Objective: To investigate the efficacy of the intraoperative posterior pericardial window technique in preventing pericardial tamponade following open heart surgery. Patients and methods: Adult patients undergoing coronary and/or valve surgery were randomly divided into a control (traditional) or a pericardial window (PW) technique group. Pre-, intra-, peri-and postoperative clinical data were collected prospectively, including incidence of pericardial tamponade, cardiac arrest, drainage volume, ventilation assistance time and moderateto-large pericardial effusion. Results: In total, 458 patients were included: 230 controls and 228 in the PW group. The incidence of pericardial tamponade in the PW group was significantly lower than in controls. Cardiac arrest occurred in one patient (0.4%) in the PW group and five (2.2%) controls; this difference was not statistically significant. Moderate-to-large pericardial effusion after drainage extubation and newonset atrial fibrillation were significantly more common in controls than in the PW group. After stratification by age ( 70 versus >70 years), there was no between-group difference in duration of endotracheal intubation, although in the PW group, after removal of the tracheal cannula, duration of noninvasive positive pressure ventilation was significantly longer in older patients. Conclusions: The pericardial window procedure did not increase the rate or severity of procedure-related complications. This simple technique significantly decreased the incidence of postoperative pericardial tamponade and new-onset atrial fibrillation.
Gastric cancer (GC) is often a deadly disease due to the late diagnosis and chemoresistance that characterizes many cases of this disease. The aim of this study was to explore a panel of candidate cytokines as diagnostic and predictive biomarkers for GC. Sixteen tissue samples of GC and adjacent noncancerous mucosa were selected from GC patients (n=8) for antibody microarray analysis. Proteomic chip-based analysis was performed to simultaneously identify 507 cytokines using a cytokine antibody array in the gastric tissues to screen for differential proteins related in cases of GC. Fold changes of protein expression >2.0 or <0.5 were considered significant. The proteins that showed significant differences in levels between the cancerous and non-cancerous samples were analyzed using bioinformatics analysis. One hundred and five cytokines that were significantly different (p<0.05) between GC tissues and normal gastric mucosa were identified. Gene Ontology (GO) enrichment analysis showed that these differentially expressed proteins are involved in many biological and immunological processes, mainly in response to stress, chloroplast thylakoid membrane, vacuole, photosynthesis, aspartic-type endopeptidase activity and flavin adenine dinucleotide binding. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis indicated that these proteins mainly were involved in the process of cytokine-cytokine receptor interaction, transforming growth factor-β (TGF-β) signaling pathway, pathways in cancer, tumor necrosis factor (TNF) signaling pathway, and mitogen-activated protein kinase (MAPK) signaling pathway. These findings suggest that the differentially expressed proteins could be associated with GC in patients. Further study of these cytokines may provide a promising approach for diagnosis, classification and prognosis of GC.
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