1.Principal component analysis for exploring gene expression patterns.
Chengxiong WANG ; Nini RAO ; Yu WANG
Journal of Biomedical Engineering 2007;24(4):736-741
When projecting microarray data of yeast time series into principal component space based on time-points (arrays), we can not only ascribe biologically meaningful explanations to the first few principal components, but also discover sensible gene expression patterns and the according genes with periodic fluctuation this helps the subsequent research of gene periodic expression and gene regulatory network.
Algorithms
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Gene Expression Profiling
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methods
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Gene Expression Regulation
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Oligonucleotide Array Sequence Analysis
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methods
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Principal Component Analysis
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Yeasts
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genetics
2.Rabbit artery bypass grafting model by using vascular anastomosis wheel
Longsheng DAI ; Yang YU ; Mingxin GAO ; Chunxiao WANG ; Fan ZHANG ; Chengxiong GU
Chinese Journal of Thoracic and Cardiovascular Surgery 2015;31(1):31-34
Objective To establish a close clinical and easy to operate animal artery bypass grafting model by using vascular anastomosis wheel.Methods 15 rabbits that weighted 2.5-3.5 kg were studied.Each animal underwent an end-toend anastomosis of jugular vein and carotid artery by vascular anastomosis wheel.Carotid ultrasound and flow detection were taken immediately and 2 months after surgery respectively,as well as morphology and pathology were recorded to analyze and evaluate the intimal hyperplasia of vein graft and arteriovenous anastomotic site.Results 14 rabbits were successfully established CABG model,however 1 rabbit died of respiratory inhibition caused of excessive anesthesia.Compared with normal carotid artery,the vein bridge showed significantly lower blood flow [(50.81 ± 1.33) ml/min vs.(70.59 ± 0.68) ml/min,P <0.01,higher PI(2.15 ±0.07vs.1.22 ±0.04,P <0.01)] immediately after surgery.Compared with the vein grafts immediately after surgery,the vein grafts 2 months after surgery showed significantly lower blood flow [(27.46 ± 2.15) ml/min vs.(50.81 ± 1.33) ml/min,P < 0.01].Compared with normal jugular vein,the vein grafts 2 months after surgery showed significantly higher intimal hyperplasia[(160.30 ± 1.78) μm vs.(49.06 ± 2.76) μm,P < 0.01],and higher number of elastic plates(12.36 ± 0.25vs.3.21 ± 0.15,P < 0.01).Conclusion The use of vascular anastomosis wheel to establish an artery bypass graft model can imitate the pathological changes of vein grafts after CABG,which can provide an ideal animal model for various researches on vein grafts.
3."""No Touch"" ostial cardioplegia delivery for aortic valve replacement"
Chuan WANG ; Chengxiong GU ; Weiguo MA ; Jingxing LI ; Xinsheng HUANG ; Wei SONG
Chinese Journal of Thoracic and Cardiovascular Surgery 2015;31(8):462-465
Objective To summary and explore the indications,safety and effectiveness of no touch ostial cardioplegia delivery method during aortic valve replacement(AVR) for severe aortic insufficiency(AI),in order to provide guidance for clinical application.Methods Between September 2012 and February 2015,63 cases were randomly divided into two groups,in study group we used this technique in 31 patients with a mean age of(58.0 ± 15.0) years and a range of 31 to 74 years old.The degree of AI averaged (3.5 ± 0.5) according to a semiquantitative 5-grade scale[1].32 patients were enrolled in control group with a mean age of(60.4 ± 9.4) years and a range of 22 to 73 years old.The degree of AI averaged (3.6 ± 0.5).The abnormal aortic cusps were sutured though the aortic incision,which would be closed temporarily.Blood cardioplegia was infused repeatedly into the coronary osita through the closed aortic incision during the remainder of the procedure except AVR,when the closed aortic incision was reopened.Results In the study group,spontaneous resumption of nodal and normal sinus rhythm shortly after the removal of aortic cross-clamp was achieved in all patients,no hearts had to be electrically defibrillated and electrocardiogram showed no obvious S-T segment elevation.The time from cross-clamp removal to sinus rhythm was(12.3 ± 7.7) minutes in the study group,versus (18.6 ± 8.2) minutes in the control group(P =0.037).No operative mortality occurred in both groups.There was a significant increase in left ventricular ejection fraction[from(0.54 ± 0.09) preoperatively to(0.62 ± 0.06) postoperatively] (P =0.005) in patients of the study group,which was not seen in patients of the control group.Conclusion Preliminary results have shown that the no touch ostial cardioplegia delivery method is a feasible method for cardioplegia infusion during aortic valve replacement in patients with severe AI.
