Objective To evaluate the clinical efficacy of interventional occlusion of ventricular septal rupture (VSR) complicating acute myocardial infarction (AMI). Methods Six patients with VSR complicated after AMI underwent transcatheter interventional occlusion in Chinese PLA General Hospital between May 2009 to May 2015 were retrospectively analyzed. Their clinical features, interventional treatment protocols, and occurance of postoperative complications were studied. Results Among the 6 patients, VSR were successfully occluded in 5 patients. One patient failed the operation due to instability of occluder after it was deployed and the occluder was retrieved. The paitents died of heart failure 6 months later. Among the 5 patients with successful closure, 4 patients presented mild residual shunt after occlusion and acute left heart failure occurred in 1 patient after operation. Two patients died during hospital stay after operation. Between them, one patient died 3 hours after operation because of cardiac tamponade and the other patient died of cardiogenic shock after withdrawal from IABP. Three patients were followed up until now and follow up echocardiography showed satisfactory cardiac function without heart failure. Conclusions Transcatheter occlusion was a reliable therapy for patients with ventricular septal rupture complicated in acute myocardial infarction which could improve cardiac function and reduce mortality.

With the continuously exploration,in recent years,further understanding of anatomical characteristics of the cervical pedicle brings great breakthrough in cervical pedicle screw implantation.In addition,pedicle screw implantation in cervical spine is considered as a technique with high safety and reliability,which can be widely used in cervical trauma fracture,cervical instability,degenerative,inflammatory,benign or malignant tumor,deformity and other neck diseases.Because of the tremendous differences between upper cervical spine (C1,C2) and lower cervical spine (C3-7) in anatomical morphology,cervical pedicle screw implantation in C1 and C2 differs from in lower cervical spine.Due to the similar structure of C3-7,pedicle screw implantation methods are based on the same principle and sharing a few points in common.The pedicle screw technique can be classified in two groups according to the practice methods:navigation technology and manual placement of cervical pedicle screw.Navigation nailing is considered as reliable,easy handing,and with clear operative vision,however,with disadvantages as complex procedures,highly cost operation equipment,and risk in navigation draft.Therefore,manual placement of pedicle screw is more reasonable and practical comparing with the former.In this study,it analyzed anatomical characteristics of lower cervical pedicle and the measurement of pedicle structure,discussed technique of manual placement of pedicle screw in lower cervical spine and biomechanical study of pedicle screw,and summed up the comparison of the advantages and disadvantages of current representative manual placement technology.

Objective:To explore how electrical stimulation of the sciatic nerve affects learning and memory in cases of chronic cerebral hypoperfusion and its mechanism.Methods:Thirty-two Sprague-Dawley rats were randomly divided into a normal group, a sham-operation group, a model group and a stimulation group, each of 8. In the model and stimulation groups a chronic cerebral hypoperfusion model was established using the modified 2-VO method. The stimulation group then received electrical stimulation of the sciatic nerve for 4 weeks. Afterward all of the rats′ learning and memory were tested using the Morris water maze. HE staining and immunohistochemistry were used to observe any morphological change in the hippocampus and the expression of neuron-specific enolase (NSE) and vascular endothelial growth factor (VEGF).Results:The model and stimulation groups demonstrated significantly longer escape latency, fewer platform crossing times and shorter target quadrant times than the normal and sham-ope-ration groups before the intervention. All of these indicators had improved after the intervention. According to the HE staining, neuronal damage in the hippocampus was aggravated significantly in the model group compared with the normal and sham-operation groups, while the degree of damage was reduced in the stimulation group. Moreover, the immunohistochemistry results suggested that the expressions of NSE and VEGF were reduced significantly in the model group compared with the normal and sham-operation groups, while in the stimulation group they had increased significantly compared with the model group.Conclusions:Electrical stimulation of the sciatic nerve can improve learning and memory in cases of chronic cerebral hypoperfusion, at least in rats. It is probably related to the increased expression of VEGF in the hippocampus.

