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Inflammation， the basic pathological process of many diseases， can occur in various tissues and organs of the body and cause many diseases including cancer. So far， there are thousands of anti-inflammatory drugs on the market， but most of these drugs have adverse reactions of gastrointestinal injury， and can even cause greater damage to the body. In recent years， the research on the repurpose of Chinese medicine is in the ascendant， and the innovative research on the specific antimalarial drug artemisinin has attracted extensive attention from scholars in China and abroad. Artesunate is a water-soluble derivative of artemisinin， which has the characteristics of quick effect and low toxicity. In addition to its significant therapeutic effect on malaria， artesunate also has a potential anti-inflammatory effect. In this review， the anti-inflammatory effect and mechanism of artesunate were elaborated in detail by consulting the relevant literature. It was found that artesunate had good anti-inflammatory effects in the respiratory system， liver injury， osteoarthritis， dermatitis， kidney inflammation， colitis， neuroinflammation， and even in novel coronavirus disease 2019 （COVID-19）. It was concluded that artesunate mainly participated in apoptotic signal transduction， mediated immune regulation， and improved oxidative stress to play an anti-inflammatory role by acting on nuclear factor-κB （NF-κB）， nuclear factor E2-related factor 2 （Nrf2）， phosphatidylinositol-3 kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， Toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/tumor necrosis factor receptor-associated factor 6 （TRAF6）， high mobility group box 1 （HMGB1）/receptor for advanced glycation endproduct （RAGE）， and other pathways. Through the review of the anti-inflammatory effect and mechanism of artesunate， it is expected to provide a reference for the application of artesunate in inflammation resistance and further development and utilization of artesunate in the future.
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ObjectiveTo investigate the effects of flavanomarein on the transcriptome of small intestinal organoids in insulin-resistant mice. MethodFirstly， small intestinal organoids of C57BL/6J and db/db mice were established. Ki-67 and E-cadherin expression was determined by immunofluorescence. Small intestinal organoids were divided into the following three groups： C57BL/6J mouse small intestinal organoids as the normal control group， db/db mouse small intestinal organoids as the model group （IR group）， and db/db mouse small intestinal organoids treated with flavanomarein as the administration group （FM group）. Western blot was used to detect the expression of glucagon-like peptide-1（GLP-1） protein on the small intestinal organoids of the three groups. Finally， transcriptome sequencing was performed on samples from the three groups. ResultOn the 6th day of small intestine organoids culture， a cyclic structure was formed around the lumen， and a small intestine organoids culture model was preliminarily established. Immunofluorescence detection showed that ki-67 and E-cadherin were expressed in small intestinal organoids. Western blot results showed that the expression of GLP-1 protein was increased by flavanomarein. In the results of differential expressed gene （DEG） screening， there were 1 862 DEGs in the IR group as compared with the normal control group， and 2 282 DEGs in the FM group as compared with the IR group. Through protein-protein interaction（PPI） network analysis of the DEGs of the two groups， 10 Hub genes， including Nr1i3， Cyp2c44， Ugt2b1， Gsta1， Gstm2， Ptgs1， Gstm4， Cyp2c38， Cyp4a32， and Gpx3， were obtained. These genes were highly expressed in the normal control group， and their expression was reduced in the IR group. After the intervention of flavanomarein， the expression of the above genes was reversed. ConclusionFlavanomarein may play its role in improving insulin resistance by reversing the expression levels of 10 Hub genes， including Nr1i3， Cyp2c44， Ugt2b1， Gsta1， Gstm2， Ptgs1， Gstm4， Cyp2c38， Cyp4a32， and Gpx3.
