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OBJECTIVE@#To investigate the effect of miR-4443 expression on migration and invasion of breast cancer.@*METHODS@#We examined the expression of miR-4443 in breast carcinoma in situ and paired adjacent tissues from 3 breast cancer patients with high-throughput sequencing and verified the results using TCGA database. We also detected miR-4443 expressions using real-time quantitative PCR (RT-qPCR) in low invasive and highly invasive breast cancer cells (MCF-7 and MDA-MB-231 cells, respectively). The changes in apoptosis, migration and invasion of MCF-7 and MDA-MB-231 cells after transfection with miR-4443 mimics, mimics-NC, miR-4443 inhibitor or inhibitor-NC were analyzed using flow cytometry, wound healing assay and Transwell invasion assay. The target gene of miR-4443 was predicted by bioinformatics software and validated by a dual luciferase reporter gene system. RT-qPCR and Western blotting were performed to detect the expression of recombinant human phosphatidyl ethanolamine binding protein 1 (PEBP1) in the transfected cells.@*RESULTS@#The expression of miR-4443 was significantly higher in the breast cancer tissues than in the adjacent tissues (@*CONCLUSIONS@#MiR-4443 promotes the migration and invasion of breast cancer cells by inhibiting the expression of PEBP1, suggesting the possibility of suppressing miR-4443 expression as a potential therapeutic strategy for breast cancer.
Subject(s)
Humans , Breast Neoplasms/genetics , Cell Line, Tumor , Cell Movement , Cell Proliferation , Gene Expression Regulation, Neoplastic , MCF-7 Cells , MicroRNAs/genetics , Neoplasm Invasiveness/genetics , Phosphatidylethanolamine Binding ProteinABSTRACT
Objective Decitabine (DAC) combined with the half dose priming regimen (HDPR) is a common treatment of myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) in the elderly. This study was to compare the clinical effect and safety of DAC combined with all-trans retinoic acid (ATRA) versus DAC plus HDPR in the treatment of MDS with excess of blasts (MDS-EB) or AML in elderly patients. Methods We retrospectively analyzed 48 elderly patients (≥60 years) with myeloid neoplasms (AML, MDS-EB-1 or MDS-EB-2) ineligible for standard chemotherapy treated in our hospital from January 2014 to October 2018, 22 by DAC+ATRA (group A) and the other 26 by DAC+HDPR (group B). We compared the overall response rate (ORR), overall survival (OS) and adverse events between the two groups of patients. Results No statistically significant difference was observed between groups A and B in ORR (86.4% vs 76.9%, P = 0.643) or median OS (26.2 vs 24.9 mo, P = 0.920). The median time to response was significantly longer in group A (2 courses) than in B (1 course) (P = 0.006). Compared with group A, group B showed remarkably lower incidence rates of grade-3 to -4 cytopenia (54.5% vs 84.6%, P = 0.029) and infection (45.5% vs 76.9%, P = 0.037), longer duration of neutropenia (P < 0.05), and higher volumes red blood cell infusion and platelet infusion (P < 0.05). There was no statistically significant difference in the incidence rate of bleeding between the two groups (P = 0.643). Conclusion DAC+ATRA and DAC+HDPR have comparable clinical effects on myeloid neoplasms in elderly patients, but the former is safer and better tolerated while the latter can achieve a more rapid response.
