Upper hemisternotomy versus full sternotomy access approach for Stanford A acute aortic dissection: a propensity score matching analysis / 中华胸心血管外科杂志

Objective:In comparison with full sternotomy, we explore the safety and clinical efficacy of upper hemisternotomy for Stanford A acute aortic dissection.Methods:Retrospective analysis of 78 patients with Stanford type A acute aortic dissection from January 2014 to December 2018(20 patients underwent UHS invasive, 58 patients underwent FS invasive). Based on variables including gender、age、BMI、LVEF、Euro SCORE Ⅱ and type of surgery, two matched cohorts including 18 patients respectively were constructed: group UHS and group FS, the baseline data and perioperative indicators were analyzed.Results:Operative mortality was 3.9%(3 of 78). The patients＇baseline data were nearly balanced between the two groups after matching( P>0.05), only 1 case died of infectious cerebral hemorrhage in the FS group. The UHS group had a shorter cardiopulmonary bypass time than the FS group[(202±41)min vs.(235±39)min, P=0.041]. There was no significant difference in aorta clamping time[(159±38)min vs.(158±59)min, P=0.918] and hypothermic circulatory arrest time[(40±10)min vs.(50±20)min, P=0.081] between the two groups. The bladder temperature in the UHS group was significantly higher than that in the FS group[(24.0±3.1)℃ vs.(28.2±2.3)℃, P=0.001]. Compared with the FS group, the UHS group had less red blood cell transfusion[(4.8±2.8)U vs.(7.2±3.9)U, P=0.038], less postoperative drainage[(855±657)ml vs.(1510±703)ml, P=0.007], shorter ventilation support time(22 h vs. 58 h, P=0.037), shorter intensive care unit retention time[(4.6±2.7) days vs.(7.2±2.8) days, P=0.009], and shorter postoperative hospital stay time[(8.2±3.8) days vs.(18.4±3.8) days, P=0.001], but the incidence of pericardial puncture was higher in the UHS group[7(33%) vs. 1(6%), P=0.041]. 3 cases had postoperative renal insufficiency(requires dialysis), 5 cases(13.9%)had neurological complications, 1 case received re-exploration in the two groups respectively. Conclusion:The upper hemisternotomy approach is safe and feasible for Stanford A acute aortic dissection, with excellent early outcomes.

Effects of miR-373 on proliferation, invasion and migration of osteosarcoma cells / 中国医师杂志

Objective@#To detect the expression of miR-373 in osteosarcoma cells and explore its effects on cell proliferation, invasion, and migration.@*Methods@#Human osteosarcoma cell line SJSA-1 and human osteoblast hFOB 1.19 cultured in vitro. Human osteosarcoma cell line SJSA-1 were randomly divided into four groups: blank control group (CK group), negative control group (NC group), miR-373 over-expressed plasmid group (miR-373 mimic group) and miR-373 inhibited plasmid group (miR-373 inhibitor group). Cells were transfected with FuGENE® HD transfection reagent. After 48 hours of transfection, the relative expression of miR-373 was detected by quantitative real-time polymerase chain reaction (qRT-PCR), cell proliferation by cell counting kit-8 (CCK-8) and cell invasion and migration by Transwell.@*Results@#The relative expression of miR-373 in SJSA-1 cells was significantly higher than that in hFOB-1.19 cells (P<0.05); compared with CK group and NC group, the relative expression of miR-373 in the miR-373 mimic group increased significantly (P<0.05), and the relative expression of miR-373 in the miR-373 inhibitor group was significantly lower than that in the control group (P<0.05); optical density (OD) value of miR-373 mimic group at 24 h, 36 h, and 48 h were significantly higher than that of CK group and NC group (P<0.05), and OD value of miR-373 inhibitor group at 24 h, 36 h, and 48 h were significantly lower than that of CK group and NC group (P<0.05); the number of cell migration in the miR-373 mimic group was significantly higher than that in the CK group and NC group (P<0.05), and the number of cell migration in the miR-373 inhibitor group was significantly lower than that in CK group and NC group (P<0.05); the number of cell migration in the miR-373 mimic group was significantly higher than that in the CK group and NC group (P<0.05), and the number of cell migration in the miR-373 inhibitor group was significantly lower than that in CK group and NC group (P<0.05).@*Conclusions@#The expression of miR-373 is up-regulated in osteosarcoma. Overexpression of miR-373 can promote the proliferation, invasion, and migration of osteosarcoma cells, while the low expression of miR-373 can inhibit the proliferation, invasion, and migration of osteosarcoma cells, which may be an important target for the diagnosis and treatment of osteosarcoma.

