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Objective:To evaluate the effectiveness and safety of the home-made umbrella-shaped Octoparms inferior vena cava filter in the prevention of pulmonary embolism.Methods:A multicenter, randomized, positive parallel controlled, non-inferiority clinical trial was conducted in ten hospitals in China from October 2017 to March 2019. A total of 188 subjects were enrolled according to the same inclusion and exclusion criteria in different institutes. The 188 subjects were randomly divided into the trial group or the control group according to 1∶1 by the central randomization system, with 94 cases in each group. Octoparms inferior vena cava filter was used in the trial group, and the Celect inferior vena cava filter in the control group. The primary effective index was clinical success rate,including the clinical success rate of filter placement and filter retrieval. The secondary index included the rate of manual success of the delivery sheath system,incidence of pulmonary embolism(within 6 months), incidence of filter fracture,migration (>20 mm),tilt(>15°) on insertion/retrieval,and the situation of inferior vena cava flow(within 6 months). Safety evaluation included the incidence of filter related complications and device-related adverse events immediately after surgery and during follow-up.Results:The success rate of implantation was 100% in 188 subjects. Filter retrieval was performed in 87 cases (92.55%) in the trial group and 91 cases (96.81%) in the control group. The clinical success rate of the trial group was 97.87%(92/94) and that of the control group 98.94%(93/94). There was no significant difference between the two groups (χ 2=0.77, P=0.380). The success rate of delivery sheath system was 96.81%(91/94) and 98.94%(93/94) in the trail group and the control group,respectively. There was no significant difference between the two groups( P=0.621). There was 1 case (1.22%) of new asymptomatic pulmonary embolism in the trial group after filter placement and 2 cases (2.44%) in the control group. There was no significant difference between the two groups ( P>0.05). No filter fracture or migration (>20 mm) occurred in either group. The tilting of filter (>15°) was found in 1 case (1.06%) in the test group and 1 case (1.06%) in the control group when the filter was placed. The tilting of filter (>15°) was found in 0 case in the test group and 2 cases (2.44%) in the control group when the filter was retrieved. There was no significant difference between the two groups ( P>0.05). Inferior vena cava thrombosis before filter retrieval was found in 5 cases (5.75%) in trial group and 3 cases (3.30%) in control group. There was no significant difference between the two groups ( P=0.489). There were no immediate serious complications during filter placement/removal in either group. No filter obstruction,migration,deformation,penetration and occlusion of inferior vena cava. The incidence of device-related adverse events was low in both group. There was no significant difference between the two groups ( P>0.05). Conclusion:The home-made umbrella-shaped Octoparms inferior vena cava filter is effective and safe in preventing pulmonary embolism, and is not worse than Celect filter.
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The patient, a 61-year-old female, was admitted to the hospital for 15 days of frequent urination, urgency, painful urination and hematuria. B-ultrasound showed irregular hypoechoic masses on the anterior wall of the bladder. CT showed that the right anterior wall of the bladder protruded into the cavity of the soft tissue mass, which was lobulated, and the edge of the mass showed arc-shaped calcification; enhancement shows that the mass continues to enhance. Cystoscopy showed a lobulated soft tissue mass protruding into the cavity on the right anterior wall of the bladder, and cystoscopy showed tumor-like lesions. The preoperative clinical and imaging diagnosis was a malignant tumor of the bladder. Open partial resection of the right anterior wall of the bladder under general anesthesia, and pathological diagnosis of bladder leiomyosarcoma after surgery. Adjuvant chemotherapy (gemcitabine 1.6 g + epirubicin 80 mg + cisplatin 30 mg) was started 2 months after the operation. The chemotherapy was discontinued after a year, and the patient had no obvious adverse reactions. There were no signs of recurrence and metastasis after a 2-year follow-up.
