ABSTRACT
Objective To study the feasibility and long-term effects in 173 infants with congenital ventricular septal defect who underwent transcatheter therapy by double-disk ventricular septal defect occluder. Methods We analyzed the clinical data of 173 infants with ventricular septal defect who were performed interventional therapy followed by a follow up study from December 2002 to October 2013. Results The procedure was performed in 173 infants (male = 81 cases and female = 92 cases) aged 11 month-3 years[(2.1±0.7)years]. The weight were 6-15 kg[(10.2±3.6)kg]. The diameter of the defects ranged from 2.5-9.0 mm[(5.1±1.7) mm]. The characteristics of septal were classiifed into four types:the simply perimembranous ventricular septal defects (88 patient,50.8%), the perimembranous ventricular septal defects with pseudoaneurysm (52 patients, 30.0%), the perimembranous ventricular septal defects complicated with aortic valve prolapse (13 patients, 7.5%), and the intracristal ventricular septal defect (20 patients, 11.7%). The diameter of the occluders were between 4-12 mm[(6.3±2.2)mm]. The period of follow-up ranged from 1 month-10 years[(6.2±1.3)years]. The 168 defects were completely occluded in 173 patients(97.1%closure rate) except 5 infants, which 3 patients because the occluder hinder the function of aortic valves and the other occurred complete atrioventricular block(CAVB) when the catheter through defect. One patient occurred CAVB on the third day after the procedure, was reversed by dexamethasone after 4 days. 3 patients with complete left bundle branch block(CLBBB) after the procedure and one went to sustained, but did not observed heart failure in this case during 5 years follow-up. One patient observed sustained CLBBB on the fourth year after the procedure, also did not observed heart failure in this case during 3 years follow-up. 8 patients with trivial residual shun and 4 patients with newly appearance of trivial aortic regurgitation after the procedure, the shun all disappear at one year and the regurgitation did not progress during longest follow-up period at 8.5 years. No other complications, including late-onset CAVB, hematolysis, the occluder displacement and detachment, occurred during 1 month-10 years of follow-up. Conclusions Transcatheter closure of congenital ventricular septal defects is an efifcient method that can be safely used in the majority of infants with ventricular septal defects and have signiifcant long-term effects.
ABSTRACT
Objective To explore the feasibility of enhanced green fluorescent protein (EGFP) transfection into the joint synovial tissues of rheumatoid arthritis (RA) rats by ultrasound-mediated microbubble destruction.Methods Twenty-eight normal rats were established the RA rat model,four rats were control group,twenty-four rats were categorized into four experimental groups:EGFP,ultrasound +EGFP,microbubbles + EGFP,and ultrasound + microbubbles + EGFP.The last group was irradiated with ultrasound for 10 min after the mixture consisting of 300 μl Sono Vue and 10 μg EGFP was injected into the joint cavity.The rats were sacrificed after 3 days and the joint synovial tissues were collected for EGFP observation under fluorescence microscopy and quantitative analysis by real-time polymerase chain reaction (RT-PCR).Results Comparing with control group,EGFP expression was observed in the rat joint synovial tissues from all groups.However,a strong EGFP expression was observed in the ultrasound + microbubbles +EGFP group.EGFP expression had no statistically significant difference (the P values were 0.89,0.93,and 0.82,respectively,P ＞ 0.05) in the EGFP,ultrasound + EGFP and microbubbles + EGFP groups.However,EGFP expression in the EGFP,ultrasound + EGFP,microbubbles + EGFP groups significantly differed (all P values were ＜0.01) from that in the ultrasound + microbubbles + EGFP group.Conclusions Ultrasound-mediated microbubble destruction can improve EGFP transfection efficiency into the joint synovial tissues of RA rats.
ABSTRACT
Objective To observe the bioeffects on the normal rats synovial with diagnostic ultrasound combined with different doses contrast medium. Methods Twenty normal cleaning level Wister rats were divided into 5 groups (each with 4 rats and 8 knees): ultrasound+100 μl contrast medium, ultrasound+200 μl contrast medium, ultrasound+300 μl contrast medium, ultrasound+500 μl contrast medium, a simple ultrasound irradiation (control group). Each group was irradiated with diagnostic ultrasound for 10 min. Rats were sacrificed after 1 week and joints synovial tissues were observed with pathological HE staining. Results In group ultrasound+100 μl contrast medium, ultrasound+200 μl contrast medium, ultrasound+300 μl contrast medium and control group, no significant damage in synovial tissues was found. In group ultrasound+500 μl contrast medium, synovial cells swelling, showing round, oval or polygonal, synovial tissues hyperplasia, arranged disorder, capillary proliferation, some muscle fiber structure dissolved fracture, inflammatory cell infiltration in the surrounding tissue were found. Conclusion Ultrasound combined with contrast medium can significantly enhance the bioeffects of synovial tissues, and the more the contrast medium doses, the more serious injury occurs in synovial tissues.