Bioassay-guided isolation of α-Glucosidase inhibitory constituents from Hypericum sampsonii / 中国天然药物

This study employed the α-glucosidase inhibitory activity model as an anti-diabetic assay and implemented a bioactivity-guided isolation strategy to identify novel natural compounds with potential therapeutic properties. Hypericum sampsoniiwas investigated, leading to the isolation of two highly modified seco-polycyclic polyprenylated acylphloroglucinols (PPAPs) (1 and 2), eight phenolic derivatives (3-10), and four terpene derivatives (11-14). The structures of compounds 1 and 2, featuring an unprecedented octahydro-2H-chromen-2-one ring system, were fully characterized using extensive spectroscopic data and quantum chemistry calculations. Six compounds (1, 5-7, 9, and 14) exhibited potential inhibitory effects against α-glucosidase, with IC50 values ranging from 0.050 ± 0.0016 to 366.70 ± 11.08 μg·mL-1. Notably, compound 5 (0.050 ± 0.0016 μg·mL-1) was identified as the most potential α-glucosidase inhibitor, with an inhibitory effect about 6900 times stronger than the positive control, acarbose (IC50 = 346.63 ± 15.65 μg·mL-1). A docking study was conducted to predict molecular interactions between two compounds (1 and 5) and α-glucosidase, and the hypothetical biosynthetic pathways of the two unprecedented seco-PPAPs were proposed.

Surgical versus conservative treatment for acute type A aortic intramural hematoma: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To compare the outcomes following emergency surgery or conservative treatment for patients with acute type A aortic intramural hematoma (IMH). Methods    Clinical data of consecutive patients diagnosed with acute type A aortic IMH in our hospital from September 2014 to December 2018 were retrospectively analyzed. The patients who met our surgical indications received surgery (an operation group) and other patients received strict conservative treatment (a conservative treatment group). Results    Finally 127 patients were enrolled, including 112 males and 15 females with an average age of 53.6±13.0 years. Of 127 patients, 85 (66.9%) patients accepted emergency surgery and 42 (33.1%) patients accepted strict conservative treatment. There was no difference between the two groups in early mortality or complications (P>0.05). The 5-year survival rate was 90.4% in the operation group and 74.3% in the conservative treatment group (P=0.010). A maximum aortic diameter in the ascending aorta and aortic arch≥45 mm and maximum thickness of IMH in the same section≥8 mm were risk factors for IMH-related death in patients undergoing conservative treatment (P<0.001). Conclusion    The mortality associated with emergency surgery for patients with acute type A aortic IMH is satisfactory. In clinical centers with well-established surgical techniques and postoperative management, emergency surgical treatment may provide a better outcome than conservative treatment for patients with acute type A aortic IMH.

Gene-phenotype correlation analysis of 226 cases of sporadic thoracic aortic diseases in southern China / 中华胸心血管外科杂志

Objective:To identify the causative genes of sporadic thoracic aortic aneurysm or dissection (TAAD) and their correlation with clinical phenotype in the southern Chinese.Methods:We analyzed 11 core genes of TAAD probands without specific family history of 226 cases by next-generation sequencing technology, and performed sanger sequencing for their close relatives. Clinical data of each patient, including age of onset, syndromic phenotypes, involvement of aortic root, aortic maximum diameter and D-dimer were collected. And statistical software SPSS was used to evaluate the correlation between clinical phenotypes and gene mutations.Results:A total of 106 variants were detected in 226 probands with gene-positive frequency of 44.69%, consist of 16 pathogenic (P) variants, 18 likely pathogenic (LP) variants and 71 variants of uncertain significance (VUS). More than half of the mutations were from the non-syndromic TAAD, in which the FBN1 still was the most common causative gene. Earlier age of onset, an increase of women, larger diameter of aorta, Stanford B dissection and severe aortic regurgitation were likely to occur on carriers of P/LP, while thoracic aortic aneurysm occurs on carriers of VUS. Phenotype of both syndrome and dissection with aneurysm could increase the likelihood of carrying gene mutation, but D-dimer and involvement of aortic root couldn’t.Conclusion:Patients with sporadic aortic diseases in southern China have significant genetic heterogeneity and specific correlation between their clinical phenotype and gene mutation, especially in non-syndromic population. Earlier age of onset in carriers of FBN1 or ACTA2 genes, and larger maximum diameters of aorta in carrier of P/LP.