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Objective To compare the effects of general anesthesia and spinal anesthesia on prognosis of cesarean section in parturients with medium and severe pulmonary arterial hypertension (PAH).Methods Parturients with medium and severe PAH,at ≥ 24 weeks of gestation,aged 20-45 yr,undergoing elective cesarean section under general or epidural anesthesia from November 1,2011 to December 31,2017 in our hospital,were divided into general anesthesia group and epidural anesthesia group according to the anesthetic method.General anesthesia was combined intravenous-inhalational anesthesia.The highest temperature within 5 days after surgery,the lowest SpO2 (inhaling oxygen 2-4 L/min via a nasal tube) within 3 days after surgery,duration of intensive care unit stay,time of postoperative use of antibiotics,requirement for targeted drugs for pulmonary hypertension,results of laboratory tests (blood biochemistry,coagulation function),postoperative mechanical ventilation,length of hospital stay,and hospitalization costs were recorded.The Apgar score and weight of the newborn,postoperative complications and death of the newborn and parturients in hospital were recorded.Cox regression analysis was used to identify the risk factors after cesarean section in parturients with medium and severe PAH.Results Fifty-seven parturients were enrolled in this study,with 21 cases in general anesthesia group and 36 cases in epidural anesthesia group.Compared with general anesthesia group,the rate of postoperative mechanical ventilation was significantly decreased,the incidence of adverse events of parturients in hospital and mortality rate were decreased,the postoperative level of albumin was increased,activated partial thromboplastin time was shortened (P＜0.05),and no significant change was found in the other parameters in epidural anesthesia group (P＞ 0.05).The results of Cox regression analysis showed that anesthetic method and preoperative SpO2difference were independent risk factors for cesarean section-related adverse events and death of parturients with medium and severe PAH.The risk of adverse events and death of parturients was significantly higher in general anesthesia group than in epidural anesthesia group (P＜0.05).Conclusion Epidural anesthesia produces better prognosis than general anesthesia when used for cesarean section in parturients with moderate and severe PAH.
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Objective To evaluate AngioJet in patients treated for acute deep venous thrombosis (DVT) by mechanical aspiration thrombectomy combined with catheter-directed thrombolysis (CDT).Methods A retrospective analysis of 83 acute DVT patients treated by mechanical aspiration thrombectomy combined with CDT from Dec 2014 to Oct 2018 in the Third Hospital of Hebei Medical University was conducted.Results 43 cases (routine group) were treated by mechanical aspiration thrombectomy using a large-caliber catheter combined with CDT,and 40 cases (AngioJet group) were treated by AngioJet aspiration thrombectomy combined with CDT(P ＞ 0.05).Thrombosis was completely dissolved in 28 cases in AngioJet group while in 10 cases in large-caliber catheter group.Venous damage rate was higher (38 cases vs.13 cases) in routine group.Conclusion AngioJet combined with CDT can effectively and safety remove thrombus in the lower extremity deep venous system.
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To analyze the prognostic factors for patients with or without cardiovascular diseases after craniotomy for aneurysm clipping, and to provide evidences for the improvement of perioperative management in these patients. Methods: We collected 297 patients who underwent craniotomy for aneurysm clipping in Xiangya Hospital of Central South University from May 2016 to February 2017. The patients were divided into two groups: the cardiovascular disease group and the non-cardiovascular disease group. The perioperative clinical data, neurological function assessments at admission and discharge and Glasgow Outcome Scale (GOS) scores of one-year-follow-up after discharge were analyzed. The primary outcome of this study was the GOS scores collected at one year after discharge. The secondary outcomes were the lengths of their ICU stay, neurological functions at discharge and adverse events morbidity during the hospitalization. Results: A total of 241 patients were eventually enrolled. There was no significant difference in their general data between the two groups except for their ages. The GOS scores of the one-year-follow-up were significantly different between the two groups (P=0.007). The lengths of ICU stay, neurological dysfunctions at discharge and adverse events morbidity during hospitalization were also significantly different (P=0.036, P=0.011, P=0.005, respectively). A multivariate logistic regression analysis in which GOS score was the dependent variable with age adjusted also supported the previous results that long-term prognosis was not significantly correlated with the age of patients (P>0.05), but it was correlated with cardiovascular disease and sanity at admission (P=0.001). In patients with cardiovascular diseases, there was significantly different in perioperative mortality and neurological recovery of patients who had or had not cardiovascular events (P=0.006, P=0.001, respectively). Conclusion: Undergoing craniotomy for aneurysm clipping, patients with cardiovascular diseases have worse outcomes in both of short and long terms. Perioperative treatments for cardiovascular disease could not only improve postoperative neurological deficits, but also reduce mortality for these patients.
