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Objective: To explore the long-term clinical efficacy of transcatheter repair of mitral paravalvular leak (PVL) post surgical mitral valve replacement. Methods: This study is a retrospective study. Patients who completed transcatheter repair of paravalvular leak after surgical mitral valve replacement at Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine from March 2010 to December 2018 were included. Technical success was defined as the occluder being stably implanted in the paravalvular leak site without affecting the function of the mitral valve and surrounding tissues; and there were no intervention-related complications, such as new hemolysis or aggravated hemolysis, and echocardiography confirmed mitral paravalvular regurgitation reduced by more than 1 grade. Patients were followed up at 30 days, 1, and 3 years after the intervention. The main endpoints were all-cause death and re-surgery due to interventional failure or serious complications. The occurrence of occluder-mediated hemolysis and chronic renal insufficiency was recorded, and patients were monitored with echocardiography during follow up. Results: A total of 75 patients were included, aged (54.3±22.9) years old, and 38 patients were males. All patients had decreased cardiac function and/or hemolysis before intervention. Procedural success was achieved in 54 patients (72.0%). Incidence of device-mediated hemolysis was 18.7% (14/75). During the follow-up period, all-cause death occurred in 7 patients (9.3%), and 3 were cardiac deaths.The 3-year event-free survival rate was 81.3% (61/75). The need for cardiac surgery was 9.3% (7/75): 3 cases due to severe device-mediated hemolysis, 2 cases due to prosthetic valve failure and 2 cases due to moderate to severe residual regurgitation. The echocardiography follow-up results showed that the position of the occluder was stable, there was no impact on the artificial valve function and surrounding structures, and the residual regurgitation was stable without progressive increase in event-free patients. Compared with pre-intervention, the left ventricular end systolic diameter ((33.9±7.4)mm vs. (38.3±8.9) mm, P=0.036), end diastolic diameter ((53.7±8.3) mm vs. (58.4±9.1) mm, P=0.045) and left atrial diameter (59.3 (44.5, 90.7) mm vs. 64.3 (44.8, 96.6) mm, P=0.049) were significantly reduced, pulmonary artery systolic pressure was also significantly decreased ((36.5±15.8) mmHg vs. (46.3±14.9) mmHg, P=0.022, 1 mmHg=0.133 kPa). There was no significant difference between 3 years and 1 year after transcatheter repair of mitral paravalvular leak post surgical mitral valve replacement (all P>0.05). Conclusion: Transcatheter repair of mitral paravalvular leak post surgical mitral valve replacement is an effective treatment option in selective patients.
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Male , Humans , Adult , Middle Aged , Aged , Female , Mitral Valve/surgery , Heart Valve Prosthesis Implantation , Heart Valve Prosthesis , Retrospective Studies , Hemolysis , China , Mitral Valve Insufficiency/surgery , Treatment Outcome , Cardiac Catheterization , Prosthesis FailureABSTRACT
Objective: To investigate the influencing factors of in-stent restenosis (ISR) following successful stent implantation in patients with ablation-associated severe pulmonary vein stenosis (PVS) who undergo atrial fibrillation ablation. Methods: Data of patients who underwent pulmonary vein angiography to confirm PVS after radiofrequency ablation for atrial fibrillation (AF) and received pulmonary vein stenting at Shanghai Chest Hospital from March 2010 to December 2017 were retrospectively analysed. All patients were followed up for a long period of time (pulmonary vein contract-enhanced CT within 6 to 12 months after operation was performed, and pulmonary angiography was performed if CT indicated stenosis>50%). The incidence of ISR was recorded. According to angiography, the patients were divided into ISR group and non-ISR group. The clinical and intraoperative imaging characteristics and interventional data were compared between the two groups. Logistic regression was used to analyse the influencing factors of ISR. Results: A total of 47 patients ((47.1±12.2) years old) were enrolled in this study, including 28 males(59.6%). There were 19 cases in ISR group and 28 cases in non-ISR group. Compared with the non-ISR group, the ISR group received more pulmonary vein isolation ((2.8±0.9) vs. (1.8±1.3), P=0.02), and the interval between last ablation and stenting was longer ((19.4±9.6) vs. (13.0±12.4), P=0.03). The incidence of ISR in patients with stent diameter≤8 mm was significantly higher than those with stent diameter>8 mm (33.3%(20/60) vs. 8.1%(3/37), P<0.01). Logistic regression analysis found that the number of radiofrequency ablation>1 (OR=2.1, 95%CI 1.3-3.9, P=0.02), and the time from the last ablation to stent placement>12 months (OR=1.5, 95%CI 1.1-2.5, P=0.03), reference diameter of stenosed distal vessel (OR=0.7, 95%CI 0.5-0.9, P=0.04), post procedural minimal luminal diameter (OR=0.4, 95%CI 0.2-0.8, P=0.02) and stent diameter (OR=0.6, 95%CI 0.3-0.9, P=0.03) were independent factors of ISR. Conclusions: The greater number of radiofrequency ablations and the longer time from the last ablation to stent placement increase the risk of ISR. The larger reference diameter of the stenosed distal vessel, stent diameter and post procedural minimal luminal diameter are the protective factors of ISR.
