Objective To investigate the role and possible mechanism of ultrasound-targeted microbubble destruction for accelerating neovascularisation in ischemic skeletal muscle. Methods Unilateral hind limb ischaemia was surgically induced in thirty wister rats. On postoperative day 7 , the rats were randomly divided into three groups: ultrasound-targeted microbubble destruction group (group A), ultrasound group (group B), and control group. After the end of the experiment , parafin sections for the skeletal muscle from one rat in each group were made to observe the changes in microstructure. The remaining rats were sacrificed at 24 h and on day 7. VEGF expression, inflammatory factor E-selectin, and monocyte chemotactic factor-1 (MCP-1) were detected in the rats. Results As compared with the other two goups, expressions of VEGF, neovascularization, E-selectin, and MCP-1 in the skeletal muscle were significantly increased in group A. Conclusions Microvascular rupture caused by ultrasound-targeted microbubble destruction can promote angiogenesis by stimulating secretion of endogenous VEGF in skeletal muscle; meanwhile, an increase in expression level of inflammatory factors may be one of the mechanisms.

Objective To explore the cardiovascular risk factors and clinical features of coronary lesions in male patients with premature coronary artery disease(CAD).Methods A total of 448 male patients with CAD confirmed by angiography were divided into two groups by age: premature CAD(n=145,

Objective To investigate the compliableness and cardiac rehabilitation effect of application of the Android‐based cardiac rehabilitation risk assessment simulative software in the patients with coronary heart disease (CHD) .Methods A total of 150 discharge patients with CHD treated in the cardiology department of multiple hospitals in Guangzhou City from December 2014 to December 2015 were selected as the research subjects and divided into the observation group for applying the Android‐based car‐diac rehabilitation risk assessment software and control group according to the random number table ,75 cases in each group .The compliableness and cardiac rehabilitation effect after this software out‐of‐hospital application in the CHD patients were observed . Results Among 150 cases ,141 cases continued to follow up ,the follow up rate was 94 .0% ,including 72 cases in the observation group and 69 cases in the control group ,the re‐hospitalization rate and the standard‐reaching rate of blood pressure ,blood glucose and blood lipid in the observation group were superior to those in the control group with statistical difference (P<0 .05);the com‐pliableness of behaviors following doctor′s advice and comprehensive evaluation of living quality in the observation group were su‐perior to those in the control group ,and the differences were statistically significant (P<0 .05) .Conclusion The application of the Android‐based cardiac rehabilitation risk assessment software is an effective measure for out‐of‐hospital cardiac rehabilitation , which can increase the compliableness of cardiac rehabilitation in the CHD patients .

Objective: To test the feasibility of drag-reducing polymers (DRP) for improving coronary microcirculation in a canine model in order to provide the experimental basis for treating myocardial microcirculation dysfunction. Methods: A total of 8 dogs received open-chest surgery and they had intravenous injections, in turn, with adenosine (ADN), DRP 250 mg/L and DRP+ADN. The function y=A × (1-e-βt) was used to calculate the myocardium capillary volume (A value), capillary velocity (β value) and myocardial blood lfow (A ? β value) by myocardial contrast echocardiography. Results: With DRP infusion, the A value in experimental canine was similar to the baseline condition,P>0.05; while theβ value and A ? β value were signiifcantly increased as (0.57 ± 0.10) 1/s vs (0.23 ± 0.03) 1/s,P<0.01 and (11.51 ± 1.96) VI/s vs (5.15 ± 0.86) VI/s,P <0.05 respectively. With combined infusion of DRP+ADN, the β value and A ? β value were similar to the baseline condition, bothP>0.05. Conclusion: DRP improved coronary microcirculation primarily by modulating the β value in experimental canine model, and hopefully, this unique hemodynamics could provide a new approach for treating myocardial microcirculation dysfunction.

AIM: To investigate the use of therapy ultrasound to enhance nonviral gene delivery. METHODS: Endothelial cells (EC) and vascular smooth muscle cells (VSMC) were cultured in 6-well plates. Plasmid (pcDNA3.1/His/LacZ) with or without microbubbles at the different concentrations was transfected into the cells with the use of ultrasound for 1 min at 2 MHz, 1.8 mechanical index (MI). Additional controls included ultrasound alone, microbubble alone and microbubble plus plasmid. The rate of blue cells and the activities of ?-Gal were measured. In addition, cell viability was detected with different time from 1 to 30 min of ultrasound irradiation and the different concentrations of microbubbles. RESULTS: In the group of ultrasound with microbubble, the rate of blue cells and activity of ?-Gal markedly increased by 60% and 9-fold, respectively. Microbubbles at concentration of 10% led to the highest transfection effect. Ultrasoud exposure at 1 to 30 minute had no cell toxic effects, while microbubbles at the concentration of 50% had significant effect on cell survival. CONCLUSIONS: Albumin-coated microbubbles markedly enhance gene delivery by therapeutic ultrasound-mediated microbubble destruction, which can be used as a safe and practicality vectors in gene therapy.

