Safety and efficacy of transcatheter closure of ruptured sinus of Valsalva aneurysm / 中华心血管病杂志

Objective@#To investigate the safety and efficacy of transcatheter closure of ruptured sinus of Valsava aneurysm(RSVA).@*Methods@#A total of 33 RSVA patients underwent transcatheter closure from January 2006 to March 2017 in our hospital were included in this retrospective study. The RSVA was diagnosed by echocardiography.Different type of occluders were applied for transcatheter closure based on the aortography results. All the patients were followed up after the procedure.@*Results@#The patients were (37.6±12.1) years old,and the male patients accounted for 78.8%(26 cases).RSVA from right coronary sinus was found in 25 patients,and draining chamber was right atrium in 13 cases, right ventricle in 12 cases. RSVA from noncoronary sinus was diagnosed in 8 patients,and the draining chamber was right atrium. Aortography defined the narrowest diameter at the rupture site was (6.4±1.7)mm. The ratio of Qp/Qs was 2.2±0.5,and the mean pressure of pulmonary artery was 24.0(21.2,33.7)mmHg(1 mmHg=0.133 kPa). One patient developed serious occluder related aortic regurgitation and underwent surgery, transcatheter closure was successfully performed in 32 patients. The success rate of transcatheter closure was 97.0%. Two types of device were used in the study including small-waist double-disk ventricular septal defect(VSD) occluders in 20 cases and patent ductus arteriosus(PDA) occluders in 12 cases. During a median follow-up of 73.5(28.3,89.5) months, there were no infective endocarditis, residual shunt, thrombosis, device displacement,serious aortic regurgitation, serious arrhythmia or death.At the last follow-up, the left atrial diameter((37.4±6.5) mm vs. (41.5±5.3)mm,P<0.01),right atrial diameter((42.4±3.0) mm vs. (48.5±6.0)mm,P<0.01), right ventricular diameter((22.2±3.8) mm vs. (27.7±7.2)mm,P<0.01) and left ventricular end-diastolic diameter((51.3±4.9) mm vs.(55.0±4.3)mm,P<0.01)measured by echocardiography were all smaller than pre-procedural level.@*Conclusion@#Transcatheter closure of RVSA is a safe and effective strategy and associated with a good long-term outcome.

Clinical efficacy and long-term outcome of transcatheter occlusion for rupture of valsalva aneurysm ruptured into right atrium / 中国介入心脏病学杂志

Objective To evaluate the clinical safety, efficacy and long-term outcome of transcatheter occlusion for ruptured aortic sinus of valsalva aneurysm (RASA) into the right atrium.Methods Between January 2006 and April 2013, fifteen patients [11 males and 4 females,aged from 21 to 48 years with an mean age of (35.50±8.79) years] with RASA ruptured into the right atrium were enrolled in this study.Domestic made patent ductus arteriosus (applied in six patients) or small waist double-disk ventricular septal defect (applied in nine patients) occluders were used for transcatheter closure.All the patients were followed up for any change in cardiac rhythm,and residual shunt,occluders morphology and possible valve regurgitation by echocardiography.Results All RASA were confirmed by aortography,including eleven cases with rupture of right coronary sinus of valsalva and four cases with rupture of the noncoronary sinus of valsalva shunting into the right atrium.NYHA function class was(2.56±0.63)before the occlusion.Cardiac catheterization showed mean pulmonary arterial pressure and Qp/Qs ratio were (25.38±8.21)mmHg (1 mmHg=0.133 kPa) and 1.34-2.81(1.93±0.39), respectively.Aortic angiography showed that the RSA was 4-10(6.42±1.92)mm at its narrowest end.There was no serious complication during the operation and all the patients had successful transcatheter closure without residual shunt.After transcatheter RASA occlusion, mean pulmonary artery pressure decreased to (16.1±5.3) mmHg (P<0.05).The diameter of right atrium,right ventricle, left atrium and pulmonary artery diameter and left ventricular end-diastolic dimension all showed significant decrease (P<0.01).All patients were followed up for 35-132(78.6±28.57)months.All patients presented with a NYHA function class Ⅰ to Ⅱ cardiac function in their last follow up which was significantly improved compare to pre-occlusion level (P<0.01).There were no infective endocarditis,device displacement and embolism,serious aortic regurgitation,myocardial ischemia,serious arrhythmia or death in any of the patients during follow up.Conclusions Transcatheter closure of Valsalva aneurysm ruptured into right atrium with the domestic made patient ductus arteriosus and small-waist ventricular septal defect occluder is safe and effective with a good long term prognosis.