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Adult , Female , Humans , Male , Middle Aged , Atrial Fibrillation , Catheter Ablation , China , Constriction, Pathologic , Coronary Restenosis , Pulmonary Veins , Retrospective Studies , Stenosis, Pulmonary Vein , Stents , Treatment OutcomeABSTRACT
Objective To understand the epidemic status of clonorchiasis sinensis in western region of Jilin Province, so as to provide the evidence for formulating the planning and strategy of prevention and control of the disease. Methods In 2017, the areas where the residents had the customs of eating Sashimi were selected as the research areas in the western region of Jilin Province, and according to the cluster sampling, 25 villages in 25 towns (each village per town) of 5 counties in the region were selected as the investigation points. The basic information of crowd was collected by a questionnaire investigation. The Kato-Katz method was used for etiological examinations. The results were analyzed statistically. Results A total of 4 980 people in the 25 villages were investigated, and 1 220 people were infected with Clonorchis sinensis. The average infection rate was 24.50%. There was a significant difference among different counties (cities, districts) in the infection rate of C. sinensis (P < 0.01), and the infection rate in Daan City was the highest (53.82%). In addition, there were significant differences between/among the gender, nation, age, educational level, and occupation in the infection rate (all P values < 0.01). The infection rate of the male was higher than that of the female, the rate of Han was higher than that of other ethnic groups, the rate of the high age group was higher than that of the low age group, the rate of the college degree group was higher than that of the other educational level groups, the rate of the cadre was higher than that of the other occupation groups, and the rate of the group who had vermifuge before the investigation was lower than that of the group who did not have vermifuge. Conclusions The western region of Jilin Province is still the highincidence area of clonorchiasis sinensis. Therefore, the comprehensive control and prevention measures, such as giving vermifuge and health education, should be strengthened in key population and areas in the future.
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Imaging techniques play a vital role in evaluating myocardial damage in patients with myocardial infarction. Accurate evaluations of postinfarction function and scar can help identify high-risk patients and provide prognosis information, which contributes much to clinical practice. The assessment of myocardial damage mainly includes overall evaluations of ventricular function and remodeling and targeted characterization of myocardial infarction including infarct size, myocardial viability and microvascular obstruction. Echocardiography, cardiac magnetic resonance, CT and nuclear examinations are most common imaging techniques currently. This review is to update evidence on applications of these modalities in evaluation of postinfarction myocardial damage and offer some helps to health workers.
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Drug-coated balloons (DCB) have emerged as a new application in percutaneous coronary intervention. It is developed to circumvent some of the limitations faced by drug-eluting stents (DES). DES has some limitations, as follows: it could not be implanted in some lesions; bleeding risks are associated with prolonged dual antiplatelet therapy; risks of late and very late stent thrombosis increase. Many clinical trials had confirmed the efficacy and safety of DCB, particularly, the application of DCB in coronary small vessel diseases. This review discussed the basic concept, development, evolution of DCB and some clinical studies associated with the application of DCB in coronary small vessel diseases.
