[Expression of cytokines Il-6, IL-34 and M-CSFR in chronic periodontitis and its clinical significance].

PURPOSE: To detect the expression of IL-6，IL-34 and M-CSFR in chronic periodontitis and healthy gingival tissue and discuss the role of IL-6，IL-34 and M-CSFR in the etiology of chronic periodontitis. METHODS: A total of 8 patients with mild chronic periodontitis and 8 patients with severe chronic periodontitis were collected in this study. As control，8 normal gingival tissues from extracted healthy were selected. The expression of IL-6, IL-34 and M-CSFR mRNA was detected by real-time PCR; the expression of IL-6, IL-34 and M-CSFR protein was detected by Western blotting. Statistical analysis was performed using GraphPad Prism 6.0. RESULTS: The levels of IL-6, IL-34, M-CSFR mRNA and protein expression in chronic periodontitis was significantly higher than that of the normal gingival tissue(P<0.05). CONCLUSIONS: IL-6, IL-34 and M-CSFR may be closely related to the development of chronic periodontitis.

The correlation between carotid-femoral pulse wave velocity and composition of the aortic media in CAD patients with or without hypertension.

OBJECTIVES: To investigate the influence of hypertension on large artery elasticity and the microstructure of the ascending aortic media in patients with coronary artery disease (CAD), and the association between arterial compliance and composition of the ascending aorta. METHODS: 60 patients with CAD who underwent coronary artery bypass graft surgery were divided into two groups: 30 patients in a hypertension group and 30 patients in a non-hypertension group. Carotid-femoral pulse wave velocity (cfPWV) was measured by an automatic device (Complior, Artech, France). The severity of coronary atherosclerosis was assessed after selective coronary angiography using the Gensini score system. A quantitative study was conducted on ascending aorta specimens by histological and computer image analysis. RESULTS: cfPWV of the hypertension group was higher than that of the non-hypertension group. The relative content of collagen in the ascending aortic media of the hypertension group was higher than that of the non-hypertension group, while the relative content of elastin in the ascending aortic media of the hypertension group was lower than that of the non-hypertension group. cfPWV showed a positive correlation with relative contents of collagen in the ascending aorta and a negative correlation with relative contents of elastin in the ascending aorta in the two groups. CONCLUSIONS: Hypertension may raise the contents of collagen and decrease the contents of elastin in the ascending aortic media of patients with CAD, which in turn may decrease the patients' large artery compliance. cfPWV may reflect the quantitative changes of collagen and elastin in the ascending aortic media in CAD patients independently of hypertension.

Mesenchymal stem cells differentiate into an endothelial phenotype, reduce neointimal formation, and enhance endothelial function in a rat vein grafting model.

Autologous vein grafts is still commonly used for arterial reconstructive procedures. Their success is limited by the development of neointimal hyperplasia. Clinical and experimental evidence suggest that the bone marrow derived mesenchymal stem cells (MSCs) participate in the neovascularization. The current study used a direct approach to test the hypothesis that, after vein grafting in a rat model, MSCs have potential effects on reendothelialization and neointimal formation. MSCs were isolated by bone marrow cell adherence. Autologously interpositioning left external jugular vein (LEJV) to left common carotid artery-induced vein grafting model of r at w as utilized. Vascular lesion formation after transplantation of MSCs labeled with 4',6-diamidino-2-phenylindole (DAPI) was investigated. Two weeks after implantation, immunofluorescence studies revealed that engrafted cells acquired an endothelial phenotype, and some expressed endothelial nitric oxide synthase (eNOS). Furthermore, proliferation of cells and neointimal formation decreased significantly after MSC implantation. Real-time reverse transcription-PCR and western blotting analysis showed a rise of eNOS expression in the MSC group compared with the vein grafting group. Therefore, engrafted MSCs appeared to differentiate into endothelial cells, diminish the neointima formation and contribute to the improvement on endothelial function, which indicates that MSCs may exert an important function as repair mechanism in vascular injury after vein grafting.

