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Objective To investigate the cell composition and the transcriptional characteristics in microenvironments of hepatic tissues in mice at late stage of Echinococcus multilocularis infection at a single-cell level. Methods Peri-lesion and paired distal hepatic specimens were collected from two BALB/c mice (6 to 8 weeks old) infected with E. multilocularis for single-cell RNA sequencing. The Seurat package in the R software was employed for quality control of data, multi-sample integration and correction of batch effects, and uniform manifold approximation and projection (UMAP) algorithm was used for cell clustering. Cell types were annotated using classical marker genes. Differentially expressed genes were screened in each cell type through differential gene expression analysis, and the biological roles of cells were predicted using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Results A total of 43 710 cells from peri-lesion and distal hepatic tissues of E. multilocularis-infected mice were analyzed, and were classified into 11 cell types, including neutrophils, T cells, macrophages, granulocyte-monocyte progenitor cells, B cells, plasma cells, basophils, hepatic stellate cells, endothelial cells, hepatocytes, and platelets. T cells were the largest population of immune cells in the microenvironment of hepatic tissues, including five CD4+ T cell subsets, two CD8+ T cell subsets and phosphoantigen-reactive γδT cells. The proportions of CD4+ helper T cells and cytotoxic CD4+ T cells decreased and the proportion of T helper 2 (Th2) cells increased in peri-lesion tissues relative to distal hepatic tissues. In addition, the differentially expressed genes in Th2 cells were associated with negative regulation of the immune system, and the highly expressed genes in cytotoxic CD4+ T cells correlated with activation of the immune system. Conclusions Single-cell RNA sequencing deciphers the cell composition and distribution in microenvironments of hepatic tissues from mice infected with E. multilocularis, and the increased proportion of Th2 cells in peri-lesion hepatic tissues may be associated with formation of immunosuppressive microenvironments.
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Alveolar echinococcosis (AE) caused by infection with E. multilocularis metacestode, represents one of the most fatal helminthic diseases. AE is principally manifested with infiltrative, proliferating hepatic mass, resembling primary hepatocellular carcinoma. Sometimes metastatic lesions are found in nearby or remote tissue. AE diagnosis largely depends on imaging studies, but atypical findings of imaging features frequently require differential diagnosis from other hepatic lesions. Serological tests may provide further evidence, while obtaining reliable AE materials is not easy. In this study, alternative antigens, specific to AE were identified by analyzing E. granulosus protoscolex proteins. An immunoblot analysis of E. granulosus protoscolex showed that a group of low-molecular-weight proteins in the range from 14 kDa to 16 kDa exhibited a sensitive and specific immune response to AE patient sera. Partial purification and proteomic analysis indicated that this protein group contained myosin, tubulin polymerization promoting protein, fatty-acid binding protein, uncharacterized DM9, heat shock protein 90 cochaperone tebp P-23, and antigen S. When the serological applicability of recombinant forms of these proteins was assessed using enzyme-linked immunosorbent assay, DM9 protein (rEgDM9) showed 90.1% sensitivity (73/81 sera tested) and 94.5% specificity (172/181 sera tested), respectively. rEgDM9 showed weak cross-reactions with patient sera from the transitional and chronic stages of cystic echinococcosis (3 to 5 stages). rEgDM9 would serve as a useful alternative antigen for serodiagnosis of both early- and advanced-stage AE cases.
