OBJECTIVE:To observe clinical effects of alprostadil combined with nitric oxide in the treatment of congenital heart disease complicated with pulmonary hypertension and its effects on immune function. METHODS:In retrospective study,40 cases of congenital heart disease complicated with pulmonary hypertension in thoracic and cardiovascular surgery department of our hospital during Aug. 2009 to Feb. 2015 were selected and divided into nitric oxide group(single group)and alprostadil+nitric oxide group(combination group)according to therapy method,with 20 cases in each group. Both groups received conventional surgery. Single group was given extrinsic inhalation of nitric oxide(volume fraction of 20×10-6)after surgery;combination group was addi-tionally given intravenous pump of alprostadil 5 ng/(kg·min) for consecutive 72 h,on the basis of combination group. The heart rate,left ventricular ejection fraction(LVEF),mean arterial pressure,pulmonary arterial pressure,T lymphocyte and immunoglob-ulin(Ig)of children before and after treatment,and the occurrence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups (P>0.05). After treatment,heart rate,LVEF, mean arterial pressure,the levels of CD3+,IgA,IgM and IgG in 2 groups had no significant change,but CD4+,CD4+/CD8+,Treg/CD4+ were increased significantly;pulmonary arterial pressure,the levels of CD8+,Th1,Th2,Th1/Th2 and Th17/CD4+,supple-ment C3 and supplement C4 were decreased significantly,compared to before treatment. Above indexes in the combination group was significantly better than the single group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Alprostadil combined with nitric oxide could significantly reduce the pulmonary hypertension in children with congenital heart disease complicated with pulmonary hypertension,improve the level of T lymphocytes,and decrease the levels of supplement C3 and supplement C4 with good safety.

Objective To explore the expression of resistin-like molecules-a (RELMa) in atherosclerotic plaque of ApoE-/- mouse, and to study the effects of RELMa on the proliferation and migration of vascular smooth musclee cells (VSMCs) . Method Nine ApoE-/- mice and nine C57BL/6J mice were fed with high fat diet. All mice were sacrificed 24 weeks after force feeding. Vessels were dissected from to abdominal aorta. Sections of aortic tissue were stained with HE dyeing and RELMa in aortic tissue was assayed by immunohistochemistry. The expression of RELMa mRNA in vessels was detected by RT-PCR. The effects of different concentration RELMa in different concentrations on the proliferation and migration of VSMCs were detected. Data was expressed as mean ± standard deviation. ANOVA were used for comparison in SPSS 11.0, and changes were considered as statistically significant if P value was less than 0.05. Results Atherosclerosis plaque formed in aortic root of ApoE-/- mice after they were fed with high fat diet for 24 weeks. RELMa protein and RELMa mRNA were found by immunohistochemistry and RT-PCR in atherosclerotic plaque of ApoE-/- mouse. RELMa protein didn't be found in vessels of control mouse. RELMa promoted the proliferation of VSMCs (RELMa groups: 2811. 21 ± 216. 89,4056. 87 ±220.65,5061.45 ± 335.86, vs. control 1609.58 ± 203.53, P < 0.01). RELMa promoted the migration of VSMCs (RELMa groups: 130.54±12.98,158.39±11.58,203.50± 17.37 vs. control:70.54± 11.92, P<0.01).Conclusions RELMa expresses in atherosclerotic plaque of ApoE-/- mouse. RELMa enhances the proliferation and migration of VSMCs of aorta.

AIM: To observe the effect of piceatannol on the kidney of diabetic nephropathy rats in early stage, and to explore the possible mechanisms.METHODS: The rats were randomly divided into 5 groups: control group, model group, low dose of piceatannol treatment group, medium dose of piceatannol treatment group and high dose of piceatannol treatment group.The rat model of diabetic nephropathy was induced accordingly, and the rats received 20 mg/kg, 40 mg/kg or 60 mg/kg of piceatannol by gavage once a day for 4 weeks.Blood glucose was detected by glucometer.The urea nitrogen and creatinine levels in the serum were measured by urease-glutamate dehydrogenase enzymatic and inosine acid oxidase methods, respectively, and 24 h urinary microalbumin was analyzed by immune transmission turbidimetry test.Moreover, the pathological changes of the kidney tissues were observed under microscope with HE staining.The protein expression of TGF-β1 and Smad 7 and the phosphorylation levels of Smad2 and Smad3 were determined by Western blot.RESULTS: Compared with model group, piceatannol treatment significantly decreased the levels of blood glucose, blood urea nitrogen and urinary microalbumin, but had no effects on serum creatinine.Furthermore, HE staining showed that the increased mesangial cells, matrix hyperplasia and degenerated epithelial cells in model group were markedly inhibited after piceatannol treatment.Additionally, piceatannol treatment also reduced the protein expression of TGF-β1 and Smad 7, and the phosphorylation levels of Smad2 and Smad3.CONCLUSION: Piceatannol attenuates pathological progression in the kidney of diabetic nephropathy rats in early stage, which may be through inhibiting TGF-β/Smad signaling pathway.

