Clinical efficacy analysis of different interventional approaches for patent ductus arteriosus in children (≤7 years) / 中国胸心血管外科临床杂志

@#Objective    To explore the safety and effectiveness of different interventional approaches for the treatment of patent ductus arteriosus (PDA) in children. Methods    The children (≤7 years) who underwent interventional treatment for PDA from 2019 to 2020 in our hospital were retrospectively included. The patients were divided into 3 groups according to the procedures: a conventional arteriovenous approach group, a simple venous approach group, and a retrograde femoral artery approach group. The clinical efficacy of the patients was compared. Results     A total of 220 patients were included. There were 78 males and 142 females, with an average age of 3.21±1.73 years, weight of 14.99±5.35 kg, and height of 96.19±15.77 cm. The average diameter of the PDA was 3.35±1.34 mm. A total of 85 patients received a conventional arteriovenous approach, 104 patients received a simple venous approach, and 31 patients received a retrograde femoral artery approach. The diameter of PDA in the retrograde femoral artery group was smaller than that in the other two groups (3.44±1.43 mm vs. 1.99±0.55 mm; 3.69±1.17 mm vs. 1.99±0.55 mm, P<0.001); the contrast medium usage [40 (30, 50) mL vs. 20 (20, 30) mL; 35 (25, 50) mL vs. 20 (20, 30) mL, P≤0.001] and operation time [32 (26, 44) min vs. 25 (23, 30) min; 29 (25, 38) min vs. 25 (23, 30) min, P<0.05] in the simple venous approach group were significantly less or shorter than those in the other two groups; the length of hospital stay of the conventional arteriovenous group was longer than that in the other two groups [3 (3, 5) d vs. 4 (3, 6) d; 4 (3, 5) d vs. 4 (3, 6) d, P<0.05]. There was no significant difference in postoperative complications. Conclusion    It is safe and effective to close PDA through simple venous approach. The retrograde femoral artery approach has the advantage of simplifying the surgical procedure for PDA with small diameters.

Effects of Qingfei Shenshi Decoction on the expressions of MMP-2, MMP-9 and TIMP-1 in lung tissue of bronchial asthma mice / 国际中医中药杂志

Objective:To investigate the effects of Qingfei Shenshi Decoction on the expressions of matrix metalloproteinase-2 (MMP-2) and MMP-9 and tissue inhibitor of metalloproteinase timps-1 (TIMP-1) in lung tissue of asthma mice.Methods:Totally 50 male BALB/C mice were divided into 5 groups: normal group, model group, dexamethasone group, Qingfei Shenshi Decoction low- and high-dosage groups (10 mice /group) according to random number table method. Asthma model mice were prepared by ovalbumin (OVA) challenge method. After successful modeling, the dexamethasone group was given dexamethasone for gavage at the rate of 1.56 mg/kg, while Qingfei Shenshi Decoction groups were given high and low doses of Qingfei Shenshi Decoction for gavage at the rate of 14.235 g/kg and 28.470 g/kg, respectively. Normal group and model group were given 0.9% sodium chloride solution by gavage. At the end of gavage administration for 4 weeks, the airway reactivity (Penh value) in each group was detected; HE staining was used to observe the pathological changes of lung tissue; the contents of interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor -α (TNF-α) in alveolar lavage fluid were determined by enzyme Linked immunosorbent assay (ELISA); the expressions of MMP-2, MMP-9 and TIMP-1 in lung tissue were detected by Western-blot.Results:Compared with model group, the damage of airway wall and alveolar wall of lung tissue in Qingfei Shenshi Decoction groups was significantly reduced. Compared with model group, the Penh value, IL-6, IL-1β and TNF-α levels in Qingfei Shenshi Decoction low- and high-dosage groups decreased ( P<0.05), and the expressions of MMP-9, MMP-2 and TIMP-1 in lung tissue decreased ( P<0.05), with a certain dose dependence. Conclusion:Qingfei Shenshi Decoction can effectively alleviate airway inflammation, reduce airway hyperresponsiveness, improve lung function and inhibit airway remodeling in asthmatic mice. Its mechanism may be related to down-regulating the expressions of MMP-2, MMP-9 and TIMP-1.