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Objective To investigate the postoperative complications of ex vivo liver resection combined with autologous liver transplantation in the treatment of end-stage hepatic alveolar echinococcosis at high altitude and related prevention and treatment strategies. Methods Surgical data and follow-up data were collected from 11 patients with end-stage hepatic alveolar echinococcosis who underwent autologous liver transplantation in Qinghai People's Hospital from January 2013 to March 2019, and intraoperative and postoperative conditions were analyzed. Results All 11 patients underwent autologous liver transplantation successfully, without intraoperative death, among whom 2(18.18%) underwent hemi-extracorporeal hepatectomy and 9 (81.82%) underwent total extracorporeal hepatectomy. For the reconstruction of the retrohepatic inferior vena cava, 2 patients (18.18%) underwent reconstruction with the autologous great saphenous vein, 4 patients (36.36%) underwent reconstruction with artificial vessels, and the autologous retrohepatic inferior vena cava was preserved in 5 patients (45.45%). For biliary reconstruction, 8 patients (72.73%) underwent choledochoenterostomy and 3 (27.27%) underwent choledochocholedochostomy. The main postoperative complications of the 11 patients included bleeding in 2 patients (18.18%), bile leakage and abdominal infection in 4 patients (36.36%), bilioenteric anastomotic stenosis in 1 patient (9.09%), thrombus in 2 patients (18.18%), pulmonary infection and pleural effusion in 2 patients (18.18%), and echinococcosis recurrence in 1 patient (9.09%). Of all 11 patients, 2 (18.18%) died during the perioperative period, and the other 9 patients (81.82%) were improved and discharged. Conclusion Bleeding, biliary complications, and infection are the main causes of death in patients undergoing autologous liver transplantation at high altitude. An accurate understanding of surgical indication, careful multidisciplinary evaluation before surgery, superb operation during surgery, standardized surgical procedures, and fine perioperative management are the key to reducing perioperative mortality, avoiding and reducing postoperative complications, and achieving good long-term survival in patients undergoing autologous liver transplantation.
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Objective@#To investigate the safety and efficacy of transcatheter closure of ruptured sinus of Valsava aneurysm(RSVA).@*Methods@#A total of 33 RSVA patients underwent transcatheter closure from January 2006 to March 2017 in our hospital were included in this retrospective study. The RSVA was diagnosed by echocardiography.Different type of occluders were applied for transcatheter closure based on the aortography results. All the patients were followed up after the procedure.@*Results@#The patients were (37.6±12.1) years old,and the male patients accounted for 78.8%(26 cases).RSVA from right coronary sinus was found in 25 patients,and draining chamber was right atrium in 13 cases, right ventricle in 12 cases. RSVA from noncoronary sinus was diagnosed in 8 patients,and the draining chamber was right atrium. Aortography defined the narrowest diameter at the rupture site was (6.4±1.7)mm. The ratio of Qp/Qs was 2.2±0.5,and the mean pressure of pulmonary artery was 24.0(21.2,33.7)mmHg(1 mmHg=0.133 kPa). One patient developed serious occluder related aortic regurgitation and underwent surgery, transcatheter closure was successfully performed in 32 patients. The success rate of transcatheter closure was 97.0%. Two types of device were used in the study including small-waist double-disk ventricular septal defect(VSD) occluders in 20 cases and patent ductus arteriosus(PDA) occluders in 12 cases. During a median follow-up of 73.5(28.3,89.5) months, there were no infective endocarditis, residual shunt, thrombosis, device displacement,serious aortic regurgitation, serious arrhythmia or death.At the last follow-up, the left atrial diameter((37.4±6.5) mm vs. (41.5±5.3)mm,P<0.01),right atrial diameter((42.4±3.0) mm vs. (48.5±6.0)mm,P<0.01), right ventricular diameter((22.2±3.8) mm vs. (27.7±7.2)mm,P<0.01) and left ventricular end-diastolic diameter((51.3±4.9) mm vs.(55.0±4.3)mm,P<0.01)measured by echocardiography were all smaller than pre-procedural level.@*Conclusion@#Transcatheter closure of RVSA is a safe and effective strategy and associated with a good long-term outcome.
