Application of SYNTAX and its Derivative Scores in the Selection of Revascularization Strategies for Complex Coronary Heart Disease / 中国医学科学杂志(英文版)

Complex coronary heart disease (CHD) has become a hot spot in medicine due to its complex coronary anatomy, variable clinical factors, difficult hemodynamic reconstruction, and limited effect of conservative drug treatment. Identifying complex CHD and selecting optimal treatment methods have become more scientific as revascularization technology has improved, and coronary risk stratification scores have been introduced. SYNTAX and its derivative scores are decision-making tools that quantitatively describe the characteristics of coronary lesions in patients based on their complexity and severity. The SYNTAX and its derivative scores could assist clinicians in rationalizing the selection of hemodynamic reconstruction treatment strategies, and have demon-strated outstanding value in evaluating the prognosis of patients with complex CHD undergoing revascularization treatment. The authors in this article summary the practical application of SYNTAX and its derivative scores in complex CHD in order to deepen the understanding of the relationship between the choice of different revascularization strategies and SYNTAX and its derived scores in complex CHD and provide a further reference for clinical treatment of complex CHD.

Circular RNAs in peripheral blood mononuclear cells from ankylosing spondylitis / 中华医学杂志(英文版)

BACKGROUND@#Circular RNA (circRNA) is a type of closed circular noncoding RNA (ncRNA), mostly formed by back-splicing or alternative splicing of pre-messenger RNA (mRNA). The aim of this study was to explore the expression profile of circRNA in peripheral blood mononuclear cells (PBMCs) of patients with ankylosing spondylitis (AS) and discover potential molecular markers of AS.@*METHODS@#The circRNA microarray technology was used to detect the expression of circRNAs in the peripheral blood of 6 patients with AS and 6 healthy controls (HC). To screen the differentially expressed circRNAs by fold change (FC) and P value, these differentially expressed circRNAs were analyzed by bioinformatics. In 60 cases of AS and 30 cases of HC, 4 circRNAs were subjected to real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and their correlation with various clinical indicators was analyzed. Finally, the receiver operating characteristic (ROC) curve was used to analyze their potential as AS diagnostic markers.@*RESULTS@#The microarray results showed that there were 1369 significantly differently expressed (P  1.5) circRNAs between the AS and HC groups (675 upregulated and 694 downregulated). The results of bioinformatics analysis suggested that they were mainly involved in "enzyme binding," "adenosine ribonucleotide binding," "MAPK signaling pathway", etc. The RT-qPCR results showed that the expressions of hsa_circRNA_001544 (U = 486.5, P < 0.05) and hsa_circRNA_102532 (U = 645, P < 0.05) were significantly different between the AS group and the HC group. The AS group was further divided into two subgroups: active AS (ASA) and stable AS (ASS). After analysis, it was found that compared with the HC group, hsa_circRNA_001544 was significantly increased in both ASA (U = 214, P < 0.05) and ASS groups (U = 273, P < 0.05), while hsa_circRNA_008961 (U = 250, P < 0.05) and hsa_circRNA_102532 (U = 295, P < 0.05) were only significantly increased in the ASA group. Furthermore, hsa_circRNA_012732 was significantly different between the ASA and ASS groups (U = 194, P < 0.05), and there was no statistical significance among the remaining groups. Correlation analysis results showed that hsa_circRNA_012732 was negatively correlated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), high-sensitivity C-reactive protein (hsCRP), and globulin (GLOB) and positively correlated with lymphocyte count (LY), mean corpusular volume, and albumin (ALB), and hsa_circRNA_008961 was negatively correlated with platelet (PLT) count. ROC curve analysis showed that hsa_circRNA_001544 (95% CI = 0.610-0.831, P < 0.05) and hsa_circRNA_102532 (95% CI = 0.521-0.762, P < 0.05) were statistically significant, and their area under curve (AUC) values were 0.720 and 0.642, respectively.@*CONCLUSIONS@#There are differentially expressed circRNAs in PBMCs of AS patients, and they may be involved in the occurrence and development of AS. Among these differentially expressed circRNAs, hsa_circRNA_012732 has the potential to become an indicator of disease activity, and hsa_circRNA_001544 has the potential to become a molecular marker for AS diagnosis.

