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@#Objective To analyze the effectiveness of in vitro fenestration versus bypass surgery techniques in the treatment of type B aortic dissection involving the left subclavian artery by thoracic endovascular aortic repair (TEVAR). Methods Among the 53 patients with type B aortic dissection involving the left subclavian artery admitted to our center from January 2017 to October 2020, 23 underwent in vitro fenestration + TEVAR (a fenestration group with 18 males and 5 females aged 53.6±5.3 years), and 30 patients underwent left common carotid artery-left subclavian artery bypass + TEVAR (a bypass group with 24 males and 6 females aged 51.8±3.8 years). The effectiveness and safety between the two groups were compared. Results The surgical success rate was 100.0% in both groups. And there was no death within postoperative 30 days and during the follow-up. There was no endoleak immediately postoperatively and during 1-year follow-up in the two groups. The operation time and hospitalization expenses in the fenestration group was less or shorter than those in the bypass group (P<0.05). The reduction in blood pressure of the left upper limb in the fenestration group was greater than that in the bypass group (P<0.05). There was no symptom of left upper limb ischemia, dizziness or hoarseness in both groups. Conclusion The two methods of reconstruction of the left subclavian artery are safe and effective. In vitro fenestration can reduce surgical trauma and costs, and bypass surgery can provide better forward blood flow for the left subclavian artery.
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Objective To evaluate the value of color flow angio(CFA)in judging the status of thyroid function by analyzing the ultrasonographic features and quantitatively measuring the blood flow signals in patients with thyroid diffuse lesions.Methods Totally 100 patients with thyroid diffuse lesions diagnosed by ultrasonography between Oct.2016 and Jun.2017 were divided into three groups:hyperthyroidism group(n=30),hypothyroidism group(n=34)and euthyroid group(n=36).Moreover,30 cases of healthy volunteers were chosen as control group.The blood flow index including vascularity index(VI)value and Vascularity value of region of interest from all cases was measured through CFA imaging technique.The differences of VI and Vascularity from above 4 groups were compared using one-way analysis of variance.Comparison among groups was carried out by SNK-q test.The subjects' work curves(ROC curves)were plotted and analyzed using clinical diagnosis as gold standard.At the same time,the correlation between VI and thyroid function in hyperthyroid group and hypothyroidism group was analyzed through Pearson correlation coefficient.Results The levels of VI and Vascularity in hyperthyroid group,hypothyroid group,euthyroid group and control group were decreased gradually with significant differences between every two groups.VI : control vs hyperthyroid,hypothyroid and euthyroid group: q=13.67,7.00 and 3.93,all P＜0.01.Euthyroid vs hyperthyroidism and hypothyroid group: q=10.35,P＜0.01 and q=3.27,P＜0.05.Hyperthyroidism vs hypothyroid group: q=7.09,P＜0.01.Vascularity: control vs hyperthyroid,hypothyroid and euthyroid group: q=15.23,10.16 and 6.58,all P＜0.01.Euthyroid vs hyperthyroidism and hypothyroid group: q=9.33 and 3.83,both P＜0.01.Hyperthyroidism vs hypothyroid group: q=5.55,P＜0.01.The area under the curve of hyperthyroidism group and hypothyroidism group was 0.733,with 9.526%as the diagnostic cutoff point.The sensitivity and specificity were 70.0%and 76.5%respectively.The area under the curve of the abnormal group and normal group was 0.768,with 7.404%as the diagnostic cutoff point.The sensitivity and specificity were 62.5%and 88.9%,respectively.The VI value of hyperthyroidism group was positively correlated with FT3 and FT4(r=0.584,0.499,both P＜0.05),and negatively correlated with TSH(r=-0.447,P＜0.05).The VI value of hypothyroidism group was negatively correlated with FT4(r=-0.342,P＜0.05),and had no significant correlation with FT3 and TSH(r=0.121,-0.007,P＞0.05).Conclusion CFA imaging technology can quantitatively measure the blood flow signals of thyroid parenchyma and evaluate the thyroid function in patients with thyroid diffuse lesions.