Analgesic effect of periarticular multimodal drug injection versus nerve block in total knee arthroplasty / 中国组织工程研究

BACKGROUND:Periarticular multimodal drug cocktail injection for pain management after total knee arthroplasty (TKA) has been reported,but there are few studies concerning its effect on the range of motion and volume of drainage postoperative,and difference to nerve block.OBJECTIVE:To compare the analgesic effect of periarticular multimodal drug injection and nerve block in TKA.METHODS:Fifty-eight patients undergoing primary unilateral TKA in the First Affiliated Hospital of Anhui Medical University from 1 June 2016 to 31 October 2016 were randomly assigned to experimental and control groups (n=29 per group),followed by received a periarticular intraoperative injection of a 100 mL mixture containing ropivacaine,epinephrine,morphine,and normal saline,and preoperative combined femoral and sciatic nerve block,respectively.Subsequently,the Visual Analogue Scale scores,and range of motion,volume of drainage,hospitalization time,number of the patients given remedial analgesia and complications were compared between two groups.RESULTS AND CONCLUSION:(1) The Visual Analogue Scale scores at rest in the experimental group were significantly lower than those in the control group at 3 days after surgery (P ＜ 0.05).(2) The Visual Analogue Scale scores on movement in the experimental group were significantly lower than those in the control group at 1,2 and 3 days after surgery (P ＜ 0.05).(3) There were no significant differences in the range of motion,volume of drainage,hospitalization time and number of the patients give remedial analgesia between two groups postoperatively (P ＞ 0.05).(4) None appeared with obvious nausea,vomiting and other complications in the two groups.(5) These results indicate that the analgesic effect of periarticular multimodal drug injection is superior to nerve block,and the former is easy to operate,economical and practical.

Risk factors and early diagnosis of severe thrombocytopenia complicating transcatheter occlusion of a ;patent ductus arteriosus / 中国介入心脏病学杂志

Objective To investigate the risk factors and early diagnosis of the severe thrombocytopenia complicating transcatheter ccclusion of patent ductus arteriosus ( PDA ) . Methods Between February, 2011 and May, 2015, 80 patients with patent ductus arteriosus underwent percutaneous intervention occlusion were studied. Results Average age were ( 17. 5 ± 17. 1 ) years, 63 were females (78. 8%), mean weight were (35. 6 ± 20. 2)kg (from 6. 0 to 75. 0 kg), mean body surface area (BSA) were (1. 09 ±0. 44) m2(from 0. 32 to 1. 91 m2). A bolus of heparin calcium (80 U/kg) was administered by intravenous injection. The mean diameters of patent ductus arteriosus were 4 mm (from 2 to 18 mm), and the mean diameters of occluders were 12 mm (from 6 to 30 mm). 14 patients were found to have severe thrombocytopenia (PLT count﹤100 × 109/L). The reduction rate of platelet in 12 of 14 patients was more than 19%. The diameters of all occluders were equal to or more than 14 mm, the mean diameters of patent ductus arteriosus were 10 mm ( from 6 to 18 mm) and the mean diameters of occluders were 18 mm ( from 14 to 30 mm). All the 14 patients started to present progressive decrease in PLT count since the second day post procedure. Taking the selected occluder diameter greater than 14 mm as cut-off points in diagnosis of severe thrombocytopenia, the sensitivity was 100%, specificity was 68%, the positive predictive value was 40%, and the negative predictive value was 100%. Combined with the postprocedural second day complete blood count analysis and the platelet count decreased by 10% as cut-off points in diagnosis of severe thrombocytopenia patients, the sensitivity was 93%, specificity was 67%, the positive predictive value was 65%, the negative predictive value was 93% . If taking the platelet count decreased by 7% on second day as cut-off points in diagnosis of severe thrombocytopenia patients, the sensitivity was 100%, specificity was 57%, the positive predictive value was 61%, the negative predictive value was 100% . Logistic regression analysis discovered that risk factors of severe thrombocytopenia after PDA are procedural platelet count and occluder diameter. Conclusions The risk factors of severe thrombocytopenia complicating transcatheter ccclusion of patent ductus arteriosus were the procedural reduction of platelet count and big occluder diameter. Patients with PDA who were inplanted with occluders equal to or bigger than 14 mm should retest the numbers of platelet on the second day after procedure and retest on third day if the numbers reduce on the second day, which may help in the prediction of severe thrombocytopenia.

