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BACKGROUND@#LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer.@*METHODS@#We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels.@*RESULTS@#On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]).@*CONCLUSION@#LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT04563936.
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Humans , Male , Antineoplastic Agents, Hormonal/therapeutic use , East Asian People , Gonadotropin-Releasing Hormone/agonists , Goserelin/therapeutic use , Prostate-Specific Antigen , Prostatic Neoplasms/drug therapy , TestosteroneABSTRACT
ObjectiveTo investigate the deafness genetic mutation spectrum in nonsyndromic hearing impairment (NSHI) associated with enlarged vestibular aqueducts (EVA). MethodsFrom October, 2015 to August, 2016, 85 patients with NSHI from Hubei Yichang Special Education School were examined with temporal bone CT, and 20 deafness-related gene mutations in GJB2, GJB3, SLC26A4 and mtDNA 12S rRNA were detected with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. ResultsA total of 31 patients were found EVA with temporal bone CT. Compared with non-EVA patients, the proportion of deafness-related gene mutations was more in patients with EVA (χ2 = 11.160, P = 0.001), especially for c.919-2A>G mutation of SLC26A4 (χ2 = 23.870, P < 0.001). ConclusionThe deafness gene mutation spectrum is different in NSHI patients with or without EVA. It is needed to optimize genetic testing scheme for deafness for early diagnosis and intervention of NSHI associated with EVA.
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Objective To investigate the effect of vitamin D on platelet reactivity after combined treatment with aspirin and clopidogrel in elderly patients with ischemic stroke??Methods A total of 190 elderly patients with ischemic stroke treated with aspirin and clopidogrel in Beijing Bo′ai Hospital from June 2017 to August 2018 were enrolled in this study??Venous blood was collected for platelet aggregation rate,25?hydroxyvitamin D[25(OH)D] and clinical biochemical indexes during 1～2 weeks??According to 25 (OH) D quartile,the patients were further divided into Q1(≤7??18 μg／L) group ( n＝50),Q2: (＞7??18－≤9??39 μg／L) group (n＝50),Q3: (＞9??39－≤13??74 μg／L) group (50),Q4: (＞13??74 μg／L) (n＝40)??In order to evaluate the effect of calcitriol on platelet aggregation,platelet rich plasma ( PRP) in healthy group (15 cases) and clopidogrel resistance group (15 cases) were treated with calcitriol (10 nmol／L) and saline (37℃ pretreatment for 5 minutes),respectively,and to compare the difference of maximum platelet aggregation rate induced by ADP between the two treatments??Results There were significant differences in ADP? induced maximum platelet aggregation rate ( MPAR) (( 49??36 ± 23??34)%,( 48??80 ± 20??90)%, ( 37??02 ±18??24)%,(36??02± 14??46)%, F＝ 3??426, P＝ 0??018) and clopidogrel resistance ( CR)／ clopidogrel sensitive (CS) ratio (30／20,24／26,15／35,10／30,χ2＝15??119,P＝0??002) among the vitamin D quartiles (increasing)??Moreover, the MPAR and CR showed a decreasing trend with the increase of vitamin D concentration??Logistic regression analysis showed that serum 25( OH) D level was an independent inhibited factor for clopidogrel resistance in elderly patients with ischemic stroke ( Q4 vs Q1, OR＝0??699,95%CI 0??582～0??838,P＜0??001; Q3 vs Q1,OR＝0??848,95%CI 0??755－0??953,P＝0??006)??In vitro,compared with physiological saline,the aggregation rates of platelet in healthy group and CR group decreased after calcitriol pretreatment,and the difference was statistically significant ( healthy group: ( 69??8 ± 12??7 )% vs ( 58??6 ±11??5)%,t＝12??13,P＜0??001;CR group: ( 65??5 ± 8??3)% vs ( 56??3 ± 7??6)%, t＝11??48, P ＜0??001)??Conclusion Vitamin D reduces the high residual platelet reactivity after antiplatelet therapy??Further study is needed to determine whether vitamin D supplementation may improve the efficacy of clopidogrel??
