0.05) but was stronger than that under conditions of a and c ( P

OBJECTIVE: To investigate the geometric changes and ventricular function of heart after percutaneous closure of atrial septal defect according to patient age at the time of the procedure. METHODS: A total of 109 patients with atrial septal defect admitted to Department of Cardiology, Guizhou Provincial People's Hospital between June 1998 and October 2008 were retrospectively analyzed, including 53 males and 56 females aged 3.5-70 years. According to their age, the patients were divided into child group (aged=7 years, n=31), adolescent group (n=42, aged 8 18years) and adult group (n=36, aged > 18 years). Cardiac remodeling was assessed by transthoracic echocardiography before ASD closure and 6 months after atrial septal defect closure, including lateral diameter of left and right atrium (LALD, RALD), ratio of LALD/RALD, diastolic diameter of left and right ventricle (LVDD, RVDD), RVDD/LVDD ratio, and pulmonary diameter (PD), ejection fraction (EF) of LV and RV. RESULTS: 109 patients were all included in final analysis. Compared with preoperative results, the right atrium, RALD, RVDD,RALD/LALD, RVDD/LVDD ratio and PD were significantly decreased, while the left atrium and LALD significantly increased,and EF of left and right atrium was remarkably improved 6 months following atrial septal defect closure (P< 0.05-0.01).Moreover, the heart remodeling and heart function amelioration after atrial septal defect closure of child group were better than adolescent and adult groups (P < 0.05), but there were no significant differences between adolescent and adult groups (P>0.05).CONCLUSION: Transcatheter closure of atrial septal defect is safe and effective for all patients of different ages; in particular,results at children stage are better than adolescent and adult stages.

BACKGROUND:A newly developed calcium phosphate/β-tricalcium phosphate composite bone cement with a negative surface charge (genex?) has been reported to possess osteoinductivity properties. However, to our knowledge, no previous literatures have reported genex? for vertebroplasty in the osteoporotic spine.
OBJECTIVE:To evaluate the biomechanical properties and osteogenesis of vertebral bodies injected with genex? cement in a rabbit vertebroplasty defect model.
METHODS:Thirty New Zealand rabbits were used to establish osteoporosis models. Four weeks after modeling, model rabbits had an iatrogenical y created cavitary lesion at L 3 and L 5 and were injected with either genex? cement (experimental group) or polymethyl methacrylate bone cement (control group). The L 1 vertebral body served as model group without treatment. After 3 and 6 months, 15 rats from each group were executed respectively, and three vertebral samples were taken for Micro-CT analysis and biomechanical tests.
RESULTS AND CONCLUSION:(1) The Micro-CT showed better three-dimensional structure parameters of the trabecular bone in the experimental group than the control group (P<0.05) after 3 months, which however had no difference from the model group (P>0.05). After 6 months, the structure parameters in the experimental group were superior to those in the control and model groups (P<0.05). (2) After 3 months, the vertebral body compression strength of the experimental group was lower than that of the control group (P<0.05), but higher than that in the model group (P<0.05). The vertebral stiffness of the experimental group was lower than that in control and model groups (P<0.05). After 6 months, the vertebral body compression strength of the experimental group was not different from that of the control group (P>0.05), but stil higher than that of the model group (P<0.05). The vertebral stiffness showed no difference between three groups (P>0.05). These findings indicate that genex? cement can rapidly repair osteoporotic vertebral defects and improve the bone strength. Verterbroplasty with genex? cement has adequate osteoinductivity, biocompatibility, and adequate compressive strength.

[ ABSTRACT] AIM:To investigate the changes of peroxisome proliferator-activated receptors ( PPAR)α/peroxi-some proliferator activated receptor coactivator 1 alpha ( PGC-1α) in doxorubicin ( DOX) induced dilated cardiomyopathy ( DCM) and its effect on the energy metabolism and myocardial function in mice .METHODS:Forty mice were randomly divided into 4 groups:control group, DOX group, PPARαinhibitor group and PPARαagonist group.The DCM model was established by injection of DOX.The protein levels of PPARα/PGC-1αwere detected.The PPARαinhibitor and PPARαagonist were used 2 weeks beforeinjection of DOX.The contents of adenine acid and phosphocreatine ( Pcr) in the mito-chondria were measured by high-performance liquid chromatography ( HPLC) .The ANT activity was analyzed by the atrac-tyloside-inhibitor stop technique.The changes of the echocardiography and hemodynamics were also observed.RESULTS:DOX induced DCM model was successfully established.The protein levels of PPARαand PGC-1αin control group were significantly higher than those in DOX group (P<0.05).Both of the high-energy phosphate contents and the transport ac-tivity of ANT were decreased in DOX group (P<0.05), and the hemodynamic parameters were disordered (P<0.01). Compared with DOX group, PPARαinhibitor pre-treatment significantly reduced the PPARα/PGC-1αexpression.Mean-while, high-energy phosphate contents in the mitochondria and the ANT transport activity of the mitochondria decreased, as well as the left ventricular function ( P<0.05) .On the other hand, PPARαagonist significantly increased the expression of PPARαand PGC-1α, and improved the transport activity of ANT.In addition, the hemodynamic parameters were amel-iorated, but the high-energy phosphate contents of the mitochondria did not significantly change.CONCLUSION:PPARα/PGC-1αplays an important role in the regulation of ANT transport activity in dilated cardiomyopathy induced by DOX, and the activation of PPARα/PGC-1αhas protective effects on the DCM induced by DOX.

