Vascularization of intravitreal injection of Conbercept in the treatment of retinopathy of prematurity / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate retinal vascularization caused by the intravitreal injection of Conbercept in the treatment of a series of retinopathy of prematurity(ROP)cases in Type Ⅰ(threshold and pre-threshold period)and aggressive ROP(A-ROP).METHODS: The data of 34 ROP cases(67 eyes)treated by intravitreal injection of Conbercept(IVC)in the ophthalmology department of the Xiamen Children's Hospital from July 2017 to March 2020 were retrospectively analyzed. Reactivation, which refers to recurrence of acute phase features, occurred at any stage of the disease in the presence or absence of other diseases. RESULT: The average gestational age of the 34 children was 28.82±2.32wk. The average birth weight was 1155.18±398.22g. The lesion zone of 19 cases(37 eyes)was Zone Ⅰ. In 10 cases(20 eyes), the lesion was in Zone Ⅱ, and in 5 cases(10 eyes), the lesion was in the posterior Zone Ⅱ. The total effective rate of disease control in ROP children treated with once IVC was 73.1%(49/67), and the vascularization of Zone Ⅱ was completed. The patients showed variable changes in the vascularization in Zone Ⅲ. For the patients who received one treatment and did not reactivate, the average rate of Type Ⅰ vascularization of ROP was 9.11±2.49wk, and the A-ROP was 13.40±4.04wk. The rate of A-ROP vascularization in Zone Ⅱ was significantly longer compared to Type Ⅰ.CONCLUSION: IVC effectively completes vascularization in Zone Ⅱ.

Prokaryotic expression, subcellular localization and enzymatic activity analysis of DXS gene from Platycodon grandiflorum / 药学学报

1-Deoxy-D-xylulose-5-phosphate synthase (DXS), the first key enzyme in 2-methyl-D-erythritol-4-phosphate (MEP) pathway, catalyzes the condensation of glyceraldehyde-3-phosphate with pyruvate to 1-deoxy-xylose-5-phosphate (DXP). In this study, PgDXS1, PgDXS2, and PgDXS3 genes were cloned from the root of Platycodon grandiflorum (P. grandiflorum). The open reading frame (ORF) of PgDXS1, PgDXS2, and PgDXS3 were 2 160, 2 208, and 2 151 bp in full length, encoding 719, 735, and 716 amino acids, respectively. Homologous alignment results showed a high identity of PgDXSs with DXS in Hevea brasiliensis, Datura stramonium and Stevia rebaudiana. The recombinant expression plasmids of pET-28a-PgDXSs were constructed and transformed into Escherichia coli (E. coli) BL21 (DE3) cells, and the induced proteins were successfully expressed. Subcellular localization results showed that PgDXS1 and PgDXS2 were mainly located in chloroplasts, and PgDXS3 was located in chloroplasts, nucleus and cytoplasm. The expression of three DXS genes in different tissues of two producing areas of P. grandiflorum were assayed via real-time fluorescence quantitative PCR, and the results showed that all of them were highly expressed in leaves of P. grandiflorum from Taihe. Under methyl jasmonate (MeJA) treatment, the expression levels of three PgDXS genes showed a trend of first decreasing and then increasing at different time points (3 - 48 h), and the activity of DXS showed a trend of first increasing and then decreasing in three tissues of P. grandiflorum. This study provides a reference for further elucidating the biological function of PgDXS in terpenoid synthesis pathway in P. grandiflorum.

Application of Duplex Droplet Digital PCR Detection of miR-888 and miR-891a in Semen Identification / 法医学杂志

OBJECTIVES@#To establish a system for simultaneous detection of miR-888 and miR-891a by droplet digital PCR (ddPCR), and to evaluate its application value in semen identification.@*METHODS@#The hydrolysis probes with different fluorescence modified reporter groups were designed to realize the detection of miR-888 and miR-891a by duplex ddPCR. A total of 75 samples of 5 body fluids (including peripheral blood, menstrual blood, semen, saliva and vaginal secretion) were detected. The difference analysis was conducted by Mann-Whitney U test. The semen differentiation ability of miR-888 and miR-891a was evaluated by ROC curve analysis and the optimal cut-off value was obtained.@*RESULTS@#There was no significant difference between the dual-plex assay and the single assay in this system. The detection sensitivity was up to 0.1 ng total RNA, and the intra- and inter-batch coefficients of variation were less than 15%. The expression levels of miR-888 and miR-891a detected by duplex ddPCR in semen were both higher than those in other body fluids. ROC curve analysis showed that the AUC of miR-888 was 0.976, the optimal cut-off value was 2.250 copies/μL, and the discrimination accuracy was 97.33%; the AUC of miR-891a was 1.000, the optimal cut-off value was 1.100 copies/μL, and the discrimination accuracy was 100%.@*CONCLUSIONS@#In this study, a method for detection of miR-888 and miR-891a by duplex ddPCR was successfully established. The system has good stability and repeatability and can be used for semen identification. Both miR-888 and miR-891a have high ability to identify semen, and the discrimination accuracy of miR-891a is higher.

