Application of partial least squares algorithm to explore bioactive components of crude and stir-baked hawthorn for invigorating spleen and promoting digestion / 中国中药杂志

This study was aimed at identifying the bioactive components of the crude and stir-baked hawthorn for invigorating spleen and promoting digestion, respectively, to clarify the processing mechanism of hawthorn by applying the partial least squares(PLS) algorithm to build the spectrum-effect relationship model. Firstly, different polar fractions of crude and stir-baked hawthorn aqueous extracts and combinations of different fractions were prepared, respectively. Then, the contents of 24 chemical components were determined by ultra-high performance liquid chromatography-mass spectrometry. The effects of different polar fractions of crude hawthorn and stir-baked hawthorn aqueous extracts and combinations of different fractions were evaluated by measuring the gastric emptying rate and small intestinal propulsion rate. Finally, the PLS algorithm was used to establish the spectrum-effect relationship model. The results showed that there were significant differences in the contents of 24 chemical components for different polar fractions of crude and stir-baked hawthorn aqueous extracts and combinations of different fractions, and the gastric emptying rate and small intestinal propulsion rate of model rats were improved by administration of different polar fractions of crude and stir-baked hawthorn aqueous extracts and combinations of different fractions. The bioactive components of crude hawthorn identified by PLS models were vitexin-4″-O-glucoside, vitexin-2″-O-rhamnoside, neochlorogenic acid, rutin, gallic acid, vanillic acid, citric acid, malic acid, quinic acid and fumaric acid, while neochlorogenic acid, cryptochlorogenic acid, rutin, gallic acid, vanillic acid, citric acid, quinic acid and fumaric acid were the bioactive components of stir-baked hawthorn. This study provided data support and scientific basis for identifying the bioactive components of crude and stir-baked hawthorn, and clarifying the processing mechanism of hawthorn.

Effects of saikosaponin b_2 on inflammation and energy metabolism in mice with acute liver injury induced by LPS/GalN / 中国中药杂志

To study the effects of saikosaponin b2( SS-b2) on inflammatory factors and energy metabolism against lipopolysaccharide/galactosamine( LPS/Gal N) induced acute liver injury in mice. Mice were randomly divided into normal group( equal amount of normal saline),model group( 100 g·kg~(-1) LPS and 400 mg·kg~(-1) Gal N),low,medium,high dose group of SS-b2( SS-b25,10,20 mg·kg~(-1)·d-1) and positive control group( dexamethasone,10 mg·kg~(-1)). All of the groups except for the normal group were treated with LPS/Gal N though intraperitoneally injection to establish the acute liver injury model. The organ indexes were calculated. The levels of serum transaminases( ALT and AST) and the activities of ATPase( Na+-K+-ATPase,Ca2+-Mg2+-ATPase) in liver were detected. The activity of tumor necrosis factor-α( TNF-α),interleukin-1β( IL-1β) and interleukin-6( IL-6) were determined by the enzyme-linked immunosorbent assay( ELISA). The contents of lactate dehydrogenase( LDH) in liver were determined by micro-enzyme method. HE staining was used to observe the histopathological changes of the liver. Histochemical method was used to investigate the protein expression of liver lactate dehydrogenase-A( LDH-A). The protein expressions of Sirt-6 and NF-κB in the liver were detected by Western blot. According to the results,compared with the model group,there were significant changes in organ indexes in the high-dose group of SS-b2( P<0. 05). The level of ALT,AST,TNF-α,IL-1β,IL-6 and the activities of LDH in serum of mice with liver injury were significantly reduced in the medium and high dose groups of SS-b2( P<0. 01). With the increase of the concentration of SS-b2,the range of hepatic lesions and the damage in mice decreased. The activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase in liver of mice were significantly enhanced in each dose group( P<0. 01). The expression of NF-κB in liver tissues was significantly down-regulated in the medium and high dose group( P<0. 01). Meanwhile,the expression of Sirt-6 protein in the liver of mice with acute liver injury was significantly increased in each dose group( P<0. 01).In summary,SS-b2 has a significant protective effect on LPS/Gal N-induced acute liver injury in mice,which may be related to the down-regulation of NF-κB protein expression and up-regulation of Sirt-6 protein expression to improve inflammatory injury and energy metabolism.