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Objective To evaluate the safety of influenza vaccine and 23-valent pneumococcal polysaccharide vaccine (PPV23) immunized alone or in combination in elderly people and to raise the awareness of vaccine safety among the elderly. Methods From October 2014 to September 2015,454 eld-erly people who were over 60 years old and immunized with influenza vaccine and PPV23 alone or in combi-nation were recruited in this study and divided into five groups. Local and systemic reactions occurred within one month after vaccination were recorded. Results (1) Incidences of adverse reactions among all subjects and people vaccinated with influenza vaccine alone,domestic PPV23 alone,imported PPV23 alone,domes-tic PPV23 combined with influenza vaccine and imported PPV23 combined with influenza vaccine were 10.13%,5.35%,11.63 %,9.52%,17.24% and 12.63%,respectively. Local reaction,injection site pain and mild reaction were the common reactions to vaccination. All reactions occurred within seven days and most of them occurred within 30 minutes to one day after vaccination(82.61%). All subjects recovered within seven days and most of them recovered within one day (84.78%). (2) Compared with the people immunized with domestic or imported PPV23 or influenza vaccine alone,those immunized in combination had higher incidences of reactions to vaccination. Among the three single vaccination groups, domestic PPV23 group had the highest incidence of reactions,followed by imported PPV23 and influenza vaccine groups,but no significant difference was found among them(P>0.05). The incidence of responses to influenza vaccine combined with domestic PPV23 was higher than that to influenza vaccine combined with imported PPV23, but no significant difference was found between them (P>0.05). (3) In each group,women,people aged≥70 years or with chronic diseases had a higher incidence of responses to vaccination than men,people aged 60 to 69 years or without chronic diseases,respectively (P>0.05). Conclusion Immunization with influ-enza vaccine and PPV23 alone or in combination is safe and tolerable in elderly people regardless of gender, age,or whether they are suffering from chronic diseases or not. Both domestic and imported PPV23 have the feature of good safety.
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Objective To investigate the epidemiological characteristics of measles outbreak caused by genotype D8 virus in Pinghu city of Zhejiang province,and provide evidence for the control of the outbreak.Methods The measles outbreak data were collected through National Measles Surveillance System.The outpatient records and admission records were checked,field investigation and outbreak response were conducted.Blood samples in acute phase and swab specimens were collected from the patients for laboratory testing,including serology test,RNA extraction and amplification,measles virus isolation and genotype identification.Software SPSS 17.0 and Excel 2016 were used for data analysis.Results A total of 10 confirmed measles cases were reported in Pinghu city,and 8 cases were aged ＞40 years.Six blood samples were collected,in which 5 were measles D8 virus positive and 1 was negative in measles virus detection.There were epidemiological links among 10 cases which occurred in a factory,a hospital and a family at the same time.There was no statistical difference in symptoms among cases caused by D8 virus and H1a virus.After the emergent measles vaccination,the measles outbreak was effectively controlled.Conclusion Untimely response due to the uneasy detection of measles cases in the early stage,nosocomial infection and weak barrier of measles immunity in adults might be the main reasons for this outbreak.Measles vaccination is effective in the prevention of measles D8 virus infection.It is necessary to strengthen measles genotype monitoring for the tracing of infection source and control of outbreaks.
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Objective To investigate the epidemiological characteristics of measles outbreak caused by genotype D8 virus in Pinghu city of Zhejiang province,and provide evidence for the control of the outbreak.Methods The measles outbreak data were collected through National Measles Surveillance System.The outpatient records and admission records were checked,field investigation and outbreak response were conducted.Blood samples in acute phase and swab specimens were collected from the patients for laboratory testing,including serology test,RNA extraction and amplification,measles virus isolation and genotype identification.Software SPSS 17.0 and Excel 2016 were used for data analysis.Results A total of 10 confirmed measles cases were reported in Pinghu city,and 8 cases were aged ＞40 years.Six blood samples were collected,in which 5 were measles D8 virus positive and 1 was negative in measles virus detection.There were epidemiological links among 10 cases which occurred in a factory,a hospital and a family at the same time.There was no statistical difference in symptoms among cases caused by D8 virus and H1a virus.After the emergent measles vaccination,the measles outbreak was effectively controlled.Conclusion Untimely response due to the uneasy detection of measles cases in the early stage,nosocomial infection and weak barrier of measles immunity in adults might be the main reasons for this outbreak.Measles vaccination is effective in the prevention of measles D8 virus infection.It is necessary to strengthen measles genotype monitoring for the tracing of infection source and control of outbreaks.