Therapy experience and clinical features of patients with acute type A aortic dissection involving coronary malperfusion / 中华胸心血管外科杂志

Objective:To investigate the clinical characteristics, surgical methods and prognosis of patients with acute type A aortic dissection combining coronary artery involvement.Methods:415 patients diagnosed with acute type A aortic dissection from October 2016 to September 2019 were included in the study.Among them, 358 were males and 57 were females; aged(51.2±10.7) years old.According to the results of intraoperative coronary probes, 342 patients in the group were without coronary involvement, and the other 73 were with coronary involvement.Data on the coronary involvement classification, site, and treatment methods of the coronary involvement group were collected by consulting the ward medical record system.Meanwhile, preoperative baseline data, surgical data and prognostic results were retrospectively collected between the two groups. The data of the two groups were compared by chi- square test, t-test and Mann- Whitney U test. Results:Coronary involvement group: Among 73 (17.6%, 73/415) patients with coronary involvement, 8 (11.0%) in the left coronary, 48 in the right (65.8%), and 17 (23.3%)cases with involvement of both left and right coronary arteries. Classification of coronary artery(90) involvement: Neri A in 47(52.2%, 47/90), 33 with Neri B (36.7%, 33/90), and 10 with type Neri C (11.1%, 10/90). Type Neri B/C coronary artery involvement was mostly treated with artificial vascular coronary artery replacement or coronary artery bypass grafting. Comparison between the two groups show, patients in the coronary involvement group had higher preoperative levels of CK-MB, D-dimer and more severe aortic valve regurgitation compared to the coronary non-involvement group. The comparison of surgical data suggests that the coronary involvement group had a higher proportion of aortic root treatment, longer operation time, cardiopulmonary bypass time and aortic clamping time. A higher percentage of intimal tear located in the ascending aorta or aortic root was found in the coronary involvement group. The mortality rate in the coronary involvement group was significantly higher than that of the non-involvement group (12% versus 4%), and it was more likely to combine heart failure (5% versus 1%) and renal failure (26% versus 13%).Conclusion:Compared with pure type A dissection, patients with coronary artery involvement are more common in patients whose primary intimal tear were found at the proximal aorta, and are more prone to severe aortic valve regurgitation. Coronary artery treatment procedures include direct suture and fixation, coronary artery replacement, and coronary artery bypass grafting. Among them, Neri A coronary involvement can mostly be fixed with direct suture and stabilization, while the Neri B / C type mostly requires artificial vascular replacement of the affected coronary artery or coronary artery bypass. Patients with coronary artery involvement have a higher proportion of deaths and confer relatively higher risk of post-operative renal/cardiac failure.

Early and intermediate outcomes of second-grade false-lumen endovascular occlusive repair for aortic dissection / 中华普通外科杂志

Objective:To summarize the early and intermediate outcomes of second-grade false-lumen endovascular occlusive repair (FLEVOR) for aortic dissection.Methods:The clinical data of 12 patients undergoing second-grade FLEVOR after proximal repair of aortic dissection at our center from Aug 2016 to Aug 2019 was retrospectively analyzed.Results:The mean age was (51.3±14.9) years old. Four patients received open repair due to Stanford type A aortic dissection previously, the other 8 patients underwent thoracic endovascular aortic repair for Stanford type B aortic dissection. The time to the proximal repair varied from 3 months to 16 years. The technical success rate was 100%. Visceral ischemia, early spinal cord ischemia and in-hospital death did not occur perioperatively. The mean follow-up time was 16.7 months. Persistent false lumen perfusion was found in 3 patients, complete thrombosis of false lumen was achieved in the other 8 patients. The maximum diameter of abdominal aorta decreased in 8 (72.7%) patients.Conclusions:FLEVOR could block the blood flow from the false lumen and induce the thrombosis of false lumen, which promotes the aortic remodeling. Meanwhile, FLEVOR could protect the blood supply of spinal cord and viscera, and reduce the risk of type Ⅱ endoleaks.