Protective effect of earthworm active ingredients against endoplasmic reticulum stress induced L-02 hepatocyte apoptosis / 中国中药杂志

This study focused on the protective effect of earthworm active ingredients (EWAs) on hepatocyte apoptosis induced by endoplasmic reticulum stress (ERS) in L-02 cells. The L-02 cells were cultured in vitro. The cell viability was measured with CCK-8, the apoptosis of L-02 cells was detected by flow cytometry, and the relevant protein and mRNA expressions were detected by Western blot and qPCR. According to the findings, tunicamycin (TM) could obviously reduce the survival rate of L-02 cells in a time-dependent and dose-dependent manner. Compared with normal group, the apoptosis rate in model group was significantly increased (<0.05 or <0.01). The protein and mRNA expressions of ERS-related signal molecules, such as GRP78, PERK, eLF2α, ATF4, CHOP and Bax, were significantly up-regulated (<0.05 or <0.01), while Bcl-2 was significantly down-regulated (<0.05 or <0.01). After the administration with different concentrations of EWAs, compared with model group, EWAs could significantly increase the survival rate ofL-02 hepatocyte and decrease the cell apoptosis rates. It could also reduce the protein and mRNA expressions of ERS-related signal molecules, such as GRP78, PERK, eLF2α, ATF4, CHOP and Bax, in a dose-dependent manner (<0.05 or <0.01) and increased the protein and mRNA expressions of Bcl-2(<0.05 or <0.01). These results showed that EWAs had a significantly protective effect on hepatocyte apoptosis induced by ERS in L-02 cells. Its mechanism may be related to the down-regulation of mRNA and protein expressions of GRP78, PERK, ATF4, eLF2α, CHOP and Bax, and the up-regulation, the relief of ERS and the promotion of the proliferation of impaired L-02 cells.

Differentially expressed genes of HepG2 cells treated with gecko polypeptide mixture / 中国药理学与毒理学杂志

OBEJECTIVE Gecko has been clinically used in China for many years. It has been proved that the gecko polypeptide mixture(GPM)extracted from gecko could inhibit the growth of multiple types of tumor cells.In order to investigate the possible anti-tumor molecular mechanisms of GPM,we used RNA-seq technology to identify the differentially expressed genes of human hepatocellular carci-noma(HCC)HepG2 cells treated with or without GPM.METHODS The HepG2 cells were treated with different concentration of GPM(0,0.1,0.2,0.3,0.4 mg·mL-1)for 6 h,12 h and 24 h,respectively.MTT assay was used to detect the viability of HepG2 cells. DAPI fluorescence staining was performed to observe nucleus morphological changes of HepG2 cells.Western blot analysis was applied to observe the expres-sion of apoptosis- related proteins and endoplasmic reticulum stress (ERs)-related proteins in HepG2 cells.Flow cytometry was also applied to detect reactive oxygen species(ROS)generation.In this report, we showed that GPM could induce HepG2 cells apoptosis and influence HepG2 cells proliferation in a dose-dependent manner.We applied many analysis methods,including differentially expressed genes analysis,Gene Ontology(GO)enrichment analysis,KEGG pathway enrichment analysis,protein-protein interaction network analysis to screen out possible molecular mechanisms.RESULTS ER-nucleus signaling pathway, cellular response to stress and apoptotic processes were identified the potential anti-cancer molecular biological process of GPM.GPM may also induce apoptosis in HepG2 cells via endoplasmic reticulum stress pathway. The GPM could induce ROS generation and up-regulate ERs-related proteins. CONCLUSION The present study revealed the potential anti-tumor mechanism of GPM.

Preparation and performance detection of small-diameter tissue-engineered blood vessels / 中国组织工程研究

BACKGROUND:Due to limited sources,poor hemocompatibility and poor anticoagulation performance,small-diameter tissue-engineered blood vessels cannot be applied in clinical practice.OBJECTIVE:To explore the physicochemical and mechanical properties of sheep carotid arteries after the decellularization in order to find appropriate materials for the preparation of tissue-engineered blood vessels.METHODS:Fresh carotid arteries from sheep were randomly divided into two groups:control group,in which,the sheep carotid arteries were cryopreserved for use after trimming and cleaning;experimental group,in which,after trimming and cleaning,the carotid arteries were decallularized by Triton X-100.sodium deoxycholate and EDTA for 24 hours,rinsed for 72 hours,digested with RNA/DNA enzymes for 24 hours,rinsed for 24 hours and reserved for later use.In both groups,blood samples were subjected to hematoxylin-eosin staining,collagen fiber staining,elastic fiber dyeing,and electron microscopy observation.The physical and chemical properties of the blood vessels are tested by tensile strength,wall tension and thickness.RESULTS AND CONCLUSION:(1) The collagen fibers in both two groups were neat and compact in alignment,with no obvious fracture.(2) Hematoxylin-eosin staining showed that:in the control group,the nuclei were distributed in the inner membrane,middle lamella and outer membrane of the vessels,and the fibers ran regularly;in the experimental group,the fibers ran in order but loosely,and there were no nuclei in the inner membrane,middle lamella and outer membrane of the vessels.(3) Elastic fibers in the control group were regular in alignment and mainly distributed in the middle lamella and outer membrane of the vessels,while in the experimental group,the elastic fibers ran regularly but loosely,and mainly distributed in the middle lamella and outer membrane of the vessels.(4) Under the scanning electron microscope,the originally formed vessels were observed in the experimental group,with no cell residues,and the collagen fibers ran orderly with no fracture and with uniform pore structure.(5) The vessel thickness was lower in the experimental group than the control group (P ＜ 0.01),but the tensile strength showed no difference between the two groups,which was 46.55 kPa in the two groups.To conclude,the decelluarized sheep carotid artery can retain the necessary mechanical properties of the blood vessels after achieving the maximum removal of antigenicity.