Clinical significance and survival analysis of hyperbilirubinemia after heart transplantation / 中华器官移植杂志

Objective:To explore the postoperative hyperbilirubinemia after heart transplantation(HT)and examine its related in-hospital mortality and long-term survival status.And the relationships between preoperative pulmonary hypertension or postoperative right heart dysfunction and hyperbilirubinemia are also elucidated.Methods:From 2014 to 2021, the relevant perioperative data are retrospectively reviewed for 142 HT recipients at Tongji Hospital of Tongji Medical College of Huazhong University of Science & Technology.Based upon the presence or absence of postoperative bilirubin, they were divided into two groups of hyperbilirubinemia(group A, 73 cases) and non-hyperbilirubinemia(group B, 69 cases). And the correlation between preoperative pulmonary hypertension, postoperative right ventricular dysfunction and postoperative hyperbilirubinemia is examined by contingency table; Kaplan-Meier survival curve of postoperative hyperbilirubinemia is plotted.Results:This cohort is composed of 109 males(76.76%)and 33 females(23.24%)with an average age of(47.01±15.31)years.Hyperbilirubinemia occurred in 51.41% of recipients.Logistic analysis revealed in-patient mortality become markedly elevated in hyperbilirubinemia group (OR: 3.855; 95% CI: 1.202~12.367). However, no significant difference existed in 8-year survival curve post-transplant( P=0.09). For group A, 24 cases(32.87%)have pulmonary hypertension pre-operation and duration of CPB was(188.15±63.18)min, 37 and 30 cases(50.68%, 1.67%)have either right or left ventricular dysfunction post-operation.Intra-aortic balloon pump(IABP, 17cases, 23.29%)and extracorporeal membrane oxygenation(ECMO, 11 cases, 15.07%)are employed.The above parameters are all higher in group A than those in group B. Conclusions:The incidence of postoperative hyperbilirubinemia and related in-hospital mortality remains high after HT.However, no significant difference exists in medium/long-term survival rate after adequate treatment.Preoperative pulmonary hypertension and postoperative right heart dysfuncion are associated with hyperbilirubinemia postoperatively.Clinical interventions for risk factors of hyperbilirubinemia are required during perioperative period.

Short-term outcome of ascending aorta replacement combined with total aortic arch fenestration technique for acute type A aortic dissection / 中国胸心血管外科临床杂志

@#Objective    To report our clinical experience and outcomes of thoracic endovascular aortic repair (TEVAR) for acute Stanford type A dissection using ascending aorta replacement combined with implantation of a fenestrated stent-graft of the entire aortic arch through a minimally invasive technique. Methods    From 2016 to 2020 in our hospital, 24 patients (17 males and 7 females, aged 45-72 years) with complicated Stanford type A aortic dissection, underwent replacement of the proximal ascending aorta with TEVAR. None of the patients with dissection involved the three branches of the superior arch, and all patients were replaced with artificial blood vessels of the ascending aorta under non-hypothermic cardiopulmonary bypass, preserving the arch and the three branches above the arch, and individualized stent graft fenestration. Results    Surgical technical success rate was 100.0%. There was no intraoperative complication or evidence of endo-leak in 1 month postoperatively. Hospital stay was 10±5 d. During postoperative follow-up, the stent was unobstructed without displacement, the preserved branch of the aortic arch was unobstructed, and the true lumen of the descending aorta was enlarged. Conclusion     This hybrid technique by using TEVAR with fenestrated treatment is a minimally invasive and effective method to treat high-risk patients with acute Stanford type A aortic dissection.