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Objective:To study the effect of vascular endothelial growth factor 165b (VEGF165b) on the biological characteristics of human hepatocellular carcinoma HepG2 cells,and to explore its mechanisr.Methods;The HepG2 cells were divided into blank group (treated with transfection reagent),control group (transfected with pcDNA3.0 expression vector) and pcDNA-VEGF165b group (transfected with pcNDA-VEGF165b).MTT assay was used to detect the survival rate of HepG2 cells;RT-PCR and Western blotting method were used to detect the expression levels of VEGF165b and VEGF165 mRNA and protein in the HepG2cells;Transwell chamber assay was used to measure the migration ability of HepG2 cells.Results:Compared with blank group,there was no significant changes in the expression levels of VEGF165b and VEGF165 mRNA and protein in the HepG2 cells in control group (P＞0.05).Compared with blank group,the expression levels of VEGF165b mRNA and protein in the HepG2 cells in PcDNA-VEGF165b group were significantly increased (P＜0.05),and the expression levels of VEGF165 mRNA and protein were significantly decreased (P＜0.05).There was no significant difference in the survival rates between blank group and control group (P＞0.05).The survival rate of HepG2 cells in PcDNA-VEGF165b group was lower than those in blank group and control group,but the differences were not statistically significant (P＞0.05).The cell migration experiment results showed that there was no significant difference in the migration rate between blank group and control group (P＜0.05).Compared with blank group and control group,the migration rate of HepG2 cells in PcDNA-VEGF165b group was significantly reduced (P＜ 0.05).Conclusion:VEGF165b can inhibit the expressions of VEGF165 mRNA and protein,and VEGF165b has no effect on the proliferation of hepatocellular carcinoma cells;but it can reduce the migration of hepatocellular carcinoma cells.
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Objective@#To explore the relationship between fragmented QRS complex(fQRS) and coronary collateral circulation(CCC) in patients with chronic total occlusion(CTO)lesion without prior myocardial infarction.@*Methods@#This retrospective study analyzed 238 consecutive patients with CTO lesion in one of the major coronary arteries from May 2014 to October 2015 in our department. Patients were divided into poor CCC group (grade 0 and 1, 58 cases) and good CCC group(grade 2 and 3, 180 cases) based on Rentrop′s classification of CCC. The fQRS was defined as the presence of an additional R wave or notching of R or S wave or the presence of fragmentation in two contiguous electrocardiogram leads corresponding to a major coronary artery territory. Multivariate logistic regression was used to analyze the relationship between CCC and fQRS on electrocardiogram.@*Results@#Compared with good CCC group, patients in poor CCC group had older age((65.2±8.9)years old vs. (60.3±10.1) years old, P=0.03), higher plasma glucose ((7.22±3.00) mmol/L vs.(6.31±1.83)mmol/L, P=0.04), and lower left ventricular ejection fraction ((45.2±11.4)% vs. (51.2±13.5)%, P=0.02). None of patients had Rentrop grade 0, the presence of fQRS on ECG in patients with Rentrop grade 1, grade 2, and grade 3 CCC was 69.0% (40/58), 48.6% (35/72) , and 19.4% (21/108), respectively (P<0.01). The presence of fQRS were higher in poor CCC group than in good CCC group (69.0%(40/58)vs. 31.1%(56/180), P<0.01), and number of leads with fQRS were higher in poor CCC group than in good CCC group (3(0, 4)vs.0(0, 3), P<0.01). Multivariate logistic regression analysis demonstrated that poor CCC growth in patients with CTO lesion without prior myocardial infarction was independently related to the presence of fQRS (OR=3.659, 95%CI 1.619-8.217, P<0.01).@*Conclusion@#Poor CCC in patients with CTO lesion without prior myocardial infarction is independently related to the presence of fQRS on electrocardiogram.
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Objective To Summarize the application of digital artery dorsal distal interphalangeal joint perforator flap to repair finger tip skin defect,and at the same time,the method and effect of anastomosis of finger dorsal branch of digital nerve sensory reconstruction.Methods From September 2012 to March 2015,78 patients 92 fingers were treated in Orthopedics Department of Jinshan Branch Hospital of the Sixth People′s Hospital of Shanghai,all patients with finger artery distal interphalangeal joint dorsal cutaneous branches of the dorsal flap pedicled with retrograde,transferred to repair the skin defect of finger end,and anastomosis of dorsal branch of the proper digital nerve reconstruction.Results Postoperative vascular crisis occurred in 8 cases,2 cases of partial flap necrosis and healed after symptomatic treatment.All flaps survived,the wounds healed in I stage,and the donor site healed in I stage.All the 73 cases were followed up,the follow-up period ranged from 3.0 to 12.0 months,an average of (7.8±2.5) months.The postoperative appearance and feel good,soft texture,abrasion resistance,no tenderness,cold resistance,dynamic two-point recovered to 4.0-8.0 mm,average (5.3±0.9) mm.Static two-point discrimination was 4.0-9.0 mm,average (5.8±1.2) mm.The method of TAM was used to determine the function of the 67 fingers,good for the 7 finger,but also for the 5 finger and the difference of the 0 finger.The excellent and good rate was up to 93.7%.Conclusion The operation without sacrifice of major arteries and nerves by finger,the middle finger dorsal skin for non functional surface area,and at the same time by anastomosis of dorsal branch of the proper digital nerve reconstruction,without surgery two times,is one of the ideal surgical repair of skin defect of the finger end.
