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Objective:To investigate the efficacy of radiofrequency ablation combined with ozone therapy under CT guidance in the treatment of lumbar disc herniation.Methods:A total of 93 patients with lumbar disc herniation who were admitted to The First Hospital of Jiaxing from January 2019 to May 2022 were included in this study. They were randomly divided into an observation group ( n = 47) and a control group ( n = 46). The control group was treated with radiofrequency ablation and the observation group was treated with radiofrequency ablation combined with ozone therapy. Efficacy was compared between the two groups at 3 months after surgery. The pain was compared between the two groups before and 7 days and 3 months after surgery. Inflammatory factors were compared between the two groups before and 7 days after surgery. The lumbar spine function was compared between the two groups before and 3 months after surgery. Results:At 3 months after surgery, the excellent and good rate in the observation group was significantly higher than that in the control group [89.36% (42/47) vs. 71.74% (33/47), χ2 = 4.63, P < 0.05). At 7 days and 3 months after surgery, Visual Analogue Scale scores in the observation group were (2.91 ± 0.54) points and (1.32 ± 0.31) points, respectively, which were significantly lower than (3.76 ± 0.62) points and (2.08 ± 0.47) points in the control group ( t = 7.06, 9.22, both P < 0.001). At 7 days after surgery, serum interleukin-1β, interleukin-6, and tumor necrosis factor-α in the observation group were (0.24 ± 0.05) μg/L, (18.49 ± 3.47) ng/L, and (97.94 ± 17.43) ng/L, respectively, which were significantly lower than (0.37 ± 0.09) μg/L, (24.31 ± 4.12) ng/L, and (148.87 ± 20.13) ng/L, respectively in the control group ( t = 8.63, 7.37, 13.05, all P < 0.05). At 3 months after surgery, the Japanese Orthopedic Association score in the observation group was significantly higher than that in the control group [(25.68 ± 2.28) points vs. (21.17 ± 3.24) points, t = -7.78, P < 0.001], and the Oswestry Disability Index in the observation group was significantly lower than that in the control group [(9.84 ± 1.43) points vs. (13.46 ± 2.18) points, t = 9.49, P < 0.001]. Conclusion:Radiofrequency ablation combined with ozone therapy under CT guidance is highly effective on lumbar disc herniation. The combined therapy can reduce pain and inflammatory reactions in patients and improve lumbar function.
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Objective To evaluate left ventricular systolic function with two-dimensional speckle tracking imaging (2D-STI) in rats with simple obesity.Methods A total of 16 healthy male rats were fed with normal diet (NF group,n=6)and rich fat diet (group HFD,n=10) for 12 weeks.The parameters of conventional echocardiography were recorded,and the strain and strain rate of left ventricular myocardium were analyzed with 2D-STI.The degree of myocardial fibrosis,mast cell infiltration and the expression level of light chain 3 (LC3) protein were observed.Results Compared with NF group,in HFD group,the weight,abdominal circumference,abdominal fat content,fasting blood glucose and triglyceride increased (all P＜0.05),while the radial strain rate of anterior septum,the radial strain of anterior septum and anterior wall in left ventricular decreased (all P＜0.05),so did the longitudinal strain and strain rate in posterior septal basal segment,middle segment,apical segment and lateral wall basal segments in left ventricle (all P＜0.01).In HFD group,the arrangement of cardiac muscle cells was disordered,and the fat vacuoles was found;the myocardial collagen fiber deposition and the infiltration of mast cells obviously increased,while the expression of LC3 protein decreased.Conclusion The left ventricular function of early stage obese rats has been damaged in varying degrees when no obvious changes of heart structure could be observed.