In this paper, a new conception pressure displacement wave of vascular wall (PDWVW) and a novel method for diagnosing the vascular disease early were proposed for the first time in accordance to the principle of Frank elasticity of vascular wall; moreover, an original diagnostic equipment noninvasive diagnostic system of human vascular wall, was developed. The feasibility and practicability of the method and equipment assessed in the clinical experiment are also presented.
Blood Flow Velocity ; Blood Vessels ; physiology ; physiopathology ; Elasticity ; physiology ; Humans ; Hypertension ; diagnosis ; physiopathology ; Monitoring, Physiologic ; instrumentation ; Pattern Recognition, Automated ; Pulsatile Flow ; Signal Processing, Computer-Assisted

Objective: To detect the expression of SIRT1 and Ac-FOXO1 in rats after endurance training and acute exhaustive exercise, and explicit the myocardial protective effect of SIRT1. Methods: Rats were randomly divided into four groups: control group(n=20), exhaustive exercise group (E group, n=20), exhaustive exercise group + endurance training (TE group, n=18), exhaustive exercise group + endurance training + selective SIRT1 inhibitor (TSE group, n=17). The Control and E groups were fed routinely for 5 weeks. The TE and TSE groups were subjected to swimming exercise for 5 weeks for endurance exercising. The TSE group was intraperitoneally injected with selective SIRT1 inhibitor Sirtinol(2 mg/kg) at 30 minutes before endurance exercising. The E, TE and TSE groups were subjected to exhaustive exercise. The myocardial tissues of rats were collected after exhaustive exercise. Real-time polymerase chain reaction (PCR) and Western blot analysis were performed to detect the myocardial mRNA and protein expressions of SIRT1 and Ac-FOXO1. The myocardial protein expression of Bax and Bcl-2 was also detected by Western blot. Terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) assay was used to assess the apoptosis of myocardial cells. Results: Compared with Control group, the SIRT1 and Bcl-2 expression in the myocardial tissue was obviously decreased, while the Ac-FOXO1, Bax, and the myocardial cell apoptosis were significantly increased in E group (all P<0.01). Compared with E group, the expression of SIRT1 and Bcl-2 was obviously up-regulated (both P<0.01), while the Ac-FOXO, Bax and the myocardial cell apoptosis was significantly reduced in TE group (all P<0.01). Compared with TE group, the SIRT1 and Bcl-2 expression was obviously lower (both P<0.01), while Ac-FOXO1, Bax, and the cell apoptosis were significantly higher in group TSE (all P<0.01). Conclusion Endurance training could protect myocardium by reducing the myocardial oxidative stress injury and apoptosis via activating SIRT1 signaling pathway, up-regulating the myocardial expression of SIRT1 and regulating the deacetylation of FOXO1.

Objective To discuss the techniques and methods of surgery for brain gliomas located in eloquent areas at awake anesthesia. Methods Nineteen patients with brain gliomas in eloquent areas, admitted to our hospital from December 2014 to May 2017, were operated under awake anesthesia with neuronavigation and intraoperative ultrasonography for locating the lesions and intraoperative direct electrical stimulation for functional mapping of the eloquent areas. All patients were followed up from 3 to 18 months; the surgical efficacies were analyzed. Results Of 19 patients, 18 (94.74％) were achieved awake and alert during brain mapping and resection of the tumors;17 (89.47％) were detected the motor areas by intraoperative direct electrical stimulation, 6 (31.58％) were detected the sensory cortex and 12 (63.16％) were detected language related cortex. Of 19 patients, MR imaging 2-3 months after surgery indicated that 5 (26.32％) received total resection of lesions, 9 (47.37％) subtotal resection of lesions and 5 (26.32％) partial resection of lesions. Seven patients (36.84％) had transitory postoperative aphasia, 4 (21.05％) were with transitory postoperative dyskinesia and one (5.26％) with permanent dyskinesia. Conclusion Comprehensive applications of awake anesthesia, neuronavigation, intraoperative ultrasonography and intraoperative direct electrical stimulation technologies allow maximum safe resection of gliomas in eloquent areas and protection of brain function.