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Objective To compare the results of mitral valve reconstruction and replacement as treatments for moderate to severe ischemic mitral regurgitation(IMR), and report the mid-term outcome. Methods From June 2002 to May 2008, 83 pa-tients with moderate IMR(35 cases) and severe IMR (48 cases) underwent coronary artery bypass grafting(CABG) combined with mitral valvuloplasty (MVP) (n = 43) or mitral valve replacement (MVR) (n = 40). There were 49 males and 34 females with a mean age of (59.3±7.5) years(51 -77years). The procedures of MVP included annuloplasty with a Dacron or autologous per-icardium ring in 21cases, commissural annuloplasty in 9, quadrangular resection of the posterior leaflet in 9 and using St. Jude mitral annuloplasty ring in 4. In the cases underwent MVR, 28 patients received mechanical prostheses and 12 received biopros-theses. Results 30-day mortality rate was 2.3% for MVP and 5.0% for MVR (P >0.05). The 30-day complication rate was similar for the 2 groups but mechanical ventilation time was longer for MVR patients. Mild MR ocurred in 6 patients with MVP (P <0.05). Sevonty-six patients were followed by outpatient department visit or telephone for (20.2 ± 4.9) months (3 - 60 months). During the follow-up period, 7 patients with MVP had mild insufficiency but free off etber complications. All the valve prothesis functioned well. However, 3 cases had thromboembolic complications and 7 late deaths were recorded in MVR group. Five-year complication-free survival rate was 90% for MVP group and 61% for MVR. Conclusion MVP resulted in excellent durability and provided significant mid-term survival benefit over MVR. MVP should be the first choice for patients with chronic IMR.
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The effects of stromal-derived factor 1 preconditioning (PC) on apoptosis of bone mesenchymal stem cells (BMSCs) treated with hypoxia plus serum deprivation were investigated. Bone mesenchymal stem cells were cultured with the whole marrow-adherence technique. RT-PCR and immunohistochemistry were used to detect the expression of CXCR4. BMSCs were incubated in medium for 24 h with 10 ng/mL and 100 ng/mL SDF-1 respectively, and then they were treated with hypoxia plus serum deprivation for 6 h. Apoptosis rate was determined by flow cytometry and TUNEL method. The results showed that BMSCs had CXCR4 expression. The number of apoptotic cells was significantly reduced in SDF-1 PC group as compared with the control group, and 100 ng/mL SDF-1 PC group had the lowest level of apoptosis. It was concluded that SDF-1 preconditioning suppresses the apoptosis of BMSCs treated with hypoxia plus serum deprivation.
