Long-term results of surgical treatment of aortic and mitral regurgitation with enlarged left ventricle.

Mitral valve and aortic valve regurgitation associated with enlarged left ventricle remains difficult to manage and the long-term results following surgical treatment is uncertain. Between April 1988 and September 2000, 82 patients with aortic and mitral regurgitation associated with enlarged left ventricle underwent valve replacement at Anzhen Hospital. The valve disease was rheumatic in origin in 75 patients (91.5%) and congenital in 7 (8.5%). Twenty-eight patients were in New York heart Association Functional (NYHA) class II and 39 in class III and 15 in class IV. Echocardiogram showed severe aortic insufficiency associated with mild to moderate mitral regurgitation in 66 patients and severe mitral regurgitation associated with mild to moderate AI in 16 patients. The mean left ventricular diastole diameter (LVDD) was 77.8 ± 5.2 mm. Valve replacement was performed under hypothermic cardiopulmonary bypass (CPB). Early hospital mortality was 7.3%. Two weeks after surgery the echocardiogram showed a reduction of LVDD. Follow up was completed in 69 patients with mean of 13.5 years. 20 patients were in NYHA class I; 26 in Class II and 3 in Class III and 2 in class IV. The follow-up survival rate was 73.9%, and follow-up mortality was 26.1%. LVDD reduced from 77.8 ± 5.2 mm to 58.3 ± 4.5 mm (P < 0.001). In 24 patients, the LVDD was less than 50 mm. Double valve replacement and/or repair carried out an acceptable early and Long-term clinical outcomes in patients with MR and AI with associated LV great enlargement. Both LVDD and NYHA improved following surgical treatment in survival patients.

Double-perovskite magnetic La2NiMnO6 nanoparticles for adsorption of bovine serum albumin applications.

Double-perovskite La2NiMnO6 (LNMO) nanoparticles were synthesized by co-precipitation process, and the adsorption of bovine serum albumin (BSA) protein on these nanoparticles was carried out. The powder samples were annealed at 750, 850, 950, and 1,050°C, respectively. X-ray diffraction (XRD) results reveal that there are double perovskites and exhibit mixed orientations, without any impurity phases. Transmission electron microscopy results as well as the XRD estimate results show that the crystalline size is about 34 to 40 nm. The adsorption of BSA on the magnetic nanoparticles was analyzed using a UV spectrophotometer at room temperature. The results show that the as-prepared LNMO nanoparticles display a good adsorbing ability for BSA, and the nanoparticle sintered at 850°C has the highest value of 219.6 mg/g, which is much higher than others.

In Vitro Screening for Antihepatic Steatosis Active Components within Coptidis Rhizoma Alkaloids Extract Using Liver Cell Extraction with HPLC Analysis and a Free Fatty Acid-Induced Hepatic Steatosis HepG2 Cell Assay.

A high-throughput method was developed and applied to screen for the active antihepatic steatosis components within Coptidis Rhizoma Alkaloids Extract (CAE). This method was a combination of two previously described assays: HepG2 cell extraction with HPLC analysis and a free fatty acid-induced (FFA) hepatic steatosis HepG2 cell assay. Two alkaloids within CAE, berberine and coptisine, were identified by HepG2 cell extraction with HPLC analysis as high affinity components for HepG2. These alkaloids were also determined to be active and potent compounds capable of lowering triglyceride (TG) accumulation in the FFA-induced hepatic steatosis HepG2 cell assay. This remarkable inhibition of TG accumulation (P < 0.01) by berberine and coptisine occurred at concentrations of 0.2 µ g/mL and 5.0 µ g/mL, respectively. At these concentrations, the effect seen was similar to that of a CAE at 100.0 µ g/mL. Another five alkaloids within CAE, palmatine, epiberberine, jateorhizine, columbamine, and magnoline, were found to have a lower affinity for cellular components from HepG2 cells and a lower inhibition of TG accumulation. The finding of two potent and active compounds within CAE indicates that the screening method we developed is a feasible, rapid, and useful tool for studying traditional Chinese medicines (TCMs) in treating hepatic steatosis.

[Clinical application of redo coronary artery bypass grafting].

