Taohong Siwu decoction ameliorates atherosclerosis in rats possibly through toll-like receptor 4/myeloid differentiation primary response protein 88/nuclear factor-κB signal pathway.

OBJECTIVE: To investigate the effect of Taohong Siwu decoction (, TSD) on atherosclerosis in rats as well as investigate the underlying mechanism based on molecular docking. METHODS: Sixty healthy male Sprague-Dawley rats were randomly divided into 6 groups with 10 rats in each group: control group, model group, atorvastatin group (AT, 2.0 mg/kg), and TSD groups (20, 10, 5 g/kg) after 7 d of acclimation. The model of atherosclerosis was successfully established except the control group by high fat diet (HFD) and vitamin D2. Biochemical analyzers were used to detect the levels of triglyceride (TG), total cholestero (TC), low density lipoprotein-cholesterol (LDL-C) and high density lipid-cholesterol (HDL-C) in blood lipid. The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1ß (IL-1ß) were determined by enzyme-linked immunosorbent assay. Sudan IV staining and Hematoxylin and eosin staining (HE staining) were performed to observe the pathological changes in aortic tissue. Molecular docking technology was used to predict the best matching between the main components of TSD and the target proteins. The expression of target proteins was further detected by quantitative real time polymerase chain reaction (qRT-PCR) and Western blot analysis. RESULTS: The results showed that TSD restricted atherosclerosis development and decreased the inflammatory cytokines in plasma. Molecular docking results predicted that the main components of TSD showed a strong binding ability with toll-like receptor (TLR4), myeloid differentiation primary response protein 88 (MyD88), and nuclear factor kappa-B (NF-κB). The results of qRT-PCR and Western blot analysis showed that the mRNA and protein expressions of TLR4, MyD88 and NF-κB p65 in the aorta were reduced in atorvastatin group and TSD group. CONCLUSIONS: TSD can ameliorate atherosclerosis in rats, and the underlying mechanism is supposed be related to the suppression of inflammatory response by regulating TLR4/MyD88/NF-κB signal pathway.

Echocardiography-guided percutaneous closure of patent ductus arteriosus without arterial access: Feasibility and safety for a new strategy / 中南大学学报(医学版)

Objective:To evaluate the feasibility and safety of device closure of patent ductus arteriosus (PDA)using only venous access under echocardiography guidance alone.Methods:A total of 102 consecutive pediatric patients underwent transcatheter PDA closure without arterial access,under the guidance of only echocardiography.The patients were followed up by clinical examination,electrocardiogram,and echocardiogram at 1,3,6 12,and 24 months.Results:Transvenous PDA closure under echocardiographic guidance was successful in 99 (97.1％)patients.There were no acute procedural complications or severe adverse events.The duration ranged from 10 to 65 minutes (median,21 minutes).Immediate complete closure of PDA was achieved in 87 patients (87.9％),and 100％ of the patients were completely closed after 24 h.There were no severe adverse events in the period of 1-24 months (median,12 months) follow up.Conclusion:Transvenous PDA closure without fluoroscopy avoids radiation exposure,contrast agent usage and potential arterial complications.It can be used as an alternative procedure,especially for children.

Application of permissive hypercapnia in thoracoscopic surgery of neonates with congenital esophageal ;atresia / 临床麻醉学杂志