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Objective To investigate the sequential biological effects and outcomes of microbubble-enhanced ultrasound (MEUS) combined with prothrombin on microwave ablation (MWA) in rabbit VX2 liver tumors using examination of transmission electron microscopy ,histopathology and contrast-enhanced ultrasound(CEUS) . Methods Eighty New Zealand rabbits with VX2 liver tumors were randomly divided into 4 groups ( 20 per group ) , including physiological saline group , prothrombin group , cavitation of microbubbles group ( cavitation group ) and cavitation of microbubbles combined prothrombin group (combined group) . After treatment ,the targeted liver tumors in all groups were ablated with MWA . On the 0 ,3 ,7 and 14 d ,the volumes of coagulated areas of 5 rabbits of each group randomly were measured using CEUS . Tissues in ablated areas ,transition areas and surrounding areas were examined under light microscopy with histopathology and transmission electron microscopy to observe the differences among 4 groups . Tumor metastasis was graded using visual method . Results On the 0 ,3 ,7 and 14 d ,the coagulated volumes in combined group were larger than those in remaining 3 groups ( all P ＜ 0 .001) . Under light microscopy with HE stain ,in transition area ,the fibra band in combined group was wider than those in remaining 3 groups on the 7 and 14 d ( all P ＜ 0 .05 ) . The observations under transmission electron microscopy showed that the cellular ultrastructure disorder in ablated area on the 0 d and mitochondrial injury in transition area on the 7 d were more severe in combined group than those in remaining 3 groups . Compared with the remaining 3 groups ,the degree of tumor metastasis in combined group was less ,and the time of ocurrence was later . Conclusions MEUS combined with prothrombin can significantly expand ablation volume ,enhance the necrosis of ablated tissues ,and inhibit tumor metastasis on rabbit VX 2 liver tumors . The fibra bands in the transition areas can promote the organization and repair the surrounding tissue in the ablation areas .
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Purpose To evaluate the myocardial perfusion in diabetes mellitus (DM) rats with insulin intervention at different times by myocardial contrast echocardiography (MCE) so as to explore the value of MCE in evaluating the treatment of diabetic cardiomyopathy (DCM).Materials and Methods In this prospective study,90 rats were randomly divided into normal control (NC) group,DM group and insulin intervention (INS) group,with 30 rats in each group.After the DM models were established,the INS group was then divided into three subgroups of A,B and C treated with insulin intervention at 0,4 and 8 weeks respectively and further treated continuously for 12 weeks.The NC and DM groups were also randomly divided into three subgroups and fed synchronously just as the INS group but without insulin intervention.At the end of 12,16 and 20 weeks after modeling,the rats in each subgroup were examined by MCE.The changes of myocardial blood volume (A),blood velocity (β) and blood flow (A×β) were analyzed,and the myocardial tissues were also collected for pathological examination.Results A,β and A×β were increased in INS group compared with DM group (P＜0.05).Compared with NC group,the values of INS group including A×β in A subgroup,A and A×β in B subgroup,A,β and A×β in C subgroup were decreased (all P＜0.05).In INS group,there was no difference in the three values of myocardial blood between A and B subgroup (P＞0.05),but A and A×β were lower in C subgroup than those in A subgroup (P＜0.05).On pathology,the thickness of capillary basement membrane of INS group improved compared with DM group;the capillary density of INS group increased compared with DM group,but there was significant difference only inA subgroup (P＜0.05).Conclusion Early insulin intervention can improve myocardial microvascular structure and increase myocardial blood flow.MCE can be used to evaluate the myocardial microcirculation of DCM rats sensitively and accurately,which can be used as an important method for early diagnosis and dynamic monitoring of DCM with clinical significance.