Imaging features of predicting stroke recurrence in patients with symptomatic intracranial artery stenosis / 国际脑血管病杂志

Intracranial atherosclerotic stenosis (ICAS) is one of the most common causes of ischemic cerebrovascular disease. Compared with other causes such as extracranial diseases or cardiogenic embolism, symptomatic ICAS (sICAS) has a higher risk of stroke recurrence, often leading to the aggravation of neurological impairment and even death. More and more evidence shows that imaging features play an important role in predicting the risk of stroke recurrence and individualized secondary prevention in patients with sICAS. This article reviews the imaging features of ischemic stroke recurrence in patients with sICAS, which provides a basis for identifying sICAS patients with high risk of recurrent stroke and effective secondary prevention.

Primary practice of transcatheter edge-to-edge repair for mitral regurgitation: Early results of MitraClip in multiple centers / 中国胸心血管外科临床杂志

@#Objective    To investigate the early clinical results of MitraClip system in domestic patients. Methods     We retrospectively analyzed the clinical data of 36 patients who underwent transcatheter edge-to-edge repair procedure using MitraClip system in Beijing Fuwai Hospital, Shenzhen Fuwai Hospital and Fuwai Yunnan Cardiovascular Hospital between January and June 2021. There were 24 males and 12 females, with a median age of 70 (47-86) years. Ten (27.8%) patients had 3+ mitral regurgitation (MR) and 26 (72.2%) patients had 4+ MR preoperatively. Results    All procedures were successfully performed. The reduction in MR was 2+ at least immediately after surgery, and 91.7% of patients had MR≤2+ at 3 days postoperatively. There was no statistical difference in left ventricular ejection fraction change postoperatively. Forward velocity and peak gradient of mitral valve were increased after the procedure. Mean gradient of mitral valve were increased at 3 days postoperatively than immediately after surgery (P<0.001). Two patients had acute pericardial effusion intraoperatively, and received pericardial puncture and drainage immediately. Conclusion    MitraClip system has been applied well in domestic patients and can significantly improve MR. This sutdy has a good consistency with foreign studies, and the early results are satisfactory.

Short and Mid-term Efficacy of Device Closure of Patent Foramen Ovale for Treating the Patients With Patent Foramen Ovale Combining Cryptogenic Stroke and Transient Ischemic Attack / 中国循环杂志

Objective: To explore the short and mid-term efficacy of device closure of patent foramen ovale (PFO) for treating the patients with PFO combining cryptogenic stroke (CS) and transient ischemic attack (TIA). Methods: A total of 56 PFO patients with CS and TIA receiving device closure in our hospital from 2009-05 to 2015-12 were retrospectively studied. Transthoracic echocardiography (TTE), electrocardiogram (ECG), chest X-ray were examined at 24h, 1 month, 3 and 6 months after theoperation; telephone visit was conducted every 6 months thereafter. Results: There were 54/56 PFO patients combining CS and 2 combining TIA; 53 (94.6%)patients received PFO occluder from Starway medical technology. Aspirin was used for 6 months after the operation. The patients were followed-up for the average of (34.67±23.24) months. No body suffered from post-operative stroke and TIA; no residual shunt was observed. Conclusion: The short and mid-term efficacy of device closure has been satisfactory for treating the patients with PFO combining CS and TIA; its overall clinical value should be further investigated in large population and long-term study.

Clinical study application of Amplatzer duct occluder Ⅱ to occlude aortopulmonary collateral arteries / 中国介入心脏病学杂志