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Objective To understand the situation of prevention and control knowledge of echinococcosis in people,and analyze the influencing factors of prevention and control knowledge of echinococcosis,so as to provide efficient and targeted evidence for taking intervention measures against echinococcosis.Methods All the districts (counties) in agricultural and pastoral area-based cities (zhous) in Qinghai Province were selected,3 townships were selected in each district (county),and 100 residents were randomly selected in each township via the stratified random sampling method.In each district (county),students of Grade Four or higher were randomly selected via the multi-stage stratified cluster sampling method,they were all investigated through a questionnaire survey about echinococcosis in Qinghai Province in 2012-2014.The influencing factors of prevention and control knowledge of echinococcosis were analyzed using Logistic regression analysis,including age,gender and district.Results Totally 11 959 residents and 23 600 students were selected and surveyed,and the qualified rate of residents and students in prevention and control knowledge of echinococcosis was 62.4％ (7 464 cases) and 66.0％(15 566 cases),respectively,and the difference was statistically significant (x2 =43.695,P ＜ 0.01).The aware rate of echinococcosis knowledge between residents and students was significantly different (x2 =113.680,60.712,1 204.943,273.296,P ＜ 0.01) except the question "washing hands before eating".Logisitic regression analysis showed that the main factors influencing the qualified rate of echinococcosis of residents were age (OR =0.989,95％CI:0.986-0.991) and district (compared with Huangnan Zhou,Haidong City OR =3.478,95％CI:2.978-4.063;Haixi Zhou OR =10.284,95％CI:8.578-12.330;Hainan Zhou OR =7.750,95％CI:6.468-9.286;Haibei Zhou OR =11.056,95％CI:9.089-13.448;Guoluo Zhou OR =7.309,95％CI:6.132-8.713;and Yushu Zhou OR =0.319,95％CI:0.258-0.393);and the main factors influencing the qualified rate of echinococcosis of students were age (OR =0.981,95％CI:0.964-0.998),gender (OR =1.103,95％CI:1.040-1.170) and district (compared with Huangnan Zhou,Xi'ning City OR =5.428,95％CI:4.823-6.109;Haidong City OR =3.860,95％CI:3.437-4.334;Haixi Zhou OR =6.557,95％CI:5.750-7.477;Hainan Zhou OR =2.757,95％CI:2.444-3.112;Haibei Zhou OR =9.968,95％CI:8.498-11.692;Guoluo Zhou OR =4.306,95％CI:3.653-5.075;and Yushu Zhou OR =0.616,95％CI:0.545-0.695).Conclusions The general aware rate of echinococcosis knowledge in people is not high in Qinghai Province.The main factors that have influenced the qualified rate of echinococcosis knowledge of residents are age and district,and of students are age,gender and district.It is necessary to implement the targeted intervention measures to improve mastering level of prevention and control knowledge of echinococcosis of people in Qinghai Province.
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Objective:To investigate the ethical cognition of clinical research among medical staff working at different grades of hospitals in Qinghai Province and thus to provide references for the construction of medical ethics organization in hospitals.Methods:A questionnaire survey was conducted to investigate the knowledge of hospital ethics among medical staff from 11 hospitals of different grades in Qinghai Province.Results:Among the 611 med-ical staff,329 (53.8％) received medical ethics education in continuing education and 378 (61.9％) knew that the ethics committee had been set up in their hospitals.The medical staff in different grades of hospitals showed a statistical difference (P ＜ 0.05) in the medical behavior cognition of ethical laws and regulations and the need for ethical review.Conclusion:Hospitals in Qinghai province need to strengthen the training of medical ethics knowl-edge,improve medical staff's awareness of ethics committee,and promote the efficient operation of hospital ethics.
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Objective To detect the levels of carotid intima-media thickness(CAIMT),serum homocysteine(HCY),malondialdehyde(MDA) and superoxide dismutase(SOD) activity,in order to investigate the correlation between carotid atherosclerosis(CAS) and serum HCY and oxidative stress in essential hypertension(EH) patients.Methods 50 patients with EH and 266 healthy controls were enrolled in this study.The color Doppler ultrasonography was used to detect CAIMT,and circulating enzyme method was used to detect serum HCY,and MDA levels were detected by TBA and SOD activity was detected by colorimetric assay of and the results of the examination were statistically analyzed.Results The incidence rate of CAS in EH patients was 62.8%(167/266),associated with age,disease and related course,and there was no significant difference in gender.In EH concurrent CAS group,the serum HCY level,MDA level and SOD activity were (28.06±6.94)μmol/L,(13.10±2.75)μmol/L and (69.73±6.51)U/mL,respectively,which of the control group were (11.74±3.62)μmol/L,(4.71±1.18)μmol/L and (136.07±10.16)U/mL,respectively,the levels of serum HCY and MDA in EH complicated CAS group were significantly higher than those in the control group(t=7.118,6.326,all P<0.05),and the activity of SOD was significantly decreased.The serum HCY level was positively correlated with MDA level(r=0.493,t=9.207,P<0.05),and negatively correlated with serum SOD activity(r=-0.562,t=11.040,P<0.05).Conclusion EH patients have high levels of HCY,MDA and SOD activity of low levels.HCY level is significantly increased and oxidative stress is increased in CAS patients.Oxidative stress is associated with serum HCY level.