Analysis of risk factors and threshold of hyperbilirubinemia after cardiovascular surgery assisted by cardiopulmonary bypass / 中华胸心血管外科杂志

Objective:To investigate the perioperative risk factors in contribution of hyperbilirubinemia following cardiopulmonary bypass(CPB) assisted cardiovascular surgery, of which cutoff values of key factors are defined.Methods:1 286 patients received cardiac surgery assisted by CPB from January 2017 to March 2019 were included in the study. The perioperative data and the peak serum total bilirubin at selected timepoints were recorded. Logistic regression of multi-factor analysis was used to define risk factors and then broken-line analysis was applied to predict the risky threshold. Results:312(24.26%)patients developed hyperbilirubinemia after surgery, with the in-hospital mortality rate up to 34.62%(108 cases). In those patients, valve surgery(45.51%, 142/312), great vessel open surgery(37.82%, 118/312) and heart transplantation(7.69%, 24/312) were mostly performed. The duration of postoperative ICU stay and the use of ventilation were 6 days and 68 hours, which were significantly higher than those in non-hyperbilirubinemia group( P<0.01). Multivariate logistic regression showed that the postoperative ventilation time>49 h, the cardiopulmonary bypass(CPB) time>181 min and the abnormal preoperative liver function, use of intra-aortic balloon pump and extracorporeal membrane oxygen, unplanned re-exploration for bleeding were the risk factors for postoperative hyperbilirubinemia( P<0.01). The cutoff duration of postoperative mechanical ventilation and CPB affecting the incidence of hyperbilirubinemia, ICU days and in-hospital mortality were 120.21 h and 143.26 min, 248.20 h and 239.51 min, 259.50 h and 190.60 min, respectively. Conclusion:Preoperative abnormal liver function, intraoperative CPB time, postoperative mechanical ventilation time, postoperative use of IABP or ECMO assistance, and unplanned secondary thoracotomy were high-risk factors for hyperbilirubinemia after CPB-assisted cardiovascular surgery.

Analysis of whole-mouth taste function test results in 584 healthy adults / 中华耳鼻咽喉头颈外科杂志

Objective: To assess the taste function of healthy Chinese adults with the reliable whole-mouth taste test, and to analyze the correlation of taste function with age and gender. Methods: The clinical data of 584 participants reporting the normal sense of smell and taste from March 2019 to January 2020 in the Physical Examination Center of Beijing Anzhen Hospital were analyzed in the study, including 297 males and 287 females, aging (46.9±16.6) years. The subjects were divided into youth group (19-35 years old), middle aged group (36-50 years old), middle-elderly aged group (51-65 years old) and elderly group (66-80 years old). The taste test involved 5 tastants (sour, sweet, salty, umami and bitter) and 7 concentrations. The perception and recognition scores of five tastes were obtained through the whole-mouth taste test. SPSS 22.0 software was used for statistical analysis. Results: The intra-class correlation coefficients of the whole-mouth taste test were 0.751 to 0.828, which showed high test-retest reliability. The total score of perception and recognition of five tastes showed the significant negative correlation with age (r value was -0.49 and -0.44, respectively, both P<0.001). Compared with the other two groups, taste function of middle-elderly aged and elderly group decreased significantly (all P<0.001). There was no significant difference in total perception scores and total recognition scores between youth and middle aged group (all P>0.05). The perception scores and recognition scores of sour, salty, umami, bitter and total scores in females were higher than those in males (all P<0.05), but there was no significant difference in perception scores and recognition scores for sweet between them (P value was 0.584 and 0.223, respectively). Conclusions: The taste function is significantly negatively correlated with age. Except the sweet, females are more sensitive to the sour, salty, umami and bitter tastes than males.

Evaluation of chemosensory function in patients with upper respiratory tract post-viral olfactory dysfunction / 中华耳鼻咽喉头颈外科杂志