4.Clinical outcomes after medial temporal lobe epilepsy surgery: Anterior temporal lobectomy versus selective amygdalohippocampectomy
Chengxiong WANG ; Dingyang LIU ; Zhiquan YANG ; Zhuanyi YANG
Journal of Central South University(Medical Sciences) 2018;43(6):638-645
Objective:To compare the anterior temporal lobectomy (ATL) with transsylvian selective amygdalohippocampectomy (SeAH) in 72 patients with medial temporal lobe epilepsy (MTLE) regarding the seizure control and neuropsychological outcomes.Methods:Clinical data and follow-up data were collected and retrospectively analyzed.SeAH and ATL were used in 39 and 33 patients,respectively.All eligible patients were followed up at least one year.Wechsler Adult Intelligence Scale-Revised and the Wechsler Memory Scale-Revised were used to test the patients' neuropsychology before and after the surgery for one year.Results:Fifty-nine patients (81.9%) achieved satisfactory seizure control (62.5% Engel Class Ⅰ and 19.4% Class Ⅱ).ATL obtained 84.8% satisfactory seizure control (28 patients),and the success rate was 79.5% (31 patients) for SeAH.There was no significant difference in seizure control between SeAH and ATL (P=0.760).The postoperative verbal IQ of SeAH group increased significantly in both side surgery (P<0.05),while the increase was not significant in the group of ATL of both side surgery (P>0.05).Regarding left-side surgery,postoperative verbal memory and total memory were increased significantly in the group of SeAH (P<0.05),while the increases were not significant in the group ofATL (P>0.05).In the right-side surgery,postoperative verbal memory and total memory were increased significantly in the two surgery strategy groups (P<0.05),while no significant increases were seen in non-verbal memory of the two surgery strategy groups (P>0.05).Conclusion:Microsurgery for the treatment of refractory MTLE is successful and safe,and should be encouraged.The seizure outcome is not different between ATL and SeAH,while regarding as verbal IQ and verbal memory outcomes,SeAH may be superior to ATL in dominant hemisphere surgery.
5.Study on the coronary endarterectomy combined with electrocautery in the treatment of diffuse coronary artery disease
Chuan WANG ; Tongxun LI ; Fan ZHANG ; Chengxiong GU ; Jingxing LI
Chinese Journal of Thoracic and Cardiovascular Surgery 2020;36(2):83-88
Objective:To explore the outcomes and mechanisms of coronary endarterectomy combined with electrocautery in patients with diffused coronary artery disease undergoing coronary artery bypass grafting (CABG).Methods:From January 2017 to September 2018, 300 patients undergoing CABG with left anterior descending artery endarterectomy were randomly divided into two groups, after fully informed the risks and other related issues regarding the operations. All the patients in the two groups were treated with CABG. In the study group, patients underwent electrocautery immediately after endarterectomy, whereas in the control group, patients underwent endarterectomy only. The electrocardiogram and serological examination (TNI, IL-6 and TNF-a) were performed at 2 h, 24 h, 72 h and 120 h after operation. The follow-up duration was 1 year.Results:Nine patients in the study group, and 25 patients in the control group had ST segment elevation. The levels of TNI, IL-6 and TNF-a were continuously increased in both groups, and reached the peak at 24 h, then decreased slowly. The levels of TNF-a were significantly lower at 2 h postoperatively in the study group ( P=0.01). There was no significant difference in the levels of TNI and IL-6 between the two groups. The levels of TNI, TNF-a and IL-6 were significantly lower in the electrocautery group at 24 h, 72 h, and 120 h after operation( P<0.05). One year after operation, incidences of ST segment elevation in the study group were significantly lower than that in the control group, and there was no significant difference in restenosis rate and myocardial infarction rate. Conclusion:Endarterectomy combined with electrocautery may prevent the restenosis of the lumen and blood turbulence, smooth the inner wall of the vessel, slow down the release of inflammatory factors in the peripheral blood, inhibit the expression of inflammatory factors in the vessels, and reduce the myocardial damage. The short-term effect was satisfactory; the long-term anti-inflammatory and antithrombotic effect still need further investigations.