Protective effect of earthworm active ingredients against endoplasmic reticulum stress-induced acute liver injury in mice / 中国中药杂志

To study the protective effect of earthworm active ingredients(EWAs) against endoplasmic reticulum stress(ERS)-induced acute liver injury in mice. The model of liver injury was induced through intraperitoneal injection of 10%CCl4. Serum glutamic-pyruvic transaminase(ALT), glutamic-oxaloacetic transaminase(AST), superoxide dismutase(SOD) and glutathione peroxidase(GSH-PX) activity and malondialdehyde(MDA) concentration were detected by colorimetric method. Histological examination was performed through hematoxylin-eosin staining and light microscopy, and apoptosis was detected using terminal transferase dUTP nick end labeling. The expressions of ERS related proteins, including glucose regulated protein 78(GRP78), protein kinase R-like ER kinase(PERK), eukaryotic transcription initiation factor 2α(eIF2α), active transcription factor-4(ATF4) and CCAAT/enhancer binding homologous protein(CHOP), were measured by immunohistochemistry and Western blot. According to the results, compared with the model group,serological indexes in the high, middle and low doses of EWAs were significantly improved (P<0.05 or P<0.01), the extent of liver lesion was decreased and the degree of injury was significantly reduced, and that the liver index and the spleen index of mice were significantly changed(P<0.05 or P<0.01). In liver tissue, the expressions of GRP78 and CHOP were significantly decreased(P<0.05 or P<0.01). The protein expressions of GRP78, CHOP and its upstream signaling pathway PERK-eIF2-ATF4 were significantly decreased in each dose group(P<0.05 or P<0.01). In summary, EWAs has a significant protective effect on ERS-induced acute liver injury, and its mechanism may be correlated with the inhibition of oxidative stress and ERS, and down-regulation of ERS marker protein CHOP expression, andinhibition of apoptosis.

Nitric oxide donor PABA/NO induced mitochondrial-mediated apoptosis in HepG2 cells / 中国药理学与毒理学杂志

OBJECTIVE To investigate the effects of nitric oxide (NO) donor, O2-{2,4-dinitro-5-[4-(N-methylamino) benzoyloxy]phenyl}1-(N,N-dimethylamino)diazen-1-ium-1,2-diolate (PABA/NO) on apop-tosis in human hepatocarcinoma cells. METHODS Proliferation of HepG2 cells treated with PABA/NO 7.5, 15.0 and 30.0μmol · L-1 was measured with Cell Counting Kit-8 (CCK-8) assay, the morphological features were observed under fluorescence microscopy, the level of NO was measured by DAF-FM DA staining, the apoptosis rate was determined by Annexin Ⅴ-FITC staining, mitochondrial membrane potential was determined by Rhodamine 123 staining, and protein expressions of Bcl-2, Bax, cleaved caspase 3, cytochrome c (Cyt c) and apoptosis inducing factor (AIF) were measured by Western blotting analysis. RESULTS Compared with cell control group, PABA/NO could obviously inhibit the proliferation of HepG2 cells (P<0.01). IC50 value of HepG2 cells treated with PABA/NO for 24 h was (10.8±0.6)μmol·L-1. The cells became round, deformed and appeared shrunken.The level of NO was increased and the fluores-cence intensity was 121 ± 9 (P<0.05), 174 ± 31 (P<0.05) and 230 ± 43 (P<0.01). The apoptosis rate was increased from (2.9 ± 0.5)％ to (17.0 ± 4.5)％ (P<0.01), (39.8 ± 5.4)％ (P<0.01) and (74.3 ± 45.2)％ (P<0.01). The fluorescence intensity of Rh123 was reduced from 668±69 to 605±73, 420±65 (P<0.05) and 242±47 (P<0.01). Compared with cell control group, PABA/NO down-regulated Bcl-2, up-regulated Bax and activated cleaved caspase 3. Meanwhile, the expression of Cyt c in the cytoplasm was increased from 0.15±0.04 to 0.27±0.06 (P<0.05), 0.38±0.07 (P<0.01) and 0.82±0.16 (P<0.01). The expression of AIF in the nucleus was increased from 0.183±0.032 to 0.231±0.011, 0.682±0.020 (P<0.01) and 0.966± 0.090 (P<0.01). Addition of carboxy-PTIO (NO scavenger) 50 μmol · L- 1 blocked PABA/NO-induced down-regulation of Bcl-2, up-regulation of Bax and cleaved caspase 3 activation. Additionally, up-regu-lation of Cyt c in the cytoplasm and up-regulation of AIF in the nucleus were also blocked by carboxy-PTIO in PABA/NO-treated HepG2 cells (P<0.01). CONCLUSION PABA/NO may induce HepG2 cell apoptosis through a mitochondrial pathway.