Effects of miR-373 on proliferation, invasion and migration of osteosarcoma cells / 中国医师杂志

Objective To detect the expression of miR-373 in osteosarcoma cells and explore its effects on cell proliferation,invasion,and migration.Methods Human osteosarcoma cell line SJSA-1 and human osteoblast hFOB 1.19 cultured in vitro.Human osteosarcoma cell line SJSA-1 were randomly divided into four groups:blank control group (CK group),negative control group (NC group),miR-373 over-expressed plasmid group (miR-373 mimic group) and miR-373 inhibited plasmid group (miR-373 inhibitor group).Cells were transfected with FuGENE(R) HD transfection reagent.After 48 hours of transfection,the relative expression of miR-373 was detected by quantitative real-time polymerase chain reaction (qRT-PCR),cell proliferation by cell counting kit-8 (CCK-8) and cell invasion and migration by Transwell.Results The relative expression of miR-373 in SJSA-1 cells was significantly higher than that in hFOB-1.19 cells (P ＜ 0.05);compared with CK group and NC group,the relative expression of miR-373 in the miR-373 mimic group increased significantly (P ＜ 0.05),and the relative expression of miR-373 in the miR-373 inhibitor group was significantly lower than that in the control group (P ＜ 0.05);optical density (OD) value of miR-373 mimic group at 24 h,36 h,and 48 h were significantly higher than that of CK group and NC group (P ＜ 0.05),and OD value of miR-373 inhibitor group at 24 h,36 h,and 48 h were significantly lower than that of CK group and NC group (P ＜ 0.05);the number of cell migration in the miR-373 mimic group was significantly higher than that in the CK group and NC group (P ＜ 0.05),and the number of cell migration in the miR-373 inhibitor group was significantly lower than that in CK group and NC group (P ＜ 0.05);the number of cell migration in the miR-373 mimic group was significantly higher than that in the CK group and NC group (P ＜ 0.05),and the number of cell migration in the miR-373 inhibitor group was significantly lower than that in CK group and NC group (P ＜ 0.05).Conclusions The expression of miR-373 is up-regulated in osteosarcoma.Overexpression of miR-373 can promote the proliferation,invasion,and migration of osteosarcoma cells,while the low expression of miR-373 can inhibit the proliferation,invasion,and migration of osteosarcoma cells,which may be an important target for the diagnosis and treatment of osteosarcoma.

Correlation between characteristic parameters of photoplethysmography and severity of coronary artery lesions / 中华老年心脑血管病杂志

Objective To study the correlation between characteristic parameters of photoplethysmography( PPG)and severity of coronary artery lesions.Methods Two hundred and twenty-six CHD patients who underwent CAG in our hospital from August 2018to November 2018were divided into single-vessel lesion group(n=55),double-vessel lesion group(n=74)and multi-vessel lesion group(n=97)according to their CAG.Their stiffness index(SI),crest time(CT),normalized crest time(NCT)and crest time ratio(CTR)were recorded by PPG and analyzed by correlation analysis.Results The SI was significantly different in single-vessel lesion group,double-vessel lesion group and multi-vessel lesion group(6.479±0.819m/s,6.692±1.051m/s and 6.943±1.096m/s,P=0.024).No significant difference was detected in CT,NCT and CTR among single-vessel lesion group,double-vessel lesion group and multi-vessel lesion group(P＞0.05).The SI was positively correlated with the severity of coronary artery lesions(r=0.162,P=0.015).Conclusion The SI is correlated with the severity of coronary artery lesions,which is of a certain value in predicting the severity of coronary artery lesions.