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OBJECTIVE@#Quantitative assessment of white blood flow in semi-oval center of patients with delayed neuropathological sequelae (DNS) after carbon monoxide poisoning treated with acupuncture combined with hyperbaric oxygen (HBO) based on magnetic resonance multi-inversion time arterial spin labeling imaging (mTI-ASL), and to evaluate its efficacy indirectly.@*METHODS@#Twenty-six patients with clinically diagnosed DNS were randomly divided into an observation group (13 cases) and a control group (13 cases). The conventional therapy combined with HBO were given in the control group. In the observation group,on the base of the treatment, acupuncture was applied, the main acupoints were Shuigou (GV 26), Neiguan (PC 6), Baihui (GV 20), Shangxing (GV 23), Yintang (GV 29), Sanyinjiao (SP 6) on the affected side, Sishencong (EX-HN 1), Fenglong (ST 40), Lianquan (CV 23) and Jinjin (EX-HN12) for slurred speech, Jianyu (LI 15), Waiguan (TE 5) and Shousanli (LI 10) for upper limb pain, Huantiao (GB 30), Yanglingquan (GB 34), Yinlingquan (SP 9) for lower limb pain, the treatment was given once every day, 5 days as one course, with an interval of 2 days between the course. The treatment for 6 courses was required. The conventional head MR scan, mTI-ASL and diffusion tensor imaging (DTI) scans before and 1 week after treatment were adopted, Matlab (R2014b), Mricron and Syngo.via software were adopted to measure the cerebral blood flow (CBF) and anisotropy (FA) values of the semi-oval center. The correlation between the parameters was evaluated by Pearson method. And the simple intelligent mental state examination scale (MMSE) was uesd to assess cognitive function.@*RESULTS@#After treatment, the CBF, MMSE scores in both groups and FA values in the observation group were higher than those before treatment (<0.05). After treatment, the CBF, FA and MMSE scores in the observation group were significantly higher than those in the control group (<0.05). There was a positive correlation between CBF, FA and MMSE scores (<0.05), and the correlation between CBF and MMSE was the best ( =0.822).@*CONCLUSION@#Acupuncture combined with hyperbaric oxygen can significantly improved early white matter hypoperfusion and improved cognitive function score in patients with DNS. The curative effect is better than that of hyperbaric oxygen therapy alone. The mTI-ASL imaging can quantitatively evaluate its curative effect.
Subject(s)
Humans , Acupuncture Therapy , Carbon Monoxide Poisoning , Diffusion Tensor Imaging , Hyperbaric OxygenationABSTRACT
Objective To observe the alteration and clinical significances of blood coagulation indicators in patients with lymphoplasmacytic lymphoma (LPL). Methods Twenty patients who were newly diagnosed LPL in the First People's Hospital of Changzhou from January 2008 to October 2017 and twenty healthy controls were studied. The patients were treated by chemotherapy, plasma exchange, supplement of coagulation factor or other supportive therapy. The parameters of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), D-dimer (D-D), and platelet count (Plt) were detected in LPL group and healthy controls. Results The levels of PT and APTT in LPL group were dramatically higher than those in control group [(12.9±1.2) s vs. (11.6±0.9) s, (41.7±9.8) s vs. (24.7±2.9) s], and the level of Plt in LPL group was lower than that in control group [112×109/L (3×109/L - 379×109/L) vs. 210×109/L (170×109/L - 271×109/L)], and the differences were statistically significant (all P< 0.05). There were no significant differences in FIB, TT and D-D levels between LPL group and control group (all P ＞0.05). There were no statistical differences in PT, APTT, FIB, TT, D-D and Plt levels among LPL patients with different types of immunoglobins (all P ＞ 0.05). After treatment, all the coagulation abnormalities got relieved and no patient died of hemorrhage or thrombosis. Conclusions The LPL patients have coagulation disorders and hypercoagulability, and this is independent of the type of immunoglobulin. Clinical attention should be paid to monitoring coagulation indicators to prevent the occurrence of adverse reactions.
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BACKGROUND:An inferior vena cava filter is an effective tool to prevent fatal pulmonary embolism. The existing filters have some shortcomings that limit their clinical application. OBJECTIVE:To evaluate the feasibility and capture efficiency of a new self-convertible inferior vena cava filter (SCF)in vivo. METHODS:L-lactide and ε-caprolactone were fused and polymerized to act as a degradable deformable switch of the filter. Medical stainless steel wire as the metal structure of the filter was combined with the degradable deformable switch to make the SCF. Eight SCFs were implanted into the inferior vena cava of eight adult Beagle dogs. The inferior vena cava angiography was performed to evaluate the release process, morphology and location of the filter. Venous angiography was performed 2 weeks later to evaluate the morphology and location of the filter and inferior vena cava patency. Detection of pulmonary embolism or other complications was performed at autopsy. RESULTS AND CONCLUSION:Eight SCFs were successfully implanted and positioned accurately with no tilt, and they were converted successfully at 2 weeks after the implantation, as assessed by the venous angiography. One of the eight SCFs migrated to the orifice of the right atrium, and caused asymptomatic inferior vena cava obstruction. The remaining SCFs were normally positioned with no tilt and local lesion or obstruction after deformation. No marked filling defect in the trunk of the pulmonary artery was shown by the pulmonary artery angiography. The autopsy report revealed that the filter arm had been endothelialized, and the inferior vena cava that was in contact with the filter arm had no obvious stenosis. Mild intimal hyperplasia, less than 1 mm in thickness, was found in the bottom of the filter arm, but it did not cause a stenosis in the lumen. No vena cava perforation, retroperitoneal hemorrhage, and injury of the surrounding viscera were found. Overall, the design of the SCF is feasible.
