[Preliminary experience of transcatheter pulmonary valve replacement using domestic balloon-expandable valve].

Objectives: To evaluate the feasibility and preliminary clinical results of transcatheter pulmonary valve replacement (TPVR) with the domestically-produced balloon-expandable Prizvalve system. Methods: This is a prospective single-center observational study. Patients with postoperative right ventricular outflow tract (RVOT) dysfunction, who were admitted to West China Hospital of Sichuan University from September 2021 to March 2023 and deemed anatomically suitable for TPVR with balloon-expandable valve, were included. Clinical, imaging, procedural and follow-up data were analyzed. The immediate procedural results were evaluated by clinical implant success rate, which is defined as successful valve implantation with echocardiography-assessed pulmonary regurgitation

[Feasibility and safety of transseptal transcatheter mitral valve replacement for severe mitral regurgitation].

A prospective, single-center, single-arm, and open-design study was performed to evaluate the feasibility and safety of transseptal transcatheter mitral valve replacement in the treatment of severe mitral regurgitation. Patients with symptomatic moderate-severe or severe mitral regurgitation at high-surgical risk and anatomically appropriate for the HighLife transseptal mitral valve replacement (TSMVR) system in West China Hospital, Sichuan University from December 2021 to August 2022 were enrolled. Four patients (1 male and 3 females) with severe mitral regurgitation were included, with a median age of 68.5 (64.0-77.0) years and a median Society of Thoracic Surgeons (STS) score of 8.1% (6.4%-8.9%). Technical success was achieved in all the patients. There was no residual mitral regurgitation, paravalvular leakage, or left ventricular outflow tract obstruction. Three major cardiovascular and cerebrovascular adverse events occurred within 30 days after the procedure, including ventricular tachycardia, iatrogenic atrial septal defect closure, and heart failure readmission. The current study preliminarily demonstrates that transcatheter mitral valve replacement using the HighLife system via the transseptal approach for severe mitral regurgitation is feasible and relatively safe.

[Effects of low-dose photodynamic therapy on the function of human adipose mesenchymal stem cells and its mechanism].

