Objective To study the eorrelation between the plasma cardiotrophin-1(CT-1)level and cardiac function of patients with diabetic cardiopathy.Methods Using the Biotin-StreptAvidin-enzyme-linked immunosorbent assay(BSA-ELISA),the level of plasma CT-1 jn 35 normal controls,40 patients with type 2 diabetes and 60 patients with diabetic cardiopathy was measured.The relation to heart function was observed.Results The difference of plasma CT-1 level in the three groups was significant(all P＜0.05).The level of plasma CT-1 in diabetic cardiopathy group was apparently higher than that of type 2 diabetes group and normal controls(all P＜0.01);The level in type 2 diabetes group was significantly higher than that of normal controls(P＜0.01).The level of plasma CT-1 elevated with the worsening of heart failure(NYHA classification).The level of plasma CT-1 was correlated with EF(r=0.669,P＜0.01);LAD(r=0.528,P＜0.01);PVE(r=0.502,P＜0.01);CK-MB(r=0.312,P＜0.01);TG(r=0.187,P＜0.05);DBP(r=0.158,P＜0.05)o Stepwise regression analysis revealed that EF and LAD were the most significant agents affecting the plasma CT-1.Conclusion The plasma CT-1 level could reflect the state of cardiac function of diabetic cardiopathy patient,it could help to diagnose diabetic cardiopathy earlier.

Objective To investigate the influence of the hematoma involving the aortic arch in endovascular aortic repair of complicated type B intramural aortic hematoma. Methods A total of 69 patients[58men; mean age(58.1±8.9)years; range 38-77]underwent endovascular repair between February 2011 and June 2015 were retrospectively reviewed. Patients with hematoma involving about the left subclavian artery level were categorized as group A(n=28) and patients without hematoma involvement to the aortic arch were categorized as group B (n=41). Results All the patients were treated with coverd aortic stents. The success rate was 97.1％ with complete isolation of lesion in 67 patients. The average follow-up period was(19.6±14.1)months. During perioperative period, no procedure related deaths was recorded. Perioperative complications include paraplegia in 1case(1.4％) in group B and stent graft-induced new entry in 2 cases(2.9％) in group A. During the follow-up period 1 case in group A within 1 month and another 1 case in group B within 1 year developed new entries at proximal end of stents. 1 case (1.4％) in group B had asymptomatic type Ⅰ endoleak 2 years after TEVAR. Conclusions Type B aortic intramural hematoma with arch involvement is not a risk factor of stent-induced new entry in perioperative period after endovascular treatment and further studies are needed. Strict control of blood pressure is essential for the prevention of stent-related complications.

Coronary Artery Disease ; therapy ; Fistula ; therapy ; Humans ; Percutaneous Coronary Intervention

Objective To evaluate the safety and efficiency of transcatheter anastomotic leakage closure after surgical procedures for non-infected ascending aortic pathology with different occlusion devices. Methods From Dec. 2013 to Sep. 2015, six cases received interventional therapy for anastomotic leakage after surgical procedures for non-infected ascending aortic pathology using occluders. Four cases were with proximal graft-vessel anastomotic leakage, including two pseudoaneurysms at the site of aortic roots and two ascending aorta to right atrium shunts. The other two cases were with artificial grafts to intraoperative stent anastomotic leakage leading to endoleak type Ib. The anastomotic leakage was totally occluded by single ADOⅡrespectively in four cases. Two detachable coils were implanted in one case with artificial graft to intraoperative stent anastomotic leakage, but mild residual shunt to false lumen was detected by DSA and follow-up CTA. The second interventional procedure was carried out one month later, and one ADO Ⅱ was used to close the residual leakage totally. One PDA occluder was implanted along arteriovenous guide-wire track via aortic root to right atrium fistula in one case. Results All the anastomotic leakages of the six cases were totally excluded by different occlude devices percutaneously. The technical success rate was 100%. Follow-up time was from 1 month to 4 years. The patients' clinical condition improved obviously. Follow-up CTA showed no recurrence of anastomotic leakage. Complete thrombosis and marked shrinkage of the pseudoaneurysm were achieved in two cases, and the partial thrombosis and shrinkage of the false lumen were achieved in 2 cases. Conclusion Trans-catheter closure is an alternative treatment for ascending aortic surgical anastomotic leakage, which may achieve satisfactory short-and mid-term results.