Different influence of simvastatin on p27 protein expressions of vascular smooth muscle cells and endo-thelial cells in rats / 心血管康复医学杂志

Objective:To observe influence of simvastatin on p 27 protein (cyclin‐dependent kinase inhibitor ) expres‐sions of vascular smooth muscle cells (SMC) and endothelial cells (EC) in rats for screening new generation coating drugs of eluting stents .Methods :Primary aortic SMC and EC of rat were isolated and cultured by methods of adher‐ent and enzymatic digestion respectively .Which were inoculated on fibronectin -coated culture plates .α smooth muscle actin immunofluorescence staining was used to identify SMC ,and von Willebrand factor (vWF) immunofluo‐rescence staining was used to identify EC .SMC and EC were cultured for 24h with different concentrations of simv‐astatin (0.01 ,0.1 ,1 and 10 μmol/L) ,then Western blot was used to measure p27 protein expression .Results:Compared with blank control group ,0.01μmol/L simvastatin had no significant influence on p 27 protein expression of SMC ,but 0.1 ,1 and 10 μmol/L simvastatin significantly raised p27 protein expression of SMC [ (0.53 ± 0.08) vs .(0.86 ± 0.05) ,(1.20 ± 0.05) ,(1.60 ± 0.04)] , P 0.05 ,indicating that simvastatin only dose‐de‐pendently promoted p27 protein expression of SMC .Conclusion:Simvastatin dose -dependently promotes p27 pro‐tein expression of vascular smooth muscle cells without affecting p 27 protein expression of endothelial cells .So local application of simvastatin may inhibit restenosis and promote reendothelialization of injured vessels .

Curative effect of fenestrated occluders in atrial septal defects with severe pulmonary arterial hypertension / 中国介入心脏病学杂志

Objective To evaluate clinical effectiveness of transcatheter closure of atrial septal defects ( ASD) with severe pulmonary arterial hyperyension ( sPAH) by fenestrated Amplatzer septal occluders ( ASO) . Methods From September 2002 to April 2013, 17 patients of ASD with sPAH received transcatheter ASD closure using fenestrated occluders. Aged from 18 - 72 years, the diameters of ASDs were 18 - 33 mm. The systolic pulmonary arterial hypertension measured by transthoracic echocardiogram were 80 - 112 (96. 9 ± 8. 9) mmHg. The follow-up study included electrocardiography, chest radiography and echocardiography. All the patients were followed up for 1. 5 - 12 ( mean 6. 4 ± 0. 7) years. Results Systolic pulmonary arterial pressure (sPAP) of 60 - 108 (88. 7 ± 11. 7) mmHg and mean pulmonary artery pressure ( mPAP) of 29. 3 - 60 (51. 0 ± 8. 1) mmHg were measured by cardiac catheterization before ASD closure. Qp/ Qs was 1. 50 - 2. 44 (1. 8 ± 0. 31) and the pulmonary vascular resistance was 3. 1 - 9. 7 (5. 6 ± 1. 5) wood units (wu) . Immediately after the implantation of fenestrated occluders, sPAP decreased to 56 - 99 (70 ± 11. 5) mmHg and mPAP to 27 - 51. 7 (41. 1 ± 7. 1) mmHg. On the 3 d, 3 m and 6 m follow-up exam, RVEDd decreased ( P ﹤ 0. 05), while LVEDd, LVEDV and LVEF increased significantly (P ﹤ 0. 05) . sPAP decreased significantly after transcatheter closure at 3 m and 6 m as compared to pre-closure levels (both P ﹤ 0. 05) . The mean sPAP in long term follow up was (60. 2 ± 13. 3) mmHg which had significant decrease compared to pre-closure level ( P ﹤ 0. 01), but no significant difference found when compared to 6 m follow up (P ﹥ 0. 05). Conclusions ASD closure with fenestrated ASO is a satisfactory approach for ASD with severe PAH.