Renal ischemia reduction in TAAA hybrid operation by VORTEC renal artery revascularization / 中华普通外科杂志

Objective:To compare the effect of hybrid open-endovascular repair (HOER) and Viabahn open revascularization technique (VORTEC)+HOER in the treatment of thoracoabdominal aortic aneurysms (TAAA).Methods:From Apr 2005 to Jul 2019, 33 TAAA patients underwent HOER including 21 cases of standard HOER, and 12 of VORTEC+HOER. The intraoperative renal ischemia time (RIT), incidence of postoperative acute kidney injury (AKI), rate of renal artery patency (RAP) and another short-term outcome were observed.Results:RIT was significantly shorter in the VORTEC+HOER group than in the standard treatment group [(9±3) minutes vs. (15±6) minutes, P<0.05]. The increase in serum creatinine (SCr) levels on the 1st postoperative day in the standard treatment group was significantly higher than that in the VORTEC+HOER group [(1.68±0.79) μmol/L vs. (1.05±0.06) μmol/L, P<0.05]. AKI occurred in 5 patients in the standard HOER treatment group (5/21, 24%), while no patient experienced AKI in the VORTEC+HOER group (0/12, 0). Conclusion:VORTEC significantly reduces RIT and postoperative SCr increasing, thereby potentially decreasing the incidence of postoperative AKI.

Short term result of COOK-ZFEN custom-made endovascular stent graft system for the treatment of short-neck abdominal aortic aneurysm / 中华普通外科杂志

Objective:To evaluate the safety and efficacy of a Zenith fenestrated aortic stent-graft (ZFEN) system in the treatment of short-necked aneurysms.Methods:The clinical data of 5 patients receiving F-EVAR in Zhongshan Hospital, Fudan University from Mar 2018 to Sep 2019 according to the standards of short-necked abdominal aortic aneurysm and COOK ZFEN custom stent were retrospectively analyzed.Results:Patients' average age was (69±11) years old. The time of stent customization was 4-6 weeks. The average maximum diameter of AAA was (60.8±14.0) mm. The average proximal neck diameter was (26.0±2.6) mm and the average length anchoring zone was (6.4±2.2) mm. The rate of technical success was 100%. There was no intraoperative loss of visceral vessels and stent displacement. The meane follow-up time was 6.8 months. The perioperative mortality was 0, and there were no other major complications. There were 3 patients with simple type Ⅱ endoleak and 1 patient with type Ⅲ endoleak. The endoleaks disappeared in 4 patients during follow-up of 3-12 months. 1 patient suffered with type Ⅱ and type Ⅲ endoleak, and the visceral vessels and branching stents were patent in all patients.Conclusion:The short term result of COOK ZFEN stent-graft system was safe and feasible for the treatment of short-necked AAA.

Inhibitory Effect and Mechanism of Jingulian Capsule on Human Breast Cancer MDA-MB-231 Cells / 中国实验方剂学杂志