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BACKGROUND: Inferior vena cava filter is an effective way to prevent fatal pulmonary embolism. The existing filters have some shortcomings that limit the clinical application. OBJECTIVE:To evaluate the feasibility and capture efficiency of a new self-convertible inferior vena cava filter(SCF)in vitro. METHODS: The biodegradable switch was constructed of a copolymer of ε-caprolactone and L-lactide (75%/25%, PCLA75). The biodegradable switch bound together with the apices of the convertible struts to make the self-convertible filter. The deformability and capture efficiency of the filter were tested in an in-vitro flow model with three different diameters (22, 25, 28 mm). A total of 15 filters were implanted both in the vertical and horizontal positions, and the tilt angle of the filter was tested after release. To accelerate switch degradation, a lipase perfusate was injected into the flow model and refreshed every 8 hours until conversion. RESULTS AND CONCLUSION: (1) All the filters were successfully implanted without tilting, both in the vertical and horizontal positions in the three different diameter models. (2) All the 15 SCFs were converted successfully without tilting, structural damage, and displacement. (3) The capture efficiency of the SCF had significant difference between the different diameter of the models, the size of the embolus and the position of the two models (P < 0.001). The mean capture efficiency was 82.5%, and the capture efficiency exhibited a downward trend with the increase of pipe diameter, the decrease of emboli size, and the position of pipeline changing from vertical to horizontal. All these results show that the SCF is feasible and highly efficient.
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Objective To evaluated the safety and feasibility of excimer laser atherectomy (ELA) combined with drug-eluting balloon angioplasty in treating chronic ischemia of lower limbs.Methods ELA combined with paclitaxel-eluting balloon angioplasty was adopted to treat chronic ischemia of lower limbs caused by arteriosclerosis occlusive disease of lower extremity in three patients.All three patients had arteriosclerosis occlusive disease of superficial femoral artery;in two of them the disease was primary occlusive lesion and in another patient the disease was in-stent re-occlusion lesion after sten implantation.Results After the treatment,the blood flow in the diseased arteries was unobstructed,the blood supply of the lower limbs was obviously improved.No procedure-related complications occurred.Two weeks after the treatment,no recurrence of ischemic symptoms was observed,the blood flow in superficial femoral artery kept unobstructed.The patients recovered smoothly.Conclusion For the treatment of chronic ischemia of lower limbs,which are caused by the primary arteriosclerosis occlusive disease of lower extremity or by the in-stent re-occlusion lesion after sten implantation,ELA combined with paclitaxel-eluting balloon angioplasty is clinically safe and feasible,although its long-term effect needs to be clarified with more studies.
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Objective To test a snapback primer for the identification of Legionella and Legionella pneumophila ( L.pneumophila) strains in a one-step real-time PCR assay.Methods A novel primer was designed with a pair of genus-specific primers of Legionella strains.The species-specific probe sequences of L.pneumophila strains were linked at the 5′end of the reverse primer.The sensitivity and specificity of the novel PCR assay were tested with 43 types of Legionella and non-Legionella strains.The established PCR as-say was used to identify 186 wild Legionella strains isolated from 11 provinces of China and 15 environmental water samples.Results The amplicon melting peak of Legionella strains was detected at 85-86℃.The snapback melting peak of L.pneumophila was detected at 71℃.No melting peak of non-Legionella strains was detected.The sensitivity of the standard strains and simulated water samples were 1 ng/μl DNA tem-plates and (1×103-1×104 )/ml, respectively.186 Legionella strains and 44 L.pneumophila strains isolated from environmental water samples were successfully identified with the snapback primer.Twealve Legionella strains and 4 L.pneumophila strains were identified from 15 environmental water samples with the snapback primer as compared with 8 Legionella strains identified with the culture method.Conclusion The snapback primer mediated one-step PCR assay could be used for the identification of Legionella and L.pneumophila strains with the advantages of high specificity and sensitivity.
