Objective To investigate surgical treatment and effect of secondary endocardial fibroelastosis,based on respective analysis of clinical data and follow-up data of patients with secondary endocardial fibroelastosis (SEF) between 2010 and 2012.Methods A retrospective analysis was performed including 10 patients with secondary endocardial fibroelastosis from January 2010 to December 2012 in Wuhan Union Hospital.All patients were diagnosed by Untrasonic Cardiogram and/or CT angiography of heart and great vessel,and had cardiac insufficiency in different degree [EF 0.37 ± 0.08 (0.26 ～ 0.48)].All patients except 2 patients with anomalous origin of the coronary artery received treatment of digitaloid drugs before operation,which promoted preoperative cardiac function.5 patients with SEF complicated with Congenital Coarctation of the Aorta (CoA),2 patients underwent correction of CoA,2 patients underwent correction of CoA and partial resection of endocardium,1 patient underwent correction of CoA,partial resection of endocardium and mitral vavuloplasty.2 patients with SEF complicated with anomalous origin of the left coronary artery from the pulmonary artery,who were underwent correction of anomalous origin of coronary artery.2 patients with SEF complicated with aortic stenosis,who were underwent aortic commissurotomy and partial resection of endocardium.1 patient with SEF complicated with mitral stenosis and insufficiency,who underwent mitral valve replacement.The intraopertive gross appearance of endocardium was opaque greyish-white not transparent pink.The postoperative pathological examination showed obviously positive dyeing of elastic fibers.In 3,6,12 and 24 months after operation,Untrasonic Cardiogram evaluated cardiac function and endocardium.Results one 6 months patients with origin of left coronary from pulmonary artery died of severe post-operative low cardiac output syndrome,while another 1 months patients with origin of left coronary from pulmonary artery obtained post-operative good recovery,and the Untrasonic Cardiogram show disappearance of endocardial fibroelastosis.The post-operative mean time of using respirator(4.0 ± 1.5) days (2-7 days).Compared with the preoperative data,the cardiac function index (EF) was not significantly better at 2 weeks and 3-6 months[0.38 ± 0.07 (0.28 ～ 0.48),P ＞ 0.05 ; 0.39 ± 0.08 (0.30 ～ 0.50),P ＞ 0.05],and the non-resected fibroelatic endocardium still existed and were not attenuated.But the cardiac function index (EF) significantly increased [0.44 ± 0.08 (0.38 ～ 0.55),P ＜ 0.05] than the pre-operative EF,and the 3 of 5 cases the fibroelatic endocardium were attenuated or disappeared,while 2 of 5 cases the fibroelatic endocardium still existed.Conclusion SEF is the important causes of the infant intractable heart failure,which has the characteristic of high mortality and limited therapy.For SEF patients with anomalous origin of the coronary artery,the SEF is completely reversed by early diagnosis and early correction of the malformation.For SEF patients with CoA or aortic stenosis,the surgical treatment could promote recovery of cardiac function,but whether the SEF were reversed is still subject to further follow-up.The heart transplantation is the best therapy for SEF with severse heart failure.

Objective To investigate the changes of relevant characteristics in the Beagle model of type 2 diabetes mellitus(T2DM) induced by high fat diet and low dose streptozotocin (STZ) injection. Methods Thirty male Beagles were randomly divided into three groups:(1) Control group (n=10), fed with a standard chow. (2) High fat diet group (n=10), fed with high fat diet. (3) Model group (n=10), fed with high fat diet for two months and then given STZ in?jection. Lee index, fasting blood glucose, serum insulin levels, urine glucose and blood biochemical indexes were regularly detected. Oral glucose tolerance test ( OGTT) and histopathological examination were performed. Results After treatment for two months, the insulin resistance and dyslipidemia appeared and Lee index significantly increased in the high fat diet group and model group (P<0?01). In the diabetic beagles, fasting blood glucose levels were prominently increased (P<0?01), as compared with the control group and high fat diet group, and held on a high blood glucose level for three months. Among the three groups, the dogs with OGTT values>11?1 mmol/ L and were not restored at three hours, showed some pancreatic histological damages and diseases. Conclusions A beagle model of type 2 diabetes mellitus is construc?ted, exhibiting some characteristics of human type 2 diabetes mellitus such as hyperglycemia,hyperinsulinism,dyslipidemia and other typical features.

