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@#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.
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Various of long-lasting and persistent bradyarrhythmia can induce cardiomyopathy.The pathogenesis of bradycardia-induced cardiomyopathy(BIC) is not clear,which is possibly related to significantly prolonged ventricular diastole,overloaded volume,changes of atrioventricular activation sequence,changes of atrioventricular sequence contraction,myocardial hypoperfusion,effect of neuroendocrine,etc.Diagnosis of disease includes a medical history of persistent bradycardia;relevant clinical symptoms (fatigue,dizziness,black Meng even syncope);the signs and symptoms of right or left heart failure in serious cases;electrocardiogram prompt bradycardia;echocardiography shows dilation of heart,less obvious reduction left ventricular ejection fraction (compensatory),but the left ventricle index can be decreased.Treatment is mainly to early identify the causes of bradycardia and remove it and pharmacotherapy,cardiac pacemaker therapy.Heart function can be back to normal after therapy(cardiac pacemaker).
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Objective To determine if fetal stem cells can enter the maternal circulation during pregnancy and re-pair the injuries of maternal heart.Methods C57 female mice at the age of 6-8 weeks were randomly assigned to three groups:sham control, surgery without pregnancy, and surgery with pregnancy ( n=8,eath group) .The control sham group was developed by opening and closing of the chest.The other two groups underwent heart surgery.The myocardial infarc-tion ( MI) model was induced by ligation of the left anterior descending coronary artery.Half of the surgical mice mated with e-GFP transgenic male mice, and another half group was not.Electrocardiogram ( ECG) and echocardiographic images were recorded at pre-operation, post-operation and postpartum.The collected data were used to evaluate the heart function. The GFP expression was detected by immunohistochemistry and q-PCR.Results When compared with the sham group, both the ischemia surgery groups with and without pregnancy, the ECG ST segment was significantly increased.This meas-urement indicated that the myocardial ischemia surgery was successful, and no significant difference in the ST segments be-tween two ischemia surgery groups was found.However, when ECG was measured in the surgical mice after postpartum, their myocardial ischemia was dramatically improved when compared with that of the ischemia surgery only mice.Echocar-diographic images also indicated that both the surgery groups had myocardial ischemia, however, no significant difference was observed in the pregnant mice before and after postpartum.The order of the cardiac function indexes from high to low was the sham group, surgery with pregnancy group, and surgery with no pregnancy group;in particular, the cardiac func-tion of pregnancy group was significantly enhanced compared with that of the surgery with no pregnancy group (P<0.05). More importantly, both immunofluorescence and q-PCR results showed that the embryonic stem cell translocation through circulation system with GFP expression in the heart of pregnancy group, while negative in other two groups.Conclusions Embryonic stem cells can be transferred into the maternal circulation of pregnant mice, and play a role in the repairing of their cardiac injuries.
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Objective To explore the possible role of sulfur dioxide (SO2) in endoplasmic reticulum stress (ERS) protein expression in myocardial tissue of rats with left to right shunt.Methods A total of 24 male Sprague Dawley rats were randomly divided into sham group(n =8),shunt group(n =8)and shunt plus SO2 donor group (n =8).The rats of shunt group and shunt plus SO2 donor group,an abdominal aorta and inferior vena cava shunting was created.Na2SO3/NaHSO3 was administrated intra-peritoneally in rats of shunt plus SO2 donor group.Eight weeks later,the ratio of quantity of pulmonary to quantity of system (Qp/Qs) was measured ; Heart weight/body weight (HW/BW) and right ventricle/left ventricle + ventricular septum [RV/(LV + SP)] were detected;Expressions of collagen type Ⅰ in right ventricle myocardial tissue was measured by enzyme linked immunosorbent assay (ELISA) ;High performance liquid chromatography was used to measure SO2 content in right ventricle myocardial tissue.Glucose regulated protein 78 (GRP78),c-jun N-terminal kinase(JNK) and phosphorylation-c-jun N-termina kinase(p-JNK) mRNA and protein expressions in RV myocardial tissue were detected by Western blot and real time-polymerase chain reaction(RT-PCR).Results After 8-weeks shunting,Qp/Qs in the shunt and shunt plus SO2 groups were higher significantly than those of the sham group(all P ＜ 0.05).Compared with sham group,HW/BW,RV/LV + SP and expressions of collagen type Ⅰ in the shunt group were significantly higher(all P ＜ 0.05).Treatment of SO2,HW/BW and RV/LV + SP and collagen type Ⅰ in the shunt group were lower significantly(all P ＜ 0.05).The level of SO2 of RV in shunt group increased significantly compared with sham group (all P ＜ O.05),but significantly lower than that of shunt plus SO2 donor group (P ＜ 0.05).Compared with sham group,the expressions of GRP78,JNK and p-JNK mRNA and protein in RV increased significantly in shunt group(P ＜ 0.05).After treatment with SO2,the expressions of GRP78,JNK and p-JNK mRNA and protein decreased significantly (P ＜ 0.05).Conclusion SO2 might protect RV myocardial tissue of the rats with left-right shunt by regulating the expressions of ERS.