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Objective To compare the effect of lacrimal ducts retrograde intubation and dacryocystorhinosto-my in treating chronic dacryocystitis.Methods 104 patients with chronic dacryocystitis were selected and divided into observation group and control group by lottery.There were 64 cases in observation group and 40 cases in control group.Lacrimal ducts retrograde intubation was given in observation group,while dacryocystorhinostomy was given in control group.Same postoperative care was given in both two groups.The surgery related conditions and effect of treat-ment were compared.Results There were 63 effective cases in the observation group in 3 months after operation,the effective rate was 98.44%,40 effective cases in the control group,the effective rate was 100.00%,and there was no significant difference between the two groups (χ2 =0.185,P >0.05).There were 62 effective cases in the observation group in 6 months after operation,the effective rate was 96.88%,40 effective cases in the control group,the effective rate was 100.00%,and there was no significant difference between the two groups (χ2 =0.306,P >0.05).There were 59 effective cases in the observation group in 12 months after operation,the effective rate was 92.19%,38 effective cases in the control group,the effective rate 95.00%,and there was no significant difference between the two groups (χ2 =0.227,P >0.05).The mean operation time in the observation group was (10.8 ±2.7)min,while (0.1 ± 9.6)min in the control group,the mean operation time in the observation group was shorter than that in the control group(t =18.074,P <0.05).The mean hospitalization in the observation group was (2.5 ±0.3)days,while (6.3 ± 1.4)days in the control group,the mean hospitalization in the observation group was shorter than that in the control group(t =3.171,P <0.05).The mean hospital expenses in the observation group was (1467.1 ±26.7)yuan,while (1971.6 ±59.1)yuan in the control group,the mean hospital expenses in the observation group was less than that in the control group(t =39.482,P <0.05).Conclusion The recent therapeutic effects of lacrimal ducts retrograde intubation and dacryocystorhinostomy in treating chronic dacryocystitis were same,and it was safer,lower operative difficult,less treatment expenses to applying lacrimal ducts retrograde intubation.It was worthy of clinical application.
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<p><b>BACKGROUND</b>Sarpogrelate is a selective 5-hydroxytryptamine (5-HT) receptor subtype 2A antagonist which blocks 5-HT induced platelet aggregation and proliferation of vascular smooth muscle cells. We compared the efficacy of sarpogrelate-based dual antiplatelet therapies for the prevention of restenosis and target lesion revascularization (TLR) rates comparing with that of clopidogrel after percutaneous endovascular interventions (EVIs) of femoropopliteal (FP) arterial lesions.</p><p><b>METHODS</b>This prospective, multicenter, randomized clinical trial recruited a total of 120 patients with successful EVI of FP lesions at seven centers across China between January 2011 and June 2012. Patients were randomized to receive either sarpogrelate (100 mg trice daily for 6 months, n = 63) or clopidogrel (75 mg once daily for 6 months, n = 57). All patients also received oral aspirin (100 mg once daily for 12 months). Clinical follow-up was conducted up to 12 months postprocedure.</p><p><b>RESULTS</b>There was no significant difference between the two groups in basic demographic data. The restenosis rate was higher in the clopidogrel group (22.80%) than in sarpogrelate group (17.50%), but there was no significant difference between these two groups (P = 0.465). The TLR rate, ipsilateral amputation rate, mortality in all-cause and bleeding rate were also similar in the two groups (P > 0.05).</p><p><b>CONCLUSIONS</b>Aspirin plus sarpogrelate is a comparable antithrombotic regimen to aspirin plus clopidogrel after EVI of FP arterial lesions. Dual antiplatelet therapies might play an important role in preventing restenosis after successful EVI of FP lesions.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Arterial Occlusive Diseases , Drug Therapy , Fibrinolytic Agents , Therapeutic Uses , Kaplan-Meier Estimate , Peripheral Vascular Diseases , Drug Therapy , Popliteal Artery , Pathology , Serotonin Antagonists , Therapeutic Uses , Succinates , Therapeutic Uses , Ticlopidine , Therapeutic UsesABSTRACT