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Humanos , Craniotomia , Aneurisma Intracraniano , Período Pós-Operatório , Prognóstico , Resultado do TratamentoRESUMO
Objective To investigate the CT characteristics of ectopic pheochromocytoma and improve the diagnostic accuracy. Methods The CT imaging of 27 cases with surgery and pathology proved ectopic pheochromocytoma were retrospectively analyzed, and the tumor site, size, shape, density, cystic change, calcification, boundary and strengthening characteristics of these tumors were observed. Results Tumor located in mesentery in 6 cases and in the left side of abdominal aorta in 6 cases. Tumor located in duodenal ampulla, inferior vena cava, hepatic hilum, left renal portal, right adrenal gland and bladder in 2 cases for each spot. Tumor located in right jugular foramen, left carotid body and right lower lung in 1 case for each spot. The maximum diameter of the tumor was 2.8-19.0 (6.3 ± 2.4) cm. CT plain scan showed low density in 9 cases, isodensity in 10 cases, and high density in 8 cases. CT value was 20-58 (35.0 ± 11.6) HU. Enhanced CT scan showed that the CT value was 40-96 (74.0 ± 16.4) HU, 37- 90 (63.0 ± 14.2) HU in venous phase and 35-67(55.0 ± 12.6) HU in delayed phase. In arterial phase, 15 cases showed marked enhancement in parenchyma, 5 cases showed moderate enhancement, and 7 cases showed mild enhancement. In venous phase, the degree of enhancement decreased significantly in 5 cases, slightly in 15 cases, and continued in 7 cases. In delayed phase, the degree of enhancement decreased in 20 cases and continued in 7 cases. Conclusions The CT findings of ectopic pheochromocytoma have certain characteristics, CT examination is helpful to locate and characterize ectopic pheochromocytoma and to clarify the relationship between tumor and surrounding tissue structure.
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Objective To investigate the multi-slice CT (MSCT) imaging features of pancreatic neuroendocrine carcinoma (PNEC). Methods A retrospective analysis of the MSCT and pathological findings of 10 PNEC patients confirmed by surgery and pathology was performed. Results Among the 10 patients, the tumor locating at pancreatic head was in 1 case, at pancreatic body was in 1 case, and at pancreatic tail was in 8 cases. The maximum diameter was 1.8-8.5 (4.7 ± 3.6) cm. The boundary between mass and normal pancreas was unclear, among which there was a circle-like shape in 4 cases, and irregular shape in 6 cases. The plain scan showed that there were cystic changes in the mass, including cystic lesion locating in the center of the lesion in 7 cases, and that locatingd in the periphery of the lesion in 3 cases. The plain CT value was (36.0 ± 8.3) HU. The enhancement scan showed that the circumference was mainly ring enhancement, the arterial phase CT values was (78.0 ± 6.7) HU, the portal venous phase CT values was (83.0 ± 8.2) HU, and the balanced phase CT values was (69.0 ± 9.1) HU. Under the microscope, found that the tumor were made up of small cells and large cells, the tumor tissue was invasive. The atypia of tumor cells was obvious, diffuse and distribution was diffuse, with necrosis. The nuclear division was more common. The immunohistochemical result showed that synaptophysin (Syn) positive was in 10 cases, neuron-specific enolase (NSE) positive was in 7 cases, chromogranin A (CgA) positive was in 7 cases, and CD56 positive was in 6 cases; the percentage of Ki-67 expression positive cell < 3% was in 3 cases, 3%-20% was in 4 cases, and ＞20% was in 3 cases. Conclusions The MSCT imaging findings of PNEC has certain characteristics, and multi-period dynamic contrast-enhanced scan is helpful for the diagnosis of pancreatic neuroendocrine carcinoma.