Objective:To investigate the expressions of Mfn2(mitofusin 2) in non-small-cell lung cancer (NSCLC) tissues and non-cancerous lung tissues,and analyze its relationship with clinicopathological characteristics of lung carcinomas.Methods:The expressions of Mfn2 mRNA and protein in 92 cases of NSCLC tissues and 27 cases of non-cancerous lung tissues were detected by in situ hybridization and immunohistochemical methods. Results:The positive rates of Mfn2 mRNA and protein in pulmonary squamous cell carcinoma were higher than those in adenocarcinoma (83.33% and 89.58% vs 56.82% and 65.91%), respectively. The positive rates of Mfn2 mRNA and protein in NSCLC were higher than those in the non-cancerous lung tissues (25.93% and 29.63%) . The difference was statistically significant among the three groups (P<0.001 and P<0.01). The expressions of Mfn2 mRNA and protein in well-differentiated (93.75% and 100%) and moderately-differentiated NSCLC (91.67% and 91.67%) were higher than those in poor-diffe-rentiated NSCLC (21.43% and 42.86%). The difference was significant (P<0.001). The expressions of Mfn2 mRNA and protein had no correlation with the gender, age, tumor size, TNM stage and lymph node metastasis (P>0.05). The expression of Mfn2 mRNA was consistent with that of Mfn2 protein in NSCLC.Conclusion:Mfn2 was involved in the initiation and progression of lung cancer, and the expression of Mfn2 was related to the histological types of lung cancer and its differentiation degree.

AIM: To investigate the effect of inhibiting myosin light chain kinase ( MLCK) on endothelin-1 (ET-1) induced proliferation and apoptosis of rat pulmonary artery smooth muscle cells (PASMCs).METHODS: Rat PASMCs were cultured and stimulated with ET-1.The cells were randomly divided into control group , ET-1 group and ET-1+MLCK inhibitor group (ET-1+M).Western blotting, MTT assay, [3H]-TdR incorporation and flow cytometry were employed to test the expression of myosin light chain (MLC) and MLCK, cell proliferation, cell cycle and apoptotic rate of PASMCs ,respectively .The phosphorylation of MLC was determined by glycerol-PAGE coupled with Western blotting .RE-SULTS:Compared with control group , the protein expression of MLCK and MLC phosphorylation significantly enhanced af -ter ET-1 stimulation.ET-1 markedly induced the proliferation and decreased the percentage of apoptotic rate in the PASMCs.However, pretreatment with ML-7, a MLCK inhibitor, significantly reversed the above effects induced by ET-1. CONCLUSION:MLCK inhibitor effectively inhibits the ET-1-induced proliferation and the cell cycle progression .

Objective: To investigate the safety and effectiveness of three-dimensional (3-D) rotational angiography reconstruction of left atrial and pulmonary vein stereo image embedded with real-time X-ray fluoroscopy system for guiding radiofrequency catheter ablation (RFCA) in treating the patients with atrial ifbrillation (AF).
Methods: A total of 60 consecutive AF patients who received RFCA in our hospital from 2011-04 to 2013-04 were studied. The patients were randomly divided into 2 groups and 3-D Carto3 mapping system was applied for guiding RFCA in both groups. n=30 in each group. Treatment group, the patients received Siemens ARTIS Zeego digital subtraction system for left atrial and pulmonary vein rotational angiography, then, stereo images were reconstructed and embedded with real-time X-ray lfuoroscopy for RFCA guidance. Control group, conventional left and right pulmonary venography was conducted for RFCA guidance. The procedural and X-ray exposure times, rates of success and complications were recorded and compared between 2 groups.
Results: All 60 patients had successful RFCA, compared with Control group, the patients in Treatment group had obviously less procedural time and X-ray exposure time, while the success rate and complications were similar between 2 groups.
Conclusion: 3-D rotational angiography reconstruction of left atrial and pulmonary vein stereo image embedded with real-time X-ray lfuoroscopy system is safe and effective for guiding RFCA in treating the AF patients, which may reduce the procedural and X-ray exposure times.

OBJECTIVETo evaluate the biomechanical properties of geneX cements for use in vertebroplasty in a calf osteoporotic vertebral compression fracture model.

METHODSThirty vertebral bodies (T(9)-L(4)) were harvested from 4 fresh calf spines. The bone mineral density was measured with dual-energy radiographic absorption. Osteoporotic vertebral model was induced in each vertebra using decalcifying chemical agents, and was then compressed to determine their initial strength and stiffness before injecting the cement. Thirty vertebral bodies were divided randomly into geneX(®) cement group, CSC group, and PMMA group. The fractures were repaired using a transpedicular injection of cements and re-compressed to measure posttreatment strength and stiffness.