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Objective To investigate the effects of preconditioning (PC) with stromal-derived factor 1 alpha (SDF-1) on the levels of apoptosis of bone marrow stromal cells (BMSC) treated with hypoxia plus serum deprivation, and observe the therapeutic efficacy of cellular transplant with BMSC preconditioned with SDF-1 in rats with acute myocardial infarction. Methods BMSC were cultured with the whole marrow-adherence way. RT-PCR and immunohistochemistry were used to determine the expression of CXCR4. BMSC were incubated in medium for 24 h with 10 and 100 μg/L SDF-1 respectively, then treated with hypoxia plus serum deprivation for 6 h. The levels of apoptosis were detected by flow cytometry and TUNEL method. Acute myocardial infarction (AMI) model was established in SD rats, and BMSC preconditioned or non-preconditioned with SDF-1 were transplanted into border zone around infarct area, then heart function was measured after two weeks by ultrasonography. Results BMSC exhibited the CXCR4 expression. The number of apoptotic cells was significantly reduced in SDF-1 PC group than in control group (P<0.05), and 100μg/L SDF-1 PC group had the lowest level of apoptosis. AMI model was established successfully. Two weeks after BMSC transplant, significant improvement in cardiac function was observed in 100 μg/L SDF-1 PC group as compared with the non-PC group (P<0.05). Conclusions PC with the chemokine SDF-1 suppresses the apoptosis of BMSC treated with hypoxia plus serum deprivation. SDF-1 PC is a novel approach for enhancing therapeutic efficacy of cellular transplant in rats with AML
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To investigate the effects of metallothionein (MT) on isolated rat heart, 16 Wistar rats were randomly divided into 2 groups. In control group (group C), distilled water was injected intraperitoneally and 24 h later isolated hearts were perfused with Langendorff and stored at 4 degrees C for 3 h with histidine-tryptophan-ketoglutarate (HTK) solutions, and then isolated hearts were perfused for 2 h by Langendorff. In experimental group (group E), 3.6% ZnSO(4) was injected intraperitoneally, 24 h later isolated hearts were perfused by Langendorff and stored at 4 degrees C for 3 h with HTK solutions, and then the isolated hearts were perfused for 2 h with Langendorff. MT content, the recovery of hemodynamics, myocardial water content (MWC), lactate dehydrogenase (LDH) and creatine kinase (CK) leakage, adenosine triphosphate (ATP) and malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, myocardial cell Ca(2+) content, Ca(2+)-ATPase activity of mitochondria ([Ca(2+)-ATPase](m)) and its Ca(2+) content ([Ca(2+)](m)), synthesizing ATP activity of mitochondria ([ATP](m)), and the ultrastructure of cells were examined. There were a significant increase in group E in hemodynamic recovery, ATP content, SOD activity, [Ca(2+)-ATPase](m) activity, [ATP](m) activity, and substantial reduction in MWC, LDH and CK leakage, MDA content, myocardial cell Ca(2+) content, [Ca(2+)](m) content, and the ultrastructural injury were obviously milder than that of group C. This study demonstrated that MT has protective effects on isolated rat heart.
Subject(s)
Cardiotonic Agents/pharmacology , Creatine Kinase/metabolism , L-Lactate Dehydrogenase/metabolism , Metallothionein/biosynthesis , Metallothionein/pharmacology , Myocardium/metabolism , Myocardium/ultrastructure , Random Allocation , Rats, Wistar , Superoxide Dismutase/metabolism , Zinc Sulfate/pharmacologyABSTRACT
To investigate the effects of metallothionein (MT) on isolated rat heart, 16 Wistar rats were randomly divided into 2 groups. In control group (group C), distilled water was injected intraperitoneally and 24 h later isolated hearts were perfused with Langendorff and stored at 4℃ for 3 h with histidine-tryptophan-ketoglutarate (HTK) solutions, and then isolated hearts were perfused for 2 h by Langendorff. In experimental group (group E), 3.6% ZnSO4 was injected intraperitoneally, 24 h later isolated hearts were perfused by Langendorff and stored at 4℃ for 3 h with HTK solutions, and then the isolated herts were perfused for 2 h with Langendorff. MT content, the recovery of hemodynamics, myocardial water content (MWC), lactate dehydrogenase (LDH) and creatine kinase (CK) leakage, adenosine triphosphate (ATP) and malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, myocardial cell Ca2+ content, Ca2+-ATPase activity of mitochondria ([Ca2+-ATPase]m) and its Ca2+ content ([Ca2+]m), synthesizing ATP activity of mitochondria ([ATP]m), and the ultrastructure of cells were examined. There were a significant increase in group E in hemodynamic recovery, ATP content, SOD activity, [Ca2+-ATPase]m activity, [ATP]m activity, and substantial reduction in MWC, LDH and CK leakage, MDA content, myocardial cell Ca2+ content, [Ca2+]m content,and the ultrastructural injury were obviously milder than that of group C. This study demonstrated that MT has protective effects on isolated rat heart.