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Objective:To determine the intervention measures for the decrease of cerebral tissue oxygen saturation during anesthesia for the congenital heart disease in children.Methods:Twenty-eight children with cardiac surgery were enrolled.Anesthesia was deepened with propofol (3 mg/kg) intravenous injection.The data of cerebral tissue oxygen saturation(SctO2),mean arterial pressure (MAP),HR,bispectral index (BIS),arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2),hemoglobin (Hb) and middle cerebral artery (MCA) mean flow velocity (Vm) at different points were collected after intravenous injection ofpropofol at 3 mg/kg.The changes of SctO2 and the influential factors were analyzed.Results:SctO2 decreased by 4.99％ after deepen anesthesia,with 95％ CI 4.33％ to 5.65％ (P＞0.05).There was no significant differince in MAP,PaO2,PaCO2,and Hb between the time points after deepen anesthesia and the baseline (P＞0.05).MCA Vm decreased obviously after deepen anesthesia for 1,5,10 min (P＜0.05).The decrease in MAP,HR,PaCO2 and MCAVm is positively correlated with the decrease in SctO2.Conclusion:The decrease of MAP,HR,PaCO2,and MCAVm is the risk factor for SctO2.To avoid the decrease,it needs to maintain the stability of SctO2 and prevent neurological complications.
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Objective To investigate radiological features on computed tomography (CT) in the di agnosis of portal venous and intestinal wall gas in patients with ischemic bowel disease.Methods The clinic-pathological data of 17 patients with portal venous and intestinal gas associated with ischemic bowel diseases from Wenzhou People's Hospital (n =6),Yueqing People's Hospital (n =5),Shanghai Xuhui Dahua Hospital (n =3) and the Second Affiliated Hospital of Wenzhou Medical University (n =3) from January 2013 to October 2016 were analysed retrospectively.All the patients have been fasting for 8 h prior to CT scans.Enhanced CT study was performed following routine CT with no abdominal pressure for breath less scanting.Portal venous gas,intestinal wall gas,intestinal thickness and density,mesentery thickness,celiac effusion,and severity of intestinal wall enhancement were recorded.Results All the 17 patients ex perienced abdominal distension and pain.Additionally,nausea and vomiting was observed in 9 patients,di arrhea in 7,melena in 7,periumbilical tenderness in 11 and rebound tenderness in 8.CT scans of these 17 patients showed portal venous gas,including massiveprune-tree signs of hepatic vein and portal vein (n =11) and scanty gas shadows in distal hepatic vein (n =6).Intestinal gas sign was determined in all these patients (n =17),including single bubble shadow (n =8),multiple bubble shadow (n =7),and band-shaped bubble (n =2).Furthermore,CT study indicated extensive intestinal wall thickening with edema (n =13),predominate luminal extension of thinner bowels (n =4),scanty celiac effusion (n =3).Enhanced CT scans demonstrated 8 patients with decreased enhancement of intestinal wall and mesentery with diseases,target and halo signs observed in enhanced scans.Conclusions Portal venous and intestinal wall gas may demonstrate distinctive CT imaging.CT study could have superior sensitivity and spe cialty in clinical diagnoses of ischemic bowel diseases.