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Objective To define the mutation spectra of deafness gene in 318 Chinese Han population with nonsyndromic hearing loss (NSHL). Methods From October, 2015 to April, 2016, anticoagulant venous whole blood of 318 patients with NSHL were collected. The genes including GJB2, SLC26A4, GJB3 and 12Sr RNA were detected with polymerase chain reaction (PCR) and Matrix Assisted Laser De-sorption/Ionization Time-Of-Fight Mass Spectrometry (MALDI-TOF MS). Results Among these patient, 111 cases (34.9%) had GJB2 muta-tions, in which the mutation carrying rate of 235delC was the highest (25.47%), 43 cases (13.5%) had SLC26A4 mutations, 3 cases (0.94%) had GJB3 mutations, and 12 cases (3.77%) had mitochondria 12Sr RNA mutations. Conclusion Definition of mutation spectrum among dif-ferent populations with NSHL is important for development of optimal genetic screening services for congenital hearing impairment.
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Objective To analyze the effect of PDCA cycle quality management model on multi-drug resistant organism (MDROs) infec-tion control in a tertiary rehabilitation hospital. Methods From March, 2013 to December, 2015, targeted surveillance of MDROs infection control was performed with PDCA cycle quality control. The MDROs detection rate, the awareness rate of MDROs prevention and control, the rate of doctor issuing isolation orders and execution rate of medical sanitation disinfection and isolation were analyzed. Results The de-tection rates of methicillin-resistant staphylococcus aureus and Carbapenem-resistant Pseudomonas aeruginosa decreased (χ2>3.922, P399.17, P<0.001). Conclusion PDCA cycle quality management model played an impor-tant role in the prevention and control of MDROs in rehabilitation hospital.
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Objective To investigate the inflammation levels of 2-diabetes patients before and after 3 months of improving glycemic control.Methods A longitudinal study was performed in a subgroup of 48 subjects with T2D and poor glycemic control.Forty-four healthy individuals were taken as control group.The serum concentration of C-reactionprotein (CRP),interleukin-6 (IL-6),interleukin-6 (IL-8),transforming growth factor-β1 (TGF-β1) and transforming growth factor-β1 (MCP1) in all participants were measured simultaneously by multiplexed Luminex assay.Results The serum levels of CRP,MCP-1 of 2-diabetes patients were 3.96 (3.45,5.58) mg/L and (195.0± 129.8) ng/L,significant higher than those in control group (2.25 (1.24,3.22) mg/L,(148.5±85.7) ng/L),and the differences were significant(t=-2.580,P=0.010;t=-2.118,P =0.047).No significant difference was found in the serum levels of IL-6,IL-8,TGF-β lbetween the two groups (P＞0.05).TGF-β1 level in patients with good glycemic control decreased to 26.85 (23.17-31.12) ng/l,significant lower than that before glycemic control (43.5(26.5-62.25) g/L;Z=-2.191,P=0.028),and there were no significant differences among the other 4 kinds of inflammatory factors before and after blood glucose control(CRP:Z =-0.937P =0.372;IL-6:Z =-0.875,P =0.396;IL-8:Z =-1.215,P =0.286;MCP-1:t =-1.846,P=0.065).Conclusion Low grade systemic inflammation status in T2D patients.Improvement of glycemic control reduces TGF-β1 levels and plays a key role in delaying the development of diabetic nephropathy.