OBJECTIVETo investigate the safety and feasibility of laparoscopic radical right hemicolectomy using caudal-to-cranial approach (yellow-white borderline between right mesostenium and retroperitoneal is firstly cut as the entry to dissect the fusion fascial space between the visceral and parietal peritoneum, which is called caudal-to-cranial approach for right hemicolectomy).

METHODSFrom January 2014 to May 2015, 76 consecutive patients with right side colon cancer underwent laparoscopic radical right hemicolectomy using caudal-to-cranial approach. The baseline characteristics, intraoperative and postoperative outcomes were prospective collected and reviewed retrospectively.

RESULTSAll the 76 patients completed operations successfully, and one patient (1.3%) was converted to open surgery because of intraoperative bleeding due to unexpected injury of ileocolic artery. The mean operative time was (152.8±42.1) min with a mean estimated blood loss of (70.4±43.5) ml. The mean time of first flatus was (49.3±22.9) h and mean liquid oral intake was (58.5±17.6) h. The postoperative complications appeared in 7 patients (9.2%), including one (1.3%) of pulmonary infection, one(1.3%) of urinary system infection, two (2.6%) of wound infection, two (2.6%) of inflammatory bowel obstruction and one (1.3%) of lymphatic fistula, and they were all cured with conservative treatments. The postoperative hospital stay was (7.8±5.4) d. The mean number of harvested lymph node was 34.2±10.9, among which 4.1±2.8 was positive.

CONCLUSIONSLaparoscopic radical right hemicolectomy using caudal-to-cranial approach is safe and feasible.

Objective:To observe the transparency and tissue structure changes of human corneal stromal lenticules after long-term cryopreservation and explore a simple and feasible method for long-term effective preservation of corneal stromal lenticules.Methods:Two hundred samples of intact human corneal stromal lenticules from 200 eyes were obtained during femtosecond laser small-incision lenticule extraction (SMILE) in Hainan Eye Hospital, Zhongshan Ophthalmic Center from 2013 to 2020.The samples were divided into 1-month, 24-month, 60-month and 80-month group and were stored in an ultra-low temperature freezer for 1, 24, 60 and 84 months respectively at -80 ℃ according to grouping, with 50 samples in each group.Transmittance of the corneal lenticules at wavelength of 300-800 nm was measured with an ultra-micro spectrophotometer and every lenticule was measured for 10 times with a 50 nm interval.The histomorphology and collagen fiber structure of the corneal lenticules were examined by hematoxylin-eosin staining and Masson staining, respectively.The arrangement of collagen fibers and ultrastructure changes of keratocytes in the samples were inspected with a transmission electron microscope.The apoptosis rate of keratocytes was determined by TUNEL staining.The study protocol was approved by an Ethics Committee of Hainan Eye Hospital at Zhongshan Ophthalmic Center (No.2013-003). This study complied with the Declaration of Helsinki.Written informed consent was obtained from each subject before surgery.Results:The corneal lenticules were clear and intact in all groups and no significant difference in the transmittance within 450-800 nm wavelength was seen among the 4 groups (all at P>0.05). Masson staining revealed that the collagen fibers in the lenticules were neatly arranged and tightly packed in the 1-month group.In the 24-month group, interfibrous vacuoles were found in some collagen fibers.The arrangement of the collagen fibers was loose and more vacuoles were displayed in the 60-month group, and the loss of some collagen fibers appeared and the lenticules were thinned in the 84-month group.It was found through hematoxylin-eosin staining that the morphological changes of corneal stromal lenticules corresponded to the alterations of collagen fibers.Transmission electron microscopy showed that in the 1-month group, the collagen fibers of the corneal stroma lenticules were neatly arranged and regular, and the corneal stromal cells were elongated and spindle-shaped, and the nuclear membrane was intact and the cytoplasm was abundant.In the 24-month group, the collagen fibers showed slightly loose arrangement, and the corneal stromal cells were deformed with incomplete nuclear membrane.In the 60-month group, the collagen fibers were in loose and irregular arrangement, and the nuclei were atrophied and deformed.The 84-month group showed disorganized arrangement of collagen fibers, wrinkled and atrophied corneal stromal cells, discontinuous nucleus membrane and nucleoplasmic lysis.TUNEL staining showed that the percentage of apoptotic corneal cells in lenticules was (87.80±1.17)%, (89.50±1.05)%, (89.30±1.51)% and (90.20±1.47)% in the 1-month, 24-month, 60-month and 84-month groups, respectively, with no statistically significant difference found in overall comparison ( F=4.525, P=0.053). Conclusions:The disorder of collagen fibers and apoptosis of keratocytes occur in the human corneal stromal lenticules till 84 months after cryopreservation, however, the transparency and integrity remain excellent.The ultra-low temperature preservation technique provides an effective and simple solution for long-term storage of human corneal stromal lenticule.