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The mechanisms of rHu-EPO attenuating the apoptosis after myocardial infarction in rats were studied. Thirty-two rats were divided into three groups: sham operation group (Sham), acute myocardial infarction group (MI) and rHu-EPO-treated group (MI+ EPO). Acute myocardial infarction model was made by ligating the anterior descending coronary artery. rHu-EPO was administered i. p. in MI+EPO group at the dose of 5 000 IU/kg body weight immediately after the ligation. Each rat in MI+EPO group received the same dose of rHu-EPO daily the next 6 days. On the 14th day all rats underwent hemodynamic measurements and then killed. The samples were examined with HE stain, immunohistochemistry technique (bcl-2, bax) and TUNEL dyeing. The results showed that hemodynamic function in MI+ EPO group was much better than in MI group.The number of the cells positive for bax and TUNEL in MI+EPO group was less than that in MI group. The number of the cells positive for bcl-2 in MI+EPO group was more than that in MI group. These findings suggested that rHu-EPO could treat myocardial infarction by preventing apoptosis and attenuating post-infarction deterioration in hemodynamic function.
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The effects of L-carnitine, as an ingredient of cardioplegia solution, on cardiac function and cardiomyocyte apoptosis in patients undergoing heart valve replacement operation were investigated. Twenty-three cases undergoing heart valve replacement with cardiopulmonary bypass (CPB)were randomly allocated into two groups: L-carnitine group (n= 12, 12 g/L L-carnitine was put in the ST. Thomas cardioplegia) and control group (n= 11, identical to the L-carnitine group except that normal saline was administered instead of L-carnitine). Serum cardial troponin I (cTnI) levels,the left ventricular ejection fraction (LVEF), and cardiac index (CI) were measured perioperatively. A bit of myocardial tissue obtained from right atria was taken before CPB and by the end of intracardiac procedure to undergo electron microscopy examination and estimate apoptosis by terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL). From the end of CPB to 3 days after operation, the serum levels of cTnI in the L-carnitine group was significantly lower than that in the control group (P＜0.05). Heart color ultrasonogram showed that the CI index and LVEF at 7th day postoperatively in the L-carnitine group were significantly higher than in the control group (P＜0.05). Compared to the control group, L-carnitine significantly alleviated the morphologic changes of cardiac muscle cells (electron microscopy examination) and decreased the amounts of apoptotic cardiac muscle cells (TUNEL). Furthermore, the dosage of vasoactive drugs used after operation was significantly less in the L-carnitine group (P＜0.01). It was concluded that L-carnitine cardioplegia solution could improve cardiac function in patients undergoing heart valve replacement operation and alleviate CPB-mediated apoptosis of cardiac muscle cells.
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The mechanisms of rHu-EPO attenuating the apoptosis after myocardial infarction in rats were studied. Thirty-two rats were divided into three groups: sham operation group (Sham), acute myocardial infarction group (MI) and rHu-EPO-treated group (MI+ EPO). Acute myocardial infarction model was made by ligating the anterior descending coronary artery. rHu-EPO was administered i. p. in MI+EPO group at the dose of 5 000 IU/kg body weight immediately after the ligation. Each rat in MI+EPO group received the same dose of rHu-EPO daily the next 6 days. On the 14th day all rats underwent hemodynamic measurements and then killed. The samples were examined with HE stain, immunohistochemistry technique (bcl-2, bax) and TUNEL dyeing. The results showed that hemodynamic function in MI+ EPO group was much better than in MI group. The number of the cells positive for bax and TUNEL in MI+ EPO group was less than that in MI group. The number of the cells positive for bcl-2 in MI+ EPO group was more than that in MI group. These findings suggested that rHu-EPO could treat myocardial infarction by preventing apoptosis and attenuating post-infarction deterioration in hemodynamic function.