6.Distal anastomosis support for bypass grafting for the small posterior descending artery
Haitao LI ; Jingxing LI ; Xinsheng HUANG ; Liangshan WANG ; Changcheng LIU ; Chengxiong GU
Chinese Journal of Thoracic and Cardiovascular Surgery 2021;37(6):349-353
Objective:To describe a distal anastomosis support (DAS) technique, and retrospectively investigate the effect of DAS on the mid-term graft patency of patient with small posterior descending artery.Methods:Between January and December 2016, 100 patients with triple-vessel disease and small PDA who continuously underwent off-pump coronary artery bypass grafting (OPCABG) (OPCABG group, n=50) and OPCABG with DAS for anastomosis of PDA grafted by saphenous vein (SVG) (OPCABG+ DAS group, n=50) were evaluated retrospectively. The dynamic changes of electrocardiogram and TnI level were observed within 48h after the surgery. All patients came back to follow-up visit 6th, 12th, 24th and 36th postoperative month. The primary endpoint was the graft failure (FitzGibbon B or O) of SVG-PDA on the follow-up CTA.Results:There was no death during the operation. There was no acute inferior wall myocardial infarction confirmed by electrocardiogram. Peak TnI within 48h of surgery was 0.74(0.98)ng/ml vs. 0.92(1.29)ng/ml, P>0.05, and the number of patients with peak TnI≥70×ULN was 3(6%, 3/50) vs.5(10%, 5/50), P>0.05. There was no postoperative death, and all the patients were discharged 5-15 days postoperatively. We found significantly improved cumulative graft patency in OPCABG+ DAS group at 36 months after operation [85.7%(42/49) vs. 68.0%(34/50), P<0.05). In multivariate logistic regression analysis, PDA with atherosclerotic lesions ( OR=6.513, 95% CI: 1.279-33.180, P=0.024), and peak TnI≥70×ULN within 48 h of surgery ( OR=5.948, 95% CI: 1.128-31.368, P=0.036) were independent predictors of graft failure, whereas concomitant DAS ( OR=0.222, 95% CI: 0.069-0.713, P=0.011) was significant protective factor. Conclusion:Concomitant DAS conferred superior mid-term patency of SVG-PDA in patients with small PDA. Adding the DAS procedure to OPCABG may be a promising surgical option for small PDA with atherosclerotic lesions.
7.The role of CYP2C19 gene assay in antiplatelet therapy after off-pump coronary artery bypass grafting
Hui HU ; Changcheng LIU ; Liangshan WANG ; Wei SONG ; Yang YU ; Chengxiong GU
Chinese Journal of Thoracic and Cardiovascular Surgery 2019;35(1):45-48
Objective To evaluate the guiding role of CYP2C19 gene assay in dual antiplatelet therapy(DAPT) after off-pump coronary artery bypass grafting ( OPCABG ) .Methods The patients who received scheduled OPCABG between May 2017 and May 2018 were recruited in this study.According to the results of CYP2C19 gene assay, the patients who carried CYP2C19 gene *2/*2,*2/*3 and*3/*3 mainly causing slow metabolism of clopidogrel were randomly divided into two groups: the clopidogrel group(patients receiving 100mg/qd aspirin plus 75mg/qd clopidogrel after surgery ), the ticagrelor group(patients receiving 100mg/qd aspirin plus 90mg/bid ticagrelor after surgery).Patients in the two groups underwent plate-let aggregation rate test first day before surgery and the 1, 4, 7 days antiplatelet therapy after surgery.And the major adverse cardiac events(MACE) was investigated 30 days after surgery in the two groups.Results A total of 244 patients were recrui-ted in the study with the clopidogrel group(n=122) and the ticagrelor group(n=122).The platelet aggregation rate after one day of postoperative DAPT in the ticagrelor group was lower than that in the clopidogrel group[(28.5 ±9.7)% VS(51.8 ± 16.8)%, P<0.05].After 4 days of postoperative DAPT, platelet aggregation rate in the ticagrelor group maintained a stable and desired level.The MACE 30 days after surgery in the clopidogrel group and the ticagrelor group were 3.3% and 1.6% re-spectively, and ticagrelor plus aspirin reduced MACE in patients undergone coronary endarterectomy , P=0.043.Conclusion According to the results of CYP2C19 gene assay, ticagrelor replacing clopidogrel could shorten the duration of desired platelet aggregation rate in patients with DAPT after OPCABG , and may be reduce the risk of MACE after OPCABG and coronary end-arterectomy.
