ABSTRACT
@#Objective To evaluate the clinical effectiveness of valve-sparing aortic root replacement (VSARR) in the treatment of patients with dilated aortic root after operation for tetralogy of Fallot (TOF). Methods A retrospective analysis was conducted on clinical data of TOF patients with aortic root dilation who underwent VSARR in our hospital from 2016 to 2022. Results Finally 14 patients were collected, including 8 males and 6 females, with a median age of 22 years ranging from 12-48 years. Among them, 5 patients had severe aortic valve regurgitation, 4 moderate regurgitation, and 5 mild or no regurgitation. Six patients had sinus of valsalva dilation, and 8 significant dilation of the ascending aorta. One patient had residual shunt due to ventricular septal defect, and 9 severe pulmonary valve regurgitation. The David procedure was performed in 10 patients, Yacoub procedure in 2 patients, and Florida sleeve in 2 patients. There was no perioperative mortality in the group. The median follow-up time was 2.9 years (ranging from 0.4 to 6.0 years). One patient had mild aortic valve regurgitation, and the rest had minimal or no regurgitation. One patient had mild stenosis of the left ventricular outflow tract, and the rest patients had no obvious stenosis. Conclusion VSARR is a satisfactory treatment for aortic root dilation in patients with TOF, with no significant increase in the incidence of left ventricular outflow tract stenosis or aortic regurgitation during mid-term follow-up.
ABSTRACT
@#Introduction: Preclinical studies on mesenchymal stromal cells (MSC) have allowed the cells to be considered as a promising candidate for cellular therapy. In recent years, conflicting data have been reported regarding various aspects of their characteristics, development and differentiation potential, which may be due to arrange of factors. Among the factors worth investigating is the culture medium formulation. Methods: Here we have made a comparative characterization of mouse bone marrow mesenchymal stromal cells (mBM-MSC) that were cultured using two common supplements, MesenCult™ Stimulatory Supplement (MSS) and fetal bovine serum (FBS), under the same experimental conditions at different passages. Clonogenic potential, cumulative population doubling level (CPDL), population doubling time (PDT), immunophenotyping, differentiation, immunosuppression potentials and chromosome analysis of early and late passages mBM-MSC were assessed. Results: Our findings showed that the CPDL, immunophenotype and immunosuppression potential of mBM-MSC were similar. However, variations were seen in their clonogenicity, population doubling time and differentiation efficacy whereby all of these were enhanced in DMSS. These observations suggest that their genetic make-up may be affected by both supplements upon prolonged culture. Interestingly, this conjecture was supported when chromosomal analysis revealed genetic instability of mBM-MSCs cultured in both supplements. Conclusion: In conclusion, culture medium formulation was shown to cause variations and spontaneous transformation in mBM-MSCs raising concerns on the usage of late passages mBMMSCs in fundamental and preclinical downstream experiments.
