Objective To evaluate the feasibility and effect of transthoracic echocardiography(TTE)on guiding the occlusion of the soft-rim atrial septal defect(ASD).Methods Sixty two patients with the soft-rim ASD were enrolled.The size of ASD was measured and rim of ASD was observed by TTE on various views by using color Doppler system with tissue harmonic function before occlusion,and filmy rim of ASD with flapping which could not sustain occluder was eliminated.The size of occluder was selected by integratively judging the size of ASD and"sustainable diameter of ASD"The waist size of occluder was measured after releasing occluder and compared with the longest diameter of ASD and"sustainable diameter of ASD"measured by TTE.Results The longest diameter of ASD measured by TTE before occlusion was 11-35 mm[average(21.6±5.2)mm],the "sustainable diameter of ASD"was 15-37 mm[average(25.6±5.(J)mm],the size of selected occluder was 18-44mm[average(30.7±5.5)mini and the waist size of released occluder was 13-35 mm[average(24.2±5.6)mm].Fine correlation was existed between the longest diameter of ASD measured by TTE and the waist size of released occluder(r=0.86,P＜0.000I).Morever,improved correlation was found between the"sustainable diameter of ASD"measured by TTE and the waist size of released occluder(r=0.89,P＜0.0001).Occluder was firmly fixed without falling in all patients.Conclusions TTE with tissue harmonic function can be used to measure the size of soft-rim ASD and the"sustainable diameter of ASD".It is a feasible,and effective method on guiding occlusion of soft-rim ASD.

Adolescent ; Adult ; Anemia, Aplastic ; etiology ; therapy ; Benzene ; poisoning ; Bone Marrow Cells ; drug effects ; pathology ; Female ; Humans ; Male ; Occupational Diseases ; etiology ; therapy ; Occupational Exposure ; adverse effects

OBJECTIVETo evaluate the safety and efficiency of local paclitaxel delivery using the double-balloon perfusion catheter to prevent restenosis in the canine coronary artery.

METHODSTwenty domestic canines underwent bare-mental stent implantation after balloon injure of the left coronary artery. A novel double-balloon perfusion catheter was used to deliver the drug locally in the canine coronary artery. In the treatment group (n = 15), paclitaxel (10 ml, 20 micromol/L) was delivered using the double-balloon perfusion catheter before stent implantation. In the control group (n = 5), 10 ml saline was delivered using the double-balloon perfusion catheter before stent implantation. The perfusion time in both groups was (26.45 +/- 5.18) s. Animals underwent coronary angiography and optical coherence tomography (OCT) 90 days after stent implantation and were sacrificed. Vessels were perfusion-fixed and morphometric analysis was performed using conventional techniques.

RESULTSCoronary angiography results showed restenosis rate in control group was significantly higher than that in treatment group (60% vs. 33.33%, P < 0.05). The parameters of OCT showed in treatment group and control group: the neointimal thickness was (0.19 +/- 0.08) mm and (0.38 +/- 0.03) mm, the neointimal area was (1.52 +/- 0.49) mm2 and (2.51 +/- 0.47) mm2, the lumen area was (3.50 +/- 0.66) mm2 and (2.78 +/- 0.57) mm2, the extent of stenosis was (30.13 +/- 8.56)% and (47.40 +/- 4.50)%, and all the variances above were significantly different between the two groups (P < 0.05). The histologic parameters showed in treatment group and control group: the neointimal thickness was (0.22 +/- 0.10) mm and (0.47 +/- 0.05) mm, the neointimal area was (1.85 +/- 0.78) mm2 and (3.43 +/- 0.25) mm2, the lumen area was (3.15 +/- 0.43) mm2 and (1.85 +/- 0.55) mm2, the extent of stenosis was (36.00 +/- 10.97)% and (65.40 +/- 8.23)%, and all the variances above were also significantly different between the two groups (P < 0.05). The stents of both the groups were fully endothelialized. No thrombus or aneurysm was found in stents.

