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Objective:To evaluate the safety of cardiac catheterization intervention therapy and transthoracic small incision surgery in the occlusion bydomestic occluder under echocardiography guiding in patients with atrial septal defect (ASD).Methods:A total of 1 080 patients with ASD in the occlusion by domestic occluder were analyzed retrospectively,and the interventional treatment were performed in 734 cases through cardiac catheterization intervention therapy and 346 cases through transthoracic small incision surgery.The patients undergone cardiac catheterization intervention therapy were guided under the digital substraction angiography (DSA) and were monitored by transthoracic echocardiography (TTE) in the whole interventional process,and the efficacy was evaluated with TTE.The occlusion of transthoracic small incision surgery was guided under the transesophageal echocardiography (TEE),which was used to monitor the position of occluder and evaluate the efficacy immediately.Results:Two kinds of intervention in the occlusion by domestic occluder had achieved satisfactory results in patients with ASD.There was no statistically difference in the longest size of ASD between the 2 intervention methods,while there were statistically differences in the ratio between ASD longest diameter and atrial septal length,and the size of the occlusion,and the disparity between the size of the occluder and ASD longest diameter (D value),respectively (all P＜0.05).When the size of arithmetic mean of the ASD was ＜30 mm,the success rate of the 2 methods was both 100％.When the size of arithmetic mean of the ASD was ≥ 30 mm,the success rate was 100％ in the transthoracic small incision surgery and 50％ in the cardiac catheterization intervention therapy.Conclusion:Domestic occluder is safe.Compared with the imported one,its cost is lower.When the size of the defects is same,the occlusion is smaller in the transthoracic small incision surgery compared with that in the cardiac catheterization intervention therapy.When the size of arithmetic mean of the ASD is ≥ 30 mm,the success rate of the transthoracic small incision surgery is higher compared with the cardiac catheterization intervention therapy.When the cardiac catheterization intervention therapy fails,the transthoracic small incision surgery may be a better choice.
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Objective To observe the changes of tissue doppler Tei index (TDI-Tei index) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in children with atrial septal defect(ASD) before and after interventional therapy,in order to investigate the evaluation value of the two parameters on the improvements of right cardiac function.Methods Ninety children with ASD who were treated in the First Hospital of Hebei Medical University from June 2013 to June 2015 as the ASD group,including 48 male and 42 female at the age of (3.0-13.0) years old,and the average age was (5.4±2.7) years old.Fifty healthy children with matched age and gender as the control group.Concentrations of serum NT-proBNP were measured by using Bi-directional lateral flow immunoassay before and the 7th day and 6th month after cardiac catheterization,respectively.The right ventricular Tei index(RV-Tei index) was measured by tissue doppler Imaging.The changes and the correlations of parameters before and after interventional therapy were compared and analyzed respectively.Results (1) Before interventional therapy,the right ventricular TDI-Tei index in ASD group was higher than control group(0.56±0.09 vs 0.31 ±0.05,P＜0.01),and the TDI-Tei index was decreased gradually at different time points after interventional therapy in ASD group,especially at the 6th month was lowest(P＜0.01);TDI-Tei indexes at before and the 7th day and 6th month after the procedure were significantly different(0.56±0.09 vs 0.44±0.06,0.56±0.09 vs 0.33±0.04;t=22.56,23.27;P＜0.05).Compared with control group,there was significant difference about the TDI-Tei index in ASD group at the 7th day after transcatheter closure(P＜0.05),while there was no significant difference about TDI-Tei index at the 6th month (P＞0.05).(2) Before interventional therapy,the level of serum NT-proBNP in ASD group was higher than control group ((259.49± 43.99) ng/L vs (102.11 ± 34.53) ng/L,P＜0.01),and the levels of NT-proBNP were decreased gradually at different time points after interventional therapy in ASD group,especially at the 6th month was lowest(P＜0.01);the levels of NT-proBNP at before and the 7th day and 6th month after interventional therapy were significantly different ((259.49 ± 43.99) ng/L vs (192.93 ± 56.46) ng/L,(259.49±43.99) ng/L vs (108.46±36.88) ng/L;P＜0.05).Compared with control group,there was significant difference about the level of serum NT-proBNP in ASD group at the 7th day after transcatheter closure (P ＜0.05),while there was no significant difference about NT-proBNP at the 6th month(P＞0.05).(3) Before and the 7th day and 6th month after interventional therapy,NT-proBNP level and the right ventricular TDI-Tei index was significantly positive correlated in ASD group (r =0.719,0.753,0.732;P＜0.01).Conclusion The changes and correlations of the right ventricular TDI-Tei index and serum NT-proBNP in the children with ASD after intervention operation indicates that TDI-Tei index and serum NT-proBNP could evaluate the improvement of right cardiac function.