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Objective:To explore the feasibility and safety of long-distance urological nephrotomy with the support of 5G communication technology by using the domestic robot.Methods:Clinical data of the patients with remote robot-assisted laparoscopic nephrectomy, which were completed from March to April 2021 by the Affiliated Hospital of Qingdao University (as the host hospital where the main operating system located) were retrospectively analyzed. There were 3 patients, including 2 males and 1 female.The average age was 61 (49-73) years, and the average body mass index was 23.73 (20.00-27.76) kg/m 2. One patient had a ASA classification of grade 2, and the other 2 patients had grade 3. All patients met the surgical criteria for non-functional nephrectomy. The chief surgeon who performing the telesurgery was located at the Affiliated Hospital of Qingdao University. The surgeon remotely controlled the bedside operating system (slave system) in 3 local hospitals located in other cities in Shandong Province (network communication distances of 82.5, 141 and 229 km, respectively) by manipulating the master system located in Qingdao. Images and operating instructions during surgery were transmitted using 5G wireless communication technology. Intraoperative network conditions, robot operation, and patient perioperative data were summarized. Results:All 3 tele-nephrectomies were successfully completed. The average network signal latency time was 27.3 (23-30) ms, with no packet loss, and the average total latency time was 177.3(173-180) ms. The mean resection time was 79.3 (52-111) min, and the average intraoperative blood loss was 31.1 (15.6-41.9) ml. There were no network related adverse events occurred during the operation, and the robot-related adverse events occured 3 times, all three of which were characterized by inconsistent master and slave movements of the manipulator arm and the bedside robotic arm. None of these adverse events affected the successful performance of the telesurgery. The mean postoperative exhaust time was 60.5 (38.5-78.0) h. The mean postoperative VAS score at 24 hours was 3.7 (3-4). The Clavien-Dindo classification were all grade I. No significant abnormality was found on the 30th day after surgery, and the patients recovered well at the follow-up until 6 months postoperatively.Conclusions:It is safe and feasible to perform remote robot-assisted laparoscopic nephrectomy based on 5G communication technology with no serious adverse events or surgical complications.However, the conclusion needs to be further verified by large sample and multi-center prospective study.
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A fast,reliable,and cost-effective liquid chromatography-tandem mass spectrometry method was established to determine the effects of the traditional Chinese medicine employed to treat coronavirus disease 2019,namely,Lianhua Qingwen granules,Huoxiang Zhengqi capsules,Jinhua Qinggan granules,Shufeng Jiedu capsules,and Angong Niuhuang pills,on the pharmacokinetics of lopinavir/ritonavir in rats.Blood samples were prepared using the protein precipitation method and atazanavir was selected as the internal standard(IS).Separation was performed on an Agilent ZORBAX eclipse plus C18(2.1 mm x 50 mm,1.8 μm)column using acetonitrile and water containing 0.1％formic acid as the mobile phase for gradient elution.The flow rate was 0.4 mL/min and the injection volume was 2 μL Agilent Jet Stream electrospray ionization was used for mass spectrometry detection under positive ion multiple reaction monitoring mode at a transition of m/z 629.3→447.3 for lopinavir,m/z 721.3→296.1 for rito-navir,and m/z 705.4→168.1 for the IS.The method showed good linearity in the concentration range of 25-2500 ng/mL(r=0.9981)for lopinavir and 5-500 ng/mL(r=0.9984)for ritonavir.The intra-day and inter-day precision and accuracy were both within±15％.Items,such as dilution reliability and residual effect,were also within the acceptable limits.The method was used to determine the effects of five types of traditional Chinese medicines on the pharmacokinetics of lopinavir/ritonavir in rats.The pharmaco-kinetic results showed that the half-life of ritonavir in the groups administered Lianhua Qingwen granules and Huoxiang Zhengqi capsules combined with lopinavir/ritonavir was prolonged by approx-imately 1.5-to 2-fold relative to that in the control group.Similarly,the pharmacokinetic parameters of lopinavir were altered.Overall,the results of this study offer important theoretical parameters for the effective clinical use of five types of traditional Chinese medicines combined with lopinavir/ritonavir to reduce the occurrence of clinical adverse reactions.
