[Effects of inhibiting the expression of lncRNA PVT1 on the proliferation, apoptosis and oxidative stress of vascular endothelial cells induced by hyperglycemia].

Objective: To investigate the effects of inhibition of lncRNA PVT1 on the proliferation, apoptosis and oxidative stress of vascular endothelial cells induced by hyperglycemic. Methods: Human umbilical vein endothelial cells (HUVECs) were cultured in vitro and divided into four groups: control group (5.5 mmol/L glucose), high glucose group (30 mmol/L glucose), high glucose + siNC group (30 mmol/L glucose +siNC, negative control group), HG + siPVT1 group (30 mmol/L glucose + siPVT1, lncRNA PVT1 silencing group). The expression of PVT1 after transfection was detected by quantitative real-time PCR. MTT assay was used to detect the effect of siPVT1 (small interfering RNA PVT1) on the proliferation of HUVECs cells induced by high glucose. Flow cytometry was used to detect ROS and apoptosis of HUVECs cells induced by siPVT1. Western blot was used to detect the expression levels of apoptotic proteins such as Bax, Bcl-2, and cleaved caspase-3 in HUVECs cells. Results: Compared with the control group, after transfection with siPVT1, the expression level of PVT1 was decreased significantly (P＜0.05). MTT results showed that the proliferation activity of HUVECs cells in the high-glucose group was reduced significantly after 24 h and 48 h. Compared with the HG + siNC group, the proliferation activity of HUVECs cells in the HG + siPVT1 group was increased significantly (P＜0.05) after 24 h and 48 h. Flow cytometry results showed that ROS and apoptosis rate of HUVECs cells in the high-glucose group were increased significantly compared with the control group. Compared with the HG + siNC (negative control) group, ROS and apoptosis rates of HUVECs cells in the HG + siPVT1 group were reduced significantly. Compared with the control group, the expression levels of cleaved-caspase-3 and Bax in the high-glucose group were significantly up-regulated, while the expression level of Bcl-2 was down-regulated. Compared with the HG + siNC group, the expression levels of cleaved-caspase-3 and Bax were down-regulated, and the expression level of Bcl-2 was up-regulated. The differences were statistically significant (P＜0.05). Conclusion: Inhibition of lncRNA PVT1 can significantly increase the proliferation activity of HUVECs cells induced by hyperglycemia, reduce oxidative stress and inhibit cell apoptosis.

Endoscopic characteristics of multidrug-resistant tuberculosis combined with tracheobronchial tuberculosis / 中国内镜杂志

Objective To explore the endoscopic characteristics of multidrug-resistant tuberculosis (MDR-TB) combined with tracheobronchial tuberculosis (TBTB). Methods 248 MDR-TB as study group, they hospitalized from October 1st 2008 to June 31st, 2016. 274 cases of non MDR-TB with bacteria positive as control group over 2015, all of them received bronchoscopy, sputum cultured and drug sensitivity tested of Isoniazid and Rifampicin. We analyzed the results of bronchoscopy and demographic data. Results 248 cases of MDR-TB patients, of 175 (70.56%) were diagnosed TBTB by bronchoscopy, of 73 (29.44%) without TBTB. 274 cases of non MDR-TB with bacteria positive patients, of 146 (53.28%) were diagnosed TBTB, of 128 (46.72%) non TBTB, the difference of comparisons was statistically significant (χ2 = 16.42, P = 0.000). MDR-TB combined with TBTB median age was 32 years, non MDR-TB combined with TBTB median age 42 years, the difference was statistically significant (U = 9932.00, P = 0.001). Among the MDR-TB patients, of 75 (42.86%) TBTB in the upper right bronchial, of71 (40.57%) upper left bronchus, while non MDR-TB patients, of 70 (47.95%) and 60 (41.10%), there was no statistically significant difference (χ2 = 2.44, P = 0.786). Among the MDR-TB, of 76 (43.43%) were inflammation infiltration type, of 11 (6.29%) were necrosis type, of 13 cases (7.43%) granulation proliferative type, of 72 (41.14%) were scar stricture type, of 3 (1.71%) tube wall softening type. Among the non MDR-TB, in turn, TBTB type were 50 (34.25%), 41 (28.08%), 9 (6.16%), 40 (27.40%), 5 (3.43%), the difference were statistically significant (χ2 = 30.50, P = 0.000). Conclusions The detection rate of TBTB was higher in MDR-TB patients, that common occur in younger patients. TBTB common infringe on upper right bronchial and upper left bronchus, TBTB type most are inflammatory infiltration type and scar stricture type. More attention should be paid to bronchoscopy among MDR-TB patients.

