Objective To evaluate the usefulness of real-time three-dimensional transesophageal echocardiography (RT-3D TEE) in the perventricular device occlusion of the ventricular septal defect (VSD).Methods Sixty patients underwent perventricular device occlusion of VSD were divided into two groups.Group A:30 patients,3D images of VSD were obtained intraoperatively by RT-3D TEE.3D images were analyzed and the maximal and minimum area and maximal diameter of VSD were measured in the cardiac cycle.The size of selected VSD occluder was the diameter calculated from the maximal area based on the formula πD2/4 and plus 1～2 mm.Simultaneously,two dimensional transesophageal echocardiography (2D TEE) images of VSD were obtained and measured on standard views.Group B:other 30 patients,intraoperative 2D TEE was performed to measure the diameter of VSD on standard views.The selection VSD occluder was based on the maximal diameter plus 1～2 mm.Results The VSDs shape showed oval,class round and irregular by RT-3D TEE imaging.There was a significant difference between the maximal area and smallest area of VSD appeared in the cardiac cycle obtained by RT-3D TEE (P<0.01).There was a significant difference between the maximal diameter by measurement of RT-3D TEE and 2D TEE (P<0.01).Of all 30 patients with evaluation of VSD size based on the RT-3D TEE,1.1 times attempts of device occlusion were performed on one patient (33/30).Of the other 30 cases with evaluation of VSD size by 2D TEE,2 cases were failed with device occlusion because of instant residual shunt.Of the remaining 28 cases,1.43 attempts of device occlusion were performed on one patient (40/28).Conclusions RT-3D TEE can accurately reveal the size of VSD,and aid in the selection of VSD occluder in the device occluding procedure of VSD.

Objective To study the the feasibility of real-time 3D transesophageal echocardiography (RT-3D TEE) to measure the distance between the coronary ostial and the junction of left ventricle and artery.Methods The RT-3D TEE image of the aortic root was collected intraoperative in 65 cases who were refered to our center for valve replacement.The reconstruction of the aortic annulus was done in the QLAB quantitative analysis software and the height parameter of the annulus could be generated.Meanwhile the coronary artery position was observed and the distance between the coronary ostial and the junction of left ventricle and artery was measured respectively.Results In the 65 cases,49 cases clearly showed bilateral coronary ostial,three cases only showed the left coronary ostial,six cases only showed the right coronary ostial,seven cases of both sides of the coronary ostial were unclear.The shows rate of right coronary ostial was 84.61％ (55/65),with the left coronary ostial 81.54％ (52/65).The measured value of the L-AA in systole and diastole were (15.5 ± 1.9)mm,(12.8 ± 1.5)mm,the R-AA systole and diastole measured values were (13.7 ± 1.8)mm,(12.4 ± 1.7)mm,respectively,there was significant difference between systole and diastole respectively.The aortic annulus height (H) got by 3D reconstruction of the aortic annulus was lower than ventricular-arterial junction to the coronary artery distance in both systole and diastole.Conclusions Not only can RT-3D TEE reconstruct the annulus,but also can show and measure the distance between the coronary ostial and the junction of left ventricle and artery respectively.

Objective To investigate the application of real-time three-dimensional transesophageal echocardiography (RT-3D TEE) in quantification of the aortic anuulus diameter in patients with severe aortic stenosis.Methods RT-3D TEE image of aortic root was get perioperatively in 65 patients with sever aortic valve stenosis during the surgery procedure.The aortic annulus was reconstructed in the quantitative analysis software to generate the parameters of 3-dimensional area based aortic anuulus diameter(3D-AAAD) and 3-dimensional circumference based aortic anuulus diameter(3D-C-AAD).The parameters was compared with intraoperative aortic anuulus diameter(IO-AAD),which was get by the standard cylindrical valve sizer.Results The three dimensional form of the aortic annulus was related to the number of the valves.The value of 3D-C AAD and 3D-A-AAD were (22.4 ± 2.1) mm,(23.4 ± 1.9) mm,no significant difference could be detected between them and the IO-AAD (P ＜ 0.05).The 3D-C-AAD had a better agreements with IO-AAD than 3D-A-AAD.Conclusions RT-3D TEE can reconstruct the three dimensional sharp of aortic anuulus,and can be used as quantitative tools to calculate its diameter.