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Objective:To investigate the effect and mechanism of NACK knockdown on the proliferation and apoptosis of T-cell acute lymphoblastic leukemia (T-ALL) Jurkat cells. Methods:Lentivirus transfection technology was used to transfect Jurkat cells and knock down NACK gene.Real time fluorescent quantitative PCR and Western blot were used to detect the silencing efficiency of NACK gene.CCK-8 method and flow cytometry were used to detect the effects of NACK knockdown on the proliferation and apoptosis of Jurkat cells.The expressions of protein related with Notch1 pathway, such as Hes1 and c-Myc, were detected by Western blot. Results:After NACK-shRNA was successfully transfected into Jurkat cells by lentiviral vector, the expression of NACK mRNA and protein was reduced signi-ficantly ( P<0.05). Compared with the negative control group and the blank control group, the CCK-8 method showed that the cell proliferation in the experimental group was significantly inhibited [The inhibition rates of cell proliferation in the experimental group, negative control group and blank control group were (37.27±4.48)%, (4.25±2.10)% and (2.43±1.40)%, respectively]( F=132.640, P<0.05), and the flow cytometry test showed that the apoptosis in the experimental group increased significantly [The apoptosis rates of experimental group, negative control group and blank control group were (26.38±3.03)%, (6.07±2.61)% and (3.40±1.98)%, respectively]( F=90.534, P<0.05). Western blot results confirmed that the expression of Notch1 pathway-related proteins Hes1 and c-Myc was down-regulated compared with the negative control group and the blank control group, and the difference was statistically significant ( P<0.05). Conclusions:Targeting silent NACK can down-regulate the expression of Notch1 pathway-related proteins, which leads to the inhibition of Jurkat cell proliferation and increased apoptosis, thereby exerting its anti-T-ALL effect.
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The regulatory mechanisms of pubertal development are complex and affected by many factors.MicroRNAs, which major participants in epigenetics, are short single-stranded RNAs composed of 21-25 nucleotides.They can regulate the expression or translation of multiple target genes, playing an important role in complex biological phenomena.During pubertal development, microRNAs can regulate the expression of related genes on the hypothalamic-pituitary-gonadal axis(HPGA). Recently, studies have found that the lack or overexpression of some specific microRNAs can cause abnormal pubertal development(premature or delayed)and lead to reproductive disorders, providing a new direction for the diagnosis and treatment of puberty diseases.Here we mainly review the regulatory mechanisms that microRNAs participate in pubertal development.
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Objective:To compare the short-and long-term effects of conservative and interventional treatment in patients with lower extremity arteriosclerosis obliterans of Fontaine stage Ⅱ.Methods:This is a retrospective analysis,184 patients (219 limbs) admitted to the Department of Vascular Surgery, First Affiliated Hospital of Shandong First Medical University from Jun 2014 to Jun 2017, were divided into the conservative treatment group (93 limbs) and interventional treatment group (126 limbs).Results:The short-term effective rate in the intervention group was better than that of the conservative group (83.33% vs. 45.16%, P<0.05). After one year follow-up, the total effective rate in the groups was similar (60.32% vs. 53.76%, P>0.05). While the total effective rate of the conservative group was better than that of the intervention group (60.21% vs. 53.17%) after the 3-year follow-up,though the differences were not statistically significant ( P>0.05). The rates of all-cause death, amputation, and cardiovascular events in the conservative group were lower; though the difference was not significant ( P>0.05). However, the intervention group had a significantly higher rate of restenosis and re-intervention rate during the 3-year follow-up period ( P<0.05). Conclusion:Compared to intervention group,the conservative treatment is more economical ,effective and safe for patients with lower extremity arteriosclerosis obliterans of Fontaine stage Ⅱ.
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Objective To identify the pathogen and origins of 286 clustered cases of rotavirus infection in Hohhot, and to provide reliable basis for formulating preventive measures of rotavirus infection outbreaks. Methods Epidemiological investigation was conducted on 286 rotavirus outbreaks involving 8,560 cases in Hohhot from December 2017 to December 2020. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the genotypes, and the related risk factors were analyzed. Results Of the 286 rotavirus outbreaks, 165 were clustered outbreaks, and the duration was 5 to 8 days, with an average of (7.05±1.06) days, presenting temporal and spatial clustering. The causes of the outbreaks included rotavirus contamination in drinking water, improper management of household infections, and inadequate hospital preventive measures. The total number of cases was 8,560, and the positive rate of rotavirus was 47.17% (4 038/8 560). Group A and B rotavirus strains were detected in vomit or stool samples. Rotavirus infection in children was mostly caused by group A rotavirus (100%) and in adults by group B rotavirus (97.59%), and the common symptoms included diarrhea, vomiting and fever. The infection rate of children (87.67%, 3,540/4,038) was significantly higher than that of adults (12.33%, 4,98/4,038) (χ2=115.520, P<0.05). Rotavirus infection occurred most frequently in autumn and winter. Conclusion Clustered outbreaks account for most of rotavirus infection events, and children are the key targets of prevention and treatment. Rotavirus screening should be strengthened.