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Objective To evaluate the carotid and left ventricular function changes in patients with subclinical atherosclerosis (SA) using echo-tracking (ET) and three-dimensional speckle tracking echocardiography (3D-STE).Methods Eighty patients with SA were divided into low-risk group (27 cases),middle-risk group (26 cases) and high-risk group (27 cases) according to the Framingham risk score (FRS).Each of them was examined by echocardiography and carotid ultrasound to obtain the parameters including carotid intima-media thickness (cIMT),stiffness parameter (β),Pressure-strain elastic modulus (Ep),pulse wave conducting velocity(PWVβ),LV peak systolic global longitudinal strain (GLS),LV peak systolic global circumferential strain (GCS),myocardial wall stress (MWS) and left ventricular ejection fraction(LVEF) for analysis.The study got approval from the Ethics Committee of Tongji Medical College,Huazhong University of Science and Technology (NO:IORG00371).Results Ep,left atrial volume (LAV) and MWS had significantly differences among the three groups (all P ＜0.05).Compared with low-risk group,cIMT,β,PWVβ were higher and GLS was lower in high-risk group (all P ＜0.05).There were no statistical difference in LVEF and GCS among the three groups (all P ＞ 0.05).β was positively correlated with age and FRS,and negatively correlated with GLS (all P ＜ 0.05).LAV was positively correlated with age and E/e (all P ＜0.05).GLS was negatively correlated with FRS and β (all P ＜ 0.05).MWS was positively correlated with β and SBP,and negatively correlated with LVEF (all P ＜0.01).Conclusions ET combined with 3D-STE could be applied to evaluate the carotid and left ventricular function accurately in patients with subclinical atherosclerosis,and provide scientific bases for establishing intervention strategy.
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Objective To evaluate the efficacy and safety of ureteral stenting after transurethral resection ( TUR) of bladder tumors involving the ureteral orifice.Methods From March 2009 to November 2015,34 cases of non-muscle invasive bladder tumor including 28 male and 6 female aged from 26 to 79 years( mean 51 years) were treated by TUR.14 cases had single tumor and 20 had multiple tumors,and 29 were primary and 5 were recurrent.All the patients had tumors involving the ureteral orifice without preoperative hydronephrosis revealed by IVU or CTU examination.The tumors were resected into the deep muscle layer and the involved ureteral orifices were resected during the procedure,and after that a double-J ureteral stent was placed in 18 cases.All patients received one immediate intravesical instillation of 50mg epirubicin after TUR, and further scheme of adjuvant intravesical chemotherapy instillations were made according to the pathological diagnosis.Ureteral stents were removed 10-12 weeks after TUR,and cystoscopy and urinary tract ultrasound examinations were performed every 3 months for 1-2 years postoperatively. Results The operations were successful without complications.No serious adverse reaction occurred in immediate and further adjuvant intravesical chemotherapy.During the follow-up period of 3-71 months, no ureteral stricture, hydronephrosis or tumor recurrence in the upper urinary tract occurred in all the 18 patients with ureteral stent, and the resected ureteral orifices recovered well with normal appearance and ejecting urine.Hydronephrosis was observed in 3 of 16 patients without ureteral stent including 2 cases of nontumoral stenosis at the ureterovesical junction requiring ureteral reimplantation and 1 case of lower ureteral tumor on the involved side requiring nephroureterectomy and bladder cuff excision.No patient complained of symptoms secondary to vesicoureteral reflux or continuous unrelievable lower urinary tract symptoms.2 cases of bladder tumor recurred out of the resected area.Conclusions Ureteral stenting after TUR of bladder tumors involving the ureteral orifice can prevent stricture at the ureterovesical junction without increasing the risk of tumor cell seeding along the upper urinary tract.The existence of a double-J ureteral stent does not increase complications of adjuvant intravesical chemotherapy, and also won't cause intolerable lower urinary tract symptoms.