Objective To summarze our experience and evaluate the therapeutic effect of hepatectomy for intrahepatic bile duct stones. Methods The clinical data of 316 patients suffering from intrahepatic lithiasis who underwent hepatectomy from Feb. 1985 to Dec. 2004 were retrospectively analyzed. Stones distribution, operation modality, postoperative complications, and therapeutic effect were evaluated. Among the 316 patients, 192 cases(60.76%) were treated with left lateral hepatectomy, 58 cases(18.35%) with left hemihepatectomy, 12 cases(3.80%)with quadarate lobectomy, 54 cases(17.09%) with right hemihepatectomy or segmentectomy, and 14 cases(4.43%)with left and right segmentectomy. Additional biliary procedures including common bile duct exporation and cholangio-enterostomy were performed in 184 patients(58.23%). Results Postoperative complications occurred in 56(17.72%)cases, including biliary fistula, hemobilia, and subdiaphragmatic infections. Three patients(0.95%)died. The follow-up study conducted in 258 patients(81.65%)for an average of 10.3 years showed that excellent results were achieved in 90.31% of the patients. Conclusions Regular hepatic lobectomy/segmentectomy is the most effective treatment for intrahepatic lithiasis.

Autonomic nervous system activation can result in significant changes of atrial electrophysiology and facilitate induction of atrial fibrillation. By recording influence of different concentrations of acetylcholine (ACh) on atrial fibers (AF), we investigated the role of the increased vagal tone in electrical remodeling in atrial fibrillation. Parameters of action potentials and force contraction (Fc) in atrial fibers were recorded by using standard intracellular microelectrode technique and force transducer. It was found that: (1) ACh at 0.1 μmol/L had no significant influence on spontaneous action potentials (SAPs) and Fc (n=6, P>0.05); ACh at both 1.0 and 10.0 μmol/L shortened action potential duration (APD) and Fc of human AF from right atrium (n=6, P<0.05); there was no significant difference in shortening APD between 10.0 and 1.0 μmol/L of ACh; (2) ACh at 0.1 μmol/L had no significant desensitization (n=6, P>0.05), but ACh at 1.0 and 10.0 μmol/L had desensitization (n=6, P<0.05) to SAPs and Fc. The desensitization of ACh on APD in AF was concentration- and time-dependent. It was shown that APD was longer than the control along with extending time of continuous Tyrode's solution perfusion after desensitization. It is concluded that ACh changes the electrophysiological characteristics of human AF, indicating that increased vagal tone plays a role in the development of a vulnerable substrate for atrial electrical remodeling in atrial fibrillation.

Autonomic nervous system activation can result in significant changes of atrial electrophysiology and facilitate induction of atrial fibrillation.By recording influence of different concentrations of acetylcholine (ACh) on atrial fibers (AF),we investigated the role of the increased vagal tone in electrical remodeling in atrial fibrillation.Parameters of action potentials and force contraction (Fc) in atrial fibers were recorded by using standard intracellular microelectrode technique and force transducer.It was found that:(1) ACh at 0.1 μmol/L had no significant influence on spontaneous action potentials (SAPs) and Fc (n=6,P＞0.05); ACh at both 1.0 and 10.0 μmol/L shortened action potential duration (APD) and Fc of human AF from right atrium (n=6,P＜0.05); there was no significant difference in shortening APD between 10.0 and 1.0 μmol/L of ACh; (2) ACh at 0.1 μmol/L had no significant desensitization (n=6,P＞0.05),but ACh at 1.0 and 10.0 μmol/L had desensitization (n=6,P＜0.05) to SAPs and Fc.The desensitization of ACh on APD in AF was concentration- and time-dependent.It was shown that APD was longer than the control along with extending time of continuous Tyrode's solution perfusion after desensitization.It is concluded that ACh changes the electrophysiological characteristics of human AF,indicating that increased vagal tone plays a role in the development of a vulnerable substrate for atrial electrical remodeling in atrial fibrillation.