Influence of simvastatin on differentiation, proliferation, migration and adhesion of smooth muscle progenitor cells / 心血管康复医学杂志

Objective:To observe influence of simvastatin on differentiation ,proliferation ,migration and adhesion of marrow-derived smooth muscle progenitor cells (SPCs) and screen coated eluting stent drugs of new generation . Methods :The mononuclear cells (MNCs) were isolated from rat marrow by density gradient centrifugation method , and then plated on fibronectin-coated culture dishes ,after culture 8d ,marrow-derived SPCs were identified by α-smooth muscle actin (α-SMA) immunofluorescent staining and counted under inverted fluorescence microscope .The MNCs and adhesion cells were treated with simvastatin (0.01~10 μmol/L) respectively for 8 d and 24h .SPCs pro-liferation ,migration and adhesion were observed by Tritium thymidine (3 H-TdR) intake method ,modified Boyden chamber assay and adhesion assay .Results:Compared with control group (no simvastatin intervention ) ,0.01μmol/L simvastatin significantly inhibited the MNCs differentiation towards SPCs [ (85 ± 4) vs .(79 ± 5)] ,proliferation [ (4070 ± 184) vs .(3833 ± 126)] ,migration [ (44 ± 3) vs .(39 ± 3)] and adhesion of SPCs [ (59 ± 5) vs .(52 ± 4)] , P<0.05 all ,and number of SPCs significantly reduced along with simvastatin concentration increased (P<0.01) . Conclusion:Simvastatin could inhibit the differentiation ,proliferation ,migration and adhesion of marrow-derived smooth muscle progenitor cells .

Relationship between the size of ostium secundum atrial seplal defect and the pulmonary arterial pressure in children less than 5 years of age / 介入放射学杂志

Objective to investigate the relationship between the size of ostium secondary atrial septal defect (ASD) and the pulmonary arterial pressure (PAP) in children less than 5 years of age. Methods During the period from April 2000 to January 2011, a total of 189 child patients less than 5 years of age with ostium secondary ASD were admitted to General Hospital of Shenyang Military Command. Under general anaesthesia with ketamine cardiac catheterization was performed, PAP was measured, and percutaneous occlusion of ASD was carried out in all patients. The clinical indexes, including sex, age, body height, body weight, body surface area, diameter of ASD defect, heart- to- thorax ratio, the systolic, diastolic and mean pressure of the pulmonary artery, etc. were determined. The patients were followed up for one year and postoperative cardiac ultrasonography was performed to check the results. The patients were divided into groups according to the defect size. Results The 189 patients consisted of 77 males and 112 females with a male-to-female ratio of 1 ∶ 1.5. The mean age was (4.1 ± 0.9) years old, ranging from 2 to 5 years old. The mean weight was (17.2 ± 3.6) kg, ranging from 10.0 to 30.0 kg. The mean height was (104.9 ± 9.2) cm, ranging from 77 to 135 cm. The mean body surface area (BSA) was (0.71 ± 0.10) m2, ranging from 0.46 to 1.02 m2. The mean size of ASD was (12.6 ± 4.8) mm, ranging from 5 to 29 mm. The mean size of ASD, which was modified by BSA, was (18.0 ± 7.0) mm/m2, ranging from 5.3 to 38.9 mm/m2. The mean systolic PAP was (41.1 ± 8.9) mmHg with a range of 15 - 67 mmHg. The mean diastolic PAP was (16.8 ± 6.5) mmHg with a range of 3 - 45 mmHg. The mean PAP was (24.9 ± 6.7) mmHg with a range of 12 - 48 mmHg. One hundred and fifty- nine patients (89.4%) had pulmonary arterial hypertension (PAH) which was determined by right heart catheterization, but no patient showed PAH when the pulmonary arterial pressure was measured by echocardiography before the procedure as well as 1, 3, 6, 12 months after the procedure. No definite correlation existed between the size of ASD and the pulmonary artery pressure (P > 0.05). Conclusion Pulmonary artery pressure measured by right heart catheterization has no definite correlation with the size of ASD in children less than 5 years of age. Pulmonary artery pressure obtained from right heart catheterization is higher than that determined by cardiac ultrasonography, which may be caused by the effect of ketamine when general anaesthesia is used in performing right heart catheterization.