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<p><b>OBJECTIVE</b>To assess the pathologic markers for evaluation of reversibility in pulmonary hypertension (PAH) related to congenital heart disease.</p><p><b>METHODS</b>Twenty-eight patients with congenital heart disease complicated by PAH were subclassified into reversible pulmonary hypertension (RPAH) and irreversible pulmonary hypertension (IPAH), according to post-operative mean pulmonary artery pressure (MPAP). Pulmonary vascular lesion was analyzed according to Ruan's method. Mean medium thickness percent, mean medium area percent and pulmonary arteriolar density were measured by quantitative morphometry. Immunohistochemical study for transgelin and filamin A was carried out.</p><p><b>RESULTS</b>Amongst the 28 cases studied, 24 were RPAH and 4 were IPAH. Of the 24 patients with RPAH, 13 (54.2%, 13/24) had pulmonary vascular lesion of grade 0, 9 (37.5%, 9/24) of grade 1 and 2 (8.3%, 2/24) of grade 2. Of the 4 patients with IPAH, 1 had lesion of grade 1, 1 of grade 2 and 2 of grade 3. Both preoperative and postoperative MPAP were higher in IPAH patients than that in RPAH patients[(53.3±23.4) mmHg versus (34.1±12.7) mmHg, P=0.020 and (35.0±8.8) mmHg versus (17.8±3.9) mmHg, P<0.01]. Compared to patients with pulmonary vascular lesion of grades 0 and 1, the preoperative MPAP in patients with grades 2 and 3 showed no significant difference, but the postoperative MPAP was higher (P<0.05 or 0.01). Compared to control group, mean medium thickness percent and mean medium area percent were significantly higher in RPAH and IPAH categories (12.0±3.5, 8.5±2.0 versus 5.7±1.0, P<0.01 and 55.8±11.1, 49.0±9.4 versus 34.0±5.5, P<0.01). Mean medium thickness percent was significantly higher in IPAP group than that in RPAH group (12.0±3.5 versus 8.5±2.0, P=0.001). Correlation analysis demonstrated that mean medium thickness percent and mean medium area percent had positive correlation with preoperative and postoperative MPAP. There was no correlation between grading of pulmonary vascular lesion and reversibility. Transgelin and filamin A had stronger staining in pulmonary vascular smooth muscle cells in IPAH than those in RPAH and controls(P<0.05).</p><p><b>CONCLUSIONS</b>Pathologic assessment of lung biopsy remains the gold standard for evaluation of the reversibility in PAH related to congenital heart disease. Mean medium thickness percent, mean medium area percent and immunoreactivity for transgelin and filamin A are useful parameters.</p>
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Humans , Biomarkers , Metabolism , Biopsy , Filamins , Metabolism , Heart Diseases , Pathology , Hypertension, Pulmonary , Diagnosis , Pathology , Lung , Pathology , Microfilament Proteins , Metabolism , Muscle Proteins , MetabolismABSTRACT
Objective: To study if there is an aryl-hydrocarbon receptor (AHR) expression in patients of pulmonary arterial hypertension associated with congenital heart disease (CHD-PAH) and to explore if the amount of AHR expression related to pulmonary vascular remodeling. Methods:A total of 32 CHD-PAH patients diagnosed by echocardiography and right heart catheterization for surgical repair were enrolled, and the lung tissue biopsy was performed during the operation. The pulmonaryAHR was detected by immunolfuorescence assay, the ratios of vessel wall area/total area (WA/TA) and vessel wall thickness/vessel external diameter (WD/TD) of small pulmonary arteries were calculated with the imaging software, the mRNA expression of AHR, hypoxia-inducible factor-1α (HIF-1α), aryl-hydrocarbon receptor nuclear translocator (ARNT) and vascular endothelial growth factor (VEGF) were examined by RT-PCR. In addition, blood level of AHR was measured by ELISA. Results: There was AHR expression in pulmonary tissue in all 32 patients. And AHR mRNA expressions were positively related to mPAP (r=0.809,P Conclusion: AHR might be involved in pulmonary vascular remodeling in CHD-PAHpatients.
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Objective To investigate the basis of ultrasound microbubble technology enhanced thermal ablation effect.Methods All 48 rabbits bearing hepatic tumors were averagely randomly divided into four groups:only laser group,sham,destruction + laser group,and blank group.The filling defect area changes of before and after treatment were observed and the differences between groups were compared.Results Pathology confirmed ablation of tumor tissue could produce coagulation necrosis for experiment group.The conventional ultrasound showed there was no significant variation in the maximum diameter and area in the pre and post treatment of experiment group and control group(P ＞0.05).There was no change for the control group.Ultrasound imaging showed an area of filling defect were:laser treatment alone group (0.83 ± 0.06) cm2,microbubbles false break combined with laser therapy group (0.65 ± 0.05) cm2,microbubbles break combined with laser therapy group (2.40 ± 0.16)cm2,blank control group (0.01 ± 0.01) cm2.The filling defect area of the treatment group,which was combined with ultrasound microbubble break technology and laser ablation was increased,there was significant variation in the each group (P ＜0.05).Conclusions Microbubble burst combined laser ablation could expand the single needle laser ablation area of rabbit VX2 liver tumor and increase the therapeutic effect.