[Clinical values of detection of serum levels of S100B and NSE in diagnosis of brain injuries at early period after cardiopulmonary bypass].

OBJECTIVE: To investigate the clinical values of detecting the blood serum levels of S100B and neuron-specific enolase (NSE) in diagnosis of brain injuries at early period after cardiopulmonary bypass (CPB). METHODS: Forty-eight patients with heart disease were divided into 2 groups: CPB group (n = 40) and off-CPB group (n = 8). Before operation, and 24 hours and 48 hours after CPB specimens of peripheral blood were collected and ELISA was used to detect the serum levels of S100B and NSE. Forty-eight hours after the operation brain damage quotient (DQ) was calculated. RESULTS: The serum levels of S100B 24 and 48 hours after operation of the CPB group were 0.61 microg/L +/- 0.18 microg/L and 0.37 microg/L +/- 0.12 microg/L respectively, both significantly higher than that before the operation (0.05 microg/L +/- 0.03 microg/L, P < 0.001). The serum levels of NSE 24 and 48 hours after operation of the CPB group were 10.14 microg/L +/- 3.87 microg/L and 5.77microg/L +/- 2.31 microg/L respectively, both significantly higher than that before operation (2.98 microg/L +/- 1.49 microg/L, P < 0.001). The serum levels of S100B 24 and 48 hours after operation of the off-CPB group were 0.05 microg/L +/- 0.03 microg/L and 0.04 microg/L +/- 0.03 microg/L respectively, both not significantly different from that before operation (0.04 microg/L +/- 0.03 microg/L, P > 0.05). The serum levels of NSE 24 and 48 hours after operation of the off-CPB group were 2.91 microg/L +/- 1.56 microg/L and 2.87 microg/L +/- 1.41 microg/L respectively, both not significantly different from that before operation (2.76 microg/L +/- 1.23 microg/L, P > 0.05). The levels of S100B and NSE 24 hours after CPB were positively correlated with age, CPB time, and cross-clamp time (all P < 0.05). The levels of S100B and NSE 48 hours after CPB were positively correlated with the brain DQ (r = 0.739 P < 0.01, r = 0.371 P < 0.05). The multiple correlation coefficient square (R2) of detection of the levels of both S100B and NSE was 0.851, significantly higher than that of mere detection of S100B (R2 = 0.703) and that of mere detection of NSE (R2 = 0.482) (both P < 0.01). CONCLUSION: Both serum S100B and serum NSE are sensitive markers in the early diagnosis of brain injuries after CPB. Detection of both S100B and NSE is the most specific, and mere detection of S100B comes behind.

[Effects of recombined human neuregulin on the contractibility of cardiac muscles of rhesus monkeys with pacing-induced heart failure].

OBJECTIVE: To evaluate the effects of recombined human Neuregulin on the contractibility of cardiac muscles of Rhesus Monkeys with pacing-induced heart failure and to reveal the possible mechanisms involved. METHODS: Twenty four rhesus monkeys were randomly divided into three groups (shame operated group, heart failure group and Neuregulin treated group), each with 8 monkeys. Heart failures were induced by rapid pacing (240 heartbeats/min). Daily intravenous injection of recombined human Neuregulin [3 microg/(kg x d)] and medical salt fluid were given to the monkeys for 10 days for the Neuregulin treated group and heart failure group respectively. Hemodynamic measurements such as peak positive rate of change in left ventricular blood pressure (+dP/dtmax) and left ventricular systolic, and end-diastolic blood pressures (LVSP and LVEDP) were compared between groups. The real-time quantitative RT-PCR was undertaken to detect the expression of myosin heavy chain mRNA in the left ventricular cardiac muscle. RESULTS: The monkeys in the heart failure group had lower levels of +dP/dtmax and LVSP and higher levels of LVEDP than those in the shame operated group (P < 0.05). The monkeys in the Neuregulin treated group had higher levels of + dP/dtmax than those in the heart failure group (P < 0.05). Lower expression of alpha-myosin heavy chain mRNA in the heart failure group was found compared with the shame operated group and Neuregulin treated group (P < 0.05). CONCLUSION: Recombined human Neuregulin can enhance the contractibility of cardiac muscles and relieve heart failure syndrome through reversing the falling of alpha-myosin heavy chain induced by rapid ventricular pacing.