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Objective To understand the epidemic status of alveolar echinococcosis in Tibetan children in south Qinghai Province. Methods The imageology and serology methods were applied to investigate the epidemic status of alveolar echinococ?cosis of elementary school students in Yushu and Guoluo prefectures. Results Totally 19 629 children were investigated by the portable B ultrasound and 221 children were diagnosed as alveolar echinococcosis with the morbidity of 1.13%. Totally 9 888 were investigated by the indirect ELISA,and the positive rate of serum tests was 12.59%(190/9 888). The total morbidity of al?veolar echinococcosis of children in Yushu Prefecture was 0.42%(31/7 454)and it was 1.57%(190/12 175)in Guoluo Prefec?ture and there was a significant difference between them(χ2=53.42,P0.05). The total morbidity of alveolar echinococcosis of children in different age groups was from 1.00%to 1.13%,and there was no significant difference among the age groups(χ2=2.73,P>0.05). The P1a type,P1b type and P2 type accounted for 67.76%(145/214),10.75%(23/214)and 16.36%(35/214)respectively among the alveolar echinococcosis patients. The diameters of nidus of 87.38%(187/214)patients were less than 5 cm,and 2.80%(6/214)were more than 10 cm. Conclusions The epidemic status of alveolar echinococcosis of Tibetan children in south Qinghai Province is serious,but most of the patients were at early stage of the disease. The screening work of al?veolar echinococcosis should be strengthened in Tibetan children,so as to perform the early diagnosis and treatment.
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Echinococcosis is a severe zoonosis parasitic disease and mainly caused by the larvae of Echinococcus granulosus and E. multilocularis. Because of the limitation of operation level,such as recurrence and death,the drug treatment is still the most important method in our country. Meanwhile,the annual number of drug treatments is far greater than surgical treatments. Drugs play a significant role in the preoperative reduction of lesions,reducing pain,extending the life of patients .This article re-views the status of animals treatment and clinical treatment of echinococcosis treated by the benzimidazole drugs and their new formulations,provides the basis for exploring the development direction of anti-echinococcosis drug treatment research.
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Objective To investigate the risk factors and early diagnosis of the severe thrombocytopenia complicating transcatheter ccclusion of patent ductus arteriosus ( PDA ) . Methods Between February, 2011 and May, 2015, 80 patients with patent ductus arteriosus underwent percutaneous intervention occlusion were studied. Results Average age were ( 17. 5 ± 17. 1 ) years, 63 were females (78. 8%), mean weight were (35. 6 ± 20. 2)kg (from 6. 0 to 75. 0 kg), mean body surface area (BSA) were (1. 09 ±0. 44) m2(from 0. 32 to 1. 91 m2). A bolus of heparin calcium (80 U/kg) was administered by intravenous injection. The mean diameters of patent ductus arteriosus were 4 mm (from 2 to 18 mm), and the mean diameters of occluders were 12 mm (from 6 to 30 mm). 14 patients were found to have severe thrombocytopenia (PLT count﹤100 × 109/L). The reduction rate of platelet in 12 of 14 patients was more than 19%. The diameters of all occluders were equal to or more than 14 mm, the mean diameters of patent ductus arteriosus were 10 mm ( from 6 to 18 mm) and the mean diameters of occluders were 18 mm ( from 14 to 30 mm). All the 14 patients started to present progressive decrease in PLT count since the second day post procedure. Taking the selected occluder diameter greater than 14 mm as cut-off points in diagnosis of severe thrombocytopenia, the sensitivity was 100%, specificity was 68%, the positive predictive value was 40%, and the negative predictive value was 100%. Combined with the postprocedural second day complete blood count analysis and the platelet count decreased by 10% as cut-off points in diagnosis of severe thrombocytopenia patients, the sensitivity was 93%, specificity was 67%, the positive predictive value was 65%, the negative predictive value was 93% . If taking the platelet count decreased by 7% on second day as cut-off points in diagnosis of severe thrombocytopenia patients, the sensitivity was 100%, specificity was 57%, the positive predictive value was 61%, the negative predictive value was 100% . Logistic regression analysis discovered that risk factors of severe thrombocytopenia after PDA are procedural platelet count and occluder diameter. Conclusions The risk factors of severe thrombocytopenia complicating transcatheter ccclusion of patent ductus arteriosus were the procedural reduction of platelet count and big occluder diameter. Patients with PDA who were inplanted with occluders equal to or bigger than 14 mm should retest the numbers of platelet on the second day after procedure and retest on third day if the numbers reduce on the second day, which may help in the prediction of severe thrombocytopenia.