Objective To assess the feasibility and efficacy of Amplatzer duct occluder Ⅱ (ADOⅡ) in occlusion of aortopulmonary collateral arteries. Methods Seven patients,6 males and 1 female, with aortopulmonary collateral circulation diagnosed previously by cardiac Computed Tomograpy or cardioangiography from Mar 2014 to Apr 2015 were enrolled. All of them were treated with ADO Ⅱ. Results The age of the patients ranged between 5 - 71 months old and weight 4. 2 - 22. 0 kg. Successful hybrid approach was achieved in 6 of 7 patients. One patient failed the occlusion because of severe hypoxemia and mild-moderate residual shunt after catheter intervention. Total 15 aortopulmonary collateral vessels were embolized by 7 ADO-Ⅱ, 22 non-detachable coils ( Cook corp. ) and 2 detachable micro-coils ( Boston Scientific corp. ). Complete embolization was achieved in 2 patients,4 patients had mild residual shunt and 1 patient had mild-moderate residual shunt after the embolisation. No interventional complications recorded. Conclusions ADO Ⅱ has high controllability and suitable for application through small delivery catheter for minimally-invasive procedures to the vessels. It is a preferable alternative in treating pediatric patients with large and tortuous aortopulmonary collateral arteries.

Therapeutic effects of early open decompression drainage on acute pulpitis / 中华老年医学杂志

Objective To investigate the clinical effects of open decompression drainage on acute pulpitis.Methods Totally 180 acute pulpitis patients hospitalized during January 2012 to September 2014 in our department were selected and randomly divided into control group and observation group (n=80 each).The control group was treated with pulp inactivating agent and the observation group was given open decompression drainage.The clinical effects,analgesia efficiencies at 7d after treatment,treatment course and the complications were compared between the 2 groups.Results There was significant difference in the effective rate between control and observation groups after treatment [61.3％ (49/80 cases) vs.86.3％ (69/80 cases),P＜0.05].The analgesia efficiencies at 7d after treatment was 46.3％ (37/80 cases) in control group and 73.8％ (59/80 cases)in observation group (P＜0.05).There was no significant difference in treatment course between two groups [(7.7±1.4) times vvs.(6.1± 1.2) times,P＞0.05]].6 patients developed periapical periodontitis in control group,and only 4 cases in the observation group (P＞0.05).Conclusions Early open decompression drainage has good clinical effects and analgesia efficiencies in treatment of acute pulpitis,which is worthy of clinical application.

Expression of Ezrin and its significance in giant-cell tumor of bone / 国际肿瘤学杂志

Objective To detect the expression of Ezrin in giant-cell tumor of bone,and to investigate its cilincal significance. Methods 60 cases of biopsy which had been confirmed as bone giant-cell tumors in our hospital from January 2008 to December 2013 were set as observation group;tumor tissues from 8 cases of reactive new bone in nonmalignant bone diseases,12 cases of osteoid osteoma and 11 cases of osteoblastoma in the corresponding period were set as control group. Protein and gene levels of Ezrin were tested with Western blotting method and real-time PCR detection,simultaneously proceeded the corresponding analysis combined with the clinical data of patients;60 cases of bone giant-cell tumor patients accepted tumor resection and pros-thesis replacement,2 courses of preoperative chemotherapy;mitochondria morphological changes of tumor tissue and Ezrin protein and genetic changes were observed before and after chemotherapy. Results In the giant-cell tumors of bone,the Ezrin protein mainly located in the cytoplasm,and its expression positive rate was much higher than that in reactive new bone of nonmalignant bone diseases(19. 7% ),osteoid osteoma(21. 2% )and osteoblastoma(20. 7% );the difference was statistically significant(χ2 = 4. 18,P = 0. 024),but no statistical difference in the Ezrin expression among the groups of osteosarcoma,osteoid osteoma and osteblastoma(χ2 =6. 18,P = 0. 087). In the giant-cell tumors of bone tissue after chemotherapy,mitochondria pyknosis and the phenomenon of liquid cavitation was less than that before the treatment,and Ezrin protein expression decreased and gene levels reduced[(23. 99 ± 1. 49)vs(20. 11 ± 1. 11),t = 5. 03,P = 0. 018)]. Conclusion The expression of Ezrin in giant-cell tumor of bone is much higher than other benign bone tumor,and it could be a biological marker for differentiating benign and malignant bone tumor. Early intervention in Ezrin may be helpful for reatment of giant-cell tumor of bone.

Developing a high quality video transmission system based on mobile network / 中国医疗器械杂志

To meet the demands of high definition of video and transmission at real-time during the surgery of endoscope, this paper designs an HD mobile video transmission system. This system uses H.264/AVC to encode the original video data and transports it in the network by RTP/RTCP protocol. Meanwhile, the system implements a stable video transmission in portable terminals (such as tablet PCs, mobile phones) under the 3G mobile network. The test result verifies the strong repair ability and stability under the conditions of low bandwidth, high packet loss rate, and high delay and shows a high practical value.

