ABSTRACT
Background: The expression levels of long noncoding RNAs (lncRNAs) and mRNAs in human acute Stanford type A aortic dissecting aneurysm and normal active vascular tissues were compared using the array lncRNA/mRNA expression profile chip technology. Methods: The tissue samples of 5 patients who presented with Stanford type A aortic dissections and the normal ascending aorta tissues from 5 donor heart transplantation patients receiving surgical treatment in Ganzhou People's Hospital were collected. Hematoxylin and eosin (HE) staining were performed to investigate the structural features of the ascending aortic vascular tissue. Nanodropnd-100 was used to detect the surface level of RNA in 10 samples included in the experiment, to ensure that the quality of the standard was consistent with the core plate detection. NanoDrop ND-1000 was used to detect the RNA expression levels in 10 specimens included in the experiment to ensure that the quality of specimens satisfied the requirements of the microarray detection experiment. The Arraystar Human LncRNA/mRNAV3.0 expression profile chip (8×60K, Arraystar) was used to detect the expression levels of lncRNAs and mRNAs in the tissue samples. Results: A total of 29,198 lncRNAs and 22,959 mRNA target genes could be detected in the above tissue samples after the initial data were standardized and low-expression information was filtered. The data in the middle of the range of 50% value consistency was higher. The scatterplot results preliminarily suggested that there were large numbers of lncRNAs with increased and decreased expression in Stanford type A aortic dissection tissues compared with normal aortic tissues. The differentially expressed lncRNAs were enriched in BPs including apoptosis, nitric oxide synthesis, estradiol response, angiogenesis, inflammatory response, oxidative stress, and acute response; cell components (CCs) including cytoplasm, nucleus, cytoplasmic matrix, extracellular space, protein complex, and platelet α granule lumen; and MFs including protease binding, zinc ion binding, steroid compound binding, steroid hormone receptor activity, heme binding, protein kinase, cytokine, superoxide dismutase, and nitric oxide synthase activities. Conclusions: Gene ontology analysis demonstrated that many genes in Stanford type A aortic dissection were involved in cell biological functions, cell components, and molecular functions through upregulating and downregulating the levels of expression.
ABSTRACT
OBJECTIVE: To investigate the clinical implementation of ventricular septal defect closure using the three transthoracic approaches. METHODS: A total of 70 children with septal defects admitted to our hospital from January 2017 to December 2020 were selected as the study subjects. Among them, 10 children with the left thorax-right ventricle-left ventricle approach were assigned to Group A, 8 children with the right thorax-atrium dextrum-right ventricle-left ventricle approach were assigned to Group B, and 52 children with the subxyphoid-right ventricle-left ventricle approach were assigned to Group C. The surgical indices were recorded, the success rates of closure and cardiopulmonary function indices were compared, electrocardiogram (ECG), echocardiogram and X-ray film were investigated at 1, 3 and 12 months after surgery, and the incidence of complications was recorded. RESULTS: There was no statistically significant difference in the success rate of closure among the three groups (P > 0.05). The duration of intracardiac operations in Groups A and C was remarkably shorter than that in Group B, and the duration of skin incision and suture and hospital stay in Groups A and B were noticeably shorter than those in Group C (P < 0.05). After surgery, there was statistically significant difference in the contents of creatine kinase MB (CK-MB) isoenzyme, lactate dehydrogenase (LDH), serum malondialdehyde (MDA) and superoxide dismutase (SOD) among the three groups (P > 0.05). Airway resistance (Raw), oxygenation index (OI), and alveolar-arterial oxygen gradient (AaDO2) indicated that the postoperative pulmonary function in Group C was more effectively protected. There was no statistically significant difference in the incidence of complications among the three groups (P > 0.05). CONCLUSION: Ventricular septal defect closure using the three transthoracic approaches exhibited a high success rate and a high safety profile.
ABSTRACT
OBJECTIVE: To investigate the influences of deep hypothermic circulatory arrest (DHCA) on postoperative cranial nerve function in patients undergoing surgery for type A aortic dissection. METHODS: A total of 100 patients undergoing DHCA during the surgery for type A aortic dissection in our hospital were selected as the study subjects. After surgery, 32 patients with neurological complications were assigned to Group A, and 68 patients without neurological complications were assigned to Group B. The clinical outcomes were compared between the two groups, and the risk factors of postoperative neurological complications were analyzed by univariate and multivariate logistic regression analysis. RESULTS: During the surgery, patients underwent cerebral perfusion at 5 min and 10 min during DHCA had remarkably decreased cerebral oxygen saturation (rSO2) and VmMCA than those before anesthesia induction (P<0.05). After recovery of CPB, rSO2 and mean velocity in middle cerebral artery (VmMCA) recovered to the preoperative levels. The correlation analysis revealed a positive correlation between rSO2 and VmMCA (P<0.05). The univariate analysis suggested that the history of hypertension, hydropericardium, surgical duration, duration of cardiopulmonary bypass (CPB), aortic occlusion, ICU, and ventilator-assisted respiration, and hypoxemia significantly affected postoperative cranial nerve function (P<0.05). The logistic multivariate regression analysis demonstrated that the duration of CPB and aortic occlusion and hypoxemia were independent risk factors for postoperative cranial nerve dysfunction (P<0.05). CONCLUSION: There were noticeable changes in hemodynamic and blood oxygen parameters in patients with type A aortic dissection undergoing DHCA during the perioperative period. The long duration of CPB and aortic occlusion and preoperative hypoxemia are the independent risk factors leading to postoperative impaired cranial nerve function.
