Early outcome of transapical transcatheter aortic valve replacement for aortic insufficiency / 中国胸心血管外科临床杂志

@#Objective    To assess the early outcome of transapical transcatheter aortic valve replacement (TAVR) for patients with aortic insufficiency. Methods    The patients with aortic valvular disease who underwent transapical TAVR from October 2020 to October 2022 in the Department of Cardiac and Vascular Surgery, the First Affiliated Hospital of Anhui Medical University were enrolled in the current retrospective study. The patients with aortic stenosis were assembled in a group A, and the patients with aortic insufficiency were assembled in a group B. The improvements of heart function and complications were assessed for the two groups. Results    A total of 56 patients were enrolled, including 32 males and 24 females with an average age of 73.34±5.10 years. There were 31 patients in the group A and 25 patients in the group B. There was no statistical difference between the two groups in the age, gender, height, weight, hypertension, coronary artery disease, peripheral vascular disease, chronic obstructive pulmonary disease, renal disorder or classification of heart function (P>0.05). Also, there was still no statistical difference in the rate of permanent peacemaker implants, emergent open surgery, valve re-implants, or perivalvular leakage (P>0.05). After TAVR, the left ventricular diastolic diameter, left ventricular ejection fraction, complicated moderated mitral and tricuspid regurgitation were significantly improved in both groups compared with preoperative findings (P<0.05); however, there was no statistical difference in these parameters between groups (P>0.05). Conclusion    Interventional valve (J-Valve) in the treatment of patients with aortic insufficiency through transapical TAVR significantly improves cardiac function and reduces functional valve regurgitation.

cGAS enhances the HTLV-1 reverse transcription intermediate ssDNA90-induced innate immune re-sponses / 中华微生物学和免疫学杂志

Objective To investigate the role of cyclic GMP-AMP synthase (cGAS),a cytosolic DNA sensor,in regulating innate immune responses induced by reverse transcription intermediate of human T cell leukemia virus type 1 (HTLV-1). Methods (1)ssDNA90,the reverse transcription intermediate of HTLV-1,was transfected into HeLa cells to observe changes in the expression pattern of cGAS in transfected-HeLa cells with immunoblot assay. (2) HeLa cells were firstly transfected with cGAS-encoding plasmid and then ssDNA90 24 hours later. Real-time PCR was used to measure the expression of interferon ( IFN)-β, IFN-gamma-inducible protein 10 ( IP-10 ), regulated on activation, normal T cell expressed and secreted (RANTES) and tumor necrosis factor (TNF)-α. Immunoblot assay was performed to measure phosphorylated interferon regulatory factor 3 (IRF3) and p65. (3)cGAS expression was silenced by siRNA in HeLa and phorbol-12-myristate-13-acetate (PMA)-treated THP1 (PMA-THP1) cells and then ssDNA90 was transfect-ed into these cells 24 hours later. Real-time PCR was used to measure the expression of IFN-β,IP-10,RAN-TES and TNF-α. Immunoblot assay was performed to measure phosphorylated IRF3 and p65. Results Ex-pression of cGAS was increased in HeLa cells after ssDNA90 transfection. Compared with control cells, cGAS-transfected HeLa cells showed increased expression of IFN-β, IP-10, RANTES and TNF-α and en-hanced phosphorylation of IRF3 and p65 after ssDNA90 transfection. Compared with control cells,both HeLa and PMA-THP1 cells with silenced expression of cGAS showed impaired production of IFN-β,IP-10,RAN-TES and TNF-α after ssDNA90 transfection. Moreover,ssDNA90-induced phosphorylation of IRF3 and p65 were decreased after cGAS gene-knockdown. Conclusion cGAS might promote HTLV-1 RTI ssDNA90-in-duced innate immune responses.

