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@#Objective To study the diagnosis and treatment of aortopulmonary window (APW) associated with severe pulmonary hypertension. Methods The clinical data of 23 patients with APW undergoing surgical treatment in The First Affiliated Hospital of Air Force Medical University from 2010 to 2018 were retrospectively reviewed. There were 9 male and 14 female patients. The age was 3-132 (4.63±2.14) months. The weight was 3.3-35.0 (17.3±3.6) kg. Results Windows were situated in the proximal of semilunar valve (type Ⅰ) in 8 patients, and distal of the aorta (type Ⅱ) in 14 patients, from proximal to distal (type Ⅲ) in only 1 patient. Eleven patients were isolated APW, the others were combined with cardiac defects. The mean pulmonary artery pressure was 68.4±7.5 mm Hg. All patients underwent surgical correction under general anesthesia and hypothermia cardiopulmonary bypass. All patients were discharged uneventfully, with an average follow-up time of 4 years. The patients showed good outcomes and no residual shunt after surgery, and the pulmonary artery pressure decreased to normal. Conclusion APW is an uncommon congenital cardiac anomaly. The clinical presentation is an excessive left-to-right shunt, and most patients present early in life. Development of pulmonary hypertension and pulmonary vascular resistance is usually rapid. Operative treatment is indicated as soon as the diagnosis is established, regardless of the patient’s age, and most patients after surgery have a good long-term outcome.
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This research was carried out to investigate the effect of basic fibrous growth factor (bFGF) controlled release hydrogel nanoparticles on the proliferation and differentiation of mesenchymal stem cells. The dex-GMA-bFGF-NPs were prepared by an improved emulsion polymerization method; their morphology, size and encapsulated ratio were assessed by routine procedure. Dynamic dialysis method was used to determine the release characteristics of dex-GMA-bFGF-NPs in vitro. The secondary culture MSCs were divided into four groups according the different ingredients being added into the DMEM culture medium: free bFGF group (A), blank dex-GMA nanoparticles group (B), dex-GMA-bFGF nanoparticles group (C), nothing group (D). The proliferation of cultured MSCs was measured by using cell counting method, MTT method and flow cytometry. ALP kit was used to evaluate the ALP activity of the MSCs to show the differentiation of the cells by adding the dex-GMA-bFGF-NPs to the DMEM culture medium (C group) or bFGF only (A group). B group and D group were taken as the controls. The results were analyzed by statistical analysis software (SPSS11.0). All results showed that the shape of dex-GMA-bFGF-NPs was spherical. The encapsulated ratio was 88% and more than 85% of the encapsulated bFGF could be released during 14 days. The in vitro cellular study showed the control release of bFGF from nanoparticles could promote the proliferation of MSCs. After 12 days, the cell number in groups A, B and C was (21.97 +/- 0.25) x 10(4) cells/ml, (12.43 +/- 0.13) x 10(4) cells/ml, (27.45 +/- 0.78) x 10(4) cells/ml and (12.03 +/- 0.43) x 10(4) cells/ml, with the difference being statistically significant among them (P < 0.05). The flow cytometry revealed that the G2/M+S percentage in group C was the highest at 4-8 days after plate culture(P < 0.05). During the first 3 days, the proliferation and differentiation of BMSCs between group A and group B were of no significance (P > 0.05), but were much faster than those of group C and D. After 7 days, dex-GMA-bFGF-NPs could enhance BMSCs proliferation and differentiation continually, but bFGF had no enhancement any more, the difference between group A and group B became more significant (P < 0.05). So we made the conclusions the bFGF loading dex-GMA hydrogel nanoparticles can release bFGF more than 21 days and can promote the proliferation and differentiation of the BMSCs through a long period of controlled release of bFGF. Dex-GMA-bFGF-NPs may be an ideal controlled release carrier for bioactive growth factors.