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Objective@#To investigate the clinical value of two-dimensional speckle tracking echocardiography(2D-STE) combined with high-sensitive cardiac troponin T (hs-cTnT) in early detection of the cardiotoxicity induced by chemotherapy drug.@*Methods@#Seventy-five non-Hodgkin′s lymphoma patients who received the CHOP regimen were recruited in this study. Conventional echocardiography and 2D-STE were performed on these patients before chemotherapy, the second day after the third course of chemotherapy (during chemotherapy) and the second day after the last course of chemotherapy (after chemotherapy). The parameters included left ventricular ejection fraction (LVEF), global longitudinal strain (LS), global circumferential strain (CS) and global radial strain (RS). The serum hs-cTNT levels were tested simultaneously.@*Results@#Three cycles of CHOP were completed in 30 patients and 6-8 cycles of CHOP were completed in 45 patients. The LVEF of 75 patients before, during and after chemotherapy was (63.8±2.6)%, (63.8±2.8)% and (64.0±3.3)%, respectively, without significant difference (P=0.91). However, the LS of 75 patients before, during and after chemotherapy was (-18.5±1.7)%, (-16.5±1.9)% and (-16.0±1.6)%, respectively. The CS was (-20.9±2.9)%, (-19.3±3.5)% and (-19.2±3.2)%, respectively. The RS was (39.2±6.4)%, (35.3±5.2)% and (35.0±6.2)%, respectively. The hs-cTnT was (0.001 0±0.002 0)ng/ml, (0.006 3±0.008 9)ng/ml and (0.007 3±0.003 8)ng/ml, respectively. The LS, CS and RS were significantly decreased while hs-cTnT was significantly increased during chemotherapy when compared to those before chemotherapy (all of P<0.01). Alternatively, the LS, CS, RS and hs-cTnT after chemotherapy were marginally different from those during chemotherapy (all of P>0.05). Moreover, TLS-SD, TCS-SD and TRS-SD showed no significant difference before, during and after chemotherapy (all of P>0.05). The reduction of LS was positively associated with the enhancement of hs-cTnT after chemotherapy (r=0.60, P<0.01).@*Conclusion@#2D-STE combined with hs-cTnT can effectively and precisely detect the occult cardiotoxicity induced by anthracycline.
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Objective To provide evidence for effective implementation of influenza and pneumonia immune strategies, we investigated the awareness of influenza and pneumonia and the willingness of vaccination among chronic disease patients.Methods A stratified multistage cluster sampling method was used to investigate 720 patients less than 75 years of age.Results Overall, 717 completed responses were received.The awareness rates of influenza and pneumonia diseases were 59.83% and 59.55%, respectively.However, the awareness rates of influenza and pneumonia vaccine were 17.71% and 6.00%, respectively.The vaccination rate of influenza vaccine was 1.26% while no patients received pneumonia vaccination.Among those not vaccinated the most frequent reasons for not receiving the vaccine included "Believed oneself unlikely to be infected with influenza/pneumonia" and "No recommendation has been received for influenza/pneumonia vaccination".The influence on recommendations by doctors at vaccine clinic and by general practitioner had no significant statistical difference (P>0.05).Conclusion The main reasons for such low awareness and willingness may be due to their poorly knowledge on the risk of influenza/pneumonia diseases, and related vaccines.Health education and intervention should be taken to heighten the vaccination rates of influenza/pneumonia vaccines.
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Objective To evaluate the risks of vaccination operation in order to provide scientific basis for policy makings of vaccination operation.Methods The risk matrix and analytic hierarchy process approach were used to evaluate the risks of vaccination operation,including the possibility,severity,risk weight,and risk level.Results Seven items for the first level and thirty one items for the second level vaccination risk factors were determined.In the first level,E level risk (Extremely serious risk ) was vaccination implementation risk,and H level risk (high risk ) was the risks of pre -notification and health education and risks of vaccine and cold chain management.Vaccination implementation risk accounted the largest weight (weight coefficient=38.95%).In second level,E level risk was three inspection and seven verification before vaccination,and H level risk were personnel professional quality,personnel responsibility,pre -inspection,informed before vaccination, vaccination route, site and dose, vaccination operation, post vaccination notification and retention,and three inspection and seven verification before vaccination,accounted the largest weight (weight coefficient=10.14%).The weight of the logical consistency of the test results were satisfactory (consistency ratio<0.1 ).Conclusion The integrated application of risk matrix and analytic hierarchy process in risk assessment of vaccination operation helps to further regulate vaccination services and has application and promotion value.