[Effects of pulmonary arterial perfusion with shenqi fuzheng injection on lung injury during cardiopulmonary bypass].

OBJECTIVE: To observe the effect of pulmonary arterial perfusion with Shenqi Fuzheng Injection (SFI)on lung injury during cardiopulmonary bypass (CPB). METHODS: Twenty-two patients with cardiac valvular disease and pulmonary hypertension were randomly divided into the control and the SFI group equally. SFI mixed pure oxygenated blood to the SFI group, and oxygenated blood alone to the control group was perfused via pulmonary artery during CPB. Plasma malondialdehyde (MDA), pulmonary vascular resistance (PVR), ratio of leucocyte counts in venous and arterial blood, and time of mechanical ventilation applied were measured before and at the end of CPB, and 6th, 24th hours after CPB. RESULTS: After treatment, MDA content and PVR were significantly higher than those before CPB (P < 0.05), and reduced to normal level 24 h after CPB in both groups, but the peak levels were lower in the SFI group than those in the control group (P < 0.05). The leucocyte counts ratio in venous and arterial blood were significantly higher at the end of CPB and 6 h later than those before CPB in both groups (P < 0.05), but the increment were lower in the SFI group than those in the control group (P < 0.05). Furthermore, the applying mechanical ventilation time in the SFI group was 16.1 +/- 5.5 h, significantly shorter than that in the control group (29.1 +/- 6.9 h, P < 0.01). CONCLUSION: Pulmonary arterial perfusion with SFI could alleviate the CPB induced lung injury.

[Effects of blood washing and autotransfusion during cardiopulmonary bypass on erythrocyte immune and kidney function].

OBJECTIVE: To study changes of erythrocyte immune and kidney function after autotransfusion washed red blood cells during cardiopulmonary bypass (CPB). METHODS: Thirty-two patients undergoing valve replacement with CPB were randomly divided into study group and control group (16 in each group). In study group, the blood in operative field and the residual blood in the extracorporal machine were collected, centrifuged, washed and retransfused to patients. Patients in control group were transfused with the residual blood in the extracorporal machine without any disposal or banked blood. All patients were used with membrane oxygenator. Before CPB, 12 h, 24 h, 72 h and 7 d after CPB, whole blood were taken, then the erythrocyte immune function (C3bRR, RICR) and level of plasma free hemoglobin (FHB) were assayed, and post-operation renal function was compared between the two groups. Moreover, total volume of banked blood transfused to patients after CPB was recorded. RESULTS: (1) After 12 hours, 24 hours, 72 hours, 7 days of CPB, the RBC-C3bRR (14.3% +/- 4.7%, 15.9% +/- 3.6%, 16.6% +/- 2.8%, 19.9% +/- 4.1%) and RBC-ICR (8.7% +/- 1.9%, 9.2% +/- 2.0%, 9.5% +/- 2.6%, 12.0% +/- 2.0%) in study group were significantly elevated than that in control group (RBC-C3bRR 10.7% +/- 2.4%, 11.3% +/- 3.0%, 12.3% +/- 3.5%, 14.5% +/- 2.0%, RBC-ICR 5.9% +/- 1.4%, 6.0% +/- 1.8%, 7.0% +/- 1.7%, 8.7% +/- 2.7%). The erythrocyte immune function after CPB was better and restored faster in study group than that in control group (P < 0.05 in all). (2) After 12 hours, 24 hours of CPB, the levels of FHB (0.41 g/L +/- 0.13 g/L, 0.03 g/L +/- 0.02 g/L) in study group were significantly lower than that in control group (1.02 g/L +/- 0.23 g/L, 0.54 g/L +/- 0.09 g/L) (P < 0.01). After 24 hours of CPB, the level of urinary protein excretion (0.19 g/d +/- 0.08 g/d) in study group was significantly lower than that in control group (0.32 g/d +/- 0.07 g/d) (P < 0.05). (3) After 24 hours of CPB, the level of 24 h creatinine clearance was significantly elevated in study group (68 ml x min(-1) x 1.73 m(-2) +/- 10 ml x min(-1) x 1.73 m(-2)) than that in control group (45 ml x min(-1) x 1.73 m(-2) +/- 4 ml x min(-1) x 1.73 m(-2)) (P < 0.01). (4) The total volume of banked RBCs transfused after CPB were fewer in study group (2.0 U +/- 1.1 U) than that in control group (7.4 U +/- 2.3 U) (P < 0.01). CONCLUSION: Autotransfusion of washed red blood cells during CPB may improve significantly the erythrocyte immune function and protect kidney function better than transfusion of residual blood in the extracorporal machine or banked blood.