OBJECTIVETo study the phosphorylation activity of mitochondrial signal transducer and activator of transcription 3 (STAT3) in the myocardium of rats with selenium deficiency and its association with myocardial injury.

METHODSThirty-six rats were randomized into normal control group (n=18) and selenium deficiency model group (n=18) for feeding with normal and low-selenium chow, respectively, for 20, 30 and 40 weeks. The cardiac function of the rats was evaluated by carotid artery intubation, and the damage of cardiac mitochondria was observed under electron microscopy. The cardiac mitochondria were extracted for assessing succinate dehydrogenase and cytochrome C oxidase activities, and the protein expressions of phosphorylated and total STAT3 were detected.

RESULTSCompared with the corresponding control groups, the rats in the model group showed significantly decreased cardiac function with obvious structural and functional damage of the cardiac mitochondria (P<0.05), which aggravated as the low-selenium feeding time extended (P<0.05). The rats in the model group also showed significantly decreased mitochondrial STAT3 activity (p-STAT3/STAT3) in the myocardium as the low-selenium feeding time prolonged (P<0.05). Pearson linear correlation analysis showed that the activity of cardiac mitochondrial STAT3 had positive correlations with the left ventricular systolic pressure, maximal increased rate of the left ventricular pressure, and the activities of succinate dehydrogenase and cytochrome C oxidase (P<0.01).

CONCLUSIONSelenium deficiency down-regulates the activity of mitochondrial STAT3 in rat heart to contribute to cardiac mitochondrial injury and the progression of heart failure.

Animals ; Diet ; Electron Transport Complex IV ; metabolism ; Female ; Heart Injuries ; metabolism ; Male ; Mitochondria, Heart ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley ; STAT3 Transcription Factor ; metabolism ; Selenium ; deficiency ; pharmacology ; Signal Transduction ; Succinate Dehydrogenase ; metabolism

Objective To analyze the characteristics and changes of Oncomdania snail distribution in regions with different epidemic types and degrees of Jiangsu Province,so as to provide the evidence for implementing the feasible schistosomiasis control strategy.Methods A retrespeetive survey was performed,and the 5-year database of snail status in Jiangsu Province was established based on the collected reports of snail habitat cards and schistosomiasis control in Jiangsu Province from 2004 to 2008.The changes of snail areas,infected snail aroas,infection rates of snails in different years were analyzed,and tIIe annual vailations of snail areas,infected snail areas and infection rates of snails in areas with different epidemic types and degrees were eomparedI Results The actual snail areas and infected snail areas decreased by 3 799.86 hm~2 and 2 006.35 hm~2.respectively in Jiangsu Province.2006-2008.with the annual meaan decreasing rates of 9.64% and 18.83%.Among them,the actual snail areas in marshland and lake regions,water net regions and mountainous regions decreased by 3 546.10.209.19 hm~2 and 44.57 hm~2,respectively,with the annual meall decreasing rates of 9.59%,10.29% and 11.18%,respectively.An area of 22.02 hm~2 of new snail habitatswas detected during the 5 years,and thewater net regions accounted for 89.24%.Theproportions of actual snail areas in historical snail ale,as were between 2.77% and 5.36%.Among them.the proportions of actual snail areas in historical accumulative snail area8 in transmission-uncontrolled.trailsmission-controlled and transmission-interrupted areas were 13.29%-22.82%,0.88%-3.54% and 0.14%-0.32%,respectively,and there were significant differences among them(P<0.01).The constituent ratios of the actual snail areaswere 93.79%-95.60%.3.67%-5.45% and 0.73%-1.01%, respectively in marshland and lake regions,water net regions and mountainous regions from 2004 to 2008.The infection rate of snails in Jiangsu Province reduced from 0.15% in 2004 to 0.02% in 2008,with a reduction rate of 85.50%(P<0.01).The constituent ratios of infected snail areas in transmission-uncontrolled, transmission-controlled and transmission-interrupted areas were 98.15%-100%,0-0.81%, and 0-1.43%,respectively.Conclusions As a whole,there is a decreasing tendency of snail areas and infected snail areas in Jiangsu Province.and the snail control has been consohdated step by step in transmission-interrupted areas.The effective control of snails in marshland and lake regions and infected snails in transmission-uncontrolled areas are the key points in the future schistosomiasis control of Jiangsu Province.