Protection of curcumin against tumor necrotic factor-alpha-mediated inflammatory injury of vascular endothelial cells / 中国组织工程研究

BACKGROUND:Previous studies have shown that, curcumin plays a crucial role on the inflammation in cells caused by oxidative stress. OBJECTIVE:To elucidate the biological effect and mechanism of curcumin in the pathological inflammation reaction in vascular endothelial cells. METHODHuman vascular endothelial cells were taken as the cellmodels. Tumor necrosis factor (10μg/L) treatment was used to induce the inflammation of cells. Curcumin (0, 50, 100μg/L) treatment for 24 hours was used to intervene the cells. The intercellular hyperpermeability of the vascular endothelial cellmonolayers was examined by HRP-conjugated bovine serum albumin, and intercellular filamentous actin stress fiber formation was examined by rhodamin-phal oidin staining. ELISA assay was used to detect the secretion of interleukin-1βin vascular endothelial cells. Immunoflurensece staining was applied to investigate the expression and translocalization of nuclear factor-κB. Western blot analysis reflected the expression of NRLP3 and caspase-1. RESULTS AND CONCLUSION:HRP-bovine serum albumin detection results showed that, curcumin inhibited the intercellular hyperpermeability of the vascular endothelial cellmonolayers and the formation of robust intercellular filamentous actin in a dose-dependent manner. ELISA assay showed that curcumin protected vascular endothelial cells against tumor necrotic factor-α-induced interleukin-1βsecretion in a dose-dependent manner. Meanwhile, the nuclear factor-κB expression was increased and the translocation of nuclear factor-κB into the nuclei was obviously seen in vascular endothelial cells induced by tumor necrosis factor-α, but the translocation was not changed in 100μg/L curcumin-treated cells. Furthermore, western blot analysis revealed that the expression of NRLP3 and caspase-1 were inhibited in curcumin-treated cells. Curcumin can inhibit tumor necrosis factor-α-induced activation of inflammasome and secretion of interleukin-1βin vascular endothelial cells by down-regulating the expression of nuclear factor-κB, thus prevent pathological inflammatory injury in cells.

Expressions of endothelin-1 in primary cultured atrial myocytes during early rapid pacing / 心血管康复医学杂志

Objective: To study the expressions of endothelin-1 in primary cultured atrial myocyte model at early stages of atrial fibrillation by rapid pacing. Methods: The primary rat atrial myocytes were cultured, in which a rapid paced cell model was established. The polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA) were applied to detect the messenger ribonucleic acid (mRNA) expression and secretion of endothelin-1 on 3 h, 6 h, 12 h and 24 h after rapid pacing. Results: Compared with before pacing, there were continuous and significant increase in expression of ET-1mRNA [ (0.31±0.02) vs. (0.52±0.07), (0.62±0.09), (0.75±0.05) ] and secretion of endothelin-1 [ (3.4±0.8) ng/L vs. (6.0±1.4) ng/L, (8.3±1.5) ng/L, (11.2±2.1) ng/L] on 6 h, 12 h and 24 h after rapid pacing, P<0.01 all. Conclusion 　 Expressions of ET-1mRNA and secretion of endothelin-1 significantly increase depend on time in early rapid pacing atrial myocytes, indicating that endothelin-1 participates in atrial pathological remodeling during atrial fibrillation.