Objective To summraize the safety and efifcacy of modiifed transcatheter closure of atrial septal defect. Methods From Dec. 2012 to Dec. 2013, 100 cases performed modiifed transcatheter closure of atrial septal defect in our center (72 were famale and 28 were male) with average age (37±16) years. The diagnosis was conifrmed by transthoracic echocardiography. All the atrial septal defect closures were completed in the modiifed way by direct delivery of the closure devices without the need of guidence wire. Results One hundred and one defects were identiifed in 100 patients, with 1 patient had 2 defects. The mean diameter of the defect was (20.3±6.6) mm. 100 devices were implanted successfully. Complete closure was revealed in all the patients after the procedure. One patient developed atrial ifbrillation during the procedure. No other serious complication occurred till the last follow-up. Conclusions The modiifed transcatheter closure of atrial septal defect is an effective procedure with high successful rate and low rate of complications.

Objective: To investigate the molecular mechanism and identify potential drugs for subthreshold depression (SD), and elucidate the detalied mechanism of Danzhi Xiaoyao powder (DZXY) in SD. Methods: Using RNA-sequencing, we identified differentially expressed genes (DEGs) in leukocytes of SD compared to healthy controls, deciphered their functions and pathways, and identified the hub genes of SD. We also assessed changes in leukocyte transcription factor activity in patients with SD using the TELiS platform. The Connectivity Map database was retrieved to screen candidate drugs for SD. Based on network pharmacology, we elucidated the “multi-component, multi-target, and multi-pathway” mechanism of DZXY in the treatment of SD. Results: We identified 1080 DEGs (padj <0.05 and |log2 (fold change)| ≥ 1 & protein coding) in the leukocytes of patients with SD. These DEGs, including hub genes, were primarily involved in immune and inflammatory response-related processes. Transcription factor activity analysis revealed similarities between the leukocyte transcriptome profile in SD and the conserved transcriptional response to adversities in immune cells. Connectivity Map analysis identified 28 potential drugs for SD treatment, particularly SB-202190 and TWS-119. Constructing the “Direct Compounds-Direct Targets-Pathways” network for DZXY and SD revealed the curative mechanisms of DZXY in SD, primarily including inflammatory response, lipid metabolism, immune response, and other processes. Conclusion These results provide new insights into the characteristics and functional changes of leukocytes in SD, partially illustrate the pathogenesis of SD, and suggest potential drugs for SD. The curative mechanisms of DZXY in SD are also partially elucidated.

Objective To explore the aortic remodeling after thoracic endovascular aortic repair for acute type stanford B aortic dissection. Methods Retrospective analysis the clinical data of 51 patients who diagnosed with acute type B aortic dis-section and received TEVAR between September 2015 and August 2016. The maximal diameters of false and true lumen were measured directly at the level of primary tear entry, the level of the bronchial bifurcation,and the level of the celiac trunk and the the lower edge of left renal artery,changes in diameter were evaluated between the preoperative and postoperative CT scan. Results The marked change in the true lumen dilatation and false lumen regression trend at the level of primary tear entry after thoracic endovascular repair(1 month vs 1 year, P<0. 05), while the changes of its diameter above level were not obvious af-ter thoracic endovascular repair(3 months vs 6 months, P>0. 05). the true lumen dilatation and false lumen regression trend at the level of the bronchial bifurcation along with time. The true lumen dilatation is a process of slow change at the level of the celiac trunk and the lower edge of left renal artery after TEVAR, and the false lumen changed not obviously. Conclusion En-dografting is effective for acute type B aortic dissection which can promote positive descending aortic remodeling changes,but it has no significant effect on abdominal aortic remodeling.

Objective: To clarify the structural and functional characteristics of the gut microbiota in individuals with qi stagnation constitution (QSC) and identify the potential biomarkers related to QSC.Methods: This cross-sectional study involved individuals with QSC and balanced constitution (BC) confirmed by TCM clinicians. The clinical features were recorded, and fecal samples were collected for 16S rDNA sequencing. The structure of the fecal-associated microbiome (FAM) was described by the alpha-diversity indexes, beta-distances, and relative abundances of dominant taxa. The differences in FAM distribution were analyzed by the Wilcoxon rank-sum test, MetagenomeSeq, and LEfSe analysis. The 16S rDNA gene sequences were assigned to the KEGG dataset to predict the functional information of bacterial metabolic pathways by using PICRUSt. Differences in functional pathways between groups were assessed with the Wilcoxon rank-sum test. The ROC curve based on specific operational taxonomic units (OTUs) was constructed, and the AUC was calculated. Results: Twenty-two individuals with BC and 8 with QSC were recruited. Significant differences between the two groups were found in body mass index, health status, and low-density lipoprotein, etc. There was no significant difference in the alpha-diversity index. PCoA showed no evident clustering of bacterial communities according to constitutions. Bacteroidaceae, Lachnospiraceae, Ruminococcaceae, and Pre-votellaceae were the four common bacteria with high abundances. Notably, MetagenomeSeq, LEfSe analysis, and the Wilcoxon rank-sum test identified significantly different distributions of 66, 42, and 36 OTUs, respectively. Predictive function analysis showed that 13 metabolic pathways were significantly differentially distributed, including those related to fatty acid synthesis. Five specific OTUs were selected as potential biomarkers of a QSC, and the AUC was 0.94. Conclusion: Individuals with QSC have unique FAM structure and related functional characteristics. Five specific OTUs were identified to serve as potentially effective biomarkers related to QSC.