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Objective: To explore the effect of calcium channel blocker (CCB) treatment in patients of idiopathic pulmonary arterial hypertension (IPAH) with positive acute pulmonary vasodilator test, and to compare the hemodynamic differences between the positive and negative patients. Methods: A total of 156 consecutive IPAH patients with acute pulmonary vasodilator test were studied. The patients were divided into 2 groups according to the testing result. Positive group, n=23 and Negative group, n=133. The positive patients were followed up by clinical or telephone visit to investigate their CCB dose, WHO PAH cardiac classiifcation and the survival conditions. Kaplan-meier curve was conducted to analyze the living condition and t test was used to compare the hemodynamic differences between the positive and negative patients. Results: There were 43 male and 113 female patients at the male/female ratio of 1: 2.6, and 14.7% (23/156) positive patients. The average follow-up period for Positive group was (50.9 ± 3.8) months. There were 13 patients using diltiazem with the mean dose of (277 ± 108) mg/d at the range of (90-450) mg/d; 3 patients using amlodipine, 1 with the dose of 15mg/d and 2 with the dose of 7.5mg/d. The 1, 2 and 3 years survival rate for the positive patients were for 91.3%, 86.6% and 79.7% respectively. The mean pulmonary arterial pressure and pulmonary vascular resistance were lower, P=0.000, while the mixed venous oxygen saturation was higher in Positive group than Negative group, P=0.009.The NT-pro BNP level was lower in Positive group, P=0.001. Conclusion: IPAH patients has lower ratio of positive acute pulmonary vasodilator test. The positive patients has the higher 1, 3 and 5 years survival rate and better hemodynamic parameters as the mean pulmonary arterial pressure, pulmonary vascular resistance and better level of NT-pro BNP.
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Objective To assess the myocardial function with early insulin treatment by velocity vector imaging (VVI) combined with dipyridamole stress in diabetic rats.Methods The 30 rats comprised 20 diabetic rats and 10 normal rats in the study.The 20 diabetic rats were divided into the diabetes mellitus(DM) group and the treatment group.Every rat in the treatment group was hypodermic injected with protamime biosynthetic human insulin after the diabetic model established.The control group was including 10 normal rats of the same age.After 8 weeks,each rat was performed with VVI at baseline and after dipyridamole stress.Results At baseline VVI,the parameters in the DM and the treatment groups were reduced compared with those in the control group.The systolic velocity,circumferential strain,systolic and diastolic circumferential strain rate in the treatment group were increased significantly compared with those in the DM group.After stress,the VVI reserve parameters in the treatment group were higher than those in the DM group.Conclusions The myocardial function are improved with early insulin treatment in the diabetic rats.
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Objective To detect the positive rate of anti-endothelial cell antibody (AECA) in patients with pulmonary arterial hypertension (PAH) associated with connective tissue diseases(CTD)and to investigate the specific target antigen.Methods Sera of 68 patients with CTD associated PAH were collected to detect AECA by Western blotting with extracted membrane protein of the endothelial cell line EA.hy926.Sera of 61 CTD patients without PAH,20 with idiopathic pulmonary arterial hypertension(IPAH),20 with chronic obstructive pulmonary diseases and pulmonary arterial hypertension (COPD-PAH) and 20 healthy donors were collected as controls.The correlation between PAH and specific bands of AECA was studied by X2 test.Liquid chromatography-electrospray ionization mass spectrography was used to detect the target antigens related to PAH associated with CTD.Results The specific molecular size of antigen was 78 000.The AECA-78 000positive rate of CTD patients with PAH was 79% (54/68).not significantly ditierent from that of CTD with glomerulonephritis(71%,15/21),but significantly higher than those of CTD with interstitial lung disease (ILD)(15%,3/20)and CTD without systemic involvement(P<0.01 and P<0.05 respectively).also higher than those of IPAH(8%,1/12).The AECA-78 000 was negative in COPD-PAH and healthy controls.The target antigen of AECA-78 000 was identified by proteomic techniques as moesin.Conclusion CTD patients with different target organ involvement have different AECA-78 000 positive rates,which could be frequently detected in CTD associated PAH and those with glomerulonephritis.The common antigen is moesin.
