RESUMO
Objectives:To evaluate the valvular and cardiac function,cardiac reverse remodeling at 6-month after transcatheter edge-to-edge repair(TEER)for patients with functional and degenerative mitral valve regurgitation,and summarize the experience of echocardiography application. Methods:The clinical data of 93 patients with moderate to severe mitral regurgitation(MR)treated with TEER and completed 6-month follow-up in Yunnan Fuwai Cardiovascular Hospital from July 2022 to February 2023 were retrospectively analyzed.Patients were divided into functional mitral regurgitation(FMR)and degenerative mitral regurgitation(DMR)groups according to MR etiology.The valve characteristic parameters,as well as valvular function,chamber volume and cardiac functional parameters before and at 6 months after operation were compared.The key points of echocardiography application were summarized. Results:Among all patients,71 were FMR and 22 were DMR.There were differences in valve structure between the two groups.Mitral TEER were successfully accomplished and all patients completed 6-month follow-up.The key points of echocardiography application included:valve structure analysis,atrial septal puncture location,device delivery process monitoring and image optimization during clamping process.The mitral regurgitation grade and NYHA grade were significantly improved in all patients at 6 months after TEER(P<0.05),and the mean mitral valve pressure gradient was higher than that before operation(P<0.05).Left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left atrial volume index in FMR group were significantly decreased(P<0.05),while left ventricular and left atrial volume in DMR group remained unchanged(P>0.05).There were no significant changes in left ventricular ejection fraction and left ventricular global strain in both groups during the observation period(P>0.05).The changes of LVEDV and LVESV before and after operation were more significant in FMR group than those in DMR group(P<0.05). Conclusions:Mitral TEER can reduce the degree of regurgitation and improve cardiac function in the early postoperative period for moderate and severe MR patients with different etiologies.There are differences in preoperative valve structure and postoperative cardiac reverse remodeling between FMR and DMR patients.Echocardiography is an important imaging technique for the evaluation and monitoring process before,during and post mitral TEER.
RESUMO
Objective:To quantitatively analyze the static geometric structure and dynamic changes of the mitral annulus(MA) in patients with degenerative mitral regurgitation (DMR) by three-dimensional transthoracic echocardiography.Methods:Thirty-five patients with DMR (both mitral valve prolapse and Barlow) were collected as DMR group in Yunnan Fuwai Cardiovascular Disease Hospital from August 2019 to March 2021, and 42 healthy volunteers were selected as control group during the same period. The mitral annulus area (MAA), mitral annulus perimeter (MAP), mitral annulus anterolateral-posteromedial diameter (DALPM), anteroposterior diameter (DAP), non-planar angle (NPA), mitral annulus height (AH), and the ratio of height to intercommissural diameter (AHCWR) were measured during the late-diastole, early-systole, mid-systole and late-systole, and the systolic change fractions of the above parameters were calculated. The differences of static structure and dynamic change of MA between the two groups were compared, and the characteristics of dynamic change of MA in the whole cardiac cycle were analyzed.Results:Static structure: MAA, MAP, DAP and DALPM in DMR group were higher than those in control group during the whole cardiac cycle, and the differences were statistically significant (all P<0.05). Compared with the control group, the saddle structure in DMR group were flattened in the middle and late contraction stages (AHCWR: 0.17±0.01 vs 0.21±0.01 and 0.15±0.01 vs 0.23±0.01, both P<0.05), while the saddle structure was relatively preserved in the rest of the contraction stage. Dynamic changes: Presystole contraction (MAA, MAP, DAP, DALPM decreased, all P<0.05) were appeared durng the late-diastole and early-systole in the control group, and saddle shape deepened (NPA decreased, AH and AHCWR increased, all P<0.05). Compared with the control group, presystole MA contraction and saddle deepening disappeared in DMR group (there were no significant differences in all MA parameters between late-diastole and early-systole, all P>0.05). The systolic dynamic changes were weaker and impaired when compared with the control group, which showed that the systolic change scores of DALPM, NPA and AHCWR were lower than those of the control group (all P<0.05). There were no statistical differences in the 4 time phases of MA parameters except DAP (all P>0.05). Conclusions:The saddle-shape structure of MA in normal subjects is obvious, and the dynamic change of MA in the cardiac cycle is significant, with obvious contraction before contraction and saddle-shape deepening. The saddle structure of DMR patient is flattened in the middle and late systolic period, and the MA kinetic energy of DMR patient is weakened throughout the cardiac cycle, the contraction phenomenon disappeared before contraction, and the dynamic change of systolic period is impaired to varying degrees.