Effect of sufentanil postconditioning on level of cathepsin B in myocardium during ischemia-reperfusion in rats / 中华麻醉学杂志

Objective To evaluate the effect of sufentanil postconditioning on the level of cathepsin B in the myocardium during ischemia-reperfusion (I/R) in the rats.Methods Eighteen healthy adult male Sprague-Dawley rats,weighing 250-300 g,were divided into 3 groups (n=6 each) using a random nunber table:shamn operation group (group S),group I/R and sufentanil postconditioning group (group SP).The rats were anesthetized with intraperitoneal 20％ urethane 5 ml/kg.Myocardial I/R was induced by occlusion of the left anterior descending branch of the coronary artery for 30 min followed by 120 min reperfusion.At 5 min before reperfusion,sufentanil 1.0 μg/kg was intravenously injected in group SP,and the equal volume of normal saline was given instead in S and I/R groups.At the end of reperfusion,blood samples from the abdominal aorta were collected for determination of serum cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) concentrations,and myocardial specimnens were obtained for examination of the ultrastructure of cardiomyocytes (using transmission electron microscopy) and for determination of Beclin1,microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ) and cathepsin B expression (by Western blot) and cathepsin B activity (by fluorometric assay).Results Compared with group S,the serum cTnI and CK-MB concentrations were significantly increased,the expression of Beclin-1,LC3 Ⅱ and cathepsin B was up-regulated,and the activity of cathepsin B was enhanced in I/R and SP groups (P＜0.05).Compared with group I/R,the serum cTnI and CK-MB concentrations were significantly decreased,the expression of Beclin-1 and LC3 Ⅱ was down-regulated,the expression of cathepsin B was up-regulated,and the activity of cathepsin B was enhanced (P＜0.05),the pathological changes of myocardial tissues were signifieantly attenuated,and autophagosomes were reduced in group SP.Conclusion The mechanism by which sufentanil postconditioning inhibits cardiomyocyte autophagy during myocardial I/R is probably related to increased expression and activity of cathepsin B in rats.

Oleanolic acid induces G₂/M phase arrest and apoptosis in human hepatocellular carcinoma Bel-7402 cells / 中国中药杂志

This study was to examine the mechanism of oleanolic acid (OA) induces G2/M phase arrest and apoptosis in human hepatocellular carcinoma Bel-7402 cells. MTT and trypan blue exclusion test assay were adopted to detect the proliferate status of cells treated with OA. We assayed the cell cycle by flow cytometry using PI staining. Apoptosis was determined by Annexin V-FITC staining and PI labeling. The expressions of cycle related proteins and apoptotic related proteins were determined by Western blot analysis. OA strongly inhibited human hepatoma cells proliferation. When Bel-7402 cells were pretreated with OA for 24 h, OA induced apoptosis and G₂/M phase cell cycle arrest in a concentration-dependent manner. Analysis of the cell cycle regulatory proteins demonstrated that OA decreased the protein levels of cyclin B1, but increased the protein levels of p-Cdk1 (Tyr15) and p-Cdc25C (Ser 216). Moreover, OA modulated the phosphorylation of protein kinases Chk1 and p2l. Western blotting assay also showed significant decrease of Bcl-2 protein expression and increase of Bax protein expression, the cytosol Cyt c level, cleaved-caspase-9 and cleaved-caspase-3 activity. These data suggest that OA produces anti-tumor effect via induction of G₂/M cell cycle arrest and apoptosis.