Early-onset facioscapulohumeral muscular dystrophy is a rare clinical syndrome characterized by severe muscle weakness started in early childhood,with extramuscular manifestations such as retinal vascular tortuosity,sensorineural hearing loss and epilepsy.Herein we report a case with early-onset facioscapulohumeral muscular dystrophy and Coats syndrome.Early diagnosis of Coats syndrome is critical for the prognosis.

Objective:To evaluate the relationship between the application of statins and the risk of hepatocellular carcinoma in patients with chronic liver disease.Methods:PubMed, the Cochrane Library, EMBASE, Web of science, WeiPu, Wanfang Med online, and China National Knowledge Infrastructure database were searched. The literatures about statins and the risk of hepatocellular carcinoma in patients with chronic liver disease were collected, with a search deadline of February 2020. Two researchers independently conducted literature screening, data extraction, quality evaluation and proofreading. RevMan5.3 software was used for data analysis. The I2 combined with χ2 test was used to evaluate the heterogeneity. Funnel plots were used to evaluate the publication bias of the included literature. Results:A total of 12 articles were included. Statins application had significantly reduced the risk of hepatocellular carcinoma in patients with chronic liver disease ( OR = 0.50, 95% CI: 0.43~0.58, P < 0.01). Subgroup analysis showed that statins had reduced the incidence rate of hepatocellular carcinoma in patients with chronic hepatitis B ( OR = 0.56, 95% CI: 0.47~0.66, P < 0.01) and chronic hepatitis C ( OR = 0.56, 95% CI: 0.45~0.71, P < 0.01). Lipophilic statins had significantly reduced the risk of chronic liver disease development to hepatocellular carcinoma ( OR = 0.48, 95% CI: 0.39~0.59, P < 0.01), but hydrophilic statins did not reduce the incidence rate of chronic liver disease development to hepatocellular carcinoma, and the difference was not statistically significant ( OR = 0.64, 95% CI: 0.36~1.14, P = 0.13). Conclusion:Statins can effectively reduce the risk of hepatocellular carcinoma development in patients with chronic liver disease, including chronic hepatitis B and C. Among them, the lipophilic statins have a significant preventive effect on the development of chronic liver disease to hepatocellular carcinoma, but hydrophilic statins have no obvious effect.

OBJECTIVETo investigate the role of ATP-binding cassette transporter G1 (ABCG1) in endothelial dysfunction induced by high glucose.

METHODSHuman aortic endothelial cells (HAECs) were incubated in the presence of 5.6 or 30 mmol/L glucose for 24-72 h with or without a 2-h pretreatment with the LXR agonist 22(R)-hydroxycholesterol. Real-time PCR and Western blotting were used to measure the mRNA and protein expressions of ABCG1; the intracellular cholesterol efflux and endothelial nitric oxide synthase (eNOS) activity were measured by scintillation counting.

RESULTSHigh glucose time-dependently suppressed ABCG1 expression and cholesterol efflux to HDL in HAECs. High glucose also decreased eNOS activity. ABCG1 down-regulation induced by high glucose, along with decreased cholesterol efflux and eNOS activity, was abolished by treatment of the cells with the LXR agonist.

CONCLUSIONEndothelial dysfunction induced by high glucose is associated with decreased ABCG1 expression.

ATP Binding Cassette Transporter, Sub-Family G, Member 1 ; ATP-Binding Cassette Transporters ; genetics ; metabolism ; Aorta ; cytology ; Cell Line ; Down-Regulation ; drug effects ; Endothelial Cells ; cytology ; metabolism ; physiology ; Glucose ; pharmacology ; Humans