Objective: To investigate the effects of low-dose photodynamic therapy on the proliferation, regulation, and secretion functions of human adipose mesenchymal stem cells (ADSCs) and the related mechanism, so as to explore a new method for the repair of chronic wounds. Methods: The experimental research methods were adopted. From February to April 2021, 10 patients (5 males and 5 females, aged 23 to 47 years) who underwent cutaneous surgery in the Department of Dermatology of the First Affiliated Hospital of Army Medical University (the Third Military Medical University) donated postoperative waste adipose tissue. The cells were extracted from the adipose tissue and the phenotype was identified. Three batches of ADSCs were taken, with each batch of cells being divided into normal control group with conventional culture only, photosensitizer alone group with conventional culture after being treated with Hemoporfin, irradiation alone group with conventional culture after being treated with red light irradiation, and photosensitizer+irradiation group with conventional culture after being treated with Hemoporfin and red light irradiation, with sample number of 3 in each group. At culture hour of 24 after the treatment of the first and second batches of cells, the ADSC proliferation level was evaluated by 5-ethynyl-2'-deoxyuridine staining method and the migration percentage of HaCaT cells cocultured with ADSCs was detected by Transwell experiment, respectively. On culture day of 7 after the treatment of the third batch of cells, the extracellular matrix protein expression of ADSCs was detected by immunofluorescence method. The ADSCs were divided into 0 min post-photodynamic therapy group, 15 min post-photodynamic therapy group, 30 min post-photodynamic therapy group, and 60 min post-photodynamic therapy group, with 3 wells in each group. Western blotting was used to detect the protein expressions and calculate the phosphorylated mammalian target of rapamycin complex (p-mTOR)/mammalian target of rapamycin (mTOR), phosphorylated p70 ribosomal protein S6 kinase (p-p70 S6K)/p70 ribosomal protein S6 kinase (p70 S6K) ratio at the corresponding time points after photodynamic therapy. Two batches of ADSCs were taken, and each batch was divided into normal control group, photodynamic therapy alone group, and photodynamic therapy+rapamycin group, with 3 wells in each group. At culture minute of 15 after the treatment, p-mTOR/mTOR and p-p70 S6K/p70 S6K ratios of cells from the first batch were calculated and detected as before. On culture day of 7 after the treatment, extracellular matrix protein expression of cells from the second batch was detected as before. Data were statistically analyzed with one-way analysis of variance and least significant difference test. Results: After 12 d of culture, the cells were verified as ADSCs. At culture hour of 24 after the treatment, the ADSC proliferation level ((4.0±1.0)% and (4.1±0.4)%, respectively) and HaCaT cell migration percentages (1.17±0.14 and 1.13±0.12, respectively) in photosensitizer alone group and irradiation alone group were similar to those of normal control group ((3.7±0.6)% and 1.00±0.16, respectively, P>0.05), and were significantly lower than those of photosensitizer+irradiation group ((34.2±7.0)% and 2.55±0.13, respectively, P<0.01). On culture day of 7 after the treatment, compared with those in normal control group, the expression of collagen Ⅲ in ADSCs of photosensitizer alone group was significantly increased (P<0.05), and the expressions of collagen Ⅰ and collagen Ⅲ in ADSCs of irradiation alone group were significantly increased (P<0.01). Compared with those in photosensitizer alone group and irradiation alone group, the expressions of collagen Ⅰ, collagen Ⅲ, and fibronectin of ADSCs in photosensitizer+irradiation group were significantly increased (P<0.01). Compared with those in 0 min post-photodynamic therapy group, the ratios of p-mTOR/mTOR and p-p70 S6K/p70 S6K of ADSCs in 15 min post-photodynamic therapy group were significantly increased (P<0.01), the ratios of p-p70 S6K/p70 S6K of ADSCs in 30 min post-photodynamic therapy group and 60 min post-photodynamic therapy group were both significantly increased (P<0.01). At culture minute of 15 after the treatment, compared with those in normal control group, the ratios of p-mTOR/mTOR and p-p70 S6K/p70 S6K of ADSCs in photodynamic therapy alone group were significantly increased (P<0.05 or P<0.01). Compared with those in photodynamic therapy alone group, the ratios of p-mTOR/mTOR and p-p70 S6K/p70 S6K of ADSCs in photodynamic therapy+rapamycin group were significantly decreased (P<0.05). On culture day of 7 after the treatment, compared with those in normal control group, the expressions of collagen Ⅰ, collagen Ⅲ, and fibronectin of ADSCs in photodynamic therapy alone group were significantly increased (P<0.01). Compared with those in photodynamic therapy alone group, the expressions of collagen Ⅰ, collagen Ⅲ, and fibronectin of ADSCs in photodynamic therapy+rapamycin group were significantly decreased (P<0.01). Conclusions: Low-dose photodynamic therapy can promote the proliferation of ADSCs, improve the ability of ADSCs to regulate the migration of HaCaT cells, and enhance the secretion of extracellular matrix protein by rapidly activating mTOR signaling pathway.

A personalized approach identifies disturbed pathways and key genes in hepatitis C virus-cirrhosis with hepatocellular carcinoma.

OBJECTIVE: This work aimed to identify disturbed pathways in hepatitis C virus (HCV)-cirrhosis with hepatocellular carcinoma (HCC) based on individualized pathway aberrance score (iPAS) method. MATERIALS AND METHODS: First of all, gene expression data and pathway data were recruited and preprocessed. Next, iPAS method, which contained three steps (gene-level statistics based on average Z algorithm, pathway-level statistics and pathway significant analysis based on Wilcoxon-test), was performed to identify differential pathways in HCV-cirrhosis with HCC. Then, a protein-protein interaction (PPI) network was conducted based on the genes enriched in the differential pathways. Finally, topological analysis of the PPI network combined with cancer genes was conducted to identify hub disease genes. RESULTS: After a systematic operation by the iPAS method, a total of 34 differential pathways were identified (p-value < 0.01). From the PPI network that was constructed using the 243 genes in the differential pathways, a total of 24 hub genes were obtained by conducting degree centrality, and 4 hub cancer genes (UBC, MAPK1, NOTCH1 and RHOA) were identified. An in-depth analysis indicated that NF-kB is activated and signals survival pathway contained the most cancer genes (number = 7), in which there was a hub cancer gene UBC. In addition, as we set the p-value in ascending order, we found that opioid signaling pathway was the most significant pathway (p = 1.59E-06), and hub cancer gene MAPK1 was enriched in this pathway. CONCLUSIONS: The altered pathways and several key genes identified by this method were predicted to play important roles in HCV-cirrhosis with HCC and might be potentially novel predictive and prognostic markers for HCV-cirrhosis with HCC.