Investigation on effects of the nourishing kidney and eliminating toxicity decoction on immunological imbalance of Th1, Th17 and Treg in HBV transgenic mice.

OBJECTIVE: To study the immune mechanism of nourishing kidney and eliminating toxicity decoction (NKETD) on Chronic Hepatitis B (CHB), we detected the serum concentrations of IFN-γ (the characteristic cytokine of Th1), IL-17A (the characteristic cytokine of Th17) and the quantitative proportion of CD(+) 4CD(+) 25 foxp3 Treg to CD(+) 4 Treg in HBV transgenic mice. METHODS: The HBV transgenic mice were randomly divided into six groups: high-dose group, middle-dose group, low-dose group, lamivudine group, model control group and normal mice control group. The serum concentrations of IFN-γ and IL-17A in mice were measured by ELISA method and the ratio of CD(+) 4CD(+) 25 foxp3 Treg to CD(+) 4 Treg was detected by Flow Cytometry Method (FCM). RESULTS: The decoction could increase the serum concentration of IFN-γ and decrease that of IL-17A in HBV transgenic mice. The higher the dose was, the more significantly the concentration of IFN-γ increased. And high-dose decoction could decrease the serum concentration of IL-17A in HBV transgenic mice significantly and continuously while middle-dose and low-dose decoction had no significant effects. However, there wasn't statistically significant variation on the ratio of CD(+) 4CD(+) 25 foxp3 Treg to CD(+) 4 Treg in HBV transgenic mice. CONCLUSION: The decoction could treat CHB by regulating the immune function by promoting the generation of Th1 and/or enhancing its function while inhibiting Th17. The immune regulation by decoction had more significant effects than lamivudine.

Totally thoracoscopic closure for atrial septal defect on perfused beating hearts.

OBJECTIVES: To investigate the feasibility and safety of non-robotically assisted totally thoracoscopic closure for atrial septal defect (ASD) on perfused beating hearts. METHODS: Twenty-four patients (8-45 years, mean 14.4 ± 18.7) underwent ASD closure on beating hearts by a totally thoracoscopic approach without the aid of a robotic surgical system. Additional 72 patients undergoing totally thoracoscopic ASD closure on cardioplegic arrested hearts were selected as a control. Cardiopulmonary bypass (CPB) was achieved peripherally. The aorta was not cross-clamped in the study group but it was cross-clamped in the control group. RESULTS: ASD closure was successful in all study and control group patients without in-hospital mortality or major complications. The total duration of operation (76 ± 9 vs. 98 ± 6 min, P = 0.012), CPB time (32 ± 5 vs. 48 ± 4 min, P = 0.001), duration of intensive care stay (10.0 ± 5.1 vs. 19.2 ± 4.2 h, P = 0.003) and post-operative hospital stay (4.5 ± 0.8 vs. 5.0 ± 1.1 days, P = 0.045) in the study group were shorter than in the control group. There was no statistically significant difference in the proportion of patients requiring in-operation blood transfusion between study group and control group (25.0 vs. 36.1%, P = 0.226). Follow-up transthoracic echocardiography on Day 5 and Day 30 showed no residual shunts in study or control group patients. CONCLUSIONS: Non-robotically assisted totally thoracoscopic closures of ASD on perfused beating hearts are feasible and safe. These procedures are associated with a shorter operation time and a shorter hospital stay than in surgeries on cardioplegic arrested hearts.

Quality of life in patients undergoing totally thoracoscopic closure for atrial septal defect.

