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Objective:To observe influence of exercise rehabilitation combined diet guidance on cardiac function and quality of life (QOL) in patients after heart valve replacement .Methods:A total of 120 patients after heart valve replacement were selected and randomly divided into control group (n=60 ,received routine health education ) and experiment group (n=60 ,received diet guidance and exercise rehabilitation based on routine health education ) .After discharge ,patients re‐ceived outpatient follow‐up for six months ,body weight ,cardiac function and QOL on six months after surgery were fol‐lowed up and observed in two groups ,and the results were statistically compared .Results:Compared with control group six months after discharge ,there were significant rise in left ventricular ejection fraction [ (51.75 ± 9.30)% vs .(57.73 ± 6.13)% ] andoxygenmetabolicequivalent [(7.05±1.85)METsvs.(11.34±2.18)METs],andeachitemscoreofQOL and total score of QOL [ (4.98 ± 0.40) scores vs .(6.49 ± 0.53) scores] ,P<0.05 or <0.01;and significant reduction in body weight [(67.75 ± 10.67) kg vs .(61.25 ± 10.34) kg] in experiment group ,P<0.01. Conclusion:Exercise rehabili‐tation combined diet guidance can avoid rapid increase in body weight after surgery ,promote recovery of cardiac function and improve quality of life after surgery in patients with heart valvular diseases .
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BACKGROUND:The open reduction and internal fixation in treatment of middle and inferior humeral fractures often choose anterolateral approach. As the rapid development of microsurgical technique in recent years, some domestic hospitals try to adopt the medial approach, but the operation safety and efficacy are rarely reported. OBJECTIVE:To evaluate the clinical efficacy of two different approaches of open reduction and internal fixation for treating the middle and inferior humeral fractures. METHODS:A total of 68 patients with the middle and inferior humeral fractures were selected from Orthopedic Center of Xinjiang Medical University from January 2010 to January 2012, and were retrospectively analyzed. According to the approach of incision, the involved patients were divided into anterolateral approach group (n=33) and medial approach group (n=35). The blood loss in two groups was analyzed using Gross equation. The postoperative complications and functional recovery were compared. RESULTS AND CONCLUSION:During the fol ow-up at 12-18 months, X-ray results showed that the fractures achieved bone healing, fracture healing time was 16.9±3.9 weeks in anterolateral approach group and 15.5±2.2 weeks in the medial approach group. Shoulder Neer system score was 86±5 points in anterolateral approach group and 84±4 points in the medial approach group;elbow Mayo system score was 78±7 points in anterolateral approach group and 81±8 points in the medial approach group. Three cases in anterolateral approach group and one case in medial approach group presented postoperative radial nerve numbness and wrist dorsiflexion weakness, which were self-healed after 3 months. There was no nonunion, chronic osteomyelitis for other complications. The fracture healing time, the incidence of complications and the functional recovery between the two groups showed no significant difference (P>0.05). The medial approach is a feasible and safe surgical approach of internal fixation for treating the middle and inferior humeral fractures.
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OBJECTIVE@#To determine the improvements of post-infarction heart function after transplantation of autologous skeletal myoblasts transfected with VEGF165 in rabbits.@*METHODS@#Myocardium infarction was induced in rabbits by left anterior descending coronary artery ligation. At 2 weeks, 1.75×10(7) autologous skeletal myoblasts transfected with pcDNA3.1-VEGF165 were infused into the region of MI via direct intramuscular injection; pcDNA3.1 served as a control.@*RESULTS@#The DAPI-labeled and Desmin-positive immunostained skeletal myofibers were found throughout the infracted areas and border zones, and the density of blood capillary in the MI region transplanted by myoblasts with VEGF165 was increased (measured 4 weeks later and compared with controls). Heart function was examined by the Buxco system and demonstrated that maximum dp/dt [(1607.23±102.67) mmHg/s vs (1217.77±89.91) mmHg/s] and minimum dp/dt [(-1535.09 ± 81.34) mmHg/s vs (1174.58 ± 91.5) mmHg/s] were improved in the heart transplanted with the transfected myoblasts(P<0.05).@*CONCLUSION@#Autologous skeletal myoblasts transfected with VEGF165 could ameliorate the blood supply in the MI region, and aid recovery of heart function more quickly in post-infarction hearts. This suggests an effective treatment for myocardium infarction.
Subject(s)
Animals , Female , Rabbits , Myoblasts, Skeletal , Metabolism , Transplantation , Myocardial Infarction , Therapeutics , Recovery of Function , Transfection , Transplantation, Autologous , Vascular Endothelial Growth Factor A , Genetics , Metabolism , Ventricular Function, Left , PhysiologyABSTRACT
ObjectiveTo evaluate the radial rotation osteotomy and ulnadouble rotation osteotomy obstetric brachial plexus injury (obstetric brachial plexus palsy) forearm pronation deformity sequelae value.MethodsFrom August 2007 to August 2011, twenty cases of obstetric brachial plexus palsy sequelae in children with forearm pronation deformity, the implementation of a simple radial rotating radial osteotomy (5cases),double-rotation radius and ulna osteotomy (15 cases) and two surgical type,and by 6 to 54 months after surgery (mean 25 months) follow-up.The groupfunctions to forearm pronation angle and conscious function improvement as the evaluation criteria. ResultsThe 15 cases of radius and ulna osteotomy in children with dual function and appearance in 14 cases significandy improved,one case of supination deformity;five underwent simple radial pronation osteotomy,three patients had improved function and appearance,followed up for 6 months, eight months after the merger which radial head dislocation in 2 cases due to poor efficacy of dual-line radius and ulna osteotomy, twenty patients in this group did not appear nonunion.ConclusionSimple radial rotation osteotomy surgery in obstetric brachial plexus palsy forearm pronation deformity complications without radial head dislocation has some value, radius and ulna double osteotomy in forearm pronation deformity with radial head dislocation aftermath of the effect is more excellent.