Objective:This study aimed to explore the structural and functional characteristics of the fecal-associated microbiome(FAM)between the phlegm-dampness constitution(PDC)and balanced consti-tution(BC),and to screen the related specific operational taxonomic unit(OTU)biomarkers.Methods:This was a cross-sectional study.After strictly identifying the constitution of subjects,their clinical index was recorded and counted.Fecal samples were collected for 16S rDNA sequencing.Alpha diversity,beta diversity,and the relative abundance of dominant bacterial taxa were used to describe the FAM structure,and the Wilcoxon rank-sum test,MetagenomeSeq,and linear discriminant analysis effect size(LEfSe)were used to screen specific bacterial taxa.Specific OTUs were screened to construct receiver operating characteristic(ROC)curves.Results:Thirty-two subjects were enrolled,including 22 subjects with BC and 10 subjects with PDC.There were significant differences in cold preference,levels of aspartate transaminase,β2-microglobulin,and creatine kinase MB,and alpha diversity indices(Shannon and Shannoneven)between the two groups.In principal coordinate analysis by abund-jaccard distance measure and partial least squares discriminant analysis,bacterial communities clustered separately between the two groups.Furthermore,based on MetagenomeSeq,LEfSe,and the Wilcoxon rank-sum test,a total of 43,18,and 130 OTUs were differentially distributed between BC group and PDC group,respectively,and OTU200,OTU133,and OTU353 were screened when P＜.01.The area under the ROC curve constructed from the 3 selected OTUs was 0.93.Conclusion:The FAM structure and related functional characteristics of the PDC group differed from those of the BC group.In particular,OTU200,OTU133,and OTU353 can be used as unique markers of PDC to assist clinical diagnosis.

Objective To analyze the value of fractional flow reserve (FFR) measurement on endovascular therapy for patients with renal artery stenosis.Methods Clinical data of 12 patients with Stanford B type aortic dissection complicated with renal blood flow injury in Anzhen hospital hospitalized from May 2013 to February 2014 were retrospectively analyzed.Renal artery angiography was performed and fractional flow reserve (FFR) was measured before Thoracic endovascular aortic repair.After operation, renal artery FFR was measured again, and renal artery stenting was performed in patients with FFR≤0.90 or average pressure difference between proximal and distal of renal artery ＞ 20 mmHg(1 mmHg =0.133 kPa) and not applied for patients with FFR ＞ 0.90.The patients were then subsequently followed up clinically.Kidney function were measured after 1 month, and contrast-enhanced ultrasonography data were obtained at 1 and 3 months later, respectively.Results The FFR of 1 patient was 0.90, while the FFR of other patients were less than 0.90 before thoracic endovascular aortic repair.After the procedure, the angiography showed that the blood flow of renal artery in 8 patients were fluency, and the FFR index was over 0.90.There were 4 patients with FFR less than 0.90.After renal artery stenting, the FFR of these 4 patients were all above 0.90.Compared with pre-procedure, blood urea nitrogen ((8.84 ± 3.99) mmol/L vs.(5.18 ± 1.69) mmol/L, P =0.011) and uric acid ((359.3 ± 77.3) μmol/L vs.(276.9 ± 108.3) μmol/L, P =0.008) decreased significantly after 1 month, and there was no significant difference in serum creatinine (P =0.760).Contrast-enhanced ultrasonography results showed that blood flow of renal artery were fluency after 1 month and 3 months.Conclusion In patients with aortic dissection complicating renal blood flow injury, the FFR measurement is meaningful in evaluating the blood flow status of target organs and guide the endovascular revascularization