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BACKGROUND@#MAVERIC (Mitral Valve Repair Clinical Trial) validates the safety and efficacy of the ARTO system. We here report the first two successful cases of utilizing the ARTO system in patients with symptomatic heart failure (HF) with functional mitral regurgitation (FMR) in Asia.@*METHODS@#Two patients, aged 70 and 63, had severe HF with FMR. Transesophageal echocardiography confirmed that the left ventricular ejection fractions were less than 50% with severe mitral regurgitation (MR) in both patients. Optimizing drug treatment could not mitigate their symptoms. Therefore, we used the ARTO system to repair the mitral valve for these patients on March 5 and 6, 2019, respectively.@*RESULTS@#Mitral valve repairs using the ARTO system were successfully performed under general anaesthesia for these two patients. MR was decreased immediately after the procedures in both patients. The 30-day and 3-month transthoracic echocardiography (TTE) revealed a moderate to severe MR in both patients, and the New York Heart Association (NYHA) scales were also partially improved.@*CONCLUSION@#The first two cases in Asia indicate that the ARTO system is feasible for patients with heart failure with FMR, and the patient selection appears to be crucial.
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BACKGROUND@#Transapical off-pump NeoChord procedure is a novel minimally invasive surgical repair of degenerative mitral regurgitation (MR). Here, we report the first four cases of NeoChord procedure in patients with mitral valve prolapse in Chinese mainland.@*METHODS@#Four patients, aged 86, 84, 80 and 60 years, with severe MR due to posterior middle scallop prolapse (P2), underwent transapical off-pump artificial chordae implantation on April 9 and 10, 2019. The procedure was performed by left mini-thoracotomy under general anaesthesia and guided by 2D and 3D dimensional transoesophageal echocardiography (TEE).@*RESULTS@#Mitral valve repair via NeoChord procedure was successfully performed with implantation of 3 artificial chordae in the first patient and 3, 2, and 3 artificial chordae in the following patients, respectively. Intraoperative TEE and pre-discharge transthoracic echocardiography (TTE) showed only mild to moderate MR of these four patients and no postoperative complications were noted. There were no changes of TTE finding between one-month follow-up and pre-discharge.@*CONCLUSION@#The successful NeoChord procedures in four Chinese indicate that the valve repair using the NeoChord system for Chinese population is feasible.
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According to the professional characteristics of the operating room,on the basis of basic principles of hierarchical management and post management of nursing department,taking clinical needs as guiding ideology,combined with the development needs of surgical departments,we developed the operating room nursing staff management model,and set up 23 jobs.We adjusted it accordingly in practice,and constantly optimized nurses' career plan by providing clinical,teaching,research,management and other multi-channel development direction,meanwhile provided better quality care for patients.
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According to the professional characteristics of the operating room,on the basis of basic principles of hierarchical management and post management of nursing department,taking clinical needs as guiding ideology,combined with the development needs of surgical departments,we developed the operating room nursing staff management model,and set up 23 jobs.We adjusted it accordingly in practice,and constantly optimized nurses' career plan by providing clinical,teaching,research,management and other multi-channel development direction,meanwhile provided better quality care for patients.
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ABSTRACT Shark-skin surfaces show the non-smoothness characteristics due to the presence of riblet structures. In this work, biomimetic shark-skins were prepared by means of different bio-replicated forming techniques. These techniques include the PDMS elastomeric stamping method (e.g., PES method) and the PDMS embedded-elastomeric stamping method (e.g., PEES method). The study characterized the fabricated biomimetic surfaces through the use of scanning electron microscopy (SEM) as well as 3D microscope. The accuracy of the two replication routes were compared, which included measuring the surface integrity and dimensional parameters ( s, h ) of the riblet-groove structure. The results show that fresh shark-skin without chemical treatments should be used as a replication template whenever possible to attain a satisfactory replication accuracy of the riblet structure. The PES and PEES methods proposed here are effective bio-replicated forming routes in simulating the microstructures of a shark-skin surface. Compared with the PES method, the PEES method has greater precision in simulating the microstructures of a shark-skin surface.