RESUMO
Teaching level and quality of experimental curriculum were promoted markedly by deepening the reform of experimental teaching, constructing qualified experimental curriculum, opti-mizing and standardizing experimental teaching process. Medical students' innovative ability was in-tensified by constructing open innovative platform and evolving vigorous extracurricular innovative activities. Meanwhile, students' innovative consciousness, scientific research ability, ability of compre-hensive analysis and problem-solving were promoted.
RESUMO
Objective To observe the effects of Astragalus polysaccharide ( APS) on tumor growth, cytokine and immune function impairment induced by cisplatin ( DDP) in mice bearing Lewis lung cancer.Methods A total of 90 mice were used in this study:10 for blank control group, and 80 mice with transplanted Lewis lung cancer were randomly divided into 8 groups:model control group (physiological saline), positive control group treated with DDP (6 mg/kg), low dose APS (50 mg/kg), moderate dose APS (100 mg/kg) and high dose APS (200 mg/kg) groups and three combinations of APS+DDP groups ( the same three APS levels with half dose of DDP, respectively) .0.3 mL of the drugs was intraper-itoneally injected to the mice, respectively, on the second day after moldeling.DDP was injected once a week and other drugs were injected once per day for consecutive 20 days.On the 21st day, blood samples were collected and serum levels of cytokine IL-2, IL-6, IL-12 and TNF-αwere determined by ELISA, and the tumor inhibition rate and immune organ in-dexes were assessed.Results The tumor inhibition rates of the positive control, low, moderate and high dose APS groups and three combinations of APS+DDP groups of mice bearing Lewis lung carcinoma were 49.30%, 17.21%, 39.68%, 17.21%, 51.02%, 57.21%and 65.11%, respectively.Compared with the model group, P<0.05 or P<0.01, and compared the three combination groups with the DDP group, P<0.05.Compared with the blank control group, the spleen index was significantly increased in the moderate and high dose APS groups and the three combinations of APS +DDP groups.There was a significant difference between the spleen indexes of the model control group, and the spleen indexes of high dose APS and the combination with high dose APS groups were significantly higher than that of the model control group (P<0.05).Compared with the DDP group, APS in various doses and combinations increased the thymus index and spleen index.Conclusions APS can improve the levels of cytokine IL -2, IL-6, IL-12 and TNF-αin mice bearing Lewis lung cancer, enhance the immune function impairment induced by DDP, has certain protective effect on the immune organs, and inhibit the growth of Lewis lung cancer in mice.When APS is used in combination with a half-dose of DDP, APS enhanced the inhibition of tumor growth.This mechanism may be related to the enhanced body immune function.Our results indicate that APS enhances the therapeutic effect of DDP and reduces its toxicity, therefore, may have potential application value in future treatment of solid tumors.
RESUMO
OBJECTIVE@#To investigate the mutation of small sequence changes in microRNA-7 gene in Chinese patients with Parkinson's disease (PD).@*METHODS@#We analyzed miR-7 variants in 225 PD patients from Chinese Han group by DNA sequence.@*RESULTS@#None of the patients had miR-7 variants.@*CONCLUSION@#MiR-7 variation is not associated with PD in Chinese patients.