Objective:To observe effect of Jingulian capsule on the proliferation of human breast cancer MDA-MB-231 cells and investigate its action mechanism against triple negative breast cancer （TNBC）. Method:The ingredients of Jingulian capsule were identified by ultra-performance liquid chromatography-tandem mass spectrometry（UPLC-MS/MS）. The inhibitory effect of Jingulian capsule at different doses （0.125，0.25，0.5，1，and 2 g·L^-1） against the proliferation of MDA-MB-231 cells were detected by methyl thiazolyl tetrazolium （MTT） assay. After treatment for 24 h， the morphological changes in nuclear apoptosis of MDA-MB-231 cells were detected by Hoechst 33258 staining. The effect of different concentrations of Jingulian capsule on the apoptosis and cycle of MDA-MB-231 cells after different treatment time were determined by flow cytometry. The protein expression levels of Poly-ADP-ribose polymeras （PARP）， proto-oncogene c-Myc， cyclin B₁， and phosphorylated extracellular signal-regulated kinase （p-ERK） in each group were assayed by Western blot. Result:A total of 113 compounds in Jingulian capsule were identified by UPLC-MS/MS. As revealed by MTT assay，compared with blank group，Jingulian capsule （0.125，0.25，0.5，1，2 g·L^-1） significantly inhibited viability of MDA-MB-231 cells （<italic>P</italic><0.01）， with the half maximal inhibitory concentration （ IC₅₀） of（0.13±0.02）g·L^-1. According to flow cytometry，compared with the blank group，Jingulian capsule at 1 g·L^-1 significantly induced the apoptosis of MDA-MB-231 cells （<italic>P</italic><0.05）and Jingulian capsule at 0.5， 1 g·L^-1 obviously increased the number of MDA-MB-231 cells in S phase （<italic>P</italic><0.05，<italic>P</italic><0.01）. The results of Western blotting demonstrated that the protein expression levels of PARP，c-Myc，and cyclin B₁ in 0.5， 1 g·L^-1Jingulian capsule groups were remarkably down-regulated as compared with those in the blank group（<italic>P</italic><0.01）， and the protein expression level of p-ERK in 1 g·L^-1Jingulian capsule group was also down-regulated （<italic>P</italic><0.01）. Conclusion:Jingulian capsule is able to inhibit the proliferation of MDA-MB-231 cells，induce S phase cell cycle arrest， and promote their apoptosis， which may be related to the inactivation of the MAPK signaling pathway.

Mechanism of Magnoliae Officinalis Cortex in treatment of peptic ulcer based on network pharmacology and molecular docking / 中国中药杂志

Magnoliae Officinalis Cortex(Houpo) can treat peptic ulcer disease(PUD), the mechanism of which remains unclear. In this study, network pharmacology and molecular docking were employed to predict the mechanism of Houpo in the treatment of PUD. Through literature review and TCMSP screening, 15 main active ingredients were obtained. The SwissTargetPrediction database was used to predict the potential targets of the ingredients, and Therapeutic Target Database(TTD), DrugBank, and Human Phenotype Ontology(HPO) to screen the disease-related targets. A total of 49 potential targets were obtained by the intersection of active ingre-dients-related targets and disease-related targets. Cytoscape 3.6.1 was employed to construct the protein-protein interaction network for the targets with high confidence(score>0.700) screened out by STRING. The DAVID database was used for GO and KEGG pathway enrichment of potential targets. GO enrichment analysis showed that the treatment mechanism was mostly related to nuclear receptor activity, ligand-activated transcription factor activity, and G protein-coupled acetylcholine receptor activity. KEGG enrichment analysis found that Houpo could regulate material metabolism, endocrine system, p53 signaling pathway, and PPAR signaling pathway. Molecu-lar docking verified that all 15 ingredients had good binding activities with key targets(CHRM1, CHRM2, FABP1, mTOR, and STAT3). The results mean that Houpo can treat PUD by participating in cell metabolism, inhibiting inflammatory cytokines, and regulating cell proliferation and apoptosis.

Treatment for arteriosclerosis obliterans complicated with acute thrombosis of lower extremity / 中华普通外科杂志

Objective:To discuss the clinical treatment for arteriosclerosis obliterans combined with acute thrombosis (ASOCAT) of lower extremities.Methods:The treatment methods and results of 30 patients with ASOCAT admitted to our center from Jan 2009 to May 2019 were retrospectively analyzed.Results:The course of acute thrombosis in 30 patients was (9.5±5.2) days, and the average course of ASO was (2.1±1.4) years. Among 30 patients, 13 patients had aortoiliac occlusion (type Ⅰ), and 17 patients had femoropopliteal lesion (type Ⅱ). Twenty-eight patients underwent endovascular treatment, 1 had hybrid operation, and 1 was given aorto-bilateral femoral bypass. One patient died perioperatively. 24 patients were followed up for (16.3±16.1) months. One died during follow-up.Two patients underwent above-knee amputation within 6 months. Two patients had distal superficial femoral artery reocclusion within 12 months. The restenosis/reocclusion rates within 12 months of type Ⅰ and Ⅱ patients were 12.5% and 21.4%, respectively. The 6/12-month amputation-free survival rates for type Ⅰ and type Ⅱ were 87.5%/87.5% and 92.8%/85.7%, respectively.Conclusion:Reasonable and active use of open surgery, endovascular treatment or hybrid operation could achieve acceptable outcomes in patients with ASOCAT.