BACKGROUND: Quality of life in patients undergoing totally thoracoscopic closure of atrial septal defect is unclear. METHODS: Thoracoscopic atrial septal defect repair was performed in 96 patients (37 males, aged 19.4 ± 8.7 years) without the aid of a computerized robotic surgical system. An additional 56 patients (23 males, aged 21.0 ± 16.1 years) undergoing conventional atrial septal defect closure through sternotomy were enrolled as a control group. Quality of life was assessed with the Medical Outcomes Study Short Form Survey on day 60 after surgery. RESULTS: Atrial septal defect closure was successful in all patients. There was no perioperative mortality or reoperation for bleeding. Total duration of operations (98 ± 11 versus 128 ± 21 minutes, p < 0.01) and hospital stays (5.3 ± 1.7 versus 6.9 ± 2.1 days, p = 0.024) were shorter in the study group than in the control group, respectively. At discharge, patients with moderate to severe incisional pain in the study and control groups was 11.6% and 62.5%, respectively (p = 0.008). The time interval between discharge and returning to school or work in the study group was shorter than in the control group (28 ± 4 versus 42 ± 7 days, p = 0.003). The mean scores of eight variables in the Short Form Survey, such as physical function, bodily pain, social function, and general or mental health in the study group were higher than in the control group (p < 0.05 or p < 0.01). CONCLUSIONS: Compared with conventional sternotomy, totally thoracoscopic atrial septal defect closure was associated with a faster recovery of physical function and a better quality of life.

Totally thoracoscopic repair of ventricular septal defect: a short-term clinical observation on safety and feasibility.

OBJECTIVES: We sought to investigate the feasibility and safety of totally thoracoscopic repair of a ventricular septal defect. METHODS: Totally thoracoscopic repair of a perimembranous ventricular septal defect was performed in 36 patients (16 male patients; age, 5-19 years; average age, 10.2 ± 4.5 years). Patients with a pulmonary arterial systolic pressure of 60 mm Hg or greater or with supracristal or muscular ventricular septal defects were excluded. An additional 16 patients undergoing open-chest ventricular septal defect repair were selected as a control group. Through 3 port incisions in the right chest, pericardiotomy, bicaval occlusion, atriotomy, and ventricular septal defect repair were performed by a surgeon by means of thoracoscopy. RESULTS: The cardiopulmonary bypass and aortic crossclamp times were 66.2 ± 21.3 and 36.4 ± 8.2 minutes, respectively. The length of stay in the intensive care unit was 20.0 ± 4.1 hours. There were no mortalities and no major complications. Transesophageal echocardiographic analysis 5.2 ± 3.6 months after the operation showed complete closure of the defect without residual shunt. The intensive care unit (17 ± 2 vs 25 ± 5 hours, P = .01) or postoperative hospital (4.2 ± 1.1 vs 6.7 ± 2.1 days, P = .03) stays in the thoracoscopic group were shorter than in the control group. The percentage of patients who required postoperative opioid analgesics in the thoracoscopic group was lower than in the control group (37.5% vs 87.5%, P = .001). CONCLUSIONS: Totally thoracoscopic repair of a perimembranous ventricular septal defect is feasible and safe for older children. This technique is associated with a reduced intensive care and hospital stay in comparison with conventional ventricular septal defect repair.

Totally thoracoscopic repair of atrial septal defect without robotic assistance: a single-center experience.

OBJECTIVE: The recent advent of robotically assisted surgery has enabled totally endoscopic repair of atrial septal defects and patent foramen ovale. This study investigates the feasibility and safety of totally endoscopic repair of an atrial septal defect through small incisions on the chest without robotic assistance. METHODS: Forty patients (23 female patients; average age, 15.4 ± 8.7 years; age range, 6-47 years) with secundum-type ASDs were selected for this study. Cardiopulmonary bypass was achieved peripherally. Through 3-port incisions in the right chest, pericardiotomy, bicaval occlusion, atriotomy, and ASD repair were performed by a surgeon through a thoracoscopy. RESULTS: The cardiopulmonary bypass and aortic crossclamp times were 56.2 ± 21.1 and 38.3 ± 8.6 minutes, respectively. The length of stay in the intensive care unit was 23.0 ± 4.1 hours. There were no mortalities and no major complications in this cohort. Patients were discharged from the hospital 4 to 6 days after the operation. Transesophageal echocardiographic analysis immediately after the operation and at 30 days showed complete closure of the defect without residual shunt. CONCLUSIONS: Totally endoscopic atrial septal defect repair can be achieved without a robotically assisted surgical system. This technique is safe and effective and can be used as a therapeutic option for ASD.