Hydrogen sulfide is produced endogenously by a variety of enzymes involved in cysteine metabolism. Clinical data indicate that endogenous levels of hydrogen sulfide are diminished in various forms of cardiovascular diseases. The aim of the current study was to investigate the effects of hydrogen sulfide supplementation on cardiac function during reperfusion in a clinically relevant experimental model of cardiopulmonary bypass. Twelve anesthetized dogs underwent hypothermic cardiopulmonary bypass. After 60 minutes of hypothermic cardiac arrest, reperfusion was started after application of either saline vehicle (control, n = 6), or the sodium sulfide infusion (1 mg/kg/hour, n = 6). Biventricular hemodynamic variables were measured by combined pressure-volume-conductance catheters. Coronary and pulmonary blood flow, vasodilator responses to acetylcholine and sodiumnitroprusside and pulmonary function were also determined. Administration of sodium sulfide led to a significantly better recovery of left and right ventricular systolic function (P < 0.05) after 60 minutes of reperfusion. Coronary blood flow was also significantly higher in the sodium sulfide-treated group (P < 0.05). Sodium sulfide treatment improved coronary blood flow, and preserved the acetylcholine-induced increases in coronary and pulmonary blood (P < 0.05). Myocardial ATP levels were markedly improved in the sulfide-treated group. Thus, supplementation of sulfide improves the recovery of myocardial and endothelial function and energetic status after hypothermic cardiac arrest during cardiopulmonary bypass. These beneficial effects occurred without any detectable adverse hemodynamic or cardiovascular effects of sulfide at the dose used in the current study. The aim of the current study was to test potential cytoprotective and anti-inflammatory effects of the novel biological mediator hydrogen sulfide in murine models. Murine J774 macrophages were grown in culture and exposed to cytotoxic concentrations of nitrosoglutathione, or peroxynitrite (a reactive species formed from the reaction of nitric oxide and superoxide). Pretreatment of the cells with sodium sulfide (60-300 µM) reduced the loss of cell viability elicited by the nitric oxide donor compound (3 mM) or by peroxynitrite (3 mM), as measured by the MTT method. Sodium sulfide did not affect cell viability in the concentration range tested. In mice subjected to bacterial lipopolysaccharide (LPS, 5 mg/kg i.p.), treatment of the animals with sodium sulfide (0.2 mg/kg/hour for 4 hours, administered in Alzet minipumps) reduced the LPSinduced increase in plasma IL-1β and TNFα levels. These responses were attenuated when animals were pretreated with the heme oxygenase inhibitor tin-protoporphyrin IX (6 mg/kg). The current results point to the cytoprotective and anti-inflammatory effects of hydrogen sulfide, in cells exposed to nitrosative stress, and in animals subjected to endotoxemia. Introduction It has been previously shown that the two forms of acute cholecystitis, acute acalculous cholecystiti...
BackgroundChina doesn't have efficient primary medical care and referral system. Patients can choose any hospitals or any doctors they like to seek medical care. As a result, most patients with rheumatic diseases rushed to a few large cities. Survey shows that more than 40% of the rheumatic disease patients are unnecessary to go to hospital and they only need advices from specialist. Smart System of Disease Management (SSDM) is a series of applications for chronic diseases management, which develop the interaction between doctors and patients. Our previous study showed that rheumatoid arthritis (RA) patients can master the SSDM and perform self-management after training, including disease activity score with 28 joints (DAS28) and health assessment questionnaire (HAQ) evaluations, as well as medication and lab test data entries.ObjectivesTo evaluate the feasibility and benefit of the medical economics of online consultation based on SSDM by rheumatologist.MethodsThe rheumatologists implemented the education and training programs on patients in using SSDM and assist the patients in downloading SSDM mobile application. The SSDM includes doctors' and patients' applications. After data entry, patients can synchronize data to their authorized doctor. On the basis of these data, the rheumatologists can accept the request from their follow-up patients through SSDM and practice consultation in the form of text or telephone call.ResultsFrom February 2015 to January 2017, 333 rheumatologists supplied 3,119 patients (RA 46%, systemic lupus erythematosus 22%, ankylosing spondylitis 12%, Gout 11%, osteoarthritis 4%, other rheumatic diseases 5%) with 136 times free and 3,556 paid consultations. Paid consulting included 3,537 times text Q&A and 19 telephone consultations. The consulting fee ranged from RMB 10 to 500 yuan (EUR: RMB =1: 7.33) each in average of 121.3±55.19 yuan, which rate match the registration fee in hospital. The total collection of fee for consultations was 399,320 yuan RMB. 35.9% patients receiving online consultation lived in different city with the rheumatologists. If patients seek medical in hospital, in addition to the registration fees and medical expenses, the mean cost of transportation, accommodation, meals and lost wages was 552.68±477.51 (200 - 2,800) yuan. The total of cost for all patients would have been 2, 509,920 yuan RMB, which is 6.29 times compare with the cost of online. Through the SSDM system for online consultations, patients can save 84.09% of the cost. Survey shows all patients were satisfied and 60.28% of them were “very satisfied” with the consultations.ConclusionsUsing SSDM system to obtain online consultation, Chinese patients with rheumatic disease can enjoy reduced cost with high satisfaction. In the era lack of primary care system in China, SSDM may serve a complimentary platform to control medical care cost, as well as relieve the tensions between health care professionals and patients.Disclosure of InterestNone declared
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