Hybrid transthoracic periventricular device closure of ventricular septal defects: single-center experience

Abstract Objective: To evaluate the efficacy of hybrid transthoracic periventricular device closure of ventricular septal defects (VSDs) in a single center. Methods: All patients who underwent hybrid transthoracic periventricular device closure of VSDs between January 2018 and December 2019 were retrospectively analyzed. The preoperative, operative and postoperative findings and clinical follow-ups were reviewed. Results: A total of 59 patients underwent the procedure. Transesophageal echocardiographic guidance was used in all procedures. The procedure was successful in 57 procedures (97%). The procedures of two patients were changed to open-heart surgery during the same intervention due to severe aortic insufficiency (the device was not deployed) and significant residual shunt after device deployment. One major complication (1.7%) was observed after the procedure. The patient's device was dislodged within 12 hours after the procedure, and this patient underwent device extraction and VSD patch closure due to significant residual shunt. Eight (14%) minor complications were observed after the procedure, and three of them persisted during follow-up. Three of these eight complications were incomplete right bundle branch block, one of which resolved during follow-up; two were mild residual shunts, one of which resolved during follow-up; two were mild new-onset tricuspid valve insufficiencies; and one was mild new-onset mitral valve insufficiency; all valvular insufficiencies were resolved during follow-up. Conclusions: Hybrid transthoracic periventricular device closure of VSD seems to be a good alternative approach due to its procedural success and low risk rates. The best advantage of the procedure is the possibility of switching to open-heart surgery, if necessary.

Research on correction method of palatal rugae morphology in forensic digital identification system / Investigación sobre el método de corrección de la morfología de las rugas palatinas en sistema digital de identificación forense

SUMMARY: Palatal rugae is an irregular soft tissue, which is located in the front third of the hard palate, and is asymmetrically distributed from the middle suture to the sides. The difference, stability and extensive characteristics of palatal rugae morphology have gradually make it a characteristic indicator of forensic identification. However, a mature digital palatal rugae identification system has not yet been established at present. Feature extraction is the premise of palatal rugae image recognition. In order to obtain palatal rugae feature information in all directions and improve the reliability of forensic identification, it is necessary to collect palatal rugae images from a plurality of different angles. When the collected images are sent to the recognition system, the diversity of angles will often cause problems such as error recognition. If the tilted images are not rotated properly, it will make the forensic identification face many difficulties. To solve the problem of image skew caused by the diversity of acquisition angle, an algorithm based on orientation vector to correct the tilted palatal rugae images was proposed in this paper. Firstly, the criteria for standard palatal rugae image and the selection rules for feature points were set; Secondly, characterizing feature points according to the rules, and fitting two lines and find their direction vector; Finally, to obtain the corrected images, the tilted images were rotated by the angle determined by the two direction vectors. Simulation results show that the proposed algorithm can correct the tilted palatal rugae images collected from different angles and has strong robustness.

RESUMEN: Las rugas palatinas son tejidos blandos irregulares, que se ubican en el tercio frontal del paladar duro y se distribuyen asimétricamente desde la sutura mediana hacia los lados. La diferencia, la estabilidad y las características extensivas de la morfología de las rugas palatinas la han convertido gradualmente en un indicador característico de la identificación forense. Sin embargo, un sistema de identificación de rugas palatinas digitales maduras todavía no se ha establecido en la actualidad. La extracción de características es la premisa del reconocimiento de imágenes de las rugas palatinas. Para obtener información sobre las características de las rugas palatinas en todas las direcciones, y mejorar la confiabilidad de la identificación forense, es necesario recopilar imágenes de las rugas palatinas desde una pluralidad de ángulos diferentes. Cuando las imágenes recogidas se envían al sistema de reconocimiento, la diversidad de ángulos a menudo causará problemas como el reconocimiento de errores. Si las imágenes inclinadas no se giran correctamente, la identificación forense se enfrentará a muchas dificultades. Para resolver el problema del sesgo de la imagen causado por la diversidad del ángulo de adquisición, en este documento se propuso un algoritmo basado en el vector de orientación para corregir las imágenes de las arrugas palatinas inclinadas. En primer lugar, se establecieron los criterios para la imagen de las rugas palatinas estándar, y las reglas de selección para los puntos de características. En segundo lugar, se determinaron puntos de características según las reglas, y se ajustaron dos líneas y encontrar la dirección del vector. Finalmente, para obtener las imágenes corregidas, las imágenes inclinadas se giraron según el ángulo determinado por la dirección de dos vectores. Los resultados de la simulación muestran que el algoritmo propuesto puede corregir las imágenes de rugas palatinas inclinadas recopiladas desde diferentes ángulos y tiene una gran robustez.