Cyclic GMP-AMP synthase ( cGAS) inhibits the replication of human T cell leukemia virus type 1 (HTLV-1) in HeLa cells through regulating innate immune response / 中华微生物学和免疫学杂志

Objective To investigate the function and the possible mechanism of cyclic GMP-AMP synthase (cGAS), a DNA sensor, in HeLa cells during human T cell leukemia virus type 1 (HTLV-1) in-fection.Methods HeLa cells were co-cultured with MT2 cells (HTLV-1-positive T cells) and then detec-ted by immunoblot assay to analyze the changes in the expression of cGAS .A hemagglutinin ( HA)-tagged cGAS plasmid was constructed and transfected into HeLa cells .Twenty-four hours after transfection , these cells were co-cultured with MT2 cells for another 24 hours.Immunoblot assay was used to detect the expres-sion of HTLV-1 proteins Tax and p19.Real-time PCR was performed to measure the expression of HTLV-1 Tax, p19, Env, HBZ and px at mRNA level .Immunoblot assay was also used to analyze the phosphorylation of interferon regulatory factor 3 (IRF3) and p65.Expression of interferon (IFN)-β, IFN-gamma-inducible protein 10 ( IP-10 ) , RANTES ( regulated on activation , normal T cell expressed and secreted ) and tumor necrosis factor (TNF)-αwas detected by real-time PCR assay.Results Expression of cGAS was enhanced in HeLa cells after co-cultured with MT2 cells.Compared with control cells , the HeLa cells that were trans-fected with cGAS plasmid showed lower levels of Tax and p 19 proteins, suppressed expression of HTLV-1 Tax, p19, Env, HBZ and px at mRNA level , enhanced phosphorylation of IRF 3 and p65, and higher levels of IFN-β, IP-10, RANTES and TNF-αafter co-cultured with MT2 cells.Conclusion cGAS might promote the innate immune response and inhibit HTLV-1 replication in HTLV-1-infected HeLa cells .

Effect of dexmedetomidine postconditioning combined with limb ischemic postconditioning on myocardial ischemia-reperfusion injury in rats / 中华麻醉学杂志

Objective To evaluate the effect of dexmedetomidine postconditioning combined with limb ischemic postconditioning on myocardial ischemia-reperfusion (I/R) injury in rats.Methods Fifty male Sprague-Dawley rats,aged 2-3 months,weighing 275-335 g,were randomly divided into 5 groups (n =10 each) using a random number table:sham operation group (group S);I/R group;dexmedetomidine postconditioning group (group DP);limb ischemic postconditioning group (group LP);dexmedetomidine postconditioning combined with limb ischemic postconditioning group (group DLP).Myocardial I/R was induced by occlusion of the left anterior descending branch of coronary artery for 30 min followed by 180 min reperfusion.At 15 min before reperfusion,dexmedetomidine 50 μg/kg was injected intraperitoneally in DP and DLP groups,while normal saline 0.5 ml was injected intraperitoneally in I/R and LP groups.In LP and DLP groups,the animals underwent 10 min ischemia of bilateral hind limbs starting from 10 min before reperfusion,followed by reperfusion.Blood samples were taken from the internal carotid artery at 180 min of reperfusion for determination of the plasma creatine kinase-MB (CK-MB) and glutathione peroxidase (GSH-Px) activities and the concentrations of cardiac troponin I (cTnI),malondialdehyde (MDA),interleukin-1beta (IL-1β),IL-6 and tumor necrosis factor-alpha (TNF-α).Myocardial specimens were obtained at 180 min of reperfusion for determination of the myocardial infarct size.Results Compared with group S,the plasma CK-MB activity,myocardial infarct size and plasma cTnI,MDA,TNF-α,IL-1β and IL-6 concentrations were significantly increased,and GSH-Px activity was significantly decreased in I/R,DP,LP and DLP groups (P＜0.05).Compared with group I/R,the plasma CK-MB activity,myocardial infarct size and plasma cTnI,MDA,TNF-α,IL-1β and IL-6 concentrations were significantly decreased,and the GSH-Px activity was significantly increased in DP,LP and DLP groups (P<0.05).Compared with DP and LP groups,the plasma CK-MB activity,myocardial infarct size and plasma cTnI,MDA,TNF-α,IL-1β and IL-6 concentrations were significantly decreased,and the GSH-Px activity was significantly increased in group DLP (P ＜ 0.05).Conclusion Dexmedetomidine postconditioning combined with limb ischemic postconditioning provides better efficacy than either alone in reducing the myocardial I/R injury in rats,and the mechanism may be related to the inhibition of lipid peroxidation and systemic inflammatory responses.