OBJECTIVE: To determine the clinical characteristics and outcomes of redo CABG. METHODS: The outcomes of 42 consecutive patients who underwent redo CABG from January 2002 to December 2010 was analyzed. There were 29 males and 13 females, aging from 46 to 78 years old with a mean of (61.2 ± 2.1) years. Off-pump CABG was applied for 31 patients and on-pump CABG for 11 patients. There were 1 patient underwent concomitant aortic valve replacement and 1 patient underwent aortic root and right aortic arch replacement respectively. RESULTS: Three patients died of right ventricle rupture, heart failure and multiple system organ failure respectively and the perioperative mortality rate was 4.8%. The post-operatively mechanical ventilation time varied from 9 to 27 h with a mean of (17 ± 7) h. There was no residual angina and perioperative myocardial infarction in the remaining patients who were all discharged uneventfully. Intraoperative 6 patients had accepted intraaortic balloon counterpulsation. During the follow-up from 6 months to 4.5 years for 38 patients, which showed no evidence of recurrent angina and postoperative coronary CT angiography in 12 patients showed the patency of grafts is good. CONCLUSION: Satisfactory outcome of redo coronary artery bypass grafting can be achieved if proper indication were choose and reasonable management were performed.

[The early and middle-long term clinical results of surgical treatment for ventricular septal rupture].

OBJECTIVE: To explore the way of promoting the efficacy of surgical treatment for ventricular septal rupture (VSR) after acute myocardium infarction in terms of perioperative and long term survival. METHODS: The clinic data of 37 VSR cases underwent surgical treatment from October 1994 to October 2007 were analyzed retrospectively. There were 24 male and 13 female, and the age was (63.4 +/- 7.6) years old. The whole group was divided into the VSR repair plus revascularization group (group A, 26 cases) and simple VSR repair group (group B, 11 cases). RESULTS: There were 4 operative deaths in group A (15.4%), 7 deaths in group B (63.6%), P = 0.006. With the follow-up of (34.0 +/- 29.8) months ranged from 2 to 103 months of the 26 operational survivors, there were 5 late deaths, of which 2 deaths in group A and 3 deaths in group B. According to the Kaplan-Meier survival curve, the actuarial survival rate at 6 to 8 year was (64.3 +/- 21.0)% for group A and the actuarial survival rate at 4 year was (25.0 +/- 21.7)% for group B, P = 0.011. Of the 21 mid-long term survivors, 17 cases were in NYHA class I to II and 4 cases in NYHA class III to IV. There were 4 cases suffered from VSR recurrence. According to Logistic regression, the risk factors for the early death were not adoptive of revascularization, cardiogenic shock and emergency surgical procedure, while the risk factors for late death were not adoptive of revascularization and low cardiac output after the procedures. CONCLUSIONS: VSR repair plus revascularization could improve the perioperative and mid-long term survival for the surgical treatment of VSR. The appropriate timing and procedures of the surgical operation are very important to promote perioperative survival and to prevent VSR recurrence.

[Long-term results of surgical repair of ruptured sinus of aortic sinus aneurysm].

OBJECTIVE: To summarize the clinic characteristics and effect of surgical repair of ruptured aortic sinus aneurysm. METHODS: From September 1997 to September 2007, 43 patients with ruptured aortic sinus aneurysm underwent surgical procedures. There were 32 male and 11 female patients. The age ranged from 11 to 50 years old with a mean of (29.0 +/- 11.5) years old. The origins of rupture were the right coronary sinus in 34 patients and the noncoronary sinus in 9 patients. The aneurysms ruptured into the right ventricle in 30 patients, the right atrium in 8 patients, the right ventricle and right atrium in 3 patients, and the ventricular septum and then the right ventricle in 2 patients. Associated cardiac anomalies included ventricular septal defect in 26 patients, aortic regurgitation in 15 patients, infectious endocarditis in 8 patients, tricuspid regurgitation in 6 patients, atrial septum defect in 4 patients, mitral valve regurgitation in 2 patients, patent ductus arteriosus in 2 patients, and pulmonary valve vegetation in 1 patient. All the patients underwent the repair of ruptured aortic sinus aneurysm and correction of associated anomalies with cardiopulmonary bypass. RESULTS: There were no deaths after the operation and during the follow-up. The complications, including acute heart failure and III atrioventricular block, occurred in 5 patients. Follow-up was 6 to 120 months with a mean of (68.0 +/- 17.7) months. Two patients underwent reoperation for aortic valve replacement at the 6(th) and 8(th) year after the first operation. There were 2 patients which the aortic regurgitation deteriorated from grade I to II. CONCLUSIONS: Repair of ruptured aortic sinus aneurysm presents a satisfactory result. Aggressive treatment in early time, prevention of post-operative complications and long-term follow-up are recommended in the treatment for patients of ruptured aortic sinus aneurysm with infectious endocarditis and aortic regurgitation.