ABSTRACT
Objective:To investigate the impact of obstructive sleep apnea(OSA)on cardiac structure and function in elderly patients with type 2 diabetes mellitus(T2DM).Methods:This was a case-control study.Elderly patients with T2DM aged 65 years and above at the Department of Geriatrics of Tianjin Medical University General Hospital were consecutively enrolled in this study, and eventually 61 patients with complete general information were included.All patients were examined with polysomnography(PSG). They were divided into the T2DM group and the T2DM+ OSA group based on whether there was concurrent OSA.Differences in cardiac structure and function were compared between the two groups and between patients with mild OSA and those with moderate-severe OSA.The correlation of OSA with cardiac structure and function in T2DM patients was analyzed by using Pearson correlation and multiple linear regression analysis.Results:The left ventricular ejection fraction(LVEF)was lower in the T2DM+ OSA group than in the T2DM group(52.38±4.70 % vs.56.34±5.92%, t=2.892, P=0.005). The anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness increased in the T2DM+ OSA group compared with the T2DM group(21.50±1.49 mm vs.20.55±1.05 mm, 10.21±0.88 mm vs.9.52±1.04 mm, 10.42±0.83 mm vs.9.83±0.83 mm, t=-2.670, -2.770 and -2.716, P=0.010, 0.007 and 0.009). LVEF was lower in patients with moderate-severe OSA than in those with mild OSA group(50.58±3.55% vs.55.83±4.83%, t=3.813, P=0.001). The anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness were greater in patients with moderate-severe OSA than in those with mild OSA(21.86±1.39 mm vs.20.79±1.46 mm, 10.48±0.82 mm vs.9.69±0.75 mm, 10.68±0.80 mm vs.9.92±0.64 mm, t=-2.231, -2.871 and -2.943, P=0.032, 0.007 and 0.006). Pearson correlation analysis showed that the Apnea Hypopnea Index(AHI)was correlated with LVEF, the anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness( r=-0.425, 0.340, 0.458 and 0.473, P=0.001, 0.007, <0.001 and <0.001). After adjusting for age, body mass index, systolic blood pressure and triglycerides, multiple linear regression analysis showed that AHI was also correlated with LVEF, the anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness( β=-0.385, 0.520, 0.604 and 0.388, P=0.036, 0.011, 0.001 and 0.039). Conclusions:OSA aggravates cardiac remodeling and systolic insufficiency in T2DM patients and may be related to the severity of intermittent hypoxia.
ABSTRACT
Diarrhea is characterized by increased bowel movements and loose and even watery stools. Its occurrence and development have been proved by modern research to be closely related to the imbalance of intestinal flora. Traditional Chinese medicine （TCM） pays a special attention to syndrome differentiation in treating diarrhea. Exploring the TCM syndromes of diarrhea is of great significance to the formulation of TCM diagnosis and treatment scheme of diarrhea and the improvement of clinical curative effects. There exist many similarities between TCM theory and micro-ecological theory concerning diarrhea. With the deepening of intestinal flora research， the significance of intestinal flora in TCM syndrome research has been increasingly highlighted. The close correlation of intestinal flora with the occurrence and development of diarrhea has provided new ideas of deducing syndrome and selecting prescription based on intestinal flora. This paper summarized the relationship between TCM syndromes of diarrhea and microscopic indexes such as immune response， neurotransmitters， brain-gut peptide， and proteins and analyzed the intestinal flora characteristics related to six common TCM syndromes of diarrhea. Meanwhile， based on the theory of deducing syndrome by prescription， namely deducing the syndrome by the efficacy of prescription or its medicinal components， the correlation between TCM syndromes of diarrhea and intestinal flora was indirectly verified， so as to identify the research direction of correlation between intestinal flora and TCM syndromes in the future. Numerous studies have shown that the TCM syndromes of diarrhea were highly correlated with the microscopic indexes such as inflammatory cytokines， neurotransmitters， and proteins. Syndromes and dysbacteriosis both resulted from pathogenic factors acting on the body， which were summarized from different angles. Different TCM syndromes corresponded to specific objective indicators of intestinal flora. Intestinal flora has the potential of being an internal material basis for powerfully revealing the TCM syndromes of diarrhea in the future.
ABSTRACT
The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore's development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in commemoration of the International Day of Radiology in 2020, as well as the 200th anniversary of the Singapore General Hospital in 2021. This pictorial essay comprises gastroenterology, musculoskeletal and obstetrics and gynaecology cases from the archives.