Application of located needles guided by intraoperative ultrasound in resection of brain cavernous malformations / 中华超声影像学杂志

Objective To explore the value of the located needles guided by intraoperative ultrasound in resection of brain cavernous malformations. Methods Fourteen patients diagnosed as brain cavernous malformations confirmed by preoperative CT and MRI. Detected by the located needles under intraoperative ultrasound guidance, 14 lesions were excised. Results Intraoperative ultrasound-guided needles accurately located 14 cases of patients with brain cavernous malformations. Fourteen lesions were removed successfully. The distances between lesions and the dura mater were 1.5-2.9 cm,the sizes of lesions were 0.8-2.8 cm. Fourteen lesions by color Doppler flow imaging showed point-like blood flow. Conclusions Brain cavernous malformations can be accurately detected by the located needles under intraoperative ultrasound guidance.

Experiment and clinical study of contrast-enhanced ultrasonography in evaluating brain injuries / 中华超声影像学杂志

Objective To explore the value of contrast-enhanced ultrasonography(CEUS) in brain injuries. Methods ① Models of graded brain trauma were created in brains of 10 healthy mongrel dogs after the animals were anesthetized and the cranium were removed. Conventional ultrasonography(US) and CEUS were performed to observe the characteristics of traumatic region. ② Thirteen patients with traumatic brain injuries were collected to perform intraoperative ultrasonography. The location, depth, size, internal echo and boundary of traumatic brain injuries were clearly displayed. Eight injury sites were chosen to undergo CEUS. Results ① Twelve injury sites in brains of 10 dogs were detected,and CEUS were peformed in 10 lessions, of which 1 was diagnosed with cerebral contusion, 1 with cerebral contusion and cerebral hemorrhage, 7 with intracerebral hematoma, 2 with ventricular hematoma, 1 with blood vessels in intracerebral hematoma. ② Fifteen lesions were detected by preoperative CT scan, but 18 lessions were detected by intraoperative ultrasound. During operation epidural hematomas in 4 cases were detected. After CEUS,the area of lessions was clearly revealed to be extended, the hemorrhage area was exempt from enhancement while peripheral normal cerebral tissue was homogenously enhanced. Conclusions Conventional ultrasonography could display brain injuries. In case of accurate intraoperative encephalocele, intraoperative untrasound conduces to discover delayed intracranial hematoma. Different traumatic brain injuries had their special CEUS findings.

Treatment and clinical analysis of larngeal function preserring surgery in hypophngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the therapeutic effect and the prognosis of the laryngeal function preserving surgery (LFPS) and total laryngectomy in hypophngeal carcinoma.Method:Ninety-three cases of laryngopharynx carcinoma were retrospectively analyzed from September 1974 to September 2006.Among which 57 cases were primary pyriform sinus cancer,20 cases were postero-cricoid cancer and 16 cases were postero-pharyngeal wall cancer.53 cases were treated by LFPS,and 40 cases were treated by total laryngectomy.The treatment effectiveness,complication,survival rate and repair materials were analysed.Result:Adopting Kaplan-Meier survival analysis,the 3-year survival rates were 69.9%and 5-year survival rates were 43.0%.The 3-year survival rates of LFPS and Non-LFPS were 73.6% and 67.5%, and the 5-yenr survival rates of LFPS and Non-LFPS were 49.1% and 32.5%. There was no significant difference between the two groups(χ~2=2.566,P>0.05). Single element analysis indicated survival rates concerned with T-stage(χ~2=9.764,P<0.05), neck lymphatic transfer(χ~2=10.472,P<0.01) and the degree of pathological differentiation(χ~2=25.894,P<0.01).Cox regression analysis suggested that T-stage,the degree of pathological dfferentiaton and wheather going through the surgical operation were the independent elemant of the patient's prognosis.There was no significant difference between LFPS and No-LFPS in the neoplasms location, complication,neoplasms residuum and neoplasms recurrence.Conclusion:LFPS did not affect the survival rates and LFPS was feasible.LFPS can increase the living quality of laryngopharynx careinoma patients.