Objective: To observe the changes of olfactory function, intranasal trigeminal nerve function and taste function in patients with upper respiratory tract post-viral olfactory dysfunction (PVOD), and to explore the correlation of chemosensory function. Methods: The clinical data of 42 patients with PVOD who visited to the Olfactory and Taste Center of Otorhinolaryngology Head and Neck Surgery Department of Beijing Anzhen Hospital from January to December of 2019 were analyzed retrospectively, including 20 males and 22 females, aging (48.86±11.47) years (x¯). Twenty subjects in normal control group were selected according to the sex ratio of PVOD patients. Sniffin' Sticks olfactory tests were performed on the subjects, including threshold test (T), discrimination test (D) and identification test (I), and the sum of the above three test scores was the TDI value. At the same time, olfactory event-related potentials (oERPs), trigeminal event-related potentials (tERPs) and taste function test were performed. According to the taste function test, the patients were divided into normal gustation (NG) group and gustatory dysfunction (GD) group. The results of olfaction, taste and intranasal trigeminal nerve function tests were compared among different groups, and the correlation analysis was carried out. SPSS statistical software was used for statistical analysis. Results: GD was present in 14 (33.3%) of 42 PVOD patients with a course of PVOD of 5 (3, 6) months (M (Q1, Q3)). The gustatory function of patients with PVOD was related to gender (r=0.565, P<0.001), smoking status (r=-0.512, P=0.001), duration (r=-0.357, P=0.020) and olfactory function (all P<0.05). The olfactory function of GD group was worse than that of NG group, and the differences of TDI value and T value between the two groups were statistically significant (10.25±4.58 vs 13.35±3.61, 1.54±0.66 vs 2.10±0.88, t value was 2.40 and 2.10 respectively, both P<0.05). The amplitudes of oERPs and tERPs were significantly lower in GD group than those in NG group (all P<0.05). Conclusion: In patients with PVOD, the subjective and objective olfactory function, intranasal trigeminal nerve function and taste function were decreased, and there was a correlation, suggesting that there was a synergistic effect between the chemosensory functions of PVOD patients.

Effect of panlong needling at Jiaji (EX-B 2) on motor dysfunction in patients with Parkinson's disease of liver and kidney deficiency: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the curative effect of panlong needling at Jiaji (EX-B 2) combined with western medication and western medication alone on motor dysfunction in patients with Parkinson's disease (PD) of liver and kidney deficiency.@*METHODS@#A total of 98 patients with PD were randomly divided into an acupuncture and medication group (49 cases, 1 case dropped off) and a western medication group (49 cases,1 case was removed). The patients in the western medication group were given oral of levodopa and benserazide hydrochloride tablets, 125 mg each time, three times a day in the 1st week, and the dose was increased according to the needs of the patients' condition from the 2nd week until 250 mg each time, three times a day, for 16 consecutive weeks. On the basis of the same western medication treatment as the western medication group, panlong needling was applied at Jiaji (EX-B 2) from C2 to L5 in the acupuncture and medication group, once a day, 20 times as a course of treatment, for 4 consecutive courses. The scores of unified Parkinson's disease rating scale (UPDRS-Ⅲ, UPDRS-Ⅳ), TCM symptoms score, and 39-item Parkinson's disease questionnaire (PDQ-39) score were evaluated before treatment, after treatment and during follow-up of 1 month after treatment, respectively. The safety of the two groups was compared.@*RESULTS@#After treatment and during follow-up, except the PDQ-39 score of the western medication group, the scores of UPDRS-Ⅲ, UPDRS-Ⅳ, TCM syndrome and PDQ-39 were lower than those before treatment in the two groups (P<0.05), and the scores of above indexes in the acupuncture and medication group were lower than those of the western medication group (P<0.05). The total incidence of adverse reactions in the acupuncture and medication group was 10.4% (5/48), which was lower than 29.2% (14/48) in the western medication group (P<0.05).@*CONCLUSION@#Panlong needling at Jiaji (EX-B 2) combined with western medication could significantly improve the motor dysfunction and clinical symptoms, improve the quality of life and has high safety, and the efficacy is superior to western medication alone.

Which Is Safer, Chinese Medicine or Western Medicine? Comparative Analysis Based on Chinese Spontaneous Reporting Database / 中国结合医学杂志

OBJECTIVE@#To compare the safety differences between Chinese medicine (CM) and Western medicine (WM) based on Chinese Spontaneous Reporting Database (CSRD).@*METHODS@#Reports of adverse events (AEs) caused by CM and WM in the CSRD between 2010 and 2011 were selected. The following assessment indicators were constructed: the proportion of serious AEs (PSE), the average number of AEs (ANA), and the coverage rate of AEs (CRA). Further comparisons were also conducted, including the drugs with the most reported serious AEs, the AEs with the biggest report number, and the 5 serious AEs of interest (including death, anaphylactic shock, coma, dyspnea and abnormal liver function).@*RESULTS@#The PSE, ANA and CRA of WM were 1.09, 8.23 and 2.35 times higher than those of CM, respectively. The top 10 drugs with the most serious AEs were mainly injections for CM and antibiotics for WM. The AEs with the most reports were rash, pruritus, nausea, dizziness and vomiting for both CM and WM. The proportions of CM and WM in anaphylactic shock and coma were similar. For abnormal liver function and death, the proportions of WM were 5.47 and 3.00 times higher than those of CM, respectively.@*CONCLUSION@#Based on CSRD, CM was safer than WM at the average level from the perspective of adverse drug reactions.

