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Objective:To explore the effect of miR-7 on the formation of abdominal aortic aneurysm by up-regulating the expression of ERK and MMP-9 proteins.Methods:Download the miRNAs expression profile chip data from the GEO database, the differentially expressed miRNAs were screened out by GEO2R and the correlation between target genes and ERK genes was analyzed; twenty 4-week male C57BL/6J mice with SPF grade were selected and randomly divided into a model group (only 0.6% BAPN solution was given, n=10) and miR-7 group (fed with 0.6% BAPN solution+ injected with 1×10 9 PFU/ml lentivirus containing miR-7 over expression gene via tail vein, n=10), after 7 weeks of continuous feeding, the mice were anesthetized intraperitoneally with chloral hydrate. After the abdominal cavity and thorax were dissected, the abdominal aorta was separated from the left ventricle perfusion with normal saline under physiological pressure and pathological sections were prepared. Masson staining and α-SMA staining were used to evaluate the lesion degree of abdominal aortic vessels in each group; the protein expression levels of p-ERK1/2 and MMP-9 in the diseased abdominal aorta of each group were detected by WB. Results:By screening differential genes, we found that miR-7 was highly expressed in patients with abdominal aortic aneurysm, and further analysis revealed that miR-7 was positively correlated with ERK1/2; Masson staining showed that the tumor of abdominal aortic aneurysm in miR -7 group was significantly larger than that in the model group, and the difference was statistically significant ( P<0.05), the results of α-SMA histochemical staining showed that the number of α-SMA positive VSMC in miR-7 group was significantly lower than that in the model group, and there was almost no-SMA staining in some VSMC; WB results showed that the highest expressions of P-ERK1/2 and MMP-9 proteins in the abdominal aorta of miR-7 group were significantly higher than that of the model group, with statistically significant differences ( P<0.05). Conclusion:MiR-7 accelerated the formation of abdominal aortic aneurysms by up-regulating the expression of ERK and MMP-9 proteins.
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Objective To summarize the clinical experience and significance of 101 cases of thoracic endovascular aortic repair(TEVAR).Methods From October 2008 to August 2013,101 patients received endovascular repair.Among the cases,81 patients were male,and 20 were female.Before operation,all patients underwent thoracoabdominal aortic CTA examination,there were 5 cases of traumatic aortic diseases,10 cases of severe aortic penetrating ulcer,86 cases of Stanford type B aortic dissection.All patients follow up with CTA 1 weeks,3 months,half a year,and annually postoperatively.Postoperative complications,efficacy,morphology and its vascular stent were observed.Results All cases received TEVAR,there were 90 cases of simple repair of aortic lumen (89.11％),11 cases of brachiocephalic vessels bypass (10.89％),2 cases of death (1.98％),1 case of type Ⅰ endoleak(0.99％),3 cases of the application of lumbar cistern drainage(2.97％),1 case of severe stress ulcer(0.99％),1 patient died after surgery with paraplegia,acute renal failure,stroke,lower limb artery embolization,dissection rupture.Conclusion Thoracic endovascular aortic repair has obvious advantage,risks and complications incidence of preoperative period is low,the technology is worth popularizing widely,but needed to pay attention to strictly control the indications of operation and ensure the brain blood supply.
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Objective To analyze retrospectively the therapeutic effect and safety of minimally invasive transthoracic device closure of perimembranous ventricular septal defect (PVSD).Methods One hundred and twenty-nine patients with PVSD from January 2011 to December 2011 in our hospital were selected and a 3 to 5 cm incision was made in the inferior sternum,which performed minimally invasive transthoracic device closure of ventricular septal defect (VSD).Right ventricular free wall was punctured and guided by transthoracic echocardiography (TEE),and then the occluder was released after a delivery sheath passed through the VSD.Location of occluder,effect on heart valve,fastness and residual shunt were evaluated by TEE instantly during operation.All patients were followed up intimately after operation,echocardiogram and electrocardiogram were rechecked regularly.Results One hundred and fourteen cases were successfully occluded.Fifteen cases were performed VSD repair operation with cardiopulmonary bypass.The amounts of concentric occluder and eccentric occluder were 96 and 20,respectively.The patients performed minimally invasive transthoracic device closure of VSD had no severe complications after operation.Conclusion Although the short-term therapeutic effect of minimally invasive transthoracic device closure of PVSD is definitely and has favourable prospect of application,the long-term follow-up remains to be studied.
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Objective Analysis of myocardial microvascular perfusion in patients with chronic total coronary occlusion (CTO) who underwent a coronary artery bypass graft (CABG) use real-time myocardial contrast echocardiography (RTMCE),to provide an effective method of detecting viable myocardium and a reference for the choice of CABG indications.Methods Twenty-seven patients with CTO underwent RTMCE 1 week before CABG,they underwent follow-up echocardiography and coronary artery 256-slice multislice computed tomography aagiography 1 year after CABG.Myocardial viability was defined as a postoperative ultrasound wall motion significantly improved ≥ 1 point.Semi-quantitative analysis of contrast images,myocardial viability was defined as myocardial perfusion score ≤ 2 points.Viable myocardium by quantitative assessment of myocardial blood flow (MBF) was determined by analyses of receiver-operating characteristic (ROC) curves.Results Patients with LVEF increased significantly after CABG (P ＜ 0.01),Of 259 segments with wall motion abnormality,149 (58％) showed wall motion significantly improved ≥ 1 point after CABG,considered viable myocardium,110 (42％) were not observed in wall motion improved,considered to be non-viable.The viable myocardial segments were significantly greater than non-viable myocardial segments in A,β,A × β value (P ＜ 0.01).Compared with the semi-quantitative analysis,quantitative analysis of MBF increased the sensitivity and accuracy of RTMCE for detecting viable myocardium (P ＜ 0.05).Conclusion RTMCE could accurately assess myocardial viability and provide a strong reference for clinical decision making and judging prognosis.
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Objective To comparatively analyze effect of different cooling temperature on postoperative results of patients with Stanford type A aortic disaection underwent surgical treatment.Methods Clinical data of 65 patients with Stanford type A aortic dissection perforred aortic root shaping,ascending aorta and total aortic arch replacement combined with stented elephant trunk technique from April 2007 to March 2012 were retrospectively analyzed.According to the cooling temperature,the patients were divided into two groups:group A and group B.The cooling temperature was 20 ℃ to 24 ℃ in group A and 25 ℃ to 2.8 ℃ in group B.Extracorporeal circulation time,circulatory arrest periods,volume of postoperative drainage,ventilation time and cerebral complications incidence after operation were analyzed contrastively.Results There was significant difference between two groups about extracorporeal circulation time,circulatory arrest periods,volume of postoperative drainage,ventilationtime and transient neurological dysfunction(TND) incidence after operation.There was no significant difference between two groups in postoperative pemunent neurological dysfunction (PND),use of continuous renal replacement therapy (CRRT) and mortality.Conclusion It is safe to appropriately increase the standard of cooling temperature through operating skillfully under the circumstance of deep hypothermic circulatory arrest.It,to some extent,shortens operating time and decreases injuries on patients,time of recovery,volume of blood transfusion and complications.