ABSTRACT
Objective@#To explore the perioperative clinical treatment of thyroid cancer patients with heart disease.@*Methods@#A retrospective analysis was conducted on 39 thyroid cancer patients with heart disease admitted to the Department of Otorhinolaryngology Head and Neck Surgery, Beijing Anzhen Hospital,Capital Medical University from April 2014 to February 2018,including 25 males and 14 females, the age ranged from 59 to 75 years,with an average age of 67.3±6.2 years. Perioperative clinical monitoring indicators included cardiac ultrasound left ventricular ejection fraction (LVEF), degree of vascular stenosis revealed by coronary CT, hypersensitive troponin I (TNI), b-type natriuretic peptide (BNP), fibrinogen degradation products,and coagulation indexes. This panel of patients comprised 26 cases with 50% ≤ LVEF<60%,10 cases with 40% ≤ LVEF<50%, 3 cases with 36% ≤ LVEF<40%, 27 cases with 0≤BNP<100 ng/L, 7 cases with 100≤BNP<400 ng/L, and 5 cases with 400≤BNP<700 ng/L. Coronary CT showed no coronary artery stenosis>75%. The vascular graft was patent and the coronary artery after stenting was unobstructed. For 3 patients with LVEF<40% and 5 patients with BNP>400 ng/L,cardiotonic,diuretic,and nutritional myocardial therapy were used for 1 week. SPSS 17.0 software was used to analyze the data.@*Results@#All 39 patients successfully completed the operation under general anesthesia,including 32 cases of total thyroidectomy,7 cases of glandular lobe and isthmic resection,and 40 cases of lateral neck dissection. One patient developed heart failure three days after surgery and was discharged after two weeks of treatment. No other cardiac related events,cerebrovascular and pulmonary thrombosis occurred during the perioperative period. The anesthesia preparation time was significant different between the group with 0≤BNP<100 ng/L and 50%≤LVEF<60% and the group with 0≤BNP<100 ng/L and 36%≤LVEF<50%.@*Conclusions@#Multi-indicators were utilized to adequately assess cardiac function before surgery. According to the results of cardiac ultrasound and coronary CT examination, the corresponding treatment should be conducted to improve the cardiac function. After the perioperative risk assessment and management of thyroid cancer patients with heart disease,standardized thyroid cancer surgery can be performed safely.
ABSTRACT
Objective@#To investigate the effect of magnetic-induced cell targeted transplantation (MagIC-TT) on repair of bone defects in mice using therapeutic fluorescent gene labeled cells into bone tissue and its mechanism.@*Methods@#The proliferation, apoptosis and targeted migration ability were compared between magnetized and unmagnetized murine bone marrow stromal cells labeled with green fluorescent protein (GFP-BMSCs) (n=3). GFP-BMSCs were loaded into tissue engineering bone (TEB) by MagIC-TT in the experimental group (n=5) before the TEB was transplanted into the large femur defects in the model of red fluorescent protein (RFP) transgenic mice. In the control group (n=5) TEB was not loaded with GFP-BMSCs while in the blank group (n=3) the large femur defects were only fixated with intramedullary nails. The effects and mechanism of bone repair were explored 3 months after surgery using X-ray, micro-CT, semi-solid decalcification (SSD) and histology, respectively@*Results@#There were no significant differences between magnetized and non-magnetized GFP-BMSCs in proliferation (0.760±0.029 versus 0.733±0.033) or in survival rate (87.9%±1.0% versus 87.4%±2.0%) (P>0.05), but the mobility of magnetized GFP-BMSCs was significantly higher than that of non-magnetized GFP-BMSCs (P<0.05). The X-ray 3 months after surgery showed that the scaffolds in the experimental group were degraded and that the proximal and distal ends of the femoral defects were connected by new bone tissue. No new bone formation was found in the blank group while a small amount of bone formation was observed in the control group. The Micro-CT showed that stable new bone tissue formed in the femur defects after removal of intramedullary nails in the experimental group. The SSD showed that GFP-MSCs were densely distributed in the scaffolds with red fluorescent protein (RFP) recipient cells penetrating them, indicating involvement of both donor and recipient cells in the formation of new bone.@*Conclusions@#MagIC-TT can be used to promote introduction of therapeutic cells into bone tissue to achieve a fine effect on repairing bone defects. Dual fluorescence gene marking combined with SSD shows that both donor and recipient cells may take part in the bone repairing.
ABSTRACT
Objective To investigate the effect of magnetic-induced cell targeted transplantation (MagIC-TT) on repair of bone defects in mice using therapeutic fluorescent gene labeled cells into bone tissue and its mechanism.Methods The proliferation,apoptosis and targeted migration ability were compared between magnetized and unmagnetized murine bone marrow stromal cells labeled with green fluorescent protein (GFP-BMSCs) (n =3).GFP-BMSCs were loaded into tissue engineering bone (TEB) by MagIC-TT in the experimental group (n =5) before the TEB was transplanted into the large femur defects in the model of red fluorescent protein (RFP) transgenic mice.In the control group (n =5) TEB was not loaded with GFP-BMSCs while in the blank group (n =3) the large femur defects were only fixated with intramedullary nails.The effects and mechanism of bone repair were explored 3 months after surgery using X-ray,micro-CT,semi-solid decalcification (SSD) and histology,respectively Results There were no significant differences between magnetized and non-magnetized GFP-BMSCs in proliferation (0.760 ±0.029 versus 0.733 ±0.033) or in survival rate (87.9％ ±1.0％ versus 87.4％ ±2.0％) (P＞ 0.05),but the mobility of magnetized GFP-BMSCs was significantly higher than that of non-magnetized GFP-BMSCs (P ＜ 0.05).The X-ray 3 months after surgery showed that the scaffolds in the experimental group were degraded and that the proximal and distal ends of the femoral defects were connected by new bone tissue.No new bone formation was found in the blank group while a small amount of bone formation was observed in the control group.The Micro-CT showed that stable new bone tissue formed in the femur defects after removal of intramedullary nails in the experimental group.The SSD showed that GFP-MSCs were densely distributed in the scaffolds with red fluorescent protein (RFP) recipient cells penetrating them,indicating involvement of both donor and recipient cells in the formation of new bone.Conclusions MagIC-TT can be used to promote introduction of therapeutic cells into bone tissue to achieve a fine effect on repairing bone defects.Dual fluorescence gene marking combined with SSD shows that both donor and recipient cells may take part in the bone repairing.