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Objective:To assess the changes of left ventricular systolic function and global synchronization and myocardial work in patients with left bundle branch pacing (LBBP) by two-dimensional multi-layered speckle tracking imaging.Methods:Forty-two patients with Ⅱ degree Ⅱ type or Ⅲ degree atrioventricular block (AVB) in the Cardiovascular Hospital of Xiamen University from April to December 2019 were selected as pacing group, which were further divided into two groups according to different pacemaker modes: twenty patients with right ventricular septal pacing (RVSP), twenty-two patients with LBBP, and twenty patients with normal ECG and cardiac structure were enrolled as control group. Echocardiography of pacing group and control group was performed and analyzed. The left ventricular subendocardial longitudinal strain peak(LSendo), the middle layer myocardial longitudinal strain peak(LSmid), subepicardial longitudinal strain peak(LSepi), global myocardial longitudinal strain peak(GLS), peak strain dispersion (PSD), global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) were acquired. The differences among the three groups were analyzed and the high difference indexes were screened by statistical modeling.Results:LSendo in three groups had no difference ( P>0.05). LSmid, LSepi, GLS in the control group, LBBP group and RVSP groups were decreased gradually ( P<0.05). GLS in LBBP group was higher than in RVSP group ( P<0.05). Compared with the control group, the increases of QRS and PSD in LBBP group were not statistically significant ( P>0.05), while the decreases of QRS and PSD in LBBP group were statistically significant compared with the RVSP group ( P<0.05). The values of GCW among three groups had no statistical significance ( P>0.05). Compared with the control group, the decrease of GWI in LBBP group was not statistically significant ( P>0.05), while the increase of GWW and the decrease of GWE were statistically significant ( P<0.05). Compared with the RVSP group, the increases of GWI and GWE and the decrease of GWW in LBBP group were statistically significant ( P<0.05). QRS, LSendo, GLS, LSmid, left ventricular apex rotation to basal rotation peak time(ApexBase period) were the indexes with significant difference among LBBP and RVSP groups and all index characteristics showed better in LBBP than RVSP group. Conclusions:Two-dimensional multi-layered speckle tracking imaging can be used to evaluate the effect of LBBP on left ventricular systolic function and global synchronization and myocardial work. LBBP longitudinal mechanical synchronization is better than right ventricular septal pacing by improving the peak global myocardial longitudinal strain and myocardial work after pacemaker.
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Objective:The blood free carnitine levels of preterm infants with neonatal respiratory distress syndrome (NRDS) were detected within 7 days after birth, and the correlation between blood free carnitine levels and NRDS in preterm infants was explored.Methods:Seventy premature infants with gestational ages from 28 to 36 weeks who were admitted to the NICU of the Affiliated Hospital of Inner Mongolia Medical University from January 1, 2017 to December 31, 2019 were selected as the participants.Among them, 35 cases were in the NRDS group, while 35 cases of premature infants without NRDS were chosen as the control group.Heel blood samples were collected from all subjects within 6 hours, 3 days and 7 days after birth, and the levels of blood free carnitine were detected by tandem mass spectrometry.Results:Within 7 days after birth, the levels of free carnitine in blood of premature infants in the two groups gradually decreased with time, but the decreasing trend was not similar( F=4.096, P=0.021). Compared with 6 hours after birth, the blood free carnitine level in NRDS group decreased significantly with 3 days after birth[(35.24±9.58) μmol/L vs.(23.96±7.12) μmol/L, P<0.05]. The levels of blood free carnitine in NRDS group at 6 hours and 3 days after birth were significantly lower than those in control group[(35.24±9.58) μmol/L vs.(40.85±11.39) μmol/L; (23.96±7.12) μmol/L vs.(29.60±8.05) μmol/L, P<0.05]. There was no significant difference in blood free carnitine levels between the two groups at 7 days after birth ( P>0.05). Conclusion:The blood free carnitine levels of premature infants decreased within 7 days after birth.The decrease of carnitine level in premature infants with NRDS may be related to the occurrence and development of NRDS.