The correlation between expression of DLC-1 and colon cancer staging / 肿瘤研究与临床

Objective To investigate the relationship between the expression level of deleted in liver cancer-1 (DLC-1) gene and colon cancer staging or lymph nodes metastatic ratio.Methods Total 60 resection specimens were collected from colon cancer patients between September 2009 and September 2011,and 10 resection specimens from patients with trauma,colonic diverticulitis and colitis were used as the control.The DLC-1 mRNA level was measured with real time quantitative RT-PCR in colon cancer patients and the control group.TNM system was used for colon cancer staging.The linear correlation analysis was performed to determine the relationship between DLC-1 expression level and colon cancer staging or lymph nodes metastatic ratio.Results The mRNA level of DLC-1 was significantly reduced in colon cancer tissues in comparison to that in adjacent normal tissues,while adjacent tissues showed significantly lower DLC-1 level than normal clone tissues.The expression of DLC-1 was negatively correlated with both colon cancer stage and the lymph nodes metastatic ratio (r =0.46,P ＜ 0.05).Conclusions DLC-1 expression was negatively correlated with pathological stage and lymph node metastasis ratio,indicating a critical role of DLC-1 gene in colon cancer genesis,which provide a possible new direction for colon cancer research.

Role of ERK/FoxO3a signal axis in inhibitory effect of vitexin 1 (VB-1) in HepG2 cell proliferation / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate whether the ERK/FoxO3a signal axis could induce the inhibitory effect of vitexin 1 (VB-1) in HepG2 cell proliferation.</p><p><b>METHOD</b>The MTT method was adopted to observe the effect of different concentrations of VB-1 on human hepatoma carcinoma cell line HepG2 and immortalized human embryo liver cell line L-02. The cell growth was assessed by the clone formation assay. The protein phosphorylation levels of ERK1/2 and FoxO3a were measured by the western blot.</p><p><b>RESULT</b>VB-1 inhibited the viability of HepG2 cell line in a concentration-dependent manner, with a weak effect on L-02 cell line. VB-1 could effectively inhibit the anchorage-dependent growth of HepG2 cells, and reduce the expression levels of pERK1/2 and pFoxO3a in a concentration-dependent manner. MEK1/2 inhibitor PD98059 could enhance VB-1' s effect in inhibiting HepG2 cell proliferation and ERK1/2, FoxO3a phosphorylation.</p><p><b>CONCLUSION</b>VB-1 inhibits the proliferative activity of hepatoma carcinoma cell line HepG2 by blocking the ERK/FoxO3a signal axis.</p>

Role of PI3K/Akt pathway in effect of paeoniflorin against Aβ25-35-induced PC12 cell injury / 中国中药杂志

<p><b>OBJECTIVE</b>To study the role of PI3K/Akt pathway in the neuroprotective effect of paeoniflorin on PC12 cells.</p><p><b>METHOD</b>The paeoniflorin group (5, 10, 20 μmol · L(-1)) was pretreated for 30 min, and then added with Aβ25-35 (20 μmol · L(-1)) for interaction for 24 h. Inhibitor LY294002 (10 μmol · L(-1)) was pretreated for 30 min before the action of paeoniflorin (10 μmol · L(-1)). The MTT colorimetric method was used to detect the cell viability. The apoptosis rate was tested by the FITC-Annexin V/PI staining. The protein expression of p-AKT, Bax, Bcl-2 and cleaved caspase-3 protein were detected by Western blot analysis.</p><p><b>RESULT</b>Paeoniflorin could significantly inhibit the Aβ25-35-induced PC12 cell toxicity and apoptosis. Its protection effect may be achieved by up- regulating AKT phosphorylation level, increasing Bcl-2 protein expression, reducing Bax protein expression, inhibiting the activation of caspase-3. Inhibitor LY294002 could weaken the above protective effects of paeoniflorin.</p><p><b>CONCLUSION</b>Paeoniflorin could activate PI3K/Akt signaling pathway to protect the PC12 cell injury induced by Aβ25-35.</p>