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Objective To analyze the real world status of traditional known cardiovascular risk factors in patients with coronary heart disease ( CHD ) .Methods 6040 in-hospital patients with CHD or suspected CHD undergoing angiography from 01/01/2013 to 02/28/2015 were retrospectively analyzed . According to angiography result , patients with severe coronary artery lesion and undergoing percutaneous coronary intervention (PCI) were enrolled in the PCI group (n=2808) and patients without severe coronary artery lesion and not undergoing PCI or CABG were enrolled in the No-PCI/CABG group (n=3232).Patients in the PCI group were further divided into 3 subgroups which were STEMI group , NSTEMI/UA group and stable angina (SA) group.Results (1) Compared with the No-PCI/CABG group, patients in the PCI group have higher ratio of male patients (75.4% vs.53.1%, P<0.0001), older average age (64.83 ±0.20 vs. 63.39 ±0.18 years old , P <0.0001 ) , and higher existing rates of traditional risk factors including hypertension (66.7%vs.54.7%, P<0.0001 ) , diabetes/impaired glucose tolerance ( IGT ) ( 37.0% vs. 20.8%, P<0.0001), stroke(7.0%vs.5.4%,P=0.0098)and chronic kidney disease (CKD) (4.3%vs. 2.8%, P=0.001 ) , but there was no statistic difference in existing rates of dyslipidemia between the two groups.(2)In the PCI group,female patients had higher prevalence of hypertension (74.1%vs.64.3%, P<0.001), diabetes/IGT (42.5%vs.35.3%, P=0.0007) and stroke (9.4%vs.6.2%, P=0.0054) than the male patients.There were no significant sex difference in these comorbidities as above in No-PCI/CABG group.Female patients had higher prevalence of dyslipidemia than male patients in both PCI and No -PCI/CABG groups.(3) Among all the 3 PCI subgroups, STEMI patients presented with youngest average age (62.54 ±0.45 vs.65.15 ±0.28 vs.66.17 ±0.34 years old, P<0.0001) and highest male patient ratio (83.9%vs.72.9% vs.72.3%, P<0.0001).Patients in the SA subgroup had the highest prevalence of hypertension and prior revascularization including PCI and CABG .Patients in the NSTEMI/UA subgroup had the highest rates of diabetes/IGT.No significant differences were observed in the prevalence of dyslipidemia , CKD and stroke among all the subgroups .Conclusions Hypertension and diabetes are the leading risk factors of coronary artery disease , and prior revascularization is also an important cause of stable angina and NSTEMI /UA undergoing PCI.Patients requiring PCI were found to be more of male gendor , but female patients has higher prevalence of traditional cardiovascular risk factors including hypertension , diabetes/IGT or stroke than male patients.
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<p><b>OBJECTIVE</b>To investigate the value of intravascular ultrasound (IVUS) on assessing pulmonary vascular properties (PVPs) and its relationship with hemodynamics, and mortality rate in patients with pulmonary arterial hypertension associated with connective tissue disease (PAH-CTD).</p><p><b>METHODS</b>Patients (n=51) with highly suspected PAH-CTD were prospectively enrolled in our department between July 2011 and March 2014. All patients underwent right heart catheterization (RHC) and IVUS, and were divided into 3 groups: PAH-CTD (n=25), PAH due to other reasons (n=15), and non-PAH control group (n=11). Based on IVUS, PAH patients were divided into distal (n=22) and proximal (n=18) remodeling subtypes.A total of 408 pulmonary segments were detected by IVUS, and all patients were followed up to (19 ± 10) months.</p><p><b>RESULTS</b>IVUS evidenced higher mean wall thickness (MWT) ((0.30 ± 0.02) mm and (0.33 ± 0.02) mm vs. (0.21 ± 0.02) mm) and percentage of MWT (WTP) ((13.62 ± 0.59)% and (14.39 ± 0.77)% vs. (9.57 ± 0.97)%) values in PAH patients compared to control patients (all P<0.01). Pulmonary vascular mechanical properties (PVMPs) including compliance ((8.85 ± 0.82) × 10(-2)mm(2)/mmHg(1 mmHg=0.133 kPa) and (6.28 ± 0.65) × 10(-2)mm(2)/mmHg vs. (41.59 ± 5.02) × 10(-2) mm(2)/mmHg, all P<0.01), distensibility ((0.83 ± 0.09)%/mmHg and (0.55 ± 0.06)%/mmHg vs. (3.16 ± 0.38) %/mmHg, all P<0.01), elastic modulus ((169.25 ± 15.10) mmHg and (253.00 ± 22.11) mmHg vs.