Long-term follow up outcomes of surgical resection of Shamblin Ⅱ/Ⅲ carotid body tumor: a single center analysis / 中华普通外科杂志

Objective:To evaluate the correlation between tumor size and surgical outcomes of Shamblin Ⅱ/Ⅲ carotid body tumor (CBT) and the prognosis.Methods:From Apr 2011 to Dec 2017, 88 patients with Shamblin Ⅱ and Ⅲ CBTs undergoing tumor resection were retrospectively analyzed. The long-term prognosis of surgical resection was also evaluated.Results:One patient died of multi-organ failure postoperatively, two patients abandoned surgery. The perioperative mortality was 1%. 85 patients having 87 lesions successfully resected were analyzed. There were 13 Shamblin Ⅱ and 74 Shamblin Ⅲ CBTs resection. Two patients had bilateral CBTs resection. The median of tumor size, procedural blood loss, procedural time, and length of hospital stay was 3.0 (1.2-5.5) cm, 200 (0-2 500) ml, 162 (85-430) min, and 10 (6-28) d, respectively. Seventy-two patients had carotid vascular intervention during the procedure, and thirty-three patients had neurological complications after the procedure. Correlation analysis showed that the tumor size had positive relationship with blood loss (Spearman R=0.35, P<0.01) and procedural time (Spearman R= 0.54, P<0.01). Tumor size was positively associated with the risk of cranial neurological complication ( OR=1.72, 95% CI 1.08-2.73, P=0.02) and carotid vascular intervention ( OR=2.69, 95% CI 1.27-5.69, P=0.01). There were four patients who were diagnosed with malignant CBT due to the metastasis. Three suffered CBT recurrence after 1, 5, and 7 years during the follow up. Conclusions:Shamblin Ⅱ or Ⅲ CBTs should be intervened as early as possible to facilitate the surgical resection, as well as to reduce the risk of carotid vascular and neurological complications.

Timing of radical surgery in patients with postoperative incidentally discovered gallbladder cancer / 中华肝胆外科杂志

Objective To compare the tumor characteristics and survival between postoperative incidentally discovered gallbladder cancer (ID-GBC) and preoperatively suspected gallbladder cancer (PS-GBC).Methods The data of 276 GBC patients who underwent surgical resection with curative intent between January 2004 and December 2014 at the Eastern Hepatobiliary Surgery Hospital were retrospectively analyzed.Results The 1-,3-,and 5-year cumulative survival rates of the ID-GBC group (88.8％,52.2％,and 33.0％,respectively) were significantly better than those in the PS-GBC group (57.5％,25.7％,and 16.6％,P ＜ 0.05).In the ID-GBC group,multivariate analysis revealed that T staging,hepatic invasion and time interval from cholecystectomy to re-operation were independent prognostic factors.The overall survival (OS) in the group with the time interval within 2 weeks was significantly better than those in the other two groups (both P ＜ 0.05).However,there were no significant differences in OS between the groups with the time interval of 2 weeks to 1 month and more than 1 month (P ＞ 0.05).Conclusions Postoperative ID-GBC had significantly better survival outcomes than PS-GBC.Reoperation within two weeks in patients with ID-GBC is a good strategy.