Objective To investigate the application of permissive hypercapnia in the thoraco-scopic surgery of neonates with congenital esophageal atresia.Methods Thirty newborns with con-genital esophageal atresia,seventeen males,thirteen females,aged 1-5 days,weighing 1.42-3.28 kg, ASA physical status Ⅱ or Ⅲ,undergoing the thoracoscopic surgery,were randomly divided into group P and group C,n =1 5 in each group.The newborns were intratracheally intubated and adopted intravenous anesthesia combining inhalational anesthesia.FiO 2 100%,fresh gas flow 2 L/min,then adjusted the respirator parameters according to the results of airway pressure and arterial blood gas a-nalysis.Group P maintained PaCO 2 ranging at 60-80 mm Hg,group C maintained PaCO 2 ranging at 35-45 mm Hg.Arterial blood gas analysis was conducted respectively before artificial pneumothorax (T0 ),1 5 min after foundation of artificial pneumothorax (T1 ),30 min after foundation of artificial pneumothorax (T2 ),60 min after foundation of artificial pneumothorax (T3 )and 1 5 min after artifi-cial pneumothorax (T4 ).Two hours after surgery,a chest X ray photograph was taken to observe pneumothorax.The time from the end of the surgery to the ventilator weaning was recorded. Results At T1-T3 ,the PET CO 2 [(73.93 ± 3.53 )mm Hg vs.(41.53 ± 1.59 )mm Hg,(73.46 ± 3.04)mm Hg vs.(41.30±1.29)mm Hg,(74.13±2.85)mm Hg vs.(41.67 ±1.35)mm Hg]in group P were greatly higher than those in group C (P <0.05);the arterial blood pH value of group P (7.25±0.02 vs.7.38 ± 0.03,7.24 ± 0.01 vs.7.37 ± 0.03,7.25 ± 0.01 vs.7.38 ± 0.02 )were greatly lower than those in group C (P <0.05);PaCO 2 [(74.80±2.45)mm Hg vs.(41.93±1.39) mm Hg,(75.33±2.1 9)mm Hg vs.(42.01±1.31)mm Hg,(75.20±2.08)mm Hg vs.(42.13± 1.1 9)mm Hg ] were greatly higher than those in group C (P < 0.05 ).The incidence of pneumothorax of group P was obviously lower than that of group C (6.7% vs.40.0%,P <0.05 ). There was no statistically significant difference of the time from the end of surgery to the ventilator weaning [(3.6±0.6)d vs.(3.5 ±0.6)d]between the two groups.Conclusion Permissive hyper-capnia significantly reduces the incidence of pneumothorax in the thoracoscopic surgery of neonates with congenital esophageal atresia.Permissive hypercapnia (PaCO 2 60-80 mm Hg)can be safely ap-plied to the thoracoscopic surgery of neonates with congenital esophageal atresia.

Application of perimembranous ventricular septal defects closure solely by femoral vein approach under transesophageal echocardiography guidance / 中南大学学报(医学版)

Objective:To investigate the feasibility and safety of perimembranous ventricular septal defects (PmVSD) closure solely by femoral vein approach under transesophageal echocardiography (TEE) guidance.Methods:From January 1,2014 to May 31,2016,26 patients with PmVSD in Second Xiangya Hospital were selected,with age at 3.2-6.0 (4.3±0.7) years old and body weight at 15.0-19.5 (16.7±1.4) kg.The diameter of VSD was 3.5-4.8 (4.1±0.3) mm.All patients were treated by percutaneous PmVSD closure solely by femoral vein approach under TEE guidance.The effect of the procedure was evaluated by TEE and transthoracic echocardiography (TTE).The clinical follow-up study was conducted by TTE at 1,3,6 and 12 month (s) after the procedure.Results:Twenty cases were successfully treated with percutaneous PmVSD closure solely by femoral vein approach under TEE guidance,and the success rate was 76.9％.Six patients were converted to perventricular closure under TEE guidance because the guide wire in two cases or catheter in other cases could not pass through PmVSD.The diameter of symmetrical VSD occluder was 6.0-7.0 (6.2±0.4) mm.The procedural time was 12.0-64.0 (26.8±6.3) min.The residence time at ICU was 1.8-2.4 (26.8±6.3) h.The in-hospital time was 4.0-5.0 (4.4±0.5) d.There were 3 patients with immediate post-operative trivial residual shunt and incomplete right bundle branch block (IRBBB).All patients survived with no peripheral vascular injury or complications such as tricuspid regurgitation,pericardial tamponade and pulmonary infection.The residual shunt disappeared in 3 patients and IRBBB became normal rhythm in 3 patients at 1 month follow-up time point.No patients suffered from occluder malposition,residual shunt,pericardial effusion,arrhythmia (atrio-ventricular block),aortic valve regurgitation and tricuspid regurgitation.Conclusion:TEE-guided percutaneous PmVSD closureby femoral vein approach is safe and effective.

Impact of Down syndrome on the surgical treatment of congenital heart defects / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the impact of Down syndrome (DS) on surgical management in patients with congenital heart defects (CHD).@*METHODS@#We retrospectively analyzed the clinical data from 35 children with DS and CHD, who underwent cardiac surgery between 2004 and 2009. The data on surgical mortality, complications and follow-up results are emphasized.@*RESULTS@#All of the patients underwent primary repair. One child (2.9%) with DS and complete atrioventricular septal defect (CAVSD) died early postoperatively because of pulmonary hypertension. Two patients (5.7%) had low cardiac output syndrome, and 15 (42.9%) suffered pulmonary complications. III degree atrioventricular block (AVB) occurred in 4 patients (11.5%). Thirty children who were followed up 10 months to 6 years [(3.8±1.1) years] are in NYHA class I or II. There were no reoperations or later death.@*CONCLUSION@#CHD in DS children can be repaired with a low risk of mortality, although a high incidence of severe infections and III degree AVB can result in a complicated postoperative course. The results of mid-term follow up are satisfactory.