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Objective To understand the situation of prevention and control knowledge of echinococcosis in students in Qin?ghai Province,so as to provide an evidence for effective prevention and control of echinococcosis. Methods The students of Grade Four or above were randomly selected with the multi?stage stratified cluster sampling method and investigated with the questionnaire about echinococcosis in Qinghai Province. Results Totally 23 600 students were selected and surveyed,with the pass rate of 66.0%(15 566 cases). The pass rates of the male and female students were 65.1%(7 947 cases)and 66.9%(7 619 cases)respectively,and the difference was significant(χ2=8.454,P<0.01). The difference of pass rates among different dis?tricts of Qinghai Province was statistically significant(χ2=3 848.619,P<0.01). Conclusion The general aware rate of echino?coccosis knowledge in students is not high in Qinghai Province,and therefore,it is necessary to enhance the health education, especially for students in pasturing areas.
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Objective To evaluate clinical effectiveness of transcatheter closure of atrial septal defects ( ASD) with severe pulmonary arterial hyperyension ( sPAH) by fenestrated Amplatzer septal occluders ( ASO) . Methods From September 2002 to April 2013, 17 patients of ASD with sPAH received transcatheter ASD closure using fenestrated occluders. Aged from 18 - 72 years, the diameters of ASDs were 18 - 33 mm. The systolic pulmonary arterial hypertension measured by transthoracic echocardiogram were 80 - 112 (96. 9 ± 8. 9) mmHg. The follow-up study included electrocardiography, chest radiography and echocardiography. All the patients were followed up for 1. 5 - 12 ( mean 6. 4 ± 0. 7) years. Results Systolic pulmonary arterial pressure (sPAP) of 60 - 108 (88. 7 ± 11. 7) mmHg and mean pulmonary artery pressure ( mPAP) of 29. 3 - 60 (51. 0 ± 8. 1) mmHg were measured by cardiac catheterization before ASD closure. Qp/ Qs was 1. 50 - 2. 44 (1. 8 ± 0. 31) and the pulmonary vascular resistance was 3. 1 - 9. 7 (5. 6 ± 1. 5) wood units (wu) . Immediately after the implantation of fenestrated occluders, sPAP decreased to 56 - 99 (70 ± 11. 5) mmHg and mPAP to 27 - 51. 7 (41. 1 ± 7. 1) mmHg. On the 3 d, 3 m and 6 m follow-up exam, RVEDd decreased ( P ﹤ 0. 05), while LVEDd, LVEDV and LVEF increased significantly (P ﹤ 0. 05) . sPAP decreased significantly after transcatheter closure at 3 m and 6 m as compared to pre-closure levels (both P ﹤ 0. 05) . The mean sPAP in long term follow up was (60. 2 ± 13. 3) mmHg which had significant decrease compared to pre-closure level ( P ﹤ 0. 01), but no significant difference found when compared to 6 m follow up (P ﹥ 0. 05). Conclusions ASD closure with fenestrated ASO is a satisfactory approach for ASD with severe PAH.