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To explore the relation between human heat shock protein 70 (hsp70) and TLR4 in human monocytes in vitro, human monocytes were stimulated with various concentrations of HSP70, and TNF-alpha production in supernatants was measured by ELISA. Pre-incubated with or without anti-TLR4 mAb, and stimulated with hsp70 (5.0 microg/ml), NF-kappaB p65 of human monocytes in different time points were detected by immunohistochemistry and monocyte surface expression of TLR4 was measured by flow cytometry. After the human monocytes were pre-incubated with various concentrations of anti-TLR4 and stimulated with hsp70 (5.0 microg/ml), TNF-alpha production in supernatants was measured. The results showed that hsp70 enhanced NF-kappaB activation, which was clearly inhibited by anti-TLR4, with the positive cell ratios being 67.44%, 39.17%, 31.56% and 28.05 %, respectively. TLR4 was rapidly down-regulated in the presence of hsp70. MFI of TLR4 on monocytes in different time points were 87.77 +/- 5.38, 78.16 +/- 6.01 and 45.17 +/- 4.97 (P<0.05), 26.98 +/- 5.83 (P<0.01), respectively. Moreover, hsp70-induced TNF-alpha production by human monocytes was inhibited by anti-TLR4. It is suggested that TLR4 is involved in the hsp70-mediated activation of innate immunity.
Subject(s)
Humans , HSP70 Heat-Shock Proteins , Metabolism , In Vitro Techniques , Monocytes , Metabolism , Toll-Like Receptor 4 , Metabolism , Transcription Factor RelA , Metabolism , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
Aim To investigate the effect of 3,3′,4′,5,7-pentamethylquercetin(PMQ) on angiotensin Ⅱ(AngⅡ) induced cardiac fibrosis.Methods Thirty rats were randomly assigned to the 5 groups,6 each:① control group: Saline was administrated daily via gavage for 21 days;② PMQ group: PMQ(50 mg?kg-1) was administrated daily via gavage for 21 days;③ AngⅡ group: AngⅡ(288 ?g?kg-1?d-1)was injected subcutaneously daily from the 15 th day;④ PMQ+ AngⅡ group: PMQ and AngⅡ were administrated as above;and ⑤ solvent+ AngⅡ group: Solvent and AngⅡ were administrated as above.After the rats were euthanized on the 22 nd day,the myocardial hydroxyproline content,SOD activity and MDA content were measured,and the expression of collagenⅠ,collagenⅢ,and NADPH oxidase subunits Nox2 and p47phox mRNA were determined by real time-PCR.Collagen volume fraction(CVF) Ⅰand Ⅲ were detected by immunohistochemistry,and CVFⅠ/CVFⅢ was calculated.Results PMQ reduced cardiac fibrosis in AngⅡ induced hypertension rats by decreasing the myocardial hydroxyproline content,downregulating the expression of collagenⅠand collagenⅢ mRNA,and decreasing CVFⅠ,CVFⅠ/CVFⅢ.PMQ exerted antioxidant function by increasing SOD activity and decreasing MDA content and reducing the mRNA expression of NADPH oxidase subunits Nox2 and p47phox.Conclusion PMQ could reduce cardiac fibrosis,which may result from the inhibition of the expression of NADPH oxidase.The results suggest that PMQ may represent a promising therapeutic approach for CHF treatment.
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Objective To study the diagnosis and treatment of pneumonia infected by Stenotrophomonas maltophilia (Sm) after open heart surgery.Methods The infections of Sm were proved by sputum culture.The data of risk factors?clinical feature and drug susceptibility were collected.Results Pneumonia of Sm occurred in 8 patients.They were often in poor conditions,in need of continuous mechanical ventilation and other inventions, and in use of extend-spectrum antibiotics.The infections of Sm hadn't special clinical manifestations. The isolates of Sm resistant to many antibiotics were usually found with other microorganisms.Conclusion It is important to pay more attention to pneumonia of Sm and to complete microbiological examinations in time,because patients after cardiosurgery are in great risk of the infection.
