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Considering the surgical risk stratification for patients with severe calcific aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) is a reliable alternative to surgical aortic valve replacement (SAVR) (Fan et al., 2020, 2021; Lee et al., 2021). Despite the favorable clinical benefits of TAVR, stroke remains a dreaded perioperative complication (Auffret et al., 2016; Kapadia et al., 2016; Kleiman et al., 2016; Huded et al., 2019). Ischemic overt stroke, identified in 1.4% to 4.3% of patients in TAVR clinical practice, has been associated with prolonged disability and increased mortality (Auffret et al., 2016; Kapadia et al., 2016; Levi et al., 2022). The prevalence of hyperintensity cerebral ischemic lesions detected by diffusion-weighted magnetic resonance imaging (DW-MRI) was reported to be about 80%, which is associated with impaired neurocognitive function and vascular dementia (Vermeer et al., 2003; Barber et al., 2008; Kahlert et al., 2010).
Subject(s)
Humans , Transcatheter Aortic Valve Replacement , Aortic Valve Insufficiency , Diffusion Magnetic Resonance Imaging , Aortic Valve Stenosis , StrokeABSTRACT
Objective:To evaluate the effectiveness and prognosis of emergent transcatheter aortic valve replacement (TAVR) and to provide standardized procedural suggestion for the development of emergent TAVR in China.Methods:From January 2020 to April 2021, 12 patients who underwent emergent or salvage TAVR in the Second Affiliated Hospital Zhejiang University School of Medicine were retrospectively enrolled from the TORCH registry (Transcatheter Aortic Valve Replacement Single Center Registry in Chinese Population, a prospective cohort study; NCT02803294). Baseline, periprocedural and 30-day follow up data were collected. Post-operative data were compared with pre-operative data using Paired-Samples test.Results:Patients’ median Society of Thoracic Surgeons score (STS score) was 15.432%. There was a significant decrease of mean gradient after emergent TAVR procedure (1.69 m/s vs. 4.90 m/s, P<0.01). During the 30-day follow up, there were 1 patient (8.3%) died and 2 patients received permanent pacemaker implantation. No disabling stroke, acute kidney injury, major vascular complication occurred during the first month after emergent TAVR. Among the survival patients, there was a significant releasing of heart failure symptoms to New York Heart Association function stage Ⅰ/Ⅱ in 81.8% patients at 30-day follow up. Left ventricular ejection fraction also improved significantly from (47.4±9.5)% to 58.8±8.0% ( P= 0.026). The mean gradient were (1.57±0.30) cm 2 and no patients had a moderate or severe paravalvular leakage. Besides, a significant decrease of pro-B-type natriuretic peptide (1 089.9 pg/mL vs. 12 215.5 pg/mL , P=0.001) and troponin T (0.020 ng/mL vs. 0.337 ng/mL, P=0.003) were found at 30 days after emergent TAVR. Conclusions:For patients with severe aortic stenosis and acute cardiac decompensated, emergent TAVR is a safe and effective rescue treatment.
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This article summarized the clinical experience of Professor WANG Meng-yong in treating lupus nephritis from the symptoms and essence. Professor WANG Meng-yong believes that treatment for lupus nephritis should attach importance to clinical features of setting deficiency of liver, spleen and kidney as the essence and toxin and blood stasisas symptoms, in which the essence is deficient and the symptoms are excess and combination of external and internal pathogenesis. He flexibly uses methods of nourishing liver and kidney, tonifying spleen, and stomach, clearing heat and cooling blood, activating blood and promoting diuresis to alleviate water retention, which have obvious efficacy, effectively avoid adverse reactions and reduce the risk of recurrence, and improve patient prognosis.
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Objective To explore the effect of silencing metastasis-associated in colon cancer 1 ( MACC1 ) gene on proliferation and invasion of cervical cancer Hela cells. Methods siRNA MACC1 and siRNA NC were transfected into cervical cancer Hela cells with liposomes. The expression of MACC1 protein and mRNA was detected by western blot and RT-PCR. Cell viability and invasion ability were measured by MTT and transwell assay, respectively. The expression of cyclin D1, cyclin E matrix metalloproteinase 2 (MMP2), MMP9 and the level of extracellular regulated protein kinases ( ERK) phosphorylation was detected by western blot. Results Compared with siRNA NC, the expression of MACC1 protein and mRNA was down-regulated, cell viability and invasion ability were reduced ( P < 0. 01 ) , cell cycle was arrested at G1 phase (P < 0. 01), the expression of cyclin D1, cyclin E, MMP2, MMP9 and p-ERK1/2 was down-regulated (P< 0. 01). Conclusions siRNA MACC1 can inhibit proliferation and invasion of cervical cancer Hela cells, which migiht be related to down-regulation of p-ERK.