Biocompatibility of human amniotic mesenchymal stem cells with human acellular amniotic membrane scaffold / 中国组织工程研究

BACKGROUND: Anterior cruciate ligament (ACL) injury is commonly seen, and mainly treated with ACL reconstruction. Ligament tissue engineering treatment for ACL injury has become the current focus due to the extensive use of tissue engineering techniques in clinical practice. OBJECTIVE: To investigate the biocompatibility of human amniotic mesenchymal stem cells (hAMSCs) and human acellular amniotic membrane(HAAM)scaffolds in vitro. METHODS: hAMSCs were isolated using enzyme digestion and then identified. The fresh human amniotic membrane was subjected to decellularization using enzymatic digestion and chemical decontamination. Hematoxylin-eosin staining and immunofluorescence were used to detect the removal of cell components and destruction of the extracellular matrix. hAMSCs were cultured with HAAM extract (experimental group) and normal L-DMEM/F12 medium (control group). Cell proliferation was detected by cell counting kit-8. Cell adhesion and growth were observed by scanning electron microscope and inverted microscope at 14 days after co-culture with HAAM. RESULTS AND CONCLUSION: hAMSCs exhibited a spiral, adherent growth under the inverted phase contrast microscope; and the cells highly expressed vimentin and lowly expressed CK-19, with osteogenic, adipogenic, and chondrogenic potential. Hematoxylin-eosin staining showed that human acellular amniotic epithelial cells and mesenchymal stem cells were completely removed and the extracellular matrix had no obvious damage. Immunofluorescence staining showed positive expression of type I collagen and type III collagen. The HAAM extract had no cytotoxicity to hAMSCs and exerted no effect on its proliferative activity. HAAM could promote the proliferation and adhesion of hAMSCs after incubation under the inverted microscope and scanning electron microscope. These findings indicate that HAAM has good biocompatibility and is favorable for the proliferation of hAMSCs.

An in vitro study of enhancing tendon-bone healing by human amniotic mesenchymal stem cells co-modified with hypoxia-inducible factor 1 alpha and Scleraxis gene / 中国组织工程研究

BACKGROUND: Tendon-to-bone healing is a complex and slow process, which often hinders the therapeutic outcomes. To enhance the tendon-to-bone healing, increasing cell bioactivity on the contact surface is a new strategy. Hypoxia-inducible factor 1α (HIF-1α) can induce the formation of blood vessel and bone tissue via many ways.However,it is unclear whether HIF-1α can strengthen differentiation of human amniotic mesenchymal stem cells (hAMSCs) induced by Scleraxis, a specific marker of tendon, and can be used in tendon and bone repair. OBJECTIVE: To investigate the ability of HIF-1α in enhancing Scleraxis to modify hAMSCs aiming to promote tendon-to-bone healing and its molecular mechanism. METHODS: Passage 3 hAMSCs were infected with AdHIF-1α, AdScx, AdGFP and AdHIF-1α+AdScx. The expressions of related genes of tendon, cartilage and bone tissue were detected at 3 and 7 days after infection. RESULTS AND CONCLUSION: Under the inverted phase contrast microscopy, the passage 3 hAMSCs were in spindle shape and presented with vortex-like adherent growth. Under the transmission electron microscopy, hAMSCs were in oval shape and had clear structure, with abundant endoplasmic reticulum and mitochondria. Fluorescence photographs were taken at 24 hours after adenovirus infection, showing about 50% red fluorescence expression in the AdHIF-1α group, while about 70% green fluorescence expression in the AdScx and AdGFP groups. Real time-PCR results showed that at 3 and 7 days after infection, the mRNA expressions of collagen type I, Fibronectin, RUNX2, VEGF and ALP in the AdHIF-1α+AdScx group, AdHIF-1α group and AdScx group were higher than those in the AdGFP group (P < 0.05); the mRNA expressions of collagen type I, Fibronectin, RUNX2, VEGF and ALP in the AdHIF-1α+AdScx group were significantly higher than those in the AdScx group (P < 0.05). Fluorescence immunohistochemistry results showed that the expression of collagen type I in the AdHIF-1α+AdScx group at 7 days after infection was higher than that at 3 days after infection. To conclude, HIF-1α can enhance the ability of Scleraxis to modify hAMSCs to promote tendon-to-bone healing by upregulating the expressions of molecular markers of tenocytes, chondrocytes and osteocytes.