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Objective:To analyze the changes of total gray matter volume in patients with subcortical vascular cognitive impairment (SVCI) and their correlation with cognitive impairment.Methods:Data of fifty patients with subcortical ischemic vascular disease (SIVD) who admitted to the outpatient department or ward of the Department of Neurology, the First Affiliated Hospital of Anhui Medical University from November 2017 to March 2019, were collected for the study, including 23 patients with SVCI and 27 patients with subcortical ischemic vascular disease without cognitive impairment (SIVD-NCI). All subjects were assessed using the Minimal Mental State Examination (MMSE), the Montreal Cognitive Assessment scale (MoCA), the Cambridge Cognitive Assessment scale for the elderly-Chinese version (CAMCOG-C), the Stroop test, the Geriatric Depression Scale, and the Activity of Daily Living scale (ADL). All subjects underwent 3.0 T magnetic resonance imaging scans to obtain T 1WI, T 2WI, fluid attenuated inversion recovery (FLAIR) images and 3D-T 1 structural image data. Voxel-based morphometry (VBM) was used to analyze and compare the differences in gray matter volume between SVCI group and SIVD-NCI group. Results:Compared with the SIVD-NCI group, the MMSE score (22.00 (20.00, 24.00) vs 28.00 (27.00, 29.00), Z=-6.073, P<0.001), MoCA score (15.00 (13.00,19.00) vs 24.00 (23.00, 26.00), Z=-5.233, P<0.001), total score of CAMCOG-C (67.65±13.35 vs 88.41±10.98, t=-6.032, P<0.001) and the directional (8.00 (5.00, 9.00) vs 10.00 (9.00, 10.00), Z=-4.133, P<0.001), language (24.00 (21.00, 26.00) vs 27.00 (24.00, 28.00), Z=-3.171, P=0.002), memory (11.00 (9.00, 15.00) vs 19.00 (17.00, 21.00), Z=-4.648, P<0.001), attention (4.00 (2.00, 6.00) vs 7.00 (6.00, 7.00), Z=-3.929, P<0.001), executive (8.00 (6.00, 10.00) vs 11.00 (9.00, 12.00), Z=-3.696, P<0.001), calculation (2.00 (2.00, 2.00) vs 2.00 (2.00, 2.00), Z=-2.528, P=0.011), thinking (6.00 (3.00, 6.00) vs 6.00 (6.00, 8.00), Z=-4.029, P<0.001), perception (6.00 (6.00, 7.00) vs 8.00 (7.00, 9.00), Z=-4.221, P<0.001) in the SVCI group were obviously decreased. ADL score (21.00 (20.00, 26.00) vs 20.00 (20.00, 20.00), Z=-2.634, P=0.008) and Stroop test score (28.61±4.53 vs 20.04±6.07, t=5.704, P<0.001) were significantly higher in the SVCI group than in the SIVD-NCI group. The total gray matter volume ((556.86±49.19) mm 3vs (618.13±51.73) mm 3, t=-3.572, P=0.001) and white matter volume ((479.35±48.17) mm 3vs (507.22±43.84) mm 3, t=-2.141, P=0.037) in the SVCI group were smaller than that in the SIVD-NCI group. VBM analysis showed that the SVCI group had significantly smaller gray matter volume in the left inferior temporal gyrus ( t=5.17, P<0.001, family wise error (FWE) correction), right middle temporal gyrus ( t=4.99, P<0.001, FWE correction), right orbital superior frontal gyrus ( t=5.02, P<0.001, FWE correction), left middle occipital gyrus ( t=5.67, P<0.001, FWE correction), right middle occipital gyrus ( t=5.77, P<0.001, FWE correction). MoCA score was positively correlated with the volume of gray matter in the left inferior temporal gyrus of patients with SIVD ( r=0.292, P<0.05), language function score was positively correlated with the volume of gray matter in the left inferior temporal gyrus ( r=0.322, P<0.05), and Stroop test score was negatively correlated with gray matter volume in the left inferior temporal gyrus ( r=-0.329, P<0.05). Conclusion:Gray matter atrophy exists in multiple brain regions in patients with SVCI, and these atrophic brain regions are associated with cognitive impairment of SIVD.
