Aortic valve degenerative disease with patent ductus arteriosus infective endocarditis: A case report / 中南大学学报(医学版)

Infective endocarditis (IE) refers to the pathogenic microbial infect the endocardium, valves or intima adjacent to the cardiac arteries through the bloodstream with the formation of vegetations. Valves are the most frequently affected sites. Here, we described a 49-year-old female, who admitted to respiratory outpatient department in the Third Xiangya Hospital, Central South University for long time of fever. Chest computer tomography (CT) found a thick wall cavity in the apex of the right lung with smooth wall and fluid plane, without enhancement, which was considered as inflammation and tuberculosis to be excluded. Echocardiography showed vegetations on the aortic valve, where abscess was found on the root. Accidentally in surgery, a patent ductus arteriosus (PDA) was found. The surgeon closed the PDA and performed aortic valve prosthetic valve replacement. Bacterial colony of coccus was found in the pathological tissue, which was consistent with the diagnosis of valvular degeneration with infection. Lung lesion was obviously absorbed after 6 weeks of treatment with vancomycin, which has been confirmed as a sensitive antibacterial drug to Enterococcus faecalis. Overall, the pulmonary lesion was caused by the detachment of bacterial neoplasm of aortic valve, which has passed through the PDA and entered the pulmonary circulation.

Manifestation, distribution of pathogen, and resistance of bloodstream infections after renal transplantation：clinical anylasis of 71 patients / 中南大学学报(医学版)

Objective:To investigate the clinical manifestation and determine the distribution of pathogens and their characteristics of drug susceptibility to bloodstream infections (BSIs), and provide evidence for clinical anti-infection treatments after renal transplantation. Methods:Totally 81 episodes of BSIs occurred in 71 patients between July 2003 and June 2013. We retrospectively analyzed the pathogens and their drug susceptibility characteristics with BD microbiological assay system. We also collected the clinical and laboratory data of the patients . Results:The main pathogens were gram negative bacteria (67.90%), followed by gram positive bacteria (28.40%) and fungi (3.70%). The most common gram negative bacillus was Escherichia coli.While for gram positive bacteria, the main bacillus was coagulase-negative staphylococci. The gram negative bacteria were relatively sensitive to aminoglycosides and carbapenem. The gram positive bacteria were sensitive to glycopeptides and oxazolidone. Conclusion:The clinical manifestations included high body temperature, onset in the early period after kidney transplantation and high mortality. Though gram positive coccus plays an important role, most infections are caused by gram negative bacteria in BSIs after the renal transplantation. The antibiotic resistant rate for gram negative bacteria is very high as well as gram positive bacteria.

Roles of periostin in proliferation and migration of vascular smooth muscle cells and the effect of atorvastatin on them / 中南大学学报(医学版)

OBJECTIVE@#To investigate the expression of periostin in in vitro cultured vascular smooth muscle cells (VSMCs) induced by TGF-β1 and the relationship between periostin expression and the migration and proliferation of the VSMCs. Further, to investigate the effects of atorvastatin on the above-mentioned processes and the molecular mechanisms of atorvastatin inhibition of TGF-β1- induced periostin production.@*METHODS@#Rat aorta smooth muscle cells were cultivated by the method of tissue explants adherence. Cells of generation 3 to 6 were used as the experimental system. Primary cultured rat vascular smooth muscle cells were treated by TGF-β1 and different concentrations of atorvastatin,Y-2763 (Rho kinase inhibitor), or atorvastatin plus MVA for 24 hours. The expression of periostin was measured by RT-PCR and Western blot. A Boyden chamber assay was used to measure cell migration, and an MTT test was used to measure cell proliferation.@*RESULTS@#Periostin expression in rat VSMCs stimulated by TGF-β1 increased significantly (4.158 ± 0.515 vs 0.385 ± 0.031), VSMC migration(25 ± 4 vs 8 ± 2) and proliferation (0.85 ± 0.06 vs 0.32 ± 0.03) also increased significantly. Atorvastatin significantly inhibited TGF-β1-induced periostin production in rat VSMCs, as well as VSMC migration and proliferation, in a dose-dependent manner. Rho kinase inhibitor Y-27632 significantly inhibited TGF-β1-induced periostin production in rat VSMCs (2.082 ± 0.245). The inhibitory effect of atorvastatin on periostin upregulation induced by TGF-β1 was reversed by mevalonate (3.838 ± 0.326).@*CONCLUSION@#Periostin can promote rat VSMC migration and proliferation. Atorvastatin inhibition of periostin expression induced by TGF-β1 in VSMCs may be exerted by inhibition of the production of MVA and other isoprene compounds and by blocking the Rho/Rho kinase signaling pathway.