(43.78 ± 4.27) mmHg, all P<0.01) and stiffness index β (4.19 ± 0.41 and 5.18 ± 0.34 vs. 2.39 ± 0.27, P<0.05 or 0.01) in PAH groups were all significantly worse than in control group (all P<0.01). An inverse exponential association was found between PVMPs and hemodynamics with R(2) ranging from 0.544 to 0.777 (P<0.001). PVMPs tended to be better in group PAH-CTD than in PAH group due to other reasons.Mortality rate was similar between the two PAH groups, while PAH with distal remodeling subtype was linked with significantly higher mortality rate than PAH with the proximal remodeling subtype (23 % vs. 0, HR=10.14, P<0.05).</p><p><b>CONCLUSIONS</b>IVUS plays an important role in the assessment of PAH-CTD patients in terms of evaluating PVPs and predicting mortality rate. PAH patients have deteriorated PVPs, but PVMPs tended to be better in PAH-CTD than in PAH patients due to other reasons. The mortality rate was similar between PAH groups, while PAH patients with the distal remodeling subtype is linked with a higher mortality rate than PAH patients with the proximal remodeling subtype.</p>
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Humans , Cardiac Catheterization , Connective Tissue Diseases , Hemodynamics , Hypertension, Pulmonary , Lung , Pulmonary ArteryABSTRACT
<p><b>BACKGROUND</b>First generation drug-eluting stents (DES) were associated with a high incidence of late stent thrombosis (ST), mainly due to delayed healing and re-endothelization by the durable polymer coating. This study sought to assess the safety and efficacy of the Nano polymer-free sirolimus-eluting stent (SES) in the treatment of patients with de novo coronary artery lesions.</p><p><b>METHODS</b>The Nano trial is the first randomized trial designed to compare the safety and efficacy of the Nano polymer-free SES and Partner durable-polymer SES (Lepu Medical Technology, Beijing, China) in the treatment of patients with de novo native coronary lesions. The primary endpoint was in-stent late lumen loss (LLL) at 9-month follow-up. The secondary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction or target lesion revascularization.</p><p><b>RESULTS</b>A total of 291 patients (Nano group: n = 143, Partner group: n = 148) were enrolled in this trial from 19 Chinese centers. The Nano polymer-free SES was non-inferior to the Partner durable-polymer DES at the primary endpoint of 9 months (P < 0.001). The 9-month in-segment LLL of the polymer-free Nano SES was comparable to the Partner SES (0.34 ± 0.42) mm vs. (0.30 ± 0.48) mm, P = 0.21). The incidence of MACE in the Nano group were 7.6% compared to the Partner group of 5.9% (P = 0.75) at 2 years follow-up. The frequency of cardiac death and stent thrombosis was low for both Nano and Partner SES (0.8% vs. 0.7%, 0.8% vs. 1.5%, both P = 1.00).</p><p><b>CONCLUSIONS</b>In this multicenter randomized Nano trial, the Nano polymer-free SES showed similar safety and efficacy compared with the Partner SES in the treatment of patients with de novo coronary artery lesions. Trials in patients with complex lesions and longer term follow-up are necessary to confirm the clinical performance of this novel Nano polymer-free SES.</p>
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Aged , Female , Humans , Male , Middle Aged , Coronary Artery Disease , Drug Therapy , General Surgery , Drug-Eluting Stents , Immunosuppressive Agents , Therapeutic Uses , Prospective Studies , Sirolimus , Therapeutic UsesABSTRACT
Objective To explore the establishment of a rabbit model of atrial fibrillation by wireless telemetering and stimulation technology.Method An implantable telemetering stimulator which was independently designed and devel-oped was hypodermically implanted in New Zealand rabbits.The implantable telemetering stimulator was made with the core development and design of MSP single-chip microcomputer of TI Corporation ( Texas Instruments) and RF wireless trans-ceiver chip CC2250 of TI Corporation.The design of the implantation system was optimized to cater to the exploratory ex-periment to establish atrial fibrillation model of New Zealand rabbits.The implanter was implanted into the abdominal sub-cutaneous tissue of the New Zealand rabbits, the collecting electrodes were placed in the oxter subcutaneous tissues of the left and the right upper extremities, and the two stimulating electrodes were sutured at the left auricle and the left atrium. The signals were collected and stimulated by the wireless transceiver.The I-lead ECG electrical signals were continuously monitored on the body surface by a Powerlab physiological recorder.High frequency ( >20 Hz) suprathreshold