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<p><b>OBJECTIVE</b>To identify the epidemiology and etiology characteristics of Tibetan sheep plague in Qinghai plateau.</p><p><b>METHODS</b>The background materials of Qinghai Tibetan sheep plague found during 1975 to 2009 were summarized, the regional, time and interpersonal distribution, infection routes, ecological factors for the spread were used to analyze; followed by choosing 14 Yersinia pestis strains isolated from such sheep for biochemical test, toxicity test, virulence factors identification, plasmid analysis, and DFR genotype.</p><p><b>RESULTS</b>From 1975 to 2009, 14 Yersinia pestis strains were isolated from Tibetan sheep in Qinghai province. Tibetan sheep, as the infection source, had caused 10 cases of human plague, 25 plague patients, and 13 cases of death. All of the initial cases were infected due to eating Tibetan sheep died of plague; followed by cases due to contact of plague patients, while all the initial cases were bubonic plague. Cases of bubonic plague developed into secondary pneumonic plague and septicemia plague were most popular and with high mortality. Most of the Tibetan sheep plague and human plague occurred in Gannan ecological zone in southern Gansu province, which was closely related to its unique ecological and geographical landscape. Tibetan sheep plague coincided with human plague caused by Tibetan sheep, especially noteworthy was that November (a time for marmots to start their dormancy) witnesses the number of Yersinia pestis strains isolated from Tibetan sheep and human plague cases caused by Tibetan sheep. This constituted the underlying cause that the epidemic time of Tibetan sheep plague lags obviously behind that of the Marmot plague. It was confirmed in the study that all the 14 strains were of Qinghai-Tibet Plateau ecotype, with virulence factors evaluation and toxicity test demonstrating strains as velogenic. As found in the (Different Region) DFR genotyping, the strains isolated from Yushu county and Zhiduo county were genomovar 5, the two strain isolated from Nangqian county were genomovar 5 and genomovar 7, while those isolated Delingha region were genomovar 8.</p><p><b>CONCLUSION</b>Tibetan sheep were vulnerable to plague infection, hence causing human plague as the infectious source. The Yersinia pestis strains isolated from Tibetan sheep plague carried pathogen characteristics of Qinghai-Tibet plateau plague, developing many new characteristics of such plague.</p>
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Animals , Humans , Ecology , Genotype , Geography , Marmota , Plague , Epidemiology , Plasmids , Sheep , Microbiology , Tibet , Epidemiology , Yersinia pestisABSTRACT
Objective:To observe influence of simvastatin on differentiation ,proliferation ,migration and adhesion of marrow-derived smooth muscle progenitor cells (SPCs) and screen coated eluting stent drugs of new generation . Methods :The mononuclear cells (MNCs) were isolated from rat marrow by density gradient centrifugation method , and then plated on fibronectin-coated culture dishes ,after culture 8d ,marrow-derived SPCs were identified by α-smooth muscle actin (α-SMA) immunofluorescent staining and counted under inverted fluorescence microscope .The MNCs and adhesion cells were treated with simvastatin (0.01~10 μmol/L) respectively for 8 d and 24h .SPCs pro-liferation ,migration and adhesion were observed by Tritium thymidine (3 H-TdR) intake method ,modified Boyden chamber assay and adhesion assay .Results:Compared with control group (no simvastatin intervention ) ,0.01μmol/L simvastatin significantly inhibited the MNCs differentiation towards SPCs [ (85 ± 4) vs .(79 ± 5)] ,proliferation [ (4070 ± 184) vs .(3833 ± 126)] ,migration [ (44 ± 3) vs .(39 ± 3)] and adhesion of SPCs [ (59 ± 5) vs .(52 ± 4)] , P<0.05 all ,and number of SPCs significantly reduced along with simvastatin concentration increased (P<0.01) . Conclusion:Simvastatin could inhibit the differentiation ,proliferation ,migration and adhesion of marrow-derived smooth muscle progenitor cells .