Comparison of postoperative changes in inflammatory marker levels between transthoracic and transcatheter device closures of atrial septal defects in children

Abstract Objective: To explore the postoperative changes in inflammatory markers in children who underwent device closure of an atrial septal defect (ASD) via a transthoracic or transcatheter approach. Methods: The experimental and clinical data were retrospectively collected and analyzed for a total of 53 pediatric patients between September 2018 and December 2018. According to the different treatments, 19 patients who underwent transthoracic device closure were assigned to group A, and the remaining 34 patients who underwent a transcatheter approach were assigned to group B. Results: All patients were successfully occluded without any device-related severe complication. Compared with the preoperative levels, the postoperative levels of most inflammatory cytokines in both groups were significantly increased and reached a peak on the first day after the procedure. The level of postoperative inflammatory cytokines was significantly lower in group B than in group A. In addition, there was no significant difference in procalcitonin before and after the transcatheter approach. Conclusion: Systemic inflammatory reactions occurred after transthoracic or transcatheter device closure of ASDs in pediatric patients. However, these inflammatory reactions were more significant in patients who underwent a transthoracic approach than in patients who underwent a transcatheter approach.

Comparative study between surgical repair of atrial septal defect via median sternotomy, right submammary thoracotomy, and right vertical infra-axillary thoracotomy

Abstract Objective: To compare the results of surgical repair via median sternotomy, right submammary thoracotomy, and right vertical infra-axillary thoracotomy for atrial septal defect (ASD). Methods: This is a retrospective analysis of the relative perioperative and postoperative data of 136 patients who underwent surgical repair for ASD with the abovementioned three different treatments in our hospital from June 2014 to December 2017. Results: The results of the surgeries were all satisfactory in the three groups. No statistically significant difference was found in operative time, duration of cardiopulmonary bypass, blood transfusion amount, postoperative mechanical ventilation time, duration of intensive care unit, length of hospital stay, and hospital costs. However, the median sternotomy group had the longest incision. Meanwhile, there was no significant difference in postoperative complications. Conclusion: All three types of surgical incisions can be safely and effectively used to repair ASD. The treatments via right submammary thoracotomy and right vertical infra-axillary thoracotomy have advantages over the treatment via median sternotomy in cosmetic results and should be the recommended options.

A comparative study of perventricular and percutaneous device closure treatments for isolated ventricular septal defect: a chinese single-institution experience

Abstract Objectives: To compare the advantages and disadvantages of perventricular and percutaneous procedures for treating isolated ventricular septal defect (VSD). Methods: A total of 572 patients with isolated VSD were selected in our hospital between January 2015 and December 2016. The patients' median age and weight were five years (1-26 years) and 29 kg (9-55 kg), respectively. The median diameter of VSD was 6.0 mm (5-10 mm). Patients were divided into two groups. In group A, perventricular device closure was performed in 427 patients; in group B, 145 patients underwent percutaneous device closure. Results: Four hundred twelve patients in group A and 135 patients in group B underwent successful closure. The total occlusion rate was 98.5% (immediately) and 99.5% (3-month follow-up) in group A, which were not significantly different from those in group B (97.7% and 100%, respectively). Patients in group A had longer intensive care unit (ICU) stay than those in group B, but patients in group B experienced significantly longer operative times than those in group A. The follow-up period ranged from 8 months to 1.5 year (median, 1 year). During the follow-up period, late-onset complete atrioventricular block occurred in two patients. No other serious complications were noted in the remaining patients. Conclusion: Both procedures are safe and effective treatments for isolated VSD. The percutaneous procedure has obvious advantages of shorter ICU stay and less trauma than the perventricular procedure. However, the perventricular procedure is simpler to execute, results in a shorter operative time, and avoids X-ray exposure.

Effect of Stage-based Acupuncture-moxibustion on Endometrial Thickness After Repeated Implantation Failure in IVF-ET / 上海针灸杂志

Objective To observe the effect of stage-based acupuncture-moxibustion therapy on the endometrial thickness in patients suffering from repeated implantation failure in IVF-ET (in vitro fertilization and embryo transfer). Method Seventy-two patients suffering from repeated implantation failure in IVF-ET were randomized into two groups. Thirty-six cases in the treatment group were intervened by stage-based acupuncture-moxibustion therapy plus oral administration of Estradiol valerate tablets; the other 36 cases in the control group were prescribed with oral administration of Estradiol valerate tablets alone. The implantation result of IVF-ET was analyzed 3 cycles later. The endometrial thickness was compared before and after the intervention. Result The endometrial thickness of the non-pregnant women increased after the treatment in both groups (P<0.05), and the increase in the treatment group was more significant than that in the control group (P<0.05). The clinical pregnancy rate in the treatment group was significantly higher than that in the control group (P<0.05). Conclusion Stage-based acupuncture-moxibustion therapy can improve the endometrial thickness, promote the growth of endometrium, benefit the implantation of embryo, and enhance the clinical pregnancy rate.