Objective To observe the role of the renin-angiotensin system in myocardial injury induced by experi-mental vascular dementia.Methods Eighteen adult male rats were categorized into a normal group,sham group,and modified 2-vessel occlusion group(model).To assess the myocardial injury caused by experimental vascular dementia,immunostaining was conducted to evaluate the interstitial collagen fraction and myocyte cross-sectional ar-ea.The concentrations of angiotensin Ⅱ(Ang Ⅱ)and angiotensin 1-7(Ang1-7)in the serum,as well as the ex-pression levels of angiotensin converting enzyme(ACE),angiotensin converting enzyme 2(ACE2),Ang Ⅱ,Ang1-7,angiotensin type 1(AT1)receptor,and Mas receptor in the myocardium,were assessed.Results Modified 2-vessel occlusion led to pronounced cognitive dysfunction(P＜0.01)and myocardial injury(P＜0.000 1)when compared to the sham and normal groups.Additionally,modified 2-vessel occlusion induced significant upregulation of the ACE/Ang Ⅱ/AT1 receptor axis(P＜0.01)and downregulation of the ACE2/Ang1-7/Mas axis(P＜0.05)of the renin-angiotensin system in the myocardium.Conclusion Myocardial injury in rats with experimental vascu-lar dementia may be related to dysregulation of the renin-angiotensin system.

Objective:To investigate the effects of microskin transplantation with antigen-free porcine peritoneum (AFPP) as substitutive carrier for allogeneic skin graft in treating patients with extensive deep burns.Methods:Medical records of 32 patients with extensive deep burns, hospitalized in Changhai Hospital of Naval Medical University meeting the inclusion criteria were investigated from January 2014 to December 2017. Twenty patients [12 males and 8 females, aged (35.4±2.2) years]with microskin transplantation using allogeneic skin graft as microskin carrier were included in allogeneic skin graft group and 12 patients [6 males and 6 females, aged (32.1±4.8) years] with microskin transplantation using AFPP as microskin carrier were included in AFPP group. On post injury day 3-7, the vital signs of patients were stable and escharectomy and autologous microskin grafting of head were performed. The expansion ratio of microskin, the application time of albumin and antibiotics, the percentage of infectious autologous microskin grafting area, the survival rate of microskin, and dressing change times of patients in 2 groups were recorded. Data were statistically analyzed with t test. Results:The expansion ratio of microskin of patient in AFPP group was 14.8±0.6, which was close to 13.5±0.6 of allogeneic skin graft group ( t=1.531, P>0.05). The application time of albumin and antibiotics of patients in AFPP group were close to those of allogeneic skin graft group ( t=0.027, 1.121, P>0.05). The percentage of infectious autologous microskin grafting area of patients in AFPP group was (8.5±1.2)%, which was significantly lower than (18.1±0.6)% in allogeneic skin graft group in 4 weeks after surgery( t=7.593, P<0.01), the survival rate of microskin of patients in AFPP group was (82.5±1.1)%, which was significantly higher than (72.5±0.6)% in allogeneic skin graft group ( t=8.689, P<0.01). The dressing change time of patients in AFPP group was significantly less than that in allogeneic skin graft group ( t=4.743, P<0.01). Conclusions:Compared with allogeneic skin graft, microskin transplantation with AFPP as carrier can reduce wound infection, improve the survival rate of microskin graft, and reduce dressing change time, so that AFPP is a good carrier of microskin.

Objective:We evaluated frailty in elderly hospitalized patients with atrial fibrillation and analyzed the relevance, consistency, and diagnostic power of different frailty tools.Methods:From September 2018 to April 2019, a total of 197 elderly patients with atrial fibrillation aged ≥ 65 years in Beijing Hospital, Chinese PLA General Hospital, and Beijing Tsinghua Changgung Hospital were prospectively enrolled.Five frailty tools, including the clinical frailty scale(CFS), FRAIL scale(FRAIL), Fried frailty phenotype(Fried), Edmonton frail scale(EFS), and comprehensive geriatric assessment-frailty index(CGA-FI), were used for frailty assessment.Results:A total of 197 hospitalized elderly patients with atrial fibrillation were enrolled, with an average age of(77.5±7.1)years old(57.4% male). The prevalence of frailty, according to the five frailty tools, were 25.4%(FRAIL), 27.9%(EFS), 34.5%(Fried), 40.6%(CFS), and 42.6%(CGA-FI), respectively.CFS had a good correlation(correlation coefficient 0.80)and and consistency(Kappa value 0.71, 95% CI 0.61~0.81)with CGA-FI.The combined frailty index was used as the gold standard for frailty diagnosis.The results showed that CFS and CGA-FI had high diagnostic sensitivity(95.9 % and 98.0 %, respectively)and specificity(77.7 % and 75.7 %, respectively). Conclusions:Frailty is common in elderly hospitalized patients with atrial fibrillation, showing multidimensional features, and physical weakness is not prominet.CFS and CGA-FI are recommended for the assessment of frailty in patients with atrial fibrillation, which had good correlation and consistency.