stimulus ( intensity 2 mA, pulse width 1 ms) was emitted by specialized stimulation software of a computer program by the interval ( stimulating for 2 s and pausing for 2 s) .In case of atrial fibrillation during intervals, the stimulation could be stopped by hand.In case of sinus rhythm, the stimulation could be continued.Results The implantable telemetering stimulator can work stably in vivo ( including collecting stimulated electrocardio signal and emitting stimulations) for 30 days.Atrial fibril-lation can be induced after stimulating in vivo of the New Zealand rabbits for 3 weeks, with a duration of >48 h.Conclu-sions Applying implantable telemetering stimulator can build a New Zealand istead of beagles model of atrial fibrillation which is more consistent with welfare optimization and substitution principle for laboratory animals.
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<p><b>OBJECTIVE</b>To investigate the effect of farnesoid-X-receptor (FXR) antagonist Z-guggulsterone in an in vivo high-fat fed apolipoprotein E knockout (ApoE(-/-)) mice model of myocardial ischemia/reperfusion (I/R).</p><p><b>METHODS</b>Male ApoE(-/-) mice were randomly divided into three groups: standard ApoE(-/-) group (fed with standard mouse diet for 12 weeks before myocardial I/R procedure, n = 18), high-fat ApoE(-/-) group (fed with high-fat mouse diet for 12 weeks before myocardial I/R procedure, n = 22), and high-fat ApoE(-/-) + FXR antagonist group(fed with high-fat mouse diet for 12 weeks and received FXR antagonist Z-Guggulsterone 30 minutes before myocardial I/R procedure, n = 17). The expression of FXR was detected by real-time quantitative-PCR. Myocardial infarct size was determined by Evans blue/TTC double staining methods. Myocardial apoptosis was determined by in situ TUNEL technique. Markers of the mitochondrial-mediated apoptotic pathway (cytochrome c release, caspase-9 activity, and BAX and BCL-2 levels), endoplasmic reticulum stress apoptotic pathway (caspase-12 activity and CHOP level), and death receptor apoptotic pathway (caspase-8 activity, and Fas and FasL levels) were also measured.</p><p><b>RESULT</b>FXR expression (3.7-fold higher, P < 0.01), myocardial infarct size [(62.1 ± 7.0)% vs. (33.8 ± 5.8)%, P < 0.01] and myocardial apoptosis index[ (36.8 ± 5.7)% vs. (17.2 ± 3.8)%, P < 0.01]were all significantly higher in high-fat ApoE(-/-) group than those in standard ApoE(-/-) group. Compared with high-fat ApoE(-/-) group, myocardial infarct size [(24.4 ± 4.7)% vs. (62.1 ± 7.0)%, P < 0.01] and myocardial apoptosis index [(13.8 ± 2.7)% vs. (36.8 ± 5.7)%, P < 0.01] were significantly reduced in high-fat ApoE(-/-) + FXR antagonist group. Moreover, levels of mitochondrial-mediated apoptotic pathway markers (cytochrome c release, caspase-9 activity, and BAX/BCL-2 levels) and endoplasmic reticulum stress apoptotic pathway markers (caspase-12 activity and CHOP level) were significantly lower in high-fat ApoE(-/-) + FXR antagonist group than those in high-fat ApoE(-/-) group (all P < 0.01). Levels of death receptor apoptotic pathway markers (caspase-8 activity, and Fas and FasL levels) were similar between high-fat ApoE(-/-) group and high-fat ApoE(-/-) + FXR antagonist group.</p><p><b>CONCLUSION</b>FXR antagonist alleviates myocardial reperfusion injury in cholesterol-fed ApoE(-/-) mice via inhibition of the mitochondrial-mediated and endoplasmic-reticulum stress pathway.</p>
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Animals , Male , Mice , Apolipoproteins E , Genetics , Apoptosis , Caspase 9 , Metabolism , Cholesterol, Dietary , Cytochromes c , Metabolism , Disease Models, Animal , Endoplasmic Reticulum Stress , Mice, Knockout , Myocardial Reperfusion Injury , Metabolism , Pathology , Pregnenediones , Pharmacology , Proto-Oncogene Proteins c-bcl-2 , Metabolism , Receptors, Cytoplasmic and Nuclear , Metabolism , bcl-2-Associated X Protein , MetabolismABSTRACT
Heat shock protein (HSP) is a group of evolutionarily highly conserved cell chaperone proteins involved in the processes of molecular chaperone, cytoprotection, anti-apoptosis and immunoregulation. Recent studies found that HSP is also involved in spermatogenesis, sperm capacitation and fertilization, which play a significant role in male reproduction. Therefore, further studies on the action mechanisms of HSP in male infertility may offer a new insight into the management of the problem.