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Objective:To investigate the methods and complications of ultrasound-guided percutaneous nephrostomy (PCN) for treat-ing cancer-related hydronephrosis. Methods:From June 2003 to December 2015, 289 patients (342 kidneys) with cancer-related hy-dronephrosis were treated by ultrasound-guided PCN in Fujian Provincial Hospital. Among the 97 cases of renal insufficiency, 4 pa-tients were treated with hemodialysis before PCN. Except for the anterior mid calyx of nine kidneys in nine patients, the posterior mid or lower pole calyx of all other kidneys was punctured with ultrasound guidance. With the one-step PCN technique, 8F pigtail nephros-tomy tubes were placed into six kidneys in six patients;with the Seldinger PCN technique, 14F balloon and Malecot catheters were placed into 25 kidneys in 25 patients and 311 kidneys in 258 patients, respectively. Results:No severe bleeding and injury in the intes-tine, liver, spleen, pleura, or lung occurred. Two pigtail tubes were blocked one week after PCN. Seven balloon catheters failed to drain well because of the tip and balloon of the catheters located in the proximal part of the dilated ureters. Four balloons slipped out of the collection system of the kidney because of the auto-deflation of three balloons and one case of meager renal parenchyma failing to hold the balloon after a severe hydronephrosis was emptied. All, except 1, Malecot catheter drained well, and 8/9 PCNs through anteri-or mid calyx were successful. Serum creatinine levels were significantly decreased in all the 97 patients with renal insufficiency, of which 81 cases returned to normal, and no one needed persistent hemodialysis. Conclusion:Ultrasound-guided PCN is safe and effec-tive for treating cancer-related hydronephrosis. For appropriately selected patients, puncturing the anterior mid calyx may be an op-tion without additional complications. One-step pigtail nephrostomy tubes are recommended for patients with poor systemic condi-tions. For patients with long life expectancy or suspected complicated urinary infection, large sized Malecot catheters should be consid-ered.
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Objective To investigate the MRI characteristics of low grade fibromyxoid sarcoma (LGFMS).Methods The MRI imaging of 13 cases with operation and pathology proven low grade fibromyxoid sarcoma were retrospectively analyzed.Comparative study of the relationship between the signal,boundary,cystic,and the enhancement degree with tumor tissue components was performed.Results The tumors were located in thigh (n=7),lower leg (n=3),elbow,shoulder and upper arm (n=l for each).The average diameter of tumor was (7.01 ±2.89) cm (range from 2.5 to 12.0 cm).The tumors with maximal diameter larger than 5 cm were seen in 11 patients.All tumors had well-defined margin.Necrosis and cystic change was seen in 5 tumors,tumor compartment in 3 cases,intratumoral fluid fluid level in 2 cases,and peritumoral edema in 3 cases.T1WI showed hypointensity in 6 cases,iso-,hopointensity in 4 cases,isointensity with slightly hyperintensity in tumor center in 4 cases,heterogeneous intensity in 1 case.T2WI showed hyperintensity in 6 cases,central higher intensity in 4 cases,hyper-,iso-,hypo-intensity in 4 cases,and hyper-,hypo-intensity in 3 cases.T2WI with fat suppression sequence showed hyper-,iso-,hypo-intensity in 8 cases and high intensity solid part and much higher intensity in tumor center in 5 cases.Heterogeneous enhancement of the tumors was noted,including mild enhancement in 8 cases,moderate enhancement in 4 cases,and marked enhancement in one case.Pathological results showed that the tumors were gray and white or yellow,well-defined,and hard texture,in which 5 cases cystic degeneration with tremelloid material can be seen in 5 cases.Microscopy results showed alternating distribution of fibrous and myxoid areas.Nine cases had rosettes formation and characteristic arcuate vessels were seen in 2 tumors.Immunohistochemical results showed negative Vimentin,Desmin,and S-100 in 5 patients,while 3 patients were positive for SMA and CD34.Conclusions LGFMS has some characteristic MRI finding.Combination of MRI and the clinical findings can suggest the diagnosis of LGFMS,however,the final diagnosis depends on pathological examination.
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Objective To investigate the predictive value of Alberta stroke program early CT score on diffusion-w eighted imaging (DWI-ASPECTS) for predicting new cerebral microbleeds (CMBs) in patients w ith acute middle cerebral artery infarction. Methods The patients w ith acute middle cerebra artery infarction w ere enroled prospectively. MRI examinations w ere completed w ithin 48 h on admission and they w ere examined again at 10 to 14 d after onset. Susceptibility-w eighted imaging (SWI) w as use to detect CMBs. DWI-ASPECTS w as used to assess the infarction extent. Results A total of 82 patients w ith acute middle cerebra artery infarction w ere enroled, including 27 females and 55 females. Their ages w ere 71.7 ± 8.9 years. Eighteen patients (22.0%) had old CMBs, 25 (30.5%) had new CMBs, 57 (69.5%) did not have new CMBs. Compared w ith the non-new CMB group, DWI-SPECTS (3.20 ±1.73 vs.7.11 ±1.69;t = 9.573, P 5), the risk of new CMBs w ould decrease 86 % (odds ratio 0.14, 95%confidence interval 0.17 -0.48; P < 0.001). Receiver operating characteristic curve analysis show ed that the sensitivity of prediction of DWI-ASPECTS ≤5 for the new CMBs w as 87.7%, specificity w as 88.3%, and the area under the curve w as 0.940. Conclusions DWI-ASPECTS can effectively predict the new CMBs in patients w ith acute middle cerebra artery infarction.