Aim To explore the feasibility of using machine learning algorithms combined with coronary computed tomography(CT)derived perivascular fat attenuation index(FAI)and plaque information to evaluate myocardial ischemia in stable coronary heart disease patients.Methods A retrospective analysis was conducted on the clinical and imaging data of patients who underwent preoperative coronary CT angiography(CCTA),invasive coronary angiography(ICA),and flow reserve fraction(FFR)measurements at Zhongshan Hospital Affiliated to Fudan University from April 2019 to October 2021.206 patients with stable coronary heart disease were selected.The semi-automatic plaque analysis software was used for quantification of plaque and lumen parameters and perivascular FAI measurement,with man-ual delineation of a 40 mm segment of the coronary artery starting 10 mm from the ostium for perivascular FAI measure-ment.Differences in plaque characteristics,perivascular FAI,and coronary perivascular FAI between stable coronary heart disease patients with FFR≤0.8 and FFR＞0.8 were compared.The diagnostic performance of combining perivascu-lar FAI,coronary perivascular FAI,and plaque features using machine learning algorithms for myocardial ischemia in stable coronary heart disease patients was evaluated through ROC curves.Results 206 stable coronary heart disease patients were divided into FFR≤0.8 group(50 cases)and FFR＞0.8 group(156 cases).The mean periplaque FAI of patients with FFR≤0.8 was-69.28±5.65 HU,significantly higher than that of patients with FFR＞0.8 at-80.10±7.75 HU(P＜0.001).Further analysis was conducted using machine learning models,including XGBoost,random forest,and Logistic regression models,all of which had an accuracy rate of over 0.8 in diagnosing myocardial ischemia.Among them,the XGBoost model performed the best with an accuracy of 0.903,an F1 value of 0.774,and an AUC of 0.931,in-dicating its high effectiveness in diagnosing myocardial ischemia.Conclusion The combination of FAI and machine learning algorithm XGBoost model is a new method for diagnosing myocardial ischemia,which has better diagnostic value in evaluating myocardial ischemia in stable coronary heart disease patients.

The radial artery pulse wave contains a wealth of physiological and pathological information about the human body, and non-invasive studies of the radial artery pulse wave can assess arterial vascular elasticity in different age groups.The piezoelectric pulse wave transducers were used to non-invasively acquire radial artery pulse waves at different contact pressures in young and middle-aged and elderly populations. The radial artery waveforms were decomposed using a triangular blood flow model fitting method to obtain forward and reflected waves and calculate reflection parameters. Finally a correlation analysis and regression analysis of the contact pressure P_sensor with the reflection parameters was carried out. The results showed that the reflection parameters RM, RI and R_d had a strong negative correlation with P_sensor in both types of subjects, and the correlation coefficients and slopes of the regression curves were significantly different between the two types of subjects (P<0.05). Based on the results of this study, excessive contact pressure on the transducer should be avoided when detecting radial artery reflection waves in clinical practice. The results also show that the magnitude of the slope of the regression curve between the reflection parameters and the transducer contact pressure may be a potentially useful indicator for quantifying the elastic properties of the vessel.
Middle Aged ; Aged ; Humans ; Blood Pressure/physiology* ; Arteries ; Blood Flow Velocity/physiology* ; Elasticity ; Pulse Wave Analysis ; Radial Artery/physiology*