Objectives To assess the clinical outcomes,the technical characteristics of percutaneus endoscopic interlaminar decompression for lumbar lateral recess stenosis in elderly patients.Methods From May 2014 to June 2015,76 elderly patients with lumber lateral recess stenosis were accepted percutaneus endoscopic interlaminar decompression,including 48 males and 28 females aged from 60-91 years old (average,71.7:8.8 years).There were 40 patients with stenosis in L45,29 patients with stenosis in L5S1 and 7 patients with stenosis in L4.5 and L5S1.Back and leg pain were assessed by visual analogue scale (VAS).The influence of pain was evaluated by Oswestry disability index (ODI).The change of spinal canal was assessed by lateral recess angle.The MacNab criteria was evaluated at last follow-up.Results All of the 76 operations had been completed successfully with an average operation time of 64.3±23.9 min (range,56-98 min).An average follow-up time was 31.5 months (range,24-36months).There was no operative segment errors and nerve root tear during operation.Dural sac tear in 1 case,2 cases of nerve root injury and 1 case of postoperative kakesthesia,transient seizures after anesthesia occurred in 1 case and 1 case had postoperative delirium.There were significances in lumbocrural pain scores,leg pain scores and ODI scores between preoperation and postoperative 1,3,6,12 month and last follow-up (P＜0.05).In the MacNab last follow-up,the fineness rate was 92.1％,including 52 cases of excellence,18 cases of good,and 6 cases of fair.The latera recess angle between preoperation and postoperation was significantly different.During follow-up period,there were 3 cases developed into lumbar instability.No recurrence,discitis and leakage of cerebrospinal fluid were found,delayed incision healing was found in 1 case.Conclusions Percutaneus endoscopic interlaminar decompression for lumbar lateral recess stenosis in elderly patients is a safe,effective and minimally invasive method of operation with the characteristics of precise decompression of bone stenosis,sufficient resection of ligamentum flavum to decompress soft stenosis,small effect on spinal stability and low complications.

Objective To evaluate the clinical efficacy of anterior single segmental decompression and instrumentation through Endoring self-support retractor-assisted minimally invasive small incision approach in the treatment of Denis type B thoracolumbar burst fractures.Methods A retrospective case series study was made on 26 cases (14 males and 12 females,mean age of 48.5 years) of Denis type B thoracolumbar burst fractures treated by anterior single segmental decompression and instrumentation through Endoring self-support retractor-assisted minimally invasive small incision approach from January 2007 to June 2009.Age was 18-68 years (mean,48.5 years).The fractured vertebrae included T1 in three cases,L1 in 18 and L2 in five.The neurological status was Grade C in eight cases,Grade D in 12 cases and Grade E in six cases according to American Spinal Injury Association (ASIA) classification.The operation duration,blood loss and incision length were recorded.The neurological function,lower back pain were evaluated by visual analogue score (VAS),correction of kyphosis and restoration of the fractured vertebral body height followed and documented at 3,6 and 9 months and annually after surgery.The healing of the graft was assessed using Brantigan method based on 3-dimensional computed tomography at final follow-up.Results All patients were successfully managed with this approach.The operation duration was (214.6 ± 30.5)min,and the intraoperative blood loss was (389.7 ± 57.1) ml.The length of incision was (8.5 ± 1.3) cm.All patients were followed up for (6.3 ± 0.4) years.At final follow-up,the neurological functions of all patients with incomplete neurological deficit were improved for at least one grade.The VAS of lower back pain was improved from preoperative (7.8-± 1.6) points to (2.1 ± 0.8) points at final follow-up (P ＜ 0.05).The height of the intervertebral body was restored from preoperative (29.8 ± 5.3) mm to (35.2 ± 2.4) mm at final follow-up (P ＜ 0.05).The kyphosis was corrected from preoperative (20.4 ± 11.7) ° to (11.3 ± 5.5) ° at final follow-up (P ＜ 0.05).Bone fusion was achieved in all patients,with no looseness,breakage or displacement of internal fixation at follow-up.Conclusions Anterior single segmental decompression and instrumentation through Endoring self-support retractor-assisted minimally invasive small incision approach can reduce the surgical trauma,achieve complete spinal canal decompression,adjust kyphosis,fix segment,obtain high rate of bone graft fusion and hence is a safe and effective method with minimal invasion for Denis type B thoracolumbar burst fractures.

