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Objective: To observe the effects of Astragalus Injection (AI) on renal function in patients after cardiac valve replacement with cardiopulmonary bypass (CPB).
Methods: Forty patients scheduled to receive cardiac valve replacement with CPB were randomly assigned to 2 groups equally, the control group and the AI group. Patients in the AI group were administered with AI 40 mL before anesthesia by diluting it in 250 mL 5% glucose solution via intravenous dripping, 20 mL by adding it into the priming solution before CPB and 40 mL once a day diluted as before via intravenous dripping at the foremost 5 successive days after operation. For patients in the control group, equal volume of Ringer's Liquid was given instead of AI. Peripheral blood sample and urine were collected at various time points: before anesthesia (T0), the 1st (T1), 3rd (T3), 5th (T5) and 7th day (T7) after operation, for determining blood levels of urea nitrogen (BUN), creatinine (Cr) and beta2-microglobulin (beta2-MG), as well as urinary levels of beta2-MG, microalbumin (m-Alb) and N-acetyl-D-glucosaminidase (NAG).
Results: As compared with those at T0, in the control group, BUN, Cr at T1 and T3, serum beta2-MG at T3, urinary beta2-MG m-Alb and NAG at T1-T7 were significantly higher, while in the AI group, urinary m-Alb, NAG at T1-5 n and urinary beta2-MG at T1-7 were higher (P < 0.05). As compared with those in the control group, serum BUN at T1-3., Cr and blood beta2-MG at T3, urinary beta2-MG, m-Alb and NAG at T1-7 were lower (P < 0.05) in the AI group.
Conclusion: CPB could induce renal failure, and applying AI at the perioperative stage can protect renal function to some certain extent.
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Interv Neuroradiol
September 2025
Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
IntroductionVenous sinus stenting (VSS) is an effective, less invasive alternative to ventriculoperitoneal shunting (VPS) for idiopathic intracranial hypertension (IIH). While efficacy is comparable, with some evidence favoring VSS for headache control, perioperative costs remain under-characterized due to reliance on reimbursement rates rather than actual expenditures.ObjectiveTo compare the perioperative cost of elective VSS and VPS for IIH, including outpatient workup and follow-up costs, using detailed institutional cost data.
View Article and Find Full Text PDFClin Orthop Relat Res
September 2025
Leni & Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Background: Peripheral nerve injury commonly results in pain and long-term disability for patients. Recovery after in-continuity stretch or crush injury remains inherently unpredictable. However, surgical intervention yields the most favorable outcomes when performed shortly after injury.
View Article and Find Full Text PDFJ Alzheimers Dis
September 2025
Paula Costa-Urrutia Medical Affairs, Terumo BCT, Edificio Think MVD, Montevideo, Uruguay.
BackgroundTherapeutic plasma exchange (TPE) with albumin replacement has emerged as a potential treatment for Alzheimer's disease (AD). The AMBAR trial showed that TPE could slow cognitive and functional decline, along with changes in core and inflammatory biomarkers in cerebrospinal fluid.ObjectiveTo evaluate the safety and effectiveness of TPE in a real-world setting in Argentina.
View Article and Find Full Text PDFJAMA Surg
September 2025
Department of Surgery, Meander Medical Center, Amersfoort, the Netherlands.
Importance: Stoma reversal is associated with few complications. However, recent studies show that 1 in 3 patients develop an incisional hernia, for which half of the patients receive surgical correction.
Objective: To investigate whether prophylactic synthetic mesh placement in the retromuscular space during stoma reversal reduces the rate of stomal site incisional hernias.
JAMA
September 2025
Division of Surgery and Interventional Science, UCL, London, United Kingdom.
Importance: Multiparametric magnetic resonance imaging (MRI), with or without prostate biopsy, has become the standard of care for diagnosing clinically significant prostate cancer. Resource capacity limits widespread adoption. Biparametric MRI, which omits the gadolinium contrast sequence, is a shorter and cheaper alternative offering time-saving capacity gains for health systems globally.
View Article and Find Full Text PDF