Balloon dilation of pulmonary valve stenosis with 10 F domestic balloon catheter in children≥10 kg / 中国介入心脏病学杂志

Objective To assess the safety and efficacy of balloon dilation of pulmonary valve stenosis with 10 F domestic balloon catheter in children ≥ 10 kg. Methods From May 2009 to June 2014, eighty-three consecutive children with weight ≥ 10 kg and age of (4.5±2.8)(ranged from 1-12) years underwent percutaneous balloon pulmonary valvoloplasty(PBPV) with 10 F domestic balloon catheter. Indication for treatment, procedural details, catheterization data, complication rate, peak-to-peak systolic gradient across the valve and pulmonary insufficiency on echocardiography were respectively analyzed. Forty-four patients were followed up 6-44 months after procedure. Results All procedures were completed successfully. The peak-to-peak systolic gradient across the pulmonary valve decreased from (67.7±26.2) mmHg to (15.4±11.6) mmHg (P < 0.01) immediately after PBPV. Two patients developed reactive infundibular spasm after dilation. They were relieved at 6 months post PBPV. No patient had severe pulmonary insufficiency, tricuspid regurgitation or reintervetion. Conclusions PBPV with 10 F domestic balloon catheter in children with weight≥10 kg is a safe and effective method.

Transcatheter closure treatment for patients with atrial septal defect complicated by atrial fibrillation:a postoperative follow-up study / 介入放射学杂志

Objective To explore the prognosis and management of atrial fibrillation (AF) in patients with atrial septal defect(ASD) accompanied by AF after transcatheter closure of ASD. Methods During the period from July 2010 to May 2013, a total of 24 patients with ASD accompanied by AF were admitted to authors’ hospital to receive transcatheter closure of ASD. Electrocardiogram (ECG), chest X-ray film and transthoracic echocardiography (TTE) were performed before and one day after the operation. Follow-up information was obtained through telephone or at out-patient clinic interview. Results Successful occlusion of ASD was obtained in all patients, and in no patient the AF rhythm turned to sinus rhythm after the procedure. In one patient preoperative AF turned to postoperative atrial flutter, and AF recurred in one case who had received transcatheter ablation of AF before the procedure. One female patient developed gastric bleeding during the course of orally taking warfarin, and she died of cerebral infarction at three days after ceasing the use of warfarin. Of the 24 patients, no anticoagulant drug was used in 5 (20.8%), oral administration of aspirin was given in 7 (29.2%), and oral medication of warfarin was employed only in 11 (45.8%). Conclusion The spontaneous conversion rate of AF is very low in patients with ASD complicated by AF after transcatheter closure of ASD. Postoperative medication of anticoagulation should be strictly standardized and carefully managed.

Preliminary Study of TCM Syndromes of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Malnutrition / 中国中医药信息杂志

Objective To observe the TCM syndromes of acute exacerbation of chronic obstructive pulmonary disease (COPD) with malnutrition. Methods TCM Syndromes Questionnaire of Acute Exacerbation of COPD was formulated with TCM clinical epidemiology methods. Totally 220 cases of hospitalized patients met the inclusion criteria were divided into two groups, 120 cases of malnutrition and 100 cases of non-malnutrition. The clinical data were observed and syndrome elements of malnutrition group and non-malnutrition group were analyzed to discuss the rule of syndromes in acute exacerbation period. Results In addition to respiratory system, the frenquency of symptoms such as weight loss, shortness of breath, easy cold, aversion to wind and cold, poor appetite, abdominal distension, constipation, belching, dizziness and tinnitus, tooth loose and hair loss, soreness and weakness of waist and knees significantly increased in COPD with malnutrition, mainly involving in syndromes of spleen deficiency and incoordination between spleen and stomach. In patients with acute exacerbation of malnutrition COPD, the single syndromes were 36 cases (30%), the composite syndromes were 84 cases (70%). The simple excess syndromes were 38 cases (31.67%), the simple deficiency syndromes were 23 cases (19.17%), and the intermingled deficiency and excess syndromes were 59 cases (49.17%). Conclusion Patients with acute exacerbation of COPD with malnutrition are mainly composite syndromes and the intermingled deficiency and excess syndromes. Spleen deficiency and incoordination between spleen and stomach may be the important pathogenesis of COPD with malnutrition.