Investigation on quality control and radiation protection of dental X-ray equipment in Beijing Dongcheng District / 中国辐射卫生

Objective To investigate the status of quality control of dental X-ray equipment in Beijing Dongcheng District, to explore the problems involved in radiation protection. Methods 41 medical dental X-ray machines were detected in Beijing Dongcheng District in accordance with Specification for testing of quality control in dental X-ray equipment (WS 581—2017). Results The qualified rate was higher in imported machines (100%) than that in domestic machines (76.92%), the overall qualified rate was 92.68%. In performance detection, the qualified rates were 100% except for the deviation of loading time (92.68%) and tube voltage (95.12%). No leakage was detected in 41 dental institutes. Conclusion The overall status of dental X-ray machines was good in Beijing Dongcheng District. More attention was paid to shield protection than to quality control of dental X-ray machines. Therefore, health administration should take measures to strengthen advocation of WS 581—2017, and improve radiation protection through routine equipment performance test, supervision of X-ray protection and radiation health education.

Study on determination and quantity transfer of multi index components in Wenjing Decoction / 中国中药杂志

Based on the textual research on literature, the key information of Wenjing Decoction were tested and identified, and 15 batches of lyophilized powder samples of Wenjing Decoction were prepared. The specific components, including paeoniflorin, glycyrrhizin, ginsenosides(Rg_1, Re and Rb_1), glycyrrhizic acid, and paeonol, were used as indexes to establish the HPLC method for quantitative evaluation, and the content ranges and transfer rates of these components were determined. The results showed that the contents of paeoniflorin, glycyrrhizin, ginsenosides Rg_1 + Re, ginsenoside Rb_1, glycyrrhizic acid, and paeonol in the 15 batches of samples were 0.62%-0.86%, 0.25%-0.76%, 0.14%-0.30%, 0.07%-0.21%, 0.63%-1.16%, and 0.09%-0.25%, respectively, and their transfer rates from the decoction pieces to the reference materials were 14.99%-19.42%, 28.11%-40.93%, 25.92%-61.88%, 25.03%-64.06%, 23.43%-35.53%, and 5.34%-10.44%, respectively. The consistency of the transfer rates between batches indicated that the preparation process was stable. It is suggested that the contents of paeoniflorin, glycyrrhizin, ginsenosides Rg_1 + Re, ginsenoside Rb_1, glycyrrhizic acid, and paeonol in Wenjing Decoction should not be less than 0.52%, 0.35%, 0.15%, 0.10%, 0.63%, and 0.12%, respectively. In this study, we determined the contents and analyzed the quantity transfer process of the index components in Wenjing Decoction, which can provide a basis for the follow-up development of Wenjing Decoction and the quality control of related preparations.

Study on the clinical characteristics of isolated congenital anosmia / 中华耳鼻咽喉头颈外科杂志

Objective: To retrospectively analysely the electrophysiological and imaging features of isolated congenital anosmia (ICA) and to assess the clinical phenotypic characteristics and classification of ICA. Methods: Clinical data of 30 ICA patients in Beijing Anzhen Hospital from 2012 to 2019 was retrospectively reviewed, including 13 males and 17 females, aged (35±19) years. The control group consisted of 30 healthy people from medical examination center, including 13 males and 17 females, aged (39±14) years. The clinical characteristics of ICA were analyzed using Sniffin' Sticks test, olfactory event-related potentials (oERPs), trigeminal event-related potentials (tERP) and olfactory pathway MRI. SPSS 17.0 software was used to compare the difference of olfactory function between the two groups. The correlation between olfactory bulb, olfactory sulcus structure and age was observed, and the clinical phenotype characteristics of ICA patients were analyzed. Results: The subjective olfactory function was completely lost in ICA patients. oERP was absent in all of the ICA patients, but showed normal N1 and P2 waves in controls. tERP could be evoked in 63.3% (19/30) of ICA patients, and signals in these patients showed higher amplitude in the N1 ((-10.33±6.93) μV vs (-5.11±2.71) μV, t=-10.113, P<0.01) and P2 ((+17.25±8.51) μV vs (+7.31±3.46) μV, t=5.443, P<0.01) waves than that of the controls. Olfactory bulbs were aplastic in 80.0% (24/30) of patients and hypoplastic in 20.0% (6/30) of patients. Fifty-six point seven percent (17/30) of patients had bilateral olfactory sulcus deletion while 43.3% (13/30) had dysplasia, and all of the patients exhibited a depth of olfactory sulcus less than 8 mm. Both the structure of olfactory bulbs and olfactory sulcus were not associated with age for ICA patients (r value was -0.174 and 0.325, respectively, all P>0.05). Conclusions: ICA patients show neurophysiologic deficits and some anatomic differences compared with healthy controls. The absence of oERP combining with a depth of olfactory sulcus less than 8 mm is the important indicator for clinical diagnosis of ICA. The structure of olfactory bulb may be a critical factor for clinical classification of ICA.