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Food impaction with tight proximal contacts, also known as kinetic food impaction and food impaction without anatomical structure destruction, is mainly caused by a transient separation in contacts area during mastication. It′s an intractable food impaction with high morbidity and low cure rate. There are two kinds of pathogenesis accepted: the shifting of anterior teeth incongruous with adjacent teeth or lack of anterior shifting; lack of food escape grooves. The preferred treatment is occlusal adjustment, but it′s difficult to determine the area and extent of selective grinding, to quantify the occlusal adjustment, or to predict the prognosis. This review summarized the pathogenesis and treatment modality for kinetic food impaction in order to provide evidence for future researches and clinical application.
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The role of malate dehydrogenase 2 (MDH2) in tumors is double-sided,it has a cancerpromoting effect in some tumors and an inhibitory effect in other tumors.The function of MDH2 is related to energy metabolism,tumor resistance and its pseudo hypoxia.MDH2 plays an important role in the occurrence,development,invasion and metastasis of tumors.An in-depth understanding of the functional mechanism of MDH2 in tumors can provide new molecular targets for tumor intervention in the clinic.
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Objective To explore the feasibility of using the optimization parameters modification and optimization processes modification to reduce the total monitor units ( MUs ) in the Eclipse radiotherapy treatment planning system (TPS). Methods Based on the radiotherapy plan of 10 patients with nasopharyngeal carcinoma, a total of 90 plans were designed for 9 groups using different optimization parameters and processes. The total MUs and the exposure dose of the organs among the different plans were compared. Results There was no significant difference in the doses of the organs at risk (class I) under the premise of target dose requirements (all P>0.05). The increase of the weight of the target area and the organs at risk will increase the total MUs. The increase of the preset limit value of the minimum MUs in the subfield will reduce the total MUs. The increase of the fluence smoothness in the X and Y directions will increase the total MUs. An unreasonable minimum MU value will increase the total MUs. Under the condition that the organ exposure is not changed significantly, the influencing factors of MU are ranked as weight>fluence smoothness>minimum MUs. Conclusions Parameter setting and process planning can reduce the total MUs to a certain extent. However, due to the complexity of the influence of optimization parameters on the plan, the optimization process should be preferred. Especially in the Eclipse TPS, the method of gradual optimization to achieve the final dose distribution requirement and then remove the fluence re-optimization is more convenient and effective for reducing the total MUs.
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Objective To investigate the correlation between methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism and plasma homocysteine (Hcy) levels and white matte hyperintensities (WMHs). Methods PubMed, EMbase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Weipu and Wanfang databases were retrieved to search studies on correlation between MTHFR gene C677T polymorphism and plasma Hcy levels and WMHs. The search deadline was October 31, 2018. Stata 14.0 software was used for statistical analysis. Results Six eligible literatures on the correlation between MTHFR gene and WMHs were included. The results of meta-analysis showed that there was no significant correlation between MTHFR C677T gene polymorphism and WMHs in 5 genetic models (T allele vs. C allele, TC vs. CC genotype, TT vs. CC genotype, TT+TC vs. CC genotype, and TT vs. TC+CC genotype). A total of 22 eligible literatures on the correlation between plasma Hcy level and WMHs were included. The results of meta-analysis showed that the plasma Hcy levels in patients with WMHs were significantly higher than those in the control group (weighted mean difference 3.48, 95% confidence interval 2.36-4.60; Z=6.03, P<0.01). Conclusions There was no significant correlation between MTHFR gene C677T polymorphism and WMHs, and the elevated plasma Hcy levels may be a risk factor for WMHs.