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sequência de Bases , China , Etnologia , MicroRNAs , Genética , Dados de Sequência Molecular , Mutação , Doença de Parkinson , GenéticaRESUMO
Objective To explore the effects of andrographolide(AP),extracted from the traditional Chinese herb Andrographlis paniculata(AP),on injury induced by radiation exposure.Methods Sixty male rats were randomly divided into 4 equal groups and irradiated with 60Co γ-rays at the doses of 1,2,and 4 Gy,respectively:low dose AP group(intragnstrically administered with AP at the dose of 100 ms/kg daily for 10 d before irradiation),and high dose AP group(intragastrically administered with AP at the dose of 200 ms/kg daily for 10 d before irradiation),model group(administered with the same volume of normal saline instead of AP for 10 d before irradiation),and control group(irradiated only at 3 different doses).One day after irradiation all rats were killed with their livers being fixed to make paraffin section.The morphological feature was observed under light microscope after HE staining,and the cell apoptosis was detected by TUNEL technology.Results Compared to the control and model groups,the pathological changes of liver were significantly gentler in the AP treatment groups.The apoptosis rates of the liver cells of all the AP sub-groups were significantly lower than those of the control and model subgroup(t=2.19-4.80.P<0.05).Conclusions AP might have prevention effect against radiation exposure.
RESUMO
Objective To study the feasibility of noninvasive detection of unstable plaques with ~(18)F-Fluorodeoxyglu-cose (~(18)F-FDG) PET/CT imaging. Methods Atherosclerotic plaques were induced in male New Zealand white rabbits. Animals were injected with FDG labeled with ~(18)F, then examined with PET/CT. Aorta was explanted for photography with digital camera, and ~(18)F-FDG uptake analysis. Thirty unstable plaques and 30 stable plaques were choosed so as to compare the quantitativly ~(18)F-FDG uptake. The number of macrophages and smooth muscle cells was detected by immunohistochemical technique. Results Experimental group showed inconsistent uptake of ~(18)F-FDG in the abdominal aorta. The results were confirmed in the ex vivo digital photo of the explanted aorta. The target to non target ratio (T/NT) and macrophages of unstable plaques were higher than stable plaques (P<0.01) , but smooth muscle cells obviously reduced (P <0. 01). Correlation analysis showed that there was a positive correlation between T/NT and macrophage content (r=0. 815,P<0. 01), and a negative correlation between T/NT and SMC content(r=-0. 684,P <0. 01). Conclusion ~(18)F-FDG PET/CT can constitute an attractive imaging method for the noninvasive detection of experimental unstable plaques.
RESUMO
AIM: To prepare urokinase-loaded immunoliposomes, with anti-D-dimer mouse monoclonal antibody that can selectively target to thrombotic site and test the thrombolytic effect in the rabbit model of acute pulmonary embolism (PE) in early phase. METHODS: 40 New Zealand white rabbits were randomly divided into five groups: TBS group (TBS buffer, negative control group), urokinase (UK) group (150 000 IU/kg UK, positive control group), Lip group (Lip-UK, containing 50 000 IU/kg UK), Ab group (Ab-Lip-UK, containing 50 000 IU/kg UK) and 2 Ab group (2 Ab-Lip-UK, containing 50 000 IU/kg UK but double DDmAb of Ab group). PE model was established. Five minutes later, five solutions (TBS, UK, Lip-UK, Ab-Lip-UK, 2 Ab-Lip-UK) were transfused through femoral vein respectively. Right ventricular systolic pressure (RVSP) and right ventricular diastolic pressure (RVDP) were estimated within one hour. The pathological changes of lung, heart, liver and kidney were all observed. RESULTS: RVSP in TBS group had no significant changes within one hour after administration. However, RVSP had respective notable decline at 30 min, 40 min, 30 min, 20 min in UK, Lip, Ab and 2 Ab group, respectively. The means of residual emboli were as follows: 4.0±0 in TBS group, 2.4±0.9 in UK group, 3.1±0.6 in Lip group, 2.4±0.9 in Ab group and 1.9±0.6 in 2 Ab group. The lungs in each group showed scattering local congestion, effusion and swelling on the surface. Obvious hemorrhage of heart, kidney and liver was found with HE staining in UK group, no pathologic change was observed in other groups. CONCLUSION: 2 Ab-Lip-UK with early thrombolytic effect and security may be an ideal thrombolytic agent for treating pulmonary embolism.