Comparison between transthoracic and transesophageal echocardiography in diagnosing adult multiple atrial septal defect / 中国医学影像技术

Objective To explore the value of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in diagnosing adult multiple atrial septal defect (MASD). Methods Thirty adult patients with MASD were examined with TTE, 25 patients were examined also with TEE, 26 patients were examined with cardiac catheterization as well. Transcatheter closure of MASD was performed in 20 patients and succeeded in 18, while open-chest operation was performed in 4 patients. Results Foramen secundum atrial septal defect was diagnosed with both TTE and TEE with an accuracy rate of 60.00% (18/30) and 96.00% (24/25), respectively. The main color Doppler flow imaging (CDFI) feature of adult MASD was multiple colorful left-to-right shunt signals through the atrial septal designated, i.e. colander sign of CDFI. Conclusion TTE has some difficulties and TEE has specific value in diagnosing adult MASD. TTE can be used before open-chest operation. TEE is necessary before transcatheter occlusion to make sure of the amount and location of atrial septal defect.

Color Doppler echocardiographic characteristics of bilocular heart and associated cardiac malformations / 中华超声影像学杂志

Objective To probe into the color Doppler echocardiographic characteristics of bilocular heart (BH) and associated malformations. Methods Twenty patients of BH were examined with color Doppler echocardiography (CDE) and the characteristics were observed. All the CDE results were compared with angiocardiography and 14 were confirmed by operation. Results Nineteen cases were properly diagnosed based on the CDE characteristics,1 case were misdiagnosed as mitral atresia. CDE characteristics of BH were obvious:① Apical four-chamber view of two-dimensional echocardiography (2DE) showed total echo dropout in both the interatrial septum and the interventricular septum and disappearance of the intracardiac "cross". The common atrioventricular valve closed during systole and appeared as figure "8", named 2DE "8" sign. During diastole, the common atrioventricular valve opened to a common ventricle. ② Color Doppler flow imaging (CDFI) showed common intra-atrial flow signal entereda common ventricle through common atrioventricular valve during diastole in all patients and colorful reflux through common atrioventricular valve during systole in 15 cases. ③ Among the 20 eases, 16 of the common atria were situs solitus,4 were situs inversus; 10 of the common ventricles were type A,2 were type B and 8 were type C. According to the spatial relationship of the great arteries,there were 4 type Ⅰ ,7 type Ⅱ and 9 type Ⅲ.There were 18 pulmonary stenosis and 2 pulmonary hypertension. ④ In the presence of pulmonary stenosis, CDFI showed colorful shunt signals through pulmonary artery during systole. Conclusions BH and associated malformations have obvious echocardiographic characteristics. CDE has a specific value in diagnosing BH and associated malformations.

Change of estrogen in patients with pulmonary artery hypertension secondary to congenital heart disease / 中国医师进修杂志