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Objective To explore the therapeutic effect of erythropoietin (EPO)combined oral iron in patients with chronic congestive heart failure( CHF)accompanied by anemia. MethodsNinety six patients with CHF accompanied by anemia, whom were consecutively hospitalized from January 2007 to December 2009, were enrolled into this study. They were randomly divided into treatment group accepted routine anti-heart failure therapy combined EPO and oral iron, and control group solely accepted routine anti-heart failure therapy. After 6 months follow up, the changes of hemoglobin ( Hb ), cardiac function classification, left ventricular ejection fraction(LVEF) ,6-minute walking distance,readmission rate of CHF and cardiac death were compared between two groups. ResultsCompared with those before therapy, we found significant improvements of hemoglobin level ( [ 120. 12 ± 10. 42 ] g/L vs [ 86.40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2. 65 ± 0. 67 vs 3. 13 ±0. 61, P ＜ 0. 01 ), LVEF ( [ 37.21 ± 4. 96 ]％ vs [ 33. 92 ± 7. 28 ]％, P ＜ 0. 01 ), 6-minute walking distance ( [ 443.52 ± 97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in treatment group after EPO combined oral iron administration. After 6 months follow up, we also found significant improvements of Hb level ( [ 120. 12 ±10. 42 ] g/L vs [ 86. 40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2.65 ± 0. 67 vs 2. 98 ± 0. 81,P＜0.01),LVEF([37.21 ± 4.96]％ vs [34.67 ±4.10]％,P ＜ 0. 01),6-minute walking distance ( [443.52 ±97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in the comparison between treatment and control group. The readmission rate of CHF fell significantly in treatment group compared to control (20. 83％ vs 39. 58％ ,P ＜ 0. 05 ). However, we found no significant difference in cardiac death rate ( 0％ vs 4. 17％, P ＞0. 05). ConclusionTreatment of EPO combined oral iron could significantly improve the cardiac function,increase exercise tolerance,lower the readmission rate of CHF in patients with chronic congestive heart failure (CHF)accompanied by anemia.
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Objective To construct a prokaryotic plasmid to express the testis development related gene 1 (TDRG1) recombinant protein and obtain anti-TDRG1 mAb by immunizing mice, and to identify the biological properties of the mAb. Methods The coding sequence of TDRG1 was amplified by RT-PCR from normal human testis tissue and cloned into the vector pET21, and then was expressed in the E. coli BL 21(DE3) to get TDRG1 recombinant protein. The purified TDRG1 recombinant protein was injected to immunize the BALB/C mice to develop anti-TDRG1 mAb. Splenocytes of the immunized mice were collected and fused with the mouse myeloma cell line Sp2/0 cells. The hybridoma cells that secreted anti-TDRG1 mAb were subcloned with limited dilution. Enzyme-linked immunosorbent assay (ELISA) was used to evaluate titers and subtypes of mAb. Western blot and immunohistochemistry were used to detect specificity of mAb.Results The prokaryotic plasmid expressing the recombinant protein was constructed, and the TDRG1 recombinant protein was expressed and purified. Two hybridoma cell lines that secreted anti-TDRG1 mAb were obtained. The titer of the mAb in ascites was 1∶1.6×10~6, and the subtype of the mAb was IgG_1. Westem blot and immunohistochemistry analysis indicated the mAb showed specific combination with TDRG1 protein in human testes.Conclusion The TDRG1 recombinant protein is highly purified and has strong antigenicity. The anti-TDRG1 mAb is produced successfully.
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Objective To investigate the aging features of pure leukoaraiosis (LA) in nondemented outpatients. Methods The outpatients with age older than 40 years, without taking cholesterol lowering and B vitamin medications and with mini-mental state examination more than 24 scores were selected from July 2008 to December. 2009 in Beijing Tiantan Hospital. LA was defined with MRI. Patients were classified into two groups i. e. LA group consisting of 138 patients with leukoaraiosis but without lacunar lesions and cortical infarcts and a control group consisting of 124 patients without any lesion in brain. Age and other vascular risk factors were also investigated. Results Age of the patients in the LA group was significantly higher than that in the control group (P< 0.001). Multivariable logistic regression analysis showed that age was independently associated with pure LA ( OR 1.080, 95% CI 1.042-1.120), after adjusting sex, vascular risk factors and presence of atherosclerosis in cervical arteries. If age-stratification was further considered, logistic regression analysis showed that OR (95% CI) for LA was 2.693 (95% CI 1.103-6.575) in a 60-69 year group and 13. 527(95%CI 3.319-55.131) in a≥70 year group as compared with a 40-49 year group. Conclusion Age is a determining risk factor for pure LA and patients with age older than 60 years are at high risk of LA.
