[Medium- and long-term outcomes of cardiac assist devices after coronary artery bypass grafting in left ventricular dysfunction patients].

Objective: To evaluate the medium-and long-term outcomes of cardiac assist devices after coronary artery bypass grafting (CABG) in patients with left ventricular dysfunction. Methods: From January 2012 to May 2018, a total of 127 patients with low left ventricular ejection fraction (LVEF) value (≤40%) undergoing CABG in the Department of Cardiovascular Surgery of the First Affiliated Hospital of Zhengzhou University were selected. Meanwhile, another 2 454 cases with LVEF>55% were also enrolled as controls. Clinical data of intra-aortic balloon pump (IABP) and extracorporeal membrane oxygenation (ECMO) application were compared and analyzed. All patients were followed up at the Outpatient Clinic at different time points (3 and 6 months after surgery, then every year). Results: Compared to the control group, IABP usage (10.2% vs 0.8%), ECMO usage (6.3% vs 0.3%) and the mortality (4.7% vs 0.7%) were higher (all P<0.05) in the left ventricular dysfunction group. Additionally, Intensive Care Unit stay [(50±12) h vs (33±10) h] and the hospital stay after surgery [(15±3) d vs (11±4) d] was longer in the left ventricular dysfunction group (all P<0.05). In the left ventricular dysfunction group, LVEF at 3, 6 month and 1 year was (48±8)%, (51±9)%, and (55±9)%, respectively, and then maintained stable. Conclusions: Patients with left ventricular dysfunction who received coronary artery bypass grafting had a high rate of cardiac assist devicesuse, however, optimal perioperative management can save the lives of some patients, whose medium-and long-term outcome are good. Therefore, it is worthy of being recommended in clinical practice.

The expression of MMP-7 in serum and aneurysm tissues of patients with abdominal aortic aneurysm associated with hypertension and the clinical efficacy of endovascular exclusion.

OBJECTIVE: To investigate the expression of matrix metalloproteinase-7 (MMP-7) in abdominal aortic aneurysm (AAA) with hypertension, and the clinical efficacy of endovascular exclusion. PATIENTS AND METHODS: Seventy-two cases of AAA with hypertension were retrospectively analyzed. Patients were divided into the observation group (34 cases) and control group (38 cases). The control group was treated by AAA incision with artificial vascular replacement, while the observation group was treated by endovascular graft exclusion. Over the same period, 72 age- and sex-matched healthy adults and 72 patients with hypertension were selected. MMP-7 expression in patients with hypertension, aneurysm associated with hypertension, and healthy controls were measured by ELISA and immunohistochemical staining. RESULTS: ELISA showed that serum MMP-7 levels of patients with an aneurysm were significantly higher than those of patients with simple hypertension and healthy controls (p<0.05). The operative time, blood loss, and blood transfusion in the observation group were significantly lower than those in the control group (p<0.05). At the 1-month follow-up, the prevalence of pulmonary infection, incision infection, lower limb thrombosis, and lower limb weakness in the observation group were significantly lower than in the control group (p<0.05). The quality of life scores in the observation group after 1 and 3 months was significantly higher than those in the control group (p<0.05). Immunohistochemistry showed that the expression of MMP-7 in aneurysm tissue was significantly higher than in normal tissue. The expression of MMP-7 in the two groups was significantly decreased compared with before surgery (p<0.05). CONCLUSIONS: The detection of MMP-7 expression in hypertensive patients is an early marker of the occurrence of AAA. The use of endovascular exclusion for the treatment of AAA with hypertension is minimally invasive and safe. Furthermore, postoperative vital signs of patients are stable, and the quality of life is improved.

Infected bone inactivation combined with transplantation of autologous platelet-rich plasma and bone marrow for treatment of chronic osteomyelitis.