CONCLUSIONLocal delivery of paclitaxel with the double-balloon perfusion catheter to prevent restenosis in coronary stents is safe and efficient.

Angioplasty, Balloon, Coronary ; Animals ; Catheters ; Coronary Restenosis ; prevention & control ; Disease Models, Animal ; Dogs ; Injections ; Paclitaxel ; administration & dosage ; therapeutic use ; Stents

OBJECTIVETo evaluate the accuracy of optical coherence tomography (OCT) in evaluating neointimal proliferation in canine coronary artery following stenting.

METHODSIn 15 domestic dogs, a single bare-metal stent was implanted in the anterior descending or the circumflex branch of the left coronary artery. Ninety days after stenting, the dogs underwent coronary angiography and OCT, followed by quantitative histological assessment of neointimal proliferation in the target arterial segments. The parameters of OCT and the histological findings were analyzed comparatively.

RESULTSA total of 15 OCT-histology matched frames acquired at the point with the most severe stenosis in every stent, and 60 pathological sections from all the stents were analyzed. The difference of the stent area assessed by OCT was comparable to that defined histologically (5.01∓0.79 mm(2) vs 4.99∓0.81 mm(2), P>0.05). Neointimal thickness and area were smaller with OCT assessment than with histological assessment (0.19∓0.08 mm vs 0.22∓0.10 mm, and 1.52∓0.49 mm(2) vs 1.85∓0.78 mm(2), respectively, P<0.05). The lumen area was larger by OCT assessment than by histological assessment (3.50∓0.66 mm(2) vs 3.15 ∓ 0.43 mm(2), P<0.05). Close correlations were found between OCT and histological evaluations of the neointimal thickness (R(2)=0.5280.767), neointimal area (R(2)=0.5280.537) and stent area (R(2)=0.528), but the correlation was poor for lumen area (R(2)=0.5280.307). All the stents showed full endothelialization without thrombus or aneurysm in the stents.

CONCLUSIONOCT allows precise and reproducible assessment of neointimal proliferation in the coronary artery following stenting, but for measurement of the lumen area, OCT shows a poor correlation to histological evaluation.

Angioplasty, Balloon ; adverse effects ; instrumentation ; Animals ; Coronary Angiography ; Coronary Vessels ; diagnostic imaging ; pathology ; Dogs ; Male ; Models, Animal ; Neointima ; pathology ; Stents ; adverse effects ; Tomography, Optical Coherence ; Tunica Intima ; pathology

OBJECTIVETo observe the therapeutic effect of moxibustion and exercise comprehensive scheme intervention for children with short stature of deficience of the kidney essence.

METHODSTwenty four cases of children in 12 to 14 years old were selected, 12 male and 12 female, they were treated with comprehensive therapy of exercise therapy and moxibustion. Running and jumping were selected as main exercise therapy, it became a suitable exercise amount when the heart rate reach to 150 to 170 times per minute, thrice each week, 35 to 45 minutes each time. After exercises they were treated with moxibustion, Qihai (CV 6), Guanyuan (CV 4), Zusanli (ST 36), Dazhu (BL 11), Xuanzhong (GB 39), Geshu (BL 17) etc. were selected. After treatment for half a year, the changes of the body height, body weight, bone age(BA), growth hormone (GH), testosterone (T) and estradiol (E2) were compared before and after treatment.

RESULTSThe body height and bone age of the boys and girls were significantly higher than those before treatment (all P<0.05), the growth of body height was more than 4 cm, the growth of bone age was more than 0.5 years old in half a year; the testosterone of all children was significantly increased (all P<0.05), and there were no significant differences in body weight, GH and E2 compared to those before treatment (all P>0.05).

CONCLUSIONMoxbustion and exercise comprehensive scheme can effectively improve the children with short stature of deficience of the kidney essence, the mechanism is related to the improving of the testosterone level.