Roles of autophagy onself-renewal and differentiation of mesenchymal stem cells / 华西口腔医学杂志

Mesenchymal stem cells (MSCs), which have the potential of self-replication and differentiation, are a very valuable cell source for stem cell-based medical therapy. Their application has opened up a new way for disease research. Although MSCs can maintain cell stemness through self-renewal, with the prolongation of cell passage and culture time, the stemness of MSCs gradually decays, and the cell aging and differentiation potential decreases gradually. Autophagy is a highly conserved cytological process that degrades the modified, excess, and deleterious cytoplasmic components in autophagosomes, which are then degraded by fusion with lysosomes. As the main intracellular degradation and recycling pathway, autophagy plays an active role in maintaining cell homeostasis, self-renewal and pluripotency. In this paper, the role of autophagy in self-renewal and maintenance of multidirectional differentiation potential of MSCs was reviewed, which laid a theoretical foundation and practical basis for the research and application of MSCs.

Prevalence of Intracranial Aneurysm in Patients with Aortopathy: A Systematic Review with Meta-Analyses / 대한뇌졸중학회지

Background@#and Purpose Patients with aortic disease might have an increased risk of intracranial aneurysm (IA). We conducted this research to assess the prevalence of IA in patients with aortopathy, considering the impact of gender, age, and cardiovascular risk factors. @*Methods@#We searched PubMed and Scopus from inception to August 2019 for epidemiological studies reporting the prevalence of IA in patients with aortopathy. Random-effect meta-analyses were performed to calculate the overall prevalence, and the effect of risk factors on the prevalence was also evaluated. Anatomical location of IAs in patients suffered from distinct aortic disease was extracted and further analyzed. @*Results@#Thirteen cross-sectional studies involving 4,041 participants were included in this systematic review. We reported an estimated prevalence of 12% (95% confidence interval [CI], 9% to 14%) of IA in patients with aortopathy. The pooled prevalence of IA in patients with bicuspid aortic valve, coarctation of the aorta, aortic aneurysm, and aortic dissection was 8% (95% CI, 6% to 10%), 10% (95% CI, 7% to 14%), 12% (95% CI, 9% to 15%), and 23% (95% CI, 12% to 34%), respectively. Gender (female) and smoking are risk factors related to an increased risk of IA. The anatomical distribution of IAs was heterogeneously between participants with different aortic disease. @*Conclusions@#According to current epidemiological evidence, the prevalence of IA in patients with aortic disease is quadrupled compared to that in the general population, which suggests that an early IA screening should be considered among patients with aortic disease for timely diagnosis and treatment of IA.

Treatment strategy selection of Marfan syndrome combined with thoracoabdominal aortic diseases / 中国胸心血管外科临床杂志