AlM:To explore the efficacy and safety of mitomycin C used in trabeculectomy by analyzing intraocular pressure and blood flow.METHODS:A total of 103 patients with glaucoma were divided into 2 groups randomly, and all patients were treated with trabeculectomy, while patients in the observation group were given mitomycin C extra. At 6~12mo follow-up were completed after operation, and the clinical efficacy, complications and hemodynamic characteristics of central retinal artery were compared between groups.RESULTS: The clinical efficacy of the observation group was higher than that of the controls (P0. 05), but the complication type was differentiate to some extent. Low intraocular pressure and photophobia symptoms occurred mostly in the observation group, while cicatricial obstruction occurred mostly in the controls. Before treatment, there was no significant difference in hemodynamic characteristics between groups (P>0. 05). One month after treatment, the peak systolic velocity ( PSV) and end diastolic velocity ( EDV ) of the observation group were obviously lower, while resistance index ( Rl ) and pulsatility index ( Pl ) were higher than those of the controls, the difference was statistically significant ( P<0. 05). Six months after treatment, the PSV and EDV of the observation group were obviously higher, while Rl and Pl were lower than those of the controls, the difference was statistically significant (P<0. 05).CONCLUSlON:Mitomycin C has a short-term harmful effect on glaucoma patients after trabeculectomy, but its long-term effect is safe and reliable.
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Objective To develop an HPLC method for simultaneous content determination of ginsenoside Rg1, Re and Rb1 in Panacis Japonici Rhizoma.Methods Chromatographic separation was carried out by using an Agilent Poroshell 120 C18 column (4.6 mm × 100 mm, 2.7μm). The mobile phase consisted of acetonitrile-0.1% phosphoric acid with gradient elution at a flowrate of 1.0 mL/min, and the injection volume was 10μL. The detection wavelength and column temperature were 203 nm and 30℃ respectively.Results Ginsenoside Rg1, Re and Rb1 had the baseline separation and were in good linear range. The recovery rates were 99.5%, 103.0% and 100.5% respectively.Conclusion The approach is simple, accurate, with good repeatability and short analysis period, which can determine the contents of ginsenoside Rg1, Re and Rb1 correctly and provide references for quality control of Panacis Japonici Rhizoma.
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Objective To identify two suspected Legionella pneumophila (L.pneumophila) strains isolated from environmental water and air conditioning cooling water systems in Guangzhou city.Methods The two strains were identified by their cultural characteristics,biochemical test,Legionella-specific primer PCR identification,PCR-enzymatic digestion analysis,16S rRNA,mip and rpoB gene sequencing analysis.Results The two suspected L.pneumophila isolates were identified as gram-negative bacillus appeared as white colonies on BCYEα-agar after incubation for 48 hours at 36℃.Both isolates were positive for oxidase,gelatinase and hydrolysis of hippurate,and negative for urease activity and nitrate reduction.Their phenotypic characteristics were similar to those of L.pneumophila strains.Results of PCR identification by using Legionella-specific primer were positive.Enzymatic digestion analysis showed that the 226 bp PCR products of two isolates were not digested by Taa Ⅰ.The two strains were classified as Legionella busanensis as indicated by gene sequencing analysis of 16S rRNA,mip and rpoB gene.Conclusion Two L.busanensis strains were first isolated from environmental and air conditioning cooling water systems in China.Due to their biochemical characteristics,L.busanensis strains were commonly misidentified as L.pneumophila,but could be effectively identified by PCR-enzymatic digestion analysis and multiple genes identification.