ABSTRACT
Purpose@#We aimed to identify the anterolateral ligament (ALL) tears in anterior cruciate ligament (ACL)-deficient knees using standard 1.5-Tesla magnetic resonance imaging (MRI). @*Methods@#We included all patients who underwent primary ACL reconstruction at our center between 2012 and 2015. Exclusion criteria included patients with multiple ligament injuries, lateral collateral ligament, posterolateral corner, and infections, and patients who underwent MRI more than 2 months after their injury. All patients (n = 148) had ACL tears that were subsequently arthroscopically reconstructed. The magnetic resonance (MR) images of the injured knees performed within 2 months of injury were reviewed by a musculoskeletal radiologist and an orthopedic surgeon. The patients were divided into two groups. The first group of patients had MRI performed within 1 month of injury. The second group of patients had MRI performed 1–2 months after the index injury. Both assessors were blinded and the MR mages were read separately to assess the presence of ALL, presence of a tear and the location of the tear. Based on their readings, interobserver agreement (kappa statistic (K)), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were compared. @*Results@#The ALL was identified in 100% of the patients. However, there was a discrepancy of up to 15% in the identification of tear of the ALL. In the first group in which MRI scans were performed within 1 month of injury, the ALL tear was identified by the radiologist in 92% of patients and by the surgeon in 90% of patients (Κ = 0.86). In the second group in which MRI scans were performed within 1–2 months of the injury, the ALL tear was identified by the radiologist in 78% of patients and by the surgeon in 93% of patients (K = 0.62). @*Conclusion@#The ALL can be accurately identified on MRI, but the presence and location of ALL tear and its location cannot be reliably identified on MRI. The accuracy in identification and characterization of a tear was affected by the interval between the time of injury and the time when the MRI was performed.Level of evidence: Diagnostic, level IIIb, retrospective.
ABSTRACT
Objective:To investigate the effect of elevated low-density lipoprotein(LDL)cholesterol on the release of endothelial microvesicles into the circulatory system in elderly patients with obstructive sleep apnea(OSA).Methods:This was a case-control study.A total of 69 elderly inpatients aged ≥ 60 years were divided into the OSA group(n=48)and the normal control group(n=21)based on the apnea/hypopnea index(AHI). Sleep monitoring was carried out in the two groups, and venous blood samples were taken after the monitoring.Density gradient centrifugation was used to extract microparticles and flow cytometry was used to analyze patients' blood levels of endothelial microvesicles.Blood lipid levels of patients were measured by biochemical analysis methods.The correlation between LDL cholesterol levels and endothelial microvesicles in OSA patients was analyzed.Results:LDL cholesterol levels were higher in OSA patients than in normal controls(2.6±0.6 mmol/L vs.2.2±0.7 mmol/L, t=2.089, P=0.041). Endothelial microvesicle levels were elevated in OSA patients compared with the normal controls[(28.2±12.2)×10 -6events/L vs.(19.6±7.8)×10 -6 events/L, t=-3.164, P=0.003]. Endothelial microvesicle levels increased in OSA patients with elevated LDL cholesterol compared with OSA patients with normal LDL cholesterol[(39.3±12.6)×10 -6 events/L vs.(28.2±12.2)×10 -6 events/L, t=2.899, P=0.006]. There was a significant correlation between LDL cholesterol levels and endothelial microvesicle levels in OSA patients( r=0.497, P=0.032), while levels of HDL, total cholesterol, triglycerides, blood pressure and blood glucose had no significant correlation with endothelial microvesicle levels. Conclusions:The level of endothelial microvesicles released into the circulation is higher in elderly OSA patients than in normal elderly people, and the elevated concentration of LDL can further promote the release of endothelial microvesicles in OSA patients.
ABSTRACT
The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore's development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in 2020 in commemoration of the 20th anniversary of the formation of SingHealth, the 55th National Day of Singapore, and the 125th anniversary of the International Day of Radiology. This pictorial essay comprises cardiovascular, respiratory and neurological cases from the archives.