Emergency coronary artery bypass grafting for acute coronary syndrome: mid-term follow-up results / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the experience with emergency coronary artery bypass grafting (ECABG) for management of acute coronary syndrome and analyze the mid-term follow-up results.</p><p><b>METHODS</b>Forty-five ECABG surgeries were performed in 34 male and 11 female patients (aged 65.6∓5.8 years) for cardiogenic shock (5 cases), acute heart failure (6 cases) and refractory unstable angina (34 cases). Twenty patients received the operation within one week after acute myocardial infarction (AMI) and 18 were preoperatively supported by intra-aortic balloon pumping (IABP). All patients had triple-vessel disease and 15 had left main stenosis. Ten patients experienced two myocardial infarctions and 6 had chronic renal dysfunction including two requiring hemodialysis. On-pump operations were performed in all cases with a mean CPB time of 104.2∓29.7 min and cross clamping time of 69.0∓21.3 min. Cold blood or HTK cardioplegia was used for myocardial protection. The left internal mammary artery (LIMA) was routinely anastomosed to the left anterior descending artery (LAD), and the great saphenous vein (GSV) to other target vessels. The mean number of grafts was 2.9∓0.6.</p><p><b>RESULTS</b>Forty-one patients were cured and discharged and 4 patients died with an in-hospital mortality of 8.9%, including one associated with cardiac event (2.2%). IABP was weaned off within 28.5∓10.6 h after surgery except for one patient who died of multiple organ and system failure (MOSF). Thirty-eight patients (92.7%) were followed up for a mean of 37.3∓16.7 months, during which 2 patients died with a mid-term survival rate of 94.7%. Thirty-five (92.1%) patients had New York Heart Association (NYHA) class I and II. The freedom from cardiac event was 90.5%. Follow-up echocardiography showed significantly improved left ventricular dimension and ejection fraction in these cases (P<0.05), and graft patency was 95.8% for the LIMA and 90.5% for the GSV.</p><p><b>CONCLUSION</b>Despite a slight increase of the in-hospital mortality, ECABG can improve the mid-term survival, freedom from cardiac event, and cardiac function when the indications and timing for surgery are well controlled with optimal perioperative management.</p>

Efficacy of oral bosentan for treatment of congenital heart disease-associated pulmonary arterial hypertension / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of oral bosentan in the treatment of congenital heart disease-associated pulmonary arterial hypertension.</p><p><b>METHODS</b>24 patients with congenital heart disease-associated pulmonary arterial hypertension, including 4 receiving heart surgery and 20 with surgical contraindications, were enrolled in this study. All the patients were given oral bosentan and followed up regularly for analyzing the outcomes and side effects.</p><p><b>RESULTS</b>One patient was lost to follow up and one patient died. Systolic pulmonary artery pressure showed no significant changes at 2 (93.6 ± 17.2 mmHg) and 4 months (85.7 ± 25.5 mmHg) of bosentan treatment compared to that before the medication (97.8 ± 14.9 mmHg) (P=0.096), but decreased significantly after a 6-month therapy (80.9 ± 25.0 mmHg, P=0.029). The 6-minute walking distance increased significantly after a 2, 4, and 6-month therapy [(488 ± 98.8, 496.3 ± 89.0, and 491.3 ± 114.2 m, respectively; P=0.004, 0.003, and 0.004 vs the distance before medication (317.0 ± 134.1)]. The New York heart functional classification was improved significantly after a 2, 4, and 6-month therapy [(2.0 ± 0.5, 1.8 ± 0.4, and 1.7 ± 0.5, respectively; P<0.001 vs pre-medication score (2.9 ± 0.5)). Hepatic and renal function remained normal, and ALT and AST showed no significant variations during the medication (P>0.05).</p><p><b>CONCLUSION</b>Oral bosentan can effectively relieve the symptoms, decrease pulmonary artery hypertension, and improve exercise tolerance and cardiac function classification in patients with pulmonary artery hypertension associated with congenital heart disease with good safety and mild side effects.</p>

Establishment of a chronic left ventricular aneurysm model in rabbit / 老年心脏病学杂志（英文版）