Effects of Gubenkeli capsule on matrix metallopeptidase 9 and tissue inhibitor of metalloproteinase1 levels in lung tissue of a rat model of chronic obstructive pulmonary disease* / 中国组织工程研究

BACKGROUND: The effectiveness and safety of traditional Chinese medicine treatment for chronic obstructive pulmonary disease (COPD) have been preliminarily approved by clinical practices.OBJECTIVE: To investigate the effects of Gubenkeli capsule on the protein expression of matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase1 (TIMP-1) in lung tissue of COPD model rats.METHODS: A total of 50 Wistar rats were randomly divided into five groups with 10 rats in each group: normal control, model, prednisone, Gubenkeli capsule-low dose, and Gubenkeli capsule-high dose. COPD rat models were established in all rats with the exception of the normal control rats by smoking and intratracheal instillation of LPS. At 29 days after COPD induction, rats from the prednisone, Gubenkeli capsule-low dose, Gubenkeli capsule-high dose groups were intragastrically administered prednisone (1.04 mg/kg per day), Gubenkeli capsule (0.4, 0.94 g/kg per day), once a day, to observer rat general conditions. Protein expression of MMP-9 and TIMP-1 in the lung tissue was detected by immunohistochemical methods. RESULTS AND CONCLUSION: Protein expression of MMP-9 and TIMP-1 in the lung tissue of COPD rats was significantly increased (P < 0.05). After drug intervention, the general conditions of COPD rats were greatly improved, and protein expression of MMP-9 and TIMP-1 in the lung tissue was decreased. Prednisone yields the strongest effects, followed by high-dose Gubenkeli capsule and low-dose Gubenkeli capsule. These findings demonstrate that Gubenkeli capsule alleviates the clinical manifestations of COPD model rats, improve airway remodeling, and correct the imbalance between prolease and antiprotease in a dose-response manner.

Advances and problems in allograft tendon transplantation / 中国组织工程研究

Given the limited sources of autogenic tendon and the difficulties of the tissue engineering tendon to clinical application, the allograft tendon transplantation was a good way for tendon repairing defects. The domestic and foreign scholars have done a lot of studies on the acquisition, preservation, immunological characteristics, clinical application and prognosis of allograft tendon transplantation technology. The allograft tendon transplantation has been more and more used to repair the tendon tissue defects, but there still were some problems to be solved, such as the preservation, immunological characteristics, mechanical strength and postoperative adhesions.

Role of humoral bioactive factors in fracture healing following traumatic brain injury / 中国组织工程研究

AIM: To analyze and screen humoral bioactive factors associated with accelerated fracture healing after traumatic brain injury. METHODS: A computer-based online search of Chinese Journal Full-text Database and Pubmed database was undertaken to identify related articles. After the first trial, only articles about the effect of humor changes after brain trauma or humoral factors on fracture healing were selected, and those published in recent five years and published in a authoritative journal were preferred. Repetitive research was excluded. RESULTS: Fracture healing can be accelerated, especially for people with traumatic brain injury. Brain injury, spinal cord injury, different parts of the spinal cord injury, and nerve injury have different influences on fracture healing. There are cell active factors in humour of patients after traumatic brain injury, which can induce karyogenetic division and proliferation of bone marrow-derived stroma cells. Bone morphogenetic protein (BMP) is a very important factor in fracture healing, but it seems not one of factors that are associated with accelerated healing mechanism. Transforming growth factor-? (TGF-?) is correlated with brain injury and bone healing. It is likely to be one of cell factors that can promote fracture healing. Basic fibroblast growth factor (bFGF) has an early expression in traumatic brain injury patients, which can promote osteoblast by stimulating vascular endothelial growth factor (VEGF) and TGF-? expressions. VEGF is only a member of various factors in the network in fracture healing. The action mechanism of single factor needs further exploration. Growth hormone has a high concentration in patients with traumatic brain injury, and can promote fracture healing through interaction with insulin-like growth factor. However, the mechanism is still uncertain. Nerve growth factor, prolactin and melantonin concentration significantly change after traumatic brain injury. They may be the humoral factors that influence bone healing, but the mechanism has not yet been identified. CONCLUSION: Accelerated fracture healing associated with traumatic brain injury is influenced by systemic and local bioactive factors. Currently, the researches about the association of some humoral factors such as BMP, TGF-? and bFGF with fracture healing have been conducted, but others need to further study.