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Objective To investigate the evaluation value of magnetic resonance spectroscopy (MRS) combined with S-100B protein in the severity and prognosis in patients with acute subdural hematoma ( ASDH).Methods Eighty cases of ASDH patients and 20 cases of healthy check-up were selected.MRS was used to test NAA/Cr, Cho/Cr, NAA/Cho, and Glx /Cr in thalamus and corpus callosum.The blood S-100B protein was detected in 72 h after injury.The relationships of those MRS detection indices with glasgow coma scale ( GCS) and glasgow prognostic score ( GOS) for 2 months after injury were analyzed .Results MRS detection in-dex and the S100B protein in ASDH were compared between each group relative to normal control group , all difference had statistical significance ( P <0.05).As aggravating the severity of traumatic brain injury , Cho/Cr, Glx/Cr ratio, and S-100B protein concentra-tion were elevated , and NAA/Cho and NAA/Cr were reduced .All differences were statistically significant among poor recovery , good recovery, and normal control groups ( P <0.05).For patients with traumatic brain injury, there were worse prognosis, the higher ra-tios of Cho/Cr and Glx/Cr, higher concentration of S-100B protein, and lower ratios of NAA/Cho and of NAA/Cr.GCS score and GOS scores were negatively correlated with Cho/Cr and Glx/Cr ratios of corpus callosum , and were positively correlated with NAA/Cho, NAA/Cr ratios of corpus callosum .S-100B protein was positively correlated with Cho/Cr and Glx/Cr, and was negatively correlated with NAA/Cho and NAA/Cr.MRS combined S-100B can improve the prognosis of patients with up to the accuracy of 81%.Conclu-sions MRS detection in the early stage after injury of ASDH patients has important value in assessment of the severity of the injury and its prognosis , the accuracy of assessment of prognosis is improved with a combination of MRS detection and blood S -100 B protein meas-urement.
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<p><b>OBJECTIVE</b>To investigate the drug resistance of imipenem-resistant (IR) Gram-negative bacilli (GNB) in coal workers' pneumoconiosis (CWP)-chronic obstructive pulmonary disease (COPD) patients with lower respiratory tract infection (LRTI) and to provide a basis for clinical treatment.</p><p><b>METHODS</b>Sixty-six strains of IR-GNB were isolated from the sputum of CWP-COPD patients with LRTI, and the bacterial spectrum was investigated. The drug resistance of bacterial strains was studied by KB disk diffusion method.</p><p><b>RESULTS</b>Among the 66 strains of IR-GNB, 29 (43.9%) were Pseudomonas aeruginosa, 17 (25.8%) were Acinetobacter baumannii, and 11 (16.7%) were Stenotrophomonas maltophilia. The drug sensitivity test showed that all bacteria had high drug resistance; Pseudomonas aeruginosa had a susceptibility rate higher than 50% to ciprofloxacin, polymyxin B, fosfomycin, and amikacin, Acinetobacter baumannii had a susceptibility rate higher than 55% to fosfomycin, polymyxin B, and cefoperazone/sulbactam, Stenotrophomonas maltophilia had a susceptibility rate higher than 50% to cotrimoxazole, ciprofloxacin, piperacillin/tazobactam, levofloxacin, polymyxin B, and cefoperazone/sulbactam, and Pseudomonas cepacia had a susceptibility rate higher than 50% to piperacillin/tazobactam, ciprofloxacin, cefoperazone/sulbactam, and polymyxin B.</p><p><b>CONCLUSION</b>The main species of IR-GNB are such non-fermentative bacteria as Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia in CWP-COPD patients with LRTI. These bacteria have high drug resistance and are sensitive to only a limited range of antibiotics.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Middle Aged , Anthracosis , Microbiology , Drug Resistance, Multiple, Bacterial , Gram-Negative Bacteria , Imipenem , Pharmacology , Microbial Sensitivity Tests , Pulmonary Disease, Chronic Obstructive , MicrobiologyABSTRACT