Objective To study the change of estrogen in patients with pulmonary artery hypertension (PAH) secondary to congenital heart disease (CHD). Methods A total of 144 patients with CHD including 36 patients with normal pulmonary arterial pressure as control group, and 108 with PAH were investigated as PAH group. Their pulmonary artery pressure was measured by right heart catheterization and the serum concentrations of estradiol, progesterone, prolactin and follicle stimulating hormone (FSH) were detected by chemiluminescence immunoassay. Results The serum concentrations of estradiol, progesterone, prolactin and FSH in PAH group were significantly higher than those in control group (P<0.05). Multiple regression analysis showed that the concentrations of estradiol, progesterone and prolactin were not correlated with the site of shunt but significantly correlated with physiologic factor including sex, age and menstrual cycle, and the level of mean pulmonary arterial pressure. The correlation coefficient of mean pulmonary arterial pressure to them was 0.607,0.531 and 0.518 respectively. The concentration of FSH was positively correlated with the prolactin and estradiol with a related coefficient of 0.917 (P=0.012) and 0.759 (P= 0.000). Conclusion The estrogen plays an important role in modification of the pulmonary arterial pressure in patients with CHD and PAH.

Imaging characteristics and regularity of adult congenital coronary artery fistula in color Doppler echocardiography / 中华超声影像学杂志

Objective To probe into the imaging characteristics and regularity of color Doppler echocardiography(CDE) in congenital coronary artery fistula(CAF) in adults. Methods CDE was used to examine 31 adult patients with CAF and the imaging characteristics and regularity were observed. Angiocardiography was performed in 26 cases. Seven of the 31 cases were treated interventionally and 24 of them surgically. Results Of the 31 patients, 29 were correctly diagnosed according to the CDE characteristics (diagnosis accuracy was 93.5%) and all the complicated anomalies were correctly diagnosed. artery is the origin and whichever heart chamber is the entry site of the fistula, the left atrium and the left showed abnormal blood flow signals in the heart chamber into which the fistula drained and in pulmonary drained into the right ventricle was more common than that into the right atrium, the left atrium, the left or the pulmonary artery was easily misdiagnosed because left ventricular systolic pressure was equal to aortic pressure which made the abnormal blood flow in CDFI indistinct. Conclusions CDE showed obvious imaging characteristics and regularity for CAF in adults and has specific value for the diagnosis of this disease. But CAF that drained into the left ventricle or the pulmonary artery is easily misdiagnosed.

Diagnosis and treatment of patent foramen ovale / 介入放射学杂志

Patent foramen ovale(PFO)is a special kind of atrial septal abnormal communication with no significant hemodynamic abnormal shunting between the two atrial together with no correlative clinical signs and symptoms.During recent years,there is a new finding of PFO,concerning about the occurrences of abnormal embolism,stroke,migraine etc,which are closely or indirectly related with the existence of PFO.In addition,atrial septal bulging complicated with PFO is also a risk factor for cerebral infarction arousing the critical attention for this disorder.This article presents a comprehensive evaluation about the incidence,clinical features,diagnosis and preventive measures of PFO.

Clinical application analysis of transcatheter therapy for 941 cases with patent ductus arteriosus / 中国介入心脏病学杂志

Objective To evaluate the clinical value of interventional therapy of patent ductus arteriosus(PDA).Methods A total of 941 patients(259 male and 682 female) with PDA admitted from March 1998 to August 2007,aged from 3 months to 74 years old(mean age 13.7?14.5 years old) were included in this study.The clinical characteristics and the outcomes of the therapy were retrospestively studied.Results These PDA types were classified according to Krichenko's classification by aortic angiography.Among all the patients,641 of then(68.1%) had type A PDA,11 patients(1.1%) had type B,202 patients(21.5%) had type C,8 patients(0.85%) had type D and 79 patients(8.4%) had type E PDA.The ranges for the minimun inner diameter of PDA was 1.2-1.5(4.6?2.9) mm,the inner diameter of aorta end was 2.0-32.7(11.1?5.7) mm,the length was 2-42.6(6.7?3.3) mm and the mean pulmonary arterial pressure was 9.7-106(34.7?19.4) mm Hg.Various occlusion devices were used to close the PDA including AGA mushroom occluder in 146 patients,AGA atrioseptal defect device in 2 patients,homemade PDA ductal occluders in 720 patients,homemade membranous ventricular septal defect device in 18 patients,homemade muscular ventricular septal defect device in 6 patients, eccentricity PDA devices in 18 patients and Germany pfm spring coil in 31 patients.Transcather closure was unsuccessful in 7 patietns and the success rate of operation was 99.3%(934/941).Conclusion Most patients can be cured by catheterization closure.To master procedural indication and accurate manipulation skill can reduce the procedural complications.The procedures should be handled carefully in infants or patients with pulmonary artery hypertension.The evaluation of pulmonary artery pressure is the key point prior to the interventional therapy.The experience on long-term efficacy of transcatheter PDA closure in patients complicated with pulmonary artery hypertension needs further exploration.

