黄志勇
中国医学科学院阜外医院深圳医院 麻醉科
Perioperative coagulopathy and bleeding are common complications in cardiovascular surgery with cardiopulmonary bypass and result in an increased rate of allogeneic blood transfusion. Both bleeding and transfusion can increase postoperative mortality and morbidity. Patient blood management can significantly reduce allogeneic blood transfusions, improve clinical outcomes, and conserve blood resources; however, measures to protect platelets from destruction by cardiopulmonary bypass still are lacking. As an unusual method of autologous blood transfusion, autologous platelet-rich plasmapheresis can effectively protect platelets from damage and has been used successfully in cardiovascular surgery. This narrative review aims to address some major clinical applications and debates of using autologous platelet-rich plasmapheresis in cardiovascular surgery. In addition, this review summarizes the application of autologous platelet gel, a product developed from autologous platelet-rich plasma, in cardiac surgery.
Journal of cardiothoracic and vascular anesthesia 2020
BACKGROUND:TGF-β1 contributes to chronic heart failure. It is known that lncRNA GASL1 can inactivate TGF-β1 in cancer biology.METHODS:All the participants were enrolled in the First People's Hospital of Zhaoqing during the period June 2012 to June 2013. ELISA, RT-qPCR, vectors, transient transfections and western blot were carried out during the research.RESULTS:We found that plasma levels of TGF-β1 were significantly higher, while levels of GASL1 in plasma were significantly lower in chronic heart failure (CHF) patients compared to the control group. TGF-β1 and GASL1 were inversely correlated in CHF patients. Low pretreatment plasma levels of GASL1 were closely associated with poor survival of CHF patients. GASL1 expression was not significantly affected by TGF-β1 overexpression in cardiomyocytes, while cardiomyocytes with GASL1 overexpression showed downregulated TGF-β1. Overexpression of GASL1 led to a decreased, while TGF-β1 overexpression led to an increased apoptotic rate of cardiomyocytes under H2O2 treatment. In addition, TGF-β1 overexpression attenuated the effect of GASL1 overexpression.CONCLUSION:In conclusion, GASL1 was downregulated in CHF. GASL1 overexpression may improve CHF by inhibiting cardiomyocyte apoptosis through the inactivation of TGF-β1.
Cellular & molecular biology letters 2019