Research about Prescription and Technology of Brucea javanica Oil Subnanoemulsion Injection / 中国中医药信息杂志

Objective To optimize the prescription and technology of Brucea javanica oil subnanoemulsion injection. Methods Using superfine Brucea javanica oil as oil phase,yolk lecithin and poloxamer 188 as the complex emulsifying agents. The dosage of oil,emulsifier and stabilizer were optimized and the preparation was optimized by orthogonal experiments. Results The optimum precription was 10% oil phase,1.2% emulsifier and 0.1% stabilizer. The optimum technology was that aqueous phase and oil phase mixed at 70 ℃,sheared 20 min by high speed shearing machine and then passed the ultra-high pressure nano homogenizer 6 times under the pressure of 900 bar. Conclusion The physical stability of Brucea javanica oil subnanoemulsion injection is good.

Efficacy of Letrozole in the Treatment of Breast Cancer in Postmenopausal Women:A Systematic Review / 中国药房

OBJECTIVE:To evaluate efficacy of letrozole in the treatment of breast cancer in postmenopausal women. METHODS:RCTs about letrozole in the treatment of breast cancer in postmenopausal women were collected using Cochrane systematic evaluation method by retrieving from Cochrane Library,PubMed,CBMdisc and CNKI. The quality evaluation of those trials and data extraction were performed and Meta-analysis was conducted by RevMan 5.0 software. RESULTS:6 RCTs involving 6 316 patients were included. In neoadjuvant endocrine therapy,letrozole was more effective than tamoxifen in PFS but there was no statistical significance in difference of total survival rate;in rescue therapy for recurrence and transform,letrozole was more effective than long-term therapy of tamoxifen in OS,PFS and OR;in new neoadjuvant endocrine therapy before operation,letrozole was more effective than tamoxifen in OR. CONCLUSION:The current evidence shows that letrozole is more effective than tamoxifen for breast cancer in postmenopausal women.More high-quality clinical trials are expected for further study.

Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension in adults / 中华放射学杂志

Objective To evaluate the effect of self-expandable occluder on closure of patent ductus arteriosus(PDA)with severe pulmonary arterial hypertension(PH)in adults.Methods Twenty-eight adult patients underwent transcatheter closure of PDA at a mean age of(31.3?11.6)years [(18—58)years].Either Amplatzer duct occluder or domestic device was used in the present study.X-ray,EKG and UCG were repeated in one day,one month,three months,and six months.Results Twenty of the 28 patients had successful occlusion,and the other 8 patients were given up.In the successful group,the narrowest diameter of PDA was(10.4?2.7)mm [(6—16)mm],the diameter of selected occluder was(15.6?3.2)mm [(10—20)mm] at the end of pulmonary artery.Systemic artery oxygen saturation(SAsat)before and after oxygen inhalation was(93.5?1.8)%,(98.2?1.8)%,respectively(P

Long-term follow-up results of percutaneous balloon mitral valvuloplasty in mitral stenosis with severe pulmonary hypertension / 介入放射学杂志

Objective To assess long term results (more than 5 year) after percutaneous balloon mitral valruloplasty (PBMV) on mitral stenosis (MS) with severe pulmonary hypertension. Methods Thirty patients after PBMV underwent critical evaluations including echocardiography, chest film and clinical status throughout the follow up period (6.4?1.4 years). Results Before and after PBMV and at follow up, mean mitral valve areas were (1.19?0.32) cm 2 vs (1.99?0.45) cm 2 vs (1.44?0.42)cm 2 respectively ( P