[Prevalence of deep venous thrombosis in burn patients and its influencing factors].

OBJECTIVE: To investigate the prevalence of deep venous thrombosis (DVT) in burn patients, and to explore its influencing factors. METHODS: Clinical data of 2 506 burn patients admitted to our ward from January 2009 to January 2014, conforming to the study criteria, were retrospectively analyzed. Patients were divided into DVT group (n=26) and non-DVT group (n=2 480) according to whether or not DVT occurred during hospitalization. The incidence of DVT was calculated. The diagnosis time and type of DVT were recorded. The data of gender, age, depth of burn, total burn area, location of injury, cause of injury, infection of wound, venous transfusion of fluid (hypertonic solution and blood), location of intravenous catheterization, skin grafting, timing of first skin grafting after injury, D-dimer, bedridden duration after injury among patients between two groups were compared with chi-square test and Wilcoxon test. Indexes with statistically significant differences between two groups were selected, and they were processed with multivariate logistic stepwise regression analysis to screen the independent risk factors of DVT. RESULTS: (1) The incidence of DVT was 1.04% (26/2 506). The diagnosis time of DVT was 16-62(40±12)d, and patients diagnosed as having DVT after the 20th day post injury accounted for 92.3% (24/26). All DVT occurred in lower limbs, with 1 case of central type, 24 cases of peripheral type, and 1 case of mixed type. (2) There were no statistically significant differences in gender, location of injury (upper limbs, trunk, head and face), cause of injury, jugular vein catheterization, skin grafting, and timing of first skin grafting after injury among patients between two groups (with χ(2) values from 1.853 to 3.742, Z=3.342, P values above 0.05). There were statistically significant differences in age, depth of burn, total burn area, burn in lower limbs, infection of wound, venous transfusion of hypertonic solution and blood, femoral vein and subclavian vein catheterization, D-dimer, and bedridden duration after injury among patients between two groups (with χ(2) values from 4.569 to 11.324, Z values respectively 7.357 and 7.012, P<0.05 or P<0.01). (3) Age, total burn area, burn in lower limbs, infection of wound, and D-dimer were the independent risk factors of DVT (with odds ratio respectively 2.904, 2.655, 3.574, 2.786, 3.142, 95% confidence interval respectively 1.504-7.652, 1.368-6.594, 1.958-8.511, 1.459-7.001, 1.922-8.062, P values below 0.05). CONCLUSIONS: The incidence of DVT in burn patients is relatively low; it is diagnosed after the 20th day post injury in most patients, and the overwhelming majority is the peripheral type. Age, total burn area, burn in lower limbs, infection of wound, and D-dimer are the independent risk factors of DVT in burn patients, with which its occurrence could be predicted.

Flow pattern analysis of a full-scale expanded granular sludge bed-type reactor under different organic loading rates.

The hydraulic characteristics of a lab-scale and a full-scale (275 m(3)) expanded granular sludge bed (EGSB)-type reactor under different organic loading rates varying from 10 kg COD m(-3)d(-1) to 45 kg COD m(-3)d(-1) were investigated. A modified combined model composed of two completely mixing regions and a plug flow region was sufficient for simulating the flow pattern of a full-scale EGSB-type reactor. Moreover, the outputs fitted the measured tracer distribution results well. The simplified model structure was in very good agreement with the physical structure of a full-scale EGSB-type reactor. The upflow (liquid+gas) velocity, high concentration of granular sludge, and gas hold-up effect may contribute to the generation of dead spaces (maximum of 19.5%). The bed expansion characteristics indicated that the sludge bed of the EGSB-type reactor performed as a suspended bed, in which the bed expansion was controlled between 20% and 30%, rather than the usually considered expanded bed.