Objective: To verify the effect of Jinmaitong composita (JMTC) on red blood cell aldose reductase activity (RBC-AR), red blood cell sorbitol (RBC-S) and nerve conductive velocity in diabetic peripheral neuropathy (DN) patients. Methods: Sixty-six patients with DN were randomly divided into two groups, 33 patients in the treated group treated with JMTC and 33 patients in the control group treated with Jingui Shenqi capsule (JGSQ). RBC-AR, RBC-S and nerve transmission speed were observed before and after three months treatment.Results: Level of RBC-AR, RBC-S apparently decreased and nerve conductive velocity increased (P<0.05, P<0.01) after JMTC treatment.Conclusion: JMTC can improve the nerve conductive velocity significantly with a lowering of RBC-AR and RBC-S and has a good result in treating diabetic peripheral neuropathy.

Adult ; Aged ; Carcinoma, Hepatocellular ; radiotherapy ; Female ; Humans ; Liver Neoplasms ; radiotherapy ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplastic Cells, Circulating ; pathology ; Portal Vein ; pathology ; Radiotherapy Planning, Computer-Assisted ; methods

AIM:To study the effect of Aurora protein kinase inhibitor VX-680 on homogeneous adhesion and migration ability in human hepatocellular carcinoma cell line HepG 2.METHODS:The HepG2 cell were divided into ex-perimental group and control group, respectively.VX-680 was used in experimental groups at 3 concentrations(3.125 μmol/L group,6.25 μmol/L group and 12.5 μmol/L group).DMSO was used in the control group.The effects of VX-680 at different concentrations on the adhesion ability of human hepatocellular carcinoma HepG 2 cells were observed by cell slow aggregation test and separation experiment.The effects of VX-680 at different concentrations on the migration ability of HepG2 cells was detected by wound healing assay.The expression of E-cadherin in HepG2 cells was detected by Western blot.RESULTS:The results of the slow aggregation test showed that compared with the control group,the number of cell clumps formed in experimental groups was significantly decreased(P<0.01).The results of separation experiment showed that the ratio of NTC/NTEgradually decreased with the increased concentration of VX-680.The results of wound healing as-say showed that as the concentration of VX-680 increased, the cell scratch healing ability gradually weakened compared with control group.The results of Western blot showed that the protein expression of E-cadherin in the HepG2 cells in-creased with the increased concentration of VX-680(P<0.05).CONCLUSION:VX-680 increases the homogeneous ad-hesion and inhibits the migration of HepG 2 cells.

OBJECTIVETo investigate the effect and related mechanism of retinoid X receptor (RXR) activation on oxidized low-density lipoprotein (ox-LDL) induced differentiation of macrophage into dendritic cell.

METHODSRAW264.7 murine macrophage cell line was cultured with ox-LDL for 48 h in the absence and presence of RXR activator 9-cisRA or SR11237. Cell morphology was observed by phase contrast microscope and cell surface markers involved in dendritic cell immune maturation and activation was analyzed by FACS. Cellular reactive oxygen species production was detected by CM-H2DCFDA fluorescent probe.

RESULTSox-LDL-treated RAW264.7 murine macrophage cell line differentiated into dendritic like cells after 48 h and cell surface markers CD40, CD86, CD83, MHC Class II and CD1d were upregulated. These changes could be attenuated by cotreatment with 9-cisRA or SR11237. Upregulated cell surface markers CD40, CD86, CD83, MHC Class II and CD1d by ox-LDL were decreased about 47%, 43%, 48%, 32% and 17% respectively by 9-cisRA and 38%, 38%, 46%, 36% and 32% respectively by SR11237. The effect of 9-cisRA and SR11237 was dose dependent. Cellular reactive oxygen species were significantly increased in ox-LDL-treated RAW264.7 cells (MFI 38.24 +/- 4.20 vs. 4.46 +/- 0.39, P < 0.05) and which was significantly reduced by 9-cisRA (10(-7) mol/L) and SR11237 (10(-6) mol/L) to 12.60 +/- 1.52 and 17.89 +/- 1.91 respectively (all P < 0.05).