ABSTRACT
Purpose@#We aimed to identify the anterolateral ligament (ALL) tears in anterior cruciate ligament (ACL)-deficient knees using standard 1.5-Tesla magnetic resonance imaging (MRI). @*Methods@#We included all patients who underwent primary ACL reconstruction at our center between 2012 and 2015. Exclusion criteria included patients with multiple ligament injuries, lateral collateral ligament, posterolateral corner, and infections, and patients who underwent MRI more than 2 months after their injury. All patients (n = 148) had ACL tears that were subsequently arthroscopically reconstructed. The magnetic resonance (MR) images of the injured knees performed within 2 months of injury were reviewed by a musculoskeletal radiologist and an orthopedic surgeon. The patients were divided into two groups. The first group of patients had MRI performed within 1 month of injury. The second group of patients had MRI performed 1–2 months after the index injury. Both assessors were blinded and the MR mages were read separately to assess the presence of ALL, presence of a tear and the location of the tear. Based on their readings, interobserver agreement (kappa statistic (K)), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were compared. @*Results@#The ALL was identified in 100% of the patients. However, there was a discrepancy of up to 15% in the identification of tear of the ALL. In the first group in which MRI scans were performed within 1 month of injury, the ALL tear was identified by the radiologist in 92% of patients and by the surgeon in 90% of patients (Κ = 0.86). In the second group in which MRI scans were performed within 1–2 months of the injury, the ALL tear was identified by the radiologist in 78% of patients and by the surgeon in 93% of patients (K = 0.62). @*Conclusion@#The ALL can be accurately identified on MRI, but the presence and location of ALL tear and its location cannot be reliably identified on MRI. The accuracy in identification and characterization of a tear was affected by the interval between the time of injury and the time when the MRI was performed.Level of evidence: Diagnostic, level IIIb, retrospective.
ABSTRACT
Appendiceal neoplasms are rare and often only discovered incidentally during surgery performed for acute appendicitis. Computed tomography (CT) has been demonstrated to be a reliable technique for accurately establishing the preoperative diagnosis of appendiceal neoplasms that manifest as acute appendicitis through the presence of certain imaging findings. Other manifestations of appendiceal neoplasms include appendiceal mass, mucocoele, localised abscess formation, ileus, increasing abdominal girth from pseudomyxoma peritonei, and intussusception. This pictorial essay illustrates varied CT findings of neoplasms of the appendix, with emphasis on the more commonly encountered manifestations of these tumours.
ABSTRACT
Objective To monitor reactive oxygen species(ROS) levels in renal proximal tubular epithelial cells cultured in vitro under albumin overload and their effect on autophagy activation,and to investigate the underlying mechanisms.Methods HK-2 cells cultured in vitro were divided into a normal control group (NC),an albumin (ALB) group,an ALB + N-acetyl-L-cysteine (NAC) group,an NAC group,an ALB+chloroquine(CQ)group and an ALB+ rapamycin(RAP)group.The expression of molecular markers for autophagy,Beclin-1 and microtubule-associated protein 1 light chain 3 (LC3),were detected by Western blotting.ROS levels were measured by a dichloro-dihydro-fluorescein diacetate(DCFH-DA) immunofluorescence method.Results Albumin overload-induced autophagy was activated in HK-2 cells as assessed by the significant upregulation of Beclin-1 and LC3-Ⅱ levels,compared with the control group(both P＜0.05).Albumin overload triggered oxidative stress in HK-2 cells as revealed by the increased production of ROS and the enhancement of green fluorescence brightness,compared with the control group [(22.47 ± 0.79) vs.(10.15 ± 0.57),P ＜ 0.05].The antioxidant NAC significantly inhibited albumin-induced autophagy(P ＜0.05).Moreover,the increase in ROS levels caused by albumin overload was promoted by chloroquine and blocked by rapamycin (both P＜0.05).Conclusions The mechanisms for albumin overload-induced autophagy in HK-2 cells were related to oxidative stress.
ABSTRACT
A 74-year-old woman receiving long-term anticoagulation with warfarin for chronic atrial fibrillation presented with severe acute abdominal pain, diarrhoea and vomiting. Initial laboratory workup revealed a deranged coagulation profile. Computed tomography of the abdomen and pelvis demonstrated spontaneous distal jejunal intramural haematoma with associated reactive ileus. No overt pneumatosis intestinalis, intraperitoneal free gas or haemoperitoneum was seen. Based on clinical and imaging findings, a diagnosis of over-anticoagulation complicated by small bowel intramural haematoma was made. The patient was managed non-operatively with analgesia, cessation of warfarin and reversal therapy with vitamin K. Warfarin therapy was recommenced upon resolution of symptoms and optimisation of coagulation status. The clinical presentation, radiological features and overall management of anticoagulation-induced bleeding are further discussed in this article.