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Objective To investigate expression of CXCR4 and CXCR7 protein and mRNA, which are the receptors of stromal cell derived factor-1α(SDF-1α), in the bone marrow mesenchymal stem cells (BMSCs);to explore the role of SDF-1α/CXCR4/CXCR7 axis in migration of BMSCs in vitro and the possible mechanism .Method BMSCs were isolated from rats and cultured in vitro.CD29, CD44 and CD34 of the cells were identified by flow cytometry .CXCR4-selective antagonist AMD 3100 and CXCR7-specific neutralizing antibody were applied to block CXCR 4 and CXCR7 respectively.The expressions of CXCR4 and CXCR7 mRNA and protein on BMSCs were detected with RT-PCR and Western blotting .Transwells chamber test was used to observe the migration of BMSCs .The BMSCs were divided into the BMSCs group ( A ) , the AMD3100 pretreated BMSCs group ( B ) , the CXCR7-specific neutralizing antibody pretreated BMSCs group(C), the AMD3100 +CXCR7-specific neutralizing antibody pretreated BMSCs group ( D).Result Flow cytometry showed that the expressions of CD 44 and CD29 were positive, while the expression of CD34 was negative in the third passage of BMSCs (P3-BMSCs).CXCR4 and CXCR7 protein and mRNA were both expressed in P3-BMSCs. Compared with the A group, the expression of CXCR4 and CXCR7 protein declined significantly in the B group and the D group;the protein expression of CXCR7 in the C group was lower compared with the A group (P<0.05).However, the expression of CXCR4 mRNA and CXCR7 mRNA had no significant difference between groups .SDF-1αfactor promoted migration of BMSCs ( P <0.05 ).Compared with the 0μg/L group, the numbers of migrated cells were increased significantly in both of the 10μg/L group and the 100μg/L group ( P<0.01 ) .The number of migration of BMSCs was significantly higher in the 100μg/L group than that of the 10μg/L group ( P <0.01 ) .AMD3100 and CXCR7-specific neutralizing antibody both inhibited significantly the migration of BMSCs ( P<0.05 ) , and the attenuate effect was more significant when they worked together ( P<0.05 ) .Conclusion CXCR4 and CXCR7 receptors are co-expressed in P3-BMSCs;the SDF-1αfactor can promote the migration of BMSCs in the concentration dependent manner ;SDF-1α/CXCR4/CXCR7 axis is involved in the migration of BMSCs , and both of the CXCR4 and CXCR7 receptors have a synergistic promoting effect to the BMSCs migration .
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BackgroundThe relationship between lipids and coronary artery disease has been well established. However, this is not the case between lipids and heart failure. Ironically, high lipid levels are associated with better outcomes in heart failure, but the mechan-isms underlying the phenomenon are not fully understood. This study was performed to test the hypothesis that reduced intestinal lipid absorption due to venous congestion may lead to low lipid levels.MethodsWe collected data of clinical characteristics, echocardio-graph, and lipid profile in 442 unselected patients with congestive heart failure. Correlations between lipid levels[including total cho-lesterol(TCL), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), and triglycerides(TG)]and right ventricle end diastolic diameter (RVEDD), left ventricle end diastolic diameter (LVEDD), right atrium diameter (RA), left atrium diameter (LA), or left ventricle ejection fraction (LVEF) were analyzed using Pearson correlation and partial correlation. RVEDD, LVEDD, RA, and LA were indexed to the body surface area.ResultsThere was a significantly inverse correlation between TCL le-vels and RVEDD (r=-0.34,P<0.001) and RA (r=-0.36,P<0.001). Other lipids such as LDL-C, HDL-C, and TG had asimilar inverse correlation with RVEDD and RA. All these correlations remained unchanged after adjusting for age, gender, smoking status, physical activity levels, comorbidities, and medication use.ConclusionsLipid levels were inversely correlated to RVEDD in patients with congestive heart failure; however, because this was an observational study, further investigation is needed to verify our results as wellas identify a causal relationship, if any.
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Objective: To explore the relationship between plasma levels of calcitonin gene related peptide (CGRP) and cardiac function in ventricular septal defect (VSD) children before and after the interventional therapy. Methods: Our research included 2 groups:VSD group, n=90 containing 43 male and 47 female at the age of (3-12) years and treated in our hospital from 2011-09 to 2012-09, Control group, n=50 healthy children with matched age and gender. The levels CGRP were measured at before and 24 hours, 3 days, 5 days, 3 months after the therapy. The cardiac function as left ventricle end-diastolic diameter (LVEDD), left ventricle end systolic diameter (LVESD), left ventricle end diastolic volume (LVEDV), left ventricle end systolic volume (LVESV) and ejection fraction (EF) were examined by echocardiography at before and after the procedure. Results: Before interventional procedure, the level of CGRP in VSD group was lower than Control group (35.28 ± 7.25) pg/ml vs (50.90 ± 8.60) pg/ml, t=11.42, P Conclusion: Plasma levels of CGRP closely related to ventricular cavity diameter, which was important for evaluating the cardiac function in VSD children after the interventional therapy.