<p><b>BACKGROUND</b>Totally laparoscopic aortic surgery is still in its infancy in China. One of the factors preventing adoption of this technique is its steep learning curve. The objective of this study was to evaluate the feasibility and safety of laparoscopic surgery for aortoiliac occlusive disease (AIOD).</p><p><b>METHODS</b>From November 2008 to November 2012, 12 patients were treated for severe AIOD with a totally laparoscopic bypass surgery at our university hospital. The demographic data, operative data, postoperative recovery data, morbidity and mortality were analyzed and compared with those of conventional open approach.</p><p><b>RESULTS</b>Twelve totally laparoscopic aortic surgery procedures, including two iliofemoral bypasses (IFB), three unilateral aortofemoral bypasses (UAFB), and seven aortobifemoral bypasses (ABFB), were performed. Conversion to open procedures was required in three patients. The mean operation time was 518 (range, 325-840) minutes, mean blood loss was 962 (range, 400-2500) ml, and mean aortic anastomosis time was 75 (range, 40-150) minutes. Compared with conventional open approach for aortofemoral bypasses performed concomitantly during this period, laparoscopic patients required fewer narcotics and a shorter in-hospital stay and earlier recovery. Postoperative complications developed in four patients, including a single patient with transient left hydronephrosis, ischemic colonic fistula and pneumonia, residual aortic stenosis proximal to the anastomotic site, and asymptomatic partial left renal infarction. All patients recovered and were discharged on postoperative Days 7-14 except one patient that died of respiratory failure on Day 46. All grafts were patent with follow-up imaging performed by Duplex examination, with a mean follow-up time of 10.7 (range, 2-61) months.</p><p><b>CONCLUSION</b>Totally laparoscopic bypass surgery is a feasible and safe procedure for AIOD, but attention needs to be paid to improve laparoscopic skills of vascular surgery in order to minimize morbidity during the learning curve of this advanced procedure.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Aortic Diseases , General Surgery , Arterial Occlusive Diseases , General Surgery , Iliac Artery , General Surgery , Laparoscopy , Methods , Postoperative ComplicationsABSTRACT
A 68-year-old female patient was treated for unhealed ulcer in the fourth toe of the left foot. Clinical examinations identified severe stenosis of the proximal segment and occlusion of the distal segment of the left anterior tibial artery, and occlusion of the left posterior tibial artery and the peroneal artery. The proximal stenotic segment of the left anterior tibial artery was dilated, but the distal occlusive part failed to be re-canalized. Left anterior tibial artery to dorsal pedal artery bypass was performed on the patient with an epoxide-crosslinked, special radicals antigen-sealed, porcine-derived biological graft; debridement of the left 4th digiti pedis was also performed. Postoperation course was uneventful. The pulse of the left dorsal pedal artery was strong. The ankle brachial index (ABI) increased from 0.60 to 1.09. Warfarin and two antiplatelet drugs were given after the operation. Six months after operation, computed tomographic angiogram (CTA) identified the patent graft.
Subject(s)
Aged , Female , Humans , Blood Vessel Prosthesis , Diabetic Foot , General Surgery , Ischemia , General Surgery , LegABSTRACT
<p><b>BACKGROUND</b>Takayasu's arteritis (TA) is a chronic idiopathic inflammatory disease that affects large and medium size arteries. The brachiocephalic trunk is the most frequently involved site in TA, and multi-vessel lesions are common. Surgical treatment includes vessel reconstruction surgery and percutaneous transluminal angioplasty (PTA). Herein, we report our preliminary experience with surgical treatment of cerebral ischemia caused by cervical arterial lesions due to TA.</p><p><b>METHODS</b>From January 2000 to December 2007, 38 patients with cerebral ischemia caused by cervical arterial occlusive lesions due to TA were treated surgically. There were three males and 35 females, with an age range of 15 - 42 years (mean 26.5 years). All patients had operative repairs undertaken. Twenty eight patients received bypass operation and 10 patients received percutaneous transluminal angioplasty. One case with coronary stenosis received coronary artery bypass simultaneously. Patients were followed up for 11 months to eight years.</p><p><b>RESULTS</b>There were no peri-operative deaths in cerebrovascular reconstruction patients. Symptoms of cerebral ischemia were improved or cured in 25 of 38 patients. There was a low incidence of cerebral reperfusion syndrome. Two patients died at five and seven years after surgery due to heart failure. Another 8 patients (20%) required further surgery for stenosis (5 patients) or anastomotic aneurysms (3 patients). Percutaneous transluminal angioplasty was performed successfully for treatment of aortic and renal lesions. Repeated angioplasty for revascularization was performed in six PTA cases with restenosis after 5 - 24 months.