OBJECTIVETo explore the mechanism of lumen loss of the left circumflex ostium after main vessel stent implantation.

METHODSTwenty-eight patients undergoing provisional T technique were enrolled in this study. Intravascular ultrasound (IVUS) examination was performed before and after main vessel stenting and kissing balloon post-dilatation to evaluate the geometrical changes of the vessels.

RESULTSThe CSA of LCX ostium lumen decreased significantly from 5.9∓2 mm(2) to 4.9∓1.9 mm(2) (P<0.01) after the procedure, and the CSA of LCX ostium P and M increased from 5.4∓2.9 mmmm(2) to 5.7∓2.9 mm(2) (P=0.21) after the main vessel stenting. The changes in LCX ostium lumen CSA was correlated with the changes of LCX ostium EEM CSA but not the LCX ostium P and M CSA. After kissing balloon post-dilatation, the CSA of LCX ostium lumen increased from 4.9∓1.9 mm(2) to 5.5∓1.9 mm(2) (P<0.01) , and the CSA of LCX ostium P and M showed no obvious changes (5.7∓2.9 mmmm(2) vs 5.7∓2.6 mmmm(2), P=0.89). The changes of LCX ostium lumen CSA were correlated with the those of the LCX ostium EEM CSA (R=0.432, P=0.02).

CONCLUSIONAfter stent implantation from the LMCA to the LAD, most of lumen losses of the LCX are due to carina shift, and in occasional cases, plaque shift occurs from the distal LMCA to the ostium of the LCX. Kissing balloon technique can adjust carina shift but can not improve plaque shift.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Coronary Stenosis ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome ; Ultrasonography, Interventional

Objective·To investigate the causal relationship between atrial fibrillation(AF)and cognitive impairment.Methods·A two-sample Mendelian randomization(TSMR)analysis was used to assess the potential causality of AF on cognitive dysfunction.Single nucleotide polymorphisms(SNPs)strongly associated with AF were extracted as instrumental variables by using a dataset of a large-scale genome-wide association study(GWAS)on AF.The associations of SNPs with Alzheimer's disease dementia,Parkinson's disease dementia,vascular dementia,Lewy body dementia,frontotemporal dementia,undefined dementia,and overall cognitive function assessment were extracted separately from publicly available GWAS data on cognitive dysfunction.The inverse variance-weighted(IVW)method was used for the main analysis,and sensitivity analyses were conducted by using Cochran's Q test,MR-Egger regression,and leave-one-out method.To verify the robustness of the results,replicate analyses and meta-analyses were performed by using different GWAS data.Results·In the initial analysis,101 SNPs were extracted as instrumental variables from a meta-analysis of a genome-wide association study involving up to 1 030 836 individuals.The IVW analysis showed no evidence for causal associations between AF and dementia[dementia(OR=1.032;95％CI 0.973-1.094;P=0.290),Parkinson's disease dementia(OR=1.004;95％CI 0.780-1.291;P=0.977),vascular dementia(OR=1.123;95％CI 0.969-1.301;P=0.125),or unspecified dementia(OR=1.013;95％CI 0.910-1.129;P=0.807)].In the replication analysis,27 SNPs were extracted as instrumental variables from the FinnGen AF GWAS data,and the 1VW analysis were consistent with the initial analysis[cognitive function(OR=0.999;95％CI 0.982-1.016;P=0.874),Alzheimer's disease dementia(OR=0.977;95％CI 0.943-1.012;P=0.193),Lewy body dementia(OR=1.014;95％CI 0.898-1.145;P=0.826),or frontotemporal dementia(OR=0.996;95％CI 0.745-1.333;P=0.980)].Both Mendelian randomization analyses and meta-analyses showed no evidence of an association between genetically predicted AF and different types of dementia or overall cognitive function assessment.MR-Egger regression suggested no horizontal pleiotropy and leave-one-out analysis showed stable results after individually removing each SNP.Conclusion·No evidence of a causal relationship between AF and cognitive impairment was found.The associations observed in observational studies can be partially attributed to confounding factors such as shared biology or co-morbidities.