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Objective To compare and analyze the synchrony of cardiac contraction when left bundle branch area pacing ( LBBP ) using tissue Doppler imaging ( TDI ) . Methods T wenty‐four patients with LBBP and 20 patients with right ventricular pacing ( RVP ) were enrolled in the study . Among them , 35 cases were diagnosed as sick sinus syndrome ( SSS ) and 9 cases were diagnosed as Ⅱ or Ⅲ degree atrioventricular block ( AVB) before operation . Echocardiographic images were collected with ventricular pacemaker‐on ,and patients with SSS in LBBP group under the condition of pacemaker program control also collected the image of self‐conduction . TDI was used to measure time of the peak velocity ( T s ) of myocardial contraction in the left ventricular 12 segments ,right ventricle 2 segments ,and atrial 3 walls .The difference between the basal segment of left ventricular lateral wall and right ventricular free wall ( T s‐LV‐RV ) ,the mean value of the right ventricular 2 segments ( T s‐2‐RV ) ,the average( T s‐12‐LV ) and standard deviation ( T sd‐12‐LV ) of the left ventricular 12 segments ,and the difference in peak systolic time among 3 walls T AL‐R ,T AI‐R ,T AL‐I were calculated . Results Compared with the RVP pacing state ,the parameters of left ventricular systolic synchrony in LBBP pacing were shortened ,and the difference was statistically significant ( P ＜ 0 .05 ) . T here was no significant difference in parameters of left ventricular/right ventricular systolic synchrony and cardiac function between the LBBP group and the self‐conduction status ( P＞0 .05) . Conclusions Left ventricular systolic synchrony is superior to RVP in LBBP pacing ,and left/right ventricular systolic synchrony and cardiac function are not different from self‐conduction . LBBP is a new physiological pacing . TDI is able to quantitatively assess cardiac systolic synchrony .
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Objective This study aimed to evaluate the safety and efficacy of video-assisted thoracoscopic bipolar radio-frequency ablation in the treatment of isolated paroxysmal atrial fibrillation.Methods From September 2010 to December 2016,Seventy-two consecutive patients with paroxysmal atrial fibrillation underwent video-assisted thoracoscopic bipolar radio-frequency ablation at Fuwai Hospital.There were 50 males and 22 females with an average age of(56.5 ± 10.5) years and duration of atrial fibrillation with (6.5 ± 4.8) years.45 patients had previous catheter ablation.The patients were followed up at postoperative 3 months,6 months,1 year and annually.Success of ablation was defined as sinus rhythm and no duration of ≥30 s for rapid atrial arrhythmias,including atrial fibrillation,atrial flutter or atrial tachycardia in 24 h Holter examination.Univariate and multivariate logistic regression models were used to analyze the risk factors for atrial fibrillation recurrence.Results One patient converted to sternotomy due to bleeding on operation.All patients were successfully discharged.69 patients completed follow-up,with an average follow-up of(28 ± 18)months(3-60 months).The overall success rate was 73.9％,and the success rate without antiarrhythmic drug was 62.3％.Subgroup analysis showed that the success rate was 80％ when left atrial anterior and posterior diameter(LAD) ≤40 mm,and 57.9％ when LAD ＞ 40 mm (P =0.035).Multivariate logistic regression analysis showed that LAD ＞40 mm was an independent risk factor for postoperative recurrence of atrial fibrillation.Conclusion Video-assisted thoracoscopic bipolar radiofrequency ablation is a safe and effective method for the treatment of paroxysmal atrial fibrillation,especially in patients with LAD≤40 mm.
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Objective To investigate the correlation between dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) quantitative parameters and pathological grading in esophageal squamous cell carcinoma(SCC). Methods Prospective analysis of esophageal squamous cell carcinoma confirmed by electronic gastrointestinal endoscopy was performed. Thirty nine patients who underwent radical resection of esophageal carcinoma with MRI examination one weeks before operation were included. All patients underwent routine chest MRI and DCE-MRI scans, and DCE-MRI quantitative parameters including volume transfer constant (Ktrans), exchange rate constant (Kep) and extravascular extracellular volume fraction(Ve)were measured.Pathological analysis of postoperative specimens,including pathological grading(highly differentiated,moderately differentiated,poorly differentiated,undifferentiated),gross tumor pathological type(ulcerative type,medullary type,fungating type,sclerotic type)and local infiltration degree (T staging) were performed. Kruskal-Wallis H test was used to compare the differences of quantitative parameters between different pathological T staging,gross tumor pathological types and pathological grades of DCE-MRI,and a Dunn-Bonferroni test for post hoc comparisons.Spearman rank correlation analysis was used to evaluate the correlation between DCE-MRI parameters and pathological grading of esophageal squamous cell carcinoma.The ROC curves was used to evaluate the efficiency of different parameters in the diagnosis of poorly differentiated esophageal squamous cell carcinoma. Result Among the thirty nine patients, they were divided into three group according to pathological findings: well differentiated (12 patients),moderately differentiated(15 patients)and poorly differentiated group(12 patients);ulcerative type (19 patients), fungating type(10 patients), medullary type(10 patients);T1, 2 stage(16 patients), T3 stage(14 patients), and T4 stage(9 patients). There was no significant difference in the value of Ktrans, Kepand Ve between different T staging groups and different tumor pathological types groups(all P>0.05).The differences of Ktrans, Kepand Vebetween different pathological grading groups were statistically significant (all P<0.05). There were positive correlation between Ktrans, Kep, Veand the pathological grading, rs value were 0.874, 0.672, 0.578 respectively, all P<0.01. The ROC curve area of Ktrans, Kepand Vein the diagnosis of poorly differentiated esophageal squamous cell carcinoma was 0.941,0.809 and 0.773 respectively.The diagnostic efficiency of Ktranswas the best.Conclusions The quantitative parameters of DCE-MRI are correlated with the pathological grading of esophageal squamous cell carcinoma. Ktrans, Kepand Vecan reflect the perfusion characteristics of esophageal squamous cell carcinoma.
