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Objective: To evaluate the feasibility and safety of right ventricular endomyocardial biopsy (EMB) via the right internal jugular vein approach. Methods: It was a retrospective and descriptive study. A total of 272 patients, who underwent right ventricular EMB from December 2014 to June 2020 in Fuwai Hospital and Peking Union Medical College Hospital were enrolled. The preliminary diagnosis included suspected myocarditis, myocardiopathy, unexplained heart failure etc after exclusion of coronary heart disease. Clinical characteristics including age, sex, height, weight, NYHA functional class, NT-proBNP, chest radiography, echocardiography, and hemodynamics parameters were collected at baseline. EMB was performed via right internal jugular vein approach under the biplane fluoroscopic guidance. Success rate was calculated in this study. Complications related to operation were recorded according the following definitions. Major complications included death, urgent cardiac surgery, advanced cardiac life support, pericardiocentesis in cardiac tamponade, permanent complete atrioventricular block requiring permanent pacing etc. Minor complications included pericardial effusion without pericardiocentesis, temporary (lasting less than 24 hours) or permanent right bundle-branch block, temporary Mobitz type Ⅱ atrioventricular block (AV block) with AV conduction 2∶1 requiring medical treatment with atropine, or additive temporary pacing, non-sustained ventricular tachycardia with long runs of more than 10 ventricular complexes, and an episode of atrial fibrillation lasting less than 12 hours or cardioversion of atrial fibrillation. Other complications included tricuspid anterior chorda rupture and new onset tricuspid regurgitation after EMB. Results: In this study, right ventricular EMB were performed successfully in 270 patients, the total success rate was 99.3% (270/272), and EMB were failed in 2 (0.7%) patients. Age of the enrolled patients was (42.7±16.9) years, and there were 164 (60.3%) males. Major complication including cardiac tamponade requiring pericardiocentesis occurred in 2 (0.7%) patients. Minor complications such as small amount pericardial effusion occurred in 18 (6.6%) patients, tricuspid anterior chorda rupture occurred in 1 (0.4%) patient. No patient died, or requiring permanent pacing, or requiring emergency cardiac surgery. The complication rate was 9.3% (13/140), 7.8% (7/90), and 2.4% (1/42) in operators with 1, 2, and 3 years' experience. Conclusions: EMB via the right jugular vein approach under fluoroscopic guidance is a simple, safe and feasible procedure. The complication rates decrease significantly with increasing operator experience.
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Objective To study the chemical constituents from the n-butanol extract of Guizhi Fuling Capsule. Methods The chemical constituents were isolated and purified by multiple chromatographic methods. Their structures were identified on the basis of the spectral data and physicochemical properties. Results Five compounds were identified as 3'-O-galloylsucrose (1), 4'-O-galloylsucrose (2), 6'-O-galloylsucrose (3), 1'-O-galloylsucrose (4), and 1,2,3,4,6-pentagalloylglucose (5). Conclusion Compounds 1-5 are isolated from Guizhi Fuling Capsule for the first time, and compound 1 is a new compound. Compounds 1-5 inhibited calcium influx in uterine smooth muscle cells of primary mice.
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<p><b>OBJECTIVE</b>To study the chemical constituents and activity of total flavonoids contained in Yushen Tang,in order to lay a foundation for defining active consituents of the prescription and their mechanism.</p><p><b>METHOD</b>The activity of total flavonoids contained in Yushen Tang were evaluated by in vitro H2O2-induced human umbilical vein endothelial cell injury experiment. The chemical constituents were separated and purified by such methods as silica column chromatography, macroporous resin chromatography, sephadex and HPLC preparation,and their structures were identified on the basis of their spectral data and physicochemical properties.</p><p><b>RESULT</b>Total flavonoids contained in Yushen Tang showed the effects in inhibiting hydrogen peroxide-induced human umbilical vein endothelial cell (HUVEC) injury and down-regulating PAI-1 expression (P<0.05). Nine flavonoids were separated from total flavonoids contained in Yushen Tang and identified as calycosin (1), linarin (2), 3',4',7 -trihydroxyflavone-7-O-beta-D-glucopyranoside (3), 7,3'-dihydroxy-4'-methoxyflavone-7-glucoside (4), quercetin (5), kaempferol (6), rutin (7), pratensein-7-O-beta-D-glucoside (8) and 7-O-glucosyl liquiritigenin (9).</p><p><b>CONCLUSION</b>Total flavonoids contained in Yushen Tang showed the effect in inhibiting HUVEC injury. All of the nine flavonoids were separated from Yushen Tang for the first time, and compounds 1,3,4,8,9 may be derived from astragalus mongholicus, while compounds 4,5-7 may be derived from herba cepbalanoplosis segeti and hairyvein agrimony. Among them, compounds 3,4 and 9 were seperated from single ingredient of the prescription for the first time.</p>