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Humans , Male , Heat-Shock Proteins , Metabolism , Infertility, Male , Metabolism , Spermatozoa , MetabolismABSTRACT
Objective To evaluate the teaching effect of seminar method in clinical teaching of department of urinary surgery.Methods A total of 30 clinical medical students were randomly divided into two equal groups:test group with seminar teaching method and control group with traditional teaching method.Results Were evaluated by scores of theoretic test,operating skill and survey after 3 months.Results Scores of theoretic test and operating skill in test group were significantly higher than those in control group(P ＜0.05).There were significant differences in scores of survey between two groups(P ＜ 0.05).Conclusions Seminar teaching method could effectively improve student learning initiatives and teaching effect,and is worth further exploration.
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Objective To evaluate the right heart dysfunction in SLE patients with/ without pulmonary arterial hypertension (PAH) using the parameters recommended by the American Society of Echocardiography (ASE),and to examine whether the right heart dysfunction is directly related to elevated pulmonary arterial systolic pressure(PASP) and pulmonary vascular resistance(PVR).Methods Study population composited of 43 patients with SLE.The patients were divided into two groups according to the PASP measured by echocardiography:Group A was 24 patients with PASP ≤35 mm Hg,Group B was 19patients with PASP＞35 mm Hg.Twenty-two healthy subjects with age and gender matched were set as control group.Routine transthoracic echocardiography study was performed on all patients and 26 parameters were measured in order to compare the differences of the parameters among the three groups.Results There were significant differences in 17 parameters among the three groups (P ＜0.05).Tricuspid annular plane systolic excurtion(TAPSE) and E/A ratio of tricuspid flow velocities in SLE patients without PAH significantly decreased compared to control group (P =0.04 and 0.03).There were significant differences in 11 parameters between SLE with and without PAH group (P ＜0.05).Multivariate logistic regression analysis indicated that after adjustment for age and gender,the patients with elevated PVR associated with a 6.18-fold increase in right ventricular dysfunction compared to the patients with normal PVR (P =0.02).Conclusions The impairment of right ventricular function in SLE patients was directly related to PVR and PASP.Elevation of PVR was an important predictor for right heart dysfunction.
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The effects of testosterone on norepinephrine release were investigated in the isolated rat hearts. Sprague-Dawley male rats (n=120) were randomized to testosterone and control groups. The rats in testosterone group were perfused with modified Krebs-Henseleit buffer containing different concentrations of testosterone (0.1, 1.0, 10.0, and 100.0 nmol/L, respectively). Myocardial ischemia was induced by globally stopping the perfusion flow. Exocytotic norepinephrine release was induced by electrical field stimulation at 5 V (effective voltage) and 6 Hz (pulse width of 2 ms) for 1 min. The overflow of norepinephrine was determined by high pressure liquid chromatography and electrochemical detection (HPLC-EC). Following acute ischemia, testosterone (1.0, 10.0 and 100.0 nmol/L) significantly reduced norepinephrine release (P0.05). Electrical stimulation of the ventricle evoked norepinepherine release, and this was diminished by the perfusion with testosterone at the concentrations of 1.0, 10.0 and 100.0 nmol/L (P<0.01). It is suggested that testosterone suppresses ischemia- and electrical stimulation-induced norepinepherine release in the isolated rat hearts.