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Objective To explore the protective effects of Ulinastatin on lung transplantation. Methods Orthotopic pulmonary autograft transplantation models of 24 New Zealand rabbits were established and randomly divided into four groups: groupⅠ (control group,n=6), groupⅡ(given 6000U/kg UTI 30min before ischemia, n=6), groupⅢ(given 12000U/kg UTI 30min before ischemia, n=6), groupⅣ(given 12000U/kg UTI respectively 30min before ischemia and during reperfusion, n=6). Then blood samples were taken from left and right atrium respectively before ischemia, and 30min after reperfusion for white blood cells counting. lung tissue DMA content was measured and lung biopsy were performed respectively before ischemia and 2h after reperfusion. Results Compared with groupⅠ, in groups Ⅱ,Ⅲ and Ⅳ, the white cell ratio of right atrium/left atrium was significantly lower, the ratio of wet/dry lung tissue weight and lung tissue DMA content were lower, and the pathological lesion was less. Conclusion Ulinastatin has protective effects on rabbit lung transplantation.
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Objective To study the effects and mechanisms of Lovastatin preconditioning on cardiac myocyte apoptosis in acute ischemic and reperfused (I/R) rat hearts. Methods 24 Sprague-Dawley male rats were randomly divided into three groups: control group (C); Lovastatin group (L) treated with lovastatin 15 mg/kg once a day for two weeks; Lovastatin and L-NAME group (N) treated with the same dose of Lovastatin with L group and L-NAME 30 mg/kg once a day for two weeks. Rat heart models of I/R were established with coronary occlusion 30 mintues and reperfusion 30 mintues of the left anterior descending artery after two-week administration. Expression of Bcl-2,Bax protein and myocardium apoptosis were investigated in every group. Results There was no change in blood lipin, expression of Bax protein was increased (P
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AIM: To determine the combined effect of transmuscle laser revascularization (TMR) and endothelial progenitor cells(EPCs) treatment on ischemic hindlimb of nude rats.METHODS: Mononuclear cells (MNCs) isolated from human umbilical cord-blood (HUCB) by density gradient centrifugation were expanded in vitro. Immunocytochemistry and flow cytometry studies were performed. EPCs were labeled with 1, 1'- dioctadecyl-1 to 3, 3, 3', 3'- tetramethyl-indocarbocyanine perchlorate (DiI) before injected into the laser induced channels or ischemic region. Acute ischemic limb was created in 4 groups of nude rats by ligating right external iliac artery. All animals were divided randomly into the following four groups: TMR+EPCs group: local transplantation of EPCs into laser channels; TMR group: transmuscular channels were created without EPCs; EPCs group: EPCs were injected into ischemic hindlimb; control group: ischemic model without TMR or EPCs. All rats underwent femoral artery ultrasonic blood flow measurements of the ischemic and nonischemic limbs to obtained a flow ratio [femoral artery flow index (FAFI): right femoral artery flow /left femoral artery flow] at baseline (after ligating artery immediately) and 28 days postoperation, and then the samples of ischemic limb muscle underwent histochemical and immunohistologic analysis. RESULTS: The attached cells expressed endothelial cell (ECs) markers (KDR, CD34, CD31, AC133 and von Willebrand factor) and exhibited function similar to that of ECs judged by Ac-LDL incorporation. Flow cytometric analysis disclosed that AT cells were positive for CD34 (62%?7%) and AC133 (57.2%?9.8%) at day 7 of culture. 28 days after therapy, FAFI was significantly higher in the TMR +EPCs (0.66?0.09, P0.05). FAFI in the control group was unchanged and no difference was found between TMR group and control group. TMR+EPCs (5.66?0.77), TMR (4.96?0.31) as well as EPCs (4.68?0.44) treatment resulted in an increased number of capillaries in the treated regional area compared with control group (2.60?0.31, P