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Objective To investigate the effect of multidisciplinary intervenient on survival of patients with malignant tumor. Methods Six hundred and thirty-nine malignant tumor patients were randomly assigned to the intervenient and the control group. A total of 584 completed the follow-up study. The intervenient group received comprehensive treatment for 2 years,while the control group was in a process of self-rehabilitation. The 2-year survival rate was compared between the groups by using Cox proportional hazard model. Results The 2-year survival rate was 94. 74% (108/114) or 80. 67% (121/150) in II stage patients of the intervenient or control group, respectively ( P < 0. 01 ) . The 2-year survival rate was 88. 03% (163/177) or 82. 8% (184/222) in early and medium stage patients of the intervenient or control group,respectively(P <0. 01). Conclusion The multidisciplinary intervenient may help to improve the 2 year survival of early or moderate stage malignant tumors.
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Objective To study the long-term effect of neoadjuvant chemotherapy on advanced breast cancer. Methods The CAF neoadjuvant chemotherapy 〔CTX 500 mg/m2(1st day, 8th day), 5-FU 500 mg/m2(1st day, 8th day), and ADM 30 mg/m2 (1st day) every 3 weeks〕 was carried out in 31 breast cancer patients (stageⅢ,Ⅳ) for 2 cycles before operation, compared with 30 patients (stage Ⅲa) whose therapies were never done and operations could be feasible. Results The overall response rate was 87.1%(27/31). The stages of 19 patients among 31 (61.3%) declined (6 patients to stage Ⅲa, 8 to stageⅡb, 4 to stageⅡa, 1 to stage 0, 1 to complete response and none to pathological complete response). The disease-free survival time of the patients was 56.3 months which was obviously longer than that of the patients without neoadjuvant chemotherapy (43.5 months, P
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Purpose:To study the effect of combined treatment on advanced endometrium carcinoma. Methods:45 cases of stage Ⅲ endometrium carcinoma with combined treatment were retrospectively reviewed. Operation was the most used mode in the combined treatment. Depending on the pathology, metastatic site etc. 31 cases were treated in combination with chemotherapy, 11 cases with operation and radiotherapy, 3 cases with radiotherapy. All cases had hormonotherapy. The multi-drug chemotherapy was dominated by platinum agents. CFP 17 cases (54.83%),EFP 5 cases (16.12%), CAP 4 cases (12 90%), CP 3 cases(9.68%), others 2 cases. Survival analysis were done by Kaplan-Meier model of SPSS 8.0. Results:15 cases of Ⅲ stage were treated by operation and chemotherapy, 16 cases by operation chemotherapy and radiotherapy, 11 cases by operation and radiotherapy. The 2-year survival rate was 69.23%,78.97%, 70.71%. There was no difference in statistics. The 5-year survival rate was 30.29%,47.38%,14.14%. Chemotherapy in the combined treatment partly improved long-term cure P
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Paying attention to improving the quality of life for patients with malignant tumors is an inevitable trend of social progress.The paper gives a brief account of the current state of research on the quality of life for patients with malignant tumors in China,explains the significance of research in this aspect,and points out existing problems and difficulties in and makes prospects for improving the quality of life for patients with malignant tumors.It is suggested that,in view of the fact that the quality of life for patients with malignant tumors is affected by somatic and psychological factors and social functioning,health departments attach importance to conducting health education involving multidisciplines like oncology,psychology and sociomedicine and take comprehensive measures of intervention so as to improve the quality of life for patients with malignant tumors.
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Objective To investigate the quality of life for clinical patients with malignant tumors and the influencing factors so as to provide health departments with basis for improvement. Methods(Using) methods of interviews and questionnaires,investigations were made on the quality of life for 639 patients with malignant tumors diagnosed between January 2001 and July 2002 in the various cities and regions of Sichuan and the influencing factors by means of filling out quality of life assessment scales.(Results) The quality of life for patients with malignant tumors was in general pretty low,scoring 54.40?10.95.Careers in management were positively related to psychological status(P
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Objective To analyze the nucleotide sequences of novel HLA class I le,B*1316.Methods Routine sequence-specific oligonucleotide(SSO) typing and sequencing based typing(SBT) was used.Results The B*1316 allele differs from B*1302 by one nucleotide substitution in exon 3: T to A at nt position 184,which results in an amino acid substitution at codon 62 from Val to Glu.Conclusion A novel HLA class I allele,B*1316 has been identified,and was officially recognized by WHO Nomenclature Committee in April 2006.