CONCLUSIONRXR activation partly inhibits the differentiation of ox-LDL induced macrophage into dendritic cell by reducing oxidative stress injury.

Animals ; Benzoates ; pharmacology ; Cell Differentiation ; drug effects ; Cell Line ; Dendritic Cells ; cytology ; drug effects ; Lipoproteins, LDL ; metabolism ; Macrophages ; cytology ; drug effects ; Mice ; Retinoid X Receptors ; metabolism ; Retinoids ; pharmacology ; Tretinoin ; pharmacology

OBJECTIVETo evaluate the efficacy and safety of olmesartan medoxomil compared with losartan potassium in patients with mild to moderate essential hypertension.

METHODThis is a randomized, double-blind, double-dummy, active-controlled, parallel, multi-center study. After a 2-week placebo run-in period, a total of 287 eligible subjects were randomized at 1:1 ratio to receive olmesartan medoxomil 20 mg or losartan potassium 50 mg, once daily for 8 weeks. The blood pressure was assessed after 4 weeks treatment. If the subject's seating diastolic blood pressure (SeDBP) was still >or=90 mm Hg, the dosage was doubled for another 4 weeks; for those subjects whose SeDBP was <90 mm Hg after 4-week treatment, the initial dosage remained unchanged and the treatment continued until completion of the study.

RESULTS(1) The mean trough reduction in SeDBP from baseline in olmesartan group was significantly greater than that in losartan group after 4 weeks (11.72 mm Hg vs 9.23 mm Hg, P=0.004) and 8 weeks treatment (12.94 mm Hg vs 11.01 mm Hg, P=0.035). (2) The number and percentage of responders in olmesartan group (81, 65.3%) were statistically higher than those (68, 52.7%) in losartan group (P=0.028) after 4 weeks treatment and were similar between the two groups after 8 weeks treatment (P>0.05). (3) Individual and overall trough/peak ratios of DBP and SBP in 24-hour ambulatory blood pressure monitoring were higher in olmesartan group than losartan group. The hypotensive effect of olmesartan was more durable than losartan at 24 hour interval. (4) The incidence of study drug-related adverse events (AEs) in olmesartan group (10.5%) was similar as that in losartan group (13.9%, P>0.05). Most of these AEs were mild and transient.

CONCLUSIONThis study shows that olmesartan medoxomil, at oral dose of 20 mg-40 mg once daily was effective and safe for hypertension treatment and the hypotensive effect was superior to losartan potassium (50 mg-100 mg once daily).

Adolescent ; Adult ; Aged ; Antihypertensive Agents ; administration & dosage ; China ; Double-Blind Method ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Imidazoles ; adverse effects ; therapeutic use ; Losartan ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Olmesartan Medoxomil ; Tetrazoles ; adverse effects ; therapeutic use

BACKGROUNDMyocardial tissue-level perfusion failure is associated with adverse outcomes following ST-elevation myocardial infarction (STEMI) despite successful epicardial recanalization. We have developed a new quantitative index-thrombolysis in myocardial infarction (TIMI) myocardial perfusion frame count (TMPFC)--for assessing myocardial tissue level perfusion. However, factors affecting this novel index of myocardial perfusion are currently unknown.

METHODSA total of 255 consecutive STEMI patients undergoing primary angioplasty were enrolled. Myocardial tissue level perfusion was assessed by TMPFC, which measures the filling and clearance of contrast in the myocardium using cine-angiographic frame counting. We differentiate three groups with two cut off values for TMPFC: a TMPFC of 90 frames was the upper boundary of the 95% confidence interval (CI) for the TMPFC observed in normal arteries, and a TMPFC of 130 was the 75th percentile of TMPFC.