Clinical Study of PTAS Therapy for Patients with Ischemia Cerebrovascular Disease Caused by Artery Stenosis / 华中科技大学学报（医学）（英德文版）

The curative efficacy of percutaneous transluminal angioplasty and stenting (PTAS) in the treatment of patients with ischemia cerebrovascular disease caused by artery stenosis was explored.The clinical data of 111 patients with ischemia cerebrovascular disease receiving PTAS in Guangdong Province General Hospital from Aug.2007 to Nov.2009 were retrospectively analyzed.In total 132 stents were implanted in the 111 patients.The mortality and rate of neural and non-neural complications were assessed perioperatively.Outcomes [including the frequency of transient ischemic attack (TIA),stroke,or death from vascular diseases) were assessed after operation.NIHSS rating was performed in all cases before and at first week,6th month and 12th month after the operation.The PTAS success rate was 100％.The degree of stenosis was reduced after PTAS.The total complication rate during perioperative period was 15.3％ (the rate of neural complications was 3.6％).Sixty-seven patients were followed up.Three patients (4.48％) developed cerebrovascular events within 1 month,containing one case of TIA,one case of ipsilateral mild stroke and one case of contralateral mild stroke.No severe stroke or death was observed.During a follow-up period of 12 months 7 patients had cerebrovascular events (10.44％),including 2 cases of ipsilateral TIA (2.99％),2 cases of ipsilateral mild stroke and 2 cases of contralateral mild stroke (2.99％),one case of severe stroke (1.49％).In 13 patients receiving DSA re-examination one year after PTAS,2 patients (15.38％) had in-stent restenosis.NIHSS scores were obviously decreased during a follow-up period as compared with those pre-operation (P＜0.05).It was concluded that PTAS could significantly alleviate the neural function deficit of the patients with ischemia cerebrovascular disease.The success rate of PTAS was high,and the rate of complications was lower and the clinical outcomes were satisfactory.PTAS is a safe and effective therapeutic method,though the long-term outcomes need further study.

Controlled study on therapeutic effects of electroacupuncture and modified electric convulsive therapy on catatonic schizophrenia / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the clinical therapeutic effect of electroacupuncture for treatment of catatonic schizophrenia.</p><p><b>METHODS</b>Eighty cases were randomly divided into an observation group and a control group, 40 cases in each group. The observation group was treated with electroacupuncture, Baihui (GV 20) and Taiyang (EXHN 5) were selected, once daily; the control group was treated with modified electric convulsive therapy (MECT), the treatment was given once every 2 days or 3 days, 14 to 21 days constituted one course in the two groups.</p><p><b>RESULTS</b>The markedly effective rate and total effective rate were 72.5% and 92.5% in the observation group, 77.5% and 97.5% in the control group, respectively, there was no significant difference between the two groups (both P>0.05).</p><p><b>CONCLUSION</b>The therapeutic effect of electroacupuncture is similar to that of MECT.</p>