Nuclear factor κB and IKB expression and calcium deposition of atherosclerotic plaques in apolipoprotein E and low density lipoprotein receptor knockout mice / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the histopathological features, nuclear factor-κB (NFκB) and IKB expressions as well as calcium deposition of atherosclerosis plaques (AS) in apolipoprotein E (ApoE) and low density lipoprotein receptor (LDLR) knockout mice (ApoE(-/-), LDLR(-/-)fed high-fat diet.</p><p><b>METHODS</b>Eight C57BL/6J mice fed with normal diet were used as control, 32 ApoE(-/-) mice and LDLR(-/-) mice were divided into normal diet and high-fat diet groups (n = 8 each). After 4 months, aorta was collected for morphologic (HE, Oil Red O, Von Kossa) and immunohistochemistry (nuclear factor-κB, IKB, macrophage surface molecule-3, α-smooth action protein) analysis.</p><p><b>RESULTS</b>Degree of AS in ApoE(-/-) and LDLR(-/-) mice fed with high-fat diet were significantly severer than those fed with normal diet and AS was more significant in ApoE(-/-) mice than in LDLR(-/-) mice. NFκB and IKB expressions in high-fat diet group were significantly higher than the normal diet group (P < 0.05). Double-labeling of NFκB revealed dominant expression in smooth muscle cells. Calcium deposition was significantly more in ApoE(-/-) mice fed with high-fat diet than mice fed with normal diet (P < 0.05) and was similar in LDLR(-/-) mice fed with high and normal diet (P > 0.05).</p><p><b>CONCLUSION</b>High-fat diet contributes to the formation of AS plagues in ApoE(-/-) and LDLR(-/-) mice joined by upregulated NFκB and IKB expressions and calcium deposition.</p>

Efficacy comparison between video-assisted minimally invasive radiofrequency ablation and catheter ablation in the treatment of persistent atrial fibrillation / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the efficacy of the video-assisted minimally invasive radiofrequency ablation in comparison with catheter ablation for the treatment of persistent atrial fibrillation (AF).</p><p><b>METHODS</b>A total of 172 patients [116 male, mean age (56 ± 12) years] with persistent AF underwent ablation procedures during the last 4 years in our institute (83 patients underwent video-assisted minimally invasive radiofrequency ablation, group MIA and 89 patients underwent circumferential pulmonary vein linear ablation, group CA). Mean duration of preoperative AF was (72 ± 68) months. Patients were follow-uped for a period of 1 to 3.6 years [mean (2.2 ± 0.8) years].</p><p><b>RESULTS</b>There was no procedure related death. During follow-up, one patient died of encephalorrhagia in CA group, one patient died of sudden death in each group. At the end of the procedure, there were 67 sinus rhythm (39.0%), 4 pacing rhythm (2.3%), 29 atrial flutter or atrial tachycardia (16.9%) and 72 AF (41.9%). Before discharge, sinus rhythm was recorded in 53 patients (63.9%) of MIA group and in 78 patients (87.6%) of CA group; AF recorded in 24 patients (28.9%) of MIA group and in 4 patients (4.5%) of CA group (P < 0.01). At the latest follow-up, sinus rhythm was recorded in 65 patients (79.3%) of MIA group and in 54 patients (62.1%) of CA group; AF or atrial flutter was recorded in 14 patients (17.1%) of MIA group and in 24 patients (27.6%) of CA group (P = 0.028). The Kaplan-Meier survival analysis showed that the long-term efficacy of MIA is superior to CA in terms of incidence of free of AF, AF recurrence and antiarrhythmic drugs (P = 0.03, P = 0.028, P = 0.017, respectively).</p><p><b>CONCLUSIONS</b>The video-assisted minimally invasive ablation was safe and effective, and had an optimistic long-term success rate for patients with long-lasting persistent AF. Thus, a randomized study comparing the long-term efficacy between the two procedures for patients with long-lasting persistent AF is warranted.</p>

Efficacy of mitral valve repair for anterior leaflet prolapse of mitral valve / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic effects of mitral valve repair for the treatment of the anterior leaflet prolapse of mitral valve.</p><p><b>METHODS</b>From November 1998 to October 2007, 210 patients with severe anterior leaflet prolapse of mitral valve underwent valve repair. The condition of valve was preoperative, intraoperative, and postoperative assessed with echocardiography.</p><p><b>RESULTS</b>Edge-to-edge repair technique was used in 134 cases (63.8%). The cardiac function was NYHA class I in 168 cases and class II in 40 cases after operation. Patients were followup for 1 - 150 (25.7 +/- 29.0) months, two patients (0.95%) died of postoperative low cardiac output syndrome. Echocardiography examination indicated that the mean JP2 postoperative left atrial diameter was (37.7 +/- 9.2) mm against the preoperative value of (47.5 +/- 12.7) mm (P < 0.05), the mean postoperative left ventricular end-diastolic diameter was (51.7 +/- 7.9) mm against the preoperative value of (67.7 +/- 10.3) mm (P < 0.05), the mean postoperative left ventricular ejection fraction was (62.2 +/- 3.2)% against the preoperative value of (52.2 +/- 6.4)% (P < 0.05), and the mean preoperative regurgitation area was (10.4 +/- 4.1) cm(2) against the postoperative value of (4.1 +/- 1.7) cm(2) (P < 0.01).</p><p><b>CONCLUSIONS</b>Optimal outcome was achieved by appropriate edge-to-edge technique or other mitral valve repair techniques for anterior leaflet prolapse of mitral valve. Edge-to-edge technique is a reliable and efficient surgical technique.</p>

