ABSTRACT
Objective To investigate pediatric hemoptysis recurrence related to vascular malforma-tions after transcatheter occlusion and offer suitable preventive actions for reducing the rate of hemoptysis recurrence.Methods The clinical data of 27 children,collected form Department of Cardiology,Children's Hospital of Chongqing Medical University between June 2012 and April 2017,with hemoptysis related to vascular malformations were retrospectively analyzed.The clinical manifestation,image feature and occlusion program of children with hemoptysis recurrence were re-analyzed and evaluated. Results All 27 children with hemoptysis received transcatheter occlusion, whose vascular malformations included bronchial-pulmonary artery fistula (24 cases,88.9%) and pulmonary arteriovenous fistulas (3 cases,11.1%) by angiography. Six cases,approximately 26.1%,suffered from recurrent hemoptysis after therapy,and the interval time of hemoptysis recurrence was roughly (5.6 ± 2.3)months.It indicated mycoplasma pneumonia infection in all children with hemoptysis recurrence, and re-angiography showed that more abnormal vessels were found, other minor vessels except for vessels occluded grew thick and large,vessels except for vessels occluded were recanalization in children with recurrent hemoptysis.Conclusion Recurrence is the common complication of hemoptysis related to vascular malformations in children,and bronchial-pulmonary artery fistula is the most common type with hemoptysis recurrence. The main causes of hemoptysis recurrence include mycoplasma pneumonia infection,vessels without occlusion enlargement and recanalization.
ABSTRACT
BACKGROUND: The study of cell transplantation to repair injured cardiac muscle and improve cardiac function of dilated cardiomyopathy (DCM) has become a hotspot in recent years. However, the effect of cardiac electrophysiology following transplantation is still unknown.OBJECTIVE: To explore the influence of ailogenic implanted mesenchymal stem cells (MSCs) on cardiac function, structure and electrophysiology of rabbits with DCM.DESIGN, TIME AND SETTING: Randomized controlled animal trial was performed at Electrophysiology Laboratory of Institute of Pediatrics, Chongqing Medical University between January 2004 and May 2006.MATERIALS: Forty-three New Zealand whiterabbits, weighing 3.0-3.5 kg, irrespective of gender, were selected. Adriamycin was produced by Haizheng Medical Products Company of Zhejiang Province, China, No. 050307. The Ultrasonograph SSD-5000 came from Aloka, Japan, and RM6240 multiplying channel electrophysiolograph of Chengdu Instrument Company was applied.METHODS: All animals were randomized into normal group (n=12), cell transplantation group (n=13), and DCM model group (n=13). Except the normal group, adriamycin was applied to create rabbit DCM model, I mg/kg, twice a week for successive 8 weeks. Bone marrow solution was harvested from the remaining 5 rabbits, and MSCs were isolated, amplified and purified using attachment method. Three weeks after modeling, the MSCs were transplanted into left ventricle anterior wall at four sites in cell transplantation group, model group was injected with matching DMEM/FI2 medium, while the normal group was not given any treatment.MAIN OUTCOME MEASURES: At four weeks postoperatively, left ventricular end-diastolic dimension, end systolic dimension,left ventricular ejection fraction, and shortening fraction were monitored by ultrasonograph; the value for monophasic action potential amplitude (MAPA) and the maximum velocity in 0 phase (V,,~), the value for 50% monophasic action potential durations (MAPDs0) and 90% monophasic action potential durations (MAPDg0) were detected by electrophysiolograph. In addition, the cardiac tissues harvested from implanted region were observed by light microscope and electron microscope, and also the expression of cardiac troponin T (cTnT) and connexin 43 (Cx43) was detected through immunohistochemistry.RESULTS: Of 43 rabbits, 9 rabbits each of the transplantation group died of the acute or chronic toxic effects of Adriamycin, finally, 25 rabbits were included in final analysis. Compared with model group, the end systolic dimension was diminished, and the left ventricular ejection fraction and shortening fraction in cell transplantation group were significantly increased (P ＜ 0.05). The MAPDs0 and MAPDgo in cell transplantation group prolonged significantly compared with model group (P ＜ 0.05). In model group,cardiac myocytes appeared mitochondria swelling and hyperplasia, and their sarcomere had different lengths, arranged unevenly,accompanied by abnormal contraction bands. In addition, myolysis was found in parts of myocardium under electron microscope.However, the structural abnormalities in the cell implantation group were less than the DCM model group, and the implanted MSCs could express cTnT and Cx43.CONCLUSION: Allogenic MSCs transplantation can improve cardiac function, lessen structural abnormalities and may inhibit the progression of electrophysiology derangement.
ABSTRACT
Objective:To explore the feasibility of adriamycin-induced dilated cardiomyopathy model in rabbits.Methods:26 rabbits were given 1mg.kg-1 body wt.of adriamycin intravenously twice a week for 8 weeks,then received echocardiography and histoligical examination after 3 weeks of final injection.Results: 17 rabbits survived.Compared to the baseline station,the value for the Left ventricular diastolic dimension(LVEDD) and the Left ventricular systolic dimension(LVESD) increased significantly,while the value for the Left ventricular ejection fraction(LVEF)and the Left ventricular short fraction(LVFS) decreased significantly after treated with adriamycin(P