CLINICAL ANALYSIS OF 75 CASES WITH THE DOUBLE-CHAMBERED RIGHT VENTRICLE / 解放军医学杂志

Assess retrospectively 75 cases of double chambered right ventricle confirmed by clinical examination and operation. The diagnosis and differential diagnosis were made by physical signs, chest X rays, electrocardiograph, echocardiogram, catheterization and right ventricular cardiograph features. Results showed that there were only 9 cases of simple form among 57 (76 %) cases with double chambered right ventricle before operative confirmation,and in 48 (64 %) cases it was accompanied by other intracardiac malformation. Eighteen (24%) cases were not diagnosed preoperatively. In order to raise the diagnotic rate, it was important to measure the pressure gradient between the pulmonary artery and the inflow tract of right ventricle, and evaluate carefully the right ventricular size and morphology by angiocardiography.

Association analysis between TBX1 gene and human conotruncal defects / 中国实用内科杂志

Objective Two single nucleotide polymorphisms(SNPs)in TBX1 gene,G2857C(rs737868)and G2963A(rs28649236),were chosen to investigate their distribution in contruncal defects(CTD)patients and normal controls in order to determine the relationship between TBX1 gene and CTD.Methods By PCR-RFLP,genotypes of these two SNPs were analyzed in 100 patients with CTD and 100 normal controls during Mar.2004 to May.2006. 2 test was applied to analyze the genotype frequency and allele frequency between CTD groups and control groups.Results Remarkable significance were observed at G2963A between CTD groups and normal controls,the G allele frequency in CTD groups were much higher than that in normal controls(?2=5.30,P

Effects of ginsenoside Rg_1 on the expression of VEGF and HIF-1? in acute myocardial infarction in rat / 解放军医学杂志

Objective To determine the influence of ginsenoside Rg1 on angiogenesis and the expression of vascular endothelial growth factor (VEGF) and hypoxia inducible factor-1? (HIF-1?) in rat acute myocardium ischemia (AMI) in rat. Methods A murine model of AMI was reproduced. Wistar rats (n=104) were randomly divided into shamoperation group, AMI control group, low ginsenoside Rg1 group (1mg/kg) and high ginsenoside Rg1 group (5mg/kg). Microvascular density, VEGF protein, VEGF and HIF-1? mRNA were assessed at 3, 7, 10 and 14 days after operation. Results The values of VEGF and HIF-1? mRNA were increasing with the duration of ischemia and hypoxia, and positive relationship was found between the time of AMI and the expression of HIF-1? mRNA. Ginsenoside Rg1 enhanced the formation of angiogenesis (P

CLINICAL ANALYSIS OF 104 PATIENTS WITH INFECTIVE ENDOCARDITIS PATIENTS / 解放军医学杂志

patients with infective endocarditis were analyzed. Anong them, 75 were patients with congenital heart disease (72 1%), 21 were patients with rheumatic heart disease and 8 were patients without heart disease(7 7%). It is suggested that early diagnoses and treatment of CHD are the main pretective methods for reducing the incidence of IE; the incidence of fever, anaemia, embolism, hepatomegaly and splenomegaly, etc. declines notably; the possibility of excrescence invading aortic valve (44 2%) is higher than that of mitral valve (24 7%), and IE of aortic valve results in heart failure in a short while and the valve replacement should be done as early as possible; positive rate of blood culture declines because of extensive use of antibiotics; appropriate medical treatment combined with active surgical treatment plays an important role in the treatment of IE.