Objectives To establish a cost-effective and reproducible procedure for induction of chronic left ventricular aneurysm (LVA) in rabbits. Methods Acute myocardial infarction (AMI) was induced in 35 rabbits via concomitant ligation of the left anterior descending (LAD) coronary artery and the circumflex (Cx) branch at the middle portion. Development of AMI was co n-firmed by ST segment elevation and akinesis of the occluded area. Echocardiography, pathological evaluation, and agar i n-tra-chamber casting were utilized to validate the formation of LVA four weeks after the surgery. Left ventricular end systolic pressure (LVESP) and diastolic pressure (LVEDP) were measured before, immediately after and four weeks after ligation. D i-mensions of the ventricular chamber, thickness of the interventricular septum (IVS) and the left ventricular posterior wall (LVPW) left ventricular end diastolic volume (LVEDV) and systolic volume (LVESV), and ejection fraction (EF) were recorded by echo-cardiography. Results Thirty one (88.6%) rabbits survived myocardial infarction and 26 of them developed aneurysm (83.9%). The mean area of aneurysm was 33.4% ± 2.4% of the left ventricle. LVEF markedly decreased after LVA formation, whereas LVEDV, LVESV and the thickness of IVS as well as the dimension of ventricular chamber from apex to mitral valve annulus significantly increased. LVESP immediately dropped after ligation and recovered to a small extent after LVA formation. LVEDP progressively increased after ligation till LVA formation. Areas in the left ventricle (LV) that underwent fibrosis included the apex, anterior wall and lateral wall but not IVS. Agar intra-chamber cast showed that the bulging of LV wall was prominent in the area of aneurysm. Conclusions Ligation of LAD and Cx at the middle portion could induce develo pment of LVA at a mean area ratio of 33.4%±2.4%which involves the apex, anterior wall and lateral wall of the LV.

Analysis of blood flow in sequential and individual saphenous vein grafts in off-pump coronary artery bypass grafting / 中南大学学报(医学版)

OBJECTIVE@#To compare the blood flow in sequential and individual saphenous vein grafts (SVGs) and to analyze the influence of the location of the target vessel in off-pump coronary artery bypass grafting (OPCAB).@*METHODS@#A total of 464 SVGs in 412 patients receiving OPCAB were nested into individual SVG (n=206), double (n=241) or triple sequential SVG (n=15), and analyzed.@*RESULTS@#The blood flow in double and triple SVGs was significantly higher than in individual SVGs [(43.4±22.5), (43.7±19.2) and (28.9±18.7) mL/min, respectively, P<0.001, P=0.047]. There were no differences between flow in double and triple SVGs (P=0.96). Pulsatility index (PI) of the three groups were similar (2.6±1.2, 2.5±1.6, 2.8±0.9, respectively, P=0.49, P=0.49). In individual SVGs to right coronary artery, the blood flow was higher than in the posterior descending branch (PDA) (P=0.047) and posterior branch of left ventricle (PBLV), the flow-time in systole period was longer than diagonals (P=0.003), obtuse marginal (OM) (P=0.013) and PDA (P=0.002), PI was significantly lower than PDA (P=0.033) and PBLV (P=0.032). The blood flow in individual SVGs to diagonals was significantly lower than in other target vessels except for PBLV (P<0.05). Flow in double SVGs to PDA-PBLV was significantly lower than in PDA-OM.@*CONCLUSION@#The mean blood flow in double and triple sequential SVGs is about 1.5 times higher than in individual SVGs. Individual, double, and triple SVGs have similar pI. Flow in individual SVGs to diagonals was significantly lower than in other target vessels except for PBLV.

Value of ultrasound elastography in diagnosis of focal lesions in the parotid and submandibular glands / 中华超声影像学杂志

Objective To evaluate the applicative value of ultrasound elastography in diagnosis of focal lesions in the parotid and submandibular glands.Methods 30 patients(30 lesions) were scanned by real-time ultrasound elastography and were analyzed in elastography evaluated criteria (5 score method).All the results were compared with the pathological types.Results The elastographic grades of most benign nodules were 1 - 3,while most of malignancy were 4 - 5.The elastographic grades of benign and malignant lesions were of significant difference statistically( P ＜0.01 ).If elastographic grade 4 or 5 were diagnosed as malignancies,the sensitivity,specificity and accuracy for diagnosing malignant l(e)sions in the parotid and submandibular glands were 72.73 ％,84.21 ％,80.00 ％,respectively.Conclusions Ultrasound elastography is useful in the differential diagnosis of focal lesions in the parotid and submandibular glands.