@#Objective    To summarize the surgical treatment plan and experience of patients with Marfan syndrome complicated with Stanford type B aortic dissection, and to explore the treatment strategy selection. Methods    A retrospective analysis was conducted on 27 patients with Marfan syndrome complicated with thoracoabdominal aortic diseases who were treated in the department of cardiovascular surgery of our hospital from January 2013 to June 2019, including 13 males and 14 females, with an average age of 32.2±8.6 years. According to the patients' conditions, 19 of them received single pump-assisted blood transfusion combined with total thoracoabdominal aortic replacement (TAAAR), and 8 received thoracic endovascular aortic repair (TEVAR) in critically ill and pregnant patients. The patients were followed up in the outpatient clinic, and the thoracoabdominal aortic CT angiography was reexamined at 3 months, 6 months, 12 months and annually. The outcome of surgery, the incidence of intermediate cardiovascular adverse events, defined as the reoperation due to aortic or cardiac diseases, and intermediate survival rate were studied. Results    All 27 patients successfully completed the operation, the operation time was 60-852 (395.10±222.60) min, the spinal cord ischemia time was 14-26 (19.33±3.44) min, and the abdominal viscera ischemia time was 16-23 (19.83±1.94) min. Eight patients of TEVAR were all operated in acute phase and 19 patients of TAAAR in chronic phase. Two early postoperative deaths occurred in TEVAR patients. One died of puerperal infection and multiple organ dysfunction after cesarean section at the same time. After TEVAR, type A dissection re-ocurred in one patient. The family member gave up the treatment, and the patient died of the dissection ruptured after cesarean section. During the average follow-up of 47.6±36.7 months, 1 patient died of cerebrovascular accident and 9 patients were reoperated for adverse cardiovascular events, including 4 in TEVAR and 5 in TAAAR. Conclusion    TAAAR is the first choice for the treatment of Marfan syndrome combined with thoracoabdominal aortic diseases. TEVAR is easy to operate, with a low incidence of early mortality and complications, but has the risk of internal leakage and avulsion, and a high reoperation rate in the middle stage, so it can be used for high-risk elderly patients not suitable for open surgery, or as a bridge therapy for emergency patients before open surgery.

Expression of tropomyosin 2 in aortic dissection tissue / 中华心血管病杂志

Objective: To investigate the expression pattern of tropomyosin 2(TPM2) in aorta of patients with aortic dissection and explore its clinical implication. Methods: Thirteen cases with acute type A aortic dissection(TAAD) diagnosed by transabdominal aortic angiography from 2015 in Tongji Hospital were included. During the operation, the aortic wall tissues of these patients were collected. Ten patients with heart transplantation were selected as control group, and normal aortic wall tissues were taken. The hematoxylin-eosin (HE) and Verhoeff's Van Gieson (EVG) staining were performed to observe the morphological changes of aorta. The mRNA expression level of TPM2 was measured by real-time fluorescent quantitative-PCR, and the protein levels of TPM2 were detected by Western blot and immunohistochemical staining. Image The J software was used to collect the optical density values of each point on the image, obtain the integrated optical density(IOD) value, and calculate the average density(%, IOD/area of the target distribution area). Results: HE and EVG staining revealed medial degeneration and broken elastic fiber in aorta of TAAD patients. The mRNA expression levels of TPM2 were significantly upregulated in aorta of TAAD patients as compared to the control group (P<0.05), so as the TPM2 protein expression levels ((9.73±1.20)% vs. (0.11±0.04)%, P<0.05). And TPM2 was mainly expressed in cytoplasm. Conclusion: The increased expression of TPM2 in TAAD patients hints that TPM2 might be involved in the pathogenesis of aortic dissection.

Association between brain glucose metabolism and cardiac dysfunction in patients with ischemic heart disease undergoing (18)F-FDG PET/CT imaging / 中华心血管病杂志

Objective: To evaluate the relationship between the brain glucose metabolism and left ventricular function parameters, and to explore the cerebral glucose metabolism reduction regions in patients with ischemic heart disease (IHD). Methods: A total of 110 consecutive IHD patients who underwent gated (99)Tc(m)-sestamibi (MIBI) SPECT/CT myocardial perfusion imaging, gated (18)F-fluorodeoxyglucose (FDG) PET/CT myocardial and brain glucose metabolic imaging within three days in Beijing Anzhen Hospital from April 2016 to October 2017, were enrolled in this study. Left ventricular functional parameters of SPECT/CT and PET/CT including end-diastolic volume (EDV), end-systolic volume (ESV) and left ventricular ejection fraction (LVEF) were analyzed by QGS software. Viable myocardium and myocardial infarction region were determined by 17-segment and 5 score system, and the ratio of viable myocardium and scar myocardium was calculated. According to the range of viable myocardium, the patients were divided into viable myocardium<10% group (n=44), viable myocardium 10%-<20% group (n=36) and viable myocardium≥20% group (n=30). Pearson correlation analysis was used to analyze the correlation between the range of viable myocardium and scar myocardium and the level of cerebral glucose metabolism. Brain glucose metabolism determined by the mean of standardized uptake value (SUV(mean)) was analyzed by SPM. The ratio of SUV(mean) in whole brain and SUV(mean) in cerebellum were calculated, namely taget/background ratio (TBR). Differences in cerebral glucose metabolism among various groups were analyzed by SPM. Results: There were 101 males, and age was (57±10) years in this cohort. The extent of viable myocardium and the extent of scar, LVEF evaluated by SPECT/CT and PET/CT were significantly correlated with TBR (r=0.280, r=-0.329, r=0.188, r=0.215 respectively,all P<0.05). TBR value was significantly lower in viable myocardium<10% group, compared with viable myocardium 10%-<20% group (1.25±0.97 vs. 1.32±0.17, P<0.05) and viable myocardium≥20% group (1.25±0.97 vs. 1.34±0.16, P<0.05). Furthermore, in comparison with viable myocardium≥20% group, the hypo-metabolic regions of viable myocardium<10% group were located in the precuneus, frontal lobe, postcentral gyrus, parietal lobe, temporal lobe, and so on. Conclusions: There is a correlation between impaired left ventricular function and brain glucose metabolism in IHD patients. In IHD patients with low myocardial viability, the level of glucose metabolism in the whole brain is decreased, especially in the brain functional areas related to cognitive function.