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Abstract A new microfluidic system with four different microchambers （a circle and three equilateral concave polygons） was designed and fabricated using poly（dimethylsiloxane） （PDMS） and the soft lithography method. Using this microfluidic device at six flow rates （5, 10, 20, 30, 40, and 50 μL/h）, the effects of microenvironmental geometry and aqueous flow on bacterial adhesion behaviors were investigated. Escherichia coli HB101 pGLO, which could produce a green fluorescent protein induced by L-arabinose, was utilized as the model bacteria. The results demonstrated that bacterial adhesion was significantly related to culture time, microenvironment geometry, and aqueous flow rates. Adhered bacterial density increased with the culture time. Initially, the adhesion occurred at the microchamber sides, and then the entire chamber was gradually covered with increased culture time. Adhesion densities in the side zones were larger than those in the center zones because of the lower shearing force in the side zone. Also, the adhesion densities in the complex chambers were larger than those in the simple chambers. At low flow rates, the orientation of adhered bacteria was random and disorderly. At high flow rates, bacterial orientation became close to the streamline and oriented toward the flow direction; All these results implied that bacterial adhesion tended to occur in complicated aqueous flow areas.The present study provided an on-chip flow system for physiological behavior of biological cells, as well as provided a strategic cue for the prevention of bacterial infection and biofilm formation.
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A new microfluidic system with four different microchambers (a circle and three equilateral concave polygons) was designed and fabricated using poly(dimethylsiloxane) (PDMS) and the soft lithography method.Using this microfluidic device at six flow rates (5,10,20,30,40,and 50 μL/h),the effects of microenvironmental geometry and aqueous flow on bacterial adhesion behaviors were investigated.Escherichia coli HB101 pGLO,which could produce a green fluorescent protein induced by L-arabinose,was utilized as the model bacteria.The results demonstrated that bacterial adhesion was significantly related to culture time,microenvironment geometry,and aqueous flow rates.Adhered bacterial density increased with the culture time.Initially,the adhesion occurred at the microchamber sides,and then the entire chamber was gradually covered with increased culture time.Adhesion densities in the side zones were larger than those in the center zones because of the lower shearing force in the side zone.Also,the adhesion densities in the complex chambers were larger than those in the simple chambers.At low flow rates,the orientation of adhered bacteria was random and disorderly.At high flow rates,bacterial orientation became close to the streamline and oriented toward the flow direction.All these results implied that bacterial adhesion tended to occur in complicated aqueous flow areas.The present study provided an on-chip flow system for physiological behavior of biological cells,as well as provided a strategic cue for the prevention of bacterial infection and biofilm formation.