ABSTRACT
Objective To investigate effects of albumin overload on mitochondrial membrane potential and ultrastructural changes in renal tubular epithelial cells (HK-2).Methods Vitrocultured HK-2 cells were treated with different concentrations of albumin.The mitochondrial membrane potential in HK-2 cells was detected by fluorescence probe JC-1,and the electron microscopy was used to detect the mitochondrial ultrastructure of cells.Results JC-1-detected red/green ratio was 2.34 ± 0.21 at 0 g/L of albumin treatment,0.83 ± 0.09 at 4 g/L,0.41 ± 0.07 at 8 g/L,0.38± 0.08 at 16 g/L albumin overload,which showed a gradually decreased red and green fluorescence intensity ratio along with increased albumin overload(F =162.794,P ＜0.001),and with significant differences in the ratio among groups (all P ＜ 0.05).Albumin overload-induced mitochondrial abnormality in transmission electron microscope included mitochondrial swelling,disordered cristae arrangement,cristae lysis and cavitation,and the increase of bilayer membrane structures in HK-2 cells.Conclusions Albumin overload can induce the decline of mitochondrial membrane potential,mitochondrial damage and autophagy in renal tubular epithelial cells,which suggest that mitochondrial damage and autophagy may be one of the mechanisms of albumin overloadinduced renal tubular epithelial cell injury.
ABSTRACT
OBJECTIVE: To prepare of a torotrope transdermal patch for in vitro consistency evaluation and explor of the impact of quality standard characteristics on industrialization. METHODS: The tulobuterol transdermal patch was prepared with polyisobutylene B50, polybutene and petroleum resin as auxiliary excipients. The drug content in the sample was determined by high-performance liquid chromatography; in vitro consistency was evaluated by microscopy, differential thermal analysis, Fourier transform infrared spectroscopy, viscosity tester, dissolution Tester, and transdermal tester. The dissolution of the patch and its relationship with transdermal permeation, drug crystallization and in vitro release mechanism of the patch were studied in order to explore the influence of quality standard characteristics on industrialization. RESULTS: The self-made patch and the reference preparation have conformity in the drug content, drug crystallization, DSC, MATR, heat resistance, cold resistance, viscosity and shape. The dissolution tests were performed in medium of water and phosphate buffer (pH 7.4, 6.8, 4.0), and the corresponding f2 were 72.516, 94.840, 90.905, and 81.760. The average transdermal permeability ratio is 1.02 and the skin retention ratio is 0.88. The drug solubility is pH dependent while the in vitro dissolution is not sensitive to pH. The correlation between transdermal and dissolution in vitro is good. The in vitro release is affected by the composition of the excipients and the crystallization of the drug. CONCLUSION: The self-adhesive and the reference preparation have good consistency in vitro evaluation; the in vitro dissolution test can effectively reflect the transdermal permeation and absorption process of the drug in vitro. The drug crystallization evaluation index in the preparation is introduced to improve the quality control detection efficiency and quality assurance in the industrialization process. Research reference is provided for the consistency evaluation research, industrialization and quality standard improvement of this product.
ABSTRACT
Polycomb group (PcG) ring finger protein 6 (PCGF6), though known as a member of the transcription-repressing complexes, PcG, also has activation function in regulating pluripotency gene expression. However, the mechanism underlying the activation function of PCGF6 is poorly understood. Here, we found that PCGF6 co-localizes to gene activation regions along with pluripotency factors such as OCT4. In addition, PCGF6 was recruited to a subset of the super-enhancer (SE) regions upstream of cell cycle-associated genes by OCT4, and increased their expression. By combining with promoter capture Hi-C data, we found that PCGF6 activates cell cycle genes by regulating SE-promoter interactions via 3D chromatin. Our findings highlight a novel mechanism of PcG protein in regulating pluripotency, and provide a research basis for the therapeutic application of pluripotent stem cells.