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OBJECTIVE@#To investigate the effects of mTOR-STAT3 pathway on the invasion and migration of hepatoma cell.@*METHODS@#mTOR and STAT3 expression in the hepatocellular carcinoma cell line HepG2 and normal liver cell line L02 were detected by reverse transcription PCR (RT-PCR) and western blotting. The migration and invasion abilities of cells and expression of STAT3 were detected by scratch adhesion test and transwell migration assays, after siRNA transfection blocking mTOR expression of HepG2 cells.@*RESULTS@#The HepG2 cells expression is higher compared with normal cells L02 expression. Western blotting assay showed the mTOR expression was blocked, while STAT3 expression was also decreased, after the siRNA transfection of HepG2 cells. The migration (scratch adhesion test) and invasion (transwell assays) abilities of HepG2 cells which the mTOR expression was blocked by siRNA interference were significantly decreased (P<0.05).@*CONCLUSION@#mTORSTAT3 expression in hepatoma cells HepG2 was significantly higher than that in normal liver cells. mTOR blocking can reduce the expression of STAT3, which is also closely related to the invasion and metastasis of liver cancer cells.
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Humanos , Carcinoma Hepatocelular , Genética , Línea Celular , Movimiento Celular , Genética , Células Hep G2 , Neoplasias Hepáticas , Genética , Invasividad Neoplásica , Genética , Factor de Transcripción STAT3 , Genética , Metabolismo , Serina-Treonina Quinasas TOR , Genética , Metabolismo , TransfecciónRESUMEN
<p><b>OBJECTIVE</b>To investigate the aortic elastic properties and its clinical significance in intracranial aneurysms (IAs).</p><p><b>METHODS</b>One hundred and seven IAs patients (57 with hypertension) and 108 healthy subjects were recruited. The internal aortic diameters in systole and diastole were measured by the M-mode echocardiography, the aortic elasticity indexes were calculated and compared.</p><p><b>RESULTS</b>The aortic distensibility (DIS) was lower and the aortic stiffness index (SI) was higher in IAs patients than those in controls (both P <0.001). DIS was lower and SI was higher in IAs patients with hypertension (IAs-HP) than those in IAs with no hypertension (P <0.001). Similar results were obtained when the aortic elasticity index were adjusted for body surface area and body mass index.</p><p><b>CONCLUSION</b>Abnormal aortic elasticity is a common finding in IAs patients and hypertension is closely related to the severity of aortic elasticity.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Aorta , Diagnóstico por Imagen , Estudios de Casos y Controles , Elasticidad , Aneurisma Intracraneal , UltrasonografíaRESUMEN
Background & objective: Gastric cancer is the fourth most common cancer and the second leading cause of cancer-related deaths after lung carcinoma. The aim of this study was to understand the difference in clinicopathological behaviours and prognosis of gastric cancer in patients from China and Japan. Methods: Paraffin-fixed tissue samples of gastric cancer were collected retrospectively from two hospitals between 1993 to 2006 in Japan (n=2063) and during 1980-2003 in China (n=2496) respectively, and staging was done by TNM system and typing by Japanese Endoscopy Society criteria or Borrmann’s classification. The histological architecture of the tumours was expressed according to Lauren’s classification. Results: Compared to Japan, the occurrence of gastric cancer was more common in younger Chinese population and prone to invasion and metastasis in muscularis propia, lymphatic, lymph node, liver, peritoneal parts, and exhibited large tumour size and high TNM staging in both the sexes and in different age groups (P<0.05). Intestinal and mixed types of carcinomas were more frequently observed in Japanese patients compared to Chinese and the difference was significant (P<0.05). It was observed that the commonly reported types in early gastric cancers (EGC) in Japanese patients were IIc, IIa+IIc or IIa while those of Chinese patients were IIc, III or IIb. In the case of advanced gastric cancers (AGC), type II and III were most common in both the countries. The cumulative survival rate of Chinese patients was significantly (P<0.05) higher compared to Japanese in different stratified groups via depth of invasion, TNM staging or Lauren’s classification. Interpretation & conclusion: Gastric cancers in Chinese patients had more aggressive pathological characteristics and poorer prognosis than those from Japan. To reduce incidence and to improve treatment facilities, it is necessary to have a systematic screening system.
