1.Compare the myocardial protection effect of HTK solution with blood cardioplegic solution during valve replacement surgery
Nan ZHANG ; Nan GUO ; Chuanming BAI ; Shutian SONG ; Jiewu ZHOU
Journal of Chinese Physician 2012;14(3):339-341
Objective To evaluate the effect of HTK solution on myocardial protection during valve replacement surgery.Methods 42 patients with rheumatic heart disease were randomized to receive 4∶1cold blood (control group,n =21 ) and HTK ( protective gronp,n =21 ) cardioplegic solution during valve replacement.The changes of CO and CI were collected at different time points including pre-operation,postoperative 6 hours,12 hours and 24 hours.Aortic clamping time,the ratio of spontaneous cardiac rhythm recovery and inotropic drugs application were calculated,and mechanical ventilation support time and the incidence of arrhythmia were recorded.Results The measurements of CO and CI showed that there was significant higher level in protective group at postoperative 12 hours and 24 hours [ 12 h:(4.82 ± 0.18 ) L/min vs ( 3.50 ± 0.32 ) L/min,( 3.80 ± 0.48 ) L/( min · m2 ) vs (2.79 ± 0.39) L/( min · m2 ) ;24 h:(4.97±0.45)L/min vs ( 3.81 ±0.19)L/min,(4.22±0.17)L/(min · m2) vs (2.91 ±0.21)L/(min·m2 ),P < 0.05].The clinical parameters including aortic clamping time,incidence of cardiac arrhythmia,inotropic support,duration of mechanical ventilation and length was lower than in control group [ (53.6 ±24.3 ) min vs ( 68.9 ± 26.1 ) min ; ( 1.8 ± 1.3 ) min vs ( 2.3 ± 1.2 ) min ; ( 33 ± 11 ) min vs ( 42 ± 13 ) min ;(10.2±2.1) μg/(kg · min) vs (15.7 ±3.8) μg/(kg · min);(14.6 ±4.8)h vs (20.7 ±5.1)h,P <0.05].The auto-beating rate was higher than in control group (90% vs 67%,P <0.05).Conclusions HTK solution is better than classical blood cardioplegia in myocardial protection during valve replacement.
2.Expression and significance of bone sialoprotein and matrix metalloproteinase-9 in calcified metral valves of rheumatic heart disease
Chuanming BAI ; Bin ZHANG ; Nan ZHANG ; Shutian SONG ; Zhigang ZHANG ; Yuqing BIAN ; Jiewu ZHOU
Clinical Medicine of China 2012;28(10):1056-1058
Objective To investigate the expression and significance of bone sialoprotein and matrix metalloproteinase-9 in calcified mitral valves in patients with rheumatic heart disease.Methods A total of 150 mitral valves were divided into the rheumatic group (n =120) and the non-rheumatic group (n =30 ).Expressions of bone sialoprotein and matrix metalloproteinase-9 were determined by immunohistochemistry.Results Expressions of bone sialoprotein ( 91.6%,x2 =56.6354 ) and matrix metalloproteinase-9 ( 90.8%,x2 =59.4272) in the rheumatic group increased significantly than in the non-rheumatic group (P < 0.01).Conclusion Both bone sialoprotein and matrix metalloproteinase-9 are highly expressed in the calcified rheumatic group.This suggests that caficify of rheumatic mitral valves is related with the degradation and remodeling of extra cellular matricx by matrix metalloproteinase-9,as well as osteoblastlike bone formation by bone sialoprotein.
3.The expression and significance of bone sialoprotein and matrix metalloproteinase-9 in calcified valves of patients with rheumatic heart disease
Chuanming BAI ; Bin ZHANG ; Nan ZHANG ; Shutian SONG ; Zhigang ZHANG ; Yuqing BIAN ; Jiewu ZHOU
Chinese Journal of Postgraduates of Medicine 2012;35(20):13-15
ObjectiveTo observe the expression of bone sialoprotein(BSP) and matrix metalloproteinase-9 (MMP-9) in calcified valves of patients with rheumatic heart disease.MethodsA total of 150 mitral valves which were resected by surgery were divided into rheumatic group ( 120 valves) and nonrheumatic group (30 valves).Immunohistochemical staining was taken by SP method and the expressions of BSP and MMP-9 in two groups were observed and compared.ResultsThe positive expressions of BSP and MMP-9 in rheumatic group were 91.7%(110/120) and 90.8%(109/120),respectively,which were significantly higher than those in non-rheumatic group [23.3%(7/30) and 20.0%(6/30) ](P< 0.01 ).Conclusions The expressions of both BSP and MMP-9 are higher in the valves of patients with rheumatic heart disease.The calcification of rheumatic mitral valves is closely related with the degradation and remodeling of extracellular matrix caused by MMP-9,and osteoblast-like bone formation induced by BSP.