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OBJECTIVE@#To determine the diagnostic value of real-time Rigiscan monitoring and Doppler ultrasonography following intracavernous injection of prostaglandin E1in erectile dysfunction(ED).@*METHODS@#From January 1998 to December 2007, 1 392 ED patients completed the test. PGE(1) was injected into corpus cavernosum penis near the radix penis with injection guns. After 1 or 2 minutes, the Rigiscan Plus device was used for real-time evaluation of penile rigidity. Optimal injected dosage of each patient with positive reaction was determined. Injected dosage of patients with negative reaction was gradually increased from to 60 microg. As the dosage was established, color Doppler ultrasonography was used to assess the morphodynamic features of cavernosal arteries.@*RESULTS@#Altogether 1 039 patients were positive, while 353 patients were negative by Rigiscan. In the 1 039 positive patients,663 were injected with 10 microg PGE(1), 265 patients 20 microg, 97 patients 30 microg,and 14 patients 60 microg while 89(13.4%),39(14.7%),41(42.3%),and 10(71.4%) patients were diagnosed vascular ED. Of the 353 negative patients, 267(75.64%) patients were diagnosed vascular ED. During intracavernous pharmacological testing,the more PGE(1) was used, the more vascular ED patients would be found(P<0.001).@*CONCLUSION@#PGE(1) is safe and effective for the erectile responses. The dosage of PGE(1) following intracavernous injection is related to vascular ED. Real-time Rigiscan monitoring combined with color Doppler ultrasonograph can be helpful to diagnose penile vascular diseases.
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Adult , Humans , Male , Alprostadil , Erectile Dysfunction , Diagnosis , Diagnostic Imaging , Penile Erection , Penis , Diagnostic Imaging , Ultrasonography, Doppler, ColorABSTRACT
OBJECTIVE: Radial artery hemostasis devices of TR Band and RDP made in Japan has used in China and abroad. However,comparisons of application effects are rarely reported. The aim of this paper is to investigate the safety and effectiveness of radial artery hemostasis devices of TR Band and RDP after transradial intervention procedures. METHODS: A total of 300 cases with transradial route coronary arteriongraphy and percutaneous coronary intervention, were randomly divided into 3 groups, with 100 cases in each group. TR Band, RDP, and "8" character Bandaging were used respectively. The hemostasis effectiveness, hemostasis time, patients' degree of comfort, disorder of venous return,saturation of blood oxygen of thrums of compressed hands, as well as ischemia and necrosis status in local skin of access site were compared.RESULTS: Two kinds of devices were able to hemostasis effectively. The saturation of blood oxygen of cases in each group was within normal limits, which had no significantly difference (P> 0.05). Patients' degree of comfort was significantly different among three groups (P< 0.05), but there was no insignificantly different between TR Band and RDP groups (P> 0.05).Swelling in arms and ischemia and necrosis status of local skin at access site were notably different among three groups (P <0.05), however, ischemia and necrosis status of local skin at access site had no difference between TR Band and RDP groups (P>0.05).CONCLUSION: Application of radial artery hemostasis devices of TR Band and RDP-700(800) after transradial intervention procedures is safe and effective.
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Long period of constipation will affect the health of the elderly people. The constipation of the elderly people often appears deficient characteristics. In TCM, the principles of tonifying the spleen for helping digestion, simultaneously applying of moistening and subduing, and wanning and supplementing the Vital Gate are commonly used.