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Objective to investigate the relationship between the size of ostium secondary atrial septal defect (ASD) and the pulmonary arterial pressure (PAP) in children less than 5 years of age. Methods During the period from April 2000 to January 2011, a total of 189 child patients less than 5 years of age with ostium secondary ASD were admitted to General Hospital of Shenyang Military Command. Under general anaesthesia with ketamine cardiac catheterization was performed, PAP was measured, and percutaneous occlusion of ASD was carried out in all patients. The clinical indexes, including sex, age, body height, body weight, body surface area, diameter of ASD defect, heart- to- thorax ratio, the systolic, diastolic and mean pressure of the pulmonary artery, etc. were determined. The patients were followed up for one year and postoperative cardiac ultrasonography was performed to check the results. The patients were divided into groups according to the defect size. Results The 189 patients consisted of 77 males and 112 females with a male-to-female ratio of 1 ∶ 1.5. The mean age was (4.1 ± 0.9) years old, ranging from 2 to 5 years old. The mean weight was (17.2 ± 3.6) kg, ranging from 10.0 to 30.0 kg. The mean height was (104.9 ± 9.2) cm, ranging from 77 to 135 cm. The mean body surface area (BSA) was (0.71 ± 0.10) m2, ranging from 0.46 to 1.02 m2. The mean size of ASD was (12.6 ± 4.8) mm, ranging from 5 to 29 mm. The mean size of ASD, which was modified by BSA, was (18.0 ± 7.0) mm/m2, ranging from 5.3 to 38.9 mm/m2. The mean systolic PAP was (41.1 ± 8.9) mmHg with a range of 15 - 67 mmHg. The mean diastolic PAP was (16.8 ± 6.5) mmHg with a range of 3 - 45 mmHg. The mean PAP was (24.9 ± 6.7) mmHg with a range of 12 - 48 mmHg. One hundred and fifty- nine patients (89.4%) had pulmonary arterial hypertension (PAH) which was determined by right heart catheterization, but no patient showed PAH when the pulmonary arterial pressure was measured by echocardiography before the procedure as well as 1, 3, 6, 12 months after the procedure. No definite correlation existed between the size of ASD and the pulmonary artery pressure (P > 0.05). Conclusion Pulmonary artery pressure measured by right heart catheterization has no definite correlation with the size of ASD in children less than 5 years of age. Pulmonary artery pressure obtained from right heart catheterization is higher than that determined by cardiac ultrasonography, which may be caused by the effect of ketamine when general anaesthesia is used in performing right heart catheterization.
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BACKGROUND:Previous studies have shown that, curcumin plays a crucial role on the inflammation in cells caused by oxidative stress. OBJECTIVE:To elucidate the biological effect and mechanism of curcumin in the pathological inflammation reaction in vascular endothelial cells. METHODHuman vascular endothelial cells were taken as the cellmodels. Tumor necrosis factor (10μg/L) treatment was used to induce the inflammation of cells. Curcumin (0, 50, 100μg/L) treatment for 24 hours was used to intervene the cells. The intercellular hyperpermeability of the vascular endothelial cellmonolayers was examined by HRP-conjugated bovine serum albumin, and intercellular filamentous actin stress fiber formation was examined by rhodamin-phal oidin staining. ELISA assay was used to detect the secretion of interleukin-1βin vascular endothelial cells. Immunoflurensece staining was applied to investigate the expression and translocalization of nuclear factor-κB. Western blot analysis reflected the expression of NRLP3 and caspase-1. RESULTS AND CONCLUSION:HRP-bovine serum albumin detection results showed that, curcumin inhibited the intercellular hyperpermeability of the vascular endothelial cellmonolayers and the formation of robust intercellular filamentous actin in a dose-dependent manner. ELISA assay showed that curcumin protected vascular endothelial cells against tumor necrotic factor-α-induced interleukin-1βsecretion in a dose-dependent manner. Meanwhile, the nuclear factor-κB expression was increased and the translocation of nuclear factor-κB into the nuclei was obviously seen in vascular endothelial cells induced by tumor necrosis factor-α, but the translocation was not changed in 100μg/L curcumin-treated cells. Furthermore, western blot analysis revealed that the expression of NRLP3 and caspase-1 were inhibited in curcumin-treated cells. Curcumin can inhibit tumor necrosis factor-α-induced activation of inflammasome and secretion of interleukin-1βin vascular endothelial cells by down-regulating the expression of nuclear factor-κB, thus prevent pathological inflammatory injury in cells.