Application of contrast-enhanced ultrasound in brain perfusion / 中国医学影像技术

Ultrasound brain perfusion imaging can evaluate brain perfusion in normal and pathological conditions. After basilar stent implantation, contrast-enhanced ultrasound (CEUS) can show normal visualization of color flow within the stent and provide essential functional information by evaluation of blood flow velocities. Furthermore, CEUS can estimate the volume of brain hemorrhage and readily identify residual tumor. CEUS can be used in thrombolysis, and will be applied in cerebral trauma. The value of CEUS in brain perfusion imaging was reviewed in this article.

Treatment and clinical analysis of laryngeal function preserving surgery in hypopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the therapeutic effect and the prognosis of the laryngeal function preserving surgery (LFPS) and total laryngectomy in hypopharyngeal carcinoma.@*METHOD@#Ninety-three cases of laryngopharynx carcinoma were retrospectively analyzed from September 1974 to September 2006. Among which 57 cases were primary pyriform sinus cancer, 20 cases were postero-cricoid cancer and 16 cases were postero-pharyngeal wall cancer. 53 cases were treated by LFPS, and 40 cases were treated by total laryngectomy. The treatment effectiveness, complication, survival rate and repair materials were analysed.@*RESULT@#Adopting Kaplan-Meier survival analysis, the 3-year survival rates were 69.9% and 5-year survival rates were 43.0%. The 3-year survival rates of LFPS and Non-LFPS were 73.6% and 67.5%, and the 5-year survival rates of LFPS and Non-LFPS were 49.1% and 32. 5%. There was no significant difference between the two groups (chi2 = 2.566, P > 0.05). Single element analysis indicated survival rates concerned with T-stage (chi2 = 9.764, P < 0.05), neck lymphatic transfer (chi2 = 10.472, P < 0.01) and the degree of pathological differentiation (chi2 = 25.894, P < 0.01). Cox regression analysis suggested that T-stage, the degree of pathological differentiation and whether going through the surgical operation were the independent element of the patient's prognosis. There was no significant difference between LFPS and No-LFPS in the neoplasms location, complication, neoplasms residuum and neoplasms recurrence.@*CONCLUSION@#LFPS did not affect the survival rates and LFPS was feasible. LFPS can increase the living quality of laryngopharynx carcinoma patients.

THE USE OF MICROSURGiCAL TECHNIC IN LARYNGEAL / 解放军医学杂志

120 cases were treated by microlaryngoscopic surgery alone from March to December 1985. Among them, 73 cases were polypoid cord, 28 cases vocal cord nodule, and 19 cases of other conditions. The immediate curative results were good in 114 cases, 5 cases fair and only 1 case was poor. The postoperative complications are: dentes primoris moving in 2 cases and aerodermectasia in 1 case. The operation method is very satisfactory through an endotracheal tube without laryngeal injury. It can accomplish the unsuccessful operation done by mirior, direct and fibrous laryngoscopy surgery. The patients were under general anesthesia by an endotracheal tube without any pain or anxiety and can obtain good relaxation. The authors wish to recommend this technique to treat the related laryngeal disease.

SUPRAGLOTTIC HORIZONTAL PARTIAL LARYNGECTOMY FOR LARYNGEAL CARCINOMA: A Report of 41 Cases / 解放军医学杂志

From 1982 to 1988, we have performed supraglottic horizontal partial laryngectomy for 41 cases of laryngeal carcinoma. 19 of them were males and 22 females. 40 cases of squamous cell carcinoma accounted for 97.6%,and 75.6% of cases were in second or third stage. All the cases have been followed up. The three-year survival rate is 93.7%, the five-year survival rate is 86.5%. 95% of the patients retained their phonation ability. Decannulation rate of tracheostomy tube is 65.9%. Normal deglutition ability is found in 90.2% of cases. Indications for operation, postoperative complications, late results, and failure of removal of tracheostomy tube are discussed.

AN ANALYSIS OF THE RESULTS OF RECONSTRUCTIVE LARYNGECTOMY / 解放军医学杂志

55 cases of laryngeal cancer were treated with surgery alone from 1977 to 1981 in our hospital. The operative techniques employed included the Arslan's method (31 cases) and Vega's method (24 cases). All the cases were followed up for 3-7 years. The results showed that 5-year survival rate was achieved in 78% of the cases of supraglottic cancer and in 77% of the cases of glottic cancer.