OBJECTIVE: To investigate the effects of methanol-ethyl acetate partitioned fractions from (MEDS) on the proliferation and apoptosis of human non-small cell lung cancer H1975 cells. METHODS: The systemic solvent extraction method was used to preliminary separation of the effective fractions in the methanol extract of . The cytotoxicity of each extract (5, 10, 20, 40, and 80 μg/mL) was tested using MTT assay. Colony cloning method was used to assess the effect of different concentrations of methanol-ethyl acetate partitioned fractions from MEDS (5, 10, 20, 40, and 80 μg/ mL) on the proliferation of H1975 cells. Flow cytometric analysis with Annexin V-FITC/PI staining was performed to detect the apoptosis of the cells after treatment with different concentrations of MEDS fractions (10, 20, and 40 μg/mL). Western blotting was used to evaluate the effects of MEDS fractions on the expressions of apoptosis-related proteins Akt, Bax, and Bcl-2. The anti-tumor activity of 100 mg/kg MEDS fractions was tested in a nude mouse model bearing H1975 cell xenografts. RESULTS: MTT assay and colony forming experiment showed that MEDS fractions significantly inhibited the proliferation of H1975 cells in a dose-and time-dependent manner ( < 0.05). The results of flow cytometry showed that MEDS fractions induced obvious apoptosis of H1975 cells in a concentration-dependent manner ( < 0.05). MEDS fractions also significantly decreased the expressions of Bcl-2 and Akt protein and increased the protein expression of Bax ( < 0.05). In the tumor-bearing nude mouse model, MEDS fractions showed potent anti-tumor effects with a low toxicity to affect the body weight and organs of the mice. CONCLUSIONS The methanol-ethyl acetate partitioned fractions from MEDS show potent anti-tumor activity both and , suggesting their value as promising therapeutic agents against lung cancer.
Acetates ; Animals ; Antineoplastic Agents, Phytogenic ; isolation & purification ; pharmacology ; Apoptosis ; drug effects ; Carcinoma, Non-Small-Cell Lung ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Heterografts ; Humans ; Lung Neoplasms ; pathology ; Methanol ; Mice ; Mice, Nude ; Plant Extracts ; isolation & purification ; pharmacology

Objective:To screen the HIV standard strains with typical biological characteristics of HIV strains circulating in China through the isolation, culture, genotype and phenotype identification of HIV from the whole blood samples of HIV-infected persons, confirm genetic characteristics, traceability, and in line with the Standard Strains of Pathogenic Microorganism-technical Specifications for Establishment of HIV Strains (T/CPMA 027—2023).Methods:Whole blood samples were collected from 48 HIV infected patients. Peripheral blood mononuclear cells (PBMCs) were isolated from the samples and co-cultured with PBMCs isolated from healthy persons′ whole blood samples to isolate and culture HIV from infected persons. We determined concentration of p24 antigen and the virus titer in the culture supernatant. The viral RNA was extracted from the successfully isolated strains, and the gag, pol genes and env C2V3 fragments of the viral genome were amplified and sequenced. The genotype, gene recombination and drug resistance sites were determined according to the viral gene sequences. Virus infection and replication were monitored by inoculating the virus culture supernatant into Ghost cells expressing CCR5 or CXCR4 to determine the viral tropism.The formation of syncytium was observed by inoculating the virus culture supernatant into MT-2 cells to determine whether was a syncytium-induced phenotype. Results:Fourteen strains with p24 antigen concentration > 1 ng/ml in culture supernatant were isolated and cultured from 48 fresh EDTA anticoagulated whole blood samples of HIV infected persons. Of the 14 strains, only one strain with a titer≥10 5 TCID 50/ml, 8 strains with titers ≥10 4 TCID 50/ml, and the other 5 strains with titers≥10 3 TCID 50/ml. Phylogenetic analysis showed that the genotypes of the strains were 9 strains of subtype B, 3 strains of CRF01_AE and 2 strains of CRF07_BC recombinant. Genotypic resistance analysis showed that 11 strains contained drug resistance sites. Ghost cells were used to verify the tropism of the strains, and it was found that 8 strains were CCR5 tropism, 6 strains were CXCR4 & CCR5 dual tropism. Only 2 of the 14 strains could induce MT-2 cytopathic effect, which was syncytium-inducing phenotype. Conclusions:Fourteen HIV strains with typical biological and genetic characteristics were isolated to screen the standard HIV strains. Among which, 1 strain was evaluated as a standard HIV strain that meets the Standard Strains of Pathogenic Microorganism-technical Specifications for Establishment of HIV Strains (T/CPMA 027—2023). This study can also provide technical guidance for the screening of the HIV standard strains. Next step is to complete the application and reserve database construction according to the sharing mechanism of the HIV standard strains, to provide resources for the researches of HIV vaccines and drugs.