8. Combined epicardial and transapical endocardial radiofrequency ablation for ventricular tachycardia with ventricular aneurysm in a porcine model
Bo LI ; Changcheng LIU ; Liangshan WANG ; Haiming LI ; Longsheng DAI ; Chengxiong GU
Chinese Journal of Thoracic and Cardiovascular Surgery 2019;35(12):744-747
Objective:
To evaluate the feasibility and validity of combined directly epicardial and transapical endocardial substrate ablation guided by Carto mapping for ventricular tachycardia(VT) with left ventricular aneurysm(LVA) intra-operation in a swine model.
Methods:
Twenty-four swine models with sustained VT and LVA were randomly divided into study group(radiofrequency ablation, RFCA, from epicardium via direct-view and endocardium via transapical access, 12 cases) and control group(endocardial RFCA via retrograde transaortic access, 12 cases). Substrate mapping for captured abnormal potentials via endocardium and epicardium was used to precisely locate the low-voltage areas. After ablation in two groups, VT was induced again to compare the effectiveness of different RFCA strategies.
Results:
Three dimensional electro-anatomic mapping was implemented successfully in two groups under open chest. And VT substrates were largely located in the border zone of LVA. All objects in the study group underwent endocardial ablation via transapical access smoothly without operative failure. When VT inducing again, 2 cases of study group was with inducible VT, however, VT recurrence in control group was 5 cases,
9. The synchronous mechanism of myocardial regeneration-cell disintegration-myocardial fibrosis and its relationship with heart failure
Hongchao WEI ; Chengxiong GU ; Yang YU ; Chuan WANG ; Mingxin GAO ; Haitao LI ; Jingxing LI
Chinese Journal of Thoracic and Cardiovascular Surgery 2019;35(10):629-634
Objective:
To observe the cardiomyocytes regeneration after myocardial infarction in Chinese small pigs, analyze the mechanism of myocardial fibrosis after myocardial regeneration.
Methods:
Nine Chinese small pigs, weight 18-20 kg, 6 pigs in the experimental group(to ligate LAD at the equal blood flow point), and 3 in the control group(no any operation was performed). Monitor the hemodynamics of the left ventricle. Cardiac specimens were taken after 4 weeks of LAD ligation, the left ventricle was divided into 17 segments, and fixed in 4% paraformaldehyde for 1 week. Hematoxylin-Eosin/(HE) staining, PTAH、Ki-67-DAB and α-sarcomeric-actin-DAB staining for pathological observation.
Results:
Four weeks of LAD ligation, different range of infarct size could be found in all the 17 segment of left ventricle. There was significant systolic pressure difference between the proximal and distal part in the left ventricular cavity. After 4 weeks of LAD ligation, there were a large number of new cardiomyocytes around the infarction area, which connected with the original mature cardiomyocytes directly. Large number of disassembled cardiomyocytes in the infarcted area and myocardial fibers were broken, cell structure disappeared, and nuclei were scattered in fibrotic tissues.
Conclusion
New cardiomyocytes after myocardial infarction were derived from the mature cardiomyocytes. Myocardial regeneration, cell disintegration, and myocardial fibrosis were performed synchronously under the influence of myocardial tension.