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Factores de Edad , China/epidemiología , Femenino , Técnicas Histológicas , Humanos , Incidencia , Japón/epidemiología , Masculino , Estadificación de Neoplasias/estadística & datos numéricos , Pronóstico , Estudios Retrospectivos , Estadísticas no Paramétricas , Neoplasias Gástricas/clasificación , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patologíaRESUMEN
<p><b>BACKGROUND</b>Tissue Doppler imaging (TDI) has provided an objective means to quantify global and regional left ventricular (LV) and right ventricular (RV) function with improved accuracy and greater reproducibility than conventional echocardiography. This study was conducted to assess RV myocardial systolic activation by TDI in subjects with pulmonary arterial hypertension (PAH).</p><p><b>METHODS</b>A total of 30 patients with PAH and 30 healthy volunteers, all comparable in age and sex, underwent standard Doppler echo and TDI. Using pulsed Doppler echocardiography combined with TDI, the following regional parameters were evaluated in three different myocardial segments (RV basal lateral wall, basal septal, and LV basal lateral) on apical 4-chamber view: systolic (Sm), early- and late-diastolic (Em and Am) peak velocities. RV myocardial systolic activation delay was defined as the difference in time to peak TDI systolic velocities between the RV basal lateral wall and basal septal. In addition, RV end-diastolic and end-systolic areas were measured to calculate RV fractional area change from the same apical 4-chamber view.</p><p><b>RESULTS</b>Compared with the control group, patients with PAH showed increased RA and RV end-diastolic diameter (RA: (4.5 +/- 1.2) cm vs (3.0 +/- 0.8) cm, P < 0.05 and RV: (4.8 +/- 1.9) cm vs (3.4 +/- 0.5) cm, P < 0.05) and reduced RV fractional area change; (35 +/- 14)% vs (56 +/- 9)%, P < 0.05. These PAH patients showed lower myocardial peak velocities and a significant activation delay compared with controls (P < 0.05). Moreover, a strong correlation between RV myocardial systolic activation delay and RV fractional area change was shown in patients with pulmonary arterial hypertension (r = -0.82).</p><p><b>CONCLUSIONS</b>In PAH, RV myocardial systolic activation was markedly delayed, which was directly related to the RV fractional area change. RV myocardial systolic activation delay assessed by TDI could offer a unique approach to predict RV dysfunction.</p>
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Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Diástole , Ecocardiografía Doppler , Hipertensión Pulmonar , Sístole , Disfunción Ventricular Derecha , Función Ventricular DerechaRESUMEN
<p><b>OBJECTIVE</b>To investigate the relationship between right ventricular (RV) mechanical delay and RV dysfunction in patients with pulmonary hypertension (PH).</p><p><b>METHODS</b>A total of 51 patients with PH were divided into mild, moderate and high PH groups and 30 healthy volunteers served as control group. RV mechanical delay (defined as the difference in time to peak systolic annular velocity between the RV free wall and the ventricular septum) and RV fractional area change were obtained on apical four chamber view with Quantitive Tissue Velocity Imaging (QTVI).</p><p><b>RESULTS</b>RV mechanical delay increases in proportion to pulmonary pressure. RV fractional area change was similar between control and mild PH patients while significantly reduced in moderate and high PH patients compared to controls. RV mechanical delay significantly correlated to RV fractional area change in all PH groups (r = -0.79; r = -0.66; r = -0.80, all P < 0.05).</p><p><b>CONCLUSION</b>RV mechanical delay measured by QTVI can be used to evaluate RV dysfunction in patients with pulmonary hypertension.</p>
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios de Casos y Controles , Ecocardiografía Doppler en Color , Hipertensión Pulmonar , Diagnóstico por Imagen , Función Ventricular DerechaRESUMEN
Objective:To find the clinical features and to provide the preventive and therapeutic methods by analyzing the disease spectrum and major death causes of in-patients.Methods:The clinical data of the elderly in-patients in urban and outskirt hospitals between1989 and 1998 were surveyed and analyzed retrospectively.Results:The cumulative data of ten years according to systems showed that diseases of digestive system ranked the first (21.1%),and the other systems ranking in order were respiratory system, cardiovascular system, nervous system and so on.Among the first ten common diseases chronic bronchitis and chronic obstructive emphysema (9.27%)ranked the first,and then other diseases ranking in order were cerebral vascular disease,coronary heart disease,cholelithiasis,essential hypertension,primary bronchogenic carcinoma of lung,diabetes mellitus,benign prostatic hyperplasia,chronic cor pulmonale,chronic gastritis and peptic ulcer.Of diseases ranked the first,which accounted for 1.56%,and then the other death causes ranking in order were gastro-intestinal disease,nervous system disease,cardiovascular disease,accidents and toxic damage etc.The death causes according to types ranked in order as follows.The first one was malignant tumor,its mortality being 1.22% in the elderly in-patient group.The following death causes ranking in order were cerebral vascular disease,chronic bronchitis and emphysema,coronary heart disease, etc.Conclusions:The common diseases of elderly patients ranking in order were diseases of digestive system,respiratory system,cardiovascular system,nervous system and so on.The major death causes of the elderly patients were diseases of respiratory system,cardiovascular system and malignant tumor.It is of importance for the aged to take preventive measures.It is suggested to do routine physical examination to detect and prevent risk factors of some diseases and change the improper living habits and strengthen the preventive and therapeutic methods.