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Objective To determine the clinical significance of pulmonary function test(PFT)in evaluating the features and severity of lung impairments associated with connective tissue diseases(CTD)by comparing the differences of pulmonary function test parameters among groups of CTD associated pulmonary disorders.Methods Cases of CTD associated pulmonary disorders were prospectively enrolled and assigned into 3 groups according to their lung impairments:CTD associated pulmonary arterial hypertension group (CTD-PAH,n=29),CTD associated interstitial lung disease group(CTD-ILD,n=35),CTD associated PAH plus ILD group(CTD-PAH+ILD,n=16)and CTD control group(n=34).Pulmonary function test parameters,including total lung capacity(TLC % predicted),forced vital capacity(FVC % predicted),forced expiratory volume in the first second(FEV_(1.0)% predicted),FE_(1.0)%/FVC and diffusing capacity of the lung for carbon monoxide(DLco,% predicted)were measured and compared among the four groups.Results One hundred and forteen eases were included and predominantly female with average onset age of 35～39 years old.CTDs that were predisposed to lung diseases were mixed connective disease(MCTD),systemic sclerosis(SSc),systemic lupus erythematosus(SLE)and primary Sj(o)ren syndrome(pSS),in order.There were 10,29 and 46 percent of patients presented with decreased TLC% in CTD-PAH,CTD-ILD and CTD-PAH+ILD group respectively,50,36 and 71 percent of patients with decreased FVC% respectively,54,47 and 71 percent of patients with decreased FEV_(1.0)% respectively,and 100,82 and 100 percent with decreased DLco% respectively.ANOVA analysis demonstrated that TLC%,FVC%,FEV_(1.0)%,DLco% had significant differences between CTD control group and each of the CTD associated lung disease group(P＜0.05),although none of them was lack of difference between the PAH and ILD groups.TLC% was significantly higher in CTD-PAH group than CTD-PAH+ILD group[(89±15)% vs(79±12)%,P＜0.05],while FVC% was significantly lower in CTDPAH+ILD group either than CTD-PAH group or than CTD-ILD group[(81±13)%,(80±16)% vs(65±22)%,P＜0.05].ConclusionPulmonary function test may be valuable in early screening for CTD associated lung disorders than distinguishing CTD-PAH from ILD,which usually reveal restrictive ventilation dysfunction and/or diffusing capacity dysfunction.
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Objective Immune and inflammatory mechanisms could play a significant role in genesis or progression of interstitial lung disease and pulmonary arterial hypertension,especially in patients with connective tissue diseases.Specific antibodies may predict the occurrence of this condition.Methods The plasma of patients with systemic sclerosis(SSc)or mixed connective tissue disease(MCTD)were screened with enzyme linked immunoserbent assay(ELISA)and Western blotting using recombinant mocsin.The clinical data were recorded and pulmonary function tests(PFTs)were performed in 78 consecutive individuals in order to identify the difference in clinical manifestations between anti-mocsin positive group and negative group.Results Our results showed high titers of anti-mocsin antibodies in 21(53%)of 40 patients with SSc,and 15(39%)of 38 patient with MCTD.The presence of anti-moesin antibodies was significantly correlated with pulmonary involvement(ILD and PAH)in SSc and MCTD patiens(P=0.001).Comparing with the antibody negative group,the total lung capacity[(82±10)% vs(90±14)%,P=0.027),forced vital capacity [(76±13)% vs(85±17)%,P=0.040]and diffu-sing capacity of the lung for carbon monoxide[(58±16)% vs (72±23)%,P=0.014]of PFTs in anti-moesin antibodies positive group were noted to be significantly decreased(P＜0.05).Conclusion Specific antibodies to moesin is prevalent in patients with SSc and MCTD,so it may be an early predictor of pulmonary involvement in patients with SSc or MCTD.