Subject(s)
Animals , Female , Male , Rats , Bone Marrow Cells , Cell Biology , Cell Differentiation , Cell Proliferation , Cells, Cultured , Culture Media , Fibroblast Growth Factor 2 , Pharmacology , Mesenchymal Stem Cells , Cell Biology , Nanoparticles , Rats, Sprague-DawleyABSTRACT
Objective To investigate the immunomodulatory effect of mesenchymal stem cells (MSCs) and their role in prolonging allograft survival in rat heart transplantation. Methods Inbred Wistar rats were used as donors, and Fisher 344 as recipients. MSC were isolated from femur and tibia bone marrow of donors and cultured in vitro. Mixed lymphocyte reaction assays were performed to assess the immunosuppressive effects of different concentrations of MSC on allogeneic T cell proliferation. Cardiac allograft model was established and according to different intervention measures recipients were divided into two groups (MSC treatment group and control group) (n=8 in each group). In MSC treatment group, recipients were infused with 2×106 MSC via the tail vein at designated intervals (one week before operation, during operation and consecutive three days postoperation), while in control group, the recipients were treated with Ringer's solution at the same interval& At day 5 posttransplantation real-time PCR was used to detect the changes in the expression of Thl and Th2 cytokine genes in transplanted hearts. Results In vitro allogeneic T cell response was greatly suppressed by MSC in a dose-dependent manner. Real-time PCR revealed that IL-1β,IFN-γ, IL-4 and IL-10 were expressed in MSC treatment group, while IL-4 and IL-10 were not expressed in control group but with significantly higher expression of IL-1β and IFN-γ. As compared with control group, survival of MSC-treated allografts was markedly prolonged as compared with control group (mean survivaldays: 12.4±5.3 vs 6.4±2.0, P＜0.05). Conclusion Intravenous adrninistmtion of MSC can prolong the survival of transplanted heart possibly by induction of allograft tolerance through changing Th1/Th2 balance.
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Objective To remove cellular compenents from porcine aortic valve with different reagents, providing acellular tissue matrix(ACTM) scaffolds for tissue engineering of heart valve. Methods Different detergents (TritonX-100、Sodium dodecyl sulfate and sodium deoxycholate) and enzyme (trypsin) were used to remove cells and its, compenents from porcine aortic valves, respectively. According to the different detergents, specimens of porcine aortic valve were divided into three groups(Sodium dodecyl sulfate, sodium deoxycholate, and Triton X-100). Specimens were observed grossly uncroscopically. Haematoxylin-eosin and DNA assay was performed to confirm the removal of cells. Transmission electron microscope was used to observe the integrity of collagen and elastin. The changes of mechanical properties were also studied. Results The cells were removed effectively from cusps and roots of porcine aortic valves by Triton X-100 and sodium dodecyl sulfate in 96 h. Sodium deoxycholate could not effectively remove the cells from the root of aortic valve. Treatment with SDS disrupted collagen fiber structure of porcine aortic valve, resulting in poor mechanical properties. Treatment with TritonX-100 result in an acellular porcine aortic valve matrix with retention of near normal structure and mechanical properties. Conclusion Porcine aortic valve can be successfully decellularised with retention of near normal structure and mechanical properties by Triton X-100.
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Objective To observe the clinical effects of endoscopic great saphenous vein harvesting(ESVH) in coronary artery bypass grafting. Methods Endoscopic great saphenous vein harvesting was performed in 89 patients undergoing coronary artery bypass grafting(CABG) from April 2004 to May 2005.An incision 2 cm in length was made on the knee joint and the great saphenous vein was harvested using the VasoView-5 system.Clinical data of the 89 patients(Endoscopic Group) were compared with another 38 patients undergoing conventional great saphenous vein harvesting for CABG from April 2003 to March 2005(Conventional Group) in respect of complications of the leg, the recovery time to walking,and the patency rate at 6 postoperative months.Results The number of harvested vein grafts in the Endoscopic Group was 2~3(mean,2.6).Complications of the leg were significantly less in the Endoscopic Group(6/89) than in the Conventional Group(8/38)(?~2=4.197,P=0.040).The occurrence of pain and numbness of the leg was 7/89 in the Endoscopic Group and 36/38 in the Conventional Group(?~2=89.740,P=0.000).The occurrence of swelling of the leg was 9/89 in the Endoscopic Group and 30/38 in the Conventional Group(?~2=59.299,P=0.000).The recovery time to walking was significantly shorter in the Endoscopic Group(2.3?0.9 d) than in the Conventional Group(3.4?1.6 d)(t=-4.952,P=0.000).There was no significant difference in the patency rate at 6 postoperative months between the Endoscopic Group(96.0%,48/50) and the Conventional Group(95.3%,19/20)(?~2=0.000,P=1.000).Conclusions Use of endoscopic vein harvesting in coronary artery bypass grafting decreases the incidence of postoperative leg-wound infections,post-operative pain,and length of hospital stay.