Assessment of supra-arch branches bypass on cerebral oxygen saturation and carotid hemodynamics in patients with Stanford type B aortic dissection / 中华胸心血管外科杂志

Objective:To evaluate the effects of supra-arch branches bypass on cerebral oxygen saturation and hemodynamics in patients with Stanford type B aortic dissection.Methods:From January to December 2018, consecutive 27 patients with Stanford type B aortic dissection were enrolled in the study. All patients received hybrid treatment, including supra-arch branches bypass(right axillary artery-left common carotid artery-left subclavian artery) and thoracic endovascular aortic repaire(TEVAR). All the operations were performed by the same surgical team. The left and right cerebral oxygen saturation were measured after anesthesia(T1), left carotid artery occlusion(T2) and after operation(T3); peak systolic velocity(PSV) and resistance index(RI) of left and right carotid arteries were measured before(t1) and after operation(t2).Results:The left cerebral oxygen saturation was 0.62 ±0.01, 0.54±0.01 and 0.62±0.01 at T1, T2 and T3, respectively. There was significant difference between T2 and T1 and T3( P=0.002, P=0.001), but there was no significant difference between T1 and T3. The PSV of left carotid artery at t1 and t2 were(0.91±0.11)m/s and(0.76±0.09)m/s respectively, with no significant difference( P= 0.191). The RI of left carotid artery at t1 and t2 were 0.83±0.06 and 0.93±0.13 respectively, with no significant difference( P= 0.575). Conclusion:If one side of carotid artery was blocked for a short time during supra-arch branches bypass, the cerebral oxygen saturation would be decreased temporarily, but the changes of cerebral oxygen metabolism could be completely restored after operation. However, the hemodynamics of carotid artery would not change significantly. In the hybrid treatment strategy for the patients with aortic dissection Stanford type B, blocking bilateral carotid arteries can be avoided. Making the right axillary artery-left common carotid artery-left subclavian artery shunt is a safe and effective choice.

Protective Effect of Syringaresinol on Excitatory Damage Induced by Sodium Glutamate in SH-SY5Y Cells / 中国实验方剂学杂志

Objective: To establish a model for the injury of human neuroblastoma cell (SH-SY5Y) induced by sodium glutamate, and to observe the protective effect of syringaresinol on cell damage from Viscum liquidambaricolum hayataon, and to explore its mechanism. Method: Construction of SH-SY5Y cell injury model using sodium glutamate.The experiment was divided into normal cell group, injury model group (sodium glutamate 50 mmol·L-1, sodium glutamate 50 mmol·L-1 + DMSO),syringaresinol experimental group (6.25, 12.5, 25 μmol·L-1), by cell counting, cell morphology observation, Annexin V-FITC/PI apoptosis detection, ROS reactive oxygen species detection, mitochondrial membrane potential, and Western blot, evaluation of syringaresinol on glutamate-induced neuronal excitability injury neuroprotective activity. Result: Compared with normal group, the cell survival rate of the model group was significantly decreased (PPPPP-1) showed a concentration-dependent increase in cells. Survival rate (PPPPPConclusion: Syringaresinol has significant protective activity against excitatory damage induced by sodium glutamate in SH-SY5Y neurons, the mechanism may be through anti-oxidative stress, repairing mitochondrial function and DNA damage to significantly reduce sodium glutamate-induced neuronal apoptosis.

Transplantation of peripheral purified CD34+ cells in treatment of thromboangiitis obliterans / 中华普通外科杂志

Objective To evaluate the safety and efficacy of transplantation of purified CD34 + cells (PCCs) in treatment of critical limb ischemia (CLI) caused by thromboangiitis obliterans (TAO).Methods From May 2009 to June 2015,34 TAO-induced-CLI cases underwent PCCs transplantation.None of these patients were eligible for surgical or endovascular revascularization.G-CSF was subcutaneously injected for 5 days before peripheral CD34 + cells were isolated,purified and intramuscularly injected in the limbs.Patients were regularly follow-up.Results Technical success was achieved in all cases.The mean number of transplanted cells was (7.5 ± 2.4) × 105/kg.The follow-up was accomplished in 32 cases,ranging from 6 to 79 months (mean 45 ±24 months),and two patients were lost.Wong-Baker FACES pain rating scale score significantly decreased from 8.0 ±2.0(4-10)to 2.2 ±3.1 (P ＜0.05) at 1 month.The Peak pain-free walking time improved from (4.0 ± 2.0) min to (13.5 ± 5.3) min (P ＜ 0.05) at 3 months and (19.0 ± 3.1) min (P ＜ 0.05) at 6 months.The ankle-brachial index increased from 0.42 ± 0.20 to 0.50 ± 0.10 (P ＜ 0.05) at 3 months and 0.52 ± 0.11 (P ＜ 0.05) at 6 months,respectively.Transcutaneous partial oxygen pressure rose from (25 ± 11) mmHg to (48 ± 11) mmHg(P ＜ 0.05) at 3 months and (58 ± 10) mmHg (P ＜ 0.001) at 6 months,respectively.Ulcers healed in 21 out of 22 patients at (5 ± 4) months.The overall amputation-free survival rate was 94.1％ at 6 months and 91.2％ at 48 months.No major adverse events were observed perioperatively or postoperatively.Conclusions Transplantation of PCCs could yield safe,satisfactory and durable treatment outcomes in patients with TAO-induced-CLI.