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Objecfive To study the clinical characteristics of acute inferior myocardial infarction.Methods 100 patients with acute inferior infarction were divided into 2 groups according to coronary angiography:group A (n=76) with right coronary artery occlusion;group B(n=24) with left circumflex artery occlusion.Results The frequencies of Electrocardiogram(ECG) ST segment elevation ST Ⅲ>ST Ⅱ and ST segment depression STAVL>STI in group A was significantly higher than that in group B(P<0.05);The frequency of ECG ST segment elevation STⅢ<STⅡ in group A wag significantly lower than that in group B(P<0.01);The frequency of ECG STV4R elevation >O.1 mV in group A was significantly higher than that in group B(P<0.05);The number of ECG with precor-dial lcads V1～6 ST segment depression >0.1 mv with lesion of left anterior descending coronary was more significant than that without precordial Vl-6 leads ST segment depression (P<0.05).Left ventricular ejection fraction (LVEF)(51%±14%) in group A was significant lower than that in group B(57%±10%)(P<0.05);The patients in group A with right ventricular infarction were more significant than those in group B(P<0.05);The total hospital mortality of patients with acute inferior myocardial infarction was 6%,and they were all in group A.But there was no significance between the two groups about cardiogenic shock,heart failure,Ⅱ degree and Ⅲ degree atrial ventricular b1ock,ventrieular tachycardia/ventrieular fibrillation and the hospital mortality.The mortality with cardiogenic shock was 83.3%.Conclusion The changes of ECG ST segment in Ⅲ,Ⅱ,Ⅰ,AVL and V4R leads can predict relatedinfarct coronary artery with acute inferior myocardial infarction.The patients with precordial Vl～6 leads ST segment depression indicates lesion of LAD.The LVEF of patients with RCA occlusion is lower than that with LCX occlusion. The primary cause of death is eardiogenic shock.
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BACKGROUND:It has been reported that treatment with granulocyte-colony stimulating factor (G-CSF) increases the abundance of circulating CD34+ cells in rats. Data from the study, more important, suggested that mobilized by G-CSF may enhance rapid reendothelization and reduce neointimal formation after vascular injury.OBJECTIVE: To evaluate whether BM-derived CD34+ cells could enhance rapid reendothelization and reduce neointimal formation after balloon-injured carotid artery in an intact rat model.DESIGN: Randomized control animal study.SETTING: Nanjing First Hospital Affiliated to Nanjing Medical University.MATERIALS: The experiment was carried out in Nanjing First Hospital from December 2005 to April 2006. A total of 40 male Sprague-Dawley rats, weighing 200-250 g and of SPF grade, were purchased from National Rodent Laboratory Animal Resources, Shanghai Branch. The recombinant human G-CSF was purchased from Qilu Pharmaceutical. The 2F Fogarty arterial embolectomy catheters were purchased from Edwards Lifesciences. Anti-human CD34 and anti-human CD45 were purchased from Multi Sciences.METHODS: SD rats were divided randomly into treated group (n =20) and control group (n =20). Subcutaneous injection of recombinant human G-CSF (100 μg/kg/day) once daily for 8 days for treated group. Control group as treated with subcutaneous injection of saline. Five days after initiation of G-CSF treatment or saline, the rats were anesthetized by intraperitoneal injection with ketamine. The left common carotid artery was exposed through a midline incision of the ventral side of the neck. A 2F Fogarty arterial embolectomy catheter was inserted through the external carotid artery,inflated with 200 μL air, and passed 3 times along the length of the segment, which was defined proximally by the carotid bifurcation and distally by the edge of the omohyoid muscle. After removal of the catheter, the proximal ligature of the external carotid artery was tied off. ① An average of 1 mL venous blood per rat was collected for enumeration of the white blood wells (WBCs) and CD34+ cells before and 5 days after initiating G-CSF or saline treatment. ② Ten rats in each group were killed with overdose ketamine at 14 and 28 days after balloon injury and left common carotid arteries were harvested. The luminal surface of carotid arteries (n =5, each group) was exposed to calculate the reendothelialized area, which was manually traced with software (Image ProPlus). Reendothelialized area = non-stained with Evans blue area/the total area of balloon-injuried. The cross sections of carotid arteries (n =5, each group) were stained with hematoxylin and eosin (HE) and calculated intima-to-media area ratio (I/M) with software (Image ProPlus) to assess the extent of neointimal thickening. ③ To evaluate the extent of reendothelialization of arteries injury, sections were stained with CD31 and vWF by immunohistochemistry analysis.MAIN OUTCOME MEASURES: ① The number of WBCs and CD34+ cells; ② the extent of reendothelialization of arteries injury; ③ the extent of neointimal hyperplasia (I/M); ④ CD31 + and vWF+ endothelial cells.RESULTS: A total of 40 rats were involved in the final analysis. ① The number of WBCs and CD34+ cells: After 5 days of treatment, the number of WBCs in the treated rats increased more than 2.7-fold compared with control group [(27.60±2.45) ×109 L-1, (10.11±1.81) ×109 L-1, P ＜ 0.01], CD34+ cells increased more than 12.2-fold compared with control group (38.31×107 L-1, 3.14×107 L-1, P ＜ 0.01). ② The extent of reendothelialization: At 14 and 28 days after balloon injury,carotid artery of reendothelialization in the treated group were (68.3±8.3)％ and (97.6±4.1)％, superior than the control group (33.8±6.3)％ and (76.1±5.2)％ (P ＜ 0.01). ③ The extent of neointimal hyperplasia: At 14 and 28 days after balloon injury, the neointima-media (I/M) ratios in the treated rats were 0.39±0.11 and 0.45±0.09, less than the control group 0.87±0.15,1.26±0.16 (P ＜ 0.01). A highly significant inhibition of neointimal hyperplasia was observed in the treated group. ④ CD31+ and vWF+ endothelial cells: At 28 days after injury, sections from G-CSF treated group showed almost complete and continuous monolayer of CD31 and vWF positive cells.In contrast, a patchy and interrupted CD31 and vWF positive cells were found lining the lumen of control group.CONCLUSION:Treatment with G-CSF significantly increases the number of CD34+ cells and accelerates the rate of reendothelialization of injured vessels, leading to marked inhibition of neointimal formation after vascular injury in rats.