Adolescent ; Body Height ; Child ; Estradiol ; metabolism ; Exercise Therapy ; Female ; Growth Disorders ; metabolism ; physiopathology ; therapy ; Human Growth Hormone ; metabolism ; Humans ; Kidney ; physiopathology ; Male ; Moxibustion ; Testosterone ; metabolism ; Treatment Outcome

A rapid, sensitive and simple liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed for the simultaneous determination of yogliptin and its metabolite in Wistar rat plasma. Linagliptin and dexamethasone were chosen as the internal standards of yogliptin and its metabolite, (R)-8-(3-hydroxypiperidine- -yl)-7-(but-2-yn-1-yl)-1-((5-fluorobenzo[d]thiazol-2-yl)methyl)-3-methyl- H-purine-2, 6 (3H, 7H)-dione, respectively. After a simple protein precipitation using acetonitrile as the precipitating solvent, both analytes and ISs were separated on a Grace Altima HP C18 column (2.1 mm x 50 mm, 5 microm) with gradient elution using methanol (containing 0.1% formic acid, 4 mmol x L(-1) ammonium acetate)-0.1% formic acid (containing 4 mmol x L(-1) ammonium acetate) as the mobile phase. A chromatographic total run time of 4.4 min was achieved. Mass spectrometric detection was conducted with electrospray ionization under positive-ion and multiple-reaction monitoring modes. Linear calibration curves for yogliptin and its metabolite were over the concentration range of 0.5 to 500 ng x mL(-1) with a lower limit of quantification of 0.5 ng x mL(-1). The intra- and inter- assay precisions were all below 14%, the accuracies were all in standard ranges. The method was used to determine the concentration of yogliptin and M1 in Wistar rat plasma after a single oral administration of yogliptin (27 mg x kg(-1)). The method was proved to be selective, sensitive and suitable for pharmacokinetic study of yogliptin and M1 in Wistar rat plasma.
Animals ; Chromatography, Liquid ; Dexamethasone ; blood ; Dipeptidyl-Peptidase IV Inhibitors ; blood ; pharmacokinetics ; Linagliptin ; blood ; Rats ; Rats, Wistar ; Tandem Mass Spectrometry

Moving the mandibular posterior teeth into a severely atrophic edentulous space is a challenge. A carefully designed force-and-moment system that results in bodily protraction of the posterior teeth with balanced bone resorption and apposition is needed in such cases. This report describes the treatment of a 19-year-old woman with missing mandibular first molars due to juvenile periodontitis. Miniscrews were used as absolute anchorage during protraction of the mandibular second and third molars. Bodily mesial movement of the mandibular second and third molars was achieved over a distance of 11 to 17 mm after 39 months of orthodontic treatment.

AIM:To investigate the effect of paeoniflorin(PF)on TLR4/MyD88 signaling pathway in liver of rats with metabolic dysfunction-associated fatty liver disease.METHODS:SPF grade male SD rats were randomly divid-ed into four groups:normal control(NC)group,model control(MC)group,low-dose paeoniflorin(PL)group,and high-dose paeoniflorin(PH)group.The normal group was given standard diet,and the other three groups were given high-fat diet for 8 weeks.From the fifth week,rats in paeoniflorin groups were given low dose(25 mg·kg-1·d-1)or high dose(50 mg·kg-1·d-1)paeoniflorin for 4 weeks.Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC)and triglyceride(TG)were measured by biochemical method.The levels of tumor necrosis factor(TNF)-α was detected by ELISA.Pathological change of the liver was detected with hematoxylin-eosin(HE)staining and oil red O staining,and evaluated semi-quantitatively with the nonalcoholic fatty liver disease activity score(NAS).The expres-sion levels of TLR4,MyD88 and phosphorylated nuclear factor(p-NF)-κB p65 in liver tissues were detected by immuno-histochemistry and Western blot.RESULTS:Compared with the NC group,rats in the MC group showed increased TC,TG,ALT,AST and TNF-α in serum(P<0.05),and more lipid droplets in hepatocytes and inflammatory cell infiltration in the portal area,with higher NAS,TLR4,MyD88 and p-NF-κB p65 proteins in liver tissue(P<0.05).However,pae-oniflorin could reduce TC,TG,ALT,AST and TNF-α in serum(P<0.05),improve histopathological changes of liver,decrease the NAS scoring(P<0.05),and inhibit hepatic TLR4/MyD88/p-NF-κB p65 expressions(P<0.05).CONCLU-SION:Paeoniflorin could improve the lipid metabolism disorder and reduce liver inflammation during MAFLD,and the latter effect might be in part related to the inhibition of TLR4/MyD88 signaling pathway.