Initial clinical study of virtual touch tissue quantification on Hashimoto's thyroiditis / 中华超声影像学杂志

Objective To explore the clinical application value of virtual touch tissue quantification (VTQ) technique in Hashimoto's thyroiditis(HT).Methods Fifty-three patients with HT and 46 health subjects were examed by conventional ultrasonography and VTQ, their shear were velocity (Vs) was measured.A receiver-operating characteristie(ROC) curve was drew according to Vs which can obtain the value of optimal operating point for diagnosing HT.Results The 2D ultrasonic appearance of 53 cases HT were classified into five species, but there was no significant difference in the Vs (F = 0.424, P = 0.790).The area under the ROC curve was 0.976,which showed a high statistical significances(P = 0.000).ROC curve displayed that Vs of 2.53 m/s could be used to diagnose HT,the sensitivity and specificity were 87％and 100％ ,respectively.Fifty-three patients with HT were classified into three groups according to thyroid function, 10 patients with hyperthyroidism, 25 patients with hypothyroidism and 18 patients with euthyroidism.The Vs of HT among the three groups were no significant difference(P = 0.884), but their Vs were all obviously higher than that of normal thyroid Vs(P = 0.000).Conclusions VTQ technique can evaluate the hardness of thyroid and has some help for differential diagnosis of HT.

Relationship of mean color vessels density and microvessel density in rectal cancer and their clinical significance / 中华超声影像学杂志

Objective To explore the relationship of the mean color vessels density (MCVD) and pathologic microvessel density(MVD) in rectal cancers and their relation with T stags and lymph node metastasis.Methods MCVD were caculated preoperationly with transrectal color power angiography(TRCPA).After operation MVD was assessed immunohistochemically using anti-CD105 monoclonal antibody.The relationships within MCVD, MVD and T stages and lymph node metastasis were analysed.Results There were positive correlation between MCVD and MVD (r=0.763, P＜0.01) in rectal cancer.There were significant difference of MCVD and MVD in both the depth of carcinoma invasion and metastasis of lymphatic nodes( P＜0.05).Conclusions MCVD can display features of the blood supply and distribution of pathologic microvessels and reflect the development of rectal cancers.MCVD is a credible index to choose available treatment and to evaluate prognosis before operation of rectal cancer.

Safety of Sarcoplasmic Reticulum Ca2+-ATPase Gene Transfer by Intramyocardium Administration in Chronic Heart Failure Beagles / 中国康复理论与实践

@#ObjectiveTo assess the safety of intramyocardium injection of sarcoplasmic reticulum Ca2+-ATPase (SERCA2a) to rescue chronic heart failure beagles. MethodsThe heart failure beagles were assessed with myocardium enzymology, cAMP content of myocardium, myocardial oxygen consumption, arrhythmia, systemic inflammation factors, and the function of liver and kidney after SERCA2a gene transferred. ResultsThere were no increase of cAMP content, no more arrhythmia, myocardial oxygen consumption, no apparente systemic inflammation, and no injures to hepatic and renal function. ConclusionOverexpression of SERCA2a by intramyocardium injection is relatively safe.

The risk factors of elasticity of lower limb artery in type 2 diabetic patients by echo-tracking technique / 中华超声影像学杂志

Objective To analyze risk factors of elasticity of common femoral artery(CFA)and popliteal artery(PoA)in type 2 diabetic(T2DM)patients by echo-tracking(ET)technique.Methods Thirty healthy subjects(control group)and sixty-eight T2DM patients were enrolled in this study.The stiffness β of common femoral and popliteal artery were automatically measured by ET technique.The differences in ordinary and biochemical indices between control group and T2DM group were compared and analyzed by the method of linear regression and multiple linear regression.Results In both control and the T2DM group,β of CFA and PoA were significantly correlated with age,systolic blood pressure.TC, LDL,ApoB and LPa of CFA were also significantly correlation with β in T2DM group(P<0.05).Conclasions The stiffness of CFA and PoA in patients with T2DM increased followed by the increase of age, systolic blood pressure,TC,VLDL,ApoB and LPa.