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Objective To explore the value of wave intensity (WI) parameters in evaluating hemodynamic changes of cardiovascular system before and after 131I therapy in hyperthyroid patients.Methods Forty-seven hyperthyroid patients were enrolled as hyperthyroid group,while 47 healthy volunteers were considered as control group.Both of the hyperthyroid and control group took WI examinations,and WI curves of their right common carotid arteries were recorded.WI parameters of WI curve were automatically measured as followed:value of the first positive peak (W1),value of the second positive peak (W2),area of the negative peak (NA),and the square root of NA (A).Twenty-five patients of the hyperthyroid group received 131I therapy were enrolled as treatment group.All these patients were followed up for 3 months.The repeatability of the WI parameters was evaluated in 10 hyperthyroid patients and 10 normal volunteers selected at random from the investigation.Results W1,W2,A in hyperthyroid group increased compared with those in control group,and independent-samples t test showed very significant difference (P=0.000,P=0.000,P=0.000).W1,A decreased after 131I therapy compared with those before treatment,and paired-samples t test showed significant difference (W1:P=0.001;A:P=0.011).A in hyperthyroid group had positive correlation with FT3 (r=0.508,P=0.003);W1 after 131I therapy in treatment group had positive correlation with FT3 and FT4 (r=0.601,P=0.002;r=0.680,P=0.00);W2 after 131I therapy in treatment group had positive correlation with FT3 and FT4 (r=0.549,P=0.005;r=0.570,P=0.004).The repeatability of W1,W2,NA and A were good by consecutive measurement of identical observer.Conclusions WI peak parameters of hyperthyroid patients were higher than those of healthy volunteers,and some sensitive parameters were decreased after 131I therapy,which may provide the basis for assessing the effectiveness of 131I therapy.
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This study aimed to examine the preparation of cationic lipid microbubble (CLM), and evaluate its physical and chemical properties and toxicity, measure the gene transfection efficiency by ultrasound triggered microbobble destruction (UTMD) in combination with CLM. The CLM was prepared by the method of the thin film hydration, and its morphology was observed under the electron microscopy at 1st, 3rd, 7th, 10th, and 14th day after preparation, respectively. The size, Zeta potential and stability of CLM were tested. The acute toxicity of CLM was assessed. The green fluorescent protein gene (EGFP) transfection efficiency was evaluated. The experiment grouping was as follows: naked plasmid group (P group), ultrasonic irradiation plus naked plasmid group (P-US group), naked plasmid plus CLM group (P-CLM group), naked plasmid plus ultrasound and CLM group (UTMD group). The expression of EGFP was detected by fluorescent microscopy and flow cytometry. The results showed that CLMs were spherical in shape, with the similar size and good distribution degree under the light and electron microscopies. The size of CLMs was varied from 250.4±88.3 to 399.0±99.8 nm and the Zeta potential of CLMs from 18.80±4.97 to 20.1±3.1 mV. The EGFP expression was the strongest in the UTMD group, followed by the P-CLM group, P-US group and P group. Flow cytometry results were consistent with those of fluorescent microscopy. The transfection efficiency was substantially increased in the P-US group, P-CLM group and UTMD group as compared with that in the P group, almost 7 times, 10 times and 30 times higher than that in the P group respectively. It is suggested that CLMs prepared by the method of thin film hydration are uniform in diameter, and proved non-toxic. UTMD combined with CLM can significantly increase the transfection efficiency of EGFP to targeted cells.
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This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1st), interval between W1 and W2 (1st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the W1, W2, NA, and (1st-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with W1, W2, NA, (1st-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.
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Objective To explore the characteristics of resting myocardial perfusion of type 2 diabetes mellitus(T2DM) by real-time myocardial contrast echocardiography(RT-MCE). Methods Thirteen patients with T2DM and 12 in control were enrolled in the study. RT-MCE was performed using a continuous infusion of SonoVue with vena mediana in elbow. Images of left ventricle filled with contrast were acquired from apical 4-, 2-chamber and long axis views with real-time myocardial contrast mode of GE Vivid 7 Dimension system. All above images were captured in continuous 3 cardiac cycles before "flash" ,and then 15 cardiac cycles after "flash". All clips were stored for off-line analysis. Results In quiescent condition, there were significant decrease on indices of A,k and A × k in patients compared with control group (A:6.46 ±1.60 vs 6.81 ± 1.53, P ＜0.05;k:1.04 ± 0.39 vs 1.28 ± 0.31*, P ＜0.01;A× k:6.55 ± 2.72 vs 8.78 ±3.16, P ＜ 0.01, respectively). Conclusions RT-MCE could evaluate the early change of myocardial perfusion in T2DM patients and offers important reference for clinical diagnosis and treatment.