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Objective To explore the clinical value of serum vascular endothelial grow th factor(VEGF), γ-glutamyl transferase(GGT)and soluble myeloid cell trigger receptor-1(sTREM-1)in early chronic obstruc-tive pulmonary disease(COPD).Methods 30 cases of COPD patients admitted from February 2013 to Febru-ary 2015 were selected as the observation group,and 30 healthy subjects were selected as the control group. The levels of serum VEGF,GGT and sTREM-1 were compared between the two groups.Results The levels of serum VEGF,GGT and sTREM-1 were significantly decreased in the observation group after treatment,the difference was statistically significant(P<0.05).The levels of serum VEGF,GGT and sTREM-1 in the obser-vation group were significantly higher than those in the control group(P<0.05).The serum VEGF,GGT and sTREM-1 were respectively detected under the ROC curve area was 0.83,0.80,0.67,specificity and sensitivi-ty were 73.3%,71.1%,58.9% and 91.3%,88.6%,80.2%.ROC curve area of combined detection of VEGF, and GGT in early diagnosis of COPD was 0.94,the sensitivity and specificity were 81.3% and 96.4%;ROC curve area of combined detection of VEGF,and sTREM-1 in early diagnosis of COPD was 0.89,the sensitivity and specificity were 75.5% and 92.8%.Conclusion Serum VEGF,GGT,sTREM-1 level can be used as an important monitoring index for early diagnosis of COPD.
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Objective To summarize the experience and strategy of surgical treatment of Kommerell diverticulum and related aortic dissection aneurysm.Methods From November 2012 to January 2018,4 patients(all males),with median age of 44 (from 40 to 49) years old,underwent surgical treatment in our institution.All the patients had fight-sided aortic arch and aberrant left subclavian artery.One patient had type A aortic dissection and other 3 had type B aortic dissection(one had chronic type B dissection).The patient with type A aortic dissection had Bentall procedure plus total arch replacement and frozen elephant trunk implantation.One patient with chronic type B aortic dissection received type 2 hybrid aortic arch repair.One patient with acute type B aortic dissection had ascending aorta and total arch replacement plus frozen elephant trunk implantation followed by TEVAR.The last patient underwent graft replacement of aorta,total arch and descending thoracic aorta.Results There was no operative mortality.The median mechanical ventilation time was 229 (from 13 to 485) hours,the median ICU stay was 12 (from 2 to 27) days.One patient died from respiratory and circulatory failure due to compression of left main bronchus on the 17th day after operation.One patient had irritating cough due to mild compression of bifucation of trachea and the symptom resolved spontaneously before discharge.One patient had critical illness polyneuropathy after operation and received mechanical ventilation therapy for 485 hours.He recovered through neurotrophic drug treatment.The median follow-up time is 15 (from 4 to 36) months.The patients with type A dissection had delayed dilation of descending thoracic aorta beyond the frozen elephant trunk and received TEVAR 6 months later.The CT scans of the other two patients during follow-up time showed good morphology and patency of graft and branches.There was no anastomotic leakage and pseudoaneurysm.Conclusion The decision making of treatment of Kommerell diverticulum and related aortic dissection should be on the basis of classification of aortic dissection.Operation combined with TEVAR is safe and effective.