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Objective Allograft vasculopathy (AV), feature of chronic rejection, is a major serious long-term post-operation complication in organ transplantation. The accurate mechanisms for AV have not been definitively established, but extensive basic and clinical studies demonstrate AV is triggered by immune reaction and nonimmunologic factors, and also possibly attributed to the metabolism of branched-chain amino acids (BCAA). Methods The transplanted hearts from Lewis to Sprague-Dawely rats served as allografts and those from Lewis to Lewis rats as isografts based on Ono 's model. The differential proteins in transplanted hearts were separated by comparative proteomic technique, and some enzymes which regulated the metabolism of BCAA were identified and validated.Results All transplanted hearts at second week postoperation were characterized by lumen loss (total area-luminal area/total area) in coronary artery, but more predominant at 8th week. All samples from the left ventricles were analyzed by proteomic techniques and the subunits E1 a, E1β and E3 of branched-chain α-ketoacid dehydrogenase (BCKDH) complex were decreased in the heart allografts.Immunohistological detection also showed the expression of BCKDH was reduced not only in the cardiac muscle but also more significantly in blool vessels with cardiac allograft vasculopathy (CAV).BCAA concentrations were increased in the cardiac allografts, but there was no difference in the serum. Conclusion These findings suggest that the catabolic pathways of the BCAA may be inhibited owing to the reduced expression of BCKDH complex, and elevated intracellular concentrations of leucine. The vascular smooth muscle cell and cardiac muscle cell proliferation is stimulated via mTOR-dependent and mTOR-independent pathways, which is associated with the formation of myocardial hypertrophy and AV in the heart allografts.
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Objective To detect the expression of connective tissue growth factor (CTGF) in acute heart allograft rejection in rats and to investigate the relationship between CTGF expression and cardiac allograft fibrosis. Methods Sixteen Wister rats served as donors and another 16 Sprague-Dawely (SD) rats served as recipients. Intra-abdominal heterotopic heart transplantation was performed. All rats received 10 mg/(kg·d) cyclosporine,40 mg/(kg·d)CellCept, and 3 mg/(kg·d)methylprednisolone immunosuppression after the surgery. Ten allografts were harvested 2 weeks postoperation while 10 normal Wister rats served as controls. The paraffin sections of harvested heart specimens were stained with hematoxylin and eosin (HE),and van Gieson(VG) for the examination of morphological changes to observe the lumen loss of myocardial coronary arteries and myocardial fibrosis. The expression of CTGF was studied by immunnohistochemical method and was measured semi quantitatively. The correlation between the CTGF expression and allograft fibrosis was studied. Results The allografts showed a typical symbol of acute rejection with excessive granulocyte infiltration around the vessel wall and myocardial interstice. There were also intimal proliferation and obvious fibrosis in the acute group and the differences between the acute and control group were significant (P<0.05). The expression of CTGF protein was mainly located around the vascular and myocardial lesions in the acute group while the control group showed no CTGF expression. The gray scale value of CTGF was (AR vs NH: 103.52±6.42 vs. 182.61±8.72,P<0.05). Strong negative correlations were found between the gray scale value and fibrosis formation(r=-0.734,P<0.01). Conclusion CTGF was overexpressed in acute allograft rejection rat hearts and might be involved in the pathogenesis of transplanted heart fibrosis.
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BACKGROUND: Chronic rejection limits the long-term success of cardiac transplantation and the underlying causes of the disease are unknown. Connective tissue growth factor (CTGF) is considered as a mitogenic and chemotactic factor for fibroblasts and is associated with cell proliferation and collagen synthesis.OBJECTIVE: To evaluate the role and significance of expression of CTGF in rat chronic rejection heart aliografta.DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at the Laboratory Animal Center of the Second Xiangya Hospital between April and August 2007.MATERIALS: Twenty Wistar rats serving as donors and twenty Sprague-Dawely (SD) rats serving as recipients were included. An additional 10 Wistar rats were included as controls.METHODS: After intra-abdominal heterotopic heart transplantations, rats received cyclosporine A, mycophenolate, and methylprednisolone immunosuppression. Ten recipient rats were anesthetized and sacrificed for heart harvesting at 2 and 8 weeks postoperation, respectively.MAIN OUTCOME MEASURES: Coronary vessel density, fibrosis grade, and intimal occlusion were observed by hematoxylin-cosin staining and Van Gieson staining. Myocardial fibrosis was semi-quantitatively scored. CTGF expression was detected by immunohistochemistry. The associations between CTGF expression and allograft fibrosis and CAV formation were analyzed.RESULTS: Allografts harvested at 8-week post-surgery showed more obvious coronary intimal proliferation, fibrosis and higher CTGF expression compared with the 2-week allografts and the controls (P < 0.05-0.01 ) while the cardiac artery density was lower than the control group (P < 0.05). However, the control group in our study showed negligible CTGF expression. There were strong negative correlations between the gray value of CTGF protein expression and cardiac fibrosis and coronary intimal occlusion (r = -0.734, -0.713, P < 0.01), demonstrating that CTGF protein expression was positively correlated with cardiac fibrosis and coronary intimal occlusion.CONCLUSION: CTGF is expressed in cardiac myocyte with CAV. The increased expression of CTGF in the cardiac allograft is associated with CAV development and fibrosis formation and is involved in the pathogenesis of cbronic heart rejection