Video-assisted minimally invasive radiofrequency ablation in the treatment of persistent atrial fibrillation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effectiveness of the video-assisted minimally invasive radiofrequency ablation combined irbesartan use for the treatment of the persistent atrial fibrillation (AF).</p><p><b>METHODS</b>From January 2006 to December 2009, 83 patients with persistent AF having a video-assisted minimally invasive radiofrequency ablation. There were 58 males, 25 females with a mean age of (57 ± 11) years. Mean duration of preoperative AF was (61 ± 65) months. Follow-up for the whole patients ranged from 1.0 to 3.6 years [mean (2.2 ± 0.8) years]. Patients were randomly divided into irbesartan group (n = 42) and without irbesartan group (n = 41) postoperatively.</p><p><b>RESULTS</b>No patient died postoperatively. During follow-up, there was 1 patient died of unknown reason. At the end of the procedure, 38 patients (45.7%) were sinus rhythm, 4 patients (4.9%) were pacing rhythm, 5 patients (6.0%) were atrial flutter or atrial tachycardia, and 36 patients (43.4%) were AF. Before discharge, 53 patients (63.9%) were sinus rhythm, 24 patients (28.9%) were AF. At late follow-up, 65 patients (80.2%) were sinus rhythm; 14 patients (17.3%) were AF or atrial flutter. After follow-up, the Kaplan-Meier analysis showed the irbesartan group had fewer patients with AF (P = 0.020). The hazard ratio for AF recurrence in patients treated with irbesartan was 0.24 (95% CI: 0.087 to 0.637, P = 0.004).</p><p><b>CONCLUSIONS</b>The video-assisted minimally invasive radiofrequency ablation is safe and effective. The patients treated with irbesartan have a lower rate of recurrence of AF.</p>

Intraoperative treatment for atrial fibrillation using bi-polar radiofrequency ablation system: a clinical report of 91 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To observe the short and mid-term therapeutic effects of Bi-polar ablation systems for intraoperative treatment of atrial fibrillation (AF).</p><p><b>METHODS</b>From March 2005 to January 2007, 91 patients received intraoperative treatment of atrial fibrillation with Bi-polar ablation systems, including 5 cases of paroxysmal atrial fibrillation and 86 persistent/permanent cases. The main concomitant heart diseases were rheumatic mitral valve diseases. Atricure Dry Ablation System was used for 37 cases and Cardioblate Irrigated Ablation System for 54 cases. The ablation lesion patterns included Cox-maze III, Modified Cox Mini-maze and Left-sided Maze.</p><p><b>RESULTS</b>Mean ablation time was (14.1+/-6.7) min. No ablation-related complications occurred. Three patients died perioperatively. Two patients had permanent pacemaker implantation 3 months after operation. One case suffered from stroke and lower limb thrombosis 2.5 years after operation. Follow-up lasted for 6 to 29 months. The none-AF rhythm were 62.5%, 85.2%, 79.0% and 74.5% at discharge, 3 months, 6 months, and>or=12 months respectively. Compared to Uni-polar Ablation therapy group, the restoration of sinus rhythm in Bi-polar group were significantly higher at 6 months and>or=12 months postoperatively. The latest follow-up results indicated that 100% of preoperative paroxysmal atrial fibrillation patients restored sinus rhythm and 75.3% of persistent/permanent patients were free from atrial fibrillation. The none-AF rhythm of Atricure group (81.1%) showed no difference from the Cardioblate (77.5%). Meanwhile there were no significant differences among the three ablation lesion groups.</p><p><b>CONCLUSION</b>Intraoperative radiofrequency ablation with Bi-polar systems is a feasible, safe and highly effective surgical option compared to the Uni-polar ablation technique.</p>

Effect of IL-10 on LOX-1 expression of peripheral blood monocytes in patients with acute coronary syndrome / 中南大学学报(医学版)