[Influence of pulmonary artery perfusion with solution of washed red blood cells on lung injury after cardiopulmonary bypass].

OBJECTIVE: To observe the influence of intra-operative pulmonary artery perfusion with hypothermic washed red blood cell (RBC) solution on lung injury after cardiopulmonary bypass (CPB). METHODS: Thirty patients of mitral disease with pulmonary hypertension undergoing mitral valve replacement were randomly divided into 2 equal groups: control group, and perfusion group (with the pulmonary artery infused with 4 degrees C washed RBC protective solution during CPB). The blood cell count, pulmonary vascular resistance (PVR), white blood cell (WBC) ratio (venous blood/arterial blood), plasma malonyldialdehyde (MDA), and oxygenation index (OI), were measured and the time of mechanical ventilation was obtained as well. RESULTS: (1) The PVR at the end of CPB, and 12 h and 24 h after CPB of the perfusion group were 46.4 kPa.s.L(-1) +/- 8.1 kPa.s.L(-1), 48.5 kPa.s.L(-1) +/- 7.0 kPa.s.L(-1), and 36.1 kPa.s.L(-1) +/- 6.3 kPa.s.L(-1) respectively, all significantly lower than those of the control group (65.7 kPa.s.L(-1) +/- 5.3 kPa.s.L(-1), 79.8 kPa.s.L(-1) +/- 8.7 kPa.s.L(-1), and 47.9 kPa.s.L(-1) +/- 7.1 kPa.s.L(-1) respectively, all P < 0.05). (2) The levels of MDA at the end of CPB, and 12 h and 24 h after CPB of the perfusion group were 14.3 mmol/L +/- 0.8 mmol/L, 16.1 mmol/L +/- 0.7 mmol/L, and 13.3 mmol/L +/- 0.5 mmol/L respectively, all significantly lower than those of the control group (18.9 mmol/L +/- 0.9 mmol/L, 21.6 mmol/L +/- 0.4 mmol/L, and 22.5 mmol/L +/- 0.7 mmol/L respectively, all P < 0.05). (3) The WBC ratios of vein and artery (V/A) a the end of CPB and 12 h after CPB of the perfusion group were 1.16 +/- 0.05 and 1.20 +/- 0.05 respectively, both significantly lower than those of the control group (1.53 +/- 0.07 and 1.68 +/- 0.25 respectively (both P < 0.01). (4) The OI at the end of CPB, and 12 h and 24 h after CPB of the perfusion group were 370 +/- 33, 388 +/- 41, and 414 +/- 39 respectively, all significantly higher than those of the control group (217 +/- 30, 210 +/- 36, and 222 +/- 33 respectively (all P < 0.05). (5) The time of mechanical ventilation the perfusion group was 13 h +/- 4 h, significantly shorter than that of the control group (27 h +/- 6 h, P < 0.01). CONCLUSION: Pulmonary artery perfusion with hypothermic washed RBC protective solution alleviates the lung injury after cardiopulmonary bypass.