OBJECTIVE: Here we tested the therapeutic efficacy of infected bone inactivation combined with transplantation of autologous platelet-rich plasma and bone marrow in chronic osteomyelitis. PATIENTS AND METHODS: 64 patients with chronic osteomyelitis were randomly divided into two groups. Patients in control group received conventional antibiotic and surgical treatments, while patients in the experimental treatment group underwent infected bone inactivation combined with transplantation of autologous platelet-rich plasma and bone marrow. The X-ray, histological, and biochemical (alkaline phosphatase) changes were assessed at 4, 8, 12 and 16 weeks after the treatment. RESULTS: At all tested study points, X-ray and histological scores, and alkaline phosphatase levels were significantly better in patients of the experimental treatment group. CONCLUSIONS: Infected bone inactivation combined with transplantation of autologous platelet-rich plasma and bone marrow achieves beneficial therapeutic results in chronic osteomyelitis.

The double-RNA-specific adenosine deaminase (DSRAD) gene in dyschromatosis symmetrica hereditaria patients: two novel mutations and one previously described.

BACKGROUND: Dyschromatosis symmetrica hereditaria (DSH, MIM 127400) is an autosomal dominant pigmentary genodermatosis. Pathogenic mutations in the double-RNA-specific adenosine deaminase (DSRAD) gene encoding an RNA editing enzyme have recently been identified. OBJECTIVES: To identify gene mutations of DSRAD in Chinese patients with DSH. METHODS: Three unrelated Chinese patients with DSH were subjected to mutation detection in DSRAD. Two had family histories of DSH. All the coding exons and their flanking sequences were amplified and sequenced. RESULTS: All three patients had heterozygous mutations including one non-sense, one frameshift and one missense mutation in DSRAD. CONCLUSIONS: Two novel mutations, c.3169delC (p.L1057fs) and c.3247C-->T (p.R1083C), and one recurrent mutation c.1420C-->T (p.R474X), were found in this series of Chinese patients with DSH.

A homozygous nonsense mutation in the EVER2 gene leads to epidermodysplasia verruciformis.

Epidermodysplasia verruciformis (EV) is a genodermatosis with mainly autosomal recessive inheritance. Pathogenic mutations in two adjacent genes, EVER1 and EVER2, have recently been identified. In this study, we performed mutation detection for the EVER1 and EVER2 genes on samples from a Chinese patient with EV, who had consanguineous parents. A homozygous C-->T transition at nucleotide position 568 within exon 6 of the EVER2 gene was detected. The mutation led to a premature translation termination (R190X) and the predicted protein lacked 537 amino acids. This novel nonsense mutation is, to our knowledge, the first mutation reported in Chinese patients with EV.

Four novel mutations in ATP2C1 found in Chinese patients with Hailey-Hailey disease.

BACKGROUND: Familial benign chronic pemphigus or Hailey-Hailey disease (HHD; OMIM 169600) is an autosomal dominant blistering disease. Pathogenic mutations in ATP2C1 encoding a novel Ca2+ pump have recently been identified. OBJECTIVES: To identify mutations in ATP2C1 in Chinese patients with HHD. METHODS: Eleven unrelated Chinese patients with HHD were subjected to mutation detection in ATP2C1. Eight of them had a family history of HHD. The 27 coding exons and their flanking sequences were amplified and sequenced. RESULTS: Five of the 11 patients were identified to have heterozygous mutations including three nonsense mutations and two splicing mutations in ATP2C1. CONCLUSIONS: Four novel mutations, nonsense mutations S887X and W795X and splicing mutations 118-1 g-->a and 1890+1del(gtgag)ins53, were found in this series of Chinese patients with HHD.

Experimental increase in accommodative potential after neodymium: yttrium-aluminum-garnet laser photodisruption of paired cadaver lenses.