ABSTRACT
To establish the spectrum-effect relationship between HPLC fingerprint and free radicals activity scavenging in Guizhi Shaoyao Zhimu Decoction( GSZD),and provide a basis for the quality evaluation and modernization of classical prescriptions. Shimadsu GL-science C18 column( 4. 6 mm×250 mm,5 μm) was used with acetonitrile-0. 1% formic acid solution as the mobile phase for gradient elution. The detective wave length was 254 nm; the column temperature was set at 32 ℃; the injection volume was 20 μL; and the flow rate was 1. 0 m L·min-1.10 batches of primary standard samples of GSZD were detected,and their HPLC fingerprint was established by using the similarity evaluation system for chromatographic fingerprint of traditional Chinese medicine( TCM). The activity of scavenging free radicals was studied by 1,1-diphenyl-2-trinitrophenylhydrazine( DPPH) method,and the spectrum-effect relationship was studied by Pearson bivariate correlation analysis. The common mode of GSZD fingerprints was established,and 26 common peaks were marked,with similarities ranging from 0. 929 to 0. 998. Eight of the chromatographic peaks were identified by using the control comparison method: gallic acid,mangiferin,paeoniflorin,glycyrrhizin,asparagus,5-O-methylvisamicin,cinnamic acid,and ammonium glycyrrhetate. Among them,the content changes of No. 14( paeoniside),20,12( mangiferin),13 and 23( cinnamic acid) common peaks were negatively correlated with free radical scavenging activity. The fingerprint showed high precision,repeatability and stability,and the common peaks were well separated,so it can be used for the quality evaluation of GSZD,and could provide reference for further studies on the material basis of GSZD.
Subject(s)
Chromatography, High Pressure Liquid , Cinnamomum aromaticum , Chemistry , Drugs, Chinese Herbal , Chemistry , Free Radical Scavengers , Chemistry , Medicine, Chinese TraditionalABSTRACT
Objective To explore the relationship between multiple serological indexes and cardiac prog-nosis risk of patients;To compare the four predictive value of prognosis of patients with cardiac surgery. Meth-ods A total of 127 patients treated by cardiopulmonary bypass surgery were enrolled from July 2013 to March 2015 in our department.Their baseline data were recorded.All patients were followed up for 2 years.Patients with adverse outcomes were defined as the unfavorableprognosis group during the follow-up period while the patients with nodisease progression were defined as the favorableprognosis group. Univariate analysis and Cox proportional risk model wereapplied to evaluate the effects of all factors on the patient's prognosis. Meanwhile,the prediction ability of multiple serological indexes in predicting prognosis of patients with cardiac surgery was calculated by ROC curve analysis. Results Multivariate Cox proportional hazard model showed that the △NT-proBNP(P =0.019),△plasma levels of cystatin C(P=0.037),△troponin I(P=0.028)and LVEF(P=0.045)have signifi-cant influence on the prognosis of the patients and the △NT-proBNP has the highest degree(RR = 1.598);The AUC of the NT-proBNP combined with LVEF in diagnosis of patients with cardiac surgery was 0.842,and the sen-sitivity and specificity were 75.3% and 76.2%,respectively. Conclusions The level of △NT-proBNP and LVEF have a good predictive ability for cardiac outcome in patients undergoing surgery,which is expected as a conven-tional evaluation index of cardiac surgery with cardiopulmonary bypass.