[Effects of Huafenqinutang and vardenafil for treatment of chronic prostatitis/chronic pelvic pain syndrome with concomitant erectile dysfunction].

OBJECTIVE: To evaluate the effects of Huafenqinutang combined with vardenafil for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with erectile dysfunction. METHODS: One hundred and thirty-eight cases diagnosed as CP/CPPS with erectile dysfunction were randomized into trial group (70 cases) and control group (68 cases) for treatment with Huafenqinutang for 8 weeks, and in the former group, vardenaffil was added since the fifth weeks. All the cases were evaluated according to NIH-CPSI and IIEF-5 scores at 4 weeks and 8 weeks, respectively. RESULTS: At the end of the fourth weeks, NIH-CPSI score was 13.1-/+4.7 in the trial group and 13.3-/+4.5 in the control group, which were comparable between the two groups (P>0.05) but significantly decreased compared with the pre-treatment scores in both groups (P<0.01). IIEF-5 score was also similar between the two groups (14.1-/+3.3 vs 14.3-/+5.0, P>0.05) but significantly increased compared with the pre-treatment scores in both groups (P<0.01). At the end of the eighth week, NIH-CPSI score was 7.8-/+2.2 and IIEF-5 score 20.1-/+4.4 in the trial group, which were significantly different from those at the end of the fourth week (P<0.01). In the control group, NIH-CPSI score was 12.7-/+2.3 and IIEF-5 score 14.3-/+4.5 at the eighth week, similar to those at the end of the fourth week (P>0.05). There were significant differences in NIH-CPSI and IIEF-5 scores between the 2 groups (P<0.01), and the change of NIH-CPSI score was negatively correlated with IIEF-5 score in the trial group (r=-0.89, P<0.01). CONCLUSION: For patients with CP/CPPS with erectile dysfunction, Huafenqinutang treatment in combination with vardenafil can effectively improve the erectile functions and decrease the NIH-CPSI score to favor the recovery from CP/CPPS.

[Research on extracting process for compound shenzhutiaozhi capsule].

OBJECTIVE: The technics of optimal extraction for compound shenzhutiaozhi capsule is investigated in this study. METHODS: Orthogonal test were employed for selecting the optimum of extraction technics and the contents of oleanolic acid and salvianolic acid B were detected by TLC-scanning and HPLC, respectively. RESULTS: Five volume of 70% alcohol, extracting 3 times with half an hour for each time, and seven volume of water, extracting 3 times with half an hour for each time were considered the optimum extraction technics of Frugtus Ligustri lucid, Salvie miltiorrhizae as well as Reizaoma Atractylodis Macrocfphalae, respectively. CONCLUSION: The considerable extraction rate of active components in the drugs is achieved by applying the selected technics.

[Jingjielianqiao Decoction promotes leg ulcer healing in rabbits].