Analysis of fibrillin-1 new mutations in patients with Marfan syndrome / 中华胸心血管外科杂志

Objective To detect 14 genes including fibrillin-1(FBN1) and so on mutations in 17 patients with Marfan syndrome(MFS) and family members of 2 patients and to investigate the correlation between FBN1 gene mutation and MFS.Methods Genomic DNAs were extracted from whole blood sample of 17 patients and 43 family members.After DNA samples were amplified by polymerase chain raction(PCR), we used capture panels to get target genes which would be sequenced by Illumina HiSeq2500 Analyzers(Illumina, SanDiego, USA).The target genes included ACTA2、CBS、FBN1、FBN2、MYH11、COL3A1、SMAD3、TGFBR1、TGFBR2、MYLK、MSTN、COLA2、TGFB2 and SLC2A10.The results of sequencing would be compared with multiple databases, including NCBI dbSNP, HapMap, 1000 human genome dataset and database of 100 Chinese healthy adults, to find gene mutation.Finally, these mutations would be validated using conventional Sanger sequencing methods.Results A total of 10 FBN1 mutations and 1 actin alpha2(ACTA2) mutation in 17 patients were identified, of which 8 FBN1 mutations and 1 ACTA2 mutation were novel.One FBN1 mutation was underwent family investigation and we found in this family, all patients had this mutation and others did not have it.Conclusion Missense mutation of c.7280G>A in the 59th exon of FBN1 gene is new pathogenic mutation for MFS.The other 8 novel mutations may be the pathogenic factors of MFS.

Endovascular aortic repair of abdominal aortic aneurysm of short neck with Endurant stent graft / 中华外科杂志

Objective@#To evaluate the safety and effectiveness of the Endurant stent graft for abdominal aortic aneurysm cases with proximal neck length <10 mm.@*Methods@#This study was a retrospective analysis. From January 2010 to May 2015, 22 consecutive abdominal aortic aneurysm patients with proximal neck length <10 mm were treated with endovascular aortic repair by Endurant stent graft in Department of Vascular Surgery, Zhongshan Hospital, Fudan University. There were 19 (86.3%) male cases, aging from 57 to 84 years. All patients underwent preoperative CT angiography and the anatomic parameters of abdominal aortic aneurysm were measured. All patients performed standard endovascular aortic repair first and if there was obvious proximal typeⅠ endoleak, the CUFF or the chimney technology were applied to observed the perioperative technical and the clinical success rate. During follow-up, the incidence of adverse events and the reintervention rate were observed.@*Results@#These 22 cases had proximal neck length 5 to 9 mm with the average of (7.2±1.4) mm. Immediate endoleak occurred in 5 patients with 4 cases of proximal typeⅠ endoleak, 3 cases were implanted proximal CUFF, 1 case implanted CUFF and left renal artery chimney. One case died perioperatively, the clinical success rate was 95.4%, the technical success rate was 77.3%. During the follow-up of 6 to 54 months, there was 1 case with delayed proximal type-1 endoleak, during operation the patient had no endoleak, but disappeared 6 months later without further intervention. So the incidence of adverse event was 4.5% and reintervention rate was 0.@*Conclusion@#The Endurant stent graft for abdominal aortic aneurysm cases with proximal neck length < 10 mm is safe and effective.