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Objective To evaluate the effects of four agents including cyclophosphomide,thalidomide,total glucosides of peony (TGP) and simvastatin on cell-proliferation and endothlin-1 secretion of human endothelial cells (ECs).Methods EA.by926 cells were cultured until confluence WSS achieved,then incubated separately for 24 h.48 h and 72 h with various concentration of these four agents.The proliferation of ECs waft detected with 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium-bromide (MTT).The amount of endothlin-1 in supernatants of ECs was determined with enzyme linked immunosorbent assay.Results (1)Cyclophosphomide,TGP and simvastatin inhibited ECs proliferation in a dose dependent manner at 72 h (P＜0.05).(2)Cyclophosphomide (50-2000 μmol/L) and simvastatin (5-10 μmol/L) decreased endothlin-1 secretion but not in dose dependent manner. Conclusion Cyclophosphomide.TGP and simvastatin can inhibit ECs proliferation.Cyelophosphomide and simvastatin can decrease endothlin-1 secretion of human ECs.
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Objective To investigate the prevalence of anti-endothelial cell antibody fAECA) in the sera of patients with connective tissue diseases(CTD)complicated with pulmonary arterial hyperten-sion (PAH)and to detect the specific antigens of AECA which may be related to clinical manifestations.Methods AECA was detected with Western blotting in 39 CTD patients with PAH.22 CTD patients without PAH and 30 healthy donors.Results The prevalence of AECA was 82%in CTD patients with PAH.73%in CTD patients without PAH and 20%in healthy donors.Anti-22 000 AECA was only detected in CTD patients with PAH(15%).Anti-75 000 AECA was more frequently detected in CTD patients with PAH than in thosewithout PAH(51%vs 23%.P＜0.05).In CTD patients complicated with PAH.anti-75 000 AECA was morefrequently detected in those with Raynaud's phenomenon or with positive anti-RNP antibody.Conclusion AECA can be more frequently detected in CTD patients with or without PAH.Furthermore,anti-22 000 and anti-75 000 AECA may play a special role in CTD patients with PAH.
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Objective To set up an animal model with severe head injury that is similar to clinical condition and treated with mild hypothermia. Methods A total of 120 SD rats were randomly divided into eight groups (n=15 in each group), ie, before cooling, cooling 6, 12, 24, 48, 72, 96 and 120 hours groups. The model was induced by dropping a object of 60 g from a height of 50 cm onto the epidura and treated with mild hypothermia (32-34℃). Blood pressure and ECG were observed and serum K+, Na+ and Mg 2+levels measured. The change of neuron microstructure in rat cerebral traumatic tissue of every group was observed by transmission electron microscope (TEM). Results Animal mortality increased but serum K+ and Mg 2+levels gradually decreased with the treating time lasting. Serum Na+ showed insignificant change. Bradytachycardia occurred in one rat of 72 hours group, two of 96 hours group and two of 120 hours group. TEM showed that the rat’s encephaledema presented gradual relief trend during mild hypothermia treatment. There was one rat in 96 hours group and one in 120 hours group with diffuse tubuli renales necrosis. Conclusion The established model is in conformity with the characteristics of vital sign, serum electrolyte and cerebral microstructure of clinical severe head injury treated with mild hypothermia.
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0.05 );P br O 2 was lower in cooling group than that in control group at 24 hours/48 hours/72 hours after cooling ( P 0.05).The mortality rate of patients with severe head injury (GCS 6～8) in mild hypothermia group is obviously lower than that in control group ( P