RESUMO
Objective To evaluate surgical treatment of lower limb ischemia due to combination of thromboangiitis obliterans (TAO) and arteriosclerosis obliterans (ASO). Methods Clinical data of six patients suffering from lower limb ischemia due to TAO and ASO were retrospectively analyzed. All patients had a history of smoking, and complained of rest pain. Three patients had foot ulcer and one had toe gangrene. Two patients reeeived aortie artery endartereetomy combined with FIFE graft bypass to deep femoral artery and below knee popliteal artery plus saphenous vein graft bypass to tibial artery. One patient received aortic thrombectomy and endarterectomy plus aortofemoral and femoropopliteal PTFE graft bypass. One patient with a history of left graft thrombosis after aorto-bifemoral arterial bypass using PTFE graft before admission underwent left PTFE graft thrombectomy via left groin and left deep femoral artery endarterectomy followed by femoropopliteal arterial bypass. One patient received left common iliac artery endarterectomy plus left profound femoral PTFE graft-left anterior tibial arterial bypass using in situ great saphenous vein graft. One patient received right to left femorofemoral arterial bypass using PTFE graft to left posterior tibial artety bypass using reversed great saphenous vein graft. Results One patient receiving aortoiliac thrombectomy and endarterectomy with aortofemoropopliteotibial arterial bypass suffered from graft thrombosis several hours after operation and emergency thrombectomy with distal posterior tibial arteriovenous fistulization was performed. The rest pain disappeared in 5 patients and partially relieved in one. All the grafts were patent on discharge. The foot ulcer reduced in 3 patients. All the 6 patients were followed up with a mean of 6. 5 months. 3 foot ulcers healed. One patient eventually received below knee amputation due to foot gangrene three months later. Conclusion Although it is difficult to treat combined limb ischemia of TAO and ASO, satisfactory results could be achieved when proper surgical procedure is adopted.
RESUMO
@#Objective To explore the effect of speech therapy on articulation disorder of indifferent kinds of children with cerebral palsy(CP).Methods 49 CP children with articulation disorder were divided into the common group(n=21)and family rehabilitation group(n=28).All children in the two groups were treated with systemic speech therapy,but those in the family rehabilitation group were added with family rehabilitation.The changes of articulation disorder of children in two groups before and after treatment were observed.Results After treatment,all children got improvement,but the effect of children with spastic type was superior to those with other CP types.The efficiency rate of the family rehabilitation group was 39.3%,that of the common group was 14.3%,there was a significant difference between two groups(P<0.05).Conclusion The children with different CP type have different therapeutic effects for articulation disorder,the family rehabilitation can improve the therapeutic effect.
RESUMO
Objective To study the feasibility of noninvasive detection of unstable plaques with 18F-Fluorodeoxyglucose (18F-FDG) PET/CT imaging. Methods Atherosclerotic plaques were induced in male New Zealand white rabbits. Animals were injected with FDG labeled with 18F,then examined with PET/CT. Aorta was explanted for photography with digital camera,and 18F-FDG uptake analysis. Thirty unstable plaques and 30 stable plaques were choosed so as to compare the quantitativly 18F-FDG uptake.The number of macrophages and smooth muscle cells was detected by immunohistochemical technique. Results Experimental group showed inconsistent uptake of 18F-FDG in the abdominal aorta. The results were confirmed in the ex vivo digital photo of the explanted aorta. The target to non target ratio(T/NT) and macrophages of unstable plaques were higher than stable plaques(P
RESUMO
OBJECTIVE To compare different methods of processing of homograft costal cartilage. METHODS Homograft costal cartilage samples were processesd by three methods-irradiation, freezing, and alcohol fixation-before being inserted into the rabbit nasal dorsum. They were taken out 12 weeks later and evaluated for histological responses under a optical microscope. RESULTS The histological responses consisted of inflammatory cell infiltration, necrosis, vasal responses and fibroplasia. The was a significant different in degree of inflammatory cell infiltration and necrosis in all three groups(P