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Objective:To observe the curative effect of different surgical arthroscopy on treatment for the discoid meniscus injury in knee joint.Methods: The clinical data of 78 patients with discoid meniscus injury who received treatment of arthroscopic minimally invasive surgical were retrospectively studied. 42 patients were complete discoid meniscus injury, and 36 patients were incomplete discoid meniscus injury in the 78 cases. The 42 patients with discoid meniscus injury of complete type were divided into observation 1 group (22 cases) and observation 2 group (20 cases), and the 36 patients with discoid meniscus injury of incomplete type were divided into control 1 group (19 cases) and control 2 group(17 cases). The patients of observation 1 group and control 1 group were treated with complete resection operation, and the patients of observation 2 group and control 2 group were treated with partial resection arthroplasty. The knee physiological function of all patients before and after treatment were assessed by using Lysholm knee function score and the subjective assessment table of International Knee Joint Documentation Committee (IKDC) for knee, and the curative effects of each group was compared.Results: After treatment, the Lysholm and IKDC scores of 4 groups significantly increased than that of before treatment(P<0.05), and the Lysholm and IKDC scores of observation 1 group was significantly higher than that of observation 2 group (t=9.193,t=9.065,P<0.05). But there was no statistically significant difference between the control 1 group and control 2 group about Lysholm and IKDC scores (t=0.874, t=0.891,P>0.05). The excellent rate of the observation 2 group was significantly lower than that of observation 1 group(x2=5.292,P<0.05), while the difference of the excellent rate between the control 1 group and the control 2 group was no statistically significant (x2=0.734,P>0.05).Conclusion: All of patients with discoid meniscus injury of knee joint receives different surgical treatment under arthroscopy can obtain good effect, but the curative effect of patients with discoid meniscus injury of complete type who receives completely excision is significantly better than that of who receives partial resection arthroplasty.
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Objective To explore the effect of silencing metastasis-associated in colon cancer 1 ( MACC1 ) gene on proliferation and invasion of cervical cancer Hela cells. Methods siRNA MACC1 and siRNA NC were transfected into cervical cancer Hela cells with liposomes. The expression of MACC1 protein and mRNA was detected by western blot and RT-PCR. Cell viability and invasion ability were measured by MTT and transwell assay, respectively. The expression of cyclin D1, cyclin E matrix metalloproteinase 2 (MMP2), MMP9 and the level of extracellular regulated protein kinases ( ERK) phosphorylation was detected by western blot. Results Compared with siRNA NC, the expression of MACC1 protein and mRNA was down-regulated, cell viability and invasion ability were reduced ( P < 0. 01 ) , cell cycle was arrested at G1 phase (P < 0. 01), the expression of cyclin D1, cyclin E, MMP2, MMP9 and p-ERK1/2 was down-regulated (P< 0. 01). Conclusions siRNA MACC1 can inhibit proliferation and invasion of cervical cancer Hela cells, which migiht be related to down-regulation of p-ERK.
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Objective:To observe the curative effect of different surgical arthroscopy on treatment for the discoid meniscus injury in knee joint.Methods: The clinical data of 78 patients with discoid meniscus injury who received treatment of arthroscopic minimally invasive surgical were retrospectively studied. 42 patients were complete discoid meniscus injury, and 36 patients were incomplete discoid meniscus injury in the 78 cases. The 42 patients with discoid meniscus injury of complete type were divided into observation 1 group (22 cases) and observation 2 group (20 cases), and the 36 patients with discoid meniscus injury of incomplete type were divided into control 1 group (19 cases) and control 2 group(17 cases). The patients of observation 1 group and control 1 group were treated with complete resection operation, and the patients of observation 2 group and control 2 group were treated with partial resection arthroplasty. The knee physiological function of all patients before and after treatment were assessed by using Lysholm knee function score and the subjective assessment table of International Knee Joint Documentation Committee (IKDC) for knee, and the curative effects of each group was compared.Results: After treatment, the Lysholm and IKDC scores of 4 groups significantly increased than that of before treatment(P<0.05), and the Lysholm and IKDC scores of observation 1 group was significantly higher than that of observation 2 group (t=9.193,t=9.065,P<0.05). But there was no statistically significant difference between the control 1 group and control 2 group about Lysholm and IKDC scores (t=0.874, t=0.891,P>0.05). The excellent rate of the observation 2 group was significantly lower than that of observation 1 group(x2=5.292,P<0.05), while the difference of the excellent rate between the control 1 group and the control 2 group was no statistically significant (x2=0.734,P>0.05).Conclusion: All of patients with discoid meniscus injury of knee joint receives different surgical treatment under arthroscopy can obtain good effect, but the curative effect of patients with discoid meniscus injury of complete type who receives completely excision is significantly better than that of who receives partial resection arthroplasty.
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<p><b>OBJECTIVE</b>To study the effects of Shibao Powder on the expression of b-FGF and TGF-beta 1 in granulation tissues of rabbit models with soft tissue injuries, so as to explore mechanism of external Chinese drugs for repairing of soft tissues in molecular levels.</p><p><b>METHODS</b>The rabbit models were established by classical method of full-thickness skin wounds. After 8% sodium sulfide was used and routine disinfection completed, intra-peritoneal anaesthesia was adopted. The skin was cut to expose gastrocnemius muscle, and imcomplete sharp dissection was made near the tendon insertion. The length of the incision was 0.8 cm and the width was 0.4 cm. The rabbits in the experimental group were treated with spread of Shibao Powder at the wound; the rabbits in clean group were treated with routine dressing changes and disinfection; and the rabbits in the control group were treated with dressing changes only. The granulation tissues in different stages were collected and observed with high power microscope. The expression of Transforming Growth Factor-beta 1 (TGF-beta 1) protein and b-FGF protein in wound tissues were detected using StreptA-ridin-Biotin-Complex (SABC) method.</p><p><b>RESULTS</b>The results showed that the expression of b-FGF protein had significant differences among 3 groups at the 6th day after trauma (P<0.05). The TGF-beta 1 protein expression also had significant differences among 3 groups at the 10th and 14th days after trauma (P<0.05). At the same time, the growth states of granulation tissues had difference among 3 groups at the same trauma stage, and within the same group among different trauma stages.</p><p><b>CONCLUSION</b>This experimental study shows that Shibao Powder is effective to promote the repair of soft tissues after trauma by stimulating production of endogenous growth factor from cells in wound.</p>