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Objective: To study the expressions of endothelin-1 in primary cultured atrial myocyte model at early stages of atrial fibrillation by rapid pacing. Methods: The primary rat atrial myocytes were cultured, in which a rapid paced cell model was established. The polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA) were applied to detect the messenger ribonucleic acid (mRNA) expression and secretion of endothelin-1 on 3 h, 6 h, 12 h and 24 h after rapid pacing. Results: Compared with before pacing, there were continuous and significant increase in expression of ET-1mRNA [ (0.31±0.02) vs. (0.52±0.07), (0.62±0.09), (0.75±0.05) ] and secretion of endothelin-1 [ (3.4±0.8) ng/L vs. (6.0±1.4) ng/L, (8.3±1.5) ng/L, (11.2±2.1) ng/L] on 6 h, 12 h and 24 h after rapid pacing, P<0.01 all. Conclusion Expressions of ET-1mRNA and secretion of endothelin-1 significantly increase depend on time in early rapid pacing atrial myocytes, indicating that endothelin-1 participates in atrial pathological remodeling during atrial fibrillation.
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Objective To explore the value of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in diagnosing adult multiple atrial septal defect (MASD). Methods Thirty adult patients with MASD were examined with TTE, 25 patients were examined also with TEE, 26 patients were examined with cardiac catheterization as well. Transcatheter closure of MASD was performed in 20 patients and succeeded in 18, while open-chest operation was performed in 4 patients. Results Foramen secundum atrial septal defect was diagnosed with both TTE and TEE with an accuracy rate of 60.00% (18/30) and 96.00% (24/25), respectively. The main color Doppler flow imaging (CDFI) feature of adult MASD was multiple colorful left-to-right shunt signals through the atrial septal designated, i.e. colander sign of CDFI. Conclusion TTE has some difficulties and TEE has specific value in diagnosing adult MASD. TTE can be used before open-chest operation. TEE is necessary before transcatheter occlusion to make sure of the amount and location of atrial septal defect.
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Objective To probe into the imaging characteristics and regularity of color Doppler echocardiography(CDE) in congenital coronary artery fistula(CAF) in adults. Methods CDE was used to examine 31 adult patients with CAF and the imaging characteristics and regularity were observed. Angiocardiography was performed in 26 cases. Seven of the 31 cases were treated interventionally and 24 of them surgically. Results Of the 31 patients, 29 were correctly diagnosed according to the CDE characteristics (diagnosis accuracy was 93.5%) and all the complicated anomalies were correctly diagnosed. artery is the origin and whichever heart chamber is the entry site of the fistula, the left atrium and the left showed abnormal blood flow signals in the heart chamber into which the fistula drained and in pulmonary drained into the right ventricle was more common than that into the right atrium, the left atrium, the left or the pulmonary artery was easily misdiagnosed because left ventricular systolic pressure was equal to aortic pressure which made the abnormal blood flow in CDFI indistinct. Conclusions CDE showed obvious imaging characteristics and regularity for CAF in adults and has specific value for the diagnosis of this disease. But CAF that drained into the left ventricle or the pulmonary artery is easily misdiagnosed.
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Objective To probe into the color Doppler echocardiographic characteristics of bilocular heart (BH) and associated malformations. Methods Twenty patients of BH were examined with color Doppler echocardiography (CDE) and the characteristics were observed. All the CDE results were compared with angiocardiography and 14 were confirmed by operation. Results Nineteen cases were properly diagnosed based on the CDE characteristics,1 case were misdiagnosed as mitral atresia. CDE characteristics of BH were obvious:① Apical four-chamber view of two-dimensional echocardiography (2DE) showed total echo dropout in both the interatrial septum and the interventricular septum and disappearance of the intracardiac "cross". The common atrioventricular valve closed during systole and appeared as figure "8", named 2DE "8" sign. During diastole, the common atrioventricular valve opened to a common ventricle. ② Color Doppler flow imaging (CDFI) showed common intra-atrial flow signal entereda common ventricle through common atrioventricular valve during diastole in all patients and colorful reflux through common atrioventricular valve during systole in 15 cases. ③ Among the 20 eases, 16 of the common atria were situs solitus,4 were situs inversus; 10 of the common ventricles were type A,2 were type B and 8 were type C. According to the spatial relationship of the great arteries,there were 4 type Ⅰ ,7 type Ⅱ and 9 type Ⅲ.There were 18 pulmonary stenosis and 2 pulmonary hypertension. ④ In the presence of pulmonary stenosis, CDFI showed colorful shunt signals through pulmonary artery during systole. Conclusions BH and associated malformations have obvious echocardiographic characteristics. CDE has a specific value in diagnosing BH and associated malformations.