Curative effect analysis of Sun’s procedure for acute or chronic Stanford A aortic dissection: A case control study / 中国胸心血管外科临床杂志

@#Objective     To analyze the surgical effect of total aortic arch replacement and stented elephant trunk (Sun’s procedure) for acute or chronic Stanford type A aortic dissection, and to investigate the optimal surgical timing for Stanford type A aortic dissection involving aortic arch. Methods     We retrospectively reviewed the clinical data of 327 patients with acute or chronic Stanford type A aortic dissection treated by Sun's procedure from June 2010 to June 2014 in Guangdong Cardiovascular Institute. Patients were divided into two groups according to whether the time from onset to operation was longer than 2 weeks: an acute group with 229 patients (≤2 weeks, the average time of onset to operation 5.70±3.50 d) and a chronic group with 98 patients (>2 weeks, the average time of onset to operation 21.60±15.70 d). There were 186 males and 43 females with a mean age of 47.47±11.19 years in the acute group, and 76 males and 22 females with a mean age of 45.62±12.92 years in the chronic group. The patients discharged from hospital were followed up for one year. Results     There was no significant difference between the two groups in preoperative data. The rate of coronary artery bypass grafting, cardiopulmonary bypass time, aortic cross-clamping time, intraoperative and postoperative 24 h red blood cell intake were higher or more in the acute group than those in the chronic group (P<0.05).  The in-hospital morality, ICU stay, mechanical ventilation time, the incidence of neurological dysfunction, low cardiac output syndrome, acute renal failure with continuous renal replacement therapy, hepatic insufficiency, poor wound healing were higher or more in the acute group than those in the chronic group (P<0.05). During one year follow-up, the survival rate of the acute and chronic groups was 97.0% and 97.6% respectively (P>0.05). No new complications were found in the two groups. The irreversible neurological dysfunction, paraplegia and renal failure showed no significant difference between the two groups. Conclusion     The short-term mortality and complications of acute Stanford A aortic dissection involving aortic arch treated by Sun’s procedure are significantly higher or more than those of chronic Stanford type A aortic dissection. The risk of surgical treatment in acute phase is high.

The Predictive Value of Carbohydrate Antigen-125 for New-onset of Atrial Fibrillation in Patients With Chronic Heart Failure / 中国循环杂志

Objective: To investigate whether serum level of carbohydrate antigen-125 (CA-125) could predict the new-onset of atrial fibrillation (AF) in patients with chronic heart failure (CHF). Methods: A total of 200 CHF patients without previous and current AF admitted in our hospital from 2012-01 to 2016-01 were enrolled. Serum level of CA-125 was examined in all patients at their stable condition. Follow-up study was conducted to observe AF occurrence in order to evaluate the relationship between CA-125 level and new-onset of AF. Results: There were 8 patients died within 6 months, 14 lost contact and 178 finished at least 1 time follow-up at the mean of (20.1±9.9) months (from 6 to 54 months). 40/178 (22％) patients developed new-onset of AF. Compared with sinus rhythm, AF patients had the higher CA-125 level as 108 (44-228) U/ml vs 49 (21-118) U/ml, P=0.001. ROC indicated that CA-125>72.58 U/ml was the optimal cut-off value for predicting new-onset of AF. Single factor analysis indicated that serum CA-125>72.58 U/ml, increased left atrial diameter, right ventricular dilatation, pulmonary hypertension, lower LVEF and moderate to severe mitral regurgitation (MR) had the predictive value for new-onset of AF. With adjusted meaningful single factors, multivariate Cox regression analysis presented that serum CA-125>72.58 U/ml (HR=2.709, 95％ CI 1.308-6.876, P=0.008) and moderate to severe MR were the independent predictors for new-onset of AF. Conclusion: Serum CA-125 level was related to new-onset of AF in CHF patients; the patients with elevated CA-125 had the higher chance to develop new-onset of AF.

The Predictive Value of Carbohydrate Antigen-125 for New-onset of Atrial Fibrillation in Patients With Chronic Heart Failure / 中国循环杂志