RESUMO
AIM: To investigate the effect of volatile anesthetics on function,metabolism,ATPase activity and free radicals in isolated ischemia /reperfusion(I/R) rat hearts.METHODS: 136 SD rats were anesthetized with pentobarbital and randomly divided into six groups and 17 sub-groups(n=8),according to the given drug.In a normal thermal isolated Langendorff rat heart model,four volatile anesthetics in 1.5 MAC concentration were given before global ischemia 25 min and during reperfusion 30 min.Coronary flow(CF),LVEDP,left ventricular developed pressure(LVDP),?dp/dt were monitored at 15 min of equilibrium,15 min of drug treatment,the end of reperfusion.Myocardial adenosine triphosphate(ATP),malodialdehyde(MDA),activity of Ca2+-ATPase and Na+-K+-ATPase,and superoxide dismutase(SOD) were determined at 15 min of equilibrium,15 min of drug treatment or absence,10 min global ischemia and the end of reperfusion.RESULTS: CF and LVEDP were iocreased significantly after exposured to volatile anesthetics 15 min,and LVDP,+dp/dtmax were significantly decreased.However,LVDP and +dp/dtmax were increased at the end of reperfusion in the treated groups.HR in halothane and isoflurane groups was decreased before ischemia and after reperfusion.The myocardial ATP content was significantly increased before and after ischemia in the treated groups.At the end of reperfusion,the activity of SOD was significantly higher and myocardial MDA content was significantly lower in the treated groups than those in control group.The activity of Ca2+-ATPase,compared with the control group,was markedly decreased before ischemia in halothane,enflurane and isoflurane group.Nonetheless,the activity of Ca2+-ATPase was clearly increased in the treated groups during ischemia and at the end of reperfusion.The activity of Na+-K+-ATPase was only enhanced in halothane group at the end of reperfusion among groups.CONCLUSION: The volatile anesthetics depress myocardial systolic function.There are markedly protective effects against myocardial I/R injury.Meanwhile,the volatile anesthetics improve the recovery of function and metabolism,and increase CF and the activity of Ca2+-ATPase and Na+-K+-ATPase in rats.
RESUMO
AIM: To observe the targeting thrombolytic effect of a monoclonal antibody specific for cross-linked fibrin connected with liposomal urokinase(UK) in the model of rabbit artery thrombosis.METHODS: Preparation of thrombolytic solutions: with the method of controllable dialysis eradicator in liposomat, empty liposomes, liposomally entrapped urokinase and liposomally entrapped urokinase linked with D-dimer antibody were made. Experiment in vivo: a rabbit thrombosis model of abdominal aorta was induced by ferric chloride. When the blood pressure fall to the lowest, 5 different solutions were separately imported (PBS, maximal-level UK, Ab/Lip/UK, Ab/UK-Lip, Ab-UK-Lip) and observed for 40 min continuously. RESULTS: The varieties of 5 groups blood pressures were analyzed with q-test. Significant differences were observed among Ab-UK-Lip group, maximal-level UK group and others (P
RESUMO
AIM: To study the effects of 1.5 MAC halothane and sevoflurane on ischemic myocardium. METHODS: The isolated rat heart were perfused with halothane and sevoflurane and HR, LVEDP, LVDP, +d p /d t , -d p /d t , coronary flow (CF), the myocardial ATP content and Ca 2+ -ATPase activity were determined before and 10 min and 25 min after ischemia. In the meantime, LVP was recorded during 25 min ischemia. RESULTS: 1.5MAC sevoflurane significantly increased CF in normal isolated rat hearts. Both halothane and sevoflurane depressed myocardial contractile function, increased normal myocardial energy storage. After 10 min ischemia, the decrease of myocardial ATP content were slowed down by halothane and sevoflurane, especially halothane. During 25 min of ischemia, the onset time of contracture was significantly delayed, and the contracture intensity was alleviated by halothane, but not sevoflurane. CONCLUSION: Halothane has better protective effect on ischemic myocardium than sevoflurane through preventing the decrease of myocardial ATP content and Ca 2+ -ATPase activity during ischemia.