PURPOSE: Loss of lens elasticity is one of several proposed mechanisms responsible for the decline in accommodation with age and is the most accepted explanation for presbyopia. We wish to confirm the lens elasticity premise and attempt to experimentally reverse the age-dependent loss of accommodative potential as measured by polar strain. DESIGN: Experimental human autopsy eye study. PARTICIPANTS AND CONTROLS: Thirty-six cadaver lenses were tested to determine the age-dependent polar strain. Eleven lens pairs were then tested with one lens treated with neodymium:yttrium-aluminum-garnet (Nd:YAG) laser and the other left untreated before rotation as an age control. TESTING: Using a custom-made rotational apparatus (described by Fisher, 1971), freshly excised cadaver lenses (<48 hours postmortem) were rotated at 1000 rpm on a 9-mm diameter pedestal to simulate the physiologic pull of the zonules. Lenses were initially tested to determine the age-dependent polar strain. One lens in a pair was then treated with an Nd:YAG laser and the other left untreated before testing. Treatment consisted of 100 suprathreshold pulse placed in a central annular pattern of 2- to 4-mm diameter. Treatment energies varied from 2.5 to 7.0 mJ/pulse, depending on the relative clarity of the lenses. Polar strain was both microscopically measured and calculated from projected photographs before and after rotation of both lased and unlased lenses. Statistically significant differences were determined by paired t test. MAIN OUTCOME MEASURES: Polar strain (decrease in axial thickness with rotation) of the lens. RESULTS: An age-dependent decrease in polar strain was observed that paralleled the findings of Fisher. Both measured and projected polar strain were greater in the lased than unlased lens, and this difference was highly significant by paired t test (P = 0.001 and P = 0.004, respectively). CONCLUSIONS: Age-dependent loss of lens elasticity (polar strain) can be experimentally reversed (increased) by selective intralenticular photodisruption.

Pattern of retinal dysfunction in acute zonal occult outer retinopathy.

PURPOSE: To elucidate the pathophysiology of the diseases recently grouped under the name of acute zonal occult outer retinopathy (AZOOR). METHODS: Twenty-four patients with the diagnosis of multiple evanescent white dot syndrome, acute idiopathic blind-spot enlargement syndrome, acute macular neuroretinopathy, multifocal choroiditis, or pseudo-presumed ocular histoplasmosis syndrome, or a combination of these diagnoses, were evaluated on one or more visits with full-field electroretinograms (ERGs) and kinetic and static perimetry. Sera and IgG fractions were tested using immunofluorescence on cryostat sections of fixed and unfixed human and rat retina. RESULTS: Patients with AZOOR as a group showed abnormal results for all eight ERGs and two visual field parameters measured. Interocular asymmetry was a prominent feature of the patients' test results. Logistic regression indicated that interocular differences in ERG parameters significantly increased the efficacy of identifying patients with AZOOR beyond that of the parameter values alone. Visual field area correlated well with ERG a-wave amplitude. Serial visual function tests in a subset of patients showed that there could be short-term partial recovery or progressive loss of function. Autoantibodies to a specific retinal cell type were not detected. CONCLUSIONS: All patients with AZOOR showed a pattern of visual dysfunction that was photoreceptor in origin, patchy in its distribution across the retina, and asymmetric in the two eyes. There was considerable variability in the severity and the natural history of retinal dysfunction in the patients studied. The full-field ERG was found to be a valuable adjunct in diagnosing AZOOR, especially when the expected interocular variation in measured parameters was known for control subjects. No evidence was obtained for autoantibodies to any retinal cell type in the patients with AZOOR who were tested.

[Mass photofluorography in early detection of peripheral lung cancer].

During 5 consecutive years of 100 mm photofluorography, 21 cases of primary lung cancer were discovered among 211,881 checked subjects in 54 factories in the suburbs of Beijing. Detection rate was 9.9/100,000. In the male smokers 40 years old or over, who comprised 13.7% of all examined with a detection rate of 55.0/100,000. Among the 21 cases, peripheral cancer was 61.9%, in which 38.4% were stage I 69.2% were treated by surgical resection, much higher than that of the central type. It may be concluded that photofluorography in mass screening has a certain value in early detection of the peripheral lung cancer and the male smokers 40 years or over should be examined as a priority group.