</p><p><b>CONCLUSIONS</b>When cerebral perfusion has potential to be affected by TA, a definitive corrective procedure is advised when the patient is relatively stable. Although the recurrence rate is very high, percutaneous transluminal angioplasty is the first choice procedure. Bypass operation is optimal for brachiocephalic-vessel involvement in TA. Cerebral reperfusion syndrome can be avoided by careful selection of the operation method and improved post-operative treatment.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Arteritis , Drug Therapy , Brachiocephalic Trunk , Pathology , General Surgery , Brain Ischemia , Pathology , General Surgery , Cerebral Revascularization , Methods , Methylprednisolone , Therapeutic Uses , Takayasu Arteritis , Pathology , General Surgery , Treatment OutcomeABSTRACT
G-protein-coupled receptors (GPCRs), the largest family of cell surface receptors, play an important role in the production of therapeutic drugs. The functions of GPCRs are closely related to their classification and subclassification. It is difficult to obtain the spatial structure of GPCRs sequence by experimental approaches. It is highly desired to develop powerful tools and effective algorithms for classifying the family of GPCRs. In this study, based on the concept of pseudo amino acid composition (PseAA) originally introduced by Chou, approximate entropy (ApEn) of protein sequence as an additional characteristic is used to construct PseAA. A 21-D (dimensional) PseAA is formulated to represent the sample of a protein. Fuzzy K nearest neighbors (FKNN) classifier is adopted as prediction engine. The datasets in low homology are used to validate the performance of the proposed method. Compared with prior works, the successful rates achieved of our research are the highest. The test results indicate that the novel approach can play the role of a compliment to many of the existing methods, which promises to be a useful tool for GPCRs function prediction.
Subject(s)
Humans , Algorithms , Amino Acids , Chemistry , Artificial Intelligence , Chemical Phenomena , Entropy , Fuzzy Logic , Hydrophobic and Hydrophilic Interactions , Receptors, G-Protein-Coupled , Chemistry , Classification , Sequence Analysis, Protein , MethodsABSTRACT
<p><b>OBJECTIVE</b>To evaluate medium-long term patency of below-knee bypass on patients who suffered from diabetic lower limb ischemia.</p><p><b>METHODS</b>Clinical and follow-up data of 51 patients was retrospectively analyzed who underwent 56 below-knee bypass because of diabetes from November 2001 to December 2006. There were 35 male and 16 female with an average age of 68 years. They endured 26 months ischemic time lag in average, and had suffered from diabetes for 11 years. All of the patients were performed bypass to below-knee (posterior tibial, anterior tibial or peroneal) arteries. Kaplan-meier method was applied. The subgroups of different operative methods and different out-flow vessels were compared by Log-rank tests.</p><p><b>RESULTS</b>An average follow-up time of 23 months was achieved, and lost-follow-up rate was 15%. The total 1- and 5-year primary patent rates were 68% and 54% respectively, secondary patent rate were 70% and 60% respectively, limb salvage rates were 69% and 65%, survival rates were 82% and 60%. One year (3 years) of patent rate(s) of operative method subgroups of femoral-popliteal-infrageniculate bypass with composite grafts, femoral/popliteal-infrageniculate bypass with artificial grafts and femoral/popliteal-infrageniculate bypass with autologous veins were 70% (50%), 33% (33%) and 70% (70%) respectively. One year (4 years) of patent rate(s) of out-flow vessel subgroups of posterior tibial artery, anterior tibial artery and peroneal artery were 65% (60%), 80% (53%) and 77% (66%) respectively. However, both subgroups did not show any statistic differences by log-rank tests.</p><p><b>CONCLUSIONS</b>Partial or whole autologous veins as bypass grafts should be chosen when infrageniculate bypass is considered in diabetic patients. Considerable patent rates are acceptable no matter what kinds of out-flow vessels are chosen.</p>