Objective: To investigate whether serum level of carbohydrate antigen-125 (CA-125) could predict the new-onset of atrial fibrillation (AF) in patients with chronic heart failure (CHF). Methods: A total of 200 CHF patients without previous and current AF admitted in our hospital from 2012-01 to 2016-01 were enrolled. Serum level of CA-125 was examined in all patients at their stable condition. Follow-up study was conducted to observe AF occurrence in order to evaluate the relationship between CA-125 level and new-onset of AF. Results: There were 8 patients died within 6 months, 14 lost contact and 178 finished at least 1 time follow-up at the mean of (20.1±9.9) months (from 6 to 54 months). 40/178 (22％) patients developed new-onset of AF. Compared with sinus rhythm, AF patients had the higher CA-125 level as 108 (44-228) U/ml vs 49 (21-118) U/ml, P=0.001. ROC indicated that CA-125>72.58 U/ml was the optimal cut-off value for predicting new-onset of AF. Single factor analysis indicated that serum CA-125>72.58 U/ml, increased left atrial diameter, right ventricular dilatation, pulmonary hypertension, lower LVEF and moderate to severe mitral regurgitation (MR) had the predictive value for new-onset of AF. With adjusted meaningful single factors, multivariate Cox regression analysis presented that serum CA-125>72.58 U/ml (HR=2.709, 95％ CI 1.308-6.876, P=0.008) and moderate to severe MR were the independent predictors for new-onset of AF. Conclusion: Serum CA-125 level was related to new-onset of AF in CHF patients; the patients with elevated CA-125 had the higher chance to develop new-onset of AF.

Improvement of quality control method of liuwei dihuang pills / 中国药学杂志

OBJECTIVE: To improve the quality control method of Liuwei Dihuang Pills. METHODS: Morroniside and loganin from processed Fruetus Corni were identified by TLC. Morrniside, loganin and paeonol in Liuwei Dihuang Pills were determined by HPLC. The determination was performed on a Phenomenex Gemini 110A C18 column (4.6 mm×250 mm, 5 μm) maintained at 40℃ with gradient elution of acetonitrile (A) and 0.3% phosphoric acid aqueous solution (B) at a flow rate of 1 mL·min-1. The detective wavelength was set at 240 nm for morroniside and loganin and 274 nm for paeonol. RESULTS: The TLC spots were clear. Morrniside, loganin and paeonol showed good linear relationship in the range of 0.02078-1.039, 0.02034-1.017, and 0.04576-2.288 μg, respectively. The average recoveries (n=9) were 99.97%-100.99% with RSDs less than 2.3%. CONCLUSION: The method is simple, rapid, accurate and can be used to control the quality of Liuwei Dihuang Pill more effectively.

Effects of Blood Activating Wind Dissipating Acupuncture on Blood Pressure of Prehypertension Patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effects of blood activating wind dissipating acupuncture (BAWDA) on blood pressure (BP) of prehypertension (PHT) patients.</p><p><b>METHODS</b>Totally 60 PHT patients were assigned to the control group and the acupuncture group according to random digit table, 30 in each group. All patients were intervened by life style. BAWDA was additionally performed in patients in the acupuncture group for 6 weeks (30 times). The improvement of BP after intervened by acupuncture was observed. BP success rates and the proportion of PHT progressing to hypertension (HT) were also observed after 6-week intervention of acupuncture and at 1-year follow-up.</p><p><b>RESULTS</b>Systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased after 6-week intervention in the acupuncture. The BP control rate was 56.7% (17/30 cases) in the acupuncture group vs.10.0% (3/30 cases) in the control group with statistical difference (chi2 = 14.70, P < 0.01). At 1-year follow-up BP success rate was 36.7% (11/30 cases) in the acupuncture group, remarkably higher than that of the control group [13.3%, (4/30 cases)] (chi2 = 4.36, P < 0.05).</p><p><b>CONCLUSIONS</b>BAWDA showed BP regulating roles in a gradually stable decreasing tendency. It also could elevate BP success rate of PHT, and reduce the risk of PHT progressing to HT.</p>

Diagnosis of popliteal artery entrapment syndrome with multidetector row spiral computed tomography / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the role of multidetector row spiral computed tomography in the diagnosis of popliteal artery entrapment syndrome (PAES).</p><p><b>METHOD</b>Ten patients (13 limbs) were diagnosed as PAES through open surgery in Peking Union Medical College Hospital from January 2006 to December 2009, among whom three (30.0%) had both limbs involved.</p><p><b>RESULTS</b>Eleven limbs (84.6%) had occlusions in popliteal artery at admission. While only 15.4% of the patients were diagnosed as PAES by positional stress test, Doppler ultrasound, and arterial angiography, the disease was confirmed in all 10 patients by spiral computed tomography. As shown by inter-operative exploration, the PAES types included type 1 (n=2, 15.4%), 2(n=5, 38.5%),3 (n=4, 30.8%), and 5 (n=2, 15.4%). Two limbs underwent popliteal artery release only, 8 limbs underwent politeal artery release, thromboendarterectomy, and angioplasty with a venous or prosthetic patch, and 3 patients underwent catheter-based thrombolysis and popliteal artery release subsequently. During the follow-up (mean: 22 months; range: 4-33 months), the primary patency rate was 92.3% (12/13), the total patency rate was 100% (13/13), and the limb salvage rate was 100%.</p><p><b>CONCLUSION</b>Positional stress test, Doppler ultrasound, and arterial angiography play limited roles in the diagnosis of PAES with popliteal artery occlusion, while multidetector row spiral computed tomography is much helpful in diagnosing and typing PAES.</p>