Surgical management for 40 adult patients with aortic coarctation / 中国胸心血管外科临床杂志

@#Objective    To summarize the experiences of the surgical management for adult patients with aortic coarctation. Methods     Clinical data of 40 adult patients diagnosed with aortic coarctation undergoing surgical repair in our center between July 2004 and March 2015 were retrospectively analyzed. There were 28 males and 15 females with a mean age of 26.3±11.0 years (ranging 16-57 years). We evaluated the effect of surgery by the change of pressure gradient between upper limb and lower limb, mechanical ventilation time, and length of ICU stay and hospital stay. Results    Forty surgeries were finished successfully. One patient died after surgery. The follow-up ranged from 12 to 36 months. The mean pressure gradient reduced significantly after surgery. There were 6 patients suffering blood hypertension at their discharge, and all of them still need antihypertensive drugs. Conclusion    Surgical repair is an effective treatment for adult with aortic coarctation. Extra-anatomic ascending-to-descending aortic bypass and concomitant repair of intracardiac anomalies is safe and effective.

Endovascular treatment of popliteal artery aneurysm in a clinical analysis of 9 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of endovascular repair of popliteal artery aneurysm (PAA) and to summarize the clinical experience and lessons.</p><p><b>METHODS</b>A clinical data of 9 PAA cases (males 8, females 1, age range 55-84) undergoing endovascular repair from October 2006 to December 2014 at Zhongshan Hospital Fudan University were retrospectively analyzed. CT angiography was made in all of the 9 cases preoperatively, and 10 PAA were included in the analysis. Of the 9 cases, 6 cases were symptomatic. The mean diameter of PAA was 3.9 cm (range, 2.1-8.2).</p><p><b>RESULTS</b>The technique successful rate of endovascular repair was 10/10. The preoperative complications were 2/10, including one case suffered hematoma in the arterial puncture site and 1 case with distal artery embolization. The mean follow-up was 33 months (range, 3-87). During the follow-up, 2 cases received the secondary intervention and drug thrombolysis because of the stent distal thrombosis. The stent-graft primary patency at 1 year was 78.8% (95% CI: 48%-91%). One case suffered stent fracture, and one case died of brainstem hemorrhage 15 months post endovascular repair of PAA.</p><p><b>CONCLUSIONS</b>Endovascular treatment of PAA is safe and effective in perioperative and midterm follow-up. However, individual endovascular strategy and postoperative complications in the long-term follow-up should be payed more attention.</p>

Synthesis and Application of a Spirobenzopyran-based Probe for Detection of Cu2+and Hydrazine / 分析化学

A spurobenzopyran-based probe ( L) for the detectuon of Cu2+ and hydrazune was synthesuzed by usung 4-methyl-2, 6-duformylphenol and 1, 3, 3-trumethyl-2-methyleneundolune, and uts structure was characteruzed by 1 H NMR, 13 C NMR, FT-IR and H RMS( ESI-MS) . The recognutuon propertues of the probe L wuth nuneteen kunds of metral uons, eughteen kunds of anuon uons and nune kunds of amune compounds had been unvestugated un Trus-HCl ( pH = 7. 40 )-ethanol solutuon ( 1 ∶ 1, V/V ) by UV-Vus, fluorescence spectrophotometry, 1 H NMR tutratuon and MS. The results showed that the probe L exhubuted hugher selectuvuty and sensutuvuty towards Cu2+ and hydrazune over other unterferung objects un Trus-HCl ( pH=7. 40 )-ethanol solutuon(1∶1, V/V), and the color changes of L caused by Cu2+ and hydrazune could be observed by naked eyes. Thus, L could be loaded as test paper for detectung Cu2+ at μmol/L level un water solutuon by naked eyes. Notably, probe L could be used to detect hydrazune un luquud and gas state wuth dufferent concentratuons by detectung the color changes from readuly prepared TLC plates. On the basus of thus, the probe L was used un the determunatuon of Cu2+ un the water and drug samples wuth recoverues of 83. 5%-111. 0% and RSD of 4 . 0%. The results showed that thus probe L had potentual applucatuons un the monutorung of envuronmental pollutuon and the analysus of Cu2+ and hydrazune un drug.