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Objective To investigate the effect of bone marrow mesenchymal stem cells(MSCs) transplation on reparing carotid artery endothelium in S-D rat injured by balloon.Methods Twenty four male Sprague-Dawley(SD) rats underwent balloon overstretch injury in the right common carotid artery and were randomly divided into treatment group(MSCs suspension injected) and control group(phosphate buffered solution injected).Animals were killed to assess vessel morphology and histology at 14 and 28 days after injury in the two groups.Results By H-E staining,morphometric analysis at 14 and 28 days showed that MSCs injection after balloon injury significantly reduced neointimal thickening compared with PBS injection after balloon injury [(0.57?0.06) cm vs(1.09?0.07) cm at 14 days,P
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Objective To explore the effects of berberine(BBR)on the prevention of left ventricular remodeling after acute myocardial infarction(AMI)in New Zealand rabbits.Methods AMI were conducted by ligating left coronary artery in female New Zealand rabbits.Five days after the procedure,the 28 survival rabbits were randomized into the controls(n=14)or BBR treatment group [n=14,BBR 8 mg/(kg?d)iv.].Hemodynamic studies were performed 4 weeks after the completion of treatment.Pathology study of the rabbits hearts was carried ont and matrix metalloproteinases(MMPs)2 and 9 were detected by immunohistochemical analysis in the non-infarct myocardium.Results Compared with the control group,left ventricular relative weight(LVRW)and LV end diastolic pressure(LVEDP)were decreased in the treatment group 4 weeks after BBR intervention(1.55?0.12 vs 1.69?0.13,P
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<p><b>OBJECTIVE</b>To determine the mid-term effects of cutting balloon angioplasty (CBA) on in-stent restenosis.</p><p><b>METHODS</b>A total of 69 patients with in-stent restenosis were divided into 2 groups randomly: cutting balloon angioplasty and plain old balloon angioplasty. The mechanisms of restenosis and dilation results were determined by quantitative coronary angiography and intravascular ultrasound. Follow-up was performed.</p><p><b>RESULTS</b>The procedural success rate was 100% without death and acute closure. One patient experienced dissection at the distal end of the stent and needed another stent. The mean follow-up period was 6.7 +/- 2.3 months. The final re-restenosis rate was 15% and 18% at 3 months and 6 months respectively, markedly lower than after plain old balloon angioplasty (38% and 43%). Acute gain by intravascular ultrasound (IVUS) was 1.72 +/- 0.52 mm after cutting balloon angioplasty, higher than 1.15 +/- 0.54 mm after plain old balloon angioplasty. The lumen diameter late loss in the cutting balloon group was 0.26 +/- 0.05 mm and 0.38 +/- 0.06 mm at 3 months and 6 months respectively, significantly lower than for those in conventional balloon group (0.78 +/- 0.19 mm and 0.89 +/- 0.16 mm, respectively, P < 0.001). As shown by IVUS, the main mechanism of cutting balloon angioplasty was marked reduction of plaque area without significant increase of vessel area (less vessel trauma).</p><p><b>CONCLUSION</b>Cutting balloon angioplasty is feasible and effective for the treatment of in-stent restenosis with less vessel trauma.</p>