ABSTRACT
OBJECTIVE: To prepare the tulobuterol crystal reservoir patch, and to evaluate morphology, stability and crystallization factors of the crystal in the patch, adhesive force, dissolution, transdermal properties in vitro and the pharmacokinetics in rabbits. METHODS: The transdermal patch was prepared on the basis of drug recrystallization and characterized by morphology, stability and crystallization factors using microscope and adhesive force using initial adhesion tester, adhesion tester and peel tester. The dissolution and transdermal properties were evaluated by using the dissolution tester and transdermal tester. In addition, pharmacokinetics was studied using New Zealand rabbits as experimental animals. RESULTS: The drug crystals were evenly distributed in the form of filaments, which had average width of (4.4±1.8)μm and kept stable at 2-40 ℃. The crystallization in patches is affected by tulobuterol supersaturation and temperature. The adhesive force of patch was suitable and its dissolution matched standard which can be fitted by the Higuchi equation. In the diffusion cell in vitro, the drug penetrated through the skin in a Zero-order kinetic equation, and the cumulative penetration percentage and skin retention concentration were 92.04% and 10.36 μg·cm-2 with in 24 h. The pharmaceutic parameters showed that the tulobuterol blood concentration can be maintained within 24 h, whose tmax and ρmax were (6.67±3.06)h and (3.08±1.32) ng·mL-1, respectively. CONCLUSION: The tulobuterol crystal reservoir patch can be established by control of recrystallization conditions. The patch has good adhesive properties and sustained release characteristics in vitro and in vivo, which has the practical significance for further study.
ABSTRACT
Objective To assess the echocardiographic characteristics of embolism and in-hospital mortality in patients with infective endocarditis using three-dimensional transesophageal echocardiography (3D TEE).Methods Retrospective review of 124 patients with native valve infective endocarditis was performed to examine its characteristics by two-dimensional transthoracic echocardiography (2D TTE),multi-plane and 3D TEE.The primary endpoint was embolism and mortality that occurred within one month before or after operation.The combined simple score was calculated by assigning 1 point each for the presence of large vegetation,abscess or fistula,rupture of valvular chord,moderated or severe valvular regurgitation and perforation or serious valvular destruction.Hosmer and area under the curve was calculated to predict embolism and adverse events with the combined simple score,length of vegetation,serious valvular destruction with abnormal morphology.Results In 124 patients,embolic events occured in 27 cases (27/124,21.77％).Multi-plane and 3D TEE can identify the exact location and length of vegetation compared with 2D TTE,which miss-diagnosed vegetation in left atrium and papillary muscle.The clinical presentation of embolism patients was remarkable for lower hemoglobin level (P＜0.05).The ratio of multi-located vegetation,mortality and serious valvular destruction with abnormal morphology were higher in embolism and adverse events patients than those in non-embolism and adverse events patients (all P＜0.05).The area under the curve of combined simple score,lengh of vegetation for embolisms and adverse events and serious valve destruction with abnormal morphology for embolism and adverse events were 0.65 (P=0.06),0.60 (P=0.19)) and 0.70 (P=0.03).Conclusion Multi-plan and 3D TEE plays a key role in the diagnosis of patients with infecitive endocarditis,especially vegetations in occasional location.Serious valve destruction with abnormal morphology is associated with embolism and adverse events.
ABSTRACT
Objective To investigated the effects of intermittent hypoxia on neuronal apoptosis and autophagy in hippocampus.Methods 30 Wistar rats were randomly divided into normal control group (NC),intermittent normoxia group (IN) and intermittent hypoxia group (IH).The spatial learning and memory function of the rat was assessed using Morris water maze test.The apoptotic cells and the ultrastructure of neurons in the hippocampus tissue were observed by TUNEL and transmission electron microscope,respectively.And the expression of autophagy marker protein LC3 and Beclin-1 were measured by Western blotting.Results The escape latency was significantly longer in IH than in NC and IN group.And the ratio of time spent in the target quadrant was lower in the IH group than in NC and IN group (P＜0.05).The apoptotic rate of rat hippocampal neurons (F =6.01,P=0.037),the amount of double-layer membrane structure-complicating autophagic vacuoles with karyopyknosis,and protein expression level of LC3 and Beclin-1 were significantly higher (all P ＜0.05) in intermittent hypoxia group than in IN and NC group.Conclusions Intermittent hypoxiainduced autophagy and apoptosis in rat hippocampus are significantly increased,which might be one of the possible mechanisms for cognitive dysfunction caused by intermittent hypoxia.