RESULTSSTEMI patients with TMPFC > 130 frames (68 patients, 26.7%) had higher clinical and angiographic risk factor profiles as well as a higher 30-day MACE rate compared with those with TMPFC ≤ 90 frames and those with TMPFC > 90 and ≤ 130 frames. Multivariable analysis identified that the independent predictors of TMPFC > 130 frames were age ≥ 75 years (OR 2.08, 95%CI 1.21 to 3.58, P = 0.007), diabetes (OR 1.37, 95%CI 1.01 to 1.86, P = 0.042), Killip class ≥ 2 (OR 1.52, 95%CI 1.05 to 2.21, P = 0.027), and prolonged pain-to-balloon time (OR 1.73, 95%CI 1.07 to 2.79, P = 0.013). TMPFC > 130 frames was identified as the strongest independent predictor of 30-day major adverse cardiac event (MACE) (OR 2.77, 95%CI 1.21 to 6.31, P = 0.008), along with age ≥ 75 years (OR 2.19, 95%CI 1.11 to 4.33, P = 0.016), female gender (OR 1.67, 95%CI 1.03 to 2.70, P = 0.038), and Killip class ≥ 2 (OR 1.83, 95%CI 1.07 to 3.14, P = 0.021).

CONCLUSIONSSTEMI patients with poor myocardial perfusion assessed by TMPFC had higher risk factor profiles. Advanced age, diabetes, higher Killip class, and longer ischemia time were independent predictors of impaired TMPFC after primary percutaneous coronary intervention. These results emphasize that particular attention should be paid on myocardial microvascular reperfusion in STEMI patients with these risk factors.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnostic imaging ; pathology ; therapy ; Myocardial Reperfusion ; Myocardium ; metabolism ; pathology

BACKGROUNDAmyotrophic lateral sclerosis (ALS) is a progressive degenerative disease characterized by the loss of motor neurons in the spinal cord, brainstem, and cerebral cortex, which results in muscle weakness, atrophy. Sporadic ALS (SALS) accounts for about 90% of ALS cases, but the etiology is largely unknown. Most of the researchers consider it to be a complex disease. There have been several genome-wide association (GWA) studies reporting several single nucleotide polymorphisms (SNPs) which are susceptible to ALS, but no data of Asians (including Chinese) yet. We investigate whether the polymorphism of rs10260404 in DPP6 gene is associated with SALS in Chinese Han origin to compare the ethnic differences between Chinese Han origin and other populations.

METHODSThe genomic DNA was extracted from the leukocytes of whole blood samples in 58 Chinese Han patients with SALS and 52 healthy controls. The asymmetric PCR was processed in the presence of an unlabeled probe that contained the rs10260404 locus. The product was genotyped on a light scanner using high resolution melting method and some were confirmed with sequencing.

RESULTSThe rs10260404 polymorphism was in Hardy-Weinberg equilibrium in patients and controls. The CC genotype and the C allele were similar in patients compared with healthy subjects and not associated with an increased risk of Chinese SALS patients (chi(2) = 0.29, OR = 1.26, 95% CI 0.55 - 2.87, P > 0.05).

CONCLUSIONSThe rs10260404 is not associated with ALS susceptibility in Chinese people with Han origin which may be due to ethnic differences. More study with large number of cases in Chinese population is really necessary.

Adult ; Alleles ; Amyotrophic Lateral Sclerosis ; genetics ; Asian Continental Ancestry Group ; genetics ; Dipeptidyl-Peptidases and Tripeptidyl-Peptidases ; genetics ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Nerve Tissue Proteins ; genetics ; Polymerase Chain Reaction ; Polymorphism, Genetic ; genetics ; Potassium Channels ; genetics ; Sequence Analysis, DNA ; Young Adult