Septal anterior ventricular exclusion operation for left ventricular anterior aneurysm:effects on left ventricular shape,volume and function by intraoperative transesophageal echocardiography / 中华超声影像学杂志

Objective To assess the effects of septal anterior ventricular exclusion(SAVE)procedure on left ventricular(LV)shape,volume and function in patients with post-infarction LV anterior aneurysm by intraoperative transesophageal echocardiography(TEE).Methods Twenty patients with LV anterior aneurysm underwent surgical ventrieular restoration(SVR)with the SAVE procedure.Intraoperative TEE was performed before cardiopulmonary bypass(CPB)and after weaning from CPB.LV volume and ejection fraction(EF)was measured using the biplane Simpson's method.LV end-diastolic and end-systolic volumes,indexed by body surface area(EDVI and ESVI,respectively)were calculated.To estimate the shape of LV,end-diastolic sphericity index(SI)of LV was determined.Results Compared with pre- CPB,after SVR,LV shape became more elliptical:SI increased from 0.76±0.04 to 0.84±0.05,P＜0.001.LV size became more normal:EDVI decreased from(121.51±16.91)ml/m2 to(60.27±9.93)ml/m2,P＜0.001,and ESVI decreased from(85.81±15.02)ml/m2 to (32.44±5.36)ml/m2,P＜0.001,respectively.EF was increased significantly:(46.02±3.90)% vs(29.52±6.0)%,P＜0.001.Conclusions The SAVE technique is easy to reshape LV to ellipsoid fogln and normal size and the resultant improved configuration may contribute to improving EF for patients with post-infarction LV anterior aneurysm.

Surgical treatment of myocardial bridge: A report of 15 cases / 中国微创外科杂志

Objective To investigate the therapeutic efficacy of surgical treatment of myocardial bridge. Methods Fifteen patients with myocardial bridge had been treated in our hospital from January 1999 to October 2006. Thirteen patients who had typical angina had been treated regularly by medication, but their symptom remission was not satisfactory. One patient suffered from acute myocardial infarction, and another 1 patient complained of palpitation and syncope. All the patients were given surgical treatment. Surgical strategies included minimally invasive off-pump surgery in 9 patients (supraarterial myotomy in 3 patients, coronary artery bypass grafting in 2, and coronary artery bypass grafting with supraarterial myotomy in 4) and on-pump surgery in 6 patients (coronary artery bypass grafting with supraarterial myotomy in 5 patients and supraarterial myotomy in 1). Results All the operations were successfully completed. The operative duration of off-pump and on-pump surgery was 2.8?1.9 h and 3.5?1.7 h, respectively. The extracorporeal circulation time was 59?37 min. No surgery related death or complications occurred. At 3 months after operation, all the patients were free from symptoms, and electrocardiogram returned to normal in 11 patients. During a follow-up for 0.5~7 years (1.9?1.2 years), recurrent palpitation was seen in 1 patient and others reported no angina. Conclusions Surgical treatment of myocardial bridge has good immediate and long-term results.

Restoration of cardiac function in failing beagle hearts by recombinant adeno-associated viral gene transfer of sarcoplasmic reticulum Ca~(2+)-ATPase / 中国病理生理杂志

29.3% decrease in ejection fraction).4 of 11 were used as heart failure group(HF,n=4).9 HF beagles were randomized to receive either a recombinant adeno-associated viral carrying the SERCA2a gene(HF+SERC A2a,n=5) or the reporter gene enhanced green fluorescent protein(HF+EGFP,n=4) by thoracotomy.All HF beagles paced by 180 beats/min in order to maintain failing state.Thirty days after infection,parameters of systolic and diastolic function were measured by doppler echocardiography and hemodynamic monitor in all beagles.RESULTS:At 30 days after gene transfer,symptoms of HF+SERCA2a dogs improved.Echocardiogram parameters were superior to those in HF+EGFP group(P