OBJECTIVETo investigate damages to the quality of boar sperm frozen in 5 ml straws, pellet and 0.25 ml straws as well as the ultrastructural changes of frozen boar sperm in 5 ml straws.

METHODSWe compared 3 different freezing packages of 5 ml straws, pellet and 0.25 ml straws to determine their effects on frozen boar semen, and observed the morphological and ultrastructural changes of the boar sperm in the 5 ml straws using scanning electron microscopy.

RESULTSIn the 5 ml straws, the vitality and motility of the boar sperm after freezing were not significantly different from those in the other two formulations, the normal apical ridge (NAR) was 52.65%, higher than in the pellet but not significantly different from that in the 0.25 ml straws, and the sperm membranes were mostly bubbly, some locally broken, which indicated the damage induced by freezing and thawing.

CONCLUSIONAt the present time, boar semen frozen in 5 ml straws were not significantly different from those frozen in 0.25 ml straws. The existing freezing-thawing method may cause certain damage to the quality and ultrastructure of boar sperm, and therefore needs to be further improved.

Acrosome ; ultrastructure ; Animals ; Cell Membrane ; ultrastructure ; Cryopreservation ; methods ; Male ; Microscopy, Electron, Scanning ; Semen Preservation ; methods ; Spermatozoa ; ultrastructure ; Swine

Objective To explore the effects of preoperative anxiety on intraoperative body temperature,adverse reactions during recovery and incision healing in elderly patients undergoing radical mastectomy under general anesthesia.Methods A total of 139 elderly patients who underwent radical mastectomy under general anesthesia in the Fourth Affiliated Hospital of Nanjing Medical University from January 2020 to December 2022 were selected as the study objects,and they were divided into the non-anxiety group(87 cases)and the anxiety group(52 cases)according to whether they were complicated with anxiety before surgery.The nasopharyngeal temperature before surgery,after 30 minutes,60 minutes,90 minutes of surgery and at the end of surgery,the ratio of intraoperative nasopharyngeal temperature<36.0℃,the ratio of perioperative blood loss>300 mL,the occurrence of adverse reactions during the recovery period and the incision healing of patients in the two groups were compared.Results There was no statistically significant difference in the nasopharyngeal temperature before surgery and after 30 minutes of surgery of patients between the two groups(P>0.05).After 60 minutes,90 minutes of surgery and the end of surgery,the nasopharyngeal temperatures of patients in the anxiety group were lower than those in the non-anxietey group,and the differences were statistically significant(P<0.05).There were statistically significant differences in the nasopharyngeal temperature at different times of patients in the two groups(P<0.05).The ratios of patients with intraoperative nasopharyngeal temperature<36.0℃and perioperative blood loss>300 mL in the anxiety group were higher than those in the non-anxiety group,and the differences were statistically significant(P<0.05).The incidence of delayed awakening,shivering reaction,and poor postoperative incision healing in the anxiety group were higher than those in the non-anxiety group,with statistically significant differences(P<0.05).Conclusion Elderly patients undergoing radical mastectomy under general anesthesia combined with anxiety show obvious temperature drop after 60 minutes of surgery,and perioperative blood loss has significantly increased,with a higher incidence of intraoperative hypothermia,adverse reactions during recovery and poor postoperative incision healing,which should arouse clinical attention.