methods 60 BALB/c female mice were randomly divided into PBS control group ( A group, n = 6) , OVA group, OVA/RSV group, dexamethasone group ( D group, n =6) . Kinetics of AHR of OVA group mice was carried out on day 21, 25, 29 and 33 ( B1, B2, B3, B4 groups, n =6) , and the same with the OVA /RSV group( C1, C2, C3, C4 groups, n = 6 ) . The mouse asthma model was established by OVA-sensitization of intraperitoneal injection and repeated inhalation of OVA while the mice in OVA/RSV group were treated with combined intranasal inoculation with RSV ( 1. 0 ×106 pfu/mL in 50 μL) . Airway resistance of expiringphase ( RL ) and compliance of throax and lung ( CTL ) with different doses of acetylcholine ( Ach) were measured. Lung tissue sections were stained with hematoxylin and eosin ( HE) and periodic acid-Schiff ( PAS) for general morphology. Results Compared with B1 group, RL increased and CTL decreased in C1 group when Ach dose is above 5 g/L ( P lt; 0. 05, respectively) , and the effects prolonged ( 6 d, 10 d after challenge with OVA, respectively) much more than B1 group ( 2 d after challenge with OVA) . Compared with C1 group, RL decreased and CTL increased in D group and the infiltration of inflammatory cells was obviously alleviated in C1 group after treatment with dexamethasone. Conclusions Airway hyperresponsiveness increases obviously in OVA-sensitized and RSV-infected mice. The prolonged increase inRL and decrease in CTL ( 6 d, 10 d, respectively) may imply that RSV infection aggravates airway inflammation. The small airway inflammation may play a critical role in the persistence of airway hyperresponsiveness.