Application of balloon ocdusion for pernicious placenta previa and its side injuries / 中国实用妇科与产科杂志

As the rate of cesarean section increases,the incidence of pernicious placenta previa increases,and risk of complications also increases.At present,interventional therapy in obstetrics,especially postpartum hemorrhage,has a wide range of application,which may lead to corresponding complications such as puncture site damage,vascular injury,thrombosis,etc.This article focuses on the complications of prophylactic balloon occlusions.

3.0 T cardiac magnetic resonance intravoxel incoherent motion in evaluating microvascular dysfunction of hypertrophic cardiomyopathy patients / 第二军医大学学报

Objective To explore the value of 3.0 T cardiac magnetic resonance (CMR) intravoxel incoherent motion (IVIM) for evaluating microvascular dysfunction in hypertrophic cardiomyopathy (HCM) patients. Methods Twenty-six HCM patients and 12 healthy controls, who received CMR examination in the First Hospital of Lanzhou University from Apr. 2016 to Oct. 2017, were enrolled. All volunteers underwent short-axis cardiac cine and IVIM scans, and HCM patients underwent late gadolinium enhancement (LGE) scan. The fraction of fast apparent diffusion coefficient (f), fast apparent diffusion coefficient (ADCfast) and slow apparent diffusion coefficient (ADCslow) were measured using MITK-Diffusion post-processing software. End-diastolic thickness (EDTH) was measured on short-axis cine image. HCM patients were grouped according to the severity of the left ventricular hypertrophy and whether having LGE or not. The differences of f value, ADCfast and ADCslow were compared between HCM patients and healthy controls, non-hypertrophic segments and hypertrophic segments of HCM patients, LGE segments and non-LGE segments of HCM patients, and different hypertrophic subgroups in hypertrophic segment group. Spearman correlation analysis was performed to explore the correlation between IVIM parameters (f value, ADCfast and ADCslow) and EDTH in each segment. Results The ADCslow and ADCfast of the HCM patients were lower than those of the healthy controls (ADCslow: 0.003 [0.002, 0.005] mm2/s vs 0.004 [0.002, 0.007] mm2/s, ADCfast: 0.046 [0.025, 0.074] mm2/s vs 0.069 [0.052, 0.086] mm2/s), and the differences were significant (Z=-2.434 and -7.268, both P0.05). The ADCfast values of the non-hypertrophic segment group and the hypertrophic segment group in the HCM patients were 0.051 (0.029, 0.077) mm2/s and 0.027 (0.019, 0.052) mm2/s, respectively, which were both significantly lower than that of the healthy controls (Z=-5.505 and -8.144, both P0.05). The f value and ADCfast of the segmental myocardia with LGE were significantly lower than those without LGE (Z=-2.704 and -2.143, P=0.007 and 0.032). Spearman correlation analysis showed that EDTH was significantly negatively correlated with f value and ADCfast (r=-0.195 and -0.282, both P<0.01). Conclusion CMR IVIM technology can non-invasively and quantitatively reflect cardiac microvascular dysfunction in HCM patients. The severity of microvascular dysfunction is related to the severity of myocardial hypertrophy. Microvascular dysfunction is also present in non-hypertrophic and non-LGE myocardia.