[Study on the effect of adrenomedulin and urotensin-II on pulmonary hypertension of patients with congenital heart disease].

OBJECTIVE: To evaluate the effect and clinical significance of adrenomedulin (ADM) and urotensin-II (UII) on pulmonary hypertension (PH), by detecting their levels of patients with congenital heart disease and pulmonary hypertension. METHODS: 52 patients with congenital heart disease who had left-to-right shunt were selected randomly. 52 patients were divided three groups according to pulmonary artery systolic pressure (PASP): group A was not pulmonary hypertension (PASP < 30 mm Hg, n = 17); group B was mild pulmonary hypertension (PASP30-49 mm Hg, n = 18); group C was moderate and severe pulmonary hypertension (PASP > or = 50 mm Hg, n = 17). The plasma levels of ADM and UII were detected at each period by radioimmunoassay (RIA) method. It was analyzed the changes of their levels within pre-operation, 20 mins and 7 days post-operation and the interrelation between them and PASP. RESULTS: (1) Following the severity degree of pulmonary hypertension, the plasma levels of ADM increase. There is positive correlation between PAP and plasma level of ADM (pre-operation r = 0.8012, P < 0.01; 20 min post-operation r = 0.6325, P < 0.01; 7 d post-operation r = 0.7126, P < 0.01). (2) Following the severity degree of pulmonary hypertension, the plasma levels of UII don't change obviously. There is no correlation between PAP and plasma level of UII (P > 0.05). (3) The plasma levels of ADM: group A (pre-operation: 33 pg/ml +/- 5 pg/ml, 20 mins post-operation: 29 pg/ml +/- 4 pg/ml, 7 d post-operation: 20 pg/ml +/- 3 pg/ml); group B (pre-operation: 44 pg/ml +/- 8 pg/ml, 20 mins post-operation: 40 pg/ml +/- 6 pg/ml, 7 d post-operation: 34 pg/ml +/- 4 pg/ml); group C (pre-operation: 60 pg/ml +/- 10 pg/ml, 20 mins post-operation: 58 pg/ml +/- 8 pg/ml, 7d post-operation: 38 pg/ml +/- 4 pg/ml). Plasma level of ADM of each group after CPB is lower than that of each group before operation. It is statistical difference only 7 days post-operation (group A q = 5.41, P < 0.01; group B q = 4.76, P < 0.01; group C q = 6.32, P < 0.01). (4) The plasma levels of UII: group A (pre-operation: 2.2 pmol/L +/- 0.5 pmol/L, 20 mins post-operation: 2.2 pmol/L +/- 0.44 pmol/L, 7 d post-operation: 2.2 pmol/L +/- 0.6 pmol/L); group B (pre-operation: 2.7 pmol/L +/- 0.6 pmol/L, 20 mins post-operation: 2.6 pmol/L +/- 0.6 pmol/L, 7 d post-operation: 2.6 pmol/L +/- 0.5 pmol/L); group C (pre-operation: 2.9 pmol/L +/- 0.6 pmol/L, 20 mins post-operation: 2.6 pmol/L +/- 0.7 pmol/L, 7 d post-operation: 2.8 pmol/L +/- 0.4 pmol/L). Compared with that of each group before operation, Plasma level of UII of each group after operation is no obvious difference (P > 0.05). CONCLUSION: (1) Following the severity degree of pulmonary hypertension, the plasma levels of ADM increase. ADM plays an important role in the formation of pulmonary hypertension and restructure. (2) Following the severity degree of pulmonary hypertension, the plasma levels of UII don't change obviously. There is no correlation between PAP and plasma level of UII, but UII may be play an important role in the formation of pulmonary hypertension and restructure. (3) Measuring the levels of ADM may be a reliable method to follow the change of pulmonary pressure and worsening of pulmonary hypertension.