RESULTSThe normal mean BMD of the calf vertebra was 1.425∓0.072 g/cm(2), which was reduced significantly to 1.074∓0.065 g/cm(2) after decalcification. The mean injected volume was similar between geneX(®) (4.5∓0.7 ml), CSC (4.3∓0.8 ml) and PMMA (3.8∓0.4 ml) groups. The vertebral strength was restored after the treatment to 1198∓529 N in geneX(®) group, 1212∓430 N in CSC group and 1672∓704 N in PMMA group. All the cements produced significantly greater strength than the initial strength (P<0.05). The augmented strength in geneX(®) and CSC groups were similar (P>0.05), but both were significantly less than that in PMMA group (P<0.05). The stiffness in geneX(®), CSC, and PMMA groups was 233∓130, 242∓191, and 323∓145 N/mm, respectively, showing no significant difference between them (P>0.05). No significant difference was found in the augmented stiffness among the 3 cements (P>0.05).

CONCLUSIONgeneX(®) cement is a useful alternative to PMMA in vertebroplasty for osteoporotic vertebral compression fractures, but further study is needed to evaluate its biosorption in vivo.

Animals ; Biomechanical Phenomena ; Bone Cements ; therapeutic use ; Cattle ; Disease Models, Animal ; Fractures, Compression ; etiology ; surgery ; Lumbar Vertebrae ; injuries ; Osteoporosis ; complications ; pathology ; Thoracic Vertebrae ; injuries ; Vertebroplasty

The stability of the occipitocervical region mainly depends on the integrity of the bony structure,surrounding ligaments and joint capsules.The instability of this region often leadsto the clinical symptoms of compression injury of nerve and vascular,which requires early surgical intervention to rebuild its stability.Posterior occipitocervical fixations are main surgical treatment for the occipitocervical diseases.However,the posterior fixations are not suitable for some patients with congenital or iatrogenic causes.Recently,the anterior occipitocervical fixation with the screws anchored at clivus or into the occipital condyles have been used for the following operations.1.Anterior bone graft fusion.One case which was performed by oral approach was reported well fusion,but the stability was poor and there was a possibility of displacement.2.Anterior shaped titanium cage and plate fixation.The literatures reported that this anterior operation was completed in 35 cases by oral,oral combined with mandibulotomy,and anterior retropharyngeal approaches.This fixation has a good biomechanical stability and is widely used in clinical applications,including occipitocervical tumors and deformities.And the complications including intraoperative vascular,spinal and dural injuries,postoperative drinking cough,non-fusion,deep infection,and death.3.Anterior occipital-atlantoaxial joint screw fixation.Seven cases were performed by anterior occipital-atlantoaxial joint screw fixation through anterior percutaneous approach.This fixation is less trauma,but required precise placement of screw and not conducive bone fusion,and it is suitable for traumatic instability of the upper cervical spine,atlantoaxial dislocation and basilar invagination.Each procedure of anterior occipitocervical fixation is not suitable for all patients,and it should be adopted according to the patient's condition,surgical hardware conditions and the surgeon's habits.

OBJECTIVETo conduct a clinical trial of ketogenic diet (KD) in patients with acute spinal cord injury (SCI) and evaluate its safety and feasibility by measuring blood ketone bodies and blood glucose levels.

METHODTen patients with acute SCI were recruited in the trial during the period from May, 2012 to October, 2013. The patients received a standard KD after fasting for 48 h. The levels of blood ketone, blood glucose and uric ketone were tested daily, and routine blood examination, electrolytes, liver and kidney function, body mass index (BMI), sensory and motor function, and adverse reactions were monitored weekly to assess the safety and feasibility of KD.

RESULTSKD treatment lasted for a mean of 12.9 days (4 to 29 days) in these patients. In all the patients, blood ketone level increased during the fasting and maintained a level above 2.0 mmol/L after taking KD, while the uric ketone level ranged from +++ to ++++. The blood glucose level was in the normal range during KD. Except for blood chloride level and BMI, routine blood test results, electrolytes, liver and kidney function showed no significant changes after KD. No significant changes were observed in the sensation of light touch and pinprick. The average motor ASIA score increased from 33.3 to 35.1 after KD. Gastrointestinal dysfunction (diarrhea, nausea, poor appetite, gastric pain, and abdominal distension) was recorded in 5 patients, hypoglycemia occurred in one patient early after KD, and one patient experienced urticaria during KD. All the adverse reactions were relieved after symptomatic treatments.

CONCLUSIONThis preliminary clinical trial demonstrated that KD could increase ketone bodies level and maintain a normal blood glucose level, suggesting its safety and feasibility in patients with acute SCI.

Adolescent ; Adult ; Aged ; Diet, Ketogenic ; adverse effects ; methods ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; diet therapy ; Treatment Outcome ; Young Adult