4.Clinical observation of comprehensive treatment for type Ⅲ A prostatitis
Yiao TAN ; Linyu ZHOU ; Jiewu SHI ; Yuping ZHU ; Hongbin SONG ; Wei WU ; Kun HUANG
Clinical Medicine of China 2011;27(3):312-314
Objective To study the efficacy of comprehensive treatment for type ⅢA prostatitis.Methods One hundred and eighty-four patients with type Ⅲ A prostatitis, recruited to this study, were comprehensively treated for 8 - 12 weeks by oral antibiotics and α-1 receptor antagonist,indometacin suppository applied into rectal, prostate massage and psychological counseling. The clinical effects of the treatment were evaluated according to the NIH chronic prostatitis symptom index (NIH-CPSI) and leukocyte counts in the expressed prostatic secretions ( EPS ). Results Before and after the treatment, the NIH-CPSI scores were 28. 6 ± 6. 5 and 12. 9 ± 3. 8 ( t = 28. 3, P < 0. 05 ); the pain or discomfort scores were 14. 1 ± 3. 3 and 6. 4 ± 2.2( t = 26. 3, P < 0. 05 ), the urinary symptoms scores were 5.6 ± 1.8 and 2. 1 ± 0. 9 ( t = 23.6, P < 0. 05 ), the scores of life quality were 8.9 ± 3. 1 and 4. 4 ± 2.4 ( t = 15.6, P < 0. 05 ), the leukocyte counts were ( 24. 5 ±4. 4)/HP and ( 6. 2 ± 2. 7 )/HP ( t = 48.1, P < 0. 05 ) respectively, all comparisons showed significantly differences. Seventy-nine cases recovered completely, 57 cases recovered excellently, 36 cases recovered effectively and 12 cases did not recover, the overall effective rate was 93.5%. Conclusion Comprehensive treatment is an effective method for type Ⅲ A prostatitis.
5.Expressions and clinical significance of chemokine receptor-4 and vascular endothelial growth factor in renal cell carcinoma
Jiewu SHI ; Linyu ZHOU ; Yiao TAN ; Aijun GU ; Jin YU ; Qiang XUAN
Clinical Medicine of China 2011;27(2):173-177
Objective To study the role and clinical significance of chemokine receptor-4 (CXCR4) and vascular endothelial growth factor (VEGF) in the occurrence and development of renal cell carcinoma. Methods Expression of CXCR4 and VEGF were detected by SP immunohistochemical technique in 56 cases of kidney carcinoma tissues (including 20 cases of lymph node metastasis), 10 normal tissues nearby kidney cancer. Results The positive rates of CXCR4 and VEGF were 66. 1% (37/56) and 73. 2% (41/56),which were significantly higher than those in normal tissues( 20. 0% (2/10) and 30. 0% (3/10), respectively) (P < 0. 05 =. The expression of CXCR4 protein was significantly positively correlated with that of VEGF protein (r = 0. 315 ,P < 0.05 = in renal cell carcinoma. The expression of CXCR4 and VEGF was closely related to stages of tumor ( χ2 = 9. 520, P = 0. 023; χ2 = 9. 072, P = 0. 027 ), lymphatic metastasis, degree of invasion ( χ2 =4. 972, P = 0. 026; χ2 = 3.910, P = 0. 034 ), and microvessel density ( MVD) ( P < 0. 05 =. However, they were not related to sex ( χ2 = 0. 020, P= 0. 887; χ2 = 0. 001, P = 0. 716 ), tumor size ( χ2 = 0. 003, P = 0. 995; χ2 =0. 108, P = 0. 990) and pathologic types ( χ2 = 1. 960, P = 0. 900; χ2 = 0. 112, P = 0. 994). Conclusion There is a significant positive correlation between high expressions of CXCR4 and VEGF proteins in renal cell carcinoma,the high expressions of CXCR4 and VEGF proteins may be related to the metastasis and prognosis of renal cell carcinoma,thus they could be used as important indicators in judging the metastasis prognosis of renal cell carcinoma,and offer prospects for the treatment of renal cell carcinona.