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Objective:To evaluate the safety and efficacy of ultrasound guidance for percutaneous balloon pulmonary valvuloplasty (PBPV) in comparison with conventional X-ray guidance.Methods:Our research included in 2 groups:Ultrasound group,n=102 patients with PBPV under ultrasound guidance in our hospital from 2013-03 to 2016-08 and X-ray group,n=280 patients with PBPV under traditional X-ray guidance in our hospital at the same period of time.Post-operative effect was evaluated by echocardiography and compared between 2 groups.Results:The patients' age,body weight,pulmonary artery diameter,immediate post-operative pulmonary transvalvular pressure gradient (PTPG),the in-hospital time and cost were similar between 2 groups,P＞0.05.The success rate of operation in Ultrasound group and X-ray group was 99.0％ vs 100％,P=0.267.In the ultrasound group,1 patient was converted to a conventional surgery due to right ventricular outflow tract muscle spasm after dilation.The operation time in X-ray group was longer than Ultrasound group,(38.9±9.2) min vs (34.6±10.0) min,P＜0.001.The X-ray exposure time was (3.9±1.2) min in X-ray group.The mean follow-up time was (25.5±13.2) months and PTPG in Ultrasound group and X-ray group were (16.2±4.3) mmHg and (15.3±4.5) mmHg,P=0.120.No serious complications as death,peripheral vascular injury,cardiac perforation and pericardial effusion occurred in either group.Conclusion:PBPV under complete ultrasound guidance may not only avoid radiation and contrast agent,but also keep the safety and efficacy of minimally invasive conventional percutaneous interventional treatment.
ABSTRACT
Objective:To evaluate the safety and efficacy of ultrasound guidance for percutaneous balloon pulmonary valvuloplasty (PBPV) in comparison with conventional X-ray guidance.Methods:Our research included in 2 groups:Ultrasound group,n=102 patients with PBPV under ultrasound guidance in our hospital from 2013-03 to 2016-08 and X-ray group,n=280 patients with PBPV under traditional X-ray guidance in our hospital at the same period of time.Post-operative effect was evaluated by echocardiography and compared between 2 groups.Results:The patients' age,body weight,pulmonary artery diameter,immediate post-operative pulmonary transvalvular pressure gradient (PTPG),the in-hospital time and cost were similar between 2 groups,P＞0.05.The success rate of operation in Ultrasound group and X-ray group was 99.0％ vs 100％,P=0.267.In the ultrasound group,1 patient was converted to a conventional surgery due to right ventricular outflow tract muscle spasm after dilation.The operation time in X-ray group was longer than Ultrasound group,(38.9±9.2) min vs (34.6±10.0) min,P＜0.001.The X-ray exposure time was (3.9±1.2) min in X-ray group.The mean follow-up time was (25.5±13.2) months and PTPG in Ultrasound group and X-ray group were (16.2±4.3) mmHg and (15.3±4.5) mmHg,P=0.120.No serious complications as death,peripheral vascular injury,cardiac perforation and pericardial effusion occurred in either group.Conclusion:PBPV under complete ultrasound guidance may not only avoid radiation and contrast agent,but also keep the safety and efficacy of minimally invasive conventional percutaneous interventional treatment.
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BACKGROUND:Osteoporosis is a bone metabolic disease that affects women more than men. Prevention and treatment of osteoporosis is becoming a serious medical problem because of the aging of the population. OBJECTIVE:To explore the effects of lithium chloride treatment on bone microarchitecture and bone marrow stromal cel differentiation of ovariectomized osteoporosis rats. METHODS:After ovariectomy, 28 of 30 healthy female Sprague-Dawley rats, 3 months old, were randomly divided into the folowing three groups: ovariectomizedin vivo group (9 rats), ovariectomizedin vitro group (10 rats), and lithium chloride group (9 rats). At the 11th week postoperatively, rats in the lithium chloride were intragastricaly injected with lithium chloride at a dose of 15 mg/kg, three times per week. After 8 weeks of treatment, the bone microarchitectures of the rat left femur in the ovariectomizedin vivo group and lithium chloride group were detected by micro-CT. The bone marrow mesenchymal stem cels were freshly isolated from the bone marrow of the bilateral femurs and tibia of rats in the ovariectomizedin vitro group. After 24 hours of inoculation, the cels were cultured in lithium chloride and divided into 0 mmol/L (control), 1 mmol/L and 5 mmol/L groups. At 6 and 8 days of culture, the medium was changed and lithium chloride with the corresponding concentrations was added. At 10 days of culture, western blot assay was adopted to detect protein expression of Runx-2, SP7 and PPARγ2. RESULTS AND CONCLUSION:(1) Compared with the ovariectomizedin vivo group, the volume density of trabecular bone, number of trabecular bone, and bone volume fraction in the lithium chloride group were significantly increased and the separation of trabecular bone was significantly decreased. However, no differences were seen in the thickness of trabecular bone and structure model index. (2) Lithium chloride at 1 and 5 mmol/L could increase the protein expression of Sp7 and Runx-2 in bone marrow stromal cels, but decrease the protein expression ofPPARγ2. These results indicate that lithium chloride may improve the microarchitecture of the trabeculr bone in ovariectomized osteoporosis rats through stimulating the osteogenic differentiation of bone marrow stromal cels.
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Objective The aim of this study was to observe the effects of whole-body vertical vibration, treadmill exercise, genistein administration and estrogen injection on the uterus weight index and uterus histology as well as the ex-pression of glycogen synthase kinase ( GSK-3β) protein in the uterus of ovariectomized osteoporotic rats.Methods Sev-enty-two healthy 3-month old female SD rats were randomly divided into two groups by body weight:sham-operation group (Sham) and ovariectomized group (OVX).At 10 weeks after OVX operation, the OVX rats were randomly divided into the following five groups by body weight: OVX group, whole-body vertical vibration group (WBVV), treadmill exercise group ( TX) , genistein group ( G) and 17β-estrogen group ( E2 ) .Then they were treated with different methods according to the experiment design.At the end of experiment, the uterus weight was measured with an electronic balance.The uterus histology was observed with HE staining and the expressions of GSK-3βand P-GSK-3βproteins were detected by Western blot.Results Apart from E2 treatment, all the other three treatments did not increase the uterus weight and the thickness of endometrium compared with that in the OVX rats.Apart from genistein treatment, all the other three treatments increased the ratio of protein expression of P-GSK-3βto GSK-3βcompared with that in the OVX rats.Conclusions Both whole-body vertical vibration and treadmill exercise can stimulate the phosphorylation of GSK-3βin the uterus of OVX osteoporotic rats.However, genistein has no such stimulation effect.