OBJECTIVE: To study the effect of Jingjielianqiao Decoction in promoting leg ulcer in rabbits. METHODS: Nine adult male New Zealand albino rabbits with chronic leg ulcers were randomized into 3 groups, namely group A treated with Jingjielianqiao Decoction, group B with Shengjiyuhong Decoction, and group C with normal saline. Gross observation of the wounds was carried out regularly for evaluating the changes in the ulcerous area, depth and wound surface excretion. After 3 weeks of treatment, the tissues on the edge of the ulcer were sampled and prepared for routine pathological examination, electron microscopy and immunohistochemistry for vascular endothelial growth factor (VEGF) and CD34. The number of blood vessels and their areas were also recorded. RESULTS: The wounds showed no significant differences between the 3 groups by gross observation during the treatment, but after completion of the 3-week treatment, routine pathological examination and electron microscopy revealed significant differences between the groups. Immunohistochemistry for VEGF and CD34 yielded comparable results between groups A and B (positive control), but showed significant differences between group C and the other two groups (P<0.01). CONCLUSION: Jingjielianqiao Decoction and Shengjiyuhong Decoction can obviously promote the healing of leg ulcer in rabbits.

[Effect of Jingjielianqiao decoction on healing of skin ulcer in rats].

OBJECTIVE: To study the pharmacodynamics of Jingjielianqiao decoction in promoting the healing of skin ulcer in mice. METHODS: Mouse models of skin ulcer were established by inducing skin trauma and scald, respectively. The skin ulcer of the mice was treated with Jingjielianqiao decoction or recombinant human epithelial growth factor (rhEGF), and the ulcer area after treatment was compared between the two groups and with their respective self control. Inflammatory cell infiltration in the ulcer was observed under the microscope. RESULTS: Compared with the self-control group, the skin ulcer area of mice treated with Jingjielianqiao decoction was reduced obviously (P<0.001), and the inflammatory cell infiltration also alleviated (P<0.001). Jingjielianqiao decoction produced significantly better therapeutic effect than rhEGF. CONCLUSION: Jingjielianqiao decoction can obviously improve the healing of skin ulcer in mice with better effect than rhEGF.

[Effect of saikosaponins on epileptic rat electroenciphalogram].

OBJECTIVE: To study the effect of saikosaponins on the electroencephalogram (EEG) of epileptic rats to evaluate its therapeutic effect against epilepsies. METHODS: Sixty 8-week-old healthy SD rats were randomized into normal control group (A), epileptic model group (B), lamotrigine group (C), and 3 saikosaponin groups of small, moderate and high doses (D, E, and F groups, respectively), with 10 rats in each group. Penicillin was used to induce epilepsy in the latter 5 groups, and the EEG and onset of epileptic seizures were observed in each group. RESULTS: In group B, the EEG contained obvious epileptic discharges, which were not found in that in group A. After treatment with saikosaponins and lamotrignie, the EEG of group C and F became normal, whereas the EEG in group D still contained epileptic discharges at a low level, and that in group E was basically normal. The EEGs of group C, D, E, and F were significantly different from that in group B (P<0.001). CONCLUSION: Saikosaponins can obviously alleviate the severity of epileptic seizure in epileptic rats.

[Digital model of the theory of Yin and Yang in traditional Chinese medicine].

To construct a digital model of Yin and Yang of traditional Chinese medicine (TCM), computerized binary digital coding was used for decomposition and reconstruction of the theory of Yin and Yang, which proved to be a successful simulation of the major ingredients of the theory and suggested the possibility of digitalization of the fundamental theories in TCM.

[Mechanism of quercetin as an antidiarrheal agent].

OBJECTIVE: To investigate the antidiarrheal mechanism of quercetin extracted from Psidium guajava L. METHODS: The effects of quercetin on the contractility of guinea pig ileum in vitro and on the peristaltic motion of mouse small intestine in vivo were observed, and the peak value of contractility and peristaltic distance recorded. The inhibitory effect of quercetin on the permeability of the abdominal capillaries was also observed. RESULTS: Quercetin inhibited the contraction of guinea pig ileum in vitro and the peristaltic motion of mouse small intestine, and reduced the permeability of abdominal capillaries. CONCLUSION: Quercetin can inhibit the intestinal movement and reduce capillary permeability in the abdominal cavity, which may be the antidiarrheal mechanism of Psidium guajava L extract.

Progress of intervention of renal interstitial fibrosis with Chinese traditional herbal medicine.

This article reviews the current status of progress in the research of renal interstitial fibrosis therapy using traditional Chinese herbal medicine, which exerts its therapeutic effect through inhibiting cytokine expression and fibroblast proliferation, inducing apoptosis of the renal myofibroblasts and other mechanisms.