OBJECTIVE@#To determine the expression of lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) of peripheral blood monocytes in patients with acute coronary syndromes (ACS),and to further explore the effect of anti-inflammatory factor interleukin-10 (IL-10) on the expression of LOX-1.@*METHODS@#Twenty-eight healthy controls and 28 ACS patients were enrolled in the study. The levels of IL-10 and tumor necrosis factor (TNF-alpha) were determined by enzyme-linked immunosorbnent assay(ELISA). The monocytes of peripheral blood in patients and controls were isolated and incubated with exogenous IL-10 (20 microg/L). The expression of LOX-1 protein and mRNA in the monocytes was examined by Western blot and reverse transcriptase PCR (RT-PCR).@*RESULTS@#Compared with the healthy controls, the levels of serum IL-10 and TNF-alpha were significantly elevated in ACS patients (P<0.01). The expression of LOX-1 protein and mRNA was markedly upregulated in the isolated monocytes from ACS patients, which could be downregulated by IL-10 (20 microg/L, 3 h) (P<0.01).@*CONCLUSION@#The effect of anti-inflammatory factor IL-10 on the atherosclerosis may be a new mechanism resulting in plaque stabilization via the decreased LOX-1 expression of peripheral monocytes in ACS patients.

Thoracoscopy video assisted minimally invasive bilateral pulmonary vein isolation for treatment of atrial fibrillation / 中华心血管病杂志

<p><b>OBJECTIVE</b>This study is to evaluate the feasibility and safety of thoracoscopy video assisted minimally invasive bilateral pulmonary vein isolation for treatment of atrial fibrillation.</p><p><b>METHODS</b>From December 2006 to April 2007, thorascopy video assisted off-pump epicardial pulmonary vein isolation was performed in 20 patients with atrial fibrillation. All patients were either refractory or intolerant to antiarrhythmic drug therapy or already experienced unsuccessful catheter-based ablation. The procedure includes 21 cm ports for the thoracoscopic camera and ablation device, and a 5 cm working port on each side of the chest wall. Bilaterally pulmonary vine were isolated by using an stricure(TM) bipolar radiofrequency device. LAA was removed by using a Johnson & Johnson EZ45G stapler. Intraoperative pacing and sensing was used to confirm bidirectional block of the ablation lines.</p><p><b>RESULTS</b>The procedure was successful in all patients. Nineteen patients were in sinus rhythm immediately after the surgery and 1 patient was still in AF rhythm post surgery and converted to sinus rhythm by electrical conversion in the operation room. One patient was reintubated because of low SaO2 and 1 patient received IABP for LV failure. Mean operation time was (130 +/- 25) min and average hospital stay was (8.0 +/- 3.8) d. 3-months follow up was finished in 12 patients at after the surgery and 10 patients were free of AF (10/12, 83.3%), 6-months follow up was finished in 3 patients and all in sinus rhythm (3/3, 100%).</p><p><b>CONCLUSION</b>Our results suggested that thoracoscopy video assisted minimally invasive bilateral pulmonary vein isolation is a safe, feasible and effective technique for treatment of atrial fibrillation.</p>

Combined endocardial and epicardial radiofrequency modified Maze procedure in the treatment of atrial fibrillation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effectiveness of the combined endocardial and epicardial saline-irrigated radiofrequency modified maze procedure for the treatment of atrial fibrillation (AF).</p><p><b>METHODS</b>During a period of 3 years, 295 patients with AF having concomitant cardiac surgery underwent the procedure. Patients underwent either the endocardial and epicardial group (n=185) or the endocardial group (n=110) radiofrequency ablation. There were 124 males, 171 females with a mean age of (52 +/- 11) year old. Mean duration of preoperative AF was 36 +/- 43 months. And about 90.8 percent valve pathology was rheumatic. Valve operation was performed in 289 patients, coronary artery bypass graft surgery in 19 patients and congenital heart disease operation in 6 patients respectively. Follow-up for the whole patients ranged from 3 to 47 months (mean 28 +/- 5 months).</p><p><b>RESULTS</b>Ten patients died postoperatively (3.4%). Four patients died of low cardiac output, five patients died of multisystem and organ failure, one patient died of cerebral hernia. There were 2 patients died of nerves system complication during follow-up. At the end of the procedure 228 patients (77.3%) were sinus rhythm, including 78 patients (70.9%) in endocardial group while 150 patients (81.1%) in endocardial and epicardial group (P<0.05). At late follow-up, 191 of 259 patients (73.7%) were in stable sinus rhythm. Sinus rhythm was present in 64 patients (66.0%) in endocardial group while 127 patients (78.4%) in endocardial and epicardial group (P<0.05). Histopathology of the endocardial group revealed foci coagulative necrosis was limited to the endocardial side. While endocardial and epicardial ablation had full-thickness alteration of atrial tissue besides ill defined borders and inflammatory cell infiltration.</p><p><b>CONCLUSIONS</b>Combined endocardial and epicardial saline-irrigated radiofrequency modified maze procedure was performed safely and efficiently. And it restored sinus rhythm better than endocardial ablation only.</p>