Triptolide-induced Apoptosis by Inactivating Nuclear Factor-kappa B Apoptotic Pathway in Multiple Myeloma in vitro / 华中科技大学学报（医学）（英德文版）

The effect of triptolide on proliferation and apoptosis of human multiple myeloma RPMI-8226 cells in vitro,as well as the roles of nuclear factor-kappa B (NF-κB) and IκBα was investigated.The effect of tritptolide on the growth of RPMI-8226 cells was studied by MTT assay.Apoptosis was detected by Hoechest 33258 staining and Annexin V/PI double staining assay.The expression of NF-κB and IκBα was observed by Western blot and confocal microscopy.The results showed that triptolide inactivated NF-κB apoptotic pathway in human multiple myeloma RPMI-8226 cells.Triptolide at nM range induced proliferation inhibition in a dose- and time-dependent manner and apoptosis in a dose-dependent fashion in RPMI-8226 cells.Besides,we observed the inhibition of NF-κB/p65 in the nuclear fraction was correlated with the increase in the protein expression of IκBα in the cytosol.These results suggested that triptolide might exhibit its strong anti-tumor effects via inactivation of NF-κB/p65 and IκBα.

Protective effect of the extract of Terminalia catappa leaves on acute liver injury induced by D-GalN in mice / 中国中药杂志

<p><b>OBJECTIVE</b>To study the hepatoprotective effect of the extract of Terminala catappa leaves (TCE) and the possible mechanisms underlying its protection on acute liver injury induced by D-Galactosamine (D-GalN).</p><p><b>METHOD</b>In vivo: D-GalN-induced liver injury model was used to evaluate the effect of TCE on the activities of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in mice. Structure of liver was observed and liver mitochondrial swelling was measured following D-GalN injection without or with TCE. In vitro: D-GalN-induced primary cultured hepatocytes injury model was used to value the effect of TCE on cultured hepatocytes. Cell viability was measured by means of MTT assay, and the AST and superoxide dismutase (SOD) activities in supernatant of cultured cells were investigated also.</p><p><b>RESULT</b>In acute hepatic injury test, with oral pretreatment of TCE, remarkable rises in serum AST and ALT activities (2.95 fold and 3.35 fold) induced by D-GalN were obviously reversed and significant morphological changes were remarkably lessened. In addition, the decrease in sensitivity of mitochondrial swelling to the exotic Ca2+ stimulation induced by D-GalN was also prevented by TCE. In primary cultured hepatocytes of mice, it was found that incubation with TCE could prevent the decrease in cell viability in a dose-dependent manner. It was also found that both the increase in AST level (1.9 fold) and the decrease in SOD activity (48.0%) in supernatant of primary cultured hepatocytes induced by D-GalN could be inhibited by pretreatment of TCE.</p><p><b>CONCLUSION</b>TCE has hepatoprotective activity and the mechanisms underlying its protective effect may be related to its antioxidant activity and protection on both hepatocytes and liver mitochondria.</p>

Experimental Study on the Estrogenic Activity of Dibutyl Phthalate / 环境与健康杂志

Objective To determine the estrogenic activity of dibutyl phthalate DBP. Methods The tested compound was dibutyl phthalate. Human estrogen-dependent MCF-7 breast cancer cells were cultured in RPMI 1640 medium containing 10% fetal bovine serum FBS. Five days before the addition of the tested compounds the cells were rinsed by phosphate balanced solution PBS and the medium was substituted with a phenol red-free RPMI 1640 medium containing 5% dextral charcoal-stripped FBS. The respective tested compound was added in fresh medium and the control cells received only the vehicle ethanol. The proliferation of MCF-7 cells was analyzed by the MTT assay growth curves mitotic index and coloning efficiency. Results Compared with the control the proliferation of tested cells treated with DBP like estradiol was markedly enhanced and the activity of the cell proliferation reached the maximum at 10-5 mol/L DBP. During log phase the mitotic index of the test cells treated with DBP and estradiol was significantly increased. The cell coloning efficiency was enhanced which was treated by 10-5 mol/L DBP only for 48 hours. The results showed the time-dependent and dose-dependent model. Conclusion Dibutyl phthalate may enhance the proliferation of human breast cancer MCF-7 cells in vitro that demonstrates an estrogenic activity of dibutyl phthalate.